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2018 Vol. 15, No. 18
Published: 2018-06-25
4
Effect of consistence pressure on expression of Wnt/beta-catenin signaling pathway and VEGF of the rabbit intervertebral disc motion segments vertebral endplate in vitro organ culture
ZHAN Jiawen1,3 FENG Minshan2,3 WANG Shangquan1▲ ZHU Liguo2,3 HAN Tao1 YIN Xunlu1 WEI Xu4
Objective To study the effect of consistence pressure on the expression of VEGF and beta -catenin in vertebral endplate, and further explore the molecular mechanism between VEGF and intervertebral disc degeneration. Methods A total of 16 New Zealand rabbits were sacrificed after removed under sterile conditions in the spinal motion segment, were randomly divided into control group and pressure group(8 rabbits in each group). Rabbits were placed in vitro loading and culture device for culture, in which the pressure group were treated with consistence pressure 3 kg, the control group did not under pressure, pro-culture and 3, 7, 14 d after culture, 10 samples were collected from each group, the expression of VEGF and beta-catenin were detected by immunohistochemistry (IHC), Western blot and Real time-PCR. Results IHC staining showed that the VEGF staining intensity in the endplate under pressure 7 d after cultured decreased significantly(0.182±0.063), compared with the control group(0.237±0.051), the difference was statistically significant (P < 0.05); the staining intensity was further decreased at 14 d after culture (0.156±0.035), compared with the control group (0.211±0.038), the difference was statistically significant(P < 0.05). On the contrary, the consistence pressure increased the expression of beta-catenin in the endplate, and compared with that of the control group, the difference was statistically significant (P < 0.05). Western blot results showed that compared with fresh specimen and control group, consistence pressure significantly increased the expression of beta-catenin, the differences were statistically significant (P < 0.05). Real-time PCR results showed the relative expression of VEGF gene was reduced by consistence pressure(0.842±0.002), and the difference was significant compared with the control group (0.965±0.005, P < 0.05). Conclusion Consistence pressure leads to a decrease of VEGF expression and an increase of the expression of beta-catenin in the vertebral endplate of spinal motion segment, which suggests that continuous pressure may regulate the expression of VEGF in the vertebral endplate through the Wnt/beta-catenin signaling pathway.
2018 Vol. 15 (18): 4-8 [
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Differentially expression profile of circular RNAs in hypoxia-preconditioned human placenta chorionic mesenchymal stem cells
SUN Xunsha1 WU Jieying2,3 CHEN Jinsong2,3 LU Yan2,3 YU Qiuxia2,3 LI Ru2,3 WANG Dan2,3 LI Yan2,3 WU Shaoqing2,3▲
Objective To analyze the expression profile variation of circular RNA (circRNA) between hypoxia preconditioned human placenta chorionic mesenchymal stem cells (H-hpcMSCs) and normoxic preconditioned hpcMSCs (N-hpcMSCs). Methods Human circRNA microarray was performed to detect the difference of circRNA expression between 3 paired specimens of H-hpcMSCs and its N-hpcMSCs. The circRNA differental expression and the predicted miRNA of differentially expressed circRNA were analyzed. Results Of the 13 617 circRNAs, 12 114 circRNAs with analytical results. In H-hpcMSCs, a total of 102 circRNAs showed differentially expressed which have more than 1.5 times variation and significant difference (P < 0.05). Among them, 85 increased and change′s fold more than 1.5 times, while 17 reduced and change′s fold more than 1.5 times, a total of 27 circRNAs showed a greater than 2-fold change and all were up-regulated. Five miRNAs of each with differentially expressed circRNA were predicted according to specific base pairing. Conclusion The circRNA expression profile of H-hpcMSCs changed significantly in comparison with N-hpcMSCs, the circRNA may be associated with the hypoxia precondition.
2018 Vol. 15 (18): 9-11 [
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Cardiac function in rat models with abdominal aortic constriction and the therapeutic effect of Qianyang Decoction evaluated by color Doppler echocardiography
LU Cheng1,2,3 LIU Yongming3 CHEN Qisong1
Objective To evaluate cardiac function in rat models with abdominal aortic constriction and the therapeutic effect of Qianyang Decoction by means of color Doppler echocardiography. Methods Forty male Wistar rats, clean grade, were divided into four groups by random number table, including sham group, control group, TCM group and Perindopril group, with 10 rats in each group. All rats were undergone the abdominal aortic constriction surgery, except the rats in the sham group. Drug intervention was initiated 8 weeks after the models were made, with a total of 12 weeks of intervention. Then the peripheral blood pressure and cardiac function were studied in each group of rats at the end of 12 weeks after treatment. Results At 20 weeks after models made, the systolic pressure (SBP) of the rats in the control group was significantly increased (P < 0.05). Compared with the control group, the SBP of the rats in the TCM group and the Perindopril group were reduced (P < 0.05). The interventricular septal thickness (IVSd) in the control group was increased (P < 0.05). Compared with the control group, the IVSd was decreased in TCM group (P < 0.05), the IVSd was decreased in Perindopril group as well(P < 0.05). Peak E-Wave Velocity was decreased in the control group (P < 0.05). Compared with the control group, Peak E-Wave Velocity was increased in TCM group (P < 0.05). The ratio of E/A was obviously decreased in the control group (P < 0.05). Compared with the control group, the ratio of E/A was increased in TCM group (P < 0.05). Conclusion Color Doppler echocardiography is a useful tool for evaluation of cardiac diastolic function in rat models with abdominal aortic constriction. Qianyang Decoction can effectively reduce peripheral blood pressure of abdominal aortic constriction rats, inhibit left ventricular hypertrophy and improve left ventricular diastolic function.
2018 Vol. 15 (18): 12-15 [
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Mechanism of Danhong Decoction in protecting cerebral ischemia reperfusion injury
ZHENG Jun1 CHEN Shaoxiu2 ZHANG Xiaochun1
Objective To study the protective mechanism of Danhong Decoction on cerebral ischemia-reperfusion injury. Methods The 48 SD rats were divided into MCAO group, positive drug group (Nebivolol) and observation group (Danhong Decoction) by random number table, with 16 cases in each group, which were in accordance with the modified focal cerebral ischemia reperfusion model (MCAO). They were intervened for one week. Before and after intervention, Longa neurological scores were taken to measure cerebral infarct volume and NO, nitric oxide synthase (eNOs), superoxide dismutase (SOD) and malondialdehyde (MDA) in cerebral infarct tissue and Ca2+ content were detected. The endothelin-B (ET-B) receptors in cerebral cortical microglia and the expression of vascular endothelial growth factor (VEGF) protein and its gene in infarcted brain tissue were compared. Results After intervention, the levels of NO, eNOs, SOD, VEGF-mRNA, VEGF protein and Longa neurological score in the observation group were increased, while the levels of MDA, ET-B protein, ET-B mRNA, Ca2+ and infarct volume were decreased, with statistically significant differences (P < 0.05). After intervention, the differences of those indices between the observation group and the MCAO group were statistically significant (P < 0.05). Besides, the differences of VEGF-mRNA, VEGF protein, MDA and SOD levels between the observation group and the positive drug group were statistically significant (P < 0.05). Conclusion Danhong Decoction has a protective effect on cerebral ischemia reperfusion injury.
2018 Vol. 15 (18): 16-19 [
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Research progress of preventing aspiration in elderly patients with nasal feeding
CHEN Weibing MA Hongmei▲ SHEN Xiangying
Aspiration is one of the serious complications in elderly patients with long-term nasal feeding, which often leads to the ventricular or even death. The clinical medical staff have carried out a large number of studies on preventing aspiration with it. This paper reviewed in such as the selection of gastric tube， in the length, position and fixed method of the tube, the speed and the quantity of the nasal feeding, the risk assessment of the aspiration and the residual amount, to reduce the aspiration and ensure the safety of clinical nursing.
2018 Vol. 15 (18): 20-23,39 [
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Structure and function of the CRISPR/cas9 gene editing system and its application progress in glioma
WANG Chaojia WANG Hui
Glioma is the most common primary malignant tumor of the brain. Currently, surgery, chemotherapy and radiotherapy are not effective. Gene therapy may become an important development direction of glioma in the future. The existing gene editing techniques have RNA interference, TALEN, ZENs and so on. Because of their complex design operation and high miss distance, they have not been used well. (CRISPR) /CRISPR-associated (Cas) 9 is a natural immune system for many bacteria and most of the palaeophytes. By specific identification of the invaded virus and nucleic acid, the Cas protein is used to cut the virus to achieve its own immunity. Compared with the above methods, it has obvious advantages. This article reviews the structure and function of CRISPR/Cas9 and its application in the treatment of glioma, in order to provide a new therapeutic approach for the treatment of brain glia.
2018 Vol. 15 (18): 24-27 [
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Application progress of transcranial ultrasonography in diagnosis of Parkinson′s disease
ZHANG Xuemin1 HE Juan2▲ WANG Yingfei1 LIU Guiying2
Parkinson′s disease (PD) is a common degenerative disorder of the nervous system in middle-aged and old people. The clinical symptoms include motor and non motor. The misdiagnosis rate and missed diagnosis rate are high because the cause of the disease is not clear and the medical level is limited. At present, the treatment of the disease is limited to the control of symptoms, delay the condition, there is no radical cure, its late deformity rate is high, which seriously affects the quality of life in the late years of the patient. Transcranial ultrasound is a new method of imaging examination, which has been developed in recent years. It has the advantages of moderate price, safety and short operation time. It has attracted more and more researchers′ attention. It can clearly display the two-dimensional display images of the mesencephalon and subcortical structures of each plane, and provide an important imaging basis for the diagnosis and differential diagnosis of PD. It can greatly reduce the misdiagnosis rate and missed diagnosis rate of PD patients, and do the early detection and early intervention as much as possible to reduce the impact of the disease on the patients. At present, transcranial ultrasound has become a widely used neuroimaging examination method.
2018 Vol. 15 (18): 28-31 [
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Research progress and application evaluation of markers for acute kidney injury
LIU Yadong XING Yanfang
When the markers of acute kidney injury (AKI) are abnormal, the kidney often has micromorphology and histological changes, which seriously affect the prognosis of the patients. In this paper, the biological markers of human neutrophil gelatinase-associated lipocalin, kidney injury molecule 1, cystine inhibitor C, interleukin-18, N-acetyl-beta-D glucosaminidase, liver fatty acid binding protein and insulin like growth factor binding protein-7 are reviewed in order to provide a clinical basis for the early diagnosis, development and prognosis of AKI.
2018 Vol. 15 (18): 32-35 [
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ATF4 gene and tumor
WANG Hui1 LIU Qinjiang2
Activating transcription factor 4 (ATF4) belongs to the ATF/CREB family and plays an important role in stress responses such as hypoxia, amino acid deletion, oxidative stress and endoplasmic reticulum stress. In most tumors, the expression of ATF4 is up-regulated, and it can enhance the hypoxia tolerance of tumors and promote the expression of tumor growth and angiogenic factors, and then participate in the process of regulating the development of tumor. Therefore, ATF4 may be a potential new target in the field of tumor therapy. This paper reviewed the related advances of ATF4 gene in tumor research.
2018 Vol. 15 (18): 36-39 [
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Analysis of 2057 questionnaires on the knowledge of birth defect prevention
ZHOU Qing FU Yali ZHANG Ruijin LIU Shuaimei LIN Ning WU Yulin XU Haoqin
Objective To understand the status of knowledge, attitude and demands of birth defect prevention among the responds in Jiangsu Province in order to provide the bases for the service modes of primary prevention work of birth defect. Methods A survey was made among the responds from Zhenjiang, Taixing, Suining and Lianyungang from November 2016 to June 2017, and the contents of questionnaire contained personal characteristics, the knowledge of birth defect prevention and sources of knowledge. Results A total of 2143 questionnaires were collected and the valid questionnaires were 2057, with an effective rate of 96.0%. The survey indicated that the levels of the knowledge of birth defect prevention were 6.6%-96.7%. The male awareness rates were 4.9%-96.3% and the female awareness rates were 7.3%-96.9%. The levels of knowledge of birth defect prevention varied in different education level, per capita annual income of the family and careers. The awareness rates of the some items were increased with the education level (P < 0.05). The awareness rates of some items of cadres, teachers and doctors were higher than that of labors, farmers, businessmen and the other careers (P < 0.05). The awareness rates of some items were increased with per capita annual income of the family (P < 0.05). The responds understood the knowledge mainly through newspapers, radio and television and publicity materials and 90.2% of them wanted to get knowledge of birth defect prevention. Conclusion It is important to increase the publicity of birth defects prevention knowledge and provide the education varying from person to person, and a convenient and effective way of knowledge acquisition to improve the levels of the knowledge of birth defect prevention.
2018 Vol. 15 (18): 40-43,47 [
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Investigation and research on the current situation of training and management of clinical nurse specialist in Anhui Province
CHEN Xiaoyu QIAN Zhigang YANG Liying HU Manman SI Fei
Objective To investigate nurses training information and the use of hospital nurses and management status in Anhui Province. Methods The self-adapted linkt questionnaire was used to investigate the training and management of 315 students who had completed the training of specialist nurses from December 2015 to December 2016 by convenient sampling. Results A total of 9 specialist nurses training specialist nurses training field were opened in Anhui Province, 315 participants were from 113 hospitals above grade two. Among them, there were 33 hospitals in grade three, 80 in grade two hospitals. There was no difference of management satisfaction of specialist nurses in grade three and two hospitals (P > 0.05). The total score of job satisfaction of specialist nurses was (3.23±1.62)points, and job satisfaction was at a moderate level. The scores of hospital management mode, changes in work content, responsibilities, professional opportunities and income were lower. Conclusion The training of specialist nurses has been paid attention to, and full off training is still facing great difficulties. The training field of specialist nurses and the development of TCM nursing in the province should actively be expanded. Occupation development path of developing specialized nurses, improve nurses benefits, improve nurse certification system, promote the development of specialist nurses.
2018 Vol. 15 (18): 44-47 [
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The distribution and drug resistance of pathogenic bacteria of urinary tract infection in department of kidney disease of hospital of traditional Chinese medicine
LIU Guangzhong1 NI Wei1 YANG Liu1 XIAO Mingzhong2
Objective To investigate the differences between the pathogenic bacteria and drug resistance in patients with urinary tract infection from Department of Kidney Disease between Hubei Province Hospital of Traditional Chinese Medicine and other hospitals including western hospitals and hospitals of traditional Chinese medicine. To discuss the problems of Department of Kidney Disease in the prevention and control of hospital infection, put forward effective measures for reference. Methods The specimens of patients with urinary tract infection from Department of Kidney Disease in Hubei Province Hospital of Traditional Chinese Medicine from June 2016 to June 2017 were isolated and cultured, bacterial identification and drug susceptibility analysis were performed, and personal data was collected. Results The detection rate of pathogenic bacteria was 48.67% in patients with urinary tract infection from Department of Kidney Disease in Hubei Province Hospital of Traditional Chinese Medicine. The detection rate was lower than other hospitals including western hospitals and hospital of traditional Chinese medicine. Gram-negative bacilli, gram-positive cocci and fungi accounted for 71.31%, 25.14% and 3.55% respectively, and it was most common in escherichia coli, coagulase negative staphylococcus aureus and white candidiosis. The antibiotic resistance rate of gram-negative bacilli was 62.70%-75.00%. However, the drug resistance rate was only 35.68%-56.25% for the high grade antibiotics such as cefepime, aminotram and imipenem. The drug resistance rate of gram positive cocci to penicillin was 100.00%. The sensitivity of quinolone antibiotics and vancomycin was 0.00%-63.64%. The resistance rate of fungi to commonly used antibiotics was 80.00%. The drug resistance rate of amphotericin B was only 20.00%. Conclusion Compared with other western hospitals and hospitals of traditional Chinese medicine, the detection rate of pathogen in patients with urinary tract infection in Department of Kidney disease of Hubei Province Hospital of Traditional Chinese Medicine is low, most antibiotic resistance rate is better controlled, but the monitoring of multidrug resistant bacteria should be strengthened, the role of Chinese medical treatment in the prevention and control of hospital infection is emphasized.
2018 Vol. 15 (18): 48-51 [
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Effect of extracorporeal shock wave lithotripsy on non-target area blood flow and surface permeability in different parts of kidney stones and its effect comparison
ZHANG Weilin
Objective To explore the effect of high energy shock wave extracorporeal lithotripsy on patients with different parts of renal calculi. Methods A total of 168 patients with kidney stones in Department of Urology, First People′s Hospital of Huizhou from January 2015 to June 2017 were selected as the research objects and divided into the suprarenal calyx group (110 cases) and inferiorrenal calyx group (58 cases) according to position of the stone. All the patients were treated with high energy shock wave (E = 12-15 kV) for extracorporeal lithotripsy. According to the renal calculi, CT perfusion scanning was performed on the non-target kidneys in both groups before and after surgery. The non-target renal blood flow (BF), surface permeability (PS) changes, postoperative complications and the stone success rate were compared between the two groups. Results There were no statistically significant differences in the CT perfusion parameters of BF and PS in non-target areas between the two groups and within groups (P ＞ 0.05). There was no statistically significant difference in the total incidence of complications between the two groups (P ＞ 0.05). However, the incidence of colic and fever in the suprarenal calyx group were significantly higher than those of inferiorrenal calyx group, and the incidence of hematuria and stone streets in inferiorrenal calyx group were significantly higher than those of suprarenal calyx group, with statistically significant differences (P ＜ 0.05). The success rate of stone in the suprarenal calyx group was higher than that of inferiorrenal calyx group, with statistically significant differences (P ＜ 0.05). Conclusion High energy shock wave extracorporeal lithotripsy has less damage to non-target kidney in patients with different parts of renal calculus, but there are different postoperative complications in suprarenal renal calyx and inferiorrenal calyx. The effect of high energy shock wave extracorporeal lithotripsy in stone of suprarenal calyx is better than that of inferiorrenal calyx.
2018 Vol. 15 (18): 52-55 [
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Effect of single-row simple mattres suture and single-row modified Mason-Allen technique under arthroscopy in the treatment of small and medium rotator cuff injuries
HUANG Degang1 YANG Xin1 HE Huazheng1 LI Zhenwei1 QIAO Bin1 XU Hongguang2▲
Objective To compare the effect of single-row simple mattres suture and single-row modified Mason-Allen technique under arthroscopy in the treatment of small and medium rotator cuff injuries. Methods Twenty-eight patients with small and medium tearing injuries of the rotator cuff treated with arthroscopic surgery in the First Affiliated Hospital of Wannan Medical College from January 2014 to May 2017 were selected as the research object and divided into the single-row simple mattres suture group (13 cases, group A) and the single-row modified Mason-Allen technique group (15 cases, group B) by different treatment. The shoulder function was evaluated by ultrasonography for retearing rate, satisfaction rate, the scores of UCLA (University of California at Los Angeles, UCLA scoring system), Constant-Murley and visual analogue scale (VAS). Results All the patients were followed up and the time ranged from 6 to 24 months. There were no statistically significant differences in retearing rate, scores of UCLA, Constant-Murley and VAS before operation and at the last follow up (P ＞ 0.05); but the scores of Constant-Murley and VAS in the two groups at the last follow up were all significant higher than those of before operation, the score of VAS was significant lower than that before operation, with statistically significant differences (P ＜ 0.05). After operation, the satisfaction rate in the group B was higher than that of group A, with statistically significant difference (P ＜ 0.05). Conclusion Single-row simple mattres suture and single-row modified Mason-Allen technique are both clinically effective for shoulder function recovery, but the modified Mason-Allen technique may have better healing quality.
2018 Vol. 15 (18): 56-59 [
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The expression and clinical significance of TNF-α in serum and synovial fluid in patients with gouty arthritis
LAI Aiyun XU Jian TAO Li
Objective To study the expression and clinical significance of tumor necrosis factor-α (TNF) in serum and synovial fluid in patients with gouty arthritis (GA). Methods Eighty GA patients in First Affiliated Hospital of Kunming Medical University from December 2016 to November 2017 were selected as the observation group and then divided into two subgroups according to the severity of the disease: observation group 1 (36 cases, severe) and observation group 2 (44 cases, mild). Both were treated with colchicine and etoricoxib. Sixty healthy people were selected as the control group at the same time. The treatment outcome were record and the levels of TNF-α in serum and synovial fluid were detected in the three groups. The expression of TNF-α in serum and synovial fluid of patients with different therapeutic effects and during treatment were compared. Results Thirty-one cases were cured, 24 cases were markedly effective, 21 cases were effective, 4 cases were ineffective, the markedly effective rate was 68.75%. The TNF-α levels of serum and synovial fluid in the observation group 1 and group 2 at admission were significantly higher than those of the control group, with statistically significant differences (P ＜ 0.05). The level of TNF-α in synovial was significantly higher than that of serum in the observation group (P ＜ 0.05). At the treatment of 10 d and 2 weeks, the TNF-α level in serum and synovial fluid in the observation group 1 and group 2 were significantly lower than those of admission (P ＜ 0.05). The TNF-α level in synovial fluid in the effective group were significantly lower than that of ineffective group at admission and 2 weeks after treatment; 2 weeks after treatment, the TNF-α level in serum and synovial fluid were all higher than those of admission, with statistically significant differences (P ＜ 0.05). Conclusion The level of TNF-α in serum and synovial from GA patients are significantly higher than healthy people. To monitor the level of TNF-α in the synovial fluid of the affected limb is helpful to evaluate the therapeutic effect and guide clinical intervention.
2018 Vol. 15 (18): 60-63 [
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The effect comparison of two different internal fixation methods in the treatment of humeral shaft spiral fracture
SONG Qihe1 ZHANG Xiaozhou1 QIU Bo2
Objective To explore the clinical efficacy of interlocking intramedullary nail combined with the shape memory embracing fixator and the locking compression plate technique in the treatment of humeral shaft spiral fracture. Methods A total of 51 patients with humeral shaft spiral fracture in the Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2014 to January 2016 were selected as the research objects and divided into the IMN group (25 cases) and LCP group (26 cases) by random number table. The IMN group was treated with interlocking intramedullary nail combined with the shape memory embracing fixator and the LCP group was treated with locking compression plate. The operation time, the amount of bleeding, the function of the shoulder and the elbow joint [Neer score, hospital for special surgery knee score (HSS)] and the incidence of complications were compared between the two groups. Results There was no statistically significant difference in the operation time between the two groups (P ＞ 0.05). The total amount of bleeding in the IMN group was lower than that of LCP group, with statistically significant difference (P ＜ 0.05). After operation, the scores of Neer was lower than that of LCP group, and HSS was higher than that of LCP group, with statistically significant differences (P ＜ 0.05). One case of wound infection occurred in both groups after surgery. No delayed fracture healing, nonunion or radial nerve injury occurred 16 weeks after surgery in the IMN group. Conclusion The efficacy of interlocking intramedullary nail combined with the shape memory embracing fixator and the locking compression plate technique in the treatment of humeral shaft spiral fracture are good, but the former has better reduction, less trauma, less bleeding than those of the latter.
2018 Vol. 15 (18): 64-67,71 [
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Effect of laparoscopic ovarian endometriosis cyst peeling surgery combined with Leuprolide on the ovarian reserve function of patients with ovarian endometriosis
MIN Aiping WU Yu
Objective To discuss the effect of laparoscopic ovarian endometriosis cyst removal surgery combined Leuprolide on the ovarian reserve function of patients with ovarian endometriosis cyst. Methods A total of 112 patients with ovarian endometriosis cyst for operation treatment in Department of Gynaecology and Obstetrics of the People′s Hospital of Leshan were chosen from January 2013 to December 2015, which were divided into observation group and control group according to random number table method, 62 cases in the observation group , while 50 cases in the control group. The control group was treated with laparoscopic ovarian endometriosis cystectomy treatment, and the observation group was treated with Leuprolide on the base of the treatment of the control group with 3 cycles. Levels of anti Mullerian hormone serum follicle stimulating hormone (FSH), estradiol (E2), and CA125 were detected by radioimmunoassay. After 1 year of follow-up, the recurrence rate of cysts and ovarian reserve function were counted. Results The levels of AMH, FSH, E2 at preoperative and postoperative after 1 year had no statistical significance (P > 0.05). The number of basal follicles, ovarian volume and peak systolic flow velocity observed by transvaginal ultrasound were no significant difference between the two groups postoperative after 1 year (P > 0.05). And there was also no significant difference in the preoperative CA125 level between the two groups (P > 0.05). The levels of serum CA125 of the observation group was significantly lower than that of the control group 1 year after operation (P < 0.05). CA125 levels of the two groups between preoperation and postoperation were compared, and the differences were all statistically significant (P < 0.05). The recurrence rate of the observation group was lower than that of the control group 1 year after operation, the difference was statistically significant (P < 0.05). Conclusion Laparoscopic ovarian endometriosis cyst peeling surgery combined with Leuprolide can reduce the recurrence rate, and has no significant effect on ovarian reserve function, so it is worth in clinical promotion.
2018 Vol. 15 (18): 68-71 [
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Clinical efficacy of Chuankezhi Atomization Inhalation in adjuvant therapy for respiratory syncytial virus bronchiolitis in infants
YAO Qiang
Objective To explore the clinical effect of Chuankezhi Atomization Inhalation in adjuvant therapy for respiratory syncytial virus bronchiolitis in infants. Methods Ninety infants with respiratory syncytial virus bronchiolitis from June 2015 to February 2017 in Maternity Hospital of Hangzhou City were selected and divided into two groups according to the random number table method, with 45 cases in each group. Patients in the control group were treated with clinical routine treatment plus Montelukast Chewing Tablets, while patients in the observation group were treated with Chuankezhi Atomization Inhalation on the basis of the control group. After treatment for 7 d, the pulmonary function indices (respiratory rate, tidal volume, peak tidal expiratory flow, inhalation time/total breathing time, serum cysteine), the level of inflammatory cytokines (CysLTs, LTE4), and the immune function index (CD4+/CD8+, T-IgE) of two groups were compared before and after treatment, and the total effective rate of the clinical treatments in two groups was calculated. Results The total effective rate of the observation group was 93.3%, higher than that of the control group (77.8%), the difference was statistically significant (P < 0.05). The value of RR and Ti/Tt in the observation group were significantly lower than those in the control group, the value of TV and tPTEF/tE were significantly higher than those in the control group, the differences were statistically significant (P < 0.05). The levels of serum LTE4 and CysLTS in the observation group were significantly lower than those of the control group, the differences were statistically significant (P < 0.05). The CD4+/CD8+ in the observation group was significantly higher than that of the control group, and the T-IgE was significantly lower than the control group, the differences were statistically significant (P < 0.05). Conclusion The application of Chuankezhi Atomization Inhalation in adjuvant therapy for respiratory syncytial virus bronchiolitis in infants can inhibit airway inflammatory reaction and improve lung function and immune function.
2018 Vol. 15 (18): 72-75,91 [
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Long-term efficacy and safety of Oulongma Drops in children with nasal-sinusitis
MENG Xiangtao1 YANG Xiao2
Objective To explore the long-term efficacy of Oulongma Drops in children with nasal sinusitis and to analyze the safety of treatment. Methods A total of 300 cases of nasal-sinusitis were enrolled in Zhuozhou City Hospital from January 2016 to January 2017. They were divided into 100 cases of group A, B and C according to the random number table, patients of the group A and group B were treated with Oulongma Drops, 1-6-year-old children of group A with starting dose of 4 mL/time, after 5 d adjusted to 2 mL/time, >6-12 years old children 6 mL/time, after 5 d to 3 mL/time, 1-6 years old children of group B were given the dose of 2 mL/time, >6-12 years old mL/time, group C was given Mu Shu Tan syrup treatment, 1-6 children 2.5 mL/time, >6-12 years old 5 mL/time. The clinical efficacy of the two groups in 1 and 3 months after treatment were observed, and the recurrence rate was analyzed after 8 months follow-up. The nasal, mucosal hyperemia, sleep disorders, runny nose scores were assessed by the nasal sinus outcome test-20 (SNOT-20) scale and the adverse events were recorded. Results The total effective rates of group A and group B were 90.0% and 89.0% respectively, which were higher than that of group C (72.0%), the difference was statistically significant (P < 0.05). The total effective rate of group A, B and C after 3 months was 88.0%, 86.0%, 61.0%, and the recurrence rate was 2.0%, 3.0% and 11.0% respectively， the total effective rate of group C was lower than that of A and B group, the recurrence rate was higher than that of group A and B, the differences were statistically significant (P < 0.05). The scores of nasal congestion and mucosal congestion were lower in group A and group B than those in group C (P < 0.05). The incidence of adverse reactions in group B was 2.0%, which was lower than that in group A and group C (9.0%, 9.0%), the difference was statistically significant (P < 0.05). Conclusion Compared with the Mu Shu Tan syrup, the Oulongma Drops can further improve the nasal sinusitis in children with symptoms, curative effect is distinct, the small dosage of medicine not only can obtain ideal therapeutic effect, but also with low incidence of adverse reactions, worthy of clinical promotion.
2018 Vol. 15 (18): 76-79 [
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Levels and clinical significances of serum 25-hydroxyvitamin D3, IL-10 and IL-17 in children with recurrent upper respiratory infection
LIU Wei
Objective To investigate the levels and clinical significances of serum 25-hydroxyvitamin D3 [25(OH)D3], interleukin-10 (IL-10) and interleukin-17 (IL-17) in children with recurrent upper respiratory infection (rURTIs). Methods A total of 60 children with rURTIs in Beijing Luhe Hospital, Capital Medical University from August 2016 to August 2017 were selected as the infection group, 60 healthy children during the same period were selected as control group. Enzyme-linked immunosorbent assay was used to detect levels of serum 25(OH)D3, IL-10 and IL-17. The expression levels of serum 25(OH)D3, IL-10 and IL-17 in two groups were compared. The relationships among three indices and the clinical significances with rURTIs were observed. Results The levels of serum 25(OH)D3 and IL-10 in rURTIs in infected group were significantly lower than those in control group, while the level of IL-17 was significantly higher than that in the control group, the differences were all statistically significant (P < 0.01); the levels of serum 25(OH)D3 and IL-10 of rURTIs in infected children of 0-2 years old were significantly lower than those of ＞2-6 years old ones, the level of IL-17 was significantly higher than that of ＞2-6 years old ones, and the differences were all statistically significant (P < 0.01). Pearson correlation analysis showed that the serum 25(OH)D3 was positively correlated with IL-10 in children with rURTIs (r = 0.647, P = 0.000), and had significant negative correlation between serum 25(OH)D3 and IL-17 in children with rURTIs (r = -0.774, P = 0.000), and had significant negative correlation between serum IL-10 and IL-17 in children with rURTIs (r = -0.467, P = 0.000). Multivariate analysis of COX showed that age, BMI, 25(OH)D3, IL-10 and IL-17 were independent influnce factors to rURTIs (P < 0.05). Conclusion The levels of serum 25(OH)D3 and IL-10 decrease, while the level of IL-17 increase significantly in children with rURTIs. 25(OH)D3 deficiency may be an important reason for the down-regulation of serum IL-10 and the up-regulation of IL-17 in children with rURTIs.
2018 Vol. 15 (18): 80-83 [
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Relationship between HPV subtype 33 positive and high-grade cervical lesions
LI Ran YIN Xiaojun▲ LI Ying
Objective To study the correlation of high-risk human papillomavirus (HPV) subtype 33 positive and high-grade cervical lesions. Methods A total of 380 patients with cervical screening abnormalities, who received cervical biopsy in colposcopy clinic in the Second Hospital of Kunshan from January 2015 to January 2018 were collected and the relationship between HPV subtype 33 positive and high-grade cervical lesions were studied. Results All 380 women enrolled in this study, a total of 220 cases was cervical benign lesions, 20 cases were single type HPV33 infection, a total of 92 cases was LSIL, 12 cases were single type HPV33 infection, a total of 68 cases was LSIL, 20 cases were single type HPV33 infection. The infection rates of single type HPV33 infection in different groups were 9.1%, 13.3%, 29.4%. With the aggravation of cervical lesions, infection rates of single type HPV 33 gradually increased, the difference was statistically significant (χ2 = 18.097, P = 0.000). In patients of single type HPV 33 infection, the abnormality of TCT increased with the aggravation of cervical lesions, but the difference was not statistically significant (χ2 = 2.708, P = 0.258). Conclusion Patients with single type HPV 33 infection maybe receive colposcopy as soon as possible, and powerful interventions should be taken to block the progression of cervical diseases to cancer.
2018 Vol. 15 (18): 84-87 [
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190
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Adjuvant therapeutic effect of Clostridium butyricum powder on neonatal pathological jaundice
LI Yan
Objective To investigate the clinical efficacy of oral administration of Clostridium butyricum powder in the treatment of neonatal pathological jaundice. Methods Eighty term newborns with pathological jaundice born in the Department of Pediatrics of People′s Hospital of Dachang Hui Autonomous County from January 2015 to January 2016 were selected, and they were divide into control group and observation group by randomized digital table, with 40 cases in each group. The newborns in the control group were received routine treatment such as blue light therapy and liver enzyme inducer. In the observation group, the neonates were taken twice daily on the basis of conventional treatment, and 500 mg of Clostridium butyricum powder was taken daily for 5 days. The changes of serum total bilirubin levels before and after treatment were observed in both groups, and the daily bilirubin levels, peak bilirubin concentrations, duration of jaundice, and yellowing of the inner tube within 72 h were compared. Results There was no significant difference in serum total bilirubin levels between the two groups before treatment (P > 0.05). After treatment, the peak serum bilirubin concentration in the observation group was significantly lower than that in the control group, and the incidence of newborns with hyperbilirubinemia was 17.5%, which was lower than that of the control group (40.0%), the difference was statistically significant (P < 0.05). The daily decrease in neonatal serum bilirubin in the observation group was significantly higher than that in the control group, the difference was statistically significant (P < 0.01). After treatment, the duration of jaundice in the observation group was significantly shorter than that of the control group and the rate of yellowing of the inner tuberculosis within 72 h after birth was significantly higher than that of the control group, the difference was statistically significant (P < 0.05). Conclusion Oral administration of Clostridium butyricum powder, as an adjuvant therapy, can effectively reduce the level of bilirubin in the serum of pathological jaundice newborns and shorten the duration of neonatal jaundice, and it is worthy of clinical application.
2018 Vol. 15 (18): 88-91 [
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Comparative study of MRI and pathological manifestations of ovarian diseases with pedicle torsion
WANG Ya1 WANG Qiang1 ZHENG Xiaoling2 GONG Miaomiao1 YANG Yigang1 WANG Zhong1
Objective To evaluate MRI manifestations of ovarian diseases with pedicle torsion and promote the knowledge and diagnostic level. Methods The MRI manifestations of 12 patients with pedicle torsion of ovarian diseases which were confirmed by surgery and pathology from March 2012 to March 2017 in Dongguan Maternal and Child Health Care Hospital were retrospectively analyzed. The twisted pedicles, signal characteristic of the diseases and vascular changes near by the torsion were studied. The MRI manifestations of torsional positio and torsional degrees of pedicle were investigated. Results Twelve patients were benign ovarian lesions. The torsion pedicle which was solid mass-like structures showed irregular long soft tissue (n = 6), with round and circle shape (n = 4), and nodular shape (n = 2), 10 with vascular signal. The lesions were cystic or cystic-solid, which proved eccentric wall thickening, and with hemorrhage. The pedicle torsion was composed of the ovarian ligament and the oviduct (n = 10); the lesion turned in up and down direction (n = 6); the lesion turned in inside and outside direction (n = 4). The pedicle torsion was composed of the ovary between the lesion (n = 2). MRI show cord-like structure, ring like structure with vascular signal diagnosis torsion with diagnostic coincidence was 92% in the combined of eccentric thickening. The wall of the torsional which was twisted half circle was slightly thickened, and 2-5 circles was eccentric wall thickening, 5 circles was most thicken. The artery was enlarged which was twisted 5 circles. Conclusion Ovarian diseases pedicle torsion have some MRI characteristic manifestations, understanding the location of the torsion, distinguishing the severity of torsion (different twisted turns).
2018 Vol. 15 (18): 92-95 [
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Application of pedicled buccal fat tissue flap for buccal mucosa defect repair and its healing effect
KANG Jing1 LI Zhao2▲ ZHANG Yanxia3 MA Chao4 WANG Hong5
Objective To investigate the application of pedicled buccal fat tissue flap in the repair of buccal mucosal defects and its healing effect. Methods A total of 90 patients with buccal mucosa defects treated in the General Hospitial of Jizhong Energy Fengfeng Group from August 2015 to August 2017 were selected and divided into control group (n = 45) and observation group (n = 45) according to the repair protocol. The control group was treated with tongue flap repair surgery, and the observation group was treated with autologous pedicle buccal fat pad tissue flap. Both groups were repaired for 3 months and the repair effect was evaluated after the repair. The diameter of wounds in the two groups before and 1, 2 months and 3 months after the repair and tissue flap necrosis, opening restriction, dyskinesia and edema incidence at three months after repair were recorded and counted, and the repair effect of two groups and the effect on the healing effect were compared. Results There was no significant difference in the diameter of wounds between the observation group and the control group before repair (P > 0.05). The defect wounds in the observation group and the control group at 1, 2 months and 3 months after the repair were smaller than those before the repair (P < 0.05); the defect wounds in the observation group at 1, 2 months, and 3 months after repair were all smaller than those in the control group (P < 0.05). Three months after the repair, the incidences of necrosis, opening limitation, dyskinesia and edema were all lower than those in the control group (P < 0.05). Conclusion The pedicled buccal pad flap is ideal for the repair of buccal mucosal defects. It can shorten the diameter of the wound and the incidence of postoperative complications, which is worthy of clinical application.
2018 Vol. 15 (18): 96-99 [
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Reasons of visual impairment and cataract surgical rate of elder people aged 60 years old or more in Shuxin Town, Chongming District, Shanghai
HUANG Yue1 YE Jingying1 ZHANG Qian1 ZHENG Yan1,2▲
Objective To analyze the reasons of visual impairment and cataract surgical rate of elder people aged≥60 in Chongming District, Shanghai，for evaluating the blindness and low vision status and the efficacy of the prevention blindness program in this district. Methods By ophthalmic screening and questionnaire surveying, people aged 60 years old or more were selected for the study in Shuxin Town, Chongming District, Shanghai from October 2016 to December 2017. Results In this study, 6016 notifications were distributed to people in 20 villages of Shuxin Town and actually 4260 cases (70.81% of people aged 60 years old or more) participated in the screening. The common oculopathy affecting vision were cataract (2182 cases, 51.22%), retinopathy（473 cases,11.10%）, glaucoma (443 cases, 10.40%), pterygium (175 cases, 4.11%), keratonosus (154 cases, 3.60%) and the other diseases (including injury, old uveitis, ptosis and high myopia,21 cases, 0.49%). The surgical rate in mild cataract (corrected vision≥0.5) was 11.90%, moderate cataract (0.3≤ corrected vision﹤0.5) was 12.83% and severe cataract (corrected vision﹤ 0.3) was 23.87%. In this town, among all the individiuals aged≥60, the rate of monocular blindness and low vision was 2.79%,7.74% respectively, and the rate of bilateral blindness and low vision was 1.87%, 5.99% respectively. Conclusion At the current stage, cataract was still the primary oculopathy which impairs the vision of people aged 60 years old or more in Chongming District, Shanghai. Particularly, the surgical rate was still very low in severe cataract that affects normal life. All the governments should pay attention and the medical workers should strengthen the propaganda and education among patients in order to screen and treat them timely, and consequently, the population of people who are reduced to poverty due to diseases can drop dramatically.
2018 Vol. 15 (18): 100-102,107 [
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195
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Analysis on redistributive effect of income from healthcare financing in rural Guangxi after the universal coverage of New Cooperative Medical Scheme
QIN Xianjing WEI Bo FENG Qiming▲
Objective To access the redistributive effect of income from healthcare financing in Guangxi. Methods Two counties of a city in Guangxi were selected as samples to analyze the demographic data and household expenditure data from 2009 to 2013, Aronson, Johnson and Lambert model, employed to demonstrate the vertical and horizontal equal effect of the healthcare financing in rural Guangxi. Results The Kakwani index of tax in 2009 and 2013 were -0.0135 and 0.0013, respectively; the Kakwani index of social insurance were -0.3488 and -0.2125, respectively; the RE value were -0.0907 in 2009 and -0.0393 in 2013; the Kakwani index of out of pocket payment were 0.1055 and -0.1706, and the redistribution analysis showed that domination of the inequity of OOP changed from horizontal inequity to vertical inequity. Conclusion The health financing of rural Guangxi in 2009 and 2013 haven′t achieved a good income redistribution effect, vertical inequity and horizontal inequity both exist, and horizontal unfairnessplays a dominated role. The financing system needs to adjust and optimize the resource in a better way, and the new rural cooperative medical system needs more effective enhancement and equity construction in the future.
2018 Vol. 15 (18): 103-107 [
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221
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Application of HPLC in the verbascoside content determination of Wenshen Xiaozhong Pills
TANG Anfu CUI Enzhong GONG Lei TANG Hao WANG Shudong GONG Guangming
Objective To establish a method for the verbascoside content determination in Wenshen Xiaozhong Pills. Methods High performance liquid chromatography method was used with Hedera-ODS-2 C18 column (250 mm×4.6 mm, 5 μm) and a mobile phase of acetonitrile-0.8% glacial acetic acid (19∶81). Flow rate was 1.0 mL/min, the detection wave length at 334 nm, column temperature was 25℃ and sample loop volume was 10 μL. Results The calibration curve was linear within the range of 6.33-101.28 μg/mL of verbascoside, the average recovery was 100.06% (RSD = 1.51%). Conclusion This method is simple, reliable and repeatable, which can be used for the quantitation control of Wenshen Xiaozhong Pills.
2018 Vol. 15 (18): 108-110,119 [
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228
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Tanshinone ⅡA Sulfonate Sodium Injection for patients with heart failure: a systematic evaluation
ZHENG Chaoyang LAI Renkui PAN Guangming QU Yuchun TANG Boyan
Objective To evaluate the clinical comprehensive therapeutic effect of TanshinoneⅡA Sulfonate Sodium Injection plus western medicine in the treatment of chronic heart failure. Methods Databases including PubMed, Cochrane library, EMbase, CNKI, WanFang, CBM and VIP from the inception to July 2016 were electronically searched. Randomized clinical trials of TanshinoneⅡA Sulfonate Sodium Injection for heart failure were enrolled. According to document screening and quality evaluation, valid data was put in Meta-analysis. Results Sixteen RCTs involving 1248 cases were included. The results of Meta-analysis showed that clinical comprehensive effect (RR = 1.22, 95%CI: 1.16-1.29, P ＜ 0.000 01), left ventricular ejection fraction (LVEF) (MD = 7.65, 95%CI: 4.89-10.41, P ＜ 0.000 01), plasma brain natriuretic peptide (BNP) (MD = -172.06, 95%CI: -260.65 - -83.47, P = 0.0001), left ventricular end diastolic dimension (LVEDD) (MD = -4.60, 95%CI: -5.98 - -3.23, P ＜ 0.000 01), E/A (MD = 0.20, 95%CI: 0.16-0.24, P ＜ 0.000 01) of routine treatment combined with TanshinoneⅡA Sulfonate Sodium Injection were better than those of routine treatment, there were statistically significant differences (P ＜ 0.05). Conclusion Compared with routine treatment, combining with TanshinoneⅡA Sulfonate Sodium Injection has better clinical comprehensive effect for heart failure, while multi-center, large sample randomized controlled trials are still needed to confirm this conclusion.
2018 Vol. 15 (18): 111-115 [
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The effect of Octreotide and somatostatin in adjuvant therapy of non biliary acute moderate and severe pancreatitis and its influence on inflammatory mediators
WANG Xuwei ZHANG Fubin LI Jun ZHANG Zunqi ZHANG Shiteng
Objective To compare the efficacy of Octreotide and somatostatin in adjuvant therapy of non biliary acute moderate and severe pancreatitis and its influence on inflammatory mediators. Methods One hundred and eighteen cases of non biliary acute moderate and severe pancreatitis treated in PLA 105 Hospital from October 2015 to March 2017 were selected as research objects and divided into group A (61 cases) and group B (57 cases) according to random number table method. On the basis of routine treatment, group A and B were treated with Octreotide and somatostatin respectively for 7 days, and the recovery time of clinical indices, efficacy and complications of the two groups were compared. Results The recovery time on abdominal pain, fever, white blood cell count, serum amylase and the mean hospitalization time between the two groups had no significant differences (P ＞ 0.05). After treatment for 7 days, the differences on decreased acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores of the two groups were not statistically significant (P ＞ 0.05). The overall efficacy of the two groups had no significant difference (P ＞ 0.05); the decreased values of the two groups on tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-8, high-sensitivity C-reactive protein (hs-CRP) showed no statistically significant difference (P ＞ 0.05). The incidence of pancreatic pseudocyst, pulmonary infection, gastrointestinal bleeding, respiratory failure, flatulence in the two groups had no significant differences (P ＞ 0.05). Group A had a lower hypoglycemia rate than that of group B (P ＜ 0.05). Conclusion Octreotide and somatostatin in adjuvant therapy of non biliary acute moderate and severe pancreatitis has similar efficacy, both can significantly reduce inflammatory mediators, but hypoglycemia incidence is higher than that of somatostatin treatment.
2018 Vol. 15 (18): 116-119 [
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Study on TCM syndrome elements identification scale for chronic gastritis
ZHENG Sisi1 LI Junxiang2 WANG Yunliang2 WEN Zhanquan3 WANG Li3 HAN Aiqing3
Objective To establish a TCM syndrome elements identification scale for chronic gastritis. Methods The item pool of TCM symptoms for chronic gastritis was made. The four diagnostic data of 243 outpatients with chronic gastritis in Dongfang Hospital Affiliated to Beijing University of Chinese Medicine from January 2013 to December 2016 was collected, of which, TCM syndrome elements having over 5% occurrence frequency were retained. TCM syndrome elements were extracted based on complex system entropy cluster. Statistical software SPSS 20.0 was used to analyze the data, and logistic regression of forward (conditional) method was used for the selection of scale items, so as to form item pool. Binary logistic regression analysis was used to confirm the weight coefficient of all symptoms, then receiver operating characteristic (ROC) curve was used to confirm the diagnostic threshold of all syndrome elements. Results Through items screening, a total of 36 significant items were retained, on basis of which, the TCM syndrome elements identification scale for chronic gastritis was established. There were 9 syndrome elements in the scale, including qi-stagnation, qi-deficiency, fire-heat, dampness, yin-deficiency, yang-deficiency, blood stasis, cold and phlegm. The diagnostic threshold score was 60 points. Conclusion The development of TCM syndrome elements identification scale for syndrome factors of chronic gastritis is an effective exploration for standardization of chronic gastritis syndrome.
2018 Vol. 15 (18): 120-123 [
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233
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Research review and reconsideration of Yin Shan Zheng Yao from the perspective of traditional Chinese medicine
LI Jinghua1 YAO Ziang2 ZHONG Fengying1 ZHAI Xing3 WANG Ping3
Throughout the past half century, the study about Yin Shang Zheng Yao is mainly based on historical data and ethnic culture, and the most of them involved medicated food, diet therapy and health care. There are few researches on the connotation of traditional Chinese medicine. This article bases on the present researches on Yin Shang Zheng Yao, and in the perspective of connotation of traditional Chinese medicine discusses, thinks and summarizes its achievements, that hopes to play a positive role to discovery precious information of ethnic traditional Chinese medicine and promote the development of ethnic traditional Chinese medicine.
2018 Vol. 15 (18): 124-126 [
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Clinical efficacy and safety of acupuncture combined with Buyang Huanwu Decoction in the treatment of refractory facial paralysis
TANG Zhengdong CUI Huashun SHEN Weidong
Objective To observe the clinical efficacy and safety of acupuncture combined with Buyang Huanwu Decoction in the treatment of refractory facial paralysis. Methods Seventy patients treated for refractory facial paralysis in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2013 to December 2016 were selected, and divided into treatment group (35 cases) and control group (35 cases) by random number table method. The control group was treated with acupuncture therapy, while the treatment group was treated with Buyang Huanwu Decoction based on the treatment of control group, all the patients were treated for 1 month. The TCM syndrome score, facial nerve function rating scale and facial disability index score were recorded, the total effective rate and incidence of adverse events were observed. Results After 1 month of treatment, the total effective rate of the treatment group was 88.57%, which was higher than that of the control group (74.29%) (P ＜ 0.05). After treatment, the TCM symptom scores of the two groups were lower than those before treatment, and the score of treatment group after treatment was lower than that of the control group (P ＜ 0.05). The neurological function classification of the two groups after treatment was improved compared with those before treatment. After treatment, the neurological function classification of the treatment group was better than that of the control group (P ＜ 0.05). Facial disability index score and physical function social of the two groups were higher than those before treatment, and the score of the treatment group was higher than the control group (P ＜ 0.05). There was no statistically significant difference of adverse events between treatment group and control group (P ＞ 0.05). Conclusion Acupuncture combined with Buyang Huanwu Decoction can significantly improve symptoms, facial nerve function and facial disability index of refractory facial paralysis patients. Exact efficacy and good safety of the treatment therapy lay a solid foundation for the wide promotion.
2018 Vol. 15 (18): 127-130 [
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Influence of Xiaoqinglong Decoction on airway inflammation and clinical outcome of patients with chronic obstructive pulmonary disease
LEI Peishan SU Xiaoyin WANG Qiang WU Zhijian
Objective To discuss the influence of Xiaoqinglong Decoction on airway inflammation and clinical outcome of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 118 cases of patients with AECOPD admitted to Panyu Hospital of Chinese Medicine in Guangzhou City from January 2017 to January 2018 were enrolled as objects and divided into different groups according to critical degrees of arterial blood gas. 60 AECOPD patients without respiratory failure were included in non-respiratory failure group and 58 AECOPD patients with type Ⅱ respiratory failure were included in respiratory failure group. They were in depth grouped by random number table method: 30 cases in non-respiratory failure observation group, 30 cases in non-respiratory failure control group; 30 cases in respiratory failure observation group, 28 cases in respiratory failure control group. All patients were given standard treatment of western medicine treatment; patients of observation groups were given Xiaoqinglong Decoction for 21 days on the basis of the treatment above. Procalcitonin (PCT), interleukin 6 (IL-6) and C-reaction protein (CRP) were detected before and after treatment and 90-day follow-up was done. Serum IL-6, body mass index, airflow obstruction, dyspnea, and exercise capacity index (BODE index) at 30th, 60th, 90th day were monitored. The acute attack frequency of COPD and death events were recorded. The indices above in the observation group and control group, two observation groups and four groups were compared respectively. Results The differences in serum IL-6 and BODE index before treatment among four groups were statistically significant, and the indices were higher and the disease condition was worse in the respiratory failure group (P ＜ 0.05). The differences in serum PCT, CRP, IL-6 and BODE index between non-respiratory failure observation group and non-respiratory failure control group before treatment (first day) were not statistically significant (P ＞ 0.05). The serum CRP at 7th day and IL-6 at 90th day of non-respiratory failure observation group were decreased more obviously than those of control group, the differences were statistically significant (P ＜ 0.05). The BODE index at 90th day of non-respiratory failure observation group was improved more obviously compared with that of control group (P ＜ 0.05). The differences in serum PCT, CRP, IL-6 and BODE index between respiratory failure observation group and respiratory failure control group before treatment were not statistically significant (P ＞ 0.05). The serum PCT and CRP at 7th day of respiratory failure observation group was decreased more obviously compared with that of control group, there was statistically significant difference (P ＜ 0.05); the serum IL-6 at 30th day and 90th day were decreased more remarkably compared with those of control group, the differences were statistically significant (P ＜ 0.05). The BODE index of respiratory failure observation group at 30th, 60th, 90th day improved more obviously compared with those of control group, the differences were statistically significant (P ＜ 0.05). The number of patients that suffered from acute exacerbation of COPD in respiratory failure observation group in 90 follow-up days was less than that of control group (P ＜ 0.05). The differences in serum PCT and CRP between two observation groups before treatment were not statistically significant (P ＞ 0.05), and the difference in serum PCT at 7th day of treatment was not statistically significant (P ＞ 0.05). The difference in patients that suffered from acute exacerbation of COPD between two observation groups in 90 follow-up days was not statistically significant (P ＞ 0.05). Conclusion Xiaoqinglong Decoction can improve airway inflammation of AECOPD patients, reduce acute exacerbation frequency of AECOPD with type Ⅱ respiratory failure, and improve survival quality and clinical prognosis of AECOPD patients.
2018 Vol. 15 (18): 131-135,139 [
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Clinical experience of professor Qiu Xiaotang in treating hyperuricemia
ZHOU Hongzheng QIU Xiaotang
Along with “preventing disease from exacerbating” thought of “preventive treatment of disease”, and in combination with years of clinical experience of professor Qiu Xiaotang, he summarizes pathogen and pathology of TCM in hyperuricemia. He promotes that the pathogenesis of this disease is wet phlegm stagnating the blood. It should be treated by principles as “dispelling wet muddy, regulating qi, dredging collaterals, and clearing heat”. His modified prescriptions are usually based on Simiao Powder, and he founded Huashi Jiangzhuo Decoction, in which Rhizoma Smilacis Glabrae and Radix Clematidis are put in high dose, with significant hypouricemic effects. The whole prescription plays the roles of eliminating dampness, invigorating the circulation of blood and tendons.
2018 Vol. 15 (18): 136-139 [
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The experience of professor Li Guodong in treating melanosis coli from the perspective of blood stasis
HE Yinghua1 XU Jia2 JIA Fei1 ZHI Jianwen1 FENG Lipeng1 YANG Yi1 LI E1
Melanosis coli (MC) has no equivalence name in traditional Chinese medicine (TCM), so it is ascribed to “constipation” “abdominal distension”, and so on according to clinical manifestations. Professor Li Guodong proposes that MC is a result of wrong treatment that brings the deficiency of qi and blood, the deficiency gives rise to blood stasis, which is the real reason of MC. In the treatment of MC, professor Li Guodong aims at activating blood circulation and removing stasis, strengthening spleen and kidney, nourishing qi, so as to achieve the effects of activating blood circulation and removing stasis, loosening the bowel to relieve constipation. Removing stasis can shorten the course of MC. During the course of treatment based on syndrome differentiation, professor Li Guodong pays attention to the qi and blood of whole body, makes good use of modified Taohong Siwu Decoction according to different syndromes, so as to nourish blood, activate blood, and remove stasis, with ideal clinical efficacy.
2018 Vol. 15 (18): 140-142 [
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Professor Cui Shusheng′s experience summary in digital acupoint pressure of Shenque, Tianshu and Qihai
JIANG Mengjia1 DING Honglei2 YOU Lu3 ZHANG Xu4 LI Luguang5 CUI Shusheng6▲
Digital acupoint pressure of Shenque, Tianshu and Qihai, which is an important part of professor Cui Shusheng's characteristic treatment for acute lumbar sprain, and it is also the key to the work. Professor Cui Shusheng emphasizes the combination of trembling manipulation and acupoint pressure, acupoint Tianshu as deep as Shenque, acupoint Qihai to set the qi in motion and dissipate the stasis, also to transfer the heat into body. It commands doctors to be calm, dexterity, steady and quiet when using the acupuncture point to achieve the effect of softness, thickness and penetration. Professor Cui Shusheng chooses Shenque, Tianshu and Qihai according to syndrome differentiation to get yang from yin, which treats the pain caused by the irregular flow of the qi. It reflects the core idea of TCM overall view and dialectical treatment, and its clinical effect is remarkable.
2018 Vol. 15 (18): 143-146 [
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Stellate ganglion block guided by ultrasound used on breakthrough pain of herpes zoster in the head and neck: a case report
ZHOU Hongmei ZHANG Jiannan PEI Yanfang CAI Liangyu▲
Stellate ganglion block is usually applied in the treatment of postherpetic neuralgia around the head and neck. In this case, a 64-year-old woman was adimitted to hospital for the pain in the left earlobe and occiput for 4 d, erythema and herpes in left neck for 1 d. The herpes zoster was located on the left neck and shoulder, but in the left earlobe and occipital area, the herpes disappeared and were mainly painful. The pain was paroxysmal, and the score of visual analogue scale during breakthrough was 10 and the intermittent period was 4. The therapy was combined with anti-virus, neuro nutrition and analgesia. After one performace of stellate ganglion block guided by ultrasound, the patient derived excellent relief from pain. The purpose of this paper is to summarize the experiences of this kind of disease and give a guidance for diagnose and treatment in pain clinic.
2018 Vol. 15 (18): 147-149 [
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Thoughts on improving the development of medical care and pension institutions in China
XU Guanghao LI Chuanshi CUI Ruilan
With the increasing problem of aging in China, the demand for diversified and professional care and care of the elderly is increasing. However, the separation of “medical” and “raising” for the elderly in our country has caused the elderly to be very prominent in the maintenance demand problem. The path of “Integrating pension service with medical service” is an inevitable choice to alleviate the current severe and healthy aging situation. At present, it is urgent to break through the following difficult problems in the health and continuous development of medical care and pension institutions in China: the problem of occupancy and operation, the management of the government, the difficulty of implementing the policy, the shortage of talent resources, the single service mode and so on. In this paper, to solve the above problems, some suggestions are put forward, including encouraging the participation of the social forces, improving the government management mechanism, strengthening the construction of the talent team and innovating the mode of service for the aged. It is of great significance to improve the development of medical care and pension institutions, to solve the serious problems of the old age, to accelerate the implementation of the “healthy China” strategy, to boost the process of building a well-off society in an all-round way and to enhance the people's sense of gain and happiness.
2018 Vol. 15 (18): 150-153 [
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Application and clinical significance of renal oxygen saturation monitoring in infants with noncyanotic congenital heart disease surgery
XIE Yuetao XING Dajun▲ YAO Cuicui MA Xinggang WANG Change
Objective To explore the clinical significance of continuous renal oxygen saturation monitoring. Methods Fifty cases 3 months - 3 years old children with acyanotic congenital heart disease accepted surgical treatment from January to November 2017 in Shenzhen Children Hospital were selected. Sufentanil Sevoflurane inhalation combined with tracheal intubation anesthesia were used. At the time point of before anesthesia (t0), 5 min after anesthesia (t1), 5 min after operation (t2), 5 min after cardiopulmonary bypass (t3), 15 min after cardiopulmonary bypass (t4) the beginning of CPB, after open aortic 5 min (t5), 5 min after closing the anaesthesia machine (t6) and ending of the surgery (t7), the renal regional oxygenation saturation (RrSO2), cerebral regional oxygen saturation (CrSO2), mean arterial pressure (MAP), the nose temperature and rectal temperature and other changes were recorded. Results At the time point of t3, t4, t5, t6, t7, RrSO2 and CrSO2 were higher than t0, the differences were statistically significant (P < 0.05). RrSO2 was positively correlated with CrSO2 (r = 0.682, P = 0.000), and RrSO2 was positively correlated with MAP (r = 0.258, P = 0.061), and negatively correlated with nose temperature, rectal temperature （r = -0.169, -0.166, P = 0.083, 0.101). There was a positive correlation between CrSO2 and MAP (r = 0.287, P = 0.076), CrSO2 was negatively correlated with nose temperature, rectal temperature (r = -0.177, -0.180, P = 0.064, 0.097). There was no significant difference in PO2, blood lactate and urea nitrogen before and after systemic circulation after systemic circulation. There was no significant difference in PCO2, PO2, blood lactate and urea nitrogen between before systemic circulation, during systemic circulation, after systemic circulation (P > 0.05), comparison between any two means, the differences were not statistically significant (P > 0.05). Conclusion Renal oxygen saturation monitoring can be used as a new renal oxygenation monitoring application in infants with congenital heart disease surgery.
2018 Vol. 15 (18): 154-157 [
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Application status of enhanced recovery after surgeryin colorectal surgery
FU Kai1 NAI Yongju2 CAO Hongyong1
Enhanced Recovery After Surgery (ERAS) is a concept that optimizes perioperative management, including preoperative, intraoperative, and postoperative ERAS. This article will focus on the application of ERAS concept in colorectal surgery. This article briefly describes the classification and clinical value of preoperative, intraoperative and postoperative ERAS protocols, and analyzes the specific application of the ERAS protocol in colorectal surgery, and points out that the ERAS protocol can promote the recovery of postoperative organ function in colorectal surgery. The advantages of reducing surgical stress and complications, shortening hospitalization time and reducing medical expenses, etc., in order to provide reference for the implementation of ERAS measures for clinicians, and provide theoretical basis for the perfection of ERAS.
2018 Vol. 15 (18): 158-162 [
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Study of moving r between homogeneous and formula assays to test LDL-C
CHEN Xuannan WANG Zhifu LIN Yahui
Objective To observe the effect of lipid levels on the correlation between homogeneous and formula assays for measuring low-density lipoprotein cholesterol (LDL-C), and compare the relationship and difference between homogeneous and five formula assays, in order to explore the clinical application of formulas. Methods From May 2014 to July 2014, total 17 488 patients from Fuwai Hospital were recruited. All of apolipoprotein B (ApoB), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), LDL-C and total triglyceride (TG) were measured by an automatic biochemical analyzer (AU5421, Beckman). The moving correlation coefficients (Moving r, Mr) were computed to evaluate lipid effects on the correlation between homogeneous assay and formulas. Meanwhile, observe the correlation and the difference between different methods. Results There were strong correlations between five formulas and homogeneous method (r > 0.95, P < 0.05). Biases of median ranging were from -3.065% to -8.145%, the differences were statistically significant (P < 0.05). Mrs changed with levels of ApoB, TC and HDL-C, which decreased firstly, then increased with LDL-C level, and hold constant, then decreased with TG level. The correlations between Delong, Hu Bocheng and Wu Xiuru methods were the strongest (r = 0.97, P < 0.05). It was also found that LDL-C was correlated with ApoB and TC levels (r = 0.92，P < 0.05). Conclusion There are significant correlations as well as the differences were statistically significant (P < 0.05) between the homogeneous assay and the formulas. It is recommended that the laboratory would employ the homogeneous assay.
2018 Vol. 15 (18): 163-166 [
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Application of the establishment of internal control system in medical disposable materials management in public hospitals
LI Lin
The public hospitals urge to establish an effective and complete internal control system in the medical disposable materials management so that they can prevent different type of risks existing in medical activities and guarantee the efficiency of the medical disposable materials management as well as the consistent development of the hospitals in the long run. Although the public hospitals give more importance to this issue, the internal control system in most public hospitals has many weaknesses, such as lack of cost control, imperfect use and charging mechanism and lack of effective control on the use of high value consumables, which caused great management inefficiency, so it is urgent to build a scientific and effective internal control system for medical disposable materials. This article will carry out risk prevention and effective control analysis according to consumables access, price negotiation, prior to admission into a hospital clinical use, financial settlement, after patient rights and interests protection, etc, in order to provide some basis and reference for the internal controls of medical disposable materials.
2018 Vol. 15 (18): 167-181 [
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The intervention effect of cognitive behavior modification on cancer-related fatigue in patients with cancer
BI Xiaoling1 SHI Meihua1 CHI Yingchun2
Objective To explore the intervention effect of cognitive behavior modification on cancer-related fatigue in patients with cancer. Methods From November 2015 to August 2017, 120 cases of patients admitted to Department of Oncology, the 309th Hospital of Chinese People's Liberation Army were selected as the research objects and divided into the control group and the experimental group by the random number table, with 60 cases in each group. The control group was given routine nursing care and the experimental group was given cognitive behavior modification on the bases of control group. Both of the groups were intervened for 8 weeks. revised Piper fatigue scale and the European organization for research and treatment of cancer (EORTC) QLQ-C 30 were applied to evaluate the degree of fatigue and life quality of the patients. Results There were no statistically significant differences in the degree of fatigue and the score of life quality before intervention between the two groups (P ＞ 0.05). After intervention, the indexes above in the experimental group were all better than those of before intervention and the same period of control group, with statistically significant differences (P ＜ 0.05); but there was no statistically significant difference in the control group before and after intervention(P ＞ 0.05). Conclusions Cognitive behavior modification can effectively improve the degree of fatigue and improve the life quality of the patiens. It is worthy of clinical promotion and application.
2018 Vol. 15 (18): 171-174 [
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Clinical effects of stereotactic navigation in treatment of brainstem hemorrhage undergoing both sub-temporal and suboccipital operations
GAO Jinbao LI Wende YU bin LI Yunjun CHEN Lihua▲
Objective To investigate the clinical effects of two kinds of surgical methods for the treatment of brainstem hemorrhage under the guidance of stereotactic navigation. Methods From January 2014 to December 2017, in Bayi Brain Hospital Affiliated to Army General Hospital, 52 patients with brain stem hemorrhage underwent operation treatment were selected, according to treatment methods, the patients were divided into group A (n = 26), and treated with the operation mode of the infratemporal approach; group B (n = 26), treated with operation mode of the occipital approach for treatment. The clinical effects and prognosis of the two groups were analyzed and compared according to the prognosis criteria of Glasgow. Results The good rate of group A was 19.23% (5/26), the rate of heavy disability was 11.54% (3/26), the mortality rate was 69.23% (18/26), the good rate of group B was 23.08% (6/26), and the rate of heavy disability was 15.38% (4/26) and the mortality was 61.54% (16/26); two groups were compared, the differences were not statistically significant (P > 0.05). Conclusion The clinical curative effect of the two groups is equal, the hospital should make the best operation plan according to the patients′ actual condition.
2018 Vol. 15 (18): 175-177 [
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Effect of liquid based cytology test in the diagnosis of primary lung cancer
PAN Gujie1 TAO Xuefang2
Objective To explore the diagnostic effect of liquid-based cytology under fiberoptic bronchoscopy on patients with primary lung cancer. Methods The clinical data of 1461 patients admitted to Shaoxing Central Hospital from January 2013 to June 2016 were retrospectively analyzed. The diagnostic effect of liquid-based cytology under fiberoptic bronchoscopy of patients with primary lung cancer was analyzed. Results A total of 1461 patients were treated with fiberoptic bronchoscopy to brush the sample fluid base, of which 1254 patients had clinical follow-up or histopathological results, included 1055 patients with primary lung cancer and 199 patients with benign lesions. Among 1055 patients with primary lung cancer, 604 cases (57.25%) were diagnosed with primary lung cancer by forceps biopsy tissue pathological, 538 cases (50.99%) were diagnosed with primary lung cancer by liquid based cytology, 213 cases (20.18%) were diagnosed with primary lung cancer only by the liquid based cytology. The accuracy of liquid-based cytology in the classification of small cell carcinoma and non-small cell carcinoma was 99.00% (Kappa=0.969, P = 0.001). The classification accuracy of liquid based cytology of squamous carcinoma, adenocarcinoma and small cell carcinoma were 95.90%, 95.90% and 100.00% respectively, the classification accuracy of forceps biopsy histology of squamous carcinoma, adenocarcinoma, and small cell carcinoma were 96.96%,97.97% and 98.98% respectively. There was no statistically significant difference among the above groups (P > 0.05). Conclusion The detection rate of primary lung cancer is high, and the classification accuracy is high.
2018 Vol. 15 (18): 178-181 [
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