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2019 Vol. 44, No. 11
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2019, 44(11): 1437-1440.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.001
Abstract:
ObjectiveTo construct the eukaryotic recombinant plasmid pCDNA3.1-Flag-PTEN and prokaryotic recombinant plasmid pGEX-6P-1-GST-PTEN of phosphatase and tension homologue deleted on chromosome ten(PTEN), and study the biological effects of PTEN fusion plasmid. MethodsThe primers of PTEN gene were designed according to the sequence in Gene Bank.The target fragment was inserted into pCDNA3.1-Flag and pGEX-6P-1-GST empty vector by genetic recombination technique, and the inserted gene sequence was identified by PCR and DNA sequencing.The pCDNA3.1-Flag-PTEN was transfected into HEK293 cells and pGEX-6P-1-GST-PTEN was transfected into Escherichia coli BL-21.The expression of PTEN protein was detected by Western blot and Coomassie brilliant blue staining. ResultsThe PCR results showed that the target gene was successfully inserted.The results of DNA sequencing showed that the inserted sequence was completely consistent with the target gene sequence, and no site-mutation was found.The results of Western blot and Coomassie brilliant blue staining confirmed that the fusion plasmid could be correctly expressed in vivo. ConclusionsThe successful construction and correct expression of PTEN in eukaryotic and prokaryotic expression vectors can provide a basis for further study of the mechanism of PTEN in Parkinson's disease.
2019, 44(11): 1441-1444.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.002
Abstract:
ObjectiveTo explore the effects of puerarin on the bone tissue and PI3K/Akt signal transduction pathway in rats with femoral head osteonecrosis induced by hormone. MethodsThe rats were divided into the control group, model group and observation group.The model of femoral head osteonecrosis induced by hormone was established by intramuscular injection of methylprednisolone sodium succinate.The observation group was established by intraperitoneal injection with puerarin in model rat.The general state, pathological change and bone mineral density of femoral head, serum levels of vascular endothelial growth factor(VEGF) and nitric oxide(NO), and levels of Akt and p-Akt protein in femoral head among three groups were compared. ResultsThe activity of the rats in observation group increased significantly after administration, and the hair color and spirit were good.The serum levels of VEGF and NO in model group were less than those in control group and observation group(P < 0.01).The differences of the expression levels of Akt protein in femoral head among three groups were not statistically significant(P>0.05), and the expression level of p-Akt protein in model group was significantly higher and lower than that in control group and observation group, respectively(P < 0.01). ConclusionsPuerarin plays a therapeutic effect on the femoral head necrosis, and the mechanism of which may be related to increase the level of angiogenic activity factor, form the angiogenesis, reconstruct the blood supply and circulation, and promote the formation of new bone at the necrotic site.
2019, 44(11): 1445-1448, 1452.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.003
Abstract:
ObjectiveTo explore the difference between epithelial-mesenchymal transition(EMT) and autophagy properties in triple negative breast cancer. MethodsThe epithelial-mesenchymal transition(EMT) and autophagy characteristics were compared between three negative breast cancer(TNBC) cell line BT-549 and non-triple negative breast cancer(non-TNBC) cell line MCF-7.The EMT were investigated using the cell morphology, plate cloning, transwell invasion assay and western blot analysis.The autophagy characteristics were observed by electron microscopy, immunofluorescence assay and western blot analysis. ResultsThe proliferation and invasion in TNBC were stronger than that in non-TNBC.The N-cadherin, Vimentin and β-catenin of interstitial cell markers were relatively high expression in TNBC group, and the E-cadherin of epithelial cell markers was relatively high expression in non-TNBC group.Under electron microscope, the mitochondrial autophagy was detected in non-TNBC cells, and the autophagy microtubule associated protein 1 light chain 3 was relatively high expression in TNBC group. ConclusionsThe proliferation and invasion in TNBC are stronger than that in non-TNBC, and the EMT and degree of autophagy are high in TNBC.
2019, 44(11): 1449-1452.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.004
Abstract:
Objective To observe the effects of pulsed electric stimulation combined with curcumin on melanoma of foot back skin in mice. Methods The B16-F10 mouse melanoma cells were subcutaneously injected into the C57/BL6 mouse dorsal foot to establish the dorsal melanoma model.The melanoma was treated with pulsed electric stimulation combined with curcumin, and the tumor size, growth and apoptosis were observed. Results The pulsed electric stimulation or combined with curcumin could inhibit the tumor growth of melanoma(P < 0.01), and the combined therapy was more effective(P < 0.05).The number of apoptotic cells increased after combined therapy(P < 0.05). Conclusions The model of dorsal foot melanoma is easy to observe the morphology and measure the volume of the tumor.The pulsed electric stimulation combined with curcumin can inhibit the growth of melanoma by inducing apoptosis, which is an effective treatment method for melanoma.
2019, 44(11): 1453-1457.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.005
Abstract:
ObjectiveTo investigate the expression levels of connexin 26(Cx26) and nuckar factor κB(NF-κB) in primary lesion and metastatic lymph nodes of triple negative breast cancer(TNBC), and its clinical significance. MethodsThe TNBC paraffin tissues diagnosed by postoperative pathology and molecular classification were collected.Forty-nine cases of primary lesions and 27 cases of lymph nodes metastatic lesions were divided into group A and group B, respectively.Group A included 22 cases without regional lymph node metastasis(group A1) and 27 cases with regional lymph node metastasis(group A2).The expression levels of Cx26 and NF-κB in all cases were examined using immunohistochemical staining.The relationship between Cx26 and NF-κB, and their correlations with clinical features were analyzed. ResultsThe positive expression rates of Cx26 and NF-κB in group A2 were higher than those in group A1(P < 0.01 and P < 0.05).The positive expression rates of Cx26 and NF-κB in group B were higher those in group A1(P < 0.01).The expression level of Cx26 was correlated with the menopause state and lymph node metastasis(P < 0.01), and the NF-κB level was correlated with pTNM staging and lymph node metastasis(P < 0.01 and P < 0.05).In lymph nodes metastatic lesions, the expression of Cx26 was positively correlated with the expression of NF-κB(P < 0.01). ConclusionsCx26 and NF-κB may co-participate in the invasion and metastasis of TNBC, and can be used as an effective indicator to predict TNBC metastasis and recurrence and evaluate clinical prognosis.
2019, 44(11): 1457-1461.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.006
Abstract:
ObjectiveTo explore the application value of closed-loop target control system to activate precise anesthesia in painless enteroscopy. MethodsForty patients scheduled by painless enteroscopy, ASA Ⅰ-Ⅱ, aged 60-75 years, 22 males and 18 females, were randomly divided into the observation group(group S) and control group(group D) (20 cases in each group).The group S was treated with closed-loop target-controlled infusion of propofol with a target-controlled plasma concentration for 6μg/mL and BIS value for (55±5).The group D was treated with intravenous injection of propofol with 2 to 3 mg/kg.The HR, MAP, SpO2, BIS values, recovery time, propofol dosage during operation, departure score after sedation/anesthesia and perioperative adverse reactions were observed and compared between two groups. ResultsAfter anesthesia, the levels of MAP and HR in two groups decreased(P < 0.01), the BIS value in group S decreased(P < 0.01), and was stable at about 55.Compared with the group S, the MAP decreasing and HR slowering in group D were more obvious in group S(P < 0.01).The SpO2 in group D decreased after anesthesia(P < 0.01), and which was lower than that in group S(P < 0.01).The propofol dosage and recovery time in group S were significantly lower than those in group D(P < 0.01).There was not statistical significance in departure score after sedation/anesthesia between two groups(P>0.01). There was not statistical significance in the incidence rate of perioperative adverse reactions between two groups(P>0.01). ConclusionsThe application of closed-loop target control system in precise anesthesia during painless enteroscopy can significantly reduce the dosage of propofol, shorten the recovery time, maintain the stabliation of intraoperative circulation and respiratory function, and make patients more comfortable after operation.It is a safe and effective method of painless enteroscopy anesthesia, and worthy of promotion.
2019, 44(11): 1461-1464.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.007
Abstract:
ObjectiveTo apply the near-infrared spectroscopy regional cerebral saturation techniques(NIRS rSO2) in patients treated with cardiac surgery, take corresponding intervention measures according to its value to reduce the incidence rate of postoperative cognitive dysfunction(POCD) in cardiac surgery patients. MethodsSixty patients treated with cardiac surgery under extracorporeal circulation were randomly divided into the NIRS rSO2 group(group T, 30 cases) and routine monitoring group(group C, 30 cases).In group T, after the NIRS rSO2 value decreased to the 11% of baseline, the NIRS rSO2 value could be restored to baseline by intervening the head position, position of the superior and inferior vena cava cannula, mean arterial pressure, arterial oxygen saturation, arterial carbon dioxide, hemoglobin and mixed oxygen saturation.The vital signs in group C could be maintained at an acceptable level according to the experience of anesthesiologists.The incidence rates of POCD in two groups were evaluated using MMSE scale, S100β protein and NSE values. ResultsThe NIRS rSO2 value in group T was higher than that in group C(P < 0.01), the NSE and S100β protein value and incidence rate of POCD in group T were lower than those in group C(P < 0.05 to P < 0.01). ConclusionsThe NIRS rSO2 monitoring techniques and appropriate intraoperative interventions can reduce the incidence rate of POCD in cardiac surgery patients with extracorporeal circulation, which is worthy of clinical promotion.
2019, 44(11): 1465-1467, 1472.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.008
Abstract:
ObjectiveTo investigate the effects of the sacral canal decompression combined with lumbar-pelvic fixation in the treatment of traumatic sacral fractures complicated with spine-pelvic separation. MethodsSixteen patients with traumatic sacral fractures(Denis type Ⅲ) complicated with spine-pelvic separation were treated with sacral canal decompression combined with lumbar-pelvic fixation, and followed up for more than 2 years.The relative indexes of patients before and after the operation were recorded.The neurological Gibbons scores of patients were compared between before operation and last follow-up.The comprehensive efficacy was evaluated according to the Majeed functional score, and the complication was recorded. ResultsThe operations of all patients were successfully completed.The time of operation, blood loss, hospital stay and time of fracture healing of patients were (172.34±43.23)min, (670.98±98.34)mL, (25.76±6.45)d and (4.21±0.43) months, respectively.Compared with before operation, the last follow-up Gibbons score and Majeed score of patients significantly decreased and increased, respectively(P < 0.01).The results of the last follow-up showed the excellent in 7 cases, good in 4cases, fair in 4 cases and poor in 1 case, and the good rate of which was 68.75%.The postoperative incision infection in 2 cases, hemorrhoids in 1 case, and no serious complications, such as steel plate, connecting rod fracture, fracture and displacement, were found. ConclusionsThe sacral canal decompression combined with lumbar-pelvic fixation can reconstruct the pelvic ring and spinal stability, and improve the postoperative neurological function and activity in patients with traumatic sacral fractures complicated with spine-pelvic separation.
2019, 44(11): 1468-1472.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.009
Abstract:
ObjectiveTo investigate the effects of selenium intervention on the clinical curativeeffect and oxidative/antioxidant system in Hashimoto thyroiditis(HT). MethodsSixty cases with HT were randomly divided into the selenium group(group A) and levothyroxine group(group B), and further divided into the A1 and A2 subgroups(euthyroidism), and B1 and B2 subgroups(hypothyroidism).Patients in group A and B were both treated with levothyroxine replacement therapy.Besides, patients in group A received particular treatment of selenium geast.Thirty healthy people were set as the normal control group(NC group).The changes of the serum levels of selenium, TT3, TT4, TSH, thyroid peroxidase antibody(TPOAb), thyroid globulin antibody(TgAb), oxidation index(MDA) and antioxidant index(GPX) in each group were analyzed before and after treatment.And the corretations of the indexes were also analyzed. ResultsBefore treatment, the serum levels of selenium in HT patients were significantly lower than that in NC group(P < 0.05), and which in hypothyroidism group were lower than that in euthyroidism group(P < 0.05).After treatment, the serum levels of selenium in group A increased greatly(P < 0.05), and there was not obvious change in group B(P>0.05).After treatment, the serum levels of TSH in A2 and B2 groups decreased greatly(P < 0.05), and the difference of the thyroid function in other groups was not statistically significant(P>0.05).After treatment, the levels of TPOAb and TgAb in group A decreased remarkably on the whole(P < 0.01), and the change of which in group B was not obvious(P>0.05).Before treatment, the concentration of MDA and GPX activity in HT patients were higher and lower than that in NC group, respectively(P < 0.05).After treatment, the total serum level of MDA and GPX activity in group A decreased and increased greatly, respectively(P < 0.05), and the changes of two indexes were not obvious in group B(P>0.05).Before treatment, the serum level of selenium was positively correlated with TT4(r=0.294, P < 0.05), and negatively correlated with TSH(r=-0.343, P < 0.01).There was not significant correlation among other indicators(P>0.05). ConclusionsThe serum level of selenium in HT patients is lower than that in healthy people.The selenium yeast can reduce the levels of thyroid autoantibodies(TPOAb and TgAb), strengthen the antioxidant capacity, and reduce the oxidative damage in HT patients.The treatment effect of selenium combined with levothyroxine is superior to the single use of the latter.
2019, 44(11): 1473-1476.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.010
Abstract:
ObjectiveTo investigate the prognostic value of comorbidities in patients with stable chronic obstructive pulmonary disease(COPD). MethodsThe clinical data of 51 stable COPD patients were retrospectively analyzed, and the Charlson comorbidity index(CCI) was calculated.According to the CCI, patients were divided into high score group(n=25) and low score group(n=26).The patients were divided into the less co-morbidity group(n=24) and more co-morbidity group(n=27) according to co-morbidity numbers.The clinical characteristics, and correlation of number and type of comorbidities with pulmonary function were compared between two groups. ResultsCompared with the low score group, the age was older, the ratio of FEV1 accounting for expected value was lower, the number of COPD related comorbidities was larger, and the number of hospitalizations was more during 1 year following-up in high score group(P < 0.05 to P < 0.01).Compared with the less co-morbidity group, the age was older, the mMRC score was higher, the ratio of FEV1 accounting for expected value was lower, the CCI score and CCI score after adjusting age were higher, and the treatment course with systemic glucocorticoids and antibiotics because of the COPD acute exacerbating increased during the following-up in more co-morbidity group(P < 0.05 to P < 0.01).There was no statistical significance in the total number of acute exacerbation patients between less co-morbidity group and more co-morbidity group during the following-up(P>0.05).The number of hospital stays and total number of acute exacerbations in patients with COPD complicated with bronchiectasis were higher than those in patients without bronchiectasis(P < 0.05).However, there was no statistically significance among the number of outpatient and community visits, and emergency visits due to exacerbation of COPD(P>0.05). ConclusionsThe type and disease degree of comorbidities are correlation with the diagnosis and prognosis value in COPD patients.
2019, 44(11): 1477-1480, 1483.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.011
Abstract:
ObjectiveTo investigate the distribution of pathogens and bacterial resistance in children with severe community-acquired pneumonia(CAP). MethodsOne thousand and fourteen children with SCAP from 2017 to 2018 were investigated, and 450 cases were selected after exclusion.One hundred and twenty children aged 1 to < 3 years, 151 children aged 3 to >6 years and 179 children aged ≥ 6 years were divided into the infant group, preschool group and school-age group, respectively.A disposable sputum suction tube was used to absorb sputum in oral cavity, and the sputum of children with mechanical ventilation was sucked through organ insertion catheter device.The positive nucleic acid was set as the virus standard, the molecular biology method was used to detect.The fluorescent quantitative PCR was used to detect Mycoplasma pneumoniae(MP) in sputum samples.The patients were treated with intravenous injection of cefuroxime sodium, oral azithromycin dry suspension and mechanical ventilation. ResultsAmong 450 cases, the positive pathogens in sputum of 389 cases were identified, and the positive rate of which was 86.44%.A total of 632 pathogens were detected, and the proportion of bacteria and viruses were 56.01% and 35.60%, respectively.The differences of the distribution rates of viruses, bacteria, MP, Chlamydia trachomatis(CT) and fungi infection among the infant group, preschool group and school-age group were statistically significant(P < 0.01).The distribution differences of the virus, bacteria, MP, CT and fungus infection among four seasons were statistically significant(P < 0.01), and the difference of the mixed infection was not statistically significant(P>0.05).Haemophilus influenzae was low resistant to ofloxacin, and Escherichia coli was resistant to imipenem and cefaclor.Streptococcus pneumoniae was not resistant to vancomycin, linezolid and penicillin, and low resistance to amoxicillin.Staphylococcus aureus was not resistant to vancomycin and linezolid. ConclusionsBacteria are the main pathogens in CAP.The detection rates of children's virus, bacteria, MP and CT are high, and the bacterial resistance is severe.The targeted antibiotics is recommended to use after the pathogen and bacterial resistance tests are identified.
2019, 44(11): 1481-1483.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.012
Abstract:
Objective To evaluate the clinical efficacy and safety of tranexamic acid perfusion in the treatment of postoperative bleeding of complex tibial plateau fracture. Methods Seventy-three patients with complex tibial plateau fracture were randomly divided into the observation group(n=37) and control group(n=36).Two groups were operated by the same surgeon.The incisions in observation group and control group were perfused with tranexamic acid solution and 0.9% sodium chloride injection, respectively.The clinical efficacy and safety between two groups were compared. Results The total blood loss and hidden blood loss in observation group were less than that in control group(P < 0.05 and P < 0.01), and the difference of the dominant blood loss between two groups was not statistically significant(P>0.05).The postoperative drainage volume and limb diameter in observation group were significantly lower than those in control group(P < 0.01).The ultrasound examination results of lower limb veins showed that there were not severe complications, such as deep venous thrombosis and cardiopulmonary cerebral embolism, in two groups after 10 d of operation. Conclusions Tranexamic acid perfusion in treating complex tibial plateau fracture can significantly reduce the peroperative blood loss and postoperative drainage volume, do not increase the incidence rate of thrombosis, which is worthy of promotion in clinic.
2019, 44(11): 1484-1486.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.013
Abstract:
ObjectiveTo evaluate of the effects of vildagliptin on the levels of bone metabolism and mineral density in perimenopausal women with type 2 diabetes mellitus. MethodsAmong 96 perimenopausal patients with type 2 diabetes, 47 patients were treated with metformin combined with vildagliptin(combination group), and 49 patients were treated with metformin(control group).The levels of hemoglobulin, osteocalcin, bone alkaline phosphatase, type Ⅰ collagen carboxyl terminal, tartrate-resistant acid phosphatase in two groups were measured using ELISA.The bone mineral density and total bone density of femoral neck, femoral shaft and greater trochanter in two groups were detected using the dual energy X-ray. ResultsAfter treatment, the levels of the osteoprotegerin and type Ⅰ collagen carboxyl terminal in combination group were lower than those in control group(P < 0.05 to P < 0.01), the differences of the levels of osteocalcin, bone alkaline phosphatase, tartrate-resistant acid phosphatase between two groups were not statistically significant(P>0.05), and the levels of the osteoprotegerin and type Ⅰ collagen carboxyl terminal in combination group were lower than those before treatment(P < 0.05).Before treatment, the differences of the bone mineral density of left femoral neck, lumbar vertebra2-4, proximal femur and Wards triangle between two groups were not statistically significant(P>0.05).After treatment, the bone mineral density of left femoral neck, lumbar vertebra2-4, proximal femur and Wards triangle in combination group were significantly higher than those in control group(P < 0.05). ConclusionsVildagliptin can reduce the bone resorption in perimenopausal women with type 2 diabetes, alleviate the bone resorption in condition of diabetes, and increase the bone density.Vildagliptin can be as the preferred glucose-lowering drug for perimenopausal women with type 2 diabetes, and which is worthy of clinical promotion.
2019, 44(11): 1487-1489, 1493.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.014
Abstract:
ObjectiveTo investigate the clinical efficacy and safety of methylprednisolone and cyclophosphamide combined with 99Tc-MDP in the treatment of thyroid-associated ophthalmopathy(TAO). MethodsFifty patients with TAO were divided into the control group(22 cases) and observation group(28 cases) according to the treatment schemes.The control group was treated with methylprednisolone and cyclophosphamide, and the observation group was treated with methylprednisolone and cyclophosphamide combined with 99Tc-MDP.The thickness of extraocular muscle, clinical activity score(CAS) and severity of disease before and after treatment, and incidence rate of adverse reactions were compared between two groups. ResultsBefore treatment, the differences of the CAS score, thickness of extraocular muscle and severity of disease between two groups were not statistically significant(P>0.05).After treatment, the CAS score and severity of disease in two groups significantly decreased compared with before treatment(P < 0.01), the thickness of extraocular muscle in the observation group was significantly lower than that before treatment, and the CAS score, severity of disease and thickness of extraocular muscle in observation group were lower than those in control group(P < 0.05 to P < 0.01).The incidence rate of adverse reactions during treatment in observation group(5.36%) was lower than that in control group(20.45%)(P < 0.05). ConclusionsThe methylprednisolone and cyclophosphamide combined with 99Tc-MDP in the treatment of TAO can effectively improve the clinical efficacy and reduce the occurrence of adverse reactions, which is worthy of clinical promotion.
2019, 44(11): 1490-1493.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.015
Abstract:
ObjectiveTo investigate the effects of different doses of dexmedetomidine hydrochloride on the pressor effect in orthopedic general anesthesia patients. MethodsOne hundred and twenty surgical patients with ASA grade Ⅰ or Ⅱ were divided into the small dose group(Dex1 group, n=40), large dose group(Dex2 group, n=40) and control group(group C, n=40) according to random number table method.The Dex1 group, Dex2 group and control group were injected with 0.5 μg/kg of dexmedetomidine hydrochloride before anesthesia induction, 0.8 μg/kg of dexmedetomidine hydrochloride and equal amount of 0.9% sodium chloride solution, respectively.All patients were intravenously injected with 0.1mg/kg of ephedrine after 5 min of Laryngeal-mask-airway(LMA).The heart rate(HR), systolic blood pressure(SBP) and diastolic blood pressure (DBP) were compared among three groups after entering the operating room(T1), before anesthesia induction (T2), after 1min of anesthesia induction(T3), LMA(T4), and immediately after injection of ephedrine(T5).The time of the maximum HR and blood pressure(MtHR and MtBP) after 10 min of injection of ephedrine, and the differences value of the maximum value of HR, SBP and DBP to the value at T5(ΔHR, ΔDBP and ΔSBP) were compared among three groups. ResultsThe HR, SBP and DBP in Dex1 group and Dex2 group were lower than those in group C at T2, T3, T4 and T5(P < 0.01), the SBP and DBP in Dex2 group were lower than those in Dex1 group at T2, T3, T4 and T5(P < 0.01), and the differences of HR between Dex1 group and Dex2 group at T2, T3, T4 and T5 were not statistically significant(P>0.05).The ΔHR, ΔDBP and ΔSBP in Dex1 group and Dex2 group were significantly higher than those in group C(P < 0.01), and the MtHR and MtBP in Dex1 group and Dex2 group were significantly lower than those in group C(P < 0.01).The ΔHR, ΔDBP and ΔSBP in Dex2 group were lower than those in Dex1 group(P < 0.01), and there was no statistical significance in the MtHR and MtBP between the Dex1 group and Dex2 group(P>0.05). ConclusionsDexmedetomidine hydrochloride can enhance the the pressor effect and accelerate the response time, and the pressor effect of 0.8 μg/kg is significantly better than that of 0.5 μg/kg in orthopedic general anesthesia patients.
2019, 44(11): 1494-1496, 1499.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.016
Abstract:
ObjectiveTo investigate the differences of therapeutic effects and adverse reactions between two kinds of intensity-modulated radiotherapy(IMRT) combined with chemotherapy in treating postoperative lymph node-positive gastric cancer. MethodsTwenty-nine patients with postoperative lymph node-positive gastric cancer were treated with two kinds ofIMRTcombined with chemotherapy, and the differences of therapeutic effects and adverse reactions between two kinds of methods were compared. ResultsThere is no difference in the effecacy between 5 fietd IMRT with 5 fields combined with chemotherapy and 9 fields combined with chemotherapy(P>0.05).The incidence rates of the nausea, vomiting and neutropenia of static IMRT with 5 fields were significantly higher than those of 9 fields(P < 0.01).After chemoradiotherapy, the chemotherapeutic tolerance of patients treated with static IMRT with 5 fields was significantly lower than that of static IMRT with 9 fields(P < 0.05). ConclusionsDuring IMRT for patients with gastric cancer, the 9-field irradiation should be selected as far as possible after considering the influencing factors.
2019, 44(11): 1497-1499.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.017
Abstract:
ObjectiveTo analyze the reason of the eradication failure of Helicobacter pylori(HP), and its clinical influencing factors. MethodsTwo hundred and fifty-seven patients with HP infection were divided into the failure group(77 cases) and cure group(180 cases) according to the eradicating result.The general information and clinical indicators in two groups were collected to analyze the failure causes of eradicating HP. ResultsThe failure rate of eradicating HP was 29.96%(77/227).The results of univariate analysis showed that the differences of the residence, education level, infection of family members, CagA positive, oral HP infection, treatment status, irregular medication, drug resistance and incomplete supervision between two groups were statistically significant(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the education level and irregular medication were the independent influencing factors of eradication failure(P < 0.01 and P < 0.05). ConclusionsA variety of factors, such as cultural level and irregular medication, can affect the eradication results of HP, and the clinical intervention should be conducted as early as possible according to relevant influencing factors.
2019, 44(11): 1500-1504.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.018
Abstract:
ObjectiveTo explore the effects of locking plate internal fixation combined with sodium hyaluronate on postoperative knee function and comprehensive stress of tibial plateau fracture. MethodsOne hundred cases with tibial plateau fracture were randomly divided into the observation group and control group(50 cases in each group).The control group was treated with locking plate internal fixation, and the observation group was treated with locking plate internal fixation combined with sodium hyaluronate.The knee function and comprehensive stress in two groups were evaluated. ResultsThe weight bearing time and healing time in observation group after stitch were significantly shorter than those in control group(P < 0.01).After 1, 2, 4 weeks of operation, the knee mobility and Rasmussen score in two groups gradually increased, and which in observation group was significantly higher than that in control group(P < 0.01).At postoperative 1, 3 and 7 days, the VAS scores of knee pain in two groups reduced gradually, and which in observation group after 3 and 7 days were significantly lower than that in control group(P < 0.01).At postoperative 1, 3 and 7 days, the expression levels of pain stress(NPY, PGE2 and SP), inflammatory stress(IL-1β, TNF-α and CRP) in two groups reduced gradually, and which in observation group was significantly lower than that in control group(P < 0.01).The differences of the levels of CAT and SOD after 1 day of operation between two groups were statistically significant(P < 0.01 and P < 0.05), and the difference of the levels of CAT, total antioxidant capacity and SOD after 3 and 7 days of operation between two groups were statistically significant(P < 0.01). ConclusionsLocking plate internal fixation combined with sodium hyaluronate treating tibial plateau fracture can reduce the knee pain and stress response and promote the knee function recovery, which is worthy of clinical application.
2019, 44(11): 1505-1507.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.019
Abstract:
ObjectiveTo investigate the coincidence rate of chromosomal abnormalities in pregnant women with different prenatal diagnosis indications, and evaluate the clinical application value of noninvasive prenatal testing(NIPT) of maternal peripheral blood fetal free DNA as a first-line prenatal screening technology. MethodsThe chromosome karyotype of amniotic fluid cells from ultrasound-guided amniocentesis in 1134 pregnant women with different prenatal diagnosis indications from January 2017 to March 2019 were analyzed. ResultsA total of 91 cases with abnormal karyotypes were detected, and the abnormal detection rate was 8.02%(91/1134).The abnormal chromosome number(including chimera) in 79 cases(86.81%) was found, which included 21 trisomy in 46 cases, 18 trisomy in 13 cases, 13 trisomy in 4 cases, sexual chromosome abnormality in 6 cases and chimera in 10 cases.The abnormal chromosome structure in 12 cases was identified, and the abnormal detection rate of which was 13.19%(12/91).The coincidence rate of the abnormal amniotic fluid karyotype with different prenatal diagnosis indications included that the positive NIPT of which was 88.24%(the highest)(P < 0.01), the abnormal ultrasound screening of which was 9.73%(the second)(P < 0.01).The differences of the coincidence rates of abnormal amniotic fluid karyotype among the serological screening with high risk(3.81%), high age(3.42), abnormal ultrasound screening(9.73%) and other(2.38%) were not statistically significant(P>0.05). ConclusionsThe high risk of prenatal serological screening(Down's screening) is the main indication of amniocentesis, which is the highest coincidence rate.The NIPT test in the second trimester can provide more accurate screening and eugenics guidance for pregnant women.
2019, 44(11): 1508-1510.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.020
Abstract:
ObjectiveTo investigate the diagnostic value of the serum levels of procalcitonin(PCT) and high sensitivity C reactive protein(hs-CRP) and white blood cell count(WBC) in early childhood infection. MethodsOne hundred and sixty children with infectious diseases from March 2017 to March 2018 were divided into the virus group(75 cases) and bacterial group(85 cases) according to the infection pathogen, and 60 healthy children were set as the healthy control group.The serum levels of PCT, hs-CRP and WBC were measured and compared among three groups, and the sensitivity, specificity and receiver operating characteristic(ROC) curves of three indexes were calculated and plotted. ResultsThe differences of the serum levels of PCT and hs-CRP, and WBC value among three groups were statistically significant(P < 0.05).The serum levels of PCT and hs-CRP, and WBC in bacteria group were significantly higher than those in virus group and healthy control group, and the serum levels of PCT and hs-CRP, and WBC in viral group were significantly higher than those in healthy control group(P < 0.01).When the PCT was used to diagnose the bacterial infections, the area under the ROC curve of PCT, sensitivity and specificity were 1, 100% and 100%, respectively, and which was greater than whose of hs-CRP and WBC. ConclusionsThe serum levels of PCT and hs-CRP, and WBC have certain diagnostic value in early bacterial infection in children.Moreover, the sensitivity and specificity of PCT are higher, and the diagnostic value of PCT is better than that of hs-CRP and WBC.
2019, 44(11): 1513-1517.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.022
Abstract:
ObjectiveTo observe the CT images and clinical pathological features of primary pulmonary cryptococcosis(PPC), so as to improve its diagnostic accuracy. MethodsThe data of CT image and pathological features of 31 cases with PPC confirmed by histopathology were retrospectively analyzed. ResultsAmong 31 patientts, solitary nodule/mass in 16 cases, multiple nodules/mass in 6 cases, infiltrative consolidation in 5 cases and mixed type in 4 cases were identified.Among 31 cases, 21 cases located in subpleural region(67.7%), 11 cases showed pleural "indentation sign"(35.3%), 10 cases showed "air bronchogram" (32.3%), 9 cases showed "speculation"(29.0%) and 8 cases showed "halo sign"(25.8%), respectively.The enhanced CT scan in 25 cases were implemented, 6 cases with "angiographic sign", 21 cases with mild or moderate enhancement(including 19 cases with niform and 2 cases with uniform) and 4 cases with obvious homogeneous enhancement were found.Histopathologically, all lesions were granulomatous with abundant cryptococcal spores. ConclusionsThe CT features of PPC are various, the nodules/masses in the subpleural area of lower lung are most common, which is complicated with "speculation", "air bronehogram", "halo sign", pleural indentation sign", mild or moderate homogeneous enhancement.These findings may be helpful for the preoperative diagnosis.
2019, 44(11): 1517-1521.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.023
Abstract:
ObjectiveTo investigate the clinical significnace of superb micro-vascular imaging(SMI) in the detection of neovascularization of carotid plaque. MethodsSixty-two patients with carotid atherosclerosis were identified using the routine color Doppler, and 70 carotid plaque cases with new blood vessel signal were screened using SMI, and further examined using contrast-enhanced ultrasound(CEUS).The consistency of two methods in detecting the number of neovascularization in carotid plaque was compared. ResultsThe plaques were graded according to the distribution and number of neovascularization detected by SMI, grade 0 in 10 cases, grade 1 in 35 cases and grade 2 in 25 cases were identified according to the score of SMI.The grade 0 in 15 cases, grade 1 in 35 cases and grade 2 in 20 cases were identified according to the score of carotid CEUS.The consistency of SMI CEUS in detecting the neovascularization of carotid plaque was good(Kappa=0.769, P < 0.05). ConclusionsSMI has good coincidence with CEUS in the diagnosis of neovascularization of carotid plaque.SMI has high safety, easy operation and high reproducibility.SMI has important reference value in evaluating the neovascularization of carotid plaque, and can be used as an important method in the diagnosis of neovascularization of carotid plaque.
2019, 44(11): 1522-1525, 1529.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.024
Abstract:
ObjectiveTo investigate the effects of baseline blood pressure level of the Kailuan cohort study(2010) and blood pressure changes 2 years later(2012) on newly developed carotid artery plaque. MethodsThe physical examination and carotid ultrasound in stroke cohort in Kailuan study were performed in 2010 and 2012, respectively.According to the changes of blood pressure during the two years, the 1445 participants were divided into the normal blood pressure group(group Ⅰ, n=284), normal blood pressure progressing to high-normal blood pressure group(group Ⅱ, n=184), high-normal blood pressure dropping to normal blood pressure group(group Ⅲ, n=138), stabilizing at the normal high blood pressure group(group Ⅳ, n=498) and normal blood pressure or high-normal blood pressure progressing to hypertension group(group Ⅴ, n=241).The relationship between the changes in blood pressure and new carotid artery plaque was analyzed. ResultsThe detection rate of new carotid artery plaque in normal blood pressure population was higher than that in high normal blood pressure population(P < 0.01).The detection rates of new carotid artery plaque in the group Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ were 18.9%, 14.3%, 17.1%, 24.2 and 26.4%, respectively.With the increasing of blood pressure level, the detection rate of new carotid artery plaque showed an increasing trend(P < 0.05).After adjusting the other risk factors, compared to the groupⅡ, the RR value(95%CI) of new carotid artery plaque in group Ⅳ and Ⅴ were 2.007(1.162 to 3.464) and 1.823(1.009 to 3.291), respectively. ConclusionsAmong non-hypertension people, the detection rate of carotid artery plaque increases with the increasing of blood pressure.Compared with the normal blood pressure progressing to high-normal blood pressure people, the risk of atherosclerosis increases in blood pressure stabilizing at high-normal level people.
2019, 44(11): 1526-1529.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.025
Abstract:
ObjectiveTo explore the clinical value of ultrasonic features of intracranial structures in the diagnosis of open spina bifida(OSB) in fetus with 11 to 13+6 weeks of gestation. MethodsEighty healthy fetuses and 80 fetuses with OSB at 11 to 13+6 weeks of gestation were divided into the health group and OSB group, respectively.The intracranial structures in two groups were detected using ultrasound.The intracranial transparency thickness(ITT), brain stem diameter(BS), brain stem-occipital distance(BSOB) were measured, and the ratio of BS/BSOB was calculated. ResultsThe "8" shape of diencephalon to mesencephalon and ntracranial hyaline layer could be clearly displayed in health group.In OSB group, the diencephalon and mesencephalon distorted, the intracranial structures in the posterior fossa shifted, and the intracranial transparent layer partly blocked.The levels of ITT, BS and BSOB in OSB group were significantly lower than those in health group, and the BS/BSOB level in OSB group was significantly higher than that in health group(P < 0.01).In the term of OSB identification, the ITT less than 1.0 mm was set as the critical value, the results of ROC analysis showed that the sensitivity and specificity were 90.00% and 87.50%, respectively.The BS/BSOB more than 1.0 mm was set as the critical value, the sensitivity and specificity were 87.50% and 85.00%, respectively.When two indictors were considered together, the sensitivity and specificity were 97.5% and 97.5%, respectively. ConclusionsThe morphological distortion of diencephalon and mesencephalon, reduction or disappearance of ITT, reduction of BS, BSOB and BS/BSOB increasing are the important ultrasonic features of intracranial structures of OSB.Observing the orphological characteristics of diencephalon and mesencephalon, and analyzing the ITT and BS/BSOB can help diagnose OSB, and the diagnosis effect is better under combining two aspects.It is worthy of further clinical promotion.
2019, 44(11): 1533-1536.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.027
Abstract:
ObjectiveTo explore the prevalence of premenstrual syndrome(PMS), and its correlation with personality traits and menstrual attitudes among female college students. MethodsEight hundred and twenty female college students were selected by cluster sampling, and investigated using premenstrual syndrome scale(PMSS), Eysenck personality questionnaire-revised scale for Chinese(EPQ-RSC) (including extroversion, neuroticism, and psychosis subscale) and menstrual attitude questionnaire(MAQ). ResultsAmong 803 female college students, 379 cases with PMS were identified, the detection rate of PMS was 47.2%, which included the mild in 209 cases(55.15%), moderate in 153 cases(40.37%) and severe in 17 cases(4.48%).The PMS symptoms mainly included the inattention(62.14%), agitation(61.15%), drowsiness(58.78%) and anxiety(55.04%).The scores of psychosis and neuroticism scale in PMS college students were higher than those in non-PMS students(P < 0.01 and P < 0.05), the score of extroversion scale in PMS college students was significantly lower than that in non-PMS students(P < 0.01), and the difference of the MAQ score between PMS and non-PMS college students was not statistically significant(P>0.05).The correlation analysis results showed that the scores of psychosis, neuroticism and MAQ were positively correlated with PMSS score(P < 0.01), the score of extroversion scale was negatively correlated with PMSS score(P < 0.01), and the score of mental quality scale was negatively correlated with MAQ score(P < 0.01). ConclusionsThe PMS is amore common health problem, and is correlated with personality traits and menstrual attitudes among female college students.
2019, 44(11): 1537-1540.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.028
Abstract:
ObjectiveTo explore the relationship among the job satisfaction, emotion management ability and self-efficacy of residents with standardized training. MethodsThree hundred and fifty-two participants were investigated using the Minnesota satisfaction questionnaire, general self-efficacy scale and emotional management ability of medical students scale. ResultsThere were significantly positive correlations among job satisfaction, emotion management ability and self-efficacy of resident physicians with standardized training(P < 0.01).The job satisfaction could affect the self-efficacy of residents with standardized training through the mediating of emotion management ability. ConclusionsThe emotion management ability of resident physicians with standardized training plays a mediating role in the relationship between job satisfaction and self-efficacy.
2019, 44(11): 1541-1544.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.029
Abstract:
ObjectiveTo analyze the effects of continuous nursing intervention on postoperative level of hope and quality of life in patients treated with radical resection of colon cancer. MethodsEighty-four patients treated with radical resection of colon cancer were randomly divided into the observation group and control group(42 cases in each group).The control group was treated with conventional discharge guidance and following-up method, and the observation group was nursed with continuous nursing intervention and followed up for 3 months.The postoperative level of hope and quality of life in two groups were evaluated using the Herth Hope Index and Quality of Life Questionnaire-Core 30(QLQ-C30) at discharge and end of following-up, and the difference of the rehabilitation between two groups was compared. ResultsAt discharge, there was no statistical significance in the HHI between two groups(P>0.05).At 3 months of following-up, there was no statistical significance in the positive action scores Herth score of between two groups(P>0.05), but the total scores of the positive attitude, intimate relationship and hope in observation group were higher than those in control group(P < 0.05 to P < 0.01).At the end of following-up, the social function score in QLQ-C30 in observation group was higher than that in control group(P < 0.01), while the differences of the physical function, role function, cognitive function and emotional function between two groups were not statistically significant(P>0.05), and the scores of the symptom fields(including poor appetite, pain, constipation, diarrhea, nausea and vomiting) in observation group were lower than those in control group(P < 0.05 to P < 0.01). ConclusionsThe continuous nursing intervention for patients treated with radical resection of colon cancer can improve the hope level and quality of life.
2019, 44(11): 1545-1548.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.030
Abstract:
ObjectiveTo investigate the level of fear disease progression in breast cancer patients treated with postoperative chemotherapy, and analyze its influencing factors. MethodsThree hundred and twelve postoperative patients with breast cancer were investigated using general information questionnaire, fear of progression questionnaire-short form, social support rating scale and Herth hope index. ResultsThe score of fear disease progression was(38.54±5.26), and the physiological health dimension score and social and family dimension score were(20.23±3.03) and(18.30±2.46), respectively.The differences of the scores of fear disease progression in different ages, education levels, per capita monthly income, working status and relapse or metastasis breast cancer patients treated with postoperative chemotherapy were statistically significant(P < 0.01).The results of the Pearson correlation analysis showed that the score of fear disease progression was significantly negatively correlated with the scores of social support and hope level(P < 0.01).The results of multiple linear regression analysis showed that the age, education level, family per capita monthly income, recurrence or metastasis, social support and hope level were the independent influencing factors of fear disease progression of patients(P < 0.01). ConclusionsMedical staff should pay more attention to the level of fear disease progression and its influencing factors in breast cancer patients treated with postoperative chemotherapy, and provide effective clinical psychological intervention.
2019, 44(11): 1549-1553.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.031
Abstract:
ObjectiveTo apply the best available evidence of the management of anxiety and depression in lung cancer patients during postoperative chemotherapy to improve the compliance of nurses and promote the improvement of emotional state of patients. MethodsAccording to the standard procedure of JBI-PACES in Australia, the best available evidence was searched to formulate six audit criteria.A 10-month quality review in 20 nurses and 20 patients were conducted. ResultsAfter the evidence was applied in the quality review, the implementation rate of the five review indicators(including evaluation tools, education and training, health education, progressive muscle relaxation training and aerobic exercise of nurses) reached 100%, the implementation rate of group psychotherapy reached 90%, and the implementation rate of all review indicators increased by 25% to 100%.Meanwhile, the knowledge level of lung cancer chemotherapy of patients was also significantly improved(P < 0.05 to P < 0.01), and the incidence rates of anxiety and depression of patients significantly reduced(P < 0.01). ConclusionsEvidence-based quality review, the application of the best available evidence of the management of anxiety and depression in lung cancer patients during postoperative chemotherapy improves the nursing practice.However, the quality review is needed to continue for improving the management of anxiety and depression.
2019, 44(11): 1554-1557.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.032
Abstract:
ObjectiveTo explore the application value of predictive nursing based on Maslow's basic needs hierarchy theory in preventing acute depression in patients with basal ganglia cerebral infarction. MethodsOne hundred and fifty-eight patients with new basal ganglia infarction were randomly divided into the observation group(n=78) and control group(n=80).The predictive nursing guided by needs hierarchy theory and high quality routine nursing were applied in observation group and control group, respectively.The general clinical data, occurrence of depression and score of activity of daily living(ADL) were compared between two groups, and the logistic regression was used to identify the risk factors for depression. ResultsCompared with the control group, the incidence rate of depression significantly decreased(P < 0.05), and the ADL score significantly increased in observation group(P < 0.01).Compared with the control group, the score of the Hamilton Depression Scale(HAMD) of mild depressed patients decreased(P < 0.01), and the ADL score of mild depressed patients significantly increased in observation group(P < 0.01).There was no statistical significance in moderate and severe HAMD scores and length of stay between two groups(P>0.05).The results of multivariate logistic analysis found that the predictive care was still an independent protective factor of depression occurrence after adjusting the scores of gender, age, solitary and social support(OR=0.142, P < 0.01). ConclusionsAmong nursing patients with new basal ganglia infarction, the predictive nursing based on Maslow's basic needs hierarchy theory can significantly reduce the incidence of depression in acute phase patients, and it may have potential value in improving the self-care ability of the patients.
2019, 44(11): 1558-1563.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.033
Abstract:
ObjectiveTo analyze the experience of taking care of patients with malignant tumor in China. MethodsAll qualitative studies on the experience of taking care of patients with malignant tumor were searched from CNKI, Wanfang, CBM and VIP database, the qualitative evaluation was implemented using JBI critical appraisal tool, and the result of which was intergrated using the pooled integration approach. ResultsA total of ten studies were investigated, and 40 complete findings were extracted.The similar results were combined to form 10 new categories, and which was integrated into two integrations:(1)caregivers not only experienced the complex negative emotion and psychological experience, but also undertook the heavy burden of care, physical and mind pressure, and financial stress; (2)caregivers longed for help, and grew by constant adjustment and adaptation. ConclusionsThe negative emotion and burden of care in caregivers for malignant tumor are notable and heavy.It is demanded to improve the social support system, strengthen the guidance of disease-related knowledge and skill, and promote the growth of this group.
2019, 44(11): 1563-1566.
doi: 10.13898/j.cnki.issn.1000-2200.2019.11.034
Abstract:
ObjectiveTo explore the effects of the prospective nursing intervention on sleep quality, anxiety and depression of awake patients in ICU. MethodsEighty critically ill patients in ICU were divided into the observation group and control group according to the random number table method(40 cases each group).The control group was nursed using the traditional nursing method, and the observation group was nursed using the prospective nursing intervention based on the control group.Two groups were evaluated using Pittsburgh sleep quality scale(PSQI), Zung anxiety self-rating scale(SAS) and depression self-rating scale(SDS) before intervention and after 2 weeks of intervention. ResultsThe differences of all PSQI scores between two groups before intervention were not statistically significant(P>0.05), all PSQI scores in two groups after intervention decreased compared with before intervention(P < 0.05 to P < 0.01), and the PSQI scores in observation group after intervention were significantly lower than that in control group(P < 0.01).The differences of the scores of SAS and SDS between two groups before intervention were not statistically significant(P>0.05), the scores of SAS and SDS in two groups after intervention decreased compared with before intervention(P < 0.05 to P < 0.01), and the scores of SAS and SDS in observation group after intervention were significantly lower than those in control group(P < 0.01). ConclusionsThe application of the prospective nursing intervention in awake patients in ICU can help to improve the sleep quality, and alleviate the anxiety and depression of patients.
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