2019 Vol. 17, No. 2

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The analysis on academic papers published by community health center and community rehabilitation center of China in 2017—2018
SHI Xiao-xiao, YU De-hua, WANG Chao-xin, PAN Ying, SHI Jian-jun, FAN Hui-qin, SONG Yang, LU Yuan
2019, 17(2): 167-170. doi: 10.16766/j.cnki.issn.1674-4152.000630
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Objective In recent years, with the increasing investment in the construction of community health center and community rehabilitation center in China, not only the level of equipment, personnel and clinical practice has been upgraded, but also the level of scientific research has been greatly upgraded. In order to investigate the current situation and problems of primary medical institutions in China on scientific research of general medicine practice. We searched the literature published in primary medical institutions in China between 2017 and 2018. Methods Retrieving the scientific literature published by primary medical institutions in China from January 2017 to January 2018 from CNKI, Wanfang data and VIP network, we conducted qualitative and quantitative analysis of the distribution of periodicals, the distribution of regional distribution, and the situation of the funds of these papers. Results The study found that the number of articles published in the national community health service center from January 2017 to January 2018 was 5 499, and all the articles published in the core periodicals were 697, accounting for 12.7%, and the other 4 802 articles were published in non-core periodicals, which accounted for 87.3%. The top five provincial-level administrative regions for scientific research are Shanghai, Beijing, Guangdong, Tianjin and Jiangsu. The number of current studies in each journal was the largest, with 3 338 descriptive studies (60.7%), 2 033 analytical studies (36.9%), and 717 experimental studies (13.0%) among them, 536 (9.7%) articles involved two or more research methods. A total of 1 134 articles in the study were supported by various funds. Conclusion In our community hospitals, the level of scientific research is uneven and the quality of literature needs to be improved. We should pay more attention to improving the level of clinical research in the field of general science, promote the enthusiasm of the research in the community hospitals, create a good scientific research atmosphere, and accelerate the development of the general medicine in our country.
LI Yun-yun, QU Hong-dang
2019, 17(2): 171-172.
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Clinical observation of Suoquan capsule and Xingpi Yanger granule treatment on infantile enuresis based on the clinical syndromes
SHEN Xiao-yu, GUO Zhu-ying, JIN Ying-ying, FANG Ling
2019, 17(2): 173-175,204. doi: 10.16766/j.cnki.issn.1674-4152.000631
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Objective Enuresis is a common and frequently occurring disease, and the treatment effect of western medicine is not so satisfied. The purpose of this study is to compare the curative effect of Suoquan and Xingpi Yanger granule in children with different clinical syndromes, so as to guide clinicians to select appropriate drugs according to clinical syndromes. Methods According to the clinical symptoms, auxiliary examination results and therapeutic standards of TCM syndrome for pediatric enuresis, 21 enuresis children without basic diseases, such as diabetes and epilepsy, were divided into deficiency of kidney-qi group (n=10), and deficiency of spleen and lung-qi group (n=11), who were treated in the Department of Rheumatism of Shanghai Children's Medical Center from June 1 to November 31 in 2017. The deficiency of kidney-qi group, with admission syndrome of growing development and urinary symptoms, was treated with Suoquan capsule for 3 months; the deficiency of spleen and lung-qi group, with admission syndrome of gastrointestinal symptoms, body weight, tooth marks and tongue coating, was treated with Xingpi Yanger granule for 3 months. And the therapeutic effects, adverse drug reactions and recurrence rate were observed. Results In the deficiency of kidney-qi group, 4 cases were CR, 3 cases were PR, and 3 cases were PD, with a total effective rate of 70.00% (7/10). In the deficiency of spleen and lung-qi group, 4 cases were CR, 4 cases were PR, and 3 cases were PD, with a total effective rate of 72.72% (8/11). There was no significant difference in the curative effect between the two groups (P>0.05). Three months follow-up did not observed the obvious adverse reaction and recurrence case. Conclusion The rational use of Suoquan capsule or Xingpi Yanger granule in the treatment of infantile enuresis according to the clinical signs (enuresis, urinary and gastrointestinal symptoms), body weight and growth status will achieve the desired result. The method, with good clinical practicality, is simple and convenient.
Expression and significance of Nrf2 and Keap1 protein in esophageal squamous cell carcinoma
AIDIYE·TiliWalidi, ZHENG Chao, MUAITAIER·Maitinuri, BAI Ge, MAYIMUER·Aili
2019, 17(2): 176-178. doi: 10.16766/j.cnki.issn.1674-4152.000632
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Objective Lots of researches had shown that nuclear factor erythroid-2 p45-related factor 2 (Nrf2) and Kelch-like ECH-associated protein 1 (Keap1) were correlated with the formation and development of tumors. This study was designed to detect the expression of Nrf2 and Keap1 protein in esophageal squamous cell carcinoma and explore its relationship with clinicopathological parameters, and to explore their role in the formation and development of esophageal cancer. Methods From July 2010 to November 2016, the cancer and adjacent tissues of 174 cases of esophageal cancer in the First Affiliated Hospital of Xinjiang Medical University were collected to detect the expression level of Nrf2 and Keap1 protein by using immunohistochemistry. The data was analyzed statistically by using SPSS 17.0 statistical software. Results ① The expression level of Nrf2 in the cancer tissues of esophageal squamous cell carcinoma was significantly higher than that in adjacent normal tissues (χ2=21.259, P<0.001), but the expression level of Keap1 in the cancer tissues was significantly lower than that in adjacent normal tissues (χ2=34.863, P<0.001). ② There was a statistically significant difference in the expression of Nrf2 and Keap1 among the different ethnic groups in Xinjiang (Nrf2: χ2=12.674, P=0.020, Keap1: χ2=11.237, P=0.004). ③ The positive expression of Nrf2 was associated with tumor lymph node metastasis (χ2=5.040, P=0.036) and esophageal cancer tissue grading (χ2=10.187, P=0.020). The positive expression of Keap1 was associated with tumor lymph node metastasis (χ2=6.916, P=0.010) and esophageal cancer tissue grading (χ2=15.432, P<0.001). ④ There was a correlation between the expression of Nrf2 and Keap1 in esophageal squamous cell carcinoma (r=0.219, P=0.031). Conclusion In the formation, development and metastasis of esophageal squamous cell carcinoma, multiple factors may be involved, including Nrf2 and Keap1 proteins. This result will provide some new ideas for the further study of the prevention and clinical treatment of esophageal cancer and prognosis.
Relationship between male infertility caused by varicocele and body constitution in TCM
FANG Yue-kun, TAO Fang-ze, CUI Yun, ZHENG Jun-zhuang, DU Bao-xin, LIU Bing, LIU Qing, FANG Teng-duo
2019, 17(2): 179-182. doi: 10.16766/j.cnki.issn.1674-4152.000633
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Objective To explore the distribution rule of TCM constitution identification in patients with varicocele infertility, and analyze the correlation between the parameters of related semen and TCM constitution. Methods Total 146 patients meeting the inclusion criteria of male infertility caused by varicocele, aged 20 to 45 years, from the andrology clinic in Ningbo Hospital of TCM from September 2016 until November 2017 were enrolled into study. The general information, semen analysis and body constitution in TCM were collected by "Questionnaire of Clinical Symptoms of Male Infertility Caused by Varicocele" and "Scale for Body Constitution in TCM", and their relationships were analyzed by using statistical methods. Results ①Among the 146 cases, qi-stagnation constitution accounted for 17.59%, qi-deficiency constitution for 16.67%, blood-stasis constitution for 11.57%, yin-deficiency constitution for 11.34%, yang-deficiency constitution for 10.88%, phlegm-dampness constitution for 9.72%, damp-heat constitution for 9.49%, gentleness constitution for 7.87%, and special-innateness constitution for 4.86%. ②There was statistically difference in the sperm concentration between qi-deficiency constitution and non qi-deficiency constitution patients and between yin-deficiency constitution and non yin-deficiency constitution patients by using the nonparametric rank sum test or t-test for independent samples (all P<0.05). However, there is no statistical significance between the main TCM constitution and the rate of forward moving sperm and normal morphological sperm (all P>0.05). Conclusion Varicocele infertility is related to TCM constitution.The sperm concentration is respectively correlated with qi-stagnation constitution and yin-deficiency constitution, and the total sperm motility is correlated with qi-deficiency constitution.
Effect of apigenin on the expressions of IL-1β, IL-6, TNF-α in rats with hepatic ischemia-reperfusion injury
FENG Wei-wei, WU Ai-bing, WANG Hong-bin
2019, 17(2): 183-185. doi: 10.16766/j.cnki.issn.1674-4152.000634
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Objective To investigate the effect of apigenin on expressions of IL-1β, IL-6, TNF-α in rats with hepatic ischemia-reperfusion injury. Methods Forty healthy male Wistar rats were randomly divided into sham operation(A), ischemia-reperfusion(B), apigenin groups (10 mg/kg in C group, 20 mg/kg in D group). The animal model of hepatic ischemia-reperfusion was established. Hepatic pathologic chang was studied by HE staining. Blood sample was used to detect the content of IL-1β, IL-6, TNF-α, ALT and AST. Results Compared with B group , hepatic pathologic change alleviated. Plasma IL-1β, TNF-α, ALT and AST in C group was higher than D group, but predominantly lower than IL-1β, IL-6, TNF-α, ALT, AST in B group(all P<0.01). ALT positively correlated with IL-1β, IL-6 and TNF-α(r=0.56, 0.64, 0.57, all P<0.01). AST positively correlated with IL-1β, IL-6 and TNF-α(r=0.61, 0.58, 0.63, all P<0.01). Conclusion Apigenin attenuates hepatic ischemic-reperfusion injury in rats by down-regulating serum IL-1β, IL-6 and TNF-α.
A randomized controlled trial of different physical methods for preventing deep venous thrombosis of lower extremities after pelvic fracture operation
DAI Ya-qin, ZHANG Jun, FU Li-qin, SHAO Ting
2019, 17(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.000635
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Objective To explore the clinical efficacy of anticoagulant combined with intermittent pneumatic compression (IPC) device and graduated compression stockings (GCS) on preventing deep venous thrombosis (DVT) of lower extremities. Methods From January 2013 to June 2017, 210 patients were enrolled in the prospective randomized controlled study, and assigned into IPC group, GCS group and the combination group (IPC+GCS) with 70 patients in each group. The patients of the three groups were administrated with anticoagulant. And the patients in IPC group were managed with intermittent pneumatic compression, the patients in the GCS group with graduated compression stockings, and the combination group with IPC+GCS. On the first day before the operation, the second and seventh day after the operation, the levels of plasma D-dimer were tested, and color Doppler ultrasonography was performed for DVT. CT pulmonary angiography was conducted on patients suspected of pulmonary embolism for confirming the diagnosis. Results On 7th days after the operation, the difference between in the incidence of total DVT, intramuscular DVT and plasma D-dimer levels among the three groups were statistically significant (all P<0.05). There was no significant difference in the incidence of proximal DVT and distal DVT among the three groups (all P>0.05). Conclusion On the basis of using anticoagulation, when compared with IPC or GCS alone, the combining use of IPC and GCS can significantly reduce the plasma concentration of D-dimer and the incidence of calf intermuscular DVT after pelvic fracture.
Effect of ischemic preconditioning on liver and kidney function in surgery for large vessels
LIU Jian-hua, JIANG Wei, SHI Guang, LIANG Qiao-ru, YAN Xiao-qing
2019, 17(2): 190-192,208. doi: 10.16766/j.cnki.issn.1674-4152.000636
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Objective To investigate the effect of ischemic preconditioning (IPC) on the function of liver and kidney in the surgery for large vessels. Methods Total 57 patients undergoing surgery for large vessels in Henan Chest Hospital from February 2015 to July 2017 were selected and randomly divided into observation group (n=30) and control group (n=27). The observation group was given pressured remote ischemic preconditioning, while the control group was only treated with tourniquet, operations, the liver function and renal function at before the operation (T0), 1 h (T1), 6 h (T2), 24 h (T3) and 48 h (T4) after CPB were observed and compared between the two groups. Results There were no significant difference in the operation time, extracorporeal circulation time, aorta blocking time, ICU stay time and hospitalization time in the observation group and the control group (all P>0.05); the levels of ALT, AST, TBIL and HMGB1 of the observation group and the control group at the time of T1, T2, T3 and T4 were higher than those at the T0 (all P<0.05); At the time of T1, T2, T3 and T4, the levels of ALT, AST, TBIL and HMGB1 of the observation group were significantly lower than those of the control group (all P<0.05); The levels of Scr, BUN and KIM-1 in the observation group and the control group at the time of T1, T2, T3 and T4 were higher than those at the T0 (all P<0.05); The levels of Scr and BUN of T4 in the observation group were significantly lower than those of the control group (all P<0.05); The KIM-1 of T2, T3 and T4 in the observation group was significantly lower than that of the control group (all P<0.05). Conclusion The application of remote ischemic preconditioning in the surgery for large vessels has a certain protective effect on the injury of the liver and kidney, and has a certain clinical value.
Clinical value of peripheral blood parameters in the diagnosis and treatment of intestinal Behcet's disease
YE Jing-fen, CHEN Yong, LIN Chen-hong, SHEN Yan, ZOU Jun, GUAN Jian-long
2019, 17(2): 193-196. doi: 10.16766/j.cnki.issn.1674-4152.000637
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Objective To analyze the characteristics of peripheral blood parameters in patients with intestinal Behcet's disease (BD) and its correlation with disease activity, and provide a simple method for the overall evaluation of intestinal BD. Methods A total of 50 patients with intestinal BD in our hospital between January 2015 and January 2017 were enrolled into this study. Total 50 mucocutaneous BD patients (mucocutaneous BD group) and 40 patients with recurrent aphthous ulcer (RAU group) were selected as the control groups. The difference in peripheral blood parameters among the three groups was compared. The simple endoscopic score for Crohn's disease (SES-CD) was used to assign the 50 cases of intestinal BD into active group and stable group with 25 cases each group to evaluate the relationship between hematological parameters and ulcer activity in patients with intestinal BD. Results The RBC and HGB were significantly decreased, however, the level of FIB, ESR and CRP were significantly increased in the intestinal BD when compared with the control groups (all P<0.05). HGB and CRP were able to distinguish intestinal BD with mucocutaneous BD with the areas under the ROC curve of 0.826 and 0.871, respectively. The levels of ESR, CRP and FIB were significantly increased in active intestinal BD (all P<0.05), while the level of HGB was significantly reduced when compare with the stable group (P=0.001). The areas under the ROC curve of HGB, ESR, CRP and FIB for the detection of ulcer activity in intestinal BD were 0.758, 0.787, 0.888 and 0.792, respectively. Conclusion BD patients with low level of hemoglobin and elevated CRP in peripheral blood need to be paid more attentions to BD patients with intestinal ulcer. HGB, ESR, CRP and FIB are simple makers of intestinal ulcer activity in patients with BD.
Efficacy of rehabilitation intervention by WeChat follow-up in elderly patients after knee replacement surgery
ZHAO Zhi, DAI Xiu-song, JIANG Yong, WANG Zhi-yan, ZHU Zhong-lian
2019, 17(2): 197-199,268. doi: 10.16766/j.cnki.issn.1674-4152.000638
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Objective To performed WeChat follow-up among the elderly patients in the postoperative rehabilitation after knee replacement surgery and assess evaluate the efficacy of the continuation of rehabilitation program. Methods Seventy patients undergoing total knee arthroplasty in our hospital between June 2016 and November 2017 were enrolled and divided into study group and control group by using the random number table method, with 35 cases in each group. The basic information of all patients was registered before discharge. The patients of study group received the general discharge instructions and follow-up by WeChat after discharge, the suitable rehabilitation intervention was carried out according to the conditions; while the control was given the general discharge instructions. Hospital for Special Surgery (HSS) knee score system (KSS) was used to assess the postoperative rehabilitation of patients 2 weeks, 4 weeks and 3 months after the surgery, including the degree of knee flexion and extension, knowledge and skills for rehabilitation training, self-care ability and psychological health. The result was statistically analyzed. Results There was no significant difference in HSS knee score before the surgery between the two groups (P>0.05). At 2 weeks, 4 weeks and 3 months after the surgery, the knee score of the study group was higher than that of the control group, and the difference was statistically significant (all P<0.05). After the intervention through WeChat follow-up, the knee flexion and extension, knowledge and skills for rehabilitation, self-care ability and psychological health of the patients were significantly improved. Conclusion The rehabilitation intervention by WeChat follow-up can effectively relieve the unhealthy psychological factors of patients, improve the patients' knowledge and skills for rehabilitation, knee function, self-care ability and quality of life, and the follow-up compliance.
Effect of TRPV1 on the apoptosis of H9c2 cardiomyocyte after hypoxia-reoxygenation injury and its mechanism
LUO Jian-hua, WANG Huan
2019, 17(2): 200-204. doi: 10.16766/j.cnki.issn.1674-4152.000639
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Objective To investigate the protective effect and possible mechanism of transient receptor potential cation channel subfamily V member 1 (TRPV1) on apoptosis of H9c2 cardiomyocyte after hypoxia-reoxygenation injury. Methods H9c2 cardiomyocyte were randomly divided into control group, model group (hypoxia/reoxygenation), capsaicin group (hypoxia/reoxygenation + capsaicin), capsaicin + LY group (hypoxia/reoxygenation + capsaicin + LY294002). The cell survival rate of cardiomyocyte was determined by CCK-8 method. The apoptosis rate of cardiomyocyte was determined by flow cytometry. Western blot and reverse transcription-polymerase chain reaction (RT-PCR) were used to determine caspase-3, B-cell lymphoma 2 gene (Bcl-2), Bcl-2 related X protein (BAX), phosphoric acid- protein kinase B (p-Akt) and protein kinase B (Akt) levels. Results Compared with the control group, the cell survival rate of cardiomyocyte and the Bcl-2 level in the model group, capsaicin group and capsaicin + LY group decreased (all P<0.05), the apoptosis rate and the levels of caspase-3, Bax, p-Akt increased (all P<0.05); Compared with the model group, the cell survival rate of cardiomyocyte and the levels of Bcl-2, p-Akt in the capsaicin group were increased (all P<0.05), and the apoptosis rate and the levels of caspase-3 and Bax were decreased (all P<0.05). There were no significant difference in each indexes between the model group and the capsaicin + LY group (all P>0.05). Conclusion TRPV1 can inhibit H9c2 cardiomyocyte apoptosis after hypoxia-reoxygenation inury, and its mechanism may be related to TRPV1 activation of phosphatidylinositol 3-kinase (PI3k)/Akt signaling pathway.
Clinical analysis of the relationship between the level of cystatin C in serum and cerebrospinal fluid with Guillain-Barré syndrome
SUN Cui-mei, LU Yi, ZHANG Ru, MA Bo, XIE Jing
2019, 17(2): 205-208. doi: 10.16766/j.cnki.issn.1674-4152.000640
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Objective To investigate clinical relevance between the level of the serum cystatin C (CysC) and Guillain-Barré syndrome (GBS), and the discrepancy in the levels of CysC between serum and cerebrospinal fluid (CSF) in patients with GBS. Methods Total 30 cases of GBS in our department from December 2015 to February 2018 were collected as GBS group, while other 30 patients undergoing spinal anesthesia were collected from Orthopedics department and General surgical department as the control group. The levels of CysC in serum and cerebrospinal fluid and other clinical data were collected in the two groups. Results ①There was no statistically difference in the levels of CysC in the cerebrospinal fluid between the two groups, P=0.450. ②The level of serum CysC in the GBS group was higher when compared with the control group (P=0.005); The level of serum CysC in patients with severe GBS increased significantly as compared with the patients with mild GBS, the difference was statistically significant (P=0.012). ③There was a positive correlation between serum CysC level and Hughes score in GBS patients (r=0.759, P<0.001), however, there was no correlation between CSF CysC level and Hughes score in GBS patients (P>0.05). ④The Hughes score of GBS patients was positively correlated with age, serum CysC and cerebrospinal fluid protein, and negatively with the precursor events, but not with the level of CSF CysC and sex. ⑤Taking Hughes score as the dependent variable, taking precursor events, serum CysC, cerebrospinal fluid protein and age as independent variables, we found that the levels of serum CysC and cerebrospinal fluid protein were risk factors of Hughes score. Conclusion Serum CysC may be used as an indicator of the severity of GBS patients; the levels of serum CysC and cerebrospinal fluid protein are the risk factors of limb paralysis in GBS patients.
Impact of recurrent preeclampsia on clinical manifestations and pregnancy outcomes
CHEN Ya, ZHANG Ying
2019, 17(2): 209-211,287. doi: 10.16766/j.cnki.issn.1674-4152.000641
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Objective To investigate the impact of recurrent preeclampsia (PE) on clinical manifestations and pregnancy outcomes. Methods A retrospectively study on patients with preeclampsia terminated in our hospital from January 2014 to December 2017 was performed. The patients with a history of PE were assigned into recurrent group (n=46), and those without a history of PE were assigned into the first onset group (n=56). The clinical outcomes were analyzed between the two groups. We also analyzed some items within the recurrent preeclampsia group and the situation of interval period between the previous preeclampsia and the recurrent one. Results The proportions of severe PE and early onset PE were 91.30% and 73.92% in the recurrent group, while 73.21% and 53.57% in the first onset group (P<0.05). During the previous pregnancy in recurrent group, the proportion of early onset PE was 32.61%, which was different from the recurrent one (P<0.05). There were significant difference in the abnormal ratios of the visceral function and umbilical cord blood flow between the two groups (all P<0.05), so as to compare with the ratio of the last time attack. But the ratios of eclampsia, placental abruption and the amount of postpartum bleeding were the same (all P>0.05). The recurrent group had earlier onset weeks than the last time attack, and also had lower birth weight and Apgar score than those in the first onset group. The fellow-up rate after the previous PE was 30.43%, and the regular examination during the second pregnancy was 39.31%. Conclusion The onset recurrent preeclampsia usually occurs early as compare with its last time onset and the first onset patients, with more serious clinical condition and poor pregnancy outcomes. The patients who have recurrent preeclampsia usually pay less attention on the disease, and lack of regular follow-up and prenatal examination.
Clinical observation of clopidogrel combined with aspirin in the treatment of non-cardiogenic acute cerebral infarction
ZHANG Cheng-gang, SUN Zhong-wu
2019, 17(2): 212-215. doi: 10.16766/j.cnki.issn.1674-4152.000642
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Objective To study the efficacy of clopidogrel plus aspirin in treatment of non-cardiogenic acute cerebral infarction and safety assessment. Methods A retrospective analysis was carried on for the patients with non-cardiogenic acute cerebral infarction who are unable or refusing to undergo thrombolytic therapy in the first people's hospital of Chuzhou from September 2015 to March 2017. Thirty patients were randomly selected from the patients treated with clopidogrel plus aspirin as the observation group. Thirty patients were randomly selected from the patients treated with aspirin as the control group. All of them had been given chewing aspirin 100 mg at the emergency department. The observation group oral clopidogrel 75 mg combined with aspirin 100 mg daily and the control group oral aspirin 100 mg daily from the day of admission. After 3 weeks treatment, the NIHSS score, total effective rate, the levels of plasma fibrinogen and homocysteine were compared between the two groups. The recurrence rate of cerebral infarction and the incidence of adverse drug reactions in 1-year follow-up visits between the two groups were compared. Results After 3 weeks treatment, the NIHSS score, total effective rate, the levels of plasma fibrinogen and homocysteine decrease effectively compared to the time of the admission (P<0.05). The total effective rate of observation group (93.33%) was significantly higher than that in control group (70.00%, P<0.05). During 1 year follow-up, the recurrence rate of cerebral infarction in observation group was 6.67%, significantly lower than that in control group (30.00%,P<0.05). The incidence of adverse reactions between the two groups had no significant (P>0.05) and no cerebral hemorrhage occurred in both groups. Conclusion For the treatment of non-cardiogenic acute cerebral infarction patients, comparing with aspirin alone, clopidogrel combined with aspirin can significantly improve the treatment effect of patients with acute cerebral infarction, and effectively reduce the levels of plasma fibrinogen and homocysteine in patients. It can also effectively reduce the recurrence rate of cerebral infarction, and there is no significant increase in adverse drug reactions.
Plasma levels of big ET-1 in patients with normal high blood pressure and hypercholesterolemia in young and middle-aged patients and the effect of comprehensive intervention on their levels
SHOU Xiao-ling, ZHOU Rong-fang, WANG Lei, ZHU Li-yue, WANG Bo-zhong, REN Ai-hua
2019, 17(2): 216-218,340. doi: 10.16766/j.cnki.issn.1674-4152.000643
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Objective To explore the effect of comprehensive intervention on plasma big ET-1 Level in normal middle-aged patients of normal high blood pressure with hypercholesterolemia. Methods Two hundred patients with normal blood pressure were selected as the control group, and 200 patients with normal high blood pressure were selected as the observation group from October 2012 to December 2014 in Zhejiang Hospital. Patients in the observation group were given comprehensive intervention. The levels of triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) level were measured by automatic biochemical analyzer. The level of plasma big ET-1 was determined by enzyme-linked immunosorbent assay (ELISA). Results The systolic and diastolic blood pressure and the levels of TC, TG, LDL-C, big ET-1 in the observation group were higher than those in the control group (all P<0.05). After intervention, the systolic blood pressure, diastolic blood pressure, TC, TG, LDL-C, and big ET-1 levels at various time points were lower than those before intervention (all P<0.05). With the prolongation of the intervention time, the systolic blood pressure, diastolic blood pressure, TC, TG, LDL-C and big ET-1 levels continued to decrease, and there were statistically significant differences among the time points (all P<0.05). Systolic blood pressure, TC and HDL-C were the influencing factors of plasma big ET-1 (all P<0.05). Conclusion The level of plasma big ET-1 in patients with normal high blood pressure with hypercholesterolemia is significantly higher. Comprehensive intervention can reduce the plasma ET-1 levels of the patients, and has great significance on the prevention of endothelial dysfunction.
Effect of Shenlingbaizhu powder on senile sepsis patients with intestinal dysfunction
ZUO A-fang, XIA Guo-lian
2019, 17(2): 219-221,233. doi: 10.16766/j.cnki.issn.1674-4152.000644
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Objective To investigate the effect of Shenlingbaizhu powder on senile sepsis patients with intestinal dysfunction and its influence on hemorheology and immune function. Methods A total of 66 senile sepsis patients with intestinal dysfunction in Zhejiang Province People's Hospital from January 2016 to June 2017 were enrolled and divided into observation group (33 cases) and control group (33 cases) according to the random number table method. The control group was treated with western medicine, while the observation group was supplemented with Shenlingbaizhu powder on the basis of the control group. The length of hospital stay and intensive care unit (ICU) stay, 28 d mortality, clinical efficacy, hemorheology and immune function of the two groups were compared. Results The length of hospital stay, ICU stay and 28 d mortality of the patients in the observation group were significantly lower than those in the control group (all P<0.05). After treatment, the acute physiology and chronic health evaluation (APACHE Ⅱ) score, intestinal dysfunction score and the levels of serum diamine oxidase (DAO) decreased significantly in both groups (all P<0.05), and these indexes in the observation group were significantly lower than those in the control group (all P<0.05). After the treatment, the levels of high whole blood high-shear viscosity, whole blood lower-shear viscosity and plasma viscosity in two groups decreased significantly (all P<0.05), and those in the observation group was significantly lower than those in the control group (all P<0.05). After treatment, the levels of immunoglobulin-A (IgA), IgG and IgM in the two groups increased significantly (all P<0.05), and the level of IgA and IgG in the observation group was significantly higher than that in control group (all P<0.05), however, there was no significant difference in the level of IgM between the two groups (all P>0.05). Conclusion Shenlingbaizhu powder is effective in treating senile sepsis patient with intestinal dysfunction through improving intestinal dysfunction, hemorheology and immune function of the patients.
Comparison of results of different surgical modalities for middle turbinate in endoscopic sinus surgery
MENG Fan-jie, BI Jing, SHENG Ying-tao, YU Quan
2019, 17(2): 222-224,229. doi: 10.16766/j.cnki.issn.1674-4152.000645
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Objective To investigate the difference of nasal airway resistance score and subjective symptom score between preservation and partial resection of middle turbinate in endoscopic sinus surgery. Methods A total of 154 patients with chronic sinusitis of type Ⅱ or higher who were admitted to our ENT from January 2016 to October 2017 were randomly divided into study group and control group with 77 cases in each group. The patients in the control group received preservation of middle turbinate in the endoscopic sinus surgery, while the patients in the study group received partial resection of the middle turbinate. The curative efficacy, postoperative clean-up time, and the incidence of adhesion were compared between the two groups. The differences in nasal airway resistance (NAR) score by the active anterior rhinomanometry and subjective symptom score by visual analogue scale test (VAS) between the two groups were analyzed before and after the treatment. Results The total remission cases in the study group and control group were 73 cases (94.81%) and 63 cases (81.82%), respectively, the difference was statistically significant (P<0.05). The postoperative clean-up time and incidence of adhesion in the study group were significantly lower than those in the control group, the difference was statistically significant (all P<0.05). There was no difference in NAR scores before the treatment between the two groups(P>0.05). After the treatment, the NAR scores in both groups decreased significantly, especially in the study group, the difference between the two groups was statistically significant (P<0.05). There was no difference in VAS scores between the two groups before surgery (P>0.05); However, the scores decreased in both two groups after surgery, especially in the study group, the difference between the two groups was statistically significant (P<0.05). Conclusion Different surgical modalities for middle turbinate in endoscopic sinus surgery can affect NAR and VAS scores in endoscopic sinusitis patients. Rational removal of middle turbinate can effectively reduce the cleaning time and the incidence of nasal mucosal adhesion, and the clinical effect is better.
The predictive value of serological markers Aβ1-42, sICAM-1 and VILIP-1 for vascular dementia after cerebral infarction
WANG Dong-liang, WANG Jin-hua, HAN Wei-wei, XIE Chao-yan, FANG Xing, XIE Zeng-hua, TANG Xiao-long, CHEN Qiang, WU Yun-qin, PENG Yong
2019, 17(2): 225-229. doi: 10.16766/j.cnki.issn.1674-4152.000646
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Objective To explore the predictive value of serological markers β-amyloid peptide 1-42 (Aβ1-42), soluble intercellular adhesion molecule 1 (sICAM-1) and visinin like protein 1 (VILIP-1) for vascular dementia (VaD) after cerebral infarction. Methods Totally 338 patients with acute stoke were selected and divided into 2 groups according to whether attacked by VaD, including 68 cases in VaD group and 270 cases in non- VaD group. Venous blood of all the subjects was extracted to detect serum Aβ1-42, sICAM-1 and VILIP-1 levels. And the predictive value of each index was analyzed by ROC curve. Results The serum level of Aβ1-42, sICAM-1 and VILIP-1 of VaD group were all higher than non- VaD group both in hospitalization and discharging, the modified Rankin score of VaD group were both higher than non- VaD group in 3 months and 6 months after discharging, the difference between groups had statistical significance (P<0.05). ROC analysis results showed that serum Aβ1-42, sICAM-1 and VILIP-1 levels at the time of hospitalization and discharging all had predictive value for VaD. The optimal operating point of Aβ1-42, sICAM-1 and VILIP-1 levels at the time of hospitalization were 87.5 ng/L, 408.0 ng/L and 11.5 ng/L, the sensitivity were 52.9%, 67.6% and 35.3%, and the specificity were 83.7%, 71.9% and 92.6%. The optimal operating point of Aβ1-42, sICAM-1 and VILIP-1 levels at the time of discharging were 60.0 ng/L, 264.0 ng/L and 7.5 ng/L, and the sensitivity were 85.3%, 79.4% and 64.7%, the specificity were 57.8%, 61.5% and 68.9%. Conclusion Serological markers Aβ1-42, sICAM-1 and VILIP-1 have good predictive value for VaD after cerebral infarction.
The levels and association of adipokines with DAS28 in patients with rheumatoid arthritis
HUA Li, WANG Li-min, FAN Jia, HONG Xue-lian, SHI Xiao-yu, ZHU Dan, DU Hong-wei
2019, 17(2): 230-233. doi: 10.16766/j.cnki.issn.1674-4152.000647
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Objective To investigate the levels of adipokines in patients with rheumatoid arthritis (RA) and to explore their association with DAS28. Methods One hundred and twenty-six patients with RA admitted to Jinhua central hospital from March 2017 to August 2017 were selected as observation group. One hundred people who received physical examination in our hospital during the same period were selected as control group. The levels of visfatin, adiponectin and resistin in two groups were compared. Then, according to the patient's disease activity, 126 patients with RA were divided into 47 patients with high activity group and into 79 patients with moderate-low activity group, the serum lipid, adiponectin and resistin levels were measured by enzyme linked immunosorbent assay(ELISA) the levels of visfatin, adiponectin and resistin were compared between the two groups. Finally, pearson correlation analysis was used to analyze the correlation between the levels of lipoprotein, adiponectin, resistin in patients and DAS28. Results Visfatin was (6.68±1.25) ng/L, adiponectin was (11.36±3.29) μg/mL and resistin is (13.78±4.21) ng/mL in the observation group, visfatin was (4.13±1.16) ng/L, adiponectin was (6.57±1.38) μg/mL and resistin was (6.85±2.34) ng/mL in the observation group, the levels of visfatin, adiponectin and resistin in the control group were significantly higher than those in the control group(P<0.05). Visfatin was (4.81±1.95) ng/L, adiponectin was (22.64±8.96) μg/mL and resistin was (15.72±7.97) ng/mL in the highly active group, visfatin was (4.05±1.66) ng/L, adiponectin was (19.35±9.62) μg/mL and resistin was (13.28±5.96) ng/mL in the moderate-low activity group, the levels of visfatin in the highly active group was significantly higher than that in the moderate-low activity group(P<0.05), there was no significant difference in adiponectin and resistin levels between the two groups(P>0.05). Pearson correlation analysis showed that the levels of serum visfatin, adiponectin, and resistin were positive correlated with the DAS28 score (P<0.05). Conclusion The levels of adipokines in RA patients are high, especially in patients with higher disease activity and positively correlated with DAS28 scores, suggesting that adipokines may be involved in the inflammatory immune response of RA and can be used as a measure of disease activity in patients.
Early predictive value of serum anti-α-actinin antibody on lupus nephritis in SLE patients
DING Bei-bei, SU Wen-ting
2019, 17(2): 234-237. doi: 10.16766/j.cnki.issn.1674-4152.000648
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Objective To explore the predictive value of serum levels of anti-α-actinin antibody, complements and serum protein on lupus nephritis in the diagnosis of lupus nephritis (LN) in SLE patients. Methods A total of 212 patients with SLE were enrolled into this study, 39 of 212 patients developed LN during the follow-up. The levels of serum AαA, Anti-dsDNA and ACA were detected with ELISA. The serum complements levels and liver function indexes were detected by automatic biochemical analyzer. Results The mean ages of the LN group and the non-LN group were (30.2±7.6) years and (38.3±8.2) years, respectively (t=5.645, P<0.001). The mean albumin to globulin ratio (AGR) of LN group was significantly lower than that of the non-LN group (t=3.975, P<0.001). The mean levels of serum AαA and complement C3 in the LN was (82.5±36.2) pg/ml and 53.2±26.3 respectively, which were both lower than those in non-LN group (P<0.05). Cox risk ratio regression analysis showed that the age, serum AαA, AGR and complement C3 were the independent factors for the incidence of LN in SLE patients. ROC analysis showed that serum AαA had the highest diagnostic efficiency (AUC=0.845, 95% CI: 0.776-0.915. P<0.001), followed by AGR (AUC=0.774, 95% CI: 0.776-0.915. P<0.001), then was AUC of age and complement C3 level (ACU= 0.594 and 0.728, respectively). Conclusion There is a strong correlation between low AαA and low AGR levels and LN at the diagnosis of SLE. The younger age and lower serum C3 level also increase the risk of LN. The early diagnosis and intervention of LN can be achieved by monitoring the above indexes.
Analysis of liver pathological features in chronic HBV infection patients with persistently normal ALT
WANG Xing-fei, SHEN Hua-jiang, XU Wen-fang
2019, 17(2): 238-240,309. doi: 10.16766/j.cnki.issn.1674-4152.000649
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Objective To analyze the liver histopathological features in chronic HBV infection patients with persistently normal ALT. Methods A total of 146 chronic HBV infection patients with persistently normal ALT in our hospital were enrolled. The characteristics of liver tissue inflammation and fibrosis stage under different age groups, different serum HBV-DNA load and different serum HbeAg status were analyzed. Results The ratio of inflammatory grade≥G2 and the ratio of fibrosis stage≥S2 in patients over 40 years old were higher than those in patients under 40 years old (54.35% vs. 8.00%, χ2=38.688, P<0.001 and 45.65% vs. 12.00%, χ2=20.396, P<0.001); the ratio of inflammatory grade≥G2 and the ratio of fibrosis stage≥S2 in patients with serum HBV-DNA load>1.0×107 copies/mL were higher than those with serum HBV-DNA load≤1.0×107 copies/mL (29.21% vs. 12.28%, χ2=5.695, P=0.017 and 30.34% vs. 10.53%, χ2=7.795, P=0.005); the ratio of inflammatory grade≥G2 and the ratio of fibrosis stage≥S2 in patients with serum HBeAg (+) were lower than those with serum HBeAg (-) (9.43% vs. 30.11%, χ2=8.248, P=0.004 and 13.21% vs. 27.96%, χ2=4.198, P=0.041). The difference was statistical significant. Conclusion For the chronic HBV infection patients with persistent ALT, aged≥40 years old, serum HBV-DNA load>1.0×107 copies/mL and HbeAg (-), the liver biopsy should be performed in time to avoid the optimal timing of antiviral therapy.
Effect of labor Analgesia on Inflammatory Factors, Complement and Immune Function of Parturient
LIU Li-ping, XUAN Rong-rong, ZHU Hong, ZHOU Ning, ZHANG Yan-ke, ZHANG Ying-zhi
2019, 17(2): 241-244. doi: 10.16766/j.cnki.issn.1674-4152.000650
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Objective To investigate the effect of labor analgesia on inflammatory factors, complement and T lymphocytes (CD3+, CD4+, CD4+/CD8+) of parturient, and analyze its effect on immune function. Methods A total of 278 pregnant women were selected in department of obstetrics and gynecology of affiliated hospital of medical college of Ningbo university from February 2015 to February 2017, those pregnant women were divided into observation group (167 cases) and control group (111 cases) according to whether they were willing to receive labor analgesia. The observation group was treated with epidural labor analgesia, the control group did not take any analgesic measures. At the time of the cervix was open to 2-3 cm (T1), the cervix was full opened (T2), after the childbirth (T3) and 24 hours after delivery (T4), the visual analogue scale (VAS) scores, the levels of IL-1β, IL-6, hypersensitive C-reactive protein (hs-CRP), complement C3, complement C4, CD3+, CD4+, CD4+/CD8+, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), duration of labor and 1 min Apgar score of newborn in the two groups were observed. Results Compared with T1, the VAS scores of other time (T2-T4) in observation group decreased significantly (all P<0.05), and the VAS scores of observation group were significantly lower than those of control group (all P<0.05). Compared with T1, the levels of IL-1β, IL-6 and hs-CRP of other time (T2-T4) in two groups increased significantly (all P<0.05), and the levels of observation group were significantly lower than those of control group (all P<0.05). Compared with T1, the levels of complement C3 and C4 of other time (T2-T4) in two groups decreased significantly (all P<0.05), and the levels of observation group were significantly higher than those of control group (all P<0.05). Compared with T1, the levels of CD3+, CD4+, CD4+/CD8+ of other time (T2-T4) in two groups decreased significantly (all P<0.05), and the levels of observation group was significantly higher than those of control group (all P<0.05). There was no significant difference in SBP, DBP and HR between the two groups at each time (all P>0.05); There was no significant difference in the time of first, second and third labor and the Apgar score of 1 min in neonates between the two groups (all P>0.05). Conclusion Labor analgesia can significantly reduce pain and inflammation of parturient, improve the levels of complement and T lymphocytes, further improve the immune function.
Changes and clinical significance of hypersensitive CRP, PCT and WBC in children with mycoplasma pneumoniae pneumonia complicated with systemic inflammatory response syndrome
SUN Jing-wei, PENG Wan-sheng, HUANG Yu-zhu, LI Na, LI Jia-chen
2019, 17(2): 245-247,255. doi: 10.16766/j.cnki.issn.1674-4152.000651
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Objective To explore the relationship between the changes of inflammation-associated factors, hypersensitive C-reactive protein (hs-CRP), WBC, procalcitonin (PCT), and the mycoplasma pneumonia (MPP) combined with systemic inflammatory response syndrome (SIRS) in children. To clarify the significance of clinical condition evaluation and therapeutic effect assesment. Methods A total of 104 children with Mycoplasma pneumoniae pneumonia, from January 2016 to December 2017, at Bengbu First People's Hospital were selected, 52 cases with concomitant SIRS and 52 cases without SIRS. The 52 cases with concomitant SIRS were then divided into severe group (26 cases) and mild group (26 cases) according to the severity of the disease. The levels of hs-CRP, WBC, and PCT in all cases were detected. Results Compared to the data of before the treatment, hs-CRP (P<0.001), PCT (P=0.007), and WBC (P<0.001) were decreased after treatment in the group with concomitant SIRS, and the difference was statistically significant. However, in the group without concomitant SIRS, only PCT (P=0.008) was decreased compared to the data of before the treatment, and the difference was statistically significant. After treatment in severe groups, hs-CRP (P<0.001), PCT (P=0.007), and WBC (P<0.001) were all decreased compared to the data of before the treatment, and the difference was statistically significant. After treatment in mild groups, hs-CRP (P=0.002) and WBC (P<0.001) were decreased, and the difference was statistically significant. In the group with concomitant SIRS, the application rate of third generation cephalosporin and glucocorticoid in severe group (69.2%, 76.9%) was higher than that in mild group (30.8%, 38.5%), and the difference was statistically significant (all P<0.05). Conclusion The detection of hs-CRP, PCT, and WBC in children with Mycoplasma pneumonia combined with systemic inflammatory response syndrome could help determine the severity, therapeutic efficacy, and prognosis of the disease.
Clinical effect of Zhidai decoction combined with recombinant human interferon in treatment of chronic cervicitis patients with high-risk HPV infection
CHEN Geng-hong, WANG Zhi-ying
2019, 17(2): 248-251. doi: 10.16766/j.cnki.issn.1674-4152.000652
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Objective To observe the clinical effect of Zhidai decoction combined with recombinant human interferon in treatment of chronic cervicitis combined with high-risk HPV infection. Methods Total 338 cases of chronic cervicitis with high risk HPV infection were enrolled into this study and were divided into control group (n=169) and observation group (n=169) by the random number table. The patients in the control group were administrated with recombinant human interferon α2b suppository, while the patients in the observation group were treated with Zhidai decoction combined with recombinant interferon α2b suppository. The adverse drug reactions during the treatment were recorded. The improvement of leucorrhea and the changes of positive rate of high risk HPV were observed. The curative effect and the recurrence of cervicitis were statistically compared. Results There was no statistically significant in the incidence of adverse drug reactions between the observation group (5.32%) and the control group (3.55%), P<0.05. The levels of serum TNF-α, IL-6 and IL-8 in the observation group were significantly lower than those in the control group (P<0.05). The improvement rate of leucorrhea quantity, leucorrhea purulent and positive high risk type HPV (96.45%, 97.04% and 92.90%) were significantly higher than those in the control group (85.21%, 86.39% and 80.47%) at the end of treatment (P<0.05). The total effective rate of cervicitis in the observation group (95.27%) was significantly higher than that in the control group (82.25%), P<0.05. The recurrence rate on the 6th and 12th month after the treatment in the observation group (3.55% and 8.88%) was significantly lower than that of the control group (10.06% and 19.53%), P<0.05. Conclusion Compared with recombinant interferon therapy alone, Zhidai decoction combined with recombinant human interferon, with a high safety, can more effectively improve the clinical symptoms and curative effect of chronic cervicitis patients with high-risk HPV infection, decrease the positive of high risk type HPV infection, and prevent the recurrence of cervicitis.
Study on the influence factors of prostate specific antigen in the community-based non-prostatic cancer individuals
ZHANG Shu-xian, WANG Ze-zhou, SHI Rong, ZOU Ya-wei, SHEN Tian
2019, 17(2): 252-255. doi: 10.16766/j.cnki.issn.1674-4152.000653
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Objective Prostate specific antigen (PSA) is one of the important methods of prostate cancer screening, but its specificity is not high. This study aims to explore the association between serum PSA level and Body Mass Index (BMI), age and International Prostate Symptom Score (IPSS) in non-prostate cancer individuals. Methods Serum PSA level, demographic information (age, education, marital status, etc.) and various clinical parameters (height, weight, IPSS, etc.) were collected through questionnaire investigation and laboratory testing from 1 575 non-prostate cancer male in the community, using cluster random sampling. Student's t test. Analysis of Variance, Chi-square test, and unconditional multivariate logistic regression was conducted to analyze the potential influence factors of the serum PSA level. Results The average serum PSA level was 0.60 (0.32-1.12)ng/mL, of which 55 samples were greater than or equal to 4.00 ng/mL, accounting for 3.5% of the total number. The serum PSA was associated with age and IPSS scores and had no correlation with other clinical parameters. Conclusion The increase of age and IPSS score in non-prostatic cancer individuals are the risk factors for the increase of serum PSA level. The diagnosis of prostate cancer acquires the combination of the serum PSA measurement and other methods in order to reduce the false positive rate.
Effectiveness evaluation of on-the-job training for general practitioners in rural community health service center in the outlying suburbs of Shanghai
CAI Li-qiang, HOU Jin, LU Xin-jian
2019, 17(2): 256-258. doi: 10.16766/j.cnki.issn.1674-4152.000654
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Objective To explore the suitable standardized on-the-job training mode for general practitioners in rural community health service center in the outlying suburbs and to evaluate its effect. Methods The "learn-at-lunch" training, "Credit system" management model, "Complementary advantages" lectures, and "One lesson by two lectures" course arrangement employed to train the professional theoretical knowledge, study and share the treatment guidelines, discuss and report the illness cases, and practice skills. A 12-month standardized on-the-job training program was performed in 37 general practitioners from the rural community health service center in the outlying suburbs of Shanghai, and the effectiveness was evaluated. Results After the training, the scores of clinical specialty theory and practice skills of 37 general practitioners were (75.70±6.77) scores and (78.27±6.67) scores, respectively, that was improved obviously when compared with these before the training, the difference was statistically significant (t=3.386 and t=4.460, all P<0.01); After the training, general practitioners' satisfaction with the training time, course schedule, daily management and overall evaluation were improved significantly (all P<0.01); After the training, the ratio of outpatient rehydration and ratio of antibiotic prescriptions were 3.31% and 5.54%, respectively, which showed a declining trend (χ2=1 055.031 and χ2=644.423, both P<0.01). The number of outpatient visits (228 239 vs. 207 108) and the proportion of rational use of antibiotics (81.23%) increased (χ2=289.038, P<0.01). Conclusion The modes of "learn-at-lunch" training, "Credit system" management model, "Complementary advantages" lectures, and "One lesson by two lectures" arrangement have some effectiveness in the on-the-job training for general practitioners in rural community health service center in the outlying suburbs, that is worth of widely application.
Quality of life, anxiety and depression in facial dermatitis patients with pruritus
CAO Yuan, XIE Zhi-qiang, GUO Jin-zhu, ZHANG Chun-lei
2019, 17(2): 259-261. doi: 10.16766/j.cnki.issn.1674-4152.000655
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Objective To evaluate the quality-of-life, anxiety and depression in patients with facial dermatitis, and to analyze the possible impact factors. Methods Totally 85 patients with facial dermatitis were recruited. They were assessed with erythra severity score, Visual Analogue Sale (VAS), Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS), while outcomes and related factors were analyzed by SPSS 23.0. Results The patients with facial dermatitis scored higher in HADS than the healthy controls (P<0.05), the mean scores of "anxiety" and "depression" were HAD-A 5.14±3.12 and HAD-D 3.76±3.06 respectively, 21.3% were anxious, 12.5% were depressed, and 8.8% were both anxious and depressed. Quality of life was impaired obviously (DLQI scored 8.89±6.03). The age, gender, and course of disease have no correlation with quality of life, anxiety or depression level. Erythra severity scores were negatively correlated with Quality of life (r=0.261, P<0.05), meanwhile they showed no correlation with anxiety and depression level (P>0.05). The degree of itch (VAS) was positively correlated with anxiety level (r=0.403, P<0.01), negatively correlated with Quality of life (r=0.513, P<0.01), and it showed no correlation with depression level. Multivariable regression showed that pruritus was an independent impact factor of anxiety and quality-of-life in patients with facial dermatitis. Conclusion The patients with facial dermatitis had higher levels of anxiety and depression compared with healthy controls, and lower quality of life. Quality of life was negatively affected with both subjective and objective symptoms severity. Anxiety level was only negatively affected with Subjective severity (degree of itch). The more severe itching, the worse the quality of life, and the higher the anxiety level. Not only disease but also patients' psychological needs should be paid attention in clinical work, and multidisciplinary treatment should be tried.
Clinical effect of dietary nursing interventions and health education in diabetes mellitus patients with ketoacidosis
LI Xue-qin, WANG Li-hong, SHAO Wen-fei, CAI Miao-guo
2019, 17(2): 262-264. doi: 10.16766/j.cnki.issn.1674-4152.000656
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Objective To investigate the clinical effect of dietary nursing interventions and health education in diabetes mellitus (DM) patients with ketoacidosis. Methods Total 76 DM patients with ketoacidosis in Enze Medical Center (Group) Luqiao Hospital from January 2015 to January 2017 were selected as subjects, and randomly divided into two groups according to random number, 38 cases in each group. Patients in control group were given routine nursing, and patients in the research group were enrolled individualized dietary intervention management and health education. The treatment status (24 h maximum blood sugar level, blood glucose control time, ketone body negative time, hospitalization time), health knowledge level (pathogenesis, prevention and treatment methods, diet, exercise), healthy diet compliance, and satisfaction of two groups were compared. Results The 24 h maximum blood sugar level, blood glucose control time, ketone body negative time, hospitalization time of research group were significantly lower than those of control group, the difference was statistically significant (P<0.05). After interventions, the health knowledge level (pathogenesis, prevention and treatment methods, diet, exercise) and healthy diet compliance of two groups were significantly improved (P<0.05), and health knowledge level (pathogenesis, prevention and treatment methods, diet, exercise) and healthy diet compliance of research group were significantly higher than those of control group, the difference was statistically significant (P<0.05). The satisfaction of research group was significantly higher than those of control group, the difference was statistically significant (P<0.05). Conclusion The dietary nursing interventions and health education had an obvious effect in DM patients with ketoacidosis can shorten the illness improvement time, and improve health knowledge, compliance and satisfaction.
Application value of cardiac magnetic resonance imaging (CMR) in diagnosis and treatment of ventricular arrhythmia
GUO Nai-cai, ZHAO Yu-xia
2019, 17(2): 265-268. doi: 10.16766/j.cnki.issn.1674-4152.000657
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Objective To evaluate the value of cardiac magnetic resonance imaging (CMR) in the diagnosis and treatment of ventricular arrhythmia. Methods Total 45 patients with ventricular arrhythmias from January 2016 to January 2017 were selected as subjects. All subjects underwent first pass perfusion and delayed scan analysis (LEG) to record the information of cardiac structure, cardiac function and myocardial ischemia. The left ventricular end diastolic diameter, left ventricular systolic area, left ventricular septal thickness, left ventricular posterior wall thickness, left ventricular ejection fraction and right ventricular ejection fraction were recorded. The results were compared with those of echocardiography (UCG) and coronary angiography (CAG). Results Left ventricular end-diastolic diameter, left ventricular systolic area, left ventricular septal thickness, left ventricular posterior wall thickness, left ventricular ejection fraction and right ventricular ejection fraction measured by CMR were positively correlated with UCG. There was no significant difference in left ventricular structure and function evaluation between the two groups (P>0.05). There were 10 cases of right ventricular enlargement and 16 cases of right ventricular systolic dysfunction, while none of the UCG cases were detected. There was no significant difference in the detection of myocardial ischemia between CMR and UCG in different coronary lesions (P>0.05), but the detection rate of myocardial ischemia by CMR was higher than that by UCG in different degree of coronary stenosis. Conclusion CMR has a stronger ability to differentiate the right ventricular physiological structure lesions in patients with ventricular arrhythmia, and has a higher detection rate of myocardial ischemia in patients with different degree of coronary artery stenosis. CMR has a higher application value in the diagnosis and treatment of ventricular arrhythmia, and is worthy of clinical application.
Value of ultrasound in evaluation of metastasis of cervical lymph nodes in differentiated thyroid cancer after operation
ZHANG Ran, LUO Ling-ling, YAO Xiao-bo, LIU Xue-gong
2019, 17(2): 269-271. doi: 10.16766/j.cnki.issn.1674-4152.000658
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Objective To investigate the ultrasonographic features of cervical lymph node metastasis after differentiated thyroid cancer (DTC), evaluate the diagnostic features of ultrasonography, and improve the diagnostic rate. Methods A total of 123 patients with DTC were enrolled in this study. Forty cases of cervical lymph node metastasis confirmed by fine needle aspiration cytology or surgical pathology(observation group), 83 cases without metastasis(control group), compared between the two groups. Ultrasound sonographic features of cervical lymph nodes before treatment: long-term/short-diameter ratio of lymph nodes, microcalcification, presence of lymphatic portal structures, color Doppler flow imaging, cystic or liquefaction changes. The comparison between the group count data was analyzed by χ2, and the sensitivity, specificity, accuracy, specificity, positive and negative predictive value of the ultrasound diagnosis were analyzed. Results In the observation group, the ratio of length to diameter of 33 lymph nodes was <2, and 9 cases in the control group.In the observation group, 17 cases were microcalcification, 2 cases in the control group, and 7 cases in the lymphatic observation group were unclear. Two cases showed unclear; 12 cases in the color flow observation group showed abundant blood flow, and 3 cases in the control group. There were 4 cases in the cystic or liquefied area observation group and 1 case in the control group. The positive proportions of the five sonograms were 82.5%, 42.5%, 17.5%, 30.0%, and 10.0%, respectively. The long-term/short-diameter <2 in the cervical lymph node metastasis was significantly higher than that in the cervical lymph nodes. The patients with metastasis were statistically significant(P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of cervical lymph node metastasis after DTC were 82.5%, 74.7%, 77.2%, 61.1% and 89.9%. Conclusion Ultrasonography has high sensitivity and specificity for the diagnosis of cervical lymph node metastasis after DTC.It can diagnose cervical lymph node metastasis through various characteristic ultrasound findings.
Research status and progress of thymidine DNA glucosidase
GE Zhang-yu, XU Peng, GONG Xie-yang, KUANG Ye
2019, 17(2): 272-275. doi: 10.16766/j.cnki.issn.1674-4152.000659
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Thymidine DNA glycosidase (TDG) belongs to the superfamily of monofunctional uracil DNA glycosidase, which plays a dual role in genome stability and epigenetic regulation. TDG participates in the regulation of DNA methylation and demethylation. DNA methylation is mainly cytosine (C) methylation, which refers to the formation of 5-methylcytosine (5mC) by adding a methyl to the 5th carbon atom of cytosine under the action of DNA methyltransferase (DNMTs) with S-adenosylmethionine (SAM) as methyl donor. And 5mC is widely distributed in mammalian genomes and plays an important role in maintaining genomic stability, tissue-specific gene silencing, and reverse transcription transposon silencing and many other biological processes. DNA demethylation refers to the reduction of 5mC to C, which is also accomplished by DNMTs. DNA demethylation includes two ways: passive demethylation and active demethylation. Passive DNA demethylation refers to the passive dilution of newly synthesized sub-stranded DNA that fails to maintain its methylation state during DNA replication; Active demethylation of DNA does not involve DNA replication. It refers to the removal of 5-methyl-cytosine (5mC) and 5-carboxy-cytosine (5hmC) oxides, i.e.5-methyl-hydroxy-cytosine (5fC) and 5-carboxy-cytosine (5caC), by enzymes such as TDG. TDG also cleaves N-glycoside bonds between sugars and target bases through the base excision repair pathway (BER) and plays an important role in correcting mismatched and damaged DNA base pairs (bps). Recent studies have shown that TDG also plays an important role in transcriptional regulation, embryonic development and tumor therapy. This paper summarizes the research status and progress of TDG in recent years, and provides theoretical support for further in-depth study.
Advances in the application of speckle tracking imaging in the evaluation of myocardial abnormalities
XU Jing-jing, TIAN Rui-xia
2019, 17(2): 276-279. doi: 10.16766/j.cnki.issn.1674-4152.000660
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Myocardial disease is a group of cardiovascular diseases that are impaired by cardiac structure and wall function, leading to abnormal cardiac movement and progressive cardiac dysfunction. It often complicates arrhythmia, heart failure and even sudden cardiac death, which affects the quality of life and human health. Therefore, it is particularly important to discover the change of myocardial abnormality through non-invasive, convenient and effective examination. Because of its economic, non-invasive, simple, repeatable and other advantages, echocardiography has become an important examination method for clinical observation of myocardial movement and evaluation of cardiac function. With the rapid development of science and technology, the application of various new technologies in echocardiography is also rapidly changing. Among them, speckle tracking imaging technology is particularly prominent. Speckle tracking imaging tracks cardiac motion by identifying acoustic spots on the myocardium, analyzing myocardial deformation, and dynamically observing cardiac motion and hemodynamic changes to assess myocardial systolic and diastolic functions locally and globally. Compared with the traditional ultrasound technique, which is limited to evaluating the overall function of the heart, speckle tracking imaging can better reflect the local myocardial function and is independent of angle between the beam direction and the wall motion direction. Myocardial movement and cardiac function have higher accuracy and the clinical value is more impressive. This article aims to review the theoretical basis of speckle tracking imaging and its clinical application in myocardial disease.
The influence of long-term scalp acupuncture combined with different acpoints with electroacupuncture in different brunnstromon stage on the lower extremity motor function and balance function after stroke
BAO Ye-hua, CHEN Fei-yu, LIU Xiao-ping, CHU Jia-mei, SHI Hong-li, WANG Yan-wu, XU Shan-shan
2019, 17(2): 280-283. doi: 10.16766/j.cnki.issn.1674-4152.000661
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Objective To explore the effects of long-term scalp acupuncture combined with different acpoints with electroacupunctrue in different brunnstromon stage on the lower extremity motor function and balance function after stroke. Methods One hundred cases met the inclusion criteria were randomly divided into control group (traditional acupuncture + rehabilitation) and treatment group (long-term scalp acupuncture + using different acpoints with electroacupunctrue in different brunnstromon stage + rehabilitation), 50 cases in each group with the therapy of each group.Berg Balance Scale (BBS), simplified Fugl-Meyer assessment mark (SFMA) and Holden functional ambulation classification (Holden FAC) were observed before and after 4 and 8 weeks' treatment, respectively. Each case was treated on the ward. Treatment course of acupuncture and rehabilitation was once per day, 5 times a week, resting at weekends, treated for 8 weeks. Results BBS, SFMA and Holden FAC were improved in same group after 4 and 8 weeks' treatment, compared with before (all P<0.05), and the indexes after 4 weeks' treatment is superior to that after 4 weeks' treatment (all P<0.05). After 4 weeks' treatment, BBS, SFMA and Holden FAC of treatment group were better than control group, and the same outcome after 8 weeks' treatment. Conclusion With the basic treatment of routine rehabilitation training, long-term scalp acupuncture combined with different acpoints with electroacupunctrue in di fferent brunnstromon stage is more beneficial to improve low limb dysfunction and balance dysfunction than traditional acupuncture.
Clinical observation on treatment of active ulcerative colitis with Chinese herbal decoction for oral taking and enema
ZHANG Bing, XIE Jing-ri, SUN Tao
2019, 17(2): 284-287. doi: 10.16766/j.cnki.issn.1674-4152.000662
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Objective To observe the patients’ clinical symptoms and histopathological changes of Chinese herbal decoction for oral taking and enema in the treatment of active ulcerative colitis(UC), and evaluate the clinical efficacy and safety. Methods The 68 cases of UC were selected from January 2014 to June 2016 in the first affiliated hospital of Heilongjiang university of TCM department of Gastroenterology. The 68 patients with active ulcerative colitis were randomly divided into control group and treatment group with 34 cases in each group. Two groups of patients were given the necessary routine medical treatment. On these, the treatment group was treated with Chinese herbal decoction for oral taking and enema. Oral Chinese medicine were given 1 dose daily, 2 times/day, half an hour after breakfast and dinner. Enema Chinese medicine were given every night 1 dose daily. The control group was given Mesalazin Enteric-coated tablets orally, 1 g/times, 4 times/day. The two groups were treated for 1 months.After treatment, we observed the improvement of three main symptoms and colonic mucosal scores of two groups. We compared the clinical effect and observed the adverse reactions. We used statistics software SPSS 19.0 for the research of statistical data. Results After treatment, the total clinical efficiency of the treatment group was 85.29%, significantly better than 61.77% in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the symptoms of abdominal pain, diarrhea, pus and blood stool and mucous abscess and the internal mirror score of the colonic mucosa was significantly lower than before of two groups (all P<0.05). The improvement rate of the treatment group was significantly better than the control group after treatment (all P<0.05). Conclusion It was effective in the treatment of active ulcerative colitis with Chinese herbal decoction for oral taking and enema. It can obviously improve the main symptoms like abdominal pain, diarrhea, pus and blood stool. After that, it can repair mucosal injury and promote ulcer healing, and no obvious adverse reactions.
The clinical observation of Jianpibushen formula in subclinical hypothyroidism associated with osteoporosis patients of spleen kidney yang deficiency
ZHANG Lian-huan, ZHAO Ping, ZHANG Ning-jie, TONG Pei-jian
2019, 17(2): 288-290,324. doi: 10.16766/j.cnki.issn.1674-4152.000663
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220 1
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Objective To observe the clinical observation of Jianpibushen formula in subclinical hypothyroidism (SCH) associated with osteoporosis (OP) patients of spleen kidney yang deficiency. Methods From January 2015 to January 2017, 120 SCH with OP patients were randomly divided into the research group and the control group according to the random number table. The control group were given the conventional radiation of improving the thyroid gland and osteoporosis treatment. While the research group were given Jianpibushen formula on the basis of the control group. After one year treatment, thyroid function, bone metabolism, cytokine, bone mineral density (BMD), symptom score, curative effect and adverse reaction were compared between the two groups. Results After treatment, TSH [(3.01±0.42) mU/L], PTH: [(18.75±4.39) ng/L], bone metabolism [BGP: (12.92±4.39) ng/mL, PINP: (240.79±9.38) μg/L, CTX (0.23±0.01)mmol/L], cytokine [IL-10: (2.63±1.07) pg/mL, IL-6: (85.71±9.25) pg/mL], symptom score[(21.45±4.33) scores], and curative effect(84.0%) in the research group were significantly better than those in the control group. The differences were statistically significant (all P<0.05). Conclusion Thyroid function was an important factor on affecting bone metabolism. SCH can cause bone loss and reduce the BMD. Combing the Jianpibushen formula with the conventional treatment of SCH with OP patients of spleen kidney yang deficiency had satisfaction curative effect. It can significantly improve the thyroid function, promoting the bone formation, decreasing the bone resorption, increasing the BMD, and improving clinical symptoms and curative effect.
The therapeutic effect of Huoxuexiaozhi capsule on SOD, MDA and CYP450 in treating fatty liver disease
YANG Ru-yi, CAO Chang-xia, GUO Zhan-fang, XU Hai-zhen, ZHAO Wen-ling, LIU Yong-ping, SUN Zhao, WANG Jun, WANG Hong-bin
2019, 17(2): 291-294. doi: 10.16766/j.cnki.issn.1674-4152.000664
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Objective To observe the therapeutic effect of traditional Chinese medicine decoction Huoxuexiaozhi capsule on Fatty liver diseases superoxide dismutase (SOD), malondialdehyde (MDA), Cytochrome P450 (CYP450) in blood serum, and approach its mechanism. Methods A prospective randomized controlled study was conducted, including 100 patients who were definitely diagnosed as fatty liver and admitted into affiliated Qinghai University Hospital from January 2014 to December 2016, and they were divided into a treatment group and a control group, 50 cases in each group by random number table method. Traditional Chinese medicine Huoxuexiaozhi capsule was taken orally in treatment group, 4 capsules each time, three times each day, and Dongbaogantai tablet was taken orally in control group, 3 Tablets each time, three times each day. One course of treatment was five weeks.After treatment, the clinic effect was analysed.the changes of patients symptoms, liver function, SOD, MDA, CYP450 in blood serum were studied and analysed. Results Fourteen cases were cured, 18 cases were significantly effective, 12 cases improved and 6 cases were null and void in treatment group, the totol effective rate is 88.0%. Seven cases were cured, 11 cases were significantly effective, 18 cases improved and 14 cases were nulland void in treatment group, the totol effective rate is 72.0%. And there were statistical significant between two groups (P<0.01). Huoxuexiaozhi capsule improved symptoms significantly of fatty liver diseases, such as loss of appetite, often loose stools weak, abdominal distension full side rib pain, nausea and vomiting, there were statistical significant between two groups (all P<0.05). Huoxuexiaozhi capsule improved ALT, AST, γ-GT and ALP, there were statistical significant between two groups (all P<0.01). Huoxuexiaozhi capsule increased SOD, redused MDA and CYP450, there were statistical significant between two groups after treatment (all P<0.01). Conclusion Huoxuexiaozhi capsule can treat fatty liver disease, improve symptoms, liver function, increase SOD, decrease MDA and CYP450, its effect is better than Dongbaogantai tablet (all P<0.01).
Application of Flipped Classroom Based on Micro-lecture in Physiological Experiment Teaching of Higher Vocational Nursing Specialty
QIN Yong-ting, LI Chen, CHEN Shan-shan, LI Guang-zhi, DING Shi-teng, ZHOU Xun
2019, 17(2): 295-297,336. doi: 10.16766/j.cnki.issn.1674-4152.000665
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Objective Based on the present teaching situation of physiology experimental course of higher vocational nursing specialty in our college, we discuss the implementation method and application effect of flipped classroom teaching mode based on micro-lecture in physiology experimental teaching, in order to provide reference for the promotion of this teaching mode in physiology experimental teaching. Methods The study object selected class 1 and 2 of three years higher vocational nursing specialty in our college, and class 1 was the control group (n=40)， and class 2 was the experimental group (n=40). The traditional teaching mode was used in the control group, and the experimental group used the teaching mode of flipped classroom on basis of micro-lecture. The flipped teaching based on micro-lecture mainly included four steps, namely, teachers' preparation before class, students' independent learning before class, classroom implementation and consolidation after class. After the end of the course, the teaching effects of two groups of students were evaluated in experimental theory, experimental skill and questionnaire investigation. We used software SPSS 19.0 in the statistics of data. T-test was used in comparing between groups, and we used χ2 test in the comparison of count data. Results The experimental group's average score of experimental theory test [(84.85±7.43) points] was more than control group's [(80.47±7.69) points], and the experimental group's average score of experimental skill test [(83.93±7.48) points] was also more than control group's [(78.78±6.44) points], and the differences were statistically significant (all P<0.05). The results of the questionnaire survey showed that the experimental group students' recognitions of the teaching mode were better than that of the control group in learning interest, self-learning ability, awareness of teamwork and ability to analyze and solve problems, and the differences were statistically significant (all P<0.05). Conclusion The flipped classroom teaching mode based on micro-lecture can enhance students' mastery of experimental skill and experimental theory, help to improve students' interest in learning, develop students' self-learning ability, enhance students' awareness of teamwork and improve students' ability to analyze and solve problems. Therefore, this teaching mode deserves further study and promotion in the physiology experimental teaching.
Preliminary exploration on the management mode of the space workers' weight management application group
SUN Zhi-ying, ZHANG Han, ZHAO Yi, WU Yun-feng, ZHANG Chao-yan, MOU Yu-jie, ZHAO Mei-hua, FAN Yan-li, GAO Hui, ZHAO Hong-yu, HUANG Li-ming
2019, 17(2): 298-302. doi: 10.16766/j.cnki.issn.1674-4152.000666
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Objective Weight management is an essential part of health management. There are many ways in weight management such as diet management or exercise management. In order to better carry out the aerospace workers' weight management, health center adopts the way that is the combination of diet and exercise in weight management, and uses the group management to sum up experience. We can develop system of weight management deeply in order to form the standard process. Methods A weight management team consists of a health manager, a food manager, a sports manager, a doctor and a nurse. A combination of diet and exercise for 86 volunteers, who were overweight or obese, has been done in the form of three months' group management. The group of diet management is divided into three groups, namely, Mediterranean diet group, "5+2" light diet group and restricted energy (low GL) group. Exercise management consists of strength training and aerobic exercise. There are many ways in the group management such as WeChat, one-to-one instruction, video teaching, group class, and members' communication. Three months later, relevant data, body composition and body fitness were measured. Results According to the results of three months' weight management, the weight, fat content, muscle content, body fat ratio and waist-to-hip ratio of each group decreased significantly. The higher present rate in dietary intervention and exercise intervention, the greater the change in the index of various body components, and the better the weight loss effect. The communication between the team and volunteers can do good to participate actively in weight management. Conclusion Using group management and different diets is feasible in weight management. The main factors that affect weight management are the participants' initiative and participation. The higher the participation level, the better the reduction effect.
Risk factors and preventive measures of nosocomial infection in patients with ureteral calculi after flexible ureteroscopic lithotripsy
YU Hui-qin, LI Rui-peng, ZHU Jing-yu
2019, 17(2): 303-305,320. doi: 10.16766/j.cnki.issn.1674-4152.000667
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Objective To explore the risk factors and preventive measures of nosocomial infection in patients with ureteral calculi after flexible ureteroscopic lithotripsy. Methods A total of 97 patients with ureteral calculi who suffered from nosocomial infection after flexible ureteroscopic lithotripsy treated in our hospital from May 2015 to May 2017 were selected. Pathogenic bacteria were cultured from patients' clean urine, and the types and drug resistance rates of pathogens were analyzed, and the risk factors of nosocomial infection were analyzed. Results A total of 141 pathogenic bacteria were detected in 97 patients, of which 96 (68.09%) were gram-negative bacteria, 28.13% were Escherichia coli, 45 (31.91%) were Gram-positive bacteria and 42.22% were Enterococcus faecalis. The drug resistance of Escherichia coli to gentamicin was the highest and its sensitivity to imipenem was the highest. Enterococcus faecalis was the most resistant to penicillin and Enterococcus faecalis was the most sensitive to vancomycin and furantoin. Of 97 patients with nosocomial infection, 7 had iatrogenic infection, 45 had improper wound care, 32 had upper genitourinary tract infection and 13 had other causes. The incidence of postoperative bleeding, postoperative pain, residual stones and postoperative renal injury increased significantly (all P<0.05). Multivariate analysis showed that postoperative pain, postoperative hemorrhage, postoperative renal injury and residual calculi were independent risk factors for renal injury after ureteroscopic lithotripsy (all P<0.05). Conclusion Escherichia coli and enterococcus faecalis are the main pathogens of infection in patients with ureteral calculi after flexible ureteroscopic lithotripsy. The risk factors include postoperative pain, postoperative hemorrhage, postoperative kidney injury, residual calculi and so on.
The expression pattern and biological role of ubiquitin-binding enzyme UBE2T in colorectal cancer
PAN Feng-ping, XU Yan, XU Long-sheng, MA Xing-jie, CHEN Yi-peng
2019, 17(2): 306-309. doi: 10.16766/j.cnki.issn.1674-4152.000668
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Objective To investigate the expression pattern and biological role of ubiquitin-binding enzyme UBE2T in colorectal cancer. Methods Immunohistochemistry was used to detect the protein expression of UBE2T in 78 pair specimens of colorectal cancer and corresponding normal tissues. After UBE2T-siRNA and control NC-siRNA were transfected into colorectal cancer cell SW480 by lipofectamine 2000, proliferation was evaluated by cell counting kit (CCK-8) and plate clone assay. Cell cycle was detected by flow cytometry. The protein expression of UBE2T, cyclin D1 and cyclin E were detected by Western blotting. Results Compared with normal colorectal tissue, the expression of UBE2T in colorectal cancer was significantly increased (P<0.001). The abnormally high expression of UBE2T in cancerous tissues was associated with poor pathological features: tumor size (P=0.014), histological grade (P=0.005), depth of invasion (P=0.033) and TNM stage (P=0.014). Both CCK-8 proliferation assay and plate clone formation assay suggested that silencing UBE2T expression could significantly inhibit the proliferation of colorectal cancer cells. Silencing UBE2T inhibits the expression of cyclin D1 and cyclin E, and promotes G1/S cell cycle arrest in colorectal cancer cells. Conclusion UBE2T is highly expressed in colorectal cancer tissues and is associated with poor pathological parameters. Silencing UBE2T inhibits the proliferation of colorectal cancer cells by promoting G1/S cell cycle arrest.
The effect of early enteral nutrition on chemotherapeutic complications and nutritional status of patients with digestive tract cancer under nutritional screening
YE Zhong-wei, WU Xue-lian, WU Min-hua, ZHOU Yue-fen
2019, 17(2): 310-313. doi: 10.16766/j.cnki.issn.1674-4152.000669
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Objective To explore the effect of early enteral nutrition on chemotherapeutic complications and nutritional status of patients with digestive tract cancer. Methods From January 2015 to January 2016, 108 patients with digestive tract tumors treated in our hospital were selected, and nutritional risk screening 2002 (NRS2002) was used to assess the risk of the patients. A total of 98 patients with nutritional risk were randomly divided into the routine group (49 cases) and the observation group (49 cases), and were given delayed and early enteral nutrition respectively after the operation. Both groups were followed up for 1 year, while the nutritional status, immune function, postoperative recovery situation, chemotherapeutic complications and chemotherapy termination situation were compared between the two groups before and after chemotherapy. Results Two weeks after chemotherapy, the weight, TP, ALB, HB and skin fold thickness in the observation group were significantly higher than those in the control group (all P<0.05). The levels of CD4+, CD8+, CD4+/CD8+, IgG and IgA in the observation group were significantly higher than those in the control group (all P<0.05). The postoperative bowel sound recovery time, anus exhaust time, out-of-bed activity time and hospitalization time were significantly lower than those of the control group (all P<0.05). There was no significant difference in the incidence of anastomotic infection and bleeding between the two groups (all P>0.05); The incidence of complications after chemotherapy in the observation group was lower than that in the conventional group (8.16% vs. 28.57%, P=0.029).The termination rate of chemotherapy in the observation group was significantly lower than that in the conventional group [HR=0.396,95% CI (0.195, 0.803), P=0.011]. Conclusion If the patients after digestive tract tumor surgery were given early enteral nutrition under nutritional screening, it can improve the nutritional status, enhance the immune function, shorten the hospitalization time, reduce the incidence of chemotherapy complications and improve the tolerance of chemotherapy.
Effects of oral health risk assessment tools on oral health of children with mental developmental disabilities
XIE Le, JIANG Mao-ying, XU Jing-qiu
2019, 17(2): 314-316,328. doi: 10.16766/j.cnki.issn.1674-4152.000670
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Objective To evaluate the oral health risk of children with intellectual development disorder based on the oral health risk assessment tool and to explore the effect of oral care intervention. Methods A total of 316 children aged 6 to 10 years old with mental disabilities in 6 deaf schools in the city were randomly selected for a questionnaire survey based on oral health risk assessment tools. Children with oral health risks were divided into control group (126 cases) and intervention group (125 cases). Without nursing interventions, the intervention group used comprehensive nursing interventions to conduct a 1-year follow-up survey to assess the risk of dental caries and dental restorative needs, and to record the number of dental caries and periodontal conditions. Results Of 316 cases, 198 were in urban area and 118 in suburban area. There were 153 cases (77.3%) of children with dental caries in urban areas and 98 cases (83.1%) in suburban areas. Among 198 urban children, 168 (84.8%) required oral care, and 108 children (91.5%) were children in suburban areas. After one year of intervention and tracking, there was a statistically significant difference in the risk of tooth decay and restorative demand after intervention in both groups (P<0.01). The control group had 65 cases of dental caries, and the average number of caries was 2.1±0.5. There were 20 cases of dental caries in the intervention group and the average number of caries was 1.2±0.2. There was a significant difference in caries between the two groups (P<0.01). In addition, the control group had 55 cases of gingival bleeding, 74 cases of calculus, 21 cases of gingival bleeding in the intervention group, and 25 cases of dental calculus. Compared with the control group, and the periodontal status of the intervention group was significantly improved (P<0.01). Conclusion Oral health problems are common among children with mental retardation. Suburban counties are more severe than urban areas. Oral care interventions can effectively improve oral health problems.
Effect of sedative drug use on ICU patients with mechanical ventilation based on normal rest
GUO Li-juan, PAN Li-fei
2019, 17(2): 317-320. doi: 10.16766/j.cnki.issn.1674-4152.000671
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Objective To analyze the clinical application of sedative drugs in Intensive Care Unit (ICU) patients with mechanical ventilation based on normal rest, to provide a referencefor its clinical care. Methods Sixty patients with ICU mechanical ventilation who were diagnosed and met in our hospital in January 2016 and January 2017 were divided into observation group (30 cases) and control group (30 cases) according to the random number table method. The patients in the control group were treated with routine intervention mode. The patients in the observation group adjusted the use of sedative drugs according to the normal rest. The sedative and analgesic depth of patients with mechanical ventilation was controlled by the Ricker Sedation-Agitation Scale (SAS) and the Critical-care Pain Observation Tool (CPOT). Comparison of the incidence of adverse events (ventilation time, ICU treatment time, systolic blood pressure, diastolic blood pressure, heart rate, arterial oxygen saturation) and the differences of the clinical indicators between the subgroups. Results The incidence of VAP in the observation group was significantly lower than that in the control group (P<0.05). The level of arterial oxygen saturation (SaO2) of observation group were significantly higher than those of control group (all P<0.05). The ventilation time, ICU treatment time, systolic blood pressure, diastolic blood pressure, heart rate and the dosage of fentanyl, propofol and dexmedetomidine in observation group were significantly lower than those of control group (P<0.05). Conclusion According to the normal rest to adjust the use of sedative drugs can significantly reduce the incidence of adverse reactions and improve the level of clinical indicators of patients, which has high clinical value in the treatment of ICU patients with mechanical ventilation.
Application of intensive care in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with type 2 respiratory failure
WANG Yan-hong, YU Yi-hua
2019, 17(2): 321-324. doi: 10.16766/j.cnki.issn.1674-4152.000672
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Objective To analyze the effects of intensive care on patients with chronic obstructive pulmonary disease complicated with type 2 respiratory failure. Methods A total of 110 patients with chronic obstructive pulmonary disease complicated with type 2 respiratory failure who were admitted to the respiratory department of our hospital from January 2017 to May 2018 were selected. Patients in the control group were given routine nursing care while patients in the observation group were given intensive nursing intervention. The changes of clinical symptoms, lung function and blood gas indexes before and after the nursing intervention of the two groups were compared, and the incidence of complications during the nursing period of the two groups were calculated. Results Before nursing intervention, there was no statistically significant difference in pulmonary function and blood gas indexes between the two groups (all P>0.05). After nursing intervention, patients in the observation group were significantly shorter than those in the control group in terms of the duration of pulmonary murmur disappearance (all P<0.05). After the intervention, the indicators of lung function FEV1, FVC and FEV1/FVC in the observation group were significantly better than those in the control group (all P<0.05). The improvement of blood gas index pH value, oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2) in the observation group was superior to the control group (all P<0.05). During the nursing period, patients in the two groups had different degrees of complications, but the incidence of aspiration, aspiration pneumonia and oropharyngeal discomfort in the observation group was significantly lower than that in the control group (all P<0.05). Conclusion The application of intensive care in patients with chronic obstructive pulmonary disease complicated with type 2 respiratory failure can improve the pulmonary function, improve the blood and gas index and reduce the incidence of complications, which is worthy of clinical application.
Study on the intervention of hot point of foot acupuncture on hypothermia recovery after general anesthesia in patients with cancer
SU Qin, JIANG Zai-long, PAN Dao-xia, WANG Huan, JIN Ying
2019, 17(2): 325-328. doi: 10.16766/j.cnki.issn.1674-4152.000673
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Objective In recent years, some progress has been made in the intervention of traditional Chinese medicine on hypothermia. Foot points are abundant, which is a common body part for external treatment of traditional Chinese medicine. This study analyzed the effect of foot heat ironing on hypothermia in patients with tumor after general anesthesia, thus to provide reference for postoperative hypothermia intervention. Methods According to the relevant criteria of this study, 80 patients with general anesthesia in our hospital were randomly divided into two groups by drawing lots, and the control group was controlled by room temperature. Routine nursing care, such as covering bedding and so on, was used in the observation group. After heating in the incubator, the observation group was wrapped with a small towel and ironed for 20 minutes at the points of Yongquan and Chongyang respectively. The temperature of the patients before operation and returning to the ward was recorded, and the temperature of the foot back was recorded, and the temperature of the foot was recorded, as well as the recovery time of foot skin to basic body temperature and the time of shivering retreat, the time of subjective cold feeling regression, the evaluation of the degree of shivering in the two groups, and the investigation of nursing satisfaction. Results There was no significant difference in body temperature and skin temperature between the two groups before operation and back to ward (all P>0.05), the time to recover back temperature to basic body temperature in the observation group was shorter than that in the control group (all P<0.001), and the time of shivering subsiding in the observation group was less than that in the control group. The disappearance time of subjective cold feeling was shorter than that of the control group (all P<0.001), the rate of shivering in the observation group was 15.00%, which was lower than 30.00% in the control group (χ2=2.581, P=0.108), and the nursing satisfaction rate (90.00%) was higher than (72.50%) in the control group (χ2=4.021, P=0.045). Conclusion The nursing care of foot hot ironing can promote hypothermia of tumor patients after general anesthesia, eliminate the discomfort caused by shivering and hypothermia as soon as possible, reduce the occurrence of severe shivering, and improve nursing satisfaction.
Clinical effect of auricular pressing therapy, acupoint sticking, meridian moxibustion combined with emotional therapy on patients undergoing radical mastectomy
JIN Hui-ying, ZHAI Dong, JIN Shan-en, ZHOU Rui, ZHANG Jun-xia, FANG Qun
2019, 17(2): 329-332. doi: 10.16766/j.cnki.issn.1674-4152.000674
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Objective To explore the clinical effect of auricular pressing therapy, acupoint sticking, meridian moxibustion combined with emotional therapy on breast cancer patients after radical surgery, and to provide reference for clinical treatment of patients undergoing radical mastectomy. Methods A total of 60 breast cancer patients undergoing radical mastectomy in the third affiliated physician of Zhejiang University of Traditional Chinese Medicine from 2012 to 2018 were selected and divided into control group (30 cases) and observation group (30 cases) by random number table method. The control group received routine nursing, while the observation group received additional auricular application pressure, acupoint sticking, meridian moxibustion combined with emotional therapy. Seven days after surgery, the arm circumference was measured, the concomitant symptom (upper limb skin tightness, swelling and pain) were examined, and the anxiety and depression of the patients were assessed by the depression self-rating scale and anxiety self-rating scales. The sleep quality of the patients was assessed by using the Athens Insomnia Scale (AIS) before the surgery and 7 days after the surgery. The activity of shoulder joint was measured 3 months after surgery. The postoperative complications (limb edema, scalp hydrops and flap necrosis), concomitant symptom (upper limb skin tightness, swelling and pain), sleep quality, anxiety and depression of patients at 7 d after the surgery, and the range of motion of shoulder joint at 3 months after surgery were compared between the two groups. Results There was no significant difference in the incidence of postoperative complications between the two groups at 7 days after the surgery (P>0.05). The concomitant symptom, sleep quality, anxiety and depression in the observation group was improved significantly when compared with the control group (all P<0.05). The incidence of shoulder dysfunction in the observation group was significantly lower than that in the control group at 3 months after the surgery (P<0.05). Conclusion The auricular pressing therapy, acupoint sticking, meridian moxibustion combined with emotional therapy show a good clinical nursing effect on patients undergoing radical mastectomy, which can effectively reduce the occurrence of accompanying symptoms, anxiety and depression after breast cancer surgery, significantly improve the sleep quality of patients, and contribute to the recovery of shoulder joint function.
Study on the nursing value of evidence-based nursing for patients with skin sores after treatment with Ruyi golden yellow powder topical application
SHEN Li-li, LIN Hui-hong, FENG Dong-fen, LANG Ya-zhen
2019, 17(2): 333-336. doi: 10.16766/j.cnki.issn.1674-4152.000675
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Objective To explore the clinical value of evidence-based nursing intervention in the treatment of patients with skin ulcers with Ruyi golden yellow powder. Methods A total of 100 patients with skin ulcers who were treated in our hospital from August 2016 to August 2017 were selected, and were divided into routine nursing group and evidence-based nursing group with 50 cases in each group according to the numerical randomization method. Patients with skin ulcers were selected for the treatment with ruyi golden powder external application, and the conventional nursing group received basic nursing and the evidence-based nursing group received evidence-based nursing intervention. The self-rating Anxiety Scale (SAS) and self-rating Depression Scale (SDS) of the two groups were statistically analyzed, as well as the scores of quality of life and quality of care. The satisfaction rates of patients and family members in both groups were calculated. Results After nursing, the SAS and SDS scores of patients in the conventional nursing group and the evidence-based nursing group were significantly decreased, and the SAS and SDS scores of patients in the evidence-based nursing group were lower than those in the conventional nursing group, showing a statistical difference (all P<0.05). After nursing, the scores of somatic function, emotional function and social function of patients in the two groups all increased to some extent, and the scores of somatic function, emotional function and social function of patients in the evidence-based nursing group were higher than those in the conventional nursing group, showing statistical differences (all P<0.05). Patients in the evidence-based nursing group with skin sores were hospitalized for a shorter time and had a higher quality of care score, which was statistically different from the conventional nursing group (all P<0.05). The total satisfaction of family members of the evidence-based nursing group was as high as 96.00%, significantly higher than that of the routine nursing group (84.00%), showing a statistical difference (P<0.05). Conclusion Evidence-based nursing can significantly improve patients' mental state, promote patients' physical recovery and make patients and their families more satisfied.
Clinical application value of comfort nursing in chronic nonspecific ulcerative colitis
TANG Meng-yi, JIANG Yi
2019, 17(2): 337-340. doi: 10.16766/j.cnki.issn.1674-4152.000676
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Abstract:
Objective To study the clinical effect of comfort care in chronic nonspecific ulcerative colitis. Methods A total of 130 cases of patients with chronic nonspecific ulcerative colitis were selected from April 2016 to April 2018 treated in our hospital. According to the different methods of nursing care, they were divided into routine nursing group and comfortable nursing group, with routine nursing group receiving routine nursing intervention and comfortable nursing group receiving comfortable nursing intervention in six aspects including medical care, psychological care, music, nursing, enema, diarrhea nursing and diet nursing. Double antibody clamp method was used to detect the Tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) was used to measure patients' life quality, nursing effect and post-nursing satisfaction. Results After the nursing intervention, the levels of TNF-α and IL-6 in the comfort nursing group were significantly lower than those in the conventional nursing group, with statistically significant differences (all P<0.05). The quality of life of patients in the post-nursing comfort care group was better than that in the conventional care group, and the difference was statistically significant (all P<0.05). The total nursing efficiency of comfort nursing group was higher than that of conventional nursing group, and the difference was statistically significant (all P<0.05). The overall satisfaction rate of patients in the comfort nursing group was higher than that in the conventional nursing group, and the difference was statistically significant (P<0.05). Conclusion Comfort care can effectively improve the level of inflammatory factors in patients with chronic nonspecific ulcerative colitis, promote the physical recovery of patients and make patients more satisfied.

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