2016 Vol. 14, No. 2

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Analysis and policy suggestion on current situation of floating population health insurance in Shanghai
BAO Yong, GUO Li-juan, NIE Huan-huan
2016, 14(2): 167-169,253. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.001
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Objective To investigate the current situation and management of health care among the floating population in Shanghai city. Methods Thedata materials from “the national survey of population dynamic monitoring of health and family planning in 2014” in Shanghai city were cited. Total 7 999 floating population (4 108 males and 3 891 females,aged 15 to 59 years old,non-permanent address residents of Shanghai but lived more than three months in Shanghai) were enrolled into this study.The current situation of health insurance was statistically analyzed. The related internal factors were assessed. Results The types of medical insurance for floating population were relatively concentrated. The differences in rate of participation innew rural cooperative medical service were not different among the people from the different domicile. The general status of participation in medical insurance was different among the floating population with different demographic characteristics. Conclusion The basic medical insurance for urban workers engaged in the floating population of agriculture,forestry,animal husbandry and fishery industry should be paid attentions.At the same time,the coverage rate of industrial injury insurance for the floating population in higher risk occupations such as the production / transportation (including the construction industry) should be further improved.The complete control of the current situation of the floating population health will help them improve the level of health protection,and ultimately achieve the goal of improving the health and quality of life of floating population.
CHEN Lan-ju
2016, 14(2): 170-171.
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Evaluation of cerebrovascular reactivity in patients with glioma by breath-hold f MRI
QI Le, ZHANG Han, DING Jian-ping, XU Hai-song, WANG Zi-rong, ZHANG Di
2016, 14(2): 172-175,263. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.002
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Objective To evaluate the cerebrovascular reactivity of patients with glioma by breath-hold fMRI and plan the safest surgical trajectory. Methods Eight patients with glioma (five male and three female;ages 18 to 53 years old,average 33.4 years) were performed the fMRI with resting-state and breath holding task.SPM8 was applied in data processing(P＜0.05，FDR correction),AFNI was used to calculate the percentage of signal change of BOLD in the tumor regional and contralateral normal brain tissue.The difference of the signal change in two ROI was analyzed.The resting-state fMRI(R-fMRI) mapping and BH fMRI CVR mapping was compared. Results Independent component analysis(ICA) was not only able to reveal the location of the motor function area,but also can display the different functional systems around the tumor tissue.Relative to the mirror side normal brain parenchyma,BH BOLD signal around glioma was significantly decreased(P＜0.05),and there was the intersection of the negative region of BOLD signal in R-fMRI. Conclusion ICA of R-fMRI was more comprehensive and accurate in the function system of tumor tissue.BH-fMRI was a convenient and reliable method for CVR assessing to suggest the phenomenon of NVU,and to find false negative areas of fMRI function mapping.It could provide important reference for the formulation of brain tumor surgical plan and the judgment of risk after operation.
Effect ofrhodiola on serum SOD,MDA,OX-LDL and MMP-2 levels in patients with acute cerebral infarctionin plateau areas
LIU Pei, CAI Hong-bin, LIU Zhi-yan, ZHANG Lan-fang, CENG Zhao-yang, GE Chao-ming
2016, 14(2): 176-178. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.003
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Objective To investigate the clinical curative effect of rhodiola glucoside in patients with acute cerebral infarction in plateau areas. Methods Sixty cases of acute cerebral infarction from plateau areas were randomly divided into two groups trial group(n=30) and control group(n=30).The patients in the trial group were given conventional treatment and big bead rhodiola injection,while the patients in the control group were given conventional treatment.The serum levels of Superoxide dismutase(SOD),malondialdehyde(MDA),oxidized low density lipoprotein(OX-LDL) and matrix metalloproteinase-2(MMP-2) were detected before the treatment and 10 days after the treatment. Results After the treatment,as compared with the control group,the level of SOD increased obviously[(97.19±8.68) vs. (89.90±9.48) Nu/ml] in the trial group;but the levels of MDA[(6.88±1.95) vs. (8.36±2.98) nmol/ml]、OX-LDL[(29.20±8.99) vs. (38.19±8.55) μg/dl] and MMP-2[(20.00±8.04) vs. (25.70±8.24) μg/dl] decreased significantly,the difference between the two groups was statistical significant (P＜0.05). Conclusion The rhodiola injection is effective for patients with acute cerebral infarction in plateau areas throughupregulating the expression of SOD and downregulating the expression of MDA,OX-LDL and MMP-2,thereby improve the antioxidant and inhibit atherosclerosis.
Association study between plasma level of brain-derived neurotrophic factor and C270T polymorphism in schizophrenia patients with the symptoms of hallucination and delusion
SONG Ming-fen, DONG Jie-zheng, ZHANG Long, CHEN Hai-ping, TAO Yun-hai, ZHU Chun-yan, SHEN Bian-hong, ZHANG Kai-yuan, SHI Jian-fei
2016, 14(2): 179-181. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.004
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Objective To study the relationship between C270T polymorphism of the brain-derived neurotrophic factor (BDNF) gene and the plasma BDNF level in the schizophrenia patients,and to clarify the association of BDNF and its gene with schizophrenia. Methods Total 104 schizophrenia patients with the symptoms of hallucination and delusion and 100 healthy normal subjects were recruited.Their blood samples were collected for plasma BDNF levels by ELISA and C270T polymorphism determination by PCR-RFLP.The differences of C270T genotype frequency,T allele frequency and plasma BDNF levels between the two groups were compared via χ2 or t test. Results The case group had obviously higher C/T genotype frequency(34.6％) as compared with the control group(17.0％),P=0.013.The frequency of T allele in schizophrenia patients(20.2％) was significantly higher than healthy controls(10.5％),P=0.007.Plasma BDNF of C/T and T/T genotype in both groups[(0.85±0.13) ng/ml,(0.99±0.17)ng/ml] was significantly lower than that in C/C genotype[(1.21±0.28) ng/ml,(1.38±0.24) ng/ml),P＜0.001].In the same genotype,plasma BDNF of patients was obviously lower than that of healthy controls[C/C genotype:(1.21±0.28) ng/ml vs.(1.38±0.24) ng/ml,P＜0.001;C/T and T/T genotype:(0.85±0.13) ng/ml vs.(0.99±0.17) ng/ml,P＝0.005]. Conclusion T allele in the C270T site of BDNF gene may be associated with the susceptibility to schizophrenia via the reduction of BDNF expression.
An experimental investigation on Influence of APE1 overexpression on immune function of CD4+ CD25+regulatory T cells
WANG Lin-xia, TANG Lu-ming, WANG Min, YAN Chun-xue, PAN Guo-quan
2016, 14(2): 182-184. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.005
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Objective To research the impact of APE1 overexpression on the immune function of CD4+CD25+Treg cells with the stimulation of PGE2 in vitro. Methods We collected BALB/C mice,isolated and cultured CD4+CD25+Treg cells,constructed APE1 overexpression lentivirus vector and transfected into CD4+CD25+Treg cells,establish APE1 overexpression of CD4+ CD25+Treg cells,as the experimental group cells;the empty vector lentiviral vectors were transfected into the same amount of CD4+CD25+Treg cells,as the control group.In vitro,two groups were stimulated by PEG2 for 72 h,IL-10,TGF-βand APE1 mRNA levels were tested,the results were analyzed using t-test,P＜0.05 was considered statistically significant. Results The APE1 gene lentiviral vector was constructed,APE1 gene lentiviral vector transfected the CD4+CD25+Treg successfully.After stimulation with PGE2 to transfected APE1 overexpressed CD4+CD25+Treg and empty vector transfected CD4+CD25+Treg in vitro,The levels of TGF-β and IL-10 (1.17±0.42,1.02±0.12) were significantly lower in transfected APE1 overexpressed CD4+CD25+Treg group as compared with the other group of cells(2.69±0.21,2.25±0.31),all with statistical significance;APE1 mRNA relative expression was significantly higher in APE1 overexpressed CD4+CD25+Treg(6.57±0.49) than the other group(2.24±0.23),with significant difference;APE1 protein expression also showed the same results. Conclusion PGE2 stimulation can result in the expression of APE1 of CD4+CD25+Treg cells,and decline the immunosuppression function of the CD4+CD25+Treg,which may be related to the downregulation of IL-10 and TGF-β.
Effects of different intervention measures on quality of life of patients with obstructive sleep apnea hypopnea syndrome
LU Hua-dong, FENG Xue-ren, HUA Feng
2016, 14(2): 185-187. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.006
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Objective To investigate the curative effect of nasal continuous positive airway pressure(NCPAP) and uvulopalatopharyngoplasty(UPPP) on the quality of life of patients with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods A total of 120 patients with moderate and severe OSAHS patients in our hospital from August 2012 to August 2014 were selected as the research object,according to the treatment measures,they were divided into nCPAP group(treated with nCPAP,n=60),UPPP group(treated with UPPP,n=30) and untreated group(n=30);at the same time,the 30 cases of healthy people were recruited as the control group.The results of polysomnography(PSG) test and Quebec sleep questionnaire(QSQ) were compared among the groups. Results After the treatment,the apnea hypopnea index(AHI),lowest oxygen saturation(SaO2),REM sleep,proportion of 3+4 phase and the total score of QSQ in the nCPAP group and UPPP group were better than those before the treatment and those in the control group(P＜0.05);On 18th week,the above indexes of nCPAP group were better than those in UPPP group(P＜0.05). Conclusion The moderate and severe OSAHS have obvious influence on the quality of life of the patients,NCPAP and UPPP can improve the quality of sleep and quality of life of patients.nCPAP shows more effective in improving the recent quality of life and sleep in patients with OSAHS,this is worthy of attention in clinic.
Expression and role of suppressor of cytokine signaling 3 in liver and skeletal muscle of diabetes lab rats
CHEN Jun-guo, ZHANG Xu, WU Ming, LU Yan, ZHANG Ai-lian, WANG Qiong
2016, 14(2): 188-190. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.007
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Objective To observe the expression of suppressorsofcytokinesignaling3(SOCS-3)in liver and skeletal muscleofrat model of type 2 diabetes and to investigate its role in the pathogenesis of insulin resistance. Methods Fortymale SD rats were randomly divided into two groups.Thecontrol group(20 malerats) were fed with standard diet,while thediabetesgroup(20 malerats)were fed with high sucrose-fat diet for 4 weeks and then injected intraperitoneally with streptozotocin(STZ),16 malerats satisfied the case definitionof type-2 diabetes.Thelevel of serum insulin wasmeasured with radioimmunity,the level of glucose wasmeasured withglucose oxidase method,and the insulin sensitivity index and insulin resistance index were calculated.Thelevelsof SOCS-3 mRNA and SOCS-3 protein expression in liver and skeletal musclewere detected by real-time PCR and Western blot.The data were analyzed by T-test and Pearson linear correlation analysis. Results ①Normal SD rats fed with high sucrose-fat diet for 4 weeks and then injectedintraperitoneally with STZ could establish type-2 diabetes model.②Compared withcontrol group,the levelsof serum insulin andglucose,andthe insulin resistance index in diabetes group were increasedsignificantly(P＜0.05),while the insulin sensitivity index was decreased significantly(P＜0.05).③The SOCS-3 mRNA and protein expression level of liver and skeletal muscle in the diabetes group were higher than in thecontrol group(P＜0.05).④The SOCS-3 protein expression level of liver and skeletal muscle in the diabetes groupwere higher than in the control group(P＜0.05).⑤The SOCS-3 mRNA and protein expression of liver and skeletal musclewere positively correlated with the levelsof serum insulinin diabetes group(r=0.813，0.871，0.851，0.874,P＜0.05). Conclusion The increased expression of SOCS-3 may act as the negative factors of insulin signaling pathway and may play an important role in insulin resistance.
Ginsenoside Rg3 affecting mature and function of dendritic cells
LIU Yong-hua, TAN Shu-ying, GAO Rui-lan, JIANG Jin-hong, WANG Peng, YIN Li-ming, ZHENG Zhi-yin, FANG Bing-mu
2016, 14(2): 191-193. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.008
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Objective To investigate the effect of ginsenoside Rg3 on the maturation and function ofhuman peripheral blood monocyte-derived dendritic cells(DC). Methods ①The differentiation of peripheral blood mononuclear cells(PBMC) to immature DC(imDC) was induced by the combination of GM-CSF and IL-4.On the fifth day,TNF-α was added to make the mature of DC,so as different doses of Rg3,which were divided into low dose group(10 μg/ml),middle dose group(20 μg/ml),high dose group(40 μg/ml) and control group.The expression of CD80,CD86 and CD83 on DC cell surface which induced by Rg3 at the 7th and 14th day were detected byflow cytometry.②Rg3-DCs were collected at the 7th and 14th day,then mixed lymphocyte reaction was performed,MTT method was used to analyze the influence of ginsenoside Rg3 and DCs on the stimulation of allogeneic lymphocyte proliferation;③The interleukin-12(IL-12) level produced by Rg3-DCs were detected with ELISA. Results ①The expression of DC markers CD80,CD86 and CD83 on cell surface of middle and high Rg3 dose groups were significantly increased after culture for 7 and 14 days,the difference was significant as compared with the control group(P＜0.05).The mature markers of CD83 at the 14th day of middle and high dose groups were (38.60±2.21)% and (44.21±4.94)%,respectively,which was significantly higher than that of the control group (28.45±7.20)%,P＜0.05 and P＜0.01.①Rg3-DCs showed more effective in the high dose group on stimulating lymphocyte proliferation when compared with the other groups(P＜0.05).③In the high dose group,IL-12 level produced by Rg3-DC was (34.45±4.42)pg/ml,which was higher than that of the control group (10.24±8.82)pg/ml,P＜0.05. Conclusion Ginsenoside Rg3 can induce DC maturation,promote thefunctional conversion.A dose-dependent can be observed within a certain concentration.
Effect of early purgative therapy on gastrointestinal dysfunction in critically ill patients
CHEN Yang-bo, CHEN Yong-yi
2016, 14(2): 194-196. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.009
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Objective To observe the preventive and therapeutic effect of early purgative therapy on the gastrointestinal dysfunction in critically ill patients. Methods A total of 74 cases of critically ill patients were randomly divided into early purgative therapy group(group A,n=26),purgative therapy group(group B,n=26) and control group(group C,n=22),all the patients received the routine treatment.Dachengqi decoction was administrated in group B when internal environment stable for 48 hours,and in group A group within 48 hours.APACHEⅡ score,MODS score,gastrointestinal function score,intra-abdominal pressure and ICU mortality before the treatment and 3,7,14 days after the treatment.The data were analyzed by the variance analysis and Chi square test. Results After the treatment,there were 6 patients died in group A,while 13 cases died in group C.Gastrointestinal function score in group Awas decreased when compared with that before treatmenton d7,and more significantly on d14.On d14,the gastrointestinal function score in group C increased,and was higher than that in group A and group B;On d14,APACHEⅡ score of group A was lower than that in group C,MODS score also was lower than that in C group;and the intra-abdominal pressure decreased when compared with that before the treatment and on d3 and d7;The intra-abdominal pressure of group C increased as compared with that before the treatment or 3d and 7d after the treatment,which was significantly higher than that in group A and B,the difference was statistical significance.In group A,the blood potassium on d3 was higher than that in group C,and the blood sodium on d7 was lower than that in group B,and the blood sodium on d14 was lower than that in both group B and C.The difference in blood potassium,sodium and chlorine before and after treatment were not statistically significant between group B and C.Intra-abdominal pressure and gastrointestinal function score was positively correlated with APACHE score,MODS score and ICU mortality. Conclusion The purgative therapy especially early purgative therapy can reduce the intra-abdominal pressure,gastrointestinal function score,severe symptom score and mortality,have preventive and therapeutic effect on the gastrointestinal dysfunction in critically ill patients,and the effect of early purgative therapy is more significant.
Evaluation of right heart function in patients with type 2 diabetes mellitus
JIANG Yue-ming-ming, XU You-feng, ZHANG Sheng-min, YIN Feng-ying, LI Jia-lin, CHEN Li-bin, MAO Feng, SU Nan, YU Fei
2016, 14(2): 197-199. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.010
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Objective To evaluate the right heart functions in patients with type 2 diabetes mellitus(T2DM)by echocardiography,and to find out the correlation between echocardiographic findings and the severity of T2DM. Methods A total of 149 patients with T2DM were selected and divided into the non-diabetic microangiopathy group(70 cases,T2DM-Ⅰ)and the diabetic microangiopathy group(79 cases,T2DM-Ⅱ)according to the diagnostic criteria of T2DM.And 90 healthy age-matched volunteers were selected as controls.All subjects underwent echocardiography.The right ventricular size and function were compared among the three groups. Results Tricuspid orifice E/A of Two T2DM groups were lower than that of the control group (P＜0.01);Tricuspid E/E’ was significantly different between T2DM-Ⅰand the control group(P＜0.05),and it was significantly different between T2DM-Ⅱand the control group(P＜0.01)as well.There were also significant differences of RV-strain and Tei index in the T2DM-Ⅱ as compared with T2DM-Ⅰand the control group(P＜0.01).There were no significant differences in FAC and TAPSE among the three groups(P＞0.05).The indexes except RVWT between T2DM-Ⅱ and T2DM-Ⅰ were significant difference (P＜0.01).The right ventricular size and function were not significant difference(P＞0.05). Conclusion With the development of diabetes,the functional impairment of the right heart appears earlier than structural changes,and right ventricular diastolic function is early impaired than the systolic function.
Peri-operative Influences of gasless and CO2 pneumoperitoneum laparoscopy no patients with varicocele
WU Yu, LIU Jian-min, ZHANG Jia-jun, GAO Wu-yue, LIU Bei-bei
2016, 14(2): 200-202. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.011
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Objective To analyze the treatment method of gasless laparoscopic and CO2 pneumoperitoneum laparoscopic varicocele,compare the of hemodynamic changes and perioperative variations of different methods. Methods The 40 cases of varicocele patients (all the left) were divided into gasless group and CO2 pneumoperitoneum group according to the order of admission time randomly,and there were 20 patients in each group.All patients were given High-level ligation of spermatic vein;Comparison of per-operative changes were done between gasless group and CO2 pneumoperitoneum laparoscopic group,including detection of two groups of patients before the start of anesthesia(T1),suspension or gas after the abdomen after the establishment of 30 min(T2) and the suspension or removal of pneumoperitoneum 10 min(T3) and mean arterial pressure of three time-point,central venous pressure,heart rate,oxygen saturation,PH value, arterial pressure of CO2(PaCO2) level,and post-operative changes. Results Surgery of 40 patients were successful,the time of bowel function recovery,the incidence of nausea and vomiting between the two groups were statistically significant differences(P＜0.05),and the central venous pressure in the experimental group,PaCO2 levels were points in time T2 the difference were statistically significant differences (P＜0.05). Conclusions Gasless laparoscopic technique is a safe and feasible method for treatment of varicocele,and easy to maintain stabilization of patient’s vital signs during operative time,and also have advantages of small incision,quick recovery,scar hidden.CO2 pneumoperitoneum group was gurgling sound recovery time is longer,higher incidence of nausea and vomiting,no hemodynamics and internal environment of the patient’s blood vessel CO2 gasless laparoscopic surgery.
The correlation of mild cognitive impairment and plasma homocysteine,hs-CRP levels in patients with cerebral small vessel disease
CHEN Jian-mei, ZHANG Xu, MAO Xin-lei
2016, 14(2): 203-205. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.012
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Objective To discuss the correlation of mild cognitive impairment and plasma homocysteine(Hcy) and high-sensitivity C-reactive protein(hs-CRP) level in patients with cerebral small vessel disease. Methods From March 2015 to July 2015,100 cases of cerebral small vessel disease patients were collected,according to their level of cognitive function in patients with normal cognitive function grouping(group A,n=40) and cognitive impairment without dementia(Part B,60 cases);others choose the same period 100 cases of healthy control group;extracted under fasting venous blood,using fluorescence polarization immunoassay plasma Hcy levels,using OLMPUS 5400 and matched reagent test hs-CRP;analysis of plasma Hcy levels between hs-CRP and cerebral cognitive dysfunction in patients with small vessel disease relevance. Results Compared with the control group,hs-CRP,Hcy levels in A,B two groups of patients were significantly increased; compared with Group A,Group B was significantly increased,the difference was significant,P＜0.05;MoCA scores in B groups were significantly lower than the control group; compared with group A,group B low,P＜0.05.Hcy levels in patients with cerebral small vessel disease,hs-CRP levels and Montreal Assessment Scale score,attention and computing power,visual-spatial and executive function,abstract force subscales were negatively correlated,P＜0.05;however positively correlated with age sex,P＜0.05. Conclusions The increased hs-CRP and Hcy levels of risk factors may occur in patients with small vessel disease of brain cognitive dysfunction,however high Hcy and hs-CRP levels may be involved in cognitive impairment in patients with small vessel brain.Therefore,early detection of plasma hs-CRP and Hcy levels can be effective in preventing cognitive dysfunction,which will help improve the prognosis and quality of life.
Multiple factor analysis of preoperative renal function in Stanford type B aortic dissection
DU Yu-kui, MAIMAITIAILI·Aizei, LI Xiao-xia, ZHANG Li, HE Liang, AYIBIEKE· Naibi, GUO Sheng, GUO Yong-zhong, LIU Yun, ZHANG Zong-gang, YANG Xiu-bin, TANG He-nian
2016, 14(2): 206-208. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.013
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Objective To investigate preoperative renal function and realative influencing factors in Stanford type B aortic dissection. Methods From January 2004 to September 2013,151 consecutive patients with Stanford type B aortic dissection were admitted to hospital.95 age and sex mached healthy people were taken as the control group.The fasting venous blood was collected to test the renal function.The primary entry tear and extent of aortic dissection was measured by CTA.The aortic valve insufficiency and left ventricular size were measured byColor Doppler ultrasonic diagnostic apparatus.Various factors that may affect renal function were analized by Pearson correlation analysis. Results The level of renal function indexes(BUN,CERA) existed difference between aortic dissection group and control group(t=-2.903,-3.110;P=0.004,0.002).Among three subgroups,UA existed difference between acute stage group and subacute stage group(F=3.776;P=0.025).Trough correlation analysis,BUN negatively correlated with left ventricular end-diastolic diameter and end-systolic diameter,CERA negatively correlated with patients gender and patients age,positively with the left ventricular end-diastolic diameter and end-systolic diameter and conditions of the left renal artery opening.UA negatively correlated with patients gender and patients age,positively with left ventricular end-diastolic diameter and end-systolic diameter and extent of aortic dissection and conditions of the left renal artery opening. Conclusion There exists damaged renal function in preoperative Stanford type B aortic dissection.The gender and age,left ventricular diameter,extent of aortic dissection and left renal artery opening condition have certain effects on the preoperative renal function of Stanford type B aortic dissection.
Experiences of vacuum sealing drainage combined with split-thickness skin graft for treatment of venous ulcer of lower extremity
CHEN Shi-yuan, GAO Yong, TANG Wen-bo, LIU Chun-jiang, WANG Xiao-gao, FANG Chang-wen, NIE Zhong-lin
2016, 14(2): 209-211. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.014
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Objective To study the clinical effect of vacuum sealing drainage (VSD) combined with split-thickness skin graft in the treatment of venous ulcer of lower extremity. Methods Total 40 cases of venous ulcer of lower extremity,included 14 cases of simple varicose vein combined with ulcer,12 cases of Cockett syndrome combined with ulcer,8 cases of Budd Chiari syndrome with ulcer,and 6 cases of lower extremity deep vein thrombosis associated with ulcer,were recruited in our hospital between January 2013 and April 2014.All patients were given conventional dressing and symptomatic treatment in order to achieve wound cleaner.The wound culture was performed and antibiotics were given on the basis of indications.Biopsy was performed for the larger ulcer wound to exclude the possibility of malignancy.For the patients with simple varicose vein combined with ulcer the split-thickness skin graft were performedsimultaneously;for the patients with Cockett syndrome,Budd Chiari syndrome or post thrombotic syndrome,the recanalization were performed and the split-thickness skin graft followed 3-7 days later.VSD was conducted for all patients. Results Forty patients were treat with VSD on average of 6 days.The skin grafts were all survived in 32 cases,survived 92% in 6 cases,and survived 60% in 2 cases,all wound were healed after dressing change.No case needs the second operation. Conclusion Effect of VSD combined with split thickness skin graft for venous ulcer were clear.VSD can reduce the tissue edema,improve local microcirculation,accelerate the fresh granulation tissue growth.At the same time,VSD with advantage of better wound drainage,control infection,promote wound attached,is conducive to the graft survival.
Relationship between the exercise maximal ST segment / heart rate slope and coronary angiography
DU Guo-wei, HUANG Zuo-gui, YIN Bo, LI Xiao-hua, LI Hou-rong, LI Qian, JIN Hai-yan, XIANG Juan, YU Hua, GUO Min, RAN Liang, PAN Nan
2016, 14(2): 212-214. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.015
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Objective To study the relationship between the exercise maximal ST segment/heart rate slope(ST/HR slope) and coronary angiography in patients with coronary artery disease(CHD). Methods Total 280 patients with suspected CHD received treadmill exercise test and coronary angiography in two weeks,and were divided into CHD group and non-CHD group according to the results of coronary angiography.The exercise maximal ST segment/heart rate slope and the severity of coronary arterial lesions were compared between the two groups. Results The exercise maximal ST segment/heart rate in CHD group was significantly higher than that in non-CHD group(P＜0.01),and the metabolic equivalents(METs) in CHD group was significantly lower than that in non-CHD group(P＜0.01).If ST/HR slope≥2.2 μV/(bp·min),1 branch coronary artery vessel disease accounted for 28.98%;ST/HR slope≥4.0 μV/(bp·min),2 branch coronary artery vessel disease accounted for 32.60%;ST/HR slope≥6.0 μV/(bp·min),3 branch coronary artery vessel disease accounted for 38.40%(P＜0.05).The exercise maximal ST/HR slop was positively correlated to the depression of ST segment and the severity of coronary artery lesion.The maximal(METs) was negatively correlated to ST segment depression and the severity of coronary arterial lesions. Conclusion The increase of exercise maximal ST segment/heart rate in patients with CHD may show the myocardial ischemia and the severity of coronary arterial lesions.
Clinical study on treatment of 40 cases of knee osteoarthritis with acupotomy combined sodium hyaluronate
HAN Yan, ZHOU Wen-fang, WU Yun-gang, WU Jian-jing
2016, 14(2): 215-216. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.016
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Objective To observe clinical efficacy of acupotomy combined with sodium hyaluronate in the treatment of early and middle stage knee osteoarthritis. Methods A randomized controlled clinical research method was used to assigned 80 cases of grade 1 to 3 knee osteoarthritis confirmed by X-ray randomly into experimental group and control group with 40 cases in each group.There were 99 knees,including 61 unilateral knee and 19 bilateral knees.The control was given intra-articular injections of sodium hyaluronate,one time a week for 5 weeks,while the experimental was given acupotomy combined with sodium hyaluronate injections.3-5 pain points were chosen for acupotomy one time a week,total one to three times according to the condition.Lequesne index of severity and disease activity were used to assess the efficacy before and after the treatment in both groups.The adverse reactions were also recorded. Results After the treatment of five weeks,the Lequesne’s score decreased to 7.93±8.31 in the experimental group and 12.47±8.25 in the control group,the symptoms of both groups were relieved.The total effective rate was 92.5% in the experimental group,and 75% in the control group(χ2=4.501,P＜0.05),there was statistical significance.No adverse reactions occurred in the two groups. Conclusion Acupotomy combined with intra-articular injections of sodium hyaluronate in the treatment of early and middle stage knee osteoarthritis is effective with few side effects,and can be popularized in hospitals of various levels.
An experimental research for the treatment of rats with short bowel syndrome with side population cells from intestinal mucosa
FAN Jia-rong, LI Wan-fu, LIANG Ting
2016, 14(2): 217-218,306. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.017
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Objective To explore the effect of transplantation method with side population cells from intestinal mucosa on short bowel syndrome in rats. Methods The side population cells were isolated from the intestinal mucosa of infant Wistar rats(donors) at gestational age of 4 weeks and transplanted into 20 female rats(receptor) to establish the short bowel syndrome model.The effect of cell transplantation,basic Characteristics and absorption to nutritional substances of small intestine were compared between the two groups. Results The weight after the treatment of the rats in both groups showed a trend of increasing,and increase in the experimental group was significantly higher than that in the control group,and the difference was significant(P＜0.05);the humidity,length and area of small intestine in the experimental group were higher than that of the control group,the difference was significant(P＜0.05);the absorptivity of xylose and fat,and nitrogen-use efficiency in the in the experimental group were higher than that of the control group,the difference was significant(P＜0.05);the intestinal villus height and depth of the crypts in the experimental group were lower than that of the control group,but the density was higher than that in the control group,the difference was significant(P＜0.05). Conclusion The transplantation method with side population cells from intestinal mucosa can effectively improve the ability of small intestine to absorb nutrition in rats with short bowel syndrome,and has certain guiding significance in clinical application.
The effects of different thyroid function in elderly patients with chronic heart failure on clinical prognosis and cardiac function
PANG Yu-ping
2016, 14(2): 219-221. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.018
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Objective To investigate the effects of different thyroid function in elderly patients with chronic heart failure on clinical prognosis and cardiac function. Methods The 247 elderly patients with CHF which has baseline thyroid function tests were chosen.The cases were divided into hypothyroidism group(43 cases),subclinical hypothyroidism group (79 cases) and normal thyroid function group(125 cases) according thyroid function.The general clinical data,duration of heart failure,cardiac function and readmission rates,the incidence of acute heart failure,acute coronary syndrome incidence,mortality,and other indicators of the incidence of the composite endpoint between the three groups were compared. Results There were no significant difference in age,gender and cardiovascular risk factors (including hypertension,hyperlipidemia,diabetes,smoking),medications and the like in three groups of patients(P＞0.05).Euthyroid group average duration of heart failure was(3.1±0.7) years,subclinical hypothyroidism average duration of heart failure was(4.7±0.9) years,the average duration of heart failure hypothyroidism group was(5.9±0.7) years.The difference between the three groups of heart failure duration was significantly(F=4.126,P＜0.05).The prevalence of thyroid dysfunction with heart failure duration＞5 years was 75.9%(66/87),3-5 years was 54.1%(33/61),＜3 years 23.2%(23/99).With the extension of the duration of heart failure,the prevalence of thyroid dysfunction gradually increased(χ2=52.031,P＜0.01).The admission rates,heart failure exacerbation,mortality and incidence of the composite end point in patients with hypothyroidism and sub-clinical hypothyroidism were significantly higher than those in normal thyroid function group(P＜0.05),and indexes above in hypothyroidism group were significantly higher than those in the subclinical hypothyroidism group(P＜0.05).NYHA difference in three groups were significantly different(χ2=19.152,P＜0.01),with the loss of thyroid function,the proportion of Ⅱ grade of patients with cardiac function is small,while the proportion of patients with grade Ⅲ and Ⅳ cardiac function increased. Conclusion Hypothyroidism and elderly patients with chronic heart failure NYHA has relevance and monitoring thyroid hormone levels have predictive value for heart function and its prognosis.
Curative effect of Weah dew combined with prednisone in the treatment of vitiligo
ZHAO Xiao-ming
2016, 14(2): 222-223,226. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.019
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Objective To study the curative effect of prednisone combined with Weah dew in the treatment of vitiligo,and evaluate the advantage and application prospects of this regimen. Methods A total of 48 outpatients(27 male and 25 female) from October 2013 to October 2014 were enrolled and randomly divided into two groups.The treatment group(n=26) underwent external Weah dew combined with prednisone therapy,while the control group received Weah dew therapy.After 2 months of treatment,leukoplakia subsided area and adverse reactions were observed.The data were statistically analyzed. Results After 2 months of treatment,the curative rate of the treatment group was 23.1%,effective rate was 88.5%,while in the control group,the curative rate was 7.7%,effective rate was 53.8%.All the data were statistically analyzed.The curative and effective rate in the treatment group was higher than those in the control group.The main adverse reactions were local erythema and mild burning sensation,9 individuals in the control group were found with small blisters form.The incidence of adverse reaction in the treatment group was 57.7%,and in the control group was 80.8%,the incidence of adverse reaction rate in the treatment was much lower than that in the control group. Conclusion The application of low dose prednisone could lighten the side effect of Weah dew in the treatment of vitiligo,and improve the curative rate.Weah dew combined with prednisone could be a kind of priority treatment method,and should be promoted.
Anesthesia effect of fentanyl and remifentanil in thoracic surgery
LI Lin
2016, 14(2): 224-226. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.020
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Objective To compare the clinical safety and efficacy of fentanyl and remifentanil in thoracic surgery,and provide reference for reasonable anesthesia choice in thoracic surgery. Methods Total 142 patients undergoing thoracic surgery in our hospital from February 2014 to February 2015 were chosen for the study and were randomly divided into two groups according to the anesthesia methods,the Fentanyl group with 70 cases(group A) and the Remifentanil group with 72 cases of patients(group B).The anesthetics in group A was propofol combined with fentanyl[25 ng/(kg·min)],and the anesthetics in group B was propofol and remifentanil[0.2 μg/(kg·min)].The main physiological indicators during surgery and postoperative recovery time were compared.The restlessness 15 min after the removal of catheter was assessed with Riker sedation-agitation score (SAS),as well as the pain postoperative 1,6,12 h using visual analog pain score(VAS),and the pain scores and the sedation-agitation score were compared. Results There was no significant difference in the mean blood pressure,oxygen saturation and respiratory rate between the two groups,and the mean heart rate group B was(60.2±7.8),and group A was(77.6±5.9),and the recovery time of the group B was (9.1±1.8)min,and group A was (15.0±6.1)min,P＜0.05,and the difference was statistically significant.The sedation-agitation score of group B was(2.1±0.9),and group A was(3.4±0.8),P＜0.05.The pain scores of group B postoperative 1,6,12 h were both lower than that of group A,P＜0.05,and the difference was statistically significant. Conclusion In the thoracic surgery,compared with fentanyl,the anesthesia time of remifentanil was shorter than that of the Fentanyl,and remifentanil had better analgesic and sedative effects,and was a safety,efficacy and ideal narcotic analgesic drugs,worthy for clinical application.
Analysis on the clinical consultation of cardiovascular drugs in a hospital
LI Jing, ZHENG Ying, BAO Shi-hui
2016, 14(2): 227-229. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.021
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Objective To analyze the data of patient counseling for drugs and cardiovascular outpatient prescription,explore the clinical intervention effect of clinical medication consultation service. Methods The cardiovascular outpatient prescriptions in our situation during January to December in 2014 were collected. The clinical pharmacists in our hospital have been specially trained to provide consulting services for clinical medicine，have a specially knowledge of medicine,medical background and knowledge of medicine.They recorded the specific information of the patients aim at medicine consulting.Data on patient’s compliance had been evaluated. Results During 2014 in clinical consulting medicine clinics,a total of 3 640 patient’s consulting in cardiovascular outpatient clinics,was accounting for 26.4% of the number of cardiovascular outpatient service patients.More patients with education of middle school or ages higher than 60 years old had a much higher percentage in the rate of patients consulting(P＜0.05).Cardiovascular consulting information in outpatients was a total of 4 720.In consultation content,87.6% of counseling problems involved the drugs of lipid-lowering and blood pressure.For lipid-lowering drugs,patients payed more attention to the usage and dosage,drug prices,side effects(P＜0.05);On blood pressure medication,patients pay more attention to the usage and dosage,side effects and coverage ratio(P＜0.05).Overall,96.2% of cardiology clinic patients can basic prescribed medication in year of 2014.It was a statistically significant difference comparing with the data before 2010 which was 53.9% of patients with compliance(P＜0.05). Conclusion Clinical medication consultation service can provides medical and drug background knowledge to patients,also basic understanding of drug used,and it’s known possible side effects or unknown possible adverse reaction,and the methods of taking medicine,the rational use of drugs,to cultivate patients with a good habits and compliance with the doctor’s advice.
Clinical analysis of total glucosides of paeony combined with methotrexate in treatment of Sjogren syndrome
LIU Yi, DENG Hao
2016, 14(2): 230-231,278. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.022
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Objective To explore the clinical effect of TGP(total glucosides of paeony) combined with methotrexate in the treatment of Sjogren’s syndrome and provide the effective basis for the future clinical work. Methods Total 56 cases of Sjogren syndrome in our hospital from January 2012 to August 2014 were recruited and they divided into two groups.The control group received methotrexate,while the observation group received TGP combined with methotrexate.The treatment course was 6 months.The Schirmer’s test result,salivary flow rate,serum gamma globulin and adverse events were observed. Results The indexes of rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein,salivary flow rate,Schirmer’s test result and serum gamma-globulin in both groups were all improved after the treatment,and the difference before and after the treatment were statistical significance in both groups(P＜0.05).The changes of C-reactive protein and other indicators in the observation group was significantly better than those in the control group,the difference was statistical significance(P＜0.05).The total curative effect was 85.71% in the observation group,which was better than 57.14% in the control group.The mild diarrhea occurred in one patient of the observation group,and mild rash phenomenon in one patient of the control group.There had no significant difference between occurrence rates of the adverse event of both groups(P＞0.05). Conclusion TGP capsule combined with methotrexate in the treatment of Sjogren syndrome has significant curative effect,which has higher safety and lower incidence of adverse reactions.
Analysis of the characteristics of symptomatic and asymptomatic neurosyphilis patients and its treatment effects
SHAO Sen, XU Ming-wei, CHEN Guan-feng, LI Kun, GUO Li-li, LUO Lian, MA Lan
2016, 14(2): 232-234. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.023
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Objective To compare the characteristics of symptomatic and asymptomatic neurosyphilis,and provide the basis for the early clinical diagnosis and treatment of neurosyphilis. Methods Total 83 patients with neurosyphilis in our hospital between March 2013 and March 2015 were recruited and randomly assigned into symptomatic group(n=45) and asymptomatic group(n=38) according to the neurological symptoms.All patients once daily received Intravenous infusion of penicillin(24 000 000 U) continuous for two weeks,while weekly intramuscular benzathine(2 400 000 U) continuous for 3 times.The test results of rapid plasma reagin(RPR),cerebrospinal fluid,number of patients receiving the tests,and the improvement of patient’s condition were compared.Student t-test for the quantitative variables and Chi-square test for the categorical variables were performed. Results The white blood cells count (19.4±5.6)×106/L,serum protein level (57.7±14.9)mg/dl,glucose levels (2.7±1.5)mmol/L of symptomatic patients was significantly higher than those of the asymptomatic group,the difference between the two groups was significant(P＜0.05);the glucose level,white blood cell count and intracranial pressure in the cerebrospinal fluid of patients in the symptomatic group was (29.5±5.3)mmol/L,(43.2±13.8)×106/L and (189.4±25.1)mm Hg,respectively,which were significantly higher than those of the asymptomatic group,the difference between the two groups was significant(P＜0.05);In the symptomatic group,27 cases were with the level of cerebrospinal fluid protein ＞50 mg/dl,28 cases with white blood cell count in the cerebrospinal fluid ＞5/mm3, 45 cases with positive serum RPR,45 cases with positive cerebrospinal fluid RPR,all were higher than those in the asymptomatic group,the difference between the two groups was significant(P＜0.05);In the symptomatic group,the symptoms of 95.6% of the patients after the treatment were improved;in the asymptomatic group,the symptoms of 97.4% of the patients were improved after the treatment,there was no significant difference between the two groups(P＜0.05). Conclusion The blood and cerebrospinal fluid indicators are helpful for the diagnosis of neurosyphilis.The penicillin is effective for neurosyphilis,worthy of popularizing in clinical practice.
The effect observation of shoulder joint axial stretching method in treatment of 38 cases of periarthritis of shoulder
WANG Yong-gang
2016, 14(2): 235-237. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.024
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Objective To observe the effect of shoulder joint axial stretching method on treatment of 76 cases of periarthritis of shoulder and to explore its clinical value. Methods Seventy-six cases with periarthritis of shoulder treated in the hospital from March 2014 to June 2015 were selected as the research objects and all patients conformed to consent and basic requirements of ethics committee and the requirements of periarthritis of shoulder diagnostic criteria.Then according to paired grouping method they were divided into two groups，38 cases in each group.The control group adopted the traditional massage therapy while observation group adopt shoulder axial pull stretch therapy,shaking method for treatment,two groups were treated 5 times/week and 2 weeks for a course of treatment,all accepted two courses of treatment,to compare two groups of curative effect. Results The observation group had 13 cases(34.2%) cured,19 cases(50.0%) were markedly effective,5 cases(13.2%) in effective,1 case(13.2%) in vain,and total effective rate of observation group was 97.4%(37 cases)，it was significantly higher than the control group.5 cases(13.2%) were cured,10 cases(39.5%) were markedly effective,15 cases(39.5%) in effective,8 cases(21.1%) were ineffective in the control group,the total effective rate was 78.9%(30 cases),the difference was statistically significant,P＜0.05.The scores of VAS in observation group were 4.6±0.7 and 2.1±0.6 after 2 courses of treatment and were significantly lower than those in control group(5.8±0.8,3.2±0.5),and the difference was statistically significant,P＜0.05.Before treatment there was not statistically significant in the pain,function and activity between two groups,P＞0.05.After treatment the pain,function and activity of the observation group were 25.2±3.5,16.9±1.6,21.4±3.2 and were significantly better than those of the control group(20.3±4.1,14.7±1.2,17.4±3.1),P＜0.05. Conclusion The effect of shoulder joint axial stretching method in treatment of 76 cases of periarthritis of shoulder is better,pain,function and activity were improved,so it has important clinical value.
Clinical effect of Docetaxel combined Nedaplatin synchronous with intensity modulated conformal radiotherapy on patients with locally advanced nasopharyngeal carcinoma
CHEN Ming-cong, XU Zhen-qian, WU Hai-bo, GUO Ya-feng, LIU Shu-xun
2016, 14(2): 238-239,269. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.025
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Objective To investigate clinical effect of Docetaxel combined Nedaplatin synchronous with intensity modulated conformal radiotherapy on patients with locally advanced nasopharyngeal carcinoma,to provide a reference for clinical treatment. Methods From June 2011 to June 2014,42 cases of locally advanced nasopharyngeal carcinoma patients were selected,and divided into observation group and control group according to the digital table (21 cases in each group).There were 14 males and 7 females in control group, mean age of (52.77±6.11)years,15 males and 6 females in observation group,mean age of (53.15±5.47) years.The control group used 5-FU and docetaxel Synchronous stressed conformal radiation therapy,the observation group used nedaplatin docetaxel Synchronous stressed conformal radiation therapy,the recent remission rate after treatment,toxicity,nose pharynx gross tumor volume reduction rate were compared. Results In observation group,complete remission rate71.43% was better than the control group (66.67%),but difference was not statistically significant(χ2=0.922，P=0.185);in observation group before and after chemotherapy nasopharyngeal gross tumor target volume respectively were (49.21±6.15)cm3,(36.14±5.07)cm3,volume reduction was 26.56%,no statistically significant difference(P＞0.05);in observation group nausea or vomiting,neutropenia,loss of appetite,bloating Ⅲ-Ⅳ degree incidence were significantly lower than the control group,the difference was statistically significant(P＜0.05). Conclusion Docetaxel combined Nedaplatin synchronous with intensity modulated conformal radiotherapy has significant effect on locally advanced nasopharyngeal with little side effects,be worthy of clinical application.
Multiple factor analysis of the efficacy of standard antiviral therapy in patients with chronic hepatitis C
ZHOU Ming-qin, JIANG Su-wen, HU Ai-rong, HU Yao-ren, DING Shi-xiong, LIANG Xiao-yue
2016, 14(2): 240-242. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.026
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Objective To investigate the influencing factors of the efficacy on virologic response of the standard antiviral therapy in patients with chronic hepatitis C(CHC) and to provide a reference value for clinical treatment. Methods The data of 97 patients with CHC were analyzed retrospectively.The conditions of hepatitis C virus(HCV) genotypes,HCV RNA,and rs8099917 genotypes in interieukin-28B(IL-28B) gene were determined,respectively.The patients were all given the standard antiviral therapy.The influencing factors of rapid virological response(RVR),early virological response(EVR),end-of-treatment virological response(ETVR) and sustained virological response(SVR) were compared and analyzed,respectively. Results The RVR,EVR,ETVR and SVR rates were significant differences in HCV genotype 1 group and in HCV non-genotype 1 group,in rs8099917 genotype TT group and in rs8099917 genotype GT+GG group,respectively(χ2=9.359,11.440,6.346,8.147,9.938,7.413,4.564,4.229;P＜0.05).The independent impact factors of RVR were HCV non-genotype 1,high levels of ALT and AST,low HCV RNA level,and rs8099917 genotype TT;of EVR were HCV non-genotype 1 and low HCV RNA level;of ETVR was high ALT level;and of SVR were HCV non-genotype 1,high ALT level,and rs8099917 genotype TT. Conclusion HCV non-genotype 1,high ALT level,and rs8099917 genotype TT are important favorable factors for SVR in patients with CHC.
The value of BNP combined with central venous pressure in evaluating volume and cardiac function in patients with hemofiltration
WAN Mei-yan, HAN Kun, CUI Yong-jun
2016, 14(2): 243-244,312. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.027
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Objective To explore the value of brain natriuretic peptide(BNP) combined with central venous pressure(CVP) in evaluating volume and cardiac structure and function in uremic patients with hemofiltration(HF). Methods Thirty-six uremic patients with hemofiltration were enrolled.According to hemofiltration,the patients were divided into 2 groups:B(Before) group and A(After) group.When the cardiac function of uremic patients with hemofiltration was from level Ⅳ to level Ⅲ or level Ⅱ,the volume status of the patients was appropriate.Some laboratory parameters and BNP were detected in all patients.All patients were measured by echocardiography for cardiac structure and function.The CVP of the two groups were measured.The clinical data,laboratory parameters and cardiac ultrasound parameters were compared between B and A group.All data were analyzed with statistical software SPSS 17.0. Results Although the values of BNP in uremic patients were significantly decreased after hemofiltration(t=6.494，P＜0.01),they were still higher than normal.The difference of interventricular septum thickness,left ventricular posterior wall thickness and left ventricular ejection fraction between B and A group were significant(t=2.131-2.591，P=0.037-0.012).The difference of CVP between B group and A group were significant(t=11.589，P＜0.01). Conclusion BNP combined with CVP can accurately evaluate the volume status and cardiac structure and function in uremic patients.The values of BNP in uremic patients were high,and it was related to left ventricular hypertrophy.
Maintenance hemodialysis patients with atherosclerosis and the relationship between chlamydia pneumonia
LIU Luo-jin, WEI Xing, CENG Ping
2016, 14(2): 245-247. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.028
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Objective To observe hemodialysis patients with atherosclerosis occurs Chlamydia pneumoniae infection,and to explore the risk of cardiovascular disease in hemodialysis patients predict new targets. Methods 300 cases of continuous hemodialysis patients in the observation group,select the same period,50 cases of non-inflammatory diseases and healthy arteriosclerotic disease as a control group,were Cpn-IgG by ELISA,Cpn-IgA,Cpn-IgM detection,color Doppler ultrasonography were examined diastolic carotid bifurcation 1 cm away from the department and the common carotid artery intima-media thickness (IMT) and plaque,simultaneously CRP,IL-6 testing,antibody testing were compared Cpn results and Cpn-IgG,Cpn-IgA,IgM titers distribution,inflammatory markers and IMT results vary. Results The study group Cpn antibody positive rate was 63.0%,34.0% higher,and its IgG antibody geometric mean titer higher,Cpn-IgG,Cpn-IgA titers have been distributed statistically significant (P＜0.05),the observation group were higher CRP and IL-6 in the results,which Cpn antibody-positive patients in the CRP and IL-6 were higher than patients with negative results,the observation group Cpn antibody positive IMT higher than Cpn antibody negative, the difference was statistically significant (P＜0.05). Conclusions Chlamydia pneumoniae infection may be one of the risk factors of maintaining hemodialysis patients and atherosclerosis progression occurs regularly in patients with Chlamydia pneumoniae serology,understand infection in hemodialysis patients,clinicians whether for hemodialysis patients antibiotics given the appropriate antibiotic therapy to reduce the incidence of atherosclerosis provide a theoretical basis to improve the ability of clinicians to predict the risk of cardiovascular disease in hemodialysis patients,and to further improve the maintenance of the quality of life in hemodialysis patients.
Correlation of fractional exhaled nitric oxide with peripheral blood eosinophilis and lung function in asthmatic children
LI Quan-heng, LI Jin-ying, TIAN Wen-qiu, ZHANG Lei, DONG Wei-ran, AN Shu-hua
2016, 14(2): 248-250. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.029
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Objective To explore the level of fractional exhaled nitric oxide(FeNO) in asthmatic children aged 6 year old and above,and its correlation with age,peripheral blood eosinophilia count(EOS%),FEV1% and FEV1/FVC. Methods A total of 70 asthmatic children(age≥6 years) were enrolled and divided into acute exacerbation group and remission group with 21 healthy children as controls.Lung function,FeNO and EOS were measured for all children. Results ①There was no statistical differences in FeNO and EOS between acute exacerbation group and remission group(P＞0.05),and there was significant statistical differences between asthmatic children and healthy children(P＜0.05).FEV1% and FEV1/FVC among acute exacerbation group,remission group and control group were different(P＜0.05),and FEV1% and FEV1/FVC in the remission group were different from the control group(P＞0.05).②FeNO had positive relationship with age(r=0.259,P＜0.05) and EOS% (r=0.151,P＜0.05),and had negative relationship with FEV1/FVC (r=-0.151,P＜0.05),and had no correlation with FEV1/FVC(r=-0.12,P＞0.05). Conclusion FeNO can stand for the levels of eosinophilic inflammation.It is helpful for early diagnosis about asthma through FeNO and FEV1/FVC,but age could be taken into account.
Correlation between serum testosterone and age with metabolic syndrome in women
WAN Hui-qing, CAI Yu-qun, LI Wei, GUO Qiao-zhen, ZHOU Jian-hong
2016, 14(2): 251-253. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.030
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Objective To investigate the relationship between the serum testosterone levels and age with the risk of metabolic syndrome. Methods A total of 485 female aged 40-65 years from Gongshu District Family Planning Publicity and Technical Guidance Station in Hangzhou City from January to June in 2014 were enrolled into this study.Testosterone levels were determined by automated chemiluminescent method.According to testosterone levels,they were divided into 4 groups,group A(0-0.40 nmol/L,n=158),group B(＞0.40-0.60 nmol/L,n=106) and group C(＞0.60-0.90 nmol/L,n=102) and group D(＞0.90-2.80 nmol/L,n=119).The correlation of serum testosterone with metabolic syndrome was analyzed by multivariate Logistic regression analysis using SPSS 16.0. Results Of 485 women,105 cases were with metabolic syndrome,the total rate of metabolic syndrome was 21.6%.The rate of metabolic syndrome in groups A,B,C and D was 29.1%,23.6%,12.7% and 17.6%,respectively.The rate of metabolic syndrome in serum testosterone levels in women was significant differences(χ2=11.316,P=0.010).Logistic regression analysis showed that,after adjusting for age,the risk of metabolic syndrome declined with serum testosterone levels rising(OR=0.780,95%CI:0.642-0.948). Conclusion Low levels of testosterone may be a potential risk factors for metabolic syndrome.
CHEN Shuang-hua, DAI Yu-xuan
2016, 14(2): 254-255,260. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.031
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Multiple penetration of nursing humanities education in community nursing education
TIAN Yu-mei
2016, 14(2): 256-257,281. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.033
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Objective To cultivate the community nursing talents with scientific literacy and humanistic quality. Methods According to the goal of nursing talents training of “Scientific literacy+humanities accomplishment” in our school,humanistic quality education was intergated into community nursing courses.Interview and questionnaire survey method were used to evaluate the effect of teaching reform.The evaluation form of scientific literacy and humanistic quality was used to compare the difference between the experience group and the control group.The evaluation questionnaire included 5 items,which were moral quality,cultural quality,legal quality,aesthetic quality and psychological quality. Results The teachers believe that the students’ occupation occupation morality and dedication have been improved.The students reflect the learning interest in community,Nursing students think they deeper understand the meaning and responsibility of community nursing work.The questionnaire shows that moral quality,cultural quality,psychological quality and legal quality of the experimental group were (32.27±2.91),(41.01±4.96),(21.52±3.31),and (43.28±4.71) scores，significantly better than the control group students’ moral quality,cultural quality,legal quality and psychological quality(31.08±3.64,38.97±6.73,20.16±3.91,41.71±6.08),the difference is statistically significant(P＜0.05). Conclusion The reform that nursing humanities education is permeated in teaching of community nursing,is helpful for the cultivation of community nursing talents with higher scientific literacy and humanistic quality.
Evaluation of the family doctor system service effect in rural-urban fringe from public health perspective
SUN Lan, MA Ying-zhong, ZHANG Ping, ZHAO Hui-lan
2016, 14(2): 258-260. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.034
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Objective To investigation the health knowledge and family doctors awareness of residents after implementing the doctor system in Huacao community between 2011 and 2014. Methods Twenty families in every village were sampled through cluster sampling.A self-designed questionnaire survey was conducted among 1 207 people in 2011 and 1 307 people in 2014 for the background,awareness of health knowledge,degree of satisfaction to family doctor and public health services.The unified training was performed for the investigators,and the survey was carried out in one time period. Results Four years after the implementation of the doctor system,the proportion of residents knowing their blood glucose and blood pressure levels and receiving health education and health examination was increased(P＜0.05).Residents’ awareness of family physicians was increased from 45.60% to 81.94%(P＜0.05).The rate of residents signing a service agreement with the family doctor increased from 38.94% to 79.95%(P＜0.05).97.09% of the residents established their electronic health records,72.69% of the residents will contact the family doctor to meet their health needs,and 47.82% of the residents had a contact with their family doctor in nearly a month.But the satisfaction to family doctor was only 61.82%.The public health services such as physical examination,standard management of patients with chronic diseases,immunizations,and health education provided by family doctors was also increased(P＞0.05). Conclusion The family doctor system is conducive to the implementation of basic public health services.The family physician awareness from the residents was increased,but the satisfaction was not enough.The practical medical technology that meets the health needs of residents should be developed and popularized in family doctors to improve the health level of them.
Curative effect and influence on quality of life of aripiprazole combined music therapy in treatment of schizophrenia
YANG Wei-hua
2016, 14(2): 261-263. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.035
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Objective To study the curative effect and influence on quality of life of aripiprazole combined with music therapy in the treatment of patients with schizophrenia and depression. Methods Total 170 cases of schizophrenia with depression in our hospital between January 2012 and January 2014 were recruited randomly divided into observation group and control group with 85 cases in each group.The observation group received aripiprazole combined with music therapy,while the control group received aripiprazole therapy.The positive and negative symptoms scale(PANSS),Hamilton depression scale(HAMD),clinical general impression scale(CGI-SI) and the quality of life scale score(QOL-100) between the two groups were compared before the treatment and 4,12,24 weeks after the treatment. Results The PANSS scores,negative symptom scores,positive symptom scores and general pathological score of both groups before the treatment had no significant difference(P＞0.05).PANSS scores,negative symptom scores,positive symptom scores and general pathology score for 12 weeks and 24 weeks after the treatment in the two groups as compared with before and 4 weeks after treatment was statistically significant,and the improvement in the observation group was more obvious,the comparison between the two groups with statistical significance(P＜0.05).HAMD scores and CGI-SI score in both groups before the treatment had no significant difference(P＞0.05).HAMD score in the observation group for 12 and 24 weeks after the treatment and CGI-SI score 4 weeks after the treatment were significantly better than that of the control group(P＜0.05).When compared with before treatment,the scores of both groups after the treatment were significantly better,the difference was statistically significant between groups(P＜0.05).Before the treatment,QOL-100 score had no statistically significant difference between the two groups(P＞0.05),24 weeks after the treatment the scores of both groups were all obviously improved than that before the treatment(P＜0.05),and the observation group was better than the control group(P＜0.05). Conclusion Aripiprazole combined with music therapy for patients with schizophrenia and depression is effective and can obviously improve the clinical symptoms,mental status and quality of life of patients,and is worth popularization and application in the clinical practice.
YE You-qing
2016, 14(2): 264-265. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.036
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ZHANG Xing-wen, TANG Ying, ZHANG Yi-xiong, ZHU Yi-min
2016, 14(2): 266-269. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.037
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187 0
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Genotype of OXA and Amp C Beta-lactamases in Acinetobacter baumannii in our hospital
ZHANG Ji-sheng, WANG Ying, FAN Xue-cai, WANG Yu-chao, LI Hui-ling, WANG Yong, ZHANG Xiao-li
2016, 14(2): 270-272. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.038
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Objective To discuss the distribution of carbapenem-resistant related genes(OXA and AmpC Beta-lactamases) and ISAba1 in Acinetobacter baumannii(AB) in our hospital,and provide a reasonable basis for the selection of antimicrobial drugs. Methods Clinical specimens were collected at the First Affiliated Hospital of Jiamusi University from September 2013 to September 2014.The VITEK-Ⅱ automated microbial identification/susceptibility testing machine was used to select 69 cases of A.baumannii and 16SrRNA was detected.Multiplex PCR detection method was used to identify Acinetobacter baumannii carrying carbapenem related resistant genes blaOXA-23,blaOXA-24,blaOXA-51,blaOXA-58,blaADC,blaDHA and ISAba1,and resistance genes of the positive amplified products were subjected to DNA sequence analysis. Results The selected 69 AB samples showed the resistant rate of SCF,IMP and MEM were 12.5%,36.7% and 38.5%， respectively.Sixty-six(95.7%) carrying blaOXA-51,32(46.4%)carrying blaOXA-23,53(76.8%)carrying blaADC and 34 (49.3%) carrying ISAba1.Out of 26 carbapenem resistant strains of Acinetobacter baumannii identified,22(84.6%) carried blaOXA-23,including 19 strains(73.1%) of the upstream detected ISAba1,24(92.3%) carried blaADC,including 10 strains of upstream ISAba1 detected. Conclusion The blaOXA-23 and blaADC may be responsible for the main reason of Acinetobacter baumannii carbapenem antimicrobial enzyme resistance.
Effect of prednisone on apoptosis signal pathways of T and NK cells in patients with ITP
ZHOU Guo-zhong, ZHONG Yong-gen, SUN He, YU De-bao
2016, 14(2): 273-274,297. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.039
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Objective To investigate the effect of prednisone on apoptosis signal pathways of T lymphocyte and NK lymphocyte in peripheral,from the point that prednisone could alleviate the symptom of patients with Idiopathic thrombocytopenic purpura(ITP). Methods Thirty-one incipient ITP patients were treated by prednisone for 6 months.The flow cytometry was adapted to detect molecules(CD95L,Caspase-3,and Caspase-8) on T cells and NK cells lymphocyte before and after treatment. Results Compared with the levels before treatment,the expression of CD3,NK,CD3+CD95L+,and CD3+Caspase-8+ were significantly increased(P＜0.05) and NK+Caspase-8+was significantly decreased(P＜0.05).It was positive correlation both NK+Caspase-8+and NK+Caspase-3+(P＜0.01),and NK+Caspase-3+was positively correlated with NK+CD 95L+(P＜0.01),it showed that Caspase and Fas-FasL were associated with apoptosis pathway on NK cells.It was positive correlation both CD3+Caspase-8+and NK+Caspase-8+(P＜0.01),it showed that T lymphocyte start with NK cells apoptosis process. Conclusion Prednisone may regulate apoptosis signal pathway (CD95L,Caspase-3,and Caspase-8)mediated by T and NK lymphocyte to alleviate the symptom of patients,which can be used as a reference for clinical treatment.
Change in antimicrobial resistance of enterobacteriaceae from 2012 to 2014 in a teaching hospital
KANG Hai-quan, DENG Li-hua, JIANG Fei, ZHAO Xiao-jie, MA Ping, GU Bing
2016, 14(2): 275-278. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.040
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Objective To investigate the trend of specimen source，distribution and antimicrobial agents resistance of Enterobacteriaceae from 2012 to 2014. Methods Enterobacteriaceae isolated from a affiliated hospital of a Medical College were identified by BD Phoenix.and the data were judged with CLSI2013 and analyzed with WHONET5.6. Results A total of 9 031 strains of Enterobacteriaceae were collected,and mainly come from the ICU,neurology,neurosurgery,urology,and respiratory department，and mainly come from specimens of sputum,urine,blood.Secretion,ascites and cerebrospinal fluid.The strains mainly included Klebsiella pneumoniae,Escherichia coli,Proteus mirabilis,Enterobacter cloacae,Serratia marcescens and Enterobacter aerogenes.The strains showed high sensitivity ratio for carbapenems,enzyme inhibitor and amino glycosides. Conclusion Enterobacteriaceaes were mainly pathogen in the hospital,and expressed high resistance for most antibiotics. Carbapenems were still the optimum selection for control infections of Enterobacteriaceae,but Carbapenem-Resistant Enterobacteriaceae(CRE) already appeared increasingly.Clinicians should pay attention to CRE and promote the rational use of antimicrobial agents to avoid the spread of CRE in hospital.
CHEN Xue-fang
2016, 14(2): 279-281. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.041
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248 2
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FU Liu, WANG Zhi-rong
2016, 14(2): 282-284. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.042
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ZHANG Xu-hao, LI Shuang, AN Bei-ying, GUAN Yi, ZHU Shan, CHEN Jing-tao
2016, 14(2): 285-287,327. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.043
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241 1
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YIN Xiao-long, LI Yan-hua
2016, 14(2): 288-290. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.044
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LI Dun-ling
2016, 14(2): 291-293. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.045
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188 1
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CUI Huai-ren, ZHANG Heng
2016, 14(2): 294-297. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.046
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Effect of warming needle moxibustion on gastrointestinal hormone of diabetic gastroparesis patients
GE Jia-yi, JIANG Yue-wei, WANG Dong-yu, ZHENG Shi-li, LIU Peng-cheng, LIN Shang-zhu
2016, 14(2): 298-299,316. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.047
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Objective At present many reports use acupuncture for treatment of diabetic gastroparesis,but most reports only summarize the clinical efficacy,and explore the mechanism of acupuncture for the treatment of the disease is still small,lack of treatment results and persuasive repeat ability.This study evaluated the efficacy and provide ideas for warm acupuncture therapy of diabetic gastroparesis by acupuncture study the effect of temperature on patients with diabetic gastroparesis gastrointestinal hormones. Methods One hundred patients were randomly divided into two groups. In treatment group,50 patients were given warm acupuncture treatment,1 day,5 times a course of treatment,complete a course of treatment every two days of rest;in the control group,50 cases were treated with domperidone 10 mg treatment,orally 30 min before meals,three times a day,the two groups were treated for 4 weeks,clinical efficacy,changes in gastrointestinal hormones before and after treatment,a small strip in the stomach residual barium situation. Results The total effective rate was 78.00% in the control group,total effective rate was 98.00% in treatment group,has a statistically significant(P＜0.05).Group 2 overall symptom score after treatment,a small residual barium strip in front of the stomach,the gastrointestinal hormone therapy with the same group,the difference was statistically significant(P＜0.05).After treatment,the overall symptom score,a small residual barium strip in the stomach,the gastrointestinal hormone levels compared with control group,the differences were statistically significant(t values were 11.02,13.23,16.27,15.81,P＜0.05). Conclusion Warm Acupuncture is an effective method for treatment of diabetic gastroparesis,improve gastric motility significant effect,its mechanism may be decreasing gastrointestinal hormone levels of patients. Acupuncture provides a guideline for the warm treatment of diabetic gastroparesis treatment mechanism.
Analysis based on TCM body constitution theory on risk factors for cerebral artery stenosis in patients with ischemic cerebrovascular disease
QIU Xiao-qiong, YANG Jun, LU Chuan, HUANG Guo-qing, YU Jun
2016, 14(2): 300-302. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.048
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Objective To study the correlation between cerebral arterial stenosis and TCM body constitution in patients with ischemic cerebrovascular disease(ICVD). Methods We conducted a questionnaire survey among 297 patients with ICVD by using the standard of TCM body constitution theory.All the patients underwent aortic archand cerebral angiography.The method of binaryLogistic regression analysis was applied.For the cerebral arterial stenosis,binary variable was taken as dependent variable.The independent variables included TCM constitution,age,BMI,gender,hypertension,diabetes,dyslipidemia,smoking,drinking. Results Of the 297 patients,238 patients were with cerebral arterial stenosis,59 patients without stenosis.Logistic regression showed that phlegm-dampness constitution(OR=5.028，95%CI 1.924-13.145，P=0.001),blood stasis constitution(OR=7.689，95%CI 1.626-36.361，P=0.010),age(OR=4.348，95%CI 1.990-9.498，P＜0.001),the histories of hypertension(OR=5.860，95%CI 1.210-28.323，P=0.028),diabetes(OR=7.041，95%CI 2.916-17.002，P＜0.001),dyslipidemia(OR=3.295，95%CI 1.440-7.539，P=0.005)and smoking(OR=4.341，95%CI 1.829-10.299，P=0.001)were the independent risk factors for the cerebral artery stenosis. Conclusion TCM body constitution was associated with cerebral artery stenosis in patients with ICVD.The analysis of risk factors for the cerebral arterial stenosis should be combined with TCM body constitution theory.
Clinical observation of filiform needle acupuncture combined with rehabilitation therapy in the treatment of lumbar disc herniation
LI Jiao-jiao, CHEN Li-qiu, ZHU Xun-bing
2016, 14(2): 303-306. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.049
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Objective To investigate the clinical efficacy of filiform needle acupuncture combined with rehabilitation therapy in the treatment of lumbar disc herniation. Methods Between February 2014 and April 2015,80 cases of lumbar disc herniation in our department were randomly divided into treatment group(41 cases) and control group(39 cases).The treatment group was given filiform needle acupuncture and rehabilitation therapy simultaneously,while the control group was given conventional acupuncture.After 2 periods of treatment,the effective rate and JOA scores before and after treatment in both groups were analyzed statistically.The measurement data were compared with t test,two proportions was compared using χ2 Test. Results Before the treatment,the JOA score of the treatment group was (17.17±2.11) and of the control group was (16.76±2.72);after 2 periods of treatment,were (23.95±2.75) and (21.82±3.14) in the two groups,respectively.The JOA scores were significantly increased in the treatment group after the treatment and significantly higher than that in the control group,the difference was statistically significant(P＜0.05).The clinical effective rate of the treatment group was 92.68%,better than that of control group(76.92%),and the difference between of two groups was statistically significant(P＜0.05). Conclusion Filiform needle acupuncture combined with rehabilitation therapy in the treatment of lumbar disc herniation is easy to observe,with low cost,little pain and satisfied clinical curative effect.It is a new method for the effective treatment of lumbar disc herniation,and worthy of clinical promotion and research.
Clinic effect of Bushenhuoxuetiaojing decoction in treatment of 40 cases of polycystic ovary syndrome
ZHENG Xiao-ping
2016, 14(2): 307-308,335. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.050
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Objective To investigate the clinical effect of Bushen Huoxue Tiaojing Decoction in the treatment of polycystic ovary syndrome(PCOS),and provide guidance for the clinical medication. Methods The clinical data of 75 PCOS in our hospital between March 2013 and February 2015 were reviewed.The patients were randomly divided into observation group and control group according to hospital admission orders.35 cases in the control group was given spironolactone tablets 40 mg,2 times/d,continuous administration for 20 d;Metformin tablets 0.5 g,3 times/d,to stop when normal ovulation;Clomiphene capsule 50 mg/d,5 d;Vitamin C 200 mg,3 times/d,20 d.While 40 cases in the observation group,on the base of treatment in the control group,was given Bushen Huoxue Tiaojing decoction,twice a day,taking it in morning and evening.Since the 7th day of the menstrual cycle,continuous administration for 3 d and discontinuance phase for 1d as one course,total 3 courses.The therapeutic effect,changes in uterine blood flow and hormone levels were compared between the two groups. Results The total effective rate in the observation group was 92.5% and in the control group was 71.4%,the difference was significant(P＜0.01);The follicular maturation rate,restoration of ovulation,pregnancy rate in the observation group were significantly better as compared with the control group(P＜0.05);After the treatment,The levels of LH,T,LH/FSH,RI and PI in observation group were significantly improved,and is superior to the results in the control group(P＜0.05). Conclusion Bushen Huoxue Tiaojing decoction is effective in the treatment of polycystic ovary syndrome(PCOS),it can improve the blood perfusion in uterine and ovary,regulate hormone levels,profit ovulation,and improve pregnancy rate.
Application of PBL mode integrated with medical dispute case analysis in orthopedic clinical teaching
ZHAO Zhi, WU Min, GUAN Jian-zhong, ZHU Zhong-lian, CUI Ning-ning
2016, 14(2): 309-312. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.051
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Objective To adopt the clinical typical case analysis of medical disputes combined PBL in orthopedic clinical teaching,and investigate the feasibility and practical effect of this teaching method,and the influences on the learning strategies,motivation,academic record of student. Methods Total 84 clinical medicine undergraduate students practiced in our department from 2012 to 2013 were assigned into study group and control group.The study group received PBL combined with clinical typical case analysis of medical disputes,while the control group received conventional teaching methods.After the clinical practice teaching,the test scores were used to evaluate teaching achievements.The questionnaires were employed to assess the learning attitude and acceptance. Results The score in the study group was significantly higher than that in the control group.PBL model combined with medical dispute case analysis stimulated the interest of students in learning and their desire for knowledge,and improved the ability of students to analyze and solve clinical problems and skills of doctor-patient communication,train their of awareness of prevention of medical disputes and creative thinking. Conclusion Hot spots of college teaching reform is the reform of teaching methods,the purpose of reformation is to improve the students’ ability in clinical practice,comprehensive knowledge and self-learning.PBL combined with clinical typical case analysis of medical disputes is based on case teaching principles,emphasize on the learning in a meaningful context,which meet the laws of learning,help students develop the ability in clinical practice,also promote the growth of knowledge to improve student discipline and self-learning ability.This method has achieved good clinical teaching effectiveness,and is well received by students.The penetration of medical disputes prevention education for students in clinical practice together with the professional knowledge education will help the students to decrease the medical disputes in their works.It is worth application and promotion in the surgical teaching and clinical teaching.
Evaluation on emergency rescue education for pupils
HUANG Yan, XU Qin-ying, GE Jia-feng, XU Zu-fang
2016, 14(2): 313-316. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.052
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Objective To study the different effect of education on emergency knowledge on children in different grades,and to explore the efficient training methods and time,so that to provide reference for the future studies. Methods The study was conducted between March and November in 2014.All the pupils in grades one to five were collected from The Third Primary School in Hongkou District of Shanghai,and a total of 2 010 pupils were included as study samples.A combination of training and knowledge education was applied within each class.The evaluation was conducted via questionnaire before and after the training program.Data analysis was performed in excel 2010,mainly with descriptive analysis method,and the difference test with chi-square test,in which P＜0.01 was considered statistically significant. Results Before the training program,a significant difference on emergency knowledge could be found between pupils from different grades(P＜0.01),and compared to high-grade students,low-grade ones showed more serious lack of knowledge of the emergency situation.After training,all grades of primary school students made correct answer rate more than 50%,and the correct answer rate was not significantly different among different grades of primary school students(P＞0.01).comparison the before with the after,students of all grades of questions answered correctly rate got greatly improved,in which low-grade pupils got the largest improved in ways to deal with epistaxis,common sense of safe escape from earthquake and other aspects. Conclusion Students in different grades showed different abilities in knowledge absorption of emergency rescue,and low-grade pupils got better improved than high-grade ones,which prompted emergency rescue education should be undertaken as soon as possible.In this study,although there are some design deficiencies,it still could be a certain reference for follow-up related work.
Perioperative care of patients undergoing percutaneous transforaminal endoscopic discectomy
YANG Yan, SUN Yun, LI Rui, YANG Fang, YANG Qiao-hui, XUE Wei-gao, BIAN Na, MA Qiong, HAN Kang
2016, 14(2): 317-319. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.053
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Objective To observe and summarize nursing methods,characteristics and matters of patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy. Methods The clinical data and nursing methods were retrospectively analyzed of the 182 cases of patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy from January 2011 to January 2014.The pain,anxiety and the quality of life improved were observed and compared.In the preoperative,intraoperative and postoperative,respectively,psychological nursing,radiation protection and functional exercise were given. Results The group of 182 patients,168 patients recovered well after surgery,and 2 patients with infection of incision,9 patients with postoperative recurrence,1 patient with nerve damage,2 patients with spinal instability.Patients with postoperative pain index(2.82±0.86) and anxiety index (38.15±8.00) were improved significantly compared with the previous (6.81±1.03;59.45±6.60),P＜0.01.In terms of quality of survival,in eight indexes such as physiological function,there were clear improved after operation. Conclusion Correct and effective perioperative care such as psychological nursing,radiation protection and functional exercise play a significant role in the treatment process of patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy which should be further promoted and used in clinical work.
Effect of post discharge nursing intervention on quality of life of patients with coronary stent implantation
ZHAO Yong-ping
2016, 14(2): 320-322. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.054
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Objective To study the effect of post discharge nursing intervention on the nursing quality and quality of life of patients with coronary stent implantation. Methods One hundred and twenty patients with coronary disease undergoing PCI in our hospital between July 2014 and July 2015 were enrolled and randomly assigned into experimental group and control group with 60 cases in each group.The experimental group received the strengthened post discharge nursing intervention,including establishing the special nursing intervention management team outside the hospital and providing sustained health education guidance,psychological guidance,medication guidance and dietary guidance;while the control group received the conventional nursing intervention by random access.All patients were followed up for 1 year and were investigated by questionnaire. The gender,average age,medical history,complications,and the incidence rate of target blood vessel formation,re-hospitalization,rate of adverse events,behavior of self-management and nursing satisfaction were compared between the two groups. Results The re-hospitalization rate,myocardial infarction and other adverse events rate in the control group were higher than those in the experimental group,the difference was statistically significant(χ2=16.752,P＜0.05);the post discharge self-nursing ability scores in each dimension were lower in the control group than those in the experimental group,the difference was statistically significant(t=7.974,P＜0.05);the total nursing satisfaction rate in the control group was 86.21%,which was significantly lower than 98.31% in the experimental group,the difference was statistically significant(χ2=5.926,P＜0.05). Conclusion The method of strengthening post discharge nursing intervention can decrease the risk of adverse cardiac events,improve the subjective activity,post discharge quality of nursing care and quality of life of patients undergoing PCI.It’s worthy to be popularized.
Clinical value of improved nursing care on patients with coronary stent implantation
JIN Hui-xian
2016, 14(2): 323-325. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.055
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Objective To analyze perioperative improved nursing care on patients’ anxiety and fear,intraoperative and postoperative complications in patients with coronary stent implantation. Methods Thirty-four patients of coronary stent implantation admitted in hospital between August 2013 and July 2014 were selected as control group,and received regular nursing intervention;the other patients of coronary stent implantation admitted in hospital from August 2014 to July 2015 were selected as observation group,which received improved nursing care.The preoperative Self-Rating Anxiety Scale(SAS) score,the complications incidence during and post surgery and nursing satisfaction between two groups were compared.The SAS score are expressed as the mean±SD,and were analyzed using SPSS 17.0.Student’s t test was used to compare complications incidence during and post surgery and nursing satisfaction.A level of P＜0.05 was considered statistically significant. Results The preoperative SAS score in the observation group was 46.17±10.15,which was significantly lower than that of the control group(60.08±10.62),the nursing satisfaction of the observation group was 97.06%,which was significantly higher than that of control group(73.53%),the difference statistically significant(P＜0.05);Compared with the control group,the intraoperative complications,including elevated blood pressure,vagal reflex,radial artery spasm,hypotension,arrhythmia and sinus tachycardia in the observation group was notable lower(P＜0.05),and postoperative complications,including serious cardiac arrhythmias,hemorrhage,acute radial artery occlusion,hypotension,in the observation group was notable lower(P＜0.05). Conclusion The improved nursing care can relief patient’s anxiety and fear,reduce the incidence of intraoperative and postoperative complications in coronary stent implantation,which is benefits for patient’s physical rehabilitation.
YU Zhi-hai, CHENG Ke, WANG Hai-tao
2016, 14(2): 326-327. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.056
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NIE Han-qiu
2016, 14(2): 328-329,330. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.057
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XU Hong-ming, YANG Hai-jun, GUO Wen-hao, YOU Xin, LIAO Zheng-yin
2016, 14(2): 330-332. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.058
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CHEN Yan
2016, 14(2): 333-335. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.059
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HUANG Yi-ling, ZHANG Jia-kun, ZHANG Ri-yuan, QUE Ri-sheng
2016, 14(2): 336-338. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.060
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MA Can-chen, XU Sheng-qian, GONG Xun, WU Ying, QI Shan, LIU Wen, XU Jian-hua
2016, 14(2): 339-340. doi: 10.16766/j.cnki.issn.1674-4152.2016.02.061
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