Ischemic stroke has the characteristics of high morbidity,high mortality and high disability rate,which brings to the society and family burden and pain.Therefore,effective prevention is especially important.Primary prevention of stroke is to prevent maiden stroke,mainly to improve lifestyle,and control all kinds of controllable risk factors positively.Secondary prevention of stroke is to prevent the recurrence of stroke,in addition to the causes,prevention,antiplatelet therapy,and anticoagulant therapy are included.

OBJECTIVETo explore the maintenance effects of acupoint catgut embedding at early time on gastrointestinal function in patients with craniocerebral injury.

METHODSSixty craniocerebral injury patients with 5 to 12 points of Glasgow coma scale (GCS), according to treatment order, were alternately divided into an observation group and a control group, 30 cases in each one. Patients in the control group were treated with regular treatment and nursing care. Based on this, patients in the observation group, according to different pathogenesis and symptoms presented within 24 h into hospitalization, were additionally treated with acupoint catgut embedding. The recovery time of borborygmus, time of first anal aerofluxus, time of first defecation, abdominal pressure at different time points, the occurrence rate of complications (upper gastrointestinal hemorrhage, diarrhea, vomiting), time of enteral nutrition tolerance rate reaching 30 kcal/kg x d were observed and recorded.

RESULTSThe recovery time of borborygmus, time of first anal aerofluxus, time of first defecation and time of enteral nutrition tolerance rate reaching 30 kcal/kg x d in the observation group were all earlier to those in the control group (all P<0.01). At 48 h, 4 d and 7 d into hospitalization, the abdominal pressures in the observation group were all lower than those in the control group [(11.10 +/- 1.47) mmHg vs. (13.50 +/- 1.43) mmHg, (8.40 +/- 1.25) mmHg vs. (11.90 +/- 1.56) mmHg, (6.73 +/- 0.74) mmHg vs. (10.80 +/- 1.30) mmHg, all P<0.01]. There were 8 cases with complications of gastrointestinal hemorrhage, diarrhea and vomiting in the observation group with the occurrence rate o 27% (8/30), which was lower than those in the control group (70.0% (21/30), P<0.01.

CONCLUSIONThe acupoint catgut embedding at early time in craniocerebral injury patients could improve the recovery of gastrointestinal function, reduce intolerance of enteral nutrition and occurrence rate of various complications.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Catgut ; Craniocerebral Trauma ; physiopathology ; therapy ; Female ; Gastrointestinal Tract ; physiopathology ; Humans ; Male ; Middle Aged ; Young Adult

Objective To investigate the effect of labetalol in treatment of severe preeclampsia clinical effect.Methods The control group of severe preeclampsia patients received routine clinical treatment,the study group were treated with labetalol,two groups of patients with severe preeclampsia were treated for 7 d.Results After treatment,the two groups of DBP,SBP,HR,and 24 HUP were significantly lower than before,the study group improved the above indicators better(P<0.05).The study group of patients with severe preeclampsia premature delivery rate,postpartum hemorrhage rate,neonatal asphyxia rate(10.20%,8.16%,6.12%)were significantly lower than the control group(28.57%,34.69%,20.41%)(P<0.05).Conclusion The application of conventional therapy combined with labetalol can significantly improve the hypotensive effect of severe preeclampsia,is conducive to the protection of maternal physical and mental health and life safety.

Objective To investigate the influence of low-dose,long-term arsenite exposure on keratinocyte (HaCat) cell apoptosis and the expression of Bcl-2 and Bax proteins.Methods HaCat cells were exposed to different concentrations of NaAsO2[0(control group),0.05,0.10 μmol/L] for 15 weeks.A total of 10 000 cells in each group were measured to detect the level of apoptosis by flow cytometry.The protein expressions of Bcl-2 and Bax were determined by Western blotting method.Results The cell apoptosis rate was significantly different between groups (F =17.19,P ＜ 0.05).Compared with that of the control [(1.42 ± 0.13)％],the apoptosis rates of the 0.05 and 0.10 μmol/L groups [(1.23 ± 0.08)％ and (1.04 ± 0.06)％] decreased significantly (all P ＜ 0.05); the 0.10 μmol/L group was significantly lower than that of the 0.05 μmol/L group(P ＜ 0.05).The protein expressions of Bcl-2 and Bax were significantly different between groups (F=107.38,346.45,all P＜ 0.05).The protein expression of Bcl-2 of the 0.05 and 0.10 μmol/L groups were (143.89 ± 7.74)％ and (199.96 ± 12.18)％,respectively,which were significantly higher than that of the control group[(100.00 ± 1.45)％,all P ＜ 0.05] ; the 0.10 μmol/L group was significantly higher than that of the 0.05 μmol/L group (P ＜ 0.05).The protein expression of Bax of the 0.05 and 0.10 μmol/L groups were (70.78 ± 1.53)％ and (54.80 ± 1.34)％,respectively,which were markedly lower than that of the control group[(100.00 ± 3.09)％,all P ＜ 0.05]; the 0.10 μmoL/L group was significantly lower than that of the 0.05 μmol/L group(P ＜ 0.05).Conclusion Decreased level of apoptosis induced by low level and long-term arsenic exposure may be associated with increased expression of Bcl-2 protein and decreased expression of Bax protein.

Objective To study the effects of different drying processes on the effective constituents in Wen Codonopsis pilosula (WPP) Decoction Pieces; To develop the optimized producing and preparing integration process based on fresh WPP.MethodsFresh WPP in harvest period was prepared respectively as follows:① Fresh WPP was dried to different percentage (30%–100%) of original moisture contents of crude drugs at 80℃ in oven, then sliced and dried at 50℃ to obtain eight decoction pieces of WPP (XⅠYP1–8).② The fresh WPP was baked to 50% of water content of crude drug under different temperatures (50–120℃), respectively, then sliced and dried at 50℃ to obtain eight decoction pieces of WPP (XⅡYP1–8).③ Dried WPP was moistened, sliced and naturally dried, then were renamed as traditional decoction pieces. The contents of lobetyolin and atractylenolideⅢ was determined by HPLC. The phenol-sulfuric acid and colorimetric method were applied respectively to detect contents of polysaccharide and total flavonoids. The contents of aqueous and alcoholic extracts were determined simultaneously. Results The contents of alcoholic extracts (55.36%), aqueous extracts (54.91%) and atractylenolideⅢ (10.95 μg/g) in XⅠYP3 pieces were higher than other decoction pieces.Conclusion The optimized process was that fresh WPP was baked to water content of 50% at 80℃, then sliced and dried. Compared with conventional preparing methods,the integration process was time-saving and effort-saving. Meanwhile, the prepared pieces have higher content of active ingredients.

Objective To investigate the effects of mirror visual feedback (MVF) and electromyographic biofeedback (EMGBF) on upper extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group (n=30), EMGBF group (n=30) and MVF group (n=30). All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addition. They were assessed with Fugl-Meyer Assessment (FMA) and the Upper Extremity Function Test (UEFT), and their integrated electromyogram (iEMG) of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the iEMG after treatment (P<0.05), and ranked as the MVF group, the EMGBF group and the control group from improving more to less (P<0.05). Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.

Objective:To compare and observe the different clearance effect of milk containing anti-Helicobacter pylori specific antibody. Methods:Four H. pylori strains were used to immune dairy cows to obtain milk containing anti-Helicobacter pylori specific antibody,of which,one was standardized strain and the other three were locally epidemic. Totally 148 people were screended,in which 72 were C-14 urea breath test positive, finally 39 meet the criteria. They were divided into two groups, the test group contained 21 subjects,were treated milk containing anti-Helicobacter pylori specific antibody;the 18 subjects in control group with common milk. The study was continued for 2 months. Results:Conducting the C-14 urea breath test,9 subjects in test group were negative,but no one was changed in control group. The effective clearance rate of the test group was 42. 86%,and there was no effective clearance in the control group,so there was significant difference in the two groups(P=0. 005,P<0. 05). Conclusion: The milk containing anti-Helicobacter pylori specific antibody is polyclonal and has higher valence,and could clear H . Pylori effectively.

Objective:To explore the application value of Jiawei Yangyin Jiedu Decoction in the treatment of epidermal growth factor receptor (EGFR)- tyrosine kinase inhibitor (TKI)- related rash of lung cancer, and observe its influence on inflammatory index and immune function of patients, aiming to provide effective treatment for this disease.Methods:From December 2016 to January 2019, 90 patients with EGFR-TKI-related rash belonging to Yin deficiency and toxic type in Traditional Chinese Medicine (TCM) syndromes in Yongkang Traditional Chinese Medicine Hospital of Zhejiang Province were included. The patients were divided into control group and observation group by random digits table method with 45 case each. The patients in control group were treated with mupirocin ointment, and the patients in observation group were treated with Jiawei Yangyin Jiedu Decoction on the basis of the control group. The clinical efficacy was compared after 4 weeks.Results:After treatment, the number of lesions and the number of sites, rash area estimation, rash color and other symptoms in observation group were significantly lower than those in control group: (0.71 ± 0.27) scores vs. (1.36 ± 0.32) scores, (0.68 ± 0.14) scores vs. (1.24 ± 0.27) scores, (0.53 ± 0.17) scores vs. (1.31 ± 0.24) scores, the total effective rate was significantly higher than that in control group: 80.00% (36/45) vs. 28.89% (13/45), and there were statistical differences ( P<0.01). The blood samples of the elbows were taken before and after treatment. The immune function indexes of CD 4+/CD 8+, CD 4+ and CD 3+ after treatment in observation group were significantly higher than those in control group: 1.46 ± 0.20 vs. 1.27 ± 0.23, 0.378 ± 0.042 vs. 0.323 ± 0.031 and 0.573 ± 0.062 vs. 0.518 ± 0.060, and there were statistical differences ( P<0.05). The levels of carcinoembryonic antigen and cancer antigen 125 after treatment in observation group were significantly lower than those in control group: (28.17 ± 8.45) μg/L vs. (35.37 ± 9.73) μg/L and (25.29 ± 6.15) kU/L vs. (36.42 ± 12.06) kU/L, the quality of daily life score was significantly higher than that in control group, and there were statistical differences ( P<0.05). After treatment, the levels of inflammatory markers such as tumor necrosis factor-α and interleukin-1β in observation group were lower than those in control group, and there were statistical differences ( P<0.05). Conclusions:For patients with lung cancer EGFR-TKI-related rash, it is important to treat them with Jiawei Yangyin Jiedu Decoction, which can reduce inflammation, improve immunity and improve rash. It is worth promoting.

ObjectiveTo investigate the association between thromboelastography (TEG) parameters and bleeding in patients with liver cirrhosis and whether TEG can be used to predict the risk of spontaneous bleeding in patients with liver cirrhosis, and to provide a basis for its preventive treatment. MethodsA retrospective analysis was performed for the clinical data of 174 patients with liver cirrhosis who attended Huadu People’s Hospital from May 2018 to April 2020 and did not receive invasive procedure, and according to the condition of bleeding, they were divided into non-bleeding group(n=64), gastrointestinal bleeding group(n=61), and mucocutaneous/oronasal bleeding group(n=49). The medical record system and laboratory information system were used to collect related information and laboratory test results for statistical analysis. The t-test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. MedCalc software was used for receiver operating characteristic (ROC) curve analysis, and the area under the ROC curve (AUC) was calculated for commonly used coagulation markers and TEG parameters in predicting the risk of bleeding in patients with liver cirrhosis. Cut-off value, sensitivity, specificity, positive predictive value, and negative predictive value were determined, and the Z test was used for comparison of indices in predicting mucocutaneous/oronasal bleeding. ResultsOf all 174 patients, 110 (63.2%) experienced spontaneous bleeding, among whom 61 (55.5%) had gastrointestinal bleeding and 49 (44.5%) had mucocutaneous/oronasal bleeding. There were significant differences in maximum amplitude (MA) and K between the bleeding group and the non-bleeding group (t=2.241 and -2.605, both P＜0.05). There were significant differences between the mucocutaneous/oronasal bleeding group and the non-bleeding/gastrointestinal bleeding groups in platelet count (PLT) and the TEG parameters of clot formation time, a-angle, MA, and coagulation index (CI) (F=3.947, H=12.867, F=4.007, F=8.498, F=5.420, all P＜0.05). Among the TEG parameters, reaction time and Lys30 were generally within the normal range, while there was a prolonged kinetics (K) time and reductions in a-angle, MA, and CI. PLT ≤40×109/L, MA ≤357 mm, K time ＞4.2 minutes, a-angle ≤51.6, and CI ≤-5.9 could be used to predict spontaneous mucocutaneous/oronasal bleeding in patients with liver cirrhosis (all AUC ＞0.7), with positive predictive values of 82.4, 88.9, 81.0, 72.7, and 73.7, respectively, and negative predictive values of 68.3, 72.5, 73.0, 69.4, and 66.7, respectively. ConclusionPLT and the TEG parameters of K time, a-angle, MA, and CI can predict spontaneous bleeding caused by abnormal coagulation in liver cirrhosis, while conventional coagulation parameters prothrombin time and activated partial thromboplastin time cannot predict such bleeding, which provides a basis for the treatment of coagulation disorder and transfusion of blood components for patients with liver cirrhosis.

With the deepening of the reform of the medical and health system and the continuous optimization of the medical order,it is especially important to organize the development of admission and discharge standards and improve the service of preparing patients for discharge.In recent years,the research and application of machine learning technology in the medical field has been intensifying,and it has unique advantages in processing data and risk prediction research.Therefore,this paper reviews the development process,types of machine leaming,the content and effects of its application in patient discharge preparation services,and the current problems,in order to provide references for healthcare professionals to implement the best clinical decisions and further improve the patient discharge preparation service model.