【Objective】 To observe the promoting action of spleen-strengthening and Qi-promoting herbs on enteral nutrition(EN) for patients after abdominal surgery.【Methods】 Sixty patients after abdominal surgery were equally randomized into groups A and B.The two groups received oral use or tube feeding of enteral nutrition(Fresubin).Group A received oral use or tube feeding of the decoction with spleen-strengthening and Qi-promoting actions(composed of Radix Pseudostellariae,Rhizoma Dioscoreae,Fructus Hordei Germinatus,Pericarpium Citrus Reticulata,Radix Notoginseng) additionally.The treatment lasted one week.Before and after EN treatment,the contents of hemoglobin(Hb),total lymphocyte count(TLC),albumin(Alb),serum total protein(TP) and the ratio of albumin and globumin(A/G) were observed.【Results】After EN treatment,the above laboratory parameters were increased in the two groups as compared with those before treatment(P

Objective To identify the applicability of Traditional nutritional evaluation method,short-form mini-nutritional assessment (MNA-SF) and nutrition risk screening 2002 (NRS 2002) on screening malnutrition in elderly in-patients.Methods 100 elderly in-patients with malnutrition were screened by the above screening instruments.The evaluation effects of the 3 methods were compared by sensitivity,specificity and ROC curve.Results The detection rates of elderly in-patients with malnutrition by BMI,MNA-SF and NRS 2002 was 7％,58％ and 39％ respectively.Taking the human body measurement instrument as standard,the sensitivities of BMI,MNA-SF and NRS 2002 was 0.475,0.918 and 0.410respectively,the specificities was 0.615,0.103 and 0.641 respectively.3 tools series test sensitivity and specificities was 0.557 and 0.913 respectively,parallel test sensitivity and specificities was 0.929 and 0.435 respectively.Conclusions There is significant difference among the sensitivities of the 3 methods,NRS 2002 has the highest accuracy and is applicable to the screening of nutrition risks in elderly patients.Combined 3 kinds of tool can better improve the effect.

Depressive disorder seriously affects people's physical and mental health.Acupuncture is a safe and effective treatment for depression,yet,its mechanism is unclear.Therefore,acupuncture's action mechanism in intervening depression was summarized from several perspectives,including morphology and ultrastructure of neurons in depression-related brain areas,function and structure of glial cells,brain functional and structural connectivity,and neuroelectrophysiology.It's discovered that acupuncture can repair the morphological and ultrastructural damage of neurons in the hippocampus and prefrontal lobe,mitigate the functional and structural injuries of glial cells in the hippocampus and prefrontal lobe,strengthen functional connectivity and heal structural connection,and promote neuroelectrophysiological activities,which possibly are the principal mechanisms of how acupuncture works in intervening depressive disorder.

Objective To explore the pressure ulcer incidence and nutrition evaluation of 102 hospitalized super aging patients (80-90 year-old) by the subjective comprehensive nutrition evaluation method (SGA),the micro-nutrition evaluation method (MNA-SF),and nutritional risk screening 2002 (NRS 2002).Methods A total of 102 hospitalized super aging patients had been selected by the convenient sampling method and documented the incidence pressure ulcer according to three methods of nutritional screening from August 2012 to December 2014.We combined with the traditional measurement methods and laboratory index to compare the correlation between them,and combined with the ROC to evaluate the sensitivity and specificity of different pressure ulcers.The evaluation of the advantages and disadvantages were also discussed.Results In elderly patients,the incidence of pressure ulcers was 35.29％,the detection rate of MNA-SF,NRS 2002,SGA evaluation methods in malnutrition were 74.5％,54.9％ and 29.4％.The MNA-SF detection rate of malnutrition was higher than the other two methods.All three nutrition detection methods had negative correlation with traditional nutrition measurement and indexes results of laboratory (P ＜ 0.05),and had statistical significance at assessment of nutrition risk,malnutrition,normal nutrition with incidence rate of pressure ulcer (P ＞ 0.05).While we assessed the sensitivity of pressure ulcer,the MNA-SF was 86.1％,NRS 2002 61.0％,SGA 33.3％,and the three specificity were 68.2％,51.5％,27.3％.Conclusions MNA-SF has a better effect than SGA and NRS 2002 at detection of malnutrition and the effect of pressure ulcer.

Objective To study multimodal analgesia in patients who underwent transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods 60 patients who underwent TACE for HCC from Aug.2016 to Nov.2016 were randomized into two groups:the multimodal analgesia group and the control group.The pain scores of these two groups of patient during the procedure and at different posttreatment time points,and the rates of adverse effect and pharmacoeconomic differences were recorded.Results When compared to the control group,the pain scores at 0 h,2 h,4 h,6 h,12 h after treatment in the multimodal analgesia group were significantly lower (P ＜ 0.05),and the satisfactory scores for the patients were significantly improved (96.6％ vs.66.7％).The multimodal group of patients also had significandy lower adverse effect rates of nausea and vomiting,and it was more cost-effective.Conclusions Patients who required multimodal analgesia had better pain relieve,patient satisfaction and less adverse reactions after TACE than patients in the control group.Multimodal analgesia was a safe,effective and economic way to control TACE pain and it was worth recommended in clinical practice.

Objective To explore the changes and effect of functional connectivity(FC) of reward network in chronic heroin addicts(HA) using resting-state fMRl(rs-fMRI). Methods rs-fMRI was performed on 26 chronic heroin addicts(HA group) and 25 matched normal volunteers(control group).The rs-fMRI data were proceeded by usingrs-fMRI(DPARSF) software on Matlab 2009a. Bilateral nucleus accumbens(Nacc) were set as ROIs. Then the mean time series of ROI were compared with other voxels within the brain by the rs-fMRI data analysis toolkit(REST). Intra-and inter-group analysis was performed with single sample and two sample t test respectively.The association of intensity of FC in brain regions and the duration/doses of heroin consumption was investigated. Results In HA group, positiveresting-state FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus and pons, while temporal lobe, negative found in part of parietal cortex and occipital cortex, part of dorsal lateral prefrontal cortex and cerebellum. Within control group, positive FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus, hippocampal gyrus and pons, occipital cortex, negative FC with ROIs found in part of dorsal lateral prefrontal cortex and cerebellum(P<0.005, voxels>26). Compared with the control group,the FC between the right Nacc and the bilateral calcarinegyrus, left middle occipital gyrus(voxel numbe r=31,28,47;t=3.99, 3.74,3.74;and P<0.005,respectively)were significantly increased in the HA group.The FC between the left Nacc and left fusiform gyrus and right precuneus(voxel number=40,26;t=3.77,3.57;and P<0.005, respectively)were significantly increased, while between the left Nacc and left dorsal medial/lateral prefrontal cortex and bilateral dorsal anterior cingulate(voxel number=98;t=-4.14;and P<0.005)were significantly decreased in the HA group. There was no corrlation between the abnormal FC and the duration/doses of heroin consumption in HA group(P>0.05). Conclusion The abnormal interaction between Nacc and the regions involved in cognitive control and visual spatial attention may contribute to the heroin addiction.

Objective To compare and validate the efficiency of four models predicting the malignancy of solitary pulmonary nodules (SPN). Methods Patients diagnosed with SPN during health check-up were selected as the research subjects. Risk assessment was conducted using four predictive models. Outcomes were obtained through prospective follow-up. Statistical description and univariate analysis were performed for all risk factors of the four models. ROC curve was applied to compare the efficiency of the four predictive models. Results A total of 479 cases were included in this study. Among these patients, 82 were diagnosed with lung tumor, and the malignant rate was 17.12%. Age, nodule diameter, smoking, family history of tumor, history of extrapulmonary tumor ≥5 years, upper lobe site, unclear boundary, and spiculation rates were higher in the malignancy group than those in the benign group (P < 0.05). The efficiency of Brock model was the best. Its AUC was 0.833, sensitivity was 80.49%, and specificity was 74.31%. Its Youden index, positive likelihood ratio, positive predictive value, and negative predictive value were the highest, and its negative likelihood ratio was the lowest. The AUC, sensitivity, and specificity of Mayo model were 0.815, 81.71%, and 67.51%, respectively; those of PKUPH model were 0.754, 69.51%, and 73.55%, respectively; and those of VA model were 0.738, 68.29%, and 67.55%, respectively. Conclusion The Brock model might be the most appropriate predictive model for the risk assessment of SPN among the health check-up population, and the VA model is the worst. The combination of Brock, Mayo, and PKUPH models requires further study.

Objective To explore the ideal positions for venous indwelling needle among elderly patients. Methods A total of 135 elderly patients, who required transfusion aged from 70 to 90 years old, were randomly divided into observation group (n=66) and control group (n=69). Patients of the observation group underwent the pricking of forearm vein whiles patients of the control group received the pricking of dorsal hand vein. We compared the indwelling length of venous indwelling needle, incidences of related complications, success rate of pricking at first time and the pain level of pricking. Results The indwelling time of observation group was (4. 45 ± 0. 75) d higher than (4. 16 ± 0. 85) d of the control group; the complications such as phlebitis, fluid exudation in the observation was 12. 1% lower than 27. 5% in the control group (t/χ2 =2. 136, 5. 010;P<0. 05). There was no statistical significance for pain level of pricking and success rate of pricking at first time [(4. 12 ± 1. 99) vs (3. 61 ± 1. 58) score; 86. 4% vs 89. 9%; t/χ2 =1. 652, 0. 394;P>0. 05]. Conclusions The venous indwelling needle in forearm vein has some priority, decreases the complications incidences during needle indwelling, and postpones the length of indwelling, which can be the first choice.

Objective To explore the changes of cerebral local neuronal spontaneous activity between heroin dependent individuals and normal controls.Methods 3.0 T MRI were used for data acquisition,fMRI data were acquired during resting state from 20 male heroin dependent individuals(HD)and 1 5 matched normal controls(NC),and then the difference of amplitude of low frequency fluctuation (ALFF)between groups were analysised.Results Compared with NC,ALFF in rostral cingulated zone(bilateral anteri-or cingulate cortex ,medial prefrontal cortex )was significantly reduced in HD.Conclusion Dysfunction of resting state in RCZ were observed in HD,which may result in cognitive impairment and plays an important role in the transitions from ideas into behav-ior of relapse in addiction.

Objective To study the application of autoregressive integrated moving average(ARIMA)model to predict the monthly reported malaria cases in China,so as to provide a reference for prevention and control of malaria. Methods SPSS 24.0 software was used to construct the ARIMA models based on the monthly reported malaria cases of the time series of 2006-2015 and 2011-2015,respectively. The data of malaria cases from January to December,2016 were used as validation data to compare the accuracy of the two ARIMA models. Results The models of the monthly reported cases of malaria in China were ARIMA(2,1,1)(1,1,0)12 and ARIMA(1,0,0)(1,1,0)12 respectively. The comparison between the predictions of the two models and actual situation of malaria cases showed that the ARIMA model based on the data of 2011-2015 had a higher ac-curacy of forecasting than the model based on the data of 2006-2015 had. Conclusion The establishment and prediction of ARIMA model is a dynamic process,which needs to be adjusted unceasingly according to the accumulated data,and in addi-tion,the major changes of epidemic characteristics of infectious diseases must be considered.