Objective To investigate effects of hypertensive agents on regional cerebral blood flow (rCBF)and prognosis in patients with hypertensive intracerebral hemorrhage (HICH). Method Thirty patients withFILCH were divided into group A,B and C according to mean arterial pressure(MAP) with various ranges of <10%, 10 ～ 20%, and > 20%, respectively. Patients of three groups were checked with single photon emissioncomputed tomography (SPECT),and computerized tomography of head successively, 24 hours, 3 ～ 5 days, and 12～ 15 days after admission for the assessment of therapeutic effects. The rtes of the decrease in rCBF compared be-twecn groups were analyzed with t test. Neurologic function defect scale, activities of living scale and number of re-bleeding compared between two groups were analyzed by X2 test, respectively. Results There were statisticallysignificant differences in the rate of the decrease in rCBF. The neurologic function defect scale and activities of liv-ing scale at 24 hours, 3 ～ 5 days, and 12 ～ 15 days after admission compared between group C and group A, andbetween group C and group B showed significant differences ( P < 0.05). There were statistically significant differ-enees in rebleeding during acute phase of HICH between group A and group B or group C (P < 0.05).Conclusions If the systolic blood pressure is above 185mmHg or diastolic blood pressure over 95mmHg,it is ra-tional and safe to lower the MAP by about 15% with hypotensive gents so as to minimize the impact on regionalcerebral blood flow.

The left lateral incisor with occlusal soreness of a 30-year old female was examined and treated.Radiographic examination re-vealed periradicular radiolucency around the apical and 3 canals.The 3 root canals were treated by root canal therapy,the tooth was restored by all-ceramic crown for the prevention of fracture.12 month follow-up showed that the treatment was effective.

Objective:To investigate the clinical efficacy of different enteral nutrition methods combined with swallowing rehabilitation training in the treatment of Alzheimer's disease complicated by dysphagia.Methods:A total of 120 patients with Alzheimer's disease and dysphagia who received treatment in the Department of Geriatric Medicine, the Second Hospital of Jinhua from October 2019 to March 2021 were included in this study. They were randomly and evenly divided into four groups: A, B, C, and D. Patients in groups A, B, C, and D were given nasogastric tube feeding, naso-intestinal tube feeding, nasogastric tube feeding + swallowing rehabilitation training, and naso-intestinal tube feeding + swallowing rehabilitation training, respectively. After 12 weeks of treatment, total response rate, nutritional status, and complications were compared between the four groups.Results:After 12 weeks of treatment, total response rate in group D was the highest (100.0%), which was significantly higher than that in the other three groups (group A: 13.3%; group B: 40.0%; group C: 73.3%; χ2 = 45.88, 25.71, 9.23, all P < 0.05). After treatment, the nutritional status [body mass index (BMI): (21.42 ± 1.85) kg/m 2, (23.17 ± 2.03) kg/m 2] and patient satisfaction (60.0%, 100.0%) in groups C and D were significantly superior to those in group A [BMI: (19.01 ± 1.72) kg/m 2; patient satisfaction: 10.0%) and group B [BMI: (19.86 ± 1.69) kg/m 2; patient satisfaction: 33.3%]. Group D had the best nutritional status ( t = 7.01, 5.14, 1.78, all P < 0.05) and the highest patient satisfaction ( χ2 = 49.09, 30.00, 15.00, all P < 0.001). Conclusion:Naso-intestinal tube feeding combined with swallowing rehabilitation training is the best treatment for Alzheimer's disease complicated by dysphagia among the studied enteral nutrition feeding methods and therefore deserves clinical promotion.

Objective: To investigate the sodium,potassium and blood pressure of adult residents in Liandu District of Lishui,and to provide evidence for salt reduction intervention. Methods: A stratified random sampling method was used to select residents aged 18 to 69 years in Liandu District from December 2016 to February 2017. A questionnaire survey and physical examination were conducted to collect basic information. The 24-hour urine samples were collected to detect sodium and potassium intake. Results: Among 300 participants,the average daily intake of sodium was（10.59±3.90）g,which was higher in men than in women [（11.11±4.33）g vs.（10.08±3.37）g,P<0.05]. There were 274 participants with average daily intake of sodium more than 6 g,accounting for 91.33%. The average daily intake of potassium was（1.67±0.71）g,which was higher in women than in men [（1.77±0.72）g vs.（1.57±0.68）g,P<0.05]. The average daily intakes of potassium were significantly different among different age groups,with participants aged 20 to 29 years the lowest（P<0.05）. There were 217 participants with average daily intake of potassium less than 2 g,accounting for 72.33%. The ratio of sodium to potassium was 4.7±2.2,which was higher in men than in women（5.3±2.7 vs. 4.1±1.4,P<0.05）and decreased with age（P<0.05）. There were 291 participants with the ratio more than 1.87,accounting for 97.00%. The prevalence of hypertension was 31.67%,which was 33.65% in men and 29.80% in women. Conclusion The residents in Liandu District have high intake of sodium and prevalence of hypertension,yet low intake of potassium.

Objective:To investigate the analgesic effect of ultrasound-guided transversus abdominis plane block versus ultrasound-guided quadratus lumborum block in older adult patients undergoing inguinal hernia repair surgery. Methods:A total of 150 older adult patients who underwent inguinal hernia repair surgery at the Marine Police Corps Hospital of Chinese People's Armed Police Force from April 2019 to May 2022 were included in this study. They were randomly divided into a control group ( n = 75) and a study group ( n = 75) using a random number table method. All patients underwent elective laparoscopic tension-free inguinal hernia repair surgery. Patients in the control group received ultrasound-guided transversus abdominis plane block after inguinal hernia repair surgery, while those in the study group received ultrasound-guided quadratus lumborum block. The changes in Visual Analog Scale (VAS) score and Ramsay score within 48 hours after surgery were compared between the two groups. Inflammatory factors and stress factors including serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol, were measured at 24 and 48 hours after surgery. The use of analgesics, drug-related adverse reactions, and incidence of nerve block-related complications within 48 hours after surgery were also compared between the two groups. Results:There was no significant difference in Ramsay score between the two groups at 4, 8, 12, 24, and 48 hours after surgery (all P > 0.05). There was no significant difference in VAS score between the two groups at 4 and 8 hours after surgery (both P > 0.05). At 12, 24, and 48 hours after surgery, the VAS score in the study group was (1.36 ± 0.57) points, (2.05 ± 0.56) points, and (1.79 ± 0.55) points, respectively, which were significantly lower than (1.92 ± 0.59) points, (2.68 ± 0.62) points, and (2.36 ± 0.59) points in the control group ( t = 6.65, 7.31, 5.86, all P < 0.001). At 24 and 48 hours after surgery, serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol levels in the study group [24 hours: (63.89 ± 4.65) ng/L, (156.59 ± 8.62) ng/L, (97.02 ± 6.95) g/L, (36.95 ± 3.26) g/L; 48 hours: (49.66 ± 3.74) ng/L, (131.45 ± 7.73) ng/L, (74.63 ± 5.91) g/L, (30.41 ± 2.96) g/L] were significantly lower than those in the control group [24 hours: (76.42 ± 5.17) ng/L, (189.32 ± 10.41) ng/L, (105.53 ± 7.83) g/L, (45.16 ± 3.74) g/L; 48 hours: (58.15 ± 3.94) ng/L, (162.74 ± 8.49) ng/L, (89.51 ± 6.37) g/L, (36.92 ± 3.31) g/L, t = 10.49-26.38, all P < 0.001]. The proportion of patients who received analgesics within 48 hours after surgery in the study group was 8.00% (6/75), which was significantly lower than 25.33% (19/75) in the control group ( χ2 = 8.11, P = 0.004). The overall incidence of drug-related adverse reactions within 48 hours after surgery in the study group [6.67% (3/75)] was significantly lower than that in the control group [11% (11/75), χ2 = 4.61, P = 0.032]. Conclusion:Compared with ultrasound-guided transversus abdominis plane block, ultrasound-guided quadratus lumborum block better helps alleviate postoperative pain in older adult patients undergoing inguinal hernia repair surgery, inhibits inflammation and stress reactions, reduces the dosage of analgesic drugs, and decreases the incidence of adverse drug reactions.

To prepare the polyclonal antibody against the 3D polymerase of foot and mouth disease virus (FMDV), the 3D polymerase gene of this virus was amplified by PCR and doubly digested with BamH I and Nde I. Then, it were cloned into expression vector pET-30a(+) to obtain the recombinant plasmid pET-3D and this plasmid was transformed to E.coli BL21(DE3) with induction by IPTG.The target protein was identified and purified with SDS+PAGE, and the inclusion bodies were extracted. The purified target protein was used as antigen to immunize New Zealand rabbits to prepare the polyclonal antibody against 3D polymerase of FMDV, which was then characterized by indirect ELISA and Western blotting. As demonstrated by SDS-PAGE, the target protein with a molecular weight at 46 ku was expressed. The polyclonal antibody showed high affinity and obvious specificity and its titer was above 1:8 000. This polyclonal antibody may lay a foundation for the further studies on the biological functions and epitopes of the 3D polymerase of FMDV.

Objective:To elucidate the factors influencing the differences in the survival rates of esophageal squamous cell carcinoma (ESCC) patients between the rural and urban regions in China. Methods:A total of 36,723 ESCC patients derived from the clinical data-bases containing 500,000 esophageal and gastric cardia carcinoma cases (1973-2015) of the Henan Key Laboratory for Esophageal Can-cer Research of the First Affiliated Hospital, Zhengzhou University, were analyzed. Of these patients, 33,625 were from the rural re-gions (91.6%), comprising 20,906 male patients with an average age of 58.98 ± 8.71 years and 12,719 females with an average age of 59.59 ± 8.53 years. The remaining 3,098 were from the urban regions and composed of 2,089 male patients with an average age of 60.84±9.10 years and 1,009 females with an average age of 62.46 ± 9.14 years. All the patients underwent radical esophagectomy, de-tailed histopathological diagnosis, and TNM staging. Chi square test, Kaplan-Meier, Log-rank, and Cox proportional hazards regression model were used to analyze the differences between ESCC patients from rural regions and those from urban regions and among the risk factors in prognosis. Results:Kaplan-Meier and Log-rank analysis results showed that the ESCC patients from the rural regions had significantly higher overall survival than the urban patients (χ2=12.971, P=0.000). Further analysis showed that rural patients≥50 years old and diagnosed with stage IIa and IIb (middle stage) ESCC had higher survival rates than urban patients in males and females (male:χ2=16.188, P<0.001;female:χ2=5.019, P=0.025). However, the survival rates of rural and urban patients with stage 0,Ⅰa,Ⅰb (early stage) and Ⅲa, Ⅲc, and Ⅳ (late stage) were similar (P>0.05). The results of Cox proportional hazards regression model analysis showed that age, gender, and TNM stages were independent risk factors for rural and urban ESCC patients. When the rural and urban ESCC patients were both considered, the Cox proportional hazards regression model analysis results showed that male ESCC patients≥50 years old, urban residence, and TNM stages were independent risk factors. Conclusion:Rural ESCC patients have significantly high-er overall survival than urban patients. Male, age of≥50 years old, urban residence, and TNM stages were independent risk factors for ESCC patient survival.

Objective : To investigate the knowledge,attitude and practice of salt reduction for hypertension prevention among residents in Liandu District of Lishui,and to provide reference for intervention of salt reduction. Methods : Residents aged 18-69 years in two communities and three towns of Liandu District were selected by multistage stratified random sampling method. They were investigated the prevalence of hypertension and knowledge,attitude and practice of salt reduction for hypertension prevention. Logistic regression models were used to analyze the influencing factors for knowledge,attitude and practice of salt reduction for hypertension prevention. Results : Among 1 801 participants,1 509 completed the survey,with a response rate of 83.79%. The prevalence of hypertension was 31.88%. The proportions of the participants who had knowledge, attitude and practice of salt reduction for hypertension prevention were 33.40%,60.70% and 58.58%,respectively. The results of multivariate logistic regression analysis showed that women（OR=1.583,95%CI：1.248-2.008）,hypertension（OR= 1.734,95%CI：1.303-2.308）,30 to 39 years old（OR=0.368,95%CI：0.226-0.597）,junior high school and above education（OR=0.057-0.403,95%CI：0.036-0.577）were the influencing factors for the knowledge of salt reduction for hypertension prevention;women（OR=1.342,95%CI：1.072-1.679）,married（OR=1.582,95%CI：1.167-2.144）,junior or senior high school education（OR=0.235-0.525,95%CI：0.163-0.736）,having the knowledge（OR=2.640,95%CI：2.033-3.430）were the influencing factors for the attitude of salt reduction for hypertension prevention;women（OR=1.632,95%CI：1.304-2.044）,30 to 39 years old（OR=0.494,95%CI：0.346-0.705）,rural residents（OR= 1.617,95%CI：1.276-2.050）,family history of chronic diseases（OR=1.455,95%CI：1.148-1.845）,having the knowledge（OR= 1.396,95%CI：1.084-1.797）,having the attitude（OR=4.059,95%CI：3.203-5.145）were the influencing factor for the practice of salt reduction for hypertension prevention. Conclusion The residents in Liandu District had low levels of the knowledge,attitude and practice of salt reduction for hypertension prevention. The higher levels of the knowledge and attitude of salt reduction for hypertension prevention,the higher level of the practice.

The complexity of coding surgical procedures related to renal replacement therapy in nephrology stems from a deficiency in clinical knowledge regarding renal replacement therapies and an incomplete understanding of the classification rules within the ICD-9-CM-3 coding system.This paper delves into the clinical aspects of renal replacement therapy and organizes the corresponding coding classification rules,clarifying the codes for various treatment modalities.For instance,the establishment of dialysis access is coded as 38.95 for hemodialysis venous intubation,39.27 for vascular fistula,and 54.93 for peritoneal dialysis intubation via a cutaneous peritoneal stoma.Maintenance hemodialysis is coded as 39.95,while peritoneal dialysis is coded as 54.98.The removal of dialysis catheter is differentiated into surgical and non-surgical;surgical removal is coded as 86.05,and non-surgical removal as 97.86 or 97.89.For instances of internal fistula stenosis or thrombosis,balloon dilation is coded as 39.50.Stent implantation for stenosis or isolation of a false aneurysm is coded as 39.90 for bare stent,and 00.55 for covered stents.The resection and reconstruction involving stenosis,thrombus segments,or false aneurysms,are coded as 39.42.This classification aims to improve the accuracy of coding for such procedures.

Objective By analyzing the main diagnostic choices of inpatient records in obstetrics and the problems exist-ing in ICD codes,we can improve the quality of the main diagnostic choices and coding in obstetrics.Methods A total of 205 obstetric inpatient medical records were randomly selected from a hospital from January 1 to April 30,2024,and the medical re-cords were checked jointly by three senior coders,and the errors were summarized and analyzed by using the check table.Results Among 205 obstetrical medical records,72(35.12％)were found to have errors in the selection and coding of major diagnoses;among them,there were 55 cases of incorrect selection by clinician and incorrect compilation by coders,13 cases of correct selection by clinician,incorrect compilation or omission by coders,4 cases of omission by clinician and omission by cod-ers.Conclusion The selection and coding of the main diagnosis in obstetrics are very special and difficult,so the training of cli-nicians should be strengthened,the writing of clinicians should be standardized,and the importance of the main diagnosis selec-tion should be strengthened.At the same time,strengthen the management of coders,standardize the coding operation process,strengthen the learning of professional knowledge,improve professional reserves,strengthen the two-way communication with cli-nicians,and jointly improve the main diagnosis selection and coding accuracy rate of obstetrics,so as to ensure the quality of data on the first page of obstetric inpatient medical records.