Objective: To investigate the clinical features and prognostic factors of gastric cancer patients under the age of 40. Methods : The clinical data of 126 young gastric cancer patients under the age of 40 were retrospectively analyzed. Log⁃Rank test and Cox regression model were used to analyze prognostic risk factors ,respectively. Results: The average age of gastric cancer patients in our group was 33. 6 years ,and there were more female patients than male patients(female ∶ male = 1. 25 ∶ 1) , Upper abdominal pain and fullness discomfort were the most common clinical manifestations ,and the predominant sites were gastric antrum angle (43. 7% ) and gastric body (42. 9% ) . Lauren type was mainly diffuse type (89. 7% ) , Nakamura type was mainly undifferentiated type (91. 3% ) , and WHO type was the most common type of low⁃adherence carcinoma (46. 8% ) . 71. 4% of patients were diagnosed with advanced 46. 7% , respectively. The results of univariate analysis showed that the levels of serum CA199 ,tumor length ,depth of tumor invasion ,lymphatic metastasis ,vascular invasion ,and surgical approach were risk factors affecting the prognosis of patients. Multivariate analysis revealed that the levels of serum CA199 ,the depth of tumor invasion and surgical approach were independent prognostic factors. Conclusion Young gastric cancer has a high degree of malignancy and strong biological invasiveness. Most patients are diagnosed at the advanced stage of the tumor,and the overall prognosis is poor. The levels of serum CA199 ,the depth of tumor invasion and surgical approach were independent prognostic factors.

Objective:To evaluate the clinical efficacy and safety of fecal microbiota transplantation(FMT)for the treatment of chronic functional constipation in the elderly.Methods:A total of 33 elderly patients with chronic functional constipation were included and given three sessions of FMT.Changes in fecal characteristics, constipation, mood and quality of life in these patients were evaluated using the Bristol stool form scale(BSFS), the constipation assessment scale(CAS), patient assessment of constipation symptoms(PAC-SYM), the Zung self-rating anxiety scale(SAS), the Zung self-rating depression scale(SDS), and the patient assessment of constipation quality of life(PAC-QOL)before and 12 weeks after treatment.The clinical efficacy was based on comparison between pre-and post-treatment results for each patient.Results:Clear improvement was achieved in 33 patients 12 weeks after treatment, compared with before transplantation.Post-treatment scores of the constipation assessment scale and symptom self-assessment questionnaire for patients with constipation were(8.9±1.2)scores and(26.5±2.4)scores, respectively, significantly lower than pre-transplantation scores of(12.2±1.1)scores and(32.4±2.4)scores( t=15.034, 13.904, both P<0.001). Similarly, post-treatment scores were also lower than pre-transplantation levels for the self-rating anxiety scale[(50.4±8.4)scores vs.(57.5±9.0)scores, t=10.333, P<0.001], the self-rating depression scale[(50.6±8.4)% vs.(55.0±10.5)%, t=5.301, P<0.001], and self-assessment questionnaire for quality of life[(88.2±7.3)scores vs.(103.7±7.3)scores, t=23.300, P<0.001]. Conclusions:FMT can improve fecal characteristics and constipation symptoms, relieve anxiety and depression, improve the quality of life, and provide a new option for the treatment for elderly patients with chronic functional constipation.

Objective:To understand the incidence of post-traumatic stress disorder(PTSD) in fathers with premature infants and analyze the risk factors.Methods:Conveniently, the 203 fathers of premature infants in NICU of Affiliated Hospital of Jining Medical University of Shandong Province from May to August 2021 were selected as the subjects to fill in the general data questionnaire, Perinatal Post-traumatic stress disorder Questionnaire-Chinese edition (PPQ-C), Parents, Perception of Uncertainty Scale, Social Support Rating Scale, Simplified Coping Style Questionnaire. Logistic regression was used to analyze the risk factors of PTSD and establish a nomogram model. ROC curve was used to verify the discrimination ofthe model. Hosmer-Lemeshow goodness-of-fit test and Calibration Plot were used to verify the calibration.Results:PPQ-C total score of 203 fathers was 17.17 ± 8.77, 81 fathers, symptoms were positive and the incidence of PTSD was 39.90%(81/203). Logistic regression analysis showed college degree ( OR = 0.297, 95% CI 0.116 - 0.763, P<0.05), very low birth weight ( OR = 2.491, 95% CI 1.027 - 6.044, P<0.05), sense of disease uncertainty ( OR = 1.038, 95% CI 1.012 - 1.066, P<0.05), negative coping style ( OR = 1.871, 95% CI 1.127 - 3.108, P<0.05) were risk factors of PTSD in fathers with premature infants. The nomogram model was established basing on the results of the Logistic regression analysis, and the ROC curve proved (AUC = 0.751) the model having a good discrimination.The Hosmer-Lemeshow goodness-of-fit test ( P = 0.974) and the calibration plot demonstrated that the prediction values tends to coincide with the actual monitoring values. Conclusions:A higher incidence of PTSD was observed in fathers with hospitalized premature infant. It was related to education level, the infants′s birth weight, disease uncertainty and coping style. Therefore, the nurses should give information support and psychological guidance according to the individual situation of the infants′ father to reduce the incidence of PTSD.

Objective:To explore the expression features of cytochrome C oxidase subunit Ⅰ (MT-CO1), BCL2 interacting protein 3 (BNIP3) and interleukin (IL)-1β in the liver of MRL/lpr lupus mice.Methods:The mRNA and protein levels of MT-CO1, BNIP3, IL-1β, p16 and p21 in lupus mice and control mice were detected by polymerase chain reaction (PCR) and Western blot, the IL-1β expression site were detected by hematoxylin and eosin (HE) staining and immunohistochemical method, and themalondialdehyde (MDA) was detected by colorimetry. Hepatocytes and macrophages were stimulated with lipopolysaccharide (LPS), while hepatocytes were also cultured with supernatants obtained after macrophages stimulated with LPS, and the mRNA and protein levels of MT-CO1, BNIP3 and LC3B, as well as p16 and p21 expression, were determined by qPCR and Western blot. The expression of mitochondrial reactive oxygen species (mtROS) was detected by immunofluorescence. One way Analysis of Variance (ANOVA) was used to compare the mean of each group, and LSD method was used to compare the means of multiple samples, and Tamhane's T2 method was used to compare the means of multiple samples when the variance was uniform. Results:The results of PCR showed that the mRNA levels of MT-CO1 and BNIP3 in the liver tissue of the lupus group (0.14±0.04; 0.16±0.05) were significantly lower than those of the control group (0.11±0.04; 0.16±0.06), and the differences were statistically significant ( t=7.16, P<0.001; t=4.54, P<0.001). The expression levels of IL-1β, p16 and p21 in the lupus group (2.06±0.69; 0.37±0.14; 0.16±0.06) were significantly higher than those of the control group (0.23±0.06; 0.25±0.08; 0.11±0.04) ( t=9.58, P<0.001; t=24.35, P<0.001; t=22.36, P<0.001). The results of Western blot were consistent with those of PCR. HE staining showed lymphocyte infiltration in the liver tissue of lupus mice, and immunohistochemistry showed IL-1β in the liver tissue of lupus mice. The positive cells were mainly concentrated in the sinusoids, and the expression of hepatic parenchymal cells was not rearkable. The content of MDA in liver tissue of the lupus group (0.19±0.10) was higher than that of the control group (0.17±0.09), and the difference was statistically significant ( t=4.33, P=0.005). LPS directly stimulated AML12 hepatocytes (0.069±0.028; 0.17±0.07). The PCR results showed that compared with the control group (0.176±0.072; 0.08±0.03), the expression of MT-CO1, and BNIP3 were not significantly different ( t=1.01, P=0.337; t=0.88, P=0.399). The expression of IL-1β was significantly higher when incubated with the supernatants of LPS stimulated macrophages (0.28±0.09) compared than that of the control group (0.15±0.05) ( t=28.26, P<0.001). The results of PCR showed that the mRNA levels of MT-CO1 and BNIP3 in the LPS stimulated group (0.046±0.026; 0.17±0.05) were significantly lower than those in the control group (0.143±0.083; 0.18±0.06), and the differences were statistically significant ( t=7.52, P<0.001; t=4.24, P<0.001), The expression of p16 and p21 in LPS stimulated group (0.29±0.09; 0.27±0.09) were significantly higher than those in the control group (0.18±0.06; 0.22±0.07) ( t=13.54, P<0.001; t=8.69, P<0.001). The results of Western blot were consistent with those of PCR. Immunofluorescence showed that the fluorescence intensity of mtROS in LPS stimulated group (0.25±0.10) was higher than that in the control group (0.08±0.03), and the difference was statistically significant ( t= 4.86, P<0.001). Conclusion:Immune-mediated inflammation in the liver tissue of lupus mice can stimulate liver parenchymal cells to cause intracellular mitochondrial dysfunction. However, the mechanism of liver organ damage in lupus mice is not limited to the immune-mediated inflammation of immune active cells, but also include parenchymal cell mitochondrial dysfunction.

Objective:To evaluate the impact of the Japanese encephalitis vaccine included in an expanded immunization program on the reported incidence rate of Japanese encephalitis in Gansu province.Methods:Information on the reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was collected through the National Population Health Science Data Center and the China Disease Prevention and Control Information System. In addition, the trend of Japanese encephalitis reported incidence rate in Gansu province before and after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program was analyzed using an interrupted time-series design.Results:The annual reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was 0.448/per 100 000. However, after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program in Gansu province in 2008, the amount of change in the level of Japanese encephalitis reported incidence rate was -2.223/per 100 000 ( t=-2.90, P=0.007), the amount of change in the slope of Japanese encephalitis reported incidence rate was 0.082 ( t=2.87, P=0.008) with the slope of Japanese encephalitis reported incidence rate as 0.071 ( β1+ β3=0.071). Conclusions:The Japanese encephalitis vaccine has achieved good prevention and control effects in Gansu province in the short term after its inclusion in the expanded immunization program, but outbreaks of Japanese encephalitis have still occurred. Therefore, in the future, Gansu province should promptly adjust the immunization strategy of the Japanese encephalitis vaccine, and strengthen the vaccination of the adult population, especially the rural adult population in the southeastern region of Gansu province, based on the continued focus on the works on Japanese encephalitis vaccination for children and adolescents.

Objective:To analyze the risk factors of medical adhesive-related skin injury (MARSI) in preterm infants to establish a nomogram model to predict the risk of MARSI.Methods:From July to September 2018, 268 premature infants who were hospitalized in NICU were enrolled in this study. Their clinical data were analyzed and univariate analysis was used to detemine the risk factors related to MARSI, The significant variables were included in the multivariate logistic regression analysis to analyze the independent risk factors for MARSI. Then the R software was used to establish a predictive nomogram model, Bootstrap method was used to validate the nomogram model and the consistency test of the correction curve was used to explore the predictive efficacy of the model in predicting the MARSI.Results:A total of 64 cases out of 268 premature infants had MARSI. The prevalence rate was 23.9 % (64/268). Birth age (28 to 32 weeks) ( P value was 0.021, OR value was 2.736, 95 % CI 1.163-6.435), edema ( P<0.01, OR value was 33.782, 95 % CI 10.510-108.583), maternal diabetes ( P value was 0.039, OR value was 16.011, 95 % CI 1.146-223.692), easy to tear tape ( P value was 0.027, OR value was 13.567, 95 % CI 1.340-137.311) were all independent risk factors for MARSI. The nomogram model showed a conformance-index of 87.29 %, while the consistency test of the correction curve showed that the prediction probability is consistent with the actual occurrence probability. Conclusions:The nomogram built based on the indexes of fetal age, skin state, maternal disease, mucous product has good discrimination and accuracy which could be helpful for screening the patients with high risk, with potentially high clinical application value.

Objective:To evaluate the effect of oropharyngeal colostrum administration on building adequate enteral feeding process of very low birth weight neonates and extremely low birth weight neonates.Methods:A total of 62 very/extremely low birth weight neonates in NICU were selected from a tertiary hospital in shandong province. They were randomly assigned to the observation group ( n=32) and the control group ( n=30) according to the random number table. The observation group was given oropharyngeal colostrum administration. The control group was given oral care with 0.9% sodium chloride solution, and the wiping method and frequency was the same as the observation group. Gastric retention, enteral feeding time, adequate enteral feeding time, the weight at the time of discharge, etc. were compared between two groups. Results:Gastric retention times on the 10th day in the observation group (1.90±1.30) was significantly lower than that in the control group (2.77±1.50), and the two groups were statistically significant ( t value was -2.449, P<0.05). The duration of 100 ml·kg -1·d -1 enteral feeding and adequate enteral feeding (150 ml·kg -1·d -1) in the observation group [(24.63±9.42) days, (29.75±10.15) days] were significantly shorter than those in the control group [(33.90±2.73) days, (35.13±9.29)days], and the two groups were statistically significant ( t value was-4.621, P<0.01; t value was -2.362, P<0.05). The weight of the observation group was higher than that in the control group at the time of discharge ( t value was 4.677, P<0.05). Conclusion:Oropharyngeal colostrum administration can reduce gastric retention times, shorten the adequate enteral feeding time, promote growth and development in very low birth weight neonate and extremely low birth weight neonate.But it had not been proved to reduce the incidence of related infection indicators.

Objective:To explore the application effects of dual probiotic preparation and colostrum oral immunotherapy on improving feeding intolerance in very low birth weight infants.Methods:A systematic sampling method was used to select 173 very low birth weight infants who were admitted to the Neonatal Intensive Care Unit (NICU) from December 2017 to December 2018. According to the random number table method, they were divided into in group A ( n=56) , group B ( n=59) and group C ( n=58) . Group A was given routine nursing, parenteral nutrition and enteral nutrition and minimal breast feeding. Group B was given dual probiotic preparation on the basis of routine nursing. Group C was given colostrum oral immunotherapy on the basis of routine nursing. After 7 days of intervention, the improvement of feeding intolerance was observed, and the feeding intolerance rates were compared among the three groups after 3 d, 5 d and 7 d of intervention. Intestinal flora, incidence of complications, length of NICU stay and speed of birth weight recovery were compared. Results:The intake of milk in group B and group C were higher than those in group A, and the retention milk volume, retention times and duration of abdominal distension were all lower than those in group A, while retention times and duration of abdominal distension in group C were shorter than those of group B, and the differences were statistically significant ( P<0.05) . On the 3rd, 5th and 7th day of intervention, the feeding intolerance rates of the three groups continued to decrease. The feeding intolerance rates of group B and C were lower than those of group A, and the feeding intolerance rate of group C was lower than that of group B on the 3rd day of intervention , and the differences were statistically significant ( P<0.05) . The number of Enterococcus faecium, the number of Bacillus subtilis and the ratio of the logarithmic number of bifidobacteria to the logarithmic number of Escherichia coli (B/E value) in groups B and C were all higher than those in group A, and the incidences of sepsis and necrotizing enterocolitis in group B and group C were lower than those in group A, and the differences were statistically significant ( P<0.05) . The length of stay in NICU was ranked from long to short as Group A, Group B, and group C, and the speed of birth weight recovery was ranked from slow to fast as group A, Group B, and group C, and the differences were statistically significant ( P<0.05) . Conclusions:Colostrum oral immunotherapy can improve the feeding intolerance of very low birth weight infants, reduce complications related to premature delivery, promote the growth and development of neonates and shorten the length of stay in NICU. The clinical effect is slightly better than that of probiotics.

Objective To investigate changes in nutritional status in senile dementia patients with malnutrition treated with enteral nutrition combined with rehabilitation therapy evaluated by using the Mini Nutritional Assessment-Short Form(MNA-SF).Methods Fifty hospitalized patients with senile dementia and malnutrition at the internal medicine department of our hospital from July 2014 to July 2017 were enrolled and further divided into an enteral nutrition group(a control group,n =25)and an enteral nutrition combined with rehabilitation therapy group(an observation group,n=25).Anthropometric parameters including body mass index,biceps circumference,calf circumference,triceps skin-fold thickness,and blood biochemical parameters including hemoglobin,total cholesterol,triacylglycerol,albumin,lymphocyte count before and after treatment were compared between the groups.Results Anthropometric parameters such as body mass index,biceps circumference,calf circumference and triceps skin-fold thickness had no significant difference between the two groups before treatment (P ＞ 0.05),while after 30 days of treatment,anthropometric parameters saw improvement in both groups compared with those before treatment,and the improvement was greater in the observation group than in the control group(P ＜0.01).Blood biochemical parameters had no significant difference between the two groups before treatment(P＞0.05).After 30 days of treatment,levels of total cholesterol and triacylglycerol had no significant difference compared with those before treatment or between the two groups(P ＞0.05),while levels of hemoglobin,albumin and lymphocyte count improved compared with those before treatment (t =2.645,2.843,2.967,respectively,P ＜0.01),and had significant differences between the groups (t =2.548,2.864,2.976,respectively,P＜0.01).Conclusions Enteral nutrition combined with rehabilitation therapy has a measurable,positive influence on nutritional status in senile dementia patients with malnutrition.

bjective? To explore the effects of animation demonstration combined with health education on the knowledge-attitude-practice and psychological status of parents of neonates with hyperbilirubinemia. Methods? Totally 136 neonates with hyperbilirubinemia and their parents admitted from February 2017 to February 2018 in Affiliated Hospital of Ji'ning Medical University were selected for the study and were divided into the observation group and control group according to the random number table method, with 68 cases in each group. The control group was given routine health education, and observation group was given animation demonstration combined with health education. The parents knowledge-attitude-practice level of jaundice prevention and treatment,compliance degree, Self-rating Anxiety Scale(SAS) score were compared between the two groups. Results? After intervention,the parents knowledge-attitude-practice level of jaundice prevention and treatment significantly increased in the two groups,and the observation group increased more than the control group with statistical difference (P＜ 0.05). After intervention, the parents compliance level in the observation group was higher than the control group with statistical difference (P＜ 0.05); SAS score of the observation group declined more than the control group with statistical difference (P＜ 0.05). Conclusions? Animation demonstration combined with health education can effectively improve the knowledge-attitude-practice level and execution compliance of parents of neonates with jaundice,and improve the psychological status of the parents.