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2021 Vol. 18, No. 13 Published: 2021-05-05

	4	Comparison of molecular characteristics of Bacillus cereus from bloodstream infection and food poisoning
		LIU Juan1* XIE Chengbin2* SU Zhe2 WANG Pinjia1
		Objective To compare the molecular characteristics of Bacillus cereus from bloodstream infection (BSI) and food poisoning (FP), to establish a database of Bacillus cereus toxin carrying status and genotyping. Methods From January 2015 to June 2019, 18 strains of Bacillus cereus were isolated from blood of inpatient children in Sichuan Provincial Maternity and Child Health Care Hospital， and 21 strains of Bacillus cereus isolated from fecal samples of food poisoning patients in Sichuan Provincial Maternity and Child Health Care Hospital and Sichuan Provincial Center for Disease Control and Prevention during the same period. The antimicrobial susceptibility test for 14 antibiotics was performed by micro-broth dilution method. Ten virulence genes (hbl A, hbl C, hbl D, nhe A, nhe B, nhe C, ent FM, cyt K, bce T and EM1) were detected by PCR. Genotyping was performed by ERIC-PCR. Results The drug resistance rate of 39 strains of Bacillus cereus to Penicillin G and Ampicillin was more than 95%. The drug resistance rate of the isolates from BSI to Compound Sulfamethoxazole was higher than that from FP (P < 0.05). All strains carried at least 3 virulence genes, and no vomiting related genes were found in the isolates from BSI strains. Thirty-nine isolates Bacillus cereus were divided into 31 genotypes by ERIC-PCR, showing high diversity. Conclusion Bacillus cereus from BSI and FP may have differences in drug resistance spectrum and virulence spectrum, and therefore active monitoring and tracing should be performed.
		2021 Vol. 18 (13): 4-7,12 [Abstract] ( 84 ) HTML (1 KB) PDF (996 KB) ( 24 )

	8	Study on the difference of aporphine alkaloids in Radix linderae before and after processing methods by UPLC-QTOF-MS/MS
		SHE Bo1 XIANG Xingliang1 SHI Qingxin1 JIN Shu’na2 ZHANG Lijun2 SONG Chengwu1 SU Chao1▲ HUANG Rongzeng1▲
		Objective To identify and characterize aporphine alkaloids in Radix linderae by UPLC-QTOF-MS/MS, and to investigate the effect of different processing methods on such compounds. Methods Waters ACQUITY BEH C18 column (1.7 μm, 2.1 mm×100 mm) was performed, column temperature was 40℃, and mobile phase was methanol-water with gradient elution. Electrospray ion source and MSE (full information tandem mass spectrometry) scanning in positive ion mode were used. The aporphine alkaloids in raw and processed products were analyzed. Results A total of 36 kinds of aporphine alkaloids were identified. Compared with the raw, the relative contents of aporphine alkaloids decreased by 18 and increased by 9 after frying; the relative content decreased by 21 and increased by 6 after treated with vinegar; the relative content decreased by 21 and increased by 6 after wine treatment; the relative content decreased by 23 and increased by 7 after salting. Conclusion After processing, the content of most aporphine alkaloids has changed significantly, which can provide the material basis for the effect change of Radix linderae.
		2021 Vol. 18 (13): 8-12 [Abstract] ( 64 ) HTML (1 KB) PDF (946 KB) ( 76 )

	13	Discussion on mechanism of Zhuanyao Decoction in the treatment of degenerative lumbar spinal stenosis based on network pharmacology
		LI Luguang1 ZHU Liguo1 GAO Jinghua1，2 GAO Chunyu1 WANG Baojian1 WEI Xu1 YIN Xunlu1 LI Hui1
		Objective To explore the mechanism of Zhuanyao Decoction in the treatment of degenerative lumbar spinal stenosis (DLSS) based on network pharmacology. Methods The main active components and targets of Zhuanyao Decoction were obtained through TCMSP, BATMAN database and literature, and the “active ingredient-target” network of Zhuanyao Decoction was constructed by Cytoscape. The pathogenic target of DLSS was obtained by DisGeNET, GeneCards and OMIM disease database. The analysis of protein-protein interaction (PPI) was carried out on the String platform. The PPI network was constructed by Cytoscape and the main targets in the network were screened out according to the degree value. Metascape was used to analyze the biological process and pathway of Zhuanyao Decoction in the treatment of DLSS. Results Eighty-six main active components and corresponding 185 targets of Zhuanyao Decoction were screened, 1168 pathogenic targets of DLSS and 84 intersection targets of DLSS treated with Zhuanyao Decoction were screened. PPI showed that it was closely related to JUN, TNF, AKT1, MAPK1, and other targets. There were 1987 biological function items and 142 signal pathways obtained by GO biological function and KEGG pathway analysis. Conclusion Zhuanyao Decoction has the characteristics of multi-component, multi-target and multi-pathway in the treatment of DLSS.
		2021 Vol. 18 (13): 13-18 [Abstract] ( 123 ) HTML (1 KB) PDF (1663 KB) ( 130 )

	19	Study on the effect and mechanism of Bixie Qufeng Decoction on gouty arthritis rats with dampness-heat amassment pattern
		QIU Qingzhong1 QI Zirong2 XING Zhenlong1
		Objective To explore the effect and mechanism of Bixie Qufeng Decoction on gouty arthritis rats with damp- ness-heat amassment pattern. Methods Fifty rats were divided into blank control group, model group, Colchicine group, high-dose Bixie Qufeng Decoction group and low-dose Bixie Qufeng Decoction group according to random number table method, with 10 rats in each group. The blank control group was fed normally, and the model group, Colchicine group, high-dose Bixie Qufeng Decoction group and low-dose Bixie Qufeng Decoction group were used to make the model of gouty arthritis with dampness-heat amassment pattern in rats by double modeling method. After the model was successfully established, the high-dose and low-dose Bixie Qufeng Decoction group were given high-dose and low-dose Bixie Qufeng Decoction extract by gavage (8.31, 4.52 g/kg) respectively, the Colchicine group was given Colchicine solution by gavage (at 9 mg/kg), and the model group and the blank control group were given equal volume of normal saline. The changes of joint swelling degree were observed before and after modeling, and the levels of uric acid (UA), interleukin (IL)-1β and cysteine aspartate (Caspase-1) were assessed by blood sampling. Results The joint swelling degree of the high-dose Bixie Qufeng Decoction group was lower than that of the model group, and the difference was statistically significant (P ＜ 0.05). Compared with the model group, the serum levels of UA, IL-1β and Caspase-1 in the high-dose Bixie Qufeng Decoction group were decreased, while the serum UA level in the low-dose Bixie Qufeng group were decreased, with statistical significance (all P ＜ 0.05). Conclusion In the treatment of gouty arthritis with dampness-heat amassment pattern, Bixie Qufeng Decoction may alleviate the inflammatory response of gouty arthritis by inhibiting the inflammatory mediators such as IL-1β and Caspase-1, and reduce the UA level of the body.
		2021 Vol. 18 (13): 19-22 [Abstract] ( 195 ) HTML (1 KB) PDF (711 KB) ( 91 )

	23	Exploration and experimental teaching reform of chemistry for Chinese materia medica based on O2O mode
		MENG Yonghai YANG Lin GUAN Feng WANG Zhibin ZHOU Yuanyuan ZHAI Chunmei XIE Guoliang YANG Bingyou
		Through the development of online teaching activities such as online teaching and online learning to improve the experimental teaching quality of chemistry for Chinese materia medica. According to the particularity of online teaching, the online to offline (O2O) mode is adopted to redesign and practice the teaching content and methods of chemistry for Chinese materia medica in the research. The experimental teaching strategy is optimized, the experimental resources are added, and an evaluation and feedback mechanism suitable for online teaching of chemistry for Chinese materia medica is established. The results show that the experimental teaching mode of chemistry for Chinese materia medica based on the O2O model can promote the improvement of teaching quality, enrich the teaching methods and teaching resources of chemistry for Chinese materia medica, and provide new teaching methods and resources for the cultivating of high-quality talents of Chinese materia medica specialty.
		2021 Vol. 18 (13): 23-26 [Abstract] ( 57 ) HTML (1 KB) PDF (853 KB) ( 114 )

	27	Predictive value of serum LRG1 for contrast nephropathy in patients with coronary heart disease undergoing percutaneous coronary intervention
		QIAO Haixia1 WANG Pengfei2 GUO Jingtao1 ZHOU Jiang1 LIANG Yandong1 FU Lijun1
		Objective To explore the predictive value of serum leucinerich-alpha-2-glycoprotein-1 (LRG1) in contrast nephropathy after percutaneous coronary intervention (PCI) in patients with coronary heart disease. Methods A total of 293 patients with coronary heart disease undergoing PCI in Chengde Central Hospital from January 2017 to December 2019 were divided into contrast nephropathy group (57 cases) and non-contrast nephropathy group (236 cases) according to the occurrence of contrast nephropathy after PCI. The serum LRG1 level was detected by enzyme linked immunosorbent assay, and demographic data, glucose and lipid metabolism indexes, and renal injury related indexes were collected. Multivariate logistic regression analysis was used to analyze the influencing factors of contrast nephropathy in patients with coronary heart disease after PCI. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum LRG1 for contrast nephropathy. Results The white blood cell (WBC), red blood cell distribution width (RDW), uric acid (UA), Cystatin C (Cys-C), serum creatinine (Scr), LRG1 and contrast dose levels in contrast nephropathy group were higher than those in non-contrast nephropathy group, estimated glomerular filtration rate (eGFR) levels was lower than non-contrast nephropathy group (P ＜ 0.05). Elevated Cys-C, Scr, contrast dose and LRG1 were independent risk factors of contrast nephropathy after PCI (OR = 1.537, 1.465, 1.664, 1.592; P ＜ 0.05), and elevated eGFR was protective factor of contrast nephropathy (OR = 0.809, P ＜ 0.05). ROC curve showed that the AUC of LRG1 in predicting contrast nephropathy was 0.853, the cut-off value was 319.67 ng/mL, sensitivity was 83.47% and specificity was 80.70%. Conclusion Elevated serum LRG1 is an independent risk factor of contrast nephropathy in patients with coronary heart disease after PCI. Early detection can be used as a biochemical index to predict contrast nephropathy.
		2021 Vol. 18 (13): 27-30 [Abstract] ( 158 ) HTML (1 KB) PDF (693 KB) ( 132 )

	31	Study on preparation of Venenum Bufonis Chitosan Microspheres and sustained release characteristics in vitro
		LIU Li1 LI Zongyun2 HE Shixue2 ZHAO Yue2 ZHANG Chunbao2
		Objective To prepare the Venenum Bufonis Chitosan Microspheres with deacetylated chitosan as a carrier and study the characteristics of Venenum Bufonis Chitosan Microspheres sustained release in vitro. Methods The Venenum Bufonis Chitosan Microspheres were prepared by emulsification-crosslinking method and their components were identified by thin layer chromatography. High performance liquid chromatography was used to detect the content of cinobufagin and resibufogenin and to detect the encapsulated efficiency of microspheres (the amount of drug encapsulated in the system divided by total dose of encapsulated and unencapsulated). The ultraviolet spectrophotometer was used to detect the indole alkaloids. Results The prepared microspheres had smooth surface and an average particle size of 9.20 μm. The three batches of microspheres showed fluorescence spots corresponding to the control substance and were negative without interference. The total drug loading of cinobufagin and resibufogenin, encapsulation rate and indole alkaloids content of microspheres were 6.06%, 73.30% and 6.59% respectively. Conclusion The prepared Venenum Bufonis Chitosan Microspheres have a good sustained release effect.
		2021 Vol. 18 (13): 31-34,46 [Abstract] ( 63 ) HTML (1 KB) PDF (894 KB) ( 75 )

	35	Overview of acupuncture treatment for knee osteoarthritis in recent five years
		ZHU Rui1 YUAN Puwei2 DONG Bo2 ZHENG Jie1
		Knee osteoarthritis is one of the most common joint diseases in clinical practice, mainly manifested by knee joint pain and joint function loss, the incidence of which increases with the increase of age. Due to the unknown pathogenesis, Western medicine lacks effective treatment, but the acupuncture treatment of knee osteoarthritis has been effective, and has been widely recognized by the society. This article reviews the clinical research progress of acupuncture and moxibustion in the treatment of knee osteoarthritis in the past five years from the two aspects of acupoint selection characteristics and common treatment methods.
		2021 Vol. 18 (13): 35-38 [Abstract] ( 181 ) HTML (1 KB) PDF (502 KB) ( 168 )

	39	Research progress on relationship between platelet activating factor and chronic spontaneous urticaria
		LI Mengli1 GUO Jianhui1，2 ZHAO Na1，2 GUO Wen1，2 GONG Ke1 WANG Fang1 DU Kaiqing1 ZHANG Man1
		Chronic spontaneous urticaria is a special type of chronic urticaria. Mast cell disorder and basophil activation and degranulation are considered to be the center of this process. In the course of pathogenesis, it stimulates the release of platelet activating factors related to allergic inflammation. In addition, platelet activating factor is a very important pathogenic component that can cause severe allergic reactions. It can also activate mast cells and aggravate inflammatory reactions, which has gradually attracted attention in this research field. In this paper, the current research on the relationship between platelet activating factor and chronic spontaneous urticaria will be sorted out to provide a new direction for the effective prevention and treatment of chronic spontaneous urticaria.
		2021 Vol. 18 (13): 39-42 [Abstract] ( 183 ) HTML (1 KB) PDF (541 KB) ( 44 )

	43	New progress of artificial intelligence in medical application
		LI Yan1 YANG Guoqing2 SHUANG Jiaoyue1
		As a new auxiliary tool, artificial intelligence (AI) is widely used in all walks of life. However, its application in the medical field is not well known to most medical staff, resulting in a large amount of data can not be effectively used. In order to let more medical workers better understand AI, this paper reviews the related concepts of AI and its application in imaging, surgery and pathology. It mainly includes image-based disease diagnosis, treatment evaluation and avoidance of examination side effects; annotation of structure and steps in surgery, application of surgical robot; judgment of lesion infiltration depth in pathological examination and risk assessment of patients. It is expected to inspire clinicians and encourage medical workers to join in AI research.
		2021 Vol. 18 (13): 43-46 [Abstract] ( 81 ) HTML (1 KB) PDF (537 KB) ( 531 )

	47	Reflection on bilingual course teaching reform and internationalization in the university of traditional Chinese medicine
		WANG Ruoning WANG Xiaohong XIE Hui YAN Guojun LI Junsong DI Liuqing
		In recent years, with the rapid economic development and the internationalization of pharmaceutical industry, the demands for international traditional Chinese medicine talents in China are increasing. Bilingual teaching caters to the trend of economic globalization and education internationalization, which is an inevitable trend of the development of higher traditional Chinese medicine education. In order to promote the higher education of traditional Chinese medicine to face the world better and to cultivate interdisciplinary talents with international vision and high quality, China has put forward higher requirements for bilingual teaching in universities of traditional Chinese medicine. Under the strong support of national policies, bilingual teaching has achieved certain results in some colleges and universities. However, at present, there are obvious deficiencies in the bilingual construction of traditional Chinese medicine specialty in China, such as the lack of teachers, the lack of teaching materials, and the single teaching method. Based on the research background of bilingual teaching and in view of the current situation of bilingual teaching in traditional Chinese medicine colleges and universities in China, this paper discusses the existing problems and puts forward reasonable strategies, in order to promote the bilingual teaching of traditional Chinese medicine courses in China more effectively so as to better meet the needs of its internationalization.
		2021 Vol. 18 (13): 47-50 [Abstract] ( 75 ) HTML (1 KB) PDF (610 KB) ( 218 )

	51	Application of “contraction circle+three-level clue” thinking in clinical teaching of department of neurology
		LI He1 LI Shanshan1 SU Wenquan1 HAO Xiaohui2 WU Shengxian2
		The thinking of “contraction circle + three-level clue” is a kind of neurology thinking which can realize diagnosis from “surface to point” by analyzing clinical data at different levels and angles. Starting from the problems existing in the clinical teaching of neurology, this paper explains the specific operation mode of the thinking, and discusses the advantages of its application in the clinical teaching of department of neurology. Practice shows that the application of “contraction circle + three-level clue” thinking in neurology teaching can broaden students’ thinking and improve their clinical diagnosis ability.
		2021 Vol. 18 (13): 51-54,59 [Abstract] ( 75 ) HTML (1 KB) PDF (629 KB) ( 71 )

	55	Application of interprofessional education in vocational training of radiographers in cardiac catheterization room
		ZHOU Xuan1 WEN Yi2 LIU Yuxuan1 PENG Yong2
		Objective To explore the application effect of interprofessional education (IPE) model in vocational training of radiographers in cardiac catheterization room. Methods Ten radiographers working in the Cardiac Catheterization Room, West China Hospital, Sichuan University (hereinafter referred to as “our hospital”) from September 2018 to February 2019 were selected as the research objects, and 20 doctors or nurses working in the cardiac catheterization room of our hospital during the same period were randomly selected to participate in the questionnaire survey. IPE model was used to teach radiographers for a period of six months. Before and after the teaching and training, the radiographers were evaluated theoretically and operationally, and the radiographers were self-evaluated on the teaching effect. According to the questionnaire survey results of doctors and nurses, the team cooperation of radiographers was evaluated. Results The theoretical scores, operational scores and total scores of radiographers after IPE teaching and training were higher than those before IPE teaching and training, with statistical significance (all P ＜ 0.05). After the completion of IPE teaching and training, radiographers have published many articles and patented many inventions. The self-evaluation scores of self-confidence, knowledge, clinical experience, teamwork and scientific research ability of radiographers after IPE teaching and training were all higher than those before the teaching and training, with statistical significance (all P ＜ 0.05). Clinical skills, cooperation evaluation and team relationship scores of radiographers after IPE teaching and training were higher than those before the teaching and training, with statistical significance (all P ＜ 0.05). Conclusion The rational application of IPE model in the vocational training of radiographers in cardiac catheterization room not only helps to improve the clinical skills, psychological quality and scientific research ability of the technicians, but also strengthens the cooperation tacit understanding and cohesion of the surgical team in cardiac catheterization room.
		2021 Vol. 18 (13): 55-59 [Abstract] ( 107 ) HTML (1 KB) PDF (875 KB) ( 107 )

	60	Exploration of lifelong learning ability training of medical technology students based on task driven teaching method
		HAO Meiling ZHANG Lihong ZHANG Yanhong AN Lihua LI Qingwei JI Shunxin
		Based on the discussion of the internal relationship among lifelong learning ability, task driven teaching method and career planning, the author takes the teaching practice of college students’ career planning course as an example to elaborate how to design and implement teaching around four basic links: creating situations, determining problems (tasks), autonomous learning and collaborative learning, and effect evaluation, with the purpose of adopting task driven. The dynamic mode can cultivate the lifelong learning ability of medical technology students and help them meet the challenge of lifelong education after graduation. At the same time, it is expected to provide reference for the reform of training mode of medical technology professionals.
		2021 Vol. 18 (13): 60-63 [Abstract] ( 62 ) HTML (1 KB) PDF (642 KB) ( 84 )

	64	Application of mind mapping combined with problem-based learning teaching method in clinical clerkship of infectious diseases
		SUN Yu1 ZHANG Honghai1 WANG Haiyan1 CHENG Xiangpu2 HUANG Chaoyang2 ZHANG Yonghong1
		Objective To study the application effect of mind mapping combined with problem-based learning (PBL) teaching method in clinical clerkship of infectious diseases. Methods Thirty-six students from a class of Grade 2016 in Capital Medical University were selected as the study subjects and they were divided into the research group (n = 18) and the control group (n = 18) by using of random number table method. The control group were employed for PBL teaching method, and the research group were employed for mind mapping combined with PBL teaching method. The teaching effect was evaluated by examination and questionnaire survey. Results The test scores of theory and case analysis in the research group were higher than those in the control group, and the differences were statistically significant (all P < 0.05). The evaluation scores of the research group were higher than those of the control group in terms of clear organization, prominent important and difficult points, in-depth content understanding, increased interest in learning, improved ability to ask questions, improved clinical thinking ability, improved self-study ability and improved learning efficiency, and the differences were statistically significant (all P < 0.05). Conclusion The application of mind mapping combined with PBL teaching method is effective in clinical clerkship of infectious diseases, and it is worth popularizing and applying.
		2021 Vol. 18 (13): 64-67 [Abstract] ( 74 ) HTML (1 KB) PDF (644 KB) ( 79 )

	68	Exploration and practice of the teaching reform of biochemistry in pharmacy
		ZHONG Yan1 GUO Yunjing2 YAN Yongwang3
		In view of the difficulties in the teaching of biochemistry course for pharmacy in higher vocational college, centering on the goal of improving students’ learning interest and teaching effect, starting from the training goal of talents in pharmacy in higher vocational college the characteristics of students and the actual situation of the school, the main problems existing in the teaching of biochemistry was deeply diagnosed, the teaching philosophy that suitable for higher vocational pharmacy was analyzed and the teaching content optimization design aiming at the vocational job demand and the improvement of vocational skills were demonstrate. The teaching methods of stimulating students’ subjective initiative in learning are discussed with examples, the examination and evaluation methods are reformed to improve students’ professional quality in an all-round way, and the construction of teaching resource base considering students’ perspective is put forward to explore the path of improving the teaching quality of biochemistry courses in higher vocational colleges.
		2021 Vol. 18 (13): 68-71,79 [Abstract] ( 64 ) HTML (1 KB) PDF (1189 KB) ( 116 )

	72	Clinical observation on treatment of high anal fistula with umbrella incision and double thread drawing
		MA Shumei1 DU Guanchao2 ZHU Zibei1 REN Yi1 LI Huashan3
		Objective To evaluate the efficacy of umbrella incision and double thread drawing in the treatment of high anal fistula. Methods From January 2015 to January 2020, a total of 60 patients with high anal fistula were selected from the Department of Anorectal, Shijingshan District Hospital of Traditional Chinese Medicine, they were divided into treatment group (30 cases) and control group (30 cases) according to the random number table method. The treatment group were treated with umbrella incision and double thread drawing, the control group were treated with traditional incision and thread drawing. The clinical efficacy, postoperative pain, time of thread falling off, wound healing time and anal function were compared between the two groups. Results There was no significant difference in the total effective rate between the two groups (P ＞ 0.05). The time of tightening thread and wound healing in the treatment group were shorter than those in the control group (P ＜ 0.05). The wexner score of anal function at 20 days and three months after operation was lower than that of the control group (P ＜ 0.05). The pain scores in the treatment group were lower on the 7th and 14th day after operation than the control group (P ＜ 0.05), the pain scores on the 7th and 14th day after operation in the two groups were lower than the first day after operation, and the pain score on the 14th day after operation was lower on the 7th day after operation (P ＜ 0.05). Conclusion Umbrella incision and double thread drawing in the treatment of high anal fistula can reduce postoperative pain, shorten the time of thread falling off and wound healing, with less damage to anal function, which is worthy of clinical application.
		2021 Vol. 18 (13): 72-75 [Abstract] ( 126 ) HTML (1 KB) PDF (633 KB) ( 77 )

	76	Analysis of efficacy and safety of laparoscopic treatment of acute pancreatitis by cholecystolithiasis at different operative times
		XU Ziheng SUN Lei HU Wei
		Objective To investigate the efficacy and safety of laparoscopic treatment of acute pancreatitis (AP) caused by cholecystolithiasis at different operative times. Methods A total of 92 AP caused by cholecystolithiasis patients admitted to the First People’s Hospital of Lianyungang from March 2018 to February 2020 were retrospectively analyzed. According to the time of LC treatment, they were divided into two groups, with 46 cases in each group. Among them, 46 patients who underwent LC treatment within 48 hours after admission (recorded as early stage) were classified as group A, and 46 patients who received LC treatment after admission and confirmed that they firstly received drug treatment and waited for 8 to 12 weeks after their condition was stable (recorded as elective) as group B. The related rehabilitation indicators, biochemical indicators, safety and recurrence were compared between the two groups. Results There were no statistically significant differences in operation time and intraoperative blood loss between the two groups (P ＞ 0.05). The postoperative hospital stay in group A was shorter than group B, the difference was statistically significant (P ＜ 0.05). There was no statistically significant difference in the incidence of wound infection, fever, bile leakage and total incidence of postoperative complications between the two groups (P ＞ 0.05). There was no statistically significant difference in the recurrence rate between the two groups (P ＞ 0.05). Conclusion LC treatment for AP patients caused by gallbladder stones within 48 hours after admission to the hospital can effectively shorten the length of postoperative hospital stay. The effect of early LC treatment is equivalent to that of elective LC treatment, and it does not aggravate the liver damage of the patient, and the safety is good.
		2021 Vol. 18 (13): 76-79 [Abstract] ( 133 ) HTML (1 KB) PDF (600 KB) ( 53 )

	80	Application of enhanced recovery after surgery programs in colorectal cancer patients with diabetes mellitus: a meta-analysis
		FENG Le1 QIN Yan1 FAN Xin2 CHEN Jixiang2
		Objective To systematically evaluate the safety and effectiveness of enhanced recovery after surgery (ERAS) in colorectal cancer patients with diabetes mellitus. Methods Based on the key words of “colorectal cancer” “colorectal surgery” “diabetes” “enhanced recovery after surgery” and “fast track surgery”, PubMed, EMBASE, Cochrane Library, CNKI, VIP and Wanfang databases were searched for articles on the application of ERAS in the operation of colorectal cancer patients with diabetes from the establishment of the database to November 2020. Qualified articles were screened out according to the inclusion and exclusion criteria, the patients were divided into ERAS group (ERAS measure processing) and control group (conventional measures treatment). The time to first flatus, time to first defecation, length of hospital stay, hospital charge and incidence of complications were compared between the two groups. Revman 5.4 software was used for meta-analysis. Results A total of 725 patients were included, including 372 patients in the ERAS group and 353 patients in the control group. In ERAS group, the postoperative anal exhaust time (SMD = -2.20, 95%CI[-2.72，-1.69], P ＜ 0.000 01), the postoperative defecation time (MD = -1.51, 95%CI[-2.09, -0.93]，P ＜ 0.000 01), the length of hospital stay (MD = -3.18，95%CI[-4.36，-2.01]，P ＜ 0.000 01) were shorter than those in the control group, the hospitalization cost (SMD = -0.73，95%CI[-0.98, -0.48], P ＜ 0.000 01) was lower than that of the control group, and the incidence of complications (OR = 0.29, 95%CI[0.18, 0.49], P ＜ 0.000 01) was lower than that of the control group. Conclusion The application of ERAS in colorectal cancer patients with diabetes mellitus is safe and effective, which is conducive to the recovery of postoperative intestinal function, reducing length of stay, hospital charge and incidence of complications, but it still needs higher level evidence-based support.
		2021 Vol. 18 (13): 80-84,92 [Abstract] ( 107 ) HTML (1 KB) PDF (1608 KB) ( 67 )

	85	Analysis of influence factors in frequent acute exacerbations of chronic obstructive pulmonary disease
		SUN Zeli DING Guozheng
		Objective To analyze influence factors in frequent acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods The clinical data of 151 patients admitted to Department of Respiratory Medicine of Anqing Municipal Hospital, Anhui Province due to acute exacerbations of COPD from October 2018 to October 2019 were retrospectively studied. They were divided into two groups according to the frequency of acute exacerbations in the previous year (October 2017 to September 2018) (≥2 times was frequent group [78 cases], and ＜2 times was infrequent group [73 cases] ). The related indicators of two groups (neutrophil count [N], lymphocyte count [L], neutrophil / lymphocyte ratio [NLR], platelet count [PLT], platelet / lymphocyte ratio [PLR], uric acid [UA], creatinine [Cr], uric acid / creatinine ratio [UA/Cr], CO2 partial pressure of arterial blood [PaCO2], duration, hospitalization days) were compared. Spearman correlation coefficient was used to analyze the relationship between those indicators and frequent acute exacerbations of COPD. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of NLR, PLR, UA, UA/Cr, PaCO2 and L in frequent acute exacerbations of COPD. Results NLR, PLR, UA, UA/Cr and PaCO2 in frequent group were higher than those in infrequent group, L was lower than that in infrequent group, disease duration and hospitalization days were longer than those in infrequent group, the differences were statistically significant (all P ＜ 0.05). The frequency of acute exacerbation in the previous year was positively correlated with NLR, PLR, UA, UA/Cr and PaCO2 (rs ＞ 0, P ＜ 0.05), and negatively correlated with L (rs ＜ 0, P ＜ 0.05). ROC curve analysis showed that the area under the curve of these indicators was ＞0.5, and the differences were statistically significant (all P ＜ 0.05). Conclusion NLR, PLR, UA, UA/Cr, PaCO2, and L values may be used as biomarkers to predict frequent acute exacerbations of COPD.
		2021 Vol. 18 (13): 85-88 [Abstract] ( 117 ) HTML (1 KB) PDF (636 KB) ( 69 )

	89	Analysis of clinical characteristics of brucellosis
		TIAN Yueyang GAO Huixia SUN Qian LI Yanfeng ZHANG Zhi
		Objective To analyze the differences in clinical manifestations and laboratory data of 219 patients with brucellosis collected in the Fifth Hospital of Shijiazhuang City, and to provide the scientific basis for the prevention and treatment of brucellosis. Methods A total of 219 patients with brucellosis admitted to the Fifth Hospital of Shijiazhuang City from January 2016 to December 2018 were collected as the research objects. According to different age groups, they were divided into ＜20 years old, 20-＜40 years old, 40-60 years old and ＞60 years old groups. The number of patients in the four groups was 9, 43, 105 and 62, respectively. The abnormal rates of CD3+T cells, CD4+T cells, CD8+T cells and CRP in four groups were compared. The incidence of complications in four groups was compared. Results There were statistically significant differences in the abnormal rates of CD3+T cells, CD4+T cells and C reactive protein (CRP) among the four groups (all P ＜ 0.05), while there were no statistically significant differences in the abnormal rates of CD8+T cells among the four groups (P ＞ 0.05). Further pair comparison showed that the abnormal rate of CD3+T cells in ＞60 years old group was lower than that in 40-60 years old group, and the abnormal rate of CD4+T cells in 40-60 years group was lower than that in 20-＜ 40 years old and ＞60 years old group, and the abnormal rate of CRP in 20-＜ 40 years old group was lower than that in 40-60 years old group and ＞60 years old group, and the differences were all statistically significant (all P ＜ 0.008). There were statistically significant differences in liver diseases, orchitis, lumbar osteogeny and pulmonary infection among the four groups (all P ＜ 0.05). There was no significant difference in the incidence of disc herniation and hypertension among the four groups (P ＞ 0.05). Further pair comparison showed that the incidence of liver disease and orchitis in ＞60 years old group was higher than that in 20-＜40 years old group and 40-60 years old group and the incidence of lumbar osteopenia was higher than that in ＜20 years old group, 20-＜40 years old group and 40-60 years old group. The incidences of pulmonary infection in the 20-＜40 and 40-60 groups were all lower than those in the ＜20 group, and the differences were statistically significant (all P ＜ 0.008). Conclusion The test results of T cell subsets can provide a basis for judging the immune status of patients with brucellosis, and the CRP value is used as an auxiliary index to judge the severity of inflammation in patients with brucellosis.
		2021 Vol. 18 (13): 89-92 [Abstract] ( 55 ) HTML (1 KB) PDF (603 KB) ( 35 )

	93	Study of the correlation between PSG and serum ET-1, NO, Hcy, LP and CRP levels in hypertension patients with OSAHS
		ZHAO Ying1 WENG Jun2 MA Ying1 TANG Xiaoxia2 ZHANG Pingshu1 LIU Yunqiu2
		Objective To study the correlation between polysomnography (PSG) and serum endothelin-1 (ET-1), nitric oxide (NO), homocysteine (Hcy), leptin (LP) and C reactive protein (CRP) levels in hypertension patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods A total of 260 patients with hypertension who received outpatient or inpatient treatment in Kailuan General Hospital of Tangshan, Hebei Province from April 2017 to May 2019 were selected. They were divided into observation group (hypertension with OSAHS, 115 cases) and control group (hypertension alone, 145 cases) according to whether they were complicated with OSAHS. PSG monitoring indexes (apnea hypopnea index [AHI], microarousal index [AI], oxygen desaturation index below 90% [Ts90], oxygen desaturation index [ODI]) and serological indexes (ET-1, NO, Hcy, LP, CRP) were compared between the two groups, and the relationship between PSG results and serological indexes was analyzed. Results AHI, AI, Ts90 and ODI in the observation group were higher than those in the control group, and the differences were statistically significant (all P ＜ 0.05). The levels of ET-1, Hcy, LP and CRP in the observation group were higher than those in the control group, and the level of NO in the observation group were lower than that in the control group, with statistical significance (all P ＜ 0.05). Correlation analysis showed that AHI, AI, Ts90 and ODI were positively correlated with the levels of ET-1, Hcy, LP and CRP (r ＞ 0, P ＜ 0.05), and negatively correlated with the level of NO (r ＞ 0, P ＜ 0.05). Conclusion OSAHS has a certain influence on the sleep of patients with hypertension, which may play a role by affecting the levels of serum ET-1, NO, Hcy, LP and CRP.
		2021 Vol. 18 (13): 93-95，99 [Abstract] ( 119 ) HTML (1 KB) PDF (943 KB) ( 105 )

	96	Effect of different doses of Butorphanol Tartrate on the occurrence of chills in parturients during cesarean section under combined spinal and epidural anesthesia
		TANG Yinping FANG Zhibing CHEN Renjun BIAN Guoyun
		Objective To explore the effect of different doses of butorphanol tartrate (BT) on the occurrence of chills in parturients during cesarean section under combined spinal and epidural anesthesia. Methods From January 2019 to July 2020, 84 parturients receiving cesarean section under combined spinal and epidural anesthesia who admitted to Department of Obstetrics, the First People’s Hospital of Chuzhou, Anhui Province were selected as the research subjects. They were divided into group A (42 cases) and group B (42 cases) according to the random number table method. Group A received 1 mg BT intraoperatively, and group B received 2 mg BT intraoperatively. The occurrence of chills, sedation, newborn birth and adverse reactions were compared between two groups. Results The total incidence of chills in group B was lower than that in group A, and the difference was statistically significant (P ＜ 0.05). The Ramsay sedation score 5 and 10 min after delivery of fetus in group B were higher than those in group A , and the differences were statistically significant (all P ＜ 0.05). There were no significant differences in Apgar scores of two groups at 1, 5, and 10 min after birth (P > 0.05). There was no statistically significant difference in total incidence of adverse reactions between two groups (P > 0.05). Conclusion It is safe to use BT in parturients during cesarean section with combined spinal and epidural anesthesia and has no respiratory depression for newborns. Compared with 1 mg BT, 2 mg BT can significantly reduce the occurrence of chills and have a better sedative effect.
		2021 Vol. 18 (13): 96-99 [Abstract] ( 75 ) HTML (1 KB) PDF (455 KB) ( 68 )

	100	Effect of ultrasound-guided bilateral pudendal nerve block combined with epidural block on perineal protection and pregnancy outcome of spontaneous delivery parturient
		ZHOU Jialong LI Chabing WANG Yiqiao
		Objective To explore the effect of ultrasound-guided bilateral pudendal nerve block combined with epidural block on perineal protection and pregnancy outcome of spontaneous delivery parturient. Methods From January 2019 to June 2020, 80 cases spontaneous delivery parturient who were hospitalized in the Second People’s Hospital of Anhui Province for delivery were selected as study subjects. According to the random number table method, they were divided into control group and study group, with 40 cases in each group. The control group were received epidural block, and the study group were received ultrasound-guided bilateral pudendal nerve block combined with epidural block. The perineal conditions and visual analogue score (VAS) at different time points (full hysterectomy [T1], fetal head exposure [T2], perineal suture [T3]) of two groups were compared, and the pregnancy outcomes of two groups were observed. Results The perineal integrity rate of study group was higher than that of control group, and the perineal lateral resection rate was lower than that of the control group, and the differences were statistically significant (all P < 0.05). There was statistical significance in the degree of perineal laceration between two groups (P < 0.05). VAS at T2 and T3 in the two groups were lower than those at T1, and the differences were statistically significant (all P < 0.05). VAS at T2 and T3 in study group were lower than those in control group, and the differences were statistically significant (all P < 0.05). The time of the second stage of labor in study group was shorter than that in control group; Apgar score of neonates was higher than that of control group, and the differences were statistically significant (all P < 0.05). The neonatal asphyxia rate and postpartum hemorrhage rate in study group were lower than those in control group, and the differences were statistically significant (all P < 0.05). Conclusion Ultrasound-guided bilateral pudendal nerve block combined with epidural block has significant effect on perineal protection of parturient, significantly shorten the labor process time of parturient and effectively reduce adverse pregnancy outcomes.
		2021 Vol. 18 (13): 100-103 [Abstract] ( 121 ) HTML (1 KB) PDF (451 KB) ( 47 )

	104	Ancient medical literature study on zhōngjí acupoint indications based on frequency of statistical methods
		WU Xia CHENG Huachu TAN Jinqu HU Binong XU Ming ZHANG Hong YANG Qianyun AI Kun
		Objective To sort out ancient literature of zhōngjí acupoint, and summarize the application rules of zhōngjí acupoint. Methods One thousand one hundred and fifty-six ancient books of traditional Chinese medicine included in Chinese Medical Dictionary (5th edition) were searched. The database of zhōngjí was established after systematically sorting out the single point, compatibility indications, compatibility rules of acupoints and acupuncture moxibustion methods. Results There were 515 articles of zhōngjí acupoint application standard, and 501 articles of disease treatment, covering 67 ancient works. There were 171 articles on the application of zhōngjí single acupoint, 330 compatibility articles, 132 compatible acupoints, and a total of 1205 times of use. The commonly used moxibustion stimulation amount was sanzhuang and baizhuang, the acupuncture depth was eight minutes, and the acupuncture time was ten breathes and seven breathes. Conclusion The main rule of zhōngjí acupoint is to select acupoints along meridians. Compatibility can expand the scope of indications and enhance synergy.
		2021 Vol. 18 (13): 104-107,111 [Abstract] ( 63 ) HTML (1 KB) PDF (947 KB) ( 105 )

	108	Discussion on mechanism of Xiaoqinglong Decoction in treating seasonal allergic rhinitis from the view of “lung correspondence to autumn” of the correspondence between human body and natural environment
		JIA Xiaochen1 LIANG Junwei2 CHEN Xiangjing1
		The correspondence between human body and natural environment is one of the most important ideologies in the basic theory of traditional Chinese medicine. The theory of “lung correspondence to autumn” is an important part of the theory of “four seasons-five organs-yin and yang”, which does not only reflects the important ideology of traditional Chinese medicine, but also reflects the concept of correspondence between human body and natural environment. Autumn is the high incidence period of seasonal allergic rhinitis, because the lung is connected with autumn and thereby the evil qi in autumn is easy to invade the lung, which is manifested by the abnormal function of the lung’s promotion, descending and water delivery. When the lung passes through the nose, the symptoms of sneezing and nasal congestion are more obvious. Xiaoqinglong Decoction needle has good therapeutic effect on lung loss and water transport disorder, and exogenous pathogens induce the pathogenesis of latent yin, and warm the lung and dissipate water. Based on the theory of “lung correspondence to autumn” and Xiaoqinglong Decoction in treating lung diseases, and considering connections between nose and lung, this paper discusses the mechanism of Xiaoqinglong Decoction in treating seasonal allergic rhinitis.
		2021 Vol. 18 (13): 108-111 [Abstract] ( 60 ) HTML (1 KB) PDF (740 KB) ( 112 )

	112	Analysis of Director Lao Yingrong in the treatment of vertigo based on data mining
		YU Dandan1 HE Jingshuang1 LI Jiahao1 ZHOU Wei2 LAO Yingrong2
		Objective To dig out Director Lao Yingrong’s experience in the treatment of vertigo by using the ancient and modern medical case cloud platform (V2.1) as the basis. Methods The prescription of traditional Chinese medicine for vertigo patients treated in Guangdong Hospital of Traditional Chinese Medicine from April 2011 to September 2018 was collected, digitized and standardized, and the data was visualized by charts and other methods. Results A total of 1905 traditional Chinese medicine prescriptions were included. The syndromes were intermingled phlegm and blood stasis syndrome, blockade of phlegm-turbidity syndrome, deficiency of both liver and kidney syndrome, deficiency of qi and blood syndrome and wind-phlegm invading upward syndrome. A total of 248 traditional Chinese medicines were involved. The most frequently used traditional Chinese medicines were Pinelliae Rhizoma Praeparatum, Atractylodis Macrocephalae Rhizoma, Radix Fici Simplicissimae, Poria, and Acori Tatarinowii Rhizoma, etc. The compatibility of traditional Chinese medicine was mainly composed of Radix Fici Simplicissimae-Pinelliae Rhizoma Praeparatum, Atractylodis Macrocephalae Rhizoma-Pinelliae Rhizoma Praeparatum, Poria-Atractylodis Macrocephalae Rhizoma, Poria-Pinelliae Rhizoma Praeparatum, Radix Fici Simplicissimae-Atractylodis Macrocephalae Rhizoma, etc. Main core prescriptions: Pinelliae Rhizoma Praeparatum, Radix Fici Simplicissimae, Pyrolae Herba, Atractylodis Macrocephalae Rhizoma, Angelicae Sinensis Radix, Poria, Gastrodiae Rhizoma, Curcumae Radix, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle, Zingiberis Rhizoma, Cyperi Rhizoma, Acori Tatarinowii Rhizoma, Polygoni Multiflori Caulis, Alismatis Rhizoma, Cinnamomi Ramulus, Linderae Radix, Magnoliae Officinalis Cortex, and Astragali Complanati Semen. Since 2013, there had been a significant change in the thinking of syndrome differentiation and treatment of Director Lao Yingrong, and the prescription medicine had gradually turned to the use of Sanyin Sitian Fang. Conclusion By using the data analysis function of the platform, the medication rules of Director Lao Yingrong in the treatment of vertigo are visually displayed in the form of charts, and reflect the change of his academic style.
		2021 Vol. 18 (13): 112-116 [Abstract] ( 132 ) HTML (1 KB) PDF (1787 KB) ( 116 )

	117	Summary of study on the medicinal and edible value of Momordica charantia L.
		DING Lei1 HU Yuli1 LI Mei1 WU Lili2 QIN Lingling3 LIU Tonghua2
		Momordica charantia L. is a traditional Chinese medicine with the same origin as medicine and food, which gets its name because of its unique bitter taste. Momordica charantia L. has a peculiar shape and rich nutritional value. It has been widely planted for hundreds of years since it was introduced into China, and it is loved by people as food and medicine. Pharmaceutical chemical studies show that the chemical components of Momordica charantia L. mainly include polysaccharides, proteins and peptides, saponins, flavonoids and phenolic compounds, which have different biological activities. Momordica charantia L. is used to treat a variety of diseases in traditional medicine in many countries. Modern pharmacological studies have also confirmed that Momordica charantia L. has a wide range of pharmacological effects, and the related mechanism is being studied in depth. The food and drug industry chain of Momordica charantia L. is also expanding. This paper will summarize the medicinal and edible value of Momordica charantia L. in order to provide a theoretical basis for the rational development and utilization of Momordica charantia L..
		2021 Vol. 18 (13): 117-120 [Abstract] ( 74 ) HTML (1 KB) PDF (706 KB) ( 159 )

	121	Effect of No.1 traditional Chinese medicine lotion on wound healing and serum inflammatory factors after perianal abscess operation
		ZHANG Chaoyang1 LIANG Jinghua2 SUN Linmei3 LI Pu1 FEI You1
		Objective To observe the effect of No.1 traditional Chinese medicine lotion on wound healing and serum inflammatory factors after perianal abscess operation. Methods Eighty-four patients with perianal abscess in Department of Anorectal, Shenzhen Anorectal Hospital of Traditional Chinese Medicine from February to June 2018 were selected and divided into control group and observation group according to random number table method, 42 cases in each group. Two groups were given Ceftazidime for injection for three days after operation, while control group was given potassium permanganate lotion hip bath, and observation group was given No.1 traditional Chinese medicine lotion hip bath. Two groups were given the same rehydration, acid-base balance adjustment drugs, symptomatic support treatment after operation. Clinical efficacy, wound healing time, wound edema disappearance time, visual analogue scale (VAS) and serum inflammatory factors were compared between two groups. Results There was no significant difference in clinical efficacy between two groups (P > 0.05). The wound healing time and wound edema disappearance time of observation group were shorter than those of control group, and the difference was statistically significant (P < 0.05). There were significant differences in VAS on group comparison, time point comparison and interaction (P < 0.05). There was significant difference in VAS between two groups at different time points (P < 0.05). The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in two groups at 10 days after operation were lower than those at one day after operation, and the differences were statistically significant (P < 0.05). The levels of IL-6 and TNF-α in observation group at one day and 10 days after operation were lower than those in control group (P < 0.05). Conclusion No.1 traditional Chinese medicine lotion can significantly improve the wound healing of patients with perianal abscess, reduce the pain of patients, promote wound healing, reduce the level of serum inflammatory factors, and reduce the risk of postoperative re infection, which is worthy of clinical promotion.
		2021 Vol. 18 (13): 121-124 [Abstract] ( 103 ) HTML (1 KB) PDF (741 KB) ( 39 )

	125	Professor Wan Hua’s clinical experience in treating breast diseases by using Rhizoma Coptidis
		XUE Peipei XIE Lu WAN Hua
		This paper summarizes Professor Wan Hua’s clinical experience in treating breast diseases with Rhizoma Coptidis. Professor Wan Hua believes that heat toxin and phlegm dampness are the key etiology and pathogenesis of breast diseases. Clinically, it emphasizes the combination of disease and syndrome differentiation, and attaches importance to the correlation between local syndrome differentiation and integral syndrome differentiation. From the perspective of heat toxin and phlegm dampness, the treatment methods of heat-clearing and detoxifying and drying dampness and dispersing phlegm are used according to syndrome differentiation. Carry out the idea of “communication is the most important, consumption is the most important”, we should focus on “qinghua” and “harmony”, flexibly using Rhizoma Coptidis for treatment focusing on elimination and balance. Two medical records are presented.
		2021 Vol. 18 (13): 125-128 [Abstract] ( 178 ) HTML (1 KB) PDF (709 KB) ( 81 )

	129	Professor Zhu Shan’s experience in treating children allergic purpura by stages based on warm disease theory
		FU Haibo LIU Ya HUO Xiuyun ZHU Shan
		Based on the classics of traditional Chinese medicine and clinical records, this article summarizes Professor Zhu Shan’s experience in treating children allergic purpura by stages based on the theory of warm disease. Professor Zhu Shan thinks that the main cause of allergic purpura is exogenous pathogenic factor. The pathogenesis is that heat injures blood collaterals and blood overflows outside the veins. The course of disease is in accordance with the general law of blood transmission of weifen, qifen, yingfen, and xuefen. Therefore, guided by the theory of febrile diseases, it can be divided into three stages: the stage of evil attacking the exterior, the stage of evil entering the blood and the stage of positive deficiency and evil love. The treatment follows Ye Tianshi’s treatment method of “when you enter the camp, you can still transfer qi from heat to heat. when you enter the camp, you are afraid of consuming blood and moving blood, you need to cool blood and disperse blood”. Treating by stages, dispelling pathogenic factors and calming people.
		2021 Vol. 18 (13): 129-132 [Abstract] ( 177 ) HTML (1 KB) PDF (694 KB) ( 70 )

	133	Value of DTI-TBSS in evaluating changes of white matter in patients with nasopharyngeal carcinoma before and after radiotherapy
		XU Shida WANG Qingchun ZHANG Hongyang▲
		Objective To explore the value of magnetic resonance diffusion tensor imaging (DTI)-fiber tract tracer based spatial design (TBSS) in evaluating white matter in nasopharyngeal carcinoma patients before and after radiotherapy. Methods Thirty-four patients with nasopharyngeal carcinoma admitted to Lishui Hospital of Traditional Chinese Medicine, Zhejiang Province from September 2019 to April 2020 were selected. DTI-TBSS was used to analyze the anisotropy score (FA), mean diffusion coefficient (MD), value of λ‖ and λ⊥ of white matter before and after radiotherapy. Mini-mental state examination (MMSE) scores were compared before radiotherapy and six months after radiotherapy. Results After six months of radiotherapy, the FA values of white matter in the right parietal lobe, right occipital lobe and right frontal lobe were all lower than those before radiotherapy. The MD values of whit matter in the right occipital lobe, temporal lobes, the left and right parietal lobes were higher than those before radiotherapy. The value of λ‖ in white matter of the right temporal lobe, the left occipital lobe, the left temporal lobe, the left parietal lobe and the right parietal lobe were lower than before radiotherapy. The value of λ⊥in the right occipital lobe, the left fronto-parietal boundary and the left parietal lobe were all higher than those before radiotherapy, while the value of λ⊥ in the right cerebellum white matter and the left hemioval center were all lower than those before radiotherapy; MMSE score was lower than that before radiotherapy, and the differences were all statistically significant (all P ＜ 0.05). The FA value of white matter in the right occipital (r = 0.383, P ＜ 0.05) and the λ‖ value of white matter in the right parietal white matter (r = 0.391, P ＜ 0.05) were positively correlated with the MMSE score after radiotherapy, while the value of λ⊥ in the left fronto-parietal boundary (r = -0.404, P ＜ 0.05) and MD value (r = -0.411, P ＜ 0.05) were negatively correlated with the MMSE score after radiotherapy. Conclusion DTI-TBSS can be used to evaluate the white matter damage in patients with nasopharyngeal carcinoma after radiotherapy, which is helpful for the diagnosis of radiation brain injury.
		2021 Vol. 18 (13): 133-136 [Abstract] ( 48 ) HTML (1 KB) PDF (412 KB) ( 30 )

	137	Application of echocardiography combined with DTI technology in cardiac function evaluation after hemodialysis and peritoneal dialysis for six months
		LI Fabing QIAN Guangrong
		Objective To explore the application of echocardiography combined with Doppler tissue imaging (DTI) technology in evaluating cardiac function after hemodialysis and peritoneal dialysis for six months. Methods A total of 100 patients with end-stage renal disease admitted to Ma’anshan People’s Hospital, Anhui Province, from January 2016 to January 2020 were selected for study. According to different dialysis methods, they were divided into hemodialysis group (60 cases) and peritoneal dialysis group (40 cases). Left ventricular posterior wall thickness (LVPWTd), end diastolic interventricular septum (IVSTd), left ventricular end-systolic diameter (LVDs), left ventricular end-diastolic diameter (LVDd), left atrial diameter (LAD), left ventricular ejection fractions (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular short axis shorting rate (FS), stroke output (SV) were measured by echocardiography combined with DTI before and six months after dialysis in both groups. Results There was no significant difference in the results of heart examination between the two groups before dialysis (P ＞ 0.05). After dialysis, LVPWTd, IVSTd, LVDs, LVDd, LAD, LVEDV, LVESV, FS, and SV in both groups were higher than those before dialysis, while LVEF was lower than that before dialysis, LVPWTD, IVSTD, LVEDV and LVESV in the hemodialysis group were higher than those in the peritoneal dialysis group, the differences were statistically significant (all P ＜ 0.05). There were no significant differences in LVDs, LVDd, LAD, FS, SV and LVEF between the two groups after dialysis (P ＞ 0.05). Conclusion Echocardiography combined with DTI indicate that there are changes of cardiac function in dialysis patients, and the changes of cardiac function and morphology in hemodialysis patients are more obvious.
		2021 Vol. 18 (13): 137-140 [Abstract] ( 85 ) HTML (1 KB) PDF (409 KB) ( 58 )

	141	Clinical control study of Escitalopram Oxalate and Sertraline combined with cognitive behavior in the treatment of adolescent depression
		ZOU Liang1 ZHANG Xingong2 SUN Lili3 ZHANG Lingling4▲ WANG Hanyu2
		Objective To investigate the clinical efficacy of Escitalopram Oxalate and Sertraline combined with cognitive behavior in the treatment of adolescent depression. Methods A total of 70 cases with adolescent depression treated in the third people’s Hospital of Fuyang City, Anhui Province from May 2017 to September 2020 were selected as the object of study. According to the random number table method, they were divided into the control group and the observation group, with 35 cases in each group. The control group was treated with Sertraline combined with cognitive behavioral therapy; the observation group was treated with Escitalopram Oxalate combined with Cognitive behavioral therapy. After four weeks of continuous treatment, the severity of the disease and clinical efficacy were evaluated by hamilton depression scale (HAMD) and hamilton anxiety scale (HAMA), and the safety of drugs was evaluated by treatment emergent symptom scale (TESS). Results There was no significant difference in the total effective rate between the two groups after four weeks of treatment (P ＞ 0.05); the scores of HAMD and HAMA were different in different time and group, and there was interaction between time and group, and the difference was statistically significant (all P ＜ 0.05); further pairwise comparison showed that there were significant differences in HAMD and HAMA scores before treatment, the second week and the fourth week of treatment (P ＜ 0.05); there was no significant difference in the scores of HAMD and HAMA between the two groups before treatment, the second week of treatment and the fourth week of treatment (P ＜ 0.05); there was no significant difference in the incidence of ADR between the two groups (P ＞ 0.05). Conclusion Escitalopram Oxalate and Sertraline combined with cognitive behavior therapy in adolescent patients with depression had satisfactory clinical effects and good tolerance, but sertraline had more adverse reactions.
		2021 Vol. 18 (13): 141-144 [Abstract] ( 80 ) HTML (1 KB) PDF (394 KB) ( 71 )

	145	Analysis on the operating efficiency of the basic medical insurance fund for urban and rural residents of Xinjiang Corp
		MA Shaowei1 ZHAO Jiuyang2,3 XIE Huiling1
		Objective To analyze the operational efficiency of the XPCC’s urban and rural residents’ medical insurance fund from 2010 to 2018, and make suggestions for improving the operating efficiency of the XPCC’s urban and rural residents’ medical insurance fund. Methods Data envelopment analysis model was used to analyze the income and expenditure data of the resident medical insurance fund of the 14 divisions and directly affiliated units of the Corps, the number of insured persons, the utilization rate of the fund, the amount of compensation per capita and other indicators. The changes in corps residents’ medical insurance was analyzed from three indicators: comprehensive efficiency, scale efficiency, and pure technical efficiency. Results The growth rate of fund expenditure was higher than the growth rate of financing, and the utilization efficiency of medical insurance funds had been improved year by year; the operational efficiency of medical insurance funds was only four years in a comprehensive effective state; the trend of pure technical efficiency scores was stable, and the average pure technical effective divisions accounted for more than 70% in eight years, comprehensive effective divisions accounted for 58.33%. Conclusion The change of medical insurance policy will lead to the change of the overall efficiency of the fund. The change of medical insurance policy has a small impact on pure technical efficiency, but has a greater impact on scale efficiency, and the allocation of medical insurance resources does not reach the optimal ratio. It is recommended to rationally allocate medical insurance resources, improve the construction of medical insurance system, and formulate appropriate policy goals.
		2021 Vol. 18 (13): 145-148 [Abstract] ( 49 ) HTML (1 KB) PDF (582 KB) ( 60 )

	149	Influence and enlightenment of public health matters on the economic operation efficiency of public hospitals
		WANG Mingli1 LIU Wanlin2 XING Wenhua2
		The relevant theories of the impact of public health events on the economics of public hospitals are still lacking in scientific and systematic research in academia, and there are empirical evidences such as lack of theory in formulating special response policies. This article discusses the impact of public health issues on the economic operation efficiency of public hospitals, as well as the emergency management system and emergency management system, from the development and review of the economic operation and financial response attitude and strategy adjustment of public hospitals in response to the impact of public health events, as well as the emergency management system and government funds continue to play an effective role in the prevention and control strategy of suppressing economic fluctuations and timely follow-up and implementation of emergency finance, and providing reference and reference for the prevention and control of public health incidents in the field and the same field, and the economic recovery and restart of public hospitals.
		2021 Vol. 18 (13): 149-152,158 [Abstract] ( 140 ) HTML (1 KB) PDF (566 KB) ( 84 )

	153	Establishment of the input-output evaluation system of the scientific research fund of the tertiary hospital
		SHI Han1 GAO Yuan1 JIAO Jingxuan1 LIU Sihan2 ZHAO Haiyu3
		Objective To construct the input-output evaluation index system of scientific research funds for tertiary general hospitals, and lay the foundation for the hospitals to carry out scientific research fund evaluation. Methods From January to June 2020, this research conducted 3 rounds of questionnaire consultation with 29 experts from universities, research institutes, and public hospitals of tertiary level and above. The Delphi method and analytic hierarchy process were used to determine scientific research evaluation indicators and weight coefficients, and the hospital scientific research fund input-output evaluation indicator system was established. Results The effective recovery rates of the three rounds of questionnaires were all > 80%, and the experts were highly motivated; the authority coefficients of the experts on the evaluation indicators were all > 0.7, and the consultation results were credible; the Kendall’s W coordination coefficients of the indicators at all levels were 0.300-0.776, and the coordination degree of the experts was relatively high. Finally, 2 first-level indicators, 9 second-level indicators, and 23 third-level indicators were established. Conclusion The evaluation index system for scientific research funds constructed with scientific research input and output models is scientific and reliable, and can provide reference for similar hospitals to carry out related work.
		2021 Vol. 18 (13): 153-158 [Abstract] ( 101 ) HTML (1 KB) PDF (749 KB) ( 570 )

	159	Analysis and suggestions on the budget performance management of financial provision in public hospitals
		XU Lingqian
		This article mainly analyzes the status quo and problems of performance management in public hospitals through expert consultation and investigation and research methods. Through investigation, it is found that many problems in public hospitals’ financial budget performance management are fundamentally attributed to the imperfect performance management system. The performance target system is unreasonable, the process monitoring is not strong enough, the evaluation method is unscientific, and the evaluation result is insufficiently transformed. There is still a lot of room for reform in the budget performance management of financial subsidy expenditures. The article analyzes the above problems, summarizes and explores corresponding countermeasures, and recommends public hospitals from system construction, process specification, performance index system optimization and performance evaluation results application, etc. in order to improve the efficiency and effectiveness of the appraisal of fiscal expenditure budgets.
		2021 Vol. 18 (13): 159-163 [Abstract] ( 191 ) HTML (1 KB) PDF (586 KB) ( 71 )

	164	Application of integrated medical care for patients with adenomyosis in high-intensity focused ultrasound treatment of perioperative pain management
		LIU Jia WANG Sha SI Jingge▲ JI Xin LI Dan WANG Yajing
		Objective To explore the application and effect of integrated medical care model in the perioperative pain management of patients with adenomyosis treated by high-intensity focused ultrasound. Methods A total of 102 patients with adenomyosis who received high-intensity focused ultrasound (HIFU) treatment from the Minimally Invasive Center of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University were selected from May 2016 to May 2019. They were randomly divided into study group and control group by computer, and implemented group nursing. The 51 cases in the control group were used the conventional nursing model, and the 51 cases in the study group were used the integrated medical care model for perioperative pain management. The postoperative pain scores, the use of analgesics, anxiety, and nursing satisfaction were compared between the two groups. Results There was no significant difference in visual analogue scale (VAS) between the two groups at 2 h after surgery (P ＞ 0.05). VAS at 24 h after surgery in both groups were significantly lower than those at 2 h after surgery, while the study group was lower than that in the control group, and the differences were statistically significant (P ＜ 0.05 or P ＜ 0.01). The anxiety score of the study group was lower than that of the control group, while the proportion of patients in the study group who used analgesics after surgery was lower than that of the control group, and the differences were statistically significant (P ＜ 0.05). The nursing satisfaction of the study group was higher than that of the control group, and the difference was highly statistically significant (P ＜ 0.01). Conclusion For patients with adenomyosis receiving high-intensity focused ultrasound treatment, the doctor-nurse-patient integrated mode could effectively help patients correctly interpret and evaluate the pain generated during treatment, thereby improving nursing pain management, alleviating postoperative pain and anxiety, reducing drug use and improving patient satisfaction.
		2021 Vol. 18 (13): 164-167,180 [Abstract] ( 115 ) HTML (1 KB) PDF (703 KB) ( 107 )

	168	Influence of peer support self-management education on the cognitive level and healthy behavior of patients with ulcerative colitis
		MENG Lizhu1 LU Shixu2
		Objective To explore the impact of peer support self-management education on the cognitive level, healthy behavior and quality of life of patients with ulcerative colitis. Methods From July 2018 to December 2019, a total of 105 patients with ulcerative colitis admitted to Huai’an First People’s Hospital, Jiangsu Province were selected and divided into intervention group of 54 cases and control group of 51 cases by random number table method. Patients in the control group were given routine nursing and self-management education, and the intervention group was combined with peer support education. Follow-up for six months, disease cognition level, healthy behavior, and quality of life of the two groups were compared. Results During the six-month follow-up, the disease recognition scores of the two groups were higher than before the intervention (P ＜ 0.05 or P ＜ 0.01), and the general knowledge, drug knowledge, and complication knowledge scores of intervention group were higher than those of the control group (P ＜ 0.05). The taking medication, regular diet, proper exercise, and regular review of health behaviors of intervention group were higher than those of control group, and the differences were statistically significant (P ＜ 0.05). The quality of life scores of the two groups were higher than those of the same group before the intervention, and the scores of intestinal symptoms, systemic symptoms, emotional problems, and social ability in the intervention group were higher than those of the control group, and the differences were statistically significant (P ＜ 0.05 or P ＜ 0.01). Conclusion Peer support and self-management education can help patients with ulcerative colitis improve their disease awareness, promote the development of healthy behaviors, and improve the quality of life of patients.
		2021 Vol. 18 (13): 168-171 [Abstract] ( 99 ) HTML (1 KB) PDF (680 KB) ( 28 )

	172	Effect of preoperative upper limb functional exercise combined with respiratory function training on the range of motion of the shoulder joint and lung function in patients undergoing thoracic surgery
		WANG Fen DAI Xiujuan
		Objective To explore the effect of preoperative upper limb function exercise combined with respiratory function training on the range of motion of the shoulder joint and lung function in patients undergoing thoracic surgery. Methods A total of 96 thoracic surgery patients admitted to Nantong Hospital of Traditional Chinese Medicine in Jiangsu Province from January 2017 to December 2018 were selected and divided into intervention group of 50 cases and control group of 46 cases according to the random number table method. Patients in both groups were given postoperative upper limb functional exercises and respiratory function training, while the intervention group combined preoperative upper limb functional exercises and respiratory function training. The indexes of shoulder joint range of motion, lung function and quality of life were compared between the two groups when they were discharged from the hospital. Results At discharge, the angles of lift, extension, and external rotation of the two groups were significantly smaller than before the intervention, and the maximum angles of lift, extension, and external rotation of the patients in the intervention group were significantly more than those of the control group, and the differences were statistically significant (P ＜ 0.05 or P ＜ 0.01). The forced vital capacity (FVC), forced expiratory volume in first second (FEV1), and maximal voluntary ventilation (MVV) of the two groups were significantly lower than those at admission, while the FVC, FEV1, and MVV of the intervention group were significantly higher than those of the control group, and the differences were statistically significant (P ＜ 0.05 or P ＜ 0.01). The symptoms, activity limitation, and the impact on quality of life score of intervention group were significantly lower than those of the control group, and the differences were statistically significant (P ＜ 0.05). Conclusion Preoperative upper limb function exercise combined with respiratory function training can help to promote the recovery of upper limb function and lung function of thoracic surgery patients, and improve the quality of life of patients.
		2021 Vol. 18 (13): 172-175 [Abstract] ( 59 ) HTML (1 KB) PDF (652 KB) ( 93 )

	176	Application effect of fine management in nursing care of neonatal hyperbilirubinemia
		DING Min HU Zhangmin YIN Yiju ZHOU Qian▲
		Objective To explore the effect of fine management in nursing care of neonatal hyperbilirubinemia. Methods A total of 80 cases of full-term neonatal hyperbilirubinemia in the Department of Neonatal Pediatrics, Anhui Children’s Hospital from January to August 2020 were selected, they were divided into the observation group and the control group by the random number table method, with 40 cases in each group. The control group was given routine nursing, and the observation group was given fine management, they were received continuous nursing for five days. The blue light treatment time, jaundice subsided time, length of hospital stay, serum total bilirubin level, body weight and complications were compared between the two groups. Results The blue light treatment time, jaundice regression time and length of hospital stay in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P ＜ 0.05); there were significant differences in the level of serum total bilirubin, the comparison of each time point and the interaction between the two groups (P ＜ 0.05), further pairwise comparison showed that the levels of serum total bilirubin in the two groups at 2, 4 and 5 days after nursing were significantly lower than that before nursing, at 4 and 5 days after nursing were lower than that at 2 days after nursing, and at 5 days after nursing was lower than that at 4 days after nursing, the differences were statistically significant (P ＜ 0.05), compared between groups, the levels of serum total bilirubin in the observation group were lower than those in the control group at 2, 4 and 5 days after nursing, and the differences were statistically significant (P ＜ 0.05); the body weight of the observation group was significantly higher than that of the control group (P ＜ 0.05); the total incidence of diarrhea, fever and rash in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P ＜ 0.05), there was no need for exchange transfusion and bilirubin encephalopathy in both groups. Conclusion Fine management in neonatal hyperbilirubinemia nursing effect is significant, which is beneficial to the recovery of children, and can significantly shorten the hospitalization time, relieve the tension of neonatal ward, improve the turnover rate of hospital bed, and reduce the hospitalization cost of children, which is worthy of application and promotion.
		2021 Vol. 18 (13): 176-180 [Abstract] ( 122 ) HTML (1 KB) PDF (664 KB) ( 163 )

	181	Application of co-participatory nursing in low weight premature infants
		CAI Ruyi XU Yeqin LIU Beibei▲
		Objective To observe the application value of co-participatory nursing in low weight premature infants, to guide the formulation of a reasonable care plan for low-weight premature infants in the future. Methods A total of 200 cases of low weight premature infants who were delivered in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from June 2016 to June 2019 were selected, according to the random number table method, they were divided into control group and observation group, each with 100 cases. The control group was adopted the routine nursing model, and the observation group was adopted the co-participatory nursing on the basis of the control group, and both were received nursing for three months. Before nursing and three months after nursing, the general self-efficacy scale （GSES）, the family function assessment scale （APGAR）, and the Chinese version of parenting sense of competence scale （C-PSOC） were used to evaluate and compare the self-efficacy, family function and parenting competence of patients in two groups （selected one of them）; the clinical indicators of the two groups’ children, the occurrence of hospital infection and feeding intolerance in the two groups’ children were recorded and compared; recorded and compared. Results Before nursing, the GSES, APGAR and C-PSOC scores of the two groups were compared, the difference was not significant statistically (P ＞ 0.05); at three months of nursing, the GSES, APGAR and C-PSOC scores of the two groups were higher than those before nursing, and the observation group was higher than the control group, the differences were significant statistically (P ＜ 0.05); the growth rate of the children in the observation group was higher than that of the control group, the box oxygen time, nasal oxygen time and hospital stay were shorter than those in the control group (P ＜ 0.05); the incidence of hospital infection and feeding intolerance in the observation group was lower than those in the control group, and the differences were significant statistically (P ＜ 0.05). Conclusion Co-participatory nursing can effectively improve the self-efficacy of the parents of low birth weight premature infants, improve the family function of the children, and enhance the parenting ability of the parents. Effectively promote the recovery of low birth weight preterm infants and effectively reduce the risk of hospital infection and feeding intolerance.
		2021 Vol. 18 (13): 181-184 [Abstract] ( 86 ) HTML (1 KB) PDF (686 KB) ( 157 )

	185	Effects of active and passive rehabilitation exercises based on the transformation of motivational behavior on the functional recovery of patients after knee replacement
		WU Shanshan
		Objective To investigate the effect of active and passive rehabilitation exercise based on motivational behavior transformation on the functional recovery of patients after knee replacement. Methods The clinical data of 80 patients who underwent knee replacement in the Department of Joint Surgery of Wanbei Coal and Power Group General Hospital in Anhui Province from January 2017 to December 2019 were retrospectively analyzed, according to the time of admission, they were divided into control group (from January 2017 to June 2018) and study group (from July 2018 to December 2019), with 40 cases in each group. Patients in the control group were given routine nursing, and patients in the study group were given active and passive rehabilitation exercises based on the transformation of motivational behavior on the basis of the control group. The hospital for special surgery (HSS) and active joint range of motion (AROM) were compared between the two groups before nursing and at discharge, visual analogue scale (VAS) was compared between the two groups at different postoperative time points, and complications and nursing satisfaction of the two groups were analyzed. Results At discharge, the HSS score and AROM of the two groups were significantly increased, and the HSS score and AROM of the study group were significantly higher than those of the control group (P ＜ 0.05). Comparison of VAS score time, intergroup and interaction at different postoperative time points between the two groups showed statistically significant differences (P ＜ 0.05). Further pairwise comparison was made between the two groups and intra-group comparison, the VAS scores of the two groups at 3 and 7 days after operation were significantly lower than those at one day after operation, the VAS score at 7 days after operation was significantly lower than that at 3 days after operation, and the differences were statistically significant (P ＜ 0.05); the VAS scores the study group were significantly lower than those in the control group (P ＜ 0.05); the total complication rate of the study group was significantly lower than that of the control group (P ＜ 0.05); the nursing satisfaction of the study group was significantly higher than that of the control group (P ＜ 0.05). Conclusion The application of active and passive rehabilitation exercises based on the transformation of motivational behavior in patients after knee replacement can effectively promote the rapid recovery of their knee joint functions, effectively relieve the pain level, and further improve their satisfaction with nursing.
		2021 Vol. 18 (13): 185-188 [Abstract] ( 162 ) HTML (1 KB) PDF (655 KB) ( 23 )

	189	Effect of continuous nursing of mutual care of mind and body on self-management and mental resilience in patients with multiple myeloma chemotherapy
		XU Jing ZHANG Ling ZHANG Yang
		Objective To observe the effect of continuous nursing of mutual care of mind and body on self-management and mental resilience of patients with multiple myeloma (MM) chemotherapy. Methods A total of 94 patients with MM chemotherapy admitted from the First Affiliated Hospital of Hebei North University from January 2017 to December 2019 were selected as the research objects. They were divided them into the control group and the observation group by random number table method, each with 47 cases. The control group was received routine nursing, and the observation group was combined mutual care of mind and body with continuous nursing. Before intervention and three months after follow-up, connor-davidson resilience scale (CD-RISC), health promotion lifestyle scale-Ⅱ (HPLP-Ⅱ) and MM self-management ability scale were compared between the two groups; the occurrence of adverse events in the two groups were recorded. Results After three months of follow-up, the scores of tenacity, strength and optimism in CD-RISC of the two groups were higher than those before intervention, and the scores of tenacity, strength and optimism in CD-RISC of the observation group were higher than those of the control group, and the differences were statistically significant （P ＜ 0.05）. The scores of HPLP-Ⅱ and self-management ability in the two groups were higher than those before intervention, and the scores of HPLP-Ⅱ and self-management ability in the observation group were higher than those in the control group, and the differences were statistically significant （all P ＜ 0.05）; the incidence of adverse events between the two groups were compared, the difference was not significant statistically （P ＞ 0.05）. Conclusion The continuous nursing of mutual care of mind and body in patients with MM chemotherapy is beneficial to improve their self-management ability and mental toughness, and can improve the healthy behavior of patients to a certain extent, with high application value.
		2021 Vol. 18 (13): 189-192 [Abstract] ( 98 ) HTML (1 KB) PDF (686 KB) ( 107 )

	193	Effect of the whole green channel nursing path mode on the stopping time and antipyretic time of febrile convulsion in children
		ZHU Yaqiong1 ZHU Xiaoyu2 YI Man1▲
		Objective To explore the effect of whole green channel nursing path model on the convulesions subsided time and antipyretic time of febrile convulsion in children. Methods A total of 106 cases of children with febriley convulsion admitted to the First Affiliated Hospital of Air Force Military Medical University from January 2016 to March 2020 were selected as the research objects, they were divided into the experimental group and the control group according to the random number table method, each with 53 cases. The control group received routine first-aid nursing, while the experimental group received the whole green nursing path mode. The effects of the two interrentions were compared. Results The stable rate of the experimental group was higher than that of the control group, and the incidence of complications was lower than that of the control group (P ＜ 0.05). The indexes of antifebrile disease, disappearance of convulsion, triage, waiting, transport and total first aid time in the experimental group were shorter than those in the control group, and the differences were statistically significant (P ＜ 0.05). The body temperature of the experimental group was lower than that of the control group 1 h after admission, and the difference was statistically significant (P ＜ 0.05). The satisfaction of family members in the experimental group was higher than that in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion The whole green channel nursing model can promote the stability of the disease in children with hyperpyretic convulsion, shorten the rescue time and improve the satisfaction of the family members.
		2021 Vol. 18 (13): 193-196 [Abstract] ( 58 ) HTML (1 KB) PDF (654 KB) ( 74 )

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