Objective To study the effect of homecare on the health of diabetic patients in China. Methods A retrieval was done all on CNKI, Wanfang database, VIP database, China Biological Medicine. After excluding the literature out of the criteria, the meta-analysis was performed to compare the intervention group and control one in terms of the fasting plasma glucose , 2-hour postprandial blood glucose , quality of life , treatment compliance , standardized mean difference ( SMD ) and risk ratio ( RR ) . Results 12 RCTs, which involved 1,193 participants including 596 patients in the intervention group and 597 patients in the control group, were included in the final analysis. The fasting plasma glucose, 2-hour postprandial blood glucose, the quality of life, treatment compliance of the intervention group were significantly better than those of the control group , with effect size and 95% CI: SMD =-1.77, 95%CI (-2.28,-1.26);SMD=-1.62, 95%CI (-2.28,-0.95);SMD=1.31, 95%CI (0.50, 2.13);RR=1.27, 95%CI (1.13, 1.43) (P<0.01). Conclusion Homecare can improve the plasma glucose and quality of life of patients with diabetes and can help them to develop a healthy lifestyle.

Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; Death, Sudden ; Humans ; Male ; Middle Aged

Objective To study the inconsistent relation of twin discordancy and the umbilical artery blood flow parameter of systolic/diastolic ratio.Methods 358 pregnant women were divided into the two groups of develop-mental nonidentity( n=67 ) and developmental identity ( n=291 ) according to the criterion that the differences of twins weight exceeded 25 percent.The umbilical artery blood flow parameter of systolic/diastolic ratio were observed. Meanwhile,the difference of weight and the umbilical artery blood flow parameter of systolic/diastolic ratio in the group of developmental nonidentity were observed.Results A significant difference of the umbilical artery blood flow parameter of systolic/diastolic ratio were found in the two groups of developmental nonidentity and developmental identity(7.81%vs 32.56%,P<0.05).There were 56 cases that twins weight exceeded from 25 to 35 percent,7 cases that twins weight exceeded from 35 to 45 percent and 4 cases that twins weight exceeded 45 percent in the group of developmental nonidentity which the umbilical artery blood flow parameter of systolic/diastolic ratio were (23.66 ± 5.78)%,(27.16 ±7.25)% and (33.16 ±4.23)% correspondingly with significant difference(F=23.21,P<0.05 ) .Conclusion The umbilical artery blood flow parameter of systolic/diastolic ratio has significance in diagnosis of twin discordancy.

Objective To study the expression of Bcl-2 and E2F-1 in human adenomyosis and to explore the correlation between the expression and pathogenesis of human adenomyosis. Methods Immunohistochemical S-P method was employed to detect the expression of Bcl-2 and E2F-1 in 58 specimens of ectopic endometrium, eutopic endometrium of adenomyosis and 30 specimens of normal endometrium. Results The expression of Bcl-2 and E2F-1 in ectopic and eutopic endometrium of adenomyosis were significantly higher than those of normal endometrium (P

Objective To compare the efficacy of vidarabine monophosphate and ribavirin for treating hand-foot-mouth disease (HFMD) in children.Methods 120 children with HFMD and admitted to a hospital from April 2013 to April 2015 were randomly divided into observation group and control group,60 cases in each group,observation group treated with vidarabine monophosphate,control group treated with ribavirin,the therapeutic efficacy between two groups were compared.Results After treatment,the negative conversion rate of intestinal virus EV and EV71,as well as Coxsackie virus A16(CA16) in observation group were 87.0％,85.7％,and 93.1％ respectively,in control group were 64.0％,69.8％,and 78.6％ respectively,difference between two groups was statistically significant (all P＜0.05).The average length of hospital stay in observation group was shorter than control group ([4.5 ± 1.3] days vs [6.2 ± 1.2] days,P＜0).05),symptom(fever,stomatitis,skin rash) control time in observation group were all shorter than control group(all P＜0.05).Whether patients with or without complication,therapeutic effect of the observation group was better than that of control group;myocardial enzyme data,C reactive protein (CRP),and white blood cell(WBC) in observation group were all lower than control group(all P＜0.05).Conclusion Efficacy of vidarabine monophosphate for treating children with HFMD is better than ribavirin,but it needs further study.

Background:Clinical features and outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios (HRs) of endpoints of short-term all-cause mortality (SAM),long-term all-cause mortality (LAM),long-term cardiovascular death (LCD) and long-term HF rehospitalization (LHR) among patients with HFmrEF and HF with preserved ejection fraction (HFpEF),HF with reduced ejection fraction (HFrEF) were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6 ± 2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF (reference) HR:1.07,95％ confidence interval (CI):1.00-1.15 (I2=63％,P =0.0005);HFmrEF:HFrEF (reference) HR:0.80,95％ CI:0.73-0.88 (I2=70％,P ＜ 0.0001).However,HFmrEF patients had the lowest rate in LAM (30.94％),SAM (2.73％),LCD (17.45％),LHR (26.36％) compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special "separation phenomenon" showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.

Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.

Objective To compare and analyze the clinical efficacy of locking plates versus artificial joint replacement for proximal humeral complicated fractures.Methods The retrospective data of 200 cases with locking plate or artificial joint replacement for the treatment of comminuted proximal humeral fractures were collected from February 2013 to July in our hospital.Patients were divided into locking plate group (n =114) and artificial joint replacement group (n =86) according to the treatment.The pain,functional recovery,activity,anatomical position,complications and Neer score after treatment were compared between the two groups.Results In artificial joint replacement group,Neer score was excellent in 34 cases,good in 23 cases,fair in 25 cases,poor in 4 cases,and the excellent and good rate was 66.3％ (57/86).In locking plate group,Neer score was excellent in 53 cases,good in 47 cases,fair in 10 cases,poor in 4 cases,and the excellent and good rate was 87.7％ (100/114).The excellent and good rate was higher in locking plate group than in artificial joint replacement group (x2 =13.35,P＜0.001).The scores of pain,functional recovery,activity and anatomical position were (26.9 ± 8.5),(22.4 ± 7.1),(19.8 ± 5.5) and (8.0 ± 1.8) respectively in locking plate group,and (24.8±10.2),(20.2±6.7),(18.1±6.6) and (7.9±2.1) respectively in artificial joint replacement group.There were significant differences in scores of functional recovery and activity between groups (t＝ 2.22 and 1.99,P =0.014 and 0.024),while no significant differences were found in scores of pain and anatomical position (t=1.59 and 0.36,P＝0.057 and 0.359).There were 2 cases with ankylosis,1 case with malunion and 1 case with humeral head necrosis in locking plate group,and 1 case with ankylosis,1 case with wound infection,1 case with refracture and 1 case with humeral head necrosis in artificial joint replacement group after treatment.There were no significant differences in complications between groups (x2 =0.17,P=0.683).Conclusions The locking plate and artificial joint replacement are effective in the treatment of comminuted proximal humeral fractures.Compared with artificial joint replacement,the locking plate can improve the functional recovery,activity and Neer score evaluation with a low technical requirement,which is an ideal method for comminuted proximal humeral fractures.

This study aimed to promote medical and health informationization construction, strengthen the top-level design, construct a standard of medical and health information, and develop an information sharing and safety management system. For the reform of integrated hospital and clinical information systems, the Tumor Research Institute of the Second Affiliated Hospital of the Third Military Medical University aimed to solve the existing problem using pain assessment management (PAM). The PAM information platform is affiliated with the Military's No. 1 Basic Information System, which can manage PAM information. Moreover, PAM can optimize the pain assessment process and costs, and improve the work efficiency of nurses, Thus, PAM can achieve basic goals, such as data sharing, individualized records, and smart reminders, and encourages the use of pain management information systems outside the hospitals.

Objective To explore the effect of cognitive therapy for gastrointestinal carcinoma postoperative pstients to relieve nausea and vomiting.Methods 80 patients with gastrointestinal carcinoma were randomly divided into intervention group(n=40)and control group(n=40).The degree of nausea and vomiting and symptom were compared between the two groups.Results The incidence of nausea and vomiting in the intervention group was lower than that in the control group.So did the degree of nausea and vomiting.The difference was significant(P＜0.05).In SCL-90,the scores of the somatization,obsessive-compulsiwe,depression and anxiety phobicanxiety,parsnoid,psychofism were significantly different with that of the Chinese normal(P＜0.05).The scores in the intervention group were lower than that of the control group after cognitive therapy(P＜0.05).Conclusion Cognitive therapy can help to alleviate psychological health score,nausea and vomiting from gastrointestinal carcinoma postoperative,so as to improve the quality of life for patients with gastrointestinal carcinoma.