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2020 Vol. 17, No. 19
Published: 2020-07-05
4
Gender difference of cardiac function and the ACE and AT1 mRNA and protein expression in heart tissue of renovascular hypertensive rats
Maimaitituer·Kelimu1,2 Wuliya·Yiming1 Awaguli·Dawuti1 LIU Dan1 Ainiwaer·Wumaier1
Objective To investigate gender difference of cardiac function and the angiotensin converting enzyme (ACE) and AT1 mRNA and protein expression in heart tissue of renovascular hypertensive rats. Methods The renovascular hypertensive rat model was established in 75 SD rats by two-kidney one-clip (2K1C) method and 25 female rats among them were prepared with low estrogen renovascular hypertensive model by removing bilateral ovaries. A total of 75 SD rats were divided into three groups, namely, male 2K1C group (2K1C-M group), female 2K1C group (2K1C-F group), and female ovariectomized group (2K1C-OVX group), with 25 rats in each group. At 32 weeks, weight was measured and cardiac hemodynamics was performed and then the heart was quickly taken out, rinsed with normal saline and frozen in liquid nitrogen. Part of the left ventricular myocardial tissue specimens were left, protein expression was detected by Western blot, and mRNA expression of relevant molecules in the tissue was detected by RT-PCR. Results The hemodynamic results showed that the systolic blood pressure of the 2K1C-OVX group was significantly lower than that of the 2K1C-F group, and the difference was statistically significant (P < 0.05). The maximum indoor pressure drop rate in the 2K1C-OVX group was significantly higher than that in the 2K1C-F group, and the difference was statistically significant (P < 0.05). RT-PCR results showed that ACE1, AT1a and AT1b mRNA expression levels of the 2K1C-M group were higher than those of the 2K1C-F group and 2K1C-OVX group, while ACE2 mRNA expression level was lower than that of the 2K1C-F group and 2K1C-OVX group, with statistically significant differences (all P < 0.05). In terms of protein expression, the AT1 protein expression level in the 2K1C-M group was higher than that in the 2K1C-F group and 2K1C-OVX group, while ACE2 protein expression level was lower than that in the 2K1C-F group, with statistically significant difference (all P < 0.05). Conclusion The cardiac function, mRNA and protein expressions of ACE1 and AT1 in cardiac tissue show gender difference in renovascular hypertensive rats.
2020 Vol. 17 (19): 4-7 [
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In vitro culture and identification of tubal pregnancy trophoblast cells
JIAN Yongnan1 ZHENG Wenlan2
Objective To explore the methods and identification of tubal pregnancy trophoblasts in vitro. Methods The villi of 3 patients with early tubal pregnancy admitted to the Department of Gynecology, the First Affiliated Hospital of Guizhou University of Chinese Medicine were taken. Collagenase-trypsin mixed digestion method was used to digest cells, and differential adherence method was used to purify and isolate cells. Finally, the cells were identified by immunofluorescence confocal method. Results Co-expression of keratin and vimentin was detected by immunofluorescence double-labeling staining. Conclusion Microscope and immunofluorescence can detect cell shape and skeleton. It is preliminarily determines that the cell may be a trophoblast cell.
2020 Vol. 17 (19): 8-10,15 [
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67
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Study on the antitumor activity of CAR-NK-92 cells targeting MSLN in gastric cancer
ZHANG Jun1 DONG Yalu2
Objective To explore the antitumor activity of NK-92 cells modified with chimeric antigen receptor targeting mesothelin (MSLN) in gastric cancer. Methods The second generation chimeric antigen receptor targeting MSLN was constructed and transfected into NK-92 cells by lentivirus transfection to obtain MSLN CAR-NK-92 cells. The expression of MSLN in human gastric cancer tissues and human gastric cancer cells was detected by immunohistochemistry, flow cytometry and Western blot. The specific recognition ability and the anti-tumor activity of CAR-NK-92 cells were studied through in vitro activation and in vivo tumor inhibition experiments. Results MSLN was highly expressed in human gastric cancer tissue and tumor cells. CAR-NK-92 cells could specifically activate and lyse tumor cells. Compared with NK-92 cells transfected with an empty vector, CAR-NK-92 cells can significantly inhibited the growth of gastric cancer (P < 0.01). Conclusion CAR-NK-92 targeting MSLN has shown significant activity in vivo and in vitro to kill gastric cancer cells specific to MSLN+, which may provide a new idea in the treatment of gastric cancer.
2020 Vol. 17 (19): 11-15 [
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195
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Expression and function study of kisspeptin/kiss1r system in the ovaries of rats with polycystic ovarian syndrome
LIU Ranran1 LUO Qianqian2 SUN Xiaojuan1 LI Lianqin1 ZHANG Hongqin2
Objective To establish a rat model of polycystic ovary syndrome (PCOS) and investigate the expression and function of kisspeptin/kiss1r system in ovarian tissue. Methods Twenty Wistar rats at the 10th day of gestation were divided into PCOS group and normal group according to the random number table method, with 30 rats in each group. In PCOS group, Letrozole and carboxy methyl cellulose (CMC) were administered continuously for 21 days, while in normal group, CMC of equal volume was administered. Body weight parameters and serum hormone levels of two groups were measured after model establishment; the ovarian histomorphology was detected by HE staining; the expression of kisspeptin and kiss1r in the ovarian tissue was detected by immunohistochemistry and qRT-PCR. Results Compared with normal group, the weight, the content of retroperitoneal fat and the weight of ovary in PCOS group were increased, and the levels of serum luteinizing hormone, follicle stimulating hormone and testosterone were increased (P < 0.05 or P < 0.01). Compared with normal group, the expression of kiss1-mRNA in the ovaries of PCOS group was decreased (P < 0.05). There was no significant difference in kiss1r-mRNA expression between two groups (P > 0.05). PCOS group showed typical polycystic changes in ovaries. Conclusion Down-regulation of kisspeptin/kiss1r system in the ovaries of PCOS rats may play an important role in the occurrence and development of PCOS.
2020 Vol. 17 (19): 16-19 [
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Effects of different imaging techniques based on dual-source CT on examination efficiency and image quality of coronary CTA
GONG Wanfeng AO Weiqun JIA Yuzhu XU Zhihua WANG Jian CAO Yulin
Objective To investigate the effects of different techniques based on dual-source CT on examination efficiency and quality of coronary CT angiography (CTA). Methods A total of 107 patients undergoing coronary CTA in Tongde Hospital of Zhejiang Province from June 2018 to October 2019 were collected, while they were divided into group A (55 cases, using low-dose test technology) and group B (52 cases, using contrast agent automatic tracking technology) by simple random grouping method. The age, body mass index (BMI), heart rate, radiation dose and examination time of the two groups were recorded, and the image signal-to-noise ratio (SNR), contrast noise (CNR) and CT values of the two groups were measured, while the coronary artery image quality were evaluated and compared. Results There were no significant differences in age, BMI, heart rate, volume CT dose index, effective dose, CT of different segments of coronary artery, SNR of aortic root and each segment of coronary artery between the two groups (P > 0.05). The CNR of distal right coronary artery and distal left circumflex artery in group B were superior to group A, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in image quality ratings between the two groups (P > 0.05). The examination time of group B was significantly shorter than that of group A, and the difference was highly statistically significant (P < 0.01). Conclusion Contrast agent automatic tracking technology can improve the inspection efficiency under the premise of ensuring image quality.
2020 Vol. 17 (19): 20-22 [
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Application value and clinical significance of elastica staining in visceral peritoneal elastic lamina invasion and vascular invasion of colorectal cancer
YU Xuejiao1 ZHANG Fang2 ZHOU Lei2 WEI Xiaoming2 HUANG Weiqing2
Objective To explore the application value and clinical significance of elastica staining in identifying visceral peritoneal elastic lamina invasion and vascular invasion of colorectal cancer. Methods From January 2013 to December 2016, 75 colorectal cancer histological specimens were selected from Qingdao Municipal Hospital, the peritoneal invasion of the visceral layer, the peritoneal invasion of the visceral layer and the vascular invasion in the specimens were observed by conventional HE staining and lichen red elastic fiber staining. The relationship among lymph node metastasis, vascular invasion, nerve invasion and tumor budding were observed. Correlations between visceral peritoneal elastic lamina invasion and lymph metastasis, vascular invasion, perineural invasion, tumor budding were also investigated. Results Elastic fiber staining results showed the positive rate of visceral peritoneal elastic lamina invasion was higher than that of HE staining, and the difference was statistically significant (P < 0.05); the incidence of lymph metastasis, vascular invasion and tumor budding in visceral peritoneal elastic lamina invasion positive cases were higher than those in peritoneal elastic lamina invasion negative cases, the differences were statistically significant (P < 0.05); the incidence of nerve invasion in patients with positive visceral peritoneal elastic layer invasion was higher than that in patients without visceral peritoneal elastic layer invasion, and the difference was statistically significant (P < 0.05); elastic fiber staining revealed that the detection rate of vascular invasion was higher than HE staining, and the difference was statistically significant (P < 0.05), and with 100.00% specificity and the 65.8% sensitivity. Conclusion Elastic fiber staining can significantly improve the detection rate of visceral peritoneal elastic layer invasion and vascular invasion. Patients with positive visceral peritoneal elastic layer invasion suggest poor tumor prognosis, and visceral peritoneal elastic layer invasion may be one of the clinicopathological indicators for colorectal cancer staging.
2020 Vol. 17 (19): 24-26,34 [
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Study on quality evaluation of removing rough bark of officinal magnolia bark based on UPLC fingerprint
LI Yanzhen1,2 LU Yun1,2 CHEN Danyan1,2 WANG Shoufu1,2 JIANG Qiwen1,2 WEI Mei1,2
Objective To study the content of main components and fingerprint differences of officinal magnolia bark, removing rough bark of officinal magnolia bark, rough bark of officinal magnolia bark, and provide evidence for the used as medicine of removing rough bark of officinal magnolia bark. Methods Waters Acquity UPLC BEH-C18 column (50 mm×2.1 mm, 1.7 μm) was used as the column. Acetonitrile-0.2% phosphoric acid solution was used as mobile phase for gradient elution. The flow rate was 0.4 mL/min, column temperature was 35℃, and the detection wavelength was 230 nm. The contents of magnolol and honokiol were determined for officinal magnolia bark from different areas, removing rough bark of officinal magnolia bark, rough bark of officinal magnolia bark. The peak area of the common peak was compared, and the similarity was analyzed. Results The total contents of magnolol and honokiol was removing rough bark of officinal magnolia bark>officinal magnolia bark>rough bark of officinal magnolia bark. The peak area of 6 common peaks of removing rough bark of officinal magnolia bark was higher than that of officinal magnolia bark and rough bark of officinal magnolia bark. Conclusion It can improve the quality of officinal magnolia bark pieces and provide experimental reference for removing rough bark of officinal magnolia bark.
2020 Vol. 17 (19): 27-30 [
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Study on the optimization of extraction technology and antioxidant activity of total flavonoids from lasianthus lancilimbus
CHEN Qingyao1 LIN Shuisen1 XIE Zhixin1 LIN Yangjun1 XIE Yonghua2
Objective To study the optimum extraction condition and the antioxidant activity of total flavonoids from lasianthus lancilimbus. Methods The orthogonal experiment was designed to optimize the extraction process. The antioxidant activity was evaluated by DPPH free radical, superoxide anion radical and hydroxyl free radical scavenging ability. Results The optimum extraction condition was obtained as follows: the extraction time was 60 min, the solid-liquid ratio of 1∶40 (g/mL), ethanol concentration was 40%. The scavenging abilities for DPPH free radical, superoxide anion radical and hydroxyl free radical were obviously related to the concentrations. Conclusion The total flavonoids from lasianthus lancilimbus have strong antioxidant activities.
2020 Vol. 17 (19): 31-34 [
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Research progress of caspase-1 in ocular disease
LI Huazhang1 LI Zhijian2
Cysteinyl aspartate specific proteinase-1 (caspase-1) as an inflammation regulator has been shown to be a key link in inflammation regulation and cell apoptosis. A large number of studies have shown that caspase-1 is widely involved in the molecular mechanisms of cardiovascular diseases, metabolic diseases and liver cirrhosis and other systemic diseases. Caspase-1 is also closely related to the occurrence of a variety of ophthalmic diseases, and plays an important role in common diseases such as age-related cataracts, age-related macular degeneration and diabetic retinopathy. This article mainly summarizes the role of caspase-1 in the above diseases.
2020 Vol. 17 (19): 35-37 [
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Advances in the research of pre-medical care plan for dementia patients
WANG Bo1 YIN Yongtian2▲ ZHANG Ping1 ZHANG Xiaoman1 CHEN Lijun1
The population of dementia group is increasing rapidly, which brings heavy psychological and care burden to patients, families and society. Advance care planning (ACP), as an important part of high-quality care for Alzheimer′s disease and other dementia patients, can help improve the quality of life and hospice care for dementia patients. This paper reviews the related concepts of ACP, the necessity of ACP implementation in dementia patients, the status of ACP implementation, the implementation plan and effect, and the influencing factors that hinder its implementation, in order to provide reference for better implementation of ACP in dementia population in China in the future.
2020 Vol. 17 (19): 38-42 [
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Research progress of vitamin D, diabetic nephropathy and osteoporosis in Chinese and Western medicine
HAN Yumei1 TIAN Fengsheng2▲ BAI Hailong2
Diabetic nephropathy is one of the most common microvascular complications of diabetes. With the progress of the course of the disease, the loss of vitamin D increases, and the lack of hydroxylation of vitamin D lead to the occurrence of osteoporosis, which belongs to the kidney main bone marrow theory of traditional Chinese medicine. Vitamin D is a steroid hormone, and its deficiency is not only linked to osteoporosis, but also to the development of diabetic kidney disease. Osteoporosis brings heavy burden to family and society, which attracts more and more people′s attention.
2020 Vol. 17 (19): 43-46 [
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Research progress on surgical treatment of thoracolumbar spinal tuberculosis
SHI Zhengwei WU Jianchao ZHOU Jianwei PAN Yixin LI Shaoping WANG Yuliang
Spinal tuberculosis is a localized manifestation of tuberculosis in the osteoarticular system. Antituberculosis medication alone often results in neurological dysfunction and kyphosis. Surgery is the ultimate treatment for spinal tuberculosis. Thorough removal of lesions and reconstruction of spinal stability are fundamental strategies for surgical treatment of spinal tuberculosis. At present, there is no uniform standard surgical guideline, and the choice of surgical approach is still controversial. This article reviews the surgical treatment of thoracolumbar tuberculosis, in order to improve the understanding of the disease.
2020 Vol. 17 (19): 47-50 [
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Effect comparison of case-based collaborative learning and problem-based learning in clinical noviciate teaching of dermatology
WANG Lijuan GE Rui ZHOU Yan HAN Dan MOU Kuanhou MU Xin
Objective To compare the educational effectiveness of case-based collaborative learning (CBCL) and problem-based learning (PBL) in the clinical noviciate teaching of dermatology. Methods From January to December 2018, 32 undergraduate students of clinical majors were selected for clinical probation in the Department of Dermatology of the First Affiliated Hospital of Xi′an Jiaotong University, which was divided into CBCL teaching group (16 cases) and PBL teaching group (16 cases) by random number table method. After the end of clinical probation, the teaching effect of the two teaching modes in clinical probation of dermatology was evaluated comprehensively according to the theoretical examination results, the degree of clinical skill mastery and the teaching effect questionnaire scores. Results There were no significant differences in theoretical test scores and clinical skill proficiency between two group (P > 0.05). However, for students with lower than average scores in previous exams, the theoretical exam scores of CBCL group were higher than those of PBL group, with statistically significant differences (P < 0.05). The questionnaire showed that more students in CBCL group thought the teaching mode applied in teaching was interesting and highly engaged. Conclusion In clinical probation teaching of dermatology, CBCL teaching mode is more helpful to mobilize the enthusiasm and initiative of students with low academic performance in learning theoretical knowledge.
2020 Vol. 17 (19): 51-54 [
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Evaluation of the effect of Presentation-Assimilation-Discussion classroom teaching system on cultivating college students′ core literacy
LIU Qiaofeng LIANG Yundan FAN Meng CHEN Wei GUAN Xuan WANG Xin▲
Objective To study the method and effect evaluation of using Presentation-Assimilation-Discussion classroom teaching method to improve students′ core literacy in neurobiology courses. Methods In September 2019, 98 students on the elective neurobiology course at Chengdu Medical College were enrolled as the research subjects. Presentation-Assimilation-Discussion classroom teaching method was used in teaching, and questionnaires were used to evaluate the core qualities that students wanted to improve and the effect of cultivating core qualities in the Presentation-Assimilation-Discussion classroom teaching system. Results The core competence that students wanted to improve before starting the course was self-study ability, critical thinking ability, innovation ability, communication and expression ability and cooperation ability. The students′ core literacy ability after the implementation of Presentation-Assimilation-Discussion classroom was higher than that before the implementation, and the difference was highly statistically significant (P < 0.01), among which the improvement of self-learning ability was the most obvious. Conclusion Presentation-Assimilation-Discussion classroom teaching method improves students′ core quality, conforms to students′ development requirements, and promotes the development of medical education.
2020 Vol. 17 (19): 55-57,61 [
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Application of the diagnosis and treatment guidelines to standardized training in urology residency
LIU Zelin ZHAI Guanzhong WANG Qinghua WANG Xiao GUO Jia▲
Objective To evaluate the clinical teaching effect of urological disease diagnosis and treatment guidelines in the standardized training of urological residents. Methods From September 2016 to September 2019, a total of 80 students in the standardized training were selected for rotation in the Department of Urology, Renmin Hospital of Wuhan University. According to the educational level of the regular students (bachelor, master, doctor), stratified and randomly divided into two groups. Guideline group guides clinical diagnosis and treatment with reference to Chinese Guidelines for Diagnosis and Treatment of Urological Diseases (40 cases). The control group referred to Surgery for guidance in clinical diagnosis and treatment (40 cases), the normalized training time both were 3 months. The two groups of were evaluated and surveyed by questionnaire when they were leaving the department, and their professional theoretical knowledge, case analysis, writing of medical records, clinical skills and operational ability and satisfaction with teaching were compared between the two groups. Results The scores of professional theoretical knowledge, case analysis, and writing of medical records in the guide group were all higher than those in the control group, with statistically significant differences (P < 0.05). There was no statistically significant difference between the two groups in clinical skill operation scores (P > 0.05). The students′ satisfaction with teaching in the guide group was higher than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion The application of the diagnosis and treatment guidelines to the standardized training in urology residency can improve the training effect, and enhance the learning interest and satisfaction of students. This provides a theoretical basis for further application and popularization of diagnosis and treatment guidelines in the resident doctor standardization training.
2020 Vol. 17 (19): 58-61 [
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Application research of smart classroom in pharmacy professional course teaching
LI Gang WANG Chenping ZHEN Jiahuan HU Weijun JIA Yi DOU Yin
The application of smart classroom in colleges and universities is more and more extensive. How to make full use of the advantage of smart platform to obtain high-quality teaching effect has become the focus of the majority of educators. Taking the pharmacy professional course as a pilot, Department of Pharmaceutics, Army Medical University (hereinafter referred to as “our university”) based on the “Dofar intelligent teaching system” established by our university summarizes a series of suitable training programs after detailed exploration of multiple related factors, including teachers, students, teaching content, etc.. After the implementation of the scheme, the efficiency of intelligent teaching has been significantly improved, which is mainly reflected in the high efficiency of knowledge transfer, collaborative learning and personalized learning, pleasant scientific research output, and strong sense of belonging to the subject. This study also provides an effective reference for the application of smart classrooms in other universities and different disciplines.
2020 Vol. 17 (19): 62-65 [
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Analysis of recessive education in college English teaching in medical colleges
LIU Qi ZHANG Yan SHI Xue
In college English teaching activities, the education of infiltrating the core values of socialism is of great significance both in deepening teaching reform and promoting students′ growth. Nowadays, the training of qualified medical personnel with high quality and high skills has become an educational consensus in medical colleges. Moreover, the implicit education in English teaching can play a significant value in teaching development and talent training, which is increasingly attracting attention from society, teachers and students. Therefore, how to efficiently carry out implicit education in college English teaching is a key task for medical colleges. In this paper, the definition of implicit education, the importance of introducing implicit education in college English teaching are analyzed, discusses the practical significance and constituent elements of implicit education in college English teaching in medical colleges, and the three constituent elements of implicit education in college English teaching are proposed, namely teachers, teaching materials, and teaching methods. Starting from these three constituent elements, this paper analyzes the construction of implicit education curriculum in college English, and discusses the practical significance and constituent elements of implicit education in college English teaching in medical colleges. In addition, suggestions are given on how to develop implicit education in college English teaching in medical colleges.
2020 Vol. 17 (19): 66-69 [
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Countermeasure research on international talents training in acupuncture and massage under the background of “One Belt And One Road” construction
BAI Yu1 LIU Chuming1 ZHOU Donglei2 GUAN Xinrui1 CHEN Yusu1 LI Hewei3
Under the background of “One Belt And One Road” construction, acupuncture and massage has ushered in an unprecedented opportunity for development, and its therapeutic and health care effect is significant, suitable for international development needs. However, at present, the internationalization training of traditional Chinese medicine colleges and universities is relatively weak, the talent gap is large, and the specialty setting is single, which makes it difficult to meet the practical needs of the international development of traditional Chinese medicine. Therefore, traditional Chinese medicine colleges and universities need to combine the characteristics of countries along the “One Belt And One Road” route, perfect the construction of the existing curriculum system, strengthen the professional characteristic therapy skills training, strengthen the promotion and popularization of traditional Chinese medicine culture, promote the international culture exchange, set up effective communication platform, establish the way of training international talents of acupuncture and massage, provide talent support for the international development of acupuncture and massage.
2020 Vol. 17 (19): 70-73 [
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Analysis on the reform of medical experiment teaching under the background of “Internet +”
WEI Haifeng1 LI Yan2 LIU Qiao3 WANG Yuan4 WANG Shijun4 MA Ke4 ZHAO Haijun4
The national health strategy puts forward higher requirements for the quality of medical education. Medical experimental teaching occupies an important position in the medical higher education system and is of great significance to the training of medical talents. However, medical experimental teaching is faced with such difficulties as low status, insufficient attention of students, more verifiable experiments, less comprehensive experiments, scattered curriculum system, and disconnection from clinical practice. Under the era background of the “Internet +”, there are more bail-out strategy in medical experimental teaching: through the integration of education and technology, the first one is to form integrated medical experimental teaching courses, the second one is to carry out experimental teacher training based on “Internet +”, the third one is to build digital experimental teaching environment, the forth one is to carry out reform and exploration based on “Internet +” experimental teaching method, and the fifth one is to develop the experiment teaching course suitable for intelligent terminal. Through the implementation of the “Internet +” medical experiment teaching bail-out strategy, plays the important role of medical experimental teaching in personnel training, and contribute to the “healthy China′s 2030 strategy”.
2020 Vol. 17 (19): 74-77 [
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Study on the role of Berberine combined with Quadruple therapy in initial Helicobacter pylori eradication
XU Xiaoqing ZHOU Fan WU Xiaoxi LU Juan CAO Qin
Objective To investigate the efficacy and safety of Berberine combined with Quadruple therapy as a primary therapy for Helicobacter pylori(Hp) eradication. Methods A total of 100 Hp infected patients with chronic gastritis diagnosed by gastroscopy were enrolled in Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from November 2018 to November 2019. They were divided into the experimental group and the control group by random number table method, with 50 cases in each group. The control group was treated with Quadruple therapy,while the experimental group was treated with Berberine on the basis of the control group. The curative effect, eradication rate and adverse reactions of two groups were assessed. The drug resistance of Hp were tested for three common antibiotics by the agar dilution method, and the effect of antibiotic resistance on the eradication rate of the two groups was analyzed. Results According to the treatment intention analysis, the Hp eradication rate in the experimental group was higher than that in the control group, and the difference was statistically significant (P < 0.05); according to the per-protocol analysis, there was no statistically significant difference in Hp eradication rate between the two groups (P > 0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P > 0.05), and the incidence of nausea and diarrhea in the experimental group was significantly lower than that in the control group (P < 0.05). The resistant rates of Hp to Clarithromycin, Metronidazole and Amoxicillin were 32.0%, 64.0%, 0.0%, respectively. The eradication rate of the experimental group was significantly higher than that in the control group in patients with clarithromycin-resistant strains (P < 0.05). Conclusion Berberine combined with Quadruple therapy can increase the eradication rate of Hp and has high safety. It can be used as an option for first-line treatment in areas with high resistance to Hp Clarithromycin.
2020 Vol. 17 (19): 78-81 [
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Influence factors of postoperative delirium after orthopaedic surgery in older adults
LI Min LIU Di CHENG Xiangyang LIANG Qisheng
Objective To study the influence factors of postoperative delirium in olderly patients with artificial joint replacement, so as to provide basis for effective prevention and treatment of postoperative delirium in elderly patients. Methods A total of 151 cases of artificial joint replacement patients undergoing prosthetic replacement surgery at the Department of Orthopedics of the First Affiliated Hospital of Bengbu Medical College from October 2018 to August 2019 were selected as the subjects. The frailty scale was used to measure the frailty of the patients before surgery, and the age, sex, anxiety score (APAIS), Charlson comorbidities index (CCI), daily activity score (ADL), albumin level, American Society of Anesthesiology grading (ASA) and other general data were recorded. Patients with postoperative delirium were screened out according to delirium scale (CAMCR). The patients were divided into the postoperative delirium group and the non-postoperative delirium group, and risk factors of postoperative delirium were analyzed. Results There were 37 cases in the postoperative delirium group and 114 cases in the non-postoperative delirium group. The incidence of postoperative delirium was 24.5%. Compared with the non-postoperative delirium group, the postoperative delirium group was older, the preoperative anxiety score was higher, the Charlson score was higher, the ADL score was lower, and the numbers of debilitating was more, the differences were statistically significant (all P < 0.05). Binary regression analysis showed that weakness, anxiety, co-existence of various diseases and decreased ability of daily activities were independent risk factors for postoperative delirium (P < 0.05). Conclusion Frailty, anxiety, comorbidities and decreased ability of daily activities are independent influence factors for postoperative delirium in elderly patients undergoing artificial joint replacement.
2020 Vol. 17 (19): 82-84,92 [
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Application effect and bleeding risk observation of titanium clip in EMR of colonic polyp
GU Shisong LYU Ke ZHU Kedong▲
Objective To study the effect and bleeding risk of titanium clips in endoscopic mucosal resection (EMR) of colorectal polyps. Methods From January 2018 to December 2019, 50 patients with colonic and rectal polyps who admitted to the Department of Gastroenterology, the First People′s Hospital of Chuzhou were selected as the study objects. They were divided into the observation group and the control group according to the random number table method, with 25 cases in each group. Routine EMR was performed in the control group, while titanium clip was used in the observation group on the basis of the control group. The operation time, intraoperative bleeding volume, recovery time of bowel sounds, visual analogue scale (VAS) score of defecation pain, score of defecation difficulty, secondary operation rate and complications during hospitalization were compared between the two groups. The levels of cortisol (COR), adrenaline (E), noradrenaline (NE) and dopamine (DA) were compared before and 12 h after operation. Results The amount of bleeding, VAS score and the number of secondary operations in the observation group were significantly lower than those in the control group (P < 0.05). Compared with pre-operation, the postoperative COR, E, NE and DA of the two groups were increased, and the difference was statistically significant (P < 0.05). There was no statistically significant difference in COR, E, DA between the two groups (P > 0.05). The postoperative NE of the observation group was lower than that of the control group, and the difference was statistically significant (P < 0.05). The incidence of bleeding and complications in the observation group were significantly lower than those in the control group, and the differences were statistically significant (all P < 0.05). Conclusion The application of titanium clip in EMR of colon and rectum polyp can reduce the risk of bleeding and the incidence of postoperative complications.
2020 Vol. 17 (19): 85-88 [
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Association study on neuroimaging features and cognitive impairment of patients with cerebral microbleeds
TAN Qingjing LIU Yonghui YANG Junwei WANG Tianbao LIN Haohai
Objective To study the association between the neuroimaging features and cognitive impairment of patients with cerebral microbleeds. Methods From December 2017 to October 2019, 60 patients with cerebral microhemorrhage who admitted to the District Two, Department of Encephalopathy in the First Affiliated Hospital of Guangxi University of Chinese Medicine were selected as the observation group and 60 healthy subjects as the control group. The degree of cognitive impairment was assessed using the mini-mental state examination (MMSE) and the montreal cognitive assessment (MoCA), and the relationship between the fractional anisotropy (FA) and average diffusion coefficient (ADC) as well as the number of intracerebral microhemorrhages and cognitive impairment was observed using magnetic resonance plain scan and multimodal magnetic resonance imaging. Results The MMSE score and MoCA score of the observation group were significantly lower than those of the control group (P < 0.05). FA values of frontotemporal, parietal and basal ganglia regions in the observation group were significantly lower than those in the control group (P < 0.05), ADC values of frontotemporal, parietal and basal ganglia regions were higher than those in the control group (P < 0.05). There was no significant difference in FA and ADC values between the two groups (P > 0.05). The number of intracerebral microhemorrhage in the observation group was significantly higher than that in the control group (P < 0.05). Cognitive dysfunction in patients with cerebral microvascular disease was correlated with the FA and ADC values of frontotemporal lobe and the number of intracerebral microhemorrhage (P < 0.05). Conclusion The cognitive impairment in patients with cerebral microbleeds is strongly associated with the severity of white matter damage and the number of microbleeds.
2020 Vol. 17 (19): 89-92 [
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Relationship between the expression of IgE, IgG1 and T cell activation in anaphylactic shock caused by cystic echinococcosis
LI Jie DAI Qing Yali·Yasen NIU Yue MA Yan
Objective To explore the relationship between specific allergens and T cell activation during anaphylactic shock caused by cystic echinococcosis, and to provide new ideas for clinical treatment. Methods Serum was collected from 30 patients (research group) who were underwent cystic hydatid cystectomy in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2017. The patients with anaphylactic shock during the operation were taken as the anaphylactic shock group (10 cases), while patients without anaphylactic shock were taken as the non-anaphylactic shock group (20 cases), and the blood samples of healthy examinees from the same period were selected as the control group (30 people). The levels of serum immunoglobulin (Ig) E and IgG1 in each group were analyzed, while the expression levels of interleukin (IL)-10, IL-4, IL-2 and γ interferon (IFN-γ) in the serum of each group were detected, and correlation analysis was performed. Results The expression levels of IgE and IgG1 during the operation in the anaphylactic shock group were higher than those in the non-anaphylactic shock group, and the differences were statistically significant (P < 0.05). There were no statistically significant differences in serum IgE and IgG1 expression levels among the groups after 1 week of operation (P > 0.05). The expression levels of serum IL-4 and IL-10 before the operation in the study group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The serum IL-4 and IL-10 during the operation in the anaphylactic shock group were lower than those in the non-anaphylactic shock group, while the IFN-γ and IL-2 were higher than those in the non-anaphylactic shock group, and the differences were statistically significant (P < 0.05). The serum IL-4 and IL-10 expression levels of the anaphylactic shock group were higher than those of the non-anaphylactic shock group and the control group after 1 week of operation, and the differences were statistically significant (P < 0.05). IgE was positively correlated with IL-2 and IFN-γ (r = 0.96, 0.68, P < 0.05), while IgG1 was positively correlated with IL-2 and IFN-γ (r = 0.60, 0.79, P < 0.05). Conclusion As long as anaphylactic shock occurs, Th1 and Th2 type cells are imbalanced. Th1 type plays a leading role in anaphylactic shock, and its activation is related to IgE and IgG1.
2020 Vol. 17 (19): 93-96 [
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Clinical study of Huaier Granules combined with Taxol and Oxaliplatin in the treatment of advanced gastric cancer
XU Ming1 TANG Shu2 LIU Qi3
Objective To explore the clinical effect of Huaier Granule combined with Taxol and Oxaliplatin in the treatment of advanced gastric cancer. Methods A total of 100 patients with advanced gastric cancer who were treated in Chenzhou NO.1 People′s Hospital from January 2017 to January 2019 were selected as the research object, while they were divided into observation group (50 cases) and control group (50 cases) by random number table method. The control group was treated with Taxol and Oxaliplatin, and the observation group was treated with Huaier Granules on the basis of the control group. The clinical efficacy, serum carcinoembryonic antigen (CEA), sugar chain antigen 724 (CA724), sugar chain antigen 199 (CA199), T lymphocyte subsets, quality of life and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). After treatment, the levels of CEA, CA724, and CA199 in the two groups were significantly lower than those before treatment, while the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). The levels of CD3+, CD4+, CD4+/CD8+ in the two groups were significantly higher than those before treatment, while the observation group were higher than those in the control group; the CD8+ levels of the two groups were significantly lower than those before treatment, while the observation group was lower than the control group, and the differences were statistically significant (P < 0.05). The quality of life of the two groups were significantly higher than those before treatment, while the observation group was higher than the control group, and the differences were statistically significant (P < 0.05). The total incidence of adverse reactions between the two groups was not statistically significant (P > 0.05). Conclusion The use of Huaier Granules combined with Taxol and Oxaliplatin in patients with advanced gastric cancer has a significant effect, which can effectively improve the serum tumor marker levels and quality of life of patients.
2020 Vol. 17 (19): 97-100 [
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Analysis of risk factors and pathogenic bacteria in patients with acute stroke complicated with severe pneumonia
LI Kuangyi FENG Jinfang WU Zhixin KUANG Minhua ZHONG Juying CAI Hairong HONG Dandong
Objective To investigate the risk factors and pathogenic bacteria distribution in patients with acute stroke complicated with severe pneumonia. Methods A total of 431 patients with acute stroke treated in Foshan Hospital Traditional Chinese Medicine, Guangdong Province from January 2016 to May 2019 were retrospectively analyzed. According to whether or not with severe pneumonia, they were divided into severe pneumonia group (53 cases) and without severe pneumonia group (378 cases). The risk factors of acute stroke complicated with severe pneumonia, the type of pathogenic bacteria in patients and the results of drug sensitivity were analyzed. Results The age, hospital stay, Glasgow coma scale (GCS) score, national institutes of health stroke scale (NIHSS) score, invasive procedure, chronic obstructive pulmonary disease (COPD) and diabetes were compared between the two groups, and the differences were statistically significant (P < 0.05). Logistic regression analysis showed that age (OR = 1.131), GCS score (OR = 0.663), NIHSS score (OR = 2.467), and invasive procedures (OR = 16.890) were the influencing factors of stroke complicated with severe pneumonia (P < 0.05). Among the 431 patients with acute stroke, 53 cases were secondary to severe pneumonia, with an infection rate of 12.3%. 38 strains of pathogenic bacteria were cultured, including 28 strains of Gram-negative bacteria (73.7%), 8 strains of Gram-positive bacteria (21.1%), and 2 strains of fungi (5.2%). The top three Gram-negative bacteria were Pseudomonas aeruginosa, Acinetobacter baumannii, and Escherichia coli. Gram-positive bacteria were mainly Staphylococcus aureus and fungi were Candida albicans. Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae had a higher resistance rate to Cefazolin, Ceftriaxone, Ciprofloxacin, Levofloxacin and Gentamicin (resistant drug rate>50%); more sensitive to Carbapenem antibiotics meropenem and Imipenem, and Quinolones ciprofloxacin and Levofloxacin (resistance rate<20%). Conclusion In patients with acute stroke, it is necessary to fully evaluate the underlying diseases of patients and adopt an active treatment measure. In terms of pathogenic bacteria, acute stroke complicated with severe pneumonia is mainly caused by Gram-negative. In the choice of early antibiotics, attention should be paid to avoiding the abuse of antibiotics and reducing the emergence of resistant strains.
2020 Vol. 17 (19): 101-104 [
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Professor Chen Tongyun′s clinical medication experience in treating melasma
LIU Ting1 SUN Liyun2 QU Jianhua2▲
Objective To analyze and summarize the experience of Professor Chen Tongyun′s clinical medication experience in treating melasma. Methods A total of 109 medical records of melasma patients treated by Professor Chen Tongyun in Beijing Traditional Chinese Medicine Hospital, Capital Medical University were collected from September 2017 to July 2019. These medical records from the category, character, taste, and meridian tropism of Chinese herbal medicines were summarized and analyzed. Results Regarding the type of medication, the most frequently used drugs were tonic and activating blood stasis medicine, which were 40.99% and 29.00% respectively. In terms of medicinal properties, thermophilic drugs accounted for the majority (49.05%), mediocre drugs accounted for 30.50%, and cold drugs accounted for 20.44%. In terms of medicinal taste, the use frequency of bitter, sweet and spicy medicines were significantly higher than other medicines, which were 29.07%, 29.26% and 28.75% respectively. In terms of medicines, the proportion of medicines in the five internal organs was large, about 84.38%. Among the visceral meridians, liver meridian accounts for the largest proportion, followed by spleen meridian and kidney meridian. Conclusion Professor Chen Tongyun′s clinical treatment of melasma is mainly based on the method of replenishing deficiency and promoting blood circulation and removing blood stasis. The professor attaches importance to liver and kidney, and takes care of the spleen and stomach. Most of the medications are spicy, bitter, sweet, and warm and calming drugs.
2020 Vol. 17 (19): 105-107,111 [
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104
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Effect of Propofol combined with Sevoflurane on brain index and cognitive function after general anesthesia in children
WU Shubao1 CHENG Wei2
Objective To observe the effect of Propofol combined with Sevoflurane anesthesia on brain index and cognitive function in children under general anesthesia. Methods According to the difference of anesthesia methods during operation, a total of 96 children undergoing general anesthesia in Xinyi People′s Hospital, Jiangsu Province were divided into simple group (epidural Propofol anesthesia) and compound group (epidural Propofol + laryngeal mask Sevoflurane anesthesia) with 48 cases in each group. The brain index between the two groups 1 min before anesthesia and 30 min after anesthesia, cognitive function scores before and 3 days after surgery, and adverse reactions during and after surgery were compared. Results Compared with 1 min before anesthesia, the brain index of children in the simple group were significantly reduced 30 minutes after anesthesia, while the composite group were significantly lower than those in the simple group, and the differences were statistically significant (P < 0.05). Compared with before surgery, the Montreal cognitive assessment scale scores of children in the simple group were significantly decreased on 3 days after surgery, while the composite group were significantly higher than those in the simple group, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in the adverse reaction rate between the two groups (P > 0.05). Conclusion Simple epidural Propofol general anesthesia has a certain effect on the brain index and cognitive function in children after surgery, but Propofol combined with Sevoflurane has little effect on the brain index and cognitive function in children after general anesthesia.
2020 Vol. 17 (19): 108-111 [
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Mechanism of Lycii Fructus on the basis of network pharmacology
GUO Yanli1 LIU Weili1 WU Lihong1 JU Aixia2 SUN Shuang2 LI Qiuhong2
Objective To study the main active components and targets of Lycii Fructus by network pharmacology, and speculate the possible pharmacological mechanism. Methods The bioactive components of Lycii Fructus were searched on the platform of BATMAN-TCM. The bioactive components were screened according to the criteria of oral bioavailability (OB)≥30% and drug like (DL)≥0.18, and the corresponding targets of the bioactive components were found. The purpose protein interaction network of active ingredients of Lycii Fructus was constructed, and the GO function enrichment and KEGG signal pathway enrichment were performed using the DAVID database. Results Forty-five kinds of active components that were OB≥30%, DL≥0.18 in Lycii Fructus were screened, among which, 36 active components had a total of 208 targets eliminating duplicates. In the DAVID database, performed under the condition of “P < 0.05, number of genes>10”, and 56 GO items of main biological functions of Lycii Fructus were obtained, 84 KEGG pathways were obtained. Conclusion The exploration of the multi-functional substance basis and multi-dimensional pharmacological effects of Lycii Fructus can provide reference for the further study.
2020 Vol. 17 (19): 112-115,119 [
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Discussion on the etiology and pathogenesis of newly onset type 2 diabetes from “deficient-qi stagnation” theory
XU Manman1 WEI Ni′na2 CUI Hanming1 ZHANG Qiuyan1 HUANG Shijing1
Newly onset type 2 diabetes belongs to the category of “thirst quenching” in traditional Chinese medicine. Its etiology and pathogenesis are complex and changeable, and there is no typical clinical manifestation, which increases our difficulty in understanding it. Based on the theory of “deficient-qi stagnation”, this article analyzes its etiology and pathogenesis characteristics, and conclusions are achieved that internal trauma, inadequate diet and inadequate endowment are its morbidity condition; insufficient qi and deficiency of viscera are the basis of its pathogenesis; pathological products such as qi stagnation, blood stasis, phlegm turbidity and poisonous aggregation are the pathogenesis; qi deficiency and stagnation interact with each other, and “deficiency” and “stagnation” are mutual causes and effects, forming a pathogenesis model of spiral development. It provides new ideas for early intervention of diabetes and has important clinical guidance significance.
2020 Vol. 17 (19): 116-119 [
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Application of Xuefu Zhuyu Decoction in otorhinolaryngologic diseases
ZHANG Linjing YAN Zhanfeng JIAO Lulu LIU Siming LIU Jianhua ZHU Yajing SUN Hong HUANG Xiaorui
Xuefu Zhuyu Decoction is from Yilin Gaicuo, which has the effect of promoting blood circulation for removing blood stasis, activating qi and eliminating pain. It is a commonly used prescription for activating qi and blood. It is used for body′s lesion as a result of blood stasis block. In recent years, the common syndrome differentiation of otorhinolaryngology diseases is the orifices obstructed by blood stasis. If blood stasis obstructs the orifices, qing yang will be not rising, the orifices will be not nourished. So our body will appear some bad symptoms of otolaryngology. Xuefu Zhuyu Decoction is widely used in the treatment of otorhinolaryngology diseases. Based on the principle of co-treatment of different diseases, this article introduces its three cases of treating tinnitus, chronic hypertrophic rhinitis and vocal cord polyp. So we hope to expand the thinking for clinic.
2020 Vol. 17 (19): 120-122,139 [
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117
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Clinical effect of Jianpi Xiaozhang Decoction umbilical paste in the treatment of sepsis with gastrointestinal dysfunction
ZHANG Jidan ZHANG Lifen ZHU Yuanqing XU Zhibing
Objective To explore clinical effect of Jianpi Xiaozhang Decoction umbilical paste in the treatment of sepsis patients with gastrointestinal dysfunction. Methods Eighty sepsis patients with gastrointestinal dysfunction hospitalized in Emergency Intensive Care Unit of the Seventh People′s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from July 2017 to February 2019 were selected and randomly divided into treatment group (40 cases) and control group (40 cases) by random number table method. Two groups were given basic treatment. In treatment group, shenque point was pasted with Jianpi Xiaozhang Decoction on the basis of basic treatment, the course was 7 days. The sequential organ function (SOFA) score, gastrointestinal dysfunction score, gastrointestinal dysfunction index level and comprehensive efficacy between two groups were compared. Results The score of SOFA in control group after treatment was higher than that before treatment (P < 0.05). After treatment, the scores of SOFA and intraperitoneal pressure in treatment group were lower than those before treatment and in control group, and the peritoneum in treatment group was shorter than that before treatment and in control group (P < 0.05). The scores of gastrointestinal dysfunction and traditional Chinese medicine syndrome in control group after treatment were lower than those before treatment (P < 0.05). After treatment, the number of bowel sounds in treatment group was more than that before treatment and in control group, and the scores of gastrointestinal dysfunction and traditional Chinese medicine syndrome were lower than those before treatment and in control group (P < 0.05). The level of serum intestinal fatty acid binding protein (IFABP) in control group after treatment was lower than that before treatment (P < 0.05). The levels of IFABP and D-lactate in treatment group were lower than those before treatment and in control group (P < 0.05). The total effective rate of Chinese medicine syndrome effect and comprehensive effect of treatment group was higher than control group, the difference was statistically significant (P < 0.05). The incidence of multiple organ dysfunction syndrome of treatment group was lower than control group, the difference was statistically significant (P < 0.05). Conclusion Jianpi Xiaozhang Decoction umbilical paste can improve clinical symptoms such as abdominal distention, abdominal pain, fatigue and defecation, enhance gastrointestinal motility, improve gastrointestinal barrier function and the state of ischemia and anoxia.
2020 Vol. 17 (19): 123-127 [
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Clinical study of Huoluo Tongbi Pills combined with Methotrexate in the treatment of rheumatoid arthritis
LI Ting ZHENG Baolin YE Meixing HUANG Yanhua CHEN Junli LIANG Jianliang
Objective To explore clinical efficacy of Huoluo Tongbi Pills combined with Methotrexate in the treatment of rheumatoid arthritis (RA). Methods Eighty-five patients with RA admitted to Foshan Hospital of Traditional Chinese Medicine from January 2017 to December 2018 were divided into control group (43 cases) and observation group (42 cases) according to the random number table method. Control group was treated with Methotrexate, while observation group was treated with Huoluo Tongbi Pills combined with Methotrexate. Two groups were treated for 12 weeks. Clinical efficacy was evaluated after treatment. The joint swelling number, joint tenderness number, morning stiffness times and hands grip strengths were compared between two groups. The levels of rheumatoid factors (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-3 (MMP-3) of two groups were compared before and after treatment. The adverse reactions of two groups during treatment were compared. Results Total effective rate of observation group was significantly higher than that of control group, the difference was statistically significant (P < 0.05). After treatment, the number of joint swelling and joint tenderness in two groups were less than those before treatment, the time of morning stiffness was shorter than that before treatment, and the hand grip strength was higher than that before treatment (P < 0.05); the improvement of the above indexes in observation group was better than that in control group (P < 0.05). After treatment, the levels of RF, ESR and CRP in two groups were significantly lower than those before treatment (P < 0.05), and those in observation group were lower than those in control group (P < 0.05). The levels of MMP-1 and MMP-3 in two groups after treatment were significantly lower than those before treatment (P < 0.05), and the level in observation group was significantly lower than that in control group (P < 0.05). During treatment, there was no serious adverse reactions of two groups. Conclusion Huoluo Tongbi Pills combined with Methotrexate in the treatment of RA has a good efficacy, it can improve the clinical symptoms, reduce the serum levels of MMP-1 and MMP-3, and has good safety.
2020 Vol. 17 (19): 128-131,143 [
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Textual research on common folk medicines of lung meridian grass (false aloe) in Sichuan and Guizhou
CAI Lingyun1,2 LI Peiwu3 HE Qin3 CHEN Yang3 LI Junhe3 GUO Weiwei4
Lung meridian grass (false aloe) is a common folk medicine in Sichuan and Guizhou Province. It is generally record in the literature by lung meridian grass or false aloe, without any difference. There are “foreign body of the same name”. Both of them can treat lung diseases such as cough. But they come from different families of plants. Absolutely, they should be used differently. Records of lung meridian grass (false aloe) are study from the aspects of name, basic principle, nature, taste, efficacy and chemical composition. The differences between two are pointed out by the study, which provide the possibility for the correct records in the future literature and the basis for the correct use of the folk medicine.
2020 Vol. 17 (19): 132-135 [
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157
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Application study of classical prescriptions in the treatment of rheumatoid arthritis based on literature mining
OUYANG Huixin YANG Haimei ZHENG Baolin
Objective To explore the characteristics of classical prescriptions in the treatment of rheumatoid arthritis (RA) by exploring literature. Methods “CNKI” database was searched, the literature in accordance with the research from August 1994 to August 2019 was collected, traditional Chinese medicine syndrome type, syndrome, prescription and other information were extracted, and statistical analysis was made. Results A total of 105 references, 159 medical records and clinical experiments were included. Syndrome types were mainly cold and heat syndrome, damp heat syndrome and wind cold syndrome. Guizhi, Fuzi, Huangqi and Mahuang were the main prescriptions. Main function of traditional Chinese medicine was to relieve the exterior and tonify the deficiency, remove the blood stasis, remove the rheumatism and warm the interior. Conclusion Classical prescriptions are applied to relieve pain by dispersing wind and cold or warming yang. Also they suppress the symptom by dispelling wind and dampness and removing blood stasis to promote blood circulation, treat the root by strengthening body resistance.
2020 Vol. 17 (19): 136-139 [
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The difference and similarity of promoting blood circulation and removing blood stasis in the treatment of acute and chronic cardio-cerebrovascular diseases
GUO Sheng1 ZHOU Chengzhi2
Cardio-cerebrovascular diseases is a common disease of middle-aged and elderly people. It has the characteristics of high morbidity, high disability, high mortality, high recurrence rate and many complications, which seriously threatens human life and health. Blood stasis syndrome is a common type of various cardio-cerebrovascular diseases, which runs through the course of various clinical diseases. The method of promoting blood circulation and removing blood stasis is a basic treatment method for treating blood stasis syndrome of traditional Chinese medicine. Due to the clinical course of various cardio-cerebrovascular diseases, the etiology and pathogenesis are different. Traditional Chinese medicine believes that the pathogenic factors of acute blood stasis syndrome mainly include wind pathogen, cold pathogen, and qi reversal, while the chronic pathogenic factors of chronic blood stasis syndrome mainly include phlegm turbidity, virtual, and obstruction. In the treatment, we should dialectically treat the disease, based on the premise of promoting blood circulation and removing blood stasis, combining its specific pathogenic factors, and flexibly combining with other treatments according to the condition to exert better curative effect. This article summarizes the ancient and modern doctors′ understanding of blood stasis syndromes and their treatment methods, and explores the similarities and differences between the method of promoting blood circulation and removing blood stasis in the treatment of blood stasis type acute and chronic cardio-cerebrovascular diseases.
2020 Vol. 17 (19): 140-143 [
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Diagnostic value of ultrasound in children with fracture of the distal ulna and radius
WU Xing LI Xiongtao XIA Jingdong CHENG Xiaoliang ZHOU Zhiguo ZHANG Ping SHEN Xiantao
Objective To evaluate the diagnostic value of ultrasound in children with suspected fracture of the distal ulna and radius. Methods A total of 131 children with suspected fracture of the distal ulna and radius were admitted to the emergency Department of Orthopedics, Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology, from January to June 2018. Emergency pediatric orthopedic surgeons performed ultrasound examination first and then completed routine X-ray examination of children with suspected fracture of the distal ulna and radius. The results of both tests were blind. The diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the receiver operating characteristic curve (ROC) of ultrasound in children′s fracture of the distal ulna and radius were evaluated using X-ray as the standard control. Results Ultrasound examination confirmed 55 cases of fracture of the distal ulna and radius, including 36 cases of fracture of distal radius, 16 cases of double of fracture of the distal ulna and radius and 3 cases of fracture of distal ulnar. The sensitivity and specificity of ultrasound examination for the diagnosis of fracture of the distal ulna and radius were 93.1% and 98.6%, respectively, with an accuracy of 96.2%, a positive predictive value of 98.2% and a negative predictive value of 94.7%. There was no significant difference in the positive rate of ultrasound diagnosis and X-ray diagnosis (χ2=0.8, P = 0.371), and the consistency of ultrasound diagnosis and X-ray diagnosis was good (Kappa = 0.922, P < 0.001). The area under ultrasonic ROC was 0.959 (95%CI = 0.917-1.000). Conclusion Ultrasound has high sensitivity and specificity in diagnosing fracture of the distal ulna and radius. Therefore, ultrasound is an alternative diagnostic test for the diagnosis of fracture of the distal ulna and radius in children.
2020 Vol. 17 (19): 144-146 [
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Analysis on 249 cases of adverse drug reactions reports in Nanchong Central Hospital in 2018
TANG Zhiyong1,2 SU Qiang1,2 YANG Siyun1,2
Objective To analyze the regularity and characteristics of adverse drug reactions (ADR) of Nanchong Central Hospital (“our hospital” for short) in 2018 to explore the possible causes and influencing factors of ADR, in order to promote clinical rational drug use and make sure the safe in patient. Methods A retrospective statistical analysis was performed on 249 ADR reports submitted by our hospital from January to December 2018, which were collected from the national ADR monitoring system network. Results In 249 ADR reports, the proportion of males (52.61%) was slightly higher than that of females (47.39%). The number of ADR patients over 60-80 years old was the most, accounting for 44.57%. The most common reaction type was “general ADR”, accounting for 50.21%. ADR caused by anti-tumor drugs was the first, accounting for 35.79%, followed by the ADR caused by anti infective drugs, accounting for 30.53%. Injection induced ADR accounted for 67.22% of the total. Circulatory system damage was the most common clinical manifestation in ADR, accounting for 36.65%. 99.60% of the patients were improved and recovered after ADR. Conclusion Clinical attention should be paid to the monitor of ADR, strengthening drug administration and establish a perfect medication supervision system. In clinical medication, we should strengthen the monitoring of the elderly patients, and try to reduce the use of injection drugs, so that we can take orally without intravenous medication. In the process of intravenous administration, we should pay close attention to the clinical symptoms of patients to ensure the safety of patients.
2020 Vol. 17 (19): 147-150 [
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Clinical application value of high-sensitivity real-time PCR in low load viral hepatitis
CHEN Peng1 SUN Yuliang1 DENG Xing1 XIAO Mingzhong2
Objective To evaluate the clinical application value of high-sensitivity real-time polymerase chain reaction (real-time PCR) in the quantitative detection of viral nucleic acid in viral hepatitis, and to provide the basis for the widespread application of this method. Methods A total of 895 patients with viral hepatitis were enrolled from January 2016 to December 2018 in Hubei Provincial Hospital of Traditional Chinese Medicine (hereinafter referred to as “our hospital”), and meanwhile another 100 normal people in our hospital were recruited as control group. Serum viral loads were detected by routine and high sensitive real-time PCR, then the difference of results between the two methods was compared. The trends and characteristics of biochemical indices,immunological markers, international standardized ratio of coagulation (INR), index of liver fibrosis FIB-4 and their correlation with viral load were analyzed statistically in viral hepatitis patients with low viral load. Results The proportion of patients with low viral load was high among the population surveyed. The positive rate of HBV DNA detected by real-time PCR with high sensitivity was much higher than that by routine method(P < 0.05),but for HCV RNA, the two methods showed good consistency. The fluctuation of several biochemical indices was not obvious in low viral load patients, and multiple biochemical indexes were not correlated with viral nucleic acid load (P > 0.05). Most hepatitis B patients with low viral load showed a status of low level HBeAg-negative replication. There were different degrees of inconsistency and weak correlation between immunological diagnostic markers and viral load results. INR of coagulation and FIB-4 index of liver fibrosis in patients with low viral load were higher than those in the control group, and the difference was statistically significant (P < 0.05), but there was no correlation between them and viral nucleic acid load (P > 0.05). Conclusion High sensitivity real-time PCR has incomparable advantages in the detection of viral nucleic acid,combined with other diagnostic markers,it can play an irreplaceable role in the course management of low viral load hepatitis.
2020 Vol. 17 (19): 151-155 [
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Changes of intestinal flora in patients with ulcerative colitis and its correlation with inflammatory factors and TOLL-like receptor molecules
LI Huirong1 CUI Zhao2 LIANG Bo2 LI Guodong3 HE Mingxuan4 LIU Yawei5 ZHOU Jianhua2
Objective To investigate the changes of intestinal flora in patients with ulcerative colitis (UC) and its correlation with inflammatory factors and TOLL-like receptors (TLRs) molecules. Methods A total of 82 patients with UC admitted to the NO.2 Hospital of Baoding Hebei Province from February 2016 to August 2018 were selected as the observation group, and 70 volunteers who underwent physical examination during the same period were selected as the control group. The levels of interleukin (IL)-4, IL-6, tumor necrosis factor-α (TNF-α), intestinal flora content and the expression of TLRs molecules (TLR4 and TLR9) were detected and compared. Pearson correlation was used to analyze the correlation between TLRs expression and intestinal flora and inflammatory factors. Results The contents of Enterobacter, Bacteroides, Enterococcus and Fusobacterium in the observation group were higher than those in the control group, while the contents of Lactobacillus and Bifidobacterium in the observation group were lower than those in the control group, with statistically significant differences (all P < 0.05). TLR4, TLR9, IL-6 and TNF-α in the observation group were higher than those in the control group, and IL-4 was lower than that in the control group, with statistically significant differences (all P < 0.05). Pearson correlation analysis showed that TLR4 and TLR9 in UC patients were positively correlated with Enterobacter, Bacteroides, Enterococcus, Fusobacterium, IL-6 and TNF-α (r > 0,P < 0.05), but negatively correlated with Lactobacillus, Bifidobacterium and IL-4 (r < 0,P < 0.05). Conclusion In patients with UC, intestinal flora is dysregulated, which can promote the expression of TLRs molecules to increase the level of pro-inflammatory factors, reduce the level of anti-inflammatory factors, and mediate the inflammatory response of intestinal mucosa.
2020 Vol. 17 (19): 156-159 [
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Research on talent development strategy and countermeasures of Hebei three-level general hospital under the background of Winter Olympics
JING Chao1 HUANG Xiantao2 HAO Xiangfeng3 ZHANG Pei4 ZHANG Jiaqi5
After winning the bid for the 2022 Beijing·Zhangjiakou Winter Olympic Games, Beijing and Hebei Province, especially Zhangjiakou three-level general hospitals, have developed extensive cooperative relations and conducted in-depth and comprehensive cooperations in discipline construction, technical support, talent training and other aspects to jointly provide medical security for the olympic games. This paper expounds the current situation and existing problems of the talent development of tertiary general hospitals in Hebei Province, the main body of the Olympic medical security, and puts forward corresponding countermeasures to improve the talent development strategy by taking advantage of the opportunities brought by the Winter Olympics, which has strong theoretical value and practical significance.
2020 Vol. 17 (19): 160-162,170 [
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Practice and thinking on the delicacy management of Peking Union Medical College Hospital
PAN Huixian LI Li JIANG Hong LI Zhuoting ZHANG Ye LIU Zhaoyu
The normal development of various medical work in the hospital is inseparable from a high-level, high-quality, and orderly administrative management work. Exploring and applying the scientific strategy of delicacy management has become the primary work of hospital management. This article discusses and considers several methods of delicacy management in Peking Union Medical College Hospital in recent years, in order to help and play a certain reference role in the administrative work of other hospitals.
2020 Vol. 17 (19): 163-166 [
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Effect of hypnotherapy on nausea and vomiting in patients with breast cancer during chemotherapy
SU Yali1 WANG Pilin1 LIU Jun′e2 HAN Jing2 YANG Shenshen2
Objective To investigate the effect of hypnotherapy on nausea and vomiting in patients with breast cancer during chemotherapy. Methods From July 2017 to August 2018, 110 cases with breast cancer patients who received chemotherapy in Beijing Tiantan Hospital, Capital Medical University were selected as research objects. They were divided into the experimental group (56 cases) and the control group (54 cases) according to the random number table method. The control group received routine care, and the experimental group received hypnotherapy intervention. The nausea and vomiting frequency, degree and chemotherapy compliance of the two groups were compared before and after intervention. Results There was no significant difference in the incidence of nausea and vomiting between the two groups (P > 0.05); and the degree of nausea and vomiting in the experimental group was lower than that in the control group, with statistically significant difference (P < 0.05). The compliance rate of the experimental group was higher than that of the control group, with statistically significant difference (P < 0.05). Conclusion Hypnotherapy can effectively reduce the degree of nausea and vomiting in patients with breast cancer chemotherapy and improve their compliance with chemotherapy.
2020 Vol. 17 (19): 167-170 [
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Study on the design of evaluation index system for the sentiment capability of endocrine nurses
SONG Yang1 LOU Nan1 HUANG Xiantao2
Objective To design the evaluation index system for the sentiment capability of endocrine nurses and to train their ability. Methods In July 2019, 5 nurses from the Department of Endocrine, Rocket Army Characteristic Medical Center were selected to set up a research team. Fifteen experts were selected, Delphi expert consultation method was used to design the evaluation index system for the sentiment capability of endocrine nurses, and analytic hierarchy process was used to analyze the weight of each index. Results The enthusiasm of expert consultation in high level and the reliability of expert consultation in high level. After two consultations with experts, the coordination coefficients of indicators of level 1, 2 and level 3 ranged from 0 to 1, and the differences were highly statistically significant (P < 0.01). The evaluation system of nursing staff′s sentiment capability included 4 indexess of level 1, 8 indexes of level 2 and 33 indexes of level 3, among which the consistency ratio of 15 groups of evaluation matrix experts were 0.001-0.096, with high consistency. Conclusion The evaluation index system of the sentiment capability of the endocrine nurses can be used as an objective and scientific evaluation basis for the evaluation of the nurses′ sentiment capability.
2020 Vol. 17 (19): 171-174 [
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Application of cluster nursing in rehabilitation treatment of postpartum patients with diastasis recti abdominis
LAN Xiaoman LAN Ying QIN Guilian
Objective To observe the effect of cluster nursing in rehabilitation treatment of postpartum patients with diastasis recti abdominis. Methods From February 2017 to July 2019, 60 cases with diastasis recti abdominis who treated in the First Affiliated Hospital of Guangxi University of Science and Technology were selected as the objects. They were divided into the control group and the observation group by the random number table method, with 30 cases in each group. The patients in the control group were received routine nursing after the treatment of neuromuscular electrical stimulation combined with thunder-fire moxibustion. The observation group were received cluster nursing intervention on the basis of the control group. The distance of diastasis recti abdominis, the improvement of low back pain and patient satisfaction were observed before and after treatment. Results Before treatment, there was no statistically significant difference between the two groups in the distance of diastasis recti abdominis (P > 0.05). After treatment, the distance of diastasis recti abdominis between the two groups were shorter than those before treatment, and the observation group was shorter than the control group, with statistically significant differences (all P < 0.05). There was no significant difference in the improvement of low back pain between the two groups (P > 0.05). The number of the improvement of low back pain patients in the two groups were less than those before treatment, and the observation group was less than the control group, with statistically significant differences (all P < 0.05). The satisfaction rate of patients in the observation group was higher than that in the control group, and the difference was statistically significant(P < 0.05). Conclusion Cluster nursing intervention can effectively improve the rehabilitation effect and satisfaction of patients with postpartum rectus abdominis separation, and has higher clinical application value.
2020 Vol. 17 (19): 175-178 [
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Effect of animation video on perioperative psychological status in children with OSAHS
ZHENG Yaqi1 ZHANG Meixue1▲ LI Bilian2
Objective To investigate the perioperative psychological status of children with obstructive sleep apnea hypopnea syndrome (OSAHS) and explore the effect of animation video, so as to reduce the occurrence of perioperative anxiety. Methods A total of 60 children who underwent OSAHS surgery in Department of Otolaryngology, Guangzhou Women and Children′s Medical Center from June to August 2019 were selected as objects. They were divided into the experimental group and the control group according to random number table method, with 30 cases in each group. The experimental group was received preoperative education with self-developed animation video, and the control group was received routine preoperative education. The anxiety scores of the two groups were compared on 1 d before operation (before intervention) and 3 min before anesthesia induction (after intervention). Anesthesia induction coordination degree scores, family satisfaction degree and salivary cortisol levels before intervention, after anesthesia induction and before postoperative recovery of ventricular extubation (wake period) were compared between the two groups. Results There was no significant difference in anxiety score between the two groups before intervention (P > 0.05). After intervention, the increased anxiety scores of the experimental group were lower than those of the control group (P < 0.05). The ICC scores in the experimental group were lower than those in the control group (P < 0.05). Family satisfaction degree scores in the experimental group were higher than those in the control group (P < 0.05). The levels of salivary cortisol in the experimental group after anesthesia induction and wake period were lower than those in the control group (P < 0.05). Conclusion The OSAHS children have high incidence of perioperative anxiety. Animation video can significantly reduce the incidence of perioperative anxiety in children with OSAHS and reduce perioperative complications, which is beneficial to the rapid recovery of patients.
2020 Vol. 17 (19): 179-182 [
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Influence of quality control circle activities on the satisfaction of health education of orthopedic inpatients
QI Fenghua TANG Suhua YANG Jie SHAO Jianwei YUE Xiaoli LI Hongxia GUO Yingyan LI Hongmei
Objective To explore the influence of quality control circle activities on the satisfaction of health education of orthopedic inpatients. Methods A total of 100 orthopedic inpatients from May 2016 to April 2018 in Qian′an People′s Hospital of Hebei Province were selected as the subjects of this study. They were divided into control group and experimental group by the method of drawing lots, with 50 patients in each group. The control group was given routine nursing management, the experimental group was given quality control circle management, and the patients′ management satisfaction, awareness rate of health education, professional skill score of nurses and the incidence of adverse events in the two groups were observed. Results The awareness rate of health education in the experimental group was significantly higher than that in the control group, the satisfaction of nursing in the experimental group was significantly higher than that in the control group, the score of vocational skills in the experimental group was significantly higher than that in the control group, and the incidence of adverse events in the experimental group was significantly lower than that in the control group and the differences were statistically significant (P < 0.05 or P < 0.01). Conclusion The activities of quality control circle can effectively improve the awareness rate of health education and satisfaction of nursing management of inpatients in orthopedic department, improve the professional skill score of nursing staff, and reduce the incidence of adverse events, which has a high clinical promotion value.
2020 Vol. 17 (19): 183-185,189 [
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Status and relationship analysis of emotional intelligence, empathy and supportive communication among clinical nurses
GUO Yangcun ZHOU Lihua▲ WANG Weili
Objective To investigate the current situation of emotional intelligence, empathy and supportive communication among clinical nurses and analyze the relationship among them. Methods Convenience sampling was sued, from July to September 2018, 410 nurses from the First Affiliated Hospital of Anhui Medical University and the First Affiliated Hospital of University of Science and Technology of China were selected as the study subjects, general information questionnaire, emotional intelligence scale, interpersonal response indicator questionnaire and supportive communication scale were used to investigate. Results Finally, 382 copies were recovered with an effective recovery rate of 93.2%. The total scores of emotional intelligence, empathy and supportive communication were (82.63±11.76), (46.00±9.13) points and (70.64±5.64) points, respectively. Opinion selection, sympathy and care, self-emotional monitoring, emotional application and emotional regulation were positively correlated with supportive communication (r = 0.331, 0.139, 0.337, 0.344, 0.256, P < 0.01). Personal distress was negatively correlated with supportive communication (r = -0.012, P < 0.01). Empathy was a mediator between emotional intelligence and supportive communication. Conclusion Emotional intelligence and empathy are important factors influencing the supportive communication of clinical nurses. Managers and clinical nurses should pay attention to improving the emotional intelligence and empathy of nurses, so that nurses can provide quality care to patients more efficiently.
2020 Vol. 17 (19): 186-189 [
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Study on activity timing of patients with atrial fibrillation after radiofrequency ablation
ZHAO Shirong1 WANG Xue1 YAN Yan2▲
Objective To investigate the effect of radiofrequency ablation of atrial fibrillation via femoral vein on the recovery time of patients. Methods A total of 167 patients with ATRIAL fibrillation who underwent femoral vein radiofrequency ablation in the Department of Cardiology, Dalian Municipal Central Hospital of Liaoning Province from November 2018 to September 2019 were selected as study subjects. Patients were divided into control group (83 cases) and experimental group (84 cases) by random number table method. Routine nursing was used in the control group, and early postoperative bed activity was used in the experimental group. Complications (bleeding at puncture site, urinary retention), general comfort questionnaire (GCQ), pain score and anxiety score were observed in the two groups. Results There was no significant difference between the two groups in the incidence of postoperative hemorrhage and urinary retention (P > 0.05). Low back pain score and low back GCQ score of patients in different time and groups were different, and there was interaction between time and groups, and the differences were statistically significant (P < 0.05). Further pair comparison and intra-group comparison: in the control group, the score of lower back pain at each time point after surgery was higher than that when patients returned to the ward, and the GCQ score of lower back was lower than that when patients returned to the ward, and the comparison of each time point after surgery (P < 0.05). The score of lower back pain in the observation group at all postoperative time points was lower than that when returning to the ward, and the GCQ score of lower back was higher than that when returning to the ward, and the comparison of postoperative time points (P < 0.05). Comparison between groups: the GCQ score of lower back of the experimental group was higher than that of the control group, and the score of lower back pain was lower than that of the control group, the differences were statistically significant (P < 0.05). The self-rating anxiety scale score of the control group 6 h after surgery was higher than that before surgery (P < 0.05), while the self-rating anxiety scale score of the test group was not statistically significant compared with that before surgery (P > 0.05). 6 h after surgery, the self-rating anxiety scale score of the experimental group was lower than that of the control group, with statistically significant difference (P < 0.05). Conclusion Early activity does not increase the incidence of complications in patients with AF after RADI of requency ablation, but it can improve the lower back pain, comfort level and psychological anxiety symptoms of patients. Therefore, it is advisable to conduct early postoperative activity in patients with AF treated by radiofrequency ablation through femoral vein.
2020 Vol. 17 (19): 190-193 [
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Effect of improved nursing measures on skin injury of patients after shoulder arthroscopy
NING Jing LIU Yan▲ GUO Xinyue
Objective To explore the causes of skin injury in patients undergoing shoulder arthroscopy, to research the measures to prevent skin injury, and to formulate effective nursing measures. Methods Using convenient sampling method, a random selection of 260 patients undergoing shoulder arthroscopy surgery in the Department of Sports Medicine of Peking University Third Hospital from January 2018 to June 2018 was selected and set as the control group. The skin lesions were observed and recorded immediately after patients returning to the ward until the discharge. The causes of skin lesions were analyzed in 56 patients with skin lesions after surgery, and the corresponding nursing measures were formulated. From September 2018 to February 2019, 231 patients undergoing shoulder arthroscopic surgery were randomly selected as the experimental group to receive improved nursing measures. The causes of skin lesions and the incidence of skin injury were compared in two groups. Results The incidence of skin injury in the control group was 21.53%, among which 15 cases (5.77%) were caused by iodine, 25 cases (9.62%) caused by medical adhesive, and 3 cases (1.15%) caused by burns during the surgery, 4 cases (1.54%) of skin damage caused by shoulder joint braces, 2 cases (0.77%) of skin injury caused by perfusion induced swelling of the affected limb during surgery, 7 cases (2.69%) of skin injury caused by allergic medical adhesive. The incidence of skin injury in the experimental group was 4.76%, of which 4 cases (1.73%) caused by iodine, 6 cases (2.60%) caused by medical adhesive, and 1 case (0.43%) caused by skin burns during the surgery. The incidence of skin injury in the experimental group were lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion Improving the skin nursing measures of patients after shoulder arthroscopy can effectively improve the quality of nursing and increase the comfort of patients.
2020 Vol. 17 (19): 194-封三 [
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