Objective To investigate the incidence of fetal malnutrition( FM), its affected factors and their relationship with small - for gestational - age (SGA) fetus. Methods The intrauterinal growth of fetus was evaluated by the body weight of neonates and FM was detected by clinical assessment of nutritional status ( CANS ). Results ①33 out of 204 cases were found to be FM (16% ). FM in SGA group was significantly higher than that in AGA group ( 5.9% ) (x2 = 69.9, P ＜ 0. 01 ).② When ot = 0. 05, the body weight and head circumference of neonates, the education level of mothers were included into logistic regression model, and their regression coefficient were negative. Conclusion SGA was supposed to be two of the risk factors in developing FM. Fetus with low body weight, small head circumference and not - so - well educated mother were prone to suffer from FM.

Objective To observe the clinical feasibility and effects of regional nerve blockade in patients with heart failure.Methods The study enrolled a total of 10 patients,age range from 55 to 75 years old(average 64?11 years old).The subject includes 8 males and 2 females,among which 6 cases were ischemic cardiomyopathy and 4 cases were dilated cardiomyopathy.All the patients met the criteria of NYHA class Ⅲ-Ⅳ heart function with heavy fluid load unresponsive to optimal medical therapy.Patients with diabetes and renal failure were ruled out from the study.After application of local anesthesia,15 mL of 0.25% Naropin was injected inside Gerota's fascia to achieve regional nerve blockade under CT guidance.Serum and urine electrolytes,neurohormones,renal clearance of sodium and 24-hour urine volume were recorded 24 h before and after the operation.Variartions in heart rate,blood pressure and symptons of dyspnea and edema were also under monitor.Results After nerve blockade,the 24-hour urine volume and renal sodium clearance increased obviously while the level of neurohormones decreased compared with that before operation.No obvious changes in heart rate and blood pressure were recorded and the symptons of heart failure were improved in the patients after operation. No complication was recorded in the study. Conclusion Regional nerve blockade may be a feasible,safe and effective treatment for congestive heart failure patients who do not respond well to the existing optimal medical therapy.

0.05) while other indicators did not. All the data were simply related to each other. The primary influencing factors to NDS score 1, in decreasing order of impact were volume of infarction, position of infarction, hs-CRP and FBS. While the primary influencing factors to NDS score 3 at the end of 1 month treatment, in decreasing order of impact, were NDS score 1, size of infarction, FG, hs-CRP and TC. Conclusions Volume of infarction and hs-CRP are very important determining factors in both NDS score 1 at the beginning of the treatment and NDS score 3 at the end of 1 month treatment. However, in determining NDS score 3 at the end of 1 month treatment, the impact of FG is greater than hs-CRP. The other influencing factors include FBS, TC and so on. Therefore we conclude that it is helpful to recover from neurologic deficit through lowing these influencing factors directly by medication.

Objective To compare the clinical effects of mini phalangeal external fixation and mini plate in the treatment of intraarticular fractures of the metacarpal bone head,and to provide a theoretical basis for clinical selection of surgical plan. Methods Seventy?four cases of metacarpal bone head intraarticular fractures treated in Huizhou People′s Central Hospital from March 2014 to March 2016 were selected as the research object. All cases were closed fractures and were randomly divided into the external fixation group and the mini plate group,37 cases in each group and treated respectively with the mini phalangeal external fixator and mini AO plate. The patients were followed up for 6 months to 1 year,the function of the metacarpophalangeal joint,the union of the fracture and the incidence of side effects were compared between the two groups. Results The excellent rates of the external fixation group at 6 months and I year after operation were 91. 9% ( 34/37) and 97. 3%( 36/37) respectively,which were significantly higher than those of the mini plate group ( 73. 0%( 27/37) ,81. 2%( 30/37 ) ) , the difference was statistically significant (χ2 = 7. 120, 7. 062, P<0. 05 ) . The complication rate of the external fixation group was 2. 7%( 1/37) ,which was significantly lower than that of the mini plate group ( 24. 3% ( 9/37 ) ) , the difference was statistically significant ( P=0. 014 ) . The average fracture healing time in the external fixator group was (2. 6±0. 4) months,which was significantly lower than that in the mini plate group (3. 1±0. 7) months,the difference was statistically significant (t=2. 40,P<0. 001) . Conclusion In the treatment of metacarpal bone head fracture,the external fixation has small trauma,can do cross joint fixation,and maintain a good fixation strength,and promote the healing of fracture and the recovery of metacarpophalangeal joint function. It is worthy of clinical application.

Objective To evaluate the feasibility of catheter ablation of Para-Hisian Atrial Tachycardia guide by CARTO. Method Catheter ablation guided by CARTO was performed after activation map in three patients with Para-Hisian Atrial Tachycardia. Result Successful ablation was got at right atrial in two patients and at non-coronary in one patient. Conclusion Catheter ablation guided by CARTO is safe and efficient for Para-Hisian Atrial Tachycardia.

The therapeutic effects of a high fibre diet composed of naturally high fibre foodstuffs containing protein, various essential amino acids and trace elements (Zn, Cr etc.) on diabetics were tested both experimentally and clinically. The high fibre diet or steamed bread (for control) with identical carbohydrate content was taken by normal mice, alloxan diabetic mice and nine healthy volunteers. The high fibre diet caused significant reduction in the blood glucose area (carbohydrate tolerance) as compared with the steamed bread. In another study, eighteen non-insulin dependent diabetic patients (10 females, 8 males) were administered the high fibre diet for 34 days, the average fasting and 2 h postprandial blood glucose level were significantly lower than those before the test, but no difference was observed in blood electrolytes. This implied that no malabsorption occurred during the testing period. At the same time, 16 of the 17 overweight patients were found to have a reduction of weights. In addition, improvement of symptoms (poly-dipsia polyuria, constipation etc) both in diabetic animals and in patients was observed. This study indicates that the high fibre diet is benificial for diabetic patients.

Objective:To investigate the diagnostic value of 11C-Pittsburgh compound B (PIB) in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD) and explore the factors that may affect the binding of 11C-PIB. Methods:From January 2017 to December 2019, the 11C-PIB uptake of 6 patients with normal cognitive (NC; 3 males, 3 females, age: (64.5±12.3) years), 11 patients with MCI (4 males, 7 females, age: (64.5±9.8) years) and 21 patients with AD (7 males, 14 females, age: (68.1±9.1) years) from Daping Hospital, Army Medical University were retrospectively analyzed. Regional 11C-PIB binding was assessed by using standardized uptake value ratio (SUVR) and visual reading of 11C-PIB scan. Clinical data, including age, gender, education level, cognitive impairment, neuropsychological scale score, vascular risk factors (VRF), apolipoprotein E (ApoE) gene, were collected and differences among groups were analyzed by using one-way analysis of variance, least significant difference t test or Fisher exact test. Factors that affected the 11C-PIB binding were analyzed by multiple linear regression. Results:SUVR of cerebral lobe among NC, MCI and AD groups were significantly different (range of mean SUVR: 1.16-1.26, 1.19-1.35 and 1.40-1.61; F values: 5.331-9.279, all P<0.05). For positive PIB patients, SUVR of posterior cingulate and precuneus were increased in MCI group compared with NC group (1.20±0.15 vs 1.50±0.12, 1.18±0.15 vs 1.59±0.13; F values: 6.389 and 10.668, t values: -2.33 and -3.10, both P<0.05), and there were no significant differences in all lobes between MCI and AD group ( t values: from -1.29 to -0.51, all P>0.05). Visual analysis showed that the positive rates of PIB in frontal lobe (85.7%(18/21)), posterior cingulate (85.7%(18/21)), precuneus (81.0%(17/21)), temporal lobe (81.0%(17/21)) and occipital lobe (47.6%(10/21)) in AD were higher than those in MCI (4/11, 4/11, 4/11, 3/11 and 1/11, respectively; all P<0.05). Multiple linear regression showed that the degree of cognitive impairment were independent risk factors for SUVR of all lobes ( b values: 0.377-0.536, all P<0.05). The ApoE ε4 gene was independent risk factor for SUVR of precuneus ( b=0.290, P<0.05). Conclusion:11C-PIB is helpful for clinical diagnosis of MCI and AD patients and the degree of cognitive impairment and ApoE ε4 gene may be independent risk factors for increasing 11C-PIB binding.

PURPOSE: This study aimed to describe the system of continuing medical education (CME) in the Guangxi Zhuang Autonomous Region and to ascertain the perceived needs related to that system, in order to improve the performance of health professionals in Chinese township health centers (THCs). METHODS: In-depth key informant interviews were conducted to gain insights into the current CME system. A cross-sectional survey using a self-administered structured questionnaire was also carried out from March to August 2014 in order to identify perceived needs among THC personnel in the Guangxi Zhuang Autonomous Region. Logistic regression was used to identify factors related to respondents' interest in pursuing different levels of degree study. RESULTS: The areas of need perceived by the respondents included general clinical competence and emergency or first aid knowledge. Most respondents wanted to study at medical colleges in order to obtain a higher degree. Respondents aged below 45 years with neutral or positive attitudes about the benefit of degree study for the licensure examination were more likely to attend a bachelor-level CME program than their older peers and respondents with negative attitudes towards degree study. Female respondents and respondents aged below 45 years were more likely to attend a junior college CME program than males and older respondents, respectively. CONCLUSION: It is necessary to develop degree-linked CME programs to meet the need for young health professionals in Chinese THCs; therefore, this programs can improve the expertise of poorly educated young health workers, who overwhelm rural Chinese heath systems.
Asian Continental Ancestry Group* ; China ; Clinical Competence ; Cross-Sectional Studies ; Surveys and Questionnaires ; Dronabinol ; Education, Medical, Continuing* ; Emergencies ; Female ; First Aid ; Health Occupations* ; Health Services Needs and Demand ; Humans ; Licensure ; Logistic Models ; Male ; Child Health

Objective:To explore the effect of the care and nursing practice plan based on the timing theory in primary caregivers of infants with infantile spasms.Methods:From July 2019 to June 2020, 80 infants with infantile spasm and 80 primary caregivers in the Department of Neurology of Hunan Children's Hospital were selected as the research object. All infants with infantile spasms were numbered according to the time of admission. The odd-numbered infants were admitted to the First Department of Neurology as the observation group, and the even-numbered children were admitted to the Second Department of Neurology as the control group, with 40 infants and 40 primary caregivers in each group. The control group carried out conventional treatment and nursing, and the observation group implemented a care and nursing practice plan based on the timing theory on the basis of the control group. Before and after the intervention, the Caring Ability Inventory (CAI) , Family Caregiver Task Inventory (FCTI) , Caregiver Burden Inventory (CBI) , and Gesell Developmental Schedules (GDS) were used to evaluate the caring ability, caregiving ability, care load of the primary caregivers of the two groups of infants, and the cognition function of the two groups of infants.Results:After the intervention, the total CAI scores of the primary caregivers in the observation group were higher than those before intervention and those in the control group after the intervention, and the total scores of FCTI and CBI were lower than those before intervention and those in the control group after the intervention, and the differences were statistically significant ( P<0.05) . After the intervention, the developmental quotient (DQ) values of the five energy areas of GDS in the observation group were higher than those before the intervention, and the DQ values of the three energy areas of gross motor, fine motor, and language were higher than those of the control group after the intervention, and the differences were statistically significant ( P<0.05) . Conclusions:The care and nursing practice plan based on the timing theory can improve the caring ability and caregiving ability of the main caregivers of children with infantile spasms, reduce the care load, and improve the cognitive function of the children.

OBJECTIVETo evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in children with pancreaticobiliary diseases and the characteristics of pancreaticobiliary disorders in children.

METHODRetrospective review was conducted on the data of patients younger than 18 years who underwent ERCP between 2005 and 2012 at West China Hospital. The indications,ERCP findings, ERCP procedures, complications, and clinical outcomes were evaluated.ERCP procedures were performed using standard duodenoscopes under general anaesthesia or sedation, which included all endoscopic treatments, such as endoscopic sphincteropapillotomy, stone extraction, stent treatment and so on.

RESULTOne hundred and two ERCPs were performed on 68 patients, and all the procedures were successfully completed in 100% cases. There were 39 girls (57%), and median age at time of procedure was 14.6 years (range, 5-17 years).General anesthesia and sedation were performed in 81% and 19% of procedures, respectively. The ERCP findings were classified as follows:bile duct stone(s) (n = 37, 54%), pancreatic duct stone(s) (n = 8, 12%), bile duct benign stricture (n = 7, 10%) and other nonmalignant pancreaticobiliary diseases (n = 16, 24%).Four cases (4/102, prevalence 4%) were complicated with post-ERCP pancreatitis.Symptoms such as abdominal pain and jaundice were cured obviously after the procedures of ERCP were performed.

CONCLUSIONThe main characteristics of pancreaticobiliary disorders in children were nonmalignant pancreaticobiliary diseases, such as bile duct stone, pancreatic duct stone, and bile/pancreatic duct benign stricture.When performed by well-trained endoscopists, ERCP is safe and effective in children.

Adolescent ; Biliary Tract Diseases ; diagnostic imaging ; surgery ; Calculi ; diagnosis ; pathology ; surgery ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; diagnosis ; pathology ; surgery ; Female ; Humans ; Male ; Pancreatic Diseases ; diagnosis ; pathology ; surgery ; Pancreatic Ducts ; diagnostic imaging ; surgery ; Retrospective Studies ; Treatment Outcome