Objective To observe the therapeutic efficiency of naoxintong capsule on the patients with moderate obstructive sleep apnea hypopnea syndrom ( OSAHS ) of cognitive dysfunction. Methods Sixty pa?tients of moderate OSAHS were randomly divided into treatment group and control group, 30 cases in each group. Patients in the treatment group were given naoxintong capsule,three goals,three times a day,at the same time,with double level positive pressure ventilation therapy for 3 months. Patients in the control group accepted double level positive pressure ventilation therapy for 3 months. The questionnaires of Montreal Cognitive Assess? ment( MoCA) were administered to assess cognitive in all the patients before and after treatment. Results There was no statistically significant difference in term of MoCA score between the two groups before treatment( t=0. 14,P>0. 05). After treatment,the MoCA score of the treatment group was (25. 83+1. 70),of control group was (22. 70+2. 51),the difference was statistically significant(t=5. 62,P<0. 05). The visual space and execu?tive function,naming,attention,language,abstract,delayed recall and directional score in the treatment group af?ter treatment were (5. 03±0. 81) points,(2. 90±0. 31) points,(4. 73±0. 58) points,(2. 63±0. 49) points, (1. 97±0. 18) points,(3. 93±0. 98) points,(5. 03±0. 56) points respectively,compared with before treatment ((4.07±0.79) points,(2.17±0.59) points,(3.40±0.50) points,(2.03±0.49) points,(1.80±0.41) points,(2. 87±0. 73) points,(4. 03±0. 77) points),the differences were statistically significant (t=6. 55, 6. 89,13. 36,5. 29,2. 41,4. 87,6. 60;P<0. 05) . The naming,attention,language,abstract,delayed recall and di?rectional score in the control group after treatment were ( 2. 77 ± 0. 43 ) points, ( 4. 07 ± 0. 75 ) points, ( 2. 20 ±0. 55) points,(1. 87±0. 35) points,(3. 10±0. 66) points,(4. 67±0. 71) points respectively,ompared with be?fore treatment((2. 30±0. 65) points,(3. 43±0. 68) points,(2. 00±0. 70) points,(1. 73±0. 45) points,(2. 93 ±0. 58) points,(3. 93±0. 69) points),the differences were statistically significant(t=5. 04,4. 34,2. 26,2. 11, 2. 41,6. 28;P<0. 05) . MoCA score in treatment group than the control group have improved significantly in visu?al space and executive function,attention,language and delayed recall,directional ( t=4. 51,3. 80,3. 22,3. 86, 2. 23,P<0. 05) . Conclusion Naoxintong capsule can improve cognitive dysfunction in patients with moderate OSAHS.

Objective To investigate health status of primary or middle school teachers. Methods A total of 4482 physical examination results of the teachers from Qiaokou District of Wuhan in 2008 were compared with 5526 data obtained in 2006. The rate of healthy to unhealthy participants was evaluated. The overall and age-specific disease incidence, including overweight, hypertension, hyperlipidmia, hyperglycemia,liver dysfunction, abnormal EGG, concrement, adiposis hepatica, and HBV infection, was recorded. X2 test was used for statistical analysis. Results Abnormal examination results were more common in 2008 when compared with those in 2006( X2 = 28. 35, P ＜ 0. 05 ). The incidence of hypertension was descended ( X2 =4. 51 ,P ＜ 0. 05 ), although the rates of hyperlipidimia, hyperglycemia, liver dysfunction, abnormal ECG,concrement, and adiposis hepatica were increased in 2008 ( P ＜ 0. 05 ). The incidence of hyperlipidimia, liver dysfunction, abnormal ECG, and adiposis hepatica increased in all age groups ( P ＜ 0. 05 ). The incidence of hyperglycemia and concrement increased in those ＞ 35 years old ( P ＜ 0. 05 ). Conclusion Except for hypertension and HBV infection, the incidence of common diseases has been increased in the young and middle-aged teachers during the last 2 years. Thus the health management for the primary or middle school teacher should be improved in the future.

Background and purpose:Radiomics refers to the comprehensive quantification of human tissues through assessing a large number of quantitative image features. Radiomics approach is used to decode tumor phenotypes and predict treatment outcomes. Here we present a study investigating radiomic analysis to assess normal liver features and predict chemotherapy-associated liver injury.Methods:Gastric cancer patients treated with surgery and adjuvant chemotherapy were enrolled in this study retrospectively. CT images were obtained before chemotherapy. The whole liver organ was delineated by radiation oncologists. Images were extracted and filtered by radiomic approach to extract radiomic features. Clustering was performed to reveal clusters of patients with similar radiomic expression patterns. Chi-squared tests were used to assess the association of radiomic data with clinical data and chemotherapy-related liver injury.Results:Radiomic features of 73 patients were clustered into two clusters. A significant association with gender (P=0.004, chi-squared test) was observed, where in male showed a higher presence in cluster Ⅰ. Incidence of abnormal liver function after chemotherapy was 48.7% in cluster I and 67.6% in cluster Ⅱ, respectively (Δ=18.9%). Clinical data including age, gender, chemotherapy modality, number of chemotherapy cycles, HBV infection history, HBs-antigen presence were not associated with liver function abnormalities after chemotherapy. Accuracy of radiomic analysis to predict liver injury is 0.59.Conclusion:Radiomic approach revealed different imaging features of liver between men and women. It could help to predict chemotherapy-associated liver injury. It is feasible to use radiomics approach to decode normal liver features and predict treatment-associated liver injury.

Objective:To investigate the effect of the application of "internet +" disease management based on the AISAS model on the young and middle-aged patients after PCI therapy.Method:A total of 90 young and middle-aged patients hospitalized in cardiological department of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) were enrolled between June 2018 to October 2019, and they were randomly divided into observation group and control group with 45 cases in each group. Patients in the control group received telephone follow-up while "internet +" disease management based on the AISAS model was applied in the observation group. The drug therapy compliance, acquisition of the disease knowledge, quality of life, anxiety and depression levels, return to workand incidence of cardiovascular events.Results:One year after the intervention, the drug therapy compliance score, disease-related knowledge score, quality of life score, SAS and SDS scores of the observation group were 7.55±1.21, 7.29±1.27, 701.17±74.86, 32.55± 4.31, 34.74±4.16, the scores of patients in the control group were 6.48±1.56, 6.12±1.94, 670.58±65.29, 41.72±4.33, 40.79±4.17. The difference was statistically significant ( t value was 2.066-11.203, P<0.05). The comparison between the return of the patients and the incidence of cardiovascular events in the two groups was statistically significant ( χ2 value was 5.031, 11.275, P<0.05). Conclusion:This management model can increase the knowledge of disease PCI postoperative patients, improve their quality of life, make patients return to society earlier, and promote the improvement of the quality of continuous nursing service.

Objective: To verify the costs, benefit and effectiveness of hepatitis B immunoprophylaxis strategies in Shenzhen during 2006-2030. Methods: The markov model was constructed to reflect the reality of the newborn vaccination and prevention of mother to child transmission (PMTCT) strategy, the cost, benefit and effectiveness during 2006-2015 and 2016-2030 was evaluated and predicted by the model. The model was constructed with the basic parameters such as the positive rate of hepatitis B surface antibody, perinatal HBV infection rate, the screening rate and positive rate of HBsAg of pregnant women, the utility value of hepatitis B and the parameters of markov model. and the coverage rates, vaccination fee of hepatitis B and the expenditures of patients with HB-related diseases.The costs were calculated from the payer, medical-care and all society perspective. The effectiveness and benefits of the strategy were evaluated and predicted by the numbers of HBV infection and the patients with HBV-related diseases prevented, life years (LYs), quality adjusted life years (QALYs), the net benefits (NBs) and benefit cost ratio (BCRs). Results: From the payer, medical-care and all society perspectives, the costs for the strategy were 153 million Yuan, 5.51 billion Yuan and 10.92 billion Yuan, respectively from 2006 to 2030 of which the forecast costs for 2016-2030 were 120 million Yuan, 3.87 billion yuan and 7.81 billion yuan. During the year 2006-2030, the numbers of HBV infection and the HBV-related diseases was 2.48 million, more than 1.335 million LYs and 1.619 million QALYs should be obtained from the strategy implemented. From medical-care and all society perspectives, NBs should be 88.68 billion yuan and 150.13 billion yuan with the BCRs of 17.08 and 14.75, respectively. Particularly, the NBs value of 22.37 billion yuan and 37.98 billion yuan and the BCR value of 14.62 and 13.20 was calculated for the past period, but the future NBs of 66.31 billion yuan and 112.15 billion yuan and BCR of 18.12 and 15.36 in the year 2016-2030. The further benefits were increased evidently in the future. Conclusion The hepatitis B immunization in Shenzhen has a high economic effectivenee and benefits, and it is worth to invest sustainably.

Objective: To edentify the increased cost, the decreased benefits and effectiveness of hepatitis B vaccine event reported by media in 2013 in China both in Chinese nationwide and in Shenzhen. Methods: The decision analytic-Markov models were constructed. The cohort born in 2013 in nationwide and in Shenzhen were respectively introduced to the models. The vaccination coverage and the rates of antibody to hepatitis B surface antigen were determined as major parameters. The average costs and benefits per case, the effectiveness which included the numbers of hepatitis B virus (HBV) infection and the patients with HBV-related diseases, the average quality-adjusted life years (QALYs) per case were calculated from the medical-care and societal perspectives. The benefit cost ratio (BCR), ratio of the total costs and the net QALYs were as indicators of cost-benefit and cost-effectiveness analysis, respictively. Results: In nationwide, the BCRs decreased from 9.10 and 8.58 to 2.48 and 2.43, respectively, because the average costs increased to 6 796.60 yuan (RMB) and 8 451.45 yuan, and average benefits decreased to 6 799.57 yuan and 8 484.41 yuan, respectively, from the medical-care and societal perspectives. In Shenzhen, the BCRs decreased from 16.21 and 14.51 to 3.11 and 3.04 with the average costs of 5 244.88 yuan and 8 937.64 yuan, and average benefits of 5 248.11 yuan and 8 977.27 yuan. Totally, the increase of 2.1314 million and 181 hundreds of the HBV infectors occurred for the event in nationwide and in Shenzhen, respectively. Of all the infectors increased the most, the numbers of acute and chronic hepatitis B were 1 904 hundreds and 807 hundreds in nationwide, 794 and 395 in Shenzhen, espectively. The decreases of average QALY per case were 0.119 8 in nationwide and 0.090 6 in Shenzhen. The costs per averted a QALY increased from 6 231.90 yuan to 22 883.51 yuan in nationwide, from 3 567.25 yuan to 1 8571.49 yuan in Shenzhen (for medical-care perspective), from 8 252.79 yuan and 6 807.45 yuan to 29 091.92 yuan and 32 553.60 yuan (for societal perspective). Conclusion The hepatitis B vaccine event reported by media in 2013 in China caused the costs increased, both benefits and the economic values obviously decreased.

Objective To investigate the postoperative application and effect of surgical drainage device package in patients with esophageal cancer.Methods With controlled clinical research method, 23 eligible patients treated from October 2015 to February 2016 were selected as the control group, while 23 eligible patients treated from March to June 2016 were selected as the observation group. Patients in the control group were treated with conventional drainage nursing, while besides that, surgical drainage device package were used for patients in the observation group. Incidence rate of unplanned extubation, compliance of early ambulation, and patients′ comfort during hospitalization were compared between patients in the two groups. Results Incidence rate of unplanned extubation in the observation group was 0, while in the control group, 17.4% (4/23) (P<0.05); compliance of early ambulation in the observation group was better than that in the control group (P<0.05); comfort level of patients 24 h after the surgery in both groups were not significantly different (P>0.05); at 48 h and 72 h after the surgery, comfort level in the observation group was significantly higher than that in the control group (P<0.05).Conclusions Surgical drainage device package can effectively prevent drainage tube from falling off from patients with esophageal cancer, improve comfort level of patients, promote compliance of early ambulation of the patients after the surgery, and reduce the incidence of adverse nursing events.

Objective:To explore the influencing factors of chronic atrophic gastritis (CAG) with peripheral neuropathy.Methods:Patients with CAG in Zhoupu Hospital Affiliated to Shanghai University of Medical&Health Science from October 2015 to October 2018 were prospectively selected and divided into peripheral neuropathy group (149 cases) and no peripheral neuropathy group (398 cases). Serum creatinine, serum gastrin, vitaminA, vitaminB1, vitaminB6, vitaminB9 (folic acid), vitaminB12, vitaminE, Serum 25 hydroxyvitamin D3(25(OH)D3) and helicobacter pylori (HP) were measured.The peripheral nerve conduction velocity was detected before and after the treatment.The influencing factors of CAG with peripheral neuropathy were analyzed, and the correlation between potential vitamin content and peripheral nerve conduction velocity was analyzed.One way ANOVA was used to assess changes in patients after treatment.Results:Folic acid ( OR=0.412, 95% CI 0.280-0.607, P<0.001), vitamin B12 ( OR=0.974, 95% CI=0.968-0.979, P<0.001) and 25(OH)D3 ( OR=0.759, 95% CI=0.711-0.810, P<0.001) were the independent protection factors of CAG with peripheral neuropathy.The motor nerve conduction velocity of the median nerve was positive related with serum folic acid ( r=0.443, P=0.019), vitamin B12 ( r=0.482, P=0.028) and 25(OH)D3 level ( r=0.331, P=0.020). After treatment, serum folic acid ( F=5.013, P=0.028), vitamin B12 ( F=6.051, P=0.016) and 25(OH)D3 levels ( F=5.630, P=0.020) gradually increased, the motor nerve conduction velocity of median nerve ( F=8.336, P=0.005) also gradually increased. Conclusion:Vitamin B12, folic acid and vitamin D are protective factors for CAG patients with peripheral neuropathy.

In order to understand the prevalence and antimicrobial resistance of Enterococcus faeca-lis(E.faecalis)and Enterococcus faecium(E.faecium)isolated from human,pig and environ-ment in a Xinjiang pig farm,and to investigate the prevalence and potential harm of antimicrobial resistance genes,858 fecal samples from pig farm workers,anal swabs from pig and environment were collected for isolation,identification,antimicrobial susceptibility test and drug resistance gene detection.The results showed that 429 strains of E.faecalis and 222 strains of E.faecium were i-solated.The distribution of Enterococcus species varied among different sources.The isolation rate of E.faecalis was higher in pig anal swabs(73.1％,309/423)and human fecal samples(68.4％,26/38).E.faecium(42.3％,168/397)was mainly isolated from environmental samples.The drug resistance of E.faecalis and E.faecium isolated from pigs was similar to that of E.faecium isola-ted from environment.The drug resistance rates of E.faecalis and E.faecium isolated from pigs were more serious than those from humans to tetracycline,doxycycline,florfenicol and erythromy-cin,and they were more sensitive to ciprofloxacin and levofloxacin.More than 30.0％of E.faecalis and E.faecium isolated from pigs and environment were intermediate to linezolid.E.faecalis from three sources and E.faecium from environmental sources were mainly resistant to five drugs,while E.faecium from pigs was mainly resistant to six drugs.The detection rates of tet(M)and tet(L)genes in E.faecalis and E.faecium isolates from human,animal and environmental sources were more than 70.0％,which was consistent with the results of drug sensitivity.In addition,the cfr,optrA and poxtA genes that mediate oxazolidinone resistance were detected to varying extent.The cfr gene was only detected in four E.faecalis isolates from swine,one E.faecalis isolate from environment and two E.faecium isolates from environment.The positive rate of optrA gene in E.faecium isolated from pigs and environment was higher than that from humans,and the posi-tive rate was more than 60.0％.The positive rate of poxtA gene in E.faecium isolated from pigs and humans was more than 45.0％.The similar drug resistance situation suggests that there is the phenomenon of mutual contamination of drug-resistant bacteria in human-animal-environment.Therefore,we should consider from the perspective of one health,formulate comprehensive disin-fection and control programs,block the transmission route of drug-resistant strains and drug re-sistance genes between human-animal-environment,standardize the use of antibiotics,and reduce the enrichment of antibiotics in human-animal-environment,so as to reduce the risk of drug-resist-ant bacteria.

Objective: To identify the prevalence of sleep problems in children with autism spectrum disorder (ASD) and to explore the association with the main melatonin metabolite, 6-sulfatoxymelatonin (6-SM). Method: This was a prospective case-control study. Children with ASD were recruited from Child Development and Behavioral Research Center (CDBRC) of the Harbin Medical University and Harbin Special Education School from October 2015 to April 2017 (ASD group) . Healthy controls were selected from five kindergartens and one primary school in Harbin by the stratified cluster random sampling (control group) . The Children's Sleep Habits Questionnaire (CSHQ) was used to investigate the sleep problems of the two groups. The patients were matched in a 1∶1 ratio for the age and sex, and the urine samples of case-control pairs were collected in the morning. The level of 6-SM was measured by the enzyme linked immunosorbent assay (ELISA). The student's t test was used for comparison between the ASD group and control group, and the Pearson correlation analysis was used to determine the correlation difference. Result: A total of 212 ASD children (mean (±SD) age was (6.0±2.7) years, and 181 patients (85.4%) were male), and a total of 334 healthy children(mean (±SD) age was (5.9±2.6) years, and 272 patients (81.4%) were male) were recruited. Among them, 101 matched case-control pairs completed the collection of urine samples. According to the statistical analysis, the scores of total CSHQ, bedtime resistance, sleep onset delay, sleep duration, night waking, parasomnia, sleep disordered breathing and daytime sleepiness in children with ASD were significantly higher than those in the control group (48.2±6.2 vs. 46.6±5.4, 11.4±2.5 vs. 10.7±2.8, 1.7±0.8 vs. 1.5±0.7, 4.1±1.4 vs. 3.7±1.1, 4.2±1.5 vs. 3.8±1.1, 8.5±1.5 vs. 8.3±1.4, 3.7±1.0 vs. 3.4±0.8, 11.7±2.5 vs. 12.4±2.7, t=3.16, 3.00, 3.23, 2.76, 3.19, 1.99, 3.45,-2.72, P=0.002, 0.003, 0.001, 0.006, 0.002, 0.048, 0.001, 0.007), the level of 6-SM was significantly lower in children with ASD than that of healthy controls ((1.24±0.50) vs. (1.68±0.63)μg/h, t=-5.50, P<0.01), and the total CSHQ score was negatively correlated with the level of 6-SM (r=-0.50, P<0.01). Conclusion The children with ASD were at high risk for sleep problems, and the melatonin metabolite of ASD group was abnormal compared with that of the control group. Moreover, there was a negative correlation between the severity of sleep problems and the level of 6-SM in ASD children. The results of our study indicate that the abnormal melatonin metabolism may be one of the causes of sleep problems in children with ASD.