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2019 Vol. 16, No. 5 Published: 2019-02-15

	4	Effect of melatonin on acute kidney injury and miR-146a level in septic mice
		ZHANG Jianing1 CAO Mengyuan2 LI Lincheng1 LIU Mingchuan1 LIU Yang3 HE Ting3▲
		Objective To investigate the effect of melatonin (MT) on apoptosis of renal cells and inflammation in lipopolysaccharide (LPS)-induced septic mice, and to explore the effect of MT on renal injury in sepsis as well as the role that microRNA-146a(miR-146a) plays. Methods Forty-eight male Balb/c mice were divided into sham-operated group (Sham group), MT treatment group (MT group) and placebo group (NS group) according to random number table method, with 16 mice in each group. Mice in the latter two groups were injected with LPS (10 mg/kg body weight) intraperitoneally to prepare sepsis model. Mice in MT group were injected with MT (30 mg/kg body weight) three times separately at half an hour before LPS injection, the same time as LPS injection and 4 hours after injection. At the same time，mice in NS group and Sham group were injected with same volume saline. After LPS treatment for 24 hours, the levels of interleukin (IL)-1β and IL-6 mRNA, miR-146a, the expression of apoptotic proteins Caspase-3 and Bax, serum creatinine (Cr) and urea nitrogen (BUN) were detected. After LPS treatment for 72 hours, the renal pathological changes and injuries of mice in each group were observed. Results ①The renal structure was normal in Sham group. The renal tubules in NS group were of tubular type, with unclear tubular structure, glomerular pyknosis, and a large number of inflammatory cells infiltrating; the number of necrotic glomeruli in MT group was much less than that in NS group. ②The levels of serum Cr and BUN in NS group were significantly higher than those in Sham group (P ＜ 0.01). The levels of Cr and BUN in MT group mice were significantly lower than those in NS group (P ＜ 0.01). ③The levels of Cleaved-caspase 3 and Bax in MT group mice were significantly lower than those in NS group (P ＜ 0.01). ④The levels of IL-1β and IL-6 in these three groups mice had statistically significant difference (P ＜ 0.05). In MT group, the levels of IL-1β and IL-6 in renal tissues were lower than those in NS group (P ＜ 0.01). ⑤The levels of miR-146a in renal tissues were highly statistically different in these three groups mice (P ＜ 0.01). In MT group, it was significantly higher than that in NS group (P ＜ 0.01). Conclusion MT can significantly improve renal injury in LPS-induced septic mice, which may related to the upregulation of miR-146a and suppression of inflammation and cell apoptosis.
		2019 Vol. 16 (5): 4-8 [Abstract] ( 262 ) HTML (1 KB) PDF (636 KB) ( 145 )

	9	The study of the pathogenesis of hyperthyroidism-induced atrial fibrillation and atrial sympathetic nerve remodeling
		ZHENG Jialin1 DAI Hualei1 ZHANG Xinjin1 LI Jianmei2
		Objective To study the pathogenesis of hyperthyroidism-induced atrial fibrillation and atrial sympathetic nerve remodeling. Methods According to random number table method, 50 adult healthy Japanese big ear rabbits were divided into two month administration group (n = 20), four month administration group (n = 20) and control group (n = 10). The two month administration group received intraperitoneal injection of thyroxine 50 μg/kg daily for 2 months, the four month administration group received intraperitoneal injection of thyroxine 50 μg/kg daily for 4 months, and the control group received intraperitoneal injection of equal dose of normal saline for 4 months. Animal models of hyperthyroidism and atrial fibrillation vulnerability were prepared. The basic data, left atrial effective refractory period (LAERP), induced rate of atrial fibrillation, and expression of related indicators of sympathetic nerve activation and remodeling were compared among the three groups. Results ①After the experiment, the body weight of two month administration group and four month administration group were lower than those of control group, and the body weight of four month administration group was lower than that of two month administration group (P ＜ 0.05); the heart rate of two month administration group and four month administration group were faster than those of control group (P ＜ 0.05). ②The LAERP in the two month administration group and four month administration group were shorter than those in the control group, and that in the four month administration group was shorter than that in the two month administration group (P ＜ 0.05). ③The induced rate of atrial fibrillation in the four month administration group was higher than that in the two month administration group and the control group (P ＜ 0.05). ④The level of norepinephrine in the two month administration group and the four month administration group were higher than those in the control group (P ＜ 0.05). ⑤The relative expression of tyrosine hydroxylase (TH) and growth associated proteins-43 (GAP-43) mRNA in the two month administration group and four month administration group were higher than those in the control group (P ＜ 0.05), and the relative expression of GAP-43 mRNA in the four month administration group was higher than that in the two month administration group (P ＜ 0.05). ⑥The relative expression of TH and GAP-43 protein in the two month administration group and four month administration group were higher than those in the control group (P ＜ 0.05), and the relative expression of GAP-43 protein in the four month administration group was higher than that in the two month administration group (P ＜ 0.05). Conclusion Atrial sympathetic nerve is overactivated and remodeled under continuous high level of thyroxine exposure, which may be one of the pathogenesis of hyperthyroidism-induced atrial fibrillation.
		2019 Vol. 16 (5): 9-13,18 [Abstract] ( 203 ) HTML (1 KB) PDF (792 KB) ( 74 )

	14	Establishment of hypoxia-resistant gastric cancer cell line and biological characteristics identification
		CHE Xiaofang1，2 SHI Xiaonan1，2 ZHENG Chunlei1，2 YANG Zichang1，2 ZHANG Xiaojie1，2 QU Xiujuan1，2 LIU Yunpeng1，2
		Objective To establish a hypoxic-resistant gastric cancer cell line and analyze its biological characteristics to provide a good model for the study of hypoxic microenvironment in gastric cancer. Methods The hypoxic-resistant gastric cancer cell lines MGC803/hypo and BGC823/hypo, which were tolerant to 2% O2, were established by gradually decreasing the oxygen concentration. The morphology of the cells was observed by inverted microscope. The cell metastasis ability was detected by Transwell chamber. The cell proliferation ability was detected by MTT assay. The protein expression was detected by Western blot. The biological characteristics of the gastric cancer cell lines were compared with those of their parents. Results Compared with the parental gastric cancer cell line, the hypoxic-resistant gastric cancer cell line showed spindle-shaped changes and loosely arranged. The color of the culture medium was easy to turn yellow, the migration ability was significantly enhanced (P < 0.05), and the proliferation ability was weakened (P > 0.05). Hypoxia-related index HIF-2α was significantly up-regulated, Glut1 was up-regulated in glycolytic index, ZO-1 was down-regulated in epithelial mesenchymal transition (EMT), vimentin was up-regulated, and metastasis-related indicators MUC1, integrin α5, and integrin β1 were up-regulated. Conclusion This study established hypoxic-resistant gastric cancer cell lines MGC803/hypo and BGC823/hypo which can tolerate 2% O2 concentration. The Metastasis ability is obviously enhanced and the proliferative ability is relatively weakened. This provides a good model for exploring the mechanism of hypoxic microenvironment promoting tumor metastasis.
		2019 Vol. 16 (5): 14-18 [Abstract] ( 243 ) HTML (1 KB) PDF (891 KB) ( 111 )

	19	Effects of different proportions of cryoprotective agents on transplanted human granule fat in nude mice
		SUNYin1 WU Mingzheng2 GU Luosha3 BAI Jie1 GU Jinsong1▲ YU Jiang1 YAN Runhu1 ZHANG Yi1
		Objective To investigate the effects of cryoprotective agents with different proportions on transplantation of frozen human granular fat in nude mice in order to optimize the selection of cryoprotectants. Methods The excess granular fat after liposuction on the inner side of the thigh was taken into the cryoprotective agents of A and B in different proportions, group A and group B respectively and they were stored at -80°C for 6 months. After 6 months, the specimens were resuscitated and transplanted subcutaneously into the back of nude mice, and 0.2 mL granular fat was injected at each transplant site. After 4 weeks, the nude mice were sacrificed, and the grafts were taken out for volume and weight detection, and observed under hematoxylin-eosin (HE) staining and transmission electron microscopy. Results The mean volume of residual fat in group A was greater than that in group B, and the difference was statistically significant (P < 0.05). HE staining showed that the neovascularization of group A was more than that of group B. Under transmission electron microscope, the fat cells of group A were more complete and there were more new fat cells. Conclusion The long-term frozen fat of group A cryoprotective agents has higher activity, and fetal bovine serum can be replaced by calf serum. The adipose tissue can still be effectively transplanted after cryopreservation for half a year.
		2019 Vol. 16 (5): 19-22 [Abstract] ( 181 ) HTML (1 KB) PDF (982 KB) ( 66 )

	23	Advances in research on the relationship between stroke location and sleep disorders
		ZHANG Fang MAN Yuhong YAO Gang YU Tingmin
		The occurrence and clinical manifestations of post-stroke sleep disorders are related to the injury site of stroke. Brain stem stroke leads to rapid eye movement sleep behavior disorder, sleep-disordered breathing, restless leg syndrome and periodic limb movement in sleep. Patients with thalamic stroke often show increased sleep. Hypothalamic stroke related sleep disorders manifest as somnolence and narcolepsy. Prefrontal cortical stroke causes insomnia. The regulation of the wake-sleep cycle depends on the anatomical and functional integrity of the cortical and subcortical neural networks. The mechanisms of post-stroke sleep disorders are mainly associated with the destruction of anatomical fibers and impaired neurotransmitter function after stroke in different locations. As post-stroke sleep disorders affect the improvement of neurological function, clinicians should pay attention to this as early as possible.
		2019 Vol. 16 (5): 23-26 [Abstract] ( 194 ) HTML (1 KB) PDF (544 KB) ( 109 )

	27	Advances in the study of LINE-1 retrotransposition in nervous system
		MAO Yang LI Xiaoyu
		Long interspersed nuclear element 1 (LINE-1) belongs to retrotransposon, which is the only currently known active autonomous transposon in human cells. It comprises a large proportion of human genome, and its transposition may induce genetic instability and cause serious consequences. Usually, host cells develope multiple strategies to restrict LINE-1 retrotransposition and LINE-1 is inactive in most somatic cells. However, the nerve cells is an exception: LINE-1 can express and transpose in nerve cells, and each neuron is genetically unique by the fact that LINE-1 can insert into various genomic locations. LINE-1 retrotransposition could contribute to some physiological significance such as long-term memory, on the other hand, the expression of LINE-1 may also have some pathological effects. We hope this paper may shed light on the acknowledgement of function of LINE-1 in the nervous system.
		2019 Vol. 16 (5): 27-29,46 [Abstract] ( 189 ) HTML (1 KB) PDF (793 KB) ( 132 )

	30	Research progress in the treatment of threatened abortion
		LIU Deguang MA Hongli WANG Yu GAO Jingshu WU Xiaoke▲
		Biomarker detection can determine the prognosis of threatened abortion. The decrease of serum estradiol, progesterone, beta-human chorionic gonadotropin (β-HCG) levels are closely related to threatened abortion in early pregnancy, and the risk of abortion increases with the increase of serum saccharide antigen (CA125), which has guiding significance for clinical treatment of threatened abortion. Traditional Chinese medicine believes that the main cause of threatened abortion is kidney deficiency. It is advisable to use tonifying kidney for preventing miscarriage as a treatment method. The prescription should be supplemented with Shoutai Pills, which can assist with acupuncture treatment, thus alleviating the tension and anxiety and abdominal pain of pregnant women with threatened abortion and improving their quality of life. Progesterone is the main drug for threatened abortion in Western medicine, and it is only suitable for early pregnancy threatened abortion due to low progesterone levels caused by luteal insufficiency.
		2019 Vol. 16 (5): 30-33 [Abstract] ( 200 ) HTML (1 KB) PDF (505 KB) ( 134 )

	34	Advances in the clinical application of bone marrow biopsy pathology in anaemia related blood system diseases
		KONG Linghong1 YE Fang2 LIU Xiaogang1
		There are many types of blood diseases, but the clinical symptoms of different blood diseases are very similar, often accompanied by anemia. It is difficult to make accurate diagnosis only by clinical symptoms. Bone marrow biopsy pathology is the most basic examination method for the morphological diagnosis of hematopathy. This article summarizes the bone marrow biopsy pathology of aplastic anemia, myelodysplastic syndrome, myelofibrosis, gigantic young cell anemia, leukemia, multiple myeloma, the clinical application of blood system diseases such as bone marrow biopsy pathology in clinical diagnosis and treatment guidelines, curative effect evaluation and prognosis evaluation and research progress of aims to improve the blood for clinical diagnostic rate, reduce the misdiagnosis rate to provide a safe and efficient diagnostic method.
		2019 Vol. 16 (5): 34-37 [Abstract] ( 227 ) HTML (1 KB) PDF (505 KB) ( 135 )

	38	Multicenter survey of Mycoplasma pneumoniae infection and 23S rRNA mutation in children in Taizhou region
		YING Xiaoming1 WANG Lizhen2 ZHENG Changhua3 YANG Shanpu4
		Objective To know about the infection conditions of Mycoplasma pneumonia (MP) and conditions of drug resistance to macrolides of children with acute respiratory infection in Taizhou region. Methods Through multicenter investigation of pediatric departments in the 4 hospitals of Taizhou First People′s Hospital, Taizhou Hospital of Zhejiang Province, the First People′s Hospital of Wenling and the People′s Hospital of Yuhuan, the respiratory tract samples of 4395 cases of children with acute respiratory infection were collected from January 2016 to December 2017. Real-time PCR was used to detect the positive rates of MP and the mutations of its drug resistance gene (23S rRNA). Then the clinical data was analyzed. Results The results of Real-time PCR showed that among 4395 children with acute respiratory infection, 742 cases were MP positive, the infection rate was 16.88%, among whom, there were 422 cases of mutation of 23S rRNA, the mutation rate was 56.87%. There was statistically significant difference of the positive rates of MP among different seasons (P ＜ 0.05), among which, summer (23.56%) was the highest. There was statistically significant difference in the positive rates of MP among different age groups (P ＜ 0.05), and it increased with age. There was no significant difference in infection rate of MP between children of different sexes (P ＞ 0.05); there was no significant difference in mutation rate of 23S rRNA among children of different seasons and sexes (P ＞ 0.05); and there was statistically significant difference in mutation rate of 23S rRNA among children of different ages (P ＜ 0.05). Conclusion This multicenter combining research shows that MP infection may have correlation with climate and age. MP infection is more common in summer and older children. At the same time, MP has higher drug resistance rates for macrolides.
		2019 Vol. 16 (5): 38-41 [Abstract] ( 235 ) HTML (1 KB) PDF (473 KB) ( 78 )

	42	Analysis on key drivers of patients′ medical experience from the perspective of satisfaction
		SONG Haiyan ZUO Xu CUI Chengsen SUN Xinyue MENG Kai
		Objective To analyze key drivers of patient′s satisfaction for providing scientific basis for the improvement of the patients′ medical experience. Methods A self-developed questionnaire was used and convenience sampling method was applied to conduct a satisfaction survey on 518 patients in a hospital in July 2018. The importance matrix analysis method was used to identify the key drivers of patient′s satisfaction. Results The hospital had advantages in terms of "nurse technical operation" and "nurse service attitude". The disadvantages were "the smooth of medical process", "the reasonableness of medical charges" "logistics services" "visiting or inpatient environment" "the type and quantity of hospital facilities and equipment" and "the level of doctors′ treatment". Conclusion These six items at a disadvantage have a greater impact on satisfaction and a lower satisfaction score, which are the key drivers of patient′s satisfaction. Therefore, future reforms should focus on further optimizing the clinic process, improving the doctors′ clinic levels, reforming logistics services, and strengthening hospital facilities and environmental construction.
		2019 Vol. 16 (5): 42-46 [Abstract] ( 264 ) HTML (1 KB) PDF (576 KB) ( 126 )

	47	Clinical efficacy of Ginkgo bilobate extract combined with deproteinized calf blood extratives for injection in the treatment of acute cerebral infarction
		HUANG Heming1 GAO Xia1 ZHANG Rui1 CHEN Shi1 ZOU Liangyu2
		Objective To investigate the clinical efficacy of Ginkgo bilobate extract combined with deproteinized calf blood extratives for injection in the treatment of acute cerebral infarction. Methods A total of 80 patients with acute cerebral infarction admitted to Shenzhen People′s Hospital from February 2013 to December 2017 were selected. Patients were divided into control group (40 cases) and study group (40 cases) by random number table method, and the control group was treated with deproteinized calf blood extratives for injection, while the study group was treated with Ginkgo bilobate extract on the basis of the control group treatment. The clinical efficacy of the two groups after treatment was compared. Serological indicators were compared between the two groups before and after treatment, including the serum levels of interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), endothelin-1 (ET-1), nitric oxide (NO), and hemorheological index. The incidence of adverse reactions during the treatment of the two groups was recorded and compared. Results The total effective rate of the study group was significantly higher than that of the control group (P ＜ 0.05). After treatment, the levels of IL-6, hs-CRP, TNF-α and ET-1 in the two groups were lower than those before treatment, and those in the study group were lower than those in the control group (P ＜ 0.05); NO was higher than that before treatment, and that in the study group was higher than that in the control group (P ＜ 0.05). After treatment, the plasma viscosity, blood viscosity, hematocrit and erythrocyte aggregation index of the two groups were lower than those before treatment, and those in the study group were lower than those in the control group (P ＜ 0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P ＞ 0.05). Conclusion Ginkgo bilobate extract combined with deproteinized calf blood extratives for injection is effective in the treatment of acute cerebral infarction. It can maintain the stability of hemorheological index, improve the serological indicator of the patients, and the therapy does not increase the incidence of adverse reactions. It has certain clinical application value.
		2019 Vol. 16 (5): 47-50 [Abstract] ( 256 ) HTML (1 KB) PDF (494 KB) ( 101 )

	51	Effect of different doses of Atorvastatin combined with Metoprolol in the treatment of acute congestive heart failure complicated with renal insufficiency
		LI Jing1 LYU Guofen2 LIU Junfa1▲
		Objective To study the effect of different doses of Atorvastatin combined with Metoprolol in the treatment of acute congestive heart failure (CHF) complicated with renal insufficiency. Methods A total of 120 patients with acute CHF combined with renal insufficiency from April 2017 to April 2018 admitted to the Second Hospital of Handan City were selected as the research subjects and they were divided into observation group and control group by method of random sampling, with 60 cases in each group. The observation group was given Metoprolol and high-dose Atorvastatin (40 mg/d), and the control group was given Metoprolol and low-dose Atorvastatin (20 mg/d). After four weeks, the treatment effect of the two groups was compared, the cardiac function, renal function and levels of inflammatory factors were recorded before and after treatment in the two groups, and the incidence of adverse reactions during the treatment was recorded. Results There was no significant difference in the total effective rate between the two groups (P ＞ 0.05). The effect of the observation group was significantly better than that of the control group, the difference was statistically significant (P ＜ 0.05). After treatment, the left ventricular ejection fraction (LVEF) and the distance of 6 min walking test (6MWT) in the observation group were significantly higher than those before treatment and than those of the control group after treatment. After treatment, the left ventricular end diastolic diameter (LVEDD) of the observation group was significantly lower than that before treatment and that of the control group, and the difference was statistically significant (P ＜ 0.05). After treatment, the glomerular filtration rate (GFR) of the observation group was significantly higher than that before treatment and that of the control group. After treatment, the blood urea nitrogen (BUN) and the serum creatinine (Scr) of the observation group were significantly lower those before treatment and those of the control group, the differences were statistically significant (P ＜ 0.05). After treatment, the levels of hs-CRP, IL-6 and TNF-α in the observation group were significantly lower than those before treatment and those of the control group, the differences were statistically significant (P ＜ 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion High dose Atorvastatin combined with Metoprolol is superior to small dose in the treatment of acute CHF patients complicated with renal insufficiency, and the safety is high.
		2019 Vol. 16 (5): 51-54,62 [Abstract] ( 180 ) HTML (1 KB) PDF (517 KB) ( 121 )

	55	Serum HDL2b level changes and clinical significance in patients with atherosclerosis and acute coronary syndrome
		LUO Jianhua WANG Chao YUE Yuguo
		Objective To study the changes and clinical significance of serum high density lipoprotein 2b (HDL2b) in patients with atherosclerosis and acute coronary syndromes. Methods A total of 81 cases with atherosclerosis admitted to Zhejiang Provincial General Hospital of Chinese People′s Armed Police Force (“our hospital” for short) from February 2016 to December 2017 were selected as group A, another 175 cases with acute coronary syndrome admitted to our hospital in the same period were selected as group B, and then 100 healthy individuals that performed physical examination in our hospital in the same period were taken as control group. Serum HDL2b level and serum lipid level were compared among the three groups, and their correlation was analyzed. Serum HDL2b levels were compared in patients with acute coronary syndrome of different degrees coronary artery disease. Results The serum level of HDL2b in group A and B were lower than that in the control group, and the serum level of HDL2b in group B was lower than that in group A, the differences were statistically significant (P ＜ 0.05). High density lipoprotein cholesterol (HDL-C) level in group A and B were lower than that in the control group, and HDL-C level in group B was lower than that in group A, and the differences were statistically significant (P ＜ 0.05). According to the Pearson correlation analysis results, there was a positive correlation between serum HDL2b and HDL-C in group B (P ＜ 0.05). There was a decreasing tendency of HDL2b level in the single vessel lesion group, double vessels lesion group, multiple vessels lesion group orderly. Single factor analysis of variance could prompt that the differences among the three groups were statistically significant (P ＜ 0.05). Conclusion Serum HDL2b levels is low expressed in patients with atherosclerosis and acute coronary syndrome. In clinic, the relationship between metabolic disorder and disease can be determined by detecting serum HDL2b level, and it can provide guidance for clinical treatment therapy.
		2019 Vol. 16 (5): 55-58 [Abstract] ( 245 ) HTML (1 KB) PDF (491 KB) ( 60 )

	59	Effect of the statins to the elder patients over 80 years old with dyslipidemia
		XU Wenxia1 GONG Yan1▲ YANG Chunhua1 LE Yan2 PANG Xiaofen1
		Objective To investigate the benefit and safety situation of statins delivered to the elder people over 80 years old with dyslipidemia in clinical practice, and consequently provide guideline for the statins therapy applied to the elder people. Methods A total of 80 cases of the registered retired officers over 80 years old from August 2014 to Mag 2017 in Huangpu District, Shanghai, with dyslipidemia were selected. According to the random number table method, all the cases were divided into control group and study group, with 40 cases in each group. The control group was given blood lipid knowledge education, low fat diet and proper physical practice; the study group was given 40 mg/d Pravastatin po qn on the basis of the therapy of the control group. The two groups were followed up for 6 months about blood lipid, hepatorenal function, myocardial enzyme and inflammatory factor and analysis was performed. Results After treatment, the total cholesterol and uric acid level of the control group significantly reduced compared with those before treatment, and the difference was significant (P ＜ 0.05). After treatment, the total cholesterol, low density lipoprotein-cholesterol, tumor necrosis factor and interleukins-6 levels significantly reduced compared with those before treatment, and the difference was significant (P ＜ 0.05). After treatment, the total cholesterol level of the study group was significantly lower than the control group, and the difference was significant (P ＜ 0.05). Conclusion Applying to elder people over 80 years old, Pravastatin can reduce blood lipid and inflammatory factor, meanwhile it has no obvious side effects on hepatorenal function, creatase and ventricular function.
		2019 Vol. 16 (5): 59-62 [Abstract] ( 253 ) HTML (1 KB) PDF (493 KB) ( 93 )

	63	Clinical characteristics of lymphoma associated hemophagocytic syndrome
		LI Yongqian1 CHEN Sushan1 CHEN Manna1 CAI Songhao1 YE Junbin1 YANG Qimei1 DU Zepeng2 HONG Shaojie1
		Objective To investigate the clinical characteristics of lymphoma associated hemophagocytic syndrome. Methods The clinical data of 18 patients with lymphoma associated hemophagocytic syndrome admitted to Shantou Central Hospital from January 2012 to June 2017 was analyzed retrospectively. Results Among 18 patients, there were 13 cases of patients with T cell lymphoma, and the main clinical stages were moderate and advanced stages. There was no significant difference of pathological types of lymphoma in different gender (χ2 = 0.628, P ＞ 0.05). The clinical stage of lymphoma was positively correlated with the age of onset (r = 0.765, P ＜ 0.05). The older the patients were, the later the clinical stage of lymphoma was. The related gene detection of lymphoma associated hemophagocytic syndrome showed that there were 9 cases of gene mutation, among which, 6 cases had UNC13D mutations. According to hemophagocytic syndrome-94 regimen, all patients were given glucocorticoid and Etoposide to improve hemophagocytic symptoms and then gradually transferred to chemotherapy. 13 of 18 patients died. EB virus infection and severe thrombocytopenia were the major causes of death of lymphoma related hemophagocytic syndrome. Conclusion Lymphoma related hemophagocytic syndrome has a wide variety of clinical manifestations and high mortality. Most patients have EB virus infection. Early diagnosis and treatment is the key.
		2019 Vol. 16 (5): 63-67 [Abstract] ( 237 ) HTML (1 KB) PDF (435 KB) ( 169 )

	68	Clinical effect of subthalamic nucleus deep brain stimulation in the adjunctive treatment of Parkinson′s disease
		YANG Yinghao1 YAO Qianming1▲ CHENG Guoxiong1 XU Zhenqiu1 TAN Hongyu2
		Objective To study the clinical effect of subthalamic nucleus deep brain stimulation (SNDBS) in the adjunctive treatment of Parkinson′s disease (PD). Methods Ninety-one cases of PD patients treated in the First Affiliated Hospital of Guangzhou Medical University from February 2017 to April 2018 were selected. According to the random number table method, the patients were divided into the observation group（46 cases）and the control group (45 cases). Patients in both groups were treated by conventional therapy such as back percussion and sputum suction, oxygen inhalation and atomization and nutritional support. The control group was given Levodopa and Benserazide Tablets, the observation group was given SNDBS treatment on the basis of the control group. After 3 months of treatment, the curative effect and adverse reactions of the two groups were compared. The unified Parkinson disease rating scale (UPDRS) score, quality of life score, uric acid (UA) and methane dicarboxylic aldehyde (MDA) level were compared between the two groups before and after 3 months of treatment. Results The total effective rate of the observation group was higher than that of the control group (P ＜ 0.05). After treatment, the UPDRS score of the two groups were lower than those before treatment, and the observation group was lower than that of the control group; the quality of life score of the two groups were higher than those before treatment, and the observation group was higher than that of the control group, the differences were statistically significant (P ＜ 0.05); the UA and MDA level of the two groups were lower than those before treatment, and the observation group was lower than that of the control group, the differences were statistically significant (P ＜ 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion SNDBS is effective in the adjunctive treatment of PD patients. It can improve the symptoms and quality of life of patients, and reduce oxidative stress level.
		2019 Vol. 16 (5): 68-71 [Abstract] ( 258 ) HTML (1 KB) PDF (423 KB) ( 71 )

	72	The changes and significance of serum Lp-PLA2 and ox-LDL in patients with acute cerebral infarction
		HONG Weijun1 HUANG Qin2
		Objective To observe the changes and significance of lipoprotein-associated phospholipase A2 (Lp-PLA2) and oxidized low density lipoprotein (ox-LDL) in patients with acute cerebral infarction (ACI). Methods One hundred and twenty-three patients with initial ACI admitted in Taizhou Enze Medical Center (Group) Enze Hospital in Zhejiang Province from January 2015 to January 2018 were selected as the observation group, and 120 cases of healthy volunteers were selected as the control group. The levels of Lp-PLA2 and ox-LDL were detected immediately after admission and at 12, 24, 72 hours after admission. According to the severity of cerebral infarction, the patients in the observation group were divided into severe cerebral infarction group (n = 34), moderate cerebral infarction group (n = 52) and mild cerebral infarction group (n = 37). The serum levels of Lp-PLA2 and ox-LDL were compared among the three groups. According to different infarct size, the patients in the observation group were divided into large infarction group (n = 38), middle infarction group (n = 49) and small infarction group (n = 36). The changes of Lp-PLA2 and ox-LDL level were compared among the three groups. Results The serum levels of Lp-PLA2 and ox-LDL in the observation group were significantly higher than those in the control group at admission and 12, 24, 72 hours after admission, the differences were statistically significant (P ＜ 0.05). In addition, the serum Lp-PLA2 and ox-LDL levels in the observation group increased first and then decreased with the increase of admission time. The levels of Lp-PLA2 and ox-LDL in severe cerebral infarction group were higher than those in moderate and mild cerebral infarction group (P ＜ 0.05), and that in moderate infarction group was higher than that in mild cerebral infarction group (P ＜ 0.05). The levels of Lp-PLA2 and ox-LDL in the large infarction group were higher than those in the middle and small infarction group (P ＜ 0.05), and that in middle infarction group was higher than that in small infarction group (P ＜ 0.05). Conclusion The levels of serum Lp-PLA2 and ox-LDL are significantly increased in patients with ACI, which can reflect the severity of the disease to a certain extent. They can be used as serum markers, which is of positive significance in evaluating the condition and prognosis of ACI.
		2019 Vol. 16 (5): 72-75 [Abstract] ( 282 ) HTML (1 KB) PDF (426 KB) ( 128 )

	76	Effect of respiratory viral infection on Th1/Th2 cytokines balance in children with bronchial asthma
		WANG Kaimei1 LIN Zhixiong1 HU Xiangying1 ZHENG Guangqiang1 QIU Wenhai2
		Objective To investigate the effect of respiratory viral infection on Th1/Th2 cytokines balance in children with bronchial asthma. Methods From March 2016 to February 2018, in Haikou Women′s and Children′s Hospital, 153 children with bronchial asthma were selected, and another 69 healthy children at the same period were selected as the control. The respiratory viral infection types of children with bronchial asthma were statistically analyzed, and the ratio of Th1, Th2 and Th1/Th2 in peripheral blood of children, airway function [forced expiratory volume at 1 second (FEV1), and forced vital capacity (FVC), peak expiratory flow rate (PEFR) and FEV1/FVC] and blood gas index [blood oxygen partial pressure (PaO2) and partial pressure of carbon dioxide (PaCO2)] of the children were compared. In addition, the correlation among the ratio of Th1, Th2 and Th1/Th2 in peripheral blood and airway function and blood gas index in children with bronchial asthma was analyzed. Results The positive rate of respiratory viral infection in children with bronchial asthma was 66.67% (102/153), there were 21 cases of adenovirus (AV), 27 cases of influenza virus (IFV) group 24 cases of parainfluenza virus (PIV), 30 cases of respiratory syncytial virus (RSV). Th1, Th1/Th2, FEV1, FVC, PEFR, FEV1/FVC and PaO2 of children with bronchial asthma were significantly lower than healthy children (P < 0.05), Th2, PaCO2 were significantly higher than healthy children (P < 0.05); Th1, Th1/Th2 in IFV children and RSV children were significantly lower than simple asthma children (P < 0.05), Th2 was significantly higher than simple asthma children (P < 0.05). The FEV1, FVC, PEFR, FEV1/FVC and PaO2 in children with bronchial asthma complicated with respiratory virus infection were significantly lower than simple asthma children (P < 0.05), PaCO2 was significantly higher than simple asthma children (P < 0.05). Th1, Th1/Th2 was positively correlated with FEV1, PEFR, FEV1/FVC and PaO2 (P < 0.05), but negatively correlated with PaCO2 (P < 0.05); Th2 was positively correlated with PaCO2 (P < 0.05), Th2 was negatively correlated with PEFR, FEV1/FVC and PaO2 (P < 0.05). Conclusion Respiratory virus infection affects Th1/Th2 cytokines balance in children with bronchial asthma, it inhibits Th1 cell function and activates Th2 cell function, PSV and IFV have more obvious effect among them.
		2019 Vol. 16 (5): 76-79 [Abstract] ( 211 ) HTML (1 KB) PDF (556 KB) ( 90 )

	80	Study of defining normal value of levator-urethra gap in postpartum women by tomographic ultrasound combined with pelvic floor muscle strength assessment
		XU Yaoxuan1 SONG Lei1 ZHANG Li1 ZUO Yunpeng1 ZHAO Huashuo2
		Objective To discuss the normal value of levator-urethra gap (LUG) in postpartum women. Methods From December 2016 to May 2018, in Xuzhou Maternal and Child Health Hospital, 95 patients re-examined in the postpartum clinic were selected, they were performed transperineal 3D pelvic ultrasound and pelvic floor muscle strength assessment, the TUI images of levator ani hiatus in resting and maximal anal retraction states were respectively collected, and the left and right LUG value in both states were measured. Results In predicting the decrease of pelvic floor muscle strength, under different working conditions of all kinds of muscle fibers, the diagnostic efficacy of the measured values and mean values of the left and right LUG in resting and maximal anal retraction states was higher (0.7 < AUC < 0.9) (P < 0.05). The cut-off value as a normal value reference indicates had a high clinical guiding significance. Conclusion Tomographic ultrasound combined with pelvic floor muscle strength assessment has certain guiding value for the definition of normal value of LUG in postpartum women.
		2019 Vol. 16 (5): 80-83 [Abstract] ( 210 ) HTML (1 KB) PDF (711 KB) ( 94 )

	84	Expression and significance of P37, P16 and PAX-2 in endometrial hyperplasia
		JIAO Yan
		Objective To analyze the expression and significance of P37, P16 and PAX-2 in endometrial hyperplasia. Methods From December 2012 to August 2017, in Qinhuangdao Maternal and Child Health Hospital, the pathological tissue specimens of patients with endometrial hyperplasia diagnosed by pathological biopsy were selected, including 31 specimens of simple and complicated endometrial hyperplasia and 30 specimens of atypical endometrial hyperplasia; 30 normal endometrium specimens were selected as controls. The positive expression rates of P37, P16 and PAX-2 protein in different tissue specimens were detected by immunohistochemical SP method. Results There was no positive expression of P37 protein in normal endometrium tissues, the positive expression rate in atypical hyperplasia was higher than simple or complex hyperplasia, the difference was statistically significant (P < 0.05). The positive expression of P16 protein showed atypical dysplasia tissue < simple or complex hyperplasia < normal endometrium tissue, the difference was statistically significant (P < 0.01), while the positive expression of PAX-2 protein showed atypical dysplasia < simple or complex hyperplasia < normal endometrium tissue, the difference was statistically significant (P < 0.01). Conclusion There exists abnormal expression of P37, P16 and PAX-2 in atypical endometrial hyperplasia, which is worthy of further study.
		2019 Vol. 16 (5): 84-87 [Abstract] ( 159 ) HTML (1 KB) PDF (549 KB) ( 96 )

	88	Effectiveness of the balloon tamponade in treatment of postpartum hemorrhage of lower uterine segment
		ZOU Jinfang ZHANG Xia LI Xiaodan
		Objective To study the therapeutic effect of balloon tamponade in the treatment of postpartum hemorrhage of the lower uterine segment. Methods From October 2015 to October 2017, in Wuxi Maternal and Child Health Hospital, 60 patients with postpartum hemorrhage of the lower uterine segment were selected, according to random number table method, they were divided into observation group and control group, with 30 cases in each group. The control group received Oxytocin+Carboprost tromethamine intrauterine injection therapy, the observation group received balloon tamponade treatment based on the control group. The general condition, hemostasis effect, perioperative blood loss, postoperative recovery, postoperative complications of two groups were recorded and compared. Results The hemostatic effect in observation group was better than control group, the difference was statistically significant (P < 0.05). The blood loss during the operation, 2 h after operation, 24 h after operation in observation group were lower than control group, the differences were statistically significant (P < 0.01). The abnormal temperature time, menstrual recovery time and blood lochia time in observation group were significantly less than control group, the differences were statistically significant (P < 0.01). Incidence of adverse reactions in observation group was less than control group, the difference was statistically significant (P < 0.05). Conclusion The balloon tamponade can be used in treatment of postpartum hemorrhage of lower uterine segment by improving the hemostatic effect, it is worthy of clinical application.
		2019 Vol. 16 (5): 88-91 [Abstract] ( 198 ) HTML (1 KB) PDF (543 KB) ( 75 )

	92	Diagnostic value of serum miR-6861-5p combined with CA153 for breast cancer
		FU Hongwei DONG Yuyang
		Objective To study the diagnostic value of serum micro RNA-6861-5p (miR-6861-5p) combined with carbohydrate antigen 153 (CA153) in breast cancer. Methods A total of 83 cases of breast cancer patients admitted to Anshan Tumor Hospital (hereinafter referred to as “our hospital”) from April 2015 to April 2018 were selected, which were recorded as the breast cancer group. In addition, 80 patients with benign breast diseases who received diagnosis and treatment in our hospital during the same period were selected as the benign breast disease group, and 80 healthy people who underwent physical examination in our hospital during the same period were selected as the control group. Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of serum miR-6861-5p in each group, and the serum CA153 level was detected by chemiluminescence. The levels of serum miR-6861-5p and CA153 in the three groups were compared, and the relationship between the above two indicators and the clinicopathological characteristics of breast cancer patients was analyzed. The diagnostic efficacy of serum miR-6861-5p combined with CA153 levels in breast cancer was analyzed using the receiver operating characteristic (ROC) curve. Results The levels of serum miR-6861-5p and CA153 in the breast cancer group were higher than those in the benign breast disease group and the control group, with statistically significant differences (all P < 0.05). Ⅰ-Ⅱ period with no lymph node metastasis of breast cancer patients serum miR - 6861-5 P levels were lower than Ⅲ-Ⅳ period and the patients with lymph node metastasis, the differences were statistically significant (all P < 0.05). Ⅰ-Ⅱ period with no lymph node metastasis of breast cancer patients serum CA153 levels were lower than Ⅲ-Ⅳ period and the patients with lymph node metastasis, the differences were statistically significant (all P < 0.05). The sensitivity and specificity under the curve of miR-6861-5p combined with CA153 in diagnosis of breast cancer were all higher than those of miR-6861-5p and CA153 alone (all P < 0.05). Conclusion The application of serum miR-6861-5p combined with CA153 detection in breast cancer patients has high diagnostic efficacy, and can be used as an effective means for clinical diagnosis of breast cancer.
		2019 Vol. 16 (5): 92-95 [Abstract] ( 222 ) HTML (1 KB) PDF (618 KB) ( 131 )

	96	Clinical effect of Zoledronic acid combined with concurrent chemoradiotherapy in the treatment of bone metastasis of advanced breast cancer
		WU Kuo LIU Mengqi▲ ZHAO Qinshu
		Objective To investigate clinical effect of Zoledronic acid combined with concurrent chemoradiotherapy in the treatment of bone metastasis of advanced breast cancer. Methods From January 2016 to January 2018, 107 patients with bone metastasis of advanced breast cancer who were treated in the Jizhong Energy General Hospital of Xingtai Mining Group were selected, and they were divided into observation group (n = 53) and control group (n = 54) according to the treatment plan finally. The observation group was treated with Zoledronic acid combined with concurrent chemoradiotherapy, while the control group was treated with chemoradiotherapy. The therapeutic effect, visual analogue (VAS) score and adverse reactions of the two groups were observed, and serum calcium and vascular endothelial growth factor (VEGF) levels were detected before and after treatment. Results The curative effect of the observation group was better than that of the control group (P ＜ 0.05), there was no significant difference in VAS score between the observation group and the control group before treatment (P ＞ 0.05). The VAS score of the observation group and the control group after treatment were lower those that before treatment (P ＜ 0.05), the score of VAS in the observation group after treatment was significantly lower than that in the control group after treatment (P ＜ 0.05). There was no significant difference in serum calcium and VEGF between the observation group and the control group before treatment (P ＞ 0.05), the serum calcium and VEGF in the observation group and the control group after treatment were lower than those before treatment (P ＜ 0.05). The serum calcium and VEGF in the observation group after treatment were significantly lower than those in the control group after treatment (P ＜ 0.05), there was no significant difference in the incidence of adverse reactions between the observation group and the control group (P ＞ 0.05). Conclusion Zoledronic acid combined with concurrent chemoradiotherapy in the treatment of advanced breast cancer has good clinical effect, and is worthy of clinical application.
		2019 Vol. 16 (5): 96-99 [Abstract] ( 275 ) HTML (1 KB) PDF (549 KB) ( 59 )

	100	Relationship between FHIT and Bcl-2 protein expression and Helicobacter pylori infection in gastric carcinoma
		ZHAO Kaifeng1 LIU Huiying2 JIANG Daoliang1 MIAO Ye2 ZHANG Jing1
		Objective To investigate the relationship between fragile histidine triad (FHIT) and Bcl-2 protein expression in gastric cancer tissues and helicobacter pylori (Hp) infection. Methods From January 2013 to January 2017, 80 gastric carcinoma tissue samples were collected after radical gastrectomy in the 464th Hospital of PLA, and 43 paracancerous tissues were selected. Rapid urease assay paper and Warthin-Starry staining were used to detect whether the tissue samples were infected with Hp, and the expressions of FHIT and Bcl-2 in the tissue samples were detected by immunohistochemical staining. Results FHIT positive expression rate in gastric carcinoma tissues was lower than that in para-carcinoma tissues (P < 0.05), Bcl-2 positive expression rate in gastric carcinoma tissues was higher than that in para-carcinoma tissues (P < 0.05). The expression of FHIT in gastric carcinoma tissues was related to lymphatic metastasis, distant metastasis, degree of differentiation, degree of infiltration and Hp infection (all P < 0.05). Bcl-2 expression was related to tumor diameter, differentiation degree, infiltration degree and Hp infection (all P < 0.05). The positive rate of FHIT was negatively correlated with Hp infection (r = -0.295, P < 0.05), and the positive rate of Bcl-2 was positively correlated with Hp infection (r = 0.393, P < 0.05). Conclusion The expression of FHIT protein in gastric carcinoma tissues is weakened, and the expression of Bcl-2 protein is enhanced, which are closely related to Hp infection, and the three interactions lead to the occurrence of gastric carcinoma.
		2019 Vol. 16 (5): 100-103 [Abstract] ( 228 ) HTML (1 KB) PDF (596 KB) ( 102 )

	104	Effect of total thoracic esophageal cancer radical surgery on inflammatory reaction and stress response in patients with esophageal cancer
		HUANG Xiuming CHEN Xianshan CHEN Fengxia
		Objective To investigate the effect of total thoracic esophageal cancer radical surgery on inflammatory response and stress response in patients with esophageal cancer. Methods Eighty-four patients with esophageal cancer admitted to Hainan General Hospital from January 2014 to January 2018 were selected and divided into control group (n = 42) and research group (n = 42) according to the randon number table method. The control group was treated with open thoracic esophageal cancer radical surgery, the study group was treated with total thoracic esophageal cancer radical surgery. The clinical indexes of the two groups were compared. The inflammatory reaction indicators [interleukin-6 (IL-6), IL-10, tumor necrosis factor-alpha (TNF-alpha)], stress response indicators [C-reactive protein (CRP), serum free triiodothyronine (FT3), free thyroxine (FT4) and cortisol] were observed before and one week after the operation. The postoperative complication of the two groups were observed. Results The operation time, intraoperative blood loss, postoperative drainage and hospitalization time in the study group were lower than those in the control group (P < 0.05); there was no significant difference in the number of lymph nodes between the two groups (P > 0.05). The levels of IL-6, IL-10 and TNF-α were higher in the control group than in the study group one week after operation (P < 0.05). The levels of CRP, FT3, FT4 and cortisol were higher in the two groups one week after operation (P < 0.05), but there was no significant difference between the two groups (P > 0.05). There was no significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion Compared with open radical esophageal cancer, radical thoracoscopic radical esophagectomy can significantly reduce the inflammatory reaction in patients with esophageal cancer, and has no significant effect on the body′s stress response and postoperative complications.
		2019 Vol. 16 (5): 104-107 [Abstract] ( 221 ) HTML (1 KB) PDF (550 KB) ( 60 )

	108	Meta-analysis of the effect of preoperative neoadjuvant therapy and radical chemoradiotherapy on ⅢA (N2) NSCLC
		JING Xiaoliang1 ZHANG Liwei1 ZONG Liang1 LI Desheng1 Julaiti·Ainiwaer1 YANG Fan2
		Objective To compare the effects of preoperative neoadjuvant therapy combined surgery with radical chemoradiotherapy for stage ⅢA (N2) non-small cell lung cancer (NSCLC). Methods PubMed, Medline, Ovid, CNKI, VIP and Wanfang databases were retrieved by computer, and supplemented by manual search. The publicly published studies concerning the treatment of stage Ⅲ A (N2) NSCLC with neoadjuvant therapy combined surgery and radical chemotherapy were collected from building database to April 2018, and the samples were divided into neoadjuvant therapy combined surgery group and radical chemoradiotherapy group according to the treatment method. Results A total of 14 studies met the inclusion criteria, including 5 randomized controlled trials, 9 retrospective case-control studies, with a total sample size of 12 713 cases, including 1792 cases in neoadjuvant therapy combined surgery group and 10 921 cases in radical chemoradiotherapy group. The 3-year survival rate of the neoadjuvant therapy combination surgery group in the randomized controlled trial was not significantly different from the radical chemotherapy group (OR = 0.93, 95% CI: 0.71-1.22, P = 0.61). In the case-control study, the 3-year survival rate of the neoadjuvant combination surgery group was superior to that of the radical chemotherapy group (OR = 0.63, 95% CI: 0.55 - 0.72, P < 0.00 001). The 5-year survival rate of the neoadjuvant therapy combined surgery group in the randomized controlled trial was not significantly different from the radical chemoradiotherapy group (OR = 0.77, 95% CI: 0.52-1.12, P = 0.17). In the case-control study, the 5-year survival rate of the neoadjuvant combined surgery group was better than that of the radical chemo group (OR = 0.36, 95% CI: 0.25-0.51, P < 0.00 001). Conclusion Neoadjuvant therapy combined with surgical treatment can make patients with stage Ⅲ A (N2) NSCLC have longer survival time or achieve cure effect. Pneumonectomy after neoadjuvant therapy may be safe and feasible. Further randomized controlled studies on survival analysis of patients undergoing neoadjuvant therapy combined with surgery, especially pneumonectomy, are of great significance.
		2019 Vol. 16 (5): 108-113 [Abstract] ( 207 ) HTML (1 KB) PDF (1390 KB) ( 50 )

	114	Effect of tyrosine kinase inhibitor combined with whole brain radiotherapy time on brain metastasis of lung adenocarcinoma with EGFR gene mutation
		YAN Yafei GE Wei
		Objective To investigate the effect of tyrosine kinase inhibitors (TKI) combined with whole blood recalcification time (WBRT) on brain metastasis of lung adenocarcinoma with mutant epidermal growth factor receptor (EGFR) gene. Methods From June 2014 to June 2017, 42 patients with brain metastasis of EGFR-mutated lung adenocarcinoma diagnosed by pathology in Renmin Hospital of Wuhan University were collected, including 22 patients treated with EGFR-TKI combined with WBRT (combination therapy group) and 20 patients treated with EGFR-TKI alone (pure treatment group). Overall survival (OS) was the main observation index, the secondary observational indicator was intracranial progression (iPFS). Results There were statistically significant differences between the two groups in the presence or absence of intracranial symptoms and the diameter of intracranial metastases (P ＜ 0.05). There were no statistically significant differences in the number of intracranial metastases, gender, age, smoking history, ECOG score, presence or absence of extracranial metastases, CEA, CA125, CYFRA, SCC, and NSE (all P ＞ 0.05). IPFS in the combined treatment group was longer than that in the pure treatment group (P ＜ 0.05). Combined treatment may prolong OS in patients, but the difference between the two groups is not statistically significant (P ＞ 0.05). Conclusion No significant survival benefit was observed in patients with EGFR mutant lung adenocarcinoma with brain metastasis treated with WBRT, which should be validated by prospective randomized controlled studies.
		2019 Vol. 16 (5): 114-117 [Abstract] ( 224 ) HTML (1 KB) PDF (685 KB) ( 76 )

	118	Analysis of S region gene mutation in patients with HBsAg+/HBsAb+ chronic hepatitis B
		SUN Yu1* ZHANG Honghai1* CHEN Dexi2 WEI Feili2 GUO Xianghua2 SHI Ying2
		Objective To study the S region gene mutation in patients with hepatitis B surface antigen (HBsAg) +/ hepatitis B surface antibody (HBsAb) + chronic hepatitis B (CHB). Methods From June 2012 to October 2017, 32 cases of CHB patients with double positive HBsAg and HBsAb in Beijing You′an Hospital, Capital Medical University (hereinafter referred to as “our hospital”) were selected as subjects (HBsAg+/HBsAb+ group),79 cases of CHB patients diagnosed with HBsAg+ and HBsAb- in our hospital in the same period were randomly selected as the control group (HBsAg+/HBsAb- group). The plasma viral DNA was isolated, the S region gene was amplified by PCR, and the mutation was analyzed by sequencing. Results All patients in the HBsAg+/HBsAb+ group had S-region mutation (100%), and the frequency was significantly higher than that in the HBsAg+/HBsAb- group (84.81%) (P ＜ 0.05). Moreover, the mutations were mostly concentrated in the subunits 1 and 3 of S region. The proportion of multiple site mutations in S region in HBsAg+/HBsAb+ group was significantly higher than that in HBsAg+/HBsAb- group (P ＜ 0.01). Conclusion The increased frequency of S region gene mutation and the presence of multiple mutations are closely related to the change of S antigen antibody in CHB patients, and the accumulation of this mutation indicates an adverse disease process.
		2019 Vol. 16 (5): 118-121 [Abstract] ( 187 ) HTML (1 KB) PDF (699 KB) ( 77 )

	122	Application of thoracic muscle approach for lymph node dissection in Auchincloss operation of breast cancer
		ZHOU Lihao1 CHEN Benxin1 CAO Zhiguo1 ZHU Yunchao2
		Objective To explore the necessity, feasibility and efficacy of lymph node dissection through pectoralis muscle approach in Auchincloss operation of breast cancer. Methods From May 2008 to June 2013, clinical and follow-up data of 63 patients with breast cancer who underwent Auchincloss operation plus thoracic muscle approach lymph node dissection in the Affiliated Hospital of West Anhui Health Vocational College were collected, and the LevelⅢ group of lymph node metastasis and risk factors were statistically analyzed. Results Breast cancer patients had adequate surgical exposure and satisfactory lymph node dissection, LevelⅢ group of lymph node metastasis rate was 27.0%. Group LevelⅢ cancer lymph node metastasis was related to tumor size, clinical stage, axillary lymph node status, Her-2 in the cancer tissue and PDCD4 expression (all P ＜ 0.05). Large tumors, staging, axillary lymph node positive rate, its Her-2 expression in cancer tissue and lack of PDCD4 expression were the high risk factors of the LevelⅢ group lymph node metastasis. No serious complications were found in the postoperative follow-up, and the 5-year survival rate was 87.3%. Conclusion To have LevelⅢ group factors of breast cancer patients at high risk of lymph node metastasis Auchincloss surgery, and chest into the way lymph node cleaning is necessary and feasible, with curative effect affirmation.
		2019 Vol. 16 (5): 122-125 [Abstract] ( 188 ) HTML (1 KB) PDF (679 KB) ( 61 )

	126	Relationship between serum homocysteine, C-reactive protein and carotid arteries atherosclerosis in patients with type 2 diabetes mellitus complicated with cerebral infarction
		YANG Ping1 LIAO Ping2 WU Wenjuan1
		Objective To investigate the relationship between serum homocysteine (Hcy), C-reactive protein (CRP) and carotid atherosclerosis in patients with type 2 diabetes mellitus complicated with cerebral infarction. Methods A total of 100 patients with type 2 diabetes mellitus complicated with cerebral infarction admitted to the Second Affiliated Hospital of Guangxi University of Science and Technology (“our hospital” for short) from January 2015 to January 2018 were included in the diabetes mellitus complicated with cerebral infarction group, and 100 patients with simple type 2 diabetes treated in our hospital during the same period were included in the simple diabetes group, and another 50 healthy individuals who underwent physical examination in our hospital during the same period were selected as the control group. Hcy, CRP, carotid intima-media thickness (IMT), fasting plasma glucose (FPG) and 2 h postprandial plasma glucose (2 h PBG) were measured and compared in each group. The correlation among Hcy, CRP and IMT, FPG and 2 h PBG was analyzed. Results There was a significant difference in Hcy, CRP, IMT, FPG and 2 h PBG between the diabetes mellitus complicated with cerebral infarction group and the simple diabetes group (P ＜ 0.05), and all the indices of the two groups were higher than those in the control group (P ＜ 0.05). In the diabetes mellitus complicated with cerebral infarction group, Hcy, CRP, FPG and 2 h PBG increased as the increase of IMT, and the difference was statistically significant (P ＜ 0.05). After intensive insulin therapy, the levels of Hcy, CRP, IMT, FPG and 2 h PBG in diabetes mellitus complicated with cerebral infarction group were significantly lower than those before treatment (P ＜ 0.05). Pearson correlation analysis result showed that Hcy and CRP had positive correlation with IMT, FPG and 2 h PBG (P ＜ 0.05). Conclusion The severity of carotid arteries atherosclerosis plaque in patients with type 2 diabetes mellitus complicated with cerebral infarction is higher than that of patients with simple diabetes, and the level of serum Hcy and CRP is positively correlated with the degree of carotid arteries atherosclerosis, which may be involved in the development process of carotid arteries atherosclerosis.
		2019 Vol. 16 (5): 126-129,141 [Abstract] ( 240 ) HTML (1 KB) PDF (670 KB) ( 121 )

	130	The relationship between the imbalance of Th17/Treg cells and the degree of disease activity and inflammation in patients with ulcerative colitis
		HE Zhichao LIN Nan YIN Pifa
		Objective To study the relationship between the imbalance of Th17/Treg cells and the degree of disease activity and inflammation in patients with ulcerative colitis (UC). Methods Ninety-three patients with UC from January 2017 to May 2018 admitted to Yunnan Geriatric Hospital (“our hospital” for short) were selected and studied. Among the patients, 56 cases in UC active period were as the active period group, 37 cases in remission period were as the remission period group. The active stage group was divided into subgroups according to the modified Mayo scoring: 19 cases in the mild group, 24 cases in the moderate group, and 13 cases in the severe group. Another 40 healthy volunteers undergoing physical examination in the same period were selected as the control group. The levels of Th17/Treg, C-reactive protein (CRP), interleukin (IL)-10, IL-17 were detected and compared. Th17, Treg cells in each group were measured and the relationship between Th17, Treg cells and disease activity and inflammation was analyzed. Results The proportion of Th17 cells and the level of Th17/Treg in the active period group and the remission period group were significantly higher than the control group, and those in the active period group were significantly higher than the remission period group (P ＜ 0.05), and the proportion of Treg cells in the active period group was significantly lower than the control group (P ＜ 0.05). Th17/Treg level in the severe group was significantly higher than the mild group and moderate group, and the proportion of Th17 cells was significantly higher than the mild group (P ＜ 0.05). The proportion of Treg cells in the severe group was significantly lower than the mild group and moderate group (P ＜ 0.05). The CRP and IL-17 in the active period group and the remission period group were significantly higher than the control group, and the CRP and IL-17 in the active period group were significantly higher than the remission period group (P ＜ 0.05). The IL-10 in active period group and remission period group was significantly lower than the control group (P ＜ 0.05). The CRP and IL-17 in the severe group were significantly higher than the mild group (P ＜ 0.05). The CRP in the severe group was significantly higher than the mild group, and the CRP in the severe group was significantly higher than the mild group (P ＜ 0.05). According to Pearson correlation analysis method, the Th17 cells and Th17/Treg were positively correlated with disease activity and IL-17, and was negatively correlated with IL-10 (P ＜ 0.05). The Treg cells was negatively correlated with disease activity, CRP, IL-17 and positively correlated with IL-10 (P ＜ 0.05). Conclusion There is a close relationship between the imbalance of Th17/Treg cells and the degree of disease activity and inflammation in the patients with UC. The balance of Th17/Treg cells in patients with UC should be ensured as much as possible in clinic, which is beneficial to the prevention and control of the disease.
		2019 Vol. 16 (5): 130-133 [Abstract] ( 237 ) HTML (1 KB) PDF (651 KB) ( 79 )

	134	Effect of low dose thyroxine on hemodynamics and inflammatory cytokines in patients with severe pneumonia septic shock complicated with low T3 syndrome
		SHU Jiaojie1 LIU Sibo1 LIU Guoliang1 ZHOU Hengjie1 GE Dong1 GUO Yumei2▲
		Objective To investigate the effects of low dose thyroxine on hemodynamics and inflammatory factors in patients with severe pneumonia (SP) septic shock (IS) complicated with low T3 syndrome (LT3S). Methods A total of 99 patients with SP and IS combined with LT3S who were treated in Dalian Municipal Central Hospital from September 2016 to May 2018 were selected for the study. According to the random number table method, the patients were divided into two groups, 49 cases in the observation group and 50 cases in the control group. The control group was treated with conventional cluster therapy, and the observation group was given a small dose of levothyroxine Tablets on the basis of the treatment of the control group, and the treatment lasted for 7 days. The patients were followed up for 28 days, and the survival prognosis and drug safety of the two groups were compared. Thyroid hormones, hemodynamic indicators, lung function and inflammatory factors before and after treatment were compared. Results The survival rate in the observation group was higher than that in the control group, and the mortality was lower than that in the control group (P ＜ 0.05). After treatment, triiodothyronine (T3), tyroxine (T4) and free thriiodothyronine (FT3) levels in the observation group were higher than those in the control group, and thyroid stimulating hormone (TSH) level was lower than that in the control group (P ＜ 0.05). The whole body vascular resistance index (SVRI), mean arterial pressure (MAP) and central venous pressure (CVP) in the observation group were higher than those in the control group, while the pulmonary vascular resistance index (PVRI), left ventricular work (LCW), right ventricular work (RCW), cardiac index (CI) and stroke index (SI) in the observation group were lower than those in the control group (P ＜ 0.05). There was no significant difference in lung function between the two groups (P ＞ 0.05), while the levels of TNF-α and IL-6 in the observation group were lower than those in the control group (P ＜ 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion The treatment of SP and IS combined with LT3S with low dose thyroxine can better improve the prognosis of patients, and has obvious improvement effect on thyroid hormones, hemodynamics and inflammatory factors. The drug IS safe and worthy of promotion.
		2019 Vol. 16 (5): 134-137,150 [Abstract] ( 203 ) HTML (1 KB) PDF (877 KB) ( 136 )

	138	Effect of dynamic blood glucose monitoring combined with insulin pump in the treatment of gestational diabetes mellitus on secretory frizzled related protein 5 and neonatal prognosis
		CHEN Fengling SUN Donghua YANG Hongying GUO Dongqing
		Objective To investigate the dynamic blood glucose monitoring combined with insulin pump in the treatment of gestational diabetes mellitus on secreted frizzled related protein 5 (Sfrp5) and neonatal prognosis. Methods The clinical data of 84 patients with gestational diabetes mellitus who were diagnosed with oral glucose tolerance test (OGTT) in the Department of Obstetrics, the No 4 People′ Hospital of Hengshui from May 2015 to May 2017 were retrospectively analyzed. They were divided into study group (n = 42) and control group (n = 42) according to the treatment method. The study group was treated with dynamic blood glucose monitoring combined with insulin pump, and the control group was treated with dynamic blood glucose monitoring combined with insulin injection. Blood glucose, insulin, Sfrp5 levels, islet resistance index (HOMA-IR) and neonatal prognosis were compared between the two groups. Results After treatment, the levels of fasting blood glucose and postprandial 2 h blood glucose, fasting insulin and HOMA-IR were lower than before treatment (all P < 0.05), and the study group was lower than the control group (all P < 0.05); the Sfrp5 levels in the latter two groups were higher than those before treatment (P < 0.05), and the study group was higher than the control group (P < 0.05). The incidence of adverse neonatal outcomes in the study group was significantly lower than that in the control group(P < 0.05). Conclusion Dynamic blood glucose monitoring combined with insulin pump in the treatment of gestational diabetes mellitus, can significantly improve the Sfrp5 level of pregnant women, and improve blood sugar and insulin levels of patients, reduce the incidence of neonatal adverse pregnancy outcomes, it is worthy of clinical promotion and application.
		2019 Vol. 16 (5): 138-141 [Abstract] ( 200 ) HTML (1 KB) PDF (611 KB) ( 66 )

	142	Analysis of serum 25-hydroxyvitamin D levels in patients with rheumatoid arthritis and its related factors
		ZHANG Yuhui1 SONG Weimin2 SUN Li1 MA Qin1 LI Xiaojun1 DING Xiang1 SHI Guixiu3
		Objective To investigate serum 25-hydroxyvitamin D levels in patients with rheumatoid arthritis and its related factors. Methods Eighty-two cases of patients with rheumatoid arthritis and 82 cases of healthy controls were collected from Bozhou People′s Hospital from March to December 2017, the serum 25-hydroxyvitamin D level was measured, and the general characteristics, body mass index, sun exposure time, rheumatoid factor, cyclic citrullinated peptide antibodies, antinuclear antibodies, calcium, disease activity score (DAS28), tender joint count and swollen joint count were collected. Results The serum 25-hydroxyvitamin D level insufficiency and deficiency was detected in 97.6% of rheumatoid arthritis patients. The serum 25-hydroxyvitamin D concentration in rheumatoid arthritis patients were lower than that in healthy control (P ＜ 0.01). Patients with rheumatoid arthritis with a course of less than 2 years had a higher level of 25-hydroxyvitamin D than patients with a course of more than 2 years (P ＜ 0.05). Among patients with rheumatoid arthritis, 25-hydroxyvitamin D levels in male were significantly higher than in female (P ＜ 0.05). In rheumatoid arthritis patients, serum 25-hydroxyvitamin D level was significantly associated with female (r = -0.291, P ＜ 0.01), average sun exposure time (r = 0.237, P ＜ 0.05), course (r = -0.322, P ＜ 0.01), calcium level (r = 0.300, P ＜ 0.01), tender joint count (r = -0.348, P ＜ 0.01), swollen joint count (r = -0.238, P ＜ 0.05) and DAS28 (r = -0.258，P ＜ 0.05). Conclusion 25-hydroxyvitamin D insufficiency and deficiency is quite common in patients with rheumatoid arthritis. Female, average daily sun exposure time less than 30 minutes, longer course, hypocalcemia, higher DAS28, more tender joint count and swollen joint count might be the predictors.
		2019 Vol. 16 (5): 142-145 [Abstract] ( 193 ) HTML (1 KB) PDF (616 KB) ( 68 )

	146	Establishment and investigation of practice effect of quality control system for information outpatient pharmacy service
		YAN Lixia ZHANG Feng▲
		Objective To establish a quality control system for information outpatient pharmacy service, and to investigate its practice effect and explore the way to optimization and promotion. Methods Since January 2017, the quality control system of information outpatient pharmacy service has been carried out in Changzhou Second People′s Hospital of Jiangsu Province (“our hospital” for short), which included prescription audit, drug dispensing and drug administration. The rate of outpatient prescription, the error rate of drug dispensing work, the changes of patient′s drug proportion and satisfaction were compared before (from January to December 2016) and after (from January to December 2017) the implementation of the quality control system. The practical effect of the quality control system of information outpatient pharmacy service was investigated, and the application experience was summarized. Results In our hopsital, the total number of prescriptions increased in 2017 compared with 2016, but the proportion of unqualified prescriptions decreased significantly (P ＜ 0.05). The error rate of drug dispensing decreased significantly in 2016 (P ＜ 0.05). In 2016, the proportion of drugs and patients′satisfaction in our hospital was 46.08% and 82.44%, respectively. In 2017, the proportion of drugs and patients′ satisfaction in our hospital was 42.15% and 95.33%, respectively. After the implementation of the quality control system of pharmaceutical care in informationized outpatient clinics, the proportion of drugs in our hospital decreased by 8.53%, and the satisfaction of patients increased by 15.64%, there were statistically significant differences of the proportion of drugs and patients′ satisfaction before and after implementation (P < 0.05). Conclusion The establishment of quality control system for information outpatient pharmacy service can effectively reduce unqualified prescriptions and drug dispensing errors, which is of positive significance for rational allocation of medical resources and improvement of medical quality.
		2019 Vol. 16 (5): 146-150 [Abstract] ( 180 ) HTML (1 KB) PDF (605 KB) ( 143 )

	151	Effects of atypical antipsychotics on blood thyroid hormones and lipids in children and adolescents with schizophrenia
		DUAN Xiaxia1 ZHANG Yan2 ZHANG Meng1 YU Yanju1
		Objective To investigate the effects of atypical antipsychotics on blood thyroid hormones and lipids in children and adolescents with schizophrenia. Methods From September 2015 to July 2017, the clinical data of inpatients in the Department of Child and Adolescent Psychology in Xi′an Mental Health Center was analyzed retrospectively. A total of 86 patients with application of single drug were selected and divided into the Aripiprazole group (29 cases), the Olanzapine group (29 cases) and the Risperidone group (28 cases) according to different drugs they took. Each group was given drugs from small doses for 6 weeks. Before and after treatment, the levels of thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL) were analyzed, and the efficacy and safety of each drug were evaluated by positive and negative symptoms scale (PANSS) and treatment emergent symptom scale (TESS). Results ①After treatment, the scores of PANSS in the three groups were significantly lower than those before treatment (P ＜ 0.01). ②In Olanzapine group, the levels of TC, TG, LDL and HDL were significantly higher than those before treatment (P ＜ 0.01 or P ＜ 0.05), while T4 and FT4 were significantly lower than those before treatment (P ＜ 0.01); in Risperidone group, LDL was significantly higher than that before treatment (P ＜ 0.01), and T3 and T4 were significantly lower than those before treatment (P ＜ 0.05); Aripiprazole had no significant differences on blood lipids and thyroid hormones (P ＞ 0.05). ③Comparison among the three groups showed that Olanzapine had the greatest effect on lipids, and Risperidone had the greatest effect on T3. ④There was no significant difference of the incidence of adverse reactions among the three groups (P > 0.05). Conclusion Aripiprazole, Olanzapine and Risperidone have significant therapeutic effects on children and adolescents with schizophrenia. Aripiprazole has no significant effect on blood lipids and thyroid hormones, Olanzapine affects blood lipids significantly, Risperidone affects T3 significantly.
		2019 Vol. 16 (5): 151-154 [Abstract] ( 203 ) HTML (1 KB) PDF (355 KB) ( 77 )

	155	Study on the reliability and validity of the Nursing Needs and Satisfaction Scale for Elderly Inpatients
		XU Xu MA Hongmei LIU Yanhua ZHANG Yanxia CAI Hui
		Objective To develop the Nursing Needs and Satisfaction Scale for Elderly Inpatients, and to verify the reliability and validity of the scale. Methods By consulting literatures and expert consultation, and taking Maslow′s Needs Theory as the theoretical framework, a self-designed Nursing Needs and Satisfaction Scale for Elderly Inpatients was designed, and 240 elderly inpatients from 6 tertiary general hospitals in Hubei Province from June to November 2016 were selected by convenience sampling method to conduct a questionnaire survey. Results There was a good correlation between the items of the scale. The correlation coefficients between the dimensions and the total scale were 0.587-0.731, and between the dimensions were 0.207-0.529. The scale-level content validity index (S-CVI) of the scale is 0.853, and the content validity index (CVI) of each dimension is ＞ 0.75; the total Cronbach′s alpha coefficient of the scale is 0.812, and the Cronbach′s alpha coefficient of each dimension is ＞ 0.6; the cumulative contribution rate of the seven main factors produced by factor analysis to the variables is 57.69%. Conclusion The scale has good reliability and validity, and can be used to evaluate the nursing needs and satisfaction of the elderly inpatients.
		2019 Vol. 16 (5): 155-158 [Abstract] ( 218 ) HTML (1 KB) PDF (450 KB) ( 66 )

	159	Application effect of saline in skin swab before cephalosporin antibiotic allergy test
		GAO Menghui1 BAI Xiaojing1 MA Li2
		Objective To investigate the effect of normal saline on skin wiping before cephalosporin antibiotic allergy test. Methods A total of 500 patients who underwent cephalosporin antibiotic allergy test in the Department of Lower Extremities of Sichuan Provincial Orthopaedic Hospital from September 2016 to March 2017 were randomly divided into experimental group and control group, with 250 cases in each group. The experimental group was cleaned with physiological saline before the cephalosporin antibiotic allergy test; the control group was directly disinfected with 75% alcohol. The cephalosporin antibiotic allergy test results and bacteriological test results of the two groups of patients were compared. Results The false positive rate of the experimental group was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). There were no bacterial test failures in both groups, and the sterility pass rate was 100.00%. Conclusion The use of saline for skin cleansing in cephalosporin antibiotic allergy tests can effectively reduce the incidence of false positives in cephalosporin allergy tests.
		2019 Vol. 16 (5): 159-161,167 [Abstract] ( 252 ) HTML (1 KB) PDF (747 KB) ( 117 )

	162	Causes analysis and precautions of missed and mistaken diagnosis of atypical pancreatic cancer
		LIU Xin LIU Wanli▲ KAN Minqiang LIU Yi YU Yang
		According to statistics, the incidence of pancreatic cancer is increasing year by year. Because of lacking obvious early symptoms and effective early diagnosis deficiency, the rate of missed and mistaken diagnosis is high. By analyzing the cause of missed and mistaken diagnosis of eleven pancreatic cancer cases, this article investigates the effective measures of precautions of missed and mistaken diagnosis of pancreatic cancer, such as diagnosing and differential diagnosing simultaneously, improving the diagnosis and treatment skill of iconography doctors, dynamic observing multiple tumor markers and so on, for reference of relevant scholars.
		2019 Vol. 16 (5): 162-164 [Abstract] ( 189 ) HTML (1 KB) PDF (453 KB) ( 74 )

	165	Psychological analysis of 1 case with obsessive-compulsive disorder
		YAN Gangwei1 ZHANG Kun2
		The incidence of obsessive-compulsive disorder reaches from 1% to 3% in Chinese population. In patients with mental disease, ratio of obsessive-compulsive disorder occurrence is high, especially in teenagers. People in home pay much attention to mental health, and a lot of people worry about having some psychological diseases. Most of them diagnose themselves on line, or trust in nonprofessional tests by mistake. All above is not fit psychological disease diagnosis standardization. And then this paper mainly introduces the concept of obsessive-compulsive disorder to get people right knowledge. At the same time, one nontypical case of obsessive-compulsive disorder is analyzed on the mental health status and pathogen, so that the classification is cleared further and this article will throw light on how to treat this disease properly.
		2019 Vol. 16 (5): 165-167 [Abstract] ( 194 ) HTML (1 KB) PDF (415 KB) ( 124 )

	168	Current situation and development of import and export of Chinese pharmaceutical products under the background of “The Belt and Road”
		PAN Qi1,2 WANG Juan3 XU Xiaoyuan1 GUO Mengjia2
		The implementation of “The Belt and Road” Initiative has given some opportunities and challenges for Chinese pharmaceutical import and export. This paper expounds the effects of “The Belt and Road” Initiative on Chinese pharmaceutical industry, analyzes the situations of import and export between China and the countries along “The Belt and Road” after the initiative was launched respectively from Northeast Asia, Southeast Asia, South Asia, West Asia and North Africa, Central and Eastern Europe, Central Asia and other six countries in the Commonwealth of the Independent States, and finds the existing shortages of Chinese pharmaceutical foreign trade such as the low degree of industry concentration, the little difference on products, the insufficient innovation ability, and proposes some suggestions, such as developing the large pharmaceutical market along “The Belt and Road”, exploring the pharmaceutical market demand along “The Belt and Road”, improving the level of independent innovation technology, and studying the market access policy of the main countries along “The Belt and Road”, which will play a positive role in the further deepening of “The Belt and Road” Initiative in pharmaceutical industry.
		2019 Vol. 16 (5): 168-171 [Abstract] ( 445 ) HTML (1 KB) PDF (1060 KB) ( 182 )

	172	Discussion on the medical insurance problems of undergraduate in the private-owned independent institute
		FU Pingting
		Objective To study the medical insurance problems of undergraduate in the private-owned independent institute, which has positive and realistic significance for promoting the development of educational business and health cause in China. Methods A questionnaire survey was conducted among college undergraduate of an independent college in Guangdong Province in 2017. The basic insured conditions of medical insurance of undergraduate, the view of undergraduate on medical insurance, personal medical habits of undergraduate, the satisfaction of undergraduate for school hospital and other indicators were statistically analyzed. Results A total of 200 questionnaires were issued and 181 valid questionnaires were returned. The survey showed that only 17.2% of students in the survey knew a lot about medical insurance, 65.2% of the students in the survey participated in medical insurance, 61.9% of the students in the survey thought that the annual cost of medical insurance was reasonable, while 60.8% of the students in the survey thought that the proportion of medical insurance compensation was low. 36.5% of the students in the survey said that they knew about the reimbursement process, meanwhile, more than half (54.1%) of the students in the survey found that the reimbursement process was inconvenient. After illness, the first choice of medical treatment for the students in the survey was school hospitals (38.1%), followed by clinics or pharmacies (36.5%), and finally medical institutions designated by medical insurance (17.7%). 54.1% of the students in the survey were generally satisfied with the current school hospital services. Conclusion Aiming at the existing problems of medical insurance of undergraduate in the private-owned independent institute, this paper puts forward that private-owned independent institute should strengthen the publicity of health care prevention of undergraduate, ensure the high insured rate of medical insurance through various channels, improve the reimbursement link of medical insurance, relocate the school hospital, try to build online mutual community of critical illness for undergraduate and other countermeasures.
		2019 Vol. 16 (5): 172-176 [Abstract] ( 170 ) HTML (1 KB) PDF (564 KB) ( 81 )

	177	Supervision technology of information security classified protection in medical profession
		SHI Jinghua
		Whether the medical information system is safe or not is a hidden trouble which affects the efficiency and benefit of the system, and it is serious hidden danger which affects the medical profession to complete its mission of curing and saving people. Therefore, countries arounds the world generally regard the security protection of medical information system as the critical information infrastructure protection (CIIP). Document No.85 of the origina Ministry of Health of China in 2011 requires that the level of security protection of important health information systems is not lower than the third in principle. The paper introduces the basic concept and classification of classified protection of information system security in our country, and the present situation of security supervision technology in medical profession in our country. On this basis, the paper analyzes the future direction of optimization and adjustment in terms of security supervision technology in Chinese medical industry. In order to adapt to the information development, this paper also puts forward some suggestions to further do well in security supervision.
		2019 Vol. 16 (5): 177-180 [Abstract] ( 171 ) HTML (1 KB) PDF (557 KB) ( 107 )

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