OBJECTIVE To explore the influence of surgical history on chemotherapy -induced nausea and vomiting （CINV）. METHODS A retrospective case -control study was adopted ，with 824 patients undergoing chemotherapy as the object . A total of 27 items were collected ，including demographic data ，medical history data ，pre-chemotherapy data ，and chemotherapy treatment status. Logistic regression model was used to analyze the relationship between the history of surgery and the risk of CINV . The multiple models were constructed to correct potential confounding factors ，and subgroup analysis was performed on patients with surgical history . RESULTS The incidence of CINV was higher in patients with surgical history . The statistical result before adjustment was [OR＝1.72，95%CI（1.31，2.28），P＜0.001]；after adjusting potential confounding factors ，the statistical result was [OR＝1.78，95% CI（1.28，2.48），P＝0.001]. In the subgroup analysis ，the time between surgery and chemotherapy was different ， and the impact of surgical history on CINV was different ，and the results were statistically significant （P＝0.027）. The risk of CINV showed decreasing trend with the time ，and the results were statistically significant （P for trend ≤0.050）. Compared with patients who had not undergone surgery ，patients who had undergone surgery within one year had a higher risk of CINV [OR＝ 2.33，95%CI（1.52，3.59），P＜0.001]. CONCLUSIONS Patients with surgical history are more prone to CINV ，and the risk of CINV shows a downward trend in the length of time from surgery .

Objective:To explore the application and treatment efficacy of less invasive surfactant administration (LISA) and nasal high-frequency oscillation ventilation (nHFOV) in very low and extremely low birth weight preterm infants with neonatal respiratory distress syndrome (NRDS).Methods:A total of 85 very low and extremely low birth weight preterm infants with gestational age ranging between 27-32 weeks who were diagnosed with NRDS in the Second Affiliated Hospital of Zhengzhou University from July 2018 to October 2019 were enrolled.After being stratified by gestational age of >27-29 weeks, >29-30 weeks, >30-31 weeks, >31-32 weeks, the neonates were divided into the LISA group (40 cases) and the intubation-surfactant-extubation (INSURE) group (45 cases) by the random envelope method.The LISA group was subdivided into the continuous positive airway pressure (CPAP) group (25 cases) and the nHFOV group (15 cases) by the same method.The patients in the INSURE group were infused with pulmonary surfactant (PS) through the endotracheal tube under positive airway pressure, and then treated with CPAP after extubation.The patients in the LISA group were first treated with CPAP and injected with PS through the gastric tube.After removing the gastric tube, the patients in the CPAP group were given CPAP-assisted ventilation, while the patients in the nHFOV group were given nHFOV-assisted ventilation or mechanical ventilation if nHFOV-assisted ventilation failed.The feasibility of LISA technology and nHFOV was observed, and the adverse reactions, mechanical ventilation, oxygen duration, hospital stay and the incidence of NRDS complications in different groups of the patients were compared.Results:(1) The mechanical ventilation rate (5.0% vs.22.2%), the incidence of broncho-pulmonary dysplasia (BPD) (20.0% vs.42.2%) and the incidence of periventricular leukomalacia (PVL) (12.5% vs.42.2%) in the LISA group were significantly lower than those in the INSURE group (all P<0.05). There were no statistically significant differences in total oxygen duration, hospitalization duration, intraventricular he-morrhage (IVH), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) between the LISA group and the INSURE group (all P>0.05). (2) There was no significant difference in adverse reactions between the LISA group and the INSURE group as well as between the CPAP group and the nHFOV group (all P>0.05). (3) The younger the gestational age at birth, the higher the incidence of NRDS complications.Patients in the LISA group had a lower incidence of NPDS complications than patients of the same gestational age in the INSURE group, but the diffe-rence was not statistically significant (all P>0.05). (4) There was no significant difference in the mechanical ventilation rate and the incidence of BPD, IVH, PVL, NEC and ROP complications between the CPAP group and the nHFOV group (all P>0.05). Conclusions:In the treatment of very low and extremely low birth weight preterm infants with NRDS at the gestational age of 27-32 weeks, LISA technology is a safe and effective PS delivery method, which can reduce the mechanical ventilation rate and the incidence of BPD and PVL.The nHFOV can be used as an initial model for respiratory support of NRDS preterm infants with very low and ultra-low birth weight.LISA combined with nHFOV is applicable to the treatment of preterm infants with NRDS.

Objective: To understand the current status of follow up of people living with HIV/AIDS by health service at grass root in rural area of Jiangxi province and related factors, and provide references for the promotion of the follow up by grass root health service. Methods: People living HIV/AIDS aged ≥18 years and diagnosed before 31 December 2017 in 6 townships of Xinjian, Yushan counties and Guixi city were included in the study in Jiangxi province. They had been followed up for more than one time after the first epidemiologic survey. The information about their demographic characteristics and HIV infection status were collected by using self-designed questionnaire. Univariate and multivariate logistic regression analyses were conducted to identify the factors that influencing the acceptance of follow up by grass root health service. Results: Of the 373 surveyed HIV infected subjects aged (53.06±16.15) years, 261 were males (70.0%, 261/373). Among the surveyed subjects, the illiteracy and people who received only primary school education accounted for 54.7% (204/373). The rate of follow up of the HIV infected subjects by grass root health service was 55.8% (208/373), and those through heterosexual contact were 58.5% (190/325). The multivariate regression analysis showed that the acceptance of follow up by grass root health service was higher in those who were farmers (OR=7.36, 95%CI: 2.52-21.45), had family support (OR=16.01, 95%CI: 2.25-49.73), didn’t worry about discrimination (OR=12.97, 95%CI: 4.75-35.42), trusted health care provider (OR=5.07, 95%CI: 2.19-11.76) and showed AIDS symptoms (OR=10.58, 95%CI: 2.25- 49.73). Conclusions The performance of follow up of people living with HIV/AIDS by grass root health service was well, suggesting it is a feasible management model. Being famer or not, family member supporting or not, worry about discrimination or not, trusting health care provider or not and showing AIDS symptoms or not were the main factors influencing the acceptance of follow up by grass root health service.

The HIV-infected people were investigated for their satisfactory situation towards the follow-up management of primary medical and health care institutions in Xinjian County, Yushan County and Guixi City of Jiangxi Province from January to July 2018 and related factors were also analyzed. The total score of the Infected Patients′ Follow-up Management Satisfaction Scale higher than 59 was defined as the satisfactory. 75.68% of 259 infected patients were satisfied with the follow-up management. Compared to farmers and other follow-up modes, non-farmers (OR=10.72, 95%CI: 2.07-55.63), and patients receiving follow-up service in responsible institutions (OR=6.44, 95%CI: 3.12-13.30) were more satisfied with follow-up management.

The HIV?infected people were investigated for their satisfactory situation towards the follow?up management of primary medical and health care institutions in Xinjian County, Yushan County and Guixi City of Jiangxi Province from January to July 2018 and related factors were also analyzed. The total score of the Infected Patients′Follow?up Management Satisfaction Scale higher than 59 was defined as the satisfactory. 75.68% of 259 infected patients were satisfied with the follow?up management. Compared to farmers and other follow?up modes, non?farmers (OR=10.72, 95%CI: 2.07-55.63), and patients receiving follow?up service in responsible institutions ( OR=6.44, 95%CI : 3.12-13.30) were more satisfied with follow?up management.

The HIV?infected people were investigated for their satisfactory situation towards the follow?up management of primary medical and health care institutions in Xinjian County, Yushan County and Guixi City of Jiangxi Province from January to July 2018 and related factors were also analyzed. The total score of the Infected Patients′Follow?up Management Satisfaction Scale higher than 59 was defined as the satisfactory. 75.68% of 259 infected patients were satisfied with the follow?up management. Compared to farmers and other follow?up modes, non?farmers (OR=10.72, 95%CI: 2.07-55.63), and patients receiving follow?up service in responsible institutions ( OR=6.44, 95%CI : 3.12-13.30) were more satisfied with follow?up management.

Objective To observe the effect of electroacupuncture at the beginning and ending points of bicipital muscle on the superficial electromyography (sEMG) of the spastic limb in hemiplegia.Method Forty patients with spastic hemiplegia after cerebral stroke were divided by the random number table into a group of electroacupuncture at the beginning and ending points (group A) and a group of electroacupuncture at antagonistic muscles (group B). The former selected Ashi points at the beginning and ending points of bicipital muscle, while the latter selected points at the antagonistic muscles [Tianjing (TE10), Qinglingyuan (TE11), etc.], to receive perpendicular puncturing. The needles were retained for 30 min, and the sEMG of bicipital muscles in resting state was detected after the removal of the needles. The spastic bicipital muscle was examined by sEMG prior to the acupuncture treatment, and respectively after 2-week and 4-week acupuncture treatment, and the detected parameters included root mean square (RMS) and integrated electromyography (IEMG).ResultThe EMG and IEMG declined gradually in the two groups after the acupuncture treatment; the intra-group comparisons of the RMS and IEMG values at three time points, e.g. prior to acupuncture treatment, after 2-week acupuncture treatment and after 4-weekacupuncture treatment, showed that the values changed significantly compared to those at the previous time point (P<0.05); the between-group comparisons showed that there were no significant differences in comparing the RMS and IEMG values regardless of different time points (P>0.05). The RMS and IEMG values presented same changing tendencies after 4-week acupuncture treatment in the two groups.ConclusionAcupuncture at the beginning and ending points and at the points on antagonistic muscles both can decrease the resting-state muscle tension in hemiplegia patients; sEMG is of certain significance in evaluating the treatment of hemiplegia.

Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with per-cutaneous microwave ablation(MWA)in treatment of large-sized hepatic carcinoma.Methods A total of 84 patients with large-sized hepatic carcinoma were randomly and equally divided into the study group(n=42)and control group(n=42).TACE combined with MWA was carried out in the patients of the study group,while only TACE was performed in the patients of the control group.Results The effective rate of the study group and the control group was 71.4% and 42.8% respectively,and the difference between the two groups was statistically significant(P <0.05).In the study group,the survival rates at 6,12,18,24 months after the treatment were 88.1%,73.8%,52.3% and 33.3% respectively,while in the control group the survival rates were 76.2%,57.1%,30.9% and 9.5%respectively.There was no statistically significant differences in the postoperative complications between the two groups.Conclusion TACE combined with MWA appears to be an effective approach for the treatment of large-sized hepatic carcinoma.The effect of combined therapy is obviously superior to the only TACE.

Objective To evaluate the outcome and safety of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) in the management of esophageal mucosal lesion.Methods The clinical data of 70 patients with esophageal mucosal lesion were analyzed.Twenty-five patients were treated by ESD (ESD group) and 45 patients were treated by EMR (EMR group).The enbloc resection rate,tissue healing resection rate,operation time,complication and recurrence rate were compared between two groups.Results The enbloc resection rate,tissue healing resection rate in ESD group were significantly higher than those in EMR group [60.0％(15/25) vs.48.9％(22/45),48.0％(12/25) vs.40.0％ (18/45)] (P ＜0.05).The local recurrence rate in ESD group was lower than that in EMR group [4.0％ (1/25) vs.20.0％ (9/45)] (P ＜ 0.05).The severe complication such as delayed hemorrhage,perforation,stenosis between two groups had no significant difference (P ＞ 0.05).The operation time in ESD group was (64.3 ±27.1) min,and significantly longer than that in EMR group [(27.6 ± 14.1) min] (P ＜0.05).Conclusions Compare with EMR,ESD has better enbloc resection rate,tissue healing resection rate,and lower recurrence rate.It is more safe and effective in the therapy of esophageal mucosal disease.

Objective To investigate the significance of treadmill exercise test in male patients with coronary heart disease.Methods Two hundred and twenty-four male patients who diagnosed as coronary heart disease by coronary angiography were enrolled in this study,and treadmill exercise test were performed before and 1 month after coronary angiography.The coronary artery stenosis degree and scope were compared between two methods.Results In coronary angiography of 224 patients,the positive was 171 patients and negative was 53 patients.The single stenosis,double stenosis and triple stenosis was 87,55,29 patients.In treadmill exercise test of 224 patients,the positive was 143 patients and negative was 81 patients.The sensibility of treadmill exercise test compared the standard of coronary angiography was 81.3％,positive predictive value was 97.2％.Meanwhile in patients combined with hypertension or diabetic,treadmill exercise test found that the ST segment depression appeared earlier,persistence time longer.The persistence time and the number of down lead in double stenosis and triple stenosis was higher than that in single stenosis.Conclusion Treadmill exercise test is an important method in the diagnosis of coronary artery disease,and can preliminarily estimate the extent of coronary artery stenosis.