Objective To investigate the relevant risk factors for cardiovascular autonomic neuropathy (CAN) in diabetic patients. Methods 712 cases of diabetic patients were divided into two groups according to their cardiovascular autonomic function test: one group with CAN (n=160) , and the other without CAN (n=552). Duration of diabetes, profession, body mass index (BMI), blood glucose, lipid profile, glycosylated hemoglobin (HbA1C) and urinary albumin excretion rate (UAER) were measured. Results Duration of diabetes, the levels of fasting plasm glucose (FBG), triglyceride (TG), VLDL-C, APOB, UAER were significantly higher in CAN group than in non-CAN group (P

In this paper,the structure,principle and application of combined chemical oxygenerator is described.Its character is that through the adjustable valve controlled by inspiration and expiration,it offers and halts oxygen supply.The utilization rate of oxygen is over 98%.The physico-chemical indices of the oxygen produced reach the national standard for medical oxygen.The experimental results in alti- tude field have shown that it can alleviate the syndroms of acute mountain sickness and reduce heart rate.

Objective To explore the feasibility and application skills of transabdominal preperitoneal prosthesis (TAPP) with cross-encircling arms of mesh.Methods From Septemer 2009 to February 2012,46 cases were given TAPP with cross-encircling arms of mesh.The clinical data and surgery videos were retrospectively analyzed.Results All of the 46 cases with 53 inguinal hernias were successful in TAPP.The mean operative time of unilateral hernia was (57.74 ± 11.89) min,the mean operative time of 7 cases with biliateral hernia was (83.86 ±20.42) min and the longest time was 125 min.There were 6 cases with the contralateral hidden hernia,2 cases with hematoma,1 case with paresthesias of skin,no realpse.Conclusion The mesh with cross-encircling arms can be exactly fixed by spermatic cord,ductus deferens or round ligament of uterus,without stitching and stappling.

Objective:To establish the method for detecting lower respiratory infections (LRIs) bacterialpathogens using nanopore sequencing, and evaluate the feasibility of this method.Methods:Bronchoalveolar lavage fluid (BALF) samples from 33 patients with LRIs who visited the Department of Respiratory and Critical Care Medicine of Beijing Hospital from July 2019 to September 2020 were collected.Nanopore 16S amplicon sequencing were performed on these samples. In order to evaluate the clinical value of the nanopore sequencing, χ 2 test was used to analyze the pathogen differences between the detection rate and pathogen types results found with using the nanopore 16S sequencing and the results found with bacterial culture. Results:The process and method of nanopore sequencing used in the detection of the LRIs pathogens were established. The pathogen detection rate of the 16S sequencing was higher than that of the traditional bacterial culture (75.8% [25/33], 45.5% [15/33], χ2=5.140, P<0.05). From the 25 positive samples found with nanopore 16S sequencing, 16 pathogens were detected, including Haemophilus parainfluenzae, Haemophilus influenzae, Streptococcus pneumoniae, Streptomonas maltophilia, Acinetobacter baumannii, and Acinetobacter junii, Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus faecalis, Enterococcus gallinarum, Corynebacterium striatum, Mycobacterium paraintracellulare, Serratia marcescens, Achromobacter insuavis, Citrobacter murliniae and Mycoplasma pneumoniae. More than 6 pathogens were tested in clinical culture, including Haemophilus parainfluenzae, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Streptomonas maltophilia (χ2=7.949, P<0.05). 16S sequencing aligned to species level sequences accounted for 80.0 (60.0, 86.0)% of the genus level. The results obtained by using16S sequencing and bacterial culture were consistent in 11 (33.3%) samples. Conclusions:Nanopore 16S amplicon sequencing can quickly identify pathogenic bacteria from BALF in LRIs patients. Nanopore 16S amplicon sequencing has a high detection rate, it can detect more pathogens than traditional bacterial culture, and it can also identify most bacteria to the species level. This technology is a very promising platform with broad application prospects.

Objective: To investigate the relationship between violence exposure and depression in adolescents, and to explore possible moderating effects of emotional balance, so as to provide the evidence reference for understanding the status and characteristics of adolescents violence exposure. Methods: A total of 2 506 middle school students from three middle schools in Ganzhou selected by convenient cluster random sampling. Violence Exposure Scale(VES), Center for Epidemiological Studies Depression Scale(CES-D) and Emotional Balance Scale were used for questionnaire survey. Results: There were statistically significant differences in the scores of violence exposure among middle school students of different genders, grades, whether the only child or not, father educational level,mother s educational level and family types ( t/F =3.85, 21.14, 2.90, 7.62, 8.13 ,8.12, P < 0.01 ). There were statistically significant differences in the scores of depression among middle school students of different genders, grades and family types ( t/F =-7.05, 18.61,7.42, P <0.01 ). There were statistically significant differences in the scores of emotional balance among middle school students of different genders, grades, father s educational level and mother s educational level ( t/F =7.93, 9.22, 7.71 ,6.86, P <0.01 ) . Emotional balance was positively related to the depressive mood of middle school students ( r =0.34, P < 0.01 )，and emotional balance was negatively related to depression( r =-0.20, P <0.01). Emotional balance had the moderating effect on violence exposure and depression among middle school students ( t =-3.35, β =-0.02, P <0.01). Conclusion Violence exposure is related to depression of middle school students. Improving the emotional balance ability of adolescents can effectively reduce the negative effects of violent exposure on early adolescent depression, and reduce the incidence of adolescent depression.

Objective To explore the effect of food improvement on the retention time of nasogastric tube in stroke patients with dysphagia. Methods Sixty cases were assigned to the control group(30 cases) and the experimental group(30 cases) by random digits table method, the control group received routine nasogastric feeding, and the experimental group were given texture modified foods and thickened liquid to try to help them eating through the mouth. The feeding tube was pull out when the person in experimental group was capable of taking texture modified foods and thickened liquid without difficulty,while the tube was pull out when the person in control group was able to eat regular food and drink regular fluids. The retention time of nasogastric tube of two groups was compared. Results The retention time of nasogastric tube was(6.13±2.96)d in the experimental group and(18.93±7.58)d in the control group, there was significant difference (t =-8.162, P<0.01). Conclusions Food improvement can effectively shortenthe retention time of nasogastric tube in stroke patients with dysphagia.

Baphicacanthus cusia ,widely distributed in the Southwest ,Southern and Eastern regions of China ,is an im-portant medicinal plant of Acanthaceae family .Indigo made from stem and leaf of Baphicacanthus cusia in Fujian has the best quality in China ,and is known as “Jian Indigo naturalis” ,which is the genuine medicinal of Fujian Province .The rhizoma of Baphicacanthus cusia could be used as medicine ,called“Nanbanlangen” ,which together with indigo were included in the“Chi-nese Pharmacopoeia” .Indigo and its original plant both contain indirubin ,which has anti-cancer activity .Indirubin is an active ingredient of Huangdai Pian and Danggui Longhui Wan ,two kinds of traditional Chinese medicine ,which have been successful-ly used in the treatment of malignancies such as chronic myelogenous leukemia .The international advances in the biological characteristics ,genetic diversity ,cultivation technology and molecular biology of Baphicacanthus cusia germplasm resources were summarized .The main problems in Baphicacanthus cusia germplasm resources research are indicated ,which could pro-vide references for the further study and application of Baphicacanthus cusia germplasm resources .

Three healthcare revolutions and four medical paradigm shifts have had a profound impact on the development of healthcare system, which has greatly improved human health, however, the COVID-19 pandemic has exposed hidden dangers and problems in the construction of the healthcare system. In this paper, we made a brief introduction of population medicine and value-based healthcare for the purpose of suggesting new ideas and directions for the future development of healthcare system.

Objective:To investigate the changes in clinical signs and laboratory testing results and their risk-tiring diagnostic effectiveness in elderly patients with pulmonary embolization (PE) with different risk levels.Methods:A retrospective analysis was conducted on the clinical data of elderly hospitalized PE patients in Beijing Hospital and other coordinated hospital from 2012 to 2020.Differences in 43 clinical signs and detection indicators between patients with four different risk levels were compared.The univariate and multivariate regression models were used to analyze differences between high-risk and non-high-risk PE and between intermediate-risk and low-risk PE with ROC analysis.Results:In the multi-group comparison, there are 33 clinical tests having significant differences between four risk groups, 29 clinical tests having significant differences between three risk groups(high, intermediate and low groups), and 21 clinical tests having significant differences between two groups(high and non-high groups). In the ROC analysis of risk stratification in high-risk and non-high-risk groups, it was found that the range of area under the curves(AUC)of 14 significantly changed clinical tests were 0.611 to 0.802 in the univariate regression analysis.The AUC of the model of systolic blood pressure(SBP)combined with white blood cell count(WBC)and aspartate aminotransferase(AST)was 0.8593(95% CI: 0.795-0.924)in the multivariate regression analysis.While in the ROC analysis between intermediate-risk and low-risk, the range of AUC of 12 significantly changed clinical tests were 0.592 to 0.835 in the univariate regression analysis.The B-type natriuretic peptide(BNP)and N-terminal B-type natriuretic peptide(NT-proBNP)can assist the risk stratification in intermediate-risk and low-risk PE groups.No efficient combined diagnosis model was found. Conclusions:The basic vital signs and multiple clinical laboratory tests were significantly different among four risk levels of elderly PE patients, such as blood gas analysis, coagulative function, liver and kidney function and myocardial markers.The combination of SBP, WBC, and AST can effectively assist the risk stratification in high-risk and non-high-risk PE groups.

Objective:To investigate the efficacy and side effects of concurrent chemoradiotherapy with or without nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma after neoadjuvant chemotherapy.Methods:In the prospective study, 100 patients with stage Ⅲ-Ⅳa locally advanced nasopharyngeal carcinoma (except T 3N 0M 0 stage) who met the inclusion criteria were randomly divided into the experimental and control groups using the random number table method. Patients in both groups were treated with neoadjuvant chemotherapy using TPF (paclitaxel liposome, cisplatin, and 5-fluorouracil) regimen for 2 cycles. At 2 weeks after chemotherapy, concurrent chemoradiotherapy plus nimotuzumab targeted therapy was given in the experimental group, and concurrent chemoradiotherapy was delivered in the control group. The main observation index was the distant metastasis-free survival (DMFS) rate. Log-rank test and multivariate Cox regression analysis were used. Results:The objective remission rate and complete remission rate in the experimental and control groups were 100% vs. 98% ( P=1.000) and 92.0% vs. 80% ( P=0.084). The 3-year DMFS in the experimental and control groups were 91.4 % vs. 76.1 % ( P=0.043). The 3-year progression-free survival (PFS), locoregional recurrence-free survival (LRFS) and overall survival (OS) in two groups were 87.3 % vs. 74.1 % ( P=0.097), 94.5 % vs. 85.6 % ( P=0.227) and 90.5% vs. 85.2% ( P=0.444). Subgroup analysis showed that patients with age<60 years ( HR=0.34, 95% CI=0.12-0.94, P=0.037), neutrophil-to-lymphocyte ratio (NLR)≤4 ( HR=0.34, 95% CI=0.13-0.89, P=0.028) received concurrent chemoradiotherapy plus nimotuzumab obtained better PFS. Multivariate analysis showed that NLR was an independent risk factor for disease progression ( HR=5.94, 95% CI=1.18-29.81, P=0.030) and distant metastasis ( HR=13.76, 95% CI=1.52-124.36, P=0.020). Conclusions:Compared with concurrent chemoradiotherapy alone, concurrent chemoradiotherapy combined with nimotuzumab after neoadjuvant chemotherapy can significantly increase DMFS rate for patients with locally advanced nasopharyngeal carcinoma. The incidence of side effects is similar in two groups. Concurrent chemoradiotherapy plus nimotuzumab after neoadjuvant chemotherapy may be a preferred treatment strategy for locally advanced nasopharyngeal carcinoma.