中华全科医学

Trend analysis of health level of Chinese population and policy proposal——big data analytics in healthcare

BAO Yong, LU Dan-ni, DING Yu-fei

2016, 14(4): 515-517,523. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.001

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Objective To describe the trend and characteristic of two week prevalence and morbidity Rate of chronic diseases in China from 1998 to 2013,so as to provide the basis for the policy making. Methods The descriptive analysis and linear regression analysis were conducted to study the health-related data from 1998 to 2013 in China. Results The survey results showed an overall upward trend in two weeks prevalence and morbidity rate of chronic diseases among the samples.The rise of chronic diseases in China mainly includes two aspects. One is the influence of population aging due to the increase in life expectancy and the age structure of the population from the “adult” to “old” sharp transition.This leaded to the rising of morbidity rate of age-related diseases. Conclusion Based on the above analysis,some suggestions are put forward:①The government should increase health the investment in medical and public health services and improve rural medical level,reduce the gap between urban and rural residents.②According to the current hygienic status in China,some elements with urban and rural characteristics,such as rural community health services focusing on the prevention and treatment of respiratory system and digestive system diseases,dissemination of good eating habits and control of tobacco should be added;The urban community health service should pay more attentions to the diet control and three controls.③To further promote chronic disease prevention and control.

KONG Hui, DOU Peng-fei

2016, 14(4): 518-519.

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Effects of thoracic sympathetic modulation on postoperative sympathetic arousal level and T lymphocyte subsets of patients with primary palmar hyperhidrosis

FEI Yong, HUANG Bing, YAO Ming, GUO Jian-guo, NI Hua-dong, LING Chen, WANG Han-qi, XU Shi-jie

2016, 14(4): 520-523. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.002

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Objective To investigate the effects of thoracic sympathetic modulation on the therapy efficacy,postoperativesympathetic arousal level and T lymphocyte subsets in patients with primary palmar hyperhidrosis. Methods From July 2014 to September 2015,40 patients with primary palmar hyperhidrosis who were prepared for thoracic thoracic sympathectomy(Group P) and 30 outpatient healthy volunteers(Group C) were recruited in the First Hospital of Jiaxing.The venous blood samples were prepared before the operation(T0),10 minutes,24 h,48 h,72 h after the operation(T1,T2,T3,T4) at Group P,while before the operation(T0) at Group C,for determination of plasma cortisol,epinephrine,norepinephrine,T-lymphocyte subsets and CD4⁺/CD8⁺ ratio. Results In group P,Oximetry-derived perfusion index raised(8.70±1.10) times and the average temperature of hands raised(2.92±0.86)℃ times,and the symptoms of hyperhidrosis disappeared in both hands.All of the patients with palmar hyperhidrosis were cured within 6 months,and the recurrence rate within 1 year was 7.5%(3/40).There was no severe complication.Theplasma levels of cortisol,epinephrine and norepinephrine at T1,T2,T3 and T4 were significantly decreased after the treatment in the group P(P<0.05),but not in the group C(P>0.05).CD3⁺,CD4⁺ and CD4⁺/CD8⁺ at T1,T2,T3 and T4were significantly increased,while CD8⁺ significantly decreased after the treatment in the group P(P<0.05),but not in the group C(P>0.05). Conclusion Thoracic sympathetic modulation may reduce postoperativesympathetic arousal and improve cellular immune function of patients.

Clinical research of blood lipids in primary sjogren's syndrome

LI Ju, TANG Feng-ying, WANG Lian, PAN Wen-you

2016, 14(4): 524-526. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.003

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Objective To investigate the changes of serum lipids and risk factors in primary Sjogren’s syndrome(pSS). Methods By retrospective analysis,weinvestigated 81 primary Sjogren’s syndrome patients who accepted the first treatment in our hospital and 78 healthy controls.The level of serum triglyceride(TG),total cholesterol(TC),high density lipoprotein-cholesterol(HDL-c),low density lipoprotein-cholesterol (LDL-c),immunoglobulin(Ig),erythrocyte sedimentationrate(ESR) and C-reaction protein(CRP) were determined.pSS patients were divided into hyperlipidaemia group and non-hyperlipidaemiagroup,Comparison of these data between groups was analyzed by SPSS 18.0.The corrections between variables were also analyzed. Results There was no significant difference in serum TC,TG,HDL-c,LDL-c,and blood glucose between PSS patients and normal controls(P>0.05).In dyslipidemia group of pSS patients,the positive rates of ANA,RF,and hypergammaglobulinemia were 69.35%,40.74%，23.46%,which was compared with a normal blood lipid group in pSS,there was no statistically significant difference(P>0.05).The rate of elevated serum lipid in PSS was 76.54%.Spearman’s correlation test demonstrated that HDL-c levels correlated negatively with ESR of pSS(r=-0.37，P=0.03).There was no significantly correlated between ESR and TC,TG,LDL-c(P>0.05).The levels of serum CRP was not significantly correlated with TG、TC、HDL-c and LDL-c(P>0.05). Conclusion The incidence of dyslipidemia in pSS patients is 76.54%，which are associated with higher levels of ESR,suggesting a high risk of cardiovascular disease.

Clinical study of oxycodone hydrochloride on the prevention of emergency delirium in older patients undergoing esophagectomy

LIU Yang, PAN Tian, YU Liang, HUANG Hui-lian, WANG Wei-xing

2016, 14(4): 527-529,558. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.004

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Objective To evaluate the effect oxycodone hydrochloride on the prevention of emergency delirium in older patients undergoing esophagectomy after general anesthesia. Methods Sixty ASAⅠ-Ⅲ patients,age≥60 years old,received general anesthesia and OLV using left double-lumen endotracheal tube undergoing esophagectomy,were randomly divided into group O(n=30) and group S(n=30),patients were assigned to give intravenous oxycodone 0.07 mg/kg,while sufentanil 0.15 μg/kg(equal volume of normal saline)15 min before the end of the operation.Records were made on the recovery time of autonomous respiration,called eye opening time,extubation time during recovery period.The incidence and severity of the VAS and the SAS were observed and recorded in the PACU,at arrival,5,15,30,50 and 60 min.Adverse reactions of patients and emergency delirium were observed. Results Compared with group S of patients the incidence of emergency delirium and drowsiness significantly lower(P＜0.05);VAS score,Riker SAS score,decreased significantly in group O(P＜0.05). Conclusion Oxycodone can reduce the emergency delirium during recovery period in older patients undergoing esophagectomy after general anesthesia.

Expression of serum cytokines in patients with acute cerebral infarction detected by antibody chip

WANG Bin-da, ZHANG Ya-ping, LIU Chun-yan, TANG Wei-guo, HE Song-bin

2016, 14(4): 530-532. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.005

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Objective To analyse the expression of cytokines in serum from patients who are in the different periods of acute cerebral infarction by the cytokines antibody chip technology. Methods Fourty cases of acute cerebral infarction patients were collected,according to different onset time,divided into five groups,2 hours,4 hours,6 hours,24 hours and 72 hours,8 cases in each group.In addition, 8 healthy cases were used as controls.Apply cytokines antibody chip technology to detect 60 kinds of cytokines in serum. Results Compared with healthy controls,the expression of cytokines in blood spectrum of cerebral infarction patients has changed significantly.①There are 15 kinds of cytokines generally appears as a high level,including:IL-1β,IL-1ra,IL-2,IL-5,IL-6,IL-7,IL-10,IL-15,IL-16,GM-CSF,M-CSF,TNF-α,LIGHT,GDNF,Leptin and so on.Among them,some are higher in the early cerebral infarction incidence,including:IL-6,IL-7,IL-10.Otherwise some express more in late than early,including:IL-5，GM-CSF.Some are particularly high in one specific period of cerebral infarction,including:IL-5,IL-3,IL-15,MCP-4.② There are 9 kinds of cytokines expressing lower level,including:BMP-4,Eotaxin-3,IGFBP-3,IGFBP-4,GCP-2,I-309,MCP-1,RANTES,CNTF. Conclusion The cytokines may directly or indirectly involve in the activation and infiltration of the inflammatory cells,and play an important role in the process of the damaging and repairing the neurons.

Protective effect of Rosuvastatin aginst Doxorubicin-induced mice hepatotoxicityvia Sirt1/NF-κB signal pathway

WANG Xiu, WANG Zhi-yun

2016, 14(4): 533-535,539. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.006

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Objective To investigate the role of Sirt1/NF-κB signal pathway in doxorubicin(DOX)-induced mice hepatotoxity damage and the effect of Rosuvastatin(Ros) on this pathway. Methods Thirty male,8 weeks old,C57BL/6J mice were randomly divided into 3 groups(n=10).In DOX-treated group,the mice received intra-peritoneal injection of DOX(15 mg/kg)to build hepatotoxicity damage model,and then received intragastric normal saline for the same volume.DOX/Ros group,the mice were pre-intragastric Ros 10 mg/(kg·d)for 5 d,followed by a single intra-peritioneal injection DOX(15 mg/kg),and then post-intervention for another 5 d.Serum lipid and liver function were detected with semi-automatic biochemical instrument.The expression of SOD,MDA,Sirt1 and NF-κB were evaluated with immunohistochemical method.The morphological changes of the liver cells were observed with HE staining. Results When compared with the control group,the levels of TC,TG,LDL-C,ALT,AST and MDA in the model group were significantly increased,but LDL-C and SOD were decreased(P<0.05),and hepatocytes swelled,blood vessels congested with lymphocytic infiltration.The expression of Sirt1 in the model group significantly decreased,NF-κB significantly increased(P<0.05).Compared with the model group,the levels of TC,TG,LDL-C,ALT,AST and MDA in the intervention group significantly decreased whereas HDL-C and SOD increased(P<0.05),andhepatocytes arranged orderly.The expression of Sirt1 markedly increased,NF-κB decreased(P<0.05). Conclusion Rosuvastatin has protective effect against DOX-induced hepatotoxicity by up-regulating Sirt1 and inhibiting NF-κB.

Analysis and intervention evaluation of PICC catheter related infections in elderly tumor patients

XU Hong-en, JIA Yong-shi, WU Shu-qiang, WU Ying, GAO Hui-hui

2016, 14(4): 536-539. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.007

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Objective To analysis the risk factors of PICC catheter related infections (PICC-RI) in elderly tumor patients,and put forward specific intervention strategies. Methods The 258 elderly tumor patients received treatment and indwelling PICC catheter in the hospital from January 2013 to September 2015 were selected,clinical data of the patients were retrospectively analyzed,the risk factors of PICC-RI were analyzed.Age,sex,season,puncture mode,retention time,catheter moving,complications,catheter maintenance,immune function and other factors were included,these factors were analyzed by univariate analysis,single factor which with statistically significant difference were multivariate Logistic regression analyzed. Results A total of 31 patients had postoperative PICC-RI,the PICC-RI rate was 12.0%,28 pathogens were isolated,including 16 strains gram negative bacteria,accounting for 57.1%,11 strains gram positive bacteria,accounting for 39.3%,1 strains fungi,accounting for 3.6%;univariate analysis showed that the difference of season,puncture method,catheter movement,concurrent diabetes,retention time,catheter maintenance,immune functionwere statistically significant (P<0.05),that is,the above factors were risk factors for PICC-RI in elderly tumor patients,further multivariate Logistic regression analysis to the above factors showed that season,catheter movement,catheter maintenance,retention time,immune function were independent risk factors for PICC-RI in elderly tumor patients. Conclusion G-bacteria were the main pathogens of infection for SSIin PICC-RI in elderly tumor patients,the occurrence of infectionis closely related to winter/summer catheter,catheter movement,longer retention time,no catheter maintenance and low immune function.

Mechanism study of using Caulis Spatholobi combined with iron to treat iron-deficiency anemia

YAO Hui, YANG Wei-jia, YANG Min-chun, HUANG Jian-xin, ZHENG Pei-fen

2016, 14(4): 540-543. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.008

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Objective To study the clinical effects and safety of oral iron with decoction of Caulis Spatholobi in the treatment of iron-deficiency anemia. Methods From May 2014 to May 2015 in our hospital 120 patients with iron deficiency anemia were selected and randomly divided into Caulis Spatholobi group,oral iron group and combination group(40 cases in each group);The Caulis Spatholobi group was given suberect spatholobus stem water decoction 15 g/day,the oral iron group was given niferex 150 mg/day,while the combination group was given suberect spatholobus stem water decoction 15 g/day and niferex 150 mg/day,which were all treated for 42 d;Before and after the treatment,red blood cell(RBC) count,hemoglobin(Hb),haematocrit(Hct),serum iron(SI),serum ferritin(SF),serum transferrin(Tf),total iron binding force(TIBC),serum Hepcidin index changes of all three groups were recorded and compared,as well as the routine blood tests,routine urine tests,heart and liver and kidney functions. Results Forty-two days after the treatment,the cure rates of the Caulis spatholobi group,oral iron group and combination group were 60.0%,65.0% and 75.0%,respectively,the differences among the three groupswere statistically significant(χ²=8.309,P<0.05).Compared with the levles before treatment,RBC,Hb,Hct,SI,SF,Tf,TIBC and serum Hepcidin of all three groups were all improved significantly (t≥3.56,all P<0.05),and the difference in RBC,Hb,Hct,SI,SF,Tf,TIBC and serum Hepcidin among the three groups was statistically significant(F≥4.89,all P<0.05);RBC,Hb,Hct,SI,SF,Tf,TIBC and serum Hepcidin in the combination group were all significantly higher than those in Caulis Spatholobi group and oral iron group after the treatment(t≥2.38,P<0.05).The tests for the functions of kidney and liver as well as heart were allwithin the normal range.The incidence of adverse reactions was 15% in the oral iron group,10%in the combination group and 0 in the Caulis spatholobi group,the difference was statistically significant(χ²=6.109,P<0.05). Conclusion Caulis spatholobi combined with oral iron agent can significantly improve clinical symptoms in patients with iron deficiency anemia and iron metabolism,which mechanism may be associated with raising serum iron Hepcidin.

Pressure and duration affecting the apoptosis of passaged human skin fibroblasts in vitro

LI Jun-hua, HUANG Zhong-ming

2016, 14(4): 543-545,603. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.009

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Objective To observe the effect of different pressure and duration time on the proliferation of skin fibroblast in vitro,provide theoretical basis for decreasing the necrosis of skin flap caused by skin tissue expansion. Methods The fibroblast cells were isolated and cultured in vitro from the skin of medial malleolus of a 23 years old male.The sixth generation fibroblasts were used for pressure test.The experiment included four groups:40 kPa group(continuous 40 kPa pressure),60 kPa Ⅰ group(discontinuous 60 kPa pressure),60 kPa Ⅱ group(continuous 60 kPa pressure),and control group.The level of IL-6 in nutrient fluid was also measured.The shape of mitochondria and nucleus were observed using transmission electron microscope.The average IOD(integrated optical density) of mitochondria and nucleus of each group were calculated and compared using Plus Image-Pro 6 image analysis software. Results The level of IL-6 of 60 kPa Ⅱ group increased,the amount of mitochondria decreased and cell proliferation was inhibited with significant differences compared with blank group(P＜0.05).The fibroblast proliferation of 60 kPa Ⅰ group and 40 kPa group were similar with the control group(P＞0.05). Conclusion The risk of skin flap necrosis would not increase under discontinuous 60 kPa pressure.The discontinuous 60 kPa pressure is suitable for the instant tissue expansion surgery.

Study on the expression and clinical significance of miRNA in peripheral blood of patients with pulmonary tuberculosis

CAI Qing-shan, CHEN Yuan-yuan, XIA Qiang, SUN Ya-ping

2016, 14(4): 546-548,588. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.010

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Objective To investigate the the expression and clinical significance of miRNA in peripheral blood of patients with pulmonary tuberculosis,to provide reference for clinical early diagnosis. Methods From January 2012 to December 2014,30 patients with active pulmonary tuberculosis,30 patients with latent tuberculosis and 30 healthy persons in our hospital were selected as the research objects,the expression levels of miR-21-5p,miR-155-5p and miR-29a were detected in patients with active pulmonary tuberculosis (active group),latent tuberculosis (latent group) and healthy persons (control group) by reverse transcription fluorescence quantitative PCR. Results The expression levels of miR-155-5p,miR-21-5p and miR-29a were (0.43±2.11),(4.74±1.29),(3.17±0.65) in the active group,were higher than the latent group and control group(P<0.05);The expression levels of miR-155-5p was (0.96±0.28) in the latent group were higher than the control group(P<0.05);There was no significant difference in plasma miR-29a,miR-21-5p and the control group (P>0.05);The area under the miR-155-5p curve of miR-29a,miR-21-5p and ROC were 0.914,0.846 and 0.732,the sensitivity and specificity were 80% and 69.2%,73.3% and 82.9%,86.7% and 90%. Conclusion The expression of miR-155-5p,miR-21-5p and miR-29a in patients with active pulmonary tuberculosis and latent tuberculosis infection were significantly increased,which can be used as an important index for diagnosis of active pulmonary tuberculosis.

Clinical analysis of low serum hepatitis B virus DNA level in patients with HBV-related hepatocellular carcinoma

TONG Yong-xi, XIANG Bo, PAN Ke-nv, HUANG Hai-jun, PAN Hong-ying

2016, 14(4): 549-551. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.011

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Objective To detect the levels of serum hepatitis B virus(HBV) DNA of the patients with HBV-related hepatocellular carcinoma(HCC),explore the correlation between the low level replication of hepatitis B virus DNA and the pathogenesis of hepatocellular carcinoma,and investigate the clinical significance of detecting serum HBV DNA level in patients with chronic hepatitis B at a lower level of replication. Methods We selected 85 patients with continuous lower level of serum HBV DNA(＜1 000 IU/ml) among the patients with HBV-related HCC.The occurrence,development and evolution of their diseases were systematically reviewed.The serum samples of them were prepared for the tests of HBV markers,liver function,AFP and HBV DNA levels.The relations between the DNA level and other indexes were analyzed. Results Among the 85 HCC patients,15 cases(17.65%) were with HBeAg-positive,70 cases(82.35%) were with HBeAg-negative.52 cases(61.18%) were with abnormal(ALT and AST),65 cases(76.47%) were with an abnormal increase of AFP.72 cases(84.71%) were with low HBV DNA levels was more than 20 IU/ml,while 13 cases(15.29%) low HBV DNA levels less than 20 IU/ml. Conclusion HBV-related HCC is associated with the duration of hepatitis B virus replication.The conventional methods can only detect the HBV DNA levels more than 1 000 IU/ml.The patients with a low HBV DNA level are easy to be ignored,and receive timely the antiviral therapy that lead to disease development.The more precise detection methods for low HBV DNA level will have much clinical significance.

The clinical features and diagnostic strategies of spinal inflammatory granuloma

Fulati·maimaiti, LIANG Liang, Miriguli·shayiti, ZHU Song-qing, ZHANG Jian, SHENG Wei-bin

2016, 14(4): 552-554,568. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.012

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Objective To retrospectively analyze the clinical diagnosis of spinal granuloma confirmed by pathology after surgical debridement. Methods The ESR,C-reactive protein,blood and other laboratory tests of the patients with the symptoms and dysfunction and spinal placeholder were detected.The lateral X-ray of the spine pathological segment was used to identify and exclude spinal tumors and tuberculosis and other diseases.MRI scans were performed sagittal,coronal and axial position scanning,better display the range of lesion structure,adjacent to its relationship with its surrounding soft tissue epidural,spinal cord violations and oppression.CT and 3D reconstruction clear the scope and damage by the spinal lesion,assisting MRI to further clarify the indications for surgery.All imaging data are read by more than two senior doctors of Spine Surgery and Radiology.Clearly determine the condition and surgery indication.The pathological examination was made after surgery for the final diagnosis of the disease. Results Excluding tuberculosis,spinal tumor,the 23 cases were inflammatory granuloma confirmed by pathology after surgical debridement.There foamy histiocytosis,plasma cells and lymphocytes pro-Yun,bleeding and colorectal lesions hoof tissue.Distinguish pathological changes from tuberculosis and cancer. Conclusion It is critical in clear the nature and characteristics of Detailed imaging studies preoperative.MRI,CT and other tests have an important role in the preoperative diagnosis.Not only to distinguish the tuberculosis cancer and other diseases is necessary,but also in the scope of violations of lesions,the impact on the relationship between the spinal cord and adjacent soft tissue lesions and displayed on different levels of spinal vertebrae and spinal damage erosion has an important role in diagnosis.Final pathology results,which can be combined with the former in diagnosis inflammatory granuloma.

Expression and clinical significance of zinc finger protein 217 in human gastric cancer

MA Xue-qiang, LIANG Bin, YUAN Shi-chao, LIU Han-lin, ZHU Xiong-wen

2016, 14(4): 555-558. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.013

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Objective To investigate the expression and clinical significance of zinc finger protein 217(ZNF217)in human gastric cancer. Methods Total 58 cases of gastric cancer tissues and the corresponding tumor-adjacent normal tissues,and 30 cases of gastric mucosa which were suspected as gastric cancer but refused by biopsy pathology between March 2013 and July 2014 were collected.Real-time quantitative PCR(qRT-PCR)was applied to detect ZNF217 mRNA expression in tissues(n=58),the protein expression of ZNF217 was measured by immunohistochemistry(IHC).The relationship between the expression of ZNF217 and clinical features was analyzed by Pearson chi-square test. Results The expression level of ZNF217 mRNA was significantly higher in gastric cancer(6.911±0.139) tissues than in adjacent normal tissues(1.372±0.205),P＜0.001.The protein expression of ZNF217 was also higher in gastric cancer tissues(χ²=39.910,P＜0.001),the high expression of ZNF217 protein was positively correlated with large tumor size(χ²=5.810,P=0.016),lymphatic metastasis(χ²=5.778,P=0.016) and advanced TNM stage(χ²=4.806,P=0.028).ROC curves demonstrated that ZNF217 expression status had a high value for gastric cancer diagnosis. Conclusion The expression of ZNF217 is significantly higher in gastric cancer tissues than in tumor-adjacent normal tissues,and the up-regulation of ZNF217 is associated with clinicopathological features of tumor malignance.ZNF217 may become a new marker and effective therapeutic target in early diagnosis of gastric cancer.

Liver damage and level of blood fat in schizophrenia patient after long-term antipsychotic treatment

TAO Yun-hai, SHEN Bian-hong, ZHU Chun-yan, ZHANG Zhi-wen, JIANG Zhang-wang

2016, 14(4): 559-560,617. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.014

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Objective To study the changes blood fat level and liver damage in schizophrenia patients after the long-term application of antipsychotic agents. Methods The clinical data of 120 cases of schizophreniain our hospital from December 2012 to December 2013 were collected.75 patients taking antipsychotic drugs more than 5 years were assigned into the observation group,while 45 patients taking antipsychotic drugs less than 5 years were assigned into the control group.Eighty healthy volunteers were recruited as healthy group.B ultrasound and blood lipid detection were performed in all 3 groups. Results The incidence of liver damage in the observation group(37.33%) was higher than that in thecontrol group(26.67%) and health group(3.80%),the difference was statistical significance(P<0.05).The cases with fatty liver in the observation group(24%) were more than that in the control group,and so were the number of severe fatty liver(8%).The incidence of fatty liver and severe fatty liver in the control group was higher than those in thehealthy group.The cases with an elevated blood fat in the observation group(18.67%) were more than the control group(11.11%) and healthy group 3.75%).In the observation group,the middle and old patients(more than 55 years) or with a longer course(more than 7 years) were with a higher incidence of fatty liver(38.89% and 35.71%),the difference was statistical significance(P<0.05). Conclusion Through the antipsychotics agents show good the rapeutic effect on schizophrenia,but the long-term application of antipsychotic agents can lead to the increase of blood fat level and liver damage(fatty liver).The timely detection and prevention measures should be taken in schizophrenia patients with a long-term application of antipsychotic agents.

Effect of low-temperature plasma ablation in the treatment of early glottic cancer

ZHENG Wei-chang, ZHANG Qiao-zhen, JIANG Ci-ying, LU Zhong-ming, YU Chao-yang

2016, 14(4): 561-562,624. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.015

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Objective To analysis the short-term efficacy and safety of low-temperature plasma ablation in the treatment of early glottic carcinoma. Methods Total 93 cases of early glottic carcinoma in our hospital from March 2007 to February 2012 were enrolled into this study.Total 43 cases underwent the low-temperature plasma ablation,while 50 cases underwent the partial laryngectomy.The recurrence rate,incidence of complications and short-term survival rate of patients were compared between the two groups. Results There were 2 cases of postoperative recurrence(stage T1b and T2,one case for each stage) in the low-temperature plasma ablation group,and 5 cases(1 case of Tis,3 cases of T1a and 1 case of T2) in the partial laryngectomy group.There was no statistical difference in the recurrence rate between the two groups(χ²=0.950,P=0.329).There was 1 case of swallowing and breathing disorders in the low-temperature plasma ablation group,while there were 5 cases of incision infection,3 cases of pharyngeal fistula and 4 cases of swallowing and breathing disorders in the partial laryngectomy group,the difference in the incidence of complications was statistically significant between two groups(χ²=9.032,P=0.003).The follow-up of 3 years showed that 5 cases in the low-temperature plasma ablation group died,including 2 cases of T1b and 3 cases of T2;while 7 cases in the partial laryngectomy group died,including 3 cases of T2,2 cases of T1a and 2 cases of T1b.The difference in survival between the two groups was not statistically significant(χ²=1.758,0.035,0.734,P＞0.05). Conclusion There was slight tissue injury and fewer complications in the treatment of early glottic laryngeal cancer by the low temperature plasma ablation,and ensure the quality of life of patients after the operation,which is an ideal options for the patients with early glottic laryngeal cancer.

Clinical Analysis of 102 cases of Pemphigus with infection

LOU Xiao-hang, LIU Ji-feng, WU Ji-long, XING Chen-jing, CHEN Na

2016, 14(4): 563-565. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.016

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Objective To investigate the outcome and infection situation of patients with pemphigus,analyze the cause of infection,and provide guidance for the clinical treatment of pemphigus. Methods Total 102 cases of pemphigus in our hospital were retrospectively analyzed.According to the situation of different patients,the individualized treatment was performed,other related treatment such as protecting gastric mucosa;correcting electrolyte disorders,etc.were alsoprovided.The initial hormone doses of Methylprednisolone was equivalent to 30 to 40 mg/d(mild),60-80 mg/d(moderate) and 80-100 mg/d(severe) prednisone.The outcome of patients and infections were observed.The relationship between the prevalence and age,gender and severity of pemphigus was analyzed. Results The remission rate was 91.18%(93/102);the mortality was 2.94%(3/102).Total 37 cases got infection with an infection rate of 36.27%.Twenty-eight cases got skin infections,5 cases lung infection,4 cases sepsis,5 cases urinary tract infection,6 cases oral candida infection,8 cases multiple infections.The Bacterial culture for specimens showed that staphylococcus aureus infection rate was 13.73%.The infection rate of patients with severe pemphigus was 48.89%,which was higher than mild(17.65%). Conclusion The patients with pemphigus has a high risk of infection,also severe inflection.Preventing infection and providing positive anti-infection treatment has a role for the treatment of pemphigus.

Risk factors analysis on failure in intramedullary fixation for intertrochanteric fracture

CUI Kai, CAO Yu-qiang, TAI Peng-yue

2016, 14(4): 566-568. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.017

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Objective To investigate the incidence of failure in intramedullary fixation for intertrochanteric fracture,and discuss the risk factors associated with the failure and provide basis for the treatment. Methods The clinical data of 367 cases of intertrochanteric fractures in Panjin central hospital between January 2010 and December 2013 were retrospectively analyzed.All the patients were confirmed by X-ray,CT examination and clinical symptoms,and underwent the intramedullary fixation.The incompatible cases were excluded before the study and the incidence of fixation failure were recorded.All 367 patients included in the study were divided into successful fixation group(316 cases) and failure fixation group(51 cases) based on the fixed effect.The questionnaire on risk factors was made,and univariate analysis and Logistic analysis were used to assess the risk factors. Results Among 367 cases,51 cases failed in fixation with an rate of 13.9%.Univariate analysis results showed that the age,fracture type,reset level,osteoporosis,fixed position and underlying disease were the individual risk factors for the failure.Logistic analysis showed that the age,fracture type,reset level,osteoporosis,fixed position and underlying disease were the independent risk factors for the failure in intramedullary fixation. Conclusion After the intramedullary fixation treatment,fixation failure are not rare.And the age,fracture type,reset level,osteoporosis,fixed position and underlying disease are the risk factors for the failure in intramedullary fixation.So the risk factors should be paid more attentions in the treatment and nursing of intertrochanteric fracture.

Prevention of catheter associated urinary tract infection with topical antibacterial agent JUC and anti-reflux drainage bag

NAN Cun-jin, SU Hong-xia, HE You-hua, WANG Yi-jun, CHEN Ying-he

2016, 14(4): 569-570,642. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.018

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Objective To prevent and reduce the incidence of catheter associated urinary tract infection by spraying the JUC on the catheter surface and surrounding tissue of urethral orifice，and using anti- reflux drainage bag. Methods Patients who met the criteria of the experiment were randomly divided into control and experimental groups,each group selected 50 cases.Control group were treated with conventional catheterization care and general drainage bags，drainage bag replaced once a day.Experimental group were treated by spraying the JUC on the catheter surface,the external urethral orifice,the glans and the foreskin on the basis of conventional catheterization care，and using anti-reflux drainage bag which replaced once a week according to the instruction manual.Comparison of the results of urine culture of bladder between the experimental and control groups on day 3 and 7. Results Positive bacterial culture of control group were 12 on day 3 and 30 on day 7,there were respectively 5 and 8 in the experimental group.Compared with the control group,the infection rates of catheterization in the experimental group was significantly lower.The difference between the experimental and control groups was statistically significant in the positive rate of overall,three days and seven days(P＜0.05).There was statistically significant between difference of the positive rate of three days and seven days in the control group(P＜0.05),but the difference between the positive rate of three days and seven days was not statistically significant in the experimental group(P＞0.05). Conclusion Spraying the JUC on the catheter surface and surrounding tissue of urethral orifice，and using anti-reflux drainage bag,can significantly reduce the positive rate of bladder urine bacterial culture in patients with catheterization,suggesting it can prevent and reduce the incidence of catheter associated urinary tract infection,and the effect can be maintained for more than seven days.But with prolonged indwelling catheterization time,the incidence of catheter associated urinary tract infection was significantly higher.

The relationship of B7-H1 with clinicopathologic characteristics and prognosis of pancreatic carcinoma

LIU Jun-wei, LU Yi, SHEN Guo-liang, YAO Wei-feng, HUANG Dong-sheng

2016, 14(4): 571-574. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.019

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Objective To investigate the relationship between expression of B7-H1 and clinicopathologic characteristics and prognosis of pancreatic carcinoma. Methods The expression of B7-H1 in 46 cases of pancreatic cancer and 5 cases of normal pancreas tissues were detected by western blot and immunohistochemistry,respectively.The Spearman correlation test was used to analyze the correlation between B7-H1 expression and CA199.Survival curve was drawn by the Kaplan-Meier method,and variation of survival rate was determined by Log-rank test.Multivariate Cox proportional hazard regression model was used to analyze the independent risk factor of pancreatic carcinoma. Results The immunohistochemistry findings revealed that B7-H1 was highly expressed in carcinoma tissue(26/46),while there were no significant expressions in normal pancreatic tissues.The Western-blotting results showed that pancreatic carcinoma samples demonstrated the up-regulated expression of B7-H1(0.512±0.125) at protein level compared with normal pancreas tissues(0.122±0.027).Statistical analysis showed that the expressions of B7-H1 have relationship with lymph node metastasis,clinical stages and pathological differentiation(P<0.05).Spearman correlation coefficient showed association between B7-H1 expression and CA19-9 levels.B7-H1-negative expression prolonged postoperative survival when compared with corresponding positive ones(P<0.05) as in survival study.B7-H1-positive expression was the independent factors of prognosis assessment of pancreatic carcinoma. Conclusion These findings demonstrated the up-regulated B7-H1 expression in human pancreatic carcinoma tissues may serve as a novel biomarker for tumor progression and prognosis.

Clinical analysis of endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage for treatment of malignant obstructive jaundice

ZHANG Xiao-jian, ZHANG Lian-he, ZHANG Shi-liang, LI Dong-yan

2016, 14(4): 575-577. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.020

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Objective To investigate clinical effect of endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage for treatment of malignant obstructive jaundice,to provide a reference for clinical treatment. Methods One hundred and forty cases of malignant obstructive jaundice patients were selected,divided into ERCP group and PTCD group according to the surgical treatment .The surgical success rate,jaundice remission rate,complications,treatment costs and clinical indicators were compared. Results In ERCP group and PTCD group,the low obstruction and high obstruction success rates were 94.74% vs. 71.43%，84.21% vs. 100.00%,the differences were statistically significant(P＜0.05);the low and high obstruction obstructive jaundice remission rates were 98.25% vs. 78.57%，68.42% vs. 92.00%,the differences were statistically significant(P＜0.05);after two weeks,two groups of patients were significantly improved.The difference was statistically significant(P＜0.05).In ERCP group and PTCD group,the overall complication rate was 5.26% vs 17.19%,contrast significantly(P＜0.05),in ERCP group and PTCD group with low obstruction complication rates were 1.75 % vs. 28.57%, the differences were statistically significant (P<0.05);in ERCP group and PTCD group,length of stay,cost of surgery,treatment cost were (13.54±2.54) d vs. (20.14±3.38) d,(2.62±0.15)×10 000 Yuan vs (2.15±0.41)×10 000 Yuan,(4.82±0.69) vs. (5.04±0.71)×10 000 Yuan, the difference was statistically significant(P＜0.05). Conclusion ERCP and PTCD treatment both has good effect for malignant obstructive jaundice,for low obstruction ERCP treatment should be preferred,for high obstruction PTCD treatment should be preferred.

The discussion of treating primary trigeminal neuralgia with cyberknife

DAI Yi, WU Jian-xin, NI Xiao-ying, QIAN Wei, YU Hua, HU Jin-hua, FENG Xing-gang, WU Yu-quan

2016, 14(4): 578-579,594. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.021

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Objective To study the effect of treating primary trigeminal neuralgia with cyberknife. Methods Eightycases of primary trigeminal neuralgia patients were chosen from Jun.2013 to Jun.2014,to divide into study group and controlled group with 40 cases in each to detect CT or MRI before excluding brain tumor.The study group were treated with cyberknife,Target location for brain trigeminal nerve root into the bridge section of 2.5 mm,standard for 4 mm collimator,dose curve range is 70%-90%,center dose was 66.50-84.25 Gy,edge dose was 60-66 Gy,target size is 4.0×3.0 mm squared,4.0×(3.7-5.0) mm.The controlled group was treated with gamma knife.The followed-up was 12 months to analyze effect and incidence of second treatment. Results The total effective rate of study group was 90%,higher than 87.5% of controlled group(P<0.05).There were 2 cases targets not accurate to treat with second treatment,the incidence of second treatment was 5%.The incidence of second treatment was 10.0% of controlled group with 4 cases(P<0.05). Conclusion The Key point of treating with cyberknife and gamma knife is choosing targets and doses.And treating trigeminal neuralgia with cyberknife is effective to extend in clinic.

Observation of curative effects of continuous blood purification on the treatment of 29 patients with severe sepsis

WANG Yong-bin, JI Xiao-wei, ZHAN Lin-bing, XIE Bo

2016, 14(4): 580-582. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.022

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Objective To study the application value of continuous blood purification(CBP) therapy in the treatment of patients with severe sepsis,to provide the basis for clinical use of blood purification in the treatment of sepsis,and provide effective treatment for patients with severe sepsis. Methods Fifty-eight cases of severe sepsis patients were randomly selected from August,2013 to August,2015 in our hospital were divided into observation group(n=29) and control group(n=29).Control group were given the conventional treatment,however,in addition to conventional treatment,the observation group were given the CBP therapy 72 h.Symptoms,signs,serum biochemical indicators,inflammation index level and disease severity scores were compared between the two groups. Results The conventional therapy plus treatment with CBP effectively alleviate the patients with fever,palpitation,chest tightness,shortness of breath and symptoms of irritable,organs such as heart renal function indexes improved steadily,internal environment imbalances be corrected and stable,the expression of PCT,TNF-α,IL-8,CRP and other inflammatory factors were significantly decreased.At the same time,the body temperature,heart rate,WBC and other systemic inflammatory response indicators and blood biochemical and metabolic indicators were significantly improved,and Improvement of cyclic oxygenation,Lactic acid levels were significantly decreased,APACHE-Ⅱ,MODS and SOFA score were decreased,significantly improve the survival rate.The Symptoms,signs,serum biochemical indicators,inflammation index level and disease severity scores of observation group were significantly better than the control group(P<0.05). Conclusion Excessive inflammatory factor and toxin could be effectively removed by CBP,which corrected internal environment acid-base balance,the balance of the cell factor,improve the inflammatory reaction,and can improve the function of patients with monocytes.Furthermore,CBP blocked the development of SIRS to MODS,and promoted the organ function recovery.At last,mortality could be reduced by the use of the CBP.

Efficacy and adverse reaction of Escitalopram in treatment of 40 patients with primary insomnia

WANG Jing, HU Yan-li, XU Wei-jie, SHEN Wen-jing

2016, 14(4): 583-584,628. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.023

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Objective To study the efficacy and adverse reaction of Escitalopram in the treatment of primary insomnia. Methods Total 80 patients with sleep disorders in our hospital between June，2014 and June，2015 were enrolled and randomly divided into observation group and control group with 40 cases in each group.The observation group was given Escitalopram Oxalatetablets [After breakfast,oral,initial dose of 5 mg/d,gradually increased to 20 mg/d] and Zolpidem tablet[at bedtime,oral,initial dose of 5 to 10 mg/d] for 8 weeks,while the control group was given Zolpidem tablets [at bedtime,oral,initial doseof 5 to 10 mg/d] for 8 weeks.Before the treatment and 1,4 and 8 weeks after the treatment,Pittsburgh sleep quality index(PSQI) scale,patient health questionnaire (PHQ-9) index were measured,and the incidence of adverse reactions was observed.SPSS 18.0 was used to analyze the data. Results PAQI total score on the 1st,4th and 8th weekend after the treatment decreased in both groups，P<0.05.On the 8th weekend,the total scores of PSQI in the observation group were significantly lower than that in the control group,P<0.05.PHQ-9 total scoreon the 1st,4th and 8th weekend after the treatment decreased in both groups，P<0.05.On the 8th weekend,the total scores of PHQ-9 in the observation group were significantly lower than that in the control group,P<0.05.The mild adverse reactions were found in both groups.The incidence of adverse reactions in the observation group was 32.5%,and in the control group was 27.5%,the difference was not statistically significant，P>0.05. Conclusion Escitalopram can effectively improve the sleep quality in patients with primary insomnia,but the incidence of adverse reactions such as tremor and constipationis relatively high,which should be paid more attentions.

An associative analysis of IL-18 gene-607 C/A polymorphism and interleukin-18 levels with cognitive impairment in patients with chronic schizophrenia

WEN Na, TANG Wei, PAN Jian-she, ZHANG Jin-liang, YANG Fu-yin

2016, 14(4): 585-588. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.024

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Objective To evaluate the relationship between the IL-18 levels and cognitive functionin patients with chronic schizophrenia. Methods We recruited 158 chronic patients and 150 normal control subjectsin our hospital between Jan.2012 and Dec.2014.Repeatable Battery for the Assessment of Neuropsychological Status(RBANS) was used to measure the cognitive level,Enzyme-Linked Immunosorbent Assay(ELISA) was performed to test the peripheral blood IL-18 level,polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect IL-18 gene-607C/A polymorphism,and Positive and Negative Symptom Scale(PANSS) was used to assess the clinical symptoms of patients. Results IL-18 levels were increased in chronic schizophrenia patients as compared to normal controls (P<0.01).RBANS total score and the subscales of immediate memory and delayed memory were lower in patients than normal controls(all P<0.001).In patients,IL-18 levels were positively associated with RBANS total score and the subscales of immediate memory and delayed memory(all P<0.05).Multiple regression analysis further confirmed that IL-18 was an independent contributor to RBANS total score and the aforementioned two indexes(all P<0.05). Conclusion The immune responses may play an important role in cognitive performance in schizophrenia.Although the underlying mechanisms for the associations of IL-18 with cognitive performance are still unknown,the positive correlations may implicate some potentially neuroprotective effects of IL-18 on cognition in chronic patients.

Relationship between blood level of homocysteine and macroangiopathy in patients with type 2 diabetes mellitus

ZHOU Yu-sen, WU Wei, MEI Yan-jie

2016, 14(4): 589-590,638. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.025

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Objective To investigate the relationship between the levels of homocysteine(Hcy) and macroangiopathy in type 2 diabetes mellitus. Methods Total 80 patients with type 2 diabetes mellitus in our hospital between January 2012 and December 2013 were divide into simple diabetes mellitus group(DM1,40 cases) and macroangiopathy group(DM2,40 cases) according to the microvascular complication of diabetes,40 healthy subjects were recruited as the control group.The basic information of patients and serum biochemical indexes were reviewed.Regression analysis was conducted to determine the risk factors of microvascular complication of diabetes among Age,C-peptide,blood lipids,blood glucose,glycosylated hemoglobin(HBA1C),triglycerides(TG),cholesterol(TC) and Hcy. Results The level of Hcy in the DM1 group was not obviously higher than that in the control group(P＞0.05);The level of Hcy in the DM2 group were significantly higher than that in the DM1 and control group,the difference was statistical significant (P＜0.05).Logistic regression analysis showed that C-peptide,TG,TC,HbA1c and Hcy were related to the atherosclerosis. Conclusion The levels of Hcy is correlated to Macroangiopathy in patients with type 2 diabetes mellitus,and high homocysteine is one of the important independent risk factors for the microvascular complication.

Research of correlation of fFN and G-CSF level with chorioamnionitis in patients with premature rupture of membranes

LOU Jian-yi, ZHENG Xiu-juan, ZHUANG Shun-hong, LÜ Ying

2016, 14(4): 591-594. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.026

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Objective To explore the correlation of cervical secretion fFN level and serum G-CSF level withchorioamnionitis in patients with premature rupture of membranes(PROM). Methods Total 107 patients with premature rupture of membranes were selected as pathology objects and divided into 3 groups according to the occurrence and degree of chorioamnionitis: the patients without chorioamnionitisinto Group A,the patients with subclinical chorioamnionitisinto Group B,and the patients with clinical chorioamnionitisinto Group C.Thirty-three normal pregnancy were recruited as control group.The peripheral venous blood and cervical secretions were prepared before the deliver,and the placenta tissue were extracted after the deliver for the test of fFN and G-CSF. Results The cervical secretion fFN level and placental tissue fFN level of Group A,B,C and control group were as follow: group C>B>A>control(P<0.05).There was a positive correlation between cervical secretion fFN level and placental tissue fFN level(R²=0.521,P<0.001) in patients with premature rupture of membranes.The serum G-CSF level and placental tissue G-CSF level of Group A,B,C and control group were as follow: group C>B>A> control(P<0.05).There was positive correlation between serum G-CSF level and placental tissue G-CSF level(R²=0.865,P<0.001).Both the cervical secretion fFN and serumG-CSF level had diagnostic value to clinical chorioamnionitis and subclinical chorioamnionitis(P<0.05). Conclusion Both cervical secretion fFN and serum G-CSF havea predictive value on subclinical chorioamnionitis,and its clinical survey has positive significance for the prevention and cure of clinical chorioamnionitis.

Efficacy and safety of low dose morphine on the sedation of children suffering from severe hand foot mouth during mechanical ventilation

WANG Lin-xia, WANG Min, TANG Lu-ming, YAN Chun-xue, PAN Guo-quan

2016, 14(4): 595-597,696. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.027

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Objective To observe the efficacy and safety of low dose morphine in the patients with severe hand foot mouth disease during the mechanical ventilation of. Methods From January 2010 to December 2014,78 patients with severe hand foot and mouth disease were randomly divided into control group(Con) and low dose morphine group(Mor).The ptients in Con group were given midazolam 0.1 mg/kg,and 0.05-0.15 mg/(kg·h) infusion continuously;sufentanil 0.1 μg/kg,and 0.03-0.06 μg/(kg·h) infusion continuously;while the patients in Mor group were given morphine 40 μg/kg,to 10-30 μg/(kg·h) infusion continuously.The primary outcomes included Ramsay scores,inspiratory peak pressure(PIP),oxygenation index(OI),creatine kinase (CK-MB),mechanical ventilation time;andthe secondary outcomes included blood gas,PICU time,hospital costs,etc. Results All patients achieved the perfect calm state.The inspiratory peak pressure decreased gradually to normal duration of the mechanical ventilation,but the PIP in Mor group was significantly lower than that in Con group at T_12h,D₁ point(P=0.04;P=0.03).With the mechanical ventilation time prolonged,the OI of patients turned gradually to normal,and the OI in Mor group was better than that in Con group at T_12h,D₁ point(P=0.01;P=0.04).The creatine kinase decreased gradually with the mechanical ventilation time prolonged too,but the CK-MB in Con group was still significantly higher than that in Mor group at T_12h,D₁ and before the extubation(P=0.05;P=0.05;P=0.03).The mechanical ventilation time in Mor group was less than that in Con group(P=0.02).The duration of PICU in Mor group was less than that in Con group(P=0.02).The charge of Mor group was less too(P<0.01). Conclusion Low dose of morphine and midazolam combined with sufentanil both can achieve satisfactory sedation state to the children with severe hand,foot and mouth disease during mechanical ventilation.The low dose of morphine can improve rapidly the hypoxia and ischemia symptoms,improve heart and lung function,and reduce significantly the mechanical ventilation time,the duration of PICU and hospital costs.

Efficacy of Topiramatein treatment of childrenwith epilepsy

YU Tong

2016, 14(4): 598-599,679. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.028

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Objective To investigate the efficacy of topiramate in the treatment of children with epilepsy and evaluateits effect on serum glucose,insulin,cortisol,leptin,ghrelin and neuropeptide-Y levels and body mass index. Methods Total 20 cases of pediatric epilepsy in our hospital from October 2011 to October 2013 were retrospectively analyzed.All children were treated with topiramate at a daily dose of 5 mg/kg.Before and after the treatment,the fasting blood glucose,insulin and serum leptin,neuropeptide-Y,ghrelin,cortisol,and BMI levels were detected. Results After 3 months treatment,insulin level and body mass index levels were (4.65±2.28) μU/ml and (15.87±1.90) kg/m²,which were significantly lower than those before the treatment[(5.83±2.72) μU/ml and (16.44±1.84) kg/m²],P<0.05.But after 6 months treatment,the insulin level increased as compared with those values after 3 months treatment,and the results had no significantly difference when compared with those values before the treatment(P>0.05).After 6 months treatment,the serum cortisol and leptin levels were (10.13±4.17) μg/dl and (2.14 ±2.03) ng/ml,which were significantly lower than those before the treatment [(13.25±5.50) μg/dl and (2.89±2.63) ng/ml],P<0.05.Before and after the treatment,there were no significant differences on serum glucose,ghrelin or neuropeptide-Y levels. Conclusion In treatment of children with epilepsy,topiramate can reduce serum leptin and cortisol levels,which might be the key reasons of the decrease of body mass index.

Expression of Vimentinand Ki-67 protein and relationship with clinicopathologic feature in patients with cervical squamous cell carcinoma

YU Jian-qin, ZHOU Qing, ZHENG Fei-yun, BAO Ying

2016, 14(4): 600-603. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.029

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Objective To investigate the expression of vimentin(VIM) and Ki-67 protein in patients with cervical squamous cell carcinoma(CSCC),and its relationship with the clinical and pathological features,and analyze the correlation between the expression of Vimentin and Ki-67 in cervical carcinoma. Methods The expression of Vimentin and Ki-67 in 57 cases of CSCC tissue was detected by using immunohistochemical S-P method.The data was statistically analyzed combined with the clinicopathologic materials. Results In 57 cases of CSCC,the positive rates of cervical Vimentin were 75.4%(43/57),the average score statistics for (2.41±1.52);the positive rates of cervical Ki-67 were 100%,the average score statistics for(4.48±1.59);the positive rate of Ki-67 in cervical carcinoma was 100.0%,higher than Vimentin (75.4%)(χ²=15.960,P＜0.01).Pearson correlation analysis showed that the expression of Vimentin and CSCC in Ki-67 tissues was significantly positively correlated(r=0.984,P=0.00).Ki-67 and Vimentin expression were closely related to the patients’ local invasion,lymph node metastasis and tumor differentiation(P=0.003,0.000,0.017;P=0.001,0.003,0.008),but not with age,tumor size and stage(P＞0.05). Conclusion Ki-67 in cervical squamous cell carcinoma tissues has high expression,the expressions of Ki-67 and Vimentin are closely correlate with invasion,metastasis and differentiated degree.This result has important significance for thetreatment of cervical cancer.

Curative effect of TCM medicated bath combined with tacrolimus on moderate to severe atopic dermatitis in children and influence on serum LTB₄ on LTC₄

HUANG Wen-hui, WANG Chong-min

2016, 14(4): 604-606,685. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.030

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Objective To explore the curative effect of medicated bath of TCM combined with tacrolimus in the treatment of children moderate to severe atopic dermatitis(AD) and their influence on the serum inflammatory mediator. Methods Total 102 children with moderate to severe AD were selected and randomly divided into group A,B and C with 34 cases in each group.The patients in group A were given 0.05% desonide ointment,group B were given 0.03% tacrolimus ointment,and group C were given medicated both of TCM and tacrolimus.The treatment in three groups was all lasted until 1 week after skin lesion elimination or for 3 weeks.EASI were evaluated before the treatment,1 week,2 weeks and 3 weeks after the treatment/treatment finished.Serum LTB₄ and LTC₄,and DLQI were detected before the treatment,3 weeks after the treatment/treatment finished.The curative effects were evaluated 3 weeks after treatment/treatment finished.The adverse reactions wererecorded and follow-up for 3 months to record the recurrence. Results Comparing with the conditions before the treatment,three groups’ EASI scores were all decreased 1 week after the treatment,2 weeks after the treatment,and 3 weeks after the treatment/treatment finished(P＜0.05 or P＜0.01),and EASI score in group C was lower than those in both group A and B(P＜0.05 or P＜0.01).The effective rate in Group A,B and C was 65.63%,63.64% and 87.10%,respectively,and the effective rate in group C was higher than those in both group A and B(P＜0.05).The serum LTB₄ and LTC₄ in group B and C were both decreased 3 weeks after treatment/treatment finished(P＜0.05 or P＜0.01).By the order of group A,B and C,serum LTB₄ and LTC₄ and DLQI scores were all decreased successively(P＜0.05).The incidence of adverse reaction in group A,B and C was 40.63%,36.36%,12.90%,respectively,and the rate both in group A and B were higher than that in group C(P＜0.05).In 3 months following-up,the recurrence rate in group A,B and C was 34.38%,9.09%,3.23%,respectively,and the recurrence rate group A was higher than that in both group B and C(P＜0.01). Conclusion The medicated bath of TCM combined with tacrolimus have a good curative effect on moderate to severe AD in children,it can effectively eliminates the skin lesion,decrease serum LTB₄ and LTC₄ level,improve life quality,also has lower side effects and recurrence rate,and it is superior to simple glucocorticoid or tacrolimus in curative effect.

Effect of Ursodeoxycholic acid combined with S-Adenosylmethionine in the treatment of intrahepatic cholestasis of pregnancy

WEI Qin, XU Zhi-hong, TAN Guang-lan, ZHU Qing-qing, XIE Shuang-yu

2016, 14(4): 607-608,675. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.031

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Objective To investigate the effect of ursodeoxycholic acid(UDCA) combined withs-adenosylmethionine(SAM) in the treatment of intrahepatic cholestasis of pregnancy(ICP). Methods A total of 134 patients in the Department of Obstetrics and Gynecology between January 2010 and October 2015 were taken into this research and were divided into OBG(66 patients)and COG(68 patients)group according to random number table.The patients in OBG group received UDCA and SAM,while the COG group received the conventional treatment.The biochemical markers of liver and delivery conditions in two groups were compared. Results In OBG Group,there were 34(50.75%)cases of spontaneous labor(χ²=8.562,P=0.019),4(11.76%)cases of artificial aiding-birth(χ²=9.025,P=0.014),33(49.25%) cases of caesarean section(χ²=8.747,P=0.026),67(100%)fetal survived(χ²=8.637,P=0.009).The levels of TBil(t=16.562,P=0.035),ALP(t=18.935,P=0.024),γ-GT(t=19.025,P=0.015),TBA(t=19.365,P=0.012) and ALT (t=16.253,P=0.035) after the treatment in OBG Group recovered,which were significantly better than CTG Group(P<0.05). Conclusion Ursodeoxycholic acid and s-adenosylmethioninein the treatment of intrahepatic cholestasis of pregnancy can obviously improve thebiochemical markers of liver,promote the healthy pregnancy and natural childbirth,and improve the prognosis of patients,which is worthy of clinical use.

Effect of Vitamin D with rehabilitation on cerebral palsy children with language dysfunction

WANG Wei-wen, SUN Zeng-xian

2016, 14(4): 609-611,614. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.032

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Objective To investigate the clinical effect of Vitamin D with rehabilitation on the cerebral palsy children with language dysfunction. Methods A total of 82 consecutives cases of cerebral palsy children with language dysfunction in our hospital from March 2011 to June 2014 were divided into purely rehabilitation group(n=39) and Vitamin D assisted with rehabilitation(combined group,n=43) by random number method according to the sequences of arriving into the hospital.The conventional rehabilitation therapy included physical therapy,massage,language training and so on;Shuangjing vitamin D drops were used in the combined group by one pill per-time and per-day,three months as a period.The condition changes of patients were observed.The language development situation,Gesell Child Development Scale,Bayley Infant development scale and serum Vitamin D,calcium levels after three months of treatment were compared between the two groups. Results In combined group,the total efficacy rate of language development situation was significantly higher(95.3% vs. 74.4%,χ²=7.213,P=0.007),the developmental quotient DQ score by Gesell Child Development Scale was higher[(70.4±11.3) vs.(53.3±10.5),t=6.127,P=0.026],the normal children rate was significantly more (41.9% vs. 20.5%,F=4.304,P=0.038);the excellent ratio of development index by Bayley Infant development scale was better (F=9.202,P=0.002),and the levels of serum Vitamin D and calcium were significantly higher[ (78.9±23.8) pmol/L vs.(56.3±21.0)pmol/L,t=6.025,P=0.023;(1.9±0.4)mol/L vs.(1.3±0.1)mol/L,t=5.624,P=0.028]. Conclusion Vitamin D with rehabilitation can effectively improve the language function and development in cerebral palsy children with language dysfunction,the clinical value should be further studied.

Role of amplitude integrated electroencephalogram in diagnosis of neonatal hypoxic ischemic encephalopathy

CHENG Ke-ping, ZHU Pin-li, WANG Yan-wei

2016, 14(4): 612-614. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.033

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Objective To explore the relationship between amplitude-integrated electroencephalogram(aEEG) and umbilical arterial blood gas analysis,Apgar score of neonatal hypoxic-ischemic encephalopathy(HIE),and to find an effective method for early diagnosis of neonatal HIE. Methods According to the results of aEEG test,97 neonates with HIE were divided into aEEG normal group,aEEG mild group and aEEG severe group.The aEEG,umbilical arterial blood gas analysis and Apgar score were performed in all the three groups.The relationship between aEEG and neonatal HIE clinical graduation,MRI graduation,umbilical arterial blood gas analysis,Apgar score of neonatal HIE were assessed. Results The differences of HIE clinical grading among the three groups were statistically significant (H=6.598,P<0.05);Spearman rank correlation analysis showed that the results of aEEG examination and the clinical index of neonatal HIE were statistically correlated(r=0.758,P<0.05).The differences of MRI grading among the three groups were statistically significant(H=8.415,P<0.05);Spearman rank correlation analysis showed that the results of aEEG examination and MRI grading were statistically correlated(r=0.710,P<0.05).One-way ANOVA showed that the differences of blood gas pH and blood gas BE in the three groups were statistically significant(P<0.05);the differences of 1 min,5 min,10 min Apgar scores among the three groups were statistically significant(P<0.05). Conclusion The aEEG examination is an effective method for early diagnosis of neonatal HIE,and has good clinical application value.

SUN Jie, BAI Tu-men, YANG Su-fen, DONG Xun, HAO Zhi-min

2016, 14(4): 615-617. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.034

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Effectiveness analysis of community diabetes management based on the Internet of things technology

WANG Chun-yan, LU Zhi-ying

2016, 14(4): 618-620. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.035

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Objective To observe the impact of using the Internet on managing the community health of 2 type diabetes,to explore the new pattern of community diabetes management,and to improve the efficiency of both the management and the treatment. Methods The patients with type 2 diabetes who had been in community management system were selected.A total number of 120 patients were enrolled and randomly assigned into two groups by giving out random numbers.The intervention group(The intervention group adopted new diabetes management based on the technology of Internet,n=60) and the control group(The control group using conventional diabetes management,n=60).Follow-up visits were conducted at the beginning of the study and at the 6th month of the research.During the follow-up visits,the differences of two groups patients were analyzed by comparing blood glucose,blood fat,waist circumference and other indicators.The Diabetes prevention related knowledge,attitude and behavior include: symptoms of diabetes,blood glucose control appropriate value smoking etc,were noted down.There were 11 different indicators. Results There were significant differences in FPG and 2hPG,HbA1C,TC,LDL-C,TG,waistline,and BMI in intervention group and control group(P<0.05).Intervention group patients had more general knowledge about diabetes,including symptoms of diabetes,implications prevention measures of knowledge (98.33%,100.00%,95.00%,98.33%),which were higher than the control group (58.33%,48.33%,25.00%,48.33%),and the difference was statistically significant(P<0.05).The condition of Intervention group patients by adhering the prescribed medication,controlling diet,regular testing blood sugar,the proportion of regular exercise (100.00%,93.33%,95.00%,93.33%),which were higher than the control group(48.33%,50.00%,40.00%,50.00%) improved obviously,and the difference was statistically significant(P<0.05).The proportion of alcohol in the intervention group(10%) than the control group (50%) significantly decreased,the difference was statistically significant(P<0.05). Conclusion Diabetes management mode based on Internet is a more effective method than the previous.It can increase the cognition levels of diabetic patients and self-management ability.It is an effective approach to control of blood sugar,and to get more ideal blood lipid metabolism indexes.

The effect of family doctor's individual strategy in the management of diabetes mellitus in a community of Shanghai

XU Hong-yu, ZHAO Xiao-yan, ZHU Li-fang

2016, 14(4): 621-624. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.036

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Objective To explore the effect of family doctor individual health management strategy in the management of patients with type 2 diabetes mellitus. Methods Total 149 patients with type 2 diabetes were selected and randomly divided into the traditional group of 73 cases and the individual management group in 76 cases in Shanghai.The traditional group was given the responsibility system of family doctors,while the individual management group was implemented the individual strategy management.The patient satisfaction of both groups before and after the management and the results of satisfaction survey were compared. Results After the management of 6 months,the bad habits rate of patients in the traditional group was not improved(P>0.05),while in the individual management group was significantly improved(lower than that before the management and the rate of traditional group(P<0.05).Blood glucose,blood lipid and body mass index (BMI) situation: each index of the traditional group were slightly lower than before the management,the difference was not statistically significant(P>0.05);while each index in the individual management group were significantly better than those of the traditional group and the rate before the management,the differences were statistically significant(P<0.05).The satisfaction with family doctor team services was 88.16% in the individual management group and 72.60% in the traditional group,the difference was statistically significant(P<0.05);the patients satisfaction with the disease control was 77.63% in the individual management group and 47.95% in the traditional group,the difference was statistically significant(P<0.01). Conclusion Based on the individual situation of patients,the family doctor individual strategy can more effectively promote the health behavior of patients with diabetes,improve the patient’s condition,promote the harmonious relationship between doctors and patients.It is worth to promote the application of family doctor in chronic disease management.

Correlation between facial expression recognition ability and social anxiety/fear of negative evaluation in patients with social anxiety disorder

LIN Zi-jiang, LIN Hai-xi, LIN Xue-dan, YANG Tian-xing, WANG Chang-lu, DU Song-mei, YANG Chuang

2016, 14(4): 625-628. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.037

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Objective To analyze the facial expression recognition ability of patients with social anxiety disorder and the correlation among social anxiety,fear of negative evaluation and facial expression recognition ability. Methods Thirty cases of social anxiety disorder and 30 normal persons were measured with the Social anxiety Scale,Fear of Negative Evaluation Scale and Facial Expression Recognition Test.The results were compared by independent Samples t-Test and their relationship by Pearson’s correlation. Results There was no significant difference between the two groups on the correct numbers of facial expression recognition(P>0.05),but the reaction time of social phobia was shorter than that of the normal on the task(P<0.05);there was no significant difference between the two groups on the correct numbers of the same facial type expression recognition(P>0.05);there were more correct numbers on the “happy” facial type than other types in both groups(P<0.05);There was no significant correlation between social anxiety and facial expression recognition ability(r=0.24,P=0.32);there was no significant correlation between the fear of negative evaluation and facial expression recognition ability(r=-0.10,P=0.68),but social anxiety and fear of negative evaluation was significant related(r=0.59,P<0.05). Conclusion There is no significant decline in facial expression recognition ability of social phobias;there is no significant correlation among social anxiety,fear of negative evaluation and facial expression recognition ability.

Analysis of Polio Antibody Levels among children aged from 0 to 6 years in Anhui in 2011

WANG Bin-bing, ZHANG Xiu-jun, CHEN Xiao-qin, CHAI Yu, SHEN Yong-gang, LIU Dan-qing, ZHAO Yue-ping, YAN Kai-li

2016, 14(4): 629-631. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.038

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Objective To investigate the level of poliomyelitis antibody among preschool age children,and evaluate the effect of polio immunization. Methods Seven age groups among 0 to 7 years children were sampled by the systematic sampling method in 16 counties in Anhui,and 1 754 serum samples were collected.Microplate neutralization test was used to determine antibody level. Results All of subjects had immunization records while 96.41% of them were 3-5 times.The rates of neutralized antibodies positive to Ⅰ,Ⅱ and Ⅲ were 99.43%,99.20% and 98.86%,respectively.The geometric mean titers(GMT) toⅠ,Ⅱ and Ⅲ were 1∶193.40,1∶117.26 and 1∶85.03,respectively.98.29% of the subjects were all positive inⅠ,Ⅱ and Ⅲ.Both positive rate and GMT between each serotype had significant differences(P<0.01).The positive rates of each serotype were above 97% in all age groups.For GMTs,not like positive rates(P>0.05),a trend of decreasing with increasing age was presented(P<0.05).The positive rates of different regions as south of Anhui,middle of Anhui,north of Anhui were all above 98% but without significant differences(P>0.05).Antibody levels between different regions have significant differences (P＞0.05,except F_Ⅱ).The results of multiple-factors analysis showed that the GMTs were significantly associated with age,region and the result of all positive in each serotype(P<0.01). Conclusion In preschool age childre in Anhui,the positive rate of poliomyelitis antibody and GMTs are still maintaining a high level,and a stable immunization barrier has been established by polio immunization.

Status of occupational health of general practitioners and its influencing factor in Yunnan province

ZHAO Xin, ZI Rong, JIANG Run-sheng, HUANG Qiao-yun, LI Bing-yu, SHU Qun-qin, LI Wei-ming

2016, 14(4): 632-634,645. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.039

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Objective To investigate the status and relted influence factors tooccupational health of general practitioners(GPs)in Yunnan province on the base of the empirical study of GPs occupational health in Yunnan province. Methods According to the development level of the economic and social and the basic conditions of the medical and health work in Yunnan province.We extracted 226 GPs at the grass-roots level according to the good,medium and poor by using stratified cluster sampling method as the research objects.The spot investigation was conduced by using the self-designed self-reported questionnaire,and the dat were analyzed with χ² test and Logistic regression model,statistical test level was α=0.05.The relted influence factors to occupational health of GPs were discussed. Results The proportion of the self-assessment in the unhealthy state of 32.00%(64/200)in the 200 effective questionnaires.Unconditioned logistic regression analysis for the level of 0.05,excluding level of 0.10.The model χ²=48.061,P＜0.001,Cox&Snell R²=0.214,Nagelkerke R²=0.299,the total verification rate reached 72.5%.The results of unconditioned logistic regression analysis showed that the following five factors could affect the occupational health of GPs:few opportunities for advancement(P=0.009),due to time pressure result in fret(P=0.009),increasingly heavy burden on work(P=0.028),greatly time pressure(P=0.032),easy to relax after go home(P=0.034). Conclusion The health status of grass-roots GPs in Yunnan province is in poor,the influence factors include the current not perfect title promotion mechanism ingrassroots medical institutions,less places and heavy workload.The relevant departments should improve the professional environment of GPs and take effective measures to protect the occupational health of GPs.

Analysis of drug sensitivity of methicillin-resistant Staphylococcus aureus

ZHU Kui-xiang, YING Hua-yong

2016, 14(4): 635-638. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.040

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Objective To learn the drug sensitivity of methicillin-resistant Staphylococcus aureus(MRSA)in our hospital,and provide analysis data for clinical anti-infection treatment and the control of hospital infection. Methods From January,2014 to October,2015,128 cases of sputum,secretion,pus,blood,hydrothorax,ascites,prostatic fluid and urine samples were received,Staphylococcus aureus were detected in all of the specimens.The sensitivity of Staphylococcus aureus to antimicrobial agents was detected,and the sensitivity of MSSA and Methicillin sensitive Staphylococcus aureus(MSSA) to the antimicrobial susceptibility was compared.From 2011 to 2014,Minimum inhibitory concentration(MIC) of 30 strains of MRSA was detected. Results Forty-four strains of MRSA were detected in 128 strains of Staphylococcus aureus,MRSA positive rate was 34.38%;MRSA detection rate of sputum was highest,51.11%;the lowest MRSA detection rate was 20.51% from secretions;there were statistically significant differences in MRSA detection rates of different samples(χ²=12.301,P<0.05).The sensitivity rates of MSSA and MRSA to Quinupristin/dalfopristin,teicoplanin,vancomycin,rifampin,linezolid,tigecycline and nitrofurantoin were 100.00%;The sensitivity rates of MSSA to Oxacillin,Levofloxacin,erythromycin,clindamycin,tetracycline,ciprofloxacin,sulfamethoxazole/trimethoprim and moxifloxacin were significantly higher than that of MRSA,the differences were statistically significant(P<0.01).MIC of Vancomycin and teicoplanin to MRSA showed increasing trend,and MIC of linezolid against MRSA remained unchanged.In 2014,MIC of Vancomycin and teicoplanin to MRSA were significantly higher than in 2011(t=36.242,14.394,P<0.01). Conclusion Staphylococcus aureus isolated from different types of samples have different drug sensitivity and MRSA detection rate,monitoring MIC of glycopeptide antimicrobial agents to MRSA should be pay attention in clinical treatment.

Nucleic amplification and microfluidic chip assay test for anti-HCV in blood samples around cutoff value by ELISA

CHEN Na-yun, YAO Ren-nan, MA Ji-hui

2016, 14(4): 639-642. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.041

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Objective To investigate the efficacy of nucleic amplification and microfluidichip assay in the detection of hepatitis C virus(HCV) and judging theinfectivity of HCV in samples around Cutoff Value by ELISA. Methods Total 24 blood samples with Signal-to-Cut-Off Ratios(S/CO) values between 0.4 and 1.0 by anti-HCV ELISA and being negative by colloidal gold were collected and re-tested by using nucleic acid amplification and microfluidic chip assay and HCV CLIA. Results Among the 24 samples,16 were positive(66.67%) by nucleic acid amplification and microarray,16 were positive(66.67%) by CLIA,6 were positive(25.00%) by ELASA reagent①,and 10 were positive(41.67%) by ELISA reagent②.Nucleic acid amplification and microarray analysis were compared with the results of ELISA reagent① or reagent②,the difference in the positive rate was significant(P<0.01 and P<0.05,respectively). Conclusion Nucleicacid amplification and microfluidic chip analysis method on the detection rate of HCV is higher than that of ELISA method and colloidal gold method,therefore,the blood samples around Cutoff Value by anti-HCV ELISA assay might be with infectivity of HCV,and these samples could be tested by nucleic amplification and microfluidic chip assay or CLIA,in order to improve the detection results and prevent false detections.

The effect of methods of drawing blood on coagulation time on hemodialysis patients using warfarin with permanent catheter

WU Yao-yao, XU Wu-min, HUANG Xiao-yan, JIN Ling-wei

2016, 14(4): 643-645. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.042

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Objective To investigate the feasibility of using blood samples from internal jugular vein by vein catheter instead of peripheral vein on maintained hemodialysis patients with permanent central vein catheter when monitoring the coagulation time on hemodialysis patients taking warfarin. Methods Thirty maintained hemodialysis patients with permanent central vein catheter taking warfarin recruited in this study.Get the blood samples from the same patient at the same time by three different methods:routine blood specimens from peripheral vein as a control;20 ml blood specimens from permanent catheter in jugular vein(method one,group one);40 ml blood specimens from permanent catheter in jugular vein(method two,group two).Compares the coagulation time among those groups. Results Compared to the control group,the prothrombin time (PT) and international normalized ratio (INR),activated partial thromboplastin time (APTT),were of significant difference in group one patient(P＜0.01).The levels of PT and INR were the same in control group and group two (P＞0.05),however,APTT level was different in those two group(P＜0.05). Conclusion Blood specimens from peripheral vein is preferred when monitoring the coagulation time on hemodialysis patients taking warfarin.Methods two can be used as a substitute on patients with difficulties of blood drawing under the guidance and interpretation of doctors.

Study on the application of serum pepsinogen and CA199,CA242,CEA joint detection in the diagnosis of earlier gastric cancer

WANG Sheng, SHAN Lu-hu, SHU Xin-hua, YE Zhen

2016, 14(4): 646-648. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.043

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Objective To explore the joint determination of the serum pepsinogen PGⅠ,PGⅠ/PGⅡ and carbohydrate antigen 199(CA199),carbohydrate antigen 242 (CA242),carcino-embryonic antigen (CEA) on the clinical significance of early diagnosis of gastric cancer. Methods In the serum pepsinogen PG(PGⅠ,PGⅠ/PGⅡ) latex-enhancedimmunoturbidimetic,the tumor markers CA199,CA242,CEA with chemiluminescent particles immune method,130 cases of gastric cancer patients was detected for gastric cancer patients are pathological diagnosis clear,30 patients with gastric benign disease,120 cases of normal healthy check-up crowd,statistical analysis of the differences between three groups.Compare the sensitivity and specificity of single and joint index to see whether there is significant difference. Results The serum levels of five tumor markers(CEA,CA199,CA242,PGⅠ and PGⅠ/PGⅡ) in gastric malignant tumor were significantly different from those in benign gastric disease and control group(P<0.01).The sensitivity of the joint detections of the five tumor markers(86.1%) were significantly higher than that of the respective detection(P<0.01).However,there was no difference in specificity(P>0.05). Conclusion The positive rate of the joint detection of serum PGⅠ and PGⅠ/PGⅡ,CA199,CA242,CEA in gastric cancer patients is far higher than that of any single biomarker detection.Joint detection to improve detection rate early gastric cancer patients has clinical practical value.

QI Qi, ZHANG Yu-xin, HU Jian-guo

2016, 14(4): 649-651. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.044

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JI Zheng, ZHOU Chang-zuan, ZHU Hong-min, JIANG Feng-chun, MENG Li-ping, PAN Sun-lei, XU Fu-kang, PENG Fang, CHI Ju-fang, GUO Hang-yuan

2016, 14(4): 652-655. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.045

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SHEN Fei, LI Yi-lu, SHEN Wen-zhong, SHEN Yan-hong, XU Rong, LU Bin, GU Juan, DING Hai-guang, PING Jing, YANG Yan, HAN Yi-ping

2016, 14(4): 656-658. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.046

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ZHANG Lei, JIANG Hao

2016, 14(4): 659-661. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.047

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HU Qian-pei, XIE Bo, LI Yi-mei

2016, 14(4): 662-664. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.048

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A Comprehensive Evaluation of the appropriate technology packages by Using the Fuzzy Combined method of TOPSIS and Rank Sum Ratio

XU Jing, SHI Xue-feng, FANG Yun-yun, SHI Shi-wen, BAHe Jia-na-er

2016, 14(4): 665-668. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.049

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Objective To explore the feasibility of TOPSIS and RSR for 5 different traditional Chinese medicine appropriate technology packages in the grass area,and sort the results of the evaluation,and to provide a scientific basis for improving the technology package. Methods The article involves a total of five technical packages:“neck and back pain” of A package,“gynecological diseases” of B package,“ children with diarrhea” of C package,“ chronic stomach” of D package and “neoplastic disease” of E package.Selecting 8 index: input costs,the number of expert people,the number of senior people,the grassroots people often under the guidance of experts,the number of hours of training,number of trainers,evaluating rate and the number of users.TOPSIS,RSR and the fuzzy combined method of them were used to evaluate the effect of five kinds of traditional Chinese medicine packages. Results By TOPSIS we obtained the descending value of Ci is A package 0.76,D package 0.66,B package 0.49,C package 0.44 and E package 0.00;by RSR the descending values were A package 0.90,D package 0.80,C package 0.58,B package 0.53 and E package 0.20;the result is also obtained by the fuzzy joint law of both the maximum value is A package,D package secondly,E value of the minimum package.By TOPSIS method obtained the max C_i value is 0.76 of A package and min C_i value is 0.00 of E package.By RSR method obtained the max value is 0.90 of a package and min value is 0.20 of E package.By the fuzzy combined method of them obtained the same result.So there have a basically same result in the Technical packages by TOPSIS,RSR and the fuzzy combined method of them.A package and D package top two,the situation is better;E package Ranked last,relatively poor. Conclusion The combination of the two methods can evaluate the traditional Chinese medicine promotion effect rationally.

Effect of traditional Chinese medicine injection combined with acupoint massage and early nursing intervention on the swelling of Pilon fracture

HUANG Dong-hong, YANG Dan-hua, JIANG Yun-fu

2016, 14(4): 669-671. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.050

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Objective To investigate the effect of traditional Chinese medicine injection combined with acupoint massage and early nursing intervention on the swelling of Pilon fracture,to provide reference for clinical nursing. Methods Eightycases of Pilon from January 2013 to January 2015 in our hospital were fracture patients as the research object.According to the random number table method,the patients were divided into the treatment group and the control group (40 cases),control group were given routine nursing,patients in the treatment group were treated with traditional Chinese medicine hot and cold spray combined with acupoint massage nursing intervention on the basis of routine nursing,nursing 5 days compared two groups of patients with clinical curative effect,the swelling time and nursing after 1,3 days after the changes of pain situation. Results Nursing care in the treatment group,the total efficiency was 97.50% (39/40) and in the control group,the total efficiency is 82.50% (33/40),in the treatment group,the total efficiency was significantly higher than that in the control group,the difference was statistically significant (P<0.05).The treatment group 1 and 3 days after the VAS scores were lower than the control group,the difference was statistically significant (P<0.05);treatment group,swelling time (5.01±0.49)d,which was significantly lower than that of the control group (P<0.05);treatment group,the total satisfaction rate was 100.00% (40/40) and in the control group,the total satisfaction rate was 82.50% (33/40),in the treatment group,the total satisfaction rate was significantly higher than that of the control group,the difference had statistical significance (P<0.05). Conclusion Hot and cold spray of traditional Chinese medicine combined with acupoint massage nursing intervention reduce the Pilon fracture patients with early swelling and the degree of pain,improve patient satisfaction,operation is convenient and has no serious adverse reactions,it is worth clinical attention.

Combined application of Case-based learning and problem-based learning in internal medicine course

JIN Guo-xi, GAO Yong, BI Ya-xin, YU Lei, CHEN Hui

2016, 14(4): 672-675. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.051

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Objective In view of the difficulty for students to learn the clinical courses and the unsatisfactory of problem-based learning(PBL) in clinical course in ordinary medical college,We studied the effect of combined application of case-based learning(CBL) and PBL in clinical medicine course,and probed how to make the PBL teaching more according with the requirement of the syllabus. Methods The new formal PBL was based on teaching of integrated curricula of clinical curriculum.Taking PBL of internal medicine as example,we improved the traditional PBL in some aspects which including selections of cases and tutors,teaching procedure and the role of tutors.We appointed the senior doctors as PBL tutors and the PBL cases were selected carefully by the tutors.We added' basic knowledge reviewing’and 'basic knowledge intensifying’ teaching steps to improve the effect of PBL and made the PBL teaching more according with the syllabus and learning target. Results Both CBL and PBL are learner-centered instructional approaches.They can enhance students’motivations and group performance.Compare with the simple PBL,the combined application of CBL and PBL is favorable toovercome some defects in simple PBL,such as it is not around closely the learning outlines,distracting the students from the learning objective,taking too much time and so on. Conclusion However,the implementation of simple PBL in clinical courses is facing many changes,the combination of CBL and PBL can improve the efficiency of PBL.Combining multiple teaching methods in clinical courses in medical students of ordinary medical college,especially in senior is more efficient.Both reviewing of important knowledge and exercising of applying ability are beneficial to improve the efficiency of PBL and the coherence between the processes of PBL and teaching target.

The enlightenment of general practice training in Royal College of general practitioners

LEI Li-mei, LAN Xiang

2016, 14(4): 676-679. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.052

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With the development of society,the demand of people for medical care has been increasing,and the general practitioner(GP) is becoming more and more popular.The Britain is one of the earliest countries that have the general practice care system.After years developed,Britain has a complete National Health Service system;flexible,independent and efficient general medical clinic;strict general practice clinic system;excellent cooperative integrated services between community and general practice clinic;rigidmedical quality monitoring system and strict,high standards and homogenization GP training system.The service purposes of Britain health insurance system and the core NHS values are similar to health care reformrequirements in China.It is good experiences for currently basic health work in China such as classification treatments,basic initial diagnosis,medical support combined and general practice contract services.After two weeks training,based on the British general practitioner training model and Chinese actual situation,wesuggest that it is necessary to improve general practice care system,develop basic health service system,establish general practitioner “gatekeeper” system,promote classification treatment and two-way referral,advance the general practitioner team servicebuilding and medical modeltransform in community,further train teachers in general practicestandardized training center,integrate social services resources for community health services,increase propaganda and correctly guide people’s medical needs and explore a suitablegeneral practitioners training model for China,and promote the development of general practice.

Impact of perioperative intensive nursing on patients with esophageal varices during esophageal varices ligation

JIANG Yu-hong, XUN Yun-hao

2016, 14(4): 680-682. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.053

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Objective To observe effect of perioperative intensive nursing on the patients with esophageal varices(EV) during Endoscopic variceal ligation(EVL),and provide the basis for the optimization and selection of treatment plan for EV. Methods The perioperative intensive nursing intervention(including preoperative psychological counseling education,intraoperative and postoperative comfort care,music therapy and diet guidance and observation,etc.) were carried out in48 patients with EVLin the hospital from February 2014 to February 2015,as the intervention group;48 cases receiving only routine care (to assist in the improvement of preoperative examination,preparation of medication before operation,and guide the patients to preoperative fasting,drinking,and conventional psychological nursing)were selected as the control group.The EV removal rate,the number of required treatment,and the rate of re-bleeding of both groups were statistically analyzed,as well aspulmonary complications were recorded and compared. Results The EV removal rate,the number of required treatment,and the rate of re-bleeding in the intervention group were 91.7%(44/48),(2.3±0.7) times and 8.3%(4/48),respectively,whilein the control group were 87.5%(42/48),(3.5±1.1)times and 20.8%(10/48),respectively;the number of required treatment and the rate of re-bleeding were significantly less than the control group(P<0.05);the incidence of complications in the intervention group was 6.3%(3/48),while in the control group was 25%(12/48),the difference was statistically significant(P<0.05). Conclusion The perioperative intensive nursing intervention can effectively reduce the number of EVL surgery in EV patients,improve the treatment effect,and reduce the incidence of complications,which is worthy of further promotion in clinic.

Effectiveness of discharge planning in neonatal intensive care unit on effective transitional carefor premature infants

MO Min-ling

2016, 14(4): 683-685. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.054

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Objective To study the effectiveness of discharge planning for premature infants in neonatal intensive care unit(NICU) on the parents depression anxiety and physical development of infants within six months. Methods Total 100 premature infants undergoing treatment in NICU of our hospital were randomly and equally divided into two groups.The control group was given conventional nursing care,while the experimental group received discharge planning for hometransitional care.The nursing effect in both groups was compared. Results The depression score and anxiety score in the experimental group were obviously lower than that depression score and anxiety score in the control group[(35.8±4.4) scores and (34.1±0.6) scores vs.(42.7±4.8) scores and (46.9±0.8) scores],the difference was statistically significant(P<0.05).The height of premature infantsat the 3rd and 6th months were(59.8±8.9)cm and (67.5±6.4)cm in the experimental group,which was significantly higher than that [(49.5±9.5)cm and (55.5±5.6)cm] in the control group (P<0.05).The neonatal weight at 3rd and 6th months were (6.8±1.1)kg and (8.1±1.5)kg in the experimental group,which was significantly higher than that[(5.1±0.8)kg and (6.9±1.3)kg] in the control group(P<0.05). Conclusion Discharge planning in NICU shows obvious effect on the transitional care of premature infants,which can improves the anxiety and depression symptoms of parents,promote the physical development of neonates.

Effectiveness of Dorothea Orem's Self-Care Theory in postoperative nursing intervention and influence on quality of laryngocarcinoma patient

LIN Yan-hong, DAI Lin-lin, WANG Ying, LI Li, LIU Bing, QU Xue-hua

2016, 14(4): 686-688. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.055

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Objective To evaluate the effect of Dorothea Orem ’ s Self-Care Theory in the postoperative nursing intervention and the influence on the QOL of laryngocarcinoma patient. Methods Total 68 laryngeal cancer patients undergoing partial resection in our hospital between February,2011 and February,2013 were enrolled into this study,and were divided into group A(32 cases) and group B(36 cases) according to the nursing approaches.Group A received the routine nursing intervention,while group B received the intervention by Orem Self-Care Theory.The phonatory function,self-care ability and quality of life between the two groups were compared after the nursing intervention. Results The self-care ability in Group B was significantly better than that in group A,the difference was statistically significant(P<0.05).There was no statistical difference in phonatory function between the two groups(χ²=0.782,P=0.258).One year follow-up showed that the verbal communication ability,capacity and total score by Washington Medical Patients Quality of Life Scale(UW-QOL) were significantly better in group B as compared with those in group A(P<0.05). Conclusion The application of Orem’s Self-Care Theory in the postoperative nursing intervention for the laryngeal cancer patients after partial resection can improve their self-care ability and quality of life.

CHENG Peng, WANG Wei-qi

2016, 14(4): 689-691. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.056

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WU Min-jie, LOU Ren-shan, PAN Ya-bin, WEI Peng

2016, 14(4): 691-693. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.057

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ZHANG Jiao-er

2016, 14(4): 694-696. doi: 10.16766/j.cnki.issn.1674-4152.2016.04.058

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About Journal

2016 Vol. 14, No. 4

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