中华全科医学

Cognitive situation of TCM "preventive treatment of disease" among community medical workers

NIE Huan-huan, BAO Yong, SUN Wei

2017, 15(1): 1-4. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.001

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Objective To investigate the cognitive status of TCM "preventive treatment of disease" among community medical workers,sum up experience and deficiencies,and give relative policy advice,thereby promote Shanghai and other areas to develop TCM "preventive treatment of disease" health project. Methods The self-designed questionnaire was used to carry out the survey among the random medical workers from community health centers in Shanghai Qingpu,Baoshan and other district.The percentage and Chi-square test to analyze the relevant data. Results Most (91.3%) community medical workers had known about TCM "preventive treatment of disease" ;the main ways were though health system like seminar/conference (53.2%),etc.Ninety-four percent medical workers were able to recognize the concept of "preventive treatment of disease" .However,there were still many community medical workers could not understand the main service object and content correctly.Some of them did not know the service content whether including diagnosis and treatment of diseases,and those who learned "preventive treatment of disease" through ways in health system seemed knowing the service target population relatively clearly.For "preventive treatment of disease" service target population,568 workers (73.9%) had the healthy population included,743(96.6%) workers had the sub-health population included,412(53.6%) workers had the patients included,442(57.5%) had the rehabilitee included.For service content,419 workers (54.5%) had the diagnosis and treatment of diseases included,705 workers (91.7%) had the preventive care included,632 workers (82.2%) had the rehabilitation and nourishing of life included,619 workers (80.5%) had the body physical identification and control included,568 workers (73.9%) had the TCM consulting/publicity included. Conclusion The cognitive status of community medical workers to TCM "preventive treatment of disease" is of great shortage,even mistaken.It is necessary to strengthen popular science education among community medical workers.

YANG Xiao-hui, BAI Ying

2017, 15(1): 5-6.

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Changes and significance of serum VEGF,PEDF,VEGF/PEDF ratio in acute ischemic stroke patients

JIN Gang-sheng, LU Yi, FENG Jiong, CHEN Yan, HU Hao-yu, XU Bin, ZHENG Shui-hong, JIN Ji

2017, 15(1): 7-9. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.002

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Objective To investigate the changes of serum vascular endothelial growth factor (VEGF),Pigment epithelium-derived factor (PEGF) and VEGF/PEDF ratio in patients with acute ischemic stroke,and to evaluate their effects and possible clinical application in diagnosis and treatment of acute ischemic stroke. Methods Total 41 patients with acute ischemic stroke were included in our study,with 45 healthy adults as control.The enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of PEDF and VEGF in sera of days 1,3,7,14 and 28 after the subjects were hospitalized. Results The VEGF expression in patients'sera increased during the 28-day-long observation after hospitalization.It reached to its peak at day 7 post-stroke (214.72±55.95) ng/L,which was significantly increased when compared to the control group (t=2.439,P<0.05).Meanwhile,the PEDF expression in patients'sera was significantly lower than the control group at the day hospitalized[(28.77±8.60) ng/L,(34.63±16.21) ng/L,respectively;t=2.063,P<0.05)].After,the expression level of PEDF in patients'sera increased gradually,and reached to a relatively high level at post-stroke day 14.There was no significant difference of serum VEGF and PEDF between the patients and control groups at other time points detected than the days 1 and 7 after hospitalization (P>0.05).The ratios of serum VEGF/PEDF in patients group were 7.48±1.98,7.86±2.83,7.39±2.18 at days 1,3,7,14 and 28 after acute ischemic stroke.The VEGF/PEDF ratios of all time points detected other than day 28 were higher than the control group (5.93±1.99).The statistical analysis showed that from post-stroke day 1 to day 7,the serum VEGF/PEDF ratio was significantly higher than the control group (t=3.63,P<0.001;t=3.68,P<0.001;t=3.24,P<0.01;respectively),while no significant difference was found between two groups for post-stroke day 14 and 28(P>0.05). Conclusion VEGF/PEDF ratio could be served as a diagnostic marker of acute ischemic stroke,serum VEGF,PEDF and VEGF/PEDF ratio might play an important role in the pathological process of acute ischemic stroke.

Comparison of BASDAI and ASDAScrp in a measure of disease activity in patients with spondyloarthropathy

LI Dong-xu, XU Sheng-qian, WU Ying, LIU Wen, QI Shan, CAI Jing, XU Jian-hua

2017, 15(1): 10-12,138. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.003

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Objective To compare the differences and clinical significance of Bath ankylosing spondylitis disease activity index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-crp) in the assessment of disease activity in patients with spondyloarthritis (Sp A). Methods A total of 177 patients with Sp A were recruited.The disease activity in Sp A were calculated by BASDAI and ASDAScrp and subsequently divided into clinical remission and disease activity according to BASDAI scoring standard,or clinical remission,low-moderate activity,high activity,very high activity according to ASDAScrp scoring standard. Results 1 One hundred and twenty-nine patients which accounted for 72.9% in all 177 patients were defined as remission stage according to BASDAI standard,and 48(27.1%) patients were categorized as disease activity.Out of 121 patients who had valid ASDAScrp scores,22(18.2%) patients were classified into remission stage,23(19.0%) patients into low-moderate active stage,53(43.8%) patients into high active stage and 23(19.0%) patients into very high activity,whilst according to ASDAScrp standard.There were significant differences between BASDAI and ASDAScrp in assessing disease activity (χ²=47.050,P<0.001),the consistency index was 0.454.Variables of ASDAScrp score,BASDAI score,BPC,ESR,CRP,PGA and BASFI in patients with ASDAScrp remission were significantly lower than that in patients with BASDAI remission (P<0.05).2 Percentage of SPARCC>0 in ASDAScrp active patients was clearly higher than that in ASDAScrp remission patient (χ²=12.903,P<0.001),while median of SPARCC score was also obvious higher than that in the latter group (z=3.477,P=0.001).No differences were found between patients with BASDAI remission and active patients (P>0.05).3 ASDAScrp positively correlated with BASDAI in Sp A (r=0.795,P<0.001).There were positive linear correlations between BASDAI/ASDAScrp and PGA,swollen joint count,tender joint count,occipital wall distance,finger-floor distance,BASFI,BPC,ESR,CRP and SPARCC scoring (P<0.05).Both BASDAI and ASDAScrp had negative linear correlations with Schober's test (P<0.001). Conclusion ASDAScrp has good correlation with BASDAI and is superior to BASDAI especially in respects of correlation with clinical and laboratory indexes.ASDAScrp can also reflect the degree of inflammation on MRI in sacroiliac joint.

Role of mean arterial pressure and urine parameter as an indicator of fluid responsiveness in patients during general anesthesia

FENG Cai-juan, LI Yu-hong, HE Rui, DING Qian-nan, RU Guo-mei

2017, 15(1): 13-16,23. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.004

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Objective To explore the indicate role of urine index or MAP of fluid responsiveness for patients during general anesthesia. Methods Fifty-six patients with ASA physical status Ⅰ-Ⅱ scheduled for gastro intestinal (GI) cancer surgery.Three times of bolus infusion (3 ml/kg) were administered 10 min after induction of anesthesia.Responsiveness was defined if stroke volume inder (SVI) increased by ≥ 10% from the bolus infusion;while SVI<10% was unresponsiveness.And according to the numbers of boluses warranted,all patients were divided into two groups:Group Ⅰ(one bolus warranted) and Group Ⅱ(two-three boluses warranted). Results Patients in Group Ⅱ have higher urinary osmolality,creatinine (Cr) concentration,and specific gravity at baseline compared with those in Group Ⅰ(P<0.05).MAP in baseline,during induction anesthesia and intubation,and during 3 boluses of fluid was nearly identical between two groups (P>0.05).The receiver-operating characteristic (ROC) curve demonstrated that the threshold value of urinary Cr ≥ 12 mmol/L for prediction of fluid responsiveness revealed the area under the curve (AUC) of 0.69(P=0.021),and cardiac inder (CI of ≤ 3.5 L/(min·m²) revealed AUC of 0.65(P=0.027).Urinary Cr in combination with CI for prediction of fluid responsiveness showed an AUC of 0.85(P=0.001) with a sensitivity of 86% and a specificity of 91%. Conclusion Urinary parameters can be used as an indicator of fluid responsiveness in patients during general anesthesia.Combination of both criteria of Cr and Urinary CI improve the accuracy of prediction,but MAP cannot be used as an indicator of fluid responsiveness.

Role of autophagy via PI3K/Akt signaling pathway in attenuation of doxorubicin-induced cardiomyopathy by Sevoflurane postconditioning

WU Yi-ni, LI Dong-li, YU Xiao-yan, CHEN De-yuan, HAN Xin, FAN Li-hua

2017, 15(1): 17-19. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.005

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Objective To investigate the effect of Sevoflurane postconditioning on PI3K/Akt signaling pathway and autophagy after doxorubicin-induced cardiomyopathy. Methods The H9c2 cardiomyocytes were randomly divided into 6groups (n=6):control group (group C),Doxorubicin group (group Dox),Sevoflurane group (group Sev),LY294002group (group LY),Solvent control group (group DMSO),3-MA group (group 3-MA).In addition to the group C,the other5 groups were all established doxorubicin-induced damage to cardiomyocytes model.Group C and group Dox did not receive any treatment,group Sev,group LY (LY294002 was added to the medium before expose),group DMSO (added DMSO),group 3-MA (added 3-MA) exposed to 2.4% Sevoflurane for 2 h.The concentrations of c Tn I and Caspase-3 in the culture medium was detected by ELISA;the expression of LC3-Ⅱ,total Akt (t-Akt) and phosphorylated Akt (p-Akt) was detected by Western blot.The quantitative data were presented as mean±standard deviation (x±s).The groups were compared using ANOVA. Results Compared with group C,the p-Akt expression was decreased,LC3-Ⅱ expression,apoptosis index,serum c Tn I and Caspase-3 concentration were significantly increased in the other five groups (P<0.05).Compared with group Dox,expression of p-Akt was increased,the expression of LC3-Ⅱ,apoptosis index,c Tn I and Caspase-3 were decreased in group Sev (P<0.05).Compared with group Sev,p-Akt was decreased,the expression of LC3-Ⅱ,apoptosis index,serum c Tn I and Caspase-3 concentration were increased in group LY (P<0.05);the expression of LC3-Ⅱ,c Tn I and Caspase-3 were decreased in group 3-MA (P<0.05). Conclusion Sevoflurane postconditioning on cardiomyocytes may reduce the myocardial cell injury induced by adriamycin,which may be related to the activation of PI3 K/Akt pathway to inhibit the excessive activation of autophagy.

Compare bronchoalveolar lavage via nasal or tracheal cannula in pathogenic diagnosis and drug resistance rate monitoring of pulmonary infection

WEN Zhong-wei, LING Zhou-gui, TANG Zhen-ming, MING Mo-yu, LIU Wei, JIANG Lian-qiang, CHEN Xiao-hua

2017, 15(1): 20-23. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.006

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Objective To investigate the value of bronchoalveolar lavage (BAL) via nasal or tracheal cannula in pathogenic diagnosis and drug resistance rate monitoring of pulmonary infection (PI). Methods We conducted a retrospective analysis of pathogenic detection and drug resistance rate by bronchoalveolar lavage via nasal or tracheal cannula in patients with PI from 2013 to 2015;the data were analyzed by SPSS 19.0 and WHONET 5 software. Results Total 1 332 patients with pulmonary infection underwent bronchoalveolar lavage by fiberoptic bronchoscopy in 3 years,207 cases via nasal (A group) and 1 125 cases via tracheal cannula (B group),and 84.5% of specimens were in the Intensive Care Unit (ICU) and neurosurgery ward.The qualification rates were similar in the 2 groups,which were 99.0% and 99.6%,respectively (P>0.05);the pathogenic detecting rate of bronchoalveolar lavage fluid (BALF) were also similar between the 2 groups,with an 85.5% and 86.9%,respectively (P>0.05).The pathogenic distributions were similar except Acinetobacter spp,however,drug resistant rates to most antibiotics were different between the 2 groups (P>0.05). Conclusions Both of transnasal or transtracheal cannula bronchoalveolar lavages are a high value approach in the pathogenic diagnosis and drug resistance monitor of pulmonary infection.

Analysis of endoscopic stenting for malignant biliary obstruction:a study of 68 patients

XU Min, FAN Heng-wei, LIU Hui-chun, CUI Pei-yuan, LU Zheng, WANG Ji-sheng, ZHOU Bin, ZHANG Qi-yu, XU Lu-bai

2017, 15(1): 24-26. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.007

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Objective To describe the clinical application value of implant biliary metal/plastic stents by endoscopic retrograde cholangiopancreatography (ERCP) to cure malignant obstructive jaundice. Methods We analyzed 68 cases of malignant biliary obstruction by endoscopic stenting between January 1,2011 to December 31,2014 in the Second Affiliated Hospital of Wenzhou Medical University. Results In this study,68 patients,46 male and 22 females,aged 28 to 99 years,mean age (67.57±12.78) years.Before the treatment,serum total bilirubin (TBil) was (217.72±125.54)μmol/L,and decreased to (149.24±126.92)μmol/L after one week treatment;serum direct bilirubin (DBil) was (126.46±70.69)μmol/L,and decreased to (75.55±68.66)μmol/L on after e week treatment,the difference was statistically significant (P<0.05);after the treatment,other liver function indicators also decreased significantly.14 caught a poor effect in diminishing jaundice,with a rate of 79.41% at one week after stent implanting.The mean survival time of patients was (10.13±10.49) months. Conclusion Endoscopic stenting for malignant biliary obstruction can improve the quality of life of patients,prolong survival,and have many advantages,such as safe,simple,minimally invasive,repeatable and so on.It is an effective way to treat malignant obstructive jaundice.

The significance of serum levels of IL-12,IL-16 and IL-17 in patients with esophageal cancer

PENG Li-juan, DU Jing-wei, XU Jun, CHANG Jin-xia, HU Wei-min, PAN Wan-long

2017, 15(1): 27-29. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.008

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Objective To investigate the role and clinical significance of IL-12,IL-16 and IL-17 on the pathogenesis of esophageal cancer by detecting the level of IL-12,IL-16 and IL-17 in serum. Methods Fifty-one patients with esophageal cancer who were treated in Nanchong Central Hospital from June,2013 to June,2014 as test group,and 40 healthy persons as control group.Collected serums and the levels of serum IL-12,IL-16 and IL-17 were detected by enzyme-linked immunosorbent assay (ELISA).Data were analyzed by independent sample t test,one-way analysis of variance (One-way ANOVA) and partial correlation analysis (Partial) with SPSS 16.0. Results The serum levels of IL-12,IL-16 and IL-17 with esophageal cancer were significantly higher than healthy controls (P<0.01).In test group,the serum levels of IL-12 were significantly higher than IL-16 and IL-17(P<0.01).In control group,the serum levels of IL-12 and IL-16 were significantly higher than IL-17(P<0.01).In the removal of IL-16,the level of IL-12 was significantly correlated with the expression of IL-17 in serum of patients with esophageal cancer (P<0.01).In the removal of IL-12,the level of IL-16 was significantly correlated with the expression of IL-17 in serum of patients with esophageal cancer (P<0.01). Conclusion IL-12,IL-16 and IL-17 were highly expressed in serum of patients with esophageal carcinoma compared with the control group.IL-12,IL-16 and IL-17 play an important role in the pathogenesis of esophageal cancer.We speculate that the level of IL-12,IL-16 and IL-17 was in the immune regulation imbalance of esophageal cancer,perhaps there is a complex signal transduction pathway among IL-12,IL-16 and IL-17.

Effect of different concentrations of Netrin-1 on proliferation and apoptosis of TEV-1 cells

ZHONG Shao-ping, LIU Xia, ZHU Xiao-yu

2017, 15(1): 30-32,75. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.009

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Objective To explore the role of different dose of Netrin-1 on regulating the proliferation and apoptosis of human trophoblast TEV-1 cells. Methods TEV-1 cells were treated with 0,10,100 and 1 000 ng/ml Netrin-1 for 24 h.Cell viability was measured by MTT assay;cell apoptosis were assessed by flow cytometry;the expression of Netrin-1 in TEV-1cells was observed by indirect cellular immunofluorescence;the mRNA and protein of Netrin-1 expression in TEV-1 cells was performed by real-time PCR and Western blot. Results Immediately after 24 hour of treatment with Netrin-1,the proliferation of TEV-1 cells was independent of Netrin-1,meanwhile,cell apoptosis decreased with the accrescence of concentration.The apoptosis rate significantly decreased to (6.63±0.07)% at 1 000 ng/ml Netrin-1 than (14.44±0.85)% without Netrin-1(P<0.05).Immunoreactivity of Netrin-1 was observed in cytoplasm of trophoblast.The expression amount of Netrin-1 protein in TEV-1 cells was independent of the accrescence of concentration by using Western blot. Conclusion Netrin-1 can reduce cell apoptosis in TEV-1 cells,but the expression level of Netrin-1 may not involve in it.

Level of fractional exhaled nitricoxide in patient with elderly asthma and its relationship with bronchial asthma severity treatment effect

CHEN Cun-guo, JIN Hua-liang

2017, 15(1): 33-35. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.010

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Objective To observe the fractional exhaled nitricoxide (Fe NO) level of elderly asthma and its relationship with bronchial asthma severity treatment effect. Methods Ninety cases of elderly patients with bronchial asthma were selected as observation group and 45 cases of healthy as control group from January,2014 to June,2016 in Taizhou hospital.The observation group patients were divided into acute exacerbation group and remission group;and were divided into level 1,level 2 and level 3 according to FEV1%.The remission group patients were divided into hormone therapy group and non-hormone therapy group according to whether hormone therapy.Fe NO levels in both groups were measured. Results The FEV1% of acute exacerbation group was lower than that of remission group and control group (P<0.05);the Fe NO of acute exacerbation group was higher than that of remission group and control group (P<0.05),the Fe NO of remission group was higher than that of control group (P<0.05).The Fe NO of non-hormone therapy group was higher than that of hormone therapy group and control group (P<0.05),the Fe NO of hormone therapy group was higher than that of control group (P<0.05).The Fe NO of level 1 group was higher than that of level 2 group and level 3 group (P<0.05),the difference of Fe NO between level 2 group and level 3 group was no statistical significance (P>0.05).The Fe NO was negative correlation with FEV1% in acute exacerbation elderly asthma patients (r=-0.441,P=0.008);the Fe NO was no correlation with FEV1% in remission elderly asthma patients (r=0.151,P=0.425). Conclusion In patients with acute elderly asthma attack,Fe NO levels elevates,FEV1% declines,Fe NO was negative correlation with FEV1%.Fe NO level is related to severity of the disease and treatment effect.

Clinical effects of arthroscopic radiofrequency ablation system onpost-traumatic synovitis of knee joint

SHEN Xiao-hui, YU Wei, YANG Fei, ZOU Hai-bing

2017, 15(1): 36-38. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.011

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Objective To investigate the clinical effects of arthroscopic radiofrequency ablation system in the treatment of post-traumatic synovitis of the knee joint. Methods Total 144 cases of post-traumatic synovitis of the knee joint in our hospital from August,2013 to June,2015 were enrolled and randomly divided into observation group and control group with 72 cases in each group.The control group received arthroscopic surgical treatment,while the observation group was given the arthroscopic radiofrequency.The outcome between the two groups were observed and compared. Results The postoperative recovery time and the incidence of joint effusion of the observation group were (9.24±1.24) d and 11.1% respectively that were significantly lower than (13.24±1.55) d and 33.3% of the control group (P<0.05).The postoperative 1 month Lysholm knee scores in the observation group and control group were (86.78±4.29) points and (80.13±5.29) points,respectively,that were significantly higher than the preoperative 1 d of (41.49±5.33) points and (40.98±4.89) points (P<0.05),while the postoperative 1 month Lysholm knee scores in the observation group were significantly higher than the control group (P<0.05).The postoperative 1 month knee joint activity in the two groups were significantly higher than the preoperative 1 d (P<0.05),while postoperative 1 month knee joint activity in the observation group were also significantly higher than the control group (P<0.05).The postoperative 1 month wound infection,edema,pain,skin pigmentation and other complications in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Arthroscopic radiofrequency ablation system for post-traumatic synovitis of the knee joint has minimally invasive and good security,it can effectively improve knee function and knee joint activity,so as to promote the rehabilitation of patients.

Relationship of clinical features of acute herpes zoster with T cell subsets

CAI Ling-qin, ZHU Xi-cong, ZHANG Ling-peng, ZHANG Wei, WANG Meng

2017, 15(1): 39-41. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.012

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Objective To investigate the correlation of the clinical features with T cell subsets in patients with acute herpes zoster. Methods The clinical data of 82 patients with acute herpes zoster in Taizhou Enze Medical Center Bridge Hospital from January,2014 to December,2015 were reviewed.Flow cytometry was used to detect peripheral blood CD4⁺T cells,CD8⁺T cells and CD3⁺T cell ratio,and the ratio of CD4 and CD8 was calculated. Results The herpes zoster condition score,the area of redness,pain,the number of blisters,the number of blisters clusters of patients aged 60 or over was not statistically different from patients less than 60 years of age (P>0.05).The CD8⁺% and CD3⁺% of patients aged 60 or over with herpes zoster were lower than that of patients less than 60 years of age (P<0.05),the CD4/CD8 of patients aged 60 or over with herpes zoster was higher than that of patients less than 60 years of age (P<0.05).The condition score,area of erythema,pain,number of blisters,number of blisters clusters in severe herpes zoster patients were higher than those in mild to moderate patients (P<0.05).The CD3⁺% of severe herpes zoster patients was higher than that in mild to moderate patients (P<0.05),the CD4⁺%,CD8⁺% and CD4/CD8 in severe herpes zoster patients were no significant difference with mild to moderate patients (P>0.05).CD4⁺% was linear correlation with blisters time and blisters cluster number of acute herpes zoster (P<0.05),CD8⁺% was linear correlation with pain time,blisters parts,blisters time and blisters cluster number of acute herpes zoster (P<0.05),CD3⁺% as linear correlation with pain time,parts of blisters,time of blisters,condition score,blisters clusters number and blisters number of acute herpes zoster (P<0.05),CD4/CD8 was linear correlation with age,blisters time,erythema area of acute herpes zoster (P<0.05). Conclusion The clinical features of acute herpes zoster are closely related with T cell subsets.

To compare the effects of muscular activator and FR Ⅱ type of functional activator for teenagers'high angle skeletal class Ⅱ malocclusion

MA Yan, LI Jin-chao, SHI You-ling, YANG Lei, BAO Wei-wei, QU Xing-hui, PANG Guang-ming

2017, 15(1): 42-44. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.013

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Objective To compare the effects of muscular activator and FRⅡ type of functional activator for teenagers'high angle skeletal class Ⅱ malocclusion,thus to provide proper reference for clinical choices. Methods Fifty-two teenagers with high angle skeletal class Ⅱ malocclusion registered in our hospital from August,2013 to December,2015 were selected and randomly divided into observation group and control group,with 26 patients in each group.And the control group was given the FRⅡ functional activator treatment,and the observation group was given the activator treatment.After three months of treatment,to observe the prognosis of deformity and to count and calculate the quantitative index of mandible and maxillary positions as well as the soft tissue profiles. Results After the treatment,the teeth arrangement in two groups were in neat rows,meanwhile the opening degree and open type were normal.The molar and the cuspid builds proper relations.The upper and lower lips returned to normal and the facial profiles were improved prominently.The total length of the lower dental arch in the two groups were significantly higher after the treatment (P<0.05),while the total length of the lower dental arch in the observation group after treatment were significantly higher (P<0.05).The total length of the upper dental arch compared before and after treatment and within groups were all not statistically significant (P>0.05).Apart from no significant change of SNA angle (P>0.05),the SNB angle of the two groups after treatment were significantly increased,and the ANB angle were significantly reduced.There were statistical significance both within and between the two groups (P<0.05). Conclusion Muscular activator and FRⅡ type of functional activator for teenagers'high angle skeletal class Ⅱ malocclusion have good treatment effects,especially the activator which is more conducive to improve relations and promote soft tissue profile improvement.Therefore,it has great application value.

Levels of Vaspin and ATGL and their gene expressions in patients with different types of coronary artery disease

ZHANG Ru-feng, LOU Guo-zhong

2017, 15(1): 45-47,166. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.014

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Objective To learn the levels of Vaspin and ATGL and their gene expressions in patients with different types of coronary artery disease and their gene expression. Methods One hundred and fifty-seven patients with different types of coronary heart disease were divided into 62 cases of SAP group,54 cases of UAP group and 41 cases of AMI group,and 55 cases of healthy persons were selected as control group.Blood lipid levels,serum Vaspin,ATGL and gene expression levels were detected,and Gensini score was used to evaluate the degree of coronary artery disease. Results TG,LDL-C,LP (a) levels of SAP,UAP,AMI groups were higher than control group,HDL-C,Vaspin,ATGL,Vaspin,ATGL gene relative expressions were lower than control group (P<0.05);TG,LDL-C,LP (a) level,Gensini score of AMI group were higher than SAP and UAP groups,HDL-C,Vaspin,ATGL,Vaspin,ATGL gene relative expressions were lower than SAP and UAP groups (P<0.05);TG,LDL-C,LP (a) level,Gensini score of UAP group were higher than SAP group,HDL-C,Vaspin,ATGL,Vaspin,ATGL gene relative expressions were lower than SAP group (P<0.05).Vaspin level of patients with coronary heart disease was positively correlated with ATGL and HDL-C (P<0.05),and was negatively correlated with TG,LDL-C,LP (a) and Gensini score (P<0.05);ATGL level was positively correlated with HDL-C (P<0.05),and was negatively correlated with TG,LDL-C,LP (a) and Gensini score (P<0.05). Conclusion ATGL,Vaspin and coronary artery disease are related;detection of Vaspin,ATGL levels and gene expressions can provide a new way for the diagnosis and treatment of coronary artery disease.

Efficacy comparison of vocal training and vocal microsurgery in patients with early vocal cord polyp

ZHUGE Pan, YOU Hui-hua, WANG Han-qing, SHI Hai-ming, DU Huan-le

2017, 15(1): 48-50. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.015

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Objective To compare the efficacies of vocal training (VT) and vocal microsurgery (VM) in patients with early vocal cord polyp (EVCP). Methods Total 38 EVCP patients in the VT group underwent 3-month vocal training,and the dynamic laryngoscope,voice handicap index (VHI),and dysphonia severity index (DSI) were applied to assess the efficacy;31 EVCP patients in the VM group received the vocal microsurgery.The efficacies of VT and VM were compared,with P<0.05 considered as statistically significant. Results The cure rates of VT and VM group were 31.6% and 100%,respectively.Mann-Whitney U-test showed that the cure rate in VM group exceeded VT Group (Z=-5.792,P<0.001).The intragroup paired-sample t-test showed that the post-treatment VHI,MPT,Jitter,F₀-High,I-Low and DSI in both groups were improved than those before the treatment.The intergroup independent-sample t-test revealed that the E value,MPT,Jitter,and DSI in VT group were improved better as compared with VM group. Conclusion Both VT and VM,with their respective advantages,can improve the vocal quality in the patients with early vocal cord polyps.

Effects of repeated extracorporeal shock wave lithotripsy treatment on renal and ureteral calculi during period of stone fragments expelling

LIU Bei-bei, WANG Sheng, ZHANG Jia-jun, YANG Xiao-huai, WANG Ming-shi, LIU Jian-min

2017, 15(1): 51-53,87. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.016

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Objective To summarize the effect of repeated extracorporeal shock wave lithotripsy (ESWL) treatment on renal calculi and ureteral calculi and the incidence of complications. Methods The clinical data of 208 patients with renal calculi (128 cases) and upper ureteral calculi (80 cases) undergoing ESWL in our hospital between 2010 and 2015 were reviewed.The stone size was between 0.6 cm and 2.5 cm in diameter.Two weeks after ESWL,a kidney,ureter,and bladder (KUB) X-ray and color Doppler ultrasound were performed to evaluate the status of stone-breaking,and then ESWL procedure was repeated for the patients which stone-breaking was not enough,and the corresponding treatment measures were implemented to promote the discharge of stones according to the situation of the patients.The occurrence of complications after repeated ESWL was observed and the prevention and treatment of complications were summarized. Results A satisfied result for repeated ESWL had been achieved in the patients with failure of first lithotripsy.One hundred and four (81.2%) of 128 cases of kidney stone and 58(72.5%) of 80 cases of ureteral calculi expelled stones successfully.The infection,serious hematuria,renal colic,and formation of ureteral "stone street" were the common complications.The expelling stone a special position,use of calcium antagonists and α-1 receptor blockers,anti-infection,adjusting urine p H,double J stent placement and other interventions could reduce the occurrence of serious complications according to the situation of patients. Conclusion The repeated ESWL for patients with poor stone-breaking in the first ESWL two weeks ago can improve the chances to discharge the stone in the first stone-expelling period.The repeated ESWL following the indications strictly combined with personalized auxiliary measures can decrease the times of treatment.The effective prevention and treatment of complications with improve the security and effectiveness of ESWL,shorten the time of the stone-expelling,and minify impairments of renal function.The repeated ESWL can increase the rate of stone expelling,but not increase the incidence of complications,which is worthy of clinical popularization and application.

Efficacy of etimicin combined with levofloxacin on MRSA infections in diabetic foot

WANG Gen-bao, ZHANG Qiu-ling, PAN Feng, DAI Wei-jian

2017, 15(1): 54-56. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.017

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Objective To investigate the efficacy of etimicin combined with levofloxacinin the treatment of Methicillin-resistant Staphylococcus aureus (MRSA) infections in diabetic foot and the polymorphism of capsular polysaccharide synthesis gene. Methods A total of 78 diabetic patients with MRSA infections in the Affiliated Hospital of Hangzhou Normal University between October,2012 and October,2014 were randomly divided into control group (n=39) and experimental group (n=39).The patients of the control group,20 males and 19 females,aged 30-72 years with an average age of (47.8±18.2) years,received levofloxacin treatment;while the patients of the experimental group,20 males and 19 females,aged 28-75 years with an average age of (49.1±19.5) years,received etimicin combined with levofloxacin treatment.The course was 4 weeks in both groups.The efficacy was evaluated with Wagner grading method.The treatment efficiency was compared between the two groups,and the polymorphism of capsular polysaccharide synthesis gene was studied. Results The clinical overall response rate in the experimental was significantly higher (P<0.05) than the in the control group;On d28,the positive rate of Staphylococcus aureus infection in the wound in experimental group was significantly lower than that in the control group (P<0.05);PCR analysis showed that the type 5 and 8 capsular polysaccharide synthesis gene were mainly the disease gene (61.5%). Conclusion Etimicin combined with levofloxacin has obviously therapeutic effect on MRSA infections in diabetic foot,which will improve the effective rate.The type 5 and 8 capsular polysaccharide synthesis gene are mainly the disease gene.

Effect of dexmedetomidine on analgesic efficacy of fentanyl in patients undergoing upper abdominal surgery

GONG Shang-zhen, YUAN Gui-hua, GAO Qing-juan, GUO Peng

2017, 15(1): 57-59. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.018

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Objective To investigate the effects of dexmedetomidine on the analgesic efficacy of fentanyl in patients undergoing upper abdominal surgery. Methods A total of 76 patients in Shaoxing Central Hospital between August 2014 and March 2016 were divided into FD group (n=38) and F group (n=38).All patients were operated by static suction combined with general anesthesia,and the patients were all connected with the analgesia pump for self-controlled intravenous analgesia.FD group was given 400 μg of dexmedetomidine combined with fentanyl 0.8 mg.F group was only given0.8 mg fentanyl.The self-controlled analgesia and the dosage of fentanyl between the two groups were compared.At 2,4,6,12,24,the visual analogue scale (VAS score),analgesia score (Prince-Henry score),sedation score standard (Ramsay score) between the two groups were compared.The complications (nausea,vomiting,excessive sedation,hypotension,itching,tachycardia,respiratory depression) were observed. Results FD group for the first time (77.92±15.61) min,total pressing times (29.12±9.25) times,the dosage of fentanyl (426.71±20.53) ml were significantly lower than the level of each index of F group[(54.68±13.95) min,(45.36±15.34) times,(509.54±26.12) ml].The difference was statistically significant (t=7.415,5.589,15.369,P<0.05).After the surgery,at 2,4,6,12,24,VAS score and PrinceHenry score in FD group were significantly lower than those in the F group,the difference was statistically significant (P<0.05).There was no significant difference in Ramsay scores between the two groups at different time points (P>0.05).The incidence of adverse reactions in group FD (7.89%) was significantly lower than that in group F (28.95%),and the difference was statistically significant (χ²=4.290,P<0.05). Conclusion Dexmedetomidine can significantly increase the analgesic effect of fentanyl in patients undergoing abdominal surgery,and reduce the dosage of fentanyl and adverse reactions.

Partial correlation of thyroid function and insulin resistance in adolescents with polycystic ovary syndrome

YIN Yi-hong, ZHAO Shan-qiong

2017, 15(1): 60-62,102. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.019

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Objective To investigate the correlation of thyroid hormone levels and the insulin resistance in adolescents with polycystic ovary syndrome (PCOS). Methods Ninety-two girls with PCOS and sixty age-matched controls underwent clinical,biochemical,hormonal evaluation.Waist-to-hip ratio (WHR),blood glucose,insulin and lipid levels were compared between the two groups.The relative indicators in patients with TSH ≥ 2.5 m IU/L and TSH<2.5 m IU/L were also observed.Due to WHR influence factors,the partial correlation analysis was made between TSH,FT3,FT4 and HOMAIR,blood lipid and blood sugar. Results 1PCOS had elevated fasting plasma glucose,insulin,HOMA IR and thyroidstimulating hormone (P<0.05);2PCOS with TSH ≥ 2.5 m IU/L had significant differences in plasma glucose,insulin,HOMA IR and thyroid-stimulating hormone as compared with another group (TSH<2.5 m IU/L),P<0.05;3Controlling the WHR influence factors,TSH was closely associated with FBI and HOMA-IR in the group TSH ≥ 2.5 m IU/L,while FT4 had obviously positive correlation with TG and FBG (P<0.05).Nevertheless,negative correlation was illustrated in the area of FBI and HOMA-IR (P<0.05),however,another group (TSH<2.5 m IU/L) showed less close correlation. Conclusion Adolescent PCOS girls with TSH ≥ 2.5 m IU/L have more obvious insulin resistance and higher WHR.However this effect of TSH on IR may be independent of WHR.

A comparative observational study of intensity modulated radiotherapy and conventional radiotherapy in patients with nasopharyngeal cancer

ZHANG Li-ping, JIA Yong-shi, LI Qiang

2017, 15(1): 63-65. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.020

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Objective To observe the acute radioreaction and clinical effect of intensity modulated radiotherapy and conventional radiotherapy in the treatment of nasopharyngeal cancer. Methods Total 72 cases of nasopharyngeal cancer in our hospital between June,2012 and November,2014 were enrolled and divided into control group and observation group with 36 cases in each group.The control group accepted the conventional radiotherapy;while the observation group accepted intensity modulated radiotherapy,for 1 time/day and 5 days/week.Both groups adopted synchronous chemotherapy or adjuvant chemotherapy with PF regimen (cis-platinum 30 mg/m²,d_1-d_3;5Fu 500 mg/m²,d_1-d_5).The acute radioreaction and survival rate of the two groups were compared. Results The thirst,swallow pain,hearing loss and skin injury occurrence rate of the observation group were 63.9%,52.8%,38.9% and 50.0%,respectively,and of the control group were 94.4%,69.4%,52.8% and 72.2%,respectively,the difference was statistical significant (χ²=10.189,4.800,4.503,4.800,P<0.05).The mucous injury occurrence rate of the observation group was 75.0%,and of the control group was 86.1%,the difference was not statistical significant (χ²=3.192,P>0.05).Up to January,2016,there was 1case of distant metastasis,no local recurrence and death case in the observation group,there was 1 case of local recurrence,2 cases of distant metastasis and no death case in the control group. Conclusion The intensity modulated radiotherapy can effectively reduce the acute radioreaction in nasopharyngeal cancer patients,improve the clinical effect and the quality of life of patients.

Affection of sevoflurane and propofol on inflammatory factors and stress response in patients with cervical cancer after laparoscopic radical hysterectomy

SHEN Ya-jian, FANG Jun, ZHOU Hui-dan, CHEN Ping, DING Ze-wu

2017, 15(1): 66-68. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.021

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Objective The laparoscopic radical hysterectomy for cervical cancer is a common gynecological cancer surgery,but surgery can lead to body damage,this study aims to investigate the effect of sevoflurane and propofol on and stress response in patients with cervical cancer after laparoscopic radical hysterectomy. Methods A total of 90 patients undergoing laparoscopic radical hysterectomy for cervical cancer from February,2015 to August,2016 were divided into observation group (45 cases) and control group (45 cases).The patients of the control group,received sevoflurane inhalation anesthesia;The patients of the observation group,received propofol intravenous anesthesia.The anesthesia duration and the time to spontaneous breathing recovery,eye opening,speech response,orientation recovery and extubation were observed.The enzyme-linked immunosorbent method was used to detect inflammatory factor tumor necrosis factor (TNF-α) and beta interleukin 1(IL-1β) level,the blood pressure monitor was used to monitor the heart rate (HR) and mean arterial pressure (MAP),the glucose meter was used to monitor the level of glucose (GLU),the radioimmunoassay was used to detect the levels of cortisol (COR) and angiotensin Ⅱ(AngⅡ).The changes of the above indexes at T0(before the anesthesia),T1(10 min after pneumoperitoneum) and T2(10 min after the surgery) were compared between the two groups. Results The time to spontaneous breathing recovery,eye opening,speech response,orientation recovery and extubation in the observation group were significantly shorter than those in the control group (P<0.05);Compared with T0,the levels of TNF-α and IL-1β was increased significantly at T1 and T2 in both groups (P<0.05);but the levels of TNF-α and IL-1β of observation group was lower than those in control group (P<0.05);There was no significant difference in HR and MAP at each time point between the two groups (P>0.05);The levels of GLU,CRO and AngⅡ at T1 and T2 were significantly higher than those at T0 in 2 groups (P<0.05),but the levels of GLU,CRO and AngⅡ of observation group was lower than those in control group (P<0.05);Incidence of adverse reactions of the observation group was 13.33%,and of the control group was 11.11%,the difference was not significant (χ²=0.104,P>0.05). Conclusion The clinical effect of sevoflurane anesthesia is good,which can inhibit the inflammatory reaction and stress reaction in patients with laparoscopic radical hysterectomy for cervical cancer.

Clinical analysis of retroperitoneal laparoscopic surgery for adrenal gland and upper urinary tract diseases:A report of 180 cases

LIU Xian-he, YANG Hong, ZHU Jia-hong, LI Jing, SHAO Huan-jun, WANG Xu

2017, 15(1): 69-71. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.022

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Objective To summarize the clinical experience and surgical technique of retroperitoneal laparoscopic management of adrenal gland,renal and upper urinary tract diseases,improve the technical level,and promote the popularization laparoscopic techniques in primary level hospitals. Methods The clinical data of one hundred and eighty patients with urological diseases undergoing retroperitoneal laparoscopic surgery in our hospital between January,2011 and April,2015 were analyzed respectively.There were 60 cases of renal cyst decortication,11 cases of adrenal disease surgery (1case of pheochromocytoma,3 cases of neurofibroma,6 cases of nonfunctional adenoma,1 case of adrenal cortical hyperplasia),30 cases of simple nephrectomy,15 cases of radical nephrectomy,4 cases of partial nephrectomy,60 cases of ureterolithotomy.To operation time,amount of blood loss,length of stay,hospital expenses,etc. Results Of the 180 cases,177 cases accomplished retroperitoneal laparoscopic surgery and 3 cases converted to open surgery.For the 11 cases of adrenal gland disease,the average operation time was 91 min,the amount of blood loss was 16 ml;for 60 cases of renal cyst decortication,the average operation time was 35 min,the average blood loss was 10 ml;for 30 cases simple nephrectomy,the average operation time was 120 min,the average blood loss was 20 ml;for 19 cases of kidney cancer surgery (15 cases of radical nephrectomy,4 cases partial nephrectomy),the average operation time was 126 min,the average blood loss was25 ml;for 60 cases of ureterolithotomy,the average operation time was 100 min,the average blood loss was 15 ml.There was no severe complication and therapeutic efficacy was satisfactory. Conclusion The retroperitoneal laparoscopic surgery for adrenal gland and upper urinary tract diseases can be widely applied in basic-level hospitals.

Effect of NLRP3 inflammasome on diabetic nephropathy renal interstitial inflammation

HONG Bao-jian, SU Li-yun, ZHU Yue-xia, LIANG Li-juan, XU Fang, ZHU Miao-ying

2017, 15(1): 72-75. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.023

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Objective To explore the effect of NLRP3 inflammasome on diabetic nephropathy renal interstitial inflammation. Methods From Zhejiang provincial people's hospital type 2 diabetic nephropathy,50 patients were selected as diabetic nephropathy group,kidney hamartoma surgery 50 patients as control group.The clinical data,urinary IL-18 and IL-1β levels,renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression were compared in two groups.The correlation between diabetic nephropathy renal interstitial inflammation and tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression,and the correlation between diabetic nephropathy renal tubular epithelial cells NLRP3,P2X4 immunohistochemical expression score and urine IL-18,IL-1β levels were analyzed. Results The urinary protein excretion,fasting blood glucose,triglycerides,total cholesterol and low density lipoprotein in diabetic nephropathy group were higher than that of control group (P<0.05).The urine IL-18 and urine IL-1β levels of diabetic nephropathy were higher than that of control group (P<0.05).The renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression of diabetic nephropathy group were high,the renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression of diabetic nephropathy group were low expression or not expression.The renal tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1βexpression scores of diabetic nephropathy group were significantly higher than that of control group (P<0.05).Diabetic nephropathy renal interstitial inflammation was positively correlated with tubular epithelial cells NLRP3,P2X4,IL-18 and IL-1β expression (P<0.05).Diabetic nephropathy renal tubular epithelial cells NLRP3,P2X4 immunohistochemical expression score were positively correlated with urine IL-18,IL-1β levels (P<0.05). Conclusion P2X4 possibly activates NLRP3 inflammatory body,regulate inflammatory cytokines,and causes diabetic nephropathy renal interstitial inflammation.

The prevalence rate and risk factors of venous thromboembolism in 239 cases with acute exacerbation chronic obstructive pulmonary disease

DONG Hong-ying, ZHANG Yun-xia

2017, 15(1): 76-78. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.024

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Objective To investigate the risk factors of acute exacerbation chronic obstructive pulmonary disease (AECOPD) with venous thromboembolism,and to provide support for clinical diagnosis and prognosis. Methods All 239 cases of AECOPD patients from January,2013 to December,2015 in our hospital were retrospectively analyzed.Based on with or without venous thromboembolism (VTE),patients were divided into two groups,52 cases in VTE group and 187 cases in without VTE group.Survey on risk factors of AECOPD with VTE were made,and age,smoking history,body mass index,severity,time in bed,diabetes,hypertension or coronary heart disease of patients were selected,and the common serum indicators and blood gas levels were observed.Univariate factor and Logistic Regression analysis were carried out to analysis the data between two groups. Results In all 239 cases of AECOPD patients,52 cases were with VTE,the VTE incidence rate reached 21.8%.Univariate and Logistic regression analysis showed that age,body mass index,smoking history,diabetes,hypertension or coronary heart disease,bed time,high D-dimer level,PaO₂ level,PaCO₂ level are the risk factors for AECOPD patients with VTE. Conclusion COPD patients easily occur VTE complications,and age,body mass index,smoking history,diabetes,hypertension or coronary heart disease,bed time,high D-dimer level,PaO₂ level,PaCO₂ level are risk factors of AECOPD with VTE.

FENG Guo-fang, ZHUO Guang-chao, ZHOU Hong, SI Qi, CHEN Lu-fang, ZHU Li-bo

2017, 15(1): 79-81,181. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.025

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Objective To investigate the related factors of treatment compliance among infertile women with mycoplasma infection and take the corresponding intervention measures to improve the curative efficacy. Methods By using a selfmade questionnaire,the survey was carried out among 263 female patients who get the positive result in genitourinary mycoplasma culture in our hospital between January,2013 and December,2013.According to the treatment compliance,they were divided into full compliance group (91 cases) and unstable compliance group (172 cases).The items of questionnaire included general demographic information,marriage and family situation,examination and treatment on mycoplasma and infection related knowledge level.The personalized measures and standardized health education were performed according to the influencing factors.The results were analyzed by statistical methods. Results There were significant differences in general demographic data and mycoplasma infection related knowledge between the two groups (P<0.05).Thirty-two to thirty-four age-groups in the full compliance group showed the best treatment compliance,and the compliance declined with the duration of infertility.The urban population with high education level and income showed increased demand mycoplasma infection and infertility related knowledge and highly awareness rate,whereas lower treatment compliance.The complex treatment,high medical costs,lack of disease knowledge,poor communication and negative psychological factors were the important factors that affected the treatment compliance. Conclusion In order to improve the treatment compliance of infertile women with mycoplasma infection,a personalized,standardized and systematic intervention system should be established combined with psychology,sociology,nursing and reproductive medicine.

Curative effect of different surgical methods on post-caesarean section uterine scar defects

HE Hui, HU Hua-min, SHEN Qi

2017, 15(1): 82-84. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.026

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Objective To compare the therapeutic efficacy among the combined laparoscopy and hysteroscopy,vaginal surgery and hysteroscopic surgery for post-caesarean section uterine scar defects (PCSD). Methods The patients received combined laparoscopy and hysteroscopy,vaginal surgery and hysteroscopic surgery in in Huzhou central hospital and Taizhou hospital of Zhejiang province from January,2010 to December,2015 were enrolled and divided into group A,B and C with 35 cases in each group.The operation,treatment expenses,duration of hospital stay,therapeutic effect,postoperative menstruation and pregnancy were compared among the three groups. Results The operative time,blood loss in group A were higher than those of group B and group C (P<0.05),the operative time,blood loss of group B were higher than those of group C (P<0.05);the postoperative bleeding of group A and B group were higher than that of group C (P<0.05).The treatment cost more group A than group B and group C (P<0.05).The group B cost less than group C (P<0.05);the hospitalization time of group B was longer than that of group A and group C (P<0.05),the hospital stay of group A was longer than that of group C (P<0.05).The differences of efficacy among the three groups were statistically significant (P<0.05),the excellent rate of group A was significantly:higher than group C (P<0.05).The postoperative menstruation normal rate of group A and group B were higher than that of group C (P<0.05),the rate of menstruation recovery after the operation between group A and B group was no significant difference (P>0.05);the postoperative pregnancy rate among the three groups was no statistically significant (P>0.05). Conclusion The combined laparoscopy and hysteroscopy,vaginal surgery and hysteroscopic surgery are all the effective method for PCSD,with its own characteristics.A comprehensive consideration is need when the surgical planning is selected.

Role of procalcitonin,albumin and interleukin-6 levels in diagnosis of infections in preterm infants

ZHAO Yan-feng, ZHANG Zhi-qun, LU Hui, MO Yu-nong, YAO Qiang

2017, 15(1): 85-87. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.027

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Objective To investigate the diagnostic value of procalcitonin (PCT),albumin (Alb) and interleukin (IL)-6levels for infections in preterm infants. Methods Total 64 cases of infections in preterm infants in neonatal intensive care unit of Department of Neonatology,Hangzhou Women's Hospital between January,2015 and April,2016 were selected as infection group,and 64 cases of non-infection premature baby in the same period were selected as control group.The levels of PCT,Alb,and IL-6 were compared,and the sensitivity and specificity of PCT,Alb,and IL-6 in the diagnosis of infections in preterm infants were evaluated. Results The levels of PCT and IL-6 in the infection group were (5.27±1.24) ng/L and (224.27±56.54) ng/L,which were significantly higher than non-infection group (0.66±0.29) ng/L and (85.31±12.13) ng/L in the control group (P<0.05);Alb level in the infection group was (24.97±6.27) g/L,which was significantly lower than (28.31±5.31) g/L in the control group (P<0.05).After the treatment,the levels of PCT and IL-6 in the infection group were significantly reduced to (0.54±0.34) ng/L and (82.47±13.84) ng/L (P<0.05);but Alb level was significantly increased to (29.45±5.83) g/L (P<0.05).The sensitivity and specificity of PCT+Alb+IL-6 in diagnosis of infections in preterm infants were significantly higher than that of single index (P<0.05). Conclusion PCT,Alb,and IL-6 could be used as clinical diagnostic indicators on infections in preterm infants,and the effect of three indicators combined were the best.Also three indicators could be used as the effective indicators to efficacy evaluation.

The expression and significance of BRCA1 and CA125 in endometrial carcinoma

LIU Rui-qian

2017, 15(1): 88-91. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.028

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Objective To investigate the expression and clinical significance of breast cancer gene-1(BRCA1) and tumor associated antigen (CA125) in endometrial carcinoma (EC). Methods A total of 56 patients with EC were selected from Deyang People's Hospital from January,2014 to February,2016.Meanwhile,another 32 cases with atypical endometrial hyperplasia and 26 cases with uterine fibroids were selected as control group.The expressions of BRCA1 and CA125 in different endometrial tissues were detected by immunohistochemistry,and the expressions of BRCA1 and CA125 under different pathological factors were analyzed. Results The positive rates of BRCA1 and CA125 expression in the endometrium of patients with EC,atypical endometrial hyperplasia or uterine fibroids were 32.14%,75.00%,96.15% and69.64%,53.13%,7.69% respectively.The expression of BRCA1 in EC was significantly lower than that of the other two groups (P<0.05),but the level of CA125 in EC was significantly higher than that of the other two groups (P<0.05).The positive rate of BRCA1 expression in clinical stage,histological differentiation,lymphoid metastasis status all had statistical significance (P<0.05),but there was no relationship between the BRCA1 expression and myometrial invasion.The expression of CA125 in EC was associated with the clinical stage,histological differentiation,myometrial invasion,but was not related to the lymphoid metastasis status.The expression of BRCA1 and CA125 in endometrial tissue was negatively correlated (r=-0.319,P=0.013). Conclusion BRCA1 has low expression and CA125 is highly expressed in EC.The expression of BRCA1 and CA125 in EC are related to the clinical stage,histological differentiation and other indicators,and it can be used to assess the degree of malignancy of EC and it's of great significance in clinical diagnosis.

Curative effect of montmorillonite powder combined with racecadotril granules on viral enteritis in children

LIU Wei-rong, WANG Xiao-xian, ZHANG Hang-hu, CHEN Xiao-hong

2017, 15(1): 92-94. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.029

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Objective To investigate the curative effect of montmorillonite powder combined with racecadotril granules on viral enteritis in children. Methods A total of 105 children with viral enteritis in Shaoxing People's Hospital from January,2015 to January,2016 were collected and divided into group A,B and C with 35 people in each group.The three groups of children were given relevant treatment,while group A received montmorillonite powder providing appropriate dose according to the age;group B received racecadotril granules,taking each dose of the drug per kilogram in accordance with 1.5 mg body weight;group C received montmorillonite powder and racecadotril granules,the dose was the same as that of group A and group B.The clinical efficacy and adverse reactions were compared between the three groups. Results The total effective rate in group C was 100.00%,which was significantly higher than that of group A and group B,88.57% and 85.71%,respectively and the difference had statistical difference (χ²=5.10,P<0.01),The antiemetic time,fever clearance time,recovery time of defecation traits back to normal,recovery time of defecation frequency back to normal were shorter than those in the other two groups,with a statistical difference (P<0.01).After treatment,the levels of AST、CK、CK-MB、LDH in three groups were significantly lower than those before the treatment (P<0.01).Between the 3 groups,the decline of AST,CK,CK-MB,LDH in group C was more significant than those in the other two groups,and the difference was significant (P<0.05).No severe adverse reactions were found during the treatment. Conclusion Montmorillonite powder combined with racecadotril is better than the other single medication groups and found no adverse reactions,which is worthy of clinical promotion.

Effect analysis of integrated Chinese and Western treatment for Liver-Yang hyperactivity syndrome hypertension in community

ZHENG Shu-ping, CHANG Wei

2017, 15(1): 95-98. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.030

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Objective In clinical practice,we found some patients with Liver-Yang hyperactivity syndrome high Hcy (H type) hypertension did not respond well to treatment for Hcy and blood pressure.Patients still experienced dizziness or headache after treatment.We sought to investigate the therapeutic effect of folic acid,Enalapril,and Qiangli Dingxuan Tablets integrated Chinese and Western medicine treatment for Liver-Yang hyperactivity syndrome high Hcy (H type) hypertension. Methods We recruited 100 patients from October,2014 to June,2015 newly diagnosed as Liver-Yang hyperactivity syndrome high Hcy (H type) hypertension stage 1 and 2 as our study cases.They were divided randomly by software into intervention group and control group,with 50 patients for each.Intervention group was treated orally with Enalapril 10 mg/d,folic acid 0.8 mg/d,and Qiangli Dingxuan Tablets 4 pieces per time,three times per day.Control group was treated orally with Enalapril 10 mg/d and folic acid 0.8 mg/d.During treatment,the change of blood pressure,Hcy values,the recognition and the symptom of Traditional Chinese Medicine constitution were observed.Continuous variables were recorded as mean±standard error,and were analyzed with student t test.Categorical variables were analyzed with chi-square test,and ranked data were evaluated with Wilcoxon rank sum test.Statistical significances were achieved as P<0.05. Results The total effective rate of the intervention group was 88%(44/50),while 30%(15/50) for the control group.The total effective rate of the intervention group was significantly higher than the control group,and the difference reached statistical significance (P<0.01).After three-month treatment,the average systolic blood pressure (SBP)/diastolic blood pressure (DBP) of the intervention group were both lower than those in the control group,and the difference was statistically significant (P<0.05).The difference of Hcy values between the intervention group and the control group failed to reach statistical significance (P>0.05).And the intergroup difference of the Liver-Yang hyperactivity syndrome scores between the intervention group and the control group was statistically significant (P<0.05). Conclusion Integrated Chinese and Western treatment for Liver-Yang hyperactivity syndrome H type hypertension has a decent therapeutic effect.Not only did it effectively control H type hypertension,but also significantly improved Liver-Yang hyperactivity symptoms like dizziness and headache.

Research on current status and strategy of community health service in Tianhe district of Guangzhou

ZHAN Chun-wang, YANG Yang, CHEN Xiu-ge, LIU Lin-fan, CENG Zhi-rong

2017, 15(1): 99-102. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.031

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Objective To investigate the status of construction and development of community health service system in Tianhe district and provide information and reference for the promotion of the reform and development of the regional community health service. Methods By using self-designed structured questionnaire,27 community health service centers in Tianhe district were surveyed for the basic situation of the community health service centers,human resources,financial payments and community health service delivery etc.Moreover,a survey for the satisfaction of treatment process,facilities and equipment,medical technology,service attitude etc.was conducted among 434 clients from district 12 community health service centers using occasional method. Results The residents of the Tianhe district showed somewhat satisfaction at the community health service,included the highest satisfaction (4.28±0.71,4.23±0.65) at the distance between the abode and service centers and medical procedures,and lowest satisfaction at facilities and the diagnosis and treatment technology (3.95±0.81,4.06±0.68),there were difference in the satisfaction among the different occupational groups (P<0.05).A lot of problems such as the not balanced allocation of resources,insufficient government input,comparatively fall behind of hardware requirements,lower overall quality of health care workers and so on were widely existed in community health service centers. Conclusion To improve community health service network,increase financial investment,encourage social capital participation,bring forth the new mechanism that attract quality resources,regard the regulation function of medical insurance,and intensify efforts to attract talents will contribute to the development of community health services in Tianhe district.

Research on the application of transcultural-theoretical-based health education in execution list

SUN Xiao-jun, YAO Hong-mei, WANG Ning-chen, ZHENG Jun

2017, 15(1): 103-105. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.032

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Abstract:
Objective To investigate the effect and application of transcultural theoretical on health education in execution list.To improve the effects of health education and the satisfication of nursing work. Methods Three hundred inpatients in a hospital and were selected and divided into intervention group and control group randomly,there were 150 patients each group.Both groups received conventional health education.Intervention group received the health education in a traditional way which were expressed in verbal form,while,control group do a multicultural assessment on the patient first,and then carry out health education and evaluation in a timely manner according to the theory of transcultural-theoretical-basedhealth education in execution list.An evaluation of the patients'degree of health education with verbal form was made according to the law consulting content.Statistical data processing was based on the chi-square paired sample T test and rank and inspection level data for analysis.The satisfaction with nurses'service was compared by using questionnaire survey and verbal form. Results Accorrding to two groups of patients to know the situation of health education content,the number of people in two groups who could answer correctly was different.The number of control group was higher than intervention group's.The difference was statistically significant (P<0.05).Satisfaction survey of two groups,according to the number of the intervention group and control group patients are overall satisfied with 146 cases and 126 cases respectively,z=-7.044,P<0.001,were highly significant difference. Conclusion By using the theory of multicultural design health education implementation of single health education,the health education can not only improve the nurse's execution,and in the implementation of the health education,nurses use is consistent with the patient cultural background of multi-culture nursing,it let patients feel respected and make education more personalized,more press close to the patient's physical and mental needs.And it improves the degree of patients on health education knowledge and the satisfaction of nursing job.On this basis,it brings nurses'objective initiative into full play.

Effect of brainwave synchronization therapy combined with repetitive transcranial magnetic stimulation on postpartum depression

ZHANG Ying, WANG Jin-quan, SU Jun, MAO Hong-jing, REN Wan-wen

2017, 15(1): 106-109,131. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.033

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Abstract:
Objective To explore the efficacy of combination therapy with brainwave synchronization,repetitive transcranial magnetic stimulation (r TMS) and fluoxetine in the treatment of postpartum depression. Methods Forty-eight cases of postpartum depression in Hangzhou Seventh People's Hospital between June,2013 and June,2015 were randomized into two groups.The combined treatment group (25 cases) received the combination therapy with brainwave synchronization,r TMS and fluoxetine,while the simple drug group (23 cases) only received fluoxetine treatment.The curative effect and adverse reactions were evaluated between the two groups by Hemilton depression scale (HAMD),Edinburgh postnatal depression scale (EPDS),clinical global impression (CGI) and treatment emergent symptom scale (TESS) before the treatment and 1,2,4 and 6 weeks after the treatment.The levels of serum cortisol (COR),three iodine thyroid glycine (T3),four iodine glycine (T4),thyroid-stimulating hormone (TSH) and estradiol were tested before the treatment and 6 weeks after the treatment. Results HAMD and EPDS score on the end of 2,4 and 6 weeks decreased obviously in the combined treatment group as compared with the fluoxetine group (P<0.01);CGI-EI on the end of 2 weeks in the combined treatment group was higher than that in the fluoxetine group (P<0.05);The difference in (CGI-GI and CGI-EI at 6 weeks after the treatment was statistically significant (P<0.05);TESS score on the end of 4 and 6 weeks in the combined treatment group was obviously lower than that in the fluoxetine group (P<0.01);After 6 weeks treatment,the difference in the levels of serum TSH,COR and estradiol was significant between the two groups (P<0.05). Conclusion The combination therapy with brainwave synchronization,r TMS and fluoxetine for postpartum depression is effective with less sideeffect.The small drug dosage can improve the compliance of patients.

Effects of psychological intervention on glucose metabolism in patients with type 2 diabetes mellitus accompanying depression in community

XUE Jun, SHI Dan-hua, AO Mei, LI Lei, FENG Chao-xia, LÜ Guo-mei, CAO Xiao-jing

2017, 15(1): 110-112. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.034

189 1

Abstract:
Objective To explore the effect of psychological intervention on glucose metabolism in community patients with type 2 diabetes mellitus (T2DM) with depressive symptoms. Methods Four hundred and ten cases of T2 DM patients in the community health service center of Baotou friendship office were selected as the research objects.According to Zung self rating depression scale (SDS) for evaluation and analysis,we found that 176 cases of T2 DM with depression.One hundred and seventy-six cases of T2 DM with depression were randomly divided into the study group and the control group with 88 cases in each group.The control group was treated with routine treatment,while the experimental group was received of psychological treatment on the basis of conventional treatment.After 3 months of psychological intervention,fasting blood glucose (FPG),postprandial two hours blood glucose (PG2h),glycosylated hemoglobin (Hb A1c) and Zung self rating Depression Scale (SDS) were measured in two groups.After two months intervention being stopped,the follow-up was conducted to determine the levels of FPG,PG2 h,and Hb A1 c,and to assess the level of depression and quality of life.Statistical analysis was performed using SPSS 17.0 statistical software. Results After 3months of psychological intervention,the results of FPG,PG2 h and Hb A1 c in the experimental group were significantly lower than those in the control group,the depression index was significantly lower than that of the control group,the difference was statistically significant (P<0.01).After two months intervention being stopped,the glucose metabolism indexes of the experimental group were significantly lower than that of the control group;the depression index was dramatically lower than that of the control group,the difference was remarkable (P<0.01). Conclusion Mental intervention can effectively improve the depression symptoms and glucose metabolism of community type 2 diabetes patients with depression,but it takes a long time.

An empirical research of task performance of general practitioner based on organizational behavior perspective

ZHANG Shu-e, CAO Qiu-ru, SUN Shao-xing, GAO Han, SHI Yu, XIE Feng-zhe, WANG Yi-su, MENG De-xin, SUN Tao

2017, 15(1): 113-115,119. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.035

217 2

Abstract:
Objective At present,the grassroots medical service status stand in backwater,the low level of community health service quality hindered the process of our new health care reform,therefore,the country started the comprehensive promotion of community health service project.Improving the general practitioner performance is the inevitable choice of community health service project.The paper aims to explore the relationship between transformational leadership and task performance of general practitioner,and test the mediating role of organizational ownership behavior. Methods The stratified sampling method was used to collect 263 community health service institution in Harbin,Daqing,Suihua,Heihe,Daxinganling and Qiqihar,and the questionnaire survey was conducted among the delegates from those community health service institution.The hierarchical multiple regressions were used to test the relationship between variables and mediating effect. Results Transformational leadership had a significantly positive influence on organizational ownership behavior (β=0.334,P<0.01) and task performance (β=0.334,P<0.01),and organizational ownership behavior had positive effects on the task performance (β=0.486,P<0.01).The organizational ownership behavior played the fully mediating role (β=0.459,P<0.01). Conclusion The transformational leadership significantly affects the performance of general practitioner by the conduction of organizational ownership behavior.This article explored the action mechanism between the relations of variables based on three theoretical perspectives.

Investigation and analysis on nutrition knowledge,attitude,behavior and body mass index of rural pupils in Chaozhou city

ZHANG Qiu-yan

2017, 15(1): 116-119. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.036

145 1

Abstract:
Objective To understand the nutrition knowledge,attitude,behavior and body mass index of rural pupils in Chaozhou city and provide scientific basis for improving the health level. Methods In May,2015,the height and weight of 983 children of 3 rural primary schools in Chaozhou were determined according to the national student physical health research handbook requirement,the body mass index (BMI) was calculated to evaluate the nutritional status of primary school students.A survey of the children was conducted with self-designed questionnaires of nutritional and health,the data was analyzed with SPSS software. Results The detection rate of low body weight,overweight and obesity were15.56%,4.88% and 1.63% among 983 rural pupils respectively and the detection rate of low body weight,overweight and obesity in boys and girls was not obvious (P>0.05).The detection rate of low body weight of boys was 14.37% and was lower significantly than that of girls (P<0.05),and the rate of boys was the highest in sixth grade and girls in fifth grade.The detection rate of overweight of boys was higher than that of girls at same grade (P<0.05),the rate of boys was the highest in third grade (6.72%) and girls in fourth grade (4.42%).The detection rate of obesity of rural pupils in Chaozhou city was relatively lower,there was no obvious difference of boys and girls (P>0.05).The nutritional and health knowledge level of rural pupils was relatively low,and it was related with educational level.Their nutritional attitude was optimistic,poor diet,unreasonable proportion of three meals and imbalance nutrition intake were widely present in primary students. Conclusion In Chaozhou city,malnutrition and super-nutrition coexisted among rural pupils,lack of nutritional knowledge.It was necessary to strengthen the nutrition education and intervention of rural pupils,improve their nutrition knowledge level,so that students develop good eating habits,improve their nutrition and health status.

Diffusional kurtosis imaging evaluation on the protective effect of limb remote ischemic preconditioning against stroke

JIANG Min, CHEN Qiu-yan, WU Fu-lin, PENG Xiao-lan, CHEN Ting-ting, WEI Ding-tai

2017, 15(1): 120-124. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.037

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Abstract:
Objective To explore the changes in diffusional kurtosis imaging (DKI) parameters after limb remote ischemic preconditioning (LRP) in experimental stroke. Methods Total 26 adult SD male rats were subjected to LRP group and sham surgery (IC group) and then subsequently underwent 1 h right middle cerebral artery occlusion (MCAo).MRI examination was executed at 48 h after reperfusion to collect data of T2 FLAIR and DKI. Results T2 FLAIR result showed that the lesion in LRP group was much smaller than that in IC group (29.80±11.09 vs.59.35±13.23,P<0.05).There were much differences in DKI parameters[mean kurtosis (MK),K_⊥,K_‖]between affected side and healthy side in IC group,whereas in LRP group,the DKI parameters showed in affected side were much closer to contralateral side.The percent changes of metrical parameters with statistical differences between LRP and IC group include MK in gray matter (GM,-3.52±22.57 vs.59.73±11.63,P<0.05).MK in white matter (WM,3.99±5.32 vs.42.57±1.94,P<0.01) and K_⊥in WM as well (-16.45±4.43 vs.19.73±5.86,P<0.01).The percent in change of K‖revealed no difference between LRP and IC group (47.40±29.20 vs.71.49±15.58,P>0.05). Conclusion LRP could improve the abnormalities in DKI metrics against ischemia,which also offer us clue for explore the neuroprotective mechanism of LRP against stroke.

Value of color Doppler spectrum and quantitative contrast enhanced ultrasound on evaluation of renal microcirculation before and after treatment of chronic glomerulonephritis

SUN Jian-ming, ZHENG Yuan-yuan, JIANG Zhen-zhen

2017, 15(1): 125-127. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.038

154 0

Abstract:
Objective To explore the value of color Doppler spectrum and quantitative contrast enhanced ultrasound on evaluation of renal microcirculation before and after treatment of chronic glomerulonephritis. Methods Fifty cases of chronic glomerulonephritis in our hospital between January,2014 and December,2015 were enrolled and divided into good prognosis group and poor prognosis group according to the therapeutic effect.The levels of blood urea nitrogen,serum creatinine and 24-hour urine protein were tested before and after the treatment.The renal arterial resistance index (RRI) and maximal blood flow velocity were measured by color Doppler spectrum.The mean transit time,area under the curve,peak intensity and time to peak were measured by contrast-enhanced ultrasonography. Results There was no significant difference of blood urea nitrogen,serum creatinine,24 h urinary protein,The long axis of the kidney and the thickness of the kidney after treatment and those before treatment (P>0.05).There was no significant difference in the resistance index and the maximal velocity of segmental artery after treatment and those before treatment (P>0.05).The area under the curve after treatment was higher than that before treatment (P<0.05).Before treatment,there were no significant differences in the mean transit time,peak time,area under the curve and peak intensity between the two groups (P>0.05).After treatment,the mean transit time,peak time,area under the curve and peak intensity of the good prognosis group were higher than that of the poor prognosis group (P<0.05).There was a negative correlation between the difference of urinary protein before and after treatment and the area under the curve before and after treatment (r=-0.901,P<0.001). Conclusion There are no significant changes in biochemical parameters and color Doppler spectrum parameters before and after treatment in patients with chronic glomerulonephritis.Contrast-enhanced ultrasound can be sensitive to the changes of renal microcirculation in patients with chronic glomerulonephritis before and after treatment.

Fetal cardiac Tei index change in second and third trimester by echocardiography and its relationship with preeclampsia

YU Xian-zeng, YUAN Hua

2017, 15(1): 128-131. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.039

146 2

Abstract:
Objective To study the fetal ventricular Tei index changes by using echocardiography,and to explore its relationship with preeclampsia. Methods From December,2012 to December,2015,70 cases severe preeclampsia pregnant women (group A),70 cases mild preeclampsia pregnant women (group B) and 220 cases normal pregnant women (group C) in our hospital were recruited.All pregnant women were checked by echocardiography.The ventricular Tei index of different gestational weeks fetal of normal pregnant women was recorded,and the birth situation,index of ventricular function and Tei of each group were observed.The correlation between Tei of fetal in preeclampsia women and birth outcome was evaluated. Results In normal pregnancy,the right ventricle Tei index was higher than the left ventricle Tei index of each gestational age,but the difference was not statistically significant (P>0.05).The birth weight,gestational age of group A were less than that of group B and group C (P<0.05),the Apgar scores at 1 minute and 5 minute after the birth of group A were less than those of group B and group C (P<0.05).The left ventricular ejection fraction and right ventricular ejection fraction of group A were lower than that of group C (P<0.05);the left ventricular isovolumic time and right ventricular isovolumic time of group A and group B were higher than that of group C (P<0.05).the left ventricular Tei index and right ventricular Tei index of group A were higher than that of group B and group C (P<0.05);the left ventricular Tei index and right ventricular Tei index group B were higher than that of group C (P<0.05).The right ventricular Tei index of preeclampsia newborn were negatively correlated with fetal birth weight,gestational age,1 minute Apgar score,5 minutes Apgar score (P<0.05). Conclusion Ventricular Tei index can be used to evaluate fetal cardiac function.The cardiac function of preeclampsia fetus is usually with a certain degree of damage,which will affect fetal prognosis.Tei index has a certain value in predicting preeclampsia fetal prognosis.

Infertile patients with transvaginal ultrasound in the evaluation of endometrial and artery Significance

FEI Jing-ying, LIN Hong, DAN Hua-ying, ZHU Yong-jian, WANG Hai-yan, JIE Zuo-ping

2017, 15(1): 132-134. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.040

155 0

Abstract:
Objective To investigate the clinical value of application infertility by transvaginal color Doppler ultrasound,and to observe the evaluation value of the endometrium of patients with arterial blood flow,provide a strong reference for clinical diagnosis and treatment of infertility. Methods In this study,Select the control group and the observation group study mode 1,our hospital in December,2013-December,2015 were treated 185 cases of primary infertility in female patients as observed in this group,and the other choose healthy women over the same period 120 cases of healthy people-oriented study group.Application of transvaginal color Doppler ultrasound in the menstrual cycle,respectively 8-11 d,the first 13-16 d and the second 20-24 d were detected uterine artery peak systolic velocity (PSV),endometrial thickness,resistance index (RI) and pulsatility index (PI).Endometrial thickness subject uterine long axis image prevail,then the pre-test subjects Palace uterine body lines,endometrial total thickness to diameter;the same time,the data obtained during the study were statistically analyzed. Results Observation group were different periods in endometrial thickness were significantly less than the control group,P<0.05;and the PSA was significantly slower than the control group,P<0.05.Observation group was significantly higher in the PI and RI values for different time periods,P<0.05. Conclusion Through the application of transvaginal color Doppler ultrasound can effectively understand and grasp infertility Hemodynamics and endometrial thickness,and thereby effectively evaluate patients with endometrial receptivity for clinical diagnosis and treatment programs choose to provide a reference,it will help protect the safety of patients.

MRI appearances of adnexal torsion:a report of 26 cases

FANG Bi-dong, WANG Yi, HUANG Qun, YAN Zhi-han, XU Chong-yong

2017, 15(1): 135-138. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.041

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Abstract:
Objective To investigate the features of magnetic resonance imaging (MRI) for adnexal torsion. Methods Total 26 cases of adnexal torsion confirmed by surgery pathology were reviewed retrospectively.All cases received ultrasonic inspection and MRI scan.And the results were compared with surgical. Results There were mesosalpinx cyst torsion (n=3),hydrosalpinx torsion (=1),primary ovarian torsion (n=4) and secondary ovarian mass torsion (n=18).MRI diagnosed 23 cases,missed 3 cases,with an accuracy rate of 88.5%(23/26).And it was higher than the rate of ultrasound 65.4%(17/26).MRI demonstrated abnormal masses in abdominal area in 26 cases.It connected with one side uterine horn and accessories.Two infants could not provide the clear imaging of the uterine.The torsional pedicle presented typical "beak sign" (n=12), "whirlpool sign" (n=12) and "disordered structure" (n=2).Beak sign and whirlpool sign exhibited as high signal intensity on diffusion weighted imaging (DWI)(9/10) and like twisted blood vessels enhancement (7/7).In 26 cases,there were adnexal torsion (n=27):cystic mass (n=16),solid-cystic mass (n=11).In T₂WI and SPIR,eccentric thickened wall or septa were observed in 12 cases;liquid-liquid levels were observed in 7 cases,the solid-cystic mass showed a mixed signal.It complicated with pelvic effusion (n=11),gestation (n=4),fibroid (n=4),teratoma of contra-lateral ovary (n=1),chocolate cyst of contra-lateral ovary (n=1) and the contralateral hydrosalpinx (n=1). Conclusion MRI performances of adnexal torsion have certain characteristics.The torsional pedicle can be clearly on MRI.MRI examination is a beneficial supplement to ultrasound.

Value of ultrasound lung comets in assessing illness severity in elderly heart failure patients and its relationship with heart rate variability and prognosis of patients

ZHOU Jian-yu, LIU Shui-jiao, CAI Jing, JIN Hong-jiang, CAI Hai-peng

2017, 15(1): 139-141,146. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.042

200 1

Abstract:
Objective To explore the value of ultrasound lung comets in assessing the illness severity of heart failure in elderly patients and its relationship with heart rate variability (HRV) and prognosis of patients. Methods A total of 95 cases of elderly heart failure in our hospital between January,2014 and June,2015 were selected as the research object.All of the patients received on bed lung ultrasound examination and comets number calculation before the treatment and were divided into group A (comets number ≥ 12,n=32) and group B (comets number<12,n=63) based on comets number.Cardiac function New York heart association (HYHA) grading and one-year survival rate were compared on the basis of follow-up.The relationships between ultrasound lung comets number and their HYHA grading,one-year survival rate and HRV were analyzed. Results Compared with group B,the ratio of HYHA class Ⅲ and Ⅳ patients in group A were higher,while the percentage of HYHA class Ⅱ patients was lower (P<0.05).The HRV indexes,such as standard deviation of all normal sinus RR intervals over 24 h (SDNN) and standard deviation of the averaged normal sinus RR intervals for all 5-mm segments (SDANN),one-year survival rate in group A were lower as compared with group B (P<0.05).Spearman correlation analysis results showed that ultrasound lung comets number of elderly heart failure patients was positively correlated with HYHA grading (r=0.886,P<0.05),while negatively correlated with one-year survival rate (r=-0.812,P<0.05);Pearson correlation analysis results showed a negatively correlated with SDNN and SDANN (r=-0.752,-0.748,P<0.05). Conclusion Ultrasound lung comets in the elderly heart failure patients are correlated with illness severity,HRV and prognosis,which can be used as reference on condition and prognosis of patients.

Construction and detection of metastases in animal models

FU Hou-wei, HE Shun-peng, SHI Xiang-de, XU Lei-bo, LIU Chao

2017, 15(1): 142-146. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.043

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Abstract:
The metastasis and recurrence of tumor are the important reasons leading to the death of patients who suffer from carcinomas.There are more and more therapeutic methods of tumors with the development of medical science.However,it still lacks methods of preventing tumors.So,it requires structuring animal tumor models and tumor metastasis models to simulate the process of tumor metastasis in human body.Analyzing domestic and overseas literature reports retrospectively,contrasting characteristics of various species animals and cell lines and analyzing methods which are used in structuring common metastatic tumor models.After structuring animal models successfully,we choose corresponding technological means according to the object of detection.The rodents are commonly used to structure metastatic tumor models,which mainly include nude mouse and rats that have clear genetic backgrounds.The choice of experiment cells depends on the requirement of experiment.We choose different characteristics of cells when structuring different tumor metastasis models.The methods of cell inoculation divide into orthotopic inoculation and ectopic inoculation according to different inoculation positions.Transplants divide into cell suspension and tissue blocks.The evaluations of experiment results require detections of tumor in situ and metastasis tumor at the same time.The detection methods divide into traditional detection modes and modern technological detection modes.When the detection objects are different,we can choose different modern technological detection mode to combine with traditional detection.In order to acquire the best ideal evaluation results of metastasis tumor models,we should combine various methods of detection and evaluation.Structuring experiment animal models can simulate the occurrence,development and metastasis of tumor in human body.Various animals can be used to structure metastasis tumor animal models and the rodent animals which have clear genetic backgrounds are the most common experiment animals.The structure of metastasis tumor animal models requires us to understand the details in every process.Whether the structure of models is successful,we can evaluate in many aspects by traditional detection methods and modern technology.

Research advancement of surgical treatment for obesity

WU Long, ZHANG Jun

2017, 15(1): 147-150. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.044

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Abstract:
Obesity is one of the serious problems that threaten the health of modern people.With the improvement of people's living standard,the incidence rate of obesity has been significantly increased in recent years,the number of morbid obesity has also increased.According to the 2014 statistics of WHO,obesity was threatening the health of about 13% of total population in the world,obesity has become a serious public health problem.In China,according to China's nutrition and health status survey in 2002,the obesity accounted for 7.1% of the total population,ten years later that number had been increased to 11.9%.As the development of surgical techniques,a new method to treat obesity is founded-surgical treatment for obesity,surgical treatment is the only way to cause stable and steady weight loss.It is internationally recognized that surgery is obviously effective in the treatment of obesity,bariatric surgery not only can loss weight,but also has therapeutic efficacy in the treatment of many metabolic diseases,which has caused a great attention of the physicians and surgeons.With the development of minimally invasive surgery,laparoscopic surgery is widely used in bariatric surgery,laparoscopic surgery has become the preferred way of weight loss surgery.Currently,there are four common surgical options,they are laparoscopic Roux-en-Y gastric bypass (LRYGB),laparoscopic adjustable gastric banding (LAGB),laparoscopic biliopancreatic diversion (LBPD) and laparoscopic sleeve gastrectomy (LSG).In this article,we mainly reviewed the present research advancement of surgical treatment for obesity.

Treating medulla oblongata dorsolateral syndrome in patients with dysphagia by using transcranial magnetic stimulation of low frequency electric and positioning

YANG Yu-xia, JIANG Yu-juan, XIANG Rong, HE Ji-hong, CHANG E

2017, 15(1): 151-153. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.045

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Abstract:
Objective To observe the curative effect of transcranial magnetic stimulation including positioning head together with the low frequency treatment on medulla oblongata dorsolateral syndrome in patients with dysphagia. Methods Thirty cases of medulla oblongata dorsolateral syndrome with dysphagia patients from May,2013 to May,2014 Cangzhou of neurology and rehabilitation center hospital were divided into treatment group and control group by using random numbers,16 cases of treatment group and control group in 14 cases.In swallowing rehabilitation training,the treatment group was given head cupping treatment together with the low frequency therapeutic apparatus.Electric acupuncture selects the discontinuous wave,frequency 50 Hz,current strength 2 m A;Low frequency using triangle wave pulse to stimulate wave width 750 ms,amplitude 0 to 25 m A,frequency of 2 Hz,the current strength of 7.0-10.0 m A,each time for2-3 s,intermittent time is 5-6 s.Treatment 2 times/d,20 min,at a time,4 weeks for 1 course of treatment;The control group given low frequency electric therapeutic treatment,2 times/d,20 min at a time,4 weeks for 1 course of treatment.Treatment group and control group respectively in both groups before treatment,4 weeks after treatment respectively for kubota drinking water test score and VFSS score.All the data with SPSS 16.0 statistical software for data analysis,the measurement data by chi-square test,measurement data,the comparison between groups using independent t test,group in comparison with paired t test,take a 95% confidence interval. Results After 4 weeks treatment,the patients with transcranial magnetic stimulation including positioning head together with the low frequency treatment of medulla oblongata dorsolateral syndrome in patients with dysphagia Kubota drinking water test and VFSS score is better than low frequency electric therapy group (P ﹤ 0.05). Conclusion Transcranial magnetic stimulation including positioning head together with the low frequency treatment of medulla oblongata dorsolateral syndrome can further improve swallowing function,avoid aspiration,and then improve the quality of life of patients.

Improvement of doctor-patient communication in clinical practice teaching of neurology and its role in the prevention of doctor-patient disputes

YUAN Lian-fang, HOU Li, WANG Fang, LIU Li-ning, LI Yu-xin, LI Hai-yan, LIU Li-ping

2017, 15(1): 154-156,178. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.046

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Abstract:
With a gradual shift of the biomedical model to biopsychosocial medical model and with the enhanced consciousness of rights safeguarding and the sound relevant legal system and the establishment of new patient-centered doctorpatient relationship,the medical disputes have been a serious problem and Doctor-patient disputes could happen in every link of medical activities,which has become inevitable problems in medical institutions that attached closed attention and seriously discussed in recent clinical practice.The doctors are required to master good communication skills and Doctorpatient communication is increasingly becoming an indispensable part in medical services.It has become more and more important to cultivate the medical students to reduce and prevent the occurrence of doctor-patient disputes in department of neurology.The risks of medical disputes originated from the clinical teaching for interns have been increasing and becoming the focus of attention.Because of its major features of high risk,how to improve the abilities of students to analyze and solve clinical problem and their communication technique with patients in hospital situation has become more and more important.The article proposed certain countermeasures to introduced to eliminate the negative impacts of medical disputes.Doctor-patient communication skills might be the most important prerequisite for establishing harmonious relationship between doctors and patients,improving the quality of medical service and reducing the number of medical disputes.

Effects of Humanized nursing intervention combined with moist wound healing in treatment of pressure sore of breast cancer patients

MU Xin-xin, WANG Jun-jie

2017, 15(1): 157-159. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.047

171 1

Abstract:
Objective To study the effects of humanized nursing intervention combined with moist wound healing in treatment of pressure sore of breast cancer patients. Methods A total of 50 breast cancer inpatient with pressure sore in our hospital from March,2013 to July,2014,20 males and 30 female,with a mean age of (63.0±2.5) years,were randomly divided into control group and experiment groups with 25 cases in each group.The patients in the control group received traditional pressure sore treatments,while the patients in the experiment group received Humanized nursing intervention combined with moist wound healing therapy.The clinical efficacy was compared between the two groups after the treatment of 28 days. Results The effective rate in the experiment group was significantly higher than that in the control group (92.0% vs.60.0%,χ²=5.031,P<0.001);the effective rate of stage Ⅱ and Ⅲ patients in the experiment group was significantly higher than that in the control group,and the difference between the subgroups was significant (92.31% vs.71.43%,χ²=4.237,P<0.001;91.67% vs.45.45%,χ²=4.932,P<0.001).Branden score and area of pressure sore after the treatment in the experiment group were both significantly lower than those in the control group (P<0.05).The frequency and time of dressing change and average hospital cost in the experiment group were all significantly less than those in the control group (P<0.001). Conclusion Humanized nursing intervention combined with moist wound healing therapy may greatly improve the pressure sore in hospitalized breast cancer patients.

Effect of diet nursing instruction on nutritional index and functional recovery of patients with frontal lobe glioma

BAI Shu-hong, ZHAO Tian-shu, WANG Shan

2017, 15(1): 160-162. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.048

185 1

Abstract:
Objective To explore the Effect of diet nursing instruction on nutritional index and functional recovery of patients with frontal lobe glioma,and to provide positive guidance for postoperative recovery. Methods Ninety-six patients accepting surgical treatment of frontal glioma in our hospital from January,2012 to January,2015 were selected,and randomly divided into the experimental group and the control group,with 48 cases in each group.The control group accepted basic nursing after frontal gliomas surgery,while the test group accepted special diet nursing guidance,comparing respectively in diet before and after three months'intervention between the two groups the nutritional indexes including the difference of body mass index (BMI),red blood cells and hemoglobin count,plus functional rehabilitation differences between the two groups. Results The test group had statistical significance before and after the intervention in hemoglobin,red blood cells,and BMI (P<0.05),Test group of patients with hemoglobin,red The cell and BMI indexes were (138.63±14.26) g/L,(3.52±0.34)×10¹²/kg and (25.86±4.17) L/m²,control group patients The hemoglobin,red blood cell and BMI indexes were divided into 3 months after the intervention of diet nursing intervention.Don't be (120.53±14.39) g/L,(3.19±0.18)×10¹²/L and (18.72±4.22) m²/kg,and there was significant difference between two groups in hemoglobin,red blood cells,and BMI after three months of intervention (P<0.05);the functional rehabilitation results show that there was statistical difference between the two groups in the degree of rehabilitation (P<0.05) with 37 excellent cases,4 good cases,6 general cases,1 invalid case in the experimental group and 21 excellent cases,9 good cases,10 general cases,8 invalid cases in the control group.The excellent rate of experimental group was85.4%,and the control group 62.5%,with a statistical difference (P<0.05). Conclusion Diet nursing guidance program is conducive to the improvement of the nutritional index of patients with frontal gliomas including hemoglobin,red blood cell count,and BMI,meanwhile,it is beneficial to the rehabilitation of patients'physical function.

Effect of Chinese medicine keritherapy on quality of life in patients with TCM qi stagnation and blood stasis type lumbar disc herniation

HUANG Yu, YAO Wen-feng, LI Zhe-lin, ZHOU Yu-qiu, NING A-mei, CHEN Huo-ling, TAN Wan-rong

2017, 15(1): 163-166. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.049

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Objective To explore the effect of Chinese medicine keritherapy on quality of life in patients with TCM qi stagnation and blood stasis type lumbar disc herniation,and its value of clinical application. Methods Total 158 cases of TCM qi stagnation and blood stasis type lumbar disc herniation in our hospital from March,2014 to March,2016 were enrolled and divided into control and experimental group according to the methods of treatment and nursing with 79 cases in each group.The control group received the conventional treatment and nursing,while the experimental group received additional Chinese medicine keritherapy intervention.The improvement of quality of life and lumbar intervertebral disc function,and the skin temperature and inflammation state were compared and analyzed. Results There were no significant difference in SF-36 score between the two groups before the treatment and nursing (P>0.05);After the treatment and nursing,SF-36 score and lumbar intervertebral disc function were improved more obviously,the difference between the two groups was significant (P<0.01);after the treatment,the skin temperature of experimental group significantly decreased,the inflammatory reaction significantly reduced,the difference between the two groups had statistically significant (P<0.01). Conclusion The Chinese medicine keritherapy based on the routine nursing care can reduce the inflammatory reaction and improve the quality of life and lumbar intervertebral disc function in patients with TCM qi stagnation and blood stasis type lumbar disc herniation.

Effect of care bundle on the fall events of the elderly patients in Department of respiration and survey on nursing satisfaction

XIANG Min, YANG Sai-juan, WEI Ji-zhen

2017, 15(1): 167-169. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.050

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Objective To investigate the effect of care bundle on the fall event in the elderly patients in Department of respiration,and survey the satisfaction of patients to care bundle intervention. Methods Total 108 elderly patients stayed in the respiratory department of our hospital between January,2015 and January,2016 were randomly divided into control group and observation group with 54 cases in each group (equal proportion).The control group received the routine nursing,while the observation group received additional care bundle.The incidence of fall events and nursing service satisfaction were compared between the two groups.All the data were analyzed with SPSS 17.0. Results Falling down event of observation group was significantly lower than that in the control group,the difference was statistically significant (P<0.05).The mean score for communication between nurses and patients,health education,nursing procedures,detailed service and functional exercise in the observation group were 9.35±0.64,9.37±0.52,9.41±0.57,9.32±0.47 and9.40±0.54,respectively,and in the control group were 8.26±1.04,8.29±0.98,8.61±1.01,8.84±0.92 and 8.70±1.02,respectively,the difference in the nursing satisfaction of patients between the two groups was statistical significant (P<0.01). Conclusion The bundling nursing intervention can effectively reduce the risk of fall events in elderly patients in the respiratory department,and improve the quality of care service and the recovery of patients.

The application of QCC in control nosocomial infections and improve nurse skills of operating room

WU Ling-ping

2017, 15(1): 170-172. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.051

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Objective To control nosocomial infections and improve nurse skills of operating room,and to compare the application effect before and after quality control circle (QCC). Methods A total of 32 nurses in operating room were chosen for a series of QCC training,to explicit training objective,establish QCC group and explore patient's condition in department.Statistical software SPSS 14.0 was used to compare the application effect of QCC,including operating room infection and nursing skills;communication skills,theoretical knowledge,clinical operation skills and clinical practice ability of nurses in two groups were assessed;patient's satisfaction degree was compared through questionnaire. Results The rate of nosocomial infection after QCC training (3.50%) was lower than that before training (13.00%),the difference was statistically significant (P<0.05);patient's satisfaction after training (94.00%) was obviously higher than that before training (76.00%),the difference was statistically significant (P<0.05).Nurse's communication skills,theoretical knowledge,operation skills and practice ability in operating room were significantly better after training than that before training (P<0.05). Conclusion QCC training can control nosocomial infection,improve nurse's communication skills with patients,harmonize the nurse-patient relationship,improve patient's satisfaction,and promote nurse's theoretical knowledge,professional operation skills and clinical practice ability,thus it is worthy of wider promotion and application.

Clinical risk factor analysis and nursing strategy of premature coronary artery disease

XIA Yan-mei, JI Guo-hua

2017, 15(1): 173-175. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.052

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Objective To investigate the risk factors of premature coronary artery disease risk,and provide reference for clinical prevention,treatment,and nursing. Methods Total 48 cases of premature coronary heart disease patients in our hospital from June,2014 to September,2015 were selected into observation group,and 48 cases of non-premature coronary heart disease patients of cardiology in the same period were selected into control group.Risk factors questionnaire was made,and the gender,age,body mass index,education level,smoking history,drinking history,hypertension history,diabetes,family premature coronary heart disease history,triglycerides,total cholesterol,very low density lipoprotein,glycosylated hemoglobin,blood uric acid,high-sensitivity C-reactive protein of two groups were accounted and analyzed using univariate and multivariate to determine risk factors for premature coronary artery disease. Results Univariate and multivariate Logistic regression analysis showed:age,smoking history,drinking history,hypertension history,diabetes,family premature coronary heart disease history,triglycerides,total cholesterol,very low density lipoprotein,glycosylated hemoglobin,uric acid,high-sensitivity C-reactive protein are the risk factors for premature coronary artery disease (P<0.05).Before data collection,participates were unified trained ensure the rigorous investigation,scientific,and technical. Conclusion Premature coronary heart disease was caused by many clinical factors,age,smoking history,drinking history,hypertension history,diabetes,family premature coronary heart disease history,triglycerides,total cholesterol,very low density lipoprotein,glycosylated hemoglobin,uric acid,high-sensitivity C-reactive protein are the risk factors.The clinical risk factors of premature coronary heart disease should be height paied attention,and early prevent and treat to reduce the incidence of premature coronary artery disease.

HUANG Shu-lin, HUANG Jian-ping

2017, 15(1): 176-178. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.053

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ZHU Ying, YANG Yan, ZHANG Xue-jun

2017, 15(1): 179-181. doi: 10.16766/j.cnki.issn.1674-4152.2017.01.054

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2017 Vol. 15, No. 1

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