Gut microbiota plays an important role in development of diabetes with frailty. Therefore, it is of great significance to study the structural and functional characteristics of gut microbiota in Chinese with frailty. Totally 30 middle-aged and the aged participants in communities with diabetes were enrolled in this study, and their feces were collected. At the same time, we developed a metagenome analysis to explore the different of the structural and functional characteristics between diabetes with frailty and diabetes without frailty. The results showed the alpha diversity of intestinal microbiota in diabetes with frailty was lower.
Aged ; Diabetes Mellitus ; Epstein-Barr Virus Infections ; Frailty ; Gastrointestinal Microbiome ; Herpesvirus 4, Human ; Humans ; Middle Aged

Objective:To evaluate the effect of early hyperbaric oxygen therapy (HBOT) on neurological function recovery of basal ganglia hemorrhage patients who didn’t receive hematoma evacuation.Methods:A total of 41 basal ganglia hemorrhage patients treated in Nanjing Zijin Hospital and PLA Air Force Hospital of The Eastern Theater Command from January 2015 to January 2020 were included in this study. They did not undergo hematoma evacuation surgery due to small hematoma volume, 18 of whom received early HBOT (treatment group), and the remaining 23 patients received the same HBOT two weeks after hemorrhage (control group). The hematoma volume and the changes of perihematomal edema (PHE) were observed using regular head CT scan, and the incidences of PHE expansion in the two groups were compared on the 10th day after the hemorrhage. All the 41 patients’ neurological functions were assessed by the National Institutes of Health stroke scale (NIHSS) and Glasgow outcome scale (GOS) upon their admission and three months after admission.Results:No re-hemorrhage was found in any patient on the head CT scan. On the 10th day after admission, the incidence of PHE expansion was 16.7% in the treatment group and 91.3% in the control group, respectively, the difference was statistically significant ( P<0.01). After three months of treatment, the NIHSS scores of both groups were decreased, and the GOS scores of both groups were increased. The NIHSS score of the treatment group was lower than that of the control group, while the GOS score in the treatment group was higher than that of the control group, both with statistically significant differences ( P<0.05). Conclusion:Early HBOT is a safe treatment for basal ganglia hemorrhage patients without hematoma evacuation, and it can reduce the occurrence of PHE and improve the prognosis of patients.

Objective:To evaluate the effect of early hyperbaric oxygen therapy (HBOT) on neurological function recovery of basal ganglia hemorrhage patients who didn’t receive hematoma evacuation.Methods:A total of 41 basal ganglia hemorrhage patients treated in Nanjing Zijin Hospital and PLA Air Force Hospital of The Eastern Theater Command from January 2015 to January 2020 were included in this study. They did not undergo hematoma evacuation surgery due to small hematoma volume, 18 of whom received early HBOT (treatment group), and the remaining 23 patients received the same HBOT two weeks after hemorrhage (control group). The hematoma volume and the changes of perihematomal edema (PHE) were observed using regular head CT scan, and the incidences of PHE expansion in the two groups were compared on the 10th day after the hemorrhage. All the 41 patients’ neurological functions were assessed by the National Institutes of Health stroke scale (NIHSS) and Glasgow outcome scale (GOS) upon their admission and three months after admission.Results:No re-hemorrhage was found in any patient on the head CT scan. On the 10th day after admission, the incidence of PHE expansion was 16.7% in the treatment group and 91.3% in the control group, respectively, the difference was statistically significant ( P<0.01). After three months of treatment, the NIHSS scores of both groups were decreased, and the GOS scores of both groups were increased. The NIHSS score of the treatment group was lower than that of the control group, while the GOS score in the treatment group was higher than that of the control group, both with statistically significant differences ( P<0.05). Conclusion:Early HBOT is a safe treatment for basal ganglia hemorrhage patients without hematoma evacuation, and it can reduce the occurrence of PHE and improve the prognosis of patients.

Objective:To explore the predictive value of China Nanjing persistent vegetative state scale (CNPVSS) on the curative effect of the patients with chronic disorder of consciousness, by analyzing the curative effect of the rehabilitation treatment combined with hyperbaric oxygen (HBO) for patients with chronic disorder of consciousness.Methods:A total of 48 patients with chronic disorder of consciousness admitted to Nanjing Zijin Hospital to receive rehabilitation treatment combined with HBO from the September of 2016 to the May of 2019 were selected according with the analytical criteria. Before the treatment, the patients were evaluated by CNPVSS and received electroencephalogram (EEG) and evoked potentials (EPs) examinations. The patients′ consciousness was evaluated again before discharge, the results of CNPVSS and electrophysiological examinations were recorded, and the correlation between the results and the changes of the consciousness was analyzed statistically.Results:The results of CNPVSS was positive correlated with near-term curative effect ( r=0.401, P=0.005); the rate of awakening after treatment was 46.2% among those who were scored as minimally conscious state (MCS) by CNPVSS; the rate of awakening after treatment was 17.1% among those who were at vegetative state (VS) or in a coma; the rate of awakening after treatment of the MCS patients was higher than those of the patients at VS or in a coma ( χ2=4.255, P=0.039). The recordings of right somatosensory evoked potentials (SSEPs) N20 was positive correlated with curative effect ( r=0.312, P=0.031); and the left visual evoked potentials (VEPs) V100 was positive correlated with curative effect ( r=0.285, P=0.049). There were no statistical significance found between other electrophysiological recordings with curative effect. Conclusion:CNPVSS can be an important tool to predict the outcome of the rehabilitation treatment combined with HBO for the patients with chronic disorder of consciousness, and the recordings of SSEPs and VEPs also are of a certain reference value in predicting the prognosis.

Objective:To explore the predictive value of China Nanjing persistent vegetative state scale (CNPVSS) on the curative effect of the patients with chronic disorder of consciousness, by analyzing the curative effect of the rehabilitation treatment combined with hyperbaric oxygen (HBO) for patients with chronic disorder of consciousness.Methods:A total of 48 patients with chronic disorder of consciousness admitted to Nanjing Zijin Hospital to receive rehabilitation treatment combined with HBO from the September of 2016 to the May of 2019 were selected according with the analytical criteria. Before the treatment, the patients were evaluated by CNPVSS and received electroencephalogram (EEG) and evoked potentials (EPs) examinations. The patients′ consciousness was evaluated again before discharge, the results of CNPVSS and electrophysiological examinations were recorded, and the correlation between the results and the changes of the consciousness was analyzed statistically.Results:The results of CNPVSS was positive correlated with near-term curative effect ( r=0.401, P=0.005); the rate of awakening after treatment was 46.2% among those who were scored as minimally conscious state (MCS) by CNPVSS; the rate of awakening after treatment was 17.1% among those who were at vegetative state (VS) or in a coma; the rate of awakening after treatment of the MCS patients was higher than those of the patients at VS or in a coma ( χ2=4.255, P=0.039). The recordings of right somatosensory evoked potentials (SSEPs) N20 was positive correlated with curative effect ( r=0.312, P=0.031); and the left visual evoked potentials (VEPs) V100 was positive correlated with curative effect ( r=0.285, P=0.049). There were no statistical significance found between other electrophysiological recordings with curative effect. Conclusion:CNPVSS can be an important tool to predict the outcome of the rehabilitation treatment combined with HBO for the patients with chronic disorder of consciousness, and the recordings of SSEPs and VEPs also are of a certain reference value in predicting the prognosis.

Objective To translate the 3-minute diagnostic confusion assessment method(3D-CAM)into Chinese,to revise it,and to test its reliability and validity in elderly patients.Methods We translated and culturally adapted 3D-CAM into Chinese.The sample was formed by 230 elderly patients over 65 years of age.We tested inter-assessors reliability and criterion validity (diagnostic validity)and then computed the sensitivity,specificity,positive predictive value,and negative predictive value of the Chinese version of 3D-CAM.Results Correlation analyses between each item and its total score showed that the correlation coefficients ranged between 0.290 and 0.724,all reaching statistical significance(P＜0.01).Inter-assessor reliability in a sample size of 30 patients resulted in a kappa value of 0.78 (P ＜ 0.001).Compared with the gold standard,the diagnostic and statistical manual of mental disorders(DSM-5)by American Psychiatric Association(APA),the sensitivity of the Chinese version of 3D-CAM was 94.73％,the specificity was 97.92％,the positive predictive value was 90.00％,and the negative predictive value was 98.95％.Conclusions The Chinese version of 3D-CAM has achieved satisfactory reliability and validity through pilot runs in surgery and internal medicine inpatients,proved to be easy and convenient to administer,and can be used as an assessment tool for delirium in elderly surgery and internal medicine patients.

Objective To investigate the clinical application of the 2011 edition of China Nanjing Persistent Vegetative State (NPVSS 2011).Methods Three hundred and one patients with vegetative state (VS),persistent vegetative state (PVS) and minimally conscious state (MCS) admitted into hospital from February 22,2011 to May 30,2014 were chosen for the study.Patient conditions and treatment efficacy were assessed by using the NPVSS 2011.Results With regard to conscious state at admission into hospital,109 cases were in VS,65 were in PVS and 127 were in MCS.When discharged from hospital,there were 8 VS cases,72 PVS cases,91 MCS cases,and 130 Ⅲ cases that could carry out more complicated instructions.Of all the cases,164 cases had prominent efficacy,31 were improved,106 were invalid,and 130 cases that had consciousness recovery to the state of Ⅲ.Conclusions The CNPVSS could reflect the changing processes of patient conditions,having the features of being simple and clear,conforming to clinical practice,and above all being easy to master and operate.With this reason,it could be applied to clinical practice.

Objective To investigate the clinical application of the 2011 edition of China Nanjing Persistent Vegetative State (NPVSS 2011).Methods Three hundred and one patients with vegetative state (VS),persistent vegetative state (PVS) and minimally conscious state (MCS) admitted into hospital from February 22,2011 to May 30,2014 were chosen for the study.Patient conditions and treatment efficacy were assessed by using the NPVSS 2011.Results With regard to conscious state at admission into hospital,109 cases were in VS,65 were in PVS and 127 were in MCS.When discharged from hospital,there were 8 VS cases,72 PVS cases,91 MCS cases,and 130 Ⅲ cases that could carry out more complicated instructions.Of all the cases,164 cases had prominent efficacy,31 were improved,106 were invalid,and 130 cases that had consciousness recovery to the state of Ⅲ.Conclusions The CNPVSS could reflect the changing processes of patient conditions,having the features of being simple and clear,conforming to clinical practice,and above all being easy to master and operate.With this reason,it could be applied to clinical practice.

Objective: To analyze the effects of the catastrophic disease insurance of New Rural Cooperative Med-ical Scheme ( NRCMS) on alleviating the economic burden of patients in Beijing, and evaluate the effect of the policy implementation. Methods: Based on high, middle and low economic development levels and the implementation pro-ceedings of catastrophic disease insurance of NRCMS, this paper selects 3 districts of Beijing, from which it chooses two or three villages and towns with the highest numbers of catastrophic disease patients, in order to understand the opera-tional status quo of the catastrophic disease insurance through in-depth interviews with managers. This paper conducts questionnaire survey among all catastrophic disease patients from the sampled villages and towns, and uses 497 valid questionnaires received to understand patients' subjective feelings and collect relevant data of family income and medical expenditure of catastrophic disease patients in 2013. Then it carries out data docking with the platform of NRCMS man-agement centers and measure the economic burden of catastrophic disease patients. In this paper, quantitative and qualitative data are analyzed using statistical and thematic analyses, respectively. Results: The catastrophic disease in-surance of NRCMS has significantly played an important role in reducing the average medical expenditure of catastroph-ic disease patients and improving the actual compensation ratio in varying degrees. However, the incidence of cata-strophic health expenditures has not significantly improved. Conclusion: This paper suggests to increase deductibles and reimbursement ratios of catastrophic disease insurance in order to broaden reimbursement directory and other initiatives to improve the compensation level and focus on alleviating the economic burden of catastrophic disease patients.

Objective:To understand the patients'satisfaction on catastrophic medical insurance of New Rural Cooperative Medical Scheme ( NRCMS ) , and provide references for effective management and policy improvement. Methods:According to the principles of representative sampling, a questionnaire survey conducted. 484 patients got compensation for catastrophic insurance in 2013 were surveyed, and information of medical costs was analyzed. Re-sults:The average medical cost accounts for 84. 57% of total household expenditure. Mandatory medical expenditure is still high and economic burden of diseases is heavy. This policy has increased the compensation rate, and the actu-al compensation rate increases 4. 79% in three districts. The average score of patients' attitude toward catastrophic medical insurance is (3.95±1.05) points, 88. 43% of patients continue to participate in medical insurance. Con-clusions and suggestions:Patients' satisfaction on catastrophic medical insurance of NRCMS is high. It is suggested that the existing financing modes should maintain stability in the short term, and the compensatory rate should be im-proved reasonably.