Objective:To observe the clinical effect of combining acupuncture, Chinese medicine and rehabilitation training for subacute stroke. Methods:A total of 120 subacute stroke cases were randomly allocated into a treatment group (n=60) and a control group (n=60). Patients in the control group received standard rehabilitation therapy alone, whereas patients in the observation group received additional acupuncture and Chinese medicine. Before treatment, after 30-day and 60-day treatments, and 3 months after treatment, the neurologic deficit severity was evaluated using the National Institute of Health stroke scale (NIHSS); the motor function was evaluated using the Fugl-Meyer assessment scale (FMA); the activities of daily living (ADL) was evaluated using the Barthel index (BI); and the changes of traditional Chinese medicine (TCM) symptoms were evaluated according to TCM symptom scores. Results:After 30-day, 60-day treatments, and 3 months after treatment, the NIHSS, FMA, BI and TCM symptoms scores were statistically different from those before treatment in both groups (allP<0.05); and there were between-group statistical differences at same time points (allP<0.05). Conclusion:Combining acupuncture, Chinese medicine and rehabilitation training can improve neurologic deficit, motor function and ADL in subacute stroke patients and its efficacy is better than rehabilitation therapy alone.

BackgroundRevascularization and statin therapy are routinely used in the management of stable coronary artery disease. However, it is unclear whether the estimated high-density lipoprotein (HDL) particle size (eHDL-S), the ratio of HDL cholesterol (HDL-C) to apoprotein A-I (apoA-I), is associated with the clinical outcomes of diabetic patients with stablecoronary artery disease (CAD).MethodsWe per-formed a prospective cohort study of 328 patients diagnosed with stable CAD by coronary angiography. Patients were followed up for a mean duration of 12 months. The patients were divided into three groups by the tertiles of eHDL-S: low eHDL-S (< 0.71,n= 118); interme-diate eHDL-S (0.71-0.79,n= 111); and high eHDL-S (> 0.79,n= 99). The associations between the baseline eHDL-S and short-term out-comes were evaluated using the Kaplan-Meier method and Cox proportional regression.Results The low eHDL-S group had higher trig-lyceride, hemoglobin A1c, uric acid, and leukocyte count than the other groups. During the follow-up period, 47/328 patients experienced a pre-specified outcome. According to the Kaplan-Meier analysis, the incidence of pre-specified outcomes was lower in the high eHDL-S group (P = 0.04). However, eHDL-S was not independently associated with adverse outcomes in Cox proportional hazards regression (haz-ard ratio (HR): 0.23, 95% confidence interval (95% CI): 0.01-11.24,P = 0.493).ConclusionAlthough the eHDL-S was associated with inflammatory biomarkers, it was not independently associated with the short-term prognosis of diabetic patients with stable CAD in the era of revascularization and potent statin therapy.

Informationization teaching resources contain a large number of information so rea-sonable and effective application of the resources is of great significance to the teaching. The article tries to explore and work out some teaching strategies for effective application of informationization teaching resources through action research combined with literature research , questionnaire survey method , interview and other methods. The research process: the original teaching strategies of infor-mationization teaching resources were implemented , implicated and verified in the first round action research; the problems in the first round were summarized and analyzed and the original teaching strategies were adjusted and optimized in the next round action research; finally, the teaching effec-tiveness between the two rounds action research was evaluated and analyzed by the “classroom teach-ing effectiveness criteria based on the use of information technology teaching resources”. The results show that effective application of informationization teaching resources is of great help to the teaching effect. It can enhance the learners' interest in learning and improve their academic performance. Ap-propriate and rational teaching strategy should be provided flexibly according to the learning back-ground and characteristics of students as well as learning contents.

Objective To describe the status quo of Aged care willingness among nursing undergraduates,and to explore its influencing factors. Methods A total of 382 nursing undergraduates were enrolled by convenience sampling method. They were investigated with a self-designed questionnaire about the demographic data, the Kogan′s Attitudes toward Old People Scale, the Palmore′s Facts on Aging Quiz Scale and College Students′ Gratitude Trait Questionnaire. Results The overall aged care willingness score for nursing undergraduates was 17.75 ± 3.62. Appreciation, old training, happiness, retribution and living with the older people entered the multiple regression equation. Conclusions The Aged care willingness level of 382 nursing undergraduates is at medium level. Appreciation, old training, happiness, retribution and living with the older people are important influencing factors.

Objective To evaluate the value of early diagnosis and follow-up of bleeding and necrotizing pancreatitis by ultrasound.Methods 52 cases with bleeding and necrotizing pancreatitis confirmed by operation and pathology were examined by ultrasound. The pancreas were observed section by section in the blood vessel surrounding the pancreas acted as the mark under reduced the influence of gas in gastro-intestine and using adopting protruding probe with high resolution and compounding scanning technique in multi-posture. Results The accurate rate of diagnosis by ultrasound was 92%(48/52).During the follow-up period, pseudocysts and other complications were found in 9 cases, all cases recovered gradually after operations and treatment of symptoms except 3 cases who died caused by complications such as multiple organ dysfunction. Conclusion Ultrasound can identify bleeding and necrotizing pancreatitis early and also can regard as a significant follow-up method.

Objective To train medical students' competence of independent thinking and problem solving and to improve the quality of teaching.MethodsThe case-based PBL teaching model was introduced to teaching practice for 25 undergraduates majoring in medical laboratory.The teaching process included pre-class mobilization,question,self-study,discussion and summary.Effectiveness of teaching was evaluated with questionnaire.Results For these medical students,the enthusiasm of learning ( 83.3％ ),ability of self-learning and information seeking ( 79.2％ ),ability of discussing and problem solving ( 79.2％ ),ability of scientific thinking and clinical reasoning ( 79.2％ ) were significantly improved.Teaching satisfaction rate of case-based PBL teaching model was up to 95.8％.ConclusionBetter results of teaching were achieved and the case-based PBL teaching model is worth spreading.

[ABSTRACT]OBJECTIVETo compare the differences of aerodynamic characteristics of pharyngeal cavity between normal subjects and OSAHS patients, and to study the nasal obstruction in the pathogenesis of the OSAHS.METHODSA total of 60 normal subjects and 60 OSAHS patients were enrolled in this study. Numerical simulation was performed to calculate the airflow dynamic indexes of three sections of pharyngeal cavity. Correlation analysis of the nasal resistance and negative pressure were studied.RESULTSThe average pharyngeal negative pressure and airflow velocity in OSAHS patients were significantly increased than that in normal subjects. The total nasal airway resistance significantly correlated with the average negative pressure of pharyngeal cavity. CONCLUSIONAirflow dynamic indexes of OSAHS patients had significant different pharyngeal aerodynamic characteristics from normal subjects. The increased average negative pressure in pharynx might contribute to the severity of pharyngeal collapse for OSAHS patients. Higher total nasal resistance might play a role in the pathophysiological mechanisms of OSAHS.

OBJECTIVE:To observe the effects of remifentanil-induced controlled hypotension (CH) on postoperative cogni-tive dysfunction (POCD) and serum S100β protein in elderly patients underwent spinal surgery,and to investigate their relation-ship. METHODS:Sixty elderly patients undergoing selective laminectomy decompression internal fixation of lumbar or thoracic fractures under general anesthesia were selected prospectively from orthopedics department of our hospital during Jan. 2014-Dec. 2015,and then divided into CH group and non-CH group in accordance with random number table,with 30 cases in each group. Both groups received general anesthesia of injection and inhalation via endotracheal intubation. Mean arterial pressure (MAP) of CH group were reduced to 70%-80%of the basic values by adjusting remifentanil infusion rate;those of non-CH group were main-tained at basic level. Surgery duration,anesthesia duration,intraoperative blood loss,the incidence of POCD and serum concentra-tion of S100β protein were observed in 2 groups. The relationship of serum concentration of S100β protein with POCD was ana-lyzed,and the occurrence of ADR was recorded. RESULTS:The intraoperative blood loss of CH group was significantly less than that of non-CH group,with statistical significance (P<0.05). There was no statistical significance in the incidence of POCD be-tween 2 groups on the 1st and 7th day after surgery(P>0.05). The incidence of POCD and serum concentration of S100β protein in CH group were significantly higher than in non-CH group on the 2nd and 3rd day after surgery,with statistical significance(P<0.05). The serum concentration of S100β protein may be related to the incidence of POCD (r=0.992 7,P=0.001 3). CONCLU-SIONS:Remifentanil CH used in elderly patients underwent spinal surgery can reduce intraoperative blood loss,but increase the se-rum concentration of S100βprotein and the incidence of POCD at early stage.

Objective To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke depression.Method Forty-one patients with post-stroke depression were randomized into a treatment group of 22 cases and a control group of 19 cases. In addition to the basic internal medicine treatment, the treatment group received acupuncture plus rehabilitation training, while the control group was intervened by rehabilitation training alone. The Hamilton Depression Scale (HAMD) and National Institutes of Health Stroke Scale (NIHSS) were observed and compared before and after treatment.Result The HAMD and NIHSS scores in the two groups were significantly changed respectively after 4-week and 8-week treatment (P<0.05,P<0.01). Respectively after 4-week and 8-week treatment, the HAMD and NIHSS scores in the treatment group were significantly different from that in the control group (P<0.05,P<0.01).Conclusion Acupuncture plus rehabilitation training is an effective approach in treating post-stroke depression.

Objective To investigate the association between epicardial adipose thickness(EAT)and coronary artery plaque vulnerability evaluated by intravascular ultrasound(IVUS)in patients with coronary heart disease.Methods A retrospective case-control study was conducted.A total of 261 patients who were diagnosed with coronary heart disease via coronary angiography from August 2014 to March 2017 were enrolled in this study.Patients were divided into an acute coronary syndrome(ACS)group(n=92)and a stable angina pectoris(SAP)group(n=169).EAT and coronary artery plaque vulnerability evaluated by IVUS were compared between the two groups.The correlation between EAT and coronary artery plaque vulnerability was analyzed.Results EAT was greater in the ACS group than in the SAP group(5.4 ± 1.1)mm vs.(2.9±0.7) mm,t =12.664,P＜0.01).The plaque burden,the rates of soft plaque detection and the rates of spotty calcification detection were higher in the ACS group than in the SAP group(67.8±8.0)％ vs.(57.4 ± 10.4) ％,35.9％ or 33/92 vs.18.9％ or 32/169,0.4 ％ or 28/92 vs.17.8％ or 30/169,all P ＜0.05),while there was no significant difference in luminal area between the two groups(P =0.772).The proportion of positive remodeling was higher in the ACS group than in the SAP group(35.9％ or 33/92 vs.8.3％ or 14/169,P＜0.01).Linear regression analysis showed that EAT was correlated with plaque burden(r =0.592,P ＜0.01),lumen area(r =-0.273,P ＜0.01) and reconstruction index(r =0.447,P ＜0.01).Conclusions Epicardial adipose thickness is correlated to coronary artery plaque vulnerability evaluated by IVUS.