Objective:To investigate the effects and the possible mechanisms of Neiguan(PC6)and Gongsun(SP4)on the hypothalamic-pituitary-adrenal(HPA)axis in rats with functional dyspepsia(FD),thus to provide a theoretical basis for the clinical application of the Eight Confluent Points.Methods:Forty specific-pathogen-free Sprague-Dawley rats were divided into a blank group,a model group,an electroacupuncture(EA)group,and a Western medicine group by the random number table method,with 10 rats in each group.Rats in the blank group did not receive modeling or intervention.Rats in the other three groups were subjected to the FD with mood disorder model using the compound etiology modeling method.After the successful modeling,rats in the model group did not receive any interventions,rats in the Western medicine group received deanxit and mosaprid intervention,and those in the EA group received EA intervention on the ipsilateral Neiguan(PC6)and Gongsun(SP4)for 21 d.The sugar-water consumption rate was measured before the experiment and before and after interventions to assess the emotional status.The gastric emptying rate was measured after interventions to assess the gastrointestinal dynamics.The expression levels of hypothalamic corticotropin-releasing hormone(CRH),pituitary adrenocorticotropic hormone(ACTH),and adrenal corticosterone(CORT)were measured by enzyme-linked immunosorbent assay.Results:Compared with the blank group,the sugar-water consumption rate and the gastric emptying rate were decreased(P<0.01),and the hypothalamic CRH,pituitary ACTH,and adrenal CORT expression levels were increased(P<0.01)in the model group.Compared with the model group,the sugar-water consumption rate and the gastric emptying rate were significantly increased(P<0.01),while the expression levels of hypothalamic CRH,pituitary ACTH,and adrenal CORT were significantly decreased(P<0.01)in the EA group and the Western medicine group.The differences between the EA group and the Western medicine group were not statistically significant(P>0.05).Conclusion:The Eight Confluent Points Neiguan(PC6)and Gongsun(SP4)can improve the mood and gastrointestinal dynamics in FD rats,which may be achieved by down-regulating the hypothalamic CRH,pituitary ACTH,and adrenal CORT,as well as by correcting the HPA axis hyperfunction.

ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome types and influencing factors of protein-energy wasting （PEW） in chronic kidney disease （CKD） undergoing maintenance hemodialysis （MHD）. MethodsAccording to diagnostic criteria， 164 patients with MHD were divided into PEW group and non-PEW group. The clinical data of all patients were collected， including general information such as gender， age， height and weight， disease characteristics such as course， cormobidity， and haemodialysis duration， laboratory indicators such as blood routine， liver function， renal function， electrolyte， blood lipid， grip strength， and the four examinations. Logistic regression analysis was used to find the influencing factors of PEW by taking the clinical indicators with significant differences between the two groups （P＜0.05） as the independent variables， diagnosis of PEW as the dependent variable， and normal values as the reference. ResultsOut of 164 patients with MHD， there were 96 （58.5%） cases in PEW group and 68 cases （41.5%） in non-PEW group. Compared to the non-PEW group，PEW group had increased age， ratios of bedrest， deep vein preservation， edema， and low grip strength， percentages of comorbidities type 2 diabetes， cardiovascular and cerebrovascular diseases，infections and anemia， and levels of alanine aminotransferase and permine amin aminotransferase， as well as decreased body mass index， self-care ratio，internal arteriovenous fistula， red blood cell count， hemoglobin， serum total protein， serum albumin levels （P＜0.05）. The PEW group had significantly higher frequency of poor appetite and digestion， abdominal distension， fear of cold and preference of warmth， weak breathing and fatigue， poor appetite， oliguria， nausea and vomiting than non-PEW group （P＜0.05）. The incidence of both yin and yang deficiency syndrome and damp-turbidity syndrome were significantly higher in the PEW group than the non-PEW group， while that of liver-kidney yin deficiency syndrome and stirring of wind syndrome were lower （P＜0.05）. Logistic regression analysis showed that low BMI （＜22 kg/m²）， inability to take care of oneself， low grip strength，low serum albumin （＜38 g/L）， infection， older age， fear of cold and cold limbs，and poor appetite were the risk factors of PEW in patients undergoing MHD （P＜0.05）. ConclusionThe root syndrome of MHD-PEW patients is both yin and yang deficiency， concurrent with damp-turbidity syndrome. Low BMI， low serum albumin， infection and older age may be the influencing factors of PEW in patients undergoing MHD.

Objectives:To systematically evaluate effectiveness and safety of early warning and prevention of hospital-acquired venous thromboembolism (HAT) .Methods:Computers were used to search PubMed, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, China Biology Medicine disc, CNKI and Wanfang Database. RCTs of early warning and prevention HAT at home and abroad was searched systematically and the retrieval time was from the establishment of databases to June 1, 2020. Two researchers independently screened the literature according to the literature inclusion and exclusion criteria, extracted data and evaluated the risk of bias in the study. RevMan 5.3 software was used to conduct Meta-analysis of the incidences of HAT, pulmonary thromboembolism (PTE) , deep vein thrombosis (DVT) , bleeding and prevention rate of HAT.Results:A total of 8 articles were included. Results of Meta-analysis showed that the incidence of PTE in the early-warning group ( RR=0.69, 95% CI 0.53-0.91, P=0.009) and the prevention rate of HAT ( RR=1.45, 95% CI 1.14-1.84, P < 0.001) were statistically significantly different from those in the non-warning group. However, the incidences of HAT ( RR=0.89, 95% CI 0.68-1.16, P=0.380) , DVT ( RR=0.99, 95% CI 0.76-1.29, P=0.970) and bleeding ( RR=0.95, 95% CI 0.81-1.11, P=0.500) had no statistically significant difference between the two groups. HAT prevention was defined as a subgroup of appropriate prevention. There was no statistically significant difference in the HAT prevention rate of patients between the two groups ( RR=1.01, 95% CI 0.95-1.07, P=0.810) . In the subgroup that did not describe in detail whether prevention was appropriate, the HAT prevention rate in the early-warning group was higher than that in the non-early warning group, and the difference was statistically significant ( RR=2.28, 95% CI 2.09-2.49, P<0.001) . Conclusions:Early warning can reduce the incidence of PTE by increasing the prevention rate of HAT without increasing the incidence of bleeding, but it has no significant effect on the incidences of HAT and DVT. Limited by the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality studies.

Objective To compare the diagnostic value of ultrasound,molybdenum target,magnetic resonance(MRI)and single examination for breast cancer.Methods From January 2017 to February 2018,100 patients with suspected breast cancer in Lishui Central Hospital were selected in the study.All patients were detected by ultrasound,mammography and MRI three ways for diagnosis.The results were verified with postoperative pathologic results as the standard.The diagnosis accuracy of three ways for breast cancer were analyzed.Results The detection accuracy of three ways joint detection in patients with breast cancer was the highest(91.00％),which was significantly higher than that of ultrasound(63.00％),mammography(72.00％)and MRI(72.00％)in single mode,the differences were statistically significant(χ2 =22.364,20.154,16.032,all P<0.05).Conclusion Ultrasonography,molybdenum target X ray and MRI have their respective advantages in the process of breast cancer differentiation and diagnosis,and the detection rate can be significantly improved if combined use.

Objective To analyze the epidemiological and clinical characteristics of 5 patients with importing yellow fever ,and to explore the preventive and control strategies of infection in hospital .Methods The epidemiological and clinical characteristics of 5 cases of importing yellow fever in Infectious Disease Hospital of Fujian Medical University from March 18th to April 6th in 2016 were retrospectively reviewed and analyzed .Results Five patients were all from Angola Luanda .One of them was vaccinated before going aboard ,and the others were vaccinated 1—10 days before disease onset in Angola .All of them were bitten by mosquitoes ,and their onset date ranged from March 11th to March 27th ,before returned to Fujian .The main clinical symptoms were fever ,chilly ,shivering ,fatigue ,arthrodynia ,headache ,and liver and kidney injury .At manifestations ,two patients had positive nuclear acid of yellow fever virus in serum samples and 3 patients were positive in urine samples .All of these patients were negative for dengue virus and Zika virus testing ,meanwhile no plasmodium was found in blood smears .All patients were cured and discharged . Conclusions There is risk of yellow fever transmission in Fujian Province . Prevention and control of the disease should be focus on improving the ability of finding and coping with the importing cases .Vaccination and hygiene knowledge propagation should be given for those who are going to epidemic country/area .Emergency monitoring and control of mosquitoes are necessary .

Objective To investigate the effect of nutritional guidance on the energy intake and body weight of patients with gastric cancer chemotherapy. Methods The experimental study was used to study the 144 cases with gastric cancer for the first time of chemotherapy. They were randomly divided into the experimental group and the control group, 72 cases in each group. Routine healthy guidance was used in the control group, while the patients in the experimental group were treated by the nutrition prescription, the nutrition guidance, the purpose and the significance of the chemotherapy, and the follow-up of the patients after discharge. The body weight of patients was collected before chemotherapy, and the dietary questionnaire was used for second days after first days of dietary intake, and the changes of energy consumption and body weight were compared between the two groups. Results The mean values of energy intake within 24 hours in the first 3 days after the chemotherapy in the experimental group was 5 068.92 kJ, which was 51%of the RNI. The mean values of energy intake within 24 hours in the first 3 days after the chemotherapy in the control group was 3 439.25 kJ, which was 38%of the RNI. The difference between the two groups was significant (P<0.01). The weight of patients in the experimental group at the time point of before the 5th and 6th time of chemotherapy were significant higher than those in the control group (P<0.05). Energy intake had influenced the patients′weight, high energy intake with low decrease of body weight. Conclusions Nutritional guidance can effectively improve the energy intake of patients with gastric cancer when chemotherapy, so that the weight remained stable during chemotherapy.

Objective To investigate the CT and MRI features of desmoid-type fibromatoses(DF).Methods The images of 29 ca-ses with DF proved by pathology were reviewed retrospectively.CT and MRI examinations were performed in 1 5 cases respectively, and both in 1 case.Results The median age was 33.0 years with a male-to-female sex ratio of 1 ︰ 2.2.36 lesions were discovered,among which 26 cases were solitary while 3 cases had multiple focus.1 9 lesions were extra-abdominal,14 ones in the abdominal wall and 3 ones intra-abdominal.The largest diameter of tumors was 13 -1 75 mm.27 lesions displayed ovoid or elongated shape while 9 ones were irregular .The boundary could be clear or unclear.25 lesions extended along muscle planes with consistent long axis.23 focuses grew aggressively,1 6 of which crossed the muscle clearance,while 13 lesions grew expansively.On CT,20 lesions appeared iso-den-sity or slightly hypo-density compared with normal muscles,mostly homogeneous(1 5/20).Most lesions exhibited gadually moderate or obvious enhancement on post-contrast CT,and the enhancement was homogeneous or heterogeneous.1 7 lesions were found on MRI,which presented signal intensity similar to or slightly higher than that of muscles on T1 WI and most were homogeneous(12/1 7);on T2 WI,all were heterogenous with slightly high or high intensity.All lesions demonstrated obvious enhancement on MRI after contrast administration ,and most were heterogeneous(12/1 7).Sheets or bands of low signal were detected within 1 1 lesions with no enhancement.Conclusion DF has some characteristics on CT and MRI,which are valuable for accurate pre-operative diagnosis,and for evaluation of the lesion extent and involvement of adjacent structures.

PurposeTo prospectively investigate the effect of gadolinium contrast media on the quality of intravoxel incoherent motion (IVIM) MRI images and the quantification of corresponding parameters for abdominal solid organs, and to explore the appropriate time for abdominal IVIM scan.Materials and MethodsTwenty patients underwent the same abdominal IVIM scan before and after gadolinium contrast administration. The signal-to-noise ratio (SNR) of liver, spleen, pancreas and kidneys were measured on diffusion-weighted imaging (DWI) images at b=50 s/mm2, 300 s/mm2 and 800 s/mm2. SNR and contrast-to-noise ratio (CNR) of hepatocellular carcinoma (HCC) (n=16) were also calculated. Apparent diffusion coefficient (ADC) value and IVIM parameters including pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f) of liver, spleen, kidneys parenchyma and HCC were measured and compared. ResultsSNR of liver on post-contrast DWI at b=50 s/mm2 were significantly lower than that of pre-contrast (t=2.397,P<0.05). CNR of HCC increased significantly on b=300 s/mm2 DWI images after contrast (t=-3.380,P<0.01). SNR of kidneys on DWI of any b value decreased after contrast administration (Z=-2.675--2.201,P<0.05). SNR of spleen, pancreas and HCC were not statistically different between pre-contrast and post-contrast images (t orZ=-1.324-1.104,P>0.05). As for IVIM parameters, only ADC and D values of kidneys demonstrated a significant reduction after contrast (ADC:t=3.569,P<0.01; D:Z=-3.053,P<0.01). No significant differences were detected for all parameters of liver, spleen and HCC between pre-contrast and post-contrast images (t=-1.102-1.689,P>0.05). ConclusionAdministration of gadolinium contrast media may result in decrease of SNR of liver on low b value DWI and SNR of kidneys at any b value, but it increases CNR of hepatic lesions on medium b value DWI. Administration of gadolinium contrast media does not make a significant effect on SNR of spleen, pancreas and hepatic lesions. Furthermore, ADC and D values of kidneys decrease after administration of gadolinium contrast media. There is no significant influence of contrast medium on DWI and IVIM parameters of liver, hepatic lesions and spleen.

Objectives This study was conducted to detect and analyze the presence of plasmidmediated quinolone resistance (PMQR) determinants [qnr,aac-(6′)-Ib-cr and qepA] among clinical isolates of Citrobacter freundii strains isolated from patients in Anhui,China,and to understand the susceptibility of PMQR positive strains to commonly used antimicrobial agents.Methods During the year 2009,31 Citrobacter strains were collected from the First Affiliated Hospital of Anhui Medical University.Polymerase chain reaction (PCR) was used to detect PMQR genes.Amplicons were purified,sequenced and compared with data from the GenBank.Conjugation experiments were conducted to determine whether the qnr-carrying plasmids were self-transferable.The susceptibility of the positive isolates and transconjugants were tested by agar dilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines.The minimum inhibitory concentrations (MIC) of ciprofloxacin and levofloxacin were determined by E-test strips.Results Among the 31 Citrobacter strains,the qnr genes were detected in 8 isolates (25.8％),among which,6 carried qnrB.Aac-(6′)-Ib-cr and qepA were not identified in these isolates.The qnr genes were transferred from four clinical isolates to their transconjugants.Sequence analysis identified one novel qnrB variant (qnrB24).The resistant rate of qnr-positive clinical isolates to quinolone was 87.5 ％.Most of them were also resistant to various other antibiotics,including cefotaxime (75.0 ％),amikacin (7.5 ％),ceftazidime (62.5 ％),cefapime (37.5 ％),and gentamycin (87.5 ％).All qnr positive strains were susceptible to imipenem.MIC of all transconjugants showed reduced susceptibility to fluoroquinolones,with MIC increased by 10-23 folds.Conclusions Our study shows that qnr gene has occurred in Citrobacter freundii isolates from Anhui Province,China.QnrB is most prevalent in these isolates.Most qnr positive isolates are resistant to commonly used antimicrobial agents.

ObjectiveTo evaluate the reliahility and validity of the chronic HBV-infections related stigma scale.MethodsThe initial items and construct of the scale were developed according to theoretical analysis and interviews of experts and patients.A total of 151 patients with chronic HBV-infection were administered by convenient sampling method in this pilot study. The reliability and the validity of the scale were then evaluated.ResultsThe response rate of the scale was 94.5％.The Cronbach α coefficients of all dimeusions ranged from 0.75-0.87.The results of correlation analysis showed that there were higher correlation coefficients ( r ranged from 0.62-0.86) between items and their hypothesized subscales than those with other subscales ( r ranged from 0.14-0.55).The scale distinguished between patients with low subscale scores ( the subscale scores were ( 1.89 ±0.30 ),( 1.86 ± 0.29 ),( 1.96 ± 0.23 ),( 2.29 ± 0.45 ),( 1.59 ± 0.42 ) independently) and those with high subscale scores(the subscalc scores were (3.62 ±0.44),(3.99 ±0.41 ),(3.79 ±0.37),(4.13 ±0.34),(3.10 ±0.53 ) independently) (P ＜ 0.01 ).Confirmatory factor analysis showed that the main indices of goodness of fit CFI was 0.94,NNFI 0.92,RMSEA 0.087.ConclusionThe chronic HBV-infections related stigma has good psychometric properties regarding to reliability and validity.