2021 Vol. 19, No. 11

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Expert Forum
The theory and practice of community health portraits from the perspective of general practitioners
LI Qian, WANG Yi-fei, SHI Jian-wei, YU Wen-ya, ZHOU Liang, GAO Xiang, WANG Zhao-xin, LYU Yi-peng
2021, 19(11): 1797-1801. doi: 10.16766/j.cnki.issn.1674-4152.002170
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As a tool to achieve accurate personalized information service, user portrait has been widely concerned in recent years. User portrait is a "virtual representation based on the real data of users". The most important characteristics are authenticity, dynamics and uniqueness. Based on different portrait building point of view, the user portrait main methods can be divided into four kind of genre: portrait based on ontology, portrait based on user behavior painting, portrait based on themes, and portrait based on user interests. The build process is a user characteristic data acquisition, data mining and filtering, labels, extraction and the process of restructuring, rich user portrait description, because of its precision, the characteristics of personalized service, user portrait can be used for personalized recommendation, precision marketing, behavior prediction, anomaly detection and other directions. Community portrait is based on the user portrait of the specific group to carry out the front range and boundary confirmation, emphasizing the common characteristics of the given group, so there are corresponding differences in research content and methods. Community health portrait is the extension of community portrait in the field of health care, the essence is a certain area of community subject in the field of health care information collection, according to the different purposes of portrait based on user similarity portrait or based on the difference of the community portrait. In the future, it can be applied to regional medical resource allocation, precision and personalized medical service, medical and health service level evaluation, and community residents' health monitoring. However, with the continuous advancement of graded diagnosis and treatment system and the continuous updating of data support technology, the allocation of medical resources in grassroots communities will become a hot research topic in the field of public health in the future, and the application of community health portrait will also be more and more. This paper introduces the current research progress and key technologies of user portrait and community portrait, and puts forward the concept, construction process and method of community health portrait and its application prospect, which provides reference for further research on community health portrait. Keywords: Portrait; User data; Community health.
Diagnosis and treatment of common acute complications of diabetes mellitus
WU Chen-chen, WU Xiao-fei
2021, 19(11): 1802-1803.
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The relationship between serum HIF-1α, TGF-β1 and renal interstitial fibrosis and disease progression in patients with chronic kidney disease
LIN Yong-qiang, CHEN Tian-tian, WANG Chao-chao, ZHOU Ying, CAI Xiao-qiao, JIANG Yi, LIN Sheng-fen
2021, 19(11): 1868-1871,1978. doi: 10.16766/j.cnki.issn.1674-4152.002188
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  Objective  To investigate the changes of serum hypoxia-inducible factor-1α (HIF-1α), transforming growth factor (TGF-β1) and tubular interstitial fibrosis (TIF) in patients with chronic kidney disease (CKD) and their predictive value for disease progression.  Methods  A total of 158 cases of CKD patients were selected admitted to Department of Nephrology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2020. The patients were staged according to the glomerular filtration rate (eGFR) value: stage 1 (n=38), stage 2 (n=42), stage 3 (n=30), stage 4 (n=28), stage 5 (n=20). Another 40 cases of healthy subjects were selected as control group. The clinical data and blood samples of above groups were collected. The levels of HIF-1α and TGF-β1 were detected with Enzyme-linked immunosorbent assay (ELISA). TIF area was assessed with Masson staining.  Results  The levels of HIF-1α [(25.48±4.26) ng/mL, (30.98±5.36) ng/mL, (35.88±6.78) ng/mL, (42.25±5.63) ng/mL, (68.96±6.98) ng/mL], TGF-β1 [(3.98±0.36) ng/m, (5.23±0.45) ng/m, (6.78±0.63) ng/m, (8.96±1.52) ng/m, (12.97±2.98) ng/mL] of CKD stage 1-5 were significantly higher than control group [(12.78±0.69) ng/mL and (1.22±0.15) ng/mL, all P < 0.05]. The levels of serum CysC, Scr, HIF-1α, and TGF-β1 of non-TIF group were lower than TIF group (all P < 0.05). The serum HIF-1α, TGF-β1 were positively correlated with serum CysC, Scr, TIF area by Pearson correlate factor analysis (all P < 0.05). The HIF-1α and TGF-β1 can improve the value of early CKD diagnosis by receiver specific curve (ROC).  Conclusion  The increase of serum HIF-1α and TGF-β1 levels is related to the increase of CysC, Scr and TIF. The serum HIF-1α and TGF-β1 can be used as early CKD serum standards, and the combined detection of the two can improve the diagnostic accuracy.
Observation on the curative effect of tanshinone combined with azithromycin in the treatment of children with mycoplasma pneumonia
ZHANG Hui-juan, QIU Jian-li, YAN Yong-bin, SUN Xiao-xu, ZHAO Qian-yi
2021, 19(11): 1872-1874,1983. doi: 10.16766/j.cnki.issn.1674-4152.002189
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  Objective  To observe the efficacy of tanshinone in the treatment of children with mycoplasma pneumonia (MP) and its effect on the expression of serum IL-6, TNF-α, TGF-β1 and Smad3.  Methods  A total of 100 children with MP were selected from January 2018 to September 2020, and they were divided into observation group and control group according to the random number table method, with 50 cases in each group. Azithromycin was used in the control group, and azithromycin combined with tanshinone was used in the observation group. The total effective rate, the time of symptom disappearance, the expression of serum IL-6, TNF-α, TGF-β1 and Smad3, and adverse reactions were compared between the two groups.  Results  The total effective rate in the observation group was 92.00%, which was higher than 76.00% in the control group (P < 0.05). The disappearance time of cough, fever, rales and wheeze in the observation group were (5.37±0.94) d, (2.71±0.51) d, (4.73±0.84) d, (5.82±1.02) d, which were shorter than those in the control group [(6.89±0.88) d, (3.53±0.72) d, (6.23±0.91) d, (7.11±1.31) d, P < 0.05]. The serum levels of IL-6, TNF-α, TGF-β1, and expression of Smad3 after treatment in the observation group were (16.16±5.49) pg/mL, (7.18±1.71) pg/mL, (15.22±3.06) μg/L, 0.20 ± 0.06, which were lower than those in the control group [(25.41±6.0) pg/mL, (12.98±2.61) pg/mL, (27.27±5.28) μg/L, 0.26±0.07, all P < 0.05]. There was no significant difference in total incidence of adverse reactions (14.00% vs 10.00%) between the two groups (P>0.05).  Conclusion  Tanshinone can down-regulate the expression of Smad3 to reduce serum TGF-β1, IL-6, and TNF-α. It has satisfactory results in the treatment of children with MP and has high safety.
Comparative study of several Chinese patent medicines for strengthening spleen and digestion in the treatment of subacute eczema in children
YANG Ming, GU Fei, ZHU Yun, LIU Xiao-yan, GAO Ying
2021, 19(11): 1875-1879. doi: 10.16766/j.cnki.issn.1674-4152.002190
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  Objective  To observe and compare the clinical efficacy and safety of several Chinese patent medicines for strengthening spleen and digestion in the treatment of subacute eczema in children.  Methods  The clinical data of 186 cases of children with subacute eczema treated in the Children' s Hospital Capital Institute of Pediatrics from June 2018 to June 2019 were retrospectively analyzed. The children were divided into control group (48 cases, conventional Western medicine) and observation group (138 cases, combined with Chinese patent medicines for strengthening spleen and digestion on the basis of the treatment of the control group) according to the treatment plan. The observation group was divided into group A (42 cases), group B (57 cases) and group C (39 cases) according to the difference of Chinese patent medicine, and the medicines included Xiaoerfupi Granule, Xiaoerkang Granule and Shenquxiaoshi Oral Liquid. Then, the efficacy, recurrence, pruritus, quality of life and adverse reactions were compared.  Results  After one course of treatment, the total effective rates of observation groups A, B and C (83.33%, 85.96% and 79.49%, respectively) were higher than that of the control group (58.33%), and the difference between group B and the control group was significant (P < 0.008). After one course of treatment, the pruritus and quality of life scores of observation groups A, B and C [the pruritus score was (0.64±0.53) points, (0.49±0.37) points and (0.56±0.48) points, respectively; CDLQI scores were (5.24±1.93) points, (5.04±1.01) points and (5.59±2.13) points, respectively] were significantly improved compared with the control group [pruritus score and CDLQI score were (1.41±0.72) points and (8.70±2.91) points, respectively, all P < 0.05]. However, no significant difference was observed amongst the three observation groups (all P>0.05). The recurrence rates of eczema at 3 months in the three observation groups were obviously lower than that in the control group (P < 0.008), and this rate at 3 months was significantly lower in group B (19.30%) than in group A (46.34%, P < 0.008). Only minor adverse reactions occurred in each group during treatment, and no significant difference was observed in the incidence of adverse reactions (P>0.05).  Conclusion  In the treatment of subacute eczema in children with the Chinese patent medicines for strengthening spleen and digestion combined with western medicine for routine treatment, Xiaoerkang Keli have more advantages in improving curative effect and reducing the recurrence rate, and deserve further attention.
Clinicopathological analysis of 165 cases of total hysterectomy with cervical HSIL
PENG Zhao-qing, LI Yu-zhi, LIU Hong-li, LIU Meng-jun, DENG Li-wen
2021, 19(11): 1880-1883. doi: 10.16766/j.cnki.issn.1674-4152.002191
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  Objective  To investigate the related risk factors and pathological characteristics of pathologically upgraded invasive carcinoma after total hysterectomy in the initial treatment of cervical high-grade squamous intraepithelial lesion (HSIL).  Methods  Retrospective analysis was performed on 165 patients who received total hysterectomy as initial treatment for HSIL in the First Affiliated Hospital of Bengbu Medical College from January 2010 to January 2020. They were divided into premenopausal group (52 cases) and menopausal group (113 cases). According to pathology, they were divided into infiltrating group and non-infiltrating group. The related risk factors and pathological characteristics of pathological progression were studied.  Results  Among the 165 HSIL cases, 26 cases had invasive cancer, with a total incidence of (15.8%, 26/165). The pathological upgrading rate of the premenopausal group was 11.5% (6/52). The pathological upgrading rate of the menopausal group was 17.7% (20/113). Univariate analysis in premenopausal group: lesion number ≥ 3 points, lesion gland accumulation and abortion ≥ 2 times were the risk factors of pathological upgrading. Logistic regression analysis showed that lesion number ≥ 3 points and lesion gland accumulation were the independent risk factors of pathological upgrading. Univariate analysis in menopausal group: the number of lesions ≥ 3 points, gland accumulation and menopausal years ≥ 5 years were the risk factors of pathological upgrading. Logistic regression analysis showed that these three points were also the independent risk factors of pathological upgrading. Six cases of invasive cancer in premenopausal group, 4 cases of ⅠA1 stage, 2 cases of lymphatic vascular infiltration in ⅠA2 stage. Among the 20 patients in the menopausal group, 16 patients had stage ⅠA1, including 1 patient with lymphatic vascular infiltration and 4 patients with stage ⅠA2.  Conclusion  There is no significant difference in pathological upgrading between menopausal and premenopausal patients. For patients with HSIL, regardless of menopause or not, the number of lesions ≥ 3 and the number of lesion glands should be vigilant against the occurrence of invasive cancer. The pathological upgrading rate will increase in patients with menopausal years>5 years. The pathology of HSIL patients after total hysterectomy was all early invasive carcinoma.
Study on the correlations between heat shock protein 70 and severe preeclampsia
YAN Meng-jie, GU Mao-hong, XU You-di
2021, 19(11): 1884-1887. doi: 10.16766/j.cnki.issn.1674-4152.002192
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  Objective  To observe and compare the clinical characteristics of early-onset and late-onset severe preeclampsia (EOSP and LOSP), and to explore the correlation between heat shock protein 70 (HSP70) and severe preeclampsia.  Methods  The clinical characteristics of 84 EOSP cases and 252 LOSP cases in Nanjing First Hospital from July 2013 to March 2020 were retrospectively analyzed. Enzyme-linked immunosorbent assay was used to detect the serum HSP70 levels of EOSP group, LOSP group and 448 normal full-term pregnancy group. The differences in the results amongst the three groups were compared.  Results  There were statistical differences in ages, pre-pregnant BMI, onset gestational weeks, delivery gestational weeks, days of expectation treatment, blood pressure (systolic and diastolic blood pressure), 24 h urinary protein quantity (24h-Upr), creatinine (Cre), blood urea nitrogen (BUN), alanine transaminase (ALT), aspartate aminotransferase (AST), and platelet count (PLT) between the EOSP and LOSP groups (all P < 0.05). The values of HSP70 in the EOSP group [(101.81±6.44) ng/mL] was significantly higher than that in the LOSP group [(86.51±10.70) ng/mL, P < 0.05], while the HSP70 levels in the control group [(51.33±15.48) ng/mL] was significantly higher than LOSP group (P < 0.01).  Conclusion  HSP70 levels in the severe preeclampsia group is significantly higher than that in the normal pregnancy, and it is higher in the EOSP group than that in the LOSP group, indicating that Hsp70 in serum may be related to the pathogenesis of severe preeclampsia.
Implementation strategies for constructing a clinical path of 'cardiac rehabilitation in the community' for community general practice care under hierarchical medical system
WANG Qing-qing, CHEN Bi-hua, LI Qing, GAO Wen-juan, KANG Jing
2021, 19(11): 1888-1892. doi: 10.16766/j.cnki.issn.1674-4152.002193
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  Objective  China's community health service has entered the period of disciplinary connotation construction. The construction of specialised community health institutions is the current targeted strategy to improve grassroots services and retain the needs of grassroots health. The specialty disciplinary depends on the solution construction of the specialty critical illness. This study aims to review the two-year practice of 'cardiac rehabilitation in the community' in Longhua community by understanding the core elements and basic principles in the successful construction of community general practice care on critical illness. This study discusses how to systematise and structurally comb out the 'implementation countermeasures to construct the clinical path of community general practice care on critical illness' in the height of discipline construction.  Methods  Centre on the five aspects of 'service connotation and organisational structure and department setting around implementation countermeasures; personnel access and training strategies; technology supplier selection and cooperation mechanism establishment; service process development and supporting facility deployment; ground implementation plan establishment and quality control and evaluation system Establishing a combination of specific practices', introduced Longhua's specific practices and experience.  Results  Through the review and carding of the five aspects, the concrete practice of Longhua community was fully explored and presented. It has sorted out two lists, three tools and a set of process used by Longhua community in the practice process, which is a reference kit for future technology development of the community.  Conclusion  The full preparation and implementation of the above five dimensions is the guarantee for the smooth and solid implementation of the 'cardiac rehabilitation in the community' project with the characteristics of community and general practice. The two lists, three tools and a set of process developed and used in the construction of Longhua community can help peers grasp the details and guide the implementation.
Application of rehabilitation path based on linkage of hospital-community-family in patients with ischemic stroke
ZHENG Hong-yan, YU Yan, LUO Shu-yin, JIA Lan, HU Wen
2021, 19(11): 1893-1896. doi: 10.16766/j.cnki.issn.1674-4152.002194
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  Objective  To explore the application effect of rehabilitation path based on the linkage of hospital-community-family in patients with ischemic stroke.  Methods  A total of 120 patients with ischemic stroke admitted to our hospital from January 2018 to April 2020 were selected and randomly divided into the control group and observation group, with 60 cases each. The control group received traditional rehabilitation management, whilst the observation group received rehabilitation path management based on linkage of hospital-community-family. The nerve function, limb function recovery, activities of daily living, quality of life, mental state and complications of both groups were compared.  Results  The neurological deficits of stroke in the observation group [(21.12±2.32) points] were lower than those in the control group [(27.81±4.33) points], whilst the simple mental status score in the observation group was higher than that in the control group (all P < 0.05). The Fugl-Meyer limb movement function in the observation group [(39.49±5.38) points] was higher than that in the control group [(33.67±4.02) points]. Moreover, the modified Barthel index in the observation group [(77.17±8.20) points] was higher than that in the control group [(65.17±9.21) points, all P < 0.05]. The quality of life in the observation group after stroke [(164.65±18.76) points] was higher than that in the control group [(110.76±21.83) points, P < 0.05]. The scores of the anxiety self-rating scale and depression self-rating scale in the observation group were lower than those in the control group (P < 0.05). The incidence of complications in the observation group during the intervention period was lower than that in the control group (P < 0.05).  Conclusion  The rehabilitation path model based on the linkage of hospital-community-family can promote the recovery of patients with ischemic stroke after discharge, improve the quality of life and reduce the negative emotions and adverse reactions of patients.
Subjective sleep quality and its influencing factors in male patients with severe mental illness
ZHU Tong, TANG Xiao-wei, GENG Zai-xiang, DAI Ming-di
2021, 19(11): 1897-1900. doi: 10.16766/j.cnki.issn.1674-4152.002195
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  Objective  To investigate the subjective sleep quality and its influencing factors in male patients with severe mental illness.  Methods  A total of 108 male patients with severe mental illness admitted to our hospital from February 2017 to June 2020 were selected as the research subjects, and they were divided according to different diseases: 82 patients with schizophrenia and 26 patients with bipolar disorder. The subjective sleep quality and its influencing factors were analysed.  Results  The total subjective sleep time [(9.12±1.03) h] and subjective sleep time [(29.64±6.72) min] were significantly higher than the total objective sleep time [(7.98±1.02) h] and objective sleep time [(17.89±5.85) min] (P < 0.01). The total subjective sleep time [(6.72±1.67) h] was significantly lower than the total objective sleep time [(7.83±1.79) h] (P < 0.05), whilst the subjective sleep time [(23.52±4.87) min] was significantly higher than the objective sleep time [(11.76±4.96) min] (P < 0.01). The sleep time and sleep disorder factor score of patients with schizophrenia were significantly higher [(1.32±0.18) points and (0.88±0.13) points] than those of patients with bipolar disorder [(0.92±0.17) points and (0.78±0.12) points] (P < 0.01), whilst the hypnotic drug factor score of patients with schizophrenia was significantly lower [(0.21±0.08) points] than that of patients with bipolar disorder [(0.61±0.07) points, P < 0.01]. The analysis of the influencing factors of subjective sleep perception showed that the higher the score of anxiety factor, the lower the evaluation of sleep (P < 0.01), whilst the lower the score of hostility, the higher the evaluation of sleep (P < 0.01).  Conclusion  The subjective and objective sleep status of patients with severe mental illness is different, and patients often exaggerate the degree of their own poor sleep quality. Moreover, negative emotions such as anxiety and hostility will aggravate patients' wrong perception of their own sleep quality, which is a risk factor affecting the subjective sleep of male patients with severe mental illness.
Clinical application effect of the health education model of knowledge, attitude, belief and practice on postoperative breast cancer patients
LU Yi-xian, YU Jing-jing, LIU Hong, GU Run-huan, LI Xiao-jie, ZHONG Li-li, XU Yue-e
2021, 19(11): 1901-1904. doi: 10.16766/j.cnki.issn.1674-4152.002196
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  Objective  To explore the effect of the mode of knowledge, attitude, belief and practice on postoperative clinical application of breast cancer patients.  Methods  A total of 120 breast cancer patients admitted in Affiliated Huai'an Hospital of Xuzhou Medical University from February 2018 to June 2019 were selected and divided into intervention group (60 cases) and control group (60 cases) according to the random number table method. The control group was given routine care, whilst the intervention group was given the mode of knowledge, attitude, belief and practice. The health behaviour, quality of life, negative emotions and sexual psychological burden of both groups were compared.  Results  The scores of cognitive function, physical function and overall health status in the control group were higher than those before the intervention, and the scores of the total symptom and SAS were lower than those before the intervention, the differences were statistically significant (all P < 0.05). The scores of the functional items in the intervention group were higher than those before the intervention, and the scores of the total symptom, SAS and SDS were lower than those before the intervention, the differences were statistically significant (all P < 0.05). The degree of positivity (or cognition) in all dimensions of health behaviour and functional items of life quality (except social function) in the intervention group were higher than those in the control group, and the differences were statistically significant (all P < 0.05). The total symptom score of the intervention group [(41.62±17.27) points] was lower than that of the control group [(48.46±19.04) points]. The scores of SAS, SDS and sexual psychological burden indicators (including the disappearance of secondary sexual characteristics, diminished female charm, sexual unsuitability and sexual communication disorders) were lower in the intervention than in the control group, the differences were statistically significant (all P < 0.05).  Conclusion  The mode of knowledge, attitude, belief and practice can reduce the negative emotional and psychological burden of breast cancer patients, increase healthy behaviours and improve the quality of life after surgery.
Response of schizophrenia patients with different intestinal flora distribution to olanzapine
YANG Zhi, GAO Xiao-feng, NI Yan-fei, CAO Peng-xue, ZHENG Li-feng
2021, 19(11): 1905-1907. doi: 10.16766/j.cnki.issn.1674-4152.002197
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  Objective  To explore the distribution of intestinal flora in patients with schizophrenia and the response of patients with different intestinal flora to olanzapine.  Methods  From March 2020 to January 2021, 40 schizophrenic patients who were diagnosed and treated in our hospital for the first time were selected as the research objects. 16S rRNA sequencing and gene database were used to detect the distribution of intestinal flora. According to the results, the patients were divided into groups and treated with olanzapine for 8 weeks. The scores of the positive and negative syndrome scale (PANSS), personal and social performance scale (PSP) and Wisconsin Card Sorting Test were compared.  Results  In 40 patients, 9 cases had type 1 flora (mainly Prevotella), and 31 cases had type 2 flora (mainly Bacteroides, Brucella, Anaerostipes and Eggerthella). After 8 weeks of treatment, the significant efficiency, effective rate and ineffective rate of treatment of patients with type 1 flora distribution were 55.56%, 44.44% and 0.00%, respectively, and those of patients with type 2 flora distribution were 19.35%, 54.85% and 25.81%, respectively. The difference was statistically significant (Z=2.531, P < 0.05). The PANSS score of patients with type 1 intestinal flora distribution was lower than that of patients with type 2 intestinal flora distribution (t=4.261, P < 0.05), and the PSP score was higher in the former than in the latter (t=5.921, P < 0.05).  Conclusion  Schizophrenic patients with type 1 intestinal flora distribution have better response to olanzapine, which is more conducive to improving symptoms and personal and social performance. Therefore, the prognosis of patients can be determined according to their intestinal flora.
Application value of H-FABP, RDW and NT-proBNP levels in the diagnosis of acute non ST segment elevation myocardial infarction
LI Ao-hang, TIAN Yuan-yuan, GAO Yan, ZHANG Jin-fang
2021, 19(11): 1908-1911. doi: 10.16766/j.cnki.issn.1674-4152.002198
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  Objective  To investigate the application value of heart-type fatty acid binding protein (H-FABP), red blood cell volume distribution width (RDW) and terminal pro brain natriuretic peptide (NT-proBNP) levels in the diagnosis of acute non ST segment elevation myocardial infarction (NSTEMI) and to provide a reference for the clinical diagnosis of NSTEMI.  Methods  Forty-five patients with acute NSTEMI who were admitted to our hospital from January 2019 to January 2020 were designated as the NSTEMI group, and they were divided into mild, moderate and severe groups according to Gensini score. Forty-five patients with noncardiogenic chest pain and angina pectoris in the same period were designated as non-NSTEMI group. Forty-five healthy people were designated as the control group. The levels of H-FABP, RDW and NT proBNP in each group were compared to analyse the diagnostic value of those in the NSTEMI group.  Results  The levels of H-FABP, RDW and NT-proBNP in the NSTEMI group were higher than those in the non-NSTEMI and control groups, and the levels of H-FABP, RDW and NT-proBNP in the non-NSTEMI group were apparently higher than those in the control group (all P < 0.05). The levels of H-FABP, RDW and NT-proBNP in the severe NSTEMI group were apparently higher than those in the mild and moderate groups, and the levels of H-FABP, RDW and NT-proBNP in the moderate NSTEMI group were apparently higher than those in the mild group (all P < 0.05). The levels of H-FABP, RDW and NT-proBNP in NSTEMI patients were positively correlated with Gensini score (all P < 0.05). The AUC values of PH-FABP, RDW and NT-proBNP alone and in the combined diagnosis of NSTEMI were 0.813, 0.758, 0.866 and 0.887, respectively.  Conclusion  Serum ph-FABP, RDW and NT-probNP participate in the occurrence and development of acute NSTEMI, the level of which increased gradually with the aggravation of the illness of patients with acute NSTEMI. The combined detection of ph-FABP, RDW and NT-probNP have a higher diagnostic value for NSTEMI.
Clinical effect of multi-slice spiral CT enhanced scan and MRI in the differential diagnosis of renal parenchymal tumours
GAO Yin, YANG Chong-yi, HE Jian-hua, YANG Feng-qiang, WANG Wei-gen, YING Bi-wei
2021, 19(11): 1912-1915. doi: 10.16766/j.cnki.issn.1674-4152.002199
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  Objective  To compare the effect of multi-slice spiral CT enhanced scan and MRI in the differential diagnosis of renal parenchymal tumours.  Methods  A total of 140 patients with renal tumours in our hospital from December 2017 to December 2020 were selected as the research objects. All cases were examined by multi-slice spiral CT enhanced scan and MRI. The results of histopathological examination were taken as the gold standard, and the diagnostic efficiency of the two methods in the differential diagnosis of different pathological types and different lesion sizes of renal tumours were statistically analysed.  Results  No significant difference was observed in the sensitivity, specificity and accuracy of multi-slice spiral CT enhanced scan (88.68%, 85.29% and 87.86%) and MRI (90.57%, 82.35% and 88.57%) (χ2=0.203, 0.108, 0.034; P=0.652, 0.742, 0.853). Moreover, no significant difference was observed in the sensitivity, specificity and accuracy of multi-slice spiral CT enhanced scan (95.45%, 92.31% and 94.74%) and MRI (97.73%, 92.31% and 96.49%) in the qualitative diagnosis of renal parenchymal tumour with diameter>4 cm (χ2=0.345, 0.000, 0.209; P=0.557, 0.999, 0.647). The sensitivity, specificity and accuracy of multi-slice spiral CT enhanced scan and MRI in the qualitative diagnosis of renal parenchymal tumour with diameter < 4 cm (83.87%, 80.95% and 83.13%) were not significantly different from those of MRI (85.48%, 76.19% and 83.13%, χ2=0.345, 0.141, 0.000; P=0.557, 0.707, 0.999).  Conclusion  Multi-slice spiral CT enhanced scan detection and MRI detection have high clinical application value for the diagnosis of renal parenchymal tumours, and have high differential diagnosis efficiency for small renal parenchymal tumours. Clinical diagnosis can be reasonably selected according to the actual situation of patients.
Application of intravenous gamma globulin in neonatal diseases
ZHOU Huan, CHEN Yu-fei, CHEN Xiao-qing
2021, 19(11): 1916-1920. doi: 10.16766/j.cnki.issn.1674-4152.002200
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Compared with foetus, newborns have undergoing tremendous physiological changes. However, their immune system is weak and insufficient. Thus, newborns are susceptible to infectious diseases, such as neonatal infectious pneumonia, neonatal sepsis, neonatal purulent meningitis, neonatal viral encephalitis and neonatal enteroviral myocarditis. The occurrence and development of these diseases affect the quality of life and the prognosis of newborns, which increase the burden on the family. At the same time, the autoimmune antibodies, obtained from the mother's blood but have not been metabolised, can cause immune damage to the newborn, such as neonatal haemolytic disease, neonatal lupus erythematosus, neonatal hemochromatosis, neonatal alloimmune thrombocytopaenia, neonatal alloimmune neutropaenia and temporary neonatal myasthenia gravis. Some of these diseases are relieved following the metabolism of antibodies but still increase neonatal mortality. In addition, some diseases are related to immune dysfunction, such as Kawasaki disease, hypoxic-ischemic encephalopathy, neonatal autoimmune blistering disease, macrophage activation syndrome, Guillain-Barré syndrome and stiff-person syndrome. Although they are not common in the newborn population, one or more of these diseases will occasionally occur. Adjuvant therapy using intravenous gamma globulin can effectively treat these diseases. In addition, gamma globulins have similar ability to antibodies against certain antigens, so they have a certain impact on vaccination. This article reviews the potential mechanism of gamma globulins in neonatal diseases.
Research progress of microRNA-145 in endometriosis
GAO Shuang, XU Peng, WANG Bei-di, LI Li-yang, GUO Yu, KUANG Ye
2021, 19(11): 1921-1924. doi: 10.16766/j.cnki.issn.1674-4152.002201
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Endometriosis (EMs) is a common oestrogen-dependent disease, the cause of which is not clear. Epigenetic abnormality may be a potential pathogenic mechanism of EM, which changes the response of hormones and environmental factors to gene expression. Amongst them, small microRNAs (miRNAs) are differentially expressed in EM and play a certain role in the occurrence and development of the disease. miRNAs are non-coding regulatory single-stranded RNAs that regulate gene expression at the transcription or post-transcription level by binding to the 3′ untranslated region of mRNA. Several studies have revealed that miRNAs are potentially powerful biomarkers of EM. Some of these dysregulated miRNAs are directly involved in the occurrence of diseases, whilst others are related to the existence of diseases. However, their biological role is unclear. Amongst these miRNAs, miR-145 has obvious differential expression in EM. miR-145 mediates cell adhesion molecules and cytoskeletal elements, such as plasminogen activator inhibitor-1, octamer-binding transcription factor-4 and FSCN1. miR-145 is also regulated by its upstream RNA molecules. For example, long non-coding RNA prostate cancer-associated transcript 1 can have an impact on the risk of EM through the miR-145 signalling pathway that targets and regulates the expression of specific genes. In addition, the changes of miR-145 expression levels may be related to infertility in EM. This study aims to describe the mechanism of action of miR-145 in EM, including cell angiogenesis, peritoneal adhesion, invasion, migration, proliferation, autophagy and infertility, in order to provide further theoretical support for the clinical treatment of EM.
Clinical study of Jiedu Huoxue Decoction enema combined with oral Chinese medicine in patients with ulcerative colitis
JIANG Hai-yan, WANG Yin-xue, WANG Jian-yun, LIU Da-min, SUN Hui-yi, ZHANG Wen
2021, 19(11): 1925-1928,1955. doi: 10.16766/j.cnki.issn.1674-4152.002202
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  Objective  To evaluate the efficacy of Jiedu Huoxue Decoction enema combined with oral Chinese medicine in treating ulcerative colitis (UC) and explore the possible mechanism of action.  Methods  Total 80 patients with UC were selected from inpatients and outpatients in Dongzhimen Hospital of the Beijing University of Chinese Medicine and the Third Hospital affiliated Beijing University of Chinese Medicine from July 2016 to June 2018. According to the random number table method, 40 patients in the enema group were treated with Jiedu Huoxue Decoction enema combined with oral Chinese medicine, whereas 40 patients in the control group were treated with oral Chinese medicine only. The modified Mayo score was used to determine the clinical efficacy before and after treatment. The levels of inflammatory cytokine in the serum before and after treatment were determined. The expressions of vascular endothelial growth factor (VEGF) and anti-mucosal addressin cellular adhesion molecule-1 (Madcam-1) in the colon tissue before and after treatment were also observed. Effective telephone follow-up was conducted for 2 years.  Results  The modified Mayo scores of both groups decreased with time after treatment (P < 0.05). After 2 and 4 weeks of treatment, the improved Mayo scores of the enema group [(3.30±0.18) points and (4.30±0.27) points], were significantly lower than those of the control group [(4.85±0.45) points and (6.15±0.38) points, P < 0.05]. After 3 months of treatment, the serum levels of IL-8, TNF-α, VEGF and Madcam-1 in the two groups were significantly lower than those before treatment (P < 0.05). The serum levels of IL-8, TNF-α, VEGF and Madcam-1 in the enema group were significantly lower than those in the control group (P < 0.05). The expressions of VEGF and Madcam-1 in the colonic mucosa of the two groups were lower than before treatment (P < 0.05). The results of 2-year telephone follow-up showed that the recurrence rate of the enema group was significantly lower than that of the control group (P < 0.05).  Conclusion  Oral Chinese materia medica is effective in treating UC, whereas enema can relieve symptoms more quickly. It may reduce the release of inflammatory factors, thus reducing vascular inflammation and keeping patients in remission for a longer period.
Effect of electroacupuncture combined with ear point seed embedding on postoperative nausea and vomiting in patients undergoing gynaecological laparotomy
YANG Guang, LI Sha, ZHENG Man
2021, 19(11): 1929-1931,1959. doi: 10.16766/j.cnki.issn.1674-4152.002203
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  Objective  To investigate the effectiveness of combined preoperative electroacupuncture (EA) and postoperative ear point seed embedding for postoperative nausea and vomiting (PONV) after gynaecological laparotomy.  Methods  Total 90 patients undergoing gynaecological laparotomy in Jiangsu Provincial Hospital of Traditional Chinese Medicine from December 2016 to December 2018 were randomly divided into the preoperative EA group (group A), postoperative ear point seed embedding group (group B) and preoperative EA combined with postoperative ear point seed embedding group (Group C). Group A was given EA one day before the operation, group B was given ear point seed embedding treatment after the operation, and group C was given EA combined with ear point seed embedding treatment one day before the operation. The incidence of nausea and vomiting at 6, 24 and 48 h after operation, the use of antiemetic drugs, the time of first ventilation after operation and VAS score were recorded.  Results  Compared with the other two groups, the incidence of postoperative nausea (PON) and postoperative vomiting (POV) in group C at 6 and 24 h after surgery were significantly lower (all P < 0.05). The incidence of PON and POV was 30.00% and 26.67% at 6 h and 33.33% and 30.00% at 24 h, respectively. Amongst the three groups, group C had the shortest time to passage of first flatus (19.44±3.36) h (P < 0.05) and the least consumption of antiemetics after surgery (30.00%, all P < 0.05). No significant differences were observed regarding the incidence of PON and POV at 48 h after surgery and VAS score at 6, 24 and 48 h after surgery in all groups (all P>0.05).  Conclusion  Combined EA and postoperative ear point seed embedding after gynaecological laparotomy could decrease the incidence of PONV, shorten the time to passage of first flatus and reduce the consumption of antiemetics.
Therapeutic effect observation of Xingnao Kaiqiao Acupuncture combined with occupational therapy on upper limb dysfunction after stroke
ZHANG Wei, LU Yan, LI Chao, XU Lei
2021, 19(11): 1932-1934,1972. doi: 10.16766/j.cnki.issn.1674-4152.002204
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  Objective  To observe the effect of Xingnao Kaiqiao Acupuncture combined with occupational therapy on upper limb dysfunction after stroke.  Methods  Sixty patients with upper limb dysfunction after stroke were selected to be treated in the Fifth People's Hospital of Fuyang City from May 2019 to October 2020. SPSS 21.0 was used to make random tables. Then, the patients were randomly divided into the treatment group and control group, each with 30 cases. The control group was treated by occupational therapy, whilst the treatment group was treated with Xingnao Kaiqiao Acupuncture combined with occupational therapy. Both groups were treated once a day, five times a week for a total of 4 weeks. The upper-extremity Fugl-Meyer scale (U-FMA), modified Barthel index (MBI) and clinical efficacy of both groups were compared.  Results  After treatment, the U-FMA in both groups [(45.37±5.12) points, (38.80±4.35) points] was improved significantly than before treatment [(31.37±4.33) points, (32.57±4.19) points, t=16.025, 14.297, both P < 0.05], with the treatment group showing more significant improvement than the control group (t=5.352, P < 0.05). After treatment, the MBI in both groups (57.83±6.65, 47.33±5.68) improved significantly than before treatment (41.17±5.97, 40.17±7.01, t=25.673, 15.577, both P < 0.05), with the treatment group showing more significant improvement than the control group (t=6.572, P < 0.05). The total effective rate of the treatment group was significantly higher than that of the control group (96.67% vs. 73.33%, χ2=4.706, P < 0.05).  Conclusion  Xingnao Kaiqiao Acupuncture combined with occupational therapy can improve the upper limb motion function of stroke patients and the activity of daily life.
Application of objective structured clinical examination in annual assessment of standardised training for residents
CHEN Xiao-hui, CHEN Jing, WANG Wei, GAO Yong
2021, 19(11): 1935-1938. doi: 10.16766/j.cnki.issn.1674-4152.002205
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  Objective  To guide the examination question setting of Objective Structured Clinical Examination (OSCE) in the future and make the examination questions more standardised and reasonable through research on the application of OSCE in the annual assessment of standardised training for residents.  Methods  The assessment results of 62 internal medicine students in 2018 and 64 in 2019 who participated in the annual assessment of standardized training for residents in the First Affiliated Hospital of Bengbu Medical College in 2020 were selected as the research object. The reliability, validity, difficulty, degree of differentiation of OSCE were respectively analysed. The test scores of students of two grades at each station were compared. The reasonable degree of OSCE test question setting and the impact of training time on their scores were discussed.  Results  The OSCE reliability selection evaluator was analysed, and the results were good. Validity was evaluated by content validity, which was relatively high. The OSCE tests ranged from 0.55 to 0.78 with a total difficulty of 0.72 for 2018 students, and from 0.49 to 0.79 with a total difficulty of 0.67 for 2019 students. The single-station difficulty and overall difficulty of the two grades basically reached the appropriate standard. The distinction of the OSCE question for the class of 2018 was 0.18, and the distinction for the class of 2019 was 0.19, which was insufficient. By comparing the test scores of students in each station of both grades, there were five stations (a total of six stations) of students in the class of 2018 whose scores were higher than those of students in the class of 2019, and the difference was statistically significant (P < 0.001).  Conclusion  The OSCE examination station is set reasonably, which can objectively reflect the training level and clinical practice ability of the students, and there is room for improvement in the assessment differentiation. The training time is positively correlated with the results.
Application of scientific visualization works in the teaching of pharmacology
JIANG Mu-jun, LI Min, MA Lin-yan, SONG Yi-ning, DONG Shu-ying
2021, 19(11): 1939-1942. doi: 10.16766/j.cnki.issn.1674-4152.002206
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  Objective  Scientific visualization (SV) works are visual images created by professional painters using computer technology based on their understanding of a scientific information. In this study, a new teaching model of applying scientific visualization works to different teaching sessions was used to improve the teaching effectiveness of pharmacology in undergraduate students. The teaching effectiveness was evaluated on students' test scores and questionnaire results.  Methods  A total of 8 classes (250 students) from the Second Department of Clinical Medicine of Bengbu Medical College, Grade 2018, majoring in clinical medicine, were selected to take part in the pharmacology lessons. The classes were then randomly divided into 2 groups using the random number method, with 4 classes or 125 students in each group. The control group was taught in the traditional mode while the experimental group was taught with the aid of scientific visualization works during lesson previews, classroom interactions and lesson reviews.  Results  The test scores were (81.21±15.30) points for the experimental group and (66.00±21.70) points for the control group, with pass rates 91.20% (114/125) and 60.80% (76/125), respectively. Both indicators for students in the experimental group were significantly higher than those in the control group (P < 0.01). Among the 125 valid questionnaires returned, 73.6% (92/125) of the students in the experimental group thought that the classroom atmosphere was lively and interactive, 92.0% (115/125) thought the new mode helpful in sorting out knowledge points, 86.4% (108/125) thought the new mode could improve their interest in learning.  Conclusion  The reasonable use of scientific visualization works can integrate teaching resources, stimulate students' learning enthusiasm, strengthen students' understanding and memory of knowledge points, and improve the teaching effect.
Application of PBL and CBL in ultrasonic medical teaching
DU Xiao-ying, TANG Wen-bo, SONG Tao, SUN Yi-xue
2021, 19(11): 1943-1945. doi: 10.16766/j.cnki.issn.1674-4152.002207
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  Objective  To explore the effect of problem based learning (PBL) combined with case based learning (CBL) teaching method in the training of ultrasonic medicine practice students.  Methods  Fifty students undergoing ultrasonic medicine practice and training in the First Affiliated Hospital of Bengbu Medical College from January 2020 to December 2020 were selected. They were randomly divided into experimental group and control group according to random allocation method, with 25 participants in each group. The control group adopted traditional teaching methods according to the teaching syllabus, whilst the experimental group adopted PBL combined with CBL teaching mode. The teaching effects of the two teaching modes were compared through theoretical assessment and questionnaire survey. The ultrasound basic knowledge and professional knowledge of the mastery of the situation, operational skills to the master of the situation were investigated through theoretical assessment. At the end of teaching, the ultrasound theory knowledge, learning interests, ability to solve practical problems, self-learning ability, teamwork ability, clinical skills improvement, overall satisfaction of the two groups were analysed by questionnaire. The students' satisfaction with the teaching model was comprehensively judged.  Results  The scores of the experimental group were (83.45±8.45) points, (84.86±8.28) points and (85.25±5.26) points, which were higher than those of the control group [(76.45±5.78) points, (74.35±6.68) points and (76.45±4.38) points], and the difference was statistically significant (all P < 0.05). The survey and evaluation of all students in the experimental group showed excellent results of PBL combined with CBL.  Conclusion  In the teaching of ultrasound medicine, the teaching mode of PBL combined with CBL can promote the cultivation of students' comprehensive ability more than the traditional teaching mode, and has achieved good teaching effect, which is worthy of popularisation and application.
Reporting quality evaluation of meta-analyses on cognitive interventions for Alzheimer's disease in China
HAN Guang-hong, PANG Xiao-li, SUN Hui-li, WANG Wei
2021, 19(11): 1946-1950. doi: 10.16766/j.cnki.issn.1674-4152.002208
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  Objective  To assess the reporting quality of meta-analyses on cognitive interventions for Alzheimer's disease in China and explore whether a linear correlation exists between the reporting quality and abstracts.  Methods  The CNKI, Wanfang and VIP databases were used to comprehensively collect meta-analyses on cognitive interventions for Alzheimer's disease in China. The retrieval period was from inception to September 17th 2019. The reporting quality of abstracts and full texts was assessed on the basis of the PRISMA-Abstracts and PRISMA statement, respectively. Compliance with each PRISMA item was investigated. Pearson correlation analysis was used to explore the correlation between reporting quality and abstract.  Results  A total of 9 meta-analyses were included. PRISMA-Abstracts were rated 6-9 with an average score of 7.56. PRISMA statement was scored 19-24, with an average score of 21.78, and the compliance ranged from 70.37% to 88.89%. Pearson correlation analysis found no correlation between the reporting quality and the abstract (r=0.401, P=0.285).  Conclusion  The reporting quality of meta-analyses on cognitive interventions for Alzheimer's disease in China is generally good. However, the abstracts and 7 PRISMA items [item 5(protocol and registration), item 15(bias across studies), item 16(other analyses), item 19(bias within studies), item 22(bias across studies), item 23(other analyses), item 27(funding)] are not reported adequately and needed to be further improved.
Current situation and influencing factors of anticoagulant therapy for patients with atrial fibrillation in county hospitals based on data mining
LIN Chun-zhong, ZHAO Liang, WANG Zhao-xin, BIE Zi-dong
2021, 19(11): 1951-1955. doi: 10.16766/j.cnki.issn.1674-4152.002209
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  Objective  To understand the current situation and influencing factors of anticoagulant therapy for patients with atrial fibrillation in county-level hospitals in eastern China, and to optimise anticoagulant treatment, prevent stroke and reduce disease burden of these patients in the future.  Methods  Through retrospective analysis of the diagnosis, treatment and prescription data of 2 452 patients with atrial fibrillation in three county-level hospitals in eastern China from 2018 to 2019, the basic situation of these patients was described and analysed, and the differences of anticoagulation in different dimensions and the influencing factors of anticoagulation treatment were compared.  Results  The overall anticoagulation rate of three county-level hospitals was 49.96%, and the anticoagulation rate of patients whose CHA2DS2-VASc score ≥ 2 was 50.4%. Significant differences were observed in the anticoagulation rate amongst different admission years, admission departments, age groups, combined diseases and bleeding risk groups (all P < 0.05). A CRT decision tree model was constructed to analyse the influencing factors of anticoagulation in county-level hospitals. Finally, 15 variables including main diagnosis of atrial fibrillation, coronary heart disease, heart failure, number of comorbid diseases, department of admission, risk of stroke and bleeding, CHA2DS2-VASc score were included. The accuracy of the model was 65.0%, and the area under the ROC curve was 0.70.  Conclusion  The anticoagulation rate of patients with atrial fibrillation in county hospitals in eastern China has improved to a certain extent, but there is still room for improvement compared with tertiary hospitals. In addition, the anticoagulation standardization of doctors in county-level hospitals needs to be improved, and the training of doctors in county-level hospitals in anticoagulation treatment of atrial fibrillation still needs to be strengthened in the future.
An empirical study on performance evaluation index system of basic public health services in Chongqing
TAN Tao, CHENG Sa-nuo, DENG Yu
2021, 19(11): 1956-1959. doi: 10.16766/j.cnki.issn.1674-4152.002210
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  Objective  To evaluate national basic public health service projects in 40 districts (counties) of Chongqing in 2017, so making the implementation and management of national public health service projects in Chongqing more standardized, and discuss the advantages and disadvantages of the performance evaluation index system.  Methods  According to the level of regional economic development, 40 districts (counties) in Chongqing were divided into four regions: main urban area, suburban area, Northeast Chongqing and Southeast Chongqing. The performance evaluation index system of basic public health services (organization management, fund management, project implementation, project effect and family doctor signing service, a total of five level-1 indicators) more suitable for the actual situation of Chongqing was applied to on site evaluate the basic public health service project in 2017 in December 2017. The difference of the performance evaluation results among different regions was analyzed.  Results  Except organizational management and capital management, the other indicators were significant differences in the four different economic regions, which were total score, project execution, project effect and family doctor contract service (all P < 0.05). The scores of all indicators (organizational management 6.23 points, capital management 4.76 points, project execution 69.35 points, project effect 8.99 points and family doctor contract service 2.07 points) in the main urban area were in the forefront of Chongqing. The scores (organizational management 6.07 points, capital management 4.48 points, project execution 60.94 points, project effect 8.42 points and family doctor contract service 2.04 points) of the economic development area in southeast Chongqing were in the last place. The scores on project effect were generally low in each district and county.  Conclusion  According to the evaluation, there is a clear regional gap in basic public health services in Chongqing, and the equalization of basic public health services still needs to be improved. The quality of basic public health services is not high and the effect is not so good. The new index system makes up for the deficiencies of the performance evaluation of basic public health services in Chongqing, simple and quantitative indicators, etc.
Study on the current status of perception and influencing factors of hospital ethical climate in oncological nurses of tertiary hospital
WANG Li-ping, WANG Ying, WANG Xin-wen, LI Qiong-yao, TU Jia, LAI Jian-jun, WU Zhi-bing
2021, 19(11): 1960-1963. doi: 10.16766/j.cnki.issn.1674-4152.002211
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  Objective  To explore the current status of hospital ethical climate perception in oncological nurses of tertiary hospitals, analyze its influencing factors, and provide some reference and basis for the solution of clinical ethical problems and the management of oncological nurses.  Methods  There were 291 oncological nurses recruited from 5 tertiary hospitals in Zhejiang Province from June to December 2019 by convenience sampling. The basic data questionnaire, Ethical Climate Questionnaire and Big-Five Factor Inventory were used in the investigation. Single factor analysis and multiple linear regression were used to analyze the influencing factors of hospital ethical climate perception in clinical oncology nurses.  Results  The score of hospital ethical climate in oncological nurses was (3.43±0.86) points. The subscale scores from high to low were legal normative style of (3.92±0.77) points, regular style of (3.51±0.73) points, caring style of (3.42±0.72) points, utilitarian style of (3.27±0.72) points and independent judgment style of (2.81±0.63) points. Multiple linear regression analysis showed that ethical training in the work, responsibility personality, pleasant personality, working years and contract nurses were the influencing factors of the perception of ethical climate, which could explain 51.4% of the total variation (F=27.823, P < 0.001).  Conclusion  Nursing managers should pay attention to the ethical training of oncological nurses, especially ethical consciousness and ethical problem-solving skill in nurses with short working years and contract nurses, arrange their jobs reasonably according to their personalities, and improve their perception of hospital ethical climate.
Application of chain management to prevent pressure injury in paediatric neurosurgery
WANG Yu, HAN Ding, BIAN Han-xue, WU Xin-yan, CHEN Mei-li, PAN Shou-dong
2021, 19(11): 1964-1968. doi: 10.16766/j.cnki.issn.1674-4152.002212
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  Objective  To observe and analyse the effect of chain management to prevent pressure injury in paediatric neurosurgery.  Methods  A total of 120 neurosurgical children who met the inclusion criteria from March 2019 to January 2020 in our hospital were selected. According to the random number table generated by SPSS 22.0, the patients were divided into control group and experimental group with 60 cases in each group. The control group received routine nursing mode to prevent pressure injury. The observation group received chain management to prevent pressure injury. A multidisciplinary cooperative nursing group for pressure injury was formed in the ward, operating room, anaesthesia recovery room and intensive care unit, specific to the skin conditions to stress injury prevention measure. The closed-loop 'chain' management was applied. The score of pressure injury within 2 days after operation and satisfaction rate of medical staff and children were compared between the two groups.  Results  The incidences of perioperative pressure injury in the observation group and control group were 3.3% (2/60) and 11.7% (7/60), respectively, with no statistical difference (P>0.05). From immediately after surgery to 24-h post-surgery, the skin condition of the pressure site was better in the observation group than in the control group (P < 0.05). The satisfaction rates of parents and medical staff in the observation group were significantly higher than those in the control group (all P < 0.05).  Conclusion  As a multidisciplinary collaborative management mode, the use of chain management in paediatric neurosurgery is helpful to reduce the incidence of perioperative pressure injury, improve parents' and medical staff's satisfaction rates and promote team cooperation, which is worthy of clinical promotion.
Application effect of fast rehabilitation nursing on patients after laparoscopic hysterectomy
KONG Hai-yan, CHEN Li-fen, ZHOU Ying-zi, TENG Zhi-min, YU Shu-ju, HU Wei, ZHANG Xu
2021, 19(11): 1969-1972. doi: 10.16766/j.cnki.issn.1674-4152.002213
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  Objective  To study the application effect of fast rehabilitation nursing on patients after laparoscopic hysterectomy and to provide a basis for improving the quality of nursing.  Methods  A total of 220 patients who underwent laparoscopic hysterectomy from July to December 2020 were randomly divided into the control group and observation group, with 110 cases in each group. The control group was given routine nursing intervention, whilst the observation group was given fast rehabilitation nursing, including reducing the anxiety and depression of patients, shortening the time of fasting and water deprivation before operation, limited intraoperative infusion, early postoperative feeding, early extubation, early exercise, pain management and other nursing measures. The psychological status, pain score, postoperative recovery and complication rate of both groups were compared.  Results  After nursing (one day before the operation), the SAS and SDS scores of the observation group were significantly lower than those of the control group (all P < 0.05). The NRS scores of the observation group at different time points after operation were significantly lower than those of the control group (all P < 0.05). The first exhaust time, the first ambulation time and the postoperative hospital stay of the observation group were (16.73±1.65) h, (12.78±1.43) h and (3.71±0.42) days, which were significantly lower than those of the control group [(20.61±2.38) h, (21.06±2.45) h and (5.03±0.65) days], respectively (all P < 0.05). The incidence of complications in the observation group was 5.45%, which was significantly lower than that (29.09%) in the control group (P < 0.05).  Conclusion  The clinical effect of fast rehabilitation nursing in patients after laparoscopic hysterectomy is good, which is worthy of clinical promotion.
2021, 19(11): 1973-1975. doi: 10.16766/j.cnki.issn.1674-4152.002214
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2021, 19(11): 1976-1978. doi: 10.16766/j.cnki.issn.1674-4152.002215
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General Practice Research
Effect of tamsulosin combined with transurethral plasmakinetic resection of prostate on quality of life and sexual function in patients with benign prostatic hyperplasia
TANG Fei, TAO TAO, LUO Yong, ZHU Wen-yao
2021, 19(11): 1804-1806, 1879. doi: 10.16766/j.cnki.issn.1674-4152.002171
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  Objective   To investigate the influence of transurethral plasmakinetic resection of prostate (TUPKRP) and1 oral tamsulosin on quality of life and sexual function in patients with benign prostatic hyperplasia (BPH).   Methods   A total of 80 patients with BPH admitted to The Department of Urology of The Third People's Hospital of Bengbu from June 2018 to January 2020 were selected and divided into treatment group (n=40) and control group (n=40) by random number table method. The treatment group was treated with TUPKRP combined with oral tamsulosin, while the control group was treated with TUPKRP only. Quality of life [International prostate quality of Life Score (QOL), International prostate symptom Score (IPSS), maximum urine flow rate (Qmax), residual urine volume (RUV), times of night urination], sexual function [International erectile function index (IIEF-5)] and incidence of complications were compared between 2 groups before and 6 months after treatment.   Results   There were no significant differences in QOL, IPSS, Qmax, RUV and IIEF-5 between the two groups before treatment (all P>0.05). Six months after treatment, IIEF-5 of the treatment group and the control group were (19.35±4.16) points and (17.03±3.52) points. QOL, IPSS, Qmax, RUV and IIEF-5 of the two groups were improved compared with that before treatment, IPSS, QOL, Qmax and IIEF-5 of the treatment group were better than that of the control group. Nocturia [(1.13±0.88) times] in the treatment group was less than that in the control group [(1.65±0.86) times], and the incidence of complications in the treatment group was less than that in the control group, with statistical significance (all P < 0.05).   Conclusion   Tamsulosin combined with TUPKRP is beneficial to improve postoperative urination, quality of life and sexual function in patients with BPH, which is worthy of clinical application.
Effects of Annexin A1 on inflammatory response and collagen deposition of lung fibroblast
CAI Xin, LI Yan-yu, SU Guo-mei, LYU Qiu-rong, LAI Tian-wen
2021, 19(11): 1807-1810,1900. doi: 10.16766/j.cnki.issn.1674-4152.002172
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  Objective  To investigate the effects of Annexin A1 on inflammatory response, proliferation and collagen deposition of pulmonary fibroblasts.   Methods  The primary lung fibroblasts of C57/BL6 mice were isolated. After 24 or 48 hours of intervention with different concentrations of Annexin A1, the expression of inflammatory factors, cell proliferation and collagen deposition were detected. C57/BL6 mice were randomly divided into control group and Annexin A1 intervention group according to the random number table method, with 6-8 mice in each group. Each mouse in the Annexin A1 intervention group was instilled with mouse recombinant Annexin A1 (1 μg/50 μL) into the trachea, and each mouse in the control group was instilled with 50 μL saline. After continuous intervention for 7 days, mice were sacrificed for measurement. Inflammatory factors, collagen Ⅲ and airway smooth muscle actin (α-SMA) were detected.   Results  Inflammatory cytokines (IL-6, IL-8), proliferation, collagen Ⅲ, and α-SMA were significantly increased in the Annexin A1 intervention group compared with the control group (all P < 0.05). Compared with control mice, the total number of cells in the alveolar lavage fluid of the Annexin A1 intervention group [(2.91±0.26)×104/mL vs. (7.03±0.48)×104 /mL, t=7.432, P=0.008] and the number of neutrophils [(0.12±0.04)×104/mL vs. (1.01±0.05)×104/mL, t=13.810, P < 0.001] were significantly increased, and the expression of inflammatory cytokines, collagen deposition, and smooth muscle were also significantly increased (all P < 0.05).   Conclusion  Annexin A1 induces inflammation, proliferation and collagen deposition in the lung fibroblasts, suggesting that Annexin A1 maybe involved in the pathogenesis of airway remodeling.
Analysis on the characteristics of middle cerebral arterial plaque in young and middle-aged patients with acute ischemic cerebrovascular disease
SONG Jian-long, WANG Zi, WEI Jian-lin, LIU Chang, HU Wei, XIA Cheng-yu, ZHU Yu-you
2021, 19(11): 1811-1814. doi: 10.16766/j.cnki.issn.1674-4152.002173
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  Objective  To study the characteristics of middle cerebral artery plaques in young and middle-aged adults with acute ischemic cerebrovascular disease using high-resolution magnetic resonance vessel wall imaging.   Methods  We collected 74 young and middle-aged patients with acute ischemic stroke or transient ischemic attack hospitalised from June 2018 to February 2020 using high-resolution magnetic resonance imaging to evaluate the location and nature of plaques and to compare the location distribution characteristics of symptomatic and asymptomatic middle cerebral arteries and plaques of different properties.   Results  There were 74 patients, including 62 cases of intracranial atherosclerotic plaque. A total of 124 middle cerebral arteries were scanned by magnetic resonance imaging in 62 patients, of which 48 were symptomatic side vessel roots (38.7%) and 76 were non-symptomatic lateral vessels (61.3%). There were 96 plaques, 39 stable plaques (40.6%), 57 unstable plaques (59.4%), 16 superior plaques (16.7%), 38 inferior plaques (39.6%), 10 dorsal plaques (10.4%) and 32 ventral plaques (33.3%). There were 41 and 16 symptomatic and non-symptomatic central cerebral artery unstable plaques (P < 0.01); stable plaques and unstable plaque locations (ventral 10 vs. 22, dorsal 2 vs. 8, superior 5 vs. 11, inferior side 22 vs. 16, all P < 0.05); symptomatic side and non-symptomatic middle cerebral artery plaque location (ventral 16 vs. 16, dorsal 6 vs. 4, superior 9 vs. 7, inferior 14 vs. 24, all P < 0.05).   Conclusion  The middle cerebral artery plaques in young and middle-aged patients with acute ischemic cerebrovascular disease are mainly distributed in the lower and ventral side of the blood vessels, and the properties of symptomatic plaques are mostly unstable plaques, which tend to be distributed in the ventral, dorsal and upper side of the middle cerebral artery.
Correlation between 25-hydroxyvitamin D deficiency and heart failure with preserved ejection fraction in the elderly
JIANG Su-rong, CAO Ya-ru, WANG Ying-ying, WANG Xiao-yan, HONG Jian, GUO Yan
2021, 19(11): 1815-1818, 1835. doi: 10.16766/j.cnki.issn.1674-4152.002174
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  Objective  To investigate the correlation between serum 25-hydroxyvitamin D [25(OH)D] deficiency and heart failure with preserved ejection fraction in the elderly.   Methods  A total of 219 elderly patients treated in the Department of Geriatric Cardiology of the First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2020 were enrolled and divided into the HFpEF group (n=118) and control group (n=101). General data, routine biochemical index results, 25(OH)D, NT-ProBNP and echocardiography parameters of all patients were collected and compared. The correlation between serum 25(OH)D level and echocardiographic parameters was analysed, and the risk factors of HFpEF were analysed by multivariate stepwise logistic regression.   Results  The level of 25(OH)D in the HFpEF group [(37.58±12.92) nmol/L] was significantly lower than that in the control group [(60.82±13.61) nmol/L, P < 0.001]. The HFpEF group had higher echocardiographic parameters such as LAD, LVDd, LVDs, IVS, LVMI, E/e', LAVI, TRV and PASP and lower LVEF and average e' compared with the control group (all P < 0.05). Spearman correlation analysis showed that the 25(OH)D level was negatively correlated with LAD, IVS, LVPW, LVMI, E/e', LAVI, TRV, PASP and NT-proBNP and was positively correlated with average e' (all P < 0.05). Multivariate stepwise logistic regression analysis showed that 25(OH)D level was an independent influence factor for HFpEF in the elderly (OR=0.814, 95% CI: 0.723-0.916, P=0.001).   Conclusion  25(OH)D deficiency is related to HFpEF and can be an independent risk factor for elderly HFpEF.
Correlation between homocysteine and sarcopenia in elderly inpatients
LU Bing, LIU Ye, CHEN Ji-hai, GU Liu-bao, FAN Yao, OUYANG Xiao-jun
2021, 19(11): 1819-1822. doi: 10.16766/j.cnki.issn.1674-4152.002175
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  Objective  To explore the association of serum homocysteine (Hcy) levels with sarcopenia and cognitive function in elderly inpatients.   Methods  A total of 346 elderly patients hospitalized in The Affiliated Geriatric Hospital of Nanjing Medical University from June 2017 to March 2020 were selected, including 122 cases (35.3%) with sarcopenia and 224 cases (64.7%) without sarcopenia. Walking speed, grip strength and limb skeletal muscle index (ASMI) were used to diagnose sarcopenia, and MMSE was used to assess cognitive function. The differences in Hcy level and cognitive function between the sarcopenia group and the non-sarcopenia group were compared, the relationship between Hcy level and the severity and cognitive function of sarcopenia was analyzed, and the influencing factors related to sarcopenia were analyzed by multiple factors.   Results  (1) Compared with the non-sarcopenia group, the sarcopenia group was older and had lower body mass index (BMI), serum albumin level, MMSE score and education level (all P < 0.001) and higher Hcy level (P=0.011). (2) Pearson correlation analysis showed that high Hcy level was negatively correlated with low gait speed, low ASMI and low MMSE score (all P < 0.05). (3) Multivariate logistic regression analysis revealed that age, high BMI and high education level were related to sarcopenia in total subjects. High education level and high BMI in males and age, high Hcy level, high BMI and high education level in females were associated with the presence of sarcopenia.   Conclusions  The higher Hcy level in elderly patients with sarcopenia, the more severe the decline of ASMI, gait speed and cognitive function. High Hcy level is a risk factor for sarcopenia in elderly women. High education level and high BMI are protective factors for sarcopenia. Serum Hcy level may be used as a monitoring index for sarcopenia, which has a certain clinical significance in disease evaluation and prognosis prediction.
Treatment effect and analysis of prognostic factors of neoadjuvant chemotherapy followed by concurrent chemoradiotherapy for advanced cervical cancer with pelvic lymph node metastasis
ZHANG Hui-hui, WANG Bei-bei, ZHANG Xian-wen, WANG Li-hua, WEI Li, LI Yan, ZHANG Jing
2021, 19(11): 1823-1826, 1839. doi: 10.16766/j.cnki.issn.1674-4152.002176
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  Objective   To evaluate the efficacy and prognostic factors of neoadjuvant chemotherapy followed by concurrent chemoradiotherapy of advanced cervical cancer patients with pelvic lymph node metastasis.   Methods   A total of 67 cases of advanced cervical cancer patients with pelvic lymph node metastasis (ⅡA - ⅢB) were collected in our hospital from January 2015 to January 2018. They were assigned to two groups: the treatment group (n=27) was treated with neoadjuvant chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy, whilst the control group (n=40) only received concurrent chemoradiotherapy and consolidation chemotherapy. The clinical effect and related prognostic factors were observed. The survival curve was established via the Kaplan-Meier method. The survival of the two groups was compared via log-rank test. Multivariate Cox regression analysis was used for multivariate analysis.   Results   Compared with the control group, the treatment group showed improved objective response rate (88.9% vs. 67.5%, P < 0.05) and 3-year progression-free survival (PFS) rate (70.4% vs. 45.0%, P < 0.05). No significant difference was observed in the 3-year overall survival (OS) rate between the two groups (77.8% vs. 65.0%, P>0.05). Bone marrow inhibition, gastrointestinal reactions and urinary system reactions were not significantly different in both groups (all P>0.05). Multivariate analysis showed that FIGO stage and location of lymph node metastasis were independent prognostic factors of OS. FIGO stage, location of lymph node metastasis and neoadjuvant chemotherapy were independent prognostic factors of PFS.   Conclusion   The addition of neoadjuvant chemotherapy to concurrent chemoradiotherapy and consolidation chemotherapy is superior to concurrent chemoradiotherapy and consolidation chemotherapy for advanced cervical cancer with pelvic lymph node metastasis. Moreover, the adverse reactions can be tolerated.
Comparison of the clinical effects of percutaneous transforaminal endoscopic discectomy and plasma-mediated radiofrequency ablation combined with collagenase in the treatment of lumbar disc herniation
ZHAO Long, ZHANG Rong-yi, LIU Chang
2021, 19(11): 1827-1830. doi: 10.16766/j.cnki.issn.1674-4152.002177
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  Objective  To compare the clinical effect of percutaneous transforaminal endoscopic discectomy (PTED) and low-temperature plasma-mediated radiofrequency ablation combined with collagenase in the treatment of lumbar disc herniation (LDH).   Methods  Total 72 patients who were treated with LDH in the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2020 were retrospectively analysed. The patients were divided into two groups: group A (36 patients treated with PTED) and group B (36 patients treated with low-temperature plasma-mediated radiofrequency ablation combined with collagenase). The postoperative hospital stay and visual analogue scale (VAS) score at different time points were compared between the two groups. The modified MacNab criteria were used to evaluate the clinical efficacy.   Results  Compared to preoperatively [A: (6.75±1.20) points, B: (7.00±1.17) points], the VAS score of both groups decreased significantly at 1 week [A: (3.39±1.29) points, B: (4.00±1.62) points], 1 month [A: (2.19±0.86) points, B: (2.56±0.97) points], 3 months [A: (1.81±0.98) points, B: (2.25±1.00) points], 6 months [A: (1.36±0.64) pointa, B: (1.94±0.89) points] and 12 months [A: (1.08±0.77), B: (1.69±0.79) points] after surgery (all P < 0.05).   Conclusion  PTED and low-temperature plasma-mediated radiofrequency ablation combined with collagenase could achieve satisfactory short-term effects in the treatment of LDH. Both surgical techniques could significantly alleviate the pain symptoms and improve the quality of life, whilst PTED could achieve better long-term effect.
Inhibition of trigeminal ganglion satellite glial cell inflammation by isohalothane regulating the NF-κB/iNOS-COX2 signalling pathway
HAN Hong-liang, HONG Dao-xian, CHEN Ying, SONG Jun-jie, HE Dong-hai, LI Hong-ying, JIA Qiu-fang
2021, 19(11): 1831-1834. doi: 10.16766/j.cnki.issn.1674-4152.002178
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  Objective  To investigate the effect of isohalothane (ISO) on rat trigeminal ganglion satellite glial cell inflammation in vitro and its mechanism.   Methods  Rat trigeminal ganglion satellite glial cells were cultured in vitro. Methyl thiazolyl tetrazolium and lactate dehydrogenase were used to select the appropriate ISO concentration. Cells were divided into the control group, model group, ISO group and SN50 group [nuclear factor (NF)-κB depressor] group. Nitroglycerin (GTN) was used to construct a satellite glial inflammatory model. The ISO group was treated with 1.5% ISO at a rate of 2 L/min for 30 min, and the other groups were treated with air at the same rate for 30 min. The levels of interleukin-1β (IL-1β), tumour necrosis factor-α (TNF-α) and prostaglandin E2 (PGE2) and the content of NO in the cell culture medium were measured by enzyme-linked immunosorbent assay and nitric oxide (NO) assay. The protein expressions of NF-κB p65, cyclooxygenase-2 (COX2) and inducible nitric oxide synthase (iNOS) were detected by western blot. The concentration of calcium ions was detected by Fluo-3/AM probe loading method.   Results  The levels of IL-1β, TNF-α, PGE2 and NO and calcium ion concentration in the ISO group were (121.49±12.37) ng/L, (88.41±9.53) ng/L, (439.92±28.81) pg/mL, (9.03±1.04) μmol/L and (101.11±8.23) mmol/L, respectively, which were significantly lower than those in the model group (all P < 0.05). The results of western blotting analysis showed that the protein expression levels of NF-κB p65, COX2 and iNOS in the ISO group were 0.74±0.15, 0.59±0.14 and 0.51±0.11, respectively, which were significantly lower than those in the model group (all P < 0.05). The changing trend of each index in the SN50 group was consistent with that in the ISO group.   Conclusion  Appropriate dose of ISO can inhibit GTN induced inflammation of trigeminal ganglion satellite glial cells, and the mechanism may be related to reducing the release of inflammatory factors, inhibiting NF- κB/inos-COX2 signalling pathway and the decreasing the calcium concentration.
The effect of paricalcitol on the cardiac function of secondary hyperparathyroidism patients with maintenance hemodialysis
XIE Wei-nan, LIU Zhi
2021, 19(11): 1836-1839. doi: 10.16766/j.cnki.issn.1674-4152.002179
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  Objective  To observe the changes of cardiac function related parameters in secondary hyperparathyroidism (SHPT) patients with maintenance hemodialysis (MHD) after using paricalcitol.   Methods  Forty SHPT patients with MHD in Huainan First People's Hospital from December 2019 to September 2020 were included. The clinical data, serum intact parathyroid hormone (iPTH), calcium, phosphorus and heart parameters before the treatment of paricalcitol were collected. The parameters included left ventricular ejection fraction (EF), left ventricular end-diastolic dimension (LVDd), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular end systolic diameter (LVDs), left atrium diameter (LAD), left ventricular fractional shortening (FS), left ventricular mass (LVM) and left ventricular myocardial mass index (LVMI). The changes of the above-mentioned indicators before and after the medication were compared.   Results  Compared with baseline value, the serum iPTH of SHPT patients decreased significantly at 1, 3, and 6 months after using paricalcitol (P < 0.001), and serum calcium, phosphorus, calcium and phosphorus product levels were relatively stable. After 6 months of paricalcitol treatment, there were 21 SHPT patients (52.5%) whose iPTH decreased by greater than or equal to 50%, and 28 patients (70.0%) whose iPTH decreased by greater than or equal to 30%. After 6 months of paricalcitol treatment, LVMI, LVM, IVST, LVDd, LVPWT of 40 patients decreased significantly, and FS was increased (all P < 0.01). While LAD, LVDs and EF had no change (all P>0.05). The LAD, LVMI, LVM, IVST, LVDd, LVPWT of LVH group patients were also significantly lower than before, and FS was increased (all P < 0.01). While the non-LVH group patients showed no significant change (all P>0.05).   Conclusion  Paricalcitol can significantly reduce the serum iPTH level, treat SHPT patients with MHD effectively and has fewer adverse effects. It also could subside LVH or delay its progression.
New type of nerve block needle in supraclavicular brachial plexus block
GAO Jing, BIAN Bu-rong, XUE Li-jun, GAO Yan-dong, GUO Yu-feng, LUO Rui
2021, 19(11): 1840-1842, 1968. doi: 10.16766/j.cnki.issn.1674-4152.002180
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  Objective  To explore the advantages of a new type of nerve block needle in supraclavicular brachial plexus block and postoperative analgesia.   Methods  A total of 60 patients from the Second Affiliated Hospital of Yan'an University, the First Hospital of Yulin, undergoing elective radial fracture surgery, ASAⅠ- Ⅲ were randomly assigned in two different groups: the control group using common nerve block needles (group C, n=30) and the new nerve block needle group (group N, n=30). The outcome measurements included anaesthesia operation time, the success rate of catheterisation, the incidence of local anaesthetic toxicity, the amount of other analgesic drugs used, the postoperative analgesic effect of PCA pump, the incidence of nausea and vomiting, perioperative nerve damage, infection of the puncture site and patient satisfaction.   Results  Under ultrasonic guidance, the anaesthesia operation time were (9.3±1.6) min in the group C and (6.2±1.1) min in the group N, the difference was significant between the two groups (P < 0.001). No tube was placed in the control group, and intravenous analgesia pump was connected after operation. The VAS score showed a statistically significant difference at 6, 12, 24 and 48 h after surgery. At post-operation follow-up, a significant difference was observed in the incidence of nausea and vomiting between the two groups (P < 0.001). The scores of the patient satisfaction survey 48 h after the operation were (8.2±0.3) in the group C and (9.5±0.5) in the group N (P < 0.001). Infection of the puncture site and incidence of local anaesthetic toxicity, nerve damage and respiratory depression were not observed in both groups. All patients did not receive any other analgesics.   Conclusion  The new type of nerve block needle for supraclavicular brachial plexus block is confirmed to be a more efficient and safer anaesthesia method that has better postoperative analgesic effect and patient satisfaction, which provides a reference for clinical practice.
Efficacy analysis of donepezil and memogen combined with risperidone in the treatment of mental behavioural symptoms of Alzheimer's disease
QI Ruo-bing, YANG Yong-xiu, JIANG Hui-quan, YIN Xiao-wen, CHEN Bin-hua, FEI Jian-hui, LEI Lan-ying, ZHANG Xue-ping
2021, 19(11): 1843-1845,1915. doi: 10.16766/j.cnki.issn.1674-4152.002181
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  Objective  To analyse the efficacy and safety of donepezil and memantine combined with risperidone in the treatment of behavioural and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD).  Methods  A total of 150 patients with AD and BPSD who were admitted to Hangzhou Seventh People's Hospital from January 2017 to June 2019 were randomly divided into risperidone group (group A), risperidone+donepezil group (group B) and risperidone+donepezil+memogen group (group C) through a random number method, with 50 patients in each group. Before treatment, the positive and negative syndrome scale (PANSS), MOCA scale, blood sugar, triglyceride and cholesterol were recorded. Twelve weeks after treatment, the PANSS, MOCA scale, treatment emergent symptom scale (TESS), blood sugar, triglyceride, cholesterol test of the three groups were compared, with special attention to PANSS, MOCA scale, blood glucose, blood lipids and adverse reactions.  Results  After treatment, the MOCA and PANSS scores of group C patients were significantly improved compared with those of the other two groups. MOCA score of group A [(14.86±3.78) points], group B [(16.94±3.57) points] and group C [(19.10±3.73) points], the difference was statistically significant (F=9.858, P < 0.05). PANSS scores were (110.52±11.55) points in group A, (99.96±8.47) points in group B and (86.14±5.48) points in group C, and the difference was statistically significant (F=94.100, P < 0.05). The incidence of adverse reactions was lower in group C than that in the other two groups, and the results were statistically significant. After treatment, the improvement of blood glucose, blood lipid, TESS and risperidone dosage in group C was more obvious than that in groups A and B.  Conclusion  Risperidone+donepezil group and risperidone+donepezil+memantine groups have better cognitive function improvement after treatment of BPSD, less side effects, reduced dose of risperidone drug treatment and improved quality of life.
miR-200C-3p inhibit the proliferation and migration of prostate cancer cells via targeting ZEB2
LI Hu, ZHU Yong-shi, WANG Ning-ning, GUO Shao-yong, CHEN Zhi-jun
2021, 19(11): 1846-1850. doi: 10.16766/j.cnki.issn.1674-4152.002182
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  Objective  To explore the effect of miR-200C-3p on prostate cancer cell lines and analyze the potential mechanisms of miR-200C-3p and Zinc finger E-box-binding homeobox 2 (ZEB2).  Methods  The expression of miR-200C-3p in prostate cancer cell lines PC-3, DU145, and prostate epithelial cells RWPE-1 was detected by qRT-PCR. After DU145 was transfected with miR-200C-3p, the proliferation and migration ability were determined by CCK-8, scratch repair test and Transwell test. After silencing ZEB2, the proliferation and migration ability of DU145 was analyzed, and the potential relationship between miR-200C-3p and ZEB2 was determined by double-luciferase reporter and western blotting.  Results  The results of qRT-PCR showed that the expression of miR-200C-3p in RWPE-1 was about 2.5 times that of DU145. After DU145 was transfected with miR-200C-3p mimics, the proliferation ability of experimental group was significantly weaker than that of the control group. The healing ability of the experimental group (20.33±1.45) % was significantly lower than that of the control group (46.67±2.40) % (P < 0.001), and the migration ability of the experimental group (114.30±5.21) was significantly lower than that of the control group (212.00±6.49, P < 0.001). Silencing ZEB2 inhibited the proliferation and migration ability of DU145 cells (P < 0.05). The dual luciferase report and western blot experiments confirmed that the overexpression of miR-200C-3p in DU145 reduced the protein expression of ZEB2 (P < 0.05).  Conclusion  miR-200C-3p inhibits the proliferation and migration of DU145 by mediating ZEB2.
General Clinical Research
Clinical value of fenestration decompression in the treatment of jaw cysts
JIN Lan, ZHAO Wen-yan, RUAN Yan, ZHONG Lin-ling, YANG Fan, ZHANG Guo-xing
2021, 19(11): 1851-1854. doi: 10.16766/j.cnki.issn.1674-4152.002183
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  Objective  To explore the clinical value of fenestration decompression in the treatment of jaw cysts.  Methods  The clinical data of 88 patients with jaw cysts who were diagnosed and treated in the Oral and Maxillofacial Surgery of People's Hospital of Zhuji City from June 2015 to May 2019 were retrospectively collected and divided into the study group (fenestrated decompression, n=48) and the control group (traditional curettage of jaw cyst, n=40) according to different surgical methods. The operation status of both groups was recorded, and their cyst lesions were compared before and after the operation. The changes in the volume of the sac cavity, the volume of the sac cavity area and the bone density were recorded. The occurrence of surgical complications in both groups was counted, the status of adjacent pulp necrosis between both groups was followed up and observed, and the difference in recurrence rates at follow-up was compared.  Results  The operation time, intraoperative blood loss and postoperative hospitalisation time in the study group were (29.83±2.18) min, (12.43±2.11) mL and (2.11±0.48) days, respectively, which were significantly less than those in the control group [(51.52±10.28)min, (52.34±2.99)mL, (4.72±0.52)d, t=-14.254, -73.191, -24.454, all P < 0.001]. The volume of the cyst and the volume of the sac cavity area in the study group were less than those in the control group at 3, 6 and 12 months after the operation, and the bone density was higher than that of the control group (all P < 0.001). The complication rate in the study group was 4.17% at 3 months after the operation, which was lower than 25.00% in the control group (χ2=8.041, P=0.005). The necrosis rate of adjacent pulp in the study group was 0.00% at 3 months after the operation, which was significantly lower than 12.50% in the control group (P=0.039). The recurrence rate at follow-up was 0.00%, which was slightly lower than 7.50% in the control group, but the difference was not statistically significant (P=0.180).  Conclusion  Fenestration decompression in the treatment of jaw cysts can reduce intraoperative blood loss, minimise jaw cysts, promote cyst repair, increase bone density, reduce postoperative complications and reduce the incidence of necrosis of adjacent pulp.
Analysis on the length of stay of inpatients with acute coronary syndrome in Xicheng District of Beijing
YANG Ling, DU Xue-ping
2021, 19(11): 1855-1857. doi: 10.16766/j.cnki.issn.1674-4152.002184
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  Objective  To analyse the distribution characteristics in different populations, change tendency and influencing factors of length of stay (LOS) of patients with acute coronary syndrome (ACS) in Xicheng District, Beijing.  Methods  Cluster sampling was carried out. A total of 31 448 ACS inpatients were screened in Beijing Municipal Health Information Center by searching the medical records of Xicheng District, Beijing between 2012.1.1 and 2016.12.31, and then all sub-items under the six major items "I20.--; I21.--; I22.--; I23.--; I24.--; I25.--" were searched according to the International Classification of Diseases (ICD)-10 codes including the keywords "coronary atherosclerosis heart disease", "angina" and "myocardial infarction", after sorting out the household address, rereporting cases screening and reviewing the data integrity and accuracy. SPSS 25 software was used to analyse the data. Measurement data were represented by M (P25, P75). Counting data were statistically described by the actual number and percentage (%), and multivariate logistic analysis was used to analyse the influencing factors of LOS.  Results  The median LOS of ACS patients was 8 days, which increased with age. The median LOS in non-tertiary hospitals was 12 days, whilst that in tertiary hospitals was 8 days. The LOS of 59.09% (13 710/23 202) of patients with unstable angina (UA), 72.88% (2 819/3 868) of patients with non-ST-elevation myocardial infarction and 77.09% (3 375/4 378) of patients with ST-elevation myocardial infarction were < 10, < 14 and < 14 days, respectively. According to multivariate logistic analysis, hospital level, hospitalisation frequency, age, ACS diagnostic classification, cost category, interventional diagnosis and treatment, emergency admission, gender and hospitalisation cost were the factors that affected the LOS (all P < 0.001).  Conclusion  There are still some ACS patients whose LOS exceeds the standard recommended by the clinical pathway, especially UA patients. The average LOS in non-tertiary hospitals is greater than that in tertiary hospitals. Primary and secondary hospitals need to further standardise and improve the diagnosis and treatment technology of ACS. Meanwhile, secondary prevention/cardiac rehabilitation of coronary heart disease should be carried out to reduce repeated hospitalisation, which is conducive to shortening the LOS.
Effect of tanshinone capsule combined with conventional western medicine on acne vulgaris
LUO Hua-fang, LIU Zhen-qiang
2021, 19(11): 1858-1860,1867. doi: 10.16766/j.cnki.issn.1674-4152.002185
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  Objective  To explore the clinical effect of tanshinone capsule combined with isotretinoin soft capsule and clarithromycin tablets in the treatment of acne vulgaris.  Methods  A total of 137 cases of acne vulgaris treated in the 904th Hospital of PLA Joint Logistics Support Force from January 2019 to December 2020 were selected and randomly divided into control group (n=68, isotretinoin soft capsule and clarithromycin tablets) and study group (n=69, tanshinone capsule combined with isotretinoin soft capsule and clarithromycin tablets). The curative effect, security and the skin lesion score, inflammatory factors and humoral immune indexes were compared before and after treatment between both groups.  Results  The total effective rate of the study group (82.61%) was higher than that of the control group (66.18%, P < 0.05). After treatment, the IgG [(8.12±1.28) g/L vs.(12.08±1.29) g/L], IL-4 [(19.13±2.39) ng/L vs.[(25.67±3.36) ng/L], IL-17 [(1.98±0.33) ng/L vs.(2.47±0.41) ng/L], TNF-α [(28.67±4.52) ng/L vs.(36.28±5.46) ng/L] and the scores of pustules [(1.51±0.35) points vs. (1.89±0.46) points], papules [(1.34±0.22) points vs. (1.73±0.41) points], acne [(1.31±0.28) points vs. (1.79±0.32) points], nodules and cysts [(1.24±0.26) points vs. (1.69±0.22) points] were lower than those in the control group (P < 0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05).  Conclusion  Tanshinone capsule combined with isotretinoin soft capsule and clarithromycin tablets can effectively treat acne vulgaris, and improve the immune function to a certain extent.
Effect of levosimendan combined with lyophilised recombinant human brain natriuretic peptide on ventricular remodelling in patients with ischemic cardiomyopathy
MAO Huan-hao, YE Jian-fei, ZHENG Wei-feng, YANG Ying
2021, 19(11): 1861-1863,1950. doi: 10.16766/j.cnki.issn.1674-4152.002186
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  Objective  To observe the clinical efficacy of levosimendan combined with lyophilised recombinant human brain natriuretic peptide (neoactivin) in the treatment of ischemic cardiomyopathy and the improvement of cardiac function damage and ventricular remodelling.  Methods  A total of 240 patients with ischemic cardiomyopathy heart failure admitted to the Department of Cardiology in Ningbo Fourth Hospital from June 2018 to February 2021 were selected as the research objects. The patients were randomly divided into the control group (120 cases) and study group (120 cases) according to the random number table method. The patients in the control group were given conventional treatment, whilst those in the study group were treated with levosimendan combined with neoactivin. The serum levels of TGF-β1, NF-κB, FGF23, CysC, CK-MB, NT-proBNP and hs-CRP in both groups before and after treatment were detected. The changes in LVEDD, LVESD, LVEDV, LVESV and LVEF were statistically analysed. The clinical efficacy of heart failure after treatment was evaluated. The 6-min walk test was conducted. The incidence of adverse drug reactions during treatment was observed.  Results  After treatment, serum levels of NF-κB, CysC, CK-MB, NT-proBNP and hs-CRP in the study group were significantly lower than those in the control group (all P < 0.05). The detection values of LVEDV and LVESV in the study group were significantly lower than those in the control group, whilst LVEF (54.18±4.94) % was significantly higher than that in the control group (49.62±4.61) % (all P < 0.05). The total effective rate of the study group (90.83%) was significantly higher than that of the control group (76.67%, P < 0.05). The results of the 6-min walk test in the study group [(436.51±33.82) m] was significantly better than that in the control group [(392.74±28.61) m, P < 0.05]. No adverse drug reactions were observed in both groups during treatment.  Conclusion  Levosimendan combined with neoactivin can effectively alleviate ventricular remodelling, inhibit myocardial injury, improve myocardial function, improve the level of curative effect and has high safety.
Effect of goal-directed volume combined with dexmedetomidine on hemodynamics and brain protection in patients with craniocerebral injury
SUN Jie-qiong, GUAN Yi-xiang, WANG Xun, WANG Dong-liu
2021, 19(11): 1864-1867. doi: 10.16766/j.cnki.issn.1674-4152.002187
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Abstract:
  Objective  To evaluate the effect of goal-directed fluid therapy combined with dexmedetomidine in the perioperative period on haemodynamics and brain protection in patients with traumatic craniocerebral injury, so as to provide a basis for clinicians to choose treatment methods.  Methods  A total of 70 patients with traumatic craniocerebral injury admitted in our hospital from August 2018 to August 2020 were enrolled by convenience sampling method. According to the random number table method, they were divided into the observation group and control group, with 35 patients in each group. Both groups were treated with goal-directed fluid therapy. Patients in the observation group were induced by continuous intravenous infusion of dexmedetomidine, while patients in the control group were treated with normal saline. Anaesthesia induction (T0), open the dura (T1), close the dura (T2), the end of surgery (T3) of heart rate (HR), mean arterial pressure (MAP) and the level of serum S100β, GCS score of preoperative and 7 days after operation were closely observed and recorded.  Results  No statistically significant difference was observed between both groups in terms of gender, age, BMI, ASA classification and other general information (all P>0.05). Moreover, no significant difference was found in the HR, MAP and serum S100β levels between both groups at T0 (all P>0.05). The HR, MAP and serum S100β levels in the observation group were lower than those in the control group at T1, T2 and T3 (all P < 0.05). No difference was observed in the preoperative GCS score between both groups (P>0.05). The GCS score of the observation group was significantly higher than that of the control group 7 days after the operation [(13.21±1.04)points vs. (11.01±1.55) points, P < 0.05].  Conclusion  The application of goal-directed fluid therapy combined with dexmedetomidine in perioperative treatment of patients with traumatic craniocerebral injury can maintain the stability of cerebral haemodynamics, better protect brain function and has a broad clinical application prospect.

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