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2020 Vol. 17, No. 34
Published: 2020-12-05
4
Research on the mode and strategy of medical consortium cultural integration based on symbiosis theory
MA Ya1 LIU Tao2 SHEN Junlong3 SUN Zhonghe4
The cultural integration of medical consortium plays an important role in the medical consortium, and it is directly related to the operation effect of the medical consortium construction. Based on the perspective of symbiosis theory, this paper analyzes and discusses the symbiotic conflicts and solutions in the cultural integration of medical alliance from three dimensions of symbiosis unit, symbiotic environment and symbiosis mode, and summarizes three targeted measures to select reasonable symbiotic unit, create efficient symbiotic environment and select appropriate symbiotic mode, so as to gradually improve the overall effect and work effect of medical union culture integration.
2020 Vol. 17 (34): 4-7 [
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130
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Current status of core competency of elderly nursing staff in integrated treatment and convalesce institutions of Urumqi and its influence factors
CHEN Bingjie1 DOU Li2 HAN Wenwen1 NIE Yuqin2
Objective To understand the current status of core competency of elderly nursing staff in integrated treatment and convalesce institutions of Urumqi and analyze the influencing factors. Methods From December 2019 to January 2020, the convenience sampling method was used to conduct a questionnaire survey on elderly nursing staff in integrated treatment and convalesce institutions of Urumqi. The core competence questionnaire and general self-efficacy scale were used. Results Total score of core competency of elderly nursing staff in integrated treatment and convalesce institutions in Urumqi was (106.27±15.17) points. Personal quality, communication ability, ethics knowledge, nursing knowledge, nursing skills and core competence were positively correlated with self-efficacy (r = 0.282, 0.229, 0.257, 0.423, 0.260, 0.376, all P < 0.01). Working years, professional titles and whether they have participated in relevant pre job training have an impact on the core competence of nursing staff (P < 0.05). Conclusion The core competency of elderly nursing staff in integrated treatment and convalesce institutions is in the upper middle level. Managers should strengthen the training of nursing knowledge and skills, pay attention to improve the core competence of nursing staff with low professional title and working age, enhance self-efficacy and improve the core competence of nursing staff.
2020 Vol. 17 (34): 8-11,29 [
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116
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SWOT analysis and suggestion on the development of health industry in Hebei Province
ZHANG Xiuju YANG Zhenru LIU Bo LIU Siwen ZHAI Junxia
Health industry is a new industry with huge market potential. The state promotes the development of health industry in many aspects. In this paper, SWOT method is used to analyze the development trend of health industry in Hebei Province. The advantages, disadvantages, opportunities and challenges are analyzed in depth to find out the advantages and problems of health industry development in Hebei Province. Some suggestions are put forward, such as promoting the scientific, accurate and intelligent development of health industry; promoting the development of pension service industry and improving the training system of health management personnel; relying on its own resource advantages, building a characteristic large health industry chain in Hebei Province; strengthening government guidance and strict market supervision. In order to improve the health industry and better serve the health of residents in Hebei Province.
2020 Vol. 17 (34): 12-15 [
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Effect of Qingre Dehumidification Gel on mitochondria apoptosis protein of HPV 16 positive cervical cancer tumor-bearing mice
LIU Jun1,2 MA Xiuli1 XUE Xiao’ou1
Objective To study the effect of topical Chinese medicine Qingre Dehumidification Gel on the mitochondrial apoptosis protein of human papillomavirus (HPV) 16-positive cervical cancer tumor-bearing mice. Methods The HPV 16 positive human cervical cancer SiHa cell line to prepare a cell suspension with a concentration of 2×107/mL was cultured. Five-week-old female nude mice were selected, 1 mL syringe to draw a well-mixed cell suspension were used and injected under the skin of the upper right front leg of the nude mice, resulted in an HPV 16-positive xenograft model. After successful modeling, the tumor-bearing mice were divided into five groups with ten mice in each group by random number method. Namely model group, carbomer 940 group, traditional Chinese medicine group, Cisplatin group and combination medication group. The traditional Chinese medicine group was given a Qingre Dehunidification Gel external coating (0.3 mL of gel per 50 mm3 tumor volume per day) at the tumor formation site; in the Cisplatin group: 10 mg of cisplatin was dissolved in 66.7 mL of normal saline to make Cisplatin injection liquid intraperitoneal injection (0.2 mL per 10 g body weight, once every three days); carbomer 940 group (excipients in the gel): carbomer 940 externally applied (0.15 mL per 50 mm3 volume per day); combination medication group: both external application of Chinese medicine and intraperitoneal injection of Cisplatin were given for 28 days in each group. Then the tumor tissue of the right front leg of the mouse was anesthetized and removed, and the cell apoptosis was detected by immunofluorescence method. At the same time, the apoptosis-related proteins Bax, Bcl-2, Caspase-9 and Caspase-3 in the tissue were detected by Western blot method. Results Compared with the model group and the carbomer 940 group, the apoptosis rate of the Chinese medicine group, the Cisplatin group, and the combination medication group were all increased, while the combination medication had the highest apoptosis rate, and the differences were statistically significant (P < 0.05); there was no statistically significant difference in the apoptosis rate between the carbomer 940 group and the model group (P > 0.05). Compared with the model group and the carbomer 940 group, the expressions of Bax and Caspase-3 in the traditional Chinese medicine group, the Cisplatin group, and the combination group were all up-regulated, while the expression of Bcl-2 was decreased, while the expression in the combination group was the most obvious, and the differences were statistically significant (P < 0.05). Compared with the model group and the carbomer 940 group, the expression of Caspase-9 in the Cisplatin group and the combination group was up-regulated, and the difference was statistically significant (P < 0.05). Conclusion Qingre Dehumidification Gel can change the apoptosis of HPV 16-positive cervical cancer tumor-bearing mice. The mechanism of the anti-toxin and anti-tumor effect of the topical drug may be related to the up-regulation of mitochondrial apoptosis-related proteins Bax, Caspase-9, and Caspase-3 in tumor tissues, and the down-regulation of Bcl-2.
2020 Vol. 17 (34): 16-20 [
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Effects of different doses of Stigma Croci extract on optic nerve and axoplasma flow in rats with chronic ocular hypertension
YU Jingni YANG Xinguang YANG Shangfei GONG Ke WANG Xiaoyu▲
Objective To investigate the effects of different doses of Stigma Croci extract on optic nerve injury and axoplasma flow in rats with chronic ocular hypertension. Methods A total of 32 SD rats were divided into control group, high ocular hypertension group, low dose group and high dose group by random number table method, with 8 rats and 16 eyes in each group. The bulbar conjunction of rats in the high ocular hypertension group, low dose group and high dose group were cut open, and the cauterized vortex veins were used to make the model of high chronic ocular hypertension, while the bulbar conjunction was only cut open in the control group. The low dose and high dose groups were intraperitoneally injected with 20 mg/kg and 80 mg/kg of Stigma Croci extract respectively and the high ocular hypertension group and the control group were injected with 0.5 mL normal saline for 28 consecutive days. All rats were sacrificed by anesthesia and optic nerves behind the eyeball and retina slices were collected. Ultrathin sections of optic nerve were made and observed under electron microscope. The axoplasma flow and the retinal ganglion cells were observed with countercurrent fluoro-gold. Results The ultrastructure of the optic nerve in the control group was clear, the ultrastructure of the optic nerve in the high ocular hypertension group was seriously damaged, and the ultrastructure of the optic nerve in the low dose group was improved, while the ultrastructure of the optic nerve in the high dose group was significantly improved and close to the control group. Compared with the control group, the number of axons in the high ocular hypertension group decreased, and the difference was highly statistically significant (P < 0.01). Compared with the high ocular hypertension group, the number of axons increased in the low dose group and the high dose group, and the differences were highly statistically significant (all P < 0.01). Compared with the low dose group, the number of axons increased in the high dose group, and the difference was highly statistically significant (P < 0.01). In the control group, the labeled retinal ganglion cells were evenly distributed in all quadrants, and no fluoro-gold leakage was observed outside the cells. Retinal ganglion cells in the high ocular hypertension group had low density in each area and irregular distribution, and some fluoro-gold leakage. The number of retinal ganglion cells increased and individual cells had prominences in the low dose group. In the high dose group, the number of retinal ganglion cells was abundant and there was no leakage and some of the prominences were clearly visible. Compared with the control group, the number of countercurrent fluoro-gold labeled ganglion cells in the high ocular hypertension group decreased, with a highly statistically significant difference (P < 0.01). Compared with the high ocular hypertension group, the number of countercurrent fluoro-gold labeled ganglion cells increased in the low dose group and the high dose group, and the differences were highly statistically significant (all P < 0.01). Compared with the low dose group, the number of countercurrent fluoro-gold labeled ganglion cells increased in the high dose group, and the difference was highly statistically significant (P < 0.01). Conclusion Chronic ocular hypertension can destroy the ultrastructural appearance of rat retrobulbar optic nerve and cut down axoplasm flow; the high dose Stigma Croci extract has a protective effect on the optic nerve and axoplasm flow injured by chronic ocular hypertension.
2020 Vol. 17 (34): 21-25 [
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Study on sieving and purification of the Pollen Typhae
LIU Yaping1 GAO Mingliang2 CHEN Peidong2 ZHOU Guisheng2
Objective To study the content of flavonoids changes in Pollen Typhae before and after the purification. Methods The content of flavonoid glycosides in the pollen grains and impurities after sieving of Pollen Typhae was determined by high performance liquid chromatography. A PRAZIS C18 (250 mm × 4.6 mm, 5 μm) column was used. Acetonitrile and 0.05% phosphoric acid gradient elution was used. The column temperature was set at 30℃ and the injection volume was 10 μL. Results The average recovery of typhaneoside was 96.67%, RSD was 1.70%; the content in pollen grains after 6-8 sieve was 4.05, 4.22 mg/g and 4.04 mg/g, respectively. Isorhamnetin-3-O-neohesperidin average recovery was 101.84%, RSD was 1.77%; the content in pollen grains was 3.50, 3.67 mg/g and 3.51 mg/g, respectively. Conclusion The content of flavonoids in pollen grains is the highest when the Pollen Typhae is purified by No. 7 sieve.
2020 Vol. 17 (34): 26-29 [
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Visual analysis of literature on the activating blood and resolving stasis in cardiovascular field
XU Rongrong1,2 HU Yuanhui1,2 SHI Jingjing2 WANG Dandan1
Objective To analyze the relevant literatures of activating blood and resolving stasis in the field of cardiovascular research in recent years, and study the development process, research hot spots and frontiers of this field. Methods A computer search was conducted on CNKI about the related literatures on the study of activating blood and resolving stasis in the cardiovascular field. CiteSpace software was used to analyze the visualization of the authors, institutions and keywords. Results In recent years, the main researchers in this field included Shi Dazhuo, Chen Keji, Wang Jie, etc. The core forces were Xiyuan Hospital of China Academy of Chinese Medical Sciences, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Beijing University of Chinese Medicine. Research hot spots were mainly on related diseases and their TCM syndromes, related prescriptions, mechanism, clinical efficacy and inspection indicators, and so on. In recent years, studies on Xuefu Zhuyu Tang and percutaneous coronary intervention have become hot spots. Conclusion This study reveals the development law of this field in the past ten years and provides reference for later related research.
2020 Vol. 17 (34): 30-33,38 [
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130
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Relationship between structure of volatile constituents in the stalk of Uncaria macrophylla and chromatography retention time
HAN Ningjuan1 FANG Huanle1 LIU Jianli2
Objective To establish the relationship model between the structure of 58 compounds in the stalk Uncaria macrophylla and chromatographic retention time. Methods The structure of 58 compounds in the stalk of Uncaria macrophylla was parameterized. The multiple linear regression and partial least squares methods were employed to build the relationship model between the structure and retention time. The “leave one out” cross validation correlation coefficient was used to evaluate the model. Results Correlation coefficients for the two modelsare were 0.949 and 0.945; the “leave one out” cross validation correlation coefficient were 0.886 and 0.867 respectively. Conclusion The molecular descriptors can properly show structural features of these compounds. Moreover, these models display good predictive ability and robustness, which can accurately predict the chromatographic retention time of 58 compounds in Uncaria macrophylla. This study provides certain reference value for quantitative structure-chromatographic retention relationship study of organic compounds in Chinese herbal medicine.
2020 Vol. 17 (34): 34-38 [
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Expression of LncRNA PRAL in serum of patients with multiple myeloma and its relationship with clinicopathological parameters and prognosis
ZHANG Liyu GU Zheyun ZHOU Xiaodan WANG Ling TAO Jian
Objective To study the expression of long-chain non-coding RNA (LncRNA) PRAL in patients with multiple myeloma (MM) and its relationship with clinicopathological parameters and prognosis. Methods The clinical data of 82 patients with MM diagnosed and treated in the Second Affiliated Hospital of Nantong University (hereinafter referred to as “our hospital”) from January 2016 to January 2017 were selected as case group, 50 patients with other blood diseases in the same period in our hospital were selected as case control group, and 51 persons with physical examination in the same period in our hospital were taken as healthy control group. Quantitative real-time PCR was used to detect the expression of serum LncRNA PRAL of each group, and the expression difference of each group and their relationship with clinicopathological characteristics were statistically analyzed. According to the mean value of serum LncRNA PRAL expression of 2.125, 82 MM patients were divided into high LncRNA PRAL expression group (40 cases) and low LncRNA PRAL expression group (42 cases), the curative effect of the two groups was compared. The prognostic differences in patients with different LncRNA PRAL expression levels were analyzed by Kaplan-Meier survival analysis (Log-rank test). Results The expression of LncRNA PRAL in the case group was significantly lower than the case control group and the healthy control group (P < 0.05). The expression of serum LncRNA PRAL of MM patients with high International staging system (ISS) stage was significantly lower than that in MM patients with low ISS stage (P < 0.05), while the relative expression of serum LncRNA PRAL of patients with different age, gender, diagnostic typing, Durie-Salmon stage, blood lactate dehydrogenase, blood calcium and hemoglobin levels were not statistically significant (all P > 0.05). The curative effect of patients with high expression of LncRNA PRAL was better than that of patients with low expression of LncRNA PRAL (P < 0.05). The 3-year overall survival rate of low LncRNA PRAL expression group was significantly lower than high LncRNA PRAL expression group, and the average survival time was significantly shorter than high LncRNA PRAL expression group(P < 0.05). Conclusion The expression of serum LncRNA PRAL of MM patients is reduced. The low expression of serum LncRNA PRAL is related to the higher ISS stage and the poor prognosis of patients, and may become an important indicator for evaluating the prognosis of MM.
2020 Vol. 17 (34): 39-42,47 [
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Analysis on the correlation between Bcl-2 and LC3 on the development and prognosis of bladder cancer
ZHOU Wanli1 ZHANG Jianping1▲ PAN Yongsheng2 XU Weidong1
Objective To investigate the expression and biological behavior of Bcl-2 and autophagy related gene LC3 in bladder urothelial carcinoma cells, and to explore their effects on the prognosis of bladder cancer. Methods Bcl-2 siRNA plasmid was transfected into human bladder transitional cell carcinoma (T24) cells, Western blot and reverse transcription polymerase chain reaction were used to detect the expression of Bcl-2 and LC-3, and to study Bcl-2 knockout. The effect of T24 on the growth and apoptosis of T24 cells in vitro were studied. The expression of Bcl-2 and LC3 in the pathological specimens of cancer tissues were detected, and the prognosis was analyzed. Results Bcl-2 siRNA recombinant plasmid was successfully transfected into T24 cells, the expression of Bcl-2 mRNA was down-regulated by about 80%, the expression of Bcl-2 protein was down-regulated by about 70%, and the mRNA and protein levels of LC3 were down-regulated by about 40%. The protein expression of Bcl-2 and LC3 in the pGenesil-1 Bcl-2 siRNA group was lower than that of the NC group and the empty plasmid group, and the difference was statistically significant (P < 0.05). The cell viability of T24 decreased to (66.8±5.8) %, and the cell apoptosis rate was 56.68%. The cell viability of the pGenesil-1 Bcl-2 siRNA group were higher than those of the empty plasmid group and the NC group, and the differences were statistically significant (P < 0.05). There was a statistically significant difference in the positive rate of LC3 expression between normal bladder tissue and bladder cancer (P < 0.05). The positive rate of Bcl-2 protein expression in normal bladder tissue and bladder urothelial carcinoma was compared, and the difference was statistically significant (P < 0.05). The expression of LC3 protein in bladder urothelial carcinoma samples of different grades and stages was compared, and the difference was statistically significant (P < 0.05). There was a statistically significant difference in the expression of Bcl-2 protein in bladder urothelial carcinoma samples with or without lymph node metastasis (P < 0.05). Conclusion Down-regulation of Bcl-2 gene will reduce the expression level of bladder cancer cell LC3, inhibit cell growth and promote its apoptosis. The combination of Bcl-2 and LC3 helps to judge the prognosis of bladder urothelial carcinoma.
2020 Vol. 17 (34): 43-47 [
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The effect of TNF on hematopoietic regulation and its role in high altitude polycythemia
Xie Youbang1 Nian Wei2 Liu Yanmin3 Gao Yunmei1 Shi Xuefeng4 Xi Aiqi5
As one of the hematopoietic inhibitors, there are two main types of tumor necrosis factor (TNF) family: TNF-α and TNF-β. The effects of the two on stem cells and progenitor cells are different under different colony stimulating factor (CSF) stimulation. TNF-α activates nuclear factor-κB (NF-κB) through its classical pathway, in which inhibitor-κ binding protein (IκB) is phosphorylated and releases NF-κB dimer, which translocates to the nucleus to bind specific NF-κB DNA. The binding site activates gene expression and positively regulates gene transcription involved in the maintenance and homeostasis of hematopoietic stem cells (HSC) and progenitor cells. TNF-α activates Notch and NF-κB signal transduction pathways through TNFR2, and promotes HSC production under inflammatory signal transduction. TNF-β receptor also named lymphotoxin-β receptor (LTβR) which expresses in many hematopoietic tissues. TNF-β can activate the NF-κB signaling pathway to produce a series of biological effects. LTβR signaling leads to NF-κB activation in a cell type-restricted manner. The level of TNF-β in bone marrow supernatant of high altitude polycythemia (HAPC) was significantly increased. There is PI3K/Akt signaling pathway activation in bone marrow CD71+ cells of HAPC. The above suggests that TNF-β may play an important role in the erythropoiesis regulation of HAPC.
2020 Vol. 17 (34): 48-51 [
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Progress in the treatment of drug-resistant nontuberculous mycobacteria in pulmonary disease
WEI Huaying YANG Yang WU Yongfeng HUA Wei ZHANG Yulin▲
Nontuberculous mycobacterial (NTM) infection often causes pulmonary disease, and the most common pathogens are Mycobacterium avium, Mycobacterium abscessus and Mycobacterium kansasii. The therapeutic drugs for different pathogens are different. The identification of bacterial species is the prerequisite for effective treatment. The use of drugs based on guidelines is still the most basic treatment and helps to improve the prognosis, but the development of drug resistance reduces the success rate of treatment. Understanding the mechanism of drug resistance and the characteristics of pathogens can provide targets for the research of new drugs, but there is no new drug that can be applied to clinical patients. Therefore, re-exploring the therapeutic effect of existing drugs can be used as one of the treatment options. This article summarizes the guideline basic drugs for NTM pulmonary disease caused by the above three pathogens and the choice of treatment options after drug resistance.
2020 Vol. 17 (34): 52-55 [
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Research progress on measurement methods of tibial prosthesis rotation angle after total knee arthroplasty
DING Chuan DENG Jiang
Total knee arthroplasty (TKA) is currently the fastest and most effective method for the treatment of end-stage knee osteoarthritis, and the rotation angle of the tibial prosthesis is an important factor in determining its clinical efficacy, and it is also the of important evaluation index clinical efficacy after TKA. Although scholars at home and abroad are based on commonly used imaging techniques such as X-ray, 2D-CT, 3D-CT or MRI, refer to the anatomical landmarks such as posterior edge of tibial prosthesis, tibial tubercle, medial third of tibial tubercle, patellar tendon, Akagi line, reported that the Beger scheme, Mayo scheme, CTTT distance and PLCL technology can accurately assess the rotation angle of tibial prosthesis after TKA, but there is still no gold standard which is method recognized to measure the rotation angle of tibial prosthesis. This article summarizes the measurement methods of the rotation angle of the posterior tibial prosthesis in TKA, aiming to provide reference for the joint surgeon in choosing the measurement method of the rotation angle of the posterior tibial prosthesis in TKA and further research on the optimal angle of the tibial prosthesis rotation in TKA.
2020 Vol. 17 (34): 56-59 [
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Study of fall assessment tools for the elderly
SONG Mi1,2 PI Hongying2 XU Yue2 JI Shuaifei1
Falls are the leading cause of injury and death among the elderly, seriously affecting their physical and mental health, quality of life and life expectancy, and hindering the process of healthy aging. As an important part of fall prevention, risk assessment is helpful for early identification of fall risk. The incidence of falls in the elderly can be effectively reduced by the intervention of risk factors. The purpose of this study is to summarize the fall assessment tools, clarify the indications and contents of the fall assessment for the elderly, and the applicable scope and effect of the assessment tools, so as to provide reference for medical staff to distinguish and choose the appropriate fall assessment tools, and provide ideas for the standardized assessment of falls and the improvement of the assessment process.
2020 Vol. 17 (34): 60-63 [
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Research progress of sedative and analgesic drugs applied in gastrointestinal endoscopy
SHI Yuan DONG Beibei YU Yonghao▲
Gastrointestinal endoscopy can clearly detect gastrointestinal lesions through endoscopyas well as treating some gastrointestinal lesions. However, the patients always feel discomfort during the operation, which would affect the operation of the doctors. Anesthesiologists can provide the patients with moderate sedation and analgesia, relieve the patients’ discomfort and thus reduce surgical associated complications by intravenous drug administration. While the application of Propofol is welcomed by endoscopy doctors and patients, the adverse reactions such as hypotension and respiratory depression should not be ignored. As a result, drug developers and manufacturers have been trying to find alternatives to Propofol sedation. The latest finding is Remimazolam, a new drug of benzodiazepines that exhibits promising superiority in faster metabolic rate. In addition, many protocols for drug combination applications, such as Propofol-Demetomidine and Propofol-Chloramine combination, can markedly improve drug safety without affecting sedation quality. In this paper, the newly developed sedative and analgesic drugs and new drug combination strategies to provide some references for the clinicians.
2020 Vol. 17 (34): 64-67 [
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Application process on mobile technology in continuous care of enterostomy patients
WANG Shuaiying1 LIU Qin1 LUAN Tao2 HAN Yuan1 ZHANG Nan3
Enterostomy is the most common postoperative outcome for patients with colorectal cancer. Due to the change of the patient’s normal way of defecation, it affects patients’ physical and mental health ultimately. Continuous care is a commonly used nursing method for patients with enterostomy, which is conducive to improving the quality of life of patients. With the development of information technology, mobile technology plays a vital role in the continuous care of patients with enterostomy. At present, the tools of mobile technology used for continuous care of patients include phoning, texting, social platforms, mobile app, etc. This article describes the application progress of mobile technology in continuous care of enterostomy patients, in order to provide reference for promoting the application of mobile technology in continuous care.
2020 Vol. 17 (34): 68-70,90 [
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Advances in research on social support for caregivers of cancer patients
ZHANG Meining1 DING Liping1 YANG Heng1 LU Jingyu1 LU Huanzhen2
With the increasing incidence of malignant tumors, caregivers of cancer patients are under great physical and mental pressure, and their health status affects the treatment and prognosis of patients to some extent. At present, researchers have paid little attention to the social support of caregivers of cancer patients. This paper summarizes the relevant concepts of social support, theoretical basis of social support, social support research tools (social support rating scale, understanding social support scale, social support questionnaire), general demographic characteristics caregivers, the influence of social support for patients with tumor and the research status at home and abroad, and put forward the tumor patient caregivers care pressure in our country, the low level of physical and mental health, social support problems such as insufficient understanding degree, points out that along with the continuous development of modern society and the deepening of the research of social support, caregivers of cancer patient in our country will get more broader social support services.
2020 Vol. 17 (34): 71-74 [
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Exploration of the educational mode for foreign postgraduates of ultrasonic medicine
HE Ying LIAO Yiyi YI Cuo LIU Zheng XU Yali▲
The scale of foreign postgraduates students of ultrasonic medicine has gradually expanded with the improvement of international exchanges and cooperation. The subject characteristic of ultrasonic medicine determines its strong practical demand, ultrasound medicine is indispensable for diagnosis knowledge and operation skills. How to standardize the cultivation of foreign postgraduates of ultrasonic medicine, improve the quality of teaching, and adapt to their needs are urgent problems to be solved. This paper focuses on the actual characteristics of foreign postgraduates of ultrasonic medicine, and analyzes the current situation and existing problems of ultrasonic medicine training. The main problems include the limitation of teaching curriculum, the single teaching method, the lack of qualified teachers and the uneven teaching ability. By optimizing the teaching content, enriching teaching means, attaching importance to clinical skills and emphasizing scientific research training, we can improve the training quality of foreign postgraduates of ultrasonic medicine. Combined with strengthening the construction of teaching staff, a new standardized teaching mode is explored.
2020 Vol. 17 (34): 75-78 [
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Thoughts and strategies on improving the graduation design quality of undergraduates majoring in pharmacy in military universities
YE Weiliang1 XIN Chunyan2 NIE Huifang3 BAO Han1 QIU Pengcheng4 ZHOU Siyuan1
The quality of pharmacy undergraduate graduation design in military universities is directly related to the construction and development of the army. It is an important part of cultivating pharmacy military talents. Air Force Military Medical University has stricter requirements for graduation design of pharmacy undergraduates. However, with the changes of experimental environment and management system, there are still many problems in undergraduate graduation design of pharmacy. Taking the Air Force Military Medical University as an example, this article analyzes the major problems existing in undergraduate students of pharmacy in the military universities, such as unreasonable graduation design schedule, poor quality of topic selection, non-standard thesis writing, weak ability to consult literature,and imperfect supervision system of thesis. By discussing how to improve the novelty, authenticity and feasibility of undergraduate course graduation design topic selection, how to improve the standardization of thesis writing, how to improve the interaction between instructors and students, and how to perfect the supervision system of graduation design, in order to increase the enthusiasm and initiative of pharmaceutical undergraduate students in military universities, and improve the quality of graduation design of pharmacy undergraduates in military universities.
2020 Vol. 17 (34): 79-82 [
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Qualitative study of the real experience of newly recruited nurses on standardized training in department of emergency
ZHAO Sijia1 JIANG Jinxia1 TIAN Meimei2
Objective To explore the real experience of newly recruited nurses on standardized training in the emergency department. Methods Using phenomenological research methods, the reflective diaries of 36 nurses who were newly recruited in Tenth People’s Hospital of Tongji University in Shanghai from August 2019 to May 2020 were analyzed, summarized and abstracted using Colaizzi phenomenological data seven-step analysis method. Results Six themes were extracted, including theoretical knowledge of first aid to be improved, skills of emergency specialists to be enhanced, model mentors to take the lead, strong willingness for emergency training in public health emergencies, nursing and patient communication skills to be enhanced, and professional identity to be improved. Conclusion Nursing managers should take effective training measures according to the psychological characteristics of new recruited nurses in the standardized training in the emergency department in different periods, and further improve the standardized pre-job training for new recruited nurses in the emergency department, so as to help them adapt to the emergency environment as soon as possible, improve the comprehensive ability of nursing and improve the quality of nursing.
2020 Vol. 17 (34): 83-86 [
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Application of improved PDCA cycle in clinical teaching management of postgraduate students majoring in surgery
WANG Lei1 LIU Hao1 ZHENG Sufang2 LIU Xiuheng1▲
Objective To explore the effect of the improved PDCA cycle teaching method on postgraduates majoring in surgery. Methods From September 2018 to August 2019, 150 postgraduates majoring in surgery in clinical rotation study in Renmin Hospital of Wuhan University were selected and divided into traditional teaching group, traditional PDCA teaching group and improved PDCA teaching group according to the random number table method, with 50 cases in each group. At the end of each clinical rotation, the students took the corresponding clinical theory and skill operation examination, and the questionnaire was used to evaluate the teaching effect, and the differences of the basic theory, skill operation and teaching effect of graduate students were compared of the three groups. Results The improved PDCA teaching group scored higher in the assessment of medical record writing, basic theory assessment and clinical operation assessment than the traditional PDCA teaching group and the traditional teaching group, and the traditional PDCA teaching group scored higher in the assessment of medical record writing, basic theory assessment and clinical operation assessment than the traditional teaching group, with statistically significant differences (all P < 0.05). In addition, the questionnaire results showed that the improved PDCA teaching method was conducive to the grasp of theoretical knowledge and clinical operation skills, as well as the improvement of clinical thinking, strain capacity, doctor-patient communication ability. Conclusion The implementation of improved PDCA cycle teaching for postgraduate students majoring in surgery can significantly improve the teaching quality and promote the improvement of theoretical knowledge and operational ability of postgraduate students, which is worthy of promotion and implementation in the training of postgraduate students majoring in surgery.
2020 Vol. 17 (34): 87-90 [
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Teaching method reform of clinical medicine education under the new situation
SHEN Yanping WU Cenhao▲
In recent years, with the rapid development of science and technology and modern medicine in China, people have higher requirements for their own health, and their demand for high-quality medical talents is also increasing day by day. Nowadays, modern medicine is not a pure technical discipline, but a synthesis of ethics, psychology, biology and other disciplines. In this new situation, the disadvantages of the mainstream teaching methods are increasingly obvious. In view of these drawbacks, this paper clarifies the new goals and principles of the reform of clinical medicine teaching methods, and gives examples of specific reform methods according to each principle, for example: problem-based cearning teaching method and standardized patient case teaching, multimedia technology of teaching and self-study with MOOC, improved tutor system during basic teaching stage. To sum up, clinical medicine aims to cultivate high-quality medical talents to meet international needs in the future, so it must keep pace with the times in teaching methods and make breakthroughs in traditional teaching ideas.
2020 Vol. 17 (34): 91-93,97 [
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Application of PBL teaching method combined with CBL teaching method in cardiovascular internal medicine internship
ZONG Jing1,2 LI Fangfang1,2 QIAN Wenhao1,2 LIU Jiali1,2 XU Luhong1,2
Cardiovascular internal medicine is not only one of the main contents of internal medicine, but also one of the key and difficult points for medical students to learn. PBL teaching method is a problem-based teaching method. CBL teaching method is a case-based learning method. PBL teaching method and CBL teaching method are both student-centered education models, which have been widely used in medical colleges at home and abroad. In order to help medical students better master the learning content of cardiovascular medicine, PBL teaching method and CBL teaching method are applied to the undergraduate internship of cardiovascular medicine, which not only gives full play to students’ subjective initiative, but also cultivates students’ clinical thinking and improves the teaching quality.
2020 Vol. 17 (34): 94-97 [
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101
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Application of PBL teaching method with WeChat platform in standardized training of pediatric surgery residents
XIONG Zhu1 YU Wei2 SUN Ke1▲ YU Qianhui3 TANG Shengping1 LI Shoulin4 ZENG Hongwu3
Objective To investigate the application of problem-based learning (PBL) teaching method with WeChat platform in the standardized training for pediatric surgery residents. Methods From 2017 to 2018, 30 medical students major in pediatric surgery were enrolled in this study. According to the random number table, they were divided into the experimental group and the control group, with 15 students in each group. The experimental group adopted PBL teaching method based on WeChat platform for teaching; the control group adopted traditional classroom teaching methods. The two groups were investigated by questionnaire and the teaching effect was analyzed. Results The scores of learning interest stimulation, self-learning ability improvement and teamwork spirit in the experimental group were higher than those in the control group, and the differences were statistically significant (all P < 0.05). The ratio of students in a dominant position, high learning pressure, self-study ability improved obviously and significantly improve ability to analyze the problems, problem solving skills improved obviously, more harmonious interpersonal relationship, language expression ability improve, continue to implement the PBL teaching of the experimental group were higher than those of the control group, and the ratio of learning content integrity was lower than that of the control group, the differences were statistically significance (all P < 0.05). Conclusion The application of PBL teaching method with WeChat platform in the standardized training of pediatric surgery residents can effectively improve the students’ clinical thinking and decision-making ability, expression and communication ability, and ultimately improve the students’ clinical work ability, which meets the development needs of the standardized training of modern pediatric surgery residents.
2020 Vol. 17 (34): 98-101 [
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Application effect of diversified teaching for standardized training of residents in ultrasound department
CHEN Zhaobei LI Yezhao ZHANG Xia SU Haiqing
Objective To explore the application value of diversified teaching methods based on post competency combined with problem-based learning (PBL) and case-based learning (CBL) in standardized training of resident in ultrasound department. Methods From January 2016 to December 2019, 89 physicians who received standardized training of resident in the Department of Ultrasound, Affiliated Minzu Hospital of Guangxi Medical University were selected as the subjects of the study. Forty-one physicians who received lecture-based learning (LBL) teaching method from January 2016 to February 2018 were included in the control group. From March 2018 to December 2019, 48 physicians who received diversified teaching of PBL and CBL were included in the experimental group. The results of the two groups’ passing examinations (written tests and skills) and questionnaires were compared. Results The written test, skill assessment and total score in the experimental group were higher than those in the control group, and the differences were statistically significant (all P < 0.05). The passing rate of the experimental group was higher than that of the control group, and the difference was statistically significant (P < 0.05). The satisfaction aspects of self-learning ability, humanistic care, communication ability, skill operation, teaching teacher, learning pressure in the experimental group were higher than those of the control group, with statistically significant differences (all P < 0.05). The teachers believed that the experimental group was more satisfied with the teaching atmosphere, students’ thinking ability, students’ operation report writing and students’ attitude than the control group, and the differences were statistically significant (all P < 0.05). Conclusion Diversified teaching based on post competency combined with PBL and CBL is conducive to improving the teaching quality of standardized training for resident physicians in ultrasound department, and can better train medical professionals with both ability and quality.
2020 Vol. 17 (34): 102-105 [
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Meta-analysis of the prognostic significance of neutrophil-to-lymphocyte ratio in chonic kidney disease
YANG Fangyu1 LIAO Juan2 HUANG Qianyi1 HAN Huajing1 DIAO Qizhi1
Objective To systematically evaluate the effect of neutrophil-to-lymphocyte ratio (NLR) on the prognosis of chronic kidney disease (CKD). Methods CNKI, Wanfang Data, VIP, PubMed, EMbase, Web of Science and Cochrane Library were searched by computer, and the search period was from January 2000 to January 2020. The relevant studies on the relationship between NLR and the prognosis of CKD patients were collected. The Stata 14.0 statistical software was used to assess the pooled hazard ratio (HR), along with 95% confidence interval (CI) about all-cause mortality, adverse cardiovascular events and end-stage renal disease. Results This study included 19 studies with a total of 120 377 patients with CKD. All-cause mortality (HR = 1.39, 95%CI: 1.13-1.70, P = 0.002) and adverse cardiovascular events (HR = 1.25, 95%CI: 1.09-1.43, P = 0.001) of high NLR patients were higher than those of low NLR patients; there was no significant differents between two groups of the occurrence risk of end-stage renal disease (HR = 1.46, 95%CI: 0.95-2.26, P = 0.087). Conclusion High NLR is an independent risk factor for adverse cardiovascular events and all-cause motality in patients with CKD.
2020 Vol. 17 (34): 106-110 [
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Influence of comprehensive hand hygiene intervention for children’s accompanying family members on the control of nosocomial infection
YAN Xiaoyong FU Hong▲ LI Linwei ZHANG Shuqing NIE Xunmei XIAN Anjing
Objective To explore the influence of comprehensive hand hygiene intervention for children’s accompanying family members on the control of nosocomial infection. Methods The accompanying family members of 983 hospitalized children who admitted to the pediatric general ward of Chongqing Jiangjin Center Hospital from January to December 2019 were selected as the research objects. According to the hospitalization number of the children, they were divided into the observation group (475 people) and control group (508 people). Special education and guidance on hand hygiene (informing the importance of hand hygiene, explaining and guiding the correct seven-step hand washing method, placing quick hand sanitizer and hand hygiene reminder cards at the bedside, checking during daily rounds and urge the family members to implement them correctly) were given to the observation group on admission; the control group received the regular hospital admissions and education including hand hygiene. The hand hygiene compliance, wash hands correctly ability, hand hygiene effect and nosocomial infection rate of children and the incidence of nosocomial infection in children hospitalized during the same period in the two groups were analyzed. Results The consumption of rapid hand disinfectant in the observation group was higher than that in the control group, and the difference was highly statistically significant (P < 0.01). The hand hygiene compliance of hospitalized children’s family members in the observation group was higher than that in the control group, and the difference was highly statistically significant (P < 0.01). The average score of wash hands correctly of hospitalized children’s family members in the observation group was higher than that in the control group, and the difference was highly statistically significant (P < 0.01). After hand hygiene, the number of hand bacteria in the observation group was lower than that in the control group, and the difference was highly statistically significant (P < 0.01). The incidence of gastrointestinal infection and total infection in the observation group was lower than those in the control group, and the differences were statistically significant (all P < 0.05). Conclusion Comprehensive hand hygiene interventions for the children’s accompanying family members can improve the hand hygiene ability and hand hygiene effects of the children’s accompanying family members, further improve the hand hygiene compliance of the children’s accompanying family members, and can play a positive role in reducing the incidence of nosocomial infections.
2020 Vol. 17 (34): 111-114 [
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Effect of Dandao Paishi Mixture combined with percutaneous transhepatic cholangioscopic lithotomy in the treatment of calculus of intrahepatic duct
WU Jian ZHU Yaqing CHEN Bin
Objective To study the effect of Dandao Paishi Mixture combined with percutaneous transhepatic cholangioscopic lithotomy (PTCSL) in the treatment of calculus of intrahepatic duct. Methods A total of 63 patients with the diagnosis of calculus of intrahepatic duct from the First Affiliated Hospital of Guangzhou University of Chinese Medicine from November 2017 to December 2018 were divided into the observation group (32 cases) and the control group (31 cases) according to the random number table method. The control group was treated with PTCSL, and the observation group was given Dandao Paishi Mixture after the treatment on the basis of the control group for six months. The number of PTCSL recurrences after surgery, the one-year recurrence rate, the volume of bile drained by the percutaneous transhepatic cholangial drainage (PTCD) tube and the degree of stone removal were compared between the two groups. Results The number of PTCSL recurrences after surgery and one-year recurrence rate in the observation group were both lower than those in the control group, the differences were statistical significance (P < 0.05). The overall analysis of the two-way repeated measures variance found that the differences between groups, time point comparisons and interaction comparisons were statistically significant (all P < 0.05). Intra-group comparison:Compared with the third day after surgery, the PTCD bile drainage volume increased in the observation group on the seventh day and two months after surgery, and two months after surgery was more than the seventh day after surgery, the differences were statistically significant (all P < 0.05). Comparison between groups:the bile drainage volume of PTCD tube in the observation group was higher than that in the control group on the seventh day and two months after the operation, and the differences were statistically significant (all P < 0.05). The degree of removal of stones in the observation group was better than that in control group, and the difference was statistically significant (P < 0.05). Conclusion PTCSL can effectively remove the calculus of intrahepatic duct. The combined use of Dandao Paishi Mixture can promote bile secretion, promote stone excretion, reduce the number of operations and postoperative recurrence rate, and prevent the recurrence of stones. It is worthy of clinical application.
2020 Vol. 17 (34): 115-118 [
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Changes and clinical significance of serum YKL-40 levels in patients with liver cirrhosis
LIU Libo1 DUAN Xufeng1 KONG Xuezhe1 ZHANG Baoru1 WANG Shuhui1 LI Hui1 YANG Ting1 FENG Jun2
Objective To study the relationship between changes in serum YKL-40 levels and clinical characteristics in patients with liver cirrhosis, and to discuss its clinical significance. Methods From February 2016 to December 2018, 90 patients with liver cirrhosis (the liver cirrhosis group) and 40 patients with physical examination (the control group) diagnosed and treated in the No.981 Hospital of the Joint Support Force of the Chinese People’s Liberation Army were selected. The level of serum YKL-40 of the two groups was detected by enzyme linked immunosorbent assay (ELISA).The relationship between YKL-40 levels and clinical characteristics were analyzed. The correlation between serum YKL-40 levels and liver function indicators [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (Alb), and prothrombin time (PT)] in patients with liver cirrhosis were analyzed by Pearson linear correlation analysis. Results The TBil, ALT, AST, serum YKL-40 levels and PT in the liver cirrhosis group were significantly higher than those in the control group, with Alb level significantly lower than that in the control group (all P < 0.05). There were no statistically significant differences in serum YKL-40 expression levels in the liver cirrhosis group with different age, gender and cirrhosis causes (all P > 0.05), while there were statistically significant differences in serum YKL-40 expression levels in the liver cirrhosis group with different Child-Pugh grades, different degrees of liver fibrosis, and complications or not (all P < 0.05). The expression levels of serum YKL-40 in liver cirrhosis group was positively correlated with serum TBil, PT, ALT and AST (r = 0.532, 0.459, 0.572, 0.622, all P < 0.05), and significantly negatively correlated with serum Alb (r = -0.513, P < 0.05). Conclusion The level of YKL-40 in the serum of patients with liver cirrhosis is increased, and is related to Child-Pugh classification of liver function, liver fibrosis and complications and liver function indexes. It is expected to become a new indicator of liver cirrhosis diagnosis and judgment of disease severity.
2020 Vol. 17 (34): 119-122 [
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Exploration on pathogenesis and treatment of ovarian cancer from yang deficiency constitution
WU Xiaoqing LU Wenping
Scholars have studied the constitution theory of traditional Chinese medicine for decades, and the study of yang deficiency constitution occupies an important part, and its formation is influenced by both congenital and acquired aspects. Traditional Chinese medicine believes that yang deficiency constitution is easy to suffer from cold syndrome, and the formation of ovarian cancer is closely related to cold congelation and blood stasis. The formation of yang deficiency constitution is affected by parents’ constitution and qi and blood. It can also be affected by acquired exogenous cold pathogen, endogenous deficient cold and old body decline. Wind-cold enter from air, yang qi is damaged; or drinking cold, spleen yang is damaged; or because of mental disorder, dispersing liver qi, yang qi is depressed, deficient cold is produced in vivo; or because of old and feeble, the true yang insufficiency, yang deficiency constitution is formed. Yang deficiency and cold excessiveness, as well as qi deficiency, lead to blood stasis, insufficiency of vital qi, cancer grows over time, and the four are mixed into accumulation. In the treatment of traditional Chinese medicine, warming yang and benefiting qi, promoting blood circulation and detoxication are used as the method. Warmly dredging drugs are often used to activate the meridian. Insect drugs are often used to promote blood circulation and eliminate accumulation, and to attack poison with poison, so as to achieve the purpose of strengthening vital qi to eliminate pathogenic factor and preventing recurrence.
2020 Vol. 17 (34): 123-126 [
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Clinical observation of Selfmade Tonifying Kidney and Promoting Blood Decoction in the treatment of polycystic ovary syndrome with hypomenorrhea and oligomenorrhea
LI Qiao1 LIU Tiannan1 BIAN Xiaohui1 LIN Xiaohua2
Objective To observe the clinical effect of Selfmade Tonifying Kidney and Promoting Blood Decoction in the treatment of patients with polycystic ovary syndrome with hypomenorrhea and oligomenorrhea. Methods From January to December 2019, 60 patients with polycystic ovary syndrome with hypomenorrhea and oligomenorrhea admitted to Hebei Hospital of Traditional Chinese medicine were selected, they were divided into two groups according to the random number table, with 30 cases in each group. The treatment group was given Selfmade Tonifying Kidney and Promoting Blood Decoction, and the control group was given Yougui Capsules, they were all treated for 3 menstrual cycles. The differences in the pictorial blood loss assessment chart (PBAC) score, menstrual cycle, TCM syndrome scores and clinical efficacy between the two groups were observed. Results After treatment, the PBAC score in both groups was higher than that before treatment, and the TCM syndrome scores were lower than those before treatment. And the PBAC score in the treatment group was significantly higher than that in the control group, and the TCM syndrome score was significantly lower than that in the control group, with statistically significant differences (P < 0.05). After treatment, the menstrual cycle of the treatment group was shorter than that before treatment (P < 0.05). In the control group, there was no significant difference of menstrual cycle before and after treatment (P > 0.05). After treatment, the menstrual cycle of the treatment group was significantly shorter than that of the control group (P < 0.05). The clinical efficacy of the treatment group was significantly better than the control group (P < 0.05). Conclusion The effect of Selfmade Tonifying Kidney and Promoting Blood Decoction on hypomenorrhea and oligomenorrhea in polycystic ovary syndrome is significant, which can significantly improve blood volume of menstruation, menstrual cycle and TCM symptoms.
2020 Vol. 17 (34): 127-130 [
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Effect of Yiqi Yangyin Formula in the treatment of chronic nephritis patients with deficiency of both qi and yin syndrome
KONG Lin1 CHEN Xinzheng1 BAI Xueyuan2 WANG Chunli1 SUN Chen1▲
Objective To analyze the effect of Yiqi Yangyin Formula in the treatment of chronic nephritis patients with deficiency of both qi and yin syndrome. Methods Eighty-six patients with chronic nephritis with deficiency of both qi and yin syndrome from January 2018 to October 2019 admitted to Department of Nephrology in Baoji Hospital of Traditional Chinese Medicine were selected as subjects. According to different treatment methods, they were divided into control group (41 cases) and observation group (45 cases). Control group was treated with conventional Western medicine, while observation group was treated with Yiqi Yangyin Formula for eight weeks. The renal function index, immune function index and traditional Chinese medicine syndrome curative effect were compared between two groups before and after treatment. Results After treatment, urine protein count, urine red blood cell count, 24-hour urine protein quantity, urea nitrogen and serum creatinine levels in observation group were lower than those before treatment and in control group (P < 0.05). After treatment, urine protein count and serum creatinine levels in control group were lower than those before treatment (P < 0.05). Total effective rate of traditional Chinese medicine syndrome in observation group was higher than that in control group (P < 0.05). After treatment, the levels of complement C3 and IgA in observation group were higher than those before treatment (P < 0.05), the level of complement C3 in control group was higher than that before treatment (P < 0.05), and the levels of complement C3 and IgA in observation group were higher than those in control group, the differences were statistically significant (P < 0.05). Conclusion Yiqi Yangyin Formula can significantly improve the renal function and immune function of chronic nephritis patients with deficiency of both qi and yin syndrome, and improve the curative effect of traditional Chinese medicine syndrome.
2020 Vol. 17 (34): 131-133,137 [
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Effect of rolling tuina combined with sitting position knee adjustment method in the treatment of knee osteoarthritis
SHAO Sheng1 GONG Li1 SUN Wuquan1 ZHU Qingguang2 KONG Lingjun2 LI Jianhua1 CHU Yuzhou1 FU Yangyang1 HE Pengfei1 FANG Min2
Objective To observe the clinical effect of rolling tuina combined with sitting position knee adjustment method in the treatment of knee osteoarthritis (KOA). Methods From April 2017 to April 2018, 60 cases of KOA admitted to Department of Tuina in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were divided into control group and treatment group according to the random number table method, with 30 patients in each group. Both groups were given rolling tuina, and the treatment group was given sitting position knee adjustment method based on rolling tuina. The clinical efficacy and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three dimension gait analysis of two groups before and after treatment were observed. Results There was no significant difference of total effective rate between the two groups (P > 0.05). After 5 weeks of treatment, the pain, stiffness, daily activities scores and total scores of WOMAC in the two groups were lower than those before treatment, the step length, stride length, walk velocity all increased, bilateral stance phase was extended, the maximal flexion angle of knee joint increased, the differences were statistically significant (P < 0.05). And the pain, daily activities scores and total scores of WOMAC in the treatment group were lower than those of the control group, the step length, stride length, walk velocity and bilateral stance phase were higher than those of the control group, the differences were statistically significant (P < 0.05). Conclusion The rolling tuina combined with sitting position knee adjustment method can reduce the pain and stiffness symptoms of KOA patients, improve the knee function and walking ability. It is worthy of clinical promotion.
2020 Vol. 17 (34): 134-137 [
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Analysis on the effect of modified Simiao Powder on hyperuricemic nephropathy based on “state-target” strategy
DENG Chenglong LIU Qian OUYANG Meiping HU Miaoqing ZHOU Ke
“State-target” strategy is first proposed by academician Tong Xiaolin. It realizes the organic combination of the characteristic advantage of traditional Chinese medicine “macro syndrome differentiation” and modern medicine “micro target”, providing a basis for the further development of traditional Chinese medicine syndrome differentiation theory. In the treatment of hyperuricemic nephropathy, for its “deficiency of spleen and kidney, phlegm-dampness-heat block” and “symptom targets” such as joint pain, dysuria, hematuria, edema, waist pain, frequent nocturia and foamy urine, etc. And “calibration targets” of urinary protein, high blood uric acid, high blood creatinine, hypertension, etc, we can use Simiao Powder plus Astragali Radix, Smilacis Glabrae Rhizoma, Dioscoreae Spongiosae Rhizoma for “conditioning” and “target” treatment. It can improve the symptoms of patients with hyperuricemic nephropathy in many ways.
2020 Vol. 17 (34): 138-141 [
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Interpretation of four medical cases of Chen Tingru in bingshen spring based on the theory of five evolutive phases and six climatic factors
ZHOU Wei1 LAO Yingrong1 BIN Wei2 WU Xinming1
It is an important principle in clinical diagnosis and treatment of traditional Chinese medicine to do the right thing at the right time. According to the theory of five evolutive phases and six climatic factors in traditional Chinese medicine, the factors of yunqi in patients’ onset and treatment are of great significance to diagnosis and treatment. Based on the theory of five evolutive phases and six climatic factors, this paper interprets the four spring medical cases of the year of bingshen, which are treated by Chen Tingru, a physician in the Qing Dynasty, for example, hematemesis and lumbago, cold and heat of amenorrhoea, diarrhea and vomiting of chest pain, testical ptosis and tendon pain. It is preliminarily believed that there is a high correlation between the factors of yunqi in the year of bingshen and the pathogenesis of the disease and Chen’s clinical thinking, suggesting that the application of the theory of yunqi should be emphasized in the process of clinical diagnosis and treatment of traditional Chinese medicine. When the disease patients can not only hurt the yun, but also hurt qi, and even hurt yunqi. Among the elements of yunqi, which is the most important one: suiyun, sitian, zhuyun, keyun, zhuqi, keqi. When the specific situation, detailed investigation of the disease, careful examination of the pathogenesis can be known. In addition, to interpret medical cases, we need to consider the status and reality of yunqi, and the pathogenic factors of yunqi are often determined by the deficiency of patients’ qi.
2020 Vol. 17 (34): 142-145 [
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Experience of professor Li Peiwen in treating cardiotoxicity related to breast cancer treatment
ZHOU Jialin1 WANG Zhaodongfang1 ZHANG Jing1 WAN Donggui2
Anthracycline chemotherapy drugs and targeted drugs such as Trastuzumab are commonly used anti-tumor drugs in the treatment of breast cancer, and cardiotoxicity is the common reason to limit their use, which seriously affects the anti-cancer treatment and prognosis of breast cancer patients. With the gradual development of breast conserving surgery, left chest wall radiotherapy induced cardiac injury is also one of the influencing factors of breast cancer patients with cardiac dysfunction in the future. Professor Li Peiwen has rich clinical experience in the diagnosis and treatment of cardiotoxicity related to breast cancer treatment. He thinks that the treatment of cardiotoxicity caused by anthracycline drugs, Trastuzumab and radiotherapy are different. Cardiotoxicity caused by Trastuzumab is mainly deficiency of heart qi, cardiotoxicity caused by anthracyclines is mainly blood stasis, and cardiotoxicity caused by left chest wall radiotherapy is mainly yin deficiency. In the treatment, the methods of benefiting heart qi, promoting blood circulation and removing blood stasis, eliminating heat by nourishing yin have achieved satisfactory clinical results.
2020 Vol. 17 (34): 146-149 [
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Ultrasound and magnetic resonance imaging image characteristics in the diagnosis of dangerous placenta previa
LIU Min1 LIU Lei2▲ LU Yu1
Objective To analyze the image characteristics of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of dangerous placenta previa (PPP). Methods Sixty patients with PPP confirmed by postoperative pathology in Changzhou Hospital of Traditional Chinese Medicine from August 2017 to April 2020 were selected. With postoperative pathological diagnosis as the gold standard, the ultrasound and MRI diagnosis results were compared, and the image characteristics were analyzed. Results A total of 50 cases were confirmed by postoperative pathology with placental implantation; ultrasonography was used to diagnose 42 cases with placental implantation; MRI diagnosis of 45 cases with placental implantation, and ultrasonography combined with MRI was used to diagnose 48 cases with placental implantation. The PPP accuracy, sensitivity, specificity, Yoden index and AUC values of the joint examination were 90.00%, 92.00%, 80.00%, 0.72 and 0.93, respectively, which were all higher than the single examination method, with statistically significant differences (P < 0.05). Conclusion Both ultrasound and MRI images of PPP patients have characteristics, and ultrasound combined with MRI is helpful to improve the diagnostic accuracy of PPP.
2020 Vol. 17 (34): 150-152,160 [
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Effect of Xingbei Zhike Granules in the adjuvant treatment of children with acute bronchitis
DONG Wenfang1* WANG Wenyu2* LIN Jie1 WU Yufen1 YUAN Shuhua1 ZHANG Hao1 ZHANG Bin2
Objective To observe the effect of Xingbei Zhike Granules combined with Western medicine in the adjuvant treatment of children with acute bronchitis. Methods One hundred and eight children with acute bronchitis diagnosed by Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University Medical College from January to December 2019 were divided into control group and treatment group according to random number table method, 54 cases in each group. Control group was given conventional Western medicine treatment, namely anti infection and symptomatic treatment; treatment group was given Xingbei Zhike Granules at the same time. The course of treatment was one week. The clinical outcome was followed up. Cough symptom score, fever regression time, pulmonary rales disappearance time and adverse reactions were recorded. Results Total effective rate of treatment group was significantly higher than that of control group (P < 0.01). There was no significant difference in cough symptom scores between two groups before treatment and the seventh day of treatment (P > 0.05). The third day of treatment, the cough symptom score of treatment group was significantly lower than that of control group (P < 0.01). The time of fever regression in treatment group was shorter than that in control group (P < 0.05). There was no significant difference in the disappearance time of pulmonary rales between two groups (P > 0.05). There was no significant difference in the incidence of adverse reaction between two groups (P > 0.05). Conclusion Xingbei Zhike Granules combined with Western medicine in the adjuvant treatment of children with acute bronchitis, early medication can reduce cough symptoms in the third day of treatment, and can shorten the time of fever regression and improve the total effective rate, with low incidence of adverse reactions, which is worthy of clinical promotion.
2020 Vol. 17 (34): 153-156,180 [
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Clinical significance of abnormal blood separation in multiple myeloma
CHU Nali1 FAN Hong1 GUO Li2 XU Di2 ZHANG Hua2 ZHANG Jingyu1▲
Objective To investigate the abnormal blood separation in multiple myeloma (MM). Methods A total of 282 MM patients (152 cases of IgG type,92 cases of IgA type, 6 cases of IgD type and 32 cases of light chain type), 200 autoimmune diseases patients and 200 healthy physical examinees were selected from Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province from March 2008 to October 2019. Fasting venous blood was collected by vacuum blood collection with separation gel, and the results of blood separation were observed after centrifugation. The patients were divided into the control group and the abnormal group according to the blood separation results, and the differences of immunoglobulin (Ig), total protein (TP), hemoglobin (Hb), hematopoietic volume (Hct), platelet count (PLT), and fibrinogen (Fig) levels were compared between the two groups. Results The blood of patients with autoimmune disease, healthy physical examinees and partial MM patients were divided into three layers, followed by serum, separation glue and red blood cells from top to bottom, and the proportion of serum and red blood cells was appropriate. Patients with abnormal blood separation were MM patients, and the abnormal blood was separated into four layers, successively from top to bottom: serum, red blood cell, separation glue and red blood cell. There was a small amount of serum in the upper layer, a increase of red blood cells in the lower layer, and a small amount of red blood cell in the bottom layer. Abnormal blood separation was found in 46 cases of the 282 MM patients (16.31%). Abnormal separation was found only in IgG (28 cases) and IgA (18 cases), accounting for 60.87% and 29.13%, respectively. The levels of TP and Ig in the abnormal group were higher than those in the control group, while the levels of Hb and Hct in the abnormal group were lower than those in the control group (all P < 0.05). Conclusion Abnormal separation phenomenon occurred after centrifuged in patients with MM. In case of abnormal blood separation in daily work, timely communication with clinicians should be conducted and further confirmatory tests should be conducted.
2020 Vol. 17 (34): 157-160 [
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Research on the construction of hospital infection management team guided by the concept of top-level design
QIN Xiaoping1 YU Lei2 LU Lianhe3 CHEN Baomin4 GUO Liang5 XIE Xianghui6
Hospital infection management in China has been paid more and more attention by leaders and medical institutions at all levels. The level of hospital infection control has become an important indicator of medical quality evaluation and plays an important role in ensuring the occupational safety of medical staff. However, the lack of hospital infection control specialty in China’s medical colleges and universities has led to deficiencies in discipline construction, team construction and other aspects, which have restricted the development of the major. However, to change this situation will not be solved in a short time. Chaoyang District of Beijing took the lead in establishing the district hospital infection management quality control center in 2010. Under the guidance of the concept of “top-level design”, the center carries out the research on the training of full-time and part-time staff of regional hospital infection control, and achieves certain results. In order to make up for the deficiencies of the construction of hospital infection professional team, some ideas and methods can be used for reference, which are of great significance for promoting the sustainable development of hospital infection management.
2020 Vol. 17 (34): 161-164,192 [
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Qualitative research on palliative care attitude of nurses in oncology department
AN Fangfang1 JING Zhaoxia2 FU Yahui3
Objective To understand the status quo of palliative care attitude of nurses in oncology department. Methods From October 2019 to January 2020, 12 nurses from the Oncology Department of the Second Affiliated Hospital of Shaanxi University of Chinese Medicine were interviewed in a semi-structured manner using objective sampling and phenomenological research methods, and Colaizzi 7-step analysis was used to sort out and analyze the data. Results Four themes were extracted from the interview: awareness of palliative care; palliative care implementation attitude; palliative care experience; issues facing the development of palliative care. Conclusion Oncology nurses have a comprehensive understanding of palliative care and a positive attitude towards implementation, but their experience of palliative care has negative emotions. Therefore, all relevant departments should strengthen the promotion of palliative care concept.
2020 Vol. 17 (34): 165-168 [
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162
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169
Efficacy evaluation of multidisciplinary collaborative medical care model for rapid recovery in elderly patients with acute exacerbations of chronic obstructive pulmonary disease
DENG Xia1 WU Yongmei2▲ ZENG Ying2 XU Lulu2 WANG Lu1
Objective To investigate the effect of multidisciplinary collaboration (MDT) medical care model on rapid recovery in elderly patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods From September 2018 to September 2019, a total of 160 elderly AECOPD patients admitted to Chongqing People’s Hospital were selected as study subjects. The subjects were randomly divided into the control group and the observation group according to their admission numbers, with 80 patients in each group. The control group received routine AECOPD medical care, and the observation group received MDT medical care mode on the basis of the control group. Pulmonary function severity (CAT), dyspnea index (mMRC), activity of daily living (ADL), ventilator use time, length of stay and satisfaction rate of hospitalization were compared between the two groups before and after intervention. Results Before intervention, CAT score, mMRC index and ADL index were compared between the two groups, and the differences were no statistically significant (all P > 0.05). After intervention, CAT score and mMRC index in both groups were lower than before intervention (all P < 0.05), and ADL score in both groups was higher than before intervention (all P < 0.05). After intervention, CAT score, mMRC index, ventilator use time and hospitalization time in the observation group were all lower than those in the control group (all P < 0.05), while ADL score and hospitalization satisfaction rate in the observation group were higher than those in the control group (all P < 0.05). Conclusion Multidisciplinary collaborative medical care model not only contributes to the rapid recovery of lung function in elderly AECOPD patients, but also improves the overall quality of care, which is worthy of clinical application.
2020 Vol. 17 (34): 169-172 [
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140
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173
Application of Omaha System-based nursing intervention in the prevention of deep vein thrombosis of lower extremities in patients undergoing total hip replacement
QI Jun1 YU Keling1 WANG Cui1 LI Hongtao2▲
Objective To explore the application of Omaha system nursing intervention in the prevention of deep vein thrombosis of the lower extremities of patients undergoing total hip arthroplasty (THA). Methods From January 2018 to December 2019, the study subjects selected 85 patients in the orthopedic ward of Xinhua Hospital Affiliated to Dalian University who were admitted to undergo THA, and according to odd and even numbers, they were randomly divided into control group (42 cases) and observation group (43 cases). The control group received routine nursing intervention in the hospital, and the observation group implemented the Omaha system nursing intervention on the basis of the control group; the anxiety, pain, hip joint function and the incidence of deep vein thrombosis (DVT) of the two groups were compared. Results After intervention, the scores of patient anxiety scale and visual simulation score of the two groups were lower than those before intervention, and the observation group was lower than the control group, with statistically significant differences (P < 0.05). In addition to the deformity score lower than that of the control group, the function, activity and pain of the observation group were all higher than that of the control group, with statistically significant differences (P < 0.05). The incidence of lower limb swelling and DVT in the observation group was lower than that in the control group, and patient satisfaction was higher than that in the control group, with statistically significant differences (P < 0.05). Conclusion The application of nursing intervention based on the Omaha system is effective in preventing DVT in patients undergoing THA, reducing anxiety and pain, and improving patient satisfaction and hip joints function, worthy of clinical promotion.
2020 Vol. 17 (34): 173-176 [
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177
Effect of influence of nursing intervention under the guidance of the concept of fast track surgery on the stress response and rehabilitation effect of thoracoscopic pulmonary nodule resection
WENG Yun CHEN Jinxiu JIANG Ji
Objective To investigate the effect of nursing intervention based on the concept of fast track surgery on the stress response and rehabilitation effect of patients undergoing thoracoscopic pulmonary nodule resection. Methods A total of 92 patients undergoing thoracoscopic pulmonary nodule resection in the Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University were selected. According to the operation time, they were divided into 48 cases in the treatment group (October 2018—May 2019) and 44 cases in the control group (February 2018—September 2018). The control group was given routine nursing intervention, and the treatment group was given nursing intervention based on the concept of fast track surgery. The stress response, operation-related indicators, and complications were compared between the two groups. Results After 72 h operation, the heart rates of the two groups were lower than those before the operation, Interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were all higher than those before the operation (P < 0.01). The heart rate of the treatment group was significantly higher than that of the control group, and IL-6, TNF-α, CRP were significantly lower than the control group (P < 0.01). There was no significant difference in operation time between the two groups of patients (P > 0.05). The amount of intraoperative fluid infusion, the time to remove the tracheal tube, the time to remove the chest drainage tube, and the length of stay were significantly shorter than those of the control group (P < 0.01). The incidence of complications was significantly lower than that of the control group (P < 0.05). Conclusion Nursing intervention based on the concept of fast track surgery can help relieve the stress response of patients undergoing thoracoscopic pulmonary nodule resection, promote postoperative recovery, and reduce complications.
2020 Vol. 17 (34): 177-180 [
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80
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Effect of health education with feedback method on acute radioactive vaginal mucosal reaction after interstitial implantation followed by radiotherapy in elderly patients with cervical cancer
ZENG Yuting1 LONG Xianfeng1 ZENG Hongping2 LI Lirong1 MO Ying1 CHEN Zhaohong1 FANG Hongyan1
Objective To analyze the effect of health education with feedback method on the acute radioactive vaginal mucosal reaction of elderly patients with cervical cancer after interstitial implantation followed by radiotherapy. Methods From August 2018 to September 2019, a total of 32 elderly patients with cervical cancer in the radiotherapy department of a tertiary first-class hospital underwent interstitial implantation followed by radiotherapy as the experimental group, and 32 elderly patients in the same department from June 2017 to July 2018, patients with cervical cancer who underwent interstitial implantation followed by radiotherapy served as the control group. The experimental group used the health education with feedback method, and the control group received conventional health education. The incidence of acute radioactive vaginal mucosal reaction was compared and the compliance of the prevention of acute radioactive vaginal mucosal reaction between the two groups were compared. Results It was judged 4 weeks after the after loading, the radioactive vaginal mucosal reaction of the experimental group was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). The compliance of the experimental group to prevent acute radioactive vaginal mucosal reactions was significantly higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion Health education with feedback method can effectively improve the management of the vagina of elderly patients undergoing radiotherapy after interstitial implantation followed by radiotherapy of cervical cancer, reduce the incidence of acute radioactive vaginal mucosal reactions, while improve the compliance of patients to prevent acute radioactive vaginal mucosal reactions.
2020 Vol. 17 (34): 181-184,196 [
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187
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185
Mediating role of self-management behaviors in the education level and quality of life of patients with schizophrenia
ZHANG Xiuying1,2 LI Xiaolin2 WU Shuang1,2 LAI Hua1,2 ZHENG Lulu1,2 LIU Lifang1,2
Objective To explore the relationship between education level, quality of life and self-management behavior of patients with schizophrenia. Methods A total of 126 patients with schizophrenia who were hospitalized in the Mental Health Center of West China Hospital of Sichuan University from October 2019 to May 2020 were selected as the research objects. The quality of life questionnaire for patients with schizophrenia and the self-management behavior questionnaire for patients with schizophrenia were used to evaluate patients. Results The quality of life score of patients with schizophrenia was (39.77±19.26) points; the score of self-management behavior was (84.65±23.47) points. The total scores of quality of life and the dimensions of psychosocial scale, symptom and side effects scale of schizophrenia patients with different levels of education were compared, and the differences were statistically significant (P < 0.05); there was a statistically significant difference in the drug management dimension of self-management behavior (P < 0.05). The patient’s education level (β = -0.246) and the self-efficacy dimension of self-management behavior (β = -0.474) negatively predicted the quality of life; the level of education had an indirect effect on the quality of life through the self-efficacy dimension, and the mediation effect accounted for 42.2% of the total effect. Conclusion Patients with schizophrenia with a high level of education are confident in self-management of the disease, and their quality of life is good. Therefore, according to the patients’ different education levels, focus on cultivating the patient’s disease self-management ability to improve the patient’s quality of life.
2020 Vol. 17 (34): 185-188 [
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106
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189
Application of cognitive behavioral intervention in stroke patients with constipation
CONG Nan1 ZHANG Yi1 GUO Chuang2
Objective To explore the effect of cognitive behavior intervention in patients with stroke and constipation. Methods Sixty patients with stroke and constipation who were hospitalized in the Department of Neurosurgery of Peking Union Medical College Hospital from January 2018 to December 2019 were selected as the research objects. The study subjects were randomly divided into two groups according to the order of hospitalization, with 30 cases in each group. The control group was given conventional treatment and nursing for constipation, and the experimental group was given cognitive behavioral intervention on the basis of conventional treatment and nursing for constipation. The improvement of constipation symptoms in the two groups of stroke patients with constipation before intervention and after 7 and 14 d of intervention were compared. Results The differences in the time, inter-group, and interaction of stroke patients between the two groups were highly statistically significant (P < 0.01). Further pairwise comparison, intra-group comparison: the constipation score of stroke patients after intervention for 7, 14 d were lower than that before intervention, and the differences were statistically significant (P < 0.05); comparison between groups: after 7, 14 d of the intervention, the constipation score of stroke patients in the experimental group was lower than the control group, and the difference was statistically significant (P < 0.05). The effective rate of the experimental group was significantly higher than that of the control group, and the difference was statistically significant (P < 0.05). The differences in the time, inter-group, and interaction of stroke patients between the two groups were highly statistically significant (P < 0.01). Further pairwise comparison, intra-group comparison: the Barthel index (BI) score of stroke patients after 7 and 14 d of intervention were higher than those before intervention, and the differences were statistically significant (P < 0.05); comparison between groups: after 7, 14 d of the interventional, the BI score of stroke patients in the experimental group was higher than the control group, and the difference was statistically significant (P < 0.05). Conclusion Cognitive behavioral intervention can improve the symptoms of constipation in stroke patients, improve its clinical effects, and further improve the quality of life of patients.
2020 Vol. 17 (34): 189-192 [
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71
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193
Refined research and development of the ophthalmic appointment source pool system
WU Peiyu FENG Kemi HU Ruilin
Objective To contract a hospital number pool sharing platform based on the service-oriented architecture architecture to maximize the sharing of appointment number sources, based on the refined research and development and application of the ophthalmic appointment source pool system. Methods The ophthalmology appointment source pool system was applied to the outpatient of Eye Hospital of Wenzhou Medicine University from April 2018 to March 2019, while the number pool system applied before and after the application of the number of outpatient appointment sources, total number of visits and changes in the rate of absentee appointments were analyzed. Results After the ophthalmology number pool system was applied to outpatient clinics, the total number of patients who made appointments on site was reduced by 35 582. There was a statistically significant difference in the source of appointments before and after the application of the number pool system for half a year (P < 0.05). The system increased the total number of outpatients by 56 345, and reduced the rate of missed appointments from 7.3% to 6.6%. There was a statistically significant difference in the number of total patients, online appointments, and on-site appointments before and after the application of the number pool system (P < 0.05). Conclusion After the application of the ophthalmology appointment source pool system, the congestion on the outpatient clinic site is significantly alleviated, the total number of patient visits are increased, and the rate of missed appointments are decreased. The ophthalmology appointment source pool system can improve outpatient management and improve patient experience.
2020 Vol. 17 (34): 193-196 [
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