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2018 Vol. 15, No. 23
Published: 2018-08-15
 
 
4 The mechanism of cinobufagin in inducing the death of liver cells by inhibition of histone acetylation
BI Cheng1 XU Ruicheng2 ZOU Shuang2 WANG Congcong2 ZHANG Yan2 XU Zhongwei2
Objective To investigate the mechanism of cinobufagin in regulating the death of liver cells by regulating epigenetic modification. Methods The CCK-8 assay was used to detect the changes of proliferation ability after different concentrations (0, 0.75, 1.5, 2.5, 5, 10 μmol/L) of cinobufagin acting on the HepG2 cells for 24 h; after 5 μmol/L of cinobufagin acting on the HepG2 cells for 12, 24 h, the cell cycle was detected by flow cytometry, and the expression levels of Ca2+/Calmodulin-dependent protein kinase 2β (CaMK2B), methylated-cpg binding protein (MeCP2), phosphorylation-MeCP2 (p-MeCP2), acetylated histone H3.1 (Ac-Histone3.1) and methylated histones (Met-Histone3.1) were detected by Western blot; after 5 μmol/L of cinobufagin acting on the HepG2 cells for 24 h, the interaction between CaMK2B and MeCP2 in HepG2 cells was detected by cell immunofluorescence combined with confocal scanning. Results Cinobufagin could inhibit the growth of HepG2 cells in a dose-independent manner, the difference was statistically significant (P ＜ 0.05), after the drug acting on the cells, the cell cycle comes up G2/M phase arrest, the difference was statistically significant (P ＜ 0.05). 5 μmol/L of cinobufagin could promote the incorporation of CaMK2B and MeCP2 in cell nucleus, the results of Western blot showed that the cinobufagin could increase the expression of CaMK2B and MeCP2 after acting on HepG2 cells (P ＜ 0.05), inhibit the expression of the Ac-Histone3.1, and promote the Met-Histone3.1 (P ＜ 0.05). Conclusion Cinobufagin can induce the death of liver cells by activating the CaMK2B-MeCP2 signal path, inhibiting histone acetylation and promoting histone methylation.
2018 Vol. 15 (23): 4-8 [Abstract] ( 239 ) HTML (1 KB)  PDF (838 KB)  ( 340 )
9 Mechanism research on apoptosis of hepatocellular carcinoma induced by sodium bicarbonate
ZHANG Yan1 QIAO Luxin2 ZENG Jing2 XU Jun1 SHI Ying2▲
Objective To explore the apoptotic mechanism of hepatocellular carcinoma (HCC) induced by sodium bicarbonate (SB). Methods HepG2 cells were implanted the subcutaneous of 5 athymic mice (7-week age) to form hepatocarcinoma mouse model and the growth and necrosis of hepatocellular carcinoma was observed under the condition of local mass injection of 5% SB. The apoptosis of hepatocellular carcinoma cell line HepG2 was observed by Calcein/PI staining and flow cytometry at SB exposure and different pH gradients. The expression of Bax/bcl2 were also detected in HepG2 cells under SB exposure by real-time PCR and western blotting. Results Animal in vivo studies revealed that 5% SB local injection for 4 weeks could inhibit tumor growth and cause tumor necrosis in 3 of 5 hepatocarcinoma mice. One hepatocarcinoma mice died and another mice had an enlarged tumor. 5% SB was diluted to the volume ratio 3/4, 1/2, 1/4, 1/8, 1/16 and negative control by DMEM and Calcein/PI staining in vitro showed that HepG2 apoptosis mice decreased in turn. Flow cytometry showed the similar results in 5% SB volume ratio: 1/2, 1/4, 1/8 and 1/16. The medium DMEM was titrated to pH6.0, pH6.25, pH6.5, pH6.75, pH7.0, pH7.25, pH7.5, pH7.75 and pH8.0. The lowest rate of HepG2 apoptosis was at pH7.0 and pH7.25. As the increasing of acidity or alkalinity, the apoptosis rate of HepG2 increased gradually. Flow cytometry also showed the similar results. Compared with control, Bax mRNA and protein expression in SB exposed HepG2 cell were not changed, but bcl2 mRNA and protein expression were decreased. Conclusion SB can induce HCC apoptosis by changing the internal environmental pH and inhibiting the expression of apoptotic protein blc2.
2018 Vol. 15 (23): 9-12 [Abstract] ( 229 ) HTML (1 KB)  PDF (826 KB)  ( 138 )
13 Optimization of the experimental conditions of CCK-8 in lymphocyte proliferation assays
WANG Jin MA Xiaorong▲ ZHANG Wanggang
Objective To optimize the experimental conditions of CCK-8 in lymphocyte proliferation assays. Methods An orthogonal test was designed to investigate the influence of four major factors (cell density, culture period, concentration of LPS and duration of incubation with CCK-8) on cell proliferation of human PBMC and mouse splenocyte. ANOVA was carried out to analyze the stimulation indices of all experimental condition combinations. Results The optimal conditions for CCK-8 was as follows: for PBMC, cell density was 2.5×106/mL, culture period was 48 h, concentration of LPS was 1 μg/mL, and duration of incubation with CCK-8 was 4.5 h; and for splenocyte, cell density was 5.0×106/mL, culture period was 48 h, concentration of LPS was 1 μg/mL, and duration of incubation with CCK-8 was 4.5 h. Conclusion The optimized CCK-8 protocol is a sensitive, convenient and stable quantitative method to evaluate lymphocyte proliferation. This result can provide evidence in screening of immunomodulating drugs and investigation of their immunopharmacology.
2018 Vol. 15 (23): 13-16 [Abstract] ( 291 ) HTML (1 KB)  PDF (566 KB)  ( 128 )
17 Relationship between Her-2, Topo-Ⅱα and clinicopathological parameters in patients with breast cancer and their significance in evaluating the efficacy of neoadjuvant chemotherapy
LIU Yan1 LIU Shuzhen2 MA Hao3 XU Xiuping1 MENG Wenjuan1 GAO Yuan1 YU Guohua2
Objective To investigate the relationship between Her-2 and clinicopathological parameters and the relationship between Topo-Ⅱα and clinicopathological parameters, and analyze the clinical significance of Her-2 and Topo-Ⅱα expression in neoadjuvant chemotherapy based on anthracycline. Methods From January 2016 to October 2017, 54 patients in Weifang People's Hospital diagnosis of breast invasive cancer after underwent tumor puncture and their paraffin-embedded tissues were selected. The expression levels of ER, PR, KI-67, and Her-2 of all patients were detected. The expression of Topo-Ⅱα of all patients were detected by immunohistochemistry, the expression of Her-2 and Topo-Ⅱα in patients with different therapeutic effects was observed. Results Among the 54 patients, 48 patients had lymph node metastasis. The positive rate of Her-2 was 88.9%, and the positive rate of Topo-Ⅱα was 87.0%. Her-2 expression was not associated with age, size, location, axillary lymph node metastasis (P > 0.05), and was related to stage and genotype (r = -0.3, 0.3, P < 0.05). The expression of Topo-Ⅱα was not related to age, size, location, axillary lymph node metastasis, stage, or subtype (P > 0.05). The expression of Topo-Ⅱα was positively correlated with Her-2 (r = 0.7, P < 0.05). The ORR of Her-2 negative patients was 50.0%; the ORR of Her-2 positive patients was 75.0%, the difference was statistically significant (P < 0.05). The ORR of Topo-Ⅱα positive patients was 78.7%, and the ORR of Topo-Ⅱα negative patients was 28.6%. The difference was statistically significant (P < 0.05). The ORR of patients with Topo-Ⅱα and Her-2 positive was 80.4%, and the ORR of patients with Topo-Ⅱα and Her-2 negative was 20.0%. The difference was statistically significant (P < 0.05). Conclusion Immunohistochemical examination of Her-2 and Topo-Ⅱα has important guiding significance for the treatment of breast cancer. Topo-Ⅱα positive expression can effectively improve the anthracycline-assisted treatment. Topo-Ⅱα and Her-2 may have sensitizing effect in neoadjuvant chemotherapy.
2018 Vol. 15 (23): 17-21 [Abstract] ( 246 ) HTML (1 KB)  PDF (532 KB)  ( 61 )
22 Research progress in pharmacological action of fisetin
YE Bingjie LIU Mingxin LI Wei TANG Yanhong
Fisetin (3,3′4′7-4 hydroxyl flavone) is a plant flavonol, a dietary flavonoids, which exists in a variety of fruits (strawberry, apple, mango, persimmon, kiwi fruit and grape), vegetables(tomato, Onion, cucumber), nuts and wine. The highest levels of fisetin are found in strawberries, apples and persimmons. It is estimated that the average daily intake of fisetin is 0.4 mg. Fisetin has strong effect of antioxidant, anti-inflammatory, anti-tumor, hypoglycemic, neuroprotective and cardioascular protection. This paper reviews the physicochemical property and pharmacological effects of fisetin and provides a basis for further modern research and clinical application of fisetin.
2018 Vol. 15 (23): 22-25 [Abstract] ( 354 ) HTML (1 KB)  PDF (516 KB)  ( 182 )
26 Research progress on improvement of insulin resistance based on PI3K /Akt signal pathway in traditional Chinese medicine
FANG Ling1 ZHANG Qi2 WEI Entao1 JIA Zipei1
The physiological function of insulin is closely related to the normal operation of insulin signal transduction. Impaired in any part of the transduction pathway can lead to insulin resistance（IR）. PI3K/Akt signaling is the classical pathway of insulin signaling, and it is also one of the important targets for the prevention and treatment of IR-related diseases in Chinese medicine. This article summarizes the PI3K/Akt signal pathway and its relationship with IR, and as a starting point, a brief review of traditional Chinese medicine monomers and compounds used in experimental research in recent years, in order to provide researchers with more in-depth study of Chinese medicine prevention and treatment of IR.
2018 Vol. 15 (23): 26-29 [Abstract] ( 335 ) HTML (1 KB)  PDF (567 KB)  ( 217 )
30 Research progress of risk factors for ischemic white matter lesions in middle and senile patients
HUANG Chaonan HUANG Shijing
Ischemic white matter lesions is one of the most common cerebral white matter diseases. Many etiological factors could lead to ischemic white matter lesions. Early identification, definition of risk factors, and intervention of the disease could help to improve the patient′s quality of life in the future. This article reviews the studies on the risk factors, pathophysiological mechanisms and clinical manifestations of ischemic white matter lesions in middle and senile patients in the last decade.
2018 Vol. 15 (23): 30-33 [Abstract] ( 243 ) HTML (1 KB)  PDF (523 KB)  ( 96 )
34 Research progress of pulse information analysis method
CHEN Chao1 ZHOU Lingyun2 LIU Jia2 WEI Hao1 YIN Junxian1 ZHANG Jiaqi2 WANG Nanyue2▲
Objective study on the pulse diagnosis is one of the hot spots of the modernization of traditional Chinese medicine. Many scholars have done a lot of researches on the method of acquisition and analysis of pulse information. In this paper, based on the pressure pulse diagram, we combed the common methods and research progress of carding pulse signal after filtering, dividing cycle, parameter extraction, statistical analysis and other stages carding, and expect to find a path in the further research to avoid duplication, accelerate the establishment of standard system, promote the practical application of objectification of pulse diagnosis system.
2018 Vol. 15 (23): 34-36,40 [Abstract] ( 254 ) HTML (1 KB)  PDF (804 KB)  ( 106 )
37 Investigation and analysis of clinical skills training of internal medicine
CHEN Xing FANG Yanling XU Miqing
Objective To further increase clinical skills for medical students interns by investing and analyzing their training of clinical skills in the medicine department. Methods Sixty medical student interns of 2013 clinical medicine department, who have finished their clinical practice in the medicine department in the Second Affiliated Hospital of Guangzhou Medical University from September 2017 to January 2018, were recruited for questionair survey and evaluated for teaching effect of common-used clinical skills in the medicine. Results Student interns were basically satisfied with clinical practice in the medicine department. In opinions of near half of student interns, poor training effect was attributed to lack of practices. In all clinical skills selected by the survey, lumbar puncture was regarded as the most difficult practice with the least chances of practice, and finger blood glucose testing was selected as the easiest one, which, however, was thought to be less of practice chance by more than half of student interns. Conclusion To continue to improve student interns′ level of clinical skills, teaching innovation should be promoted continuously with more chances of clinical practices given to student interns.
2018 Vol. 15 (23): 37-40 [Abstract] ( 226 ) HTML (1 KB)  PDF (427 KB)  ( 51 )
41 Study on the demographic and clinical characteristics of the patients with easy-to-blame and severe mental disorder in Changzhou Area
WAN Li HE Jun SHU Jingping YANG Lulu WANG Zhou
Objective To explore the demographic and clinical characteristics of the patients with easy-to-blame and severe mental disorder in Changzhou Area. Methods Respectively, 150 cases patients admitted during the period of general hospital patients and easy-to-blame to the hospital patients in Mental Health Center of Changzhou De′an Hospital from January 2014 to December 2017 were selected by random extraction method, and the demographic data and clinical data of the selected patients were retrospectively investigated. Results The ratios of male, 18 to 40, floating population, educational level in primary school and below, without a spouse, family monthly income of less than 1500 yuan, no health care, family history of mental disorders of the negative form in the easy-to- blame group was significantly higher than those of the control group, with statistically significant difference (P < 0.05). The composition of schizophrenia in the easy-to- blame group was significantly higher than that in the control group, while the hospitalization in the easy-to- blame group was significantly lower than that in the control group, with statistically significant difference (P < 0.05). In the subtype analysis of schizophrenic patients of the two groups, the bigotry composition ratio in the easy-to- blame group was significantly higher than that in the control group, with statistically significant differences (P < 0.05). The positive and negative symptoms scale (PANSS) positive symptoms, negative symptoms, general psychopathology and total score in the easy-to- blame group were significantly higher than those of control group and the national norm, with statistically significant differences (P < 0.01). Conclusion In Changzhou Area, easy-to-blame with severe mental disorders in the indicators, such as male, younger under the age of 40 years, floating population, educational level in primary school and below, spouse, health care, low family income and family history of the negative aspects of all showed significant demographic characteristics, besides schizophrenia paranoid, PANSS score high and fewer treatment for the clinical characteristics of these patients are significant.
2018 Vol. 15 (23): 41-44 [Abstract] ( 240 ) HTML (1 KB)  PDF (431 KB)  ( 56 )
45 The relationship between serum FKN level and vascular endothelial function in patients with essential hypertension
CHEN Qijing LUO Jiangbin ZHANG Yunbo CHEN Lin
Objective To explore the changes of serum fractalkine (FKN) level in patients with essential hypertension (EH) and its effect on vascular endothelial function. Methods One hundred and six EH patients in Sanya People's Hospital from July 2016 to July 2017 were selected as the observation group, 80 cases of healthy check-up were selected as the control group. The levels of serum FKN and high sensitive C reactive protein (hs-CRP), endothelin (ET-1) and nitric oxide (NO), two methyl arginine (ADMA) and brachial artery endothelial dependent vasodilation (FMD) of observation group at admission and control group were compared; the changes of blood pressure of observation group before and after treatment were observed; the serum levels of FKN, hs-CRP, ET-1, NO, ADMA and FMD in the observation group before and after treatment were compared; the correlation between serum FKN and hs-CRP, ET-1, NO, ADMA and FMD in EH patients was analyzed. Results At admission, the levels of serum FKN, hs-CRP, ET-1 and ADMA in the observation group were significantly higher than those in the control group (P ＜ 0.05), while the levels of serum NO and FMD in the observation group were lower than those in the control group (P ＜ 0.05). After treatment, the systolic and diastolic pressures of the observation group were significantly lower than those before treatment, there was a statistically significant difference (P ＜ 0.05). The levels of serum FKN, hs-CRP, ET-1 and ADMA in the observation group were significantly lower than those before treatment, and the levels of NO and FMD were significantly higher than those before treatment (P ＜ 0.05). Pearson correlation analysis showed that serum FKN level was positively correlated with hs-CRP, ET-1 and ADMA level in EH patients (r = 0.332, 0.456, 0.432, all P ＜ 0.05), and negatively correlated with NO and FMD (r = -0.443, -0.505, all P ＜ 0.05). Conclusion The serum level of FKN in EH patients is abnormal elevate and affects the endothelial function of blood vessels. Elevated FKN level may be associated with increased blood pressure mediated vascular injury.
2018 Vol. 15 (23): 45-48 [Abstract] ( 263 ) HTML (1 KB)  PDF (393 KB)  ( 71 )
49 Clinical effect of neuroendoscope transsphenoidal surgery in the treatment of giant invasive pituitary adenoma
QU Zhe1 TIAN Jun1 HU Yuhong2 SU Baiyu3 WANG Kun1 TAN Haopeng1 LI Jianhua1
Objective To study the clinical effect of endoscopic transsphenoidal surgery in the treatment of giant invasive pituitary adenoma. Methods A total of 76 patients with giant invasive pituitary adenoma admitted to the First Hospital of Shijiazhuang from March 2015 to January 2017 were selected. They were divided into observation group (39 cases) and control group (37 cases) according to digital random table method. The observation group was treated with neuroendoscopic transsphenoidal surgery, and the control group was treated with transcranial microscopy. The patients in the two groups were followed up for 1 year, and the clinical indicators, such as total cut rate, postoperative symptom remission rate, postoperative complications rate, tumor residual rate and recurrence rate were compared. Results The operation time and postoperative hospitalization time of the observation group were shorter than those of the control group, the intraoperative blood loss was less than the control group, and incidence of postoperative complications, tumor residual rate and recurrence rate were lower than those of the control group, while the total incision rate and postoperative symptom remission rate were higher than those of the control group, with statistically significant differences (all P < 0.05). Conclusion Neuroendoscopic transsphenoidal surgery has obvious clinical efficacy in the treatment of giant invasive pituitary adenoma, which can effectively shorten the operation time, reduce the amount of bleeding, promote the early recovery of patients, and effectively reduce the incidence of postoperative complications, as well as the residual rate and recurrence rate of tumors, which are safe and worthy of clinical application.
2018 Vol. 15 (23): 49-51,55 [Abstract] ( 217 ) HTML (1 KB)  PDF (522 KB)  ( 136 )
52 Application of intracranial pressure combined with cerebral blood flow monitoring after standard bone flap decompression for patients with severe craniocerebral injury
HAN Zhitong ZHANG Ruijian▲ CHEN Yunzhao ZHAO Weiping LIANG Xiuping
Objective To investigate the effect of intracranial pressure (ICP) combined with cerebral blood flow monitoring on prognosis of patients with severe craniocerebral injury (sTBI) after standard decompressive craniectomy. Methods Ninety-two patients with sTBI admitted to Neurosurgery of Inner Mongolia People′s Hospital from January 2015 to June 2017 were divided into control group and observation group according to the random number stable, 46 cases in each group. Both groups were treated with standard decompressive craniectomy and postoperative routine clinical management. The observation group was guided by ICP combined with cerebral blood flow monitoring after operation. The Glasgow prognosis scale was used to evaluate the therapeutic effect, and the complications of two groups were recorded. Results The total effective rate of the observation group was 67.39%, significantly higher than that of the control group (43.48%), and the difference was statistically significant (P < 0.05). The incidence of electrolyte imbalance and epilepsy of the observation group was significantly lower than that of the control group and the difference was statistically significant(P < 0.05). Conclusion ICP combined with cerebral blood flow monitoring and targeted therapy can optimize cerebral blood flow, control the degree of secondary brain injury, and improve the clinical prognosis of patients with sTBI.
2018 Vol. 15 (23): 52-55 [Abstract] ( 232 ) HTML (1 KB)  PDF (551 KB)  ( 70 )
56 The effects of hypothermia on prognosis in severe traumatic brain injury patients: a systematic review
HE Haiyan1,2 HUANG Huaping2 KANG Xiuhua2 FU Jing1▲
Objective To explore the effects of hypothermia on prognosis in severe traumatic brain injury (sTBI) patients, and provide the best evidence to clinical practice. Methods The databases PubMed, the Cochrane library, clnicaltrials.gov and CNKI were systematically searched from their inception to June 2017 to identify relevant randomized controlled trials (RCTs). Two authors independently reviewed and extracted data from included studies. The outcome variables of the study were mortality and neurologic recovery. All data was analyzed by Review Manager version 5.3 and CMA version 3.0, TSA version 0.9 beta was applied to estimate whether the pooled outcome was conclusive. Results A total of 14 trials involving 2024 sTBI patients divided into subhypothermia treatment group and normal temperature treatment group were included in this study. The pooled results showed that there was no significant statistical difference in mortality between two groups (RR = 0.92, 95%CI=0.74-1.14, P = 0.43), and TSA indicated that the current available evidence was conclusive. However, patients receiving hypothermia therapy had better neurological outcome than those receiving normothermia therapy (RR=1.23, 95%CI=1.02-1.49, P = 0.03), and TSA indicated that more studies should be included to clarify this issue. Conclusion Hypothermia can improve long-term neurological recovery for sTBI patients, but which is not helpful to decrease the mortality. Based on the low overall quality of included articles, more high-quality studies are needed to verify these results.
2018 Vol. 15 (23): 56-61,75 [Abstract] ( 243 ) HTML (1 KB)  PDF (1604 KB)  ( 76 )
62 Prognosis analysis of 49 cases with autoimmune encephalitis
GUO Tongli1 LI Guangqin1 SUN Jinhui2 LUO Yetao3
Objective To analyze the features of clinical symptoms, neurological functional recovery and the prognostic factors of autoimmune encephalitis. Methods A retrospective study of 49 patients diagnosed with autoimmune encephalitis in the First Affiliated Hospital of Chongqing Medical University from January 2013 to February 2017 was performed. Clinical data were collected and followed up. The neurological functional recovery was evaluated through modified ranking scale (mRS). The patients were divided into the recovery group (mRS score 0-1, 32 cases), partial recovery group (mRS score 2-3 scores, 7 cases), and poor prognosis group (mRS score > 3 scores, 10 cases), and the prognostic factors were analyzed using statistical methods of Logistic regression analysis of ordered categorization. Results 79.59％ patients were completely recovered or remained mild neurological dysfunction. 75.61％ of the mental and behavior disorders were fully recovered, 94.29% of the seizures were controlled, 69.57％ of the recent memory disorders were completely recovered, 87.50％ of the inadvertent movement were controlled, 90.63％ of the central nervous system focal damage were fully recovered and 16.33％ of the patients relapsed. Comparison of clinical data of initial onset among the three groups showed that people in abnormal immune status before onset and initial clinical manifestation with autonomic dysfunction or central hypoventilation had statistically significant difference(P < 0.05). Abnormal immune status before the disease and the first onset accompanied by autonomic nervous dysfunction or central hypoventilation are independent predictors of poor prognosis in patients  with autoimmune encephalitis (P < 0.05). Conclusion The majority of autoimmune encephalitis patients have favorable prognosis, but some of the patients may remain various degrees of neurological deficiency, including mental and behavior disorders and recent memory disorders. People in abnormal immune status before the onset and initial clinical manifestation with autonomic dysfunction or central hypoventilation may indicate a poorer prognosis． Immunotherapy can improve outcomes.
2018 Vol. 15 (23): 62-66 [Abstract] ( 324 ) HTML (1 KB)  PDF (575 KB)  ( 32 )
67 Clinical efficacy of intratracheal instillation of Budesonide combined with pulmonary surfactant in the treatment of meconium aspiration syndrome
WANG Li WANG Qiuyue▲
Objective To study the clinical efficacy of Budesonide combined with pulmonary surfactant (PS) in neonates with meconium aspiration syndrome (MAS). Methods A total of 98 neonates with MAS in General Hospital of China Aviation of China Medical University from May 2014 to May 2017 were enrolled and divided into the control group (n = 49) and the treatment group (n = 49) by random number table. The control group was treated with PS dropping into trachea, the treatment group was treated with Budesonide combined with PS dropping into trachea, both were intratracheal drops. The clinical efficacy of the two groups; the PaO2, PaCO2 and TcSaO2 of the two groups at the times of before treatment (0 h), 12 h after treatment, 24 h after treatment and 48 h after treatment; the hospital stays, oxygen exposure time and mechanical ventilation time of the two groups were recorded and compared. The adverse reactions rates of the two groups after treatment were compared. Results The total efficacy rate of the treatment group was 93.88% (46/49), was higher than that of the control group [75.51% (37/49)], the difference was statistically significant (P < 0.05). The PaO2, PaCO2 and TcSaO2 of the two groups at each time poinits after treatment were significantly better than at the times of 0 h (P < 0.05), as the extension of time, the PaO2 and TcSaO2 gradually increased, the PaCO2 gradually reduced, and the PaO2, PaCO2 and TcSaO2 of the treatment group at each time points after treatment were significantly better than that of the control group, the differences were statistically significant (P < 0.01). The hospital stays, oxygen exposure time and mechanical ventilation time of the treatment group were significantly shorter than those of the control group, the differences were statistically significant (P < 0.01). After treatment, the adverse reaction rate of the treatment group was significantly lower than that of the control group, the difference was statistically significant (P < 0.05). Conclusion Budesonide combined with PS in the treatment of neonates with MAS has a good efficacy and low adverse reactions, can reduce the treatment time, improve the oxygenation function, it is worth popularizing in clinical application.
2018 Vol. 15 (23): 67-70 [Abstract] ( 273 ) HTML (1 KB)  PDF (510 KB)  ( 64 )
71 Medication adherence and its influencing factors among the hepatitis B patients in the middle and later period of pregnancy
DU Xiaona TIAN Hongwei WU Huiping DONG Jiawei LIU Xiaojing DONG Zhenghong
Objective To investigate the status and influencing factors of medication adherence among hepatitis B patients in the middle and later period of pregnancy. Methods A total of 124 hepatitis B patients in the middle and later period of pregnancy treated in the Fifth Hospital of Shijiazhuang City from April 2016 to April 2017 were recruited. Medication adherence was assessed by the Morisky Medication Adherence Questionnaire (MAQ). The main measuring instruments included the general Characteristics Questionnaire, the hepatitis B knowledge questionnaire and the Medication belief scale. Multiple Logistic regression analysis was used to analyze the influencing factors of medication adherence of hepatitis B patients. Results The score of overall hepatitis B related knowledge, the Medication belief and medication adherence were fair to middling, and the patients with good compliance accounted for 60.5%(75 cases). Multivariate Logistic regression analysis showed that education level (OR = 0.578, 95%CI: 0.104-0.877), parents have or no hepatitis B (OR = 0.392, 95%CI: 0.177-0.631), diagnosis time of hepatitis B (OR = 3.998, 95%CI: 1.188-5.285), hepatitis B related knowledge (OR = 0.746, 95%CI: 0.389-0.847), medication beliefs (OR = 0.787, 95%CI: 0.259-0.977) were influencing factors for medication adherence (P < 0.05). Conclusion Health care workers should combine the influencing factors of medication adherence to carry out targeted health education, so as to improve their medication adherence and reduce the vertical transmission rate of hepatitis B.
2018 Vol. 15 (23): 71-75 [Abstract] ( 246 ) HTML (1 KB)  PDF (533 KB)  ( 96 )
76 Analysis of high-risk factors for postpartum hemorrhage in second puerpera
SHEN Jie
Objective To explore the reason and high-risk factors for postpartum hemorrhage in second puerpera. Methods The clinical data of 694 second puerpera in Zhaoqing NO.2 People′s Hospital from June 2015 to June 2017 were retrospectively analyzed. Univariate analysis and multiple Logistic regression analysis were applied to identify the related factors for postpartum hemorrhage in second puerpera. Results The incidence rate of postpartum hemorrhage in second puerpera was 11.67%. Univariate analysis showed that the incidence rate of postpartum hemorrhage was significantly increased in second puerpera with one or more of the following factors: age (>35 years), abnormal gestational week (<37 weeks or >42 weeks), cesarean section history, uterine atony, placenta previa, placental adhesion, placental abruption, soft birth canal injury and cesarean section (P < 0.05). Multiple Logistic regression analysis showed that uterine atony, placenta previa, placental adhesion, placental abruption, cesarean section, age (>35 years), abnormal gestational week (<37 weeks or >42 weeks), soft birth canal injury and cesarean section history were the high-risk factors for postpartum hemorrhage in second puerpera (P < 0.05). Conclusion There are various high-risk factors influencing postpartum hemorrhage in second puerpera, hence, targeted countermeasures should be taken to reduce the occurrence of postpartum hemorrhage.
2018 Vol. 15 (23): 76-79 [Abstract] ( 208 ) HTML (1 KB)  PDF (484 KB)  ( 59 )
80 Clinical efficacy of ABCD regimen for relapsed/refractory multiple myeloma
ZHOU Hongwei ZHOU Xiaoyan WANG Zhihong LIANG Yaojie ZHOU Minhang YAO Yibing LIU Mo SUN Junzhong
Objective To investigate the therapeutic effectiveness and side effects of ABCD regimen for relapsed/refractory multiple myeloma (MM). Methods Clinical data of 5 patients suffered from relapsed/refractory MM from November 2013 to May 2015 were analyzed retrospectively, including age, sex, peripheral blood and bone marrow characteristics and so on. These patients were treated by ABCD regimen (Epirubicin 40 mg/m2 d1, Carmustine 62.5 mg d1, Cyclophosphamide 600 mg/m2 d1, Dexamethasone 20 mg d1-4) for 3 to 6 course. The therapeutic effectiveness and side effects were evaluated. Results Among 5 patients, 1 patient was male and 4 patients were females with the age ranged from 48 years to 74 years. Their median myeloma cell ratio was 7.75%, median blood serum β2 microglobulin and albumin was 3.3 μg/L and 37.9 g/L before salvage therapy, respectively. The median course of treatment received by the series was 5. After treatment by ABCD regimen, 3 patients achieved partial remission, 1 patient achieved minimal response, 1 patient achieved stable disease. The median progression survival time was 4 months. The main side effects of treatment were grade 2 of gastrointestinal symptom (3 cases) and fatigue (3 cases), 1 case of grade 3 bone marrow and lung infection. Conclusion ABCD regimen is promising for the treatment of relapsed/refractory MM patients in terms of overall response rate and manageable adverse effects.
2018 Vol. 15 (23): 80-83 [Abstract] ( 248 ) HTML (1 KB)  PDF (414 KB)  ( 42 )
84 Effect of anthracycline on right ventricular function assessed by strain rate imaging in women with breast cancer
LIU Junfeng LIU Weiliang LU Haiyong CHEN Yunxuan WEN Dehui WANG Yicheng GAO Xinchun
Objective To investigate the value of strain rate imaging for assessing the effect of anthracycline on right ventricular function in women with breast cancer. Methods From October 2015 to October 2016, 80 women pathologically diagnosed as breast cancer and undergoing CAF chemotherapy protocol at the First Affiliated Hospital of Hebei North University were recruited in this study. By the way of self-control, conventional echocardiography and strain rate imaging were performed to assess the right ventricular function at the first day before starting chemotherapy and the fifth day of every 5 chemotherapy cycles. Results The tricuspid annular plane systolic excursion  was significantly lower, while the right ventricular myocardial performance index was significantly higher in women after the sixth cycles of chemotherapy compared with those before chemotherapy (P < 0.05). Strain rate imaging showed that global longitudinal strain rate, global radial strain and global circumferential strain in women after the sixth cycle of chemotherapy were significantly lower than those before chemotherapy(P < 0.05). Conclusion Strain rate imaging can reflect the change of right ventricular function at an early stage in breast cancer women treated with anthracycline.
2018 Vol. 15 (23): 84-87 [Abstract] ( 759 ) HTML (1 KB)  PDF (410 KB)  ( 63 )
88 Effect of folic acid and VitB12 in the expression of Cys C, Hcy, SOD in elderly patients with hyperhomocysteinemia and cerebral infarction with carotid atherosclerosis
GAO Yizhi1 DONG Chenglin1 ZUO Quan2 QIAN Zijuan3 LI Wanqing1 ZHANG Hui1 TIAN Xiaoli1 LI Renjie1
Objective To explore the effects of folic acid and VitB12 in the expression of cystatin C (Cys C), homocysteine (Hcy) and superoxide dismutase (SOD) in the elderly patients with hyperhomocysteinemia and cerebral infarction with carotid atherosclerosis. Methods A total of 130 elderly cerebral infarction patients with carotid atherosclerosis treated in Shanghai MCC Hospital from February 2015 to February 2016 were divided into observation group and control group by simple randomization method, with 65 cases in each group. All the patients accepted carotid plaque integral ultrasound examination. Control group was treated with Atorvastatin 20 mg qd, and Aspirin Enteric-coated Tablets 100 mg qd. Based on the routine treatment, observation group was treated with folic acid 5 mg qd and VitB12 500 μg bid for 6 months. The levels of Hcy, folic acid, VitB12, Cys C, SOD and carotid-atherosclerotic-plaque-scores were measured before treatment (baseline) and 6 months after hospital discharge. Results Before treatment, there was no statistically significant difference between the two groups in the levels of Hcy, folic acid, VitB12, Cys C, SOD and carotid-atherosclerotic-plaque-scores (P ＞ 0.05). After treatment, the levels of serum Hcy, Cys C, carotid atherosclerotic plaque scores of the observation group were lower than those in the control group (P ＜ 0.05); the levels of serum folic acid, VitB12, SOD of the observation group were higher than those in the control group (P ＜ 0.05). There was positive correlation of carotid atherosclerosis with the Cys C (r = 0.637, P ＜ 0.05) and negative correlation with the level of SOD (r = -0.585, P ＜ 0.05). The negative correlation also was found between the levels of SOD and Cys C (r = -0.608, P ＜ 0.05). Conclusion Serum Cys C and SOD take role in the pathogenesis of hyperhomocysteinemia and cerebral infarction with carotid atherosclerosis. Folic acid and VitB12 can improve the degree of elderly hyperhomocysteinemia and cerebral infarction with carotid atherosclerosis, reduce the levels of serum Hcy and Cys C, and improve the level of SOD.
2018 Vol. 15 (23): 88-91,95 [Abstract] ( 1084 ) HTML (1 KB)  PDF (614 KB)  ( 102 )
92 Analysis of factors related to quality of life and effects of psychological intervention on patients with strokeWEN Yan   YANG Hui▲
WEN Yan YANG Hui▲
Objective To explore the factors influencing the quality of life of stroke patients, and analyze the effects of psychological intervention on neurological and cognitive function in stroke patients with anxiety and depression. Methods Two hundred cases with stroke treated in Chongqing Mental Health Center from May 2012 to October 2015 were selected as the research subjects. All cases were conducted general investigation, and evaluated by the quality of life (QOL) scale determined by the World Health Organization. Of all the cases, 80 cases with anxiety and depression were selected for survey in deep. They were randomly divided into experimental group and control group by random number table method, with 40 cases in each group. Both groups were given the treatment of nutritioning brain cells, improving cerebral circulation and routining control of intracranial pressure, blood pressure and blood glucose. The experimental group was given psychological intervention in addition. After 2-month treatment, Hamilton depression scale (HAMD) score, anxiety scale (HAMA) score, Canada nerve functional rating scale (CNS) score, simplify Fugl-Meyer (FMA) sports score were compared between two groups before and after treatment. The cognitive function of patients was assessed by a simple mental state scale (MMSE). Results The QOL scores had significant differences among patients with different marital status, cultural level, monthly income, and self-attitude (P ＜ 0.01). After treatment, HAMD, HAMA and CNS scores were significantly lower than those before treatment, while the FMA scores were significantly higher than those before treatment, and the differences were statistically significant (P ＜ 0.01). After treatment, HAMD, HAMA and CNS scores of the experimental group were significantly lower than those in the control group, and the FMA scores were significantly higher than those in the control group, the differences were statistically significant (P ＜ 0.01). The total improvement of cognitive function after treatment in the experimental group was significantly higher than that in the control group (85.0% vs. 62.5%), and the difference was statistically significant (P ＜ 0.05). Conclusion For stroke patients with anxiety and depression, a reasonable, comprehensive and psychological intervention can enhance patients′ confidence in the recovery, obviously improve adverse mental state and the quality of life.
2018 Vol. 15 (23): 92-95 [Abstract] ( 754 ) HTML (1 KB)  PDF (586 KB)  ( 66 )
96 Study on the amount of Malassezia in the skin of patients with atopic dermatitis and its correlation with the disease severity
WU Hongmei LU Mao OU Mei LUO Yuanyuan
Objective To detect the amount of Malassezia in the skin of patients with atopic dermatitis (AD), and explore its correlation with the disease severity. Methods 20 mild, 20 moderate and 20 severe AD patients were selected from the First Affiliated Hospital of Chengdu Medical College from April to September 2017. Skin scales were collected as samples from the lesion and non lesion areas on the face and upper limb of AD patients as well as the corresponding areas of 20 healthy control subjects. The density of Malassezia was recorded at high magnification by fluorescent staining method. Then the correlation between the density of Malassezia and the disease severity was analyzed. Results The density of Malassezia in the lesion and non lesion areas on the face of the mild, moderate and severe AD patients was significantly higher than those of the upper limbs (P ＜ 0.05). The density of Malassezia in each skin area of mild, moderate and severe AD patients was significantly higher than that of healthy control subjects (P ＜ 0.05). The density of Malassezia in each skin area of AD patients was not correlated with the disease severity (P ＞ 0.05). Conclusion The amount of Malassezia in the skin of AD patients is related to the site, but not to the disease severity.
2018 Vol. 15 (23): 96-99 [Abstract] ( 188 ) HTML (1 KB)  PDF (590 KB)  ( 186 )
100 Application of transcranial Doppler ultrasound and microvascular Doppler ultrasound in detecting vasospasm after the aneurysm rupture
JI Zhongqing WANG Jin
Objective To investigate the application value of transcranial Doppler ultrasound (TCD) and microvascular Doppler ultrasound (MDU) in the treatment of hemorrhagic aneurysm. Methods A total of 78 patients with hemorrhagic aneurysm in the Second Central Hospital of Baoding City from October 2015 to May 2017 were selected and according to the order number, they were randomly divided into control group and study group, with 39 cases in each group. Both groups undertook craniotomy. Before and after aneurysm clipping, the study group was detected by MDU, and the control group was detected by TCD. For patients with vasospasm, the location of aneurysm clips was adjusted according to the situation of exploration. Before and after treatment, the treatment conditions (adjustment rate of aneurysm clip, reoperation rate, time of hospitalization), complication rate, activity of daily living (ADL) scores, quality of life (SF-36) scores and prognosis effect were statistically analyzed. Results The adjustment rate of aneurysm clips in the study group (38.46%) was higher than that in the control group (17.95%), the reoperation rate (5.13%) was lower than that in the control group (20.51%), and the time of hospitalization was shorter than that in the control group (P ＜ 0.05). The incidence rate of complications in the study group (10.26%) was lower than that of the control group (28.21%) (P ＜ 0.05). The scores of ADL and SF-36 in 6 months after operation were higher than those before operation, and the study group was higher than the control group (P ＜ 0.05). The prognosis of the study group was better than that of the control group (P ＜ 0.05). Conclusion The application of MDU in the treatment of hemorrhagic aneurysms is helpful to find the phenomenon of incomplete clipping or mistaken clips in the operation. Timely adjustment of the position of aneurysm clips can help to reduce the reoperation rate, shorten the hospitalization time, reduce the postoperative complications, improve the daily life ability and quality of life of patients, as well as the short-term prognosis.
2018 Vol. 15 (23): 100-103 [Abstract] ( 226 ) HTML (1 KB)  PDF (585 KB)  ( 127 )
104 Application value of immature granulocyte count in the early prediction of severe acute pancreatitis
WAN Yafeng1 WANG Li2
Objective To evaluate the early predictive value of immature granulocyte count and combined detection of severe acute pancreatitis (SAP). Methods The clinical data of 63 patients with acute pancreatitis who were admitted to Hangzhou First People′s Hospital from February to December 2017 was analyzed retrospectively, and the patients were divided into severe group (22 cases) and mild - to - moderate group (41 cases) according to whether the patient had persistent organ failure or local complications. At the time of admission, patients were checked about immature granulocyte count (IG#), immature granulocyte percent (IG%), C-reactive protein (CRP), procalcitonin (PCT), blood routine and biochemical routine. In the univariate analysis, parameters with statistical differences between the groups were included in the multivariate analysis. Finally, ROC curve was used to compare the predictive value of IG%, PCT, CRP and combined detection in the early determination of severe acute pancreatitis. Results The intra-abdominal pressure (IAP), acute physiology and chronic health evaluation (APACHE Ⅱ) scores, CT severity index (CTSI) scores and modified Marshall scores of the severe group were significantly higher than those of the mild - to - moderate group (P ＜ 0.001). In laboratory indicators, there were significant differences in CRP, PCT, IG% and albumin between the two groups (P < 0.001); multivariate analysis showed that IG% (P = 0.026), CRP (P = 0.011), and PCT (P = 0.029) were independent risk factors to predict severe acute pancreatitis. The ROC curve showed that CRP, PCT, and IG% all proved to have predictive value for severe acute pancreatitis (P ＜ 0.001). The combined detection of IG%+CRP+PCT had a higher AUC than the single indicator (P ＜ 0.001). Conclusion Within 48 hours of the attack of acute pancreatitis, IG% is a useful index for predicting SAP. IG%, CRP, and PCT are independent risk factors to predict SAP, and the combination of the three indicators has a higher sensitivity and specificity in the assessment of severity evaluation.
2018 Vol. 15 (23): 104-108 [Abstract] ( 228 ) HTML (1 KB)  PDF (692 KB)  ( 106 )
109 Clinical analysis of 6 cases of malignant melanoma of the esophagus
LIU Qinghao LONG Zhiqiang HUANG Weiming SHANG Xueqian LI Jian
Objective To investigate the clinical features, diagnosis, treatment and prognosis of malignant melanoma of the esophagus. Methods Clinical data of 6 patients with malignant melanoma of the esophagus admitted to Peking University First Hospital from January 2013 to May 2017 were retrospectively analyzed and all patients were followed up. Results The average age of the 6 patients was 57.7 years old, 4 males and 2 females. There were 2 cases in the middle segment of the esophagus and 4 cases in the lower part of the esophagus. There were 2 cases misdiagnosed by endoscopic biopsy, and definite diagnosis need pathological section and immunohistochemistry method. All the 6 cases undertwent surgery, 1 case undertwent surgery alone, and 5 cases received postoperative adjuvant therapy. They were divided by postoperative pathological stage, 2 cases in stage Ⅰ, 3 cases in stage Ⅱ, and 1 case in stage Ⅲ. Among them, 1 case underwent resection of pulmonary metastases 21 months after operation, and the case was followed up for 60 months after operation. The survival time was 8 to 60 months, and the median survival time was 18 months. Conclusion Malignant melanoma of the esophagus is a rare and highly invasive malignant tumor. Early diagnosis and early treatment can improve the prognosis. Strictly selected PMME patients with isolated/localized, and removal of metastatic tumors has survival benefits. The progress of immune-targeted therapy can improve the prognosis of more patients, which is worthy of further study.
2018 Vol. 15 (23): 109-112 [Abstract] ( 281 ) HTML (1 KB)  PDF (585 KB)  ( 73 )
113 The effect of Triclosan on the resistance mechanism of Stenotrophomonas maltophilia
GAO Ruihao1 WANG Yousen1 LIU Demei2▲
Objective To investigate the changes of Antibiotic resistance of Stenotrophomonas maltophilia and the expression of efflux pump SmeDEF in the induction of Triclosan. Methods From March to June in 2017, 10 strains of Stenotrophomonas maltophilia isolated from bacterial lab cultured in Weifang People′s Hospital were selected. The MIC of Stenotrophomonas maltophilia before and after the induction of Triclosan was compared and the repression level of the mRNA of efflux pump smeD was monitored by RT-PCR. Results The inhibition of 10 strains of bacteria pump sensitive to antibiotics was positive or negative. The levofloxacin MIC of 6 strains was 3-5 dilution higher than that before induction, and the MIC of 6 strains was reduced when the efflux pump inhibitor CCCP was used. The repression level of smeD of both pump inhibitor positive strains antibiotic overnight group and logarithmic growth addition group was significantly higher the no antibiotic group. Conclusion The resistance to antibiotics of Stenotrophomonas maltophilia clinical isolates induced by triclosan has increased, which is related to the expression of efflux pump SmeDEF.
2018 Vol. 15 (23): 113-116 [Abstract] ( 280 ) HTML (1 KB)  PDF (475 KB)  ( 96 )
117 Effect of Modified Zhibai Dihuang Pills combined with Alendronate Sodium and Vitamin D3 Tablets on bone mineral density, estradiol and immune function in postmenopausal osteoporosis patients with deficiency of liver and kidney
JIANG Qian1 HUANG Jianhua2 ZHENG Jun3 LIU Yingjie1
Objective To investigate the effect of Modified Zhibai Dihuang Pills combined with Alendronate Sodium and Vitamin D3 Tablets on bone mineral density, estradiol and immune function in postmenopausal osteoporosis (PMO) patients with deficiency of liver and kidney. Methods Two hundred PMO patients with deficiency of liver and kidney in Rui′an Hospital of Traditional Chinese Medicine from October 2014 to April 2016 were selected, and they were divided into control group and treatment group by random number table, with 100 cases in each group. The control group was given Alendronate Sodium and Vitamin D3 Tablets combined with Gukang Capsules, while the treatment group was treated with Modified Zhibai Dihuang Pills combined with Alendronate Sodium and Vitamin D3 Tablets. The bone mineral density, estradiol and immune function were compared between the two groups. Results Compared with before treatment, the bone mineral density of lumbar 1- lumbar 4 (L1-L4) and femoral neck (FN), serum estradiol, IgG and IgM in two groups increased (P ＜ 0.05). After treatment, the bone mineral density of L1-L4 and FN, serum estradiol, IgG and IgM in treatment group were higher than those in control group (P ＜ 0.05). There was no statistically significant difference in the IgA level between the two groups (P ＞ 0.05). Conclusion Modified Zhibai Dihuang Pills combined with Alendronate Sodium and Vitamin D3 Tablets in treatment of PMO patients with deficiency of liver and kidney can effectively improve immune function, regulate hormone levels and increase bone mineral density.
2018 Vol. 15 (23): 117-120 [Abstract] ( 275 ) HTML (1 KB)  PDF (415 KB)  ( 150 )
121 Effects of continuous health education on lung function and quality of life in elderly patients with stable chronic obstructive pulmonary disease
WANG Juan GONG Fanghua▲
Objective To investigate the effect of continuous health education on lung function and quality of life in elderly patients with stable chronic obstructive pulmonary disease (COPD). Methods From June 2015 to October 2016, in Department of respiration of Hu′nan People′s Hospital, 98 elderly patients with stable COPD were selected, according to random number table method, they were divided into control group and research group, with 49 cases in each group. The control group was given routine health education, while the research group was given continuous health education on the base of the control group. The forced expiratory volume at the first second (FEV1), maximal mid-expiratory flow curve (MMEF), forced vital capacity (FVC), the ratio of FEV1 and FVC (FEV1%) and quality of life of two groups before discharge and 6 months after discharge were compared and analyzed, the success rate of smoking cessation and the compliance rate of drug were compared between two groups. Results The FEV1, MMEF, FVC, FEV1% and the scores of the somatic function, psychological function, social function, specific module and total scale in the two groups 6 months after discharge were significantly higher than those before discharge (P < 0.05), these in the research group were significantly higher than the control group (P < 0.01). The success rate of smoking cessation and the compliance rate of drug of the research group were significantly higher than the control group (P < 0.05). Conclusion Continuous health education can significantly improve the lung function of the elderly patients with stable COPD, increase the success rate of smoking cessation and the compliance rate of drug, and improve the life quality of patients significantly.
2018 Vol. 15 (23): 121-124 [Abstract] ( 219 ) HTML (1 KB)  PDF (599 KB)  ( 52 )
125 Application effect of comprehensive nursing intervention on replantation of amputated finger
XU Hua1 YING Minrong1 FAN Liyun2
Objective To investigate the application effect of comprehensive nursing intervention on replantation of amputated finger. Methods From July 2015 and December 2017, in Department of Microscopic Orthopaedic, the Second People′s Hospital of Hefei City, 62 patients with replantation of amputated finger were selected. According to random number table method, they were divided into observation group and control group, with 31 cases in each group. The control group was given routine nursing care, the observation group was given vascular crisis nursing, comprehensive psychological nursing, delicate occupational rehabilitation training and traditional Chinese medicine nursing intervention based on routine nursing care. The survival rate and vascular crisis occurrence rate of severed finger, nursing service satisfaction in two groups were compared after patients leaving hospital, before nursing intervention and 3 months after surgery, severed finger function was assessed by total active movement (TAM), Purdue pegboard test (PPT) and Minnesota manual dexterity test (MMDT). Results The survival rate of the replantation severed finger in the observation group was higher than control group, the incidence of vascular crisis was lower than control group, the results of TAM, PPT, and MMDT were better than control group 3 months after surgery, the rate of nursing satisfaction was higher than control group, the differences were statistically significant (P < 0.05). Conclusion The comprehensive nursing intervention can effectively improve severed finger survival and function rehabilitation after replantation, it has high application value.
2018 Vol. 15 (23): 125-128,133 [Abstract] ( 241 ) HTML (1 KB)  PDF (628 KB)  ( 120 )
129 Influence of severe COPD patients in ICU by transition nursing
LI Xuemei1 TIAN Zhihong2▲ TANG Yu1 ZHAO Liqiong1 CHEN Xiaohua1 YANG Fang1 NIE Chenghui1
Objective To approach influence of severe COPD patients in ICU by transition nursing. Methods From June 2015 to June 2017, in ICU of Nanchong Center Hospital, the clinical data of 300 patients with severe COPD were retrospectively analyzed and divided into two groups by different nursing method, inclding routine nursing group (150 cases) and transition nursing group (150 cases). The clinical symptoms, lung function, living quality in two groups before and after intervention were detected, the incidence of return ICU, patients′ satisfaction of two groups were detected. Results Before intervention, the respiratory rate, heart rate, FEV1, FEV1/FVC, FEV1%, scores of general health, social function, body function, physiological functions, daily activity ability, physical discomfort, affective fluctuation and mental state score in two groups were compared, the differences were not statistically significant (P > 0.05). After intervention, the respiratory rate, heart rate in two groups were lower than before intervention, the above indicators in transition nursing group after intervention were lower than routine nursing group, the differences were statistically significant (P < 0.05); the FEV1, FEV1/FVC, FEV1%, and scores of general health, social function, body function, physiological functions, daily activity ability, physical discomfort, affective fluctuation, mental state score in two groups were higher than before intervention, the above indicators in transition nursing group were higher than routine nursing group, the differences were statistically significant (P < 0.05). The incidence of return ICU in transition nursing group was lower than routine nursing group, the patients′ satisfaction rate in transition nursing group was higher than routine nursing group, the differences were statistically significant (P < 0.05). Conclusion The application of transition nursing in severe COPD patients in ICU can improve respiratory rate, heart rate，increase lung function and living quality, decrease return ICU rate, which is worthy of clinical application.
2018 Vol. 15 (23): 129-133 [Abstract] ( 197 ) HTML (1 KB)  PDF (618 KB)  ( 97 )
134 Effect of continuous nursing on level of hope and self management of patients after percutaneous coronary intervention
MEI Guiying
Objective To explore the effect of continuous nursing on the level of hope and self management of patients after percutaneous coronary intervention (PCI). Methods From January 2012 to October 2016, in Central Hospital of Chaoyang City, 93 patients with ST segment elevation acute myocardial infarction who received PCI treatment were selected; according to ballot method, they were divided into observation group (47 cases) and control group (46 cases). The observation group was given continuous nursing and the control group was given routine nursing. The level of hope and self management of patients in two groups were evaluated in hospital and 6 months after discharge respectively. The incidence of major adverse events after 1 years of discharge in two groups was compared. Results There was no significant difference in the total score of hope and the level of self management between the two groups (P > 0.05). The total scores of hope and self management level of the patients in the observation group were higher than those in the control group at 6 months of discharge, the differences were statistically significant (P < 0.05). The incidence of major adverse events of the patients in the observation group was lower than that in the control group after 1 year of discharge follow-up，the difference was statistically significant (P < 0.05). Conclusion Continuous nursing can improve patients' self-management ability and hope level and reduce the incidence of major adverse cardiac events after PCI, which is worthy of clinical application.
2018 Vol. 15 (23): 134-137,145 [Abstract] ( 218 ) HTML (1 KB)  PDF (628 KB)  ( 62 )
138 Influence of primary nursing on mentality, nerve function and life quality for cerebral thrombosis patients
XUE Huarui HE Aixia▲
Objective To arpproach influence of primary nursing on mentality, nerve function and life quality for cerebral thrombosis patients. Methods From February 2016 to February 2017, in Department of Neurology, the Second Hospital in Yulin City, the clinical data of 200 patients with cerebral thrombosis were analyzed and patients were divided into control group (100 cases) and primary nursing group (100 cases) by different nursing methods. The anxious was detected by self-rating anxiety scale, the depressed was detected by self-rating depressed scale, the nerve function defect was detected by NIHSS rating scales, the daily living activity was detected by Barthel index score, the life quality was detected by life quality rating scales. The anxious score, depressed score, nerve function defect score, Barthel index score, life quality score before nursing and after nursing, and the recurrence rate and satisfaction after nursing of two groups were compared. Results Before nursing, the anxious score, depressed score, nerve function defect score, Barthel index score, life quality score of patients in two groups before nursing were compared, the differences were not statistically significant (P > 0.05). After nursing, the anxious score, depressed score, nerve function defect score in two groups were lower than before nursing, and these in primary nursing group were lower than control group, the differences were statistically significant (P < 0.05). Barthel index score, life quality score in two groups were higher than before nursing, these in primary nursing group were higher than control group, the differences were statistically significant (P < 0.05). The recurrence rate in primary nursing group was lower than control group, the satisfaction rate was higher than control group, the differences were statistically significant (P < 0.05). Conclusion The application of primary nursing in cerebral thrombosis patients can decrease anxious, depressed, recove nerve function, increase life quality and satisfaction, decrease recurrence rate.
2018 Vol. 15 (23): 138-141 [Abstract] ( 238 ) HTML (1 KB)  PDF (600 KB)  ( 66 )
142 Efficacy study of behavioral intervention combined with psychological nursing on patients with schizophrenia
WANG Fang CHEN Jin XUE Li LU Huijie▲
Objective To explore the effect of behavioral intervention combined with psychological nursing on the first-episode schizophrenia patients. Methods From December 2013 to December 2014, in Shanghai Mental Health Center, 74 schizophrenic patients were selected as the research object. According to the random number table, they were divided into observation group and control group, with 37 cases in each group. Patients in the control group were treated with risperidone only, while the observation group was treated with behavioral training combined with psychological nursing intervention on the basis of the control group, the intervention period was 2 months. The insight and treatment attitude questionnaire (ITAQ) was used to compare the cognition and attitude towards the treatment of patients in the two groups, the Brief Psychiatric Rating Scale (BPRS) was used to evaluate psychiatric symptoms in two groups before and after treatment, the global assessment scale (GAS) was used to measure the severity of the disease before and after treatment. Results Before treatment, there was no significant difference in ITAQ, BPRS and GAS scores of patients in the two groups (P > 0.05). After treatment, ITAQ, BPRS scores in two groups were higher than before treatment, and ITAQ, GAS scores in observation group were higher than control group, the differences were statistically significant (P < 0.05); BPRS scores were lower than before treatmnet, and BPRS scores in observation group were lower than control group, the differences were statistically significant (P < 0.05). Conclusion The behavioral intervention combined with psychological nursing intervention can improve the negative emotions of schizophrenic patients, alleviate symptoms to some extent, improve the level of general function, thus worthy of promotion.
2018 Vol. 15 (23): 142-145 [Abstract] ( 184 ) HTML (1 KB)  PDF (608 KB)  ( 56 )
146 Application of vertical short scar breast reduction technique in moderate and severe of benign and malignant ptosis breast diseases
CHEN Ying1 XIE Wanjun2 XIE Fengfeng1 LIU Dan1 ZHONG Shaowen1 CHEN Qianjun1▲
The vertical intra-areolar incision is a useful procedure for reduction mammaplasty. With the widespread use of breast plastic technique, this method has been used in treating benign and malignant breast disease. The typical Lejour′s design and SPAIR′s design is used in Department of Galactophore of Guangdong Hospital of Traditional Chinese Medicine ("our department" for short), the suitable glandular pedicle is selected according the range which needs to be excised, then elevate the nipple-alveolar complex to a proper position, only surround Areola and vertical scar are left. Fifteen patients (30 breasts) were treated using this method in our department, the results were satisfactory except “dog′s ear” occurred in 2 patients. This paper mainly introduce the technique in treating 3 patients with breast cancer, multiple fibroadenoma, mastitis, separately. It is considered that vertical reduction mammaplasty is very useful in those with moderate and severe of benign and malignant ptosis breast disease, this method can not only resect the lesions completely, but also give the good breast shape, is worthy of promotion.
2018 Vol. 15 (23): 146-149,163 [Abstract] ( 218 ) HTML (1 KB)  PDF (994 KB)  ( 153 )
150 Research on the strategy of the flipped classroom teaching modes in the big-class theory teaching of pharmaceutics
WU Min YIN Huanli FENG Yi HE Manyu
The improvement of teaching quality in flipped classroom obtained from reforming teaching process in imparting the knowledge in advance and the optimizing knowledge internalization. This study aimed at the problems existing in the big-class theory teaching of pharmaceutics, the innovative flipped classroom teaching mode was presented in the course of designing the flipped classroom teaching mode based on problem-driven. Therefor, the reconstruction of classroom teaching of pharmacy was implemented. Three teaching modes namely“completely inverted classroom”, “partly inverted classroom” and “inverted classroom in short-time” were put forward in pharmacy theoretical teaching on the basis of practice. At the same time, connecting with the characteristics of the pharmacy curriculum, two kinds of effective methods were explored to help students build complete knowledge structures including the learning method based on technological process and the construction method based on blackboard design. This study provides a fire-new teaching mode for big-class pharmaceutics theory teaching of pharmacy and relevant professional curriculums.
2018 Vol. 15 (23): 150-155 [Abstract] ( 230 ) HTML (1 KB)  PDF (1025 KB)  ( 121 )
156 Discussion on the effect of ICU transfusion safety management based on problem management model
YANG Baoyi1 WANG Rong1 DENG Chunyan1 MA Xiaofang1 GUO Xuezhen1 LI Yaling2
Objective To explore the application effect of management by problem in safety management of ICU blood transfusion. Methods From July 2016 to June 2017, a total of 378 patients who were hospitalized in the ICU at Taihe Hospital of Shiyan City and required blood transfusion were selected as study subjects. A total of 182 patients from July to December 2016 were served as a before MBP group and traditional methods were used for blood transfusion safety management, while 196 patients from January to June 2017 were treated as after MBP group, and the problem management model was used to management by problem for blood transfusion safety. The standard rate of blood transfusion safety management and the satisfaction of patients to nursing work were compared between two groups. Results After the problem management model was introduced into the patient′s blood transfusion safety management, the compliance rate of ICU blood transfusion safety management (59/60 cases, 98.3%) was higher than that before the implementation (55/60 cases, 91.67 %) (P ＜ 0.05). After the implementation of MBP, the patient′s satisfaction was 97.96%, which was higher than the 92.31% before implementation (P ＜ 0.05). Conclusion MBP model can improve the nursing quality of blood transfusion safety management and the satisfaction of patients to nursing work, and it is worth popularizing and applying in clinic.
2018 Vol. 15 (23): 156-159 [Abstract] ( 214 ) HTML (1 KB)  PDF (732 KB)  ( 59 )
160 Reform and exploration of a county public hospital that co-cooperation between government and university in Guangdong Province
QIAN Yi1 ZOU li′ai2 CHEN Yuandong3 WENG Yibing4▲ DENG Jie5
In recent years, the co-cooperation between government and university has gradually become a new mode. It has become an important driving force to achieve the leap development of the hospital and a new viewing angle to promote the reform of the country-level public hospitals. A case study was conducted in the co-cooperation between government and university in Guangdong Province. The study focuses on the general situation that existed in the hospital before the reform, summarizes the hospital comprehensive reform measures and analyzes its mode. The practice shows that the co-cooperation between government and university and the reform of county-level public hospitals can promote each other and develop together. This model innovates the reform and development path of county-level public hospitals in the province and provides references for other medical colleges to cooperate with the government and medical institutions.
2018 Vol. 15 (23): 160-163 [Abstract] ( 192 ) HTML (1 KB)  PDF (657 KB)  ( 171 )
164 Advantages of medical institutions in the combination of medical care and pension services in Qujing
GAO Jigui1 LI Qiaofen1 PENG Chun1 LI Rui1 DI Yaxia1 YANG Yungui1 SHI Zhuyun2 WANG Juling1
As the policy of the combination of medical care and pension services in Qujing has established and improved, the private pension institutions have developed quickly, the innovation are appearing in the service mode of medical support combined with pension service, the industry of the combination of medical care and pension services are developed. Based on such reality, this paper analyzed how the medical institutions provide service which combined the medical and pension services together by method of SWOT, throngh the four dimensions such as strengths,  weaknesses, opportunities and threats, and it finds that a comprehensive planning and coordination is required by both the government departments and medical institutions. In future, it should to strengthen the government level planning guidance and leadership, integrate the functions of different government departments such as civil affairs bureau, health and family planning commission, aging committee, human resources and social security departments. It must strengthen the communication and coordination among these departments, to investigate the matching situation of the demand and the supply for the combination of medical care and pension services in Qujing, and ensure the pertinence. With the development of hospital united systems, the integration and optimization of quality medical resources are required, combining with the existing service capacity and workload of medical institutions, a scientific and rational hierarchical design is carried out. Also, It must establish a set of complete and scientific admission and discharge, pension, medical mutual transformation between dynamic evaluation system and evaluation standards, to determine medical services into health care expenses, pension service fees according to the standard;  otherwise, it must measure and control the cost of medical institutions scientifically and reasonably in order to make them work properly and reflect public welfare at the same time, and then the old people can benefit from these measures.
2018 Vol. 15 (23): 164-168,181 [Abstract] ( 206 ) HTML (1 KB)  PDF (850 KB)  ( 95 )
169 Experience of dermatologists participating in scientific research and innovation project of medical undergraduates
CHEN Hui ZHAO Chen LIAN Shi ZHU Wei
In order to train medical undergraduates′ scientific research thinking and stimulate their innovative ability, Capital Medical University has launched scientific research and innovation project of undergraduates in recent years. The scientific research and innovation project should be derived from clinical practice. In the process of project implementation, the enthusiasm of undergraduates should be fully mobilized. Under the guidance of the teacher, undergraduates overcome their deficiency of background knowledge and scientific research foundation and improve their manipulative ability and the ability to solve practical problems. Scientific research and innovation project can also enhance undergraduates′ literature retrieval ability and writing level, cultivate team awareness and improve humanistic quality. Meanwhile, the abilities of teachers in project design and scientific research management are promoted. Scientific research and innovation project benefits teachers as well as medical undergraduates.
2018 Vol. 15 (23): 169-172 [Abstract] ( 232 ) HTML (1 KB)  PDF (724 KB)  ( 110 )
173 Research and thinking on the innovation of hospital budget management under the new form of medical reform
WANG Mingli1 WANG Guoqiang2 ZHU Yong3
The hospital budget management level is the core of the hospital financial management efficiency, which involves the hospital management goal and all aspects of its operation. At present, with the continuous deepening of medical reform in the new era, hospital budget management is facing many new problems and challenges. It is becoming a hot topic in the field of economic management to explore new methods and ideas of hospital budget management innovation. This paper will take the new form of medical reform as the background, and base on the "function-benefit" of public hospitals to increase the cost-benefit framework, starting from the situation and tasks faced by budget management, and based on the current situation of hospital budget management and the existing problems of universality. From the aspects of budgeting, execution, control path and other management topics, this paper gives practical discussion, and elaborates on the target strategy of the innovation of hospital budget management under the new form of medical reform. It aims to provide a theoretical basis for the sustainable and healthy development of hospital financial management.
2018 Vol. 15 (23): 173-177 [Abstract] ( 190 ) HTML (1 KB)  PDF (661 KB)  ( 133 )
178 Discussion on quality control measures of clinical examination laboratory in comprehensive hospital
GAO Qi GUO Xin
Objective To discuss the quality control measures of clinical examination laboratory in comprehensive hospital. Methods Three hundred cases of patients from May 2016 to May 2017 in Beijing Friendship Hospital, Capital Medical University were randomly selected, the clinical information data of 300 cases was analyzed retrospectively, the main influence factors of quality control of clinical laboratory were found out, then the targeted measures were enacted. Results Among the 300 patients, there were 64 cases of poor quality control. In the aspect of time of occurrence, there were 34 cases in the sample preparation stage, 11 cases in the sample collection stage, 9 cases in the sample processing test stage, accounted for 53.1%, 17.2% and 14.1% respectively, and 10 cases in the test equipment application, accounted for 15.6%. Conclusion The influence factors of clinical examination laboratory in comprehensive hospital are mainly sample preparation stage, acquisition stage, processing and inspection stage errors or improper application testing equipment failure, the clinic should actively take effective measures to improve the hospital clinical laboratory quality.
2018 Vol. 15 (23): 178-181 [Abstract] ( 199 ) HTML (1 KB)  PDF (828 KB)  ( 147 )
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