2019 Vol. 17, No. 4

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Comprehensive prevention and treatment of diabetes by traditional Chinese medicine in community combined with health science and technology strategy under health initiative
FANG Zhao-hui, YOU Liang-zhen, SHEN Guo-ming, LI Ze-geng
2019, 17(4): 523-525,629. doi: 10.16766/j.cnki.issn.1674-4152.000725
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To implement the healthy China strategy, we need to change the traditional concept of health, establish the concept of "great health", and turn the treatment of diseases into the people's health as the center. Health initiative is an important measure to promote a healthy China, which is an effective way of coping with all sorts of health risks. Highlighting and giving full play to the advantages of traditional Chinese medicine (TCM) is an important aspect of active health. Currently, the incidence of diabetes in the world shows a sharp rise. Diabetes produces a huge threat to the people's healthy and causes a serious burden to the country and people. Community-based diabetes health management is an effective way of prevention and cure of diabetes. Based on how to take full advantages of TCM in the prevention and treatment of diabetes in community combining with realizing the diabetes prevention and treatment of "strategic forward, pass forward", this paper expounds the application of active health and medical treatment in the prevention and treatment of diabetes, analyzes the strategic position of the community in the prevention and treatment of diabetes and the unique advantages of Chinese medicine. This paper argues that: ①the insufficient service ability of TCM in communities restricts the exertion of the advantages of TCM in diabetes prevention and treatment; ②The model of community diabetes health management involving traditional Chinese medicine has not been improved; ③Diabetes community TCM prevention and treatment initiative health and science and technology response is weak. Based on the existing practice, this paper puts forward some suggestions and strategies. They include: ① explore the establishment of a government-hospital-community integrated diabetes TCM service network; ②to build a comprehensive prevention and control system of diabetes mellitus in community; ③ build a platform for community application and promotion of TCM diabetes prevention and treatment key technologies; ④enhance the community of traditional Chinese medicine diabetes prevention and treatment collaborative innovation and science and technology ability.
ZHOU Xia, SUN Zhong-wu
2019, 17(4): 526-527.
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Curcumin inhibits sodium nitroprusside-induced apoptosis of rat chondrocytes via mitochondria-dependent pathway
YUAN Wei, BIAN Yang-yang, ZHU Heng-jie, CHENG Shao-wen, PENG Lei
2019, 17(4): 528-532. doi: 10.16766/j.cnki.issn.1674-4152.000726
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Objective To research the mechanism that curcumin inhibits sodium nitroprusside (SNP) -induced apoptosis of chondrocytes in rats. Methods The carilage cells were obtained from articular cartilages of SD rats (4 rats in each group). The cartilage cells were divided into control group (A), the SNP injured group (B), SNP+5 μmol/L curcumin group(C), SNP+10 μmol/L curcumin group (D), SNP+ 20 μmol/L curcumin group(E), and SNP+ 30 μmol/L curcumin group (F). The effects of different concentrations of curcumin on the proliferation of chondrocytes and the activity of chondrocytes in each group were detected by CCK8 method. The expression of MMP-13, caspase-3, Bax and Bcl-2 genes in chondrocytes were detected by RtPCR. The nuclear apoptosis of chondrocytes were detected by Hoechst 33342 staining. Western blotting technique was used to detect the expression of mitochondrial apoptosis pathway-associated protein. Results ① The 20 μmol/L curcumin had the most proliferative effect on chondrocytes. ② The cells activity by CCK8 assay: group A＞group E＞ group D＞group C＞group F＞group B. ③In group C, D, E and F, the expression of caspase-3, Bax and Bcl-2 in chondrocytes was significantly different from group A and B. ④Hoechst 33342 staining showed that curcumin inhibit SNP-induced chondrocyte nuclear chromatin damage and reduce mitochondrial membrane potential in chondrocytes. ⑤The caspase-3 and Bax protein expression of chondrocyte by Western blotting: group B＞group E＞group A; The Bcl-2 protein expression of chondrocyte by Western blotting: group A＞group E＞group B. Conclusion The curcumin can prevent SNP-induced rat chondrocyte apoptosis via inhibition of mitochondria-dependent pathway.
Mechanism for upregulation of TIMP3 by suppressing the overexpression of miR-21-5p to inhibit ECM and EMT in SCSP-571 cells
LI Yu-bing, JIANG Shao-bo, REN Xiao-gang, YAN Jia-sheng
2019, 17(4): 533-537,608. doi: 10.16766/j.cnki.issn.1674-4152.000727
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Objective To investigate the effect and mechanism of up-regulating metalloproteinase tissue inhibitors (TIMP3) by targeted regulation of miR-21-5p to suppress matrix degradation (ECM) and epithelial mesenchymal transformation (EMT) in bladder cancer cells. Methods Bladder cancer SCSP-571 cells were cultured on 96-well plates and divided into Control group, Plasmid group, miR-21-5p silencing group, TIMP3 silencing group and miR-21-5p+TIMP3 silencing group. The cells in Control group were cultured as normal, cells in Plasmid group were co-cultured with plasma, cells in miR-21-5p silencing group were co-cultured with miR-21-5p inhibitor, cells in TIMP3 silencing group were co-cultured with TIMP3 -shRNA plasma, and cells in miR-21-5p+TIMP3 silencing group were co-cultured with both miR-21-5p inhibitor and TIMP3 -shRNA plasma. When cells were cultured for 72 h, the mRNA expression of miR-21-5p and TIMP3 in each group was determined by fluorescence quantitative PCR and the expression of ECM and EMT markers in each group was determined by WB experiment. Cell migration and invasion were measured by Transwell assay. Results Compared with Control group and Plasmid group, the expression levels of E cadherin and TIMP3 in miR-21-5p silencing group were increased, while the expression levels of N cadherin, fibrin, MMP-2, MMP-7 and MMP-9 were decreased, and the cell migration and invasion count were decreased. The expression levels of E cadherin and TIMP3 in TIMP3 silencing group were decreased, while the expression levels of N cadherin, fibrin, MMP-2, MMP-7 and MMP-9 were decreased, and cell migration and invasion were increased. The difference had statistical significance (P＜0.05). The indexes of miR-21-5p+TIMP3 silencing group were between miR-21-5p silencing group and TIMP3 silencing group, and the differences were statistically significant (P<0.05). Conclusion The targeted regulation of miR-21-5p could inhibit the invasion and metastasis of SCSP-571 cells, and the mechanism may be related to the improvement of TIMP3 expression, thereby inhibiting the MMPs mediated ECM and EMT.
Value of Wells score combined with D-dimer test for the diagnosis of uncertain acute pulmonary embolism
HONG Dou, XU Jun, YAN Yong-qing, ZOU Jun-yong, LIAO Yu-feng, CHEN Guo-ping
2019, 17(4): 538-542,613. doi: 10.16766/j.cnki.issn.1674-4152.000728
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Objective To evaluate the predictive value of different Wells score combined with D-dimer level in the diagnosis of acute pulmonary embolism (PE). Methods A total of 200 patients with suspected PE admitted in our hospital from 2013 to 2016 were enrolled into this study and divided into PE group and non-PE group by using computed tomography pulmonary angiography (CTPA). The risk factors for pulmonary embolism was investigate through statistical analysis. Receiver operating characteristic (ROC) curve analysis was used to compare the different predictive models. Results Of 183 patients included in this study, 101 patients were assigned into PE group and 82 in Non-PE group. The difference in the incident of chronic cardiac insufficiency, vascular diseases, the history of PE or DVT (deep vein thrombosis), difficult breathing, unilateral lower limb pain, lower extremity deep venous tenderness and single limb swelling, elevated levels of D-dimer, high Wells score was statistically significant between PE group and Non-PE group (all P<0.05), and not significant for other variables (all P>0.05). The areas under the ROC curves (AUC) of different assessment Methods were 0.834 (95% CI: 0.758-0.911), 0.775 (95% CI: 0.688-0.862), 0.732 (95% CI: 0.643-0.820), 0.857 (95% CI: 0.783-0.931), and 0.887 (95% CI: 0.820-0.954), respectively. The AUC for the combination of original Wells score version and D-dimer level was greater than that for the combination of simplify Wells score version and D-dimer level, and that for the method alone (all P<0.05). When the cut-off value of the combination of original Wells score version and D-dimer level was 0.96, and the weighted maximum sensitivity was 87.76% and specificity was 85.37%, and it reached the best reliability of diagnosing and eliminating PE. Conclusion Original Wells score version combined with D-dimer level shows a higher value in predicting acute pulmonary embolism than each method alone.
Application of magnetically controlled capsule endoscopy in upper gastrointestinal tract disease screening
CHEN Yu-fei, WANG Qi-zhi, KE Xi-quan, ZHU Yu, LIU Xiao-yang, DENG Xiao-jing
2019, 17(4): 543-546,600. doi: 10.16766/j.cnki.issn.1674-4152.000729
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Objective To explore the feasibility, safety and some factors influencing the efficiency of magnetically controlled capsule endoscopy (MCE) in upper gastrointestinal tract disease screening. Methods Sixty patients with upper gastrointestinal symptoms undergoing MCE in our hospital between March 2017 and March 2018 were selected to record the main anatomical site within the stomach esophagus, gastric mucosa visibility, and time for capsule through gastrointestinal tract, detection of upper gastrointestinal disease, success rate of inspection and incidence of discomfort. Thirty of 60 cases underwent gastroscopy at 4 weeks before and after MCE to detect diseases. The operation safety, feasibility and tolerance of MCE, disease detection rate and the influence of age on esophagus through time were evaluated. Results In 60 patients, the completion rates of cardiac examination, gastric fundus examination, gastric body examination, gastric Angle examination, gastric sinus examination and pylorus examination were 85.00%, 88.33%, 100.00%, 95.00%, 98.33% and 100.00%, respectively. There was no statistically significant difference in the time of capsule through esophageal tract between the patients aged 60y and less than 60y. Among them, 43 cases of upper digestive tract lesions were found, with a positive diagnosis rate of 71.67% (43/60), and 30 patients underwent gastroscopy within 4 weeks before and after the examination, with a consistent rate of 90.0% (27/30). All 60 patients successfully finished MCE examination, and 1 patient suffered discomfort, and the capsule was discharged within 1 week. Conclusion Compared with gastroscopy, MCE has a high detection rate of upper digestive tract lesions, and the examination process is noninvasive and controllable, which can be used for the screening of upper digestive tract diseases.
Influence of achyranthan on bone metabolism and biomechanical characteristics of elderly rats model of osteoporosis
LANG Xiao-qin, GAO Yue, ZHOU Ye, CHEN Mei-hong, XU Chu-yun
2019, 17(4): 547-550,589. doi: 10.16766/j.cnki.issn.1674-4152.000730
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Objective To explore the influence of achyranthan on bone metabolism and biomechanical characteristics of elderly osteoporosis model rats. Methods Totally 120 female SD rats were divided into 6 groups. In addition to the rats in the control group (Control) and the sham operation group (SO), the others were prepared for osteoporosis modes by surgical castration. After the surgery, the rats in intervention 1, 2, 3 were given intragastric administration with achyranthan of 100, 200, 400 mg/(kg·d), for 3 months. The levels of osteocalcin (OC), bone specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TPACP5b), Ⅰ type collagen cross-linking N-terminal peptide (NTX) and Ⅰ type collagen cross-linking C- terminal peptide (CTX) of abdominal venous blood of rats were detected by ELISA kits. The receptor activator of NF-kappa b (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG) expression of myelosis of rats were detected by WB. Maximum stress and fracture absorb energy of centrum and thighbone of rats was detected by using servo-hydraulic materials testing machines. Results Compared with the Control/SO group, the serum OC and BAP level, and the medullispinal OPG and RANK expression of the model group decreased, and the serum TPACP5b, NTX and CTX level, and the medullispinal RANKL expression of the model group increased. Compared with model group, the serum OC and BAP level, and the medullispinal OPG and RANK expression of intervention 1, 2, 3 group decreased successively, and the serum TPACP5b, NTX and CTX level, and the medullispinal RANKL expression of intervention 1, 2, 3 group increased successively, the difference among the different groups was statistically significant (P＜0.05). Compared with the control/SO group, the maximum stress and fracture absorb energy of the model group decreased. Compared with model group, the maximum stress and fracture absorb energy of the intervention 1, 2, 3 group increased successively, the difference among the groups was statistically significant (P＜0.05). Conclusion Achyranthan can improve bone metabolism, increase bone density and bone compressive ability of elderly osteoporosis rats, and has potential application value in the field of anti-osteoporosis.
Impact of non-tracheal intubation video-assisted thoracoscopic surgery on humoral immune response
QI Fen-qiang, WU Gen-she, XIANG Min-feng, YUAN Tian-zhu
2019, 17(4): 551-553. doi: 10.16766/j.cnki.issn.1674-4152.000731
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Objective To understand the immune advantages of non-tracheal intubation video-assisted thoracoscopic surgery (VATS) by comparing with influence of tracheal intubation for VATS on the humoral immunity. Methods Between January 2015 to May 2017, 118 patients undergoing VATS in our hospital were assigned into two groups according to non-tracheal intubation anesthesia group (group A, n=48) and tracheal intubation anesthesia group (group B, n=70) according to the patient's informed choice. Ten mL of peripheral blood was prepared at 1 day before the surgery, and 1 day, 3 days and 7 days after the surgery for the measurement of IgA, IgG, IgM, CRP, C3 and C4 by using immunoturbidimetric assay. The results between the two groups were compared by using SPSS 18.0 for statistical data processing and statistical analysis. P<0.05 was considered to be statistically significant. Results After the operation, the levels of all the immunoprotein reduced in different degree, except for CRP. There were no significance on IgA, IgG, C3, C4 level between the two groups on D1, D3 and D7 (all P>0.05, t=1.746, 0.899, 1.342, 1.775, 1.440, 1.779, 0.192, 0.633, 0.242, 0.931, 0.996, 0.741, respectively). The level of IgM on D1 and D3 after the surgery in the non-tracheal intubation anesthesia group was significantly higher than that in tracheal intubation anesthesia group (P<0.05, t=2.868, 2.930), however, the level of CRP in the non-tracheal intubation anesthesia group was significantly lower than that tracheal intubation anesthesia group (P<0.05, t=4.952, 3.271). Conclusion When compared with tracheal intubation anesthesia, non-tracheal intubation VATS can decrease the postoperative humoral immune response.
Evaluation of the subgingival air polishing in the treatment of moderate to severe chronic periodontitis
ZHANG Lei, HE Xin, SUN Xiao-yu, CHENG Nan, ZHU Ting-ting
2019, 17(4): 554-556,567. doi: 10.16766/j.cnki.issn.1674-4152.000732
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Objective The periodontitis, with a morbidity of 70%-85%, seriously endangers oral health. It is urgent to explore a new effective periodontal treatment method. Subgingival air polishing has the characteristics of high comfort, safety and high efficiency in periodontal treatment. The purpose of this study is to evaluate the clinical effect of subgingival air polishing technology for moderate and severe chronic periodontitis. Methods Thirty-six patients with moderate to severe chronic periodontitis were selected from August 2016 to March 2018 in the Department of Periodontal Mucosa, Affiliated Stomatological Hospital of Anhui Medical University. The data of periodontal exploration one week after supragingival air scaling were taken as baseline data. The principle of oral control design was adopted. One side of the same patient's teeth was randomly designed as experimental group, subgingival air polishing was performed, and the other side as control group, ultrasonic subgingival scaling was performed. After three months, the clinical indicators were reviewed by periodontal exploration. VAS pain score was used to assess the pain level of the two groups. Results The difference in plaque index (PLI), bleeding index (BI), probing depth (PD) and attachment loss (AL) between the two groups in baseline was not significant. Three months after treatment, the above indexes were improved as compared with the data in baseline, but the difference was not significant between the two groups (P>0.05). The pain score of VAS immediately after the treatment in the experimental group was lower than that in the control group (P<0.05). Conclusion During the three-month follow-up period, subgingival air polishing achieved the same effect as ultrasonic subgingival scaling for moderate and severe chronic periodontitis patients, and could reduce patients' discomfort.
Differentiation-inducing effect of 5-azacytidine in rat adipose-derived mesenchymal stem cells and the expressions of related protein
XIA Jing, XU Li-yan, LIU Xue-lan, FANG Jian-jiang, XU Shao-bo, CHEN Jing-jing
2019, 17(4): 557-560. doi: 10.16766/j.cnki.issn.1674-4152.000733
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Objective To investigate the differentiation inducing effect of 5-Azacytidine (5-Aza) in rat adipose-derived mesenchymal stem cells (ADMSCs) and the expressions of related protein. Methods The abdominal subcutaneous adipose tissue of Sprague-Dawley (SD) rat was isolated and cultured by enzyme digestion and adhesion method. The cultured cells were identified by using anti-monocyte human leukocyte antigen DR (HLA-DR), rabbit anti-CD13, CD44, CD105 and von willebrand factor (vWF) polyclonal antibody. The hematopoietic stem cells and fibroblasts were excluded. The third passage ADMSCs cells were used to inoculate into 24 well culture plates with the concentration of 1×104 cells/well. And the cultured cells were randomly divided into normal group and induction group, the cells in normal group was cultured in normal saline with sterile saline, the cells in induction group was incubated with 5-Aza at a concentration of 10 μmol/L. The morphological changes, cardiac troponin T (cTnT), cardiac troponin I (cTnI) and Connexin43 mRNA expression and cTnT, cTnI, Connexin43 protein expression were compared between the two groups. Results The proliferation of ADMSCs cells in the induction group was slowly, their volume was increased and gradually changed into a rod-shaped or wide-spindle shape, the morphology was characterized by cardiomyocytes; RT-qPCR results showed that the mRNA expression of cTnT, cTnI and Connexin43 were enhanced in the induced group; Immunohistochemistry results showed that the brownish yellow or chocolate brown granular matters were obviously visible in the cytoplasm of induction group, there were fewer brownish yellow or chocolate brown granular matters in the cytoplasm of the normal group, and the protein positive expression scores of cTnT, cTnI and Connexin43 in the induced group was significantly higher than that of the normal group (P<0.05). Conclusion Rat adipose tissue contains mesenchymal stem cells (MSCs) with multi-directional differentiation potential, 5-Aza can induce rat ADMSCs to differentiate into cardiomyocytes cells, and ADMSCs are expected to become the seed cells for the treatment of myocardial infarction.
Value of mitochondrial dynamic protein 1 in the early diagnosis of Alzheimer's disease
QIU Ling-shan, TAO Ping-yu, SUN Guo-qing, ZHANG Xue-ping, WANG Sheng-dong
2019, 17(4): 561-563,704. doi: 10.16766/j.cnki.issn.1674-4152.000734
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Objective To explore the clinical value of plasma and cerebrospinal fluid Dynamic-related protein 1(Drp1) as biomarkers in the early diagnosis of Alzheimer's disease. Methods Total 125 patients in the department of geriatrics of Hangzhou 7th people's hospital from June 2015 to June 2017 were selected as subjects, including 67 cases of mild cognitive impairment(MCI), 58 cases of AD, and 32 normal control as control. The cognitive function score were assayed according to Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Activity of Daily Living Scale (ADL). The levels of Drp1 and SNO-Drp1 in plasma and cerebrospinal fluid were tested by using Western blot. Results There was significant difference in MMSE and MoCA scores among the three groups (P<0.05). The plasma Drp1 of AD group was significantly lower than that of the control group (P<0.05). The expression of SNO-Drp1 in cerebrospinal fluid in AD group was significantly higher than those in the MCI group and control group (P<0.05), and the SNO-Drp1/Drp1 ratio in AD group was significantly higher than that in the control group. The sensitivity and specificity by ROC curve for MCI were 77.6% and 56.2%, and for AD were 86.2% and 87.5%. Conclusion The sensitivity and specificity of cerebrospinal fluid SNO-Drp1/Drp1 ratio for AD diagnosis is high and proximate, which is worthy of promotion.
Expression of TIM-3 in tumor microenvironment of colon cancer and its correlation with clinicopathological features
WENG Shou-xiang, ZHANG Wen-long
2019, 17(4): 564-567. doi: 10.16766/j.cnki.issn.1674-4152.000735
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Objective To investigate the expression of T cell immunoglobulin mucin 3(TIM-3) in tumor microenvironment of colon cancer and its correlation with clinicopathological features. Methods The study selected 57 patients with colorectal cancer who were treated from March 2013 to May 2015 in Zhejiang Taizhou Hospital. Immunohistochemistry was used to detect the expression of TIM-3 in colorectal cancer tissues and adjacent tissues of these patients. The correlation between the expression of TIM-3 and the clinicopathological features of patients with colorectal cancer and the relationship between the expression of TIM-3 and the follow-up survival were analyzed. Results The weak and strong expression of TIM-3 were 35.09% and 64.91% respectively in colorectal cancer, 71.93% and 28.07% respectively in adjacent tissues, and the strong expression percentage of TIM-3 in tumor was significantly higher than that in adjacent normal tissues (P<0.05). In colon cancer tissues, the strong expression of TIM-3 was significantly correlated with histological classification, tumor stage and lymph node metastasis (all P<0.05), but not with gender, age and tumor size (all P>0.05). The survival rate of colon cancer patients with weak expression of TIM-3 in tumor tissue was significantly better than that of patients with strong expression of TIM-3 in tumor tissue (P<0.05). Conclusion The expression of TIM-3 in the tumor microenvironment of colon cancer is highly correlated with histological classification, tumor stage and lymph node metastasis, and the survival of patients with high expression of TIM-3 is poor after operation. The expression of TIM-3 may be one of the potential prognostic indicators of patients with colon cancer.
Short term and long-term outcomes of the affected lobe combined with isthmus of the thyroid gland resection in the treatment of micropapillary thyroid cancer
ZHENG Jue-ru, DAI Lei, WU Xian-jiang, HU Jin-xing
2019, 17(4): 568-570,656. doi: 10.16766/j.cnki.issn.1674-4152.000736
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Objective To analyze the short-term and long-term effects of thyroidectomy combined with isthmus resection in the treatment of micropapillary thyroid cancer, and to explore the most effective treatment for this disease. Methods Sixty patients with micropapillary thyroid cancer in our hospital from January 2007 to December 2008 were enrolled and assigned into control group (n=30) and observation group (n=30) according to the random number table. The control group was treated with total thyroidectomy combined with central lymph node dissection, and the observation group was treated with thyroidectomy combined with isthmus resection. The short-term effect (operation time, intraoperative bleeding volume, incision length, postoperative medication dosage, hospitalization time, parathyroid hormone and serum calcium level, hypocalcemia, hypothyroidism, recurrent laryngeal nerve injury and other complications) and long-term effect (total remission rate, recurrence rate, tumor-free survival rate and fatality rate of 5 years and 10 years) were compared between the two groups. Results The clinical related indexes of the observation group were better than those of the control group; the levels of parathyroid hormone and serum calcium in both groups were lower than those before the operation, but the decrease of the observation group was less than that of the control group; the incidence of postoperative complications in the observation group (10.0%) was lower than that in the control group (33.33%); there was significant difference between the two groups (all P<0.05). The total remission rate, recurrence rate, tumor-free survival rate and fatality rate of the observation group were similar to those of the control group in 5 and 10 years, with no significant difference (all P>0.05). Conclusion The short-term and long-term effect of thyroidectomy combined with isthmus resection is better than that of total thyroidectomy combined with central lymph node dissection in the treatment of micropapillary thyroid cancer. It can obviously improve the levels of parathyroid hormone and serum calcium, reduce complications, and reduce recurrence rate and fatality rate.
A prospective study of eradication of Helicobacter pylori infection in patients with varying degrees of pathological changes in gastric mucosal intestinal metaplasia
LU Guang-rong, HE Bo-qi, LIN Ying, XU Chang-long, XIA Xuan-ping, XUE Zhan-xiong, ZHOU Yu-hui
2019, 17(4): 571-573. doi: 10.16766/j.cnki.issn.1674-4152.000737
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Objective To determine whether eradication of H.pylori can reverse the intestinal metaplasia (IM) to a certain extent, and how the eradication of H.pylori affects IM development by a prospective follow-up study of Helicobacter pylori-positive gastric mucosal intestinal metaplasia patients, to provide some reference for prevention of intestinal type gastric cancer and determining the best time to eradication of Helicobacter pylori. Methods A total of 280 patients who were confirmed with H.pylori infection and gastric mucosal intestinal metaplasia in the endoscopy center of the Second Affiliated Hospital of Wenzhou Medical University from April 1, 2017 to April 1, 2018 were enrolled. They were divided into two groups according to the patients' wishes and the severity and distribution of intestinal pathology, and followed up for 6 and 12 months. The differences of the pathological changes of patients with mild, moderate and severe IM in two groups were compared, respectively. Results During the follow-up of 6 months and 12 months, the degree of IM after H.pylori eradication in mild to moderate IM patients was lower than that of H.pylori patients who had not received H.pylori eradication(P<0.05). However, when it came to severe IM patients, eradicating H.pylori or not showed no significant difference in degree of IM (P>0.05). Conclusion Patients with mild or moderate IM in gastric mucosa should receive Helicobacter pylori eradication therapy as soon as H.pylori is found.It may be the best time to eradicate Helicobacter pylori.
Clinical effects of Milligan-Morgan hemorrhoidectomy combined with purse-string suture for grades Ⅲ-Ⅳ mixed hemorrhoid
LU Zhen-feng, ZHANG Xiu-feng, SHEN Zhong, YANG Guan-gen, WANG Hou-dong
2019, 17(4): 574-576,604. doi: 10.16766/j.cnki.issn.1674-4152.000738
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Objective To evaluate the clinical efficacy of Milligan-Morgan hemorrhoidectomy combined with purse-string suture in the treatment of grades Ⅲ-Ⅳ mixed hemorrhoid. Methods A total of 136 patients with grade Ⅲ and Ⅳ mixed hemorrhoids admitted to our hospital between December 2015 and December 2017 were enrolled and divided into control group and observation group according to the different surgical methods, with 68 cases in each group. The control group received Milligan-Morgan hemorrhoidectomy, while the observation group received Milligan-Morgan hemorrhoidectomy combined purse-string suture. The surgical analysis related indexes (operation time, wound healing time, hospitalization time), postoperative anal pain (VAS), postoperative anal margin edema, incidence of postoperative complications (urine dysfunction, postoperative bleeding, anorectal stenosis, skin formation) and clinical outcomes were compared retrospectively. Results There was no significant difference in the operation time between the two groups (P>0.05), but the wound healing time and hospitalization time in the observation group were significantly lower than those in the control group (all P<0.05). The VAS score and the anal edema score of the anus pain were decreased in both groups within 7 days after the surgery, and these score on D1,D3, D5 and D7 after the surgery in the observation group was significantly lower than those in the control group (all P<0.05). The urinary dysfunction score and postoperative bleeding score in the observation group were significantly lower than those in the control group (all P<0.05). The incidence of anorectal stenosis and skin formation in the observation group was significantly lower than that in the control group (all P<0.05). The total effective rate was 98.53% in the observation group and 95.59% in the control group. There was no significant difference in the total effective rate between the two groups (P>0.05). Conclusion The Milligan-Morgan hemorrhoidectomy combined with purse-string suture for grades Ⅲ-Ⅳ mixed hemorrhoid can achieve a similar clinical efficacy to Milligan-Morgan hemorrhoidectomy. However, the Milligan-Morgan hemorrhoidectomy combined with purse-string suture can promote the wound healing, reduce postoperative pain and decrease the incidence of postoperative complications. It is worthy of clinical application.
Effects of radiofrequency ablation combined with 125I seed implantation for advanced intrahepatic cholangiocarcinomas
ZHANG Gui-jun, LI Hong, MA Ji-bo, YE Hua, LI Feng, SUN Qin-xue, ZHU Bin-bin
2019, 17(4): 577-579. doi: 10.16766/j.cnki.issn.1674-4152.000739
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Objective To evaluate the curative effect of radiofrequency ablation (RFA) combined with 125I seed implantation in treatment of advanced intrahepatic cholangiocarcinoma (ICC). Methods The clinical data of 48 patients with advanced ICC confirmed by histopathological examination, in our hospital between June 2012 and June 2014 were retrospectively analyzed. A Total of 48 patients were assigned into control group and study group with 24 cases in each group. The study group received the radiofrequency ablation combined with 125I seed implantation, while the control group was administrated with systemic venous chemotherapy. The level of tumor markers, short-term results and long-term survival rates of the two groups were compared and analyzed. Results The levels of tumor biomarkers were significantly decreased in both groups after the treatment as compared with their pretreatment levels, but their decreasing amplitudes were significantly greater in the study group than those in the control group (all P<0.05). There was no statistical difference in benefit rate between the study group and control group (75.00% vs. 87.50%, P=0.267), but the response rate in the study group was significantly higher than that in the control group (70.83% vs. 37.50%, P<0.05). The 1-year, 2-year and 3-year survival rates showed no statistical difference between the two groups (all P>0.05), but the over 3-year survival rate in the study group was significantly higher than that in the control group (P<0.05). Conclusion RFA combined with 125I seed implantation for advanced intrahepatic cholangiocarcinoma can achieve good short-term effects, increase long-term survival and reduce the level of tumor markers.
Analysis of risk factors for bacterial infection of Enterobacteriaceae resistant to carbapenem in intensive care unit
ZHOU Fen, JIN Yu-hong, WANG Guang-fen, DING Yi, ZHENG Mei-xia, YANG Jun-jie, ZHOU Fei-fei
2019, 17(4): 580-582,648. doi: 10.16766/j.cnki.issn.1674-4152.000740
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Objective To investigate the risk factors of carbapenem-resistant Enterobacteriaceae infection in intensive care unit (ICU). Methods From January 2016 to December 2017, 66 patients with Enterobacteriaceae infection resistance to carbapenem were selected as the main observation object (observation group), and carbapenem drug sensitivity in the same period of admission was selected as the main observation object (observation group). The demographic characteristics of 146 patients (control group) were collected. The basic clinical data, severity score, invasive operation and other general data were compared. The single factor difference between the two groups was determined by retrospective analysis, and multivariate Logistic regression analysis was used to identify the risk factors of carbapenem-resistant Enterobacteriaceae infection in intensive care unit (ICU). Results The incidence of carbapenem-resistant Enterobacteriaceae infection in intensive care unit was 31.13% (66/212). Among 66 strains of Enterobacteriaceae, 39 were Klebsiella pneumoniae (59.09%), 12 were Escherichia coli (18.18%), 11 were Enterobacter cloacae (16.67%), 4 were Enterobacter aerogenes (6.06%). There were significant differences in APACHE Ⅱ score, invasive operation and drug use before infection between patients with CRE infection and control group (P<0.05). The risk factors of APACHE Ⅱ score, operation, and endotracheal intubation were significantly different from those in control group (all P<0.05). Antibiotics were used before infection (OR>1; all P<0.05), and GCS score was the protective factor (OR<1; P<0.01). Conclusion The risk factors of Enterobacteriaceae infection in intensive care unit mainly included Apache Ⅱ score, operation, tracheal intubation and antibiotics before infection as protective factors, and Apache Ⅱ score was high. Severe coma patients undergoing surgery and endotracheal intubation should be given more attention and early screening if they have a history of antibiotic therapy.
The evaluation of routine hypertension therapy based contract service on the long-term prescription in Shanghai
ZHENG Dong-peng, LU Ai-min, XU You-xian
2019, 17(4): 583-585,681. doi: 10.16766/j.cnki.issn.1674-4152.000741
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Objective To evaluate the effect of routine hypertension therapy based contract service on the long-term prescription in Shanghai. Methods Two hundreds subjects were selected according to the inclusive criteria from September 2016 to February 2018, and were randomly assigned to long prescription group and non-long prescription group. The subjects in long prescription group signed the chronic disease long-term description service, and received the drugs for 8 weeks every visiting time. While the subjects in non-long prescription group only received drugs for 4 weeks. The study lasted 6 months. All subjects were tested and evaluated both at the beginning and end of the term. Results In the long prescription group, there were no significant differences insystolic and diastolic blood pressure before and after treatment (all P>0.05); there were significant differences in medication compliance, service satisfaction, patient visits, the time of medical treatment and the cost of medical treatment within 6 months. The net change values between the two groups were not significant in both systolic and diastolic blood pressure (all P>0.05); there were significant difference in cognitive symptom management, symptom management self-efficacy, communication with doctors, health self-assessment, health concerns, the impact of disease on life, medication compliance, service satisfaction, medical visits, the time and cost of medical treatment within 6 months (all P<0.05). Conclusion Our results showed that the effects of routine hypertension therapy based contract service on the long-term prescription were promising in our community. The long prescription model can be borrowed to manage other chronic diseases community health service centers.
Effect evaluation of humanistic care concept combined with respiratory function exercise on patients with lung adenocarcinoma
LIN Han-hui, CHEN Jie, LIN Xiao-min, YI Li-sha, LI Qian-qian, LIN Xi-fang, FANG Zhen-hong
2019, 17(4): 586-589. doi: 10.16766/j.cnki.issn.1674-4152.000742
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Objective To investigate the effects of humanistic care concept combined with respiratory function exercise on pulmonary function, negative emotion and quality of life in patients with lung adenocarcinoma. Methods Eighty-six cases of advanced lung adenocarcinoma patients in our hospital from January 2014 to June 2016 were selected as the research object and were randomly divided into control group and observation group; the control group were given respiratory function exercise, the observation group were given humanistic care concept combined with respiratory function exercise. The lung function of the two groups was evaluated by FEV1 and FEV1/FVC. The emotional state of the two groups was evaluated by SAS and SDS. The quality of life of the two groups was evaluated by 36-SF scale. The lung function, negative emotion, quality of life and treatment compliance were compared between the two groups. Results After 1 month of treatment, the FEV1 (1.66±0.22) in the observation group was significantly higher than that in the control group (1.43±0.24), the FEV1/FVC in the observation group (67.92±10.06) was significantly higher than that in the control group (58.19±9.35). The difference was significant (both P<0.05). The SAS and SDS in the observation group (38.75±2.68, 35.47±3.04) were significantly lower than those in the control group (47.67±4.29, 47.35±4.28), all P<0.05. The quality of life of the observation group was significantly higher than that of the control group. The treatment compliance of observation group (90.70%) was significantly better than the control group (62.80%), P<0.05. Conclusion Humanistic care concept combined with respiratory function exercise can improve the lung function and reduce the negative emotions of pemetrexed combined with cisplatin in patients with lung adenocarcinoma, and improve their quality of life and treatment compliance.
Evaluation of lifestyle management on the treatment of adolescent with polycystic ovary syndrome
WANG Lu-lu, ZHU Yi, HU Ting, WAN Ling-yi
2019, 17(4): 590-593. doi: 10.16766/j.cnki.issn.1674-4152.000743
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Objective To analyze the influence of lifestyle management on the therapeutic effect of adolescent polycystic ovary syndrome (PCOS) patients, and to provide evidence for improving the therapeutic effect of adolescent PCOS patients from the perspective of lifestyle management. Methods A total of 112 adolescent patients with polycystic ovary syndrome (PCOS) from March 2017 to February 2018 were enrolled in this study. Lifestyle management and drug therapy were carried out. After six months, the mean scores of the five dimensions of the self-rating scale for lifestyle of patients with PCOS were divided into high score group and low score group. The levels of testosterone, ovarian volume, BMI, hirsutism and acne were compared between the high and low score groups, and the effects of different lifestyles management on the treatment effect of adolescent polycystic ovary syndrome were analyzed. The data were analyzed by SPSS 19.0 statistical software. Results The testosterone level, ovarian volume, body mass index and Rosenfield score of the low score group of dietary rhythm, dietary content, body constitution awareness and life rhythm were lower than those of the high score group. The testosterone level, ovarian volume, body mass index and Rosenfield score of the high score group of exercise awareness were lower than those of the low score group, the difference was statistically significant(all P<0.05), However, there was no significant difference in F-G scores between the high and low scores of the five dimensions of the self-rating scale for lifestyle of patients with polycystic ovary syndrome(all P>0.05). Conclusion Good lifestyle plays an active role in promoting the therapeutic effect of adolescent patients with polycystic ovary syndrome, reducing testosterone level, ovarian volume, weight control and acne symptoms, but has little effect on hirsutism.
Effects of budesonide combined with azithromycin sequential therapy on pulmonary function, levels of CRP, IL-6 and TNF-α in children with mycoplasma pneumoniae
LYU Xiao-juan, TANG Wei-hong, SHEN Dao-jiang, WANG Hui-ting, LIU Wei, GUAN Min-chang
2019, 17(4): 594-596,677. doi: 10.16766/j.cnki.issn.1674-4152.000744
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Objective To study the effects of budesonide combined with azithromycin sequential therapy on mycoplasma pneumoniae pneumonia (MMP) in children. Methods A total of 120 patients were randomly divided into four groups according to random number table method: group A, group B, group C and group D, with 30 cases in each group. Group A received azithromycin, 10 mg/kg, intravenous instillation, 1 time/day for 3 days; after withdrawal for 4 days, azithromycin dry suspension was given to patients, 10 mg/kg, oral, 1 time/day, for 7 days. Group B received azithromycin for 5 days and after withdrawal for 4 days, azithromycin dry suspension was given to patients for 5 days. On the basis of group A, Group C received additional budesonide, 1 mg, aerosol inhalation, 1 time/ day, for 14 days. On the basis of group B, Group D received additional budesonide for 14 days. After the treatment of 14 days, the total effective rates, disappearance times of symptoms and signs, pulmonary function, levels of C-reactive protein (CRP), IL-6 and TNF-α, and the incidences of adverse reactions in the four groups were observed and compared. Results After the treatment, the total effective rates of group C (93.3%) and group D (96.6%) were much higher than group A (73.3%) and group B (73.3%). The disappearance times of symptoms and signs of group C and group D were much shorter than that in group A and group B, which were significantly different (all P<0.05). After the treatment, FEV1, FVC, PEF, CRP, IL-6 and TNF-α were much better than before the treatment in all the four groups (all P<0.05), and these in group C and group D were better than group A and group B (all P<0.05). The total incidences of adverse reactions of group A (10.0%) and group C (6.7%) were much lower than group B (36.7%) and group D (30.0%), which were significantly different (all P<0.05). Conclusion Budesonide combined with azithromycin sequential therapy in children with MPP is more effective, which can shorten the courses of disease and ameliorate pulmonary functions and the levels of inflammatory factors; furthermore, it is more safety for using intravenous injection of azithromycin for 3 days.
Correlation between effector T cell and regulatory T cell imbalance and severity of bronchial asthma in children and its predictive value for Disease Control
DOU Xiao-bin, WU Tie-feng, CAI Zhen-dang
2019, 17(4): 597-600. doi: 10.16766/j.cnki.issn.1674-4152.000745
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Objective To study the correlation between the imbalance of effector T cells (Th) and regulatory T cells (Treg) and the severity of bronchial asthma in children and its predictive value for disease control. Methods One hundred and twenty-four children with bronchial asthma from July 2017 to July 2018 were divided into mild group (56 cases) and severe group (68 cases) according to the severity of the disease. Th and Treg levels were detected by flow cytometry, and the correlation between Th, Treg and their ratio and the severity of the disease was analyzed. The children were followed up two months to observe the recurrence of the two groups. The children were divided into recurrence group (45 cases) and non-recurrence group (79 cases), Th and Treg levels were measured and ROC curves were drawn to predict the recurrence of the two groups. Results Th and Th/Treg in severe group were significantly higher than those in mild group, while Treg was significantly lower than that in mild group (P<0.05). Pearson correlation analysis showed that the severity of bronchial asthma was highly correlated with Th, Treg and their ratios (r=0.651, -0.681, 0.786); Th, Treg and their ratios in recurrent group were significantly higher than those in mild group (P<0.05). ROC curves showed that Th, Treg and their ratios had a high predictive power for the recent recurrence of bronchial asthma in children, AUC were 0.511, 0.617 and 0.773 respectively, and the AUC value of Th/Treg was significantly higher than that of Th and Treg (P<0.05). The sensitivity of Th/Treg was 82.22%, significantly higher than those of Th and Treg. Conclusion There is a significant correlation between the imbalance of effector T cells and regulatory T cells and the severity of bronchial asthma in children, and the ratio of Th to Treg has a higher diagnostic efficiency in predicting the short-term recurrence in children.
Effect of Zhulian Zhenfa acupuncture on polycystic ovary syndrome in obesity women and its influence on life quality of patients
LIU Hong-juan, YI Lei, YUE Jin, LIU Chun-fang
2019, 17(4): 601-604. doi: 10.16766/j.cnki.issn.1674-4152.000746
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Objective To investigate the clinical efficacy of Zhulian Zhenfa acupuncture on polycystic ovary syndrome (PCOS) in obesity women and its influence on life quality of patients. Methods Sixty obesity women with PCOS in our hospital from January 2017 to June 2018 were selected as subject and divided into control group and observation groups according random number table, with 30 cases in each group. The control group was given ordinary acupuncture, while the observation group was given Zhulian Zhenfa acupuncture. The BMI, SDS score, SAS score, life quality (SF-36) and the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and testosterone (T) of two groups were compared before and after treatment to investigate effect of Zhulian Zhenfa acupuncture on PCOS. Results After the treatment, the BMI of both groups were significantly decreased (P<0.05), and the observation group was better than the control group (P<0.05). There was no significant difference in SDS and SAS scores in the control group (P＞0.05), however, there was significant difference in the observation group when compared with pretreatment values (P<0.05). After the treatment, the observation group was better than the control group in improving the quality of life (P<0.05). After the treatment, the levels of LH, E2 and T in the two groups were significantly dcreased (P<0.05), and the observation group was better than the control group (P<0.05). Conclusion Zhulian Zhenfa acupuncture on PCOS in obesity women can significantly improve the state of depression, anxiety and quality of life of patients. The improvement of LH, E2, T and other sex hormones levels may be the potential mechanism in patients undergoing Zhulian Zhenfa acupuncture.
Significance of pediatrician admission to obstetrics wards rounds in the management of neonatal jaundice
ZHU Ya-fei, WU Guang-sheng, XIAO Yun-bin, YI Xiao-lian, YIN Hui-mei
2019, 17(4): 605-608. doi: 10.16766/j.cnki.issn.1674-4152.000747
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Objective To explore the clinical impact of pediatricians in obstetric ward rounds and standardize the implementation of neonatal jaundice management guidelines for neonatal hyperbilirubinemia. Methods The healthy, full-term infants or late preterm infants form April 2017 to April 2018 were selected and divided into management group (n=3 785) and control group (n=4 131). There was no significant difference in gender, birth weight and gestational age between the two groups. Transcutaneous bilirubin (TcB) and total serum bilirubin monitoring were performed. The incidence of hyperbilirubinemia, rate of rehospitalization of outpatient, serum total bilirubin at admission, rate of compliance with transfusion guidelines, and outpatient follow-up rate were retrospectively reviewed. Results ①The incidence of neonatal hyperbilirubinemia was 16.2% in the management group and 15.6% in the control group, with no statistically significant (χ2=0.551, P=0.446). ②The rate of rehospitalization of outpatient with hyperbilirubinemia was 35.5% in the management group, which was higher than 29.3% in the control group (χ2=5.534, P=0.024). ③ The level of serum total bilirubin was (299.0±27.6) μmol/L in the management group, which was lower than (303.0±31.9) μmol/L in the control group (t=2.380, P=0.022). ④ The rate meeting the standard of blood transfusion was 2.1% in the management group, which was lower than 4.0% in the control group (χ2=3.891, P=0.047). ⑤ The neonatal jaundice outpatient follow-up rate was 82.7% in the management group, which was significantly higher than 54.6% in the control group. ⑥ The risk factors for neonatal jaundice included perinatal factor (38.4%), early breast milk jaundice (23.6%), infection (10.6%), hemolysis (9.1%) and scalp hematoma (4.5%). Conclusion Pediatrician admission to obstetrics wards rounds can standardize and intervene the management of neonatal jaundice in the Department of Obstetrics and avoid severe hyperbilirubinemia by effective follow-up.
Establishment of Shanghai community nursing quality indicators system: Based on Donabedian's structure-process-outcome approach theory
GE Jin-jin, LIU Wei-qun, JIANG Zhang-ying, LIU Ying-yan, HONG Bo
2019, 17(4): 609-613. doi: 10.16766/j.cnki.issn.1674-4152.000748
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Objective To construct Shanghai community nursing quality evaluation indicators system in order to provide an evaluation tool for comprehensively improving the quality of community nursing. Methods According to Donabedian's structure-process-outcome approach theory, an expert consultation questionnaire about evaluation of community nursing quality indicators system was prepared. Two rounds of Delphi consultation were conducted by purposive sampling and selecting experts such as primary medical management personnel, administrative personnel of primary health institutions, community nursing managers and professors of community nursing major in colleges and universities. Results Data analysis showed that expert positive coefficient was 94% and coefficient of authority was 0.85. Two rounds of enquiry for Kendall coefficient results were 0.253 (χ2=311.285, P<0.01) and 0.401 (χ2=498.971, P<0.01). The structural indicators included organizational structure, staff composition, rules and regulations, nursing training and 6 corresponding three-level indicators; Process indicators include resources, environment management, community care quality management, participation in community key population management, participation in Family doctor service team, hospice care, home care and 15 corresponding third-level indicators; The outcome indicators include nursing safety events, satisfaction rate of service objects, compliance rate of nursing quality control, training rate of community nurses, assessment qualified rate of community nurses, work innovation and achievement promotion and corresponding 27 three-level indicators. Conclusion The community nursing quality evaluation system based on the "structure-process-result" model has good reliability, operability and prospective, which can reflect the community nursing operation, nursing quality, nursing service and other conditions, and can also help community nursing managers to comprehensively develop nurse teams.
Effect of Supportive Group Psychotherapy on Anxiety and Depression of Elderly Inpatients in Community Health Service Centers
ZHAO Hui
2019, 17(4): 614-618. doi: 10.16766/j.cnki.issn.1674-4152.000749
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Objective By exploring the effect of supportive group psychotherapy on intervening anxiety and depression of elderly inpatients in community health service centers, we provide theoretical basis for community health service centers to enhance their service capacity and therapeutic effect on elderly inpatients. Methods From January 2018 to February 2018, 30 hospitalized patients were selected as the observation group by simple random number method in the inpatient wards of the community health service center, 60 hospitalized patients in the inpatient wards of the two nearby community health service centers, who were of the same gender as and of similar age with those in the observation group, were selected as control group. The observation group received supportive group psychotherapy on the basis of routine rehabilitation guidance, while the control group only received routine rehabilitation guidance. The subjective and Objective anxiety and depression level as well as the quality of inpatient life of the 2 groups were evaluated by Self-Rating Anxiety Scale, Self-Rating Depression Scale, Hamilton Anxiety Scale, Hamilton's Depression Scale, and self-designed questionnaire on quality of life. Results There was no significant statistical difference between the 2 groups in all scales before supportive group psychotherapy intervention. There were significant statistical differences in the rehabilitation belief, subjective feeling and SAS, SDS, HAMA total score, HAMA severity and HAMD total score after intervention between the 2 groups, while the observation group changed positively. By comparing the 2 groups before and after intervention, we can find that in the observation group, there were significant statistical differences and positive change in rehabilitation beliefs, subjective feelings, SAS, SDS, HAMA total score, HAMA severity, and HAMD total score. While in the control group, there were significant statistical difference only in the SAS and SDS scales. Conclusion Supportive group psychotherapy is more effective on intervening the anxiety and depression of elderly inpatients than regular rehabilitation instruction. But for patients with moderate or severe depression, the combination of psychotherapy and medication should be considered. The intervention treatment in this study can enhance the rehabilitation beliefs of elderly inpatients and their subjective feelings of hospitalization.
Study on the expression of endoplasmic reticulum stress-related genes and microRNA-16, microRNA-124 and microRNA-195 in peripheral blood of depressive patients
ZHAO Yong, TAN Zhong-lin, JIANG Xiao-ying
2019, 17(4): 619-621. doi: 10.16766/j.cnki.issn.1674-4152.000750
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Objective To investigate the expression of endoplasmic reticulum stress-related genes and microRNA-16, microRNA-124 and microRNA-195 in peripheral blood of depressive patients. Methods A total of 97 patients with depression admitted to our hospital from July 2017 to July 2018 were selected as the study subjects, and 63 health examinees from July 2017 to July 2018 were selected as the control group. Western blot was used to detect the expression of IRE1 alpha and JNK, and the relative value was calculated and analyzed according to OD relative value = target band expression intensity/GAPDH expression intensity. PT-cPCR was used to detect the expression of microRNA-16, microRNA-124 and microRNA-195, and the original CT value was obtained. The average value of three times was taken and the relative value of microRNA was calculated by 2-CT method. Results The relative value of OD expression of IRE1α and JNK in depression group was higher than that in control group (P<0.05). The expression levels of microRNA-16 and microRNA-195 in depression group were lower than those in control group, while the expression levels of microRNA-124 in depression group were higher than those in control group (P<0.05). Conclusion IRE1 α and JNK are highly expressed in the peripheral blood of depressive patients, and the expression levels of microRNA-16 and microRNA-195 are abnormally decreased, while the expression levels of microRNA-124 are abnormally increased. Therefore, it is considered that IRE1 alpha and JNK can be used as biological indicators for diagnosis and evaluation of prognosis of depressive patients.
Analysis of the relationship among social support, depression, loneliness and quality of life about the parents who lost their only child
WANG Guo-min, ZHENG Li-feng, ZHOU Bo, NI Yan-fei, YANG Kai-ren
2019, 17(4): 622-624,640. doi: 10.16766/j.cnki.issn.1674-4152.000751
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Objective To evaluate the relationship among social support, depression, loneliness and quality about the parents who lost their only child, and to provide reference for improving their mental health and quality of life from the perspective of social support. Methods From April 2018 to June 2018, 136 parents who lost their only child were included in the study. Scale of perceived social support (PSSS), Self-rating depression scale (SDS), California at Los Angels Loneliness Scale (PSSS), and Short-Form Health Survey Scale (SF-36) were assessed. The data were analyzed by SPSS 19.0. Results The PSSS score of the subjects was 45.75±11.62. The SDS scores of low PSSS group were higher than those of high PSSS group (t=2.658, P=0.009). The UCLA score of PSSS group was higher than that of middle PSSS group (t=2.062, P=0.042) and high PSSS group (t=2.907, P=0.005). The score of PSSS was negatively correlated with the scores of SDS and UCLA (r=-0.376, P=0.013, r=-0.412, P=0.011) respectively. The scores of MCS in low PSSS group were lower than those in middle PSSS group(t=-2.331, P=0.022) and high PSSS group (t=-2.478, P=0.015). The scores of PSSS were positively correlated with the scores of MCS (r=0.560, P=0.007). Conclusion Social support has a certain effect on depression and loneliness of the parents who lost their only child. Social support has no significant effect on the physical health of the parents who lost their only child, but has a significant impact on mental health, higher social support means higher mental health level.
Application of internet based mindfulness stress reduction psychological nursing therapy in the nursing of patients with inflammatory arthritis
LI Hong-yan, ZHANG Hong-yan, REN Zhan-fen, FANG Xiao, BIAN Qiu-hong, BAI Xiao-min
2019, 17(4): 625-629. doi: 10.16766/j.cnki.issn.1674-4152.000752
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Objective To explore the application effect of internet-based mindfulness decompression therapy psychological nursing in the nursing of patients with inflammatory arthritis. Methods From July 2017 to November 2018, 126 patients with inflammatory arthritis which met the inclusion and exclusion criteria were enrolled in the Department of Rheumatology and Joint Surgery, and 126 patients were randomly divided into two groups, namely experimental group (62 cases) and control group (64 cases) using the convenient sampling method. The mental health education was given to the control group, and the experimental group was given Internet-based mindfulness decompression therapy intervention. The depression level, anxiety level, mindfulness level, quality of life, cortisol concentration and personality traits of the two groups were compared before and after the intervention. Results Before the intervention, there was no statistically significant difference in scores on these indicators between the two groups. After the intervention, the scores of depression BDⅠ-Ⅱ, anxiety SAS, comprehensive quality of life, cortisol concentration, neuroticism, psychoticism and dissimulation in the experimental group were all lower than those in the control group, mindfulness score and introversion dimension score were higher than those in the control group, and the difference was statistically significant (all P<0.05). Conclusion Internet-based psychological care for mindfulness decompression therapy can alleviate the negative emotions of patients with inflammatory arthritis, improve the level of mindfulness and quality of life, adjust the function of the hypothalamic-pituitary-adrenal axis, improve personality traits, and promote clinically. Internet based mindfulness stress reduction psychological nursing therapy could provide data support and practical experience.
Clinical application of systematic rehabilitation nursing in neurogenic bladder of patients with traumatic spinal cord injury
HUANG Jing-li, SHENG Zhi-ren, HU Jian-li, LANG Jian-fang, YE Yan-ling
2019, 17(4): 630-632,685. doi: 10.16766/j.cnki.issn.1674-4152.000753
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Objective To study the clinical application of systematic rehabilitation nursing in neurogenic bladder of patients with traumatic spinal cord injury(TSCI). Methods Sixty patients with TSCI admitted to the Affiliated Hospital of Medical College of Ningbo University from June 2017 to March 2018 were divided into intervention group and control group according to the random group design, by admission period. The control group of 30 patients were given routine nursing. On the basis of routine nursing, the intervention group of 30 patients were given individualized bladder function training, intermittent catheterization demonstration, psychological intervention, diet care, follow-up supervision and other systematic rehabilitation care. The quality of life (QOL), bladder function, incidence of urinary tract infection and satisfaction rate of nursing were evaluated after 6 months of continuous intervention. Results There was no significant difference in urinary tract infection between the two groups, but the number of infections in the intervention group was lower than that in the control group. The time required for the intervention group to reach the equilibrium state of the bladder was significantly shorter than that of the control group (P<0.05), and the satisfaction rate of the nursing work in the intervention group was also significantly higher than that of the control group (P<0.05). There was no significant difference in defects and coercion between the two groups. The intervention group was significantly better than the control group in terms of anxiety and emotion (both P<0.05). Conclusion Systematic rehabilitation nursing intervention can significantly shorten the time required for NB patients to reach the equilibrium state of the bladder, reduce the incidence of urinary tract infections, help to reduce the anxiety of patients, improve the quality of life of patients and the satisfaction rate of nursing work, and effectively improve the healing effect of neurogenic bladder.
Study of left ventricular global function and myocardial fibrosis in patients with primary dilated cardiomyopathy by cardiac magnetic resonance imaging
HONG Xue-dong, ZHENG Sui-sheng, XU Ling, ZOU Li-wei, SHI Kai-hu
2019, 17(4): 633-636,665. doi: 10.16766/j.cnki.issn.1674-4152.000754
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Objective To investigate the value of 1.5T cardiac magnetic resonance imaging in the study of left ventricular global function and myocardial fibrosis in primary dilated cardiomyopathy (DCM). Methods Selected Twenty seven patients were admitted to the Department of Radiology, the Second Affiliated Hospital of Anhui Medical University from June 2016 to June 2018 with dilated cardiomyopathy (DCM) and 27 healthy volunteers were collected. All subjects were examined with conventional 1.5T cardiac magnetic resonance plain scan and gadolinium enhancement. Left ventricular short axis film (plain scan) and delayed enhanced cardiac magnetic resonance images (DE-MRI) were obtained. The left ventricular function indices (standardized body surface area) and myocardial delayed enhancement images were obtained. The functional indices included left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular myocardial mass (LVMM), left ventricular ejection fraction (LVEF), and left ventricular peak ejection rate (LVPER), left ventricular peak filling rate (LVPFR) and interventricular septal thickness (IVSTD), etc. The differences of values between the two groups were compared. In DCM group, the above values were divided into DE-MRI (+) group and DE-MRI (-) group according to delayed enhancement, and the differences between the two groups were compared. Results ①The LVEF, LVPER, LVPFR and IVSTD of the patients group were lower than those of the healthy control group, and the remaining indicators were significantly higher than those of the healthy control group, with statistical significance; ②The LVMM and LVESV of DE-MRI (+) group were higher than those of DE-MRI (-) group, while LVEF decreased in DE-MRI (+) group, with statistical significance. There was no difference among the other groups. ③Delayed myocardial enhancement was found in 17 patients (62.96%) with 153 segments, including 101 segments (66.01%) between the muscles, and the ventricular septal wall (12 cases, 70.58%) were the main sites. Conclusion ①Decreased global left ventricular function in DCM is accompanied by left ventricular myocardial fibrosis, and the distribution of septal wall is significant. ②LVMM can roughly evaluate the degree of myocardial fibrosis (MF) in DCM.
The value of contrast-enhanced transcranial doppler in screening patients with migraine and patent foramen ovale
ZHANG Yong-yin, CHEN Wei-li, CHEN Guang-yong, SONG Meng-wan, SHOU Shi-xin, ZHU Li-dong, HUANG Xue-rong
2019, 17(4): 637-640. doi: 10.16766/j.cnki.issn.1674-4152.000755
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Objective To investigate the value of contrast-enhanced transcranial doppler (c-TCD) in the screening of patients with migraine and patent foramen ovale (PFO). Methods A total of 128 migraine patients in the Third Affiliated Hospital of Wenzhou Medical University from September 2014 to September 2018 were enrolled, who were given c-TCD and transesophageal echocardiography(TEE). With TEE as the "gold standard" for PFO diagnosis, the positive rates of c-TCD and TEE were compared, and the positive predictive value, negative predictive value, sensitivity, specificity together with accuracy of c-TCD were calculated. Results There were no statistical differences in the positive rates between c-TCD and TEE(40.63% vs. 45.31%,χ2=0.574,P=0.449); the positive predictive rate of c-TCD was 96.15%, the negative predictive rate was 89.47%, the sensitivity was 86.21%, the specificity was 97.14%, the accuracy 92.19%, and the Kappa value was 0.841. Conclusion c-TCD is another effective method to diagnose patients with migraine and patent foramen ovale. c-TCD may be considered as an alternative to TEE when medical conditions are limited, or patients are reluctant to accept TEE.
Role of ultrasonography in diagnosis of muscle injury caused by exercise
WANG Hua, SHEN Hua-liang, CHEN Jia-jia, TAN Yan, LIU Xia-tian
2019, 17(4): 641-643. doi: 10.16766/j.cnki.issn.1674-4152.000756
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Objective To investigate the value of ultrasonography in the diagnosis of exercise-induced muscle injury and summary characteristics of ultrasound image for the diagnosis of muscle injury caused by exercise. Methods From February 2015 to February 2017, 112 cases of suspected exercise-induced muscle injury patients in our hospital were selected as the research objects. The ultrasonography was performed in all patients, and the final diagnosis was also combined with medical history, clinical manifestations, and biopsy by local tissue biopsy if necessary. With the final diagnosis as the standard, the accuracy rate of muscle injury detected by ultrasound was investigated, and the imaging features of muscle injury under ultrasound were discussed. Results A total of 112 cases were diagnosed as lower extremity muscle injury without tendon injury and myometrial injury, including 87 cases of gastrocnemius injury and 25 cases of extensor injury. The accuracy of ultrasound diagnosis was 91.96%, and the misdiagnosis rate was 8.04%. The diagnostic accuracy of ultrasound for simple muscle contusion, simple intramuscular hematoma, partial muscle rupture with hematoma and complete muscle rupture with hematoma were 91.11% (41/45), 92.68% (38/41), 93.33% (14/15) and 90.90% (10/11), respectively. Ultrasound imaging features of muscle injury include: for simple muscle contusion, there was mainly muscle swelling, increased thickness, and blurred pinnate enhanced echo; for muscle partial rupture combined with hematoma, there was mainly muscle partial rupture, and no echo hematoma around it; for the complete muscle rupture and hematoma, there were muscle continuity destruction, disruption and anechoic hematoma. Conclusion Ultrasound diagnosis of muscular injury caused by exercise has high accuracy. It is easy to operate, quickly to get results, and repeatable. It can be used as the first choice for clinical diagnosis of muscular injury caused by exercise.
Regulation and mechanism of CREB signaling pathway in nervous system diseases
ZHANG Dong-yun, JIN Wei-dong, LIU Hong-liang, FU Wei-ling, ZHANG Yang
2019, 17(4): 644-648. doi: 10.16766/j.cnki.issn.1674-4152.000757
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Nervous system diseases have become one of the main threats to human health due to the complexity of their pathogenesis, which has brought a heavy economic burden to society and patients themselves. So far, the etiology and pathogenesis of most neurological diseases have not been fully elucidated. Therefore, the study of neurological disease-related molecules is particularly important for the diagnosis and treatment of the diseases. CREB is a transcriptional transduction factor for intracellular cAMP changes, and its major function is to regulate gene transcription and protein synthesis. As an important nuclear regulatory factor, CREB regulates transcription through its own phosphorylation and dephosphorylation. At present, a large number of studies have shown that CREB has an important regulatory role in the nervous system such as synaptic plasticity, learning and memory, and early brain injury. The role of CREB in the nervous system is to terminate and meet many signaling pathways. The regulatory signal molecules and their target genes and CREB are involved in a variety of normal physiological activities, such as neural stem cell proliferation, cell cycle regulation, neuron-induced differentiation, and learning and memory. Therefore, CREB signaling pathway-related molecules has become a more concerned potential drug intervention target for neurological diseases. This article summarizes the structure of CREB and its transcription factor family, the regulating mechanism of CREB related signaling pathways, and its application in central nervous system diseases such as, memory disorders, epilepsy, cerebral ischemia-reperfusion injury and hemorrhagic cerebrovascular disease, alcohol addiction and Parkinson's disease. This review provides a new way to understand the pathogenesis of neurological diseases and the selection of clinical therapeutic targets.
Advances in imaging studies of wake-up stroke
ZOU Ning, YANG Wen-song, ZHU Dan
2019, 17(4): 649-652. doi: 10.16766/j.cnki.issn.1674-4152.000758
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Stroke has become an important disease that threatens our lives. It is well known that stroke is a preventable disease. Of course, there are more and more treatments for this disease. But stroke, particularly wake-up stroke seems to be limited in our current treatment, and we lack understanding of this type of stroke, and such clinical stroke, accounting for a large proportion. We only use anti platelet aggregation, stable plaques, and protection of the cranial nerve treatment. The development of clinical thrombolysis and intravascular therapy has provided a powerful solution for the treatment of stroke. However, due to insufficient knowledge of post-wake stroke, the treatment of post-wake stroke has been limited, so that we lack the active and effective means to alleviate or improve the symptoms and prognosis of patients. Combined with the existing imaging development, stroke thrombolysis and mechanical we collect the bolt may need to change the original views, as we understand further from the original time window of stroke transition to the window, it could also mean we can provide new insights through effective screening to stroke patients. We see the dawn, we see the challenges, and the future can have large samples, random, multicenter studies that provide more evidence for this type of stroke. The history of stroke is also the history of human progress. We constantly update knowledge, constantly breakthroughs; our ultimate aim is to bring benefit to our patients. Yet, the most important thing is to renew the idea, however, the patient should renew the idea, however our clinical workers also need to update the knowledge, and renew the idea. This requires us to constantly learn and constantly update our thinking. We used to focus on time, but with modern technology, especially imaging. The treatment of stroke is likely to transition from time window to tissue window, thanks to the development of imaging. The development of neuroimaging has provided a more powerful tool for stroke, and new keys have been opened for the treatment of post-resuscitation stroke, to study the relevant literature on stroke after awakening.
The Investigation of Clinical Efficacy and Safety on BupiYishen Prescription in Elderly Frailty Patients
HONG Xiu-fang, TANG Xiao-fang, ZHANG Xue-feng, SI Cai-juan
2019, 17(4): 653-656. doi: 10.16766/j.cnki.issn.1674-4152.000759
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Objective To investigate the effect and safety of frailty treatment with BupiYishen prescription in older frail patients aged over 65 years. Methods One hundred and twenty older frail patients (65-91 years old) were randomly divided into therapy group and control group with 60 of each. The control group was received only western medicine treatment. In addition to western medicine treatment, therapy group was received BupiYishen prescription, one agent per day. The agent was decocted with water for oral intake, and twice a day, 150 mL each time. Before and 12 weeks after treatment, scores of Fried frailty criteria, serum levels of nutrition-related proteins and clinical adverse reactions were observed. Results After treatment for 12 weeks,compared with control group (3.0±1.4), frailty scores of therapy group (2.6±1.2) decreased more significantly (P<0.05). In the therapy group, compared with levels of serum prealbumin [PA, (213.49±46.29) mg/L], albumin [ALB, (37.47±3.28) g/L] and retinol binding protein [RBP, (39.30±10.38) mg/L] before the treatment, 12 weeks after the treatment, levels of PA [(231.98±52.75) mg/L], ALB [(40.06 ±3.44) g/L], RBP [(44.39±15.56) mg/L] increased more significantly (P<0.05). No severe adverse reactions were found in both groups. Conclusion BupiYishen prescription can safely enhance clinical efficacy for the treatment of frailty. Results of the investigation may provide some reference to the prevention and treatment of frailty.
Application of rehabilitation program in elderly patients with obstructive sleep apnea hypopnea syndrome
JIANG Ru-ting, JIANG Yang
2019, 17(4): 657-660. doi: 10.16766/j.cnki.issn.1674-4152.000760
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Objective In this study, a self-made rehabilitation program was used in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyzed the results of application, in order to improve the treatment compliance and prognosis of patients. Methods A total of 106 patients with OSAHS who were treated in our hospital were selected from September 2016 to August 2018, and they were randomly divided into observation group (n=53) and control group (n=53) according to the random number table method. The patients in the control group received routine nursing, while the patients in the observation group received rehabilitation program. The sleep quality, daytime sleepiness and patient satisfaction were compared between the two groups. Results Before implementation, there was no significant difference in sleep quality index between the two groups (P>0.05), one month after implementation, the sleep quality score of the observation group was 6.68±2.31, and the sleep quality score of the control group was 12.65±3.57, the sleep quality indices of the two groups were significantly lower than those before implementation (P<0.05), and the sleep quality index of the observation group was significantly lower than that of the control group (P<0.05). Before implementation, there was no significant difference in daytime sleepiness score between the two groups (P>0.05), one month after implementation, the sleepiness score of the observation group was 8.56±2.12, and that of the control group was 15.74±2.54, the daytime sleepiness scores of the two groups were significantly lower than those before the implementation (all P<0.05), and the daytime sleepiness score of the observation group was significantly lower than that of the control group (P<0.05). The patient satisfaction of the observation group was 94.34% (n=50), while that of the control group was 73.58% (n=39), the patient satisfaction of the observation group was significantly higher than that of the control group (P<0.05). Conclusion Rehabilitation program has achieved good results in the application of elderly patients with OSAHS, it can effectively improve the sleep quality, reduce daytime sleepiness, and improve patient satisfaction, the program helped to improve patients' treatment compliance and prognosis.
Exploration of the construction of general medicine department under the close medical association
ZHANG Yu-cai, XIE Chun, XIANG Li-qiang, LIN Dan-na, XIAN Jun-fang, LUO Xin-le
2019, 17(4): 661-665. doi: 10.16766/j.cnki.issn.1674-4152.000761
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Objective To explore the orientation of general medicine department under the close medical association. Methods Through the comparative analysis of the development of general practice in China and the actual operation of general practice in five district hospitals in Shenzhen, the author explored the construction of general practice in organizational structure, functional orientation and discipline development under the mode of close medical association. Results The development of general medical science in China mainly depends on subject alliance, and the relationship between clinical base and practice base is established by teacher output and training. Under the model of close medical association, the development of general practice can be strongly promoted by administrative means, which is conducive to hierarchical medical treatment. In 2016, the person-times of basic medical services provided by community health institutions in Shenzhen accounted for 42.66% of the total outpatient and emergency treatment of public medical institutions in the city. A total of 8.63 million people, accounting for 70% percent of the total number of people in the city, participated in medical insurance for the first time in their communities. In terms of organizational structure, general medicine department of Shenzhen district hospitals mostly adopt the dual management mode, namely, they are managed by functional departments such as medical department in business and community health management center in administration. In terms of functional orientation, the discipline of general practice attaches importance to the teaching of general practitioners, and focuses on the cultivation of general practitioners, so as to provide qualified general practitioners at the primary medical institutions. General outpatient department is the main teaching place for general practice doctors. General inpatient department is suitable for patients with multiple diseases, undifferentiated diseases and teaching, which is conducive to the systematic learning for general practice doctors. Conclusion The model of close medical association is conducive to the advancement of hierarchical medical treatment. Under this model, the organizational structure of general practice can adopt dual management. Its function is positioned as general practitioners teaching, and its discipline development direction is to care for patients with multiple diseases.
Effect of lactulose combined with probiotics on intestinal microflora in elderly patients with severe pneumonia
CHEN Dan, QI Ying
2019, 17(4): 666-669. doi: 10.16766/j.cnki.issn.1674-4152.000762
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Objective To study the effects of lactulose combined with probiotics on Intestinal Microecology in elderly patients with severe pneumonia. Methods One hundred and twenty elderly patients with severe pneumonia admitted to Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2016 to January 2018 were divided into lactulose intervention group and combined intervention group. The lactulose intervention group was treated with Duphalac, and the combined intervention group was treated with BIFICO and Duphalac. Ke was treated with combination therapy. After one month of treatment, the changes of intestinal microecology, intestinal barrier function, white blood cell count and C-reactive protein expression were detected. The clinical indicators, total effective rate, pulmonary infection score and adverse reactions were observed and counted. Results The levels of lactobacillus, enterococcus, Enterobacter and digestive Streptococcus in the combined intervention group were significantly lower than those in the lactulose intervention group, and the levels of Bifidobacterium were higher than those in the lactulose intervention group (all P<0.05). The levels of diamine oxidase (DAO) and blood D-lactic acid in the combined intervention group were significantly lower than those in the lactulose intervention group (all P<0.05). WBC and CRP expression levels were significantly lower in the combined intervention group than in the lactulose intervention group (all P<0.05); the clinical observation indexes in the combined intervention group were better than those in the lactulose intervention group (all P<0.05); the pulmonary infection score in the combined intervention group was significantly lower than that in the lactulose intervention group (all P<0.05); and the total number of patients in the combined intervention group was significantly lower than that in the lactulose intervention group (P<0.05). The effective rate was significantly higher than that of lactulose intervention group,and the incidence of adverse reactions was significantly lower than that of lactulose intervention group (all P<0.05). Conclusion Lactofructose combined with probiotics can effectively improve the intestinal microenvironment and clinical symptoms of elderly patients with severe pneumonia, reduce the damage caused by antibiotics, and improve the quality of life of patients.
Applications of Evidence-based Nursing and Forecasting Nursing in Emergency Treatment of Upper Gastrointestinal Bleeding：a system review and Meta-analysis
TONG Gui-quan, LI Ying, LIU Rui, YUAN Xue-hua, WANG Ai-ying, LIU Qian, SUN Hai-yang
2019, 17(4): 670-673. doi: 10.16766/j.cnki.issn.1674-4152.000763
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Objective Meta-analysis was used to evaluate the application of evidence-based nursing and the forecasting nursing in first aid for upper gastrointestinal bleeding. Methods The search databases included: China Knowledge Network, Wanfang Data, Weipu, China Biomedical Database, PubMed, MEDLINE, Cochrane and Embase, etc. We formulated searching key words and strategies. Literature quality assessment was performed using The Newcastle-Ottawa Scale (NOS). Data processing was conducted on RevMan 5.3 software, drawing a forest map. The effect index used RR value and 95%CI, and the heterogeneity test index was I2 and P value. Sensitivity testing was performed and the results of the publication bias were evaluated using the Egger's method on the Stata 12.0 software. Results Compared with the predictive nursing group, Z=3.04 (P=0.002) and RR (95%CI): 1.05 (1.02, 1.08) in the evidence-based nursing group showed statistical significance (P<0.05). As for sensitivity analysis, after changing the effect model, eliminating low-quality literature, and eliminating case-control studies, the results were still statistically significant (P<0.05). As for the publication bias evaluation, t=0.97, P=0.343, 95%CI: (-0.62, 1.70) indicated no statistical significance (P>0.05). Conclusion Evidence-based nursing has a better effect on the hemorrhage of upper digestive tract than forecasting nursing, and it is worthy of clinical application.
Application effect of multidisciplinary cooperation process management in emergency critical care patients in hospital transportation
WANG Fang, GU Ji-fang, LIU Qing-fen, JIA Ru, LIU Jian-ren
2019, 17(4): 674-677. doi: 10.16766/j.cnki.issn.1674-4152.000764
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Objective To analyze the effect of multidisciplinary collaborative process management on hospital transport of critical patients in emergency department. Methods Three hundred and eighty patients in emergency department from January 2017 to December 2017 were randomly divided into the control group and the observation group, 190 patients in each group. The observation group was managed in-hospital transport by using multidisciplinary process management. The process management included the establishment of in-hospital transport group for critical patients in emergency department, and multidisciplinary joint development of transport flow chart. The control group was transported by emergency routine procedure. The changes of nursing defect rate and satisfaction degree of family members were compared between the two groups. Results Multidisciplinary collaborative process management led to the transfer of critical patients from single operation to multi-disciplinary collaboration. Nursing deficiencies were compared between the two groups. This study showed that the incidence of accidental extubation was reduced from 4.2% to 1.9%; the incidence of missing items was decreased from 4.7% to 1.6%; the incidence of transfusion tube shedding or obstruction was reduced from 5.3% to 1.1%; MEWS score rate was from 4.7% to 1.1%. The incidence of adverse events in the two groups was significantly lower than that in the control group, the difference was statistically significant (P<0.001). The satisfaction degree of the observation group was significantly higher than that of the control group (P<0.001). Conclusion The application of multi-disciplinary cooperative process management embodies the advantages of two-way or multi-disciplinary cooperation, makes the hospital transfer process more streamlined and systematic, ensures the safety and efficiency of critical patients in the process of transport, promotes the improvement of transport quality and improves the satisfaction of patients' family members.
Effect of comprehensive guided nursing on skin injury and quality of life of patients with breast cancer treated by radiotherapy
WU Jie, JIN Yun-yu, DONG Li-hua
2019, 17(4): 678-681. doi: 10.16766/j.cnki.issn.1674-4152.000765
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Objective To study the effect of comprehensive guided nursing on nursing quality of breast cancer radiotherapy patients. Methods Total 150 cases of patients with breast cancer treated by radiotherapy were selected in our hospital from April 2015 April 2017. The patients were divided into the routine nursing and comprehensive guide nursing groups with digital method of random. The skin damage symptom score, mental state (using self-rating anxiety scale, SAS; self-rating depression scale, SDS), and life quality (using health status survey summary table, SF-36) on the patients in two groups were compared before and after intervention. Finally, the nursing satisfaction on the patients in two groups was calculated. Results There was no statistically significant difference in the skin injury degree symptom scores between the two groups before the nursing intervention (all P>0.05), and the skin injury degree symptom score of the comprehensive guidance nursing group after the nursing intervention was significantly lower than that of the conventional nursing group (all P<0.05). The SAS and SDS scores of patients in the two groups after nursing were significantly lower than those before nursing, and the SAS and SDS scores of patients in the comprehensive guidance nursing group after nursing were significantly lower than those in the conventional nursing group after nursing (all P<0.05). The quality of life scores of patients in both groups after nursing were higher than those before nursing, and the quality of life scores of patients in the comprehensive guidance nursing group after nursing intervention were significantly higher than those in the conventional nursing group (P<0.05). The overall satisfaction of patients in the comprehensive guidance nursing group was significantly higher than that in the conventional nursing group (P<0.05). Conclusion Comprehensive guidance nursing can reduce the degree of skin damage of breast cancer patients after radiotherapy, improve their psychological state and quality of life, and improve their nursing satisfaction.
Study on the effect of optimizing emergency nursing procedure on emergency treatment of patients with acute cerebral infarction
LIANG Zhong-qin, WU Yue-feng
2019, 17(4): 682-685. doi: 10.16766/j.cnki.issn.1674-4152.000766
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Objective To explore the effect of optimizing emergency nursing process on neurological deficit and daily living ability in patients with acute cerebral infarction (ACI). Methods Totally 88 patients with ACI who were diagnosed and treated in Shaoxing people's hospital from January 2017 to June 2018 were selected and divided into observation group and control group with 44 cases in each group. The control group was treated with routine emergency nursing procedure, and the observation group was treated with optimizing emergency nursing process. Record and compare the times of doctor arrival, door to CT examination, door to CT report and door to needle (DTN) between the two groups. Compare the National Institutes of Health Stroke scale (NIHSS) score and Barthel index (BI) before and 24 hours after thrombolytic therapy between the two groups. Compare the first aid success rate, mortality rate and disability rate between the two groups. Results The times of doctor arrival, door to CT examination, door to CT report and DTN in the observation group were significantly shorter than those in the control group (all P<0.05). Before thrombolytic therapy, there was no significant difference in NIHSS score and BI between the two groups (all P>0.05). The NIHSS score of the observation group was significantly lower than that of the control group 24 hours after thrombolysis (P<0.05), and the BI of the observation group was significantly higher than that of the control group 24 hours after thrombolysis (P<0.05). The success rate of first aid in the observation group was 81.82%,which was significantly higher than 59.09% in the control group (P<0.05), but there was no significant difference in mortality rate and disability rate between the two groups (all P>0.05). Conclusion The optimization emergency nursing process can shorten the time of first aid to ACI patients, improve the success rate of emergency treatment, and improve the neurological deficit and daily living ability of patients.
Intervention effect of holistic nursing intervention based on nursing procedure on patients with thoracolumbar spine fracture after internal fixation
CHENG Xia, WANG Cui-juan, WU Dan, WANG Wan-li, PAN Hao
2019, 17(4): 686-689. doi: 10.16766/j.cnki.issn.1674-4152.000767
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Objective To investigate the effect of holistic nursing on thoracolumbar spine fracture patients after internal fixation based on nursing procedure. Methods A total of 106 patients from January 2015 to December 2017 with traumatic thoracolumbar spine fractures were enrolled as observation objects. According to the random number table method, the patients were accepted with routine nursing (control group, 53 cases) or holistic nursing based on nursing procedure (observation group, 53 cases) after operation respectively. To investigate the healing of incision, the rate of excellent and good treatment, drainage (drainage volume and drainage time), the incidence of complications after operation, and the related indicators after operation (average hospitalization time, fracture healing time, muscle strength recovery time). Results There was significant difference in the time of drainage tube extraction between the two groups (t=4.480, P<0.05). Two weeks after operation, the incisions of both groups were healed. The excellent and good rate was 94.34%(50/53) in the observation group and 81.13%(43/53) in the control group. There was significant difference between the two groups(χ2=4.140, P<0.05). The average hospital stay in the observation group (15.35±2.28 days) was significantly less than that in the control group (23.74±3.60)days, (t=14.334, P<0.05).The complete healing time (8.34 ±1.27)months and muscle strength recovery time (13.05±2.29)months in the observation group were significantly better than those in the control group [(5.12±0.16)months, (3.75±0.43)months], all P<0.05. The incidence of postoperative complications in the observation group was 1.89% (1/53), significantly lower than that in the control group (13.21%, 7/53, χ2= 5.740, P=0.017). Conclusion The holistic nursing intervention based on nursing procedure can effectively guarantee the effect of operation, reduce the incidence of postoperative complications, shorten the hospitalization time of patients with spinal fracture after internal fixation, and promote faster recovery of patients.
Application of continuity nursing in targeted treatment of HER2 positive gastric cancer patients and the impact on quality of life
ZHU Wei-zhen, XIE Yan-ru, WU Long-ying
2019, 17(4): 690-692,701. doi: 10.16766/j.cnki.issn.1674-4152.000768
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Objective To explore the effect of continuous nursing on the quality of life of patients with human epidermal growth factor receptor 2 (HER2) positive gastric cancer after targeted therapy. Methods A total of 140 patients with HER2-positive gastric cancer who were treated with trastuzumab in our hospital from January 2016 to January 2017 were selected. All patients were randomly divided into continuous nursing group and conventional nursing group, 70 cases in each group. Conventional nursing group used routine nursing measures for nursing, while continuing nursing group used continuing nursing on the basis of routine nursing. The quality of life, depression, anxiety and self-perceived burden of the two groups before and after nursing were evaluated, and the hospitalization time and patients' satisfaction were compared between the two groups. Results After nursing, the scores of quality of life in the two groups were higher than those before nursing, and those in the continuing nursing group were higher than those in the conventional nursing group (all P<0.05); after nursing, the scores of HAMD and HAMA in the two groups were lower than those before nursing, and the scores of HAMD and HAMA in the continuing nursing group after nursing were lower than those in the conventional nursing group (all P<0.05); after nursing, the scores of SPB in the two groups were lower than those in the conventional nursing group and the SPB scores of continuing nursing group were lower than those of routine nursing group (all P<0.05). The length of stay in continuing nursing group was lower than that of routine nursing group (P<0.05), and the total satisfaction of nursing patients in continuing nursing group was higher than that of routine nursing group (P<0.05). Conclusion Continuous nursing intervention after targeted therapy for HER2-positive gastric cancer patients can effectively improve the quality of life of patients, reduce the burden of self-perception, and make patients more satisfied.
Application effect of crisis management mode combined with traditional trauma emergency care on patients with emergency craniocerebral trauma
CHEN Mei-fang, WU Yue-feng, HUANG Chun-hua
2019, 17(4): 693-695. doi: 10.16766/j.cnki.issn.1674-4152.000769
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Objective To explore the application effect of crisis management mode combined with traditional trauma emergency care on patients with emergency craniocerebral injury. Methods Ninety patients with emergency craniocerebral trauma admitted from February 2017 to September 2018 were randomly divided into observation group and control group, with 45 cases in each group. The patients in the control group were treated with traditional trauma emergency care, and the patients in the observation group were combined with the crisis management model based on the control group. Complication rate, incidence of adverse events during nursing, neurological function (stroke scale, NIHSS score) and coma degree (Glasgow coma index, GCS score) were compared between the two groups. Results There were no serious complications (cerebral hernia) in both groups. The total incidence of complications including limb dysfunction, swallowing dysfunction, pulmonary infection and electrolyte disturbance in the observation group was 4.4%(2/45), which was lower than that in the control group (17.8%, 8/45), P<0.05. The incidence of crisis events in the observation group was 8.9% lower than that in the control group (24.4%, P<0.05); there was no significant difference in NIHSS score and GCS score between the two groups before nursing intervention (P>0.05). After nursing, the NIHSS score of the patients in the observation group was significantly lower than that of the control group, and the GCS score of the patients in the observation group was higher than that of the control group(P<0.05). Conclusion Crisis management mode combined with traditional trauma first aid nursing is conducive to improving the first aid efficiency of emergency patients with craniocerebral injury, reducing the occurrence of complications, and improving patients' nervous function, and reducing the incidence of adverse events during nursing, which is worthy of clinical application.
Application effect of integrated nursing intervention on postoperative patients with thoracolumbar fracture
CHEN Xue-feng, LIN Li-guo, ZHENG Sang, LI Lei
2019, 17(4): 696-698. doi: 10.16766/j.cnki.issn.1674-4152.000770
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Objective To investigate the effect of integrated nursing intervention on postoperative patients with thoracolumbar fractures. Methods A total of 110 patients with thoracolumbar fractures treated with pedicle screw internal fixation from May 2017 to October 2018 were selected as the study subjects. According to the random number table method, they were divided into observation group and control group, with 55 cases in each group. The control group was treated with conventional nursing method, and the observation group was treated with integrated nursing intervention on the basis of the control group. The effect of functional recovery (excellent rate of lumbar and dorsal muscle function recovery), pain degree score (VAS score), mental state score (SAS, SDS score) before and after nursing intervention, and complications during hospitalization were compared between the two groups. Results The excellent and good recovery rate of lumbar muscle function in the observation group was 92.7% (51/55), which was significantly higher than that in the control group (78.2%,43/55), P<0.05. Before nursing intervention, there was no significant difference in pain score and mental state score between the two groups(P>0.05); after nursing intervention, the VAS score of the observation group was significantly lower than that of the control group (P<0.05); after nursing intervention, the SAS score and SDS score of the observation group were lower than those of the control group (P<0.05); during the nursing intervention, the observation group was concurrent. The total incidence was 25.5%(14/55), which was lower than 45.5% (25/55) of the control group(P<0.05). Conclusion Holistic nursing intervention can significantly improve the postoperative functional recovery of patients with thoracolumbar fractures, reduce the pain of patients, alleviate the bad mood of patients and reduce the incidence of complications, which is worthy of clinical application.
2019, 17(4): 699-701. doi: 10.16766/j.cnki.issn.1674-4152.000771
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2019, 17(4): 702-704. doi: 10.16766/j.cnki.issn.1674-4152.000772
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