中华全科医学

The general situation of science and education of the traditional Chinese medicine in the countries along the maritime silk road

PAN Sha-sha, ZHANG Si-rong, MIAO Qing, LUO Mei, TAN Li-hong, PENG Li-sheng

2017, 15(5): 729-732,798. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.001

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Objective To understand the general situation of science and education of the traditional Chinese medicine in those countries along the maritime silk road in the 21st century,and to explore the problems of the traditional Chinese medicine which the countries along the maritime silk road faced. Methods Collecting and sorting the information about science and education of the traditional Chinese medicine in the countries along the maritime silk road from Platform for International Service of Sci-tech Information TCM,used CNKI and Wanfang database in recent years. Results The developmental level varies in science and education in countries along the maritime silk road.Southeast Asia,Africa,Europe,and the South Pacific island nations enjoys rapid development,among which Southeast Asia greatly popularizes and has lots of colleges of traditional Chinese medicine and numerous academic organizations,meanwhile closely communicating with China;Africa's development is rapid,which actively develops various exchanges and cooperation projects with China;European development is mature,due to reasons like history,which has got fast development of Chinese medicine in recent decades,and the general level of science and education of the traditional Chinese medicine increased and improved with the traditional Chinese medicine which has received recognition in Europe;It is creating the pioneer for the Pacific island nations.Nowadays people can study a bachelor's degree in Australia.In South Asia and west Asia,the development is relatively slow,of which the main reason probably is that South Asian and west Asian countries attach great importance to developing its own traditional medicine. Conclusion The general science and education level of the traditional Chinese medicine in the countries along the maritime silk road is mainly manifested in the pattern of traditional Chinese medicine and institutions on the unbalanced development,so it should be further improved.

2017, 15(5): 733-734.

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Clinical efficacy of breath training on the rehabilitation of dysphagia in elderly stroke patients

ZHAN Yan, JIANG Li, YE Xi-hong, XIAO Cheng-cheng, WANG Shan-shan, LEI De-bao, YAN Qi-wen, XUN Ya-jing, GAO Yuan, ZHAI Hong-yu, ZHANG Xue, LIU Pei-jun

2017, 15(5): 735-737. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.002

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Objective To investigate the clinical efficacy of breath training for dysphagia in elderly stroke patients. Methods Totally 70 hospitalized post-stroke elderly patients with dysphagia,from January,2012 to February,2015,were randomly assigned into control group (n=35) and experimental group (n=35).The control group was given conventional swallowing function rehabilitation training,while the experimental group was added with breath training.treatment was administrated once a day and 6 times a week for 4 weeks.Post-stroke dysphagia was assessed with Water swallow test and respiratory function was evaluated by forced vital capacity (FVC),forced expiratory volume in 1s (FEV1) and peak expiratory flow (PEF) before and after treatment. Results After treatment,swallowing function and lung function in both groups were improved compared with those before treatment (P<0.05),and the effective rate of experimental group was statistically higher than that in control group.Breathing function in experimental group was improved significantly after treatment (P<0.05),and the experimental group improved obviously higher compared with that in the control group (P<0.05). Conclusion Breath training combined with swallowing function rehabilitation training can significantly improve the respiratory function and swallowing disorder in elderly stroke patients with dysphagia,which suggests that this approach is worthy to be popularized in clinic for its validity and feasibility.

Clinical evaluation of surgical navigation system in the reconstruction of mandibular defects

XU Xu, ZHU Hui-yong, LI Zhi-yong, HUANG Xu, ZHAO Wen-quan, YOU Jia, WANG Hui-ming, LIU Jian-hua

2017, 15(5): 738-741. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.003

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Objective To compare the clinical effects of surgical navigation system and CAD/CAM surgical template in the reconstruction of mandibular defects. Methods Twenty-two patients with mandibular tumor resection and concurrent defect reconstruction were selected.Ten patients received real-time Brain LAB navigation system to position vital parts of the bone autograft after CAD/CAM surgical guide template technology (group A);12 cases received CAD/CAM surgical guide template technology (group B).Preoperative computer aided design (CAD) and intraoperative model surgery treatment were carried in both groups.After the operations,postoperative 3D CT was used to compare with preoperative design.Mandibular angle point (A) and condylar poles outside (C) was selected as key landmarks of mandibular.Geomagic studio 12.0 software was used to measure the straight-line distance of two landmarks in the preoperative design model and postoperative model (AL,CL) for performing statistical analysis.Patients were observed for facial symmetry at the time of 6 months after operation for surgical effect comparison. Results The surgery of both groups was successfully performed.The AL and CL value of A group was (1.86±0.20) mm and (2.96±0.85) mm,respectively.The matched results were analyzed with a comparative t-test,there was significant differences (P<0.05);Location of key landmarks in A group was more precise than group B,also the facial symmetry in group A was better than group B. Conclusion Compared with CAD/CAM surgical template,surgical navigation system can improve the accuracy and effects of mandibular defect reconstruction,and restore facial symmetry.

Application of vermilion flap and functional reposition of orbicularis oris in reconstruction of unilateral cleft lip

SHEN Yan, LI Guang-zao, XU Jing

2017, 15(5): 742-744. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.004

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Objective To investigate the clinical effect of vermilion flap and functional repair of orbicularis oris in reconstruction of unilateral cleft lip by using the vermilion flap and functional reposition of orbicularis oris based on the design of Millard technique. Methods From September,2010 to December,2015,76 cases of congenital unilateral cleft lip underwent orbicularis oris degloving anatomy,functional reposition,reconstruction of nasal basal and muscle remodeling,and vermilion flap.For the upper lip,Millard technique was conducted on flexible use of the"4","7" fixed point method to effectively decrease the height of the affected lip,and to reset the anatomy of the upper lip tissue;For vermilion zone,the vermilion-mucosal junction (red line) of Noordhoff technique was used to embed and align vermilion flap and obtain a plump appearance;For function repair,orbicularis oris muscle degloving anatomical technique was used to reconstruct nasal basal and upper lip orbicularis oculi muscle,thus to achieve functional recovery. Results All 76 patients were achieved primary healing.Fifty-seven cases were followed up for 3 months to 30 months.Fifty-four cases at static state were with satisfactory upper lip shape,neat lip to lip,aligned and symmetrical peaks on both sides,plump lip beads,obvious philtrum ridge in the affected lip and aligned with the normal side,not obvious scar in upper lip;At the dynamic state,without obvious ectopic stretch,deformation and local depression formation in upper lip due to muscular movement.Three cases were with upper lip scar hyperplasia,slightly local skin red and hard,slightly protruding the surface of the skin,the repaired lip slightly shorter than the contralateral lip,ipsilateral lips appear sunken at the dynamic state. Conclusion The modified Millard technique can effectively reduce the upper lip,when combined with vermilion flap and orbicularis oris functional reconstruction,a satisfactory repair for congenital unilateral cleft lip can be obtained both in anatomy and function.The design is simple and flexible,which is worthy of promoting in clinic.

Selective unilateral percutaneous balloon kyphoplasty with viscosity gradient cement injection for kyphosis and scoliosis induced by osteoporotic vertebral compression fractures

GU Xiao-hui, BI Qing, LI Ya-song, ZHANG Zhe, LV Jun

2017, 15(5): 745-747,766. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.005

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Objective To evaluate the feasibility and therapeutic effects of selective unilateral percutaneous balloon kyphoplasty by injection of multi-viscosity bone cement in the treatment of kyphosis and scoliosis induced by senile osteoporotic vertebral compression fractures (OVCF). Methods The clinical data of 16 cases of OVDF (17 vertebral bodies) in our hospital between June,2013 and October,2015 were analyzed retrospectively.Preoperative CT and X-ray showed that vertebral bodies were with anterior and lateral vertebral compression fractures,and spine with kyphosis and scoliosis.The unilateral percutaneous balloon kyphoplasty was conducted by the concave side of vertebral compression.Balloon was inflated in order to re-expand the vertebral body and to create a void in its spongy bone.The gradient viscosity of bone cement was slowly injected under fluoroscopic guidance to ensure there was no leakage of cement outside of the vertebral body.The operative time and frequency of X-ray imagining were documented.Visual Analogue Pain Scale (VAS) and Oswestry Disability Index (ODI) were used to assess fracture-related pain and patient's disability.The preoperative and postoperative radiographic parameters were compared. Results The mean operative time was 29.6 min (25-43 min),the average number of fluoroscopy was 18.6(13-21).The mean kyphosis and scoliosis (Cobb angle) and injured vertebral height (front and central part) was improved significantly (P<0.05).The difference in VAS and ODI scores before and after the operation was significant (P<0.01).The procedure-related complications such as epidural cement leakage or neural damage were not demonstrated in the study. Conclusion Selective unilateral percutaneous balloon kyphoplasty with viscosity gradient cement injection is a simple,safe and effective minimally invasive procedures for scoliosis and kyphosis caused by osteoporotic thoracolumbar compression fractures.It can accurately restore and fix the fractured vertebra.The multi-viscosity bone cement can strength the injured vertebra and reduce the epidural cement leakage,with less number of fluoroscopy.

Transradial catheterization guided by improved ultrasonic technology for shock patients in ICU

LI Xiu-yan, FANG Gui-zhen, WANG Lan-fang, ZHENG Chun-mei, WANG Ling-cong, YANG Dan-hua

2017, 15(5): 748-751,837. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.006

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Objective To observe the effects of the improved ultrasound technology with out-of-plane orientation followed by in-plane guide for shock patients in ICU,and evaluate its safety. Methods Total 106 cases of shock in ICU were randomly divided into in-plane approach group (control group) and improved ultrasound group (experimental group).The patients in both groups were treated with intravenous sedation and analgesia.The radial artery puncture and catheterization in the control group was guided by in-plane approach,while in the experimental group by out-of-plane orientation followed by in-plane technique.One-time success rate and failure rate of puncture (punctured three times without success),time for puncture and incidence of complications were compared between the two groups. Results ①One-time success rate of the experimental group (81.3%) was significant higher than that (40.4%) of the control group,P<0.05.②The time for catheterization of the experimental group[(8.38±6.10) seconds]was significant shorter than that[(24.07±21.38) seconds) of control group],P<0.01.③The incidence of hematoma and puncture oozing of the experimental group (2.1% and 4.2%) were significant less than those (14.9% and 10.6%) of the control group,P<0.05. Conclusion Compared to the in-plane method,the improved ultrasound technology with out-of-plane orientation followed by in-plane guide for shock patients in ICU can improve the one-time success rate of puncture,decrease time for the puncture and reduce the incidence of complications.

Clinical analysis of 70 children with malignant arrhythmias

XIONG Mei, CHEN Ming-wu

2017, 15(5): 752-754,795. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.007

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Objective To discuss constituent ratio,concomitant disease and medication effects of malignant arrhythmias (MA) in children. Methods The clinical data of 70 children with MA diagnosed in our hospital from January,2012 to January,2016 were retrospectively analyzed.The constituent ratio of different types of arrhythmias and concomitant disease were described according to the diagnostic criteria of MA and concomitant diseases.The age distribution characteristics of different types of MA were investigated.According to the treatment outcome,the children were assigned into refractory arrhythmia group and non-refractory arrhythmia group.Fisher exact probability test was performed to analyze the distribution of different arrhythmias between the two groups. Results Among 70 children,there were 45 cases of male and 25 cases of female;there were 5 cases of atrial flutter,12 cases of atrial tachycardia,12 cases of atrioventricular heart-block,40 cases of supraventricular tachycardia,and 1 case of atrial tachycardia with auricular fibrillation.There were different types of arrhythmias at different ages.The atrial septal aneurysm was all found in neonates.Different types of arrhythmia were with different concomitant diseases:supraventricular tachycardia was associated with respiratory infection,atrial tachycardia was combined with cardiac enlargement,atrial flutter was combined with atrial septal aneurysm,supraventricular tachycardia was associated with respiratory infection,atrioventricular block was associated with myocarditis.The probability of refractory arrhythmia in supraventricular tachycardia was significantly lower than that of atrial tachycardia and atrioventricular heart-block (P<0.01).There was no difference in the incidence of refractory arrhythmia between atrial flutter and atrial tachycardia or heart-block (P=0.10). Conclusion The clinical characteristics and medication effects were different among different MA in children.The therapeutic effect of supraventricular tachycardia was superior to atrial tachycardia and atrioventricular block.

Expression of hsa-miR-145-5p in pancreatic cancer and its bioinformatics analysis

YANG Li-tao, YU Peng-fei, DAI Gai-guo, DU Yi-an

2017, 15(5): 755-758. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.008

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Objective To investigate the expression pattern of hsa-miR-145-5p in the plasma of patients in pancreatic cancer and normal person,and explore the feasibility of hsa-miR-145-5p as a diagnostic marker for pancreatic cancer,and further clarify its possible regulatory mechanism in the development and progression of pancreatic cancer. Methods Target genes prediction and functional analysis of hsa-miR-145-5p by bioinformatics method.MiRanda,TargetScan and RNAhybrid software were used to predict the target genes of hsa-miR-145-5p and the target genes supported by experimental data,and GO enrichment,KEGG Pathway enrichment analysis and protein interaction analysis were performed to study the function of target genes.RT-qPCR was used to detect the expression of hsa-miR-145-5p in pancreatic cancer and normal control group. Results hsa-miR-145-5p mature sequences were high conserved in several species.The number of target genes were predicted to be 8 679,and the number of target genes that the experimental data supported was 1 408.The GO enrichment analysis of the target genes,which was supported by the experimental data,was mainly concentrated in the biological processes and functions such as intracellular transport,gene expression regulation,intracellular signal transduction,cell growth regulation,energy metabolism,and so on (FDR<0.01).KEGG pathway enrichment analysis was significantly enriched in p53 signaling pathway,ErbB signaling pathway,MAPK signaling pathway,chronic myeloid leukemia,bladder cancer,glioma,prostate cancer,pancreatic cancer,and so on (P<0.01).Compared with the normal group,the expression of hsa-miR-145-5p was down regulated. Conclusion hsa-miR-145-5p regulates multiple tumor related genes,plays an important regulatory role in the biological process of pancreatic cancer and provides clues for the study of a miRNA diagnostic marker in pancreatic cancer.

Distribution characteristics of pathogens and its influence on semen quality parameters in patients with male infertility

XIA Qing-qing, WEI Ren-xiong, CUI Yun, ZHANG Xiao-xia, ZHOU Jun

2017, 15(5): 759-762. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.009

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Objective To investigate the presence of bacteria in semen,strain distribution,bacterial resistance and the effects of bacterial infection on sperm analysis parameters. Methods The semen analysis,culture,identification and drug sensitivity tests were performed in 325 cases of masculine sterility in our hospital,and their influence on the sperm analysis parameters (sperm concentration,survival rate,and forward movement ratio and liquefaction time) was evaluated. Results A total of 127 strains of bacteria were isolated among 325 cases of male infertility with an infection rate of 39.1%,including G⁺ cocci (59.9%,mainly Staphylococcus aureus) and G^- bacilli (22%,mainly Escherichia coli).Drug sensitivity analysis showed that cephalosporins and macrolides resistance in staphylococcus was high;Ampicillin and Cotrimoxazole resistance in Escherichia coli was high.The sperm concentration in Neisseria gonorrhoeae group were significantly lower than that in the other infection groups (P<0.01);The survival rate of sperm in the Staphylococcus aureus and Escherichia coli group was significantly lower than those in the other infection groups (P<0.01);The difference in the rate of forward movement were found in Staphylococcus aureus,Escherichia coli and Neisseria gonorrhoeae group when compared with the other infection groups (P<0.01).The liquefaction time in the Escherichia coli group was longer than that of the other infection groups. Conclusion The positive rate of G⁺ cocci was higher than that of E.coli in bacterial culture of semen in male infertility patients;the effects of coagulase negative staphylococcus aureus,staphylococcus aureus,E.coli and gonorrhea neisseria bacteria on the semen analysis parameters has the characteristic respectively,and needed to be concerned.

Association of CYP2C19 gene polymorphism and coronary heart disease in Yunnan Han population

WANG Xiao-huan, FU Wei, ZHANG Yun-kun, CAO Hong-kun

2017, 15(5): 763-766. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.010

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Objective Coronary artery disease (CAD) represents a leading cause of morbidity and mortality worldwide,and genetic factors contribute to the development of this disease.The rate of coronary heart disease showed a rising trend in China.The CYP2C19 gene encodes a member of the cytochrome P450 superfamily of enzymes.It is an important drug metabolizing enzyme.We conducted a case-control study to assess the correlation between gene polymorphism of CYP2C19 and coronary heart disease (CHD) in Yunnan Han population. Methods One hundred and ninety-eight normal persons (control group) and 514 patients of coronary heart disease (CHD group) both written informed consents were recruited from September,2012 to September,2015.Three Polymorphisms rs4986893,rs4244285,rs4917623 in CYP2C19 gene were genotyped using the SEQUENOM Mass-ARRAY system.To investigate the correlation between gene polymorphism of cytochrome P450(CYP)2C19 and coronary heart disease using Logistic regression analysis. Results There were no significant differences in the genotypes and frequencies of alleles of CYP2C19 between the two groups (P>0.05).Logistic regression analysis showed that the rs4986893 A allele was associated with the increased risk of CHD[the dominant model:OR 1.07,95%CI(1.00-1.14),P=0.036]. Conclusion There is correlation between gene polymorphism of CYP2C19 and the risk of coronary heart disease in Yunnan Han Population.Future well designed large studies might be necessary.

HIF-1α,VEGF,MMP-9 expression level and significance in patients with invasive pituitary adenoma

JIN Jian-xiang, GU Chi

2017, 15(5): 767-769,910. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.011

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Objective To detect the HIF-1α,VEGF,MMP-9 expression level and explore the significance of these factors in order to provide theoretical basis for clinical treatment. Methods Fifty-eight cases with pituitary adenoma in our hospital from February,2013 to February,2016 were selected and divided into invasive group (34 cases) and noninvasive group (24 cases) according to pathological examination.Immunohistochemical Envision was used to detect the expression level of HIF-1α,VEGF and MMP-9 and SPSS software was used to analyze the data. Results The strong positive expression rate and total positive expression rate of HIF-1α in invasive group[47.1%(16/34),91.2%(31/34)]were higher than that of noninvasive group[12.5%(3/24),45.8%(11/24)](P<0.05).The strong positive expression rate and total positive expression rate of VEGF in invasive group[58.8%(20/34),94.1%(32/34)]were higher than that of noninvasive group[16.7%(4/24),58.3%(14/24)],P<0.05.The strong positive expression rate and total positive expression rate of MMP-9 in invasive group[55.9%(19/34),85.3%(29/34)]were higher than that of noninvasive group[8.3%(2/34),41.7%(10/24)],P<0.05.Pearson showed that HIF-1α and VEGF had positive correlation in invasive pituitary adenoma (r=0.940,P<0.05),HIF-1α and MMP-9 had positive correlation in invasive pituitary adenoma (r=0.412,P<0.05).VEGF and MMP-9 had positive correlation in invasive pituitary adenoma (r=0.783,P<0.05).There was no correlation between the three groups in the non-invasive group. Conclusion The expression levels of HIF-1α,VEGF and MMP-9 in invasive pituitary adenocarcinoma patients were significantly higher.Its expression can reflect the occurrence and development of tumor in patients,which provide the appropriate basis for the clinical diagnosis.There is a mutual promotion relationship among the three proteins.

Affection of blood pressure regulation combined with completely mechanical ventilation on the prognosis of patients with severe craniocerebral trauma after craniotomy

CHEN Bi-xin, XU Zhao-jun

2017, 15(5): 770-772. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.012

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Objective Observation of blood pressure regulation combined with completely mechanical ventilation in the treatment of patients with severe craniocerebral trauma after craniotomy.The cerebral oxygen uptake rate (CERO₂) after surgery,the improvement rate and mortality rate in 3 months were observed,the influence of the method on the prognosis of severe craniocerebral trauma were observed. Methods Fifty-four cases of severe craniocerebral trauma patients from July,2013 to June,2015 were selected and randomly divided into observation group and control group by means of random number table,28 cases in the observation group and 26 cases in the control group.The control group was given conventional ICU treatment.The observation group was given conventional ICU treatment,blood pressure regulation and complete mechanical ventilation.Compare the two groups with general situation,24,48,72 hours CERO₂ changes before and after the surgery.Followed up with patients for 3 months or end point events (death).Compare the prognosis of the two groups. Results The use time of the breathing machine observation group was significantly longer than that of the control group (P< 0.05).The observation group after surgery 24,48,72 hours of CERO₂ was significantly reduced,compared with the preoperative and control group,the difference was statistically significant (P<0.05),which showed that the treatment method had a certain effect on reducing the CERO₂.The improvement rate of observation group was 53.57% and control group was 15.38%,the mortality rate of observation group was 3.57% and control group was 30.77%,the improvement rate of observation group was higher than that of control group,the mortality rate was lower than the control group,the difference was statistically significant (P<0.05). Conclusion The blood pressure control combined with completely mechanical ventilation can reduce the CERO₂ in the patients with severe traumatic brain trauma and improve patient outcomes.Attention should be paid to the prevention and treatment of ventilator associated nosocomial infection.

The expression and clinical significance of Beclin1 and p62 in colon cancer tissue

ZHAO Jian-pei, DAI Xiao-yu, XIE Yang-yang

2017, 15(5): 773-775,826. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.013

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Objective To evaluate the expression and clinical significance of Beclin1 and p62 in colon cancer tissue. Methods Forty two patients with colon cancer were selected for this study.All the included patients are collected the cancer tissue and the normal colon tissue.Immunohistochemical staining was performed to test the expression of Beclin1 and p62.Five-year survival rate was recorded and the Cox regression analysis was conducted to analyses the risk factor for cancer death. Results The expression of Beclin1 is higher in the patients that CEA ≥ 5 ng/ml,normal tissue and the T1-T2 phase than that in CEA<5 ng/ml,cancer tissue and T3-T4 phase.The difference was significant difference (P<0.05).And the p62 expression is higher in the cancer tissue than that of normal tissue,and the difference was statistically significant (P<0.05).The Cox regression analysis indicated that the p62 is the risk factor for cancer death,and combined administration p62 with Beclin1 is the predicable factor for the cancer patient survival.SPSS 20.0 was used for statistically analyses and P<0.05 was considered as statistically significant. Conclusion The autophagy activity in colon cancer is decreased and the Beclin1 was correlated with the CEA level and depth of tumor invasion.Combined Beclin1 with p62 can be better predicting the colon cancer prognosis.

Prognosis and influencing factors of radical resection for patients with adrenocortical carcinoma

DAI Guo-ping, LIU Qing, WU Hui-ling, XU Ting

2017, 15(5): 776-778. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.014

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Objective To investigate the analysis of adrenocortical carcinoma (adrenocortical,carcinomas,ACC) patients underwent radical resection related influencing the postoperative long-term survival rate and the factors for clinical reference increased mortality risk discriminant factors. Methods A retrospective analysis of Jinhua People's Hospital from January,2005 to January,2010 in Zhejiang during the biopsy confirmed the clinical data of 18 ACC patients ACC parallel radical resection of the adrenal gland,analysis and application of Cox proportional hazard model for single factor,calculate the patient survival rate by Kaplan-Meier method,compared the survival rate by log-rank method,analysis of the long-term prognosis and effect of patients prognostic factors. Results The median age of the patients was 48 years (23-67 years).Eighteen patients were followed up for a median of 75 months (3-165 months),with a mean of 3,5-and 10 year survival rates of 55.5%,44.4%,and 16.7%,respectively.The median survival time was 46 months (1-158 months).Univariate analysis showed that the degree of tumor infiltration and lymph node metastasis (P=0.02,0.01) were related to the long-term prognosis,and the disease-free survival rates of the patients at 3,5 and 10 years were about 55.5%,33.3%,respectively.Single factor analysis showed that the degree of tumor infiltration and lymph node metastasis were also associated with tumor free survival (P<0.01,P=0.03). Conclusion Radical resection can provide an opportunity for ACC,and the degree of tumor infiltration and lymph node metastasis are important factors affecting the prognosis of patients with ACC.

The efficacy and safety of retroperitoneal laparoscopy combined with resectoscope in the treatment of renal pelvic tumors

YUAN Yao-yu, LIU Shi-xiong, ZHANG Xin-sheng, ZHANG Zu-zhao, ZHANG Wen-gang, WANG Hui, LIN Qi, HE Jian

2017, 15(5): 779-781. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.015

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Objective The comparison of retroperitoneal laparoscopy combined with resectoscope and traditional open surgery in the treatment of renal pelvic tumors. Methods According to different surgical methods,102 patients with renal pelvic tumors between January,2008 and January,2016 were divided into the observation group and control group.The observation group was treated by retroperitoneal laparoscopic resection,while the control group was treated by traditional open surgery.To compare intraoperative blood loss,operation time,postoperative anal ventilation time,postoperative drainage drainage time,postoperative first ambulation,length of stay and complications.All patients were postoperative followed-up,including history,urine analysis,liver and kidney function,color Doppler ultrasound,chest X-ray film,cystoscopy and other content,metastasis and recurrence (bladder cancer status).All data were statistical analyzed to investigate the effect and safety of retroperitoneal laparoscopy combined with resectoscope. Results The intraoperative blood loss of in the observation group was significantly less than that of the control group,Operation time,postoperative anal recovery time,duration of postoperative indwelling drainage,postoperative first ambulation and hospital stay were significantly shorter than those of the control group,the difference was significant (P<0.05);The total incidence of intraoperative and postoperative complications in the observation group was significantly lower than that in the control group (P<0.05);The patients were followed up for 1 year,There was no significant difference in local recurrence rate,skin incision metastasis rate and distant tumor metastasis rate between the two groups (P>0.05). Conclusion Laparoscopic combined resectoscope in treatment of renal pelvis tumors effectively reduce the surgical trauma,and promote postoperative recovery,reduce the incidence of complications.

Effects of hip and knee flexion exercise on pain-related factors in patients with lumbar disc herniation after minimally invasive treatment

YU Guo-cheng, LIU Guo-qiang, XU Hai-bo, TONG Hai-jiang

2017, 15(5): 782-784,886. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.016

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Objective To investigate the effects of hip and knee flexion exercise on pain-related factors in patients with lumbar disc herniation after minimally invasive treatment. Methods Total 294 cases of lumbar disc herniation in our hospital between March,2010 and March,2015 were enrolled and randomly divided into observation group and control group with 147 cases in each group.All patients underwent transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) therapy,postoperative straight leg raising exercise and lumbodorsal muscles exercises;the observation group received additional hip and knee flexion exercise.The pain and pain-related factors before and after the treatment in two groups were compared. Results VAS score and the levels of MMP-3,IL-1,IL-6 and TNF-alpha at d1,d7 and d14 after the operation were significantly reduced in both groups,and VAS score and pain-related factors levels at d7 after the operation in the observation group were significantly lower than those in the control group (P<0.05);there were no significant difference in VAS score and pain-related factors levels before the operation,at d1 and d14 after the operation between the two groups (P>0.05).JOA score at d1 and d7 after the operation increased significantly in both groups,and JOA score at d7 and d14 in the observation group were significantly higher than control group (P<0.05);there were no significant difference in JOA score before the operation,at d1 after the operation between the two groups (P>0.05).Three months after the operation,the total effective rate was 85% in the observation group,which was higher than that (66.7%) in the control group (P<0.05). Conclusion Hip and knee flexion exercise can reduce the postoperative pain in patients with lumbar disc herniation after minimally invasive treatment,and decrease pain-related factors levels,improve the outcome of patients.It is worthy of clinical promotion.

Treatment effect of soft tissue defect of fingers with free flap of superficial palmar branch of wrist volar radial artery

LV Jian-min, LIN Chuan-fu, ZHU Zi-guan

2017, 15(5): 785-788. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.017

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Objective To investigate the therapeutic effect of soft tissue defect of fingers with free flap of superficial palmar branch of wrist volar radial artery. Methods Total 80 patients with finger soft tissue defects of Rui'an City People's Hospital from October,2013 to October,2015 were randomly divided into two groups according to the number of hospital admissions and the random number table.Patients in control group (n=38) were given the dorsal fascia flap for treatment,and the patients in observation group (n=42) were given free flap of superficial palmar branch of wrist volar radial artery for treatment.The patients were followed up for 1 months and 6 months,to observe the appearance of the fingers,the survival rate of the skin flaps and the function of the fingers. Results One month after the surgery,the finger appearance and function scores of observation group were (16.5±2.7) and (15.8±3.4) points,higher than those of control group (12.8±2.4) and (13.6±3.2) points,P<0.05;6 months after surgery,the finger appearance and function scores of observation group were 18.5±2.4 and 18.7±3.3,higher than those of control group and the scores of 1 month (P<0.05);after 6 months of follow-up,the excellent rate of observation group was 97.6%(41/42),higher than that of the control group 81.5%(31/38),P<0.05;the finger feeling,blood circulation and recovery score of observation group were (33.5±4.2),(26.4±4.3) and (34.5±4.8) points,higher than those of the control group[(22.3±3.8),(16.9±4.5) and (28.9±4.9) points],P<0.05. Conclusion The free flap of superficial palmar branch of wrist volar radial artery is more suitable for the repair of the soft tissue defect of the finger.It can improve the appearance of the soft tissue defect and restore the function of the fingers with good application prospects.

Effects of alprostadil on inflammatory factor and oxidative stress in diabetes patients with lower limb vascular lesions

FEI Yang, YU Shao-chu, SUN Li-qin, YUAN Chun-gang, ZHOU Wen-jing

2017, 15(5): 789-791,819. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.018

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Objective The diabetic vascular complications are closely related to inflammatory factors and oxidative stress,the aim of this paper is to investigate the effect of alprostadil on inflammatory factor and oxidative stress in diabetic patients with lower extremity vascular disease. Methods We collected 140 diabetic patients with lower extremity vascular disease,and assigned them into treatment group and control group according to random number method.The control group received routine treatment,while the treatment group received additional alprostadil on the basis of conventional therapy.The ankle-brachial index (ABI),clinical symptom score,cytokines and oxidative stress levels before and after treatment in both groups were measured. Results Before the treatment,the difference of ABI,clinical symptom score,cytokines and oxidative stress levels of the two groups were not statistically significant (P>0.05).After the treatment,ABI and superoxide dismutase in the treatment group were higher than those in the control group (P<0.05),the clinical symptom score,8-epi-PGF2α and ox-LDL levels in the treatment group were lower than those in the control group (P<0.05),there was no significant difference in IL-10,IL-6 and TNF-α levels between the two groups (P>0.05).After the treatment,ABI and superoxide dismutase levels in the treatment group were higher than those before the treatment (P<0.05);the clinical symptom score,8-epi-PGF2α and ox-LDL levels were lower than those before the treatment (P<0.05),the IL-10,IL-6 and TNF-α levels were not significantly different with those before the treatment (P>0.05).The difference of the above changes were not statistically significant in the control group after the treatment (P>0.05). Conclusion Alprostadil can improve the clinical symptoms and lower extremity blood flow in diabetic patients with lower extremity vascular disease,and reduce the oxidative stress,but has no obvious effect on inflammatory cytokines.

Clinical study of Mudan granule combined with Mecobalamin in treatment of diabetic peripheral neuropathy

CHANG Chen, LI Yan

2017, 15(5): 792-795. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.019

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Objective To investigate the clinical effect of Mudan granule combined Mecobalamin on diabetic peripheral neuropathy. Methods Ninety-eight cases of diabetic peripheral neuropathy patients were randomly divided into 2 groups (49 cases in each group).The control group was given mecobalamin,and observation group was given Mudan granule based on control group.Before and after treatment,serum biochemical parameters[serum total cholesterol (TC),triglyceride (TG),whole blood high shear viscosity (HBV),whole blood low shear viscosity (LBV)],clinical symptom score (Limb numbness and tingling sensation,acral temperature sensory disturbance,acral reflex sensitivity and limb weakness),nerve conduction velocity[motor nerve conduction velocity (MNCV) and sensory conduction velocity (SNCV) of median nerve,common peroneal nerve and anterior tibial nerve]of two groups were detected,and the clinical effect of two groups were accounted. Results After treatment,the TC,TG,HBV and LBV levels of two groups were significantly reduced (P<0.05);and TC,TG,HBV and LBV levels of observation group were significantly lower than control group (P<0.05).After treatment,limb numbness and tingling sensation,acral temperature sensory disturbance,acral reflex sensitivity and limb weakness of two groups were significantly reduced (P<0.05);and limb numbness and tingling sensation,acral temperature sensory disturbance,acral reflex sensitivity and limb weakness of observation group were significantly lower than control group (P<0.05).After treatment,median nerve,common peroneal nerve and anterior tibial nerve MNCV and SNCV of two groups were significantly increased (P<0.05);and median nerve,common peroneal nerve and anterior tibial nerve MNCV and SNCV of observation group were significantly higher than control group (P<0.05).The total effective rate of the observation group was 89.8%,which was significantly higher than control group (73.5%,P<0.05). Conclusion Mudan granule combined Mecobalamin could significantly improve the clinical symptoms of diabetic peripheral neuropathy with satisfactory effect.

Research on the impact of obstructive sleep apnea syndrome on blood glucose and lipid metabolism in patients with chronic obstructive pulmonary disease

YANG Wen-juan

2017, 15(5): 796-798. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.020

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Objective To investigate the blood glucose and lipid metabolism levels in elderly chronic obstructive pulmonary disease (COPD) patients with obstructive sleep apnea syndrome (OSAS) and the significance. Methods One hundred cases of COPD patients in respiratory department of our hospital from January,2011 to December,2015 were selected,including 45 cases in COPD with OSAS group (mild OSAS 15 cases,moderate OSAS 18 cases,severe OSAS 12 cases),and 55 cases in COPD without OSAS group.The blood lipids and blood glucose levels of COPD group and COPD with OSAS group were compared,and their correlation with AHI was analyzed to investigate the effect of obstructive sleep apnea syndrome on chronic obstructive pulmonary disease. Results The BMI and LDL levels of COPD with OSAS group were significantly higher than that of COPD group,and HDL level of COPD with OSAS group was significantly lower than that of COPD group,all with statistically significant differences (P<0.05).The differences in FPG,HOMA-IR,HbA1C,LDL,AHI levels of mild OSAS,moderate OSAS,severe OSAS were statistically significant (P<0.05).And the AHI level of OSAS patients was significantly in positive correlation to BMI,LDL,FPG,HOMA-IR levels (P<0.05). Conclusion OSAS increased the risk of high blood lipids and diabetes of COPD patients,which might be associated with the increasing of insulin resistance and LDL levels.

A comparative study of short term effect,air-conduction thresholds and recurrence rate by intratympanic steroid aerosol inhalation via eustachian tube and intratympanic steroid injections via the tympanic puncture in patients with chronic secretory otitis

SHENG Ying-tao, MENG Fan-jie, WANG Ping

2017, 15(5): 799-801. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.021

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Objective To observe the short term effect,air-conduction thresholds and recurrence rate by intratympanic steroid aerosol inhalation via eustachian tube and intratympanic steroid injections via the tympanic puncture in patients with chronic secretory otitis media. Methods Total 88 cases of chronic secretory otitis media in our hospital between January,2014 and January,2016 were enrolled into eustachian tube inhalation group and tympanic membrane puncture injection group with 44 cases in each group.After local anesthesia,the tympanic membrane puncture injection group performed tympanic puncture guided by nasal endoscope,followed by absorption of effusion and hormone injection;while the eustachian tube inhalation group performed the inflation of the eustachian tube guided by nasal endoscope,then budesonide aerosol inhalation delivery via eustachian tube into tympanic cavity.The course in both groups was 15 days.The 250,500,1 000,test 2 000,4 000 Hz air conduction threshold and listening ability were measured at 1-2 d before the treatment and 15 d after the treatment.The short term effect,air-conduction thresholds and recurrence rate were compared between the two groups. Results There was no significant difference between the two groups in age,course of disease,symptoms and signs,pure tone test and acoustic impedance terms (P>0.05).Six months after the treatment,the total effective rate of the eustachian tube inhalation group and tympanic membrane puncture injection group was 90.9% and 93.2%,respectively,there was no significant difference between the two groups (P>0.05);however,the cure and effectiveness of the eustachian tube injection group showed significant difference to the eustachian tube inhalation group (P<0.05).There was no significant difference in the recurrence rate between the two groups (P>0.05).The air conduction threshold at 250,500,1 000,test 2 000,4 000 Hz in both groups decreased after the treatment (P<0.05),but there was no statistical significance between the two groups (P>0.05). Conclusion Both intratympanic steroid aerosol inhalation via eustachian tube and intratympanic steroid injections via the tympanic puncture in the treatment of chronic secretory otitis media were obviously effective,with the approximate recurrence rate.They can reduce the air conduction threshold.The tympanic puncture injection is with a higher cure rate.

Correlation between Th17-related cytokines in induced sputum and BODE index and GOLD degree among patients with COPD

LING Yan-jun

2017, 15(5): 802-804. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.022

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Objective To detect the level of Th17-related cytokines in induced sputum and analyze its correlation with BODE index and GOLD degree among the patients with chronic obstructive pulmonary disease (COPD). Methods Fifty-there patients with chronic obstructive pulmonary diseases with acute exacerbation (AE-COPD) were selected as pathologic study object,and 40 healthy volunteers during the same period were selected as the controls.The induced sputum before (Group AE-COPD) and after the treatment (Group S-COPD) were prepared and its Th17 related cytokines level (IL-23,IL-1β,IL-17A and IL-17F) were tested.Its correlation with BODE index and GOLD degree were analyzed. Results The IL-23,IL-1β,IL-17A and IL-17F levels of Group AE-COPD and Group S-COPD were significantly higher than those of the control group (P<0.05),and IL-23,IL-1β,IL-17A and IL-17F levels of Group AE-COPD were significantly higher than those of Group S-COPD (P<0.05).The BODE index and GOLD degree of Group AE-COPD were significantly higher than those of Group S-COPD (P<0.05).Correlation analysis showed that IL-23,IL-1β,IL-17A and IL-17F levels of Group AE-COPD had positive correlation with BODE index and GOLD grade (P<0.05),and the IL-17A and IL-17F levels of Group S-COPD had positive correlation with BODE index and GOLD grade (P<0.05). Conclusion IL-23,IL-1β,IL-17A and IL-17F are all involved in the occurrence and development of COPD,and their acute phase levels are all positively correlated with BODE index and GOLD grade.

Clinical efficacy and enalapril combined with folic acid in the treatment of H-type hypertension and its influence on vascular endothelial function

CHEN Hui, XU Qun-wei

2017, 15(5): 805-807,867. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.023

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Objective To evaluate the clinical efficacy of enalapril combined with folic acid in the treatment of H type hypertension and its influence on vascular endothelial function. Methods From October,2014 to October,2015,170 cases of H type hypertension patients in our hospital were selected and randomly divided into the observation group and the control group (85 cases in each group);The control group were given enalapril maleate tablets,while the observation group had folic acid tablets on basis of the control group;Before and 24 w after the treatment,the 24 h ambulatory blood pressure,the levels of Hcy,sICAM-1,IMT,ET-1 and NO were tested and compared. Results After the treatment,24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP,24hSBPV,24hDBPV,dSBPV,dDBPV,nSBPV and nDBPV were all significantly decreased in both groups (P<0.05),more significantly in the observation group (P<0.05).After the treatment,the levels of Hcy,sICAM-1,NO,ET-1 and IMT were (7.4±2.9)μmol/L,(342.4±39.5)μg/L,(78.4±9.1)μmol/L,(53.4±9.6) ng/L and (1.0±0.6) mm,respectively,which were obviously superior to the control group[(9.2±3.0)μmol/L,(366.5±39.5)μg/L,(75.3±8.0)μmol/L,(57.4±9.8) ng/L and (1.3±0.6) mm,respectively],the difference was statistically significant (P<0.05). Conclusion Enalapril combined with folic acid can improve blood pressure and blood pressure variability in patients with H-type hypertension,which could delay the process of atherosclerosis and improve vascular endothelial function,worthy of clinical promotion.

Comparison of efficacy and toxicities of paclitaxel liposome and traditional paclitaxel combined with carboplatin in the treatment of ovarian cancer

ZHANG Fu-bin, CUI Li-ning, XU Ke-jun

2017, 15(5): 808-810. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.024

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Objective To investigate the paclitaxel lipid body and traditional paclitaxel combined with carboplatin in the treatment of ovarian cancer the curative effect and adverse reaction of contrast analysis. Methods Altogether 92 patients with late-stage ovarian cancer were divided into two groups,with 46 cases in each group.Study group was treated with paclitaxel liposome combined with carboplatin chemotherapy.The control group used traditional paclitaxel and carboplatin chemotherapy.The clinical effect and adverse reaction of the two groups after treatment were compared. Results The total effectiveness rate was 76.09% in the study group and 69.57% in the control group.There was no significant difference between the two groups (P>0.05).The white blood cell reduction,thrombocytopenia,hemoglobin reduction,renal dysfunction,diarrhea,hair loss,and incidence of anorexia between the two groups were compared.The difference was not statistically significant (P>0.05).Muscle and joint pain (4.35%),dyspnea (2.17%),nausea (13.04%),vomiting (13.04%),facial flushing (8.70%),peripheral neurotoxicity (4.35%),rash of incidence of the study group were significantly lower than those of the control group (21.74%,15.22%,34.78%,36.96%,28.26%,19.57%).The difference was statistically significant (χ²=6.133,4.929,5.974,7.015,5.845,5.060,P<0.05). Conclusion The curative effects of paclitaxel lipid body and traditional paclitaxel plus carboplatin in the treatment of ovarian cancer were even,but the adverse reactions of paclitaxel liposome occurred was significantly lower than that of the conventional paclitaxel.

Changes of peripheral blood lymphocyte subsets and CD4⁺T cell subsets in children with asthma

CHEN Zhen, WANG En-jie, GUAN Min-chang

2017, 15(5): 811-813. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.025

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Objective The development of asthma in children is affected by the immune system,the aim of this paper is to investigate the changes of peripheral blood lymphocyte subsets and CD4⁺T cell subsets and it clinical significance in children with asthma. Methods Eighty children with asthma (asthma group) and 80 healthy children (control group) in our hospital from January,2013 to December,2015 were enrolled into this study.The peripheral blood lymphocyte subsets and CD4⁺T cell subsets were measured. Results The levels of CD3⁺,CD4⁺,CD19⁺,CD4⁺/CD8⁺in asthma group were (62.13±11.24)%,(32.97±6.57)%,(24.35±11.21)% and (1.66±0.31)%,respectively,which were significantly higher than those in control group[(71.16±12.64)%,(37.68±7.12)%,(13.87±8.46)%,(1.43±0.28)%,P<0.05].The level of CD8⁺(19.87%±4.21%) in asthma group was lower than that in control group (26.37±4.65%),P<0.05.The levels of Th2,Th17,Treg,Th17/Treg in the asthma group were (4.42±2.14)%,(1.71±0.97)%,(7.65±1.35)% and (0.22±0.05)%,respectively,which were higher than those in the control group[(1.96±1.25)%,(0.89±0.42)%,(5.91±1.28)%,(0.15±0.03)%,P<0.05].The Th1/Th2(1.31±1.32%) in the asthma group was lower than that in the control group (2.70±1.47%),P<0.05.There was no significant difference in Th1 between the two groups (P>0.05).The lymphocytes in the asthma group (36.57±13.24%) was significantly lower than that in the control group (59.64%±15.47%),P<0.05,the monocytes in the asthma group (12.17±4.21%) was higher than the control group (3.68%±1.74%),P<0.05.There was no significant difference in white blood cells and neutrophils between the two groups (P>0.05).The lymphocytes were negatively correlated with Th1,Th2 and Th17(P<0.05).The monocytes were negatively correlated with CD3⁺,CD4⁺ and CD19⁺(P<0.05),and was positively correlated with CD8⁺(P<0.05). Conclusion The lymphocyte subsets and CD4⁺T cell subsets in children with asthma are abnormal.Peripheral blood lymphocyte subsets and CD4⁺T cell subsets can be used to determine the immune function of children with asthma.

Analysis of 158 patients with characteristics of Kawasaki disease with no responsiveness immunoglobulin therapy therapy

CHEN Miao-yue, WU Su-ling, XUE Gong-shou

2017, 15(5): 814-816. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.026

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Objective To investigate clinical characteristics of Kawasaki disease with no responsiveness immunoglobulin therapy therapy,so as to improve its prevention and treatment. Methods We retrospectively reviewed the clinical data of 158 cases of children with Kawasaki disease from February,2013 to February,2015,those who were sensitive to initial treatment were assigned as sensitive group,use for invalid without as Non-sensitive group.Analysis of the two groups of children with clinical manifestation,laboratory examination,cardiovascular complications and prognosis etc,and no response group treatment again. Results After gamma globulin treatment,132 cases (83.54%) for sensitive people,no responders 26 cases (16.46%).Non-sensitive group of laboratory examination of PLT,ESR,ALT and CK-MB group was significantly higher than sensitive group,but Hgb significantly below the sensitive group,the difference was statistically significant (P<0.05).Non-sensitive group of 26 cases underwent additiona ivIg treatment,glucocorticoid treatment,temperature was normal.Follow-up for a year,two groups of children recovered well. Conclusion High incidence of ivIg no reaction type KD,and coronary artery damage occur more often.Lymph node neck tenderness sex (>2 cm in diameter),skin rashes,PLT,ESR and ALT elevations,Hgb reducing,may be a risk factor for ivIg no reaction type KD.

Efficacy of adjuvant therapy with dexamethasone in children with lobar pneumonia and its influence on inflammatory factors and ESR levels

LIAO Xiao-ling, WU Liang

2017, 15(5): 817-819. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.027

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Objective The mortality rates are higher in children with lobar pneumonia,and the study on regimen is very important.This study aims to investigate the effect of adjuvant therapy with dexamethasone in children with lobar pneumonia,and its influence on the levels of inflammatory factors and ESR. Methods A total of 96 children with lobar pneumonia in our hospital from Jun,2015 to August,2016 were enrolled and divided into observation group (48 cases) and control group (48 cases).The two groups were given the conventional therapy including anti-inflammatory,cooling,antitussive and relieving asthma,and the observation group was additionally given adjuvant therapy with dexamethasone,with a dose of 0.2 mg/kg,1 time a day.The efficacy,levels of inflammatory factors and ESR before and after treatment were compared between the two groups. Results Total effective rate of the observation group (93.75%) was significantly higher than control group (70.83%) after the treatment (χ²=8.649,P<0.05);Clinical symptoms disappearing time and hospitalization time of the observation group was significantly lower than those in control group (t=-7.743,-8.073,-8.241,-4.112,P<0.05);The levels of TNF-α,IL-6,IL-8 and ESR were decreased significantly after the treatment in 2 groups (t_{observation group}=18.552,17.574,15.788,11.718,t_{control group}=10.500,11.085,11.979,6.315,P<0.05),and the observation group decreased more significantly than those in the control group (t=-13.250,-9.223,-9.161,-7.975,P<0.05). Conclusion Adjuvant therapy with dexamethasone has obvious effect on children with lobar pneumonia,which can obviously improve inflammation and ESR,relieve clinical symptoms,shorten hospitalization time.

Effect of clomiphene citrate with human menopausal gonadotropin on ovulation induction in women with polycystic ovary syndrome

ZONG Yan-yan

2017, 15(5): 820-822. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.028

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Objective To study the effect of clomiphene citrate with human menopausal gonadotropin (HMG) on ovulation induction in women with polycystic ovary syndrome. Methods Total 100 patients with polycystic ovary syndrome in our hospital between January,2014 and June,2015 were enrolled and divided into control group and observation group with 50 cases in each group.All patients received conventional treatment,lifestyle modification,calcium and vitamin D,oral ethinylestradiol cyproterone tablet for 3 months;oral metformin treatment for the patients with diabetes.The control group received clomiphene citrate treatment,while the observation group received additional HMG treatment.The ovulation (ovarian volume,high quality follicle number and number of sinus follicle),endocrine (T,LH,FSH),pregnancies (pregnancy rate,miscarriage rate and the rate of multiple pregnancy) and adverse reactions were compared between the two groups. Results The ovarian volume and the number of sinus follicle of the observation group were significantly less than those of the control group (8.39±0.74 vs.11.01±1.08;7.23±0.76 vs.9.44±0.83),the difference was statistically significant (P<0.01),but there was no significant difference in high quality follicle number between the two groups (P>0.05).The levels of FSH,LH and T in the observation group were significantly lower than those in the control group (P<0.01).The pregnancy rate in the observation group was significantly higher than that in the control group (38.00% vs.20.00%),the difference was statistically significant (P<0.05),but in the abortion rate and multiple pregnancy rate was not statistical significance (P>0.05).The differences in adverse reactions between the two groups was not statistical significance (P>0.05). Conclusion Clomiphene citrate with HMG for polycystic ovary syndrome can stimulate ovulation with a good effect.

Estimated glomerular filtration rate and the affecting factors in urban and rural elderly in Pudong district of Shanghai

CHEN Jian-feng, LI Ying

2017, 15(5): 823-826. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.029

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Objective To investigate the abnormal situation and affecting factors of estimated glomerular filtration rate (eGFR) in the elderly population in urban-rural integration areas,and to provide basis the treatment of chronic kidney disease (CKD). Methods In this cross sectional study,we analyzed 5 097 senior permanent residents over 60 years of age between March,2016 and May,2016,collected relevant physical data,estimated GFR using the CKD-EPI Creatinine Equation (2009),CKD was defined as an eGFR <60 ml/(min·1.73 m²).The population prevalence and the related risk factors for CKD were analyzed by SPSS 18.0. Results The average eGFR was (77.44±19.16) ml/(min·1.73 m²) in the patients over 60 years of age.In the same age group,eGFR_CKD-EPI level in the male was lower than that of the female,and there was statistical difference (P<0.01).888 were with CKD,and the prevalence rate was 17.42%,and the mean value of eGFR was (49.40±9.92) ml/(min·1.73 m²).Taking 10 years as the interval,with the age increased,eGFR_CKD-EPI gradually reduced (P<0.001).The age,male sex,hypertension and high uric acid were the risk factors for a reduced eGFR (P<0.001). Conclusion The prevalence of CKD in the elderly over 60 years old is high,especially in the oldest old.The kidney disease and related risk factors should be concerned among the elderly in community.

Correlation between the severity of Alzheimer's disease and the levels of serum copper,iron and zinc

JIANG Hong-xia, LIN Yong, FEI Yu-e, TANG Chen-dong, PU Zheng-ping, CHANG Sheng

2017, 15(5): 827-829,907. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.030

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Objective To explore the correlation between the severity of Alzheimer's disease (AD) and the levels of serum copper,iron and zinc. Methods Total 165 subjects were selected and divided into the healthy group,and mild,moderate and sever dementia group according to the scores of Mini-Mental State Examination (MMSE),which defined scores of 21 to 26 as mild dementia,10 to 20 as moderate dementia,0 to 10 as sever dementia.The levels of serum copper,iron and zinc of all the subjects were tested. Results The levels of serum copper of the moderate and sever groups were statistically higher than those of the healthy group and mild group,while the levels of serum iron and zinc of all dementia groups were statistically lower than those of the healthy group which suggested there's a decrease of serum iron and zinc in AD patients.There's negative correlation between the scores of MMSE and the levels of serum copper;there's positive correlation between the scores of MMSE and the levels of serum zinc;while there's no correlation between the scores of MMSE and the levels of serum iron,which suggested the more sever the dementia was,the higher the serum copper was and the lower the serum zinc was. Conclusion There is imbalance of microelements in AD patient whose levels of serum microelements like copper and zinc had some correlation with the severity of dementia.

Analysis on shidu families'pension needs and finding the solution to community service in Guangzhou

LIU Wen-jie, TAN Jian, ZHOU Mei-fang

2017, 15(5): 830-833. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.031

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Objective To study the living situation of the shidu families,i.e.parents who lost their only child,as well as their pension needs in Yuexiu District,and based on this study result,the author will find out some enhancements to improve the special social support system and draft strategy for solving the pension problems. Methods Fifteen accessible cases of shidu families were chosen from four streets in YueXiu District,surveyed with a set of specially designed questions via case interview.hose questions include asking subjects'needs materially,mentally and socially which also involve willingness of accepting the support from society.By observing ten subjects'behavior,the effect of Rose Families Project will be analyzed and evaluated. Results The subjects who had joined our interviews were mainly at the age of 53 to 66,durations of losing their only child were from 2 years to 22 years,and most of them were now single or widowed.Subjects who also had joined our Rose Families Project had retired and had good body situation,most of whom had lost their child for above 3 years.According to the results of the interviews,pension needs of each family are different,including three types:the deficiency of retirement pension system,the lack of social support,sufficient income and social network. Conclusion Shidu families are mainly suffering from the limitation of social communication and spiritual support,some of whom may even have nobody to rely on.Government should strengthen the pension insurance and launch some related supportive programs.Local official community should make an agreement on the community service with the social organization according to the special needs of the families.he organization should adopt individualized social approach to those types of object families,in company with the community self-service carried out,thus to promote community-based self-help retirement pension mode.

Relative analysis on family background,learning motivation and academic performance of medical students

XIAO Ying-jie, ZHENG Chen, CHEN Mao-huai, HU Jun-xian, LI Li-ping

2017, 15(5): 834-837. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.032

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Objective Understand the initial motivation of medical students for learning medicine.Reveal the influence of motivation on academic performance.Provide scientific basement for medical students on later efficient medical training and educating. Methods Before the investigation,a questionnaire was designed based on relevant references.Students in eastern Guangdong were recruited.A self-management questionnaire was applied to investigate the family background and the initial motivation for learning medicine.The relative factors about learning medicine and academic performance were analyzed. Results Sex is insignificant between different medical motivations.However,the grade point average (GPA) of female students is higher than that of male students,which is significant among academic performance (P<0.01).The academic performance of students from different grades is significant.The higher the grade,the lower mean GPA is (F=3.146,P<0.05).Source of students significantly affects academic performance.The average GPA of students from countryside is more than students from other places (F=6.470,P<0.01).Academic performance affected by multiple motivations,followed by intrinsic motivation (F=2.424,P<0.05),saving life (F=0.131,P<0.005) and extrinsic motivation (F=1.824,P<0.05),social status (F=0.186,P<0.05) and social morality (F=0.118,P<0.05) which are significant between different medical motivations. Conclusion Family background has multiple influences on learning motivation of medical students.Multiple learning motivations affect academic performance.

PIVKA-Ⅱ levels in HCC tissues and effect of vitamin K₂ on the expression of PIVKA-Ⅱ in HCC cells

ZHANG Yi-min, WANG Ming-li, DAN Lv-hu, ZHANG Jian-ying, XU Xiao-hong, XIA Wen-jin

2017, 15(5): 838-840. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.033

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Objective To observe the expression of Vitamin K deficiency or antagonist-Ⅱ-induced protein (PIVKA-Ⅱ) in human hepatocellular carcinoma (HCC) and the effect of vitamin K₂ on the expression of PIVKA-Ⅱ in HCC cells,to explore the relationship between PIVKA-Ⅱ and HCC and its possible mechanism. Methods One hundred pairs of primary liver cancer tissue and adjacent tissue samples of surgical resection in Zhejiang Cancer Hospital from January,2012 to December,2015 were selected.The expression of PIVKA-Ⅱ in tissues was determined by ABC immunohistochemical method.The level of PIVKA-Ⅱ in the samples was determined by electrochemiluminescence immunoassay.HepG-2 cells were co-cultured with VitK₂ at concentration of 20 μM.The effect of VitK₂ on the expression of PIVKA-Ⅱ in HepG-2 cells was determined by enzyme-linked immunosorbent assay (ELISA).MTT assay was used to determine the effect of VitK₂ on the growth of HepG-2 cells.The effect of VitK₂ on the invasive ability of HepG-2 cells was determined by Transwell method. Results The positive rate of PIVKA-Ⅱ in hepatocellular carcinoma (74.0%) was higher than that in para-cancerous tissues (25.0%),P<0.05.The level of PIVKA-Ⅱ in hepatocellular carcinoma (3 786.23±143.24) mAU/g was higher than that in para-cancerous tissues (167.34±21.54) mAU/g (P<0.05).The level of PIVKA-Ⅱ in hepatocarcinoma cells in control group was (3.43±0.04) ng/(ml·10⁶ cells),the level of PIVKA-Ⅱ in VitK₂ group was (2.57±0.02) ng/(ml·10⁶ cells).The PIVKA-Ⅱ level in VitK₂ group was significantly lower than that in control group (P<0.05).On the 1st,2nd,3rd,4th,5th and 6th day of VitK₂ was co-cultured with HepG-2 cells,the inhibitory rates of VitK₂ on HepG-2 cells were 9.2%,16.5%,26.7%,34.8%,41.2% and 46.7%,respectively.After 24 h of VitK₂ was co-cultured with HepG-2 cells,VitK₂ on HepG-2 liver cancer cell invasion inhibition rate was 37.2%. Conclusion The expression of PIVKA-Ⅱ in hepatocellular carcinoma was high.VitK₂ can reduce the level of PIVKA-Ⅱ in hepatocarcinoma cells,inhibit the growth of hepatocarcinoma cells and reduce the invasiveness of HCC cells.

Diagnostic and predictive value of ¹⁸F-FDG SPECT imaging for cervical lymph node metastasis cancer

YU Xiao-zhong, JIANG Zhong-yu, ZHOU Qin-bing, HUANG Zhong-ke

2017, 15(5): 841-843. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.034

162 0

Abstract:
Objective To investigate the predictive value of ¹⁸F-FDG SPECT imaging for the diagnosis of cervical lymph node metastasis cancer. Methods The clinical and pathological data of 46 suspected cervical lymph node metastasis cancer in our hospital from November,2015 to May,2016 were collected.All the patients underwent ¹⁸F-FDG SPECT scan and conventional imaging,and were all achieved pathological results.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of different screening method in the diagnosis of cervical lymph node metastasis cancer were compared.The maximum standardized uptake value (T/N) of focus in patients enrolled was measured and the ¹⁸F-FDG SPECT imaging characteristics of lymph node metastasis cancer were analyzed;The diagnostic value of different methods to check other metastasis focus were compared. Results The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ¹⁸F-FDG SPECT and conventional imaging for the primary lesion of cervical lymph node metastasis cancer were 87.5%,83.3%,87.0%,97.2%,50% and 70.0%,33.3%,65.2%,87.5%,14.28%,respectively;The average T/N of focus in patients with lymph node metastasis cancer was 7.15±3.51,while it in patients with non-metastatic lymph nodes cancer was 4.26±2.37,significantly lower than it in the lymph node metastasis cancer patients,the differences were statistically significant (P<0.05);The number of the lymph node and other metastatic focus detected by ¹⁸F-FDG SPECT were 10.24±3.47 and 1.58±1.64,while they detected by the conventional imaging were 6.18±4.38 and 0.62±0.48,significantly lower than the ¹⁸F-FDG SPECT,the differences were statistically significant (P<0.05). Conclusion ¹⁸F-FDG SPECT imaging have a higher diagnostic and predictive value for the cervical lymph node metastasis cancer,and can also find other metastases more efficiently.

Ultrasonographic evaluation of hepatic venous pressure gradient in patients with HBV infection and cirrhosis

WANG Xiao-wei, SUN Jian-gang

2017, 15(5): 844-846. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.035

225 1

Abstract:
Objective To study the value of ultrasound for evaluation of hepatic vein pressure gradient (HVPG) in patients with HBV infection and cirrhosis. Methods HVPG was measured in 96 patients with HBV infection and cirrhosis in our hospital from July,2014 to March,2016.The patients were divided into three groups according to the results of HVPG:high pressure group (16 cases),normal high value group (28 cases) and normal group (52 cases).The portal vein,the right hepatic vein and the splenic vein were examined by ultrasonography,and the ultrasonographic indexes such as diameter,flow rate,blood flow and congestion index were collected.The variance analysis was used to compare the differences among groups;the correlation between HVPG and ultrasound-related indexes was analyzed by Spearman and Logistic regression analysis.The value of ultrasound diagnosis of HVPG in patients with HBV infection and cirrhosis was evaluated. Results The liver function and portal vein diameter,flow velocity,blood flow and congestion index of the three groups were statistically different (P<0.05).Spearman test showed that liver function and portal vein diameter and congestion index were positively correlated with HVPG (r=0.524,P<0.001;r=0.614,P<0.001;r=0.458,P<0.001),flow velocity was negatively correlated with HVPG (r=-0.378,P<0.039).Logistic regression analysis showed that portal vein diameter and congestion index were independent of HVPG (OR=2.397,P=0.020;OR=2.708,P=0.013). Conclusion There is an independent positive correlation between the portal vein diameter and congestion index and the HVPG,which can be used as the basis for clinical diagnosis and treatment.

Whole-body diffusion-weighted MR imaging in diagnosis of metastatic tumor

ZHANG Zhi-jing, ZHENG Wen-long, WU Ai-qin

2017, 15(5): 847-849. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.036

283 1

Abstract:
Objective To investigate the role of whole-body diffusion-weighted imaging (WBDWI) in the detection,diagnosis and assessment of curative effect of metastatic tumors. Methods WBDWI by GE Signa HD xt 3.0 T MR Scanner was performed in 38 patients with metastatic tumor.The positive results were analyzed and diagnosed by two deputy chief physicians with double-blind method,the apparent diffusion coefficient (ADC) values of the lesions were measured on ADC imaging,and the region of interest (ROI) was 20 mm². Results A total of 38 patients with metastatic tumor were examined by WBDWI,of which,2 cases had been done for 4 times,and another 2 had been done for 2 times.The WBDWI imaging of metastatic tumors showed multiple abnormal signal lesions in the whole body,including 38 cases of multiple lymph nodes enlargement in the body,13 cases of multiple abnormal signals and 5 of solitary in liver,3 in spleen and 7 in adrenal glands,10 in lung nodules,and the diffuse infiltration of bone marrow of vertebrae,pelvis,humerus,scapula,sternum and ribs in 24 cases.The lesions showed nodular and patchy hyper-intensity on WBDWI imaging,hypo-intensity on flipped imaging of WBDWI and ADC imaging.Of 4 cases with follow-up examination after the treatment,2 showed that the number of lesions reduced and the signal intensity decreased on DWI imaging,and the ADC values increased (good curative effect),one showed that the number of lesions increased (poor curative effect),but no significant changes in signal intensity,another one was no significant change in the number of lesions and signal intensity. Conclusion As one systemic functional MR-imaging technology,WBDWI has a certain significance in the comprehensive evaluation of metastatic tumors and lesions.

Change of cystatin C,β2-microglobulin,creatinine and blood urea nitrogen in different stages of type 2 diabetic nephropathy and their diagnostic value

ZHANG Guan-ting

2017, 15(5): 850-852. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.037

346 5

Abstract:
Objective To investigate the levels of serum cystatin C (CysC),β2-MG,creatinine (Scr) and blood urea nitrogen (BUN) in different stages of type 2 diabetic nephropathy and their diagnostic value. Methods A total of 187 patients with type 2 diabetes in our hospital from January,2015 to November,2016 were selected.According to urinary albumin excretion rate (UAER),the patients were divided into group A (n=75,UAER>30 mg/24 h),group B (71 cases,early diabetic nephropathy group,UAER:30-300 mg/24 h),group C (41 cases,clinical diabetic nephropathy,UAER>300 mg/24 h).And 70 healthy volunteers were selected as the control group.The CysC,β2-MG,Scr and BUN levels of four groups were measured and compared. Results CysC,β2-MG,Scr and BUN levels of group A,B and C were significantly higher than those in control group (P<0.05).CysC,β2-MG,Scr and BUN levels of group B and C were significantly higher than those in group A and control group (P<0.05).CysC,β2-MG,Scr and BUN levels of group C were significantly higher than those in group B (P<0.05).The positive rates of CysC,β2-MG in group A and B were significantly higher than those in Scr and BUN (P<0.05),but there was no significant difference in group C (P>0.05).CysC,β2-MG,Scr,BUN were all positively correlated (P<0.05). Conclusion CysC,β2-MG,Scr and BUN can be used as early diagnostic markers in patients with type 2 diabetic nephropathy.CysC and β2-MG are more valuable in early diagnosis and treatment.

Molecular characterization and biological effects of STIL gene

ZHOU Han, WANG Ju

2017, 15(5): 853-856. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.038

255 4

Abstract:
STIL gene,an oncogene,was cloned from the T-cell acute lymphoblastic leukemia.STIL is closely related with the formation and duplication of centrioles and regulating cell mitosis in organism.Centriole is the center of cell mitosis.In cell mitosis,during the middle of G1 phase,STIL and PLK4(a centriole proliferation protein) form a complex containing coiled-coil domain (CCD) and STAN motif which participating the formation of centrioles and regulating cell mitosis.Besides,the number of the formation of centrioles is proportional to the content of STIL protein.Further studies indicate that in nervous system,STIL truncating mutations (STILT) mediate the development of MCPH (Microcephaly) by affecting the duplication of centrioles.STIL is also related to HPE (Holoprosencephaly).Enhancing the Shh signal transduction pathway mediate by STIL,which could make retinal dopaminergic cells reduce the sensitivity to neurotoxin,so as to protect the retina.It turns out that STIL expressed in multiple tumor tissues.STIL participates the formation,progress and metastasis of malignant tumor by regulating the number and structure of centriole,promoting the performance of chromosome instability.STIL is overexpressed in lung cancer especially in non-small cell lung cancer.In pancreatic cancer,STIL interacts with SUFU and Gli in Hedgehog pathway to mediating the progress of tumor.In this review,we aim to discuss the function of STIL in centriole and cell proliferation,elaborating it's association and potential mechanism in neurologic diseases and malignancies,providing a new direction of prognosis and treatment to the disease.

Advances in the research of experimental animal models of acute pancreatitis

CHEN Xing-tian, YANG Yuan-sheng, CHEN Ken, XIE Wen-rui, WANG Hui

2017, 15(5): 857-860. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.039

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Abstract:
The animal model human disease is a kind of animal which can simulate the pathological characteristics and pathogenesis of human diseases.Due to the limitation of the clinical research,such as the source of the patient,the compliance and ethics,and so on,the animal model can be used to eliminate the influence of interference factors.Acute Pancreatitis (AP) is one of the most common causes for hospitalization related to a gastrointestinal disorder,The most common pathogenesis was biliary origin,followed by a high-fat-diet (excessive diet) and alcoholic.It carries significant morbidity,and when severe,significant mortality.Multiple interventions have been studied to treat pancreatitis,but it has not effective drugs that can prevent the development of AP.The pathogenesis of acute pancreatitis has been an important research topic for a long time.In order to offer clues to etiology,pathogenesis,pathophysiology and therapy of acute pancreatits,various AP animal models have been established.These animal models can stimulate different aspects of the disease process of human AP.According to meet the different research needs,an appropriate,simple and reproducible animal models of AP should be selected.Here's to briefly conclude and analyze the recent advances in the development of animal models of AP to provide a suitable stable animal model for pathogenesis research and drug intervention of AP.

Application of traditional Chinese medicine comprehensive nursing intervention in reducing postoperative swell of patients undergoing total knee replacement

HONG Yi

2017, 15(5): 861-863,870. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.040

187 2

Abstract:
Objective To explore the application value of traditional Chinese medicine comprehensive nursing intervention in reducing postoperative swell of patients undergoing total knee replacement. Methods Altogether 148 patients admitted to our hospital from February,2015 to August,2016 were treated with total knee arthroplasty.hey were randomly divided into two groups,with 74 cases in each group.he control group received routine nursing intervention,while the observation group was treated with TCM Comprehensive nursing intervention mirabilite,herbal fumigation combined with traditional Chinese medicine iontophoresis.he conditions of both groups of patients after 1,3,7 d knee flexion,after 3,7 d,ipsilateral knee skin,swelling,flexion time,swelling disappeared time and occult blood loss were compared. Results The observation group after 1,3,7 d knee flexion was significantly greater than the control group (t=1.049,2.734,6.760,8.827,P<0.01);the observation group after 3,7 d ipsilateral knee skin temperature was significantly lower than the control group (t=4.482,4.944,P<0.01);the observation group postoperative limb swelling significantly better than the control group (Z=2.916,P<0.01);the observation group postoperative flexion time,swelling disappeared time and occult blood loss were significantly lower than the control group (t=8.505,12.011,3.075,P<0.01). Conclusion TCM Comprehensive Nursing Intervention on total knee arthroplasty after taking mirabilite and herbal fumigation combined with traditional Chinese medicine iontophoresis can effectively reduce the incidence of postoperative swelling,increase joint mobility,and reduce the hidden blood loss.

The clinical research of tonifying kidney and soothing liver therapy combined with auricular point sticking with beans in abortion patients with kidney deficiency and liver depression

QIAN Yan-qing, CHEN Shu, SUN Yun, HU Xin-xin

2017, 15(5): 864-867. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.041

159 0

Abstract:
Objective The recurrent abortion was a frequently-occurring disease for the women of childbearing age.The combination of traditional Chinese with western medicine had obvious curative effects.By clinically researching tonifying kidney and soothing liver therapy combined with auricular point sticking with beans in abortion patients with kidney deficiency and liver depression,we aim to provide new ideas and methods for treatment. Methods One hundred abortion patients with kidney deficiency and liver depression were divided into the control group (n=50) and observation group (n=50) according to random number table method.The control group was given intramuscular injection of progesterone,20 mg/d,and the observation group was given oral prescription of tonifying kidney and soothing liver therapy (1 dose per day) combined with auricular point sticking with beans (2 min per time,3 times per day).The clinical efficacy,anxiety SAS scores,clinical symptoms were observed in two groups,and the serum levels of estradiol (E2),progesterone (P) and human chorionic gonadotropin (β-HCG) were detected.SPSS 19.0 was used for data analysis. Results The total effective rate of observation group was 96.00%,and that of the control group was 82.00%.The difference had statistical significance in rank sum test (P<0.05).The scores of anxiety SAS,vaginal bleeding,abdominal pain,lumbar acid and alvine straining feeling in observation group were significantly lower than those in the control group,with statistically significant difference (P<0.05).The levels of E2,P,and β-HCG in observation group were significantly higher than those in the control group,and the difference was statistically significant (P<0.05).The follow-up found that the efficient and success rate of fetus protection were 94.00% and 90.00% in observation group,which were significantly higher than those in the control group which were 78.00% and 74.00%,with statistical significance (χ²=5.316,4.336,P=0.021,0.037).With increasing SAS scores,the total effective rate and success rate of fetus protection were reduced,and the difference was statistically significant (P<0.05). Conclusion The prescription of tonifying kidney and soothing liver therapy combined with auricular point sticking with beans in abortion patients with kidney deficiency and liver depression had clinical curative effect,which could reduce anxiety score,improve the clinical symptoms,and increase the level of serum hormone.

Eighty-seven cases analysis of joint three acupoints of shoulder combined warm acupuncture in treatment of frozen shoulder

ZHOU Ya-feng, YIN Jian-quan, YAN Wei

2017, 15(5): 868-870. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.042

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Abstract:
Objective To investigate the clinical effect of joint three acupoints of shoulder combined warm acupuncture in treatment of frozen shoulder,and its effect on pain and shoulder function. Methods One hundred and seventy-four cases of patients with frozen shoulder in our hospital from January,2014 to June,2016 were randomly divided into two groups by randomly number method,each group 87 cases.Patients in control group were given joint three acupoints of shoulder combined acupuncture,and patients in observation group were given joint three acupoints of shoulder combined warm acupuncture.After treatment,the pain[Mcgill pain scale (sensory pain,emotional category,visual pain score VAS,existing pain intensity PPI),shoulder function[Neer score (pain,function,activity)]and clinical curative effect of the two groups were accounted.Data were analyzed by SPSS soft to investigate the clinical effect of joint three acupoints of shoulder combined warm acupuncture in treatment of frozen shoulder,and its effect on pain and shoulder function. Results After treatment,sensory pain,emotional category,visual pain score VAS,existing pain intensity PPI indexs in Mcgill pain scale of two groups were significantly decreased (P<0.05),and sensory pain,emotional category,visual pain score VAS,existing pain intensity PPI in Mcgill pain scale of observation group were significantly lower than those of control group (P<0.05).After treatment,pain,function,activity in Neer scores of two groups were significantly increased (P<0.05),and pain,function,activity in Neer scores of observation group were significantly higher than that of control group (P<0.05).The total effective rate of the observation group was 90.8%,which was significantly higher than that of control group (74.7%,P<0.05). Conclusion Compared with joint three acupoints of shoulder combined acupuncture,joint three acupoints of shoulder combined warm acupuncture could effectively reduce the pain and improve shoulder function of patients with frozen shoulder,with satisfactory clinical results.

2017, 15(5): 871-872. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.043

189 1

Abstract:

The application of the experiential teaching in terminal care education among new nurses

LIU Xiao-hong, CHAO Teng-fei, HE Lian-qiu

2017, 15(5): 873-875. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.044

134 0

Abstract:
Objective To observe the efficacy of experiential teaching in terminal care education among new nurses. Methods Eighty new nurses were enrolled from our hospital in 2015,which were divided into two groups:conventional teaching group and experiment teaching group.In the conventional group,traditional teaching was used.Each new nurse was taught by a qualified clinical nurse about the typical clinical manifestation and common nursing problems of terminal patients.While in the experiment group,new nurses were divided into little groups with leaders.The leader in each group arranged their members to collect cases,to consult relevant materials and to perform the nursing care.Each member was instructed by a qualified supervisor to perform comprehensive nursing care to patients,just like a responsible nurse.Regular communication and discussions were organized by the supervisors to analyze and resolve problems in the experience process.After the teaching process,the relationship between nurses and patients,communication ability,cooperation ability,critical thinking,the satisfaction degree of nurses,and the satisfaction degree of patients between two groups were compared. Results There were 85%,82.5% and 77.5% of the nurses in the experiment group who thought that experiment teaching could enhance their communication ability,cooperation ability,and critical thinking respectively.The satisfaction degree of both nurses and patients in the experiment group was apparently higher than that in the control group (P<0.05). Conclusion Experiential teaching could improve the efficacy of terminal care education among new nurses,and increase the satisfaction degree of patients.It is worth extensive application in the clinical nursing teaching.

Effects of dexmedetomidine on perioperative intestinal barrier function in patients with sepsis

QIAN Xing-er, ZHENG Min, WANG Jue, ZHENG Jun-gang, HUANG Zhang-shun

2017, 15(5): 876-878. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.045

149 0

Abstract:
Objective To evaluate the protective effect of dexmedetomidine on perioperative intestinal barrier function in 120 patients with sepsis through comparing the 5 indicators after the operation and 28 day mortality rate. Methods A total of 120 cases of sepsis undergoing surgical treatment in our hospital between March,2014 and September,2015 were enrolled and randomly divided into observation group and control group with 60 cases in each group.In the observation group,dexmedetomidine continuous infusion via an infusion pump was performed 10 minutes before anesthesia (0.6 μg/kg) and after induction of anesthesia[0.5 μg/(kg·h)]until 30 minutes before the end of the surgery;In the control group,normal saline was used instead of dexmedetomidine.The baseline values and postoperative levels (7 days after surgery) of Tumor Necrosis Factor-α(TNF-α),Interleukin 6(IL-6),Plasma levels of Intestinal Fatty Acid Binding Protein (IFABP) Two Amine Oxidase (TAO) and D-Lactic acid (D-Lac) were compared between the two groups.The 28 day mortality rate was also compared between the two groups. Results in the two groups were significantly lower than those before treatment,the difference was statistically significant (P<0.05).The observation group after treatment,the indicators were significantly lower than the control group,the difference was statistically significant (P<0.05).The mortality rate of observation group and control group was 11.67% and 30.00% within 28 days,the difference was statistically significant (P<0.05). Conclusion The levels of TNF-α,IL-6,IFABP,TAO and D-Lac in the observation group were significantly lower than those in the control group at 28 days after the treatment.In the septic group,The postoperative intestinal barrier function and prognosis of a certain protection and improvement.

Observation on therapeutic effects of ileus tube placement combined with the early enteral nutrition on adhesive ileus

LU Yong, GUO Min-hui, BI Tie-nan, ZHANG Rui-li

2017, 15(5): 879-882. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.046

176 1

Abstract:
Objective To investigate therapeutic efficacy of ileus tube placement combined with theearly enteral nutrition on adhesive ileus. Methods A randomized controlled trial was carried out.A total of 54 patients with adhesive ileus admitted to the department of gastroenterological surgery in our hospital from January,2012 to December,2015 were randomly divided into the control group (n=27) and the observation group (n=27),including 22 cases male and 32 cases of female with an average age of (66.8±12.4).The control group received a conventional treatment including gastrointestinal decompression,correction of water-electrolyte and acid-based balance,parenteral nutrition and somatostatin by inhibiting the secretion of digestive juices,on the basis of which the observation group was given a ileus tube placement aided by gastroscope through nose to decompress the small intestine,and early enteral nutrition when the prepositive water sac started to move down.Patients were observed for their nutritional index,immunity index and clinical treatment index as well as therapeutic effects. Results One week after the operation,the pre-albumin,the transferring and body mass of the observation group were higher than those of the control group,while the levels of CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺ in the observation group were significantly higher than those in control group (P<0.05).The observation group was significantly shorter than control group in the relief of abdominal pain,abdominal distention,flatus,first anal defecation and hospital stays (P<0.05).The effective rate of the observation group was 92.6% with 17 healing,8 improving and 2 failure cases,while the effective rate of the control group was 66.7% with 8 healing,10 improving and 9 failure cases.The overall efficiency of observation group was significantly higher than that of control group (P<0.05). Conclusion Ileus tube placement combined with the early enteral nutrition on adhesive ileus significantly improved the nutritional status of patients,enhanced the body immunity and accelerated the recovery of patients.

Metformin promotes colon cancer cell apoptosis through mTOR signalling pathway

HUANG Shi-ling

2017, 15(5): 883-886. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.047

229 1

Abstract:
Objective To evaluate the effect and mechanism of metformin in promoting the colon cancer cells apoptosis. Methods HCT8 cells were randomly divided into 4 groups,control group,metformin group (5,10 and 20 mM),and the control group did not accept any intervention.Cell proliferation and the inhibition rate of colon cancer cells were identified by MTT methods,apoptosis of colon cancer cells was identified by AnnexinV-FITC cell apoptosis detection kit.Meanwhile,PCR and Western blot was performed to detection mTOR pathways related gene and protein expression respectively. Results Compared with the control group,different concentrations of metformin had inhibitory effect on HCT8,and dose dependently.Twenty mM metformin had the most significant inhibitory effect on colon cancer HCT8 cells,with 5 mM,10 mM and the control group were statistically significant (P<0.05).In addition,with the increase of time,the inhibitory effect of metformin on colon cancer HCT8 increased,72 h inhibition rate with 24 h and 48 h inhibition rate were statistically significant (P<0.05).The results showed that apoptosis rates of 5 mM,10 mM and 20 mM metformin effecting on colon cancer HCT8 cells were (3.16±0.16)%,(5.12±0.39)% and (6.11±0.15)%,respectively,and they were all higher than that of in the control group (1.5±0.28)%,and the differences of apoptosis rate between each group was statistically significant (P<0.05).When treating with metformin,the mRNA and protein expression of 4EBP1,was less than the control group,the difference was statistically significant (P<0.05). Conclusion Metformin inhibits the colon cancer cell proliferation and promote apoptosis of colon cancer cells through inhibiting mTOR signaling pathway.

Application of medical and nursing integrated mode in orthopedics nursing

HUANG Yong-li, YING Ying

2017, 15(5): 887-889,904. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.048

158 2

Abstract:
Objective To explore the application of medical and nursing integration model in orthopedic nursing. Methods Total 120 patients planning orthopedic surgery in our hospital from February,2013 to June,2016 were enrolled and divided into control group and observation group according to the random number table method (n=60).The operations for all patients were performed by the same group of medical staffs.The patients in the control group were given routine nursing care and the patients in the observation group were given the integrated nursing care mode.The visual analogue scale (VAS) was used to evaluate the postoperative pain degree of the two groups.The postoperative recovery and postoperative complications of the two groups were observed.The patient satisfaction with nursing care in the two groups was evaluated. Results The VAS score of the observation group was significantly lower than that of the control group at each time point (P<0.05).The postoperative bedtime,postoperative feeding time and hospital stay were shorter in the observation group as compared with the control group (P<0.05).In the control group,there were 10 cases of constipation,3 cases of deep venous thrombosis in lower extremity,3 cases of pneumonia,and 4 cases of urinary system infection;in the observation group,there were 6 cases of constipation,1 case of deep venous thrombosis in lower extremity,1 case of pneumonia,and 2 cases of urinary system infection,the incidence of postoperative complications in the observation group was significantly lower than that in the control group.The total patient satisfaction with nursing care in the observation group was 100%,which was obviously higher than that (83.33%) in the control group (Z=3.422,P<0.05). Conclusion The integrated health care model can postoperative pain in orthopedic patients,reduce the incidence of postoperative complications,shorten the postoperative recovery period and improve patient satisfaction with nursing care,so it is worthy of clinical application.

The application value of self-care in esophageal carcinoma patients received chemoradiotherapy

ZHENG Xiang-qin

2017, 15(5): 890-892. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.049

127 1

Abstract:
Objective To explore the effect of self-care in esophageal carcinoma patients received chemoradiotherapy. Methods Eighty cases of patients with esophageal carcinoma undergone chemoradiotherapy were randomly divided into control group and experimental group.he control group received regular nursing care while the experimental group received self-care guidance based on the regular nursing.Compare the scores of ESCA and EORTCQLQ-C30 between the two groups before and after the intervention.All data were analyzed using SPSS 19.0 software,and P<0.05 was statistically significant. Results After the intervention,the scores of self-concept,self-care skill,health knowledge level and total score were (17.7±3.8) points,(18.7±4.4) points,(46.0±11.7) points,(114.6±22.7) points in the experimental group,which were higher than (14.1±3.8) points,(11.6±4.2) points,(34.2±10.5) points,(85.5±20.5) points in the control group (P<0.05).he experimental group had higher scores on EORTCQLQ-C30 than the controls after intervention.he dimension of physical function,emotional function,cognitive function and healthy condition significantly increased in experimental group through the self-care (P<0.05).The adverse reaction rate was 10.0% in the observation group,while was lower than the control group 32.5%(χ²=6.050,P<0.05). Conclusion Self-care may improve the quality of life and self-care ability in patients with esophageal carcinoma received chemoradiotherapy,thus it is of important clinical value.

The prevention and nursing of pathologic myopia nosocomial infection after posterior scleral reinforcement

LIN Wen-wen, YE Cheng-fu

2017, 15(5): 893-895. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.050

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Abstract:
Objective To observe the application effect of nosocomial infection control in preventing pathologic myopia nosocomial infection after posterior sclera reinforcement. Methods We selected 126 cases of pathologic myopia patients who need to take posterior sclera reinforcement.Patients were divided into control group (January to June,2015,65 cases) and observation group (September,2015 to February,2016,61 cases),according to the time in hospital.Control group accepted general nursing,while observation group accepted nosocomial infection control nursing on the basis of general nursing.We observed the infection and nursing complaint of two groups.Before discharge,we used Newcastle scale to survey patients'nursing satisfaction and adopted SPSS 19.0 to analyze statistical data,P<0.05 indicating statistical significance. Results There was 1 case of postoperative infection and 1 case of nursing complaint in observation group.here were 7 cases of postoperative infection and 8 cases of nursing complaint in control group.Postoperative infection rate and complaint rate in the observation group were obviously less than those in control group,and the difference had statistical significance (χ²=5.055/3.911,P<0.05).The nursing satisfaction of observation group was 72.8±2.1,and control group was 67.2±3.3.Observation was obviously higher than control group,and the difference had statistical significance (t'=11.435,P<0.05). Conclusion After taken nosocomial infection control nursing,the nosocomial infection rate and nursing complaint were reducing,and nursing satisfaction was improving.

Application of quality control circle activity to radiation dermatitis on patients with head and neck cancer after radiotherapy

XU Guo-ying

2017, 15(5): 896-898. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.051

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Abstract:
Objective To investigate the intervention effect of quality control circle activity for radiation dermatitis on patients with head and neck cancer after radiotherapy,and explore a possible solution. Methods A Total of 160 patients with head and neck cancer in our hospital from October,2013 to October,2015 were randomly divided into two groups with 80 cases in each group.After the radiotherapy,the control group was treated according to the conventional nursing method,while the observation group was treated with the care of the quality control circle activities.We compared the occurrence of radiation dermatitis in patients after nursing care.The statistical analysis was carried out by SPSS 17.0 software,P<0.05 indicating statistical significance. Results The number of 0 degree dermatitis in observation group was 34 cases (42.5%),higher than that of the control group of 22 cases (27.5%);the number of interruption of radiotherapy was 4 cases (5%),lower than the control group 13 cases (16.3%);longer radioactive skin reaction time (10.4±2.3) days than the control group (6.5±1.5) days,and the difference was statistically significant (P<0.05);patient satisfaction of the observation group was 97.5%(78/80) higher than that of the control group,80%(64/80),and the difference was statistically significant (P<0.05). Conclusion The implementation of quality control circle activities in nursing head and neck cancer radiotherapy patients can effectively reduce the incidence of radiation dermatitis,improving the quality of life of patients after radiotherapy.

The effect of continuing nursing on postoperative rehabilitation quality of patients with destructive hand trauma

GUO Mei, WANG Shui-fei

2017, 15(5): 899-901. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.052

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Abstract:
Objective To investigate the effect of continuing nursing on postoperative rehabilitation quality of patients with destructive hand trauma,to provide nursing direction for the postoperative rehabilitation of patients with destructive hand trauma,and to provide help for clinics. Methods One hundred and fifty-eight cases of patients with destructive hand trauma from November,2013 to June,2014 in Zhoushan Hospital of Traditional Chinese Medicine were selected as study subject,and divided into observation group and control group by completely random method,with 79 cases in each group.Patients in observation group were given continue nursing after discharge,and patients in control group only given conventional telephone interviews.he satisfaction table was made,and the transplant survival rate,patients'satisfaction on flap appearance and remaining function of injured finger,and depression status of two groups were compared and analyzed,to investigate the effect of continuing nursing on postoperative rehabilitation quality of patients with destructive hand trauma. Results The survival rate of observation group was 87.34%,which was significantly higher than that of control group 56.96%,and the differences were statistically significant (P<0.05).he satisfaction of observation group was 98.73,which was significantly higher than that of the control group 44.30%,with a statistical significance (P<0.05).Patients in observation group consisted of no depressed patients,and the total score was 49.08±12.25;patients in control group consisted of moderate depression patients,and the total score was 67.37±8.23,and there were significant difference when comparing the two groups (P<0.05). Conclusion Continuing nursing had advantages in improving the survival rate of rebuilding or transplanting broken fingers,patients'satisfaction,mood stability and reducing the depression,helping to restore the work and life of patients with destructive hand trauma.

2017, 15(5): 902-904. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.053

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2017, 15(5): 905-907. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.054

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2017, 15(5): 908-910. doi: 10.16766/j.cnki.issn.1674-4152.2017.05.055

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2017 Vol. 15, No. 5

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