Objective To investigate the best time to establish the enteral nutrition (EN) in elderly patients with se?vere craniocerebral diseases. Methods Eighty-one elderly patients were divided into groups A, B and C. The EN support were given 24 h, 25-48 h, and 49-72 h after surgery. Changes of serum biochemical indexes, complications and GCS score were detected and statistical analysed. Results The serum levels of albumin and hemoglobin were significantly increased in group B than those of group A and group C. The total number of lymphocytes was significantly higher in group A and group B than that of group C (P<0.05). The amount of diarrhea was significantly fewer 7-day after operation in group B than that of group A (3.6%vs 26.9%). The amount of stress ulcer was significantly fewer in group B than that of group C (0 vs 22.2%). The amounts of lung infections (10.7%vs 38.5%) and stress ulcer (3.6%vs 25.9%) were significantly fewer 14-day after oper?ation in group B than those of group A. The scores of GCS were significantly higher 14-day after operation in group B than those of group A and group C (10.2±1.3 vs 9.5±1.2 vs 9.4±1.2, P<0.05). Conclusion The establishment of EN support 25 to 48 hours after surgery may meet the need of nutritional and metabolic support, reduce complications, be conducive to the consciousness recovery in elderly patients with severe craniocerebral diseases.

Objective To analyze the safety and effectiveness of using lumbar drainage (LD) in patients with subarachnoid hemorrhage (SAH).Methods Data from 44 patients with SAH were collected.Of these patients,the LDs group consisting 19 patients in whom a lumbar drain had been placed for cerebro-spinal fluid (CSF) drainage,whereas the control group was composed of 25 patients who received no form of CSF drainage or treated solely with an external ventricular drainage (EVD).Incidence of new cerebral infarction of the two groups was measured on sequential CT and complications of LDs group.Results This retrospective review demonstrated a statistically significant beneficial effect in LDs group on CT,reducing the incidence from 32％ to 5％.A similar degree of benefit was observed in two group patients with hydrocephalus.Complications with lumbar drains were rare and yielded no permanent sequelae.Conclusion With rare complications and definite safety,LDs are effective to reduce vasospastic cerebral infarction of SAH patients when appropriate patient selection and good technique are employed.

Objective To observe the effects of transplantation of autologous adipose-derived stem cells (ASCs) on osteoporosis (OP) in a rabbit ovariectomy (OVX) model.Methods A total of fifteen 6-month-old female New Zealand white rabbits were randomly divided into two groups:ovariectomy group (group A,n =12) and sham operation group (group B,n =3).All rabbits were subjected to bilateral ovariectomy in the group A.Six months later,bone mineral density (BMD) of group A and group B were measured by dual energy X-ray absorptiometry (DXA) to check the result of OVX-OP.ASCs harvested from adipose of OP rabbits were cultured to be expanded and differentiated in osteogenic medium in vitro.Osteogenesis was evaluated by alizarin red staining,alkaline phosphatase (ALP) staining and quantitative assays of osteocalcin (OCN).Autologous osteo-induced ASCs were mixed in calcium alginate hydrogel (CAH) and then transplanted in the left distal femurs,while CAH was transplanted in the right distal femurs of OP rabbits.At 12 weeks after implantation,BMD,micro-CT and histomorphological analyses were performed on these rabbits.Results The BMD of femurs in group A rabbits were obviously lower than that of group B rabbits (P ＜ 0.05) at 6 months after OVX.Compared with control group,ASCs cultured in osteo-induction medium had similar proliferation rate as the non-induced cells,but displayed positive ALP and alizarin red staining and OCN contents.At 12 weeks after implantation,the cell-treated femurs displayed higher BMD,bone trabecula number,trabecula thickness and separation than those of control group,while the structure model index and porosity were lower (P ＜ 0.05).Histological examination indicated that the trabecular thickness increased with complete CAH resorption in cell-treated group,while CAH remained in control group.Conclusions Transplantation of autologous ASCs can help strengthen osteoporotic bone in OVX-OP rabbits,providing a novel approach to OP treatment.

Helicobacter pylori (Hp) is a Gram-negative bacterium, mainly and specifically colonized on the surface of gastric mucosa, and closely related to upper gastrointestinal diseases such as chronic gastritis, peptic ulcer, gastric mucosa-associated lymphoid tissue lymphoma, and gastric cancer. At present, the infection rate of Hp in the world has been more than half of the population. In China, due to a series of reasons such as the abuse of antibiotics, the infection rate of Hp has already exceeded the world average. Solving the problem of antimicrobial resistance has become the key to the successful eradication of Hp. This article reviewed the advances in study on molecular mechanisms of antibiotic resistance of Hp.

Fecal microbiota transplantation(FMT) is a new treatment method for intestinal diseases, especially for recurrent Clostridium difficile infection(CDI), which is very effective.It can reconstruct the intestinal flora of patients and effectively correct the disorder of intestinal flora.In recent years, the clinical application of fecal transplantation has been more and more extensive.This paper reviews the development history, operation process, clinical application and adverse reactions of fecal transplantation.

Objective:To explore the influence of online and offline family therapy based on the Satir model on emotions of adolescents with depressive disorder and their parents in remote areas.Methods:A total of 98 cases adolescents with depressive disorder treated in the psychosomatic medicine of the Second Affiliated Hospital of Nanchang University from January 2021 to June 2021 and their parents were selected as the objects. The adolescents with depressive disorder and their parents were randomly divided into the control group (49 parents and 49 adolescents) and the observation group (49 parents and 49 adolescents). The control group received the medical treatment (sertraline 100 mg/d) and the routine health education, while the observation group received the online and offline Satir family therapy on the basis of the intervention of the control group. Generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used to investigate the negative emotions of the parents of the two groups before and 12 weeks after the intervention. The screen for child anxiety related emotional disorders (SCARED) and depression self-rating scale for childhood (DSRS) were used to investigate the negative emotions of the adolescents before and 12 weeks after the intervention.The SPSS 20.0 software was used for statistical analysis. t test was used to compare the SCARED scale score and DSRS score changes of the adolescents in the two groups, and χ 2 test was used to compare the proportional changes of parents' anxiety and depression. Results:The scores of SCARED (51.55±12.69 vs 36.82±7.69, t=15.839) and DSRS (25.08±4.81 vs 16.88±2.16, t=13.047) of adolescents in the control group were significantly different before and after the intervention (both P<0.05). The scores of SCARED (51.16±15.84 vs 31.31±7.72, t=14.385) and DSRS (24.12±4.81 vs 14.08±2.03, t=14.723) of adolescents in the observation group were significantly different before and after the intervention (both P<0.05). After the intervention, the scores of SCARED and DSRS in the observation group were lower than those in the control group ( t=3.540, 6.609, both P<0.05). Before intervention, there was no significant difference in the proportion of anxiety and depression between the parents of the two groups (χ 2=1.837, 3.547, both P>0.05). After 12 weeks of intervention, there was a statistically significant difference in the proportion of anxiety and depression between the two groups, which were lower in the observation group than those in the control group (χ 2=5.995, 4.009, both P<0.05). Conclusion:Online + offline family therapy based on the Satir model can not only effectively reduce anxiety and depression of adolescents, but also effectively reduce anxiety and depression of their parents.It is especially suitable for outpatient management of children with depressive disorder in remote areas.

Objective To investigate the prevalence of dyslipidemia in subjects with type 2 diabetes mellitus in Beijing urban communities.Methods Total 3316 subjects with type 2 diabetes (age 20-80 years) were recruited from 15 urban community health centers in Beijing using a multi-stage random sampling approach.Dyslipidemia was diagnosed according to Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults:2007 version.Results Among 3316 diabetic subjects (1329 malesand 1987 females),75.6％ (2506/3316) had dyslipidemia,the prevalence was 72.5％ (964/1329)in men and 77.6％ (1542/1987) in women.The prevalence of hypertriglyceridemia and hypercholesterolemia was 41.9％ (1388/3316) and 48.1％ (1595/3316),respectively.31.5％ (1043/3316) subjects had high levels of low-density lipoprotein cholesterol (LDL-C) and 21.2％ (703/3316) had low high-density lipoprotein cholesterol (HDL-C).Among all subjects with dyslipidemia only 22.9％ (575/2506) took hypolipid agents.The overall blood lipid control rates of triglyceride (TG),total cholesterol (TC),LDL-C and HDL-C in 1393 subjects with dyslipidemia history were 48.0％ (669/1393),17.4％ (242/1393),30.9％ (430/1393) and 75.8％ (1056/1393),respectively.Diabetics with dyslipidemia had higher body mass index,waist circumference,blood pressure,plasma glucose and hemoglobin A1c.The prevalence of dyslipidemia in the overweight and uncontrolled-glucose group were 79.0％ (1678/2125),78.9％ (1756/2227),respectively.Logistic regression analysis showed that gender,age,body mass index and hemoglobin A1c were associated with dyslipidemia.Conclusions The prevalence of dyslipidemia in diabetic subjects in Beijing urban communities is high and less than one quarter patients take hypolipid agents.Age,body mass index and hemoglobin A1c are the risk factors of dyslipidemia in type 2 diabetic patients.

Objective To investigate current status of use of oral hypoglycemic drugs and insulin among adult patients with type 2 diabetes mellitus (T2DM) in urban community of Beijing.Methods In total,3297 T2DM patients aged more than 20 years from 15 urban communities of Beijing were studied.Their body weight,height,fasting plasma glucose level and glycosylated hemoglobin Alc (HbAlc) were measured.A door-to-door questionnaire survey on use of oral hypoglycemic drugs and insulin was conducted for them.All the T2DM patients surveyed were divided into four groups based on their received intervention.Results ①Of 3279 T2DM patients,454 (13.8％) received lifestyle intervention,971 (29.5％) used only one oral hypoglycemic drug,1179 (35.7％) with combined oral hypoglycemic drugs,and 693(21.0％) with insulin.②There was significant difference in average HbAlc among the four groups of T2DM patients with lifestyle intervention,only one oral hypoglycemic drug,combined oral hypoglycemic drugs,and insulin,with HbAI c of (7.0 ± 1.9) ％,(7.1 ± 1.5) ％,(7.4 ± 1.5 ) ％,and (7.5 ± 1.5 ) ％for them,respectively ( F =15.1,P ＜ 0.01 ).Proportions of the T2DM patients with HbAlc equal to or higher than 7.0％ were 32.2％,39.4％,52.1％ and 59.5％ for the four groups,respectively ( x2 =117.7,P ＜ 0.01 ).③In the T2DM patients with lifestyle intervention,32.2％ (146/454) of them with HbA1 c equal to or higher than 7.0％ were untreated with any oral hypoglycemic drug.In those with only one oral hypoglycemic drug,39.4％ (383/971) of them with HbAlc equal to or higher than 7.0％ were not treated with combined oral hypoglycemic drugs and/or insulin.In those with combined oral hypoglycemic drugs,52.1％ (614/1079) of them with HbAlc equal to or higher than 7.0％ were not received combined insulin treatment.④ Fasting plasma glucose level,treatment strategies,postprandial 2-h blood glucose level and length of the illness were independent risk factors for HbAlc level equal to or higher than 7.0％,with odds ratio (OR) of 1.757,1.256,1.175 and 1.031,respectively.⑤ In 2843 T2DM patients with oral hypoglycemie drugs and/or insulin treatment,1494 (52.6％ ) received biguanides and 693 received (24.4％ )insulin,respectively.Conclusions More than half of adult patients with T2DM do not meet the target of glycemic control of HbAlc less than 7.0％ in urban communities of Beijing,due to not active use of oral hypoglycemic drugs,and not timely adoption of combined use of oral hypoglycemic drugs and insulin therapy.

【Objective:】 To explore the relationship between the moral courage of nurses in Intensive Care Unit (ICU) and the hospital ethical climate, and to provide a theoretical basis for enhancing the moral courage of ICU nurses. 【Methods:】 A total of 468 ICU nurses from 8 tertiary A hospitals in Shaanxi Province were selected as the subjects by convenience sampling method, and the General Information Form, Hospital Ethical Climate Survey, and Nurses’ Moral Courage Scale were used for the questionnaire survey. 【Results:】 A total of 468 questionnaires were distributed and 463 valid questionnaires were returned, with an effective recovery rate of 98.93%. The score of hospital ethical climate for ICU nurses was (100.69±19.76), and the score of moral courage was (83.67±15.48). There was a positive correlation between hospital ethical climate and moral courage (r=0.866, P<0.001). Hierarchical multiple regression analysis showed that hospital ethical climate entered the influencing factor model of ICU nurses’ moral courage, which can independently explain 57% of the variation in ICU nurses’ moral courage. 【Conclusion:】 The moral courage of ICU nurses was at a medium level, and positively correlated with the hospital ethical climate, that is, the better the hospital ethical climate perceived by ICU nurses, the higher their level of moral courage. Nursing managers should focus on deepening the hospital ethical climate, and enhance the level of hospital ethical climate through scientific methods to promote the improvement of ICU nurses’ moral courage.