2020 Vol. 18, No. 5

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Strategic thinking on the development of general medicine based on the traditional Chinese medicine theory system
PANG Li-jian, LU:Xiao-dong, WANG Ming-jun, ZHANG Yao-yi, SHI Yan-nan, WANG Lin-lin
2020, 18(5): 705-709. doi: 10.16766/j.cnki.issn.1674-4152.001335
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With the continuous development of medical research and science technology, the division of medicine has been gradually refined, and some advanced medical diagnosis and treatment equipment emerges at the right moment. Although these measures bring convenience to the diagnosis and treatment of diseases, they ignore the examination and adjustment of the overall state of patients. This kind of specialized treatment for specialized diseases cannot achieve both physical and mental health of patients at the same time, and the high price of medical equipment adds to the economic burden of patient. As a comprehensive clinical medicine discipline, general medicine integrates clinical medicine, preventive medicine, rehabilitation medicine, humanities and social sciences and other related contents. Its purpose of providing "simple, effective and inexpensive" medical services for individuals, families and communities has been paid more and more attention. As a treasure of Chinese traditional culture, Chinese medicine has many similarities with general medicine in its formation and development. The formation background, core connotation and status of the theoretical system of TCM are the basic conditions, core motivation and guarantee for the development of general medicine in the soil of China. It plays an important role in promoting the development of general medicine system. The theory of traditional Chinese medicine can be combined with the modern scientific thought of western medicine to establish a new medical thinking mode of general medicine with traditional Chinese thinking. For this reason, this paper proposes to take the theory of traditional Chinese medicine as the guide, combine the advantages of the development of modern medicine, and take the development law of the theoretical system of traditional Chinese medicine as the example. Through the analogy, dialectical view of the development of general medicine, to build a suitable for our country's general medicine road, further promote the scientific and orderly development of general medicine.
HOU Chuan-yun, LI Zhi-jun
2020, 18(5): 710-711.
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A novel sirt1 receptor agonist SRT2104 inhibits the proliferation of the damaged intima
WEI Huan, JIANG Xuan, GU Tian-xiang
2020, 18(5): 712-716. doi: 10.16766/j.cnki.issn.1674-4152.001336
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Objective To investigate the microstructure of different voltage electrospinning outer sheath and discuss the inhibitory effect of SRT2104 biodegradable outer sheath on intima proliferation of vein bridge. Methods Two voltage ranges of 5-8 kV and 12-15 kV were selected to construct the outer sheath of PLGA and observe the microstructure. Thirty New Zealand white rabbits were randomly divided into control group, non-drug loading vascular sheath group and SRT2104 group. Seven days after the operation, 4 subjects in each group were randomized to compare the results of ki-67 fluorescence staining. The remaining 6 subjects were measured immediately after the operation, 1 week and 8 weeks, and the rate of change was compared. The intimal thickness and the ratio of intimal media in each group were compared 8 weeks after surgery. Results Under electron microscope, the 5-8 kV spinning was rough and broken, and the 12-15 kV spinning was smooth and continuous. The rate of inner diameter change in SRT2104 group decreased significantly(all P<0.01) 1 and 8 weeks after surgery. The rate of change of SRT2104 group 8 weeks after surgery was also much lower than that of the non-drug carrier group(P<0.05). The change rate of peak blood flow in SRT2104 group 1 week after surgery did not change significantly(P<0.05), and the trend was the same 8 weeks after surgery(P<0.01 vs. control group; P<0.05 vs. non-drug carrier sheath group), the change rate of peak blood flow in the non-drug loading sheath group was lower than that in the control group(P<0.05). HE staining at 8 weeks after surgery showed that the film thickness of SRT2104 group decreased significantly(all P<0.01). Intima-media ratio was significantly smaller(P<0.01 vs. control group; P<0.05 vs. non-drug loading sheath). Compared with the control group, the non-drug carrier sheath group decreased significantly(P<0.01). Conclusion Spinning under 12-15 kV voltage has a good microstructure, and the SRT2104-loaded outer sheath can inhibit the intimal proliferation of vein Bridges.
Analysis of clinical and laboratory characteristics of ocular damage in patients with Behcet's syndrome
CAO Sai-xia, LI Yu-hui, YANG Shu-yan, JIA Yuan
2020, 18(5): 717-719,738. doi: 10.16766/j.cnki.issn.1674-4152.001337
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Objective To understand the clinical and laboratory characteristics of ocular damage in patients with Behcet' s syndrome. Methods The patients admitted to the Department of Rheumatology and Immunology of Peking University People's Hospital from May 2008 to May 2018 were collected to analyze the features of ocular damage and the relationship with other systemic involvement and laboratory indicators. Results Among 101 patients, 35(34.6%) had ocular damage, among which uveitis was the most common(22/35, 62%), followed by cataract(6/35, 17%), conjunctivitis(12%) and keratitis(3/35, 9%). Compared with the group without ocular damage, ocular damage occurred more in men(all P<0.05), and the incidence of heart valve disease and aneurysms was lower(P<0.05). There was no significant difference between the two groups in mucocutaneous, skin, gastrointestinal, nervous system, joint involvement and thrombosis(all P<0.05). The positive rate of anti-endothelial cell antibody(AECA) was lower in the patients with ocular damage group(P<0.05).There was no significant difference between the two groups in increasing of IgG, d-dimmer, ESR, CRP, decreasing of complement, and positive rate of anti-phospholipid antibody(all P<0.05). Conclusion The incidence of ocular damage in patients with Behcet's syndrome is higher in male than female. Among ocular damage, uveitis is most common. Ocular damage is negatively correlated with valvular heart disease and aneurysm, the positive rate of AECA is lower in the patients with ocular damage than those without. Glucocorticoid, immunosuppressants and biological agents can get better results.
Study on the association between rheumatoid arthritis autoantibodies and interstitial lung disease
MEI Yong-jun, FEI Yan-fang, WANG Jian, PAN Hai-feng, LI Zhi-jun
2020, 18(5): 720-722. doi: 10.16766/j.cnki.issn.1674-4152.001338
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Objective To explore the potential association between serum autoantibodies in patients with rheumatoid arthritis(RA) and RA complicated with interstitial lung disease(ILD). Methods Total 856 RA patients hospitalized in the Rheumatology and Immunology Department of the First Affiliated Hospital of Bengbu Medical College from 2015 to 2018 were retrospectively analyzed, 152 patients with secondary Sjogren's syndrome(SS) of whom were divided into another group for observation. Anti cyclic citrullinated peptide antibody(anti-CCP2) and rheumatoid factor(RF) in patients' serum were quantitatively detected. Anti-SSA/Ro52, anti-SSA/Ro60 and anti-SSB antibodies were qualitatively detected to evaluate the potential risks of these autoantibodies and ILD complicated by RA patients. Results The incidence of ILD in RA and RA secondary SS was 19.89% and 24.34%, respectively. There was no significant difference in the incidence of ILD between the groups(χ2=1.511, P=0.219). Compared with RA patients without ILD, RA patients with ILD were older, had a longer course of disease, higher anti-CCP2 antibody levels, and higher RF titers, and The differences between the two groups were statistically significant(all P<0.05). Binary logistic regression analysis of age, course of disease, and risk of multiple autoantibodies and ILD in all RA patients showed that whether RA patients had secondary SS, age, course of disease, and anti-CCP2 antibodies were significantly related to the incidence of ILD(all P<0.05). Conclusion Anti-CCP2 positive in serum of RA patients is associated with concurrent ILD. Anti-SSA/Ro60, anti-SSA/Ro52 and anti-SSB antibodies in serum of RA patients with secondary SS are not related to the onset of ILD.
Clinical effect analysis on different using methods of Cocktail compound liquid in total knee replacement under enhanced recovery after surgery mode
GUO Dong-sheng, LIU Yu-bo, CHEN Guang-xiang, SHEN Jun, SHANG Ning-er, ZHANG Xiang-xin, WANG Dong-lai
2020, 18(5): 723-726,838. doi: 10.16766/j.cnki.issn.1674-4152.001339
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Objective To study the clinical effects and safety of different applications of cocktail treatment in total knee replacement under enhanced recovery after surgery(ERAS) mode. Methods Total 120 cases of total knee replacement during June 2016 to June 2018 in the Department of Joint Surgery of the Affiliated Suzhou Hospital of Nanjing Medical University were included. Patients were randomly divided into three groups:group A(total complex liquids of cocktail were infused and injected to the surroundings of the knees), group B(the cocktail was injected to the knee cavities), and group C(one part of the complex liquids of cocktail was infused and injected to the surroundings of knees, and the other part was injected to the knee cavities). Age, gender, BMI and other related indicators were observed and compared. Results In 6 hours, 8 hours, 12 hours, 24 hours postoperative VAS assessment, group B had the highest score and group C had the lowest score, the difference had statistical significance(all P<0.05). In 48 hours, 72 hours postoperative VAS assessment, the difference had no statistical significance(all P>0.05). In postoperative relief analgesic rate during 24 hours, group B had the highest score and group C had the lowest score(P<0.05). In the postoperative maximal decreased value of hemoglobin, group C had the lowest score and group B had the highest score(P<0.05). In the volume of drainage during 24 hours after surgery, group C had the lowest volume, group B had the highest volume(P<0.05). The patients in group C could have functional exercise in a larger scale(P<0.05). Compared with the other two groups, group C had a higher 3 days postoperative HSS assessment(P<0.05). There was no significant difference in the other indicators(all P>0.05). Conclusion The method of local infiltration combined with intraarticular injection of cocktail compound liquid in total knee arthroplasty under ERAS mode can effectively reduce patients' pain and blood loss after operation, which is safe and beneficial to patients' postoperative recovery.
The effect of Vitapex on pulp revascularization in immature permanent teeth
WANG Xiao-li, XU Li, ZHANG Rong-xiu, LIAO Sheng-kai
2020, 18(5): 727-729,756. doi: 10.16766/j.cnki.issn.1674-4152.001340
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Objective To compare the clinical efficacy of Vitapex and triple antibiotic paste(TAP) as root canal disinfectant in pulp revascularization. Methods From January to July 2017, 40 young patients with pulp necrosis or periapical periodontitis in the Department of Dental Pulp, the First Affiliated Hospital of Bengbu Medical College were randomly divided into experimental group(n=20) and control group(n=20). PRF(platelet-richfibrin) enhanced pulp revascularization was performed in both patients. The root canals were disinfected with Vitapex paste in the experimental group and TAP in the control group. The clinical symptoms and fillings were observed at 3 months, 6 months, 9 months and 12 months after operation. Apical films were taken to observe the root development of the affected teeth and measure the root canal length and root canal wall thickness. The clinical effective rate, root canal length, root canal wall thickness and tooth discoloration rate were compared between the two groups. Results The total clinical effective rate was 90.0% in the experimental group and 85.0% in the control group(P>0.05). The root length of the experimental group was(8.74±0.24) mm before treatment and(9.12±0.18) mm after treatment, while that of the control group was(8.81±0.21) mm and(9.21±0.24) mm respectively, with no significant difference between the two groups(P>0.05). The thickness of root canal wall in the experimental group was(2.12±0.32) mm before treatment and(2.66±0.24) mm after treatment, while that in the control group was(2.15±0.28) mm before treatment and(2.71±0.28) mm after treatment, with no significant difference between the two groups(all P>0.05). The tooth discoloration rate was 25.0% in the experimental group and 100.0% in the control group(P<0.05). Conclusion Vitapex and TAP can achieve the same disinfection effect in pulp revascularization of immature permanent teeth, but Vitapex as root canal disinfectant can effectively reduce the discoloration rate of affected teeth.
The application of cone beam CT in the diagnosis of vertical root fracture with different depth of periodontal pocket
CHEN Xing, CHEN Chong-chong, HUANG Zheng, ZHONG Liang-jun
2020, 18(5): 730-733. doi: 10.16766/j.cnki.issn.1674-4152.001341
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Objective To evaluate the role of cone beam computed tomography(CBCT) in clinical diagnosis of vertical root fracture(VRF). Methods A total of 99 suspected VRF teeth were included from 95 patients who visited the Department of Stomatology, Affiliated Hospital of Hangzhou Normal University from August 2016 to August 2019. Both digital periapical radiographs and CBCT were performed respectively. Two experienced periodontists independently analyzed each tooth and reached a consensus diagnose. The gold standard for the diagnosis of VRF is the crack observed directly in the treatment of teeth. The positive rate, specificity, accuracy and sensitivity of CBCT and X-ray apical radiography were statistically analyzed, and the influence of deep periodontal pocket(probing depth ≥ 5 mm) on the diagnosis result of CBCT was analyzed. Results In the 99 suspected VRF teeth, 84 teeth were eventually diagnosed with VRF. The positive rate, sensitivity and accuracy of CBCT in diagnosing VRF were 75.8%, 89.3% and 90.9% respectively, which were significantly different from digital periapical radiographs(41.4%, 48.8% and 54.5%, respectively, all P<0.001). In the deep periodontal pocket group(probing depth ≥ 5 mm), the positive rate and sensitivity of using CBCT for diagnosis of VRF were 81.7% and 93.5%, which were different from the non-deep periodontal pocket group(probing depth ≤ 4 mm, all P<0.05), but there was no statistical difference in accuracy and specificity. Conclusion CBCT is superior to digital periapical radiographs in the diagnosis of VRF, and the presence or absence of deep periodontal pocket will affect the positive rate and sensitivity. In future, CBCT is firstly recommended in the diagnosis of suspected VRF, especially combining the clinical sign of deep periodontal pocket.
Study on the expressions of MDC and IL-17A in peripheral blood of patients with severe ulcerative colitis and prognosis
CHEN Yi, JIA Jie, ZHENG Juan-hong
2020, 18(5): 734-738. doi: 10.16766/j.cnki.issn.1674-4152.001342
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Objective To investigate the changes of myeloid dendritic cells(MDC) ratio and interleukin-17 A(IL-17 A) expression in peripheral blood mononuclear cells(PBMC) of patients with severe active ulcerative colitis(UC), and to analyze their relationship with prognosis. Methods Total 90 patients with severe active UC from January 2016 to March 2019 in the Wenzhou Integrated Traditional Chinese and Western Medicine Hospital were divided into good prognosis group(n=49) and poor prognosis group(n=41). MDC in PBMC was detected by flow cytometry, and IL-17 A expression in plasma was detected by enzyme-linked immunosorbent assay(ELISA). Results After treatment, the proportion of MDC in PBMC and the expression of IL-17 A in plasma of the two groups were significantly lower than those before treatment(P ≤ 0.001). The proportion of MDC in PBMC of patients with good prognosis before and after treatment was(0.48±0.15)%,(0.29±0.09)%, which were significantly lower than those of patients with poor prognosis(0.56±0.17)%,(0.44±0.13)%(all P<0.05). The levels of IL-17 A in plasma were(12.97±4.24) ng/L,(9.05±2.96) ng/L, which were significantly lower than those in the poor prognosis group(16.02±5.13) ng/L,(11.88±3.90) ng/L(all P<0.05). The proportion of MDC in PBMC was positively correlated with the level of plasma IL-17 A expression in patients with severe active UC(r=0.692, P<0.001). Diarrhea(≥ 10 times per day) at admission, MDC ratio and IL-17 A were independent risk factors for adverse prognosis of UC patients in severe active stage after treatment(all P<0.05). The AUC of MDC ratio in PBMC combined with plasma IL-17 A expression predicting the adverse prognosis of severe UC patients in active stage was 0.943, the prediction effect was better than single detection. Conclusion Increased MDC ratio and plasma IL-17 A expression in PBMC can be used as potential markers for evaluating the adverse prognosis of severe UC patients in active stage.
Expression of LncRNA TapSAKI in serum of patients with renal calculi and its relationship with prognosis
CAI Ying, CHEN Sheng, XU Yong
2020, 18(5): 739-742. doi: 10.16766/j.cnki.issn.1674-4152.001343
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Objective To explore the expression level of long non-coding RNA(LncRNA) TapSAKI in serum and its relationship with prognosis of patients with renal calculi. Methods Total 144 patients with renal calculi were selected as renal calculi group from January 2017 to June 2019, and 148 healthy people were selected as normal group at the same period. The level of serum LncRNA TapSAKI was detected by real-time fluorescence quantitative PCR(qRT-PCR), the levels of monocyte chemoattractant protein-1(MCP-1), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) were measured by enzyme-linked immunosorbent assay(ELISA). The prognosis of patients with renal calculi undergoing percutaneous nephrolithotripsy was analyzed. The serum levels of LncRNA TapSAKI, MCP-1, IL-6 and TNF-α in two groups with different prognosis were compared. The correlations between level of serum LncRNA TapSAKI and the levels of MCP-1, IL-6, TNF-α in patients with renal calculi were analyzed. The influencing factors of prognosis of renal calculi were analyzed. SPSS 22.0 statistical software was used for analysis. Results The levels of serum LncRNA TapSAKI, MCP-1, IL-6 and TNF-α in renal calculi group were significantly higher than those in normal group(all P<0.05). The incidence of adverse complications was 23.6%(34/144). The levels of serum LncRNA TapSAKI, MCP-1, IL-6 and TNF-α in poor prognosis group were significantly higher than those in the normal group(all P<0.05). The serum LncRNA TapSAKI was positively correlated with MCP-1, IL-6 and TNF-α levels in patients with renal calculi(all P<0.05). The LncRNA TapSAKI, MCP-1, IL-6 and TNF-α were risk factors for poor prognosis in patients with renal calculi(all P<0.05). Conclusion LncRNA TapSAKI is highly expressed in the serum of patients with renal calculi, high level of LncRNA TapSAKI may be a poor prognostic factor for patients with renal calculi, and can be used as a reference index for evaluating the prognosis of renal calculi.
Clinical observation of the treatment of malignant pleural effusion of lung adenocarcinoma by intravenous chemotherapy with Aidi injection and cisplatin pleural perfusion combined with pemetrexed disodium
LI Yu, QIAN Chao-xia, FANG Chen, CHEN Yong, WU Wei-li, LI Dian-ming
2020, 18(5): 743-745. doi: 10.16766/j.cnki.issn.1674-4152.001344
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Objective To explore the clinical effect of Aidi injection and cisplatin pleural perfusion combined with pemetrexed disodium in the treatment of lung adenocarcinoma with malignant pleural effusion. Methods Total 68 cases of lung adenocarcinoma with malignant pleural effusion admitted to the Respiratory Department of the Third People's Hospital of Bengbu City from June 2018 to April 2019 were randomly divided into observation group(34 cases) and control group(34 cases). After B-ultrasound exploration and positioning, all patients were placed into the central venous catheter, and then the pleural effusion was detected by B-ultrasound after intermittent drainage. After the pleural effusion was fully drained, the pleural perfusion was performed. On the basis of intravenous application of pemetrexed disodium, the patients in the observation group were given Aidi injection and cisplatin chest perfusion, while those in the control group were given cisplatin chest perfusion. Cisplatin(50 mg/m2) was infused into the thorax 2-3 times a cycle, Aidi injection was given 50 mL each time, twice a week. One month after the end of four cycles of chemotherapy, the clinical efficacy was evaluated by the WHO standard for the efficacy of malignant pleural effusion, the quality of life was evaluated according to the physical KPS score, and the incidence of drug toxicity was evaluated according to the WHO standard for the toxicity and side effects of anticancer drugs. Results In the clinical efficacy, the total effective rate of the observation group(82.35%) was better than that of the control group(58.82%), P=0.033. In the quality of life, the total effective rate of KPS score of the observation group(88.24%) was better than that of the control group(64.71%), P=0.022. In terms of side effects, the incidence of asthenia(P=0.004) and class Ⅲ-Ⅳ side effects(P=0.031) in the observation group was significantly lower than that in the control group. In terms of myelosuppression, liver and kidney function damage, fever, gastrointestinal reactions, there was no significant difference between the two groups(all P>0.05). Conclusion On the basis of cisplatin combined with pemetrexed disodium in the treatment of pleural effusion of lung adenocarcinoma, the use of Aidi injection can improve the clinical effect, reduce the incidence of serious side effects, improve the physical strength and improve the quality of life.
Clinical study on influencing factors of early cognitive dysfunction in critically ill patients after ICU
YAN Xiu-xia, HAN Ruo-dong, YUE Ya-jie, SONG Ke-yi
2020, 18(5): 746-748,825. doi: 10.16766/j.cnki.issn.1674-4152.001345
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Objective To explore the influencing factors of early cognitive dysfunction in critically ill patients after ICU. Methods Total 165 critically ill patients discharged or transferred out of Bozhou people's hospital after receiving treatment in ICU from January 2014 to December 2019 were selected. They were divided into group A(no cognitive dysfunction, 135 cases) and group B(cognitive dysfunction, 30 cases) according to whether there was cognitive dysfunction. The basic data of the two groups were collected. The influencing factors of early cognitive impairment in post-intensive care patients were analyzed by multivariate logistic regression. Results The incidence of early cognitive impairment in post-intensive care patients was 18.18%(30/165). Multivariate logistic regression analysis indicated that the age(OR=1.187, 95% CI:1.085-1.299, P<0.001), acute physiological health score-Ⅱ(APACHEⅡ) maximum score in the course of disease(OR=1.392, 95% CI:1.170-1.657, P<0.001), ICU stay time(OR=1.089, 95% CI:1.016-1.166, P<0.001) were risk factors for cognitive impairment in post-intensive care patients. The no delirium(OR=0.209, 95% CI:0.054-0.803, P=0.023) was negatively correlated with the degree of cognitive dysfunction. Conclusion The age, APACHEⅡ maximum score in the course of disease, ICU stay time are the main influencing factors of early cognitive dysfunction(within 3 months) in post-intensive care patients. The no delirium is its protective factor. Clinicians should pay attention to the influencing factors of cognitive dysfunction and reduce the incidence of cognitive impairment in post-intensive care patients.
Efficacy and safety of modified CAPIRI and standard FOLFIRI regimen for metastatic colorectal cancer
WANG Yong-hui, HAN Chuan-jun, HUANG Jian-hui, TU Jian-fei
2020, 18(5): 749-751,811. doi: 10.16766/j.cnki.issn.1674-4152.001346
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Objective To compare the clinical efficacy of modified CAPIRI regimen with the standard FOLFIRI regimen in the treatment of metastatic colorectal cancer and to analyze its safety. Methods Patients with metastatic colon cancer who failed treatment with the first-line FOLFOX regimen from January 2015 to January 2016 were randomly assigned to the modified CAPIRI group and the standard FOLFIRI group. The clinical efficacy and safety between the two groups were compared. Results There were no significant differences between the two groups in pre-treatment tumor markers, and quality of life scores. CEA, CA199 and AFP in the modified CAPIRI group and the standard FOLFIRI group were lower than before, but there was no significant difference between the groups(all P>0.05). The overall quality of life scores of patients in the modified CAPIRI group[(43.71±4.52)scores] after treatment were significantly higher than those in the standard FOLFIRI group[(40.09±3.96)scores, t=3.862, P<0.001]. The ORR and DCR(20.00%, 75.00%) of patients with modified CAPIRI(23.81%, 66.67%) were similar to those of the standard FOLFIRI group(χ2=0.174, 0.687; P=0.677, 0.408). The median OS and PFS in the modified CAPIRI group were similar to the standard FOLFIRI group(Log Rank χ2=0.621, 0.206; P=0.431, 0.650), but the total incidence of adverse reactions and drug withdrawal rate in the modified CAPIRI group(52.50%, 0.00%), which were significantly lower than those in the FOLFIRI group(76.19%, 9.52%; χ2=5.030, 4.005; P=0.025, 0.045). Conclusion The improved CAPIRI regimen is similar to the standard FOLFIRI regimen in the treatment of metastatic colon cancer, but with fewer adverse effects and better tolerance.
Study on the myocardial protective effect of dexmedetomidine whole course pump injection for cardiopulmonary bypass valve replacement
ZHANG Jin-hui, CAI Shu-nü
2020, 18(5): 752-756. doi: 10.16766/j.cnki.issn.1674-4152.001347
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Objective To observe the myocardial protective effect of dexmedetomidine whole course pump injection for cardiopulmonary bypass valve replacement. Methods Total 140 patients underwent cardiopulmonary bypass heart valve replacement in Yiwu central hospital from August 2015 to August 2019 were selected as the research object. All patients were divided into study group(n=70) and control group(n=70) according to random number table method. All patients underwent cardiopulmonary bypass valve replacement. The study group received dexmedetomidine whole course pump injection, and the control group received the same amount of normal saline. The hemodynamic parameters such as HR, MAP and SPO2 were recorded before anesthesia induction, after aortic opening, at the end of cardiopulmonary bypass, at the end of operation and 24 hours after operation were analyzed. The ICU stay time and hospitalization time were recorded. The cardiac rebound was observed. The levels of inflammatory factors and myocardial injury indexes were detected before and after the operation. The occurrence of adverse cardiac events was observed. Results There was no significant difference in HR, MAP and SPO2 between the two groups(all P>0.05). There was no significant difference in ICU stay time and hospitalization time between the two groups(all P>0.05). There was no significant difference in the rate of automatic cardiac rebound between the study group(92.86%) and the control group(87.14%, χ2=1.270, P=0.260). The levels of serum inflammatory factors(TNF-α, IL-6 and IL-8) and myocardial injury indexes(CK-MB, cTnI and NT-proBNP) in the study group were significantly lower than those in the control group(all P<0.05). The overall incidence of adverse cardiac events in the study group within 30 days(12.86%) was significantly lower than that in the control group(32.86%, χ2=7.940, P=0.005). Conclusion Dexmedetomidine whole pump injection can effectively inhibit the inflammatory response, reduce the degree of myocardial injury and the incidence of adverse cardiac events.
Effect analysis of different blood purification methods on the toxin elimination capacity of patients with maintenance hemodialysis
PENG Hai-ping, WU Guang-li
2020, 18(5): 757-759,800. doi: 10.16766/j.cnki.issn.1674-4152.001348
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Objective To analyze the effect of different blood purification methods on the toxin elimination capacity of patients with maintenance hemodialysis(MHD). Methods Total 80 patients with MHD treated with blood purification in our hospital from January 2015 to April 2018 were divided into low-flux hemodialysis(LFHD) group(n=25), high-flux(HFHD) group(n=31) and hemodiafiltration(HDF) group(n=24) according to the random number table method. The toxin elimination capacity was compared among the three groups. Results ①There was no statistically significant difference in solute clearance among the three groups(P>0.05). ② After treatment, concentrations of serum urea nitrogen(BUN), hippuric acid(HA), p-cresol sulphate(PCS) and indoxyl sulphate(IS) in both groups were significantly decreased. However, there was no obvious change in 3-carboxyl-4-methyl-5-propyl-2-furan-propionic acid(CMPF), and there was no statistically significant difference in the concentration of serum solute among all groups(P>0.05). There were statistically significant differences in declines of HA, PCS, IS and CMPF and the total removal amount of protein-binding toxoid solutes among the three groups(all P<0.05). Besides, the declines of HA, PCS, IS and CMPF and the total removal amount of protein-binding toxoid solutes in HDF group were significantly higher than those in LFHD group and HFHD group(all P<0.05). Conclusion LFHD, HFHD and HDF all can remove toxin, but HDF can clear HA, PCS, IS and CMPF more obviously, which is worthy of clinical attention.
Serum complement C5a levels and its association with inflammatory factors in patients with Alzheimer's disease
HU Chen-ling, ZHANG Xue-ping, YANG Rong-mei, ZHOU Fen-fang
2020, 18(5): 760-762. doi: 10.16766/j.cnki.issn.1674-4152.001349
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Objective To investigate the serum complement C5 a level and its relationship with inflammatory factors in patients with Alzheimer's disease(AD) in order to elucidate its clinical significance. Methods Total 110 patients with AD in Hangzhou Seventh People's Hospital from January to December 2018 were selected as AD group, and 110 healthy subjects were selected as control group. The serum C5 a level, high sensitive C-reaction protein(hs-CRP), interleukin-1β(IL-1β), IL-6 and tumor necrosis factor-α(TNF-α) levels were measured. Results The score of the simple mental state scale(MMSE) of the AD group[(15.62±3.21) scores] was lower than that of the control group[(29.34±3.82) scores, t=28.839, P<0.05], and the level of C5 a[(73.51±9.42) pg/mL] was higher than that of the control group[(64.29±9.34) pg/mL, t=7.290, P<0.05]. The levels of serum hs-CRP, IL-1β, IL-6 and TNF-α in the AD group[(5.03±0.60) pg/mL,(37.49±7.46) pg/mL,(105.34±13.13) pg/mL,(196.54±12.06) pg/mL] were higher than those in the control group(t=45.395, 9.939, 25.704, 7.086, all P<0.05). The levels of serum C5 a, hs-CRP, IL-1β, IL-6 and TNF-α in AD patients were negatively correlated with MMSE scores(r=-0.421,-0.523,-0.436,-0.445,-0.507, all P<0.05). The serum C5 a was positively correlated with serum hs-CRP, IL-1β, IL-6 and TNF-α levels in AD patients(r=0.564, 0.602, 0.641, 0.539, all P<0.05). Conclusion Serum complement C5 a level is elevated in patients with AD, and it is closely related to cognitive function and serum inflammatory factor levels in AD patients.
Correlation between arthroscopic treatment of medial meniscus injury and mediopatellar plica
SHEN Mi, FU Chang-ma, QIAN Chun-sheng, LIU Jia-neng, ZHU Chen
2020, 18(5): 763-765,834. doi: 10.16766/j.cnki.issn.1674-4152.001350
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Objective To investigate the correlation between medial meniscus injury and mediopatellar plica(MPP) under arthroscopy. Methods Eighteen patients with medial meniscus injury who received arthroscopic treatment in our hospital from January 2016 to January 2018 were collected. Medial meniscus plasty or suture was performed, and MPP was removed under arthroscopy. According to the presence or absence of MPP under arthroscopy, the patients were divided into two groups. According to whether there is pathological MPP under arthroscopy, the patients were divided into two groups. Lysholm score was used for knee function before and after surgery. Covariance analysis was used to compare the data, and Spearman analysis was used to analyze the correlation between the two factors. Results Before surgery, the preoperative Lysholm score of the no MPP group(38.36±3.12) was higher than that of the MPP group(30.43±1.75), and after surgery, the postoperative Lysholm score of the no MPP group(78.91±4.52) was higher than that of the MPP group(70.36±3.71). Before surgery, the preoperative Lysholm score of MPP group A and B(38.37±3.23) was higher than that of C and D group(30.78±1.10), and after surgery, the postoperative Lysholm score of MPP group A and B(79.75±2.90) was higher than that of C and D group(70.27±2.81, all P<0.05). Spearman correlation analysis showed that the postoperative Lysholm score was negatively correlated with MPP content(correlation coefficient r=-0.792, P<0.05). Conclusion MPP affects the efficacy of patients with medial meniscus injury of the knee joint, and accurate removal of MPP, especially type C and D, is required under arthroscopy.
Effect of trimetazidine combined with bisoprolol on NT-proBNP level and cardiac function in patients with ischemic cardiomyopathy
LONG Jing-wei, LI Ping
2020, 18(5): 766-768. doi: 10.16766/j.cnki.issn.1674-4152.001351
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Objective To investigate the clinical effect of trimetazidine combined with bisoprolol on the treatment of ischemic cardiomyopathy and its effect on N terminal pro B type natriuretic peptide(NT-proBNP) and cardiac function. Methods Total 86 patients with ischemic cardiomyopathy admitted to Haikou Third People's Hospital from January 2016 to October 2018 were randomly divided into two groups:control group treated with bisoprolol and study group treated with trimetazidine and bisoprolol, 43 cases in each group. After 3 months of treatment, the changes of heart function indexes and NT proBNP level were observed. Results The total clinical effective rate of the study group was 90.70%, which was significantly higher than that of the control group(74.42%, P<0.05). After treatment, the levels of LVEDd and LVESd in the two groups were significantly decreased, and the levels of LVEF were significantly increased. The improvement of the indexes in the study group was significantly better than those in the control group(all P<0.05). After treatment, the levels of NT-proBNP in both groups were significantly decreased, and the degree of reduction in the study group was significantly better than that in the control group(P<0.05). Conclusion Trimetazidine combined with bisoprolol can significantly improve the cardiac function of patients with ischemic cardiomyopathy, reduce NT-proBNP level, and improve the total efficiency of clinical treatment. It is worth popularizing.
Effect of exercise intervention in elderly patients with diabetic peripheral neuropathy
HU Hui-ying, ZHANG Zheng-yu
2020, 18(5): 769-772. doi: 10.16766/j.cnki.issn.1674-4152.001352
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Objective To observe the effect of exercise intervention on lower limb vascular function and peripheral nerve conduction function in elderly patients with diabetic peripheral neuropathy. Methods From December 2017 to January 2019, 90 patients with diabetic peripheral neuropathy who were first diagnosed in the Department of geriatrics of Lishui Second People's hospital were randomly divided into control group and observation group according to the complete randomized method, 45 cases in each group, and both groups were treated with clinical routine treatment. The observation group was treated with exercise intervention on the basis of routine treatment. Before and after treatment, the venous blood of the two groups was drawn, BMI was calculated, blood glucose, blood lipid, lower extremity vascular function, peripheral nerve conduction function, diabetic peripheral neuropathy, lower extremity motor function and quality of life were measured. Results IMT, PSV, VEGF and VEGFR-2 were(0.21±0.06)mm,(36.74±1.70)cm/s,(85.01±5.97)pg/mL,(5.51±0.19)ng/mL in the observation group after treatment, which were lower than those in the observation group and the control group(all P<0.05). The peripheral nerve conduction velocity of the observation group were(56.68±3.48)m/s,(67.66±5.42)m/s,(37.72±3.75)m/s,(54.77±3.86)m/s,(64.69±4.45)m/s respectively, which were faster than that of the observation group and the control group(all P<0.05). Conclusion Exercise intervention in elderly patients with diabetic peripheral neuropathy can improve peripheral nerve conduction function and lower limb motor ability, alleviate symptoms and improve the quality of life of patients.
Analysis of factors affecting hearing after canal wall-down tympanoplasty for chronic suppurative otitis media
CHEN Min-fen, PAN Zhao-hu, XU Jin
2020, 18(5): 773-775,820. doi: 10.16766/j.cnki.issn.1674-4152.001353
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Objective To investigate the factors affecting postoperative hearing in canal wall-down tympanoplasty for chronic septic otitis media(CSOM). Methods Eighty-six patients with CSOM admitted to our hospital from October 2015 to October 2017 were enrolled, who were treated with canal wall-down tympanoplasty The air conduction(AC), Bone conduction threshold(BC) and air-bone gap(ABG) between 1 week before and 6 months after surgery were compared. In addition, the relevant factors that may affect the hearing during surgery were collected. Logistic regression analysis was performed to find out the factors affecting hearing in open tympanoplasty. Results The difference of AC[(65.73±8.25)dB vs.(47.52±6.82)dB] and ABG ABG[(30.60±3.20)dB vs.(11.50±2.11)dB] between 1 week and 6 months after operation was statistically significant(t=15.777,45.122; P<0.001). The AC of the humerus or humerus floor not destroyed was better than that of destroyed. The AC of posterior tympanic opened was better than that of not opened(χ2=8.010, 7.668; P=0.018, 0.022). Whether the humerus or tibial floor was damaged or whether the posterior tympanic cavity was open were the independent factors affecting postoperative hearing in open tympanoplasty for CSOM(P=0.011, 0.014). Conclusion Open tympanoplasty has a certain effect on improving postoperative hearing in CSOM patients. Preserving the integrity of the humerus or tibial floor during operation and the open tympanic cavity are important factors influencing postoperative hearing.
Clinical values of non-bacterial pathogen IgM antibodies detection in children with respiratory tract infections
CAI Yu, GAO Dong-mei, DING Rui, HUANG Sheng-hai
2020, 18(5): 776-778,842. doi: 10.16766/j.cnki.issn.1674-4152.001354
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Objective To investigate the infection of non-bacterial pathogens in children with acute respiratory tract infections below 14 years old in the author's hospital. Methods In the First People's Hospital of Hefei, a total of 724 serum samples of respiratory tract infections were enrolled during the period from January to December in 2018. The 724 cases were divided into baby group(339 cases, 0-1 years old), infant group(188 cases,1-3 years old), preschool group(131 cases,3-6 years old) and school group(66 cases, 6-14 years old).The IgM antibodies of legionella pneumophila(LP), mycoplasma pneumonise(MP), coxiella burnetii(COX), chlamydia pneumoniae(CP), adenovirus(ADV), respiratory syncytial virus(RSV), influenza a virus(INFA), influenza b virus(INFB) and parainfluenza virus(PIVs) in the serum were detected by using indirect immunofluorescence assay(IFA) and a retrospective clinical analysis was performed with those positive cases. Results The results showed that the total positive rate was 37.71%(273/724) and the five detected pathogens were MP(29.70%), INFB(5.80%), RSV(4.56%), ADV(0.55%) and PIVs(0.14%), respectively. Mixed-infections of pathogens were detected in 22 cases, accounting for 8.06%(22/273) of positive cases. The total positive rates of IgM were no significant different between male and female groups(P=0.059). However, the positive rate of MP IgM antibodies were statistically significant between the two gender groups(P=0.001). The total positive rates of babies, infants, preschool and school groups were 27.14%, 53.19%, 54.20% and 48.48%, respectively. Among the four age groups, there were significant differences in the detection rates of MP,RSV and INFB(all P<0.05). MP occurred frequently in winter(50.00%, 102/204), while the prevalence of INFB was in spring. Conclusion MP is the primary non-bacterial respiratory infection occurred in hospitalized children in the First People's Hospital of Hefei. Besides, the pathogen infections of MP, RSV and INFB have characteristics of age and seasonal distribution.
Investigation of vitamin D levels and analysis of related risk factors in 5132 children under 6 years old in Weifang area
ZHANG Ming, QIU Lei, HE Yu-shuang, DONG Chun-ping, ZHONG Zhao-gang, WANG Ming-yue
2020, 18(5): 779-782. doi: 10.16766/j.cnki.issn.1674-4152.001355
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Objective To analyze the Vitamin D levels and analysis of related risk factors in 5 132 children under 6 years old in Weifang area, and to provide reference for prevention and treatment of diseases related to vitamin D deficiency or unsufficient. Methods A total of 5 132 children under 6 years old examined in our hospital from August 2016 to August 2018 were selected as research subject. The serum 25-hydroxyvitamin D[25-(OH)D] levels of children were determined by enzyme-linked immunosorbent assay. The nutritional status of vitamin D in children were analyzed from the aspects of gender, age and season. The possible risk factors were analyzed by single factor and logistic multiple regression analysis. Results The vitamin D deficiency rate was 10.76% in children under 6 years old, and the unsufficient rate was 16.62%. The serum 25-(OH)D levels, vitamin D deficiency rate, and unsufficient rate were not significantly different between boys and girls under 6 years of age(all P>0.05). The vitamin D deficiency rate and unsufficient rate in children aged 3 to 6 years old is higher than 0-1 years old, 1-2 years old, 2-3 years old(all P<0.05), and the serum 25-(OH)D levels of 3-6 years old is was lower than 0-1 years old, 1-2 years old, and 2-3 years old(all P<0.05). The vitamin D deficiency rate and unsufficient rate in summer and autumn were significantly lower than those in spring and winter(P<0.05). The risk factors affecting vitamin D deficiency or unsufficient in children under 6 years old were chaotic or not taking vitamin D preparation, breastfeeding alone, outdoor exercise<2 hours/day, low maternal education, repeated upper respiratory tract infection, Repeated diarrhea, picky or anorexia and repeated bronchial asthma. Conclusion The deficiency or unsufficient rate of vitamin D is 27.38%, which is related to age and season. The deficiency or unsufficient of vitamin D is mainly concentrated in the age of 3-6 years and spring and winter. The main influencing factors are feeding mode, outdoor sports, picky or anorexia, vitamin D preparation, mother culture, repeated upper respiratory tract infection, repeated diarrhea and repeated bronchial asthma.
Clinical effect of addition and subtraction of traditional Chinese medicine adjuvant therapy on threatened abortion and its influence on related factors
LAI Juan, LIU Fang, QIAN Li-feng, KE Zhong-mei, DENG Juan, MA Rui-fen
2020, 18(5): 783-786. doi: 10.16766/j.cnki.issn.1674-4152.001356
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Objective To explore the clinical effect of addition and subtraction of traditional Chinese medicine adjuvant therapy on threatened abortion and its effects on immune, inflammatory response and reproductive endocrine hormones. Methods A total of 82 threatened abortion patients treated in Gynecology Department of Jiaxing Hospital of Traditional Chinese Medicine from June 2018 to April 2019 were selected as the study subjects, they were randomly divided into observation group(n=41) and control group(n=41). The control group was treated with progesterone injection, while the observation group was treated with traditional Chinese medicine on the basis of the control group. The clinical total effective rate, interleukin-2(IL-2), interleukin-10(IL-10), interferon-γ(IFN-γ), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), human chorionic gonadotropin(β-HCG), progesterone(P), and estradiol(E2) levels were compared between the two groups. Results The clinical total effective rate of the observation group was 95.12%(39/41), which was significantly higher than that of the control group(78.05%, 32/41, P<0.05). The levels of IL-2 and IFN-γ in the observation group were significantly lower than those in the control group(all P<0.05), and the levels of IL-10 in the observation group were significantly higher than those in the control group(P<0.05). The level of TNF-α in the observation group was significantly lower than that before treatment and in the control group(all P<0.05), and the level of IL-6 in the observation group was significantly lower than that before treatment(P<0.05), but there was no significant difference between the two groups(P>0.05). The levels of β-HCG and E2 in the observation group were significantly higher than those before treatment and in the control group(all P<0.05). The levels of P in the observation group were significantly higher than that before treatment(P<0.05), but there was no significant difference between the two groups(P>0.05). Conclusion The treatment of threatened abortion by adding or subtracting traditional Chinese medicine can improve the immune ability of patients, reduce the occurrence of inflammatory reaction and improve the level of endocrine.
A correlation study of bronchopulmonary dysplasia and encephalopathy of prematurity in premature infants
XU Shu-jing, YU Zeng-yuan
2020, 18(5): 787-789,793. doi: 10.16766/j.cnki.issn.1674-4152.001357
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Objective To study the correlation of bronchopulmonary dysplasia(BPD) and encephalopathy of prematurity(EOP) in premature infants,and to provide the theoretical basis for clinical evaluation of prognosis and appropriate intervention measures. Methods From February 2014 to February 2018, 124 preterm infants with BPD in intensive care unit of children affiliated to Zhengzhou University were chosen,248 patients without BPD were assigned into the control group. The head magnetic resonance imaging examination was performed at the corrected gestational age of 37-42 weeks. The incidence and imaging characteristics of EOP in the two groups were analyzed. Results Forty cases(32.2%) of late-onset sepsis occurred in BPD group, which was significantly higher than that of 42 cases in control group(16.9%),P<0.05. EOP occurred in 41 premature infants(33.1%) in BPD group, which was significantly higher than that in control group(16.1%), P<0.001. There were 17 cases(20.2%) of EOP in 84 cases of mild BPD and 24 cases(60%) of EOP in 40 cases of moderate and severe BPD. The incidence rate of EOP in moderate and severe BPD group was significantly higher than that in mild BPD group(P<0.001). The incidence rate of white matter injury in EOP in BPD group was significantly higher than that in control group(P<0.05). Conclusion BPD and EOP may be correlated in preterm infants. Infection is a risk factor of EOP for premature infants with BPD,and surveillance of infection and follow-up evaluation of nervous system should be strengthened.
Early levels and significance of serum amyloid A and D-dimer in children with mycoplasmal pneumonia
LUO Ming-xin, HUA Shan, WEI Wen, CHEN Tian-ping
2020, 18(5): 790-793. doi: 10.16766/j.cnki.issn.1674-4152.001358
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Objective To compare and analyze serum amyloid A and D-dimer in children with refractory mycoplasma pneumoniae pneumonia and mycoplasma pneumoniae pneumonia and to help clinicians to diagnose RMPP children early. Methods A total of 52 children with a diagnosis of mycoplasma pneumonia who were admitted to the Department of Respiratory Medicine of Anhui Provincial Children's Hospital from January 18 to June 19 were randomly selected. Venous blood was collected immediately after admission for SAA and D-dimer of polymer levels. The above-mentioned children were treated with Azithromycin. If their body temperature was normal, cough symptoms were relieved or chest imaging examination was rechecked, the lesions were classified into ordinary MPP group; On the contrary, they were classified into RMPP group. The results of SAA and D-dimer were compared with the normal standard values, and the results of the two groups were compared. Results The early SAA level of children in the general MPP group was(11.56±5.96) mg/L, and the D-dimer level was(0.61±0.32) μg/mL. There was no statistically significant difference from the normal standard values(all P>0.05). The early SAA level of children in the RMPP group was(42.85±35.25) mg/L, and the D-dimer level was(2.82±2.06) μg/mL. There were statistically significant differences from the normal standard values(all P<0.05). The serum levels of SAA and D-dimer in the RMPP group were higher than the normal MPP group. The difference was statistically significant(P<0.05). Conclusion The increase of serum SAA and D-dimer levels in children with mycoplasma pneumonia indicates that the disease is easy to progress to RMPP.
A study on the effect of Danggui Shaoyao Powder on the pre-pregnancy intervention of early recurrent abortion based on the theory of"chronic diseases in collaterals"
YE Yong-ju, CHENG Hui-fang, JIANG Wei-hua, SHI Ming-qing
2020, 18(5): 794-796,881. doi: 10.16766/j.cnki.issn.1674-4152.001359
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Objective To investigate the effect of Danggui Shaoyao Powder on the pre-pregnancy intervention of early recurrent abortion based on the theory of "chronic diseases in collaterals". Methods Using retrospective research method, 60 patients with early recurrent abortion of liver stagnation and spleen deficiency and syndrome of internal blockade of static blood syndrome in the outpatient department of our hospital from February 2015 to August 2017. Based on the theory of "chronic diseases in collaterals", Danggui Shaoyao Powder was added and subtracted for treatment. At the end of the treatment course, the treatment outcome of 60 patients was summarized, and the factors influencing the treatment outcome were analyzed. Results At the end of the course of treatment, 19 patients(31.67%) successfully achieved a natural pregnancy. The results of χ2 analysis shown that the number of spontaneous abortion(P=0.013), endometrial type(P=0.027), the abnormal uterine artery blood flow(P=0.034), the main syndrome score of TCM(P<0.001), and the improved endometrium, artery blood flow and the syndrome score of TCM(P<0.05) were correlated with the outcome of treatment, but the course of disease(P=0.558) was not related. Furthermore, logistic regression analysis showed that endometrial type C(P=0.027), abnormal uterine artery blood flow(P=0.034) and TCM main syndrome score ≥ 4(P=0.001) were independent risk factors for the adverse outcome of the treatment. Conclusion The precise syndrome differentiation based on the theory of "chronic diseases in collaterals" can reduce the TCM syndrome scores, significantly improve clinical efficacy.
Research demand and utilization of traditional Chinese medicine"Disease Prevention"service among community residents of high-risk diabetes
WANG Hong-xing, WANG Yang, WANG Qi-kai, LI Jun, ZHU Zhu-qin, LIN Jing-jing
2020, 18(5): 797-800. doi: 10.16766/j.cnki.issn.1674-4152.001360
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Objective To investigate the demand and utilization of "disease prevention" service among community residents of high-risk diabetes, and analyze this influencing factors, provide better services of traditional Chinese medicine "disease prevention" for them. Methods Self-made questionnaire was using to inquiry 874 residents of high-risk diabetes in 10 neighborhood committee in Zhoujiadu districts. The content of the questionnaire included basic situation, and cognition, demand and utilization in traditional Chinese medicine "disease prevention". Results Among respondents, there were 71.9% heard about the concept of traditional Chinese medicine "disease prevention", and ranked in turn:friends(family), hospital, media. There were 67.2% received traditional Chinese medicine "disease prevention" service, and select the intervention project for itself in turn:cupping therapy, acupuncture for treatment, cream formulae,chose medical institutions in turn:Chinese medicine hospital, comprehensive hospitals, community hospitals. The community residents of high-risk diabetes with different ages, education background and occupation were significantly different in the proportion of being willing to utilize the service(P<0.05). Conclusion The community residents of high-risk diabetes in utilization service is not high, therefore there is a broad development space, need to increase the publicity effort of the concept of traditional Chinese medicine "disease prevention" in society; strengthen the service ability in county; follow the rules of residents' life to create opportunities for service and provide sustainable high-quality service.
Investigation on Mental Health of Normalized General Practice Training Doctors in Nanjing
CHEN Nan, ZHAO Ling, WANG Jin-yan, TANG Zhong-quan, LI Yun-tao, CHEN Yong-zhen
2020, 18(5): 801-804,884. doi: 10.16766/j.cnki.issn.1674-4152.001361
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Objective To investigate the mental health status of standardized training of general practitioners in Nanjing, and to provide reference for further improvement of standardized general practice training. Methods A questionnaire survey was conducted among 110 general practitioners in Nanjing with the Symptom Checklist 90(SCL-90) and the self-made General Situation Questionnaire. Results The positive rate of SCL-90 of general practitioners in Nanjing was 24.5%, with a total average score of(121.51±30.69), which was lower than the national norm score of(129.96±38.76), t=-2.888, P<0.05. Apart from obsessive-compulsive factor, the average scores of eight factors, including somatization, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia and psychosis, were lower than those of the national norm, among which there were statistically significant differences in somatization, interpersonal sensitivity, depression, anxiety, hostility and paranoia. Mental health status of students whose training time longer than or equal to one year was better than that of students whose training time less than one year. The mental health status of the students who had completed the general theory study was better than that of the students who had not attended the general theory study. Conclusion The mental health status of Nanjing general practice standardized training physician is still good. Measures such as increasing students' professional interest, implementing the dual tutorial system for resident doctors and conducting group mental health education may effectively improve the mental health status of trained physicians.
Effectiveness of health education based on SHOW mode on self-management ability of venous thrombosis in patients with advanced lung cancer
ZHAO Jia-yi, FAN Jian, HAN Yi-ping
2020, 18(5): 805-807,855. doi: 10.16766/j.cnki.issn.1674-4152.001362
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Objective To explore the effect of health education on venous thrombosis self-management in patients with advanced lung cancer based on the "short video+handbook+oral+WeChat" SHOW model. Methods A total of 140 patients who met the inclusion criteria were randomly divided into the experimental group and the control group. Each group has 70 patients. During the hospitalization, the control group used a single form such as a written manual or oral instruction to conduct the mission, while the experimental group used the SHOW model for health education. Both groups of patients underwent the VTE self-management related knowledge test before admission. The VTE self-management related knowledge test is revised according to the survey scale of Green et al., including the degree of recognition of the importance of VTE, the ability to recognize early symptoms and the mastery of relevant first-aid skills. At the time of discharge, the VTE self-management related knowledge test was again performed on the two groups of patients to judge the patient's ability to self-manage venous thrombosis. Results Patients with healthy education in SHOW mode scored significantly higher on VTE than those who received single-form education(4.81±0.39 vs. 4.59±0.55, t=-2.827, P=0.005). The health education in SHOW mode improved more than single form education. The correct rate of response to thromboprophylaxis for venous thrombosis and thrombosis in patients with advanced lung cancer(91.43% vs. 75.71%, χ2=6.295, P=0.021; 91.43% vs. 77.14%, χ2=5.393, P=0.035). In terms of thrombosis risk assessment, symptom identification of thrombosis and pulmonary embolism, both health education methods can improve the self-management ability of venous thrombosis in patients. Conclusion Health education based on SHOW mode can help to strengthen the self-management ability of venous thrombosis in patients with advanced lung cancer, especially in the prevention and emergency treatment of thrombosis.
Roles of tidal lung function and FeN O detection in bronchiolitis
ZHAO Ying-xu, YANG Zhen, WANG Kai, LIU Jing-yan
2020, 18(5): 808-811. doi: 10.16766/j.cnki.issn.1674-4152.001363
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Objective To investigate the roles of tidal lung function and fractional exhaled nitric oxide(FeNO) detection in bronchiolitis. Methods Children with bronchiolitis who were treated in pediatric department of the hospital from January 2016 to February 2017 were enrolled. The 69 children with bronchiolitis were divided into mild group(24 cases), moderate group(26 cases) and severe group(19 cases) according to disease severity at visit time. MasterScreen spirometer produced by German JAEGER company was performed to monitor tidal volume, ratio of time to peak(TPTEF/TE), ratio of volume to peak(VPEF/VE) and respiratory rate in three groups. Sunvou-D100 Nacolon(Wuxi Shangwo Medicine) Nitric Oxide Analyzer was performed to detect FeNO in three groups. The receiver operating characteristic(ROC) curves were performed to analyze value of tidal lung function combined with FeNO for assessing severity of bronchiolitis. Pearson correlation coefficient analysis was performed to analyze relationship between FeNO and tidal lung function in bronchiolitis children. Results There was no significant difference in tidal volume among mild group, moderate group and severe group(all P>0.05). However, TPTEF/TE and VPEF/VE in mild group were significantly larger than those in moderate group and severe group. The above indexes in moderate group were also significantly higher than those in severe group(all P<0.05). The respiratory rate in mild group and moderate group was significantly lower than that in severe group(all P<0.05). There was no significant difference between mild group and moderate group(P>0.05). FeNO in mild, moderate and severe groups was significantly increased in turn(all P<0.05). ROC curve analysis indicated that the area under the ROC curve of TPTEF+VPEF+FeNO combined detection for assessing bronchitis severity was significantly higher than that of any one of the three. FeNO level in bronchitis patients was significantly negatively correlated with their pulmonary function indexes such as TPTEF/TE and VPEF/VE(r=-0.385,-0.314, all P<0.05). Conclusion Tidal lung function combined with FeNO detection can effectively reflect severity of bronchiolitis. The combination detection of the two may be an effective evaluation method for severity of bronchiolitis.
The significance of the four indicators of urine test in determining whether there is early renal damage and the degree of damage in elderly patients with essential hypertension
SUN Qiao-yan, YAN Li-hua, YUAN Kai, ZHANG Hai-ping, HUANG Xi-tong
2020, 18(5): 812-814. doi: 10.16766/j.cnki.issn.1674-4152.001364
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Objective To explore the clinical significance of monitoring the four indicators of urine test in elderly patients with essential hypertension with different grades and disease courses. Methods From June to December 2018, 263 elderly patients with essential hypertension were included in our hospital's outpatient department for routine urine examination. According to the classification of hypertension, the patients were divided into three groups:grade 1(94 cases), grade 2(102 cases) and grade 3(67 cases). To compare the levels of four commonly used indexes in urine test of elderly patients with hypertension in different grading groups, including 24 h urinary protein quantity, urinary microalbumin, urinary β2 microglobulin and N-acetyl-β-d-glucosaminidase. Results The comparison of urine test levels of elderly patients with essential hypertension in different hypertension grading groups(F=6.452, 36.750, 33.911 and 7.180) and different course groups(F=6.452, 36.750, 33.911 and 7.180) showed statistically significant differences(all P<0.05). The level of urine test in grade 2 group and grade 3 group was higher than that in grade 1 group(P<0.05). The grade 3 group was higher than the grade 2 group(P<0.05). The levels of the four indicators of urine test in the group with disease course of 10(including)-20 years and ≥ 20 years were higher than those in the group with disease course<10 years(all P<0.05). The course of disease ≥ 20 years was higher than that of 10-20 years(P<0.05). Conclusion The elderly patients with hypertension have different grades and course of hypertension. The higher the score of hypertension and the longer the course of hypertension, the higher the level of the four commonly used indexes and the more serious the condition. It is suggested that clinical attention should be paid to the monitoring of four indicators commonly used in urine test for elderly hypertensive patients with long course of disease and severe condition.
Research progress of blood eosinophils as the biomarker in chronic obstructive pulmonary disease
WANG Hong-mei, LIU Yun-chong, ZHENG Dan-lei, CHEN Ya-hong
2020, 18(5): 815-820. doi: 10.16766/j.cnki.issn.1674-4152.001365
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Blood eosinophil(EOS) is recommended as a biomarker of chronic obstructive pulmonary disease(COPD) in GOLD 2017 for the first time. GOLD 2020 emphasizes that blood EOS is of great benefits in guiding the use of inhaled corticosteroids(ICS) in patients with stable COPD who are suffering from the high risk of acute exacerbations. Blood EOS highlights personalized assessment and precise treatment when making clinical decisions, which has great potential to promote the treatment of COPD from "risk management" to "targeted". However, there are still many controversies in the efficacy and safety when it comes to clinical application. Firstly, whether blood EOS can truly reflect the severity of airway EOS inflammation and disease and the risk of acute exacerbations in COPD patients. Secondly, whether the curative effect of adding ICS in patients with elevated EOS for preventing exacerbations is accurate. Thirdly, the benefit-risk ratio of the curative effect and the side effect such as pneumonia of ICS should be taken into consider in patients with elevated EOS. Fourthly, the threshold used to predict the risk of acute exacerbations and the curative effect of ICS isn't yet unified. Finally, the curative effect of targeted treatment therapy associated with blood EOS is uneven. Recently, blood EOS gradually becomes a hotspot and a focus of controversies in the field of treatment for COPD patients, with related researches emerging in an endless stream. This review focuses on EOS, including the progress and controversy about the stability, the efficacy to forecast the airway inflammation, disease severity and the risk of the acute exacerbations, the value in guiding the clinical application of ICS and targeted therapy, in order to have a deeper understanding in the efficacy and safety of EOS.
Advances in the study of ossification of posterior longitudinal ligaments of the cervical spine
ZHAO Chun, ZHANG Zhang-chun, ZHOU Ping-hui, ZHANG Zhi-li, WU Nan
2020, 18(5): 821-825. doi: 10.16766/j.cnki.issn.1674-4152.001366
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Ossification of the posterior longitudinal ligament of cervical spine(OPLL) refers to a group of neurological impairment syndromes caused by ossification of the posterior longitudinal ligament of cervical vertebra, which compresses the spinal cord and nerve root, and is one of the important causes of cervical spondylosis. Ossification of the posterior longitudinal ligament is a rare pathological process of lamellar bone deposition that can lead to spinal cord compression. Although studies have found that the occurrence and development of OPLL are related to a variety of genetic and environmental factors, the understanding of its pathophysiology is still unclear. Asymptomatic patients can be treated conservatively, nerve root or surgical decompression should be considered in patients with spinal cord disease can be carried out on the nerve, spinal cord decompression surgery, slow progress in OPLL, but is also likely to be dural tear, nerve damage and axial pain related complications, such as the choice of treatment has been a problem in the physician, the influence of different treatments on prognosis, different shape and size, and location of OPLL is important to the choice of surgical approach and technique, and nerve function, image credits can also guide the choice of treatment. The epidemiology, pathological anatomy and pathophysiology, clinical manifestations and imaging manifestations of cervical OPLL treatment still need to be further studied. In this review, our goal is to address the existing literature on the etiology, history, presentation, and management of OPLL, to make generalizations to better understand OPLL, and to provide our recommendations for the treatment of OPLL patients.
Application of caudal block guided by ultrasound in clinical anesthesia
PAN Bei, CHENG Wei-bo, LI Jiang-yue
2020, 18(5): 826-829. doi: 10.16766/j.cnki.issn.1674-4152.001367
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Sacral anesthesia has the advantage of stable circulation because of its limited blockade scope and little influence on cardiovascular system. The traditional way of sacral block anesthesia is based on bony markers. Most adult anatomical markers are not clear, or because of obesity, anatomical variation, deformity and other conditions, it is often difficult to palpate the sacral horn, inaccurate location of sacral hiatus, leading to puncture difficulties, high failure rate of anesthesia. Therefore, sacral block is mostly used in pediatric short surgery, but seldom used in adults. With the rapid development of biotechnology and microelectronics, bedside ultrasound has been widely used in clinical anesthesia for its powerful advantages of portability, non-invasiveness, safety, visualization and repeatability. Ultrasound scanning can identify blood vessels, nerves, muscles, tendons, joints and other tissues. Ultrasound-guided sacral block can identify sacral canal structure, sacral canal space, measure space depth, accurately locate sacral hiatus, guide puncture path, direct puncture process, reduce repeated puncture, significantly reduce the failure rate of sacral block, vascular nerve injury, toxic reaction of local anesthetics, etc. At the same time, it can observe and monitor the process of drug injection and evaluate the anesthetic effect. The effectiveness and safety of sacral block were greatly improved. Under the guidance of ultrasound, sacral anesthesia is widely used in clinical anesthesia and postoperative analgesia, ranging from single sacral block to continuous sacral block, from short operation to long complex operation. With the popularization of equipment and the deepening of the concept of rapid rehabilitation, it can also be used in outpatient examination, pain treatment and rehabilitation medicine in the future. The application scenario will be more and more, and the applicable population will gradually expand to all patients. This article reviews the application of ultrasound-guided sacral block in clinical anesthesia.
Effect of local anesthetics on the prevention and treatment of chronic post-surgical pain
LI Ai-lun, CANG Jing
2020, 18(5): 830-834. doi: 10.16766/j.cnki.issn.1674-4152.001368
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Despite researches that have been thoroughly done on the mechanism of pain and the appeals for standardized management of pain, the high incidence of chronic post-surgical pain(CPSP) is still a serious problem in clinical work. The problem remains particularly in certain types of surgery as amputation(30%-50%), breast cancer surgery(20%-30%) and thoracotomy(30%-60%), among which 2%-10% patients have suffered from severe CPSP and even lost their ability to live and work. CPSP often develops from severe acute post-surgical pain, accompanied by a complex pathological process after surgical trauma. Therefore, a rational and effective perioperative analgesia management of acute post-surgical pain is real important for reducing CPSP. Local anesthetics, which can reversibly block the conduction of nerve impulse,are widely used in clinical practice to treat postoperative pain for its safety and efficacy. Growing evidences show that peripheral and central sensitization caused by nerve injury during operation and inflammation after operation are vital factors in pathophysiology and development of CPSP. The pharmacological properties of local anesthetics in blocking signal transduction and anti-inflammatory are closely connected with the mechanism of CPSP. This article reviews the main pharmacologic properties of local anesthetics in treating CPSP, discusses the future broad application as well as the limits of local anesthetics and considers better strategies to help treat CPSP.
Clinical efficacy evaluation of electroacupuncture combined with acupuncture and cupping in the treatment of postherpetic neuralgia
HUANG Ai-ping, GU Zhen, XUE Chun-chun, XIE Lei
2020, 18(5): 835-838. doi: 10.16766/j.cnki.issn.1674-4152.001369
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Objective To observe and analyze the clinical effect of electro-oacupuncture combined with acupuncture and cupping in the treatment of post-herpeticneuralgia(PHN). Methods A total of 90 cases of patients with PHN treated in our hospital from February 2017 to February 2019 were selected according to the random table method and randomly divided into observation group and control group(45 cases each group).The observation group line acusector joint thorn cupping therapy 1 time/d for the 10 days for a period of treatment, the treatment of three consecutive period of treatment. The control group patients with oral pregabalin, 75 mg, 2 times/d, to 10 days for a period of treatment, the treatment of three consecutive period of treatment, observe and compare the clinical total effective rate of two groups of patients with treatment. The two groups were compared in terms of pain assessment index(PRI), current pain intensity(PPI), visual analogue score(VAS) and quality of life score. Results The total effective rate was 95.56% in the observation group and 75.56% in the control group. The total effective rate in the observation group was significantly higher than that in the control group(χ2=7.283, P<0.05). The indexes of PRI, PP and VAS in the observation group were significantly lower than those in the control group(P<0.01). The scores of daily life, pain degree, social function, physiological function and mental health in the observation group were significantly better than those in the control group(P<0.01). Conclusion Compared with the clinical treatment of western medicine, electroacupuncture combined with acupuncture and cupping can significantly improve the clinical treatment effect of postherpetic neuralgia, effectively relieve the pain, and improve the quality of life of patients, which is worthy of clinical promotion and use.
Observation on therapeutic effect of traditional Chinese medicine intervention in patients with cerebral infarction of wind-phlegm stasis type
GAO Bin, WANG Lu, FANG Chao-hui
2020, 18(5): 839-842. doi: 10.16766/j.cnki.issn.1674-4152.001370
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Objective To explore the therapeutic effect of Banxia Baizhu Tianma decoction combined with Taoren Honghua Decoction in the treatment of wind phlegm stasis type cerebral infarction and its influence on the total cholesterol(TC) and triglyceride(TG) in the serum of the patients. Methods From August 2015 to July 2018, 54 patients with wind phlegm stasis type cerebral infarction were selected from the Department of Integrated Traditional Chinese and Western Medicine of the Third People's Hospital of Bengbu. The patients were divided into two groups with 27 cases in each group. The patients in the control group were given general routine treatment, while those in the observation group were given Banxia Baizhu Decoction and Taoren Honghua Decoction on the basis of the control group, decoction 200 mL once, twice a day. After 10 days of treatment, the neurological function, activities of daily life and TCM symptom scores of the two groups were evaluated, and the clinical efficacy and adverse reactions of the two groups were observed. One month later, the patients were followed up and their blood lipids were reexamined. Results After treatment, the neurological deficit score and TCM symptom score of the two groups were lower than before treatment, and the daily life activity score was higher than before treatment, the observation group was better than the control group(all P<0.05). The total effective rate of the observation group(85.19%) was higher than the control group(55.56%, P<0.05). One month later, the serum TC and TG in the observation group were lower than those in the control group(all P<0.05). During the treatment, there was no obvious adverse reaction in both groups. Conclusion Banxia Baizhu Tianma decoction combined with Taoren Honghua Decoction in the treatment of wind phlegm stasis type cerebral infarction can effectively improve the degree of neurological deficit, enhance the ability of daily life, reduce the level of TC and TG, and improve the clinical efficacy.
A multicenter study on the distribution characteristics of traditional Chinese medicine syndrome types in 500 cases of precocious puberty girls in Shanghai
LU Chao-yuan, ZHAO Yun, ZHU Sheng-guo, SUN Wen, ZHAO Ping, CHEN Lan
2020, 18(5): 843-845. doi: 10.16766/j.cnki.issn.1674-4152.001371
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Objective The incidence of precocious puberty, one of the common diseases currently, increases year by year. By collecting the cases of girls with precocious puberty throughout Shanghai,we applied the TCM syndromes score sheet to determine the main syndromes of precocious puberty, and observed the main syndromes characteristics of precocious puberty to provide the evidence for early detection, diagnosis and treatment, and to provide reference for standardized diagnosis and treatment of precocious puberty in TCM. Methods e analyzed syndromes of 500 girls with precocious puberty from pediatric departments of 6 hospitals throughout Shanghai from January 2013 to June 2016. In accordance to the severity of clinical symptoms by TCM, we scored 0, 2, 4, 6 to match with nil, light, middle, serious, and calculated the scores to summarize the characteristics of TCM Syndrome. There were three types of TCM syndromes, Yin deficiency and Fire prosperity(315 cases, occupied 63.0%), damp-heat smoldering(98 cases, 19.6%) and liver constraint transforming into fire(87 cases, 17.4%).For TCM syndromes, the top ten clinical syndromes(more than 25.0% by frequency) were fear of heat and night sweats, feverishness in palms and soles, swollen breasts, pulse breakdown, dysphoria, dry stool, tidal fever, the mouth swallows dry does, eating too much sweet and greasy food, red tongue with little coating. Conclusion The number of Yin deficiency and Fire prosperity is the largest, while the number of damp-heat smoldering is close to that of liver constraint transforming into fire. The research on the TCM syndrome of girls with precocious puberty is useful to not only observe the early clinical symptoms and early diagnosis, but also provide sounded clues and evidence for diagnosis and prescription.
Application of four-step didactics in teaching of laparoscope simulator
LIU Bei-bei, GUO Yuan-yuan, YUE Xiao-e, YANG Xiao-huai, SUN Wei, GAO Wu-yue, LI Li-qiang, LIU Jian-min
2020, 18(5): 846-848. doi: 10.16766/j.cnki.issn.1674-4152.001372
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Objective To explore the application effect of four-step didactics in teaching of laparoscope simulator. Methods Total 132 clinical medical doctors receiving standardized training in the Training Center of the First Affiliated Hospital of Bengbu Medical College from May to December 2019 were divided into control group(n=66) and experimental group(n=66) according to random number table. The control group were taught with conventional didactics, and the experimental group were taught with four-step didactics. The teaching contents included three basic operations:transferring beans, stitching knots and cutting graphics under endoscope simulator. Three weeks later, the assessment combined with the classroom feedback questionnaire for teaching effect were analyzed and compared. Results Compared with the control group, the experimental group had advantages in objective score[(59.06±4.37) points vs.(57.39±4.45) points], subjective score[(19.73±1.36) points vs.(18.98±2.62) points] and total score[(78.79±4.40) points vs.(76.38±5.27) points], and the difference was statistically significant(P<0.05). The scores of the experimental group were significantly higher than those of the control group(Z=2.093, P=0.036). Conclusion The application of four-step didactics in laparoscopic simulator teaching can improve the basic skills, which is worth applying and popularizing in bed teaching.
Application of CBL combined with PBL teaching method in standardized training of residents in general surgery
HU Kai-feng, XU Li, XIA Ya-bin, LI Shu-ren, HUANG Xiao-xu, JIN Yan, HU Hao, YU Jie-gen
2020, 18(5): 849-851,870. doi: 10.16766/j.cnki.issn.1674-4152.001373
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Objective To explore the application of case-based learning(CBL) combined with problem-based learning(PBL) and traditional teaching method(LBL) in the standardized training of general surgery residents. Methods From September 2016 to September 2018, 36 residents in General Surgery Department of Yijishan Hospital of Wannan Medical College were selected as subjects. They were randomly divided into experimental group(CBL + PBL group, 18 cases) and control group(LBL group, 18 cases). The differences of teaching effect and satisfaction between the two groups were compared. Results There was no significant difference between the two groups in average age, gender, admission examination results, original unit of students(all P<0.05). In basic theory examination, the average scores of resident trainees in the experimental group(47.1±1.4) and the control group(42.2 ±1.2) were significantly different(P<0.05). In skill operation assessment, the average score of the students in the experimental group(45.5±1.3) was significantly better than that in the control group(40.6±1.5), and the difference was statistically significant(P<0.05). The interest in learning, autonomous learning ability, clinical operation skills, team cooperation ability, literature review ability, clinical thinking ability of students in the experimental group were higher than those in the control group(all P<0.05). Conclusion CBL combined with PBL teaching method is helpful to deepen the understanding of general surgery theory knowledge of resident physicians, and to cultivate the ability of autonomous learning and problem solving. It is obviously superior to LBL teaching method and can effectively improve the standardized training effect of resident physicians in general surgery.
Result analysis of"Acute Abdominal Pain"simulated case from Emergency Skills Competition in Hubei Province
JIN Xiao-qing, LI Hui-ping, NI Shao-zhou, ZHAO Yan
2020, 18(5): 852-855. doi: 10.16766/j.cnki.issn.1674-4152.001374
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Objective To analyze the results of the "Acute Abdominal Pain" simulated clinical case of the Hubei Provincial Emergency Physician Skills Competition, compare the score of comprehensive treatment, emergency ultrasound, cardiopulmonary resuscitation and comprehensive ability, understand the emergency medical treatment and first-aid skills of emergency doctors in the province, and provide evidence for improving the operational level of emergency doctors. Methods The scores of the teams participating in the finals were calculated in percent. Statistics of the error rate of each team, and the average error rate of each item were calculated. Finally, we analyzed the reason of specific error scores of the participating teams in each project. Results The average error rate was sorted as follows:comprehensive treatment(39.1%), emergency ultrasound(30.3%), cardiopulmonary resuscitation(27.5%) and comprehensive ability(16.5%). The order of highest error rate was the same as the average failure rate, which was comprehensive treatment(47.2%), emergency ultrasound(40.0%), cardiopulmonary resuscitation(32.0%) and comprehensive ability(21.0%). The highest error rate was comprehensive treatment, and the lowest was comprehensive ability. There were two aspects of misdiagnosis in all participating teams:First, for unexplained dyspnea, there was no sequential treatment from non-invasive respiratory support to invasive respiratory support; second, in bedside emergency ultrasound, cardiopulmonary evaluation skills were found needing to be improved. Conclusion The emergency doctors in our province are in good condition in the critical care and first aid skills. In this competition, there are fewer errors in comprehensive ability and cardiopulmonary resuscitation. However, it is necessary to strengthen the bedside ultrasound skills training, and to improve the "emergency clinical thinking" ability more importantly.
Expression of Panx1 gene in non-small cell lung cancer and bioinformatics analysis of biological function
WANG Guo-fang, WANG Yu-juan, LANG Hua
2020, 18(5): 856-859. doi: 10.16766/j.cnki.issn.1674-4152.001375
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Objective To investigate the relationship between the expression of Pan connexin 1 gene and prognosis in human non-small cell lung cancer(NSCLC). Methods The differential expression of Panx1 gene was analyzed in TCGA. The interaction network of Panx1 gene coding protein was constructed in the STRING database. The function of Panx1 gene was enriched and annotated, and the related signal pathway was analyzed. According to the expression level of Panx1 gene in cancer tissues, the patients were divided into high expression group and low expression group. At the same time, 61 patients with NSCLC were selected to detect the expression of Panx1 in cancer and normal tissues adjacent to cancer by immunohistochemistry. The relationship between the expression of Gpx1 and the clinicopathological characteristics and prognosis of patients was analyzed and compared. Results The expression level of Panx1 gene in NSCLC was significantly higher than that in normal lung tissue, and there was significant difference in NSCLC and Panx1 gene in different stages of NSCLC(F=3.300, P=0.020). The coding products of Panx1 gene were mainly involved in the biological processes of multiple organ development, cell-cell communication and response to stimulation. The signaling pathways were mainly enriched in cell proliferation signaling pathway, apoptosis signaling pathway and calcium related signaling pathway. There was a positive correlation between pafah1 b2 and Panx1 gene expression(r=0.650, P=0.023). However, c22 orf32 was negatively correlated with Panx1 gene expression(r=-0.340, P=0.032). The total survival(OR) of NSCLC patients with high expression of Panx1 gene was significantly correlated. The OS of high expression group was lower than that of low expression group(HR=1.400, P=0.001), while the expression level of Panx1 gene was not significantly correlated with disease free progression survival(DFS). Subgroup analysis showed that Panx1 gene expression was related to OS survival of lung adenocarcinoma(HR=1.400, P=0.017). Panx1 expression was related to TNM stage(χ2=7.244, P=0.007) and mediastinal lymph node metastasis(χ2=7.582, P=0.006) in NSCLC patients. Conclusion The expression of Panx1 gene is up regulated in non-small cell lung cancer, whihc is related to the short survival time of patients.
Analysis of the current situation and influencing factors of experiential avoidance in patients with total hip arthroplasty
ZHENG Li-si, HUANG Le-ping, YE Jie-yu
2020, 18(5): 860-863. doi: 10.16766/j.cnki.issn.1674-4152.001376
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Objective To investigate the current situation of experiential avoidance in patients with total hip arthroplasty, and to analyze the influencing factors to provide theoretical basis for clinical intervention. Methods Using time stage continuous cases the cluster sampling method, 227 patients with total hip arthroplasty at two top three hospitals(Guangzhou Red Cross Hospital, The Second Affiliated Hospital of Guangzhou Medical University) from February to December 2018 were selected. All patients were surveyed by the general questionnaire, Acceptance and Action Questionnaire-2 nd Edition(AAQ-Ⅱ), General Self-Efficacy Scale(GSES) and Social Support Rating Scale(SSRS). Results The experiential avoidance score of patients with total hip arthroplasty was(26.26±7.44) points. Univariate analysis showed that patients with different gender, education, and Harris hip score had statistically significant differences in their experiential avoidance scores(all P<0.05). Pearson correlation analysis showed that the general self-efficacy, social support dimensions and total scores of patients were negatively correlated(all P<0.05). Multiple stepwise regression analysis showed that general self-efficacy, total social support score, Harris hip score, and gender entered the regression equation(F=37.115, P<0.001). Conclusion Patients with total hip arthroplasty have a higher level of experiential avoidance, and gender, Harris hip score, general self-efficacy, and social support influence it. Clinicians should take targeted interventions, implement self-efficacy interventions, and mobilize the patient's social support system to reduce the level of experiential avoidance.
Analysis of the effect of Whole process nursing in the patients with postpartum hemorrhage
WANG Hong-juan, HU Jian-nü
2020, 18(5): 864-866. doi: 10.16766/j.cnki.issn.1674-4152.001377
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Objective To explore the effect of Whole process nursing and routine nursing on postpartum hemorrhage patients. Methods From January 2017 to December 2018, 120 patients with postpartum hemorrhage were selected from the Third People's Hospital of Hangzhou. According to the method of random number table, they were divided into intervention group and control group, 60 cases in each group. The patients in the control group were given routine nursing, and the patients in the intervention group were given Whole process nursing. The success rate of hemostasis, psychological state(SAS, SDS), complication rate and nursing satisfaction of the two groups were compared. Results After intervention, the success rate of hemostasis in the intervention group was 100.00%, significantly higher than that in the control group(83.33%, P<0.05). Before intervention, the SAS and SDS scores of the two groups were not significant(P>0.05), and after intervention, the SAS and SDS scores of the intervention group(48.14±3.57, 46.25±4.01) were significantly lower than those of the control group(55.21±3.12, 56.07±3.79). After intervention, the incidence of complications in the intervention group(3.33%) was significantly lower than that in the control group(15.00%, P<0.05). After intervention, the nursing satisfaction of the intervention group was 91.66%, significantly higher than that of the control group(58.33%, P<0.05). Conclusion The application of whole process nursing in the treatment of postpartum hemorrhage can significantly improve the success rate of hemostasis and nursing satisfaction, improve the patients' depression and anxiety symptoms, and reduce the incidence of complications.
Application of self-efficacy intervention in improving nursing of patients with chronic gastritis
WANG Yin-fang, DUAN Jian-hua
2020, 18(5): 867-870. doi: 10.16766/j.cnki.issn.1674-4152.001378
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Objective Investigate the effect of self-efficacy intervention in improving the care of patients with chronic gastritis. Methods A total of 120 patients with chronic gastritis treated in our hospital from December 2017 to June 2019 were selected and divided into two groups according to the random number grouping method, that is, the control group(n=60) used conventional nursing; the observation group(n=60) used self-efficacy intervention; the two groups were evaluated after 3 months of intervention, and the two groups were compared. Self-efficacy(measurement of self-efficacy assessment scale), health behavior[measurement of health promotion lifestyle scale(HPLP-Ⅱ)], and compliance behavior(measured by our hospital's self-compliance questionnaire) before and after intervention. Results After 3 months of intervention, the scores of self-efficacy(43.51±3.42) in the observation group were higher than those in the control group(37.42±3.40), t=9.786, P<0.05.The scores of healthy behavior(127.96±14.58) were higher than those in the control group(102.51±13.97), t=9.763, P<0.05. The difference of adherence of regular medication, regular review, emotional control, reasonable diet and accurate exercise between the two groups were all statistically significant(Uc=11.580, 7.500, 6.710, 10.210 and 7.070, all P<0.05). Conclusion Self-efficacy intervention can improve self-efficacy, enhance compliance of patients with chronic gastritis, and help patients to establish healthy behaviors. It is of great clinical significance and is worth promoting.
Effect of clustering comprehensive nursing intervention on patients with schizophrenia during maintenance period
SHI Chun-mei, XIA Yong
2020, 18(5): 871-873,877. doi: 10.16766/j.cnki.issn.1674-4152.001379
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Objective To observe the effects of clustering comprehensive nursing intervention on negative symptoms, body weight and BMI in patients with schizophrenia during maintenance. Methods A total of 72 patients with schizophrenia from March 2017 to March 2018 were collected. The patients were randomly divided into observation group and control group,each 36 controls. Patients in the control group were accepted routine nursing intervention. Patients in the observation group were accepted clustering comprehensive nursing intervention. The intervention lasted for 8 weeks.The total scores of PANSS and the scores of various subscales, body weight and BMI between groups were compared. Results The differences of two groups of the total scores of PANSS, negative symptom scores, the weight and BMI[observation group(55.6±8.7) scores,(26.6±8.0) scores,(70.2±6.6) kg,(24.6±2.5) kg/m2; control group(59.4±6.9) scores,(30.9±7.3) scores,(73.8±7.2) kg,(26.2±2.9) kg/m2] were significantly(t=-2.053, P=0.044; t=-2.382, P=0.020; t=-2.211, P=0.030; t=-2.507, P=0.014). The positive symptoms scores and general psychopathological scores[observation group(25.5±6.4) scores,(28.3±7.5) scores; control group(24.7±8.6) scores,(29.0±6.8) scores] were not significant different(t=0.448, P=0.656; t=-0.415, P=0.680) between the two groups. Conclusion Clustering comprehensive nursing intervention for patients with maintenance schizophrenia can effectively improve their scores of PANSS, especially the negative symptoms, and help them manage their body weight and BMI better.
Analysis of the prognostic management value of Omaha System Combined with pharmacist service in children with Henoch Schonlein purpura nephritis
ZHU Xiu-hua, QIAO Xiao-hui, CHEN Bo
2020, 18(5): 874-877. doi: 10.16766/j.cnki.issn.1674-4152.001380
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Objective To explore the value of continuous nursing based on Omaha System and pharmacist service for prognosis management of Henoch Schonlein purpura nephritis(HSPN). Methods Forty-six children with HSPN who were hospitalized from January 2016 to January 2019 were randomly divided into two groups, 22 in the observation group and 24 in the control group. Routine pediatric nursing was used in the control group, and continuous nursing based on Omaha System and pharmacist service was used in the observation group. The immune indexes, the recurrence rate of nephritis, treatment compliance and nursing satisfaction were compared between the two groups before nursing for 3 months and 6 months after discharge. Results After discharge, the ratio of CD4+ T lymphocyte and CD4+/CD8+ T lymphocyte in the observation group was higher than those in the control group(all P<0.05). There were no significant difference in the levels of CD8+ T lymphocyte, IgG, IgM and IgA between the two groups(all P>0.05). The cumulative recurrence rate of HSPN in the observation group was 4.55% at 6 months(P>0.05). The treatment compliance of the observation group was higher than that of the control group(8.33%), P<0.05. The treatment compliance of the observation group were higher than that of the control group at 3 and 6 months after discharge(all P<0.05). The nursing satisfaction of the observation group was 95.45%, and that of the control group was 70.83%, the difference was statistically significant(P<0.05). Conclusion Comparing with the routine nursing, the continuous nursing based on Omaha System and pharmacist service does not significantly improve the immune index of children with Henoch Schonlein purpura nephritis, but there is a trend of relevant changes, and there might be significant differences in the extended follow-up.
Intervention effect of different nursing measures on radiation skin injury
FU Qiong, ZHANG Ya-ping, ZHAO Zhen-hua
2020, 18(5): 878-881. doi: 10.16766/j.cnki.issn.1674-4152.001381
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Objective To explore the preventive and therapeutic effects of medical radiation protector(ork) combined with sulfadiazine silver cream on radiation skin lesions. Methods From January 2017 to December 2018 in Greentown Cardiovascular Hospital, a total of 150 patients with nasopharyngeal carcinoma who received linear accelerator radiotherapy were randomly divided into three groups, 50 cases in each group. Three groups were given different nursing intervention measures. In observation group Ⅰ, the medical radiation protection spray-Oak spray was used in the irradiation area for external use before radiotherapy. In observation group Ⅱ,the medical radiation protection spray-Oak spray was used in the irradiation area for external use before radiotherapy. After radiotherapy, silver sulfadiazine cream was used for external use in the irradiation area. In control group, routine nursing method was adopted. By the end of the total course of treatment, the incidence of skin lesions(incidence, occurrence time, severity) and wound healing(healing time, healing rate) were compared among the three groups. Results The incidence of skin lesions after radiotherapy was 100% in all three groups. There was significant difference in the occurrence time of skin lesions in three groups(F=3.329, P<0.05). The occurrence of skin lesions in group Ⅱ was later. There was significant difference in the degree of skin lesions after radiotherapy among the three groups(P<0.05). The incidence of severe radiation lesions(grade Ⅲ-Ⅳ) was lower in group Ⅱ. The total effective rate of the three groups after treatment and intervention was significantly different(P<0.05), and the clinical effect of group Ⅱ was better. The healing time of skin lesions in three groups was significantly different(P<0.05). The healing time of skin lesions in group Ⅱ was shorter. There was significant difference in the percentage of healed wounds among the three groups(P<0.05). The percentage of healed wounds in group Ⅱ was higher. Conclusion Oxypent combined with silver sulfadiazine can better reduce the incidence of radiation-induced skin lesions and promote the healing of radiation-induced skin lesions in patients with nasopharyngeal carcinoma.
LI Zi-xuan, ZOU Yu-qiong, WANG Li-juan, HUANG Yan-jing, LI Ya-song
2020, 18(5): 882-884. doi: 10.16766/j.cnki.issn.1674-4152.001382
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CHEN Ai-ju, ZHENG Yue
2020, 18(5): 885-886. doi: 10.16766/j.cnki.issn.1674-4152.001383
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