2019 Vol. 17, No. 6

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Development tactics and initiatives of Chinese health industry based on international experience
BAO Yong, WANG Su-ping
2019, 17(6): 887-890. doi: 10.16766/j.cnki.issn.1674-4152.000818
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In a broad sense, health industry is a set of all industries and departments which are somehow related to human health, centered on the health construction, based on the premise of health concept and targeted at the health of people. In a narrow sense, health industry is a collection of industries and departments of various kinds of products and services, directly and highly relevant to health, aiming at health maintenance, health improvement and health promotion of people. Recently, with the rapid development of the global economy, people's life quality is improving and their awareness of health is increasingly strengthened. Meanwhile, health industry has become one of the strategic choices of effective response to the financial crisis, enhancing the vitality of economic development, meeting the diverse needs, and preempting the commanding heights of the division of the global health industry throughout the world especially in Europe, the United States, and the majority of Emerging Market Countries. American health industry is traced back to 1963, which develops the fastest in the last decade accounting for more GDP annually. From political, social and economic perspective, this article illustrates the domestic health industry including its slow development, undesirable supporting facilities, low pharmaceutical manufacturing, unbalanced services and underdeveloped pension industry. Thus, government policies are expected to motivate the development of health industry, which could be achieved via raising nationwide awareness, balancing medical resources and developing diversified health systems aiming at different groups of people.
ZHOU Xia, SUN Zhong-wu
2019, 17(6): 891-892.
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Study on the sagittal parameters of spino-pelvic alignment in patients with lumbar disc degeneration
CHEN Xu, WANG Ming-qi, ZHOU Cheng-pei, GAO Hao-ran, QIAN Ji-xian
2019, 17(6): 893-896,901. doi: 10.16766/j.cnki.issn.1674-4152.000819
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Objective To understand the characteristics of sagittal parameters of spino-pelvic in patients with Lumbar disc herniation (LDH), explore the differences of sagittal parameters in age and sex, and evaluate the correlation between sagittal parameters of spino-pelvic and healthy life quality in patients with Lumbar disc herniation. Methods A retrospective analysis was made on the spinal surgery in the orthopaedic hospital of Tangdu hospital of the fourth military medical university. From January 2016 to September 2018, 120 patients with lumbar disc herniation were admitted to the hospital. On the full-length radiographs, we measured pelvic incidence (pelvic incidence, PI), pelvic tilt Angle (pelvic tilt, PT), sacral slope Angle (sacral slope, SS), thoracic kyphosis(TK), lumbar lordosis Angle (lumbar lordosis, LL), PI-LL matching values, sagittal plane vertical axis (sagittal vertical axis, SVA) and collates records ODI values. The differences of sagittal parameters were compared according to gender and age group, and the correlation between sagittal parameters and ODI values was analyzed. Results There was no significant difference in age, TK, LL, SVA, PI, PT, SS, PI-LL between male and female in patients with Lumbar disc herniation. The comparison of ODI values between male and female showed that male ODI was 46.94±20.09, female ODI was 55.92±21.26, which is significant differences (P=0.020). Conclusion There was no statistical difference in the sagittal parameters of the spino-pelvic between different genders and ages of LDH patients. However, the PI of female patients with LDH have a significantly larger trend. Further research is needed. There was no correlation between the spino-pelvic sagittal parameters and quality of life in patients with lumbar disc herniation. The poor quality of life of female patients with LDH in this study has no significant correlation with PI, but further research is needed to confirm it according to previous reports.
Effect of lncRNA PVT1 on proliferation and migration of NSCLC cells and its mechanism
ZHANG Shuang-mei, WANG Bin, CHEN Yi, ZHANG Xiao-huo, SHI Xue-fei
2019, 17(6): 897-901. doi: 10.16766/j.cnki.issn.1674-4152.000820
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Objective To investigate the role and mechanism of lncRNA plasmacytoma variant translocation 1 (PVT1) in the proliferation and migration of non-small cell lung cancer (NSCLC) cells by up-regulating or down-regulating the expression of PVT1, and then analyze the target gene of PVT1 by using RNA-Seq for its action mechanism. Methods ① The relationship between the expression of PVT1 in NSCLC cells and the survival time of NSCLC patients through studying TCGA database (The Cancer Genome Atlas); ② Using Ki67 immunofluorescence assay and cell colony formation assay to investigate the effect of up-regulation or down-regulation of PVT1 on the proliferation and migration of NSCLC cells; ③ Using RNA-seq technology to explore the downstream target genes of PVT1, and then use siRNA to silence the gene to explore the ability of this gene to proliferate and invade NSCLC cells. Results ① The high level expression of PVT1 was significantly associated with the decrease of survival time of lung cancer patients (P<0.001). ②The high level expression of PVT1 significantly promoted the increase of tumor volume in lung cancer patients, and was closely related to tumor stage and lymph node metastasis (all P<0.05); ③ The overexpression of PVT1 promoted the proliferation and migration of NSCLC cells; ④Down-regulation of PVT1 by Si-RNA inhibited the proliferation and migration of NSCLC cells; ⑤Down-regulation of PVT1 significantly increased the expression level of LATS2. Conclusion PVT1 can promote the proliferation and migration of NSCLC cells by apparently regulating LATS2.
Comparison of the curative effect and prognosis of patients with single segment lumbar degenerative disease of different BMI undergoing posterolateral spinal 360° fusion
SUN Ying-fei, SHI Dong-ping, ZHANG Qi-dong, LI Zhong-shi
2019, 17(6): 902-905. doi: 10.16766/j.cnki.issn.1674-4152.000821
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Objective To compare the curative effect and prognosis of patients with single segment lumbar degenerative disease of different body mass index (BMI) undergoing posterolateral spinal 360° fusion. Methods A total of 216 patients with single segment lumbar degenerative disease admitted to the hospital from January 2013 to November 2017 were divided into normal group (84 cases, BMI less than 24 kg/m2), overweight group (80 cases, 24 kg/m2 not less than BMI less than 28 kg/m2) and obesity group (52 cases, BMI not less than 28 kg/m2) according to different BMI. All patients underwent posterolateral spinal 360° fusion. The surgery-related data, the scores of Japanese orthopaedic association's low back pain assessment (JOA) and oswestry disability index evaluation system (ODI) at each follow-up time before and after surgery of the three groups were obtained. Results Arranging the intraoperative blood loss and postoperative drainage from small to large, the corresponding order was normal group, overweight group and obesity group. Arranging the operation time and postoperative hospital stay from short to long, the corresponding order was normal group, overweight group and obesity group. Arranging the incidence of wound complication from low to high, the corresponding order was normal group, overweight group and obesity group. The above indicators in each group were statistically significant (all P<0.05). The JOA score and ODI score of the three groups at each follow-up time after surgery were significantly improved compared with those before surgery (all P<0.05). There was no significant difference in the improvement of JOA score and ODI score between 1 month and 3 months after surgery (all P>0.05). The JOA scores in the normal group and overweight group were significantly higher than those in the obesity group at 6 months and 12 months after surgery, while the ODI score was significantly lower than that in the obesity group (all P<0.05). Conclusion Posterolateral spinal 360° fusion in the treatment of single segment lumbar degenerative disease can achieve good curative effect. The intraoperative blood loss and postoperative drainage are more in overweight or obese patients. The operation time and postoperative hospital stay are longer. And the incidence of wound complications is higher. Especially, the prognosis in obese patients is relatively poorer.
Analysis of genetic test results of common deafness in 128 cases of sensorineural deafness in Jianghuai region
HAN Yue-feng, XU Bin-bin, LIU Xue-bao
2019, 17(6): 906-908,1013. doi: 10.16766/j.cnki.issn.1674-4152.000822
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Objective To analyze the mutation characteristics of common pathogenic genes of sensorineural deafness in Jianghuai area, and to provide reference for clinical and research on prevention and treatment of deafness. Methods A total of 128 patients with extremely severe sensorineural hearing loss were included in the department of otolaryngology, head and neck surgery of the First affiliated hospital of Bengbu medical college from January 2015 to June 2018. After relevant examinations including audiology examination (otoacoustic emission examination), otoacoustic emission examination failed, and the patient continued to conduct acoustic conduction resistance, multi-frequency homeostasis, brainstem evoked potential and other related examinations, to judge that the degree of hearing loss of the patient reached extremely severe sensorineural hearing loss, and the final diagnosis was confirmed. Peripheral blood was collected from patients diagnosed with sensorineural hearing loss, and 9 common mutation sites of 4 common deafness genes (GJB2, GJB3, SLC26A4, mitochondria 12S rRNA) were detected by genetic deafness gene chip kit. Results A total of 128 cases of patients were detected, and the comprehensive common gene mutations in 47 cases of deafness patients, accounted for 36.72%, including a total of 21 cases of GJB2 gene mutations, accounted for 16.40% (21/128), the positive rate was 44.68% (21/47), SLC26A4 gene mutations, a total of 15 cases, accounting for 11.72% (15/128), the positive rate of 31.91% (15/47), mitochondrial 12S rRNA gene mutations in 9 cases, accounting for 7.03% (9/128), and the positive rate was 19.15% (9/47). Single gene GJB3 mutation has not been detected. GJB3 heterozygous gene mutation + mitochondrial 12SrRNA homozygous mutation in 1 case (1/128, 0.78%), positive rate was 2.13%(1/47), GJB2 heterozygous mutation + SLC26A4 (216A>G) heterozygous mutation in 1 case (1/128) 0.78%, and positive rate (1/47) 2.13%. Conclusion The gene mutation of sensorineural deafness patients in Jianghuai area is mainly GJB2 gene, followed by SLC26A4 gene and mitochondrial 12SrRNA gene. The gene chip can be used to screen deafness in clinic and provide basis for clinical diagnosis.
Study on the mechanism and targets of qiangguyin based on bioinformatics in postmenopausal osteoporosis treatment
LIANG Bo-cheng, LI Min, WANG Jun-hua, ZHANG Jia-feng, MAO Yi-fan, SHI Xiao-lin
2019, 17(6): 909-914. doi: 10.16766/j.cnki.issn.1674-4152.000823
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Objective To investigate the molecular basis of Qiangguyin(QGY) and its predictive targets, to clarify the multi-targets characteristics of QGY in the treatment of Postmenopausal osteoporosis. Methods First, the method of system biology was used to determine the known compounds corresponding to the herbs by the Chinese medicine comprehensive database (TCMID). The name of the compound was determined by NCBI data into the unique ID number. And then we put the data of the unique ID number into the molecular mechanism of the Chinese medicine molecular mechanism bioinformatics analysis tool (BATMAN-TCM) to predict the drug-related gene / protein targets, and then use the bioinformatics method to predict the Gene ontology (GO) , signal pathway and protein - protein interaction network of the targets. Results In this study, a total of 435 compounds were included from 12 herbs, and 2 487 targets were retrieved，which were further enriched in 138 GO terms, such as Nucleic Acid Binding Transcription Factor Activity, Signal Transducer Activity, Oxidoreductase Activity (all P<0.05). A total of 211 signal pathways was significantly enriched (all P<0.05). Conclusion The herbs, compounds and targets related to compounds of QGY are effective research carriers for QGY. The prevention and treatment of osteoporosis with QGY is based on multiple target strategies. QGY by coordinating the body's metabolic balance is preventing and treating osteoporosis for the cause of the disease.
Protective effect of vitamin C on reproductive toxicity of dibutyl phthalate in male sprague dawley rats
XU Gui-xi, CONG Liang-zi, XIONG Wei, FANG Hai-qin
2019, 17(6): 915-919. doi: 10.16766/j.cnki.issn.1674-4152.000824
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Objective To study the possible pathogenesis of infertility caused by di-butyl phthalate (DBP) and investigate the effects of Vitamin C (Vit C) on DBP-induced reproductive function damage in male Sprague Dawley (SD) rats. Methods Sixty male SD rats were divided into 6 groups, including normal control, Vit C (30 mg/kg BW), DBP (100, 500, 1 000 mg/kg BW), and DBP (1 000 mg/kg BW)+Vit C (30 mg/kg BW) groups with ten rats in each group. After the treatment conducted by DBP and Vit C for three weeks, the rats were sacrificed and testicular tissues were collected to calculate organ coefficient and determine sperm motility, concentration, deformity rate. And the index including hematology, and serum chemistry, serum T, LH, FSH concentration were detected. Results Compared with the normal group, the testes of the high-dose DBP group showed obvious atrophy, LDH concentration significantly decreased, the sperm motility and concentration decreased significantly, and the deformity rate of sperm increased, the concentration of T, LH, FSH in serum decreased significantly. Conclusion DBP can cause testicular atrophy in rats, sperm motility, and sperm deformity rate increases. DBP can reduce serum T and LH levels and increase FSH levels. Vit C can improve DBP-induced productive function injury, increase sperm motility and decrease sperm abnormality, elevate the level of serum T, LH, and FSH, and thus promote the reproductive function of the male rat.
Clinical efficacy of PFNA with anti-osteoporosis drugs in the treatment of intertrochanteric fracture in elderly patients
ZHOU Ping-hui, LE Yi, ZHANG Zhi-li, ZHAO Yu-peng, WU Min, GUAN Jian-zhong
2019, 17(6): 920-923. doi: 10.16766/j.cnki.issn.1674-4152.000825
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Objective To observe the clinical efficacy of proximal femoral nail antirotation (PFNA) and Gamma nail (TGN) in the treatment of femoral intertrochanteric fractures of elders. To provide clinical evidence for internal fixation choice of the elderly patients with femoral intertrochanteric fractures. Methods Retrospective analysis of 40 cases of elderly patients with femoral intertrochanteric fracture admitted in the orthopaedics of the First Affiliated Hospital of Bengbu Medical College from 2017 to 2018 was made. According to the different operative methods, they were divided into PFNA group (n=20)and TGN group (n=20).The intraoperative blood loss, operation time, hospital stay, postoperative complications, fracture healing time, bone mineral density and Harris hip scores were compared between the two methods. Data were analyzed with SPSS 20.0 statistical software. Results The PFNA group was followed up for 3 to 6 months, while TGN group was followed up for 3 to 6 months. The operation time, blood loss volume in PFNA group were less than those in TGN group, bone mineral density of the PFNA group was superior to the TGN group, and the difference between the two groups was statistically significant (all P<0.05). There was no statistical significance in hospital stay, postoperative complications, fracture healing time between PFNA group and TGN group(all P>0.05). Conclusion PNFA should be considered more preferential than TGN when choosing internal fixation in elderly patients with femoral intertrochanteric fractures.
The effect of Bentall operation on ascending aorta aneurysm combined with aortic insufficiency and its effect on cardiac function index
ZHANG Sheng-qiang, LIU Xue-gang, LIU Yi-yao, LIU Ge, YANG Shao-feng, SHI Chao
2019, 17(6): 924-926,950. doi: 10.16766/j.cnki.issn.1674-4152.000826
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Objective The clinical efficacy of the patients with ascending aortic aneurysm combined with aortic regurgitation before and after operation was analyzed by Bentall surgery. Methods From January 2014 to December 2018, 70 patients with ascending aortic aneurysm complicated with aortic valve insufficiency underwent Bentall operation in Cardiac Surgery Department of the First Affiliated Hospital of Bengbu Medical College were selected to observe the effect of operation and the grading of cardiac function before and after treatment, and to observe the differences of related ultrasound and serum indexes. Results All the 70 patients underwent successful operation, with an average cardiopulmonary bypass time (165.3±45.7) min, aortic occlusion time (98.3±26.4) min, perioperative mortality rate 4.29%, postoperative adverse reaction rate 25.71%, postoperative 93.75 The cardiac function of the patient was restored to grade Ⅰ-Ⅱ. Cardiac output (CO), stroke volume (SV) , left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) before and after Bentall surgery , amino terminal B-type natriuretic peptide precursor (NT-proBNP), cardiac fatty acid binding protein (H-FABP), galectin-3 (Galectin-3). The difference was statistically significant (all P<0.05). Conclusion Bentall operation is a safe and feasible method for the treatment of ascending aortic aneurysm and aortic valve insufficiency.
A retrospective study on the key factors that influence the liver regeneration after the stage-1 associating liver partition and portal ligation for staged hepatectomy
JIN Wang-xun, WANG Bing, HUANG Ling, ZHANG Yun-li, WANG Xin-bao, GUO Jian-min
2019, 17(6): 927-931,1032. doi: 10.16766/j.cnki.issn.1674-4152.000827
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Objective As seen in literature, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) could promote the rapid regeneration of the future liver remnant (FLR). One reason is that occluded portal ligation could significantly increase the portal blood supply of the remaining liver. Another reason is that it might be provoked by dividing liver. Yet, the leading reason remains unclear. By retrospective study, we aim to find out whether it is the hepatic blood inflow that plays key role in this process. Methods From June 2014 to June 2016, thirteen patients received ALPPS at our department, among whom 5 patients accepted complete ALPPS(complete ALPPS group), and 8 patients accepted partial ALPPS. The correlation with the regeneration of the FLR was evaluated. The time interval between stage-1 ALPPS and stage-2 ALPPS and other clinical data were compared between partial ALPPS and complete ALPPS. Results One patient with moderate cirrhosis in the complete ALPPS group had absent hypertrophy of FLR due to recanalization of the ligated right portal vein but his FLR augmented significantly after repeated transcatheter arterial chemoembolization (TACE). After stage-1 ALPPS, the FLR of other twelve patients increased significantly; partial ALPPS promotes the regeneration of FLR much slower than complete ALPPS, and the time interval between stage-1 ALPPS and stage-2 ALPPS was (10.0±1.6) days for complete ALPPS and (31.3±5.2) days for partial ALPPS respectively, indicating statistical significance (P<0.001). Conclusion Recanalization of the portal vein, the intrahepatic portal collaterals after partial ALPPS that divert portal blood from FLR could slow down the augment of FLR; transcatheter arterial embolization (TAE) could increase arterial blood supply to FLR and promote the regeneration of FLR. Less invasive portal vein occlusion and TAE might replace ALPPS to promote the regeneration of the FLR. Hepatic blood supply is probably the key factor that influences the regeneration of the FLR after ALPPS.
Induction of apoptosis in acute myeloid leukemia HL-60 cells by bufotalin via mitochondrial pathway
LI Wei, CUI Sheng-nan, ZHOU Zhi-hui, LI Yuan-yuan, HE Chun-ling, TIAN Miao, DONG Chang-hu
2019, 17(6): 932-935,954. doi: 10.16766/j.cnki.issn.1674-4152.000828
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Objective To study the effect of bufotalin on acute myeloid leukemia HL-60 cells and its mechanism, so as to provide new ideas for the treatment of acute myeloid leukemia. Methods The HL-60 cells in the logarithmic growth phase were treated with quercetin at a final concentration of 0, 40, 80, and 160 μg/mL for 24 h, and the cell proliferation was detected by CCK-8 kit. The mitochondrial morphology was observed by transmission electron microscopy. The expressions of Bax, Bcl-2 and Cleaved-Caspase-9 genes were detected by Western blotting. The toxic effects of the compounds on normal cells were observed by using normal peripheral blood B lymphocytes as control group. The results of the experiment were recorded with SPSS 22.0 and tested. P<0.05 was considered statistically significant. Results Bufotalin could inhibit the proliferation of HL-60 cells and induce its apoptosis, and its normal cytotoxicity is smaller than that of cancer cells, with statistical significance (P<0.05). With the increase of drug concentration, nuclear showed abnormalities, nuclear membrane showed separation, and heterochromatin increased significantly, along with mitochondria with edema expansion, fuzzy disappearance of some mitochondrial ridges and vacuolization, while the control mitochondria morphology was better. When the proportion of Bax/Bcl-2 increased, Cleaved-Caspase-9 gene expression increased gradually, and the difference was statistically significant (all P<0.01). Conclusion The results of this experiment indicate that bufotalin also inhibits non-solid tumor cells of acute myeloid leukemia HL-60 cells, and has less impact on normal cells. The mechanism of its action is mainly to induce tumor cell apoptosis through mitochondrial pathway.
Measurement of nasolabial features in children with unilateral cleft lip
YE Guang-chun, LI Guang-zao, SHEN Yan, ZHANG Li, DUAN Zhi-hong, XU Jing
2019, 17(6): 936-939. doi: 10.16766/j.cnki.issn.1674-4152.000829
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Objective To observe the restoration of the nasolabial structure and symmetry of unilateral cleft lip before and 2 weeks after surgery, and to observe the improvement and development of the nasolabial morphology of the children after 1 year of follow-up. Compared with the previous research and measurement in our department, this study forms a systematic and integrated study, which provides a comparison and theoretical reference for the follow-up three-dimensional measurement research, and provides a detailed theoretical reference and clinical guidance for the repair of children with cleft lip. Methods A total of 35 children treated in our department from December 2015 to December 2017 were selected. The total width of the nose, the angular distance of the lip peak, the distance of the alar lip peak, the distance of the columella lip peak, the width of the nasal base, the width of the nostril, the height of the nostril, the length of the medial crest, the length of the medial column, and the height of the columella were measured by direct measurement method before and 2 weeks after surgery together with one-year follow-up to assess their nasolabial development. Results Paired t-test was performed on the 11 measurement items, and the results showed that P<0.05, indicating that there was statistical significance between the measurement items before and 2 weeks after surgery. Follow-up showed that most children with nasal labial form good improvement, the symmetry of the healthy side, double side lip high approximately equal to the area of scar is not obvious, the continuity of the lip bow and dry wet lips and form is good, no eclabium, bilateral nostrils, alar basal symmetry improve obviously, crest form of upper lip movement is not observed in children with depression and distortion. Conclusion After 1 year of follow-up and combined with the previous measurement studies in our department, the shape and fullness of the nasolabial, the continuity of the labial arch and the symmetry of the healthy and the affected sides of the unilateral cleft lip were significantly improved in the short term after repair. It can provide certain reference for the repair of children with cleft lip and the choice of the repair period of secondary deformity.
Relationship between serum Galectin-3 level and in-stent restenosis in patients with type 2 diabetes mellitus
ZHANG Jing-hong, YU Dan, XU Xiao-hong, LI Zheng
2019, 17(6): 940-943. doi: 10.16766/j.cnki.issn.1674-4152.000830
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Objective To investigate the relationship between serum galectin-3 and in-stent coronary stenosis (ISR) in patients with type 2 diabetes mellitus and coronary heart disease. Methods Patients with type 2 diabetes mellitus complicated with coronary heart disease and previous drug-eluting stent (DES) implantation treated in Zhejiang Hospital from January 2015 to January 2016 were included. According to the results of coronary angiography, all patients were classified into ISR group and non-ISR group. The relationship between clinical data and ISR was analyzed by multivariate logistic regression. Results A total of 357 patients were enrolled, of whom 36 were in group ISR (10.1%). Compared with non-ISR group, ISR group had higher age, proportion of smokers, serum Galectin-3 level, longer stent length and smaller stent diameter (P<0.05). Multivariate logistic regression analysis showed that age (OR=1.087, 95% CI: 1.038-1.134, P<0.001), stent length (OR=1.078, 95% CI: 1.012-1.103, P<0.001), stent diameter (OR=0.425, 95% CI: 0.243-0.708, P<0.001) and serum Galectin-3 level (OR=1.074, 95% CI: 1.016-1.121, P<0.001) were independent risk factors for ISR. In addition, serum Galectin-3 level was correlated with ISR type. Conclusion High serum Galectin-3 level increases the risk of ISR in type 2 diabetes mellitus, which may be an independent risk factor for ISR. This provides a new idea for the application of serological markers in assessing the severity of coronary artery disease.
Clinical efficacy of different doses of intravenous immunoglobulin in the treatment of children with Kawasaki disease
LI Dong-e, ZHOU Rui, CHEN Ming-wu
2019, 17(6): 944-946. doi: 10.16766/j.cnki.issn.1674-4152.000831
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Objective To investigate the clinical efficacy and safety of different doses of intravenous immunoglobulin in the treatment of children with Kawasaki disease. Methods The children with Kawasaki disease admitted from January 2012 to December 2016 were randomly divided into control group and study group according to the digital table method. The two groups were both treated with aspirin as the basic treatment. The control group was given intravenous immunoglobulin 1 g/(kg·d) for 1-2 days (2 days in case of continuous high temperature). While the study group was given twice doses. The clinical efficacy and the adverse reactions of the two groups were compared. Results The fever reducing time in the study group was significantly shorter than that in the control group (t=5.853, P<0.05), but there was no significant difference in the regression time of mucosal blood transfusion, cervical lymph node swelling and hand-foot swelling between the two groups (t=1.418, 1.552, 0.719, all P>0.05). After the treatment, WBC, CRP, ESR, PLT and other laboratory indicators in the two groups were significantly improved compared with their own group before treatment (all P<0.05), but there was no significant difference between the two groups after treatment (all P>0.05). There were 7 cases of coronary artery disease in the study group and 13 cases of coronary artery disease in the control group after treatment. Statistical analysis showed that the incidence of coronary artery disease in the study group (14.00%) was significantly lower than that in the control group (26.00%) and the difference was statistically significant (χ2=4.089, P=0.043). One of the children in the study group had adverse reactions such as chills and nausea after injecting intravenous immunoglobulin. The symptoms were relieved and disappeared after decreasing the intravenous drip speed. In addition, there were no other obvious adverse reactions in the two groups. Conclusion The therapeutic effect of intravenous immunoglobulin 2 g/(kg·d) dose is significantly better than 1 g/(kg·d) dose in treating Kawasaki disease with fewer complications, low incidence of coronary artery disease and high safety, which is worthy of clinical promotion.
Role of medical care and pension combination mode in improving panic disorder and rehabilitation quality of elderly patients after hip replacement
ZHU Zhong-lian, WANG Zhao-dong, GAO Xu-bin, WANG Xu-yi, HU Hai-bei, WU Min, ZHAO Zhi
2019, 17(6): 947-950. doi: 10.16766/j.cnki.issn.1674-4152.000832
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Objective To observe the role of the mode of combination of medical care and pension in improving panic disorder and rehabilitation quality of elderly patients after hip replacement. Methods Eighty elderly patients undergoing hip replacement in our hospital between December 2016 to December 2017 were selected and randomly divided into control group and observation group with 40 cases in each group. The control group was given routine rehabilitation training after the operation, and the observation group was given rehabilitation training with the mode of the combination of medical care and pension. The short-term efficacy, occurrence of postoperative panic disorder, and improvement of postoperative hip function and daily living activity of patients were compared between the two groups. Results There was no significant difference in preoperative pain intensity at 12 h from the end of the operation, sleep length in 72 h, time to ambulation and length of hospital stay between the two groups (all P>0.05). The incidence rate of postoperative panic disorder in the observation group was significantly lower than that in the control group (2.50% vs. 20.00%), P<0.05. The Harris score in both groups at 6 months after the treatment was significantly higher than those in the same group before the treatment, and the Harris score in the observation group was significantly higher than that in the control group (91.58±8.12 vs.81.24±8.04), P<0.05. The ADL score in both groups at 6 months after treatment was significantly lower than those in the same group before the treatment, and the ADL score in the observation group was significantly lower than that in the control group (15.12±1.53 vs.16.86±1.67), P<0.05. Conclusion The rehabilitation training with combination of medical care and pension can significantly improve the short-term efficacy of patients undergoing hip replacement, reduce the incidence rate of postoperative panic disorder, improve hip function and daily living activity, and it is worthy of clinical promotion and application.
Clinical value of CYFRA21-1, MMP-9 and TTF-1 levels in differentiating benign from malignant lung tumors
QIAN Jun-feng, XU Fang, WANG Hong-yuan, CAO Zhuo
2019, 17(6): 951-954. doi: 10.16766/j.cnki.issn.1674-4152.000833
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Objective To explore the clinical value of cytokeratin 19 fragment (CYFRA21-1), matrix metalloproteinase 9 (MMP-9) and thyroid transcription factor -1 (TTF-1) in identifying benign and malignant lung tumors. Methods Twenty seven cases of malignant lung tumors, 45 cases of benign lung tumors, and 30 healthy subjects who were admitted to Lishui People's Hospital of Zhejiang Province from March 2016 to May 2018 were selected and assigned into malignant tumor groups, benign tumors group and control group. The levels of CYFRA21-1 were detected by electrochemiluminescence and the levels of TTF-1 and MMP-9 were detected by enzyme-linked immunosorbent assay. Results The serum levels of CYFRA21-1, MMP-9 and TTF-1 in the malignant tumor group were significantly higher than those in the benign tumor group and the healthy control group, and the difference was statistically significant (all P<0.05). Logistic regression analysis showed that there was no correlation between CYFRA21-1, MMP-9 and TTF-1 and benign lung tumors (all P>0.01), which was correlated with malignant lung tumors (all P<0.01). ROC curve analysis showed that the AUC of serum CYFRA21-1 in differentiating benign and malignant lung tumors was significantly higher than that of MMP-9 and TTF-1, and the difference was statistically significant (all P<0.05), and there was no significant difference between MMP-9 and TTF-1 (P>0.05). The sensitivity and specificity of serum CYFRA21-1 were 67.8%, 93.1%, of MMP-9 were 42.1% and 87.2%, and of TTF-1 were 44.3% and 95.7%, respectively. Conclusion The serum levels of CYFRA21-1, MMP-9 and TTF-1 have certain potential value in differential diagnosis of benign and malignant lung tumors, among which CYFRA21-1 is the highest.
Primary research on prostatic arterial embolization combined with laparoscopic radical prostatectomy for prostate cancer patients with large prostate glands
SUN Peng, WU Hai-xiao, GUO Xiao-hua, HU Yang, HU Xiao-gang, ZHU De-sheng
2019, 17(6): 955-958. doi: 10.16766/j.cnki.issn.1674-4152.000834
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Objective To investigate the clinical significance of prostatic arterial embolization(PAE) combined with laparoscopic radical prostatectomy for prostate cancer patients with large prostate glands(>80 g). Methods Sixteen prostate cancer patients with large prostate glands were treated during January 2014 to October 2018 in Jinhua Municipal Center Hospital. Sixteen cases (group A) which received laparoscopic radical prostatectomy 2 months after prostate biopsy by using B ultrasound guidance. In group A, there were 10 cases of T2b, 6 cases of T2c, aged from 65 to 79 years. Sixteen cases (group B) diagnosed with prostate cancer which received laparoscopic radical prostatectomy 2 months after prostatic arterial embolization. In group B, there were 9 cases of T2b, 7 cases of T2c, aged from 67 to 80 years. Operating time, amount of bleeding during operation, postoperative indwelling catheterization time, the hospital stay and complications were compared between group A and group B. Results All the 32 cases were operated successfully. Laparoscopic radical prostatectomy in large prostate glands poses a significant challenge to urologists. Two months after PAE, prostate volume decreased for 51.09%-38.45% in group B. In group B, operating time, amount of bleeding during operation, postoperative indwelling catheterization time, the hospital stay and complications were all better than those in group A (P<0.05). Moreover, the results of PSA of all 32 patients decreased to <0.01 ng/mL at postoperative two months. Conclusion For prostate cancer patients with large prostate glands which received laparoscopic radical prostatectomy 2 months after prostatic arterial embolization, it can reduce the difficulty of operation and reduce complications.
The role of serum NSE and proGRP in the diagnosis and treatment of small cell lung cancer
ZHANG Ting-su, YUAN Chun-ying, QIU Hai-jiang, TU Xiao-long
2019, 17(6): 959-961,965. doi: 10.16766/j.cnki.issn.1674-4152.000835
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Objective To analyze the value of neuron-specific enolase (NSE) and pro-gastrin-releasing peptide (proGRP) in the diagnosis and treatment of small cell lung cancer (SCLC). Methods The clinical data of 52 patients with SCLC and 70 patients with non-small cell lung cancer (NSCLC) who were first diagnosed and treated in our hospital from January 2016 to June 2018 were retrospectively analyzed. The serum levels of NSE and proGRP were detected by ELISA and chemiluminescence respectively. Results Before treatment, the serum NSE level in SCLC group was higher than that in NSCLC group (P<0.001), the serum NSE level in ED group was higher than that in LD group (P<0.001), the serum ProGRP level in SCLC group was higher than that in NSCLC group (P<0.001), and the serum ProGRP level in ED group was higher than that in LD group (P<0.001). After 2 cycles of chemotherapy, there were 39 cases in the effective group and 13 cases in the ineffective group. The level of serum NSE in the effective group after treatment was lower than that before treatment, and the difference was statistically significant(P<0.001)|the level of serum NSE in the ineffective group before and after treatment had no statistical significance(P>0.05)|the level of serum ProGRP in the effective group after treatment was lower than that before treatment, and the difference was statistically significant(P<0.001)|the level of serum ProGRP in the ineffective group after treatment was higher than that before treatment, and the difference was statistically significant(P<0.05). Conclusions The elevated levels of serum NSE and ProGRP may be helpful for the differential diagnosis between SCLC patients and NSCLC patients. Serum levels of NSE and ProGRP can be used as an auxiliary basis for SCLC staging. ProGRP may have higher application value than NSE in monitoring the changes of SCLC and evaluating the therapeutic effect.
Retrospective analysis of 115 cases of elderly immune thrombocytopenia
FENG Yu-ying, LUO Hong-qiang, ZHONG Yong-gen, FU Lei-hua, FU Jia-ping
2019, 17(6): 962-965. doi: 10.16766/j.cnki.issn.1674-4152.000836
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Objective To analyze the clinical characteristics, therapeutic effect and prognosis of primary immune thrombocytopenia (ITP) in the elderly. Methods The clinical data of 115 elderly patients with ITP hospitalized in our department of hematology from January 2013 to October 2017 were retrospectively analyzed, who were over 60 years old. The clinical characteristics of all patients with ITP were recorded, including bleeding score, treatment method and treatment effect. Bone marrow image and Th1/Th2 cytokine expression, secondary infection and other complications as well as prognosis. Statistical analysis were conducted by SPSS 17.0. Results There were 52 males and 63 females in 115 elderly patients over 60 years with ITP. The median age was 67 years old, ranging from 60 to 91. Of 115 elderly ITP patients, with the increase in age, the higher would be the risk of bleeding, and so did the proportion of severe bleeding patients. In elderly patients with ITP, IFN-γ and IL-10 were significantly decreased, and other indicators such as TNF-α, IL-2, IL-4 and IL-5 were significantly increased (P<0.05). The therapeutic effects were decreased with increased age or delayed course. The treatment effective rate of 60-69 years old group was the highest (86.9%). The elderly ITP patients easily suffered from infections during the use of glucocorticoid (22.1%), and the most common was pulmonary fungus infection. Six patients died (5.2%): four died of pulmonary infection, only one of intracranial hemorrhage. Conclusion Elderly ITP patients were more severe. With increasing age and duration of the disease, the patient's treatment efficiency is lower. There is disturbance of immune balance of Th1/Th2 in elderly ITP patients. Patients have a higher incidence of infections and becomes the cause of death during the use of glucocorticoids. The choice of treatment needs to balance advantages and disadvantages.
Effects comparison of low temperature plasma radiofrequency ablation and CO2 laser treatment on voice function of patients with laryngeal precancerous lesions
JIANG Shun-ming, GONG Xiao-cheng, DING Ru-liang, ZHENG Jing-qiong, ZHENG Shuang
2019, 17(6): 966-968,973. doi: 10.16766/j.cnki.issn.1674-4152.000837
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Objective To compare the effect of low temperature plasma radiofrequency ablation and CO2 laser treatment on voice function of patients with laryngeal precancerous lesions. Methods A total of 83 patients with laryngeal precancerous lesions treated in our hospital from September 2014 to March 2018 were selected as subjects, and divided into two groups according to random number method, and 42 patients in observation group and 41 patients in control group. The control group was treated with CO2 laser, and the observation group was treated with low temperature plasma radiofrequency ablation. After treatment, the operation time, hospitalization time, postoperative 1 day pain score (VAS score), postoperative 1 month mucosal recovery score and other surgical related indicators were compared with the postoperative 1 month fundamental frequency (F0), base frequency micro Changes in arpeggio functions such as jitter, amplitude perturbation (Shimmer), standardized noise energy (NNE), and postoperative complications. Results There was no significant difference on hospitalization time, and postoperative 1 day pain score between the observation group and the control group (all P>0.05). However, the operation time and mucosal recovery scores after surgery 1 month of observation group were significantly lower than those of control group (all P<0.05). After treatment, the F0, Jitter, Shimmer and NNE of two groups were significantly reduced (all P<0.05), However, there was no significant difference on F0 level between the two groups (P>0.05), and Jitter, Shimmer and NNE of observation group were lower than those of control group (P<0.05). There were no complications such as dysphonia, dyspnea and vocal cord adhesion in the two groups. There were no recurrence in the observation group, and 2 cases in the control group relapsed and then recovered after CO2 laser treatment. Conclusion Compared with CO2 laser treatment, low-temperature plasma radiofrequency ablation is more effective in the treatment of laryngeal precancerous lesions, which can effectively shorten the operation time and promote the recovery of mucosal and voice function as soon as possible.
The study on inhibition of 5-AZA on human uveal melanoma cell proliferation
HUANG Yi-rui, HE Wei, LI Rui, JIANG Zi-pei
2019, 17(6): 969-973. doi: 10.16766/j.cnki.issn.1674-4152.000838
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Objective DNA methylation is an important epigenetic regulatory mechanism, which is catalyzed with DNMTs and closely related to tumorigenesis. Currently, it has been found that more than 50 key genes were hypermethylation during the process and development of melanoma. Our study is to investigate the effects of DNA methylase inhibitor 5-AZA on proliferation and migration of human uveal melanoma cells and explore its molecular mechanism. Methods OCM-1 and OCM-3 cells were treated with 4 μM 5-AZA as experimental group, and the cells were treated with DMSO as control group. Then, the effect of 5-AZA on cell proliferation was detected by MTS and cell clone formation assay; the cell cycle was analyzed by flow cytometry; and the effect of 5-AZA on cell migration was evaluated by cell scratch assay; Real-time PCR and Western blotting were used to determine the gene expression of 5-AZA on cell cycle. All data were analyzed using two-tailed t-test to determine statistical significance to assess the difference between the control group and experimental group. Results 5-AZA significantly inhibited the proliferation of human uveal melanoma cells (P<0.01) and the ability of cell clone formation. 5-AZA could induce G1 phase arrest of human uveal melanoma cells. 5-AZA had no significant effect on the migration of human uveal melanoma cells. 5-AZA significantly could upregulate p21 expression and downregulated CDK2 expression in uveal melanoma cells. Conclusion 5-AZA inhibits proliferation of human uveal melanoma cells by up regulating p21 and down regulating CDK2. And 5-AZA can be applied potentially into clinical treatment of uveal melanoma.
Effect of recombinant bovine basic fibroblast growth factor on patients with hormone-dependent dermatitis: a clinical analysis of 150 cases
FANG Qiao-ying, DU Xiao-hang, ZHANG Chun-yan, CHEN Xiao-guo, LU Jun-tian, WANG Ping
2019, 17(6): 974-976,103. doi: 10.16766/j.cnki.issn.1674-4152.000839
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Objective To explore the effect of recombinant bovine basic fibroblast growth factor on patients with hormone-dependent dermatitis, so as to find effective and safe therapeutic drugs for hormone-dependent dermatitis patients. Methods A total of 150 patients with hormone-dependent dermatitis who were treated in our hospital were selected from 2013 to 2018, and they were divided into observation group (n=81) and control group (n=69) according to different treatment methods. The patients in the observation group were treated with recombinant bovine basic fibroblast growth factor, while the patients in the control group were treated with carbomer. The clinical score, cuticular water content, percutaneous water loss, epidermal sebum content and adverse reactions were compared between the two groups. Results There were significant differences in clinical scores before treatment, 2 weeks and 4 weeks after treatment (all P<0.05), 2 weeks and 4 weeks after treatment, the clinical score of the observation group was significantly lower than that of the control group (all P<0.05). There were significant differences in percutaneous water loss and epidermal sebum content among the three groups before treatment, 2 weeks and 4 weeks after treatment (all P<0.05), there were significant differences in the cuticular water content before treatment, 2 weeks and 4 weeks after treatment in the observation group (P<0.05), but there was no significant difference in the cuticular water content before treatment, 2 weeks and 4 weeks after treatment in the control group (P>0.05). Two weeks after treatment, the percutaneous water loss in the observation group was significantly lower than that in the control group (P<0.05), and the epidermal sebum content in the observation group was significantly higher than that in the control group (P<0.05), but there was no significant difference in the cuticular water content between the two groups (P>0.05); 4 weeks after treatment, the cuticular water content and epidermal sebum content in the observation group were significantly higher than those in the control group (all P<0.05), and the percutaneous water loss in the observation group was significantly lower than that in the control group (P<0.05). No obvious adverse reactions occurred in the two groups. Conclusion Recombinant bovine basic fibroblast growth factor has a good effect in the treatment of hormone-dependent dermatitis, it can improve the clinical symptoms and signs, promote the repair of skin barrier, and has high safety.
Effect of early enteral nutrition combined with acute abdomen Ⅲ on clinical symptoms and gastrointestinal function indexes in patients with severe acute pancreatitis
YE Yuan-ling, WANG Rui-ming, HU Fang-yu
2019, 17(6): 977-980. doi: 10.16766/j.cnki.issn.1674-4152.000840
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Objective To investigate the efficacy of early enteral nutrition (enteral nutrition, EN) combined with acute abdomen Ⅲ in the treatment of severe pancreatitis (severe acute pancreatitis, SAP) and its influence on gastrointestinal tract related indicators. Methods A total of 68 patients with SAP admitted to the emergency department of Hangzhou Traditional Chinese Medicine Hospital from July 2014 to June 2018 were randomly divided into observation group and control group (34 cases each) according to the random number table. The control group was placed in the ICU. Enteral nutrition was given within 24 hours. The observation group was supplemented with the self-made traditional Chinese medicine preparation acute abdomen Ⅲ on the basis of the control group. The two groups of patients were continuously used for 7 days. The clinical efficacy and clinical symptom relief time, ICU stay time, gastrointestinal function, inflammation index and complications of the two groups were compared. Results The clinical effective rate of the observation group was 91.18%, the difference was statistically significant compared with the control group(all P＜0.05), and ICU hospitalization. The time was significantly shorter than that of the control group (all P<0.05). After treatment, serum D-lactic acid, ET, DAO, gastrointestinal function score and urinary lactulose/mannitol levels decreased in different degrees (all P<0.05). The D-lactide, ET, DAO, gastrointestinal function scores and urinary lactulose/mannitol levels were lower in the control group than in the control group (all P<0.05). The AMY, CRP, TNF-α and APACHE-Ⅱ scores in the observation group were significantly lower after treatment. In the control group, IL-10 levels were higher than the control group, the difference was statistically significant (all P<0.05); while the 28d mortality rate and complication rate in the two groups after treatment showed no statistical difference (all P>0.05). Conclusion EN combined with acute abdomen Ⅲ treatment of SAP has significant curative effect, which would alleviate clinical symptoms, protect gastrointestinal function and reduce inflammation.
Effects of carbohydrate counting on patients with type 2 diabetes mellitus combined non-alcoholic fatty liver disease
WANG Wei-guang, ZHANG Xiao-yan, SI Cai-juan, LIAO Dan, YU Xiao-long, SHU Long, ZHANG Lun, ZHENG Pei-fen
2019, 17(6): 981-983,1017. doi: 10.16766/j.cnki.issn.1674-4152.000841
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Objective To investigate the effects of carbohydrate counting on patients with type 2 diabetes mellitus combined non-alcoholic fatty liver disease. Methods A total of 128 subjects treated only with oral drug were included from Outpatient service and Diabetes center of China and the United States of Zhejiang hospital from December 2014 to December 2016. Subjects were divided into two group randomly, The experimental group was intervened by carbohydrate counting including the preparation of a standardized diabetic meal based on the carbohydrate exchange table for patients with the help of doctors. Control group was intervened by ordinary diet. Index of Fasting blood-glucose (FPG), 2 hours postprandial blood glucose, Hemoglobin A1c (HbA1c), Triglyceride (TG), Total cholesterol (TC), High density lipoprotein cholesterol (HDL-C), Low density lipoprotein cholesterol (LDL-C), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), height, body weight and Body mass index (BMI) were compared before and after 6 months of intervention, and liver function recovery after intervention were assessed. Results After the intervention, FPG, 2 hours postprandial blood glucose, HbA1c, TG, LDL-C reduced observably, and significantly lower in the experimental group than those in the control group. After the intervention, the ALT and AST in two groups were reduced observably, and the ALT and AST in the experimental group were significantly lower than those in the control group, and the recovery of liver function in the experimental group was significantly better than that in the control group. Conclusion Carbohydrate counting method significantly ameliorated blood glucose levels, blood lipid levels and liver function in patients with type 2 diabetes mellitus combined non-alcoholic fatty liver disease.
The correlation of serum IL-18, IL-33 and FeNO with mycoplasma pneumonia in children
LIAO Zhen, LOU Ling-yun, GUAN Min-chang, ZHU Yan-yan, CHEN Jie
2019, 17(6): 984-986. doi: 10.16766/j.cnki.issn.1674-4152.000842
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Objective To investigate the correlation between serum interleukin-18 (IL-18), interleukin-33 (IL-33) and expiratory nitric oxide (FeNO) in children with mycoplasma pneumonia. Methods Altogether 87 children with mycoplasma pneumonia admitted to our hospital from January 2017 to July 2018 was selected as observation group, and 90 children who underwent physical examination in Hospital from January 2017 to July 2018 were selected as the control group. The expiratory velocities of 25% vital capacity (FEF25%), 50% vital capacity (FEF50%), 75% vital capacity (FEF75%), forced vital capacity (FVC) and 1 second forced expiratory volume (FEV1) were measured by pulmonary function instrument; all subjects were collected peripheral venous blood on the 2nd day of admission, and serum was separated. Serum levels of IL-18 and IL-33 were determined by ELISA; and FeNO was detected by electrochemical method. The changes of pulmonary function, serum levels of IL-18 and IL-33 and FeNO in the two groups were compared, and the correlation between FeNO and IL-18 and IL-33 was analyzed. Results FEF 25%, FEF 50%, FEF 75%, FVC and FEV1 in the observation group were lower than those in the control group (all P<0.05). the serum levels of IL-18 and IL-33 the observation group were higher control group (P<0.05). FeNO value in the observation group was higher than that in the control group (all P<0.05). FeNO was positively correlated with IL-18 and IL-33. Conclusion Serum levels of IL-18, IL-33 and FeNO in children with mycoplasma pneumonia are increased, and there is a linear positive correlation between FeNO and IL-18 and IL-33, which is worthy of clinical reference.
Correlation analysis between functional constipation of infant and maternal factors during pregnancy
LU Yan, PAN Guo-qin, JIN Xiao-tian, YIN Yan
2019, 17(6): 987-989,1024. doi: 10.16766/j.cnki.issn.1674-4152.000843
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Objective To explore the incidence of functional constipation in infants, factors during pregnancy and the correlation between them. Methods From January 2016 to June 2016, 263 newborns born in our hospital were selected and were followed up for 2 years, they were divided into constipation group and non-constipation group according to whether functional constipation occurred. The general data of two groups when constipation occurred were compared, the maternal factors during pregnancy of two groups were also compared, logistic regression was used to analyze the independent risk factors of functional constipation. Results Fifty-one cases (19.39%) of functional constipation occurred in this study. The proportion of women in the constipation group was significantly higher than non-constipation group (56.86% vs. 38.35%; χ2=5.751, P=0.016), there were significant differences in maternal blood pressure, blood glucose, BMI before pregnancy and probiotics supplementation during pregnancy between the two groups (P<0.05). Multivariate logistic regression analysis showed prenatal blood pressure, prenatal blood glucose, prenatal BMI were risk factor for functional constipation(P<0.05), and prenatal probiotics supplementation was protective factors for functional constipation (P<0.05), multivariate logistic regression analysis showed that maternal obesity was independent risk factor for functional constipation(OR=1.405, P=0.019), probiotics supplementation was independent protective factors for functional constipation (OR=0.325, P=0.025). Conclusion Infant functional constipation has a certain correlation with maternal factors during pregnancy. Controlling pregnancy weight and supplementing probiotics can effectively reduce the occurrence of constipation.
SWOT analysis and countermeasure research on the status quo of human resources in Shanghai
HU Min, LIU Deng, CHEN Qi, HEI Zi-ming, LEI Rui, PAN Ju-mei
2019, 17(6): 990-993. doi: 10.16766/j.cnki.issn.1674-4152.000844
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Objective To study the community health service centers in Shanghai soothing care service development situation, the analysis of the service to carry out and implement the related problems and its influence factor, and aim at how to continue to expand coverage for hospice care to relieve care equipment, human resources, optimizing the community industry's sustainable development to provide scientific advice. Methods This article analyzed baseline survey data report of hospice care service in Shanghai in 2015. At the same time, sampling method was used to select part of the community health service center of Shanghai for qualitative group interview. The SWOT analysis method was used to summarize the Shanghai community in present situation of soothing care human resources and the service project policy framework and safeguard mechanism, industry standard rules, preliminary build talent team, a multidisciplinary team of strengths, weaknesses, opportunities and challenges. Results At present, there are 80 hospices in Shanghai, but only 5 hospitals have complete human resource allocation and professional training, thus lack of support staff. The industry lacks in-depth assessment and detailed standards, and there is a big gap in connotation construction. The main factors affecting the development of palliative care services are the lack of industry regulations and rules, the shortage of professional talents, the incomplete connection of medical insurance, and the lack of government and social investment. Conclusion It is necessary to integrate hospice care service needs and develop the strategy of hospice care development. At the same time, Shanghai hospice training and certification center was set up to promote social philanthropy into the field of hospice care, to maximize the focus on patients, and finally form a complete hospice care model.
Effect of structural psychological intervention on psychological status and stress level in patients with acute myocardial infarction
FEI Xiao-qin, CHENG Zhen-feng, XU Hua
2019, 17(6): 994-996. doi: 10.16766/j.cnki.issn.1674-4152.000845
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Objective To explore the effect of structural psychological intervention on psychological status and stress level in patients with acute myocardial infarction. Methods A total of 96 patients with acute myocardial infarction admitted to the emergency department of our hospital from March 2017 to January 2019 were selected as the research objects. According to the random number table method, they were divided into observation group and control group with 48 cases each. The control group was given routine emergency nursing, while the observation group was given structured psychological nursing intervention on the basis of the control group. According to the Self-rating Anxiety Scale (SAS) and self-rating depression scale (SDS), the psychological status of the two groups before and after nursing intervention was compared. The changes of stress indicators before and after nursing in the two groups were compared, including systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and epinephrine (E), and the nursing satisfaction of the two groups was counted. Results Before nursing intervention, there was no significant difference in mental state score and stress level between the two groups (all P>0.05); after nursing intervention, SAS and SDS scores of the observation group were lower than those of the control group (all P<0.05); after nursing intervention, the levels of SBP, DBP, HP and E of the observation group were significantly lower than those of the control group (all P<0.05); the nursing satisfaction of the observation group was 100.0%(48/48), which was far higher than 85.4% (41/48) of the control group (P<0.05). Conclusion Structural psychological intervention can significantly improve the negative emotions such as depression and anxiety in patients with acute myocardial infarction, effectively reduce the stress level of patients, improve the satisfaction of patients and their families, and promote the establishment of harmonious nurse-patient relationship, which is worthy of clinical application and promotion.
Effect of mindfulness and decompression therapy on anxiety and sleep quality in patients with lower extremity arteriosclerosis obliterans
ZHENG Chun-lan, SHANG Yu-shan, WANG Jing
2019, 17(6): 997-999,1045. doi: 10.16766/j.cnki.issn.1674-4152.000846
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Objective As a lower limb ischemic chronic disease, lower extremity arteriosclerosis obliterans is often accompanied by a variety of complications, high disability rate and mortality, which is a major problem in clinical nursing work. To evaluate the therapeutic effect of mindfulness decompression therapy on anxiety, depression and sleep quality in patients with lower extremity arteriosclerosis obliterans. Methods A total of 55 patients with lower extremity arteriosclerosis obliterans who met the inclusion criteria were enrolled and randomized into an intervention group (n=28) and a control group (n=27). In the intervention group and the control group, both patients received routine treatment and nursing, and the intervention group received one and a half hours of mind-mining decompression therapy at a fixed time interval of 6:00-7:30 in the morning, while the control group was in the control group. The rest of the period was kept quiet and the total intervention time lasted for 4 weeks. The anxiety, depression and sleep quality of the two groups were evaluated before and after treatment. Results There were no significant differences in demographic data, baseline anxiety self-rating scale, depression self-rating scale score, sleep time, sleep time, and sleep efficiency score between the two groups (P>0.05). After 4 weeks of treatment, the anxiety self-rating scale, depression self-rating scale, sleep time, sleep time and sleep efficiency of the intervention group were significantly lower than those of the control group. The difference between the two groups was statistically significant (P<0.05). Conclusion Mindfulness decompression therapy can effectively improve the anxiety and depression of patients with lower extremity arteriosclerosis obliterans, reduce their sleep time, increase their sleep time and sleep efficiency, improve their sleep quality, and thus help improve the patient's condition and promote the recovery of patients. Improve patient satisfaction with care.
Effects of pre-activated cardiac catheterization process and mental cognition intervention on reperfusion time of patients with acute myocardial infarction and anxiety of family members
LU Yan, WU Lian-ling, XUAN Ling
2019, 17(6): 1000-1003. doi: 10.16766/j.cnki.issn.1674-4152.000847
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Objective To investigate the effects of pre-activated cardiac catheterization process and mental cognition intervention on reperfusion time of patients with acute myocardial infarction and anxiety of family members. Methods Fifty patients with acute myocardial infarction who underwent percutaneous coronary intervention (PCI) were selected. Of them, 25 cases were given routine process and included in the control group. The other 25 cases were given pre-activated cardiac catheterization process and mental cognition intervention and included in the observation group. The reperfusion time, anxiety scores of family members, satisfaction of family members, PCI success rate, in-hospital mortality and incidence of complications were compared between the two groups. Results The electrocardiogram-catheter chamber time, portal-catheter chamber time and portal-balloon time in the observation group were shorter than those in the control group (all P<0.05). There was no significant difference in portal-electrocardiogram time or catheter chamber-balloon time between the two groups (P>0.05). The anxiety scores of family members in the observation group were lower than those in the control group (all P<0.05), while satisfaction score of family members was higher than that in the control group (all P<0.05). The success rate of PCI in the observation group was was higher than that in the control group (92.00% vs. 68.00%), P<0.05. The in-hospital mortality of the observation group was was lower than that of the control group (0.00% vs. 12.00%). The incidence of complications in the observation group was lower than that in the control group (28.00% vs. 40.00%). There was no difference in the in-hospital mortality and complication rate between the two groups (all P>0.05). Conclusion Conducting pre-activated cardiac catheterization process can significantly shorten reperfusion time and improve rescue efficiency for patients with acute myocardial infarction undergoing PCI. Its combination with mental cognition intervention can effectively reduce anxiety and improve satisfaction of family members, which meets the people-oriented quality service concept.
Study of three dimensiona arterial spin labeling in white matter perfusion change and cognitive impairment of patients with severe OSAS
MAO Xin-feng, ZHAO Yu-ying, YAO Li-di, ZHANG Hui-mei, SHEN Jian, LU Hua-dong
2019, 17(6): 1004-1007. doi: 10.16766/j.cnki.issn.1674-4152.000848
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Objective The three dimensional arterial spin labeling (3D-ASL) was used to study cerebral blood flow(CBF) in patients with severe obstructive sleep apnea syndrome (OSAS), and analyze the correlation of white matter perfusion abnormalities with apnea hypopnea index (AHI) and cognitive impairment. Methods Fifty-six cases of OSAS patients (AHI>30 times per hour) which were confirmed by clinic were included in this study. The control group had been set-up in age-matched 56 healthy volunteers without OSAS disease (AHI<5 times per hour). 3D-ASL sequences were examined in two groups of subjects using GE Discovery 750 MR. Cerebral blood flow (CBF) were measured in brain white matter (bilateral white matter of frontal lobe, parietal lobe white matter, bilateral anterior limb of the internal capsule, bilateral posterior limb of the internal capsule, bilateral external capsule, bilateral centrum semiovale, bilateral occipital lobe, bilateral temporal white matter and the genu of corpus callosum, corpus callosum and splenium of corpus callosum). Independent samples t test was used for statistical analysis of the two groups of the regional CBF. P values less than 0.05 were considered significant. The correlation between CBF value and AHI and MoCA score in the low perfusion areas was analyzed. Results CBF (mL/min·100 g) of the white matter area of severe OSAS group (the right frontal lobe white matter, left frontal lobe white matter, right parietal lobe white matter, left parietal lobe white matter, right occipital white matter and left occipital white matter, posterior branch of right and left internal capsule were 21.420±4.789, 21.787±4.713, 46.151±8.217, 47.112±7.800, 17.805±5.788, 17.356±5.365, 31.443±6.020, 30.636±5.890, respectively) were all decreased compared with the healthy control group (all P<0.05). The CBF value in the cerebral hypoperfusion areas were negatively correlated with the AHI value, and positively correlated with MoCA score. Conclusion White matter hypoperfusion areas could be found and measured in the severe OSAS patients by 3D-ASL sensitively, which correlated with the decline of cognitive function and apnea hypopnea index (AHI).
Research progress of SIRT6 in respiratory diseases
LI Hao-long, LAI Tian-wen, WU Bin
2019, 17(6): 1008-1013. doi: 10.16766/j.cnki.issn.1674-4152.000849
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Sirtuins are a class of proteins that possess either mono-ADP-ribosyltransferase, or deacylase activity. Sirtuins have been implicated in influencing a wide range of cellular processes like aging, transcription, apoptosis, inflammation and stress resistance, as well as energy efficiency and alertness during low-calorie situations. Sirtuins can also control circadian clocks and mitochondrial biogenesis. Mammals possess seven sirtuins (SIRT1-7). SIRT6, a member of the Sir2 protein family, is known to have NAD+ dependent histone deacetylase, mono-ADP-ribotransferase and deadipoacylase catalysis. Through these functions, SIRT6 plays an important role in regulating DNA repair, telomere maintenance, inflammatory response and the occurrence and development of cancer. This paper reviews the role of SIRT6 in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, asthma, non-small cell lung cancer, and other respiratory diseases. In terms of the pathogenesis of COPD, SIRT6 plays a role in lung aging, which is manifested in DNA damage, telomere shortening, and, autophagy. SIRT6 is involved in pulmonary epithelial-mesenchymal transition (EMT) in idiopathic pulmonary fibrosis, and it is resistant to intrapulmonary EMT induced by bleomycin, showing that the role of resistance to fibrosis. SIRT6 deacetylation can mediate the reduction of airway inflammation in bronchial asthma and also participate in the process of autoimmune inflammation. SIRT6 plays a key role in the formation and growth maintenance of NSCLC. Understanding the role of SIRT6 in the respiratory system is conducive to revealing the disease mechanism and exploring new therapeutic targets or developing new drugs.
Analysis of effects of acupressure combined with Chinese traditional medicine for Tsusanli external application on motilin and gastrin in patients undergoing colorectal surgery
JIN Hui-ying, ZHAI Dong, JIN Shan-en, ZHOU Rui, ZHANG Jun-xia, FANG Qun
2019, 17(6): 1014-1017. doi: 10.16766/j.cnki.issn.1674-4152.000850
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Objective To analyze the effects of acupressure combined with Chinese traditional medicine for Tsusanli external application on motilin and gastrin in patients undergoing colorectal surgery, and to provide reference for the clinical treatment of patients undergoing colorectal surgery. Methods A total of 90 patients who underwent colorectal surgery in our hospital from June 2016 to March 2018 were selected, and the patients who received colorectal surgery from June 2016 to April 2017 were set as the control group (n=40), the patients who received colorectal surgery from May 2017 to March 2018 were set as the observation group (n=50). The control group was treated with routine treatment, while the observation group was treated with acupressure combined with Chinese traditional medicine for Tsusanli external, the recovery time of bowel sounds, the normal time of bowel sounds, the first exhaust time and the first defecation time after surgery were compared between the two groups; The gastric juice volume, the levels of motilin and gastrin before and after surgery and the incidence of postoperative incision infection, incision dehiscence, intestinal anastomotic fistula were compared between the two groups. Results The recovery time of bowel sounds, the normal time of bowel sounds, the first exhaust time and the first defecation time of the observation group were significantly earlier than those of the control group (all P<0.05); Before surgery there were no significant differences in gastric juice volume, the levels of motilin and gastrin between the two groups (all P>0.05), after surgery, the gastric juice volume of the two groups was significantly lower than that before surgery (all P<0.05), and the observation group was significantly lower than the control group (all P<0.05), the levels of motilin and gastrin of the observation group were significantly higher than those before surgery (P<0.05), and the observation group was significantly higher than the control group (all P<0.05); Overall complication rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion Acupressure combined with Chinese traditional medicine for Tsusanli external application can effectively improve the gastrointestinal function of patients after colorectal surgery, and it can reduce gastric juice volume, and improve the levels of postoperative motilin and gastrin, which has a certain safety.
Influence of pharyngeal treatment machine supplemented with motor imaging training on quality of life and swallowing function of stroke patients with deglutition disorder
XU Shu-fen, CHAI Wen-juan, XU Qin-rong
2019, 17(6): 1018-1020,1028. doi: 10.16766/j.cnki.issn.1674-4152.000851
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Objective To investigate the influence of pharyngeal treatment machine supplemented with motor imaging training on quality of life and swallowing function of stroke patients with deglutition disorder. Methods Sixty cases of stroke patients with deglutition disorder from August 2016 to February 2018 in our hospital were selected. According to the random number table method, all the patients were divided into the experiment group and the control group, 30 cases in each group. The control group was treated with dysphagia therapy on the basis of routine rehabilitation training; the experiment group was given motor imagery therapy on the basis of the control group. After 6 weeks of intervention, the quality of life, swallowing function and complications were compared between the two groups. Results After 6 weeks of intervention, the SSA scores of the two groups were significantly lower than those before intervention (P<0.05), the SSA score of the experiment group was significantly lower than that of the conventional group, the difference were statistically significant (all P<0.05). The SWAL-QOL scores of the two groups were significantly higher than those before intervention (P<0.05), the total score of SWAL-QOL and the scores of all dimensions in the experimental group were significantly higher than those in the control group, the difference were statistically significant (all P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion Pharyngeal treatment machine supplemented with motor imaging training can effectively improve the swallowing function of patients with dysphagia neurogenic dysphagia, improve the quality of life, and do not increase the incidence of complications, it is worthy of clinical attention.
Application of thermal moxibustion combined with functional training in the rehabilitation of knee osteoarthritis and the effect of joint function
ZHU Xiao-yan, XIE Kai, HE Yong, GAO Feng
2019, 17(6): 1021-1024. doi: 10.16766/j.cnki.issn.1674-4152.000852
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Objective To explore the effect of heat-induced moxibustion combined with functional training on rehabilitation of knee osteoarthritis and its effect on joint function. Methods Sixty-four patients with knee osteoarthritis treated from June 2017 to March 2018 were selected as subjects and divided into the control group (n=32) and the observation group (n=32) using a random number table. Control group was given thermal moxibustion treatment, and the observation group was provided with joint function training on the basis of the control group. Three months after treatment, the treatment effect was evaluated via the JOA knee function score respectively from pain and walking ability of pain, swelling, up and down the stairs and flexion angle and the rigidity, highly evaluating contracture of joint function in patients with four aspects. The knee osteoarthritis quality of life scale was used to evaluate the effect of patients from five dimensions of society, body, work, symptoms and influence, and to compare the clinical effect, joint function and quality of life of the two groups. Results The total effective rate of thermal moxibustion combined with functional exercise for 3 months in the observation group was 93.75%, significantly higher than 71.88% in the control group (P<0.05). The scores of pain, walking ability, swelling, ability of walking up and down stairs, flexion Angle, rigidity and height contracture were all higher in the two groups 3 months after treatment than before treatment (all P<0.05). The scores of pain, walking ability, swelling, ability of walking up and down stairs, flexion Angle, rigidity and height contracture in the observation group were all higher than those in the control group (all P<0.05). After 3 months of treatment, the scores of social, physical, work, symptom and influence in both groups were higher than those before treatment (all P<0.05) while the scores in the observation group were all higher than those in the control group (all P<0.05). Conclusion The application of thermal moxibustion combined with functional training in the rehabilitation treatment of knee osteoarthritis can achieve a relatively high short-term efficacy, which is helpful to improve the joint function of patients, promote the recovery of knee joint function, improve the clinical symptoms of patients, and thus improve the quality of life of patients.
Applied efficacy of CPC combined with LBL teaching method in the course of introduction to general practice
QIAN Hong, LIU Li-jing, HU Ke, HE Jian-bin, LI Wen-jun
2019, 17(6): 1025-1028. doi: 10.16766/j.cnki.issn.1674-4152.000853
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Objective General practice is a relatively new developing discipline in China. With the reform of the medical and health system, local governments and medical colleges attach more importance to the cultivation of general practitioners, and our school has listed Introduction to General Medicine as a compulsory course in medical education. Introduction to General Practice is a comprehensive medical discipline which is human-centered, community-oriented and family-oriented, integrates clinical medicine, preventive medicine, rehabilitation medicine and humanities and social disciplines. This paper combines case-centered, problem-based, community-oriented teaching mode (CPC) with traditional lecture-based learning (LBL). The application effect in the course of Introduction to General Practice is preliminary exploration, which provides beneficial reference for future teaching. Methods According to the digital table method, 248 students from the 2015 undergraduate clinical medicine majors of our school were randomly selected as the research subjects. They were divided into control group (n=120) and experimental group (n=128). The students in control group received the LBL method. On the basis of this, CPC and LBL teaching method were applied to the ones in experimental group. In the end, the teaching efficacy was evaluated according to the results of the general medical theory, test scores, questionnaires and teaching satisfaction. Results In the experimental group, the results of the general medical examinations and the appraisal scores of the students in the experimental group were significantly higher than those in the control group (all P<0.01). In addition, the evaluation of the general medical teaching in the questionnaire survey and teaching satisfaction in experimental group was superior to control group (P<0.01). Conclusion CPC combined with LBL teaching method is a scientific and effective teaching method that is suitable for Introduction to General Practice in medical colleges. It can enhance medical students' understanding of Introduction to General Practice, cultivate their comprehensive ability and knowledge application ability, and improve their post competence. It is worth popularizing in future teaching.
Study of α2A receptor agonists on improving postoperative cognitive dysfunction in elderly patients with brain tumor surgery by inhibiting inflammatory response and oxidative stress
FENG Li, LAI Qin-mei, ZHOU Gong-min, ZHAO Yuan-yuan, JIANG Long, CHEN Long, WU Hui-ying, ZHU Li-ying
2019, 17(6): 1029-1032. doi: 10.16766/j.cnki.issn.1674-4152.000854
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Objective To study the effects of α2A receptor agonists on cognitive function, inflammatory response and oxidative stress in elderly patients with brain tumor surgery, and to explore the possible mechanism of α2A receptor agonists on improving postoperative cognitive dysfunction in elderly patients with brain tumor surgery. Methods A total of 160 patients with brain tumor surgery from June 2013 to December 2017 treated in Wangjiangshan District of Zhejiang Provincial People's Hospital were selected, and were divided into the control group and the dexmedetomidine group according to the random number method, with 80 cases in each group. The dexmedetomidine group patients were preoperatively pumped with the α2A receptor agonist dexmedetomidine until the end of surgery. The MMSE scores were used to measure cognitive function of the patients. The serum IL-6 and TNF-α levels were determined by ELISA. The serum MDA concentration was determined by thiobarbituric acid staining. The serum SOD activity was measured by xanthine oxidase method. Results The incidence of postoperative cognitive dysfunction in the dexmedetomidine group (18.75%) was lower than that in the control group (38.75%, χ2=7.811, P=0.005). There were no significant differences in MMSE scores, serum IL-6 and TNF-α levels, serum MDA concentrations and SOD activities between the two groups before surgery (all P>0.05). After surgery, the MMSE score [(26.71±2.04) scores] and SOD activity [(88.42±8.74) U/mL] in the dexmedetomidine group were higher than those in the control group (all P<0.05), the serum IL-6 [(42.13±3.38) pg/mL], TNF-α levels [(16.27±1.95) pg/mL] and MDA concentrations [(5.14±1.27) nmol/mL] were lower than that in the control group (all P<0.05). Conclusion α2A receptor agonists improve postoperative cognitive dysfunction in elderly patients with brain tumor surgery by inhibiting inflammatory response and oxidative stress.
Effects of continuous thoracic paravertebral block combined with general anesthesia on postoperative rehabilitation and immune function in lung cancer surgery
WU Dan, LEI Li-pei, ZHANG Jie, ZHOU Ya-mei, DING Lei-ming, CHEN Long
2019, 17(6): 1033-1036,1041. doi: 10.16766/j.cnki.issn.1674-4152.000855
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Objective To investigate the effect of continuous thoracic paravertebral block (CTPVB) combined with general anesthesia on postoperative rehabilitation and immune function in lung cancer surgery, in order to provide theoretical basis for its clinical promotion. Methods From February 2016 to February 2018, 102 cases with open chest resection of lung cancer were continuously collected, and divided into study group (CTPVB combined with general anesthesia, n=69) and control group (single general anesthesia, n=33) according to patients' wishes. Differences in postoperative serum pain medium, stress hormone, immune function were compared between at 1st hour, 3rd and 7th day after operation, and postoperative rehabilitation differences also compared. Results No statistical differences were found in general clinical data and surgical data between two groups (all P>0.05). However, serum pain medium neuropeptide Y, 5-hydroxytryptamine and prostate E2 in the study group were significantly lower than those in the control group (all P<0.05) in the first hour, 3rd day and 7th day after operation. These indicated that CTPVB combined with general anesthesia had significant analgesic effect.Also, serum stress hormone angiotensin, adrenocorticotropic hormone, cortisol were significantly lower and immune function indexes IgA, IgG and HLA-DR in were significantly higher the study group than those in the control group (all P<0.05) in the first hour and 3rd day after operation. These suggested that the combination of general anesthesia with CTPVB can effectively reduce the level of postoperative stress response and the degree of postoperative immune injury in patients with lung cancer.Forced expiratory volume in the 3rd day after extubation and oxygenation index in the 3rd and 7th day after extubation in the study group was significantly higher than that in the control group (P<0.05). These suggested that the combination of general anesthesia with CTPVB has less damage to respiratory function, which was in favour of postoperative rehabilitation. Conclusion CTPVB combined with general anesthesia has a significant analgesic effect in the surgery of patients with lung cancer, moreover, can effectively reduce postoperative stress response and immune injury degree, promoted the recovery of lung function, thus contributed to the postoperative rehabilitation and worthy of clinical promotion.
Study on risk of hemorrhagic influenza infection in patients with PICC
YE Guan-jun, SUN Ya-er, LU Ping, GUI Zong-ying, ZHOU Qin, YU Yan-fen
2019, 17(6): 1037-1041. doi: 10.16766/j.cnki.issn.1674-4152.000856
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Objective To investigate the influencing factors of the occurrence of thrombosis and blood flow infection in patients undergoing peripherally inserted central catheter (PICC). Methods A total of 1 008 patients with PICC in our hospital from January 2018 to August 2018 were selected as subjects. The clinical data, including general data, medical history, laboratory examination, were collected. Bivariate logistic regression analysis was used to screen the risk factors of thrombosis and related bloodstream infection. Results Thrombosis occurred in 45 out of 1 008 patients, the incidence was 4.46%. A total of 15 patients with PICC had bloodstream-related infections, the infection rate was 1.49%. Bivariate Logistic regression analysis showed that prolonged indwelling of PICC catheter was an independent risk factor for catheter-related bloodstream infection, puncture vein and FIB content were independent risk factors for thrombosis. Conclusion PICC patients have a high risk of thrombosis and complications of catheter-related bloodstream infections. Coagulation parameters and selection of puncture veins have a great impact on the occurrence of thrombosis. Long-term indwelling of PICC is an independent risk factor for catheter-related bloodstream infections. Therefore, on the one hand, nurses should strengthen the understanding of the complications of PICC patients with thrombosis and related hemorrhagic influenza infection, adopt targeted and predictable grading nursing intervention measures, and reduce the incidence of catheter-related thrombosis through drug prevention and grading nursing measures.
Cancer-related fatigue and influencing factors analysis in lymphoma patients receiving chemotherapy
WANG Wu-ping, LIN Hai-yan, QIAN Yuan-yuan, LIN Xiao-ji, LI Xia, LIN Hai-yu, ZHOU Xin-hua
2019, 17(6): 1042-1045. doi: 10.16766/j.cnki.issn.1674-4152.000857
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Objective Cancer-related Fatigue (CRF) in patients with tumors or tumor treatment process include the subjective feeling of tired, depression, cognitive decline, loss of interest, disability in the original job. These symptoms cannot be relieved after a rest, which seriously affect the daily function, social activities, physical and mental health and quality of life. The objective of this study is to describe the status of Cancer-related fatigue in lymphoma patients receiving chemotherapy, and to explore its influencing factors, so as to provide evidence for the development of effective nursing interventions. Methods A total of 128 lymphoma patients receiving chemotherapy in our hospital from March 2015 to March 2018 by convenience sampling were enrolled into this study. The patients were investigated by general data questionnaire and Piper Fatigue Scale. Variance analysis and Spearman correlation analysis were used in the univariate analysis and logistic regression analysis in the multivariate analysis. Results The score of overall fatigue in 128 research objects was 5.32±2.19, which was at a moderate level. A total of 103 patients were with cancer-related fatigue, with the incidence of 80.5%. Emotional fatigue level was (7.37±3.26) points, which was in a severe fatigue level; the sensory dimension score was (5.48±2.11) points; behavior/severity dimension scored average (5.12±1.97) points, which was the lowest; cognitive/emotional dimension score was (5.87±2.32). Logistic multivariate analysis showed that gender (OR=3.225), times of chemotherapy (OR=2.883) and Ann Arbor staging (OR=3.003) were statistically significant among all the factors that influenced the patients receiving chemotherapy (P<0.05). Conclusion The lymphoma patients receiving chemotherapy are usually with a moderate to severe level cancer-related fatigue, and the incidence is high. The targeted care is suggested to perform among the male patients and the patients with chemotherapy over 10 times or with Ann Arbor stage Ⅲ/Ⅳ to relieve the current state of fatigue.
Efficacy and security of urinarykallid in treatment of acute cerebral infarction and effects on nerve function
DAI Sheng-bing, YAN Wang, LIU Yan, HU Li-xia, ZHI Yan-fang, HU Xiao-yan, CHEN Tao
2019, 17(6): 1046-1048. doi: 10.16766/j.cnki.issn.1674-4152.000858
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Objective To investigate the efficacy and security of urinarykallid in treatment of acute cerebral infarction and effects on nerve function. Methods Sixty patients with acute cerebral infarction were admitted to our hospital from May 2015 to May 2017. Patients were divided to treatment group and control group by the random number table. The control group was given conventional treatment. Patients in the treatment group were also given intravenous infusion of uninary kallid 0.15 U normal saline 100 mL once daily for 14 days. The blood routine, blood glucose, blood lipids, liver and kidney function, and myocardial enzymes before and after treatment were compared. And the efficacy and incidence of adverse drug reactions of two groups were observed. Results There were no significant changes in blood routine, liver and kidney function and myocardial function before and after treatment in the two groups, and there was no significant difference between the two groups after treatment (P>0.05). Two weeks after treatment, the NHISS score and the disability score were lower than those before treatment, and the treatment group was significantly better than the control group, the difference was statistically significant (P<0.05). At the end of the study. The difference was not statistically significant between the two groups (U=2.742，P=0.006). During the treatment, 2 cases of adverse reactions occurred in the treatment group (1 case of fever, 1 case of arrhythmia), the incidence rate was 6.7%; 3 cases of adverse reactions occurred in the control group (1 case of fever, 1 case of hypotension, 1 case of palpitations), occurred The rate was 10.0%, and the difference was not statistically significant (χ2=0.218, P=0.640). Conclusion Urinarykalid in treatment of acute brain infarction can effectively improve the nerve function of patients and improve the total treatment effectiveness of patients.
Application of individualized continuous diet nursing in patients with chronic hepatitis B and hepatic fibrosis
HUANG Jun-li, LI Xian-peng, MAO Min-fen, XIE Shuai
2019, 17(6): 1049-1051,1055. doi: 10.16766/j.cnki.issn.1674-4152.000859
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Objective To study the effect of individualized continuous dietary nursing in patients with chronic hepatitis B and liver fibrosis. Methods A total of 196 patients with chronic hepatitis B and liver fibrosis who were treated in our hospital from January 2015 to January 2017 were selected as the subjects. Patients were divided into observation group and control group with random table method. After admission, both groups were given routine nursing education. Patients in the observation group were given individualized continuous dietary care interventions. The levels of serum total bilirubin (TBIL), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured before and 6 months after diet intervention. FibroScan was used to detect the degree of hepatic fibrosis. Quality of life scale (SF-36) was used to evaluate the quality of life of patients. Results There was no significant difference in TBIL, AST and ALT between the two groups (all P>0.05) before intervention. After intervention, the levels of TBIL, AST and ALT in the observation group were significantly lower than those in the control group (all P<0.05). There was no significant change in the control group. There was no significant difference in stiffness value between the two groups (P>0.05). After intervention, the levels of stiffness value in the observation group were significantly lower than those in the control group (P<0.05). There was no significant change in the control group. There was no significant difference in SF-36 value between the two groups (all P>0.05) before intervention. After intervention, the score of SF-36 in the observation group were significantly higher than those in the control group (all P<0.05). There was no significant change in the control group. Conclusion Continuous dietary care can help restore liver function and liver fibrosis of patients with chronic hepatitis B liver fibrosis, and can improve the quality of life of patients.
Effect of continuous nursing intervention on patients with chronic hepatitis B treatment compliance and quality of life
ZHOU Li-ping, XU Wen-fang, JIN Yi, XU Mei-fang
2019, 17(6): 1052-1055. doi: 10.16766/j.cnki.issn.1674-4152.000860
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Objective To evaluate the effect of continuous nursing on treatment compliance and quality of life of patients with chronic hepatitis B, and to provide scientific basis for reducing readmission rate and improving treatment. Methods From January 2016 to January 2017, 133 patients with chronic hepatitis B diagnosed in Shaoxing Municipal Hospital were randomly divided into observation group and control group. The control group was given routine nursing care. The observation group was given continuing nursing intervention. One year later, the patients' treatment compliance and quality of life were evaluated. Results The proportion of complete compliance, partial compliance and non-compliance in the control group was 58.73%, 28.57% and 12.70% respectively. The proportion of complete compliance, partial compliance and non-compliance in the observation group was 84.13%, 12.70% and 3.17% respectively. The compliance in the observation group was better than that in the control group (P<0.05). The first three lowest scores in the control group were health change, energy and physiological function in turn, in the observation group. The first three lowest scores were health change, physiological function and physical pain. There was no significant difference in the scores of physiological function, physical pain, general health status and physiological content between the control group and the observation group (all P>0.05), while the scores of physiological function, energy, social function, emotional function, mental health, health change and psychological content in the control group were lower than those in the observation group (all P<0.05). Conclusion Continuous nursing care for patients with chronic hepatitis B can improve their treatment compliance, make their treatment more standardized and achieve better long-term effect, which is of great significance to improve the quality of life.
Nursing value of standardized nursing care after vaccine replication in the middle-aged and elderly with low and non-response hepatitis B vaccine
CHE Li-ping, LAI Ling-ping, SHOU Feng-qin
2019, 17(6): 1056-1058. doi: 10.16766/j.cnki.issn.1674-4152.000861
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Objective To explore the nursing value of standardized nursing for patients with low response and no response to hepatitis b vaccine after reseeding. Methods A total of 160 middle-aged and elderly people who received multiple vaccination of hepatitis B vaccine from January 2017 to January 2018 in Shaoxing Municipal Hospital were selected. All the subjects were randomly divided into two groups: routine nursing group and standardized nursing group, with 80 cases in each group. The recombinant hepatitis B surface antigen vaccine (yeast) was used to inoculate the deltoid muscle of upper arm of two groups of subjects. The subjects in the routine nursing group were given routine nursing, and the subjects in the standardized nursing group were given standardized nursing. Immunotransmission turbidimetry was used to detect hepatitis B virus markers. A special questionnaire was used to investigate the satisfaction of family members of all the subjects. The incidence and treatment of adverse reactions after vaccination were counted and compared between the two groups. Results After two groups of subjects injected with hepatitis B vaccine and received nursing, the total satisfaction of family members in the standardized nursing group was significantly higher than that in the conventional nursing group, with statistical significance (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups after injection of hepatitis B vaccine (P>0.05). After nursing, all the patients in the standardized nursing group who had adverse reactions were treated in time, which was significantly higher than 36.36% in the conventional nursing group (P<0.05). Conclusion The standardized nursing intervention can timely deal with the adverse reactions after vaccination and make the family members more satisfied.
Effect of individualized nursing mode on self-efficacy, blood glucose level and quality of life in hemodialysis patients
LI Er, BAO Jian-feng, NIAN Su-juan
2019, 17(6): 1059-1061,1068. doi: 10.16766/j.cnki.issn.1674-4152.000862
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Objective To explore the nursing effect of individualized nursing model of responsibility in hemodialysis patients and its effect on patient self-efficacy and blood glucose level. Methods A total of 94 hemodialysis patients admitted from March 2016 to February 2018 were enrolled. The random number table was divided into control group (n=47) and observation group (n=47). The control group received routine care, and the observation group used the responsibility individualized nursing mode to evaluate the patient's effect after 15 days of nursing. The chronic disease self-efficacy energy table (CDSES) was used to evaluate emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and self-efficacy of health problems before and after 15 days of care. The levels of urea nitrogen (BUN), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c) and serum creatinine (Scr) were measured before and after 15 days of treatment. The quality of life of the two groups was assessed by quality of life scale (QOL). The effects of the two groups of nursing and their effects on self-efficacy and blood vessel levels were compared. Results The control of emotional control, reasonable rest, pain and discomfort, self-care, compliance with medical drug management and health problems scores in the observation group were higher than those in the control group (all P<0.05). In the observation group, BUN, FBG, the levels of HbA1c and Scr were lower than those in the control group (all P<0.05). The scores of cognition, role, physical, emotional and social angles in the observation group were higher than those in the control group (all P<0.05). Conclusion The use of responsible individualized nursing mode in hemodialysis patients can improve patients' self-efficacy, improve patients' blood glucose levels, and contribute to the improvement of patients' quality of life. It is worthy of popularization and application.
Study on the effect of integrated medical and nursing care in patients with gastric polyps undergoing endoscopic mucosal resection
ZHU Ya-fang, SUN Xiao-jun, HU Jian-hao
2019, 17(6): 1062-1064. doi: 10.16766/j.cnki.issn.1674-4152.000863
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Objective To explore the effect of integrated nursing mode on gastric polyposis patients undergoing endoscopic mucosal resection. Methods A total of 120 patients with gastric polyps admitted to the Affiliated Hospital of Shaoxing University of Arts and Sciences from January 2017 to January 2019 were selected. All patients underwent endoscopic mucosal resection. They were divided into observation group (60 cases) and control group (60 cases) according to random number table method. Patients in the observation group were given integrated medical and nursing care, while patients in the control group were given routine nursing care. The post-operative recovery of the two groups was compared, and the psychological state scores of the 2 groups before and after nursing intervention were compared according to the State Trait Anxiety Scale. The incidence of complications and nursing satisfaction of the two groups were counted. Results The recovery time of bowel sounds, the first exhaust time, the first defecation time and the hospitalization time of the patients in the observation group were shorter than those in the control group (all P<0.05); before nursing intervention, there was no significant difference in the scores of state trait anxiety scale between the two groups (all P>0.05); after nursing intervention, the scores of the patients in the observation group were lower than those in the control group (all P<0.05); the incidence of complications in the observation group was 3.3% (2/60) lower than that in the control group 13.3% (8/60), P<0.05; the scores of nursing satisfaction in the observation group (timeliness, suitability, continuity and comprehensiveness were higher than those in the control group (all P<0.05). Conclusion Compared with routine nursing, the integrated nursing mode can promote the recovery of gastric polyp patients after endoscopic mucosal resection, reduce hospitalization time, reduce anxiety, reduce the occurrence of postoperative complications and improve nursing satisfaction, which is worthy of clinical application.
Clinical value of nursing intervention for diabetic nephropathy based on Maslow's hierarchy theory
XIAO Hui-yu, WANG Yu-mei
2019, 17(6): 1065-1068. doi: 10.16766/j.cnki.issn.1674-4152.000864
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Objective To explore the effect of nursing intervention for diabetic nephropathy based on Maslow's hierarchy theory. Methods Seventy patients with diabetic nephropathy admitted to our hospital from April 2017 to April 2018 were divided into two groups according to random number table method. Patients in the control group were given routine nursing mode. Patients in the study group were given nursing intervention based on Maslow's hierarchy theory on the basis of routine nursing. Results After nursing, the blood sugar, urea nitrogen and creatinine of the study group were lower than those of the control group (all P<0.05). The physiological score, social score, psychological score, disease score, satisfaction score and total nursing score of the study group were higher than those of the control group (all P<0.05). Before nursing, the scores of anxiety and depression in the control group were (54.1±6.3) and (55.6±5.8), respectively, while those in the study group were (54.2±6.5) and (55.8±5.7). After nursing, the scores of anxiety and depression in the control group were (47.8±7.4) and (48.5±7.5). The scores of anxiety and depression in the study group were (40.1±5.1) and (41.1±5.1), respectively, which were lower than those before nursing, and were lower than those before nursing. The scores of anxiety and depression in the study group were lower than those in the control group (P<0.05). Conclusion Maslow's hierarchical nursing model is more effective than the conventional nursing model in the treatment of diabetic nephropathy. The blood sugar index of patients is improved better. Its quality of life is improved significantly compared with the conventional nursing. Negative emotions are also under strong control. It is worthy of active promotion and application in clinical nursing.

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