2016 Vol. 14, No. 8

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Assessment of current cognitive status in community medical staffs about family doctor service in Beijing
WANG Min, ZHAO Jing, ZHAO Jian-gong, ZHANG Xiang-dong
2016, 14(8): 1243-1246. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.001
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Objective To investigate the current cognitive status in community medical staffs about family doctor service in Beijing,and provide strategies and suggestions for further promotion of the family doctor service. Methods The selfdesigned questionnaire for basic condition,current working condition and their cognition of family doctor service was used to survey in March,2014 among the medical staffs from 8 community health service centers(4 from urban area and 4 from suburbs) that were selected by cluster sampling. Results A total of 469 questionnaires were sent out,464 valid questionnaires were returned and the valid rate was 98. 9%. Of all the community medical staffs,85. 6% had a degree of college or above; 54. 3% were primary professional title; the major form of the service was the clinic; the daily working hours of the community medical staffs was 8. 5,family doctor service time took up 43. 5% of the working time per day; 90. 9% of the team members believed that the workload was more than before the signing of the contract; the health consultation,telephone follow-up,health record management and chronic disease management were the main job of the community medical staffs; 93. 4% of the medical staffs could answer the concept of family doctor service; 38. 9% of the medical staffs thought that the assessment and incentive measures from the government and relevant departments were effective; 72. 6% of the medical staffs were willing to become a community health service team member; 89. 7% of the medical staffs agreed to implement a community health care system; 53. 4% of the medical staffs thought that the existing laws and regulations could not protect community health service personnel to carry out family doctor service; 73. 7% of the medical staffs thought that the development of family doctor service could ease the "medical treatment difficult,expensive"phenomenon; 90. 9% of medical staffs thought that the family doctor service was very important; The higher the awareness of the medical staff on the family doctor service,the greater the willingness of the team members to become a member of the team. Conclusion At present,the current cognitive status of community medical staffs on the family doctor service in Beijing is better. The further promotion of the family doctor service need more community medical personnel,support of law and effective incentive measures.
CHEN Ai-bin, MAO Shuang-gen
2016, 14(8): 1247-1248.
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Influence of glycyrrhiza(Gc34) on the invasion and proliferation of Hep G-2 cell
LU Gen-lin, WU Ai-bing, WANG Hong-bin
2016, 14(8): 1249-1251,1318. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.002
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Objective To investigate the influence of glycyrrhiza(Gc34) on the invasion and proliferation of Hep G-2 cell and its mechanism. Methods Hep G-2 cells were divided into control group and Gc34 group. Hep G-2 cells were treated with 12. 5,25. 0,50. 0 mg/L Gc34 and 0. 5% alcohol. Cell invasion assay was used to detect the invasion of Hep G-2 cell.The proliferation of Hep G-2 cell was detected by methyl thiazolyl tetrazolium(MTT). Matrix metalloproteinase 2,9,GSH/GSSG,MDA and SOD of Hep G-2 cell supernatant were measured. Results The nucleus of Hep G-2 cell under light microscope was abnormal with an increase in the ratio of nucleus to cytoplasm and nucleus fission,nucleus anachromasis,meganucleus,binucleus,polynucleus. Inhibition of Gc34 on the proliferation of Hep G-2 cell was time-dependent and concentration-dependent(P < 0. 01). The invasive ability,content of MMP-2,9,GSH/GSSG,SOD of Hep G-2 cell supernatant in Gc34 group was 45 ±7,(40. 3 ±6. 2) mg/L,(42. 7 ±5. 6) mg/L,4. 2 ±0. 8,(67. 2 ±7. 9) U/(mg·L),respectively,which were significantly lower than those in the control group(P < 0. 01). The content of MDA of Hep G-2 cell supernatant in Gc34 group was(45. 4 ±8. 5) mmol/g which was predominantly higher than that in control group(P < 0. 01). The invasion positively correlated with MMP-2,MMP-9(r=0. 65,0. 72,P < 0. 01). The proliferation positively correlated with GSH/GSSG,SOD(r=0. 55,0. 64,P < 0. 01),negatively correlated with MDA(r=- 0. 58,P < 0. 01). Conclusion Gc34 can inhibit the invasion of Hep G-2 cell by down-regulating MMP-2,9 and attenuate the proliferation by down-regulating GSH/GSSG,SOD and up-regulating MDA.
Clinical analysis of 41 cases of Mycoplasma Pneumoniae pneumonia complicated with Epstein-Barr virus infection
WANG Chao-ying, FANG Jie, GUO Sheng, WU Liang-xia
2016, 14(8): 1252-1254,1398. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.003
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Objective To analyze the clinical features of Mycoplasma Pneumoniae pneumonia(MPP) complicated with Epstein-Barr virus(EBV) infection in children. Methods Total 94 cases of MPP children in our hospital from August,2013 to December,2014 were enrolled. Forty-one cases were diagnosed of MPP complicated with EBV infection(research group),53 cases of MPP without EBV infection were as control. The general information,clinical manifestation,auxiliary examination,extra-pulmonary complications,therapeutic method and prognosis were analyzed. Results The constituent ratio of age in both groups had statistically significant difference(P < 0. 05). Length of hospital stay,duration of pulmonary rales,severe pneumonia occurrence rates(29. 3%,5. 7%) and lymphadenectasis occurrence rates(41. 4%,15. 1%) of the two groups had significant differences(P < 0. 01). The occurrence rates of elevated white blood cell amount(36. 6%,13. 2%),pleural effusion(9. 8%,0. 0%) and pulmonary consolidation(2. 4%,0. 0%) had significant differences(P <0. 01). The occurrence rates of liver function damage(9. 8%,0. 0%) had significant difference(P < 0. 05). No significant difference was found between two groups in febrile time,occurrence rates of elevated C-reactive protein,erythrocyte sedimentation rate,procalcitonin,and extra-pulmonary complications(P > 0. 05). Conclusion The infants with MPP are more likely to be complicated with EBV infection. Compared with MPP cases,MPP complicated with EBV infection cases have longer duration of pulmonary rales and higher occurrence of pleural effusion,pulmonary consolidation,liver function damage,lymphadenectasis,severe pneumonia and longer length of hospital stay. In some cases the adoption of glucocorticoid or protopic immunomodulator may be necessary.
Effects of hydrogen sulfide on apoptosis of intestinal mucosal epithelial cells during ischemia / reperfusion in rats
ZHU Ren-wu, GU Ye-chun, ZHANG Yu-cheng, JIANG Yang-gui, DAI Yong-yue
2016, 14(8): 1255-1258. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.004
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Objective To explore the effects of hydrogen sulfide(H2S) on apoptosis of intestinal mucosal epithelial cells during ischemia/reperfusion in rats and discuss the potential mechanisms. Methods The superior mesenteric artery was separated and blocked from the root using vascular clamp for 1 hour,then remove the clamp to restore blood supply,which accomplish duplicating intestinal ischemia/reperfusion animal model. Twenty-four male SD rats were randomly divided into3 groups with 8 rats in each group:Sham-operation control group(C group),Ischemia/reperfusion group(I/R group) and H2 S pretreatment group(Na HS group). Collect blood and intestinal tissue samples to assay the levels of superoxidase dismutase(SOD),malondialdehyde(MDA) and glutathione peroxidase(GSH-Px) after 2 hour reperfusion. The intestinal mucosal injury and histological alteration under through HE staining was observed. TUNEL method was used to detect apoptosis cells. Caspase-3 protein was measured by Western blot. Results Compared with C group,the damage of small intestinal mucosal tissue and gland was obvious in both I/R group and Na HS group,the levels of SOD and GSH-Px in serum and intestinal tissue was significantly decreased,cell apoptosis index(AI),MDA levels and caspase-3 protein expression were increased significantly. H2 S pretreatment markedly alleviated the pathological damage of small intestinal mucosal tissue,reduced the number of apoptosis cells,decreased the levels of MDA and caspase-3 protein expression,and promoted the levels of SOD and GSH-Px(P < 0. 01),as compared with I/R group. Conclusion H2 S can relieve the injury of intestinal mucosal tissues after ischemia/reperfusion,reduce the intestinal mucosal epithelial cells apoptosis,which maybe relates to its relieving the oxidative stress reaction during ischemia/reperfusion.
Effectiveness of porous tantalum implant combined with core decompression on adult early avascular necrosis of femoral head
WU Min, GUAN Jian-zhong, XIAO Yu-zhou, ZHOU Xin-she, ZHANG Zhang-chun, WANG Yuan-song, WANG Zhao-dong
2016, 14(8): 1259-1261,1292. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.005
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Objective To evaluate the curative effectiveness of porous tantalum implant combined with core decompression in the treatment of adult early avascular necrosis of femoral head(ANFH). Methods The 23 hips of 20 patients,including 16 males(18 hips) and 4 females(5 hips),aged from 24 to 60 years old(averaged 38. 2),with femur head necrosis were treated with porous tantalum implant combined with core decompression. According to the Association Research Circulation Osteous(ARCO) classification,2,1,8,9 and 3 hips were in stage ⅠB,ⅠC,ⅡA,ⅡB and ⅡC. Harris score was average 56. 6 ±7. 0 preoperatively. The outcome measures included Harris Hip Score,radiographic outcome,and survivorship analysis with reversion to THA. Results There were 20 successful surgical procedures,with a mean operative time of 30 min(range 20- 55 min) and an average blood loss of 60 ml(ranged from 30 to 110 ml). These cases acquired follow-up,the meaning follow-up duration was 33. 2 months(17- 45 months). Harris score was average 85. 4 ±6. 8 postoperatively. As total hip arthroplasty for the endpoint,the femoral head survival rate was 95. 65%. One hip who had a hormone-using history had aggravated to femoral head collapse as stage Ⅳ,no aggravation in collapse and necrosis in other cases were found by X ray examination. Conclusion The porous tantalum implant combined with core decompression in the treatment of adult early femur head necrosis can achieve a good clinical result. The operation has the advantages of more convenient operation,minimally invasive,safe,less complications,and better hip functional recovery. It is an effective method for adult early ANFH.
Observation of anterior compartment in primipara with postpartum stress urinary incontinence by pelvic floor ultrasound
YANG Yan, ZHONG Hua, YAN Dong-mei, WU Yan-ling, ZHOU Yu-ting, CENG Mei-qing
2016, 14(8): 1262-1265,1401. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.006
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Objective To investigate the application value of pelvic floor ultrasound to observe the structure changes of anterior compartment in primipara with postpartum stress urinary incontinence. Methods Transperineal pelvic floor ultrasound was performed on a random sample of 182 primiparas in 6 to 8 weeks after vaginal delivery,who were divided into SUI group(72 cases) and control group(110 cases). The structure changes of ultrasonic images of anterior compartment were observed at rest state and on maximal Valsalva maneuver. The observation and measurement parameters include:bladder neck-symphysis pubis distance(BSD),detrusor wall thickness(DWT),retrovesical angle(RA) at rest state and bladder neck descent(BND),urethral rotation,urethral mouth funnel formation,bladder prolapse on maximal Valsalva maneuver. Results The detrusor wall thickness of SUI group was(3. 21 ±0. 86) mm,and that of control group was(3. 11 ±0. 76) mm. It showed no statistical difference at rest state(t=0. 798,P=0. 426). The position of bladder neck of SUI group was lower[(23. 61 ±4. 57) mm vs.(25. 35 ±4. 05) mm],and RA was greater than control group[(134. 14 ±21. 04) ° vs.(114. 29 ±10. 53) °]. There was a statistically significant change(t value was- 2. 697 and8. 422,P value was 0. 008 and 0. 000 respectively). BND[(30. 39 ±8. 37) mm vs.(21. 82 ±7. 65) mm] and urethral rotation[(45. 21 ±12. 78) ° vs.(33. 25 ±14. 58) °]of SUI group was also greater than that of control group on maximal Valsalva maneuver. There was significant difference(t value was 7. 115 and 5. 673 respectively,P value was 0. 000). The urethral mouth funnel formation rate(55. 56% vs. 27. 27%) and bladder prolapse formation rate(63. 89% vs.24. 55%) of SUI group were significantly higher than that of control group(χ2value was 11. 831 and 28. 041,P value was0. 001 and 0. 000 respectively). Conclusion The occurrence of postpartum stress urinary incontinence has a significant relation to the impairment of supporting structure of bladder neck,urethra and levatorani. The changes of structure and function of anterior compartment can be observed by pelvic floor ultrasound. Abnormal changes of pelvic floor can be detected early. It can provide the objective basis for the clinical diagnosis and treatment of postpartum stress urinary incontinence.
Nutritional assessment patients with hilar cholangiocarcinoma and its relationship with postoperative complications
GUO Jian, ZHOU Yong-bin, ZHAI Ze-min, SUN Fang-yuan, MA Hai-ning, ZHANG Yan-zhong
2016, 14(8): 1266-1268. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.007
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Objective To investigate the proportion of malnutrition in patients with hilar cholangiocarcinoma(HC),and analyze the factors associated with the malnutrition and the influence of malnutrition to postoperative complications. Methods Total 53 cases of hilar cholangiocarcinoma met the criterion of radical excision in our hospital between January,2000 and January,2015 were enrolled into this study and the clinic date were reviewed. All of them were assigned into well nutrition group and malnutrition group according to the scored patient-generated subjective global assessment(PG-SGA).The relationship between the malnutrition and postoperative complications were evaluated. Results According to PGSGA,29 cases(54. 7%) were with malnutrition. The factors associated with malnutrition includedage,duration of jaundice,liver function classification by13C-methacetin breath test and stage of tumor(P < 0. 05 respectively),but not with gender,Bismuth- Corletttyping,BMI,preoperative albumin level and Child Pugh Score(P > 0. 05). The incidence of postoperativecomplications was higher in malnutrition group that did not receiving nutrition innervation than that in well nutrition group(χ2=4. 201,P=0. 040). There were no obvious differences in the incidence of postoperative complications between the malnutrition group that receive nutritional support and the well nutrition group(χ2=0. 438,P=0. 508). Conclusion The incidence of malnutrition is commonin patients with hilar cholangiocarcinoma before the surgery treatment,and perioperative nutritional support may reduce postoperative complications.
Analysis on distribution and drug resistance of 136 strains of hospital-acquired Pseudomonas aeruginosa related with bloodstream infections
ZHAO Zhi-gang, QIU Tian, WANG Kai-fei, LIANG Zhi-xin, CHEN Liang-an
2016, 14(8): 1269-1271,1321. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.008
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Objective The morbidity and mortality of hospital-acquired Pseudomonas aeruginosa related with bloodstream infections presented an increased trends recently. This article aimed to analyze clinical distribution and drug resistance of hospital-acquired pseudomonas aeruginosa bacteremia to provide reference for clinical prevention and treatment. Methods The distribution and comorbidity of patients suffered from pseudomonas aeruginosa bacteremia from January,2010 to December,2014 in PLA general hospital were analyzed retrospectively. The susceptibility to antimicrobials of Pseudomonas aeruginosa isolated from blood specimens was tested by Kirby-Bauey methods and the results were performed using WH0 NET 5. 6. At the same time,the differences of drug resistance ratio in recent years were analyzed using SPSS17. 0. Results Total 136 strains of pseudomonas aeruginosa were isolated from blood specimens from January,2010 to December,2014,34 strains(25. 00%) of which distributed in Intensive Care Unit,23 strains(16. 91%) in department of hematology,14 strains(10. 29%) in department of gastroenterology,13 strains(9. 56%) in department of respiratory and so on. The patients with malignant cancers and leukemia were easily affected with bloodstream infections caused by pseudomonas aeruginosa,accounting for 30. 15% and 20. 59%,respectively. Twenty-two strains were multi-drug resistant pseudomonas aeruginosa,the detection rate was 16. 18%. Pseudomonas aeruginosa was seriously resistant to carbopenems,such as imipenem and meropenem,the rates were 33. 09% and 26. 47%,respectively,while Pseudomonas aeruginosa had low resistance rates to amikacin,cefepime,ciprofloxacin,the rates were 13. 24%,16. 18%,18. 38% respectively. The differences of drug resistance ratio of common antibiotics in recent years were not significant(P > 0. 05),but resistance rates of cefoperazone,aztreonam,imipenem,levofloxacin presented increased trends. Conclusion Pseudomonas aeruginosa bacteremia distributes widely in our hospital. The drug resistance of pseudomonas aeruginosa related with bloodstream infections is a bit serious,so drug resistance test should be strengthened and the clinical application of antibiotics should be performed based on the result of drug susceptibility test.
Analysis on pathogenic microorganism and drug-resistance of ventilator associated pneumonia in ICU
LIU Cheng-chan, LIU Ru-xi, ZHOU Jie, LI Min, WU Qiang
2016, 14(8): 1272-1274. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.009
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Objective To investigate the pathogenic distribution and drug resistance characteristics of ventilator associated pneumonia(VAP) in ICU. Methods The medical record datawere retrospectively collected inpatients withinvasive mechanical ventilation who diagnosed VAP in the ICU of our hospital from October,2014 to October,2015. Results A total of 47 patients were enrolled includingmale 31,female 16,age 14 to 74 years old,42 cases with intubation,26 cases with tracheostomy,Sixty-six cases of positive secretion culture,53 cases with application of antimicrobial agents before culture.66 case of VAP were diagnosed. Ninety bacterial strains isolates,which included 58(64. 4%) of gram negative bacilli,23(25. 6%) of gram positive bacteria,and 11(12. 2%) of fungus. The top five pathogenic bacteria were Paumanii(16 strains,17. 8%),Pseudomonas aeruginosa(13 strains,14. 4%),Staphylococcus aureus(11 strains,12. 2%),Klebsiella pneumoniae(9 strains,10%) and Escherichia coli(8 strains,8. 9%). The drug-resistant of Paumanii was the most serious. It has a high drug-resistant rate for Cephalosporins(100. 0%),Ampicillin/sulbactam(93. 8%),Quinolones(93. 8%). The rate of resistance to Cefoperazone/Sulbactam was minimum(48. 3%). The resistance of Pseudomonas aeruginosa to Penicillins(92. 3%) was the highest,to Ceftazidime also reach 53. 8%,to Amikacin(23. 1%) was the lowest. The resistance of Klebsiella pneumoniae to Gentamicin(100. 0%) was the highest,to Imipenem(11. 1%) was the lowest. The resistance of Escherichia coli to Ampicillin(100. 0%),Gentamicin(100. 0%) and Chemitrim(100. 0%) was the highest,to Imipenem(12. 5%) was the lowest. Methicllin-resistant strains in S. aureus(MRSA) accounted for54. 5%(6/11). No staphylococcal strains were found resistant to Vancomycin or linezolid. Conclusion VAP in ICU was mainly caused bygram negative bacilli,and multidrug-resistantare most common.
The clinical effectiveness of voice therapy on patients with vocal cord polyps after phonomicrosurgery
ZHUGE Pan, YOU Hui-hua, WANG Han-qing, ZHANG Yu-lan, DU Huan-le
2016, 14(8): 1275-1278. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.010
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Objective To evaluate the clinical effectiveness of voice therapy on patients with vocal cord polyps after phonomicrosurgery. Methods In experimental group,there were 55 patients with vocal cord polyps after phonomicrosurgery underwent voice therapy. Laryngostroboscopy,voice handicap index(VHI),and dysphonia Severity Index(DSI) were applied for evaluation of the patients' voice quality. In control group,no voice therapy was given to 41 patients after phonomicrosurgery. The inter-group and intra-group differences of laryngostroboscopy,VHI,and DSI were compared statistically. Results No statistical inter-group differences of mucosal wave and incomplete glottal closure were found between two groups before and after surgery. No statistical inter-group differences of values of VHI and MPT,Jitter,F0-High,ILow,DSI were found between two groups before surgery. The values of VHI improved after surgery in two groups,and the values of VHI in experimental group were all lower than those in control group after surgery. The value of Jitter in experimental group was lower than that in control group after surgery. Jitter,I-Low,and DSI improved after surgery in experimental group,but in control group Jitter and DSI got better after surgery. Conclusion Laryngostroboscopy,VHI,and DSI could assess voice quality of patients with vocal polyps comprehensively. Voice therapy could improve patients' self-evaluated voice quality and vocal stability after phonomicrosurgery.
A comparative study of endoscopic and open resection for colorectal cancer affecting body stress and cell immunity
WANG Yong-sen, XIE Yi-xiang, WANG Chuan-si, HUANG Hong-wu, WU Shen-wei
2016, 14(8): 1279-1281. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.011
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Objective To explore the effect of laparoscopic and open radical operation for colorectal cancer on the cell immunity and body stress,and evaluate the advantage of laparoscopic technique in the treatment of rectal cancer from immunology perspective. Methods A total of 40 cases of colorectal cancer were randomly divided into 2 groups. The laparoscopic group(20 cases) received laparoscopic resection of colorectal cancer,while the control group(20 cases) received traditional open resection of colorectal cancer. The levels of CD3~+,CD4~+,CD8~+,s IL-2R,CRP were detected and compared one day before the surgery,and 1st,3rd and 7th day after the surgery. Results There was no significant difference in blood levels of all index between laparoscopic resection group and open operation group on first day before the surgery(all P > 0. 05). There was no significant difference in blood levels of CD3~+,CD4~+,CD8~+,CRP between laparoscopic resection group and open operation group on the first day after the surgery(all P > 0. 05),the level of s IL-2R in laparoscopic group was lower than that in open operation group,the difference was statistically significant(P < 0. 05). At third days after the operation,CD3~+,CD4~+,in the laparoscopic group was higher than that in the open operation group,the difference was statistically significant(P < 0. 05); s IL-2R and CRP were less than open surgery group,the difference was statistically significant(P < 0. 05),there was no significant difference between CD8~+and CD4~+/CD8~+(P > 0. 05). At seventh days after the operation,the level of CRP in the laparoscopic group was less than that in the open group,and the difference was statistically significant(P < 0. 05); The other was not significant(P > 0. 05). Compared with all index,first day,3rd and 7th day were significantly decreased,the difference was statistically significant(P < 0. 05). Conclusion Compared with the traditional open surgery,laparoscopic radical resection of colorectal cancer has positive significance in the protection of early cell immunity and reduction of early stress response.
Study of molecular mechanism of miR-34c in the inhibition of endometrial carcinoma
ZHANG Jin-xia, LIN Ming-yan, LIN Ya
2016, 14(8): 1282-1285. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.012
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Objective MicroRNAs(miRNAs) are endogenously expressed 22-nucleotide small RNAs which repress protein translation through binding to a target mRNA. The recent studies have shown that some miRNAs can regulate proliferation and migration of tumor cells. The role of miRNAs in endometrial carcinoma,however,warrants for further investigation. In the present study,we investigated miR-34 c expression pattern,function and molecular mechanism in endometrial carcinoma. Methods Real-time RT-PCR was performed to detect the expression of miR-34 c in 20 endometrial carcinoma specimens. The miR-34 c was transfected into RL95-2 cells by using lipofectamine reagent. The proliferation of RL95-2cells was examined by MTS cell proliferation assay and colony formation assay. The cell cycle was analyzed by flow cytometry and cell migration was evaluated by Transwell assay. The target of miR-34 c was predicted by bioinformatics and confirmed by luciferase assay. C-Met was down-regulated by RNAi. Western blot analysis was carried out to examine the effects of miR-34 c on c-Met and proteins in important cellular signaling pathways. Results MiR-34 c was dramatically down-regulated in most endometrial carcinoma samples. Ectopic miR-34 c can inhibit the proliferation of RL95-2 cells through cell cycle G1 arrest. Furthermore,miR-34 c suppressed RL95-2 cell migration. Bioinformatics revealed c-Met was a target gene of miR-34 c and confirmed by luciferase assay. Western blot analysis indicated that miR-34 c down-regulated the expression of c-Met,p-Akt,p-ERK1/2,CDK4,CDK6 and p-Rb. Conclusion The miR-34 c can inhibite endometrial carcinoma cell proliferation and migration by targeting c-Met,which indicates that miR-34 c may act as an important tumor suppressor in ndometrial carcinoma.
Cerebrovascular reactivity in patients with lacunar stroke
CHEN Fang-fang, HU Xia, ZHANG Min, KONG Xiang-feng
2016, 14(8): 1286-1288,1372. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.013
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Objective To investigate the cerebral vasoreactivity in patients with lacunar stroke and influencing factors. Methods Total 75 cases of acute lacunar stroke were consecutive selected in our hospital between January,2014 and January,2015. Sixty healthy cases with matched age and sex were selected as control. Detailed clinical data and imaging features were recorded in patients with lacunar stroke. The degrees of leukoaraiosis were measured by Fazekas scale classification. The Mean flow velocity(MFV) and breath holding index(BHI) were calculated by the transcranial Doppler(TCD) breath-holding test in patients with lacunar stroke and the control group. Further analysis of the influence of clinical related factors to BHI was performed in lacunar stroke patients. Results The based MFV[(56. 5 ±8. 9) cm/s] and BHI(1. 09 ±0. 18) were lower in lacunar stroke patients than those in the control group[MFV:(59. 9 ±6. 6) cm/s;BHI:1. 39 ±0. 14],the difference was statistically significant(P < 0. 05); The degrees of leukoaraiosis was negatively correlated with BHI in lacunar stroke patients(r=- 0. 869,P < 0. 01). The lower the BHI score was correlated with the higher grades of Leukoaraiosis. The multivariate linear regression analysis showed that age(OR=- 0. 333,P < 0. 01) and degree of leukoaraiosis(OR=- 0. 583,P < 0. 01) were the risk factors for BHI in lacunar stroke patients. Conclusion The vascular reactivity in lacunar stroke patients is commonly severe destroyed,and cerebral blood flow regulation function is severely impaired; The more severe white matter damage,the more severe vasoreactivity injure. Age and grade of leukoaraiosis are risk factors for the cerebral vasoreactivity in patients with lacunar stroke.
Application of thrombelastography in evaluating effect of antiplatelet drugs for patients undergoing percutaneous coronary intervention and relationship with prognosis
GONG Yan-jun, QIU Lin, QU Chen-xue, YANG Fan, WANG Zhi, LI Jian-ping, LIU Zhao-ping, HONG Tao
2016, 14(8): 1289-1292. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.014
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Objective To analyze the incidence and influencing factors of high on-treatment platelet reactivity(HPR)using thrombelastography(TEG) in patients undergoing percutaneous coronary intervention(PCI) and dual anti-platelet therapy,and explore the relationship between the incidence of HPR and prognosis. Methods The data was collected from335 patients undergoing PCI and TEG examination in our hospital from January,2013 to December,2014. All patients were receiving dual anti-platelet therapy with Aspirin and clopidogrel. The medical records and prescription were reviewed. The platelet inhibition rate was examined with TEG and the rate of HPR was calculated,and the risk factors were analyzed. The follow-up for the clinical events was carried out to analyze the relationship between the occurrence of HPR and prognosis. SPSS 19. 0 statistical software was used for data analysis. Results The prevalence of HPR after treatment with aspirin was 35. 2%(118/335),with clopidogrel was 34. 6%(116/335). The occurrence of HPR was affected by some clinical conditions. 308 patients were followed up,and 289 of them did not change the anti-platelet drugs. HPR was correlated at some extent with the ischemic events in patients receiving aspirin treatment(P=0. 003),nut not for clopidogrel treatment. Conclusion The incidence of HPR by TEG is prevalent in clinical practice,and some clinical conditions may affect HPR. HPR in patients receiving aspirin treatment is related with ischemic events.
Effects of different blood purification methods on serum parathyroid hormone of patients on maintenance hemodialysis
LI Hong, WANG Ji-ping, WANG Xiao-hui
2016, 14(8): 1293-1295. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.015
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Objective To investigate the effects of different blood purification methods on serum parathyroid hormone(PTH) of patient on maintenance hemodialysis,and observe the symptoms improvement of skin itchy,joint pain,muscle weakness in each group. Methods Total 60 cases of patients on maintenance hemodialysis in our blood purification center were enrolled,and randomly divided into three groups:hemodialysis(HD) group,hemodiafiltration(HDF) group,hemoperfusion combined hemodialysis(HD + HP) group,20 cases in each group. After six months,the levels of serum PTH and serum PTH clearance observed,and the skin,itching,joint pain,muscle weakness symptoms improvement were recorded. Results The levels of serum PTH were decreased as compared with that before the treatment; The level of serum PTH in HD group was not significant decrease(P > 0. 05),but in HDF group and HD + HP group were significantly decreased(P < 0. 01). The serum PTH clearance rate in HDF group(40. 30 ±2. 70)% and HDF + HP group(41. 16 ±5. 30)% were better than HD group(5. 65 ±3. 25)%(P < 0. 01),and there were no significant difference between the HDF group and HD + HP group(P > 0. 05); The symptoms improvement of skin itchy,joint pain,muscle weakness in HDF group and HD + HP group were better than HD group(P < 0. 05). Conclusion Treatment with HDF and HD + HP can effectively remove the accumulation of serum PTH,reduce long-term dialysis-related complications and improve quality of life of patients.
Clinical value of 64-Multislice spiral computed tomography combined with immunoglobulin E and homocysteinefor detecting the stability of coronary artery plaques
JIE Xiao-jiang, XIAO Xue-hui, LIU Yan-yang
2016, 14(8): 1296-1298. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.016
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Objective To investigate the value of 64-MSCT combined with Ig E and Hcy for estimating the stability of coronary artery plaques of patients with coronary heart disease. Methods The 83 patients in-hospital doubtful or diagnosed coronary heart disease admitted to our hospital were enrolled. All patients conducted with CT tomography and coronary angiography(CAG),the result of CT tomography of who were negative,were divided into control group. According to the results of CAG and medical history,the others were divided into acute coronary syndrome(ACS) group,stable angina pectoris(SAP) group. According to the results of coronary artery plaques detected by MSCT,both ACS and SAP groups were further divided into vulnerable plaque group,mixed plaque group and stable plaque group. The levels of serum immunoglobulin E(Ig E) and homocysteine(Hcy) were detected. The clinical characteristics of patients were recorded. Ig E and(Hcy) were measured. Results 1The distribution of vulnerable plaques in ACS group was higher than that in SAP group(P < 0. 05),while that of stable plaques lower than in SAP group(P < 0. 05). 2The levels of homocysteine(Hcy)in SAP and ACS group were higher than those in control group(P < 0. 05),and there was significant difference between SAP and ACS groups(P < 0. 05). The levels of Ig E were not significant different between SAP and ACS groups(P >0. 05),3The levels of homocysteine(Hcy) in every plaque group were all obviously higher than those in the control group(P < 0. 05),and those in vulnerable and mixed plaque group were also higher than those in stable plaque group(P < 0. 05). The levels of homocysteine(Hcy) in vulnerable plaque group were higher than those in mixed plaque group(P < 0. 05). The levels of Ig E in every plaque group were not higher than those in the control group(P > 0. 05). Conclusion 164-MSCTcan accurately characterize the composition of the coronary artery plaques. 2The relationship between the levels of Hcy and the stability of coronary artery plaques were intimate,which can reflect the stability of coronary artery plaques,the relationship between Ig E and unstable coronary artery plaques is not notable. 3The detection of 64-MSCT combined with homocysteine(Hcy) had predictive value of unstable coronary artery plaques.
JAK2V617F mutation and myeloproliferative neoplasms with BCR / ABL negative gene clinical correlation analysis
YIN Chun-rong, WENG Wei, HOU Hai-zhu, DU Chao, HE Gao-fen
2016, 14(8): 1299-1301,1337. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.017
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Objective To investigate the Clinical correlation analysis between JAK2V617 F mutation and myeloproliferative neoplasms(MPN) with BCR/ABL negative gene. Methods Collect 124 patients in my hospital with MPN of BCR/ABL negative,whole blood DNA extracted from peripheral blood or bone marrow,Allele specific PCR technology detect samples whether there is any JAK2V617 F gene locus mutation,combined with clinical data for further analysis. Results Among 124 patients with MPN of BCR/ABL negative,64 cases of male,60 cases of female,the median age of 58(19-83),there has no correlation between JAK2V617 F mutation and gender,and has correlation between JAK2V617 F mutation and age,JAK2V617 F mutation was 70 cases,the positive rate of JAK2V617 F mutation was 56. 45%,the disease of polycythemia vera(PV) patients with positive rate was 62. 07%(18/29),primary thrombocythemia(ET) in patients with positive rate was 53. 57%(45/84 cases),patients with chronic bone marrow fibrosis(IMF) positive rate was 63. 64%(7/11 cases). Conclusion JAK2V617 F mutation can help the diagnosis of MPN with negative BCR/ABL gene. JAK2V617 F mutation can affect hematologic features in some degrees,no correlation between JAK2V617 F mutation and gender,and age have correlation.
The diagnostic value of human epididymis protein 4 in lung cancer
ZHANG Jian, DONG Xin-min, WU Jing, CAO Chun-li, KANG Shi-rong
2016, 14(8): 1302-1304. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.018
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Objective To investigate the diagnostic value of human epididymis protein 4(HE4) in lung cancer. Methods Serum HE4 level and carcinoembryonic antigen(CEA) level were measured in serum samples from 86 patients with lung cancer and 76 healthy controls using enzyme-linked immunosorbent assay(ELISA) and with electrochemical luminescence instrument and related reagents. Receiver operating characteristic(ROC) curve of HE4 and CEA for differentiation between lung cancer and healthy controls was drawn with the pathological diagnosis as the golden standard. At last,to explore the diagnostic value of HE4 combined with CEA. Results It proved that serum HE4 levels were significantly higher in lung cancer group[(257. 93 ±40. 51) pmol/L]than in control group[(257. 93 ±40. 51) pmol/L]. No significant difference was observed between stage Ⅰ- Ⅲ group[(251. 68 ±38. 59) pmol/L] and stage Ⅳ group[(268. 49 ±40. 66) pmol/L,P=0. 60)]. No significant difference was observed among Different pathological type of lung cancer(lung adenocarcinoma group:(261. 37 ±261. 37) pmol/L,lung squamous carcinoma group:(257. 42 ±257. 42) pmol/L,undifferentiated carcinoma of the lung group:(259. 75 ±28. 13) pmol/L,small cell lung cancer group:(266. 54 ±266. 54) pmol/L. The areas under the receiver operating characteristic(ROC) curve of serum HE4/CEA was 0. 908/0. 839. And the sensitivity of HE4 combined with CEA was 79. 1% which was larger than CEA(57. 9%) or HE4(73. 3%) alone. The specificity of HE4 combined with CEA was 85. 5%. For HE4,the specificity was 90. 8% and for CEA it was 86. 7%. Conclusion HE4 could be a potential diagnostic marker for lung cancer patients and has certain clinical value in the diagnosis of lung cancer.
Placement of endoscopic spiral nasal jejunal nutrition tube in patients with acute pancreatitis
ZHOU Lei, ZHANG Xu, CAO Hai-long
2016, 14(8): 1305-1307. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.019
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Objective To study the procedure and effect of spiral nasal jejunal nutrition tube in patients with moderate or severe acute pancreatitis,and discuss their influence on the enteral nutritional support,and provide the reference for the use of nasal jejunal tube in such patients. Methods The data of 60 cases of moderate or severe acute pancreatitis undergoing spiral nasal jejunal nutrition tube placement in our hospital between January,2011 and November,2015 were reviewed retrospectively. The nasal jejunal tube was previously placed in the control group,while was placed directly with endoscope in the observation group. The successful rate,time for placement and the use of assistant device were compared between the two groups. Results The success rate in both groups was 100 percent and there was no obvious differences.The average time for placement in the control group use was(13. 68 ±3. 65) minutes,while in the observation group was(8. 69 ±2. 92) minutes,the difference was significant(P < 0. 05). 89. 3% of the patients in the control group were with the help of alligator pliers,while 53. 1% in observation group were with the help of it,so the cost for the assistant device use was reduced. Conclusion The advantage of endoscopic spiral nasal jejunal nutrition tube in patients with acute pancreatitis is obvious in the time for placement and the use of assistant device as compared with the previous placement,which will reduce the patients' pain and the economy burden. The special preparations and devices are not needed in the endoscopy room,and the method is easily to be mastered,so it is worthy to be widely promoted.
Clinical observation on efficacy of 2% fusidic acid cream in the treatment of children facial impetigo
ZHANG Chi, ZHOU Hai-lin, LIU Yu, LIU Qiong, WANG Juan, LIU Jin-li, HU Bai
2016, 14(8): 1308-1309,1385. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.020
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Objective To observe the efficacy and safety of 2% Fusidic acid cream and 2% Mupirocin Ointment in the treatment of children facial impetigo and to provide the evidence for clinic using. Methods Children with Facial Impetigo came from out-patients clinic from April,2014 to February,2015 were enrolled in our study. Children were divided into two groups according with random number table. The 2% Fusidic acid cream was applied topically to the facial infected area twice daily in one group and 2% Mupirocin Ointment was in another in same way. The response was assessed and side-effect was recorded by designated doctor after 4 days and 7 days. Results A total of 116 children with facial impetigo entered into final analysis. There is no statistical difference of two groups in gender,age,lesion number,lesion areas and course of disease. The effect rate was 86. 67% in Fusidic acid cream group and 82. 14% in Mupirocin group after 4days and it was 96. 67% in Fusidic acid group and 92. 85% in Mupirocin group after 7 days. The comparing results showed that there is no significant effective in two groups. No children were to terminate treatment because of adverse reactions. Only a few children have mild discomfort in treatment areas. Conclusion It is satisfactory clinical efficacy and safety when 2% Fusidic acid cream was treated topically in facial impetigo. 2% Fusidic acid cream applying topically will be a prior method for treatment to facial impetigo.
Application value of fast track surgery management in perioperative period of patients with rupture of liver and spleen
TAN Huang-ye, FAN Xian-jun, MA Heng-tao, YANG Li, XIAO Yong-mei, SAI Sha-jin, LONG You, LIAO Bin
2016, 14(8): 1310-1312. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.021
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Objective To investigate the safety and effectiveness of fast track surgery(FTS) management in the perioperative period of patients with hepatic and splenic injury without hemorrhagic shock by trauma. Methods Total 76 patients meeting the criteria in our hospital from January,2011 to December,2014 were recruited,48 patients undergoing fast track surgery in perioperative period were assigned into the trial group,28 patients using traditional protocol into the control group. Two groups were comparable on more characteristics. The C-reactive protein(CRP) levels before the operation and at 1th and 5th day after the operation,postoperative recovery time and timeto extubation,daily average VAS score,postoperative bowelventing,hospital stay time,cost of medical treatment and incidence of complications were compared. Results All 76 patients were cured. When compared with the control group,the CRP level at 1th and 5th day after the operation in the trial group was decreased,postoperative recovery time and time to extubation were shortened,daily average VAS score was improved,postoperative bowel venting was early recovered,hospital stay time and the cost of medical treatment was decreased(P < 0. 05). The postoperative complications and comfortless of the two groups showed no difference(P > 0. 05). Conclusion Fast track surgery management in perioperative period of hepatic and splenic injury by trauma patients is safe and efficient,which could accelerate the recovery after the surgery.
Expression of PinX1 gene in gastric cancer and its impact on the biological behavior of gastric tumor cells
ZHANG Jun, CUI Jian-xin, WEI Bo
2016, 14(8): 1313-1315. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.022
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Objective To explore the expression of Pin X1 in gastric cancer and its impact on the biological behavior of gastric tumor cells. Methods Plasmid transfection was performed to up-regulate the expression of Pin X1,and RNA interference was performed to down-regulate the expression of Pin X1 in gastric cancers. Then western blotting was used to detect the expression of Pin X1 in normal gastric cancer cells,cells with Pin X1- Plasmid transfection and cells with RNAi.CCK8 assay was used to describe cell growth curve of different group cells. Pin X1 expression was also detected by WB in36 pairs of gastric cancer tissues and normal gastric mucosa tissues. The correlation between tumor staging and Pin X1 expression was also calculated. The data was analyzed by SPSS(version 17. 0),and Chi-square test and T test were used to compare the differences between different groups of qualitative or quantitative data. P < 0. 05 was statistically significant. Results The expression of Pin X1 in SGC7901 and MKN28 was lower than in the normal gastric cell line GES-1. After plasmid transfection,Pin X1 was up-regulated in MKN28 cells,which made the growth slower than normal MKN28 cells(P < 0. 05). After RNA interference,Pin X1 was down-regulated in SGC7901 cells,which made the growth faster than normal SGC7901cells(P < 0. 05). The positive rate of Pin X1 expression in gastric cancer tissues was lower than in the adjacent normal mucosa tissues(P < 0. 05),and was related to T staging. Conclusion The expression of Pin X1 in gastric cells and tissues is lower,which may play a negative role of regulation of the malignant behavior of gastric cancer cells.
The effect of pressure target P value in the biological feedback training treatment of severe functional constipation
ZHONG Yan-min, LIU Hai-yan, YANG Zhu-ying, ZHAO Qiu-feng
2016, 14(8): 1316-1318. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.023
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Objective To investigate the effect of different values of the pressure P in poisoning functional constipation biofeedback training. Methods From April,2012 to October,2014,120 cases of patients with functional constipation in severe hospital diagnosis and treatment were selected. According to the pressure target P value(P1=10 mm Hg,P2=25 mm Hg,P3=35 mm Hg),divided into three groups,each 40 cases. Using pressure-mediated biofeedback training,ten times as a course of treatment,three groups of patients three courses. Clinical efficacy record three groups of patients,colon rectal pressure measurement results measured by experiment and. Results The results showed that,in P1 group,the total efficiency was 50. 00%,in P2 group,the total effectiveness was 77. 50%,in P3 group,the total efficiency was 40. 00%,the P2 group was significantly better than the P1 and P3 groups,the difference was statistically significant(P < 0. 05). Rectal pressure measurement show that in the first treatment,the three groups of patients anal resting pressure,reduced pressing pressure,bowel pressure was not statistically significant(P > 0. 05),after treatment,P2 patients anal resting pressure,reduced pressing pressure,defecation Pressure group were higher than P1,P3 groups,P2 group defecation pressure higher than P1 group,the differences were statistically significant(P < 0. 05). Colon through trial showed that before treatment,the number of cases discharged three groups of patients,the discharge rate was not statistically significant(P > 0. 05),after treatment,P2 number of cases of patients discharged,the discharge rate is higher than P1 group,P3 group,P2 group discharge number of cases,the discharge rate is higher than P1 group,the differences were statistically significant(P <0. 05). Conclusion In summary,biofeedback in the treatment of functional constipation curative effect is sure and in pressure P value is 25 mm Hg,the clinical efficacy in patients with the most significant and pressure of rectum and colon by experimental results,and the best,it is worth of clinical application.
Therapeutic effect and mechanism of urinary kallidinogenase combined with edaravone on acute cerebral infarction
CHOU Chen-feng, FENG Xue-wen, WU Wei-lin, BAO Xian-jun
2016, 14(8): 1319-1321. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.024
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Objective To observe the clinical efficacy of urinary kallidinogenase combined with edaravone in the treatment of the acute cerebral infarction(ACI) and its mechanism of neural protection. Methods Total 92 cases of ACI were randomly divided into control group and observation group. The observation group was given edaravone combined with urinary kallidinogenase,while the control group was given edaravone,the course was 14 days. The blood rheology index,serum TNF-α,IL-8 and MMP-9 and VEGF,ESS and BI score and the clinical efficacy were compared between the two groups. Results After the treatment,the indexes of the two groups were significantly decreased(P < 0. 01). Compared with the control group,the observation group decreased more significantly(P < 0. 01). After the treatment,the levels of serum TNF-α,IL-8 and MMP-9 in both groups decreased significantly,VEGF levels increased significantly(P < 0. 01),and these indexes in the observation group decreased more significantly and VEGF increased more significantly(P < 0. 01).After the treatment,the ESS and BI scores of the two groups were significantly higher than those before treatment(P <0. 01),and the improvement of the observation group was significantly better than the control group(P < 0. 01). The total effective rate of the observation group was 89. 1%,which was significantly higher than that of the control group(P <0. 01). Conclusion Urinary kallidinogenase combined with edaravone can be better in the treatment of ACI as compared with single edaravone by decreasing the serum levels of inflammatory cytokines,inhibiting the inflammatory injury,improving the blood supply in brain tissues,and promoting the recovery of neurological function.
Sevoflurane for induction and maintenance of anesthesia in thyroidectomy
KONG Yan, LI Xiao-hong
2016, 14(8): 1322-1324. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.025
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Objective To observe the efficacy of sevoflurane for the induction and maintenance of anesthesia in thyroidectomy,and discuss the safety and effectiveness of solely inhaled sevoflurane in minor surgery for adults. Methods A total of 47 patients undergoing elective thyroidectomy,with ASA physical status Ⅰ- Ⅱ,were enrolled into this study. The induction of anesthesia was performed in all patients with high-flow sevoflurane inhalation combined with sufentanil and cisatracurium,and the anesthesia was maintained with sevoflurane and sufentanil. The time to the transient loss of consciousness,time for the induction of anesthesia,time to recovery of consciousness and removal of laryngeal mask airway were recorded,and the intraoperative haemodynamics and use of vasoactive drugs were observed. The intraoperative awareness and incidence of postoperative nausea and vomiting were followed up. Results The 45 in 47 patients underwent successfully the surgery without using vasoactive substances. The time to the transient loss of consciousness was(55. 76 ±14. 02)s,time for the induction of anesthesia was(2. 82 ±0. 33) min,time to recovery of consciousness was(2. 08 ±0. 76)min,and time to removal of laryngeal mask airway was(5. 50 ±1. 06) min. The changes of hemodynamics in different time point:the systolic pressure,diastolic pressure and heart rate in 5 min after intubation was significantly lower than baseline blood pressure(BBP) and baseline heart rate(BHR) index(P < 0. 05). HR increased significantly at the removal of laryngeal mask airway as compared with BHR(P < 0. 05),however,BP increased not obviously(P > 0. 05). There was no significant change in HR and BP during the induction and skin incision(P > 0. 05). The follow up at 24 h after the operation showed that the incidence of postoperative nausea and vomiting of level 0 was 44. 4%(20 cases),of level 1 was35. 6%(16 cases),of level 2 was 20%(9 cases). The antiemetic was administrated in 2 cases(4. 4%). All patients were discharged in 2 to 3 days after the operation. Conclusion The stable anesthesia state can be achieved by using sevoflurane for the induction and maintenance of anesthesia in thyroidectomy,with the advantage of less time for recovery of consciousness. However,more experiments should be carried to explore the application of sevoflurane in the induction and maintenance of anesthesia in adults.
Effect analysis of laparoscopic D2 radical distal gastrectomy for advanced gastric cancer
DING De-sheng
2016, 14(8): 1325-1326,1350. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.026
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Objective To investigate the effect of laparoscopic D2 radical distal gastrectomy for advanced gastric cancer. Methods Total 92 patients with advanced gastric cancer in our hospital from January,2014 to December,2015 were randomly divided into two groups with random number method. Forty-six patients in the control group underwent open D2 radical distal gastrectomy,while 46 patients in the observation group underwent laparoscopic D2 radical distal gastrectomy.After the surgery,the perioperative conditions(operative time,blood loss,incision length,postoperative time to ambulation,hospital stay),postoperative complications and cleared lymph nodes number of the two groups were observed. The results of two groups were analyzed using SPSS18. 0. Results The operation time,blood loss,incision length,postoperative time to ambulation,hospital stay of the observation group were significantly less than those in the control group,the differences were statistically significant(P < 0. 05). The incidence of complication in the observation group was 2. 1%,significantly less than that in the control group(13. 0%),the difference was statistically significant(P < 0. 05). The cleared lymph nodes number of the two groups were 25. 4 ±3. 1 and 23. 1 ±4. 3,respectively,there was no significant difference in the cleared lymph nodes number between the two groups(P > 0. 05). Conclusion Compared with open D2 radical distal gastrectomy,laparoscopic open D2 radical distal gastrectomy can effectively treat advanced gastric cancer with advantage of less operation time,low blood loss,incision length,short postoperative time to ambulation and short hospital stay. The surgery method should be selected on the base of the individual circumstances.
Clinical observationof corneal haze after laser assisted sub-epithelial keratomileusis
XIA Lu
2016, 14(8): 1327-1329. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.027
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Objective To analyze the etiology,prevention and treatment measures of corneal haze after the excimer laser corneal surgery(Laser Assisted Sub-Epithelial Keratomileusis,LASEK). Methods The clinical data of 50 cases undergoing LASEK between June 1,2013 and December 31 were analyzed retrospectively. LASEK was performed in 92 eyes.The follow-up of 12 months was carried out to study the incidence and severity of corneal haze. Results After LASEK,corneal hazeoccurred in 36 eyes(39. 1%) with an average grade of 0. 81 ±0. 48,and the diopter of 20 eyes was greater than- 5. 0 D. The local non-steroidal anti-inflammatory therapy and Corticosteroid were administrated and UV was avoided. Six months later,3 eyes were with corneal haze(3. 3%) with an average grade of 0. 5. 24 of 36 eyes with haze received LASEK in summer. Conclusion LASEK is a safe and effective operation for the treatment of high myopia. The complications such as severe haze are closely related to high myopia,allergies,autoimmune diseases,andfrequent exposure to ultraviolet light. The carefully preoperative screening and strictly control the indications will ensure the successful operation. The regular follow-up and reexamination can monitor the occurrence and development of haze,and adjust the dose of medicines according to theseverityandintraocular pressure. The effective nursing measures will also decrease the incidence of haze and improve the prediction and accuracy of LASEK.
Comparison of benzene sulfonic acid amlodipine and Valsartan in reversion of left ventricularhypertrophy in patients with essential hypertension
LI Xiao-ming, SHANG Rui, HAO Pan-pan
2016, 14(8): 1330-1331,1424. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.028
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Objective Left ventricular hypertrophy(LVH) is a common complication of hypertension patients. It is not clear to reverse LVH with hypotensive drugs. In order to evaluate and compare valsartan and benzene sulfonic acid amlodipine to treat high blood pressure and reverse LVH. Methods We selected 240 elderly patients with mild and moderate hypertension and LVH in Chinese population of Shandong province. The 120 patients were randomly selected andgiven benzene sulfonic acid amlodipine(5- 10 mg/d) or valsartan(80- 160 mg/d). Theblood pressure of patients before and after treatment was monitored by cardiac ultrasound examination to calculate left ventricular end-diastolic diameter(LVDd),interventricular septum thickness(IVST),left ventricular posterior wall thickness(PWT) and left ventricular mass index(LVMI) changes. Results In 240 patients with LVH,systolic blood pressure(SBP),diastolic blood pressure(DBP),and LVMI were significantly decreased in all patients(P > 0. 05). The blood pressure drops no statistical significance for drug category. By using multiple linear regression,the degree of LVMI decline significantly greater in the patients with valsartan,the difference is statistically significant(F=6. 713,P=0. 012). Conclusion The two drugs can significantly reduce the blood pressure of patients and reverse left ventricular hypertrophy,and the effect of valsartan is better.
Analysis of 1 811 referral patients with chronic disease in a college of Beijing
XIE Xing-wei, KONG Ling-wei, LIU Hong-jun, LU Yun-tao, YU Xiao-ming
2016, 14(8): 1332-1334,1421. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.029
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Objective To investigate the prevalence of common chronic diseases among the college staffs,and provide reference for the scientific management of chronic diseases. Methods A total of 6 440 referral reimbursement receipts to the higher level hospital were chosen to establish a database through Epidata and analyzed with SPSS. Results The top ten of morbidity were hypertension,coronary heart disease,hyperlipidemia,diabetes,cerebral vascular disease,osteoporosis,bone and joint disease,mental disorders,chronic renal function insufficiency,chronic gastroenteritis. 59. 59% of the referral patients were chronic patients and the prevalence increased with age(χ2trend=346. 728,P < 0. 001). But the gender difference was not significant(χ2=2. 726,P=0. 101). The treatment number of chronic patients was 3 times that of nonchronic ones in the study time period. Of the total cost,89. 64% was for the chronic patients. The average cost by chronic patients was nearly twice as much as the non-chronic ones. And,the medicine cost by chronic patients accounted for75. 33%. Among the chronic patients,53. 85% suffered at least 3 kinds of diseases. The total number diseases suffered by chronic patients had a significant effect on the average cost(χ2trend=287. 209,P < 0. 001). Conclusion The college hospital is a main position to prevent and control the chronic diseases. Therefore,to improve the availability of the commonly used medicine and formulate chronic disease stratification strategy of health management can help them to play a greater role as the 'Health Keeper'.
Blood pressure viability after using amlodipine combined with perindopril in Elderly Patients with Essential Hypertension
PAN Chun-qi, WANG Lin, LIU Wen-min
2016, 14(8): 1335-1337. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.030
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Objective To observe the influence of amlodipine combined with perindopril on blood pressure viability(BPV) in elderly patients with essential hypertension. Methods From October,2014 to October,2015 in our hospital,82 patients with essential hypertension(EH) were divided into observation group and control group according to the random numbers(41 cases in each group). The control group were given amlodipine(10 mg/d),the observation group were given amlodipine(5 mg/d) combined with perindopril(4 mg/d),both groups were treated for eight weeks. 24 h ambulatory blood pressure was measured with noninvasive portable ambulatory blood pressure monitoring before and after the treatment. BPV was assessed using the standard deviation(SD) and coefficient variation(CV). Results In the control group,the SD for the systolic and diastolic blood pressure during the day and night at 24 h after the treatment day night were significantly lower than that before the treatment(P < 0. 05); While in the observation group,the SD and CV for the systolic and diastolic blood pressure during the day and night at 24 h after the treatment day night decreased significantly as compared with that before the treatment(P < 0. 05); After the treatment,both SD and CV in the observation group were lower than those in the control group(P < 0. 05). The total effective rate was 95. 1% in the observation group,which was significantly higher than 78. 0% in the control group(Z=- 3. 86,P < 0. 05); During the treatment,the routine urine and blood test results,functions of heart,liver and kidney were all within the normal range in both groups. And in the observation group,the incidence of adverse reactions was 6. 67%,which was significantly lower than 17. 1% in the control group(χ2=5. 615,P < 0. 05). Conclusion Amlodipine combined with perindopril can effectively reduce BPV of 24 hours systolic and diastolic blood pressure,with better curative efficacy and lower incidence of adverse reactions,and worthy of further promotion in clinics.
Expression and intracellular distribution of ezrin and cytoskeleton in endometrium tissues of patients with endometriosis
LI Jin, WU Rui-jin
2016, 14(8): 1338-1341. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.031
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Objective To check the expression and location of ezrin,microfibril and microtubule in endometrium tissues of patients with endometriosis,and explore the subcellular mechanisms of endometriosis. Methods The expression and location of ezrin,microfibril and microtubule in the endometrial cells of 13 women with normal endometrium,and in the eutopic and ectopic endometrium cells of 11 patients with endometriosis were examined by immunofluorescence(fluorescence intensity semiquantitative test) and laser confocal microscope,t test was used to analyze the difference between groups by using SPSS 11. 5. Results Ezrin was dispersedly distributed in stroma of ectopic endometrium and the cells lost their normal polarity; The level of Ezrin protein in ectopic endometrial stroma(47. 88 ±6. 75) was significantly higher than in normal endometrium from healthy controls(8. 64 ±1. 61) and in the homologous eutopic endometrium(7. 97 ±0. 93),P < 0. 05; Microfibril was dispersedly distributed both in stroma and glandular epithelium cells of ectopic endometrium tissue; the expression level of microfibril in ectopic endometrial stroma(71. 36 ±4. 27) was ignificantly higher than homologous eutopic endometrium(35. 98 ±5. 76) and normal endometrium from healthy controls(40. 68 ±6. 12),P <0. 05; while the expression levels in the glandular epithelium cells of ectopic,homologous eutopic and normal endometrium were 21. 74 ±2. 28,37. 99 ±6. 60 and 41. 54 ±2. 14,respectively,P < 0. 05. There was no significant difference in the expression of microtubule among the three groups,P > 0. 05. Conclusion The cell migration and implantation in the endometriosis are accompanied with cytoskeleton reconstructions; The expression of ezrin is involved in the occurrence of endometriosis and cytoskeleton reconstructions of endometriosis; Stroma cells play an important role in the process of cell migration and invasion in endometriosis.
Molecular characterization of rotavirus in children with diarrhea in Urumqi
JIA Ji-hang, HE Jian-hua, YI Bu-la-yin, YANG Xue-lei
2016, 14(8): 1342-1344,1347. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.032
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Objective To analyze the epidemiology and genotype characteristics of group A rotavirus in children under 5years old with diarrhea in Urumqi. Methods During the year of 2007,a total of 3 662 diarrhea stool samples were collected from outpatients and children hospitalized under the age of 5 in the First People's Hospital of Urumqi. RV antigens were detected by colloidal gold assay and ELISA. About 10% RV positive samples were randomly selected for G/P genotyping. Results RV was detected in 1 470 of 3 662 samples(40. 1%) and a total of 142 positive samples were typed by PCR. Of the 121 infants and children with RV infection,G1 accounted for 36. 4%,followed by G3(20. 7%),G2(15. 7%) and G9(13. 2%),the G mixed infection was 6. 6% and 9 couldn't be typed. For P-type,P[8]was the predominant genotype with 60. 3%,followed by P[4](18. 2%),and P[6](5. 8%). P mixed was 15. 7%. The major G/P combination was G1P[8](28. 1%),next for G3P[8](19. 8%),G2P[4](14. 9%) and G9P[8](8. 3%). G1P[6],G1P[4],G9P[4] and G9P[6] were also detected as the G/P uncommon combinations. 21 neonates with RV diarrhea showed G9 was the major G genotype(9/21),followed by G1(4/21),G3(3/21) and G2(1/21). G mixed infections were3 and 1 was undetermined. P[6] ranked first with 10,P[8] and P mixed were 5,respectively. One was P[4]. G9P[6]was found to be the major G/P type in neonates. G1P[8],G3P[8] and G1P[6] were detected for 2 each and G2P[4],G9P[8] for one each in neonates. Conclusion RV genotypes were complex and diverse in 2007 in Urumqi. G1P[8]was the main G/P combination in infants and children,and G9P[6]was the main in neonates. It needs to be mindful that the mixed infection between infant RV strains and neonatal RV strains will produce new epidemic strain.
Changes of IL-4,IL-12 and IFN-γ levels in nasopharyngeal aspirates of infants with wheezing
YAO Huan-yin, ZHANG Pei-hong, LI Hua-jun, WANG Xiao-xian, LIU Shu-mei, CHEN Xiao-hong
2016, 14(8): 1345-1347. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.033
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Objective To test the levels of IL-4,IL-12 and IFN-γ in nasopharyngeal aspirates(NPS) of infants with wheezing,and to explore the relationship between the infantile wheezing and the type of cytokine response. Methods The NPS of IL-4,IL-12 and IFN-γ levels were measured by ELISA and compared in 58 cases of acute stage and convalescent stage with infantile wheezing and 47 cases of infantile pneumonia. Results The NPS of IFN-γ levels in acute group[(142. 55 ±26. 56) ng/L] were significantly lower than(275. 11 ±30. 27) ng/L of the infantile pneumonia group,(253. 76 ±39. 9) ng/L in the control group and(260. 88 ±28. 07) ng/L in the recovery group,P < 0. 01; while the IL-4[(8. 51 ±2. 02) ng/L,(3. 14 ±1. 16) ng/L,(4. 95 ±1. 93) ng/L,(3. 28 ±1. 36) ng/L] and the ratio of IL-4/IFN-γ(0. 068 ±0. 044,0. 012 ±0. 004,0. 019 ±0. 007,0. 014 ±0. 005) were significantly higher(P < 0. 05); Compared with the infantile pneumonia group[(1 322. 13 ±139. 74) ng/L],the acute group's IL-12 level[(587. 24 ±58. 14) ng/L] in NPS were significantly lower(P < 0. 01) and no statistical difference with the recovery group[(580. 77 ±64. 32) ng/L]and the control group[(604. 02 ±88. 38) ng/L],P > 0. 05. Conclusion The acute Stage of wheezing in infants are with the Th2-predominant response,increase of IL-4 level,decrease of IFN-γ level in NPS,and IL-12 increase in infantile pneumonia.
Immunoglobulin as adjuvant therapy for septicemia in premature infants
HU Xiao-yan, ZHOU Yu-xin, XU Song-zhou, LI Jian-xiong
2016, 14(8): 1348-1350. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.034
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Objective To investigate the mechanism and effect of immunoglobulin as adjuvant therapy for septicemia in premature infants. Methods Total 118 premature infants with septicemia were randomly divided into observation group(n=58) and control group(n=60). Both groups were given conventional anti infection treatment. The observation group was given immunoglobulin on the first day of diagnosis of septicemia,400 mg/kg per day for 3 days. The recovery time of clinical and laboratory index and the mortality rate were compared between the two groups. The serum Ig G level was compared before and after the treatment. Results The clinical recovery in the observation group was quickly as compared with the control group[(6. 93 ±1. 43) d vs.(8. 47 ±2. 13) d,P < 0. 05]. The recovery time of WBC,PLT,RP and PCT of the observation group were all earlier than those of the control group(P < 0. 05). The mortality rate of the observation group was lower than that of the control group(5. 2% vs. 16. 7%,P < 0. 05). In the observation group,the serum Ig G level increased significantly after the treatment(P < 0. 01); in the control group,the Ig G level was not improved after the treatment(P > 0. 05). Conclusion Immunoglobulin can increase the serum Ig G level and enhance the humoral immune function of the premature infants,it is effective as adjuvant therapy for septicemia in premature infants.
Survey about the habit of rational drug usage of the elderly hypertensive patients with diabetes mellitus in Zhenru community
YANG Nan
2016, 14(8): 1351-1352,1353. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.035
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Objective To know the habit of daily drug usage and improper behavior of drug usage of the elderly patients with chronic diseases to provide the basis for the guide of reasonable drug usage. Methods The clinic elderly hypertensive patients with diabetes mellitus at Zhenru community during July to September in 2015 were investigated. There are six sections and 23 questions in the questionnaire contents which include patients' basic information,the current behavior and habit of drug usage and so on. Results A total of 6 002 valid questionnaires were received. 51. 56% of the respondents first chose "observation for a period of time"when they got sick. 53. 26% of the respondents didn't have periodical physical examination in view of the situation of drug usage. Only 17. 12% of the respondents paid attention to reading the instructions before drug usage,and 34. 72% of the respondents didn't even look at the instructions. When they had a slight adverse reaction after drug usage,only 28. 38% of the respondents went to a certified hospital for seeing a doctor.For expired medicines,21. 95% of the respondents chose to take them and 69. 44% of the respondents chose to throw them away. More than half of the respondents didn't know how to distinguish between health care products and drugs. The top three which the respondents paid the most attention to drug information are dosage,adverse reactions and taking time.In addition,11. 65% of the respondents didn't focus on any medicine information. 94. 50% of the respondents first chose"doctor's guidance"when they took medicine. Other respondents chose personal experience,imitate others and advertising. Conclusion The elderly patients were lack of consciousness of rational drug usage. Drug abuse phenomenon was relatively common. The habit of drug usage was easily affected by external environment. It is necessary for community general practitioners to know resident's habits of drug usage timely,popularize knowledge of rational drug usage,guide them how to take medicines,let the community residents consciously prevent the abuse of drugs,improve drug usage rationality,reduce waste and reduce the occurrence of drugs harm events which can be avoided.
HUANG Liang-yu, SUN Xiao-ling, LI Hai-yan
2016, 14(8): 1353-1355,1407. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.036
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Effects of health education on self-management of patients with diabetes in certain community
ZHANG Di, QIN Ling
2016, 14(8): 1356-1358. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.037
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Objective To investigate the effects of health education on the self-management of patients with diabetes in a certain community. Methods From December,2011 to February,2015,120 patients with type 2 diabetes in our hospital were selected and randomly divided into the treatment group and control group with 60 cases in each group. The conventional health education was carried out in the control group,while DM peer support group was performed in the treatment group. The intervention period was three months. Results After the intervention,the indices of insulin resistance in the two groups were significantly reduced,and the indices of insulin secretion were significantly increased,the difference as compared the indices before the intervention was significant(P < 0. 05),but there was no statistically significant differences between the two groups(P > 0. 05). The fasting plasma glucose and postprandial 2 h blood glucose levels in both groups were significantly decreased after the intervention(P < 0. 05),and more significantly in the treatment group(P <0. 05). The four self-management skills scores in both groups were significantly improved after the intervention(P <0. 05),and more significantly in the treatment group as compared with the control group(P < 0. 05). After the intervention,the patients satisfaction in the treatment group and control group were 98. 3% and 85. 0%,respectively,the difference was statistical significant(P < 0. 05). Conclusion The insulin therapy for diabetes can effectively improve the indices of insulin resistance and insulin secretion. The peer support groups involved in the health education can improve the self-management skills and blood sugar levels of patients,thereby increase patient satisfaction degrees.
Effect of five tone music therapy on anxiety,depression and blood pressure in patients with cardiovascular disease: a meta-analysis
DAI Ya-qi, PEI Da-jun, LIU Juan, CHEN Fang
2016, 14(8): 1359-1362. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.038
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Objective To evaluate the efficacy of five tone music therapy in patients with cardiovascular diseases. Methods We searched Pubmed,Embase,the Cochrane Central Register of Controlled Trials(CENTRAL),the ISI web of knowledge databases,CBM,VIP,CNKI,Chinese excellent degree thesis and Wanfang database for the papers that performed randomized controlled trial(RCT) between patients with cardiovascular diseases used five tone music therapy and patients not used five tone music therapy. The publishion time was between January 31,2000 to October 31,2015. Two people screened literature by following the inclusion and exclusion criteria independently,conducted data and quality assessment. Rev Man 5. 3 software was used to give the meta-analysis. Results Four papers including 322 subjects were included. The results of meta-analysis showed:the value of SAS score,SDS score,systolic and diastolic blood pressure were statistically significant between the intervention group and the control group(Z=3. 09,P=0. 002; Z=10. 81,P <0. 000 01; Z=2. 96,P=0. 003; Z=5. 24,P < 0. 000 01),the weighted average and 95% CI were- 7. 93(- 12. 95,- 2. 90),- 10. 28(- 12. 14,- 8. 41),- 2. 48(- 4. 12,- 0. 84),- 3. 09(- 4. 25,- 1. 94). Conclusion The five tone music therapy can improve anxiety,depression,systolic and diastolic blood pressure for patients with cardiovascular diseases. It still needs high-quality,large sample,carefully designed randomized controlled trials to present a further confirmation.
Curative effect of repetitive transcranial magnetic stimulation on treatment-resistant depression
CHEN Yan-bo, TAN Zhong-lin
2016, 14(8): 1363-1365. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.039
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Objective To investigate the curative effect of repetitive transcranial magnetic stimulation(r TMS) in the treatment of treatment-resistant depression and the cognitive function of patients. Methods The clinical data of patients with treatment-resistant depression in our hospital from January 2013 to December 2014 were reviewed. The patients in the observation group received escitalopram oxalate tablets and r TMS treatment,while the patients in the control group was given escitalopram oxalate tablets combined invalid stimulation treatment by r TMS. The curative effect was compared between the two groups. The change of the level of BDNF,NE and 5-HT of the patients before and after the treatment were analyzed,and the correlation with HAMD score was performed. Results After 4 weeks of treatment,the total efficiency of the observation group was 87. 5%,of the control group was 27. 78%,Wilcoxon rank sum test showed that the total effective rate of the observation group was significantly higher than that in the control group(U=4. 86,P < 0. 001); 2 and 4weeks after the treatment,HAMD scores in the observation group was significantly lower than rate in the control group(t=2. 358,P=0. 021 vs. t=3. 594,P < 0. 001); The serum NE(t=3. 544,P < 0. 001),5-HT(t=4. 821,P < 0. 001),BDNF(t=2. 171,P=0. 331) in the observation group was significantly higher than those in the control group,the difference had statistical significance(P < 0. 05); 4 weeks after the treatment,the serum NE,5-HT and BDNF in the observation group showed significant negative correlation with HAMD scores(r=- 0. 512,- 0. 683,- 0. 624,P < 0. 05). Conclusion Low-frequency r TMS can obviously improve the clinical symptoms of treatment-resistant depression,with a good effect,which can help patients recover the cognitive function. It can be used widely in clinic.
A survey on the demands of stroke patients on health education services and social support
HUANG Xiang, YANG Hua-jie, YANG Nan, LAI Xiu-juan, OU Wei-lin, SHEN Huan-yu, MO Hai-yun, ZHANG Dong-ying, ZHOU Zhi-heng, WANG Jia-ji
2016, 14(8): 1366-1369. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.040
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Objective To understand the social support status for stroke patients,and explore its influencing factors,in order to provide the guidance and basis on health education for the stroke prevention. Methods Questionnaire survey by using SSRS were conducted among 309 hospitalized stroke patients in tertiary general hospital neurology from January to June 2014. The data were analyzed by using SPSS 18. 0. Results The average age of participants was(66. 36 ±11. 57)years. Scores of social support of patients with acute stroke(the scores of objective support was 8. 63 ±1. 54; the scores of subjective support was 27. 71 ±2. 99; the scores of utilization of support 6. 69 ±2. 75; the total score was 43. 21 ±5. 04)were lower than the domestic norm. The objective support score of living alone in 5 kinds of living conditions was the lowest. The objective support score of bad health status in 4 kinds of health status was the lowest. Patients who were over 70 years or unmarried or living alone or living in the country or poor health status had low subjective support scores. The social support score was low in those patients who were living in urban areas,income levels in the 1 000- 3 000 RMB/month. What's more,the totally social support score was low in that aspects,such as unmarried,living alone,living in the suburbs,poor health status and the income level of 1 000 RMB/month. Multivariate analysis of social support influence factors showed that the living conditions,income level and self-assessment health status were the major influencing factors of stroke patients' social support. Conclusion To create a good social support environment,and establish a scientific system of health education for stroke patients should base on the community health service institutions,thereby promote the quality of life of patients.
FANG Yan-jun, ZHUANG Can-shuo, FENG Li-zong
2016, 14(8): 1370-1372. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.041
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Expression and correlation of miR-1246,ZO-1 and vimentin in breast cancer cells
WANG Pan, ZHAO Ling-ping, ZHU Jie, CHEN Wen-ju, LI Zhao-yun
2016, 14(8): 1373-1375. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.042
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Objective To investigate the expression and correlation of ZO-1,vimentin and miR-1246 in normal breast epithelial cells(MCF10A) and breast cancer cells(MCF7,MDA-MB-231),and analyze the role of miR-1246 in promoting breast cancer epithelial-mesenchymal transition(EMT). Methods The relative expression levels of miR-1246 in MCF10 A,MCF7 and MDA-MB-231 were detected by q PCR assay; the expression of ZO-1 and vimentin protein in MCF10 A,MCF7 and MDA-MB-231 were detected by WB assay. Data were analyzed using U test,t test and spearman rank correlation analysis by SPSS 16. 0. Results The expression of miR-1246 and ZO-1 in malignant breast cancer cells were significantly decreased(P < 0. 05),the expression of vimentin in malignant breast cancer cells was significantly increased(P < 0. 05). MiR-1246 was positively correlated with ZO-1 expression(r=0. 940,P < 0. 05),miR-1246 and vimentin expression were negatively correlated(r=- 0. 714,P < 0. 05). Conclusion The expression level of miR-1246 and EMT markers is correlated,so miR-1246 is suggested to play an important role in the promotion of EMT in breast cancer.
Comparison of drug sensitivity test results of Staphylococcus aureus isolated from different types of specimen
DONG Zhe-qing, ZHU Ji, MAO Xiang-hong, XIAO Ying-jun
2016, 14(8): 1376-1378,1410. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.043
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Objective To learn the drug sensitivity of Staphylococcus aureus isolated from different specimens; To understand the drug resistance of MRSA in our hospital. Methods From July,2013 to June,2015,405 cases of skin secretions,sputum drainage,blood and urine samples were received. Staphylococcus aureus were detected in all of the specimens. The sensitivity of Staphylococcus aureus to antimicrobial agents was detected,the detection rate of MRSA was compared,and the sensitivity of MSSA and MRSA to the antimicrobial susceptibility was compared. Results The differences on the sensitive rates of Staphylococcus aureus isolated from different specimens to penicillin,vancomycin and teicoplanin were not statistically significant(P > 0. 05); The differences on the sensitive rates of Staphylococcus aureus isolated from different specimens to amoxicillin/sulbactam,cefazolincefuroxime,erythromycin,azithromycin,clindamycin,gentamicin,levofloxacin were statistically significant(P < 0. 01). One hundred and eight strains of MRSA were detected in 405 strains of Staphylococcus aureus,MRSA positive rate was 26. 67%; MRSA detection rate of sputum was highest,58. 33%; the lowest MRSA detection rate was 15. 07%,from skin secretions; there were statistically significant differences in MRSA detection rates of different samples(χ2=59. 957,P < 0. 05). The sensitivity rates of MSSA to penicillin,amoxicillin/sulbactam,cefazolin,cefuroxime,erythromycin,azithromycin,clindamycin,gentamicin,levofloxacin,vancomycin and teicoplanin were significantly higher than that of MRSA,the differences were statistically significant(P < 0. 01). Conclusion Staphylococcus aureus isolated from different types of samples have different drug sensitivity and MRSA detection rate. The clinical treatment should be based on the results of drug sensitivity test to select rational antibacterial drugs.
Clinical value of combined detection of serum TNF-α,CEA and CA242 for rectal cancer
SONG Min, LI Zong-lin, XIANG Cheng-yu, HUANG Li
2016, 14(8): 1379-1381. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.044
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Objective To dynamically observe the serum levels of tumor necrosis factor-α(TNF-α),carcinoembryonic antigen(CEA) and carbohydrate antigen 242(CA242) before and after the surgery for rectal cancer(RC). To explore the clinical value of combined detection of TNF-α,CEA and CA242 for the diagnosis,valuing curative effect and illness monitoring for RC. Methods From January,2014 to June,2014,60 cases of rectal diseases(including 30 cases of RC in Group A and 30 cases of benign rectal disease in group B) and 30 cases of healthy adults(Group C) were enrolled into this study. The serum levels of TNF-α,CEA and CA242 were measured and compared among the three groups by using one-way analysis of variance. In group A,the serum levels of TNF-α,CEA and CA242 were measured one day before the surgery,five days after the surgery,ten days after the surgery and one month after the surgery were tested and analyzed by repeated measures analysis of variance. Results The serum levels of TNF-α,CEA and CA242 in group A were significantly higher than those in group B and group C,and there was significant difference between group A and group B or C(P < 0. 05). In addition,the serum levels of TNF-α,CEA and CA242 in group A were decreased after the surgical treatment and there was significant difference at different time points(P < 0. 05). Conclusion The serum levels of TNF-α,CEA and CA242 in most patients of RC are significantly elevated and the combined detection of serum TNF-α,CEA and CA242 contributes to the diagnosis,valuing curative effect and illness monitoring for RC.
ZHANG Yong-li, XU Jia-li, WU De
2016, 14(8): 1382-1385. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.045
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ZHOU Jia-long, LIANG Qi-sheng
2016, 14(8): 1386-1388. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.046
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LIANG Li-ning, ZHONG Xia, JI Xian-fei, HU Hao-ran, SHANG De-ya
2016, 14(8): 1389-1391. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.047
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Application of 6S mode in the safety management of PIVAS
ZHANG Xiao-xia, LU Xiu-juan, WEI Wei, AN Meng-na, ZHANG Ya-ting, WANG Niu-min, XIN Xia
2016, 14(8): 1392-1394. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.048
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Objective The works in Pharmacy Intravenous Admixture Services(PIVAS) were with the characteristics of multiple processes,high risk and high intensity. 6S model management was introduced into the PIVAS safety management process,in order to reduce the internal errors of PIVAS,improve work efficiency,strengthen the safety management,and ensure the safety of clinical patients intravenous drug usage. Methods The study analyzed the internal error of PIVAS and the causes before the implementation of 6S management during the period of January to June and July to December in2012 retrospectively. Firstly,6S management implementation team was set up in PIVAS,and the training for 6S management knowledge was performed in all staffs to strength the significance and importance of 6S management,summarized the exists potential safety hazard by the method of brainstorming,and perfected the corresponding workflow. 6S management(including seiri,seiton,seiso,seiketsu,shitsuke and safety) was implemented daily from July,2012 to December,2012 strictly. The effect such as work efficiency and work quality after the implementation of 6S mode in the PIVAS were evaluated. Results The entire quality of PIVAS service was improved distinctly after the implementation of 6S mode,especially in decreasing the rate of five common internal error of PIVAS(wrong labels,wrong order of drugs,errors in label printing,wrong dose or medicine,and omissions of labels),P < 0. 05,and the efficiency and department satisfaction were improved. Conclusion 6S mode can improve the working conditions and staff professionalism,reduce the occurrence of internal errors,and ensure the safety and efficiency of configuration of intravenous admixture.
Continue to advance and improve training and education mode of rural order-directed tuition-free general medical students
YU Meng, WU Ge, REN Tian-shun
2016, 14(8): 1395-1398. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.049
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Objective By discussing the significance and problems in carrying out this training policy,to advance and improve training and education mode of rural order-directed tuition-free general medical students,and explore a possible solution. Methods The social benefit since the implementation of training policies was analyzed. The problems existing in the standard of the training,management and stimulation,employment and following up training policy were discussed.Combining the result of revolution,the urgent problems and approaches were concluded. Results It is quite clear that this policy is a national and people benefiting action,improving basic medical treatment and public health level,remitting the difficulty and high cost of getting medical treatment,especially in western areas. During the carrying out of the policy,it appears that medical school lack of autonomy of enrolling students,standards and management of general medical education is not complete,local government lack of policy and action on these kinds of medical students,great national restriction and lack of human resource in western areas,need great simulation of attracting excellent medical students. Conclusion In order to keep promoting the policy,it is necessary to complete the system of training and stimulation,such as enrolling students,admission,education,employment,standardized training etc,to strengthen the education of professional ideal and quality,to clarify and give full play to government responsibility at all levels,to further improve the policy environment of recruiting,job welfare,position evaluating,following education and examination and management,to expand the coverage of order-directed general medical students receiving free education appropriately and carry out the training of order-directed general medical students receiving free education with local needs,to build variety levels of general medical education system,to start an experimental work of education master and doctor etc.
Risk factors analysis and nursing strategy of central venous catheter-related thrombosis
FU Jing, SHI Li-li, JIANG Jin-yan, LI Jing-dan, ZHENG Zhen-zhen
2016, 14(8): 1399-1401. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.050
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Objective To investigate the risk factors of central venous catheter-related thrombosis and raise the nursing strategy based on risk factors,so as to reduce the incidence of central venous catheter-related thrombosis. Methods Total369 cases of patients with central venous catheter in perioperative period from January,2015 to December,2015 in our hospital were retrospectively analyzed. According to catheter-related thrombosis,patients were divided into thrombus group(128 cases) and no-thrombosis group(241 cases). The risk factors questionnaire including age,gender,tumor type,insertion site,preventive anticoagulant and activity factor was made,and clinical data of patients were selected and the risk factors of catheter-related thrombosis were analyzed by univariate analysis and Logistic analysis. And corresponding nursing strategies were analyzed based on these results. Results In all 369 cases patients,128 cases patients were with catheter related thrombosis,with a rate of 34. 7%. Univariate analysis showed that the gender,age,tumor type,insertion site,activity degree were univariate risk factors of patients with catheter-related thrombosis. And Logistic analysis showed that gender,age,tumor type,insertion site,activity degree were independent risk factors of patients with catheter-related thrombosis. All the nursing cares based on the risk factors would prevent catheter related thrombosis. Conclusion The catheterrelated thrombosis easily occur in the patients with central venous catheter in perioperative period. The gender,age,tumor type,insertion site,activity degree were risk factors of patients with catheter-related thrombosis. Nursing based on risk factors should be carried out to prevent catheter related thrombosis.
Effectiveness of crisis management mode in nursing management in emergency department
DING Ling-fang, CHEN Jun-guo, JIA Ya-ping
2016, 14(8): 1402-1404. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.051
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Objective To observe the effectiveness of crisis management mode in the nursing management in emergency department,and improve the quality of emergency nursing management. Methods Total 123 emergent patients from January,2014 to January,2015 were assigned into the control group,that received the routine emergency nursing from 8 nurses; while other 123 emergent patients from January,2015 to January,2016 were assigned into the intervention group,that received the nursing management based on crisis management mode. The illness treatment,number of crisis event,patient satisfaction and nursing management in the two groups were compared. Results The efficiency of emergency treatment,incidence of crisis event and patient satisfaction in the intervention group were 98. 37%,3. 25% and 97. 56%,respectively,and in the control group were 88. 62%,28. 46% and 83. 74%,respectively,the differences were significant(χ2=9. 63,29. 28,13. 86,P < 0. 05). The scores for the nurse-patient communication,operational capability,nursing documents and crisis consciousness in the intervention group were(18. 5 ±1. 0) points,(19. 2 ±0. 3) points,(19. 8 ±0. 2) points and(19. 0 ±0. 5) points,respectively,and in the control group were(11. 2 ±1. 5) points,(13. 4 ±1. 4) points,(15. 5 ±1. 1) points and(8. 7 ±1. 3) points,respectively,the difference were significant(t=11. 45,11. 46,10. 88,20. 92,P <0. 01). Conclusion The nursing care intervention on the bases of crisis management can reduce the incidence of the emergency crisis,raise efficiency of emergency treatment and improve the patient satisfaction. The overall effect is better than the conventional emergency nursing management model,thus worth of further promotion in clinical practice.
Effectiveness of continuous quality improvement in health care for patients in veteran cadres ward
LANG Xiao-qin, CHEN Mei-hong
2016, 14(8): 1405-1407. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.052
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Objective To observe the effectiveness of implementation of continuous quality improvement(CQI) in health care for patients in veteran cadres ward. Methods A total of 120 patients in the veteran cadres ward of our hospital between August 2013 August and 2015 were randomly divided into intervention group and control group with 60 cases in each group. The intervention group received CQI,while the control group received the routine nursing intervention. Pittsburgh Sleep Quality Index Scale(PSQI),activities of daily living scores(BI rate) and the Quality of Life Scale(SQLS)score were used for assessment of sleep quality and lift quality of patients in both groups. The patient satisfaction with skills,accountability model and attitude of nurses,psychological and other aspects of nursing practice was also investigated. Results The difference of PSQI score,BI rate and SQLS score before nursing intervention between the two groups was not statistically significant(P > 0. 05); After nursing intervention,PSQI score,BI rate and SQLS score in the intervention group were(36. 8 ±7. 2) points,(76. 2 ±8. 5) points and(72. 8 ±5. 2) points,respectively,and in the control group was(49. 7 ±11. 4) points,(59. 4 ±7. 7) points and(56. 5 ±6. 8) points,respectively,the difference was statistically significant(P < 0. 05); The satisfaction with nurses skills,accountability model,attitude and mental nursing practice in the intervention group was significantly higher than that in the control group(P < 0. 05). Conclusion The implementation of CQI in veteran cadres ward can effectively improve the quality of sleep of patients,improve their activities of daily living,satisfaction with nursing care was significantly higher,worth for further promotion on clinical practice.
Effect of postoperative early nursing interventions on functional exercise of affected limbs in patients with breast cancer
GUO Yong-ying, TAO Lan-fang
2016, 14(8): 1408-1410. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.053
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Objective To explore the effect of the postoperative early nursing interventions on functional exercise of affected limbs in patients with breast cancer. Methods A total of 42 breast cancer patients undergoing mastectomy were enrolled and divided into intervention group and control group. The routine nursing cares and functional exercise direction were performed in the control group,while the planned and targeted early nursing intervention on the base of routine nursing was performed in the intervention group. The compliance in functional exercise was compared,and the rating of activities of daily living at 7 and 14 day after the operation were observed. Results The responsible leader of the intervention group performed successfully a series of preoperative nursing measures including propaganda of the illness and the importance of functional exercise,mental counseling and humanistic care,and postoperative interventions including demonstration,supervising,checking,feedback and interaction. The compliance in functional exercise rating of activities of daily living in the intervention group were better than those in the control group(P < 0. 05). Conclusion The functional exercise of affected limbs can be carried out in the process of brushing teeth,washing face,eating,dressing and combing the hair according to the condition of patients. The early nursing intervention can improve the compliance in functional exercise,effect of functional exercise and the activities of daily living in the breast cancer patients undergoing mastectomy.
The effect and nursing methods of vompound polyethylene glycol electrolyte for preoperative bowel cleaning in patients with colorectal cancer
LIU Shuang-shuang
2016, 14(8): 1411-1413. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.054
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Objective To investigate the effect and nursing methods of compound polyethylene glycol electrolyte for preoperative bowel cleaning in patients with colorectal cancer. Methods Sixty-five cases of surgical patients with colorectal cancer were randomly divided into two groups:the observation group of 35 cases and the control group of 30 cases. The patients of the observation group aged 33- 91 years,average age(63. 86 ±11. 98) years,the control group of patients aged30-83 years old,average age(60. 87 ±12. 91) years. A compound polyethylene glycol electrolyte was used for bowel cleaning in the observation group,while 0. 2% soapsuds enema was used for bowel preparation in the control group(30cases). The degree of bowel cleaning,the degree of acceptance,the defecation times,postoperative exhaust time,and adverse reactions were observed and recorded. Results The observation group of patients got the percentage of bowel cleaning of 91. 4%(32/35),while the control group of patients 70%(21/30),the difference had statistical significance(P <0. 05); the complete compliance rate of the observation group was 94. 3%(33 cases),the control group was 73. 3%(22cases),the difference between the two groups was significant(P < 0. 05),there is also significant difference between two groups in defecation times and postoperative exhaust time. Conclusion For selective operation of colorectal cancer surgery,the polyethylene glycol electrolyte has many advantages,such as less pain,short duration of preoperative preparation,fewer complications,good bowel cleaning effect,and good patient compliance. Above all the polyethylene glycol electrolyte has a little effect on water electrolyte acid-base balance,which is beneficial to the patients' body recovery. At the same time,it is easy to operate the bowel cleaning of polyethylene glycol electrolyte and the workload of nurse is reduced largely.
CAI Ling-zhi
2016, 14(8): 1414-1416. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.055
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102 0
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XIE Zeng-hua, LIU Ping, ZHANG Yan-yan, CHEN Qiang, XIE Chao-yan
2016, 14(8): 1416-1418. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.056
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76 0
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WANG Shi-jia, YU Jian-juan, HUANG Bei
2016, 14(8): 1419-1421. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.057
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44 0
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DONG Yan-er, CHEN Kai-ying, ZHANG Qin-wei
2016, 14(8): 1422-1424. doi: 10.16766/j.cnki.issn.1674-4152.2016.08.058
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38 0
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