中华全科医学

The budget prediction of basic public health service in the community

HOU Wan-li, ZHAO Zhi-guang, XIA Ting-song, CHEN Xia, YAO Ke-qin, CHEN Hao-lin, ZHENG Zhong, OUYANG Fang-fang, LU Zu-xun, CHENG Jin-quan

2016, 14(6): 879-882. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.001

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Objective To measure the cost of basic public health service and predict the budget of basic public health service in next year in the community health care centers of Shenzhen city. Methods The workflow and standards of basic public health service were set up by Delphi method.Sixty community health centers were sampled according to the proportion of 10% from all CHCs of Shenzhen city by a stratified random sampling,which were investigated by questionnaire to calculate the service cost to predict the budget in 2015. Results The service providing of the investigated CHCs varied a lot.Some services were up to the national standards(such as vaccination rate is above 98%),and there were still a big gap between some services and national standards(for example,the normative management rate of hypertension patients is 15.0%,of old people is 32.9%).The unit costs of different services varied a lot,too.According to the income standards of the 60 community health centers we investigated,which was 75.3 Yuan per hour as the human resource cost price,we predicted the total cost and average cost per person of Shenzhen in 2015 as follows: high level 1.64 billion Yuan and 109.4 Yuan per person each year,middle level 1.42 billion Yuan and 94.6 Yuan per person each year,low level 0.97 billion Yuan and 64.8 Yuan per person each year. Conclusion The cost of community public health service was not paid enough.The cost far exceeded the current standard of 45 Yuan per person each year.To meet the requirement of middle level target,the average cost in 2015 should at least reach to 95.0 Yuan per person each year.

DING Jie, DOU Peng-fei

2016, 14(6): 883-884.

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Feasibility analysis of modified pedicle subtraction osteotomy for cervical 7 by evaluating radiographic results

CHENG Jian-yang, WANG Ce, MA Jun, ZHOU Xu-hui, JIA Lian-shun

2016, 14(6): 885-888,896. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.002

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Objective To illustrate the prospects of osteotomy for severe cervicothoracic kyphosis in single segment via posterior approach by exploring the feasibility of modified pedicle subtraction osteotomy(PSO) technique for the C₇ by evaluating radiographic results of healthy volunteers. Methods A retrospective study on radiographic data of CT two-dimensional reconstruction on healthy volunteers in our hospital from 2012-2015 was conducted.On the sagittal plane,we simulate osteotomy with PSO technique and document the angle of osteotomy and the necessary excision length of facet joints in adjacent segments.Pre-judge whether the C₇ and C₈ nerve roots would be compressed or not by calculating the distance between C₆ pedicle and T₁ pedicle;Pre-judge whether the pedicles of adjacent segments would be damaged by researching the relationship between oteotomy line and C₆,T₁ pedicles.And we use this result to illustrate the theoretical feasibility of modified PSO technique. Results A total of 100 healthy cervical CT reconstruction imaging data was included in the study.We measured that the modified PSO technique can improve the angle with(60.0±6.2)mm and (4.7±2.1)mm of C₆ inferior facet and (6.5±2.6)mm of T₁ superior facet need resection during the surgery.The results of simulating osteotomy show that the ratio of C₇ and C₈ nerve compression after osteotomy was 74%,and the ratio of adjacent vertebral segment pedicle without injury after complete osteotomy was 82%.Theoretically,the feasible ratio of osteotomy was 68%. Conclusion The radiographic measurements conclude that the modified PSO technique for C₇ segment is feasible，and it may a promising method for severe cervicothoracic kyphosis.

Effects of serum-free culture on apoptosis in intervertebral disc nucleus pulposus cells of rat and its primary mechanism

WU Rui-kai, QI Yi-ying, RU Xuan-liang, JIANG Zeng-hui, GUI Xian-ge

2016, 14(6): 889-892. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.003

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Objective To investigate the effects of serum-free culture on the apoptosis in intervertebral disc nucleus pulposus cells of rat and its primary mechanism. Methods The intervertebral disc nucleus pulposus cells of second generation from SD rats were randomly divided into the starvation group and the control group.The cells of the control group were culture in DMEM contain 10% serum while starvation group in Serum-free DMEM for 24 h.The cells survival were detected by CCK-8(Cell Counting Kit-8);The cells apoptosis was detected by TUNEL(terminal deoxynucleotidyl transferase mediated dUTP nick end labeling);The expression of p38MAPK protein and cleaved Caspase-3 protein was observed by immunocytochemistry;the changes of Bcl-2 mRNA,Caspase-3 mRNA and p38MAPK mRNA was measured by RT-PCR(reverse transcription-polymerase chain reaction). Results Compared with control group,the starvation group shows:①Cells survival was significantly decreased (P<0.01);②rate of cells apoptosis was significantly increased(P<0.01);③The expression of p38MAPK and cleaved Caspase-3 protein was significantly increased;④Bcl-2 mRNA was significantly decreased;Caspase-3 mRNA and p38MAPK mRNA was significantly increased(P<0.01). Conclusion Serum-free culture may lead to the apoptosis of intervertebral disc nucleus pulposus cells of rat and its mechanism is related to the down-regulation of Bcl-2 and activation of caspase 3 through the p38MAPK pathway.

Meta-analysis of Vitamin E supplement on preventive effect of myocardial infarction

WANG Xin, ZHOU Jian, TANG Yu-xiao, NIU Xiao-wen, LI Min

2016, 14(6): 893-896. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.004

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Objective To explore the effect of vitamin E on the protection on myocardial infarction by conducting meta-analysis. Methods Data base of Web of science,Pub Med and Embase were searched for all related articles about the protection of vitamin E on myocardial infarction.The search work stopped on May of 2015.According to the including and excluding criteria,two investigators choose the matched trials.Combined with quality evaluation,acquired the available information.Utilized Meta-analysis to assess selected studies and affiliated data.We utilized Review Manager 5.0 to statistic all data. Results Five studies were randomized controlled trials articles.87 296 individuals were(43 647 individuals were in test group and 43 649 individuals were in control group) analyzed and base line of two groups were comparable.The results of system assessment suggested that there was no significant difference on the protective effect of vitamin E on myocardial infarction[RR=0.94,95% CI(0.82,1.08)，P=0.39].Sensitivity analysis indicated that the result did not reverse when deleting a study[RR=1.01,95% CI(0.94,1.08)，P=0.74]，[RR=0.97,95% CI(0.86,1.09)，P=0.58]，[RR=0.91,95% CI(0.76,1.09)，P=0.31]，[RR=0.88,95% CI(0.73,1.07)，P=0.19]，[RR=0.90,95%CI(0.72,1.12)，P=0.34].The infundibulum figure showed publication bias was small and the result was credible. Conclusion There is no direct evidence for the preventive role of vitamin E on myocardial infarction.

Role of EFEMP1 in promoting invasion and migration of osteosarcoma

GAO Hao-ran, QIAN Shu, XUE Wei-gao, GAO Quan-you, ZHOU Yong, QIAN Ji-xian

2016, 14(6): 897-899,903. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.005

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Objective To detect the expression of EGF containing fibulin-like extracellular matrix protein 1(EFEMP1) in thetissues and cell lines(F4 and F5M2) of osteosarcoma,and explore the its role in promoting the invasion and migrationof human osteosarcoma. Methods The expression of EFEMP1 in tumor tissue of 45 cases of osteosarcoma and 12 cases of osteochondroma were detected by using immunohistochemical SP method;the expression of EFEMP1 protein and mRNA in F4 and F5M2 cell lines was detected by using Western-blot and quantitative Real Time PCR,respectively.The effects of EFEMP1 on the invasion and migration of F5M2 cells were investigated by Transwell methods. Results EFEMP1 was expressed in 93.3%(42/45) of osteosarcoma tissues,strongly positive in 64.4%(29/45),3(6.7%) negative cases,and negative in all osteochondroma tissues.Western-blot and quantitative Real Time PCR showed that EFEMP1 was expressed differently in the human osteosarcoma cell line F4 and F5M2,F5M2 cells had a higher level(P＜0.05).Transwell test showed that the invasion and migration of F5M2 cells in the experimental group were increased,prompting that recombinant human EFEMP1 protein can stimulate the migration and invasion of F5M2 in vitro(P＜0.05). Conclusion EFEMP1 highly expressed in the human osteosarcoma tissues and cell lines F5M2 and F4 (expression levels in F5M2 exceed F4).The recombinant human EFEMP1 protein can stimulate the invasion and migration of human osteosarcoma.To detect the expression of EFEMP1 will provide a new strategy for early diagnosis and therapy for osteosarcoma patients.

Effect of intraperitoneal injection of SRT1720 on nociceptor sensitization and expression and activity of Sirt1 in spinal cord of rats with chronic sciatic nerve constriction injury

LV Chen, GUO Xiao-wen, ZHENG Hui, YE Ling, MA Qian, ZHANG Juan

2016, 14(6): 900-903. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.006

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Objective To observe the effect of intraperitoneal injection of SRT1720 on the nociceptor sensitization and expression and activity of Sirt1 in spinal cord of rats with chronic sciatic nerve constriction injury. Methods Total 96 case of SD rats were randomly divided into 6 groups:blank control group,sham operation group,chronic constriction injury(CCI) group of the sciatic nerve,CCI+saline injection group,CCI+low dose SRT1720 group,and CCI+high dose group.After the CCI model was established,NS 2.5 ml/kg,SRT1720 20 mg/kg and SRT1720 50 mg/kg were injected into the abdominal cavity through the micro syringe,for 7 consecutive days.The mechanical shrinkage foot reflex threshold(MWT) by von Frey filaments and thermal withdrawal latency(TWL) by heat radiation method were determined before the operation and at 1,3,5,7,10 and 14 d after the operation.The spinal cord was extracted surgically to test Sirt1 protein expression and deacetylase activity. Results SRT1720 could inhibit the mechanical paw withdrawal reflex threshold and thermal paw latency,and the inhibition was more significant with the increased concentration of SRT1720 (P<0.05);SRT1720 increased the expression of Sirt1 protein in the spinal dorsal horn,and the effect increased with the concentration of SRT1720(P<0.05);SRT1720 increased Sirt1 deacetylase activity in spinal dorsal horn,and increased with the concentration(P<0.05). Conclusion Intraperitoneal injection of SRT1720 can inhibit the mechanical and thermal pain sensitivity of CCI rats,which may be related to the increase of Sirt1 expression and activity in spinal cord.

Expression and significance of Notch1 receptor and EGFR in tongue squamous cell carcinoma

ZHANG Yuan-yuan, HUANG Hong-jie

2016, 14(6): 904-906,924. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.007

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Objective To investigate the expression of Notch1 receptor and EGFR in tongue squamous cell carcinoma and analyze the potential relationship between Notch1 and EGFR. Methods A total of 71 cases of TSCC and 62 cases of tongue leukoplakia specimens and 17 cases of normal tongue mucosa specimens from January 2010 to December 2014 in our hospital were collected as study subject.The Notch1 and EGFR expression of three groups were determined by immunohistochemical method,and the results of three were statistically analyzed by SPSS 16.0. Results The Notch1 expression in normal tongue mucosa and tongue leukoplakia specimens were mainly in the horny layer and no expression in base layer.While the EGFR expression in normal tongue mucosa and tongue leukoplakia specimens were mainly in base layer and expression in horny layer and granular layer.In TSCC,Notch1-positive cell ratio of high degree specimens was higher(P<0.05) and Notch1-positive cell ratio of higher TNM stage,tongue myometrial invasion and lymph node metastasis were lower(P<0.05).While the EGFR-positive cell ratio of high degree specimens was lower(P<0.05) and EGFR-positive cell ratio of higher TNM stage,tongue myometrial invasion and lymph node metastasis were higher(P<0.05). Conclusion Notch1 receptor expression can result in the cell differentiation of tongue epithelium,and the reduction of Notch1 receptor expression can result in the inhibition of tongue epithelium.EGFR expression can inhibit the Notch1 expression,and they might have an interaction effect in the development of squamous cell carcinoma.

Combination of ultrasound irradiation and temozolomide-loaded hydrogel nanoparticle in interstitial chemotherapy after surgical resectionin rat C6 glioma models

LI Yi-ming, ZHANG Hai-xian, WANG Yi-da, WANG Xiao-hong, WANG Yi

2016, 14(6): 907-910. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.008

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Objective To study the therapeutic effect of the combination of ultrasound irradiation and temozolomide-loaded hydrogel nanoparticle in the interstitial chemotherapy after surgical resection in a rat C6 glioma model,to observe the role in enhancing the effect of interstitial chemotherapy. Methods ①15 Wistar glioma rats after surgical resection were applied to test the diffusion of fluorescein-loaded hydrogel nanoparticles around the tumor cavity combined with ultrasound irradiation.The tumor residual cavity was filled with fluorescein-loaded hydrogel nanoparticle,divided randomlyinto three groups(n=5):no ultrasound group and ultrasound irradiation groups respective with 1 MHz 1 min 0.5 W/cm²and 1 MHz 1 min 1 W/cm²,on the seventh day,the brain tissues were collected and made frozen sections.The distribution of fluorescence were observed and photographed by fluorescence microscope,the fluorescence intensity was measured,and the difference offluorescence intensity was analyzed.②24 Wistar glioma rats were divided into four groups(n=6) randomly: Control group,operation group,operation+interstitial chemotherapy group,operation+interstitial chemotherapy+ultrasound group.The survival curves were obtained through the Kaplan-Meier method. Results In no ultrasound group,the fluorescein-loaded nanoparticle concentrated around the tumor cavity,and in ultrasound irradiation group,the fluorescein-loaded nanoparticle concentrated in the adjacent region,and diffused in the further brain tissue more effective.The survival difference among the therapeutic groups or compared with the control group was all statistically significance. Conclusion Ultrasound irradiation can enhance the diffusion of nanoparticle in hydrogel around the tumor cavity;ultrasound irradiation combined with interstitial chemotherapy containing temozolomide-loaded hydrogel nanoparticle will prolong the survival time of C6 glioma rat model after the surgical resection.

Effect of serum containing Yishen Juanbi Decoction on proliferation of rat osteoblasts and osteoclasts

ZHANG Ying-ying, LI Ya-song, ZOU Yu-qiong, HAO Gui-feng, CHEN Yan-xia, WANG Li-juan

2016, 14(6): 911-914,956. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.009

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Objective The explore the preventive effects of Yishen Juanbi Decoction on bone metabolism disorder associated with ankylosing spondylitisby observing the effect of Yishen Juanbi Decoction on proliferation of rat osteoblasts and osteoclasts. Methods Yishen Juanbi decoction was prepared firstly,and the serum containing Yishen Juanbi decoction was prepared following intragastricgavage to rats.The osteoblasts and osteoclastswere isolated and differentiated by stainings of Van kossa,ALP,TRAP and toluidine blue staining.The cells were divided into placebo-treated group,low,medium and large doses of serum containing Yishen Juanbi decoction groups,Diclofenac Sodium control group and Alendronate Sodiumcontrol group.The Cell Counting Kit 8(CCK8) test was conducted to assessthe activities of osteoblast and osteoclast cells.The alkaline phosphatase activityin the cell culture supernatant was tested. Results The serum containing Yishen Juanbi decoction significantly promoted the proliferation and alkaline phosphatase secretion of rat osteoblast in vitro,and increased with the levels of serum.On the other hand,the decoction serum significantly inhibited the proliferation of rat osteoclast in vitro,positively with the contents of serum. Conclusions Yishen Juanbi Decoction can promote the proliferation of osteoblast and improve the activity of osteoblast,andsimultaneously inhibit the proliferation of osteoclast,the effects increased with the doses of decoction.The experiment suggests that Yishen Juanbi Decoction can improve the bone metabolism disorder associated with ankylosing spondylitis.

Comparative study on clinical effects of disposable circunmcision suture device and Shang ring for redundant prepuce and phimosis

CHEN Hai-chao, ZHU Wei-chao, MOU Qi-long, SHI Xiao-dong

2016, 14(6): 915-917. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.010

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Objective To compare the clinical effects of the disposable circunmcision suture device and Shang ring for redundant prepuce and phimosis. Methods Total 260 patients of redundant prepuce and phimosis were divided into disposable circunmcision suture device group(140 cases) and Shang ring group(120 cases).there were no significant statistical differences between two groups in local conditions and general conditions(P＞0.05). Results The surgery were successfully completed in both groups.The operative time and blood loss in both group had no significant difference.Compared with disposable circunmcision suture device group,Shang ring group had higher pain scores within 24 hours after the operation(P=0.002).Compared with Shang ring group,the postoperative infection,edema and wound dehiscence incidence was significantly reduced in disposable circunmcision suture device group(P＜0.001).In the disposable circunmcision suture device group,the healing time was significantly shorter than that in the Shang ring group(P＜0.03).But at the same time,the costs in the disposable circunmcision suture device group was higher(P＜0.001). Conclusion Disposable circunmcision suture device,with its advantages of 24 hours postoperative pain score,healing of incision and the rate of incision infection or cracking than Shang ring,has a wide introduction value.

Relationship between adiponectin level and inflammatory factors and coronary artery lesions in patients with coronary heart disease complicated with metabolic syndrome

SUN Jin-dong, YUAN Hong, WU Hua-min, HU Hai-qiang, BIAN Chang

2016, 14(6): 918-920. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.011

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Objective To study the level of adiponectin and inflammatory factors in patients with coronary heart disease complicated with metabolic syndrome,explore the relationship between them and coronary artery disease,and provide the basis for clinical treatment. Methods Total 190 cases of coronary heart disease in our hospital were selected from July,2013 to July,2015 and divided into study group(100 cases) and control group(n=90 cases) according to the metabolic syndrome.The level of C-reactive protein(hs-CRP) was detected by automatic biochemistry analyzer,and the serum adiponectin level,tumor necrosis factor(TNF-α) and interleukin-6(IL-6) were tested by enzyme-linked immunosorbent assay.The results were compared between the two groups,and their relations with coronary artery disease were analyzed. Results Adiponectin levels in the study group were (4.78±1.21)mg/L which significantly lower than (6.59±1.56)mg/L in the control group;The levels of TNF-α,IL-6 and hs-CRP in the study group were (25.24±6.28)pg/ml,(132.32±9.24)pg/ml and (6.23±0.29)mg/L,respectively,which were significantly higher than (15.53±5.02)pg/ml,(102.91±8.47)pg/ml and (6.23±0.29)mg/L,respectively,in the control group,the difference was statistically significant(P<0.05).There were 53 patients with triple vessels disease in the study group,which were significantly more than 28 cases in the control group;10 patients with single vessels disease,which were significantly less than 28 cases in the control group of 28,the difference was statistically significant(P<0.05);Person correlation analysis showed that the level of adiponectin was negatively correlated with IL-6,hs-CRP,TNF-a and coronary lesions(P<0.05). Conclusion The coronary lesions are more serious in patients with coronary heart disease complicated with metabolic syndrome when the level of adiponectin is lower or the levels of inflammatory factors are higher.

Effect of different anesthetic drugs in Ba-Ma mini pig model of lower extremity deep venous thrombosis and pulmonary embolism

YUAN Hai-jun, ZHANG Lei, FU Li, HUANG Xiao-xia, WANG Wei, GUO Zhi-yu

2016, 14(6): 921-924. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.012

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Objective To investigate the effect and safety of propofol combined with ketamine in miniature pig model of lower limb deep venous thrombosis and pulmonary embolism. Methods Twenty Ba-ma miniature pigs were randomly divided into observation group and control group (n=10),penehyclidiner 0.02 mg/kg and ketamine 8 mg/kg were injected in the back of the neck muscle.The observation group received the intravenous infusion maintenance of anesthesia with propofol[5 mg/(kg·h)] and ketamine[5 mg/(kg·h)],while the control group received intravenous maintenance of anesthesia with ketamine[5 mg/(kg·h)].The anaesthetic effects,induction time,mortality,circulatory and respiratory system index were recorded in both groups. Results The anesthesia effect of the two groups was good,there was no death case.The anesthesia induction time was (2.62±1.12)min in the observation group,which was significantly shorter than (4.28±1.31)min in the control group(P<0.05);T,HR,RR,SpO₂,MAP,MV,PetCO₂,TV and other indexes of the two groups were not statistically significant(P>0.05);T after the injection of anesthetics showed a downward trend in both groups,T₅,T₆ and T₀ were significant between the two groups(P<0.05);RR,MAP,MV and TV in both groups showed a decreasing trend after the injection of anesthetics,and the difference between T₀ and T₁-T₆ was statistically significant(P<0.05). Conclusion Propofol combined with ketamine is a safe and effective,and can be widely used in animal model of Ba-Ma mini pig.

The reproductive toxicity of benzene and formaldehyde for male mice

ZOU Xue-min, ZHANG Ying-biao, ZHU Le-mei, YANG Shuang-bo, WU Cheng-qiu

2016, 14(6): 925-927,972. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.013

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Objective To explore the mechanism of benzene and formaldehyde joint damage through the study of benzene and formaldehyde jointly infected in male mice testis and sperm damage. Methods Fourty SPF male mice were randomly divided into 4 groups,control group(A group),benzene respectively separate infected group(B group),formaldehyde infected group(C group),benzene and formaldehyde jointly infected group(D group),10 mice in each group.The mice in A group were intragastric saline and vegetable oil.The mice in B group were intragastric benzene 200 mg/(kg.bw).The mice in C group were intragastric formaldehyde 10 mg/(kg.bw).The mice in D group were intragastric benzene with 200 mg/(kg.bw)+formaldehyde 10 mg/(kg.bw).Each groups were exposed for 5 days,then to weigh after 30 days and be killed,to separate bilateral testes measure its testicular viscera coefficient,optical microscope sperm counts,dead sperm and sperm deformity in mice.According to the conventional method of making testicular tissue pathological slices,HE dye rear under a microscope to observe the testicular tissue pathological changes.Use the kits testicular T-AOC and Na⁺-K⁺ atpase activity.The experimental data were analyzed using SPSS 17.0. Results Body weight and testis organ coefficient of D group exposed mice were lower than A,B,C group(P<0.05).Compared with the A group and B,C group,D group mice sperm count reduced[14.9/(10⁷·g epididymitis)],mortality(45.17%),deformity rate(58.33%) were increased(P<0.05);B,C and D group in mices,were showed different degree of pathological damages,the D group mice were damaged obviously;D groups mice testis T-AOC,Na⁺-K⁺-ATP were lower than the B,C groups,its difference has statistics significance(P<0.05). Conclusion The combined toxicity of benzene and formaldehyde have obvious synergistic effect on testis and sperm damage in mice;the injury may reduce the inhibiting ability of mice testicle cell and inhibiting ATP enzyme activity.

Clinical effect of zoledronic acid combined with hyaluronic acid in the treatment of postmenopausal osteoporosis patients complicated with osteoarthritis

FENG Ji-bo, WU Yang, NI Dong-liang, MA Hua-ying, MA An-jun, TANG Xu-ri, PAN Zhe-er

2016, 14(6): 928-930. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.014

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Objective To explore the effect of zoledronic acid combined with hyaluronic acid in the treatment of postmenopausal osteoporotic(PMOP)patients complicated with osteoarthritis(OA). Methods One hundred and five patients of PMOP complicated with OA volunteering in May 2009 to April 2014 in our hospital were enrolled into this study and were randomly divided into two groups:the zoledronic acid group and the control group.They all received hyaluronic acid intra-articular injection for a cycle.The control group was given salmon calcitonin,calcium,alendronate and calcitriol and other traditional anti-osteoporosis therapy on the basis of those.The zoledronic acid group received intravenous 5mg zoledronic acid injections with 0.9% saline or 5% glucose solution once a year on the basis of the control group.The Western Ontario and McMaster American Universities Osteoarthritis Index score(WOMAC score),Lysholm knee score,VAS pain score,BMD and serum levels of β-CTX,BGP,B-ALP were recorded before and after the treatment. Results The WOMAC score,Lysholm knee score,VAS pain score and BMD of zoledronic acid group were superior than the control group(P<0.05).The WOMAC score,Lysholm knee score,VAS pain score and BMD of two groups were superior to those before the treatment(P<0.05).The serum levels of β-CTX,BGP,B-ALP after 12 months of treatment were lower than those before the treatment in zoledronic acid group(P<0.05) but had no significance in the control group(P>0.05).The serum levels of β-CTX,BGP,B-ALP in zoledronic acid group were lower than those in the control group after 12 months of treatment(P<0.05). Conclusion Zoledronic acid combined with hyaluronic acid in PMOP patients complicated with OA can significantly improve the bone metabolism,inhibit bone desorption,increase BMD and knee function,reduce knee pain and improve the quality of life of patients which deserved a clinical promotion.

Expression and clinical significance of multidrug resistance protein in laryngeal cancer before and after radiotherapy

LI Yuan, ZHOU Xue-hua, CUI Cai-xia, LIU Juan, DAI Li-li, LIU Ting-yan, CHEN Chao-hui, WEI Qing-yu

2016, 14(6): 931-933,975. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.015

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Objective To explore the expressions of P-gp,MRP1,LRP and GST-π in patients with advanced laryngocarcinoma in tumor tissue before and after radiotherapy,and the effect of radiotherapy on laryngocarcinoma drug resistance gene. Methods Immunohistochemical method was used to detect the expression intensity and distribution of P-gp,MRP1,LRP and GST-π in 76 cases with advanced laryngocarcinoma before and after radiotherapy. Results Laryngocarcinoma has primary drug resistance,in different pathological types of laryngocarcinoma tissues,P-gp shows strong positive expression with high intensity,there was significant difference with the other three multidrug resistance proteins(F=8.0839,P=0.0438).The positive expression rate of MRP1 in different pathological types of laryngocarcinoma tissues had significant difference (t=9.575,P<0.001),after radiation therapy,the positive expression rate of P-gp,MRP1,LRP and GST-π has increased,the expressions of P-gp and MRP1 had significant difference (P<0.05). Conclusion The expressions of P-gp,MRP1,LRP and GST-π in laryngocarcinoma are different,radiation can cause over-expressed laryngeal resistance gene protein,has influences on the formulation of laryngeal carcinoma chemotherapy.

The effect of radix curcumae extract on expression of P-P38 in spinal cordsof CCI rats

HU Ya-na, QIU Tao, LI Fei, LU Yu-qiang, YANG Feng, TAO Shui-liang

2016, 14(6): 934-936. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.016

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Objective To investigate the effect of different doses of Radix curcumae extract onexpression of P-P38and pain threshold of CCI rats. Methods Thirty-six healthy adult male SD rats,weight 250-250 g,were chosen.To establish the CCI rat model,the SD rats were divided into normal group,model group,radix curcumae extract low,middle and high dose group,and gabapentin group and solvent group,and all of rats in each group were measured thermal paw withdrawal latency,using Western blot detection of rat L₄-L₆ spinal cord of P-P38 expression. Results ①Compared with the normal group,rats TWL value decreased significantly(P<0.05),indicating that neuropathic model was successfully built.Compared with the solvent group,Curcuma aromatica extract high dose group can significantly increased in CCI rats TWL value(P<0.01).②After modeling,L₄-L₆ spinal cord in rats of P-P38 expression of gray value and the ratio of reference into an upward trend,compared with normal group increased significantly(P<0.01);compared with the solvent group,curcuma aromatica extract high dose group and gabapentin group can significantly reduce the L₄-L₆ spinal cord of P-P38 expression(P<0.01). Conclusion High dose of Radix curcumae extract may play a role in neuropathic pain through reducing the expression of P-P38 in spinal cord of CCI model rats.

The effect of topiramate on olanzapine-induced weight gain and glucose,lipid,insulin,leptin metabolic dysfunction

YANG Yan, XIA Yong, SUN Ji-jun, ZHU Chun-yan, CHEN Yan-bo, ZHU Zhang-jiang

2016, 14(6): 937-939. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.017

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Objective To explore the effect of topiramate on olanzapine-induced weight gain and glucose,lipid,insulin,leptin metabolic dysfuction. Methods In the 8 week placebo-controlled study,sixty schizophrenic patients with weight gain(≥7%) induced by olanzapine were randomly divided into two treatment groups,one with olanzapine plus topiramate (n=30),and one with olanzapine plus placebo(n=30),During the period the two groups use the treatment of olanzapine,treatment groups combined the topiramate,the beginning dose is 50 mg/day,the fifth day with 100 mg/day,not more than 200 mg/day.The control group used the placebo,without any other antipsychotic.Before treatment and the 8 week after treatment body mass,body mass index(BMI),waist-hip ratio(WHR),fasting blood glucose(FBG),triglycerides(TG),cholesterol (TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL).Insulin(INS),leptin(Lep) was measured with radio-immunity method. Results ①The weight gain,BMI,WHR in group were less than those in placebo group in the 8 weekdend(P<0.05).②there was a significant decrease in TG,TC,LDL,INS and leptin in topiramate group in the 8 weekend(P<0.05).there was no significant change of FBS，blood fat，INS,LEP in 8 weekend in control group(P＞0.05).③the serum level of leptin was significantly correlated with weight gain,BMI,WHR,INS in both two groups before treatment and in the 8 weekend(r＝0.372-0.489，P<0.05). Conclusion Topiramate addition therapy is effective in attenuating olanzapine-induced weight gain and TG,LDL,INS,LEP metabolic dysfunction in schizophrenic patients.Topiramate addition therapy can provide a new drug treatment way to weight gain and glucose lipid metabolic dysfunction of antipsychotics.

Role of microRNA-34a in lung cancer cell apoptosis

JIN Xiang-yu, HONG Wei

2016, 14(6): 940-943. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.018

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Objective To study the role of microRNA-34a in lung cancer cell apoptosis. Methods The A549 lung cancer cell lines were divided into three groups:microRNA-34a transfection group,control group and untransfected group.The expression of microRNA-34a in A549 lung cancer cells,the effect of microRNA-34a on A549 lung cancer cell growth cycle,cell proliferation and apoptosis,and the effect of microRNA-34a on A549 cells Bcl-2,P53 and C-MYC protein expression and mRNA expression were analyzed. Results The expression of miRNA-34a in microRNA-34a transfection group was significantly higher than that of control group(P<0.05).G₀/G₁ cells in miRNA-34a transfection group was significantly higher than that of control group and untransfected group(P<0.05).Forty-eight hours and 96 hours cells proliferation rate in miRNA-34a transfection group was significantly lower than that of control group and untransfected group(P<0.05).Apoptosis in miRNA-34a transfection group was significantly higher than that of control group and untransfected group(P<0.05).Bcl-2 protein and C-MYC protein expression levels in miRNA-34a transfection group were significantly lower than that of control group(P<0.05);P53 protein expression levels in miRNA-34a transfection group was significantly higher than that of control group(P<0.05).Bcl-2 mRNA and C-MYC mRNA expression levels of miRNA-34a transfection group was significantly lower than that of control group(P<0.05);P53 mRNA expression levels of miRNA-34a transfection group was significantly higher than that of control group(P<0.05). Conclusion MicroRNA-34a can inhibit A549 lung cancer cell proliferation and induce A549 lung cancer cells apoptosis.The mechanism may be reducing Bcl-2 and C-MYC gene and increasing P53 gene.

Influences of dexmedetomidine and propofol anesthesia on postoperative delirium in elderly patients with intervertebral disc herniation and its pharmacokinetic reserch

WANG Wei, PENG Wen-yong

2016, 14(6): 944-946. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.019

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Objective To investigate the influence of dexmedetomidine combined with propofol on the incidence of postoperative delirium in elderly patients with intervertebral disc herniation undergoing surgery under general anesthesia and the pharmacokinetic research. Methods Total 124 cases of elderly patients with lumbar disc herniation undergoing intravenous general anesthesia in our hospital from March 2012 to March 2014 were selected as research subjects.They were divided into two groups according to the random number table method.62 cases of control group were given propofol intravenous injection of 0.5 mg/kg before anesthesia,62 cases of observation group on the basis of the control group was given intravenous injection of 1 μg/kg dexmedetomidine.Two groups of patients with postoperative delirium rate and injection of narcotic drugs after 480 at different time points and blood drug concentration and drug pharmacokinetics parameters were observed and compared. Results Postoperative 1D and postoperative 3D observation group patients with delirium incidence were significantly lower than those in the control group(P<0.05),the difference was statistically significant.Blood drug levels in the two groups were decreased rapidly,but the blood concentrations of the patients in the observation group were significantly higher than those in the control group(P<0.05),the difference was statistically significant(30 min).There was no significant difference in blood serum concentrations between the two groups at each time point after 30 min(P>0.05).The central distribution volume(Vc) and clearance rate(CL)in the observation group were significantly higher than those in the control group(P<0.05),and the difference was statistically significant. Conclusion Dexmedetomidine combined with propofol can significantly reduce the incidence of postoperative delirium in elderly patients with intervertebral disc herniation undergoing the general anesthesia through the influence on the Vc and CL pharmacokinetic parameters.

Clinical significance of procalcitonin test and blood culture in diagnosis of blood stream infection with other sites infections

HAN Jing-jing, XU Ya-qing, DENG Yan-ping, ZHOU Chen-liang, ZHOU Hong-xia, LÜ Li-qiong, CHENG Yu-jia

2016, 14(6): 947-949. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.020

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Objective To evaluate the role of blood culture and procalcitonin(PCT) test in the diagnosis of blood stream infection with other sites of infections. Methods The patients who were with blood stream infection and other sites infections admitted to our hospital from January,2014 to December,2014 were enrolled into this study and their clinical data were retrospectively analyzed,while the patients without blood stream infection but with other sites infections were selected as the control group. Results PCT tests in the patients with blood stream infection and other sites infection were higher than that in the control group(P<0.001);PCT with G^- infection were higher than patients with G⁺ or fungal infection(P<0.05).According to the ROC curve,12.19 ng/ml was taken as critical value.The negative predictive value for PCT level above 12.19 ng/ml was the highest (88.38%),which can be used as the predictor of removing the false positive of the blood culture.The positive predictive value and specificity of blood culture(+) and PCT above 12.19 ng/ml were the highest(95.45%;98.16%).The sensitivity of blood culture(+) or PCT tests above 12.19 ng/ml was the highest(80.77%). Conclusion The combined PCT test and blood culture can be used in the diagnosis of blood stream infection with other sites infections,which can improve the false positive and false negative of the blood culture,and provide evidence for the clinical decision-making.

Prevalence and related factors of post-stroke depression

QIAN Shu-xia, YUE Wei-qing, ZHANG Xiao-ling, GUAN Qiao-bing

2016, 14(6): 950-952,978. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.021

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Objective To analyze the prevalence and related factors of post-stroke depression(PSD) in each period of stroke. Methods Total 64 cases of first stroke were selected in our hospital.The Hamilton Depression Rating Scale(HAMD),daily life ability Rating Scale(ADL),social support rating scale(SSRS),neurological function impairment scale and Eysenck Personality Questionnaire(EPQ-RSC) were employed to assess the patients after 1 month,3 months,6 months and 12 months of admission and analyze the incidence of PSD in each time point and related factors. Results The incidence of PSD at 1 month,3 months,6 months and 12 months were 18.75%,29.03%,37.70% and 31.03%,respectively;the ratio of women and man with introverted personality in PSD patients after 1 month,3 months and 6 months was higher than that in non-PSD patients,with significant difference(P<0.05);The daily living score and social support score at 3 months,6 months and 12 months after stroke were significantly lower than that in the control group(P<0.05);The neurological deficit score in PSD patients was higher than that in the non-PSD patients(P<0.05).Logistic regression analysis showed that the incidence of PSD at 1 month after stroke was associated with the characteristics of introvert and female gender(P<0.05),at 3 months with women,daily life,social support and neurological deficits(P<0.05),and at 12 months with the daily life,social support and neurological deficits(P<0.05). Conclusion The incidence of depression in stroke patients is high.We should pay close attention at early stage to women and patients with introverted personality in the clinical diagnosis,and at middle and late stage strengthen the monitor of daily life ability and social support and severe neurological deficit,taking early prevention and treatment methods to reduce the incidence of PSD.

Mechanism research of effect of platelet-rich plasma on flap neovascularization in diabetic rats by regulating SDF-1/CXCR4 signaling pathway

CHEN Tao, ZHENG Xin, HUANG Yang, LI Yong-sheng, RUAN Jian-wei, WANG Hai-bao

2016, 14(6): 953-956. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.022

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Objective To observe the influence of platelet-rich plasma (PRP) on the back flap neovascularization in diabetic rats and analyze the changes of the levels of vascular endothelial growth factor(VEGF),stromal cell-derived factor(SDF-1) and chemokine growth factor receptor(CXCR4). Methods Total 100 SD rats were randomly divided into five groups with 20 in each group.The reserve group was prepared PRP and platelet poor plasma(PPP),the control group was normal feed,and the other three groups were made diabetic pathological model.After model success the back flaps were prepared.PRP and PPP group were treated by PRP and PPP intervene locally.After 1 week,the angiogenesis was observed,VEGF level was measured by ELISA and SDF-1 and CXCR4 were detected by immunohistochemistry assay. Results When compared to control group,the flap survival rates of model group and PPP group were reduced,new blood vessel number and VEGF level were reduced,and SDF-1 and CXCR4 expression were reduced.The differences were statistically significant(P<0.05).Compared to model group and PPP group,flap survival rate of PRP Group was higher,the new blood vessel number and VEGF level were higher,and SDF-1 and CXCR4 expression were higher.The differences were statistically significant(P<0.05). Conclusion PRP can improve the local and systemic VEGF level of diabetic rats,increase the expression of SDF-1 and CXCR4,and promote angiogenesis,which might be the mechanisms for promoting the healing skin flap.

Relationship between urinary iodine level and clinical pathology in patients with thyroid nodule

LIU Wei-huai, LI Peng-fei, ZHANG Yuan-yan, SHI Xiao-hai, ZHU Lin-bo

2016, 14(6): 957-958,992. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.024

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Objective To study the relationship between urinary iodine level and clinical pathology in patients with thyroid nodule,and to guide scientific iodine supplementation for local citizen. Methods A total of 98 patients of Beilun district in Zhejiang in our hospital between June，2012 and January，2014 were detected for urine iodine concentration by arsenic-cerium catalytic spectrophotometry.Meanwhile 325 normal people were set as the control group. Results The median urinary iodine of our district was 135.2 μg/L of adequate iodine intake level.There was no significant difference in urinary iodine among different age-sex group in thyroid node patients(P=0.23，P=0.18).MUI of benign thyroid nodules (nodular goiter,thyroid adenoma) and thyroid cancer was 155.9 μg/L and 149.5 μg/L respectively.There were no significant difference among benign thyroid nodules,thyroid cancer and the control group(P=0.88，P=0.59，P=0.59).MUI of patients with lymph node metastasis was higher than that in patients without lymph node metastasis(P=0.04). Conclusions The Iodine nutrition of people in Beilun district is in adequate iodine intake level.There is no obvious relationship between Iodine nutrition and the incidence of thyroid node.The local citizen may continue the current iodine intake.However,there is an obvious relationship between high MUI and thyroid cancer patients with lymph node metastasis,promote that those patients should limit iodized salt intake appropriately.

Observation on clinical efficacy and tolerance of postoperative enteral nutrition support in patients with esophageal cancer

HE Xiao-qin, CHEN Zhi-ming, CHENG Peng, WU Su-qin, WANG Shuang, YU Ying

2016, 14(6): 959-961. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.025

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Objective To investigate the clinical efficacy of enteral nutrition support and the tolerance of patients with esophageal cancer after the surgery. Methods Total 95 patients with esophageal cancer were randomly divided into enteral nutrition group(54 cases) and parenteral nutrition group(41 cases).The enteral nutrition group received the enteral nutrition support after the operation,while the parenteral nutrition group received the total parenteral nutrition support after the surgery.The body weight and the levels of hemoglobin and serum albumin of both groups before and after the operations were compared,and the time to first passage of flatus and stool of the two groups were recorded,the intolerance and influencing factors in both groups were observed and analyzed. Results The postoperative body weight,levels of hemoglobin and serum albumin of the enteral nutrition group were higher than those of the parenteral nutrition group(t=1.778,1.696,1.823,P<0.05).After the surgery,the first time to first passage of flatus and stool of the enteral nutrition group were lower than those of the parenteral nutrition group(P<0.05).The enteral nutrition group was administrated with enteral nutrition solution at (2.4±0.6) d after the operations,and got the target dosage within (4.6±0.9)d.In the process of nutritional support,the intolerance rate of the enteral nutrition group was 31.5%(17/54),and of the parenteral nutrition group was 24.4%(10/41),the difference was not significant between the two groups(χ²=0.576,P>0.05).There were no significant differences in the intolerance among the patients with different sex,age,the amount of blood loss,the different time of getting the target dosage and the amount of the first input in the enteral nutrition group(P>0.05). Conclusion The postoperative enteral nutrition support can effectively improve the nutritional status of patients with esophageal cancer,and maintain a good tolerance.The therapy may be widely used in clinic.

Analysis of effect of racemic hyoscyamine eye drops applied in juvenile myopia

YE Ling

2016, 14(6): 962-964. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.023

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Objective To observe the effect of racemic hyoscyamine eye drops applied in juvenile myopia. Methods One hundred and sixty-six cases of adolescent patients with 332 myopia eyes treated in department of ophthalmology of Lishui central hospital from December 2012 to March 2014 were selected and divided into group A and groupB,randomly.0.05% racemic hyoscyamine was given in group A other than wearing glasses,and only wearing glassesgiven in group B.Visual acuity and adverse reaction were compared in 1 year. Results The mean vision in group A was 5.01±0.03，while 4.82±0.09 in group B.It was higher in group A than that in group B(t=10.504，P<0.05).The change of diopter in group A was(0.07±0.02)D,while (0.49±0.11)D in group B.It was lower in group A than that in group B(t=18.051，P<0.05).The change of axial in group A was (0.09±0.04) mm,while (0.14±0.04) mm in group B,it was lower in group A than that in group B(t=3.647，P<0.05).The intraocular pressure in group A was(15.01±2.30) mm Hg,while (14.97±2.11) mm Hg in group B.There was no statistical differences between the two groups(t=1.181，P>0.05).There were 77 cases of vision improvement,117 cases of visual disability,and 138 cases of vision decreasing in group A,and the vision decreasing rate was 41.57%，There were 24 cases of vision improvement,57 cases of visual disability,and 251 cases of vision decreasing in group A,and the vision decreasing rate was 75.60%.The decreasing rate in group A was lower than that in group B(χ²=19.015，P<0.05).There was no symptoms such as photophobia,blurred vision,eye pain,eye itching etc.and there was no obvious exception under slit lamp examination. Conclusion It was effective applying 0.05% racemic hyoscyamine treating juvenile myopia,and safe.It was worthy of clinical application.

The risk factors of hospital mortality in patients with acute stroke in the elderly

FAN Hong, WU Cheng-long

2016, 14(6): 965-967. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.026

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Objective Investigate the risk factors of hospital mortality in patients with acute stroke in the elderly.And take active method to prevent acute stroke complications. Methods 1 200 cases of elderly patients with acute stroke were retrospectively analyzed.They were divided into death group and survival group according to the outcome.Multivariate Logistic regression was used to analyze the risk factors for in-hospital mortality. Results There were 75 cases died among 1 200 cases.The mortality rate was 6.25%.The ages in death group were 75.9±8.8,significantly higher than that in survival group 64.2±6.7.The cases that were hemorrhagic stroke in death group were significantly higher than that in survival group.The cases that had history of diabetes,stroke,and coronary heart disease in death group were significantly higher than that in survival group.NIHSS scores in death group were 15.8±7.4,significantly higher than that in survival group 9.5±5.6.The difference had statistical significance(t=9.223,P＜0.05).Glasgow scores in death group were 9.3±3.1,significantly lower than that in survival group 12.6±4.9.The difference had statistical significance(t=5.755,P＜0.05).The cases who received central venous catheter,catheter,and nasogastric tube in death group were significantly higher than that in survival group.High fever,pulmonary infection,urinary tract infection,cerebrocardiac syndrome,gastrointestinal bleeding and venous thrombosis of lower extremity occurred in in death group was significantly higher than that in survival group.Multivariate Logistic regression analysis showed that low Glasgow Coma Score,pulmonary infection,combined with brain heart syndrome and upper digestive tract bleeding and history of diabetes were independent risk factors of death in hospital. Conclusion There are many risk factors of death in patients with acute cerebral stroke in elderly.Low Glasgow Coma Score,pulmonary infection,brain heart syndrome and upper digestive tract bleeding and history of diabetes were independent risk factors of death.We should pay more attention to these patients.

A comparative study of minimally invasive percutaneous nephrolithotomy and single incision retroperitoneoscopic ureterolithotomyfor upper ureteral calculi

XU Ting, ZHU Yong-feng, HU Jun-biao, DAI Guo-ping, SHU Yao-min

2016, 14(6): 968-969,1033. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.027

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Objective To compare the effect of minimally invasive percutaneous nephrolithotomy and single incision retroperitoneoscopic ureterolithotomy for upper ureteral calculi. Methods Total 400 cases of upper ureteral calculi in our hospital from January in 2013 to October in 2014 were enrolled and were randomly divided into two groups.The control group adopted minimally invasive percutaneous nephrolithotomy,while the observation group adopted single incision retroperitoneoscopic ureterolithotomy.The general information,stone clearance rate and incidence of postoperative complications were compared between the two groups. Results In the observation group,the operation time was(99.8±21.6) min which was significantly longer than (56.9±19.6) min in the control group(P<0.05).The decreased levels of hemoglobin in theobservation group was (0.4±0.1) g/L which was significantly lower than (0.7±0.2)g/L in the control group(P<0.05).The duration of postoperative naked eye hematuria,postoperative ambulation and hospitalization in the observation group were (0.9±0.4) d,(1.2±0.7) d and (3.6 ±0.9) d,respectively,which were significantly shorter than (3.6±1.3) d,(4.3±1.2) d and (5.4±1.7) d in the control group,the difference was statistical significant(P<0.05).The stone clearance rate in the observation group was 100.0%,which was significantly higher than 95.5% in the control group(P<0.05).The postoperative complications was found in 3 cases(1.5%) in the observation group,which was significantly lower than 20.0% in the control group(P<0.05). Conclusion The single incision retroperitoneoscopic ureterolithotomy for upper ureteral calculi can achieve a better effect as compared with minimally invasive percutaneous nephrolithotomy,with a lower incidence of postoperative complications,but the operation time was long.The clinical application value should be focused.

Type analysis and related factors of 85 cases of rheumatoid arthritis patients with anemia

SU Li-fang, WU Fen-zhi

2016, 14(6): 970-972. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.028

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Objective To investigate the type of anemia in patients with rheumatoid arthritis and related factors. Methods From December，2014 to January，2012,3 years,has a clear diagnosis and in the treatment of rheumatoid arthritis patients,in the early morning fasting state,the extraction of a certain amount of upper arm blood,laboratory test for related indicators.Statistical analysis of the obtained data. Results Twenty-seven cases of chronic disease anemia(ADC) accounted for 47.37%(27/57),20 cases of iron deficiency anemia(IDA),35.09%(20/57),10 cases(MA),17.54%(10/57).There were significant differences in gender distribution(P＜0.05),and the incidence of anemia in women was higher than that in male.Patients with anemia of chronic disease compared with patients without anemia group,prednisone dosage increased significantly(P＜0.01),the other two groups had no significant difference.Other factors,megaloblastic anemia patients and patients without anemia group,age was significantly increased(P＜0.05);group of patients with anemia of chronic disease compared with patients without anemia group,disease activity,ESR,C reactive protein were significantly increased(P＜0.05). Conclusion The type of rheumatoid arthritis patients with anemia of inflammation is the main chronic diseases anemia and iron deficiency anemia,and long-term oral drugs, rheumatoid arthritis disease activity,ESR,C reactive protein,rheumatoid joint inflammation in patients with anemia also need vigilance and prevention of cachexia,increase nutrition through diet intake of protein,vitamins and minerals,to prevent and avoid anemia can play an important role.

A comparative study of two surgical methods for complex proximal humerus fracture

ZHOU Ping, PANG Fei, TAO Zhi-ang

2016, 14(6): 973-975. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.029

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Objective To compare the curative effect of artificial shoulder joint replacement(ASJR) and locking proximal humerus plate(LPHP) in the treatment of complex proximal humerus fracture(PHF). Methods A total of 96 cases of consecutive complex proximal humerus fracture were enrolled into this study,45 of them with LPHP were selected as the control group and other 51 patients with ASJR were selected as the observation group,the effects and complications were compared between the two groups. Results The operation time,blood loss and incidence of complications in the perioperative period were no statistical difference between the two group(P>0.05).The total efficacy rate by Neer score in the observation group was statistically more than that in the control group(70.6% vs.48.9%,P<0.05),while there was no statistical difference by the hierarchical data comparison(P>0.05).The flexion,extension,adduction,abduction,external rotation,internal rotation angle of shoulder were all statistically larger [(96.2±4.3)° vs. (93.4±4.0)°,(38.4±5.0)° vs. (35.6±4.5)°,(90.5±4.6)° vs. (87.4±4.1)°,(34.4±2.2)° vs. (32.6±2.3)°,(33.0±2.4)° vs. (31.8±2.3)°,(56.6±8.2)° vs. (50.9±8.0)°,respectively,P<0.05].The incidence of late complications including joint inflammation and atrophy and refracture was statistically lower(7.8% vs. 22.2%,P<0.05). Conclusion The artificial shoulder joint replacement for complex proximal humerus fracture can obviously improve the function of shoulder joint and decrease the incidence of postoperative complications.

Curative effect and prognosis of Oxazepam combined with Deanxit in the treatment of 49 cases of post-stroke depression

WANG Xiao-hua, WANG Jun, YIN Qi-hua

2016, 14(6): 976-978. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.030

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Objective To observe and analyze the curative effect and prognosis of oxazepam combined with Deanxit (Flupentixol and Melitracen Tablets) on the post-stroke depression. Methods Total 98 inpatients from October,2012 to January,2015 were randomly divided into observation group and control group with 49 cases in each group.On the basis of routine psychological and drug treatment,the patients in the control group received Deanxit while the observation group received oxazepam combined with Deanxit for 4 weeks,then the curative effect,adverse reaction rate,HAMD17 scale score,clinical neurological function defect(NDS) score,Barthel index(BI) score before and after 2 and 4 weeks of treatment were compared. Results The total effective rate in the observation group was 96.0%,significantly higher than that in the control group(81.6%),the difference was statistically significant(P<0.05).There was no significant difference in adverse reactions between the two groups(20.4% vs. 18.4%),P>0.05.After 4 weeks treatment,the HAMD scale score in the observation group was significantly lower than that of the control group(13.8±2.8 vs. 17.6±3.2),it was statistically significant(P<0.05);NDS score in the observation group was significantly lower than that of control group(6.8±2.4 vs. 10.7±3.5),it was statistically significant(P<0.05);the BI score of the observation group was significantly higher than that of the control group(74.9±14.4 vs. 61.3±14.2),it was statistically significant(P<0.05). Conclusion Oxazepam combined with Deanxit for the post-stroke depression is remarkably stable,has low side effect,less complications and can significantly reduce the clinical neural function defect and improve the ability of living,it is worth spreading in clinical practice.

Effectiveness of docetaxel combined with cisplatin by different approach on cervical carcinoma

LOU Peng-rong, TAO Qing-song, GUO Jian-xin, CUI Li-ning, CHENG Xiao-chun, YU Qiu-bo

2016, 14(6): 979-980,1016. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.031

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Objective To observe the effect of effectiveness and safety of docetaxel(DCT) combined with cisplatin(CDDP) by different approach in the treatment of cervical carcinoma(CC). Methods Total 90 patients with CC in our hospital between May,2010 and July,2014 were selected,45 patients received DCT combined with CDDP chemotherapy were as the control group,while 45 cases received DCT combined with CDDP arterial infusion chemotherapy(AIC) were as the observation group.The effect was evaluated after the treatment,and the remission of parametrial invasion,salvage surgery after chemotherapy,postoperative recurrence as well as adverse reactions were followed up. Results The efficacy in the observation group was 91.1%(41/45),while in the control group was 80.0% (36/45),the difference was significant(P<0.05);the remission rate after the chemotherapy,postoperative chemotherapy rate,postoperative recurrence in the observation group were 82.2%(37/45),75.6%(34/45) and 4.4%(2/45),while in the control group was 66.7%(30/45),73.3%(33/45) and 4.4%(2/45),the remission rate after the chemotherapy in the observation group was significantly higher as compared with the control group,while the difference in the postoperative chemotherapy rate,postoperative recurrence was not statistically significant(P>0.05);the incidence of bone marrow suppression,gastrointestinal reactions,neurotoxicity was significantly lower in the observation group than that in the control group(P<0.05). Conclusion DCT combined with CDDP chemotherapy in the treatment of CC has a good short-term efficacy,and the incidence rate of adverse reactions is lower,it is a safe and effective treatment for CC.

Expression of ERCC1 and RRM1 and clinical significance in non-small cell lung cancer

ZHOU Cheng-wei

2016, 14(6): 981-983. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.032

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Objective To explore the clinical significance of the expression levels of excision repair cross-complementation group 1(ERCC1) and ribonucleotide reductase M1(RRM1) in non-small cell carcinoma(NSCLC). Methods Total 43 patients with NSCLC in our hospital from August 20,2013 to October 20,2014 were enrolled into this research.The expressions of ERCC1 and RRM1 were detected by RT-PCR.The positive expressions of ERCC1 and RRM1 in NSCLC tissue and tumor adjacent tissue,and low,middle,high differentiation of cancer tissues were compared.The relationship between the positive expression of ERCC1 and RRM1 was analyzed. Results The results of Rt-PCR detection show that the positive expressions of ERCC1 and RRM1 in NSCLS tissue (81.40%,69.76%) were obviously higher than those in tumor adjacent tissue(39.53%,25.58%),P<0.05.The expression of ERCC1 was positive in 35 patients,and the positive expressions in high differentiation of cancer tissues were higher than those in low,middle differentiation(P<0.05),but had no significant difference in squamous cell carcinoma,large cell undifferentiated carcinoma and adenocarcinoma(P>0.05).The expression of RRM1 was positive in 30 patients,and the positive expressions in low differentiation of cancer tissues were higher than those in middle,high differentiation(P<0.05),but had no significant difference in squamous cell carcinoma,large cell undifferentiated carcinoma and adenocarcinoma(P>0.05).The positive expression of ERCC1 and RRM1 had a positive correlation(correlation coefficient r=0.841,P<0.05). Conclusion The expression of ERCC1 and RRM1 in cancer tissues is more active,and there is a positive correlation between ERCC1 and RRM1 with a changed expression rate in the tissues with different degrees of differentiation.The positive expression of both is not related with the cancer types.

Prevalence of chronic obstructive pulmonary disease in urban and rural residents in Changzhou

WANG Li-dong, ZHOU Jun, DU Xiao-qiu, LU Fei-fei, CUI De-yue

2016, 14(6): 984-986,989. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.033

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Objective To study the prevalence and risk factors of chronic obstructive pulmonary disease(COPD)in urban and rural residents in Changzhou,Jiangsu province. Methods This was a population-based and cross-sectional survey on prevalence of COPD in Changzhou area of the Jiangsu province from December,2014 to March,2015.The stratified-cluster-random sampling method was performed to collect the data from 4 926 people in towner Changzhou.The subjects were interviewed with questionnaires and tested with spirometry .A post-bronchodilator FEV1/FVC<70% was defined as diagnostic of COPD. Results Completed and qualified data were obtained from 3 663 participants.The average prevalence of COPD was 7.5%(urban 6.5%;Fural 8.4%;men 12.6%;women 3.4%).SPSS 19.0 was used for the single factors logistic regression analysis.The results indicated that sex,age,BMI,smoking index,extractor hood,ventilation,respiratory diseases.From multivariate 1ogistic regression analysis showed that sex(OR=0.458,95%CI:0.226-0.931),age(OR=2.947,95%CI:0.990-8.771),BMI(OR=0.510,95%CI:0.277-0.937),smoking index(OR=1.817,95%CI:1.029-3.210),respiratory diseases(OR=5.387,95%CI:3.971-7.308) were risk factors. Conclusion Higher risk for COPD was related with sex,age,BMI,smoking index,respiratory diseases.

Relationship between serum MMP-9,TNF-α and bone turnover markers in male patients with stable chronic obstructive pulmonary disease

CHEN Gang, XU Yong-fang, GU Xiao-min, ZHU Yong-ze

2016, 14(6): 987-989. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.034

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Objective To study the relationship between serum MMP-9 and TNF-α and serum bone turnover markers in male patients with stable chronic obstructive pulmonary disease. Methods Total 90 cases of male stable chronic obstructive pulmonary disease in our hospital were enrolled into this study.Based on the results of bone mineral density tests,they were divided into osteoporosis group,low bone group and normal bone group.The levels of bone mineral density,MMP-9,TNF-α and bone turnover markers were compared and the correlation was analyzed among the three groups. Results The BMD of osteoporosis group were lower than that of low bone group and normal bone group(P<0.05),The BMD of low bone group were lower than that of normal bone group(P<0.05).Serum MMP-9 and TNF-αof osteoporosis group were higher than those of low bone group and normal bone group(P<0.05),MMP-9 and TNF-αof low bone group were lower than those of normal bone group(P<0.05).Serum sBAP and sOC of osteoporosis group and low bone group were higher than those of normal bone group(P<0.05),serum sCTX of osteoporosis Group were higher than those of low bone group and normal bone group(P<0.05).The BMD was negatively correlated with serum MMP-9(P<0.05).The BMD were positively correlated with serum sBAP(P<0.05).The BMD were positively correlated with serum sOC(P<0.05).The BMD were negatively correlated with serum sCTX(P<0.05). Conclusion The levels of serum MMP-9 and TNF-α are high in patients with chronic obstructive pulmonary disease,BMD is correlated with the levels of serum MMP-9 and TNF-α and bone turnover markers.

Effect of low dose ketamine on sleep of patients with postpartum depression

ZHOU Xiao-mei, HE Xiao-hong, WU Jing

2016, 14(6): 990-992. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.035

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Objective To evaluate the effect of low dose ketamine onpolysomnography(PSG),pitsburgh sleep qualityindex(PSQI) and edinburgh postnatal depression scale(EPDS) of patients with postpartum depression(PPD). Methods Sixty EPDS≥10 patients were divided randomly into 2 groups(n=30 each):ketamine group (group K) and normal saline group(group N).The patients in group K were intravenously administrated 0.6 mg/kg ketamine.The patients in group N were intravenously administrated normal saline.The EPDS,PSG and PSQI of patients were determined before treated(T0),two days(T1) after treated,and four days after treated(T2). Results Compared with group N,the TST and SE of patients in group K were increasedat T1 and T2(P<0.05);Compared with group N,the SIP,REM,RIP and AN of patients in group K were decreased at T1 and T2(P<0.05).Compared with group N,the PSQI and EPDS of patients in group K were decreased at T1 and T2(P<0.05).Compared with T0,the TST and SE of patients in group K were increasedat T1 and T2(P<0.05);Compared with T0,the SIP,REM,RIP and AN of patients in group K were decreased at T1 and T2(P<0.05).Compared with T0,the PSQI and EPDS of patients in group K were decreased at T1 and T2(P<0.05). Conclusion Low dose ketamine could significantly improved sleep quality of patients with PPD.

Comparative study of the effect of the free body position and the supine position on the mother and infant

YUAN Ling, FU Ai-ping, ZHOU Lin, LEI Xia, SHI Liang-fang, CHEN Zi-mei

2016, 14(6): 993-995,1021. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.036

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Objective To investigate an effective delivery way by comparing the influence of free position delivery and supine delivery on maternal and neonatal outcomes. Methods According to the order of admission,300 primiparas were randomly divided into experimental group(liberal position delivery) and control group(supine delivery),150 women for each group.The second stage of labor,the total stages of labor,perineal laceration rate,episiotomy rate,labor pain degree,neonatal asphyxia and postpartum hemorrhage were observed and compared.SPSS 17.0 software was used to analyze the data,the measurement data using t test,the count data using χ² test. Results The time of the second stage of labor in experimental group[(38.9±18.6)min] was significantly shorter than that of the control group[(58.6±23.7)min],t=6.54,P<0.05,the total labor time of two groups was not significant difference.In the control group,33 cases suffered severe pain(22.0%),while this was not happened in experimental group(U=-18.11,P<0.01).The perineal integrity rate of experimental group(14.0%,21/150) was significantly higher than that of control group(3.3%,5/150).Episiotomy rate of experimental group of was 3.3%(5/150) while the rate of the control group was 18.0%(27/150),χ²=16.93,P<0.01.Postpartum hemorrhage rate of two groups was not significantly difference(χ²=0.11,P>0.05).Two cases of neonatal asphyxia were found in experimental group,accounted for 1.3% while 12 cases were found in the control group,accounted for 8.0%.The rate of neonatal asphyxia in the control group was significantly lower than the control group(P<0.01). Conclusion Labor in free position can effectively reduce the labor pain,the rate of perineal incision,the degree of perineal laceration,the rate of neonatal asphyxia,and not increase the rate of postpartum hemorrhage.It is worthy of clinical promotion and application.

Risk factors for stroke among high-risk community residents in Shanghai

SHEN Wan-wan, NIE Huan-huan, BAO Yong

2016, 14(6): 996-998. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.037

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Abstract:
Objective To understand the exposure level and distribution characteristics of risk factors in population at high-risk of stroke in a community in Shanghai,and to put forward ways to a comprehensive community intervention for risk factors. Methods From June to July in 2015,1 142 permanent residents aged 40 and above were random cluster sampled and investigated by using a questionnaire and physical examination. Results The prevalence of at high-risk of stroke was 74.7%.Hypertension,less movement,dyslipidemia,family history of stroke,diabetes,apparently overweight,smoking,atrial fibrillation or valvular heart disease were as risk factors for stroke in turn.There were differences between different gender and age patients in the exposure factor distribution.Women have a higher exposure rate in history of stroke,history of TIA and dyslipidemia than men.Men have a higher exposure rate in smoking than women.The exposure rate of the history of stroke,hypertension,atrial fibrillation or valvular heart disease,diabetes increased with age.The exposure rate of smoking and family history of stroke in 40-49 and 50-59 age groups were more outstanding as compared with other age groups.Logistic analyses showed that age,education level,physical exercise and sleep disorder were all correlated with the incidence of stroke(P<0.05). Conclusion The exposure rate of risk factors for stroke in high-risk population is high.The prevention and control of risk factors for stroke in community,strengthening the management of blood pressure,blood glucose and blood lipid,changing the poor diet and living habits,making health education according to different people is benefit to prevention and control of stroke in community.

Evaluation of Colorectal Cancer Screening based on Community in Jinshan District,Shanghai

PENG Yan-ying, CHEN Wei, MA Cui, GU Hua-ling

2016, 14(6): 999-1000,1025. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.038

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Abstract:
Objective To assess the status of colorectal cancer screening based on community and to provide references for promoting community colorectal cancer screening. Methods Residents over the age of 40,who got colorectal cancer screening in Jinshan District of Shanghai Zhu Jing community health service center from May 2013 to January 2015 period,were selected for this study.Their screening information was analyzed in SPSS 19.0 environment,including the results of their fecal occult blood test,risk assessment and colonoscopy and biopsy test,as well as consistency of all results. Results A total of 7 787 samples were collected from May，2013 to January，2015.The positive rate was 22.4% for all participants,18.8%(1447) with positive fecal occult blood,5.7% (438) with positive hazard assessment,and 9.15%(158) with both positive).818 cases(47.37%) were referred.At last,303 cases (37.04%) were diagnosed with cancer,showing that 36.24% of positive fecal occult blood and 39.90% of positive hazard assessment were right.Upon examination,the two approaches’ consistency with the final diagnosis was not significant(P>0.05). Conclusion The methods of risk assessment and fecal occult blood testing were applied in Chinese communities currently in colorectal screening process,and their screening efficacy and repetition rates were fairly low,which guaranteed the full use of health resources.The joint of low repetition and high degree of synergy indicators could notably improve the detection and diagnosis of colorectal cancer.However,the residents’ compliance still needed to be improved.

An investigation of subjective well-being and influential factors of undergraduate male nursing students

WANG Chun-mei, SUN Xue-qin, WANG Fang, LI Shu-zhen

2016, 14(6): 1001-1003,1006. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.039

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Abstract:
Objective To explore the level and influencing factors of subjective well-being(SWB) among undergraduate male students,and to indicate the direction of how to improve the subjective well-being. Methods The self-made general information questionnaire and Happiness Scale Questionnaire were used to test the SWB among 328 undergraduate male nursing students and 466 undergraduate female nursing students in Bengbu Medical College and Wannan Medical College. Results ①The scores of life satisfaction(23.7 9±6.81) and positive effects(33.37±8.11) among undergraduate male nursing students were at a moderate-high level,the scores of negative effects(28.70±10.96)was at a moderate-low level.②There were significant differences between undergraduate female and male nursing students in subjective well-being,positive effects and negative effects(P<0.05),the score of subjective well-being in undergraduate male nursing students(141.90±25.36)was lower than that of undergraduate female nursing students(148.56±25.24);There was a significant difference in grade in negative effects(P<0.01).The score of subjective well-being(144.91±24.31)was the highest in two undergraduate male nursing students;③Family relationships was significant differences in subjective well-being,positive effects and negative effects (P<0.01);Family income was a significant difference in subjective well-being,life satisfaction and negative effects(P<0.05);Professional attitude was a significant difference in subjective well-being and life satisfaction(P<0.01);Physical health was a significant difference in subjective well-being and each dimension(P<0.05);④Multiple linear regression analysis showed that the influencing factors of undergraduate male nursing students’ subjective well-being were family income,health status,professional attitude and family relationships(P<0.05). Conclusion The undergraduate male nursing students experience higher life satisfaction and positive effects and less negative effects,SWB is relatively good,according to the influencing factors of promoting happiness measures.

Study on sub health status and related factors of civil service in Nantong city

DAI Wei-hua, SHI Jia-jia, ZHOU Chun-ying, QIU Jian-cheng, LI Lin-zhong, LUO Xue-lian, SHEN Jun

2016, 14(6): 1004-1006. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.040

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Abstract:
Objective To investigate the present sub-health status of civil service in Nantong city and relations with mental health,life events and quality of life and other factors. Methods The self-made General Information Questionnaire,16-items Sub-Health Status Self-Assessment Scale,Symptom check list-90 revised(SCL-90-R),World Health Organization Quality of Life Instruments(WHOQOL-BREF),and Life Events Scale(also known as the Holmes & Rahe Social Readjustment Rating Scale)were used to survey the mental health,life events and quality of life and other factors among 887 civil servants from 12 units ofParty and government offices by using stratified random sampling method. Results Among this samples,the subhealth prevalence rate was 10.17%;mean age in the sub health group was (41.36±1.03)years,in the non-sub healthy group was 35.15±0.43,the difference was significant(P<0.01);the total score and items score for somatization,obsessive-compulsive symptoms,human relations,depression,anxiety,hostility and sensitive,terror,paranoid,psychotic factors by SCL-90-R in the sub health group were higher than the healthy group(P<0.01);the psychological,physiological,social,environmental areas by WHOQOL-BREF in the sub healthy group were higher than those of non-sub healthy group(P<0.01);sub healthy group and non-sub healthy group showed a statistically significant difference in occupation,learning,marriage and love,family and children,economic and justice,interpersonal relationship and health life events by LES(P<0.05);there was no significant difference between man and women in the sub-health group. Conclusion The sub health state of civil servants in Nantong city is in a lower level as compared with the results of some researches;the mental health,quality of life and the number of life events are the influence factors of sub-health state of civil servants,which should be taken into consideration seriously.

Survey on knowledge,attitude and behavior about tobacco control of clinical nurses from respiratory department in Guangzhou

CHEN Shu-jun, SU Yue-ming, XIN Li-jie, HE Wei, GONG Yu-cui, JIANG Mei

2016, 14(6): 1007-1009. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.041

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Abstract:
Objective To investigate the situation of knowledge,attitude and behavior about tobacco control of clinical nurses from respiratory department and general medicine department in 10 tertiary hospitals of Guangzhou,explore the factors for tobacco control intervention and nurses’ requirements of tobacco control training course,and provide the basis for implementing tobacco control interventions of nurses. Methods Cross-sectional design was applied in the research.The self-made research questionnaires were allocated to the nurses from respiratory department and general medicine department in 10 tertiary hospitalsbetweenOctoberand December in 2013.The knowledge accuracy of tobacco control,number of supporting 95% nursestobacco control,and distribution number for each operation were summarized.The difference in knowledge of tobacco control testamongeach dimensions were analyzed by using ANOVA with thesex,age,length of service,educational degree,technical title,department,job category asindependent variables and 4 subtests of tobacco control knowledge as dependent variables. Results The significant differences existed in 4 subtests of knowledge of tobacco control testperformanceamong the independent variables.Nearly 90% of the nurses would like to take part in tobacco control activities.More than 85% of the nurses were glad to participate in tobacco control training.However,only 73.8% of them would proactivelystudy the knowledge of tobacco control.Above 95% of them believed that they should participate in tobacco control activities and guidethe smoking cessation positively. Conclusion The nurses from respiratory department/general medicine department in Guangzhou are active in tobacco control but the knowledge awareness and participation rate is low,the nurses’ consciousness of tobacco control,knowledge and skills should be strengthened,which can help the nurses play an important role in tobacco control.

Investigation ofpsychological capital and job stressors of new graduate nurses in tertiary referral hospital of Traditional Chinese Medicine

YU Chun-lan, WU Wen-hui, YU Lan-xian

2016, 14(6): 1010-1012. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.042

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Objective To explore the current situation of new graduates’ experiences when entering the nursing workforce within tertiary referral hospital of Traditional Chinese Medicine,and to identify factors that impact on psychological capital and job stressors. Methods A total of 173 new graduate nurses were directed to retrieve and complete the following data by on-the-spot investigation with a cross sectional surveydesigned by combining quantitative and qualitative approaches.Rating scale was used with Nurses’ Psychological Capital Questionnaire,Nurse Job Stressors Questionnaire and a self-designed questionnaire about demographic information.Data were calculated by SPSS software with analysis of variance on correlation factor of psychological capital,descriptive statistics on latitudinal score of psychological capital and job stressors,and correlation analysis of them. Results Overall respondents showed high psychological capital scores(mean 87.73),the dimension scores rated in sequence were optimism(76.22%),hope(72.64%),self-efficacy(72.56%) andresilience(71.87%).Whilst job stressors cannot be neglected with its mean score reaches 63.64,within which time assignment and workload were the most frequently encountered pressure(1.99±0.46),other dimensions in descending order were professional and career issue(1.98±0.44),patient care and interaction(1.97±0.25),resources and environmental problems(1.66±0.50),management and interpersonal relationships(1.44±0.35) to a least degree.Several key factors impacting on psychological capital arephysical exercise,health status,and family situation(P＜0.05).Good status,fine condition,and regularly exercise scored high.Whereas gender,section,employment,and native place showed no significant influence(P＞0.05).Significant negative correlation existed between psychological capital and job stressors in terms of latitude or overall aspects(P＜0.05). Conclusion New nurses should cultivate superior lifestyle and improve mental-health status.Together with effective strategies implemented to elevate psychological capital,prevent burnout and alleviate turnover intention,by which will enable equitable and contextually relevant stewardship of them into the future.

Establishment of reference intervals of thyroid hormones in pregnant women for Ningbo city

CHEN Qiao-qiao, WANG Zhi-cheng

2016, 14(6): 1013-1016. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.043

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Abstract:
Objective To establish the reference ranges of thyroid stimulating hormone(TSH),free thyroid hormone(FT₄) and three free triiodothyronine(FT₃) in different gestation periods. Methods This study was based at the Hospital affiliated to Ningbo University School of Medicine.A total valid of 281 pregnant women who visited the hospital between January,2014 and December,2015 were recruited in this study according to the National Academy of Clinical Biochemistry(NACB) criteria.Blood samples were sequentially collected from the women at the first(T1,9-12 weeks),the second(T2,16-24 weeks) and the third (T3,32-36 weeks)trimesters to determine the serum FT₃,FT₄ and TSH levels using Beckman DX800 detection system,meanwhile,158 cases of non-pregnant women of childbearing age were selected as healthy controls.The percentile(P_2.5-P_97.5) was employed to indicate the reference ranges of FT₃,FT₄ and TSH in different periods of pregnancy. Results TSH reference ranges were T1:0.05-3.97 mIU/L,T2:0.12-4.28 mIU/L,T3:0.30-6.01 mIU/L,control:0.08-3.81 mIU/L respectively,FT₃ reference ranges were T1:3.33-5.78 pmol/L,T2:3.10-5.23 pmol/L,T3:2.83-4.99 pmol/L,control:3.90-5.54 pmol/L respectively,FT4 reference ranges were T1:7.25-15.52 pmol/L,T2:6.88-13.27 pmol/L,T3:5.31-10.79 pmol/L,control:6.46-14.17 pmol/L respectively;the results between different pregnant periods and control were statistically significant differences in different periods (FT₃:F=76.431,P<0.01;FT₄:F=116.753,P<0.01;TSH:F=53.670,P<0.01). Conclusion The thyroid hormone levels between pregnant women and in non-pregnant women are different significantly,moreover,the results among different periods during pregnancy are not the same at all,it is significant and necessary to establish the according reference intervals of various thyroid hormones for each pregnant period in Ningbo city.

Effect of short interfering hybrids on the expression of kpc-2 gene expression in carbapenem-resistant Klebsiella pneumoniae

FAN Fang-hua, WU Guo-you, ZHOU Xiao-qiong, WANG Fang, WAN Xiao-chen

2016, 14(6): 1017-1018,1029. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.044

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Abstract:
Objective To explore the influence of short interfering hybrids(Sihybrids) on the expression level of kpc-2 gene and the antibacterial effects of meropenem in carbapenem-resistant Klebsiella pneumoniae(CRKP) and study the action mechanism of sihybrids. Methods Total 48 strains carrying kpc-2 gene resistant to carbapenems Klebsiella Klebsiella strains cultured per plant were divided into three copies,one without siHybrids as control group,two other join siHybrids as experimental group.The experimental group was divided into low concentration group(siHybrids interference dose for 0.125 μg/ml and high concentration group(siHybrids interfere with dose of 8.0 μg/ml).RT-PCR was performed in the three groups to detect the expression of the mRNA of kpc-2 gene in bacterial fluid taken at 12 h,24 h,and 48 h time points.The amount of mRNA at three time points were calculated and compared among the three groups to determine the effect of siHybrids on the expression level of kpc-2 gene.The meropenem susceptibility tests were performed to observe the antibacterial circle diameter and infer indirectly the effects of siHybrids on the expression yield of kpc-2. Results Compared with the control group,the mRNA expression of kpc-2 gene was significantly decreased after the intervention of siHybrids(P<0.05).The mRNA expression of kpc-2 gene in high concentration group was significantly lower than that in low concentration group(P<0.05);the concentration of siHybrids was negatively correlated with the mRNA expression of kpc-2 gene(r=-0.782,P=0.014);the mRNA expression of kpc-2 gene decreased significantly(P<0.05) with the prolongation of siHybrids intervention time.SiHybrids intervention can significantly increase the diameter of inhibition zone of meropenem(P<0.05),different concentrations of siHybrids of meropenem antibacterial circle diameter increased dramatically different,group of high concentration of meropenem antibacterial circle diameter was significantly greater than that of the low concentration group(P<0.05).The concentration of meropenem and the diameter of inhibition zone was positively related to the size of siHybrids(r=0.882,P=0.024). conclusion Sihybrids can reduce kpc-2 gene expression level in carbapenem-resistant Klebsiella pneumonia,improve the antibacterial effect of meropenem,and its mechanism of action may be specific silencing of the Klebsiella pneumoniae kpc-2 gene by siHybrids molecule.

Value of combined detection of serum tumor markers in the diagnosis of lung cancer

SHU Mei, WU Zhen-xing, ZHU Zhen-liang, FANG Mei-qun, LI Hong-jing, CHU Mei-fen

2016, 14(6): 1019-1021. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.045

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Objective To test the levels of serum squamous cell carcinoma antigen(SCCA),neurone specific enolase(NSE),carcinomacmbryonic antigen(CEA) and cytokeratin-19 fragment(CYFRA21-1) in patients with lung cancer,and explore their role in the diagnosis and differential diagnosis of lung cancer. Methods The serum samples of 127 patients with pulmonary carcinoma,42 patients with pulmonary benign lesion and 100 healthy volunteers were prepared and tested by using ELISA for the levels of SCC,electro-chemiluminescence immunoassay for levels of NSE,CEA and CYFRA21-1.The sensitivity,specificity and accuracy of the single test and combined test in tumor markers were compared. Results The serum of SCC,NSE,CEA and CYFRA21-1 in patients with lung cancer were significantly higher than health volunteers and patients with benign lung disease(P<0.05).There were significant differences of the serum levels of SCC,NSE and CYFRA21-1 between lung cancer patients and benign lung disease patients(P<0.05).The level of SCC and CYFRA21-1 in patients with squamous cell carcinoma was significantly higher than patients with other subtypes.The level of NSE and CEA were highest in patients with small cell lung cancer and patients with glandular carcinoma,respectively.The sensitivity of combination test was 82.68%,and accuracy was 91.08%,significantly higher than that of each single sensitivity and accuracy. Conclusion SCC,NSE,CEA and CYFRA21-1 are helpful in the diagnosis of lung cancer.The combined detection can improve the sensitivity and accuracy.

CHEN Li-fen, LU Xiao-qin

2016, 14(6): 1022-1025. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.046

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WU Jie, CHEN Wen-hu, YIN Pei-yuan, XU Zhi-liang

2016, 14(6): 1026-1029. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.047

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Abstract:

ZHANG Yan, HUANG Ji-yong

2016, 14(6): 1030-1033. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.048

104 2

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Training management and quality evaluationofthe pain nursing team

DONG Ming-fen, LIN Ai-bao, ZHOU Hong-bo

2016, 14(6): 1034-1036. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.049

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Objective To explore thetrainingmanagementmethod of thepainnursingteam,in order to promote the process of the pain assessment andthe quality of the pain management in the hospital. Methods By forming the pain nursing team,figuring out the framework,buildingteamresponsibilities,and establishing the constitution of the pain nursing care,inspection standards of the pain assessment quality,institutions of the health education,and the professional training according to the existingaccreditation criteria and the JCI Standard,then getting team members involved in improving quality of pain management.Nurses’painmanagementknowledge,attitudes toward pain management and the accuracies of pain assessment were compared in the before and after the intervention. Results Before interventions,the average correct rate about the nurses’ knowledge of pain management and the attitude questionnaire was (43.81±5.32)%,and the percent of pass was 2.22%.After interventions,the average correct rate was (65.36±3.51)%,and the percent of pass was 38.89%.There was a big difference between the very beginning and after a year of training(χ²=60.96,P<0.001).After series of interventions,nurses’ knowledge of pain management,the scores of the attitude questionnaire and the accuraciesof pain assessment were all better than before (P<0.001). Conclusion Forming the pain nursingteam,then according to the existing standards,training the nurses by the training of trainers model,could enrich nurses’ knowledge of pain care and the care skills,improve the qualification rate of pain assessment and improve the curative effect of patients with pain,and improve the hospital’s quality of pain management.

Risk management for peripherally inserted central catheter line care at home in 139 children

LI Na, YIN Hai-bin, YUAN Ming-ze, ZHANG Lin, TIAN Xin

2016, 14(6): 1037-1039,1042. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.050

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Abstract:
Objective To look for a more secure and efficient management model to decrease the manage risk of peripherally inserted central catheter(PICC),explore the application of risk management in the PICC care at home,and decrease the risk of indwelling PICC at home and improve the life quality of patients. Methods Total 139 patients with family PICC indwelling in Kunming Children’s Hospital from January to December in 2013 were enrolled into this study.72 cases with only routine care from January to June were assigned into the control group,while 67 children with routine care and risk management from July to December were assigned into the observation group.The risk factors affecting family PICC line indwelling in the control group were observed,and then the appropriate corrective measures were applied in the observation group.The incidence of catheter blockage,unplanned needle removal or extubation,and puncture site infections,and the mean time for PICC line indwelling were compared by using SPSS statistical software. Results The incidence of abnormal events before and after the implementation of risk management was 22.22%(control group) and 5.97%(observation group),respectively.There was a significant difference between these two groups.The PICC line indwelling periods was (181.63±12.38)days in the control group and (214.58±16.90)days in the observation group,the difference was statistically significant. Conclusion The risk management is a safe and effective management model,its clinical application will enhance the safety of children with family PICC line indwelling,reduce complications,extend the indwelling period,reduce the risk and difficulty of repeated vascular access,reduce the treatment costs,and improve the quality of life of children and family satisfaction.

The application of clinical nursing pathway in fiber bronchoscope

ZHANG Zhou-juan

2016, 14(6): 1040-1042. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.051

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Objective Observe the application effect of clinical nursing pathway and routine nursing in fiber bronchoscope. Methods Selected 120 cases of patients who adopted fiber bronchoscope.Divided them into control group(from July to December 2014) and observation group(from January to June 2015) according to check time, each group 60 cases.Control group adopted routine nursing and observation group adopted clinical nursing pathway.Before and after nursing,used Self-Rating Anxiety Scale(SAS) evaluate the anxiety situation of two groups.Used Newcastle Patients Satisfaction of Nursing Service(NSNS) research nursing satisfaction.Used SPSS 19.0 analyze observation data.Observed and compared SAS and satisfaction score of two groups. Results Before nursing,the SAS of observation group was 46.72±11.34,control group was 46.63±10.15.There was no obvious difference between two groups in SAS aspect(t=0.046,P＞0.05).After nursing,the SAS of observation group was 40.01±7.11,control group was 45.37±8.01,the difference was significantly (t=3.876,P＜0.05).Compared with pre-nursing,the SAS of observation group reduced obviously(t=3.883,P＜0.05),and there was no significant difference in control group(t=0.755,P＞0.05).The satisfaction of observation group was 73.91±1.28,and control group was 68.28±3.35,observation group was obviously higher than control group(t=12.160,P＜0.05).There were 5 cases of blood-stained sputum or few hemoptysis in control group and 3 cases in observation group.They all didn’t adopted special handling,the symptom was disappear in a short time.There was no other serious complication. Conclusion The effect of clinical nursing pathway in fiber bronchoscope is good,it deserves to be used widely.But in consideration of some hospitals are understaffed,so it should be decided combine with hospital practical situation.

CHEN Min, RUAN Tu-geng, LI Xiang-hong

2016, 14(6): 1043-1045. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.052

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Abstract:

ZHENG Min, QIAN Xing-er, HUANG Zhang-shun

2016, 14(6): 1045-1047. doi: 10.16766/j.cnki.issn.1674-4152.2016.06.053

48 0

Abstract:

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2016 Vol. 14, No. 6

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