中华全科医学

Application of physiological driving fidelity human patient simulator in non technical skills training of first aid in general practitioner

CAO Yi-mei, WANG Chang-yuan, WANG Jing, QIN Jian, CHEN Li-fen

2019, 17(1): 1-3,86. doi: 10.16766/j.cnki.issn.1674-4152.000584

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Objective To explore the application effect of the physiological driving fidelity human patient simulator in the training of non-technical skills of general practitioner first aid. Methods The 59 general practitioners were selected to carry out first-aid skills training at Xuanwu Hospital of Capital Medical University, who were randomly divided into control group including 29 cases and observation group including 30 cases. The teaching model of traditional theory and simple drill were used in the control group. First aid cases, such as anaphylactic shock, heart failure and cardiac arrest, were designed for general practitioner in the observation group, and the rescue process of these cases were put into the physiological driving fidelity human patient simulator, and the case program was run on the physiological driving fidelity human patient simulator, and the physiological driving fidelity human patient simulator was used to carry out first aid training in the observation group. After training, the anesthesiologist' non-technical skills system (ANTS) were used to evaluate the non-technical skills of 2 groups, the differences of non-technical ability and rescue success rate were compared between the 2 groups. The questionnaire was issued to analyze the evaluation of the effect of the general practitioner on first-aid skills training. Results After training, the score of the task management of the general practitioner in the observation group was 10.29 ±4.53, which was larger than that of the control group 7.65 ±4.67 (P=0.031). The score of decision making ability was 8.42 ±3.82, which was larger than that of the control group 6.12 ±3.73 (P=0.023), and the team cooperation ability score was 13.01 ±4.69, which was higher than that of the control group 9.17 ±4.72 (P=0.003), The score of situational awareness was 8.62 ±3.48, which was higher than that of the control group 6.57 ±3.92 (P=0.038). The questionnaire showed that the scores of the observation group in improving learning interest, improving comprehensive ability and team spirit training were higher than those in the control group (P < 0.05). Conclusion The application of physiological driving fidelity human patient simulator in first-aid skills training could significantly improve the non-technical skills of general practitioners, improve the success rate of rescue, and increase interest in learning and promote team spirit.

HAO Jia-ni, QU Hong-dang

2019, 17(1): 4-5.

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An experimental study on roles of GP73 and PI3K/Akt pathway in the Sorafenib resistant mechanism in patients with hepatocellular carcinoma

YANG Ying, ZHANG Rui-li, YANG Zhi-fang, LIU Qiang, CAI Ceng, ZHANG Hua, ZHAO Hua-rong, LI Zhi-peng, JIA Chun-li, BAO Yong-xing

2019, 17(1): 6-9,90. doi: 10.16766/j.cnki.issn.1674-4152.000585

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Objective To explore the roles of (Golgi protein 73, GP73) and PI3K/Akt pathway in the sorafenib resistant mechanism in patients with hepatocellular carcinoma. Methods MTT assay was used to detect the inhibitory rate of sorafenib on cell viability. Sorafenib resistant Hep G2 cell was established by long term and low dose sorafinib incubation.The cell morphologic change was observed under an inverted phase contrast microscope. GP73 were overexpressed and knocked down by plasmid transfection in sorafinib resistant Hep G2 cell, and the effect of GP73 on sensitivity of sorafinib was detected. GP73, EMT markers and PI3K/Akt signal pathway molecules proteins were detected by Western blot in sorafinib resistant and non-resistant cells. Results Different concentrations of sorafenib on Bel-7404, SK-Hep-1 and Hep G2 cells all had inhibitory effects. Long term and low dose of sorafinib stimulated the morphologic change of cells to long spindle shape. Overexpression of GP73 decreased the sensitivity of sorafenib; knockdown of GP73 increased drug sensitivity. Compared with non-resistant cell, GP73, N-cadherin and Vimentin expression were increased, E-cadherin was decreased (all P < 0.05). Besides, GP73, PI3 K and p-Akt levels were also elevated in resistant cell. Conclusion The up-regulation of GP73 and activated PI3K/Akt pathway, which promoted EMT, may be the possible mechanism of sorafenib resistance of HCC.

Laparoscopic and open Dixon surgery about rectal cancer：A controlled clinical trail

WANG Ming-qing, XIONG Mao-ming, CHEN Bo, CHEN Ke

2019, 17(1): 10-13. doi: 10.16766/j.cnki.issn.1674-4152.000586

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Objective To make a review and evaluation for the security and effectiveness about the laparoscopic and conventional open Dixon surgery. Methods Between 2010 to 2015, 656 rectal cancer patients underwent Dixon surgery including 274 laparoscopic surgery and 382 conventional open operation in the first affiliated hospital of Anhui Medical University, all of them do not receive preventive stoma. The operation time, peroperative bleeding, postoperative recovery (including time to anal exhaust, time drinking water, time to get out of bed, time to be hospitalized, etc.), postoperative complications (including pleural effusion, perioperative mortality, anastomotic fistula, incision infection, postoperative bleeding, and secondary surgery), pathological indicators (including the number of lymph nodes, number of positive lymph nodes, cutting edge, TNM stage, tumor diameter, etc.) about the two group patients were collected and compared; the follow up time were from 6 months to 56 months to observe the prognosis of patients. Results Twenty patients (7.30%) in the laparoscopic group converted to the open surgery. Total 6 patients died in perioperative period, 2 of them were the laparoscopic group. Laparoscopic surgery was significantly associated with lower intraoperative blood loss, earlier recovery of bowel function, reduced length of hospital stay and time to feeding liquids, as compared to open surgery, although with increased operative time. It also showed an obvious advantage for postoperative complications of postoperative hemorrhage and the infection, the laparoscopic approach was equal to open approach as regard to bowel obstruction and pyoperitoneum. The pathological examination of 656 patients after resection showed 2 cases of positive distal margin, all of them were from open group. Importantly, there were no significant differences in the number of lymph node dissection, local recurrence rates, distant metastasis rates and 3-year survival rates between the two procedures. Conclusion Laparoscopic Dixon surgery for rectal cancer is feasible and safe, and can make faster recovery, achieve satisfactory oncological outcome and provide similar short-term and long-term outcomes.

Curative effect of Yunnan Baiyao on gingivitis and its influence on function of oral osteoclast

LIU Jun, HE Hong-bing, REN Xiao-bin

2019, 17(1): 14-17,69. doi: 10.16766/j.cnki.issn.1674-4152.000587

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Objective To explore the curative effect of Yunnan Baiyao on gingivitis and its influence on the function of oral osteoclast. Methods A total of 100 cases of gingivitis treated in our hospital from June 2016 to June 2018 were randomly divided into the Yunnan Baiyao group and the control group with 50 cases in each group. Yunnan Baiyao group were given the Yunnan Baiyao solution to wash the affected part, and the control group was treated with minocycline hydrochloride ointment. Healthy and lesion area alveolar bone were collected for in vitro culture and subculture. The gingival index (GI), gingival groove haemorrhage index (SBI) and plaque index (PLI) was compared. The serum levels of tumor necrosis factor-alpha (TNFbeta), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8) and osteocalcin (OC) were measured by enzyme-linked immunosorbent assay. The morphology of oral osteoclasts was observed. The proliferation of oral osteoclasts was compared between the two groups. The mRNA expression of Type Ⅰ collagen was detected by immune transmission turbidimetry test. The level of alkaline phosphatase (ALP) was detected by double antibody sandwich method. Results After the treatment, the levels of GI, SBI and PLI in the Yunnan Baiyao group were lower than those of the control group (P < 0.05). After the treatment, the levels of TNF-beta, IL-1β, IL-6 and IL-8 in the Yunnan Baiyao group were lower than those in the control group (P < 0.05). At different time points, the proliferation rate and alkaline phosphatase activity of oral osteoclasts in the Yunnan Baiyao group were low compared with the control group, and the activity of tartaric acid acidic phosphatase was higher than that of the control group (P < 0.05). The mRNA level of type Ⅰ collagen protein, ALP activity and OC level in the Yunnan Baiyao group is lower than those in the control group after the treatment (P < 0.05). Conclusion Yunnan Baiyao can effectively inhibit the proliferation of osteoclasts in the oral cavity of gingivitis patients, promote differentiation, with a remarkable curative effect.

Analysis of the characteristics of Streptococcus pneumoniae isolated from respiratory tract infection in children under 5 years old

JIANG Yan-xia, JIN Hong-xing, LIU Xi-yong, JIN Zhi-biao, SUN Ai-hua

2019, 17(1): 18-20. doi: 10.16766/j.cnki.issn.1674-4152.000588

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Objective To study the characteristics of S. pneumoniae isolates from respiratory specimens of children under5 years old in this region, and to provide reasonable basis for clinical treatment and epidemiology. Methods The specimens of respiratory tract were collected from 5 332 children under 5 years old with respiratory tract infection from December 2013 to November 2017, germiculture and bacteria identified were done. Multiple PCR and E-test were respectively used for serotype and drug sensitivity of the isolates, and the results were statistically analyzed. Results Two hundred and twelve S. pneumoniae isolates were isolated 5 332 children under 5 years old with respiratory tract infection, the detection rate was 3.98%. The detection rates of Streptococcus pneumoniae in male and female children were 4.19% and 3.74%, respectively. There was no statistical difference (P > 0.05). S. pneumoniae isolates detection rates were different in different seasons, the highest 5.7% in winter, and S. pneumoniae detection rates (6.7%) in winter and spring was higher than that in summer and autumn (2.0%), and the difference was statistically significant (P < 0.05). Nineteen different serotypes were identified in 212 isolates by multi-PCR, of these, 19 F accounts for up to 37.3%, followed by 19A (24.5%). S. pneumoniae are all sensitive to vancomycin and moxifloxacin. Chloramphenicol, levofloxacin, cefotaxime, amoxicillin, penicillin G, clindamycin, tetracycline and erythromycin resistant rate were 4.2%, 4.7%, 9.0%, 25.0%, 30.2%, 56.1%, 80.7% and 86.8%, respectively. Conclusion Winter is the season of the highest rate of S. pneumoniae in children under 5 years old in the region, it is necessary to perform serotype detection and drug susceptibility test so as to choice preventive vaccination and treatment antimicrobial agents.

Effect of Luteolin on nonalcoholic fatty liver disease in mice

WANG Xiu-fang, YAN Chun-gen

2019, 17(1): 21-24,51. doi: 10.16766/j.cnki.issn.1674-4152.000589

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Objective To investigate the protective effect of luteolin on nonalcoholic fatty liver disease (NAFLD) in mouse. Methods A total of 52 Kunming mice were randomly divided into control group (11 mice) and model group (41 mice). The control group was given standard diet and the model group was given high fat diet. After 8 weeks of feeding, 1 mouse in control group and 1 mouse in model group were randomly selected to confirm the model success or failure by pathological test. After model success, mice in model group were randomly divided into 4 groups, including NAFLD model group and low dose group[50 mg/(kg·d)], middle dose group[100 mg/(kg·d)]and high dose group[200mg/(kg·d)], 10 mice in each group. The mice in Luteolin group were given corresponding dose of luteolin, and the control group and the NAFLD model group were given the same amount of normal saline. After 4 weeks, the mice were sacrificed and serum triglyceride (TG), serum total cholesterol (TC), aspartate transaminase (AST) and alanine aminotransferase (ALT) levels in serum were measured, and oxide dismutase (T-SOD), glutathione (GSH) and malondialdehyde (MDA) levels, tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) levels in serum and liver tissue totals were tested. Then liver tissue sections were observed. Results Compared to control group, the TG, TC, AST and ALT levels of NAFLD model group were significantly increased, MDA, TNF-α and IL-6 levels of serum and liver tissues were significantly increased (all P < 0.05), and the T-SOD, GSH levels of serum and liver tissues were significantly decreased (all P < 0.05). Compared to NAFLD model group, the TG, TC, AST and ALT levels of low, middle and high dose luteolin groups were significantly decreased (all P < 0.05), and the MDA, TNF-α and IL-6 levels of serum and liver tissues were significantly decreased (all P < 0.05), and T-SOD and GSH levels of serum and liver tissues were significantly increased (all P < 0.05). The cells number of fatty degeneration in luteolin group was significantly improved as compared with NAFLD model group. Conclusion Luteolin can reduce the deposition of nonalcoholic fatty liver lipids, reduce the degree of oxidative stress and inflammatory reaction, and protect nonalcoholic fatty liver.

Genotyping of carbapenem-resistant Acinetobacter baumannii isolated from hospitalized patients in our hospital

ZHANG Ji-sheng, ZHAO Yong-xin, WANG Ying, WANG Yong, FAN Xue-cai, WANG Yu-chao, ZHANG Xiao-li

2019, 17(1): 25-28. doi: 10.16766/j.cnki.issn.1674-4152.000590

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Objective To explore the distribution of β-Lactamase gene for resistance to β-lactamase antibiotics in Acinetobacter baumannii (A. baumannii) isolated from hospitalized patients in our hospital, and provide a reasonable basis for the clinical selection of antimicrobial drugs. Methods Total 110 strains of A. baumannii collected at the First Affiliated Hospital of Jiamusi University from September 2013 to June 2015 were tested for the bacteria identification and drug susceptibility by using the VITEK-II and Walkway-40 VITEK 2 COMPACT automatic microbiology analyzer. 16S rRNA gene sequencing and multiplex PCR for identification of Ambler class A beta-lactamases were performed. Results The resistant rate of 110 A. baumannii samples to SCF, MEM and IMP were 13.3%, 38.5% and 49.3%, respectively. The Ambler class D beta-lactamases gene were as follows:96 strains of OXA-53, OXA-23 strains (48.18%), 29 strains OXA-24 (26.36%), 6 strains of OXA-58 (5.45%), mainly OXA-51 and OXA-23; metal enzyme B included 1 strain of IMP (0.90%) and 6 strains of SIM (5.45%), 84 strains of ADC (76.36%), 66 strains of TEM (60.00%), 16 strains of GES (14.54%), 8 strains of PER (7.27%), 7 strains of SHV (6.36%), and 5 strains of VEB (4.54%).Among 50 strains of carbapenem-resistant A. baumannii, the detection rate of OXA-23, OXA-51, OXA-24, ADC and TEM were 84.00%, 92.00%, 26.00%, 92.00% and 88.00%, respectively. When compared with carbapenem-sensitive A. baumannii, there was significant difference in the positive of CSAB OXA-23, ADC and TEM gene. Conclusion OXA, Amp C and extended spectrum β-Lactamase may be responsible for the resistance to β-lactamase antibiotics in A. baumannii in our hospital.

Clinical efficacy of Tulobuterol Patch on bronchiolitis in infants

WANG Wen-hui, ZHANG Zhen, PENG Wan-sheng, ZHAO Wu

2019, 17(1): 29-31. doi: 10.16766/j.cnki.issn.1674-4152.000591

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Objective To study the clinical efficacy and safety of Tulobuterol patch (Amiaid) in the treatment of bronchiolitis in infants. Methods The 103 infants with bronchiolitis in Department of Pediatrics of the First Affiliated Hospital of Bengbu Medical College from November 2017 to February 2018 were enrolled into this study, and divided into treatment group (n=52) and control group (n=51) according to the date of the doctor's day. The patients in both groups received atomized inhalation of Budesonide suspension and Reduning injection, and sensitive antibiotics were administrated if combined with bacterial infections. When necessary, oxygen therapy, sedation, controlling cough, dilution phlegm and other symptomatic support treatment were performed. The children in the treatment group received additional tulobuterol patch, while the children in the control group received additional atomized inhalation of Albuterol sulfate inhalation solution. The improvement of clinical performance, hospitalization time and the incidence of severe adverse reactions were compared between the two groups before and after the treatment. Results The effective rate in the treatment group was significantly higher than that in the control group (P < 0.05), and the difference was statistically significant. The time for improvement of the cough, the duration of asthma, the loss of asthma in the lungs, and the length of hospital stay in the treatment group were significantly shorter those in the control group, the difference was statistically significant (all P < 0.05). The incidence and severity of adverse reactions in the treatment group was lower than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion The effect of Tulobuterol patch on the bronchiolitis of infants is significant, with highly secure, convenient and few adverse reaction, and it is worth spreading in clinical practice.

Effect of preoperative oral multivitamin beverage on day surgery for children in ophthalmic department

JIN Yue-xi, JIANG Wan-na, CHEN Hong-fei, WU Wen-xin, JIANG Ai-fen

2019, 17(1): 32-35. doi: 10.16766/j.cnki.issn.1674-4152.000592

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Objective To study the effect of oral multivitamin beverage 2 hours before the anesthesia induction on gastric emptying and postoperative complications in children undergoing ophthalmic day surgery. Methods Total 120 children undergoing the day operation were selected and divided into the liquid fasting group, the glucose group and the multivitamin group (n=40) according to random number table. All patients in the three groups fasted 12 hours before the surgery. The patients in the liquid fasting group did not drink 6 before the anesthesia, The patients in the glucose group was given 10% glucose solution 2 hours before anesthesia, and the patients in the multivitamin group took take orally multivitamin beverage 2 hours before the anesthesia, the volume of liquid was 5 m L/kg bodyweight. The amount of gastric remnants was measured by B ultrasound before taking orally liquid (2 h before operation). Mask acceptability score was carried out immediately before the anesthesia. Ramsay sedation score and CHEOPS pain score were performed between the anesthesia and operation. The levels of blood glucose and insulin were tested before the anesthesia, immediately after the operation and 3 h after the operation. The complications was recorded. Results There were no statistical difference in the sedation score among the three groups (P > 0.05). The mask acceptability score of the multivitamin group was significantly higher than those of the other two groups (all P < 0.05). The CHEOPS pain score of the multivitamin group was significantly lower than those of the other two groups (all P < 0.05). There were no statistical difference in the amount of gastric remnants among the three groups (P > 0.05). In the multivitamin group, the time of restoration of anal exhaust was shorter, and the incidence of nausea and vomiting was lower, as compared with the other two groups. Blood glucose and insulin levels in the glucose group and multivitamin group was significantly higher than that in the liquid fasting group, however, these levels immediately after the operation in the liquid fasting group exceeded the glucose group and multivitamin group, the difference was statistical significant (all P < 0.05). There was no statistically difference in the levels of blood glucose and insulin levels 3 h after the operation and the incidence of complications among the three groups (all P > 0.05). Conclusion For the children undergoing surgery under general anesthesia, oral multivitamin 200 m L at 2 h before anesthesia induction can effectively alleviate the preoperative thirst, anxiety and relieve postoperative nausea, vomiting and other complications, without increasing the risk of reflux and aspiration.

Explore the etiology and pathology of female infertility in different age groups based on syndrome distribution

CHEN Zhi-xu, CHEN Yue, ZHANG Shi-wen, SHEN Ge-ge, CHEN Jian-she

2019, 17(1): 36-38,79. doi: 10.16766/j.cnki.issn.1674-4152.000593

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Objective To explore the etiology and pathology of female infertility and the relationship with age based on syndrome distribution and according to Traditional Chinese Medicine syndromes implying the etiology and pathology. Methods Clinical data of 200 cases of female infertility from the reproductive department of Henan Traditional Chinese Medicine Hospital that diagnosed by deputy chief physician and chief physician were collected during the period from July2016 to December 2016. The distribution of syndromes on the basis of single syndrome as evidence was summed up, the distribution rules of syndromes of female infertility were summarized by descriptive analysis, the etiology and pathology were to explored, and the change of each syndrome in different age groups was clarified. Results There were 296 single syndromes in 200 patients. Kidney yang deficiency syndrome, liver depression syndrome, damp heat syndrome and blood stasis syndrome were the most common syndromes of female infertility, accounting for 31.42%, 23.65%, 21.62% and 14.86% respectively. They accounted for 91.55% of the total. The syndrome was closely related to age and the main syndromes of different ages were different. The main syndromes of 20-29 years old were dampness heat syndrome, kidney yang deficiency syndrome, liver depression syndrome and blood stasis syndrome. The main syndromes of 30-39 years old were kidney yang deficiency syndrome, liver depression syndrome, damp heat syndrome and blood stasis syndrome. The main syndromes of 40-49 years old were kidney yang deficiency syndrome, liver depression syndrome and kidney yin deficiency syndrome. Conclusion Kidney yang deficiency, liver qi stagnation, damp heat accumulation and stagnation of blood stasis are the main pathogenesis of female infertility. Each age group has its different characteristic of etiology and pathology. The pathology characteristic is damp heat accumulation in 20-29 years old, kidney deficiency and stagnation of liver in 30-39 years old and deficiency of kidney yang in 40-49 years old.

Effects of selenium on expression of PPARα, C/EBPα, SREBP-1c and SREBP-2 in simple fatty liver rats

FAN Xiu-qin, YANG Qing, JIN Hang-bin, WANG Ze-jun, WANG Hong-shi

2019, 17(1): 39-43. doi: 10.16766/j.cnki.issn.1674-4152.000594

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Objective To explore the protective effect and mechanism of selenium on rat model of simple fatty liver induced by high-fat diet. Methods A total of 40 SPF SD rats were randomly divided into the normal control group (NC), the model control group (HF), the low-dose group of selenium (L-SE, 0.5 mg/kg) and the high-dose group of selenium (H-SE, 1.0 mg/kg). The effects of selenium on body weight, serum TC, TG, HDL-C, LDL-C, ALT, AST, TC, TG, protein lipase (LPL) and hepatic lipase (HL) activity was recorded. The histopathological changes of liver tissues were observed by HE and oil red O staining, and the average area of fat cells of epididymal fat was calculated. RT-PCR was used to determine the mRNA expression of PPAR relationships, C/EBP relationships, SREBP-1c and SREBP-2 in each group. Results After application of selenium (0.5-1.0 mg/kg), the rat serum TG, LDL-C, ALT, AST and liver index level significantly decreased, and hepatic lipase activity increased significantly. RT-RCR showed that selenium element down-regulated significantly SREBP-1c and C/EBPα mRNA expression, up-regulated the expression of PPAR αm RNA (all P < 0.05), but no obvious effect on the expression of SREBP-2 mRNA. Application of selenium significantly reduced hepatauxe of rats, improved the fatty degeneration of hepatocytes, and inhibited the increase of epididymal adipose tissue. Conclusion Application of selenium can pay an important role in the prevention and treatment of simple fatty liver through correcting dyslipidemia and improving liver function and hepatic steatosis. Its mechanism may be related to the up-regulation of PPARα mRNA expression, down-regulation of C/EBPα and SREBP-1c mRNA expression, and improvement of the activity of hepatic lipase, which can further increase the TG decomposition and lower TG synthesis.

Effect of continuous renal replacement therapy on the third space effect in patients with intra-abdominal hypertension

LIU Dong-zhi, MA Wei-xing, CENG Yan-ping, DING Feng

2019, 17(1): 44-46,62. doi: 10.16766/j.cnki.issn.1674-4152.000595

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Objective To investigate the therapeutic effect of continuous renal replacement therapy (CRRT) in the treatment of third-spacing in patients with intra-abdominal hypertension (IAH). Methods A total of 86 cases of intra-abdominal hypertension with third-space fluid shift facing inclusion criteria in our hospital between April 2015 and Mar 2017 were enrolled and divided into treatment group (43 cases) and control group (43 cases) according to the random number table method. The control group was given routine treatment, while the observation group received additional CRRT based on the routine treatment. The therapeutic effect and the changes of renal function and inflammatory factors were compared between the two groups before and after the treatment. Results The effective rate of the treatment group was 88.4%; in the control group, the effective rate was 69.8%, it was significantly lower than that of the treatment group (P < 0.05); There was no significant difference in serum creatinine (SCr) and blood urea nitrogen (BUN) between the two groups before the treatment (all P > 0.05), 3 days after the treatment. The SCr and BUN parameters of the two groups were significantly lower than those before the treatment (all P < 0.05), and the difference (decrease degree) before and after treatment in the observation group was significantly higher than that in the control group (all P < 0.05); There was no significant difference in the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) between the two groups before treatment (all P > 0.05), 3 days after the treatment, the levels of TNF-α, IL-6 and CRP in the two groups were significantly lower than those before the treatment (all P < 0.05), and the difference (decrease degree) before and after the treatment in the observation group was significantly higher than that in the control group (all P < 0.05); There was no significant difference in intraperitoneal pressure between the two groups before the treatment (P > 0.05), but 3 days after the treatment, the intraperitoneal pressure of the two groups were significantly lower than those before the treatment (P <0.05), and the difference (decrease degree) before and after the treatment in the observation group was significantly higher than that in the control group (P < 0.05). Conclusion CRRT shows dramatic effect in the treatment of intra-abdominal hypertension patients with third spacing fluid, it can effectively reduce cell inflammatory factors and improve renal function.

Clinical efficacy of linezolid in the treatment of pulmonary tuberculosis complicated with severe pneumonia and effects on immune factors and prognosis

PAN Lei, MAO Min-jie, HUANG Xiao-qing, XU Jie-kun, PAN Xiao-hong, QIU Jun-ke, WANG Cai-hong, JI Xiao-bo

2019, 17(1): 47-51. doi: 10.16766/j.cnki.issn.1674-4152.000596

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Objective To explore the clinical efficacy of linezolid in the treatment of pulmonary tuberculosis complicated with severe pneumonia and effects on immune factors and prognosis. Methods From January 2016 to January 2017, 98 patients with pulmonary tuberculosis complicated with severe pneumonia were randomly divided into the control group (49cases) and the observation group (49 cases). On the basis of anti-tuberculosis treatment, the two groups were treated with imipenem cilastatin and imipenem cilastatin combined with linezolid, respectively, both groups were followed up for28 days. The clinical efficacy, bacterial clearance rate, immune function, cytokine levels, prognosis and incidence of adverse reactions were compared between the two groups after treatment. Results The total effective rate of the observation group was significantly higher than that of the control group (89.80% vs. 73.47%, P=0.037), and the bacterial clearance rate of the observation group was significantly higher than that of the control group (79.59% vs. 57.14%, P=0.017). The levels of CD4⁺, CD8⁺, CD4⁺/CD8⁺, Ig A and Ig G in the two groups were significantly higher than those before the treatment (all P < 0.05), and the above indexes in the observation group were higher than those in the control group (all P < 0.05). The levels of IL-6, IL-8 and TNF-α in the two groups were significantly lower than those before the treatment (P < 0.05), and the above indexes in the observation group were significantly lower than those in the control group (all P < 0.001). The survival rate of the observation group was significantly higher than that of the control group (HR=0.360, 95% CI:0.153-0.849, P=0.027); There was no significant difference in the incidence of adverse reactions after treatment between the two groups (12.24% vs. 10.20%, P=0.749). Conclusion Linazolamide can improve clinical efficacy, enhance immune function, reduce serum cytokine levels and improve the survival rate of patients in the treatment of pulmonary tuberculosis with severe pneumonia, and the safety is guaranteed.

A study of postoperative seizures of glioma patients and expression of high mobility group box protein B1 in tissues

WU Hao, JIN Peng-cheng, ZHENG Bu-yi, TONG Ling-yun, ZHANG Chen-hui, ZHU Peng-lei

2019, 17(1): 52-54,58. doi: 10.16766/j.cnki.issn.1674-4152.000597

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Objective To investigate and analyze the clinical features of postoperative seizures of glioma patients and the expression of high mobility group box B1 protein in glioma tissues. Methods One hundred and one cases of glioma with recurrent epileptic seizure, 70 cases of glioma without seizure, 70 cases of epileptic seizure without glioma and 50 cases of cranial decompression in our hospital between January 2013 and June 2017 were enrolled into this study. The clinical pathological factors that affected the expression of HMGB in the glioma patients with epileptic seizure were explored. The expression of HMGB1 in the brain tissues were compared among the four groups. The effects of pathological grade of glioma and the accompanied with epilepsy on the expression of HMGB1 were analyzed. Results The expression of HMGB1 in epileptogenic focus tissues was not obviously related to the gender, age and location of the epileptogenic foci in the Glioma patients with epileptic seizure (all P > 0.05), however, it significantly related to the pathological grade of glioma, episode time and frequency (all P < 0.05). The positive expression of HMGB1 in the glioma group with epilepsy was higher than that in other three groups. In the patients with lower pathological grade glioma, the expression of HMGB1 in glioma patients with epileptic seizure was higher than that in the glioma patients without seizure, the difference was significant (P < 0.05). In the patients with higher pathological grade glioma, there was no significant difference in the expression of HMGB1 between glioma patients with epileptic seizure and without seizure (P > 0.05). Conclusion The expression of HMGB1 in glioma patients with recurrent epileptic seizure is high, which is associated with the histological grade, episode time and seizure frequency. The high expression of HMGB1 may be related to epilepsy, its clinical research value should be paid.

Analysis of the influence factors of neurologic complications associated with endovascular treatment in patients with rupture intracranial aneurysms

SHENTU Hua-song, CHEN Yi-hua, CHENG Zhen-yu, SHAO Lin-hua, ZHENG Long, YU Jian-hua, FU Bin, MAO Gen-jun

2019, 17(1): 55-58. doi: 10.16766/j.cnki.issn.1674-4152.000598

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Objective To analyze the influence factors of neurologic complications associated with endovascular treatment (EVT) in patients with rupture intracranial aneurysms (RIAs) and provide a reference for the clinical treatment of EVT in RIAs patients. Methods A total of 75 cases of RIAs meeting the inclusion criteria in our hospital from Mach 2012 to January 2017 were enrolled into this study. The patients were treated with EVT and followed up for 6 months. According to the neurologic complications after EVT therapy, the patients with EVT associated neurological complications were included in the complication group (n=24), and the patients without the associated complications were included in the uncomplicated group (n=51). The general data (gender, age, hypertension, diabetes, cerebral infarction history, HuntHess classification and CT Fisher classification, etc), aneurysms related indicators (the number of aneurysms, the maximum diameter, position, shape, tumor cyst and aortic arch typing. etc) and EVT treatment (surgical procedures, surgical methods, rupture to embolization time, embolization effect and blood sodium level) were compared between the two groups. The binary logistic was performed to analyze the influence factors of neurologic complications associated with EVT in RIAs patients. Results The hypertension, Hunt-Hess classification, Fisher classification, tumor cyst, wide-necked aneurysm, surgical methods and blood sodium level in uncomplicated group were significantly differences with the complication group (P < 0.05). The main influence factors of neurologic complications in RIAs associated with EVT were the Hunt-Hess classification, surgical methods, tumor cyst and wide-necked aneurysm. Conclusion The Hunt-Hess classification, surgical methods, tumor cyst and wide-necked aneurysm are the influence factors of neurologic complications associated with EVT in RIAs patients.

Analysis of clinical characteristics of ST segment elevation in elderly patients with acute myocarditis

CHEN Shi, HU Xiao-sheng, LIANG Yi

2019, 17(1): 59-62. doi: 10.16766/j.cnki.issn.1674-4152.000599

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Abstract:
Objective To analyze the clinical characteristics of ST segment elevation in elderly patients with acute myocarditis. Methods A retrospective analysis was conducted in 62 patients with acute myocarditis from February 2010 to March 2016 in our hospital. According to electrocardiogram, 34 cases were divided into ST-segment elevation group and28 cases in non-ST segment elevation group. The general situation, clinical manifestation, laboratory examination, echocardiography, coronary angiography, treatment data and adverse events were compared between the two groups. Results Compared with non-ST segment elevation group, the heart rate of ST segment elevation group was higher, and the systolic blood pressure and the diastolic blood pressure of ST segment elevation group were lower (P < 0.05). There were 21 patients with acute fulminant myocarditis in the ST segment elevation group and 9 in the non-ST segment elevation group, the difference was statistically significant (P < 0.05). ST segment elevation group of white blood cell count, peak creatine kinase (CK), creatine kinase isoenzyme MB (CKMB) peak and troponin I (Tn Ⅰ) peak is higher than non-ST segment elevation group, the difference was statistically significant (P < 0.05). Adverse reactions occurred during hospitalization in both groups, among which cardiogenic shock (26.47%), ventricular fibrillation (14.71%) and inpatient mortality (20.59%) in the ST elevation group were higher than those in the non-ST elevation group. Conclusion ST-segment elevation in elderly patients with acute myocarditis acute onset and severe has higher risk than non-ST segment elevation elderly patients with acute myocarditis, should be timely and correctly treatment, the rational application of mechanical adjuvant therapy, can reduce the incidence of adverse reactions.

Effect of thrombolytic therapy on STEMI in patients with acute myocardial infarction and its effect on cardiac function, myocardial necrosis and inflammatory index

XIE Hua-lei, FENG Ze-rui, LYU Zhen-huan, LIU Min, WANG Jia-li, PAN Ling-yun

2019, 17(1): 63-65. doi: 10.16766/j.cnki.issn.1674-4152.000600

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Abstract:
Objective To study the effect of thrombolytic therapy on ACS in patients with acute myocardial infarction and its effect on cardiac function, myocardial necrosis and inflammatory index. Methods Seventy patients with acute myocardial infarction from December 2017 to June 2018 in our hospital emergency department admissions ST elevation cases, thrombolytic therapy for patients, and according to the time of thrombolysis were divided into thrombolysis group 0-1 h, 1-3 h, 3-6 h thrombolysis group, thrombolysis group. The cardiac function, myocardial necrosis and inflammatory index were measured and compared. Results E peak, E/A ratio, LVEF, LVEDD were higher in the 0-1 h thrombolysis group than in the thrombolysis group and the thrombolytic group of 3-6 h in the group from 1 to 3 h, the difference was statistically significant (P < 0.05), and there was a negative correlation between cardiac function and thrombolysis time.The c Tn T, LDH, CK-MB levels of 0 to 1 h thrombolysis group were lower than those of thrombolysis group and thrombolysis group from 1 to 3 h in the group from 3 to 6 h, the difference was statistically significant (P < 0.01). There were positively correlated between the indexes of myocardial cell necrosis and thrombolysis time. The inflammatory factors CRP, TNF, IL-1 levels in 0-1 h thrombolysis group were lower than those in the group of thrombolytic therapy from 1 to 3 h and from 3 to 6 h, the difference was statistically significant (P < 0.01). Inflammatory index was positively correlated with thrombolysis time. Conclusion The shorter the time of thrombolytic therapy, the better the cardiac function of patients after thrombolysis. The less necrosis of myocardial cells, the lower the level of inflammatory response.

Curative effect of endoscopic retrograde cholangiopancreatography on elderly patients with choledocholithiasis and its effect on level of serum CA19-9 and inflammatory

HU Xu-jun, FAN Yan-ping, SHANG Min-jie

2019, 17(1): 66-69. doi: 10.16766/j.cnki.issn.1674-4152.000601

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Abstract:
Objective To investigate the curative effect of endoscopic retrograde cholangiopancreatography (ERCP) on elderly patients with choledocholithiasis and its effect on the levels of serum cancer antigen 19-9 (CA 19-9) and inflammatory. Methods Total 95 elderly patients with choledocholithiasis admitted to Ningbo Second Hospital from March2017 to May 2018 were selected. According to the wishes of the patients and their families, 61 patients underwent ECRP lithotripsy were assigned into the observation group and 34 patients underwent surgical treatment into the control group.The success rate of lithotripsy and the related surgical indicators of the two groups were compared and analyzed. The incidence of complications and changes of serum CA19-9 and inflammatory level before and after operation were observed. Results The success rate of stone extraction was 93.44% in the observation group and 97.05% in the control group.There was no significant difference in the success rate of the two groups (P > 0.05). The operation time, the time lying in bed and the time of hospitalization in the observation group were significantly shorter than those of the control group (all P < 0.05). There was no significant difference between the two groups of anti-infection treatment time, abdominal pain relief time and the general time of jaundice regression (all P > 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P < 0.05). The average levels of serum CA19-9 three days after the operation decreased significantly when compared with that before operation (all P < 0.05), and the serum CA19-9 level three days after the operation in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion ERCP for the elderly choledocholithiasis is an effective method, with small body trauma, faster recovery, less complications, and good success rate of stone removal. It can effectively reduce the level of postoperative inflammation and the level of serum CA19-9. It is worthy of clinical application.

Characteristics and risk factors of postoperative infection in tibial fracture patients after plate fixation

HE Jun, HUANG Bin

2019, 17(1): 70-72. doi: 10.16766/j.cnki.issn.1674-4152.000602

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Abstract:
Objective To investigate the characteristics and risk factors of postoperative infection in tibial fracture patients after plate fixation. Methods A total of 202 patients with tibial fractures treated with plate fixation in our hospital from January 2016 to March 2017 were selected. The patients were divided into infection group (68 cases) and uninfected group (134 cases) according to postoperative infection condition. A risk factor questionnaire was prepared to collect data on risk factors for infection in both groups:age, gender, diabetes, fracture type, anatomical features, surgical timing, surgical methods, postoperative drainage, and antimicrobial agents. Univariate and Logistic regression analysis were used to analyze the collected data. Results In the infection group, a total of 38 pathogens were detected including 24Gram-positive bacteria and 14 Gram-negative bacteria. The detected Gram-positive bacteria included Staphylococcus aureus (41.7%) and Staphylococcus epidermidis (20.8%). Univariate and Logistic regression analysis found that diabetes, fracture type, anatomical characteristics, timing of surgery, surgical methods, postoperative drainage, and antimicrobial agents were the risk factors for infection of tibial fracture patients after plate fixation. Conclusion The patients with tibiofibular fractures after plate fixation develop infection easily, and Staphylococcus aureus and Staphylococcus epidermidis are mainly responsible for the infection. The diabetes, fracture types, anatomical features, surgical timing, surgical methods, postoperative drainage, and antibacterial agents are the risk factors for infection in patients with tibial fractures after plate fixation. The risk factors for infection should be emphasized in clinical work to reduce disability, and promote the early recovery of patients.

Expression and significance of osteoclastogenesis inhibitory factor and osteoclast differentiation factor in patients with osteoporotic vertebral fracture

ZHAN Yun-zhong, YE Zhou, ZHAN Bei-lei, ZHANG Jun-chao

2019, 17(1): 73-75. doi: 10.16766/j.cnki.issn.1674-4152.000603

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Abstract:
Objective To investigate the expression and significance of osteoclastogenesis inhibitory factor (OCIF) and osteoclast differentiation factor (ODF) in patients with osteoporotic vertebral fractures. Methods Total 70 cases of osteoporotic vertebral fractures were selected as osteoporosis group, and 70 cases of non-osteoporotic vertebral fractures were selected as control group in Quzhou People's Hospital from January 2013 to December 2016. The serum levels of OCIF and ODF were tested by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Dual-energy X-ray absorptiometry was used to measure the total L_1-4 bone mineral density in the lumbar spine and left femoral neck. The SPSS20.0 software was used to analyze the data. Results The levels of serum OCIF and ODF in the osteoporosis group were higher than those in the control group (all P < 0.05). The lumbar spine bone mineral density and femoral neck bone mineral density in the osteoporosis group were lower than those in the control group (all P < 0.05). The serum OCIF, ODF in the osteoporosis group were negatively correlated with lumbar spine bone mineral density and femoral neck bone mineral density (all P < 0.05). The serum OCIF and ODF levels in patients with osteoporosis had no significant correlation with the degree of fracture (all P > 0.05). Conclusion The serum OCIF and ODF levels increase obviously in the patients with osteoporotic vertebral fractures, and closely related to the bone mineral density, and not with the severity of the fracture.

Effects of dexmedetomidine on inflammatory response and renal function in Patients with Traumatic Hemorrhagic Shock

JI Ling-zheng, GAO Fang

2019, 17(1): 76-79. doi: 10.16766/j.cnki.issn.1674-4152.000604

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Abstract:
Objective To investigate the effect of dexmedetomidine on inflammatory factors, renal function and hemodynamics in patients with traumatic hemorrhagic shock (THS). Methods A total of 90 patients with THS diagnosed and treated in our hospital from March 2015 to April 2017 were randomly divided into observation group (45 cases) and control group (45 cases) according to the random number table method, the observation group and the control group were given the same amount of dexmedetomidine and normal saline after the induction of anesthesia, the changes of the inflammatory index, renal function and hemodynamics were compared between the two groups before beginning of surgery (T1), immediately after surgery (T2), 1 day after syrgery (T3) and three days after surgery (T4). Results At the time of T2, the levels of inflammatory factors in the two groups were significantly lower than those of T1 (all P < 0.05), at the time of T3, the levels of inflammatory factors in the two groups were significantly higher than those of T1 (all P < 0.05), and the△HMGB1 of the observation group was significantly lower than that of control group (P <0.05); At the time of T2 to T4, the level of the Scr of the two groups were significantly lower than that of T1 (all P < 0.05), and the △Scr of the observation group was significantly higher than that of control group (P < 0.05). At the time of T2, the level of NGAL in the two groups were significantly higher than that of T1 (P < 0.05), at the time of T3 to T4, the level of the NGAL of the two groups were significantly lower than that of T1 and T2 (all P < 0.05), and the △NGAL of the observation group was significantly higher than that of control group (P < 0.05). The improvement of CVP, MAP and HR in the observation group were better than that in the control group (all P < 0.05). Conclusion Dexmedetomidine can significantly reduce the inflammatory response in patients with THS, which is conducive to the recovery of renal function and the stability of hemodynamic level in patients.

Effect of Lucentis assisted vitrectomy on ocular function in patients with proliferative diabetic retinopathy

YU Yan-shu, CHEN Hui, XU Ke-chen, YING Jiong-huan, YU Yuan-wen

2019, 17(1): 80-82. doi: 10.16766/j.cnki.issn.1674-4152.000605

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Abstract:
Objective To investigate the effect of Lucentis assisted vitrectomy on ocular function in patients with proliferative diabetic retinopathy (PDR). Methods A total of 200 patients (271 eyes) with PDR in our hospital from January 2016 to June 2018 were randomly divided into control group (100 cases, 126 eyes) and observation group (100 cases, 145 eyes). The control group was given vitrectomy, and the observation group was added Lucentis one week prior to vitrectomy. The surgical conditions, visual acuity, intraocular pressure, retinal thickness, and complications were compared between the two groups. The data were analyzed by statistical software to investigate the effect of Lucentis assisted vitrectomy on ocular function in patients with proliferative diabetic retinopathy (PDR). Results The operation time (71.8 ±11.4) min, the electrocoagulation hemostasis number (1.14 ±0.53) time, and the retinal tear rate (5.51%) of the observation group were significantly lower than those of the control group[(82.7 ±10.8) min, (1.78 ±0.52) times, 14.29%]. After treatment, the intraocular pressure and visual acuity of the two groups were significantly improved (P <0.05), and the observation group was superior to the control group (P < 0.05). The postoperative complications incidence of observation group was significantly lower than that of the control group (P < 0.05). The patient's complications were recovered after symptomatic treatment. Conclusion Lucentis assisted vitrectomy can effectively reduce the operation time, electrocoagulation number and retinal tear rate in patients with proliferative diabetic retinopathy, effectively improve intraocular pressure and visual acuity, and reduce postoperative complications.

The relationship between hyperhomocysteinemia and cognitive dysfunction in patients with Parkinson's disease

LYU Xiao, LU Xiao-dong

2019, 17(1): 83-86. doi: 10.16766/j.cnki.issn.1674-4152.000606

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Abstract:
Objective To investigate the relationship between homocysteine (Hcy) and cognitive impairment in patients with Parkinson's disease (PD). Methods Total 228 patients with PD admitted to our hospital were enrolled in the study, who were divided into cognitive normal group (78 cases) and mild cognitive impairment group (76 cases) and dementia group (74 cases) according to the results of relevant diagnostic criteria and screening methods, and 70 healthy people from the physical examination center of our hospital as the control group. The general information (gender, age, education level), Hoehn-Yahr grading, duration of illness, other risk factors (hypertension, diabetes, hyperlipidemia), dopasine and pramipexole hydrochloride taking of all patients were collected. Plasma Hcy levels, serum folate and Vit B12 levels were measured, and the Montreal Cognitive Assessment (MoCA) scores were evaluated. Baseline data, plasma Hcy levels, and MoCA scores were compared among the four groups. Results Plasma Hcy levels in the control group, PD cognitive normal group, PD mild cognitive impairment group and PD dementia group increased in turn, and the MoCA scores decreased in turn (P < 0.05). Pearson correlation analysis showed that plasma Hcy level was negatively correlated with MoCA score of PD patients (r=-0.684, P=0.017). Conclusion Plasma Hcy levels were negatively correlated with cognitive impairment in PD patients. The higher the plasma Hcy level, the lower the MoCA score, and the more severe the cognitive dysfunction in PD patients.

Effect of application of preoperative drug intervention on rapid recovery and serum inflammatory factor of total laparoscopic hysterectomy patients

LI Jing, YANG Yang, HAN Bin, ZHANG Shao-hua, ZHOU Xiao-lan

2019, 17(1): 87-90. doi: 10.16766/j.cnki.issn.1674-4152.000607

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Abstract:
Objective To investigate the effect of application of dezocine combined with glucocorticoid on rapid recovery and serum inflammatory factor of total laparoscopic hysterectomy patients. Methods From July 2016 to July 2017 in The first affiliated hospital of Xi' an medical university (School of General Medicine), 50 total laparoscopic hysterectomy patients were involved and randomly divided into experimental group and control group (n=25). Patients in the experimental group were given taking orally with dezocine and glucocorticoid at 2 h before surgery. Patients in the control group were given taking orally with placebo at the same time. After surgery 1, 6, 12 and 24 h to record visual analogue scale of the two groups; To record the first use time of PCIA and the 24 h cumulative usage amount of PCIA drugs of each groups.To record the first time to get out of bed, gut exhaust time, hospitalization time and the incidence of nausea and vomiting of each group. The venous blood when entering the operation room, 2, 4 and 12 h after operation was extracted. The inflammatory factors (IL-6 and TNF-α) in serum were detected by ELISA. Results Compared with the control group, the VAS after surgery 1, 6 h of experimental group were lower than the control group, and the differences were statistically significant (P < 0.05). The first use time of PCIA and the 24 h cumulative usage amount of PCIA drugs of the experimental group were lower (P < 0.05). The first time to get out of bed, gut exhaust time, hospitalization time and the incidence of nausea and vomiting of the experimental group were lower (P < 0.05). The inflammatory factors (IL-6 and TNF-α) in serum of experimental group were lower than the control group (P < 0.05), and all the differences were statistically significant. Conclusion Application of dezocine combined with glucocorticoid could could reduce surgical stress and inflammatory factors, as well as the incidence of adverse reactions after surgery and promote rapid recovery of total laparoscopic hysterectomy patients.

Follow-up study of 1638 cases of induced abortion and the effect of post-abortion care services on contraception after abortion in juveniles

JI Fei, ZHUANG Wen-ming, LI Hui-juan, CAI Jie

2019, 17(1): 91-94. doi: 10.16766/j.cnki.issn.1674-4152.000608

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Abstract:
Objective To analyze the status of induced abortion, and to explore the effect of post-abortion care services on contraception after abortion in juveniles. Methods Patients with an unwanted pregnancy who voluntarily underwent abortion surgery on an outpatient basis of adolescent female between August 2015 to July 2017 before abortion received post abortion care. Analysis was made regarding of adolescent patients with abortion about the general situation, number and risk factors of induced abortion, birth control methods before and after the abortion, the setting rate of contraception, effective contraceptive rate and the rate of continuous utilization of contraceptive method 1, 3 months after operation, etc. Results A total of 1 638 cases were collected, with an average age of (21.83 ±3.67) years old, 15 years old 3 cases (0.18%), 183 cases (11.17%) from 16 to 19 years old, and 1, 452 cases (88.65%) from 20 to 24 years old. Accidental pregnancy among adolescents was due to a failed contraception or non birth control. The implementation success rate of all those teenagers who were treated with PAC abortion was 100.00%, the rate of effective contraception ranged from 1.70% up to 67.33%, and effective birth control method mainly included the compound short-acting oral contraceptives and intrauterine device. The rate of effective contraceptive method decreased in the first and third months of follow-up, with an obvious decrease of oral contraceptive use. A total of 461 cases were lost during the follow-up period, and 10 cases (0.85%) of the 1 177 patients in the follow-up were pregnant again. Conclusion The reason of adolescent accidental pregnancy included no contraception and contraceptive failure. Scientific system of quality PAC (post abortion care) can effectively guide the youth to carry out the appropriate contraception, guarantee the efficiency of contraception, and prevent adolescents' repeated miscarriages, ensuring female adolescents reproductive health.

The relationship between the levels of umbilical cord blood brain-derived neurotrophic factor and the status of nutritional supply in neonate

LIU Qiang, YIN Xu-feng, CHEN Shao-jun, CHEN Quan-jing, LEI Xun-ming

2019, 17(1): 95-97. doi: 10.16766/j.cnki.issn.1674-4152.000609

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Abstract:
Objective To investigate the relationship between the levels of umbilical cord blood brain-derived neurotrophic factor (BDNF) and the status of nutritional supply in neonate. Methods One hundred and sixty low birth weight infants were given intravenous injection and mixed intervention method for gastrointestinal tract, the 30 infants with Eu GR were classified as observation group, and 130 infants with non-EuGR were classified as control group; the status of nutritional supply were given assessment, the levels of umbilical cord blood BDNP and general information were given detection and general information survey. Results The birth gestational age, sex, body weight, body length and head circumference compared between the two groups were not significant difference (all P > 0.05). The incidence of severe infection, hyaline membrane disease, intracranial hemorrhage and other complications in the observation group was 30.0%, so that was 5.4% in the control group, the observation group was significantly higher than that in the control group (P <0.05). The levels of BDNF of the observation group and the control group were (2.56 ±1.21) ng/m L and (3.48 ±0.99) ng/m L, the observation group was significantly lower than that of the control group (P < 0.05). Correlation analysis showed that the Eu GR were significant correlated to the levels of BDNF, birth body weight, severe infection, hyaline membrane disease in the low birth weight infants (all P < 0.05); Logistic regression analysis showed that the low level of BDNF, severe infection, hyaline membrane disease were the main risk factors for the Eu GR in the low birth weight infants (all P < 0.05). Conclusion The nutritional supply in low birth weight infant is more insufficient and has a relatively high incidence of Eu GR, the levels of umbilical cord blood BDNF and nutrient supply conditions have obvious correlation, but also the the risk factors for affecting Eu GR occurrence.

Comparative study of two ventilation methods in the treatment of neonatal respiratory distress syndrome

JIANG Jin-ping, ZHANG Zhi-qun

2019, 17(1): 98-100. doi: 10.16766/j.cnki.issn.1674-4152.000610

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Abstract:
Objective To observe the clinical effect of pulmonary surfactant (PS) combined with nasal continuous positive airway pressure (NCPAP) and pulmonary surfactant combined with nasal intermittent positive pressureventilation (NIPPV) in the treatment of neonatal respiratory distress syndrome (NRDS), so as to accumulate experience and provide reference for the optimization of NRDS treatment. Methods Total 122 children of NRDS in our hospital from July 2016 to December 2017 were selected and randomly divided into group PS combined with NCPAP and PS combined with NIPPV group, each group was treated with 61 cases, blood pH, arterial partial pressure of oxygen (PaO₂), positive end expiratory pressure (PEEP), partial pressure of carbon dioxide (PaCO₂), inhaled oxygen concentration (FiO₂), the incidence of complications, such as air leakage and nasal injury, were compared between the two groups, and the statistical analysis was carried out. Results Comparison of different stages in the group, there were significant differences on 24 h about the two groups after treatment with pH, PaO₂, PEEP, PaCO₂, FiO₂ before treatment (all P < 0.05). Comparing between the two groups, there were significant differences about p H, PaO₂, PEEP, PaCO₂, FiO₂ on 24 h, and the incidence of complications in the PS combined NIPPV group was lower than that in the PS combined NCPAP group. Conclusion PS combined with NIPPV and NCPAP can help to improve the arterial blood gas related indexes of children with NRDS, and can effectively reduce the incidence of complications. In comparison, the clinical efficacy of PS combined with NIPPV is more ideal.

Analysis of risk factors for colorectal cancer with TCM physical identification in a community of Shanghai

LI Lun, LI Ying, TANG Yi-yun, LI Qi, YANG Yan-qing

2019, 17(1): 101-103,107. doi: 10.16766/j.cnki.issn.1674-4152.000611

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Abstract:
Objective To study the current situation of the risk factors of colorectal cancer and the distribution of the TCM physique type in high risk population of colorectal cancer in the community. Methods A survey of residents aged 50-74 years in Puxing community in Shanghai, using questionnaire survey and fecal occult blood test (FOBT) screening, the high-risk population were analyzed to determine the TCM physical identification and follow-up colonoscopy results. Results A total of 4 136 people completed the screening, 1 102 were judged to be high risk population, and the positive rate was 26.64% (95% CI:25.30%-27.99%), The results of FOBT were positive in 1 006 people, accounting for 24.90% (95% CI:23.57%-26.23%). And 228 people were screened for follow-up, and the compliance rate of colonoscopy was 20.69% (228/1102). The detection rate of colonic polyps was 24.56% (56/228), and the detection rate of colorectal cancer was 1.31% (3/228). The results of TCM physical identification showed that the gentle type was in the highest level of 418 people (37.9%), the biased constitution was mainly in phlegm dampness type 319 people (28.9%), qi deficiency type 142 people (12.8%), and Yang deficiency type 106 people (9.6%). Conclusion High risk population of colorectal cancer is in a higher level among middle-and-old-aged people, the results of colonoscopy is mainly polyps, and the TCM physical identification is mainly gentle type. It is suggested that the high-risk population of colorectal cancer in middle and old aged people has higher concealment, so it is necessary to carry out colorectal cancer screening. The biased constitution was mainly in phlegm dampness type, qi deficiency type, and Yang deficiency type. It shows that the middle-and-old-aged people should pay high attention to the early prevention and treatment of colorectal cancer. The TCM intervene can start with strengthening spleen, replenishing qi and warming Yang.

Research on the correlation between the AIP and CAS in the middle-aged and the elderly in the community and on the risk factors

XU Bei-zheng, YU Jian-kang, HUANG Xin-mei, FU Ming-wei, WEI Jun-ling

2019, 17(1): 104-107. doi: 10.16766/j.cnki.issn.1674-4152.000612

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Abstract:
Objective This research mainly aims to explore the correlation between the atherogenic index of plasma (AIP) and carotid arteriosclerosis (CAS) in the middle-aged and the elderly in the community, and to study various risk factors of CAS. Methods A total of 835 middle-aged and aged people (> 45 years old) were collected from those accepted physical examination in the community health service center, including 255 cases diagnosed with CAS by the carotid artery color Doppler flow imaging as the case group, while 321 cases without CAS as the control group. Two groups of subjects were given routine inspections such as blood lipid, liver function and renal function, blood glucose, and blood pressure examination, and abdominal B ultrasound. And the patients also filled the questionnaires and recorded the health of the objects. Results There were statistical differences between CAS group and the control group in BMI, blood pressure, fasting blood glucose, uric acid, etc. AIP index of the CAS group was significantly higher than that of normal control group. Via 18 sets of questionnaire survey, 7 factors showed statistical differences (all P < 0.05), namely history of fatty liver (OR=2.337), history of hyperlipidemia (OR=4.572), BMI > 24 (OR=2.801), history of diabetes (OR=11.133), daily vegetable consumption ≤ 500 g (OR=3.095), history of hypertension (OR=3.421), and regular exercise (OR=0.076), where regular exercise as the protection factor. Conclusion Our research results show that AIP is closely related with CAS in the middle-aged and the elderly in the community and AIP can be used for the measurement of LDL-C diameter and can effectively predict atherosclerosis. Carotid atherosclerosis is also associated with hypertension, diabetes, BMI, and lifestyle.

An analysis on the effect of health education for cardiovascular and cerebrovascular diseases

HU Jian-ping, WANG Bing

2019, 17(1): 108-110,136. doi: 10.16766/j.cnki.issn.1674-4152.000613

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Abstract:
Objective Via health education intervention in patients with cardiovascular and cerebrovascular disease, we aim to analyze and evaluate the effect of health education for prevention of cardiovascular disease. Methods We selected 120 patients with disease of heart head blood-vessel as the research object from February 2014 to March 2015 within the area under the administration, and randomly divided them into control group and experimental group, with each 60 cases in each group. The control group was given general treatment method combined with basic health education, on the basis of which the experimental group was provided with health knowledge education, psychological counseling, and exercise therapy, together with guidelines for healthy diet, medications, family health education and treatment of complications, which constituted a comprehensive health education intervention. Real-time observation of two groups of patients was made in the process of treatment. Results With comprehensive health education and intervention on the patients, as well as knowledge test, we obtained the corresponding results. The health knowledge rate of experimental group was 96.7%, and the incidence of complications was 3.3%. For the control group, related knowledge rate was 71.7%, and the incidence of complications was 21.7%. There was significant difference (P < 0.05). Conclusion Via education intervention measures such as knowledge training, psychological intervention, diet guidance, medication guide, sports quality, family health education and so on, the patients greatly improved their knowledge in cardiovascular and cerebrovascular diseases, changed the wrong life habits, and developed a healthy way of living. Especially by comparison, the two groups fully illustrates that the health education for prevention of cardiovascular disease has significant effect, which is worth promoting in the daily life and intervention.

Effect analysis of Xiashi Shuimian Yihao on depressive sleep disorder with deficiency syndrome

ZHU Gui-dong, WANG Ying, WU Lei, XU Wei-jie, CAO Jiang, XIA Chao-yun

2019, 17(1): 111-113. doi: 10.16766/j.cnki.issn.1674-4152.000614

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Abstract:
Objective To investigate the clinical effect of Xiashi Shuimian Yihao on depressive sleep disorder with deficiency syndrome and its effect on serotonin (5-HT) and norepinephrine (NE). Methods A total of 120 patients with depressive sleep disorder diagnosed as deficient syndrome of TCM in our hospital from December 2016 to December 2017 were divided into two groups by random number method, with 60 cases in each group. The control group was treated with fluoxetine hydrochloride capsules, and the observation group was treated with Xiashi Shuimian Yihao based on the control group. After treatment, Hamilton Depression Scale (HAMD) score, Ascension Insomnia Scale (AIS) score, serum5-HT, serum NE level, adverse reactions (dizziness headache, nausea, loss of appetite, dry mouth), and effect of two groups were compared. Results Total effective rate of observation group (88.33%) was significantly higher than that of the control group (68.33%, P < 0.05). After treatment, the HAMD and AIS scores of the two groups were significantly lower (all P < 0.05), the HAMD and AIS scores of observation group was lower than control group (all P < 0.05). After treatment, serum 5-HT and NE levels were significantly increased in the two groups (all P < 0.05), and serum 5-HT and NE levels of observation group was significantly higher than the control group (all P < 0.05). The adverse incidence of observation group (18.33%) was significantly lower than control group (41.67%, P < 0.05). Conclusion Xiashi Shuimian Yihao could effectively treat depressive sleep disorder with deficiency syndrome, alleviate the symptoms of insomnia and reduce the adverse reactions. The mechanism may be related to its upregulation of serum serotonin and norepinephrine.

Results and epidemiological analysis of stool rotavirus and adenovirus in children with diarrhea by latex chromatography

DAI Mu-gen, YANG Shang-wen, WANG Jian-bo, LIAN Qing-wu, FU Li-xia, YE Bin

2019, 17(1): 114-116. doi: 10.16766/j.cnki.issn.1674-4152.000615

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Abstract:
Objective To investigate the infection and epidemiological characteristics of rotavirus (RV) and adenovirus (Adv) in babies with diarrhea in Lishui. Methods The 1 133 cases of feces form children with diarrhea were collected from January to December 2016 in Zhejiang University Lishui hospital, and immunochromatography technique was used to diagnose RV and Adv antigens in feces of children, and the results were statistically analyzed. Results Among the 1 133 cases of diarrhea, 222 cases of rotavirus were detected, the infection rate was 19.59%. The adenovirus was 23 cases, the infection rate was 2.03%, and there were 17 cases coinfection of rotavirus and adenovirus, the infection rate was 1.5%. In male patients, the positive rate of rotavirus infection was 20.18% (134/664), the adenovirus was 2.79% (18/664), and double infection was 1.96% (13/664). In female patients, the positive rate of RV, adenovirus and double infection were18.76% (88/469), 1.07% (5/469) and 0.85% (4/469), respectively. There was no significant difference in the positive rate of gender (P > 0.05). The positive rate of rotavirus decreased with the age increase (P < 0.01). The highest positive rate of rotavirus in children was 6 to 12 months. The highest incidence of rotavirus infection in this region from November to next year February, a total of 144 cases were positive, accounting for 64.86% (χ²=57.745, P < 0.001); high incidence of adenovirus infection in May to June, 14 cases were positive, accounting for 60.86% (χ²=113.900, P < 0.001).The highest incidence of rotavirus and adenovirus double infection was from December to January of the following year, of which 12 cases were positive, accounting for 70.58% (χ²=24.852, P < 0.001). Conclusion Rotaviruses are the main pathogens for children with diarrhea in the region, and the onset of virus infection has obvious seasonal change. In particular, paying attention to infants and young children with diarrhea infection with rotavirus and adenovirus, select a fast and accurate diagnostic method for clinical diagnosis and treatment are necessary.

Etiological analysis of nosocomial infections in acute leukemia and expression of HIF-1α, VEGF and Bcl-2 in marrow tissues

FAN Xian-bin, XU Zhi, SHAO Shui-er, WANG Wen-song

2019, 17(1): 117-120. doi: 10.16766/j.cnki.issn.1674-4152.000616

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Objective To investigate the etiological characteristics of nosocomial infection in patients with acute leukemia and the expression of hypoxia inducible factor 1α (HIF-1α), vascular endothelial growth factor (VEGF) and B cell lymphoma/leukemia-2 (Bcl-2) in the bone marrow tissues of acute leukemia patients. Methods Total 171 cases of acute leukemia treated in our hospital between January 2014 and December 2017 were selected, and the incidence of nosocomial infection, the distribution of pathogenic bacteria and the drug resistance of the main pathogens were analyzed. The pathological sections of the bone marrow were taken for immunohistochemical staining to detect the expressions of HIF-1α, VEGF and Bcl-2, and the mean optical density was used for quantitative analysis. Results Among the 171 patients, 54 cases had nosocomial infection, with a rate of 31.58%. Of the 54 nosocomial infections, respiratory tract, oral cavity and gastrointestinal tract were the main type of infections, accounting for 35.19%, 24.07% and 16.67%, respectively; There were 71 strains of pathogenic bacteria isolated from 54 patients with nosocomial infection, including 39 strains of Gram-negative bacteria (54.93%), 15 strains of Klebsiella pneumoniae (21.13%), 12 strains of Staphylococcus aureus (16.90%), 10 strains of Pseudomonas aeruginosa (14.08%) and 9 strains of coagulase-negative Staphylococcus (12.68%). Among the main gram-negative bacteria, Klebsiella pneumoniae had a high resistance rate to cefoperazone (53.33%) and Pseudomonas aeruginosa had a high resistance rate to piperacillin (60.00%). Among the Gram-positive bacteria, Staphylococcus aureus had a high resistance rate to erythromycin (75.00%) and coagulase-negative Staphylococcus had a high resistance rate to erythromycin (66.67%). The average optical density of HIF-1α and VEGF in bone marrow tissue of the infected group was higher than that of the uninfected group, while the average optical density of Bcl-2 was lower than that of the uninfected group (all P < 0.05). Conclusion The incidence of nosocomial infection in patients with acute leukemia is high.The pathogenic bacteria are mainly Gram-negative bacteria, and HIF-1α, VEGF and Bcl-2 are highly expressed in the bone marrow tissues of the infected patients, which is of great significance.

The research progress of chronic disease management mode applied to the cancer management in the community

YANG Sen, ZHAO Hua-xin, JIN Hua, LU Yuan, ZHANG Bin, GE Xu-hua, ZHANG Han-zhi, LIU Ye, YU De-hua

2019, 17(1): 121-124,128. doi: 10.16766/j.cnki.issn.1674-4152.000617

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Abstract:
With the aging of population as well as the increase of residents' living pressure and the environmental pollution and other reasons, the incidence and mortality of malignant tumors have been rising year by year, which has become one of the major health problems facing the society today. Current cancer research has been included in the study of community chronic disease management. Positive and effective chronic disease management model will help reduce cancer morbidity and mortality. Community is an important place for people's daily life, social activities and maintaining their own health. It is the basic unit of health service. Carrying out publicity and education on cancer prevention and treatment knowledge, promoting the popularization of community cancer prevention knowledge, enabling community residents to actively participate in the implementation of cancer prevention programs have a positive effect on the success of cancer prevention and treatment work in the community. Community-based study of chronic disease management on malignant tumors lays a foundation for accurately determining the incidences, mortalities and their trends, assessing the burden of cancer in our society, exploring the cause of disease and its evolutionary pattern, and building a foundation for targeted disease prevention and evaluation. Currently researchers around the country have been actively exploring the community malignant chronic disease management. The main measures include cancer patients in health management, health education, cancer and other cancer screening and monitoring. This article reviews the domestic and international models of chronic disease management, the status quo of chronic disease management in domestic malignant tumors and the existing problems in community cancer disease management.

The research progress of patient transitional care after laryngeal cancer

LIU Jie, TIAN Jun, WANG Bin-quan, FENG Xiang, ZHAN Yang-ni, GUO Jue, JIA Yue, GUO Rui

2019, 17(1): 125-128. doi: 10.16766/j.cnki.issn.1674-4152.000618

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Laryngeal cancer is a common malignant tumor in head and neck tumors, with increasing morbidity in recent years. Surgery is one of the main treatment methods for patients with laryngeal cancer, and patients who are discharged after surgery often need long-term and life-long treatment and care. Transitional care aims for the needs of discharged patients providing health care services with continuity, reliability, security, usually including continuous follow-up and guidance for patients after returning to the family or community. Transitional care after discharge may be an effective strategy to help patients with laryngeal cancer adapt to postoperative functional changes, prevent complications and improve their quality of life. This review starts from "continuity care for special physiological and psychological changes of postoperative laryngeal cancer, and social development putting forward clear requirements for continuity of care" two aspects this paper expounds the necessity of postoperative patients with laryngeal cancer implementation of continuity of care; followed by "the postoperative patients with laryngeal cancer continuity of care" the main content and main ways both postoperative patients with laryngeal cancer were summarized the present situation of the continuity of care, and to assess the effect on the implementation of the clear display; finally, based on the comprehensive evaluation on the continuity of the postoperative patients with laryngeal cancer care, it points out the shortages existing in the implementation process, analyzes the domestic and foreign current study laryngeal cancer continuity care which is short, because the patient's care needs are not being adequately express and patients with laryngeal cancer after discharge from the hospital have a wide range of content, professional, complex operation, and a large amount of manpower and material resources.These analyses helps to guide the medical staff to actively carry out relevant research based on health status in China and advanced experience abroad, in order to further improve the quality of life in patients with laryngeal cancer in the future.

Anal fissure treated by anal canal dilataltion plus demibain using traditional Chinese medicine in senior patients

MA Jing, ZHENG Chen-guo, ZHENG A-fen, HUANG Chong-jie

2019, 17(1): 129-131. doi: 10.16766/j.cnki.issn.1674-4152.000619

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Objective To explore the effect of anal canal dilataltion plus demibain using traditional Chinese medicine in treatment of anal fissure. Methods A total of 110 patients diagnosed as anal fissure and met standard were collected in March 2015 to March 2017 in our hospital. They were randomly divided into two groups:the experimental group (n=55) and the control group (n=55). General information such as gender, age and cause of disease of the two groups showed no significant differences (P > 0.05). The patients of control group received anal canal dilataltion 2 times a day.Long-acting analgesic was injected subcutaneously after anal dilatation. After defecation, the patients were washed with 1500 m L 1:5 000 potassium ferrate solution, 15-30 minutes each time for 1 month. The patients of experimental group received demibain using TCM on the basis of the control group once a day after stool, 15-30 minutes each time for1 month. The therapeutic effect, NRS score, wound healing time, complications and recurrence rate of two groups were compared. Results Total effective rate of experimental group and control group were 96.36% and 74.55%, and the difference was statistically significant (P < 0.05). The NRS score and wound healing time in the experimental group were significantly lower than those in the control group after treatment (P < 0.05). Complication rate of experimental group and control group were 3.64% and 20.00%, and the difference was statistically significant (P < 0.05). One-year follow-up showed that recurrence rate of experimental group and control group were 3.64% and 27.27%, and the difference was statistically significant (P < 0.05). Conclusion Anal canal dilataltion plus demibain using TCM could alleviate pain symptoms of elderly patients with anal fissure, accelerate wound healing, reduce recurrence rate, and improve prognosis.It was worthy to be promoted due to high safety and efficacy.

Application of teacher standardized patient teaching method in nursing basic teaching in Secondary Vocational Schools

WEI Fang, WANG Qu-nan

2019, 17(1): 132-136. doi: 10.16766/j.cnki.issn.1674-4152.000620

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Objective To explore the effect of teacher standardized patient teaching method on cultivating nursing students' professional skills and professional accomplishment in the teaching of Basic Nursing Science in secondary vocational schools. Methods Classes 1 and 2 of nursing sophomores in 21 secondary vocational schools were selected in a cluster. And 54 students in Class 1 were selected as the teaching group of standardized patients. Teachers standardized patients were added to the teaching group and case introduction, situational performance, evaluation feedback, consolidation summary and practice were carried out by means of simulation and multimedia. And 46 students in Class 2 were in the traditional teaching group. They are taught in theory-teacher 's Teaching-group practice mode. After the end of teaching, comprehensive examination and teaching satisfaction survey were conducted. The results were compared with t test and P < 0.05 was statistically significant. Satisfaction survey was conducted by two groups of students to evaluate the two teaching methods from five aspects:stimulating learning interest, improving critical thinking ability, improving the ability to solve nursing problems, improving language communication ability, and strengthening the concept of love and injury. Satisfaction was the percentage of students in the total number of students. Qualitative data were described by rate.Rank sum test was used to compare the differences (α=0.05). Results The total score of standardized patient teaching group was 85.72 ±4.62, which was significantly different from that of traditional group. Teachers'standardized patient teaching method is helpful to stimulate learning interest, improve critical thinking ability and ability to solve nursing problems, improve language communication ability and strengthen the concept of love and injury. Conclusion Teachers'standardized patient teaching method has achieved good results in improving students' professional knowledge, skills and professional quality. We should make proper use of teachers'standardized patients and explore the complementarity between teachers'standardized patients and other teaching methods in order to achieve better teaching results.

Study of the application of case-led seminar teaching pattern in surgical nursing

YING Ying, WANG Guan-fu, LIN Li-jun

2019, 17(1): 137-140. doi: 10.16766/j.cnki.issn.1674-4152.000621

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Objective To explore the effect of case-led seminar teaching pattern on surgical nursing teaching, and to accumulate experience for reforming nursing teaching mode and optimizing nursing teaching effect. Methods The subjects were divided into control group and experimental group with 65 people in each group. There was no significant difference in basic information between the two groups (all P > 0.05). The control group adopted traditional nursing teaching method, and conducted theoretical teaching and operation demonstration with teachers as the leading factor. The experimental group adopts case-led seminar teaching pattern. In the pre-class stage, the teachers integrate the teaching content, determine the topic of discussion, set specific scenarios, and compile typical teaching cases; in the classroom stage, teachers introduce the theme while students report and discuss; in post-class stage, teachers summarize and improve the teaching effect. At the end of the course, the scores of professional theory examination, critical thinking ability and autonomous learning ability were compared between the two groups. All the data were analyzed by SPSS 22.0. Results The test scores of the experimental group were better than those of the control group (P < 0.05). The scores of truth-seeking, analytical ability, critical thinking self-confidence, curiosity and cognitive maturity in the experimental group were higher than those in the control group (all P < 0.05). Conclusion Seminar teaching mode guided by cases can improve the theoretical examination results of surgical nursing of nursing students, and can promote their critical thinking ability and self-learning ability.

The level change of FIB, HbA1c in acute cerebral infarction aged patients with different cognitive functions and their correlation with cognitive function

YU Liang, GU Da-dong, YANG Yue, ZHAO Ke, FU Jiang, FU Feng

2019, 17(1): 141-143. doi: 10.16766/j.cnki.issn.1674-4152.000622

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Objective To explore the level change of fibrinogen (FIB), glycosylated hemoglobin (Hb A1c) in acute cerebral infarction aged patients with different cognitive functions and their correlation with cognitive function. Methods A total of 237 acute cerebral infarction aged patients in our hospital were selected from March 2017 to June 2017. There were 114 cases in normal cognition group and 123 cases in cognitive dysfunction group according to the Montreal cognitive assessment scale (MoCA) score. The level of FIB and Hb A1c and the cognitive situation were compared between the two groups, and the relationship between FIB, Hb A1c and cognition were analyzed. Results The level of FIB and Hb A1c in the cognitive impairment group was significantly higher than those in the normal group (P < 0.05). The naming, language, attention and calculation, abstract thinking, visual-spatial and executive ability, delayed recall, and directional score in normal group was (2.75 ±0.21) points, (2.61 ±0.52) points, (5.63 ±0.29) points, (1.68 ±0.31) points, (4.17 ±0.76) points, (4.52 ±0.36) points, (5.28 ±0.54) points, respectively, the naming, language, attention and calculation, abstract thinking, visual-spatial and executive ability, delayed recall, and directional score in cognitive dysfunction group was (2.26 ±0.31) points, (1.57 ±0.48) points, (3.04 ±0.38) points, (1.19 ±0.36) points, (3.28 ±0.37) points, (2.38 ±0.31) points, (5.03 ±0.46) points, respectively, the naming, language, attention and calculation force, abstract thinking, visual space and executive ability, delayed recall and directional cognition of the cognitive dysfunction group were significantly lower than the normal group (all P < 0.05). FIB and Hb A1c were negatively correlated with naming, language, attention and computational power, visual space and executive ability, delayed recall, and total score of MoCA (all P < 0.05), but there is no correlation with abstract thinking and orientation (all P >0.05). Conclusion The level of FIB and Hb A1c can reflect the cognitive function of acute cerebral infarction aged patients, and they can be used as a basis for evaluating the progression of senile acute cerebral infarction.

Study on the status of self-perceived burden and its influencing factors in patients with head and neck tumor for radiotherapy

JIANG Hua-li, YANG Cheng, WENG Fen-nyu, SONG Yu-lan

2019, 17(1): 144-146,153. doi: 10.16766/j.cnki.issn.1674-4152.000623

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Objective To describe the status of self-perceived burden and analyze its influencing factors among the patients with head and neck tumor for radiotherapy, providing for a scientific basis to alleviate the psychological pressure and improve patients' quality of life. Methods From October 2016 to August 2017, a total of 108 hospitalized patients with head and neck tumor for radiotherapy were investigated by the Self-Perceived Burden Scale and the self-designed general scale, and analyzed by using univariate and multivariate to determine the influencing factors of patients with head and neck tumor for radiotherapy. To ensure the survey is rigorous and scientific, we took uniform training. Results The total score of the SPB was (33.35 ±6.34) points, 56.5% of patients were at a moderate level. Among them, the top three were worried that caregivers spend a lot of money worrying about the caregiver's health due to taking care of me, and worrying that the caregivers were overburdened by taking care of me. Univariate and multiple linear regression analysis showed that gender, marriage, personality, education level, the number of radiotherapy, radiotherapy response, and concurrent with chemotherapy were the factors influencing factors of SPB (P < 0.05). Conclusion The SPB of head and neck cancer patients with radiotherapy is at a moderate level. To reduce the burden of patients with self-perception and improve their quality of life, we should focus on the SPB of patients with radiation therapy, according to the patient's gender, marriage, personality, education level, radiotherapy and other related factors to take targeted care intervention.

Effect of Internet-based Home Continuous Care on Blood Sugar and Quality of Life in Diabetic Patients

YE Li-xia, SHENG Zhi-ren, CHOU Chun-bo, CHEN Jie, REN Xue-qiong

2019, 17(1): 147-149,163. doi: 10.16766/j.cnki.issn.1674-4152.000624

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Objective To explore the value of Internet-based home care for diabetic patients in diabetes community care. Methods A total of 156 patients diagnosed with diabetes in our hospital from October 2016 to October 2017 were enrolled. The patients were divided into two groups according to the random number method, with 78 patients in each group. The control group received routine care, and the observation group performed Internet-based home continuity care, both of which were treated for 6 months. After the care, the changes of blood glucose (FBG, PBG, Hb A1c), treatment adherence (drug compliance, diet control, exercise, blood glucose monitoring, foot care) and changes in quality of life (physiological, physiological, health, physical pain, social function, energy, mental health, emotional function) were compared between the two groups. Results After treatment, the levels of FBG, PBG and Hb A1c in the two groups were significantly lower (all P < 0.05), and the observation group was significantly lower than the control group (all P <0.05). After nursing, the drug compliance, diet control, exercise, blood glucose monitoring, foot care and self-management scores of the two groups were significantly increased (all P < 0.05), and the observation group was significantly higher than the control group (all P < 0.05). After nursing, the scores of physiological function, physiological function, health status, physical pain, social function, energy, mental health and emotional function of the two groups were significantly increased (all P < 0.05), and the observation group was significantly higher than the control group (all P <0.05). Conclusion Internet-based home continuity care has a clear curative effect in diabetes community care, which can improve the patient's glycemic control effect and treatment compliance, improve the patient's quality of life, and is worthy of promotion and application.

Application of multidisciplinary collaborative nursing mode in Alzheimer's disease

TANG Chun-xia, CHEN Zhe-li, XU Chun-yun

2019, 17(1): 150-153. doi: 10.16766/j.cnki.issn.1674-4152.000625

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Objective To explore the application of multidisciplinary collaborative nursing model in Alzheimer's disease. Methods A total of 100 patients with Alzheimer's disease received in our hospital from January 2017 to January 2018 were randomly divided into routine group and multidisciplinary group with 50 cases in each group. The routine group received routine nursing care, and the multidisciplinary group received multidisciplinary cooperative nursing treatment. The patients were given mini-mental state examination before and after receiving nursing care. The scores of MMSE and ADAS-cog were compared between the two groups, and the quality of life and nursing satisfaction were evaluated. Results After nursing, the MMSE score of multidisciplinary group was higher than that of routine group, with statistical difference (P < 0.05); after nursing, the ADAS-cog score of multidisciplinary group was lower than that of routine group, with statistical difference (P <0.05). After nursing, the scores of quality of life in multidisciplinary group were higher than those in routine group, with statistical difference (P < 0.05). After nursing, the total recovery rate of multidisciplinary group was 86.00%, which was significantly higher than that of conventional group (64.00%, P < 0.05). The total satisfaction rate of multidisciplinary group was 94.00%, which was significantly higher than that of routine group (78.00%, P < 0.05). Conclusion Multidisciplinary collaborative nursing therapy can effectively improve the clinical symptoms of patients with Alzheimer's disease, improve the quality of life of patients, and help patients with early rehabilitation.

Risk factors analysis and nursing strategies of bronchiectasis secondary pulmonary fungal infection

SHAO Wei-ying, CHEN Yu

2019, 17(1): 154-156. doi: 10.16766/j.cnki.issn.1674-4152.000626

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Objective To investigate the risk factors and nursing strategies of bronchiectasis secondary pulmonary fungal infection. Methods A total of 74 patients with bronchodilator secondary pulmonary fungal infection in our hospital from March 2016 to April 2018 were selected as fungal infection group, and 118 patients with bronchiectasis non-common pulmonary fungal infection were selected as non-fungal infections group. The age, sex, combined basic lung disease, hospital time, diabetes, hypoproteinemia, respiratory failure, antibiotic using time, long-term use of glucocorticoids of two groups were accounted, and univariate and logistic regression analysis were used to investigate the risk factors. Results Univariate results showed that age, combined pulmonary basic disease, hospital time, diabetes, hypoproteinemia, antibiotic using time, respiratory failure, long-term use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection, and logistic regression analysis showed that age, combined pulmonary basic disease, hospital time, diabetes, hypoproteinemia, antibiotic using time, respiratory failure, long-term use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection. Conclusion Age, combined pulmonary basic disease, hospital time, diabetes, hypoproteinemia, antibiotic using time, respiratory failure, longterm use of glucocorticoids were the risk factors of patients with bronchiectasis secondary pulmonary fungal infection. So risk factors should receive attention, and treatment and nursing should be carried out to prevent fungal infections.

Effect of comprehensive nursing intervention on psychological state and immunity of patients with cervical cancer and depression

YAO Jiao-xian, ZHOU Ying, CHEN Fang-jian, ZHU Xia-jun, XU Shun

2019, 17(1): 157-160. doi: 10.16766/j.cnki.issn.1674-4152.000627

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Objective To investigate the effect of comprehensive nursing intervention on psychological state and immunity of patients with cervical cancer and depression. Methods A total of 152 patients with cervical cancer and depression from December 2016 to December 2017 were randomly divided into two groups, with 76 cases in each group. The control group received routine nursing and the observation group received comprehensive nursing intervention. Before and after nursing, the depression status (SDS score, SAS score), life quality (GQOLI-74 score), immune status (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺) and serum inflammatory factors (TNF-α, IL-6 and IL-10) of two groups were compared. Results After nursing, the SDS and SAS scores of two groups significantly reduced (all P < 0.05), and observation group was significantly lower than control group (all P < 0.05). After nursing, the levels of CD3⁺, CD4⁺and CD4⁺/CD8⁺ of two groups were significantly increased (all P < 0.05), and observation group was significantly higher than control group (all P < 0.05). The CD8⁺ levels of two groups were significantly reduced (P < 0.05), and observation group was significantly lower than control group (P < 0.05). After nursing, the body function dimension, social function dimension, psychological function dimension and material life dimension score of the two groups significantly increased (all P <0.05), and observation group was significantly higher than control group (all P < 0.05). The TNF-α, IL-6 and IL-10 levels of two groups significantly reduced (all P < 0.05), and observation group was significantly lower than control group (all P < 0.05). Conclusion Comprehensive nursing intervention could improve the depression status immunity, life quality and body's inflammation levels of patients with cervical cancer.

2019, 17(1): 161-163. doi: 10.16766/j.cnki.issn.1674-4152.000628

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2019, 17(1): 164-166. doi: 10.16766/j.cnki.issn.1674-4152.000629

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About Journal

2019 Vol. 17, No. 1

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