中华全科医学

Establishing an evaluation system for the disabled elderly in home health care services in Beijing

XU Xiao-jing-yuan, WANG Li, WANG Mei-rong, CHEN Xiao-lei, ZHAO Ya-li, SHAO Shuang, DU Juan

2020, 18(1): 1-4,14. doi: 10.16766/j.cnki.issn.1674-4152.001153

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Objective To establish the evaluation system of home health care services for the disabled elderly for promoting the community health service institutions in Beijing to provide home health care services for the disabled elderly. Methods Based on the research of the policy documents, documents and mature evaluation tools, the paper preliminarily draws up the item pool of evaluation indexes and designs the expert consultation table. A total of 15 experts, including geriatricians, general practitioners and community nurses, who were experienced in home health care services or comprehensive elderly assessment in nationwide were invited to participate two rounds of Delphi consultation to determine the evaluation system from January to May 2019. Results The expert consultation forms were all recalled and valid. The active coefficient of experts of Delphi consultation in two rounds were 100.0%, and the degree of specialist authority was between 0.700 and 0.942, with an average of 0.847, reaching the acceptable standard. The coefficient of concordance of importance and feasibility were 0.172 and 0.207 respectively(all P<0.001) in the first round of consultation, and the second round were 0.301 and 0.314 respectively(all P<0.001). The expert opinions tended to be consistent and the consultation results were reliable. The final evaluation system included 6 first-class indexes and 28 second-class indexes, including service safety, general physical condition, cognitive and mental state, physical function, ability of daily living and environment and resources. Conclusion The experts have great initiative and authority on research subjects. After two rounds of consultation, the experts` opinion tend to be consistent and have enough coordination. The evaluation system of home health care service for the disabled elderly in this study is credible.

LI Zhi-jun

2020, 18(1): 5-6.

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Clinical significance of serum BNP, VEGF and TGF-β1 levels in the evaluation of persistent pulmonary hypertension in the newborns

ZHANG Jing-yu, CENG Li, WANG Cui, ZHANG Zhen-yu, ZHANG Ying

2020, 18(1): 7-9,44. doi: 10.16766/j.cnki.issn.1674-4152.001154

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Objective To investigate the relationship between serum levels of brain natriuretic peptide(BNP), vascular endothelial growth factor(VEGF) and transforming growth factor-β1(TGF-β1) and the condition of the newborns with persistent pulmonary hypertension(PPHN). Methods From March 2017 to June 2018, 95 children with PPHN who were admitted to the First Affiliated Hospital of Zhengzhou University in Henan Province were selected as an observation group, which were assigned into mild group(32 cases), moderate group(33 cases) and severe group(30 cases) according to pulmonary artery pressure. In the meanwhile, 95 cases of normal newborns were selected as the control group. The serum levels of BNP, VEGF and TGF-β1 were measured before and after the treatment in the observation group, and their correlation with PPHN was analyzed. Results The levels of serum BNP, VEGF and TGF-β1 in the observation group before the treatment were significantly higher than those in the control group(all P<0.05). After the treatment, the levels of serum BNP, VEGF and TGF-β1 in the observation group decreased significantly(all P<0.05). The levels of serum BNP, VEGF and TGF-β1 in the severe group were significantly higher than those in the mild and moderate group(all P<0.05). Serum BNP and VEGF were highly positively correlated with the severity of PPHN(r=0.908, P=0.013; r=0.835, P=0.001), serum TGF-beta 1 was moderately positively correlated with the severity of PPHN(r=0.697, P=0.002). The sensibility of serum BNP, TGF-β1 and VEGF levels in predicting the prognosis of PPHN were 88.97%, 86.39% and 80.26%, respectively, and the specificities were 91.13%, 86.39% and 82.52%, respectively. The accuracy was 87.62% and 84.36% and 77.58%, respectively. Conclusion The serum levels of BNP, VEGF and TGF-β1 are positively correlated with the severity of PPHN, with high value in evaluating the condition and prognosis of children.

A propensity-matched study of the relationship between elevated serum amyloid A and prognosis of locally advanced nasopharyngeal carcinoma

HU Yong, ZHANG Jing-jing, FAN Rui-tai, GU Hao, YANG Xiang-xiang, LIU Jun-qi

2020, 18(1): 10-14. doi: 10.16766/j.cnki.issn.1674-4152.001155

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Objective To investigate the effect of elevated serum amyloid A(SAA) on the prognosis of patients with locally advanced nasopharyngeal carcinoma(NPC). Methods The clinical and follow-up data of 315 patients with staged Ⅲ-ⅣA/B NPC was analyzed. Fifty-three patients with elevated SAA were enrolled in the SAA-H group. According to sex, age, KPS score, T stage, N stage and clinical stage, 106 normal SAA patients(SAA-N) were obtained by the propensity matching method. Kaplan-Meier method was used to calculate survival rate and Cox regression model was used to analyze prognostic factors. The primary endpoints was overall survival(OS), and the secondary endpoints were no loco-regional relapse-free survival(LRRFS) and distant metastasis-free survival(DMFS). Results Of the 315 patients with local advanced NPC, the 4-years OS of SAA-H group was 66.0% vs. 82.1% compared to SAA-N group(P=0.007); the 4-years LRRFS of SAA-H group was 86.8% vs. 90.1% compared to SAA-N group(P=0.385); the 4-years DMFS of SAA-H group was 58.5% vs 77.5% compared to SAA-N group(P=0.001). Among the 159 patients enrolled by the propensity-matching method, the prognosis was significantly worse in the SAA-H group than in the SAA-N group, 4-years OS: 66.0% vs. 80.2%(P=0.044); 4-years LRFSS 86.8% vs. 92.5%(P=0.198); 4-years DMFS 58.5% vs. 74.5%(P=0.023). Cox regression model showed that elevated SAA was an adverse prognostic factor for OS and DMFS. Conclusion The elevated SAA is a prognostic factor for death and metastasis in patients with locally advanced NPC. Pre-treatment SAA levels combined with TNM staging can be used to classify patients and to guide the choice of clinical treatment intensity.

The significance of m-TOR, PTEN and other related proteins expression in leiomyoma and leiomyosarcoma

HUANG Ya-nan, ZHAO Zhen-hua, YANG Jian-feng, ZHAO Li, WANG Cheng, HU Hong-jie

2020, 18(1): 15-18. doi: 10.16766/j.cnki.issn.1674-4152.001156

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Objective To investigate the expression of related proteins in leiomyoma and leiomyosarcoma,and discuss the potential value in tumor genesis, treatment and prognosis monitoring in leiomyosarcoma. Methods Between 2006 and 2016, 14 leiomyosarcoma and 65 leiomyomas were collected, and all patients underwent operation and confirmed by pathology. ERα(Estrogen receptor α), ERβ, PR(progesterone receptor), PR-b, PTEN(Phosphatase and tensin homolog deleted from chromosome 10), m-TOR(mammalian target of rapamycin), HIF-1α(hypoxia induced factor 1α), GLUT-1(glucose transport proteins-1) and Ki-67(nuclear-associated antigen) were determined by immumo-histochemical staining in leiomyoma and uterine sarcoma tissue respectively. The difference between the groups about the expression of proteins were analyzed. Student's t test and Mann-Whitney test were performed in comparison between groups. The expression of m-TOR was tested by chi square. Results An increased immune-expression of HIF-1α(P=0.011), Ki-67(P<0.001), GLUT-1(P=0.028), m-TOR(P=0.019) and decreased expression of ERα(P<0.001), PR(P<0.001), PTEN(P=0.002) were observed in leiomyosarcoma as compared to leiomyoma. The expression of other proteins showed no significant difference. Chi square showed more leiomyosarcoma patients with higher expression of m-TOR(χ²=11.695,P=0.001)while other protein expressions exhibited no significant differences. Conclusion The different expression of ERα, GLUT-1 in leiomyoma and leiomyosarcoma provides a theoretical basis for noninvasive identification of leiomyosarcoma, and m-TOR, PTEN and other related proteins in the two tumors may provide potential therapeutic target and maybe an effective prognostic biomarker.

Ratio of component causes and clinical features of chronic cough:a report of 217 cases

ZHOU Yan, WANG Yue, CHEN Xin

2020, 18(1): 19-22,55. doi: 10.16766/j.cnki.issn.1674-4152.001157

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Objective To investigate the ratio of component causes in children with chronic cough in Bengbu city and analyze the distribution of the common clinical features of chronic cough among different causes. Methods A total of 217 children with chronic cough were selected from the pediatric clinic of the First Affiliated Hospital of Bengbu Medical College from June 2017 to May 2019. The etiological diagnosis was made by referring to the Etiologic diagnostic procedure suggested for children by the Chinese Medical Association in 2013 and the clinical characteristics of the children were recorded. Chi-square test was used to analyze the etiological and clinical characteristics of chronic cough in children. Results Among the 217 cases who completed follow-up, the top four causes were upper airway cough syndrome(61 cases, 28.1%), cough variant asthma(54 cases, 24.9%), upper airway cough syndrome with cough variant asthma(37 cases, 17.1%), and post-infection cough(35 cases, 15.7%). The etiology of chronic cough in different age groups was not identical(χ²=31.718, P<0.05); The main etiology of chronic cough in 0-3 years old group was post-infection cough(31.5%), in 4-6 years old group was upper airway cough syndrome(38.9%) and in 7-14 years old group was cough variant asthma(38.2%). There was significant difference in etiologic components between male and female children(χ²=20.087, P<0.05); The primary cause in male children was upper airway cough syndrome(46 cases, 35.4%) and in female children was post-infection cough(22 cases, 25.3%). The distribution of main clinical features of chronic cough among different etiologic groups was different(all P<0.05). Conclusion The top four causes of chronic cough in children in Bengbu area are upper airway cough syndrome, cough variant asthma, cough variant asthma with upper airway cough syndrome, and post-infection cough. The etiologic components are different among different ages and sexes. The distribution of clinical characteristics among different causes are different, which can provide reference for etiologic diagnosis.

C-reactive protein level correlated with hematoma volume and long-term neurological deficits in patients with spontaneous intracerebral hemorrhage

YU Jiao-yang, DAI Hai-bin

2020, 18(1): 23-25,40. doi: 10.16766/j.cnki.issn.1674-4152.001158

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Objective To observe the relevance of serum C-reactive protein (CRP) level to the early hematoma volume and long-term neurological deficits in patients with spontaneous intracerebral hemorrhage (SICH), and to provide evi- dence for guiding the diagnosis and treatment of SICH. Methods From March 2017 to February 2018, 96 patients with SICH who were admitted to the Affiliated Hospital of Hangzhou Normal University were selected as the observation group, and 96 healthy persons as the control group. The serum CRP levels were measured on the 1st, 3rd, 7th day after the ad- mission of the observation group and on the day of physical examination of the control group respectively. The amount of cerebral hemorrhage in the observation group was calculated, and the degree of neurological deficit in observation group was evaluated one year after discharge. Results In the observation group, there were 45 cases in the small bleeding group, 34 cases in the medium bleeding group, and 17 cases in the large bleeding groups, respectively. The CRP level of the observation group got the highest on the 3rd day after the admission, which was (7. 84 ± 1. 16) mg/L, and then de- creased to (7. 13 ± 1. 13) mg/L on the 7th day, but was still higher than (5. 27 ± 1. 10) mg/L on the 1st day (F=132. 366, P< 0. 001). On the 1st and 3rd days after the admission, there were significant differences in serum CRP lev- els among different blood volume groups (all P< 0. 05). On the 1st, 3rd and 7th day after the admission, there were sig- nificant differences in serum CRP levels among different neurological deficit groups (all P< 0. 05). The levels of CRP in medium and severe neurological deficit groups were higher than those in light neurological deficit groups (all P< 0. 05). Conclusion The serum CRP level is closely related to early hematoma and long-term neurological impairment in patients with SICH. The elevated serum CRP level suggests a larger amount of hematoma and a more likely long-term neurological impairment.

A follow-up study on the relationship between family factors and recurrence of ischemic stroke

LIANG Shun-li, WU You, ZHANG Rong-bo, XU Lin-sheng, GUO Jin-hui, XU Bin

2020, 18(1): 26-29. doi: 10.16766/j.cnki.issn.1674-4152.001159

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Objective To explore the relationship between family factors and recurrence of ischemic stroke. Methods A total of 121 patients with acute ischemic stroke hospitalized in the Department of Neurology, the Second Affiliated Hospital of Zhejiang Chinese Medical University from June 2015 to May 2016 were followed up for 2 years. The patients were divided into poor prognosis group and good prognosis group according to recurrence. Family and clinical data of the patients were collected. Family intimacy and adaptability scale was used to evaluate patient's families, and stroke knowledge was assessed for the primary caregivers. The influence of family and clinical factors on the recurrence of ischemic stroke was analyzed by logistic regression. The relationship between family factors and clinical features of patients was analyzed by Pearson correlation analysis. Results The proportion of patients in poor prognosis group from rural areas? imbalanced families and families with large population was higher than that in good prognosis group, while the education, the average family income and the knowledge level of primary caregivers in poor prognosis group were lower than that in good prognosis group(all P<0.05). Logistic regression analysis showed that in family factors low education level of patients, low average family income, poor stroke knowledge of primary caregiver and imbalanced type of families were independent crisis factors for poor prognosis in ischemic stroke. The stroke knowledge level of primary caregivers was negatively correlated with the patient's LDL-C level(r=-0.793, P=0.018). Conclusion In family factors, low education level, low average family income, poor stroke knowledge of primary caregivers and imbalanced family type are independent risk factors for recurrence of ischemic stroke. The less the primary caregiver knows about stroke, the higher the patient has LDL-C level.

Effect of TGF-β1 and bFGF on tendon-to-bone healing after anterior cruciate ligament reconstruction with hamstring tendon autograft

ZHANG Pei, LIU Quan, WU Min, ZHOU Jian-sheng, XIE Xing, PAN Gong-ping

2020, 18(1): 30-33. doi: 10.16766/j.cnki.issn.1674-4152.001160

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Objective To investigate the effect of TGF-β1 and bFGF on tendon-to-bone healing after anterior cruciate ligament(ACL) reconstruction with hamstring tendon autograft. Methods A total of 48 healthy male New Zealand white rabbits, body weight 2.5-3.0 kg, were selected between January 2018 and December 2018 and divided into two groups in accordance with the random number table, with 24 in each group. ACL reconstruction with hamstring tendon autograft was performed in both groups. In group A, TGF-β1 and bFGF fibrin gel complexes were filled in the tendon-bone gap of the posterior hamstring tendon tunnel after transplantation; in group B, fibrin gel complexes were filled in the tendon-bone space of bone tunnel. The histological morphology and biomechanical properties of ACL transplanted in the two groups were observed at 4, 8 and 12 weeks after the operation, and the results were analyzed and compared. Results The results of histological examination: At 4 weeks after the operation, loose connective tissue was observed between the transplanted ligament and bone tunnel in both groups, and the collagen fibers began to form, which was more in group A as compared with group B. On W8 after the operation, the collagen fibers between the transplanted ligament and bone tunnel in the group A began to arrange in an orderly manner, and there were dense Sharpey fibers in the group B. On W12 after the operation, the ligaments in the group A began to arrange in an orderly manner. The structure of the endpoints was arranged orderly, the new fibrocartilage, calcified cartilage and osteocytes tended to mature, and the "tidal line" structure was seen dimly. The structure of the group B was still unclear. At each observation node after the operation, the new bone mass of the group A increased gradually, and at the same observation node was larger than that of the group B(all P<0.05). In mechanics, the results of ultimate tensile strength in groups A,and B were(72.69±5.09)N,(61.59±5.82)N respectively at 4 weeks,(83.00±5.24)N,(73.93±8.89)N respectively at 8 week,(102.39±6.42)N,(85.12±9.59)N respectively at 12 weeks, the load of the group A was significantly higher than that of the group B at each observation node, and the difference between the two groups was significant(all P<0.05). Conclusion TGF-β1 and bFGF can promote tendon-bone healing after ACL reconstruction with hamstring tendon autograft.

Clinical effect of propofol closed-loop target-controlled infusion system guided by bispectral index in colorectal cancer surgery

CAI Shi-hong, XU Dong, LIN Xue-zheng, XU Xiao-cheng, CHEN Ling-jun

2020, 18(1): 34-36,51. doi: 10.16766/j.cnki.issn.1674-4152.001161

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Objective To compare the efficacy of propofol closed-loop target-controlled infusion and open-loop manual regulated infusion in colorectal cancer surgery. Methods A total of 110 patients with colorectal cancer undergoing surgery were divided into study group(55 cases) and control group(55 cases) according to random number table method. The patients in the study group received intraoperative propofol infusion with closed-loop target-controlled infusion system guided by BIS, while the patients in the control group received intraoperative propofol infusion with manual adjustment. HR, MAP and SPO₂ were monitored on T1(before induction of anesthesia), T2(at intubation), T3(at skin incision), T4(after operation) and T5(at extubation) time points. The operation time, duration of anesthesia, dosage of propofol during anesthesia, recovery time of spontaneous breathing, time to recovery and extubation were recorded. The adverse reactions to anesthesia were observed. The recovery of cognitive function after anesthesia resuscitation were evaluated. Results The value of MAP at T2-T4 and HR at T2 in the study group was significantly higher than those in the control group( all P<0.01), while HR at T3 and T4 in the study group were significantly lower than that in the study group(all P<0.01). The dosage of propofol during anesthesia in the study group was(647.51±24.62)mg, which was significantly lower than that in the control group [(783.18±31.76)mg], and the recovery time of spontaneous breathing, recovery time and time to extubation were significantly shorter than those in the control group(all P<0.001). The MMSE score of the study group(26.69±1.32) was significantly higher than that of the control group(24.95±1.46) on the 1 st day after operation(t=-3.802, P<0.001). The overall incidence of adverse reactions to anesthesia in the study group(9.09%) was significantly lower than that in the control group(25.45%, χ²=5.153, P=0.023). Conclusion The closed-loop target-controlled infusion system of propofol under BIS guidance is more conducive to maintaining stability of the hemodynamic and depth of anesthesia, reducing the dosage of anesthetics, shortening the time of anesthesia resuscitation, reducing adverse reactions of anesthesia, promoting the recovery of cognitive function and improving the safety of anesthesia in patients undergoing colorectal cancer surgery.

Differential diagnostic value of NSE, S100 protein and PCT in common encephalitis

LIU Xin-sheng, LI Shi-guang, WANG Kun, LUO Xiao-na, ZHANG Rui-feng, FENG Li-jun, LI Ai-fan

2020, 18(1): 37-40. doi: 10.16766/j.cnki.issn.1674-4152.001162

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Objective To explore the value of serum and cerebrospinal fluid(CSF) neuron specific enolase(NSE), S100 protein and procalcitonin(PCT) in differential diagnosis between tuberculous meningitis and viral encephalitis. Methods A total of 44 tuberculous meningitis patients and 45 viral encephalitis patients hospitalized in the Department of Neurology, Zhengzhou First People's Hospital from January 2016 to July 2018 were selected. The severity of the disease and treatment changes was evaluated by the Central Nervous System(CNS) Infection Severity Score Scale. ELISA and electrochemiluminescence immunoassay were used to determine the levels of NSE, S100 protein and PCT in serum and cerebrospinal fluid. The levels of NSE, S100 protein and PCT in patients with tuberculous meningitis were dynamically observed before and after the treatment, and their changes and diagnostic efficacy before and after the treatment were compared among the three groups. Results The patients with moderate and severe lesions in tuberculous meningitis group were significantly more than those in viral encephalitis group(P<0.05). After the treatment, the levels of NSE, S100 protein and PCT in serum and cerebrospinal fluid of patients with tuberculous meningitis were significantly lower than those before the treatment(all P<0.05). The levels of NSE, S100 protein and PCT in serum and cerebrospinal fluid of patients with viral encephalitis were significantly lower than those of patients with tuberculous meningitis(all P<0.05). The levels of NSE, S100 protein and PCT in serum and cerebrospinal fluid had a high diagnostic value in the differential diagnosis of encephalitis vulgaris. Conclusion By comparing the levels of NSE, S100 protein and PCT in serum and cerebrospinal fluid of patients with encephalitis vulgaris, it was found that the changes of NSE, S100 protein and PCT level are consistent with the severity score of CNS infection, which can well reflect the severity and treatment changes of craniocerebral injury, and be helpful to the early differential diagnosis between tuberculosis and encephalopathy.

Effects of WMR on short-term outcomes and its predictive value in patients with large-artery atherosclerotic stroke

YU Liang, LOU Jing-jing, CHEN Miao, FU Jiang, YANG Yue, GU Da-dong

2020, 18(1): 41-44. doi: 10.16766/j.cnki.issn.1674-4152.001163

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Objective To analyze the effects of white blood cell count to mean platelet volume ratio(WMR) on short-term outcomes and its predictive value in patients with large-artery atherosclerotic stroke, so as to provide the direction for diagnosis and treatment of the disease. Methods A total of 120 patients with large-artery atherosclerotic stroke who were admitted to Zhuji People's Hospital from May 2015 to July 2018 were selected and were divided into good prognosis group(n=65) and poor prognosis group(n=55) according to the short-term outcome of patients. The demographic characteristics, vascular risk factors, baseline blood pressure, the baseline NIH Stroke Scale(NIHSS) scores and laboratory examination indexes levels of all patients were collected. The influencing factors were analyzed by binary logistic regression, and the receiver operating characteristic(ROC) curve was drawn. The area under the ROC curve(AUC) was used to evaluate the predictive value of WMR for large-artery atherosclerotic stroke. Results Systolic blood pressure, baseline NIHSS score and WMR level were independent risk factors for poor short-term outcomes of large-artery atherosclerotic stroke(all P<0.05); The WMR ratio of the good prognosis group was 0.86±0.32, and that of the poor prognosis group was 1.01±0.25, The AUC value of WMR in predicting short-term outcomes of patients was 0.826. Conclusion Systolic blood pressure, baseline NIHSS score and WMR are the independent risk factors for poor short-term outcomes of patients with large-artery atherosclerotic stroke. WMR has a good predictive value in short-term outcomes of these patients.

Gabapentin as an adjuvant treatment for post-herpetic neuralgia in the neck, shoulder and facial shingles and its effect on T lymphocyte

PI Zhi-bing, LIN Hai, PENG Yu, ZHANG Jun-kai, JIN Yuan, JIN Yan-hui

2020, 18(1): 45-47. doi: 10.16766/j.cnki.issn.1674-4152.001164

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Objective To analyze the effect of gabapentin(GBP) assisted with satellite ganglion blocks(SGB) on post herpetic neuralgia(PHN) of neck, shoulder and facial shingles and its effect on T lymphocyte. Methods A total of 66 neck, shoulder and facial shingles PHN patients diagnosed in our hospital were selected from May 2016 to August 2017, who were randomly divided into observation group(n=33) and control group(n=33) according to the random number table method. The control group was treated with SGB, and the observation group was treated with GBP based on the control group. The clinical effect, pain degree, and the level of plasma β-endorphin, the level of T lymphocyte subsets were compared between the two groups. Results The total effective rate of clinical treatment in observation group was obviously higher than that of control group(P<0.05). Before treatment, there were no significantly differences in the score of visual analogue scale(VAS), the level of plasma β-endorphin, the level of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ between the two groups(all P>0.05). After treatment, the VAS scores of two groups were obviously lower than that of before treatment(P<0.05), and the observation group was obviously lower than the control group(P<0.05). The level of plasma β-endorphin, CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were obviously higher than those of before treatment(all P<0.05), and the observation group was obviously higher than the control group(all P<0.05). Conclusion The effect of GBP assisted with SGB is significant in the treatment of PHN of neck, shoulder and facial shingles, and it can improve the level of T lymphocyte, with high clinical application value.

Changes and correlation of peripheral blood leukocyte elastase and monocyte surface lipopolysaccharide receptors in patients with sepsis undergoing continuous blood purification therapy

LI Zhi-xin, YING Li-jun, ZHOU Lei, MENG Dong-liang, XI Xiao-long

2020, 18(1): 48-51. doi: 10.16766/j.cnki.issn.1674-4152.001165

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Objective To investigate the effect of continuous blood purification(CBP) therapy on peripheral blood leukocyte elastase(HLE) and monocyte surface lipopolysaccharide receptor(mCD14) in patients with sepsis and their correlation. Methods A prospective case-control study of 60 patients with severe sepsis admitted to the Department of Critical Care Medicine, Shaoxing People's Hospital between June 2015 to December 2017 were enrolled and divided into CBP group(30 cases) and control group(30 cases) according to the implementation of continuous hemofiltration treatments. At the time of 0, 12, 24, 48, and 72 hours after the treatment in both groups, the peripheral blood samples were collected, the changes of mCD14 were detected by flow cytometry, and the changes in expression of leukocyte elastase(HLE) was detected by ELISA. Correlation analysis of HLE Level and mCD14 expression in CBP group was made by Pearson software. Results At the 12 th, 24 th, 48 th, and 72 th hours after the treatment, the HLE levels in both groups were lower than those before the treatment(all P<0.001), and the CBP group was significantly lower than the Control group. At the 12 th, 24 th, 48 th, and 72 th hours after the treatment, the mCD14 levels in both groups were up-regulated as compared with the levels before the treatment(all P<0.001), while the CBP group was more significantly as compared with the control group. There was a negative correlation between HLE level and mCD14 expression in CBP group(r=-0.644, P<0.001). Conclusion CBP treatment can reduce the level of HLE by eliminating inflammatory factors and pro-inflammatory mediators, directly or indirectly, in patients with sepsis, as well as reduce its effect on monocyte mCD14 expression, so that the patient's immune function will be restored to a certain extent. This probably may be one of the mechanisms for CBP to participate in the reconstruction of the immune homeostasis state.

Analysis of the relationship between the characteristics of ECG and the clinical prognosis in elderly patients with acute pulmonary embolism

ZHOU Peng, YANG Hui, CHEN Yong-hua, SUN Qing-feng

2020, 18(1): 52-55. doi: 10.16766/j.cnki.issn.1674-4152.001166

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Objective To investigate the relationship between the characteristics of ECG and the clinical prognosis in elderly patients with acute pulmonary embolism. Methods Eighty-three elderly patients with acute pulmonary embolism admitted in Rui'an People's Hospital were selected from April 2016 to May 2017. Abnormal ECG within 48 h and survival situation within 30 days of onset were observed. The impacts of different factors on the overall survival rate were analyzed. Kaplan Meier method was used to draw survival curve, and Cox proportional risk model was used to evaluate the influencing factors of prognosis. Results Among the elderly patients with acute pulmonary embolism, 10 were normal ECG, 73 were abnormal ECG, the abnormal rate was 87.95%. Thirty days after the onset of the disease, 48 elderly patients survived, with a total survival rate(OS) of 57.83%. The results of single factor analysis shown that there was a correlation between OS within 30 days in elderly patients with acute pulmonary embolism and coma, shock, history of heart disease, chronic lung disease, heart rate>100 times/min, clockwise rotation, complete right bundle branch block, atrial fibrillation and limb lead low voltage(all P<0.05). The Cox regression analysis showed that heart rate>100 times/min, complete right bundle branch block, shock and history of heart were independent factors influencing the clinical prognosis of elderly patients with acute pulmonary embolism. Conclusion The abnormal rate of ECG in the elderly patients with acute pulmonary embolism is very high. The abnormal rate of ECG is closely related to the clinical prognosis, and the heart rate>100 times/min, complete right bundle branch block, shock and history of heart are the independent factors influencing the poor prognosis of the elderly patients with acute pulmonary embolism.

Effect of biofeedback therapy combined with Shugang Decoction hip bath on functional anorectal pain

ZHONG Zhi-feng, CAI Cheng, LU: Min, ZHU Wen-jun, HE Qin, GE Chen-yang, ZHAO Dong

2020, 18(1): 56-58,153. doi: 10.16766/j.cnki.issn.1674-4152.001167

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Objective To study the effect of biofeedback therapy combined with Shugang Decoction hip bath in the treatment of functional anorectal pain, and further to explore an effective therapy for such diseases. Methods A total of 100 patients with functional anorectal pain in the Outpatient Department of Jinhua Central Hospital from September 2018 to August 2019 were collected and randomly divided into observation group and control group, with 50 cases each group. The control group received the biofeedback therapy, while the observation group received additional Shugang Decoction on the basis of biofeedback therapy. Pain visual analogue scale(VAS), anorectal manometry, pelvic floor function test, symptom score and clinical efficacy were compared between the two groups. Results After the treatment, the VAS score in the observation group was(1.6±1.0), which was lower than that(2.5±1.3) in the control group, t=3.880, P<0.001; the rectal resting pressure, anal resting pressure and maximum contraction pressure in the observation group were lower than those in the control group, all P<0.05; the relaxation state AVG, rapid contraction AVG Peak, intermittent contraction AVG, and coefficient of variation(CV) in the observation group were better than those in the control group, all P<0.05; the symptom score of the observation group was(14.6±7.0), which was lower than that(18.2±7.6) of the control group, t=2.464, P=0.016; the total effective rate of the observation group(92.0%) was higher than that of the control group(74.0%), χ²=5.741, P=0.017. Conclusion Biofeedback therapy combined with Shugang Decoction hip bath has a significant effect on functional anorectal pain. It can obviously relieve pain of patients, reduce anal and rectal pressure, improve pelvic floor function and reduce symptom scores. It is worthy of clinical implementation.

Efficacy and prognosis of autologous hematopoietic stem cell transplantation in treating recurrent refractory peripheral T cell lymphoma

CHEN Dong, PEI Ren-zhi, LU Ying, CAO Jun-jie, CHEN Lie-guang, LIU Xu-hui, ZHANG Pi-sheng, LIU Hui

2020, 18(1): 59-61,157. doi: 10.16766/j.cnki.issn.1674-4152.001168

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Abstract:
Objective To investigate the clinical effect and prognostic factors of autologous hematopoietic stem cells transplantation(AHSCT) in the treatment of recurrent refractory peripheral T cell lymphoma. Methods Sixty-four cases of recurrent refractory peripheral T cell lymphoma admitted in Yinzhou people's Hospital between January 2010 and January 2016 received AHSCT treatment. The patients were followed up for the analysis of therapeutic effect and clinical characteristics, and the prognosis was analyzed by COX regression. Results Hematopoietic reconstitution in 64 patients within 15 days after AHSCT was observed. The median peripheral mononuclear cells were 8.74×10⁸/kg(6.34×10⁸-16.72×10⁸/kg), the median CD34 cell count was 5.64×10⁶/kg(3.43×10⁶-9.62×10⁶/kg). The median time of neutrophil implantation(>0.5×10⁹/L) was 12 d(7-17 d), the median time of platelet implantation(20×10⁹/L) was 13 d(7-19 d). The median time of follow-up was 26 months(8-48 months). By the end of the follow-up period, 28 cases of them died, the death rate was 43.75%(survival rate 56.25%); 24 cases died of recurrence and 4 cases died of transplantation related complications. Response rates: complete response(CR) 43.75%(28/64), partial response(PR) 32.81%(21/64), stable disease(SD) 21.88%(14/64). The 3-years overall survival was 59.38%. Three-year progression-free survival rate was 48.44%, the longest disease-free survival time was 41 months. Multivariate COX regression analysis showed that bone marrow involvement, the Prognostic Index for T-cell lymphoma(PIT) and complete response after AHSCT were independent factors of poor prognosis. Conclusion AHSCT has a significant effect on recurrent refractory peripheral T cell lymphoma. The bone marrow involvement, PIT score and CR after the transplantation will give a bad prognosis.

A survey on glucose metabolism disorder in middle-aged patients with hypertension complicated with obstructive sleep apnea syndrome

SHI A-min, YAO Xiao-guang, LI Nan-fang, MAIMAITI Nu-er-gu-li, ABULIKEMU Zu-fei-ya

2020, 18(1): 62-67. doi: 10.16766/j.cnki.issn.1674-4152.001169

129 2

Abstract:
Objective To observe the influence of obstructive sleep apnea syndrome(OSAS) on glucose metabolism in middle-aged hypertensive patients. Methods The whole-night polysomnography(PSG) was performed in the hypertensive patients suspected of OSAS in our department between January to December 2010, and 895 patients were confirmed. According to exclusion criteria, middle-aged people aged between 40 and 60 were selected for follow-up. A total of 306 complete follow-up data were collected in 2017, including 86 patients without OSAS and 220 patients with OSAS(they were divided into mild, moderate and severe groups according to sleep respiratory disorder index(AHI) of OSAS patients). The follow-up included age, sex, blood pressure, fasting blood sugar, glycosylated hemoglobin, date of diabetes diagnosis and use of hypoglycemic drugs. The average follow-up time was(4.41±2.44) years. The incidence of glycometabolism disorder, the average fasting blood glucose and glycosylated hemoglobin level were compared among the different groups. Results Among middle-aged people, the incidence of diabetes mellitus and glucose metabolism disorder was 18.6% and 28.6% respectively in patients with hypertension and OSAS, which were higher than those in hypertension patients without OSAS(8.1% and 23.3%). The incidence of pre-diabetes in hypertension patients without OSAS(15.1%) was higher than that in hypertension patients with OSAS(10.0%). Conclusion The glycometabolism disorder is more likely to occur in hypertensive patients with OSAS. The incidence of glycometabolism disorder is positively correlated with the severity of OSAS.

Study on the relationship between the level of Lp-PLA2 in peripheral blood and coronary atherosclerotic plaque in diabetic patients

LIU Li, WU Gang, WU Qing, ZHOU Jing, FANG Yong-you

2020, 18(1): 68-70,118. doi: 10.16766/j.cnki.issn.1674-4152.001170

123 0

Abstract:
Objective To analyze the value of peripheral blood lipoprotein-related phospholipase A2(Lp-PLA2) levels in diabetic patients for the assessment of coronary atherosclerotic plaques. Methods A total of 211 patients with type 2 diabetes mellitus underwent coronary arteriography(CAG) in our hospital were enrolled as the object of study from February 2015 to October 2018. According to the results of the examination, they were divided into non-coronary atherosclerosis group(the control group, n=91) and coronary artery atherosclerosis group(the study group, n=120). Baseline data, laboratory indexes, and parameters of intravascular ultrasound were compared between the two groups. The correlation between plasma Lp-PLA2 level and patch burden(PB), Gensini score, plaque number and diseased vessel number were analyzed. Multivariate Logistic regression analysis was used to analyze the influencing factors of coronary atherosclerosis in patients with type 2 diabetes mellitus. Results There was no significant difference in age, body mass index(BMI), history of hypertension, triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), fasting plasma glucose(FPG), total cholesterol(TC) between the two groups(all P>0.05). The levels of glycosylated hemoglobin(HbA1 c) and plasma Lp-PLA2 in the control group were lower than those in the study group(all P<0.05). The minimum lumen area and minimum diameter of artery in patients of the study group were smaller than those in the control group, while PB in the study group was larger than those in the control group(all P<0.05). The Lp-PLA2 level in plasma was positively correlated with PB, Gensini score, number of plaques and number of pathological vessels(all P<0.05). Conclusion High Lp-PLA2 is a risk factor of coronary atherosclerosis in type 2 diabetes mellitus, and it is related to the severity of the disease. The detection of Lp-PLA2 has a positive value for the evaluation of the disease of coronary atherosclerotic plaque in diabetic patients.

Effect of ultra-early comprehensive intervention on early intellectual and physical development of late premature infants

WANG Jie, LIU Qiao-yun, WANG Jie-yun, ZHOU Yong-mei, FAN Jue, WU Lin-qing, XIA Bin

2020, 18(1): 71-73,93. doi: 10.16766/j.cnki.issn.1674-4152.001171

174 1

Abstract:
Objective To study the effect of ultra-early comprehensive intervention on early intellectual and physical development of late premature infants, and to provide reference for effective clinical intervention. Methods A total of 116 late preterm infants born in Changning Maternal and Infant Health Care Hospital of Shanghai from April 2017 to April 2018 and managed in the follow-up clinic of premature infants, which had poor repertoire GMs were randomly divided into intervention group(56 cases) and control group(60 cases) used by random number table method. In addition to the normal follow-up in Preterm Infant Clinic, the intervention group was given three comprehensive interventions(visual music therapy, sensory integration training and traditional Chinese massage) within 3 months of corrected gestational age for one course of treatment. The Gesell Developmental Scale(GDS) was used for late preterm infants at the corrected age of 6 months, and their weight, length and head circumference were simultaneously measured, and to compare the intellectual and physical development of the two groups. Results The gross motor, adaptability and social competence scores of the intervention group at the corrected age of 6 months were(99.64±8.50) points,(94.93±7.46) points and(96.59±6.34) points, which were significantly higher than(94.42±8.29) points,(89.67±10.92) points and(91.65±7.44) points of the control group, with statistically significant differences(all P<0.05). In fine motor and language areas, the scores of intervention group were(87.66±12.01) points and(91.41±8.72) points, while the control group were(83.97±9.42) points and(90.53±11.46) points, there was no significant difference between the two groups(all P>0.05). There was also no significant difference in weight, length and head circumference between the intervention group and the control group when correcting gestational age of 6 months(all P>0.05). Conclusion Ultra-early comprehensive intervention can promote early intellectual development of late preterm infants, but it has no obvious effect on early physical development.

The protective effect of high-dose EPO on brain development of premature infants in early postnatal period

CHEN Qing, QIAN Shuang-shuang, ZHOU Li, LOU Ran

2020, 18(1): 74-77. doi: 10.16766/j.cnki.issn.1674-4152.001172

126 0

Abstract:
Objective To investigate the protective effects of high dose EPO on the brain development of very low birth weight preterm infants in early postnatal period, and to provide reference for clinical practice. Methods Sixty very low-weight preterm infants from the Department of Neonatology, Wenzhou Central Hospital were selected from January 2017 to November 2017, who were randomly divided into treatment group and control group. The treatment group received 1 000 U/kg rhu-EPO once a day for 3 days, the control group was not given rhu-EPO treatment, and the routine treatment of other premature infants was the same as that of the treatment group. The neonatal neurological behavior was measured at 40 weeks of corrected gestational age, the neurological function was evaluated with Gesell scale at 6 months and 12 months of corrected gestational age, and ABR was examined at 40 weeks, 6 months and 12 months of corrected gestational age. Results The blood transfusion rate of the treatment group was lower than that of the control group(43.33% vs. 70.00%), and the difference was statistically significant(χ²=4.343, P=0.037). The NBNA score of the treatment group was better than that of the control group(35.6±2.1 vs. 34.3±1.9) when the gestational age was 40 weeks(P=0.017). The Gesell scale assessment showed that the treatment group was superior to the control group in the large exercise(68.7±4.3 vs. 66.5±3.6) and adaptability(63.8±5.3 vs. 61.2±4.3) at 6 months of corrected gestational age(P=0.036, 0.041). The treatment group was superior to the control group in terms of large exercise(103.1±5.9 vs. 99.1±4.7), fine motor(101.5±5.1 vs. 98.6±5.3), and language(98.4±5.3 vs. 96.1±3.2)(P=0.005, 0.035, 0.046) at 12 months of corrected gestational age. Conclusion Early use of high-dose EPO is beneficial for very low birth weight premature infants and can improve the prognosis of brain development.

Effect of antithrombotic pump combined with traditional Chinese medicine therapy on lower extremity venous thrombosis after pelvic surgery in menopausal women

LI Mei, DONG Xun, YANG Su-fen, YAO Lu, HONG Xiao-bo, WANG Lu-yan

2020, 18(1): 78-81. doi: 10.16766/j.cnki.issn.1674-4152.001173

210 0

Abstract:
Objective To study the effect of antithrombotic pump combined with traditional Chinese medicine(TCM) in the treatment of lower extremity venous thrombosis in postmenopausal women after pelvic surgery. Methods One hundred patients with lower extremity venous thrombosis after pelvic surgery in our hospital from June 2018 to January 2019 were divided into control group and combined group with 50 cases each according to the random number table method. The patients in the control group were treated with antithrombotic pump, while the patients in the combined group were treated with TCM on the basis of the control group. The venous blood flow velocity, prothrombin time(PT), activated partial thromboplastin time(APTT), plasma fibrinogen(FIB), thrombin time(TT), D-dimer(D-dimer) of two groups were measured, and the symptoms of TCM were evaluated. The therapeutic effect, the rate of deep vein thrombosis and complications were evaluated and compared between the two groups. Results There were no significant difference in blood flow velocity, PT, APTT, FIB, TT, D-dimer level and TCM symptom score between the two groups before treatment(all P>0.05). After treatment, the blood flow velocity of right and left femoral vein in the combined group were faster than that of the control group(all P<0.05). The PT, APTT, TT time in the combined group were longer than that in the control group, the FIB, D-dimer level and TCM symptom score were lower than those in the control group(all P<0.05). The total effective rate of the combined group was higher than that of the control group(P<0.05). There was no significant difference in the incidence of complications between two groups(P>0.05). Conclusion Antithrombotic pump combined with TCM therapy can improve the coagulation function and venous blood flow velocity of lower extremities in postmenopausal women with lower extremity venous thrombosis after pelvic surgery, alleviate the symptoms of patients, and have a good clinical effect.

Clinical analysis of the hysteroscopic lesion electrotomy combined with LNG-IUS in the treatment of early endometrial cancer and endometrial atypical hyperplasia

MA Hong-yun, MA Yan-qiong, YANG Wei, FAN Yang, LIU Fei

2020, 18(1): 82-84,138. doi: 10.16766/j.cnki.issn.1674-4152.001174

170 1

Abstract:
Objective To analyze and explore the clinical effect of hysteroscopic lesion electrotomy combined with levonorgestrel releasing intrauterine system(LNG-IUS) treatment of early endometrial cancer(EC) and endometrial atypical hyperplasia(EAH). Methods A total of 34 patients with early EC and EAH admitted to our hospital from January 2017 to March 2018 were collected, They were divided into two groups according to different treatment schemes, 17 cases in each group. The control group was treated with diagnostic curettage combined with high dose progesterone, while the observation group was treated with hysteroscopic lesion electrotomy combined with LNG-IUS. Therapeutic effects, adverse reactions and complications of two groups were observed. The serum carbohydrate antigen 125(CA125) and human epididymis protein 4(HE4) levels were detected and compared. SPSS 20.0 statistical software was used for analysis. Results The complete remission rate was 82.35%(14/17) in the observation group and the total effective rate was 100.00%(17/17), which was higher than 70.59%(12/17) and 94.12%(16/17) in the control group, but there was no significant difference between the two groups(P>0.05). The incidence of adverse drug reactions in the observation group was significantly lower than that in the control groups(P<0.05). There were 3 cases of secondary intrauterine adhesions in the control group, and there was no statistical difference between the two groups. There was no significant difference in CA125 and HE4 levels between the two groups at the same time point before and after treatment(all P>0.05). The levels of CA125 and HE4 in the two groups at 6 and 12 months after treatment were significantly lower than those before operation(all P<0.05). Conclusion Hysteroscopic lesion electrotomy combined with LNG-IUS in the treatment of early EC and EAH has definite clinical effect, less adverse drug reactions and complications of uterine cavity operation, which is expected to become the routine treatment of early EC and EAH with fertility-sparing treatment, thus is worthy of clinical promotion.

Clinical study on prenatal pelvic floor exercise combined with postpartum Juyuan Decoction granule in preventing postpartum pelvic floor dysfunction

HU Ting, WANG Lu-lu

2020, 18(1): 85-87,149. doi: 10.16766/j.cnki.issn.1674-4152.001175

140 0

Abstract:
Objective To explore the preventive effect of prenatal pelvic floor exercise and postpartum Juyuan Decoction granule on postpartum pelvic floor disorders(PFD). Methods From January 2016 to May 2018, 412 pregnant and parturient women who underwent birth examination in our hospital were selected as the main subjects. The women were divide into control group(n=206, take antenatal pelvic floor exercise) and the experimental group(n=206, on the basis of the control group, administrating additional Juyuan Decoction granule after the delivery) according to random number table method. After 4 weeks of treatment, the pelvic floor function such as pelvic floor electromyography, vagina dynamic pressure, vaginal continuous contraction time and pelvic floor muscle tension were observed and compared between the two groups. The TCM qi deficiency and the improvement of stress urinary incontinence were compared before and after treatment. Results The values of pelvic floor electromyography, the dynamic pressure of vagina, the duration of vaginal contraction and the tension of pelvic floor muscle were significantly improved after the treatment(all P<0.01). However, the improvement of pelvic floor function in the experimental group was significantly better than that in the control group(all P<0.01). The scores of TCM syndromes and urinary incontinence in the two groups were significantly lower than those before the treatment(all P<0.01). The scores of fatigue, shortness of breath, self-sweating, total score and urinary incontinence in the experimental group were significantly lower than those in the control group(all P<0.01). Conclusion Prenatal pelvic floor exercise combined with postpartum JuYuan Decoction granule can effectively improve the pelvic floor function and urinary incontinence symptoms of pregnant and parturient women. It has good effect on prevention and treatment of PFD, and has clinical application value.

Reliability and validity of Chinese version of Sense of Community Index Scale in the elderly in the community

WANG Ling, XIE Hui, YIN Hao, LIU Cheng-xiang, WEI Jiao-jiao

2020, 18(1): 88-93. doi: 10.16766/j.cnki.issn.1674-4152.001176

224 15

Abstract:
Objective To translate the Sense of Community Index(SCI) into Chinese, and to measure its reliability and validity. Methods The Chinese version of SCI(C-SCI) was translated and revised, and 351 community elders were selected by convenient sampling method to complete the reliability and validity evaluation of the scale. Results The C-SCI included 16 items. Four factors are obtained by principal component analysis and orthogonal rotation of square error. The cumulative variance contribution rate is 66.619%. The confirmatory factor analysis(CFA) indicated that the value of relative chi-square(CMIN/DF), goodness-of-fit index(GFI), comparative fit index(CFI), incremental fit index(IFI), tucker-Lewi index(TLI), root mean square error of approximation(RMSEA), root of the mean square residual(RMR) and the standardization regression coefficient were 1.644, 0.902, 0.941, 0.942, 0.926, 0.060, 0.040, 0.542-0.798, respectively. The combined reliability(CR) of each dimension is 0.726-0.825, the average variance extracted(AVE) is 0.401-0.541. The Cronbach'α and the split-half reliability coefficient of Guttman the whole scale were 0.854 and 0.811, respectively. The Cronbach'α of each dimension were 0.767-0.852. Conclusion The revised C-SCI shows acceptable reliability and validity. It can be used to evaluate and research the communication ability in the elderly in the community.

Effect of WeChat-based symptom assessment and self-intervention on adverse reactions, mental state and quality of life in patients with breast cancer during chemotherapy

WANG Xiao-yue, WANG Xue-jun

2020, 18(1): 94-97. doi: 10.16766/j.cnki.issn.1674-4152.001177

144 2

Abstract:
Objective To explore the effects of WeChat-based symptom assessment and self-intervention on adverse reactions, mental status and quality of life in patients with breast cancer during chemotherapy. Methods One hundred and forty-six patients with breast cancer who were treated with chemotherapy in our hospital from September 2017 to September 2018 were selected and divided into experimental group and control group according to the random number table method, with 73 cases in each group. Patients in the control group were given outpatient guidance during chemotherapy, and patients in the experimental group were given a WeChat remote evaluation and intervention platform during chemotherapy. Beck anxiety scale(Beck anxiety inventory, BAI), Beck depression scale(Beck depression inventory, BDI), psychological elasticity scale(Connor-Davidson resilience scale, CD-RISC), Heah hope scale(Herth Hope Index, HHI), Happiness index scale(Index of well-being, IOWB), Morisky medication Compliance scale, Quality of life measurement scale and incidence of serious adverse events were compared between the two groups. Results The BAI and BDI scores of the two groups were lower than those before the intervention, and the experimental group was significantly lower than the control group(all P<0.05). The psychological resilience scale, HHI, IOWB, and quality of life scores of the two groups were higher than those before the intervention, and the experimental group was significantly higher than the control group(all P<0.05). The adherence of the patients in the experimental group was significantly higher than that in the control group in the early, middle and late stages, and both showed a downward trend(all P<0.05). The incidence of serious adverse reactions in the experimental group was significantly lower than that in the control group(all P<0.05). Conclusion WeChat remote assessment and intervention platform can improve the psychological state of breast cancer patients during chemotherapy, improve treatment expectation and diagnosis and treatment, reduce the incidence of serious adverse reactions, and significantly improve the quality of life.

The application value of pubo-femoral distance measured by different body positions ultrasound in the screening of developmental dysplasia of the Hip

CHEN Chun-hua, LEI Gui-fu, CHEN Cai-ping, LIANG Pei-jun

2020, 18(1): 98-101. doi: 10.16766/j.cnki.issn.1674-4152.001178

168 1

Abstract:
Objective To explore the diagnostic value of pubo-femoral distance(PFD) measured by different body positions ultrasound in the screening of developmental dysplasia of the Hip(DDH). Methods A total of 65 children with suspected DDH diagnosed by ultrasound combine with clinical feature from March 2017 to March 2019 in our hospital and the first people's hospital of Xiaoshan district of Hangzhou were enrolled as DDH group, while 69 healthy children were enrolled as control group. All children were examined by ultrasonography. PFD, α angle and bone rim percentage(BRP) were compared. ROC curve was used to evaluate the diagnostic efficacy of different indexes in DDH screening. Results The α angle, BRP in the DDH group were lower than those in the control group(all P<0.05). The PFD in the DDH group was higher than that in the control group(P<0.05). The ΔPFD in the male and female children with DDH were higher than those in the control group(all P<0.017). The ΔPFD in the unilateral and bilateral DDH patients were higher than those in the control group(all P<0.017). The best cut-off point of PFD screening DDH was 5.03, AUC was 0.988, which was significantly better than α angle and BRP(Z=3.747, 4.966; all P<0.001). The diagnostic sensitivity of PFD was 90.14%, which was significantly better than other indexes(P<0.05). Conclusion The diagnostic efficacy of PFD for screening DDH is prominent and better than α angle and BRP, and the difference of PFDs between the two hips is independent of the sex of the child. PFD may become one of the observation indexes of ultrasonic diagnosis of DDH.

Evaluation of the therapeutic efficacy of acupuncture and moxibustion on postpartum female pelvic floor dysfunction by four-dimensional pelvic floor ultrasound

YU Ying-ying, TAO Xiao-ying, JIN Bei, TANG Min-min, LI Feng-zhi

2020, 18(1): 102-104,133. doi: 10.16766/j.cnki.issn.1674-4152.001179

190 0

Abstract:
Objective To explore the diagnostic value of four-dimensional pelvic floor ultrasound for postpartum female pelvic floor disorders and acupuncture treatment of postpartum female pelvic floor dysfunction. Methods Eighty prospective women with postpartum pelvic floor dysfunction and 80 women without pelvic floor dysfunction during the same period were selected to conduct a prospective study. They were set as observation group and control group, and two groups of women were subjected to four-dimensional pelvic floor ultrasound examination, Compare the levator anal fissure in the observation group with the control group. Patients in the observation group were divided into 2 groups of 40 cases each, and the four-dimensional pelvic floor ultrasound detection index, pelvic floor muscle strength score, and maximum vaginal systolic pressure in the two groups were compared. Results In the resting state and the anus contraction state, the anterior and posterior diameters, left and right diameters, and areas of the levator ani muscle in the observation group were larger than the control group, and the thickness of the levator ani muscle was smaller than the control group(all P<0.05). After treatment, the anterior levator rupture hole in the two groups was smaller than the observation group 1(all P<0.05), and the thickness of the levator ani muscle was larger than that in the observation group 1(both P<0.05). After treatment, the pelvic floor muscle strength score and the maximum vaginal systolic blood pressure in the observation group were higher than those in the observation group(both P<0.05). Conclusion Four-dimensional pelvic floor ultrasound can clearly and intuitively display the morphological characteristics of pelvic floor structure in female patients with pelvic floor dysfunction. It can also objectively evaluate the clinical effect of acupuncture in the treatment of pelvic floor dysfunction. Auxiliary diagnostic methods and efficacy evaluation methods for disorders.

The progress of research value of susceptibility weighted imaging in acute ischemic stroke

SHI Pei-pei, LUO Song, QIAN Wei-dong

2020, 18(1): 105-108. doi: 10.16766/j.cnki.issn.1674-4152.001180

143 3

Abstract:
Acute ischemic stroke is one of the most common causes of death in humans, which brings a great threat to human survival. At present, the diagnosis and treatment of acute ischemic stroke can be assisted by magnetic resonance plain scan, magnetic resonance diffusion imaging and other means. However, for some atypical cases, the diagnosis is often difficult. Magnetic sensitivity weighted imaging can narrow the diagnostic range of many neurological diseases and help to make a definite diagnosis. Moreover, with the deepening of people's understanding of the technology, it has been increasingly used in the identification of neurodegenerative diseases, intracranial calcification and hemorrhage, the evaluation of patients with brain trauma, and the qualitative and grading of brain tumors. Magnetic sensitivity weighted imaging is a kind of magnetic resonance imaging technology developed in recent years, which has the advantages of high resolution and high sensitivity. It utilizes the sensitivity differences between tissues and detects their differences through phase images. It is relatively sensitive to paramagnetic effects, mainly by evaluating the susceptibility of different tissues. T₂* weighted gradient echo sequence is the basis of its sequence, which has the advantages of high resolution and high sensitivity. The magnetic susceptibility vessel sign is a low signal shadow corresponding to the occlusion of the responsible vessel. It is mainly related to the marked increase of deoxyhemoglobin content in the fresh thrombus of the responsible vessel formation. It is a main sign of the magnetic susceptibility weighted imaging sequence in patients with ischemic stroke. Because sensitivity-weighted imaging has many applications in neurology, especially in the diagnosis and treatment of stroke patients, it should be included in the routine examination program. Based on the principle of magnetic sensitivity weighted imaging, this paper reviews the research progress of its application in patients with acute ischemic stroke, mainly from the following aspects: the evaluation of cerebral microhemorrhage, arterial thrombosis, the evaluation of etiology and prognosis, the evaluation of ischemic penumbra and collateral circulation.

Research progress on the relationship between aquaporin 3 and gastrointestinal diseases

ZHU Ye-ke, LI Yu-hong, ZHU Gui-zhou

2020, 18(1): 109-112. doi: 10.16766/j.cnki.issn.1674-4152.001181

113 0

Abstract:
Gastrointestinal diseases are still one of the most common diseases recently. Whether it is gastrointestinal inflammation or malignant tumors, people's health and quality of life are still troubled. Surgical treatment and chemotherapy can prolong life appropriately, but metastasis, surgical trauma and postoperative adverse reactions of chemotherapy drugs pose great challenges to gastrointestinal mucosal barrier function. Human gastrointestinal mucosa can not only absorb nutrients, expel waste, but also play a role in intestinal barrier, prevent intestinal flora and endotoxin transfer into blood, causing dysfunction of various organs. Aquaporins(AQPs) are a family of membrane water channels that basically function as regulators of intracellular and intercellular water flow. To date, thirteen AQPs are distributed widely to specific cell types in various organs and tissues in humans, regulating the transport of water and small molecules, and participating in many biological functions of the body. It is necessary for the organism to maintain a normal physiological state. Among them, aquaporin-3 is widely expressed in the gastrointestinal tract, permeating water, glycerol, hydrogen peroxide and other substances, which control the balance of liquid ions and promote cell proliferation and migration. Besides, it can protect the integrity of intestinal barrier and increase the resistance of gut to external stimuli. Abnormal expression of aquaporin-3 will lead to different gastrointestinal pathophysiological states, which directly affect the health of the gastrointestinal tract. The article reviews the research progress of the relationship between aquaporin-3 and gastrointestinal diseases in order to open the field for the occurrence and development of gastrointestinal diseases and to provide further thoughts for the treatment of gastrointestinal diseases.

Structure characteristics of intestinal flora in middle-aged and elderly people with phlegm-dampness constitution

MA Ye-lin, QIAN Xiao-ling, YANG Min-chun

2020, 18(1): 113-118. doi: 10.16766/j.cnki.issn.1674-4152.001182

164 1

Abstract:
Objective To explore the differences in species classification,abundance and diversity of intestinal flora samples between middle-aged and elderly people with phlegm-dampness and balanced constitution, and to find out the characteristic functional intestinal flora in middle-aged and elderly people with phlegm-dampness constitution, so as to provide the basis for the study of the relationship between phlegm-dampness constitution and metabolic diseases from the respect of microorganism. Methods People who went to department of TCM for diagnosis and treatment or medical examination center for physical examination in our hospital from May to December 2017 was selected as the study samples, and totally 30 persons with phlegm-dampness constitution and 30 persons with balanced constitution were included through the combination of TCM constitution identification software and professional syndrome differentiation. The fecal samples were collected and the total RNA was purified.The biodiversity sequencing was carried out by Miseq sequencing technology based on 16 SrRNA, and the species classification, abundance, diversity and differences between the two groups were analyzed by R(v3.1.1) software. Results ①The composition and relative abundance of intestinal flora were different among samples, but the main floras were Bacteroidetes, Firmicutes, Proteobacteria and Actinobacteria. ②The observed species, chao, ACE and shannon index of phlegm-dampness group were all smaller than those of balanced group(all P<0.05), and the simpson index was larger than that of balanced group(P<0.05). ③The relative abundance of Bacteroidetes(38.439±13.545) in phlegm-dampness group was lower than that in balanced group(46.669±12.984), while the relative abundance of Firmicutes(52.802±13.861) was higher than that in balanced group(45.742±12.990), and the difference was statistically significant(all P<0.05). Conclusion The species abundance and diversity of intestinal flora in people with phlegm-dampness constitution are significantly reduced. The relative abundance of Bacteroidetes decreasing and Firmicutes increasing are important structural features of intestinal flora in people with phlegm-dampness constitution.

Clinical study of heat-sensitive moxibustion therapy for knee osteoarthritis

GAO Feng, HAO Ya-bo, LUO Kai-tao

2020, 18(1): 119-121. doi: 10.16766/j.cnki.issn.1674-4152.001183

282 8

Abstract:
Objective To observe the clinical effect of heat sensitive moxibustion and warm acupuncture in the treatment of knee osteoarthritis, and to explore the difference of the therapeutic effect. Methods Seventy patients with knee osteoarthritis were enrolled between June 2016 and June 2017, who were randomly divided into the treatment group and the control group, 35 cases in each group. The treatment group was treated with heat-sensitive moxibustion, while the control group was treated with warm acupuncture. Two groups were treated once a day, 10 times for a course of treatment, a total of 2 courses of treatment, between the course of rest for 2 days. The changes of Lysholm knee joint function score and WOMAC osteoarthritis index score in two groups were recorded and analyzed before and after treatment. Results ①The total effective rate of heat-sensitive moxibustion therapy group was 87.10%(27/31), compared with 78.13%(25/32) in moxibustion with warming needle group(P>0.05). ②Lysholm knee joint function score of the two groups improved significantly after two courses of treatment(all P<0.01), and there was no significant difference between the two groups(P>0.05). ③WOMAC osteoarthritis index score of the two groups improved significantly after two courses of treatment(P<0.01), and there was no significant difference between the two groups(P>0.05). Conclusion Heat-sensitive moxibustion can significantly improve Lysholm knee joint function score and WOMAC osteoarthritis index score of patients with knee osteoarthritis, and the curative effect is equivalent to that of warm acupuncture.

Effect of Self-made Danxiang Rupi Powder and Tianzhu Point Scraping on Syndrome Score and Toxic and Side Effects in Patients with Liver Stagnation and Collapse

QIU Juan-juan, XU Yue-ping, YU En-guang, XING Ya-hua

2020, 18(1): 122-124. doi: 10.16766/j.cnki.issn.1674-4152.001184

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Objective To investigate the clinical effect of self-made Danxiang Rupi Powder and Tianzhu Point Scraping in patients with liver stagnation and phlegm-type chyle and its influence on syndrome score and toxic side effects. Methods Eighty-four patients with liver stagnation and chyle-type chyle who were treated from March 2018 to March 2019 were enrolled. The random number table was divided into control group(n=42) and observation group(n=42). The control group was treated with self-made Danxiang granules and external application. The observation group was treated with Tianzong acupoint scraping on the basis of the control group. The effect of the patient was evaluated after 10 days of treatment. From the mass of the tumor, the extent of the tumor, the size of the tumor and the symptoms of the whole body. The scores of syndromes before and 10 days after treatment were evaluated. The levels of estradiol and progesterone in the follicular phase were determined by automatic biochemical analyzer. The syndrome scores, hormone levels and side effects were compared between the two groups. Results In the observation group, the mass of the mass(1.42±0.28), the extent of the tumor(1.41±0.27), the size of the mass(1.32±0.24) and the score of the systemic accompanying symptom(1.51±0.27) were lower than those of the control group.(t=13.249, 13.009, 13.296, 12.797, all P<0.05). Estradiol level [(121.39±10.23) pg/mL] in the follicular phase of the observation group was lower than that of the control group(t=4.562, P<0.05). Progesterone level [(14.64±1.48) ng/mL] was higher than that of the control group(t=8.125, P<0.05). Gastrointestinal reaction, blood pressure fluctuation, liver and kidney dysfunction, dizziness headache and other occurrences in the observation group and the control group after treatment were not statistically significant(P>0.05). Conclusion The self-made Danxiang sputum powder external application combined with Tianzong point scraping for liver stagnation and phlegm-type chyle reduces the syndrome score of patients, improves hormone levels, and does not increase the incidence of toxic and side effects, which is worthy of popularization and application.

Evaluation on the Effect of Assistant General Physician Training in Yunnan Province

LI Wei-ming, SUN Mei-na, HUANG Qiao-yun, ZHANG Min, CHEN Yue-chao, YIN Jian-zhong, DONG Mei-juan, ZI Rong

2020, 18(1): 125-128. doi: 10.16766/j.cnki.issn.1674-4152.001185

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Objective To understand and analyze the effect of assistant general practitioner training in Yunnan Province, and try to further improve the teacher training mode, and provide feasible suggestions for accelerating the construction of the teaching staff team of Yunnan Province assistant general practitioner training, in order to enhance the nation assistant general practitioner training teacher training results to provide basis and reference. Methods Questionnaires and interviews were conducted to conduct a questionnaire survey and on-site interviews with 139 participants who participated in the first assistant general practitioner training course in Yunnan Province in 2018. Results The percent of the participants in the training were satisfied with the overall evaluation of the teacher training class was 91.13%. The overall evaluation of the 6.45% of the participants in the training course was general. Only 2.42% of the participants participated in the training were dissatisfied. Personal interest and unit support mainly affect the enthusiasm of the participants to participate in the training. After the participants participate in the training, the knowledge and skills that still need to be increased are in turn the teaching ability, organizational management ability and the basic concept of general medicine. Conclusion Regular training of assistant general practitioner teachers training can effectively improve the ability of teachers to teach, but there are still some factors that affect the effectiveness of teacher training. Understand the factors affecting the effectiveness of teacher training, combine the actual situation and analyze the reason, supplement and improve the selection criteria for teacher training; increase the emphasis on teacher training, mobilize the enthusiasm of assistant general teachers to participate in training; further enrich the mode and content of teacher training classes, to ensure teacher training quality and to improve the teaching level of training teachers.

Application of opportunistic screening for cervical cancer in Mali

TANG Yong-mei, LIU Hai-fang, Boubacar Sidiki Ⅰ.Dramé, Halidou Mkoné, Mohamed AMaiga, FU Ya-jun

2020, 18(1): 129-133. doi: 10.16766/j.cnki.issn.1674-4152.001186

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Objective To conduct the basic information investigation to women in Mali, evaluate the effectiveness of visual inspection with acetic acid(VIA) & visual inspection with Lugol's iodine(VILI) method and cytology method for cervical cancer and cervical intraepithelial neoplasia(CIN), and provide data support and scientific evidence for the improvement of screening techniques. Methods A total of 3 658 cases of women from 2016 to 2018 were selected as screening objects, and 3 638 cases were eligible women. The visual inspection with acetic acid(VIA) & visual inspection with Lugol's iodine(VILI) and the cytology method were respectively performed under double-blind experiment. The colposcopy was conducted in women with a positive result or clinically possible patients for the cervical biopsy. Results Among the 3 638 women who participated in the screening, the age of first sexual intercourse was 18.19±3.26 years old, the number of births was 4.5±3.1, the ratio of polygamy was 50.27%, the education level of primary school or below was 48.87%, and the recognition rate was 13.20%. The detection rate of CINⅡ+ lesions in VIA/VILI group was 4.90%(χ²=14.241, P=0.014), and the detection rate of CINⅡ+ lesions in cytology group was 5.16%(χ²=17.189, P=0.004). Meanwhile, the detection rate of pathological biopsy was 74.53%. Conclusion It is significantly important to strengthen the awareness of cervical cancer prevention knowledge, improve the cognition rate and screening rate of cervical cancer, and standardize screening programs to reduce the morbidity and mortality of cervical cancer in Mali, Africa.

Analysis of dietary nutrient intake and policy recommendations for primary and middle school students in Jiading District of Shanghai

DONG Yu-ting, BAO Yong, PENG Hui, WANG Zhi-lan, ZHANG Qin, LIU Feng, WANG Hao-quan

2020, 18(1): 134-138. doi: 10.16766/j.cnki.issn.1674-4152.001187

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Objective To investigate and analyze the intake of energy and major nutrients in in the daily diet of children and adolescents in Jiading District, Shanghai, and provide a basis for adjusting students' reasonable diet and formulating scientific and effective interventions. Methods Using the data of "Monitoring and Injury Survey of Dietary and Health Status of Primary and Secondary School Students in Shanghai", the children and adolescents aged 6 to 17 years old were selected as the survey subjects. The questionnaire data was collected by the continuous 3 d 24 h dietary review method. School and family condiments were weighed by weighing method. The energy and nutrient intake of students were obtained and compared with the reference intake of dietary nutrients(DRIs) of Chinese residents. Results The survey included 138 students, including 68 boys and 70 girls. All students had sufficient energy and protein intake. Among other major nutrients, intakes of vitamin B₁, vitamin B₂, vitamin C, iron had reached the recommended standard, but vitamin A, calcium, zinc and other intakes were relatively insufficient, while sodium intake far exceeded the recommended standard. The protein energy supply ratio meets the recommended standards, the fat supply ratio is higher, and the carbohydrate supply is lower than the recommended percentage. Conclusion The energy and main nutrients in the diet of primary and middle school students in Jiading District of Shanghai can basically meet the daily growth and development needs, but there are still some nutrient intakes, which are lower than the recommended intake. The source of energy nutrients is not balanced, carbohydrate intake is slightly insufficient and fat supply is higher. It is recommended to strengthen nutrition education, improve students' eating habits, eat dietary cereals, increase the intake of milk and its products, soybeans and their products, vegetables, fruits, etc., and reduce the high fat content of fried foods.

Feasibility analysis of improving social support of mild craniocerebral trauma patients to improve their quality of life

HU Mei, HU Xiao-jing, WU Chao-hui, YIN Bo

2020, 18(1): 139-141. doi: 10.16766/j.cnki.issn.1674-4152.001188

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Objective To investigate the effect of social support on improving the quality of life of patients with mild head injury and provide a basis for the treatment of traumatic brain injury. Methods Seventy-six patients with mild craniocerebral trauma admitted to the Second Affiliated Hospital of Wenzhou Medical University from September 2017 to September 2018 were selected as subjects, according to the social support rate scale(SSRS) and self-made. The questionnaire was divided into 40 groups in the high group and 36 cases in the low group. The clinical data of the patients were collected and analyzed to improve the impact of social support on improving the quality of life of patients. Results The subjective support score, objective support score, support utilization score and SSRS total score of the high-group patients were significantly higher than the low-group corresponding scores. The difference between the groups was statistically significant(all P<0.05). The high-group patients were completely reviewed on time. The rate of incomplete follow-up was significantly higher than that of the low-group corresponding indicators. The rate of complete non-compliance was significantly lower than that of the low group. The difference between the groups was statistically significant(all P<0.05). The material life, physical function and psychological function of patients with high grouping were statistically significant. The social function and GQOLI-74 total score were significantly higher than those of the control group, and the difference between the groups was statistically significant(all P<0.05). Conclusion The social support for patients with mild craniocerebral injury can greatly improve the behavior of following the doctor's advice and quality of life. It has obvious promotion effect on the treatment and rehabilitation of patients, and the effect is more significant. The clinical effect can be improved by similar intervention. It can be further promoted and used clinically.

Effect of Individualized Chinese Medical Nutrition Nursing Program on Liver Function,Nutritional Status and Quality of Life in Patients with Cirrhotic Ascites and Cacotrophy

MA Li-na, ZHENG Xia, YU Mei-ding

2020, 18(1): 142-145. doi: 10.16766/j.cnki.issn.1674-4152.001189

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Objective To explore the effect of individualized Chinese medical nutrition nursing program on liver function, nutritional status and quality of life in patients with cirrhotic ascites and cacotrophy. Methods A total of 120 patients with cirrhotic ascites and cacotrophy admitted to our hospital from September 2017 to February 2018 were divided into observation group and control group according to different nursing methods. Both groups received nutritional risk screening on admission, the control group adopted the routine nutrition nursing measures, and the observation group adopted the individualized traditional Chinese medicine nutrition nursing program on the basis of the control group, and they were evaluated by nutritional risk screening before discharge. The improvement of liver function and nutritional status were observed in the two groups, and the quality of life, nursing satisfaction, the total score of nutrition risk in the two groups were compared. Results The serum albumin in the observation group was significantly higher than that in the control group, and the total number of abnormal bilirubin and aspartate aminotransferase was significantly lower than that of the control group, and the difference was statistically significant(all P<0.05); the skin-fold thickness of musculus triceps brachii, upper arm circumference and hemoglobin in the observation group were significantly higher than those in the control group, and the difference was statistically significant(all P<0.05); the scores of physiological function, physiological duty, physical pain, vitality, social function, emotional duty, mental health and general health in the observation group were significantly higher than those in the control group, and the differences were statistically significant(all P<0.05); the total satisfaction of the patients in the observation group was 95.00%, which was significantly higher than 81.67% in the control group, and the difference was statistically significant(P<0.05); the total score of nutrition risk before discharge in the observation group were significantly lower than that in the control group, and the differences were statistically significant(P<0.05). Conclusion The use of individualized traditional Chinese medicine nutrition nursing program for patients with cirrhotic ascites and cacotrophy can promote the effective recovery of liver function, and obviously improve the condition of cacotrophy in patients, the score of nutrition risk decreased, improve the quality of life and the patient's satisfaction with nursing, which is worthy of clinical application.

Study on nursing practice of self-management model for patients with hepatitis B cirrhosis

ZHAO Xiao-hui, WANG Li-hua, SUO Li-na

2020, 18(1): 146-149. doi: 10.16766/j.cnki.issn.1674-4152.001190

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Objective To study the effect of self-management nursing on patients with hepatitis B cirrhosis. Methods Ninety-four patients with hepatitis B cirrhosis were selected from May 2016 to May 2017 in the General Hospital of Shenma Medical Group. They were randomly divided into routine group and research group, 47 cases in each group. The routine group was given routine nursing, while the research group was given self-management nursing. The related indicators of liver function of the two groups were detected. Child-Pugh scores, self-efficacy, self-management, quality of life evaluation before and after nursing were counted, and nursing satisfaction was counted. Results The related indexes of liver function and Child-Pugh score of the two groups after nursing were lower than those before nursing. The scores of self-efficacy, quality of life, self-monitoring, core management ability and disease knowledge of the two groups after nursing were higher than those before nursing, and the difference was statistically significant(all P<0.05). After nursing, the indexes of liver function and Child-Pugh score in the study group were lower than those in the conventional group. The scores of self-efficacy, quality of life, self-monitoring, core management ability and disease knowledge in the study group were higher than those in the conventional group. The difference was statistically significant(all P<0.05). The nursing satisfaction of the study group was 93.62%, which was higher than that of the routine group(78.72%). The difference was statistically significant(P<0.05). Conclusion The self-management nursing practice of patients with hepatitis B cirrhosis has remarkable effect. It can effectively improve the liver function of patients, improve the self-efficacy, self-management ability and quality of life of patients, and the nursing satisfaction is high.

Effect of TCM Nursing Technology on Psychological Status,Quality of Life and Sleep Quality of Patients with Coronary Heart Disease

YUAN Wen, ZHOU Xiao-yun, ZHANG Ya-li

2020, 18(1): 150-153. doi: 10.16766/j.cnki.issn.1674-4152.001191

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Objective TCM nursing technology was used to intervene patients with coronary heart disease, to explore the influence of TCM nursing technology on psychological status, quality of life and quality of sleep of patients with coronary heart disease. Methods A total of 150 patients with coronary heart disease admitted to our hospital from October 2017 to October 2018 were selected. According to the random number table method, 75 patients were divided into the traditional Chinese medicine nursing group and the general nursing group. The general nursing group received routine nursing, while the traditional Chinese medicine nursing group received traditional Chinese medicine nursing intervention. The psychological status, quality of life and physical function of the two groups before and after nursing were evaluated, and the sleep quality and complications of the two groups were compared. Results After nursing, the scores of HAMD and HAMA in TCM nursing group were 14.21±3.22 and 13.24±3.16, respectively, and those in general nursing group were 18.62±3.67 and 17.36±3.72, respectively. The scores of HAMD and HAMA in TCM nursing group were lower than those in general nursing group(t_HAMD=7.822, t_HAMA=7.310; P<0.001). The score of SF-36 in TCM nursing group was 71.32±5.86, and that in general nursing group was 66.78±5.55. The score of SF-36 in TCM nursing group was higher than that in general nursing group(t=4.871, P<0.001). The scores of sleep quality in TCM nursing group were lower than those in general nursing group(all P<0.001). The incidence of complications in TCM nursing group was 4.00%, which was lower than that in general nursing group(14.67%, χ²=5.042, P=0.025). Conclusion Intervention on patients with coronary heart disease with traditional Chinese medicine nursing technology can significantly relieve patients' negative emotions, improve their quality of life and sleep, and reduce the incidence of complications.

The application and effect evaluation of pain nursing management after hip replacement

ZHAO Ji-lu, LU Cheng, SONG Qing-ping

2020, 18(1): 154-157. doi: 10.16766/j.cnki.issn.1674-4152.001192

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Objective To evaluate the effect of the procedural pain nursing management during total hip arthroplasty. Methods From October 2016 to May 2019, 80 patients from the first people's hospital of Chuzhou who required hip replacement were chosen. The patients were divided into control group and observation group according to random number table. Each group had 40 patients. The control group adopted routine nursing measures and analgesic treatment, while the observation group set up a programmed pain management group and were given patients pain knowledge education and multi-mode analgesic measures. Patients' daily living activity score(ADL), hip joint function score scale and pain score were evaluated before operation, 24 and 48 hours after operation. Results The programmed pain nursing management had no effect on the daily living ability score of the patients 24 hours after the operation, but increased the daily living ability score of the patients 48 hours after the operation(49.78±6.51) and hip function scores(65.85±4.29). The postoperative pain degree of patients was reduced at 24 hours(3.82±1.13) and 48 hours(4.95±1.58). Conclusion The procedural pain nursing management can improve postoperative hip replacement patients daily life activities ability(48 hours after surgery) and hip function(48 hours after surgery), reduce postoperative pain reaction of patients(24 hours and 48 hours after surgery), and improve the patients' treatment adherence and psychological threshold, promote the patients' self-care ability to restore limb function in daily life, shorten the length of hospital stay, reduce the cost of treatment, and finally promote patients recovery of disease.

Effect of team-based continuous nursing on the prognosis of patients with swallowing dysfunction

CHEN Xiu-fang, WANG Chao-jun, XIANG Song-fei, LUO Guo-ying, WEI Bo

2020, 18(1): 158-160,164. doi: 10.16766/j.cnki.issn.1674-4152.001193

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Objective To explore the effect of team-based continuous nursing on stroke patients with swallowing dysfunction. Methods The overall sampling method was used to select 76 patients with swallowing dysfunction who were admitted to our hospital from December 2017 to December 2018. All patients were eligible for enrollment. The patients were divided into control group according to the principle of randomized control(n=38) and the observation group(n=38), the baseline data of the two groups were statistically different, and the difference was not statistically significant. The patients in the observation group and the control group were treated with routine nursing and team-style continuous nursing. The quality of life, improvement of dysphagia and self-efficacy of the patients before and after treatment. Results The scores of Putian drinking water test before and after treatment were(3.80±0.52) points and(1.05±0.24) points in the observation group and(3.78±0.51) points and(2.49±0.36) points in the control group. The difference was statistically significant(t=29.600, 12.738, all P<0.001); the quality of life before and after treatment EDQoL score: the observation group was(86.51±12.40),(41.02±6.72), and the control group were(85.95±12.38) points,(58.72±8.04) points. The differences were statistically significant(t=19.882, 11.371, all P<0.001). Self-efficacy scores before and after treatment:(24.80±5.36) points,(48.56±7.35) points in the observation group, and(25.02±5.41) points and(36.71±7.28) points in the control group, respectively. The differences were statistically significant(t=16.101, 7.945, all P<0.001). The scores of the drinking water test and the quality of life scores of the observation group were lower than those of the control group, and the self-efficacy was higher than that of the control group(all P<0.05). Conclusion Team-based continuous nursing can improve the quality of life of patients with swallowing dysfunction and improve dysphagia. It has high clinical value and is worth promoting.

LI Xin, MO Yin, LUO Yu-hui, SHEN Ji-hong, CHEN Yue-long, LI Hao

2020, 18(1): 161-164. doi: 10.16766/j.cnki.issn.1674-4152.001194

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WU Cheng-xiang, XU Ping, YANG Da-xing

2020, 18(1): 165-166. doi: 10.16766/j.cnki.issn.1674-4152.001195

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About Journal

2020 Vol. 18, No. 1

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