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2017 Vol. 14, No. 29
Published: 2017-10-15
 
 
4 The effect of copper metabolism domain containing 1 in U87 cells proliferation and apoptosis and mechanism study
RUAN Dong1 GUO Lirui2 WANG Fang2 YUAN Fan′en2 CHEN Qianxue2 LIU Baohui2
[Abstract] Objective To study the biological function of copper metabolism domain containing 1(COMMD1) in glioma cells U87 and its mechanism. Methods siRNA transfection was applied to knock down COMMD1 expression in U87 cells. CCK-8 and flow cytometry analysis were employed to examine glioma cells proliferation and apoptosis after COMMD1 was knocked down. Western blot was used to detect the expression of p65, cleaveage-caspase3 and BAD levels. Results Data showed that when COMMD1 was knocked down by siCOMMD1, the CCK8 results of siCOMMD1 were (0.402±0.000), (0.510±0.001), (1.021±0.002), (1.612±0.002), while the CCK8 results of siNC were (0.401±0.001), (0.452±0.002), (0.621±0.002), (0.823±0.003) at 0, 1, 2, 3 d; there were significantly differences in cell viabilities between the two group at 2 d and 3 d (P ＜ 0.05). Flow cytometry analysis results showed that the apoptosis rate of cells in siCOMMD1 group and siNC group was (2.214±0.325)% and (7.121±0.520)%, there was significantly difference between the two group (P ＜ 0.05). Western blot results showed that the expression of p65 and BAD increased 40.132% and 90.157%, cleaveage-caspase3 decreased 56.169% when COMMD1 was knocked down. Conclusion COMMD1 can regulate U87 cells apoptosis and proliferation.
2017 Vol. 14 (29): 4-6,27 [Abstract] ( 278 ) HTML (1 KB)  PDF (1207 KB)  ( 232 )
7 Neoadjuvant chemotherapy combined with limb salvage surgery in treating 26 cases of osteosarcoma
DU Mindong1 YI Shenghui2 QIN Gang1 HE Kaiyi1 HUANG Xiaohua1 ZENG Ping1 CHEN Jin1
Objective To explore the clinical efficacy of neoadjuvant chemotherapy combined with limb salvage surgery in the treatment of osteosarcoma. Methods From May 2012 to April 2014, 26 patients with limb osteosarcoma with limb salvage surgery in the First Affiliated Hospital of Guangxi University of Chinese Medicine were selected, and they were treated with preoperative and postoperative adjuvant chemotherapy. All the patients were followed up after discharge, and functional assessment of recovery was performed. Results During the follow-up period, 11 cases (42.31%) were evaluated to be excellent, while 7 cases (26.92%) were good according to the patient postoperative function, the excellent and good rate was 69.23% (18/26), the total effective rate was 88.46%. According to the survival curve, the 1,2,3 year disease-free survival rate after treatment were 92.3% (24/26), 74.1% (19/26) and 50.0% (13/26). Conclusion Neoadjuvant chemotherapy combined with limb salvage surgery is good for patients with osteosarcoma, which is worthy of clinical application.
2017 Vol. 14 (29): 7-10 [Abstract] ( 736 ) HTML (1 KB)  PDF (680 KB)  ( 266 )
11 Establishment of genotyping methods for polymorphisms of CYP2C19 gene based on pyrosequencing technology
YANG Nannan1 XU Qin1 LUO Zhenyuan2 FU Xue2 HUANG Shengwen2▲
[Abstract] Objective To establish a fast detection method for CYP2C19 genotyping based on pyrosequencing technology. Methods Genomic DNA was extracted from 50 blood samples of healthy subjects collected from December 2016 to March 2017 in Guizhou Provincial People′s Hospital, and a set of amplification primers and pyrophosphate sequencing primers were designed according to the single nucleotide polymorphism (SNP) sites of CYP2C19*2 (681G>A), CYP2C19*3 (636G>A), CYP2C19*17 (-806C>T). Single-stranded templates were made from PCR products, then sequencing and genotyping analysis were performed on a Qiagen PyroMark Q24 Sequencer System. The sequencing results were verified via Sanger sequencing. Results Based on the type and peak height of bases of DNA sequence, the genotypes of three SNPs could be identified clearly, which were consistent with Sanger sequencing results. Among the 50 samples of healthy group, 1 case was ultra-rapidmetabolism, 22 cases were rapidmetabolism, 22 cases were medium metabolism and 5 cases were slow metabolism. Conclusion The detection method of CYP2C19 polymorphism based on pyrosequencing technology is quick, accurate and convenient, which can be used to analyze the genotyping of CYP2C19 gene polymorphism.
2017 Vol. 14 (29): 11-14 [Abstract] ( 392 ) HTML (1 KB)  PDF (985 KB)  ( 255 )
15 A Meta-analysis of prognostic effect of elevated mir-92a in patients with colorectal cancer
LI Lifa1,2 CHEN Xiaobo1 HOU Songlin2 LIU Daizhi2 ZHANG Guangjun1,2 ZHOU He1 ZHOU Tong1,2
[Abstract] Objective To systematically estimate the effect of over-expression miR-92a in clinicopathological and prognosis of patients with colorectal cancer. Methods All available literatures were obtained from PubMed, CBM, CNKI, WanFang, and Vip database，from the building up to December 2016. Eventually, the pooled hazard ratio (HR), odds ratio (OR) and 95% confidence interval (95%CI) were evaluated by statistical software of stata 12.0. Results There were altogether 6 qualified articles with 695 patients in this Meta-analysis. The pooled analysis shows, ①which increased miR-92a levels were capable of predicting worse overall survival (HR=2.91, 95%CI: 1.16-7.28, P < 0.05) in CRC patients; ②which elevated miR-92a was distinctly associated with depth of tumor invasion (OR=0.56, 95%CI: 0.33-0.96, P < 0.05), TNM stage (OR=0.41, 95%CI: 0.24-0.71, P < 0.05), distant metastasis (OR=4.71, 95%CI: 1.74-12.69, P < 0.05), lymph node metastasis (OR=2.90, 95%CI: 1.64-5.13, P < 0.05); however, high expression of miR-92a was negatively correlated with gender and tumor differentiation, with pooled OR of 1.01 (95%CI: 0.6-1.69, P > 0.05) and 0.66 (95% CI: 0.33-1.30, P > 0.05), respectively. Conclusion Up-regulated miR-92a is able to predict survival outcomes and clinicopathologic features.
2017 Vol. 14 (29): 15-18,68 [Abstract] ( 293 ) HTML (1 KB)  PDF (1236 KB)  ( 198 )
19 Effects of echinacoside on liver lipid metabolism in db/db mice
TANG Fengjuan1 HAO Yarong1 ZHANG Xue1 QIN Jian2
[Abstract] Objective To investigate the effect of echinacoside (ECH) on liver lipid metabolism in db/db mice and its mechanism. Methods Twenty-one healthy male db/db mice aged 8 weeks and weighing from 40 to 48 g were divided into db/db+ECH group [n = 11, ECH, 300 mg/(kg·d)] and db/db group (n = 10, given the corresponding volume of saline) by random number table, db/m mice born with same littermates were served as normal control group, that was db/m group (n = 9, given corresponding volume of normal saline). The weight of the mice was measured weekly. The mice were sacrificed 10 weeks after the intervention. The liver tissues were sacrificed and the wet weight of the liver and the weight of the fat around the testes were measured. The total RNA of the liver was extracted and the mRNA of peroxisome proliferator-activated receptor α (PPAR-α) and carnitine palmitoyl transterase-1 (CPT-1) were detected by real-time quantitative PCR. Liver tissue hematoxylin-eosin (HE), oil red O staining were used to evaluate pathologic changes. The levels of alanine aminotransferase (ALT), aspartate transaminase (AST), triglyceride (TG), serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured by automatic biochemical analyzer after fasting for 12 hours and 1 d before the rats were sacrificed. Results Compared with db/m group, the body weight, wet weight of liver and testicular fat around the weight in the db/db group were increased, and the levels of ALT, AST, TG, TC, LDL-C in serum were increased and HDL-C in serum was decreased (P ＜ 0.05 or P ＜ 0.01), liver tissue showed liver cell swelling, vacuolar degeneration, a lot of lipid deposition; ECH intervention could reduce body weight, liver wet weight and testicular fat around the weight of db/db mice, decrease the levels of ALT, AST, TG, TC, LDL-C and increase the level of HDL-C (P < 0.05 or P < 0.01), improve the pathological changes of liver tissue and lipid deposition, and up-regulate the expression of PPAR-α and CPT-1 in liver tissue (P ＜ 0.05). Conclusion Echinacoside has protective effect on liver of db/db mice, and its mechanism may be related to up-regulating the expression of PPAR-α and CPT-1 in liver tissue and improving lipid metabolism.
2017 Vol. 14 (29): 19-23 [Abstract] ( 400 ) HTML (1 KB)  PDF (867 KB)  ( 220 )
24 Effects of Sanjie Tongluo Decoction on the expression of matrix metalloproteinase 2, tissue inhibitor of metalloproteinase 2 in rats with ischemic nephropathy of advanced stage
WANG Rui1 CHEN Guimei1 LI Wei1 LIU Lanying1▲ LI Jiaoyan1 LI Genmao2 GE Dongyu2 WANG Yaoxian3
Objective To investigate the effects of Sanjie Tongluo Decoction on the expression of matrix metalloproteinase 2 (MMP-2), tssue inhibitor of metalloproteinase-2 (TIMP-2) of nephridial tissue in rats with ischemic nephropathy of advanced stage. Methods Male SD rats were randomly divided into sham operation group, model group (both groups were given normal saline 3 mL/d), drug group [Sanjie Tongluo Decoction 10.85 g/(kg·d)] by random number table method. The unilateral renal artery insufficiency ligation was used to establish animal model. In the 28th day of experiment, the levels of 24 hours urinary protein and creatinine of rats were detected. The rats were put to death and nephridial tissue was collected to take light microscope examination, the changes of renal morphology in all groups were observed. Immunohistochemistry was used to detect the expression of MMP-2 and TIMP-2 of nephridial tissue. Results Under the light microscope, the glomerulus and tubulointerstitium in the model group and drug group had damage. Compared with sham operation group, the scores of glomerulosclerotic index and tubulointerstitial lesion in the model group and drug group were all increased (P ＜ 0.01), which of drug group were lower than those of model group (P ＜ 0.01). Compared with model group, the expression of MMP-2 in drug group was increased (P ＜ 0.01), 24 hours urinary protein, creatinine and the expression of TIMP-2 were decreased (P ＜ 0.01), which of both groups were higher than those of sham operation group (P ＜ 0.01). Conclusion Sanjie Tongluo Decoction can prevent the lesions of ischemic nephropathy of advanced stage by up-regulating the expression of MMP2 and down-regulating the expression of TIMP-2.
2017 Vol. 14 (29): 24-27 [Abstract] ( 242 ) HTML (1 KB)  PDF (648 KB)  ( 192 )
28 Clinical study and present situation of the treatment of heart disease and psychology to the patients with coronary heart disease after percutaneous coronary intervention
LI Yiping WANG Xiaolong▲
The morbidity and mortality rate of coronary heart disease (CHD) is on the rise in China, and percutaneous coronary intervention (PCI) is one of the main methods to diagnose and treat CHD. However, for most patients, the risk of disease and surgical treatment, stent-induced economic problems, postoperative restenosis, stent thrombosis and other factors will give the patients physical and mental burden, which are easy to generate anxiety, depression and other emotion problems, severe cases can even affect the efficacy and quality of life. Therefore, while physicians treat patients with active heart diseases, they also need pay attention to psychological problems that may accompany the heart diseases. And timely intervention by heart physicians can make the patient get the heart, psychological harmony and unity. This article mainly gives a brief summary of the related research progress on the psychological problems, causes, diagnosis and treatment after PCI.
2017 Vol. 14 (29): 28-31 [Abstract] ( 239 ) HTML (1 KB)  PDF (564 KB)  ( 271 )
32 Modern medical research advances on frozen shoulder
ZHANG Chang1 WANG Ruihong1 XU Yao1 HU Xianglin2 ZHOU Ying3
The article describes frozen shoulder from several respects of the concept, epidemiology, clinical manifestations, clinical evaluation, clinical diagnosis, pathological features and clinical treatment. Through the analysis it summarizes the clinical features and diagnostic points of frozen shoulder in freezing-phase, freezed-phase and thawing phase, the differential diagnoses are carried out by examining the shoulder active and passive movements and using three kinds of imaging methods, such as X-ray, MRI and arthroscopy. It proposes the ideas of treatment by disease stages according to the pathological changes, and points out that in the future the effectiveness of treatment and socioeconomic evaluation should be further developed, in order to find the best treatment.
2017 Vol. 14 (29): 32-36 [Abstract] ( 278 ) HTML (1 KB)  PDF (552 KB)  ( 269 )
37 Research progress on pathogenesis of physiological insomnia
DU Jianeng1 LIU Cong2 HAO Xuliang2 NI Yan2 XU Wenwen2 JI Haixia2
Insomnia refers to the inability to fall or stay asleep leading to a serious decline in social function during the next day. At present, physiological insomnia was mainly caused by brain gamma aminobutyric acid (GABA) neurons system dysfunction, hyperactivity of hypothalamic pituitary adrenal axis (HPA axis), melatonin (MT) secretion decline, cytokines secretion disorders and different degree expression of some specific neurotransmitters. In result of central nervous system dysfunction which leading to the occurrence of insomnia. This article summarized the pathogenesis of physiological insomnia the aspect above, aiming to provide new methods to treat insomnia.
2017 Vol. 14 (29): 37-40 [Abstract] ( 981 ) HTML (1 KB)  PDF (570 KB)  ( 526 )
41 Research progress in clinical applications of Zolpidem
LIU Guiping ZHANG Guoling▲
Insomnia is a common sleep disorder, at present, sedative and hypnotic drugs are still the main measures in the treatment of insomnia. Zolpidem is benzodiazepine receptor agonists, which is a new type of sedative and hypnotic drugs, belonging to the nonbenzodiazepine drugs. Compared to benzodiazepine drugs in the treatment of insomnia, Zolpidem has the advantages of safe and effective, less adverse reactions, widely clinical application. In order to ensure the rational use of drugs and medication safety, clinicians and pharmacists should base on the relevant guidelines, correctly select indications, closely monitor adverse drug reactions, strengthen the management of psychotropic drugs, and prevent the abuse of sedative and hypnotic drugs.
2017 Vol. 14 (29): 41-44 [Abstract] ( 828 ) HTML (1 KB)  PDF (538 KB)  ( 400 )
45 Investigation of oral treatment concepts and behavior in health cadres population in Beijing
LIU Chunxiu1 WANG Hongyu2 LIU Xia1 XIAO Ying1 BIAN Xiang1 SHI Yaqi2
Objective To investigate the oral medical treatment concepts and behaviors in healthcare cadre group in Beijing. Methods The healthcare cadres were recruited, who had participated in questionnaire survey in Beijing Xiaotangshan Hospital from January to May 2015. The analysis of survey data was performed by using SPSS 19.0. Results The totally sample capacity was 461 cases, including 211 males and 250 females. Among them, a total of 314 patients with 133 males and 181 females were treated with oral therapy in the past year, and the consultation rate of male and female was 63.03% and 72.40% respectively. The consultation rate of female was higher than that of male, and the difference was statistically significant (χ2=4.622, P ＜ 0.05). "Checking oral problems" (28.66%) and "taking preventive measures" (1.91%) were the primary and least reasons for patients to visit the dentist. General hospitals were chosen by most of patients (39.81%), but primary hospitals were only selected by very few of them (0.96%). "Oral treatmentis too trouble" (67.65%), "hospital registration is too difficult" (36.27%), and "patients have no time" (33.33%) were the top three reasons why patients were not treated in time. Conclusion The oral treatment concept of healthcare cadre group in Beijing is insufficient. Besides, the concept of males is weaker than that of females. Carrying out targeted oral health education, regular oral health examination, and strengthening the construction of primary medical institutions are important measures to improve the oral consultation rate of this group.
2017 Vol. 14 (29): 45-48 [Abstract] ( 228 ) HTML (1 KB)  PDF (635 KB)  ( 220 )
49 Reliability and validity of Chinese version of terminal cancer care load scale
ZHANG Mingjun1 KANG Xuan2 LAI Qiaorong2 ZHANG Cuiping2
Objective To evaluate the reliability and validity of Chinese version of terminal cancer care load scale, in order to provide a scientific tool for the clinical nursing evaluation of terminal cancer care load in Mainland China. Methods Totally 186 case of the main family caregivers of cancer patients in Xinjiang Uygur Autonomous Region were investigated by the Taiwan Chinese version of terminal cancer care load scale, and the reliability and validity of the results were analyzed. Results The Cronbach′s α coefficient of Chinese version of terminal cancer care load scale was 0.901, the dimensions of Cronbach′s α coefficient were 0.829-0.912, the split half coefficient was 0.874, the test-retest reliability was 0.792. The mean of content validity was 0.916. After factor analysis, the cumulative contribution rate of 4 common factors was 61.247%, and the load of each item factor was >0.5. Conclusion The Chinese version of terminal cancer care load scale has good reliability and validity, which is suitable for application in Mainland China.
2017 Vol. 14 (29): 49-52 [Abstract] ( 284 ) HTML (1 KB)  PDF (519 KB)  ( 275 )
53 The relationship between hospital administrative personnels′ job burnout, professional identity and job satisfaction
LI Junlong1,2 XU Peiyao1 GAO Jia1 BAI Qingsong3 LIANG Yike2 LI Xinyue2 SU Wei1
Objective To understand the job burnout of the administrative personnels of the hospital, and explore the impact of job burnout on professional identity and job satisfaction among administrative personnels. Methods 150 administrative personnels in 6 tertiary public hospitals of Zigong City in Sichuan Province were selected by the Maslach burnout inventory-general survey, career identity scale and job satisfaction scale from February to May 2017. The correlations of job burnout and professional identity, job satisfaction were analyzed with Pearson correlation. The causal relationship of job burnout and professional identity, job satisfaction was analyzed with hierarchical linear regression model. Results The average score of the administrative personnels job burnout was (2.44±0.93) points, emotional exhaustion was (1.97±1.38) points, depersonalization was (1.32±1.36) points, low professional efficacy was (1.81±1.44) points. The job burnout was significant negatively correlated professional identity (r=-0.485, P ＜ 0.01); the job burnout was also significant negatively correlated job satisfaction (r=-0.506, P ＜ 0.01). The professional identity and job satisfaction of administrative personnels was significantly reduced by depersonalization (β =-0.298, P ＜ 0.01) (β =-0.273, P ＜ 0.05) and low professional efficacy (β =-0.382, P ＜ 0.001) (β =-0.155, P ＜ 0.05); the job satisfaction was better predicted by emotional exhaustion (β =-0.218, P ＜ 0.05). Conclusion The phenomenon of job burnout in hospital administrators is widespread, job burnout can significantly reduce the professional identity and job satisfaction of administrative personnels.
2017 Vol. 14 (29): 53-56 [Abstract] ( 346 ) HTML (1 KB)  PDF (515 KB)  ( 552 )
57 Protective effect of short-term and high dose of different statins for the renal function of patients underwent percutaneous coronary intervention
LOU Ming1 GONG Haibin2 LIU Yi1 WANG Lulu1 CAO Qiumei1
Objective To investigate the effect of short-term and high dose of different statins on the renal function of patients underwent percutaneous coronary intervention and its possible mechanism. Methods One hundred and eighty patients underwent percutaneous coronary intervention in Department of Cardiology, Xuzhou Central Hospital from March 2015 to March 2016 were selected, and they were randomly divided into Rosuvastatin group, Atorvastatin group, and control group according to the random number table, with 60 cases in each group. From 3 d before operation to 3 d after operation, Rosuvastatin group was treated with 20 mg/d, Atorvastatin group was treated with Atorvastatin 80 mg/d, the control group was not given any statins. Before operation and 48-72 h after operation, the blood of three groups was draw to detect the levels of serum creatinine and hypersensitive C-reactive protein. The incidence of contrast-induced nephropathy and the levels of hypersensitive C-reactive protein among the three groups were compared. Results The incidence of contrast-induced nephropathy in Rosuvastatin group and Atorvastatin group was lower than that of control group, there were statistically significant differences (P ＜ 0.05), while there was no statistically significant difference between Rosuvastatin group and Atorvastatin group (P ＞ 0.05). The increased degree of postoperative hypersensitive C-reactive protein in Rosuvastatin group and Atorvastatin group was lower than that of control group, there were statistically significant differences (P ＜ 0.05), while there was no statistically significant difference between Rosuvastatin group and Atorvastatin group (P ＞ 0.05). Conclusion Short-term and high dose of Rosuvastatin and Atorvastatin can decrease the incidence of contrast-induced nephropathy and the increase of postoperative hypersensitive C-reactive protein.
2017 Vol. 14 (29): 57-60 [Abstract] ( 251 ) HTML (1 KB)  PDF (442 KB)  ( 202 )
61 Clinical significance of detection of deceleration capacity of rate in patients with primary hypertension of different circadian rhythm
ZHOU Li WANG Xingde SHEN Shurong CHENG Pei CHEN Bin CHEN Zhong
Objective To investigate the clinical significance of the changes of deceleration capacity of rate (DC) in patients with primary hypertension of different circadian rhythm. Methods One hundred and eighty-four patients with primary hypertension treated in the Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University (“our hospital” for short) from January 2014 to December 2016 were selected and given ambulatory blood pressure monitoring. According to the descent rate of nighttime blood pressure, they were divided into two groups: the patients with descent rate of ＜10% were taken as non-dipper pattern hypertension group (NDPH group, 118 cases), the patients with descent rate of ≥10% were taken as dipper pattern hypertension group (DPH group, 66 cases). 50 healthy subjects taken physical examination in our hospital at the same time were taken as control group. 24 h Holter was used to detect and compare the levels of DC, acceleration capacity of rate (AC), heart rate variability (HRV) among the three groups, and their relevance was analyzed. Results The DC and standard deviation of normal sinus RR intervals (SDNN) in NDPH group and DPH group were significantly lower than that of control group, and AC was significantly higher than that of control group (all P ＜ 0.01); the root mean square of standard deviations of differences between adjacent normal RR intervals (RMSSD) and the proportion derived by dividing NN50 by the total number of NN intervals (PNN50) in NDPH group were significantly lower than that of control group (P ＜ 0.05). DC and SDNN in NDPH group were significantly lower than that of DPH group, and AC was significantly higher than that of DPH group (P ＜ 0.05). In NDPH group, DC was significantly positively correlated with SDNN, RMSSD (P ＜ 0.01, P ＜ 0.05) and negatively correlated with AC (P ＜ 0.01). Conclusion The patients with primary hypertension of different circadian rhythm have impaired autonomic nerve function, and its imbalance in NDPH group is more obvious than that in DPH group. In clinical practice, physicians should not only care for the blood pressure control, but also pay attention to the changes of autonomic function and circadian blood pressure rhythm in the diagnosis and treatment of hypertension.
2017 Vol. 14 (29): 61-64 [Abstract] ( 228 ) HTML (1 KB)  PDF (482 KB)  ( 254 )
65 Research on the mutation of cardiac myosin binding protein C gene c.G772A in familial hypertrophic cardiomyopathy
LIU Jie*▲ LIU Fusong*▲ WANG Fang XING Xiaobo FAN Guanghong ZHU Yuzhao ZHANG Kechuan SUN Fangfang
Objective To study the pathogenic gene of Chinese familial hypertrophic cardiomyopathy (HCM), and to analyze the relationship between genotype and clinical phenotype. Methods One inpatient treated in Department of Cardiology, the Third People′s Hospital of Qingdao in 2016 was taken as the HCM family of proband, in which, the coding region and flanking region of 30 virulence gene related to HCM including cardiac myosin binding protein C (MYBPC3) were detected, and the 30 genes related to hereditary cardiomyopathy of HCM proband were identified by whole exons amplification and high-throughput sequencing through targeted exon trapping sequencing, and the identified mutation was further detected through bi-directional Sanger sequencing in the family members and 200 healthy volunteers. Pedigree analysis included clinical manifestation, physical examination, ECG and echocardiogram. Results Among 4 blood-related members in the six members of family, 3 members had MYBPC3 gene c.G772A hybrid missense mutation. The mutation was existed in the 6th exon of MYBPC3 gene, which made a 258-bit glutamic acid (E) into a lysine (K). The proband of the family carried on MYBPC3 mutation, who was attacked in the middle-age, clinical phenotype was mild, and the ultrasound showed that the interventricular septum was significantly thickened (the thickness was 18.3 mm). Conclusion MYBPC3 gene c.G772A hybrid missense mutation may be the pathogenic mutations of this HCM family. Some carriers have mild clinical phenotype, and some have no clinical manifestation, which suggests that other factors such as other genes, age, environment also participate in the development process of HCM.
2017 Vol. 14 (29): 65-68 [Abstract] ( 266 ) HTML (1 KB)  PDF (527 KB)  ( 440 )
69 A study of rTMS treatment for ADHD patients evaluated by integrated visual and auditory continuous performance test
XUE Qing1,2 QI Xiaohong3 GAO Lehong1,2 MAO Wei1 WEI Rong3 LI Liping1,2 LIN Hua1,2 WANG Yuping1,2,3,4▲
Objective To explore the effect of rTMS for attention deficit hyperactivity disorder (ADHD). Methods 20 children and adolescents with ADHD treated in Neurology and Pediatrics Outpatient Clinics of Xuanwu Hospital, Capital Medical University from January 2013 to January 2016 were enrolled in the study. These patients were then divided into two groups randomly, each group had 10 cases. The active treatment group received active stimulation and the sham treatment group were given sham stimulation. The parameters of active condition was 0.5 Hz, 100% of the motor threshold, while the sham condition was 0.5 Hz, 10% of the motor threshold; the target was right parietal region; one course was 10 days. At the end of one-course treatment, integrated visual and auditory continuous performance test (IVA-CPT) was applied to assess the severity of ADHD, and the results were compared. Results In the active treatment group, compared with before treatment, auditory response time, correct auditory response, visual response time and correct visual response showed significant improvement after treatment (P < 0.05), however, no significant improvement of any parameter was revealed in the sham treatment group (P > 0.05). Between the two groups, significant differences were showed after treatment in auditory response time (P < 0.05), visual response time (P < 0.05) and correct visual response (P < 0.05), except correct auditory response (P > 0.05), but before treatment, these parameters had no significant differences between the two groups (P > 0.05). Conclusion Right parietal region low-frequency rTMS for ADHD children and adolescents can improve their clinical symptoms.
2017 Vol. 14 (29): 69-71,79 [Abstract] ( 233 ) HTML (1 KB)  PDF (631 KB)  ( 422 )
72 Application of task form health management strategy in asthmatic children treated with continuous inhaled glucocorticoids
HA Haixia LUO Yongli▲ YANG Guanshan
Objective To explore the effect of task form health management strategy on compliance and clinical efficacy of asthmatic children treated with continuous inhaled glucocorticoids. Methods 84 children with asthma treated in Ankang Hospital of Traditional Chinese Medicine were divided into two groups according to the time of admission. Among them, 41 children who were treated from July to December 2015 were selected as the routine group, and the traditional nursing education program was adopted. 43 children treated from January to June 2016 were selected as intervention group, and the task form and health management strategy were adopted to intervene. The medication compliance, clinical symptom score and pulmonary function before and 3, 6, 12 months after the intervention of the two groups were compared. Results Comparison within the same group, compared with before intervention, the medication compliance scores, peak expiratory flow rate measured values of percentage of predicted value (PEF%) and forced expiratory volume in the first second percentage of predicted value (FEV1%) of the intervention group after 3, 6 and 12 months of intervention significantly increased (P < 0.05), the clinical symptom scores significantly decreased (P < 0.05). Compared with before intervention, the medication compliance scores of routine group after 6 and 12 months of intervention significantly decreased (P < 0.05), PEF% and FEV1% significantly improved after intervention (P < 0.05), the clinical symptom scores after 3, 6 and 12 months of intervention significantly decreased (P < 0.05). Comparison between groups, after 3, 6 and 12 months of intervention the medication compliance scores and PEF% of the intervention group were significantly higher than those of the routine group (P < 0.01); after 6 and 12 months of  intervention the clinical symptom scores of the intervention group were significantly lower than those of the routine group (P < 0.01), and the FEV1% values were significantly higher than those of the routine group (P < 0.05). Conclusion The task form health management strategy can effectively improve the compliance of asthmatic children treated with continuous inhaled glucocorticoids, reduce the clinical symptoms and improve the lung function.
2017 Vol. 14 (29): 72-75,92 [Abstract] ( 785 ) HTML (1 KB)  PDF (926 KB)  ( 324 )
76 Case analysis of infectious mononucleosis with coronary artery dilatation
LIU Jingjing1 ZHENG Chunhua2 LI Xiaohui1 BAO Min2 CAO Aimei2 REN Jun2 LIU Bo2 LIU Yan2
Objective To investigate the clinical characteristics of coronary artery dilatation (CAD) of children with infectious mononucleosis (IM). Methods From May 2015 to December 2016, the cases diagnosed with IM in Children's Hospital, Capital Institute of Pediatrics were collected and performed echocardiogram. Z value was used to estimate CAD. The clinical characteristics of IM with CAD were analyzed. Results ①Clinical features: 15 children (8 boys and 7 girls) of IM with CAD among totally 344 patients were included in this study. The incidence of IM with CAD was about 4.4%. The mean age was (3.47±1.61) years. The most common clinical manifestation included fever (15 cases, 100.0%), and lymph nodes enlargement (14 cases, 93.3%). Blood routine showed leukocytosis (14 cases, 93.3%), high lymphocyte proportion (15 cases, 100.0%) and increased atypical lymphocyte ratio (14 cases, 93.3%). The disorder of cell-mediated immunity was found in 14 cases (93.3%). ②Coronary artery: the median time of CAD was 5 (4, 8) d. The median duration of CAD was 17 (7, 41) d. The median Z-score of coronary artery was 3.74 (3.01, 5.64). The right CAD was found in 13 cases (86.7%). Conclusion CAD in patients with IM can develop within 1 week after onset, and persist for about 2-3 weeks. The right CAD is the most common finding, and the prognosis is good.
2017 Vol. 14 (29): 76-79 [Abstract] ( 287 ) HTML (1 KB)  PDF (455 KB)  ( 418 )
80 Meta-analysis of chemotherapy combined with cytokine-induced killer cells in the treatment of ovarian cancer
DUAN Wenli1 WANG Feng2 ZHANG Yan1 ZHOU Hang1
Objective To evaluate the effectiveness of chemotherapy combined with cytokine-Induced killer cells (CIK) in the treatment of ovarian cancer. Methods "Cytokine-induced killer cells" "CIK" "DC-CIK" "chemotherapy" "ovarian cance" as the retrieval words, the databases such as PubMed, Embase, the Cochrane Library, Medline, CNKI, VIP and WanFang Date were retrieved from the time of the database established to June 2017. Satisfactory randomized controlled clinical trial (RCT) or non-randomized concurrent control trial (NRCCT) were included. Meta-analysis was conducted by RevMan 5.3 software. Results Overall, 10 studies involving 788 patients with ovarian cancer were included. The results of Meta-analysis showed that, compared with chemotherapy alone group, the response rate (OR=1.93, 95%CI: 1.36-2.74, P=0.0002), disease control rate (OR=2.42, 95%CI: 1.46-4.02, P=0.0007), 1-year survival rate (OR=2.71, 95%CI:1.46-5.03, P=0.002), 2-year survival rate (OR=2.30, 95%CI: 1.31-4.04, P=0.004) and progression-free survival (MD=3.66, 95%CI: 1.31-6.01, P=0.002) in the chemotherapy combined with adoptive transfer of CIK group were improved. However, there were no significant differences between two groups in overall survival (MD=4.75, 95%CI: -3.58 -13.07, P=0.26). Conclusion For patients with ovarian cancer, the adoptive transfer of CIK can improve the efficacy of chemotherapy and delay progression, but it has no significant effect on the overall survival.
2017 Vol. 14 (29): 80-84 [Abstract] ( 313 ) HTML (1 KB)  PDF (1499 KB)  ( 243 )
85 Effects and prognosis of thoracoscopic radical resection of pulmonary carcinoma for patients with early non-small cell lung cancer
JIN Zhiyong REN Haiyan LIANG Junguo
Objective To explore the effects of thoracoscopic radical resection of pulmonary carcinoma on the clinical effects, complications and prognosis in the treatment of early non-small cell lung cancer (NSCLC). Methods The clinical data of 116 patients with early NSCLC who had been seeking treatment in the Affiliated Hospital of Inner Mongolia Medical University from April 2015 to April 2016 were selected for analysis. These patients were divided into control group (n=58) and study group (n=58), according to the operation methods applied. The control group was treated by open chest lung cancer eradication, whereas the study group was treated by thoracoscopic radical resection of pulmonary carcinoma. The clinical index, incidence of complications and life quality score in the two groups were compared. Results There was no significant difference between the two groups of lymph nodes dissected (P > 0.05). The intraoperative amount of bleeding, drainage tube placement time, VAS score 24 hours after operation and the length of hospital stay in the study group were better than those in the control group, with highly statistically significant difference (P < 0.01). The total incidence of complications in the study group was lower than that in the control group, with highly statistically significant difference (P < 0.01). Among the life quality scores, the function, emotional status, physcial conditions and social/family status in the study group were higher than the control group, with highly statistically significant difference (P < 0.01). Conclusion For patients with early NSCLC, thoracoscopic radical resection of pulmonary carcinoma can effectively improve the clinical effects, with less postoperative complications, high safety and good prognosis. Therefore, it has clinical popularization and application value.
2017 Vol. 14 (29): 85-88 [Abstract] ( 831 ) HTML (1 KB)  PDF (551 KB)  ( 380 )
89 Efficacy comparison of three-dimensional conformal radiation therapy and intensity-modulated radiation therapy cornbined with afterloading intracavitary radiotherapy respecfively in treating advanced cervical cancer
QIAO Zhi′an YANG Lixin WANG Xiaozhen
Objective To investigate the therapeutic effect of three-dimensional conformal radiation therapy and intensity-modulated radiation therapy after the afterloading intracavitary radiotherapy for advanced cervical cancer. Methods 80 patients with advanced cervical cancer in Xingtai People′s Hospital from April 2013 to April 2015 were selected. According to the different treatment methods, all the patients were divided into control group and observation group, with 40 cases in each group. The control group was treated by three-dimensional conformal radiotherapy + afterloading intracavitary radiotherapy, while the observation group was treated by intensity modulated radiation therapy (IMRT) + afterloading intracavitary radiotherapy. The short term effect, toxic and side effect and local recurrent rate, distant metastasis rate, overall survival after 2 years between two groups were compared. Results There was no statistically significant difference between the two groups in the short term effect (P > 0.05). The blood elephant abnormal, digestive tract injury and urinary system injury in the the observation group were lower than those in the control group, with highly statistically significant difference (P < 0.01). There was no statistically significant difference between the two groups in the 2 years local recurrence, distant metastasis rate, survival rate of disease progression and overall survival rates (P > 0.05). Conclusion There was no significant difference between the effect of radiotherapy and the long-term survival rate and the three dimensional conformal radiotherapy, but the incidence of toxicity was lower and the safety was higher.
2017 Vol. 14 (29): 89-92 [Abstract] ( 292 ) HTML (1 KB)  PDF (555 KB)  ( 260 )
93 Meta analysis of the clinical efficacy of antiviral combined with TACE in the treatment of hepatitis B virus associated hepatocellular cancer
CHEN Huihua WEN Lingbo LI Jian′an JIA Yanhua
Objective To evaluate the clinical efficacy of antiviral combined with transarterial chemoembolization (TACE) in the treatment of hepatitis B virus associated hepatocellular cancer. Methods The following databases such as CNKI, Wanfang Date, VIP, PubMed, The Cochrane Library, Embase were retrieved from the time of the database established to April 30, 2017.Randomized controlled clinical trials (RCTs) that antiviral combined with transarterial chemoembolization in the treatment of hepatitis B virus associated hepatocellular cancer were included, the Jadad score method was used to carryout quality assessment. Meta-analysis was conducted by RevMan 5.2 software. Results A total of 275 papers were searched. Finally 10 references, 844 patients were included in the Meta analysis. Meta analysis results showed that the Antiviral combined with TACE in the treatment of patients with hepatitis B related hepatocellular cancer in the near future clinical efficacy (OR=2.47, 95%CI:1.54-3.95,P=0.0002), ALT improve condition (OR=-34.23, 95%CI:-46.24--22.21, P < 0.00001), HBV DNA quantitative improve condition (OR=-2.91, 95%CI:-4.16--1.67,P <0.00001), AFP improve condition (OR=-33.86, 95%CI:-37.91--29.82,P < 0.00001) were better than simple TACE treatment. There were no significant differences between two groups in 1-year survival rate (OR=1.94, 95%CI:0.89-4.22,P=0.09). Conclusion Antiviral combined with TACE is superior to simple TACE in the treatment of hepatitis B related liver cancer, which is worthy of clinical recommendation.
2017 Vol. 14 (29): 93-97 [Abstract] ( 303 ) HTML (1 KB)  PDF (1377 KB)  ( 275 )
98 A Meta-analysis of the value of Kang′ai Injection in treating patients with tumor of lymphoid hematopoietic system
LING Chun1 XU Shiyun1▲ NIU Xiaowei2 DA Xiaojing3
Objective To assess the value of Kang′ai Injection for patients with tumor of lymphoid hematopoietic system. Methods The following databases such as PubMed, Embase, Web of Science, CENTRAL, CBM, VIP, CNKI, Wanfang Data were retrieved from the time of the database established to January 2017. Randomized controlled clinical trials (RCTs) that Kang′ai Injection combined with routine therapy in the treatment of tumor of lymphoid hematopoietic system were included. Meta-analysis was conducted by RevMan 5.1 software. Results 10 randomized trials involved 619 patients were included. In the Kang′ai Injection group, the clinical effects [RR=1.17, 95%CI (1.04, 1.32), P=0.008], living quality [RR=1.79, 95%CI (1.42, 2.24), P < 0.001] were increased, and adverse events such as hypoleukia [RR=0.48, 95%CI (0.33, 0.70), P < 0.001], thrombocytopenia [RR=0.39, 95%CI (0.20, 0.75), P=0.005], anemia [RR=0.59, 95%CI (0.36, 0.98), P=0.04] and gastrointestinal side effects [RR=0.63, 95%CI (0.53, 0.74), P < 0.001] were decreased, compared with control group. Conclusion The combination of Kang′ai Injection combined with conventional chemotherapy can improve the efficacy and quality of treatment of patients with tumor of lymphoid hematopoietic system, and reduce the incidence of bone marrow rejection rate and digestive tract adverse reactions.
2017 Vol. 14 (29): 98-102 [Abstract] ( 663 ) HTML (1 KB)  PDF (1399 KB)  ( 153 )
103 Effect of transcatheter arterial chemoembolization combined with ultrasound-guided microwave ablation in the treatment of primary hepatocellular carcinoma
ZHANG Meng GAO Zhong TAN Guifang LIU Zhigang QIAN Yong ZHANG Yi
Objective To analyze the effect of transcatheter arterial chemoembolization combined with ultrasound guided microwave ablation in the treatment of primary liver cancer. Methods 98 patients with primary hepatocellular carcinoma treated in Dalian Central Hospital from January 2014 to December 2016 were selected as the study subjects. According to different treatment methods, patients were divided into observation group (50 cases) and control group (48 cases). The patients in the control group were treated with hepatic artery chemoembolization, and the patients in the observation group were treated with transcatheter arterial chemoembolization combined with ultrasound guided microwave ablation. The treatment outcomes was compared between the two groups; before treatment and 3 months after treatment, the levels of alpha fetal protein (AFP), glutamate aminotransferase (ALT) and glutamate transaminase (AST) of the patients in the two groups were tested; the adverse reactions in the two groups during and after treatment were observed. Results The total effective rate and disease control rate in the observation group were higher than those in the control group, with statistically significant difference（P < 0.05）; after treatment, levels of AFP, ALT and AST of the two groups were significantly lower than those before treatment, and the observation group was lower than that of the control group, with statistically significant difference (P < 0.05). During treatment complications such as nausea, vomiting, diarrhea, skin rash, bone marrow suppression, fever, and pain happened in both groups, while the incidence of complications in the two group was not statistically different (P > 0.05). Conclusion Compared with hepatic artery embolization chemotherapy alone, transcatheter arterial chemoembolization combined with ultrasound-guided percutaneous microwave ablation therapy can provide obvious therapeutic effect, and do not increase the occurrence of adverse reactions, which is worthy of clinical promotion.
2017 Vol. 14 (29): 103-106 [Abstract] ( 282 ) HTML (1 KB)  PDF (602 KB)  ( 307 )
107 Effect of parenteral combined with enteral nutrition support therapy on liver function of malignant obstructive jaundice after percutaneous transhepatic cholangial drainage
YU Xiangyang YANG Guanghua CHEN Junmao ZHAO Peng CHEN Jianli ZHANG Guozhi HE Yanfang▲
Objective To explore effect of parenteral combined with enteral nutrition support therapy on liver function of malignant obstructive jaundice after percutaneous transhepatic cholangial drainage (PTCD). Methods 100 patients with malignant obstructive jaundice after PTCD in North China University of Technology Affiliated Hospital from June 2015 to June 2016 were divided into two groups by using the random number table method. Control group was given parenteral nutrition support therapy, while observation group was given parenteral combined with enteral nutrition support therapy. The levels of ALT, AST, ALP, GGT, TBIL, DBIL, TBA, CD4+, CD8+, CD4+/CD8+, IgA, IgG and IgM between two groups before and after treatment were compared. Results The levels of ALT, AST, ALP and GGT in observation group after treatment were significantly lower than those in control group (P < 0.05). The levels of TBIL, DBIL and TBA in observation group after treatment were significantly lower than those in control group (P < 0.05). CD4+, CD8+ and CD4+/CD8+ in observation group after treatment were significantly higher than those in control group (P < 0.05). IgA, IgG and IgM in observation group after treatment were significantly higher than those in control group (P < 0.05). Conclusion Parenteral combined with enteral nutrition support therapy can effectively improve liver function of patients with malignant obstructive jaundice after PTCD, and enhance immune function.
2017 Vol. 14 (29): 107-110 [Abstract] ( 280 ) HTML (1 KB)  PDF (558 KB)  ( 243 )
111 Application evaluation of different approaches for catheter-directed thrombolysis in acute lower-extremity deep venous thrombosis
ZHANG Qingyun1 DING Meng2 CHEN Lei1 GAO Jianguo1 ZHANG Hong1 YANG Zhi1
Objective To investigate the effect of different approaches for catheter-directed thrombolysis (CDT) in the treatment of acute lower-extremity deep venous thrombosis (DVT). Methods Sixty patients with acute lower-extremity DVT admitted to the Vascular Surgery Department of Affiliated Hospital of Chengde Medical College from January 2013 to January 2016 were selected. All patients were divided into three groups according to the random number table method, each group of 20 cases. The retrograde thrombolysis of the contralateral femoral vein was group A, arranged thrombolysis by ipsilateral popliteal vein was group B, stomach thrombolysis by ipsilateral foot vein was group C. Recent and long-term efficacy of each group was compared. Results After treatment, circumference differences between uninjured limb and injured limb in two groups were less than before treatment, the differences were statistically significant (P < 0.01). After treatment, circumference differences between uninjured limb and injured limb in group A and B were less than those in group C, the differences were statistically significant (P < 0.01). After treatment, thrombosis score of each group was lower than before treatment, the difference was statistically significant (P < 0.05). After treatment, thrombosis scores in group A and B were lower than those in group C, the differences were statistically significant (P < 0.05). The recanalization rates of injured limb in group A and B were higher than those in group C, the differences were statistically significant (P < 0.05). Follow up for 1 year, there were significant differences in preservation rate of deep venous valve in each group (P < 0.05). The incidence of Villalta and PTS in group A and B were significantly lower than those in group C (P < 0.01), there was no significant difference between group A and group B (P > 0.05). Conclusion CDT is an effective method to manage acute DVT. In the three routes tested, lateral popliteal vein route is more safe and effective.
2017 Vol. 14 (29): 111-114 [Abstract] ( 812 ) HTML (1 KB)  PDF (614 KB)  ( 223 )
115 The establishment of multicultural nursing education scheme in patients with chronic heart failure based on Delphi method
WU Yingying1 YUE Aixue1 HE Jiaqian1▲ CHEN Shulan2 XU Ping1 JIANG Wei1 GU Hongming1
Objective To establish a multicultural nursing education scheme for patients with chronic heart failure by applying Delphi method. Methods By using the method of literature information, interview and inpatient pre-survey, multicultural nursing missionary framework was established for senile patients with chronic heart failure. Two rounds of consultation were conducted by well-known experts in the industry. Results The expert positive coefficient was 100%, and the degree of specialist authority was 0.895 (>0.7). The final definition of multicultural care scheme include 10 first-class indexes, 29 second-class indexes and 117 third-class indexes. Conclusion This study can be applied in patients with chronic heart failure to implement individualized nursing education.
2017 Vol. 14 (29): 115-120 [Abstract] ( 315 ) HTML (1 KB)  PDF (620 KB)  ( 287 )
121 Clinical significance of serum autoantibodies detection in patients with hepatitis B cirrhosis
YAN Xiuping HOU Qingshun WANG Hui GUO Lu
Objective To explore the presence of serum autoantibodies in patients with hepatitis B cirrhosis and its clinical significance. Methods 60 patients with hepatitis B cirrhosis in the Sixth People′s Hospital of Qingdao City from March 2016 to June 2017 were selected and divided into autoantibodies positive group (n=13) and autoantibodies negative group (n=47) according to the test results of serum autoantibodies which were detected with immunoblot. The liver function indexes of ALT, AST, TBil, AKP, GGT and immunoglobulin between two groups were detected by using full automatic biochemical analyzer. Liver instantaneous elastic hardness (Fibroscan) was tested. Results Total positive rate of autoantibodies in patients with hepatitis B cirrhosis was 21.7%. Compared with autoantibody negative group, the age of autoantibody positive group was increased (P < 0.05), the levels of GLB, IgG and Fibroscan were significantly increased in autoantibody positive group (P < 0.05), ALB of autoantibody positive group was decreased (P < 0.05). Conclusion Autoimmune reactions exist in patients with hepatitis B cirrhosis, and cause production of autoantibodies, which are related to the age, the degree of liver damage and liver fibrosis of paients.
2017 Vol. 14 (29): 121-124 [Abstract] ( 240 ) HTML (1 KB)  PDF (602 KB)  ( 214 )
125 Influence factors analysis on secondary hyperparathyroidism in early stage patients with diabetic CKD
YANG Qingbai JI Guoxin▲ CHEN Zhizhong HUANG Yuping CHEN Hong ZHANG Huimin
Objective To analyze the influence factors on secondary hyperparathyroidism (SHPTH) in early stage patients with diabetic CKD, as to provide theoretical basis for clinical work. Methods All data of early stage patients admitted to 95th Hospital of PLA from July 2012 to July 2014 were retrospectively analyzed, and all patients were divided into combined with SHPTH group and not combined with SHPTH group according to whether the merger of SHPTH. General situation of two groups were analyzed, and at the same time, SHPTH was chosen as the dependent variable to analyze the multiple factors regression for patients with diabetic CKD. Results 481 patients were studied, in which, 214 cases (44.49%) was combined with SHPTH, 267 cases (55.51%) were not combined with SHPTH. The levels of hypertension, hyperlipidemia, serum phosphorus, 25-OH-VitD, urinary albumin and HbA1c between two groups were compared, with statistically significant differences (P < 0.05 or P < 0.01). Multivariate analysis showed that hypertension, hyperlipidemia, hyperphosphatemia, low 25-OH-VitD, high urinary microalbumin, high HbA1c and SHPTH had a certain relationship (P < 0.05). Conclusion Diabetic CKD patients whether combined with SHPTH is influenced by many factors, it can through reduce the patients' blood pressure, blood lipid, blood phosphorus, urine trace albumin, HbA1c level, improve 25-OH-VitD to improve the prognosis of patients.
2017 Vol. 14 (29): 125-127,136 [Abstract] ( 295 ) HTML (1 KB)  PDF (551 KB)  ( 282 )
128 Study of causes on channel alliance construction of Liaoning Province small and medium-sized pharmaceutical enterprises in the new round of Northeast revitalization strategy
LIU Hui
In a new round of Northeast revitalization strategy, economy of Liaoning Province is finding new growth points. The small and medium-sized pharmaceutical enterprises need seek new development planning. It is the best choice to build the channel alliance for Liaoning Province small and medium-sized pharmaceutical enterprises. The cause analysis of the channel alliance construction of Liaoning Province small and medium-sized pharmaceutical enterprisesis from macro and micro two aspects. The macro aspect mainly includes three perspectives: the new round of Northeast revitalization strategy, new policies of the state medical system, the transformation need of Liaoning Province economy. The micro aspect mainly includes two perspectives: channel alliance's correlation theories, small and medium-sized pharmaceutical enterprises′organizational management.
2017 Vol. 14 (29): 128-131,146 [Abstract] ( 220 ) HTML (1 KB)  PDF (758 KB)  ( 183 )
132 Analysis of the utilization of antibacterial drugs in patients with community-acquired pneumonia in our hospital
ZHU Hui YUAN Yongfang JIN Jian
Objective To investigate the utilization of antibacterial drugs in patients with community-acquired pneumonia in Shanghai Ninth People′s Hospital, Shanghai JiaoTong University School of Medicine (“our hospital” for short). Methods The medical records diagnosed with community-acquired pneumonia in Respiratory Medicine Department of our hospital were extracted by HIS from Januaty to December 2016. The utilization of antibacterial drugs was evaluated by Principle for Clinical Application of Antibacterial Drugs (2015). Results The majority of patients were over 65 years and most of them complicated with basic diseases. The rate of using the antibacterial drugs was 100%, concerning 13 varieties of 6 major categories. The main drugs were quinolones (80.22%) and β-lactam/β-Lactamase inhibitors (53.84%). The most common way of drug approach was the combination of quinolones and β-lactam/β-lactamase inhibitors with intravenous drip, followed by oral administration. No ADRs happened in patients. Conclusion The rate of antibacterial drugs usage is high in community-acquired pneumonia patients of our hospital. The empirical antibiotic therapy is based on quinolones and β-lactam/β-Lactamase inhibitors, which conform the requirement of guidelines for the diagnosis and treatment of community-acquired pneumonia in China.
2017 Vol. 14 (29): 132-136 [Abstract] ( 373 ) HTML (1 KB)  PDF (531 KB)  ( 438 )
137 Essential drugs of hypertension and diabetes and its drug analysis based on hierarchical medical system in China 
LIU Shiyong1,2 ZHAI Yi1 WU Jing1 LIANG Xiaofeng3
This paper checks essential medicine list and supplementary of hypertension and diabetes in some provinces, analyzes supplementary drugs coincidence rate as well as its equipment and use of hypertension and diabetes bases on hierarchical medical system in China, and finds that there is big difference in supplemented quantity of essential medicines in hypertension and diabetes, which top five of coincidence rate reaches 44.8% and 34.5%. The frequency of drug use and sales have supplemented in common compared with high coincidence rate of drugs in supplementary drugs. The paper suggests to integrate local supplement and national essential medicine list and then to increase drugs with effective treatment, less adverse reaction, high independence of patients and relatively low average daily expenses, and adjust high frequency or supplemented high coincidence rate of drugs to the next version of national essential medicine list, so as to narrow the difference of essential medicines list between the grassroots medical institutions and general hospitals, and promote the priority of essential drugs.
2017 Vol. 14 (29): 137-140 [Abstract] ( 808 ) HTML (1 KB)  PDF (476 KB)  ( 300 )
141 Clinical effect of Levodopa and Benserazide Hydrochloride combined with Entacapone in the treatment of Parkinson disease
WANG Zhiqing YAN Yan▲
Objective To investigate the effect of Levodopa and Benserazide Hydrochloride combined with Entacapone in the treatment of Parkinson disease. Methods One hundred and two patients with Parkinson disease treated in Nanjing Brain Hospital (“our hospital” for short) from January 2014 to June 2016 were selected and randomly divided into combined group and monotherapy group, with 51 cases in each group. Another 51 healthy persons taken body examination in our hospital were selected as control group. The monotherapy group was given conventional Levodopa and Benserazide Hydrochloride, on basis of which, the combined group was added with Entacapone, both groups were treated for 12 weeks. The efficacy and the scores of unified Parkinson disease rating scale Ⅲ (UPDRSⅢ) and activities of daily living (ADL) before and after treatment in the two groups were compared. The motor evoked potential (MEP) of the two groups was detected before and after treatment, including relaxed motor threshold (RMT), cortical latency (CL), cortical silent period (CSP); the levels of plasma homocysteine (Hcy), serum superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and reduced glutathione (GSH) of the two groups were observed before and after treatment, which were compared with control group; the peak concentration of Levodopa and average daily dosage of Levodopa and Benserazide Hydrochloride of the two groups were compared; the conditions of adverse reactions of the two groups were recorded after treatment for half years. Results After treatment, the scores of UPDRSⅢ, ADL in combined group were lower than those before treatment, while RMT, CL, CSR were increased compared with those before treatment (P ＜ 0.05); after treatment, the scores of UPDRSⅢ in monotherapy group were lower than those before treatment, while CL, CSR were increased (P ＜ 0.05); after treatment, the scores of UPDRSⅢ, ADL in combined group were lower than those of monotherapy group, while RMT, CL, CSR were all higher than those of control group (P ＜ 0.05). After treatment, the plasma Hcy in monotherapy group was higher than those of combined group and control group (P ＜ 0.05), while combined group was higher than control group (P ＜ 0.05); the levels of SOD, GSH and GSH-Px in monotherapy group were all lower than those of combined group and control group (P ＜ 0.05), while combined group was lower than control group (P ＜ 0.05). The peak concentration of LD in combined group was higher than that of monotherapy group, while average daily dosage of Levodopa and Benserazide Hydrochloride was lower than that of monotherapy group, the differences were all statistically significant (P ＜ 0.05). At the same time, the total effective rate in combined group (84.3%) was higher than that of monotherapy group (62.7%) (P ＜ 0.05), but the incidence of adverse reactions between combined group (19.6%) and monotherapy group (23.5%) had no statistically significant difference (P ＞ 0.05). Conclusion Levodopa and Benserazide Hydrochloride combined with Entacapone in the treatment of Parkinson disease can make the bioavailability of LD in vivo higher, inhibit the abnormal increase of plasma Hcy, relieve the damage of oxygen free radicals at the same time,  with significant effects, which is worthy of promotion.
2017 Vol. 14 (29): 141-146 [Abstract] ( 241 ) HTML (1 KB)  PDF (438 KB)  ( 213 )
147 The effect of cognitive behavior therapy on negative emotion in patients with intracranial aneurysm interventional surgery
YIN Qing1 HUANG Yunjuan2▲ MA Yingjun1 HUANG Weiyi1
Objective To investigate the effect of cognitive behavior therapy on negative emotion in patients with intracranial aneurysm interventional surgery. Methods Eighty patients underwent intracranial aneurysm interventional surgery in Wuxi People′s Hospital Affiliated to Nanjing Medical University from January 2016 to March 2017 were enrolled and allocated randomly into intervention group and control group according to the random number table, with 40 cases in each group. The control group received routine treatment and nursing, while the intervention group received cognitive behavior therapy on the basis of the control group. The self-designed general data questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Mishel uncertainty in illness scale (MUIS) were used to evaluate the effect before and after intervention. Results Before intervention, there were no significant differences in scores of SAS, SDS and MUIS between the two groups (P ＞ 0.05). After intervention, the scores of  SAS, SDS and MUIS in the intervention group were significantly lower than those of control group, the differences were statistically significant (all P ＜ 0.05). Conclusion Cognitive behavior therapy can effectively improve the anxiety and depression of patients with intracranial aneurysm interventional surgery, and reduce the uncertainty of the disease.
2017 Vol. 14 (29): 147-150,180 [Abstract] ( 357 ) HTML (1 KB)  PDF (791 KB)  ( 209 )
151 Influences of behavioral strategy on the recovery of limb function, rehabilitation of nerve function and complications in patients with cerebral infarction
CHEN Xiao1 FANG Qiaohong2 ZHANG Hong1
Objective To investigate the influences of behavioral strategy on the recovery of limb function, rehabilitation of nerve function and complications in patients with cerebral infarction. Methods The clinical data of 200 cases of patients with cerebral infarction admitted to Meishan Hospital of Traditional Chinese Medicine from January 2014 to January 2016 was analyzed retrospectively, and they were divided into the control group (conventional nursing measure) and the observation group (behavioral strategy measure) according to different nursing measures, with 100 cases in each group. The scores of quality of life and neurologic impairment, evaluation of limb function and the incidence of complications between the two groups were observed and compared. Results Before nursing, there were no statistically significant differences in the scores of quality of life and neurologic impairment between the two groups (P ＞ 0.05). After nursing, the scores of quality of life in the two groups were all higher than those before nursing, and the scores of neurologic impairment were all lower than those before nursing, and the two indicators above in the observation group were changed more remarkably, with statistically significant differences (P ＞ 0.05). The evaluation of limb function in the observation group was better than that of control group (P ＜ 0.05). There were no obvious complications in the observation group, there were 5 cases of pressure sore, 7 cases of urinary system infection and 4 cases of hypostatic pneumonia in the control group. Conclusion The nursing of behavioral strategy can improve limb function and nerve function in patients with cerebral infarction, reduce complication rate, it is worthy of clinical promotion and application.
2017 Vol. 14 (29): 151-154 [Abstract] ( 611 ) HTML (1 KB)  PDF (596 KB)  ( 171 )
155 Effects of comprehensive nursing intervention on perioperative stress response indexes and postoperative fatigue state in patients with glioma surgery
ZHANG Li CAI Wenfang▲ XIAO Jing DU Hongshuang YIN Ping ZHAN Qi
Objective To explore and analyze the effects of comprehensive nursing intervention on perioperative stress response indexes and postoperative fatigue state in patients with glioma surgery. Methods Ninety cases of patients with glioma admitted to the Fourth Affiliated Hospital of Harbin Medical University from March 2015 to March 2017 were selected and divided into routine nursing group and comprehensive nursing intervention group by random number table, with 45 cases in each group. The perioperative stress response indexes [including heart rate (HR), systolic blood pressure (SP), the heart rate-systolic blood pressure product (RPP)] and postoperative fatigue state between two groups were compared. Results After operation, there were no statistically significant differences of HR, SBP and RPP in comprehensive nursing intervention group compared with those before operation (all P ＞ 0.05), the indexes above in routine nursing group were all higher than those before operation, with statistically significant differences (all P ＜ 0.05), and the HR, SBP and RPP in routine nursing group after operation were all higher than those of comprehensive nursing intervention group, with statistically significant differences (all P ＜ 0.05). After nursing, the scores of emotion, perception, behavior severity, cognition and the total score in both groups were all lower than those before nursing, which of comprehensive nursing intervention group were lower than those of routine nursing group (all P ＜ 0.05). Conclusion Comprehensive nursing intervention can stabilize perioperative stress response indexes, improve postoperative fatigue state, and it is better than routine nursing.
2017 Vol. 14 (29): 155-158 [Abstract] ( 240 ) HTML (1 KB)  PDF (555 KB)  ( 223 )
159 Effect of health education care intervention on the quality of life and prognosis of patients with chronic heart failure
HAN Xu ZHANG Yunming XU Lei▲
Objective To explore and analyze the effect of health education care intervention on quality of life and prognosis of patients with chronic heart failure. Methods Ninety cases of elderly patients with chronic heart failure admitted to the First Affiliated Hospital of Harbin Medical University from May 2015 to May 2016 were selected and divided into the control group and the observation group by random number table, with 45 cases in each group. The control group was given routine nursing care, while the observation group was given health education care intervention. The awareness rate of knowledge on drug use and compliance rate of drug use, scores of quality of life, and the hospitalization rate and fatality rate after 1 year of follow-up between the two groups were compared. Results The awareness rate of knowledge on drug use and compliance rate of drug use in the observation group were higher than those of control group, with statistically significant differences (all P ＜ 0.05). After nursing, the scores of physical function, role function, cognitive function, emotional function and social function in the two groups were all higher than those before nursing, and the indicators above in the observation group were increased more remarkably, with statistically significant differences (all P ＜ 0.05). After 1 year of follow-up, the hospitalization rate and fatality rate of observation group were all lower than those of control group, with statistically significant differences (P ＜ 0.05). Conclusion The health education care intervention can improve the quality of life of elderly patients with chronic heart failure, improve the awareness of patients for the diseases, and promote prognosis.
2017 Vol. 14 (29): 159-162 [Abstract] ( 275 ) HTML (1 KB)  PDF (554 KB)  ( 225 )
163 Application effect of continuity care in patients with periodontal disease
LIU Jing WANG Yunjun
Objective To explore the effect of continuity care in patients with periodontal disease. Methods Seventy patients with periodontal disease admitted to Outpatient Department, Cangzhou People′s Hospital from November 2014 to December 2016 were selected and divided into control group and observation group by random number table, with 35 cases in each group. The control group was given routine nursing, while the observation group was given continuity care. The periodontal conditions in the two groups before and after nursing care were compared by Turesky modified plaque index and gingival index. The satisfaction rate of patients in the two groups was compared by self-made questionnaire. Results Before nursing, the plaque index and gingival index between the two groups showed no statistically significant difference (P ＞ 0.05). After nursing care for 1 month, the plaque index and gingival index in both groups were all lower than those before nursing care, which of observation group was much lower than that of control group, with statistically significant differences (all P ＜ 0.05). The nursing satisfaction rate in the observation group (94.29%) was higher than that of control group (82.86%), with statistically significant difference (P ＜ 0.05). Conclusion Application of continuity care in patients with periodontal disease has good effect, which can reduce the gum inflammation, improve the periodontal conditions, and it is worthy of promotion and application.
2017 Vol. 14 (29): 163-165 [Abstract] ( 229 ) HTML (1 KB)  PDF (588 KB)  ( 198 )
166 Application of healthy education mode in patients with diabetic retinopathy during perioperative period
WANG Qiao HUANG Shaolan ZHANG Jing LI Jing▲
Objective To explore the application of healthy education mode in patients with diabetic retinopathy taken vitrectomy during perioperative period. Methods From July 2015 to October 2016, 111 cases of patients with diabetic retinopathy admitted to Eye Hospital, China Academy of Chinese Medical Sciences were selected and divided into observation group (58 cases) and control group (53 cases). The control group was given routine nursing, on basis of which, the observation group was given healthy education mode. The compliance, self-efficacy, sleep quality, anxiety, the improvement of anxiety and the degree of satisfaction between the two groups were compared. Results The scores of compliance, self-efficacy, sleep quality, the improvement of anxiety and the degree of satisfaction in the observation group were better than those of control group, with statistically significant differences (all P ＜ 0.05). Conclusion Application of healthy education mode in patients with diabetic retinopathy during perioperative period can improve compliance, relieve anxiety, improve sleep quality, promote self-efficacy and enhance the degree of satisfaction, which is worthy of clinical promotion and application.
2017 Vol. 14 (29): 166-169 [Abstract] ( 548 ) HTML (1 KB)  PDF (594 KB)  ( 325 )
170 Report a case of Prader-Willi syndrome complicated with diabetes mellitus
YANG Tao1 GONG qing2 WANG Shidong2 CHUO Wenjing3 LI Jiayue2 WANG Ge2
This paper reports a case of Prader-Willi syndrome (PWS) with diabetes mellitus, the patient was diagnosed with diabetes in 1996 and was diagnosed with PWS by genetic examination in 2015, the major clinical manifestations are overeating, obesity, and uncontrollable hyperglycemia. In terms of treatment, strict diet control and exercise, the initial hypoglycemic program for oral hypoglycemic drugs combined with insulin, but the efficacy of this treatment is not obvious, and after the use of GPL-1 analogues, the patient's blood glucose levels improved significantly. PWS is a rare syndrome of genetic obesity, due to lack of related gene expression of hypothalamic dysfunction caused by neuroendocrine dysfunction and polyphagia, obesity, poor growth and development of such complicated clinical manifestations. The early diagnosis and timely intervention is important for prognosis of the disease.
2017 Vol. 14 (29): 170-173 [Abstract] ( 353 ) HTML (1 KB)  PDF (513 KB)  ( 321 )
174 A case of severe pneumonia treated by ECMO
QIAN Yuanxia1,2 GAO Aime1 TANG Jing1
The extracorporeal membrane oxygenation(ECMO) technique is an important method of extracorporeal life support for patients in Intensive Care Unit (ICU), the drug rational use and pharmaceutical care of patients with pneumonia during ECMO were less reported. This manuscript reported one patient with severe pneumonia treated by ECMO and anti-infection, anti-virus, and asthma phlegm and supported treatment, symptoms and body temperature of the patient got improved, but the body temperature rose again on the 6th day, culture of alveolar lavage yielded acinetobacter baumannii, pseudomonas aeruginosa. After following the suggestion of the clinical pharmacist, tigecycline, cefopcrazone- sulbactam, compound sulfamethoxazole were given gradually, after treatment for 12 days the patient was keeping in a stable condition. In the process of treatment, a skin rash appeared on the patients′ both arms on 8th day. With clinical pharmacists′ consultation, dexamethasone, vitamin C, loratadine were prescript and the symptoms were improved after treatment. whole process of drug treatment of a severe pneumonia patient with ECMO was participated in clinical pharmacist. Through familiar with condition change of the patient in time, combined with auxiliary examination results, analyzing drug sensitive tests with bacterial culture result, consulting the related literature, the clinical pharmacist could put forward reasonable suggestions, implement comprehensive pharmaceutical care on the selection of antimicrobial treatment scheme, antibacterial drug dosage and announcements under ECMO, pharmaceutical analysis and treatment measures when drug eruption appeared. It is important for establishing individualized regimen, improving the effectiveness and safety of drug treatment in patients.
2017 Vol. 14 (29): 174-177 [Abstract] ( 318 ) HTML (1 KB)  PDF (454 KB)  ( 371 )
178 QbD application in drug research and development
SU Xian1 GAO Yunjia2
Quality by design (QbD) has become a new method combinate science with quality risk in drug research and development, driveing by guidelines do ICH and FDA. This paper analyzes the purpose of QbD, summarizes six elements to implement QbD, lists the currently popular QbD tools to opreation: prior knowledge, risk assessment, mechanical model, process analytical technology, design of experiments and data analysis, and summarizes the situation of the FDA's implement QbD and benefit. Be acknowleged by international registration and drug research and development, QbD will improve the quality of China's pharmaceutical industry. CFDA is implementing regulatory laws and related technical guidances gradually realize international conformity.
2017 Vol. 14 (29): 178-180 [Abstract] ( 876 ) HTML (1 KB)  PDF (305 KB)  ( 526 )
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