Objective To study the correlation between intestinal flora imbalance and serum interleukin-6(IL-6),serum amyloid A(SAA)and D-lactic acid levels in chronic obstructive pulmonary disease(COPD)pa-tients with pulmonary infection.Methods The case data of totally 148 COPD patients with pulmonary infec-tion who were treated in the hospital from June 2022 to June 2023 were collected.According to the presence or absence of intestinal flora imbalance,they were divided into intestinal flora imbalance group(n=41)and in-testinal flora non-imbalance group(n=107).The levels of serum IL-6,SAA and D-lactic acid and distribution of intestinal flora in the two groups were detected,and the correlation between intestinal flora imbalance and levels of serum IL-6,SAA and D-lactic acid was analyzed.Results The levels of serum IL-6,SAA and D-lactic acid in intestinal flora imbalance group were higher than those in intestinal flora non-imbalance group(P<0.05).Eubacterium,Lactobacillus and Bifidobacterium counts in intestinal flora imbalance group were less than those in intestinal flora non-imbalance group(P<0.05),while Enterococcus and Escherichia coli counts were more than those in intestinal flora non-imbalance group(P<0.05).In intestinal flora imbalance group,there were 14 cases with degree Ⅰ imbalance(degree Ⅰ group),6 cases with degree Ⅱ imbalance(degree Ⅱgroup)and 21 cases with degree Ⅲ imbalance(degree Ⅲ group).The levels of serum IL-6,SAA,and D-lac-tate increased sequentially in the degree Ⅰ group,degree Ⅱ group and degree Ⅲ group(P<0.05).Eubacteri-um,Lactobacillus and Bifidobacterium counts were negatively correlated with serum IL-6,SAA and D-lactic acid levels(P<0.05),while Escherichia coli and Enterococcus counts were positively correlated with serum IL-6,SAA and D-lactic acid levels(P<0.05).Conclusion There is a correlation between intestinal flora im-balance and serum IL-6,SAA and D-lactic acid levels in COPD patients with pulmonary infection,and IL-6,SAA and D-lactic acid levels could be used as effective indicators to evaluate the degree of intestinal flora im-balance.

Chinese herbal piece is an important component of the traditional Chinese medicine （TCM） system， and identifying their quality and grading can promote the development and utilization of Chinese herbal pieces. Utilizing deep learning for intelligent identification of Chinese herbal pieces can save time， effort， and cost， while also reasonably avoiding the constraints of human subjectivity， providing a guarantee for efficient identification of Chinese herbal pieces. In this study， a dataset containing 108 kinds of Chinese herbal pieces （14 058 images） was constructed，the basic YOLOv4 algorithm was employed to identify the 108 kinds of Chinese herbal pieces of our database The mean average precision （mAP） of the developed basic YOLOv4 model reached 85.3%. In addition， the receptive field block was introduced into the neck network of YOLOv4 algorithm， and the improved YOLOv4 algorithm was used to identify Chinese herbal pieces. The mAPof the improved YOLOv4 model achieved 88.7%， the average precision of 80 kinds of decoction pieces exceeded 80%， the average precision of 48 kinds of decoction pieces exceeded 90%. These results indicate that adding the receptive field module can help to some extent in the identification of Chinese herbal medicine pieces with different sizes and small volumes. Finally， the average precision of each kind of Chinese herbal medicine piece by the improved YOLOv4 model was further analyzed. Through in-depth analysis of the original images of Chinese herbal medicine pieces with low prediction average precision， it was clarified that the quantity and quality of original images of Chinese herbal medicine pieces are key to performing intelligent object detection. The improved YOLOv4 model constructed in this study can be used for the rapid identification of Chinese herbal pieces， and also provide reference guidance for the manual authentication of Chinese herbal medicine decoction pieces.

Lung cancer is a highly malignant tumor with poor prognosis.For advanced lung cancer patients,a wide range of invasion,multiple distant metastases and the limited treatment options have led to extremely poor prognosis.Better treatment outcome with a high 5-year survival rate can be achieved by early detection and treatment of lung cancer.The early diagnosis is the key to the treatment of lung cancer,and the early diagnosis of lung cancer depends on the identification of benign and malignant of pulmonary nodules.With the increased safety and diagnostic accuracy of biopsy of pulmonary nodules guided by different imaging techniques,the advantage of biopsy of pulmonary nodules in diagnosis of benign and malignant lesions is prominent,which is worthy of clinical application.

Objective To explore the effect of intermittence oro-esophageal tube feeding on the comfort and swallowing function of paralytic patients with swallowing disorder.Methods A total of 80 paralytic patients with dysphagia who were hospitalized in Neurology Department of the First Affiliated Hospital of Zhengzhou University from January to December 2016 and met the inclusion criteria were selected by convenience sampling method and divided into observation group and control group according to random number table, with 40 cases in each group. Intermittence oro-esophageal tube feeding was used in observation group, and nasogastric feeding was used in control group. The nasopharyngeal comfort of both groups on the third and tenth day of intervention and patients' swallowing function before feeding and on the tenth day of intervention were compared respectively.Results On the third and tenth day of intervention, the differences between the two groups on the symptoms of nasal discomfort, throat pain, oropharyngeal dryness and swallowing discomfort were statistically significant (P<0.01). There was no statistical difference in the extent of swallowing disorder between the two groups before intervention (P>0.05). Comparing the two groups on the tenth day of intervention, the difference of patients' swallowing function was statistically significant (P<0.01). Patients' swallowing function recovery on the tenth day of intervention was statistically different between the two groups (P<0.01). Conclusions Intermittence oro-esophageal tube feeding can significantly improve the comfort and the swallowing function in stroke patients. Thus, intermittence oro-esophageal tube feeding is a worthy method to expand in clinical practice.

Objective?To analyze the mediating effects of the sense of coherence between mental stress and depression in stroke patients, and to offer guidance and assistance to reducing mental stress and depression and improving mental health in stroke patients. Methods?Totally 468 stroke patients were selected from the Department of Neurology of a ClassⅢ Grade A hospital in Zhengzhou by convenient sampling between July 2016 and July 2017 and investigated with Sense of Coherence Scale (SOC-13), Chinese Perceived Stress Scale (CPSS) and Center for Epidemiologic Studies Depression Scale (CES-D). The data were statistically analyzed with SPSS 21.0 and AMOS 22.0. Results?The total average scores for SOC-13, CPSS and CES-D in these stroke patients were (63.39±9.92), (41.65±7.29) and (23.80±4.20), respectively. The sense of coherence was negatively correlated with mental stress and depression (r=-0.47,-0.51;P＜0.01), and mental stress was positively correlated with depression (r=0.52,P＜0.01). As a meditating variable, the sense of coherence reduced the adverse prediction effects of mental stress on depression from 0.632 to 0.283. According to the re-analysis of the structural equation model, the sense of coherence was the mediating variable between mental stress and depression. The fit indexes were good (χ2/df=2.450, GFI=0.942,AGFI=0.941, CFI=0.940, TLI=0.922, RMSEA=0.052, RMR=0.036). Conclusions?As the mediating effect between mental stress and depression, the sense of coherence reduces the adverse prediction effects of mental stress on depression to some extent. Therefore, the sense of coherence in stroke patients shall be enhanced to improve their mental health and reduce the incidence of depression.

Objective To observe the effects of tracer methodology when used to trace and manage emergency intravenous thrombolysis processes in patients with acute ischemic stroke (AIS). Methods The patients' attendance process was traced, improved and constantly optimized according to the theoretical basis of tracer methodology. A total of 112 AIS patients who received thrombolysis from September 2015 to August 2016 (before tracer methodology was implemented) were divided into the control group, while another 160 AIS patients who received thrombolysis between September 2016 and August 2017 (after tracer methodology was implemented). The time between arrival and thrombolysis administration and hospital treatment were compared between the two groups. Results After tracer methodology was carried out, the time used between arrival and admission by our stroke treatment team in the observation group was (4.1±1.2)min; the time between arrival and imaging examination was (18.8±11.2)min; the time between imaging examination and thrombolysis administration was (22.5±10.2)min; and the time between arrival and thrombolysis administration was (44.6±12.5)min, all shorter than that of the control group (P＜0.05). Conclusions The application of tracer methodology effectively reduces door to needle time, improves the efficiency of intravenous thrombolysis in AIS patients.

Objective To analyze the effects of "whole-jobs" double tutorial system in clinical nursing teaching.Methods A total of 120 nursing students in the Second Affiliated Hospital of Wenzhou Medical University from 2013 to 2015 were randomly divided into the experimental group and control group with 60 cases respectively. Control group used the traditional "jobs" teacher teaching mode, while the experimental group adopted "whole-jobs" double tutorial system teaching mode. Clinical comprehensive ability and the nursing students' evaluation of the teaching mode were compared between two groups.Results After the practice, the score of the clinical comprehensive ability of the nursing students in the experimental group was (87.54±2.09), while the score in the control group was (73.89±2.15). There was statistically significant difference between two groups (t=1.781,P<0.05). The satisfaction rates of nurses to the clinical "whole-jobs" were 96.7% in the experimental group and 90.0% in the control group, with statistically significant difference between two groups (χ2=6.287,P<0.05).Conclusions The "whole-jobs" double tutorial system has significant teaching effects, with a high satisfaction of nursing students to the clinical teaching method, thus it can be promoted in clinical teaching of nursing students.

To explore the effects of inactivated rabbit serum containing compound realgar and natural indigo tablet (CRNIT) on cell line NB(4).

To study the Realgar induced T lymphocytic leukemia cell line CEM apoptosis in vitro.