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2018 Vol. 15, No. 20 Published: 2018-07-15

	4	Anti-tumor-angiogenesis effect of Cinobufagin Injection on colon cancer transplantation model
		FENG Baoyue* YANG Ying* WANG Chaoran ZHENG Junchao FEI Pengfei HU Ye WU Na ZUO Minghuan
		Objective To investigate anti-tumor-angiogenesis effect of Cinobufagin Injection on colon cancer transplantation model. Methods Mice were administered with CT26 cells by subcutaneous injection to establish colon cancer transplantation model. Then, modeled mice were divided randomly into 5 groups: high dose of Cinobufagin Injection group (CINO-H group), medium dose of Cinobufagin Injection group (CINO-M group), low dose of Cinobufagin Injection group (CINO-L group), 5-Fluorouracil (5-FU) group and normal saline group, with 4 mice in each group. CINO-H group was given Cinobufagin Injection 0.5 mL, CINO-M group was given Cinobufagin Injection 0.25 mL + normal saline 0.25 mL, CINO-L group was given Cinobufagin Injection 0.125 mL+normal saline 0.375 mL, 5-FU group was given 5-FU Injection 20 mg/kg, allocated to 0.5 mL with normal saline, normal saline group was given normal saline 0.5 mL. The mice were injected intraperitoneally with drugs once a day, for 7 days. Tumor formation conditions were observed, and pathological examination of transplanted tumor and tumor microvascular density (MVD) was measured. Results The tumor volume of 5-FU group was lower than that of normal saline group (P ＜ 0.05), but there was no statistically significant difference in tumor volume between all Cinobufagin Injection groups and normal saline group (P ＞ 0.05). Histopathological observation showed that Cinobufagin Injection caused the tumor necrosis in different degrees, which was inferior to 5-FU. All Cinobufagin Injection groups decreased MVD in tumor, and significant difference was shown in comparison with those in normal saline group (P ＜ 0.01). While, 5-FU group couldn't decrease MVD in tumor (P ＞ 0.05). Conclusion Cinobufagin Injection can decrease MVD in tumor by inhibiting tumor-angiogenesis, thus inhibiting tumor growth.
		2018 Vol. 15 (20): 4-7,24 [Abstract] ( 250 ) HTML (1 KB) PDF (1123 KB) ( 44 )

	8	Expression of brain-specific angiogenesis inhibitor 1 in colorectal cancer and its correlations with clinicopathological features of colorectal cancer patients
		WEI Jianchang* HU He* WANG Qiang CHEN Zhuanpeng YANG Ping ZHANG Tong CAO Jie
		Objective To explore the roles of brain-specific angiogenesis inhibitor 1 in colorectal cancer and its correlations with clinicopathological features and prognosis of CRC patients. Methods Fom May 2016 to July 2017, tissue microarray with 208 CRC, 8 normal colon tissues and the clinical information was purchased. The cancer genome atlas (TCGA) dataset is a publicly available dataset with 192 primary CRC patients and the mRNA expressions. BAI1 in TMA of CRC and benign glandular epithelium cells was checked by immunohistochemistry. The exlpore the connection between the express of brain-specific angiogenesis inhibitor 1 with clinicopathological features. Overall survival curve was analyzed by Kaplan-Meier method and Log-rank test. Univariate analysis and multivariate analyses were analyzed with Cox proportional hazards regression to assess the prognostic value of high BAI1 expression for CRC patients. Results BAI1 was localized in the cytoplasm of CRC and benign glandular epithelium cells, showing higher protein levels in CRC tissues compared with normal colon samples (P < 0.001). High BAI1 protein expression was associated with high pathological grade (P = 0.039), advanced clinical stage (P = 0.004) and enhanced tumor invasion (P = 0.006). The cancer genome atlas (TCGA) mRNA expression further showed that BAI1 was upregulated in CRC with advanced clinical stage (P = 0.027) and enhanced tumor invasion (P = 0.021). Kaplan-Meier survival curves revealed that CRC patients with higher BAI1 mRNA levels had shorter overall survival than those with lower expression (P = 0.02). High BAI1 mRNA expression was an independent influence of factor for prognosis of CRC (HR = 2.895; 95%CI: 1.012-8.281; P = 0.047). Conclusion BAI1 ralates to aggressive CRC. High BAI1 expression may predict poor prognosis of CRC patients.
		2018 Vol. 15 (20): 8-11 [Abstract] ( 243 ) HTML (1 KB) PDF (565 KB) ( 55 )

	12	Discussion on the influence and mechanism of vitamin E for myocardial ischemia-reperfusion injury of rats
		CHEN Lingling1* FANG Kan1* LI Longti2 WANG Ping1 PENG Guihai1 WANG Chongquan1
		Objective To discuss the influence and mechanism of vitamin E (Vit E) for myocardial ischemia-reperfusion injury (MIRI) of rats. Methods Sixty male health Wistar rats were selected and divided to Vit E group, model group and control group by random number table method, with 20 rats in each group. For the first two groups, the left anterior descending (LAD) in 2 mm near inferior margin of left auricle was ligatured, the knot was released after 30 min and taken reperfusion, then MIRI model was duplicated. For the control group, the silk yarn just was threaded through LAD rather than taken reperfusion. For Vit E group, 4.5 mg/(kg·d) of Vit E injection was injected intramuscularly as soon as the molding was done; for the model group and control group, 4.5 mg/(kg·d) of normal saline was injected intramuscularly after the operation, and the administration was conducted successively for 2 weeks. The influences of different intervention on the antioxidant index, degree of ischemic infarction and hemodynamic index in each group were tested and compared. Results ①Compared with model group, the left ventricular end systolic pressure (LVESP) in Vit E group was significantly increased, while the left ventricular end-diastolic pressure (LVEDP), atrial natriuretic peptide (ANP) were significantly decreased, the differences were highly statistically significant (P ＜ 0.01); ②compared with the model group, the contents of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), nitric oxide (NO) activity in Vit E group were significantly increased, while the contents of malondialdehyde (MDA) were significantly decreased, the differences were highly statistically significant (P ＜ 0.01); ③compared with model group, the area of infarction area (IA) and ischemia risk area (IDA), IA/IDA, IDA/LV in Vit E group were significantly decreased, the differences were highly statistically significant (P ＜ 0.01). Conclusion Vit E can improve the MIRI of rats and enhance the cardiac function through antioxidant stress, oxygen free radical removal effects.
		2018 Vol. 15 (20): 12-15 [Abstract] ( 251 ) HTML (1 KB) PDF (596 KB) ( 151 )

	16	Effects of Mingmu Dihuang Pills on autophagy and Akt-mTOR signaling pathway in retinal tissue of diabetic retinopathy rats
		XU Zhaonü ZHANG Shimiao LIU Lingling
		Objective To investigate the effects of Mingmu Dihuang Pills on autophagy and Akt-mTOR signaling pathway in retinal tissue of diabetic retinopathy (DR) rats. Methods The DR rat model was prepared by high fat and high sugar feed combined with intraperitoneal injection of Streptozotocin (40 mg/kg) method, and they were divided into model group, Calcium Dobesilate group (150 mg/kg), low (150 mg/kg), medium (300 mg/kg), high (600 mg/kg) dose of Mingmu Dihuang Pills groups by random number table method, with 10 rats in each group, and 10 rats were selected as normal control group, all the rats were given the medicine continuously for 10 weeks, the weight and blood sugar of the rats in each group were monitored. After 10 weeks of administration, the number of autophagic corpuscles in the retinal tissue was observed by transmission electron microscope; Western blot was used to detect autophagy related protein Beclin1, microtubule associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ), Akt, p-Akt, mTOR and p-mTOR protein in retinal tissue. Results Compared with the normal control group, the retina tissue of rats in the model group showed the changes of vacuoles, the cells arranged sparsely and disorder and so on, the number of autophagic corpuscles decreased significantly (P ＜ 0.05), the expression of Beclin and LC3-Ⅱ protein was obviously down-regulated (P ＜ 0.05), the expression of p-Akt and p-mTOR protein was significantly up-regulated (P ＜ 0.05); compared with the model group, the pathological changes of rats retina tissue in the low, medium and high dose of Mingmu Dihuang Pills groups were significantly improved (P ＜ 0.05), the number of autophagic corpuscles increased significantly (P ＜ 0.05), the expression of Beclin and LC3-Ⅱ protein was significantly up-regulated (P ＜ 0.05), the expression of p-Akt and p-mTOR protein was obviously down-regulated (P ＜ 0.05), in dose-dependent manners. Conclusion Mingmu Dihuang Pills can inhibit the process of autophagy in retinal tissue of diabetic retinopathy rats, and its mechanism may be achieved by the regulating the expression of autophagy related proteins through the Akt-mTOR signaling pathway.
		2018 Vol. 15 (20): 16-20,32 [Abstract] ( 252 ) HTML (1 KB) PDF (1229 KB) ( 54 )

	21	Clinical application and research progress of statins in the treatment of acute myocardial infarction
		TAN Zhihui1 GUO Ruiwei2 TAN Zhisheng2 LIU Dan3 GUO Shuo4
		Statins, the 3- hydroxyl -3 methyl amyl two acyl coenzyme A (HMG-CoA) reductase inhibitor, are the most effective lipid lowering drugs at present. It can not only reduce the total cholesterol (TC) and the low density lipoprotein (LDL), but also reduce the TG and increase the density lipoprotein (HDL) to a certain extent, it is called a comprehensive lipid-lowering drug. The mechanism of statins is to synthesize the enzyme HMG-CoA reductase by competitive inhibition of endogenous cholesterol, blocking the intracellular pathway of hydroxymethylene valerate metabolism, reducing the cholesterol synthesis in cells, and increasing the number and activity of LDL receptor on the surface of the membrane on the membrane, so that serum cholesterol is increased, which is mainly used to reduce cholesterol, especially low density lipoprotein cholesterol in clinic, and to treat atherosclerosis, is the most effective drug for the prevention and treatment of coronary heart disease. In recent years, it has been found that statins have many non lipid-lowering effects, including inhibition of atherosclerosis and thrombosis, remission of rejection after organ transplantation, treatment of osteoporosis, antitumor, and anti Alzheimer′s disease. But, combined with the pathogenesis of acute myocardial infarction, this article expounded the mechanism of statins on acute myocardial infarction, and summarized its serial role in acute myocardial infarction, so as to provide theoretical basis and guidance for clinical medication.
		2018 Vol. 15 (20): 21-24 [Abstract] ( 295 ) HTML (1 KB) PDF (479 KB) ( 75 )

	25	Review of the problems and countermeasures of standardized training of resident doctors in traditional Chinese medicine
		YANG Yan1 XU Weiming2,3 ZHANG Yiwen2 CAI Yanran2 GUO Haiyan3 LIU Shuai3
		Standardized training of traditional Chinese medicine residents is one of the important ways to cultivate excellent doctors of Traditional Chinese Medicine. At present, TCM standardized training is still in the exploratory stage. In the process of practice, the following problems are found: related policy and solutions are lack of connection and publicity of various policy needs to be strengthened, further more the implement of policy is still not applied in some areas; the development of each training base is in unbalanced condition; the existing training modes are monotonous and do not reflect the characteristics and advantages of TCM; there is a space limitation in training base, and the construction of the software and hardware still need to be strengthened. In addition, the awareness of teaching is not strong and the level of teachers is uneven; the students of TCM have a variety of bases, and they are not very active and lack of passion. Besides, the salary of the students are not high; the regulation of the evaluation is not perfect at present. The author reviews the above problems and coping strategies, with a view to provide suggestions for further improvement of TCM standardized training, so as to truly improve the level of diagnosis and treatment of traditional Chinese medicine clinicians.
		2018 Vol. 15 (20): 25-28 [Abstract] ( 253 ) HTML (1 KB) PDF (478 KB) ( 114 )

	29	Clinical research progress of hyperhomocysteinemia
		ZHANG Guoling ZHANG Lin LIU Guiping▲
		The metabolic balance of homocysteine (Hcy) is affected by folic acid and B vitamins. The main reason for the increase of homocysteine is folate deficiency, deficiency of B vitamins and gene mutation of metabolic enzyme. Hyperhomocysteinemia (HHcy) can lead to a variety of diseases such as cardiovascular and cerebrovascular diseases, nervous system diseases, diabetes, adverse pregnancy outcomes, chronic renal diseases, osteoporosis and other diseases. The positive reduction of Hcy levels can benefit the risk of related diseases. The rational supplement of folic acid and B vitamins is an effective measure to control Hcy level and prevent and treat related diseases. This article reviews the clinical research progress of HHcy in order to provide useful reference for the prevention and treatment of related diseases.
		2018 Vol. 15 (20): 29-32 [Abstract] ( 781 ) HTML (1 KB) PDF (508 KB) ( 68 )

	33	Social support and influence factors among young medical care personnel in tertiary grade A hospitals in Beijing
		ZHENG Jingjing1 CHEN Qu2 MENG Kai3▲ LIU Xu4 MA Mengmeng4 ZHANG Qi5
		Objective To investigate and analyze the social support and main influence factors among young medical care personnel in tertiary grade A hospitals in Beijing, so as to provide the basis for hospital managers to effectively promote and intervene the social support of young medical care personnel. Methods Multi-stage stratified sampling method was used to randomly select 674 in-service young medical care personnel aged less than 35 years from 5 tertiary grade A hospitals in Beijing, the questionnaire survey was conducted from August to October 2016 and 663 valid questionnaires were retrieved. The questionnaire consisted of a demographic data scale, the Chinese version of Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the social support rating scale (SSRS). Results The total score of social support of 663 young medical care personnel was (37.35±8.04) points, and the numbers of people were 135 (20.4%), 503 (75.9%) and 25 (3.8%) that were classified as high, medium and low level of social support respectively. Multivariate linear regression analysis showed that, marriage, self-evaluation of career preference, children, development training, weekly workload and housing were the influence factors of social support scores (P ＜ 0.05). Conclusion The social support of young medical care personnel in tertiary grade A hospitals in Beijing is relatively inadequate. Hospital management should take the vocational identity education, expand training and other measures to raise the level of social support for young medical care personnel.
		2018 Vol. 15 (20): 33-38 [Abstract] ( 247 ) HTML (1 KB) PDF (542 KB) ( 96 )

	39	Qualitative study of caregiver burden experience in care of patients with advanced cancer
		YOU Chunxia1 ZHANG Cuiping2 ZHANG Mingjun3▲
		Objective To study the caregiver burden experience of primary caregivers of advanced cancer patients in Xinjiang Uygur Autonomous Region, so as to provide reference for improving the quality of life of patients and caregivers. Methods A semi-structured interview was conducted among caregivers of 9 patients with advanced cancer from January to April 2017 in Tumor Hospital Affiliated to Xinjiang Uygur Autonomous Region by means of qualitative interviews. Results The interview data were analyzed and summarized by Colaizzi analysis, and 3 themes were obtained including economic stress, mental stress, lack of relevant knowledge and information, and 5 sub themes were obtained including the high cost of medical work, work and income being affected, worried about the future of the family, prominent psychological problems, lack of emotional support. Conclusion Caregiver burden is heavy among primary caregivers of advanced cancer patients in Xinjiang Uygur Autonomous Region. Clinical nurses should strengthen the assessment of the status of care load, and formulate targeted interventions to reduce the burden of care and improve the quality of life of family caregivers and patients.
		2018 Vol. 15 (20): 39-42,46 [Abstract] ( 211 ) HTML (1 KB) PDF (549 KB) ( 232 )

	43	Influential factors for anemia among non-pregnancy women in Jiangsu Province
		WANG Guanrong1,2 YANG Yuehua1,2 XU Haoqin1,2 LI Xinyan3 BA Lei1,2
		Objective To investigate the prevalence and influence factors of anemia among non-pregnant women at childbearing age in Jiangsu Province, and to provide scientific basis for prevention strategies. Methods The study included the 10 448 women who were participated in the free pre-pregnancy eugenic examination in Peixian, Taixing and Liyang of Jiangsu Province from January to December in 2014. 2236 cases of hemoglobin below 120 g/L were defined as case group while the remaining 8212 women were defined as control group. The risk factors for anemia in non-pregnant women at childbearing age were analyzed by non conditional Logistic regression. Results The overall prevalence of anemia among non-pregnancy women in Jiangsu was about 21.4%. Multiple regression results showed that the risk factors of anemia contain educational level, occupation, body mass index (BMI) <18.5 kg/m2 and live birth history (P < 0.05). Condom use and BMI 24-<28 kg/m2 were protective factors for anemia (P < 0.05). Conclusion The main influencing factors of anemia in non-pregnant women in Jiangsu Province are educational level, occupation, live birth history, BMI and contraceptive measures. The government and health departments could take these factors as the basis for the intervention of high-risk groups in this area to put forward effective measures to prevent anemia.
		2018 Vol. 15 (20): 43-46 [Abstract] ( 225 ) HTML (1 KB) PDF (544 KB) ( 105 )

	47	Application effect of Sarpogrelate combined with Clopidogrel in patients after carotid artery stenting
		ZHANG Yaoyuan1 WU Xueliang2 ZOU Yu′an1
		Objective To discuss the clinical effectiveness and safety of Sarpogrelate combined with Clopidogrel in carotid artery stenting (CAS). Methods The clinical follow-up data of 55 cases with carotid artery stenosis treated by carotid artery stenting were retrospectively collected from January 2012 to January 2015 in the Department of Neurology and Vsculr Surgery in the First Affiliated Hospital of Hebei North University. According to treatment method, all patients were divided into Sarpogrelate combined with Clopidogrel group (observation group, 28 cases) and Aspirin combined with Clopidogrel (control group, 27 cases). Postoperative new stroke, restenosis, bleeding and mortality were compared between two groups. Results There was no significant difference with new stroke and restenosis between two groups (P > 0.05). The incidence of bleeding events in the observation group was lower than that in the control group (P < 0.05). There was no death between two groups (P > 0.05). Conclusion Sarpogrelate combined with Clopidogrel compared with Aspirin combined with Clopidogrel for antiplatelet therapy after CAS has no differences in new stroke and restenosis. Sarpogrelate is more safer and effective than Aspirin.
		2018 Vol. 15 (20): 47-49,53 [Abstract] ( 196 ) HTML (1 KB) PDF (412 KB) ( 147 )

	50	Prognosis effect of intermittent hypoxic adaptation in treating patients with ST-segment elevation myocardial infarction after PCI
		LI Ying ZHAO Lihong
		Objective To discuss the effect of intermittent hypoxic adaptation on cardiac function and prognosis of patients with ST-segment elevation myocardial infarction after PCI. Methods All the 60 patients with ST-segment elevation myocardial infarction after PCI were treated in the Second Policlinic Directly under the Authority of Hebei Province from January 2016 to May 2017 selected and divided into control group (n = 30) and observation group (n = 30) by random number table. Based on the standard therapy, the observation group was treated by hypoxia interrupted and the control group was treated by regular oxygen therapy, they were treated for 6 months. The heart rate, blood pressure, Hemoglobin, red blood cell, left ventricular ejection fraction (LVEF), left ventricular end systolic dimension (LVDS), left ventricular end diastolic diameter (LVDD) and cardiac events were compared. Results There was no significant difference in heart rate, hemoglobin and RBC count between the two groups (P > 0.05). At one and six months after treatment, systolic blood pressure and LVEF in the observation group were higher than those in the control group, and LVDS and LVDD was lower than those in the control group, with statistical significance difference (P < 0.05). Conclusion Intermittent hypoxic adaptation is beneficial to the repair of damaged myocardial cells. Besides, it can improve the ability of myocardium contraction, promote myocardial microcirculation and inhibit ventricular remodeling after myocardial infarction.
		2018 Vol. 15 (20): 50-53 [Abstract] ( 267 ) HTML (1 KB) PDF (403 KB) ( 81 )

	54	Logistic regression analysis of cerebral microbleeds risk factors of patients with non-valvular atrial fibrillation and cerebral infarction
		WU Yijie1 SHEN Jiahui1 ZHOU Yi2 ZHAO Heqing3 ZHOU Lihui1▲
		Objective To analyze the cerebral microbleeds (CMB) risk factors of patients with non-valvular atrial fibrillation and cerebral infarction, and provide guidance for therapeutic schedule for these patients. Methods One hundred and seventeen patients with non-valvular atrial fibrillation and cerebral infarction were enrolled that treated in the Department of Neurology, the Taicang Affiliated Hospital of Soochow University from January 2014 to December 2016, that were divided into CMB group (48 cases) and non-CMB group (69 cases). The demographic characteristics, the common risk factors of stroke and laboratory examination indices were compared between the two groups. Results Among the 117 patients, 48 cases (41%) were detected with CMB; the average age of the CMB group was higher than the non-CMB group (P = 0.002) ; the homocyatein (Hcy) level of the CMB group was higher than the non-CMB group (P = 0.033) ; the low density lipoprotein (LDL-C) of the CMB group was lower than the non-CMB group (P = 0.037); all the differences were statistically significant. Through a Logistic regression analysis, elderly was independently associated with the presence of CMB (P = 0.07, OR = 1.079, 95%CI: 1.021-1.140). Conclusion There is a high prevalence of CMB in patients with non-valvular atrial fibrillation and cerebral infarction and the occurrence of CMB is mainly associated with elderly.
		2018 Vol. 15 (20): 54-57 [Abstract] ( 218 ) HTML (1 KB) PDF (545 KB) ( 59 )

	58	Efficacy comparison of two vascular reconstructions on the treatment for adult Moyamoya disease
		LI Hongkai XU Haitao YANG Sheng ZHANG Xiangyang HUANG Shulan▲
		Objective To compare the efficacy of Superficial temporal artery-middle cerebral artery anastomosis combining with original encephaloduromyosynangiosis (STA-MCA+EDMS) and encephalo-duro-arterio-myo-synangiosis (EDAMS) on the treatment for adult Moyamoya disease. Methods Seventy-three clinical cases of adult Moyamoya disease treated with vascular reconstruction in Wuhan People Hospital from April 2013 to April 2017 were enrolled for retrospective analysis. On the basis of different treatments, they were divided into two groups, STA-MCA+EDMS group with 35 cases and EMDS group with 38 cases. Digital subtraction angiography (DSA) results, computed tomography perfusion (CTP) results, modified Rankin scale (mRS) scores and treatment effecacy were compared between the two groups. Postoperative complications and follow-up results were recorded and compared. Results Revascularization was better in STA-MCA+EDMS group than the EMDS group, the difference was significant (P ＜ 0.05). Cerebral blood flow (CBF) value in the STA-MCA+EDMS group: 2 weeks post-operation was higher than that of 3 months post-operation; 3 months post-operation was higher than that before operation; 3 months post-operation was higher than that of 2 weeks post-operation; all the differences were statistically significant (P ＜ 0.05). The mRS scores in the STA-MCA+EDMS group: the scores before operation was higher than that of 3 months post-operation; 2 weeks post-operation scores higher than that of 3 months post-operation; the scores before operation was higher than that of 2 weeks post-operation; all the differences were statistically significant (P ＜ 0.05). The mRS scores in the EDAMS group: the scores before operation was higher than that of 3 months post-operation; 2 weeks post-operation scores higher than that of 3 months post-operation; the differences were significant (P ＜ 0.05). The scores before operation was higher than that of 2 weeks post-operation, and the difference had no significance (P ＞ 0.05). The mRS scores of 2 weeks post-operation in the STA-MCA+EDMS group was lower than that of EDAMS group, and the difference had no significance (P ＞ 0.05). The mRS scores of 3 month post-operation in the STA-MCA+EDMS group was lower than that of EDAMS group, and the difference was significant (P ＜ 0.05). Perioperative complication rate in the EDAMS group was lower than the STA-MCA+EDMS group; postoperative recurrent rate in the STA-MCA+EDMS group was lower than the EDAMS group; and the differences had no significance (P ＞ 0.05). Conclusion Compared to EDAMS, STA-MCA+EDMS has prominent efficacy in short period post operation. STA-MCA+EDMS builds collateral circulation better and improves patients’ neural symptoms. Perioperative complication rate and postoperative recurrent rate in the two groups have no differences. The long-term efficacy is expected to be observed.
		2018 Vol. 15 (20): 58-62 [Abstract] ( 235 ) HTML (1 KB) PDF (676 KB) ( 68 )

	63	Efficacy of Epalrestat combined with Mecobalamin Tablets in the treatment of diabetic peripheral neuropathy
		HUANG Yingying1 LI Lixia1 HE Su1 LONG Shiyu2
		Objective To analyze the efficacy of Epalrestat combined with Mecobalamin Tablets on patients with diabetic peripheral neuropathy (DPN). Methods Ninety-four patients with DPN treated in Nanchong Second People′s Hospital of SichuanProvince from June 2016 to June 2017 were selected. According to the random number table method, the patients were divided into the control group and the combined group, with 47 cases in each group. The control group was treated with Mecobalamin Tablets, 0.5-1.0 mg/time and 3 times/d, and the combined group was treated with Epalrestat on the basis of the control group, 50 mg/time, and 3 times/d. The two groups were treated for 8 weeks. The clinical efficacy, the changes of interleukin-1β (IL-1β) and matrix metalloproteinase 9 (MMP-9) levels before and after treatment and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of the combined group was 91.49%, which was significantly higher than that of the control group (72.34%) (P ＜ 0.05). After treatment, nerve conduction velocity in the two groups increased significantly in comparison of those before treatment, and the level in the combined group was significantly higher than that in the control group (P ＜ 0.05). The levels of IL-1β and MMP-9 in the two groups were significantly lower than those before treatment, and the levels of IL-1β and MMP-9 in the combined group were significantly lower than those in the control group (all P ＜ 0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (P ＞ 0.05). Conclusion The application of Epalrestat in patients with DPN has good therapeutic effect, which can effectively regulate the expression of IL-1β and MMP-9. And it can obviously reduce the level of serum inflammatory mediators, effectively slow down the rogression of the disease, and can enhance the clinical effect, so it has better clinical value.
		2018 Vol. 15 (20): 63-66 [Abstract] ( 700 ) HTML (1 KB) PDF (518 KB) ( 44 )

	67	Impact of couples′ body mass index on the in vitro fertilization outcomes
		WANG Jiaxiong SHEN Liyan WANG Wei LI Hong
		Objective To explore the impact of the weight of both husband and wife on assisted reproductive outcomes. Methods A retrospective analysis of patients undergoing treatment at the Center for Reproduction and Genetics of the Affiliated Suzhou Hospital of Nanjing Medical University from August 2008 to October 2015 was conducted. A total of 1223 fresh in vitro fertilization(IVF) cycles were collected and grouped according to body mass index (BMI), they were divided into 3 groups: normal group (BMI 18.5-23.9 kg/m2), overweight group (BMI >23.9-27.9 kg/m2), and obese group (BMI >27.9 kg/m2). An analysis of the correlation between BMI and IVF was conducted. Results After screening 537 patients were finally included in female BMI group: 433 cases in the normal group, 79 cases in the overweight group and 25 cases in the obese group. 805 patients were eventually included in the male BMI group: 369 cases in the normal group, 299 cases in the overweight group and 137 cases in the obese group. In female BMI group, the age, levels of FSH, E2, LH in female serum, BMI, duration of Gn, the concentration, vitality of male sperm and normal morphology sperm rate were compared among each group, and there was no statistically difference (P > 0.05). The dose of Gn in overweight group and obese group was higher than that in the normal weight group, and the difference was statistically significant (P < 0.05). In male BMI group, the age, basic levels of FSH, E2 and LH in female serum, BMI, dose and duration of Gn, the concentration, vitality of male sperm and normal morphology sperm rate were compared among each group, and there was no statistically difference (P > 0.05). The fertility rate, implantation rate and pregnancy rate of the male obesity group were significantly lower than those of the other two groups, while the abortion rate was significantly higher than that of the normal group, with statistically significant difference (P < 0.05). Conclusion The correlation between increased male BMI and poor IVF outcome might be due to the sperm DNA damage or poor sperm-oocyte interactions, suggesting that couples involved in IVF therapy, especially men, need to maintain an appropriate body weight to reduce poor IVF outcomes risk.
		2018 Vol. 15 (20): 67-70 [Abstract] ( 226 ) HTML (1 KB) PDF (515 KB) ( 79 )

	71	Effect of gestational diabetes mellitus on maternal and infant outcome
		GU Lingmei1 WEN Quying2 WAN Xiaoying1 LIU Caihong1
		Objective To explore the effect of maternal and neonatal outcomes of gestational diabetes mellitus. Methods From June 2014 to August 2016, 92 gestational diabetes mellitus pregnant women hospitalized in People′s Hospital of Zhongkai Hi-tech Indutrial Development Zone of Huizhou City were randomly selected as the study group, and 92 healthy pregnant women in the same period were used as the control group. The differences between the two groups of pregnant and parturition and perinatal outcome were recorded. The complications of pregnant and lying-in women included premature rupture of placenta, hypertension of pregnancy, excessive amniotic fluid, cesarean section, spontaneous abortion and infection. Perinatal outcomes included neonatal hypoglycemia, giant infants, neonatal asphyxia, fetal anoxia, neonatal bilirubinemia, and perinatal mortality. Results The incidences of premature rupture of placenta, hypertension of pregnancy, excessive amniotic fluid, cesarean section, spontaneous abortion, infection and other complications were significantly higher than those in the control group respectively, the differences were statistically significant (P < 0.05). Perinatal outcome: the rate of neonatal hypoglycemia, giant infants, neonatal asphyxia and perinatal mortality were significantly higher than those in the control group respectively, with statistically significant difference (P < 0.05). There was no significant difference in the incidence of hyperbilirubinemia between the two groups (P > 0.05). Conclusion Gestational diabetes mellitus can affect the health of mother and infant, and should be discovered in time, early intervention and treatment in order to obtain good pregnancy outcome.
		2018 Vol. 15 (20): 71-73,82 [Abstract] ( 259 ) HTML (1 KB) PDF (486 KB) ( 66 )

	74	Research of the transition from intra to extra-uterine environment of late preterm infant
		XIE Lu ZHANG Zheng SUN Liping LIU Yuming DI Jianhui
		Objective To evaluate the risk factors of late preterm infants (LPIs), recovery and hypothermia of LPIs, and to explore the complications of transition of LPIs. Methods The retrospective cohort study was conducted on 268 LPIs delivered consecutively in Daxing Hospital Affiliated to Capital Medical University, and they were divided into three groups：60 cases of 34 weeks group, 75 cases of 35 weeks group and 133 cases of 36 weeks group, stratified by gestational age (GA). Maternal and neonatal data, recovery, temperature at birth(T1) and 2 hours after birth (T2) were analyzed among all groups. Results Seventy cases (26.1%) of LPIs were diagnosed pregnancy complications during pregnancy, and preeclampsia and intrahepatic cholestasis were significantly higher in the 34 weeks group than in the 35 weeks and 36 weeks groups (all P < 0.05). 47 cases (17.5%) of LPIs were diagnosed ventilation resuscitation, 36 cases (13.4%) needed oxygen resuscitation (mask or tracheal intubation), the ratio of oxygen resuscitation in 34 weeks group was significantly higher than that of the 35 weeks group and 36 weeks group, and the differences were statistically significant (P < 0.05). The differences in LPIs with different gestational age, and situation of prenatal steroid therapy, spontaneous preterm birth, cesarean section and preeclampsia of pregnant mother were statistically significant (P < 0.05). Fetal age was an independent risk factor for oxygen recovery of LPIs (P < 0.05). From T1 to T2, the ratio of normal body temperature of newborns in the 34 weeks group was significantly lower than that of the 35 weeks group and 36 weeks group, and incidence of LPIs respiratory diseases and NICU admission rate of 34 weeks group were significantly higher than those of 35 weeks group and 36 weeks group, and the differences were statistically significant (P < 0.05). Conclusion The lower the GA of LPIs is, especially at 34 gestational weeks, the more maternal complications, the greater the need for resuscitation in delivery room, the risk of hypothermia, the higher the rate of respiratory diseases and NICU admission and the greater the difficulty of the transition from intra to extra-uterine environment in late preterm infant are, and target management at birth is reeded.
		2018 Vol. 15 (20): 74-78 [Abstract] ( 239 ) HTML (1 KB) PDF (644 KB) ( 63 )

	79	Relationship between 25-hydroxy vitamin D and insulin resistance in pregnant women with gestational diabetes mellitus and its significant
		FU Dan
		Objective To investigate the relationship between 25-hydroxy vitamin D (25OHD) and insulin resistance in pregnant women with gestational diabetes mellitus (GDM) and its significance. Methods From April 2015 to August 2017, 98 cases of pregnant women diagnosed with GDM in General Hospital of Fushun Mining Bureau were selected as study group, 98 cases of normal pregnant women in the same period were selected as healthy control group. The serum levels of lipids, fasting blood glucose (FBG), fasting insulin (FINS), and 25OHD were detected, the insulin sensitivity adipokines retinol binding protein 4 (RBP4) and Visfatin level of pregnant women in two groups were measured, insulin resistance index (HOMA-IR) was counted, the relationship between 25OHD and HOMA-IR, RBP4, Visfatin were analyzed. Results Level of TG in the study group was significantly higher than that of the control group, the difference was not statistically significant (P < 0.05), while the levels of TC, HDL-C and LDL-C between two groups were not significantly different (P > 0.05); levels of FBG, FINS and HbA1c in the study group were significantly higher than those in the control group, the differences were statistically significant (P < 0.05); level of 25OHD in the study group was significantly lower than that in the control group, levels of HOMA-IR, RBP4 and Visfatin in the study group were significantly higher than those in the control group, the differences were statistically significant (P < 0.05). Correlation analysis showed that, 25OHD level was negatively correlated with levels of HOMA-IR, RBP4, Visfatin (r = -0.916, -0.526, -0.153, all P < 0.05). Conclusion Insulin resistance of pregnant women with GDM is closely related with serum 25OHD level, and therefore vitamin D supplementation for pregnant women may have a positive effect in alleviating insulin resistance, reducing related adipokines, and preventing gestational diabetes, it is worthy of further research.
		2018 Vol. 15 (20): 79-82 [Abstract] ( 230 ) HTML (1 KB) PDF (475 KB) ( 100 )

	83	Clinical effects of pelvic floor muscle comprehensive training on rehabilitation of stress urinary incontinence in patients with cervical cancer after radical hysterectomy
		GONG Chen1 WANG Jianhua1 YU Qianqian1 XIONG Huihua1 ZHANG Mingsheng1 HUANG Yan2 TAO Anyu3 WANG Dan3
		Objective To explore the rehabilitation effect of pelvic floor muscle comprehensive training on stress urinary incontinence in patients with cervical cancer after radical hysterectomy. Methods From July 2013 to December 2016, in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 67 postoperative patient with stress urinary incontinence were divided into rehabilitation group (33 cases) and routine group (34 cases). Routine group was given routine postoperative nursing, rehabilitation group was given pelvic floor muscle comprehensive training. The bladder neck movement degrees, 1 h urine pad test and pelvic floor impact questionnaire 7 (PFIQ-7) were used to evalute the rehabilitation effect. Results The quantity of urinary incontinence in 1 h urine pad test after 1 and 3 months, the differences were statistically significant (P < 0.05), the bladder neck movement degrees and the PFIQ-7 value after 3 months in rehabilitation group were significantly better than the routine group, the differences were statistically significant (P < 0.05). Conclusion The pelvic floor muscle comprehensive training can improve the rehabilitation effect on stress urinary incontinence in patients with cervical cancer after radical hysterectomy.
		2018 Vol. 15 (20): 83-86,95 [Abstract] ( 246 ) HTML (1 KB) PDF (545 KB) ( 118 )

	87	Relationship between expression of STAT5B and seizure occurrence in anaplastic gliomas
		FENG Enshan1 LIANG Tingyu1 WANG Fang1 TANG Kai2
		Objective To identify the genes associated with the onset of seizure caused by anaplastic gliomas. Methods TCGA RNA-seq set from TCGA website was downloaded, there were 243 anaplastic glioma samples, the initial symptom of 119 cases was seizure and the initial symptom of 124 ones was not seizure. t test was performed to select differential genes between two groups. CGGA RNA-seq set was used for validation. The prognosis results were attained from Kaplan-Meier curves. Results In TCGA RNA-seq set, prognosis of patients with seizure was better than those without seizure(P = 0.04). 902 genes whose expression were discriminating between two groups. Through DAVID analysis of 902 genes, it showed that the pathway of regulation of multicellular organism growth including seven genes (STAT5B, AFG3L2, FTO, APP, GDF5, MBD5, PIK3CA) was different. simplify gene number, CGGA RNA-seq set was used for reducing gene number. Then STAT5B was left. But it could not affect prognosis of anaplastic gliomas. Conclusion In anaplastic gliomas, patients with seizure have better prognosis than those without seizure. The higher STAT5B expression, the lower frequency of seizure. The expression of STAT5B may be one of factors influencing seizure occurrence.
		2018 Vol. 15 (20): 87-90 [Abstract] ( 239 ) HTML (1 KB) PDF (646 KB) ( 81 )

	91	Effect of Lienal Polypeptide Injection combined with mFOLFOX6 chemotherapy in treatment of advanced colon cancer and influence on immune function
		MAO Shanshan CHENG Xiaozhen CUI Ronghua YUAN Jianghua WANG Meiqing
		Objective To investigate the clinical efficacy of Lienal Polypeptide Injection combined with mFOLFOX6 chemotherapy on advanced colon cancer chemotherapy and observe its effect on the immune function. Methods From January 2013 to December 2016, in Department of Oncology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, 80 advanced colon cancer patients were selected, according to random number table method, they were divided into observation group and control group, with 40 cases in each group. Patients of two groups were given mFOLFOX6 regimen for 4 cycles, and the observation group was given Lienal Polypeptide Injection combined with chemotherapy. After chemotherapy, the peripheral blood T lymphocyte subsets, the recent curative effect, the side effects of chemotherapy and KPS score in the two groups were compared. Results After chemotherapy, the number of CD3+,CD4+ T lymphocytes and the ratio of CD4+/CD8+ in the observation group increased, the differences were statistically significant (P < 0.05), the number of CD8+ T lymphocytes decreased, the difference was statistically significant (P < 0.05); after chemotherapy, the number of CD3+, CD4+ T lymphocytes and the ratio of CD4+/CD8+ in control group decreased, the differences were statistically significant (P < 0.05), the number of CD8+ T lymphocytes increased, the difference was statistically significant (P < 0.05); after chemotherapy, the number of CD3+, CD4+ T cells and the ratio of CD4+/CD8+ T cells in the observation group were higher than those in the control group, the differences were statistically significant (P < 0.05), the number of CD8+ T cells was lower, the difference was statistically significant (P < 0.05). The recent curative effect, total effective rate and disease control rate in the observation group were slightly higher than those in the control group, but the differences were not statistically significant (P > 0.05). The incidence rates of Ⅲ+Ⅳ degree anemia, leukopeniawere in the observation group after chemotherapy were lower than those in the control group, the differences were statistically significant (P < 0.05), and the incidence rates of peripheral sensory neuropathy, nausea and vomiting, thrombocytopenia, diarrhea, liver function damage and renal function damage in the two groups were compared, the differences were not statistically significant (P > 0.05). Compared with the control group, the KPS score and quality of life improvement of the observation group were higher after chemotherapy, the differences were statistically significant (P < 0.05). Conclusion Lienal Polypeptide Injection can effectively correct the disturbance of immune function in patients with advanced colon cancer during chemotherapy, alleviate the blood toxicity caused by chemotherapy and improve the quality of life of patients.
		2018 Vol. 15 (20): 91-95 [Abstract] ( 211 ) HTML (1 KB) PDF (532 KB) ( 63 )

	96	Changes of right ventricular function and prognosis evaluation in elderly patients with acute exacerbation of chronic obstructive pulmonary diseases and acute myocardial infarction
		ZHANG Chenchen1 SONG Shuangshuang1 LIU Linglin1 YU Juanchun2 XIONG Wei1
		Objective To investigate the changes of right ventricular function and prognosis evaluation in elderly patients with acute exacerbation of chronic obstructive pulmonary diseases (COPD) and acute myocardial infarction (AMI). Methods From October 2015 to August 2017, in Department of Geriatric, Southwest Hospital, Army Medical University, 30 elderly patients with acute exacerbation of COPD (AECOPD) and AMI patients were selected as the observation group, 30 cases of AMI elderly patients without AECOPD were selected as the control group, heart function index and right heart structure index of two groups were respectively tested by echocardiography, blood gas analysis and detection of myocardial injury markers, morbidity and mortality rate of complications were recorded. Results The PaO2 level of the observation group was significantly lower than the control group (P < 0.01), PaCO2, CK-MB cTnT and pro-BNP were significantly higher than the control group (P < 0.01); LVEF of the observation group was significantly lower than the control group (P < 0.01), the relevant indicators of the right ventricular function (RVEDV, RVESV and RVSV) of the patients in the observation group were significantly higher than the control group (P < 0.01), and RVEF was significantly lower than the control group (P < 0.01); PAD, RVED, RVAWT and Tei index of the observation group were significantly higher than the control group (P < 0.01); the electrolyte disorders, pulmonary infection, the incidence of heart failure, cardiogenic shock and respiratory failure of the observation group were significantly higher than the control group (P < 0.05), and there was no significantly difference in the mortality between the two groups (P > 0.05). Conclusion AECOPD with AMI can lead to ventricular remodeling and cardiac hypertrophy early, which can further lead to further deterioration of cardiac function in AMI patients, and seriously affect the short-term prognosis.
		2018 Vol. 15 (20): 96-99 [Abstract] ( 247 ) HTML (1 KB) PDF (589 KB) ( 131 )

	100	Partial correlation analysis between osteoporosis and ectopic calcification
		LIU Xueyuan1 YU Zhi2 XIONG Yibo1▲ DENG Zexi1 LU Shuihuan1 ZHAO Lei1 HE Jie1 TANG Huiming1
		Objective To investigate the relationship between osteoporosis and ectopic calcification in elderly inpatients. Methods Three hundred and twenty-two cases of elderly patients hospitalized in the 181st Hospital of PLA from March 2013 to September 2016 were selected. Gender, age and body mass index (BMI) were recorded. Bone mineral density (BMD) was measured in two sites of femur and lumbar spine. There were 88 patients of normal bone mass, 96 cases of osteopenia, 138 cases of osteoporosis. Bone mineral density of site L2-L4, bilateral femoral neck, trochanter and Wards triangle were measured by the DPX–NT dual-energy X-ray bone mineral density produced in America. Head, spine, knee joint, the lungs, bilateral carotid arteries, abdominal aorta, lower limb artery, liver, gallbladder, kidney were checked with CT, X-rays or color ultrasonic. BMD and calcification of the above organs were analyzed by partial correlation among the elderly, male and female groups. Results Compared in normal bone, osteopenia and osteoporosis groups: the differences of abdominal aortic calcification, lumbar compression fracture, knee joint degeneration or proliferation were statistically significant (P < 0.01). Compared with each other: the differences of abdominal aortic calcification, knee joint degeneration or proliferation were significantly severer in osteoporosis group than those in bone mass reduction group and bone normal group (P < 0.05); the lumbar compression fracture in bone mass reduction group or osteoporosis group was more common than that of normal group, the difference was statistically significant (P < 0.01). There was no difference in gallstone among all groups (P > 0.05). Partial correlation analysis according to ages: BMD was associated with lumbar fracture in all groups. BMD in all patients and elderly group were associated with abdominal aortic calcification, knee joint degeneration or hyperplasia and gallstone (P < 0.05). Calcification in carotid artery, abdominal aorta, lower extremity arterial, compared with the younger age group, the older age group were more obvious and the differences were statistically significant (P < 0.01); spinal degenerative changes and bone hyperplasia, knee joint degeneration, bone hyperplasia, urinary stone and gallstone were prevalent in older elderly group, the differences were statistically significant (P ＜ 0.05). Partial correlation analysis with gender: BMD was associated with abdominal aortic calcification, knee joint degeneration or hyperplasia and bile gallstone in male (P < 0.05). BMD was associated with kidney calcification, gallstone in female (P < 0.05). Conclusion BMD is associated with abdominal aortic calcification, lumbar compression fracture, renal calcification, knee joint degeneration, hyperplasia and gallstone.
		2018 Vol. 15 (20): 100-104 [Abstract] ( 252 ) HTML (1 KB) PDF (599 KB) ( 176 )

	105	Clinical study on the changes of coagulation function in patients with abnormal thyroid function
		CHEN Tao SHI Xiu′e LIU Ling WANG Yanqiu JIN Ping▲ WANG Yiping
		Objective To study the alteration and the value of platelet parameters and the blood clotting parameters in hypothyroidism patients. Methods Total of 120 patients with abnormal thyroid function were selected from January 2014 to September 2017 in Inpatient Department and Outpatient Clinic of Gansu Rehabilitation Center Hospital(“our hospital” for short). According to serum TSH, FT3, and FT4 levels, the patients were divided into the hyperthyroidism group consisted of 60 patients and hypothyroidism group consisted of 60 patients. In the same period, 60 healthy were selected as the control group. The levels of TSH, FT3, FT4 and platelet parameters (PLT, P-LCR, PDW) and prothrombin time (PT), activation partial thrombin time (APTT), fibrinogen (FIB) were observed in the three groups. Results There was no difference in PLT value among the three groups (P > 0.05). The contents of PDW, P-LCR and FIB in hyperthyroidism group were higher than those in the hypothyroidism group and the control group, the differences were statistically significant (P ＜ 0.05). APTT and PT levels of hyperthyroidism group were obviously lower than those in the hypothyroidism group and the control group, with statistically significant differences (P ＜ 0.05). Conclusion The coagulation function of patients with hyperthyroidism is in high coagulation state, which has a tendency of secondary thrombosis, and the coagulation function of patients with hypothyroidism is reduced and there is a risk of bleeding.
		2018 Vol. 15 (20): 105-107,111 [Abstract] ( 255 ) HTML (1 KB) PDF (600 KB) ( 31 )

	108	Clinical efficacy of single-port laparoscopic hernia needle in the treatment of indirect inguinal hernia in children
		YANG Zhoujian LIU Jun YANG Jian TANG Qingsong CHEN Caojing PU Yongbin
		Objective To study the clinical efficacy and safety of single-port laparoscopic hernia needle (SPLHN) in the treatment of indirect inguinal hernia in children (IIHC). Methods 160 children with IIHC who was given surgical treatment from September 2016 to September 2017 in Mianyang Central Hospital were studied. The children were divided into observation group (n = 80) and control group (n = 80) according to random number table. The children in the observation group were treated by SPLHN, while the children in the control group were treated by traditional two-hole laparoscopic surgery. The efficacy, postoperative safety, recurrence and levels of C-reactive protein (CRP) and interleukin-10 (IL-10) were compared between the two groups. Results There was no significant difference in operation time, bleeding volume, hospitalization time and hospitalization cost between the two groups (P > 0.05). And there was no significant difference in the total incidence of postoperative complications between the two groups (P > 0.05).The levels of CRP and IL-10 in both groups at 7 days after operation were significantly higher than those before operation, but the observation group was lower than the control group, with statistically significant difference (P < 0.01). Conclusion SPLHN treatment for IIHC is more effective, safer and less inflammatory, which is worthy of clinical application.
		2018 Vol. 15 (20): 108-111 [Abstract] ( 263 ) HTML (1 KB) PDF (587 KB) ( 116 )

	112	Clinical effect of semilunar ganglion radiofrequency thermocoagulation under CT guidance for treatment of primary trigeminal neuralgia
		ZHANG Jian1 SHI Enbiao1 DING Peiyuan1 ZHANG Wenchuan2
		Objective To explore the clinical effect of percutaneous punctured hemifacial ganglia radiofrequency thermocoagulation on primary trigeminal neuralgia (PTN) under CT. Methods Eighty-six cases of PTN patients admitted to Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, from May 2015 to August 2016 were selected, according to random number table method, they were divided into observation group (43 cases) and control group (43 cases). Patients in the control group were treated with percutaneous balloon compression, patients in the observation group were treated with semilunar ganglion radiofrequency thermocoagulation under CT guidance. The clinical efficacy, pain, sleep quality, quality of life, complications and relapse within 1 year in the two groups were compared. Results The total effective rate in observation group was higher than that in control group, but the difference was not statistically significant (P > 0.05). The VAS and QS scores in two groups decreased after treatment, and these in the observation group were significantly lower than those in the control group, the differences were statistically significant (P < 0.01). The scores of quality of life in two groups increased significantly after treatment, these in the observation group were higher than those in the control group, the differences were statistically significant (P < 0.05). The incidences of side cheek numbness and masticatory muscle descent in the observation group were significantly lower than that in the control group, the differences were statistically significant (P < 0.05); and the incidence of pain and ataxia in adjacent branch areas in the observation group were conpared with the control group, the differences were not statistically significant (P > 0.05). The recurrence rate of observation group was significantly lower than that of control group, the difference was statistically significant (P < 0.05). Conclusion Semilunar ganglion radiofrequency thermocoagulation under CT guidance for the treatment of PTN is remarkable, and it can effectively reduce the patient′s pain, improve sleep quality and quality of life, reduce the complication rate and recurrence rate.
		2018 Vol. 15 (20): 112-115,128 [Abstract] ( 212 ) HTML (1 KB) PDF (836 KB) ( 170 )

	116	Effect of Danhong Injection combined with closed thoracic drainage plus four anti-tuberculous drugs in treating tuberculous pleural effusion
		QIAO Ruijun
		Objective To explore the effect of Danhong Injection combined with closed thoracic drainage plus four anti-tuberculous drugs in treating tuberculous pleural effusion. Methods The 80 cases clinical data of early diagnose clearly tuberculous pleural effusion in the Tenth People′s Hospital of Shenyang from January to June in 2017 were selected and divided into control group (four anti-tuberculosis drugs, 40 cases) and combined treatment group (Danhong Injection cooperate thoracic close drainage and four anti-tuberculosis drugs, 40 cases) by different treatment method. The pleural effusion drainage time, pleural effusion drainage volume and hospital stays in the two groups were detected, the pleural thickness, lung function and the levels of IL-12, TNF-α, ADA in the two groups before and after treatment were compared and the clinical effects of two groups were detected. Results The pleural effusion drainage time, hospital stays in the combined treatment group were shorter than those of the control group (P < 0.05). After treatment, the pleural thickness and the levels of IL-12, TNF-α, ADA in the two groups were lower than those before treatment, and the levels of TLC, FVC, FEV1/FVC% were higher than before treatment, besides the pleural thickness and the levels of IL-12, TNF-α, ADA in the combined treatment group after treatment were lower than those in the control group, and the levels of TLC, FVC, FEV1/FVC% were higher than those of the control group, with statistically significant difference (P < 0.05). The clinical treatment total effective rate of combined treatment group was higher than that of the control group (P < 0.05). Conclusion Danhong Injection with closed thoracic drainage plus four anti-tuberculosis drugs in the treatment of tuberculous pleural effusion can shorten the time, increase the flow, and improve pleural thickness, lung function and pleural effusion, biochemical indicators and the clinical curative effect, which is worthy of clinical application.
		2018 Vol. 15 (20): 116-119 [Abstract] ( 200 ) HTML (1 KB) PDF (620 KB) ( 130 )

	120	Influences of seasonal variability on pregnancy outcomes of in vitro fertilization and embryo transfer
		XIAO Yu WANG Min WANG Yong
		Objective To investigate the influences of seasonal variability on in vitro fertilization (IVF) and embryo transfer (ET). Methods The data of 4505 IVF cycles in 6 years (from January 2010 to December 2016) treated for tube factor, oligospermatism and/or asthenospermia in Reproductive Medical Center, the International Peace Maternity and Child Health Hospital were collected retrospectively. According to the day of ET, these cycles were divided into four season groups (1172 cycles in Spring, 1356 in Summer, 1115 in Autumn, and 861 in Winter). All cycles were administered with the GnRH analog formula. Response of ovarian, embryo quality, and reproductive outcomes were compared among groups. Results The total dose and duration of gonadotropin were similar in each group (P > 0.05). The matured oocytes and fertilization number, fertilization rates, cleavage and valid embryo numbers were significantly higher in Autumn (P < 0.05), whereas the valid embryos were fewer in Winter (P < 0.05). Total oocyte numbers and maturation rates in each season group were comparable (P > 0.05). The implantation rate, clinical pregnancy rate, live birth rate and miscarriage rate among four seasons had no significant differences (P > 0.05). Conclusion Seasonality may have influences on fertilization and embryo development, which are insufficient to change the pregnancy outcomes of IVF-ET treatment. It is feasible that IVF-ET treatment could be provided in any season.
		2018 Vol. 15 (20): 120-123 [Abstract] ( 240 ) HTML (1 KB) PDF (597 KB) ( 60 )

	124	Efficacy and safety of calf spleen extract injection combined with S-1 in the treatment of advanced primary squamous cell carcinoma of the stomach
		CHEN Long1 WANG Lin4 HE Donglei2 LIANG Dong1 LIN Haifeng3 FENG Jun1 HUANG Ping4
		Objective To compare the efficacy and safety of calf spleen extract injection combined with S-1 in the treatment of advanced primary squamous cell carcinoma of the stomach. Methods A total of 31 advanced primary squamous cell carcinoma of the stomach patients with Karnofsky Performance Status (KPS) score≥60 scores and expected survival time≥3 months were enrolled from September 2011 to January 2017 in the Third People′s Hospital of Hainan Province and Hainan General Hospital. They were divided into the study group and the control group by random number table method, with 16 cases in the study group and 15 cases in the control group respectively. The patients in the study group received calf spleen extract injection combined with oral S-1 treatment. The control group received oral S-1 treatment. Each group was treated for three weeks. The efficacy and adverse events in the two groups were observed and compared post treatment for 3 months. Results The effective rates in the study group and the control group were 50.0% and 33.3% respectively, the disease control rates were 87.5% and 66.7% respectively, and the effective rate and disease control rate in the study group were both higher than those in the control group the differences were statistically significant(P ＜ 0.05). The median survival was 10.0 months in the study group and 7.0 months in the control group, the differences were statistically significant (P ＜ 0.05). The most common adverse events in the two groups were myelosuppression, diarrhea, nausea and vomiting, oral mucositis, allergy, renal impairment and so on, the incidence of adverse reactions in the two groups had no significant difference (P ＞ 0.05). Conclusion Efficacy and safety of calf spleen extract injection combined with S-1 in the treatment of advanced primary squamous cell carcinoma of the stomach are better than S-1， with less adverse reactions and it is worth clinical promotion.
		2018 Vol. 15 (20): 124-128 [Abstract] ( 315 ) HTML (1 KB) PDF (423 KB) ( 129 )

	129	Investigation and influencing factors of palliative care knowledge among nurses in cancer hospital
		LIU Jin1 ZHU Wei2 ZHANG Cuiping3
		Objective To investigate the current status of palliative care knowledge in cancer hospital nurses and to analyze the influencing factors. Methods From June to August 2017, 280 registered nurses in Tumor Hospital Affiliated to Xinjiang Medical University were selected as the research objects by convenience sampling method. The palliative care quiz for nursing (PCQN) was used to investigate the status of palliative care knowledge in nursing staff and its influencing factors were analyzed. Results Among the 3 dimensions of PCQN, pain control had the highest score, then palliative care philosophy and principles, psychological and social support respectively. There were statistically significant differences among different ages, titles, education background and working years (P ＜ 0.01); the score of nurses trained in palliative care was significantly higher than that of untrained nurses, with statistically significant difference (P ＜ 0.01). The multiple stepwise analysis of the factors influencing the score of palliative care knowledge in 3 dimensions showed that the influencing factors of pain control were education and working years (F = 66.494, P ＜ 0.01, R2 = 0.324); influence factors of palliative care philosophy and principles were education, titles and working years (F = 490.955, P ＜ 0.01, R2 = 0.842); the influencing factors of psychological and social support were age and working years(F = 114.093, P ＜ 0.01，R2 = 0.452). Conclusion The score of palliative care knowledge in nurses of tumor hospital is low, indicating that nurses is lack of palliative care knowledge. It needs to strengthen the death and palliative care knowledge education, so as to provide the basis for improving palliative nursing knowledge training.
		2018 Vol. 15 (20): 129-132 [Abstract] ( 268 ) HTML (1 KB) PDF (598 KB) ( 175 )

	133	The clinical effect of multi-disciplinary team integrating model in the surgical treatment of cerebral cavernous malformation associated with epilepsy
		JIA Qin1 LIU Wenke2
		Objective To investigate the clinical effect of multi-disciplinary team integrating model in the surgical treatment of cerebral cavernous malformation associated with epilepsy （CCME）. Methods From May 2014 to May 2016, 153 patients with CCME underwent surgical therapy in West China Hospital were selected as the research objects. Seventy-three patients with CCME before multidisciplinary teams establishment from May 2014 to May 2015 were considerd as the control group and received conventional surgical treatment, while from June 2015 to May 2016, 80 patients with CCME before multidisciplinary teams establishment were considerd as the observation group and received comprehensive diagnosis and treatment after multidisciplinary teams establishment. The effects of postoperative epilepsy on CCME were analyzed by Engel classification and improved evaluation methods in China. The postoperative complications between the two groups was compared. Results The Engel classification and improved evaluation methods in China in the observation group were significantly better 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, but with-out statistically significant differences (P ＜ 0.05). Conclusion The multi-disciplinary team integrating model plays an important role in the surgical efficacy of CCME, can significantly increase the epilepsy control rate. It should be promoted and applicated in qualified medical units.
		2018 Vol. 15 (20): 133-136,144 [Abstract] ( 182 ) HTML (1 KB) PDF (680 KB) ( 60 )

	137	Establishment of evaluation for the quality of clinical pressure sore nursing based on Donabedian theory
		YANG Yi1 YANG Xiaoying2 YU Mei2
		Objective To explore the evaluation for the quality of clinical pressure sore nursing based on Donabedian theory. Methods Delphi method was adopted in this study. Through 2-round of consultation, the general evaluation for the quality of clinical pressure sore nursing was built up by 26 experts. Results The effective rates for the experts′ questionnaire consultation in 2 rounds were 92.30% and 100.00% respectively; the variation coefficient in first round was between 0.121-0.163 and in second round was between 0.073-0.184; the determination coefficient was 0.839, the familiar coefficient was 0.847 and the degree of authority coefficient was 0.843. The Kendall coefficients were 0.541 and 0.743, and it showed that the experts had an high agreement with the system. The structure-process-outcome system includes 3 primary indicators, 15 secondary indicators and 32 tertiary indicators. Conclusion High representativeness and dependability is proved by the results of experts' consultation such as active coefficient, variation coefficient and authority coefficient. The clinical pressure sore nursing evaluation system in this study is conductive to continuous improvement of clinical pressure sore nursing.
		2018 Vol. 15 (20): 137-140 [Abstract] ( 288 ) HTML (1 KB) PDF (599 KB) ( 68 )

	141	The clinical effect of new nursing intervention in the treatment of cerebral resuscitation in patients with cardiopulmonary resuscitation underwent stepwise hypothermia therapy
		YANG Suozhu FEI Dongsheng
		Objective To explore the clinical effect of new nursing intervention in the treatment of cerebral resuscitation in patients with cardiopulmonary resuscitation (CPR) underwent stepwise hypothermia therapy. Methods A total of 90 patients underwent stepwise hypothermia therapy in CPR in the First Affiliated Hospital of Harbin Medical University from June 2015 to June 2017 were selected as the research objects and divided into the control group and the observation group by random number table, with 45 cases in each group. The control group was given routine nursing intervention and the observation group was given new nursing intervention on the basis of control group. The incidence of complications, Barthel index and nursing satisfaction were compared between the two groups. Results The incidence of complications in the observation group was higher than that of control group, with statistically significantly difference (P ＜ 0.05). The neural response index, pain index, language index, physical activity index, mental state and social activity index in the observation group were all higher than those of control group, with statistically significantly differences (P ＜ 0.05). The nursing satisfaction in the observation group was higher than that of control group, with statistically significantly difference (P ＜ 0.05). Conclusion The new nursing intervention can reduce the incidence of complications, promote the Barthel index and improve nursing satisfaction in patients underwent stepwise hypothermia therapy in CPR.
		2018 Vol. 15 (20): 141-144 [Abstract] ( 211 ) HTML (1 KB) PDF (557 KB) ( 51 )

	145	Effect of comprehensive nursing intervention in maintenance hemodialysis patients combined with arteriovenous fistula
		LIU Shaobang TIAN Dawei▲ LU Li
		Objective To investigate the nursing effects of comprehensive nursing intervention on maintenance hemodialysis patients combined with arteriovenous fistula and its prognosis. Methods From March 2015 to May 2017, 110 patients of maintenance hemodialysis combined with arteriovenous fistula admitted to Dongfeng Hospital Affiliated to Hubei University of Medicine were selected as the research objects and divided into the control group and the observation group by random number table, with 55 cases in each group. The control group was given conventional nursing intervention, while the observation group was given comprehensive nursing intervention. The 36-item short form health survey was used to evaluate the physical, cognitive, social, emotional and role functions between the two groups before and after intervention. The total incidence of complications between the two groups was compared. Results Before intervention, there were no statistically significant differences in the scores of physical, cognitive, social, emotional, and role functions in the two groups (P ＞ 0.05); after intervention, the scores above in the two groups were significantly higher than those of before intervention and the scores above in the observation group were significantly higher than those of control group, with statistically significant differences (P ＜ 0.05). The total incidence of complications in the observation group was significantly lower than that of control group, with statistically significant differences (P ＜ 0.05). Conclusion The effect of comprehensive nursing intervention in patients of maintenance hemodialysis combined with arteriovenous fistula is better, which is helpful to improve life quality and prognosis of patients. It is worthy of promotion and application.
		2018 Vol. 15 (20): 145-147,151 [Abstract] ( 232 ) HTML (1 KB) PDF (572 KB) ( 81 )

	148	The dynamic change of clinical practice behavior and its influencing factors in nursing students three months before intership
		GUO Chuang1 LI Yanqiu2▲ LI Fang1 WANG Liqin3 WANG Dongmei4 ZHU Haibo5
		Objective The purpose of this study was to explore dynamic change of clinical practice behavior and its influencing factors in nursing students three months of intership. Methods From July to September 2017, 75 undergraduate nursing students in First Affiliated Hospital, Heilongjiang University of Traditional Chinese Medicine were selected as the research objects by convenient sampling method. Self-designed nursing undergraduate general information questionnaire and Deng Renli′s revised clinical practice behavior were applied to investigate in 1, 2 months and 3 months of internship. Results The total scores of clinical practice behaviors in nursing undergraduates were all above 2.5, and the total average scores from high to low were 1, 2 months and 3 months of the internship respectively. The scores of the four dimensions in the third month of practice (including using theoretical knowledge, self-directed learning behavior, defining the rights and obligations of patients, and clinical skills dimensions) were higher than that of first month of the internship; the total score of 1 month of clinical practice behavior practice was higher than those of 2 months and 3 months of internship, with statistically significant differences (P ＜ 0.05). The score of clinical practice behavior in the students of loving nursing career was higher than that of non-loving, the score in students whose first volunteer was nursing was higher than that of the first volunteer non-nursing students (P ＜ 0.05). Conclusion Nursing undergraduates are satisfied with the clinical practice. The influencing factors of the clinical practice behavior in undergraduate nursing students are whether the first volunteer is nursing specialty or whether loving nursing career.
		2018 Vol. 15 (20): 148-151 [Abstract] ( 308 ) HTML (1 KB) PDF (598 KB) ( 132 )

	152	Study on the health status and health promotion measures of the elderly people in China
		LIN Yuanqi XU Jun XUE Yunlian XIA Cong
		At present，the overall health status of the elderly people in our country is not good. The health promotion work aimed at the characteristics of the elderly and the internal differences among the groups is still in its infancy. This paper illustrates the current status of health and health promotion of the elderly in our country，analyzes the main problems existing in the health promotion work，and puts forward corresponding health promotion countermeasures. The establishment of a health promotion model integrating many aspects of the state，community，hospital，family and individual is the future direction of the study on the health promotion of the elderly people.
		2018 Vol. 15 (20): 152-155 [Abstract] ( 236 ) HTML (1 KB) PDF (684 KB) ( 177 )

	156	Experience summary of training doctors in Pain Department
		YANG Liqiang LI Xiaolin CAO Guoqing GUO Yu′na HE Liangliang NI Jiaxiang
		Pain department is an important part of contemporary medicine, involving many disciplines of the disease. At present, pain doctors in most of the hospitals do not get the formal knowledge of pain medical training, so continuing medical education is particularly important. Through the characteristics of the theoretical study of doctors, practice teaching, independent research, academic exchange, logistical support, the clinical level, scientific research ability and professional accomplishment of training doctors in Xuanwu Hospital, Capital Medical University (“our hospital” for short) have been fully improved, so as to treat pain patients more normatively and remove pain of patients more effectively. This article will summarize the training experience of doctors in Pain Department of our hospital, so as to provide reference for training doctors in Pain Department.
		2018 Vol. 15 (20): 156-159 [Abstract] ( 269 ) HTML (1 KB) PDF (644 KB) ( 119 )

	160	Distribution and drug resistance of clinical pathogenic bacteria in our hospital from 2013 to 2015
		PAN Haiyan XIANG Yonghong LYU Cong
		Objective To analyze the distribution and drug resistance of clinical pathogenic bacteria in Guangxi Zhuang Autonomous Region National Hospital (“our hospital” for short) from 2013 to 2015, and to provide guidance for reasonable clinical drug use. Methods Clinical specimens were collected from hospitalized patients in our hospital from January 2013 to December 2015. Bacterial identification and drug susceptibility testing were performed by VITED-Ⅱ Compact 60. Results A total of 10 453 strains of pathogens were isolated from the three years, among which the gram-negative bacteria were 8948 strains (85.60%), and gram-positive bacterium were 1505 strains (14.40%). The top 5 species were Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Acinetobacter baumannii and Coagulase negative staphylococcus aureus. Enterobacteriaceae bacteria and Pseudomonas aeruginosa had high drug sensitive rates to Imipenem, Amikacin, Cefoperazone/Sulbactam and Piperacillin/Tazobactam. Drug resistance of Acinetobacter baumannii to Cefoperazone/Sulbactam was 39.68%, which had higher drug resistance to commonly used antibiotics. Conclusion The main hospital pathogenic bacteria are gram-negative bacteria, and they have high drug resistance rate to common antibacterial, thus reasonable use of antibiotics should be based on the distribution and drug resistance of pathogenic bacteria.
		2018 Vol. 15 (20): 160-162,167 [Abstract] ( 262 ) HTML (1 KB) PDF (699 KB) ( 46 )

	163	Resistance variation trend and clinical character of multi-drug resistant Acinetobacter baumannii
		CHEN Haohao1 CAI Xiaorui2 TANG Danling1 CAI De1 WEI Duncan1 LIN Yun3
		Objective To analyze the resistance trend of multi-drug resistant Acinetobacter baumanii (MDR-AB) of the inpatients in the First Affiliated Hospital of Shantou University Medical College (“our hospital” for short), in order to provide reference for clinical treatment. Methods Retrospective analysis was used for this study. The clinical data of 902 inpatients with MDR-AB infection from 2013 to 2016 in our hospital were collected. The clinical data such as sex, age, department, clinical diagnosis and drug sensitivity test results were collected. Chi-square test and Pearson were used for statistical analysis. Results The proportion of male to female was about 7 to 3. Majority of the cases were middle-aged and aged, of which over 40% were ＞65 years old, and about 50% were 18-65 years old. Sputum specimen was mainly, which accounted for over 80%. About 10% of the total specimen were blood, urine and secretions. The cases mainly distributed in Department of ICU, Neurosurgery and Neurology. The proportion of Department of ICU and Neurosurgery showed a decreasing trend, during the period from 2013 to 2016, whose proportion were reduced from 43.61% and 36.84% to 23.05% and 25.15% respectively. On the contrary, the proportion of Department of Neurology, Respiratory Medicine and Neonates showed increasingly, whose proportion were increased from 6.77%, 4.51% and 0.75% to 10.48%, 7.49% and 5.69% from 2013 to 2016. The average resistance rate of MDR-AB to Tigecycline and Polymyxin B were below 10%, to Levofloxacin and Cefoperazone/Sulbactan were close to 50%, to the other antibacterials which were analyzed in this study were above 50%, more seriously, ten of these drugs whose resistance were over 80%. In addition, the proportion of MDR-AB increased significantly (P < 0.05). The results of Pearson correlation analysis showed that resistance rates of Ceftriaxone, Cefepime, Gentamycin, Tobramycin and Ciprofloxacin were highly positive correlated with the trend of Imipenem resistance (P < 0.05). Conclusion The isolated MDR-AB are mainly located in Department of ICU, Neurosurgery and Neurology. The resistance rate of commonly used antibiotics to MDR-AB are severe. Rational application of antibacterial drugs and strengthening management of multiple-drug resistant bacteria should be implemented.
		2018 Vol. 15 (20): 163-167 [Abstract] ( 216 ) HTML (1 KB) PDF (734 KB) ( 144 )

	168	Discussion on the party building and ideological and political work of high-level medical talents in colleges and universities
		HU Lilei LI Chen SUN Bo JIA Shuying
		The Party′s 19th congress report puts forward that "socialism with Chinese characteristics has entered a new era". In the new era, in order to implement the healthy China strategy, promote the development of medical science and technology innovation, safeguard people's health, build a well-off society in an all-round way and realize socialist modernization, high-level medical professionals are the key point. In the cultivation process of high-level medical talents, party building and ideological and political education, which is throughout the overall process of talent training, has got extremely important and irreplaceable role. Therefore, it is of great significance and practical significance to strengthen the party building and ideological and political work of high-level personnel talents. Based on the research on the situations of the party building and ideological and political work for high-level medical talents in colleges and universities, this paper combs the common problems and shortcomings in the cultivation and management of high-level medical talents, carries out objective analysis, and puts forward countermeasures and suggestions.
		2018 Vol. 15 (20): 168-172 [Abstract] ( 200 ) HTML (1 KB) PDF (651 KB) ( 68 )

	173	Comparison and countermeasure research on physician training methods at home and abroad
		LI Hongjie CHANG Feng
		In order to deepen reform of medical and health system in China, the cultivation of high quality health personnel and the construction of the team are the most important. Lacking of unified treatment standards, inadequate of subsidy mechanism and fewer clinical learning opportunities make the participant enthusiasm of physicians less. On the basis of summarizing the experiences of domestic and foreign physicians training, this article proposes countermeasures and suggestions for the establishment of a unified treatment manual system, a sound financial guarantee system, and a clear definition of medical scope. The aim is to improve the standardized training of physicians in China, which contributes to the advancement of grading diagnosis and treatment models, and ultimately realizes the healthy development of China′s pharmaceutical industry.
		2018 Vol. 15 (20): 173-176 [Abstract] ( 269 ) HTML (1 KB) PDF (979 KB) ( 78 )

	177	Survey and analysis on prevalence of nosocomial infection in a traditional Chinese medicine hospital from 2014 to 2016
		LIU Jinhua1,2 ZHU Hong1,2 YU Ping1,2
		Objective To investigate and analyze the data on the prevalence of nosocomial infection and use of antibiotics in the in-patients in Hubei Provincial Hospital of Traditional Chinese Medicine (“our hospital” for short), so as to provide evidence for control and prevention of nosocomial infection. Methods On August 27, 2014, August 13, 2015 and August 25, 2016, all the in-patients in our hospital were investigated by bedside investigation and medical records checking. Results On August 27, 2014 (0∶00-24∶00), August 13, 2015 (0∶00-24∶00) and August 25, 2016 (0∶00-24∶00), a total of 2596 in-patients were investigated in whom 54 cases with nosocomial infection were diagnosed, with a prevalence rate of 2.08%. No statistical difference was found among the three years prevalence rate (P > 0.05). The prevalence rate of Department of General Surgery, Vascular Surgery, Urology Surgery, Nephropathy and Geriatrics ranked the first five places; and the first five infection sites were lower respiratory tract, urinary tract, upper respiratory tract, superficial incision and gastrointestinal tract; the first five common pathogens were Escherichia coli, Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus haemolyticus. The usage rate of antibiotics decreased year by year, and the difference was statistically significant (P < 0.05). Onefold use (75.18%) and therapeutic use (77.42%) accounted for most of antibiotics use; the rate of therapeutic use of antibacterial increased year by year, and the difference was statistically significant (P < 0.05). Conclusion The prevalence rate of nosocomial infection is kept at a low level from 2014 to 2016 in our hospital, the use rate of antibiotics decreased year by year, and the sample test rate of therapeutic use of antibiotics increased year by year.
		2018 Vol. 15 (20): 177-180 [Abstract] ( 266 ) HTML (1 KB) PDF (685 KB) ( 70 )

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