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2019 Vol. 16, No. 16 Published: 2019-06-05

	4	Regulation of SIRT1 in acquired resistance of TKIs in non-small cell lung cancer
		LI Guifang1 YUAN Xiang2 LIU Yiwen2 MA Mingyang1 SUN Jiangtao3
		Objective To analyze the regulation of histone deacetylase SIRT1 in stem cell-like properties of non-small cell lung cancer. Methods The percentage of tumor stem cells was detected by flow cytometry in PC-9 and PC-9-GR cell lines; IC50 was detected by CCK8; SIRT1 mRNA expression was detected by qPCR; SIRT1 protein expression was detected by Western blot; the experiments of cell suspension cloning into spheres was used to detect the capability of sphere-forming of different groups. Results The drug-resistant cell line PC-9-GR was successfully established. The IC50, ALDHbright tumor stem cell percentage, SIRT1 protein expression and SIRT1 mRNA expression of PC-9-GR were higher than those of PC-9 (P < 0.05). The experiments of cell suspension cloning into spheres found that PC-9-GR was significantly higher than PC-9 (P < 0.05), and the effect of PC-9-GR on the capability of sphere-forming was not statistically significant after the application of Gefitinib (P > 0.05). After the combination of SIRT1 specific inhibitor TV6 and double drug combination, the capability of sphere-forming of the two cell lines was significantly lower than that of the control group (P < 0.05). Conclusions Acquired resistance to tyrosine kinase inhibitors in non-small cell lung cancer is closely related to the enrichment of ALDH1+ labeled cancer stem cells by tyrosine kinase inhibitors. Histone deacetylase SIRT1 plays an important role in maintaining the stem of these cancer stem cells. Its inhibition of SIRT1 targeting tumor stem cells may help delay the acquired resistance of tyrosine kinase inhibitors.
		2019 Vol. 16 (16): 4-7,12 [Abstract] ( 204 ) HTML (1 KB) PDF (946 KB) ( 208 )

	8	Effect of Naoxueshu Oral Liquid on the expression of ZO-1 and AQP4 proteins in rat model of intracerebral hemorrhage
		WANG Xiaofeng1 TIAN Chao1 ZHANG Yan2 YUAN Mengchen1 ZHANG Hanlai1 WANG Liqin1 AN Na1 GAO Yonghong1
		Objective To observe the effect of Naoxueshu Oral Liquid on the expression of zonula occludens 1 (ZO-1), aquaporin-4 (AQP4) in brain of model rats with intracerebral hemorrhage. Methods A model of intracerebral hemorrhage was produced by injection of collagenase Ⅶ into the caudatum of rats. Healthy male SD rats of SPF grade (8 weeks) were divided into three groups by random number table: the sham group, the model group and the Naoxueshu group, with 8 rats in each group. Naoxueshu Oral Liquid was administrated intragastrically by 0.27 mL/(100 g·d), while saline was administrated to the sham group and model group by the same way. The histopathological change of brain tissue was tested by HE staining and transmission electron microscopy on the 7 d after intracerebral hemorrhage. The expression of ZO-1 and AQP4 in perihematoma tissue was detected by Western blot. Results Compared with the sham group, HE staining showed that large necrosis in perihematomal and the cells were irregular, loose, swollen, and the nuclear structure was unclear and undistinguishable in the 7-day model group. Transmission electron microscopy revealed that the gap between cerebral blood vessels and surrounding tissues was widened, and vacuolar changes were observed, and the astrocyte podocyte edema was obvious. The expression of ZO-1 protein in the brain tissue of the 7-day model group was decreased and AQP4 protein was increased (P ＜ 0.05). Compared with the model group, the pathological structure of the cerebral blood group was significantly improved, and the expression of ZO-1 protein was significantly increased, while the expression of AQP4 protein was significantly decreased (P ＜ 0.05). Conclusion Naoxueshu Oral Liquid can effectively increase the expression of ZO-1 protein and inhibit the expression of AQP4 protein, thereby reduce the permeability of blood-brain barrier and relieve encephaledema, and play a protective role in brain of model rats with intracerebral hemorrhage.
		2019 Vol. 16 (16): 8-12 [Abstract] ( 197 ) HTML (1 KB) PDF (792 KB) ( 103 )

	13	Effects of Buyang Huanwu Decoction on the average opening time of L-type Ca2+ channel in rats with global cerebral ischemia-reperfusion

		Objective To investigate the effect of Buyang Huanwu Decoction on the average opening time of L-type Ca2+ channel in rats with global cerebral ischemia-reperfusion. Methods Sixty-two rats with global cerebral ischemia-reperfusion were prepared by four-vessel occlusion method. They were divided into control group and research group by random number table method, with 31 rats in each group. The control group was fed with normal saline, while the research group was fed with Buyang Huanwu Decoction. After 2, 12, 24, 48 and 72 h of treatment, the rats were observed. The average opening time of L-type Ca2+ channel, brain water content, serum superoxide dismutase (SOD) and malondialdehyde (MDA) levels were compared between the two groups at different time points. Results The average opening time of L-type Ca2+ channels in the study group was significantly shorter than that in the control group (P < 0.05). Compared with 72 h after reperfusion, the average opening time of L-type Ca2+ channels in the two groups at different time points were statistically significant (P < 0.05). After ischemia-reperfusion treatment, the water content in the study group was also significantly lower than that in the control group (P < 0.05). Compared with 72 h after reperfusion, the brain water content in the other time points of the two groups were significant difference (P < 0.05). After intervention, serum SOD activity of the study group was higher than that of the control group and the MDA content was lower than that of the control group (P < 0.05). Conclusion Buyang Huanwu Decoction has a certain therapeutic effect on global cerebral ischemia-reperfusion injury in rats. Its effect is related to shortening the average opening time of L-type Ca2+ channel at different time points, decreasing the brain water content of rat, increasing the activity of serum SOD and decreasing the content of MAD in rat.
		2019 Vol. 16 (16): 13-16 [Abstract] ( 192 ) HTML (1 KB) PDF (557 KB) ( 147 )

	17	Effect of nitidine chloride on cell proliferation, apoptosis, invasion and migration in laryngeal carcinoma cell line Hep-2 in vitro
		DONG Tao1 WU Qian2
		Objective To investigate the effect of nitidine chloride on cell proliferation, apoptosis, invasion and migration in laryngeal carcinoma cell Hep-2 in vitro. Methods Hep-2 cells were cultured by nitidine chloride with 5, 10, 20, 40, 60, 80 μmol/L in vitro, and MTT was performed to observe the proliferation at different times. Annexin V-FITC/PI flow cytometry was used to determine the apoptosis rate by nitidine chloride with 10, 20, 40 μmol/L. Transwell method was used to detect the invasion and migration by nitidine chloride with 5, 10 μmol/L. Results At concent of 5, 10, 20, 40, 60, 80 μmol/L, the growth inhibition rate of nitidine chloride on Hep-2 cells increased gradually with the increase of time, compared with the control group at the same time point (P ＜ 0.05). At concent of 10, 20, 40 μmol/L, the apoptosis rate of Hep-2 cells induced by nitidine chloride gradually increased, compared with the control group, the differences were statistically significant (P ＜ 0.05); compared with the nitidine chloride with 10 μmol/L, the nitidine chloride with 20, 40 μmol/L increased the apoptosis rate, the differences were statistically significant (P ＜ 0.05). Compared to the control group, nitidine chloride with 5, 10 μmol/L reduced the number of cells of invasion and migration of Hep-2 cells significantly (P ＜ 0.05); compared with the nitidine chloride with 5 μmol/L, nitidine chloride with 10 μmol/L decreased the number more significantly (P ＜ 0.05). Conclusion Nitidine chloride could inhibit the proliferation of Hep-2 cells, the mechanism is related to the induction of apoptosis and the inhibition of invasion and migration.
		2019 Vol. 16 (16): 17-20,36 [Abstract] ( 238 ) HTML (1 KB) PDF (1078 KB) ( 77 )

	21	Effects of water extract of berberine on apoptosis and proliferation of human skin tumor A431 cells
		GAO Yaoxing1 YU Jianshe1 DU Rina2 YANG Limin2 ZHAO Pengwei3 SUN Peng3
		Objective To investigate the effect of water extract of berberine on apoptosis and proliferation of human skin tumor A431 cells. Methods The low temperature extraction process was used to extract the water-soluble small molecule mixture from the medicinal materials. MTT assay was used to detect the inhibitory effect of the drug on human skin tumor A431 cells. Four concentrations of 6.3, 12.5, 25, 50 μg/μL were set as the drug group, and those without the drug were set as the control group. The tumor inhibition rates at 24, 48 and 72 h were observed. Tunel was used to detect apoptosis. After being screened by MTT, the apoptosis pathways of caspase-3, caspase-8, caspase-9 and Bcl-2 were detected by Western blot after treating tumor A431 cells with 25 μg/μL water extract for 48 h. Results The main components were nucleic acid, alkaloid, etc. MTT showed that the inhibition rate of 25 μg/μL water extract of berberine on A431 cells reached the best at 48 h (P ＜ 0.05). Under the microscope, there was no change in the control group. After incubated with 25 μg/μL water extract of berberine for 48 h, the number of cells significantly decreased, became round and floated. Tunel showed 25 μg/μL water extract of berberine significantly increased green light at the approved location, indicating a large number of apoptosis. In this study, after incubated with 25 μg/μL water extract of berberine for 48 h, and the expressions of caspase-3, caspase-8 and caspase-9 in tumor A431 cells were significantly increased, while the expression of Bcl-2 was significantly decreased. Conclusion This study preliminarily showed that the small molecule mixture of water extract from rhizoma coptiliae could promote apoptosis of A431 cells and inhibit cell proliferation. The mechanisms include the extracellular apoptosis pathway and the intracellular apoptosis pathway, leading to the up-regulation of caspase-3, caspase-8 and caspase-9 in tumor cells and the down-regulation of the apoptotic protein Bcl-2. This study further clarified the mechanism of wat extract of berberine in the treatment of skin tumors and provided methods for the treatment of skin tumors.
		2019 Vol. 16 (16): 21-24,49 [Abstract] ( 213 ) HTML (1 KB) PDF (1073 KB) ( 138 )

	25	Effects of Ziyin Mingmu Pills on the expression of Fas/FasL in the retina of RCS rats
		WANG Ying1,2 JIANG Pengfei1,2 PAN Kun1,2 PENG Jun2,3 XU Jian1,2 PENG Qinghua1,2,3
		Objective To observe the effect of Ziyin Mingmu Pills on the expression of Fas/FasL in the retina of RCS rats. Methods The RCS rats were selected, aged (1.51±0.27) months, total 24 rats, they were randomly divided into 3 groups: blank group, model group, Ziyin Mingmu Pills group (4 male and 4 female, n = 8). Blank group: RCS (rdy+/+, p+/+) rats were given normal saline by intragastric administration; model group: RCS (rdy-/-, p-/-) rats were given normal saline by intragastric administration; Ziyin Mingmu Pills group: RCS (rdy-/-, p-/-) rats were given Ziyin Mingmu Pills by intragastric administration. After intragastric administration for 30 d, the morphological changes of each layer of the retina sample were observed by immunohistochemistry. The expression levels of Fas/FasL in the retina of rats were determined by Western blot. Results The results of immunohistochemistry showed that each layer of retinal structure of the rats in the blank group was clear; the thickness of retina in the model group was lower than that in the blank group and the structure of each layer of retina was not clear; the retinal thickness of Ziyin Mingmu Pills group was lower than that of blank group but higher than that of blank group, the structure of each layer of retina was clear. The results of Western blot assay showed that the relative expression of Fas, FasL protein in the retina of Ziyin Mingmu Pills group was lower than that in the model group, the difference was highly statistically significant (P ＜ 0.01). Conclusion Ziyin Mingmu Pills has a protective effect on the ultrastructure of retina, which can inhibit the expression of Fas/FasL of the retina and reduce the apoptosis of retinal photoreceptor cells, thus achieving the purpose of protecting visual cells.
		2019 Vol. 16 (16): 25-27,53 [Abstract] ( 200 ) HTML (1 KB) PDF (887 KB) ( 96 )

	28	Content determination of four components in Haoqin Huaban Granules by HPLC
		WANG Xia1 GONG Tao1▲ SUN Liyun2 LI Tuoxin1 ZHU Qing1 SONG Jingmei1
		Objective To establish high-performance liquid chromatography (HPLC) method for the content determination of the loganic acid, gentiopicroside, paeoniflorin and 5-O-methylvisamminol in Haoqin Huaban Granules. Methods The column was Kinetex EVO C18 (150 mm × 4.6 mm, 5 μm). The mobile phase consisted of acetonitrile-0.1% phosphoric acid solution with gradient elution at the flow rate of 1.0 mL/min. The detecting wavelength was 235 nm and the column temperature was 35℃. Results The standard curve of loganic acid, gentiopicroside, paeoniflorin and 5-O-methylvisamminol were Y = 1.5×103X - 0.88 (r = 0.9999),Y = 9.8×102X - 2.95 (r = 0.9999),Y =1.4×103X - 3.97 (r = 0.9999),Y =2.4×103X - 0.33 (r = 0.9999), and the linear ranges of loganic acid, gentiopicroside, paeoniflorin and 5-O-methylvisamminol were 0.03-0.69 mg/L, 0.15-3.00 mg/L, 0.17-3.44 mg/L, 0.01-0.11 mg/L，respectively. The average recoveries of loganic acid, gentiopicroside paeoniflorin and 5-O-methylvisamminol were 97.85%, 98.30%, 94.66%, 96.08%, the RSD were 1.00%,0.69%,1.72%,1.90%, respectively. Conclusion The method is simple, accurate and reproducible. It is effective in controlling the quality of Haoqin Huaban Granules.
		2019 Vol. 16 (16): 28-32 [Abstract] ( 290 ) HTML (1 KB) PDF (635 KB) ( 102 )

	33	Research progress of modern rehabilitation therapy in cognitive impairment
		XUE Zhiyuan XU Ping▲
		Cognitive impairment is a cognitive impairment caused by various reasons, including learning, memory impairment or accompanied by aphasia, misuse, and loss of recognition. Previously, drugs were used as first-line treatments. With the rapid development of rehabilitation medicine, new technologies for rehabilitation therapy emerge one after another. The effects of modern rehabilitation techniques such as physical therapy, rehabilitation robots and remote rehabilitation on cognitive function have become hot spots in clinical research and treatment. This article reviews the commonly used cognitive rehabilitation treatment methods in recent years, in order to provide new thinking for clinical treatment of the disease.
		2019 Vol. 16 (16): 33-36 [Abstract] ( 175 ) HTML (1 KB) PDF (597 KB) ( 156 )

	37	Research progress of gastrointestinal flora and tumor chemotherapy drugs
		TIAN Cheng1 YUAN Anlong2
		The microbiome consists of symbiotic bacteria and other microorganisms present in host epithelial barriers. Microflora plays an important role in maintaining local homeostasis and systematically regulating physiological functions such as metabolism, hematopoiesis, inflammation and immunity. Microbiota are also involved in the occurrence, development and spread of cancer in epithelial barriers and sterile tissues. Gastrointestinal microbes are involved not only in cancer, but also in cancer prevention and chemotherapy. This article reviews the relationship between gastrointestinal microecology and tumor and chemotherapy.
		2019 Vol. 16 (16): 37-41 [Abstract] ( 174 ) HTML (1 KB) PDF (585 KB) ( 108 )

	42	Research progress in radioprotectors from the family of aminothiols
		LI Xuejiao TIAN Hongqi
		With the development of nuclear technique, the threat of radiation exposure is increasing. As the first generation of radioprotectors, aminothiols can scavenge free radicals formed from ionizing radiation so that they can protect normal tissue from the harmful effects of ionizing radiation. Amifostine is the representative compound among aminothiols and the only small molecular radioprotective agent approved by FDA in clinical application at present, it has good radioprotective effects but many side effects such as hypotension. PrC-210 is a new aminothiol radioprotector, it has few side effects and high radioprotective efficacy. A better aminothiol radioprotectors can be obtained by controlling the number of amino groups in the molecular backbone and molecular weight, and modifying the sulfhydryl group in the molecule.
		2019 Vol. 16 (16): 42-45 [Abstract] ( 154 ) HTML (1 KB) PDF (870 KB) ( 152 )

	46	Reseach progress on nano-drug delivery strategy of non-invasive drug administration of the posterior eye segment
		DAI Zhu1,2 ZHU Hongda1
		Because of the unique physiological structure of eyes, routine eye topical administration for the treatment of posterior eye disease has always been a difficult problem for medical workers. The developed drug delivery system of eyes based on nano-drug delivery strategy has characters of small size, strong penetration, strong surface adhesion for biofilm, and so on, which is expected to develop into a safe, effective, economical and non-invasive new eye drug delivery system, in particular, more and more attention has been paid to drug administration in the posterior eye segment. This paper focuses on the various nano-drug delivery strategies of non-invasive drug administration of the posterior eye segment, including drug delivery systems of nanoparticles, lipidosome, nano-micelle, nano suspensions and nanoemulsion.
		2019 Vol. 16 (16): 46-49 [Abstract] ( 240 ) HTML (1 KB) PDF (572 KB) ( 171 )

	50	Research progress on the current situation of TCM nursing training for nursing staff
		XU Cui1 WU Peixiang2 XIAO Liyun1 YU Li1
		The core of the inheritance and innovation of TCM nursing career lies in the cultivation of TCM nursing talents. As practitioners of traditional Chinese medicine nursing, nurses receive standardized training of TCM nursing, which is a necessary way for nurses to learn the theory and professional skills of TCM nursing and improve the quality of TCM. This paper summarizes the characteristics of TCM nursing and the contents, forms and effects of TCM nursing training, aiming at providing a basis for improving the quality of TCM nursing training and scientific training decision-making, and providing policy guidance for health administrative departments.
		2019 Vol. 16 (16): 50-53 [Abstract] ( 198 ) HTML (1 KB) PDF (603 KB) ( 199 )

	54	Research progress of thymectomy in the treatment of non-thymomatous myasthenia gravis
		LI Jinpin XU Hongyan MO Xuean▲
		Myasthenia gravis (MG) is an autoimmune disease involving neuromuscular junction, taking pathological fatigue of skeletal muscle as main characteristics, its pathogenesis is closely related to thymic lesion, such as thymoma, megalothymus, lymphoblastic follicular hyperplasia, and thymic atrophy. The treatment of MG includes application of cholinesterase inhibitors, immunosuppressor, immune globulin, plasmapheresis and thymectomy, the effect of thymectomy in the treatment of MG patients combined with thymoma is exact. In recent years, some scholars have reported that thymotomy can be used to treat MG patients with non-thymoma, but its therapeutic value is controversial at present. This paper reviews the research progress of thymectomy in the treatment of non-thymomatous MG.
		2019 Vol. 16 (16): 54-56 [Abstract] ( 176 ) HTML (1 KB) PDF (552 KB) ( 111 )

	57	Application effect of flipped classroom in the experimental teaching of medical protection against chemical weapons
		CHEN Mingliang
		Objective To investigate the effect application of flipped classroom in the experimental teaching of medical protection against chemical weapons. Methods Two classes of the five-year undergraduate students major in clinical medicine from the Army Medical University were enrolled. The students were divided into the experimental group （n = 30） and the control group （n = 30） by a simple randomized grouping method during the experimental teaching course of medical protection against chemical weapons from May to July November in 2017. The control group was conducted according to the traditional experimental teaching method, just reviewing the related nerve agent knowledge and the experimental protocol before doing experiments. Moreover, flipped classroom was applied to the experimental group. At the end of the experimental class, the experimental operation time and the experimental report results of the two groups were counted, and the students′ satisfaction of the experimental teaching were investigated. Results The experimental operation time of the experimental group was significantly shorter than that of the control group, and the experimental scores of the experimental group was significantly higher than that of the control group, the differences were statistically significant （P < 0.05）. Questionnaire survey results showed that, compared with the control group, all participants in the experimental group believed that the experiment class inspired learning interest and initiative and hoped to continue to adopt this teaching method, the differences were highly statistically significant （P < 0.01）. The number of students who thought that the teaching method could improve the self-learning ability and promote the understanding and memory of knowledge, as well as enhance the ability of using theoretical knowledge and experimental operation was larger than that of the control group, the differences were highly statistically significant （P < 0.01）. Conclusion Flipped classroom could effectively improve the teaching quality of experimental teaching of medical protection against chemical weapons, and enhance students′ abilities to master knowledge and technical operations. These results indicate that flipped classroom should be popularized and applied in other related experimental teaching.
		2019 Vol. 16 (16): 57-60 [Abstract] ( 179 ) HTML (1 KB) PDF (567 KB) ( 80 )

	61	Construction of hybrid teaching model and its application in experimental teaching of medical immunology
		XU Qi XU Qian Fulati·Rexiti Dilinaer·Bolati WANG Song
		Experimental teaching of medical immunology is an important link between basic theory and clinical practice. The improvement of experimental teaching quality is conducive to cultivating students′ clinical thinking and innovative spirit. This research mainly to increase comprehensive experiments in immunology experiment syllabus revision content, cultivate experiment teaching faculty, especially the young teachers in the experimental teaching ability training as the prerequisite, this paper discusses the construction of experiment teaching mode of hybrid of reform measures, including experimental teaching flip the classroom teaching, guiding college students′ innovative projects, the introduction of CBS and experimental design, the scene teaching, appropriate to carry out the teaching idea of student-centered, to optimize the experiment teaching process, improve the quality of immunology experiment teaching effect.
		2019 Vol. 16 (16): 61-64 [Abstract] ( 188 ) HTML (1 KB) PDF (536 KB) ( 55 )

	65	Simulation design and virtual medical education model of hip replacement surgery
		PENG Jianqiao1* CHEN Haiyan2* LIU Yuping3*
		Objective Virtual design of joint replacement surgery model, to build a simulation platform to practice instead of teaching, on the occasion of surgical teaching to correct the "lack of practice" situation. Methods One patient who was admitted to the First Affiliated Hospital of Guangzhou Medical University from July to August 2016 and who suffered from hip osteoarthritis and planned to undergo total hip arthroplasty was randomly selected. After the lumbosacral vertebra was scanned by CT, the Mimics was imported into .dicom format to reconstruct the 3D model of the pelvis, and Freeform Modeling was imported into .stl format, the simulation surgical instrument was developed with the computer-aided design software ProE and Ghost SDK, and the visualized total hip replacement under the guidance of Phantom joystick was practiced. Results The experimental results showed that the 3D model of hip joint was clearly reconstructed by taking 3D wheeled cutting as the observation index. The geometrical shapes of the virtual designed surgical instruments and physical instruments were similar, and the total hip surgery model and physical surgery were highly simulated. Conclusion This training mode, with "training instead of teaching" as the main body, provides hands-on experience in the field, with remarkable effects. It can not only provide teaching cases for medical courses, but also provide planning basis for physical surgery.
		2019 Vol. 16 (16): 65-68 [Abstract] ( 182 ) HTML (1 KB) PDF (1032 KB) ( 131 )

	69	Application of clinical competency-oriented teaching method in clinical pracitcal pain medicine
		HE Liangliang NI Jiaxiang CAO Guoqing YANG Liqiang▲
		Objective To evaluate the efficacy of clinical competency-oriented teaching method in clinical practical pain. Methods From May 2017 to March 2018, 40 trainee doctors in Xuanwu Hospital, Capital Medical University were selected as study object and randomly divided into competency based education(CBE) teaching group and traditional teaching group, with 20 trainee doctors in each group. Teaching examination results, satisfaction and teaching implementation effect were recorded. Results Compared with traditional teaching group, the teaching examination results and satisfaction score were higher in the CBE teaching group (P < 0.05), and the improvement of learning attention, learning efficiency, learning motivation, capacity of theory with practice, problem-solving capability, clinical competence and independent learning ability were more obviously in CBE teaching group (P < 0.05). Conclusion The clinical competency-oriented teaching method can promote the switch from being teacher-centered to student-centered, inspire the student′s initiative and enthusiasm and improve the clinical teaching effect and practical ability.
		2019 Vol. 16 (16): 69-72 [Abstract] ( 178 ) HTML (1 KB) PDF (574 KB) ( 86 )

	73	Application of problem-based learning in evidence-based medicine teaching
		DONG Jiande TENG Hale HUANG Jinhong LI Zhijian ZHAO Ruonan
		Objective To investigate the effect of “problem-based learning” (PBL) used in the teaching of evidence-based medicine teaching for undergraduates. Methods From January to October 2015, 48 undergraduates of Capital Medical University who studied in the Electric Power Hospital were randomly assigned to experimental group (n = 24) and control group (n = 24), experimental group was given the PBL teaching method, the control group was given the “lecture-based learning” (LBL) teaching method. The final examination scores of the two groups were compared, questionnaires were used to investigate the improvement of students′ ability and to find evidence-based medical evidence and application of it according to clinical problems. Results There was no statistically significant difference in the basic characteristics between the two groups (P > 0.05). The results of the final examination scores and the questionnaire showed that there were statistically significant differences in raising clinical problems, searching for the best evidence and evaluating evidence between the two groups (P < 0.05). Conclusion Compared with the traditional LBL method, PBL method can effectively improve students′ ability of using evidence-based medicine to solve clinical problems.
		2019 Vol. 16 (16): 73-75,79 [Abstract] ( 350 ) HTML (1 KB) PDF (981 KB) ( 163 )

	76	Predictive value of brain natriuretic peptide for paroxysmal atrial fibrillation after acute ischemic stroke
		YUAN Mingjie1 BI Jihong2
		Objective To investigate the predictive value of brain natriuretic peptide (BNP) for paroxysmal atrial fibrillation after acute ischemic stroke ("atrial fibrillation" for short). Methods A retrospective analysis of 130 patients with acute ischemic stroke admitted to Renmin Hospital of Wuhan University from October 2016 to June 2017 was performed. Patients were divided into atrial fibrillation group and sinus rhythm group according to whether there was atrial fibrillation or a history of atrial fibrillation at admission. The sinus rhythm group underwent 24-hour dynamic electrocardiogram monitoring for atrial fibrillation within 7 days after admission. Patients with sinus rhythm were divided into new atrial fibrillation group and non-atrial fibrillation group according to whether atrial fibrillation occurred during hospitalization. Plasma BNP levels were measured within 24 h after admission, and multivariate Logistic regression analysis was used to analyze the risk factors of new atrial fibrillation after acute ischemic stroke. Results A total of 130 patients with acute ischemic stroke were included in this study, including 80 patients with sinus rhythm and 50 patients with atrial fibrillation. Eighty patients with sinus rhythm underwent 24-hour dynamic electrocardiogram examination. Among them, 14 cases had new atrial fibrillation and 66 cases had no atrial fibrillation. Multivariate Logistic regression analysis showed that BNP was a risk factor for new atrial fibrillation after acute ischemic stroke (OR = 1.163, 95%CI: 1.042-1.297, P = 0.007). Conclusion BNP can predict the occurrence of paroxysmal atrial fibrillation after acute ischemic stroke.
		2019 Vol. 16 (16): 76-79 [Abstract] ( 185 ) HTML (1 KB) PDF (650 KB) ( 58 )

	80	Expression and significance of CD4+CD25+ regulatory T cells and transforming growth factor-β1 in patients with platelet transfusion refractoriness
		CHEN Xiaojie YUAN Zhaohu YANG Xuexin YANG Huikuan LUO Shulan
		Objective To investigate the expression and significance of CD4+CD25+ regulatory T cells and transforming growth factor-β1 (TGF-β1) in patients with platelet transfusion refractoriness (PTR). Methods Thirty-four patients with severe aplastic anemia (SAA) who had PTR from April 2017 to April 2018 in Guangzhou First People′s Hospital ("our hospital" for short) were selected as the study group. Another 44 SAA patients without PTR were selected as the control group. The expression levels of CD4+CD25+ regulatory T cells and plasma TGF-β1 were detected and compared in the two groups, and the diagnostic performance of the two indicators in PTR was analyzed by receiver operating curve (ROC). Results The expression levels of CD4+CD25+ regulatory T cells in the study group before and after infusion were lower than those in the control group (P < 0.05), and the plasma TGF-β1 level in the study group was lower than that in the control group (P < 0.05). According to ROC curve analysis, the area, sensitivity and specificity of CDT+CD25+ regulatory T cells and TGF-β1 combined detection and diagnosis of PTR were higher than those of the above two indicators (P < 0.05). Conclusion CD4+CD25+ regulatory T cells and TGF-β1 levels in PTR patients are significantly lower than those in control group. The expression of these two indicators can be detected in clinical work, which can provide reference for the prevention and treatment of PTR.
		2019 Vol. 16 (16): 80-83 [Abstract] ( 179 ) HTML (1 KB) PDF (707 KB) ( 69 )

	84	Expression and significance of α1-acid glycoprotein and thrombospondin-1 in peripheral blood of patients with sepsis
		LIU Fengming QIN Huichan QIN Xianlian XIE Fumao HUANG Gui LIANG Guirong
		Objective To investigate the expression levels of α1-acid glycoprotein (AAP) and thrombospondin 1 (TSP1) in peripheral blood of patients with sepsis and its clinical significance. Methods From June 2017 to June 2018, 30 patients who underwent physical examination or 90 patients who were treated in the First People′s Hospital of Nanning ("our hospital" for short) were selected. According to the health status of the subjects, they were divided into normal group, non-sepsis SIRS group (30 cases), mild sepsis group (30 cases), severe sepsis group (30 cases), and their early morning fasting serum were obtained. The differences in expression levels of C-reactive protein (CRP), procalcitonin (PCT), AAP, and TSP1 were compared between the four groups. Results The expression levels of CRP and PCT in non-sepsis SIRS group, mild sepsis group and severe sepsis group were significantly higher than those in normal group (P < 0.05). The expression levels of AAP and TSP1 in mild sepsis group and severe sepsis group were significantly higher than those in normal group (P < 0.05). The expression levels of PCT, AAP and TSP1 in mild sepsis group and severe sepsis group were higher than those in non-sepsis SIRS group (P < 0.05), and the expression level of AAP in severe sepsis group was higher than that in mild sepsis group (P < 0.05). Conclusion PCT has advantages in the diagnosis of sepsis, AAP has advantages in the severity classification of sepsis. The combination of the two can better judge the severity of non-sepsis SIRS and sepsis patients, and provide reference for early clinical treatment.
		2019 Vol. 16 (16): 84-87,99 [Abstract] ( 227 ) HTML (1 KB) PDF (651 KB) ( 121 )

	87	Serum levels of IL-33 and S1P in patients with bronchial asthma and their clinical significance
		XU Huijuan SONG Mei LIN Zhaofan
		Objective To analyze the levels of interleukin 33 (IL-33) and 1- phosphosphingosine (S1P) in serum of patients with bronchial asthma and their clinical significance. Methods From September 2015 to May 2017, 83 patients with bronchial asthma admitted to the Second Affiliated Hospital of Shantou University School of Medicine ("our hospital" for short) were selected and divided into acute stage group (n = 48) and relief group (n = 35) according to the control of wheeze, 40 healthy subjects in our hospital in the same period were selected as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of IL-33 and S1P in serum. Lung function measures, forced expiratory volume in the first second (FEV1), maximum peak expiratory flow rate (PEF), and forced expiratory volume/forced vital capacity in the first second (FEV1/FVC). Pearson correlation coefficient was used to analyze the correlation between serum IL-33 and S1P and pulmonary function indexes. Results Serum IL-33 and S1P levels in the acute stage group and the relief group were higher than those in the control group, and the levels in the acute stage group were also higher than those in the relief group, with statistically significant differences (all P ＜ 0.05). Lung function indexes FEV1, PEF and FEV1/FVC in the acute stage group and the relief group were all lower than those in the control group, while those in the acute stage group were also lower than those in the relief group, with statistically significant differences (all P ＜ 0.05). Pearson correlief coefficient analysis results showed that the serum IL-33 and S1P levels in the acute phase group and the remission group were negatively correlated with lung function indicators (r ＜ 0, P ＜ 0.05). Conclusion Serum IL-33 and S1P levels are significantly increased in patients with bronchial asthma, which is negatively correlated with lung function. The detection of serum IL-33 and S1P levels is helpful for the diagnosis of bronchial asthma.
		2019 Vol. 16 (16): 87-90 [Abstract] ( 225 ) HTML (1 KB) PDF (671 KB) ( 44 )

	91	Effect of hyperthermia combined with intracavitary infusion chemotherapy on abdominal cancer with malignant pleural effusion and ascites
		HUANG Hansheng YANG Xiaomei FU Junmin CHEN Chaoting WEN Jianmei MO Qia
		Objective To investigate the clinical efficacy of hyperthermia combined with intracavitary infusion chemotherapy on abdominal cancer with malignant pleural effusion and ascites and its influence on tumor markers in serum and pleural effusion and ascites. Methods From January 2017 to May 2018, 80 cases of patients with abdominal cancer and malignant pleural effusion admitted to the Second Affiliated Hospital of Guangxi University of Science and Technology were selected. The patients were divided into control group (n = 40) and study group (n = 40) according to the random number table method. Patients in the control group were treated with intravitreal chemotherapy, and patients in the study group were treated with hyperthermia combined with intravitreal chemotherapy. Patients in the two groups were treated for 4 weeks continuously, and the short-term effects of the two groups were evaluated and compared. Serum (CEA), saccharide antigen 19-9 (CA19-9), saccharide antigen 12-5 (CA12-5) and cytokeratin 19 fragment (CYFRA21-1) of the two groups were measured before and after treatment, respectively, and toxic and adverse reactions of the two groups were observed. Results The total effective rate of the study group was higher than that of the control group (P ＜ 0.01). Compared with before treatment, CEA, CA19-9, CA12-5 and CYFRA21-1 levels in serum and hydrothorax of the two groups were significantly reduced after treatment (P ＜ 0.05), and the levels in the study group were lower than those in the control group (P ＜ 0.05). No serious adverse reactions occurred during the treatment in both groups. Conclusion The short-term effect of hyperthermia combined with intravitary perfusion chemotherapy in the treatment of abdominal cancer with malignant pleural effusion is significant, which can significantly reduce the level of relevant tumor markers in serum and pleural effusion, and has a good safety.
		2019 Vol. 16 (16): 91-94 [Abstract] ( 183 ) HTML (1 KB) PDF (633 KB) ( 76 )

	95	Clinical features and video electroencephalogram analysis of persistent epilepsy in senile patients with partial seizures
		LIU Tao1 LAN Chunwei1 YUAN Kunxiong1 WANG Qingyong1 XUE Lijun2
		Objective To investigate the clinical characteristics and video electroencephalogram of partial seizure status in the elderly. Methods From December 2015 to June 2018, 19 elderly patients with partial epileptic seizure status admitted to Shenzhen Hospital (Guangming) of the university of Chinese academy of sciences and the Second General Hospital of Bao′an Second People′s Hospital (Group) were selected as the research objects, and their video electroencephalogram, treatment and other data were retrospectively analyzed to summarize their clinical characteristics. Results Among the 19 patients, there were 5 cases (26.31%) with non-convulsive status epilepticus, 14 cases (73.69%) with convulsive status epilepticus, 4 cases (21.05%) with pure motor status epilepticus, and 10 cases (52.64%) with secondary tonic and clonic status epilepticus.Among the 19 patients with definite etiology, 15 patients(78.96%) had cerebrovascular disease, 2 patients(5.26%) had brain tumor, 1 patients(10.52%) had neurodegenerative disease, and 1 patients (5.26%) had dual etiology. Sixteen patients (84.22%) had different degrees of consciousness disturbance, two patients (10.52%) had Todd paralysis, and one patient (5.26%) had blurred vision. Nineteen patients were given dynamic video electroencephalogram examination, and 17 patients (89.48%) had epileptiform discharge, and the abnormal background activity of the patients showed slow-wave activity, while 2 patients (10.52%) had no correlation between abnormal discharge and limb convulsion. Conclusion Most of the elderly patients with partial seizure status have definite etiology, and the analysis of clinical and dynamic video electroencephalogram and imaging examination results is helpful to improve the diagnosis of this disease.
		2019 Vol. 16 (16): 95-99 [Abstract] ( 220 ) HTML (1 KB) PDF (1084 KB) ( 193 )

	100	Detection of induced sputum eosinophils, 25 (OH) D3 and FeNO in diagnosis of ACOS disease
		LI Li ZHAOJing▲
		Objective To analyze the significance of induced sputum eosinophils, 25-hydroxyvitamin D [25 (OH) D3] and exhaled nitric oxide (FeNO) in the diagnosis of asthma-copd overlap syndrome (ACOS). Methods From January 2016 to May 2018, 50 patients diagnosed with ACOS in the First Hospital of Yulin City, Shaanxi Province were selected as the observation group and 50 patients with chronic obstructive pulmonary disease as the control group, the levels of phlegm eosinophils, 25(OH) D3 and FeNO in each group were analyzed, and ROC curves were drawn to analyze the diagnostic value of each index. Results The levels of eosinophil and 25 (OH) D3 in the observation group were lower than those in the control group (P ＜ 0.05), and FeNO level in the observation group was higher than that in the control group (P ＜ 0.05). The positive rates of eosinophil, 25 (OH) D3 and FeNO in the observation group were all higher than those in the control group, with statistically significant differences (P ＜ 0.05). In addition, the sensitivity of FeNO diagnosis was higher than 25 (OH) D3 (P ＜ 0.05), the specificity was higher than that of eosinophil (P ＜ 0.05), and the area under the ROC curve was higher than 25 (OH) D3 (P ＜ 0.05). Conclusion The use of phlegm eosinophils, 25 (OH) D3 and FeNO in the diagnosis of ACOS disease has a high application value, but the diagnostic value of FeNO is significantly higher than that of phlegm eosinophils and 25 (OH) D3.
		2019 Vol. 16 (16): 100-103 [Abstract] ( 217 ) HTML (1 KB) PDF (706 KB) ( 41 )

	104	Application value of early intervention coagulation strategy in massive transfusion patients with severe trauma
		LI Xiudan1 HUANG Mingli1▲ QIAN Jun2 LIAO Qunfen3 YANG Tianxing1 ZENG Yali4
		Objective To explore the application value of early intervention coagulation strategy in patients with massive transfusion after severe trauma. Methods From March 2017 to March 2018, 44 patients with severe trauma requiring massive blood transfusion during the period of early intervention coagulation strategy in Mianyang 404 Hospital of Sichuan ("our hospital" for short) were selected as the research group, 44 patients with severe trauma requiring massive blood transfusion during the period of routine blood transfusion in our hospital from February 2016 to February 2017 were selected as the control group. The incidence, mortality, blood gas analysis and coagulation function of acute respiratory distress syndrome (ARDS) were compared between the two groups. Results After the intervention, the incidence and mortality of ARDS in the study group were lower than those in the control group (P ＜ 0.05); 1 and 5 days after transfusion, pH and partial arterial oxygen pressure (PaO2) in the study group were higher than those in the control group, and partial carbon dioxide pressure (PaCO2) were lower than those in the control group (P ＜ 0.05); 1 d after transfusion, Prothrombin time (PT), activation time of partial thrombin (APTT) and thrombin time (TT) were all lower in the study group than in the control group, while fibrinogen (FIB) and platelet count (PLT) were higher in the study group than in the control group (P ＜ 0.05); 5 d after transfusion, PT, TT, FIB and PLT in the study group were all higher than those in the control group, and APTT was lower than that in the control group (P ＜ 0.05). Conclusion Early intervention of coagulation strategy in patients with severe trauma and massive transfusion can reduce the incidence and mortality of ARDS, improve blood gas analysis, and reduce the impact on coagulation function.
		2019 Vol. 16 (16): 104-107 [Abstract] ( 181 ) HTML (1 KB) PDF (632 KB) ( 64 )

	108	Comparison study of resuscitation effect of hydroxyethyl starch 130/0.4 electrolyte injection and hydroxyethyl starch 130/0.4 sodium chloride solution in the treatment of septic shock
		WANG Liwei LU Yan LI Ruhong
		Objective To compare the resuscitation effect of hydroxyethyl starch 130/0.4 electrolyte injection and hydroxyethyl starch 130/0.4 sodium chloride solution on the treatment of septic shock. Methods A total of 92 patients with septic shock in Affiliated Hospital of Chengde Medical University from January 2016 to January 2018 was enrolled in this study. The subjects were divided into the control group (n = 46) and the treatment group (n = 46) according to the random number table method. The control group was treated with hydroxyethyl starch 130/0.4 sodium chloride solution, the treatment group was treated with hydroxyethyl starch 130/0.4 electrolyte injection. The blood gas related indicators (pH value, HCO3-, blood lactic acid), electrolyte indicators (K+, Na+, Cl-, Mg2+), oxidative stress indicators (SOD, GSH-PX, MDA, AOPP), blood coagulation function related indicators (PT, APTT, TT) of the two groups before recovery and 2 h after recovery were compared. The adverse reactions rates of the two groups during the treatment was compared. Results The pH value, SOD, GSH-PX of the two groups 2 h after recovery were significantly higher than before recovery, the HCO3-, blood lactic acid, MDA, AOPP of the two groups were significantly lower than before recovery, and the change range of the treatment group was significantly better than the control group (P < 0.05). The K+ and Mg2+ of the two groups at 2 h after recovery were significantly lower than before recovery, the Na+ and Cl- of the control group were significantly higher than before recovery, the Na+ and Cl- of the treatment group were significantly lower than before recovery, and the Mg2+ of the treatment group was significantly higher than that of the control group, the Na+ and Cl- of the treatment group were significantly lower than those of the control group, the differences were statistically significant (P < 0.05). There was no statistically significant difference in K+ between the two groups 2 h after recovery (P > 0.05). The PT, APTT and TT of the two groups 2 h after recovery were significantly higher than before recovery, but the PT, APTT, TT of the treatment group were significantly shorter than those of the control group (P < 0.05). During treatment, there was no statistically significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). Conclusion Compared with hydroxyethyl starch 130/0.4 sodium chloride solution, hydroxyethyl starch 130/0.4 electrolyte injection for fluid resuscitation in patients with septic shock is help to maintain the body′s electrolyte and acid-base balance, reduce the oxidative stress reaction, correct blood coagulation function disorder with higher safety.
		2019 Vol. 16 (16): 108-111,128 [Abstract] ( 231 ) HTML (1 KB) PDF (830 KB) ( 80 )

	112	Comparison of the application of combined spinal epidural anesthesia and continuous epidural anesthesia in analgesia of preclinical labor
		ZHANG Fujie１ＸIA Junlong2 MENG Fanhao1
		Objective To compare the effects of the two methods of intraspinal block anesthesia on puerperal delivery analgesia on puerperal delivery outcome, delivery process and newborn. Methods A total of 240 eligible pregnant first-time mothers in Hebei Petroleum Central Hospital from June 2017 to July 2018 were selected as the study object. According to the random number table method, they were divided into group A (continuous epidural block and analgesia, 80 cases), group B (combined lumbar stiffness block and analgesia, 80 cases), and group C (no labor analgesia). Puerpera in group A were given continuous epidural block anesthesia when the uterine opening was 1-2 cm, and 0.1% Ropivacaine hydrochloride was given 8 mL. After 30 minutes, the epidural catheter was connected with the automatic electronic analgesic pump. Puerpera in group B were treated with lumbar hard combined block anesthesia when the uterine opening was 1-2 cm, followed by subarachnoid injection of 0.1% Ropivacaine 3 mg. After 30 minutes, the epidural catheter was connected with the automatic electronic pump, and the control group C was in normal delivery. The time of onset of analgesia and patient satisfaction of group A and B were observed respectively. The duration of labor, rate of forceps, Apgar score, use of oxytocin, rate of cesarean section, and side effects were recorded in each group. Results Compared with group A, group B had faster onset time of analgesia and higher patient satisfaction (P < 0.05). The utilization rate of oxytocin in group A and B was significantly higher than that in group C (P < 0.05). Compared with group C, cesarean section rate was significantly lower in group A and B (P < 0.05), the first stage of labor was significantly shortened (P < 0.05). There was no statistically significant difference in forceps utilization rate and neonatal 5 min Apgar score among three groups (P > 0.05); compared with group C, the incidence of maternal side effects, such as nausea, vomiting, respiratory depression, itching, was lower in group A and B, the differences were statistically significant (P < 0.05). Conclusion Combined lumbar epidural anesthesia is safe and effective in the analgesia of preclinical labor, which can provide better delivery experience and is worthy of clinical promotion.
		2019 Vol. 16 (16): 112-115 [Abstract] ( 169 ) HTML (1 KB) PDF (436 KB) ( 78 )

	116	Efficacy of Tutengcao Decoction in the treatment of acute gouty arthritis with syndrome of exuberance of heat-toxin and blockade of static blood and turbidity
		ZHANG Honghong1 BU Xiangwei2 ZHANG Jianping2 WANG Kang3 ZHANG Chengcheng4 BAI Hua5 ZHANG Zhengju2 MENG Fengxian2
		Objective To observe the clinical efficacy of Tutengcao Decoction in the treatment of acute gouty arthritis. Methods The clinical data of acute gouty arthritis patients with syndrome of exuberance of heat-toxin and blockade of static blood and turbidity treated in Department of Rheumatology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine from April 2013 to May 2017 was analyzed retrospectively. According to the therapeutic regimen, the patients were divided into Tutengcao Decoction group (120 cases), Colchicine group (63 cases) and Loxoprofen Sodium group (118 cases). Tutengcao Decoction group was given Tutengcao Decoction or Particles, one dose daily, taken orally in the morning and evening. Colchicine group was given Colchicine, 1 mg per time, 3 times a day. Loxoprofen Sodium group was given Loxoprofen Sodium, 60 mg per time, 3 times a day. The intervention time was 1 week. The relief time of joint symptoms, the improvement conditions of Chinese medicine symptoms and the improvement conditions of serum uric acid (sUA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) before and after treatment among the three groups were observed. The clinical efficacy and safety of the three groups were compared. Results After 1 week of treatment, the relief time of joint pain and swelling in the Tutengcao Decoction group was shorter than those of the other two groups (P ＜ 0.01), the relief time of limitation of motion was significantly shorter than that of Loxoprofen Sodium group (P ＜ 0.01). In terms of Chinese medicine symptoms, the improvement rates of dry mouth and thirsty, dizziness, anorexia in Tutengcao Decoction group were significantly higher than those of the other two groups (P ＜ 0.05 or P ＜ 0.01), the improvement rate of constipation was higher than that of Loxoprofen Sodium group (P ＜ 0.01). Compared with those before treatment, the levels of sUA, CRP, ESR in the three groups were all significantly decreased after treatment (P ＜ 0.05). After treatment, the levels of CRP, ESR in Tutengcao Decoction group were significantly lower than those of the other two groups (P ＜ 0.05), the level of sUA was lower than that of Loxoprofen Sodium group (P ＜ 0.05). The effective rate of Tutengcao Decoction group was significantly higher than those of the other two groups (P ＜ 0.05). All three groups had no obvious adverse reactions. Conclusion In terms of improving clinical efficacy and decreasing the levels of sUA, Tutengcao Decoction is better than single Colchicine or Loxoprofen Sodium in the treatment of acute gouty arthritis.
		2019 Vol. 16 (16): 116-119 [Abstract] ( 225 ) HTML (1 KB) PDF (569 KB) ( 107 )

	120	Meta-analysis on efficacy of external treatments of TCM for constipation of Parkinson′s disease
		CAI Qiaodi1 ZHENG Chunye2 CHEN Xinjie1 LI Zhe2 LUO Xiaodong2
		Objective To systematically evaluate the clinical efficacy of external treatments of traditional Chinese medicine (TCM) for constipation of Parkinson′s disease. Methods The randomized controlled trials (RTCs) about external treatment of TCM for constipation of Parkinson′s disease in databases such as CNKI, Wan fang, VIP, CBM, Cochrane Library, PubMed were searched by computer, and all literatures published from their establishment to September 30, 2018 were included. In the RTCs, external treatment + conventional treatment/other treatments were used in the observation group and conventional treatment/other treatments were used in the control group. RevMan 5.3 software was used for meta analysis of the clinical efficacy of external treatments of TCM for constipation of Parkinson′s disease. Results Eleven studies involving 833 patients were included, including 417 cases in the observation group and 416 cases in the control group. The meta analysis showed that: there was statistically significant difference in the clinical efficiency [RR = 1.24, 95%CI (1.11, 1.39), P = 0.0002], the cure rate [RR = 1.77, 95%CI (1.40, 2.23), P ＜ 0.000 01], and the score of symptoms of constipation [MD = -1.41, 95%CI (-2.10, -0.71), P ＜ 0.0001] between the two groups. There was no statistically significant difference in the pressure of rectal resting [SMD = 0.23, 95%CI (-0.72, 1.19), P = 0.63], the pressure of anal resting [SMD = -0.13, 95%CI(-0.56, 0.29), P = 0.54], and the pressure of anal canal systolic [SMD = 0.22, 95%CI (-0.17, 0.62), P = 0.26]. Conclusion The external treatment of TCM can obviously improve the symptoms of constipation in Parkinson′s disease. The clinical efficacy is exact, and it displays a promising application. However, due to the low quality of the literatures included and the small sample size, more large samples, multi-center, well-designed, high-quality, double-blind RCTs are still needed to verify its effectiveness further.
		2019 Vol. 16 (16): 120-124 [Abstract] ( 183 ) HTML (1 KB) PDF (1344 KB) ( 100 )

	125	Effect of oral Changzaoling combined with Chinese fumigation and washing recipe on wound healing and quality of life in patients after anal fissure surgery
		CHEN Bin1 XU Xiantao1 CHEN Yan1 WANG Xudong2
		Objective To investigate the effect of oral Changzaoling combined with Chinese fumigation and washing recipe on wound healing and quality of life in patients after anal fissure surgery. Methods A total of 60 patients with anal fissure surgery admitted in the First People′s Hospital of Nantong City from January 2017 to January 2018 was selected, they were divided into control group (30 cases) and observation group (30 cases) according to random number table method. The control group was given routine treatment, and the observation group was given oral Changzaoling combined with Chinese fumigation and washing recipe on the basis of routine treatment. Both groups were treated for 2 weeks. The clinical efficacy, symptom score before and after treatment, visual analogue scale (VAS) score, Pittsburgh sleep quality index (PSQI) score, incision healing time, hematochezia times within 2 weeks after treatment, and complication was observed and compared between the two groups. Results The total effective rate was 90.00% (27/30) in the observation group, which was significantly higher than 73.33% (22/30) in the control group, the difference was statistically significant (P < 0.05). The incision healing time and hematochezia times in the observation group were significantly less than those in the control group, the differences were statistically significant (P < 0.05). After treatment, the symptom score, VAS score and PSQI score of the two groups decreased significantly after treatment, and the scores in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, the difference was statistically significant (P < 0.05). Conclusion Oral Changzaoling combined with Chinese fumigation and washing recipe can obviously promote wound healing, improve clinical symptoms, enhance the quality of life, and has fewer complications, it is worthy of clinical application.
		2019 Vol. 16 (16): 125-128 [Abstract] ( 200 ) HTML (1 KB) PDF (531 KB) ( 87 )

	129	Diagnostic value of diffusion weighted imaging in local recurrence for patients with rectal carcinoma after radical resection
		ZHUANG Xiaozhao LI Jianjun FU Lili CAI Qinlei
		Objective To study the diagnostic value of diffusion weighted imaging (DWI) in local recurrence for patients with rectal carcinoma after radical resection. Methods A total of 60 patients with rectal carcinoma who received radical resection in Hainan General Hospital ("our hospital" for short) from March 2016 to March 2018 and had local recurrence after surgery were selected as the recurrence group. Another 60 patients with rectal carcinoma who received radical resection in our hospital at the same time without local recurrence after surgery were enrolled as the control group. All patients were examined by conventional magnetic resonance imaging (MRI) and DWI. The results of local recurrence after radical resection in rectal carcinoma patients diagnosed by conventional MRI and DWI, signal intensity value, the levels of apparent diffusion coefficient (ADC value), contrast signal to noise ratio (CNR) were compared between recurrence group and control group. The diagnostic efficacy of conventional MRI and DWI in local recurrence of rectal carcinoma patients after radical resection were calculated by receiver operator characteristic curve (ROC). Results Conventional MRI showed that the local recurrence of rectal carcinoma patients after radical resection showed uneven thickened of intestinal wall, slightly long T1, long T2 signal, the signal on DWI sequence increased significantly and showed low signal on ADC map, and slight enhancement of scar tissue in patients without local recurrence after radical resection. The signal intensity value and CNR level of the recurrence group were higher than that of the control group, while the ADC value was lower than that of the control group, and the differences were statistically significant (P < 0.05). ROC curve analysis showed that the sensitivity of conventional MRI in the diagnosis of local recurrence after radical resection for rectal cancer was 92.00%, the specificity was 95.00%, and the area under the curve (AUC) was 0.731. The sensitivity of DWI in the diagnosis of local recurrence after rectal cancer was 96.00%, specificity was 93.00%, AUC was 0.815. The AUC of DWI was higher than that of conventional MRI, but the difference was not statistically significant (P > 0.05). Conclusion DWI has higher diagnostic value for local recurrence of rectal carcinoma patients after radical resection, and has higher diagnostic efficiency than conventional MRI. It is worthy of clinical application.
		2019 Vol. 16 (16): 129-133,137 [Abstract] ( 193 ) HTML (1 KB) PDF (869 KB) ( 77 )

	133	Correlation between ultrasound tumor volume doubling time and breast cancer tumor proliferation/invasion molecule expression
		HAN Yanfeng1 ZOU Shuwei2 WANG Baohua3▲
		Objective To investigate the relationship between ultrasound tumor volume doubling time (TVDT) and breast cancer tumor proliferation/invasion molecule expression. Methods From December 2016 to June 2018, 85 patients with breast cancer were selected from Taizhou Integrated Chinese and Western Medicine Hospital Zhejiang Province ("our hospital" for short). Another 56 patients in our hospital with breast adenoma diagnosed by pathology were selected. The patients were evaluated by three-dimensional ultrasound and TVDT was calculated. The pathological indexes of breast cancer and breast adenoma were analyzed statistically. Results The level of TVDT in breast cancer tumors was significantly lower than that in breast adenomas (P < 0.05), and the level of TVDT in patients with invasive ductal carcinoma was significantly lower than that in patients with ductal carcinoma in situ (P < 0.05). The proliferation-promoting genes, anti-proliferative genes, invasive genes, and anti-invasive genes were significantly different from the control group (P < 0.05). Pearson test showed that the level of TVDT in breast cancer was closely related to the expression of genes related to proliferation and invasion (\|r\| > 0.5, P < 0.05). Conclusion Abnormal TVDT levels may occur in patients with breast cancer, and the degree of reduction is closely related to the expression of genes involved in proliferation and invasion of breast cancer patients. Therefore, based on the level of TVDT, the therapeutic effect and prognosis of breast cancer patients can be evaluated.
		2019 Vol. 16 (16): 133-137 [Abstract] ( 187 ) HTML (1 KB) PDF (657 KB) ( 81 )

	138	Effects of Atorvastatin on glycogen synthase kinase-3 in lymphocytes of carotid atherosclerotic plaques in patients with early chronic kidney disease
		SUN Yinyi1 ZHANG Qingde2 LI Songhua3 QU Zhongsen4
		Objective To explore the effects of Atorvastatin on glycogen synthase kinase-3 (GSK-3) in lymphocytes of carotid plaques in patients with early chronic kidney disease (CKD). Methods One hundred and forty-three patients with CKD 1-2 and carotid plaque from January to October 2017 in East Branch of Shanghai Sixth People′s Hospital Affiliated to Shanghai University of Medicine & Health Sciences and Heze Municipal Hospital were enrolled and divided into CKD group (76 cases) and treatment group (67 cases) according to random number table method. At the same time, 50 normal people over the age of 42 years were selected as the control group. The treatment group received oral Atorvastatin 20 mg/night. After 6 months of treatment, the activity and expression changes of GSK-3β and GSK-3β at Ser9 in peripheral blood lymphocytes of patients at different time points were observed. The GSK-3 activity was measured by 32P liquid scintillography for incorporated radioactivity, and the phosphorylation of GSK-3β at Ser9 and the total GSK-3β were determined by Western blot. Results Before treatment, compared with the control group, the carotid intima-media thickness (IMT) was significantly thicker (P ＜ 0.01), and the activity of GSK-3β was significantly decreased (P ＜ 0.01), and the phosphorylation of GSK-3β at Ser9 was significantly increased in lymphocytes in CKD group (P ＜ 0.01). When the treatment group treated with Atorvastatin for 6 months, the thickened IMT was reversed (P ＜ 0.05), and the activity of GSK-3 was resumed (P ＜ 0.01), and the phosphorylation of GSK-3β at Ser9 was decreased as compared with CKD group(P ＜ 0.01). Conclusion Lower activities of GSK-3 in lymphocytes of patients with early CKD might be associated with the formation and promotion of carotid atherosclerosis plaque. Atorvastatin might inhibit carotid atherosclerotic plaques by increasing activity of GSK-3 in phosphorylation of GSK-3β at Ser9.
		2019 Vol. 16 (16): 138-142,146 [Abstract] ( 155 ) HTML (1 KB) PDF (548 KB) ( 48 )

	143	Comparison of efficacy of oral Vitamin D in the treatment of vitamin D deficiency in infants of Han nationality and Uygur nationality
		ZHU Ranke1 YAN Huiheng2 LIU Ying2 WU Jieling1▲
		Objective To study the difference between Han and Uygur children with vitamin D deficiency after the same treatment. Methods One hundred Han children and 100 Uygur children who were diagnosed with vitamin D deficiency and treated in Kashi Maternal and Child Health Care Hospital from May 2015 to December 2016 were recruited and divided into Han nationality group and Uygur nationality group. The serum 25OHD values of each child were recorded at the beginning. There were no significant differences in age, sex and initial 25OHD level between the two groups (P ＞ 0.05). The treatment plan was to take 800 U Vitamin D3 daily. The serum 25OHD level was reexamined every three months. The treatment would stop while one′s serum 25OHD level was more than 75 nmol/L. The variation of serum 25OHD levels between the two groups during the same cycle were compared. Results The serum 25OHD of the children in the Han nationality group and Uygur nationality group increased significantly at each review every three months compared with the serum 25OHD values at the beginning (P ＜ 0.05). The serum 25OHD of the children in Han nationality group was significantly higher than that of the children in Uygur nationality group at each review (P ＜ 0.05). After the same treatment time, the variation of serum 25OHD in Han nationality group was significantly bigger than that in Uygur nationality group (P ＜ 0.05). Conclusion This treatment plan has a good curative effect on Han and Uygur children, and can effectively improve the serum 25OHD level in children with vitamin D deficiency. However, the effect of this plan on Uygur children is worse than that on Han children. It should be considered to increase the daily supplementary dose of Vitamin D in Uygur children.
		2019 Vol. 16 (16): 143-146 [Abstract] ( 193 ) HTML (1 KB) PDF (449 KB) ( 129 )

	147	Study on clinical characteristics and risk factors for infection of Imipenem-heteroresistant Enterobacter cloacae
		ZHOU Yanjun1 JIA Xiaojiong1 HE Jianchun1 XIA Yun2
		Objective To investigate clinical characteristics and risk factors for infection of Imipenem-heteroresistant Enterobacter cloacae. Methods By means of case-control study, a total of 138 strains of Enterobacter cloacae isolated from the aseptic fluid samples of hospitalized patients from the First Affiliated Hospital of Chongqing Medical University from January 2014 to December 2016 were collected. Imipenem-resistant strains of Enterobacter cloacae were used as experimental group (115 strains) and non-heterogeneous drug-resistant strains as control group (23 strains). The disk diffusion was used for screening heteroresistance and PAP test confirmed the heteroresistance. The risk factors of patients'case data were analyzed by statistical method. Results There were 115 strains (83.3%) showed heteroresistance to imipenem. The rate of separation of hepatobiliary department was 34.1%. From the type of isolated specimens, most of them were derived from blood samples and the isolation rate was 35.5%. The results of multivariate analysis showed that male (OR = 3.40, 95%CI: 1.16-9.92), catheter (OR = 3.74, 95%CI: 1.25-11.24), central venous catheter (OR = 3.65, 95%CI: 1.22-10.89) and use of carbapenem antibiotics (OR = 6.79, 95%CI: 1.48-31.14) were independent risk factors for infection of Imipenem-heteroresistant Enterobacter cloacae (P < 0.05). Conclusion Clinical indications for antimicrobial agents should be strictly controlled and invasive procedures should be regulated to reduce the emergence and prevalence of heteroresistant bacteria.
		2019 Vol. 16 (16): 147-150 [Abstract] ( 171 ) HTML (1 KB) PDF (623 KB) ( 116 )

	151	Analysis of grey area of Treponema pallidum specific antibody detection
		ZHAO Jing BIAN Chengrong LI Boan WANG Han
		Objective To investigate the grey area of Treponema pallidum specific antibody detected by chemiluminescent immunoassay, and improve the validity and accuracy of syphilis laboratory diagnosis. Methods The patients with cut-off (S/CO) value 1 to 9 (assumed grey area) of Treponema pallidum specific antibody detected by chemiluminescent immunoassay from February 2016 to May 2018 were collected from the Fifth Medical Center in General Hospital of PLA. The false positive rate of chemiluminescent immunoassay in grey area was evaluated by using the methods of reverse detection process of syphilis laboratory and the results of immunoblotting as gold standard. Results A total of 25 190 cases were detected by chemiluminescent immunoassay, and 462 cases (1.83%) were observed within grey area. The false positive rate was 0.74% in 234 cases with S/CO values ranging from 1 to 3, 0.27% in 109 patients with S/CO values ranging from greater than 3 to 6, and 0.12% in 119 patients with S/CO values ranging from greater than 6 to 9. There was a significant difference among three groups (P < 0.05). Comparison of S/CO values in greater than 6 to 9 patients with lower false positive rate, the false positive rate of S/CO value greater than 6 to 7 was 0.072%, the false positive rate of S/CO value greater than 7 to 8 was 0.024%, the false positive rate of S/CO value greater than 8 to 9 was 0.020%, and the difference between three groups was statistically significant (P < 0.05). Conclusion In the assumed grey area, when the specific antibody of Treponema pallidum is detected by chemiluminescent immunoassay, the false positive rate showes a decreasing trend with the increase of S/CO value. The gray area should be set to S/CO value of 1 to 7.
		2019 Vol. 16 (16): 151-154 [Abstract] ( 232 ) HTML (1 KB) PDF (631 KB) ( 204 )

	155	Relationship between the level of serum TNF-α, BNP, Cys-C and heart-kidney function in patients with chronic heart failure
		DAI Hongmei ZHU Yifang
		Objective To investigate the level of serum tumor necrosis factor-α (TNF-α), brain natriuretic peptide (BNP) and cystatin-C (Cys-C) in patients with chronic heart failure (CHF) and their relationship with heart-kidney function. Methods Niney-five cases of patients with CHF in the Third People′s Hospital of Chengdu City in Sichuan Province from July 2016 to July 2018 were selected as study group, in addition, 68 cases of healthy volunteers in same physical examination center were selected as control group. Serum levels of TNF-α, BNP and Cys-C were measured by enzyme-linked immunosorbent assay, and left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMI) were measured by color Doppler ultrasonic unit. Renal function related indicators were also detected，included serum creatinine (Scr), blood urea nitrogen (BUN) and glomerular filtration rate (GFR). The correlation between serum biological indicators and heart-kidney function indexes was analyzed. Results The serum levels of TNF-α, BNP, Cys-C, LVEDD, LVMI, Scr and BUN in study group were significantly higher than those in control group, while the levels of LVEF and GFR in study group were significantly lower than those in control group, the differences were statistically significant (P < 0.05). With the increase of cardiac function and the aggravation of renal function, the levels of TNF-α, BNP and Cys-C of patients with CHF increased significantly, the differences were statistically significant (P < 0.05). The levels of TNF-α, BNP and Cys-C were positively correlated with LVEDD, LVMI, Scr and BUN (P < 0.05), but negatively correlated with LVEF and GFR (P < 0.05). Conclusion The elevation of serum TNF-α, BNP and Cys-C level is closely related to the cardiac function and the degree of renal injury in CHF patients. It can be used in clinical diagnosis and prognosis evaluation of CHF.
		2019 Vol. 16 (16): 155-158,162 [Abstract] ( 214 ) HTML (1 KB) PDF (622 KB) ( 144 )

	159	Changes and clinical significance of serum thyrotropin and thyroid peroxidase antibody level in patients with intrahepatic cholestasis in pregnancy
		PANG Liansheng ZHAO Wanchun
		Objective To investigate the changes and clinical significance of serum thyrotropin (TSH) and thyroid peroxidase antibody (TPOAb) level in patients with intrahepatic cholestasis in pregnancy (ICP). Methods A total of 120 patients with ICP admitted to the Second People′s Hospital of Jingzhou City in Hubei Province ("our hospital" for short) from March 2015 to March 2017 was selected as observation group. The patients of observation group were divided into mild group (n = 59) and severe group (n = 61) according to the severity of ICP. Another 60 healthy pregnant women who had normal physical examination in our hospital during the same period were selected as control group. The serum TSH and TPOAb level was measured by enzyme-linked immunosorbent assay. The serum TSH and TPOAb level of control group and observation group was compared. Change of serum TSH and TPOAb level of the pregnant women with different severity of ICP was compared. Pearson correlation analysis was used to analyze the correlation between serum TSH and TPOAb. The incidence of neonatal complications and adverse pregnancy outcomes in control group and observation group was recorded. Results The serum TSH and TPOAb levels in observation group were significantly higher than those in control group, the differences were statistically significant (P < 0.05). The serum TSH and TPOAb levels of severe group were higher than those in mild group, the differences were statistically significant (P < 0.05). The total incidence of neonatal complications and adverse pregnancy outcomes in observation group were higher than those in control group, the differences were statistically significant (P < 0.05). Pearson correlation analysis showed that serum TSH and TPOAb was positively correlated with the severity of ICP (r = 0.532, 0.503, P < 0.05). Conclusion The level of serum TSH and TPOAb of ICP patients is highly expressed. With the aggravation of ICP, the level of TSH and TPOAb increased continuously. The above serological indicators can be considered as one of the biological indicators for the diagnosis of ICP.
		2019 Vol. 16 (16): 159-162 [Abstract] ( 204 ) HTML (1 KB) PDF (557 KB) ( 74 )

	163	Relationship between serum sex hormone level and Th1/Th2 balance and endothelial function in perimenopausal women
		YANG Xueming1 CHEN Zongyao2 WANG Dengchao2
		Objective To study the relationship between serum sex hormone level and Th1/Th2 balance and endothelial function in perimenopausal women. Methods 40 perimenopausal women admitted in Deyang Maternal and Child Health Hospital in Sichuan Province ("our hospital" for short) from March 2016 to March 2018 were selected as perimenopausal group, 40 menopausal women served as menopausal group. At the same time, 40 healthy women who underwent physical examination in our hospital served as normal control group. The level of serum sex hormone, Th1/Th2 related cytokines and endothelial injury markers was compared among three groups of women, and their correlation was analyzed. Results The level of serum estradiol (E2) in normal control group, perimenopausal group and menopausal group decreased gradually. The level of serum follicle stimulating hormone (FSH) increased gradually, and the difference of serum E2 and FSH among three groups was significant (P < 0.05). Serum level of interleukin-2 (IL-2) and interferon-γ (IFN-γ) increased gradually in normal control group, perimenopausal group and menopausal group, while level of IL-4 and IL-10 decreased gradually. There was significant difference in serum level of IL-2, IFN-γ, IL-4 and IL-10 between each group (P < 0.05). The level of serum nitric oxide (NO) decreased gradually in normal control group, perimenopausal group and menopausal group, while the level of serum endothelin-1 (ET-1) increased gradually. There was significant difference in NO and ET-1 among groups (P < 0.05). Pearson correlation analysis showed that serum E2 was negatively correlated with IL-2, IFN-γ and ET-1, but positively correlated with IL-4, IL-10 and NO in perimenopausal women. Serum FSH was positively correlated with IL-2, IFN-γ and ET-1, but negatively correlated with IL-4, IL-10 and NO (all P < 0.05). Conclusion Serum sex hormone level in perimenopausal women may affect Th1/Th2 balance and lead to endothelial dysfunction.
		2019 Vol. 16 (16): 163-166 [Abstract] ( 160 ) HTML (1 KB) PDF (555 KB) ( 90 )

	167	Problems and countermeasures analysis of research institution office automation system
		KONG Chen YE Xianrong
		It is an inevitable choice to carry out office automation (OA) for scientific research institutions in the information age. There are a number of drawbacks in the current office automation construction of research institutions in terms of working methods, thinking patterns, need analysis, overall planning, promotion effort, and security as well. According to our experiences of the office automation construction of OA system in writer′s unit, it is proposed that office automation construction of research institution needs to focus on improving the attention of every department, establishing the system applicable to the office automation system, emphasizing on the secondary software development, strengthening the training of talents and normal users, implementing office automation in stages and steps, and to ensure the system security.
		2019 Vol. 16 (16): 167-170 [Abstract] ( 174 ) HTML (1 KB) PDF (492 KB) ( 93 )

	171	Application value of portable venous puncture auxiliary equipment in the medical support of basic troops
		ZHANG Wei1 LI Ping1 YE Ling2 ZHANG Manli1
		Objective to investigate the application effect of portable venipuncture auxiliary equipment in the basic unit, and collect the suggestions and suggestions for the use of the equipment, so as to further improve and perfect the equipment. Methods In September, 2018, 127 soldiers of two basic training units in different battle zones were selected as the research objects. According to the random number table method, 63 cases in the control group, were treated with the routine venipuncture method for intravenous infusion, and 64 cases in the experimental group were treated with venipuncture. A portable venipuncture accessory was used to compare the success rate of single venipuncture between the two groups and time consuming of establishing a single venous pathway and the incidence of pain. Results The success rate of single puncture in the experimental group was significantly higher than that in the control group (P < 0.05), and the time consuming in establishing a single venous pathway in the experimental group was lower than that in the control group (P < 0.05). The incidence of pain in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion Portable venipuncture auxiliary device can improve the success rate of puncture, the pain degree of patients and the establishment time of pulse pathway are greatly reduced, and the working pressure of the basic unit health worker is reduced, the working efficiency is improved, which is suitable for the venipuncture work of the basic unit.
		2019 Vol. 16 (16): 171-173,177 [Abstract] ( 205 ) HTML (1 KB) PDF (593 KB) ( 116 )

	174	Study on influencing factors of catheter-related infection in hemodialysis patients and nursing countermeasures
		WANG Jing1 HUANG Wenzhi2 CHEN Junjun1 LIN Daxiu1
		Objective To study the influencing factors and nursing strategies of catheter-related infection (CRBSI) in hemodialysis patients. Methods From January 2016 to December 2017, 450 patients with hemodialysis in West China Hospital of Sichuan University who had established venous catheter access were selected as subjects for retrospective analysis. The general data, clinical treatment plan and the information of postoperative infection of the patients were collected. Multiple factors Logistic regression analysis was used and related nursing countermeasures were worked out. Results The incidence of CRBSI in hemodialysis patients was 18.22% (82/450). All patients were divided into uninfected group and infected group. The results of univariate analysis showed that: these two groups have obvious difference in age, WBC count (WBC), erythrocyte count (RBC), hematocrit (HCT), hemoglobin (Hb), creatinine (SCr), urea nitrogen (BUN), parathyroid hormone (PTH) and indwelling catheter time, times of intubation and diabetes mellitus, and the differences were statistically significant (P < 0.05). Multivariate analysis showed that age (OR = 2.084, 95%CI: 1.812-15.825, P = 0.007), catheterization time (OR = 2.556, 95%CI: 1.842-21.794, P = 0.000), hemoglobin (OR = 1.988, 95%CI: 1.235-14.506, P = 0.013) and diabetes mellitus (OR = 2.646, 95%CI: 2.005-7.487, P = 0.026) were independent risk factors for CRBSI in hemodialysis patients. Conclusion The time of catheterization, age, hemoglobin and diabetes mellitus are the risk factors of CRBSI in hemodialysis patients with venous catheterization. It is necessary to improve the aseptic awareness and operation level of nurses when making clinical nursing plan.
		2019 Vol. 16 (16): 174-177 [Abstract] ( 174 ) HTML (1 KB) PDF (501 KB) ( 112 )

	178	Influence of family′s participatory extended nursing on early rehabilitation of home-dwelling patients with permanent pacemaker implantation
		ZHOU Jiali LIANG Jingyu TAO Jing
		Objective To probe into the influence of family′s participatory extended nursing on early rehabilitation of home-dwelling patients with permanent pacemaker implantation. Methods From July 2016 to June 2017, 62 patients who had permanent pacemaker implantation and discharged from the Department of Cardiology, Renmin Hospital of Wuhan University were collected. All of them were divided into intervention group and control group according to the time of admitting. Patients in the control group received the routine care and the telephone follow-up after discharged, the intervention group received the routine care and family members′ synchronization health education, family members participated in the patient′s extended nursing. After three months, the implementation rate of early exercise and activity ability of operative limb after permanent pacemaker implantation in two groups were compared. Results The implementation rate and activity ability of operative limb of the intervention group were higher than the control group (P < 0.01). Conclusion Family′s participatory extended nursing is beneficial to the recovery of function of home-dwelling permanent pacemaker implantation patients, it can reduce the risk of complication.
		2019 Vol. 16 (16): 178-封三 [Abstract] ( 185 ) HTML (1 KB) PDF (668 KB) ( 87 )

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