Objective: To understand levels of various foods and nutrients in school lunch based on digital platform and to provide reference for food preparation and serving. Methods: A total of 13 018 school lunch recipes in Binhai New Area of 96 schools in Tianjin from November 2020 to April 2021 were collected by using digital management platform for food safety and nutritional health.Food types including cereals and tubers, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk and dairy products, legumes and their products/nuts and others energy, and nutrients including protein, fat, carbohydrate, calcium, iron, zinc, selenium, vitamin A, vitamin B 1, vitamin B 2, vitamin C and dietary fiber were evaluated. Results: The qualified rate of all kinds of food for students lunch from high to low were 96.8% (116.4 g) of livestock and poultry meat, 92.3% (179.5 g) of cereal and potato, 65.0% (170.6 g) of vegetables, 47.7% (21.4 g) of soybeans and their products/nuts, 33.4% (18.0 g) of eggs, 14.4% (8.5 g) of fish and shrimp, 14.1% (19.6 g) of fruits, 0.3% (35.4 g) of milk and dairy products. There were significant differences in the qualified rate of various food intake among different grades( P <0.05). The qualified rate of students lunch energy was 76.9%(932.6 kcal). The qualified rates of various nutrients from high to low were iron 96.9%(9.7 mg), zinc 96.8%(5.9 mg), protein 96.4%(43.8 g), carbohydrate 87.6%(130.8 g) and selenium 82.9%(23.5 μg), vitamin C 78.5%(48.8 mg), vitamin B 1 75.9%(0.5 mg), fat 74.3%(28.5 g), vitamin A 74.1%(327.1 μ g) vitamin B 2 49.9%(0.5 mg), dietary fiber 19.5%(5.9 g) and calcium 13.4%(246.1 mg). There were significant differences in the qualified rates of energy and nutrients among different grades( P <0.05). Conclusion The digital platform basically meets school lunch requirments on food types and nutrients, but still with problems regarding insufficient fish and shrimp, fruits, milk and dairy products, vitamin B 2, dietary fiber and calcium. It is suggested to optimize school lunch recipes or increase corresponding nutrients content in other meals.

Objective:To analyze the effect of integrated care model on relocation stress and sense of coherence in caregivers of severe multiple injuries patients after ICU transfer.Methods:From January 2017 to October 2019, 102 caregivers of severe multiple injuries patients in ICU of Liuzhou Worker′s Hospital were selected and divided into control group and observation group by random digits table method,with 51 cases in each group. In the process of ICU transfer the control group received routine nursing, while the observation group carried out integrated care model based on the control group scheme. Before and after ICU transfer, the degree of relocation stress and sense of coherence of caregivers in two groups were evaluated by Family Relocation Stress Scale (FRSS) and Sense of Coherence Scale (SOCS) respectively.Results:The scores of migration preparation dimension, migration satisfaction dimension,caregiver stress dimension and the total scores of FRSS were 17.51 ± 3.46, 4.81 ± 0.48, 11.69 ± 1.82 and 49.91 ± 4.51 in the observation group, which were significantly higher than those in the control group after transfer (13.61 ± 2.83, 3.32 ± 0.53, 9.42 ± 2.17, 39.25 ± 4.01)( t values were 5.12-7.64, all P<0.05). The scores of manage ability dimension, comprehensibility dimension, meaningfulness dimension and the total scores of SOCS were 29.58 ± 4.96, 24.07 ± 2.72, 22.04 ± 3.64 and 75.52 ± 6.80 in the observation group, which were significantly higher than those in the control group (24.34 ± 4.13, 20.50 ± 2.99, 17.19 ± 3.96, 64.80 ± 6.12) after transfer ( t values were 4.51-7.01, all P<0.05). Conclusions:The integrated care model can significantly alleviate relocation stress and promote sense of coherence in caregivers of severemultiple injuriespatients after ICU transfer.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective To evaluate the clinical efficacy and safety of traditional Chinese medicine on internal and external treatment of acne.Methods 128 patients in Dermatology Department of Xiyuan Hospital CACMS from May 2012 to March 2013 were collected and randomly divided into Chinese medicine group and western medicine group.The patients of Chinese medicine group were divided into invasion of the Lung by Wind-Heat syndrome and damp-heat oflmg and stomach syndrome,respectively taking acne liquid 1 or 2 orally and using the herb mask once a week.The western medicine group took Roxithromycin Capsules orally and smeared 0.3％ Viaminate and Vitamin E Cream.The treatment period lasted for 6 weeks,and collected the photograph of the target lesion before and after research every 2 week and evaluated the efficacy.Result The total efficacy rate were 90.77％ (59/65) and 74.60％ (47/63) for Chinese medicine group and western medicine group respectively,with significant difference between them(x2=11.83,P＜0.05).The efficacy rates were 87.50％ and 93.94％ for invasion of the Lung by Wind-Heat syndrome and damp-heat of lung and stomach syndrome respectively,with no significant difference between them(x2=0.416,P＞0.05).The TCM symptom scores after treatment [Chinese medicine group (4.36 ± 2.45),western medicine group (8.62± 2.49)] had significant difference in two groups respectively compared with before treatment[Chinese medicine group(15.33±6.08),western medicine group(14.34±5.29),P＜0.05].The difference of TCM symptom scores after treatment between the two groups also had a significant difference (P＜0.05).The TCM symptom scores after treatment of invasion of the Lung by Wind-Heat syndrome group and damp-heat of lung and stomach syndrome group were (4.50±3.01) and (4.24±1.83),which had a significant difference compared with before treatment respectively[(15.37±7.03)and(15.29±5.13),P＜0.05].Conclusion The TCM internal and external treatment on acne could reduce the number of lesions and improve TCM symptom scores.The effect of treating invasion of the Lung by Wind-Heat syndrome and damp-heat of lung and stomach syndrome with TCM was almost equal.

Objective To study the relationship between high-sensitivity C-reactive protein level and carotid plaque in patients with acute cerebral infarction. Methods 73 patients with acute cerebral infarction were selected as research subject,then all the patients were tested with color doppler ultrasound.The patients were divided into unstable plaque group(A group)23 cases,stable plaque group(B group)25 cases and no plaque group(C group)25 cases,at the same time,25 healthy persons were selected as the control group(D group).The high-sensitivity C-reactive protein level and carotid plaque of the four groups were studied. Results The rate of carotid plaque with acute cerebral infarction was higher than that of healthy person(all P＜0.05),and the high-sensitivity C-reactive protein level of D group was lower than that of A group,B group and C group,and the level of A group was higher than that of B group and C group(all P＜0.05). Conclusion The detection rate of carotid plaque and high-sensitivity C-reactive protein level with acute cerebral infarction were both higher than those of healthy persons.It indicated there was cloce relationship between high-sensitivity C-reactive protein level and carotid plaque.

Objective To observe the effects of ACEI( enalapril) on expression of MMP-2 and MMP-9 in renal hypertension rats with focal cerebral ischemia-reperfusion injury. Methods Twenty-eight Wistar male rats were randomly divided into two groups: hypertension group and normaltension group. The former which formed model of renal hypertension rats by constricted renovascular were randomly divided into enalapril group (Y) and hypertension ischemia and reperfusion group(HIR),which fed with enalapril 2mg/kg and equal volum saline respectively;The latter were divided into sham-operation group ( N) and normaltension ischemia and reperfusion group (IR). The focal cerebral ischemia model was established in Wistar rats by using the method of thread inserting left middle cerebral artery occlusion(MCAO) for 2h. After ischemic 24h,the expression of MMP-2 and MMP-9 were measured by immunohisto-chemistry,and the gray scale value was measured by imaging analysis. Results Compared with N,the gray scale values of MMP-2 and MMP-9 in IR were higher(P <0. 01); Compared with IR, the gray scale values of MMP-2 and MMP-9 in HIR were higher(P<0. 05);Compared with HIR,the gray scale values of MMP-2 and MMP-9 in Y were lower(P<0.01). Conclusion Hypertension can increase the expression of MMP-2 and MMP-9 in rats with focal cerebral ischemia-reperfusion. ACEI (Enalapril) could inhibit the expression of MMP-2 and MMP-9 in renal hypertension rats with focal cerebral ischemia-reperfusion.

Objective To analyze the causes of the complications of one-stage surgical management for spinal tuberculosis and its countermeasures.Methods From May 1997 to December 2008,116 patients with spinal tuberculosis underwent operations.Among them,6 were in cervical vertebra,3 in cervicothoracie vertebra,29 in thoracic vertebra,37 in thoracolumbar vertebra.29 in lumbar vertebra and 12 in hmbrosacrum vertebra.All cases underwent the anterior and/or radical debridement,decompression,autogenous bone grafting or radical debridement,decompression,autogenous bone grafting and internal fixation.The causes of the complications of surgical management and the countermeasures were analyzed.Results One hundred and ehven cases were followed upfor an average of(3.86±2.16)years(range 6 months to 12 years).The rate of complication was 13.5%(15/111).Recurrent spinal tuberculosis occarred in 5 cases,internal fixation loosened in 1 case,rupture of the external iliac vein occurred in 2 cases,lateral ventral syndrome in 1 case,venous embolism of the lower extremity in 1 csse,reactional psychosis in 2 cases,pneumatothorax in 2 cases and femoral nerve irritating syndrome in 1 case.Among the recurrent cages,2cases with anterior debridement and 2 cases with posterior debridement underwent anterior operation again andgot good results, 1 case with anterior debridement gave up the reoperafion.Other cases relieved after conservative therapy.Conclusions Standardized anti-tuberculosis thempy is fundamental for preventing the recurrence of tuberculosis.Correct approach for the operation and thorough radical debddement are the key points for preventing the recurrence of tuberculosis.Good and effective therapy surround the operation is helpful for preventing the recurrence of tuberculosis.

Objective To explore the indications of anterior and posterior approach operations for unstable thoraco-lumbar fractures coupled with neurologic deficits and prevention of intraoperative and postoperative complications. Methods We investigated 107 consecutive eases of thoraco-lumbar fractures coupled with spinal cord injury who had been operated on from January 2000 to December 2006.Their average age was 37.8(range.17 to 78) years old. They were 71 males and 36 females. Anterior approach was selected for 46 cases and posterior approach for 61 cases according to their McCormack grades. By the Frankle system for neurologie deficits, 7 cases were graded as A,16 as B,39 as C and 45 as D. Fracture height vecoveries before and after surgery were analyzed statistically. Kyphotic deformity was assessed on lateraJ radiographs using the Cobb method. Results The mean follow-up of 97 cases was 2.8(range,0.5 to 6) years. In both groups. All the cases gained at least 1 grade improvement except those with Frankle grade A. The mean kyphotic angles before operation, after operation and at the latest follow-up were 23.7°,10.6°and13.1°respectively, with significant differences(P＜0.01),in the anterior approach group, while 16.3°,8.4°and 11.7°respectively, with significant differences(P＜0.01),in the posterior approach group. Some complications, such as deficit of cutaneous nerve of thigh, appeared in the 2 groups. Conclusions In treatment of unstable thoraco-lumbar fractures coupled with neurologic deficits, the anterior approach may be better than the posterior approach. The posterior approach can be applied for the cases with less than 7 points in McCormack index. Correct selection of operative approach, careful operation and good rehabilitation after operation are necessary for the prevention of complications.

OBJECTIVE To investigate the clinical character of patients with severe acute pancreatitis(SAP)(infected) with deep fungal organisms and its prevention and treatment with fluconazole.METHODS Among 256(patients) with SAP,46 cases with SAP and deep fungal infection treated by fluconazole were selected as(fluconazole) treatment group,66 patients with suspicious deep fungal infection were randomized into 2 groups: fluconazole(prevention) group(42 cases) and control group(24 cases).RESULTS There were lower incidences of deep fungal(infection) in fluconazole prevention group than that in control one(P

Aim To introduce and apply artificial lumbar interverte-brai disc replacement for the treatment of lumbar disc degenerative diseasesand lumbar disc herniation accompanying evident disc space narrowing andinvestigate the regulation of its recovering spinal motion and carrying a-bility. Methods Thirty-one cases (37 discs) of artificial lumbar disc re-placement were performed using SB Charite Ⅲ from April 1998 to April2000. Among them, disc degenerative diseases were in 16 cases (18discs), disc herniation accompanying evident disc space narrowing in 13cases ( 17 discs), rec urrent dise herniation in 2 cases. The rehabilitationtraining was done under postoperative instructions. Results All the caseswere followed up from 17 to 41 months (averagely 26 months) untilSeptember 2001. The clinical outcomes were excellent in 23 cases, goodin 6 cases, fair in 2 cases. The mobility of the operated level had 4.0°anterior flexion and 5. 1° posterior extension after operation and 9.1° ontotal mobility. Meanwhile, the operated intervertebral space got an average4. 2 mm higher than that before. Because of technical problem, a slightdisplacement of the core occurred in one case without any clinical symp-toms and signs. Conclusion Artificial lumbar disc replacement can re-covery spinal motion and carrying capacity and provides a new kind ofoperation for the treatment of lumbar disc degenerative diseases and discherniation accompanying evident disc space narrowing.