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2020 Vol. 17, No. 14 Published: 2020-05-15

	4	The role of miRNA-132 in multiple myeloma cell adhesion mediated drug resistance by targeting PDCD4
		ZHOU Jia′ni1 MA Yongyong2
		Objective To explore the targeting effect of miR-132 on programmed death 4 gene (PDCD4) and its role in the adhesion mediated drug resistance of multiple myeloma cells. Methods Luciferase reporter gene was used to analyze the targeting regulation of miR-132 on PDCD4. Human myeloma cell line U266 was transfected with miR mimic and inhibitor, and then the drug sensitivity of U266 cells treated with Dexamethasone (Dex), Doxorubicin (Dox) and Bortezomib (Bort) was compared. Transwell method was used to detect the migration ability of U266 cells. MTT and CCK-8 methods were used to detect cell proliferation. Results After Dex and Dox intervention, the inhibition rate of cells increased significantly (P < 0.05), while the inhibition rate of Bort did not change significantly (P > 0.05). Luciferase reporter gene analysis confirmed that PDCD4 was the target gene of miR-132. Up regulation of miR-132 could inhibit the expression of PDCD4 gene and protein (P < 0.05). The migration distance of U266 cells increased (P < 0.05). After miR-132 was up-regulated, the adhesion rate and proliferation activity of U266 cells increased (P < 0.05). Conclusion miR-132 can target PDCD4 to regulate multiple myeloma cell adhesion mediated drug resistance.
		2020 Vol. 17 (14): 4-7,13 [Abstract] ( 161 ) HTML (1 KB) PDF (1019 KB) ( 76 )

	8	Study on the inhibitory effect of Alcohol extract of Inonotus Obliquus on the development and progression of gastric cancer and its molecular mechanism
		WANG Wei1 ZHOU Zhongguang2▲ YANG Jing1 LIU Xu3 TIAN Ming3 QIAO Yu4 ZHONG Lili5
		Objective To investigate the inhibitory effect of Alcohol extract of Inonotus Obliquus (Alcohol extract of IO) on transplanted tumor of gastric cancer BGC-823 in nude mice, and speculate the relationship between the mechanism and PI3K/AKT pathway. Methods Forty-eight nude mice were used to establish gastric cancer models by heterotopic transplantation. After modeling, they were randomly divided into Alcohol extract of IO high-dose group (3 mg/g), middle-dose group (1 mg/g) and low-dose group (0.75 mg/g), negative control group (hydroxymethyl cellulose sodium lavage), model group (no drug), positive control group (Capecitabine lavage, 0.5 mg/g). according to the random number table method, with 8 mice in each group. Mice were sacrificed after 14 days of intragastric administration, tumor tissues were stripped and tumor inhibition rate was calculated by weighing. The morphological changes of tumor tissues after drug intervention were observed under light microscope and electron microscope. The expressions of 4E-BP1, p27kip1, Bcl-2, Bax and caspase-3 were detected by immunohistochemistry. The expressions of Phosphatase gene (PTEN), phosphatidylinositol-3-hydroxykinase (PI3K), protein kinase (AKT), and target of rapamycin (mTOR) were detected by reverse transcription-polymerase chain reaction (RT-PCR). The protein expressions of PI3K and p-AKT were detected by Western blot. Results Compared with the negative control group and model group, the weight of tumor were reduced in Alcohol extract of IO group (P < 0.05), the growth in each Alcohol extract of IO groups was inhibited (P < 0.05). In the each Alcohol extract of IO groups, tumor necrosis, apoptosis and organelle destruction were more obvious (P < 0.05). Compared with the negative control group and model group, the average optical density of Bcl-2 in each Alcohol extract of IO groups was decreased, the average optical density of 4E-Bp1, p27kip1, Bax and caspase-3 was increased (P < 0.05). RT-PCR detect results showed that, the expression of PTEN in each Alcohol extract of IO groups was higher than that in the negative control group and model group, and was lower than that in the positive control group (P < 0.05); the expressions of mTOR, PI3K and AKT in the each Alcohol extract of IO groups were higher than those in the positive control group, and were lower than those in the negative control group and model group (P < 0.05). Western blot detect results showed that, the expressions of PI3K and p-AKT protein in each Alcohol extract of IO groups were lower than those in negative control group and model group, and were higher those that in the positive control group (P < 0.05). Conclusion Alcohol extract of IO has obvious inhibitory effect on gastric cancer, and its mechanism may be related to PI3K/AKT pathway and its upstream and downstream factors.
		2020 Vol. 17 (14): 8-13 [Abstract] ( 157 ) HTML (1 KB) PDF (1104 KB) ( 65 )

	14	Study on the role of CDCA3 in the proliferation of hepatocellular carcinoma
		LIU Fang XU Ximing
		Objective To investigate the biological behavior of cell division cycle associated protein 3 (CDCA3) in liver cancer. Methods Tissue specimens of hepatocellular carcinoma patients who underwent surgical treatment in the Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University from January 2018 to June 2019 were collected. There were 30 liver cancer specimens and paracancer specimens. Real-time PCR was used to detect the expression of CDCA3 in different tissues. CDCA3 interfering RNA sequences and control sequences were transfected into hepatocellular carcinoma cell lines by lip3000 transfection. Cell proliferation was detected by CCK-8 and EdU immunofluorescence staining, and cell cycle was detected by elapse cytology. Results The expression level of CDCA3 in liver cancer tissues was significantly higher than that in paracancer tissues, and the difference was highly statistically significant (P ＜ 0.01). The expression levels of CDCA3 in HepG2, Huh7 and SMMC-7721 cells were significantly higher than those in LO2 cells, with statistically significant differences (P ＜ 0.05 or P ＜ 0.01), while the expression level of CDCA3 in BEL-7402 cells was not statistically significant compared with that in LO2 cells (P ＞ 0.05). The expression of CDCA3 in SMMC-7721 cells down-regulated by SiCDCA3#1 and siCDCA3#2 was statistically significant compared with that in the control group (siNC) (P ＜ 0.05). Therefore, SMMC-7721 cells were selected to complete the follow-up study. After the expression levels of CDCA3 in SMMC-7721 cells were down-regulated by siCDCA3#1 and siCDCA3#2, the number of cell proliferation at 24 h and 48 h was significantly lower than that in the siNC, and the differences were statistically significant (all P ＜ 0.05). And the number of positive cells detected at EdU was significantly lower than that in the siNC. Compared with the siNC, the G1 phase time of SMMC-7721 cell cycle was prolonged after the expression of CDCA3 in SMMC-7721 cell was down-regulated by siCDCA3#2, and the difference was statistically significant (P ＜ 0.05). Conclusion CDCA3 can promote the proliferation of liver cancer cells and is a potential therapeutic target.
		2020 Vol. 17 (14): 14-18,30 [Abstract] ( 147 ) HTML (1 KB) PDF (908 KB) ( 23 )

	19	Effect of Berberine on the expression of miRNA-29b in left ventricular hypertrophy and the mechanism of inhibition of myocardial fibrosis
		ZHENG Ying LI Xiaohua LI Qiang ZHANG Yixue CHEN Moshui
		Objective To investigate the effect of Berberine on expression of miRNA-29b in hypertensive left ventricular hypertrophy myocardial tissue and the mechanism of inhibition for myocardial fibrosis. Methods Male SD rats (n = 25) were randomly divided into sham operation group (sham group, n = 7), model group (model group, n = 9) and model administration group (model+BBR group, n = 9). Rat model of hypertensive cardiac hypertrophy was established by abdominal aortic coarctation. The cardiac structure and function were measured by echocardiography. The cardiac hypertrophy index was measured at 8 weeks postoperatively. The changes of myocardial fibrosis were detected by Masson staining. The expression of miRNA-29b and its target genes col1α1 and col3α1 mRNA in myocardial tissue were detected by RT-PCR. Results IVSd and LVPWd in model group were thicker than those in sham group, and FS and EF were lower than those in Sham group (P < 0.05). IVSd and LVPWd of model+BBR group were thinner than those of model group, and FS and EF were higher than those of model group (P < 0.05). Heart weight of model group was significantly heavier than that of sham group, and heart/body weight ratio was significantly higher than that of sham group (P < 0.01). Heart weight of model+BBR group was lighter than that of model group, and the heart/body weight ratio was lower than that of model group (P < 0.05). The volume fraction of myocardial collagen in model group was significantly higher than that in sham group (P < 0.01). The volume fraction of myocardial collagen in model+BBR group was lower than that in model group (P < 0.05). The level of col1α1 mRNA and col3α1 mRNA in model group was higher than those in sham group, and the level of miRNA-29b was lower than that in sham group (P < 0.05 or P < 0.01). The level of col1α1 mRNA and col3α1 mRNA in model+BBR group was lower than those in model group, and the level of miRNA-29b was higher than that in model group (P < 0.05). Conclusion Berberine inhibits myocardial hypertrophy and myocardial fibrosis by down-regulating miRNA-29b levels and up-regulating its target gene expression.
		2020 Vol. 17 (14): 19-22 [Abstract] ( 144 ) HTML (1 KB) PDF (750 KB) ( 228 )

	23	Predictive value of the ratio of cerebral infarction on cerebral hernia formation in patients with large area cerebral infarction
		DU Xiaoyan1，2 LIU Qingjun1，2 ZHAO Libo1，2，3 GONG Hongmin1，2 WU Lin1，2 WEI Jing1，2 TAN Qing1，2 ZHAO Rui1，2
		Objective To assess predictive value of the ratio of cerebral infarction on cerebral hernia formation in patients with large area cerebral infarction. Methods The clinical data of 71 patients with massive cerebral infarction hospitalized in Yongchuan Hospital Affiliated to Chongqing Medical University from January 2017 to January 2019 were retrospectively analyzed. They were divided into brain hernia group (17 cases) and non brain hernia group (54 cases) according to the formation of brain hernia. Single factor and binary logistic regression analysis were carried out for clinical data and imaging data. ROC curve was used to evaluate the diagnosis effect and find the best predictive value. Results Clinical data between two groups was not statistically significant (P > 0.05). The volume of cerebral infarction, the proportion of cerebral infarction and the buffer volume of cerebral hernia group were larger than those of non cerebral hernia group, the differences were statistically significant (P < 0.05). There were no significant differences in volume of brain tissue and cranial cavity between two groups (P > 0.05). The proportion of cerebral infarction was an independent risk factor for the formation of cerebral hernia in patients with massive cerebral infarction (OR = 7.749, 95%CI: 1.539-38.284, P ＜ 0.05). The proportion of cerebral infarction and the area under the volume curve of cerebral infarction was 0.818 and 0.808 respectively. When the proportion of cerebral infarction was 21%, it was the best turning point, the sensitivity was 77%, and the specificity was 76%. Conclusion The cerebral infarction proportion is an independent risk factor for the formation of cerebral hernia in patients with massive cerebral infarction, which provides a certain predictive value for judging the formation of cerebral hernia.
		2020 Vol. 17 (14): 23-26 [Abstract] ( 133 ) HTML (1 KB) PDF (718 KB) ( 185 )

	27	Application of PBL-CBL teaching model based on massive open online course in clinical teaching of breast surgery
		CAO Weigang YANG Zhenlin
		Objective To explore the application effect of problem-based learning (PBL)-case-based learning (CBL) teaching model in clinical teaching of breast surgery. Methods Sixty-six clinical interns in breast surgery from January 2018 to June 2019 in Yantai Affiliated Hospital of Binzhou Medical College were selected. According to the randomized double-blind method, they were divided into experimental group and control group, with 33 in each group. Experimental group was used the PBL-CBL teaching method, and control group was used traditional teaching methods. After the end of the internship, two groups were tested on theory and skill operation. The scores of professional knowledge, medical history collection, breast examination, image reading, differential diagnosis, diagnosis and treatment plan, body position and surgical site selection, disinfection and local anesthesia and clinical skills operation were compared between the two groups. Results The scores of breast examination, differential diagnosis, image reading, diagnosis and treatment plan and total scores of experimental group were higher than those of control group, and the differences were statistically significant (all P < 0.05). There were no statistical differences in professional knowledge, medical history collection, preoperative preparation scores between two groups (P > 0.05). The scores of learning interest, clinical ability, clinical thinking, learning ability and recognition of teaching model of experimental group were higher than those of control group, with statistically significant differences (all P < 0.05). Conclusion The effectiveness of the PBL-CBL teaching model based on massive open online courses in clinical teaching of breast surgery is better than traditional teaching methods, which is worthy promotion.
		2020 Vol. 17 (14): 27-30 [Abstract] ( 422 ) HTML (1 KB) PDF (651 KB) ( 140 )

	31	Research progress of circulating miRNA as a noninvasive marker for diagnosis and prognosis of lung cancer
		DU Xinyue1,2 YANG Huiling1,2
		Lung cancer is one of the malignant tumor with the highest incidence rate and mortality rate in the world, which seriously affects human health. Despite advances in technology for lung cancer diagnosis and targeted therapy,due to the lack of accurate and effective early detection methods, the current diagnosis and prognosis of lung cancer is still not ideal, with a low survival rate. Lung cancer is regulated by a variety of mechanisms, among which microRNAs (miRNAs) participate in gene expression regulation after transcription and accompany the whole process of tumor development. Recent studies have found that abnormal expression of circulating miRNA detected in serum and plasma biological fluids is closely related to early diagnosis and prognosis of lung cancer. In this paper, the pathway, stability and potential biomarker of early diagnosis and prognosis of lung cancer are reviewed and discussed.
		2020 Vol. 17 (14): 31-34 [Abstract] ( 165 ) HTML (1 KB) PDF (482 KB) ( 56 )

	35	Research progress of obesity cardiomyopathy
		ZHAO Gaowa1,2 YU Qin1,2
		Obesity is a chronic metabolic disease caused by a variety of factors. It is now considered as an independent risk factor for cardiovascular disease. Long term severe obesity can lead to changes in the structure and function of the heart, and eventually result to heart failure. Obesity cardiomyopathy is a metabolic disease caused by obesity. At present, with the improvement of living standards, the number of obese people is increasing, and the incidence of obesity cardiomyopathy is increasing gradually. Therefore, correct understanding of obesity cardiomyopathy and early prevention, diagnosis and treatment can significantly reduce the prevalence of obesity cardiomyopathy. This article reviews the diagnosis, pathogenesis and treatment of obesity cardiomyopathy.
		2020 Vol. 17 (14): 35-38 [Abstract] ( 143 ) HTML (1 KB) PDF (481 KB) ( 87 )

	39	Research progress on family quality of life of elderly patients with chronic diseases
		YAN Xingyu LIU Yanli▲ LU Xia WANG Shasha GUO Wei
		With the aggravation of the aging population, the incidence of chronic diseases among the elderly is also increasing year by year, which has become one of the important factors disturbing the family quality of life of the elderly. In the era of rising living standards, in order to further improve the family quality of life of the elderly patients with chronic diseases, improve happiness index, this paper mainly summarizes and evaluates the domestic and foreign researches on the family quality of life and influencing factors of chronic disease patients in recent years, and believes that the family quality of life of Alzheimer′s disease patients is also an urgent problem to be solved, and there is a great room for improvement. It provides an effective basis for nursing intervention and nursing research direction to improve the family quality of life of chronic disease patients in the future.
		2020 Vol. 17 (14): 39-42,51 [Abstract] ( 277 ) HTML (1 KB) PDF (782 KB) ( 55 )

	43	The influence and countermeasure of the reform of medical insurance payment method in a third-class hospital in Xinjiang
		CAILIKE·Baitiguli1 JIANG Xiaoming2 HU Shujiang3 ZHANG Fan4
		Objective To analyze the impact of the reform of medical insurance payment methods on a third-class hospital in Urumqi, and to propose countermeasures based on the results. Methods The medical insurance related data of a third-class hospital in Urumqi from 2014 to 2018 were collected. While combined the interview method, the results were analyzed. Results Xinjiang implements a compound payment method that was dominated by the total amount of control and the average amount of control. However, the implementation of payment by disease was slow. The number of hospital visits in the hospital from 2014 to 2018 were increased year by year. Compared the medical insurance patients' annual hospitalization and outpatient expenses, the differences were highly statistically significant (P ＜ 0.01). The average cost of medical service visits of urban employees of the hospital was higher than that of urban/urban and rural residents. In addition, from 2014 to 2018, Xinjiang′s basic medical insurance overall payment ratio was increased slightly, but there was still a large gap between different types of medical insurance. Conclusion In recent years, the hospital′s number of doctors has increased year by year, and the second-time average medical cost control work has been completed well. However, payment by project is still the main charging method, and the implementation of payment by disease is slow. The lack of specific measures and effective monitoring methods in the current reform of the medical insurance payment method in Xinjiang may result in the hospital's enthusiasm in the implementation process. The hospital should start from its own, and actively explore practical implementation methods for payment by disease, such as adjusting clinical pathways, reducing medical costs, doing a good job in fee control, improving the degree of medical insurance information, and truly implementing the reform policy.
		2020 Vol. 17 (14): 43-46,56 [Abstract] ( 132 ) HTML (1 KB) PDF (510 KB) ( 90 )

	47	The status quo of Chinese medicine service capacity in a district of Beijing
		ZHANG Yichunzi1 FENG Chuanyou2 WHANG Xu1 ZHANG Jinpeng3 ZHANG Lei2 ZHAO Mingyang1 GAO Yue1 KONG Junhui1
		Objective To research and evaluate the current status of Chinese medicine service capacity in a district of Beijing, and to provide a reference for improving the service capacity of Chinese medicine. Methods According to the characteristics of Chinese medicine hospitals and community health service centers, through the literature policy research and expert consultation, the evaluation system of Chinese medicine service capacity was built, respectively. From 2017 to 2018, a questionnaire survey was conducted on 33 Chinese medicine hospitals and 44 community health service centers in the district to analyze the main characteristics of the data and differences in indicators. Results The evaluation system of Chinese medicine service capacity included 4 first-level indicators, with 40 Chinese medicine hospitals and 25 community health service centers. In 2018, the number of hospital Chinese medicine medical technology development projects was more than in 2017, the proportion of Chinese patent medicine prescriptions was lower than that in 2017, while the hospital medical, outpatient, inpatient, total income were higher than those in 2017, and the differences were statistically significant (P ＜ 0.05 or P ＜ 0.01). The total number of clinicians, the number of clinicians and the total number of outpatient drug prescriptions in 2018 were higher than those in 2017, while the proportion of prescriptions for proprietary Chinese medicines in the community in 2018 was lower than that in 2017, and the differences were statistically significant (P ＜ 0.05 or P ＜ 0.01). Conclusion The coverage of Chinese medicine services in this area is relatively high, the outflow of hospital outpatients is obvious, while the income is optimistic. There are problems such as the unreasonable use of medical resources.
		2020 Vol. 17 (14): 47-51 [Abstract] ( 217 ) HTML (1 KB) PDF (501 KB) ( 89 )

	52	The influencing factors of professional collaboration of health workers at county and township levels in Tianchang City of Anhui Province
		LI Yuanhong1,2 DAI Tao2▲ ZHENG Ying2 ZHU Xiaoli2
		Objective To understand the influencing factors of professional collaboration between county and township health workers, while to put forward suggestions for improving the professional division and cooperation mechanism in other regions. Methods From July 22 to 25, 2019, a total of 479 medical personnel of different levels of medical institutions in the county medical community in Tianchang, Anhui Province were conducted a questionnaire survey by stratified random sampling method, while the factors affecting collaboration of medical staff at the county and township levels were analyzed by exploratory factor analysis. Results The survey issued 520 questionnaires and actually recovered 479 valid questionnaires, with an actual effective recovery rate of 92.1%. In this study, a total of 4 public factors were extracted as the influencing factors of professional collaboration between medical personnel at the county and township levels. The factors of professional division of labor and collaboration mechanism were the core elements to improve the level of professional collaboration, and the professional cooperation value recognition factor was the intrinsic motivation to improve the level of professional collaboration, incentive and restraint mechanism factors were external motivations to promote professional collaboration, while norms and standard factors for cross-professional services were the basis for professional collaboration. Conclusion Improving the professional division of labor and collaboration mechanism, enhancing the cognition level of medical staff on the value of collaboration, formulating reasonable incentive and restraint mechanisms, and building cross-professional service norms and standards are effective measures to further improve the level of professional collaboration among medical staff at the county and township levels.
		2020 Vol. 17 (14): 52-56 [Abstract] ( 109 ) HTML (1 KB) PDF (522 KB) ( 53 )

	57	Analysis of risk factors of metabolic syndrome and ASCVD in hospitalized patients with cardiovascular disease
		CAI Qiong HAN Huiwu PENG Shanshan CHEN Nengfeng XIAO Ying SHEN Lu
		Objective To analyze the correlation between the metabolic syndrome (MS) in hospitalized patients with cardiovascular disease and prediction for atherosclerotic cardiovascular disease (ASCVD) risk in China (China-PAR) score and the clinical data, and to explore the risk factors of ASCVD. Methods From April 2018 to March 2019, 327 patients with cardiovascular diseases who met the inclusion criteria in Xiangya Hospital Central South University were collected for medical history collection and physical examination. Patients were divided into MS group (201 cases) and non-MS group (126 cases) using the International Diabetes Federation diagnostic criteria. ASCVD risk assessment was carried out with the China-PAR model, and the patients were divided into the low-medium-risk group (188 cases) and the high-risk group (139 cases) for comparative analysis based on the score of China-PAR. Logistic regression was used for statistical analysis. Results In this study, the MS incidence rate of the patients was 61.47% (201/327). There were statistically significant differences between the MS group and the non-MS group in gender, abdominal circumference, body mass index, triglyceride, high-density lipoprotein, fasting blood glucose, systolic pressure, glycosylated hemoglobin, hypertension and diabetes history (all P ＜ 0.05). The total score of China-PAR was (9.97±6.00) scores. There were statistically significant differences in age, fasting blood glucose, glycosylated hemoglobin, systolic pressure, hypertension and diabetes history between the low-medium-risk group and the high-risk group (all P ＜ 0.05). Logistic regression analysis showed that MS (OR = 1.665, 95%CI: 1.001 to 2.770, P = 0.050), age ≥65 years (OR = 5.569, 95%CI: 3.324 to 9.330, P = 0.000) and history of alcoholism (OR = 2.348, 95%CI: 1.130 to 4.877, P = 0.022) were ASCVD risk factors. Conclusion The incidence of MS in hospitalized patients with cardiovascular disease is significantly higher than that of the general population. Inpatients with MS, old age, and alcohol abuse are risk factors of ASCVD.
		2020 Vol. 17 (14): 57-60 [Abstract] ( 162 ) HTML (1 KB) PDF (479 KB) ( 48 )

	61	Relationship between serum uric acid level and atherosclerotic plaque in thin-cap fibroatheroma in patients with coronary heart disease
		LI Yachao YANG Yanli AN Lei ZHANG Chunyan XUE Zengming
		Objective To investigate the relationship between serum uric acid (UA) levels and atherosclerotic plaque in thin-cap fibroatheroma (TCF) in patients with coronary heart disease. Methods A total of 110 patients with coronary heart disease admitted to Langfang People′s Hospital Affiliated to Hebei Medical University from March 2016 to March 2019 were selected as the research object. Based on the results of optical correlation tomography (OCT), they were divided into TCF group (35 cases) and non-TCF group (75 cases). Baseline data of patients were collected and biochemical indicators were detected. The relationship between UA and TCF was analyzed by logistic multivariate regression. Results The rate of the family history of coronary heart disease, body mass index, low density lipoprotein and UA levels in the TCF group were significantly higher than those in the non-TCF group, with statistically significant differences (all P ＜ 0.05). There was no significant difference between the two groups in age, sex, ratio of smoking history, ratio of drinking history, ratio of hypertension, ratio of diabetes, treatment, high density lipoprotein, triacylglycerol, total cholesterol, cardiac troponin, creatine kinase isoenzyme MB, hypersensitive C-reactive protein, B-type natriuretic peptide and creatinine (P ＞ 0.05). OCT test results showed that the thickness of fiber cap in the TCF group was significantly lower than that in the non-TCF group, while the ratio of lipid radians, plaque rupture and thrombus was significantly higher than that in the non-TCF group, with statistically significant differences (all P ＜ 0.05). However, there were no statistically significant differences between the two groups in the ratio of vascular calcification, the ratio of nourishing blood vessels, the ratio of plaque erosion, the minimum lumen area and the stenosis rate (P > 0.05). Correlation analysis showed that UA level in TCF group was significantly positively correlated with plaque rupture, thrombosis and ratio of lipid radians (r ＞ 0，P ＜ 0.05), while significantly negatively correlated with fiber cap thickness (r ＜0，P ＜ 0.05). Logistic multivariate regression analysis showed that UA, family history of coronary heart disease and LDL were independent risk predictors of TCF (all P ＜ 0.05). Conclusion UA level in patients with coronary heart disease was significantly correlated with TCF, plaque rupture and thrombosis, and UA level was an independent risk predictor of TCF.
		2020 Vol. 17 (14): 61-64,68 [Abstract] ( 153 ) HTML (1 KB) PDF (563 KB) ( 64 )

	65	Effect of synchronous electric cardioversion in the treatment of pre-hospital sudden ventricular tachycardia with hemodynamic instability
		TAO Jinzhe
		Objective To study the application effect of synchronous electric cardioversion in patients with sudden ventricular tachycardia with hemodynamic instability in the pre-hospital emergency scene. Methods A total of 82 patients with sudden ventricular tachycardia with hemodynamic instability at the first scene of pre-hospital emergency treatment by emergency personnel of North District Branch, Beijing Emergency Medical Center from May 2005 to May 2019 were selected as the research objects. According to the different treatment methods adopted on the scene, the patients were divided into the drug group (42 patients) and the electric cardioversion group (40 patients). The drug group was given conventional drug treatment, the electric cardioversion group was given synchronous electric cardioversion treatment. The effect of cardioversion, the incidence of adverse reactions and the time of on-site treatment were compared between the two groups. Results There were no statistically significant differences in the success rate of cardioversion and the total incidence of adverse reactions between the two groups (P ＞ 0.05). However, the time of cardioversion in the electric cardioversion group was lower than that in the drug group, and the difference was statistically significant (P ＜ 0.05). Conclusion In the pre-hospital emergency scene, synchronous electric cardioversion is used to treat patients with sudden ventricular tachycardia with hemodynamic instability. Treatment time is short, the effect of cardioversion is immediate, and it can quickly prevent the deterioration of the condition.
		2020 Vol. 17 (14): 65-68 [Abstract] ( 120 ) HTML (1 KB) PDF (472 KB) ( 114 )

	69	Effect of intervention model based on NIHSS score on patients with severe craniocerebral injury
		TANG Jinli GU Yan FEI Yaya GONG Peipei
		Objective To explore the influence of intervention mode based on the national institute health stroke scale (NIHSS) score on patients with severe craniocerebral injury after operation. Methods From October 2016 to October 2017, 47 patients with severe craniocerebral injury who underwent routine intervention in Affiliated Hospital of Nantong University (“our hospital” for short) were selected as the control group. Forty-seven patients admitted to our hospital from November 2017 to November 2018 with NIHSS score intervention after severe craniocerebral injury were selected as the observation group. NIHSS score, Barthel index score, quality of life score and complication rate before and after intervention were compared between the two groups. Results After intervention, NIHSS scores of the two groups were significantly lower than those before intervention, and Barthel index scores were significantly higher than those before intervention (P < 0.05); after intervention, NIHSS scores of the observation group were lower than that of the control group, and Barthel index scores were higher than that of the control group, the differences were all statistically significant (all P ＜ 0.05). The scores of physiological function, physiological function, physical pain, vitality, psychological, social function, emotional function and general health in the two groups were all higher than those before the intervention, and the differences were all statistically significant (all P ＜ 0.05). The scores of the observation group were all higher than those of the control group after the intervention, and the differences were all statistically significant (all P ＜ 0.05). The total incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion The application of the intervention model based on NIHSS score in patients with severe craniocerebral injury after surgery can reduce the degree of neurological impairment, improve the ability of daily living and quality of life, and reduce the incidence of complications, which is worthy of promotion.
		2020 Vol. 17 (14): 69-72,77 [Abstract] ( 151 ) HTML (1 KB) PDF (585 KB) ( 153 )

	73	The influence of neural stem stimulation combined with task-oriented training for lower extremity motor function in stroke patients with hemiplegia and three-dimensional gait
		ZHENG Su1 PENG Li2
		Objective To explore the effect of neural stem stimulation combined with task-oriented training on lower limb motor function in patients with stroke. Methods A total of 80 patients who met the inclusion criteria from January 2016 to December 2018 in the Rehabilitation Center of Shiyan Taihe Hospital were selected. They were divided into 4 groups according to the admission order, with 20 cases in each group. Group A was given conventional drug treatment for stroke in department of neurology, group B was treated with nerve stem stimulation on the basis of group A, group C was given task-oriented training treatment on the basis of group A, group D was treated with nerve stem stimulation combined with task-oriented training on the basis of group A. Fugl-meyer assessment (FMA), berg balance scale (BBS), modified barthel index (MBI) and three-dimensional gait assessment were performed in each group before and after 3 courses of treatment. Results Before the treatment, the three-dimensional gait parameters, FMA, BBS and MBI of the four groups were compared, and there was no statistically significant difference (P ＞ 0.05). Compared with before treatment, there were no statistically significant differences in three-dimensional gait parameters, FMA, BBS and MBI in group A (P ＞ 0.05), while there were statistically significant differences in three-dimensional gait parameters, FMA, BBS and MBI in group B, group C and group D (all P ＜ 0.05). After treatment, the three-dimensional gait parameters, FMA, BBS and MBI of group B, group C and group D were significantly higher than that of group A, with statistically significant differences (all P ＜ 0.05), and group D was higher than group B and group C, with statistically significant differences (all P ＜ 0.05). Conclusion Neural stem stimulation combined with task-oriented training can improve the FMA, BBS, and MBI scores of the lower limbs of hemiplegia after stroke, improve the three-dimensional gait parameters, enhance the lower limb movement ability, balance coordination ability and living ability of patients, and improve the rehabilitation effect of patients.
		2020 Vol. 17 (14): 73-77 [Abstract] ( 125 ) HTML (1 KB) PDF (574 KB) ( 78 )

	78	Clinical study of Gastrodin combined with Oxiracetam in the treatment of cognitive impairment in elderly patients with ischemic stroke
		LIANG Weiwei LIU Hua LI Xiaobo
		Objective To investigate clinical effect of Gastrodin combined with Oxiracetam in the treatment of cognitive impairment after ischemic stroke in the elderly. Methods One hundred and two elderly patients with cognitive impairment after ischemic stroke who were admitted to the First People′s Hospital of Yunnan Province from January 2016 to December 2018 were selected, they were divided into control group (n = 51, Oxiracetam treatment) and study group (n = 51, Gastrodin combined with Oxiracetam treatment) according to the random number table method, two groups were treated for 1 month. Clinical efficacy, adverse reactions, Montreal cognitive assessment scale (MoCA) score, activities of daily living (ADL) score and serum levels of neuron-specific enolase (NSE), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) were compared between two groups. Results The total clinical effective rate of study group was higher than that of control group (P < 0.05). After treatment, the scores of MoCA and ADL in two groups were higher than those before treatment, and the scores in study group were higher than those in control group (P < 0.05). After treatment, the levels of NSE, Hcy and hs CRP in two groups were lower than those before treatment, and the level in study group was lower than that in control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Gastrodin combined with Oxiracetam can effectively improve cognitive impairment in elderly patients with ischemic stroke. The safety of the drug is good and the effect is exact. The specific mechanism may be related to the down-regulation of NSE, Hcy, hs-CRP and other factors.
		2020 Vol. 17 (14): 78-81 [Abstract] ( 188 ) HTML (1 KB) PDF (533 KB) ( 80 )

	82	Effect of head needle combined with task orientation training on lower limb motor function in stroke
		HU Feifei WANG Leilei LUO Xin
		Objective To explore the effect of head needle combined with task orientation training on lower limb motor function in stroke. Methods Two hundred and fifty-eight patients with stroke in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from January 2017 to January 2019 were divided into routine rehabilitation group (86 cases), routine rehabilitation combined with head needle group (86 cases) and routine rehabilitation combined with head needle and task orientation training group (86 cases) according to the random number table method. The routine rehabilitation group was treated with routine rehabilitation training, routine rehabilitation combined with head needle group was treated with head acupuncture on the basis of routine rehabilitation group, routine rehabilitation combined with head needle and task orientation training group was treated with task orientation training on the basis of routine rehabilitation combined with head needle group. Three groups were treated for 8 weeks. Fugl-Meyer assessment (FMA) scores, Berg balance scale (BBS) scores, activity of daily living (ADL) scores and pace, step length of three groups before and after treatment were compared. The adverse reactions of three groups during the treatment were recorded. Results FMA scores, BBS scores and ADL scores of three group after treatment were significantly higher than those before treatment (P < 0.05). FMA scores, BBS scores and ADL scores of routine rehabilitation combined with head needle group and routine rehabilitation combined with head needle and task orientation training group were significantly higher than those of routine rehabilitation group (P < 0.05). FMA scores, BBS scores and ADL scores of routine rehabilitation combined with head needle and task orientation training group were significantly higher than those of routine rehabilitation combined with head needle group (P < 0.05). The pace of three groups after treatment was faster than before treatment, and the step length was longer than before treatment (P < 0.05). After treatment, the pace of routine rehabilitation combined with head needle group and routine rehabilitation combined with head needle and task orientation training group were faster than those of routine rehabilitation group, the step length was longer than that of conventional rehabilitation group (P < 0.05). After treatment, the pace of routine rehabilitation combined with head needle and task orientation training group was significantly higher than that of routine rehabilitation combined with head needle group, the step length was longer than that of conventional rehabilitation group (P < 0.05). During treatment, there was no adverse reaction among three groups. Conclusion Head needle combined with task orientation training can significantly improve the lower limbs motor function and balance ability in stroke, improve the quality of life of patients, which has good safety.
		2020 Vol. 17 (14): 82-85 [Abstract] ( 154 ) HTML (1 KB) PDF (529 KB) ( 163 )

	86	Clinical comparative study of gonadotropin releasing hormone and Dydrogesterone Tablets in the prevention of recurrence of endometrial polyps after electrotomy
		LI Yan WANG Juan ZHANG Renqi
		Objective To compare the clinical effect of gonadotropin releasing hormone and Dydrogesterone Tablets in the prevention of recurrence of endometrial polyps (EMP). Methods From March 2016 to December 2018, 208 patients with EMP in the First Affiliated Hospital of Xinjiang Medical University were selected from March 2016 to December 2018, they were divided into group A (n = 104) and group B (n = 104) according to the random number table. Group A was given Dydrogesterone Tablets after operation for prevention and group B was given gonadotropin releasing hormone after operation for prevention. The endometrial thickness, quality of life scal (SF-36), serum sex hormone index, recurrence rate and adverse reactions of patients were compared between the two groups. Results There was high significant difference of endometrial thickness in time, group and interaction between the two groups (P < 0.01). Further comparison between the two groups: 3, 6 months and 12 months after the operation, the endometrial thickness of the two groups decreased in turn compared with that before the operation (P < 0.05); that of group B was lower than that of group A (P < 0.05). At 12 months after operation, SF-36 scores in both groups were higher than those before operation, and group B was higher than group A, the differences were statistically significant (P < 0.05). 12 months after operation, follicle-stimulating hormone, progesterone and estradiol in the two groups were lower than those before operation, and group B was lower than group A, the differences were statistically significant (P < 0.05). The recurrence rate in group B was lower than that in group A, the difference was statistically significant (P < 0.05). The incidence of adverse reactions in group B was higher than that in group A, the difference was statistically significant (P < 0.05). Conclusion Compared with the prophylactic treatment of Dydrogesterone Tablets, the prophylactic treatment of gonadotropin releasing hormone can effectively improve the endometrial thickness, quality of life and serum sex hormone indexes, and reduce the recurrence, but its safety is relatively poor. The specific tolerance of the patients can be seen in clinical practice.
		2020 Vol. 17 (14): 86-89 [Abstract] ( 159 ) HTML (1 KB) PDF (366 KB) ( 40 )

	90	Meta analysis of the relationship between the lncRNA and clinical features of gastric cancer
		LI Fan1,2 WANG Yuping1,2 CHEN Zhaofeng1,2 GUO Qinghong1,2 GUAN Quanlin3 ZHOU Yongning1,2
		Objective To study the correlation between long non-coding RNA (lncRNA) and gastric cancer and prognosis. Methods PubMed, EMbase and Web of Science database were searched, the search ended on April 2019. According to the retrieval strategy and inclusion and exclusion criteria, the literatures were screened and the relevant data were extracted. Stata software was used for meta analysis. Results Eighteen literatures were included in this study. The risk of gastric cancer in the group with high expression of lncRNA was 1.510 times than that of the group with low expression of lncRNA (HR = 1.510, 95%CI: 1.213-1.878, P = 0.000). Meta-analysis showed that there was publication bias in the literature. LncRNA expression level and TNM stage of gastric cancer patients (HR = 1.981, 95%CI: 1.458-2.692, P = 0.000), tumor differentiation degree (HR = 1.273, 95%CI: 1.103-1.469, P = 0.001), invasion depth (HR = 1.862, 95%CI: 1.565-2.216, P = 0.000), lymph node metastasis (HR = 1.570, 95%CI: 1.086-2.270, P = 0.016), and distant metastasis (HR = 2.581, 95%CI: 1.503-4.430, P = 0.001) were significantly correlated. Conclusion lncRNA is associated with poor prognosis and clinicopathological features in patients with gastric cancer, so it may be an important biomarker for gastric cancer patients. However, its clinical application still needs to be verified through more researches in the future.
		2020 Vol. 17 (14): 90-93,105 [Abstract] ( 209 ) HTML (1 KB) PDF (850 KB) ( 88 )

	94	Clinical effect of Tigapine and Cisplatin combined with Docetaxel in the treatment of cervical cancer
		LI Jinwu1 HU Shan2 LIU Yanyun3 XU Hai3
		Objective To observe the clinical effect of Tigapine, Cisplatin and Docetaxel in the treatment of cervical cancer and to explore the possible mechanism of action. Methods From June 2017 to January 2019, 112 cases with cervical cancer who admitted to Wuhan Union Hospital of Hubei Province were selected. According to random number table method, they were divided into control group and observation group, with 56 cases in each group. Control group was treated with Tigapine combined with Cisplatin and observation group was treated with Docetaxel on the basis of control group. The clinical efficacy of the two groups, and changes in serum tumor markers, Th1/Th2 cytokine content and immune function level was compared the adverse reactions during medication was recorded. Results The disease control rate and the objective remission rate of observation group were higher than those of control group, and the difference was statistically significant (P < 0.05). After treatment, the levels of carcino-embryonic antigen, carbohydrate antigen 19-9 (CA19-9), CA125 and squamous cell carcinoma antigen in two groups were lower than those before treatment, and observation group was lower than control group, and the differences were statistically significant (all P < 0.05). After treatment, the levels of γ interferon (IFN-γ), tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2) in observation group were higher than those before treatment, and the levels of IL-4, IL-6 and IL-10 were lower than those before treatment; and the levels of IFN-γ, TNF-α and IL-2 in observation group were higher than those in control group, and the levels of IL-4, IL-6, and IL-10 in observation group were lower than those in control group, with statistically significant differences (all P < 0.05). The incidence of adverse reactions during treatment in two groups was statistically significant (P < 0.05). Conclusion The clinical effect of Docetaxel and Tigapine combined with Cisplatin in the treatment of advanced cervical cancer is definite, which is conducive to reducing the level of serum tumor markers, correcting the immune imbalance of Th1/Th2 cells and reducing adverse reactions, which is worthy of clinical promotion.
		2020 Vol. 17 (14): 94-97,117 [Abstract] ( 236 ) HTML (1 KB) PDF (597 KB) ( 73 )

	98	Relationship between serum PDCD5 and PCNA expression with clinicopathological characteristics and short-term prognosis in patients with non-small cell lung cancer
		WANG Duan WANG Anhui FU Wensheng
		Objective To study the expressions of programmed cell death 5 (PDCD5) and proliferating cell nuclear antigen (PCNA) in serum of patients with non-small cell lung cancer (NSCLC) and their relationship with the short-term prognosis. Methods From February 2017 to February 2018, 79 cases with NSCLC patients who diagnosed and treated in Suzhou Municipal Hospital of Anhui Province were selected as cancer group, and 40 healthy medical examinees in the same period were used as control group. Enzyme-linked immunosorbent assay was used to detect the expression of PDCD5 and PCNA in the serum of two groups. The relationship between PDCD5, PCNA expression and clinicopathological characteristics of NSCLC patients were analyzed. The relationship between different levels of PDCD5 and PCNA expressions and the 1-year overall survival (OS) rate in NSCLC patients were analyzed. Results The expression levels of PDCD5 in cancer group were lower than those in control group, while the expression levels of PCNA in cancer group were higher than those in control group, and the difference was statistically significant(P < 0.05). The expressions of PDCD5 and PCNA in serum of the cancer group were related to TNM stage and lymph node metastasis (P < 0.05). Serum PDCD5 was significantly negatively correlated with PCNA expression (r = -0.621, P = 0.000). Patients with low PDCD5 expression had lower OS than patients with high PDCD5 expression for 1-year (P < 0.05). The 1-year OS of patients with high PCNA expression was lower than that of patients with low PCNA expression (P < 0.05). Conclusion The expression of serum PDCD5 of NSCLC patients is decreased, while the expression of PCNA is increased, which are related to the staging of TNM and lymph node metastasis, and are expected to become a new tumor marker in NSCLC serum.
		2020 Vol. 17 (14): 98-101 [Abstract] ( 190 ) HTML (1 KB) PDF (676 KB) ( 43 )

	102	Expression of lncRNA-GAS5 and its clinical significance in nasopharyngeal carcinoma
		LUO Haiqing JIANG Danxian YANG Donghong CHEN Zhenglu ZHONG Yu′nan CHEN Zihong YU Zhonghua
		Objective To investigate the expression of long non-coding RNA-growth arrest-specific 5 (lncRNA-GAS5) in nasopharyngeal carcinoma and to evaluate its clinical significance． Methods From March 2013 and December 2018, 56 cases with nasopharyngeal carcinoma tissue samples from Affiliated Hospital of Guangdong Medical University were collected as nasopharyngeal carcinoma group, and 42 cases of normal nasopharyngeal tissue samples were collected as control group. The expression of lncRNA-GAS5 was detected by qRT-PCR. The correlations between the expression of lncRNA-GAS5 and pathological characteristics and prognostic were analyzed. Results The relative expression of lncRNA-GAS5 in nasopharyngeal carcinoma group was lower than that in control group, and the difference was statistically significant (P < 0.05). TNM stage, lymph node metastasis and tumor differentiation were closely related to the expression level of lncRNA-GAS5 (P < 0.05). The survival of patients with high expression of lncRNA-GAS5 was significantly higher than patients with low expression (P < 0.01). Conclusion The expression of lncRNA-GAS5 is down-regulated in nasopharyngeal carcinoma tissues and may serve as a potential new prognostic for nasopharyngeal carcinoma．
		2020 Vol. 17 (14): 102-105 [Abstract] ( 176 ) HTML (1 KB) PDF (608 KB) ( 83 )

	106	Clinical study of Compound Cantharis Capsules combined with mFOLFOX6 chemotherapy in postoperative patients with gastric cancer
		ZHAI Hongfang1 LIU Aijuan2 CHEN Mingda1 LIU Lili1 LI Qingke3 ZHANG Chao1
		Objective To investigate the effect of Compound Cantharidin Capsules combined with mFOLFOX6 chemotherapy (Oxaliplatin, 5-Fluorouracil, Calcium folinate) on the curative effect and immune function of patients with gastric cancer after operation. Methods A total of 118 patients with gastric cancer after operation in Tangshan People′s Hospital were selected from February 2017 to May 2019, and they were divided into the study group and the control group according to the random number table, with 59 cases in each group. The control group was treated with mFOLFOX6 chemotherapy, and the study group was treated with Compound Cantharidin Capsules on the basis of the control group. All patients received 8 courses of treatment. The clinical efficacy, serum tumor markers and immune function of the two groups were compared, and the adverse reactions during the treatment were recorded. Results The total effective rate of the study group after 8 courses of treatment was significantly higher than that of the control group (P ＜ 0.05). The levels of serum carcino-embryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 decreased after 8 courses of treatment in the two groups, and the levels in the study group were lower than those in the control group (P ＜ 0.05). The levels of CD3+, CD4+, CD4+/CD8+ in the two groups decreased, but those in the study group were higher than those in the control group (P ＜ 0.05). There was no difference in the total incidence of adverse reactions between the two groups (P ＞ 0.05). Conclusion Compound Cantharidin Capsules combined with mFOLFOX6 chemotherapy has definite curative effect on patients with gastric cancer after operation. It can effectively prevent disease progression and alleviate immune suppression, and has good safety of medication. It has certain clinical application value.
		2020 Vol. 17 (14): 106-109 [Abstract] ( 321 ) HTML (1 KB) PDF (575 KB) ( 103 )

	110	Investigation of nutritional risk screening and nutritional support status of patients with gastric cancer in perioperative period
		GUO Fei1 WU Xueliang1 ZHANG Xiaoyang2 LI Minghui1 LYU Yanqin1 SUN Guangyuan1 HAN Lei1 XUE Jun1
		Objective To investigate the application and nutritional risk of preoperative nutritional support for gastric cancer patients, and to provide scientific methods and reasonable suggestions for perioperative nutritional support for gastric cancer patients. Methods From January 2017 to January 2019, a total of 138 patients with gastric cancer were selected from the Department of General Surgery, the First Affiliated Hospital of Hebei North University. Nutritional risk screening was performed using the nutrition risk screening 2002 (NRS2002), and the incidence of postoperative complications and perioperative nutritional support of enrolled patients were statistically analyzed. Results In this study, there were 24 cases of cardia cancer, 19 cases of gastric body cancer and 95 cases of gastric antrum cancer. The incidence of malnutrition was 29.17%, 10.53%, 16.84%, and the total incidence of nutritional risk was 50.00%, 42.11%, and 48.42%, respectively. Patients with gastric cancer of age ≥60 years, ASA grade (grade 3-4), stage T3-T4 had a higher incidence of malnutrition and increased nutritional risk than patients with gastric cancer of age < 60 years, ASA grade (grade 1-2) and stage T1-T2, and the differences were statistically significant (P ＜ 0.05). Both patients at nutritional risk (69.70%) and no nutritional risk (22.22%) were given nutritional support, parenteral nutrition is the main nutrition. Among patients with gastric cancer at nutritional risk, the incidence of complications in patients with auxiliary nutritional support was significantly reduced compared with those without nutritional support, and the difference was statistically significant (P ＜ 0.05). Conclusion The NRS2002 system can accurately assess the nutritional risk of patients with gastric cancer. For patients with nutritional risk, scientific and reasonable nutritional support and intervention should be given actively, so as to reduce the incidence of complications.
		2020 Vol. 17 (14): 110-113 [Abstract] ( 226 ) HTML (1 KB) PDF (598 KB) ( 46 )

	114	Correlation between integrin α5 and epithelial ovarian cancer
		MU Xiang1 DU Weimin1 SHI Kexin2 ZHANG Yumin3 ZHANG Ping1
		Objective To investigate the expression of integrin α5 in epithelial ovarian tumors and to analyze its clinicopathological relationship with epithelial ovarian cancer. Methods From January 2015 to December 2017, Ovarian tumor tissue were collected from 80 hospitalized patients under the care of the Gynecology Center of the Qingdao Municipal Hospital (40 epithelial ovarian cancer samples, 20 borderline epithelial tumor samples and 20 benign epithelial tumor samples). Immunohistochemistry was used to detect the expression of integrin α5 protein in ovarian tumor tissues. Results The positivity of integrin α5 in epithelial ovarian cancer samples was 80.00% (32/40), which was significantly higher than that in borderline epithelial tumor samples (40.00% [8/20]) and benign epithelial tumor samples (20.00% [4/20])(P ＜ 0.01). There was no statistically significant difference in the positive expression rate of integrin α5 protein in epithelial ovarian cancer among different ages and pathological types (P > 0.05). There was a significant difference among different degree of pathological differentiation and different stages of operation and pathology (P ＜ 0.05); the difference was highly statistically significant between the presence and absence of lymph node metastasis (P ＜ 0.01). Spearman rank correlation analysis showed that the expression of integrin α5 in epithelial ovarian cancer tissues was significantly positively correlated with the surgical pathological stage, pathological differentiation degree and presence or absence of lymph node metastasis of ovarian cancer (r = 0.854, 0.765, 0.895, P ＜ 0.05). Conclusion The overexpression of integrin α5 in epithelial ovarian cancer tissues is closely related to the degree of pathological differentiation, surgical pathological stage and lymph node metastasis. Monitoring the expression of integrin α5 may help to determine the long-term prognosis of ovarian cancer patients and guide clinical treatment.
		2020 Vol. 17 (14): 114-117 [Abstract] ( 175 ) HTML (1 KB) PDF (575 KB) ( 76 )

	118	Comparison of the effects of prostate plasma enucleation and plasma resection in the treatment of large prostatic hyperplasia
		XIONG Bobo1* HE Haoxin2* ZHANG Jinsong1▲ WANG Haifeng1 ZUO Yigang1 WANG Jiansong1
		Objective To compare the efficacy of plasma prostatic enucleation and plasma prostatic electrotomy in the treatment of massive prostatic hyperplasia Methods A total of 100 patients diagnosed with mass prostatic hyperplasia (BPH) in the Ward One, Department of Urology, the Second Affiliated Hospital of Kunming Medical University from September 2017 to January 2019 were selected. According to the different surgical methods, the patients undergoing plasma resection of prostate were as the resection group (50 cases) and the patients undergoing plasma resection of prostate were as the enucleation group (50 cases). The surgical time, intraoperative blood loss, prostate resection volume, length of hospital stay, postoperative bladder irrigation time, indwelling urinary catheter time, and total postoperative complications, residual urine (PVR ), maximum urine flow rate (Q-max), international prostate symptom score (IPSS), quality of life (QOL) score, and patient quality of life score were compared between the two groups. Results The operative time, hospitalization time, postoperative bladder flushing time and postoperative indwelling catheter time of the enucleation group were all shorter than those of the resection group, the intraoperative blood loss was less than that of the resection group, the prostate resection volume was more than that of the resection group, and the total postoperative complications were less than those of the resection group, with statistically significant differences (P ＜ 0.05). The PVR, IPSS and QOL score in the enucleation group were significantly lower than that in the resection group, while Q-max was significantly higher than that in the resection group, with statistically significant differences (P ＜ 0.05). The score of quality of life in the enucleation group was significantly higher than that in the resection group, and the difference was statistically significant (P ＜ 0.05). Conclusion Prostate plasma enucleation has good clinical effect in the treatment of large-volume prostatic hyperplasia, and it is worth popularizing and applying.
		2020 Vol. 17 (14): 118-121 [Abstract] ( 198 ) HTML (1 KB) PDF (599 KB) ( 43 )

	122	Analysis of sialic acid levels in patients with senile pulmonary disease
		LIU Pei WU Guoyou ZHANG Yapei DONG Shilei
		Objective To explore the changes of sialic acid (SA) in serum of elderly patients with chronic obstructive pulmonary disease (COPD), pneumonia and lung cancer. Methods A total of 274 elderly patients admitted to Zhejiang Hospital (“our hospital” for short) from December 2017 to December 2018 were selected as the observation group. According to the diagnostic criteria of three diseases, laboratory examination and imaging examination, they were divided into the following three groups: COPD group (74 cases), pneumonia group (100 cases), lung cancer group (100 cases). A total of 100 healthy people who were examined during the same period were used as the control group. The SA kit was used to detect the SA content in serum samples from patients, while the correlation between lung diseases and sialic acid changes were analyzed. Results Compared with the control group, serum SA levels in COPD group, pneumonia group and lung cancer group were all increased, and the differences were all statistically significant (all P ＜ 0.05). Serum SA levels in the pneumonia group and the lung cancer group were higher than those in the COPD group, with statistically significant differences (P ＜ 0.05). There was no statistically significant difference in serum SA level between the pneumonia group and the lung cancer group (P ＞ 0.05). Pearson correlation analysis showed that serum SA level in COPD group was negatively correlated with that in lung cancer group (r = -0.25, P ＜ 0.05). Conclusion The use of enzymatic detection of sialic acid in serum not only provides initial clinical diagnostic value for patients with chronic lung disease, but also provides a certain auxiliary effect for targeted therapy of disease.
		2020 Vol. 17 (14): 122-124,130 [Abstract] ( 133 ) HTML (1 KB) PDF (611 KB) ( 70 )

	125	Diagnostic accuracy of breath test in detection of delayed gastric emptying: a meta-analysis
		BAI Ying1 GAO Wei2 CONG Jialin2 CHENG Shuli2 ZHAO Xingjie3 ZHANG Li4 YANG Xiaohui5,6
		Objective To evaluate the diagnostic value of breath test for delayed gastric emptying. Methods Database include PubMed, the Cochrane Library, China National Knowledge Internet, WanFang Data, VIP, CBM were searched to collect exsiting diagnostic accuracy tests on delayed gastric emptying diagnosed, the retrieval time was from database construction to April 2018. The fixed effect model was used for meta-analysis, and the research indicators included sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and the area under the curve (AUC). Results Ten studies with 434 objects were included. The sensitivity of breath test for diagnosis of delayed gastric emptying was 0.826 (95%CI: 0.728 to 0.894), and the specificity was 0.876 (95%CI: 0.800 to 0.925). The AUC was 0.92. The combined positive likelihood ratio was 6.640 (95%CI: 3.987 to 11.060), and the negative likelihood ratio was 0.198 (95%CI: 0.122 to 0.321). Conclusion Breath test is a useful tool for detecting delayed gastric emptying with a relatively high sensitivity and specificity. It is expected to be applied in clinic.
		2020 Vol. 17 (14): 125-130 [Abstract] ( 157 ) HTML (1 KB) PDF (1623 KB) ( 25 )

	131	Clinical analysis of thyroid diseases in patients with systemic lupus erythematosus
		YIN Xietian1,2,3 ZHAO Shichao4 XIANG Nan1,3 ZHOU Guangwen3,5 ZENG Mingxing3,6
		Objective To study the prevalence of thyroid disease in patients with systemic lupus erythematosus and associated risk factors of Hashimoto′s thyroiditis and subclinical hypothyroidism in systemic lupus erythematosus, so as to provide evidence for clinical prevention and treatment. Methods Sixty-six patients with systemic lupus erythematosus hospitalized in Hubei Hospital of Traditional Chinese Medicine from May 2017 to May 2019 were selected as the study subjects. Among them, a total of 15 cases with Hashimoto′s thyroiditis were observation group A, 26 cases without Hashimoto′s thyroiditis were control group A; a total of 9 cases with subclinical hypothyroidism were observation group B, a total of 52 cases without subclinical hypothyroidism were control group B. The incidence of thyroid disease in systemic lupus erythematosus was observed, and the general condition (gender, age, course of disease), blood analysis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), immune function, thyroid function, blood lipid (triacylglycerol [TG], high density lipoprotein cholesterol [HDL-C]), uric acid (UA), ENA antibody spectrum, anti-nuclear antibodies (ANA), albumin level (ALB) and clinical manifestations were statistically processed. Results Except for age, there was no statistically significant difference between group A and control group A patients (P ＞ 0.05). Age was an independent risk factor for systemic lupus erythematosus complicated with Hashimoto′s thyroiditis (OR [95%CI] = 1.064[1.004, 1.128], P ＜ 0.05). Except for immunoglobulin M (IgM) and anti-Ds-DNA antibody positive (Ds-DNA), there was no statistically significant difference between other indicators of group B and control group B (P ＞ 0.05). Anti-Ds-DNA antibody was an independent risk factor for systemic lupus erythematosus complicated with subclinical hypothyroidism (OR [95%CI] = 10.573[1.673, 66.810], P ＜ 0.05). Conclusion The incidence of systemic lupus erythematosus complicated with thyroid disease is high. Hashimoto′s thyroiditis and subclinical hypothyroidism are relatively common thyroid diseases. Age is an independent risk factor for systemic lupus erythematosus complicated with Hashimoto′s thyroiditis. Anti-Ds-DNA antibody is an independent risk factor for systemic lupus erythematosus complicated with subclinical hypothyroidism.
		2020 Vol. 17 (14): 131-134,149 [Abstract] ( 235 ) HTML (1 KB) PDF (624 KB) ( 33 )

	135	Analysis of prognostic risk factors and the prognostic assessed value of SP-A and SP-D in COPD with respiratory failure patients
		GU Yuhai1 SHI Xuefengu1 NIU Di2 XIE Youbang3
		Objective To explore the significance of serum surfactant protein A (SP-A) and surfactant protein D (SP-D) in patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure and their prognostic value. Methods A total of 70 COPD patients hospitalized in the Department of Respiratory Medicine of Qinghai Provincial People′s Hospital from September 2015 to August 2018 were selected. They were divided into COPD group (20 cases), combined with type Ⅰ respiratory failure group (25 cases) and combined with type Ⅱ respiratory failure group (25 cases), according to the presence or absence of respiratory failure. The laboratory indicators and blood gas indicators of each group were analyzed. According to the outcome indexes of COPD patients with respiratory failure, they were divided into death group (13 cases) and non-death group (37 cases), while the prognostic risk factors were analyzed. Results The C-reactive protein of the combined type Ⅰ and type Ⅱ respiratory failure groups were lower than that of the COPD group, while SP-A and SP-D were higher than those of the COPD group, and the differences were statistically significant (P ＜ 0.05). The pH of the combined type Ⅱ respiratory failure group was lower than that of the COPD group, and the difference was statistically significant (P ＜ 0.05). The partial pressure of oxygen in the combined type Ⅰ and type Ⅱ respiratory failure group were lower than that in the COPD group, while combined type Ⅱ respiratory failure group was higher than combined type Ⅰ respiratory failure group, and the differences were statistically significant (P ＜ 0.05). The partial pressure of carbon dioxide in the combined with type Ⅱ respiratory failure group was higher than those in the COPD group and the combined typeⅠrespiratory failure group, and the differences were statistically significant (P ＜ 0.05). There were statistically significant differences between the death group and non-death group in smoking, pH, SP-A and SP-D (P ＜ 0.05). Logistic regression analysis showed that pH was a risk factor for the prognosis of COPD combined with respiratory failure (OR ＞ 1, P ＜ 0.05). Conclusion In COPD patients with respiratory failure, SP-A and SP-D increased, and of little assessed value in the prognosis of COPD combined with respiratory failure, while pH has a greater assessed value of COPD combined with respiratory failure.
		2020 Vol. 17 (14): 135-139 [Abstract] ( 138 ) HTML (1 KB) PDF (648 KB) ( 71 )

	140	Meta-analysis of the efficacy of traditional Chinese medicine combined with probiotics in the treatment of irritable bowel syndrome
		KONG Weiqian1 LU Min2
		Objective To evaluate the clinical efficacy of traditional Chinese medicine combined with probiotics in the treatment of irritable bowel syndrome by meta analysis. Methods From January 2010 to June 2019, all clinical trials of traditional Chinese medicine combined with probiotics in the treatment of irritable bowel syndrome were collected by searching Chinese knowledge net, Wanfang, VIP, PubMed, Web of Science and other Chinese and English databases. Literature and extracted data were selected according to the inclusion and exclusion criteria, and the meta analysis was carried out by Stata 15.1 software. Results A total of 2191 patients were included in 24 clinical controlled trials, including 1105 patients in treatment group (traditional Chinese medicine combined with probiotics) and 1086 patients in control group. Meta analysis result showed that total effective rate of treatment group was significantly higher than that of control group (RR = 1.22, 95%CI [1.18, 1.27], P = 0.000). Sub group analysis showed that the effective rate of each sub group was higher than that of control group, among which, 16 cases of diarrehea-irritable bowel syndrome: RR = 1.22, 95%CI (1.17, 1.28), P = 0.000; 4 cases of constipation-irritable bowel syndrome: RR = 1.29, 95%CI (1.13, 1.46), P = 0.000; the remaining unclassified four items: RR = 1.18, 95%CI (1.10, 1.27), P = 0.000. There were statistically significant differences in abdominal pain score (SMD = -1.00, 95%CI [-1.51, -0.71], P = 0.000), diarrhea score (SMD = -1.75, 95%CI [-2.69, -0.82], P = 0.000), abdominal distention score (SMD = -1.41, 95%CI [-1.86, -0.96], P = 0.000) and improvement of abnormal stool characteristics (SMD = -1.07, 95%CI [-1.48, -0.66], P = 0.000) between two groups. There was no significant difference in the incidence of adverse reaction between two groups (RR = 0.96, 95%CI [0.43, 2.14], P = 0.921). Conclusion Traditional Chinese medicine combined with probiotics has a significant effect in the treatment of irritable bowel syndrome, especially in improving abdominal symptoms and stool traits.
		2020 Vol. 17 (14): 140-145 [Abstract] ( 228 ) HTML (1 KB) PDF (1979 KB) ( 37 )

	146	Study on the association between gait speed, grip strength and the risk of falls among the oldest old in community
		SHEN Jiangqiong1 WANG Xiaoyuan1 XU Weihao2 MENG Wenwen3
		Objective To explore the association between gait speed, grip strength and the risk of falls among the oldest old in communities. Methods Data of the China Health and Retirement Longitudinal Study in 2013 was collected, subjects aged≥80 years, who had measured their gait speed and grip strength, and who had fall data were selected. A total of 497 elderly people in communities were included in the study and divided into two groups based on whether they fell or not: 122 elderly people in the fall group and 375 elderly people in the non-fall group. Association between gait speed, grip strength and risk of falls was examined with logistic regression models. Results In 24 months of follow-up, 25.4% of study participants (n = 122) experienced a fall. After adjusting for age, gender, and hyperlipidemia, it was found that low gait speed (RR = 2.57, 95%CI: 1.29-5.14) was independently associated with a higher risk of falls. After analyzing the combination of gait speed and grip strength, it was found that participants with normal gait speed combined with low grip strength (RR = 1.95, 95%CI: 1.12-3.42) or with normal grip strength combined with low gait speed (RR = 2.82, 95%CI: 1.49-5.34) had a higher risk of fall, participants with both low gait speed and low grip strength had highest risk of fall (RR = 3.14, 95%CI: 1.41-7.00). Conclusion Gait speed and grip strength can predict future falls independently and jointly, taking the measurement of gait speed and grip strength into the fall risk assessment of the oldest old in the community may improve the accuracy of fall risk prediction.
		2020 Vol. 17 (14): 146-149 [Abstract] ( 165 ) HTML (1 KB) PDF (597 KB) ( 122 )

	150	Analysis on prescription rules of oral prescription for malignant pleural effusion based on data mining
		JIA Hainü1 ZHANG Yi1 ZHOU Mengling2 LYU Mingsheng3 GAO Weihua4 LI Wenzhe5 YAN Jun1
		Objective To conclude and summarize composing law of traditional Chinese medicine formulation for oral administration in treating malignant pleural effusion (MPE) based on data mining. Methods The related literatures of traditional Chinese medicine treating MPE from August 2009 to July 2019 were searched in CNKI. The internal prescriptions of literatures were screened. The medicinal properties, frequency of medication and new prescriptions of that internal prescriptions was sorted and analyzed by a software named “Chinese medicine inheritance support system”. Results One hundred and twenty-seven oral prescriptions treating MPE and 220 herbs were screened; the most frequent four nature and five flavour of drugs was wen and gan. “Semen Descurainiae”, “Poria”, “Fructus Jujubae”, “Ramulus Cinnamomi”, “Radix Astragali seu Hedysari”, “Rhizoma Atractylodis Macrocephalae” were more frequent used in herbs. A total of 28 commonly used herb pairs and combinations was found, 7 new prescriptions were clustered. Conclusion Treatment of MPE includes warming yang for resolving fluid retention, clearing heat and removing toxicity, activating qi and promoting blood circulation, and benefiting qi and diuresis. Taking care of the spleen and stomach is an important idea for treating MPE. The core of MPE treatment is to combinate classical prescriptions and astragalus following syndrome differentiation.
		2020 Vol. 17 (14): 150-154 [Abstract] ( 138 ) HTML (1 KB) PDF (744 KB) ( 54 )

	155	Effect of Chaihu Plus Longgu Muli Decoction plus five elements music therapy in the treatment of mild and moderate depression after tumor
		MIAO Bin WANG Qingxian ZHANG Limin
		Objective To evaluate the effect of Chaihu Plus Longgu Muli Decoction combined with five elements music therapy in the treatment of mild and moderate depression after tumor. Methods From July 2017 to March 2019, 120 patients with depression after tumor in the Oncology Department of Tangshan Hospital of Traditional Chinese Medicine were selected and randomly divided into control group (60 cases) and treatment group (60 cases) by using random number table method. Control group was treated with Escitalopram Tablets, and treatment group was treated with Chaihu Plus Longgu Muli Decoction combined with five elements music therapy. Therapeutic effect of two groups was compared. Hamilton depression scale (HAMD-24) and tumor quality of life scale were used to evaluate the mental state and quality of life of two groups before and after treatment. Results After treatment, the scores of HAMD-24 in two groups were lower than those before treatment, treatment group was lower than control group, the differences were statistically significant (P < 0.05). Total effective rate of treatment group was higher than that of control group, the difference was statistically significant (P < 0.05). After treatment, the scores of physical function, role function, emotional function, cognitive function, social function and overall health status in two groups were higher than those before treatment, treatment group was higher than control group, the differences were statistically significant (P < 0.05). After treatment, the scores of fatigue, pain, nausea and vomiting, insomnia, diarrhea, constipation, poor appetite, dyspnea and economic difficulties in two groups were lower than those before treatment, treatment group was lower than control group, the differences were statistically significant (P < 0.05). Conclusion The effect of Chaihu Plus Longgu Muli Decoction combined with five elements music in the treatment of mild and moderate depression after tumor is positive. It can effectively alleviate the depression of patients and improve their quality of life.
		2020 Vol. 17 (14): 155-158 [Abstract] ( 130 ) HTML (1 KB) PDF (693 KB) ( 90 )

	159	Professor Zou Xu′s experience in using pulse diagnosis to treat dilated cardiomyopathy from the five internal organs
		XU Hui1 XIE Qianfang2 SUN Haijiao2 SHANG Baoling2 ZOU Xu2
		Dilated cardiomyopathy is a kind of refractory cardiovascular disease, which often manifests as progressive heart failure and arrhythmia. Dilated cardiomyopathy has high mortality and poor prognosis, which greatly affects the survival and quality of life of patients. Professor Zou Xu is a famous traditional Chinese medicine practitioner in Guangdong Province. He is an apprentice of the first Chinese medicine master professor Deng Tietao and learned from Li Shushen who is the successor of Mr Changsang pulse method. Professor Zou Xu is good at using pulse diagnosis to treat cardiovascular diseases from the reconciliation of qi and blood, yin and yang, and the five internal organs. He believes that the basic pathogen of dilated cardiomyopathy is due to lack of heart yin and yang, combined with turbidity, dampness, blood stasis and cold. The pulse is mostly characterized by deficiency of heart yang, and the heart fire can not produce spleen soil because of the heart-yang deficiency, so that spleen qi becomes deficiency, and the phlegm and stasis are developed. In addition to benefiting the heart qi and warming the heart yang, the treatment should also focus on nourishing the heart yin, and resolving phlegm, dampness, stasis, and cold. At the same time, we should be combined with the five internal organs to comprehensively treat.
		2020 Vol. 17 (14): 159-162 [Abstract] ( 105 ) HTML (1 KB) PDF (694 KB) ( 213 )

	163	Clinical experience of Yang Zhihong in the treatment of hypertension vertigo with upper hyperactivity of liver yang
		WANG Xin1 YANG Zhihong2 ZHU Xiaona2 REN Xinrui1 LIU Sha1
		Archiater Yang Zhihong is the third batch of famous traditional Chinese medicine in Shaanxi Province. He is good at treating vertigo with clinical symptoms and is good at grasping the main symptoms and secondary symptoms. His prescription is unique, ingenious and effective. This paper summarizes Yang Zhihong′s clinical experience in the treatment of hypertension vertigo with upper hyperactivity of liver yang. Yang Zhihong thinks that vertigo is characterized by deficiency and excess, deficiency of internal organs and essence, deficiency of yang and deficiency of head, disturbance of brain orifices by wind, fire, phlegm and blood stasis. Treatment is based on nourishing deficiency and diarrhea. On the basis of calming liver and latent yang, the four methods of “calming liver and clearing heat, calming wind and fire, strengthening spleen and dampness, eliminating phlegm and turbid, removing blood stasis and unblocking collaterals to reach blood vessels, supplementing qi and blood to strengthen the body and the yuan” are applied simultaneously in clinical treatment. The validity of the case is expected, and a case is attached for the same purpose.
		2020 Vol. 17 (14): 163-165,169 [Abstract] ( 211 ) HTML (1 KB) PDF (708 KB) ( 46 )

	166	Experience of Wu Xianwen in treating radiation-induced oral mucositis by stages
		YUE Jiajia1 WU Xianwen2 CAI Linlin2 WANG Qing1 WANG Shan1
		This paper summarizes professor Wu Xianwen’s experience in the treatment of radiation-induced oral mucositis with traditional Chinese medicine. Radiation-induced oral mucositis is an inflammation of oral mucosa caused by radiation, which is one of the common complications in radiotherapy for head and neck malignant tumors. According to many years′ working experience of radiotherapy and the treatment practice of traditional Chinese medicine, professor Wu puts forward that radiation-induced oral mucositis is caused by the heat-toxin, which would cause the stagnation of qi, invasion of blood and deficiency of yin, and its pathogenesis changes with the trend of struggle between the healthy tendency and the sick tendency. He considers that through the excessive degree of “heat, blood stasis and deficiency”, this disease can be divided into “early stage, middle stage and later stage”. While in treatment, professor Wu advocates the theory of treatment by stages, with the main treatment of heat-clarifying and blood-cooling, detoxicating and promoting blood, tonifying qi and nourishing yin. He also pays attention to the regulation of qi and blood, combination of internal and external treatment, and he is skilled in using the theory of “dispersing fire for treating depressing fire”. This unique idea of staged diagnosis and treatment has remarkable clinical effect.
		2020 Vol. 17 (14): 166-169 [Abstract] ( 195 ) HTML (1 KB) PDF (695 KB) ( 186 )

	170	Analysis on the occurrence, causes and countermeasures of adverse reactions of Chinese herbal decoction pieces in our hospital
		ZOU Bingzi
		Objective To analyze the occurrence and causes of adverse reactions of Chinese herbal decoction pieces, in order to put forward corresponding countermeasures for clinical rational and safe use of Chinese decoction pieces. Methods From June 2014 to June 2019, the clinical data of 68 cases of adverse reaction in Fengtai District Maternal and Child Health Care Hospital of Beijing City was retrospectively analyzed. The types and causes of adverse reactions were counted, and the corresponding preventive measures were put forward. Results The adverse reactions of Chinese herbal tablets involved many systems, and the degree of adverse reaction was different. Among them, 25 cases (36.76%) of the skin and mucous membrane system were the first, followed, there were 22 cases (32.35%) of digestive system and 6 cases (8.82%) of cardiovascular system. The main causes of adverse reaction were 18 cases (26.47%) of improper decoction, 15 cases (22.06%) of improper compatibility and 11 cases (16.18%) of improper dosage. Conclusion Improper decoction, improper compatibility, improper use of dosage and other adverse reactions, among which improper decoction is the most prominent. Strengthen the management of safe use of drugs, do a good job of drug education and professional knowledge training, establish and improve a sound mechanism to reduce adverse reactions incidence, to ensure the safety of patients with medication.
		2020 Vol. 17 (14): 170-173 [Abstract] ( 154 ) HTML (1 KB) PDF (687 KB) ( 55 )

	174	The influencing factors of health-seeking behaviors of patients with chronic diseases
		LI Jia1,2 GAO Xing1,2 LEI Xingyun1,2 HU Hongpu1,2
		Objective To investigate the behavior and influencing factors of middle and elderly-aged patients with chronic diseases in different medical institutions, and to provide policy suggestions for the prevention and treatment of chronic diseases under the hierarchical medical system. Methods According to the Andersen behavior model, based on the data of 769 chronic disease patients who accepted outpatient care within a month from China health and retirement longitudinal study (CHARLS), the influencing factors of health-seeking by Binomial logistic regression model were analyzed. Results Gender, account, weekly exercise days, smoking, proportion of out-of-pocket visits and one-way transportation costs were the factors influencing chronic disease patients′ choice of primary health care institutions (P ＜ 0.05). Conclusion The construction of accessible health system, the health education and health policy propaganda of different characteristics of chronic patients, economic regulation, building the capacity of the primary health care system are the key points for guiding patients with chronic disease to seek medical treatment of primary health care institutions and improving the effectiveness of chronic disease management.
		2020 Vol. 17 (14): 174-177 [Abstract] ( 260 ) HTML (1 KB) PDF (389 KB) ( 109 )

	178	Effect of cluster nursing mode on shoulder function recovery and quality of life of patients with breast cancer after modified radical mastectomy
		ZHAN Haixia1 HU Dong2▲ ZHANG Wenting1 GU Ying1
		Objective To investigate the effect of cluster nursing mode on shoulder function recovery and quality of life of patients with breast cancer after modified radical mastectomy. Methods A total of 160 patients undergoing modified radical mastectomy for breast cancer in the First Affiliated Hospital of Anhui University of Science and Technology from December 2015 to April 2019 were selected and randomly divided into a experimental group of 80 cases and a control group of 80 cases by random number table method. The control group received routine nursing measures, and the experimental group received cluster nursing mode for intervention. The lateral shoulder movement and postoperative quality of life of breast cancer patients in the two groups undergoing modified radical mastectomy were compared. Results The shoulder abduction activity, shoulder rotation activity, lifting function and patient satisfaction of the patients in the experimental group were higher than those in the control group, and the differences were highly statistically significant (P ＜ 0.01); physiological condition, social/family status, emotional status, functional status and additional attention scores were higher than those in the control group，and the differences were highly statistically significant (P ＜ 0.01). Conclusion The cluster nursing model has a positive effect on the restoration of shoulder joint function and the improvement of life quality in patients with improved radical breast cancer.
		2020 Vol. 17 (14): 178-181 [Abstract] ( 183 ) HTML (1 KB) PDF (538 KB) ( 39 )

	182	Clinical data analysis and nursing experience of 12 cases of anti - NMDA receptor encephalitis
		LONG Zefang LI Enzhi CHEN Dezhi
		Objective To study the clinical characteristics and nursing principles of 12 patients of N-methyl-D-aspartate (NMDA) receptor encephalitis. Methods From February 2017 to February 2018, 12 patients with anti-NMDA receptor encephalitis admitted to the Department of Neurology, West China Hospital of Sichuan University were retrospectively analyzed. All cases were given targeted treatment and nursing methods, the general information, auxiliary examination, treatment and outcome of the patients were analyzed. Results The results of electroen cephalogram showed that, 2 cases of diffuse slow wave, 7 cases of middle and high amplitude slow wave in frontotemporal area, 1 case of epileptiform discharge; cerebrospinal fluid examination showed 4 cases of increased pressure, 10 cases of increased cell number, 7 cases of increased cerebrospinal fluid pressure; Magnetic resonance imagine examination showed 4 cases of abnormal signals in the head; abdominal imaging showed 3 cases of teratoma. All patients received hormone shock and gamma globulin therapy after admission. One case died 2 months after discharge, the other were improved. Conclusion The treatment of anti-NMDA receptor encephalitis is hormone therapy and immunoglobulin infusion, nursing work should pay attention to the possible risk of patients and carry out targeted care.
		2020 Vol. 17 (14): 182-185 [Abstract] ( 125 ) HTML (1 KB) PDF (575 KB) ( 65 )

	186	Influence of skin protective film combined with semipermeable membrane dressing on critical patients in ICU
		ZHENG Hongjie1 DU Juan1 TIAN Yuan2 ZHOU Chunhui2
		Objective To approach influence of critical patients in intensive care unit (ICU) by skin protective film combined semipermeable membrane dressing. Methods Three hundred critical patients admitted to ICU of Fuxin Mine General Hospital of Liaoning Health Industry Group from June 2018 to June 2019 were selected as the research objects. According to the random number table method, the patients were divided into the observation group and the control group, with 150 cases in each group. The control group was treated with Conway 3533 hydrocolloid semi permeable membrane dressing, and the observation group was treated with skin protective membrane + semi permeable membrane dressing. The Braden scale score, quality of life score, incidence, occurrence time and severity of incontinence related dermatitis of two groups were observed. Results The scores of Braden inventory and quality of life of two groups were compared before intervention, the differences were no statistical significance (P > 0.05). The scores of Braden inventory and life quality in two groups after intervention were higher than before intervention, and those scores of the observation group were higher than control group, the differences were highly statistical significance (P < 0.01). The incidence of incontinence associated dermatitis was lower than control group, the occurrence time was longer than control group, the severity was lower than control group, the differences were highly statistical significance (P < 0.01). Conclusion The application of skin protective film combined semipermeable membrane dressing in critical patients in ICU, which could increase life quality of patients, protect skin function, decrease incontinence associated dermatitis rate. It is worthy of clinical application.
		2020 Vol. 17 (14): 186-189 [Abstract] ( 181 ) HTML (1 KB) PDF (545 KB) ( 126 )

	190	Discussion on the discipline construction of public hospital publicity under the media convergence environment
		CAO Lijing1 GAO Xinyue2 YAO Haihong3 WU Ruilian1 CHEN Yiwen1 YAN Jianjun4
		It is well-known that public hospital publicity is extremely important in hospital management. Gongli Hospital Affiliated to Naval Medical University continues to strengthen the disciplinary development of publicity by institutional construction, personnel development, project construction and science and research construction in recent 3 years, which can better adapt the publicity strategy under the media convergence environment, actively respond to the competitive pressure of medical service market in the situation of new medical reform, exert the right direction of public opinion, build up a good image of hospital, promote the understanding of hospital by all sectors of the community, continuously enhance the internal cohesion, solidarity and appeal as well as make a positive contribution in developing harmonious doctor-patient relationship under the media convergence environment and exploring disciplinary development of administrative departments in hospitals.
		2020 Vol. 17 (14): 190-193 [Abstract] ( 155 ) HTML (1 KB) PDF (478 KB) ( 69 )

	194	Some thoughts on strengthening ethical review in clinical research
		HU Zhimin
		Ethical review is a key measure to ensure that clinical research is used for medical purposes and to protect the health and dignity of subjects. This paper reviews the exploration and practice of ethical review in China in recent years, points out that there are some outstanding problems and challenges in the current ethical review, such as the unsound legal system, the lack of independence and standardization, the imperfect mode of review, the insufficient ability of review and the weak mechanism of supervision, and focuses on the measures and suggestions to strengthen ethical review in clinical research by the means of adhering to the guidance of the legal system, enhancing the independence and impartiality of review, coordination and complementarity of various review models, improving capacity and efficiency, and strengthening supervision, in order to better protect the rights and interests of subjects and promote the healthy development of clinical research.
		2020 Vol. 17 (14): 194-封三 [Abstract] ( 242 ) HTML (1 KB) PDF (621 KB) ( 76 )

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