Objective To investigate the effect of enteral nutrition on the improvement of the nutritional status and prevention of complications in elderly stroke patients with eating difficulties,and provide theoretical guidance for clinical treatment.Methods Eighty-two cases of elderly stroke patients with eating difficulties after stroke were randomly divided into two groups by the time of admission,41 cases in control group were given with parenteral alimentation,and 41 cases in treatment group were given with enteral nutrition.Before treatment and 3 weeks after treatment triceps skinfold (TSF),arm muscle circumference (AMC),serum hemoglobin (Hb),albumin (ALB),serum total protein (TP),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglycerides (TG),total cholesterol (TC) and fasting plasma glucose (FPG) was measured,and the incidence of complications was observed.Results The TSF,AMC,Hb,ALB,TP,HDL-C,LDL-C,TG,TC and FPG after 3 weeks treatment in control group was significantly lower than that before treatment (P ＜ 0.05),but in treatment group compared with that before treatment there was no significant difference (P ＞ 0.05).The TSF,AMC,Hb,ALB,TP,HDL-C,LDL-C,TG,TC and FPG after 3 weeks treatment in treatment group was significantly higher than that in control group (P ＜ 0.05).The incidence of complications in treatment group was signifcanfly lower than that in control group [36.6％ (15/41) vs.78.0％ (32/41)] (P ＜ 0.05).Conclusions Enteral nutrition is conducive to the nutritional status of elderly stroke patients with dysphagia improvement,and can greatly reduce the incidence of complications,and improve survival rate.It is worthy of promotion.

Objective:To analyze the ultrasound and CT imaging findings of medullary soonge kidney, to improve the diagnosis level of medullary soonge kidney.Methods: Fourty cases confirmed by pathology or clinical were divided into two groups, group A: 20 cases by B ultrasonic examination, group B: 20 cases by CT examination, The two groups of imaging data were retrospectively analyzed.Results: Ultrasound examination reveals strong echo mass or strong echo plague in the renal medulla, radiate out along the renal pyramid, Strong echo edge is coarse, same size, within small anechoic areas. MSCT finds multiple small mottled stones in the cone. Enhanced scan finds contrast agent filling around renal collecting duct stones, presents visible stripes or small cystic contrast agent accumulation when no stones in renal collecting duct. CT diagnosis coincidence rate is slightly higher than that of ultrasounds, but there was no significant differences in positive rate(x2=2.057,P>0.05).Conclusion: Medullary sponge kidney has a typical ultrasound, CT performance. A combination of them is conducive to clinical diagnosis.

Objective To evaluate the cost-effectiveness of four therapeutic regimes in the treatment of pa-tients with initial vulvovaginal eandidiasis. Methods 160 patients who were found for the first time with vulvovagi-hal eandidiasis were divided into four groups randomly: group A is clotrimazole (500rag) vaginal tablets; group B is fluconazole eaptica;group C is clotrimazole vaginal tablets combined with flueonazole;group D is nystatin vaginal ef-fervescent tablets. Date was evaluated using clinic economies co,t-effectiveness analysis. Results Among four groups,the costs for group A,B,C and D were 167.20 yuan, 190.23 yuan,237.43 ynan and 216.40 yuan,respec-tively. The tatol effective rates were 90.88 %, 90.12 %, 91.67 % and 67.10 %, respectively. The cost-effectiveness ratio were 1.84,2.11,2.59 and 3.23, respectively. The incremental cost-effectiveness ratios of group B, C and D vs group A were 32.90,87.78 and 2.07. Conclusion Regime A was superior than the other therapeutic regimes.

Although coronary heart disease (CHD) and stroke share important risk factors,some associations differ between these two components of cardiovascular diseases.The objective of this study was to compare vascular risk factor profiles and in-hospital outcomes in acute stroke (AS) and acute myocardial infarction (AMI) patients.Methods We evaluated 383 consecutive patients who were admitted to the 94th Hospital of Chinese PLA and the Third Hospital of Nanchang with diagnoses of AS (ischemic stroke or intracerebral hemorrhage;n = 310) or AMI (n = 73) during a 2-year period.The frequency of risk factors and inhospital mortality rates were assessed in both groups.Results AS patients were significantly older than AMI patients ( 68.9 ± 9.1 years vs.62.8 ±11.7 years;P ＜ 0.01).AMI was significantly more common than AS in patients younger than 65 years;51% of this group had AMI and 26% had AS (P ＜ 0.001).Hypertension was more common in AS patients than in AMI patients (69% vs.58%;P = 0.042).Patients who died did not differ significantly in age between the groups.In-hospital mortality rates were significantly higher in AS than AMI cases (31% vs.12%,P ＜ 0.001 for all patients;37% vs.5%,P ＜ 0.001 for men).Women hospitalized for AMI were more likely to die in hospital than men (28% vs.5%;P = 0.002).Conclusions Patients with stroke and with AMI differ in their risk factor profile.Age at the time of presentation was a significant differentiating factor between patients with AS and AMI.We observed significantly higher in-hospital mortality for patients with AS (when adjusted for age) than for patients with AMI.(J Geriatr Cardiol 2008;5:223-226)

Aim: To develop marine microporous osmotic pump tablets and to investigate drug release in vitro of the optimized formulation and the release mechanism.Methods: Wet granulation and film-coating were used to develop marine micro-osmotic pump tablets.In vitro release studies were applied to evaluate the impacts of various factors on the release of the formulation.Central-composite design was exploited to aid the optimization of the formulation,and the mechanism of in vitro release was characterized.Results: There existed fairly good reproducibility in the preparation of marine micro-osmotic pump tablets.It was found that no change in the release rate of the tablets were elicited by the pH of the release media,the rotating speed selected,the hardness of the tablet core,and the amount of the plasticizer incorporated into the coating formulation.It was proved that the release of marine micro-osmotic pump tablets was closely related to the magnitudes of NaCl amount in the tablet core and the pore former in the coating formulation as well as the coating level.In addition,there existed 12-hr zero-order kinetics in the in vitro release study of the tablets.Moreover,it was shown that the osmotic pressure-controlled delivery is greatly responsi-ble for the release of the developed tablets.Conclusion: The prepared marine microporons osmotic pump tablets are expected to be a new sustained-release medication.

Objective To explore the application and effect of psychological intervention in stimulating intravenous infusion of drugs in neurology department. Methods In the control group, the patients in the neurology department selected appropriate stimulant drugs according to their actual conditions, and the patients in the study group received psychological intervention on the basis of stimulating drugs and intravenous treatment. Records the two groups of neurology patients treatment compliance, before and after treatment of neurological function changes, the data into the SPSS software, after statistical analysis, and draw conclusions. Results Before treatment, two groups of neurology patients were compared with the NIHSS scale score; after the treatment of nerve function improvement (NIHSS scale decline) than the control group, the study group (P<0.05). Department of neurology patients with complete compliance (82.61%) was significantly higher than the control group (50.00%, P<0.05). Conclusion On the basis of stimulating drugs intravenous infusion in the treatment of Neurology, patients with targeted psychological intervention can significantly improve the treatment compliance, and is conducive to the protection of patients with drug treatment effect.

Objective To investigate the clinical effect of psychological intervention combined with insulin, glimepiride in the treatment of patients with diabetes mellitus. Methods 60 cases of patients with diabetes treated in our hospital from January 2015 to January 2017 were divided into two groups.The control group was treated with routine nursing intervention and insulin treatment, the observation group was treated with psychological intervention+insulin+glimepiride therapy; The clinical efficacy and clinical symptoms in the two groups were compared. Results The clinical effect of the observation group was better than that of the conventional control group,the clinical symptoms improved was better than the control group, the difference was statistically significant (P<0.05). Conclusion The clinical effect of psychological intervention+insulin+glimepiride in the treatment of diabetes is significantly, can effectively improve the clinical symptoms of patients, is widely used in clinical treatment of patients with diabetes.

Objective Study the imaging characteristics of spontaneous intracranial hypotension(SIH) and the effect of epidural infusion treatment.Methods Clinical data of one patient with SIH was retrospective analysis.Results The patient presented with symptoms of postural headache,nausea,vomiting;pressure of cerebrospinal fluid(CSF) couldn't be measured.Cranial MRI found typical subdural fluid collections,diffuse thickening of the pachymeninges with enhancement,engorgement of venous sinuses,enlargement of the pituitary gland,and downward displacement of the brain.High-resolution CT myelography precisely located the site of CSF leak.Epidural infusion of normal saline relieved immediately the symptom of intracranial hypotension.Conclusions The imaging characteristics of SIH includes engorgement of venous sinuses,diffuse thickening of the pachymeninges with Gd enhancement,subdural fluid collections.The treatment with epidural infusion for SIH is very effectual.

Objective To explore the effects of glycosylation in E2 and E1 protein on specific cell fusion in rubella virus(RV)strain JR23.Methods Site-directed mutagenesis was used tO obtain mutants containing new enzyme sites on the E2 and E1 gene of RV JR23.All the mutants and wild type proteins were expressed in BHK21 cells and treated with acid medium to induce specific cell fusion.The fusion functions were assayed with Giemsa staining and reporter gene method for qualitative and quantitative analysis,respectively.Expression efficieneies of mutant proteins on cell surface were quantified with fluorescence-activated cell sorter(FACS).Hemadsorption assays were performed to detect binding activity of mutant proteins qualitatively and quantitatively.Results Mutant proteins E2 N53G,S73I and S131V had 62.73%,66.66%and 55.12% of fusion activities,and E1 T78A,T179A and T211A had 66.93%,87.33%and 90.18%of fusion activities,respectively,as compared with the wild type protein.The FACS indicated that the expression efficiencies of all the mutant proteins except E2 S131V were lower than that of the wild type protein.Hemadsorption assays demonstrated that binding abilities of E2 S73I and E1 T78A decreased slightly,but that of the other four mutant proteins Wns almost same as the wild type protein. Conclusion Glycosylation on E2 N53,N71,N129 and E1 N76 were important for the specific cell fusion,but E1 N177 and N209 were almost not.

Objective To evaluate the diagnostic superiority of endoscopic ultrasonography (EUS) in primary gastric lymphoma (PGL) and its value in follow-up.Methods From January 2012 to June 2015,38 patients with suspected PGL under regular gastroendoscopy,biopsy and surgery operation received EUS combined with targeted deep biopsy.T test and chi-square test were performed for statistical analysis.Results Among 50 patients suspected for PGL under regular gastroendoscopy,38 patients were confirmed pathologically.The sensitivity of EUS examination with targeted deep biopsy in PGL was 86.8％ (33/38),the specificity was 83.3％ (10/12) and accuracy was 86.0％ (43/50).The accuracy of EUS examination with deep biopsy was higher than that of regular gastroscopy,and the difference was statistically significant (86.0％ (43/50) vs 57.9％ (22/38),x2 =19.4,P＜0.05).The main endosonographic characteristics of PGL were partial or diffuse thickening of stomach wall presented with,even or uneven hypoechoic lesions and extramural enlarged lymph nodes.Compared with pathological stage after surgery,the accuracy of T and N stage of EUS was 8/8 and 7/8.The times to achieve complete remission of Helicobacter pylori (H.pylori) eradication group and H.pylori eradication group were (3.3±0.8) months and (4.6± 0.9) months,respectively,and the difference between the two groups was statistically significant (t =4.3,P＜0.05).Conclusions The detection rate of EUS combined with targeted deep biopsy is high,which could clearly indicate the depth and extent of lesion invasion and guide clinical stage and selection of therapy.EUS could effectively evaluate efficacy of PGL treatment.