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2019 Vol. 44, No. 3
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2019, 44(3): 281-283.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.001
Abstract:
ObjectiveTo provide the anatomical basis in preserving the upper limb lymphatic drainage to alleviate upper limb lymphedema during the sentinel lymph node biopsy (SLNB) and axillary lymph node (ALN) dissection (ALND) in breast cancer patients. MethodsThe axillary region and proximal upper arm region of 40 sides in female adult cadavers were dissected, and the number and location of lymph node in each axillary region were observed.The relationships among the superficial lymphatic reflux of proximal upper arm, axillary lymph node and axillary vein were analyzed. ResultsThe average number of lateral ALN, subscapularis ALN, pectoral ALN, central ALN and apical ALN was (3±1.3) (4±1.8) (4±1.1) (5±1.3) and (2±1.3), respectively.The superficial lymphatic drainage of upper limb draining into basilic vein in 12 cases (30.0%), lateral ALN in 25 cases (62.5%), central ALN in 13 cases (32.5%) and axillary vein in 20 cases (50.0%) were identified. ConclusionsPreservating the axillary reverse mapping lymphatic drainage and lymph nodes during ALND and SLNB can effectively protect the upper limb lymphatic drainage.
2019, 44(3): 284-288, 292.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.002
Abstract:
ObjectiveTo investigate the dynamic characteristics of microbiota in the respiratory and upper gastrointestinal tract in patients with acute respiratory distress syndrome (ARDS). MethodsThe bronchoalveolar lavage fluid (BALF) and gastric juice (GJ) from 7 ARDS patients and BALF from 4 healthy volunteers were collected.The gene sequences of bacterial 16S rDNA in all samples were obtained via high-throughput sequencing, and its bio-informatics was analyzed to understand the composition, evolution and correlation of microbiota. ResultsThe abundance of phylum Firmicutes (88.99%) significantly increased in the lung microbiota of ARDS patients compared with the healthy subjects (38.56%), and the difference of which was statistically significant (P < 0.05).The abundance of phylum Bacteroidetes in ARDS patients (7.69%) significantly decreased, and the difference of which between ARDS patients and healthy subjects (24.50%) was statistically significant (P < 0.05).The abundance of phylum Proteobacteria in ARDS patients (2.55%) significantly decreased compared with the control group (10.54%) (P < 0.05).With the intubation time prolonging, the relative abundance of phylum Proteobacteria in lung microbiota of ARDS patients increased from 2.55% to 74.65%, and the relative abundance of phylum Firmicutes decreased from 88.99% to 9.81%.The change of microbiota of upper gastrointestinal tract of ARDS patients was found during intubation, which was not statistically significant (P>0.05), and the relative abundance of phylum Acinetobacter significantly increased in the genus level (0.53% vs 53.70%, P < 0.05). ConclusionsThe microbiota diversity in respiratory tract changes, and has similarity with that of the upper gastrointestinal tract in patients with ARDS.The microbiota of the respiratory tract may involve in the onset and progress of ARDS, which can serve as a possible biomarker in the diagnosis and prognosis of ARDS.
2019, 44(3): 289-292.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.003
Abstract:
ObjectiveTo investigate the role of tumor vascular endothelial cells (GVEC) in the migration of glioma tumor cells. MethodsThe vascular endothelial cells (VEC) and GVEC were isolated, and co-cultured with glioma cell line CGH5 in vitro, respectively.The CHG5 cells were set as the control.The effects of GVEC on the migration ability and cytoskeleton of CHG5 cells were analyzed using the Transwell migration assay and immunofluorescence staining, respectively.The expression levels of Rac1 and Cdc42 in CHG5 cells after co-culture were detected using Western blotting. ResultsThe migration ability of CHG5 co-cultured with GVEC was significantly higher than that in CHG5 co-cultured with VEC and CHG5 culture alone (P < 0.05).The results of cytoskeleton immunofluorescence staining showed that the morphology of tubulin in CHG5 cells changed, and the tubulin was thick, circular and radial arrangement after the CHG5 cells were co-cultured with GVEC.The results of Western blotting showed that the expression levels of Rac1 and Cdc42 in CHG5 cells significantly increased after the CHG5 cells were co-cultured with GVEC (P < 0.05), while no obvious change of the expression levels of Rac1 and Cdc42 in CHG5 cells was found after the CHG5 cells were co-cultured with VEC (P>0.05). ConclusionsThe role of tumor cell vascularity is crucial in the migration of glioma cells.The GVEC can promote the migration of tumor cells by changing the cellular tubulin structure, and up-regulating the expression levels of Rac1 and Cdc42 proteins.
2019, 44(3): 293-296, 301.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.004
Abstract:
ObjectiveTo observe the contents of inflammatory cytokines (IL-1β, IL-6, IL-8 and TNF-α) and levels of MMPs mRNA expression in knee joints of rabbits after posterior cruciate ligament (PCL) injury, and explore the mechanism of difficult repair by itself after PCL injury. MethodsEighty adult New Zealand white rabbits were divided into the sham operation group (40 rats) and PCL injury group (40 rats) according to the random number table method.The PCL was revealed after the posterior paratellar medial incision of the right posterior limb, and the incision was sutured in sham operation group.The 1/2 PCL was cut after the posterior paratellar medial incision of the right posterior limb, and the incision was sutured in PCL injury group.Ten rabbits in each group were randomly sacrificed on the 3rd, 7th, 14th and 21st day after modeling, respectively, and the knee joint fluid of right hind limb, synovial membrane and PCL tissue were harvested.The contents of inflammatory cytokines (IL-1β, IL-6, IL-8 and TNF-α) in joint fluid were detected using the enzyme-linked immunosorbent assay (ELISA), and the levels of MMP-1, MMP-2 and MMP-3 mRNA in synovial membrane and PCL tissue were detected using RT-PCR. ResultsAfter modeling, the levels of IL-1β, IL-6, IL-8 and TNF-α in joint fluid of PCL injury group increased compared with the sham operation group.On the 3rd day after modeling, the contents of inflammatory cytokines in joint fluid of PCL injury group reached the peak.On the 7th, 14th and 21st day, the contents of inflammatory cytokines in PCL injury group decreased, but which was still higher than those in sham operation group (P < 0.01).After modeling, the levels of MMP-1, MMP-2 and MMP-3 mRNA expression in synovial and PCL tissue of PCL injury group increased compared with the sham operation group.On the 3rd day after modeling, the levels of MMPs mRNA expression of PCL injury group reached the peak.On the 7th, 14th and 21st day, the levels of MMPs mRNA expression in PCL injury group decreased, but which was still higher than those in sham operation group (P < 0.01). ConclusionsAfter the PCL injury of rabbits, the contents of inflammatory cytokines in joint fluid, and the enhanced activity of MMPs induces the excessive degradation of extracellular matrix in synovial tissue and PCL tissue, which may be an important cause of difficult repair by itself after PCL injury.
2019, 44(3): 297-301.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.005
Abstract:
ObjectiveTo investigate the effects of the down-regulation of Yes-associated protein (YAP) on the cloning ability and energy metabolism of gastric cancer cells. MethodsThe YAP small interfering RNA (YAP siRNA) and negative small interfering RNA (siRNA-NC) were transfected into the gastric cancer cell line BGC823, respectively, and the cells without transfection was set as the control (con).The levels of mRNA and protein level of YAP in cells were detected using the qRT-PCR and western blotting, respectively.The cell proliferation activity and cloning ability were determined using the MTT and plate cloning assay, respectively.The level of ATP in cells and content of lactic acid in supernatant of culture medium were determined by kit.The levels of related energy metabolism proteins HK2, PKM2 and apoptotic protein cleaved caspase-3 were determined using western blotting. ResultsThe levels of YAP mRNA and protein in YAP siRNA cells were significantly lower than those in Con cells (P < 0.05), and the differences of the levels of YAP mRNA and protein between siRNA-NC and Con cells were not statistically significant (P>0.05).The cell proliferation and colony formation rate in YAP siRNA cells were significantly lower than those in Con cells (P < 0.05), and the apoptosis rate in YAP siRNA cells was significantly higher than that in Con cells (P < 0.05).The level of ATP in cells, content of lactic acid in supernatant and levels of HK2 and PKM2 protein in YAP siRNA cells were lower than those in Con cells (P < 0.05), and the level of cleaved caspase-3 in YAP siRNA cells was higher than that in Con cells (P < 0.05). ConclusionsThe down regulation of YAP can reduce the abilities of clone formation and proliferation, induce the caspase-3 mediated apoptosis, interfer the expression of key enzymes HK2 and PKM2, decrease the level of ATP and inhibit the glycolysis in gastric cancer cells.
2019, 44(3): 302-305.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.006
Abstract:
ObjectiveTo investigate the relationhsips between the levels of interleukin 18 (IL-18) and cystatin C (CysC), and lower extremity vascular lesions in type 2 diabetes mellitus (T2DM) patients, and its clinical significance. MethodsOne hundred and twelve patients with T2DM and 30 healthy people were divided into the group A and group B, respectively.According to the arterial intima-media thickness (IMT) of lower extremity vascular detected by ultrasound, the group A was divided into the subgroup A1 (IMT < 1.0 mm), subgroup A2 (1.0 mm ≤ IMT < 1.3 mm) and subgroup A3 (IMT ≥ 1.3 mm).The levels of fasting blood glucose (FBG), glycosylated hemoglobin, blood lipid, creatinine, IL-18 and CysC were measured in all groups. ResultsThe levels of serum IL-18 and CysC in group A were higher than those in group B (P < 0.01).The serum levels of IL-18 and CysC in A3 and A2 subgroups were higher than those in A1 and A2 subgroups, and subgroup A1, respectively (P < 0.05).Multivariate linear regression analysis showed that the levels of IL-18, CysC, total cholesterol and FBG were positively correlated with the IMT of lower extremity vascular. ConclusionsThe serum levels of IL-18 and CysC are the main influencing factors of IMT, and correlated with the T2DM and IMT of lower limb artery.
2019, 44(3): 306-308, 313.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.007
Abstract:
ObjectiveTo investigate the value of serum albumin (ALB), cholinesterase (CHE) and prothrombin activity (PTA) in the diagnosis of viral hepatitis cirrhosis. MethodsSixty-three viral hepatitis cirrhosis patients, 60 viral hepatitis patients and 60 healthy volunteers were divided into the cirrhosis group, hepatitis group and control group, respectively.The levels of ALB, CHE and PTA were detected in three groups. ResultsThe levels of ALB, CHE and PTA in cirrhosis group were significantly lower than those in hepatitis group and control group (P < 0.01).The levels of ALB, CHE and PTA in Child-pugh C patients were significantly lower than those in Child-pugh B and A in cirrhosis group (P < 0.05 to P < 0.01).The areas under the ROC curve of ALB, CHE and PTA in diagnosing viral hepatitis cirrhosis were 0.835, 0.897 and 0.746, respectively; the cut-off values of those were 31.41g/L, 3 785.41 U/L and 36.59%, respectively; the sensitivity of those were 73.30%, 85.00% and 93.30%, respectively, and the specificities of whose were 81.00%, 79.40% and 44.44%, respectively. ConclusionsThe levels of ALB, CHE and PTA in patients with viral hepatitis cirrhosis significantly decrease, which can reflect the classification of Child-pugh, and has certain diagnostic value.
2019, 44(3): 309-313.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.008
Abstract:
ObjectiveTo study the efficacy and safety of low-temperature plasma ablation of dorsal root ganglion (DRG) combined with drug in the treatment of postherpetic neuralgia (PHN). MethodsSixty patients with PHN were randomly divided into the oral medicine group (group A), oral medicine combined with paravertebral nerve block group (group B), and oral medicine combined with low-temperature plasma ablation of dorsal root ganglion (group C) (20 cases each group).The pain degrees of patients before treatment and after 1 week, 8 weeks, 12 weeks and 24 weeks of treatment were investigated using short-form McGill pain questionnaire (SF-MPQ), and the occurrence of complications was recorded. ResultsBefore treatment, the differences of the PRI, VAS and PPI scores of SF-MPQ among three groups were not staistically significant (P>0.05).After 1, 8 and 12 weeks of treatment, the PRI, VAS and PPI scores in group B and group C were significantly lower than those in group A (P < 0.05 to P < 0.01).After treatment, the differences of the PRI, VAS and PPI scores of SF-MPQ between group B and group C were not statistically significant (P>0.05).Compared with before treatment, the PRI, VAS and PPI scores in three groups were significantly decreased after treatment (P < 0.05 to P < 0.01).After treatment, no obvious adverse reaction was found in group B and group C.The varying degrees of dizziness and lethargy in group B and group C were found, the patients could tolerate, and the symptoms significantly alleviated or disappeared after treatment. ConclusionsThe low-temperature plasma ablation of dorsal root ganglion combined with drug in treating PHN is safe and effective.
2019, 44(3): 314-316.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.009
Abstract:
ObjectiveTo analyze the canceration trend of different thickness tissues of nipple-areolar complex (NAC), and provide the theoretical basis of pathology for the security of reserving NAC in patients with breast cancer. MethodsThe 0.5 cm, 1.0 cm and 1.5 cm thickness tissues under NAC were harvested, marked and made into paraffin sections after 24 h of fixation in 10% formaldehyde solution, and cut into two slices with 4 μm thickness, respectively.One slice was stained with HE, the level of human telomerase reverse transcriptase (hTERT) protein in another slice was detected using Western blotting. ResultsThe results of routine HE staining showed that the positive rate of cancer cells infiltration was 7.14% in 1.5 cm thickness tissue under NAC, no cancer cells infiltration in 1.0 cm and 0.5 cm thickness tissues under NAC was found, and the difference of which was statistically significant (P < 0.05).The results of Western blotting showed that the positive expressions of hTERT in the margin of 1.5 cm and 1.0 cm thickness tissues under NAC were found, the differences of the positive rates of hTERT expression among the 0.5 cm, 1.0 cm and 1.5 cm thickness tissues under NAC were statistically significant (P < 0.05), and the positive rate of which increased with the increasing of tissue thickness.There was statistical significance in the level of hTERT in 1.5 cm thickness tissue between routine pathological detection and Western blotting (P < 0.05). ConclusionsIn evaluating the security of NAC, the molecular pathology is more sensitive than that of traditional pathology.The thickness range under NAC with molecular level change of cancer cell is more than 0.5 cm, and the thickness under NAC should not be greater than 0.5 cm in reserving the NAC.
2019, 44(3): 317-319, 324.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.010
Abstract:
ObjectiveTo investigate the clinical effects of MOTOmed intelligent training combined with spastic myoelectric stimulation in the treatment of lower limb muscle spasticity in stroke patients. MethodsNinety-three stroke patients with posterior lower limb spasm were randomly divided into the conventional group (treated with conventional rehabilitation), electrical stimulation group (treated with conventional rehabilitation combined with spastic myoelectric stimulation) and MOTOmed group (treated with conventional rehabilitation, spastic myoelectric stimulation combined with MOTOmed intelligent training) (31 cases each group).The lower limb muscle tension, motor function and activities of daily living in three groups were evaluated using the modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA) and modified Barthel index (MBI) before treatment and after 8 weeks of treatment, and which among three groups was compared. ResultsThe differences of the MAS, FMA and MBI scores in three groups between before and after treatment were statistically significant (P < 0.01).After treatment, the differences of the scores of MAS, FMA and MBI between MOTOmed group, and conventional and electrical stimulation groups were statistically significant (P < 0.01), and the treatment effect in MOTOmed group was significantly better than that in conventional and electrical stimulation groups (P < 0.01). ConclusionsThe application of MOTOmed intelligent training combined with spastic myoelectric stimulation can significantly decrease the lower limb muscle tension, improve motor function and activities of daily living in stroke patients with muscle spasticity.
2019, 44(3): 320-324.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.011
Abstract:
ObjectiveTo investigate the relationship between the levels of small dense low-density lipoprotein (sdLDL), free fatty acid (FFA) and acute coronary syndrome (ACS), and evaluate the correlation of sdLDL, FFA with Gensini score. MethodsAmong 282 patients suspected by ACS, 92 cases with acute myocardial infarction (AMI), 110 cases with unstable angina pectoris (UAP), 30 case with coronary sclerosis, and 50 cases with normal coronary were divided into the AMI group, UAP group, coronary sclerosis group and normal coronary group according to the results of coronary angiography, respectively.One hundred healthy people were set as the healthy control group.According to the results of Gensini score, the score for ≤ 20 in 81 cases, score for 21-50 in 71 cases and score for>50 in 80 cases were found.The plasma levels of sdLDL, FFA, TC, TG, HDL and LDL in all groups were analyzed. ResultsThe levels of sdLDL in AMI group and UAP group significantly increased (P < 0.05 to P < 0.01), and the difference of which was not statistically significant between two groups (P>0.05).The levels of FFA in healthy control group, normal coronary group, coronary sclerosis group, UAP group and AMI group gradually increased in turn, and the difference of which was statistically significant (P < 0.05 to P < 0.01).The level of sdLDL was not correlated with Gensini score (P>0.05), and the level of FFA was weakly positively correlated with Gensini score in patients with ACS (P < 0.05).The level of FFA in abnormal coronary patients increased with the increasing of Gensini score, and the difference of which was statistically significant (P < 0.05 to P < 0.01).There was no statistical significance in the level of FFA among Gensini groups in AMI group and UAP group (P>0.05). ConclusionsThe sdLDL and FFA are closely related to the occurrence of ACS, and FFA may be a potential indicator to judge the severity of coronary artery disease.
2019, 44(3): 325-327.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.012
Abstract:
ObjectiveTo evaluate the sensitivity and superiority of P300 combined with MMSE and MoCA in the evaluation of the cognitive function in neuropathy patients complicated with cognitive impairment. MethodsP300 was measured in 33 patients with organic diseases (such as cerebral infarction, hypertension and Parkinson's disease) and 21 healthy people, and the cognitive function in all cases was evaluated using MMSE and MoCA.The latency and amplitude of P300 between patients and healthy people were compared.The correlation of psychological scale score with latency and amplitude of P300 between patients and healthy people were compared. ResultsThe scores of MMSE and MoCA in control group were higher than those in observation group (P < 0.05 and P < 0.01), the latency of P300 in control group was significantly lower than that in observation group (P < 0.01), and the difference of the amplitude between two groups was not statistically significant (P>0.05).The latency of P300 was negatively correlated with MMSE and MoCA scores (P < 0.05).The amplitude of P300 was positively correlated with MMSE score (P < 0.05), and not correlated with MoCA score (P>0.05). ConclusionsP300 can be used as a biological indicator in evaluating organic disease complicated with cognitive impairment.P300 combined with MoCA scale can more sensitively detect the early cognitive impairment of patients, which is worthy of further clinical application.
2019, 44(3): 328-331.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.013
Abstract:
ObjectiveTo investigate the clinical effects between intervertebral foramen approach and interlaminar approach percutaneous endoscopic lumbar discectomy in the treatment of L5/S1 disc herniation. MethodsForty-three patients with L5/S1 disc herniation were divided into the intervertebral foramen approach group (n=21) and interlaminar approach group (n=22).The clinical efficacy was assessed using Visual Analog Scale (VAS) and modified MacNab evaluation criteria.The operation time, postoperative ambulation time, postoperative hospitalization time, in-patient cost and postoperative complication were compared between two groups. ResultsAll opereations were successful.The patients were followed up for mone than 6 months.The bed time, postoperative hospitalization time, total hospitalization expense in intervertebral foramen approach group were lower than those in interlaminar approach group (P < 0.01).The VAS scores of back and leg in two groups after 1 month, 3 months and 6 months of operation were significantly lower than those before operation (P < 0.05).The differences of the operation time and VAS scores of back and leg in two groups between before and after operation were not statistically significant (P>0.05).The excellent in 14 cases, good in 4 cases, fair in 3 cases and poor in 0 case in intervertebral foramen approach group, and excellent in 13 cases, good in 5 cases, fair in 4 cases and poor in 0 case in interlaminar approach group were identified using improved MacNab scale, respectively, and the difference of which between two groups was not statistically significant (P>0.05).No severe complication in two groups was found after operation. ConclusionsThe intervertebral foramen approach and interlaminar approach percutaneous endoscopic lumbar discectomy in the treatment of L5/S1 disc herniation are safe and effective.Compared with the interlaminar approach, the intervertebral foramen approach has little invasion, quick recovery and few contraindications, which is more suitable to the concept of minimally invasive surgery.
2019, 44(3): 332-334.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.014
Abstract:
ObjectiveTo investigate the effects of superior gluteal artery perforator flap in repairing sacrococcygeal pressure sores. MethodsTwenty patients with sacrococcygeal pressure sores were repaired with superior gluteal artery perforator flap.The formation time of pressure sores ranged from 3 months to 10 years, the size of pressure sores ranged from 8 cm×7 cm to 16 cm×12 cm, and the size of flaps ranged from 14 cm×6.5 cm to 20 cm×18 cm. ResultsThree cases with partial necrosis of flap were the secondary healing after symptomatic treatment, 1 case with vein congestion and swelling at postoperative 2 days was treated with partial debridement and superior gluteal artery perforator flap repair, and the primary healing and good growth of free skin in the donor area in 16 cases were identified.All cases were followed up for 1 year, the shape of the flap area was good, the shape and function of gluteus maximus were intact, and there was not local recurrence. ConclusionsSuperior gluteal artery perforator flap can provide rich blood supply, has high survival rate and flexible design, which is an ideal method to repair sacrococcygeal pressure ulcer wound.
2019, 44(3): 335-337.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.015
Abstract:
ObjectiveTo investigate the expression levels of regulatory T cells (Treg) in peripheral blood of chronic hepatitis B (CHB) patients during the treatment with nucleoside analogues, and its clinical significance. MethodsThe ratio of CD4+CD25+CD127Low/- Tregs in 130 CHB patients treated with nucleoside analogues was detected using flow cytometry before treatment and after 48 weeks of treatment. ResultsBefore treatment, the differences of the levels of CD4+CD25+CD127Low/- Treg among immune tolerance group, immune clearance group and healthy control group were statistically significant (P < 0.01), the differences of the levels of CD4+CD25+CD127Low/- Treg between immune tolerance group, and immune clearance group, healthy control group were statistically significant (P < 0.01 and P < 0.05), but the difference of the level CD4+CD25+CD127Low/- Treg between immune clearance group and healthy control group was not statistically significant (P>0.05).After 48 weeks of treatment, the differences of the levels of CD4+CD25+CD127Low/- Treg among HBeAg unchanged group, HBeAg conversion negative group, HBeAg serum conversion group and healthy control group were statistically significant (P < 0.05), the differences of the levels of CD4+CD25+CD127Low/- Treg between HBeAg unchanged group and HBeAg conversion negative group, healthy control group were statistically significant (P < 0.05), and the differences of the levels of CD4+CD25+CD127Low/- Treg among HBeAg conversion negative group, HBeAg serum conversion group and healthy control group were not statistically significant (P>0.05).After 48 weeks of treatment, the difference of the level of Treg between HBV normalization group and HBV no normalization group was not statistically significant (P>0.05), and the difference of the level of Treg between ALT normalization group and ALT no normalization group was not statistically significant (P>0.05). ConclusionsDuring the treatment of CHB patients with nucleoside analogues, the level of CD4+CD25+CD127Low/- Treg may be related to the HBeAg seroconversion and HBV normalization, which has certain predictive value in the efficacy and prognosis of disease.
2019, 44(3): 338-339.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.016
Abstract:
ObjectiveTo study the correlations between the partial pressure of carbon dioxide (PCO2) and levels of fibrinogen (FIB), D-dimmer in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). MethodsExcluding the possible coexisting disease and related factors affecting the coagulation indexes, the correlations between PCO2 and levels of FIB, D-dimmer in 92 patients with AECOPD were analyzed. ResultsThe levels of FIB and D-dimmer of AECOPD patients in PCO2 increasing group were significantly higher than those in normal PCO2 group (P < 0.01).The levels of FIB and D-dimmer were positively correlated with the PCO2 (r=0.686, 0.741, P < 0.05). ConclusionsThe more serious the carbon dioxide retention is, the higher the incidence of coagulation dysfunction is in AECOPD patients.
2019, 44(3): 340-342.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.017
Abstract:
ObjectiveTo explore the clinical significance of non-invasive detection of atherosclerosis technology in healthy physical examination. MethodsTwo hundred and forty healthy physical examination people were divided into group A (80 cases, 20 to 40 years old), group B (120 cases, 40 to 60 years old) and group C (40 cases, more than 60 years old).The pulse wave speed (PWV), ankle-brachial index (ABI) and pulse pressure index (PPI) in three groups were detected and analyzed. ResultsThe differences of the PWV, ABI and PPI between group A and B were statistically significant (P < 0.05 to P < 0.01).The differences of the PWV and PPI between group A and C were statistically significant (P < 0.01).The differences of the PWV and PPI between group B and C were statistically significant (P < 0.01). ConclusionsThe non-invasive detection of atherosclerosis technology can early screen and diagnose the atherosclerosis, which has great clinical significance, and is worth popularizing in healthy physical examination.
2019, 44(3): 343-345.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.018
Abstract:
ObjectiveTo compare the different sputum suction methods on sputum suction effect and respiratory function in patients with pulmonary infection after mechanical ventilation in ICU. MethodsTwo hundred and sixty patients with pulmonary infection after mechanical ventilation in ICU were divided into the control group (n=115) and experiment group (n=145) according to the sputum suction method.The control group was treated with open sputum suction, and the experiment group was treated with closed sputum suction.The sputum suction effect, and blood gas index and respiratory function before and after 1 min of sputum suction were compared between two groups. ResultsThe volume of expectoration in experiment group was significantly higher than that in control group (P < 0.01), the disappearance rate of pulmonary rale in experiment group was significantly higher than that in control group (P < 0.01), the incidence rates of the fresh blood in sputum or suction tube wall, and sputum ejection during sputum suction in experiment group were significantly lower than those in control group (P < 0.01).Compared with before 1 min of sputum suction, the levels of SaO2, PaO2, and PaCO2 in experiment group were increased and decreased after 1 min of sputum suction, respectively (P < 0.05 and P < 0.01).Compared with before 1 min of sputum suction, the levels of SaO2, PaO2, and PaCO2 in control group were decreased and increased after 1 min of sputum suction, respectively (P < 0.05 and P < 0.01).Compared with before 1 min of sputum suction, the levels of BF, Pplat and Ppeak were significantly increased, and level of Vt significantly decreased in control group after 1 min of sputum suction (P < 0.01).The significant changes of the above indexes were not found in experiment group (P>0.05). ConclusionsClosed sputum suction can improve the effect of sputum suction, reduce or avoid respiratory tract mucosal damage, improve the blood gas index after sputum suction, and has no affect on the respiratory function of patients.The sputum suction effect of closed sputum suction is better than that of open sputum suction.
2019, 44(3): 346-349, 352.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.019
Abstract:
ObjectiveTo investigate the effects of dexmedetomidine on the postoperative cognitive dysfuction (POCD) and intraoperative hemodynamics in colorectal cancer elderly patients treated with laparoscopic resection. MethodsForty colorectal cancer elderly patients scheduled by laparoscopic resection under total intravenous anesthesia were randomly divided into the dexmedetomidine group (group D, 20 cases) and control group (group C, 20 cases).The 0.4 μg/kg of dexmedetomidine was intravenously injected in the group D before 10 min of anesthesia induction, and which was maintained at the end of operation.The group C was treated with the same method as the group D with 0.9% normal saline.The mean arterial pressure (MAP) and heart rate (HR) in two groups at T0 (before anesthesia induction), T1 (after anesthesia induction), T2 (after intubation), T3 (after skin incision), T4 (after 5 minutes of pneumoperitoneum), T5 (at the end of surgery) and T6 (at the time of extubation) were recorded.The Mini-Mental State Examination (MMSE) scores before operation and after 1 d and 5 d of operation, incidence rate of cognitive dysfunctions at postoperative 1 d and 5 d, dosage of anesthetics, and adverse reactions were compared between two groups. ResultsCompared with group C, the HR slowed at T3, T4, T5 and T6, and the MAP decreased at T2, T3, T4, T5 and T6 in group D (P < 0.01).The MMSE score in group C decreased compared with group D, and the incidence rate of POCD in group C was higher than that in group D at postoperative 1 d (P < 0.01).The intraoperative use dosage of propofol and sufentanil in group D significantly decreased compared with group C (P < 0.01), the intraoperative use rate of atropine in group D was higher than that in group C (P < 0.05), and the incidence rate of postoperative shivering in group D decreased compared with group C (P < 0.05). ConclusionsThe total intravenous general anesthesia combined with dexmedetomidine can improve the postoperative cognitive function, decrease the incidence rate of POCD, stabilize the hemodynamics and decrease the adverse reaction in colorectal cancer elderly patients treated with laparoscopic resection.
2019, 44(3): 350-352.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.020
Abstract:
ObjectiveTo investigate the clinical value of the serum level change of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in varicocele (VC) patients. MethodsThe serum levels of 8-OHdG in 30 VC patients treated with high spermatic vein ligation were measured before and after 3 months of surgery.The differences of the serum levels of 8-OHdG between before and after surgery were compared, and the correlations of the level of 8-OHdG with incidence rate of single or bilateral VC and width of spermatic vein were analyzed. ResultsBefore surgery, there was no statistically significant in the serum level of 8-OHdG between the VC unilateral group and bilateral group (P>0.05), and there was no statistical significance in the serum levels of 8-OHdG level among patients with different widths of spermatic vein (P>0.05).The postoperative 8-OHdG level[(261.64±82.55) pg/mL] was significantly lower than that of preoperative level[(327.20±101.86) pg/mL] in 30 patients (P < 0.01). ConclusionsThe serum level of 8-OHdG increasing, an indicator of oxidative stress, is related to the infertility caused by VC, and the level of 8-OHdG decreasing has a certain clinical significance in judging the prognosis of VC patients treated with operation.
2019, 44(3): 353-355.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.021
Abstract:
ObjectiveTo investigate the relationship between the serum level of macrophage inflammatory protein-1α (MIP) -1α and disease severity in patients with traumatic brain injury. MethodsNinety-eight patients with traumatic brain injury were set as the observation group, and subdivided into the high MIP-1α group and low MIP-1α group according to the median of MIP-1α (49 cases each group).Fifty healthy people were set as the control group.At the same time, the coma degree in observation group was assessed using Glasgow Coma Scale (GCS), and the serum nerve injury indices and content of excitatory amino acid were determined. ResultsOn admission, the serum content of MIP-1α in observation group[(92.16±9.85) pg/mL] was significantly higher than that in control group[(74.51±8.68) pg/mL] (P < 0.01).The GCS score in high MIP-1α group (7.27±0.91) was significantly lower than that in low MIP-1α group (11.09±1.82) (P < 0.01).On admission, the serum neural damage indices, such as glial fibrillary acidic protein, neuron-specific enolase and S100B, and the serum contents of excitatory amino acid glutamic acid and aspartic acid in high MIP-1α group were significantly higher than those in low MIP-1α group (P < 0.01). ConclusionsThe serum content of MIP-1α in patients with traumatic brain injury increases, and the specific content is positively correlated with the severity of brain injury.
2019, 44(3): 356-358.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.022
Abstract:
ObjectiveTo summarize the clinical characteristics of common and dangerous type placenta previa, and compare the clinical efficacy of the surgical treatment in two types of placenta previa. MethodsAmong 178 patients, 94 cases with common type placenta previa and 84 cases with dangerous type placenta previa were divided into the control group and observation group, respectively.After the detailed investigating disease history and examination, the age, pregnancy time, placenta implantation, attachment site and placenta previa type in two groups were summarized.After surgical treatment, the operation time, blood loss, diffused intravasular coagulation, hysterectomy and neonatal status between two groups were compared. ResultsThe incidence rate of the placenta previa attaching anterior wall in control group (75.5%) was lower than that in observation group (92.9%) (P < 0.01).The differences of the constituent ratios of complete type, partial type and edge type between two groups were statistically significant (P < 0.01).The difference of the level of hemoglobin between two groups before operation was not statistically significant (P>0.05).After operation, the levels of hemoglobin in two groups were lower than that in normal people, the anemia signs in two groups were found, and the level of hemoglobin in control group was higher than that in observation group (P < 0.01).The operation time, blood loss, blood transfusion and postpartum hemorrhage in control group were lower than those in observation group (P < 0.01), the incidence rate of diffused intravasular coagulation of mother in control group was lower than that in observation group (P < 0.05), and the differences of the maternal postpartum haemorrhage, uterine resection rate, neonatal asphyxia rate, endotracheal intubation rate and mortality between two groups were not statistically significant (P>0.05). ConclusionsThe placenta previa is great harmful to the mother, and the intraoperative and postoperative bleeding in dangerous type placenta previa are more.Timely surgical treatment can effectively improve the quality of life of patients with placenta previa.
2019, 44(3): 359-363.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.023
Abstract:
ObjectiveTo investigate the nosocomial infection status of very-low-birth-weight infants (VLBWI) in the neonatal intensive care unit in a maternal and child health care hospital in Shanghai, and analyze the nosocomial infection status of VLBWI and its risk factors. MethodsAccording to the retrospective cohort study, the medical histories of all VLBWI with hospitalization time more than 48 hours from 2011 to 2015 were collected.Based on the medical record management system, all data of patients with nosocomial infection were identified according to the nosocomial infection report, and were analyzed using SPSS24.0 software. ResultsThe infection rate in VLBWI was 44.3%.The main infection sites were lower respiratory tract (14.2%) and blood (11.6%), the difference of the composition ratio of nosocomial infection site was statistically significant in each year (P < 0.01), and the gram-negative bacterium was the mainly pathogenic bacterium (72.4%).Multivariate logistic regression analysis showed that the multiple births, long duration of mechanical ventilation, intravenous nutrition and hospitalization, and mother with premature rupture of membrane history were the independent risk factors of nosocomial infection in VLBWI (P < 0.01). ConclusionsStrengthening perinatal health care and timely intervening the premature infants with high risk factors should be implemented.
2019, 44(3): 366-369.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.025
Abstract:
ObjectiveTo investigate the application value of two-dimensional speckle tracking imaging (2D-STI) in the quantitative evaluation of left ventricular ejection fraction (LVEF) and its correlation in patients with severe aortic stenosis (AS). MethodsThirty-five severe AS patients with reserved ventricular LVEF ≥ 50% and 25 healthy volunteers with similar gender and age were selected.The LVEF in two groups were measured using the conventional echocardiography with biplane Simpsin.The interventricular septum (IVS), left ventricular posterior wall (LVPW) thickness, left ventricular end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD) were measured using M mode ultrasonography in two groups.The flow velocity and mean transprosthetic gradient (MPG), aortic valvular area (AVA), and left ventricle overall longitudinal strain (LVGLS) and global annular strain (LVGCS) in two groups were measured using the continuous doppler, continuous equation method and 2D-STI technique, respectively.At the same time, the energy loss index (ELI) for evaluating ventricular injury was measured. ResultsThe differences of the levels of LVEDD, LVESD and LVEF between two groups were not statistically significant (P>0.05).The left ventricle IVS and LVPW thickness in AS group were significantly thicker than those in control group (P < 0.05 and P < 0.01), and the biggest and average MPG in AS group were significantly higher than those in control group (P < 0.01).The LVGLS and LVGCS in AS group were significantly lower than those in control group (P < 0.01).The ELI was significantly positively correlated with LVGLS (P < 0.01), and the LVGLS was positively correlated with AVA (P < 0.01). ConclusionsThe left ventricular systolic function in severe AS patients with retained normal left ventricular is impair.2D-STI can early detect the subclinical left ventricular dysfunction in patients with severe AS, and provide the evidence for timely intervention in patients with AS.
2019, 44(3): 372-375.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.027
Abstract:
ObjectiveTo understand the relationship between the serum level of liver transaminase and risk of metabolic syndrome. MethodsThe data of physical examination and laboratory examination from 2 460 health examinees[including 1 457 males and 1 003 females, an average age for (46.64±14.81) years] in a hospital were investigated.The levels of AST, ALT and ratio of AST to ALT were divided into four groups (Q1, Q2, Q3 and Q4) by quartile method.The relationship between the serum level of liver transaminase and metabolic syndrome was analyzed using the Spearman correlation analysis and logistic regression model, and the data were processed using SPSS 21.0 software. ResultsThe crude prevalence of metabolic syndrome was 17.03%, which in male was higher than that in female (χ2=48.542, P < 0.05).The levels of AST and ALT were positively correlated with the abnormal number of metabolic components, but the ratio of AST to ALT was negatively correlated with the abnormal number of metabolic components.By adjusting the variates of age, smoking and alcohol, compared with Q1 group, the metabolic syndrome risk of ALT level in Q4 group were 4.96 times in males (95%CI:3.33 to 7.38), and 2.64 times in females (95%CI:1.29 to 5.43), and the metabolic syndrome risk of AST level in Q4 group was 2.22 times in males (95%CI:1.55 to 3.18). ConclusionsSerum liver transaminase is closely related to the components of metabolic syndrome.The increasing levels of AST and ALT may enhance the risk of metabolic syndrome.
2019, 44(3): 376-379.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.028
Abstract:
ObjectiveTo explore the feasibility of applying the seasonal autoregressive moving average (ARIMA) model for predicting the incidence of syphilis in Bengbu city, and provide reference in the prevention and control of syphilis. MethodsARIMA model was used to fit the monthly incidence of syphilis in Bengbu from 2008 to 2016 by SPSS21.0 software, and the optimal model was established according to the BIC criterion.The incidence rate of syphilis from January to June 2017 was predicted, which was compared with the actual incidence in order to test the prediction effect. ResultsThe monthly incidence rate of syphilis was well fitted by ARIMA (0, 1, 1) (1, 0, 0) 12.The model statistic Ljung-Box Q=16.726, P>0.05, and the residual sequence was white noise.The predictive value of syphilis incidence from January to June 2017 in Bengbu was well consistent with the actual value, and the actual values were within the 95% confidence interval of the predicted value. ConclusionsARIMA model can well simulate the incidence of syphilis in Bengbu, and provide some reference basis for prevention and control of syphilis.
2019, 44(3): 380-383.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.029
Abstract:
ObjectiveTo analyze the prevalence of hypertension and other physical examination indicators of elderly people in Longzihu district of Bengbu city in 2017, so as to provide the scientific basis for the prevention and treatment of disease in the area. MethodsThe health examination data of 7 271 elderly people aged 65 and over from 7 villages and towns in Longzihu district were collected, and the gender, age, hypertension and related biochemical indicators were analyzed. ResultsAmong the 7 271 subjects, the prevalence of hypertension and diabetes were 54.11% and 21.24%, respectively.The abnormal proportions of the levels of alanine aminotransferase (ALT), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) in male elderly people were significantly lower than those in female cases (P < 0.01), and the abnormal rates of Cr and BUN levels in male elderly people were higher than those in female cases (P < 0.01).The differences of the prevalence of hypertension, and abnormal rates of BMI, FPG, ALT, Cr, BUN, TC and TG levels among different age groups, the prevalence of hypertension, and abnormal rates of FPG, ALT, AST, Cr, BUN, TC, TG, LDL-C and HDL-C levels among different BMI groups, and the prevalence of hypertension, and abnormal rates of BMI, AST, TC, TG, LDL-C and HDL-C levels among different education level groups were statistically significant (P < 0.05 to P < 0.01). ConclusionsThe prevalence of hypertension and diabetes among the elderly people in the district is higher, which is 54.11% and 21.24%, respectively, and the health condition is not optimistic.The elderly people with abnormal physical examination should be reviewed and transfered by the general practitioners of primary medical institution.Strengthening the targeted health education, active controlling the related health risk factors and standardizing the management of the patients with chronic diseases should be implemented.
2019, 44(3): 384-387.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.030
Abstract:
ObjectiveTo explore the effects of nursing intervention based on mind map on anxiety, depression, and disease awareness of primary caregivers in children with Henoch-Schonlein purpura (HSP). MethodsSixty-eight primary caregivers of children with HSP were randomly divided into the observation group and control group according to a computerized random number generator (34 cases each group).The control group was nursed with routine nursing care, and the observation group was nursed with mind map-based nursing intervention on the basis of the control group during the hospitalization of children.The negative emotion and disease awareness of primary caregivers in two groups on admission and discharge were assessed using self-rating depression scale (SDS), self-rating anxiety scale (SAS) and disease awareness questionnaire. ResultsThere were no statistical significances in the scores of SAS and SDS, and disease awareness degree of primary caregivers between two groups on admission (P>0.05).The SAS and SDS scores of the primary caregivers in two groups at discharge were lower than those on admission, and the degree of disease awareness of the primary caregivers in two groups at discharge was higher than that on admission (P < 0.01).At discharge, the SAS and SDS scores of the primary caregivers in observation group were lower than those in control group, and the degree of disease awareness of the primary caregivers in observation group was higher than that in control group (P < 0.01). ConclusionsThe nursing intervention based on mind map can reduce the negative emotion, and improve the disease awareness of primary caregivers of children with HSP, which is worthy of promotion in clinic.
2019, 44(3): 388-392.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.031
Abstract:
ObjectiveTo explore the related risk factors and nursing measures of early neurological deterioration (END) in patients with acute ischemic stroke (AIS). MethodsFour hundred and two patients with AIS from 2014 to 2017 were divided into the END group (68 cases with NIHSS score increasing by 2 or more within 7 days after onset) and non-END group (334 cases).The clinical data between two groups were compared using the univariate analysis, and the independent risk factor of END was analyzed using the logistic regression analysis. ResultsThe differences of the body temperature, history of atrial fibrillation, carotid artery stenosis, baseline NIHSS score, hyperglycemia, homocysteine, C reactive protein and white blood cell between two groups were statistically significant (P < 0.01). The results of multivariate logistic regression analysis showed that the carotid artery stenosis ≥ 50% (OR=2.483, 95%CI:1.020 to 6.044), high baseline NIHSS score (OR=1.219, 95%CI:1.135 to 1.310), high blood glucose (OR=1.101, 95%CI:1.009 to 1.202), high C reactive protein (OR=1.029, 95%CI:1.007 to 1.052) and high white blood cell level (OR=1.172, 95%CI:1.042 to 1.319) were the independent risk factors of END. ConclusionsThe more stenosis the carotid artery, higher the baseline NIHSS score, and higher the levels of blood glucose, C reactive protein and white blood cell, the greater the risk of END.The results can provide reference for clinical nurses to assess the condition of patients with AIS, and set individualized treatment and nursing measures.
2019, 44(3): 393-395.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.032
Abstract:
ObjectiveTo analyze the risk factors of catheter-related infection (CRI) in acute leukemia patients treated with peripherally inserted central catheter (PICC) to provide the reasonable strategies for clinical nursing care. MethodsThe clinical data of 132 acute leukemia patients treated with PICC were successfully collected.The general clinical data, length of catheterization, number of puncture, application of chemotherapy drugs, use of hormone and immune function in all patients were analyzed.The correlation of CRI occurrence with season, and secretion culture results of CRI patients were analyzed. ResultsAmong 132 patients, 21 cases with CRI were found, and the infection rate of which was 15.91%.The CRI occurrence was not related to the classification of acute leukemia, gender and age (P>0.05).The infection rates in patients with long time of catheter indwelling, more punctural times, chemotherapy drug use, history of use hormone and low immune function, and at summer were higher than that in patients with short time of catheter indwelling, few punctural time, no use of chemotherapy drug, no hormone history and normal immune function, and at spring, autumn and winter (P < 0.05 to P < 0.01).Among 21 CRI patients, the secretion in 2 cases were not examined.The secretion culture results of the rest 19 patients showed that the proportions of Glucose aureus, Klebsiella bacillus, corynebacterium and other bacteria infection were 52.6%, 21.1%, 21.1% and 5.2%, respectively. ConclusionsShortening the PICC catheter indwelling time, reducing the punctural time, strengthening the immune treatment, controlling the use of hormone and choosing the antibiotics based on main coccus infection for preventive treatment can avoid and control the CRI in acute leukemia patients treated with PICC.
2019, 44(3): 396-399.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.033
Abstract:
ObjectiveTo analyze the effects of multimedia health education in day ward in the application of the patients treated with great saphenous vein stripping during the perioperative period. MethodsOne hundred patients with varicose vein of lower limb were randomly divided into the observation group and control group (50 cases each group).All patients were treated with the great saphenous vein stripping in day ward combined with routine care, and the observation group was additionally nursed with multimedia health education during perioperative period.The treatment effect, postoperative complications, recovery, treatment compliance and nursing satisfaction between two groups were compared. ResultsThe effective rates in two groups were 100%, and the difference of which was not statistically significant (P>0.05).The score of treatment compliance and postoperative use rate of elastic stocking in observation group were higher than those in control group (P < 0.01).The nursing satisfaction and disease awareness in observation group were higher than those in control group (P < 0.05 and P < 0.01). ConclusionsThe multimedia health education in day ward can ensure the treatment effect, and improve the nursing satisfaction and disease awareness.It is worthy of clinical application.
2019, 44(3): 409-413.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.037
Abstract:
ObjectiveTo explore the learning attitude and strategies of students in learning medical English terminology on the basis of motivation. MethodsA questionnaire survey was conducted in the third grade clinical major students in a medical college to understand the general situation of students' learning medical English terminology, compare the differences of learning medical English terminology among different gender and basic English level students, and analyze the correlation between the cognition and learning strategies of students' learning medical English terminology. ResultsThe differences of the "degree of emphasis", "use of morphological motivation" and "use frequency in listening" among different gender students were statistically significant (P < 0.05 to P < 0.01).The differences of the "degree of emphasis", "time spent per week", "use of phonetic motivation", "use of morphological motivation", "use of etymological motivation", "use frequency in reading", "use frequency in listening", and "use frequency in speaking" among different basic English level students were statistically significant (P < 0.05).There was a positive correlation between learning cognition and learning strategies of students in medical English terminology (P < 0.01). ConclusionsMedical English teachers should help students correct their learning attitude and eliminate their concerns that they cannot learn medical English well without a high level of basic English, guide them analyzing the motivation structure of medical terminologies, cultivate them thinking mode and teach them how to "fish".
2019, 44(3): 413-416.
doi: 10.13898/j.cnki.issn.1000-2200.2019.03.038
Abstract:
ObjectiveTo investigate the status of academic degree postgraduate education of clinical medicine, analyze its problems, and provide the feasible strategies in improving the quality of postgraduate education. MethodsThe academic degree postgraduates of clinical medicine from four medical colleges and universities in Anhui province were investigated using the questionnaire. ResultsThe low quality students, low participation in scientific research, less scientific research achievement, less tutor guidance, poor research environment, and unoptimistic employment prospects were identified in academic degree postgraduates during investigation. ConclusionsThe state should improve the academic status of clinical medicine to attract more outstanding students, increase investment to improve the security system, reduce the opportunity cost of students, shorten standardized training of resident physicians after graduate, improve the recognition and demand of the academic degree graduate, and expand the job market.
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