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2019 Vol. 16, No. 34
Published: 2019-12-05
4
Study on mechanism of dopamine apoptosis and Fas gene expression in Parkinson′s disease
XIA Huan1 LUO Qin2 WANG Yuling3 GAO Hua4 YANG Xinling5▲
Objective To explore the antiapoptosis effect on dopamine cell in the rat model of Parkinson′s disease (PD) after Fas gene mRNA inhibition. Methods Seventy-five SD rats were divided into 5 groups by random number table method, with 15 rats in each group. Blank control group: normal saline was injected into the substantia nigra of rats. PD group: intracerebral injection of 6-OHDA. In Fas siRNA group: Fas gene inhibitor Fas siRNA was injected into the substantia nigra of brain, and 6-OHDA of the same amount was injected 2 days later. Positive control group and negative control group: Fas siRNA positive control and negative control were injected into the substantia nigra respectively, and 6-OHDA of the same measurement was injected 2 days later. Immunohistochemistry, PCR and Western blot were used to detect the number of dopamine positive cells, Fas mRNA and the relative expression of Fas protein. Results The number of TH positive cells in PD group was less than that in blank control group (P < 0.05). The number of TH positive cells in FAS siRNA group and positive control group was higher than that in PD group (P < 0.05). The number of TH positive cells in FAS siRNA group and positive control group was more than that in negative control group (P < 0.05). The relative expression of Fas-mRNA and Fas-protein in PD group was higher than that in blank control group (P < 0.05). The relative expression of Fas-mRNA and Fas-protein in FAS siRNA group and positive control group were lower than that in PD group (P < 0.05). The relative expression of Fas-mRNA and Fas-protein in Fas siRNA group and positive control group was lower than that in negative control group (P < 0.05). Conclusion The dopamine apoptosis can be reduced effectively after the inhibition of expression of Fas gene.
2019 Vol. 16 (34): 4-6,30 [
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Study on the protective effect of baicalein on neurotoxicity induced by PrP106-126 fragment
QIN Sheng1 PENG Jianyu1 BAI Caiying2 ZHENG Shuilan3 LAN Kai1 CAO Nannan1 CHENG Zhaomin1 ZHOU Qiang1
Objective To explore the protective effect of baicalein on neurotoxicity induced by PrP106-126 and its mechanism. Methods SH-SY5Y cells were divided into cell control group, drug control group, PrP106-126 control group, PrPScr control group and baicalein treatment group according to different treatments. Cytopathic method and MTT were used to detect the effect of PrP106-126 on the morphology and activity of SH-SY5Y cells. The MTT assay was used to detect the efficacy of baicalein in inhibiting the neurotoxicity of PrP106-126. The effect of baicalein on apoptosis induced by PrP106-126 polypeptide was detected by TUNEL. Results The morphology of SH-SY5Y cells infected with PrP106-126 was significantly different from that of cell control. It was found that the photorefractive cells became stronger and the aggregation of cells was broken. Compared with PrPScr control group, the inhibition rate of PrP106-126 was significantly higher (P < 0.05). Compared with PrP106-126 control group, the cell increment rate of baicalein group in the treatment and prevention models was increased significantly (P < 0.05). Compared with cell control group, cell apoptotic index (AI) of PrP106-126 group was significantly higher (P < 0.01). Compared with PrP106-126 control group, cell AI of baicalin treated group was decreased significantly (P < 0.05). Conclusion Baicalein has a therapeutic and prophylactic effects on prions in vitro, and its mechanism may be related to apoptosis.
2019 Vol. 16 (34): 7-10 [
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Experimental study on the effect of progesterone receptor membrane component 1 on hormone-induced breast cancer proliferation
ZHAO Yue CHENG Jiaojiao
Objective To investigate the effect of progesterone receptor membrane component 1 (PGRMC1) on hormone-induced breast cancer proliferation. Methods On the basis of in vitro studies, 36 BALB/c-nu female nude mice were selected and divided into the stable expression of PGRMC1 (T47D/HA-PGRMC1) group and the empty vector expression (T47D/HA-Vector) group according to the random number table method, with 18 mice in each group. All nude mice were inoculated with estradiol (E2) pellets 24 hours before the injection of tumor cells into both flanks. Then the two groups were inoculated with 150 μL of DMEM-F12 containing T47D/HA-PGRMC1和T47D/HA-Vector, respectively. When the mean tumor volume reached approximately 100 mm3, the two groups were divided into three subgroups, with 6 mice of each subgroups, including subcutaneous embedding sustained-release tablets of placebo (E2+placebo subgroup), norethinne (NET) (E2+NET subgroup) and progesterone (E2+progesterone subgroup). Tumor volumes were monitored for 45 d. Tumor tissue was analyzed by immunohistochemical staining for PGRMC1 and Ki-67 at the end of treatment. Results Compared with the T47D/HA-Vector group, tumor volumes in the T47D/HA-PGRMC1 group increased by 36%. In the T47D/HA-PGRMC1 group, compared with E2+placebo subgroup, E2+NET subgroup significantly promoted tumor growth, the difference was highly statistically significant (P < 0.01). There was no significant difference between E2+progesterone subgroup and E2+placebo subgroup (P > 0.05). In the T47D/HA-Vector group, there were no statistically significant differences between E2+placebo subgroup, E2+NET subgroup and E2+progesterone subgroup (all P > 0.05). In T47D/HA-PGRMC1 group, E2+NET subgroup showed positive expression of Ki-67. The comparison of expression levels of PGRMC1 and Ki-67 among 3 subgroups showed highly statistical significance (P < 0.01). The expressions of PGRMC1 and Ki-67 in E2+NET subgroup were significantly higher than those in E2+placebo subgroup and E2+progesterone subgroup, and the differences were statistically significant (all P < 0.05). There was no significant difference in the expression levels of PGRMC1 and Ki-67 between E2+placebo subgroup and E2+progesterone subgroup (all P > 0.05). There were no significant differences in the expression of PGRMC1 and Ki-67 among 3 subgroups of the T47D/HA-Vector group (all P > 0.05). Immunohistochemical results showed that PGRMC1 was positively correlated with Ki-67 expression (r = 0.839, P = 0.002). Conclusion It is the first found that E2+NET increases the tumor growth of human breast cancer cells that overexpress PGRMC1 but not with progesterone in vivo. The results are consistent with those of in vitro experiments.
2019 Vol. 16 (34): 11-14 [
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Effect of Ulinastatin against human renal tubular epithelial cell injury induced by gentamicin
YE Tingting1 SHEN Jianming1 DENG Yanyan1 LIU Huihui1 YUAN Shenping2
Objective To explore the effect of Ulinastatin (UTI) against human renal tubular epithelial cells (HK-2) injury and the probable mechanism by Gentamicin-induced. Methods HK-2 were cultured in vitro and divided into Sham group, Control group, UTI group A, B and C. Sham group does nothing, Control group and UTI group were added to Gentamicin, moreover UTI group were respectively added to different doses of UTI. The cell proliferation ability, the content of lactate dehydrogenase (LDH) and malondialdehyde (MDA), the activity of superoxide dismutase (SOD), the level of vascular cell adhesion molecule (VCAM)-1, monocyte chemoattractant protein (MCP)-1, tumor necrosis factor (TNF)-α, apoptosis rate, the express of Bcl-2 mRNA and Bax mRNA were detected. Results The cell proliferation ability and the activity of SOD in Control group were lower than those in Sham group, while the content of LDH and MDA, the levels of VCAM-1, MCP-1 and TNF-α in Control group were higher than those in Sham group, moreover apoptosis rate, and the express of Bcl-2 mRNA and Bax mRNA in Control group were higher than those in Sham group, and the differences were statistically significant (P < 0.05). The cell proliferation ability and the activity of SOD in UTI groups were higher than those in Control group, and the contents of LDH and MDA, the levels of VCAM-1, MCP-1 and TNF-α in UTI groups were lower than those in Control group, while apoptosis rate, and the expression of Bax mRNA in UTI groups were lower than those in Control group, and the expression of Bcl-2 mRNA in UTI groups was higher than that in Control group, and the differences were statistically significant (P < 0.05). Furthermore, there was a dose-response relationship (P < 0.05). Conclusion UTI can reduce Gentamicin-induced HK-2 injury by reducing oxidative stress, antagonizing inflammatory responses and inhibiting apoptosis.
2019 Vol. 16 (34): 15-18 [
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Consistency evaluation of Sodium Ferulate Tablets in vitro dissolution
FANG Xiaolin1,2,3 SHEN Aizong2 PENG Can1,3 XU Mingdi4 YU Fei3 ZHOU Wenli1,3
Objective To establish the method for determine the dissolution rate of Sodium Ferulate Tablets and to provide basis for the in vitro and in vivo dissolution consistency. Methods Five batches of Sodium Ferulate Tablets from two manufacturers in three dissolution media were determined by high performance liquid chromatograph spectrometer. Then the dissolution curves were drawn, and similarity factor (f2) was used to evaluate the similarity of dissolution curves. Model dependent method as complementary tools was evaluated the in vitro dissolution consistency. Results Sodium Ferulate Tablets were ideally dissolved in water, pH 4.5 acetate buffer and pH 6.8 phosphate buffer solution. The dissolution behavior of pH 4.5 acetate buffer and pH 6.8 phosphate buffer solution (f2> 50) had high similarity. All tested batches of Sodium Ferulate Tablets were dissolved rapidly within 50 minutes and they were stabilized at 180 minutes. The cumulative dissolution percentages of Sodium Ferulate Tablet were more than 85% and conformed to the Weibull model. Conclusion The method used in this study is stable and reliable, which can provide theoretical reference for the consistency evaluation of Sodium Ferulic Tablets.
2019 Vol. 16 (34): 19-23,36 [
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177
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Study on acute toxicology and long-term toxicology of Yiqi Xingnao Oral Liquid
PANG Tao1 CHEN Jikuai2 PIAO Shujuan1 ZHU Jiangbo2 LU Wenquan1
Objective To observe and evaluate the reaction of acute and long-term toxic of Yiqi Xingnao Oral Liquid, and to provide a secure basis for the clinical application. Methods Fifty ICR mice were randomly divided into the solvent control group, group A, group B, group C and group D by completely random method in the acute toxicology experiment. With 10 mice and with half male and half female in each group. Solvent control group was given deionized water, the other groups were respectively given Yiqi Xingnao Oral Liquid, with group A (2280 g/kg), group B (1710 g/k), Group C (1282 g/kg) and Group D (962 g/kg). The physiological changes and the death rate of mice in each group were observed, and the lethal dose 50% (LD50) was calculated. One hundred and twenty SD rats were randomly divided into solvent control group, low doses group, medium doses group, and high doses group. With 30 mice and with half male and half female in each group. Solvent control group was given deionized water, low, medium, high dose groups were respectively given Yiqi Xing nao Oral Liquid with 90, 180 and 360 g/kg. Continuous administration for 91 days and recovery for 28 days. The animals′ general symptoms, weights, food intakes, blood routine, blood biochemistry and the major organs histopathology (heart, liver, spleen, kidney, brain) in high dose groups were observed after administration and during convalescence. Results The acute toxicology results showed that the mortality rate of each group was 90% in group A, 70% in group B, 10% in group C, and none in group D. LD50 was 1630.9 g/kg, and the 95% confidence limit was 1427.2-1863.7 g/kg. The long-term toxicity results showed that the general symptoms of the rats in each dose group were normal. Compared with the solvent control group, the weight gain of male rats in high dose group were significantly lower from week 4 to week 17 (P < 0.05), and the food intake decreased significantly from week 3 to week 15 (P < 0.05). There was no significantly difference of weight gain and food intake in other groups (P > 0.05). The blood routine and blood biochemical indexes of each group of rats were within the normal physiological range. Compared with the solvent control group, the sections of heart, liver, spleen, kidney and brain were normal in the high-dose group. The safety dose of Yiqi Xingnao Oral Liquid was 180 g/kg, and that was 48 times of the clinical dose. Conclusion Yiqi Xingnao Oral Liquid has no drug-related toxic effect on two kinds of rodents, which has high tolerance, small side effects, large safety window and high clinical safety.
2019 Vol. 16 (34): 24-30 [
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Study on quality standard of Huoling Shengji Granules
WU Mei WU Fei ZHANG Jiquan FENG Yi WANG Youjie
Objective To establish the quality standards for Huoling Shengji Granules. Methods The thin-layer chromatography method (TLC) was used for the qualitative research of Astragali Radix, Atractylodis Macrocephalae Rhizoma and Poria, and the quantitative study of icariin from Epimedii Folium and loganin from Corni Fructus was determined by the high performance liquid chromatography (HPLC). The determination of icariin was carried out by Grace Apollo C18 column (4.6 mm×250 mm, 5 μm), acetonitrile-water (27:73) was used as the mobile phase of the gradient elute, with the detection wavelength of 270 nm and the flow rate of 1.0 mL/min. The determination of loganin was carried out by Pntulips RSZG C18 column (4.6 mm×250 mm, 5 μm), acetonitrile -0.1% phosphate (8.5:91.5) was as the mobile phase of the gradient elute, with the detection wavelength of 240 nm and the flow rate of 1.0 mL/min. Results In the established TLC method, the spots of Astragalus membranaceus, Atractylodes macrocephala and Poria columba were clear, with good resolution and good specificity. The icariin and loganin in the range of 0.0850-6.3720 μg (r = 1.0000), 0.04774-2.86400 μg (r = 1.0000) showed good linear relationship with the peak area. The average recovery rates (n = 9) of the two components were 97.50%, 100.97% respectively. Conclusion The established methods of TLC and HPLC are simple, and the results are accurate and reliable with a good reproducibility. This quality standards are feasible, which can effectively control the quality of Huolingshengji Granules.
2019 Vol. 16 (34): 31-36 [
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Study on quality standard of Compound Gankang Tablets
XU Yuan ZHANG Ruitao LIU Mei LIU Jing WU Dan ZHANG Yan WANG Qingwei
Objective To establish the quality standard of Fufang Gankang Tablets. Methods Thin Layer chromatography (TLC) was used for the qualitative identifications of Salviae miltiorrhizae radix et rhizoma, Astragalus membranaceus radix, scutellariae radix and Bupleuri radix. The content of baicalin was determined by high performance liquid chromatography (HPLC). Results The TLC qualitative identifications were with high resolution and without interference from the negative substances. In the high performance liquid chromatography, the linear range of Baicalin was 13.72~686.00 μg/mL, the regression equation was Y = 19.97X+71.62 (R = 0.9998). The assay was within the acceptable range and reproducible for the determination, with high resolution and without interference from the negative substances. Conclusion The method can be used in the qulity control of Compound Gankang tablets.
2019 Vol. 16 (34): 37-41 [
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Advances in targeted drug therapy for brain metastasis of non-small cell lung cancer
LI Wen′ge GE Wei
The most common distant metastasis of lung cancer is in the brain. Currently, the treatment methods for brain metastasis of non-small cell lung cancer (NSCLC) include chemotherapy, radiotherapy, molecular targeted therapy and immunotherapy. For patients with brain metastasis with specific driver gene mutations, molecular targeted drugs have achieved significant effects, among which targeted drugs combined with stereotactic radiotherapy can significantly improve the intracranial remission rate, progression-free survival and total survival time of patients. At present, the acquired drug resistance and post-treatment progress of first-line targeted drugs are the main problems in clinical practice. In this review, molecular targeting therapy for brain metastasis of NSCLC and its current status and progress are reviewed.
2019 Vol. 16 (34): 42-45,53 [
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Application of real-world research in malignant tumor research
WANG Jia1,3 YANG Zhu1,3 LONG Fengxi1,3 WU Jinlin1,3 YU Ting1,3 TANG Dongxin2,3
Real-world research refers to the selection of representative subjects, random selection of treatment plans based on the actual situation of patients, long-term observation to assess the safety and external effectiveness of the intervention. Relative to randomized controlled trials (RCT), real-world research has large sample sizes, representative subjects, no exclusion criteria, efficacy evaluations from a patient perspective, so the results are more convincing. It is mainly implemented through cohort studies, cross-sectional studies, registration studies, case-control studies. In China, real-world research is currently conducted mainly through the hospital information system (HIS) database. Real-world research has just started in the field of oncology. At present, China′s cancer treatment is still dominated by Western medicine and supplemented by traditional Chinese medicine. There are differences in the syndromes of cancer patients in traditional Chinese medicine. Traditional Chinese medicine syndrome differentiation treatment can be used as a supplementary treatment. In addition, traditional Chinese medicine injection such as Compound Kushen Injection is widely used in the treatment of malignant tumors, which is beneficial to the prognosis of cancer patients.
2019 Vol. 16 (34): 46-49 [
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Research progress on the mechanism of traditional Chinese medicine compounds in the treatment of non-alcoholic fatty liver disease base on autophagy
TAN Liping1 SHI Anhua2 ZHU Xiaosong1 DENG Xue3 LI Jixiao3 CHEN Wenhui4
Autophagy of liver is closely related to the occurrence and development of non-alcoholic fatty liver disease (NAFLD). The autophagy level of hepatocytes decreased in the stage of nonalcoholic simple fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). In the stage of hepatic fibrosis (HF), autophagy of HSCS increases, this leads to the development of the disease. Therefore, a clear understanding of the change rules and specific signal pathways of liver autophagy in different stages of NAFLD is conducive to the regulation and control of the level of liver autophagy and the alleviation of lesions. In this paper, we find that different traditional Chinese medicine compounds with different syndrome differentiation and treatment can enhance or inhibit liver′s autophagy in different stages of NAFLD, which provides new ideas for basic and clinical research of NAFLD.
2019 Vol. 16 (34): 50-53 [
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Significance, current situation and dilemma of narrative medicine research
YANG Shen
As an effective means of evaluation and intervention, narrative medicine can promote personalized nursing, emotional healing and treatment dependence, and ultimately improve the quality of life of patients. Although narrative medicine is a hot topic in medical research, there is a lack of academic progress in this field at home and abroad. This paper comprehensively reviews the research content, characteristics and current situation of the development of narrative medicine in foreign countries. With the help of node articles and publication time of cited literature of narrative medicine, and with reference to PubMed search data, this paper divides narrative medicine into three stages: the first stage is the initial stage of the theory of narrative medicine; the second stage is the scientific stage of the theory, with a small number of case-based application research; the third stage is the role of narrative medicine education and the explosive growth stage of narrative medicine application research, at this time, quantitative research began to appear, but qualitative research is still dominant. In addition, literature review shows that the current dilemma facing narrative medicine research is the lack of a unified methodology, which is manifested in a wide range of data collection and coding.
2019 Vol. 16 (34): 54-60 [
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Research progress of surface-modified sugar nanoparticles active targeting on tumors
ZHANG Changmei CHEN Zhong TANG Xuefeng LI Minghui
The surface of nano preparation modified by carbohydrate compounds can achieve tumor targeted drug delivery and enhance the anti-tumor effect of drugs. In this paper, tumor targeting effects of nanocentric drugs designed with different types of sugar compounds as transport substrates are reviewed. Meanwhile, based on Warburing effect and glucose transport process, the anti-tumor mechanism of glycolide-modified nanodrugs is studied. The glucose-ligand modified nanomaterials can effectively control or utilize the role of glucose transporters in Warburg effect, providing theoretical basis for the design of more effective and reasonable anti-tumor targeted drugs.
2019 Vol. 16 (34): 61-64 [
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267
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Research progress of cerebral autoregulation in cerebrovascular diseases
SHEN Yanxia ZHOU Yanxia HU Shiyu CHI Feng JIANG Shirui YANG Qiaoling REN Lijie
Cerebrovascular disease is one of the most common diseases in neurology department, and it is also the leading cause of death and disability. Cerebrovascular hemodynamic changes play an important role in the occurrence and development of cerebrovascular diseases. Cerebral autoregulation (CA) is the ability of cerebral arterioles to maintain the relative constancy of cerebral blood flow in accordance with brain′s metabolic needs, regardless of changes in blood pressure. In recent years, more and more studies have shown that CA is impaired in cerebrovascular disease to some extent, which in turn increases the risk of cerebrovascular recurrence. This article gives review of CA mechanism, the relationship between CA and cerebrovascular disease, CA and clinical application through literature review, aiming to provide new ideas and directions for the research and clinical application of CA in cerebrovascular diseases.
2019 Vol. 16 (34): 65-68 [
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Application research of CPPT teaching mode in clinical teaching of neurology
LIANG Jingjing ZENG Yanping XIE Yanchun ZHOU Yu LU Zu′neng XIAO Zheman
Objective To explore the application of clinical pathology, pathophysiology and treatment (CPPT) teaching model in clinical teaching of neurology. Methods A total of 120 subjects were selected from 2014 class “5+3” clinical students who came to Department of Neurology, People′s Hospital of Wuhan University in 2018, and they were divided into control group and experimental group according to the random number table method, with 60 cases in each group. The traditional teaching mode (LBL) was used in control group, CPPT teaching mode was used in experimental group. At the end of teaching, the theoretical scores, case analysis scores, skill operation scores and self-administered questionnaire of two groups of students were analyzed. Results The scores of theoretical knowledge, case analysis and clinical skills in experimental group were significantly higher than those in control group, the differences were statistically significant (P < 0.05). The scores of self-cultivation interest, active participation in practice, language expression ability, self-study ability, theoretical knowledge mastering ability, problem solving ability, team cooperation, doctor-patient communication ability, disease diagnosis and differential diagnosis level and knowledge application ability in experimental group were higher than those in control group, the differences were statistically significant (P < 0.05). The scores of frequently ask questions to students about relevant knowledge, give positive feedback to students′ questions and teach students in accordance with their aptitude to give full play to students′ enthusiasm in experimental group were higher than those in control group, the differences were statistically significant (P < 0.05). Conclusion CPPT teaching mode is better than LBL, and more in line with the clinical learning needs of interns in neurology.
2019 Vol. 16 (34): 69-72 [
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Analysis on the ways of cultivating talent path of traditional Chinese medicine in the media age
LI Baohe ZHANG Yu FUBO Siyuan LI Zhuoyue
Since the media is an independent body that distinguishes it from new and old media, it is an emerging medium of the times. With the support of this kind of media, the ideological and political education work in colleges and universities has carried out research and discussion related to it. For the ideological and political education workers in colleges and universities, opportunities and challenges coexist. Affected by multiple factors, current Chinese medicine education has more or less the phenomenon of weakening or reducing traditional Chinese medicine culture. Schools attach importance to professional knowledge education and despise humanistic quality education, thus alienating traditional culture. Educators in Chinese medicine colleges should strengthen the value of traditional Chinese medicine in talent education, and carry out the core values of Chinese medicine throughout the teaching process. With the comprehensive information from the media, the students can reach a consensus with unique Chinese medicine value. The connection and combination of self-media and talent education in Chinese medicine colleges will become an important direction for the cultivation of future education talents.
2019 Vol. 16 (34): 73-76,84 [
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Research and practice on the innovation and entrepreneurship ability training for the pharmaceutical major in higher vocational colleges
SHI Lei1,2 KE Zhonglu2 LIU Yongli2 XU Feng2 JIN Yinxiu2
Cultivating the innovation and entrepreneurship abilities of students are important task for the higher vocational education in the new era. As present, the factories pay more and more attention to innovation and entrepreneurship ability of higher vocational students, however, the effect of school training still needs to be improved. The training process does not make full use of information technology, and students′ abilities are generally low. This article studies the methods and ways of cultivating the innovation and entrepreneurship ability of higher vocational students and implements them in the pharmaceutical specialty. The reforms such as the “three classrooms” linkage and results-oriented curriculum system are implemented. The multi-function and multi-dimensions innovation and entrepreneurship bases and platforms are built as focus. These activities are implemented through multi-cooperation and full participation. Through multi-party cooperation and full participation, students′ ability to innovate and entrepreneurship can be improved, which can provide reference for other majors.
2019 Vol. 16 (34): 77-80 [
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Discussion on definition, disciplinary orientation and teaching objectives of traditional Chinese medicine English
WANG Xi ZHAO Xia
The current subject orientation of tradition Chinese medicine English is unclear. Based on the definition and disciplinary orientation of medical English, combined with the characteristics of tradition Chinese medicine English, this article concludes that traditional Chinese medicine English belongs to medical English and is a language discipline. Traditional Chinese medicine English courses are both connected and differentiated from public English courses and medical bilingual courses, while it is also the transition between them. Based on this, three guiding principles are put forward for the setting of the teaching objectives of traditional Chinese medicine English course. This research provides reference and lessons for the construction of traditional Chinese medicine English subject.
2019 Vol. 16 (34): 81-84 [
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232
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Exploration of clinical teaching methods of electronic mammary duct endoscopy
ZHANG Dongxiao FU Na DONG Hao HUANG Qiao ZHAO Wenjie SUN Yujian
Nipple discharge is one of the three main symptoms of breast diseases. Breast ductoscopy has a high diagnostic rate for nipple discharge diseases, and has the function of treating and providing surgical location and so on. This paper analyses the factors of affecting the teaching of breast duct endoscopy, and explores the specific measures to improve the teaching effect of breast duct endoscopy, such as the selection of teaching teachers, the compilation of teaching courses, the establishment of image database of breast duct lesions, one-to-one teaching mode, case discussion and counterpart support and so on. The advantages and disadvantages of the teaching methods and the problems needing attention in practice are discussed and summarized, in order to explore practical and effective ways to meet the needs of teaching breast ductoscopy in surgical specialty.
2019 Vol. 16 (34): 85-87,91 [
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237
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Application value of ABVS system in PBL teaching mode of breast ultrasound medical standardization training
YANG Pengfeng* ZOU Huimin* PAN Yu LIU Tao ZHOU Miao FENG Ziyan LIANG Weixiang
Standardized training for resident doctor is an important part of medical education. The traditional teaching mode is teacher-centered, while students are in passive learning. The problem-based learning (PBL) is to guide students to acquire knowledge actively. This teaching mode is gradually popular in medical education. Breast ultrasound is a highly specialized branch of ultrasound, and its images vary greatly among individuals. In order to improve the understanding of breast diseases among residents in ultrasound department, we introduced automate breast volume scanning (ABVS) system on the basis of PBL teaching mode. This system can conduct three-dimensional imaging of the mammary gland, which is more conducive to the observation of the breast structure and lesions, reducing the rate of missed diagnosis and misdiagnosis. This teaching mode significantly improves the initiative and enthusiasm of the students in the study of breast ultrasound, and has a profound understanding of the characteristics of typical sonograms of breast diseases and the classification of breast image reports and data systems, and the teaching effect is remarkable. In addition, this teaching model requires teachers to devote more energy to constantly improve their professional knowledge and teaching ability.
2019 Vol. 16 (34): 88-91 [
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Application of PCBL teaching method based on combined case-based learning and problem-based learning in science theory teaching in colleges and universities of traditional Chinese medicine
SI Chunying1,2 GUAN Huaimin2 WANG He2 WANG Li2 CHEN Yushan2 XIE Jinhong2 MA Jingyu1
Internal medicine is a key and difficult course for medical undergraduates with complicated contents and difficult comprehension. The basic knowledge of Western medicine of students in traditional Chinese medicine colleges is weak, and it is difficult for them to master the internal medicine knowledge. Relying on traditional teaching methods - means-lecture-based learning cannot meet the needs of the development of modern teaching, so education and teaching reform should be carried out. Designed for this, we explore the PCBL teaching method combining case-based learning and problem-based learning in an exploratory way to teach the circulatory system theory of internal medicine to students majoring in traditional Chinese medicine, and discusses its teaching characteristics and the teaching effect, in order to improve the quality of teaching, enhance students′ ability to propose, analyze and solve problems, strengthen the training of students′ knowledge goals, ability goals and emotional goals, inspire students′ awareness of innovation and teamwork, so that they can better adapt to the development needs of today′s medical field after going to clinical posts.
2019 Vol. 16 (34): 92-95 [
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Relationship between serum klotho protein level and nutritional status in hemodialysis patients
LI Jia1 WEI Shanzhai1 SUN Jie1 WANG Yu2 LIU Yitong2
Objective To investigate the relationship between serum Klotho protein level and nutritional status in hemodialysis patients. Methods A total of 113 patients with end-stage renal disease admitted to Shuyang Affiliated Hospital of Traditional Chinese Medicine of Nanjing University (“our hospital” for short) from March 2016 to December 2018 were selected as observation group. According to the modified subjective comprehensive nutrition assessment (MQSGA), the observation group was divided into group A (well-nourished, 32 cases), group B (mild to moderate malnutrition, 48 cases), and group C (severe malnutrition, 33 cases). Another 90 healthy volunteers examined in our hospital during the same period were selected as control group. The anthropological indicators, serological indicators and nutritional status between two groups were compared. Pearson correlation was used to analyze the correlation between Klotho protein and anthropological indicators, serological indicators and nutritional status. Results The body mass index (BMI), skin fold thickness (TSF), upper arm circumference (MAMC), albumin (Alb), hemoglobin (Hb) and klotho protein in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05), while serum creatinine (Scr), urea nitrogen (BUN), parathyroid hormone (PTH), fibroblast growth factor 23 (FGF-23), MQSGA were higher than those of the control group, and the differences were statistically significant (P < 0.05). Comparison of various indicators of hemodialysis patients with different levels of malnutrition, and the differences were statistically significant (P < 0.05). Klotho protein was positively correlated with TSF, MAMC, Alb and Hb in hemodialysis patients (r = 0.642,0.446,0.453,0.536,P < 0.05), however, it negatively correlated with Scr, BUN, PTH, FGF-23 and MQSGA scores (r = -0.392,-0.382,-0.412,-0.439,-0.526,P < 0.05). Conclusion There is a low expression of serum klotho protein in hemodialysis patients, and the expression level is closely related to the nutritional status of patients. It can be considered clinically as a new direction for treating hemodialysis patients with malnutrition.
2019 Vol. 16 (34): 96-99 [
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The guiding role of platelet antibody in collaboration with thrombolytic elastogram detection in perioperative blood transfusion of cardiac surgery
LIN Jiumeng1 ZHANG Ying2 ZENG Hao3 WEI Ciqiu1 HUANG Shengbin4
Objective To study the guiding role of platelet antibody in collaboration with thrombolytic elastogram detection in perioperative blood transfusion of cardiac surgery. Methods From August 2017 to December 2018, a total of 100 patients planned to receive cardiac surgery in Guigang City People′s Hospital were selected as the subjects for observation, and all of them were divided into the combined group (50 cases) and the control group (50 cases) by random number table method. The control group was received blood transfusion instruction by thrombolytic elastogram detection, while the combined group was received blood transfusion instruction by platelet antibody in collaboration with thrombolytic elastogram detection. Perioperative blood component transfusion, the corrected count increment (CCI) at 1, 24 hours after infusion, the occurrence of complications, hospitalization time and the level of hemoglobin (Hb) at discharge were compared between the two groups. Results Red blood cells, fresh frozen plasma, cryoprecipitation and platelet transfusion of combined group were lower than those of control group, and the differences were statistically significant (all P < 0.05). Compared with 1 hour after infusion, the CCI value of 24 hours after infusion in both groups were lower, and the differences were statistically significant (all P < 0.05). The CCI value of combined group at 1 hour and 24 hours after infusion were higher than those of control group, and the differences were statistically significant (all P < 0.05). The total incidence of complications in combined group were lower than those in control group, and the differences were statistically significant (all P < 0.05). Hospitalization time in combined group was shorter than that in control group, while Hb level in combined group was lower than that in control group, and the differences were statistically significant (all P < 0.05). Conclusion The platelet antibody and thrombolytic elastogram detection have significant effects in the guidance of perioperative blood transfusion during cardiac surgery, which is conducive to reducing the blood transfusion volume of each component, decreasing the risk of complications, and promoting the early recovery of patients. It is worthy of clinical application.
2019 Vol. 16 (34): 100-103,116 [
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Effect comparison of pterygium excision combined with different methods of conjunctival transplantation in the treatment of primary pterygium
ZHANG Xiuli LI Mimi ZHANG Ming LIU Zhao
Objective To investigate the clinical effect of pterygium excision combined with free conjunctival flap transplantation or pedicled conjunctival flap transplantation in the treatment of primary pterygium. Methods From November 2017 to October 2018, 60 patients with primary pterygium admitted to the Department of Ophthalmology, the First Affiliated Hospital of Xi′an Jiaotong University were seleted. According to the random number table, they were divided into free group and transposition group, with 30 cases in each group. Free group was given pterygium excision combined with free conjunctiva flap transplantation and transposition group was given pterygium excision combined with padicled conjunctiva flap transplantation. One week after operation, the corneal epithelial wounds, postoperative pain, bloodshot level and comfort level (foreign body feeling, tears) were compared. The recurrence was compared between the two groups half year after operation. Results One week after the operation, there were no significat differences in the corneal epithelial wounds and postoperative pain between two groups (P > 0.05). Bloodshot level of transposition group was lower than that of free group, the difference was highly statistically significant (P < 0.01). Comfort level of transposition group was higher than that of free group, the difference was statistically significant (P < 0.05). Half a year after surgery, pterygium recurred in both groups, but the difference in recurrence rate was not significant between two groups (P > 0.05). Conclusion Both of the two different conjunctival transplantations can effectively treat primary pterygium and reduce the recurrence rate. Moreover, pterygium surgery combined with pedicled conjunctiva flap transplantation can significantly improve the postoperative comfort.
2019 Vol. 16 (34): 104-107 [
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Application effect of I-gel laryngeal mask in laparoscopic combined with choledochoscope cholelithotomy
HAN lei1 LI yueting2
Objective To investigate the application effect of I-gel laryngeal mask in laparoscopic combined with choledochoscope cholelithotomy. Methods From August 2016 to August 2018, 64 cases with laparoscopic combined with choledochoscopic choledochoscopy under general anesthesia in Beijing Hospital of Integrated Traditional Chinese and Western Medicine were selected. According to the Excel randomizer, they were randomly divided into I-gel laryngeal mask group (A group) and endotracheal intubation group (B group), with 32 cases in each group. After anesthesia induction, laryngeal mask was placed in group A and endotracheal intubation was performed in group B. The anesthesia time, pneumoperitoneum time and tube extubation time in two groups were compared. The changes of heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in two groups were observed immediately after anesthesia induction (T1), laryngeal mask placement (or intubation) (T2), laryngeal mask placement (or intubation) 3 min (T3), and laryngeal mask placement (or intubation) 10 min(T4). Meanwhile, intubation time, degree of tube tolerance, cough, agitation and pharyngeal pain in two groups were observed. Results There were no significant differences in anesthesia time, pneumoperitoneum time and tube extubation time between two groups (P > 0.05). There were no significant differences in HR, SBP and DBP at each time point in group A (all P > 0.05). HR, SBP and DBP at time points T2, T3 and T4 in group B were all higher than those in group A, and the differences were statistically significant (all P < 0.05). In group B, HR, SBP and DBP at time points T2, T3 and T4 were all higher than T1, and the differences were statistically significant (all P < 0.05). Conclusion I-gel laryngeal mask is used for laparoscopic combined with choledochoscope cholelithotomy under general anesthesia, which is more convenient than endotracheal intubation, more stable hemodynamics and fewer complications. The application effect is safe and reliable.
2019 Vol. 16 (34): 108-111 [
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Effect of preoperative oral rehydration salt on postoperative rehabilitation process and prognosis in patients undergoing radical mastectomy
ZI Congna1 FAN Juan1 LI Yanming2 LI Fulong1 MA Xian3 XING Zhen1
Objective To study the effect of preoperative oral rehydration salt (ORS) on postoperative rehabilitation process and prognosis in patients undergoing radical mastectomy. Methods From October 2017 to March 2018, 80 cases undergoing elective radical mastectomy in the First Affiliated Hospital of Hebei North University were selected. According to the random number table method, they were divided into observation group and control group, with 40 cases in each group. Both groups were given the same anesthesia and surgical plan. Control group was treated with fasting at 8 h on preoperative and water-deprivation at 4 h on preoperative, fluid infusion during surgery. Observation group was given oral ORS solution 300 mL at 2 h on preoperative. The fluid infusion volume was adjusted according to the patient′s condition. The changes in heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) were monitored at entering room and rest state (T0), at immediate intubation time (T1), at 10 min after start of surgery (T2), at end of surgery immediately (T3) and 1 d after surgery (T4). The levels of fasting plasma glucose (FPG), fasting insulin (FINS), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) at 1 d before surgery (preoperative) and 1 d after surgery (postoperative) were observed. The anesthesia time, intraoperative transfusion volume, anesthesia recovery time, the first anal exhaust time, the first eating time, leaving bed time and incidence of adverse reactions were statistically analyzed. The survival at 1 year on postoperative was recorded. Results Comparison between groups, comparison between time points and the interaction comparison showed statistically significant differences (all P < 0.05). HR, MAP at time points T1, T2 were higher than T0 in same group of two groups, and the differences were statistically significant (all P < 0.05). HR, MAP at time points T1, T2, T3 in observation group were all lower than those in control group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in FPG, FINS, CRP and TNF-α between two groups on preoperative (all P > 0.05). FPG, FINS, CRP and TNF-α on postoperative were significantly higher than those on preoperative, and observation group was lower than control group, and the differences were statistically significant (P < 0.05). There were no significant differences between two groups in anaesthesia time, anaesthesia recovery time and leaving bed time on postoperative (all P > 0.05). Intraoperative infusion volume was less than that of control group, the first anal exhaust time and the first eating time in observation group were shorter than those in control group, and the differences were statistically significant (all P < 0.05). The incidence of total adverse reactions in observation group was lower than that in control group, and the difference was statistically significant (P < 0.05). At 1 year on postoperative, survival rates of two groups were both 100%. Conclusion Oral ORS for patients before radical mastectomy can maintain stability of intraoperative blood pressure and HR to a certain extent, improve postoperative recovery and occurrence of adverse reactions, with few effects on survival within 1 year.
2019 Vol. 16 (34): 112-116 [
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Meta analysis of Zaoren Anshen Capsules in the treatment of patients with insomnia
JI Jinshan WANG Li LI Baoli MIAO Meijing GUO Liping ZHANG Xin
Objective To systematically evaluate the effect of Zaoren Anshen Capsules in the treatment of patients with insomnia. Methods Literature on the application of Zaoren Anshen Capsules on insomnia in PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and CQVIP database were searched by computer. The search keywords were “Zaoren Anshen Capsule, Insomnia” and the retrieval time was from the database construction to February 2019. According to the established inclusion and exclusion criteria, literature were selected and relevant data were extracted. Meta analysis was carried out with RevMan 5.3 software. Results Sixteen studies were included, containing 792 cases of treatment group and 674 cases of control group. The total effective rate of Zaoren Anshen Capsules group was higher than that of control group[OR = 1.66, 95%CI (1.27, 2.16), P = 0.0002]. There was no significant difference in total PSQI score between treatment group and control group [WMD = -0.88, 95%CI (-1.88, 0.12), P = 0.09]. The total HAMA score of Zaoren Anshen Capsules group was lower than that of control group [WMD = -1.93, 95%CI (-2.61, -1.25), P < 0.000 01]. Conclusion Zaoren Anshen Capsules has a good effect on insomnia, but more higher quality studies are needed to further prove the clinical effect of Zaoren Anshen Capsules on insomnia.
2019 Vol. 16 (34): 117-121 [
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Clinical effect of Wuling Capsules combined with Fluoxetine Capsules in the treatment of type 2 diabetes mellitus with heart-kidney disharmony and emotional handicap
LIU Yan1 LI Yue2 LIU Yi2 WANG Huiying2
Objective To explore clinical effect of Wuling Capsules combined with Fluoxetine Capsules in the treatment of type 2 diabetes mellitus with heart-kidney disharmony and emotional handicap. Methods One hundred and three type 2 diabetes mellitus patients with heart-kidney disharmony and emotional handicap in Aerospace Center Hospital from May 2017 to December 2018 were selected for the study. The patients were divided into control group (n = 51) and treatment group (n = 52) according to random number table method. Both groups received routine glycemic control therapy. Fluoxetine Hydrochloride Capsules were taken orally in control group. Wuling Capsules were taken orally in treatment group on the basis of control group. Patients in both groups received continuous treatment for 12 weeks. Clinical efficacy, Hamilton depression rating scale (HDRS-17) score, traditional Chinese medicine syndrome score, blood glucose level, HOMA-IR and adverse reactions were compared between two groups. Results Total clinical effective rate of treatment group was significantly higher than that of control group (P < 0.05). After treatment, HDRS-17 score and traditional Chinese medicine syndrome score of two groups were lower than those before treatment, and those in treatment group were lower than those in control group (P < 0.05). After treatment, fasting blood-glucose, glycated albumin and HOMA-IR in two groups were lower than those before treatment, and those in treatment group were lower than those in control group (P < 0.05). There was no significant difference in incidence of adverse reactions between two groups (P > 0.05). Conclusion Wuling Capsules combined with Fluoxetine Capsules has obvious effect and high safety in the treatment of type 2 diabetes mellitus with heart-kidney disharmony and emotional handicap. It can also effectively reduce the degree of depression of patients, improve the level of blood glucose and insulin resistance, which is worthy of clinical attention.
2019 Vol. 16 (34): 122-125 [
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Correlation between glycolipid metabolic abnormalities and insulin resistance in patients with phlegm-dampness polycystic ovary syndrome
TIAN Xiaoying1 XU Fang2▲ CHEN Haobo1 MENG Xiaoyu2 HOU Lihui2
Objective To investigate the relationship between abnormal glucose and lipid metabolism and insulin resistance (IR) in patients with phlegm-dampness polycystic ovary syndrome (PCOS). Methods A total of 118 patients with phlegm-dampness PCOS were selected from the First Affiliated Hospital of Heilongjiang University of Chinese Medicine and Gynecological Clinic of Wenzhou Integrated Hospital of Traditional Chinese and Western Medicine from November 2014 to September 2018. According to IR index > 2.69, they were divided into PCOS+IR group of 67 cases and PCOS+NIR group of 51 cases. Age, weight, sex hormones, OGTT, insulin release test and blood lipid were compared between two groups. Results There was no significant difference in age, BMI and WHR between two groups (P > 0.05). The levels of LH/FSH and SHBG in PCOS+IR group were lower than those in PCOS+NIR group, the levels of AND and FAI in PCOS+IR group were higher than those in PCOS+NIR group (P < 0.05). The levels of HDL and ApoA in PCOS+IR group were lower than those in PCOS+NIR group (P < 0.05). FPG and 30, 60, 120 min glucose levels and GAUC in PCOS+IR group were higher than those in PCOS+NIR group, the differences were statistically significant (P < 0.05). FINS and 30, 60, 120, 180 min insulin levels and IAUC in PCOS+IR group were higher than those in PCOS+NIR group, the differences were statistically significant (P < 0.05). Conclusion PCOS of phlegm-dampness type is abdominal obesity. Patients with PCOS and IR show higher androgen level, and IR aggravate the abnormal glucose and lipid metabolism.
2019 Vol. 16 (34): 126-129,144 [
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Professor Hu Dongju′s experience in the treatment of malignant hematopathy fever with deficiency and excess as the principle and five internal organs as the axis
YANG Kai1 XIAO Huiying2 GUO Zijing2 WANG Yongmin2 HU Dongju2
Fever is one of the common clinical symptoms in patients with malignant hematopathy. Professor Hu Dongju thinks that the basic pathogenesis of the disease lies in the deficiency of five internal organs, endogenesis of damp heat, imbalance of yin and yang of qi and blood. The location of the disease is mainly in the liver, spleen and kidney, which is related to the viscera such as heart lung triple energizer. The treatment is mainly to regulate the spleen and stomach, liver and gall, kidney yin and kidney yang, combined with the methods of removing dampness and heat, regulating qi mechanism, and resolving evil qi. Professor Hu Dongju not only recuperates the internal organs, but also gives attention to the qi and blood. He emphasizes that we should pay attention to the return of diseases, grasp the opportunity of attack and tonic, adjust the medication according to the changes of diseases in time, so as to strengthen the body without helping the evil, remove the evil without hurting the right, so as to restore the balance of the human body, and then return the yin and yang of qi and blood to a peaceful state.
2019 Vol. 16 (34): 130-133 [
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Clinical effect of Yiqi Yangyin Decoction combined with intraorbital–electroacupuncture in the treatment of Graves ophthalmopathy
TENG Jinyan1,2 LI Yang2,3 WANG Jieyu1,2 ZUO Xinhe2,3 DING Deguang1,2 PAN Hongling1,2 YU Peihao1,2
Objective To investigate clinical efficacy of Yiqi Yangyin Decoction combined with intraorbital-electroacupuncture in the treatment of Graves ophthalmopathy (GO). Methods From May 2016 to October 2018, 70 patients with moderate to severe active GO admitted to Hubei Hospital of Traditional Chinese Medicine were selected for retrospective analysis. According to different clinical treatment methods, they were divided into group A and group B, with 35 cases in each group. In group A, methylprednisolone sodium succinate was given intermittently, 0.5 g every week, after six weeks of continuous administration, the dosage was reduced to 0.25 g every week, and then for six weeks. Group B was treated with Yiqi Yangyin Decoction and intraorbital-electroacupuncture for 12 weeks. Traditional Chinese medicine syndrome score, clinical efficacy, exophthalmos, clinical activity score (CAS) and related immune indexes of two groups were compared. Results The scores of traditional Chinese medicine syndromes in both groups after treatment were lower than those before treatment, and those in group B were lower than those in group A (P < 0.05). The total effective rate of group B after treatment was higher than that of group A (P < 0.05). The exophthalmos and CAS in both groups were lower than those before treatment, and those in group B were lower than those in group A (P < 0.05). The levels of TNF-α, IL-6, IL-17 and IGF-1 in both groups were lower than those before treatment, and those in group B were lower than those in group A (P < 0.05). Conclusion Compared with methylprednisolone intermittent treatment, Yiqi Yangyin Decoction combined with intraorbital–electroacupuncture in the treatment of GO can significantly reduce the clinical symptoms and signs of patients, enhance clinical efficacy, improve the patients′ autoimmune function, and promote rehabilitation.
2019 Vol. 16 (34): 134-137 [
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Discussion on characteristics of sequelae of pelvic inflammatory disease from the theory of "deficient vital qi leading to lingering of pathogen"
WU Dan1 CHEN Chen2 LIU Shumin3 CONG Huifang1 HU Lanrui4
Pelvic inflammatory disease sequelae seriously affect women′s reproductive health and quality of life, increase the economic burden of patients, but also affect the family and social stability and harmony. Motherland medicine treats this disease curative effect quite good. Based on the characteristics of complex etiology and changeable condition of this disease, this paper, guided by the classic theory of “deficient vital qi leading to lingering of pathogen” in traditional Chinese medicine, discussed the characteristics of the sequelae of pelvic inflammatory disease through a large number of clinical practice experience.
2019 Vol. 16 (34): 138-140,148 [
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Study on similarities and differences of effectiveness criteria of acupuncture in the treatment of lumbar intervertebral disc herniation
YAO Yuan1 ZHANG Hanwen2 HE Weipeng1 FANG Yunyun1
Objective To study similarities and differences of effect evaluation of acupuncture in the treatment of lumbar disc herniation in the domestic literature, and to lay the foundation for improving the core outcome index set of acupuncture on lumbar disc herniation. Methods Through literature research and CNKI database, the key words of “acupuncture” + “lumbar disc herniation” literature were selected from January 2017 to March 2019, and 74 journal papers were finally included. Bibliometric analysis was based on the criteria and contents (dimensions, items), the main outcome and its measuring tools, scoring methods, the secondary outcome and its measuring tools, scoring methods, etc. Results The application frequency of the standard/scale was mainly based on the diagnostic effect standard of traditional Chinese medicine disease syndromes. The evaluation dimensions of standard/scale focused on pain, activity, daily life and physical function evaluation. The main outcome of acupuncture in the treatment of lumbar disc herniation was efficiency, while the secondary outcome was pain and lumbar function. The scoring method of effect measurement was not uniform. Conclusion The effect of acupuncture on lumbar disc herniation should pay attention to the dimensions of pain, limb mobility, motor ability and daily life. It is necessary to standardize the evaluation indexes of the effect of acupuncture on lumbar disc herniation, pay attention to the quality of life of patients, make clear the measurement tools and algorithms, and improve the comparability between different research results.
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Imaging characteristics of lung-cancer associated acute ischemic stroke
LIN Jiacai1 WU Siting1 LIU Hui2 CUI Fang1 XU Rui2 SHAO Xue1 SHI Qiang1
Objective To study the imaging characteristics of lung-cancer associated acute ischemic stroke (LCA-AIS). Methods A total of 46 patients with LCA-AIS diagnosed in Hainan Hospital of Chinese PLA General Hospital from January 2014 to December 2018 were enrolled. The basic information, test data and imaging data of patients were collected and inputted for systematic analysis. Results The adenocarcinoma was more common in LCA-AIS patients with lung cancer pathology (69.57%), and the number of LCA-AIS patients in lung cancer stage Ⅳ was significantly more than the other lung cancer stages. Combined with imaging examination and laboratory results, it was found that there was a significant positive correlation between D-D polymer concentration and the number of areas involved in intracranial infarction lesions (r = 0.57, P < 0.001). The imaging manifestations of patients with LCA-AIS were diverse. After classifying the imaging manifestations, it was found that intracranial multi-focal type accounted for 60.87%, single-artery type accounted for 26.09%, and multi-artery type in the same drainage area accounted for 13.04%. The diffusion weighted imaging sequence of craniocerebral imaging examination indicated that acute infarction occurred in different stages in 21 patients (45.65%), among which 2 patients were classified as multi-artery type in the same drainage basin, and 19 patients were classified as multi-focal type in the intracranial. Conclusion The imaging manifestations of LCA-AIS patients are unique, and it is possible to identify the target patients early through imaging characteristics
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Effect of Ginkgo Biloba Extract Injection combined with Cinepazide Maleate in the treatment of sudden deafness
ZHANG Hongjie HUO Yan WANG Shanshan
Objective To explore clinical effect and safety of Ginkgo Biloba Extract Injection combined with Cinepazide Maleate in the treatment of sudden deafness (SD). Methods From January 2017 to January 2019, 102 cases of SD patients admitted to Panjin Central Hospital of Liaoning Provimce, according to the random number table method, which were divided into control group (51 cases) and observation group (51 cases). The control group was treated with Cinepazide Maleate, and the observation group was treated with Ginkgo Biloba Extract Injection on the basis of the control group. The two groups were treated for 2 weeks. Clinical efficacy was evaluated after treatment. The hearing threshold levels, peripheral blood levels of CD3+, CD4+, CD8+, CD4+/CD8+ and the levels of serum endothelin (ET), soluble vascular cell adhesion molecule (sVCAM), tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9) of the two groups were compared before and after treatment. The adverse reactions of the two groups during the treatment were recorded and compared. Results The total clinical effective rate of the observation group was significantly higher than the control group (P < 0.05). The hearing threshold levels of the two groups after treatment were significantly lower than before treatment (P < 0.05), and the observation group was significantly lower than that of the control group (P < 0.05). The peripheral blood levels of CD3+, CD4+ and CD4+/CD8+ of the two groups after treatment were significantly higher than before treatment (P < 0.05), the peripheral blood levels of CD8+ were significantly lower than before treatment (P < 0.05), while CD3+, CD4+ and CD4+/CD8+ of the observation group were significantly higher than the control group after treatment (P < 0.05), and CD8+ was significantly lower than the control group (P < 0.05). The levels of serum ET, sVCAM, TNF-α, IL-8 of the two groups after treatment were significantly lower than before treatment (P < 0.05), the levels of serum MMP-9 were significantly higher than before treatment (P < 0.05), while ET, sVCAM, TNF-α and IL-8 in the observation group were significantly lower than the control group (P < 0.05), and MMP-9 was significantly higher than the control group (P < 0.05). During treatment, there was no severe adverse reaction of the two groups. Conclusion Ginkgo biloba Extract Injection combined with Cinepazide Maleate on SD has significant effect, can promote hearing, improve the immune function and inner ear microcirculation, reduce the inflammatory response, and has good safety.
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Expression and clinical significance of miR-15b in serum of patients with acute cerebral infarction
LI Sheng1 PAN Min1 GU Lian2 LI Shenfen1
Objective To investigate the expression and clinical significance of serum miR-15b in patients with acute cerebral infarction. Methods From January to December 2018, 98 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Guangxi University of Chinese Medicine (“our hospital” for short) were selected as the acute cerebral infarction group, during the same period, 98 healthy subjects in our hospital were as the control group. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression of serum miR-15b in the two groups. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of miR-15b in acute cerebral infarction. The relationship between serum miR-15b expression and the clinicopathological characteristics of acute cerebral infarction was analyzed. Results Serum miR-15b in the two groups was (1.28±0.38) and (2.33±0.72), respectively. The expression of serum miR-15b in acute cerebral infarction group was higher than that in control group (P < 0.05). The area under the ROC curve of miR-15b in diagnosing acute cerebral infarction was 0.817, 95%CI = 0.721-1.438, the sensitivity was 91.06%, and the specificity was 79.35%. There was no significant difference in serum mir-15b expression among patients of different genders and ages (P > 0.05). There were statistically significant differences in serum miR-15b expression in patients with different infarction degrees, infarction volumes and prognosis (P < 0.05). Conclusion MiR-15b is highly expressed in the serum of patients with acute cerebral infarction and may be related to the degree, volume and prognosis of infarction, which is a potential serological marker for the diagnosis of acute cerebral infarction.
2019 Vol. 16 (34): 153-156 [
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Application of ELISA in the detection of human T-lymphocyte virus antibody detected by in blood donors in Dongguan
WANG Qing YU Lin CHEN Qingkai ZOU Jiaoli HE Ziyi CHEN Shaobin
Objective To investigate the application of enzyme-linked immunosorbent assay (ELISA) in the detection of human T-lymphocyte virus (HTLV) antibody in blood donors in Dongguan, and to carry out the corresponding test and ensure the blood safety to provide a reference basis. Methods A total of 68 323 plasma samples were collected from March 2016 to January 2017 in the blood donation in Dongguan Guangdong Province. ELISA was used as a screening method for human T-lymphocyte virus antibodies. Positive samples in the screening were supplemented by electrochemiluminescence (ECLIA) and confirmed by Western blotting (WB). Results Twenty-six samples of HTLV antibody-positive samples were screened by ELISA, the positive rate of screening was 0.038%. Nine samples were positive by ECLIA in the 26 samples, 2 samples were positive by WB, and the positive rate was 0.003%, two cases were all from Fujian Province. The positive predictive value of HTLV antibody was 7.69% (2/26). There were no statistically significant differences in the positive screening rates among blood donors of different genders, ages, educational backgrounds, whether they had donated blood for the first time and whether they were registered in Dongguan (P > 0.05). Conclusion The positive rate of screening and confirmation of HTLV antibodies in blood donors in Dongguan is low, and the positive predictive value is not high. It is recommended to use more specific ELISA or ECLIA for screening. When recruiting, the recruitment of Fujian blood donors can be appropriated strengthened.
2019 Vol. 16 (34): 157-160 [
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Application of third-party satisfaction evaluation of service profit chain model in outpatient service quality management
XIANG Kelan XIONG Jian LI Na WANG Qingli ZhANG Bingyi ZHANG Li
Objective To explore the application value of third-party satisfaction evaluation based on service profit chain model in outpatient service quality management. Methods From January 2017 to December 2018, patients and medical staff in the Outpatient Department of People′s Hospital of Three Gorges University were selected for satisfaction evaluation and monitoring. Among them, 200 outpatients and 100 out-patient medical personnel from January to December 2017 used self-designed satisfaction questionnaires, which were distributed by functional departments and the statistical results were collected for evaluation. From January to December 2018, 200 outpatient patients and 100 outpatient medical staff were implemented based on the service profit chain model, and a third-party satisfaction professional evaluation agency was introduced. Likert grade 5 was used to quantify the satisfaction of outpatient patients and medical staff, and the doctor-patient satisfaction was evaluated in a multi-dimensional scientific way by combining on-site and telephone, questionnaire, qualitative interview, etc. Once a quarter, four surveys were conducted. Results After the third-party satisfaction evaluation of the service profit chain model was implemented, the quality of outpatient service was continuously improved, and the satisfaction of outpatient patients and medical staff was significantly improved, with a highly statistically significant difference (P < 0.01). Conclusion The third party satisfaction evaluation of service profit chain model can effectively improve the efficiency of service quality management and improve the satisfaction and feeling of medical staff and patients.
2019 Vol. 16 (34): 161-164 [
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Study on the application of family integrated care in improving the care ability of family members of elderly patients with enterostomy
GU Tiantian1 ZHANG Yongmei1 ZHENG Xilan2 LI Xiaojuan3 HE Jinyan2
Objective To explore the role of family integrated care in improving the care ability of family members of elderly patients with enterostomy. Methods The convenience sampling method was used to select 67 family members of elderly patients with enterostomy who underwent gastrointestinal surgery in the Gastrointestinal Surgery, Affiliated Hospital of Zunyi Medical University from March to December 2018 as the research objects. A randomized controlled trial was conducted to divide family members into the experimental group (34 cases) and the control group (33 cases) according to the random number table. The control group received routine nursing care of gastrointestinal surgery. The experimental group received family integrated care. The awareness of enterostomy health knowledge, mastery of nursing skills and care ability of family members were compared between two groups. Results The overall analysis of family members′ mastery of knowledge of enterostomy health in the two groups showed that the differences in inter-group, time and interaction were highly statistically significant (all P < 0.01). The awareness scores of stoma knowledge of the family members of the two groups on the day before operation and the day of discharge were higher than that on the day of admission, the differences were highly statistically significant (all P < 0.01); the awareness scores of stoma knowledge of the family members of the experimental group on the day before operation and the day of discharge were higher than that of the control group, the differences were highly statistically significant (all P < 0.01). The nursing skill scores of the two groups on the day of discharge were higher than 1 d before the operation, and the nursing skill scores of the experimental group on the day of discharge and 1 d before the operation were higher than that of the control group, the differences were highly statistically significant (all P < 0.01). The experimental group was lower than the control group in the scores of adjusting to the role of care, responding to and providing assistance, assessing individual emotions, assessing family and community resources, adjusting life to meet the care needs and the total score of care ability, the differences were all highly statistically significant (all P < 0.01). Conclusion Family integrated care for elderly enterostomy patients can effectively improve the health knowledge level and nursing skills of primary caregivers, enhance their care ability and improve the prognosis of patients.
2019 Vol. 16 (34): 165-168,172 [
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Effect of graded psychological nursing on anxiety, depression and nursing satisfaction of patients with acute pancreatitis
WEI Huiyun WEI Suyu HUANG Li LI Huiping LI Shuangqi QIN yueqiu
Objective To explore the effect of graded psychological nursing on anxiety, depression and nursing satisfaction of patients with acute pancreatitis. Methods A total of 160 patients with acute pancreatitis who were hospitalized in the Department of Gastroenterology, Affiliated Hospital of Youjiang Medical University for Nationalities from July 2018 to March 2019 were selected and divided into the experimental group and the control group according to the random number table, with 80 patients in each group. Both groups received the same routine medical treatment. The control group received conventional psychological nursing in the ward, while the experimental group carried out graded psychological nursing intervention on the basis of the control group. The hospital anxiety and depression scale (HAD) was used to evaluate the patients′ psychological state and satisfaction after nursing, respectively, within 48-72 h after admission and 5 d after intervention, and the effectiveness of graded psychological nursing was analyzed. Results Before nursing, there was no significant difference between the two groups in the anxiety and depression scores of HAD scores (P > 0.05). After the implementation of graded psychological nursing, the anxiety and depression scores of the patients in both groups decreased significantly, and the anxiety and depression scores of the experimental group were significantly lower than those of the control group (P < 0.01 or P < 0.05). After nursing, the anxiety score of the second and third level patients in the experimental group was significantly lower than that before nursing (P < 0.01), while only the second level patients′ the depression score was significantly lower than that before nursing (P < 0.01). The nursing satisfaction of the experimental group was significantly higher than that of the control group (P < 0.05). Conclusion Graded psychological nursing is beneficial to the improvement of anxiety and depression in patients with acute pancreatitis in western Guangxi region, which is beneficial to improve their nursing satisfaction and has good clinical nursing significance.
2019 Vol. 16 (34): 169-172 [
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Effect of five-tone therapy on treatment compliance, joint function, and quality of life in patients with hip replacement
TIAN Lin1 YAO Dandan2 LI Hongyan3 CUI Xia4 LI Zhixin3 LIU Lihong5 WANG Qianqian6
Objective To investigate the effect of “five-tone therapy” on patients′ treatment compliance, joint function recovery and quality of life after hip arthroplasty. Methods From September 2016 to June 2018, 88 patients underwent total hip replacement Baoding No.1 Hospital of TCM of Hebei Province were selected. According to the random number table method they were divided into five tone therapy group and routine nursing group, with 44 cases in each group. The routine nursing group was given routine rehabilitation nursing after discharge. The five-tone therapy group assisted traditional Chinese medicine “five-tone therapy” on the basis of routine nursing to promote rehabilitation. The treatment compliance, hip function and quality of life and negative mood hamilton anxiety scale (HAMA) and hamilton depression scale (HAMD) were compared between the two groups. Results The score of the five-tone therapy group in the aspects of regular exercise and reasonable exercise was significantly higher than that of the conventional nursing group (P < 0.05). After 6 months, the pain, function, range of motion and total score of the five-tone therapy group were significantly higher than that of the conventional nursing group (P < 0.05). Six months after discharge, the five-tone therapy group scored higher in pain, energy, sleep, activity, emotional response, and social activity than the conventional care group, HAMA and HAMD scores were lower than those in the conventional nursing group, with statistically significant differences (P < 0.05). Conclusion Traditional Chinese medicine “five-tone therapy” can effectively improve the treatment compliance of patients after hip arthroplasty, contribute to the recovery of joint function, improve quality of life and reduce negative emotions.
2019 Vol. 16 (34): 173-176 [
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Application of continuity management model in chronic heart failure patients
LU Yang CHEN Ce YAO Na XU Dongni▲
Objective To explore the effect of continuous management mode in patients with chronic heart failure. Method A total of 115 patients with chronic heart failure from Beijing Shijitan Hospital, Capital Medical University from January 2016 to January 2018 were selected for the study, the patients were divided into control group 45 cases and observation group 70 cases according to the order of admission. The quality of life score, social support score, anxiety score and depression score of the two groups were investigated, the 6 min walking test (6 MWT), left ventricular ejection fraction (LVEF) and plasma amino-terminal brain natriuretic peptide precursor (NT-pro BNP) were compared. Follow-up was conducted for 1 year to record readmission rate and mortality. Results There were no statistically significant differences in quality of life score, social support score, anxiety score, depression score, 6 MWT, LVEF, NT-pro BNP before the implementation of management mode between the two groups of patients (all P > 0.05). There were statistically significant differences in the management model, after the implementation of the quality of life scores in the control group and observation group, social support score, 6 MWT, LVEF were higher than before the implementation of this management mode, anxiety score, depression score, NT-pro BNP were lower than before the implementation of this management mode, and the observation group of patients quality of life scale, social support score, 6 MWT, LVEF were higher than the control group, the anxiety score, depression score were lower than the control group, the difference had statistical significance (P < 0.05). There was no significant difference in NT-pro BNP between the two groups after the implementation of the management mode (P > 0.05). The readmission rate and mortality rate in the observation group within 1 year were lower than those in the control group, with statistically significant differences (all P < 0.05). Conclusion The application of continuous management mode in patients with chronic heart failure significantly improved the quality of life, social support, improved the poor psychological mood, improved the exercise tolerance, and reduced the recurrence and mortality.
2019 Vol. 16 (34): 177-180 [
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