Objective To evaluate whether Vitamin B supplementation could prevent ischemic stroke recurrence.Methods Randomized controlled trials (RCTs) observing Vitamin B supplementation in patients with stroke was performed in databases including ScienceDirect, PubMed/Medline, China National Knowledge Infrastructure, Chinese Biomedical Data-Base, Wanfang Database, and VIP Chinese Science and Technology Journal Database to find related studies in English or Chinese published before August 2016. The patients in control group received a placebo or basic therapy without Vitamin B, and those in experimental group was treated with Vitamin B alone or Vitamin B on the basis of conventional treatment. The data were collected by two researchers independently and the quality of studies was assessed by the modified Jadad Scale. The Meta-analysis was performed using Stata 12.0, funnel plot was drawn, and Egger and Begg regressions were used to evaluate the publication bias, and sensitivity was also analyzed. Results Seven RCTs studies were enrolled to analyze with a total number of 9846 stroke patients, 4755 patients in control group, and 5091 in experimental group, respectively. ① Vitamin B supplementation for prevention of recurrent stroke: heterogeneity test results showed a heterogeneity in literatures enrolled (I2 = 62.9%,P = 0.009), and a random effect model was used for Meta-analysis. It was shown that the incidence of recurrent stroke in the experimental group was significantly lower than that in the control group [pooled relative risk(RR) = 0.64, 95% confidence interval (95%CI) = 0.47-0.87], which indicated that the supplementation of Vitamin B could prevent the recurrence of stroke. Cumulative Meta-analysis showed that Vitamin B supplementation exhibited positive effects in the prevention stroke recurrence from 2012. The 95%CI tended to be stable while demonstrating good change trend as sample growing. The publication bias evaluation results showed that the funnel plot was not symmetrical by visual inspection, further quantitative analysis showed thatP value from Egger regression was 0.008, while that from Begg regression was 0.035, bothP < 0.05, suggesting there were some publication bias. The sensitivity analysis showed that the overall results were stable and reliable. ② The effect of Vitamin B supplementation on plasma homocysteine (Hcy) levels in stroke patients: heterogeneity test results showed a heterogeneity in literatures enrolled (I2 = 96.2%,P = 0.000), and a random effect model was used for Meta-analysis. It was shown that compared with control group, the plasma Hcy levels of patients after Vitamin B supplementation in experimental group were significantly decreased [pooled weighted mean difference (WMD) = -6.92, 95%CI = -9.11 to -4.73), indicating that Vitamin B could significantly reduce plasma Hcy levels in stroke patients. Cumulative meta analysis showed that, as time went on, the relevant research samples were increased, 95%CI tended to be stable and the variation tendency was better. The publication bias evaluation results showed that the funnel plot was symmetry by visual inspection, and further quantitative analysis showed that theP value from Egger regression was 0.345, and that from Begg regression was 0.764, bothP > 0.05, which indicating that there was no evidence of publication bias in the study included.Conclusions Vitamin B supplementation was associated with a lower risk of recurrent stroke in stroke patients and could significantly improve the quality of secondary prevention of stroke. Furthermore, supplementation of Vitamin B could reduce plasma Hcy levels in stroke patients which might contribute to its effect in preventing stroke recurrence.

Objective:To investigate the incidence of early enteral nutrition intolerance and related influencing factors in postoperative gastric cancer patients.Methods:90 gastric cancer patients who underwent radical gastric cancer surgery and received early enteral nutrition thereafter in our hospital were retrospectively enrolled from January 2019 to December 2020. Patients were divided into early enteral nutrition tolerance group ( n=30) and intolerance group ( n=60) according to whether they developed nausea, vomiting, abdominal distension, abdominal pain, diarrhea and other symptoms after early enteral nutrition. The general characteristics of the two groups were compared and the risk factors of early enteral nutrition intolerance in postoperative gastric cancer patients were analyzed using multivariate Logistic regression. Results:60 (66.67%) of the 90 postoperative gastric cancer patients experienced early enteral nutrition intolerance. Multivariate Logistic regression analysis showed that ≤4 hours of out-of-bed activity on the first postoperative day and nonuse of nutrition pump were independent risk factors for early enteral nutrition intolerance in these patients ( OR=2.998; 4.586, P<0.05). Conclusions:The risk factors of early enteral nutrition intolerance in postoperative gastric cancer patients were ≤4 hours of out-of-bed activity on the first postoperative day and nonuse of nutrition pump. Corresponding clinical interventions could be implemented to prevent the occurrence of early enteral nutrition intolerance in postoperative gastric cancer patients.

Objective To explore the CT imaging features of solid pseudo- papillary tumor of pancreas (SPTP) and the diagnostic value of dual-enhanced scanning in SPTP. Methods CT imaging data of 38 cases with SPTP confirmed by surgical pathology were retrospectively analyzed, among whom there were 20 cases who had underwent dual-phases enhanced scanning and 18 cases who had underwent three-phases enhanced, the CT imaging features of the tumors,enhancement degree and the enhancement peak phase of tumors′solid composition were observed. Results All the tumors were single.Tumor located in the head of pancreas in 14 cases, in the neck in 4 cases,in the body in 8 cases, in the tail in 7 cases, in the body-tail of border in 4 cases,and 1 case in the head-neck of border.The size of tumors was 2.4+7.8 cm;tumor of 12 cases was solid mainly,of 24 cases was solid and cystic,and of 2 cases was cystic mainly. Enhancement was uneven. The solid composition showed mild-to-moderate reinforcement, and the enhanced peak stage was in portal vein phase or delay phase.Conclusions There are some characteristics in CT imaging findings of SPTP, CT imaging combined with clinical characteristics can make an accurate diagnosis before operation. The diagnosis accuracy of SPTP with MSCT through dual- phases enhancement scaning and the three- phases enhancement shows no difference,and the former scaning technology can reduce the received effective radiation dose of patients and improve the efficiency of examining.It is worth of promoting.