中华全科医学

Analysis of the type and demand of mental health service in Beijing urban communities

ZHANG Man-hua, ZHAO Chong-si, ZHANG Wan-qi, GUO Ying, YANG Feng-chi

2018, 16(3): 333-336,370. doi: 10.16766/j.cnki.issn.1674-4152.000093

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Abstract:
Objective To understand the demand for mental health service and influencing factors of urban community residents, and to provide data support for further research on content and model of community mental health service. Methods Via stratified random sampling, 650 residents of one sub-district community in Beijing Dongcheng District were selected as the research object. A questionnaire survey was conducted to investigate the residents' demand for mental health services by using self-designed "Questionnaire to Community Residents' Mental Health Service Demand". Results ① Over 58% of Beijing urban community residents have demand for mental health service, with the highest demand degree for residents aged 55 and above. Emotional state and age is two important influencing factors of the degree of demand. ② The demands for form of mental health service are various among community residents. Mental health lecture is one of the most popular forms with a selection ratio of 67.8%, followed by free mental counseling, mental brochures and hotline. The demand for service form varied from different age, different gender to different education level. ③ The demand for service contents varied from different age and education level. Teenagers focus on family relationship and self development while the elder care about mental health science. And 60.3% of residents have high demand for knowledge of mental disorders. ④ On mental service institutions and personnel selection, over 40% of residents prefer to accept related consulting at community mental station or community health service center, 70% of residents require a professional mental health service to provide. Conclusion The construction of community mental health service mode and content should take the differences in age, gender and culture level into account; the professionals, service settings and measures of community health service institutions should be rationally allocated according to the characteristics of community residents.

LUO Hou-jiang, CHEN Lan-ju

2018, 16(3): 337-338.

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Effect of HIF-1α siRNA on the expression of TIMP1 and MMP1 in non-small cell lung cancer cell line A549

WANG Liang-mei, SI Jin, ZHOU Ping, LI Li-xia

2018, 16(3): 339-342,359. doi: 10.16766/j.cnki.issn.1674-4152.000094

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Abstract:
Objective To investigate the effect of HIF-1α gene silencing on the expression of TIMP1 and MMP1 in non-small cell lung cancer (NSCLC) A549 cells. Methods The siRNA-HIF-1α plasmid vector was transfected into A549 cells and cultured in hypoxic environment. The proliferation, migration and invasion of transfected cells were detected by MMT and Transwell. The expression of TIMP1, MMP1 mRNA and protein in the transfected cells were detected by real-time fluorescence quantitative and western blot. Results Compared with the control group, the expression of HIF-1α mRNA and protein in A549 group was significantly increased (P<0.05). Compared with the blank and si-NC groups, the expression of HIF-1α mRNA in si-HIF-1α group was significantly decreased (P<0.05). Compared with the blank group, the proliferation rate of si-HIF-1α group was significantly decreased at 24 h, 48 h and 72 h after the transfection (P<0.05). Compared with blank group, the migration and invasion of A549 cells in si-HIF-1α group were significantly decreased (P<0.05). Compared with blank group, the expression of MMP1 in si-HIF-1α group was significantly decreased, while the expression of TIMP1 was significantly increased (P<0.05). Conclusion HIF-1α siRNA can target silencing HIF-1α in A549 cells under hypoxia and inhibit cell proliferation, migration and invasion by down-regulating MMP1 expression and up-regulating TIMP1 expression.

The efficacy prediction diagnostic value of tumor specific growth factor for primary hepatic carcinoma patients received transcatheter arterial chemoembolization

MA Ying, MA Ming, ZHANG Chao-xia, MA Xiu-min, ZHANG Qiong, JI Ping

2018, 16(3): 343-345. doi: 10.16766/j.cnki.issn.1674-4152.000095

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Abstract:
Objective To analyze the efficacy prediction diagnostic value of tumor specific growth factor (TSGF) for primary hepatic carcinoma patients received transcatheter arterial chemoembolization (TACE). Methods Clinical data of primary hepatic carcinoma patients received transcatheter arterial chemoembolization treatment at our hospital from 2015 to 2017 were analyzed. Patients were divided into two groups by therapeutic effect, Group A:effective, n=49; Group B:invalid, n=35. AFP and TSGF were tested before and 7 days after TACE, the efficacy prediction diagnostic value was analyzed by ROC. Results Seven days after treatment, both groups got significantly decreased in AFP and TSGF (P<0.05). However, these index were lower in Group A when compared with those of Group B (P<0.05). Meanwhile, patients in group A had higher change rate of TSGF (ΔTSGF) and ΔAFP when compared with these of group B[ΔTSGF:(86.7±11.2)U/ml vs. (50.4±9.6)U/ml, t=13.900, P<0.01; ΔAFP:(351.9±15.3)ng/ml vs. (296.8±12.9)ng/ml, t=13.390, P<0.01]. ROC analysis showed that the ΔTSGF cut-off point value of 79.33 U/ml, as used for the prediction of effective TACE treatment, provided a sensitivity of 88.57%, a specificity of 83.67%, an AUC of 0.882,better than these of ΔAFP. Correlation analysis showed that, for patients in group A, the levels of ΔTSGF had significant positive correlation with ΔAFP (r=0.676, P<0.01). Conclusion The TSGF can be used as an efficacy prediction diagnostic index for primary hepatic carcinoma patients received treatment of TACE.

Experimental research on analgesic effect and side-effects of centipede-scorpion powder in mice

XU Long-sheng, FENG Qin-li, ZHANG Xiao-ping, YAO Ming

2018, 16(3): 346-348. doi: 10.16766/j.cnki.issn.1674-4152.000096

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Objective To study the analgesic effects and side effects of Centipede-scorpion (CS) powder in mice so as to provide the experimental basis for efficacy-toxicity correlation. Methods Male Kunming mice were randomly divided into 4 groups:saline control group (group NS) and CS 20 mg/kg (group C₁), CS 50 mg/kg (group C₂) and CS 80 mg/kg (group C₃), receive different doses of CS or NS for 4 days by gavage. The acetic acid writhing tests were adopted to observe analgesic effect by recording the mice writhing times. The rotarod performance test was used to examine the sensory and motor coordination of mice. Autonomic activity test was used for detecting the functional status of the central nervous system in mice. The levels of ALT and AST in serum were tested to evaluate its hepatotoxicity. Results Compared with the control group (20.3±5.3), the times of writhing was decreased in CS group (11.8±6.5, 7.6±5.7, 4.1±2.8, respectively), inhibition rates of analgesic were 41.9%, 62.6%, 79.8%, respectively, and the analgesic effect was dose-dependent (P<0.05). Compared with the control group, the average of the behavior of sensory and motor times in the rotarod performance test and autonomic activity test, were decreased in high-dose groups (P<0.05), the average of autonomic activity times were increased significantly in high-dose groups (P<0.05). Compared with the levels of ALT (30.3±5.3) and AST (19.5±3.7) in the control group, hepatotoxicity test showed that the activities of ALT (43.9±6.8) and AST (32.8±5.8) in serum were increased in C₃ group (P<0.05). Conclusion Centipede-scorpion powder had analgesic effect on experimental mice, and at the same time, accompanied by neurological damage and hepatotoxicity in high- dose group.

Curative effect of oseltamivir in the treatment of flu-like children

LI Dong-e, ZHOU Rui, XU Jia-li

2018, 16(3): 349-351. doi: 10.16766/j.cnki.issn.1674-4152.000097

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Objective To observe the clinical curative effect of oseltamivir in the treatment of flu-like children. Methods A total of 87 cases of flu-like children accepted by the first affiliated hospital of Bengbu Medical College between September, 2017 and November, 2017 are randomly divided into two groups. They are oseltamivir group and control group with 44 and 43 cases respectively. The oseltamivir group are treated with reduning injection and oseltamivir granules, and the control group reduning only. Both groups are treated for 5 consecutive days, to be observed on the development, side effect, and prognosis, so as to find out the curative effect and safety of oseltamivir. Results There is no significant difference between the normal condition, severity and blood routine of both groups before treatment. The time of fever's coming down of oseltamivir group is (27.52±6.32) h. It is shorter than that of control group with the time of (36.13±8.51) h. The difference is statistically significant (P<0.05). The total effective rates of the two groups are 93.2% and 76.1% respectively. The total effective rate of oseltamivir group is higher than that of control group. The difference is statistically significant as well(P<0.05). There are 4 cases from oseltamivir group and 2 cases from control group which are tested for H1N1. Two of oseltamivir group and that two from control group are positive. However, the sample is too small to do statistical test. There are 3 cases of nausea and vomiting in oseltamivir group,and getting better after changing the way of taking medicine. Conclusion Comparing the oseltamivir group and control group of cases accepted by the first affiliated hospital of Bengbu Medical College, the fever's coming down time of oseltamivir group is significantly shorter than that of control group. Oseltamivir is mild in side effect and safe to use. Therefore, it is worthy to popularize.

Association between MMP-2(-735 C/T) polymorphism and the risk of hemorrhagic transformation in patients with acute cerebral infarction

WANG Feng, JIN Xiao-ping, ZHU Min, HU Xiao-fei, WANG Wan-fen, ZHENG Zhou

2018, 16(3): 352-355,440. doi: 10.16766/j.cnki.issn.1674-4152.00098

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Abstract:
Objective To study the association between Matrix Metalloproteinase-2 serum level, promoter region polymorphism(-735C/T), and the risk of hemorrhagic transformation in acute cerebral infarction patients. Methods The polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) method was used to detect MMP-2 gene promoter region -735C/T site polymorphism in 581 cases of acute cerebral infarction patients. According to the genotypes, all specimens were divided into CC group and CT+TT group, and then the general and acute cerebral infarction hemorrhagic transformation was compared. Results There were no statistically significant difference in the age, sex, Systolic and diastolic blood pressure at admission, smoking and drinking history, blood glucose, triglyceride, low density lipoprotein cholesterol, NIHSS scores, anti-platelet therapy between the two groups(P>0.05). There were 52 cases of hemorrhagic transformation in CC group, accounting for 16.35%, while 26 cases of hemorrhagic transformation in CT+TT group, accounting for 9.89%, the difference between the two groups was statistically significant(P=0.023), and it showed that the hemorrhagic transformation rate of CC group was significantly higher than that in CT+TT group. In the CC group serum level of MMP-2 was also significantly higher than that in the CT+TT group(P=0.017). Conclusion The locus of MMP-2(-735C/T) polymorphism may be associated with the risk of hemorrhagic transformation in patients with acute cerebral infarction. CC genotype may be the susceptible genotype of hemorrhagic transformation in acute cerebral infarction patients, while the CT+TT genotype may be protective genotypes; the C allele may be a susceptible allelic gene, and the T allele may be a protective allelic gene.

A comparative study of safety and efficacy of ultra-early and early endovascular interventional therapy for ruptured poor Hunt-Hess grade brain aneurysms

MA Xiu-yao, REN Chao, WANG Qiang, LIU Bin, XIANG Xin

2018, 16(3): 356-359. doi: 10.16766/j.cnki.issn.1674-4152.000099

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Objective To compare the safety and efficacy of ultra-early and early endovascular interventional treatment for ruptured poor Hunt-Hess grade brain aneurysms. Methods From August, 2013 to October 2016, 215 patients with ruptured poor Hunt-Hess grade brain aneurysms admitted to our hospital and Department of Neurosurgery Guizhou Medical University were enrolled in this study. According to the timing of intervention, all patients were assigned into observation group (n=125) and control group (n=90). The patients in the observation group received ultra-early endovascular treatment (within 48 hours), while the control group received early endovascular intervention (48-96 hours). The clinical outcomes of the two groups were compared. Results There was no significant difference in preoperative Glasgow Coma Scale (GCS) between the two groups (P>0.05). However, when compared with the control group, the patients in the observation group got significantly higher levels of GCS on 3 and 14 days after the operation (P<0.05). At 3 months after the discharge of the hospital, the BI index of the observation group was higher than that of the control group (65.02 ±8.94 vs. 57.73 ±8.93, P<0.001). The rate of Glasgow outcome score of 4 or 5 was significantly higher in the observation group than that of the control group (91.20% vs.73.33%, P<0.001). And the re-bleeding rate of the observation group was lower than that of the control group (4.80% vs. 12.22%, P=0.047). There was no significant difference in the other complications between the two groups (P>0.05). Conclusion Ultra-early interventional treatment for poor Hunt-Hess grade brain aneurysms can significantly improve the clinical prognosis of patients, and decrease the incidence of recurrence of hemorrhage.

Clinical and pathological features of idiopathic membranous nephropathy: a report of 118 cases

ZHAO Li, JIN Juan, GONG Jian-guang, HE Qiang

2018, 16(3): 360-363. doi: 10.16766/j.cnki.issn.1674-4152.000100

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Objective To summarize the clinic-pathological features of idiopathic membranous nephropathy(IMN). Methods The clinical and pathological data of 118 cases of IMN confirmed by biopsy in Zhejiang Provincial People's Hospital from January, 2013 to October, 2016 were analyzed retrospectively. Results Of the 118 IMN patients, there were 69 males and 49 females, with mean age of 51.7±12.3(74.6% of them were 44 years or more). The level of protein in urine was 0.07-27.60 g/24 h, and 3.5 g/24 h or more in 58.5% of them. 76 cases(64.4%) were with nephrotic syndrome, 102 cases(86.4%) with hematuria. 102 cases(86.4%) were with eGFR of 60 ml/(min·1.73 m²) or more, and 16 cases with eGFR less than 60 ml/(min·1.73 m²). When compared with female patients, the male patients were with higher levels of serum creatinine level, blood urine nitrogen and uric acid level, the difference was statistically significant(P<0.05). Age and urine protein quantification had positive correlation with the level of serum creatinine, urate, eGFR, tubulointerstitial lesions, glomerulus sclerosis and small artery injury. Pathological stage Ⅰ and Ⅱ of IMN were the dominant pathologic pattern, which accounted for 97.5%cases. Conclusion The aged male IMN patients are usually with high uric acid and urine protein levels, renal hypofunction, tubulointerstitial lesions and small artery injury, and the early renal biopsy and diagnosis should be recommended to IMN patients.

Comparative effectiveness research of fast-track surgery and conventional perioperative treatment on immune function and inflammatory stress response in elderly patients with colorectal cancer

FENG Wei-yu, LI Bao-dong, WANG Jin-bang, XU Dong-li, ZHANG Hui-liang, CHENG Ke, ZHUANG Jing

2018, 16(3): 364-366,374. doi: 10.16766/j.cnki.issn.1674-4152.000101

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Objective To compare the effect of fast-track surgery and conventional perioperative treatment on the rehabilitation effect, immune function and inflammatory stress response in elderly patients with colorectal cancer. Methods Eighty patients undergoing surgery for gastrointestinal surgery in Henan Cancer Hospital from March, 2014 to March, 2016 were selected for clinical study. A prospective randomized study was conducted to divide patients into group FTS (perioperative fast rehabilitation surgery) and routine group (routine perioperative treatment) in 40 cases. The effects of the 2 groups were compared, the immune function and the inflammatory stress before and after the operation were compared. Results The levels of serum IL-6, IL-8, TNF-α, IL-1β on D1, D3 and D7 after the operation in FTS group of beta levels were lower than those in the normal group (P<0.05); the levels of serum IgG, IgA, IgM, CD3⁺ and CD4⁺ on D3 and D7 after the operation in FTS group were higher than those in the normal group (P<0.05), by contrast, CD8⁺ level was lower (P<0.05). The time to first flatus, first oral feeding and first defecation, duration of hospital stays and the incidence of operative complications in the FTS group were all lower than those in the conventional perioperative treatment group (P<0.05). Conclusion The perioperative fast-track surgery care for the patients with colon cancer is helpful to the recovery of immune function and reduce the inflammatory response.

Effect comparison of two surgeries on gallbladder stones and common bile duct stone

LIAN Jian-an, WU Deng-hai, MA Hong-mei, JI Chao-chao, JIANG Bin-hua

2018, 16(3): 367-370. doi: 10.16766/j.cnki.issn.1674-4152.000102

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Objective To retrospectively analyze the effect of laparoscopic cholecystectomy combined with laparoscopic choledocholithotomy on choledochoscopy lithotomy (LC + LCBDE) and endoscopic retrograde cholangiopancreatography/endoscopic duodenal sphincterotomy+Laparoscopic cholecystectomy (ERCP/EST+LC) on treatment of gallbladder stones and common bile duct stones. Methods Three hundred patients with gallstone and common bile duct stones treated in our hospital from February, 2011 to February, 2016 were enrolled in this study. According to surgical methods, patients were divided into LC + LCBDE group and ERCP/EST+LC group, each group 150 cases. The clinical data, treatment effect, postoperative complications and liver function and other related indicators of two groups were compared. Results There was no significant difference between two groups on operation success rate and laparotomy rate (P>0.05). The operation time, hospital stay and operation cost of LC + LCBDE group were significantly lower than those of ERCP/EST+LC group (P<0.05). The direct bilirubin, aspartate aminotransferase and alanine aminotransferase levels at 1 day after surgery were increased, but returned to normal levels at the 3rd day after operation. The postoperative complication rate of LC + LCBDE group was 6.67%, and postoperative complication rate of ERCP/EST+LC group was 8.67%, with no statistical significance (P>0.05). There was no significant difference in stone recurrence between two groups after discharge (P>0.05). Conclusion LC + LCBDE and ERCP/EST+LC were safe and effective methods on treatment gallbladder stones and common bile duct stones. LC + LCBDE had more advantages in operation time, hospitalization time and operation cost. In clinical work, surgical method should be selected based on the individuality principle, actual condition and hospital conditions.

Clinical analysis of 3 766 cases of root canal therapy

GAO Lu, WANG Qu-nan, CENG Su-yun, WANG Yong, CAI Wen-feng, ZHANG Fu-hua, YANG Ying-ze

2018, 16(3): 371-374. doi: 10.16766/j.cnki.issn.1674-4152.000103

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Abstract:
Objective To evaluate the clinical quality of root canal therapy (RCT) in a three-stage dental specialist hospital in Hefei, and to analyze the effect of root filling on the curative effect of RCT on pulpal periapical disease, to help clinicians to judge the prognosis of teeth. To improve the treatment process and to provide a scientific basis for improving the curing rate. Methods In this study, 3 373 patients (3 766 cases of dental teeth) who underwent RCT from the department of endometriosis or endodermal diseases in the hospital from August, 2013 to November, 2013 were enrolled in this study. Their X-ray films were read independently by two senior oral radiologists, According to the results, the evaluation of root canal preparation and the quality of filling was made. From August, 2015 to November, 2016 we followed up those who got two years of RCT and evaluated the curing effects based on "root canal therapy technical specifications and efficacy evaluation criteria". Results The rate of filling was 78.81%, the rate of insufficient filling was 11.34%, the rate of overfilling was 9.85%, the omitting filling rate was 2.5%, the average course of treatment was (3.03±1.14) weeks. The total rate of root canal was 89.88%, and the average course of treatment was 2.7 weeks. The patients who completed our two years follow-up were 764 cases (852 teeth, the returning rate of 22.62%), and the success rate was 94.72%. Conclusion The filling rate of the posterior teeth was lower than that of the anterior teeth. The clinical efficacy of RCT depends on the filling operation. The insufficient filling has the lowest successful rate, and the filling has the best clinical effect. We should strictly abide by the normal operation of root canal treatment, reduce the number of root canal therapy, and improve the filling rate which aims to ensure the quality of RCT.

Comparison between normal anatomic plate and absorbable screw with opening lateral bone flap in treatment of calcaneal fractures of Sanders Ⅱ and Ⅲ

ZHANG Yong, ZHUANG Yun-qiang, JIANG Gang-qiang, YING Ji-chong, YANG Li-feng, XIAO Bai-ping, HU Yong, MA Wei-hu

2018, 16(3): 375-379,479. doi: 10.16766/j.cnki.issn.1674-4152.000104

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Abstract:
Objective To compare the clinical efficacy between normal anatomic plate + bone graft and absorbable screw + opening lateral bone flap + bone graft in treatment of calcaneal fractures of Sanders Ⅱ and Ⅲ. Methods From February, 2011 to February, 2014, 76 patients of Sanders type Ⅱ and Ⅲ of calcaneal fractures were treated in our department. Forty patients received absorbable screw + opening lateral bone flap + bone graft were assigned into Group A, while 36 patients received normal anatomic plate + bone graft into Group B. The two groups were compared in terms of operation time, bleeding volume, postoperative drainage, postoperative complication, Bohler angle, Gissane angle, Ankle-Hindfoot Scale(AOFAS) and Maryland foot score(MFS). Results The patients were followed up for 24 to 36 months with an average of 28 months. The Group A had less operation time, bleeding volume, postoperative drainage and postoperative complication(P<0.05). There were significant differences in Bohler angle and Gissane angle one year and two year after the operation as compared with those before the operation(P<0.05), but not between the two groups(P>0.05). There were no significant difference in postoperative AOFAS and MFS(P>0.05). Conclusion It is safe and effective to treat calcaneal fractures of Sanders Ⅱ and Ⅲ with absorbable screw + opening lateral bone flap + bone graft. Compared with normal anatomic plate + bone graft, it has less operation time, bleeding volume, operation invasion, postoperative complication.

Clinical application of polyamide gauze dressing in acute and chronic wounds

WEN Ke, MA Yan, LIU Yi-lun, ZHANG Hong, ZHU Xiao-ming, CHEN Wen-hai, CHEN Xue-lian, LIU Wei-hua, LIU Yue-ming

2018, 16(3): 380-382,387. doi: 10.16766/j.cnki.issn.1674-4152.000105

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Abstract:
Objective To study the clinical application effect of different polyamide gauze in the acute and chronic wound healing process. Methods A total of 137 cases of hospitalized patients of department of burn and plastic surgery and emergency, the first affiliated hospital of Chengdu Medical College, from January, 2016 to November, 2016 were selected and divided into experimental group (n=68) and control group(n=69) according to the random number table method. There was no significant difference between the two groups in age, sex, and wound surface. Two groups of patients were treated by the same method of debridement, disinfection and marking photography. After photography, the experimental group of acute and chronic wounds was given polyamide gauze on the wound, and the control group of acute and chronic wounds given Vaseline gauze on the wound. Note the time of wounds healing and seepage stopping, and the score of VAS. And take photos. The wound healing time, wound bleeding time and the pain score during dressing change were statistically analyzed, and the clinical effects of the two groups were compared. Results Polyamide gauze and Vaseline gauze both can play the role of promoting wound healing, without statistical significance (P>0.05), but the experiment group is better than control group in healing time, seepage stop time and VAS score was statistically significant (P<0.05). Conclusion Polyamide gauze as a new material has a better treatment effect than Vaseline gauze applying at various acute and chronic wound healing process, and the clinical application is more advantageous, which is worth popularizing.

Effect of Helicobacter pylori infection on malignant transformation of gastric cancer cell lines and its mechanism

LV Wang-xia, FANG Yang

2018, 16(3): 383-387. doi: 10.16766/j.cnki.issn.1674-4152.000106

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Abstract:
Objective To investigate the effect of Helicobacter pylori infection on the malignant transformation of gastric cancer cell lines and to explore its possible mechanism. Methods The gastric cancer AGS cells were divided into cytotoxin related gene A (CagA) plasmid group (transfected with pCDNA3.1-CagA plasmid) and negative control group (transfected with pCDNA3.1 blank plasmid), and were divided into CagA plasmid group (transfected with PCDNA3.1-CagA plasmid and pEGFP-C1-PDCD4 plasmid),the CagA+programmed cell death factor 4 (PDCD4) plasmid group (transfected with pCDNA3.1-CagA plasmid and pEGFP-C1-PDCD4 plasmid) and Negative control group (transfected with pCDNA3.1 blank plasmid and pEGFP-C1 blank plasmid). The levels of PDCD4, Twist1, E-cadherin, Vimentin mRNA in cells were measured by reverse transcription-polymerase chain reaction (RT-PCR). The protein levels of PDCD4, Twist1, E-cadherin and Vimentin were determined by Western blot, cell invasion was measured using transwell chamber. Results The expression of Twist1 mRNA and Vimentin mRNA in CagA plasmid group were higher than those in negative control group (P<0.05). The expression of PDCD4 mRNA and E-cadherin mRNA in CagA plasmid group were lower than those of negative control group (P<0.05). The expression of Twist1 mRNA and Vimentin mRNA in CagA+PDCD4 plasmid group were lower than those in CagA plasmid group (P<0.05). The expression of PDCD4 mRNA and E-cadherin mRNA in CagA+PDCD4 plasmid group were higher than those of CagA plasmid group (P<0.05). The expression of Twist1 protein and Vimentin protein in CagA plasmid group were higher than those in negative control group (P<0.05). The expression of PDCD4 protein and E-cadherin protein in CagA plasmid group were lower than those of negative control group (P<0.05). The expression of Twist1 protein and Vimentin protein in CagA + PDCD4 plasmid group were lower than those in CagA plasmid group (P<0.05). The PDCD4 protein and E-cadherin protein in CagA+PDCD4 plasmid group were higher than those of CagA plasmid group (P<0.05). The number of invasive cells in CagA plasmid group was higher than that in negative control group (P<0.05). The number of invasive cells in CagA+PDCD4 plasmid group was lower than that in CagA plasmid group (P<0.05). Conclusion Helicobacter pylori infection can increase the invasion of gastric cancer cells. The mechanism may be that Helicobacter pylori independent factor CagA promotes the epithelial-mesenchymal transition of gastric cancer cells by inhibiting PDCD4 expression.

The effects of high-dose clopidogrel on the treatment of acute coronary syndrome after percutaneous transluminal coronary intervention

YU Pei-hua, XIE Bo, JI Xiao-wei, CHEN Ling-yang

2018, 16(3): 388-391. doi: 10.16766/j.cnki.issn.1674-4152.000107

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Objective To compare the effects of high- and normal- dose Clopidogrel on the treatment of acute coronary syndrome after percutaneous transluminal coronary intervention. Methods All 270 participants diagnosed to be acute coronary syndrome from February, 2013 to December, 2015 in our hospital were included and divided into two groups:the high-dose group and the normal-dose group. The high-dose group received Clopidogrel 150 mg/day and the normal-dose group received Clopidogrel 75 mg/day. Comparisons of incidences of stent thrombosis, all-cause mortality and bleeding were made between two groups. Results The incidences had no difference in both groups (P>0.05), and the stent thrombosis incidence and mortality rate had no statistical significance(P>0.05). However, the bleeding events were significantly higher in the high-dose group (P<0.001), which had higher incidence of minor bleeding (P=0.008)and moderate bleeding(P<0.001). Compared with the normal-dose group, the high-dose group treatment did not decrease the risk of stent thrombosis and death (HR=1.32, 95% CI:0.83-1.89, P=0.654) but increased the risk of bleeding events (HR=2.52, 95% CI:1.13-3.03). Conclusion In the treatment of acute coronary syndrome after percutaneous transluminal coronary intervention, patients with high-dose Clopidogrel did not decrease the risk of stent thrombosis and death but had increased risk of bleeding events.

Preliminary design of 3D patient-specific drill template based on bone cement accumulation for lag screw placement in minimal invasive retrograde intramedullary fixation of the superior pubic ramus

ZHENG Yi, YUAN Xin-hua, WANG Wei-bin, FU Qing-song, PANG Qing-jiang

2018, 16(3): 392-394,426. doi: 10.16766/j.cnki.issn.1674-4152.000108

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Abstract:
Objective To investigate the feasibility of 3D patient-specific drill template based on bone cement accumulation for lag screw placement in minimal invasive retrograde intramedullary fixation of the superior pubic ramus. Methods The clinical data of 5 cases of pelvic fracture were reviewed retrospectively, including 3 males and 2 females, with average age of 49. According to the Young & Burgess classification, the type of pelvic fracture was 4 cases of LC Ⅱ and 1 case of LC Ⅲ. Three cases were left lateral superior pubic fracture and 2 cases were right. Pro/E software was used to simulate the 1.5 mm Kirschner wire, selected the base plane, drew the 1.5 mm Kirschner wire through the stretching function of Pro/E software, and saved it in STL format. The virtual screw placement was inserted by using the registration tool in Medcad module of the Mimics software. The Kirschner wire and the model were integrated by Boolean calculation. According to CT scan images, 3D reconstruction model of the pelvis were established by image screening, mask editing, threshold extraction, image filling and segmentation, smoothing and reduction triangular facets. The pelvic reconstructed data and the virtual Kirschner's data were processed in STL format to print 1:1 three dimensional model, The screw channel and the individual drill template was designed by bone cement accumulation technique to observe if the Kirschner wires were located in the bone canal. Results Three dimensional pelvic model and digital, individual drill template confirmed the effectiveness of superior ramus of pubis fracture, all of Kirschner wires were located in the bone canal. Kirschner was placed and the accuracy of screw placement was confirmed with X-ray and CT scanning. Template and the corresponding anatomical landmark fitted well. Conclusion By means of individual bone cement technique and 3D printing technology, accurate and minimal invasive placement of superior ramus of lateral pubis fracture screws can be finished. This technology is helpful to reduce the operation time and X-rays exposure of the patient and staff.

Effect of dexmedetomidine on oxidative stress, glycometabolism and postoperative analgesia in patients with laparoscopic radical gastrectomy

CHEN Bo, PENG Wen-yong, TU Wen-long, ZHANG Yu-fan

2018, 16(3): 395-397,451. doi: 10.16766/j.cnki.issn.1674-4152.000109

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Abstract:
Objective To investigate the effect of dexmedetomidine on oxidative stress, glycometabolism and postoperative analgesia in patients with laparoscopic radical gastrectomy. Methods According to whether the application of dexmedetomidine, a total of 86 patients with laparoscopic radical gastrectomy were divided into observation group (45 cases) and control group (41 cases) from August, 2014 to October, 2016. The patients of the control group, received conventional general anesthesia, and intravenously pumped with normal saline. The patients of the observation group, received conventional general anesthesia, and intravenously pumped with dexmedetomidine. The changes of oxidative stress (MDA and SOD), glycometabolism (PFK, G-6PD and AR) and postoperative analgesia (VAS scores) were observed and compared before and after operation in 2 groups. Results Compared with before operation, the concentration of MDA increased significantly at 1 d after operation in 2 groups (P<0.05), the concentration of SOD decreased significantly at 1 d after operation in 2 groups(P<0.05), but the changes of observation group was significant smaller (P<0.05). Compared with before operation, the activity of PFK increased significantly at 1 d after operation in 2 groups (P<0.05), the activity of G-6PD and AR decreased significantly at 1 d after operation in 2 groups (P<0.05), but the changes of observation group variation was significant smaller (P<0.05). VAS scores of observation group was significant lower than that in control group at 1 d and 3 d after operation (P<0.05). Conclusion Dexmedetomidine can reduce oxidative stress injury, improve erythrocyte glycometabolism, and enhance the postoperative analgesia in patients with laparoscopic radical gastrectomy.

Clinical efficacy of sertraline combined with pregabalin in the treatment of thoracic back postherpetic neuralgia

CAI Wei, DING Juan, GONG Min-cao

2018, 16(3): 398-400,455. doi: 10.16766/j.cnki.issn.1674-4152.000110

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Abstract:
Objective To investigate the clinical efficacy of sertraline combined with pregabalin in the treatment of thoracic back postherpetic neuralgia. Methods Total 96 patients with postherpetic neuralgia of chest and back were divided into control group and research group according to random number table method, with 48 cases in each group. The control group received oral pregabalin based on the conventional treatment. The research group received additional sertraline. The patients were evaluated by visual analogue scale(VAS) before the treatment, 2 weeks, 1 months, 2 months and 3 months after the treatment. Life quality scale(QOL) was used to evaluate the quality of life of patients. The incidence of adverse drug reactions in the two groups were observed and recorded. Results The curative effect of the research group was significantly higher than that of the control group, the difference was statistically significant(Z=2.288, P<0.05). After 2 weeks, at the end of the 1 month, the 2 month and the 3 month, the VAS scores of the two groups were significantly decreased (P<0.05). After treatment for 2 weeks, 1 month, 2 months, and 3 months, the VAS score of the study group was significantly lower than that of the control group, the difference was statistically significant(P<0.05). The QOL scores of the two groups after the treatment were significantly lower than those before the treatment(P<0.05). After 2 weeks, 1 months, 2 months, and 3 months after treatment, the scores of appetite, sleep, mood and mental state of the study group were significantly lower than those of the control group, the difference was statistically significant(P<0.05). The incidence of adverse drug reactions(16.66%) in the study group was significantly higher than that in the control group(12.50%), there was no significant difference(P>0.05). Conclusion Sertraline combined with pregabalin can significantly improve the clinical symptoms of patients with postherpetic neuralgia of chest and back, improve the treatment efficiency, improve the degree of pain and quality of life.

Effect of mastoscopy assisted axillary lymph node dissection surgery on upper limb function and quality of life of patients with breast cancer

WANG De-hua, WU Jian-xiang, SHEN Jun-jun

2018, 16(3): 401-403. doi: 10.16766/j.cnki.issn.1674-4152.000111

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Abstract:
Objective To investigate the effect of mastoscopy assisted axillary lymph node dissection(ALND) surgery on upper limb function and quality of life of patients with breast cancer, and provide reference for treatment of breast cancer. Methods Total 172 cases early breast cancer in our department between June, 2010 and June, 2013 were enrolled and assigned into mastoscopic axillary lymph node dissection group(observational group) and conventional axillary lymph node dissection group(control group) with 86 cases in each group. The operation indicators, upper limb function and the quality of life were compared between the two groups. Results The amount of intraoperative bleeding and volume of axillary drainage in the observational group was significantly lower than that of the control group[(65.42±7.37 vs. 185.53±22.86)ml, (114.25±35.06 vs. 188.79±48.13)ml, respectively], t=46.375, 11.609, P<0.05; The 6-month follow-up showed that the angle of shoulder flexion, extension, adduction, abduction, pronation, and external rotation in the observational group were significantly greater than those in the control group(t=7.689, 5.339, 4.176, 16.805, 9.269 and 9.395, P<0.05); The incidence of complications such as limb paresthesia was 10.47% in the observational group, which was significantly lower than 40.70% in the control group (χ²=20.645, P<0.05). The scores of cognitive function, physical function and other quality of life in the observational group were significantly higher than those in the control group (t=5.998, 7.213, 6.439, 5.551, P<0.05). Conclusion Mastoscopy assisted axillary lymph node dissection is helpful to reduce the trauma, promote the recovery of upper limb function, improve the quality of life.

Comparative observation of different surgical methods for the treatment of acromioclavicular dislocation

JIANG Dan-sheng, HUANG Jian

2018, 16(3): 404-406. doi: 10.16766/j.cnki.issn.1674-4152.000112

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Abstract:
Objective To compare and analyze the clinical effect of clavicular hook plate fixation and loop plate internal fixation in the treatment of acromioclavicular dislocation. Methods Total 84 patients with acromioclavicular joint dislocation were selected from July, 2015 to February, 2017 as the research object. The patients were randomly divided into A group (42 cases) and B group (42 cases). The A group was treated with loop plate internal fixation, and the B group was treated with clavicular hook plate fixation. The bleeding volume, operative time, postoperative hospitalization time, shoulder joint function and pain degree in two groups were observed. The Constant-Murley score and postoperative complications in 3 months, 6 months before and after operation were observed. Results There was no significant difference in intraoperative blood loss, operation time and postoperative hospital stay between the two groups (P>0.05); Shoulder function and pain degree showed that there was no significant difference between the two groups before operation (P>0.05). After 3 months and 6 months, the Constant-Murley of group A was significantly higher than that of group B, and the score of VAS was significantly lower than that of group B, the difference was statistically significant (P<0.05); The incidence of postoperative complications in group A was 7.14%, which was significantly lower than that in group B, and the difference was statistically significant (P<0.05). Conclusion In the treatment of acromioclavicular joint dislocation, with plate internal fixation, shoulder joint function recovery of patients and pain are better than the clavicular hook plate fixation, and fixation of the safety plate in a higher, more worthy of promotion.

Effect of Nalmefene Combined Mild Hypothermia on Neurological Function of Patients with Cardiopulmonary Resuscitation

PAN Jia-xi, WANG Wei-wei, ZHANG Min-xue, ZHENG Ju-ke, PAN Jia-lin, LIN Jia-feng, FU Rong-quan

2018, 16(3): 407-409,430. doi: 10.16766/j.cnki.issn.1674-4152.000113

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Abstract:
Objective To investigate the effect of nalmefene combined mild hypothermia on neurological function of patients with cardiopulmonary resuscitation. Methods Sixty-eghit patients with cardiopulmonary resuscitation (CPR) from February, 2012 to February, 2016 were randomly divided into two groups, 34 cases in each group. The control group was given mild hypothermia, and the research group was added nalmefene. All patients were continued treated for 3 d. The rectal temperature, Glasgow Coma Scale (GCS), neurological deficit score (NFI), BI index score and 30-day mortality of two groups were compared. Results Before treatment, there was no significant difference on rectal temperature between two groups (P>0.05). After treatment 5 hours, the rectal temperature of two groups was significantly reduced compared with that of before treatment (P<0.05), but there was no significant difference between two groups (P>0.05). Before treatment, there was no significant difference on GCS score between two groups (P>0.05). After treatment, the GCS score of two groups was significantly improved compared with that of before treatment (P<0.05), GCS score of research group was significant higher than that of control group (P<0.05). After treatment, the NFI and BI scores of two groups were significantly improved (P<0.05), and the NFI score of the research group was lower than that of control group (P<0.05), the BI score of the research group was higher than that of control group (P<0.05). The fatality rate of research group was 17.65%, which was significantly lower than that of control group (41.18%, P<0.05). Conclusion Nalmefene combined mild hypothermia could effectively treat patients with cardiopulmonary resuscitation, significantly improve their neurological function, daily living activities and health status, reduce mortality, with the promotion value.

Clinical significance of dynamic serum cortisol level in patients with different severity of brain injury

WANG Jun-jie, ZHANG Zu-yong

2018, 16(3): 410-412. doi: 10.16766/j.cnki.issn.1674-4152.000114

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Abstract:
Objective To detect the dynamic serum cortisol level and evaluate its clinical significance in the patients with traumatic brain injury(TBI). Methods Total 60 cases of traumatic brain injury in our hospital from January, 2016 to June, 2016 were included, and were classified into three groups according to the Glasgow Coma Scale(GCS):mild, moderate(GCS 13-15) and severe group(GCS 9-12) after admittance(GCS 3-8). The blood sample of those patients were collected in the morning 8 am on 1 d, 3 d, 7 d, 14 d, and 6 months later; the level of serum cortisol was tested by using chemiluminescence immunoassay. Results The serum cortisol concentrations in patients with mild and moderate groups were in the normal range, and the change range was small, while the severe group had the greatest degree of variation(F=11.325, P<0.01). The change of the serum cortisol concentration of the patients in the first 1 week was the largest, and then gradually became normal. The number of patients with normal cortisol, rising or falling levels of cortisol were 28 cases, 26 cases and 6 cases, respectively. According to the definition of the prognosis, there were 11 patients with poor prognosis, 49 patients with good prognosis. The good rate was 87% in the normal and ascending group of cortisol concentration, which was significantly higher than that in the lower cortisol group(33.3%), which indicated that the lower the concentration, the worse the prognosis. Conclusion The cortisol levels changed more significantly with the severity of TBI, and the patients with low serum cortisol level usually had poor outcomes.

Radiological signs of upper cervical spine injury and guidance on prognosis analysis

WANG Guo-qing, HU Yong-liang, JIANG Shu, GUAN Si-yan, ZHAN Bei-lei

2018, 16(3): 413-415. doi: 10.16766/j.cnki.issn.1674-4152.000115

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Abstract:
Objective To observe the differences in radiological signs of cervical spine CT and X-ray in patients with upper cervical spine injury, and provide guidance for prognosis analysis. Methods The patients with atlas injury in our hospital from June, 2014 to January, 2015 were selected. X-ray and CT were performed in all patients before and after the treatment. To compare the difference in the morphologic changes of the injured cervical spine between X-ray and CT combined with the prognosis of patients. Results The accuracy rate of X-ray for fracture displacement less than 3 mm, angulation deformity, hyperextension injuries and vertical compression injury of violence was 26.67%, 50.67% and 16.00%, respectively, which was lower than 42.67%, 66.67%, 42.67% of CT(P<0.05); The correct diagnostic rate of spiral CT three-dimensional imaging technology was significantly higher than X-ray(100.00% vs. 80.00%, P<0.05); The poor prognosis of patients was correlated with the misdiagnosis or missed diagnosis(P<0.05). Conclusion The misdiagnosis and missed diagnosis can occurred by X-ray examination for upper cervical spine injury. For the patients with fracture displacement less than 3 mm, angulation deformity, hyperextension injuries and vertical compression injury of violence, spiral CT three-dimensional imaging after X-ray can improve the diagnosis accuracy, and avoid the poor prognosis.

Effect analysis of Vitallium 2000 materials and Cobalt-chromium alloy materials on removable partial denture by repair dentition defect

LI Jun, CHEN Chang-hui

2018, 16(3): 416-418. doi: 10.16766/j.cnki.issn.1674-4152.000116

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Abstract:
Objective To compare the clinical effect of Vitallium 2000 materials and Cobalt-chromium alloy materials on removable partial denture by repair dentition defect. Methods Altogether 412 patients with removable partial denture by repair dentition defect in our hospital from December, 2013 to December, 2015 were selected and divided into Vitallium 2000 group and Cobalt-chromium alloy group based on the scaffold materials, with 206 cases in each group. After repair, the denture placement rate, 2W adjustment rate, chewing efficiency, denture stomatitis rate, adverse reactions (secondary caries, periodontal disease, abutment defect, and basement impairment), and satisfaction (beautiful, comfortable, chewable, linguistic) of two groups were compared. Results The denture placement rate of Vitallium 2000 was significantly higher than that of Cobalt-chromium alloy (P<0.05), and 2W adjustment rate was significantly lower than that of Cobalt-chromium alloy (P<0.05). The masticatory efficiency of Vitallium 2000 was significantly higher than that of cobalt-chromium alloy (P<0.05), and denture stomatitis rate was significantly lower than that of cobalt-chromium alloy (P<0.05). The coagulation, thrombosis and alveolar bone absorption rate of Vitallium 2000 group were significantly lower than those of cobalt-chromium alloy group (P<0.05). The secondary caries, periodontal disease, abutment failure and adverse reactions of Vitallium 2000 group were significantly lower than those of cobalt-chromium alloy group (P<0.05). Shape satisfaction, comfort satisfaction, masticatory function satisfaction and language function satisfaction of Vitallium 2000 were significantly higher than those of cobalt-chromium alloy (P<0.05). Conclusion Vitallium 2000 has significant effect in repairing dentition defect with removable partial denture, could effectively reduce the occurrence of denture stomatitis, coagulation, thrombosis and adverse reactions, and improve the aesthetic appearance, comfort, chewing ability and language ability.

Impact of iron supplementation in maintenance haemodialysis on hemoglobin variability

CHEN Ying-ying, LIN Chun-hua, CHEN Lan, LING Yi-sheng, GUAN Tian-jun

2018, 16(3): 419-422. doi: 10.16766/j.cnki.issn.1674-4152.000117

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Abstract:
Objective To observe the impact of the way of maintenance iron supplementation on hemoglobin variability (Hb-Var) in hemodialysis (HD) patients. Methods A total of 160 HD patients in zhongshan hospital affiliated to Xiamen University from January, 2015 to December, 2015 were consecutively enrolled into this study. The patients were randomly allocated into vein group and oral group. Hb-Var were analyzed after iron supplementation through vein (iron sucrose injection 100 mg per week) or oral (iron polysaccharide complex 100 mg per day) during the maintain treatment of renalanemia. All patients were followed up for one year. Results Assessment of Hb-Var:① The residual standard deviation (SD) of the intravenous injection (IV) group was significantly lower than that in oral group[(8.04±4.58)g/L vs. (12.25±6.85)g/L, P=0.042]. ② The hemoglobin (Hb) amplitude of the IV group was lower than that in oral group[(15.88±8.07)g/L vs. (27.00±15.88)g/L, P=0.015]. ③ The individual changes and SD of the IV group which measured continuously in the adjacent time points was lower than that in oral group[respectively (8.64±4.91)g/L vs. (13.69±7.60)g/L and (6.25±3.76)g/L vs. (11.23±8.49)g/L, both P<0.05]. ④ The proportion of each groups such as above, within and below the scope of the targe (Hb:110-130 g/L):IV group was 12.85%, 71.14% and 16.01%, oral group was 6.9%, 55.17% and 37.93% (χ²=7.164, P=0.028). Transferrin saturation (TAST) and serum ferritin (SF) increased in the IV iron group[(29.29±11.80)% vs. (39.36±12.3)%, P=0.025 and (375.39±223.77)ng/ml vs. (463.05±303.26)ng/ml, P=0.005]. Conclusion The supplement methods of iron supplementation can influence Hb-Var. IV iron treatment would be more available in keeping continuous qualified Hb than oral treatment. The reason may be concerned with the stability of iron storage and the raise of ferric ion availability.

Correlation between plasma renin activity and blood pressure variability with white coat hypertension

ZHAO Hai-ying, JIANG Ling, FAN Cai-ni, WANG Hao

2018, 16(3): 423-426. doi: 10.16766/j.cnki.issn.1674-4152.000118

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Abstract:
Objective To study the effects of plasma renin activity and aldosterone level on blood pressure variability in white coat hypertension (WCH). Methods A total of 150 patients with WCH, 161 patients with mild to moderate essential hypertension (EHT), 167 cases of normotension group (NTG) were chosen from outpatient department or inpatient department from January, 2013 to December, 2016. Ambulatory blood pressure, plasma renin activity (PRA) and aldosterone (ALDO) were monitored in each group. Results Pearson correlation analysis showed that All day systolic blood pressure standard deviation (ADSSD, r=0.644), and All day diastolic blood pressure standard deviation (ADDSD, r=0.707) in WCH group were positively correlated with PRA (all P<0.001). ADDSD(r=0.861) was positively correlated with ALDO (P<0.001). The correlation between ADSSD (r=0.308) and ALDO was not statistically significant (P=0.072); the correlations between ADSSD (r=0.125, -0.167), ADDSD (r=0.036, -0.265) and PRA in EHT and NTG group were not statistically significant (P=0.560, 0.338, 0.794, 0.124). The correlations between ADSSD (r=-0.027, -0.024), ADDSD (r=0.009, 0.012) and ALDO in EHT and NTG group were not statistically significant (P=0.860, 0.890, 0.956, 0.920). Conclusion Blood pressure variability in patients with WCH is associated with PRA.

Interaction of household passive smoking with pickiness on hyperactivity behavior among preschool children

GAO Guo-peng, YAN Shuang-qin, CAO Hui, GU Chun-li, XU Ye-qing, NI Ling-ling, TAO Hui-hui, SHAO Ting, TAO Fang-biao

2018, 16(3): 427-430. doi: 10.16766/j.cnki.issn.1674-4152.000119

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Abstract:
Objective To explore the interaction between household passive smoking and pickiness on hyperactivity behavior in preschool children. Methods A total of 15 291 parents of preschool children from 91 kindergartens were investigated by self-designed questionnaire from May, 2014 to June, 2015. A "Conners abbreviated symptom questionnaire" was used to rate hyperactivity behavior. The multivariate logistic regression and the relative excess risk due to interaction (RERI) were performed to assess the interaction of household passive smoking with pickiness on hyperactivity behavior. Results In our study, the detection rate of hyperactivity behavior was 8.6%. The household passive smoking and pickiness were significantly associated with hyperactivity behavior[OR=1.24(1.10-1.39), P<0.001; OR=2.11(1.88-2.37), P<0.001]. The results of stratified analysis showed that household passive smoking was related with hyperactivity behavior in the children without pickiness[OR=1.45(1.24-1.69), P<0.001]; but whether or not with household passive smoking, the pickiness was associated with hyperactivity behavior[OR=2.60(2.19-3.10), P<0.001; OR=1.79(1.53-2.09), P<0.001]. The multiplicative interaction of household passive smoking and pickiness on hyperactivity behavior was statistically significant[OR=0.69(0.54-0.87), P<0.01], but the additive interaction was not (RERI=0.60, 95%CI=-0.14-1.34). Conclusion The household passive smoking and pickiness were significantly associated with hyperactivity behavior and had a multiplicative interaction on hyperactivity behavior.

Effects of sialidase NEU1 siRNA on proliferation, apoptosis, and invasion in human ovarian cancer-OVCAR3 cell

GUO Xiao-li, DU Jun-qiang, CHENG Qi, WANG Qi-ming

2018, 16(3): 431-433,460. doi: 10.16766/j.cnki.issn.1674-4152.000120

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Abstract:
Objective To elucidate the role of NEU1 siRNA on proliferation, apoptosis, and invasion of OVCAR3 cells. Methods The OVCAR3 cells were transfected with siRNA that knockdown of NEU1. The transfect dye solution preparation for control is about 250 μl Opti-mem serum-free medium, and MOCK group or interfere group were to add 5 μl MOCK siRNA (100 pmol) or NEU1 siRNA (100 pmol) to 245 μl Opti-mem serum-free medium. After 48 h, the transfected cells were collected and processed for Western blot, proliferation, cell cycle, apoptosis, and invasion assay. Results Cell viability assay and flow cytometry showed that NEU1 siRNA effectively inhibited the cancer proliferation, arrested cells cycle at G₀/G₁ phase, and induced apoptosis when compared to the Mock group. Transwell assay showed that invasion of cells in OVCAR3 treated with NEU1 siRNA were suppressed significantly. In addition, Western blot revealed that expressions of Cln3 and Cln5 were depressed, and ATP5B and ATP5J expressions were also reduced. Conclusion NEU1 siRNA can effectively inhibit proliferation, apoptosis, and invasion of human ovarian cancer cells by targeting lysosome and oxidative phosphorylation signaling, which can serve as a new target ovarian cancer treatment.

Clinic analysis of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

YANG Yi-hua, ZHANG Yi, HUANG Xian-mei, CHEN Yun-long, SHEN Jian, ZHANG Wei-ying

2018, 16(3): 434-436,491. doi: 10.16766/j.cnki.issn.1674-4152.000121

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Abstract:
Objective The aim of this paper is to analyze the clinic characteristics of MRMP in children by checking nucleic acid and mutational sites of mycoplasma pneumoniae(MP) from phlegm samples and help the clinic therapy of Mycoplasma pneumonia in children. Methods Total 182 children in our hospital from October, 2015 to August, 2016 were enrolled into this study. Mycoplasma pneumoniae nucleic acid and gene locus for macrolide resistance from sputum samples was detected by PCR and Taqman fluorescent probe. χ² test was conducted to compare the difference in the clinic characteristics between MRMP pneumonia and macrolide-sensitive Mycoplasma(MSMP) pneumonia. Results Among 182 MP pneumonia, there were 113 cases of MRMP accounting for 62.1%, 69 cases of MSMP accounting for 37.9%. A2063G mutation occurred in 99 cases, A2063T in 4 cases, A2063G was the main mutation. In 113 cases of MRMP pneumonia, 85 cases were with fever(temperature > 38℃) duration more than 7 days, for 75.2%; 78 cases with hospitalization time more than 7 days, for 69.0%; 69 cases with extra-pulmonary complications, for 61.1%; 58 cases with lungs lesions more than two lobes, for 51.3%, 55 cases with the use of glucocorticoid, for 48.7%, 47 cases with the level of CRP more than 40 mg/L, for 41.6%; 68 cases with Bronchoalveolar lavage, for 60.2%; 45 cases with intravenous immunoglobulin use, for 39.8%; 46 cases with the level of LDH >400 U/L, for 40.7%; MRMP had longer febrile periods, required longer hospitalization time, had higher rate of extra-pulmonary complications, lesions more than two lobes of lungs and CRP level more than 40 mg/L. More glucocorticoid, bronchoalveolar lavage and IVIG were used in MRMP. But there was no significant difference in LDH level. Conclusion The incidence of MRMP pneumonia is higher than MSMP. If children suffer from longer febrile periods, combine with extra-pulmonary complications, wide lesion range, moderately increased CRP level; we should consider the possibility of MRMP. The use of low-dose glucocorticoid, bronchoalveolar lavage and IVIG should be selected to deal with MRMP.

Effects of Betatrophin levels on glucose metabolism in patients with polycystic ovary syndrome

LI Li-feng, WANG Xiao-yan, JIANG Jian-hui, ZHAO Xiu-min

2018, 16(3): 437-440. doi: 10.16766/j.cnki.issn.1674-4152.000122

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Abstract:
Objective To investigate the effect of Betatrophin on glucose metabolism in polycystic ovary syndrome patients. Methods From January, 2016 to June, 2017, we prospectively collected 50 cases of polycystic ovary syndrome patients in our hospital as an observation group, while 50 healthy adults were collected as a control group. The Betatrophin, Matsuda index, HOMA-IR, HOMA-β, blood glucose and insulin levels of the both groups were compared. Moreover, the association between Betatrophin and glucose metabolism indexes was studied. Results When compared with the control group, patients in the observation group got a reduced Betatrophin[(0.82±0.08) ng/ml vs. 0.91±0.08 ng/ml,P<0.001]; a decrease in Matsuda index (4.82±1.10 vs. 5.37±1.38, P=0.030); an elevated HOMR-IR (2.84±0.64 vs. 2.51±0.75, P=0.020); an elevated HOMA-β (195.39±45.12 vs. 175.38±40.58, P=0.022); a higher level of glucose 30 min OGTT[(145.92±21.58) mg/dl vs. (128.38±23.58) mg/dl, P<0.001]; an increase in glucose 60 min OGTT[(123.72±29.81) mg/dl vs. (97.58±12.48) mg/dl, P<0.001]; an elevated insulin 30 min OGTT (89.75±30.12) vs. (63.58±23.58) μIU/ml, P<0.001); a higher level of insulin 60 min OGTT (80.81±25.12 vs. 61.58±20.71 μIU/ml, P<0.001); and an increased insulin 120'B OGTT (55.31±15.87 vs. 35.93±12.65 μIU/ml, P<0.001). The Betatrophin was positively correlated with the HOMA-IR and HOMA-β (P<0.05), and negatively correlated with Matsuda index, blood glucose 30'B OGTT, insulin 30'B OGTT, insulin 60'B OGTT and insulin 120'B OGTT (P<0.05). Conclusion Impaired glucose tolerance in polycystic ovary syndrome is related to the reduction of Betatrophin.

Clinical application of fascia iliaca compartment block combined with laryngeal mask airway in children undergoing femoral surgery

QIAN Xing-hua, ZHANG Wang-ping, WEI Zhang-na

2018, 16(3): 441-443. doi: 10.16766/j.cnki.issn.1674-4152.000123

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Abstract:
Objective To investigate the effects of fascia iliaca compartment block (FICB) combined with laryngeal mask airway in children undergoing femoral surgery. Methods Eighty children with femoral shaft fracture undergoing selective surgery were randomly divided into experiment group and control group (n=40). FICB combined with laryngeal mask airway were implemented into the experiment group, while general anesthesia with intubation was performed in the control group. After intubation, FICB was implemented under ultrasonic guidance in the experiment group. Anesthesia was maintained with propofol and sevoflurane to keep the bispectral index value between 45 and 55 and control the hemodynamic response to the surgical procedure within a 20% range of the preoperative value. Hemodynamic parameters were monitored, and postoperative pain was accessed by visual analogue scale within 24 hours and the requirements of propofol and sulfentanly were recorded. Postoperative complications were observed, such as time in Post Anesthesia Care Unit and time to extubation. Results Hemodynamic parameters in the experiment group were significantly higher than those in the control group (all P<0.05). The difference in VAS value for FICB was significant between the two groups at 4-12 h postoperatively (all P<0.05); when compared with control group, the dosage of propofol and sulfentanly was significantly less in the experiment group, and the time to extubation and time in postoperative anesthesia recover unit was shorter (all P<0.05). Additionally, the incidence of postoperative complication was less in the experiment group as compared with the control group. Conclusion FICB combined with laryngeal mask airway is superior to general anesthesia with intubation in children undergoing femoral surgery with less complications.

Study on influencing factors of primary caregivers’sanxiety based on structural equation model for community disabled elderly

LI Yan, HUANG Yong-xia, ZHAO Ai-ping

2018, 16(3): 444-447. doi: 10.16766/j.cnki.issn.1674-4152.000124

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Abstract:
Objective To explore the influencing factors of the community disabled elderly caregivers' anxiety, and to analyze the direct and indirect effects of the coping style, the care burden, the self-efficacy and the social support on the caregiver anxiety, and to establish establish its relationship model. Methods We utilized the self-designed patient and caregiver general information questionnaire, medical coping mode questionnaire (MCMQ), caregiver burden scale (Zarit Burden Interview, ZBI), general self-efficacy scale (GSES), the social support rating scale(SSRS) and Self-Rating Anxiety Scale(SAS) to investigate 440 disabled elderly and primary caregivers from five Jinyang communities, Pudong New District, in Shanghai City. The model of anxiety influencing factors was established and analyzed by AMOS17. 0 software. Results The model data fit well, and the structural equation model analysis showed that the care burden had indirect positive effect on anxiety (β=0.384, P<0.01). Social support had direct negative effect on anxiety (β=-0.053, P<0.01) and indirect negative effect (β=-0.590, P<0.01). Self-efficacy had direct negative effect on anxiety (β=-0.070, P<0.01) and indirect negative effect (β=-0.374, P<0.01). Coping mode had direct negative effect on anxiety (β=-0.706, P<0.01). Conclusion Coping style, self-efficacy and social support can directly affect caregiver anxiety. Care burden indirectly influence caregivers anxiety through coping style. Self-efficacy indirectly affect caregiver anxiety through care burden and coping style. Social support indirectly affect caregiver anxiety through care burden、self efficacy and coping style. Therefore, community nurses should encourage caregivers used positive coping styles, and give specific medical knowledge and improve care skills to enhance the self-efficacy of caregivers, and strengthen caregivers social support system in multi-angle multi-dimensional manner to ultimately alleviate caregiver anxiety in the future.

Research and analysis on oral health of 356 medical college students

LI Yu, HE Liu, ZHANG Ai-rong, CAO Ji-yu

2018, 16(3): 448-451. doi: 10.16766/j.cnki.issn.1674-4152.000125

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Abstract:
Objective To know the oral hygiene knowledge, oral health behaviour, the attitude of oral health and oral health status of sophomore 2015 in a medical school to explore the association between oral hygiene knowledge and behavior and student oral health status. Methods According to the WHO "Oral Health Survey Basic Method", System sampling selected 356 students for oral health check and questionnaire in September 2016, on campus. Combined with questionnaire and oral health check data for analysis. Application of EpiData 3.1 software for entry, and logical error correction, using SPSS 22.0 software for statistical analysis. Through the χ² test, independent sample t test, single factor analysis and comparison between different groups of students oral health knowledge awareness rate, attitude of oral health and oral health behavior. Establish a binary logistic regression model to adjust key demographic variables, analysis of the relevance between oral hygiene knowledge, behavior and dental caries, gingivitis occurs, the variable selection criteria is P<0.05. Results According to the questionnaire of 356 students:Father's cultural degree is different, oral health knowledge is different. The difference was statistically significant Results of oral examination of 356 students showed:that the prevalence rate was 32.0%. The detection rate of gingivitis is 29.5%. By Spearman correlation analysis and Logistic regression analysis, the impact of dental caries incidence on these two factors:can not prevent the method of periodontal disease, caries is one of the three major diseases that endanger mankind, the risk factors for gingivitis were not used with mouthwash and not supragingival scaling. Conclusion There is imbalance in the oral hygiene knowledge of students in medical college. The incidence of caries among students in this medical college is high. Oral education courses should be opened to strengthen oral health guidance and promote oral health.

The clinical value of color ultrasound in perioperative patients with carotid endarterectomy

CHEN Fu-hua, ZHOU Yi-bo, KONG Min-gang, LUO Dan-yue

2018, 16(3): 452-455. doi: 10.16766/j.cnki.issn.1674-4152.000126

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Objective To investigate the clinical value of color ultrasound in perioperativepatients with carotid endarterectomy. Methods A total of 53 breast cancer patients were selected in our hospital from February, 2015 to March, 2017. All of patients treated with carotid endarterectomy. To observe lesion location, degree of coronary artery stenosis, narrow blood vessels, hemodynamic index changes and postoperative prognosis during perioperative stage. Results There were 84 cases of arterial stenosis in 53 patients, including 20 patients with unilateral lesions and 32 patients with bilateral lesions. Consistency was good between color ultrasound detection and DSA detection (Kappa=0.857, P<0.001); After suture of carotid artery, 33 thin strips of high echo were detected by color doppler ultrasonography in 22 patients, including 31 for mild abnormalities which were < 3 mm free internal diaphragm, and the other two is significantly abnormal which were Zonal thrombus; The endovascular diameter and hemodynamic indexes were significantly improved after operation (all P<0.01); Within 3 months after operation, the mortality rate of the patients was 0, 3 patients with cervical hematoma, 1 patient with hyperplasia and edema of surgical site, 1 case with ischemic cerebral infarction whose color ultrasound showed the various free internal diaphragm of < 2 mm. Conclusion Color ultrasound has important clinical application value on preoperative diagnosis, intraoperative evaluation and postoperative prognosis in patients with carotid endarterectomy.

Clinical application of ultrasound in the diagnosis and prognosis of ovarian tumors

HAN Yun-sheng, SHEN Ji, DING Yun-feng

2018, 16(3): 456-460. doi: 10.16766/j.cnki.issn.1674-4152.000127

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Abstract:
Objective To study the value of ultrasound in the diagnosis of benign, malignant or borderline ovarian tumor and the preoperative staging of patients with malignant ovarian tumor, and to provide image evidence for clinical treatment. Methods The preoperative ultrasonic images (transabdominal and Transvaginal sonography) and pathologic data of 87 cases of pathological-confirmed benign ovarian tumor, 53 cases of borderline ovarian tumor and 99 cases of malignant ovarian tumor between 2012 and 2016 were reviewed retrospectively. The difference of ultrasonic and pathological results in benign and malignant ovarian tumor was analyzed by consistency Chi square and Kappa test. The correlation between ultrasonic imaging features and ovarian borderline or invasive tumor was analyzed by univariate and multivariate logistic, and the prediction model was established. Results The sensitivity and specificity of ultrasound for benign and malignant ovarian were 90.80% and 96.05%. The accuracy of ultrasound for the preoperative staging of patients with malignant ovarian tumor was 94.12%, 89.19%, 90.63% and 90.32% for stage Ⅰ, Ⅱ, Ⅲ and Ⅳ, respectively. The model of differentiating borderline and invasive ovarian tumor was developed based on the following variables (P<0.05):cancer antigen 125, the greatest diameter of the tumor, septa, and solid parts on ultrasound imaging. The sensitivity and specificity of the model were 81.6% and 73.5% for patients aged < 50 years, 95.2% and 80.8% for those aged ≥ 50 years, respectively. Conclusion Ultrasound is helpful to the diagnosis of benign and malignant ovarian tumors, preoperative staging of patients with malignant tumor and prediction of borderline ovarian tumors, it is also important for the clinical treatment and prognosis assessment.

The main advances in the application of proteomics in prenatal diagnosis

CHEN Li-zhu, ZHANG Mo, MA Wei, YUAN Zheng-wei

2018, 16(3): 461-464. doi: 10.16766/j.cnki.issn.1674-4152.000128

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Abstract:
Prenatal diagnosis is to make the diagnosis of fetal genetic diseases, structural abnormalities and pregnancy-related diseases before birth thus could provide basis for the intrauterine treatment or selectively termination of pregnancy. Proteomics-based identification of biomarkers for prenatal diagnosis in maternal plasma, amniotic fluid and reproductive fluids has made significant progress in the past few years. This is attributed mainly to advances in various technology platforms associated with mass spectrometry-based techniques. As these techniques are high through put, sensitive, and require only small quantities of body fluids, especially the discovery of biomarkers in maternal serum which has more advantages than traditional amniocentesis, chorionic villus sampling, and fetal blood sampling, and it is hoped that they will pave the way for the development of effective noninvasive approaches. By comparing the differentially expressed proteins between different clinical status, case and control, and different developmental period of certain disease, proteomic technology has been widely used in tumor biomarker studies. Up to now, many researchers all over the world applied proteomics in the discovery of prenatal diagnostic biomarkers, and found some candidate biomarkers for aneuploids, preeclampsia, intrauterine growth retardation, and some structural abnormalities. In this review we discuss the main advances in the application of proteomics in prenatal diagnosis.

The clinical application development of paraffin therapy

GUO Feng-hong, FAN Peng, ZHANG Xun, YANG Huan-wei, XU Lei

2018, 16(3): 465-469,483. doi: 10.16766/j.cnki.issn.1674-4152.000129

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Abstract:
Paraffin therapy is using heating paraffin to treat diseases. Paraffin therapy, a favorable conductive heat therapy with good plasticity, viscosity and ductility, could have close contact with skin, stretch optionally, transform and cling to body surface. Paraffin therapy could preserve heat for a long time and release a large amount of energy when cooling, providing a higher temperature and lasting thermal effect on tissue. Paraffin therapy stimulates dermal telangiectasia, increases the rate of blood flow, improves the circulation of blood and lymph, and increases secretion of sweat gland in treatment region. On the one hand, paraffin therapy can promote the circulation, stimulate dermal telangiectasia, increase the rate of blood flow, improve the circulation of blood and lymph, and increase secretion of sweat gland. On the other hand, paraffin therapy could reduce tissue edema, eliminate pain mediators, and achieve the purpose of relieving swelling and pain by inflammatory infiltration. In the course of cooling, the volume of paraffin wax gradually decreased. Paraffin wax contacted with skin closely during the whole treatment process. Mechanical squeezing action can promote the transmission of heat and temperature to deep tissues, prevent exudation of lymph and blood in diseased tissue, and promote absorption of exudate. Its treatment effects include warming, mechanical interaction, lubrication and so on. The therapy techniques include wax cake and wax brush method. Paraffin therapy is noninvasive, painless, showing less side effects and obvious curative effects. It is simple and practicable that is widely used in treatment of neck-shoulder and lumbocrural pain, vertebral artery type cervical spondylopathy, rehabilitation of nervous function, muscles and soft tissue damage, limb function rehabilitation, digestive system disease, gynecological disease, dermatosis and other fields. This paper summarized these clinical efficacy, explored the indications for using paraffin therapy, reduced the pain of patients, and improved their life quality, thus to provide thoughts and methods for further clinical research of paraffin therapy.

Research of Buyang Huanwu decoction combined urokinase thrombolysis on acute cerebral infarction

DONG Gang, JIA Hong-gang

2018, 16(3): 470-472. doi: 10.16766/j.cnki.issn.1674-4152.000130

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Abstract:
Objective To investigate the clinical efficacy of Buyang Huanwu decoction combined urokinase thrombolysis on acute cerebral infarction and its effect on serum VEGF and Ang-2. Methods A total of 106 patients with acute cerebral infarction treated in our hospital were randomly divided into two groups, with 53 cases in each group. The control group was given urokinase treatment, and the observation group was added Buyang Huanwu decoction based on the control group. The neurological deficits, hemorheology (whole blood viscosity, plasma viscosity, and erythrocyte sedimentation rate), serum VEGF and Ang-2 levels and clinical efficacy of two groups were compared. Results The total effective rate of observation group was 90.57%, which was significantly higher than that of the control group (67.92%, P<0.05). After treatment, the neurological deficit scores of two groups were significantly reduced (P<0.05), and the neurological deficit score of observation group was significantly lower than that of control group (P<0.05). After treatment, the whole blood viscosity, plasma viscosity and erythrocyte sedimentation rate levels were significantly decreased (P<0.05), and the index levels of observation group were significantly lower those of control group (P<0.05). After treatment, serum VEGF and Ang-2 levels of two groups were significantly increased (P<0.05), and VEGF and Ang-2 levels of observation group were significantly higher than those of control group (P<0.05). Conclusion Buyang Huanwu decoction combined urokinase thrombolysis could effectively treat acute cerebral infarction, significantly improve the nerve defects degree and microcirculation. And its mechanism might be related to its regulation of VEGF and Ang-2.

The effect of accelerated rehabilitation on the clinical prognosis of elderly patients with radical gastrectomy

YANG Fu-hua, ZHANG Yue-yan, YING Rong-chao

2018, 16(3): 473-475. doi: 10.16766/j.cnki.issn.1674-4152.000131

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Objective To learn more about the application effect of fast-track surgery (FTS) on the prognosis of elderly patients with gastric cancer undergoing radical surgery. Methods A total of 120 patients with gastric cancer treated in Fuyang District Hospital of Traditional Chinese Medicine from March, 2014 to December, 2016 were randomly divided into study group and control group, with 60 cases in each group. Patients in the control group were given general nursing care and anti-inflammatory, anti-bacterial, analgesic, rehydration and other symptomatic supportive care. Patients in the study group were given the FTS concept care on the basis of the control group's treatment. The operation time, intraoperative blood loss, hospital stay, hospitalization costs, postoperative prognosis and related complications were compared between the two groups. Results The operation time, blood loss and the number of lymph node dissection in the two groups had no significant difference (P>0.05); The anesthesia time and intraoperative fluid infusion in the study group were significantly lower than those in the control group (P<0.05); The eating time, bed ambulation time, hospital stay, anal exhaust defecation time and hospitalization costs in the study group were significantly lower than those in the control group (P<0.05); There was no significant difference in the incidence of hemorrhage, gastrointestinal fistula and other complications between the two groups (P>0.05), but the incidence of postoperative infection and pulmonary complications in study group was significantly lower than that in control group (P<0.05). Conclusion FTS for the treatment of elderly patients with gastric cancer is affirmative, which is more effective in promoting postoperative recovery, improving patient prognosis, reducing hospital costs, and improving the quality of life of patients, thus worthy of clinical promotion. However, there is still a need to combine patients with the actual use of individualized and generalized principles combined.

Research on the problems and countermeasures of teaching staff construction in affiliated hospitals of colleges and universities

XU Zhang-jie, QU Jian, TANG Pan, LI Yan-jie, HUANG Gui-hua, GUI Xiong-bin, ZHONG Yuan-ming, LUO Wei-sheng, TANG Mei-wen

2018, 16(3): 476-479. doi: 10.16766/j.cnki.issn.1674-4152.000132

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Objective To analyze the key problems in the construction of teaching staff in the current affiliated hospitals, and to put forward the corresponding construction strategies to promote the construction of teachers in the affiliated hospitals and provide references for the teaching reform in the affiliated hospitals. Methods According to the current situation of teachers in our own hospitals, combined with the status quo of teachers in affiliated hospitals in domestic colleges and universities, this paper summarized the various problems faced by the construction of high-level clinical teachers. According to the corresponding construction problems, we proposed the following aspects of the construction measures:establishing a correct teaching concept, a reasonable structure of clinical teachers, a construction of clinical teachers training system; improving the clinical teacher appointment system, implementing an effective incentive and reward and punishment mechanism; improving the clinical teaching management system and teaching supervision system and promoting the developing processes of clinical young teachers. Results Via these measures, we managed to promote the level of the construction of our team of teachers, and it is worthy of referencing to fellow universities and affiliated hospitals. Conclusion The affiliated hospitals play an important role in the development of medical students, and the training of high quality medical students depends on the clinical guidance of clinical teachers in affiliated hospitals. Therefore, the establishment of a solid foundation of teaching and an outstanding team of teachers are the keys to improving the quality of teaching and the subsidiary of all teaching activities in the hospital. According to the existing problems in the construction of the teaching staff, the teaching reform is carried out in a targeted strategy to promote the overall teaching level of the affiliated hospitals in colleges and universities.

Investigation and training of cardiopulmonary resuscitation skills of basic hospital medical staffs

SHANG Gui-ying, ZHANG Wen-wen, LI Shuang-jun, GUO Zhao-peng, JUAN Zhao-dong, ZHANG Rui

2018, 16(3): 480-483. doi: 10.16766/j.cnki.issn.1674-4152.000133

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Objective To investigate the knowledge and skills of medical staffs in primary hospital on cardiopulmonary resuscitation, and provide basis for the promotion of CPR and improvement of CPR training in local hospitals. Methods A questionnaire study from August, 2013 to August, 2016 to assess the CPR knowledge skill of medical staffs from primary hospitals in three cities (Weifang, Zibo and Dezhou) was performed based on 2010 American Heart Association Guidelines for CPR and ECC. The data samples were collected by random sampling method among the medical staffs to process statistical analysis. Results The knowledge and skills of medical staffs in primary hospital on CPR:① The high requirement of primary medical staff on cardiopulmonary resuscitation theory, anatomical structure of human heart and lungs, recognition of sudden cardiac arrest, the steps of manual CPR, and the theory knowledge of primary life support and advanced life support. ② The high requirement for chest compression, artificial respiration, open the airway, automatic defibrillation, tracheal intubation, ring membrane puncture and tracheotomy. ③ Primary medical staff were lacking of cardiopulmonary resuscitation knowledge and skills. Conclusion The mastering of CPR among primary hospital staffs is relatively weak. They lack of understanding of CPR. But clinical work is still highly demanding for CPR. The hospital training based on different education background, work experience and titles can effectively improve the first aid knowledge and skills on cardiopulmonary resuscitation of the primary hospital medical staffs.

The prevention of theophylline on contrast-induced nephropathy—a meta analysis based on 19 RCTs

LAN Jia-rong, JI Bing, LI Min, YAN Zi-you, SONG Xue-quan

2018, 16(3): 484-487,497. doi: 10.16766/j.cnki.issn.1674-4152.000134

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Objective To systematically evaluate the prophylactic effect of theophylline on the contrast-induced nephropathy(CIN). Methods Retrieve Chinese and English database in accordance with the requirements of system evaluation, comprehensively and comprehensively search for the relevant literature on theophylline drugs in the treatment of CIN. Meta analysis was carried out by using RevMan 5.0 software. Results Nineteen randomized controlled trials(RCTs) were included. In the group of theophylline vs. other preventive treatment, showed that theophylline can effectively reduce the incidence of CIN compared with other preventive treatment[RR=0.39, 95% CI:(0.22,0.68), P<0.001], but had no significant differences in serum creatinine value[RR=0.03, 95% CI:(-0.11,0.18), P=0.650] and had no significant differences in GFR value[RR=-3.24, 95% CI:(-29.60,23.11), P=0.810]. In the group of theophylline VS placebo, showed that theophylline can effectively decrease the incidence of CIN[RR=0.44, 95% CI:(0.29,0.67), P<0.001] and can effectively lower serum creatinine values[RR=-0.12, 95% CI:(-0.18,-0.07), P<0.001], can effectively increase GFR values[RR=11.82, 95% CI:(7.25,16.39), P<0.001]. Conclusion There are some prophylactic effects of theophylline on the CIN based on existing information, especially for the young patients without diabetes or high blood pressure. However, subgroup analysis resulted in less sample size in the subgroups, much more high-qualified RCTs with large samples and multicenter as well as strict design are needed to evaluate the treatment effect of theophylline on the CIN.

Study of psychological distress and relative influencing factors analysis of lung cancer patients before receiving radiotherapy

ZHANG Min, XIE Shu-ping, YANG Xi, SHEN Jia-qin, YE Ying-jun, YE Li-juan, WANG Tian-hong, YANG Si-yu, WANG Jin, HU Xiao

2018, 16(3): 488-491. doi: 10.16766/j.cnki.issn.1674-4152.000135

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Objective To investigate the degree of psychological distress before radiotherapy in patients with lung cancer, and analyze the related factors of distress for providing basis of clinical individual psychological intervention strategies. Methods Through the general information and psychological distress thermometer(DT), 237 subjects of lung cancer who had been treated before radiotherapy were selected by the cross-sectional survey admitted to Zhejiang Cancer Hospital from May, 2015 to February, 2016. Data were entered into Excel after investigation, and using SPSS 19.0 for statistical analysis, P<0.05 indicating statistically significant differences. Results Lung cancer patients of psychological distress(DT<4) accounted for 89.9%(213/237). The significant frequency of psychological distress(DT ≥ 4) was 10.1%(24/237). The main PL cause of lung cancer psychological distress ranking in the top 10 were economic problems, fear, child care, constipation, housing, dizziness, sleep problems, dealing with children/the old man, breathing, and pain. The psychological distress factors accounted for emotional problems 28.7%(68/237), physical problems 38.4%(91/237), practical problems 28.7%(68/237), communication problems 10.5%(25/237), and religious beliefs 0.8%(2/237). The Spearman correlation analysis showed that gender and psychological distress was not statistically significant(r=0.103,P=0.113). Age and therapy method were positively related with psychological distress(r=0.718,P<0.001; r=0.891,P<0.001)and education level was negatively correlated with psychological distress(r=-0.399,P<0.001). Conclusion The psychological distress for lung cancer radiotherapy patients is given priority to with mild. The age, education level and treatment are the independent factors of affecting psychological DT. The key factors of causing psychological distress are economic problems, fear, child care, constipation, housing, which may provide the right way to relieve the patients' psychological distress.

Risk factor analysis of COPD with pulmonary thromboembolism and its nursing countermeasures

LI Yan-fang, FANG Ying, LI Qin, SHI Yan, WANG Shi-qiang

2018, 16(3): 492-493,506. doi: 10.16766/j.cnki.issn.1674-4152.000136

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Objective To explore the risk factors of COPD complicated with pulmonary thromboembolism, and thus to sum up the corresponding nursing strategies. Methods A total of 95 patients with COPD complicated with pulmonary thromboembolism from May, 2015 to December, 2016 were selected into embolization group and 282 patients with COPD without pulmonary thromboembolism were selected into non-embolization group. The risk factors questionnaire was made, and the age, sex, smoking history, bed history, diabetes history, lower extremity asymmetric edema, hemoptysis, fever, venous thrombosis, D-dimer, PaO₂, PaCO₂ of both groups were accounted. And univariate and multivariate analysis were used to determine the risk factors for patients with COPD complicated with pulmonary thromboembolism. Results Univariate results showed that age, bed rest, diabetes mellitus, asymmetric edema of lower extremities, venous thrombosis, D-dimer, PaO₂ and PaCO₂ were risk factors for pulmonary thrombosis in COPD patients. And multivariate logistic regression analysis showed that age, bedtime history, diabetes mellitus, asymmetric edema of lower extremities, venous thrombosis, D-dimer, PaO₂ and PaCO₂ were risk factors for pulmonary thrombosis in COPD patients. Conclusion Age, bedtime history, diabetes mellitus, asymmetric edema of lower extremities, venous thrombosis, D-dimer, PaO₂ and PaCO₂ are risk factors for pulmonary thrombosis in COPD patients. Clinical attention should be paid to risk factors, and well treatment and nursing could prevent COPD patients from pulmonary thromboembolism.

PICC placement via the greater saphenous vein in patients with superior vena cava syndrome

WU Xiao-fei, YING Ling-mei, ZHAN Xiao-yan, TAN Wei-fen

2018, 16(3): 494-497. doi: 10.16766/j.cnki.issn.1674-4152.000137

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Objective To investigate the efficacy of PICC placement via the greater saphenous vein and explore best approach for clinical catheterization in patients with superior vena cava syndrome (SVCS). Methods A total of 12 tumor patients with SVCS who were unable to place PICC into the superior vena cava for chemotherapy via central venous catheter (CVC) in our hospital between January, 2015 and August, 2016 were enrolled into this study. On the basis of evolution and consultation with patients, family members and doctors, PICC placement via the greater saphenous vein was performed according to PICC catheterization standard operation procedure (including marker, measurement, disinfect, puncture, catheter placement and fixation with IV3000). The clinical data of all patients were summarized and analyzed. Results The catheterization via saphenous vein was performed in all 12 patients with an success rate of 100%. The extubation was carried out in 11 cases when all courses of chemotherapy were completed, and 1 case gave up chemotherapy due to intolerable side effects of chemotherapy. There was no complication in all patients during the catheter indwelling period. Conclusion PICC placement via the greater saphenous vein is a safe and effective method for patients with SVCS who were unable to place PICC into the superior vena cava for chemotherapy. With certain clinical advantages, it solves the problems in intravenous infusions in the upper extremities and is worthy of clinical application.

Nursing cooperation of minimally invasive surgery with combined surgery of the front and back joint in treatment of cataract and vitreoretinopathy

CENG Feng-mei, WU Chun-liu, RAO Fen, WU Bo-le

2018, 16(3): 498-500. doi: 10.16766/j.cnki.issn.1674-4152.000138

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Objective To explore the nursing features, nursing cooperation and matters needing attention of patients with 25G+ minimally invasive closed vitrectomy combined with 2 mm micro incision phacoemulsification and to prepare for standardized nursing of minimally invasive combined anterior and posterior operation. Methods Nursing care includes 67 cases of 25G+ minimally invasive closed vitrectomy combined with 2 mm incision phacoemulsification surgery from July, 2013 to March, 2016, Zhejiang Department of Ophthalmology, Lishui People's Hospital. In addition to the routine care of eye surgery, we should particular pay attention to the frequency of cutting speed, referring to the soft and hard wall of the eye wall, the size of the ultrasound energy, and the level of negative pressure with phacoemulsification and vitrectomy. Minimally invasive surgery of anterior with posterior segment has a special link to the timely adjustment of phaco machine and vitrectomy machine parameters according to the needs, to ensure the normal use of instruments and equipment. Liquid effusion box should not be too full, injection needle injector should be closely connected with silicone oil injection, uniform, slow and sustained action, so as to avoid the omentum under the gas accumulation. Results In the eyes of 67 eyes who received minimally invasive combined anterior and posterior surgery, 67 eyes had different degrees of vision improvement at the last follow-up, and 65 of them had visual acuity increased by 2 lines or more. No obvious corneal edema and corneal endothelial decompensation occurred after surgery. Besides, 9 eyes of diabetic traction retinal detachment were added after surgery. Conclusion Special characteristics of nursing were found in 25G+ minimally invasive vitrectomy combined with 2 mm incision phacoemulsification. Close cooperation was made during operation according to the operation process, the need for timely adjustment of phaco machine and vitrectomy machine mode as well as parameters, to ensure the normal use of instruments and equipment, and more changes in the operation difficulty, deeply familiar with equipment performance and skills, and close cooperation, to ensure the success of the 25G+ minimally invasive closed vitrectomy combined with 2 mm micro incision phacoemulsification.

Risk factors and nursing strategies for hypertensive intracerebral hemorrhage complicated with upper gastrointestinal

YANG Hong-bo, XU Hai-ying, YANG Jian-hong, SHI Ding, DING Li-jun

2018, 16(3): 501-503. doi: 10.16766/j.cnki.issn.1674-4152.000139

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Objective To investigate the risk factors and nursing strategies of hypertensive cerebral hemorrhage (HICH) complicated with upper gastrointestinal bleeding. Methods Two hundred and fourteen HICH patients admitted in our hospital from April, 2016 to September, 2017 were selected. Eighty-six HICH patients with upper gastrointestinal bleeding were set in observation group and 128 HICH patients without upper gastrointestinal bleeding were set as control group. The gender, age, hernia, pathological signs, cerebral hemorrhage sites, blood glucose level, cerebral hemorrhage, GCS score of two groups were accounted, and those risk factors of HICH patients with upper gastrointestinal bleeding was analyzed with univariate and multivariate analysis. Results In 214 HICH patients, 86 patients developed upper gastrointestinal bleeding with a rate of 40.2% (86/214). Univariate analysis showed that:age, hernia, pathological signs, cerebral hemorrhage site, blood glucose levels, cerebral hemorrhage, GCS score were the risk factor for HICH patients with upper gastrointestinal bleeding. Multivariate logistic regression analysis showed that age, hernia, pathological signs, cerebral hemorrhage site, blood glucose levels, cerebral hemorrhage, GCS score were the risk factor for HICH patients with upper gastrointestinal bleeding. Conclusion Hypertensive intracerebral hemorrhage patients easily upper gastrointestinal bleeding, and age, hernia, pathological signs, cerebral hemorrhage site, blood glucose levels, cerebral hemorrhage, GCS score were the risk factors for HICH patients with upper gastrointestinal bleeding. So those risk factors should be pay attention,and treatment and nursing carried out to prevent the occurrence of upper gastrointestinal bleeding.

XIE Ke-yue, HUANG Bing, YAO Ming, REN Xiao-mei, SUN Yan-bao

2018, 16(3): 504-506. doi: 10.16766/j.cnki.issn.1674-4152.000140

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2018 Vol. 16, No. 3

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