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2021 Vol. 18, No. 32
Published: 2021-11-15
 
 
4 Analysis of 100 years development trend of Chinese medical patent
QI Yan1 XU Haiyun2 GAO Dongping1
Objective To reveal the century-old development trend of the Chinese medicine field from the perspective of patents. Methods Innography and incoPat patent analysis platforms were used to analyze the development horizontally and vertically through multiple statistical dimensions such as application trend, grant trend, license amount, and comparisons with other countries. Results China government’s great emphasis on intellectual property had promoted the rapid growth of medical patent applications. The numbers of medical patent applications and grants of China were already in the world’s leading position, and the quality had greatly improved, however, there was a lot of room for development. Conclusion The number of high-value patents in the medical field in China is relatively small, and more attention needs to pay to the patent quality, international layout, patent transformation in the future.
2021 Vol. 18 (32): 4-8,17 [Abstract] ( 47 ) HTML (1 KB)  PDF (1241 KB)  ( 89 )
9 Expression and clinical significance of FAM83D in pancreatic cancer#br#
MIAO Yufeng1 ZHANG Youwei2 JIAO Nanlin3
Objective To investigate the expression and clinical significance of FAM83D in pancreatic adenocarcinoma (PAAD) tissues. Methods The gene expression and prognosis of FAM83D were analyzed online by Gene Expression Profiling Interactive Analysis (GEPIA) tool, and verified by KMplot database; 60 pairs of paraffin blocks were selected after PAAD operation in the Department of Pathology, Yijishan Hospital, Wannan Medical College from January 2018 to December 2019, including cancer tissues and adjacent tissues, and immunohistochemistry (IHC) was used to detect the expression of FAM83D protein; the mechanism of FAM83D was analyzed by gene set enrichment analysis. Results Compared with normal tissues, the expression of FAM83D mRNA was significantly increased in tumor tissues (P < 0.01). Compared with adjacent tissues, IHC score of cancer tissues was significantly higher (P < 0.01). The high expression of FAM83D protein in PAAD patients was associated with lymph node metastasis (P < 0.05). Compared with the low expression of FAM83D mRNA group, the overall survival and progression-free survival in the high expression of FAM83D mRNA group were significantly shorter (P < 0.01). FAM83D up-regulation was positively correlated with multiple gene sets(P < 0.05). Conclusion FAM83D plays an important role in the occurrence and development of PAAD and is expected to become a potential therapeutic target and a novel molecular marker.
2021 Vol. 18 (32): 9-12,27 [Abstract] ( 81 ) HTML (1 KB)  PDF (1304 KB)  ( 57 )
13 Effect of Danwei Formula on protease activated receptor-2 and E-cadherin in model rats with duodenal esophageal reflux#br#
ZHANG Wei1 XI Zhaohong1 LIU Mengru1 QIU Renjing2 TIAN Yaozhou1
Objective To observe the effect of Danwei Formula on protease activated receptor-2 (PAR-2) and E-cadherin in duodenal esophageal reflux model rats in order to explore the mechanism of Danwei Formula in the treatment of duodenal esophageal reflux. Methods Seventy-two SD rats were selected and divided into normal group, model group, western medicine group, Danwei Formula low dose group, Danwei Formula medium dose group and Danwei Formula high dose group according to random number table method, with 12 rats in each group. The model of duodenoesophageal reflux was established by “cardia suture + esophago duodenostomy”. Danwei Formula low dose group, Danwei Formula medium dose group and Danwei Formula high dose group was given 1.46, 2.92, 5.84 g/ml of Danwei Formula respectively. Western medicine group was given mixed solution of Mosapride Citrate and Magnesium Aluminate. Model group was gavaged with normal saline at the dose of 1 ml/100 g, once a day for four weeks. Morphological and pathological changes of lower esophageal mucosa were observed, and the expressions of PAR-2 and E-cadherin were measured by immunohistochemistry. Results Compared with normal group, Los Angeles grade score and pathological grade score of rats in model group were higher (P < 0.05). Compared with model group, Los Angeles grade score and pathological grade score of rats in western medicine group and Danwei Formula low dose group decreased (P < 0.05). Compared with normal group, average optical density of PAR-2 and E-cadherin in esophageal tissue of rats in model group increased (P < 0.05). Compared with model group, average optical density of PAR-2 in esophageal tissue of rats in western medicine group, Danwei Formula low dose group and Danwei Formula medium dose group decreased(P < 0.05). Compared with model group, average optical density of E-cadherin in esophageal tissue of rats in western medicine group and Danwei Formula low dose group decreased (P < 0.05). Compared with Danwei Formula low dose group, average optical density of PAR-2 and E-cadherin in esophageal tissue of rats in Danwei Formula medium dose group and Danwei Formula high dose group increased (P < 0.05). Conclusion Danwei Formula can improve the damage of esophageal mucosa in model rats, and has a certain therapeutic effect on duodenal esophageal reflux.
2021 Vol. 18 (32): 13-17 [Abstract] ( 36 ) HTML (1 KB)  PDF (676 KB)  ( 25 )
18 Establishment and identification of animal model of ovarian cancer xeno-transplantation#br#
LI Wei WANG Jiao SU Li▲ MIAO Jinwei WU Yumei
Objective To construct a patient-derived tumor xenograft (PDX) model for ovarian cancer research and individualized treatment. Methods Fresh surgically resected specimens from 10 patients with ovarian cancer (P0 generation) in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from July 2017 to July 2018 were collected and it was inoculated to 30 non-obese diabetic/severe combined immunodeficiency (NOD/SCID) mice and one tumor tissue sample was inoculated subcutaneously in axillary back of three NOD/SCID mice. Tumor growth was monitored after inoculation and tumor subgeneration transplantation was performed (150 mice from P1 to 4 generations totally). At the end of passage, the pathological and immunohistochemical staining of transplanted tumor tissues were analyzed to verify the model construction. Results Specimens were successfully inoculated in four patients, and the success rate was 40%. A total of 110 ovarian cancer models were successfully constructed in generations P1 to 4, and the success rates of each generation were 26.6%, 83.3%, 88.3%, and 80.1%, respectively. After tumor tissue inoculation, the body weight of mice did not decrease significantly, but increased slowly after seven to ten days. Tumor histopathology showed that the transplanted tumor was roughly spherical in appearance, slightly hard in texture, with complete capsule and visible vascular texture on the surface. After dissection, the section was milky white and cystic. Some tumors contained mucus, and some tumors had liquefaction areas. Hematoxylin-eosin staining showed luminal glandular structure, irregular shape, less stroma, obvious atypia of epithelial cells, obvious nucleoli, and pathological mitosis, which was basically consistent with the structure and atypia of human ovarian cancer cells. Immunohistochemical staining showed positive expression of estrogen receptor, progesterone receptor, P53, P16, Ki67, WT1, and Pax8, while negative expression of vimentin, which was highly consistent with the tumor tissue from the patient. Conclusion The ovarian cancer PDX animal model has been successfully constructed, which provides a platform for clinical research and choosing individual treatment for ovarian cancer patients.
2021 Vol. 18 (32): 18-21 [Abstract] ( 90 ) HTML (1 KB)  PDF (768 KB)  ( 203 )
22 Effect of miR-145 on the proliferation, invasion and migration of triple-negative breast cancer cells#br#
ZHU Lingxiao ZHANG Lan ZHANG Xuepeng LI Haoxin
Objective To investigate the effect of microRNA-145 (miR-145) on the proliferation, invasion， and migration of triple-negative breast cancer (TNBC) MDA-MB-231 cells. Methods MDA-MB-231 cells were divided into three groups， blank group (cells without special treatment), miR-145 NC group (transfected with miR-145 nonsense sequence), and miR-145 inhibitors group (transfected with miR-145 inhibitors). The relative expression levels of miR-145, adisintegrin and metalloproteinase 17 (ADAM17), and epidermal growth factor receptor (EGFR) mRNA were detected by real-time polymerase chain reaction, CCK-8 method was used to compare the proliferation ability of each group, Transwell test and scratch test were used to determine the invasion and migration ability of each group, and Western blot was used to detect the expression of ADAM17 and EGFR protein in each group. Results The expression level of miR-145 in miR-145 inhibitors group was lower than that in miR-145 NC group, and the difference was statistically significant (P < 0.05); there was no significant difference in miR-145 expression between miR-145 NC group and blank group (P > 0.05). At 24, 48 h, and 72 h after transfection, there were no significant differences in optical density (OD) values between miR-145 NC group and blank group (P > 0.05). At 72 h after transfection, OD value of miR-145 inhibitors group was higher than that of miR-145 NC group, and the difference was statistically significant (P < 0.05). At 24 and 48 h after transfection, there were no significant differences in OD values between miR-145 inhibitors group and miR-145 NC group (P > 0.05). The number of transmembrane cells in miR-145 inhibitors group was higher than that in miR-145 NC group, and the difference was statistically significant (P < 0.05); there was no significant difference in the number of transmembrane cells between miR-145 NC group and blank group (P > 0.05). The scratch healing rate in miR-145 inhibitors group was higher than that in miR-145 NC group, and the difference was statistically significant (P < 0.05); there was no significant difference in cell healing rate between miR-145 NC group and blank group (P > 0.05). The relative expression of ADAM17 mRNA in miR-145 inhibitors group was higher than that in miR-145 NC group, and the difference was statistically significant (P < 0.05); there was no significant difference in the relative expression of ADAM17 mRNA between miR-145 NC group and blank group(P > 0.05). There was no significant difference in the relative expression of EGFR mRNA between the miR-145 inhibitors group and miR-145 NC group (P > 0.05); there was no significant difference in the relative expression of EGFR mRNA between miR-145 NC group and blank group (P > 0.05). The relative expression levels of ADAM17 and EGFR protein in miR-145 inhibitors group were higher than those in miR-145 NC group, and the differences were statistically significant (P < 0.05); the relative expression levels of ADAM17 and EGFR protein in miR-145 NC group and blank group were not significantly different (P > 0.05). Conclusion After transfection of MDA-MB-231 cells with miR-145 inhibitors, the targeted activation of ADAM17/EGFR pathway promoted the proliferation, invasion and migration of MDA-MB-231 cells.
2021 Vol. 18 (32): 22-27 [Abstract] ( 146 ) HTML (1 KB)  PDF (943 KB)  ( 15 )
28 Visualization analysis of related research on treatment of femoral head necrosis with traditional Chinese medicine based on CiteSpace#br#
MA Ke1,2 ZHANG Hong2
Objective To provide ideas and treatment suggestions for follow-up research, the visualization methods were applied to analyze the research status, research hot spots and trends of traditional Chinese medicine in the treatment of femoral head necrosis over the past 10 years. Methods Literatures related to the treatment of femoral head necrosis with traditional Chinese medicine collected from January 2011 to December 2020 were searched by CNKI database, and CiteSpace 5.6.R2 analysis software was used to perform visual analysis on the authors, research institutions and keywords of the retrieved literatures. Results A total of 756 papers were included, including 106 core journals and 129 dissertations. The analysis of fund support showed that the projects supported by National Natural Science Foundation of China were the most. A total of 358 authors were included in the analysis, forming two research teams with He Wei and Chen Weiheng as the core respectively. There were 349 nodes and 641 links in the keyword co-occurrence network, forming 11 clusters. Conclusion The number of published studies per year in the field of traditional Chinese medicine for the treatment of femoral head necrosis is stable, but the interactivity between investigators and research institutions is poor. Meanwhile, the treatment of steroid induced femoral head necrosis in traditional Chinese medicine is a research hotspot and research trend in this field.
2021 Vol. 18 (32): 28-33 [Abstract] ( 179 ) HTML (1 KB)  PDF (1552 KB)  ( 15 )
34 Application value of three-dimensional reconstruction virtual reality navigation technology in thoracoscopic pulmonary segmentectomy#br#
ZHANG Yuchen ZHANG Wenqiang HAO Mengfu HUANG Zhuangshi
Objective To explore the application value of three-dimensional reconstruction virtual reality navigation technology in thoracoscopic pulmonary segmentectomy. Methods A retrospective analysis of the clinical data of 79 patients who underwent pulmonary segmentectomy in the Department of Thoracic Surgery of the Second Affiliated Hospital of Zhengzhou University from September 2018 to December 2020, according to whether three-dimensional reconstruction virtual reality navigation technology was applied or not, they were divided into experimental group and control group. Among them, a total of 35 cases in the experimental group were guided by three-dimensional reconstruction virtual reality navigation technology; a total of 44 cases in the control group were guided by conventional two-dimensional CT images. The diameter of nodules, nature of nodules, operation time, intraoperative blood loss, postoperative extubation time, postoperative drainage, postoperative hospital stay, and postoperative complications were compared between the two groups. Results The operation time, postoperative extubation time, and postoperative hospital stay in the experimental group were shorter than those in the control group, while the amount of blood loss and total postoperative drainage were less than those in the control group, and the differences were statistically significant (P ＜ 0.05); there was no significant difference in postoperative complications between the two groups (P ＞ 0.05). Conclusion The application of three-dimensional reconstruction virtual reality navigation technology in thoracoscopic segmentectomy has certain clinical value. Through preoperative evaluation and intraoperative navigation, the risk and difficulty of the operation are reduced, and the accuracy and safety of the operation are improved.
2021 Vol. 18 (32): 34-37 [Abstract] ( 49 ) HTML (1 KB)  PDF (611 KB)  ( 7 )
38 Research progress of inflammatory factors and their related signaling pathways in the regulation of spinal cord injury#br#
SONG Jiefei1 ZHOU Yuxin1 ZHANG Yu1 WU Chengjie1,2 MA Yong1,2 GUO Yang1,2
Spinal cord injury (SCI) is a serious central nervous system injury. Secondary injury is an important cause of poor prognosis in SCI, and inflammation is one of the main secondary injury. A lot of literatures have shown that inflammation cytokines and related signaling pathways, such as nuclear factor (NF)-κB, JAK/STAT and MAPK/ERK, regulate the inflammtion after SCI. They play a key role in the development of SCI. In this review, inflammation cytokines are classified into proinflammatory and anti-inflammatory factors according to their effects. This review focuses on the key proinflammatory factors interleukin 6 (IL-6), tumor necrosis factor, and anti-inflammatory factors IL-4, IL-10 and reveals their roles in the process of SCI, so that researchers in related fields can understand the molecular mechanism of inflammation after SCI widely and deeply. Based on this, they may find better biological methods for the treatment of SCI.
2021 Vol. 18 (32): 38-41 [Abstract] ( 307 ) HTML (1 KB)  PDF (405 KB)  ( 226 )
42 Research progress of different scoring systems in the prognosis assessment of sepsis#br#
CHEN Zhangyu1 LUO Kaiyuan2
Sepsis correlation score is an important means for clinicians to judge the condition and evaluate the prognosis of patients with sepsis, including general score for critical illness and special score for sepsis, such as sequential organ failure assessment, acute physiology and chronic health evaluation Ⅱ, mortality emergency department sepsis score, national early warning score, etc. Studies have confirmed that, these scores are of good practical value, however, they behave differently in different application scenarios. In addition, based on these scores, scholars have built many modified versions to better apply to different patients. This article reviews the research progress of sepsis correlation score in prognosis assessment in recent years, it provides a reference for clinicians to choose the appropriate score.
2021 Vol. 18 (32): 42-45,57 [Abstract] ( 154 ) HTML (1 KB)  PDF (782 KB)  ( 193 )
46 Investigation and analysis of the status quo of knowledge, beliefs, practice and influencing factors of nurses in the internal medicine department of a tertiary hospital to prevent medical device related pressure injury#br#
FENG Weijiao1 YU Hui2 MENG Defang3 WANG Yinglan4
Objective To investigate the current status and influencing factors of medical nurses’ knowledge, belief and practice (KBP) in medical device related pressure injury (MDRPI) prevention. Methods From April to August 2020, a total of 263 internal medicine nurses in two tertiary hospitals were selected as the research subjects, and the MDRPI prevention KBP questionnaire for internal medicine nurses was used for investigation. Results Among the 263 nurses, the average scores of MDRPI prevention knowledge, prevention belief, prevention practice, and total score of KBP prevention were accounted for 67.56%, 82.76%, 73.37%, and 73.30%. There was a statistically significant difference in the scores of prevention knowledge, belief practice, KBP total score among nurses with different working years, education backgrounds, professional titles, whether to participated in MDRPI knowledge training, whether they had nurse MDRPI patients (P ＜ 0.05). Working years, professional title, whether to participate in MDRPI knowledge training, whether to nurse MDRPI patients were the factors that affected the level of nurses’ MDRPI prevention knowledge, beliefs, and practice (P ＜ 0.05). Conclusion Internal medicine nurses lack knowledge of MDRPI prevention, and prevention behaviors need to be improved. The standardized education and training of MDRPI prevention knowledge should be strengthened to promote the development of the level of MDRPI KBP, so as to reduce the risk of patients with MDRPI.
2021 Vol. 18 (32): 46-49 [Abstract] ( 199 ) HTML (1 KB)  PDF (581 KB)  ( 225 )
50 Study on the current status of family resilience of patients with rectal cancer and enterostomy and the correlation analysis of its influencing factors#br#
XU Yanhua1 CAO Songmei2 WANG Min3 ZHOU Xiaojiang4 WANG Honggang3
Objective To understand the current status of family resilience of patients with rectal cancer and enterostomy in Taizhou and Xinhua, Jiangsu Province, and to analyze the correlation analysis of factors affecting family resilience. Methods Random sampling was used to select 136 patients with rectal cancer and enterostomy patients who were treated at Taizhou City and Xinghua City People’s Hospital in Jiangsu Province from October 2018 to June 2020 as the research objects, while the correlation between the family resilience and general clinical data, stigma, and quality of life of the final enrolled patients were analyzed. Results A total of 136 questionnaires were issued, 120 were returned, and 96 were valid questionnaires, with an effective response rate of 70.59%. The family resilience score of the enrolled patients was (177.49±21.38) points. The resilience scores of males, living in town and married families were higher than those of females, living in rural areas and other marital status, and the differences were statistically significant (P ＜ 0.05). Family resilience of patients with rectal cancer and enterostomy was negatively correlated with stigma (r = -0.418, P = 0.028), and positively correlated with quality of life (r = 0.438, P = 0.047). Multivariate analysis showed that family resilience of patients with rectal cancer and enterostomy was independently correlated with marital status, stigma and quality of life (P ＜ 0.05). Conclusion The family resilience of patients with rectal cancer and enterostomy should arouse the attention of clinical medical staff. The family resilience of patients with enterostomy is closely related to marital status, quality of life, and stigma.
2021 Vol. 18 (32): 50-53 [Abstract] ( 84 ) HTML (1 KB)  PDF (580 KB)  ( 128 )
54 Investigation on satisfaction of Chinese herbal medicine grade examination#br#
JIANG Dan CHEN Jiaxin XIAO Yao BAI Zhenfang REN Guangxi LIU Chunsheng
Objective taking the School of Chinese Materia Medica of Beijing University of Chinese Medicine as an example, to investigate and evaluate the satisfaction of students in the grade examination of Chinese herbal medicine, with a view to establishing a more complete examination system. Methods The electronic questionnaire survey method was adopted to distribute questionnaires to the students of the School of Chinese Materia Medica of Beijing University of Chinese Medicine. From November 30 to December 2, 2020, the satisfaction survey of the Chinese herbal medicine grade examination was conducted. Results A total of 605 questionnaires were issued in this survey, and 371 valid questionnaires were returned, with an effective response rate of 61.32%. The overall satisfaction rate of the Chinese herbal medicine grade examination was 65.23%, and 91.64% of the students believed that the grade examination was conducive to learning knowledge of Chinese pharmacy and Chinese medicine appraisal, and it was helpful to clinical practice, final examination, and daily life. Students’ satisfaction with the test time was low, 49.33% of the students thought the test time was too short. Students were highly satisfied with the content of the test, 66.31% of the students thought that the number of Chinese herbal medicine in the test scope was moderate. Students were highly satisfied with the examination system, but 62.53% of the students thought there were fewer examinations per semester. More than half of the students were satisfied with the exam pass rate. Conclusion Satisfaction of the Chinese herbal medicine grade examination needs to be further improved. It is recommended that the college increase the number of examinations, implement a herbarium appointment system, and conduct group examinations based on clinical common use to improve student satisfaction.
2021 Vol. 18 (32): 54-57 [Abstract] ( 77 ) HTML (1 KB)  PDF (549 KB)  ( 26 )
58 Analysis of influencing factors of bowel preparation quality before outpatient colonoscopy under the model of pharmaceutical care#br#
HUANG Mingqiu HAN Dan YANG Fan CHEN Yanhua
Objective To explore the influencing factors the quality of colonoscopy bowel preparation under the pharmaceutical care model. Methods From January 2018 to April 2019, a total of 656 outpatients for colonoscopy received education of bowel preparation by pharmacists. Questionnaires were filled out by pharmacists on the day of undergoing colonoscopy with effective recovery of 94.36%. Then univariate and multivariate logistic regression analysis were applied to analyze factors influencing bowel preparation. Results There were statistically significant differences in the left colon scores of patients with different ages, whether they were diagnosed with hypertension, or diabetes (P < 0.05); whether it was diagnosed as hypertensive patients with transverse colon score comparison, and the difference was statistically significant (P ＜ 0.05); there were statistically significant differences in the right colon scores of patients with different genders, different educational levels, and whether they were diagnosed with hypertension (P ＜ 0.05); there were statistically significant differences in the total scores of patients of different ages and whether they were diagnosed with hypertension (P ＜ 0.05). Hypertension (OR = 2.453, 95%CI: 1.284-4.684) and bowel preparation compliance (OR = 2.160, 95%CI: 1.118-3.987) were the influencing factors of the overall bowel preparation score (P ＜ 0.05); hypertension (OR = 8.880, 95%CI: 3.552-22.201) was the influencing factor of the score of left colon bowel preparation (P ＜ 0.05); education level (OR = 0.657, 95%CI: 0.445-0.970) was the influencing factor of the score of the right colon (P ＜ 0.05). Conclusion High blood pressure and low education are predictors of failure of bowel preparation for colonoscopy.
2021 Vol. 18 (32): 58-61 [Abstract] ( 115 ) HTML (1 KB)  PDF (550 KB)  ( 22 )
62 Analysis on influencing factors of gratitude level on coping style in patients with preeclampsia#br#
SUN Yan WU Wenfang SHAO Juan
Objective To explore and analyze the influence of gratitude level of patients with preeclampsia (PE) on the way. Methods A total of 120 PE patients admitted to the General Hospital of Anhui Wanbei Coal and Power Group from January 2019 to April 2021 were prospectively selected as the research subjects. Simple coping style questionnaire (SCSQ) and Gratitude resentment appreciation test (GRAT) were used to evaluate the gratitude level and coping style of patients on the day of admission. All patients were divided into negative group and positive group according to the SCSQ scoring standard. The baseline data questionnaire was designed by researchers, asked the patients and their family, the baseline data, each dimension score and total score of GRAT of patients in the two groups were recorded and compared in detail, while the influence of gratitude level on coping style of PE patients was analyzed. Results Among 120 patients with PE, a total of 20 patients tended to respond negatively, accounting for 16.67%. The per capita monthly income, education level and GRAT score of the negative group were lower than those of the positive group, and the differences were statistically significant (P ＜ 0.05). The results of multiple logistic regression analysis showed that per capita monthly income was a risk factor for negative coping in patients with preeclampsia (OR ＞ 1, P ＜ 0.05); GRAT score and education level were the protective factors for negative coping in patients with preeclampsia (OR ＜ 1, P ＜ 0.05). Conclusion Factors such as the gratitude level, GRAT score, and education level of PE patients can affect the coping style of patients.
2021 Vol. 18 (32): 62-65,70 [Abstract] ( 57 ) HTML (1 KB)  PDF (921 KB)  ( 24 )
66 Relationship between statins and hemocompatibility related clinical adverse events after extra-corporeal membrane oxygenation implantation#br#
LEI Bai HOU Jianfeng HU Shengshou
Objective To explore the relationship of hemocompatibility related clinical adverse events (HRAEs) and statin treatment after extra-corporeal membrane oxygenation (ECMO) implantation in patients with postoperative cardiac shock (PCS). Methods Clinical data of 280 patients who received ECMO implantation in Fuwai Hospital, Peking Union Medical College from February 2008 to April 2016 were collected to observe the occurrence of HRAEs after taking statins, and the basic characteristics, complications and other medication of patients were recorded. COX proportional hazard ratio regression and other methods were used to study the effect of statins on HRAEs, and propensity score was used for matching and re-analysis. Results HRAEs occurred in 40 (18.87%) and 17 (25.00%) patients in the non-statin group and 68 patients in the statin group, respectively. Log-rank test showed that patients taking statins were more likely to develop HRAEs (P = 0.014), and the incidence of bleeding events was higher in the statin group than in the non-statin group (P ＜ 0.05). Multivariate analysis showed that statins may be a risk factor for HRAEs [HR (95%CI) =2.149(1.100-4.201), P = 0.025]. After matching using a propensity score, HRAEs were more common in patients taking statins than in those not taking statins (P = 0.008). Conclusion PCS patients are prone to HRAEs with statins after ECMO implantation in 60 days. The results need to be verified by large sample studies.
2021 Vol. 18 (32): 66-70 [Abstract] ( 67 ) HTML (1 KB)  PDF (600 KB)  ( 32 )
71 Efficacy of low-dose Dopamine combined with Furosemide in the treatment of heart failure: a network meta-analysis#br#
SHI Mili1 LIU Xiaobo2 SONG Qiuyan1 MA Yue1 XU Ping1
Objective To analyze the correlation between low-dose Dopamine and Furosemide in the treatment of heart failure, and to evaluate the effect of different doses of Dopamine on Furosemide. Methods The databases of Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP, and Wanfang date base were searched for randomized controlled trials (RCT) of low-dose Dopamine combined with Furosemide in the treatment of heart failure. RevMan 5.3 software was used to evaluate the quality of the included literatures, and Stata 15.1 software was used for network meta-analysis. Results A total of 25 RCT covering Furosemide 20-40 mg/d and four Dopamine doses (0.5-2.0 μg/[kg·min], 2-3 μg/[kg·min], 5 μg/[kg·min], 20-60 mg/d) were included. Furosemide 20-40 mg/d was combined with four Dopamine doses into four combined groups. The results of inconsistency test showed that the total effective rate and left ventricular ejection fraction (LVEF) were consistent (P ＞ 0.05). The total effective rates of the four combined groups were higher than those of the Furosemide group, and the differences were statistically significant (OR = 1.85, 95%CI[1.41,2.28], OR = 1.02, 95%CI[0.21,1.83], OR = 1.21, 95%CI[0.38,2.03], OR = 1.46, 95%CI[0.96,1.96], P ＜ 0.05). The improvement of LVEF of the four combined groups was better than that of the Furosemide group, and the differences were statistically significant (MD = 8.00, 95%CI[7.24,8.77], MD = 3.99, 95%CI[1.94,6.03], MD = 4.09, 95%CI[2.33,5.86], MD = 7.90, 95%CI[6.88,8.93], P ＜ 0.05). The SUCRA order of total effective rate and LVEF improvement in each group was: Furosemide 20-40 mg/d＜Furosemide 20-40 mg/d+Dopamine 2-3 μg/(kg·min) ＜Furosemide 20-40 mg/d+Dopamine 5 μg/(kg·min) ＜Furosemide 20-40 mg/d+Dopamine 20-60 mg/d＜Furosemide 20-40 mg/d+Dopamine 0.5-2.0 μg/(kg·min). Conclusion Low dose Dopamine can enhance the efficacy of Furosemide in the treatment of heart failure, and improve the LVEF of patients. The dose of Dopamine is 0.5-2.0 μg/(kg·min) the total effective rate and LVEF improvement were better than the other three doses. Limited by the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.
2021 Vol. 18 (32): 71-77,82 [Abstract] ( 161 ) HTML (1 KB)  PDF (1215 KB)  ( 20 )
78 Meta-analysis of the relationship between MTHFR C677 gene polymorphism and coronary artery heart disease in Chinese population#br#
LIU Chengming1 PANG Jun2▲ HU Wenyu3 TANG Anying3 WU Qiang2 HUANG Jing2 ZHOU Yu2 LIU Wei2
Objective To systematically evaluate the association between the incidence of coronary artery heart disease and the MTHFR C677 allele in China. Methods Case-control studies on the correlation between coronary artery heart disease and MTHFR C677 C/T gene were searched in English databases (PubMed, Embase, Cochrane Library) and Chinese databases (CNKI, VIP, Wanfang Data) from inception to February 2021. The quality of the included literatures was evaluated. Data were meta-analyzed using RevMan 5.0 software. Results A total of 2412 cases were included in eight studies, including 1501 cases in the coronary artery heart disease group and 911 cases in the normal group. Meta-analysis showed that the expression of MTHFR C677 CC allele in coronary artery heart disease group was lower than that in normal group (OR = 1.59, 95%CI: 1.17-2.15, P = 0.003). There was no significant difference in MTHFR C677 CT allele expression between coronary artery heart disease group and normal group (OR = 0.91, 95%CI: 0.76-1.09, P = 0.30). The expression of MTHFR C677 TT allele in coronary artery heart disease group was higher than that in normal group (OR = 0.64, 95%CI: 0.52-0.79, P ＜ 0.000 01). Conclusion The expression of MTHFR C677T gene is related to the incidence of coronary artery heart disease in Chinese population, and the TT allele expression is higher in coronary artery heart disease population.
2021 Vol. 18 (32): 78-82 [Abstract] ( 121 ) HTML (1 KB)  PDF (1067 KB)  ( 20 )
83 Correlation between mindfulness level and coping style in patients with acute myocardial infarction after percutaneous coronary intervention#br#
LIU Xuefeng1 DIAO Yuanbin2 QIN Xiaoxia3 GAN Qianwen4
Objective To observe mindfulness level and coping style of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), and to analyze the relationship between mindfulness level and coping style. Methods A total of 110 AMI patients who received PCI treatment from January 2018 to January 2021 in People’s Hospital of Garzi Tibetan Autonomous Prefecture, Sichuan Province were selected as the study subjects. Mindful attention awareness scale (MAAS) and medical coping modes questionnaire (MCMQ) were used to evaluate the mindfulness level and coping style of all patients at the end of treatment, one and two weeks after treatment, Pearson correlation coefficient was used to analyze the relationship between mindfulness level and coping style. Results At two weeks after treatment, 10 of the 110 patients were shed and 100 cases were eventually included in the study. The MAAS score of AMI patients at one and two weeks after treatment was higher than that at the end of treatment, and two weeks after treatment was higher than one week after treatment, the differences were statistically significant (P ＜ 0.05). The scores of face dimension MCMQ in AMI patients at one and two weeks after treatment were higher than those at the end of treatment, while the scores of avoidance and yield dimensions were lower than those at the end of treatment; the scores of face dimension at two weeks after treatment was higher than one week after treatment, and the scores of avoidance dimension and yield dimension at two weeks after treatment were lower than one week after treatment, the differences were statistically significant (P ＜ 0.05). The results of correlation analysis showed that there was a positive correlation between MAAS score and score of face dimension in MCMQ (r ＞ 0, P ＜ 0.05), and a negative correlation between MAAS score and scores of avoidance and yield dimension in MCMQ (r ＜ 0, P ＞ 0.05). Conclusion Mindfulness level after PCI in AMI patients is related to coping style.
2021 Vol. 18 (32): 83-86 [Abstract] ( 361 ) HTML (1 KB)  PDF (549 KB)  ( 19 )
87 Effectiveness of Urokinase and Alteplase in the treatment of super-aged patients with acute ischemic stroke#br#
ZHOU Ting1,2 LIAO Juan2,3 LIU Li4 ZHAO Libo1,2,3 YANG Yonghong1,2 LIU Qingjun1,2 LIU Shudong1,2 YANG Deyu1,2,3,5

Objective To explore the effectiveness of Urokinase and Alteplase in the treatment of super-aged patients with acute ischemic stroke (AIS). Methods The clinical data of 106 super-aged patients with AIS treated in Yongchuan Hospital of Chongqing Medical University from June 2017 to October 2020 was analyzed retrospectively. According to different thrombolytic drugs, they were divided into Urokinase group (44 cases) and Alteplase group (62 cases). Twenty-nine pairs of patients in two groups were screened by propensity score matching, including 17 patients with large vessel occlusion (LVO) and 12 patients with non-LVO in the Urokinase group, Alteplase group included 20 LVO patients and 9 non-LVO patients. The baseline characteristics and observation indexes (rate of favorable outcome, modified Rankin scale[mRS] score at 90 days, changes of the National Institutes of Health stroke scale score, death rate, rate of intracranial hemorrhage, rate of symptomatic intracranial hemorrhage, and rate of extracranial hemorrhage) were compared between the two groups. Results Before matching, the time from onset to thrombolysis in urokinase group was longer than that in Alteplase group, the difference was statistically significant (P ＜ 0.05), while there was no significant difference in other baseline data and observation indicators (P ＞ 0.05). After matching, there were no significant differences in baseline data and observation indicators between the two groups (P ＞ 0.05). In LVO patients, the rate of favorable outcome of Urokinase group was lower than that of alteplase group, and the mRS score at 90 days was higher than that of Alteplase group, with statistical significance (P ＜ 0.05). In non-LVO patients, there was no statistical significance between the two groups (P ＞ 0.05). Conclusion Intravenous Urokinase thrombolytic therapy for AIS in super-aged patients is relatively safe and effective. In super-aged patients with non-LVO stroke, the efficacy of Urokinase is comparable to that of Alteplase intravenous thrombolytic therapy, and it can be used as a substitute for Alteplase.
2021 Vol. 18 (32): 87-91 [Abstract] ( 58 ) HTML (1 KB)  PDF (491 KB)  ( 34 )
92 Application effect of home rehabilitation management model of “Services for the Disabled” APP in stroke patients with hemiplegia#br#
ZHAO Yuxi1 SUN Shuai2 XIE Weidi3 CAO Bin1 WU Chen1
Objective To study the application effect of home rehabilitation management model of “Services for the Disabled” APP in stroke patients with hemiplegia. Methods A total of 192 stroke patients with hemiplegia admitted to Beijing Rehabilitation Hospital of Capital Medical University from January 2018 to January 2020 were selected and divided into control group (96 cases) and study group (96 cases) according to random number table method. The control group received routine home rehabilitation for stroke patients with hemiplegia, and the study group received home rehabilitation management model of “Services for the Disabled” APP. Both groups received intervention for three months. Modified Barthel index (MBI), Fugl-Meyer assessment scale (FMA), Berg balance scale (BBS), patient health questionnaire-9 (PHQ-9), general self-efficacy scale (GSES) between the two groups before and after the intervention were compared and analyzed. Results During the study, two patients withdrew from the study group, and 190 patients were eventually enrolled in the study. After intervention, MBI, FMA, BBS, and GSES scores of the two groups were higher than before intervention, and the study group was higher than the control group, the differences were statistically significant (P ＜ 0.05). After intervention, PHQ-9 score of the study group was lower than before and lower than that of the control group, the differences were statistically significant (P ＜ 0.05). Conclusion “Services for the Disabled” APP home rehabilitation management model can effectively improve the daily living activities and motor functions of stroke patients with hemiplegia, reduce depression and stimulate self-efficacy, which is worth promoting and applying.
2021 Vol. 18 (32): 92-95 [Abstract] ( 131 ) HTML (1 KB)  PDF (475 KB)  ( 70 )
96 Application effect of abdominal breathing training in rehabilitation of patients with stroke during recovery period#br#
FAN Xiaojiao WEI Jie WANG Liya
Objective To analyze the application effect of abdominal breathing training in rehabilitation of patients with stroke during recovery period. Methods A total of 50 patients with stroke during recovery period who received routine rehabilitation training combined with abdominal breathing training in Baoding Second Hospital, Hebei Province (hereinafter referred to as “our Hospital”) from January 2019 to December 2020 were selected as observation. A total of 50 patients with stroke during recovery period who received routine rehabilitation training in our hospital during the same period were collected as the control group. After three months of continuous intervention, lung function indexes (forced vital capacity [FVC], forced expiratory volume in one second [FEV1], FEV1/FVC), respiratory function indexes (respiratory pressure, airway resistance, airway peak pressure), modified Barthel index (MBI), and fatigue severity scale (FSS) score were compared between the two groups before and after intervention. Results After intervention, the FVC, FEV1, FEV1/FVC, and MBI in both groups were higher than before intervention, and the respiratory pressure, airway resistance, airway peak pressure, and the score of FSS were lower than before intervention, while the FVC, FEV1, FEV1/FVC, and MBI in the observation group were higher than those in the control group, and the respiratory pressure, airway resistance, airway peak pressure, and the score of FSS were lower than those in the control group, the differences were statistically significant (P ＜ 0.05). Conclusion Abdominal breathing training can reduce the fatigue degree of patients in the convalescent stage of stroke, promote the recovery of respiratory and lung functions, and improve the ability of daily living activities.
2021 Vol. 18 (32): 96-99 [Abstract] ( 167 ) HTML (1 KB)  PDF (503 KB)  ( 10 )
100 Observation on delivery complications and outcomes of different delivery modes of pregnant women with HIV infection#br#
WU Wei SHI Yue WU Yubi▲
Objective To study the delivery complications and outcomes of different delivery modes of pregnant women with human immunodeficiency virus (HIV) infection. Methods A total of 106 pregnant women with HIV infection admitted to Liuzhou Maternity and Child Health Care Hospital, Guangxi Zhuang Autonomous Region from January 2018 to January 2020 were selected. According to different delivery modes, they were divided into observation group (caesarean section, 50 cases) and control group (vaginal delivery, 56 cases). The levels of stress factors (plasma norepinephrine [NE], serum cortisol [Cor], and angiotensin Ⅱ [AngⅡ] ) were compared between two groups at 12 h after delivery and before delivery; the duration of labor, delivery complications and adverse pregnancy outcomes were compared between two groups; Apgar score at 1, 3 min, and 5 min after delivery and birth weight were compared between two groups. Results At 12 h postpartum, the levels of NE, Cor, and AngⅡin two groups were higher than those before delivery, and observation group was higher than control group, and the differences were statistically significant (P < 0.05). The total delivery time in observation group was shorter than that in control group, and the difference was statistically significant (P < 0.05). The total incidence of delivery complications in observation group was higher than that in control group, and the difference was statistically significant (P ＜ 0.05). The total incidence of adverse pregnancy outcomes in observation group was lower than that in control group, and the different was statistically significant (P ＜ 0.05). Apgar scores of 3 and 5 min after delivery in two groups were lower than those of 1 min after delivery; Apgar scores of 5 min after delivery in two groups were lower than those of 3 min after delivery, and the differences were statistically significant (P < 0.05). Apgar scores of 1, 3 min, and 5 min after delivery showed no significant difference between two groups (P > 0.05). Conclusion Vaginal delivery can reduce the stress response and delivery complications of pregnant women with HIV infection, but the cesarean section can shorten the delivery time and reduce the risk of neonatal HIV infection.
2021 Vol. 18 (32): 100-103,116 [Abstract] ( 85 ) HTML (1 KB)  PDF (732 KB)  ( 231 )
104 Expression and significance of UCH-L1 and S100B protein in peripheral blood of children with epilepsy#br#
ZHANG Shuang YAN Kai LI Shuhua ZHANG Jing JIA Yufeng
Objective To observe the expression levels of serum ubiquitin carboxy-terminal hydrolase-l1 (UCH-L1) and S100B protein in peripheral blood of children with epilepsy and to explore its significance. Methods A total of 80 children with epilepsy who were newly diagnosed in Tangshan Maternal and Child Health Hospital of Hebei Province (hereinafter referred to as “our hospital”) from October 2018 to October 2019 and had seizure within 24 hours before admission were selected as the case group, and a total of 80 healthy children in our hospital were selected as the control group. Fasting venous blood was collected in the morning, and the serum UCH-L1 and S100B protein expression levels were detected by double-antibody sandwich enzyme-linked immunosorbent assay, and the serum UCH-L1 and S100B protein expression levels were compared among the children with different seizure duration and seizure types in the case group. Results UCH-L1 and S100B protein levels in the case group were significantly higher than those in the control group (P < 0.01). UCH-L1 and S100B protein levels in epilepsy duration ≥5 min group were higher than those in epilepsy duration < 5 min group (P < 0.05 or P < 0.01). UCH-L1 and S100B protein levels in generalized seizure group were significantly higher than those in focal seizure group (P < 0.01). Conclusion UCH-L1 and S100B protein levels in the peripheral blood of children with epilepsy are increased, and the increase of both is related to the duration and type of epileptic seizure.
2021 Vol. 18 (32): 104-107 [Abstract] ( 65 ) HTML (1 KB)  PDF (446 KB)  ( 8 )
108 Expression and significance of miR-211-5p and SETBP1 in the tissue of infiltrating lobular carcinoma of the breast#br#
WENG Xiangqian1 WANG Yeling1 LIN Bing1 ZHANG Shuang1 SU Jun2
Objective To detect the expression of miR-211-5p and SET binding protein 1 (SETBP1) in the tissue of infiltrating lobular carcinoma (ILC) of the breast, and to explore the clinical significance of their expression in ILC. Methods The clinicopathological data of 82 female patients with ILC treated in the First Affiliated Hospital of Hainan Medical University from January 2019 to September 2020 were collected. Fluorescence quantitative PCR was used to detect the expression levels of miR-211-5p and SETBP1 in cancer tissues and adjacent tissues. The relationship between the expression of miR-211-5p and SETBP1 and the clinicopathological features of ILC patients was analyzed. Pearson linear correlation was used to analyze the correlation between miR-211-5p and SETBP1 expression in ILC. Bioinformatics software was used to predict the binding sites of miR-211-5p and SETBP1. Results The expression of miR-211-5p in ILC was lower than that in adjacent tissues, and the difference was statistically significant (P ＜ 0.05). The expression of SETBP1 in ILC was higher than that in adjacent tissues, and the difference was statistically significant (P ＜ 0.05). Compared with tumor TNM stage Ⅰ to Ⅱ ILC cancer tissues, miR-211-5p expression was significantly lower and SETBP1 expression was significantly higher in tumor TNM stage Ⅲ to Ⅳ ILC cancer tissues (P ＜ 0.05). Compared with ILC cancer tissues without axillary metastasis, miR-211-5p expression was significantly lower in ILC cancer tissues with axillary metastasis, while SETBP1 expression was significantly higher (P ＜ 0.05). The expression of miR-211-5p was negatively correlated with SETBP1 in ILC carcinoma tissues (r = -0.573, P < 0.05). Bioinformatics software predicted the existence of potential complementary binding sites with miR-211-5p at bases 374 to 381 in the 3’UTR region of SETBP1. Conclusion The expression of miR-211-5p is decreased in ILC cancer tissues, and SETBP1 is increased in ILC cancer tissues. The expressions of miR-211-5p and SETBP1 are correlated with tumor stage and axillary lymph node metastasis in breast cancer patients, and they are both involved in the progression of ILC, which may be diagnostic and therapeutic targets of ILC.
2021 Vol. 18 (32): 108-112 [Abstract] ( 55 ) HTML (1 KB)  PDF (536 KB)  ( 14 )
113 Application efficacy of Apatinib mesylate combined with SOX regimen for three-drug conversion therapy in patients with advanced gastric cancer who failed first-line therapy#br#
DU Chengrong CAO Qisheng HUANG Zhirong CHEN Lei
Objective To investigate the efficacy of Apatinib Mesylate combined with Tegafur+Oxaliplatin (SOX) regimen for three-drug conversion therapy in patients with advanced gastric cancer who failed first-line therapy. Methods A total of 65 patients with advanced gastric cancer who failed first-line treatment in Maanshan People’s Hospital，Anhui Province from January 2018 to April 2020 were selected as the research subjects. They were divided into control group (SOX regimen, 33 cases) and study group (Apatinib Mesylate combined with SOX regimen, 32 cases) according to random number table method. The clinical efficacy, adverse reactions and one-year survival rate of the two groups were compared. Results The objective remission rate and clinical benefit rate in the study group were significantly higher than those in the control group (P < 0.05). The total incidence of adverse reactions in the study group was significantly lower than that in the control group (P < 0.05). The one-year survival rate of the study group was significantly higher than that of the control group (P < 0.05). Conclusion Three-drug conversion therapy with Apatinib Mesylate combined with SOX regimen has a significant effect on advanced gastric cancer patients with first-line treatment failure, which significantly improves the objective remission rate and clinical benefit rate, significantly reduces adverse reactions, and further improves the one-year survival rate, which is worthy of promotion.
2021 Vol. 18 (32): 113-116 [Abstract] ( 145 ) HTML (1 KB)  PDF (430 KB)  ( 43 )
117 Effect of prophylactic medication on febrile non-hemolytic transfusion reaction：a meta-analysis#br#
LI Shuanghua1 LI Zhenhua2 LIU Chunyong3
Objective To investigate and analyze the effect of prophylactic medication before transfusion on the incidence of fever and allergic blood transfusion reaction. Methods Clinical controlled trials on prophylactic medication before transfusion published in PubMed, EmBase, The Cochrane Library, China National Knowledge Internet, China Science and VIP, WanFang Data base, and CBM from inception to October 2020 were collected. They were divided into prophylactic medication before transfusion group and control group (no prophylactic medication or placebo was administered before transfusion). Two researchers conducted methodological quality evaluation according to the systematic evaluation quality evaluation standard, extracted data, and performed meta-analysis with RevMan 5.3 software. Results Twelve articles were included. The results showed that the incidence of fever was significantly lower in the prophylactic medication before transfusion group than in the control group, and the difference was statistically significant (OR = 0.70, 95%CI: 0.55-0.88, P = 0.002). There was no significant difference in the incidence of allergic reaction between the prophylactic medication  before transfusion group and the control group (OR = 0.87, 95%CI: 0.62-1.62, P = 0.42). Funnel plot showed that there was no publication bias in the included literature. Conclusion Prophylactic medication before transfusion can reduce the incidence of febrile reaction, but not allergic reaction. However, the conclusions need to be supported by high-quality randomized controlled trials.
2021 Vol. 18 (32): 117-121 [Abstract] ( 149 ) HTML (1 KB)  PDF (1169 KB)  ( 35 )
122 Clinical effecacy of radiofrequency ablation combined with foam sclerotherapy and punctate stripping in treatment of great saphenous varicose veins#br#
FENG Weijing LI Jianming ZHOU Xuetao▲ ZEGN Wei CHEN Chen
Objective To explore the clinical efficacy of radiofrequency ablation combined with foam sclerotherapy and punctate stripping on treatment of great varicose veins. Methods A total of 80 patients with great saphenous varicose veins treated with Department of Surgery, Beijing Second Hospital from January 2014 to June 2020 were selected. A total of 38 patients treated with radiofrequency ablation combined with foam sclerotherapy and punctate stripping were as the observation group; 42 patients treated with high ligation and stripping of great saphenous veins were as the control group. Intraoperative blood loss, operation time, postoperative hospital length of stay, visual analogue scale (VAS) score, postoperative complications and venous clinical severity score (VCSS) were compared in two groups respectively. Results The amount of intraoperative blood loss in the observation group was less than that in the control group, the operation time and postoperative hospital stay were shorter than that in the control group, and the 24 h postoperative VAS score was lower than that in the control group (P ＜ 0.05). The incidence of subcutaneous ecchymosis and saphenous nerve injury in the observation group was lower than that in the control group (P ＜ 0.05). There was no significant difference in the incidence of incision infection between the two groups (P ＞ 0.05). No superficial thrombophlebitis and deep vein thrombosis occurred in the two groups. After one year follow-up, there was no recurrence in both groups. VCSS scores of the two groups one year after surgery were lower than those before surgery (P ＜ 0.05). Conclusion Radiofrequency ablation combined with foam sclerotherapy and punctate stripping have a significant effect in the treatment of great saphenous varicose veins, which can reduce intraoperative blood loss, shorten operation time and hospital length of stay, reduce complications, and facilitate rapid postoperative recovery.
2021 Vol. 18 (32): 122-125 [Abstract] ( 92 ) HTML (1 KB)  PDF (432 KB)  ( 9 )
126 Zang Donglai’s experience summary in treating coronary heart disease with Zhongman Fenxiao Decoction#br#
LIU Yunlu1 WANG Qiang2 ZANG Donglai3 ZANG Fan3
Zhongman Fenxiao Decoction comes from Li Dongyuan’s Lanshi Micang. Through warming interior for dispelling cold, activating qi and promoting diuresis method, this formula is mainly used in digestive system diseases with deficient cold of spleen and kidney,  internal retention of dampness-turbidity as the main symptoms, such as chronic gastritis, liver ascites, etc. In 50 years of clinical accumulation, Mr. Zang Donglai extended the application of Zhongman Fenxiao Decoction to treat patients with coronary heart disease and potential coronary heart disease, and achieved obvious curative effect. This paper will explore such clinical cases of Mr. Zang Donglai, provide new ideas for the prevention and treatment of coronary heart disease, and understand the corresponding relationship between “Zhongman” and modern cardiovascular diseases from a new perspective, and open up more possibilities for the modern application of traditional prescriptions.
2021 Vol. 18 (32): 126-129 [Abstract] ( 84 ) HTML (1 KB)  PDF (693 KB)  ( 61 )
130 Discussion on the mechanism of peach seed-safflower in the treatment of retinal vein occlusion based on network pharmacology#br#
JIN Qi HAO Xiaofeng XIE Like SUN Mei
Objective To explore the mechanism of peach seed-safflower in the treatment of retinal vein occlusion (RVO) by network pharmacology. Methods The composition and target of peach seed-safflower were predicted by traditional Chinese medicine systems pharmacology database and analysis platform, the target of RVO was predicted by GeneCards database, and the intersection target was obtained by Jvenn. Metascape database was used for GO analysis and KEGG pathway enrichment analysis of intersection targets, and AutoDock software was used for molecular docking verification of components and targets. Results A total of 35 components and 178 targets of peach seed-safflower were obtained, and 96 intersection targets were obtained by intersection of peach seed-safflower with 853 RVO targets. GO analysis obtained 246 biological processes, 61 cell components and 111 molecular functions, including apoptotic signaling pathways, response to oxidative stress and other biological processes. A total of 150 pathways were obtained by KEGG analysis, including AGE-RAGE signaling pathway, IL-17 signaling pathway, PI3K-Akt signaling pathway, etc. Molecular docking results showed that the compounds could stably combine with the target and exert therapeutic effect after entering the body. Conclusion The treatment of RVO by peach seed-safflower is characterized by multiple components, multiple targets and multiple pathways. It is speculated that the specific mechanism may be related to improving hemodynamics, regulating the expression of inflammatory factors and regulating the generation of oxygen free radicals.
2021 Vol. 18 (32): 130-133,137 [Abstract] ( 63 ) HTML (1 KB)  PDF (901 KB)  ( 64 )
134 Visualization analysis of acupuncture treatment for sciatica based on CiteSpace#br#
LI Ye MA Tieming
Objective To analyze the visual effect of acupuncture on sciatica with CiteSpace software. Methods Literatures related to acupuncture in the treatment of sciatica from January 2010 to December 2020 in China National Knowledge Internet database were searched by computer. After Refworks conversion, CiteSpace 5.7.R2 was used to generate the authors, research institutions, keywords co-occurrence and clustering visualization analysis atlas of acupuncture for sciatica for analysis and research. Results A total of 355 articles on acupuncture treatment of sciatica in recent ten years were retrieved, and the number of articles was analyzed, which showed that the number of articles declined from 2017. A total of 304 authors were retrieved, with WU Yaochi and other five leading authors in the number of articles published. A total of nine institutions were retrieved, and Shanghai Sixth People’s Hospital was the core institution in this field with the highest number of publications. A total of 386 keywords were included, and the hot keywords were lumbar disc herniation, electroacupuncture, warm acupuncture, clinical efficacy, etc., forming eight clusters. Conclusion The research on acupuncture treatment of sciatica needs to strengthen the communication between institutions and authors, and further basic research and in-depth analysis, so as to provide favorable conditions for the further development of this field.
2021 Vol. 18 (32): 134-137 [Abstract] ( 185 ) HTML (1 KB)  PDF (965 KB)  ( 29 )
138 Discussion on the molecular mechanism of genistein therapy for depression based on network pharmacology#br#
HU Yanzhen1 ZHANG Yuanyuan1 HUANG Bin1 WANG Yamin1 CHEN Le1▲ YANG Zhi2
Objective To systematically explore the key targets and molecular mechanisms of genistein in the treatment of depression based on network pharmacology. Methods The traditional Chinese medicine systems pharmacology database and analysis platform, comparative toxicogenomics, TTD, GeneCards, Home-NCBI-Gene and other databases were used to obtain the related targets of genistein in the treatment of depression. Protein-protein interaction (PPI) and “component-target-disease” network diagrams were constructed, and key targets were screened according to PPI interaction network diagrams. DAVID database was used to analyze the GO and KEGG pathways of target protein genes. Results Six key targets including MAPK1, PTGS2, MMP9, VEGFA, AKT1 and TNF, were identified by screening. A total of 33 GO functional information were obtained, including positive regulation of cell division, protein kinase B signal transduction, positive regulation of serine peptide phosphorylation, positive and negative regulation of RNA polymerase Ⅱ promoter transcription, immune response, positive regulation of MAP kinase activity, positive regulation of cell proliferation, blood glucose homeostasis, angiogenesis, positive regulation of NF-κB signal, etc. KEGG pathway enrichment analysis screened 23 signaling pathways, mainly involving cancer, immune inflammatory response, apoptosis, viral infection, etc. Conclusion Genistein has “multi-target-multi-pathway” regulation in the treatment of depression. This study provides a new idea for the molecular mechanism verification of genistein’s anti-depression.
2021 Vol. 18 (32): 138-142,150 [Abstract] ( 175 ) HTML (1 KB)  PDF (1210 KB)  ( 13 )
143 Clinical application of the idea of “transporting spleen and removing turbidity”#br#
LI Fuhai1 ZHAO Hanqing2 WANG Xuehong1 ZHANG Xiaoguang1 LI Xiangyang1 CAO Haifang1
Professor Lu Zhizheng, the master of traditional Chinese medicine, has been practicing medicine for more than 80 years. He advocates the idea of spleen and stomach and has researched and developed the modern theory of diseases caused by dampness. The theory of transporting spleen and removing turbidity is one of the important contents of his academic thoughts. In the 1980s, Professor Lu Zhizheng put forward the theory of “more multiple dampness in north China”, and all diseases are caused by dampness. Among them, “endogenous turbid evil” is the characteristic of his theory of diseases caused by dampness. The so-called endogenous turbid evil is the product of the abnormal function of the spleen and stomach, and is also an important pathogenic factor of human body, including the failure of the transport and stagnation of dense and turbid fine substances in the body, and the retention of damp-turbidity and turbid phlegm, which further affect the circulation of qi and blood and cause disease. By restoring the function of spleen and stomach to treat turbid evil, called transporting spleen and removing turbidity. Professor Lu Zhizheng has accumulated rich experience in more than 80 years of clinical practice, especially in the treatment of endogenous turbid evil with spleen and stomach as the center, and take into account other organs, so-called holding the central, transport four sides, light and lively medicine, more effective. Using the concept of transporting spleen and removing turbidity to treat modern internal diseases has a very good effect. The author has some understanding and research on the theory of transporting spleen and removing turbidity with Professor Lu Zhizheng for many years. This paper discusses and summarizes the concept of endogenous turbid evil and the theory of transporting spleen and removing turbidity, and expounds and summarizes the author’s therapeutic experience of transporting spleen and removing turbidity in internal medicine, trying to explain the important significance of this theory in modern clinical practice.
2021 Vol. 18 (32): 143-146 [Abstract] ( 49 ) HTML (1 KB)  PDF (688 KB)  ( 37 )
147 Effect of Magong Qingjin Ningxiao Formula combined with Budesonide in the treatment of pediatric heat asthma#br#
YU Chen1 GU Renzhuang2 CUI Wencheng3
Objective To explore the therapeutic effect of Magong Qingjin Ningxiao Formula combined with Budesonide in the treatment of pediatric heat asthma and its effect on the percentage of neutrophils (NEUT%), C-reactive protein (CRP), eosinophils (EOS), and basophils (BASO). Methods A total of 120 child patients in the Pediatric Outpatient Department of Jinan Hospital of Traditional Chinese Medicine from July 2020 to February 2021 were selected as the research subjects, and they were divided into group A (60 cases) and group B (60 cases) by random number table method. Group A was treated with Budesonide inhalation. On the basis of group A, group B was given oral treatment of Magong Qingjin Ningxiao Formula. After treatment for one week, the clinical efficacy in both groups was evaluated, and the serum NEUT%, EOS, and BASO concentration variations of the two groups before and after treatment were observed. Results After treatment, the total effective rate of group B was higher than that in group A (P ＜ 0.05). After treatment,  the serum NEUT%, CRP, EOS, and BASO concentrations in two groups were lower than those before treatment (P ＜ 0.05), which in the group B were lower than those in the group A (P ＜ 0.05). Conclusion Magong Qingjin Ningxiao Formula combined with Budesonide in the treatment of pediatric heat asthma can significantly improve airway inflammation and enhance immune function.
2021 Vol. 18 (32): 147-150 [Abstract] ( 111 ) HTML (1 KB)  PDF (733 KB)  ( 11 )
151 Clinical observation of modern rehabilitation technique combined with warm acupuncture in the treatment of peripheral facial paralysis with syndrome of wind-cold attacking collaterals#br#
WANG Ying1 GAO Hanyi2 ZHANG Qi1 YANG Qi2 FU Haiyan2
Objective To observe the clinical effect of modern rehabilitation technique combined with warm acupuncture in the treatment of peripheral facial paralysis with syndrome of wind-cold attacking collaterals. Methods A total of 40 peripheral facial paralysis patients with syndrome of wind-cold attacking collaterals admitted to Department of Rehabilitation Medicine of Affiliated Hospital of Weifang Medical University from April 2018 to January 2020 were selected and divided into observation group and control group according to random number table method, with 20 cases in each group. Patients in both groups received basic drug therapy after onset. One week after onset, the control group was additionally treated with modern rehabilitation techniques, the observation group was additionally treated with warm acupuncture on the basis of control group. Facial function was assessed by House-Brackmann (H-B), and the ratios of mean root mean square (RMS) of surface electromyography (sEMG) in frontal muscle group, nasal muscle group, buccal muscle group and orbicularis muscle group with one week after onset and four courses of treatment in both groups. Results After treatment, the total effective rate of observation group was higher than that in control group, the difference was statistically significant (P < 0.05). The H-B grade in two groups was better than that before treatment, and the H-B grade in observation group was better than that in control group, the differences were statistically significant (P < 0.05). The ratios of the mean RMS of frontal muscle group, nasal muscle group, buccal muscle group and orbicularis muscle group in the two groups were higher than those before treatment, which in the observation group were higher than those in control group, the differences were statistically significant (P < 0.05). Conclusion Modern rehabilitation technique combined with warm acupuncture has a significant effect in the treatment of peripheral facial paralysis with syndrome of wind-cold attacking collaterals. The surface myoelectricity can accurately evaluate patients’ facial function.
2021 Vol. 18 (32): 151-154 [Abstract] ( 133 ) HTML (1 KB)  PDF (690 KB)  ( 42 )
155 Application effect of mind mapping based feedback method in health education of hypoglycemia in elderly patients with type 2 diabetes#br#
LI Wufen1,2 SUN Shanbin1,2 DING Panpan1 ZHANG Junchao2 SHI Hui3 ZHANG Yuanling1 YOU Min1 ZHU Xiaoling1
Objective To evaluate the effect of mind mapping based feedback method in health education of hypoglycemia in elderly patients with type 2 diabetes mellitus. Methods A total of 62 elderly patients with type 2 diabetes who were hospitalized in the Second Affiliated Hospital of Anhui University of Chinese Medicine from January 2019 to January 2021 were selected. Random number table method was used to divide them into control group and mapping group, with 31 cases in each group. The responsible nurses in the control group received routine health education after admission, and the mapping group received the knowledge education of hypoglycemia prevention and treatment with mind mapping based feedback method. After ten days of education, the awareness rate of hypoglycemia knowledge (concept, cause, symptoms, treatment and prevention), the retest rate of hypoglycemia 15 min later, the incidence of hypoglycemia, and the blood glucose level before the next meal were compared between two groups. Results After ten days of education, the knowledge awareness rate of hypoglycemia in the mapping group was higher than that before education, and the knowledge awareness rate of hypoglycemia and the retest compliance rate of hypoglycemia after 15 min were higher than those in the control group (P ＜ 0.05). The incidence of hypoglycemia during hospitalization and blood glucose before the next meal were lower than those in the control group, with statistical significance (P ＜ 0.05). Conclusion Health education for elderly patients with type 2 diabetes can improve their awareness rate of hypoglycemia and reduce the incidence of hypoglycemia by using mind mapping based feedback method.
2021 Vol. 18 (32): 155-158,182 [Abstract] ( 188 ) HTML (1 KB)  PDF (847 KB)  ( 38 )
159 Effect of PDCA cycle health education on rehabilitation exercise compliance and self-management ability of patients with nasopharyngeal carcinoma radiotherapy#br#
WU Shuiyun1 DING Zhongjia2 XIE Wenjing3 BIAN Xueyan4 ZHOU Qiwu5▲
Objective To explore the effects of plan-do-check-action (PDCA) cyclic health education on rehabilitation exercise compliance and self-management ability of patients with nasopharyngeal carcinoma radiotherapy. Methods A total of 100 patients with nasopharyngeal carcinoma treated by the First Affiliated Hospital of Air Force Military Medical University from January 2019 to January 2020 were selected, according to the random number table method, they were divided into control group (general nursing intervention) and observation group (PDCA cycle health education), with 50 cases in each group. The rehabilitation exercise compliance, self-management ability, and the incidence of mouth opening difficulty were compared between the two groups. Results The compliance rate of mouth opening training, nasal flushing, neck exercise, and oral care in observation group was higher than that in control group (P ＜ 0.05); after nursing intervention, the self-management ability of both groups was higher than that before intervention, and the self-management ability of observation group was higher than that of control group (P ＜ 0.05). The incidence of mouth opening difficulty in observation group was lower than that in control group (P ＜ 0.05). Conclusion The health education model of PDCA cycle plays a significant role in improving rehabilitation exercise compliance and self-management ability of nasopharyngeal carcinoma radiotherapy patients, and can promote the rehabilitation of patients.
2021 Vol. 18 (32): 159-162,192 [Abstract] ( 159 ) HTML (1 KB)  PDF (988 KB)  ( 74 )
163 Effect of multidisciplinary cooperative management model on improving demoralization syndrome hope level and social support in breast cancer patients undergoing chemotherapy#br#
Mubarak Ekram1 CAO Yan2 ZHANG Cuiping3
Objective To investigate the effects of multidisciplinary cooperative management model on demoralization syndrome, hope level and social support in breast cancer patients undergoing chemotherapy. Methods A total of 122 breast cancer patients receiving chemotherapy in the day ward of the Affiliated Tumor Hospital of Xinjiang Medical University from September 2020 to April 2021 were selected as the research subjects. According to the random number table method, the patients were divided into control group and observation group, with 61 cases in each group. The control group was given routine nursing care, and the observation group was given multidisciplinary cooperative management mode. The dejection scale, hope level and social support score were assessed before and three months after intervention. Results The scores of the scores of meaninglessness, emotional upset, frustration, helplessness and failure in the two groups after intervention were lower than before, and in the observation group were lower than those in the control group, with statistical significance (P ＜ 0.05). The positive attitude, positive action and intimate relationship scores of the two groups after intervention were higher than before, and the observation group were higher than those of the control group, the differences were statistically significant (P ＜ 0.05). The subjective support, objective support and social support utilization score of the two groups after intervention was higher than that before intervention, and the observation group were higher than those of the control group, with statistical significance (P ＜ 0.05). Conclusion Multidisciplinary collaborative management model can effectively alleviate the deja syndrome of breast cancer patients undergoing chemotherapy, improve the level of social support and hope of patients, and has good intervention effect, which is worthy of clinical application.
2021 Vol. 18 (32): 163-166 [Abstract] ( 132 ) HTML (1 KB)  PDF (645 KB)  ( 20 )
167 Application effect of cluster nursing intervention in patients with pulmonary tuberculosis complicated with diabetes#br#
ZHANG Yanjuan1 YU Yan2▲
Objective To explore the application effect of cluster nursing intervention in patients with tuberculosis complicated with diabetes. Methods A total of 100 patients with pulmonary tuberculosis complicated with diabetes in the Fourth People’s Hospital of Huai’an City, Jiangsu Province from July 2018 to December 2020 were selected as the research objects. According to the random number table method, the patients were randomly divided into the observation group 50 cases and the control group 50 cases. The observation group received cluster nursing measures. Including the establishment of multidisciplinary collaborative teams, nutrition management, health education, and psychological care; the control group received routine nursing care. After three months of intervention, the incidence of complications, anxiety and depression scores and the nursing satisfaction of the patients’ family members were compared between the two groups. Results After three months of nursing intervention, the scores of anxiety and depression in two groups were lower than before, and the observation group was significantly lower than the control group, the difference was statistically significant (P ＜ 0.05). The total incidence of complications in observation group was lower than that in control group (P ＜ 0.05), the satisfaction of family members in the observation group was higher than that in the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion Cluster nursing has a good effect on patients with pulmonary tuberculosis complicated with diabetes, can significantly reduce the incidence of complications, improve the anxiety and depression of patients and improve the satisfaction of family members.
2021 Vol. 18 (32): 167-170 [Abstract] ( 124 ) HTML (1 KB)  PDF (642 KB)  ( 16 )
171 Effects of silent therapy combined with cognitive intervention on stress response and intestinal preparation quality of patients undergoing electronic colonoscopy#br#
YUAN Yuhan DING Jing▲
Objective To explore the effect of silent therapy combined with cognitive intervention in patients undergoing electronic colonoscopy. Methods A total of 113 patients with electronic colonoscopy booked in Jiangsu Province Hospital from April 2019 to May 2020 were selected. The patients were divided into observation group (57 cases) and control group (56 cases) by random number table method. Control group was given routine nursing intervention, on the basis of control group, observation group was given silent therapy combined with cognitive intervention. Stress response, intestinal preparation compliance, preparation quality, and adverse reactions were compared between the two groups. Results After the intervention, the scores of self rating anxiety scale (SAS) and self rating depression scale (SDS) in the two groups were lower than those before intervention, while the heart rate (HR) and systolic blood pressure (SBP) were higher than those before intervention, SAS, SDS, HR, and SBP in observation group were lower than those in control group (P ＜ 0.05). Diet preparation, medication preparation, bowel preparation compliance, and Boston bowel preparation scale score in observation group were higher than those in control group (P ＜ 0.05), and the rate of adequate preparation was higher than that of control group (P ＜ 0.05), and the incidence of adverse reactions was lower than that of control group (P ＜ 0.05). Conclusion Silent therapy combined with cognitive intervention can alleviate the psychological and physiological stress response of patients undergoing electronic colonoscopy, improve the compliance behavior and quality of intestinal preparation, and reduce the occurrence of adverse reactions during colonoscopy.
2021 Vol. 18 (32): 171-174 [Abstract] ( 91 ) HTML (1 KB)  PDF (644 KB)  ( 19 )
175 Application of WeChat-led jingle education in anticoagulation therapy after radiofrequency ablation for geriatric patients with atrial fibrillation#br#
ZHU Ling1 ZHU Lin2
Objective To explore the effect of WeChat-led jingle education in anticoagulation therapy after radiofrequency ablation for geriatric patients with atrial fibrillation. Methods A total of 91 geriatric patients with atrial fibrillation undergoing radiofrequency ablation admitted 904th Hospital of the People’s Liberation Army Joint Logistic Support Force from January 2017 to June 2018 were selected, they were divided into observation group (47 cases) and control group (44 cases), according to the treatment time. Geriatric patient with atrial fibrillation undergoing radiofrequency ablation was performed in both groups, and the same anticoagulation therapy and health education were used after surgery. The control group was given regular health education, and the observation group was combined with WeChat-led jingle education. The cognition level of Warfarin anticoagulation, compliance behavior of anticoagulation therapy and the occurrence of complications were compared between two groups. Results After three months of follow-up, the cognitive score of anticoagulation therapy in both groups were higher than those before intervention, and observation group was higher than control group, and the differences were statistically significant (P < 0.05). After three months of follow-up, international normalized ratio regular monitoring, lifestyle, and compliance of anticoagulant therapy total score in observation group were higher than those in control group, and the differences were statistically significant (P < 0.05). The incidence of complications in observation group was lower than that in control group, and the difference was statistically significant (P < 0.05). Conclusion WeChat-led jingle education can help to enhance the cognitive level of anticoagulation therapy in geriatric patients after radiofrequency ablation of atrial fibrillation, promote the development of anticoagulation therapy compliance behavior, and reduce the occurrence of complications.
2021 Vol. 18 (32): 175-178 [Abstract] ( 144 ) HTML (1 KB)  PDF (678 KB)  ( 29 )
179 Effect of aerobic exercise on cancer-related fatigue and quality of life in breast cancer patients undergoing chemotherapy#br#
ZHOU Yun HAN Qing MA Xinyan
Objective To investigate the effect of aerobic exercise on cancer-related fatigue (CRF) and quality of life in breast cancer patients undergoing chemotherapy. Methods A total of 120 breast cancer patients undergoing chemotherapy admitted to Huaian First People’s Hospital of Jiangsu Province from August 2018 to August 2019 were selected as study subjects, they were divided into control group and observation group by random number table method, with 60 cases in each group. The control group was given routine nursing mode, and the observation group was given aerobic exercise on the basis of the control group. Quality of life, CRF before and after nursing, and total incidence of adverse reactions were compared between two groups. Results After nursing, the scores of health feeling, body feeling, social integration, and sleep quality of two groups were higher than those before nursing, and observation group was higher than control group, and the differences were statistically significant (P < 0.05). After nursing, the scores of behavior and severity, emotion, sensation, cognition and emotion in both groups were lower than those before nursing, and which of observation group were lower than those of the control group, and the differences were statistically significant (P < 0.05). The total incidence of adverse reactions in observation group was lower than that in control group, and the difference was statistically significant (P < 0.05). Conclusion Under the intervention of aerobic exercise, patients with breast cancer undergoing chemotherapy can alleviate CRF, reduce adverse reactions, and gradually restore the quality of life, which is worthy of extensive clinical promotion and application.
2021 Vol. 18 (32): 179-182 [Abstract] ( 41 ) HTML (1 KB)  PDF (644 KB)  ( 83 )
183 Intervention effect of comfort nursing based on FMEA mode on skin pruritus of hemodialysis patients#br#
ZHOU Qi
Objective To explore the intervention effect of comfort nursing based on failure mode and effect analysis (FMEA) mode on skin pruritus of hemodialysis patients, and to provide evidence for clinical treatment. Methods A total of 80 patients with hemodialysis in Bozhou People’s Hospital of Anhui Province from August 2017 to August 2020 were selected. They were divided into the two groups, according to the random number table method, with 40 cases in each group. The control group was given routine nursing, and the observation group was given comfort nursing based on FMEA mode. The degree of pruritus and satisfaction compared between the two groups after intervention, and the scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) before and after intervention were compared. Results The degree of pruritus in the observation group was lower than that in the control group (P < 0.05). After intervention, SDS and SAS scores in the two groups were lower than those before intervention, and which of the observation group were lower than those of the control group (P < 0.05). The satisfaction rate of the observation group was higher than that of the control group (P < 0.05). Conclusion Comfort nursing based on FMEA mode has significant effect on skin pruritus of hemodialysis patients, which can reduce patients’ bad mood and improve their physical and mental health, worthy of clinical application.
2021 Vol. 18 (32): 183-186 [Abstract] ( 69 ) HTML (1 KB)  PDF (643 KB)  ( 31 )
187 Bibliometric analysis of thyroid carcinoma in recent ten years#br#
CHEN Ying1 LI Xiaoying1 XIA Guanghui1 SHAN Lianhui2 LI Yong2 HOU Li3
Objective To make a bibliometric analysis of the research status of thyroid carcinoma in recent ten years. Methods CNKI was used as the data source, the journal literatures on thyroid carcinoma published from January 2011 to December 2020 were retrieved as empirical data. Distribution of research subjects, keywords, funds, institutions, the author co-presents situations were analyzed, scientific research network was constructed, prototype system was exploited, and its application of academic social network analysis was described and simulated. Results A total of 6790 journal literatures were included in the analysis. Most of the subjects were thyroid carcinoma and surgery. The core of the most frequent co-occurrence keyword group was thyroid tumor. Most of the supported funds were national nature science foundation of China and provincial natural science foundation. The main publishing institutions were well-known hospitals with many cooperations. Multiple author groups were formed. Conclusion The scope of research subjects is relatively concentrated, frontier researchs are less, multiple scientific research teams with regional characteristics are formed, and the government is the main funding institution of scientific research funds.
2021 Vol. 18 (32): 187-192 [Abstract] ( 74 ) HTML (1 KB)  PDF (928 KB)  ( 50 )
193 Research on the development mode of health management in China#br#
FENG Yu CAO Yan
With the improvement of living standards and the aggravation of population aging, China’s health management industry develops rapidly and has various models. However, it is a new industry and lacks corresponding legal norms, which is far from the real health management. This paper introduces the world within the scope of three kinds of typical development model, combined with the current situation and problems of the development of health management in China, through to compare and analysis the abroad health management services and health management in our country, put forward our country should give priority to with business health management company, and community health care and medical basis of township health center with Chinese characteristics of mixed mode of cooperation. In order to ensure the healthy development of China’s health management industry, the relevant laws should be perfected.
2021 Vol. 18 (32): 193-196 [Abstract] ( 68 ) HTML (1 KB)  PDF (482 KB)  ( 16 )
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