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2019 Vol. 16, No. 17
Published: 2019-06-15
 
 
4 Effect of acupuncture on the expression of ANP, ACE2 and Ang(1-7)/ AngⅡ ratio in heart tissue of spontaneously hypertensive rats
JI Zhi YUAN Jingyun WANG Zijuan ZHANG Yue LIANG Jingrong WU Jiaojuan LIU Qingguo
Objective To investigate the protective mechanism of acupuncture on myocardial hypertrophy by observing the changes of myocardial tissue structure and renin angiotension system (RAS) system action factor expression in spontaneously hypertensive rats (SHR). Methods Ten Wistar Kyoto rats (WKY) were selected as normal control group, 20 SHRs were divided into model group and acupuncture group by random number table method, with 10 rats in each group. All rats were SPF grade male 10-week-old rats. After one week of acclimatization, acupuncture was applied on Taichong (LR3) and Baihui (DU20) of SHRs in acupuncture group once a day for 28 days. The other two groups only received the same grasping and fixation stimulation. Blood pressure was measured before acupuncture on day 1, 7, 14, 21 and 28. At the end of the experiment, the weight of the whole heart and left ventricle of the rats were weighed, and ratio of left ventricle weight to body weight (LVWI), heart weight index (HWI) were calculated. HE and Masson staining method were applied to observe the myocardial tissue morphology, and Real-time RCR, Western blot, enzyme linked immunosorbent assay (ELISA) were used to detect the expression of atrial natriuretic peptide (ANP), angiotensin-converting enzyme 2 (ACE2), angiotensin (1-7) [Ang(1-7)], AngⅡ and Ang(1-7)/AngⅡ, as well as the underlying mechanisms were investigated. Results Compared with normal control group, the systolic blood pressure (SBP), HWI and LVWI in the model group were significantly increased (P ＜ 0.01). Compared with the model group, SBP, HWI and LVWI values in the acupuncture group were significantly decreased (P ＜ 0.05 or P ＜ 0.01). The pathological results showed that compared with normal control group, the cell volume of rat cardiac muscle cells in the model group was significantly larger, and the arrangement was relatively disordered. Meanwhile, the cell spacing was widened, and there were a lot of blue-stained fibers. Compared with the model group, the cardiac muscle cells in the acupuncture group were smaller in volume, narrower in cell spacing, and fewer blue-stained fibers in the cell space. Compared with normal control group, the expression level of ACE2 and Ang (1-7)/AngⅡ of myocardial tissue in model group significantly decreased (P ＜ 0.01), the expression level of ANP significantly increased (P ＜ 0.01). Compared with model group, the expression level of ACE2 and Ang (1-7)/AngⅡ in acupuncture group significantly increased (P ＜ 0.01), the expression level of ANP significantly decreased (P ＜ 0.01). Conclusion Acupuncture at LR3 and DU20 could reduce blood pressure and inhibit the development of cardiac hypertrophy, which might be mediated by the regulation of ACE2/Ang(1-7) pathway.
2019 Vol. 16 (17): 4-8 [Abstract] ( 267 ) HTML (1 KB)  PDF (947 KB)  ( 105 )
9 Application value of serum CA125, HE4 and ROMA and CPH-I based on them in differential diagnosis of ovarian tumors
CHEN Yongning1 ZHANG Yadi1 CHEN Li2 LI Chanyuan1 WU Huan3 GONG Shipeng1
Objective To compare diagnostic value of carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4) and on which risk of ovarian malignancy algorithm (ROMA), Copenhagen index (CPH-I) based in differentiating malignant from benign ovarian tumors. Methods Clinical data of 719 patients with ovarian tumors, who visited Department of Obstetrics and Gynecology of Nanfang Hospital, Southern Medical University, from September 2014 to November 2016 were analyzed retrospectively. According to different prognosis, patients were divided into 92 cases of less common ovarian histopathologies (LCOHs) group, 96 cases of non-less common ovarian histopathologies (Non-LCOHs) group, 531 cases of benign ovarian tumors (BOTs) group. ROC curve were used for calculating AUC, sensitivities and specificities, so as to compare diagnostic value of CA125, HE4, ROMA and CPH-I in differentiating malignant from benign ovarian tumors. Results Among ovarian cancer, 77.1% patients in non-LCOHs group were mainly staged advanced, while those in LCOHs group, 80.4% were mainly early stage, the differences were statistically significant (P < 0.01). The age, rate of postmenstrual cases and levels of serum CA125, HE4, ROMA, CPH-I in Non-LCOHs group were higher, followed by LCOHs group and BOTs group respectively, the differences were statistically significant (P < 0.01). In differentiating Non-LCOHs from BOTs patients, AUC of CPH-I, ROMA and HE4 were both higher than CA125 (0.969, 0.968, 0.968 and 0.935), and CPH-I made highest sensitivity, followed by ROMA, CA125 and HE4 (93.8%, 92.7%, 90.6% and 88.5%). Similar AUC trend was observed in differentiating LCOHs from BOTs patients (0.735, 0.739, 0.736 and 0.642), and sensitivity of ROMA was highest and followed by CPH-I, CA125 and HE4 (44.6%, 35.9%, 32.6% and 32.6%). The specificity of CPH-I, HE4, ROMA was higher than CA125 (94.7%, 93.6%, 87.6% and 83.6%). Conclusion HE4, ROMA, and CPH-I did the comparative performance in differentiating malignant from benign ovarian tumors and both are better than CA125. In terms of predicting Non-LCOHs patients, ROMA and CPH-I are superior to CA125, and CPH-I is slightly dominant and more convenient and practical than ROMA. Both of these models perform better than HE4. Furthermore, CPH-I and HE4 has better specificities for predicting benign ovarian diseases than ROMA and the former two index made up for shortcoming of weak specificity of CA125 effectively. However, the rate of missed diagnosis in LCOHs population is still staying at a high level and further researches for more effective differential diagnosis tools are needed.
2019 Vol. 16 (17): 9-12,22 [Abstract] ( 278 ) HTML (1 KB)  PDF (649 KB)  ( 128 )
13 Effect of trichosanthin on proliferation and apoptosis of human cervical cancer cells and research on its mechanism
WANG Fan1,2 DENG Xinyan1,2 YAO Minghui1 TIAN Tian1 LIU Ying1 WANG Hui1 WANG Jia1 DONG Xiaoyun1,2▲
Objective To study the effect and mechanism of trichosanthin (TCS) on inducing apoptosis of human cervical cancer HeLa cells. Methods HeLa cells were treated with low (7 μmol/L), medium (14 μmol/L) and high (28 μmol/L) doses of TCS for 10-82 h, the cell morphology and inhibition of cell growth was observed. The cell cycle and apoptosis was detected and Western blot was performed to detect the protein expression of apoptosis proteins of cervical cancer cells HeLa after treated with TCS for 24 h. Results HeLa cells of cervical cancer treated by TSC showed wrinkles and deformation, the growth of HeLa cells was inhibited. The number of cells in low and medium dose of TCS group decreased with time (r = -0.9727, -0.9757, P ＜ 0.05). Compared with the blank control group, the G0/G1 phase of HeLa cells in medium, high dose of TCS group were significantly increased (P < 0.05), and the S phase in low, medium, high dose of TCS group were decreased after TCS treated for 24 h, the differences were statistically significant (P ＜ 0.05). The apoptosis rate of HeLa cells in the low, medium and high dose of TCS group was increased compared with that in the blank control group (P ＜ 0.05). Compared with the blank control group, the protein expressions levels of Caspase-9, Caspase-3, polyadenosine diphosphate ribosome polymerase (PARP) and p-extracellular regulated protein kinase (ERK) in low, medium, high dose of TCS group were gradually decreased in a dose-dependent manner after of TCS treatment (r = -0.969, P ＜ 0.05). Conclusion TCS can induce apoptosis by activating the Caspase family of proteins to inhibit the proliferation of cervical cancer HeLa cells to exert anti-tumor effects.
2019 Vol. 16 (17): 13-17 [Abstract] ( 273 ) HTML (1 KB)  PDF (1030 KB)  ( 67 )
18 Influence of Tiaowei Chengqi Decoction on the immunologic function of rats with gut-derived sepsis
ZHAO Fengli1 WANG Shuxin2 LUO Yuanyuan1 ZHENG Shuming1 CHEN Jing1 ZHAO Fu1 XIAN Shaoxiang3
Objective To observe the influence of Tiaowei Chengqi Decoction (TWCQ) on the immunologic function of rats with gut-derived sepsis. Methods Sixty SPF male SD rats were randomly divided into sham operation group, model group, Ulinastatin group (30 000 U/kg), TWCQ gavage group (9.45 g/kg), TWCQ enema group (9.45 g/kg) and TWCQ enema + Ulinastatine group according to their body weight (n = 8). After modeling for 2, 10, 24 h, Ulinastatine was administered by intraperitoneal injection, respectively. TWCQ was administered by gastric way and enema way respectively according to different groups, and the experiment was completed at 24 hours. The levels of serum interleukin 10 (IL-10) and tumor necrosis factor α (TNF-α) were detected by enzyme linked immunosorbent assay (ELISA), the levels of CD4+ and CD8+ T lymphocyte in mesentery of small intestine were detected by flow cytometry, and the results of HE staining in small intestine were observed under light microscope. Results Compared with sham operation group, the proportion of CD4+/CD8+ T lymphocyte in mesentery of small intestine in rats of model group was decreased significantly (P ＜ 0.05), the level of IL-10 was reduced and TNF-α was improved significantly (P ＜ 0.05), and the pathological damage of small intestine could be seen obviously. Compared with model group, the proportion of CD4+/CD8+ T lymphocyte in mesentery of small intestine in rats of TWCQ treatment group increased significantly (P ＜ 0.05), the level of IL-10 was improved and TNF-α was reduced significantly (P ＜ 0.05), and the damage degree of model small intestine was improved obviously. Compared with TWCQ gavage group, the therapeutic effect of TWCQ enema group was more obvious (P ＜ 0.05). Conclusion TWCQ has the function of improving the proportion of CD4+/CD8+ T lymphocyte and reducing immunologic function in model rats with gut-derived sepsis, and enema therapy is superior to gavage therapy.
2019 Vol. 16 (17): 18-22 [Abstract] ( 286 ) HTML (1 KB)  PDF (1034 KB)  ( 152 )
23 Advance of molecular mechanism of occult hepatitis B virus
ZHANG Li QIU Yan
Occult hepatitis B virus infection (OBI) means that HBV DNA can be detected in liver tissues of HBsAg negative infected people with highly sensitive nucleic acid detection. This paper introduces the gene molecular mechanism of OBI formation: open reading frame mutation, initiation codon and termination codon mutations of s, p, x and c genes; effect of mutations of gene regulatory sequences on transcriptional processes and post-transcriptional regulation; epigenetic regulation. At present, the studies on epigenetic regulation during the process of HBV replication and gene expression in OBI individuals are still in its infancy, with broad research prospect. In addition, this paper summarizes the gene molecular mechanisms of OBI formation in blood donors of Europe, South Africa, Southeast Asia and China.
2019 Vol. 16 (17): 23-26,30 [Abstract] ( 302 ) HTML (1 KB)  PDF (740 KB)  ( 73 )
27 Study on the relationship between traditional Chinese medicine syndrome type distribution and anxiety and depression in patients with gastroesophageal reflux disease
XU Duo LI Shu LI Shuang
Objective To investigate the relationship between traditional Chinese medicine syndrome types of gastroesophageal reflux disease (GERD) and disease duration, age, gender and self-anxiety and depression. Methods From January 2010 to April 2012, 146 patients from the Department of Gastroenterology of Shanghai Longhua Hospital who met the GERD diagnosis of Western medicine were selected for questionnaire survey. Data were collected for statistical analysis to explore the relationship between syndrome types and related factors. Results Among the 146 cases included, 56 cases were spleen-deficiency type, 49 cases were liver-stomach-stagnation type, 36 cases were qi-stagnation-resistance type, 4 cases were biliary-heat-stomach type, and 1 case was phlegm-blocking type. GERD always occurred in 40-59 years old patients, and the incidence of each type of syndrome was basically the same in this age group. In 20-39 years old, most patients with GERD were liver-stomach-stagnation type, while those over 60 years old were mainly spleen-deficiency type. The course of disease in patients of spleen-deficiency type was significantly longer than that in patients of liver-stomach-stagnation type and qi-stagnation-resistance type (P = 0.02). Gender was correlated with GERD of liver-stomach-stagnation type and qi-stagnation-resistance type (P = 0.003, P = 0.001). Males were significantly more than females in GERD of liver-stomach-stagnation type, while females were significantly more than males in GERD of qi-stagnation-resistance type. The scores of anxiety and depression of the three syndromes were significantly different (P = 0.02, P < 0.001). Conclusion The occurrence of GERD is significantly correlated with age. Anxiety and depression are common in patients with liver-stomach-stagnation type and qi-stagnation-resistance type.
2019 Vol. 16 (17): 27-30 [Abstract] ( 277 ) HTML (1 KB)  PDF (456 KB)  ( 159 )
31 Association between adolescents′ depressive mood with resilience and family environment factors
CONG Enzhao CAI Yiyun CHEN Haiying WU Yan
Objective To explore the relationship between adolescent depressive and family environment factors and mental resilience. Methods A cluster sampling method was used to select 3230 junior high school students from Xinxiang City, He′nan Province from December 2014 to July 2016 for general social data questionnaire, Kutcher Adolescent Depression Scale (11 items), and Family Environment Scale Chinese version (FES-CV), Chinese version of the Mental Resilience Scale (CD-RISC) assessment. After the evaluation, the differences in depression and emotions of different genders and ages were compared. The differences of CD-RISC scores and psychological elasticity between the depression group and the non-depression group were compared. Factors with statistically significant differerces were further analyzed by binary Logistic regression to study the relationship between resilient family environment factors and adolescent depression. Results There were 2 960 valid questionnaires, 659 (22.7%) with depression, including 221 males (20.0%) and 483 females (24.3%). 107 adolescents (28.3%) with mothers working out had depression, which was significantly higher than those with fathers (24.2%). There were significant differences in resilience (Z = 12.032), tolerance of negative emotions (Z = 9.677), ability to face difficulties (Z = 12.860), acceptance of changes (Z = 11.025) and control (Z = 11.514) between the depressive group and the non-depressive group (P < 0.05), and the depressive group was significantly lower than the non-depressive group (P < 0.05). Low scores of resilience (OR: 0.967, 95%CI: 0.961-0.973), control (OR: 0.671, 95%CI: 0.604-0.745), acceptance of change (OR: 0.725, 95%CI: 0.659-0.796), ability to face difficulties (OR: 0.720, 95%CI: 0.667-0.778), tolerance of negative emotions (OR: 0.804, 95%CI: 0.734-0.880) increase the risk of depression. After controlling for age and gender factors, the lower the emotional expression (OR: 0.928, 95%CI: 0.869-0.990), organization (OR: 0.886, 95%CI: 0.833-0.942), and entertainment (OR: 0.932, 95%CI: 0.887-0.980), intimacy (OR: 0.839, 95%CI: 0.788-0.839), the depression was more obvious; the higher the scores of independence (OR: 1.075, 95%CI: 1.010-1.114) and control (OR: 1.143, 95%CI: 1.081-1.208), the more obvious depression. Conclusion There is a significant correlation between adolescent depression and resilience, such as low tolerance of negative emotions and low acceptance changes. Low emotional expression and family intimacy are risk factors for depression in adolescents. Controlled increases increase increases the risk of depression.
2019 Vol. 16 (17): 31-34 [Abstract] ( 361 ) HTML (1 KB)  PDF (467 KB)  ( 304 )
35 Correlation between the degree of coronary artery disease and Apo AI/Apo B, homocysteine and blood lipids
LI Lin1 SONG Tingting2▲
Objective To investigate and analyze the correlation between the severity of coronary artery disease and apolipoprotein AI/apolipoprotein B (Apo AI/Apo B), homocysteine and blood lipids. Methods From December 2016 to December 2018, 67 patients with coronary heart disease diagnosed by coronary angiography (CAG) admitted to the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine (“our hospital” for short) were selected as the observation group. A total of 63 healthy medical examiners admitted to our hospital at the same time served as the control group. According to the Gensini score, patients with coronary heart disease were divided into low-risk group (n = 23), intermediate-risk group (n = 22) and high-risk group (n = 22). The levels of Apo AI/Apo B, homocysteine, low density lipoprotein, cholesterol and triglyceride in each group were compared to explore the correlation between the severity of coronary artery disease and the indexes of Apo AI/Apo B, homocysteine and blood lipids. Results There were no significant differences in cholesterol and triglyceride levels between the low-risk group, the intermediate-risk group and the high-risk group (P > 0.05). The levels of cholesterol and triglyceride in the low-risk group, the intermediate-risk group and the high-risk group were higher than those in the control group, the differences were statistically significant (P < 0.05). The Apo AI/Apo B in the intermediate-risk group and the high-risk group were lower than the low-risk group, but the homocysteine and low-density lipoprotein levels were higher than the low-risk group, the differences were statistically significant (P < 0.05); Apo AI /Apo B in the high-risk group was lower than the intermediate-risk group, but homocysteine and low density lipoprotein levels were higher than the intermediate-risk group, the differences were statistically significant (P < 0.05). The levels of homocysteine and low density lipoprotein in the low-risk group, the intermediate-risk group and the high-risk group were higher than those in the control group, and the Apo AI/Apo B was lower than that in the control group, the differences were statistically significant (P < 0.05). Apo AI/Apo B was negatively correlated with coronary artery disease (r = -0.189, P < 0.05), and positively correlated with homocysteine and low-density lipoprotein coronary heart disease (r = 0.072-0.095, P < 0.05). Conclusion Apo AI/Apo B, homocysteine and low density lipoprotein levels are correlated with the severity of coronary artery disease, which can be used to predict and judge the disease. 
2019 Vol. 16 (17): 35-38 [Abstract] ( 300 ) HTML (1 KB)  PDF (471 KB)  ( 85 )
39 Application effect of serum placental growth factor in patients with chronic heart failure
WEI Yin HE Yalei CAI Yerui ZHOU Ji ZHANG Xin CHANG Yefei
Objective To study the effect of serum placental growth factor （PlGF） in patients with chronic heart failure, and to provide reference for clinical diagnosis and treatment. Methods Eighty-five patients with chronic heart failure admitted to the Third People′s Hospital of Yunnan Province (“our hospital” for short) from January to March 2015 were selected as the observation group, and 60 healthy patients who participated in the physical examination in our hospital were selected as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of PlGF, hs-CRP and TNF-α in the two groups. The serum indexes of each cardiac function grade were measured. The patients in the observation group were treated symptomatically, and then the changes of serum indexes were compared. Results The serum levels of PlGF, hs-CRP and TNF-α in the observation group were higher than those in the control group before treatment, and the differences were statistically significant (P < 0.05). The serum levels of PlGF, hs-CRP and TNF-α in the observation group increased with the increase of cardiac function grade, and the differences were statistically significant (P < 0.05). The serum levels of PlGF, hs-CRP and TNF-α in the observation group after treatment were lower than those before treatment, and the differences were statistically significant (P < 0.05). Conclusion The serum levels of PlGF, hs-CRP and TNF-α in patients with chronic heart failure are higher than those in healthy people, and increase with the increase of cardiac function grade. Symptomatic treatment can effectively improve the above-mentioned indicators of patients and provide important reference for clinical diagnosis and treatment.
2019 Vol. 16 (17): 39-41,71 [Abstract] ( 334 ) HTML (1 KB)  PDF (800 KB)  ( 63 )
42 Study on the correlation between QRS complex and coronary artery lesions in resting electrocardiogram
ZHAO Na1 YU Qian2 LI Jing1 YUAN Chen3
Objective To investigate the correlation between QRS (fQRS) wave group and coronary angiography in resting electrocardiogram fragmentation. Methods A total of 584 patients with coronary artery disease who underwent coronary angiography and electrocardiography in Cangzhou Central Hospital (“our hospital” for short) from October 2016 to September 2018 were divided into fQRS group (n = 350) and non-fQRS group (n = 234) according to the results of electrocardiogram examination. Cardiac function indicators [the left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), 6-minute walking test (6MWT)] and the results of coronary angiography (lesion range, lesion vessel, degree of stenosis) were compared between the two groups. The correlations between QRS wave group and cardiac function, lesion range and stenosis degree were analyzed. Results The LVEF and 6MWT in the fQRS group were smaller than those in the non-fQRS group, and the LVEDVI was larger than that in the non-fQRS group (P < 0.05). The lesion range in the fQRS group was larger than that in the non-fQRS group (P < 0.05). There was no significant difference in the lesions vessel distribution between the two groups (P > 0.05). The degree of stenosis in the fQRS group was lighter than that in the non-fQRS group (P < 0.05). Spearman analysis showed that fQRS wave detection rate was positively correlated with coronary artery disease count, and negatively correlated with coronary artery stenosis degree and LVEF (P < 0.05). Conclusion The resting electrocardiogram fQRS wave is closely related to coronary artery disease. The fQRS wave can be used as a reference index for predicting cardiac function, coronary artery lesion range and stenosis, and can provide important data support for clinical diagnosis and treatment.
2019 Vol. 16 (17): 42-45 [Abstract] ( 275 ) HTML (1 KB)  PDF (491 KB)  ( 112 )
46 Clinical effect of Quetiapine combined with cranial magnetic stimulation on psychobehavioral symptoms of senile dementia
WANG Jindong1 ZHOU Tiantian1 CHEN Xiaoqin2 WANG Bailing1 CUI Weizhen1
Objective To study the clinical effect of Quetiapine combined with transcranial magnetic stimulation in the treatment of mental and behavioral symptoms of senile dementia. Methods From October 2012 to June 2018, 100 patients of senile dementia with different degrees of mental and behavioral symptoms who were treated in Qingdao Mental Health Center were selected. They were divided into control group (50 cases) and study group (50 cases) by random number table method. Patients in both groups were given conventional treatment, the control group was treated with Quetiapine, and the study group was treated with repetitive transcranial magnetic stimulation on the basis of control group, both two groups were treated for 12 weeks. The clinical efficacy of the two groups was evaluated and compared. The cognitive function (MoCA), life ability (ADL), intelligence state (SIL) and mental and behavioral symptoms (NPI) of the two groups before and after treatment was compared. The adverse reactions of the two groups during treatment were compared. Results The total clinical effective rate was 92.00% in the study group, which was significantly higher than 76.00% in the control group, the difference was statistically significant (P < 0.05). After treatment, the scores of MoCA and SIL in the two groups were higher than those before treatment, and the study group was higher than that in the control group, the differences were statistically significant (P < 0.05). After treatment, the scores of ADL and NPI in the two groups were lower than those before treatment, and the study group was lower than that in the control group, the differences were statistically significant (P < 0.05). There was no statistically difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Quetiapine combined with transcranial magnetic stimulation is effective in the treatment of mental and behavioral symptoms of senile dementia. It can significantly improve the mental and behavioral symptoms, cognitive function, intelligence state and living ability of the patients. It has a high security, and it can provide a reference for clinical treatment.
2019 Vol. 16 (17): 46-49 [Abstract] ( 287 ) HTML (1 KB)  PDF (440 KB)  ( 130 )
50 Analysis of factors associated with curative effect in patients with secondary hemichorea
Objective To investigate the related factors influencing the curative effect in secondary hemichorea patients, and to provide early effective intervention. Methods Clinical data of 38 patients with secondary hemichorea diagnosed in Beijing Luhe Hospital, Capital Medical University from November 2012 to November 2017 was retrospectively analyzed. Logistic regression analysis was used to explore the relevant factors affecting the efficacy of secondary hemichorea. Results Among the 38 patients, 23 (60.5%) were caused by acute cerebrovascular disease, 6 patients (15.8%) by non-ketotic hyperglycemia and 9 patients (23.7%) by other causes. Following up showed that, 26 patients (68.4%) in the group with satisfactory self-efficacy and 12 patients (31.6%) with unsatisfactory efficacy, there were statistically significant difference in age, history of stroke, time from onset to first diagnosis and treatment, and location of lesions between the two groups (P < 0.05). Logistic regression analysis showed that stroke history (OR = 0.961, 95%CI: 1.423-61.658, P < 0.05) and lesion location (OR = 1.0253, 95%CI: 2.087-283.919, P < 0.05) were risk factors for poor outcome in patients with secondary hemichorea. Conclusion Acute cerebrovascular disease is the main etiology of secondary hemichorea, followed by hyperglycemia. Advanced age, stroke history, onset to first diagnosis time and location of lesions, respectively affects short-term prognosis of patients. Previous stroke history and non-basal ganglia or basal ganglia combined with other multi-site lesions are high risk factors for poor efficacy of secondary hemichorea, which should be paid high attention.
2019 Vol. 16 (17): 50-53 [Abstract] ( 271 ) HTML (1 KB)  PDF (654 KB)  ( 40 )
54 Clinical effect of Tomoxetine Hydrochloride for children with ADHD complicated by transient tic disorder
JIN Lan WANG Yi ZHANG Wenjing TIAN Le▲
Objective To observe the clinical treatment of children with attention deficit hyperactivity disorder (ADHD) complicated by transient tic disorder treated by Tomoxetine Hydrochloride. Methods The clinical data of 128 children with ADHD complicated by transient tic disorder who had received treatment in the Outpatient Service of Inner Mongolia Mental Health Center from July 2016 to July 2018 were enrolled in the study, and they were divided into two groups according to the different treatment options, with 64 cases in each group. The control group was treated with Methylphenidate Hydrochloride, whereas the observation group was treated with Tomoxetine Hydrochloride. The efficacy, cognitive function, adverse reactions and other indicators were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group after 2 months of treatment (P < 0.05). There were no statistical differences in the Cormer factor scores between the two groups before treatment (P > 0.05), however, these scores were lower than before treatment in both groups (P < 0.05). The scores of learning, behavior, anxiety and other factors in the observation group were lower than those in the control group (P < 0.05). Before treatment, there was no statistical difference between the two groups in the scores of exercise twitch and vocal twitch (P > 0.05), these scores were reduced in both groups after treatment (P < 0.05), and these scores in the observation group were lower than those in the control group (P < 0.05). There were no statistical differences in the scores of cognitive function between the two groups before treatment (P > 0.05); after treatment, however, the scores were increased than before treatment in both groups (P < 0.05). The counting, coding, digital breadth, and C factor in the observation group were higher than those in the control group (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05). Conclusion For children with ADHD complicated by transient tic disorder, Tomoxetine Hydrochloride is safe, effective and with significant curative effect, which can help improve ADHD, reduce tic disorder, correct cognitive function and enhance clinical efficacy, yet incurring fewer adverse reactions.
2019 Vol. 16 (17): 54-58 [Abstract] ( 275 ) HTML (1 KB)  PDF (589 KB)  ( 118 )
59 Effect of DC-CIK cellular immunotherapy combined with chemotherapy on clinical efficacy and immune function in patients with advanced ovarian cancer
PENG Juan1 CUI Manman2
Objective To explore the effect of dendritic cell-cytokine induced killer cell (DC-CIK) immunotherapy combined with chemotherapy for patients with advanced ovarian cancer and its influence on immune function. Methods A total of 70 patients with advanced ovarian cancer in Xindu District People′s Hospital of Chengdu from January 2015 to December 2017 was divided into two groups according to the random number table method. The control group (n = 35) was treated with Paclitaxel combined with Cisplatin, and the observation group (n = 35) was treated with DC-CIK immunotherapy on the base of control group. Continuous treatment for three courses, and follow up for 6 months, the clinical efficacy between two groups was compared. The comparisons of immune function indexes such as CD3+, CD4+, CD8+, CD19, CD16+CD56+ between two groups before and after treatment was conducted. The adverse reactions during the course of treatment were recorded and compared between the two groups. Results Six months after followed up, the disease control rate and objective remission rate in the observation group were higher than those in the control group, the differences were statistically significant (P < 0.05). The liver dysfunction and bone marrow suppression in the observation group were respectively lower than those in the control group, and the total incidence of adverse reactions in the observation group was lower than that in the control group, the differences were statistically significant (P < 0.05). After treatment, the levels of CD3+, CD4+, CD19 and CD16+CD56+ in two groups were significantly higher than those before treatment, and CD8+ level was lower than that before treatment, and the levels of CD3+, CD4+, CD19 and CD16+CD56+ in the observation group were higher than those in the control group, while the CD8+ level in the observation group was lower than that in the control group, the differences were statistically significant (P < 0.05). Conclusion DC-CIK cell immunotherapy combined with chemotherapy can significantly improve the clinical efficacy and enhance immune function, which has fewer adverse reactions and worthy of clinical promotion.
2019 Vol. 16 (17): 59-62 [Abstract] ( 349 ) HTML (1 KB)  PDF (540 KB)  ( 94 )
63 The correlation between bone mineral density and serum 25-（OH）D level in preschool children
XING Cunqiao CHEN Haiqiong CENG Guangping
Objective To investigate the bone mineral density (BMD) in preschool children and its relationship with serum 25-hydroxyvitamin D [25-(OH)D]. Methods From March 2017 to March 2018, 629 preschool children aged 0-7 who underwent BMD examination in the Outpatient Department of Child Health Care of Sanya City Womenfolk and Infant Health Care Hospital were collected as subjects. BMD was measured by quantitative ultrasound, according to BMD level, the subjects were divided into normal BMD group (n = 492) and abnormal BMD group (n = 137). The influencing factor of BMD of preschool children was analyzed by multivariate Logistic regression analysis. The level of 25-(OH) was determined by ELISA, the BMD of children with different 25-(OH)D level was compared. Pearson product moment correlation analysis was used to analyze the correlation between BMD and serum 25-(OH)D in preschool children. Results The abnormal rate of BMD in preschool children was 21.78%, which in children aged 5-7 was higher than that in others, followed by children aged 1. The abnormal rate of BMD in girls, children aged 1-year-old and 5-7-year-old was higher than that in boys and children aged 2-4-year-old (P < 0.05). The abnormal rate of BMD in preschool children with activity time ≤3 h/week, sleeping time ≤8 h/d, sunshine time ≤7 h/d was higher than that of children whose activity time >3 h/week, sleeping time >8 h/d and sunshine time >7 h/d (P < 0.05). The abnormal rate of BMD in preschool children with picky diet, vitamin D intake ≤400 U/d, dairy intake ≤150 mL/d, bean products intake ≤4 times/week, fruit intake ≤5 times/week was higher than those of children without picky diet, vitamin D intake > 400 U/d, dairy intake >150 mL/d, bean products intake > 4 times/week, fruit intake > 5 times/week (P < 0.05). Compared with 2-year-old children, 1-year-old and 5-7-year-old was independent risk factors for abnormal BMD (OR = 1.113, 1.373, 1.433, 1.479, P < 0.05). Activity time, sleeping time, sunshine time, picky diet, vitamin D intake, dairy intake, bean products intake, fruit intake was the influencing factor of abnormal BMD in preschool children (OR = 1.377, 1.654, 1.642, 1.525, 1.788, 1.598, 1.384, 1.443, P < 0.05). With the decrease of 25-(OH)D level, SOS value increased gradually, Z value decreased gradually, and abnormal rate of BMD increased gradually (P < 0.05).There was a negative correlation between SOS and serum 25-(OH) D in preschool children (r = -0.729, P < 0.05), and a positive correlation between Z value and serum 25-(OH) D (r = 0.761, P < 0.05). Conclusion The abnormal rate of BMD in preschool children is higher, especially in children aged 1 and 5-7 years. Vitamin D and calcium should be supplemented reasonably for children at high risk of BMD, outdoor activities should be strengthened, and balanced diet should be paid attention to.
2019 Vol. 16 (17): 63-67 [Abstract] ( 274 ) HTML (1 KB)  PDF (665 KB)  ( 62 )
68 Expression and significance of IL-6 and STAT3 in the maternity placenta tissues with intrahepatic cholestasis of pregnancy
YE Yunfei CHEN Baixiu
Objective To study the expression and the correlations of interleukin-6 (IL-6) and signal transducer and activator transcription 3 (STAT3) in the placentas of pregnant women with intrahepatic cholestasis of pregnancy (ICP). Methods A total of 50 pregnant women with ICP and in Obstetrics Clinic of Liuzhou General Hospital Attached to Guangxi University of Technology (“our hospital” for short) from January 2016 to December 2017 was selected as ICP group, including 25 cases of mild ICP group, 25 cases of severe ICP group. At the same time, 30 healthy pregnant women taking prenatal examination in our hospital at the same period were selected in control group. Placentas of the above gravidas were collected and the expression and localization of IL-6 and STAT3 were determined via immunohistochemistry. Results The IL-6 and STAT3 positive cell rate of ICP group were significantly higher than those of control group, the differences were statistically significant (P < 0.01). There were no significant differences in positive cell rate between mild ICP group and severe ICP group (P > 0.05). The positive expression rate of IL-6 and STAT3 were gradually increased in placental trophoblast among the control group, mild ICP group and the severe ICP group. There were positive relations between IL-6 and STAT3 expression in ICP group (r = 0.694, P < 0.01). Conclusion The expression levels of IL-6 and STAT3 are positively correlated with the disease of ICP, which therefore might be used as combined diagnosis and evaluation of the state disease.
2019 Vol. 16 (17): 68-71 [Abstract] ( 195 ) HTML (1 KB)  PDF (541 KB)  ( 88 )
72 Association of first-trimester uterine artery pulsatility index with adverse outcomes in low-risk pregnancies
HE Biyuan ZHOU Yuqing▲
Objective To discuss the feasibility of uterine artery pulsatility indexes (UtA-PI) 11-13+6 weeks in predicting adverse pregnancy outcomes. Methods From January 1, 2017 to June 31, 2567 singleton pregnancies presented for routine prenatal care in Shanghai Changning Maternity & Infant Health Hospital, who were recruited as the research object. Doppler blood flow waveforms of bilateral uterine arteries of each pregnant woman were detected at 11-13+6 weeks of gestation were measured, the UtA-PI and resistance indexes (UtA-RI), and the presence or absence of early diastolic notching were recorded. The maternal and neonatal outcomes were followed up. Results Among all the 2567 cases, 55 cases were excluded because of termination for fetal abnormalities or fetal death before 28 weeks of gestation, the other 2512 cases were enrolled in this analysis. Among the 2512 cases enrolled, there were 359 cases (14.29%) of adverse outcomes, including, 99 cases of hypertensive disorder complicating pregnancies, 88 cases of preeclampsia, 76 cases of fetal growth restriction, 76 cases of small for gestational age, 11 cases of placental abruption, 9 cases of stillbirth; and the remaining 2153 cases had normal outcomes. The mean value and the 90th percentile of UtA-PI were higher in the adverse outcome group (1.8, 2.4) than that in normal outcome group (1.68, 2.19), the differences were statistically significant (P < 0.05), respectively. By using the 90th percentile of UtA-PI as cut-off value, the sensitivity was 71% and the specificity was 75% in predicting severe adverse pregnancy outcomes, but the sensitivity was low (27%) and the specificity was high (89%) in predicting any kind of adverse pregnancy outcomes, and the sensitivity (19%) was the lowest while the specificity was high (91%) in predicting fetal growth restriction. By using the 90th percentile of UtA-PI as cut-off value, the negative predicting values were high in all groups in predicting each kind of adverse pregnancy outcomes. Conclusion UtA-PI at 11-13+6 weeks of gestation shows significance in predicting the development of adverse outcomes in low-risk pregnancies, but provides a low sensitivity.
2019 Vol. 16 (17): 72-75 [Abstract] ( 256 ) HTML (1 KB)  PDF (587 KB)  ( 121 )
76 Effect research of simulated respiratory movement on dose distribution of SBRT
RUAN Changli SONG Qibin▲ LI Xiangpan▲ FU Jingguo ZHENG Yongfa
Objective To study effect of simulated respiratory movement on dose distribution of different single dose stereotactic body radiotherapy (SBRT). Methods Twenty patients with SBRT of lung cancer with a maximum diameter of 5 cm were selected from the Cancer Center in People′s Hospital of Wuhan University from January to June 2018. Seven-field three-dimensional conformal and intensity-modulated conformal plans were designed for each lung cancer patient. The single dose of 200, 400, 600, 800, 1000 cGy was studied respectively. A two-dimensional semiconductor array Mapchecker produced by Sunnuclear Company in the United States was placed on a moving plate. The approximate motion period T was 3.5 s, which was similar to the normal breathing cycle. The range of motion was ±5, ±10, ±15 mm. Horizontal dose distribution at the corresponding isocentric output of the treatment planning system under simulated respiratory motion and static state and the difference between the measured dose distribution and the measured dose distribution were compared. Results There were significant differences in three-dimensional conformal and intensity-modulated conformal radiotherapy (3%/3 mm) pass rates between SBRT with different movement ranges and different single dose (P ＜ 0.01). Conclusion Respiratory movement can reduce the conformity of dose in tumor target area and make the dose distribution blurred. It is easy to analyze the effect of respiratory movement on dose distribution of 3DCRT by Mapchecker system software, which mainly concentrates on the head and foot direction of target area, and can affect IMRT in the whole target area. The same range of motion is distributed with single dose. The dose distribution of IMRT is higher than that of three dimensional conformation.
2019 Vol. 16 (17): 76-79 [Abstract] ( 267 ) HTML (1 KB)  PDF (828 KB)  ( 50 )
80 Clinical observation of combined therapy of whole brain radiotherapy and Elemene Injection in the treatment of multiple brain metastases
HU Daoqing1 LI Xiaodong2
Objective To explore the efficacy and side effects of Elemene Injection combined with whole brain radiotherapy in the treatment of multiple brain metastases. Methods A total of 56 patients with brain metastases treated by whole brain radiotherapy in BenQ Medical Center from April 2014 to April 2017 were collected. The changes of symptoms during hospitalization and the data of brain MRI after radiotherapy were collected. According to whether elemene was used or not, the patients were divided into elemene group and radiotherapy group. The changes of tumor size, symptom improvement and toxicity were compared between the two groups. Results The objective response rate between the elemene group (47.37%) and radiotherapy group (44.44%) had no signficant difference (P ＞ 0.05). Compared with radiotherapy group, elemene group was better in controlling the symptoms of dizziness and headache, vomiting and fatigue (P ＜ 0.05), without increasing the control rate of neurological symptoms and the conditions of acute radiotoxicity. When it came to the long-term radiotherapy response (after 6 months of radiotherapy), the incidence rate of memory loss in the elemene group was 21.74%, which was significantly lower than 63.64% in the radiotherapy group (P ＜ 0.05). Conclusion Whole brain radiotherapy combined with Elemene Injection can increase the effect of radiotherapy and the rate of symptom control. But it can not increase the objective remission rate. Compared with radiotherapy alone, it dosen't increase acute radiotoxicity and can reduce the late toxicity to some extent. Elemene in combination with whole brain radiotherapy may be used in patients with brain metastases who are not suitable for chemotherapy or who are resistant to chemotherapy.
2019 Vol. 16 (17): 80-83,91 [Abstract] ( 181 ) HTML (1 KB)  PDF (661 KB)  ( 85 )
84 Correlation study of serum ProGRP, NSE levels with chemotherapy efficacy and prognosis in patients with small cell lung cancer
HUANG Yuandong1 HE Lang1 ZHAO Xiaoping2 ZHANG Sheng1 XU Yi1
Objective To investigate the relationship of serum levels of pro-gastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) with chemotherapy efficacy and prognosis in patients with small cell lung cancer (SCLC). Methods A total of 103 SCLC patients who met the diagnostic criteria diagnosed in Oncology and Respiratory Department of Chengdu Fifth People′s Hospital from February 2016 to February 2017 were selected as study objects. Two cycles or more of the standard chemotherapy regimens were given to them. Serum ProGRP level was measured by enzyme-linked immunosorbent assay (ELISA), and serum NSE level was measured by electrochemiluminescence immunoassay (ECLIA). Taking the median serum ProGRP and NSE level as the boundary, the objects were divided into high ProGRP level group and low ProGRP level group, high NSE level group and low NSE level group, the relationship of the two indexes with efficacy and prognosis was analyzed. Results The serum levels of ProGRP and NSE in SCLC patients with tumor diameter ≥4 cm, extensive metastasis, distant metastasis and smoking history were higher than those in SCLC patients with tumor diameter ＜4 cm, limited clinical stage, no distant metastasis and no smoking history (P ＜ 0.05). The chemotherapeutic efficacy of low ProGRP level group was higher than that of high ProGRP level group, and PFS of low NSE level group was higher than that of high NSE level group. The factors affecting the prognosis of SCLC patients were clinical stage (OR = 4.986, 95%CI: 3.774-9.876, P = 0.003), distant metastasis (OR = 3.659, 95%CI: 2.182-7.569, P = 0.016) and serum NSE (OR = 2.879, 95%CI: 1.487-6.721, P = 0.005). Conclusion Serum ProGRP can predict the clinical efficacy of SCLC patients, serum NSE can predict the prognosis of SCLC patients. Two indicators should be evaluated comprehensively in clinical treatment, and close attention should be paid to SCLC patients with distant metastasis or extensive clinical stage.
2019 Vol. 16 (17): 84-87,96 [Abstract] ( 316 ) HTML (1 KB)  PDF (667 KB)  ( 80 )
88 Clinical significance of SDC2 in non small cell lung cancer
HUA Haixia1 LIU Ruiji2 YU Xiaolin1 HUO Xinlong1
Objective To study the clinical significance of SDC2 in non small cell lung cancer (NSCLC). Methods The surgical resections of NSCLC tissues of 73 cases were collected in the First Hospital of Qinhuangdao City in Hebei Province from January 2015 to January 2017 as NSCLC group. The expression of SDC2 was masured by IHC staining of NSCLC compared with normal tissue adjacent to cancer (control group). Results Compared with control group, the positive expression of SDC2 was increased in NSCLC and had a realtionship with cancer differentation and TNM stages (P < 0.05). Conclusion SDC2 may be one of potentail targets for dignosis and treatment of NSCLC.
2019 Vol. 16 (17): 88-91 [Abstract] ( 260 ) HTML (1 KB)  PDF (741 KB)  ( 88 )
92 Effect of angiogenesis inhibitor on soft tissue sarcoma：a Meta-analysis
LIN Feifan1 LI Min2 SHI Xuejun1▲
Objective To evaluate the clinical effect of angiogenesis inhibitors on the advanced soft tissue sarcoma by Meta-analysis. Methods The database of PubMed, The Cochrane Library, EMbase and CNKI were searched by computer. After selecting the documents and extracting the data according to the inclusion and exclusion criteria, the randomized controlled clinical trials of angiogenesis inhibitors in the treatment of advanced soft tissue sarcoma was selected, and RevMan 5.3 was selected to work out the Meta-analysis. The search time was from begin of database to January 2019. Results 8 RCTs including 991 cases of patients were identified. Meta analysis showed that angiogenesis inhibitors can effectively improve the rate of progress in half a year [OR = 2.44, 95%CI (1.11, 5.38), P = 0.03], objective reaction rate [OR = 1.89, 95%CI (1.15, 3.10), P = 0.01] and disease control [OR = 3.33, 95%CI(2.46, 4.53), P < 0.00 001], there was no significant difference between angiogenesis inhibitors and control group in the half-year survival rate [OR = 0.94, 95%CI(0.66, 1.32), P = 0.71]. Conclusion Angiogenesis inhibitors are effective in the treatment of advanced soft tissue sarcoma, they can effectively improve the rate of progress in half a year, objective reaction rate and disease control and they are valuable in clinical treatment.
2019 Vol. 16 (17): 92-96 [Abstract] ( 201 ) HTML (1 KB)  PDF (1372 KB)  ( 146 )
97 Expression of TCR-ζ chain in breast cancer and the clinical significance of CD8+CD28+ and CD8+CD28- and CD95 expression in peripheral blood
WANG Yanmei1 WU Bo1 AI Qingyan1 ZHAO Yufeng1 YANG Jiazhou1 LIU Yuhong2
Objective To analyze the expression and clinical significance of TCR-ζ chain in breast cancer tissues. Methods Thirty patients with breast cancer confirmed by surgery and pathology in Affiliated Hospital of Yan′an University ("our hospital" for short) from May 2015 to August 2017 (corresponding to tumor tissue specimens and adjacent tissues) were collected. 30 healthy people, 30 patients with breast fibroadenoma and 30 patients with cystic hyperplasia of breast were examined and treated in our hospital during the same period as control. Flow cytometry was used. TCR-ζ chain was detected in breast cancer tissues, adjacent tissues and normal breast tissues, and the expression of serum CD8+CD28+, CD8+CD28-, CD95, TCR-ζ chain was detected in breast cancer patients. The expression of TCR-ζ chain in breast cancer tissues, normal breast tissues and adjacent tissues was analyzed. CD8+CD28+ and CD8+CD28-, CD95, TCR-ζ chain list in peripheral blood of each group was analyzed. The expression of TCR zeta chain in peripheral blood and cancer tissues was correlated with the pathological characteristics of breast cancer. Results The relative expression of TCR-ζ chain in normal breast tissue, paracancerous tissue and breast cancer tissue was significantly different (P < 0.05). The expression of CD8+CD28+, CD8+CD28-, CD95, TCR-ζ chain in peripheral blood was higher than that in normal breast tissue (P < 0.05). There were significant differences among the four types of adenofibroadenoma and cystic hyperplasia of breast (P < 0.05). The expression levels of CD8+CD28+, CD8+CD28-, CD95, TCR-ζ chain in breast cancer patients were higher than those in breast fibroadenoma, cystic hyperplasia of breast and healthy people (P < 0.05). The expression of TCR-ζ chain in peripheral blood was significantly correlated with the size of primary tumor, lymph node metastasis, pre-and post-operative levels of CA125 (P < 0.05). Conclusion TCR-ζ chain in peripheral blood can be used to screen, diagnose and understand the condition of breast cancer patients in advance, which is a very meaningful index in clinical practice.
2019 Vol. 16 (17): 97-100 [Abstract] ( 204 ) HTML (1 KB)  PDF (652 KB)  ( 64 )
101 Clinicopathologic characteristics of observation solid papillary carcinoma of the breast
XIONG Danting SUN Libin ZHANG Shasha MIAO Junjun LI Jing LIU Biao
Objective To investigate the clinicopathological features, immunophenotype, differential diagnosis and prognosis of solid papillary carcinoma of the breast. Methods Clinicopathological data of 20 cases with solid papillary carcinoma of breast were collected and reviewed during January 2013 to October 2017 in Eastern District of Suzhou Municipal Hospital in Jiangsu Province. Immunohistochemical stainings were performed, clinicopathological feature was analyzed and follow-up was conducted. Results There were 19 females and 1 male with age between 40 and 78 years old [average of (61.8±7.9) years]. Immunohistochemical staining showed that the cases of expression of synaptophysin, chromograninA, and CD56 was 16, 10, 3, respectively. 6 cases presented with absence of myoepithelial cell markers. 14 cases had the follow-up data, and no one showed the recurrence or metastasis during the follow-up periods of 1-10 months. Conclusion With the distinctive histological features, immunophenotyping and clinicopathologic characteristics, solid papillary carcinoma has good prognosis and should be distinguished from the other papillary lesions of breast. Categorizing SPC without myoepithelial cells as in situ versus invasive carcinoma is not elucidated.
2019 Vol. 16 (17): 101-104 [Abstract] ( 294 ) HTML (1 KB)  PDF (1218 KB)  ( 138 )
105 Relationship between the pre-admission FRAIL score and SOFA score after admission of patients with septic shock and their prognosis
YIN Yanyan1 DONG Bingsheng2 JIANG Li2
Objective To investigate the relationship between the pre-admission FRAIL score and the first 24-hour sequential organ failure score (SOFA) after admission of patients with septic shock and their prognosis, so as to guide clinicians to choose appropriate treatment time and timely treatment. Methods From January 2016 to February 2018, 113 patients with septic shock who were hospitalized in the ICU of the Fuxing Hospital Affiliated to Capital Medical University, were enrolled. The 28-day entry was used as the end point of observation endpoint, and those who continued to be treated or cured or discharged from ICU within 28 days as survival group observation, and those who died within 28 days as death group. The general data, FRAIL score, acute physiology and chronic health evaluation score (APACHEⅡ), arterial blood lactate (LAC) and procalcitonin (PCT) levels were compared between the two groups. Logistic regression model was used to analyze the prognostic factors of patients. The mortality risk of septic shock was predicted by SOFA, FRAIL alone and combined with SOFA and FRAIL, and the ROC curve was drawn to observe the predictive value of FRAIL scores and SOFA scores for prognosis in patients with septic shock. Results At the end of 28 days, 53 patients survived and 60 died. There were significant differences in PCT, FRAIL and SOFA between the two groups (P < 0.05). The above three indicators were used as independent variables, survival and death were used as dependent variables, Logistic regression analysis was performed, and the early warning equation of septic shock death was used. It is logit (P) =-16.045+1.608×FRAIL+1.235×SOFA. The combination of SOFA and FRAIL had the greatest predictive value for predicting septic shock death (AUC=0.928, P < 0.01). Conclusion There are many factors influencing the prognosis of patients with sepsis in ICU. Combined FRAIL score and SOFA score are simple and effective indicators for predicting death in patients with sepsis in ICU.
2019 Vol. 16 (17): 105-108,120 [Abstract] ( 332 ) HTML (1 KB)  PDF (717 KB)  ( 66 )
109 Application of self-made laparoscopic transanal assisted total mesorectal excision in patients with middle and low rectal cancer
WANG Yuncheng ZHAI Gang QIN Chuan
Objective To observe the effect of percutaneous transanal assisted total mesorectal excision (TME) in patients with moderate-low rectal cancer. Methods From June 2016 to June 2018, 45 cases of moderate-low rectal cancer patients admitted to the General Surgery People′s Hospital of Baise were selected and divided into two groups by the random number table method. There were 20 patients in the observation group and 25 patients in the control group. The control group was treated with conventional laparoscopic TME, and the observation group was treated with self-made platform laparoscopic transanal approach and transabdominal TME. The surgically related indicators and rectal surgical specimens were compared in the two groups. Treatment-related costs of the two groups were compared. Follow-up statistics and comparison of postoperative complications, recurrences, and deaths were compared and compared in the two groups. Results There was no significant difference in operation time, length of rectum resection, length of distal tumor resection margin, number of lymph node dissection, mesenteric integrity and negative rate of resection margin between the two groups (P ＞ 0.05). Intraoperative blood loss in the observation group was less than that in the control group, the incidence of complications was lower than that in the control group, and the time of anal exhaust and hospital stay were shorter than that in the control group, with statistically significant differences (P ＜ 0.05). The costs of operation and hospitalization in the observation group were significantly lower than those in the control group, with statistically significant differences (P ＜ 0.05). Two cases were lost to follow-up in the two groups, and the follow-up period was 3 months to 2 years. No recurrence or death occurred in the two groups during the follow-up period. Conclusion Compared with laparoscopic TME in the treatment of middle and low rectal cancer under self-made platform endoscopy, TME through anal assisted approach has similar operation time and surgical resection of rectum, but the former has many advantages, such as small intraoperative blood loss, fast postoperative recovery, low cost and few complications, and is worthy of promotion.
2019 Vol. 16 (17): 109-112,128 [Abstract] ( 189 ) HTML (1 KB)  PDF (767 KB)  ( 80 )
113 Expression level and clinical significance of serum lncR-MEG3 in patients with acute pancreatitis
ZHANG Yun CHEN Wenxiao ZHANG Yan
Objective To investigate the expression level and clinical significance of long non-coding RNA-MEG3 (lncR-MEG3) in serum of patients with acute pancreatitis. Methods Form March 2015 to January 2018, 97 cases of patients in Taizhou First People′s Hospital ("our hospital" for short) with acute pancreatitis were sollected as treated group, and it can be divided into patients with mild acute pancreatitis (MAP group, n = 62) and patients with severe acute pancreatitis (SAP group, n = 35), and from the same period were randomly selected 30 cases of healthy check-up for a control, using real-time fluorescent quantitative PCR method established groups of serum lncR-MEG3 expression level, and analyze its relationship with the clinical features and diagnostic value of illness severity of acute pancreatitis. Results The expression levels of lncR-MEG3 in serum of patients in MAP group and SAP group were lower than those in the control group, and those in SAP group were lower than those in MAP group (P ＜ 0.05). The improved CT severity index (MCTSI) score ≥4 points, bedside Acute pancreatitis severity bedside index (BISAP) score ≥3 points, Ranson score ≥3 points, and serum lncR-MEG3 expression levels in patients with acute pancreatitis were lower than MCTSI score＜ 4 points, BISAP score ＜ 3 points, and Ranson score＜ 3 points. The curve area (AUC) under ROC curve was used to evaluate the diagnostic value of serum lncR-MEG3 for the severity of acute pancreatitis. The results showed that the AUC was 0.805, 95%CI (0.720, 0.891), and the optimal cut-off value of lncR-MEG3 was 3.67, and the sensitivity and specificity were 0.79, 0.85, and accuracy was 0.82, respectively. Conclusion Serum lncR-MEG3 is involved in the pathogenesis of acute pancreatitis through down-regulation of its expression, which is closely related to the severity of acute pancreatitis. Early detection can be used as an important marker to evaluate the severity of acute pancreatitis.
2019 Vol. 16 (17): 113-116,132 [Abstract] ( 277 ) HTML (1 KB)  PDF (737 KB)  ( 156 )
117 Changes and clinical significance of TLR2 and TLR4 levels in pleural effusion of patients with tuberculous pleurisy
YE Taosheng ZHANG Jiaohong ZHANG Peize ZENG Xuan XU Yuxiang LI Min
Objective To investigate the changes and clinical significance of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) levels in pleural effusion of patients with tuberculous pleurisy. Methods From January 2016 to December 2018, 102 patients with tuberculous pleurisy who were admitted to the Third People′s Hospital of Shenzhen ("our hospital" for short) were selected（group A）, and 80 patients with malignant pleural effusion (group B) and 62 patients with bacterial pneumonia(group C). The enzyme-linked immunosorbent assay was used to detect all the TLR2 and TLR4, tumor necrosis factor alpha (TNF-α), monocyte chemotactic protein-2 (MCP-2), matrix metalloproteinase 1 (MMP-1) levels, Pearson correlation coefficient method was used to analyze correlation of  TLR2, TLR4 and TNF-α, MCP-2, MMP 1; the receiver-operating characteristic curve (ROC) analysis was adopted to assess the diagnostic value of TLR2 and TLR4. Results The levels of TLR2, TNF-α, MCP-2 and MMP-1 in group A were higher than those in group B and group C (P ＜ 0.05). Pearson correlation coefficient analysis showed that TLR2 was positively correlated with TNF-α, MCP-2 and MMP-1 in tuberculous pleurisy (P ＜ 0.05), while TLR4 was not correlated with TNF-α, MCP-2 and MMP-1 (P ＞ 0.05). TLR2 was positively correlated with TLR4 in patients with tuberculous pleurisy (P ＜ 0.05). The area under the curve of TLR2 in diagnosis of tuberculous pleurisy was 0.724, which was significantly higher than that under the curve of TLR4 (P ＜ 0.05). Conclusion TLR2 levels in tuberculous pleurisy patients show a significant upward trend, and are significantly positively correlated with TNF-α, MCP-2 and MMP-1 in pleural effusion, which may be involved in the occurrence and development of tuberculous pleurisy and have a better diagnostic value for tuberculous pleurisy.
2019 Vol. 16 (17): 117-120 [Abstract] ( 247 ) HTML (1 KB)  PDF (637 KB)  ( 71 )
121 Clinical features and prognostic analysis of severe accidental injury in children
LIANG Yufeng1 YU Li2 YANG Yiyu1 WU Zhiyuan1▲
Objective To analyze the clinical characteristics of children with severe accidental injuries admitted to the Pediatric Intensive Care Unit (PICU), and to provide reference for the monitoring and prevention of severe accidental injuries. Methods The clinical data of 182 children aged 0-14 years with accidental injuries admitted to the PICU of Guangzhou Women and Children′s Medical Center from October 2013 to September 2016 were retrospectively analyzed. They were divided into four groups according to age: 0 year old < infant group ≤ 1 year old (49 cases); 1 year old <children group ≤ 3 years old (91 cases); 3 years old < preschool children group ≤ 6 years old (29 cases); 6 years old < school age children group ≤ 14 years old (13 cases). The types, constituent ratios, age characteristics and mortality of accidental injuries in each group were analyzed. Results A total of 182 children suffering from accidental injuries (6.06% of PICU) were included in this study, including 118 boys (64.8%) and 64 girls (35.2%). The proportion of accidental injuries in boys was higher than that in girls (P < 0.05). The occurrence of accidental injury was 82 cases (45.05%) of airway foreign body, 31 cases (17.03%) of falling injury, 26 cases (14.29%) of food/drug poisoning, 17 cases (9.34%) of traffic injury, 11 cases (6.04%) of drowning, 9 cases (4.95%) of digestive tract foreign body and 6 cases (3.30%) of burns. The incidence of airway foreign body and falling injury in each group was significantly different (P < 0.05). The incidence of airway foreign body was the highest in the children group, and the incidence of falling injury was the highest in the infant group. The mortality rate of falling injury in each group was significantly different (P < 0.05). Conclusion When formulating preventive measures for children′s accidental injury, factors such as region, age, sex and injury type should be taken into account to improve the first aid system for children′s accidental injury prevention and reduce the occurrence of accidental injury.
2019 Vol. 16 (17): 121-124 [Abstract] ( 268 ) HTML (1 KB)  PDF (599 KB)  ( 59 )
125 Changes of serum IL-33, sST2 and MCP-1 levels in patients with chronic hepatitis B virus infection and its clinical significance
LI Jin1 LUO Zhongyu1 CHEN Liuzhen2 LIN Peiji1
Objective To investigate the changes of serum levels of interleukin-33 (IL-33) and its receptor soluble growth STimulation expressed gene 2 (sST2) and monocyte chemotactic protein-1 (MCP-1) in patients with chronic hepatitis B virus infection, and to analyze their clinical significance. Methods One hundred and five patients with chronic hepatitis B virus infection in Dongguan People′s Hospital from January 2017 to January 2018 were selected as the observation group, including 67 patients with simple chronic hepatitis B (chronic hepatitis B group), 38 patients with hepatic failure (hepatic failure group), and 50 healthy volunteers without liver diseases were selected as the control group. Serum levels of IL-33, sST2 and MCP-1 were measured in each group, and the degree of hepatic fibrosis in chronic hepatitis B group was assessed according to Ishak pathological score. The expression of the above indicators in patients with different degrees of hepatic fibrosis was compared. Results The levels of IL-33, sST2 and MCP-1 in chronic hepatitis B group and hepatic failure group were significantly higher than those in control group, and the expression of IL-33, sST2 and MCP-1 in hepatic failure group was significantly higher than those in chronic hepatitis B group (P ＜ 0.05). Compared with mild hepatic fibrosis group, the levels of IL-33, sST2 and MCP-1 in moderate hepatic fibrosis group, severe hepatic fibrosis group and cirrhosis group increased, and the levels of IL-33, sST2 and MCP-1 in severe hepatic fibrosis group and cirrhosis group were higher than those in moderate hepatic fibrosis group, while the levels of IL-33, sST2 and MCP-1 in cirrhosis group were higher than those in severe hepatic fibrosis group, the differences were statistically significant (P ＜ 0.05). Pearson correlation analysis showed that IL-33, sST2 and MCP-1 was positively correlated with Ishak score in patients with chronic hepatitis B (r = 0.573, 0.728, 0.654, P ＜ 0.05). Conclusion Serum IL-33, sST2 and MCP-1 can evaluate and predict chronic hepatitis B virus infection and the aggravation of the disease. The test of serological indexes for the patients is helpful for disease diagnosis and prognosis evaluation.
2019 Vol. 16 (17): 125-128 [Abstract] ( 307 ) HTML (1 KB)  PDF (733 KB)  ( 111 )
129 Clinical characteristics of the brainstem infarction with dizziness as the first symptom
YANG Ying1 ZHANG Yongbo2▲
To investigate the clinical and imaging features of brainstem infarction with dizziness as the first symptom. Methods Eighty-seven brainstem infarction patients who had dizziness as the primary symptom in Department of Neurology in Beijing Friendship Hospital from March 2013 to August 2016 were recruited, and underwent MRI+DWI and CT angiography (CTA) examination. They were divided into three groups according to the distribution of affected lesions, the midbrain group, the pons group, and the medulla oblongata group, and their clinical characteristics were analyzed. Results Brainstem infarction with dizziness as the primary symptom mainly occurred in the pons, accounting for 68.97%, and the medulla oblongata accounted for 24.14% secondly. All patients were observed with dizzinessin, 18 cases (accounting for 20.69%) showed isolated dizziness(no other accompanying symptoms) among them, the most common associated symptom was unilateral limb weakness (accounting for 51.72%); the responsible vessel of midbrain infarction were mainly distributed in the posterior cerebral artery, and the pons were mainly distributed in the in basilar artery with mild-to-moderate narrow, the medulla oblongata were mainly distributed in the in vertebral artery with heavy-to-occlusive narrow. Conclusion Brainstem infarction with dizziness as the primary symptom mainly occurred in the pons. The most common associated symptom is unilateral limb weakness. Pathological vessels, the midbrain are mainly distributed in the posterior cerebral artery, and the pons mainly in basilar artery with mild-to-moderate narrow, the medulla oblongata mainly in vertebral artery with heavy-to-occlusive narrow.
2019 Vol. 16 (17): 129-132 [Abstract] ( 231 ) HTML (1 KB)  PDF (603 KB)  ( 118 )
133 Clinical effect of Bailemian Capsules combined with Escitalopram Tablets in the treatment of insomnia with depression and anxiety
ZHANG Dongzi1 CHEN Yalan2 LIU Jiancong3
Objective To investigate the clinical effect of Bailemian Capsules combined with Escitalopram Tablets in the treatment of insomnia with depression and anxiety. Methods From February 2016 to April 2018, 143 cases of insomnia patients with depression and anxiety admitted to the Affiliated Hospital of Hebei University were selected. According to the random number table method, they were divided into the control group (n = 71) and the research group (n = 72). The control group was treated with Escitalopram Tablets, while the research group was treated with Bailemian Capsules on the basis of the control group. The clinical effects of the two groups were compared after 2 months of treatment, compared two groups of patients Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD), Pittsburgh sleep quality index (PSQI), serum neuropeptide Y (NPY) and substance P (SP) were compared before and after 2 months treatment, adverse reactions during treatment were recorded in both groups. Results The total effective rate of the study group was significantly higher than that of the control group (P ＜ 0.05). HAMA, HAMD and PSQI of the two groups were decreased after 2 months of treatment compared with those before treatment, and the study group was lower than the control group (P ＜ 0.05). After 2 months of treatment, the serum NPY level in the two groups was higher than that before treatment, and the level of SP in the study group was lower than that in the control group (P ＜ 0.05). The total incidence of adverse reactions during treatment in the study group was lower than that in the control group (P ＜ 0.05). Conclusion Bailemian Capsules combined with Escitalopram Tablets for the treatment of insomnia with depression and anxiety has an accurate effect, which can effectively improve the clinical symptoms of patients, improve the serum NPY and SP levels of patients, and effectively reduce the incidence of adverse reactions.
2019 Vol. 16 (17): 133-136 [Abstract] ( 250 ) HTML (1 KB)  PDF (433 KB)  ( 119 )
137 Evaluation of short-term efficacy of Apatinib in the treatment of 12 patients with advanced lung cancer
LI Chaoqun WANG Xiuming ZHU Lingyan
Objective To evaluate the clinical efficacy of Apatinib in the treatment of advanced lung cancer. Methods The clinical data of 12 patients with advanced lung cancer treated with Apatinib from June 2017 to October 2018 in Second People′s Hospital of Wuhu were retrospectively analyzed, 4 weeks for one cycle. The clinical efficacy was evaluated, adverse reactions were recorded, prevention and treatment were guided, and 3 consecutive cycles were evaluated. Results The disease control rate was 91.67% after one cycle, 63.64% at two cycles and 42.86% at three cycles. Proteinuria and blood in sputum were the most common adverse reactions, and blood in sputum was the most serious. Conclusion The short-term efficacy of Apatinib in the treatment of advanced lung cancer is remarkable. With the prolongation of treatment time, the efficacy shows a downward trend. Adverse reactions are generally tolerable and worthy of clinical promotion.
2019 Vol. 16 (17): 137-139,155 [Abstract] ( 233 ) HTML (1 KB)  PDF (781 KB)  ( 89 )
140 Application effect of continuous care of interactive standard theory in patients after artificial hip replacement in accelerated rehabilitation surgery
NVRGUL·Mithat1 SHI Lingyun2 WANG Xinling3▲
Objective To investigate the effect and evaluation of continuous care in patients undergoing artificial hip replacement (THA) by using Interactive standard theory in enhanced recovery after surgery (ERAS). Methods From December 2017 to July 2018, 102 patients with THA in Joint Surgery Department of the First Affiliated Hospital of Xinjiang Medical University were selected, patients were divided into experimental group and control group by random number table method. The control group adopted traditional discharge and follow-up nursing mode, and the experimental group adopted interactive standard theory for continuous care on this basis. The scores of hip joint function (Harris), daily living ability (ADL), pain, complication rate and satisfaction after discharge were compared between the two groups. Results During postoperative follow-up, Harris score, ADL score and patient satisfaction of the experimental group were higher than those of the control group, while pain score and complication rate were lower than those of the control group. The difference was statistically significant (P ＜ 0.05 or P ＜ 0.01). Conclusion In the case of THA patients in ERAS mode, the application of interactive compliance theory to implement continuity care achieved good results, which is conducive to further promoting the early out-of-hospital rehabilitation of patients and enriching and improving the connotation of ERAS and high-quality nursing service, which is worth promoting in clinical practice.
2019 Vol. 16 (17): 140-143 [Abstract] ( 255 ) HTML (1 KB)  PDF (600 KB)  ( 82 )
144 Application effect of focused resolution model in patients with Alzheimer′s disease complicated with cerebral thrombosis
YIN Hongxia1 ZHANG Wei1 WANG Yingli2
Objective To explore the application effect of focused resolution model in patients with alzheimer's disease complicated with cerebral thrombosis. Methods Clinical data of 200 patients with Alzheimer's disease complicated with cerebral thrombosis admitted to Dalian Central Hospital from January 2015 to January 2018 were analyzed. According to different interventions, they were divided into control group (100 cases and routine rehabilitation nursing) focusing on solving model group (focusing on solving mode) 100 cases. Before and after the intervention, the National Institutes of health stroke scale (NIHSS) score, family function score function and motor function, cognitive function, language score, and clinical efficacy of two goups were observed. Results There was no significant difference in NIHSS score, family function score, cognitive function, language function and motor function score between the two groups before intervention (P ＞ 0.05). After intervention, the NIHSS scores of two groups were higher than before the intervention, family function score was lower than before intervention, the cognitive function, the language function and motor function scores were higher than before the intervention; NIHSS scores of the focused solution model group was higher than that of the control group, and the family function score was lower than that of the control group, cognitive function, language function and motor function scoreswere higher than those of the control group, and the difference was statistically significant (P ＜ 0.05).The total clinical response rate of patients of the focused resolution model group was higher than that in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion The application of focused resolution model in patients with alzheimer's disease complicated with cerebral thrombosis can reduce neurological damage and improve cognitive and motor functions, which is worthy of clinical application.
2019 Vol. 16 (17): 144-147 [Abstract] ( 217 ) HTML (1 KB)  PDF (605 KB)  ( 40 )
148 Application of quality control circle in improving the implementation rate of early functional exercise in patients after permanent pacemaker implantation
ZHOU Jiali LIANG Jingyu WANG Nian
Objective To investigate the role of quality control circle management mode in improving the effect of early functional exercise of patients with permanent pacemaker implantation. Methods A total of 62 patients who underwent permanent pacemaker implantation in the Department of Cardiovascular Medicine, Renmin Hospital of Wuhan University from May 2015 to May 2016 were collected. Among them, patients receiving permanent pacemaker implantation from May 1, 2015 to August 31, 2015 were the control group, a total of 26 cases, who were given routine perioperative nursing measures. The patients who received permanent pacemaker implantation from January 1, 2015 to April 30, 2016 were the experimental group, a total of 36 patients were admitted into the quality control circle. The self-made questionnaire was used to evaluate the nurses, and the awareness rate of the nurses about the pacemaker before and after the implementation of QCC was compared. The implementation rates of early functional exercise after pacemaker implantation were compared between the two groups. Results After the implementation of QCC activities, the rate of nurses′ knowledge of patient care after permanent pacemaker implantation increased from 68.75% to 100.00% (P ＜ 0.05). Especially, got a comprehensive understanding of the ways of early functional exercise after operation. The implementation rate of early functional exercise increased from 61.54% to 91.43% (P ＜ 0.01). Conclusion The implementation of quality control circle can effectively improve the implementation rate of early functional exercise of patients after permanent pacemaker implantation, accelerate the recovery of patients, reduce postoperative complications, and effectively improve the professional quality of nursing staff.
2019 Vol. 16 (17): 148-151,159 [Abstract] ( 222 ) HTML (1 KB)  PDF (1069 KB)  ( 49 )
152 Discussion and effect evaluation of standardized training methods for new nurses in integrated Chinese and Western medicine hospitals
PI Qiaohong
Objective To explore and evaluate the methods and effects of the standardized training for new nurses in integrated Chinese and Western medicine hospitals. Methods The newly recruited nwrses from Beijing Hepingli Hospital in August 2016 were selected, on the basis of combining the reality of the hospital established with characteristic of combining traditional Chinese and Western medicine hospital new nurse training program, take the three stages of standardization training for a period of two years, focuses on the theory of traditional Chinese and Western medicine nursing knowledge, skills, training such as operation and clinical practice ability, and at each stage before and after training to design the paper make a comprehensive evaluation. Results After the standardized training, the new nurses′ level of integrated traditional Chinese and Western medicine nursing knowledge and operation skills were significantly higher than before the training, and the difference was statistically significant (P ＜ 0.05). In the standardized intensive training stage, the nursing comprehensive scores were all improved compared with those at the admission stage, and the difference was statistically significant (P ＜ 0.05). Conclusion Standardized training can effectively improve the theoretical knowledge and operational skills of traditional Chinese and Western medicine nursing for new nurses to a certain extent.
2019 Vol. 16 (17): 152-155 [Abstract] ( 239 ) HTML (1 KB)  PDF (594 KB)  ( 97 )
156 Report a case of wilson disease complicated with hepatic myelopathy
JIA Shupei1 YANG Wenming2
As a rare neurological disease, wilson disease has the most significant liver damage, and the metabolic disorder caused by liver failure often leads to other related complications. This paper reports a case of hepatolenticular degeneration with hepatic myelopathy. This patient was diagnosed with hepatolenticular degeneration in 2013, and was admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine for several times for the treatment of liver protection with copper discharge. In April 2018, the patient began to suffer from distal limb numbness and weakness, with progressive aggravation, and developed to be unable to walk within half a year. At present, hepatolenticular degeneration combined with hepatic myelopathy was diagnosed, and comprehensive treatment including nerve nutrition, liver protection and copper drainage was given. Both hepatolenticular degeneration and hepatic myelopathy are closely related to liver damage, and combined reports are rare. To explore the diagnosis and treatment of concurrent diseases, this report is hereby reported.
2019 Vol. 16 (17): 156-159 [Abstract] ( 749 ) HTML (1 KB)  PDF (381 KB)  ( 175 )
160 Studying on the way to be success of medical students in the new era
LIANG Meiying
As the opportunities for medical education and medical students to success appear in the new era, basic requirements for the quality of medical talents in the new era is discussed, as well as new characteristics, new changes and new problems. The way how to be success of medical students is complex. The main factors are listed as followed. First, synergistic education mechanism should be established. Second, cultural self-confidence education of medical students should be strengthened. Third, medical humanistic feelings and the innovative consciousness of medical students should be enhanced. Forth, course setting system should be optimize and so on.
2019 Vol. 16 (17): 160-164 [Abstract] ( 1114 ) HTML (1 KB)  PDF (684 KB)  ( 139 )
165 Grassroots employment guidance and practice research of traditional Chinese medicine college students
JIA Hongtao1 ZHAO Nan2 LENG Dayong1 LI Baohe1 XIAO Yang1 ZHANG Yu1 CHE Zhiyuan3
At present, with the development of medical and health services and the reforment of modern medical health system continuously in our country. The universities of Chinese medicine in expanding every year and the number of graduates has increasing year by year, but all kinds of urban medical and health industry can provide lack of jobs. The students of Chinese medicine employment is facing enormous challenges. However, the grass-roots employment as a way of university students′ employment, has become one of the important way of traditional Chinese medicine universities graduate employment. This study focuses on strengthening the guidance of grassroots employment education for students of traditional Chinese medicine, changing the concept of traditional employment and establishing the correct concept of grassroots employment. At the same time, it not only strengthens the publicity but also education of grassroots employment to create a good employment atmosphere. We will carry out community-level employment practices to improve our overall employment capacity and strengthen the guidance of grassroots employment situation. With enhancing students' employment confidence, helping students to establish a correct concept of grassroots employment, alleviating employment pressure, and then promoting the vigorous development of grassroots medical and health services.
2019 Vol. 16 (17): 165-168,172 [Abstract] ( 809 ) HTML (1 KB)  PDF (697 KB)  ( 106 )
169 Efficacy evaluation of acupuncture combined with bloodletting therapy in the treatment of acute lumbar sprain
GAO Yang1 LI Xi1 DU Shuangqing1▲ LIU Haiyong2 ZHAO Jinrong2 CHEN Wenjie2
Objective To observe the effect of dynamic acupuncture therapy combined with bloodletting therapy on acute lumbar sprain. Methods A total of 100 patients with acute lumbar sprains admitted to the Affiliated Hospital of Hebei College of Traditional Chinese Medicine and Sanhe Hospital from April 2017 to December 2018 were selected as the research objects. They were divided into observation group and control group by random number table method, 50 cases in each group. The observation group was treated with acupuncture and moxibustion, and the acupoints were Futu and Xuanzhong, combined with bloodletting therapy. The control group was treated with ordinary acupuncture, and the acupoints were bilateral lumbar Jiaji, Shenyu, Zhishi, Dachangyu, Yaoyan, once a day, 5 days as a course of treatment, and the curative effects of two groups were evaluated after one course of treatment. The lumbar flexion and extension activity before and after treatment were compared between the two groups, and the Japanese Orthopaedic Association Scores (JOA) before and after treatment were observed and compared between the two groups. Results There was no significant difference in lumbar activity between the two groups before treatment (P > 0.05). The lumbar activity of the two groups were higher than that before treatment (P < 0.05), and the observation group was higher than the control group (P < 0.05). The JOA scores of the two groups were higher than those before treatment (P < 0.05), and the observation group was higher than the control group (P < 0.05). The total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion The treatment of dynamic acupuncture therapy combined with bloodletting therapy has a quick onset and less adverse reactions, and the effect is better than ordinary acupuncture.
2019 Vol. 16 (17): 169-172 [Abstract] ( 181 ) HTML (1 KB)  PDF (688 KB)  ( 72 )
173 Application effect of high-fidelity simulation teaching in nursing clinical reasoning education of nursing students
LUO Qiaoqian
Objective To explore the application effect of high-fidelity simulation teaching in clinical reasoning teaching. Methods A total of 72 nursing interns from June 2017 to May 2018 in a third-class A hospital in Wuhan were selected by convenient sampling method. They were divided into experimental group and control group according to random number table method. The experimental group used high-fidelity simulation teaching to assist clinical reasoning courses, and the control group used traditional teaching methods to teach clinical reasoning courses. Both groups were for one month. The clinical reasoning ability of two groups were evaluated before the start of the course, at the end of the course, and three months after the end of the course. The self-made questionnaire was used to evaluate the teaching effect of the clinical reasoning course. Results Before the teaching, the scores of clinical reasoning ability were not significantly different between the two groups (P < 0.01). After the teaching, the scores of clinical reasoning ability of the two groups were significantly higher than those before the teaching, and the experimental group was significantly higher than the control group (P < 0.01). The scores of the experimental group in the four aspects of specialist nursing knowledge, nursing operation ability, team cooperation ability and communication ability were higher than those of the control group (P < 0.01). Conclusion The application of high-fidelity simulation teaching in nursing teaching can simulate the clinical situation, thus creating a safe, continuous and efficient learning environment for students, and can effectively improve their clinical reasoning ability.
2019 Vol. 16 (17): 173-177 [Abstract] ( 204 ) HTML (1 KB)  PDF (684 KB)  ( 57 )
178 Risk management of hospital logistic outsourcing service and management control measures
ZHU Meng
Hospital logistics, as an important department of hospitals, provides an important basic guarantee for the daily operation of hospitals. Combining with the new requirements and situation of the Medical and Health System Reform, this study aims to further improve the support capability of logistic services in hospitals, and focuses on logistics outsourcing services which is a core work. Through analyzing the problems and risks in logistics outsourcing services of hospitals, this study explore and proposes detailed solutions and suggestions, so as to ensure the provision of high-quality, efficient and satisfactory logistics outsourcing services.
2019 Vol. 16 (17): 178-封三 [Abstract] ( 211 ) HTML (1 KB)  PDF (822 KB)  ( 110 )
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