Objective To explore the influence between perioperative nutritional support and outcome of refractory constipation patients complicated with megacolon.Methods Seventy-three patients with refractory constipation complicated with megacolon receiving surgical interventions were enrolled,both by gastrointestinal decompression and total parenteral nutrition support treatment.Thirty-seven cases who could not recover intestinal tract unobstructed,did not receive enteral nutrition support treatment and surgery as control group; 36 cases of patients with intestinal recovery unobstructed,after 2 weeks of total enteral nutrition support undergoing elective surgery as observation group.The nutrition indicators,surgery and postoperative complications between two groups were compared.Results The operation time and intraoperative blood loss compared between two groups had no significant difference (P ＞0.05).The operation method between two groups was statistically significants (P ＜ 0.05).The incidence of anastomotic bleeding,anastomotic fistula and pneumonia in observation group were lower than those in control group [2.8％ (1/36) vs.21.6％ (8/37),0 vs.13.5％ (5/37) and 0 vs.13.5％ (5/37)],there were significant differences (P ＜ 0.05).The hospitalization time,incidence of incision infection,urinary retention,intestinal obstruction between two groups had no significant difference (P ＞ 0.05).The postoperative hospital stay in observation group was shorter than that in control group [(12 ± 3) d vs.(25 ± 6) d],there was significant difference (P ＜ 0.05).The index comparison on admission similar between two groups had no statistical significance (P ＞0.05).The preoperative fat weight,fat mass and serum albumin,transferrin and prealbumin in observation group were higher than those in control group [(41.9 ± 7.6) kg vs.(38.7 ± 3.0) kg,(13.2 ± 4.0) kg vs.(7.8 ± 2.7) kg,(37.9 ± 2.6) g/L vs.(31.3 ± 2.5) g/L,(2.9 ± 0.6) μ g/L vs.(2.0 ± 0.6) μ g/L,(243.7 ± 25.2) mg/L vs.(141.2 ± 11.9) mg/L],there were significant differences (P ＜ 0.05).After 1 month,the weight,fat weight,protein quality,fluid in cells and extracellular fluid,body mass index,albumin,transferrin in observation group were better than those in control group [(55.1 ± 6.4) kg vs.(50.9±4.7) kg,(42.9 ± 3.2) kgvs.(39.1 ± 1.3) kg,(12.2 ± 1.4) kg vs.(9.7 ± 3.2) kg,(23.7 ± 5.0) Lvs.(18.8 ± 5.5) L,(10.9 ± 4.5) L vs.(7.7 ± 0.8) L,(22.3 ± 1.9) kg/m2 vs.(17.5 ± 3.6) kg/m2,(41.9 ± 4.7) g/L vs.(33.1 ± 2.9) g/L and (3.5 ± 0.7) μg/L vs.(2.7 ± 0.5) μg/L],there were significant differences (P ＜0.05).Conclusion Refractory constipation complicated with megacolon requires surgical intervention,should as far as possible to restore the intestinal function preoperatively,enteral nutrition support treatment,can significantly reduce the incidence of perioperative complications.

ObjectiveTo investigate the clinical efficacy of wrist-ankle acupuncture plus continuous exercise therapy for post-stroke shoulder pain.MethodsEighty patients with post-stroke shoulder pain were randomly allocated to treatment and control groups, 40 cases each. The control group received continuous exercise training with an upper limb multi-joint rehabilitation training instrument and the treatment group, wrist-ankle acupuncture in addition. The affected limb SEP N9 and N13 latency values, shoulder pain severity (the VAS score) and the upper limb motor function score were observed in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.ResultsThe total efficacy rate was 90.0% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in SEP N9-N13 wave interval on the affected side in the two groups (P<0.01). There was a statistically significant post-treatment difference in SEP N9-N13 wave interval on the affected side between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the VAS score and the Fugl-Meyer score in the two groups (P<0.01). There were statistically significant post-treatment differences in the VAS score and the Fugl-Meyer score between the treatment and control groups (P<0.01).ConclusionsWrist-ankle acupuncture plus continuous exercise therapy is an effective way to treat post-stroke shoulder pain.

IEST, DGS-COPT and CV-COPT using lyophilized ova of schistosoma japonicum were performed on sera from 120 cases of schistosomiasis japonica, 120 cases of schis-tosomiasis japonica 3-8 years after being cured with praziquantel and 120 healthy individuals by single-blind method. The sensitivity and specificity of IEST was 91.7% and 95.8% respectively which were significantly higher than that of both DGS-COPT and CV-COPT. The negative conversion rate of cured patients was 70.8% with IEST, 80.8% with DGS-COPT and 81.7% with CV-COPT. The results showed that IEST has higher diagnostic value for schistosomiasis than both COPT. DGS-COPT has the same diagnostic value as CV-COPT, however, it was easy to perform and time-saving, thus it might be applied in the fields for practical purposes.

Objective:To comprehensively evaluate the utilization of some essential medicines among elderly people in clinic settings in China, in order to provide a reference for the selection of fully reimbursed medicines for the elderly.Methods:Expert consultations were conducted to evaluate the utilization of 58 essential medicines related to eight major therapeutic areas, including neurology, psychiatry, cardiovascular diseases, respiratory diseases, among elderly people.The evaluation indexes included safety, efficacy, compliance by medical staff, compliance by patients, clinical value, and pharmaceutical economics.Results:Except for psychiatry, authority coefficients for drugs related to the other therapeutic areas were greater than 0.7, indicating that experts were familiar with the indications of the medications.According to the comprehensive evaluation scores, 10 medicines, i.e., nitroglycerin, metoprolol tartrate, isosorbide dinitrate, omeprazole, metformin, amlodipine, aspirin, acarbose, valsartan, and clopidogrel, could be considered as the first choices for guaranteed essential drugs for the elderly.Meanwhile, another 10 medicines, including nifedipine, estazolam, tamsulosin, simvastatin, alfacalcidol, enalapril, bisoprolol, beclomethasone dipropionate, ipratropium, and salbutamol, could be considered as the second choices for guaranteed essential drugs for elderly people.Conclusions:The first choices recommended by experts as guaranteed essential drugs for the elderly are mainly cardiovascular, endocrine and respiratory medicines, in line with the disease spectrum of the elderly.The selection of essential medications with full cost reimbursement for elderly patients should be those frequently used and with a burden of high medicine costs.

Objective To investigate the clinical efficacy of Baduanjin combined with biofeedback on functional defecation disorders and the effect on serum brain-gut peptide.Methods From June, 2017 to February, 2018, 68 patients were randomly divided into control group (n=34) and observation group (n=34). Both groups received biofeedback therapy, and the observation group took the training of Baduanjin in addition, for twelve weeks. Then, their overall clinical efficacy, main syndrome score of constipation, the score of Patient Assessment of Constipation Quality of Life (PAC-QOL) and Brain-gut peptide level were compared before and after intervention.Results The total clinical efficacy was higher in the observation group than in the control group (Z=-2.065, P=0.039) without shedding cases. After treatment, the main symptoms of constipation significantly improved (t>2.162, P<0.05) in both groups, while the defecation inactivity, defecation time and abdominal distension score were significantly lower in the observation group than in the control group (t>2.837, P<0.01), as well as the defecation strain (t=-2.070, P<0.05); the score of PAC-QOL decreased (t>2.085, P<0.05) in both groups, and was lower (t=-2.243, P<0.05) in the observation group than in the control group; the level of serum 5-hydroxytryptamine (5-HT), nitric oxide (NO) and vasoactive intestinal peptide (VIP) decreased (t>2.420, P<0.05), while the level of serum substance P (SP) increased (t>6.780, P<0.001), the level of serum 5-HT, serum NO and serum VIP was lower (t>2.039, P<0.05), and the level of serum SP was higher (t=3.500, P<0.001) in the observation group than in the control group.Conclusion Baduanjin combined with biofeedback can improve the clinical efficacy of patients with functional defecation disorders, and its mechanism is closely related to the regulation of abnormal secretion and the expression of brain-gut peptide.