Purpose To explore the value of gray-scale ultrasound and contrast-enhanced ultrasound of carotid plaques combined with clinical factors in predicting the recurrence risk of ischemic stroke(IS)in patients with mild to moderate carotid stenosis.Materials and Methods A total of 101 patients with mild to moderate carotid artery stenosis who were initially diagnosed with IS in the First Medical Center of the Chinese PLA General Hospital were prospectively collected from May 2022 to August 2023.After one year of follow-up,patients were divided into recurrent group(n=33)and non-recurrent group(n=68)according to whether new IS occurred.The characteristics of plaque ultrasound and the clinical information of patients were compared between the two groups.A multivariate Logistic prediction model was established and its efficacy was evaluated.Results The results of multivariate analysis showed that low-density lipoprotein cholesterol(OR=2.116,P=0.046),C-reactive protein(OR=3.707,P=0.008),plaque internal echo(OR=7.410,P=0.029)and intraplaque neovascularization grading 3(OR=17.155,P=0.030)were independent risk factors for the recurrence of IS.The area under the curve of the model established using the above indicators was 0.825,the sensitivity and specificity were 87.50%and 65.15%,respectively.Conclusion The ultrasound features of carotid plaque are closely related to recurrent IS,which can provide an important basis for the clinical treatment of patients with mild-moderate carotid artery stenosis complicated with IS.

Objective:To observe the effects of 12.5% carbohydrate (CHO) solution and medium chain triglycerides (MCT) solutions at various concentrations on gastric emptying, in order to determine the optimal MCT-CHO combination for enhanced recovery after surgery.Methods:This study was a prospective study. Ten healthy volunteers were selected to ingest 400 ml of the following 5 solutions every day: water, 12.5% CHO, 1% MCT, 2% MCT and 4% MCT. According to the above results, the optimal concentration of MCT solution was 2% MCT, showing comparable gastric emptying rate compared with 12.5% CHO solution. On this basis, combinations of MCT and CHO solutions were determined to be 30 energy % (EN%) MCT+70 EN% CHO and 20 EN% MCT+80 EN% CHO according to the energy distribution ratio. Then the volunteers were given 400 ml of the following 4 solutions every day: 12.5% CHO, 2% MCT, 30 EN% MCT+70 EN% CHO (equivalent to 2% MCT+8% CHO), and 20 EN% MCT+80 EN% CHO (equivalent to 4.4% MCT+10% CHO). Gastric emptying during fasting (T m) and immediately (T 1), 30 min (T 2), 60 min (T 3), 90 min (T 4) and 120 min after ingestion (T 5) were observed by antral ultrasonography. The degree of thirst, hunger, and anxiety was assessed by Visual Analogue Scale, and the taste was rated. Results:The gastric emptying rate in descending order was 20%EN MCT+80%EN CHO group>30%EN MCT+70%EN CHO group≈2％MCT group≈12.5%CHO group. There was no significant difference in gastric emptying rate between 30 EN% MCT+70 EN% CHO group and 12.5% CHO group ( P>0.05). The scores of thirst, hunger and anxiety in 30 EN% MCT+70 EN% CHO group at T 1 to T 5 were significantly lower than those at T m ( P<0.05). 30 EN% MCT+70 EN% CHO group showed the highest taste score. Conclusion:30 EN% MCT+70 EN% CHO solution has similar gastric emptying rate compared with 12.5% CHO solution. It can relieve thirst, hunger, anxiety and other subjective feelings caused by fasting, with tastes better than 12.5% CHO solution.

Objective:To observe the effects of 12.5% carbohydrate (CHO) solution and medium chain triglycerides (MCT) solutions at various concentrations on gastric emptying, in order to determine the optimal MCT-CHO combination for enhanced recovery after surgery.Methods:This study was a prospective study. Ten healthy volunteers were selected to ingest 400 ml of the following 5 solutions every day: water, 12.5% CHO, 1% MCT, 2% MCT and 4% MCT. According to the above results, the optimal concentration of MCT solution was 2% MCT, showing comparable gastric emptying rate compared with 12.5% CHO solution. On this basis, combinations of MCT and CHO solutions were determined to be 30 energy % (EN%) MCT+70 EN% CHO and 20 EN% MCT+80 EN% CHO according to the energy distribution ratio. Then the volunteers were given 400 ml of the following 4 solutions every day: 12.5% CHO, 2% MCT, 30 EN% MCT+70 EN% CHO (equivalent to 2% MCT+8% CHO), and 20 EN% MCT+80 EN% CHO (equivalent to 4.4% MCT+10% CHO). Gastric emptying during fasting (T m) and immediately (T 1), 30 min (T 2), 60 min (T 3), 90 min (T 4) and 120 min after ingestion (T 5) were observed by antral ultrasonography. The degree of thirst, hunger, and anxiety was assessed by Visual Analogue Scale, and the taste was rated. Results:The gastric emptying rate in descending order was 20%EN MCT+80%EN CHO group>30%EN MCT+70%EN CHO group≈2％MCT group≈12.5%CHO group. There was no significant difference in gastric emptying rate between 30 EN% MCT+70 EN% CHO group and 12.5% CHO group ( P>0.05). The scores of thirst, hunger and anxiety in 30 EN% MCT+70 EN% CHO group at T 1 to T 5 were significantly lower than those at T m ( P<0.05). 30 EN% MCT+70 EN% CHO group showed the highest taste score. Conclusion:30 EN% MCT+70 EN% CHO solution has similar gastric emptying rate compared with 12.5% CHO solution. It can relieve thirst, hunger, anxiety and other subjective feelings caused by fasting, with tastes better than 12.5% CHO solution.

Purpose To explore the value of gray-scale ultrasound and contrast-enhanced ultrasound of carotid plaques combined with clinical factors in predicting the recurrence risk of ischemic stroke(IS)in patients with mild to moderate carotid stenosis.Materials and Methods A total of 101 patients with mild to moderate carotid artery stenosis who were initially diagnosed with IS in the First Medical Center of the Chinese PLA General Hospital were prospectively collected from May 2022 to August 2023.After one year of follow-up,patients were divided into recurrent group(n=33)and non-recurrent group(n=68)according to whether new IS occurred.The characteristics of plaque ultrasound and the clinical information of patients were compared between the two groups.A multivariate Logistic prediction model was established and its efficacy was evaluated.Results The results of multivariate analysis showed that low-density lipoprotein cholesterol(OR=2.116,P=0.046),C-reactive protein(OR=3.707,P=0.008),plaque internal echo(OR=7.410,P=0.029)and intraplaque neovascularization grading 3(OR=17.155,P=0.030)were independent risk factors for the recurrence of IS.The area under the curve of the model established using the above indicators was 0.825,the sensitivity and specificity were 87.50%and 65.15%,respectively.Conclusion The ultrasound features of carotid plaque are closely related to recurrent IS,which can provide an important basis for the clinical treatment of patients with mild-moderate carotid artery stenosis complicated with IS.

Purpose To explore the diagnostic efficiency of ultrasound(US)combined with contrast-enhanced ultrasound(CEUS)in breast lesions and to analyze the related factors affecting the diagnostic accuracy.Materials and Methods From January 2022 to February 2023,the clinical data and ultrasound images of 784 patients who underwent breast US and CEUS examination with definite pathological results were retrospectively collected in the First Medical Center of the PLA General Hospital.The diagnostic efficacy of US combined with CEUS in benign and malignant breast lesions was analyzed,respectively.The independent risk factors for diagnostic errors were analyzed via Logistic regression.Results The sensitivity,specificity and accuracy of US combined with CEUS in the diagnosis of benign and malignant breast lesions were 89.2%,84.4%and 88.7%,respectively.The area under the receiver operating characteristic curve was 0.932.The results of multivariate Logistic regression analysis showed that the diagnosis error rate increased when the lesions were non-mass type(odds ratio,OR=1.927,P=0.047),complex cystic and solid(OR=3.729,P=0.000),and high-enhanced CEUS(OR=1.937,P=0.023),while the diagnosis error rate decreased when the lesions were large(OR=0.688,P=0.004)and with US-detect suspicious lymph node(OR=0.143,P=0.011).Conclusion When the breast lesions are non-mass type,complex cystic and solid lesions and hyper-enhancement,the diagnosis error rate of US combined with CEUS increased.It is necessary to further explore the enhancement patterns of different lesions.

Purpose To explore the correlation between phosphatidylinositol 3 kinase/serine-threonine kinase(PI3K/AKT)signaling pathway and elastic characteristics of breast lesions.Materials and Methods A total of 115 breast lesions were prospectively analyzed in 114 patients who underwent surgery from May 2021 to May 2022 at Chinese PLA General Hospital.Ultrasound and shear wave elastography were performed preoperatively.Immunohistochemical staining was used to detect the expression of PI3K/AKT protein levels in the tissue specimens,and the correlation between the staining results and the elastic parameters of shear wave elastography was analyzed.Results Surgical pathology revealed benign breast lesions in 50 cases and malignant lesions in 65 cases(25 cases with axillary lymph node metastasis).The maximum modulus of elasticity(F=40.47),the average modulus of elasticity(F=45.11),the ratio of elasticity of the lesion to that of the surrounding tissue(F=48.98),the detection rate of"hard ring sign"(χ2=62.25),the expression level of PI3K/p-PI3K(F=15.19,58.95)and AKT/p-AKT(F=46.94,74.21)were found in benign and malignant lesions without axillary lymph node metastasis,malignant lesions with axillary lymph node metastasis(all P<0.05).The expression levels of PI3K/p-PI3K and AKT/p-AKT were positively correlated with the maximum elastic modulus value,the mean elastic modulus value,and the ratio of elasticity of the lesion to the surrounding tissues(r=0.475,0.475,0.451;r=0.533,0.540,0.542;r=0.371,0.402,0.445;r=0.482,0.455,0.545,all P<0.05).Conclusion The expression level of PI3K/AKT in breast lesions is correlated with elastic characteristics,suggesting that it plays an important role in the regulation of elastic characteristics of breast lesions.

Objective To explore the effects of individualized psychological support on sleep condition, psychological status and quality of life in patients with chronic obstructive pulmonary disease (COPD) in Respiratory Department and ICU. Methods A total of 68 patients with COPD administrated in the respiratory department and ICU of Shangqiu First People's Hospital from July 2014 to October 2016 were selected by convenience sampling method and divided into control group and observation group by random number table method, with 34 cases in each group. The patients in the control group were given routine nursing care, while the patients in the observation group were given individualized psychological nursing support on the basis of routine care till discharged or transferred. Pittsburgh Sleep Quality Index (PSQI) was applied to evaluate patients' sleep condition; Self-Perceived Burden Scale (SPBS) and Memorial University of Newfoundland Scale of Happiness (MUNSH) were used to assess patients' psychological status; and the Quality of Life Scale for Adult Patient with Chronic Obstructive Pulmonary Disease (COPD-QOL) was applied to compare the patients' quality of life between the two groups before and after the intervention. The sleep condition, psychological status and quality of life were compared between the two groups. Results Before the intervention, there were no statistical differences in sleep condition, self-perceived burden, subjective happiness and quality of life between the two groups (P>0.05). After the intervention, the scores of sleep quality and sleep condition of the observation group was significantly lower than those of the control group; the total score and the score of each dimension in the self-perceived burden scale of the observation group were all lower than those of the control group; the positive score of subjective happiness and its total score of the observation group were higher than those of the control group, while the negative score was lower than that of the control group; in addition, the total scores of patients' living ability, psychological status and quality of life of the observation group were all higher than those of the control group;the differences were all statistically significant (P<0.05). Conclusions Individualized psychological support can significantly improve the sleep quality of patients with COPD in respiratory department and ICU,relieve their self-perceived burden, encourage patients to adopt healthy and positive coping style, so as to improve the quality of life.

Objective To explore the application effects of psychological support therapy in the treatment of patients with COPD combined with emotional disorders. Methods A total of 100 COPD patients with emotional disorders treated in the First People's Hospital of Shangqiu from March 2015 to March 2017 were selected for the study using convenient sampling. The participants were divided into the control group (n=50) and the observation group (n=50). Patients in the control group were given routine therapy and nursing. Based on the routine therapy and nursing care, the observation group was given additional psychological support therapy. The percentage of FEV1 in predicted value (FEV1%), the ratio of FEV1 in the forced vital capacity (FEV1/FVC), scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), COPD Assessment Test (CAT), Modified Medical Research Council (mMRC) Score, the satisfaction degree and happiness degree were compared between two groups. Results There were no significant differences in FEV1% and FEV1/FVC between two groups after the treatment (P>0.05). The observation group had significantly lower scores of HAMA, HAMD, CAT, and mMRC compared with the control group (P< 0.05). The nursing satisfaction level and happiness degree were significantly higher in the observation group compared with the scores in the control group (P<0.05). Conclusions The psychological support therapy can effectively alleviate unhealthy emotions and improve the dyspnea symptoms in COPD patients combined with emotional disorders. It can also improve their quality of life and satisfaction and happiness level.

Objective To evaluate the impact of standardized health management and treatment on asthma control and the quality of life of the patients.Methods One hundred asthma patients were recruited in our hospital and were assigned to the health management (n=50) or the control group (n=50).The control group subjects were treated with conventional therapy,while those of the heahh management group received standardized asthma management and health education.The control of asthma and the quality of life were evaluated at baseline and six months after the intervention.Student's t test and Chisquare test were used for data analysis.Results At 6 months treatment,the rate of effective control of asthma of the health management group (56％) was higher than that of the control group (22％) (x2=12.15,P＜0.05).In the control group,the activity limitation,asthma symptoms,mentality asthma,the stimulus response,the personal health concerns and the total score of Quality of life were (47.4±5.8),(35.3±6.2),(28.2±4.3),(22.7±3.5),(17.6±3.9),(151.2±14.7),and they were (38.2±4.5),(27.1±4.8),(23.1±5.7),(18.3±4.3),(13.7±4.2),(121.4± 12.6) in the control group,they were all significantly higher in the management group than that of control group(t values were 6.17,4.42,4.98,5.76,5.43 and 6.35,all P＜0.05).Conclusion The standardized health management and the health education can effectively control asthma and significantly improve the quality of the patient's life.

Objective To explore the effect of health education and comprehensive nursing intervention on quality of patients with lung cancer.Methods One hundred lung cancer patients who were treated with chemotherapy from February 2010 to February 2013 in our hospital were selected and assigned to the intervention group (n=50) and the control group (n=50).The participants in the control group received conventional anti-cancer drug and routine primary care,however those of the intervention group additionally obtained health education and comprehensive nursing intervention.The Zung Anxiety Scale (SAS),Depression Rating Scale (SDS) and the core quality of life questionnaire (QLQ-C30) were used to evaluate the quality of life of the patients.Paired samples t test and ANOVA were used for data analysis.Results Differences of age,gender,disease duration,SAS,SDS score and EORTC QLQ-C30 score were not statistically significant between the two groups (all P＞0.05).After the intervention,SAS and SDS scores of the control subjects were 58.8±7.6 and 49.5±10.1 respectively,and SAS and SDS scores of the intervention group were 46.5±7.8 and 37.4±9.2 respectively (t velues were 5.347 and 6.215,respectively; both P＜0.05).Quality of life scores in the intervention group were as followed:general condition 57.2± 18.3,physical fitness 63.0±25.9,mutual affection 67.3±23.3,cognitive score 75.4±28.2,social role 67.7±24.8 and function scores 58.5±22.3.Quality of life scores in the control group were as followed:general condition 47.3±23.0,physical fitness 54.9±26.6,mutual affection 60.4±19.1,cognitive score 66.2±25.8,social role 54.1±26.2 and function scores 49.4±21.5 (t values were 5.725,6.144,5.021,5.702,7.137 and 6.357,respectively; all P＜ 0.05).Conclusion Health education and comprehensive nursing intervention for lung cancer patients may reduce their anxiety and depression symptoms and improve the quality of life.