中华全科医学

Difference analysis of higher-level and internal assessment of family doctors' contracted services in community health service institutions in suburban areas of Beijing

CHANG Hai-ming, CHEN Jing-jing, PENG Ying-chun

2019, 17(3): 341-344. doi: 10.16766/j.cnki.issn.1674-4152.000677

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Abstract:
Objective To understand the difference between the results of the higher-level assessment and the internal assessment of family doctors' contracted services in community health service institutions in suburban areas of Beijing, analyze the reasons and put forward countermeasures. Methods Collection of the assessment data of family doctor contracted service in a community health service center in Beijing suburban mountainous area from January 2018 to April 2018 was made, including higher-level and internal assessment. Institutional internal assessment personnel are responsible for carrying out internal assessment after unified training; at the same time, higher authorities carry out the same project assessment of the institution. Examiners at both levels checked and understood the amount of work completed by the organization via the information system. The telephone interview method was used to understand the residents' perception of the service and to judge the authenticity of the contracting work. Assessment was made regarding the quality of family doctor's contract service and health management of hypertension and diabetes patients. The authenticity and effectiveness of the work of the organization were comprehensively analyzed, and the development of the work was assessd according to above results. The study compared and analyzed the differences between the internal assessment results of the organization and those of the higher authorities. Results The authenticity and standardization of internal assessment are generally higher than the results of higher-level assessment. Conclusion In the internal assessment, the assessors are easy to communicate with the residents and get the cooperation of the residents, so they can get more real information.However, the ability of grass-roots performance appraisal personnel needs to be improved, and attention should be paid to avoid the influence of supervisory factors.Superior assessment is normative, but it is not easy to get the cooperation of residents.Therefore, it is suggested that we should make full use of objective assessment methods and take full account of the economic and cultural characteristics of mountainous areas, improve the methods of assessment of family doctors' contractual services, so that they can truly reflect the actual working conditions in mountainous areas and effectively promote the development of family doctors' contractual work.

ZHANG Wei-ping, QU Hong-dang

2019, 17(3): 345-346.

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NLR, PLR and MPV related to the severity of obstructive sleep apnea syndrome

ZHU Yue, SUN Geng-yun

2019, 17(3): 347-350,474. doi: 10.16766/j.cnki.issn.1674-4152.000678

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Objective To explore the role of neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) in the diagnosis and judgment of the severity of obstructive sleep apnea syndrome (OSAS). Methods A retrospective case-control study was conducted among the patients with OSAS. The sleep parameters were recorded by using a polysomnography (PSG). The patients were assigned into mild, moderate and serious groups according to the apnea hypopnea index (AHI). The peripheral blood neutrophil count (WBC), lymphocyte count (LC), platelet count (PLT), platelet distribution width (PDW), NLR, PLR, MPV and other related data were detected and compared among the four groups. The correlation analysis of NLR, PLR, MPV and AHI was carried out by Pearson test, and the value of each index to the diagnosis of OSAS patients was evaluated by ROC curve. Results There were statistical differences in BMI, TC, TG, LDL, nocturnal mean heart rate, NLR, PDW, MPV, minimum oxygen saturation and mean oxygen saturation among the four groups (P<0.05). There was a significant correlation between NLR, PDW, MPV and AHI, P<0.05, however, there was no significant correlation between PLR and AHI (P>0.05). ROC curves analysis showed that the area under the curve (AUC) score was 0.836 for NLR, the best cutoff for ROC was 1.685, sensitivity was 65.5%, specificity was 92.3%, positive predictive value was 96.5%, and negative predictive value was 45.3%. Conclusion NLR, PDW and MPV play an important role in the judgment of the severity of OSAS.

Relationship between hepatitis B core antibody and liver fibrosis severity in CHB patients

ZENG Yan-li, WEI Jun-feng, DING Gang-qiang,

2019, 17(3): 351-354,378. doi: 10.16766/j.cnki.issn.1674-4152.000679

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Objective To explore the correlation between serum hepatitis B core antibody (HBcAb) level and hepatic tissue pathological staging in patients with chronic hepatitis B (CHB). Methods A total of 436 CHB patients who had undergone hepatic biopsy were collected from our hospital. The HBsAg, HBeAg/HBeAb, HBcAb and HBV DNA level were measured using I2000 and M2000 of Abbott. Correlation between serum HBcAb and degree of fibrosis was assessed statistically. Results As the severity of liver fibrosis increased, the HBcAb level gradually increased, and the differences were significant between the groups (F=4.664, P=0.003). Logistic regression analysis showed that the level of HBcAb was an independent prognostic factor of moderate to severe liver fibrosis, with fibroscan score, ALT, AST, HBsAg and HBV DNA level (P<0.05). Multiple logistic regression analysis showed that HBcAb, fibroscan score, HBsAg and HBV DNA level was correlated with moderate to severe liver fibrosis (P<0.05). ROC analysis suggested that a serum HBcAb cutoff of 10 (S/CO) would provide a theoretical sensitivity of 72.9% and with theoretical specificity of 52.63% in HBeAg (+) CHB patients, and the AUC is 0.72. Conclusion HBcAb levels increase gradually along with aggravation of liver fibrosis (S2-S4). The cutoff values of 10 (S/CO) for HBcAb predicts the degree of liver fibrosis in HBeAg-positive CHB patients, and is worthy of clinical application.

Relationship between polymorphism of CYP2C19*2 genotype and cyclophosphamide treatment in systemic lupus erythematosus

ZHANG Yun, YIN Yue, LIU Shu-fen,

2019, 17(3): 355-359. doi: 10.16766/j.cnki.issn.1674-4152.000680

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Abstract:
Objective To study the frequency of CYP2 C19*2 polymorphism in Chinese people and the potential effects on adverse reactions during cyclophosphamide treatment in systemic lupus erythematosus (SLE). Methods We studied 324 unrelated Chinese systemic lupus erythematosus patients from Peking Union Medical College Hospital and 319 healthy controls. CYP2 C19*2 polymorphism was genotyped by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP), and then verified by sequencing. Further statistical analysis was carried out with clinical data. Results The observed frequency of mutant CYP2 C19*2 polymorphism is 29.9% in Chinese people. A total of 237 patients in the SLE group had been treated with cyclophosphamide, and 163 patients had been treated with cyclophosphamide for more than 6 months. The percentage of leukopenia in CYP2 C19*2 carriers was lower, and no significant correlation was found, while CYP2 C19*2 polymorphism was significantly associated with abnormal liver function and uterine bleeding. Multivariate logistic regression model analysis showed that CYP2 C19*2 polymorphism and cumulative dosage of cyclophosphamide were independent factors for abnormal uterine bleeding. Conclusion CYP2 C19*2 polymorphism is not uncommon in Chinese Han population and it might lower the risk of some toxicity of cyclophosphamide in SLE patients.

Fabrication of a radiofrequency needle bending device and its clinical application

CHEN Ya-jing, HUANG Bing, LIU Qian-ying,

2019, 17(3): 360-363. doi: 10.16766/j.cnki.issn.1674-4152.000681

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Abstract:
Objective To design and make a radiofrequency needle bending device for individual needs during the radiofrequency thermal lesioning surgery, and observe the convenience of the bent needle passing through the foramen ovale during the radiofrequency Lesion for V2 branch of trigeminal neuralgia guided by CT.MethodsDesigning and making of bending device: the 5 mm thickness stainless steel plate was cut into a semicircle of 90 mm diameter, then divided into two 1/4; one of 1/4 circular was milled to reduce 1.2 mm, and another one of 1/4 circular was also milled to get a groove with a width and depth of the 1.2 mm round the bottom, ARC length scale (0 degrees to 90 degrees, interval 5 degrees) was marked on the device.Methodsof use: the patients with V2 branch of trigeminal nerve pain received 3 mm thick layer semi-coronal CT scan of the foramen ovale area. We selected the appropriate CT images, and use CT software tool ruler pull line around the lateral wall of the maxillary sinus from puncture target to surface of the skin, if meet sphenoid bone, pull another line from the mouth of foramen ovale to the point of puncture at surface of the skin, then measured the α angle between the two lines. The common radiofrequency needle was inserted into the groove of bending device for 5 to 8 mm as needed, and bent it slightly to the side of slope of needle tip until the needle reached theαangle, thus the needle was facing the individual need. Under the guidance of CT, the needle was punctured according to the designed path, when it reached the mouth of the foramen ovale, turned its point to make a anterosuperior direction for the curve of needle, when the needle passed through the mouth of the foramen ovale, then turned its point to make a posterior inferior direction for the curve of needle. Results Among the 215 cases of radiofrequency thermal lesioning for V2 branch of trigeminal neuralgia, 65 cases who met sphenoid block used the bending device to shape the needle for individual need, the bended angle alpha value was from 11° to 32° (18.9°±4.20°). The tip of the curved needle can smoothly reach the target point; radiofrequency thermal lesioning was well finished. V2 pain disappeared completely after radiofrequency, without the injury of V1 and V3. Conclusion When the V2 branch of the trigeminal nerve was punctured through the zygomatic approach, 30.2% of the patients have the obstruction of the sphenoid bone, and the straight needle is difficult to get into the puncture target in the foramen ovale. The individual bent needle by this invented bend device can make the RF tip get to accurate position and guarantee the effect treatment.

Clinical study of Qiangxinkang granule in the treatment of chronic heart failure

LIU Shu-rong, ZHANG Xiao-hua, QIAN Feng,

2019, 17(3): 364-366. doi: 10.16766/j.cnki.issn.1674-4152.000682

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Objective To evaluate the clinical efficacy of Qiangxinkang Granule in the treatment of chronic heart failure and provide clinical case data for the development of hospital preparations. Methods Total 200 patients with chronic heart failure were randomly divided into treatment group and control group, with 100 cases in each group. On the basis of western medicine treatment, the treatment group received additional Qiangxinkang granules (1 bag, 10 g), twice a day, for 8 weeks. Before and after the treatment, the 6-minute walking distance, plasma NT-proBNP concentration, TCM syndromes score were observed and the clinical efficacy was evaluated. Results The curative effect of TCM syndrome: by rank sum test, the treatment group was superior to the control group, but there was no statistical difference between the two groups (P>0.05). In 6-minute walking distance, the walking distance after the treatment in both groups was prolonged. In the treatment group, it was improved significantly (P<0.05), however in the control group, it was not significant (P>0.05). After the treatment, there was significant difference between the treatment group and the control group (P<0.05). The level of plasma NT-proBNP after the treatment decreased in both group to varying degrees, significantly in the treatment group (P<0.05). After the treatment, there was no statistical difference in the level of plasma NT-proBNP between the two groups (P>0.05). Conclusion For patients with chronic heart failure, the addition of Qiangxinkang granule to the standardized treatment of western medicine can alleviate the clinical symptoms of patients with heart failure, increase the walking distance of patients with heart failure for 6 minutes, reduce the concentration of NT-proBNP in plasma, and improve the quality of life of patients. The result provides a reference for the research and development of hospital preparations, and worth to be widely used in clinic.

Risk factors and prognosis of vascular invasion in patients with T1a-T1b gastric cancer

LI Hang, PAN Zhi-jian, WU Wei,

2019, 17(3): 367-369,387. doi: 10.16766/j.cnki.issn.1674-4152.000683

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Objective To analyze the risk factors of vascular invasion in patients with stage T1 a-T1 b gastric cancer and their prognosis, and to provide reference for the clinical treatment of patients with gastric cancer. Methods A total of 80 patients with stage T1 a-T1 b gastric cancer faced the inclusion criteria in the Affiliated Hospital of Hangzhou Normal University from March 2013 to June 2015 were selected and divided into the vascular invasion group (24 cases) and the vascular non-invasion group (56 cases) according to whether the vessels were infiltrated. The clinicopathologic features were compared between the two groups. Cox multivariate analysis was used to analyze the risk factors of vascular invasion. The 3-year cumulative survival rate was compared between the two groups. Results When compared with the vascular non-invasion group, the patients in the vascular invasion group were with higher lymph node metastasis rate (P<0.05), lower proportion of ulcer type in gross classification of tumors (P<0.05), higher ratio of low differentiation (P<0.05), and higher proportion of T1 b stage in the depth of tumor invasion (P<0.05), the difference was statistical significant. There were no significant differences in the cancerous node and tumor diameter between the two groups (P>0.05). Cox multivariate analysis showed that lymph node metastasis and depth of tumor invasion were independent risk factors for vascular invasion in patients with gastric cancer (P<0.05). The 3 years cumulative survival rate of the vascular invasion group was significantly lower than that of the non-invasion group (P<0.05). Conclusion Lymph node metastasis and depth of tumor invasion are independent risk factors for vascular invasion in patients with T1 a-T1 b gastric cancer. The prognosis of stage T1 a-T1 b gastric cancer patients with vascular invasion is not good.

Relationship between JAM-1 and STAT3 signaling pathway in patients with ulcerative colitis

YU Ye-ming, GU Lin, YAN Shan-jun,

2019, 17(3): 370-373. doi: 10.16766/j.cnki.issn.1674-4152.000684

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Objective To investigate the expression of JAM-1 in patients with ulcerative colitis (UC) and analyze the relationship between junctional adhesion molecule-1 (JAM-1) and STAT3 signaling pathway. Methods The tissue sample of 40 UC examined by electronic colonoscopy and confirmed by pathologic examination in our hospital between January 2017 and January 2018 [faced the consensus opinion on the diagnosis and treatment of inflammatory bowel disease (2012) ] were collected as experimental groups, and 20 cases of normal intestinal mucosa in the operating room (normal tissue of the intestine resection of the gastrointestinal surgery, all the normal intestinal mucosa were the same source) were collected as the control group. The severity of colitis was assessed by histopathological grade. The expression of JAM-1, STAT3 and pSTAT3 in colon tissue was detected by immunohistochemistry (IHC). Results The histopathological examination showed that the intensity of JAM-1 staining in the colonic mucosa of the experimental group was significantly weakened, the number of stained cells decreased, and the distribution was scattered when compared with the control group. There was no significant change in the intensity of STAT3 staining. The staining intensity of pSTAT3 was significantly enhanced, and the number of stained cells increased. Immunohistochemistry results showed that the expression of JAM-1 protein was decreased and the expression of pSTAT3 was increased when compared with the control group (P<0.05). There was no statistically significant difference in STAT3 expression. Conclusion In patients with ulcerative colitis, the expression of JAM-1 can be decreased, but the level of pSTAT3 will be elevated. There is a negative correlation between expression of JAM-1 and pSTAT3 in colonic mucosa tissues of patients with ulcerative colitis.

Effects of NF-κB p65 and TNF-α on Nrf2/ARE signal pathway in patients undergoing cardiopulmonary resuscitation

XIA Jin-ming, LAI Deng-pan, WEI Xia,

2019, 17(3): 374-378. doi: 10.16766/j.cnki.issn.1674-4152.000685

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Objective To investigate the relevance between NF-κB signal pathway and Nuclear factor erythroid 2-related factor 2 (Nrf2) /ARE signal pathway through analyzing the correlation among NF-κB p65, TNF-α and Nrf2 levels in cardiac arrest (CA) patients undergoing cardiopulmonary resuscitation (CPR). Methods Medical records of CA patients undergoing CPR and survived more than 72 hours were collected, the plasma levels of NF-κB p65, TNF-α and Nrf2 were tested at CA, return of spontaneous circulation (ROSC) and 2, 8, 12, 24, 48, 72 h after ROSC, their changes and correlations were analyzed. Furtherly, the factors affecting prognosis of CPR were analyzed by ROC curve. Results Total 36 patients survived more than 72 hours in 100 CA patients undergoing CPR and had ROSC. The plasma level of Nrf2 decreased to varying degrees, and dropped to the lowest level at 8 h after ROSC. However, the plasma levels of NF-κB p65 and TNF-α increased significantly, and peaked at 12 h and 8 h after ROSC respectively. Correlation analysis showed that Nrf2 was negatively correlated with NF-κB p65 and TNF-α (r=-0.505, -0.446, P<0.05), NF-κB p65 was positively correlated with TNF-α (r=0.531, P<0.05). ROC curve showed that NF-κB p65 and TNF-α could predict the prognosis of patients with CPR. Conclusion The inflammation and oxidative stress injury will occurred in CA patients undergoing CPR, they are closely related and affected each other. The effect of inflammation on prognosis is significantly greater than oxidative stress injury.

The clinical observation of Bacillus coagulans live tablets combined with Smectite powder on the treatment of Diarrhea after laparoscopic cholecystectomy

ZHUO Qi-feng, CHEN Ming-liang, XIN Chang,

2019, 17(3): 379-383. doi: 10.16766/j.cnki.issn.1674-4152.000686

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Objective To observe the effect of Bacillus coagulans live tablets combined with Smectite powder treatment after laparoscopic cholecystectomy diarrhea and effect on intestinal microflora and intestinal barrier function. Methods One hundred and twenty patients of laparoscopic cholecystectomy with diarrhea were randomly divided into observation group 60 cases and control group 60 cases from May 2014 to June 2018, control group was given smectite powder, the observation group was treated with Bacillus coagulans live tablets, 2 groups were treated for two weeks. The changes of total clinical symptom scores, intestinal flora and intestinal mucosal barrier function were observed before and after treatment. Results The stool frequency, stool and abdominal discomfort symptoms of two groups improved after treatment, the total effective rate of observation group was 91.7% (55/60), the control group was 71.7% (43/60), the efficacy of the observation group was more significant than the control group (χ²=9.186, P=0.010). After treatment, the Escherichia coli and enterococci in the observation group decreased significantly compared with those before treatment (P<0.05), and significantly lower than those in the control group (P<0.05). The number of Lactobacillus and Bifidobacteria in the observation group increased significantly (P<0.05), and significantly higher than that in the control group (P<0.05). After treatment, the serum D-lactate index in the two groups was significantly lower than that before the treatment, and the decrease in the observation group was more obvious than that in the control group (P<0.05). The level of sIgA in the two groups was significantly higher than that before treatment (P<0.05), and the sIgA level of the intestinal tract in the observation group was significantly higher than that of the control group (P<0.05). Conclusion Bacillus coagulans live tablets combined with Smectite powder treatment can significantly relieve the clinical symptoms after laparoscopic cholecystectomy in patients with diarrhea, which may be related to its regulation in patients with intestinal microecological balance and promote the epithelial barrier function of intestinal mucosa repair.

Correlation between sympathetic skin response and plasma dopamine, serotonin and HAMD scores in patients with post-stroke depression

LI Zheng-zheng, CONG Wen-jie, ZHENG Xiao-lu,

2019, 17(3): 384-387. doi: 10.16766/j.cnki.issn.1674-4152.000687

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Objective To investigate the correlation between sympathetic skin response (SSR) and plasma dopamine (DA), serotonin (5-HT) and Hamilton Depression Scale (HAMD) scores in patients with post-stroke depression. Methods A total of 57 patients with post-stroke depression and 55 patients with stroke-free depression were enrolled from May 2016 to May 2018 in our hospital. Fifty health people were included in the study. The SSR latency and amplitude of plasma in the medial and lower extremity of the lower extremities were measured and compared. 5-HT levels as well as HAMD scores, and analysis of the correlation between them. Results The SSR latency and amplitude of upper and lower limbs in the post-stroke depression group were significantly higher than those in the normal control group (all P<0.05), and the SSR latency of upper and lower limbs in the post-stroke depression group was significantly higher than that in the post-stroke non-depression group (all P<0.05). The SSR latency of upper limbs in the non-depressive group after stroke was significantly higher than that of the normal control group (P<0.05), and the SSR amplitude of upper limbs and lower limbs was significantly lower than that of the normal control group (all P<0.05). The levels of plasma DA and 5-HT in the post-stroke depression group were significantly lower than those in the non-depression group and the normal control group (all P<0.05). The HAMD scores and SSR latency of the upper and lower limbs in the post-stroke depression group were positively correlated (all P<0.05), and were not correlated with the amplitude, but negatively correlated with DA and 5-HT (all P<0.05). The stroke-free group and the normal control group.The SSR latency of upper and lower limbs in the post-stroke depression group was negatively correlated with plasma DA and 5-HT levels (all P<0.05). The SSR latency of upper limbs in the normal control group was negatively correlated with plasma DA and 5-HT levels (all P<0.05). The SSR latency of lower limbs was negatively correlated with plasma DA (P<0.05). Conclusion Based on the detection of SSR, combined with plasma DA, 5-HT level and HAMD score, it can make more rigorous and accurate judgment on patients with post-stroke depression, and can provide a reliable diagnosis basis for clinical.

Efficacy of Dexmedetomidine for sedation in tangential excision and skin grafting for burn injury

ZHU Tao, CHEN Ling-yang

2019, 17(3): 388-391,454. doi: 10.16766/j.cnki.issn.1674-4152.000688

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Objective To investigate the clinical efficacy of Dexmedetomidine for sedation in tangential excision and skin grafting for burn treatment. Methods A total of 60 hypertension patients with burns undergoing tangential excision and skin grafting in our hospital from January 2014 to December 2017 were enrolled into this study and randomly divided into control group and treatment group with 30 patients in each group. All the selected patients were administrated with 0.5 mg penehyclidine hydrochloride intravenously 20 minutes before surgery. The control group received the routine surgical anesthesia, while the treatment group received intravenous injection of dexmedetomidine 15 min before the surgery on the basis of routine anesthesia. Results The level of sedation scores at 10 minutes after induction in the treatment group was higher than that in the control group, the oxygen saturation in the treatment group was lower than that in the control group, however, the respiratory rate in the treatment group was higher than that in the control group, the differences were statistically significant (all P<0.05). The maintenance dose of propofol per unit time was (3.9±0.8) mg/ (kg·h) in the control group, and (1.7±0.4) mg/ (kg·h) in the treatment group, of ketamine was (3.5±0.6) mg/ (kg·h) in the control group and (1.4±0.3) mg/ (kg·h) in the treatment group, respectively, the difference was statistically significant (all P<0.05). During the excision of the scab, skin harvest and skin grafting, the heart rate and systolic blood pressure in the treatment group was significantly lower than those in the control group, and the difference was statistically significant (all P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group, the l wake-up time after surgery was significantly shorter than that in the control group, and the differences was statistically significant (all P<0.05). The surgery duration of the control group and the treatment group were (151.6±71.3) min and (161.8±69.3) min, respectively, with no significant difference (P>0.05). Conclusion The intravenous infusion of dexmedetomidine can save the dose of propofol and ketamine on the base of sedation. The hemodynamics and respiration of the patients keep stablely during the operation. It can also shorten the waking-up time and decrease the incidence of adverse reaction.

Correlation between PHN and patient' s condition, VZV load, S100β, NSE level in patients with acute stage herpes zoster

CAI Wei, DING Juan, JIN Chong-ying

2019, 17(3): 392-395. doi: 10.16766/j.cnki.issn.1674-4152.000689

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Objective To investigate the changes of the patient's condition, varicella zoster virus (VZV) load, plasma S100β, neuron specific enolase (NSE) level in acute stage herpes zoster (HZ), and analyze their relationship with postherpetic neuralgia (PHN). Methods Fifty-six patients were selected from November. 2016 to May 2017 in our hospital with acute stage of HZ as observation group, before and after treatment to evaluate HZ patients condition, detect VZV DNA loads at the same time, plasma S100βand NSE level, and in the same period, 50 healthy volunteers were selected as control group. After 1 month follow-up of PHN in patients with HZ, the relationship between PHN and HZ patient's disease, VZV DNA load, plasma S100β and NSE were analyzed by Spearman. Results After treatment, the score of HZ patients was significantly lower than before treatment (P<0.05); No VZV DNA was detected in the blood of the control group, VZV DNA was detected in blister fluid of HZ patients in observation group, before treatment, there were 21 cases (37.5%) of VZV DNA positive in patients with HZ, after treatment, there were 7 cases (12.5%) of VZV DNA positive in peripheral blood of HZ patients, before and after treatment, the VZV DNA load in peripheral blood of HZ patients was significantly lower than that of the VZV DNA load in blister fluid of HZ patients (all P<0.05), and the VZV DNA load in peripheral blood of HZ patients after treatment was significantly lower than before treatment (P<0.05); Before and after treatment, the S100β and NSE levels of the observation group were significantly higher than the control group (all P<0.05), and after treatment, the S100β and NSE levels of the observation group were significantly lower than before treatment (all P<0.05); Before treatment, PHN was positive correlated with the disease, VZV and NSE (r=0.347, 0.562, 0.281; all P<0.05), and was unrelated to peripheral blood VZV and S100β, after treatment, PHN was positive correlated with the disease, peripheral blood VZV, S100β and NSE (r=0.606, 0.594, 0.606, 0.379; all P<0.05). Conclusion The changes of HZ patient's condition score, VZV load, S100β and NSE level have certain predictive value for PHN.

Expression of NPAS2 in acute myeloid leukemia and its effect on cell growth

MU Jiao, YANG Xi-liang, REN Jing-jing,

2019, 17(3): 396-398,482. doi: 10.16766/j.cnki.issn.1674-4152.000690

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Objective To explore the expression of NPAS2 in AML patients and cell lines, and to analyze the effect of NPAS2 on the growth of AML cells. Methods The mRNA expression of NPAS2 in 46 AML patients was analyzed from 2013 to 2017 by real-time PCR. The protein expression of NPAS2 in AML cell lines was analyzed by western blot. The relationship between the expression of NPAS2 and prognosis of AML patients was analyzed by statistical method. The effects of NPAS2 on the growth of AML cells were detected by using CCK-8 after using RNAi to interfere the expression of NPAS2. Results The expression of NPAS2 in AML patients and cell lines was higher than that in control group (P<0.05). Compared with control group, the expression level of NPAS2 in the AML-M1, M2, M3, M4 and M5 patients was higher (P<0.05), and the expression level in the AML-M6 and M7 patients was no different (P>0.05). AML patients with high expression of NPAS2 had a shorter overall survival period (P<0.05). Compared with the control group, the cell growth of the RNAi-NPAS2 group was significantly decreased in AML cells (P<0.05). Conclusion The expression NPAS2 was raised in AML patients and negatively correlated with the prognosis of AML patients, while NPAS2 promoted AML cell growth.

Prognostic role of inflammatory biomarkers in gliomas

ZHENG Hai-jun, YANG Xiao-qing, YANG Hong-jun,

2019, 17(3): 399-402. doi: 10.16766/j.cnki.issn.1674-4152.000691

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Objective To assess the prognostic significance of inflammatory biomarkers, including the C-reactive protein (CRP), neutrophil lymphocyte ratio (NLR) and the erythrocyte sedimentation rate (ESR), in gliomas. Methods Clinico-pathological data of 178 patients with gliomas in Zhejiang Rui'an Renmin Hospital between January 2010 and January 2016 was analyzed retrospectively in this study. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors. Results The NLR and CRP were associated with the tumor size, differentiation degree and lymphovascular invasion (all P<0.05). PLR was positively correlated with the tumor size (P<0.05). The Kaplan-Meier curves showed that the patients with gliomas had a longer time in the low NLR group, low CRP group and low ESR group than in the high NLR group, high CRP group and high ESR group respectively, showing a significant difference (all P<0.05). The multivariate analyses showed that the differentiation degree, CRP and NLR were independent factors for predicting overall survival of gliomas patients. Conclusion The CRP and NLR have prognostic value for predicting overall survival in gliomas patients.

Efficacy of laparoscopy and duodenoscopy combined with choledochoscopy in the treatment of biliary calculi

WANG Jin-bo, ZHANG Miao-zun

2019, 17(3): 403-405,463. doi: 10.16766/j.cnki.issn.1674-4152.000692

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Objective To observe the efficacy and safety of laparoscopy, duodenoscopy and choledochoscope in the treatment of extrahepatic bile duct stones, in order to provide data support for the formulation of treatment plan. Methods Total 82 patients with extrahepatic bile duct stones diagnosed in our department from August 2017 to August 2018 were selected. They were included in the control group (41 cases) and the observation group (41 cases) according to the random number table method. The control group was treated with routine laparoscopic combined with choledochoscope. The observation group was treated with laparoscopic and duodenoscope combined with choledochoscope. The success rate, stone removal rate and prognosis of the two groups were compared. Bed efficacy, clinical indicators (operation time, bleeding volume, anal exhaust time, recovery time of gastrointestinal function, out-of-bed activity time, hospital stay), complications (incision infection, common bile duct injury, bile leakage, gastrointestinal perforation) and quality of life (SF-36 score). Results The success rate (97.6%) of the observation group was higher than that in the control group (80.5%), the total efficiency of the Observation Group (92.7%) was higher than that in the control group (75.6%), and the operation time of the observation group was longer than that in the control group. The incidence of complications in the Observation Group (4.9%) was lower than that in the control group (19.5%), the scores of SF-36 in the observation group were higher than those in the control group, and the differences were statistically significant in each group (all P<0.05). The stone clearance rate in the observation group (95.1%) was slightly higher than that in the control group (90.2%), with no significant difference (P>0.05). Conclusion The three-mirror combination therapy for extrahepatic bile duct stones is effective, with high success rate, rapid recovery, good prognosis and other advantages, which is worth promoting.

Effect of Siwu decoction on coagulation function and bone metabolism of senile intertrochanteric fracture patients undergoing proximal femoral anti-rotation nail surgery

WU Zhi-min, WU Ming, HU Guan-biao,

2019, 17(3): 406-408,412. doi: 10.16766/j.cnki.issn.1674-4152.000693

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Abstract:
Objective To analyze the effect of Siwu decoction on coagulation function and bone metabolism of senile intertrochanteric fracture patients undergoing proximal femoral anti-rotation nail (PFNA) surgery, and to provide a reference for the clinical treatment of senile intertrochanteric fracture patients. Methods A total of 86 senile patients with intertrochanteric fracture who were diagnosed and inclusion criteria in our hospital were selected from July 2017 to January 2018, and they were randomly divided into observation group (n=43) and control group (n=43) according to the random number table method. The control group was treated with conventional therapy, and the observation group was treated with siwu decoction based on the control group. The fracture healing rate, coagulation function and bone metabolism related indicators levels were compared between the two groups. Results The fracture healing rate in observation group was obviously higher than that of control group (P<0.05). Before treatment, there were no significantly differences in the level of hematocrit value (HCT), hemoglobin (Hb), the hidden blood loss, bone alkaline phosphatase (BALP), osteocalcin (OC) and parathyroid hormone (PTH) and β isomer of the C-terminal telopeptide of type Ⅰ collagen (β-CTX) between the two groups (P>0.05). After treatment, the level of HCT, Hb, BALP and OC were obviously higher than those of before treatment in observation group (P<0.05), and the observation group was obviously higher than the control group (P<0.05). The level of hidden blood loss, PTH and β-CTX were obviously lower than those of before treatment in observation group (P<0.05), and the observation group was obviously lower than the control group (P<0.05). Conclusion The siwu decoction can improve fracture healing rate of patients with intertrochanteric fractures undergoing PFNA surgery, improve coagulation function and promote bone metabolism.

Effect of Tanreqing injection combined tiotropium on respiratory function of pneumoconiosis patients with stable COPD and its mechanism

QIAO Zhi-hao, LIU Chang, ZHANG Meng-ya

2019, 17(3): 409-412. doi: 10.16766/j.cnki.issn.1674-4152.000694

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Abstract:
Objective To investigate the effect of Tanreqing injection combined with tiotropium on respiratory function in patients with pneumoconiosis and stable chronic obstructive pulmonary disease (COPD) and its mechanism. Methods A total of 128 pneumoconiosis patients with stable COPD in our hospital from December 2016 to March 2018 were randomized divided into 2 groups, 64 in each group. The control group was received inhalation therapy with Tiotropium bromide aerosol, and the observation group was treated with Tanreqing injection based on control group. The clinical efficacy, clinical symptoms before and after treatment (cough, sputum, arpeggio/wheezing, wheezing/dyspnea, chest tightness/puffiness, poor appetite, abdominal distension, shortness of breath/self-perspiration, flu) scores, lung function (FEV%, FVC, FEV1/FVC), serum IL-1, TNF-α, and TGF-β1 levels of two groups were compared. Results After treatment, the total effective rate of observation group was 90.63%, which was significantly higher than that of control group (73.44%), P<0.05. After treatment, the clinical symptoms scores of two groups were significantly decreased (all P<0.05), and the observation group was significantly lower than the control group (all P<0.05). After treatment, the FEV%, FVC, and FEV1/FVC levels of two groups increased significantly (all P<0.05), and the observation group was significantly higher than the control group (all P<0.05). Serum IL-1, TNF-α and TGF-β1 levels of two groups were significantly lower (all P<0.05), the observation group was significantly lower than control group (all P<0.05). Conclusion Tanreqing injection combined Tiotropium bromide can significantly improve the clinical symptoms and respiratory function of pneumoconiosis patients with stable chronic obstructive pulmonary disease, and its mechanism might be related to the reduce of serum IL-1, TNF-α, TGF-β1 levels and relieve airway inflammation.

Effect of OSAHS on heart rate variability in elderly patients with hypertension

LIU Jie, DENG Ya-ping

2019, 17(3): 413-415. doi: 10.16766/j.cnki.issn.1674-4152.000695

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Abstract:
Objective To investigate the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on heart rate variability in elderly patients with hypertension. Methods Eighty elderly patients with hypertension in our hospital from March 2015 to September 2016 were divided into two groups, OSAHS group (38 cases) and non-OSAHS group (42 cases). Another 30 healthy volunteers were selected as healthy control group. Three groups were examined by 24-hour dynamic electrocardiogram to obtain HRV time-domain index data and frequency-domain index data. Results ① The indexes of SDNN, SDANN and rMSSD in non-OSAHS group were (118.15±15.64) ms, (121.55±16.55) ms, (27.98±10.29) ms, respectively, lower than those in control group (all P<0.05); the indexes of SDNN, SDANN and rMSSD in OSAHS group were (89.19±13.95) ms, (86.64±17.34) ms, (21.44±7.27) ms, respectively, which were lower than those in non-OSAHS group (all P<0.05). ② The LF indices of the three groups were (20.01±7.99) Hz, (21.56±8.96) Hz, (21.63±9.33) Hz (P>0.05). The HF index of non-OSAHS group was (11.32±4.56) Hz, lower than that of control group [ (14.75±5.19) Hz], P<0.05; the HF index of OSAHS group was (9.14±3.82) Hz, lower than that of non-OSAHS group (P<0.05). The L/H index of non-OSAHS group was (1.96±0.34) Hz, higher than that of control group [ (1.45±0.38) Hz], P<0.05; the L/H index of OSAHS group was (2.23±0.32) Hz, higher than that of non-OSAHS group (P<0.05). Conclusion OSAHS can reduce the HRV index of elderly patients with hypertension, aggravate the degree of sympathetic and parasympathetic imbalance, increase the sympathetic nerve tension, and aggravate the adverse prognosis of elderly patients with hypertension.

Kidney and medullary acupuncture combined with compound musk injection for the treatment of cognitive impairment after stroke

DING He-zheng, ZHAO Xue-zheng, CHEN Xi-yuan,

2019, 17(3): 416-418,499. doi: 10.16766/j.cnki.issn.1674-4152.000696

138 1

Abstract:
Objective To study the effect of kidney-nourishing needle combined with compound musk injection on cognitive impairment after stroke. Methods A total of 110 patients with post-stroke cognitive impairment who visited our hospital from June 2015 to June 2016 were selected. They were divided into control group and combined group according to different treatments. The patients in the control group were treated with 20 ml compound musk injection dissolved in 5% glucose and intravenous drip once a day. The patients in the combined group were treated with nourishing kidney and benefiting marrow acupuncture on the basis of the treatment in the control group. The two groups were treated continuously for 3 weeks. Statistical data included TCM syndrome score, Barthel score, Montreal Cognitive Assessment (MoCA) score, Glasgow Coma Scale (GCS), cerebral hematoma volume and adverse reactions. Results After treatment, the scores of TCM syndromes in the combined group (t=21.080, P<0.001), fatigue (t=20.340, P<0.001), mental fatigue (t=20.880, P<0.001), dizziness (t=22.510, P<0.001) were lower than those in the control group (all P<0.05). After treatment, the Barthel score (t =6.490, P<0.001), MoCA score (t=10.130, P<0.001) in the combined group were higher than those in the control group. The amount of cerebral hematoma in the combined group was lower than that in the control group (t=6.490, P<0.001), and the GCS score was higher than that in the control group (t=10.130, P<0.001). The incidence of adverse reactions in the combined group was 3.64%, lower than 14.55% in the control group. Conclusion The combination of kidney-nourishing needle therapy with compound musk injection has a significant effect on cognitive impairment after stroke, which can improve the level of TCM syndromes and cognitive functions and promote the recovery of patients.

Analysis of correlation among intimate relationship with spousal and prenatal depression among patients undergoing assisted reproductive technology

HU Ying, LI Zai-yuan, FANG Yu-juan,

2019, 17(3): 419-422. doi: 10.16766/j.cnki.issn.1674-4152.000697

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Abstract:
Objective To investigate the influencing factors of intimate relationship with spousal and prenatal depression among patients undergoing assisted reproductive technology, and to improvement of psychological status and health intervention for patients undergoing assisted reproductive technology. Methods From January to December 2017, a total of 426 patients undergoing assisted reproductive technology from five hospitals in Hangzhou were selected, and surveyed by Marital Adjustment Test (MAT) and Edinburgh Postnatal Depression Scale (EPDS). A database of survey questionnaire was established with SPSS 18.0 software was used for date management and analysis. The method of relation analysis was using for analysis of the relation of intimate relationship with spousal and prenatal depression among patients undergoing assisted reproductive technology. Results The scores of MAT of 426 patients undergoing assisted reproductive technology were 104.43±15.85, and a total of 229 patients (53.76%) patients was with better intimate relationship. The scores of EPDS were 8.52±4.18, and the rate of score was 24.41%. The results of Pearson correlation analysis showed that there was a negative correlation between the two (r=-0.395, P=0.008), and the difference was statistically significant. Conclusion The intimate relationship with spousal is negatively correlated with prenatal depression among patients undergoing assisted reproductive technology. The higher the level of intimate relationship, the lower the level of prenatal depression among patients undergoing assisted reproductive technology. The sociology, hospital and family should be paid more attention during the intervention to reduce the level of prenatal depression.

Clinical effect research of Xiaoyao san and Guishao Wuzi decoction combined with Shenqi glucose injection on the treatment of uterine artery resistance increased recurrent abortion

LIU Hong-juan, YI Lei, CHEN Mei-juan,

2019, 17(3): 423-425,495. doi: 10.16766/j.cnki.issn.1674-4152.000698

209 1

Abstract:
Objective To investigate the clinical effect of Xiaoyao san (menstrual period) and Guishao Wuzi decoction (non-menstrual) combined with Shenqi glucose injection on the treatment of uterine artery resistance increased recurrent abortion. Methods A total of 80 patients with uterine artery resistance increased recurrent abortion from January 2016 to June 2017 in our hospital were divided into two groups according to the random number method, with 40 in each group. Before the pregnancy, the control group was given aspirin, and the observation group was given Xiaoyao san (menstrual period) plus Guishao Wuzi decoction (non-menstrual) combined with Shenqi glucose injection. Two groups were treated for 3 courses. After treatment, the TCM syndrome score, the bilateral uterine artery blood flow resistance index (RI) and the bilateral uterine artery systolic peak flow rate/end diastolic flow rate (S/D) ratio of two groups, as well as serum chorionic gonadotropin (β-HCG) and progesterone (P) at Pregnancy 30 days and 56 days in two groups were compared, and the pregnancy success rate after pregnancy was accounted. Results After treatment, the TCM syndrome scores of the two groups were significantly lower (P<0.05), and the observation group was significantly lower than the control group (P<0.05). After treatment, the sum of the left RI, right RI and S/D ratios was significantly lower (P<0.05), and the observation group was significantly lower than the control group (P<0.05). The β-HCG and P levels of observation group at pregnancy 30 days and 56 days were significantly higher than that of control group (P<0.05). After treatment, the success rate of the fetus in the observation group was 86.84%, which was significantly higher than that of the control group (67.56%), P<0.05. Conclusion Xiaoyao San (menstrual period) plus Guishao Wuzi Decoction (non-menstrual period) combined with Shenqi glucose injection could effectively treat uterine artery resistance increased recurrent abortion, significantly improve the clinical symptoms and reduce uterine artery blood flow resistance, and improve the success rate of patients with abortion.

Clinical study on related factors of respiratory tract infection in children in island area of Yuhuan

SHEN Ren, YANG Shan-pu, WU Yue-chao,

2019, 17(3): 426-429. doi: 10.16766/j.cnki.issn.1674-4152.000699

178 5

Abstract:
Objective To study the correlation between vitamin A and E levels and respiratory tract infection in children, and to analyze the risk factors of recurrent respiratory tract infection (RRTI) in children in island area of Yuhuan. Methods A total of 452 hospitalized and outpatient children in Yuhuan people's Hospital from August 2017 to April 2018 were divided into RRTI group (142 cases), bronchopneumonia group (158 cases) and healthy physical examination group (152 cases). The rates of vitamin A, vitamin E deficiency and anemia were compared among the three groups. The differences of vitamin A, vitamin E and hemoglobin levels between the three groups were compared. RRTI was analyzed by univariate and multivariate Logistic regression analysis. Results The vitamin A deficiency rate in RRTI group was significantly higher than that in bronchopneumonia group and healthy physical examination group (P<0.05), and the vitamin A deficiency rate in bronchopneumonia group was higher than that in healthy physical examination group (P<0.05). There was no significant difference in vitamin E deficiency rate among the three groups (P>0.05). The anemia rate in the RRTI group was significantly higher than that in the health examination group (P=0.002). There were significant differences in vitamin A and hemoglobin levels among the three groups (P<0.05), but there was no significant difference in vitamin E levels among the three groups (P>0.05). Multivariate Logistic regression analysis based on univariate analysis showed that vitamin A deficiency, passive smoking, premature delivery, anemia, frequent infusion and nursery school were all independent risk factors for RRTI (P<0.05), and breast feeding was an independent protective factor (P<0.05). Conclusion The rate of vitamin A deficiency was higher and vitamin E deficiency was not obvious in children in the island area of Yuhuan, and RRTI in children was related to many factors, among which vitamin A deficiency was an important reason.

Correlation between clinicopathological features and pelvic lymph node metastasis in cervical cancer

ZHAO Xiao-ying, ZHENG Hu-zhong, JIN Wei-wei,

2019, 17(3): 430-432. doi: 10.16766/j.cnki.issn.1674-4152.000700

95 0

Abstract:
Objective To analyze the relationship between the clinicopathological features of the cervical cancer patients and pelvic lymph node metastasis. Methods We chose 102 cervical cancer patients who were admitted to our hospital from March 2015 to March 2017, including 22 cases with pelvic lymph node metastasis, the metastasis rate was 21.57%, as the observation group, the other 80 cases without pelvic lymph node metastasis as the control group, observed and discussed the two groups of tumor staging, histology type, growth type, and so on. We compared the relationship between the tumor staging, histology type, growth type with pelvic lymph node metastasis. Results In the observation group, there were 9 cases of menopause, 9/22 (40.91%) and 22 cases in the control group, accounting for 22/80 (27.5%), the difference was statistically significant (P<0.05); high risk HPV positive 22 cases, 100%, negative 0 cases; IB 14 cases, 14/22 (63.64%), IIa have 8 cases, accounting for 8/22 (36.36%); there were 14 cases of tumor more than 4 cm, accounting for 14/22 (63.64%), 8 cases of tumor<4 cm, accounting for 8/22 (36.36%), the difference was statistically significant (P<0.05); 10 cases (45.45%) of the invasive depth of cervical myometrium in the observation group, 17 (21.25%) in the control group (21.25%), and statistically significant (P<0.05) in the observation group (P<0.05). There were 17 cases of edophytic type, 5 cases of exophytic type, 0 cases of ulcerative type and cervical type in the observation group, compared with the control group, the difference was statistically significant (P<0.05). Conclusion The patients with cervical cancer have high risk of HPV, the clinical staging and the tumor size are related to the pelvic lymph node metastasis. The adenocarcinoma and endogenetic cervical cancer patients have higher pelvic lymph node metastasis, which provides a reference for the individualized treatment of cervical cancer patients.

Study on guiding effect of mental health of elderly patients with type 2 diabetes in community

TANG Jing, YANG Qi, LI Xiao,

2019, 17(3): 433-435,507. doi: 10.16766/j.cnki.issn.1674-4152.000701

68 1

Abstract:
Objective Accelerating aging of population, the increasing prevalence of type 2 diabetes, and elderly patients with type 2 diabetes prone to adverse emotions, affect glycemic control and quality of life, and to explore the effects of mental health guidance on elderly patients with type 2 diabetes and their families in the community. Methods At the end of 2015, Changqiao Community Health Service Center included diabetes patients with chronic disease management, with 600 cases who met the criteria and were selected by random number table method, and then ranked by random number. According to single and double numbers, the intervention group and the control group were divided into 300 cases in each group. Both groups of patients were given diabetes medical treatment, diet control, exercise therapy, blood glucose monitoring, and health education. On the basis of this, the intervention group conducted a one-year mental health guidance training for patients and their families, and the family members cooperated with the physicians to conduct comprehensive psychological education-type family intervention for diabetic patients. The double-blind method was used to measure the scales, and the results of the two groups were compared and analyzed. All data were analyzed by SPSS 20.0 software for statistical analysis, using descriptive statistical analysis and t test. Results One year later, 287 cases (95.7%) of the intervention group completed the guide and 13 cases (4.3%) were detached, while in the control group, 288 cases (96.0%) completed, and 12 cases (4.0%) were detached. The causes of detachment were death, relocation, and going abroad. Zung Self-Rating Depression Scale (SDS), Zung self-rating anxiety scale (SAS), fasting blood glucose (FBG), postprandial 2-hour blood glucose (PBG), glycosylated hemoglobin (HbA1 C) determination in intervention group were all lower than those in the control group, while the quality of life questionnaire (SF-36) scale in the intervention group was higher than that in the control group (all P<0.05). Conclusion Conducting mental health guidance for elderly patients with type 2 diabetes in the community has a positive impact on patients' blood glucose control and quality of life.

Education curriculum design and Implementation of community stroke self-management group

LIU Xiu-mei, FAN Xiao-hong, YU Xiao-yi,

2019, 17(3): 436-438,442. doi: 10.16766/j.cnki.issn.1674-4152.000702

75 2

Abstract:
Objective To design and explore implementation effects of community stroke self-management group education courses. Methods Based on the relevant theories of the long-term self-management education of Hong Kong Rehabilitation Association, the curriculum content of stroke self-management education was developed. A total of 115 stroke patients were randomly selected as study subjects from January 2012 to December 2016, 57 in the study group and 58 in the control group. The blood pressures before and after the two groups of patients were monitored, and the chronic disease self-efficacy scale and self-perception burden scale were evaluated before and after the course of assessment to evaluate the effect of the curriculum implementation. Results The Fangzhuang Community Stroke Self-Management Group was established for the first time, and stroke self-management education curriculum was designed at the community level to objectively evaluate the application effects of the curriculum. A survey of blood pressure and chronic disease self-efficacy and self-perception burden before and after the study subjects' intervention was completed. There was no significant difference in blood pressure values between the two groups of subjects after intervention. The chronic disease self-efficacy scale was used to measure the intervention group and the control group before the entry into the group. The average scores were (196.23±47.29) points and (203.38±54.19) points respectively, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were: (225.91±43.22) points and (204.83±54.6) points, P<0.05.The difference was statistically significant. The self-perceptual burden scales were used to measure the study group and the control group before the enrollment. The average scores were: (25.42±9.35) points, (24.66±7.58) points, P>0.05, and the difference was not statistically significant. After the end of the course, the average scores were: (22.80±10.96) points, (24.06±8.03) points, P<0.05. The difference was statistically significant. Conclusion This course is designed to be suitable for patients with stroke in the community. Through the implementation of this course, the self-efficacy of stroke patients in the community has been improved, and the burden of self-perception has been reduced.

Clinical study of brain function therapy instrument combined with psychological intervention in the treatment of elderly patients with medication overuse headache

ZHANG Dong-mei, YE Jian-xin, QIN Yin,

2019, 17(3): 439-442. doi: 10.16766/j.cnki.issn.1674-4152.000703

158 1

Abstract:
Objective To study and explore the clinical efficacy of brain function therapy combined with psychological intervention in elderly patients with medication overuse headache (MOH). Methods From July 2014 to July 2015, 120 patients were diagnosed as MOH patients in the department of cadre's ward and department of neurology. The patients were divided into observation group and control group according to the random number table method, with 60 cases in each group. The control group was treated with nifedipine and nimodipine nimodipine (30 mg tid) prophylactic treatment, based on which the observation group used YS7004 brain function treatment and psychological intervention comprehensive treatment. After four weeks treatment, VAS score, headache attack frequency and serum basic fibroblast growth factor (bFGF) concentration in the two groups before and after treatment were evaluated to compare the level of headache, the SAS and the SDS to assess the patient's mental state, compared to the health survey scale (SF-36) to assess the quality of life of patients. Results ①The VAS score, the frequency of headache and the level of serum basic fibroblast growth factor (bFGF) in the two groups were lower than those before treatment, and the decrease rate of the observation group was better than that of the control group, with statistical significance (P<0.01). ②The scores of SAS score and SDS before and after treatment were significantly different from those before treatment (P>0.05). The SAS score and SDS score of the observation group were significantly lower than those before treatment (P<0.01). ③After treatment, SF-36 scores were significantly higher than those before treatment, and the observation group was more significant, showing statistical significance (P<0.01). Conclusion On the basis of routine treatment, combined with brain function therapy instrument and psychological intervention therapy, it has a more significant effect on elderly patients with medication overuse headache, which can relieve headache, improve anxiety and depression, and improve the quality of life of patients.

HRCT imaging findings and dynamic changes of invasive pulmonary aspergillosis

ZHANG Xiao-yan, ZHAO Hong, ZHENG Sui-sheng,

2019, 17(3): 443-446,503. doi: 10.16766/j.cnki.issn.1674-4152.000704

236 5

Abstract:
Objective To investigate HRCT image findings of Invasive Pulmonary Aspergillosis (IPA) and the dynamic changes of the image before and after treatment. Methods Clinical data of 56 patients with invasive pulmonary aspergillosis confirmed by sputum culture or histopathological examination in our hospital from January 2014 to December 2017 were retrospectively analyzed. To investigate the HRCT findings of IPA and the dynamic changes of CT before and after anti-fungal therapy. Results In this group, 42 cases (75.0%) presented as patch shadow, 33 cases (58.9%) presented as pulmonary nodules, and 23 cases (23/33, 69.7%) presented as nodules with "halo" sign, 15 cases (26.8%) had "Air Crescent", 9 cases (9/15, 60%) occurred in about 3 th week. After anti-fungal therapy, the imaging changes of the clinical symptoms improvement group and the unimproved group at 1 th-4 th week after anti-fungal treatment were 0.162, 0.289, 0.010, 0.006, 29 cases (29/38, 76.3%) of the 4 groups with improved clinical symptoms presented imaging progression at 2 th week, among the 29 patients, there were 15 cases (15/29, 51.7%) with puncture gas shadow, after further treatment, the point gas will form typical "Air Crescent" signs or disappear. Conclusion Typical HRCT images of IPA showed single or multiple plaques, nodules, aspergilloma and "Air Crescent" in the lungs, while the occurrence of nodules and air crescent highly suggest IPA, most of "Air Crescent" occurred in about 3 th week, which prompts terminal IPA. CT examination is recommended at 3 th and 4 th week after anti-fungal therapy. About the 2 th week after anti-fungal therapy, the volume or number of pulmonary lesions will increase, and the puncture gas shadow will appear, at this point, the efficacy of anti-fungal therapy should be evaluated in combination with clinical objective evaluation.

Analysis of the correlation between severity of clinical symptoms and CT imaging features in patients with lumbar disc herniation

ZHENG Yong-ming, DONG Hai-bo

2019, 17(3): 447-450. doi: 10.16766/j.cnki.issn.1674-4152.000705

201 4

Abstract:
Objective To investigate the correlation between the severity of clinical symptoms and CT imaging features in patients with lumbar disc herniation. Methods Total 167 patients with lumbar disc herniation admitted to our hospital were selected as subjects, who were divided into mild (58 cases), moderate (64 cases) and severe (45 cases) according to the judgment results of the low back pain assessment scale. The correlation between severity of clinical symptoms and CT imaging features were analyzed. The correlation between the severity of clinical manifestations and the anteroposterior diameter and sagittal diameter of the dural sac was analyzed, and the correlation between the modified Japanese orthopaedic association score (mJOA) and the anterior and posterior diameter of the dural sac was analyzed by Pearson correlation analysis. Results There were significant differences in CT imaging features between patients with mild, moderate and severe lumbar disc herniation, such as pathological type of nucleus pulposus, nucleus pulposus shape, nucleus pulp density value, the degree of protrusion of the nucleus pulposu through the frontal plane, the degree of nucleus pulposus through the horizontal plane, the relationship between the nucleus pulposus and the nerve root, and the degree of compression of the dural sac after the nucleus pulposus (P<0.05). In the patients with mild, moderate and severe, the anteroposterior diameter of the dural sac increased sequentially (P<0.05), and the sagittal diameter decreased in turn (P<0.05). The correlation analysis of Pearson showed that the mJOA score was positively correlated with the anteroposterior diameter of the dural sac (r=0.584, P=0.017), and negatively correlated with the sagittal diameter of the dural sac (r=-0.603, P=0.025). Conclusion For most patients with lumbar disc herniation, the severity of clinical symptoms is correlated with some CT imaging features.

The value of transcranial Doppler ultrasound combined with carotid ultrasound in the diagnosis of ischemic cerebrovascular disease

ZHANG Yong-yin, ZHU Li-dong, CHEN Wei-li,

2019, 17(3): 451-454. doi: 10.16766/j.cnki.issn.1674-4152.000706

164 0

Abstract:
Objective To investigate the diagnostic value of transcranial Doppler ultrasound (TCD) combined with carotid ultrasound in ischemic cerebrovascular disease for clinical reference. Methods Total 739 patients with ischemic cerebrovascular disease in the department of neurology in our hospital were enrolled in the study, who were given TCD, carotid ultrasound and CT angiography (CTA) of head and neck within one week after admission, with the results as the reference for the final diagnosis. The positive rates of TCD combined with carotid ultrasonography and CTA were compared. The positive predictive value, negative predictive value, sensitivity, specificity and accuracy of combined examinations were calculated. Results ① There were no significant difference in the positive rate between TCD combined with carotid ultrasonography and CTA (49.53% vs. 51.69%, χ²=0.693, P=0.405). ② The positive predictive rate of TCD combined with carotid ultrasound was 97.27%, the negative predictive rate was 93.03%, the sensitivity was 93.19%, the specificity was 97.20%, the accuracy was 95.13%, and the Kappa value was 0.903. Conclusion The diagnostic accuracy of TCD combined with carotid ultrasound for ischemic cerebrovascular disease is close to that of head and neck CTA, which is worthy of clinical promotion.

Research progress on IL-6 in ovarian cancer

GONG Xie-yang, XU Peng, GE Chang-yu,

2019, 17(3): 455-458. doi: 10.16766/j.cnki.issn.1674-4152.000707

116 1

Abstract:
Ovarian cancer is one of the common gynecological reproductive system tumors, the incidence rate is second only to cervical cancer and endometrial cancer, but the mortality rate is the first in gynecological tumors. The treatment of ovarian cancer has always been the most difficult challenge for gynecologic cancer, because the clinical symptoms of early ovarian cancer are not obvious, and it is advanced in the diagnosis.Ideal cytoreductive surgery is the cornerstone of ovarian cancer treatment. Platinum-based combination therapy is the main treatment for ovarian cancer chemotherapy. Even if patients with advanced disease receive initial relief after the above standard treatment, 70%-80% of patients will appear. Recurrence and subsequent development of resistance to standard therapies. In recent years, many studies have suggested that the research advantages of cytokines in the field of ovarian cancer are gradually highlighted. In ovarian cancer, cytokines regulate the proliferation, survival, angiogenesis, and metastasis of tumor cells. They produce an autocrine effect on the tumor microenvironment, triggering tumor cells to activate immune regulation mechanisms to evade immune surveillance. Interleukin-6 (IL-6) is a pro-inflammatory cytokine, a core player in chronic inflammatory diseases including cancer, and a major immunoregulatory cytokine in the tumor microenvironment. Previous studies have shown that overexpression of IL-6 in ovarian cancer tissues activates related pathways such as JAK/STAT, Ras/ERK/MAPK, and PI3 K/AKT to promote tumor cell proliferation, anti-apoptosis, induction of vascular proliferation, cell infiltration and drug resistance. IL-6 is a key cytokine and an independent predictor for the development and progression of ovarian cancer. It is expected to provide new ideas for the early diagnosis and treatment of ovarian cancer. This article reviews the progress of IL-6 in ovarian cancer.

Progress in the treatment of nonspecific low back pain

LIU Jian-hang, YU Shao-yong, LI Jin-wei

2019, 17(3): 459-463. doi: 10.16766/j.cnki.issn.1674-4152.000708

196 8

Abstract:
Low back pain has always been one of the most common diseases that plague human life and work. The amount of direct or indirect economic loss that results from low back pain is huge each year. Lower back pain is a group of diseases characterized by pain in the lumbosacral region. The prevalence in middle-aged and elderly people is as high as 70%, and the probability of incapacity due to recurrence of acute low back pain and chronic pain is between 75% and 85%. According to the LBP federal guidelines, lower back pain is classified into sciatica/radicular syndrome, specific low back pain, and nonspecific low back pain. Nonspecific low back pain refers to lower back pain with no nerve root involvement or severe underlying disease originating from the waist. There has been a lack of diagnostic and therapeutic criteria for nonspecific low back pain. Nonspecific low back pain is a common disease of orthopedics in the clinic, which troubles doctors with its complex pathogenesis, diverse manifestation, dubious examination and inconspicuous treatment effect. Most of backache in the clinic belongs to NLBP. It badly affects the life quality of patients with its repeated attack. Numerous treatments for NLBP. Mainly for exercise therapy, traditional Chinese medicine treatment and physical therapy, the current prevention and minimally invasive treatment of nonspecific low back pain research has also increased. On the basis of looking up some literatures, this article will make a systematic statement in the lately progresses from scholars of domestic and international.

Effect of Hugan Zhuyu decoction combined with ursodeoxycholic acid on immunoglobulin and T lymphocyte subsets in patients with primary biliary cirrhosis

ZENG Wu-wu, WU Xue-jie

2019, 17(3): 464-467. doi: 10.16766/j.cnki.issn.1674-4152.000709

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Abstract:
Objective To investigate the effect of Hugan Zhuyu decoction combined with ursodeoxycholic acid on immunoglobulin and T lymphocyte subsets in patients with primary biliary cirrhosis (PBC). Methods A total of 110 patients with primary biliary cirrhosis (liver depression and spleen deficiency syndrome) were randomly divided into two groups from October 2013 to October 2016, 55 cases in each group. The control group was treated with ursodeoxycholic acid and the observation group was treated with Hugan Zhuyu Decoction for 2 months. The improvement of symptoms, liver function, immunoglobulin (IgA, IgG and IgM) and T lymphocyte subsets (CD4⁺, CD8⁺, CD4⁺/CD8⁺ and CD4⁺CD25⁺Treg) were observed before and after treatment. Results After treatment, the total effective rate of the observation group was higher than that of the control group (P<0.05); the score of TCM syndromes in the observation group was lower than that of the control group (P<0.05); the levels of ALT, ALP, TBiL and GGT in the observation group were lower than that of the control group (all P<0.05). The levels of IgA, IgG and IgM in group A were lower than those in control group (all P<0.05), the levels of CD4⁺, CD4⁺/CD8⁺ were lower, the levels of CD8⁺ were higher, and the levels of Treg were higher than those in control group (P<0.05). Conclusion Hugan Zhuyu Decoction combined with ursodeoxycholic acid can improve the clinical symptoms and signs of PBC with liver depression and spleen deficiency syndrome, improve liver function, and improve immune function. Hugan Zhuyu Decoction combined with ursodeoxycholic acid has the effect of multi-target therapy, and give full play to the advantages of traditional Chinese medicine in treating PBC.

Effect observation of ultramicro needle knife combined with cupping on treatment of shoulder pain after stroke

CONG Wen-jie, JIA Xiang, MENG Bo-jun,

2019, 17(3): 468-470,490. doi: 10.16766/j.cnki.issn.1674-4152.000710

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Objective To observe the clinical efficacy of ultramicro needle knife combined with cupping on treatment of patients with hemiplegic shoulder pain, and to provide reliable clinical evidence for the treatment of poststroke hemiplegic shoulder pain. Methods Total 138 patients with hemiplegia and shoulder pain after stroke in our hospital from January 2016 to December 2017 were divided into two groups according to random number method. Treatment group (68 cases) was treated with ultramicro needle knife combined with cupping, and control group (70 cases) was treated with conventional acupuncture. The two groups were treated once every other day, and the therapeutic effect was evaluated after 6 treatments. Before and after treatment, the upper limb Fugl-Meyer, Daily life ability (ADL), pain visual VAS, and life quality of two groups were evaluated. The clinical efficacies of two groups were accounted. The data of two groups were statistically analyzed, to analyze the clinical efficacy of ultramicro needle knife combined with cupping. Results After treatment, the ADL and Fugl-Meyer scores of the two groups were significantly increased (P<0.05), and the ADL and Fugl-Meyer scores of the treatment group were significantly higher than those of the control group (P<0.05). After treatment, the VAS scores of the two groups were significantly lower (P<0.05), and the VAS scores of the treatment group were significantly lower than the control group (P<0.05). After treatment, the life quality scores of two groups were significantly increased (P<0.05), and the life quality scores of the treatment group were significantly higher than those of control group (P<0.05). The clinical effect of the treatment group was better than that of the control group (P<0.05). Conclusion Ultramicro needle knife combined with cupping could effectively treat shoulder pain after stroke, significantly improve the motor function, daily living ability, and life quality.

Clinical observation on treating anorexia in children with spleen and stomach deficiency with Chinese herbal medicine combined with massage

JIANG Ning, SHAO Zheng-yang, ZHAN Lu

2019, 17(3): 471-474. doi: 10.16766/j.cnki.issn.1674-4152.000711

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Objective To analyze and discuss the clinical efficacy of Chinese medicine invigorating spleen and massage combined with massage for the treatment of anorexia of children with weak spleen and stomach, and to study the effect on gastrointestinal hormones. Methods A total of 92 cases of asthenia of spleen and stomach treated in our hospital from November 2015 to November 2017 were divided into two groups according to the treatments, with 46 cases in each group. The control group was treated with massage, while the observation group was treated with Jianpi plaster combined with massage. The scores of two groups of disease related symptoms, motilin, somatostatin, 5-serotonin, changes in saliva amylase level, blood zinc, blood calcium content, adverse reaction and clinical therapeutic effect were observed. Results The total effective rate, motilin, somatostatin, 5-serotonin, salivary amylase, blood Zn²⁺ and blood Ca²⁺ in the observation group were better than those in the control group (P<0.05). The scores of the clinical symptoms including loss of appetite, the abdominal discomfort, the decrease of food, the reacid, and the nausea and vomiting of the observation group were superior to those in the control group (P<0.05) after the treatment. There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The treatment of anorexia in children with weak spleen and stomach with Chinese medicine Jianpi sticking combined with massage can significantly improve the clinical symptoms of disease related loss of appetite, abdominal discomfort, reduced appetite, antiemesis, nausea and vomiting, and promote the recovery of gastrointestinal hormones such as motilin, somatostatin and 5-HT in patients with disease. It can significantly improve the clinical curative effect and improve the appetite of patients, and it is convenient to implement, and the compliance of patients is better, which is helpful for the prognosis of patients.

The value of core stability training in lumbar disc herniation on mean frequency

GONG Jian-qiu, ZHANG Fang, SIMA Zhen-fen,

2019, 17(3): 475-478. doi: 10.16766/j.cnki.issn.1674-4152.000712

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Abstract:
Objective To explore the effects of core stability training in lumbar disc herniation with the change of mean frequency (MNF) signals under different position on core muscles. Methods From January 2016 to June 2017, fifty-seven patients with lumbar disc herniation were randomly divided into the experimental group (core stability training plus regular physical therapy, n=29) and the control group (regular physical therapy only, n=28). The total course of treatment was 8 weeks. All patients were assessed three times (before, after 4 and 8 weeks) using Japanese orthopaedic association (JOA), oswestry disability index (ODI) and MNF of rectus abdominis, erector spinae and lumbar multifidus. Results Two therapies were both effective. The improvements on all above indexes at 4 weeks and 8 weeks after treatment were both statistically significant (all P<0.05) under different position in two groups. There was statistically significant (all P<0.05) in experimental group, but no statistically significant (all P>0.05) in control group between 4 weeks and 8 weeks. Between two groups, no significant difference (all P>0.05) was found at 4 weeks and significant difference (all P<0.05) was found at 8 weeks. Conclusion There are similar effects on patients with lumbar disc herniation between core stability training and regular physical therapy during a short time. While continuing core stability training can further improve the ability of core muscles and relieve pain and dysfunction. It should be better than the regular physical therapy and be worthy of clinical promotion.

Observation and mechanism of curative effect of ventilation, nourishing lung and strengthening spleen in elderly patients with pulmonary infection

ZHOU Su-fang, WANG Chun-lin

2019, 17(3): 479-482. doi: 10.16766/j.cnki.issn.1674-4152.000713

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Objective To explore the efficacy observation and mechanism of the ventilation, nourishing lung and strengthening spleen method (Shufeng Runfei Jianpi Decoction) in elderly patients with pulmonary infection. Methods A total of 86 elderly patients with pulmonary infection who were treated in our hospital from May 2016 to March 2018 were selected and randomly divided into two groups according to the number table method. The control group was treated with conventional drug therapy, on the basis of which the research group was treated with ventilation, nourishing lung and strengthening spleen. The treatment effect, inflammatory response degree improvement, clinical symptoms improvement and the incidence of adverse reactions were analyzed. Results The effective rate of the study group was 88.4%, and that of the control group was 69.8%. The curative effect of the study group was better than that of the control group (P<0.05); the study group had IL-6 (45.1±4.5) ng/L, Hs-CRP (3.2±0.5) mg/L, TNF-α (62.1±4.5) ng/L, the control group had IL-6 (73.4±7.1) ng/L, Hs-CRP (8.4±1.5) mg/L, TNF-α (96.1±4.6) ng/L, and the study group had significantly lower curative effect (P<0.05). In the control group, symptoms score cough (0.3±0.3), expectoration (0.3±0.1), laryngeal itching (0.2±0.2), symptoms score cough (1.7±0.8), expectoration (1.4±0.6), laryngeal itching (1.1±0.3) in the study group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions was 4.7% in the study group and control group respectively. There was no significant difference between the study group and the control group (P>0.05). Conclusion Shufeng Runfei Jianpi Decoction is effective in alleviating inflammation, reducing the concentration of inflammatory factors and the score of clinical symptoms in elderly patients with cough after pulmonary infection. It is safe and should be further popularized in clinic.

Application value of different TCM syndrome type medicated diet interventions in elderly patients with functional dyspepsia

YU Xiao-qing, BAO Xiao-ping, WANG Qing-ping,

2019, 17(3): 483-486. doi: 10.16766/j.cnki.issn.1674-4152.000714

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Objective According to the different TCM syndromes of elderly patients with functional dyspepsia, targeted dietary intervention was adopted to regulate diet, and the effect of the intervention in the treatment of functional dyspepsia was observed. Methods A total of 160 elderly patients with functional dyspepsia in our hospital from February 2016 to February 2018 were selected and randomly divided into routine intervention group and medicated diet intervention group. The routine nursing intervention group was given routine nursing intervention, and the medicated diet intervention group was given dialectical medicated diet intervention according to their different TCM syndromes, and the total effective rate of the two groups of patients after intervention was counted. The symptom scores of the two groups after nursing were compared, and the sleep quality of the two groups after nursing was evaluated. The anxiety and depression levels of the two groups before and after nursing were compared. Finally, the satisfaction degree of the patients to this nursing was counted. Results The total effective rate of the intervention group was significantly higher than that of the routine intervention group (P<0.05); the symptom scores of epigastric fullness, belching and epigastric pain in the intervention group were significantly lower than those in the routine intervention group (P<0.05); the sleep quality scores of the intervention group were significantly better than those of the normal group (P<0.05). The scores of anxiety and depression in the intervention group were significantly lower than those in the conventional intervention group (P<0.05); the total satisfaction of the intervention group was significantly higher than that of the conventional intervention group (P<0.05). Conclusion According to the different TCM syndromes of elderly patients with functional dyspepsia, medicinal diet intervention can effectively alleviate clinical symptoms, improve sleep quality and improve their psychological status. The overall effect is good, and it is recognized by the majority of patients.

Investigation and discussion on the current situation of doctor-patient communication skills of breast surgery students

ZHOU Rui, PENG De-feng, WANG Lin,

2019, 17(3): 487-490. doi: 10.16766/j.cnki.issn.1674-4152.000715

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Abstract:
Objective To improve doctor-patient communication skills by investigating and analyzing the influencing factors of doctor-patient communication skills of breast surgery students. Methods A total of 118 clinical practice medical students in department of breast surgery of the first affiliated hospital of Bengbu medical college were investigated by self-designed questionnaire on factors influencing doctor-patient communication skills of medical students and methods to improve doctor-patient communication skills. Results A total of 118 questionnaires were distributed and 118 were recovered. The effective recovery rate was 100%. Among factors that affect doctor-patient communication, 90.7% medical students thought that professional knowledge was important, 89.0% thought communication ability was important, 86.4% thought that psychological factors was important, 84.7% thought that clinical experience was important, 83.0% thought confidence was important, 79.3% believed that language popularity was important, 74.5% thought that patients and patients families factors were important, 66.9% thought clinical work was important, 61.9% of medical students lacked awareness of the importance of communication, 37.3% thought communication attitude was important, and only 22.0% thought the humanities knowledge was important. The methods of improving doctor-patient communication skills were clinical teaching (92.6%), special lecture doctor-patient communication skills training (85.1%), doctor-patient communication skills theory course (82.3%), standardized patient (81.9%), and improving diagnosis and treatment level (80.7%) according to the support rate. The most effective method for improvement was clinical teaching. Conclusion Medical students generally believed that there were many factors influencing doctor-patient communication skills in department of breast surgery, but most medical students lacked the awareness of the importance of doctor-patient communication, and few people realized the importance of humanistic knowledge and communication attitude, so it was necessary to strengthen the awareness and ability cultivation of the above three aspects in medical students.

Epidemiological investigation of ophthalmopathy among adults aged 50 years or above in Ningbo

WU Xiao-lan, YI Quan-yong, WU Yi-nan,

2019, 17(3): 491-495. doi: 10.16766/j.cnki.issn.1674-4152.000716

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Objective To assess the prevalence, causes and risk factors of ocular diseases of the people aged 50 years or older in Ningbo. Methods Random cluster sampling strategies were adopted in a population-based and epidemiological investigation of ophthalmopathy from March 2015 to July 2016 in Ningbo. Six thousand and fifty-nine subjects aged 50 years or older were selected. All the participants underwent a face-to-face questionnaire interview and detailed eye examination. To assess the prevalence of various ophthalmopathy and the causes of major blinding ophthalmopathy, ocular examinations included measurements of visual acuity, direct ophthalmoscopy, intraocular pressure (IOP), silt lamp examination, fundus photography, and computer optometry. Statistical analysis was performed by using SPSS 19.0 software for χ² test, P<0.05 was significant difference. Results In 6 059 eligible persons, totally 5 448 individuals were examined. Response rate was 89.9%. The ratio of pterygium, catarace, fundus diseases, glaucoma, refractive error and keratopathy was 14.34%, 23.22%, 12.81%, 1.08%, 38.00% and 2.06%. He ratio of bilateral blindness and low vision was 0.95% and 3.34 respectively, the ratio of unilateral blindness and low vision was 0.17% and 1.36%. Cataract was the leading cause of blindness. Age, outdoor occupation, environment (coastal and land), diabetes had statistically significance on the prevalence of cataract (all P<0.05). Age, hypertension, diabetes, smoking, drinking had statistically significance on the prevalence of fundus diseases (all P<0.05). Conclusion These data will provide key information about the prevalence of major ophthalmopathy and major causes of blinding eye diseases in the Ningbo and which can be used for planning a reasonable distribution of medical resources and the strategies for the prevention and treatments of blindness in Ningbo.

Effect of influenza prevention fragrant bag on recurrent respiratory tract infection in children

CHEN Yi-ying, LI Shu-ni

2019, 17(3): 496-499. doi: 10.16766/j.cnki.issn.1674-4152.000717

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Objective To explore the prevention and treatment of recurrent respiratory tract infection in children. Methods A total of 240 children with recurrent respiratory tract infection in our hospital from January 2016 to December 2016 were selected and divided into the treatment group (120 cases) and the control group (120 cases) according to the random number table. The routine treatment and nursing care according to the "Clinical Concept and Management Principle of Recurrent Respiratory Tract Infection" was performed in all patients, while the patients in the treatment group additionally wore influenza prevention fragrant bag. The total effective rate, frequency of upper and lower respiratory tract infection per year, duration of each course, time between each episode of two groups were compared between the two groups. The effect of influenza prevention fragrant bag was evaluated. Results The total effective rate of the treatment group were higher than that of the control group (88.3% vs. 77.5%), the difference was statistical significance (P<0.05). The frequency of upper and lower respiratory tract infection per year of the treatment group was lower than that of the control group, the difference was statistical significance [ (2.0±0.4, 1.8±0.6) vs. (3.2±1.3, 2.5±1.8) ] (all P<0.05). The duration of each course in the treatment group was shorter than that of the control group (1.7±0.3 vs. 2.1±0.4), and the time between each episode was longer than that in the control group (4.8±0.6 vs. 3.9±1.0), the differences were statistically significant (all P<0.05). Conclusion Influenza prevention fragrant bag can improve the total effective rate of children with recurrent respiratory infections, prevent recurrence of respiratory infections.

Clinical analysis of 8 cases of venous thromboembolism after spinal surgery

YE Yi, JIANG Guo-qiang, SONG Huan-jun,

2019, 17(3): 500-503. doi: 10.16766/j.cnki.issn.1674-4152.000718

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Objective To analyze the clinical data of patients with venous thromboembolism (VTE) after spine surgery, and discuss the diagnosis and treatment. Methods A retrospective analysis was performed on the clinical manifestations, diagnosis methods, treatment processes, and outcomes, which involved 8 cases of VTE after spinal surgery, who received theraphy at the department of spinal surgery of the Affiliated Hospital of Medical School of Ningbo University from January 2010 to December 2017. Combined with the relevant literature on VTE prevention, the epidemiology and prophylactico-therapeutic measures of VTE after spinal surgery were elaborated. Results In this group, there were 8 patients who suffered VTE after spinal surgery. Among these patients, 4 cases suffered single symptomatic deep venous thrombosis (DVT), and 1 case suffered single symptomatic pulmonary thromboembolism (PTE), while the other 3 cases suffered symptomatic PTE and asymptomatic DVT. The overall incidence of VTE was 0.47% (8/1 699). Four patients with symptomatic DVT were cured and discharged after anticoagulation, thrombectomy, thrombolysis, and inferior vena cava filter implantation. Of the 4 patients with PTE, 1 patient was died because of fatal PTE, and the other 3 patients were cured and discharged after thrombolysis and anticoagulation. Conclusion Although the incidence of VTE after spinal surgery is relatively low, once it happens, the consequences are serious. Therefore, it is necessary to increase the awareness of prevention of VTE, improve preoperative assessment of risk factors, and establish VTE prevention and control systems. The risk assessment and graded prevention model of VTE after spine surgery should be improve in order to provide theoretical basis for the VTE prevention in the future.

Effect of quantitative exercise on patients with esophageal cancer after minimally invasive esophagectomy

RUI Bing-feng, GONG Tai-qian,

2019, 17(3): 504-507. doi: 10.16766/j.cnki.issn.1674-4152.000719

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Objective To explore the effect of quantitative exercise on recovery speed and recovery quality of patients with esophageal cancer after minimally invasive esophagectomy. Methods A total of 244 esophageal cancer patients who underwent minimally invasive resection in our hospital from October 2015 to November 2017 were collected, and divided randomly and equally into observation group and control group. Patients in control group adopted routine nursing measures and patients in observation group adopted quantitative exercise besides routine nursing measures. Out-of-bed activity time, daily amount of exercise, rehabilitation assessment (the removal time of gastric tuber, intestinal exhaust time, the incidence of post-surgery complications) and post-surgery hospitalization duration. Results A total of 86 cases in observation group and 46 cases in control group had out-of-bed activity in 24 h post surgery, and out-of-bed activity time of patients in observation group is slightly earlier than that in control group (P<0.05). The same results were observed in the amount of out-of-bed activity of 24 h, 24-36 h and >36 h post surgery (P<0.05). The amount of out-of-bed activity of patients in observation group each day during the first five days post surgery were significantly higher than that in the control group (P<0.05). The gastric tuber detaining time of patients in observation group was shorter than that of patients in control group[ (58.0±14.8) h vs. (69.0±12.6) h, P<0.05]. The same condition was observed on intestinal exhaust time[ (39.9±17.5) h vs. (44.8±15.6) h, P<0.05] and hospitalization time [ (10.6±1.2) h vs. (11.7±1.3) h, P<0.05]. The incidence of complications in observation group was lower than that in the control group (10.65% vs. 19.67%, P<0.05). Conclusion Quantitative exercise could accelerate the recovery rate, improve the rehabilitation quality and shorten the length of stay of patients after minimally invasive esophagectomy, and could be applied to clinical practice.

Social undermining and turnover intention in ICU nurses of tertiary hospital: the mediating effect of rumination

HAN Juan, CHEN Dong-li, WANG Min-na,

2019, 17(3): 508-510,514. doi: 10.16766/j.cnki.issn.1674-4152.000720

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Objective To investigate social undermining, rumination and turnover intention in ICU nurses of tertiary hospital, and explore their relationship in order to provide reference for the management of clinical nurses. Methods Qualified 528 ICU nurses were recruited from 4 tertiary hospitals in Shaanxi Province by convenience sampling between February and July 2017. Social Undermining Scale, Chinese version of Nolen-Hoeksema Ruminative Responses Scale and Turnover Intention Scale were used to collect data. Pearson correlation coefficient was used to analyze the correlation and Amos 17.0 software was used to test the fitting of structural equation model diagram. Results The scores of social undermining was (43.63±6.22), with (22.37±5.14) in supervisor subscale, and (21.26±4.83) in coworker subscale. The scores of rumination and turnover intention were (44.83±9.32) and (17.14±5.10) respectively, among which 14.4% participants had very high turnover intention, and 49.4% had high turnover intention. The pairwise correlation analysis of social undermining, rumination and turnover intention had statistical significance (P<0.01). Rumination exerted a partial mediating effect between social undermining and turnover intention, with the mediating effect of 0.27, which accounted for 52.9% for the total effect. Conclusion ICU managers should recognize the existence of social undermining, advocate sincere cooperative colleague relationship, create a good environment, pay attention to the stress relief and psychological counseling work of ICU nurses, so as to reduce their turnover intention and improve the quality of clinical nursing services.

Application of Shenque and Hegu acupoint massage in preventing constipation of senile stroke patients

PENG Qing-jie, WONG Jun-mei, YANG Yan-fu

2019, 17(3): 511-514. doi: 10.16766/j.cnki.issn.1674-4152.000721

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Objective Stroke is a kind of senile diseases with high morbidity in our country. Due to cognitive, diet, swallowing, exercise and other factors, seniors with constipation caused increasing concern of society and family. This article discusses the application of Shenque and Hegu Acupoint massage in the prevention of constipation in senile stroke patients. Methods We selected 64 senile stroke patients admitted to the first Encephalopathy Division in Lu'an Chinese Medicine hospital from January 2016 to May 2017, and randomly divided them into control group and observation group. In the control group, the routine nursing intervention was adopted, and the patients in the observation group were given a Shenque and Hegu acupoint massage on the basis of routine nursing intervention. The first defecation time of the two groups of patients was compared. Results On the first day, there were respectively 4 patients (12.50%) and 11 patients (34.37%) defecated in the control group and observation group. The observation group's first defecation time was significantly earlier than that of the control group, via the SPSS 17.0 software for statistical analysis and χ² test for the count data (χ²=4.267, P<0.05). Conclusion The Shenque combined with Hegu acupoint can effectively prevent the occurrence of constipation in senile stroke patients, which is of great clinical significance to alleviate the suffering of patients and reduce the harm caused by constipation, which is worth popularizing and widely used in clinic.

Intervention effect of integrated traditional Chinese and western medicine rehabilitation nursing on the recovery of stroke patients

LIN Hai-hong, HU Jian-hua

2019, 17(3): 515-517,520. doi: 10.16766/j.cnki.issn.1674-4152.000722

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Objective To explore the intervention effect of integrated traditional Chinese and western medicine rehabilitation nursing during the recovery of stroke patients. Methods Eighty stroke patients treated in our hospital from March 2016 to March 2018 were divided into routine nursing group and combined nursing group with 40 cases in each group by digital random method. The routine nursing group was intervened by routine rehabilitation nursing, and the nursing group was intervened by integrated traditional Chinese and Western medicine rehabilitation nursing. The total effective rate of the two groups after nursing intervention was compared. The clinical indicators, degree of neurological impairment, daily motor function and living ability, quality of life after intervention, recurrence rate and nursing satisfaction were counted. Results The total effective rate of combined nursing group after nursing intervention was higher than that of conventional nursing group (P<0.05); the starting time, getting out of bed time and hospitalization time of combined nursing group were shorter than those of conventional nursing group (P<0.05); the CSS score, Barthel index and MAS score of combined nursing group after intervention were better than those of normal nursing group (P<0.05). The scores of quality of life items in the combined nursing group after intervention were higher than those in the conventional nursing group (P<0.05); the recurrence rate after nursing intervention in the combined nursing group was lower than that in the conventional nursing group, and the nursing satisfaction was higher than that in the conventional nursing group (P<0.05). Conclusion Rehabilitation nursing with integrated traditional Chinese and Western medicine can accelerate the recovery time of stroke patients, improve their motor function and daily living ability, and improve their quality of life, with low recurrence rate and high safety.

2019, 17(3): 518-520. doi: 10.16766/j.cnki.issn.1674-4152.000723

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2019, 17(3): 521-522. doi: 10.16766/j.cnki.issn.1674-4152.000724

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About Journal

2019 Vol. 17, No. 3

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