2019 Vol. 17, No. 11

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The development and prospect of chinese general practice since the founding of new China 70 years ago
YU Xiao-song
2019, 17(11): 1797-1799. doi: 10.16766/j.cnki.issn.1674-4152.001058
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As a secondary clinical discipline, General Practice was born in the late 1960s and originated from modern general medicine internationally. Since the late 1980s, with the rapid development of the social economy of China, the continuous improvement of people's living standards and the increasing demands on health of urban and rural residents, General Practice has been established formally and has developed considerably in mainland China as the result of the strong promotion of the Chinese government, the active efforts from experts in General Practice and other disciplines, and the broad support from the whole society. In this article, we introduce the development history of General Practice in mainland China, with emphasis on the achievements of the development of General Practice in the past 30 years. Finally, we elaborate the challenges General Practice faces and put forward six suggestions for the future development of General Practice in the light of the people's needs for health and the national strategic requirements of health China, aiming to discuss with our readers how to further strengthen the discipline construction of General Practice, to perfect the community-level medical and health service system, to improve the service level of general practitioners, and to embark on a new journey comprehensively for the development of General Practice.
XIA Heng-lei, ZHOU Zhi-ming
2019, 17(11): 1800-1801.
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Clinical evaluation of three-dimensional conformal intensity modulated radiotherapy for colorectal cancer oligometastases
YING Qiao-ling, HE Ze-lai, GUO Shu-nan, DING Jian-ming, WANG Geng-ming, ZHANG Ya-jun
2019, 17(11): 1802-1805. doi: 10.16766/j.cnki.issn.1674-4152.001059
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Objective To assess the efficacy and the safety treated by radiotherapy for colorectal cancer (CRC) oligometastases. Methods CRC oligometastases treated with radiotherapy in our cancer center between January 2012 and December 2016 were included for clinical review. After follow-up and observation, survival analysis was conducted to evaluate the efficacy and safety of oligometastases in patients with colorectal cancer. Results In this study, 48 patients with colorectal cancer oligometastases were enrolled, and the number of metastases receiving radiotherapy was 88. The proportion of lung metastasis and liver metastasis was 45.83% and 29.17%, respectively. There were 26 cases (54.17%) of recurrence and metastasis after treatment, 22 cases (45.83%) occurred in the initial diagnosis of the disease. The 1-year local control rate and 2-year local control rate were 85.50% and 73.69%, respectively. Local failure rate reached 20.83%. The 1-year and 2-year overall survival rates (OS) were 84.29% and 58.32%, respectively. The PFS of patients at 1 year and 2 years were 44.01% and 22.29%, respectively. Univariate analysis showed that the P value of the PFS and OS were 0.038 and 0.041 in patients with Synchronous oligometastases compared with nonsynchronous oligometastases,suggesting that PFS and OS benefit significantly in patients with nonsynchronous oligometastases.Gender, age, number of metastases, induction chemotherapy, maximum diameter of tumors had no significant effect on OS and PFS. The side effects were mainly acute toxicity during radiotherapy. There were only 1 case in grade 3, and others were grade 1-2. No grade 4 or more serious toxicities caused death, and no long-term toxicity was observed. Conclusion Three-dimensional conformal intensity modulated radiotherapy for colorectal cancer oligometastases has definite efficacy and higher safety, which is worthy of clinical promotion and application.
Clinical evaluation of correlation of serum cystatin C level to the risk factors for cardiovascular disease in patients with polymyositis
FAN Miao-yi, GONG Rong, WANG Han
2019, 17(11): 1806-1808. doi: 10.16766/j.cnki.issn.1674-4152.001060
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Objective To explore the relationship between serum levels of cystatin C and traditional cardiovascular risk factors in patients with Polymyositis (PM). Methods A total of 88 cases patients with PM in the Third People's Hospital of Chengdu from January 2006 to September 2017 were selected and divided into group A (with elevated serum cystatin C, n=53) and B group (normal serum cystatin C, n=35) according to serum cystatin C level. The clinical features were compared between the two groups, and Pearson correlation analysis was carried out to analyze the correlation between serum cystatin C and cardiovascular risk factors such as age, systolic pressure (SBP), triglyceride (TG). Multivariate logistic regression analysis was used to analyze the related cardiovascular risk factors of serum cystatin C. Results The prevalence of elevated serum cystatin C was 60.2% (53/88). There were significant statistical differences in age (P=0.008) and triglyceride (P=0.004) between the two groups. Spearman correlation analysis showed that serum cystatin C levels was positively correlated with age (r=0.296, P<0.05) and TG (r=0.282, P<0.05). Multivariate logistic regression analysis showed that TG (OR=2.415, 95% CI: 1.189-4.905) was closely associated with serum cystatin C level in patients with PM (P<0.05). Conclusion Changes of serum cystatin C concentration may be associated with TG.
Risk factors analysis based on cerebral DSA results in vascular vertigo patients
YAO Li, ZHANG Hong, LI Tao, WU Hai-qin
2019, 17(11): 1809-1811. doi: 10.16766/j.cnki.issn.1674-4152.001061
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Objective To analyze the results of cerebral DSA and related risk factors in patients with vascular vertigo, and to improve the understanding of vascular factors in patients. Methods A total of 148 vascular vertigo patients who were hospitalized in Neurology Department of the Second Affiliated Hospital of Xi' an Jiaotong University with cerebral DSA from March 2017 to October 2018, were selected and divided into vertebrobasilar dolichoectasia (VBD) group (n=42) and non-VBD group (n=106). The risk factors and relationship with VBD in patients with vascular vertigo were analyzed. Results The average age of 148 patients was (59.43±13.02) years, 78 (52.7%) were male, 18 (12.2%) were basilar artery stenosis (>50%) and 42 (28.4%) were VBD. There were significant differences in male, hypertension and vertebral artery dominance between VBD and non-VBD groups (all P<0.05), but there was no significant difference in diabetes, hyperlipidemia, coronary heart disease, hyperhomocysteinemia, hyperuricemia, smoking, drinking, vertigo history and vertebrobasilar artery stenosis between the two groups (all P>0.05). Logistic regression analysis showed that vertebral artery dominance was an independent risk factor for the VBD(OR=4.326,P=0.001). The DHI scores in VBD group was (81.14±9.42) and that in non-VBD group was (69.25±8.57, t=7.253,P<0.001). Conclusion With the continuous development of imaging technology and the deep understanding of disease, VBD is no longer a rare vascular disease, which may closely relate to the occurrence of vascular vertigo. Vertigo patients with VBD had more severe vertigo and higher disability. Vertebral artery dominance is an independent risk factor for the VBD.
Sleep quality and contributory factors in myasthenia gravis patients
WANG Xian-ni, YUAN Yan-qin, REN Ting-ting, ZHANG Min, ZHU Xiao-yu, WANG Hai-rong, FAN Shan-hong
2019, 17(11): 1812-1814,1832. doi: 10.16766/j.cnki.issn.1674-4152.001062
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Objective To investigate the sleep quality and its influence factors in patients with myasthenia gravis (MG) during hospitalization and to further provide theoretical basis for effective interventions. Methods A total of 121 MG patients hospitalized in Tangdu Hospital from February 2017 to June 2018 were investigated by Pittsburgh sleep quality index scale (PSQI), self-rating anxiety scale (SAS), self-rating depression scale (SDS), general information questionnaire and sleep influence factors questionnaire. All data was quantified according to GB/T2828 national standard, and SPSS 25.0 was used for variance analysis, t test and logistic regression analysis. Results The score of PSQI were more than 7 points in 93 of the 121 patients, suggesting that 76.8% of patients with myasthenia gravis had sleep problems. The total score of PSQI and scores of 6 items were significantly different from the domestic norm (all P<0.05). The course of disease, clinical classification, SAS score, SDS score and environmental quality were positively correlated with sleep quality (all P<0.05). The factors influencing sleep quality included disease severity, psychosocial, iatrogenic and environmental factors. Conclusion The MG patients generally have poor sleep quality. Besides the improvement of clinical symptoms, we should also pay more attentions to the sleep quality of patients. For the patients with a long course of disease, negative psychological state and severe systemic symptoms, some proactive interventions should be carried out according to relevant influence factors to promote their recovery and return to normal social life as soon as possible.
Clinical value of pro-BNP and cTnI in patients with sepsis related myocardial injury
LIU Bing-wei, HU Wei, ZHU Ying, WANG Jian-rong, ZENG Xiao-kang
2019, 17(11): 1815-1817,1844. doi: 10.16766/j.cnki.issn.1674-4152.001063
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Objective The mortality in sepsis patients with myocardial injury is high, and the early diagnosis is of great significance. The aim of this paper is to discuss the application of Pro-BNP and cTnI in patients with sepsis induced myocardial injury. Methods From February 2016 to August 2017, 40 patients with sepsis related myocardial injury in Department of Critical Care Medicine of Hangzhou First People's Hospital were recruited. According to left ventricular ejection fraction (LVEF) after admission, the patients were divided into LVEF>40% group (23 cases) and LVEF≤40% group (17 cases); Likewise, according to the prognosis, the patients were divided into survival group (24 cases) and death group (16 cases). The levels of Pro-BNP, cTnI and lactic acid were measured, APACHE Ⅱ score was recorded; LVEDD was measured by echocardiography, dp/dt max was monitored by PiCCO. The area under the ROC curve was used to analyze the prognostic value of Pro-BNP and cTnI in patients with sepsis related myocardial injury. The correlation among Pro-BNP, cTnI and LVEF were also analyzed. Results The Pro-BNP, cTnI, lactic acid, LVEDD, APACHEⅡ scores in the LVEF>40% group were all less than those in the LVEF≤40% group, and the dp/dt max was greater than the LVEF≤40% group, the difference was statistically significant; The Pro-BNP, cTnI, lactic acid, and APACHEII scores of the survival group were lower than those of the death group. The dp/dt max of the survival group was greater than that of the death group, and the differences were statistically significant. For prediction of prognosis in patients with sepsis myocardial injury, the sensitivity of Pro-BNP was 0.82, specificity was 0.80, an area under the ROC curve of 0.88; the sensitivity of cTnI was 0.93, specificity was 0.88, and the area under the ROC curve was 0.96. There was a negative correlation between Pro-BNP, cTnI and LVEF (r=-0.360, P=0.023; r=-0.315, P=0.048). Conclusion Both Pro-BNP and cTnI increases in the patients with sepsis related myocardial injury, the increase of pro-BNP and cTnI may correlate with poor prognosis.
Clinical analysis of surgical operations among 27 coronary heart disease patients over 70 years old
MENG Jin-jin, DIAO Wen-jie, LIU Xue-gang, LIU Ge, LIU Yi-yao, LI Hai-hui, JIANG Yi-yao
2019, 17(11): 1818-1820. doi: 10.16766/j.cnki.issn.1674-4152.001064
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Objective To investigate the safety of surgical therapy and perioperative management of coronary heart disease patients over 70 years old. Methods The coronary artery bypass grafting (CABG) was performed in twenty-seven patients aged over 70 years old in the Department of Cardiac Surgery of the First Affiliated Hospital of Bengbu Medical College between October 2015 and December 2017. The clinical data such as complications, preoperative preparation, surgical procedure, operation time, postoperative ICU monitoring time, hospitalization time, postoperative complications and mortality were reviewed. Results The aortic valve blocking time was (106.32±45.25) min, extracorporeal circulation time was (164.95±52.43) min, the postoperative tracheal intubation time was (15.8±1.6) h, and the number of transplanted blood vessels was 2.8±0.8, the stay time in ICU after the surgery was (45.3±38.5) h, the Hospitalization time (35.45±6.3) d. The intra-aortic balloon pump (IABP) was used in 2 patients.One died from the low cardiac output, acute renal failure and pulmonary infection after coronary artery bypass graft surgery. The total number of early postoperative complications was 10 times in the group, including 2 cases of postoperative low cardiac output syndrome, 1 case of malignant arrhythmia, 1 case of postoperative acute renal insufficiency, 1 case of wound infection, and 2 cases of rethoracotomy, 2 cases of severe pulmonary infection, and 1 case of cerebrovascular event. Conclusion The surgical risk in coronary heart disease patients aged over 70 years old is high, and the patients are usually with a poor postoperative recovery. However, the surgical procedure is safe and feasible under the preoperative preparation, corresponding surgical treatment, strict postoperative monitoring and comprehensive treatment, and has a positive therapeutic significance.
Clinical efficacy of oxycodone hydrochloride injection for preemptive analgesia in radical gastrectomy and its effect on stress response of patients
CAI Yun-fang, WANG Li-ren, ZHANG Run-ze, ZHANG Wen, CUI Xiao-ying, FANG Jun
2019, 17(11): 1821-1824,1863. doi: 10.16766/j.cnki.issn.1674-4152.001065
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Objective To observe the clinical effect of preemptive analgesia with oxycodone hydrochloride on perioperative pain management in patients undergoing radical gastrectomy. Methods A total of 130 patients with gastric cancer underwent radical gastrectomy in Zhejiang Cancer Hospital from March 2017 to March 2019 were selected and divided into study group (n=65) and control group (n=65) according to random number table method. All patients underwent radical gastrectomy under general anesthesia. Oxycodone hydrochloride preemptive analgesia was given in the study group 30 minutes before skin incision, while dezocine preemptive analgesia was given in the control group. The hemodynamic parameters such as HR, MAP and SpO2 were measured at different anesthesia time points. The levels of serum stress response factors were detected, and the VAS scores were compared. The dosage of self-controlled analgesics, recovery time and extubation time were recorded, and the adverse reactions were observed. Results There was no significant difference in HR, MAP and SpO2 between the study group and the control group at T0-T4 (all P>0.05). The resting VAS scores and cough VAS scores of the study group were lower than those of the control group at 6, 12, 24 and 36 hours after operation (all P<0.001). The serum E, NE and Cor levels of the study group were lower than those of the control group at 24 hours after operation (all P<0.001). The dosage of sufentanil for patient-controlled analgesia after operation in the study group (52.28±8.61) μg was less than that in the control group (74.37±12.49) μg (P<0.001). The overall incidence of adverse reactions in the study group (7.69%) was lower than that in the control group (23.08%, χ2=5.909, P=0.015). Conclusion Oxycodone hydrochloride for preemptive analgesia in radical gastrectomy can effectively maintain hemodynamic stability during anesthesia, inhibit post-operative stress response, relieve pain response intensity, reduce the dosage of analgesics, and reduce the incidence of adverse reactions rate.
Parecoxib sodium combined with dezocine injection in the treatment of severe acute pancreatitis
DU Zhao-hui, QIU Zhao-lei, YING Qiao-ling, LI Qi-liang, WANG Zhen-jie
2019, 17(11): 1825-1828. doi: 10.16766/j.cnki.issn.1674-4152.001066
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Objective To observe the analgesic effect and safety of parecoxib sodium injection combined with dezocine injection in the treatment of severe acute pancreatitis. Methods A total of 57 patients with severe acute pancreatitis from January 2017 to December 2018 of Emergency Surgery Department of the First Affiliated Hospital of Bengbu Medical College were selected. There were 31 males and 26 females among them, with an average age of (45.7±3.6) years and an average weight of (50.4±3.5) kg. They were randomly divided into groups A, B and C. Nineteen patients in the group A received parecoxib sodium + dezocine injection, 18 patients in the group B received dezocine injection, 20 patients in the group C received parecoxib sodium. The effects of physiological indicators such as gender, age and weight on the results were analyzed. The pain experience of patients with severe acute pancreatitis was evaluated by visual analogue scale (VAS). The incidence of adverse events in gastrointestinal tract and cardiac and cerebral vessels was observed. The venous blood of patients in group A was collected on day 1, 3 and 7 after admission to determine the effect of medication on blood routine test result and kidney and liver function. Results There was no significant difference in sex, age and body weight among the three groups (all P>0.05); VAS scores at each time node in group A were lower than those in group B and C (all P<0.05) except for 24 hours after medication; the incidence of gastrointestinal adverse reactions in group A was significantly lower than those in group B (all P<0.05), No statistically significant difference between group A and group C (all all P>0.05) and no respiratory and circulatory system depression was found in all the three groups. There was no statistically significant difference in blood routine test result and liver and kidney function at day 1, 3 and 7 in group A (P>0.05). Conclusion The analgesic effect of Parecoxib sodium injection combined with dezocine injection on patients with severe acute pancreatitis was significantly better than that of Parecoxib sodium injection alone and dezocine injection alone. Parecoxib sodium injection combined with diazoxin injection can be used safely and effectively in the analgesia of patients with severe acute pancreatitis.
Observation of effect of transradial emergency PCI and early PCI after thrombolysis on cardiac function in patients with ST-segment elevation acute myocardial infarction
WU Shi-li, TANG Bi, LIU Jin-jun, WANG Dong-mei, ZHANG Ning-ru, TANG Yang, CHEN Gang, WANG Hong-ju, ZHANG Heng
2019, 17(11): 1829-1832. doi: 10.16766/j.cnki.issn.1674-4152.001067
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Objective To explore the effect of transradial percutaneous coronary intervention (PCI) and early PCI after intravenous thrombolysis on cardiac function in patients with ST-segment elevation of acute myocardial infarction (STEMI) and the application value of early PCI. Methods Ninety-two patients were admitted successively From January 2016 to January 2017，in the First Affiliated Hospital of Bengbu Medical College.they were divided into emergency PCI group (76 cases) and early PCI group (16 cases) after intravenous thrombolysis. The clinical efficacy, the left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF), and the incidence of compound cardiovascular events of the two groups were analyzed. Results There was no significant difference in baseline results between the two groups. The TIMI 3 level of coronary artery blood flow in the early PCI group was significantly higher than that in the emergency PCI group (93.7% vs. 78.9%, P<0.05). After 12 months of follow-up, there was no significant difference in LVEDI (102.2±15.3 vs. 97.6±21.5), LVEF [(43.6±7.8)% vs. (46.5±5.7)%] and compound cardiovascular events (6.6% vs. 6.3%) between the two groups (all P>0.05). Conclusion For STEMI patients who were diagnosed in primary hospitals without emergency intervention conditions, it is safe and effective to transport them to superior hospitals in time for PCI in early stage after thrombolysis. It does not affect the recovery of cardiac function and do not increase the occurrence of compound cardiovascular events.
The effect of protocadherin-PC on epithelial mesenchymal transition of prostate cancer cells
YANG Xue-zhen, JIANG Xu, Tomonori Habuchi, GUO Ying-lu
2019, 17(11): 1833-1836. doi: 10.16766/j.cnki.issn.1674-4152.001068
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Objective To analyze whether the Protocadherin-PC gene is associated with prostate cancer metastasis, the effects on the epithelial protoplasm of prostate cancer cells were studied. Methods The effects of inhibitd Protocadherin-PC expression by siRNA on epithelial mesenchymal metaplasia of DU-145 and PC-3 cells were detected by western blotting, morphological detection and wound healing. Results The result of western blotting showed that suppression of the Protocadherin-PC expression could promote mesenchymal epithelial transition of DU-145 and PC-3 cells. Morphologic examination indicated that inhibition of Protocadherin-PC expression could induce DU-145 and PC-3 cells to be closer to androgen-dependent prostate cancer LNCaP. Wound healing assay suggested that the growth rate of DU-145 and PC-3 cells were down regulated by suppression of Protocadherin-PC expression. Conclusion Suppression of the Protocadherin-PC expression by siRNA reduces the invasive and metastasis ability of androgen-independent prostate cancer cells DU-145 and PC-3, and thus revealing another new function of Protocadherin-PC.
Analgesic effect of dexmedetomidine combined with sufentanil on pains caused by burn
YING Hai-feng, ZHANG Wei-ping, LI Jun, WANG Ming-cang, CHEN Ling-yang
2019, 17(11): 1837-1840. doi: 10.16766/j.cnki.issn.1674-4152.001069
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Objective To explore the effect of dexmedetomidine combined with sufentanil on the pain caused by burn and the expression of P2X7 receptor in monocyte. Methods A total of 152 patients in the Burns of Taizhou Hospital of Wenzhou Medical University between December 2015 and December 2017 were selected and divided into control group (76 cases) and observation group (76 cases) according to the admission order and odd-even method. The control group received sufentanil analgesia, while the observation group received dexmedetomidine combined with sufentanil analgesia. The arterial blood pressure and other basic vital signs, pain score, oxidative stress index and P2X7 receptor expression in peripheral blood mononuclear cells were compared between the two groups before and after the treatment. Results SBP, DBP and HR in the two groups were significantly decreased before and after intervention (P<0.05), but only SBP and DBP had significant differences between the two groups (P<0.05), while the difference between HR and SpO2 was not statistically significant (P>0.05). The pain scores of all periods decreased significantly (all P<0.05), and the scores in the observation group was significantly lower than those in the control group (all P<0.05). The pain scores showed a decreasing trend in each time period within the observation group and the difference was obvious (all P<0.05). The sedation scores at 20 min and 60 min after the administration were obviously different (all P<0.05), but there was no significant difference in sedation scores between the two groups at 5 min after dosing (P>0.05). In the observation group, the serum stress responses were significantly decreased (all P<0.05), but the control group was not (all P>0.05). Flow cytometry test showed that the expression of P2X7 receptor in CD14 cells was significantly decreased in the observation group (P<0.05), not in the control group (P>0.05). Conclusion Dexmedetomidine combined with sufentanil have an obvious analgesic effect on burn patients, without inhibition of the heart function, and it can significantly reduce the stress response and the expression of P2X7 receptor, should be clinically popularized.
Expression and significance of HPA and VEGF in skin lesions of psoriasis vulgaris at progressing stage
YIN Wen-hao, JIN Meng-zhu, WU Wan-xin
2019, 17(11): 1841-1844. doi: 10.16766/j.cnki.issn.1674-4152.001070
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Objective To research the expression level and significance of heparanase (HPA) and vascular endothelial growth factor (VEGF) in the skin lesions of psoriasis vulgaris at progressing stage. Methods The expression of HPA and VEGF in skin specimens of 25 patients with psoriasis vulgaris at progressing stage and 20 cases of normal control were detected by immunohistochemical S-P. Results The expression of HPA was brown-yellow granular and mainly located in cytoplasm. In psoriasis group, HPA was mainly expressed in spinous layer, basal layer and papillary vascular endothelial cells, but negative in healthy control group. The expression of VEGF was brown-yellow granular, mainly in the cytoplasm. In psoriasis group, the expression of VEGF was mainly in the spinous and papillary vascular endothelial cells, and a little in the basal layer. In healthy control group, the expression of VEGF was negative or a little in the basal layer. The positive rates of HPA and VEGF were 0% and 5% in the control group, and 88% and 96% in the psoriasis group. The positive rates of HPA and VEGF expression in psoriasis group were significantly higher than those in the control group (all P<0.05). The expression of HPA and VEGF in psoriatic lesions was positively correlated (r=0.585, P<0.05). Conclusion The expression of HPA and VEGF in skin lesions of psoriasis vulgaris at progressing stage is significantly higher than that in normal skin. The two factors play an important role in the pathogenesis of psoriasis, and can be used as an auxiliary index for pathological diagnosis of psoriasis vulgaris.
Treatment of lumbar spinal stenosis with percutaneous transforaminal endoscopic discectomy via anterior and lateral approach
MI Da-guo, ZHOU Bin, LU Wei, HUANG Wei, CAI Chun-yue
2019, 17(11): 1845-1848. doi: 10.16766/j.cnki.issn.1674-4152.001071
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Objective To study the curative effect of percutaneous transforaminal endoscopic discectomy (PTED) via anterior and lateral approach in the treatment of senile lumbar spinal stenosis. Methods A total of 60 patients with lumbar spinal canal stenosis were enrolled and randomly divided into two groups with 30 cases in each group. PTED was performed in the observation group, while the conventional surgical treatment was performed in the control group. The operation time, intraoperative bleeding volume and the length of stay of the two groups were documented. The visual ana-logue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the clinical efficacy. Results The operation time, intraoperative bleeding volume and length of stay in the observation group(66.93 ±7.31) min, (25.97±7.29) ml, and (3.07±0.64) days, respectively, which was effectively lower as compared with the control group. The total ODI score at 1, 3 and 6 months in the observation group was (29.93±3.54), (18.77±3.05) and (9.10±3.17), respectively, which was shorter than those in the control group, the difference was statistically significant (all P<0.05). Conclusion PTED via anterior and lateral approach, with advantages of small trauma, quick recovery and clear curative effect, is one of good surgery for the senile lumbar spinal stenosis disease.
Clinical efficacy of hemorrhoid artery ligation with mucopexy in treatment of Ⅱ-Ⅲ degree hemorrhoids and risk factors for recurrence
XU Yi-dong, ZHAO Jian-pei, DAI Xiao-yu, XIE Yang-yang
2019, 17(11): 1849-1852,1859. doi: 10.16766/j.cnki.issn.1674-4152.001072
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Objective To analyze the long-term efficacy and patient satisfaction of hemorrhoid artery ligation (HAL) with mucopexy in treatment of Ⅱ-Ⅲ degree hemorrhoids and explore the risk factors for recurrence. Methods One hundred and eighty patients with Ⅱ-Ⅲ degree hemorrhoids in our hospital from November 2013 to November 2014 were enrolled into this study and randomly divided into transanal hemorrhoidal dearterialization (THD) with mucopexy group (THDm group, 89 cases) and procedure for prolapse and hemorrhoids group (PPH group, 91 cases). The operative effect, complication, recurrence rate and patient's subjective satisfaction were observed. The risk factors for recurrence after THDm therapy were analyzed. Results Compared with PPH group, the average operation time was longer in THDm group [(37.2±6.8) min vs. (21.6±5.9) min, t=15.906, P<0.001]; the weight of resected tissue in THDm group was lighter [(3.6±1.6)g vs. (5.2±1.7)g, t=6.303, P<0.001]. In THDm group, the postoperative pain was lighter as compared with PPH group (t=14.485, P<0.001), average hospitalization days were significantly shorter than PPH group (t=15.585, P<0.001). There was no significant difference between the two groups in postoperative urinary retention and incidence of anastomotic stenosis, but the incidence of postoperative bleeding was lower in THDm group (χ2=4.305, P=0.038). However, recurrence of skin graft was higher than PPH group after THDm operation (χ2=4.681, P=0.031). The satisfaction of patients in THDm group was significantly higher than that in PPH group (Z=-3.757, P<0.001). And Ⅲ degree hemorrhoids and constipation were main risk factors of recurrence in patients undergoing THDm surgery (χ2=4.423, P=0.035; χ2=15.226, P<0.001). Conclusion THDm is an effective and safe therapy for Ⅱ-Ⅲ degrees hemorrhoids, but it has high recurrence rate, of which Ⅲ degree hemorrhoids and constipation are the main risk factors for postoperative recurrence.
Correlation between bone mineral density and serum thyroid stimulating hormone levels in postmenopausal women with type 2 diabetes mellitus
GAO Sai-sai, XU Bing
2019, 17(11): 1853-1855,1897. doi: 10.16766/j.cnki.issn.1674-4152.001073
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Objective To investigate the correlation between bone mineral density (BMD) and serum thyroid stimulating hormone (TSH) levels in postmenopausal women with type 2 diabetes mellitus (T2DM). Methods A total of 267 postmenopausal women with T2DM admitted to the Department of Endocrinology of Wenzhou Integrated Traditional Chinese and Western Medicine Hospital between October 2015 and October 2018 were selected as the subjects of study, according to TSH value, the patients were divided into three groups: A (81 cases), B (94 cases) and C (92 cases).The basic data (age, age of menopause, menopause, duration, body mass index BMI, blood pressure), biochemical indicators (fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglycerides, low-density lipoprotein cholesterol, High-density lipoprotein cholesterol, alkaline phosphatase, 25-hydroxyvitamin D, blood calcium, blood phosphorus) and thyroid function (free triiodothyronine, free tetraiodothyronine, total triiodothyronine, total tetraiodothyronine, thyroid stimulating hormone) were collected, and bone mineral density of L2-4, femoral neck and total hip were measured. The basic data, biochemical parameters, thyroid function and bone mineral density of L2-4, femoral neck and total hip were compared among the three groups, and the correlation between TSH and BMD was analyzed. Results The serum TSH of patients in group A, B and C increased in turn (P<0.05). The BMD of L2-4, femoral neck and total hip increased in groups A, B and C (all P<0.05). Person correlation analysis showed that serum TSH was positively correlated with L2-4, femoral neck and total hip BMD (r=0.535, 0.774, 0.813, P=0.007, 0.014, 0.023). Conclusion The serum TSH level was positively correlated with bone mineral density in postmenopausal women with normal thyroid function.
The predictive value of coronary artery calcification score for cardiovascular event risk in dialysis patients
CHEN Jie, CHEN Miao, YING Yi-ying, BAO Bei-yan
2019, 17(11): 1856-1859. doi: 10.16766/j.cnki.issn.1674-4152.001074
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Objective To explore the predictive value of coronary calcification score for cardiovascular event risk in dialysis patients. Methods From January 2016 to June 2017, 148 patients receiving MHD treatment in our hospital were selected and divided into observation group and control group according to whether cardiovascular events occurred during the observation period (18 months). General data, vital signs, blood biochemical examination, coronary calcification score, Framingham risk score and EuroSCORE Ⅱ score were compared between the two groups. ROC curves were used to evaluate the predictive efficacy of different models in predicting cardiovascular events. Results Sixty-one cases (41.22%) of cardiovascular events occurred in this study. There were significant differences in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density troponin, b-type natriuretic peptide and Glomerular Filtration Rate (GFR) between the two groups (all P<0.05). The coronary artery calcification score of observation group was significantly higher than control group (t=7.714, P<0.001). There were significant difference in Framingham risk score and the EuroSCORE Ⅱ score between the two groups (Z=6.288, 5.003; all P<0.001). The AUC of coronary artery calcification score, Framingham risk score and EuroSCORE Ⅱ score was 0.903, 0.768 and 0.740, respectively. The arterial calcification score was significantly better than others (Z=2.917, 3.428; P=0.003, <0.001), and the sensitivity of arterial calcification score prediction was 90.16%, which was significantly better than Framingham risk score and EuroSCORE Ⅱ score (all P<0.05). Conclusion Coronary calcification score is a good predictive value for the occurrence of cardiovascular events in dialysis patients, it is worthy of further study and discussion.
Therapeutic effect of small dose of ziprasidone combined donepezil hydrochloride on Alzheimer's disease and its effect on glucose and lipid metabolism in patients
HUA Hao-shui, SHAO Jian-feng, LU Yuan-xin, LIAO Zheng-luan
2019, 17(11): 1860-1863. doi: 10.16766/j.cnki.issn.1674-4152.001075
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Objective To observe the effect of small dose ziprasidone combined with donepezil hydrochloride in the treatment of Alzheimer's disease and the effect on sugar and lipid metabolism in patients. Methods One hundred patients with Alzheimer's disease admitted to the Third People's Hospital of Fuyang District from January 2016 to January 2018 were randomly divided into two groups, 50 in each group. The low dose group were given 20 mg ziprasidone combined 10 mg donepezil hydrochloride, while the high dose group were given 40 mg ziprasidone combined 10mg Donepezil hydrochloride. The changes of score of behavioral pathological assessment scale for Alzheimer's disease (BEHAVE-AD), nursing distress, Wechsler Adult Intelligence Test and Clinical Memory Scale (WAIS), blood sugar and blood lipid were compared between the two groups. Results After treatment, the BEHAVE-AD, nursing distress degree of two groups were better than before treatment, but the lower dose group was more significant (all P<0.05). In WAIS of two groups after treatment, the scores of each factor in low-dose group were better than that of high dose group (all P<0.05). After treatment, the scores of clinical memory scale in low dose group were significantly better than those in high dose group, except for the association study of portrait characteristics (all P<0.05). Compared with before treatment, the blood sugar, TG and TC levels in low dose group were increased after treatment, but the effect were not obvious (all P>0.05), meanwhile those in high dose group were increased with significant difference (all P<0.05). Conclusion Administration of 20 mg of ziprasidone combined with 10 mg of donepezil hydrochloride is more effective in treating patients with Alzheimer's disease, and the effect of high dose on blood sugar and lipid metabolism were more obvious.
The value of peer interactive education in improving the disease self-management of school-age asthmatic children
XU Wei, XIANG Li
2019, 17(11): 1864-1867. doi: 10.16766/j.cnki.issn.1674-4152.001076
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Objective To evaluate the value of peer interactive education in improving school-aged children asthma disease self-management ability. Methods Thirty-nine asthmatic children (age 8 to 14 years) participating rehabilitation program were chosen. During the convalescent period without parental guardianship, peer interaction asthma education (peer participation and interactive guidance) was carried out. Questionnaires were conducted before and after the study on asthma knowledge, asthma treatment methods and asthma management awareness. Results Recognition their own allergens (Z=-4.088, P<0.001), treating allergic rhinitis (Z=-2.806, P=0.007), treating asthma episodes (Z=-2.864, P=0.004), treating food allergies (Z=-3.480, P=0.001), treating skin allergies (Z=-3.517, P=0.001), using asthma inhalation device (Z=-2.726,P=0.006) and the peak flow meter (Z=-3.708, P<0.001), and understanding sport management of asthma (Z=-2.795, P=0.005) were significantly improved after the study than before. The comprehensive understanding of allergic symptoms and the ability to identify peer symptoms were improved, but there was no significant difference. After the study, the number of patients who knew that inhaled salbutamol was the first choice for the treatment of acute asthma attack (27/31) was significantly increased than that before (12/31). The number of people with the awareness of dynamic observation increased by 1.12 times (70 vs. 33). Conclusion Peer interaction asthma education can effectively improve children's asthma knowledge level and disease self-management ability, which should be carried out in the standardized management of asthma.
Application of music therapy in PICC in premature infants
FENG Rui-ling, SHI Xiao-cai
2019, 17(11): 1868-1870,1875. doi: 10.16766/j.cnki.issn.1674-4152.001077
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Objective To study the application of music therapy in peripherally inserted central venous catheter (PICC) in premature infants. Methods Eighty preterm infants scheduled for PICC in our hospital from June 2017 to June 2018 were selected and randomly divided into control group and music therapy group with 40 cases each. The control group was treated with conventional catheterization while the music therapy group was treated with music therapy. The respiratory rate, heart rate, oxygen saturation and pain score of the two groups were measured. The success rate of puncture, indwelling time, hospitalization time and complication rate of indwelling catheter were counted and compared between the two groups. Results There were no statistically significant differences in respiratory, heart rate, blood oxygen saturation and pain scores between the two groups before the catheterization (all P>0.05). At 3 and 5 minutes time point after the catheterization, the respiratory, heart rate and pain scores of the children in the music group were all lower than those in the control group, and blood oxygen saturation level was higher than that in the control group (all P<0.05). The recovery time of blood oxygen saturation, catheterization time and hospitalization time in the music group were shorter than those in the control group, with statistically significant differences (all P<0.05). The success rate of the first puncture in the music group was significantly higher than that in the control group (P<0.05). The incidence of catheterization complications in the music group was 5.00%, which was lower than that in the control group (20.00%), and the difference was statistically significant (P<0.05). Conclusion Music therapy in PICC in premature infants can effectively improve breathing, heart rate, oxygen saturation, relieve pain and reduce the incidence of complications of PICC catheterization.
Application evaluation of community graphic health education for patients with osteoporosis
LIU Yu, AI Zi-sheng, LU Yuan, DONG Chen-jie, ZHAO Yan
2019, 17(11): 1871-1875. doi: 10.16766/j.cnki.issn.1674-4152.001078
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Objective Community graphic health education was used to intervene the patients with osteoporosis, to observe the effects on the cognition, pain and quality of life of the patients, and to evaluate the effect of its implementation, so as to provide a reference for the prevention and treatment of chronic diseases, such as osteoporosis. Methods Use systematic sampling method, from April to May 2015, 160 cases of osteoporosis were selected from the screening database of elderly people in Nanxiang Town, Jiading District, Shanghai. The patients were randomly divided into observation group and control group with 80 cases each. The control group was given traditional written health education, while the observation group was given graphic health education for 1 year. To evaluate the changes of osteoporosis cognitive level score, pain score and quality of life scale score (SF-36) before and after intervention. Results ①There was no statistical significance in the cognitive level of osteoporosis between the two groups before intervention (P>0.05). After 3, 6, 9 and 12 months of intervention, the scores of osteoporosis cognition in the observation group were higher than those of the control group at each time point, and the differences were statistically significant (all P＜0.05). ②There was no statistical significance in VAS score between the two groups before intervention (P>0.05). After 3, 6, 9 and 12 months of intervention, the VAS scores of the observation group were lower than those of the control group at each time point, and the difference was statistically significant (all P＜0.05). ③There was no statistical significance in SF-36 score between the two groups before intervention (all P>0.05). After 3, 6, 9 and 12 months of intervention, the SF-36 score of the observation group was higher than that of the control group at each time point, and the difference was statistically significant (all P＜0.05). Conclusion The application of graphic health education in community patients with osteoporosis can improve the level of osteoporosis cognition, reduce the pain of patients, and improve the quality of life of patients, which is worthy of reference for clinical management of chronic diseases.
Status of the contents of the community palliative care services in Shanghai
ZHANG Rui-yun, MOU Jun, SHEN Tian-han, CAO Wen-qun
2019, 17(11): 1876-1879. doi: 10.16766/j.cnki.issn.1674-4152.001079
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Objective To improve the community palliative care services by analyzing the current status of the contents of palliative care services that have been carried out in community health service centers (CHSC). Methods We conducted semi-structured interviews to key palliative care executives in 10 CHSC of palliative care pilot units in Shanghai through the method of judgment sampling from March 2017 to April 2017. The outline for the interview was developed through the way of literature review. The contents of the interview included the basic situation of interviewees and their workplace, and the contents of palliative care services carried out in the unit of interviewees. The results of the interviews were coded, analyzed, and converted into descriptive language. The proportions of palliative care services carried out in CHSC were analyzed by the frequency method. Results The palliative care services carried out in 10 CHSC could be divide into the identical five categories: early screening, positive evaluation, physiological support, psychological support and social support. Fifty-six service contents were carried out in 10 CHSC, of which 41 contents had been carried out in all 10 communities, and others were currently only being carried out in some CHSC. There were many differences in service connotation for the same service contents that carried out in each CHSC. Conclusion For the palliative care services carried out in CHSC in Shanghai, its categories are complete, its contents reflect the current situation of palliative care in Shanghai but are different from the ones in the current national regulatory documents. The differences in the service content of the pilot units suggest that the CHSC should further improve its service ability, service standardization and legal protection of palliative care services.
Application effect of combined early intervention by doctors in children with congenital heart disease
FU Chan-rong, LYU Lan-qiu, LYU Ying-bo, HU Yan-li, CHENG Wei
2019, 17(11): 1880-1882,1917. doi: 10.16766/j.cnki.issn.1674-4152.001080
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Objective To explore the effect of combined early intervention by physicians in children with congenital heart disease. Methods A total of 140 children with congenital heart disease who were treated in Ningbo Women & Children's Hospital from March 2018 to February 2019 were divided into observation group and control group according to random number table method. The children in the control group were given routine health education and early rehabilitation intervention in pediatric care department, while the children in the observation group were given hospital-family combined early intervention on the basis of the control group. The nutritional status, quality of life and the perception of depression and anxiety of children's family members before and after intervention were compared between the two groups. Results Before intervention, there was no significant difference in nutritional status and quality of life between the two groups (all P>0.05); after intervention, the incidence of malnutrition was 2.9% (2/70) in the observation group, which was significantly lower than 11.4% (8/70) in the control group (P<0.05). The level of nutritional status increased in both groups after intervention. The serum zinc and iron levels in the observation group were significantly higher than those in the control group, the difference was statistically significant (all P<0.05). The scores of quality of life in observation group were higher than those of the control group (all P＜0.05). Before the intervention, there was no significant difference in the scores of depression scale (HAMD) and anxiety scale (HAMA) between the two groups (all P>0.05). After the intervention, HAMD scores and HAMA scores were decreased in both groups，the observation group were lower than that in control group (all P<0.05). Conclusion Doctor combined early intervention can effectively improve the nutritional status and quality of life of children with congenital heart disease, and effectively reduce the negative emotions of their families, which is worthy of clinical application.
The effect of self-confidence training on mental state of depression patients during convalescence
YE Jing, KONG Qing-fang
2019, 17(11): 1883-1885,1944. doi: 10.16766/j.cnki.issn.1674-4152.001081
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Objective To explore the effects of self-confidence training on mental state in patients with depression during convalescence. Methods Eighty patients with depression selected from January 2017 to December 2018 in our hospital were randomly divided into observation group (40 cases) and control group (40 cases) using the method of random sampling. The control group was given routine treatment, while the observation group was given self-confidence training intervention on the basis of control group. The self-rating anxiety scale (SAS), self-rating depression scale (SDS), feelings of inadequacy scale (FIS), self-esteem scale (SES), trust scale and the coping style questionnaire scores were compared between two groups. Results Before treatment, there were no significant differences in the scores of SAS, SDS, SES and FIS between the two groups (all P>0.05). After treatment, the SAS and SDS scores of the observation group were significantly decreased and lower than the control group, while the SES and FIS scores were significantly higher than the control group (all P<0.05). The dependability, predictability, trust, and total scores of the observation group were significantly higher than those of the control group (all P<0.05). The problem solving, help-seeking and rationalization scores of the observation group were significantly higher than the control group, and the self-blame, retreat and fantasy scores were significantly lower than the control group (all P<0.05). Conclusion Self-confidence training is helpful to improve depression and anxiety during convalescence, enhance the self-esteem and self-confidence. This training can effectively promote overall recovery, and help patients return to society, which has good promotion and application value.
Role of color Doppler ultrasound in studying the correlation between breast and thyroid diseases
YANG Jian, LI Xing-yun, LIU Qiu-xia, TAN Yan, CHEN Jia-jia, ZHANG Jin-tang, XU Chang-liang
2019, 17(11): 1886-1888,1960. doi: 10.16766/j.cnki.issn.1674-4152.001082
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Objective To discuss the diagnostic value of color Doppler ultrasonography in breast diseases with thyroid diseases. Methods From January 2016 to December 2018, total 150 female patients with breast malignant tumors (breast malignant tumors group), benign breast lesions (breast benign lesions group) and healthy breast patients (breast health group) were enrolled into this study using block method according to the order of admission, with 50 cases in each group. All patients in the three groups were examined by two-dimensional and color Doppler ultrasonography to diagnose thyroid diseases. The detection rate of hypoechoic thyroid nodules, the volume of thyroid gland and the mean of hemodynamic indexes of both sides of thyroid gland were investigated. The measured indexes included the diameter of thyroid artery (D), peak systolic blood flow velocity (SPV), mean blood flow velocity (MV), diastolic blood flow velocity (DV), acceleration time (AT) and deceleration time (DT). Results Compared with the healthy breast group, the proportion of hypoechoic thyroid nodules was higher in malignant breast cancer group and benign breast lesion group (P<0.05). Compared with healthy breast group, thyroid volume in malignant breast cancer group and benign breast lesion group increased significantly (all P<0.05). Compared with the other two groups, the thyroid volume increased more significantly in breast cancer group (P<0.05). Compared with the healthy breast group, the thyroid hemodynamic indexes D, SPV and DV increased, while AT and DT decreased in the malignant breast group (all P<0.05); SPV increased in the benign breast lesion group, while AT and DT decreased (all P<0.05). Compared with benign breast lesions, SPV and AT and DT in malignant breast tumors were higher than those in benign breast lesions (all P<0.05). Conclusion Breast diseases and thyroid diseases are related and interacted. Clinical screening and diagnosis of breast diseases combined with thyroid diseases by means of ultrasound imaging has practical significance for evaluating the complications and prognosis of breast diseases.
Consistency analysis of contrast-enhanced ultrasonography and Magnetic resonance imaging in assessment of lesion size and invasion for cervical cancer
ZHU Lin-lin, WANG Hai-yan, YAN Xian-shu, LI Jia-gen
2019, 17(11): 1889-1892. doi: 10.16766/j.cnki.issn.1674-4152.001083
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Objective To investigate the consistency of contrast-enhanced ultrasonography (CEUS) with MRI in assessing the lesion size and invasion of cervical cancer. Methods Seventy six patients with cervical cancer admitted to our hospital from January 2017 to November 2018 were enrolled into this study. MRI enhanced scan and CEUS were used to compare the size of the lesions and the consistency of the surrounding invasion. Results The consistency analysis showed that MRI and CEUS had good consistency in transverse diameter, longitudinal diameter and anteroposterior diameter of the lesion (ICC=0.949, 0.802, 0.866). There was no statistical difference between the mean differences (P=0.253, 0.744), and the CEUS lesions were significantly lower than the MRI (P=0.002). The diagnostic rate of CEUS and MRI for vaginal invasion was 88.16% with high agreement (Kappa=0.761). The concomitant rate of CEUS and MRI for the assessment of parametrical tissue invasion was 88.16% with high agreement (Kappa=0.799). The diagnostic agreement rate for CEUS and MRI assessment of bladder and rectal invasion was 77.63% with high agreement (Kappa=0.719). Conclusion Contrast-enhanced ultrasonography have a good agreement with MRI in assessing the size and invasion of cervical cancer, but CEUS showed similar moderate agreement with MRI in cranial-caudal diameter, bladder or rectal invasion.
Research progress of radiation-induced lung toxicity
LIU Jia, CUI Zhen
2019, 17(11): 1893-1897. doi: 10.16766/j.cnki.issn.1674-4152.001084
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Radiation-induced lung toxicity (RILT),caused by lung, esophageal thoracic tumor radiation therapy, the common and serious side effects, include the early acute radiation pneumonia and late radiation pulmonary fibrosis. Because the lungs are sensitive to radiation, radiation damage may occur when they receive a certain dose of radiation. At present, the mechanism of radioactive lung toxicity is still unclear, and there is a lack of effective prediction indicators and treatment measures, which not only limits the radiotherapy dose of tumor, but also seriously affects the follow-up treatment and quality of life of patients, becoming a bottleneck to improve the efficacy of radiotherapy for chest tumor. Recent studies have found that radioactive lung toxicity is not only closely related to the exposed dose and volume of the lung, but also related to the expression and signal transduction of various cytokines, such as inflammatory cell infiltration, inflammatory cytokine imbalance, and oxidative injury, which are all involved in the pathogenesis of radioactive lung toxicity. In addition, the patient's physical condition is also related to the occurrence of radioactive lung toxicity. Therefore, the occurrence of radioactive lung toxicity is a complex process of interaction of many factors. At present, antibiotics and glucocorticoids are mainly used in clinical treatment of lung radiation inflammation, but the overall effect is not good. Because of the lack of effective prevention and treatment of radioactive pulmonary fibrosis, so the mechanism of radioactive lung toxicity and clinical prevention and treatment research is of great significance. In recent years, the research on radioactive lung toxicity has become a hot spot. People have made more in-depth research on the mechanism of radioactive lung injury and made certain breakthroughs in clinical prevention and treatment, such as the application of cytokine inhibitors, gene therapy, Chinese and western medicine, stem cell transplantation, etc. This article reviews the mechanism, clinical factors and clinical prevention and treatment of radioactive lung toxicity.
Advance of research on immune cells and cytokines in deep vein thrombosis
YANG Wen-juan, XIA Zhong-ni, WANG Xiao-dong, YING Yin
2019, 17(11): 1898-1901. doi: 10.16766/j.cnki.issn.1674-4152.001085
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Deep vein thrombosis (DVT) is an abnormal formation of a blood clot within a deep vein, which causes blood flow back in the lumen to be blocked. DVT not only has high morbidity and mortality, but also has a high economic burden to patients. The pathogenesis is still unclear due to the absence of suitable DVT model. DVT has long been considered as a blood coagulation disorder. DVT prophylaxis focuses predominantly on the coagulation system, including thrombin (Dabigatran), active FXa (Rivaroxaban) or vitamin K-dependent clotting factors (Warfarin). Nevertheless, due to the mechanisms of normal hemostasis and pathological thrombosis are greatly overlapped, the therapeutic window of anticoagulants may be narrow because of increased risks for bleeding complications. Recently studies demonstrate that immune cells and cytokines are involved in DVT initiation, and may play a vital role in DVT. These studies consider DVT as an immunity- and inflammation-related process rather than merely coagulation-dependent thrombosis. Immune cells related to the formation of DVT include mast cells, neutrophils, monocytes, platelets, etc. The cytokines mainly include P-selectin, complement activator, cell adhesion molecule, interleukin, etc. Additionally, ROS and MRP-14 are all play an important role in DVT. Blood flow stagnation in the vein results in hypoxia, following with endothelial activation and recruitment of various immune cells, which leading to intravenous thrombosis. Inflammatory cytokines are involved in the processes, and they play a crucial role in DVT with immune cells. Now, we review the advance of research on various immune cells and cytokines in DVT, respectively.
Advances in research on SCN5A gene mutation and arrhythmia
MA Fang-fang, LI Min, ZHENG Ming-qi, WANG Le, JI Li-shuang, LIU Gang
2019, 17(11): 1902-1906,1978. doi: 10.16766/j.cnki.issn.1674-4152.001086
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In recent years, the rapid development of molecular biology and molecular electrophysiology has opened up a new era of arrhythmia mechanism research. Arrhythmias are clearly associated with abnormal expression of ion channel genes, and genes mutations in multiple ion channel can cause various arrhythmias. At present, most of the primary electrocardiographic abnormalities are caused by gene mutations encoding the major ion channel subunits. Therefore, such diseases can be referred to as ion channel diseases. The Nav1.5 channel is the main type of cardiac sodium channel in humans and is responsible for the initiation and propagation of action potentials. It is encoded by SCN5A gene. Since the first mutation in the gene SCN5A of the cardiac sodium channel alpha subunit was found in the family of long QT syndrome. Hundreds of mutations have been found to be associated with a range of hereditary arrhythmias. Such as, long QT syndrome type 3 (LQT3), Brugada syndrome, progressive cardiac conduction block (PCCD), dilated cardiomyopathy (DCM), sudden infant death syndrome (SIDS), etc. In recent years, it has been found that SCN5A gene mutation is closely related to sick sinus syndrome, atrial arrhythmia (atrial fibrillation, atrial standstill), ventricular arrhythmia and poor pacemaker capture. This article will elaborate on the recent SCN5A gene mutation in sick sinus syndrome (SSS), atrial arrhythmia (atrial fibrillation, atrial standstill), poor pacemaker capture, ventricular arrhythmia and long QT syndrome type 3, the potential mechanisms of gain-of- function and loss-of-function SCN5A mutations, and current problems and challenges.
Clinical study on the recovery of intestinal peristalsis treated with Baohe Decoction in postoperative patient with gastric cancer
LIU Hong-qin, GUO Jian-min, YANG Fang, ZHANG Rui
2019, 17(11): 1907-1910. doi: 10.16766/j.cnki.issn.1674-4152.001087
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Objective To investigate the role of Jiajian Baohe Decoction in the recovery of intestinal function after total gastrectomy. Methods A total of 120 patients with pathologically confirmed gastric cancer and total gastrectomy in Zhejiang Cancer Hospital from July 2015 to June 2017 were enrolled. According to the random sequence number, the study group and the control group were divided into 60 cases. The study group began to give Jiajian Baohe Decoction 200 mL nasal feeding twice a day within 24 hours for 3 consecutive days, and the control group was given 200 mL saline nasal feeding. The postoperative venting and defecation time, postoperative abdominal pressure, postoperative serum concentration of somatostatin, cholecystokinin and IL-6 were compared between the two groups. Results The postoperative venting time (3.20±0.73) d vs. (3.58±0.92) d and defecation time (4.40±0.85) d vs. (4.87±1.35) d in the study group were shorter than those in the control group. The postoperative abdominal pressure of study group on D1 (10.38±3.51) cm H2O vs. (13.47±6.51) cm H2O, D2 (11.57±4.43) cm H2O vs. (13.46±5.58) cm H2O, D3 (10.15±4.41) cm H2O vs. (12.06±4.98) cm H2O was lower than that of the control group. The serum concentration of somatostatin (17.09±6.66) pg/mL vs. (20.36±9.76) pg/mL and IL-6 (11.53±4.13) pg/mL vs. (13.69±5.89) pg/mL on postoperative D7 in the study group lower than that of the control group. And the serum cholecystokinin(CCK) concentration of postoperative D7 (110.18±53.21) pg/mL vs. (70.42±31.97) pg/mL In the study group was higher than that of the control group. There were no significant differences in the serum concentration of CCK, IL-6 and somatostatin on postoperative D0, D1 and D3 between the two groups. Conclusion The Jiajian Baohe Decoction in patients undergoing total gastrectomy has a significant effect on the recovery of intestinal function.
Analysis of the Acupuncture combined with Traditional Chinese Medicine in the treatment of diarrhea-predominant pattern irritable bowel syndrome patients
HAN Zhi-cun, REN Li-li, LU Fei, RUAN Chen, TANG Bin-bin
2019, 17(11): 1911-1913. doi: 10.16766/j.cnki.issn.1674-4152.001088
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Objective To explore the effect of acupuncture combined with Traditional Chinese Medicine therapy on diarrehea-predominant pattern irritable bowel syndrome (IBS-D) patients. Methods A total of 80 patients with IBS-D who were treated in our hospital from March 2015 to April 2017 were selected, and they were randomly divided into observation group (n=40) and control group (n=40) according to the random number table method. The control group was treated with Traditional Chinese Medicine, and the observation group was treated with acupuncture therapy based on the control group. The clinical effect, emotional related indicators and neuroactive substances level were compared between the two groups. Results The total effective rate of patients in observation group was 92.5%, and the total effective rate of patients in control group 72.5%, the total effective rate in observation group was significantly higher than that of control group (P<0.05). Before treatment, there were no significant differences in the scores of elf-rating depression scale (SDS) and self-rating anxiety scale (SAS) between the two groups (all P>0.05); after treatment, the scores of SDS and SAS in the two groups were significantly lower than those before treatment (all P<0.05), and the scores of SDS and SAS in observation group was significantly lower than those of control group (all P<0.05). Before treatment, there were no significant differences in the levels of neuropeptide Y (NPY), 5-hydroxytryptamine (5-HT) and calcitonin gene-related peptide (CGRP) between the two groups (all P>0.05); after treatment, the levels of NPY, 5-HT and CGRP in the two groups were significantly lower than those before treatment (all P<0.05), and the levels of NPY, 5-HT and CGRP in observation group was significantly lower than those of control group (all P<0.05). Conclusion The acupuncture combined with Traditional Chinese Medicine therapy has remarkable effect in treatment of IBS-D, which can obviously improve the emotional and nerve function of patients.
Analysis of effect and long-term results of traditional Chinese medicine comprehensive treatment for cervical spondylotic radiculopathy
HUANG Ying, DU Wei-jie, ZHOU Dong-hui, DU Hong-gen
2019, 17(11): 1914-1917. doi: 10.16766/j.cnki.issn.1674-4152.001089
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Objective To explore the efficacy, safety and long-term effects of traditional Chinese medicine comprehensive program including massage, rehabilitation and neck pain granules for cervical spondylosis. Methods A total of 86 patients with cervical spondylotic radiculopathy admitted to our hospital from February 2014 to February 2015 were divided into control group (43 cases) and observation group (43 cases) according to the random number table method. The control group was treated with cervical traction, diclofenac sodium sustained release tablets and neck circumference, while the observation group was given the comprehensive treatment of massage, rehabilitation and neck pain granules. Both groups were treated for 2 weeks. The Odom grading, clinical assessment scale for cervical spondylosis (CASCS), neck disability index (NDI), visual analogue score (VAS) and quality of life score were compared between the two groups before and after treatment. The adverse reactions occurred during treatment and the recurrence during follow-up after treatment were compared. Results After treatment, the Odom grading were all significantly improved, and the Odom grading of the observation group was significantly better than that of the control group (P<0.05). In two groups, the CASCS scores were higher than those before treatment, and the NDI and VAS scores were lower than those before treatment (all P<0.05). The CASCS score of the observation group was higher than that of the control group, and the NDI and VAS scores were lower than that of the control group (all P<0.05). The scores of the physiological, psychological, environmental and social relations fields of the two groups were improved compared with those before treatment, and the scores of the above items in the observation group were significantly higher than those of the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (4.65% vs. 9.30%, P>0.05). The recurrence rates of the observation group at 12, 24 and 48 months after treatment were significantly lower than that of the control group (all P<0.05). Conclusion The traditional Chinese medicine comprehensive program of massage, rehabilitation and neck pain granules is effective for the treatment of cervical spondylosis, which can significantly improve the clinical symptoms and life quality of patients, and significantly reduce the long-term recurrence rate, and has the good safety.
Biaoben Acupoints acupuncture in the treatment of post-stroke dysphagia
LIU Hai-fei, SONG Feng-jun
2019, 17(11): 1918-1921. doi: 10.16766/j.cnki.issn.1674-4152.001090
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Objective To investigate effect of Biaoben Acupoints acupuncture on patients with post-stroke dysphagia, so as to provide an effective theoretical basis for the treatment. Methods A total of 148 cases of post-stroke dysphagia treated in our hospital from February 2016 to February 2018 were selected and randomly divided into two groups, each with 74 cases. The control group received routine medical treatment and rehabilitation training. Based on this, the study group received the Biaoben Acupoints acupuncture. Then the clinical efficacy, Watian drinking test rating, swallowing function improvement (SSA score), TV perspective swallowing function (VFSS score) and quality of life (SWAL-QOL score) and the adverse reactions of the two groups were compared. Results ①The total effective rate of the study group after treatment was significantly higher than that of the control group (94.59% vs. 83.78%, P<0.05); ②The SSA scores between the two groups had no difference before treatment (P>0.05), and the SSA scores decreased in both groups, which were significantly lower in the study group than in the control group (all P<0.05); ③The water swallow test results between the two groups were ameliorated in both groups after treatment (all P<0.05), which were significantly better in the study group than in the control group (all P<0.05). ④There was no significant difference in VFSS scores and SWAL-QOL scores between the two groups before treatment(all P>0.05). The VFSS and SWAL-QOL scores in the two groups were higher than those before the treatment, and the VFSS score and the SWAL-QOL score in the study group were all higher than those in the control group (all P<0.05); ⑤The overall incidence rate of adverse reactions in the study group was slightly lower than that in the control group (4.05% vs. 5.41%, P>0.05). Conclusion Biaoben Acupoints acupuncture can effectively and safely ameliorate the swallowing function for patients with post-stroke dysphagia, which has less adverse reaction.
Clinical observe of Qingre Xiaocuo Decoction combined with fumigation in the treatment of moderate and mild acne vulgaris of lung meridian and wind-heat type
FAN Jian-guo, CAI Tian-guo
2019, 17(11): 1922-1924,1975. doi: 10.16766/j.cnki.issn.1674-4152.001091
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Objective To observe the clinical effect of Qingre Xiaocuo Decoction combined with fumigation in the treatment of moderate and mild acne vulgaris of lung meridian and wind-heat type. Methods A total of 124 patients with moderate and mild acne vulgaris of lung meridian wind-heat type in the Jiaxing Hospital of Traditional Chinese Medicine from August 2017 to August 2018 were divided into control group (n=62) and research group (n=62) according to random digital form. The control group was treated with retinoic acid combined with minocycline hydrochloride, while the research group was treated with Qingre Xiaocuo Decoction combined with fumigation. The TNF-α, IL-6 and IL-8 levels in serum were measured, the onset time of acne lesion reduction after treatment was counted, the adverse drug reactions were observed during treatment, the curative effect was evaluated, and the recurrence was followed up within 6 months. Results The levels of serum TNF-α, IL-6 and IL-8 in the research group were lower than those in the control group after treatment (P<0.05). The onset time of acne lesion reduction in the research group (10.72±2.47) d were shorter than those in the control group (15.31±4.10) d (P<0.05). There was no significant difference in the overall effective rate between the research group (93.55%) and the control group (88.71%) (P>0.05). The recurrence rate of acne vulgaris in the research group (10.34%) was lower than that in the control group (25.45%, P<0.05). The overall incidence of adverse drug reactions in the research group (4.84%) was lower than that in the control group (16.13%, P<0.05). Conclusion Both traditional Chinese and Western medicine can effectively improve clinical symptoms of moderate and mild acne vulgaris of lung meridian wind-heat type. However, Qingre Xiaocuo Decoction combined with fumigation can significantly reduce the intensity of inflammatory reaction, shorten the disease control cycle, prevent the recurrence of acne, and have fewer adverse reactions.
Reform and practice of practice teaching for medical laboratory students in the department of blood transfusion
YANG Wen-yong, WU Xue-ping, WANG Xiao-mei, LU Jing, DUAN Ke-li, HE Lei
2019, 17(11): 1925-1928,1937. doi: 10.16766/j.cnki.issn.1674-4152.001092
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Objective To explore the practice teaching methods for medical laboratory students in the department of blood transfusion, summarize experiences, perfect the management system, and improve the quality of practice teaching. Methods The medical laboratory students in the People's Hospital of Wenshan Zhuang and Miao Autonomous Prefecture of Yunnan Province from 2011 to 2017 were choose as the object of this study. The reform and practice of teaching are carried out in many aspects, such as improving work flow, enriching teaching methods, strengthening pre-job education, consolidating basic knowledge, improving practical ability, setting up initiative service and quality first consciousness, cultivating interest in scientific research and strengthening assessment. Results Continuous improvement of work flow, innovation in teaching methods, as much as possible to let the students to participate in the whole teaching activities, to create conditions to arrange the part of the intern for lectures, all those measures not only could exercise the expression ability, enhance the psychological quality, but also deepen the understanding and memory of the knowledge of blood transfusion, and improved the interest in blood transfusion work. Strengthening students' legal awareness had been lay the foundation for their future use of legal weapons to protect their work and stay away from medical disputes. Through a series of reforms and practices, students' ability of independent learning and independent thinking was reflected, and scientific research quality, quality awareness and professional level had been continuously improved. They had gained a sense of accomplishment and pride in the practice of blood transfusion department, and gradually transform passive learning into active learning. At the same time, the teachers were encouraged to strengthen their own learning and become excellent, and their teaching level has been significantly improved. They have won many outstanding achievements in theoretical teaching competitions at the teaching and research section, the hospital and the Guangdong medical university. Conclusion The practice teaching of medical laboratory students in the department of blood transfusion is helpful to improve the quality of practice teaching through continuous exploration, reform and practice, and summarizing experience. It can provide reference for relevant university and hospital, and has certain significance for promoting teaching reform.
Comparative study of pre-filled syringes with different needles for vaccination
LYU Min, BAI Shuang, GAO Pei, WANG Huai, FU Ji-ye, SHI Ru-jing, DONG Lin, Florence Schwarzenbach, Cecile Berteau, WU Jiang
2019, 17(11): 1929-1932. doi: 10.16766/j.cnki.issn.1674-4152.001093
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Objective To evaluate the difference between two kinds of needle design for PFS (5B27G PFS and 3B25G PFS) in subject's pain level, nurse's insertion force and incidence of adverse events at the injection site during vaccination. Methods A randomized, double-blind, parallel-controlled clinical trial was designed. Six hundred and four subjects were randomly divided into two groups, the experimental group (n=299) used 5B27G PFS and the control group used 3B25G PFS for HAV vaccination; both groups vaccinated HBV using a 3B25G PFS as a self-control. The subjects were compared for the pain level, insertion force, and the adverse reactions at the injection site. Results VAS and C-PIVRS were used for HAV-injection pain level evaluation. Moderate to severe pain ration of the experimental group was respectively 7.02% and 16.55%; while in the control group, the results were 15.73% and 20.32%, respectively. The difference between groups was significant (all P≤0.001). The VAS score of insertion force was significantly higher in the control group than that in the experimental group (P<0.001). The incidence of skin adverse reactions in the experimental group was lower than that in the control group, which was 47.49% and 65.25%, respectively (P<0.001). Conclusion Compared with 3B25G PFS, the use of 5B27G PFS can significantly reduce the pain level, nurse's insertion force, and incidence of adverse events at the injection site during vaccination.
Correlation between TCM constitution and Hysteromyoma：a meta-analysis
MA Ye-lin, YAO Hui, YANG Wei-jia, QIAN Xiao-ling, HUA Jie, YANG Min-chun
2019, 17(11): 1933-1937. doi: 10.16766/j.cnki.issn.1674-4152.001094
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Objective To explore the difference between the distribution of traditional Chinese medicine (TCM) constitution of hysteromyoma and non-hysteromyoma population through the meta-analysis of the clinical studies on the correlation between hysteromyoma and TCM constitution, in order to provide higher level evidence based on larger sample for clinical and scientific research. Methods Literatures of CBMdisc, CNKI, Wanfang database, VIP, PubMed and Embase database from the database creation to May 31,2017 were searched, and Meta-analysis was performed by Review Manager 5.2 software. Results Totally 6 studies from 2012-2015 were included with 2 193 individuals. The results showed that balanced constitution (OR=0.13, 95% CI 0.04-0.36)was a protective factor of hysteromyoma (P<0.05) while phlegm-dampness (OR=1.67, 95% CI 1.23-2.28), qi stagnation(OR=1.97, 95% CI 1.48-2.64)and blood stasis constitutions(OR=4.56, 95%CI 2.54-8.19)were risk factors of hysteromyoma (all P<0.05), and there were no obvious correlations among qi deficiency, yang deficiency, yin deficiency, damp-heat constitutions and hysteromyoma (all P>0.05). Conclusion This study provides evidence for the prevention and treatment of hysteromyoma in TCM. However, most of the included studies are moderate quality, more high-quality, multi-center, large-sample studies are expected to provide higher level evidence.
Genotyping, drug resistance and molecular epidemic characteristics of Mycobacterium tuberculosis
GE Jun, CHEN Yun, FU Yu-qian, BO Xu-fen, CHEN Zhao-jun
2019, 17(11): 1938-1940. doi: 10.16766/j.cnki.issn.1674-4152.001095
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Objective To investigate the genotyping, drug resistance and molecular characteristics of Mycobacterium tuberculosis. Methods A total of 391 Mycobacterium tuberculosis strains were selected from department of thoracic surgery from January to December 2018, and genotyped by spoligotyping method. First-line anti-tuberculosis drugs rifampicin (RFP), ethambutol (EMB), isoniazid (INF) and streptomycin (SM) were used for drug sensitive testing. Results The results of genotyping showed that the Beijing family strains were 339 strains (86.70%), the non-Beijing family were 52 strains (13.30%). Spoligotyping showed that the molecular epidemiology of Beijing family bacteria was only positive with 9 compartments between 35 and 43, while the remaining strains was negative in 1-5 sites between 35 and 43. The 391 strains were genotype ranked in the top three: Beijing type, T1 type and newly type, accounting for 86.70%, 5.12%, and 3.58%, respectively. There was no significant difference in the resistance of Beijing-type Mycobacterium tuberculosis to non-Beijing-type mycobacteria for RFP, EMB, INF and SM (all P>0.05). Conclusion The Mycobacterium tuberculosis gene is polymorphic, while the molecular epidemiology characteristics are mainly in the Beijing family and have no significant correlation with drug resistance.
Effect of SEG-shRNA complex on rabies virus infected mice
WANG Dong-jie, WANG Li-yan, HUANG Wei, XIA Ru-qiang, CHEN Guang
2019, 17(11): 1941-1944. doi: 10.16766/j.cnki.issn.1674-4152.001096
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Objective To investigate the effect of SEG-shRNA complex on rabies virus (RV) infected mice. Methods Forty BALB/c mice intramuscularly injected with RV PB3 street strain were randomly divided into control group, SEG group, shRNA group and SEG-shRNA group, 10 mice in each group. The control, SEG, shRNA and SEG-shRNA group were injected with saline, SEG, shRNA and SEG-shRNA respectively in tail vein after challenge for 3 days. The expression of RV mRNA and RV N protein in brain tissue were detected by qRT-PCR and Western blotting. The level of IFN- in serum was measured. Results The onset time and death time of mice in SEG-shRNA group were (170.54±11.21) h and (389.28±43.22) h respectively, which were significantly delayed compared with those in control, SEG and shRNA group (all P<0.05). The relative expression of RV mRNA and RV N protein in SEG-shRNA group were 1.002±0.321 and 0.999±0.232, which were significantly lower than those in control, SEG and shRNA group (all P<0.05). There was no significant difference in serum IFN- level in all groups (P>0.05). Conclusion SEG-shRNA complex has a certain therapeutic effect on RV infected mice and inhibits RV.
Clinical effect of Yunyu Decotion combined with western medicine in treating type 2 diabetes mellitus with Yin deficiency and heat excess syndrome
YING Ya-li, HUANG Qiang
2019, 17(11): 1945-1947. doi: 10.16766/j.cnki.issn.1674-4152.001097
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Objective To observe the clinical effect of Yunyu Decotion combined with western medicine in treating type 2 diabetes mellitus with Yin deficiency and heat excess syndrome, so as to explore the effective treatment of the disease and promote the improvement of patients' quality of life. Methods A total of 96 patients with type 2 diabetes admitted to our hospital from February 2018 to February 2019 were randomly divided into control group (n=48) and observation group (n=48). The two groups were treated with metformin and Yunyu Decotion combined with metformin on the basis of routine treatment respectively. The changes of syndrome integral, clinical efficacy, blood sugar level (fasting blood sugar, 2 h postprandial blood sugar and glycosylated blood sugar) and adverse reactions (diarrhea, dizziness, headache and rash) were compared between the two groups. Results After treatment, the syndrome score of the observation group (5.72±1.81) was lower than that of the control group (8.62±2.65), the total effective rate of the observation group (93.75%) was higher than that of the control group (79.17%). After treatment, the fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin (7.31 mmol/L±1.24 mmol/L, 8.72 mmol/L±2.19 mmol/L, 3.82%±1.44%) of the observation group were lower than that of the control group (8.64 mmol/L±3.37 mmol/L, 13.07 mmol/L±2.35 mmol/L, 5.05%±2.18%). The incidence of adverse reactions in the observation group (4.17%) was similar to that in the control group (6.25%). There was no significant difference between the two groups (all P>0.05). Conclusion Yunyu Decotion combined with western medicine has a significant clinical effect in treating type 2 diabetes mellitus with Yin deficiency and heat excess syndrome. It can significantly reduce the syndrome score, improve the blood sugar level of patients, and have fewer adverse reactions. It is worth promoting.
Study on the effect of comprehensive nursing intervention on postpartum depression of high-risk pregnant women
CAO Juan, WANG Lan-yun, LIU Lin, YE Guo-liu
2019, 17(11): 1948-1950,1972. doi: 10.16766/j.cnki.issn.1674-4152.001098
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Objective To investigate the effect of comprehensive nursing intervention on postpartum depression in pregnant women with high risk of pregnancy. Methods Eighty-eight patients with postpartum depression diagnosed within 2-5 days after delivery from February 2016 to February 2018 in the first affiliated hospital of Bengbu medical college were randomly divided into study group and control group, with 40 cases in each group. Patients in the control group were treated with routine nursing intervention. The patients in the study group were treated with comprehensive nursing intervention. The quality of care, depression score, anxiety score and quality of life before and after treatment were compared. Results The nursing satisfaction of the study group was higher than that of the control group (P<0.05). The nursing service level, nursing attitude, psychological intervention, and health education of the study group were significantly higher than those of the control group, the differences were statistically significant (all P<0.05). After the nursing intervention, both groups of patients had depression and anxiety scores, but there were no significant. The score of the study group was better than that of the control group (P<0.05). The quality of life of the study group was higher than that of the control group (P<0.05). The social function, physical function, the functional and cognitive functions were significantly higher than those of the control group, and the differences were statistically significant (all P<0.05). Conclusion The incidence of postpartum depression in high-risk pregnant women is higher, and the impact on maternal physical and mental health and neonatal growth is more serious. Adequate attention and nursing intervention should be given. Comprehensive nursing intervention for high-risk pregnancy patients with postpartum depression can effectively reduce the depression and anxiety scores of patients, and further improve the patients' nursing satisfaction and quality of life, which is worthy of further clinical promotion and application.
Effect of peer education based on WeChat platform on psychological, self-care ability and quality of life in patients with liver cancer after intervention
ZHANG Ru-xin, DONG Zhen-zhen, MA Bo, ZHANG Shu-di
2019, 17(11): 1951-1953,1968. doi: 10.16766/j.cnki.issn.1674-4152.001099
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Objective To explore the influence of peer education based on WeChat platform on psychological, self-care ability and quality of life in patients with liver cancer after interventional therapy. Methods One hundred and twelve patients with liver cancer intervention in Zhejiang Hospital from June 2017 to June 2018 were selected as research subject and divided into 2 groups according to random number method, 56 cases in each group. The control group was received postoperative routine nursing intervention. The observation group was added peer education nursing intervention based on WeChat platform. Both groups were nursed 4 weeks after discharge. Before and after nursing, the depression self-rating scale (SDS) and anxiety self-rating scale (SAS) were used to evaluate the depression and anxiety of the two groups. The self-care ability measurement scale (ESCA) was used to evaluate the self-concept of the two groups. Self-care ability in health knowledge, self-care skills and self-responsibility. The QOL-30 quality of life scale was used to evaluate the life quality of the two groups in terms of physiological function, psychological function, physical function and social function. Results After nursing, the SDS and SAS scores of the two groups were significantly decreased compared with the control group (P<0.05). After nursing, the self-concept, health knowledge, self-care skills and self-responsibility scores of the two groups were significantly increased compared with the control group (P<0.05). After nursing, the physiological function, psychological function, physical function and social function scores of the two groups were significantly increased compared with the control group (P<0.05). Conclusion Peer education based on WeChat platform can alleviate the depression and anxiety state of, improve the self-care ability of patients, and improve the life quality of patients with liver cancer after interventional therapy.
Clinical observation and nursing of recombinant human interferon α-2b atomized inhalation in the treatment of bronchiolitis
FANG Shan-shan, RONG Dao-xiang, LIU Ji-xiu, PENG Wan-sheng, ZHOU Rui
2019, 17(11): 1954-1956. doi: 10.16766/j.cnki.issn.1674-4152.001100
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Objective To study the clinical observation and nursing effect of recombinant human interferon α-2b injection in the treatment of bronchitis capillarity by atomization inhalation. Methods We selected 120 cases of children with bronchitis in the First Hospital of Bengbu Medical College and grouped them by random numerical tables. The control group (n=60) was treated with inhalation budesonide suspension + 0.9% sodium chloride 1 mL. The observation group (n=60) was treated with inhalation budesonide suspension combined with recombinant human interferon α-2b atomization inhalation. The two groups of treatment effect, adverse reactions, analysis of two groups of clinical symptom improvement time and hospitalization time were compared. Results The total efficiency of the observation group was higher than that of the control group by 91.7% to 73.8%, and the difference was statistically significant (P<0.05). After treatment, the disappearance time of wheezing was (4.82±0.93) days, the disappearance time of coughing was (2.85±0.76) days, the disappearance time of pulmonary rales was (6.12±0.96) days, and the length of hospitalization was (7.65±1.36) days in the observation group. In the control group, the disappearance time of wheezing was (5.37±0.12) days, the disappearance time of coughing was (3.42±1.14) days, the disappearance time of lung rashes was (6.73±1.13) days, and the length of hospitalization was (8.43±1.5) days, all of which were statistically significant (P<0.05). Conclusion The combination of recombinant human interferon α-2b atomization inhalation for children with bronchitis can effectively improve symptoms, reduce hospitalization time, and have fewer adverse reactions and safety.
The effect of personalized nursing combined with psychological induction in postoperative recovery of gastric cancer patients
GAO Xiao-li, MENG Qing-bin
2019, 17(11): 1957-1960. doi: 10.16766/j.cnki.issn.1674-4152.001101
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Objective To study the effect of personalized nursing combined with psychological induction in the recovery period of patients with gastric cancer after operation. Methods Ninety patients with gastric cancer underwent laparoscopic surgery in Wuhan NO.6 Hospital from October 2017 to April 2018 were selected and divided into conventional nursing group, personalized nursing group and psychological combined group by random number method, with 30 cases in each group. The first exhaust time and hospitalization time of the three groups were counted. The psychological status, sleep quality and quality of life of the three groups were compared before and after nursing. The compliance of the three groups in nursing process was evaluated, and the nursing satisfaction of the three groups was investigated. Results The exhaust time and hospitalization time of the combined group were lower than those of the other two groups (P<0.05). The SAS scores of the three groups were lower than those before the nursing (P<0.05). The SDS scores of the conventional nursing group and the personalized nursing group were slightly lower than that before nursing (P> 0.05). The SAS and SDS scores of the psychological combined group were significantly lower than those before nursing, and lower than those of the other two groups (P<0.05). There was no significant difference in AIS and QOL scores before and after nursing in conventional nursing group (P>0.05). The AIS scores and quality of life scores of the patients in the personalized nursing group were slightly better than those before the nursing (P>0.05). The AIS and QOL scores in psychological combined group were better than those before nursing, and better than those of other two groups (P<0.05). The compliance rate and nursing satisfaction rate of the psychological combined group were higher than those of the other two groups (P<0.05). Conclusion Personalized nursing combined with psychological induction can reduce the negative emotions during the recovery period, improve the patient's nursing compliance, the quality of life and sleep of patients, which is widely recognized by patients and their families.
Application of fast track surgery in perioperative period of total knee arthroplasty
ZHU Qian-lan, SONG Hong-hui, JIANG Xi-feng, ZHANG Peng, JIN Jia
2019, 17(11): 1961-1964. doi: 10.16766/j.cnki.issn.1674-4152.001102
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Objective To evaluate the effect of multi-modal analgesic on pain and functional exercise results of patients undergone Total Knee Arthroplasty (TKA) based on the fast track surgery (FTS). Methods Two hundred patients who undergone TKA from January to December 2018 were selected in Department of Joint Surgery. Patients included in odd-numbered months were assigned as the controlled group for routine perioperative nursing and patients included in double-numbered months were assigned to the observation group for multi-modal analgesia based on FTS, including preoperative propaganda and pain assessment, post-operative pain assessment, drug analgesia and observation, early eating, early exercise and other measures. Professional rehabilitation nurses guided and assisted by bedside and collected data. The pain degree (VAS score), the first time of straight-leg raising, the time of getting out of bed, ranges of joint flexion and HSS score were compared between the two groups. Results The VAS scores of the observation group at the time of returning to the room, 6 hours, 12 hours, 24 hours and 48 hours after operation were significantly lower than that of the controlled group. For the first time, the average time of straight leg elevation and the average time of getting out of bed activity in the observation group were 26.5(22.5,36.0)h and 38.0(24.0,49.0)h, respectively, earlier than those in the control group 49.0(31.0,58.0)h and 75.0(48.0,87.0)h. On the 3rd and 5th day after operation, the joint flexion degrees of the observation group were 83.0(65.0,98.0) degrees and 92.0(83.0,107.0) degrees, respectively, which were significantly higher than those of the control group 70.0(45.0,95.0) degrees and 81.0(64.0,102.0) degrees. The HSS scores of the observation group in 1 and 3 months after operation were 86.0(73.0,91.0) and 75.0(68.0,82.0), respectively, which were significantly higher than those of the control group in 1 and 3 months after operation 67.5(60.5,71.0) and 74.0(66.5,80.0). Conclusion Multi-modal analgesic nursing based on the concept of FTS can significantly reduce the degree of pain after total knee arthroplasty and improve the effect of functional exercise.
Application effects of detailed nursing in the intervention of patients after rotator cuff injury repair
CHENG Xia, WU Dan, PAN Hao, WANG Cui-juan
2019, 17(11): 1965-1968. doi: 10.16766/j.cnki.issn.1674-4152.001103
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Objective To investigate the application effect of detailed nursing on the intervention for patients with rotator cuff injury repair under shoulder arthroscopy. Methods Eighty patients who underwent rotator cuff injury repair under shoulder arthroscopy in Hangzhou Hospital of Traditional Chinese Medicine from January 2016 to November 2018 were randomly divided into observation group and control group, 40 cases in each group. The operation of the two groups was operated by the doctors in the same group. The control group was given routine nursing intervention. On this basis, the observation group was additionally given detailed nursing intervention. The response rates of curative effect in the two groups were compared. The following-up last for 6 months. The Constant-Murley shoulder joint was performed to evaluate shoulder joint function. The SF-36 was performed to evaluate quality of life. The self-made nursing satisfaction questionnaire was performed to evaluate satisfaction of patients. Results The total response rates of curative effect in the observation group were significantly higher than that of the control group, The scores of Constant-Murley shoulder function, quality of life and nursing satisfaction of the observation group were significantly higher than that of the control group (P<0.05). Conclusion The application of detailed nursing intervention can improve the curative effect of rotator cuff injury repair under shoulder arthroscopy, significantly improve the postoperative shoulder joint function and quality of life. And the satisfaction of patients is relatively higher.
2019, 17(11): 1969-1972. doi: 10.16766/j.cnki.issn.1674-4152.001104
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96 4
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2019, 17(11): 1973-1975. doi: 10.16766/j.cnki.issn.1674-4152.001105
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67 2
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2019, 17(11): 1976-1978. doi: 10.16766/j.cnki.issn.1674-4152.001106
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