中国医药导报
      Home                                                                                    中文
中国医药导报
 
Forthcoming Articles
Current Issue
Archive
Advanced Search
Read Articles
Download Articles
Email Alert
 
Quick Search  
  Adv Search
2019 Vol. 16, No. 35
Published: 2019-12-15
 
 
4 Neuroprotective effect of curcumin on chronic unpredictable mild stress rats
DENG Li1 GENG Chunmei2 LIAO Dehua3 JIANG Pei2 HAN Wenxiu2
Objective To explore the effect and mechanism of curcumin on corticosterone level, neuroplasticity and apoptosis in chronic unpredictable mild stress (CUMS) rats. Methods Twenty-four SD rats were divided into control group, model group and treatment group by random number table method, with 8 rats in each group. Model group and treatment group were given chronic stress model, treatment group was given 100 mg/(kg·d) curcumin, model group and control group were given the same volume of normal saline. After 4 weeks, the behavioral indexes, serum corticosterone level, BDNF, PSD-95, SYN protein expression and apoptosis in hippocampus were measured. Results The sugar preference of model group was significantly lower than that of control group, and that of treatment group was significantly higher than that of model group (P < 0.01). The immobility time of model group was significantly longer than that of control group, and that of treatment group was significantly shorter than that of model group (P < 0.01). Compared with control group, the level of serum corticosterone in model group increased significantly (P < 0.01); compared with model group, the level of serum corticosterone in treatment group decreased significantly (P < 0.01). Compared with control group, the expression of BDNF, PSD-95 and SYN protein in the hippocampus of model group decreased significantly (P < 0.05 or P < 0.01); compared with model group, the expression of BDNF, PSD-95 and SYN protein in the hippocampus of treatment group increased significantly (P < 0.05 or P < 0.01). Compared with control group, the number of apoptotic positive cells and apoptotic index increased significantly in model group (P < 0.01); compared with model group, the number of apoptotic positive cells and apoptotic index decreased significantly in treatment group (P < 0.01). Conclusion The potential antidepressant effect of curcumin is first demonstrated in the rat model of depression. Its mechanism may be related to the regulation of serum corticosterone level, neural plasticity and anti apoptosis.
2019 Vol. 16 (35): 4-7 [Abstract] ( 230 ) HTML (1 KB)  PDF (845 KB)  ( 189 )
8 Effect of repetitive transcranial magnetic stimulation with different parameters on the expression of brain-derived neurotrophic factor in serum of rats
DONG Guoying CHEN Xia ZHOU Xianju WANG Linxiao
Objective To observe the effect of repetitive transcranial magnetic stimulation (rTMS) with different parameters on serum brain-derived neurotrophic factor (BDNF) in rats. Methods A total of 54 Sprague-Dawle rats were divided into the Sham group (n = 18), 1 Hz rTMS group (n = 12), 10 Hz rTMS group (n = 12), and the intermittent theta burst stimulation (iTBS) group (n = 12). According to the stimulation intensity (the resting motor threshold, rMT), each experiment contains of the Sham group, the low-intensity group (80% rMT) and the high-intensity group (120% rMT), six mice in each group. The prefrontal cortex of rats were treated with rTMS in consecutive five days. Enzyme linked immunosorbent assay (ELISA) was used to detect the change of the serum BDNF level of rats. Results The level of BNDF in the low-intensity 1 Hz rTMS group was significantly higher than that in the Sham group, and the difference was statistically significant (P ＜ 0.05), while there was no statistically significant between the high-intensity 1 Hz rTMS group and the Sham group (P ＞ 0.05). The levels of BDNF among the Sham group, the low-intensity 10 Hz rTMS group and the high-intensity 10 Hz rTMS group were no statistically significant (P ＞ 0.05). The level of BNDF in the high-intensity iTBS group was lower than that of the Sham group, and the difference was statistically significant (P < 0.05), while there was no statistically significant between the low-intensity iTBS group and the Sham group (P ＞ 0.05). Conclusion Intensity is a key parameter affecting the effect of rTMS, while the effect of rTMS in different modes on BDNF varies with the intensity.
2019 Vol. 16 (35): 8-10,35 [Abstract] ( 179 ) HTML (1 KB)  PDF (1010 KB)  ( 80 )
11 Expression of PTEN in endometrial disease of patients taking Tamoxifen after breast cancer operation
LI Yuhe HE Yue WU Yumei
Objective To evaluate the expression of PTEN protein in endometrial disease of patients taking Tamoxifen (TAM) after breast cancer operation, and to explore its relationship with TAM-related endometrial disease on a molecular level. Methods From January to December 2018，56 cases with breast cancer receiving TAM (20 mg/d) after surgery in Beijing Obstetrics and Gynecology Hospital, Capital Medical University were selected. Among them, 10 cases with irregular vaginal bleeding or regular B-ultrasound follow-up showed abnormal thickening of the endometrium which were hospitalized for hysteroscopic curettage to obtain endometrium specimens were named as TAM group after breast cancer operation. At the same time, 10 cases with whole hysterectomy normal endometrium of “the cervical intraepithelial neoplasia grade Ⅲ or uterine fibroids” were named as normal endometrium group. 10 cases withⅠ type of endometrial adenocarcinoma were named as endometrial cancer group. Normal endometrial group and endometrial cancer group were control group. Immunohistochemistry was used to determine the expression of PTEN protein in endometrial tissues of patients in 3 groups. Results The quantitative expression of PTEN protein in the three groups were significantly different (P < 0.05). The quantitative expression of PTEN protein in endometrial cancer group was lower than that in normal endometrial group, and the difference was statistically significant (P < 0.05). The expression intensity of endometrial cancer group was lower than that of normal endometrial group, and the expression intensity of TAM group after breast cancer operation was lower than that of normal endometrial group. Conclusion The PTEN gene may used as an early molecular marker for predicting TAM-associated endometrial disease, and its mutation may play an important role in the development of TAM-associated endometrial disease.
2019 Vol. 16 (35): 11-15 [Abstract] ( 138 ) HTML (1 KB)  PDF (559 KB)  ( 36 )
15 Effect of Ethinylestradiol and Cyproterone Acetate Tablets combined with Pioglitazone on endometrial insulin receptor expression, ovarian morphology, uterine morphology and islet function in patients with normal weight polycystic ovary syndrome
CHEN Haiyan TANG Ling▲ KONG Wenjuan JIA Linna LIU Qiongjie
Objective To investigate the effects of Ethinylestradiol and Cyproterone Acetate Tablets combined with Pioglitazone on endometrial insulin receptor expression, ovarian morphology, uterine morphology and islet function in patients with normal weight polycystic ovary syndrome. Methods A total of 80 patients with normal weight polycystic ovary syndrome admitted to Dongzhimen Hospital, Beijing University of Chinese Medicine from October 2017 to October 2018 were selected as the study subjects. They were divided into the control group and the experimental group according to the random number table method, with 40 cases in each group. The control group was treated with Ethinylestradiol and Cyproterone Acetate Tablets, while the experimental group was treated with Ethinylestradiol and Cyproterone Acetate Tablets combined with Pioglitazone. The expression of endometrial insulin and its receptor, ovarian morphology, uterine morphology and islet function before and after treatment were compared between the two groups. Results Before treatment, there were no statistically significant differences in endometrial insulin and its receptor expression, mean ovarian volume, endometrial thickness, and islet function between the two groups (P ＞ 0.05). Compared with before treatment, the endometrial insulin OD value, insulin receptor OD value, mean ovarian volume, endometrial thickness, islet β cell function index and insulin resistance index of the two groups were all decreased after treatment, the differences were statistically significant (all P ＜ 0.05). The endometrial insulin OD value, insulin receptor OD value, mean ovarian volume, endometrial thickness, islet cell function index and insulin resistance index of the experimental group affter treatment were all lower than that of the control group, the differences were statistically significant (all P ＜ 0.05). Conclusion Ethinylestradiol and Cyproterone Acetate Tablets or Ethinylestradiol and Cyproterone Acetate Tablets combined with Pioglitazone in the treatment of normal weight polycystic ovary syndrome can effectively reduce the expression of endometrial insulin and its receptor, improve the morphology of ovary and uterus, and enhance the function of pancreas islet, among which, Ethinylestradiol and Cyproterone Acetate Tablets combined with Pioglitazone has a more significant effect.
2019 Vol. 16 (35): 15-18 [Abstract] ( 190 ) HTML (1 KB)  PDF (518 KB)  ( 26 )
19 Selective strategy of laparoscopic rectopexy in the treatment of rectal prolapse
CHEN Qin LI Yufei ZHOU Jiaojiao LI Huashan
Laparoscopic rectopexy is one of the main methods to treat rectal prolapse. According to the degree of rectal dissociation, fixation method, the absence of rectum and sigmoidectomy, the surgical methods are divided into laparoscopic ventral rectopexy, laparoscopic ventral mesh rectopexy, laparoscopic suture rectopexy, laparoscopic resection rectopexy, laparoscopic anterior rectopexy and laparoscopic posterior rectopexy. The laparoscopic ventral rectopexy is the most widely used in clinical practice and has become the first choice for the treatment of rectal prolapse. The application of laparoscopic ventral mesh rectopexy is still controversial and needs further study. Laparoscopic suture rectopexy can be used in children with rectal prolapse, and has a good effect. Laparoscopic resection rectopexy can improve fecal incontinence but may increase the risk of constipation. Laparoscopic anterior rectopexy is safe and effective in the treatment of elderly patients and patients with body debility. The problem of postoperative constipation still remains to be solved after laparoscopic posterior rectopexy. Therefore, according to the different degrees of patients′ age, physical conditions, anatomical abnormalities, functional disorders and other differences, good indications and appropriate fixation methods for individualized treatment will greatly improve the efficacy of surgery, reduce complications and the recurrence rate, improve the intestinal function and the satisfaction of patients.
2019 Vol. 16 (35): 19-23 [Abstract] ( 144 ) HTML (1 KB)  PDF (549 KB)  ( 161 )
24 Mechanism research advances of traditional Chinese medicine in the intervention of postpartum depression
CHEN Pengdian1 YANG Zhuoxin2▲ NING Yan1▲ LIU Fang1 LIU Yulei1 LIAO Jian1 YU Xiaoying1 CHEN Cuimei1
Postpartum depression is commonly seen among the postpartum women. This paper reviews the possible mechanisms of traditional Chinese medicine intervention to postpartum depression in recent years at home and abroad, which proposes that the mechanisms are closely correlated to the aspects as follows: traditional Chinese medicine could intervene the postpartum depression via regulating the nerve-endocrine network function, improving the neural transmitters levels, harmonizing the immune system functions and mediating the correlated signaling transduction pathway expression. These studies provide new research methods and strategies for further research of traditional Chinese medicine intervention on postpartum depression.
2019 Vol. 16 (35): 24-27 [Abstract] ( 224 ) HTML (1 KB)  PDF (541 KB)  ( 198 )
28 Research progress on immune microenvironment of lung cancer
CHEN Liang PENG Min WENG Yiming SONG Qibin
The tumor microenvironment plays a central role in the initiation and progression of lung cancer. The innate and adaptive immune cells in tumor microenvironment have the effect of promoting and suppressing tumor. Tumor cells escaped from the surveillance and killing of immune cells by over-expressing immune checkpoint molecules, resulting in the acceleration of tumor growth. Currently, immune checkpoint inhibitors for advanced non-small cell lung cancer have been written in various clinical practice guidelines. Immunotherapy is aimed at improving immune cell function or inhibiting the activity of immune checkpoints. Therefore, further understanding of the immunomodulatory function of the immune cells may help to improve the efficacy of immunotherapy and discover new therapeutic targets.
2019 Vol. 16 (35): 28-30,43 [Abstract] ( 206 ) HTML (1 KB)  PDF (560 KB)  ( 79 )
31 Research progress of renal ischemia reperfusion injury and mitochondrial autophagy SIRT1-FOXO3-PINK1-Parkin regulatory axis
WANG Suogang WANG Guangce
Renal ischemia reperfusion injury (IRI) is an important cause of delayed recovery of renal function, rejection reaction and interstitial fibrosis of renal transplantation, which has become the bottleneck restricting the long-term survival of transplant recipients and kidneys. How to alleviate renal IRI is the key issue to improve the long-term prognosis of renal transplantation. There is a close relationship between autophagy and renal IRI, and the role of mitochondrial autophagy in renal IRI has attracted more and more attention. To elucidate the relationship between renal IRI and the regulatory axis of mitochondrial autophagy SIRT1-FOXO3-PINK1-Parkin is of great significance to explore the new mechanism of renal tubular epithelial cell injury and repair after renal IRI.
2019 Vol. 16 (35): 31-35 [Abstract] ( 286 ) HTML (1 KB)  PDF (774 KB)  ( 247 )
36 Research progress in immune cell therapy for hepatocellular carcinoma
HE Yulin1 MENG Zhongji1,2,3
Hepatocellular carcinoma is one of the most common malignant tumors in the world, especially in China with the highest morbidity. Currently, hepatocellular carcinoma is mainly treated by surgery, radiotherapy, local ablation, hepatic artery chemoembolization, molecular targeted therapy, etc. Because of the occult onset of hepatocellular carcinoma, most patients have lost the opportunity for surgery when they are discovered, and the therapeutic effect is very limited. Therefore, it is of great significance to explore new treatment options. Tumor immune cell therapy is currently the most concerned emerging treatment, especially gene modified T cell therapy has shown great potential in the treatment of hepatocellular carcinoma. This paper will review the recent advances in immunotherapy for hepatocellular carcinoma.
2019 Vol. 16 (35): 36-39 [Abstract] ( 225 ) HTML (1 KB)  PDF (570 KB)  ( 171 )
40 Research progress of autophagy and hypoxic-ischemic brain injuries
HUANG Lin LU Liqun
Autophagy is a metabolic pathway in eukaryotic cells through the lysosome, including the processes of autophagosomes formation, the combination of autophagosomes and lysosomes and autophagosomes degradation. Autophagy in hypexic-ischemia brain damage is activated by different signaling pathways and its role and specific mechanism are unclear. On the one hand, autophagy plays a protective role by regulating the autophagosis-lysosome pathway or affecting apoptosis and necrosis. On the other hand, autophagy may aggravate neurons injury after ischemic/hypoxia by interfacing with apoptosis and pyroptosis. This characteristic may be related to the degree of autophagy, the stage of occurrence, and external factors.
2019 Vol. 16 (35): 40-43 [Abstract] ( 162 ) HTML (1 KB)  PDF (546 KB)  ( 78 )
44 Analysis and policy recommendations of current status of traditional Chinese medicine treatment on Parkinson′s disease
YANG Yuan1 MIAO Suhua2 ZHOU Rongsong2 MA Yu2 ZHANG Yuqi1，2
Objective To comprehend the needs, cognitive status and practical application status of traditional Chinese medicine treatment from patients with Parkinson′s disease (PD) and to explore the influencing factors of service needs and utilization in traditional Chinese medicine. Methods The self-made questionnaire survey as the method was adopted to analyze PD patients in 30 provinces and regions in China in August 2018. The questions include but not limited to individual information, basic health conditions, experiences in traditional Chinese medicine treatment services in the past, and the will to consider the traditional Chinese medicine treatment services in the future. Results A total of 435 questionnaires were distributed and 417 questionnaires were recovered. The effective recovery rate was 95.86%.73.14% of the respondents were willing to use traditional Chinese medicine treatment services, and 52.76% of the respondents who have received traditional Chinese medicine treatment believed that the symptoms like sleep disorders, constipation, and muscle stiffness are relieved. However, 39.09% of the respondents thought that traditional Chinese medicine treatment did not improve their symptoms. The unsatisfactory efficacy of traditional Chinese medicine treatment was the main reason of influencing utilization of the traditional Chinese medicine treatment. Traditional Chinese medicine decoction was the most widely used method in traditional Chinese medicine. Conclusion PD patients had great enthusiasm and cognition to traditional Chinese medicine treatment services, but the number of people who used traditional Chinese medicine treatment is not consistent with the numbers of people who are willing to practice traditional Chinese medicine. Patients′ actual satisfaction rate of treatment needs is not satisfactory, while the choices of traditional Chinese medicine treatment items are not balanced.
2019 Vol. 16 (35): 44-47 [Abstract] ( 179 ) HTML (1 KB)  PDF (505 KB)  ( 80 )
48 A qualitative study on the service needs of the incapacitated elderly in the pension agency of the combination of medical and nursing care institutions in Guangzhou
LI Haoran LIU Jiaxian ZHOU Ying DING Bang KE Chunjie
Objective To provide theoretical basis for improving the service level and increasing the life quality of the elderly disabled in the combination of medical and nursing care institutions through qualitative interviews to understand their service needs. Methods From January to April 2019, sixteen incapacitated elderly were selected in 4 combination of medical and nursing elderly care institutions in Guangzhou Friendship Elderly Apartment, Yihe Haoting Nursing Home, Songhe Nursing Home, Baiyue Baitai Nursing Home were given semi-structured interviews to understand their service needs using qualitative research methods. Results The service needs of the incapacitated elderly in the combination of medical and nursing care institutions included the following aspects: humanized facilities and services, improving self-care ability, getting attention and respect, recognizing and resolving bad emotions, and perfecting the combination of medical and nursing care system. Conclusion The pension agency of the combination of medical and nursing care institutions should give full consideration to the mental and physical health conditions of incapacitated elderly, while provide facilitation facilities and humanized service, moreover, give more attention and respect, strengthen self-care ability training for the elderly, and the initiative to understand the old man emotional and mental health. Finally, improve the system of the combination of medical and nursing care to meet the needs of the elderly people.
2019 Vol. 16 (35): 48-51 [Abstract] ( 257 ) HTML (1 KB)  PDF (496 KB)  ( 93 )
52 Exploration monitoring strategy of oral Warfarin anticoagulation therapy after cardiac valve surgery
PENG Xiaopeng1，2 ZHOU Chengbin1 HUANG Jinsong1▲ WU Min1
Objective To explore the monitoring strategy of Warfarin anticoagulant index prothrombin time-international normalized ratio (PT-INR) in patients after cardiac valve surgery, and to find a suitable follow-up monitoring method for patients after valvular surgery. Methods One hundred and seven patients undergoing cardiac valve surgery and requiring oral Warfarin anticoagulant therapy in Adult Area Two of Cardiac Surgery of Guangdong Provincial People′s Hospital were selected in this study from January to March 2019. According to the different anticoagulant monitoring methods, the same patient was divided into two groups: control group was taken Sodium Citrate intravenous anticoagulant and sent to the hospital laboratory, and the PT-INR results were obtained by using STAGO-E monitoring instrument produced by Sitagao Company of France, and two drops of whole blood from fingertip endings were taken from experimental group, and PT-INR results were obtained by Shenzhen qLabsPT-INR (Q1/Q3 model) coagulation detector. The correlation and deviation analysis of PT-INR between two groups of anticoagulant monitoring results were carried out, and the advantages and disadvantages of the two monitoring methods were discussed. Results There was a good correlation between the two blood coagulation monitoring instruments, the correlation coefficient R was more than 0.9, and the deviation of the results was small. It was consistent with INR (1.5-2.5) in the anticoagulation window after mechanical valvular replacement, and had good consistency and stability. The portable Shenzhen qLabs coagulation detector was easy to accept because of its convenient operation, quick result and obvious economic effect. Conclusion The portable Shenzhen qLabs blood coagulation detector has a good correlation with the large-scale instruments in the hospital, and is especially suitable for patients who are required to be treated within the treatment window after cardiac mechanical valve replacement.
2019 Vol. 16 (35): 52-56 [Abstract] ( 190 ) HTML (1 KB)  PDF (733 KB)  ( 44 )
57 Analysis of serum uric acid level and risk of acute ischemic stroke in middle-aged and elderly population
ZHANG Cuiping OUYANG Xiaochun YU Xiaoli PANG Jie
Objective To investigate the risk and clinical significance of serum uric acid level and acute ischemic stroke in the middle-aged and elderly populations. Methods Retrospective analysis was performed on the data of 304 patients who met the study criteria in the  No.908 Hospital of the People′s Liberation Army Joint Logistics Support Force from January 2015 to December 2017, among which 152 new acute ischemic stroke patients were in the stroke group and 152 matched non-stroke patients were in the non-stroke group. The clinical and biochemical data of the included patients were collected, and the basic information, clinical and biochemical indicators between the two groups were compared. Multivariate Logistic regression analysis was used to investigate the relationship between serum uric acid level and acute ischemic stroke. Results There were no significant differences in gender, age, systolic blood pressure, smoking, alcohol consumption, low density lipoprotein cholesterin, triglyceride, total cholesterol, blood urea nitrogen and blood glucose between the stroke group and the non-stroke group (P ＞ 0.05). Body mass index, white blood cells, platelets, high density lipoprotein cholesterol, serum uric acid, serum creatinine, glutamic oxalacetic transaminase, homocysteine and other indicators were compared, and the differences were statistically significant (P ＜ 0.05). The risk of ischemic stroke in females was 1.01 (95%CI: 1.00-1.01, P = 0.027), but there was no statistically significant difference in the risk of ischemic stroke in males (P ＞ 0.05). Conclusion Elevated serum uric acid levels increase the risk of acute ischemic stroke in females, but not significantly in males.
2019 Vol. 16 (35): 57-60 [Abstract] ( 225 ) HTML (1 KB)  PDF (552 KB)  ( 156 )
61 Effect of Compound Danshen Dripping Pills combined with Rosuvastatin on left ventricular remodeling and myocardial fibrosis in patients with acute myocardial infarction after percutaneous coronary intervention
XU Xiaojin ZHANG Yiyan ZHANG Sujie GONG Juexiao LOU Bin GU Minglin YU Shengyong
Objective To investigate the effects of Compound Danshen Dripping Pills combined with Rosuvastatin on left ventricular remodeling (LVR) and myocardial fibrosis in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods Eighty patients with AMI who underwent PCI surgery in Jiangsu Province Academy of Traditional Chinese Medicine from January 2015 to June 2018 were selected and divided into observation group and control group according to the random number table method, with 40 cases in each group. Both groups were given routine treatment after operation, and control group was treated with Rosuvastatin, while observation group was treated with Compound Danshen Dripping Pills on the basis of control group. Clinical effect, traditional Chinese medical syndrome score, echocardiography index, laboratory index before and after treatment and adverse drug reactions were compared between two groups. Results Total clinical effective rate of observation group was higher than that of control group (P < 0.05). After treatment, traditional Chinese medical syndrome scores of two groups were significantly lower than those before treatment, and observation group was lower than control group (P < 0.05). After treatment, left ventricular ejection fraction of two groups was significantly higher than that before treatment, and observation group was higher than control group (P < 0.05). After treatment, left ventricular end diastolic dimension and left ventricular end systolic diameter in two groups were significantly smaller than those before treatment, and observation group was smaller than control group (P < 0.05). After treatment, levels of matrix metalloproteinases-9, transforming growth factor-β1 and connective tissue growth factor in two groups were lower than those before treatment, and observation group was lower than control group (P < 0.05). During the treatment, there was no obvious adverse reaction in both groups. Conclusion The combination of Rosuvastatin and Compound Danshen Dripping Pills can effectively improve the clinical symptoms of AMI patients after PCI, and delay the progression of LVR and myocardial fibrosis.
2019 Vol. 16 (35): 61-64,77 [Abstract] ( 196 ) HTML (1 KB)  PDF (912 KB)  ( 127 )
65 Study on heart rate variability, deceleration capacity and ventricular repolarization dispersion in patients with different Antzelevitch classification of ventricular early repolarization
SHEN Shurong WANG Xingde ZHOU Li ZENG Jinmei CHEN Bin CHEN Zhong
Objective To investigate the role of heart rate variability (HRV), deceleration capacity (DC) and ventricular repolarization dispersion in the assessment of autonomic nervous dysfunction in patients with different Antzelevitch classification of ventricular early repolarization. Methods From January 2016 to December 2018, 126 patients with ventricular early repolarization who were diagnosed and treated in Shanghai Sixth People′s Hospital East Affiliated to Shanghai University of Medicine and Health Science were selected for electrocardiogram and dynamic electrocardiogram examination. According to Antzelevitch classification method, they were divided into three groups: type Ⅰ group of 50 cases; type Ⅱ group 41 cases; type Ⅲ group 35 examples. In addition, 50 cases of healthy physical examination in the same period were selected as the control group. The heart rate acceleration (AC), DC, HRV and ventricular repolarization dispersion of each group were compared and the correlation was analyzed. Results The DC, 24 h period of standard deviation of normal sinus R-R intervals (SDNN), and the root mean square of standard deviations of differences between adjacent normal R-R intervals (RMSSD) of type Ⅱ group and type Ⅲ group early repolarization patients were lower than those of the control group (P ＜ 0.05 or P ＜ 0.01). In type Ⅱ and Ⅲ groups, the AC and electrocardiogram T peak-T end interval (Tp-Te) was significantly higher than those of the control group (all P ＜ 0.05); compared with type Ⅰ group, the DC, SDNN value in type Ⅲ group also significantly reduced, AC value increased significantly (all P ＜ 0.05); in patients with early repolarization, DC was positively correlated with SDNN, RMSSD and the percentage of continuous normal R-R intervals with a difference of more than 50 ms within 24 h (PNN50) (r = 0.3318, P ＜ 0.01; r = 0.2777, P ＜ 0.05; r = 0.2916, P ＜ 0.01), which was negatively correlated with AC and Tp-Te (r = -0.8084, P ＜ 0.001, r = -0.1913, P ＜ 0.05). Conclusion Patients with different Antzelevitch classification of ventricular early repolarization have different degrees of autonomic nervous dysfunction and the Tp-Te internal is prolonged, among which the autonomic nervous dysfunction of type Ⅲ group is more obvious. The study on DC and HRV and ventricular repolarization dispersion can provide help for clinical diagnosis and treatment.
2019 Vol. 16 (35): 65-68 [Abstract] ( 201 ) HTML (1 KB)  PDF (562 KB)  ( 97 )
69 Effect of Dihuang Yinzi on cognitive function in patients with mild Alzheimer′s disease
ZHANG Na1 WANG Le2 MA Tao2 CHEN Zhigang1 LI Nannan1
Objective To observe the effect of Dihuang Yinzi on cognitive function in patients with mild Alzheimer′s disease (AD). Methods From December 2017 to December 2018, 50 patients with mild AD were collected from the outpatient and inpatient departments of DongFang Hospital Affiliated to Beijing University of Chinese Medicine, and they were randomly divided into traditional Chinese medicine treatment group and Western medicine control group by drawing lots, with 25 patients in each group. All the patients were given education. The traditional Chinese medicine treatment group was orally administrated with Dihuang Yinzi, while the Western medicine control group was orally administrated with Aricept. The scores of the Mini-mental State Examination (MMSE) scale, Montreal Cognitive Assessment (MoCA) scale and activity of daily living in the day of enroument and aftertreat ment were compared. Results After treatment, compared with the Western medicine control group, the calculation score, recall score, language score and total score of the MMSE scale in the traditional Chinese medicine treatment group were improved significantly (P ＜ 0.01). After treatment, compared with the Western medicine control group, the visual space and executive function score, attention score, language score, delayed memory score and total score of the MoCA scale in the traditional Chinese medicine treatment group increased significantly (P ＜ 0.01), and abstract thinking score also increased (P ＜ 0.05). After treatment, compared with the Western medicine control group, there was no significant difference in the score of ADL scale (P ＞ 0.05). Conclusion The Dihuang Yinzi can significantly improve the cognitive function of patients with mild AD.
2019 Vol. 16 (35): 69-72 [Abstract] ( 172 ) HTML (1 KB)  PDF (535 KB)  ( 84 )
73 Clinical effect of Xiaoshuan Enteric-Coated Capsules in the treatment of convalescent stage of cerebral infarction of qi deficiency and blood stasis syndrome
WANG Yun LI Yingyi TANG Lingtao ZHAO Xuemeng
Obiective To explore the clinical effect of Xiaoshuan Enteric-Coated Capsules in the treatment of convalescent stage of cerebral infarction of qi deficiency and blood stasis syndrome. Methods Using convenient sampling method, 120 patients of convalescent stage of cerebral infarction of qi deficiency and blood stasis syndrome admitted to the Xingtai Third Hospital of Hebei Province from June 2018 to June 2019 were selected and they were divided into the control group and the observation group according to the random number table method, with 60 cases in each group. The control group was treated with rehabilitation treatment and preventive treatment. The observation group was given Xiaoshuan Enteric-Coated Capsules on the basis of the control group. The therapeutic effect and the incidence of adverse reactions were observed in the two groups, the scores of motor function and daily living ability before and after treatment were compared between the two groups. The serum homocysteine and serum neurotrophic index before and after treatment were measured in the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group, the difference was statistically significant (P ＞ 0.05). Compared with before treatment, the scores of motor function and daily life ability of the two groups increased significantly，and the observation group was higher than the control group, the differences were statistically significant (P ＜ 0.05). Compared with before treatment, the level of serum homocysteine in the two groups decreased, and the observation group was lower than the control group, the differences were statistically significant (P ＜ 0.05). Compared with before treatment, the levels of brain-derived neurotrophic factor and vascular endothelial growth factor in the two groups increased significantly, the observation group was higher than the control group, and the differences were statistically significant (P ＜ 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion Xiaoshuan Enteric-Coated Capsules has a good clinical effect in the treatment of convalescent stage of cerebral infarction of cerebral infarction of qi deficiency and blood stasis syndrome, which can improve the treatment effect, improve the symptoms, without significantly increasing adverse reactions, which is worthy of clinical promotion and application.
2019 Vol. 16 (35): 73-77 [Abstract] ( 165 ) HTML (1 KB)  PDF (609 KB)  ( 106 )
78 Clinical effect of Banxia Baizhu Tianma Decoction combined with Clopidogrel in the treatment of acute ischemic stroke
TANG Yong CHEN Liang ZHANG Chao CHEN Wenbo LI Jin WANG Xiaoling
Objective To observe the clinical effect of Banxia Baizhu Tianma Decoction combined with Clopidogrel in the treatment of acute ischemic stroke. Methods A total of 183 patients with acute ischemic stroke admitted to Ankang Hospital of Traditional Chinese Medicine from March 2016 to March 2019 were divided into control group (91 cases Clopidogrel) and research group (92 cases, Banxi Baizhu Tianma Decoction combined with Clopidogrel) according to the random number table method. The clinical efficacy, national institutes of health stroke scale (NIHSS), modified Barthel index (mBI) and serum related indicators were compared between the two groups, and adverse reactions were recorded. Results After treatment, the total clinical effective rate of the study group was higher than that of the control group (P ＜ 0.05). After treatment, the NIHSS, soluble P-selectin and matrix metalloproteinase-9 decreased in both groups, and the study group was lower than the control group. mBI score, vascular endothelial growth factor and brain-derived neuronutrition increased in both groups, and the study group was higher than the control group (P ＜ 0.05). There was no difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Conventional Clopidogrel combined with Banxia Baizhu Tianma Decoction in the treatment of acute ischemic stroke can effectively improve the daily activities of patients, alleviate the degree of neurological impairment, improve the level of relevant serum indicators, and do not increase the incidence of adverse reactions.
2019 Vol. 16 (35): 78-81 [Abstract] ( 193 ) HTML (1 KB)  PDF (532 KB)  ( 132 )
82 The relationship between the expression of serum miR181b, miR-210 and inflammatory factors in patients with hypertensive disorder of pregnancy
REN Na JI Jinghuan
Objective To explore the expression of serum microRNA-181b (miR-181b), miR-210 in patients with hypertensive disorder of pregnancy (HDP) and the relationship with inflammatory factors. Methods From January 2016 to January 2018, 183 cases with HDP admitted to Cangzhou People′s Hospital were collected as case group. According to the severity of the disease, they were divided into hypertensive pregnancy subgroup (n = 51), mild preeclampsia subgroup (n = 79) and severe preeclampsia subgroup (n = 53). At the same time, 55 cases with healthy single pregnant women were randomly selected as control group. The relative expression of serum miR-181b, miR-210 and serum inflammatory factors such as interleukin (IL)-1β, IL-6, IL-10, IL-17 and tumor necrosis factor-α (TNF-α) in each group were detected and compared. Pearson accumalates correlation analysis was used to analyze the correlation between serum miR-181b, miR-210 and IL-1β, IL-6, IL-17, TNF-α and IL-10. Results The serum miR-181b and miR-210 and IL-1β, IL-6, IL-17, TNF-α in case group were higher than those in control group, and IL-10 was lower than that in control group, and the differences were statistically significant (all P < 0.05). Comparison of serum miR-181b, miR-210 and IL-1β, IL-6, IL-17, TNF-α in different HDP subgroups showed statistically significant differences (all P < 0.05). MiR-181b, miR-210 and IL-1β, IL-6, IL-17, TNF-α expression in mild preeclampsia subgroup were higher than those in hypertensive pregnancy subgroup, and IL-10 was lower than that in hypertensive pregnancy subgroup, and the differences were statistically significant (all P < 0.05). miR-181b, miR-210 and IL-1β, IL-6, IL-17, TNF-α expression in severe preeclampsia subgroup were higher than those in mild preeclampsia subgroup, and IL-10 was lower than that in mild preeclampsia subgroup, and the differences were statistically significant (all P < 0.05). Pearson accumulates correlation analysis showed that serum miR-181b in HDP patients was positively correlated with IL-1β (r = 0.722, P < 0.01), IL-6 (r = 0.759, P < 0.01), IL-17 (r = 0.713, P < 0.01) and TNF-α (r = 0.736, P < 0.01), and negatively correlated with IL-10 (r = -0.781, P < 0.01). miR-210 in HDP patients was positively correlated with IL-1β (r = 0.765, P < 0.01), IL-6 (r = 0.793, P < 0.01), IL-17 (r = 0.738, P < 0.01) and TNF-α (r = 0.772, P < 0.01), and negatively correlated with IL-10 (r = -0.745, P < 0.01). Conclusion The up-regulation of serum miR-181b and miR-210 mediates the occurrence and development of HDP, which also are closely related to the severity of the disease and the intensity of inflammation.
2019 Vol. 16 (35): 82-85,89 [Abstract] ( 176 ) HTML (1 KB)  PDF (575 KB)  ( 52 )
86 Expression of miR-216b and FOXM1 in cervical cancer and its relationship with clinicopathological features
WANG Mengyi LU Hongda CHEN Li LEI Zhang
Objective To study the expression of micro RNA (miR)-216b and forkhead box protein M1 (FOXM1) in cervical cancer and its relationship with clinicopathological features. Methods From March 2016 to March 2019, 84 cases with cervical cancer diagnosed and treated in the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science and Technology were selected as case group. In the same period, 40 cases with cervical intraepithelial neoplasia (CIN) were selected as CIN group, and 40 cases with benign uterine lesions were used as control group. The expressions of miR-216b and FOXM1 in each group were detected by real-time fluorescent quantitative PCR. Its relationship with clinicopathological features were compared and the correlation was analyzed. Results The expression of miR-126b in case group was significantly lower than that in CIN group and control group, while the FOXM1 in case group was significantly higher than that in CIN group and control group, and the differences were statistically significant (all P < 0.05). The expression of miR-126b and FOXM1 were correlated with FIGO stage, degree of tumor differentiation and depth of infiltration, but not with age, pathological type, lymph node metastasis and human papillomavirus (HPV) 16/18 infection. The expression of miR-126b was negatively correlated with the expression of FOXM1 (r = -0.694, P = 0.001). Conclusion MiR-126b and FOXM1 are abnormally expressed in cervical cancer tissues. Both of them are involved in the occurrence and development of cervical cancer, and may become new tumor markers for cervical cancer diagnosis, treatment and prognosis evaluation.
2019 Vol. 16 (35): 86-89 [Abstract] ( 177 ) HTML (1 KB)  PDF (505 KB)  ( 102 )
90 Expression changes of T lymphocyte subsets and regulatory T cells in peripheral blood of patients with cervical lesions and its clinical significance
XIA Liangping LIU Dabiao
Objective To explore the expression changes of T lymphocyte subsets and regulatory T cells in peripheral blood of patients with cervical lesions and its clinical significance. Methods From January 2017 to June 2019, 100 cases with cervical lesions admitted to Zhenjiang Fourth People′s Hospital were selected as case group. According to the types of cervical lesions, they were divided into chronic cervicitis subgroup (n = 24), cervical intraepithelial neoplasia subgroup (n = 37) and cervical cancer subgroup (n = 39). According to the infection of human papillomavirus (HPV), They were divided into HPV high-risk subgroup (n = 58) and HPV low-risk subgroup (n = 42). In the same period, 65 cases with healthy volunteers were randomly selected as control group. The expression of T lymphocyte subsets and regulatory T cells in peripheral blood of each groups were detected by the flow cytometry. Results The levels of CD3+, CD4+, CD4+/CD8+ in case group were lower than those in control group, and the levels of CD8+, CD4+CD25+CD127- were higher than those in control group, and the differences were statistically significant (all P < 0.05). The levels of CD3+, CD4+, CD4+/CD8+ in cervical intraepithelial neoplasia subgroup and cervical cancer subgroup were lower than those in chronic cervicitis subgroup, and the levels of CD8+, CD4+CD25+CD127- were higher than those in chronic cervicitis subgroup, and the differences were statistically significant (all P < 0.05). The levels of CD3+, CD4+, CD4+/CD8+ in cervical cancer subgroup were lower than those in cervical intraepithelial neoplasia subgroup, and the levels of CD8+, CD4+CD25+CD127- were higher than those in cervical intraepithelial neoplasia subgroup, and the differences were statistically significant (all P < 0.05). The levels of CD3+, CD4+, CD4+/CD8+ in HPV high-risk subgroup were lower than those in HPV low-risk subgroup, and the levels of CD8+, CD4+CD25+CD127- were higher than those in HPV low-risk subgroup, and the differences were statistically significant (all P < 0.05). Pearson accumulates correlation analysis showed that the severity of cervical lesions in patients was negatively associated with CD3+ (r = -0.617， P < 0.05), CD4+ (r = -0.592， P < 0.05), CD4+/CD8+ (r = -0.628， P < 0.05), and positively associated with CD8+ (r = 0.603，P < 0.05), CD4+CD25+CD127- (r = 0.624，P < 0.05). Conclusion The abnormal expression of T lymphocyte subsets and regulatory T cells in peripheral blood of patients with cervical lesions is closely related to the severity of cervical lesions and the risk of HPV infection.
2019 Vol. 16 (35): 90-93 [Abstract] ( 227 ) HTML (1 KB)  PDF (513 KB)  ( 20 )
94 Effect of Progesterone combined with Phloroglucin on the expression of SOCS3 and perinatal outcome in threatened abortion
ZHAO Junda GUO Chunfeng MA Junqi▲
objective To explore the effect of Progesterone combined with Phloroglucin on the expression suppressors of cytokine signaling 3 (SOCS3) and perinatal outcome in threatened abortion. Methods From June 2015 to June 2017, 94 cases with threatened abortion treated in Department of Gynecology, the First Affiliated Hospital, Xinjiang Medical University were seleted. According to random number table method, they were divided into the observation group and the control group, with 47 cases in each group. The control group was treated with Progesterone, while the observation group was added with Phloroglucin on the basis of the control group. The clinical treatment effect and the expression levels of SOCS3 of two groups were compared. The incidence of gestational hypertension, placental abruption, placental previa, placental premature rupture, gestational diabetes, neonatal malformation, full-term low birth weight, premature birth, neonatal death, and 1 min Apgar score were also recorded. Results The clinical treatment effect of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). One week after treatment, the mRNA and protein levels of SOCS3 in the observation group were significantly higher than those in the control group, with the differences were statistically significant(P < 0.05). There were no significant differences in the incidence of gestational hypertension, placental abruption, placental previa, placental premature rupture and gestational diabetes between the two groups (P > 0.05). There were no statistically significant differences between the two groups in neonatal malformation, full-term low birth weight, premature birth, neonatal death, and 1 min Apgar score (P > 0.05). Conclusion Progesterone combined with Phloroglucin in the treatment of threatened abortion clinical effect is significant, which can significantly improve the patients′ SOCS3 level and no adverse perinatal outcomes.
2019 Vol. 16 (35): 94-97 [Abstract] ( 173 ) HTML (1 KB)  PDF (570 KB)  ( 111 )
98 Analysis of prognostic factors in elderly patients with limited-stage small cell lung cancer
ZHAO Kai WANG Zhiwu YANG Junquan
Objective To explore the prognostic factors related to limited-stage small cell lung cancer in elderly patients, and to provide a reference for the selection of the best clinical treatment plan. Methods A retrospective analysis of 79 elderly patients with limited-stage small cell lung cancer treated in Tangshan People′s Hospital, Hebei Province from January 2010 to December 2016 was performed. The sex, age, Karnofsky performance status (KPS) score, smoking history, radiotherapy and chemotherapy mode, prophylactic cranial irradiation (PCI) situation, number of chemotherapy cycles and other information was collected. The study endpoint was overall survival. Univariate and multivariate survival analyses were used to identify independent prognostic factors. Results The median survival time of the 79 patients was 15.4 months, and the 2-year survival rate was 25.6%. The comparison of survival among different groups including gender, age, KPS score, smoking history, and treatment mode suggested that KPS score, PCI, and combination of radiotherapy and chemotherapy were prognostic factors (P ＜ 0.05), while age and number of chemotherapy cycles had marginal correlation with patient survival (0.05 ＜ P ＜ 0.10). The above factors were included in the multivariate analysis and the results suggested that KPS score, PCI, combined mode of radiotherapy and chemotherapy and the number of chemotherapy cycles were independent prognostic factors (P ＜ 0.05). Conclusion Good KPS, standard combination of radiotherapy and chemotherapy, adequate number of chemotherapy cycles, and performing PCI can provide survival benefits for elderly patients with limited-stage small cell lung cancer.
2019 Vol. 16 (35): 98-102 [Abstract] ( 190 ) HTML (1 KB)  PDF (575 KB)  ( 73 )
103 Study on the relationship between syndrome of traditional Chinese medicine and related factors in acute cerebral infarction
ZHANG Sha FENG Yue QIU Lixia▲
Objective To study the relationship between syndrome of traditional Chinese medicine and related factors in acute cerebral infarction. Methods A total of 516 patients with acute cerebral infarction who met the inclusion criteria were selected from the general ward of the Department of Neurology, the Third People′s Hospital of Datong, Shanxi Province from May 2017 to October 2018. There were 274 cases of wind-phlegm entering collaterals syndrome, 148 cases of yin deficiency and wind-motion syndrome and 94 cases of wind-yang disturbance syndrome, to analyze the relationship between different syndrome of traditional Chinese medicine and related factors. Univariate Logistic regression analysis was performed for factors with P ＜ 0.05 which were analyzed by univariate analysis. Results Univariate analysis showed that age, body mass index (BMI), smoking and drinking history, history of hypertension, diastolic blood pressure, triglyceride (TG), serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were all associated with syndrome of traditional Chinese medicine classification (P ＜ 0.05). The disordered Logistic regression analysis showed that the history of hypertension (P = 0.031) and diastolic blood pressure (P ＜ 0.001) were related to wind-phlegm entering collaterals, and age (P ＜ 0.001) and diastolic blood pressure(P ＜ 0.001) were related to yin deficiency and wind-motion. Conclusion Among the patients with acute cerebral infarction, the onset age is younger and have a history of hypertension, and especially the diastolic blood pressure increased mainly for the wind-yang disturbance syndrome. The age of onset of older people for yin deficiency and wind-motion syndrome.
2019 Vol. 16 (35): 103-106 [Abstract] ( 201 ) HTML (1 KB)  PDF (414 KB)  ( 86 )
107 Meta-analysis on the effect of de-escalation of antibiotic treatment on ventilator-associated pneumonia
SUN Jingjing GUO Litao▲ MA Hongye ZHANG Lei LIU Yu WANG Xue
Objective To systematically evaluate the effect of de-escalation treatment of antibiotic strategy on the patient with ventilator-associated pneumonia (VAP), so as to optimize VAP anti-infective treatment programs and improve prognosis. Methods The relevant literatures published in China and abroad from January 1995 to December 2017 were retrieved from the databases including PubMed, Cochrane library, EMBASE, CBM, CNKI, and Wangfang database by computer. The key words were ventilator-associated pneumonia, antibacterial drugs, antibiotics, target treatment and de-escalation. The Meta-analysis was performed for the eligible literatures with the Review Manager 5.2 software. The effect of step-down treatment on VAP recurrence rate, mechanical ventilation duration, initial treatment reasonable rate, intensive care unit (ICU) hospitalization time and mortality were evaluated. Results A total of 6 articles were included in the study, with 1293 patients involved, including the de-escalation group with 831 cases and the control group with 462 cases. The relapse rate of VAP in de-escalation group was lower than that in control group (RR = 0.52, 95%CI: 0.34, 0.80), while the mechanical ventilation duration of de-escalation group was shorter than that in control group (RR = -7.30, 95%CI: -10.97, -3.64), and the differences were all highly statistically significant (all P ＜ 0.01). However, there were no significant differences in the initial treatment reasonable rate of VAP, ICU hospitalization time, and mortality between the two groups (P ＞ 0.05). Conclusion The de-escalation of antibiotic therapy can decrease the relapse rate of VAP and reduce the mechanical ventilation duration effectively.
2019 Vol. 16 (35): 107-111,115 [Abstract] ( 252 ) HTML (1 KB)  PDF (1419 KB)  ( 39 )
112 Clinical effect of midline lumbar fusion in the treatment of degenerative lumbar diseases
XU Yun ZHANG Xiaoping YAN Kang GUO Weidong BAO Xiaoming LIAO Bo
Objective To explore the clinical effect of midline lumbar fusion in the treatment of degenerative lumbar diseases. Methods The clinical data of twenty patients received midline lumbar fusion with degenerative lumbar diseases were selected from May 2016 to May 2018. Operation duration, blood loss and complications of patients were recorded. Oswestry disability index (ODI) and visual analogue scale (VAS) scores for low back pain and leg pain were evaluated the clinical efficacy. Bridwell classification was used to evaluated the fusion. Results All the patients were followed up for at least 12 months, with an average of (17.50±3.53) months. The mean operation time was (172.00±25.73) min and the mean blood loss was (213.50±48.70) mL. VAS scores for low back pain, VAS scores for leg pain and ODI at postoperative 12 months were lower than those at preoperative, and the differences were statistically significant (P = 0.000). According to Bridwell classification, Ⅰ-Ⅱ fusions were observed by radiography for all the patients. No complications such as screw loosening, rupture, cage displacement, and sedimentation occurred during follow-up. Conclusion Midline lumbar fusion is safe and reliable in the treatment of degenerative lumbar diseases with good clinical results.
2019 Vol. 16 (35): 112-115 [Abstract] ( 204 ) HTML (1 KB)  PDF (797 KB)  ( 103 )
116 Treating one case of diabetic peripheral neuropathy from “dampness”
JIA Xiaoying1 LI Yixiao1 LIU Qin1 WANG Liying1 GUO Yuxin1 ZHANG Taojing2
Diabetic peripheral neuropathy is a common chronic complication of diabetes mellitus. Previous physicians believed that the pathogenesis of diabetic peripheral neuropathy is qi stagnation and blood stasis. From the reality of clinic, we believe that modern people are fond of eating fat and sweet, easy to produce dampness evil, and “dampness” is an important pathogenesis of diabetic peripheral neuropathy. According to this pathogenesis, we treat one case of diabetic peripheral neuropathy caused by dampness obstruction by invigorating the spleen and dispelling dampness, diffusing dampness, clearing away heat and drying dampness. This therapy can effectively relieve the symptoms of numbness, pain and abnormal sensation of limbs, alleviate the pain of patients and improve their quality of life. The clinical effect is remarkable. This case suggests that dampness pathogenesis should not be neglected in clinical diagnosis and treatment of diabetic peripheral neuropathy, which is worthy of clinical reference.
2019 Vol. 16 (35): 116-118,130 [Abstract] ( 207 ) HTML (1 KB)  PDF (699 KB)  ( 34 )
119 Predictive value of peripheral blood NLR in patients with acute respiratory distress syndrome
MA Yanquan YU Hongzhi TIAN Lei GE Xu
Objective To study the prognostic value of the ratio of neutrophil count (NC) to lymphocyte count (LC) (NLR) in patients with acute respiratory distress syndrome (ARDS). Methods Clinical data of 80 patients with ARDS admitted to Liaohe Oilfield General Hospital from February 2015 to February 2019 was retrospectively analyzed. All patients were divided into survival group (36 cases) and death group (44 cases) according to clinical outcome after 28 days. The baseline data, oxygenation index (PaO2/FiO2), acute physiology and chronic health (APACHE Ⅱ) score and assessment of sequential organ failure (SOFA) score were counted and compared between two groups. White blood cell count (WBC), neutrophil count (NC), lymphocyte count (LC), NLR and procalcitonin (PCT) levels were compared between two groups, and multivariate Logistic regression analysis was performed for prognosis. The predictive value of NLR and PCT in the prognosis of ARDS patients was analyzed by receiver operating characteristic curve (ROC). Results PaO2/FiO2 level in survival group was higher than that in death group, while APACHE Ⅱ and SOFA scores in survival group were lower than those in death group (P < 0.05). There was no significant difference in WBC and NC between two groups (P > 0.05); LC level in survival group was higher than that in death group (P < 0.05); NLR and PCT levels in survival group were lower than those in death group (P < 0.05). Multiple Logistic regression analysis showed that NLR and PCT were independent risk factors of ARDS (P < 0.05). NLR was superior to PCT in predicting the prognosis of ARDS (P < 0.05). Conclusion The increase of NLR in peripheral blood is a risk factor for the prognosis of ARDS patients. The detection of NLR level is helpful to evaluate the prognosis of ARDS patients.
2019 Vol. 16 (35): 119-122,134 [Abstract] ( 243 ) HTML (1 KB)  PDF (775 KB)  ( 114 )
123 Relationship between serum CyPA, Lp-PLA2 levels and disease status in patients with acute cerebral infarction
KANG Yi1 MA Yu2 LU Liuxi2 ZHAN Qunling2
Objective To explore the levels and the clinical significant of serum cyclophilin A (CyPA), lipoprotein associated phospholipase A2 (Lp-PLA2) in patients with acute cerebral infarction. Methods A total of 117 patients with acute cerebral infarction admitted to Chongqing Jiulongpo District Hospital of Traditional Chinese Medicine (hereinafter referred to as “our hospital”) from January 2016 to June 2018 were enrolled as case group, who were divided into slight group (NIHSS ＜7 scores, n = 51), moderate group (NIHSS 7-15 scores, n = 37), severe group (NIHSS ＞15 scores, n = 29) according to national institute of health stroke scale (NIHSS score). At the same time, 60 healthy examinees in our hospital were selected as control group. The serum CyPA and Lp-PLA2 of each groups were determined by enzyme-linked immunosorbent assay, and serum Cystatin C (CysC), homocysteine (Hcy) and uric acid (UA) were determined by granule immunoturbidimetry. Results The levels of serum CyPA and Lp-PLA2 in case group were higher than those in control group, and the levels of serum CyPA, Lp-PLA2 gradually increased with the condition worsened (P ＜ 0.05). The levels of serum CysC, Hcy, UA in case group were higher than those in control group, and the levels of serum CysC, Hcy, UA gradually increased with the condition worsened (P ＜ 0.05). Pearson product moment correlation analysis showed that serum CyPA was positive associated with Lp-PLA2 (r = 0.761, P ＜ 0.05). CyPA was positively correlated with CysC, Hcy and UA (r = 0.679, 0.625, 0.702, all P ＜ 0.05), Lp-PLA2 was positively correlated with CysC, Hcy and UA (r = 0.738, 0.711, 0.692, all P ＜ 0.05). Conclusion Serum CyPA and Lp-PLA2 are closely related to the severity of acute cerebral infarction. Early detection of CyPA and Lp-PLA2 has clinical value in evaluating patients′ condition.
2019 Vol. 16 (35): 123-126 [Abstract] ( 155 ) HTML (1 KB)  PDF (731 KB)  ( 86 )
127 Clinical effect of endoscopic retrograde cholangiopancreatography combined with endoscopic sphincterotomy of papilla in treatment of biliary tract disease
ZHOU Lan WANG Jianxiang PENG Dongshu
Objective To investigate the clinical effects of endoscopic retrograde cholangiopa ncreatography (ERCP) combined with endoscopic sphincterotomy (EST) in the treatment of biliary tract disease. Methods The clinical data of 124 patients with biliary tract disease admitted to the Fifth People′s Hospital of Chengdu from January 2017 to December 2018 were retrospectively analyzed. According to different treatment plans, they were divided into control group and observation group, with 62 cases in each group. The control group was treated with conventional calculus removed of laparotomy, and the observation group was treated with ERCP combined with EST. The clinical efficacy, clinical indicators, index levels of inflammatory factor, and complications were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05). In the observation group, abdominal pain relief, intestinal ventilation, serum amylase return to normal, and hospitalization time were significantly shorter than the control group (P ＜ 0.05). Before treatment, there was no statistically significant difference between the two groups in tumor necrosis factor-α and cardiopulmonary resuscitation (P ＞ 0.05). After treatment, the levels of inflammatory factors were decreased in the two groups, and the observation group was lower than the control group (P ＜ 0.05), the incidence of total complications in the observation group was higher than that in the control group (P ＜ 0.05). Conclusion For patients with biliary system diseases required surgery, the ERCP+EST program for surgical treatment has the advantages of rapid recovery and small trauma, which is worthy of clinical application.
2019 Vol. 16 (35): 127-130 [Abstract] ( 184 ) HTML (1 KB)  PDF (681 KB)  ( 28 )
131 Effect of personalized hyperextension of neck posture on vertebral artery hemodynamics in patients undergoing thyroid surgery
ZHU Jiqing HUA Wei
Objective To explore the effect of personalized hyperextension of neck posture on vertebral artery hemodynamics in patients undergoing thyroid surgery. Methods From December 2016 to December 2018，112 cases with thyroid surgery admitted to Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medicine School were divided. According to the random number table method, the patients were divided into the control group and the observation group, with 56 cases in each group. The control group was given routine thyroid surgery posture, while the observation group was given personalized hyperextension of neck posture. The incidence of postural syndrome, changes of bilateral vertebral artery blood flow in different carotid hyperextension positions and clinical satisfaction were compared. Results One week after operation, the incidence of posture syndrome of the observation group was lower than that of the control group, and the changes of bilateral vertebral artery of blood flow of the observation group was lower than that of the control group, while the clinical satisfaction of the observation group was higher than that of the control group, and the differences were statistically significant (all P < 0.05). Conclusion Personalized hyperextension of neck posture can reduce the incidence of thyroid surgery position syndrome, improve changes of bilateral vertebral arteries blood flow, and improve satisfaction.
2019 Vol. 16 (35): 131-134 [Abstract] ( 224 ) HTML (1 KB)  PDF (719 KB)  ( 39 )
135 Impact of rapid response system combined with PiCCO monitoring on the effect of liquid resuscitation and prognosis of patients with infectious shock
LU Wenfeng
Objective To approach influence of rapid response system combined with PiCCO monitoring Oon the effect of liquid resuscitation and prognosis of patients with infectious shock. Methods A total of 210 cases infectious shock patients in People′s Hospital of Ya′an City from September 2017 to January 2019 were selected as observation object, they were divided into two groups by different admission time，100 patients from September 2017 to June 2018 were as the control group (regular management model), 110 patients from July 2018 to January 2019 were as the observation group (RRT combined with PICCO monitor). The mean arterial  pressure (MAP), blood lactic acid level, urine volume, vascular active drugs score and APACHE Ⅱscore of two groups before and after 3 d of treatment were detected, the mechanical ventilation time, check in ICU time, vasoactive drugs time, recovery success rate, pulmonary edema rate and death rate of two groups were observed. Results Before the treatment, there was no statistically significant difference in the MAP, blood lactate levels, urine, blood vessels, active drug score and APACHE Ⅱ score comparison of two groups, (P > 0.05). After 3 d of treatment，the MAP, urine volume increased in two groups, and the observation group was higher than control group，there were statistically significance differences (P ＜ 0.05). Blood lactic acid level, vasoactive agent score and APACHE Ⅱ score of two groups were decreased, and the observation group was lower than control group, the differences were statistically significance (P ＜ 0.05). The duration of mechanical ventilation, intensive care unit stay and use of vasoactive drugs in the observation group were shorter than those in the control group, the success rate of resuscitation in the observation group was higher than that in the control group, and the incidence and mortality of pulmonary edema were lower than those in the control group, there were statistically significance differences (P ＜ 0.05). Conclusion The application of infectious shock patients liquid resuscitation result and prognosis by RRT combined with PiCCO monitor，which could improve liquid resuscitation result，increase pulmonary edema rate，decrease death rate，it is worth to be used.
2019 Vol. 16 (35): 135-138 [Abstract] ( 151 ) HTML (1 KB)  PDF (683 KB)  ( 71 )
139 Clinical application of intravenous infusion of Lidocaine in painless gastroscopy
TANG Lili GU Erwei▲
Objective To evaluate the effects of intravenous infusion of Lidocaine on Propofol requirements, incidence of cardiopulmonary adverse events, recovery of post-gastroscopy. Methods From November 2018 to February 2019, a total of 180 consecutive patients undergoing painless gastroscopy in the First Affiliated Hospital of Anhui Medical University were enrolled in the study, while they were divided into Lidocaine group and control group according to the random number table method, with 90 cases in each group. Patients in Lidocaine group were slowly injected with 2% Lidocaine at 1.5 mg/kg, while the equal volume of 0.9% normal saline was given in control group 2 min before induction. Propofol induction, supplementation and total dose, cardiopulmonary adverse events and local anesthetic intoxication, recovery of post-gastroscopy were recorded. Results The requirements of Propofol induction and total dose of Lidocaine group were significantly lower than those of control group, and the incidence of hypotension was lower than that of control group, while the times of postoperative wake-up, response, and free movement of Lidocaine group were significantly shorter than those in control group, and the differences were statistically significant (P ＜ 0.05). There were no significant differences in body movement, respiratory depression, and residence time in the resuscitation area between the two groups (P ＞ 0.05). Local anesthetic intoxication was not observed. Conclusion Intravenous injection of Lidocaine in painless gastroscopy can reduce Propofol requirements, obtains stability hemodynamics during gastroscopy and accelerates post-gastroscopy recovery.
2019 Vol. 16 (35): 139-142 [Abstract] ( 195 ) HTML (1 KB)  PDF (338 KB)  ( 126 )
143 Systematic evaluation and Meta-analysis of the effect of inspiratory muscle training on respiratory function in patients with stable COPD
HUANG Houqiang1 QIU Lingxiao2 CHEN Peiyun1 GUO Shengmin1
Objective To systematically evaluate the effect of inspiratory muscle training on relieving dyspnea in patients with stable chronic obstructive pulmonary disease (COPD). Methods In this study, PubMed, Cochrane Library, CINAL, Joanna Briggs Institute Database, Embase, CBM, CNKI, Wanfang Database and VIP were systematically and comprehensively searched for randomized controlled studies on the effect of inspirating muscle training on stable COPD patients. The retrieval time was from the database construction to January 31, 2019. Two researchers independently evaluated the quality of the included literature and extracted data. RevMan 5.3 software was used for data analysis. Descriptive analysis was used to study the outcome indicators that were not suitable for Meta-analysis. Results A total of 8 articles were included, with 987 patients. The results of Meta-analysis showed that inspiratory muscle training could improve patients′ maximal respiratory pressure [MD = 8.03, 95%CI (4.23, 11.84), P ＜ 0.05], improve patients′ dyspnea and improve their quality of life, however, there was no significant difference in the Meta-analysis results of the 6 min walking test [MD = -1.82, 95%CI (-11.34, 7.69), P > 0.05]. Conclusion Existing evidence supports that inspiratory muscle training can improve inspiratory muscle strength in stable COPD patients, relieve the symptoms of respiratory distress, and improve the quality of life of patients.
2019 Vol. 16 (35): 143-148 [Abstract] ( 180 ) HTML (1 KB)  PDF (1074 KB)  ( 65 )
149 Effect of anesthesia nursing on patients undergoing orthopaedic general anesthesia operation
CHANG Hong1 LIU Xinmei2 JIA Heng1 LIU Yang3
Objective To evaluate the effect of anesthesia nursing on vital signs, restlessness and nursing satisfaction of patients undergoing orthopedic general anesthesia. Methods A total of 126 patients who underwent general anaesthesia orthopedic surgery in Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from May 2017 to May 2018 were selected, according to the random number table method, the patients were divided into observation group and control group, with 63 cases in each group. The control group was given routine nursing care, and the observation group was given anesthesia nursing on the basis of the control group. The changes of heart rate and blood pressure after operation, the occurrence of postoperative agitation and nursing satisfaction evaluation of the two groups were evaluated. Results There was no significant difference in the incidence of postoperative abnormal heart rate and the mean heart rate between the two groups (all P ＞ 0.05). After nursing, the incidence of abnormal heart rate in the observation group was lower than that in the control group (P ＜ 0.05), the mean heart rate was lower than the control group, and the mean heart rate difference was higher than the control group (P ＜ 0.05). There was no statistically significant differences in the incidence of postoperative abnormal blood pressure and the mean systolic and diastolic blood pressure between the two groups (all P ＞ 0.05), there was no significant difference in mean systolic blood pressure and diastolic blood pressure after nursing (P ＞ 0.05), the incidence of abnormal blood pressure was lower than the control group (P ＜ 0.05). The incidence of restlessness in the observation group was lower than that in the control group (P ＜ 0.05). Overall nursing satisfaction was higher than that of the control group (P ＜ 0.05). Conclusion
2019 Vol. 16 (35): 149-152 [Abstract] ( 164 ) HTML (1 KB)  PDF (557 KB)  ( 43 )
153 Influence of Swanson′s theory of care on the milk secretion of mothers separated from their mothers
FENG Ling CHEN Ya▲
Objective To analyze the influence of Swanson′s care theory on the milk secretion of maternal and child separation. Methods From January 2017 to December 2018, 327 cases of Department of Obstetrics in Chongqing Maternal and Child Health Care Hospital were separated. Swanson group (163 cases) and control group (164 cases) were divided according to the random number table method. The control group received routine nursing, and Swanson group reeeived nursing based on Swanson′s care theory. The general information, milk secretion and milk volume within 72 h postpartum were compared between the two groups. According to the maternal milk secretion within 72 h, the patients were divided into two groups, ≥50 mL and ＜ 50 mL, the factors influencing milk secretion were compared and Logistic analysis was conducted. Results There was no significant difference in general information between the two groups (all P ＞ 0.05). The milk starts in time, postpartum 3 d breast swelling pain number, status-trait anxiety questionnaire (STAI), Edinburgh postnatal depression scale (EPDS) score of Swanson group were significantly lower than the control group, the lactation volume at 24 h, >24-48 h and >48-72 h postpartum and the breastfeeding rate at 42 d postpartum were significantly higher than the control group (all P ＜ 0.05). The mode of delivery, sleep time 24 h postpartum, nipple stimulation 2 h postpartum, frequency of milking within 24 h, frequency of milking at night, time of milking each time and EPDS score all had significant effects on milk secretion (all P < 0.05). Logistic regression analysis showed that Swanson care theory was an independent protective factor for maternal milk secretion (OR = 0.454, 95%CI: 0.221-0.932, P = 0.031). Conclusion Swanson′s care theory can effectively increase the milk secretion of maternal and child separation, improve the rate of postpartum breastfeeding, and effectively improve maternal anxiety and tension.
2019 Vol. 16 (35): 153-157 [Abstract] ( 187 ) HTML (1 KB)  PDF (584 KB)  ( 30 )
157 Qualitative analysis and countermeasures of depression causes in patients with acute cerebral apoplexy
YIN Zhike CAI Jihong▲ DENG Yongmei
Objective To explore the causes of depression in patients with acute cerebral apoplexy, and to provide evidence for formulating effective nursing measures. Methods Qualitative research methods were used. In-depth interviews were conducted recorded and recorded live on 16 patients with acute stroke with SDS score ≥50 who were hospitalized in Beijing Tiantan Hospital from January to April 2018. With the assistance of Nvivo 8.0 qualitative analysis software, the Claizzi analysis method was used to analyze the data. Results The main causes of depression in patients with acute stroke can be summarized into six themes, life limitation, loss of self, family responsibility conflict, lack of social support, lack of disease awareness, misattribution. Conclusion Nurses should identify the causes of depression in stroke patients as early as possible, provide targeted nursing intervention measures, eliminate the negative emotions of patients, improve the treatment effect and quality of life.
2019 Vol. 16 (35): 157-159,162 [Abstract] ( 171 ) HTML (1 KB)  PDF (999 KB)  ( 106 )
160 Discussion on clinical probation teaching methods of clinical occupational medicine
ZHAO Zanmei
The content of clinical occupational medicine is multifarious, and there have limited time for clinical probation. To finish the heavy task and improve teaching efficiency, teachers should combine different teaching methods, such as lecture based leaming, field-study teaching, participatory teaching method and case based study, according to the teaching content. First, the students will hear something from their teachers and the patients, such as theory and symptoms of the disease. And then, they will see the signs of the patients or observed how to perform lung function and pure tone audiometric and other commonly used to check. The most important thing they will do is experience inspection process by themselves. The last thing they will do is to study how to deal with the patients according medical record or analysis the test result.
2019 Vol. 16 (35): 160-162 [Abstract] ( 137 ) HTML (1 KB)  PDF (642 KB)  ( 106 )
163 Professor Yang Wei′s experience in the treatment of functional anorectal pain
ZHONG Shenglan1 LU Hong2 QU Yin2 YANG Wei2
Functional anorectal pain is a group of non organic idiopathic pain that occurs in the anus and / or rectum. It is more and more common in clinic. Its etiology, disease location are not clear, physical signs are not obvious, and treatment is difficult. Through long-term clinical practice, under the guidance of the holistic view of traditional Chinese medicine, professor Yang Wei formulates the anal pain prescription with the pathogenesis of “impassability leads to pain” and “non prosperity leads to pain”, with the treatment of invigorating qi, activating blood circulation and promoting qi to relieve pain as the treatment principle, and with the treatment of smoothing the liver, nourishing the heart, regulating Chong Ren, adding and subtracting drugs, giving full play to the characteristics of traditional Chinese medicine, obtaining clinical curative effect. This paper expounds the above experience and raises three cases.
2019 Vol. 16 (35): 163-166 [Abstract] ( 200 ) HTML (1 KB)  PDF (665 KB)  ( 140 )
167 Anomie problems and improvement countermeasures in medical dispute management of medical institutions in China
ZHANG Shaoguo LIU Chang ZHAO Yue
The factors that caused medical disputes such as the failure to inform patients promptly and timely and the absence of medical service quality assurance system can be controlled by medical institutions. The existence of these problems has a great relationship with the absence of medical institutions in the management of medical disputes. Many medical institutions in China have improper management behaviors in the prevention stage before the occurrence of medical disputes, the coping stage after the occurrence of medical disputes and the summary stage after the end of medical disputes. Learning from the experience abroad in management of medical activities, a medical dispute management system that based on quality management, centered on crisis management and backed by liability insurance should be set up in future. At the same time, the medical institutions should fulfill the responsibilities and obligations of medical personnel, and establish the assessment mechanism in preventing and dealing of medical disputes for medical staff.
2019 Vol. 16 (35): 167-170,174 [Abstract] ( 124 ) HTML (1 KB)  PDF (719 KB)  ( 112 )
171 Research of the countermeasures of compound talents cultivation of traditional Chinese medicine based on the combination of medical care and nursing
BAI Yu1 LI Hewei2 ZHOU Donglei3 YANG Yuhe1 CHE Zhiyuan4
Combination of medical care and nursing is a new medical model which has been developed gradually in recent years, which combines medical treatment and nursing organically to effectively alleviate the problem of aging growth in China today. Traditional Chinese medicine has unique advantages in the field of the combination of medical care and nursing, and the development of the combination of medical care and nursing has brought unprecedented new opportunities to traditional Chinese medicine students, so it is of great significance to train Chinese medicine compound talents who serve the combination of medical care and nursing combined with medical model. This paper expounds the problems of the existing professional characteristics of personnel training in traditional Chinese medicine colleges and universities under the mode of medical nursing, such as the lack of distinctive specialties, the insufficient number of students, the vague training objectives, the inadequate connection of specialties, the weak service concept and the lack of humanistic accomplishment, and puts forward the subject of strengthening the investment of education teachers strengthen the clinical practice of medical combination, enhance the service consciousness of traditional Chinese medicine students, and cultivate the cultivation countermeasures of traditional Chinese medicine students′ humanistic quality.
2019 Vol. 16 (35): 171-174 [Abstract] ( 177 ) HTML (1 KB)  PDF (655 KB)  ( 118 )
175 Influence and function of tax policy in medical reform
TONG Ling1 ZHU Xiaojun2 XIA Tieliang3 DU Jianbo4 LI Yijing5 GU Zhanying3 LIU Shan2
With the gradual implementation of the new medical reform policy, the national investment increased year by year, but the common people have no sense of gain, “it is difficult to see a doctor, expensive to see a doctor” has not been effectively alleviated, the health expenses paid by ordinary people continue to increase, and there are still some problems restricting the development of the medical service industry. This paper mainly analyzes the existing problems in the medical service industry from the five aspects of public hospitals, pharmaceutical manufacturing industry, pharmaceutical wholesale industry, pharmacyeutical retail industry and people′s personal health expenditure, and discusses the negative impact of tax policy as economic leverage on the medical service industry. In order to alleviate the negative impact of tax leverage on the medical service industry, a uniform standard commodity coding system should be established to eliminate the inflated price, so as to provide the basis for the formulation of industry cost standards and the basis for the formulation of industry internal control system.
2019 Vol. 16 (35): 175-177 [Abstract] ( 149 ) HTML (1 KB)  PDF (700 KB)  ( 143 )
178 Longitudinal comparison of effect of clinical trial teaching among 2016-2019 postgraduates in the PLA Medical School
SAI Xiaoyong SONG Yujian SUN Yuanyuan
Objective To evaluate the effect of clinical trial teaching on 2016-2019 postgraduates in Chinese People′s Liberation Army General Hospital (“our college” for short), and to provide reference for improving clinical trial teaching effectiveness. Methods A total of 1748 postgraduates from 2016 to 2019 were selected in our college by cluster sampling. A unified questionnaire with 10 true-or-false questions was used for face-to-face investigation both before and after the training and the accuracy rates before and after the training were compared. Results The total scores of all postgraduates after training were significantly higher than those before training, while the accuracy rate of each question was improved (P ＜ 0.05), and the degree of improvement varied depending on the question. Furthermore, the improved scores for the postgraduates in 2016-2019 before and after training were (2.49±0.10), (2.77±0.11), (2.04±0.08) points and (3.69±0.10) points, respectively, and the differences were statistically significant (P ＜ 0.05). Conclusion Clinical trials of our college have been effective in teaching for 4 consecutive years and have been improving year by year. The theoretical basis of postgraduates affects the effectiveness of teaching.
2019 Vol. 16 (35): 178-封三 [Abstract] ( 195 ) HTML (1 KB)  PDF (886 KB)  ( 55 )
Copyright © Editorial Board of 中国医药导报
Supported by:Beijing Magtech