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2019 Vol. 44, No. 4
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2019, 44(4): 421-425.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.001
Abstract:
ObjectiveTo evaluate the expression of M2 macrophages and nuclear factor κB(NF-κB) p50 in patients with different stages of hepatocellular carcinoma(HCC), and analyze the relationship between them. MethodsThe expression levels of CD163 and CD206 in 80 cases of paraffin sections of patients with HCC and 10 cases of patients with hepatolithiasis(control group) were detected.The expression levels of CD163, CD206 and NF-κB p50 in 20 cases of fresh liver tissues of patients with different stages of HCC were detected using Western blotting from October 2015 to January 2016. ResultsThe co-localization of CD163 and CD206 in paraffin section of HCC was higher than that in control group, and the co-localization of which in TNM Ⅲ+Ⅳ stage HCC was higher than that in TNM Ⅰ+Ⅱstage HCC.The results of Western blotting showed that the expression levels of CD163, CD206 and NF-κB p50 in hepatocellular carcinoma tissue were higher than those in para-carcinoma tissue(P < 0.05 to P < 0.01), and the expression levels of CD163, CD206 and NF-κB p50 in Ⅲ+Ⅳ stage hepatocellular carcinoma tissue were higher than those in Ⅰ+Ⅱ stage hepatocellular carcinoma tissue(P < 0.05 to P < 0.01).The expression of NF-κB p50 was positively correlated with the expressions of CD163 and CD206(r=0.963, r=0.944, P < 0.01). ConclusionsWith the development of liver tissue, the number of M2 macrophages and NF-κB p50 level increase, which suggest that the two may have synergistic effects to promote the progression of liver cancer.
2019, 44(4): 426-429.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.002
Abstract:
ObjectiveTo investigate the expression characteristics of human eag-related gene (HERG) protein in gastric cancer tissue, and its correlation with pathological features. MethodsThe expression levels of HERG protein in 78 gastric cancer tissue specimens and normal tissue adjacent to the cancer (from the margin of cancer >5 cm) from February 2014 to March 2017.were detected using immunohistochemistry ResultsThe positive rate of HERG protein expression in gastric cancer was 76.92%, which was significantly higher than that in adjacent tissue(0.00%) (P < 0.01).The positive rates of HERG protein expression in patients with low-middle differentiation and lymph node metastasis were 86.67% and 92.86%, which were significantly higher than those in patients with high differentiation and no lymph node metastasis (63.64% and 58.33%), respectively(P < 0.05 and P < 0.01).The positive expression rates of HERG protein were not significantly correlated with age, sex, tumor infiltration, TNM staging and tumor size in gastric cancer patients(P>0.05).The median survival time and progression-free survival time in positive HERG patients were 23 months and 20 months, respectively, the median survival time and progression-free survival time in patients with negative HERG were 30 months and 24 months, respectively, and the difference of which was not statistically significant(P>0.05). ConclusionsThe expression of HERG protein is related to the degree of differentiation and lymph node metastasis of gastric cancer, but it is not clear with the prognosis of the patients.
2019, 44(4): 429-433.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.003
Abstract:
ObjectiveTo explore the related mechanism of the lung injury of in the mouse model of sepsis constructed by cecal ligation and puncture. MethodsA total of 42 healthy male C57BL/6 mice were randomly divided into the control group, sham operation group and sepsis group(14 mice each group).The control group was not treated, the sham group was treated with cecal ligation, and the sepsis group was treated with cecal ligation combined with puncture.The lung tissue in three groups was collected after 24 hours of treatment, and the MSS score, survival rate, morphological change of lung tissue, score of lung injury, number of neutrophils and expression levels of tumor necrosis factor α(TNF-α) and interleukin-6(IL-6) in lung tissues were analyzed in three groups. ResultsThe MSS score, score of lung injury, number of neutrophils and expression levels of TNF-α and IL-6 in sepsis group were higher than those in control group and sham operation group(P < 0.01). ConclusionsSepsis can lead to the acute lung injury and increasing expression level of inflammatory factors, and decrease the survival rate of mice.The related indicator of reflecting lung tissue injury change can reflect the severity of sepsis, and study its related mechanism.
2019, 44(4): 434-436, 441.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.004
Abstract:
ObjectiveTo study the effects of concentration and temperature on the antibacterial effect of water extract of garlic. MethodsWith sterile distilled water as a solvent, the garlic water extract was prepared.The inhibitory zone diameters of several kinds of bacteria growth inhibited by different concentrations and temperatures of water extract of garlic were measured using the plate method. ResultsThe antimicrobial effects of different concentrations of garlic water extract were different.The higher the concentration, the stronger the inhibitory effect was.The equal to or more than 6.3% of garlic water extract of on Staphylococcus aureus, E.coli, Bacillus subtilis, and beta Streptococcus had certain antibacterial effects.The antimicrobial effects on Staphylococcus aureus, Bacillus subtilis, beta Streptococcus and E.coli gradually decreased in turn.The temperature could affect the antibacterial effect of the water extract of garlic, and which gradually weakened with the increasing of temperature.At the temperature of 80℃ and above, the water extract of garlic only showed a strong inhibitory effect on Staphylococcus aureus and Bacillus subtilis. ConclusionsThe antibacterial effect of garlic water extract at different concentrations and temperatures is different.
2019, 44(4): 437-441.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.005
Abstract:
ObjectiveTo investigate the clinical application value of 3D printing technology in the mini-invasive treatment of unstable distal radius fractures. MethodsTwenty-five patients with unstable distal radius fracture were divided into the MIS group(12 cases) and ORIF group(13 cases).The MIS group and ORIF group were treated with mini-invasive surgery reduction(close reduction or limited incision reduction) combined with external fixation assisted by 3D printing technology, and open reduction combined with internal fixation, respectively.The operation time, incision size and postoperative following-up of the activity of wrist motion(palmarflexion, dorsiflexion, ulnardeviation, radialdeviation, pronation, supinaion) were compared between two groups.The recovery of palmar inclination, ulnar deviation, radial length and joint surface in two groups were observed using the positive and lateral wrist radiographs.According to Gartland-Werley scoring criteria, the wrist joint function between two groups was evaluated and compared. ResultsThe operation in two groups was successfully completed, and the average operation time and incision length in MIS group were less than those in ORIF group(P < 0.01).The recovery of wrist joint function in two groups was good, and the differences of the excellent and good rate of the activity of the wrist motion, and score of wrist joint function between two groups were not statistically significant(P>0.05). ConclusionsThe mini-invasive surgery reduction(close reduction or limited incision reduction) combined and external fixation assisted by 3D printing technology combined with open reduction and internal fixation in the treatment of the unstable distal radius fractures has little incision, short operation time and good recovery of wrist joint function, which can avoid secondary surgery.
2019, 44(4): 442-445.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.006
Abstract:
ObjectiveTo explore the correlations of the prognostic nutritional index(PNI) and body mass index(BMI) with prognosis in patients with colorectal cancer. MethodsThe clinicopathological data of 116 colorectal cancer patients treated with radical colectomy were retrospectively analyzed.The receiver operating characteristic curve was used to determine the cut-off value of PNI, the survival curve was plotted using the Kaplan-Meier method, and the cox regression model was used to analyze the independent factor affecting postoperative. ResultsThe cut-off value of PNI was 47.5.The 5-year survival rate in high P survival NI group(36.2%) was higher than that in low PNI group(18.8%)(P < 0.05).The results of univariate analysis showed that the tumor differentiation, invasion depth, lymph node metastasis, distant metastasis, clinical staging, PNI and BMI were correlation with prognosis of patients(P < 0.05 to P < 0.01).The results of Cox multi-factor analysis showed that the tumor differentiation, distant metastasis, clinical staging, PNI and BMI were the independent factor affecting prognosis of patients(P < 0.05).The value of PNI combined with BMI in predicting the prognosis of patients was higher than that of PNI or BMI(P < 0.05). ConclusionsPNI and BMI are the independent factors affecting prognosis of patients with colorectal cancer, and the combination of PNI with BMI can improve the accuracy in evaluating prognosis of patients.
2019, 44(4): 446-449.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.007
Abstract:
ObjectiveTo observe the clinical effects of Huayu Jiedu decoction combined with wet compress in treating type 2 diabetes complicated with lower limb erysipelas. MethodsSixty patients with type 2 diabetes complicated with lower limb erysipelas were randomly divided into the control group and treatment group(30 cases each group).All patients were treated with diabetic diet, exercise and drug to control the blood glucose.The control group was treated with HuangLianJieDu decoction by oral combined with wet compress of magnesium sulfate, and the treatment group was treated with Huayu Jiedu decoction by oral combined with wet compress of traditional Chinese medicine.The process method of oral decoction in two groups was the same, and the decoction was orally taken in the morning and evening.The wet compress in two groups was given twice a day, 30 min/time, for 14 days.The levels of body temperature, white blood cell(WBC), neutrophil percentage(N%), C reactive protein(CRP), and curative effect in two groups were observed. ResultsBefore and after treatment, the differences of the levels of FPG, ALT and Cr between two groups were not statistically significant(P>0.05).The difference of the levels of body temperature, WBC, N% and CRP before and after treatment, and temperature after treatment between two groups were not statistically significant(P>0.05).The levels of WBC, N% and CRP in two groups after treatment changed significantly compared with before treatment(P < 0.01), and the differences of WBC, N% and CRP level after treatment were statistically significant(P < 0.01).The effective rate in treatment group was 93.99%, which was significantly better than that in control group(80.00%)(P < 0.05). ConclusionsHuayu Jiedu decoction combined with wet compress can significantly improve the clinical symptoms of type 2 diabetes complicated with lower limb erysipelas, control the body temperature, and reduce the inflammation, and has good safety.The clinical effect of which is better than that of Huanglian JieDu decoction combine with magnesium sulfate wet compress, and safe.
2019, 44(4): 449-451.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.008
Abstract:
ObjectiveTo observe the clinical efficacy of flupentixol and melitracen in the treatment of anxiety and depression in elderly diabetic patients complicated with gastrointestinal dysfunction. MethodsOne hundred and four elderly diabetic patients with anxiety and depression complicated with gastrointestinal dysfunction were randomly divided into the observation group and control group(52 cases each group).Two groups were treated with corresponding drugs, and the observation group was additionally treated with flupentixol and melitracen, 1 tablet per day, for 8 weeks.The clinical symptom scores before and after treatment, total effective rate, Hamilton Depression Scale(HAMD) score and Hamilton Anxiety Scale(HAMA) after treatment in two groups were analyzed. ResultsThe total effective rate of improvement of clinical symptom in observation group(86.5%) was better than that in control group(63.5%)(P < 0.05).The score of anxiety and depression in observation group was significantly lower than that in control group(P < 0.01). ConclusionsThe treatment of anxiety and depression in elderly diabetic patients complicated with gastrointestinal dysfunction with flupentixol and melitracen based on traditional therapy can significantly improve their mental physical symptoms, and which is worthy of promotion.
2019, 44(4): 452-454, 458.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.009
Abstract:
ObjectiveTo investigate the application value of the plasma D-dimer level in the first-line palliative chemotherapy of the advanced esophageal squamous cell carcinoma. MethodsNinety-one patients with advanced esophageal carcinoma were divided into the normal group(plasma D-dimer level ≤ 0.5 μg/mL) and increasing group(plasma D-dimer level >0.5 μg/mL) according to the plasma D-dimer level before the first-line palliative chemotherapy.The correlations between the plasma D-dimer level, and clinical features, therapeutic effects and prognosis of patients were analyzed. ResultsThe plasma D-dimer level was correlated with the platelet and fibrinogen levels of patients.The disease control rate in increasing group(33.33%) was lower than that in normal group(69.23%)(P < 0.05).The results of COX multivariate analysis showed that the plasma level of D-dimer was an independent predictive factor of prognosis(P < 0.01). ConclusionsThe plasma level of D-dimer may be a potential biomarker of the efficacy of the first-line palliative chemotherapy, which can provide certain basis in evaluating prognosis.
2019, 44(4): 455-458.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.010
Abstract:
ObjectiveTo investigate the application value of intravenous nitroglycerin controlled hypotension in the gastroscopy of high risk population with hypertension, and compare the effects between nitroglycerin and nifedipine by oral in controlling blood pressure. MethodsOne hundred and twenty hypertensive patients treated with electronic gastroscopy were randomly divided into the group A(treatment with nifedipine by oral), group B(treatment with nitroglycerin by oral), and group C(treatment with intravenous nitroglycerin).Forty healthy people were set as control group.The blood pressure, heart rate, ECG and incidence rate of adverse reactions in four groups were observed through the whole process of gastroscopy inspection. ResultsBefore inspection, the levels of systolic blood pressure and heart rate in group A and group B were higher than those in control group(P < 0.05 to P < 0.01).During the inspection, the levels of systolic and diastole pressure in group A and group B, and heart rate in group A were higher than those in group C and control group(P < 0.05 to P < 0.01).After inspection, the level of systolic pressure and heart rate in group A were higher than those in group C and control group(P < 0.05 to P < 0.01).The level of systolic pressure before inspection and heart rate after inspection in group C were higher than those in control group(P < 0.01 and P < 0.05), and the differences of other indexes between group C and control group were not statistically significant(P>0.05).Before and after inspection, the differences of the incidence rates of sinus tachycardia, ST change, ectopic heart rhythm and conduction block among three groups were not statistically significant(P>0.05).During the inspection, the differences of ST change and ectopic heart rhythm among three groups were statistically significant(P < 0.05).The differences of the incidence rates of adverse reactions among four groups were not statistically significant(P>0.05). ConclusionsIntravenous nitroglycerin is a safe method in controlling the blood pressure during gastroscopy, the effect of which is better than that of nifedipine and nitroglycerin by oral.
2019, 44(4): 459-462.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.011
Abstract:
ObjectiveTo investigate the clinical value of three kinds of ABCD score in predicting the risk of new cerebral ischemic stroke within 7 days after transient ischemic attack(TIA)in Chinese. MethodsThe scores in 150 patients with TIA were evaluated using ABCD2, ABCD3 and ABCD3-Ⅰ score within 48 h of admission, and the patients were divided into the low, medium and high risk groups according to the score.According to the onset of new ischemic stroke within 7 days after TIA, 150 patients were divided into the new ischemic stroke group(50 patients) and non-new ischemic stroke(100 patients).Three kinds of scores between two groups were compared.The number of patients with secondary cerebral infarction in the low, medium and high risk groups within 7 days after TIA was recorded. ResultsCompared with the non-new ischemic stroke group, the scores of three kinds of ABCD score significantly increased in new ischemic stroke group, and the difference of which was statistically significant(P < 0.05 to P < 0.01).Except the score of ABCD2, with the increasing of the scores of ABCD3 and ABCD3-Ⅰ, the incidence rate of secondary cerebral infarction increased continuously within 7 days after TIA(P < 0.01).The area under the ROC curve showed that the predictive AUC value of three kinds of ABCD score was 0.67, 0.84 and 0.91 within 7 days after TIA, respectively, and the differences of those were statistically significant(P < 0.01).The degrees of accuracy of ABCD3-Ⅰ and ABCD3 score in predicting the secondary cerebral infarction within 7 days after TIA were better than those of ABCD3 and ABCD2 score, respectively(P < 0.01). ConclusionsABCD2, ABCD3 and ABCD3-Ⅰ score can predict the secondary cerebral infarction within 7 days after TIA, and the higher the score, the higher the secondary cerebral infarction risk within 7 days after TIA is.The prediction accuracy of ABCD3-Ⅰ score is the highest.
2019, 44(4): 463-465, 469.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.012
Abstract:
ObjectiveTo compare the safety and efficacy of different dosages of etomidate combined with propofol in colonoscopy of elderly patients. MethodsOne hundred and eighty patients scheduled by colonoscopy, were randomly divided into the propofol group(group P), propofol combined with etomidate group(group PE) and etomidate combined with propofol group(group EP).All patients were intravenously injected with 1 μg/kg fentanyl before 1 min of colonoscopy.The group P, group PE and group EP were injected with 1.5 mg/kg propofol, 1.0 mg/kg propofol combined with 0.05 mg/kg etomidate and 0.75 mg/kg propofol combined with 0.075 mg/kg etomidate, respectively.The mean aterial blood pressure, heart rate, saturation of peripheral oxygen, anesthesia duration, operation time, recovery time, discharge time, adverse reaction, and satisfaction degrees of patients, endoscopists and anesthetists in three groups were evaluated. ResultsCompared with the group P and group PE, the recovery time and discharge time in the group EP were significantly longer(P < 0.05 to P < 0.01).The incidence rates of hypotension, bradycardia and hypoxemia in the group P were significantly higher compared with the group PE and group EP(P < 0.05 to P < 0.01).The satisfaction degrees on anesthetists in the group PE and group EP were higher compared with the group P(P < 0.01). ConclusionsThe recovery time and discharge time in patients induced by 1.0 mg/kg propofol combined with 0.05 mg/kg etomida are shorter, and adverse reaction is less.
2019, 44(4): 466-469.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.013
Abstract:
ObjectiveTo evaluate the clinical effects of the MTDSA measured by ultrasound in selecting the cuffed pediatric endotracheal tube size. MethodsThe tracheal tube sizes in 180 pediatric patients, aged 4 to 12 years, scheduled by general anesthesia operation were empirically selected according to the age based formula.The appropriate tracheal catheter type was determined according to the leakage gas test after intubation, and MTDSA was measured using ultrasound before anesthesia induction endotracheal intubation.The correlation of MTDSA, age, height and body mass with clinical optimal catheter inner diameter(ID) in cases with suitable catheter was analyzed, and the linear regression equation of which was established.The accuracy of catheter selected by ultrasound and age based formula was validated and analyzed in clinic. ResultsCompared with other factors, MTDSA was well correlated with catheter ID.The linear regression equation determined by ultrasound was established for ID=0.601xMTDSA+0.015(r=0.954).The accuracy rates of ultrasound and age based formula were 80% and 60%, respectively, and the difference of which was statistically significant(χ2=12.40, P < 0.05). ConclusionsMTDSA measured by ultrasound is an accurate and simple method in guiding the selection of cuffed tracheal tube size in children. ObjectiveTo evaluate the clinical effects of the MTDSA measured by ultrasound in selecting the cuffed pediatric endotracheal tube size. MethodsThe tracheal tube sizes in 180 pediatric patients, aged 4 to 12 years, scheduled by general anesthesia operation were empirically selected according to the age based formula.The appropriate tracheal catheter type was determined according to the leakage gas test after intubation, and MTDSA was measured using ultrasound before anesthesia induction endotracheal intubation.The correlation of MTDSA, age, height and body mass with clinical optimal catheter inner diameter(ID) in cases with suitable catheter was analyzed, and the linear regression equation of which was established.The accuracy of catheter selected by ultrasound and age based formula was validated and analyzed in clinic. ResultsCompared with other factors, MTDSA was well correlated with catheter ID.The linear regression equation determined by ultrasound was established for ID=0.601xMTDSA+0.015(r=0.954).The accuracy rates of ultrasound and age based formula were 80% and 60%, respectively, and the difference of which was statistically significant(χ2=12.40, P < 0.05). ConclusionsMTDSA measured by ultrasound is an accurate and simple method in guiding the selection of cuffed tracheal tube size in children.
2019, 44(4): 470-472.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.014
Abstract:
ObjectiveTo analyze the clinical effects and adverse reactions of oxycodone sustained-release tablet combined with zoledronic acid in the treatment of malignant tumor bone metastasis pain. MethodsSixty-four patients with malignant tumor complicated with bone metastasis pain were selected.The patients treated with oxycodone sustained-release tablet combined with zoledronic acid and oxycodone sustained-release tablet were divided into the observation group and control group, respectively.The dosage of oxycodone sustained-release tablet, adverse reaction, pain score and quality of life in two groups were retrospectively analyzed. ResultsThere was no statistical significance in the dosage of oxycodone sustained-release tablet, quality of life and NRS score between two groups after the first titration(P>0.05).The differences of the dose of oxycodone sustained-release tablet after two weeks of treatment, and quality of life after four weeks of treatment between two groups were statistically significant(P < 0.05), and the difference of the NRS score between two groups was not statistically significant(P>0.05).The differences of the adverse reactions, which included constipation, nausea, vomiting, lethargy, urinary retention, paralysis and cognitive impairment, were statistically significant between two groups(P < 0.05). ConclusionsZoledronic acid in treating bone metastasis cancer pain can reduce the dosage of oxycodone sustained-release tablet, improve the quality of life, and reduce the incidence rate of adverse reactions.
2019, 44(4): 473-475, 480.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.015
Abstract:
ObjectiveTo study the influence of buflomedil combined with ligustrazine injection on platelet and hemorheology in acute cerebral embolism patients. MethodsEighty patients with acute cerebral embolism were randomly divided into the observation group and control group(40 cases each group).The observation group was treated with buflomedil combined with ligustrazine injection, and the control group was treated with compound Danshen injection.The related indexes of platelet and hemorheology in two groups before and after treatment were detected.The clinical effects and motor function FMMS grading after treatment, and neurological deficit scores before and after treatment in two groups were analyzed. ResultsAfter treatment, the PDW, MPV, DD and FIB in observation group were significantly lower than those in control group(P < 0.01), and the hematocrit, plasma viscosity, whole blood high cut viscosity, whole blood low cut viscosity and erythrocyte aggregation index in observation group were significantly lower than those in control group(P < 0.05 to P < 0.01).After treatment, the total effective rate in observation group(95.00%) was higher than that in control group(77.50%)(P < 0.05), and the motor function FMMS grade Ⅲ and Ⅳ rate in observation group(63.00%) was higher than that in control group(37.50%)(P < 0.05).After treatment, the neurological deficit scores in two groups significantly reduced, and which in observation group was significantly lower than that in control group(P < 0.01). ConclusionsBuflomedil combined with ligustrazine injection in the treatment of acute cerebral embolism can effectively improve the related indexes of platelet and hemorheology, and effective treatment rate of patients.
2019, 44(4): 476-480.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.016
Abstract:
ObjectiveTo compare the effects between laparoscopy and open tissue separation in the treatment of abdominal wall hernia. MethodsAccording to the different treatment methods, 116 patients with abdominal hernia were divided into the control group and observation group(58 cases each group).The control group was treated with open tissue separation, and the observation group was treated with laparoscopic tissue separation.The operation time, pain, quality of life, postoperative infection, hematoma, complication and postoperative recurrence were compared between two groups. ResultsThe amount of bleeding during operation in the observation group was lower than that in the control group, and the length of incision and hospitalization time in the observation group were shorter than those in the control group(P < 0.01), but there was no statistical significance in operation time between two groups(P>0.05).The postoperative VAS score and pain duration time in observation group were lower than those in control group(P < 0.01).After operation, the SF-36 score in two groups increased, and which in observation group was better than that in control group(P < 0.01).The postoperative infection rate, hematoma rate and re-operation rate in observation group were lower than those in control group(P < 0.05 to P < 0.01), while the curative effect in observation group was higher than that in control group(P < 0.05). ConclusionsThe treatment of abdominal wall hernia with laparoscopic tissue separation can effectively reduce the postoperative infection rate and incidence rate of hematoma and reoperation of patients.
2019, 44(4): 481-483.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.017
Abstract:
ObjectiveTo compare the effects of different treatment methods of the appendix root and mesentery in laparoscopic appendectomy(LA). MethodsOne hundred seventy-one patients with appendictitis from January 2017 to March 2018 were randomly divided into groups A, B and C.The appendix root and mesentery in group A, group B and group C were treated with using Hemolok-clip clip, silk thread double ligating, and silk thread ligating mesentery combined with "8" suture after embedding the appendix root, respectively.The operation condition(including operation time, intraoperative blood loss and postoperative exhaust time), perioperative complications(including incision infection, abdominal residual abscess and early postoperative inflammatory intestinal obstruction) in three groups were evaluated. ResultsThe operation time in group A and group C was the shortest and longest, respectively(P < 0.01).The intraoperative blood loss in group B and group C was higher than that in group A(P < 0.01), and the difference of which between group B and group C was not statistically significant(P>0.05).The differences of postoperative exhaust time and perioperative complications among three groups were not statistically significant(P>0.05). ConclusionsThree methods in dealing with the appendix root and mesentery are safe and reliable in LA.Hemolok-clip can shorten the operation time, and is more suitable for beginner, silk suture combined with embedding the stump after ligation is more suitable for operator with a certain basis of laparoscopic surgery.
2019, 44(4): 484-486.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.018
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ObjectiveTo analyze the antenatal diagnosis and pregnancy outcome in high risk pregnant women with positive results of the non-invasive prenatal DNA testing, and discuss its clinical significance. MethodsThe non-invasive prenatal DNA testing in 5 077 pregnant women were implemented, the free fetal DNA in maternal peripheral blood of the second generation was sequenced.The positive was confirmed by the cell karyotype detected by amniocentesis, and followed up by telephone. ResultsAmong 5 077 pregnant women detected by non-invasive prenatal DNA testing, the high risk in 64 cases was identified, which included 28 cases of 21-trisomy, 4 cases of 18-trisomy, 3 cases of 13-trisomy, 14 cases of sexual chromosome abnormality, 8 cases of other chromosome abnormality and 7 cases of microdeletion and microduplication.Amniocentesis was performed in 54 cases, the results showed that 23 cases were confirmed among 24 cases of 21-trisomy, 2 cases were confirmed among 4 cases of 18-trisomy, 1 case was confirmed among 3 cases of trisomy, 5 cases were confirmed among 11 cases of sex chromosome, no case was confirmed among 6 cases of other chromosomes, and 2 cases were confirmed among 6 cases of micro deletion and micro duplication.The non-invasive DNA testing results showed 1 case was negative, the ultrasound examination suggested the multiple abnormalities, and the amniocentesis result showed which was the 18-trisomy. ConclusionsThe positive predictive value of 21-trisomy syndrome is higher by the non-invasive prenatal DNA testing, but the false positive and false negative result still occur, which cannot completely replace karyotype analysis.The non-invasive DNA prenatal testing is still far from the positive predictive value of 18-trisomy syndrome and 13-trisomy syndrome, but it can detect micro-deletion and micro-repetition abnormalities, which has irreplaceable superiority over the karyotype analysis.
2019, 44(4): 495-499.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.022
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ObjectiveTo analyze the flavonoids content in different extraction components from Laevigatae Rosae Fructus. MethodsThe crude flavonoid was extracted from Rosae Laevigatae Fructus using 60% ethanol(v:v), and extracted using petroleum ether, chloroform, ethyl acetate and n-butanol.The five phases of petroleum ether, chloroform, ethyl acetate, n-butanol and water were obtained, the peak value of each phase was measured using HPLC-UV, and the peak of each phase was analyzed by HPLC-DAD. ResultsThe low polar flavonoids mainly distributed in the chloroform phase, which accounted for 47.72% of the total flavonoids.The high polar flavonoids mainly distributed in the n-butanol phase, which accounted for 44.07% of the total flavonoids.The small amount of flavonoids in water phase was identified, which accounted for 9.17% of the total flavonoids.The very small amount of flavonoids in petroleum ether and ethyl acetate phases was found. ConclusionsThe flavonoids of Laevigate Rosae Fructus mainly distributes in the phase of trichloromethane and n-butanol.
2019, 44(4): 503-505.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.024
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ObjectiveTo explore the influence of Helicobacter pylori(HP) infection on the levels of homocysteine(Hcy) and blood lipid. MethodsOne hundred and two hospitalized patients were divided into the HP infection group and HP uninfection group according to the HP infection situation, respectively.The levels of Hcy, total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C), were detected in two groups.The influence of HP infection on the levels of Hcy and blood lipid between two groups was compared, and the correlation between the level of Hcy and blood lipid was analyzed in two groups. ResultsThe detection rates of HHcy in HP infection group and HP uninfection group were 19.61%(10/51) and 5.88%(3/51), respectively, and the difference of which was statistically significant(P < 0.05).The abnormal detection rates of the levels of TC, HDL-C and LDL-C in HP infection group were higher than those in HP uninfection group(P < 0.05 to P < 0.01).The levels of TC and TG in HP infection group were higher compared with the HP uninfection group, and the difference of which was not statistically significant(P>0.05).The levels of Hcy and LDL-C in HP infection group were higher than those in HP uninfection group(P < 0.05).The level of HDL-C in HP infection group was lower than that in HP uninfection group(P < 0.05).HP antibody level was positively correlated with the levels of Hcy, TC and LDL-C(P < 0.05). ConclusionsHP infection is closely related to the occurrence of HHcy, and the abnormal level of blood lipid, can lead to the risk increasing of cardiovascular disease.
2019, 44(4): 506-508.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.025
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ObjectiveTo observe the plasma expression levels of soluble receptor for advanced glycation end product(sRAGE)and pulmonary surfactant protein A(SP-A) in newborn with acute respiratory distress syndrome(ARDS). MethodsThe plasma samples of 37 newborns with ARDS from October 2015 to May 2017 were collected after 0 h, 24 h and 72 h of admission, and the plasma samples of 20 newborns without respiratory disease at three time-points were set as the control group at the same time.The plasma levels in two groups were detected using the enzyme linked immunosorbent assay, and the result of which was statistically analyzed. ResultsThe plasma levels of sRAGE and SP-A in ARDS newborns on admission were significantly higher than those in control group(P < 0.01), and the differences of the plasma levels of sRAGE and SP-A between two groups were statistically significant after 24 h and 72 h of admission(P < 0.01).The differences of the plasma levels of sRAGE and SP-A in control group among three time-points were not statistically significant(P>0.05). ConclusionsThe plasma levels of sRAGE and SP-A in newborn with ARDS are high, which may be related to the initial condition of disease.
2019, 44(4): 509-511.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.026
Abstract:
ObjectiveTo investigate the effects of different delivery ways on the area of postpartum hiatus of levator ani evaluated by real-time three-dimensional pelvic floor ultrasound. MethodsEighty postpartum 6 weeks women and 40 nulliparous women were divided into the case group and control group, respectively.The case group was subdivided into the transvaginal delivery group and selective cesarean section group.The areas of postpartum hiatus of levator ani at rest and after the maxium Valsalva movement among three groups were compared, the effects of different delivery ways on the area of postpartum hiatus of levator ani were evaluated, and the correlation of the area of hiatus of levator ani in different states with neonatal weight was anlayzed in transvaginal delivery group. ResultsThe differences of the areas of hiatus of levator ani at rest and after the maxium Valsalva movement among three groups were statistically significant(P < 0.01), which in selective cesarean section group and control group was lower than that in transvaginal delivery group(P < 0.05 to P < 0.01), ans which in control group was lower than that in selective cesarean group(P < 0.01).The area of hiatus of levator ani at rest and after the maxium Valsalva movement in transvaginal delivery group was positively correlated with neonatal weight(r=0.865, 0.876). ConclusionsThe transperineal real-time three-dimensional ultrasound in evaluating the postpartum pelvic floor structure by measuring the area of hiatus of levator ani is noninvasive, convenient and repetitive, which can be used as a routine screening method, and provide the basis in the evaluation of clinic diagnosis and treatment effect.
2019, 44(4): 512-515.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.027
Abstract:
ObjectiveTo discuss the application value of echocardiography combined with ultrasound contrast in the diagnosis of pre-apical hypertrophy cardiomyopathy(PAHCM). MethodsThirty-two patients with PAHCM diagnosed by MRI and 32 healthy volunteers were divided into the PAHCM group and normal control group, respectively.The characteristics of echocardiography and ultrasound contrast were compared between two groups. ResultsCompared with normal control group, the ratio of the myocardial thickness of left ventricular apical to posterior wall, left ventricular mass and left atrial volume increased(P < 0.05), the left ventricular apical myocardial thickness increased significantly(P < 0.01), and the value of E/A decreased significantly in PAHCM group(P < 0.01).Compared with the posterior wall myocardium of left ventricle of PAHCM group(P-LVPW group), the level of peak strength of platform(A) decreased(P < 0.05 to P < 0.01), and the curve rise slope(β) and A×β decreased significantly in P-AM group(P < 0.01).The differences of the levels of A, β and A×β between P-LVPW group and posterior wall myocardium of left ventricle in normal control group were not statistically significant(P>0.05).Using the diagnosis of MRI as a golden standard, the sensitivity and specificity of conventional echocardiography in the diagnosis of PAHCM were 28.1% and 82.1%, respectively, and both the sensitivity and specificity of echocardiography combined with ultrasound contrast in the diagnosis of PAHCM were 100%. ConclusionsEchocardiography combined with ultrasound contrast has great clinical application value in the diagnosis of PAHCM.
2019, 44(4): 516-519, 522.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.028
Abstract:
ObjectiveTo explore the diagnostic value of MRI multi-imaging in acute anterior cruciate ligament(ACL) injury. MethodsThe multiple signs of MRI of ACL injury in 23 patients were analyzed by two MRI diagnostic physicians without knowledge of arthroscopic diagnosis.The sensitivity, specificity and positive predictive value of magnetic resonance imaging(MRI) multi-imaging were analyzed, and the likelihood ratio of MRI multi-imaging was identified. ResultsThe values of MRI in the diagnosis of multi-imaging, which included ACL continuous interruption, abnormality of ligament shape, disappearance of ACL, ACL suspension bridge sign, anterior tibia, posterior angle of lateral meniscus, contusion of "proboscis" bone, Notch sign and empty intercondylar fossa sign, were great(P < 0.05 to P < 0.01).In MRI direct signs of ACL injury, the sensitivity of ACL disappearance was the lowest(13.04%), while the specificity of ACL limited or diffuse signal enhancement or thickening was relatively low.The diagnostic value of abnormality of ligament shape was the greatest, and the diagnostic sensitivity, specificity and positive predictive value were 73.91%, 100.00% and 100.00%, respectively.Among the MRI indirect signs of ACL injury, the specificities and sensitivities of anterior displacement of tibia, posterior angle of lateral meniscus, contusion of "kiss" bone, Notch sign and empty intercondylar fossa sign were higher and lower, respectively.The diagnostic values of contusion of "kiss" bone and Notch sign were the greatest. ConclusionsThe MRI direct sign is the main basis in the diagnosis of acute ACL injury.The comprehensive analysis of high specificity indirect signs can reduce the false negative diagnostic rate of MRI, and it is more reliable to diagnose complete ACL tear compared with partial tear, especially for acute ACL injury with atypical direct signs.
2019, 44(4): 520-522.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.029
Abstract:
ObjectiveTo study the relationship among the learning motivation, learning burnout and personality of medical students. MethodsFour hundred and ninety-five college students were investigated using the learning motivation questionnaire, adolescent learning burnout scale and college students tough personality rating scale. ResultsThere was no statistical significance in the scores of learning motivation, learning burnout and hardiness personality between boy and girl students(P>0.05), and there was statistical significance in the scores of learning motivation, learning burnout and hardiness personality among the different grades (P < 0.05 to P < 0.01).The scores of learning motivation in freshman, sophomore and junior gradually decreased in turn; the scores of learning burnout in freshman, sophomore and junior gradually increased in turn; the scores of hardiness personality in sophomore was higher than that in junior(P < 0.05 to P < 0.01).The scores of learning motivation were negatively correlated with that of learning burnout, and positively correlated with that of hardiness personality(P < 0.01). ConclusionsThe education of learning motivation and hardiness personality should be strengthened in senior students to decrease the learning burnout of the students.
2019, 44(4): 523-525.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.030
Abstract:
ObjectiveTo investigate the characteristics of cognitive function in methamphetamine addicts, and explore its relationship with craving. MethodsSeventy-two male methamphetamine addicts from a compulsory isolated detoxification center in Anhui Province and sixty male residents from a community were divided into the MA group and control group, respectively.The cognitive function and craving in two groups were measured using general situation questionnaire and Montreal cognitive assessment scale(MoCA).The craving in MA group was evaluated using visual analogue scale, and the correlation of cognitive function with craving in MA group was analyzed. ResultsThe visual space score, attention score, language score, abstraction score and delayed recall score, and total score of MoCA in MA group were significantly lower than those in control group(P < 0.01), and the differences of the scores of naming and orientation factors between two groups were not statistically significant(P>0.05).The correlation analysis results showed that the attention score, delayed recall score, and total score of MoCA in MA group were negatively correlated with craving(P < 0.05 and P < 0.01), and there was not significant correlation between visual space, naming, language, abstraction and orientation, and craving(P>0.05). ConclusionsThere is extensive cognitive impairment in methamphetamine addicts.Cognitive function is correlated with craving, and can predict the degree of craving, which can provide a theoretical basis for reducing craving and relapse by improving cognitive function.
2019, 44(4): 526-529, 533.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.031
Abstract:
ObjectiveTo investigate the current status of ICU nurses abiding by the cluster sedation and analgesia strategies, and analyze its influencing factors. MethodsA total of 200 ICU nurses were investigated using general questionnaire, cognitive questionnaire of cluster sedation and analgesia strategies, self-efficacy scale and behavior questionnaire of cluster sedation and analgesia strategies. ResultsThe behavior score of ICU nurses abiding by the cluster sedation and analgesia strategies was(99.17±17.94), and the items with low scores included the use of the pain and sedation scale, delirium evaluation and management, and family involvement.The results of multiple regression analysis showed that the self-efficacy, education level and ICU type were the influencing factors of ICU nurses abiding by the cluster sedation and analgesia strategies(P < 0.05 to P < 0.01), and which could explain 26% of the variance. ConclusionsThe compliance of ICU nurses abiding by the cluster sedation and analgesia strategies is not high, there is a gap between current situation and requirements of relevant evidence-based strategies, and the ICU managers should pay more attention to improve the self-efficacy sense of ICU nurses, focus on ICU nurses with low education level, strengthen the communication, learning and collaboration among different disciplines, and promote the clinical promotion of the cluster sedation and analgesia strategies.
2019, 44(4): 530-533.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.032
Abstract:
ObjectiveTo understand the health beliefs and health behaviors in high-risk population of stroke for providing the basis in the formulation of targeted intervention. MethodsOne hundred and twenty high-risk stroke patients in Shenzhen community were investigated using the health belief model scale and health promotion quality of life scale, and their health beliefs and health behaviors were analyzed. ResultsThe average scores of health beliefs and items in high-risk population of stroke were(114.86±7.50) and(3.28±0.21), respectively, the score of self-efficacy dimension was the highest, and the score of perceived disability dimension was the lowest.The average scores of health behavior and items in high-risk population of stroke were(128.44±8.51) and(2.47±0.17), respectively, the score of interpersonal relationship dimension was the highest, and the score of physical exercise dimension was the lowest.The score of health belief was positively related to the score of health behavior(r=0.394, P < 0.01). ConclusionsThe higher the health beliefs in high-risk population of stroke is, the better the health behaviors is.Medical staff should focus on the perceived barriers in health beliefs, and give more guidance on health behaviors in the dimension of physical activity.
2019, 44(4): 534-536.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.033
Abstract:
ObjectiveTo investigate the clinical effects of the mobile delivery vehicle combined with special position in correcting the transverseposition during the active period of the first stage of labor. MethodsOne hundred and thirty patients with transverseposition diagnosed by B ultrasound and without premature rupture of membrane under trial condition were randomly divided into the experimental group and control group.The experimental group without rupture of membrane during active period could free walk on mobile delivery vehicle, and when the contraction was strong, the patients stayed in bed under the lateral position of the fetal back.The control group was given the routine care, and the patients were free to choose the lying position.The fetal head positive rate, delivery mode, first stage of labor, neonatal Apgar score and complications of maternal delivery were analyzed in two groups. ResultsDuring the labor process, 60 cases in experimental group were transferred from the transverse occipital fetal head to the anterior occipital position, and 41 cases in control group were transferred from the transverse occipital fetal head to the anterior occipital position, and the positive rate of which in experimental group was higher than that in control group(P < 0.01).The rate of natural delivery in experimental group was higher than that in control group, and the rate of cesarean section in experimental group was lower than that in control group(P < 0.01).The incubation period and active period of the first stage of natural delivery in experimental group were shorter than those in control group, the neonatal Apgar score in experimental group was higher than that in control group, and the postpartum blood loss, soft birth canal injury rate and puerperal infection rate in experimental group were lower than those in control group(P < 0.01). ConclusionsDuring the active period of the first stage of labor, the mobile delivery vehicle combined with special position can improve the maternal fetal head rate, natural delivery rate and Apgar score of the newborn, significantly shorten the time of the first stage of labor, and reduce the incidence rate of postpartum complications.
2019, 44(4): 537-539, 544.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.034
Abstract:
ObjectiveTo analyze the cognition of preventing fall in elderly inpatients, and explore the effects of visual health education. MethodsOne hundred and thirty-six elderly inpatients were investigated using the cognitive questionnaire of preventing fall, and intervened using the poster, brochure and video means.The intervention effects of visual health education on the preventing fall were observed in elderly inpatients. ResultsThe cognitive score of preventing fall increased from(3.39±0.99)to(4.23±0.79) in elderly inpatients, and the cognition of the effects of the placement of object, fall history, age, place, emotion, compliance and medication on fall significantly increased(P < 0.01). ConclusionsThe visual education can improve the cognition of preventing fall, and reduce the incidence rate of fall in elderly inpatients.
2019, 44(4): 540-544.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.035
Abstract:
ObjectiveTo investigate the status quo of the occupational environment recognition in a grade A tertiary hospital, and provide suggestions and countermeasures on the basis of the results of the survey. MethodsThe recognition degrees of occupational environment in 559 nurses of different levels and departments from the hospital were investigated using Gallup's Q12 questionnaire and convenient sampling method. ResultsThe differences of the scores of Q1, Q3, Q4, Q5, Q6 and Q11 in different levels of nurses were statistically significant(P < 0.05 to P < 0.01), the differences of the dimensionalities of basic work requirement and team collarboration in different levels of nurses, and dimensionality of self-growth in different education background nurses were statistically significant(P < 0.05 and P < 0.01).The dimensionalities of basic work requirement and self-growth in charge nurses were higher than those in nurses(P < 0.01 and P < 0.05).The recognition degrees of occupational environment among nurses of different departments, and between charge nurses and nurses were statistically significant(P < 0.05 and P < 0.01). ConclusionsThe overall recognition degree of occupational environment among nurses of different levels are higher, and which is lower in a small number of nurses.The nursing managers should focus on the nurses' self-growth, timely implement incentive measures, combine strict system with flexible management, and accept different suggestions to improve the nursing occupational environment and sense of responsibility to motivate enthusiasm of nurses according to the problems in professional environment of different level nurses.
2019, 44(4): 545-547, 550.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.036
Abstract:
ObjectiveTo investigate the application value of hypertension management card in elderly patients with hypertension. MethodsOne hundred and thirty-eight patients with hypertension were randomly divided into the observation group(70 cases) and control group(68 cases).Two groups were treated with routine method, and the observation group was additionally intervened using "hypertension management card" according to the hypertension and risk factors and medication.The prognosis, related indicators and hypertension control between two groups were compared after 12 months of intervention. ResultsThe prognosis in observation group was significantly better than that in control group after 12 months of following-up(P < 0.01).The levels of blood pressure(SBP and DBP), urine albumin, total cholesterol and blood glucose in two groups after intervention were lower than those before intervention(P < 0.05 to P < 0.01).The levels of blood pressure(SBP and DBP), low-density lipoprotein, blood glucose and cystatin C in observation group were lower than those in control group after intervention(P < 0.05).The differences of the hypertension-related health knowledge, body weight control rate, rate of regular medication and blood pressure control in control group between before and after intervention were not statistically significant(P>0.05).The control rates of all indictors in observation group were significantly higher than that before intervention(P < 0.01), and in control group after intervention(P < 0.05).The difference of the living habit in control group between before and after intervention was not statistically significant(P>0.05).The quit ting smoking and wine, reducing oil and fat intake, sports, compliance with the prescribed medicine and examining blood pressure rate in observation group after intervention were higher than those before intervention(P < 0.05 to P < 0.01), and higher than those in control group after intervention(P < 0.05). ConclusionsThe effects of hypertension management card on controlling blood pressure and improving the living habit are good and effective, which is worthy of promotion.
2019, 44(4): 548-550.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.037
Abstract:
ObjectiveTo explore the clinical effects of pelvic floor rehabilitation in patients with postpartum vaginal anterior wall protrusion. MethodsA total of 60 postpartum patients with degree Ⅰ to Ⅱ anterior vaginal wall protrusion were divided into the observation group and control group according to their willingness to receive pelvic floor rehabilitation or not(30 cases each group).The observation group was treated with intravaginal electrical stimulation to obtain electromyography biofeedback, twice a week, 30 minutes every time, 12 times as a treatment course, and combined with Kegel training.The control group was given routine postnatal health education.The recovery of anterior vaginal wall and electrical distribution of pelvic floor muscle were compared between two groups. ResultsThe total efficacy rate in observation group(90.00%) was significantly better than that in control group(60.00%)(P < 0.05).The difference of the pelvic floor muscle surface potential between two groups was not statistically significant during pre-resting and post-resting(P>0.05).The pelvic floor muscle surface potential in observation group was significantly higher than that in control group during the testing endurance stage of type Ⅱ and Ⅰmuscle fiber.The pelvic floor muscle surface potential in observation group was significantly higher than that in control group(P < 0.01). ConclusionsThe pelvic floor rehabilitation can improve the pelvic floor muscular strength, the clinical efficacy in patients with anterior vaginal wall protrusion is definite, which is worthy of application.
2019, 44(4): 556-557, 561.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.040
Abstract:
ObjectiveTo explore the application effects of team-based cearning(TBL) teaching methodin the teaching of pharmacognosy. MethodsOne hundred and ten students from grade 2015 pharmacy speciality and 98 students from grade 2015 pharmacey tical analysis speciality using cluster sampling were divided into the observation group and control group, respectively.The observation group and control group were taught using TBL teaching method and traditional teaching method, respectively.At the end of the course, the teaching effect of TBL teaching method was evaluated by comprehensive examination results and questionnaire survey. ResultsThe literature retrieval ability, scientific thinking ability, problem-solving ability and total score in observation group were significantly higher than those in control group(P < 0.01).The satisfaction rates of stimulating learning interest, improving self-learning ability, cultivating innovation ability, improving communication skills, improving problem-solving ability and improving the team cooperation ability in observation group were significantly higher than those in control group(P < 0.01). ConclusionsThe application of TBL teaching method in the teaching of pharmacognosy can effectively cultivate the main role of students, help to train students' subjective learning and teamwork consciousness, and their abilities to solve practical problems.
2019, 44(4): 558-561.
doi: 10.13898/j.cnki.issn.1000-2200.2019.04.041
Abstract:
ObjectiveTo explore the improvement ways of effectiveness of medical college career guidance curriculum under the background of "Internet +". MethodsThe new teaching approach of medical college career guidance course in grade 2014 from department of clinical medicine of Bengbu Medical College was constructed under the background of "Internet +"(observation group), and the teaching effectiveness of which was compared with that of traditional teaching method in grade 2013(control group). ResultsThe overall teaching satisfaction, teaching content and relationship between employment courses and practices in observation group were better than those in control group(P < 0.01).The differences of the career preparation, mastering information, vocational cognition and cultivation of innovation and entrepreneurship abilities between two groups were statistically significant(P < 0.01). ConclusionsThe teaching ways of medical college career guidance curriculum under the background of "Internet +" can effectively improve the effectiveness of the curriculum, and which has practical significance in college students facing the pressure of employment.
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