Objective To study the relationship between cognitive dysfunction and location of lesion and prognosis in patients with cerebral infarction.Methods 120 patients with cerebral infarction in the Second People's Hospital of Yueqing were selected.According the results of the cerebral CT or MRI,the patients were divided into primary group(58 cases)and recurrence group (62 cases).3 -10days after admission,the cognitive impairment was evaluated with the method of simple mental state examination (MMSE)scale.The stroke score of the National Institutes of health(NIHSS)in the United States and ability of daily life activity Barthel index score before the admission and after the discharge were conducted on the patients.And the relationship between different lesion location of primary or recurrent infarction,cognitive disability and prognosis were observed.Results The incidence of cognitive impairment in the ecurrence group was 90.32%,which was obviously higher than 72.41% in the primary group(χ2 =6.419,P =0.011);In the two groups,the proportion of thalamic cortex was the highest,but there was no significant difference between the two groups (χ2 =0.000,P =1.000).The NIHSS and Barthel scores of patients with thalamic infarction were (11.4 ±1.6)points and (27.5 ±3.7)points respectively,both of which were the highest(FNIHSS =47.22, PNIHSS =0.000;FBarthel index =17.77,PBarthel index =0.000);the NIHSS and Barthel indexes in each part of the two groups at discharge were lower than those before the admission (all P <0.01),and the differences at admission was not statistically significant(P >0.05);the NIHSS scores of the primary group and the recurrent group at discharge were (6.3 ±0.5)points and (7.8 ±0.7)points respectively;the Barthel scores were (24.3 ±7.3)points and (30.8 ± 6.8)points respectively.And all of them were lower than those at admission and the improvement degree of the primary group were more significant than those of the recurrence group(tNIHSS =13.43,PNIHSS =0.000;tBarthel index =5.05, PBarthel index =0.000).Conclusion Cognitive impairment after cerebral infarction is associated with lesion,and thalamic infarction is the most prone to perform cognitive disfunction with poor prognosis,and the frontal and temporal lobe are also common parts where targeted prevention is needed.

Objective To investigate the Huatan Huoxue Jiangqi prescription in treating AECOPD clinical curative effect. Methods 123 patients with AECOPD were randomly divided into the treatment group and the control group. The two groups were treated with western medicine, and the treatment group added with Chinese herbal medicine treatment with Huatan Huoxue Jiangqi prescription. The syndrome effect, clinical symptom score, CAT score, mMRC classification, lung function, the serum FIB and CRP levels were obtained to evaluate the efficacy of the two groups before and after treatment. Results The syndrome effect of the treatment group was significantly better than that of the control group. Compared with the control group, there was significant difference between traditional Chinese medicine syndrome score, CAT score (P < 0.05); Lung function (including FEV1, FEV1%, FEV1/FVC) was significantly improved in the treatment group after treatment (P < 0.05). The serum FIB and CRP levels decreased significantly in the treatment group compared with the control group (P < 0.05). Conclusion Huatan Huoxue Jiangqi prescription has reliable effets on treating AECOPD.

Objective:To investigate the correlation between platelet distribution width(PDW)and cerebral microbleeds(CMB)in the middle-aged and elderly population.Methods:A total of 2 839 subjects who underwent cranial magnetic resonance imaging(MRI)examination at Lishui Hospital of Zhejiang University from May 2016 to December were enrolled in this cross-sectional study.According to MRI results, subjects were divided into the CMB group(n=525)and the non-CMB group(n=2 314). Clinical data and PDW levels were compared between the two groups.CMB-related factors were analyzed by using a logistic regression equation.A receiver operating characteristics(ROC)curve was drawn to analyze the value of PDW levels in predicting the incidence of CMB.Results:The percentage of males, the proportion of smokers, the number of subjects with diabetes and serum creatinine levels were higher in the CMB group than in the non-CMB group[(55.05%(289/525) vs.45.12%(1 044/2 314), 42.67%(224/525) vs.34.67%(802/2 314), 12.76%(67/525) vs.9.51%(220/2 314), (68.91±21.38)μmol/L vs.(66.45±15.40)μmol/L, all P<0.05]. PDW levels were higher in the CMB group than in the non-CMB group(15.52±2.49)% vs.(14.67±2.90)%, χ2=93.75, P<0.05). Multivariate logistic regression analysis showed that the PDW level was an independent risk factor for CMB in the middle-aged and elderly population( OR=1.13, P<0.05). The area under the ROC curve(AUC)of PDW in predicting the incidence of CMB was 0.582, and with 15.95% as the optimal threshold value, the sensitivity and specificity were 75.0% and 41.8%.Patients were divided into the high PDW sub-group(n=1 691)and the low PDW sub-group(n=1 083)based on the PDW cutoff at 15.95%.The number of CMB and the incidence of CMB were higher in the high PDW group than in the low PDW group(0.75 vs.0.48, 23.3% or 394/1 691 vs.12.1% or 131/1 083, χ2=30.37 and 51.28, P<0.05). Conclusions:PDW levels are high in middle-aged and elderly patients with CMB, and elevated PDW levels are an independent risk factor for CMB.

Objective: To understand the knowledge of disinfection and its influencing factors among caregivers in childcare centers in Huangpu District, Shanghai, in order to provide a basis for the future development of targeted training programs and the work plan to enhance the professional level of disinfection practitioners in childcare centers. Methods: A total of 423 caregivers from 62 childcare centers (including nursery schools) in Huangpu District were selected for a questionnaire about disinfection knowledge, influencing factors, and training needs in March 2023. Differences in disinfection knowledge among subjects with different characteristics were compared using χ 2 tests, and influencing factors were analyzed using a multi factor binary Logistic regression model. Results: The overall knowledge rate of disinfection among caregivers was 50.12%, and those in public kindergartens, private ones, and nursery schools were 51.35%, 46.18%, and 42.57%, respectively, with statistically significant differences ( χ 2=14.25, P < 0.05 ). The caregivers in the highest level kindergartens ( OR =4.50, 95% CI =1.97-10.29), in first level ones ( OR =4.29, 95% CI = 1.98-9.33), in the institutions had clusters of outbreaks ( OR =1.87, 95% CI =1.14-3.07), in which the number of children to caregivers ratio being less than 10∶1 ( OR =21.81, 95% CI =2.55-186.59), with 6-14 years of working experience ( OR =3.51, 95% CI = 1.59 -7.75) had better knowledge of disinfection( P <0.05). Conclusions Knowledge of disinfection among caregivers of childcare institutions is low in Huangpu District, Shanghai. Training of caregivers disinfection knowledge should be strengthened for caregivers with fewer years of experience, in childcare institutions, to improve caregivers disinfection expertise and skills.