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2018 Vol. 15, No. 2 Published: 2018-01-15

	4	Study on single drug toxicity of Euphorbia fischeriana Steud Powder and Decoction of Compatibility of Euphorbia fischeriana Steud and Jujubae
		MA Liwei,FAN Li,NI Shiyu,YU Hong,ZHOU Li,CHEN Zhe,LIU Jicheng
		Objective To study single drug toxicity of Euphorbia fischeriana Steud Powder (EFSP) and Decoction of Compatibility of Euphorbia fischeriana Steud and Jujubae (DEFSJ) and provide a reference for safe medication. Methods Modified Karber method was adopted to detect lethal dose 50 (LD50) and the 95% confidence interval of EFSP and DEFSJ. Blood biochemistry and histopathology were detected to evaluate the toxicity of EFSP and DEFSJ on liver and kidney of mice. Results The LD50 of EFSP was 2.12 g/kg, and the average 95% confidence interval was 1.61-2.78 g/kg. The LD50 of DEFSJ was 12.60 g/kg, and the average 95% confidence interval was 9.65-16.48 g/kg. Compared with the Jujubae Decoction group, as the dosage was increased, the mice weight was significantly decreased, however, organ coefficient was not obviously changed in EFSP and DEFSJ groups. The blood biochemical results showed that the levels of alanine transaminase and aspartate transaminase were elevated (P ＜ 0.05), and the levels of creatinine and blood urea nitrogen had an increased tendency. Pathological changes of kidney and liver were found by histopathological examination. Conclusion Both EFSP and DEFSJ have definite toxicity on kidney and liver.
		2018 Vol. 15 (2): 4-8,18 [Abstract] ( 280 ) HTML (1 KB) PDF (1263 KB) ( 211 )

	9	The effect of puerarin on the local cerebrum renin-angiotensin system in cerebral ischemia reperfusion injury
		WANG Ze1 ZHANG Yongtao2 LI Shan1 ZHU Dehui1 JI Xiaojun3
		Objective To explore the effect of puerarin on the local cerebrum renin-angiotensin system (RAS) in cerebral ischemia reperfusion injury (IRI). Methods A total of 60 Wistar rats were selected and divided into the control group (sham operation), the model group (rats in the model group were established as cerebral IRI model by inserting a monofilament into middle cerebral artery) and the treatment group (rats in the treatment group were administered with puerarin after the cerebral IRI model was established) by random number table method. All rats were sacrificed 24 h after operation. The neurological function of rats was evaluated by Zea-Longa method. The denatured cell index (DCI) in cerebrum was observed by HE staining. Main components of renin-angiotensin system including angiotensinⅡ (AngⅡ), angiotensin converting enzyme (ACE), angiotensin type 1 receptors (AT1R) and angiotensin type 2 receptors (AT2R) were determined using radioimmunoassay, Real-time PCR and Western blot. Results The neurological function scores, DCI, AngⅡ, ACE, AT1R and AT2R in the model group and the treatment group rats increased significantly compared with those in the control group (P ＜ 0.05). The neurological function scores and DCI after puerarin treatment were decreased significantly compared with those in the model group (P ＜ 0.05), in the meantime, the main components of renin-angiotensin system were also inhibited by puerarin (P ＜ 0.05). Conclusion The protective effect of puerarin on cerebral IRI in rats may have certain relationship to the inhibitory of the local RAS in cerebrum.
		2018 Vol. 15 (2): 9-12,35 [Abstract] ( 288 ) HTML (1 KB) PDF (1028 KB) ( 95 )

	13	Effect of warming Yang and dispersing masses herbs on growth inhibition and apoptosis induction of breast cancer cell SK-BR-3
		LIU Xiaofei1 LI Jingwei2 SHI Guangxi2 LI Xiangqi3 ZHANG Yang4 ZHU Qing4
		Objective To research the inhibit proliferation and induce apoptosis effect of Yanghe Huayan Decoction combined with Trastuzumab and PI3K inhibitor (LY294002) on breast cancer cell lines SK-BR-3 (HER-2 overexpression). Methods The intestinal absorption fluid of Yanghe Huayan Decoction was prepared. The breast cancer cell lines SK-BR-3 were divided into blank control group, Chinese medicines group, Trastuzumab group, Trastuzumab + Chinese medicines group, Ly group and Ly + Chinese medicine group. The inhibitory rate of the growth of the cells at 24, 48, 72 h were observed by MTT. The changes of cell apoptosis and cell cycle at 72 h were observed by flow cytometry. Results The inhibition rate, apoptosis rate and S phase cell percentage were increased, while the G2/M phase cell percentage was decreased, in the Chinese medicine group, Trastuzumab group, Trastuzumab + Chinese medicine group, Ly group and the Ly + Chinese medicine group, compared with the blank control group, with statistically significant difference (P < 0.05). Moreover, the inhibition rate of each drug group was increased gradually with the duration of drug action (24, 48, 72 h), presenting a time dependent effect (P < 0.05). The effects of the Trastuzumab group + Chinese medicine, Ly + Chinese medicine group inhibiting cell proliferation, inducing apoptosis and cell cycle arrest were better than those of the Trastuzumab group, Ly group respectively (P < 0.05). Conclusion The intestinal absorption fluid of Yanghe Huayan Decoction can effectively inhibit cell proliferation and induce apoptosis, and the combination of Chinese medicine with Trastuzumab and LY can further inhibit cell proliferation, induce apoptosis, enhance S phase retardation, and inhibit cell entry into G2/M phase. It is suggested that there may be synergistic effect in the treatment of her-2 high expression type of breast cancer by the combination of warming Yang and dispersing masses herbs with Trastuzumab and PI3K inhibitor.
		2018 Vol. 15 (2): 13-18 [Abstract] ( 219 ) HTML (1 KB) PDF (1236 KB) ( 205 )

	19	Effects of homocysteine on promoter methylation level and expression of ATP binding cassette transporter A1 in human aortic smooth muscle cells
		WANG Huiyuan1 ZHANG Zijing1 YUAN Fengyan1 ZHEN Wenqian1 MA Xu1 ZHAI Xiaojuan2 GAO Shengli2,3
		Objective To investigate the effect of homocysteine (Hcy) on the promoter methylation and expression of ATP binding cassette transporter A1 (ABCA1) in human aortic smooth muscle cells. Methods The human aortic smooth muscle cells were divided into two groups: the control group and the experimental group. The cells in the control group were cultured without Hcy, however cells in the experimental group were cultured with different concentrations of Hcy (50, 100, 200, 500 μmol/L). The cholesterol outflow rate was detected by scintillation counting technique, the expression of ABCA1 mRNA was detected by real-time quantitative PCR, the expression of ABCA1 protein was detected by Western-blotting, the ABCA1 promoter methylation was detected by nested detection of PCR. Results There was no significant difference in cholesterol efflux rate at each time point in the control group (P > 0.05). Compared with Hcy treatment for 0 h and 12 h, after treatment of 24 h and 48 h the cholesterol efflux rate of the experimental were significantly decreased (P < 0.05). After treated with Hcy for 0 h and 12 h, compared with the control group, there was no significant difference in cholesterol efflux rate (P > 0.05). After treated with Hcy for 24 h and 48 h, compared with the control group, cholesterol efflux rate of the experimental group was significantly decreased (P < 0.05). Compared with control group, ABCA1 mRNA relative expression level decreased (P < 0.05), the relative expression level of ABCA1 protein was decreased (P < 0.05), ABCA1 promoter methylation level was significantly increased (P < 0.05). There was no significant difference in ABCA1mRNA expression, ABCA1 protein expression and ABCA1 promoter methylation level between different Hcy concentrations groups (P > 0.05). Conclusion Hcy can increase the methylation level of ABCA1 promoter and decrease the expression of ABCA1 in aortic smooth muscle cells that lead to lower cholesterol efflux rate, which may be one of the pathological mechanisms of atherosclerosis.
		2018 Vol. 15 (2): 19-22 [Abstract] ( 769 ) HTML (1 KB) PDF (741 KB) ( 186 )

	23	Association of genetic polymorphisms of rs3795987 locus allele in SERPINE2 gene with susceptibility to chronic obstructive pulmonary disease between the Han and the Uygur nationality in xinjiang
		LIU Beilin ZHANG Yu WANG Liping WANG Jun ZHAO Jing WANG Haixu
		Objective To investigate the correlation between the gene polymorphism of serine protease inhibitor -2 (SERPINE2) rs3795987 site and chronic obstructive pulmonary disease (COPD) in Han and Uighur nationality in Xinjiang Uygur Autonomous Region. Methods Case-control studies were used in this study. From January to December in 2015, 88 Han and Uighur nationality COPD patients which were treated in the Department of Respiratory Diseases ofthe Fifth Affiliated Hospital of Xinjiang Medical University were separately selected as the COPD group. Meanwhile, 100 Han and Uighur nationality health people were separately selected as the control group. Genotype sequencing of SERPINE2 gene rs3795987 was performed by polymerase chain reaction, and results were analyzed statistically. Results ①There were statistically significant differences in the distribution of rs3795987 site in the patients with COPD in the Han and Uighur nationality in Xinjiang region (P < 0.05). ②There was no statistically significant difference between different genotypes of rs3795987 sites and COPD susceptibility between the Han and Uighur nationality in Xinjiang region(P > 0.05). Conclusion The gene polymorphism of SERPINE2 rs3795987 site and the occurrence of COPD in Han and Uighur nationality in Xinjiang region have no significant correlation.
		2018 Vol. 15 (2): 23-26 [Abstract] ( 239 ) HTML (1 KB) PDF (792 KB) ( 135 )

	27	Effect of Tizanidine on proliferation, migration and opoptosis of U251 cell
		LIU Bing1 HUO Huiyong1 FENG Shejun1 CAO Ling1 ZHAO Xian1 CAO Yan1 WANG Ruke2 LI Juntao1
		Objective To investigate the effect of Tizanidine on the proliferation, migration and apoptosis of U251, and to explore its mechanism, as well. Methods U251 cells were divided into two groups, one group treated with Tizanidine (20 μmol/L), and the other treated with DMSO as control group. CCK8 assay was used to detect cell proliferation; Transwell assay was performed to detect cell migration and invasion; flow cytometry was adopted to detect cell apoptosis; Western blot was used to detect the expression of PI3K-AKT signaling-related proteins and apoptosis-related proteins. Results The proliferation of U251 cell was inhibited by Tizanidine (P < 0.05); and Tizanidine treatment also inhibited migration and invasion of U251 cell (P < 0.05); Tizanidine induced apoptosis in U251 cell (P < 0.05); Western blot showed that the expression of Bcl-2 was significantly down-regulated (P < 0.05), and the expression of BAX and Active Caspase3 were both significantly up-regulated in Tizanidine-treated U251 cells (P < 0.05), respectively. In addition, Tizanidine significantly inhibited the phosphorylation levels of AKT and mTOR (P < 0.05), and the expression of related downstream proteins (P70s6k and Cyclin D1) were decreased in U251 cells (P < 0.05). Conclusion Tizanidine inhibits proliferation, migration and invasion, induces apoptosis in U251 cell, which may be achieved by inhibiting activation of the PI3K/AKT signaling pathway.
		2018 Vol. 15 (2): 27-31 [Abstract] ( 217 ) HTML (1 KB) PDF (973 KB) ( 191 )

	32	Research progress of the relationship between hepatocyte nuclear factor 4 alpha and hepatocellular carcinoma
		JI Longshan SUN Xuehua ZHOU Zhenhua ZHANG Xin GAO Yueqiu LI Man
		Hepatocyte nuclear factor 4α (HNF4α) is a transcription factor that regulates the expression of specific genes in the liver, plays an important role in hepatocyte developmental and differentiation, liver lipid and cholesterol metabolism, liver drug metabolism and inhibits the formation of liver tumor. HNF4α mainly affects the formation and development of hepatocellular carcinoma (HCC) by inhibiting the proliferation of tumor cells, promoting the differentiation and apoptosis of tumor cells, reversing the processes of hepatocyte epithelial-mesenchymal transition. In this paper, the origin, distribution, structural characteristics, biological function of HNF4α and the role of HNF4α in the formation and development of HCC were reviewed in order to explore a new approach to HNF4α intervening in HCC.
		2018 Vol. 15 (2): 32-35 [Abstract] ( 214 ) HTML (1 KB) PDF (461 KB) ( 166 )

	36	Advanced in research of alkaline sphingomyelinase and lipid metabolism related diseases
		LI Xin ZHANG Ping ZHANG Tao WANG Zhigang
		Alkaline sphingomyelinase (Alk-SMase) is the key enzyme for the hydrolysis of sphingomyelin in the digestive tract, which exists in the intestine and human bile. Decreased sphingomyelin hydrolysis and metabolic active products will cause cell proliferation, apoptosis, inflammation and ultimately leading to cancer. Lipid metabolism is an important metabolic process in humans. Alk-SMase and its metabolites can affect the metabolism of phospholipids, cholesterol and triglycerides in the intestine, leading to hepatobiliary diseases, intestinal inflammation and colon tumors. This article will focus on the relationship between Alk-SMase and lipid metabolism, and make a brief review of the research progress of Alk-SMase and lipid metabolism related diseases.
		2018 Vol. 15 (2): 36-38 [Abstract] ( 218 ) HTML (1 KB) PDF (448 KB) ( 109 )

	39	The research progress of psychological state and psychological nursing of patients with percutaneous coronary intervention
		FU Guangfang WU Min LIANG Jiaqi
		Percutaneous coronary intervention (PCI) is widely adopted in the treatment of coronary heart disease and plays a significant role in life saving, pain alleviation and outcome improvement. Meanwhile, its negative effect on mind also calls for attention. This review aims to provide support to clinical mental nursing for patients to get PCI treatment and summarized relevant studies published in recent years to elaborate the cause of unhealthy mental state of those patients, how it affects the development of coronary heart disease, as well as available mental nursing strategies to use in clinical nursing.
		2018 Vol. 15 (2): 39-42,53 [Abstract] ( 286 ) HTML (1 KB) PDF (774 KB) ( 159 )

	43	Retrospective analysis of occupational exposure in clinical medical laboratory
		YANG Yuelin1 CAI Shuanghong2 QIAN Jing1 ZHAO Xiaoli1 LI Haisheng1 HU Dachun1
		Objective To analyze occupational exposure events in clinical laboratory, find the strategy for the reduction of occupational exposure, in order to improve laboratory safety management. Methods The performance information of the exposed personnel, training records of biosafety theory and occupational exposure events from 2011 to 2015 in Department of Clinical Laboratory, the First Hospital of Kunming were analyzed, to find out possible factors associated with occupational exposures. Results There were 24 staffs involved in occupational exposures in the laboratory for nearly 5 years, account for 95.8% of which who have less than 5 years of working experience. Less than one year of working experience led to 66.7% of all occupational exposures. 100.0% of staffs involved in occupational exposures own junior titles, account for 45.8% of which were the intern students. There was no correlation between the incidence of occupational exposure in the laboratory and the number of theoretical trainingsand risk education that the staff had received about professional exposures. Acute injuries accounted for 79.2% of occupational exposures. Jobs with sharp devicesare 1.67 times of occupational exposures compared with other jobs, including blood collection, analysis of blood gas and blood culture transfer. Conclusion The junior staff and students in the laboratory are the majorpersons potentially involved in occupational exposures. The theoreticaltraining is not sufficient for preventing occupational exposures. Therefore, one of the effective ways to reduce the occupational exposures in the laboratory is to give junior staffs multiple on-the-job trainings, including operations, risk assessment and examinations.
		2018 Vol. 15 (2): 43-45,57 [Abstract] ( 864 ) HTML (1 KB) PDF (903 KB) ( 1355 )

	46	Study on the characteristic of subcortical arousal response in patients with obstructive sleep apnea hypopnea syndrome and hypertension
		WANG Yingchun ZHANG Weiwei WANG Lei YAO Xiaoguang LI Nanfang
		Objective To investigate the characteristics of subcortical arousal response in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and hypertension. Methods From October 2015 to June 2016, 120 hypertensive inpatients in the Hypertension Center, the People′s Hospital of Xinjiang Uygur Autonomous Region were selected. Polysomnography was underwent and pulse transit time (PTT) was measured in all patients to assess subcortical arousal response. According to the apnea hypopnea index (AHI), the cases were divided into four groups: non-OSAHS group (17 cases), mild OSAHS group (21 cases), moderate OSAHS group (34 cases) and severe OSAHS group (48 cases). The parameters of OSAHS and PTT of four groups were analyzed. Results In severe OSAHS group total PTT arousal index (PTTt), respiratory related PTT arousal index (PTTr), PTT arousal index in NREM (PTT-NREM) significantly increased compared with the other groups, minimum PTT value significantly decreased compared with the other groups (P ＜ 0.05). There was no statistically difference between groups in non respiratory related PTT arousal index (PTTn), the average value of PTT (P > 0.05). PTTt, PTTr PTT-REM, PTT-NREM were positively correlated with AHI, oxygen desaturation index, EEG arousal index and negatively correlated with minSaO2 (P ＜ 0.05). There was no correlation between PTTn and AHI, minSaO2, EEG arousal index and oxygen desaturation index (P > 0.05). PTT-REM was significantly higher than PTT-NREM in non-OSAHS group, mild and moderate OSAHS group (P ＜ 0.05). Conclusion PTT arousal index is an objective value and respiratory related PTT arousal index is more sensitive in judging the severity of OSAHS in OSAHS with hypertension patients.
		2018 Vol. 15 (2): 46-49,66 [Abstract] ( 258 ) HTML (1 KB) PDF (854 KB) ( 185 )

	50	Study on the change of TEG about myocardial infarction combined with diabetes
		GAO Yizhi1 WANG Zhiliang2▲ LI Chaonan1 XU Hengshi2
		Objective To analysis the difference between the indexes of thrombus mapping and platelet related factors in patients with myocardial infarction and diabetes mellitus, and to explore the correlation between the relevant indexes of TEG and the related parameters of platelet. Methods From January to December in 2016, clinical data of 114 patients in Shanghai Ninth People′s Hospital and Shanghai MCC Hospital were collected. They were divided into myocardial infarction combined with diabetes mellitus group (54 cases), diabetes mellitus group (20 cases) and control group (40 cases). The differences between TEG indicators and platelet related indicators in each group were analyzed by One-Way ANOVA. The correlation between TEG index and platelet parameters in patients with myocardial infarction combined with diabetes mellitus was analyzed by Pearson correlation. Results The α-Angle, the value of MA, CI, mean platelet volume, platelet large cell ratio and platelet volume distribution width in the myocardial infarction combined with diabetes mellitus group were higher than those in the control group (P < 0.05). Besides, the value of R and K in the myocardial infarction combined with diabetes mellitus group were lower than those in the control group (P < 0.05). The R value of myocardial infarction combined with diabetes was positively correlated with the platelet volume distribution width, and the α-angle was positively correlated with mean platelet volume, platelet large cell ratio and platelet volume distribution width, and MA was positively correlated with thrombocytocrit (P < 0.05). Conclusion TEG parameters have a certain reference value for the diagnosis of myocardial infarction combined with diabetes mellitus, and have a good correlation with platelet related indexes.
		2018 Vol. 15 (2): 50-53 [Abstract] ( 263 ) HTML (1 KB) PDF (499 KB) ( 133 )

	54	Clinical effect of Irbesartan combined with Xinbao Pills in treating senile chronic heart failure complicated with sinus bradycardia
		CHEN Zhenling ZHENG Yushui LI Wei LU Wei
		Objective To observe the clinical efficacy of Irbesartan combined with Xinbao Pills in treating elderly patients with chronic heart failure complicated with sinus bradycardia. Methods From May 2014 to May 2017, 100 elderly patients with chronic heart failure complicated with sinus bradycardia in Wanbei Coal and Electricity Group General Hospital were selected and divided into observation group and control group by random number table, with 50 cases in each groups. On the basis of routine treatment of western medicine, the control group was treated with Irbesartan, and the observation group was treated with Irbesartan and Xinbao Pills. Before treatment and 8 weeks after treatment, the cardiac function, plasma N-terminal proBNP (NT-proBNP), H-FABP and 24 h DCG were compared between the two groups. Results After treatment, LVEDD, LVESD, LVEF, CO, Stroke volume and walking distance of 6 min in the two groups were improved, exepted for LVEDD, the improvement of cardiac function in the observation group was better than that of the control group (P < 0.05). The levels of plasma NT-proBNP and serum H-FABP in the observation group decreased compared with the control group (P < 0.05). The improvement rate of 24 h DCG clinical curative effect of the observation group and were better than those of the control group (P < 0.05). Conclusion Irbesartan combined Xinbao Pills can obviously improve patients′ cardiac function, improve heart rate and clinical symptoms.
		2018 Vol. 15 (2): 54-57 [Abstract] ( 241 ) HTML (1 KB) PDF (500 KB) ( 64 )

	58	Study on the the effects of recombinant human natriuretic peptide on ventricular remodeling and cardiac function after PCI for acute antetheca myocardial infarction
		CHEN Hua LIU Xin▲
		Objective To study the effects of recombinant human natriuretic peptide (rhBNP) on ventricular remodeling and cardiac function after PCI for acute antetheca myocardial infarction (AMI). Methods The data of 80 patients with AMI in Chinese PLA General Hospital from January 2016 to January 2017 were retrospectively analyzed and divided into rhBNP group and the control group, according to different treatment, with 40 cases in each group. The control group was treated with routine PCI therapy, while the rhBNP group was treated with rhBNP intraoperative and postoperative PCI on the basis of the control group treatment. The systolic function, ventricular remodeling and plasma BNP and myocardial enzyme creatine kinase isoenzyme (CK-MB) levels and adverse reactions in two groups were observed. Results After operation, the levels of LVEF, LVPER in the both groups were on the rise, while the levels of LVTPER, LVESVI, LVEDVI, LVMI were in decline, with statistically significant difference (P < 0.05). Six months after operation, the levels of LVEF, LVPER in the rhBNP group were higher than those in the control group, while the level of LVTPER was lower than that in the control group, with statistically significant difference (P < 0.05). Besides, the levels of LVESVI, LVEDVI, LVMI in the rhBNP group were lower than those in the control group after operation (P < 0.05). Twenty-four hours after operation, the level of BNP in the rhBNP group and the levels of CK-MB in the both groups were higher than those before operation, then the level of BNP in the control group seventy-two hours after operation was higher than that before operation (P < 0.05). Conclusion rhBNP can be used to improve the left ventricular remodeling and cardiac function in patients with AMI, which has a obvious and safe effect.
		2018 Vol. 15 (2): 58-61 [Abstract] ( 302 ) HTML (1 KB) PDF (543 KB) ( 168 )

	62	The clinical and EEG features of 9 cases of patients with nonconvulsive status epilepticus
		ZHANG Min1 MA Xu1 YANG Chunxiao1 HOU Xiaohua2 BIAN Yi2 LIU Hui2 YAO Lifen2
		Objective To investigate the clinical and EEG features of 9 cases of nonconvulsive status epilepticus (NCSE) with the purpose of increasing cognition of the disease and avoiding missed diagnosis. Methods Nine cases diagnosed or highly suspected of NCSE from the First Affiliated Hospital of Harbin Medical University and the Second Affiliated Hospital of Harbin Medical University from June 2013 to June 2017 were selected, their etiological, clinical manifestations, EEG features and prognosis were analyzed. Results Among 9 NCSE patients, there were 5 cases with acute etiological factors, 2 cases with chronic etiological factors and 2 cases without any special disease. Four patients′cognitive ability was assessed by the mini-mental state examination (MMSE) scale at the stage of attack and cognitive disorder was found, 5 patients can't cooperate with the test. Three patients′ grades were improved after treatment, one was in line with before. All 9 patients presented EEG abnormal with multiple patterns, 7 cases with epileptic discharge, one with slow waves background and rhythmic delta waves discharge, one with EEG background break up accompany slow-wave gave out. Five cases′ seizure remitted after treatment, one case still had a seizure, one with the illness worsened, two cases were dead. Conclusion The etiological, clinical and EEG of NCSE are complex. Increasing cognition of the disease and giving EEG test timely is vital for diagnosis. The prognosis is in line with the etiological, patients with curable etiological factors of NCSE may have an ideal prognosis.
		2018 Vol. 15 (2): 62-66 [Abstract] ( 231 ) HTML (1 KB) PDF (1193 KB) ( 99 )

	67	Study on the related factors of 5-year recurrence in patients with cerebral infarction
		WANG Fang1 YAO Zhiping2
		Objective To explore the risk factors of 5-year recurrence in patients with cerebral infarction and construct a prognostic index model to predict recurrence, so as to provide reference for relapse prediction in patients with cerebral infarction. Methods Two hundred and eighty patients with primary incipient ischemic stroke diagnosed in Ningbo First Hospital of Zhejiang Province from January to December 2011 were selected as the research objects, and the recurrence conditions of patients were followed up, and all the follow-up work was finished until December 2016. Kaplan-Meier method was used to analyze the overall recurrence rate, the Cox proportional risk regression model was used to make single-factor and multiple-factor analysis of the risk factors of affecting the recurrence of patients, so as to build recurrence model and individual prognostic index (PI). Results At the end of follow-up, total 38 patients experienced recurrence. The 1-year recurrence rate was 4.8 per person-year, the 2-year recurrence rate was 5.6 per person-year, the 3-year recurrence rate was 7.5 per person-year, the 4-year recurrence rate was 9.7 per person-year and the 5-year recurrence rate was 10.5 per person-year. The single-factor and multiple-factor analysis of Cox proportional risk regression model showed that the independent risk factors of affecting the recurrence of cerebral infarction patients were age (X1, RR = 1.302; 95%CI: 1.018-1.652), the history of hypertension (X2, RR = 0.682; 95%CI: 1.015-3.862), the history of heart disease (X3, RR = 1.765; 95%CI: 1.126-2.865), total cholesterol (X4, RR = 2.136; 95%CI: 1.412-3.267) and family history of stroke (X5, RR = 2.657; 95%CI: 1.172-5.864). Thus, the PI equation of the recurrence model was established: PI = 0.025X1 + 0.681X2 + 0.581X3 + 0.395X4 + 0.973X5). Conclusion The age, history of hypertension, history of heart disease, total cholesterol, and family history of stroke are independent risk factors of affecting medium-long term recurrence in patients with cerebral infarction. The cerebral infarction PI equation of predicting recurrence within 5 years has good effects, which has predictive value for the recurrence of cerebral infarction.
		2018 Vol. 15 (2): 67-70,82 [Abstract] ( 288 ) HTML (1 KB) PDF (798 KB) ( 156 )

	71	Comparison on the clinical effect of treatment for hypertensive cerebral hemorrhage at different operation opportunities
		DUAN Jiqiang1 YAO Sheng1 WANG Yang1 WANG Feng1 SUI Long2
		Objective To compare the clinical effect of treatment for hypertensive cerebral hemorrhage at different operation opportunities. Methods The clinical data of 95 cases of patients with hypertensive cerebral hemorrhage admitted to Department of Neurosurgery, Weinan Central Hospital from May 2013 to May 2016 was analyzed retrospectively. All patients were treated with intracranial hematoma puncture drainage and they were divided into three groups according to different operation time: ultra-early group (24 cases), the time from bleeding to surgery was ＜6 h; early group (39 cases), the time from bleeding to surgery was 6-12 h; late group (32 cases), the time from bleeding to surgery was ＞12 h. The incidence of rehaemorrhagia after operation for 72 h and the conditions of prognosis and quality of life after operation for 1 year in the three groups were compared. Results The incidence of rehaemorrhagia after operation in early group (15.4%) was lower than that of ultra-early group (58.3%) and late group (56.3%), the differences were statistically significant (P ＜ 0.05). Followed up for one year after operation, the grading of Glasgow outcome score (GOS) in early group was significantly better than that of ultra-early group and late group (P ＜ 0.05); the scores of World Health Organization quality of life questionnaire (WHOQOL-BREF) in the three groups were all higher than those before operation (P ＜ 0.05), and the score of WHOQOL-BREF in early group was significantly higher than that of ultra-early group and late group, the differences were statistically significant (P ＜ 0.05). Conclusion For patients with hypertensive cerebral hemorrhage, the operation within 6-12 h after bleeding can obviously decrease the incidence of rehaemorrhagia, improve the quality of life, which has good clinical application value.
		2018 Vol. 15 (2): 71-74 [Abstract] ( 655 ) HTML (1 KB) PDF (453 KB) ( 118 )

	75	The clinical effects of cervical balloon in the treatment of cervical pregnancy with scar uterus
		YIN Fang LI Jinxia
		Objective To investigate the clinical effects of cervical balloon in the treatment of cervical pregnancy with scar uterus. Methods From July 2013 to June 2016, 118 pregnant women with uterine scar pregnancy were selected in Xingtai People′s Hospital and were equally divided into observation group and the control group accorded to the random envelope drawing principle, 59 women in each group. The observation group was given cervical balloon treatment, the control group was given oxytocin treatment, the effectiveness and safety of the two groups were recorded. Results There was no significant difference compared in age, gestational age, body mass index (BMI), amniotic fluid index and Bishop scores between the two groups (P > 0.05). The total effective rate of the observation group and the control group was 98.3% and 88.1%, respectively, the total effective rate of the observation group was significantly higher than that of the control group, and the differences were significantly (P ＜ 0.05). The neonatal weight and 1 min Apagr score in the observation group were (3278.42±342.91) g and (9.23±0.28) points, respectively, and the control group were (3231.40±401.49) g and (9.18±0.41) points, had no statistically significant difference between the two groups (P > 0.05). The first and second stage of labor times in the observation group were significantly shorten than the control group, and the differences were statistically significant (P ＜ 0.05); the natural childbirth rate in the observation group was significantly higher than the control group, and the differences were statistically significant (P ＜ 0.05); while the postpartum hemorrhage, puerperal infection, soft birth canal laceration, amniotic fluid contamination and other complications in the observation group were significantly lower than those of the control group, and the differences were statistically significant (P ＜ 0.05). Conclusion Compared with oxytocin, cervical balloon for uterine scar pregnancy can play more effective role in promoting cervical ripening, it has no significant adverse effects on the newborn, it can shorten the production process, improve the rate of natural childbirth, reduce abortion complications, so it is worthy of further promotion.
		2018 Vol. 15 (2): 75-78 [Abstract] ( 298 ) HTML (1 KB) PDF (499 KB) ( 169 )

	79	The diagnostic significance of the uterine epithelial cells stability of the cells free ferrous protoporphyrin for cervical cancer
		CHEN Yanhui ZHOU Xunhua ZHAO Ying
		Objective To investigate the diagnostic value of the uterine epithelial cells stability of the cells free ferrous protoporphyrin (FH) for cervical cancer. Methods Three hundred and three female patients with cervical cancer screening in Brain Hospital of Hunan Province were selected from February 2014 to December 2016, and there were 56 cases of cervical cancer and 112 cases of cervical intraepithelial neoplasia Ⅱ-Ⅲ (CIN Ⅱ-Ⅲ) by pathological diagnosis and 135 cases of normal healthy women by cervical scraping smear test, who were detected by uterine epithelial cells stability FH test and thinprep cytologic test (TCT). The pathological diagnosis was used as the gold standard, and the sensitivities, specificity, accuraciy, Youden indexes, positive and negative predictive values of the uterine epithelial cells stability FH and TCT for cervical cancer and CINⅡ-Ⅲ were analyzed. Results The total FH positive rate of cervical cancer patients and CIN Ⅱ-Ⅲ patients were significantly higher than that of normal healthy subjects (P < 0.05), of which the patients with cervical cancer were significantly higher than of the CINⅡ-Ⅲ patients (P < 0.05). There were 54 cases patients of cervical cancer and 97 patients of CIN Ⅱ-Ⅲ who were detected by uterine epithelial cells stability FH, and there were 49 patients of cervical cancer and 93 patients of CINⅡ-Ⅲ who were detected by TCT. The sensitivities, specificity, accuracies, Youden indexes, positive predictive value and negative predictive value of the uterine epithelial cells stability FH test were higher than those of the TCT. Conclusion The expressions of the uterine epithelial cells stability FH test are increased in cervical cancer, which has higher accuracies, sensitivity, specificity, positive and negative predictive values for the detection of cervical cancer.
		2018 Vol. 15 (2): 79-82 [Abstract] ( 263 ) HTML (1 KB) PDF (503 KB) ( 123 )

	83	Clinical significance of p16 protein expression in cervical intraepithelial neoplasia Ⅱ
		HUANG Liping LIN Xia▲
		Objective To observe the expression of p16 protein in the tissues of patients with different cervical lesions, and to investigate the feasibility of p16 protein as a reference index of CIN Ⅱ. Methods From January 2013 to August 2015, 170 cases underwent colposcopy and biopsy in Zhongshan BOAI Hospital Affiliated to Southern Medical University proved cervicitis, CIN Ⅰ and CIN Ⅱ, CIN Ⅲ and four cervical carcinoma group were selected, the expression of p16 were observed in different cervical lesions by p16 immunohistochemical staining, efficiency of the test of p16 protein in the diagnosis of CIN Ⅱ and above statistic (CINⅡ+, including CIN Ⅱ, CIN Ⅲ and cervical cancer) performance. And 170 cases of CIN Ⅱ patients were followed up every six months until 2 years after diagnosis with abnormal colposcopic biopsy, the relationship between the expression of p16 and outcome measures of CIN Ⅱ patients lesions was analyzed. Results ①The p16 positive rates of the cervicitis group and CIN Ⅰ group and CIN Ⅱ group, CIN Ⅲ and cervical cancer groups were 3.53%, 41.18%, 81.18%, 100% respectively, the difference was statistically significant (P < 0.05); the positive rate of p16 protein in the CINⅡ group was significantly higher than that of cervicitis group and CIN Ⅰ group, the differences were statistically significant (P < 0.01), the positive rate of p16 protein in the CIN Ⅲ group and cervical cancer group were significantly higher than CINⅡ group, CINⅠgroup, cervicitis group, the differences were statistically significant (P < 0.01). ②The sensitivity, specificity, coincidence rate, positive predictive value and negative predictive value of p16 protein in the detection of CINⅡ+ were respectively 90.59%, 77.65%, 84.12%, 80.21% respectively, 89.19%. ③62 cases (44.93%) in 138 CIN Ⅱ patients with positive expression of p16 protein had abnormal follow-up, 3 cases (9.38%) of 32 cases of disease progression CIN Ⅱ patients with negative expression of p16 protein had abnormal follow-up, the difference of two were statistically significant (P < 0.05). Conclusion The positive rate of p16 protein increased with the severity of cervical lesions. Detection of p16 protein shows better sensitivity, specificity, coincidence rate, positive predictive value and negative predictive value in the detection of CINⅡ+. The expression of p16 protein can predict the progression of CIN Ⅱ disease, and can be applied to the shunt of CIN Ⅱ in clinic.
		2018 Vol. 15 (2): 83-86,91 [Abstract] ( 260 ) HTML (1 KB) PDF (777 KB) ( 158 )

	87	Influence of Shengxuening Tablets adjuvant chemotherapy on T lymphocyte subsets and IL-23 and IL-17 levels of postoperative patients with lung cancer
		ZHU Tong RAO Jingfen LIU Chengyi ZHAO Shuang ZHANG Li
		Objective To observe the influence of Shengxuening Tablets adjuvant chemotherapy on T lymphocyte subsets and interleukin-23 (IL-23) and interleukin-17 (IL-17) levels of postoperative patients with lung cancer. Methods Ninety-two cases of postoperative patients with lung cancer treated in Affiliated Hospital of Chengde Medical University from October 2015 to January 2017 were selected as the study objects, and they were divided into observation group and control group according to random number table method, with 46 cases in each group. The control group was given concurrent chemoradiotherapy, and the observation group was added with Shengxuening Tablets on the basis of the control group. After treatment, the clinical efficacy was evaluated, and the peripheral blood, immune function, levels of IL-23 and IL-17, and the incidence of adverse reactions were observed in the two groups. Results The total effective rate of the observation group (73.91%) was significantly higher than that of the control group (52.17%) (P ＜ 0.05). After treatment, the platelets, leukocytes, neutrophils in the two groups were significantly lower than those before treatment (P ＜ 0.05), and those in the observation group were significantly lower than those in the control group (P ＜ 0.05). There was no significant difference of hemoglobin before and after treatment (P ＞ 0.05). There were no significant differences of the levels of CD3+, CD4+ and CD8+ in the observation group before and after treatment (P ＞ 0.05), while the level of CD4+/CD8+ in the observation group after treatment was significantly lower than that before treatment (P ＜ 0.05). After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the control group were significantly lower than those before treatment (P ＜ 0.05), the level of CD8+ was significantly higher than that before treatment (P ＜ 0.05). After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were significantly higher than those in the control group (P ＜ 0.05), and the level of CD8+ was significantly lower than that in the control group (P ＜ 0.05). After treatment, the levels of IL-23 and IL-17 in the two groups were all significantly lower than those before treatment (P ＜ 0.05), which in the observation group were significantly lower than those in the control group (P ＜ 0.05). There was no serious liver and kidney dysfunction, and there was no significant differences in the incidence of radiation pneumonitis and radiation esophagitis between the two groups (P ＞ 0.05). The incidence of gastrointestinal reactions and myelosuppression in the observation group was significantly lower than that in the control group (P ＜ 0.05). Conclusion Shengxuening Tablets adjuvant chemotherapy can effectively improve peripheral blood and T lymphocyte subsets, reduce the levels of IL-23, IL-17 and the incidence of adverse reactions, which can improve clinical efficacy.
		2018 Vol. 15 (2): 87-91 [Abstract] ( 206 ) HTML (1 KB) PDF (471 KB) ( 92 )

	92	Changes and clinical significance of serum macrophage inhibitory factor-1 levels in patients with gastric cancer before and after chemotherapy
		XIE Yanru WU Minhua ZHOU Yuefen YE Zhongwei
		Objective To investigate the changes and the clinical significance of serum macrophage inhibitory cytokine (MIC-1) levels before and after chemotherapy in advanced gastric cancer. Methods The clinical data of 61 patients with advanced gastric cancer admitted to Lishui Central Hospital from January 2013 to January 2015 were retrospective analyzed. Double antibody sandwich ELISA method was applied to detect the serum MIC-1 levels before chemotherapy and after 2 cycles of chemotherapy. The carcinoembryonic antigen (CEA) and cancer antigen-199 (CA199) concentration in serum samples of the gastric cancer were detected by electrochemiluminescence immunoassay analyzer. Relationship between the levels of serum tumor marker before and after chemotherapy and the clinical data were analyzed. Results After chemotherapy, the levels of MIC-1, CEA and CA199 were all significantly lower than those of before chemotherapy, with statistically significant differences (P ＜ 0.05). The level of MIC-1 was correlated with the clinical stage and the degree of differentiation, with statistically significant differences (P ＜ 0.05). MIC-1 combined with CEA and CA199 as one tumor marker, before chemotherapy, the expressions were correlated with the clinical stage, the degree of differentiation and the chemotherapy efficacy (P ＜ 0.05), and was highly correlated with ascites (P ＜ 0.01). After chemotherapy, the expressions were highly correlated with ascites, differentiation and chemotherapy efficacy (P ＜ 0.01). Conclusion This study suggests that MIC-1 has high research value in the diagnosis of advanced gastric cancer. MIC-1 combine with CEA and CA199 can better evaluate the chemotherapy efficacy in patients with gastric cancer and has certain prognostic value for determining the prognosis and the occurrence. As a new tumor marker, MIC-1 has good application prospect and research value.
		2018 Vol. 15 (2): 92-95 [Abstract] ( 661 ) HTML (1 KB) PDF (463 KB) ( 79 )

	96	Analysis on clinical pathological characteristics and prognosis of signet-ring cell carcinoma of biliary tract
		XIA Dandan WANG Runjie LIU Chaoying▲
		Objective To analyze the clinical pathological characteristics and prognosis of signet-ring cell carcinoma of biliary tract. Methods The clinical pathological data of 11 patients who were diagnosed as signet-ring cell carcinoma of biliary tract in Wuxi People's Hospital Affiliated to Nanjing Medical University from May 2007 to October 2016 was analyzed retrospectively, and the prognosis conditions of patients were followed up until December 26, 2016. Results Among 11 cases of patients with signet-ring cell carcinoma of biliary tract, there were 5 cases of male and 6 cases of female, the male to female ratio was 1∶1.2, the episode age was 43-78 years old, with an average of 62.4 years old, the main clinical symptoms were discomfort of right upper quadrant [9 cases (81.8%)] and jaundice [7 cases (63.6%)]. In the pathological location, there were 7 cases (63.6%) in gall bladder. There were 8 cases (72.7%) combined with cholecystitis, 7 cases (63.6%) combined with biliary calculus. In the pathological patterns, adenocarcinoma combined with signet-ring cell carcinoma was more [9 cases (81.8%)], single signet-ring cell carcinoma was less [2 cases (18.2%)]. There were 6 cases (54.5%) of low-differentiated and 8 cases (72.7%) with distant metastasis. All 11 cases took operative treatment, 2 cases received chemotherapy. At the end of the follow-up period, among the patients with definite prognosis, 6 cases (75%) were dead, 2 cases (25%) were survived. The overall survival time was 0-56 months, with an average of 19.3 months. Conclusion Signet-ring cell carcinoma of biliary tract is rare in clinic, which is commonly started from the middle aged and elderly population, the main pathological location is gallbladder, the main clinical symptoms are discomfort of right upper quadrant and jaundice, combining with cholecystitis and biliary calculus may be the related factors of morbidity, the main pathological pattern is adenocarcinoma combined with signet-ring cell carcinoma, the malignant grade is high, the patients are often in the middle and advanced stage when they are diagnosed, the operation is the main therapeutic method, the benefit of chemoradiotherapy still needs further research, the overall prognosis is bad.
		2018 Vol. 15 (2): 96-99,107 [Abstract] ( 251 ) HTML (1 KB) PDF (1064 KB) ( 153 )

	100	The Application on Nutritional Risk Screening 2002 in perioperative period of colorectal cancer
		WANG Jieqiong1 WU Xueliang1 GUO Fei1 YUAN Meijin2 XUE Jun1
		Objective To explore the application of Nutritional Risk Screening 2002 (NRS 2002) in perioperative period of colorectal cancer. Methods From January 2015 to December 2016, 120 patients underwent radical resection of colorectal cancer in the First Affiliated Hospital of Hebei North University were selected as research objects. The perioperative nutrition of these patients was assessed by NRS 2002, then the patients were divided into nutritional risk group (≥3 scores) and eutrophic group (<3 scores). The postoperative complications of the two groups were compared, of which the risk factors were analyzed by Logistic regression. Results There were 45 cases in the nutritional risk group and 75 cases in the eutrophic group. The study showed that were 33 cases (27.50%) with complication, including 17 cases (37.78%) in the nutritional risk group and 16 cases (21.33%) in the eutrophic group. The difference between the two groups was statistically significant (P < 0.05). In the nutritional risk group, the incidence of postoperative complications of patients with nutritional support was lower than that of patients without nutritional support (P < 0.05). The Logistic regression analysis showed that advanced age, high ASA classification, low differentiation degree and NRS 2002 score greater than 3 were independent risk factors for postoperative complications of colorectal cancer (P < 0.05). Conclusion NRS 2002 scoring system can effectively assess the incidence of postoperative complications of colorectal cancer and guide the perioperative nutritional support.
		2018 Vol. 15 (2): 100-103 [Abstract] ( 289 ) HTML (1 KB) PDF (595 KB) ( 167 )

	104	Clinical study on the postoperative nausea and vomiting prevention of catgut implantation therapy in patients after general anesthesia of thyroid gland
		LIN Jianghai XU Shaoyi NI Jianwu ZHAN Jing
		Objective To investigate the efficacy and safety of catgut implantation at Neiguan and Zusanli acupoint on prevention of postoperative nausea and vomiting(PONV) after general anesthesia of thyroid gland, so as to provide evidence for clinical treatment. Methods From July 2015 to July 2016, 80 patients underwent elective thyroid surgery in Wenzhou Traditional Chinese Medical Hospital, Affiliated to Zhejiang Chinese Medical University were selected and divided into the drug group (group C) and the catgut implantation point+drug group (group D) according to the random number table, with 40 cases in each group. Group C was treated with Azasetron combined with dexamethasone and group D was treated with catgut implantation therapy at Neiguan and Zusanli acupoint on the bases of drug group. The incidences of PONV at the time of acute and prolonged periods were compared between the two groups. Results The incidences of acute and prolonged periods in the group D were lower than those of group C, with statistically signicant differences (P < 0.05). Conclusion Catgut implantation at Neiguan and Zusanli acupoint can effectively prevent PONV after general anesthesia. It is worthy of clinical promotion and application.
		2018 Vol. 15 (2): 104-107 [Abstract] ( 273 ) HTML (1 KB) PDF (562 KB) ( 200 )

	108	Correlative study about sleep disorders of elderly patients with dementia
		HUANG Jingjing XU Zhen QU Chen FENG Meijiang
		Objective To explore the correlation between sleep disorders of elderly patients and different levels of dementia. Methods From January 2014 to December 2015, a total of 176 elderly patients were selected in the sleep disorder clinic, the Second Affiliated Hospital of Nanjing Medical University as research objects and divided into the group 1 control (scores≥27, n = 45), group 1 mild (scores 19-26, n = 42), group 1 moderate (scores 10-18, n = 44) and group 1 severe (scores≤9, n = 45) according to the mini-mental state examination (MMSE). To eliminate the effect of elderly common diseases to dementia, the patients without the elderly common diseases were also divided into 4 groups：group 2 control (scores ≥27, n = 22), group 2 mild (scores 19-26, n = 21), group 2 moderate (scores ≥10-18, n = 23) and group 2 severe (scores ≤9, n = 21). The relationship between different levels of dementia and sleep structure was analyzed by overnight polysomnography (PSG) monitoring. Results rapid eye movement (REM), sleep efficiency(SE) of the group 1 mild were lower than those of the group 1 control,with statistically significant difference(P ＜ 0.05);SL(sleep latency) in the group 1 moderate was higher than those of the group 1 control, REM, SE in the group 1 moderate were lower than those of group 1 control,while SL was higher and SE was lower in the group 1 moderate than those of group 1 mild,with statistically significant differences(P ＜ 0.05); SL in group 1 severe was higher than those in group 1 control and group 1 mild, REM and SE in group 1 severe were significantly lower than those in group 1 control, group 1 mild and group 1 moderate, with statistically significant differences (P ＜ 0.05). REM and SE in group 2 mild were lower than those of group 2 control, with statistically significant differences (P ＜ 0.05); SL in group 2 moderate was higher than that in group 2 control, REM, total sleep time(TST) and SE in group 2 moderate were lower than those in group 2 control, SL was higher than that in group 2 mild, TST, SE were lower than those in group 2 mild, with statistically significant differences (P ＜ 0.05); SL in group 2 severe was higher than those in group 2 control and group 2 mild, REM, TST and SE in group 2 severe were significantly lower than those in group 2 control and group 2 mild, REM, SE were lower than group 2 moderate, with statistically significant differences(P ＜ 0.05). Conclusion The elderly patients with dementia have a significant decline in sleep quality. The more severe the dementia was, the worse the quality of sleep was. PSG monitoring is useful for patients no matter whether they have common diseases of the elderly or not. Therefore, PSG can be used as a supplementary indicator to assess the process and development of dementia.
		2018 Vol. 15 (2): 108-111 [Abstract] ( 272 ) HTML (1 KB) PDF (601 KB) ( 100 )

	112	Clinical analysis of clinical symptoms and psychological status of severe acne students in Qinhuangdao City
		XU Haifeng LI Zhongwen ZHANG Yu WANG Yafei
		Objective To explore the clinical symptoms and psychological status of severe acne students in Qinhuangdao City. Methods A total of 200 patients with acne in First Hospital of Qinhuangdao were investigated by questionnaire from May 2016 to January 2017. The patients were divided into study group (Ⅲ, Ⅳ degree) and control group (Ⅰ, Ⅱ degree) by Pillsbury classification. Meanwhile, they were investigated by SCL-90 and PSQI, the relevant data were recorded and analyzed. Results A total of 186 valid questionnaires were collected, among which 85 cases (45.92%) were in the study group and 101 cases in the control group (54.08%). The scores of obsessive disorder, interpersonal sensitivity, depression, anxiety, hostility and psychoticism in the study group were higher than those in the control group (P < 0.05). Besides, the PSQI scores in the study group were higher than those in the control group (P < 0.01). Conclusion The psychological status of severe acne students in Qinhuangdao is mainly manifested in the aspects of obsesessive disorder, interpersonal sensitivity, depression, anxiety, hostility and psychoticism, and its sleep quality was affected.
		2018 Vol. 15 (2): 112-114 [Abstract] ( 267 ) HTML (1 KB) PDF (552 KB) ( 87 )

	115	Effect of somatosensory interactive game on cognitive impairment in patients with stroke
		ZHOU Ying XU Leyi LI Haiyan▲
		Objective To evaluate the effect of somatosensory interactive game Kinect on patients with cognitive impairment after stroke. Methods From January 2017 to June 2017, 60 patients with cognitive impairment after stroke treated in the First Affiliated Hospital of Wenzhou Medical University were selected and divided into the control group and the experimental group by random number table, with 30 cases in each group. The control group was treated with routine rehabilitation, while the experimental group was additionally treated with Kinect games on the bases of the control group. Montreal cognitive assessment (MoCA) and minimum mental state examination (MMSE) were applied before and 4 weeks after intervention. Results After intervention, the scores of MoCA and MMSE in both groups were significantly higher than those of control group, and the scores above in experimental group increased more remarkably, with statistically significant differences (P ＜ 0.05). Conclusion The somatosensory interactive game Kinect combined with routine rehabilitation can further improve the cognitive ability of patients with stroke.
		2018 Vol. 15 (2): 115-118 [Abstract] ( 741 ) HTML (1 KB) PDF (560 KB) ( 156 )

	119	The application of small-sized left-sided double-lumen tube to thoracic surgery when combined with low tidal volume ventilation
		SU Zhonghong SHI Hongwei▲ GE Yali SHI Tao WEI Haiyan
		Objective To study the feasibility of small-sized left-sided double-lumen tube for thoracic surgery anesthesia when combined with low tidal volume ventilation. Methods From October 2016 to February 2017, 30 cases of thoracic surgery patients with a single lung ventilation in the left-sided double-lumen tube in Nanjing First Hospital were selected as research objects, and divided into two groups by random number table, with 15 cases in each group. Patients of two groups were treated with different size left-sided double-lumen tubes. The trial group (group T) was applied to the small model, male application F35, female application F32. Control group (group C) was applied to the normal model, male application F37, female application F35. The resistance during intubating, airway trauma testified through fiberoptic bronchoscopy, intubation attempts and hemodynamic changes following intubation were compared between two groups. The airway peak-pressures at the beginning of double-lung ventilation following successful intubation and one-lung ventilation, together with the airway peak-pressure after one-hour′s one-lung ventilation, the oxygen saturation (SPO2) after one-hour′s one-lung ventilation were also compared between two groups. The lowest mean arterial pressure (MAP) and corresponding heart rate (HR) before intubation, the highest MAP and corresponding HR after intubation were recorded. The deviation value between the highest MAP and the lowest MAP, together with the corresponding deviation value of HR, were also compared between group T and group C. Results The resistance during intubating, airway trauma testified through fiberoptic bronchoscopy in group T were lower than those of group C, with statistically significant difference (P < 0.05). There was no statistical difference between two groups in intubation attempts (P > 0.05). During mechanical ventilation, there was no statistical difference between two groups in the double-lung ventilation following successful intubation, one-lung ventilation together with the airway peak-pressure after one-hour′s one-lung ventilation, SPO2 after one-hour′s one-lung ventilation (P > 0.05). In addition, the increased value of HR caused by intubation was less in group-T than in group C (P > 0.05) and the increased value of MAP was also less in group T than in group C (P > 0.05). Conclusion Small-sized left-sided double-lumen tube can satisfy the need of one-lung ventilation when combined with low tidal volume ventilation, and the respiratory tract injury caused by tracheal intubation was more stable. [Key words] Anesthesia; Endotracheal; Thoracic surgery; Respiration; Artificial; Hemodynamics
		2018 Vol. 15 (2): 119-122 [Abstract] ( 241 ) HTML (1 KB) PDF (564 KB) ( 157 )

	123	Analysis of Amikacin in elderly inpatients in our hospital
		WANG Wentao1 TU Chunlin2▲
		Objective To analyze the situations of Amikacin (AMK) applied in elderly inpatients in Jiading Central Hospital of Shanghai City ("our hospital" for short), to promote rational drug use in the clinic. Methods The clinical data of elderly inpatients who used AMK in our hospital from January 2015 to December 2016 was analyzed retrospectively, which contained diagnosis, microbial culture, renal function, AMK dosage regimen, curative effect and adverse reactions, etc, then statistic analysis was made. Results Four hundred and eighty-eight patients (288 male, 200 female) were enrolled in the analysis, aged from 65 to 92 years old, with an average of (70.00±8.40) years old. AMK was used most commonly in Department of Respiratory Medicine (43.65%). AMK was often used in combination with β-lactam antibiotics (61.68%) to against gram-negative bacterial infection (94.26%), and the total effective rate was 89.75%. The drug utilization index of AMK was 0.53, and the most commonly prescribed drug regimen was "0.4 g qd" (62.91%). The levels of serum creatinine of 7 patients after treatment were significantly higher than those before treatment, which may had potential renal toxicity. Conclusion The dosage of AMK in our hospital is relatively low. It is necessary to take blood drug concentration monitoring in the course of clinical treatment and make individualized drug regimen, so as to make sure that the treatment is safe and effective.
		2018 Vol. 15 (2): 123-126 [Abstract] ( 270 ) HTML (1 KB) PDF (474 KB) ( 258 )

	127	Analysis of the utilization of adjuvant drug injections from 2014 to 2016 in our hospital
		WANG Jian ZHANG Guifen ZHI Wenyu LU Hong ZHU Aiguo
		Objective To understand the current situation and development trend of the adjuvant drug injections in Changshu NO.1 People′s Hospital (“our hospital” for short), so as to provide reference for clinical rational use of the drugs. Methods According to the key monitoring directory of adjuvant drug injections issued by Suzhou and Nanjing Health and Family Planning Commission of Jiangsu Province, the relevant data of adjuvant drug injection from 2014 to 2016 was collected from HIS. The consumption sum, annual growth rate, defined daily dose system (DDDs), sorting ratio and defined daily cost (DDC) of the adjuvant drug injections were statistically analyzed according to the limited daily dose recommend to WHO. Results During 3 years, the consumption sum of adjuvant drug injections each were 70.8482, 63.5041 and 49.8739 million yuan. The consumption sum of adjuvant drug injections of 2015 and 2016 declined by 10.37% and 21.46% compared with last year. The proportion of consumption sum of adjuvant drug injections in all drugs were 19.64% in 2014, 16.52% in 2015 and 12.94% in 2016. The first and second categories of consumption sum and DDDs rank were neurological drugs and immunomodulating drugs. The top 3 varieties of single item of consumption sum were ganglioside, mouse nerve growth factor and Edaravone. The top 3 varieties of single item of DDDs were lentinan, fat-soluble vitamin (Ⅱ) and Alprostadil. Conclusion The use of adjuvant drug injections in our hospital has dropped drastically, and the effectiveness of management and control is remarkable. However, it still needs to focus on the adjuvant drugs with poor cost performance to further promote their rational use.
		2018 Vol. 15 (2): 127-131 [Abstract] ( 255 ) HTML (1 KB) PDF (471 KB) ( 161 )

	132	Effects of Azithromycin sequential therapy combined with Pidotimer on serum inflammatory cytokines and immune function in children with Mycoplasma pneumonia
		HU Lijie CHEN Yun WANG Tingting
		Objective To investigate the effect of sequential treatment with Azithromycin combined with Pidotimod on the levels of serum inflammatory cytokines and immune function in children with Mycoplasma pneumonia. Methods The subjects of 147 children with Mycoplasma pneumonia in the Fourth People's Hospital of Hengshui from January 2016 to December 2016. Randomized divided into control group and research group, including 73 cases of children in the control group, 74 cases of study group. The control group was treated with Azithromycin sequential therapy. The control group was treated with Azithromycin sequential therapy. The study group was treated with Azithromycin sequential therapy combined with Pidotimod. Serum inflammatory factors and immune parameters were compared between the two groups. Results The total effective rate in the study group was 95.95%, which was significantly higher than that in the control group (83.56%) , the difference was statistically significant (P < 0.05) . After treatment, the serum TNF-a [(0.72±0.14) mg/L], IL-4 [(25.14±2.54) ng/L], IL-6 [(7.43±2.42) ng/L], IL-10 [(26.73±2.49) ng/L] of patients in the two groups were significantly lower than the control group [(1.39±0.21) mg/L, (37.26±3.41) ng/L, (12.56±3.29) ng/L, (34.36±3.17) ng/L], the differences between two groups were statistically significant (P < 0.05). After treatment, CD3+ and CD4+ of patients in the study group increased compared with that before treatment, and the level of CD8+ in the study group was significantly lower than that before treatment (P < 0.05), and the study group changed more than the control group, the difference between the groups was statistically significant (P < 0.05). Conclusion Azithromycin sequential therapy combined with Pidotimod treatment has a good therapeutic effect, can effectively improve the patients' inflammatory response and improve the patients′ immune function, it is worth promoting.
		2018 Vol. 15 (2): 132-135 [Abstract] ( 228 ) HTML (1 KB) PDF (345 KB) ( 73 )

	136	Application effects of evidence-based nursing in patients with dilated cardiomyopathy
		LI Meng
		Objective To explore the effects of evidence-based nursing in patients with dilated cardiomyopathy (DCM). Methods From April 2016 to February 2017, 84 patients with DCM treated in the Fourth Hospital of Harbin Medical University were selected and divided into the control group and the observation group by random number table, with 42 cases in each group. The control group was given conventional nursing model and the observation group was given evidence-based nursing model. The improvement of the cardiac function, the degree of knowledge mastery and nursing satisfaction were compared between the two groups after nursing. The self-rating anxiety scale (SAS), self-rating depression scale (SAS) and the medical outcomes study 36-item short form health survey (SF-36) were applied to assess the anxity, depression and health status in the two groups before and after nursing. Results After nursing, the total effective rate in the observation group (95.24%) was higher than that of control group (78.57%), with statistically significant difference (P ＜ 0.05). The scores of knowledge mastery and nursing satisfaction were all higher than those of control group, with statistically significant differences(P ＜ 0.05). After nursing, the scores of SDS and SAS in the two groups were all lower than those of before nursing, the score of SF-36 was higher than that of before nursing, and the scores above in the observation group improved much more remarkably, with statistically significant differences (P ＜ 0.05). Conclusion The evidence-based nursing model can improve the cardiac function and health status, reduce the depression and anxiety status in patients with DCM. It is worthy of promotion and application.
		2018 Vol. 15 (2): 136-139 [Abstract] ( 253 ) HTML (1 KB) PDF (555 KB) ( 109 )

	140	The health education effects of homemade propaganda and popular science videos in parents of epilepsy children

		Objective To explore the health education effects of homemade propaganda and popular science videos in parents of epilepsy children. Methods From January to November 2016, 881 cases of epilepsy children parents in the Department of Pediatric, Xuanwu Hospital, Capital Medical University were selected as research objects and divided into the control group (435 cases) and the observation group (446 cases) according to the admission time. The control group was given routine health education and the observation group was given homemade propaganda and popular science videos education. The efficacy of health education and the nursing satisfaction of the parients in the two groups were compared. Results The nursing satisfaction in the observation group was higher than that of control group, with statistically significant difference(P ＜ 0.05). The status of knowledge of epilepsy and awareness of anti-epileptic drugs in the observation group were better than those of control group, with statistically significant difference (P ＜ 0.05). Conclusion The of homemade propaganda and popular science videos in parents of epilepsy children can improve the effects of health education, promote the nursing satisfaction, and it is better than routine health education.
		2018 Vol. 15 (2): 140-142,150 [Abstract] ( 255 ) HTML (1 KB) PDF (605 KB) ( 171 )

	143	Effects of continue nursing intervention on negative emotions, sleep quality and nursing satisfaction in postoperative patients with intracranial tumor
		JI Yanyun GU Yudan
		Objective To study the effects of continue nursing intervention on negative emotions, sleep quality, incidence of complications and nursing satisfaction in postoperative patients with intracranial tumor. Methods From January 2016 to January 2017, 90 cases of postoperative patients with intracranial tumor in Affiliated Hospital of Nantong University were divided into the control groups and the observation group by random number table, with 45 cases in each group. The control group was given routine nursing intervention, while the observation group was given continue nursing intervention. The self-anxiety scale (SAS) and self-depresion scale (SDS), the world health organization quality of life-brief (WHOQOL-BREF) and Pittsburgh sleep quality index (PSQI) were used to assess the negative emotions, life quality and sleep quality of patients in the two groups. The incidence of complications and nursing satisfaction in two groups were compared. Results After nursing, the scores of SAS and SDS were lower than those of before nursing in the two groups, those scores above in the observation group were much lower than those of control group, with statistically significant differences (P ＜ 0.05). After nursing, the scores such as psychological, physiological, environmental and social domains of life quality were all higher than those of before nursing, the indexes above in the observation group were all higher than those of control group (P ＜ 0.05). After nursing, the item scores of sleep quality, sleep duration, sleep efficiency, sleep disturbance, hypnotic drugs, daytime dysfunction and time of sleep in the observation group were all lower than those in the control group, with statistically significant differences (P ＜ 0.05). The incidence of complications in the observation group was lower than that of control group and the nursing satisfaction was higher than that of control group, with statistically significant differences (P ＜ 0.05). Conclusion Continue nursing intervention can significantly enhance the life quality, improve the nursing satisfaction, improve sleep quality, reduce the negative emotions and incidence of complications in the treatment of postoperative patients with intracranial tumor. It is worthy of promotion and application.
		2018 Vol. 15 (2): 143-146 [Abstract] ( 256 ) HTML (1 KB) PDF (553 KB) ( 74 )

	147	The clinical application of rapid rehabilitation care in perioperative nursing of patients with cervical cancer
		WANG Jun ZHOU Yiwen▲ FENG Qiong
		Objective To explore the effects of rapid rehabilitation care in patients with cervical cancer during perioperative period. Methods From January 2015 to January 2017, 80 cases of patients in Mianyang Central Hospital were selected and divided into the control group and the observation group by random number table, with 40 cases in each group. The control group was given routine nursing intervention and the observation group was given rapid rehabilitation care. The anxiety and depression status, incidence of complications and nursing satisfaction were compared between the two groups. Results After nursing, the scores of SAS and SDS in the two groups were all lower than those of before nursing, the scores above in the observation group were all significantly lower than those of control group, with statistically significant differences (P ＜ 0.05). The incidence of complications in the observation group was lower than that of control group, the nursing satisfaction in the observation group was higher than that of control group, with statistically significant differences (P ＜ 0.05). Conclusion The nursing effect of rapid rehabilitation care in patients with cervical cancer during perioperative period is remarkable. It can improve the patient's anxiety and depression status effectively. The incidence of complications is low. It is worthy of clinical pomotion and application.
		2018 Vol. 15 (2): 147-150 [Abstract] ( 219 ) HTML (1 KB) PDF (552 KB) ( 108 )

	151	Effects of the whole intervention model based on Cameron timely theory in patients with chronic obstructive pulmonary disease
		CAI Xiaoqiong ZHANG Xiaoli
		Objective To explore the effects of the whole intervention model based on Cameron timely theory in patients with chronic obstructive pulmonary disease(COPD). Methods From April 2016 to March 2017, 139 cases of COPD patients in Pangang General Hospital of Panzhihua City were selected as research objects and divided into the control group (67 cases) and the intervention group (72 cases) by admission time. The control group was given routine nursing care and the intervention group was given the whole intervention model based on Cameron timely intervention theory. The family caregiver task inventory (FCTI) and Seattle obstructive lung disease questionnaire (SOLDQ) were used to assess the care ability of the family caregivers and the life quality of the patients respectively. The acute attack, treatment conditions and hospitalization time in the two groups were compared. Results After intervention of 1 month and 3 months, the scores of all dimensions of FCTI such as care role, strain and provide assistance, handle personal emotions, assess family and community resources and adjust life to meet care needs in the two groups were all higher than those of before intervention, the scores above in the intervention group were all higher than those of control group. The physiological function, emotional function, coping skills and nursing satisfaction of SOLDQ in the intervention group were all higher than those of conrol group, with highly statistically significant differences (P ＜ 0.01). The repeated measurement of variance analysis showed that the scores of all dimensions of FCTI in the intervention group were continuously decreasing, and the scores of all dimensions SOLDQ were continuously increasing. The acute attack, treatment conditions and hospitalization time in the intervention group were lower than those of control group, with highly statistically significant differences (P ＜ 0.01). Conclusion The whole intervention model based on Cameron timely theory can effectively improve the caregivers′ care ability, pomote the patients' life quality and reduce the risk of acute attack.
		2018 Vol. 15 (2): 151-155 [Abstract] ( 739 ) HTML (1 KB) PDF (606 KB) ( 128 )

	156	The influences of comprehensive nursing intervention on compliance behavior, self-management behavior and curative effect in patients with glaucoma
		XIE Liaoqi ZHANG Hui LYU Ronghui ZHANG Lingling LYU Juying▲
		Objective To explore the influences of compliance behavior, self-management behavior and curative effect in patients with glaucoma. Methods The clinical data of 96 patients with glaucoma treated in the First People's Hospital of Xianyang City from February 2016 to March 2017 were analyzed retrospectively and divided into the control group (46 cases) and the comprehensive nursing intervention group (50 cases) by different nursing method. Before and after nursing, the compliance behavior, self-management and curative effect were evaluated by self-designed questionnaire. The vision, field defect and eye pressure were compared in the two groups. Results Before nursing, there were no statistically significant differences in the drug compliance, regular follow-up visit, cognitive dysfunction, self-check, patient consciousness and avoid recurrence, lifeway, follow-up and medication, the vision, field defect and eye pressure in the two groups (P ＞ 0.05). After nursing, the indicators above were all improved and those in the comprehensive nursing intervention group improved much more remarkably, with statistically significant differences(P ＜ 0.05). Conclusion The application of comprehensive nursing intervention in patients with glaucoma can improve the compliance behavior and self-management. It can promote the vision, reduce the field defect and eye pressure. It is worthy of promotion and application.
		2018 Vol. 15 (2): 156-159 [Abstract] ( 259 ) HTML (1 KB) PDF (593 KB) ( 111 )

	160	One case study and literature review of the percutaneous nephrolithotomy surgery of atypical renal tuberculosis misdiagnosed as kidney stone
		WANG Pengxin1 WANG Xing2 TIAN Fei1 MA Li1 ZHANG Di3 DING Yuzhi4
		In the clinical work, the typical renal tuberculosis and kidney stones are easy to be identified, but atypical renal tuberculosis is easily confused with kidney stones, leading to misdiagnosis and mistreatment. The diagnosis of atypical renal tuberculosis requires diagnostic criteria rather than general diagnostic methods. This paper summarizes the medical history, clinical features, auxiliary examinations and treatment procedures of 1 case with untypical renal tuberculosis in Dingzhou People's Hospital and discusses the pathogenesis, clinical features, diagnosis and treatment of atypical renal tuberculosis, so as to summarize experience, improve diagnosis rate, and reduce misdiagnosis rate and delay diagnosis rate, make the patients with atypical renal tuberculosis get timely and effective treatment.
		2018 Vol. 15 (2): 160-163 [Abstract] ( 268 ) HTML (1 KB) PDF (599 KB) ( 141 )

	164	Evaluation of drug treatment of acute attack of gout in one patient with diabetic nephropathy caused by Aspirin combined with Furosemide
		CHENG Xi1 JIANG Xuehua2 LONG Enwu3 KE Hong1
		Long term diabetes patients are often associated with a variety of diseases, the choice of therapeutic drugs need to be comprehensively considered. Clinical pharmacists participate in the whole process of diagnosis and treatment of one patient with diabetic nephropathy, in combination with renal function, pay close attention to drug interactions. To the acute attack of gout caused by Aspirin combined with Furosemide, clinical pharmacists timely intervene and adjust the drug treatment program to ensure the safety and effectiveness of medication. The patient was given correct medication and lifestyle guidance, so that the blood sugar levels and gout symptoms were well controlled, and the compliance of the patient was improved. Clinical pharmacists give full play to their professional advantages, optimize treatment plan to assist the doctors, and play an important role in rational drug use.
		2018 Vol. 15 (2): 164-167,171 [Abstract] ( 279 ) HTML (1 KB) PDF (809 KB) ( 191 )

	168	Analysis of the relationship between serum procalcitonin and pathogenic microorganisms in hospitalized patients
		FU Yuefeng WANG Lan▲ KONG Lingbo NIU Liqiang WANG Jian NIE Zhiyuan
		Objective To explore the relationship between serum procalcitonin and pathogenic microorganisms. Methods From December 2012 to November 2015, clinical data from 275 cases of hospitalized patients in Dongzhimen Hospital, Beijing University of Chinese Medicine were selected retrospectively and the general information of the patients (the level of PCT＞0.5 ng/mL) with positive microbial cultivation of sputum, urine, blood, pus or throat swab and the department, level of PCT, collection site and distribution of the microbial culture, microbiological classification were analyzed. The relationship between serum procalcitonin and pathogenic microorganisms was anylyzed. Results The clinical departments was mainly in the blood oncology department, intensive care unit and emergency department; the collection site of the microbial culture were mainly from sputum and urine, accounted for 80.73%; Gram-positive bacteria mainly includes Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis and Gram-negative bacteria mainly includes Acineto-bacter baumannii, Escherichia coli, Pseudomonas aeruginosa, most of the Fungi were Candida albicans, Candida glabrata, Candida tropicalis. The level of PCT in fungi positive culture was lower than that of bacterial positive culture, with statistically significant difference (P ＜ 0.05). There was no statistically significant difference between Gram-positive bacteria and Gram-negative bacteria in the level of PCT (P ＞ 0.05). Conclusions The level of PCT has significant meaning for predicting pathogenic microorganisms. Bacterial infections are significantly higher than those of the fungus. But due to the research conditions, there is no positive findings in the prediction of Gram-positive bacteria and Gram-negative bacteria. It needs further research.
		2018 Vol. 15 (2): 168-171 [Abstract] ( 249 ) HTML (1 KB) PDF (528 KB) ( 178 )

	172	Analysis of HIV infection among MSM in chinese students
		XIE Meimao1 XIONG YI2 WANG Zhongjun1 HU Yingqiu1 WANG Xiaorong1 FU Longlong1，3
		Objective To analyze the status and changes of acquired immunodeficiency syndrome (AIDS) prevalence among the male students who have sex with men(MSM) from January 2006 to December 2016 in China. Methods Data related to MSM infection among Chinese students during the period from January 1th 2006 to December 31th 2016 were searched in the datases included CNKI, wangfang and VIP database. Key words: MSM, HIV/AIDS, student and infection rate. Results A total of 8 articles were included in the study, which was found in 8 regions of the country. The total number of MSM in the study was 2295, and the HIV infection cases were 107 (4.66%). There was no linear relationship between the infection rate of HIV and the time of study; and it cannot be assumed that HVI infection was increasing year by year in the MSM population. The state was divided into the north and south, while there was no statistically significant difference between the two areas (P = 0.449): 1205 cases of MSM in the south, the HIV positive cases were 60 (4.98%), while the cases in the north was 1090 and 47(4.66%) cases were HIV positive. Conclusion It is important to determine the prevalence of HIV infection among MSN in Chinese students and make reasonable suggestions according to the characteristics of HIV infection. It will provide scientific evidence for AIDS control and prevention in China.
		2018 Vol. 15 (2): 172-175 [Abstract] ( 351 ) HTML (1 KB) PDF (510 KB) ( 159 )

	176	The analysis of history of the performance evaluation of the community health service based on CNKI in China
		YANG Songyan CAO Yan
		Objective To understand the status of the performance evaluation of the community health service in China, and explore the development, so as to provide reference for performance improvement. Methods By retrieving and screening the literature about performance evaluation of the community health service in CNKI, SPSS 22.0 and Excel 2010 were adopted for statistical analysis. It was restricted that the time of the retrieved literatures was from January 2003 to September 2017. Results There were 213 articles of literatures in line with the inclusion criteria. The total number of literatures was small. Distributed in 74 kinds of journals, they were pretty dispersive. There were 64 articles of literatures with the support of fund project with a small total number. The output of literatures created by the academic leader was low and the number was five at most. Conclusion It should increase the degree of the fund support and encourage the scientific research cooperation, to effectively transform the scientific research achievements into social benefits. Improve the performance of the community health service, and give full play to its functions and roles.
		2018 Vol. 15 (2): 176-180 [Abstract] ( 204 ) HTML (1 KB) PDF (700 KB) ( 100 )

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