Malnutrition in patients with acute stroke is quite common. It is an independent risk factor affecting stroke prognosis. Early enteral nutrition can improve the nutritional status of the stroke patients, lower infection rate and mortality, promote recovery of neurological function, and improve the quality of life. Therefore, under the premise of the gastrointestinal tolerance, the patients with severe stroke should select early enteral nutrition as early as possible.

Objective To investigate the medical cost of 70 patients with panic attack and efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment Methods The course, medical cost, types and times of main examination of all 70 patients were reviewed and analyzed The effect of SSRIs on the patients was studied with Anxiety and Depression Scale Results The 70 patients had long course, high medical cost and received many unnecessary medical examinations SSRIs were effective on patients with panic attack in light of Anxiety and Depression Scale Conclusion Patients with panic attack have long course and spend much unnecessary cost before final diagnosis SSRIs is useful and safe in the treatment of panic attack

Objective To explore the curative effect and safety of CTLA-4Ig transgene for experimental autoimmune encephalomyelitis (EAE). Methods The adenovirus loaded CTLA-4Ig was injected into Wistar rat EAE models through the lateral cerebral ventricle. The clinical symptomatic and electrophysiological changes were observed to judge the efficiency of CTLA-4Ig. Results After injection of AdCTLA-4Ig into the lateral cerebral ventricle of Wistar rat EAE models, the time of EAE onset was delayed and the incidence rate was significantly reduced. And the transductive function tested by brain-stem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) was obviously improved. Conclusion CTLA-4Ig is effective in managing EAE.

Objective To investigate the influence of misoprostol and carboprost methylate for preoperative vaginal placement on the clinical index, the cervical dilatation degree and adverse reactions of patients with submucous myoma of uterus by hysteroscopic surgery.Methods150 patients with submucous myoma of uterus by hysteroscopic surgery were chosen in the period from August 2013 to August 2016 in Yiwu Maternal and Child Health Care Family Planning Service Center and divided into two groups including group A (75 patients) with misoprostol and group B (75 patients) with carboprost methylate for preoperative vaginal placement;and the operation time, the intraoperative blood loss, the recovery time of gastrointestinal function, the effects of cervical dilatation, the width of cervical dilatation and the adverse reactions incidence of both groups were compared.ResultsThe operation time and the intraoperative blood loss of B group were significantly better than A group(P<0.05).There was no significant difference in the recovery time of gastrointestinal function between the two groups.The effects of cervical dilatation in group B were significantly better than that in group A(P<0.05).The width of cervical dilatation in group B were significantly larger than that in group A(P<0.05).There was no significant difference in the adverse effects incidence between the two groups.ConclusionCompared with misoprostol, carboprost methylate for preoperative vaginal placement in the treatment of patients with submucous myoma of uterus by hysteroscopic surgery can efficiently shorten the operation time, reduce the operation bleeding, improve the effect of cervical dilatation and not increase the adverse reactions risk.

Objective To study the effect of small dose mifepristone in the treatment of uterine fibroids.Methodsfrom January 2013~2015 year in January 100 cases of uterine fibroids were treated in Yiwu Maternal and Child Health Care Family Planning Center as the research object in the course of the study, patients began taking mifepristone in menstruation third days to 5 days, taking a total of 6.5 months, after the observation of its long-term use of low-dose mifepristone after treatment, changes in sex hormone the level of the effect of low-dose mifepristone in the treatment of patients with uterine fibroids and patients in the body, including the effects on the endometrium.The clinical symptoms and signs, the changes of hormone levels and the results of B-ultrasound were followed up.ResultsAll of the 100 patients were treated with low dose mifepristone for a period of time, all of them had amenorrhea.Before treatment, the level of estradiol in patients was (298.5±156) pmol/L, and the level of progesterone (2.8±1.3) was pmol/L.After 6.5 months of treatment, the level of estradiolof the patients was(228.4±114)pmol/L, and the level of progesterone(1.3±0.5)pmol/L was pmol/L.The results showed that the levels of progesterone and estradiol in patients after treatment were significantly lower than those before treatment, with statistical difference (P<0.05).There was no significant change in endometrial thickness after long-term low-dose mifepristone treatment (P>0.05).After treatment, the total effective number of cases was 92 cases, the effective rate was 92%.ConclusionSmall dose of mifepristone for uterine fibroids clinical treatment effect is good, to a large extent, improve the effective rate of treatment and high safety, with the clinical significance of further promotion and application.

Objective To investigate the cerebral infarction patterns and pathogenesis in patients with internal carotid artery (ICA) and middle cerebral artery (MCA) severe stenosis (the degree of stenosis 70％- 99％ ) or occlusion in order to provide evidence for the individualized prevention and treatment strategies. Methods Seventy-six patients with acute cerebral infarction who showed the responsible lesions at the corresponding MCA territory on diffusion-weighted imaging (DWI) were analyzed retrospectively. The patients were divided into ICA lesion, MCA lesion and negative result on digital subtraction angiography and CT angiogaphy (NR) groups according to the vascular examinations. Their infarcts were divided into single and multiple infarctions. According to the positions, the former was divided into perforating artery infarct (PAI), pial infarct (PI), and border-zone infarct (BZ). Results The infarct morphologies in the MCA territory were divided into 9 types. The different lesions caused infarct morphologies were different (x2 =34. 000, P =0. 001). The distribution pattern of multiinfarcts accounted for 73.68％ of all patients (56/76). The distribution pattern of PAI + PI in the ICA lesion group was significantly more than that in the NR goup (17/42 vs. 1/16,x2 =6. 837, P =0. 009). There were some correlations between the degree of artery stenosis and the infarct morphology. The severe ICA lesions mostly showed PAI with PI (7/17 vs. 1/16,x2 =5. 475, P =0. 019), and the severe MCA lesions mostly showed PAI with BZ (3/8 vs. 1/17,x2 =4. 046, P =0. 040). Conclusions In patients with cerebral infarction of ICA or MCA severe stenosis or occlusion, most of them showed multiinfarct pattern. This suggested that the different mechanisms of stroke onset might be associated with the arterial-arterial embolization or hypoperfusion.

Taking the Wechat public service platform of Administration of Traditional Chinese Medicine of Yunnan- Yunnan Zhongyi as an example,the paper uses the Importance-performance Analysis (IPA) and corresponding analysis method,from the users' satisfaction perspective,evaluates 28 satisfaction indicators,discusses the relationship between the importance recognition of health Wechat of Traditional Chinese Medicine (TCM) and user characteristic,so as to propose the development of individual TCM health information recommendation and strengthen the effective interaction of platform users.

Objective To explore the relationship between poor sleep quality and stoke.Methods A total of 738 stroke patients in Xuzhou city in 2013 were selected as the case group and age-and sex-matched healthy non-stroke subjects (n =738)as control group.The writer-designed general situation questionnaire and the Pittsburgh Sleep Quality Index(PSQI)analyses were conducted for a face-to-face investigation.Results No significant difference in mean age(66.1±10.9 and 65.8 ± 10.6,t =0.60,P =0.58)and in sex (50％ vs.50 ％) was found between two groups.There were statistically significant differences between case and control groups in baseline values of BMI(t=2.40,P =0.02),histories of hypertension(x2 =174.30,P =0.00),diabetes mellitus (x2 =27.20,P =0.00),coronary heart disease(x2 =115.60,P =0.00),smoking(x2 =6.10,P =0.01),drinking (x2 =7.30,P =0.01)and living stress(x2 =11.40,P =0.01).The PSQI sub-scores and PSQI total scores were higher in case group than in control group.The rate of poor sleep quality was higher in case group(279 cases,37.8 ％) than in control group(136 cases,18.4 ％) (x2 =6.10,P =0.01).Multivariate logistic analysis showed that,after adjusting for confounding factors of BMI,histories of hypertension,diabetes,coronary heart disease.smoking,drinking and living stress,the poor sleep quality in total male plus female was independent predictor variables for stroke[odds ratio(95 ％ CI) of 2.3 (1.8-3.0)],no matter their sex,with odds ratio (95 ％ CI) in male (2.5,1.7-3.7) or in female (2.2,1.5-3.2),respectively,but there was no significance difference in the odds ratio between male and female in case group(x2 =0.04,P=0.85).The risk stroke was 2.3 folds higher in poor sleep quality versus control in male plus female,with pure male or female of 2.5 or 2.2 folds.There was no significance difference between male and female in case group versus.the control(x2 =0.04,P=0.85).Conclusions Poor sleep quality is associated with the occurrence of stroke and may be a risk factor for stroke.

In the field of military medicine,advanced military technologies are widely used.Meanwhile they demand changes and pose challenges to military medicine.In this paper,we discuss the characteristics of those technologies and their influences.Some thoughts are proposed to strengthen the military medical research.

Objective To explore the roles of p53 in ionizing radiation induced MCF-7 cell cycle uncoupling. Methods The p53 knock-down models was established in MCF-7 with retrovirus packaged particles from 293T cells through calcium acid phosphate co-precipitation, then Western blot was used to detect the protein expression. Flow cytometry(FCM) was used to analyze the cell cycle uncoupling and polyploid after irradiation. Results Compared with p53+/+ group, the percentages of G0/G1 cells in p53 -/- group decreased, while those of S and G2+M increased (P < 0.01). In polyploidy analysis 2N cells decreased, whereas both 4N and 8N cells =increased (P<0.01). Compared with sham-irradiation, 4 Gy X-ray led to the decrease of G0/G1, S cells, and the increase of G2+M cells. The increase of 2N cells and decrease of 4N and 8N cells were observed in both p53+/+ and p53-/- cells. Compared with p53+/+ +IR group, the decrease of G0/G1 and S cells and the increase of C2 + M cells were significant (P < 0.01) in p53-/-+ IR groups. 2N cells decreased, 4N cells increased, but no changes in 8 N cells occurred. Conclusion Radiation might induce G2 arrest and cycle uncoupling, p53 plays a role in the regulation of G2 arrest, but no role in cycle uncoupling.