Patients with diabetic retinopathy often experience diabetes distress when facing the challenges of the disease, which has adverse effects on their health outcomes. This paper summarizes the current situation of diabetes distress in patients with diabetic retinopathy, and the assessment tools, influencing factors, and intervention measures, aiming to provide a reference for healthcare professionals to conduct intervention studies.

Objective:To evaluate the efficacy and safety of noninvasive high-frequency oscillatory ventilation (nHFOV) as the initial ventilation mode for respiratory distress syndrome (RDS) in premature infants.Methods:From the establishment of the databases [(PubMed, Embase, Cochrane Library, CNKI, Wanfang database, CQVIP and CBM (SinoMed)] to March 1, 2022, literature on randomized controlled trials (RCTs) using nHFOV and nasal continuous positive airway pressure(NCPAP) as the initial ventilation modes for RDS in premature infants were searched. The qualities of the included literature were evaluated according to Cochrane Evaluation Manual. RevMan 5.4 software was used for Meta-analysis.Results:Seven RCTs involving 786 children were included for the final Meta-analysis, with 395 cases in the nHFOV group and 391 cases in the NCPAP group. The results showed that the nHFOV group had lower intubation rates than the NCPAP group ( OR=0.34, 95% CI 0.22~0.51, P<0.001). No significant differences existed in mortality rates and complication rates between the two groups ( P>0.05). Conclusions:nHFOV as the initial treatment for RDS in premature infants may reduce the incidence of early treatment failure without increasing complications.

Objective:To compare the clinical efficacy of endoscopic resection and laparoscopic surgery in the treatment of gastric gastrointestinal stromal tumor (GIST) with a maximum diameter of 2 to 5 cm, and to analyze the influence of factors such as tumor surface, growth pattern and lesion origin on the choice of resection method, so as to provide a safer and more effective treatment for patients with gastric GIST.Methods:From January 2012 to November 2019, at the First Affiliated Hospital of Zhengzhou University, the clinical data of 301 patients with gastric GIST who underwent endoscopic resection (137 cases in the endoscopic resection group) or laparoscopic surgery (164 cases in the laparoscopic surgery group) were retrospectively analyzed, including age, gender, whether there was depression on the tumor surface (the local subsidence depth of the mucosa on the tumor surface was >5 mm), whether the tumor surface was irregular (non-hemispherical or non-elliptical tumor surface), whether there was combined ulcer, location, shape, origin of the lesion, growth pattern (intralumina growth or combined intraluminal and extraluminal growth), risk classification (very low risk, low risk, medium risk, high risk), whether the tumor was en bloc resection, operation time, whether bleeding or not, fasting time, indwelling time of gastric tube, time of hospitalization, time of postoperative hospital stay, postoperative complications and follow-up. Independent sample t test, chi-square test or Fisher′s exact test and Wilcoxon rank sum test were used for statistical analysis. Results:Among the 137 patients with gastric GIST in the endoscopic resection group, 85 cases (62.0%) underwent endoscopic submucosal dissection, 9 cases (6.6%) underwent endoscopic submucosal excavation, 42 cases (30.7%) underwent endoscopic full-thickness resection, and 1 case (0.7%) underwent submucosal tunnel endoscopic resection. There were no significant differences in gender, age, lesion location, tumor size, and risk classification between the endoscopic resection group and the laparoscopic surgery group (all P>0.05). The tumor surface was depressed, with ulcer or irregular in 1, 49, 26, and 2 cases of patients with gastric GIST of very low risk, low risk, medium risk and high risk, respectively. There was statistically significant difference in the proportion of depression, irregularity and ulcer on the tumor surface at different risk levels ( Z=-2.55, P=0.011). The complete tumor resection rate of the endoscopic resection group was lower than that of the laparoscopic surgery group (86.1%, 118/137 vs. 100.0%, 164/164), and the difference was statistically significant ( χ2=24.28, P<0.001). However the operation time, fasting time, the indwelling time of gastric tube, time of hospitalization, and the time of postoperative hospital stay of the endoscopic resection group were shorter than those of the laparoscopic surgery group, and the total hospitalization cost was lower than that of the laparoscopic surgery group (90.0 min (62.5 min, 150.0 min) vs. 119.5 min, (80.0 min, 154.2 min); 3 d (3 d, 4 d) vs. 5 d (4 d, 7 d); 3 d (2 d, 4 d) vs. 4 d (2 d, 6 d); 11 d (10 d, 14 d) vs. 16 d (12 d, 20 d); 7 d (6 d, 9 d) vs. 9 d (7 d, 11 d); (38 211.6±10 221.0) yuan vs. (59 926.1±17 786.1) yuan), and the differences were statistically significant ( Z=-2.46, -7.12, -4.44, -6.89 and -5.92, t=-13.24; all P<0.05). The incidence of postoperative abdominal pain and other severe postoperative complications (including shock, respiratory failure, pulmonary embolism, gastroparesis, etc.) of the endoscopic resection group were all lower than those of the laparoscopic surgery group (16.8%, 23/137 vs. 27.4%, 45/164; 0.7%, 1/137 vs. 4.9%, 8/164), and the differences were statistically significant ( χ2=4.84, Fisher′s exact test, P=0.028 and 0.043). There were no significant differences in the incidence of intraoperative bleeding, postoperative bleeding, fever and perforation between the two groups (all P>0.05). The incidence of operation-related complications of lesions with intraluminal growth and originating from muscularis propria in the endoscopic resection group were lower than those of the laparoscopic surgery group (19.5%, 25/128 vs. 32.6%, 45/138; 12.6%, 12/95 vs. 31.4%, 37/118), and the differences were statistically significant ( χ2=5.86 and 10.42, P=0.016 and 0.001). There was no significant difference in the postoperative tumor recurrent rate between the endoscopic resection group and the laparoscopic surgery group (0, 0/137 vs. 2.4%, 4/164; Fisher’s exact test, P=0.129). Conclusions:Endoscopic treatment is safe and effective for gastric GIST with a maximum diameter of 2 to 5 cm, which is superior to laparoscopic surgery. However, laparoscopic surgery is recommended for tumor with depressed, ulcerative, or irregular surface and combined intraluminal and extraluminal growth.

Cleft lip and/or palate (CLP) are the most common craniofacial malformations in humans. Speech problems often persist even after cleft repair, such that follow-up articulation training is usually required. However, the neural mechanism behind effective articulation training remains largely unknown. We used fMRI to investigate the differences in brain activation, functional connectivity, and effective connectivity across CLP patients with and without articulation training and matched normal participants. We found that training promoted task-related brain activation among the articulation-related brain networks, as well as the global attributes and nodal efficiency in the functional-connectivity-based graph of the network. Our results reveal the neural correlates of effective articulation training in CLP patients, and this could contribute to the future improvement of the post-repair articulation training program.
Brain/diagnostic imaging* ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Humans ; Magnetic Resonance Imaging ; Reading

Data of 55 cases of gastric neuroendocrine neoplasms (G-NENS) with diameter ≤12 mm in the First Affiliated Hospital of Zhengzhou University from August 2014 to August 2019 were retrospectively analyzed. According to the methods of endoscopic resection, the patients were divided into two groups: the endoscopic mucosal resection with a cap (EMR-C) group (35 cases) and the endoscopic submucosal dissection (ESD) group (20 cases). The results showed that the success rates of operation, the whole resection rates and the complete resection rates were all 100.0% in the two groups. Compared with the ESD group, the EMR-C group had a shorter median operation time (12.00 min VS 28.35 min, P<0.001), less mean hospitalization costs (21 165.19 yuan VS 28 400.35 yuan, P=0.004), and a similar overall incidence of complications [2.86% (1/35) VS 0, P=1.000]. By March 2020, the recurrence rate of EMR-C group and ESD group were 28.6% (10/35) and 15.0% (3/20), respectively, without significant difference ( P=0.418). It is suggested that for G-NENS with diameter ≤12 mm, without muscular invasion, lymph node metastasis or distant metastasis, EMR-C and ESD are both safe and effective, but EMR-C has more advantages in terms of operation time and hospitalization costs.

Objective To explore the effective measures to reduce the incidence of nosocomial infection through the implementation of continuous quality improvement measures in the neonatal intensive care unit (NICU). Methods One hundred and twenty-two premature infants hospitalized in NICU of the Affiliated Hospital of Inner Mongolia Medical University after continuous quality improvement from January 2018 to November 2018 were selected prospectively as the experimental group, and 125 premature infants using routine nursing management mode from March 2017 to December 2017 were selected as the control group. The occurrence of bloodstream infection in two groups was observed. Results The incidence of bloodstream infection in the experimental group [7.4%(9/122)] was significantly lower than that in the control group [17.6%(22/125)], and the difference was statistically significant (P＝0.015). Compared with the control group, the experimental group had statistically significant differences in implementation rate of hand hygiene, average days of peripherally insterted central catheter indwelling, and antibiotic use rate and average days (P < 0.01). Conclusions The incidence of bloodstream infections in NICU can be effectively controlled through strict continuous quality improvement measures.

OBJECTIVETo investigate acupuncture-moxibustion intervention during the different times for chemotherapy-induced nausea and vomiting (CINV) symptoms.

METHODSEighty patients received cisplatin chemotherapy with nausea and vomiting were assigned into an AB group and a BA group. Self cross control study was carried out. In the AB group, acupuncture and moxibustion were used during the intermission and there were no acupuncture-moxibustion during chemotherapy period in the first chemotherapy cycle; acupuncture and moxibustion were not applied during the intermission and acupuncture-moxibustion intervention were used during chemotherapy in the third cycle of chemotherapy. The intervention times were different correspondingly in the BA group. Acupuncture and moxibustion were not used to in the second cycle of elution period. The vomiting incidence, nausea, vomiting and retching scale (R-INVR), patient satisfaction and compliance during different chemotherapy times after acupuncture and moxibustion intervention were compared.

RESULTSOn the first and second days of chemotherapy, the nausea incidences of patients treated with acupuncture and moxibustion during the intermittent period was less than those during chemotherapy period (both <0.05), but continuous 4 days after the third day of chemotherapy, the numbers had no significant difference (all >0.05). The scores of R-INVR were not significantly different between intervention in the chemotherapy period and intermittent period (>0.05), with decreasing trend. The patients were more satisfied with acupuncture and moxibustion in the intermittent period (<0.05).

CONCLUSIONAcupuncture and moxibustion in the intermittent period can prevent vomiting induced by the chemotherapy of cisplatin, with satisfaction and compliance. Acupuncture and moxibustion intervention during chemotherapy period have the potential to improve nausea and vomiting.

OBJECTIVETo compare the differences in the clinical therapeutic effects on chronic knee joint pain between the combination of the central-square needling technique of thumb-tack needles with the routine therapy of acupuncture, moxibustion andand the routine therapy of acupuncture, moxibustion and.

METHODSOne hundred and twenty patients of chronic knee joint pain were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine therapy of acupuncture, moxibustion andwas adopted. In the observation group, at the end of treatment with the routine therapy of acupuncture, moxibustion and, the subcutaneous embedding therapy was followed with four thumb-tack needles at the sites 1 to 1.5 cm above, below and bilateral to the main point (point) separately, and the needles were retained for 24 h to 48 h. The treatment was given once every two days, three times a week, totally 6 times in two weeks; and the follow-up visit was done for 3 months in patients of the two groups. The visual analogue scale (VAS) score before and after each treatment, Lequesne index score before treatment and at the end of follow-up and the case numbers of proactive use of painkillers or receiving acupuncture treatment in the follow-up stage were compared and observed in the patients of the two groups.

RESULTSThe VAS score was reduced gradually after treatment in the patients of the two groups. The differences were significant statistically after the second treatment as compared with those before the treatment in the two groups (all<0.05), in which, the improvements in VAS scores after the third treatment in the observation group were more obvious than those in the control group (all<0.05). At the end of follow-up visit, Lequesne index scores were all improved as compared with those before treatment in the two groups (both<0.05) and the improvements were similar between the two groups (>0.05). In the follow-up stage, there were 0 case in the observation group and 9 cases in the control group in terms of proactive use of painkillers (<0.05). There were 5 cases in the observation group and 1 case in the control group receiving acupuncture treatment again (>0.05).

CONCLUSIONThe acupuncture scheme in assistance with the central-square needling technique of thumb-tack needles obviously relieves chronic knee joint pain, much better sustains the analgesic effects of acupuncture and improves patient compliance.

Objective:To establish the quality standard for Qinzhu Liangxue mixture. Methods:Seutellaria baiealensis, glyeyrrhizae and jobstears seed were identified by TLC. Baicalin and glycyrrhizic acid were determined by HPLC. Results:Seutellaria baiealensis,glyeyrrhizae and jobstears seed could be identified by TLC. The linear range of baicalin was 0. 030- 0. 971 mg·ml -1(r = 1. 000 0),and the average recovery was 97. 74%(RSD = 2. 76% ,n = 9). The linear range of glycyrrhizic acid was 0. 013- 0. 220 mg·ml -1(r = 1. 000 0),and the average recovery was 99. 02%(RSD = 1. 79% ,n = 9)Glycyrrhizic acid. Conclusion:The method is specific,simple and accurate. It can be used for the quality control of Qinzhu Liangxue mixture.

Objective: To evaluate the safety and efifcacy of cutting balloon combining main branch single stent cross-over technique for treating the patients with coronary bifurcation lesions. Methods: A total of 113 patients with 121 bifurcation lesions treated in our hospital from 2012-01 to 2014-01 were enrolled. Cutting balloon pre-dilation was applied in both main and side branches followed by drug-eluting stent implantation at main branch. The procedural success rates, side branch blood lfow status and complications were observed. Follow-up studied for MACE occurrence was conducted at 9 months after the operation. Results: Quantitative coronary angiography (QCA) presented that the minimum lumen diameters at pre- and post-operation in main branches were (2.12 ± 1.07) mm and (3.24 ± 0.87) mm, in side branches were (1.44 ± 0.73) mm and (1.82 ± 0.64) mm respectively,P<0.05-0.01, the procedural success rate was 100%. There were 11 (9.1%) lesions with dissection at proximal side branch, 5 (4.1%) lesions with side branch TIMI blood lfow