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2017 Vol. 14, No. 14 Published: 2017-05-15

	4	Ultrasound imaging characteristics analysis of benign and malignant thyroid nodules
		LI Bing WU Qi SUN Shengrong
		Objective To analyze ultrasound imaging characteristics of thyroid nodules with the relative importance of these features in predicting risk for malignancy. Methods 933 patients underwent thyroid ultrasound imaging and thyroid nodule resection from June 2012 to September 2014 in Renmin Hosptial of Wuhan University were retrospectively analyzed. 1362 resected nodules were divided into benign group (n=1022) and thyroid cancer group (n=340) according to the histopathological examination results. Ultrasound results of each nodule were analyzed, the difference between two groups was compared. Risk factors of thyroid cancer screening were analyzed by Logistic regression. Results Ultrasound nodule characteristics of tumor size, boundary, calcification type, aspect ratio, blood flow signal, echo image and cervical lymph node enlargement and other imaging characteristics between benign group and thyroid cancer group were compared, with statistical differences (P ＜ 0.05). For hypoechoic nodules following four ultrasound nodule characteristics were considered to be the only findings associated with the risk of thyroid cancer: microcalcifications (OR=27.954, 95%CI=18.119-43.128, P < 0.01), central vascularity (OR=5.841, 95%CI=4.162-8.197, P < 0.01), ill defined or spiculated margins (OR=3.034, 95%CI=2.227-4.135, P < 0.01) and cervical lymphadenopathy (OR=22.981, 95%CI=13.045-40.483, P < 0.01). Grade Ⅰ was defined as none of abnormal ultrasound imaging characteristic and the risk of cancer was less than 20%. Grade Ⅱ was defined as 1 characteristic was used as an indication for ultrasound except microcalcifications, the risk of cancer was 20%-<50%.Grade Ⅲ was defined as 2 characteristics were required for ultrasound imaging included only had microcalcifications, the risk of cancer was 50%-80%. And grade Ⅳ was defined as 3 or more suggestive ultrasound characteristics were contained, the risk of cancer was more than 80%. Conclusion Thyroid ultrasound imaging can be used to identify patients who have a low risk of cancer to reduce unnecessary and excessive treatment and biopsy.
		2017 Vol. 14 (14): 4-7,15 [Abstract] ( 162 ) HTML (1 KB) PDF (646 KB) ( 80 )

	8	Bioinformatics analysis and significance of EgAgB8/3 protein from Echinococcus granulosus in Xinjiang Uygur Autonomous Region
		MA Haimei1,2 Wulamu·Mamuti1,2 ZHANG Fengbo2,3 PANG Pan2,4 ZHAO Hui2,3 DING Jianbing2,4
		Objective To analyze the amino acid sequencing of EgAgB8/3 protein from Echinococcus granulosus in Xinjiang Uygur Autonomous Region, understand the characteristics of this protein, predict the epitope of its antigen, so as to provide theoretical foundation for further studying and selecting the best alternative antigen of immunological diagnosis and prevention of echinococcosis. Methods The amino acid sequencing and physicochemical property of EgAgB8/3 proteins were predicted by bioinformatics method, the characteristics and secondary structure of EgAgB8/3 proteins were analyzed by different bioinformatics software, and its antigenic epitope was predicted combined with multiple parameters. Results EgAgB8/3 antigen was polypeptide composed of 75 amino acid residues, the relative molecular mass was 8.58×103, isoelectric point was 8.5; the analysis of protein characteristics showed the secondary structure characteristics of α-helix, β-sheet, β-turn and random coil of EgAgB8/3 proteins, among which, there were 3 better areas of β-turn that could be as reference segment of epitope; comprehensive analysis of three software and multiple parameters predicted that, the epitope of EgAgB8/3 protein antigen was mainly located in 1-7 (FVVVAHA), 6-19 (HADDDDDEVTKTKK) and 32-38 (FQSDPLG). Conclusion The prediction for dominant epitope of three B cell epitopes of EgAgB8/3 protein by bioinformatics method has important significance for further studying the antigenicity of EgAgB8/3 and developing more valuable target for immunological diagnosis and prevention of echinococcosis.
		2017 Vol. 14 (14): 8-11 [Abstract] ( 174 ) HTML (1 KB) PDF (1027 KB) ( 88 )

	12	Changes and correlation of PTEN and p-AKT protein expression in breast cancer patients
		LIANG Faqing1 HE Yangjun2 DU Zhenggui1▲
		Objective To investigate the expression and significance of protein tyrosinase gene (PTEN) and phosphorylated protein kinase (p-AKT) in patients with breast cancer. Methods 91 cases of breast cancer tissues in West China Hospital from February 2014 to July 2016 were selected, and normal breast tissues from the edge of tumor tissues 1 cm were selected as control group, immunohistochemical method was used to detect the expression of PTEN and p-AKT protein. Results The positive rate of PTEN expression in breast cancer tissues was significantly lower than that in adjacent tissues (P < 0.05), but the p-AKT protein expression was higher than the adjacent tissue (P < 0.05). The PTEN positive expression rate in patients with axillary lymph node metastasis was significantly lower than that in patients without axillary lymph node metastasis (P < 0.05), while the positive expression of p-AKT protein was significantly higher than that without axillary lymph node metastases (P < 0.05). The expression of PTEN protein and p-AKT protein was related to the histological grade (P < 0.05), the expression of p-AKT protein was related to TNM stage (P < 0.05), the expression of PTEN protein and p-AKT protein were not correlated with age, menopausal status, tumor size, estrogen receptor and progesterone receptor in patients with breast cancer (P > 0.05). There was a negative correlation between the expression of PTEN protein and p-AKT protein in breast cancer (r=-0.337, P < 0.05). Conclusion The expression of PTEN protein is decreased in breast cancer, the expression of p-AKT protein is increased, and the expression of PTEN protein and p-AKT protein are negatively correlated, which may play an important role in the development of breast cancer.
		2017 Vol. 14 (14): 12-15 [Abstract] ( 174 ) HTML (1 KB) PDF (619 KB) ( 40 )

	16	Systolic pressure and heart heavy index changes in whole process of over-loaded heart hypertrophy
		LIANG Yue1 ZHANG Guangtao2 TANG Xiaomeng1 WANG Yingchun1 LIU Yuqin1 SHI Jun3
		Objective To discuss the change of systolic pressure and heart weight index (HWI) in the process of cardiovascular pressure overload to myocardial hypertrophy. Methods 80 healthy male Wistar rats were randomly divided into two groups, sham operation group and abdominal aorta group. Each group was randomly separated to 4 time points (3 d, 1 week, 2 weeks, 4 weeks after surgery). Hypertrophy rats model was made by transverse aortic constriction (TAC), systolic blood pressure was measured by noninvasive tail arterial blood pressure measurement and analysis system. The weight of the left ventricular and body was measured by an electronic balance, and the HWI was then calculated. Results Compared with sham operation group, 3 d after TAC surgery, systolic pressure of abdominal aorta group rose, the difference was statistically significant (P < 0.05); 1 week after TAC surgery, systolic pressure of abdominal aorta group rose, HWI increased, the differences were statistically significant (P < 0.05); 2, 4 weeks after TAC surgery, systolic pressure of abdominal aorta group rose, HWI increased, the differences were statistically significant (P < 0.05). Conclusion Rat myocardial hypertrophy model is formed gradually after 1 week and the model is stable in the fourth week. By abdominal TAC, the pressure overload was successfully produced and the myocardial hypertrophy can be induced successfully.
		2017 Vol. 14 (14): 16-19 [Abstract] ( 150 ) HTML (1 KB) PDF (839 KB) ( 77 )

	20	Effects of a combination therapy with a compound Chinese medicine and an enteral nutrition powder in the treatment of mice with chronic obstructive pulmonary diseases
		DENG Yicai1△ LIU Wenzhen2△ CHEN Zihan2,3 ZHANG Yaxin2 YAN Shufeng2 ZHENG Zhiling2,3 DONG Fang1 CHEN Zhuo2
		Objective To evaluate the validity and safety of a combination therapy with a compound Chinese medicine and an enteral nutrition powder ensure on chronic obstructive pulmonary diseases (COPD). Methods Among 96 male mice, 24 mice were randomly selected as a normal control group, the other 72 mice were induced as COPD mice after 60-day smoking. These COPD mice were then randomly divided into 3 groups: COPD positive group, Ensure treatment group (0.558 g/mL Ensure, 0.1 mL/10 g mice), combination therapy group (0.558 g/mL Ensure, 0.1 mL/10 g mice+2.5 g/mL traditional Chinese medicin, 0.06 mL/10 g mice). The weights of all mice were monitored during the whole experimental period. The serologic tests were carried out before and at different time points (2 weeks or 5 weeks) after the treatments began. Meanwhile, histological examinations of their lungs were performed. Results Compared with the normal control group mice, COPD mice showed a lower amount of serum albumin (P < 0.05) and a higher level of serum aminotransferase activity (P < 0.05) with a much slower rate in weight gaining.
		2017 Vol. 14 (14): 20-24 [Abstract] ( 165 ) HTML (1 KB) PDF (915 KB) ( 69 )

	25	Protective effects of phycocyanin on myocardium in rats with acute myocardial ischemia reperfusion injuries
		CAO Mi XU Liqin LIU Qingzhong QI Xushen
		Objective To observe the protective effects of phycocyanin on myocardium in rats with acute myocardial ischemia reperfusion injuries (MIRI), and explore the mechanism. Methods The model of acute myocardial ischemia reperfusion injury was established by ligating the left anterior descending coronary artery of 48 SPF SD rats with 30 min after reperfusion, then they were divided into 3 groups: model control group, phycocyanin group A and group B, another 8 rats were selected as normal control group. Rats in phycocyanin group A and group B were treated with phycocyanin by intragastric administration [100, 400 mg/（kg·d）] for 10 d, rats in model control group and normal control group were treated with the same does of 0.9% sodium chloride solution by intragastric administration. The activity of T-SOD and GSH-PX were detected in the tail venous blood, the content of MDA in myocardium was detected, the expression of iNOS in cardiac myocytes was detected by immunohistochemistry. The expression of cyclin dependent kinase inhibitor P21 and P27 in coronary artery was detected by image analysis. Results Compared with model control group and after modelling, the activity of T-SOD and GSH-PX in group A and group B improved significantly, the content of MDA reduced significantly, the expression of cyclin dependent kinase inhibitor P21 and P27 in coronary artery improved significantly, the expression of iNOS in cardiac myocytes reduced significantly, the differences were statistically significant (P < 0.05). Phycocyanin group A were compared with Phycocyanin group B, the differences were not statistically significant (P > 0.05). Conclusion Phycocyanin can protect myocardium with MIRI by promoting P21 and P27 gene expression, improving T-SOD and GSH-PX enzyme activity, controlling iNOS and lipid peroxidation of ischemic myocardium and reducing the myocardial cell pathological vascular remodeling.
		2017 Vol. 14 (14): 25-28 [Abstract] ( 171 ) HTML (1 KB) PDF (658 KB) ( 59 )

	29	Influences of Bushen Huoxue Granules on M1/M2 macrophage polarization in the heart of ovariectomized mice
		JIA Chengming MA Jing CHEN Changbo CAO Liang LI Yingqi WU Leitao
		Objective To explore whether Bushen Huoxue Granules could cure cardiac microvascular dysfunction by regulating M1/M2 macrophage polarization in female ovariectomized mice. Methods According to random number table, 30 SPF level and 8 weeks old C57BL/6 mice were divided into sham group, model group and treatment group. Eight weeks after ovariectomy, treatment group was given Bushen Huoxue Granules (containing crude drugs 6 g/mL) by gavage, once a day, for eight weeks. Sham group and model group were given the same volume of physiological saline. HE staining, immunofluorescence staining and real-time quantitative PCR were used to detect the influences of Bushen Huoxue Granules on organization structures of heart tissue, the ultra oxygen anion, platelets endothelial cell adhesion molecules (CD31), CD68, and the mRNA expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-10 and vascular endothelial growth factor (VEGF). Results Compared with the sham group, the expression of IL-1β mRNA, TNF-α mRNA, ultra oxygen anion, CD68 cells in model group were increased (P ＜ 0.05), while the expression of CD31, IL-10 mRNA were decreased (P ＜ 0.05). Compared with the model group, the expression of IL-1β mRNA, TNF-α mRNA, ultra oxygen anion of heart tissue in the treatment group were decreased (P ＜ 0.05), while the expression of CD31 and IL-10 mRNA were increased (P ＜ 0.05). No significant difference was found with the expression of CD68 between the model group and treatment group (P ＞ 0.05). Conclusion Bushen Huoxue Granules may cure cardiac microvascular dysfunction by regulating M1/M2 macrophage polarization in ovariectomized mice.
		2017 Vol. 14 (14): 29-32 [Abstract] ( 141 ) HTML (1 KB) PDF (668 KB) ( 94 )

	33	Progress of neuroinflammation mechanism in depression
		MA Chunyan ZHANG Chen▲
		Recently, with the development of neurobiology, the effect of neuroinflammation on depression has been highlighted. More and more research find the importance of aberrant neuroinflammation in the development of depression. In this paper, neuroinflammation mechanism of depression is to do a review.
		2017 Vol. 14 (14): 33-35 [Abstract] ( 140 ) HTML (1 KB) PDF (422 KB) ( 123 )

	36	Research process of glucose transpoter 1 in Alzheimers disease
		LI Weiping1 ZHANG Lei2 SHEN Yanfang2 DU Jumei2
		Alzheimers disease (AD) is the most common type of dementia in the elderly. The incidence of Alzheimers disease is increasing year by year. At present, the pathogenesis of Alzheimers disease has not been fully elucidated and there is no effective preventive and therapeutic measures. Glucose transporter 1 (GLUT1) is a glucose transporter expressed mainly in the blood-brain barrier endothelial cells, which transports blood glucose to the brain tissue along the blood-brain barrier and provides energy for metabolism of brain cells. It is concluded that the expression of GLUT1 in the blood-brain barrier endothelial cells of AD patients is decreased, which may be related to the pathogenesis and pathological damage of AD. GLUT1 play a important role in the damage of blood-brain barrier integrity, amyloid β-peptide (Aβ) clearance and phosphorylation of tau. By reviewing relevant literatures in recent years, we hope to explore the GLUT1 in AD to provide a reference.
		2017 Vol. 14 (14): 36-39 [Abstract] ( 158 ) HTML (1 KB) PDF (439 KB) ( 140 )

	40	Current concepts and progress in the clinical diagnosis of intracranial germ cell tumors
		WANG Haibin ZANG Li MU Yiming
		Intracranial germ cell tumor is a kind of extragonadal germ cell tumors, mainly occurs in children and teenagers under the age of 20. Due to the diversity of its clinical manifestation, the types of histopathology and the pathogenic site, different treatment regimens are often needed. Therefore, earlier and accurate diagnosis can make targeted treatment earlier, reducing the damage to the central nervous system. The current clinical diagnosis relies mainly on the clinical manifestations, imaging, tumor markers, cerebrospinal fluid cytology and surgical biopsy pathology diagnosis. In addition, microRNA may be potentially valuable biomarkers in the diagnosis of intracranial germ cell tumors. This article mainly summarizes the current status and the progress of clinical diagnosis of intracranial germ cell tumors.
		2017 Vol. 14 (14): 40-43 [Abstract] ( 138 ) HTML (1 KB) PDF (442 KB) ( 85 )

	44	The application of patient safety culture status evaluation in specialized hospital and influence factors analysis
		WANG Jinyu1 SONG Zhen1 WANG Chuan1 LI Qiuyan1 MA Xinjuan2
		Objective To investigate current situation of patient safety culture in hospital by HSOPS questionnaire, and analyze relevant influence factors, in order to provide reference for the scientific hospital administration. Methods Stratified sampling was used. Staffs from clinical department, medical technology department, and administrative department in Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences who were eligible for the inclusive criteria were selected for HSOPS investigation. Results A total of 221 staffs accounted for 10% of the total number of the whole staffs in hospital were included in the survey. The reliability and validity of questionnaires were good. Compared with the result of the United States (AHRQ) survey results, better dimensions were teamwork within the units, transition and connection, administrative support for patient safety and cooperation between different departments; however, frequency of events reporting, situation of the working staffs and reactions towards non-punishment negligence were three poor dimensions. Single factor analysis found that the higher education background, the lower frequency of events reporting, with statistically significant differences (P < 0.05). There were statistically significant differences in situation of the working staffs between doctors and staffs from other positions (P < 0.05). It is indicated that hours worked per week negatively correlated with situation of the working staffs (rs=-0.220, P < 0.05). Conclusion The HSOPS questionnaire can provide quantitative indicators and dimensions for the construction of patient safety cultural work in hospital, and help to distinguish the advantages and disadvantages.
		2017 Vol. 14 (14): 44-47 [Abstract] ( 152 ) HTML (1 KB) PDF (353 KB) ( 60 )

	48	Protective effect of Propofol combined with Benazepril on myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting under cardiopulmonary bypass
		LIU Zhifang XIA Yu PAN Bo ZHU Xiongkai
		Objective To investigate the protective effect of Propofol combined with Benazepril pretreatment on myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting under cardiopulmonary bypass. Methods From September 2014 to October 2016, 94 patients underwent coronary artery bypass grafting were divided into two groups according to random number table: observation group (47 cases), Benazepril oral before surgery 1 week, intraoperative Propofol anesthesia was continuously taken; control group (47 cases), intraoperative Propofol was taken. The levels of cTnI, CK-MB activity, sICAM-1 level and the number of patients with positive inotropic drugs were observed in two groups were observed. The incidence of adverse events, auto-resuscitation and left ventricular ejection fraction in two groups were compared. Results After surgery 6, 12, 24, 72 h, cTnI, CK-MB activity, sICAM-1 of observation group wrer lower than control group, after cardiopulmonary resuscitation 12, 24, 48 h, the number of patients with positive inotropic drugs were less than control group, the incidence of postoperative myocardial ischemia and atrial fibrillation was lower than the control group, the rates of auto resuscitation and left ventricular ejection fraction were higher than those of the control group, the differences were statistically significant (P < 0.05). Conclusion Propofol combined with Benazepril pretreatment can effectively reduce the myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting under cardiopulmonary bypass, and has clinical value.
		2017 Vol. 14 (14): 48-51 [Abstract] ( 154 ) HTML (1 KB) PDF (477 KB) ( 86 )

	52	Analysis of recent prognosis of elderly patients with acute decompensated heart failure and its influencecing factors
		WANG Yin ZHANG Bin▲
		Objective To analyze the recent prognosis of patients with acute decompensated heart failure and its influencecing factors. Methods From January 2014 to December 2016, in Traditional Chinese Medicine Hospital of Baoji City, the clinical data of elderly 135 patients (≥ 60 years) with acute decompensated heart failure were retrospectively analyzed, they were divided into two groups according to the prognosis: patients without adverse event were as the control group and patients with adverse event were as the observation group. The clinical data of patients in the two groups were compared; the influencing factors of prognosis were analyzed by multi-factor Logistic regression analysis; the Spearman rank correlation coefficient analysis was used to analyzed the correlation between the risk factors of major adverse cardiovascular events and level of NT-proBNP. Results There were 65 patients (48.15%) with adverse event and 70 patients (51.85%) without adverse event among 135 patients. There was no statistically significant difference in the sex, blood pressure, pathogenesis, CK-MB and pathogenesis of patients between the two groups (P > 0.05); the age, BMI, NYHA classification, serum creatinine, GFR, LVEF, NT-proBNP, cTnI and level of NSE of patients in the two groups had statistically significant differences (P < 0.05). Logistic regression analysis showed that the multiple factors, age≥70 years, BMI>35 kg/m2, NYHA class Ⅳ, LVEF <50%, NT-proBNP>3600 pmol/L were the influence factors of major adverse cardiovascular events in elderly patients with acute decompensated heart failure (OR = 2.198, 1.647, 3.887, 3.542, 2.239, P < 0.05). Conclusion Age, obesity, NYHA classification Ⅳ, lower LVEF and higher level of NT-proBNP is the influencecing factors of the recent prognosis of elderly patients with acute decompensated heart failure,and NYHA classification, LVEF has obvious correlation with the NT-proBNP,so the clinical should pay attention to these patients who with higher NYHA classification and lower LVEF.
		2017 Vol. 14 (14): 52-55 [Abstract] ( 148 ) HTML (1 KB) PDF (479 KB) ( 89 )

	56	Short-term prognostic analysis of elderly patients with acute inferior myocardial infarction with different infarct-related artery after primary PCI
		LI Chenggang1 XIA Yong2 GAO Wen1 TONG Jiangtao1
		Objective To investigate the elderly patients' short-term clinical prognosis of acute inferior wall ST-segment elevation myocardial infarction (STEMI) with different infarct-related artery (IRA) undergoing primary percutaneous coronary intervention (pPCI). Methods From January 2015 to April 2016, in Department of Cardiology of Affiliated Hospital of Xuzhou Medical University, 133 elderly patients (≥60 years) with the inferior wall STEMI undergoing pPCI successfully were selected. According to difference of IRA, the enrolled elderly patients were divided into rightcoronary artery group (RCA group, n = 103) and left circumflex group (LCX group, n = 30). The patients' general clinical characteristic, and all patients followed up within 30 d of major adverse cardiovascular events (MACE), including cardiacdeath, heart failure or cardiogenic shock, malignant arrhythmia and target vessel revascularization were collected. Results LVEF of RCA group after operation 7 d and follow-up 30 d were significantly lower than those of LCX group [(47.1±8.4)% vs (53.4±7.1)%, (49.5±8.9)% vs (56.3±6.9)%,], the differences were statistically significant (P < 0.05). During the follow-up period, there were 45 MACE case in the group RCA, only 6 MACE cases in the group LCX. incidence of MACE in two groups was compared (43.7% vs 20.0%), the difference was statistically significant (P < 0.05). Conclusion RCA induced inferior STEMI in elderly patients has a poorer short-term prognosis than LCX.
		2017 Vol. 14 (14): 56-59 [Abstract] ( 134 ) HTML (1 KB) PDF (479 KB) ( 96 )

	60	Analysis of clinical features of leukopenia patients in a three level general hospital in Beijing
		YE Fang ZHANG Li'nan SUN Jianli WANG Huan TONG Chun WANG Ling
		Objective To investigate the clinical features of leukopenia patients in a three level general hospital in Beijing. Methods Data of leukopenia patients, according to age, gender, distribution department, main symptoms in the hospital information management system (HIS) of Beijing Chuiyangliu Hospital Affiliated to Tsinghua University from July 2015 to July 2016 were collected and analyzed retrospectively. Results 3344 cases (12.36%) of leukopenia were found in 27 046 cases of patients with routine blood test, 1035 cases (30.59%) of men and 2309 cases (69.05%) of women. Outpatients accounted for 78.41% (2622 cases), 21.59% of hospitalized patients (722 cases). Among 722 hospitalized patients with leukopenia, neutropenia accounted for 97.65% (705 cases), 291 cases were male, accounting for about 41.28% of the total number of neutropenia, and 414 cases were female, accounting for about 58.72% of the total number of neutropenia; and agranulocytosis accounted for 1.94% (14 cases), there were 7 males, accounting for 50% of the total number of agranulocytosis, and 7 women, accounting for 50% of the total number of agranulocytosis. The hospitalized patients of leukopenia were mainly distributed in Department of Hematology, Department of Respiration, and Department of General Surgery. The outpatients with leukopenia were mainly distributed in Emergency Internal Medicine, Department of Respiration, and Department of Hematology. The hospitalized patients of neutropenia were mainly distributed in Department of Hematology, Department of Respiration, and Department of General Surgery. The hospitalized patients of agranulocytosis were mainly distributed in the Department of Respiration, ICU, Department of Hematology. Main symptoms of leucopenia outpatients were fever, cough, abdominal distension abdominal pain. Conclusion The incidence of leukopenia is high in a three lever general hospital, female more than male. Clinical symptoms are often atypical, and patients distribute in different departments. This should cause the attention of the doctors of the clinical departments.
		2017 Vol. 14 (14): 60-63 [Abstract] ( 159 ) HTML (1 KB) PDF (330 KB) ( 79 )

	64	Effect of Alteplase on ultra early stage for clinical outcome of patients with cerebral infarction
		LI Hongfei XU Dongjuan ZHANG Weiqiang GUO Xiang
		Objective To investigate the effect of Alteplase on ultra early stage for clinical outcome of patients with cerebral infarction. Methods From October 2015 to December 2016, in Dongyang People's Hospital, 120 cerebral infarction patients were selected, they were divided into the observation group (60 cases) and control group (60 cases) by random number table, the control group was given routine treatment, the observation group was given Alteplase on ultra early stage based on the control group, two groups were treated for 14 d. Neuron specific enolase (NSE), central nerve specific protein (S100β) and inflammatory factor, neurological function, life ability and adverse reaction of two groups were compared. Results After treatment, the NSE and S100 in observation group were lower than those in control group, IL-6, TNF-a, CRP was lower than those in control group, the differences were statistically significant (P < 0.05). The MBI score in observation group was higher than that in control group, the NIHSS score was lower than that in control group, the differences were statistically significant (P < 0.05). There was no significant difference in adverse reactions between the two groups (P > 0.05). Conclusion Alteplase on ultra early stage can significantly reduce inflammatory factors, NSE and S100β level of patients with cerebral infarction, improve neurological function and life ability, and less adverse reactions, it is a safe and effective treatment method.
		2017 Vol. 14 (14): 64-67 [Abstract] ( 145 ) HTML (1 KB) PDF (480 KB) ( 102 )

	68	Association study of fibrinogen genepolymorphisms and haplotypes in ischemic stroke
		OU Ningjiang1 DONG Liangzhe1 OU Yanping1 CHEN Xuan2 LI Guohui2 LI Jun1 CAI Yonglin1 TANG Minzhong1
		Objective To discuss the relationship between fibrinogen (Fg) gene polymorphism and its haplotype with cerebral infarction. Methods From January 2014 to November 2015, in Wuzhou Red Cross Hospital, 255 patients with cerebral infarction were selected as case group, and at same time, 262 healthy persons were selected as control group. βBcl-1 G/A and αTaq-1 site gene typing were taken by polymerase chain reaction (PCR) -restricted fragment length polymorphism analysis technology, Taqman real-time fluorescence quantification PCR probe method was applied to take 448G/A, -148C/T, -455G/A, -854G/A, rs6050 for gene typing, 1211A/G, 1202C/T were analyzed by nucleotide sequence determination, the establishment and analysis of gene haplotype were made by Haploview software, and finally Clauss method was taken to measure blood-plasma Fg level. Results In 9 Fg genetic locus, the difference of genotype frequency and allele frequency of -455G/A polymorphism between case group and control group was statistical significance (P < 0.01), the differences of genotype frequency and allele frequency of 448G/A, -148C/T, -854G/A nucleotide polymorphism between case group and control group were no statistical significance (P > 0.05). The relative risk of -455A carriers suffering from cerebral infarction was 5.203 times higher than that of non-carriers. Both 1211A/G, 1202C/T were wild types, mutation sites were not found. Haplotype analysis result showed that close linkage was in 3 sites that-455G/A, -148C/T, 448G/A, haplotype formed by it and occurrence of cerebral infarction had significant positive correlation, and haplotype ATA and ATG had statistically significant differences (P < 0.01). Conclusion Fg gene and cerebral infarction occurrence had significant haplotype correlation, Fgβ-455G/A, -148C/T, 448G/A may be the risk factors of people associated with cerebral infarction.
		2017 Vol. 14 (14): 68-72 [Abstract] ( 143 ) HTML (1 KB) PDF (537 KB) ( 52 )

	73	Influence factor analysis of ovarian metastasis in endometrial carcinoma
		YANG Jing1 LEI Yuan1 XING Hui2
		Objective To study the influence factor of ovarian metastasis in endometrial carcinoma. Methods 310 cases of patients with endometrial carcinoma who were first diagnosed and operatively treated in Xiangyang Central Hospital from June 2010 to June 2016 were retrospectively analyzed. Results 30 cases (9.7%) had ovarian metastasis in 310 cases of endometrial carcinoma. Single factor analysis showed that pathological type, histological grade, depth of myometrial invasion, vaginal invasion, fallopian tubes metastasis, lymph node metastasis, peritoneal fluid cytology, CA125 were significantly associated with ovarian metastasis (P < 0.05), while age, menopause, cervical invasion were not significantly associated with ovarian metastasis (P > 0.05). Multiple factors analysis showed that, independent risk factors of ovarian metastasis included positive peritoneal fluid cytology, higher CA125 level, positive lymph node metastasis, histological grade G2-G3, non-adenocarcinoma, positive fallopian tubes metastasis (P < 0.05). Conclusion Positive peritoneal fluid cytology, higher CA125 level, positive lymph node metastasis, histological grade G2-G3, non-adenocarcinoma, positive fallopian tubes metastasis are the independent predictive factors of ovarian metastasis in endometrial carcinoma. Ovarian preservation in patients with endometrial carcinoma is feasible, however, multi-center and larger sample research is necessary.
		2017 Vol. 14 (14): 73-76 [Abstract] ( 178 ) HTML (1 KB) PDF (330 KB) ( 92 )

	77	Effect of transcatheter arterial chemoembolization combined with Sorafenib in the treatment of advanced hepatocellular carcinoma
		WANG Chunyan1 WU Bin1 LAN Chuan1 DENG Dawei1 ZHANG Guangnian1 LENG Zhengwei2 LI Jianshui1
		Objective To assess the therapeutic effect of transcatheter arterial chemoembolization (TACE) combined with Sorafenib in the treatment of advanced hepatocellular carcinoma. Methods The clinical data of 88 patients with advanced hepatocellular carcinoma hospitalized in the Affiliated Hospital of North Sichuan Medical College from January 2012 to January 2016 was analyzed retrospectively. The patients were divided into TACE group and TACE + Sorafenib group (combined group), with 44 cases in each group. The disease control rate, incidence of adverse reactions, half-year survival rate, one-year survival rate of the two groups were analyzed. Results The disease control rate of combined group was 54.5%, which was higher than that of TACE group (29.5%), the difference was statistically significant (P ＜ 0.05); the incidence of adverse reactions in combined group was 81.8%, which of TACE group was 84.1%, there was no significant difference between the two groups (P ＞ 0.05). The half-year survival rate and one-year survival rate in combined group was 59.1%, 47.7% respectively, which was significantly higher than those of TACE group (36.4%, 25.0%), the differences were all statistically significant (all P ＜ 0.05). Conclusion TACE combined with Sofafenib in the treatment of advanced hepatocellular carcinoma is feasible, the therapeutic effect is good, the long-term lifetime is prolonged, the tolerance is well, which is worthy of clinical promotion.
		2017 Vol. 14 (14): 77-79 [Abstract] ( 155 ) HTML (1 KB) PDF (508 KB) ( 136 )

	80	Clinical effect of Icotinib as first-line therapy for advanced non-small cell lung cancer with sensitive gene mutations
		ZENG Aiping YU Qitao
		Objective To evaluate the short-term efficacy and adverse reactions of Icotinib as first-line therapy for advanced non-small cell lung cancer with sensitive gene mutations. Methods A retrospective analysis was conducted to the advanced non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutations, who were treated in Affiliated Tumor Hospital of Guangxi Medical University from January 2013 to October 2015. The patients were prescribed Icotinib medication, once 125 mg, 3 times/day, until tumor showed progression or the toxic side effects could not be tolerated. The clinical efficacy, benefit ratio in different periods, and adverse reactions were evaluated. Results The median progression free survival (PFS) was 13.1 (2.1, 72.4) months in 59 patients, with completed remission (CR) in 2 cases, partial remission (PR) in 40 cases, stable disease (SD) in 13 cases, and progressive disease (PD) in 4 cases. The objective remission rate (CR+PR) was 71.2%, and the disease control rate (CR+PR+SD) was 93.2%. The main side effects were rash and diarrhea. No interstitial lung disease and hematologic toxicity were observed. Conclusion Icotinib can effectively improve the efficacy and benefit rate of advanced non-small cell lung cancer patients with EGFR mutations, with high safety, but the target and precise treatment of this drug still needs large sample and multicentric researches to be confirmed.
		2017 Vol. 14 (14): 80-83 [Abstract] ( 201 ) HTML (1 KB) PDF (606 KB) ( 78 )

	84	Clinical effect of 5-Fluorouracil and Gemcitabine combined with concurrent radiotherapy in the treatment of locally advanced pancreatic carcinoma
		YE Shifu CHEN Yang SHOU Feng LIN Yuanhong YE Ling
		Objective To investigate the clinical effect of 5-Fluorouracil and Gemcitabine combined with concurrent radiotherapy in the treatment of locally advanced pancreatic carcinoma. Methods The clinical data of 80 cases of patients with locally advanced pancreatic carcinoma admitted to Jianyang People's Hospital from February 2012 to March 2016 was analyzed retrospectively, they were divided into two groups by different treatment methods, treatment group A (Gemcitabine treatment) had 30 cases, treatment group B (5-Fluorouracil, Gemcitabine treatment) had 50 cases. The physical inventory score, pain index score, general well-being assessment scale, Spitzer life quality index score of two groups before and after treatment were observed, the remission rate of clinical treatment between the two groups was compared. Results The physical inventory score, pain index score of two groups after treatment were lower than those before treatment, the general well-being assessment scale score, Spitzer quality of life index score were higher than those before treatment, the differences were all statistically significant (P ＜ 0.05). After treatment, the physical inventory score and pain index score of treatment group B were lower than those of treatment group A, the general well-being assessment scale score and Spitzer quality of life index score were higher than those of treatment group A, the differences were all statistically significant (P ＜ 0.05). The remission rate of treatment group B was higher than that of treatment group A, the difference was statistically significant (P ＜ 0.05). Conclusion 5-Fluorouracil and Gemcitabine combined with concurrent radiotherapy in the treatment of locally advanced pancreatic carcinoma can improve the patients' physical inventory, quality of life, decrease the pain degree, increase general well-being assessment and clinical effect, which is worthy of promotion and application.
		2017 Vol. 14 (14): 84-87 [Abstract] ( 152 ) HTML (1 KB) PDF (558 KB) ( 37 )

	88	Comparison on the clinical effect of laparoscopic myomectomy and trans-abdominal myomectomy
		CHEN Xin
		Objective To investigate and compare the clinical effect of laparoscopic myomectomy and trans-abdominal myomectomy in the treatment of uterine fibroid. Methods The clinical data of 90 cases of patients with uterine fibroid admitted to Mianyang People's Hospital of Sichuan province from May 2014 to May 2016 was analyzed retrospectively, the patients were divided into trans-abdominal group (40 cases) and laparoscopic group (50 cases). The trans-abdominal group was taken trans-abdominal myomectomy, the laparoscopic group was taken laparoscopic myomectomy. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative complications (infection, bleeding of incisions, intestinal obstruction, emphysema) and the conditions of recovery of menstruation, recurrence of uterine fibroid of two groups were observed. Results The intraoperative blood loss, operation time, postoperative hospital stay of laparoscopic group were less or shorter than those of trans-abdominal group, the incidence of postoperative complications in laparoscopic group was lower than that of trans-abdominal group, the differences were all statistically significant (P ＜ 0.05). There were no statistically significant differences of the proportion of recovery of menstruation and recurrence of uterine fibroidb between the two groups (P ＞ 0.05). Conclusion Laparoscopic myomectomy in the treatment of uterine fibroid has little trauma, fast recovery and less postoperative complications, which is worthy of clinical promotion and application.
		2017 Vol. 14 (14): 88-91 [Abstract] ( 130 ) HTML (1 KB) PDF (551 KB) ( 85 )

	92	Clinical effect of Oxycodone Hydrochloride Sustained-release Tablets in the treatment of moderate and severe pain of advanced malignant tumor
		LI Gaiying LI Wei SU Yanjun HU Xiaojun
		Objective To observe the analgesic effect and adverse reactions of Oxycodone Hydrochloride Sustained-release Tablets in the treatment of pain of advanced malignant tumor. Methods Ninety-one patients with moderate and severe pain of advanced malignant tumor treated in Liangxiang Teaching Hospital, Capital Medical University from May 2015 to April 2016 were selected and divided into study group (46 cases) and control group (45 cases) according to the random number table method. The study group was taken Oxycodone Hydrochloride Sustained-release Tablets, the control group was taken Morphine Sulfate Sustained-release Tablets, the dose was adjusted according to the pain of patients in the two groups, for 14 consecutive days. The clinical effect, complement, Karnofsky performance status (KPS) scores and incidence of adverse reactions between the two groups were compared. Results The total effective rate of the study group was 91.30%, which of the control group was 95.55%, the difference was not statistically significant (χ2=0.668, P ＞ 0.05). There were no significant differences in KPS score, C3 and C4 between the two groups before and after analgesia (all P ＞ 0.05); after analgesia, the KPS scores of the two groups were significantly higher than those before analgesia (P ＜ 0.05); after analgesia, the levels of C3 and C4 in the two groups were also higher than those before analgesia, the differences were statistically significant (P ＜ 0.05). The incidence of adverse reactions in the study group (13.04%) was lower than that of the control group (31.11%), the difference was statistically significant (χ2=4.330, P ＜ 0.05). Conclusion The analgesic effect of Oxycodone Hydrochloride Sustained-release Tablets in the treatment of pain of advanced malignant tumor is almost the same with Morphine Sulfate, but it has lower incidence of adverse reactions and more security of taking medicine.
		2017 Vol. 14 (14): 92-95 [Abstract] ( 140 ) HTML (1 KB) PDF (552 KB) ( 74 )

	96	Analysis of risk factors on delayed neuropsychiatric sequelae after acute carbon monoxide poisoning
		ZHANG Liang FU Le ZHANG Yu YANG Chen PANG Shuyi GUO Dazhi
		Objective To analysis the risk factors on delayed neuropsychiatric sequelae (DNS) after acute carbon monoxide poisoning (ACMP). Methods from February 2013 to March 2016, in Department of Hyperbaric Oxygen and ER, the clinical data of 119 patients diagnosed as ACMP were retrospectively analyzed. Patients were divided into DNS group (15 cases) and non-DNS group (104 cases), they occured DNS or not after poisoning 5 weeks. The factors might affect DNS development including gender,age,duration of exposure,disturbance of consciousness,if or not receiving HBOT within 24 hours after poisoning and white blood cell count (WBC), creatine kinase (CK), creatine kinase isoenzymes (CK-Mb) in vein serums were compared. Results The univariate analysis results showed: duration of exposur ≥ 6 hours, glasgow coma scale (GCS) score < 9 and insufficient HBOT within 24 h after poisoning were related with DNS development (P < 0.05). The multivariate analysis showed: independent prognostic factors were GCS score < 9 (OR = 1.05, 95%CI: 1.01-1.09) and age (OR = 5.83, 95%CI: 1.13-25.58) (P < 0.05). Conclusion ACMP patients who is elder, more serious disturbance of consciousness, has longer period of exposure and insufficient HBOT within 24 h after poisoning are likely to develop DNS. More attentions should be paid to these patients who have such characteristics.
		2017 Vol. 14 (14): 96-98,102 [Abstract] ( 134 ) HTML (1 KB) PDF (583 KB) ( 81 )

	99	Curative effect study on early continuous renal replace therapy for severe sepsis patients
		WU Xiaodi CHEN Yubing WU Xiang HUANG Xiangling
		Objective To explore the curative effect of early continuous renal replace therapy (CRRT) for severe sepsis patients. Methods 100 cases of severe sepsis patients were chosen in ICU Department of Central Hospital of Chancheng District in Foshan City from September 2014 to September 2016, and these patients were divided into the control group and treatment group retrospectively, each group had 50 cases. The control group was given conventional treatment, and the treatment group was given early CRRT (within 6 hours of diagnosis) on the basis of the control group. The indexes of inflammatory factors, immunization and prognosis (APACHEⅡ score, SOFA score and oxygenation index) were compared between the two groups. Results After 7 days treatment, the level of CRP in the treatment group was lower than that in the control group (P < 0.05), but the levels of CD4+/CD8+ and IgA in the treatment group were higher than those in the control group (P < 0.05). The scores of APACHⅡ and SOFA in the treatment group were lower than those in the control group (P < 0.05), but oxygenation index was higher than that in the control group (P < 0.05). Conclusion Severe sepsis patients treated by early CRRT, not only can eliminate over-expressed inflammatory mediators, improve T cell function and immune function disorder, but also improve prognosis of sepsis. It is worthy of clincal application.
		2017 Vol. 14 (14): 99-102 [Abstract] ( 164 ) HTML (1 KB) PDF (561 KB) ( 113 )

	103	Analysis of distribution and drug resistance of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae
		LI Li LIU Dan WANG Jiahe▲
		Objective To analyze the clinical distribution and drug resistance of extended-spectrum beta-lactamase (ESBLs)-producing Klebsiella pneumoniae in hospitalized patients in Shengjing Hospital Affiliated to China Medical University ("our hospital" for short), in order to provide references for therapy of infections. Methods ESBLs-producing Klebsiella pneumoniae isolated in our hospital from January to December 2015 were collected. The bacteria identification and drug sensitivity test were performed by the VITEK 2 Compact. The ESBLs preliminary screening and the phenotypic confirmatory test were taken according to the guideline of CLSI, and at the same time, the results of the drug sensitivity test were analyzed. Results 302 strains of ESBLs-producing Klebsiella pneumoniae were isolated, which were mostly isolated from sputum samples (38.74%), followed by blood (28.81%) and urine (13.91%). The bacteria were mainly distributed in Paediatrics Department (53.97%) and General Surgery Department (7.95%). The drug resistances of ESBLs-producing Klebsiella pneumoniae to Ampicillin, Cefazolin, Piperacillin, Ceftriaxone, Cefotaxime in hospitalized patients were more than 95%, and the resistance rate to carbapenemes was lower, less than 3%. Conclusion The isolated ESBLs-producing Klebsiella pneumoniae in hospitalized patients are highly resistant to the commonly used antibiotics, and the treatment is difficult. Therefore, the drug sensitive test should be strengthened to direct clinical rational use of antibiotics.
		2017 Vol. 14 (14): 103-106 [Abstract] ( 131 ) HTML (1 KB) PDF (600 KB) ( 77 )

	107	Effect of early enteral nutrition combined with parenteral nutrition sequential treatment for critical patients with mechanical ventilation
		LI Ping1 WEN Jing1 NIE Yuqin2▲
		Objective To determine the effect of implementing early enteral nutrition combined with parenteral nutrition sequential treatment and outcomes of critical patients with mechanical ventilation. Methods From January to December 2016, in Second Department of Intensive Care Medicine of Second Affiliated Hospital of Xinjiag Medical University, according to random number table, 100 critical patients with mechanical ventilation support were divided into treatment group and control group, with 50 cases in each group. The control group was given total parenteral nutrition support, and the treatment group was treated with early enteral nutrition combined with parenteral nutrition sequential treatment, other treatment of two groups were same. Alb, PA, TRF, IgG, TST of patients were evaluated at admission and 14 d in hospital, ventilator associated pneumonia (VAP) of patients were observed, mechanical ventilation time, ICU stay time of patients in two groups were compared. Results After intervention, Alb, PA, TRF, IgG, TST of two groups were better than admission, and these of treatment group were better than control group, the differences were statistically significant (P < 0.05). The mechanical ventilation time, ICU stay time of treatment group were less than control group, rate of VAP in treatment group were less than control group, the differences were statistically significant (P < 0.05). Conclusion Early enteral nutrition combined with parenteral nutrition sequential treatment for critical patients with mechanical ventilation can improve nutritional status, regulate the immune function, reduce the prevalence of ventilator-associated pneumonia, shorten the mechanical ventilation time and hospitalization stay.
		2017 Vol. 14 (14): 107-110 [Abstract] ( 136 ) HTML (1 KB) PDF (586 KB) ( 26 )

	111	Effect of self-care self-efficacy on respiratory function training compliance in patients with esophageal cancer after thoracotomy
		WU Yan1 KANG Xiaoyan1 LI Ning1 CHANG Haixia2
		Objective To investigate the relationship between self-care self-efficacy and compliance of respiratory function exercise in patients with esophageal cancer after thoracotomy. Methods 120 patients with esophageal cancer underwent thoracotomy in Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiag Medical University from May 2015 to October 2016 were selected. Chinese-version self efficacy scale for cancer and respiratory function exercise compliance scale were used for investigation of patients′ self-care self-efficacy and compliance of respiratory function exercise. Pearson correlation analysis was adopted to analyze the relationship between self-care self-efficacy and respiratory function training compliance in patients with esophageal cancer after thoracotomy. Results The score of self efficacy scale was (87.5±30.3) points, the score index was 62.5%, which was in the middle level. The score of respiratory functional exercise compliance scale was (55.6±14.9) points, the score index was 58.9%, which was in the middle level. Pearson correlation analysis showed that there was no correlation between announcements compliance and self decision (P > 0.05), however, there were significantly positive correlation between respiratory training compliance, respiratory training compliance, announcements compliance, overall compliance and other items of self-care self-efficacy (P ＜ 0.05). Conclusion The compliance of respiratory function exercise in patients with esophageal cancer after thoracotomy is poor, and nurses should enhance self-care self-efficacy of patients to improve the compliance, in order to improve the pulmonary function.
		2017 Vol. 14 (14): 111-114 [Abstract] ( 169 ) HTML (1 KB) PDF (586 KB) ( 91 )

	115	The value of serum lactic acid and its changes in prognosis assessment of patients with severe pulmonary infection
		DU Baoqing
		Objective To analyze the value of serum lactic acid and its changes in prognosis assessment of patients with severe pulmonary infection. Methods Clinical data of 100 cases of patients with severe pulmonary infection treated in Yantai Zhifu Hospital from February 2015 to March 2016 were analyzed retrospectively. According to the different criteria, patients were divided into different groups: ①according to the levels of blood lactate admitted in ICU, the patients were divided into hyperlactacidemia group (64 cases) and lactic acidosis group (36 cases). ②According to the value of 6 h blood lactate clearance rate, the patients were divided into high lactate clearance rate group (60 cases) and low lactate clearance rate group (40 cases). According to the prognosis, the patients were divided into survival group (79 cases) and death group (21 cases). The blood lactate levels of patients were detected, the prognosis was compared between different groups. Results Compared with lactic acidosis group, patients in hyperlactacidemia group had lower APACHEⅡ score, and higher 6 h lactate clearance rate, with statistically significant differences (P < 0.05). There were no significant differences in APACHEⅡ score and levels of blood lactate admitted in ICU between high lactate clearance rate group and low lactate clearance rate group (P > 0.05). There were no significant differences in APACHEⅡ score and levels of blood lactate admitted in ICU between survival group and death group (P > 0.05), but the 6 h blood lactate clearance rate of survival group was higher than that of control group, with statistically significant difference (P < 0.05). The mortality of hyperlactacidemia group was lower than that of lactic acidosis group, which of high lactate clearance rate group was lower than that of low lactate clearance rate group, with statistically significant differences (P < 0.05). Conclusion The level of blood lactic acid and 6 h lactic acid clearance rate can effectively reflect the severity of patients, while 6 h lactate clearance rate can also reflect the treatment effect of patients, the value in assessment is greater.
		2017 Vol. 14 (14): 115-118 [Abstract] ( 152 ) HTML (1 KB) PDF (559 KB) ( 52 )

	119	Effect of Tirofiban combined with thrombolytic therapy of Reteplase on the changes of cardiac parameters, levels of serum factors in elderly patients with ST-elevation myocardial infarction
		GUO Jiaru GUO Shougui
		Objective To discuss the effects of Tirofiban combined with thrombolytic therapy of Reteplase on the changes of cardiac parameters, levels of serum factors in elderly patients with ST-elevation myocardial infarction. Methods One hundred and six cases of elderly patients with ST-elevation myocardial infarction treated in PLA 175th Hospital from December 2013 to March 2016 were selected and divided into study group and control group according to the random digital table method, with 53 patients in each group. The control group was given thrombolytic therapy of Reteplase, while the study group was given Tirofiban combined with thrombolytic therapy of Reteplase. The changes of cardiac parameters such as left ventricular end systolic diameter (LVESD), left ventricular diastolic end diastolic diameter (LVEDD), left ventricular shoot ejection fraction (LVEF), stroke volume (SV) in the two groups were observed, as well as the serum high sensitive C reactive protein (hs-CRP), homocysteine (Hcy) and complement 3 (C3) levels and the incidence rate of complications. Results There were no significant differences in the levels of SV, LVEDD, LVESD and LVEF between the two groups before treatment (P ＞ 0.05). The LVEDD and LVESD in the two groups after treatment were significantly decreased compared with those before treatment, which in the study group after treatment were significantly lower than those in the control group (P ＜ 0.05). The levels of SV and LVEF in the two groups after treatment were significantly increased compared with those before treatment (P ＜ 0.05), which in the study group after treatment were significantly higher than those in the control group (P ＜ 0.05). There were no significant differences in the levels of hs-CRP, Hcy, and C3 between the two groups before treatment (P ＞ 0.05). The levels of hs-CRP, Hcy, C3 in the two groups after treatment were significantly decreased compared with those before treatment, which in the study group were significantly lower than those in the control group (P ＜ 0.05). The incidence rate of complications in the study group was 9.43%, which was significantly lower than that in the control group (43.40%) (P ＜ 0.05). Conclusion The application of Tirofiban combined with thrombolytic therapy of Reteplase can effectively improve the heart function, decrease the levels of hs-CRP, Hcy, C3 and reduce complications.
		2017 Vol. 14 (14): 119-122 [Abstract] ( 107 ) HTML (1 KB) PDF (490 KB) ( 34 )

	123	Clinical effect of Atorvastatin Calcium combined with Silibinin in the treatment of non-alcoholic fatty liver disease
		HE Xiaojun YANG Zhenyu DU Xilin▲ TAN Kai YANG Tao LU Jianguo
		Objective To investigate the clinical effect of Atorvastatin Calcium combined with Silibinin in the treatment of non-alcoholic fatty liver disease. Methods One hundred and seventy patients with non-alcoholic fatty liver disease treated in Tangdu Hospital of the Fourth Military Medical University from July 2015 to March 2016 were selected and divided into observation group and control group by random number table method, with 85 cases in each group. On basis of routine treatment, the observation group was added with Atorvastatin Calcium 20 mg, once a day, Silibinin 70 mg, 3 times/d; on basis of routine treatment, the control group was only applied with Silibinin 70 mg, 3 times/d, for 24 weeks. The improvement of liver function and serum lipid levels of the two groups before and after treatment was compared, and the improvement of fatty liver was detected by image examination. Results After treatment, the levels of aspartate aminotransferase (ALT) and alanine transaminase (AST) in observation group were significantly lower than those before treatment, the differences were statistically significant (P ＜ 0.05); after treatment, the levels of ALT and AST in observation group were lower than those of control group, but the differences were not statistically significant (P ＞ 0.05). After treatment, the levels of triacylglycerol (TG) and total cholesterol (TC) were all significantly lower than those before treatment, and the levels of TG and TC in observation group were lower than those of control group, the differences were all statistically significant (all P ＜ 0.05). The CT value of observation group after treatment was higher than that of control group, the difference was statistically significant (P ＜ 0.05). Conclusion Atorvastatin Calcium combined with Silibinin in treatment of non-alcoholic fatty liver disease can effectively improve the liver function and serum lipid levels, and reduce the severity of fatty liver.
		2017 Vol. 14 (14): 123-125,130 [Abstract] ( 164 ) HTML (1 KB) PDF (504 KB) ( 26 )

	126	Clinical analysis of 273 adverse drug reaction reports of antineoplastics in our hospital
		WU Haiwei BAI Yu LIU Hong ZHANG Yanhua▲
		Objective To analyze the characteristics and general rules of adverse drug reaction (ADR) in Beijing Cancer Hospital of Peking University ("our hospital" for short) in order to provide reference for further developing clinical pharmaceutist guiding rational drug use, and reduce the incidence of ADR. Methods The ADRs reports in our hospital from September 2015 to September 2016 were downloaded from the national ADR monitoring system, and the ADRs of antineoplastic drugs were screened, and the data was taken statistics and analysis by excel software. Results Among 273 cases of ADRs caused by antineoplastic drugs reported from September 2015 to September 2016, there were 19 cases of ADRs caused by auxiliary antineoplastic drugs. The male to female ratio of ADRs was 0.9∶1, the age group was mainly concentrated in 50-＜60 years old, total 92 cases (33.70%). The main route of administration causing ADRs was intravenous dripping (255 cases, 93.41%). The organs or systems involved by ADRs were constitutional reaction (27.97%), skin reaction (16.52%) and cardiovascular system reaction (13.22%). The main clinical symptoms were allergic reactions (51 cases, 11.23%), shortness of breath (33 cases, 7.27%), fever (28 cases, 6.17%), chest distress (27cases, 5.59%) and skin rush (26 cases, 5.73%). The highest incidence rate of ADR drugs were Oxaliplatin (71 cases, 20.70%) and Paclitaxel (57 cases, 16.62%). Conclusion Clinical pharmacist should take initiative to monitor ADR of antineoplastics drugs. Combined with detection of pharmacogenomics, clinical pharmacist should formulate individualized treatment plan, so as to promote rational drug use, prevent and reduce the incidence of ADRs.
		2017 Vol. 14 (14): 126-130 [Abstract] ( 153 ) HTML (1 KB) PDF (524 KB) ( 53 )

	131	Effect of comprehensive nursing intervention on nutritional status and quality of life in patients with inflammatory bowel disease
		LI Aihong WU Jue ZHANG Chunyan HUANG Mingxiang NI Ping WEN Biao
		Objective To explore the effect of comprehensive nursing intervention on the quality of life, nutritional status and mental state of patients with inflammatory bowel disease. Methods From June 2014 to August 2015, 78 patients with IBD in Department of Gastroenterology, the First Affiliated Hospital of Chengdu Medical College were selected and divided into control group (n=39) and observation group (n=39) according to random number table. The control group was only received routine nursing, the observation group was received the comprehensive nursing intervention based on the control group. The nutritional status, quality of life and mental state of two groups before and after nursing intervention were compared and analyzed. The two groups were continuously intervened for 6 months. Results 6 months after nursing intervention, the nutritional status of observation group was significantly better than that of the control group (P < 0.01); 6 months after intervention, the levels of PA and ALB and BMI in the two groups were significantly higher than those before intervention (P < 0.05), and the observation group was significantly higher than that in the control group (P < 0.05); 6 months after intervention, the intestinal symptoms, social ability, systemic symptoms, emotional ability and total scores of the two groups were significantly higher than those before intervention (P < 0.05), and the observation group was significantly higher than that of the control group (P < 0.05); 6 months after nursing intervention, the SAS score of the two groups was significantly decreased, and the GSS score was significantly higher (P < 0.05), and the scores of the observation group were better than that of the control group (P < 0.05). Conclusion Comprehensive nursing intervention can effectively improve the nutritional status, mental state, and the quality of life of patients with IBD. It is worthy of clinical application
		2017 Vol. 14 (14): 131-134 [Abstract] ( 160 ) HTML (1 KB) PDF (615 KB) ( 171 )

	135	The effect of comprehensive nursing in the patients with deep venous thrombosis after hip knee surgery
		DAI Min LI Heng
		Objective To explore the prognostic role for the patients with deep venous thrombosis (DVT) after hip knee surgery by comprehensive nursing. Methods 84 patients underwent hip knee surgery in the First Affiliated Hospital of Huzhou Teachers College from May 2015 to April 2016 were selected and divided into observation group and control group by random number table, with 42 cases in each group. The patients in control group were given to basic nursing, and the patients in observation group were given to comprehensive nursing. The general clinical indexes of two groups were observed and recorded, including hospitalization time, blood transfusion, constipation, and the number of early postoperative activities. At the same time, the DVT occurrence and satisfaction of two groups were compared. Results The cases of DVT in the observation group were lower than those in the control group (P < 0.05). The cases of postoperative early mobilization in the observation group were higher than those in the control group (P < 0.05). The average hospital stays for the observation group was lower than that in the control group (P < 0.05). The cases of constipation, blood transfusion in the observation group were lower than those in the control group (P < 0.05). The nursing satisfaction of the observation group (92.86%) was better than that of the control group (66.67%), with statistically significant difference (P < 0.05). Conclusion The comprehensive nursing can prevent the patients after hip knee surgery from DVT, also improve prognosis and the nursing satisfaction.
		2017 Vol. 14 (14): 135-137,168 [Abstract] ( 120 ) HTML (1 KB) PDF (964 KB) ( 89 )

	138	Effect of perioperative nursing intervention correction in congenital muscular torticollis surgery
		HAO Jie1 YUE Yuangeng2 YANG Bo2 JIN Wei2▲
		Objective To observe the effect of perioperative nursing intervention correction in children with congenital muscular torticollis underwent surgery. Methods From January 2014 to January 2016, 75 children with congenital muscular torticollis treated by surgery at Maternal & Child Health Care Hospital of Qinhuangdao were selected as the research object and divided into experiment group (38 cases) and control group (37 cases) according to lottery. The children in the control group were treated by routine nursing, and the children in the experiment group were treated by perioperative nursing intervention. The clinical effect, nursing satisfaction and incidence of side effect of the two groups were compared. Results The clinical effect of the experiment group was significantly higher than that of the control group, with statistically significant difference (P < 0.05). The satisfaction degree of the family members of the experiment group was significantly higher than that of the control group, with statistically significant difference (P < 0.05). The incidence of side effect in the experiment group was significantly lower than that in the control group, with statistically significant difference (P < 0.05). Conclusion Perioperative nursing intervention surgical has significantly effect in correction of congenital muscular torticollis, and which can improve the nursing satisfaction, and reduce the incidence of side effect after operation. It is worthy of clinical application
		2017 Vol. 14 (14): 138-141 [Abstract] ( 138 ) HTML (1 KB) PDF (609 KB) ( 123 )

	142	Application of humanistic quality training in teaching midwifery nursing students
		TIAN Dan XU Linyan ZHAO Yushuang SU Xinqun CHEN Weizhi▲
		Objective To explore the effect of humanistic quality training in teaching midwifery nursing students by using teaching method of humanistic quality training. Methods From August 2014 to March 2015, the 42 midwifery nursing students in Beijing Luhe Hospital Alliliated to Capital Medical University delivery room were selectedi and From August 2018 to March 2016, the 47 midwifery nursing students in the same delivery room were selected as intervening group. Routine clinical teaching method was put into effect in the control group and teaching method of humanistic quality training was put into effect in intervening group. The differences of the humanistic care ability, patient satisfaction and the satisfaction degree of nursing students between the two groups were compared. Results The scores of the humanistic care ability evaluation and its 8 dimension in intervening group were significantly higher than those in the control group (P < 0.05). The scores of the patient satisfaction survey and 10 aspects in intervening group were significantly higher than those in the control group (P < 0.01). The scores of the staff satisfaction survey except teaching environment, the other dimensions included teaching management, teaching plan, teaching methods, teaching skills, teaching content, teaching teacher and comprehensive evaluation in the intervening group were higher than those in the control group (P < 0.01). Conclusion The application of humanistic quality training in midwifery nursing students not only can improve ability of humanistic care, patient satisfaction and enhance teacher-student communication, but also can improve the satisfaction of midwifery nursing students to clinical practice. It is worthy to spread in clincial teaching of midwifery nursing students.
		2017 Vol. 14 (14): 142-146 [Abstract] ( 163 ) HTML (1 KB) PDF (659 KB) ( 72 )

	147	The clinical application of rapid rehabilitation nursing in patients with hepatolith and portal hypertension surgery
		ZHU Haiyue YIN Dalong SUN Dan
		Objective To explore the clinical application of the rapid rehabilitation nursing in patients with hepatolith and portal hypertension underwent surgery. Methods From June 2014 to June 2016, 90 patients with hepatolith and portal hypertension who received surgery in the First Affiliated Hospital of Harbin Medical University were selected. All the patients were divided into routine nursing group and rapid rehabilitation nursing group according to random number table, with 45 cases in each group. The perioperative indicators, quality of life and the incidence of complications of the two groups patients after surgery were compared. Results The bed activity time, eating time, the first defecation time and the length of hospital stay in the rapid rehabilitation nursing group were shorter than those in the routine nursing group, and the hospital costs in the rapid rehabilitation nursing group was less than that in the routine nursing group, with statistically significant difference (P < 0.05). The physical function, role function, emotional function, cognitive function and social function scores of the rapid rehabilitation nursing group were higher than those of the routine nursing group, with the statistically significant difference (P < 0.05). The total incidence of complications in the rapid rehabilitation nursing group was lower than that in the routine nursing group, with statistically significant difference (P < 0.05). Conclusion The application of rapid rehabilitation nursing in patients with hepatolith and portal hypertension surgery can improve perioperative indicators, speed up the recovery and improve the postoperative quality of life, reduce the incidence of complications.
		2017 Vol. 14 (14): 147-150 [Abstract] ( 113 ) HTML (1 KB) PDF (611 KB) ( 47 )

	151	Application of multidisciplinary team in the management of cancer chemotherapy patients with peripherally inserted central catheter
		LIN Xi1 JIANG Hu1 JIANG Ying2 FU Jianhong3 PU Hengping4
		Objective To study the effect of multidisciplinary team in cancer chemotherapy patients with peripherally inserted central catheter (PICC) management. Methods 82 cases of cancer patients who were carried out PICC in the First People's Hospital of Zunyi from January to September 2015 were selected as control group, while 110 cases of cancer patients with PICC catheter from October 2015 to June 2016 were selected as observation group. The control group received routine nursing care according to PICC nursing standard; while the observation group carried out multidisciplinary team management model based on the routine nursing. The success rate of puncture one-time, the catheter indwelling time, the incidence rate of complications, and patient satisfaction were compared between the two groups. Results Compared with the control group, the success rate of PICC one-time puncture was increased in the observation group (P < 0.05); catheter indwelling time extended (P < 0.05); in catheter-related complications, puncture point infection, mechanical phlebitis, and the occurrence of tube plugging reduced (P < 0.05); the satisfaction of patients improved (P < 0.01). Conclusion Multidisciplinary team management model can improve the PICC one-time successful puncture rate, satisfaction of patients and reduce the occurrence of catheter-related complications, which provide practice experience for improving PICC nursing quality and promoting intravenous therapy professional development.
		2017 Vol. 14 (14): 151-154 [Abstract] ( 123 ) HTML (1 KB) PDF (665 KB) ( 67 )

	156	Application effect of comprehensive nursing intervention in patients with radical operation of thyroid cancer
		ZHANG Yaqin ZHANG Yi HAO Ying MA Yufen▲
		Objective To analyze the effect of comprehensive nursing intervention on postoperative recovery in patients with radical operation of thyroid cancer. Methods From January 2015 to December 2016, 80 patients with thyroid cancer in Peking Union Medical College Hospital were selected as the research object. According to the patientsˊ admission time, they were divided into two groups: 40 patients from January to December in 2015 were selected as control group, 40 patients from January to December in 2016 were selected as research group. Patients of the two groups were given to radical surgery and routine nursing, and the observation group was given to the comprehensive nursing intervention in addition. The VAS scale was used to evaluated the degree of pain when left the hospital, SAS and SDS scales were used to evaluated the anxiety and depression status. The nursing satisfaction of patients was compared between two groups. Results The scores of SAS and SDS of patients in the research group one day preoperative were lower than those at admission, with statistically significant difference (P < 0.05). SAS and SDS score of patients in the two groups when left the hospital were significantly lower than those on admission, with statistically significant difference (P < 0.05). VAS score of patients in the group when left the hospital was lower than that of the control group, the length of hospital stays was shorter than that of the control group, incidence of postoperative complications was lower than that of the control group, with statistically significant difference (P < 0.05). The nursing satisfaction of the research group was significantly higher than that of the control group, with statistically significant difference (P < 0.05). Conclusion Comprehensive nursing intervention can effectively relieve the anxiety and depression of patients with thyroid cancer radical, reduce the patientˊs postoperative pain, improve patient satisfaction with care, worthy of clinical popularization.
		2017 Vol. 14 (14): 156-159 [Abstract] ( 139 ) HTML (1 KB) PDF (652 KB) ( 124 )

	160	Report of 4 misdiagnosed cases with Brucellosis infection
		DAI Ting1 WU Kunzhe2 XU Xiaohua1
		Clinical data of 4 cases with Brucellosis infection in Department of Nephrology, China-Japan Union Hospital of Jilin University (for short "our department") from June to November 2016 were ret-rospectively analyzed, to investigate the clinical features of brucellosis, less misdiagnosis and mistreatment. The results showed that all the 4 patients had demonstrable epidemiology history, two patients with fever and waist pain, one pain in lower limb joint with frequ-ent urination, one body bloated as the main symptoms. The 4 patients visited at our department at first, and one patient was misdiagnosed as having double kidney stones complicated with infection, one was misdiagnosed as as having osteoarthritis, one was misdiagnosed as as having urinary tract infection, and the last one was diagnosed as nephrotic syndrome. Results of serumal agglutination tests for Brucellosis in 4 patients turned to positive, and the diagnosis of brucellosis was confirmed. The first 3 cases were cured therapy with 1 or 2 kinds of Rifampicin, Tetracyclines and Levofloxacin. One case left hospital without cure. Clinical manifestations of brucellosis are complicated. For fever patients with waist pain, joint pain, clinicians must ask for details of the history of contact with diseased cattle and sheep, and takebrucellosis antibody detection as early as possible to clarify the diagnosis, in order to reduce misdiagnosis rate.
		2017 Vol. 14 (14): 160-163 [Abstract] ( 150 ) HTML (1 KB) PDF (375 KB) ( 133 )

	164	Application of random forest algorithm in the prediction of poor students in traditional Chinese medicine colleges and universities
		TANG Yan WANG Ping
		It is an important task to identify the poor students in traditional Chinese medicine colleges and universities, and there are uneconomical and unjust problems in the current methods. In order to improve the identification of poor students, this paper based on the random forest classification algorithm to study the identification of poor students. In the same data set, the decision tree algorithm and the random forest algorithm are used to classify the poor students. The correct rate of decision tree algorithm is 74.43%, while the accuracy rate of the random forest algorithm model is 85%, and further comparison of the two algorithms. Experiments show that the classification accuracy of random forest algorithm is high, which is suitable for the identification of poor students. Random forest provides a new way for the identification of poor students.
		2017 Vol. 14 (14): 164-168 [Abstract] ( 135 ) HTML (1 KB) PDF (996 KB) ( 62 )

	169	Enlightenment of foreign tumor immunotherapy regulation to China
		LIU Yongjun1 CHENG Yuqing1 WANG Yan2
		Tumor immunotherapy has made important progress in recent years, but still be a chaotic situation because of the imperfection of related system and lack of standard production and treatment procedures in China. To improving tumor immunotherapy regulations, this paper analyzes tumor immunotherapy policies at present, and studies international advanced biological therapy research and regulatory conditions by the methods of literature analysis and empirical analysis. Studies have found that in United States and Europe, tumor immunotherapy products are both regulated by corresponding biological product management offices which belongs to state drug administration, they have a strict standard system from immunotherapy clinical trials, productions and effectiveness assessments. On the other hand, Japan adopts double-track mode. The paper here suggests that treatment codes and standards of tumor immunotherapy should be issued as soon as possible, and delegate third party to supervise the strictly implement.
		2017 Vol. 14 (14): 169-172 [Abstract] ( 152 ) HTML (1 KB) PDF (528 KB) ( 80 )

	173	A study of the relationship between depression and intestinal flora based on bibliometrics
		GAO Dongping DAI A′mi DU Ranran YANG Yuan SUN Xiaobei WEI Xiaoyao LI Yang CHI Hui
		The literatures on the relationship between depression and intestinal microflora are collected from the Web of Science core collection, Wanfang database and CNKI database. USA issued more, universities and research institutes are the main research force according visualization tool Citespace. Depression, probiotics, intestinal microbiota, therapy, fecal microbiota and other keywords are more high centrality, means they plays a connection role. Depression associated with intestinal microflora studies have focused on animal models and have not been studied in large populations. How the intestinal microflora affects the central nervous system of the host is not well understood. The results of some animal models are suitable for humans or not need to be further defined.
		2017 Vol. 14 (14): 173-176 [Abstract] ( 187 ) HTML (1 KB) PDF (810 KB) ( 86 )

	177	The manufacture of electrochemical sensor based on multiwalled carbon nanotube-graphene for detection of the rubella virus IgM antibody
		LIAO Ang1 DENG Qiming1 DONG Linling1 YU Yanfei1 DIAO Qizhi2 DING Qiang3▲
		Objective To develop a electrochemical sensor based on multiwalled carbon nanotube-graphene for detection of the rubella virus IgM antibody and to evaluate its analytical performance. Methods Oxidized graphene (GS), chitosan (CHI), multi-wall carbon nano-tubes (MWCNT), 1-butyl-3-methylimidazolium hexafluorophosphate (six-[BMIM][PF6]-NH2), gold nanoparticles and thionine biological nanomaterial were used as materials to modify screen printing electrode by layer-by-layer self-assembly and then rubella antigen was immobilized on the assembled electrode surface, afterwards coated by horseradish peroxidase and eventually formed the electrochemical sensor used in this study. The layer-by-layer assembled electrode was scanned by cyclic voltammetry to detect its electrochemical performance. The optimum experimental conditions of the sensor were obtained by optimization experiments. The analytical performance of the sensor was evaluated under the optimum experimental conditions. Results After the bare electrode was assembled with above-mentioned materials, the peak current and conductivity of the electrode gradually increased, and the response current gradually decreased after being coated by antigen and horseradish peroxidase. The optimum pH value and H2O2 concentration were 7.0 and 8.0 mmol/L respectively. The optimum incubation temperature and time were 35.0℃ and 30 minutes respectively. The repeatability precision and inter-day precision of the detection of rubella virus IgM antibody were 3.4% and 4.9% respectively, the linear range was 0.1-300 pg/mL, the detection limit was 40 fg/mL, the recovery rate was 97.5%. And at the same time, the sensor had a good anti-interference performance. Conclusion Under the optimum experimental conditions, the assembled electrochemical sensor for detection of rubella virus has the advantages of higher sensitivity, better precision and accuracy, the rapid and simple operation and also quantifiability compared with the existing methods.
		2017 Vol. 14 (14): 177-180 [Abstract] ( 141 ) HTML (1 KB) PDF (825 KB) ( 82 )

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