Objective To evaluate the value of magnetic resonance cholangiopancreatography(MRCP) in the diagnosis of biliary obstruction diseases by comparison with endoscopic retrograde cholangiopancreatography (ER-CP). Methods A total of 36 patients with biliary obstruction diseases underwent both MRCP and ERCP. To review the images obtained from ERCP and MRCP ,the diagnosis were compared according to pathology. MRCP and ERCP in the diagnosis and treatment of biliary obstruction disease were analysed. Results 36 patients including 16 biliary tumors, 15 cholelithiases,and five other diseases were analysed. The diagnosis accuracy of MRCP and ERCP for bil-iary obstruction diseases were 86.1% and 91.7 %, there was no significant difference( P > 0.05). Conclusion MR-CP can accurately define the obstructively sites, identify the obstructive causes and is a noninvasive and reliable exam-ination for biliary obstruction diseases.

Objective:To investigate of AIDET communication model in caring for type 2 diabetes mellitus of hospitalized patients.Methods:A total of 113 patients with type 2 diabetes mellitus treated in our department from January 2018 to November 2019 were enrolled, and divided into the control group(receiving a conventional communication mode)and the observation group(receiving an AIDET communication mode)according to a time order in the selecting of the research patients.The changes of self-care behavior and glucose metabolism index were evaluated and analyzed between the two groups.Results:On admission, the fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin were(9.1±1.7)mmol/L, (13.8±2.9)mmol/L and(8.4±3.5)% in the observation group, and(9.4±2.1)mmol/L, (14.1±3.2)mmol/L and(8.1±2.9)% in the control group, respectively, with no statistically significances( P>0.05). At discharge, the observation group versus the control group showed a statistically significantly improved levels in FPG of(5.9±1.5)mmol/L vs.(7.8±1.9)mmol/L, in 2h-PBG of(10.1±3.7)mmol/L vs.(12.8±3.9)mmol/L and in glycosylated hemoglobin of(6.3±1.2)% vs.(7.5±0.9)%, respectively( P<0.05). The scores of management of poor blood glucose, foot care, blood glucose monitoring, medication compliance, regular exercise and diet control were higher in the observation group than in the control group at discharge( P<0.05). Conclusions:The application of AIDET communication mode can effectively enhance the self-care behavior of patients and help improve the glucose metabolism in hospitalized patients with type 2 diabetes mellitus.It has very positive effects on controlling the development of type 2 diabetes mellitus and improving the quality of life.

Objective To compare the clinical effects and safety of olanzapine and aripiprazole in the treatment of schizophrenia .Methods From February 2015 to February 2017 ,100 patients with schizophrenia were chosen in the Third People's Hospital of Yuyao .The patients were randomly divided into A group ( treated with olanzapine ) and B group ( treated with aripiprazole ) , with 50 patients in each group .The clinical efficacy , PANSS score,blood lipid levels and blood glucose level before and after treatment ,and the incidence of adverse effects of the two groups were compared.Results The total effective rates of A group and B group were 86.00％,90.00％, respectively,there was no statistically significant difference between the two groups (χ2 =1.36,P>0.05).There were no statistically significant differences in the PANSS scores after treatment between the two groups ( t=3.17,2.96, 4.21,2.75,3.56,4.01,4.55,4.49,4.71,5.07,4.26,4.92,all P>0.05).After treatment,the levels of FBG,TC and TG of A group were statistically significantly higher than those before treatment (t=3.04,2.68,4.01,P<0.05). The levels of FBG,TC and TG after treatment of B group were significantly lower than those of A group (t=4.81, 3.35,4.14,all P<0.05).The incidence rates of lethargy ,dizziness,insomnia,nausea,vomiting and constipation of A group were 28.00％,38.00％,8.00％,6.00％,36.00％,respectively,which of B group were 2.00％,10.00％, 12.00％,8.00％,10.00％,respectively,and the incidence rates of lethargy ,dizziness and constipation of B group were significantly lower than those of A group (χ2 =9.32,8.77,10.24,all P<0.05),and there was no statistically significant difference in the incidence rates of insomnia ,nausea and vomiting between the two groups (χ2 =2.16, 1.12,all P>0.05).Conclusion Olanzapine and aripiprazole in the treatment of schizophrenia possess the same clinical effects and safety;but aripiprazole can efficiently relieve the influence of blood lipid metabolism and reduce the risk of adverse drug reactions .

Objective To assess the effectiveness of traditional Chinese Medicine (TCM ) syndrome differentiation treatment for diabetic nephropathy in elderly patients. Methods A total of 96 elderly patients with diabetic nephropathy admitted to our hospital from January 2015 to December 2017 were recruited and divided into a regular care group (n= 48)and a TCM group(n= 48).Both groups received conventional treatment ,with TCM syndrome differentiation treatment added to the TCM group. The effectiveness of the treatment modalities was compared. Results In the regular care group ,significant effectiveness was observed in 12 patients ,effectiveness in 24 patients ,and ineffectiveness in 12 patients ,with a total effectiveness rate of 75％ .In the TCM group ,significant effectiveness was seen in 18 patients ,effectiveness in 27 ,and ineffectiveness 3 ,with a total effectiveness rate of 93％. The total effectiveness rate of the TCM group was higher than that of the regular care group(χ2 =6.400 ,P=0.011).After treatment ,fasting blood glucose ,2 h postprandial blood glucose , urea nitrogen ,creatinine ,and 24 h urine protein in the TCM group were significantly lower than in the regular care group and than pre-treatment levels(P<0.05). Conclusions TCM differentiation can not only significantly improve the treatment effectiveness in elderly patients with diabetic nephropathy ,but also relieve the clinical symptoms.

Objective: To study the current situation of sleep quality of senior high school students and analyze the influencing factors, so as to provide a reference for targeted sleep quality improvement of high school students. Methods: A total of 4 793 senior high school students of different grades were recruited from four different regions (Shanghai, Qinghai, Macao, Henan) in 2020. The information of demographic, sleep status, mental factors, living habits and other information were collected by questionnaire. Descriptive statistics and Logistic regression were used to analyze sleep quality and its influencing factors of the senior high school students. Results: About 24.2% of senior high school students reported sleep problems and 71.4% slept less than 7 hours at night. Interpersonal sensitivity, depression, anxiety symptoms, learning, family and interpersonal stress had significant effects on sleep problems in senior high school students( χ 2=1 147.98, 1 228.35, 1 032.54, 371.05, 497.61, 475.39, P <0.01). Drinking coffee and tea, drinking alcohol, smoking (including secondhand smoke), long term use of electronic products, late sleep, bedtime diet, poor sleep environment, parents with sleep problems were the risk factors for sleep disorders of senior high school students, regular exercise was the protective factors for sleep disorders of senior high school students, the influence was significant ( χ 2=160.28, 127.73 , 108.02, 113.27, 470.91, 340.95, 72.02, 155.53, 116.30, 76.96, 28.75, 12.89, P <0.05). Conclusion The sleep quality of senior high school students needs to be improved. Schools and parents should pay attention to the mental health and living habits of senior high school students to help them improve their sleep quality and grow up smoothly.

Objective: To investigate the prevalence of anemia among students aged 6-15 years old participated in the Nutrition Improvement Program for Rural Compulsory Education Program in 2012-2021 in Hunan Province, and to explore associated factors. Methods: A cluster random sampling method was used. The survey was conducted among compulsory education students who came from counties in Hunan Province where nutrition improvement plan and key surveillance were carried out. Height and weight were measured, hemoglobin, dietary habits and health knowledge were collected. Results: Since the implementation of nutrition improvement plan in 2012, the anemia rate decreased from 12.8% to 9.3%, the average hemoglobin content decreased from 133.9 g/L to 130.0 g/L. The proportion of students eating meat every day increased from 20.4% to 47.3%. Students eating three or more servings of table tennis ball size of meal increased from 21.4% to 47.3%. The proportion of students eating more than three kinds of vegetables per day was 39.1% in 2016 and 32.6% in 2019, and less than 30% in other years. The proportion of students eating three or more servings of table tennis ball size of vegetables increased from 19.5% to 39.6%, and the proportion of students eating snack less than once a day increased from 13.1% to 76.9%. The proportion of students drinking beverages less than once a day increased from 36.5% to 90.7%. Girls, older than 12 years, not eating meat every day, and who eat less than 1 serving of table tennis ball size of meat, eat less than 3 servings of table tennis ball size of vegetables and fruit at one time, and who eat less than 3 kinds of vegetables every day, and those who grow slowly had higher risk of anemia. Potential factors of anemia in students varied by survey year. Conclusion The implementation of the compulsory education has improved the nutritional status of compulsory education students in rural areas of Hunan Province, but anemia still occurs. Potential factors associated with childhood anemia are changing. Child health literacy education should adapt to the changing social and economic enviornment, as well as lifestyles. Targeted and appropriate nutritional education and intervention are greatly needed.

Objective To evaluate the effect of ultrasonic debridement for treating diabetic foot ulcers (DFU). Methods Randomized controlled trials ,quasi-experimental studies and cohort studies of ultrasonic debridement for DFU were searched from the Cochrane Library ,PubMed ,EMbase ,CBM ,VIP and CNKI. Two authors screened ,evaluated and extracted research articles ,and conducted meta-analysis on studies that met the quality standards. Results A total of six studies including 624 patients were included. Of them ,four studies included the outcome on the average wound healing time ,and meta-analysis showed that ,compared with traditional debridement ,ultrasonic debridement could shorten the average healing time for wounds[weighted mean differences(WMD)= -20.78 ,95% CI :-35.72-5.85 ,P=0.006].Three studies included the outcome on the average wound healing rate ,and meta-analysis showed that ultrasonic debridement had a higher average wound healing rate than traditional debridement (WMD=22.53 ,95% CI :19.19~25.87 ,P＜0.001). Two studies included the outcome on the average wound healing area ,and meta-analysis showed no significant difference between ultrasonic debridement and traditional debridement (WMD= -5.82 ,95% CI :-18.43~ 6.80 ,P= 0.370). Conclusions Ultrasonic debridement is superior to traditional debridement in treating diabetic foot ulcers.

Objective To explore the regulating mechanism ofneuregulin1β (NRG1β) on extracellular signal-regulated kinase 5 (ERK5) signaling pathway in rats with cerebral ischemia reperfusion injury.Methods Fifty male Wistar rats were divided randomly into sham-operated group,model group,treatment group,inhibitor group,and inhibitor combined with treatment group (n=10).Focal cerebral ischemic models were established by inserting a monofilament thread to achieve middle cerebral artery occlusion (MCAO).The rats were injected 5 μL (2 μg/kg) NRGlβ to the internal carotid artery.This inhibitor BIX02189 was injected into the internal carotid artery before ischemia.The neurobehavioral functions were evaluated by modified neurological severity scale (mNSS).The apoptotic cells were counted by terminal deoxynucleotidyl transferase dUTP nick-end labeling,and the expressions of phosphorylated (p-) mitogen activated proteins kinase kinase 5 (MEKK5),ERK5 and myocyte enhancer-binding factor 2C (MEF2C) were determined by immunohistochemical assay and Western blotting.Results The rats in the model group appeared neurobehavioral dysfunction,the number of apoptotic cells in the cortex was increased,and the expressions of p-MEKK5,p-ERK5 and p-MEF2C showed compensable enhancement,which were significantly different as compared with those in the sham-operated group (P＜0.05).As compared with those in the model group and inhibitor combined with treatment group,the expressions of p-MEKK5,p-ERK5 and p-MEF2C were further significantly enhanced,the number of apoptotic cells was significantly decreased and the neurobehavioral functions were significantly improved in treatment group (P＜0.05).As compared with those in the model group and inhibitor combined with treatment group,the number of apoptotic cells was significantly increased,and the expressions ofp-MEKK5,p-ERK5 and p-MEF2C were significantly decreased in the inhibitor group (P＜0.05).Conclusion NRG1β could play a neuroprotective role by activating the MEKK5-ERK5-MEF2C signaling pathway and further up-regulating the expressions of p-MEKK5,p-ERK5 and p-MEF2C to inhibit the inflammation induced by cerebral ischemia reperfusion injury in rats.