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2019 Vol. 16, No. 7 Published: 2019-03-05

	4	Study of the interaction between polymorphisms of URAT1 gene and HUA in Uyghur
		LI Rui1 QIN Liyan2 ZHANG Bei1 CHEN Wujin1 SUN Yuping1
		Objective To explore the interaction between human urate transporter 1 (URAT1) gene rs3825018, rs505802 and rs524023 gene polymorphisms and Uygur hyperuricemia (HUA). Methods A total of 2340 Uygur subjects who took part in physical examination in the health management center of an Affiliated Hospital in Urumqi from November 2014 to December 2016 were selected as subjects and divided into HUA group (n = 986) and control group (n = 1354) according to the level of uric acid. The body height, weight, waist and hip circumference, blood pressure and other general indicators were measured. The venous blood samples were collected after fasting for 12 hours. The biochemical indicators such as serum uric acid, creatinine, glucose, total cholesterol and triacylglycerol, and the polymorphisms of URAT1 gene rs3825018, rs505802 and rs524023 loci were detected. Results The distribution of alleles and genotype frequencies of rs3825018, rs505802 and rs524023 in URAT1 gene were not significantly different between HUA group and control group (P > 0.05). Genetic model analysis found that rs3825018, rs505802 and rs524023 were not significantly associated with Uyghur HUA in all three genetic models (95% CI across 1), regardless of age or gender. The results of the interaction showed that there was a negative interaction between the Uygur females carrying the rs505802 locus mutation in the additive model (S = -0.146, P < 0.05). Conclusion The mutations of rs3825018, rs505802 and rs524023 in URAT1 gene may not affect the susceptibility of Uygur HUA. The risk of HUA may be reduced to some extent by carrying rs505802 mutation in Uygur women.
		2019 Vol. 16 (7): 4-6,14 [Abstract] ( 301 ) HTML (1 KB) PDF (587 KB) ( 147 )

	7	Expression of BTG-1 in esophageal squamous cell carcinoma tissues and the effect on apoptosis of esophageal squamous cell carcinoma cell line EC9706
		GAO Ming LIU Liying LI Shenglei ZHANG Mingzhi▲
		Objective To analyze the expression of B-cell translocation gene 1 (BTG-1) in tissue of esophageal squamous cell carcinoma and the effect on apoptosis of esophageal squamous cell carcinoma cell line EC9706. Methods A total of 164 paraffin blocks of squamous cell carcinoma collected through surgery or endoscopic biopsy and 76 adjacent normal tissue surgical blocks were collected from the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2017. The expression of BTG-1 protein and mRNA in the two groups were detected by immunohistochemistry and in situ hybridization, and their relationships with pathological parameters were analyzed. The BTG-1 overexpressing cell line was established, and the apoptosis of human esophageal squamous cell carcinoma cell line EC9706 was detected by AnnexinV-FITC/PI double labeling flow cytometry. Results The positive expression rates of BTG-1 protein and messenger ribonucleic acid (mRNA) in esophageal squamous cell carcinoma tissues were significantly lower than those in adjacent normal tissues (χ2=32.718, 55.729; all P﹤ 0.001). The positive expression rates of BTG-1 protein and mRNA in specimens with lymph node metastasis, at TNM stage Ⅲ - Ⅳ and histological grade Ⅱ - Ⅲ were significantly lower than those without lymph node metastasis, at TNM stage Ⅰ - Ⅱ and of histological grade Ⅰ (χ2=29.078, 5.970, 7.660, 31.127, 8.624, 10.624; all P﹤0.001). The early apoptosis rate in BTG-1 group was significantly higher than that in blank control group (t = 15.484, P ＜ 0.001). Conclusion The expression of BTG1 in tissues of esophageal squamous cell carcinoma is significantly lower than that in adjacent normal tissues. It is closely related to the presence of lymph node metastasis, TNM stage and histological grade. High expression of BTG-1 may promote the apoptosis of cell of esophageal squamous cell carcinoma.
		2019 Vol. 16 (7): 7-10 [Abstract] ( 260 ) HTML (1 KB) PDF (679 KB) ( 119 )

	11	Effects of astragalus polysaccharide on post-stroke depression in rats
		LIU Lizhu1 LIU Wei2 FAN Lin2 GUO Lihong1
		Objective To investigate the effects and possible mechanism of astragalus polysaccharide (APS) on post-stroke depression (PSD) in rats. Methods Wistar rats were screened by open field test, and a total of 48 eligible rats were divided into blank control group, model control group, APS low dose group and APS high dose group according to random number table method, with 12 rats in each group. The model of focal cerebral ischemia was established using suture-occluded method in all groups except the blank control group, and the rat PSD model was established by isolation housing combined with chronic unpredictable stress method (CUMS). Post-surgery, rats received treatment of APS 200 mg/(kg·d) (APS low dose group), APS 400 mg/(kg·d) (APS high dose group) and equal volume of saline (model control group and blank control group) for 4 weeks by gavage. Results from the behavioral and electrophysiology experiments, and the level of protein and gene expressions of nuclear factor-κB (NF-κB) and peroxisome proliferator-activated receptor-gamma (PPAR-γ) in hippocampal CA1 region were analyzed to determine the effect of APS on PSD in rats. Results Compared with the model control group, the APS low dose group and the APS high dose group showed significantly lower spontaneous action potential (AP) and group peak potential (PS) voltages in the CA1 region by patch clamp recordings, significantly lower NF-κB protein and mRNA expression and significantly higher PPAR-γ protein and mRNA expression, the differences were statistically significant (P ＜ 0.05). The saccharification water intake experiment showed that the sucrose intake of the two APS dose groups were significantly higher than those of the model control group, the water maze test showed that the escape latency of the rats in the two APS dose groups were significantly shortened and number of platform crossings were significantly increased, the differences were statistically significant (P ＜ 0.05). The changes of the above parameters in the APS high dose group were more obvious than those in the APS low dose group, the differences were statistically significant (P ＜ 0.05). Conclusion APS may play a therapeutic role in PSD by inhibiting the phosphorylation of NF-κB signaling pathway and stabilizing the AP and PS voltages in the hippocampal CA1 region.
		2019 Vol. 16 (7): 11-14 [Abstract] ( 269 ) HTML (1 KB) PDF (585 KB) ( 140 )

	15	MicroRNA markers screening and early clinical prediction of ovarian cancer in breast cancer patients
		WU Long1 LIU Chen1 JIANG Hongchuan2 LI Jie2 ZHENG Jiyan3 SHEN Ye3 DUAN Demin3▲ WANG Shuzhen1▲
		Objective To investigate the differential expression of microRNAs and their correlation in patients with ovarian cancer after breast cancer operation by miRNA microarray, and to provide early prediction of postoperative ovarian cancer. Methods The patients with ovarian cancer who were admitted to Beijing Chaoyang Hospital, Capital Medical University from January 2000 to December 2014 were enrolled as research objects. The patients with ovarian cancer after breast cancer surgery were regarded as experimental group, patients with complication of benign gynecological tumors followed by breast cancer (benign control group) and patients with no any abnormal after breast cancer surgery (single breast cancer control group) were regarded as control. The miRNA microarray and qRT-PCR were used to detect the differentially expressed miRNA levels among the groups. Results A series of differentially expressed miRNAs were detected by miRNA microarray, among which miR-1234 was the most significantly differentially expressed, and the results of verification of miR-1234 expression by qRT-PCR also showed that the expression level of miR-1234 in the experimental group was significantly higher than that in the benign control group and the single breast cancer control group (P ＜ 0.05). The sensitivity and specificity of early prediction of ovarian cancer after breast cancer surgery by using miR-1234 were 80%. Conclusion miR-1234 is the most obvious difference between patients with ovarian cancer after breast cancer surgery and those without ovarian cancer after breast cancer surgery. It is expected to be a tumor marker for early prediction of ovarian cancer after breast cancer operation.
		2019 Vol. 16 (7): 15-19 [Abstract] ( 259 ) HTML (1 KB) PDF (941 KB) ( 150 )

	20	The protective effect of fucoidan on oxidation stress and apoptosis of MN9D cells damaged by MPP+
		LIANG Zhigang1 SUN Xuwen1 LIU Zhuli1 YANG Shaowan1 LUO Dingzhen2
		Objective To explore the protective effect of fucoidan (FUC) on the cell model of Parkinson′s disease (PD) and its mechanism. Methods PD model was established by MN9D cells which were damaged by 100 μmol/L MPP+. The cell viability of PD cell model was detected by MTS after FUC pretreatment. The reactive oxygen species (ROS) was measured by fluorescence detection, the activity of Caspase-3 in cells was measured by luciferase, the expression changes of apoptosis-related proteins Bax and Bcl-2 were measured by Western blot. Results After application of 12 h, FUC 100 μmol/L significantly increased the cell viability of MN9D cells damaged by MPP+, the difference was highly statistically significant (P ＜ 0.01). The FUC pretreatment reduced the activity of intracellular ROS of MN9D cell damaged by MPP+ in 3 h and the expression of Caspase-3 in 6 h, there were highly statistically significant differences (P ＜ 0.01). After FUC and Selegiline pretreatment, the expression of MN9D cell apoptosis-related protein Bax was decreased, and the expression of Bcl-2 was increased, the differences were highly statistically significant (P ＜ 0.01). Conclusion Fucoidan may protect the PD cell models through anti-oxidation, reducing the expression of Caspase-3 and inhibiting cell apoptosis.
		2019 Vol. 16 (7): 20-24 [Abstract] ( 292 ) HTML (1 KB) PDF (782 KB) ( 259 )

	25	Study on the new synthetic process for Olmesartan Medoxomil
		LI Fangjuan1 MENG Xiangli2 WU Yiyan1 MENG Fanqin1 GUO Qiang1 ZHAO Yujia1
		Objective To study the synthesis methods of angiotensin Ⅱ receptor antagonist olmesartan medoxomil. Methods Taking diaminomaleonitrile (2) and trimethyl orthobutyrate as starting materials to obtain intermediate Ethyl 4-(1-hydroxy-1-methylethyl)-2-propyl-imidazole-5-carboxylate (6) through cyclization, hydrolysis, esterification and Grignard reaction. Then target compound olmesartan medoxomil was obtained through condensation between compound 6 and N-(Triphenylmethyl)-5-(4′-Methylbiphenyl-2-yl)Tetrazole (7) which followed by three steps including hydrolysis, substitution and deprotection. Results Optimized and confirmed the synthesis routes of olmesartan medoxomil, the total yield was 34.9% (calculated by diaminomaleonitrile, the reported yield in literature was 25.0%) and the purity was 99.5% (Normalization method of high performance liquid chromatography was used for detection). The chemical structure was characterized by nuclear magnetic resonance spectrometry and mass spectrometry. Conclusion The synthetic route has the advantages of low cost, simple operations, mild conditions and high yields, which make it more suitable for industrial production.
		2019 Vol. 16 (7): 25-27,36 [Abstract] ( 271 ) HTML (1 KB) PDF (650 KB) ( 193 )

	28	Surveillance and analysis of bacterial resistance in Chongzuo City from 2014 to 2016
		LIANG Yumei LI Weidong LI Baoqiang NONG Zhihuan
		Objective To understand the distribution and drug resistance of pathogenic bacteria in Chongzuo City, and to grasp the situation of bacterial resistance change in this region, and provide a basis for the rational application of antibacterial drugs. Methods Data of clinical isolation pathogenic bacteria composition and drug resistance in 7 general hospitals from 2014 to 2016 were analysed. A total of 172 367 samples of pathogenic microorganisms were collected, in which 18 256 strains of bacteria were isolated. The paper method or minimal inhibitory concentration (MIC). method were used to determine the sensitivity of antibiotics. The test and judgment standards were applied according to the Clinical & Laboratory Standards Institute (CLSI) standards of each year. WHONET5.6 software was used for statistical analysis of data. Results From 2014 to 2016, Gram-positive bacteria accounted for 24.3% and Gram-negative bacteria 75.7% of clinical isolates pathogenic bacteria in Chongzuo area. The Gram-positine Racteria ranked first in the isolated pathogens from 2014 to 2016 were Staphylococcus aures, and the second were Staphlococcus epidermidis; the Gram-negatiue becteria in the isolated pathogens ranked in the top five were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterobacter cloacea. From 2014 to 2016, the detection rates of methicillin-resistant Staphylococcus aureus (MRSA) were 18.3%, 24.9%, 26.0% respectively, vancomycin-resistant Enterococcus faecalis were 2.8%, 0.0%, 0.0% respectively, and vancomycin-resistant Enterococcus faecium was not detected. From 2014 to 2016, the detection rates of penicillin- resistant Streptococcus pneumoniae (PRSP) and erythromycin-resistant Streptococcus pneumoniae (ERSP) were 67.6%, 68.9%, 68.2% and 92.3%, 96.5% 94.4%, respectively. The third generation of cephalosporins-, carbapenems- and quinolones-resistant Escherichia coli were 51.1%, 47.8%4, 5.2%; 0.9%, 0.7%, 0.4%; and 42.2%, 44.6%, 40.9%, respectively. The resistant rates of Klebsiella pneumoniae to the third generation of cephalosporins were 31.0%, 26.6%, 23.6%, and Klebsiella pneumoniae to carbapenems were 0.7%, 2.0%, 1.8%. The detection rates of carbapenems-resistant Pseudomonas aeruginosa and carbapenems-resistant Acinetobacter baumannii were 6.5%, 14.4%, 11.9% and 25.4%, 42.3%, 38.6% respectively. Conclusion It is serious of bacteria resistant to antibiotics in Chongzuo City. From 2014 to 2016, the detection rate of MRSA shows an increase trend, PRSP was higher than the average levels of Guangxi and China, and the drug resistance rate of carbapenems increased rapidly. Management of antimicrobial application and monitoring of bacterial resistance should be strengthened.
		2019 Vol. 16 (7): 28-32 [Abstract] ( 251 ) HTML (1 KB) PDF (549 KB) ( 75 )

	33	Determination of domperidone in Domperidone Tablets produced by different manufacturers by ultra performance liquid chromatography-tandem mass spectrometry
		GENG Jing LYU Lingyan FENG Xingyue JIANG Zhitao LIU Chundi
		Objective To establish a method for the determination of domperidone in Domperidone Tablets by ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and to compare the contents of domperidone in Domperidone Tablets produced by different manufacturers. Methods BEH C18 column (2.1 mm × 50 mm, 1.7 μm) was used. The mobile phase was methanol∶2 mmol/L ammonium acetate aqueous solution (85∶15, V/V). The injection volume was 2 mL, the column temperature was 30℃, and the flow rate was 0.2 mL/min. Multiple Reaction Monitoring Model (MRM) was used for positive ion pattern detection. Results Domperidone was well separated within 3 min and showed a good linear relationship with peak area in the concentration range of 10.6-5300 ng/mL. The linear regression equation was Y = 85.362 X+30 067. The limit of detection was 1.06 ng/mL, and the limit of quantitation was 10.6 ng/mL. The average recoveries was 99.2% with the relative standard deviation (RSD) being 1.7%. The contents of domperidone in Domperidone Tablets produced by different manufacturers were 10.016, 10.147, 10.092, 10.123, 10.109 and 10.075 mg respectively, which met the requirements of the 2015 edition of the Pharmacopoeia of the People′s Republic of China (Part Ⅱ). Conclusion The method is simple, rapid, reproducible and sensitive. It is suitable for rapid quantitative analysis of domperidone.
		2019 Vol. 16 (7): 33-36 [Abstract] ( 270 ) HTML (1 KB) PDF (605 KB) ( 110 )

	37	Advances in studies on quality evaluation of Corydalis decumbens
		LIU Xiaomei1，2 GAO Jin3 WU Anming4 HE Yanghu4 HUANG Hao1,3,5
		The Rhizoma Corydalis decumbentis is a commonly used traditional Chinese medicine contained in the Pharmacopoeia of the People′s Republic of China in 2015. Its medicinal part is the dried tuber of Coydalis decumbens (Thunb.) Pers.. Its main pharmacological active ingredients are alkaloids, which are commonly used in the treatment of stroke hemiplegia, headache, fall injury, lumbar and leg pain, rheumatism and arthralgia. This paper summarizes the recent studies on quality evaluation of Rhizoma Corydalis decumbentis in order to provide references for guiding the identification of Rhizoma Corydalis decumbentis and other medicinal materials and establishing scientific and reasonable quality evaluation criteria. This article provides some references for further ensuring the safety and effectiveness of clinical medication.
		2019 Vol. 16 (7): 37-40 [Abstract] ( 257 ) HTML (1 KB) PDF (630 KB) ( 322 )

	41	progress in monitoring and treatment strategies for adverse reactions of tumor immunological checkpoint inhibitors
		PAN Cen WANG Qinglan▲ ZHENG Yongfa WU Long
		At present, immunological checkpoint inhibtors (ICPIs) is one of the important choices for the treatment of malignant tumors after radiotherapy and chemotherapy. It has achieved good therapeutic effects in the treatment of various solid tumors. However, these drugs can also produce a wide range of immune-related adverse events (irAEs), affecting patients′ life quality and prognosis. Therefore, nurses as the main point of contact for immunotherapy patients need to fully understand irAEs and their appropriate treatment strategies to improve the prognosis and quality of life of patients treated with ICPIs. This article reviews the progress of adverse reactions in the treatment of tumor immunological checkpoint inhibitors and its monitoring and treatment strategies.
		2019 Vol. 16 (7): 41-44 [Abstract] ( 239 ) HTML (1 KB) PDF (597 KB) ( 109 )

	45	Advances in the digital three-dimensional reconstruction and measurement of urinary calculus
		WU Libing1,2 LI Xiaohe1 LI Zhijun2
		Urolithiasis is a common and frequently-occurring disease in urinary system. Spiral CT is one of the commonly used methods in clinical examination. The anatomy of the urinary system is complex with a wide range of lesions. Two-dimensional inspection has some limitations. Three-dimensional reconstruction technology based on plain CT scan images multidimensional reconstruction, maximum density shadow projection, surface and volume reproduction technology, surface reconstruction and virtual endoscopy after processing, can rebuild thin layer, more solid and visually present the anatomical structure of urinary system, from multiple perspectives show calculus, shape, size, the lesion site and its three-dimensional space position relations, and with the aid of three-dimensional reconstruction technology provides the digital simulation of virtual surgery may, for the diagnosis and treatment of urinary calculi has important practical significance. In this paper, three-dimensional reconstruction and simulation surgery were summarized and analyzed, and its shortcomings were summarized to provide a reference for clinical personalized accurate surgery.
		2019 Vol. 16 (7): 45-48,52 [Abstract] ( 249 ) HTML (1 KB) PDF (619 KB) ( 196 )

	49	Advances in palpation of cervical “subluxation”
		NING Yuanshuai GU Fei HE Tianxiang JI Dengjun LI Yazhou
		To summarize the research situation of cervical “subluxation” palpation at home and abroad, analyze the traditional palpation content and the superiority of spinal motion palpation, and consider that traditional static palpation include palpation of facet joints, cervical vertebra momentum examination and palpation of soft tissue around the spine. Although this type of examination method has been found to help clinicians locate the diagnosis to some extent, it is basically done under static conditions. Activity is the basic function of the joint, and static palpation does not fully reflect the ability of the spine segment to move. Dynamic palpation through the joint activity to sense local activity limitation, activity disorder, motor end sensation and other content to judge the“subluxation”segment, compared to traditional palpation has advantages, but the reliability and feasibility study of motion palpation needs further study.
		2019 Vol. 16 (7): 49-52 [Abstract] ( 289 ) HTML (1 KB) PDF (628 KB) ( 105 )

	53	Research progress on the relationship between coronary heart disease and anemia
		XU Shiying1 YE Fang2▲ PI Lin1
		Both coronary heart disease and anemia are common diseases of the elderly, and many studies have confirmed that they affect each other in terms of etiology and pathology, and jointly promote each others′ development, which has become more and more prominent problems in the aging society today. In this article, we summarize the possible internal relations between coronary heart disease and anemia from the aspects of similarity of epidemiological characteristics, common influencing factors and common pathogenesis, etc. In view of the present situation of anemia associated with coronary heart disease in China, some suggestions for clinical prevention and treatment are presented in this article, and we believed that positive correction of anemia with coronary heart disease could improve the prognosis of patients.
		2019 Vol. 16 (7): 53-55 [Abstract] ( 264 ) HTML (1 KB) PDF (588 KB) ( 158 )

	56	Research progress of Shenqi Fuzheng Injection in the clinical adjuvant treatment of patients with non-digestive system malignant tumor
		JIA Jing1 ZHANG Liying2 XU Yunxia3 GAO Xiangqun1 LIU Sha1 LIU Zengjuan1
		A series of adverse reactions in the treatment of malignant tumors have a serious impact on the therapeutic effect. Shenqi Fuzheng Injection can be used as adjuvant therapy in the clinical treatment of lung cancer, breast cancer, cervical cancer and other malignant tumors due to its effects of reducing toxicity, enhancing efficacy and improving patients′ immune function, and has achieved good results. At the same time, more and more attention has been paid to its mechanism of action.
		2019 Vol. 16 (7): 56-58,66 [Abstract] ( 307 ) HTML (1 KB) PDF (910 KB) ( 158 )

	59	The application study of the Presentation-Assimilation-Discussion classroom in medical college pathophysiology course
		LIU Qiaofeng1 GUAN Xuan2 CHEN Wei1 FAN Meng1 LIANG Yundan1 WANG Xin3▲
		Objective To research the effect of the Presentation-Assimilation-Discussion classroom teaching mode on medical college pathophysiology course. Methods A total of 218 pharmaceutical specialty undergraduates of 2016 class in grade 2 in Chengdu Medical College from February to July 2018 were selected as study subjects. All the students were divided into control group (75 students) and experimental group (143 students) by random number table method. The control group was adopted traditional teaching method, while the experimental group was accepted the Presentation-Assimilation-Discussion classroom teaching method. Teaching efficiency was assessed through the final examination and questionnaires. Results Compared with the control group, the scores of paehophysiology coure of final examination was higher in the experimental group (P ＜ 0.01). The students in the experimental group hold a positive attitude towards the PAD classroom teaching method, who thought it increased teacher-student, stuolent-stuclent interaction, critical thinking ability, communication, expression, cooperation, and creativity could improve and aspired to use the method continuously (P ＜ 0.01). Post-class learning autonory in the experimental group was higher than the control group (P < 0.01). Conclusion The Presentation-Assimilation-Discussion classroom not only improves teaching efficacy, developes student core competence, but also establishes a classroom satisfied by both teachers and students. It is worthy of promotion in medical college pathophysiology courses teaching.
		2019 Vol. 16 (7): 59-62,70 [Abstract] ( 302 ) HTML (1 KB) PDF (514 KB) ( 49 )

	63	Application of ultrasound teaching platform in standardized training of residents
		HE Ying1 CHEN Mingliang2▲
		Objective To evaluate the applying value of ultrasound teaching platform in the standardized training of residents and the teaching effect preliminarily. Methods Twenty eight residents in Department of Ultrasonography, Xinqiao Hospital of Amy Military Medical University from June to December 2016 were divided into experimental group and control group by simple and randomized grouping method with 14 residents in each group. The experimental group was adopted the case-based learning (CBL) method via ultrasound teaching platform, while the control group was accepted the traditional lecture-based learning (LBL) method. The effect of learning was measured by theoretical examination and clinical practice test before and after 6 months′ training, and questionnaire survey was performed to evaluate the interest degree of the two groups. SPSS 19.0 software was used to analyze the results of theoretical and clinical practice test before and after training. Results After training, the theoretical examination results and the clinical practice performance both improved than those before training in the two groups, the differences were statistically significant (P ＜ 0.05). Compared with the control group, the results of theoretical examination and the clinical practice performance in the experimental group were higher than those in the control group after training, the differences were statistically significant (P ＜ 0.05 or P < 0.01). All the residents in the experimental group thought that the learning interest and learning autonomy improved greatly, and they were able to acquire the latest cutting-edge knowledge in a timely manner, hoping to continue to accept this method of learning. While 25% of the residents in the control group thought that LBL teaching could promote the autonomous learning and willing to continue to accept this training mode. Conclusion The ultrasound teaching platform is helpful for improving the teaching quality in the standardized training of residents and it is worth promoting.
		2019 Vol. 16 (7): 63-66 [Abstract] ( 238 ) HTML (1 KB) PDF (490 KB) ( 168 )

	67	Application of case based learning teaching method based on picture archiving and communication system in medical imaging internship
		REN Cui YUAN Huishu LANG Ning
		Objective To evaluate the application effect of case based learning (CBL) teaching method based on picture archiving and communication system (PACS) in teaching medical imaging internship. Methods A total of 52 eight-year program clinical medicine direction students of class 2013 in Peking University Third Hospital from May to June 2017 were selected. They were randomly divided into experimental group and control group according to the random number table method, with 26 students in each group. The experimental group adopted the PACS-based CBL, while the control group adopted traditional teaching method. Ten hours’ teaching of bone and joint system imaging internship were performed in the two groups. After classe, questionnaire survey was used to investigate the students in the two groups evaluation on the present teaching mode. The results of bone and joint system reading examination were compared between the two groups. Results The quantitative scores of the satisfaction to the teaching mode, and the quantitative scores of the agreement that the mode contributed to promote the understanding of theoretical knowledge, improved the self-study and independent thinking ability, developed the communication and presentation skills, improved the clinical thinking ability, as well as the scores of the image reading ability, were significantly higher in the experimental group than the control group (P ＜ 0.01). The average results of the experimental group was also higher than the control group, the differences were all statistically significant (P ＜ 0.05). Conclusion The CBL teaching based on PACS is a scientific and effective teaching mode, which can improve the teaching effect of imaging internship.
		2019 Vol. 16 (7): 67-70 [Abstract] ( 226 ) HTML (1 KB) PDF (494 KB) ( 75 )

	71	Effect of Tripterygium Glycosides Tablets combined with Methotrexate in treatment of rheumatoid arthritis
		LONG Jie1 WANG Tao2 QU Chen3 ZHU Changliang4▲
		Objective To investigate the effect of Tripterygium Glycosides Tablets combined with Methotrexate in treating rheumatoid arthritis. Methods Forty-eight patients with RA in General Hospital of Chengdu Military Region Hospital from February 2013 to September 2017 were divided into observation group (24 cases) and control group (24 cases) according to the random number table method. The control group was treated with oral Methotrexate, the observation group was treated with oral Tripterygium Polyglycoside Tablets on the basis of the treatment of the control group, both groups were treated for 6 months. The changes of clinical efficacy and symptom bodies visual analogue score (VAS), number of tender joints, number of swollen joints, and time of morning stiffness) were observed. The inflammatory indexes interleukin-6 (IL-6) and interleukin-1 (IL-1), serum tumor necrosis factor-α (TNF-α) and related biochemical index erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF) anti CCP antibody, AKA positive change of patients were compared between two groups, adverse reactions occurred in both groups were recorded. Results After treatment, the total efficiency of clinical efficacy evaluation in the observation group was better than that in the control group, and the difference was statistically significant (P ＜ 0.05). Before treatment, there were no significant difference in VAS score, number of tender joints, number of swollen joints, and time of morning stiffness between the two groups (P ＞ 0.05). After treatment, VAS score, number of tender joints, number of swollen joints, and time of morning stiffness in both groups were significantly reduced compared with those before treatment, and the observation group was significantly better than the control group, with statistically significant differences (P ＜ 0.05). After treatment, the above indicators of joint inflammation and biochemical correlation were lower in both groups than before treatment, and the observation group was significantly lower than the control group, with statistically significant differences (P ＜ 0.05). After treatment, the positive rates of anti-CCP antibodies and AKA antibodies in the two groups were lower than those before treatment, and the positive rates of anti- CCP antibodies and AKA antibodies in the observation group were significantly lower than those in the control group, with statistically significant differences (P ＜ 0.05). The adverse reactions in both groups were mild and controllable, and most of them could be alleviated by symptomatic drug therapy. Conclusion Tripterygium Polyglycoside Tablets combined with Methotrexate has a good clinical effect in the treatment of RA. It can effectively inhibit the expression of RF and the levels of IL-6, IL-1, TNF-α in peripheral blood serum, reduce the inflammatory reaction, effectively alleviate and improve the clinical symptoms of RA patients, reduce the pain and the occurrence of adverse reactions, which is worthy of clinical promotion.
		2019 Vol. 16 (7): 71-75 [Abstract] ( 331 ) HTML (1 KB) PDF (669 KB) ( 118 )

	76	Effect of Angong Niuhuang Pills combined with Butylphthalide on severe cerebral infarction
		HU Xiaofei1 ZHU Xianhua2 ZHOU Yan1 JIN Xiaoping1
		Objective To investigate the effect of Angong Niuhuang Pills combined with Butylphthalide on severe cerebral infarction. Methods From January 2015 to December 2017, 88 patients with severe cerebral infarction to the Department of Neurology of Taizhou Hospital Affiliated to Wenzhou Medical University were selected and divided into experimental group and control group according to the random number table method, with 44 patients in each group. The control group was treated with conventional western medicine comprehensive treatment, and the experimental group was treated with Angong Niuhuang Pill combined with Butylphthalide injection on the basis of conventional western medicine comprehensive treatment. The treatment duration of both groups was 14 d. Glasgow coma scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) were scored before treatment, 7 d after treatment and 14 d after treatment, respectively, and serum neuron enolase (NSE) and matrix metalloproteinase-13 (mmp-13) levels were detected. Results The overall efficacy of the experimental group was better than that of the control group (P ＜ 0.05). The GCS scores of the experimental group were higher than that of the control group 7 d and 14 d after treatment (P ＜ 0.05). The NIHSS score, serum NSE level and mmp-13 level 14 d after treatment were lower than those in the control group, and the difference were statistically significant (P ＜ 0.05). Conclusion Angong Niuhuang Pill combined with Butylphthalide injection can reduce the degree of consciousness disorder in patients with severe cerebral infarction, reduce central nervous injury and neurological functional defects, and the effect is better than conventional western medicine comprehensive treatment.
		2019 Vol. 16 (7): 76-79 [Abstract] ( 365 ) HTML (1 KB) PDF (622 KB) ( 203 )

	80	Relationship between self-management behavior of young and middle-aged patients with coronary heart disease and quality of life, social support
		LI Shaozhi
		Objective To explore the relationship between self-management behavior of young and middle-aged patients with coronary heart disease and quality of life, social support. Methods From January 2012 to May 2016, in Foshan Traditional Chinese Medicine Hospital, 185 young and middle-aged patients with coronary heart disease were selected, and all patients were investigated by coronary heart disease self-management scale, health survey summary scale SF-36, social support rating scale, and the scores were summarized. The relationship between self-management behavior, quality of life and social support was analyzed by Pearson correlation test. Results The scores self-management of middle-aged and young people from high to low were daily life management, emotion management and disease medical management in turn. The scores of each dimension of quality of life from high to low were physiological function, social function, physiological function, somatic pain, general health, mental health, emotional function and vitality. The scores of social support from high to low were subjective support, objective support and support utilization. Quality of life was positively correlated with self-management behavior (r ＞ 0, P ＜ 0.05), and social support was positively correlated with self-management behavior (r ＞ 0, P ＜ 0.05). Conclusion Self-management behavior of young and middle-aged patients with coronary heart disease, quality of life and social support are all in the middle and lower level, and self-management behavior is closely related to quality of life and social support. It should strengthen social support to improve self-management behavior and quality of life of patients.
		2019 Vol. 16 (7): 80-83 [Abstract] ( 290 ) HTML (1 KB) PDF (655 KB) ( 159 )

	84	Effects of ventilator assisted breathing on blood gas and neurological function in patients with acute cerebral hemorrhage and respiratory failure
		WANG Jiadong HUANG Yan WU Rong TAN Mingwan LIU Jun
		Objective To explore the effect of ventilator assisted breathing on blood gas index and nerve function in patients with acute cerebral hemorrhage complicated with respiratory failure. Methods From January 2016 to December 2017, in the Fourth Hospital of Changsha City, 88 patients with acute cerebral hemorrhage complicated with respiratory failure were selected, according to the results of the patient rescue result, they were divided into succeed group (35 cases) and failure group (53 cases). The MAP, PaO2, PaCO2, and pH values of the two groups were compared before and after treatment, the NIHSS, APACHE Ⅱ, and GCS scores of patients in the succeed group were compared at different time points before and after treatment. Results After 48 h of ventilation treatment, the PaO2 and pH values in the two groups significantly improved than before the ventilation treatment (P < 0.05); the values of MAP and PaCO2 in the succeed group significantly reduced than before the ventilation treatment (P < 0.05); the PaCO2 values in the failure group significantly reduced than before the ventilation treatment (P < 0.05), the MAP value in the failure group did not significantly changed compared with before treatment (P > 0.05). The NIHSS scores in the succeed group significantly reduced after treated for 7, 28 d compared with before treatment (P < 0.05); after 48 h of ventilation treatment, the GCS scores in the succeed group significantly increased than before the ventilation treatment (P < 0.05), the APACHEⅡ scores significantly reduced than before ventilation (P < 0.05); the GCS, APACHEⅡ scores in the failure group without significantly changed compared with before treatment (P > 0.05). Conclusion Ventilator-assisted breathing can significantly improve the blood gas function of patients with acute cerebral hemorrhage complicated with respiratory failure, and promote the recovery of nerve function of successful patients.
		2019 Vol. 16 (7): 84-87 [Abstract] ( 224 ) HTML (1 KB) PDF (621 KB) ( 223 )

	88	Clinical effect of Valsartan combined with Captopril in treatment of elderly hypertensive patients
		WEI Jingmei WANG Xiaozhou
		Objective To investigate the clinical effect of Valsartan combined with Captopril in elderly hypertensive patients. Methods From February 2016 to January 2017, in Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, 174 elderly hypertensive patients were selected, according to according to draw lots of serial number, they were divided into two groups, with 87 cases in each group. The patients in control group were treated with Valsartan, the patients in study group were treated with Valsartan combined with Captopril. The blood pressure, heart rate changes, incidence of adverse reactions, NIHSS scores and clinical effects in two groups were compared. Results The blood pressure in two groups after treatment were better than before treatment, the differences were statistically significant (P < 0.05). The blood pressure and heart rate in study group were better than control group, the differences were statistically significant (P < 0.05). The NIHSS scores in two groups after 1 month were lower than before treatment, at 7 d after treatment, and the NIHSS scores in study group were lower than control group at 7 d, 14 d and 1 month after treatment, the differences were statistically significant (P < 0.05). Conclusion The treatment of valsartan combined with Captopril in elderly hypertensive patients is effective, it can not only reduce the incidence of adverse reactions in elderly hypertensive patients, but also improve the NIHSS score and clinical efficacy of patients, and it can also improve the blood pressure and heart rate of patients.
		2019 Vol. 16 (7): 88-91 [Abstract] ( 197 ) HTML (1 KB) PDF (653 KB) ( 98 )

	96	The effect of neck straight on the efficacy of inhalation in patients with chronic obstructive pulmonary disease
		TANG Shouxiang MA Jing▲
		Objective To study the effect of neck straight on the efficacy of inhalation in patients with chronic obstructive pulmonary disease. Methods Eighty patients who were admitted to Dachang Hospital of Nanjing from August 2015 to August 2016 due to moderate to severe chronic obstructive pulmonary disease were divided into experimental group and control group according to random number table method, with 40 cases in each group. Both groups were given the same treatment and standardized inhalation medication education. Only the patients in the experimental group were required to keep the neck straight during inhalation and breath holding every time the inhalation was taken. The effect of keeping neck straight during inhalation on the times of acute exacerbation and the time of conscious remission were observed. Results The conscious remission time and the times of acute exacerbation in the experimental group were significantly lower than those in the control group (P ＜ 0.05). After the use of long-term inhalation, there was no significant difference in the 6 minutes walking distance (6MWD) of the experimental group compared with that before use (P ＞ 0.05), while the 6MWD of the control group was significantly less than that before use (P ＜ 0.05), and 6MWD of the experimental group was significantly larger than that in the control group (P ＜ 0.05). Conclusion It is necessary for patients to keep the neck straight in using inhalation and it is worthy of clinical promotion.
		2019 Vol. 16 (7): 96-99 [Abstract] ( 212 ) HTML (1 KB) PDF (621 KB) ( 69 )

	100	Efficacy of three different analgesic methods for postoperative analgesia in patients undergoing cesarean section
		DU Penghui1 YANG Shengfeng2 WANG Zhenggang3 CHEN Chunyi3 FENG Xiaobo3▲
		Objective To evaluate the efficacy of three different analgesic methods when used for postoperative analgesia in patients undergoing cesarean section. Methods A total of 90 parturients scheduled for elective cesarean section in Zhongnan Hospital of Wuhan University, from March to December 2017 were selected as research subjects. All parturients underwent cesarean delivery under combined spinal and epidural anesthesia. They were divided into patient-controlled epidural analgesia group (PCEA group), patient-controlled intravenous analgesia group (PCIA group) and continuous transversus abdominis plane block group (CTAP group) according to the random number table method, with 30 cases in each group. In PCEA group, the patients received PCEA with 0.375% Ropivacaine 2 mL after surgery, and the PCEA pump was set up to deliver a 2 mL bolus dose, a 15 min lockout interval and background infusion at a rate of 2 mL/h. In PCIA group, the patients received PCIA with Sufentanil 1 μg/mL + Tropisetron 50 μg/mL mixture 2 mL after surgery, and the PCIA pump was set up to deliver a 2 mL bolus dose, a 15 min lockout interval and background infusion at a rate of 2 mL/h. In CTAP group, bilateral TAP block was performed with 0.375% Ropivacaine 20 mL under ultrasound guidance and 0.375% Ropivacaine 6-8 mL/h was infused into bilateral TAPs by pump after surgery, the pump was set up to deliver a 6-8 mL bolus dose, a 60 min lockout interval. Analgesia lasted until 72 h after operation in all groups. When resting visual analog scale (VAS) scores≥4, Tramadol 100 mg was injected intravenously as rescue analgesia. The resting and moving VAS and Bruggrmann comfort scale (BCS) scores were recorded at immediately after the end of operation and at 2, 6, 12, 24, 36, 48, 72 hours after operation, the rate of rescue analgesia, dosage of Tramadol, the recovery time of postoperative intestinal function and lower limb motor function, and the incidence of adverse reactions were also recorded within 72 h after operation. Results Compared with PCIA group, the resting and moving VAS scores were lower and the BCS scores were higher at 6, 12, 24, 36, 48 hours after operation in PCEA group and CTAP group, the differences were statistically significant (P ＜ 0.05), and the rate of rescue analgesia, dosage of Tramadol, recovery time of postoperative intestinal function and the incidence of adverse reactions were lower in PCEA group and CTAP group, the differences were statistically significant (P ＜ 0.05). There were no significant differences in moving VAS scores, BCS scores, rate of rescue analgesia, dosage of Tramadol, recovery time of postoperative intestinal function and the incidence of adverse reactions between the PCEA group and the CTAP group (P ＞ 0.05), but the recovery time of lower limb motor function in CTAP group was less than that in PCEA group (P ＜ 0.05). Conclusion Compared with PCIA and PCEA, CTAP can provide a better obstetric analgesia and less incidence of adverse reactions when used for the patients undergoing cesarean section, and the complication of CTAP is least.
		2019 Vol. 16 (7): 100-104 [Abstract] ( 298 ) HTML (1 KB) PDF (450 KB) ( 65 )

	105	Effects of Dexmedetomidine combined with Pentazocine on postoperative inflammatory response and hypercoagulability in elderly patients underwent total hip replacement
		LI Guangwei DONG Fusheng
		Objective To study the effect of Dexmedetomidine combined with Pentazocine on postoperative inflammatory response and hypercoagulability in elderly patients underwent total hip replacement. Methods From May 2016 to May 2017, 300 elderly patients who underwent total hip replacement in the Second Hospital of Qinhuangdao were selected as the study subjects. The patients were divided into study group and control group by random number table method, with 150 cases in each group. The control group was treated with Pentazocine for analgesic treatment, and the study group was treated with Dexmedetomidine combined with Pentazocine for analgesic treatment. The postoperative inflammatory response, hypercoagulability, postoperative pain at different time and adverse reactions were compared between the two groups. Results There were no significant differences in serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) between the two groups at immediate preoperative and immediate postoperative (P ＞ 0.05), the levels of IL-6 and TNF-α in the two groups at immediate postoperative and postoperative 24 hours were significantly higher than those at immediate preoperative, but the levels of IL-6 and TNF-α in the study group were lower than those in the control group at postoperative 24 hours, the differences were statistically significant (P ＜ 0.05). There were no significant differences in the levels of D-dimer and fibrinogen (Fib) between the two groups at immediate preoperative and immediate postoperative (P ＞ 0.05), the levels of D-dimer and Fib in the two groups at immediate postoperative and postoperative 24 hours were significantly higher than those at immediate preoperative, but the levels of D-dimer and Fib in the study group were lower than those in the control group at postoperative 24 hours, the differences were statistically significant (P ＜ 0.05). Visual analogue scale (VAS) scores in the study group were significantly lower than those in the control group at postoperative 6, 12, 24 hours (P ＜ 0.05). The incidence of gastrointestinal reactions and vertigo in the study group were significantly lower than those in the control group (P ＜ 0.05), and there was no significant difference in the incidence of hypertension between the two groups (P ＞ 0.05). Conclusion Dexmedetomidine combined with Pentazocine can effectively improve the inflammatory response and hypercoagulability in elderly patients underwent total hip replacement, and effectively alleviate the pain, and also has a good safety.
		2019 Vol. 16 (7): 105-108 [Abstract] ( 224 ) HTML (1 KB) PDF (436 KB) ( 170 )

	109	Modern clinical study of functional dyspepsia in traditional Chinese medicine
		NIU Ran WEI Wei▲ SUN Xiaohong SU Xiaolan ZHANG Yiqing LIU Yaxin
		Functional dyspepsia is a common disease of the digestive system. It is also a dominant disease in Chinese medicine. The main symptoms are postprandial fullness, early satiation, middle upper abdominal pain and burning pain in the middle and upper abdomen. The pathogenesis of functional dyspepsia is not yet clear. The main Western medicine treatment is improving gastrointestinal motility, anti-Helicobacter pylori infection, regulating gastric acid, protecting gastric mucosa, anti-anxiety and depression, and so on. Based on related reports in recent years, the methods and means of modern Chinese medicine in the treatment of functional dyspepsia are diverse, the effects are definite, the adverse reactions are less, the quality of life of patients is improved, which is widely used in clinical practice. With the deepening of modern Chinese medicine research, basic research finds that Chinese medicine can effectively improve the gastrointestinal motility of functional dyspepsia patients, reduce gastrointestinal sensitivity and so on. In the near future, Chinese medicine will play a greater role in the treatment of worldwide functional gastrointestinal diseases.
		2019 Vol. 16 (7): 109-112 [Abstract] ( 231 ) HTML (1 KB) PDF (545 KB) ( 127 )

	113	Analysis on the characteristics of tongue color and moss color of hyperuricemia
		LIU Hongyu1 ZHANG Changlian2 LU Xiaozuo3 SUN Xiaosheng1
		Objective To diagnose hyperuricemia more accurately and improve the clinical effect, the tongue manifestation of patients with hyperuricemia was analyzed preliminarily. Methods The tongue manifestation of 50 patients with hyperuricemia in Tianjin Wuqing Quanda Hospital by tongue manifestation analyzer from January to July 2017 was randomly collected as hyperuricemia group. At the same time, the tongue manifestation of 50 healthy persons was collected as healthy group. The RGB values of tongue color and RGB values of moss color of hyperuricemia were analyzed, and the characteristics of tongue color and moss color of hyperuricemia were analyzed preliminarily. Results There were all statistically significant differences of the tongue tip color R1, the tongue tip color G1, the tongue tip color B1, the left tongue color R2, the right tongue color R3 and the right tongue color B3 between the two groups (all P ＜ 0.05). There were all statistically significant differences of the moss color of tongue root R4, the moss color of tongue tip R6, the moss color of tongue tip G6, the moss color of central tongue B5 and the moss color of tongue tip B6 between the two groups (all P ＜ 0.05). Lilac or purple-red tongue, yellow or white moss seems to be the characteristics of tongue manifestation of hyperuricemia. Conclusion The tongue color and moss color of hyperuricemia have different characteristics compared with those of normal tongue color and moss color, which provides essential data for TCM prevention and treatment and efficacy evaluation of hyperuricemia.
		2019 Vol. 16 (7): 113-115,119 [Abstract] ( 198 ) HTML (1 KB) PDF (556 KB) ( 82 )

	116	Study on prevention and treatment of atherosclerosis by compound Chinese medicine for reinforcing kidney based on PCSK9 targeting CD36, mediating RCT
		JIA Qingling SHEN Dingzhu
		Atherosclerosis (AS) is the common pathological basis of cardiovascular and cerebrovascular events. Reverse cholesterol transport (RCT) plays an important role in the progress of AS. Proprotein convertase subtilisin/kexin type 9 (PCSK9) and cluster of differentiation 36 (CD36) are closely related to RCT. Combined with the preliminary research that compound Chinese medicine for reinforcing kidney can intervene AS, this paper intends to explore the research strategy that compound Chinese medicine for reinforcing kidney can prevent and cure AS by PCSK9 targeting CD36 and mediating RCT.
		2019 Vol. 16 (7): 116-119 [Abstract] ( 191 ) HTML (1 KB) PDF (549 KB) ( 98 )

	120	The experience summary of Professor Li Guoqin in the treatment of bronchiectasis
		RONG Yi QU Chang LI Guoqin LIU Zhiguo
		Professor Li Guoqin proposes that bronchiectasis can be divided into acute exacerbation stage and clinical remission stage. Acute exacerbation stage can be divided into syndrome of phlegm-heat obstructing lung, syndrome of liver fire invading lung, syndrome of lung collaterals injured by heat, and so on; clinical remission period can be divided into syndrome of deficiency of both qi and yin of lung, deficiency of both lung and spleen, and so on. Aimed at the treatment of acute stage, he mainly uses the methods of clearing heat and dissipating phlegm, clearing liver and cooling blood, clearing heat and nourishing yin. Aimed at remission stage, he mainly uses the methods of benefiting qi and nourishing yin, moistening lung for arresting cough, invigorating the spleen and eliminating phlegm, promoting blood circulation for removing blood stasis. Professor Li Guoqin uses treatment based on different stages, he is good at clearing method, gives consideration to blood syndrome, takes care of the spleen and stomach, supplemented by strengthening vital qi, and he has achieved a good effect in clinic.
		2019 Vol. 16 (7): 120-123 [Abstract] ( 206 ) HTML (1 KB) PDF (575 KB) ( 377 )

	124	The value of AEEG combined with MRI in the early diagnosis of viral encephalitis in children
		WANG Wei LI Jia WANG Lili LI Xiaoya ZHENG Wei DONG Yan ZHANG Shumin GAO Jingyun
		Objective To explore the value of ambulatory electroencephalography (AEEG) combined with magnetic resonance imaging (MRI) in the early diagnosis and prognosis of viral encephalitis in children. Methods Retrospective analysis was conducted on the clinical data, AEEG and MRI imaging data of 54 cases of viral encephalitis admitted to Tangshan Maternal and Child Health Hospital in Hebei Province from May 2015 to May 2017. The diagnostic accuracy of AEEG combined MRI and single MRI were observed, and the respective diagnostic results of AEEG and MRI were analyzed. Results In 54 childrens with viral encephalitis, the diagnostic accuracy of AEEG combined with MRI was 96.30%, which was significantly higher than 81.48% of the MRI single diagnostic accuracy rate, and the difference was statistically significant (P ＜ 0.05); AEEG examination showed that 12 cases were severe abnormality in 54 cases of childrens, 17 cases were moderate abnormality, 20 cases were mild abnormality, and the abnormal rate was 90.74%; in the 54 cases, 8 cases had no abnormal signal in MRI brain parenchyma, 2 cases were misdiagnosed, and 44 cases showed lesions by MRI examination, the abnormal rate was 81.48%. Conclusion AEEG combined with MRI has great value in early diagnosis of viral encephalitis in childrens. It can provide reliable diagnostic basis for doctors, early detection and treatment, so it has certain reference significance for clinical diagnosis.
		2019 Vol. 16 (7): 124-127 [Abstract] ( 243 ) HTML (1 KB) PDF (695 KB) ( 81 )

	128	Application of ultrasound graff method in the screening of developmental hip joint abnormality in infants aged 0-6 months
		HE Yan1 LIU Haixia2 RAO Jing1 FENG Guojuan1 LIU Hong1 YANG Hongmei1 ZHAO Xiaodong1▲
		Objective To analyze the value of graff method in the screening of developmental hip dysplasia (DDH) in infants aged 0-6 months. Methods From February 2017 to February 2018, 1052 infants aged 0-6 months who were diagnosed and treated in Jiangyou People′s Hospital of Sichuan Province were selected. All of them were examined by hip joint ultrasound examination using graff method. Measurement of α,β angles and statistical analysis were carried out. Results All of the 2104 hip joints in 1052 infants, 2084 were normal, 20 were abnormal and 8 were developmental. The ultrasonic testing α angle was negatively associated with β angle (r = -0.57, P ＜ 0.05), and the α angle was positively associated with months (r = 0.18, P ＜ 0.05), and the β angle was negatively correlated with age of month (r = -0.23, P ＜ 0.05). The α angle and β angle determination results difference between infants with normal and abnormal hipjoints were statistically significant (P ＜ 0.05). Conclusion Ultrasound examination of hip joint by graff method can screen developmental hip joint abnormality in infants 0-6 months old as early as possible, and provide a basis for the incidence of DDH in this region and provid important information for the early treatment of DDH children.
		2019 Vol. 16 (7): 128-130,135 [Abstract] ( 225 ) HTML (1 KB) PDF (493 KB) ( 135 )

	131	Comparison of ultrasound-guided radiofrequency ablation and microwave ablation for the treatment of papillary thyroid microcarcinoma
		SHEN Ji XU Huajun XIONG Weilü
		Objective To investigate the efficacy of ultrasound guided radiofrequency ablation (RFA) in the treatment of papillary thyroid microcarcinoma (PTMC) and to analyze the effect of RFA on the stress response of the patients. Methods From March 2016 to March 2017, 97 patients with PTMC were selected in Huzhou Central Hospital of Zhejiang Province. According to different treatment methods, all subjects were divided into RFA group (observation group, n = 45) and microwave ablation group (control group, n = 52). Ultrasonic follow up was performed at 1, 3, 6 and 12 months after operation respectively, the lesion foci volume of patients was observed, and the incidence of postoperative complications, the levels of serum inflammatory factors [interleukin -6 (IL-6), tumor necrosis factor -α (TNF-α) and C reactive protein (CRP)] were compared between the two groups. Results The total incidence complications after operation in the two groups was not statistically significant (P ＞ 0.05), and no serious complications occurred. No local recurrence or cervical lymph node metastases was found during the follow-up period, ultrasound showed that the volume of ablation in the two groups were increased at 1 month after operation, afterwards, the volume of the ablation range were gradually reduced. The volume decreased significantly at 6 and 12 months after operation, compared with before operation, the difference were statistically significant (P ＜ 0.05). There was no significant difference in the volume reduction rate and volume of ablation foci between the two groups at each follow-up time point (P ＞ 0.05). Serum IL-6, TNF-α and CRP levels of the two groups were higher 24 h after surgery than before (P ＜ 0.05). The levels of serum IL-6, TNF-α and CRP levels recovered basically 72 h after surgery, with no statistically significant difference compared with that before surgery (P ＞ 0.05). There was no significant difference in the levels of serum IL-6, TNF-α and CRP levels between the two groups 24 h and 72 h after surgery (P ＞ 0.05). Conclusion Ultrasound guided RFA is an effective and safe method for the treatment of PTMC.
		2019 Vol. 16 (7): 131-135 [Abstract] ( 204 ) HTML (1 KB) PDF (546 KB) ( 108 )

	136	Systematic review of efficacy and safety of Trimetazidine combined with Metoprolol in treatment of coronary heart disease complicated with heart failure
		CAI Xuyang1,2 JIN Zhaohui1 WU Bin1 LUO Min1 XU Ting1,2
		Objective To systematically evaluate the efficacy and safety of Trimetazidine combined with Metoprolol in treatment of patients with coronary heart disease complicated with heart failure. Methods Databases including Ovid Medline, EMBase, Cochrane Library, CNKI, CBM, VIP and WanFang Data were retrieved from database foundation to June 2018 by computer. Meta analysis was performed on the included studies by RevMan 5.3 software. Results A total of 26 RCTs involving 2691 cases were included, with 1346 cases in experimental group and 1345 cases in control group. The results of meta-analysis showed: ΔLVEF [MD = -5.15, 95%CI: -5.80--4.50, P ＜ 0.01], Δ6MWT [MD = -43.68, 95%CI: -55.70--31.66, P ＜ 0.01], total effective rate [RR = 1.18, 95%CI: 1.14-1.23, P ＜ 0.01], ΔLVESD [MD = 5.09, 95%CI: 4.39-5.79, P ＜ 0.01 and ΔLVEDD] and ΔLVEDD [MD = 4.76, 95%CI: 4.05-5.48, P ＜ 0.01] of experimental group were statistically better than that of control group. Total effective rate in experimental group was higher than control group, the difference was highly statistically significant (P < 0.01). There was no statistically significant difference in the incidence of adverse drug reactions (ADR) between two groups (P > 0.05). Conclusion Trimetazidine combined with Metoprolol can improve the cardiac function of patients with coronary heart disease complicated with heart failure without increasing the incidence of ADR.
		2019 Vol. 16 (7): 136-139 [Abstract] ( 216 ) HTML (1 KB) PDF (491 KB) ( 106 )

	140	The effect of venous thrombolysis treatment of acute ischemic stroke with Ginkgo Injection combined with Alteplase
		YU Libo1 WANG Shuai1 JIANG Ying2 GU Jiumei2
		Objective To explore effect of venous thrombolysis treatment of acute ischemic stroke with Ginkgo Injection combined with Alteplase. Methods A total of 106 cases′ clinical data of acute ischemic stroke in the Second Division of Neurology Department, Chinese People′s Liberation Army 211 Hospital from May 2015 to July 2017 were selected and analyzed. All the cases were divided by different treatment method, with 53 cases in the control group (Alteplase therapy) and 53 cases in the observation group (Ginkgo Injection combined with Alteplase therapy). The two groups were treated for 14 days. The National Institute of Health Stroke Scale (NIHSS) scores, improve mRS score, fibrinogen (FIB), prothrombin time (PT), thrombin time (TT), life quality scores, activity of daily living Barthel index of the two groups were observed and the clinical efficacy, complications of the two groups were observed. Results Before treatment, the NIHSS scores, improve mRS scores, FIB, PT, TT, life quality scores and Barthel index of two groups were compared and there was no statistically significant differences (P ＞ 0.05). After treatment, the NIHSS scores, improve mRS scores in the two groups were lower than those in the two groups, life quality scores and Barthel index in the two groups were higher than those before treatment, the differences were significant (P ＜ 0.05). After treatment, the NIHSS scores, improve mRS scores in the observation group were lower than those in the control group while the life quality scores and Barthel index were higher than those in the control group, the differences were significant (P ＜ 0.05). After treatment, FIB was lower than that before treatment and PT, TT were higher than those before treatment in the control group (P ＜ 0.05). But there was no significant difference between FIB, PT, TT before and after treatment in the treatment group (P ＞ 0.05). After treatment, FIB in the observation group was higher than that in the control group and PT, TT were lower than those in the control group, all the differences were statistically significant (P ＜ 0.05). The total clinical treatment efficiency of the observation group was higher than that in the control group, and total complications rate were lower than the control group, the differences were statistically significant (P ＜ 0.05). Conclusion The venous thrombolysis treatment of acute ischemic stroke with Ginkgo Injection combined with Alteplase could improve nerve function and life quality, by which the influence of blood coagulation dysfunction is little, the effect is remarkble, complications is few, and it is worth of promotion.
		2019 Vol. 16 (7): 140-143,148 [Abstract] ( 270 ) HTML (1 KB) PDF (797 KB) ( 64 )

	144	The clinical value of microfluidic loop-mediated isothermal amplification detection in the diagnosis of Klebsiella pneumoniae infection in sepsis patients
		SU Hua1 CHEN Chen2 JIANG Li′na3 JIAQian1 XU Yuhuan1 LI Xiaofeng1 LIU Yunning1 LI Jie1
		Objective To explore the clinical value of microfluidic loop-mediated isothermal amplification detection in the diagnosis of Klebsiella pneumoniae infection in sepsis patients. Methods From June 2015 to May 2018, 152 sepsis patients who were from the department of ICU of the First Affiliated Hospital of Hebei North University were collected, 99 cases of sputum specimens samples were collected by natural cough method, 53 cases were collected by bronchoscopy. All these samples were simultaneously detected by traditional pathogen culture method and microfluidic loop-mediated isothermal amplification method. According to the traditional bacterial culture result, all cases were divided into two group, 42 cases were Klebsiella pneumoniae infection group and 110 cases were non Klebsiella pneumoniae infection group. Results The positive rate of Klebsiella pneumoniae detected by bacterial culture was 27.6%（42/152）, and by microfluidic loop-mediated isothermal amplification detection was 38.8%（59/152）, which was higher than the former, the difference was statistically significant(P ＜ 0.01). The method of microfluidics loop-mediated isothermal amplification detected 37 positive cases from Klebsiella pneumoniae infection group, including 21 cases natural cough sample and 16 cases bronchoscopy sample, Non Klebsiella pneumoniae infection group was detected by the method of microfluidics loop-mediated isothermal amplification had 22 cases positive samples，including 15 cases natural cough samples and 7 cases bronchoscopy samples. The area under the ROC curve of the bronchoscopy suction method and natural cough collection method was 0.836 and 0.847. The Jordan index of former (0.694) was high er than the latter (0.672). The Kappa value was 0.604 ＞ 0.600, P ＜ 0.05, indicating a high consistency between the two methods. Conclusion Microfluidic loop-mediated isothermal amplification has the advantages of rapid and sensitive detection of Klebsiella pneumoniae in sepsis patients, which is highly consistent with the traditional bacterial culture method and can provide better clinical diagnosis and treatment basis.
		2019 Vol. 16 (7): 144-148 [Abstract] ( 186 ) HTML (1 KB) PDF (658 KB) ( 138 )

	149	Verification and establishment of detection limit and reference interval for detection of HBsAg by time - resolved fluoroimmunoassay
		HUANG Lijun CHAN Fan MO Zhan DIAO Qizhi
		Objectives To verify the detection limit (LOD) of hepatitis B surface antigen (HBsAg) by time-resolved fluorimmunoassay, and to evaluate the suitability of the reference interval. Methods From October 2017 to January 2018, the HBsAg secondary standard substance was diluted and then paired with time-resolved fluorescence method and enzyme-linked immunosorbent assay (ELISA) for detection, the detection limit was the last dilution degree with negative test results after standard substance concentration divided by dilution, to verify the manufacturer′s statement, the results of samples with the same dilution degree detected by the two methods was compared, and the suitability of the reference interval declared by the manufacturer was evaluated. According to the American clinical laboratory standards board (CLSI) EP17-A2 method, create blank limits (LOB) and LOD, and the suitability of the established LOD as the upper limit of the reference interval was evaluated. Results The detection limit of time-resolved fluorimmunoassay method was 0.1 U/mL, which was consistent with the manufacturer′s statement. If the reference interval declared by the manufacturer of the time-resolved fluorimmunoassay detection system was used, the standard substance was diluted 3 times and the result was found to be false negative, which was inconsistent with the ELISA test result, the LOB and LOD of HBsAg established in Department Clinical Laboratory, Yongchuan Hospital of Chongqing Medical University (hereinafter heferred to as "our hospital"), were 0.048 ng/mL and 0.137 ng/mL, respectively. If the reference interval was established with the LOD established chinical laboratory of our hospieal, the results of the two methods were consistent after 3 times of dilution, and both were positive. Conclusion The detection limit declared by the time-resolved fluorimmunoassay analysis system is acceptable, but the reference interval declared by the manufacturer is not appropriate, which is likely to lead to false negative. The clinical laboratory should establish its own LOD to establish the reference interval. It is suggested to increase the validation of the reference interval in the performance verification of the quantitative detection items of virus markers.
		2019 Vol. 16 (7): 149-152 [Abstract] ( 261 ) HTML (1 KB) PDF (518 KB) ( 152 )

	153	Application value of liver fibrosis indexes combined with AFP and GGT in the diagnosis of liver diseases
		LI Zhangyong1 LIN Yingbiao1▲ XIA Chuan1 LI Gangyong2
		Objectives To discussion of liver fibrosis index [Ⅲ type collagen (PCⅢ), collagen type Ⅳ before (Ⅳ-C), laminin (LN), hyaluronic acid (HA), gansu cholic acid (CG)], alpha fetal protein (AFP) and γ- glutamyl transpeptidase (GGT) in the diagnosis of liver disease. Methods From July 2017 to June 2018, in Chenzhou NO.1 People′s Hospital of Hunan Province ("our hospital" for short), 90 cases of chronic HBV (carry HBV group), 66 patients with cirrhosis of the liver (cirrhosis group) and 52 patients with hepatitis B related liver cancer (HBV-related liver cancer group), 60 cases (healthy control group) health physical examination were selected from the same period. The liver fibrosis indexes PCⅢ, Ⅳ-C, LN and HA, CG and AFP and GGT of each groups were detected by automatic chemiluminescence analyzer and biochemical analyzer respectively. Results PCⅢ, Ⅳ-C, HA, CG and AFP in the three groups were all higher than those in the healthy control group, and the difference were highly statistically significant (P ＜ 0.01). LN and GGT of liver cirrhosis group and HBV-related liver cancer group were higher than that of healthy control group, and the difference were statistically significant (P ＜ 0.05). There was no significant difference in LN and GGT between the chronic HBV carrier group and the healthy control group (P ＞ 0.05). HA, CG and AFP were compared among the groups, and the difference were statistically significant (P ＜ 0.05). Conclusion Liver fibrosis indicators PCⅢ, Ⅳ-C, LN, HA, CG, GGT and AFP have great application value in the diagnosis of liver disease, and have important value in guiding clinical treatment.
		2019 Vol. 16 (7): 153-156 [Abstract] ( 248 ) HTML (1 KB) PDF (482 KB) ( 104 )

	157	Study on the current situation and service management reform in public hospitals in China
		CHEN Nan XIA Guoguang▲ DAI Li
		Objective To analyze the current situation in public hospitals in China and explore the intervention measures by taking Department of Respiratory and Critical Medical, Beijing Jishuitan Hospital as an example. Methods Study data were collected from the medical statistical annual report of the Department of Respiratory and Critical Care Medicine of Beijing Jishuitan Hospital from January 2016 to December 2017, and 500 patients were randomly selected with management intervention as the time point respectively. The present situation of the staff, work efficiency, doctor-patient relationship and patient satisfaction were statistically analyzed. Results There were 69 staff in the Department of Respiratory and Critical Care Medicine, with spindle-shape age distribution, 15 with a master degree or above, accounting for 21.74%. The professional title composition of clinical professional and technical personnel was mainly in the primary and middle level, accounting for 84.06%. After management intervention, the comprehensive quality score of clinical professional and technical personnel was statistically higher than that before management intervention, the difference was highly significant (P ＜ 0.01). After management intervention, the sickbed utilization rate, the turnover number of common beds, the turnover number of monitoring beds and the efficiency index of beds were significantly higher than those before management intervention (P ＜ 0.05). After management intervention, The excellent and good rate of doctor-patient relationship was higher than that before management intervention and the incidence of medical disputes was lower than that before management intervention, the difference was highly significant (P ＜ 0.01). After management intervention, patient satisfaction was higher than that before management intervention, and the difference was highly statistically significant (P ＜ 0.01). Conclusion Strengthening the operation and management of hospital respiratory and critical care medical services is helpful to improve the comprehensive quality and work efficiency of personnel, to reduce medical disputes and improve the satisfaction of patients, which is worth of promotion.
		2019 Vol. 16 (7): 157-160 [Abstract] ( 188 ) HTML (1 KB) PDF (367 KB) ( 81 )

	161	Systematic review of the effects of cognitive behavioral therapy on quality of life and depression of informal caregivers of patients with cancer
		ZHANG Ping ZHANG Xiaoman CHEN Lijun YIN Yongtian WU Qiong WANG Bo
		Objective To systematically evaluate the effects of cognitive behavioral therapy on the quality of life and depression of informal caregivers of patients with cancer. Methods Computer was used to search the Chinese and English databases of PubMed, the Cochrane Library, CINAHL, EMBASE, CBM, CNKI, Wanfang, VIP, etc. systematically, to collect literature on cognitive behavioral therapy for the quality of life and depression of informal caregivers of patients with cancer. The searching time was from the establishment of the database to July 2018. Two researchers conducted screening, data extraction, and quality evaluation based on inclusion and exclusion criteria, and used Review Manager 5.3 for meta-analysis. Results A total of 8 randomized controlled trials were included. There were 946 informal caregivers of patients with cancer, 44 patients quitted due to halfway or other reasons, and 902 patients completed interventions, including 452 patients in the intervention group and 450 patients in the control group. The intervention group received cognitive behavioral therapy intervention. There was significant difference in quality of life between intervention group and control group [MD = 20.15, 95%CI: 5.15-35.15, P = 0.008]. Cognitive behavioral therapy could improve depression of informal caregivers of patients with cancer. Conclusion Cognitive behavioral therapy can improve the depression and quality of life of informal caregivers of patients with cancer.
		2019 Vol. 16 (7): 161-165,封三 [Abstract] ( 226 ) HTML (1 KB) PDF (940 KB) ( 176 )

	166	Application value of structured education in patients undergoing total knee arthroplasty
		LIU Li1 SUN Jing2 YUAN Fujing1 SHAO Qian1 XIANG Fusheng1
		Objective To evaluate application value of structured education on patients with total knee arthroplasty. Methods According to the single and double numbers of the hospitalization number，210 patients with total knee arthroplasty in Department of orthopedics of Ezhou Central Hospital from January 2014 to November 2017 were randomly divided into intervention group and control group, with 105 cases in each group. The control group adopted routine nursing measures, and the intervention group adopted structured education. Knee function improvement after operation 1 weeks, 2 weeks and March were assessed by range of motion (ROM). Visual rating scale (VAS) was used to assess pain. Self efficacy scale was used to evaluate postoperative recovery of self-confidence and nursing satisfaction. Results Compared with 1 week after operation, the ROM and self-efficacy scores of the two groups increased significantly with the prolongation of rehahilitation time, while VAS scones deereased significantly, and the differences were statistically significant (P < 0.01). In the intervention group, the scores of ROM, VAS and self-efficacy were significantly better than those in the control group after operation 1 weeks, 2 weeks and March (P < 0.01), and the satisfaction degree of nursing work was higher than that in the control group 2 weeks after operation (P < 0.01). Conclusion structured education can improve knee function, relieve pain and improve self-efficacy of TKA patients. It can improve the quality of life and nursing satisfaction to the greatest extent, and is worthy of promotion.
		2019 Vol. 16 (7): 166-169 [Abstract] ( 229 ) HTML (1 KB) PDF (599 KB) ( 131 )

	170	Care dependency and its influencing factors of patients with chronic heart failure at home
		WU Xiaoying FEI Fangqin
		Objective To investigate the status of care dependency of patients with chronic heart failure（CHF），and to explore the effects of different demographic and clinical features on care dependency. Methods From January to June 2017, a total of 163 patients with chronic heart failure at home were selected from 4 hospitals in Huzhou with the convenience sampling method. A cross-sectional survey was conducted with general questionnaire and care dependency scale. Statistical descriptions and multiple linear regression analysis were used to analyze the data. Results The score of care dependency scale of patients with chronic heart failure patients at home in Huzhou was （48.58±18.26）points. Influencing factors of care dependency of CHF patients at home were analyzed. The factors such as heart function classification, education level, course of disease, age and so on entered the regression equation, which could explain 58.7% of the total variance. Conclusion The level of care dependency of CHF patients at home in Huzhou is at a moderate level. The influencing factors are heart function classification, education level, course of disease and age. CHF patients at home have nursing needs that families and communities can′t meet. The human resources input of community and family nurses should be increased.
		2019 Vol. 16 (7): 170-172 [Abstract] ( 572 ) HTML (1 KB) PDF (540 KB) ( 90 )

	173	Influence of plastic leak mount on colostomy children
		LUO Shengnan TANG Chunyan GONG Shumei TANG Qiaoli▲
		Objective To approach the influence of plastic leak mount on colostomy children. Methods From November 2016 to October 2017, in Xinhua Hospital Affiliated to Shanghai Jiaotong University, 80 colostomy children were selected. They were divided into two groups by different treatment method, control group (regular ARC replacement process) 40 cases and detection group (regular ARC replacement process+plastic leak mount) 40 cases. The colostomy pocket replacement time, colostomy pocket replacement interval time of two group were detected, the DQ score, around colostomy skin score of two group before and after nursing were detected, the around colostomy dermatitis occurrence of two groups were detected. Results The colostomy pocket replacement time of detection group was shorter than control group, and the colostomy pocket replacement interval time was longer than control group, the differences were statistically significant (P < 0.05). The DQ scores, around colostomy skin scores before nursing of two group were compared, the differences were not statistically significant (P > 0.05), after nursing, the DQ scores of control group and detection group were higher than before nursing, the around colostomy skin scores was lower than before nursing, the DQ scores of detection group after nursing was higher than control group, the around colostomy skin score was lower than control group, the differences were statistically significant (P < 0.05). The around colostomy dermatitis occurrence of detection group was better than control group, the difference was statistically significant (P < 0.05). Conclusion The application of plastic leak mount on colostomy children, it can increase application efficiency of colostomy pocket and DQ，improve around colostomy skin score, decrease around colostomy dermatitis rate, and it is worth to be used.
		2019 Vol. 16 (7): 173-176 [Abstract] ( 260 ) HTML (1 KB) PDF (602 KB) ( 60 )

	177	Application detection of cerebral infarction patients by behavior changing theories
		XU Hong WANG Yingli XIN Yuying
		Objective To approach result of cerebral infarction patients by behavior changing theories. Methods From May 2015 to May 2018, in Dalian Municipal Central Hospital, 200 patients with cerebral infarction were selected as study subject, they were divided into control group (100 cases) and behavior changing theories group (100 cases) by using behavior changing theories or not. The NIHSS score, FAD score, Barthel index, Fugl-Meyer score of cerebral infarction patients in two groups before nursing and after nursing were detected, the clinical efficacy of cerebral infarction patients in two groups were detected. Results Before nursing, the NIHSS score, FAD score, Barthel index, Fugl-Meyer score of cerebral infarction patients in two group were compared, the differences were not statistically significant (P > 0.05); after nursing, the NIHSS scores, FAD scores in two groups after nursing were lower than before nursing, the Barthel index, Fugl-Meyer scores in two groups were higher than before nursing, and the NIHSS scores, FAD score in behavior changing theories group were lower than control group, the Barthel index, Fugl-Meyer scores were higher than control group, the differences were statistically significant (P < 0.05). The clinical treatment total efficiency in behavior changing theories group was higher than control group, the difference was statistically significant (P < 0.05). Conclusion The application of cerebral infarction patients by behavior changing theories can improve NIHSS score, FAD score, increase Barthel index, Fugl-Meyer score, and it is worth to be used.
		2019 Vol. 16 (7): 177-封三 [Abstract] ( 193 ) HTML (1 KB) PDF (710 KB) ( 104 )

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