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2017 Vol. 14, No. 20 Published: 2017-07-15

	4	The role of the polymorphism of CYP2C9 in Warfarin anticoagulation therapy for patients with atrial fibrillation
		LYU You YANG Jiefu
		Objective To investigate the significance of CYP2C9 gene polymorphism in Warfarin anticoagulation therapy for patients with atrial fibrillation, in order to explore the causes of Warfarin individual difference. Methods The 3rd and 7th exon of CYP2C9 in 100 patients with atrial fibrillation given Warfarin anticoagulation therapy in Beijing Hospital were detected by PCR and restriction enzyme digestion. The genotype and allelic frequencies were calculated and patients information, coagulation function and the individual Warfarin dosage requirements were recorded. Results In this group of patients with atrial fibrillation given Warfarin anticoagulation therapy, two kinds of allele were detected: CYP2C91 and CYP2C93, the frequency of 1 allele and 3 allele was 96% and 4% respectively. CYP2C91/1 was the most common genotype, with the frequency of 92%. The frequency of CYP2C91/3 was 8% in these 100 patients. After similar target INR range (2.0-3.0) achieved, variant CYP2C91/3 homozygotes or heterozygotes required lower daily mean maintain doses [(2.14±0.55) mg] than wild-type CYP2C91/1 patients did [(3.17±0.74) mg], with statistically significant difference (P < 0.05). Conclusion Polymorphism of CYP2C9 is associated with Warfarin dose requirements in patients with atrial fibrillation, which is partly the factor causing Warfarin individual difference .
		2017 Vol. 14 (20): 4-7 [Abstract] ( 144 ) HTML (1 KB) PDF (796 KB) ( 201 )

	8	Construction of prokaryotic expression vector and preparation of mouse bile salt dependent lipase protein
		YANG Yi SONG Huanlei QIAN Linxi
		Objective To construct a prokaryotic expression system for mBSDL in E. coli BL21 (DE3) cells and prepare the active mBSDL protein. Methods mBSDL cDNA was amplifed via PCR and inserted into the prokaryotic expression vector pET-28b. The expression of recombinant protein was induced by IPTG in E. coli BL21 cells. Then it was purified via His Trap FF crude purification system and refolded via dialysis system. The specificity of mBSDL protein was analyzed by Western blot. Results The prokaryotic expression vector pET-28b-mBSDL expressing mBSDL protein was successfully constructed and transformed into E. coli BL21(DE3) cells. The mBSDL protein was present as insoluble inclusion bodies in the bacterial extract. Western blot reveled that the purification of this recombinant protein was successful. Conclusion mBSDL protein in E. coli prokaryotic expression system is established successfully. The study provides some foundation for the further analysis of mBSDL protein.
		2017 Vol. 14 (20): 8-11 [Abstract] ( 164 ) HTML (1 KB) PDF (857 KB) ( 41 )

	12	Role of angiotensin-(1-7)/angiotensin-Ⅱin kidney ischemia-reperfusion injury by regulating Nrf2/HO-1 pathway in diabetic rats
		SUN Qian ZENG Cheng DUAN Weina MENG Qingtao XIA Zhongyuan
		Objective To investigate the role of angiotensin-(1-7）/angiotensin-Ⅱ[Ang-(1-7）/Ang-Ⅱ] in kidney ischemia-reperfusion injury by regulating NF-E2-related factor-2 (Nrf2)/heme oxygenase-1 (HO-1) pathway in diabetic rats. Methods Sixty male SD rats were randomly divided into four groups: Sham group, kidney ischemia-reperfusion group (IR group), diabetic group (DS group), diabetic+KIR group (DIR group), with 15 rats in each group. Kidney ischemia reperfusion model of STZ-diabetic rat model was used. After 24h reperfusion, blood urea nitrogen (BUN), creatinine (Cr), and neutrophil gelatinase-associated lipocalin (NGAL) levels in serum were measured. Renal histology was observed and evaluated. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels in renal tissues were detected. Western blot were used to observe the expression levels of Ang-(1-7), Ang-Ⅱ and Nrf2, HO-1 in renal tissues. Results Expressions of Ang-(1-7) in DS group were higher than those in sham group (P < 0.05), the expressions of Ang-(1-7) in IR group were lower than those in sham group (P < 0.05), the expressions of Ang-(1-7) in DIR group were much lower than those in IR group (P < 0.05). The expressions of Ang-Ⅱ in IR and DS group were higher than those in Sham group (P < 0.05), the expressions of Ang-Ⅱ in DIR group were higher than those in IR and DS group (P < 0.05). The expressions of Nrf2 and HO-1 in IR and DS group were higher than those in sham group (P < 0.05), the expressions of Nrf2 and HO-1 in DIR group were lower than those in IR and DS group (P < 0.05). Compare with Sham group, BUN, Cr and NGAL in serum and MDA levels in the renal tissues were increased, and SOD levels were decreased in IR and DS group (P < 0.05). Compare with IR and DS group, BUN, Cr and NGAL in serum and MDA levels in the renal tissues were further increased (P < 0.05), and SOD levels were further decreased in DIR group (P < 0.05). Conclusion Ischemia reperfusion might inhibit the Ang-(1-7), activate the Ang-Ⅱ and down regulate the anti-oxidative stress of Nrf2/HO-1 pathway, resulting in the damage of diabetic kidney.
		2017 Vol. 14 (20): 12-15,35 [Abstract] ( 153 ) HTML (1 KB) PDF (1144 KB) ( 104 )

	16	Study on the sensitivity of colon cancer cells for Oxaliplatin enhanced by RNA interference in the expression of vascular endothelial growth factor receptor-2
		YANG Ping WEI Jianchang CHEN Huacui ZHANG Tong ZENG Shanqi CAO Jie
		Objective To study the inhibitory effect of RNA interference in the expression of vascular endothelial growth factor receptor-2 (VEGFR-2) for the growth of human colon cancer cells and the chemosensitive effect of Oxaliplatin. Methods The expression plasmid of small interferon RNA (siRNA) targeting VEGFR-2 gene was constructed and human colon cancer cell line SW480 was transfected. The effect of VEGFR-2 siRNA for the expression of human colon cancer cells SW480 VEGFR-2 mRNA and protein was detected by RT-PCR and Western blot. The effect of siRNA or combining with Oxaliplatin for the cell proliferation and apoptosis was detected by MTT assay and flow cytometry. Results The mRNA and protein expression of VEGFR-2 were significantly down-regulated by VEGFR-2 siRNA (P ＜ 0.05). The combination of VEGFR-2 siRNA and Oxaliplatin could slowdown the growth of colon cancer cells, inhibit the proliferation, and significantly increase the inhibition of cell proliferation and apoptosis (P ＜ 0.05). Conclusion Silencing VEGFR-2 gene by the siRNA technology can inhibit the proliferation of SW480 cells, induce the apoptosis of SW480 cell, and enhance the chemotherapy sensitivity of Oxaliplatin for human colon cancer cells.
		2017 Vol. 14 (20): 16-19 [Abstract] ( 185 ) HTML (1 KB) PDF (727 KB) ( 52 )

	20	Culture and identification of rabbit bone marrow stromal stem cells
		DENG Chenhong1 WANG Fei2 WANG Wenlan1
		Objective To investigate the methods and effects of the establishment and identification of rabbit bone marrow stromal stem cells. Methods 6 New Zealand rabbits of SPF grade were selected and sacrificed, and the bilateral femoral bone were separated and the bone marrow was given to aspiration, the rabbit bone marrow stromal stem cells were separated and purified by adherent culture method, after several passages, the cell surface antigen was detected by flow cytometry. And the BrdU was used to label bone marrow stromal stem cells. And the bone marrow stromal stem cells were injected into the rabbit brain,1 and 3 weeks after the brain for paraffin sections and immunofluorescence staining. Results The purified bone marrow stromal cells could be obtained by adherent culture method. Immunocytochemical staining showed that the CD44+ cell rate in bone marrow stromal stem cells was over 90%, and the nuclei were not stained. The CD90+ cell rate and CD34+ cell rate in cultured bone marrow stromal cells by flow cytometry were 94.5% and 0.24%. BrdU markers showed that bone marrow stromal cells could be synthesized into DNA, and the percentage of labeled cells was above 40%. Conclusion The cultured rabbit bone marrow cells are polygonal, juvenile short spindle, it can obtain purified bone marrow stromal stem cells, BrdU can be used as one of the ideal markers of bone marrow stromal stem cells in vivo.
		2017 Vol. 14 (20): 20-22 [Abstract] ( 195 ) HTML (1 KB) PDF (709 KB) ( 45 )

	23	Effect of zero-ray radiofrequency ablation under the guidance of three-dimensional mapping system in the treatment of atrioventricular nodal reentrant tachycardia
		YAN Yifei1 LI Jinyi2▲ ZHONG Guoqiang2 HE Yan2 WEN Weiming2 ZHENG Mengbing2 WANG Lingling2 WANG An2
		Objective To compare feasibility, effectiveness and safety of zero-ray and conventional X-ray radiofrequency ablation under the guidance of Ensite system or CARTO 3 mapping system in the treatment of atrioventricular nodal reentrant tachycardia. Methods 82 patients with atrioventricular nodal reentrant tachycardia treated by radiofrequency catheter ablation in Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University from January 2014 to April 2016 were selected. Patients were divided into three-dimensional group (42 patients) and conventional group (40 patients) according to whether or not X-ray performed during the mapping process. Puncture blood vessels and place the mapping electrode time, target mapping time, total discharge time, total operation time, X-ray exposure and exposure time, surgical complications and follow-up observation efficacy of two groups were compared. 42 patients of three dimensions group were divided into CARTO 3 (20 cases) and Ensite (22 cases) according to mapping system used in operation. Total operation time, the electrode time, the target time and the number of discharges of two mapping systems were compared. Results In three-dimensional group and conventional group, the immediate success rate was 100%, without any recurrence after operation. Target mapping time, total discharge time, total operation time, X-ray exposure and exposure time of three-dimensional group were significantly shorter than or lower than those of conventional group, the differences were statistically significant (P < 0.01). Two mapping systems was compared, total operation time, place the electrode time of Ensite were shorter than those of CARTO 3 (P < 0.05). There was no significant difference between target time and the number of discharges (P ＞ 0.05). Conclusion Zero-ray radiofrequency ablation under the guidance of three-dimensional anatomical mapping system in the treatment of atrioventricular nodal reentrant tachycardia with high success rate, no X-ray damage, has important clinical value.
		2017 Vol. 14 (20): 23-27 [Abstract] ( 192 ) HTML (1 KB) PDF (939 KB) ( 110 )

	28	Research progress of Smad4 in colorectal cancer
		SONG Dan XIAO Kuang ZHENG Yongbin▲
		Smad4 protein，encoded by tumor-suppressing gene Smad4, is a signal transduction medium of TGF-βsignaling pathway, regulating the proliferation，differentiation and apoptosis of cells. It is reported that Smad4 plays an important role in colorectal cancer and low expression of Smad4 is negatively related to the colorectal cancer development. This paper mainly review the research progress on the expression and function of Smad4 in colorectal cancer at home and abroad.
		2017 Vol. 14 (20): 28-31 [Abstract] ( 197 ) HTML (1 KB) PDF (463 KB) ( 47 )

	32	Clinical problems and research progress of perioperative analgesicof laparoscopic surgery
		ZHENG Yamin WANG Yuehua LI Fei
		Postoperative pain affects the recovery and effective pain control is important content of perioperative management. Compared laparoscopic surgery with open operation, incision is minimal and pain of incision is mild. But many factors make pain except incision pain, that may be worthy of attention and studying. Different patient has individual pain sensitivity and pain control requirements. It is important to analysis the cost, effect and safety to make sure the method of perioperative analgesic for different patients; it is recommended for multimodal analgesia model, including local incision pain control and systemic analgesia. Choosing appropriate medicine maybe, not only effectively control pain, but also decrease risk of side effects.
		2017 Vol. 14 (20): 32-35 [Abstract] ( 145 ) HTML (1 KB) PDF (460 KB) ( 115 )

	36	Study progress of tissue-engineered cartilage in repairing cartilage defect
		ZHANG Zhijin1 ZENG Linru2 ZHU Fangbing3 GUO Lin4
		The pain and joint movement disorder caused by articular cartilage defects have seriously affected the quality of life of patients. The application of tissue engineering technology in the repair of cartilage defects has become a hot topic in research, which provides a new idea for its treatment. In this paper, we review the research progress of tissue engineering to repair cartilage defects on the basis of the requirements, sources and methods of seed cells, the requirements and types of biological scaffold, and the regulation of cell growth factors.
		2017 Vol. 14 (20): 36-39,61 [Abstract] ( 165 ) HTML (1 KB) PDF (859 KB) ( 33 )

	40	Study on knowledge, attitude, practice status and influencing factors of venous thromboembolism among medical staffs
		LI Fengling1,2 JIANG Guolu3,4 LI Shanshan5 DENG Meihong6 CUI Lijun2
		Objective To explore the knowledge, attitude, practice (KAP) status and influencing factors of venous thromboembolism (VTE) among medical staffs. Methods A self-designed VTE KAP questionnaire for medical staffs was used to investigate 268 medical staffs from Affiliated Hospital of North Sichuan Medical College in July 2016. Results The attitude of VTE had got higher scores, and the knowledge and practice of VTE had got lower scores. The regression analysis showed that the gender, age, working years and educational background were the influencing factors of knowledge and practice among medical staffs (adjusted R2=0.356, F=13.421, P ＜ 0.01 in knowledge dimension; adjusted R2=0.262, F=2.396, P ＜ 0.05 in practice dimension), and the seniority was the influencing factor of attitude among medical staffs (adjusted R2=0.336, F= 12.845, P ＜ 0.01). Conclusion The VTE KAP of medical staffs is influenced by various factors. The VTE KAP of medical staffs need to be strengthened. Hospital managers should establish a standardized VTE prevention and management system.
		2017 Vol. 14 (20): 40-43 [Abstract] ( 170 ) HTML (1 KB) PDF (395 KB) ( 113 )

	44	Application effect of early low molecular weight heparin anticoagulation therapy for thrombolysis in patients with acute myocardial infarction
		JIN Dapeng1 WANG Wenfeng1▲ ZHAO Xiujuan2 LI Yanhong3
		Objective To probe into the clinical application value of early low molecular weight heparin anticoagulation therapy for thrombolysis in patients with acute myocardial infarction. Methods From January 2014 to December 2015, 118 patients with acute myocardial infarction were selected in Affiliated Hospital of Chengde Medical College were selected as study objects. The patients were divided into treatment group (n=60) and control group (n=58) by random number table method. The patients in treatment group were treated with low molecular weight heparin before thrombolytic therapy. The patients in control group were treated with low-molecular-weight heparin 12 hours after thrombolytic therapy. The situation of recanalization, the level of inflammatory factors and adverse reactions of the patients with acute myocardial infarction in two groups were compared. Results Compared with control group, the recanalization rate of treatment group was significantly improved, and recanalization time of treatment group was further shortened, the differences were statistically significant (P < 0.05). Compared with before treatment, the levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and hypersensitive C-reactive protein (hs-CRP) were significantly decreased in two groups after treatment, the differences were statistically significant (P < 0.05). Compared with control group after treatment, the levels of TNF-α, IL-6 and hs-CRP in treatment group were significantly lower than those in control group, the differences were statistically significant (P < 0.05). There was no significant difference in total incidence of adverse reactions such as gingival bleeding, subcutaneous hemorrhage and upper gastrointestinal bleeding in two groups (P > 0.05). Conclusion Early application of low molecular weight heparin anticoagulant therapy has very important clinical value in regulating of cell inflammatory cytokines effectively, improving the rate of recanalization and shorting the recanalization time fundamentally for thrombolysis in patients with acute myocardial infarction.
		2017 Vol. 14 (20): 44-47 [Abstract] ( 185 ) HTML (1 KB) PDF (581 KB) ( 87 )

	48	Minimally invasive transthoracic device closure versus conventional surgical repair in the treatment of ventricular septal defects: a Meta-analysis
		TAN Qiming QIN Liangguang YU Bo CHEN Hongye ZHANG Jie LIU Jinping
		Objective To systematically review the efficacy and safety of minimally invasive transthoracic device closure versus conventional surgical repair in the treatment of ventricular septal defects. Methods The controlled trials concerning minimally invasive transthoracic device closure versus conventional surgical repair in the treatment of ventricular septal defects published at home and abroad were collected through searching medical databases such as MEDLINE, PubMed, Ovid, CNKI, CSCD, WanFang Data, CBM, using "ventricular septal defects, cardiopulmonary bypass, surgical repair, transthoracic device closure, perventricular device occlusion, perventricular device closure" for retrieval words from the date of establishment of the databases to November 2016. A meta-analysis was performed by using RevMan 5.3. Results Total 16 studies with 3879 patients were enrolled in this study. Meta analysis results showed that the operation success rate in the minimally invasive transthoracic device closure group was less than that of surgical repair group (OR = 0.14, 95%CI: 0.08-0.24, P ＜ 0.01), while the incidence of postoperative complications was lower than that of surgical repair group (OR = 0.51, 95%CI: 0.30-0.86, P = 0.01). The mortality rates and the hospitalization expenses were similar in both groups. The operation time (MD = -64.69, 95%CI: -73.41 - -55.96, P ＜ 0.01), postoperative respiratory machine auxiliary breathing time (MD = -6.94, 95%CI: -8.82 - -5.06, P ＜ 0.01) and the total length of hospital stay (MD = -2.30, 95%CI: -3.30 - -1.31, P ＜ 0.01) in the minimally invasive transthoracic device closure group were significantly shorter than those of surgical repair group, the differences were statistically significant. Conclusion Minimally invasive transthoracic device closure is simple, safe, with small trauma, rapid recovery compared with conventional surgical repair, which is an effective method in the treatment of ventricular septal defects within the scope of the indications.
		2017 Vol. 14 (20): 48-53 [Abstract] ( 145 ) HTML (1 KB) PDF (1834 KB) ( 50 )

	54	Association between interleukin-6 and global registry of acute coronary events score in patients with acute coronary syndrome
		LI Jingwei1▲ WANG Hong2 DU Fenghe1 XU Xiuying1 TIAN Junping1▲
		Objective To investigate the correlation between brain natriuretic peptide (BNP) level and global registry of acute coronary events (GRACE) risk score in patients with acute coronary syndrome (ACS). Methods One hundred and four patients with ACS admitted to Beijing Tiantan Hospital, Capital Medical University from June 2015 to August 2016 were selected. According to GRACE risk score, the patients with ACS were divided into low risk (GRACE: ≤108 points), intermediate (GRACE: 109-140 points) and high (GRACE: ＞140 points) 3 groups, the levels of BNP in each subgroup were detected. According to the BNP level, the patients were divided into 4 groups from Q1 to Q4, and the GRACE scores and high-risk percentages were calculated. The correlation between BNP and GRACE score was analyzed. Receiver operating characteristic (ROC) was used to analyze the area under the curve of BNP level and GRACE risk score for major adverse cardiac events (MACE) in patients with ACS during hospitalization, and to evaluate its predictive value. Results Among the 3 subgroups of ACS, the BNP in high risk group was higher than the middle risk group (P ＜ 0.05) and the low risk group (P ＜ 0.01), the differences were statistically significant. The GRACE score and high-risk percentage in group Q4 were higher than those in groups under Q4 (P ＜ 0.05). Correlation analysis showed that BNP results were positively correlated with GRACE score (r = 0.448, P ＜ 0.01). The area under the curve of baseline BNP level and GRACE score for ACS patients during hospitalization was 0.677 and 0.745, respectively, the difference was statistically significant (P ＜ 0.05). Conclusion Both BNP level and GRACE score can predict the occurrence of MACE in ACS patients during hospitalization, which may be an important prognostic indicator for ACS patients.
		2017 Vol. 14 (20): 54-57 [Abstract] ( 179 ) HTML (1 KB) PDF (674 KB) ( 46 )

	58	Expression and significance of serum IL-37, TGF-β in patients with acute ST-segment elevation myocardial infarction
		ZHOU Yaguang WU Huihui WANG Ronghua YANG Kun LIU Ya′nan WANG Kun HE Jingli PENG Chunxia
		Objective To investigate the expression and significance of serum interleukin (IL)-37, transforming growth factor β (TGF-β) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods Forty patients with STEMI diagnosed and taken percutaneous coronary intervention (PCI) in Department of Emergency, Civil Aviation General Hospital from September 2014 to September 2015 were selected as experimental group, and 40 normal regular healthy control were selected as control group. The concentration of serum IL-37, TGF-β in peripheral blood was detected by enzyme-linked immunosorbent assay (ELISA). Results The concentration of serum IL-37 in experimental group was significantly higher than that of control group (P = 0.02), the concentration of TGF-β was significantly lower than that of control group, the difference was statistically significant (P = 0.000). The concentration of IL-37 was negatively correlated with TGF-β in experimental group (r = -0.79, P = 0.00), while there was no obvious correlation between IL-37 and TGF-β in control group (r = 0.03, P = 0.86). Conclusion Both IL-37 and TGF-β are involved in the inflammatory process of STEMI. IL-37 and TGF-β has a negative correlation in the inflammatory process of STEMI. The anti-inflammatory effect of IL-37 may be related to TGF-β.
		2017 Vol. 14 (20): 58-61 [Abstract] ( 160 ) HTML (1 KB) PDF (587 KB) ( 151 )

	62	Influence of dual antiplatelet therapy on prognosis of patients with recurrent myocardial infarction after coronary stent implantation
		WANG Yao
		Objective To investigate the influence of dual antiplatelet therapy on prognosis of patients with recurrent myocardial infarction after coronary stent impantation. Methods Fifty-two cases of patients with recurrent myocardial infarction after coronary stent implantation admitted to Department of Cardiology, the First Affiliated Hospital of China Medical University from January 2014 to June 2015 were selected and randomly divided into control group and study group, with 26 cases in each group. The control group was treated with Aspirin 100 mg, and the study group was treated with Aspirin 100 mg and Clopidogrel 75 mg, total treatment for 12 months. Through blood collection, the indexes of hemorheology, cardiac troponin I (cTnI) and brain natriuretic peptide (BNP), inflammatory mediators and matrix metalloproteinases were detected before and after treatment for 12 months. Results Compared with those before treatment, the contents of blood viscosity, plasma viscosity and plasma fibrinogen were decreased significantly (P ＜ 0.05), the contents of cTnI and BNP were decreased significantly (P ＜ 0.05), the contents of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were decreased significantly (P ＜ 0.05), and the contents of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) were decreased significantly (P ＜ 0.05). Compared with those of control group, the contents of blood viscosity, plasma viscosity and plasma fibrinogen in the study group were significantly lower (P ＜ 0.05), the contents of cTnI and BNP were significantly lower (P ＜ 0.05), the contents of CRP, TNF-α and IL-1 were significantly lower (P ＜ 0.05), and the contents of MMP-2 and MMP-9 were significantly lower (P ＜ 0.05). Conclusion For patients with recurrent myocardial infarction after coronary stent implantation, intensive dual antiplatelet therapy can decrease the contents of serum cTnI and BNP, improve hemorheology and inflammatory state, and promote the prognosis.
		2017 Vol. 14 (20): 62-65,69 [Abstract] ( 172 ) HTML (1 KB) PDF (603 KB) ( 135 )

	66	Clinical effect of coronary intervention on elderly patients with angina pectoris
		REN Liangqiang LI Bin WANG Sheng LIU Shiwu MA Jianlin
		Objective To observe the clinical effect of percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease (more than 65 years old). Methods Clinical data of elderly patients with coronary heart disease in People 's Hospital of Hainan Province from January 2012 to December 2015 were retrospectively analyzed. The patients were divided into observation group (PCI treatment) and control group (simple drug therapy), each group of 100 cases. After 1 month of treatment, the clinical outcomes of two groups were compared. After 1 year of follow-up, the incidence of cardiovascular events and cardiovascular disease recurrence in two groups were recorded. The quality of life was assessed by seattle angina questionnaire (SAQ) score at 24 h before and after PCI (PCI). Followed up for 1 year, the recurrence rate and mortality were compared between two groups. Results After 1 month of treatment, total effective rate of observation group significantly higher than that of control group, the difference was statistically significant (P ＜ 0.01). After surgery of 1 year, the degree of somatic activity, the degree of angina pectoris, the frequency of angina pectoris, the satisfaction of treatment and the cognition of disease scores in observation group were significantly higher than before surgery and control group, the difference was statistically significant (P ＜ 0.05). Logistic multivariate regression analysis: the number of diseased vessels, the history of hypertension and the history of smoking were the independent influencing factors of patients with coronary heart disease and angina pectoris after PCI. Conclusion Curative effect of PCI for elderly patients with coronary heart disease angina pectoris is good. It has an objective effect to improve the quality of life of patients, reduce cardiovascular-related mortality and the incidence of adverse events. Clinicians for the number of vascular lesions, history of hypertension and smoking history of coronary heart disease in patients with angina pectoris after PCI should be closely tested, early detection, early intervention.
		2017 Vol. 14 (20): 66-69 [Abstract] ( 154 ) HTML (1 KB) PDF (590 KB) ( 44 )

	70	Estimated value of serum cystatin C for the risk stratification of non ST-elevation acute coronary syndrome patients with normal renal function
		CHEN Chao XU Tongda
		Objective To explore the estimated value of serum cystatin C (CysC) for the risk stratification of non ST-elevation acute coronary syndrome (NSTE-ACS) patients with normal renal function. Methods Two hundred and eighty patients diagnosed as NSTE-ACS by coronary angiography in Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2016 were selected as experimental group, 40 healthy subjects without NSTE-ACS diagnosed by coronary angiography were selected as control group. According to the scores of global registry of acute coronary events (GRACE), the experimental group was further divided into low risk group (≤108 points, 47 cases), moderate risk group (109-140 points, 106 cases) and high risk group (＞140 points, 127 cases). The differences of CysC between different groups and the correlation with GRACE score were explored, the independent predictive factors of GRACE scores were investigated, the estimated value of CysC for high risk of NSTE-ACS was analyzed by receiver operating characteristics (ROC), the independent predictive factors of high risk of NSTE-ACS were analyzed by Logistic multivariate regression analysis. Results The levels of CysC in experimental group were significantly higher than those of control group (P ＜ 0.05). The levels of CysC were positively correlated with GRACE scores (r = 0.561, P ＜ 0.05). The CysC is an independent predictive factor of GRACE score and high risk of NSTE-ACS (P ＜ 0.05). The ROC curve analysis showed that AUC was 0.788, P ＜ 0.05, the best cut-off point was 0.94, the sensitivity was 77%, the specificity was 72%. Conclusion The levels of CysC in NSTE-ACS patients with normal renal function are closely related to its risk stratification, which is the independent predictive factor of risk stratification and high risk of NSTE-ACS.
		2017 Vol. 14 (20): 70-73,100 [Abstract] ( 171 ) HTML (1 KB) PDF (957 KB) ( 92 )

	74	Correlation between serum iron level and cardiac function level, myocardial injury degree in patients with acute coronary syndrome
		LU Fengcai PENG Wenhui
		Objective To study the correlation between serum iron level and cardiac function level, myocardial injury degree in patients with acute coronary syndrome (ACS). Methods ACS patients treated in Changqing People's Hospital of Ji'nan City from January 2015 to December 2016 were selected and divided into unstable angina pectoris (UAP) group (30 cases), non ST segment elevation myocardial infarction (USTEMI) group (25 cases), ST segment elevation myocardial infarction (STEMI) group (35 cases) according to disease condition. The patients with stable angina (SAP) and healthy volunteers during the same period were selected as SAP group (45 cases) and control group (50 cases). Serum was collected and the contents of iron, myocardial injury indexes and oxidative stress indexes were measured, and the cardiac function parameters were measured by color Doppler ultrasound. Results The contents of cardiac ultrasound parameters end-systolic volume index (ESVI), end diastole volume indication (EDVI) and serum creatine kinase isoenzyme (CK-MB), troponin I (cTnI), myohemoglobin (Myo), malonaldehyde (MDA), advanced oxidation protein products (AOPP) of UAP group, USTEMI group, STEMI group were significantly higher than those of SAP group and control group (P ＜ 0.05), the cardiac ultrasound parameters left ventricular ejection fraction (LVEF) and contents of serum superoxide dismutase (SOD), catalase (CAT) were significantly lower than those of SAP group and control group (P ＜ 0.05); the more severe the ACS disease condition, the higher the cardiac ultrasound parameters ESVI, EDVI and serum CK-MB, cTnI, Myo, MDA, AOPP contents (P ＜ 0.05), the lower the cardiac ultrasound parameters LVEF and serum SOD, CAT contents (P ＜ 0.05). The serum iron levels were negatively correlated with cardiac ultrasound parameters ESVI, EDVI and serum CK-MB, cTnI, Myo, MDA, AOPP contents (P ＜ 0.05), which were positively correlated with cardiac ultrasound parameters LVEF and serum SOD, CAT contents (P ＜ 0.05). Conclusion The serum iron levels in ACS patients are significantly decreased, which may be correlated with cardiac function and myocardial oxidative stress degree.
		2017 Vol. 14 (20): 74-77 [Abstract] ( 159 ) HTML (1 KB) PDF (629 KB) ( 92 )

	78	Effect of Pig Anti-Human Lymphocyte Globulin combined with Cyclosporin in the treatment of severe aplastic anemia
		XUE Lianguo MAO Jianping JIA Tao WANG Ying CHEN Ze CAI Zhimei▲ ZHAO Lidong
		Objective To analyze the efficacy and safety of Pig Anti-Human Lymphocyte Globulin combined with Cyclosporin in the treatment of severe aplastic anemia. Methods A total of 30 cases hospitalized in Department of Hematology, the First People′s Hospital of Lianyungang City, Jiangsu Province from Apirl 2004 and December 2016 were enrolled into this study. The efficacy and safety of this treatment were analyzed, the overall survival by Kaplan-Meier method for this cohort of patients were estimated. Results The cohort of 30 patients was routinely followed up with a median follow-up of 60 (1-252) months, the median age was 26.5 (5-65) years old. Six died, the over response rate was 73.3%. The median time of the ANC＞0.5×109/L was 20 (2-40) days, transfusion of red blood cell independent was 30 (0-150) day, transfusion of palete independent was 30 (0-150) days, the 5-year survival rate was 78%. The response rate was high, but with less side effects and expense. Conclusion Long-term effect of Pig Anti-Human Lymphocyte Globulin combined with Cyclosporin in the treatment of severe aplastic anemia is significant, adverse reactions are mild, it is worthy of clinical promotion.
		2017 Vol. 14 (20): 78-81 [Abstract] ( 190 ) HTML (1 KB) PDF (384 KB) ( 126 )

	82	Determination of plasma lipoprotein associated phospholipase A2 level in patients with cerebral arterial thrombosis and its value analysis
		HAN Xiaoxia ZUO Ruiju
		Objective To explore the application value of plasma lipoprotein associated phospholipase A2 (Lp-PLA2) determination in patients with cerebral arterial thrombosis. Methods 112 cases with cerebral arterial thrombosis and 88 cases with hemorrhagic stroke were divided into the ischemia group and hemorrhage group, who were diagnosed in Neurology Department of Cangzhou People's Hospital ("our hospital" for short) from January 2015 to January 2016. At the same time in our hospital 200 cases of healthy people were selected as the control group. Blood lipid levels and Lp-PLA2 were detected by Roche COBAS8000 biochemical immunometer. The Lp-PLA2 levels of cerebral arterial thrombosis patients with different degree of nervous functional defects and different cerebral infarction areas were analyzed. Results There were no significant differences in age, gender distribution among the three groups (P > 0.05). The BMI, TC, TG, Lp-PLA2, LDL-C of the ischemia group were higher than those of the hemorrhage group and the control group, while the HDL-C level was lower than that of the hemorrhage group and the control group, with statistically significant differences (P < 0.05). The indexes of the hemorrhage group and the control group had no significant differences (P > 0.05). In the patients with cerebral arterial thrombosis, the Lp-PLA2 levels increased with the increasing cerebral infarction areas and degree of nervous functional defects (P < 0.05). Conclusion There are correlations between degree of nervous functional defects, cerebral infarction areas and the Lp-PLA2 levels in patients with cerebral arterial thrombosis. Lp-PLA2 detection can judge the severity of patients, which has early warning function in patients with cerebral arterial thrombosis.
		2017 Vol. 14 (20): 82-85 [Abstract] ( 194 ) HTML (1 KB) PDF (545 KB) ( 159 )

	86	Clinical analysis of acute cerebrovascular disease combined with cerebro-cardiac syndrome in 125 cases of middle-aged and elderly
		WANG Shuyin WANG Yishu LI Yun WANG Weili▲
		Objective To discuss the incidence, influential factors, clinical characteristics and preventive measures of cerebro-cardiac syndrome (CCS) in acute cerebrovascular disease (ACVD) patients of middle-aged and elderly. Methods The clinical data of 204 patients with ACVD treated in Beijing Xiaotangshan Hospital from October 2000 to October 2016 were analyzed retrospectively. The disease types, location, changes of electrocardiogram & myocardial enzymes, biochemical indexes, treatment and prognosis were observed. Results There were 125 cases combined with CCS, with incidence of 61.3%. There were 76 male and 49 female. The incidence of CCS in hemorrhagic cerebrovascular disease (intracerebral hemorrhage and subarachnoid hemorrhage) was significantly higher than that in ischemic cerebrovascular disease, with statistically significant difference (P < 0.01). The incidence of CCS in deep brain lesions (brain stem and cerebellum, thalamus and basal ganglia) was significantly higher than that in cerebral hemisphere lesions, with statistically significant difference (P < 0.01). Patients with CCS had electrocardiogram changes, including myocardial ischemia change, various arrhythmia. The results of laboratory examination showed that elevated myocardial enzymes, abnormal electrolyte and pathoglycemia. Mortality of the patients combined with CCS was significantly higher than that of patients without CCS (P < 0.01). Conclusion The occurrence of CCS is related with the disease types, location and outcomes of the disease. There is a guiding significance for the prognosis judgment of patients with ACVD and correct therapy by grasping the clinical characteristics of CCS.
		2017 Vol. 14 (20): 86-89 [Abstract] ( 176 ) HTML (1 KB) PDF (556 KB) ( 102 )

	90	Comparison of clinical effect between Lamotrigine and Carbamazepine in the treatment of trigeminal neuralgia
		TAN Zhiyong MA Yanfang
		Objective To explore the clinical effect between Lamotrigine and Carbamazepine in the treatment of trigeminal neuralgia. Methods 120 cases of patients with trigeminal neuralgia treated in Beijing Ditan Hospital, Capital Medical University from July 2014 to July 2016 were selected. Patients were divided into the Lamotrigine group and the Carbamazepine group by the random number table, each group had 60 cases. Patients in the Lamotrigine group and the Carbamazepine group were respectively given Lamotrigine and Carbamazepine treatment. VAS score, laboratory test indexes and changes of immunoglobulin levels in the cerebrospinal fluid were compared and analyzed between the two groups. Results VAS scores in 1 and 3 months after treatment in the Lamotrigine group were lower than those in the Carbamazepine group, with statistically significant differences (P < 0.05). Counts of cerebrospinal fluid cell and white blood cell after treatment in the Lamotrigine group were lower than those in the Carbamazepine group, with statistically significant differences (P < 0.05). Levels of IgG, IgA, IgM of patients after treatment in the Lamotrigine group were lower than those in the Carbamazepine group, with statistically significant differences (P < 0.05). Conclusion Lamotrigine in the treatment of trigeminal neuralgia has a significant effect, obviously better than Carbamazepine treatment, which can promote the improvement of laboratory test results, relieve pain and also improve the immune function of cerebrospinal fluid. It has great clinical significance.
		2017 Vol. 14 (20): 90-93 [Abstract] ( 183 ) HTML (1 KB) PDF (505 KB) ( 96 )

	94	A clinical study on changes of transcranial Doppler in patients with subarachnoid hemorrhage during headache attack
		KANG Zhixin
		Objective To identify the etiology of headache in patients with subarachnoid hemorrhage, in order to provide timely and effective treatment guidelines for patients. Methods The clinical data of 61 patients with subarachnoid hemorrhage treated in Neurology Department of CNPC Central Hospital from May 2010 to December 2013 were analyzed retrospectively. TCD was used to monitor the changes of MCA, PCA and BA blood flow velocity in patients with subarachnoid hemorrhage during hospitalization and headache attack. According to the results of TCD, patients were divided into two groups. Patients in group A were corresponded to cerebral vasospasm, patients in group B were not corresponded to cerebral vasospasm. The TCD indexes and treatment effect of the two groups were compared. Results There were 78 case-times (53.8%) in group A. The MCA, PCA and BA blood flow velocity of patients at headache attack were increased than at hospitalization in group A, the differences were statistically significant (P ＜ 0.05), and it was considered to be caused by cerebral vasospasm. All patients had remission after given timely and effective treatment. There were 67 case-times (46.2%) in group B. The differences of MCA, PCA and BA blood flow velocity between patients at hospitalization and headache attack in group B had no statistically significant (P > 0.05), and it was unrelated to cerebral vasospasm. 50 case-times (75%) of patients had remission after given alleviate cerebral edema treatment. Conclusion The changes of TCD monitoring data of SAH patients provide reliable evidences for cerebral vasopasm diagnosis. TCD real-time monitoring has important clinical value for finding and identifying cerebral vasopasm and cerebral edmema.
		2017 Vol. 14 (20): 94-96,112 [Abstract] ( 147 ) HTML (1 KB) PDF (829 KB) ( 127 )

	97	Stem cell transplantation for children with acquired severe aplastic anaemia
		WANG Bin1 WU Runhui1 PANG Yilin2 ZHU Guanghua1 ZHOU Xuan1 YANG Jun1 LI Sidan1 QIN Maoquan1▲
		Objective To explore the effect of hematopoietic stem cell transplantation (HSCT) in the treatment of severe aplastic anemia, and evaluate its safety and prognosis. Methods Clinical data of 51 children with severe aplastic anaemia received HSCT in Hematology Department of Beijing Children′s Hospital Affiliated to Capital Medical University from January 2006 to December 2015 were retrospectively analyzed. The engraftment, complications and curative effect were evaluated. Results 98 percent of patients had rapid engraftment. The median time of neutrophil exceeded 0.5×109/L and platelets recovery exceeded 20×109/L were 11 and 15 days for all transplantation patients. In this research, 10 patients were diagnosed with CMV viremia. 2 patients developed hemorrhagic cystitis. 7 cases had grade Ⅰ-Ⅱ aGVHD and 2 cases had grade Ⅲ aGVHD. 46 patients were still alive. The estimated 3-year OS of the Allo-HSCT, Haplo-HSCT and MUD-HSCT group was 100%, 89% and 75% respectively. All children less than 5 years of age (without infection) were transplanted successfully. Conclusion HSCT is effective in the treatment of acute severe aplastic anemia in children, with fewer complications and high survival rates
		2017 Vol. 14 (20): 97-100 [Abstract] ( 190 ) HTML (1 KB) PDF (330 KB) ( 132 )

	101	Clinical effects of laser acupuncture treatment on breast cancer-related lymphoedema
		JIN Mingzi1 ZHOU Yu1 CAO Hongping2 ZHANG Haimeng2
		Objective To observe the clinical effects and safety of laser acupuncture treatment on breast cancer-related lymphoedema (BCRL). Methods From November 2014 to March 2016, in Branch Courts of Huashan Hospital of Shanghai Fudan University, 32 BCRL patients were selected, according to random number table, they were divided into treatment group and control group, with 16 cases in each group. On the basis of conventional treatment (control group), the treatment group was given He-Ne laser acupuncture treatment on 10 selected acupuncture points. The 10 points were paired off and radiated for 25 min in a single treatment, 5 min per pair. The whole therapy lasted for six weeks, twice a week, adding up to a total of 12 times. The patients' affected arms were measured before treatment and after treatment, and also at 4th week follow-up after treatment finished. Data of two groups were compared and arm edema changes were recorded. Adverse reactions were observed all along. Results ①In treatment group, the patients' affected arm circumference before treatment was compared with after 6 weeks of treatment, their arm circumference decreased (symptoms relieved), the difference was statistically significant (P < 0.05), 4 weeks after the treatment ended, their arm circumference had kept decreasing, the differences were statistically significant (P < 0.05). In control group, the figures at baseline and 6th, 10th week after they joined were compared with before they joined, their arm circumference increasing tendency (symptoms aggravated), but the difference was not statistically significant (P > 0.05). ②After 6 weeks of treatment, the improvement rate in treatment group was more than control group, the difference was statistically significant (P < 0.05); 4 weeks after the treatment ended, the follow-up examination, the improvement rate in treatment group was more than control group, the difference was statistically significant (P < 0.05). ③ No adverse reaction reported during treatment and follow-up visits. Conclusion He-Ne laser acupuncture treatment is safe and reliable. And it has significant curative effect on BCRL.
		2017 Vol. 14 (20): 101-104 [Abstract] ( 137 ) HTML (1 KB) PDF (533 KB) ( 114 )

	105	Comparison of effect, T lymphocyte subsets and quality of life between laparoscopic extraperitoneal radical prostatectomy and prostatectomy by open surgery in patients with prostate cancer
		LI Zhikun TANG Lei ZHAO Yawei MA Liujiang MA Wang
		Objective To compare the effect, T lymphocyte subsets and quality of life between laparoscopic extraperitoneal radical prostatectomy and prostatectomy by open surgery in patients with prostate cancer. Methods From January to Dctober 2016, in Department of Urology, Xinjiang Production and Construction Corps Hospital, 105 patients with prostate cancer were selected, they were divided into the open surgery group (n = 45) and the laparoscope group (n = 60) according to operation methods. The open surgery group was given prostatectomy by open surgery, the laparoscope group was given laparoscopic extraperitoneal radical prostatectomy. International prostate symptom score (IPSS) and core quality of life questionnaire-30 (QLQ-C30) were employed to assess severity of clinical symptoms and quality of life. Then, the operation status, efficacy-related indices, lymphocyte subsets and quality of life were compared. Results All patients underwent successful operation, and the incidences of postoperative complications in the open surgery group and the laparoscope group were compared, the differences were not statistically significant (P > 0.05). 1 month after surgery, scores of IPSS, maximum urine flow rate, residual urine volume and levels of prostate specific antigen of the two groups were compared, the differences were not statistically significant (P > 0.05). Compared with the open surgery group, the laparoscope group had higher levels of CD4＋, CD4＋/ CD8＋ and lower level of CD8＋, the differences were statistically significant (P < 0.05). 1 month after surgery, compared with the open surgery group, scores of role function, emotional function and social function that reflected quality of life in laparoscope group were statistically higher,(all P < 0.05), the differences were statistically significant (P < 0.05). but scores of body function and cognitive function in the two groups were compared, the differences were not statistically significant (P > 0.05). Conclusion Both laparoscopic extraperitoneal radical prostatectomy and prostatectomy by open surgery are effective and safely operation modes for patients with prostate cancer. Compared with open surgery, laparoscopic extraperitoneal radical prostatectomy has less influence on cellular immune function and improves quality of life more after operation. For patients who are suitable for laparoscopic extraperitoneal radical prostatectomy, this operation mode is priority selection.
		2017 Vol. 14 (20): 105-108 [Abstract] ( 143 ) HTML (1 KB) PDF (530 KB) ( 31 )

	109	Nutritional risk screening and effect evaluation of enteral nutrition and parenteral nutrition in postoperative patients with gastric cancer
		YI Chunrong KUANG Xuechun
		Objective To screen nutritional risk and evaluate the effect of enteral nutrition and parenteral nutrition in postoperative patients with gastric cancer. Methods From December 2015 to December 2016, in Xiangya Hospital of Central South University, 100 patients with gastric cancer were divided into intervention group and control group, with 50 in each group. NRS2002 was used for screening nutritional risk. The control group was given total parenteral nutrition, the intervention group was given enteral nutrition and parenteral nutrition. Results Patients with gastric cancer had nutritional risk, NRS2002≥3 scores. After intervention, serum total protein, serum albumin, hemoglobin, immunoglobulin and BMI in the intervention group were better than the control group, the differences were statistically significant (P < 0.05). The incidence of complications in the intervention group (6 cases) was significantly lower than the control group (15 cases), the differences were statistically significant (P < 0.05). The time of anal exhaust and hospitalization time in the intervention group were shorter than those of control group, the differences were statistically significant (P < 0.05). The KPS of the intervention group was higher than that of the control group, the differences were statistically significant (P < 0.05). Conclusion Patients with gastric cancer had nutritional risk after operation. Enteral and parenteral nutrition can improve the nutritional status, reduce postoperative complications, and shorten the length of hospital stay, and improve the functional status of patients with gastric cancer.
		2017 Vol. 14 (20): 109-112 [Abstract] ( 158 ) HTML (1 KB) PDF (532 KB) ( 88 )

	113	Comparison analyzing of cardia cancer by radical total gastrectomy and radical proximal gastrectomy
		LI Peng YANG Weizhen▲
		Objective To dicuss comparison of cardia cancer by radical total gastrectomy and radical proximal gastrectomy. Methods from March 2013 to September 2015, in Center Hospital on Baoji City, the clinical data of 86 cardia cancer patients were retrospective analyzed, they were divided into two groups by different operation methods, radical total gastrectomy group (43 cases) and radical proximal gastrectomy group (43 cases). The general situation of operation, living quality score before and after treatment, postoperative complications, 1 year survival rate of two groups were observed and compared. Results The operation time, intraoperative blood loss, postoperative exhaust time of two groups were compared, the difference was not statistically significant (P > 0.05). The daily activity ability, daily life state, health feelings, social support, life apperception score of two groups before treatment and after treatment were compared, the difference was not statistically significant (P > 0.05). The postoperative complications, postoperative recurrence rate and 1 year survival rate of two groups compared, the difference was not statistically significant (P > 0.05). The postoperative gastric tube flow of radical proximal gastrectomy group were higher than that of radical total gastrectomy group, the daily activity ability, daily life state, health feelings, social support, life apperception score of radical total gastrectomy group and radical proximal gastrectomy group after treatment were higher than those before treatment, the differences were statistically significant (P < 0.05). Conclusion The radical total gastrectomy and radical proximal gastrectomy of cardia cancer have good clinical effect, they can increase living quality of patients after treatment, the prognosis is good, it is worth to be used.
		2017 Vol. 14 (20): 113-116 [Abstract] ( 163 ) HTML (1 KB) PDF (536 KB) ( 52 )

	117	Study on the clinical effect of Zhikang Granules in the treatment of hyperlipidemia
		ZHAO Xiumin LI Fengxue GU Jing
		Objective To explore the efficacy and safety of combination of Zhikang Granules (ZKG) and Atorvastatin in the treatment of hyperlipidemia. Methods 80 cases of patients with hyperlipidemia treated in the Second Hospital of Hebei Medical University from October 2014 to October 2015 were selected. According to the treatment methods, patients in the control group were treated with Atorvastatin, while on the basis of the control group, patients in the treatment group were treated with ZKG at the same time, with a course of 12 weeks. TC, TG, HDL-C, LDL-C were detected. The therapeutic effect was evaluated. The clinical symptom scores of traditional Chinese medicine were observed. Results After treatment, TG, TC, LDL-C in the treatment group and the control group were all lower than before treatment (P < 0.05), HDL-C in the treatment group was higher than before treatment (P < 0.05). After treatment there were significant differences in TG, TC, LDL-C, HDL-C between the two groups (P < 0.05). The total effective rate of the treatment group was 89.13%, which of the control group was 70.59%, the difference was statistically significant (P < 0.05). Compared with the control group, after treatment the clinical symptom scores of traditional Chinese medicine of lacking in strength, burnout lazy words, numbness of limb, obesity, dry stool in the treatment group were lower, with statistically significant differences (P < 0.05). Conclusion In the treatment of hyperlipidemia by ZKG combined with Atorvastatin is effective and it is better than Atorvastatin alone, which also can improve the clinical symptoms of traditional Chinese medicine.
		2017 Vol. 14 (20): 117-119,124 [Abstract] ( 161 ) HTML (1 KB) PDF (475 KB) ( 59 )

	120	Effect of lung protective ventilation on perioperative pulmonary function in elderly patients received pulmonary lobectomy of lung cancer
		TANG Yuru1,2 LI Hui2 SHUAI Xunjun2 HOU Nianguo2 SUN Mingjie2 XU Tangwen2 TENG Na2 AI Dengbin1,2
		Objective To evaluate the effect of lung protective ventilation strategies on the pulmonary function and postoperative pulmonary complications in elderly patients with pulmonary lobectomy. Methods A total of 60 elderly patients with lung cancer of ASA physical status Ⅰ-Ⅱ, aged 62-72 year, weighing 50-80 kg, who underwent elective pulmonary lobectomy surgery in Municipal Hospital of Qingdao from January to December 2014 were seleced. All patients were divided into two groups (n=30): protective ventilation group (group PV) and conventional ventilation group (group CV) according to random number table. In group CV, patients received volume-controlled ventilation and the VT was 10 mL/kg. In group PV, patients received pressure-controlled ventilation, the VT was 6 mL/kg, and the positive end-expiratory pressure (PEEP) was 6 cmH2O. The oxygen concentration was 100%, the inhalation and exhalation rate was 1∶2, and the partial pressure of end-tidal CO2 was 35-45 mmHg. The peak inspiratory pressure (PIP) and the plateau pressure (PPleatu) were compared and analyzed at the time of double lung ventilation (TLV) 15 min (T1), one-lung ventilation (OLV) 15 min (T2), OLV 60 min (T3), and the restore TLV 15 min (T4). The time from stopping anesthetic to extubating tracheal tube was also recorded and compared. Blood samples were collected from radial artery for blood gas analysis, the PaCO2 and PaO2 were compared and analyzed at the time of T1, T2, T3, T4, 2 h after pulmonary lobectomy surgery (POD0), the morning of 1 days after surgery (POD1) and the morning of 2 days after surgery (POD2). Chest X-ray in two groups was also compared and analyzed in POD2. Results There were no significant differences between the two groups in sex, age, weight, smoking history, preoperative pulmonary function, anesthesia time, operation time, surgical approach and duration of postoperative tracheal intubation (P ＞ 0.05). Compared with group CV, PIP, PPleatu and PaO2 were significantly decreased, PaCO2 was increased at T2, T3 in group PV, with statistically significant differences (P ＜ 0.05). Compared with group CV, PaO2 levles were significantly increased in group PV at POD0, POD1, POD2, with statistically significant differences (P ＜ 0.05). Compared with group CV, the incidence of postoperative pulmonary atelectasis, pulmonary infiltrates were significantly decreased in group PV (P ＜ 0.05). Conclusion The protective lung ventilation strategy can significantly reduce intraoperative mechanical ventilation pressure, improve postoperative pulmonary oxygenation function, reduce incidence rate of postoperative atelectasis and lung tissue infiltrates of elderly patients underwent pulmonary lobectomy.
		2017 Vol. 14 (20): 120-124 [Abstract] ( 143 ) HTML (1 KB) PDF (480 KB) ( 91 )

	125	Influence of hypophosphatemia on the short-term prognosis of elderly patients with community-acquired pneumonia
		CHEN Zhi1 JIANG Guizhong2 GUO Jielin3
		Objective To investigate the influence of hypophosphatemia on the short-term prognosis of elderly patients with community-acquired pneumonia (CAP). Methods A total of 112 elderly patients with CAP treated in People's Hospital of Huizhou Zhongkai Hi-tech Industrial Development Zone from January 2013 to August 2014 were selected. According to whether combined with hypophosphatemia or not, patients were divided into hypophosphatemia group (n=42) and non-hypophosphatemia group (n=70). The indexes of laboratory examination, including blood gas analysis, blood routine examination were detected within 24 hours of hospitalization. The average hospital stay, time of anti-infection treatment, the mortality rate and the severity of pneumonia were recorded. All the data were analyzed statistically. Results The levels of serum sodium, albumin and PaO2 in patients of the hypophosphatemia group were significantly lower than those of the non-hypophosphatemia group (P < 0.05), while CRP level and WBC were significantly higher than those of the non-hypophosphatemia group (P < 0.05). The average hospital stay, time of anti-infection treatment, APACHEⅡ score, mortality rate and severity of severe pneumonia in the patients of the hypophosphatemia group were significantly higher than those of the non-hypophosphatemia group (P < 0.05). Conclusion The level of serum phosphorus is closely related to the prognosis of elderly patients with CAP.
		2017 Vol. 14 (20): 125-127,180 [Abstract] ( 157 ) HTML (1 KB) PDF (773 KB) ( 89 )

	128	Discussion on the problems and countermeasures in the management of experimental drugs
		LIU Feng DENG Guixin LI Xueqin WANG Guifeng
		In the process of drug clinical trials, the experimental drug management is an important part in the process of study. According to the main problems in the management of experimental drugs in Drug Clinical Trial Institution, Zhongshan People's Hospital, such as management oversight in experimental drugs, the registration form is complicated; the drug management of professional department is so disorder that it can not be managed normatively; the hand-written prescription increases the workload of researchers; there is no monitoring system of temperature and humidity, so it is difficult to guarantee the drug efficacy and safety, and so on, through using the measures of revising and perfecting experimental drug management system and standard operation procedure, establishing institutional pharmacy, taking free drug coding, using the temperature and humidity monitoring system to strengthen the experimental drug monitoring. It is emphasized that the institutions should formulate the experimental drug management system and standard operation procedure for their own institutions and continue to improve base on the actual situation, in order to improve the operability of experimental drug management, so as to ensure the safety and efficacy of experimental drugs.
		2017 Vol. 14 (20): 128-131 [Abstract] ( 165 ) HTML (1 KB) PDF (697 KB) ( 70 )

	132	Bibliometric analysis of clinical pharmacists ward round in China
		ZHANG Mingzhu1 ZHANG Peijin2 XUE Hongbo1 LUO Zhuoka1 HUO Dan1
		Objective To investigate the situation and problems of the ward round of clinical pharmacist through literature analysis, to provide reference for clinical pharmacist ward round. Methods China Academic Journal, VIP Chinese scientific and technical journals database and Wanfang database were searched for related literatures from 1985 to 2015, and excel software was used for analysis. Results A total of 128 references were obtained. The number of the related papers showed a gradual growth trend year by year. According to Bradford's law, five kinds of journals were recognized as core area journals with 44 papers (34.4%). Most of the literature authors had intermediate professional titles. There were 87 tertiary hospitals, accounted for 80.6%, which was significantly higher than that of secondary hospitals. The main form of ward round was to follow physicians, followed by administrative multidisciplinary ward round and independent ward round by pharmacists. 66 literature (51.6%) belong to the theory literature, 47 literature (36.7%) belong to the practice analysis literature and 15 literature (11.7%) were summarizes researches. Conclusion The clinical pharmacist ward round work in recent years has made some progress, particularly after 2008. However, there are obvious development imbalance between different hospitals and different regions, the research level needs to be improved, and the independent ward round by clinical pharmacists is not enough, normalization of the ward round needs to be strengthened.
		2017 Vol. 14 (20): 132-135 [Abstract] ( 203 ) HTML (1 KB) PDF (498 KB) ( 39 )

	136	Clinical observation of astragalus polysaccharide in preventing the cardiotoxicity of anthracyclines
		KONG Jiaxin1 SU Xuchun1 DAI Shilei1 DENG Yuemin2 CHENG Ling1 SONG Jing1
		Objective To discuss the clinical effect of astragalus polysaccharide in preventing the cardiotoxicity of anthracyclines. Methods Eighty patients diagnosed as breast cancer or malignant lymphoma in Cancer Center of Guangzhou Medical University from September 2013 to March 2016 were selected and randomly divided into prevention group and conventional group according to random number table method, with 40 cases in each group. The conventional group was given regular anthracyclines drugs [breast cancer: Cyclophosphamide (CTX) + Epirubicin (EPI) / Theprubicin (THP) + Fluorouracil (5-FU), malignant lymphoma: CTX+EPI/THP, Vindesine (VDS)+Prednisone] and 1.0 g sodium phosphocreatine+100 mL normal saline, intravenous drip, on basis of which, the prevention group was added with 250 mg astragalus polysaccharides+500 mL normal saline, intravenous drip. The levels of plasma B-type brain natriuretic peptide (BNP), nitric oxide (NO), platelet alpha granule membrane protein (GMP-140) were detected by enzyme-linked immunosorbent assay (ELISA). The left ventricular ejection fraction (LVEF) was detected by ECG. The quality of life was assessed by Kamofsky performance status (KPS), followed up for 6 months. Results The effective rate between prevention group and conventional group had no statistically significant difference (P ＞ 0.05). The levels of plasma BNP, GMP-140 in prevention group were significantly lower than those of conventional group, the levels of plasma NO and LVEF were higher than those of conventional group, the differences were statistically significant (P ＜ 0.05). The KPS scores of prevention group after treatment for 3, 6 months were significantly higher than those of conventional group, the differences were statistically significant (P ＜ 0.05). Conclusion Astragalus polysaccharides can effectively reduce the cardiac toxicity induced by anthracycline, which is helpful to improve the quality of life, and it has no side effects on the curative effect.
		2017 Vol. 14 (20): 136-139 [Abstract] ( 176 ) HTML (1 KB) PDF (354 KB) ( 89 )

	140	The effect of comprehensive nursing intervention in psychological barriers and pain of patients with rheumatoid arthritis
		LIU Feifei E Xiaoqiang▲
		Objective To explore and analyze the effect of the comprehensive nursing intervention in psychological disorders and pain of patients with rheumatoid arthritis. Methods 90 cases with rheumatoid arthritis treated in Harbin Medical University from June 2014 to June 2016 were selected. All the patients divided into the routine nursing and the comprehensive nursing group according to the random number table, with 45 cases in each group. The curative effect, improve psychological barriers and degree of pain of the two groups were compared. Results The clinical total effective rate of the comprehensive nursing group was higher than that of the routine nursing group, with statistically significant difference (P < 0.05). After intervention, the SAS and SDS scores of two groups were lower than before intervention, and the improvement about the above indicators of the comprehensive nursing group was more remarkable, with statistically significant difference (P < 0.05). The pain degree of two groups was decreased than before intervention, and the improvement about the above indicators of the comprehensive nursing group were more remarkable, with statistically significant difference (P < 0.05). Conclusion The comprehensive nursing intervention can improve the curative effect of rheumatoid arthritis, improve mental state, pain relief.
		2017 Vol. 14 (20): 140-143 [Abstract] ( 199 ) HTML (1 KB) PDF (586 KB) ( 104 )

	144	Intervention effect of mindfulness-based model on sleep quality and psychological state of patients with cervical cancer at the intermisdion of chemotherapy
		ZHANG Yanping HE Haixia WEN Xi LI Ling
		Objective To discuss and analyze the intervention effect of mindfulness-based model on sleep quality and psychological state of patients with cervical cancer at the intermisdion of chemotherapy. Methods The postoperative patients with cervical cancer who were received chemotherapy in Department of Gynaecology, Guangdong TCM Hospital from January 2015 to October 2016 were divided into observation group and control group according to the envelop method, with 72 cases in each group. The control group was received routine nursing intervention, while the observation group was received the mindfulness-based nursing model and routine nursing for dual intervention. Self-rating anxiety scale (SAS), self-rating depression scale (SDS) and pittsburgh sleep quality index (PSQI) were applied before intervention and in the 4th, 8th and 12th weeks after intervention for comprehensive evaluation. Results The differences in scores of all dimensions of SAS, SDS and PSQI of the two groups before intervention were not statistical significance (P > 0.05). However, the scores of other dimensions except hypnotic of PSQI (the difference in hypnotic score was not statistical significance), SAS score and SDS score of the observation group in the 4th, 8th and 12th weeks after intervention were evidently lower than those of the control group (P < 0.01). Moreover, as indicated by the results of repeated measurement variance analysis, inter-group effect, time effect and interaction of the two groups at different time were of statistical significance (P < 0.01). Conclusion Mindfulness mode can improve the sleep quality and psychological state of cervical cancer patients at the intermisdion of chemotherapy significantly.
		2017 Vol. 14 (20): 144-147 [Abstract] ( 169 ) HTML (1 KB) PDF (658 KB) ( 121 )

	148	Influence of cluster intervention on negative psychology in patients with alcoholic liver cirrhosis and withdrawal syndrome
		XING Tingya1 WU Haitang2▲ WANG Qiquan3
		Objective To investigate influence of cluster intervention on negative psychology in patients with alcoholic liver cirrhosis and withdrawal syndrome. Methods 104 patients with alcoholic liver cirrhosis and withdrawal syndrome were selected in Hainan Second People′s Hospital from October 2014 to October 2016, who were divided into control group and observation group by random number table, with 52 cases in each group. Negative psychological status, SF-36 score, HAMA score, HAMD score were compared between two groups before and after nursing. Results After nursing, the scores of SF-36, HAMA score and HAMD, the distribution of anxiety and depression in the two groups were better those before nursing, and the observation group was superior to the control group (P < 0.05). Conclusion Cluster intervention can improve negative psychological status in patients with alcoholic liver cirrhosis and withdrawal syndrome, which can also improve quality of life.
		2017 Vol. 14 (20): 148-151 [Abstract] ( 147 ) HTML (1 KB) PDF (586 KB) ( 67 )

	152	Influence of caregiver participation on psychological state, quality of life in endometrial carcinoma patients
		GAO Jie QI Xin ZHANG Ying
		Objective To study the effect of caregiver participation on psychological state, life quality of endometrial carcinoma patients. Methods 102 patients with endometrial carcinoma in Beijing Obstetrics and Gynecology Hospital affiliated with the Capital University of Medical Sciences from April 2012 to December 2015 were chosen as research subject and divided into control group (55 cases) underwent routine nursing mode, observation group (47 cases) underwent caregivers participating nursing mode, according to nursing intervention mode. Before and after intervention, two group patients′ negative emotional state were assessed by SAS and SDS, hope level was assessed by HHI, quality of life was assessed by QLQ-C30. Results Before intervention, negative emotion, hope and life quality of two groups had no significant difference (P > 0.05). After intervention, SAS and SDS scores of observation group were lower than those in control group, reality scores and future attitude, take positive action, maintain close relationships with others in HHI were higher than those of control group, QLQ-C30 function scale and symptom scale, overall health status scale scores were higher than those in control group, with statistically significant difference (P < 0.05). Conclusion Caregiver participation nursing model can reduce negative emotions, improve the quality of life, improve the quality of life in endometrial carcinoma patients.
		2017 Vol. 14 (20): 152-155 [Abstract] ( 164 ) HTML (1 KB) PDF (617 KB) ( 90 )

	156	The effects of Chinese medicine pillow combining auricular point seed pressing on preoperative sleeping quality improvement in orthopaedics patients
		REN Yan
		Objective To observe the effects of Chinese medicine pillow combining auricular point seed pressing on preoperative sleeping quality improvement in orthopaedics patients. Methods From January to December in 2016, 82 cases met with inclusion criteria in the affiliated hospital of Nanjing University of TCM were recruited in this study and divided into observation group and control group by random number table. Chinese medicine pillow with auricular point seed pressing were provided for observation group, and only the latter was applied in control group. Auricular point seed pressing for two groups was conducted 1 day before the operation, while Chinese medicine pillow was conventionally utilized from admission to discharge. After the research, eligible cases for observation group and control group was 41 cases and 40 cases respectively. Final comparison was made on the satisfaction degree, unsatisfactory cause′s investigation, PSQI and safety evaluation in two groups. Results ①The satisfaction degree of the observation group was better than that of the control group (P < 0.05); within the unsatisfactory cause′s investigation, there was 1 case of inadaptation smell and 1 case of uncomfortable pillow height in observation group, and 1 case of seeding painfulness and 2 cases of not obvious effect in control group. ②There were no statistical significance differences of all PSQI items and total scores between two groups before intervention (P > 0.05); after intervention, subjective sleeping quality, sleeping time, sleeping efficacy, sleeping disorder, daytime dysfunction scaling and total score in observation group were significantly lower than those in the control group (P < 0.05), while no significant difference was found in sleeping latency and hypnotic agents scaling after intervention (P > 0.05); excluding hypnotic agents, scores of all items and PSQI total score in observation after intervention were lower than those before intervention (P < 0.05); the subjective sleeping quality, sleeping efficacy, sleeping disorder and PSQI total score in control group after intervention were lower than those before intervention (P < 0.05).③No adverse effects were noticed in two groups during the entire experiment. Conclusion Chinese medicine pillow with auricular point seed pressing significantly improved the sleeping quality in fracture patients with high satisfaction degree and favorable safety, which facilitated surgeries of orthopedics and traumatology and deserved promotion in clinical practice.
		2017 Vol. 14 (20): 156-159 [Abstract] ( 185 ) HTML (1 KB) PDF (617 KB) ( 93 )

	160	Application effect of evidence-based nursing in patients undergoing laparoscopic cystectomy for ovarian cysts
		RU Xiaonan
		Objective To study the effect of evidence-based nursing in laparoscopic cystectomy for ovarian cysts. Methods From January 2015 to January 2016, 92 cases with ovarian cyst diagnosed in the First Affiliated Hospital of Hebei North University were selected and divided into general group and observation group according to random number table, with 46 cases in each group. The general group was received routine nursing, and the observation group was received evidence-based nursing intervention. The incidence of postoperative complications, the scores of nursing quality and psychological anxiety of the two groups were evaluated. Results The incidence of postoperative complications in the general group was 28.26%, and the incidence rate of the observation group was 10.87%, the incidence of postoperative complications in the observation group was lower than that in the normal group (P < 0.05). The scores of nursing quality in the general group were lower than those in the observation group, such as the prevention of complications, psychological intervention, condition monitoring and health education (P < 0.05). The postoperative recovery of gastrointestinal function, hospitalization, and ambulation of patients in the general group were longer than those in the observation group (P < 0.05). At admission, the psychological anxiety scores of the two groups were not statistically significant (P > 0.05). After intervention, the anxiety score in the observation group was lower than that in the general group (P < 0.05). Conclusion Evidence-based nursing can effectively improve the clinical nursing quality and the psychological anxiety of patients, reduce the incidence of postoperative complications.
		2017 Vol. 14 (20): 160-163 [Abstract] ( 161 ) HTML (1 KB) PDF (587 KB) ( 50 )

	164	Effect of feedback early rehabilitation nursing intervention on postoperative rehabilitation of patients with hemorrhagic stroke
		YU Jun ZHAO Huan DU Yuanyuan
		Objective To study the effect of different early rehabilitation nursing intervention on postoperative rehabilitation of patients with hemorrhagic stroke. Methods 194 patients with hemorrhagic stroke in Qingdao Municipal Hospital from June 2014 to May 2016 were selected and divided into control group and study group, with 97 cases in each group. The control group was received early rehabilitation nursing intervention at 2-7 d after operation and the patient's vital signs were stable, while the study group was received feedback early rehabilitation nursing intervention at 2-7 d after operation and the patient's vital signs were stable. The nursing intervention program of two groups continued until 6 months discharge. The time compliance and frequency compliance, Barthel index and quality of life score before and after nursing of two groups were compared. Results The time compliance and frequency compliance during hospitalization and after discharge of study group were significantly higher than those of control group, with statistically significant difference (P ＜ 0.05). The Barthel index of two groups at discharge time, 1 months, 6 months after discharge were significiantly higher than those before nursing (P ＜ 0.05), and Barthel index of study groups at discharge time, 1 months, 6 months after discharge were significiantly higher than those of control group (P ＜ 0.05). The body role, body pain, body function, general health, vitality, social function, emotional state, mental health of two groups after nursing were significantly higher than those before nursing (P ＜ 0.05), and those of study group were significiantly higher than those of control group (P ＜ 0.05). Conclusion The early feedback rehabilitation nursing intervention provides a new model for early postoperative nursing intervention in patients with hemorrhagic stroke, which is worth to be spread.
		2017 Vol. 14 (20): 164-167 [Abstract] ( 157 ) HTML (1 KB) PDF (619 KB) ( 108 )

	168	Application of improved PBL teaching method in clinical practice teaching in Department of Neurosurgery
		ZHOU Kai WU Pengfei FAN Yandong FENG Zhaohai ZHANG Tingrong
		Objective To explore the application of improved PBL teaching method in clinical practice teaching in Department of Neurosurgery. Methods From March 2014 to March 2016, in First Affiliated Hospital of Xinjiang Medical University, 60 undergraduate internships in the Department of Neurosurgerywere were selected, according to the simple random method, students were divided into control group (given traditional teaching methods, 30 students) and observation group (given modified PBL method, 30 students). Evaluation of teaching effect of teachers and students, students score and teaching effect of students of two groups were compared. Results The teachers and students on teaching attitude, teaching content scores of two groups were compared, the differences were not statistically significant (P > 0.05); and for the teaching process and teaching guidance, teaching effect, teachers and students in the observation group were significantly higher than those in the control group, the differences were statistically significant (P < 0.05). The scores of theory test and practical technique test of students in the observation group were better than those in the control group, the differences were statistically significant (P < 0.05). Stimulating interest in learning, mastery of basic knowledge, cultivate independent thinking and self-learning ability, literature ability, training of clinical work ability, standardized treatment, critical thinking and cultivate the teamwork ability, accepted teaching method the satisfaction rate of students in observation group were better than those in the control group, the differences were statistically significant (P < 0.05). Conclusion The improved PBL teaching method can greatly improve the students' interesting in learning and academic performance, improving the quality of teaching, it is widely used in clinical practice teaching in Department of Neurosurgery.
		2017 Vol. 14 (20): 168-171 [Abstract] ( 171 ) HTML (1 KB) PDF (505 KB) ( 90 )

	172	Study on weight management model of overweight and obesity among young people in primary hospital
		LIU Fang XU Jin′gang LOU Yanhui HE Jin▲
		Objective To study how to manage weight for overweight and obese young people in primary hospital. Methods from June 2015 to December 2016, in Yiwu Fuyuan Affiliated Teaching Hospital of Zhejiang Chinese Medical Uniwersity, 150 overweight and obese patients were collected, they were divided into three groups by random number table: control group, telephone follow-up group and face to face group, with 50 cases in each group. Three groups were given obesity related health education, diet and exercise guidance, body weight index, body weight, waist circumference, fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, triglyceride and uric acid were measured. The control group followed up automatically, telephone follow-up group and face to face group were followed up by telephone and face to face at 2nd, 4th, 6th, 8th, 12th, 16th, 20th, and 24th week respectively. Meanwhile body weight, waist circumference, situation of diet and exercise was recorded. The next phase of the diet exercise program was developed. The three groups were notified to the hospital to check body weight, waist circumference, and metabolic indicators at 24th week. Results Compared with baseline, there was no significant improvement in the control group at 24th week（P ＞ 0.05), body weight, waist circumference, and low-density lipoprotein cholesterol were significantly improved in telephone follow-up group (P ＜ 0.01), body weight, waist circumference, total cholesterol, low-density lipoprotein cholesterol, and uuric acid significantly improved in face to face group (P ＜ 0.01). Compared with telephone follow-up group, body weight,）, LDL-C（P ＜ 0.05）low-density lipoprotein cholesterol, waist circumference, body weight index, total cholesterol improved more in face to face group (P < 0.05 or P < 0.01). Conclusion Health education and diet exercise therapy with continual follow-up can improve body weight and metabolic markers in overweight and obese young adults at primary hospital. Face-to-face follow-up is better than telephone follow-up.
		2017 Vol. 14 (20): 172-175 [Abstract] ( 179 ) HTML (1 KB) PDF (480 KB) ( 92 )

	176	The curative effect of denervated bone resection combined with lamina fenestration and nucleotomy on lumbar disc herniation with the posterior vertebral body amputation
		Yilixiati ZHANG Ning LIU Bo
		Objective To investigate the curative effect of denervated bone resection combined with lamina fenestration and nucleotomy (LOVE) on lumbar disc herniation (LDH) with the posterior vertebral body amputation. Methods From January 2013 to January 2014, patients treated in Beijing Jishuitan Hospital who had LDH with posterior edge separation were retrospectively analyzed. All patients underwent modified LOVE procedure. 56 patients had no nerve root compression by the posterior denervated bony. 56 patients were divided into two groups: trial group, 26 patients only underwent nucleotomy without resection of the posterior denervatied bony; and control group, 30 patients underwent nucleotomy with resection of the posterior denervated bony. All patients were followed up at least for 2 years. The operating time, intraoperative blood loss, preoperative and postoperative JOA score, VAS and intraoperative and postoperative complications between two groups were recorded. Results The operating time of trial group was significantly shorter than that of control group (P < 0.01). The blood loss of trial group was significantly less than that of control group (P < 0.01). There was no significant difference on VAS between two groups at different time points between groups (P ＞ 0.05). There was a statistically significant difference on VAS between two groups at different time points in the group (P < 0.01). There was no significant difference on JOA score between two groups at different time points between groups (P ＞ 0.05). There was a statistically significant difference on JOA score between two groups at different time points in the group (P < 0.01). There were no significant differences on curative effect between two groups after 3 months, 1 year and 2 years (P ＞ 0.05). Patients of two groups in 2-year follow-up cycle were no symptoms recurrence, no complications. Conclusion Modified LOVE in the treatment of LDH with vertebral fracture of the posterior margin, if the denervated bone hasn′t caused significant nerve root compression, neglect of denervated bone can achieve the same good curative effect, and can shorten operation time, reduce intraoperative blood loss compared with denervated bone resection.
		2017 Vol. 14 (20): 176-180 [Abstract] ( 147 ) HTML (1 KB) PDF (490 KB) ( 86 )

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