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2019 Vol. 44, No. 6
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2019, 44(6): 701-704.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.001
Abstract:
ObjectiveTo investigate the effects of JAK2/STAT3 signaling pathway on the angiogenesis of gastric cancer. MethodsThe gastric cancer tissue, pericarcinomatous tissue and normal tissue from 30 patients treated with radical gastrectomy were collected.The effects of JAK2/STAT3 signaling pathway on autophagy and cell viability, and effects of autophagy proteins on the secretion of angiogenic factors in gastric cancer cells were investigated in vitro. ResultsThe expression levels of pJAK2 and pSTAT3 in gastric cancer tissue were higher than those in pericarcinomatous tissue and normal tissue.The autophagy abilities and cell viabilities of gastric cancer cells significantly decreased after the JAK2/STAT3 signaling pathway was inhibited(P < 0.01).After Beclin-1 was overexpressed, the expression levels of VEGF and PDGF secreted by gastric cancer cells were significantly higher than those in inhibition group(P < 0.01).After the autophagy protein LC3 was overexpressed, the expression levels of VEGF and PDGF between two groups were not statistically significant(P>0.05). ConclusionsJAK2/STAT3 signaling pathway can affect the microangiogenic ability of gastric cancer cells by regulating the autophagy ability, which maybe increase the expression levels of VEGF and PDGF by activating beclin-1.
2019, 44(6): 705-707, 711.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.002
Abstract:
ObjectiveTo investigate the effect of salvianolic acid B (Sal B) against cerebral ischemia in rats. MethodsThe middle cerebral artery occlusion(MCAO) was established in 50 rats to observe the effects of Sal B at different dosage on ischemic stroke.The rats were divided into 5 groups:blank control(1 mL/kg 0.9% NaCl solution), positive control(10 mg/kg aspirin), high dosage SalB(40 mg/kg Sal B), medium dosage SalB(20 mg/kg Sal B) and low dosage SalB(10 mg/kg Sal B)groups, And each chemical and physical data of cerebral ischemia was recorded for further analysis. ResultsThere were significant differences in cerebral infarction area and behavioral score among each group(P < 0.01 and P < 0.05).Compared with the blank control group, Sal B significantly reduced cerebral infarction area with increasing doses(P < 0.01).There were significant differences in thrombus weight and platelet aggregation among the five groups(P < 0.01).The thrombus weight in blank control group was higher than that in positive control group and Sal B low, medium and high dosage group(P < 0.01), and the platelet aggregation rate was higher than that in positive control group and Sal B medium and high dosage group(P < 0.01).There was no significant difference in prothrombin time(PT) between the five groups(P>0.05), but there was significant difference in thrombin time(TT), activation of partial thromboplastin time(APTT) and fibrinogen(FIB)(P < 0.05 to P < 0.01). ConclusionsSal B can effectively protect the cerebral ischemia rats by inhibiting platelet aggregation, improving blood hypercoagulable state, reducing the risk of thrombosis.
2019, 44(6): 708-711.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.003
Abstract:
ObjectiveTo investigate the effects of low-dose LBH589 on the apoptosis of epithelial ovarian cancer cells induced by PI3K/AKT pathway. MethodsThe apoptosis and cycle of epithelial ovarian cancer cells(OVCAR-3 cells) in the experimental group with low-dose LBH589 inducing and control group without low-dose LBH589 inducing were detected using TUNEL and flow cytometry, respectively.The inhibition of low-dose LBH589 on epithelial overian cancer cell proliferation was detected using MTT assay, and the expression levels of PI3K, AKT p-PI3K and p-AKT in two groups were detected using Western blot ting. ResultsThe cell apoptosis index in experimental group was significantly higher than that in control group(P < 0.01), the number of epithelial ovarian cancer cells in S-phase in experimental group was significantly lower than that in control group(P < 0.01).The inhibitory rates of epithelial ovarian cancer cells in experimental group at 12, 24, 36 and 48 h were(12.35±0.27)%, (21.24±0.33)%, (33.54±0.26)% and(41.23±0.52)%, respectively.The inhibition rate in control group was 0.In experimental group, the sensitivity of EOC cells to cisplatin significantly increased(P < 0.01), and the reversal coefficient was 3.26 times of control group.Compared with the control group, the expression levels of PI3K, AKT, p-PI3K and p-AKT in ovarian cancer cells were significantly inhibited in experimental group(P < 0.01). ConclusionsThe low-dose LBH589 can increase the apoptosis of the epithelial ovarian cancer cells OVCAR-3, and may reverse the cisplatin resistance through the PI3K/AKT pathway.
2019, 44(6): 712-716.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.004
Abstract:
ObjectiveTo observe the effects of Traditional Chinese Medicine(TCM) dialectical maintenance therapy on the living quality and life span in advanced non-small-cell lung cancer(NSCLC) patients after first-line chemotherapy. MethodsOne hundred and twenty-five mitigatory or stable advanced NSCLC patients after standard first-line chemotherapy were randomly divided into the observation group(62 cases) and control group(63 cases).The control group received conventional symptomatic treatment with western medicine, and the observation group was treated with TCM dialectical maintenance therapy based on the control group.Two groups were treated to disease progression or intolerance.The scores of survival quality and TCM symptoms, progression-free survival(PFS) and overall survival(OS) were compared between two groups. ResultsAt the end of the experiment, 60 cases in observation group and 62 cases in control group were investigated.Compared with the control group, the scores of TCM symptoms and KPS scores were significantly improved(P < 0.05 and P < 0.01), and the scores of physiological, functional and additional status were also significantly improved in observation group after treatment(P < 0.01).The differences of the scores of emotional, social or family status between two groups after treatment were not statistically significant(P>0.05).The median PFS in observation group(13.90 months) was greater than that in control group(11.30 months)(P < 0.05).The median OS in observation group and control group were 28.90 months and 16.90 months, respectively, and the difference of which was not statistically significant(P>0.05). ConclusionsThe TCM dialectical maintenance therapy in treating NSCLC can improve the clinical symptoms of TCM and quality of life, and prolong the PFS of patients.
2019, 44(6): 716-720.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.005
Abstract:
ObjectiveTo explore the role of virtual surgery based on 3D-CT reconstruction in the preoperative evaluation, surgical program and postoperative evaluation of Bernese periacetabular osteotomy(PAO) in the treatment of developmental dysplasia of the hip(DDH). MethodsThe 10 hips with DDH were reconstructed using Mimics and Imageware software, the anatomic morphological parameters of each hip were measured, and the direction of acetabular opening and location and extent of covering defect were evaluated before operation.The computer simulating operation and designing individualized surgical program provided the reference in actual operation.The results were evaluated by comparing preoperative and postoperative anatomical and morphological parameters of hip joint, and clinical function scores. ResultsBefore operation, the average values of LCEA, ACEA, AASA and PASA in affected side were less than those in normal side(P < 0.05), and the value of AAVA in affected side was bigger than that in normal side in DDH patients(P < 0.05).Compared with before operation, the mean values of LCEA, ACEA, AAVA, and AASA in PAO patients were significantly improved after PAO surgery(P < 0.05), but the PASA decreased, and the difference of which between before and after operation was not statistically significant(P>0.05).There was no statistical significance in the postoperative LCEA, ACEA and AAVA between affected side and normal side(P>0.05).The differences of the scores of HHS and VAS between two sides in DDH patients before and after surgery were statistically significant(P < 0.05).The scores of HHS and VAS in affected side at the last follow-up were significantly improved compared with those before operation(P < 0.05). ConclusionsThe computer simulation technology based on 3D CT reconstruction can measure the anatomical and morphological parameters of hip joint, accurately quantify the anatomic structural development deformity of DDH patients before surgery, design the individualized surgical plan to guide actual surgery, and significantly improve the imaging parameters and clinical function scores after surgery.
2019, 44(6): 721-724, 728.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.006
Abstract:
ObjectiveTo explore the clinical efficacy and safety of different surgical approaches in hepatoduodenal ligament lymph node(No.12 group) dissection of distal gastric cancer. MethodsEighty-eight patients with distal gastric cancer were treated with radical gastrectomy of cancer, and randomly divided into three groups according to different surgical approaches, which included anterior approach group(30 cases), posterior approach group(26 cases) and right approach group(32 cases).The operation time of No.12 lymph node dissection, intraoperative blood loss, number of lymph nodes dissection, postoperative anal exhaust time, postoperative hospital stay and incidence rate of complications were analyzed among three groups. ResultsThe differences of the age, gender and postoperative pathological staging, number of lymph nodes dissection, postoperative anal exhaust time and postoperative hospital stay were not statistically significant among three groups(P>0.05).The operation time of No.12 lymph node dissection and intraoperative blood loss in posterior approach group were less than those in other two groups(P < 0.05 to P < 0.01), and the incidence rates of total complications during and after operation in posterior approach group were lower than those in other two groups(P < 0.05). ConclusionsNo.12 lymph node dissection of distal gastric cancer has short operation time, little bleeding volume and low incidence of complication, which is worthy of promotion in clinic.
2019, 44(6): 725-728.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.007
Abstract:
ObjectiveTo investigate the clinical characteristics of patients with different degrees of pulmonary artery hypertension(PAH) during pregnancy, and analyze the maternal and infant outcomes. MethodsAccording to the level of pulmonary systolic pressure(SPAP), 75 patients with pregnancy complicated with PAH were divided into the mild group(36 cases), moderate group(21 cases) and severe group(18 cases).The cardiac function grading, auxiliary examination indexes and maternal and infant outcomes among three groups were compared. ResultsThe differences of the cardiac function grading, and levels of brain natriuretic peptide and SPAP among three groups were statistically significant(P < 0.01), and the differences of the myocardial enzymes and left ventricular ejection fraction among three groups were not statistically significant(P>0.05).The differences of the proportion of transferring to ICU among three groups were statistically significant(P < 0.01), and the differences of the pregnancy outcomes, delivery mode and anesthesia mode among three groups were not statistically significant(P>0.05).The differences of the gestational age, neonatal body mass, neonatal asphyxia and proportion of transferring to NICU among three groups were statistically significant(P < 0.01). ConclusionsThe cardiac function grading, BNP and SPAP are related to the severity of PAH.The severity of PAH may affect the maternal and infant outcomes, and the clinical intervention should be conducted as early as possible.
2019, 44(6): 729-731, 734.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.008
Abstract:
ObjectiveTo investigate the related factors of "ineffective recanalization" after stent thrombectomy in acute anterior great vessel occlusion. MethodsThe responsible vessels in 56 acute anterior great vessel occlusion patients were successfully recanalized after the stent was removed, and the patients were divided into the valid recanalization group and invalid recanalization group.The related factors in two groups were analyzed. ResultsThe differences of the onset to recanalization time(OTR), pnucture to recanalization time(PTR), ASPECT score and number of pulling stent between two groups were statistically significant(P < 0.05 to P < 0.01).Shortening OTR could significantly reduce the incidence of ineffective recanalization.After the bolt in the patients with ASPECT ≤ 7 scores were removed, the ineffective rate of which was significantly higher than that in patients with ASPECT >7 scores.The effect of number of pulling stent on the invalid recanalization rate was significant, the invalid recanalization rate in patients with pulling stent ≥ 5 times was significantly higher than that in patients with pulling stent < 5 times.The differences of the number of pulling stent and PTR between two groups were statistically significant(P < 0.01). ConclusionsShortening the treatment process of ischemic cerebrovascular disease before and in hospital, opening up green channel, skillfully taking stent technique to reduce the times of pulling stent and shortening the time of recanalization of blood vessel can reduce the invalid recanalization.
2019, 44(6): 732-734.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.009
Abstract:
ObjectiveTo study the correlation between the serum homocysteine(HCY), and interleukin 6(IL-6), endothelin 1(ET-1) and nitric oxide(NO) in patients with coronary heart disease(CHD). MethodsOne hundred and sixty with CHD[including 64 cases with hyperhomocysteinemia(HHCY group) and 96 cases with normal homocysteine(non-HHCY group), and 40 patients with negative coronary angiography were divided into the observation group and control group, respectively.The serum levels of IL-6, ET-1 and NO in all cases were measured, and the difference of which was compared. ResultsThe incidence rate of HHCY in observation group was higher than that in control group(P < 0.01).The differences of the BMI, smoking, IL-6, NO and ET-1 between HHCY group and non-HHCY group were statistically significantly(P < 0.01).In HHCY group, HCY was positively correlated with IL-6 and ET-1(P < 0.01);and HCY was negatively correlated with NO(P < 0.01).The incidence rate of acute coronary syndrome in HHCY group was significantly higher than that in non-HHCY group(P < 0.01). ConclusionsHyperhomocysteinemia is related to the clinical severity of CHD.Hyperhomocysteinemia may be involved in the pathogenesis of CHD by promoting the inflammatory reaction to lead to the dysfunction of vascular endothelium.
2019, 44(6): 735-737, 741.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.010
Abstract:
ObjectiveTo understand the status quo of self-health management in elderly patients with chronic diseases, and analyze its influencing factors to provide data support for local governments and community health units for guiding patients to self-health management so as to improve the quality of life of elderly patients with chronic diseases. MethodsOne thousand and eighty-eight patients with chronic diseases from 20 communities of 5 cities in Anhui province were investigated using self-designed questionnaire.The general demographic characteristics, specific conditions of chronic diseases, status quo of self-health management, acquiring self-health management knowledge approach and behaviors of self-health management of patients were used to analyze the influencing factors of cognitive level of self-health management knowledge in patients with chronic diseases. ResultsThere were significant differences in the effects of age, culture level, occupation, income, self-health management time in self-health management situation, health education in health management, knowledge source of health management and paying attention to health management on the knowledge levels of health management in elderly patients with chronic diseases.The results of linear regression showed the above independent variables were positively correlated with the knowledge of self-health management in the elderly. ConclusionsThe cognitive level of self-health management in the elderly patients with chronic diseases is low.The health education in community medical units should actively be carried out to improve the self-health management behavior of patients with chronic diseases.
2019, 44(6): 738-741.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.011
Abstract:
ObjectiveTo and analyze the effects of pulmonary protective ventilation combined with pulmonary reextension on pulmonary function and oxygen partial pressure (PaO2) during the perioperative period in patients treated with laparotomy under general anesthesia. MethodsSixty patients scheduled by laparotomy under general anesthesia from March 2015 to March 2017 were randomly divided into the observation group and control group(30 cases each group).The observation group was treated with lung protective ventilation strategy(tidal volume for 6 mL/kg) combined with pulmonary resuscitation, and the control group was treated with the standard ventilation volume (tidal volume for 8 mL/kg).The airway pressure, respiratory frequency, pulse oxygen saturation(SpO2), PaO2, end-expiratory partial pressure of carbon dioxide(PETCO2) and incidence rate of complications between two groups were compared. ResultsThe respiratory frequency, airway pressure and PETCO2 in observation group during operation were higher than those in control group(P < 0.01), and the levels of SpO2 and PaO2 in observation group after operation were higher than those in control group(P < 0.01).The levels of postoperative lung function indexes in two groups decreased compared with before operation, and the predicted value percentage of FEV and FEV1, FVC and FVC, and FEV1/FVC in observation group were better than those in control group(P < 0.05 to P < 0.01).The incidence rate in observation group and control group was 6.67% and 3.33%, respectively, and the difference of which was not statistically significant(P>0.05). ConclusionsThe pulmonary protective ventilation combined with pulmonary reextension is helpful to improve perioperative pulmonary function and PaO2 in patients treated with laparotomy under general anesthesia and has safety, which is worthy of popularization and application.
2019, 44(6): 742-744.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.012
Abstract:
ObjectiveTo investigate the diagnostic value of intrapapillary capillary loop(IPCL) classification in early esophageal cancer. MethodsOne hundred patients suspected by early esophageal tumors under esophagogastroscopy were randomly divided into the IPCL group and Lugol's group(50 cases each group).After the esophagus in all patients were detected using routine white-light endoscopy, the Lugol's group was detected using the routine iodine staining, and the IPCL group was detected using the endoscopic narrow band imaying combined with magnifying endoscopy.The clarity of lesion tissue in two groups was evaluated, the IPCL classification of lesion tissue was compared with the results of histopathological examination, and the sensitivity and specificity of IPCL classification to early esophageal tumor were evaluated. ResultsThe difference of the clarity of lesion tissue between two groups was not statistically significant(P>0.05), and the differences of the diagnostic coincidence rate, sensitivity to early esophageal cancer and positive predictive value between two groups were statistically significant(P < 0.05~P < 0.01).The difference of the specificity between two groups was not statistically significant(P>0.05).The accuracy rate of the IPCL classification in the judgement of the depth of invasion of early esophageal cancer was 70.83%. ConclusionsIPCL classification can accurately judge the nature and depth of invasion of esophageal lesion, improve the diagnostic rate of early esophageal tumors, and has important guiding significance for clinical treatment.
2019, 44(6): 745-748.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.013
Abstract:
ObjectiveTo compare the effects between catheter-directed thrombolysis combined with iliac vein stent implantation and catheter-directed thrombolysis in the treatment of acute iliofemoral vein thrombosis. MethodsThe clinical data of 86 patients with acute iliofemoral vein thrombosis complicated with severeiliac vein stenosis treated with anticoagulation combined with catheter-directed thrombolysis were retrospectively analyzed.Thirty-two patients treated with catheter-directed thrombolysis combined with balloon dilatation and stent implantation to open iliofemoral vein and 54 patients treated with catheter-directed thrombolysis alone were divided into the observation group and control group, respectively.The thrombosis elimination rate, limb swelling relief and perioperative complications were counted.The occurrence of post-thrombotic syndrome(PTS) and severity of venous clinical symptoms in two groups after 3, 6, 12 and 24 months of operation were evaluated using Villalta scale and Vcss scale. ResultsThe elimination rate of grade Ⅲ thrombus in two groups by catheter-directed thrombolysis was 82.6%.There was no statistical significance in thrombolytic time, urokinase dosage, length of stay, perioperative complications, incidence of PTS and thrombus recurrence rate between two groups(P>0.05).The circumference difference of up 15 cm of knee in observation group was smaller than that in control group(P < 0.05).During the following-up 3, 6 12 and 24 months, the Villalta signs and symptoms evaluation and Vcss score in observation group were smaller than those in control goup(P < 0.05 to P < 0.01). ConclusionsThe thrombus clearance rate of catheter-directed thrombolysis in the treatment of acute iliofemoral venous thrombosis is high, which combined with opening iliofemoral vein with balloon dilatation and stent implantation can improve the symptoms and clinical therapeutic effect.
2019, 44(6): 749-751.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.014
Abstract:
ObjectiveTo explore the correlation between the serum level of vitamin D and thyroid function, clinical indicators in type 2 diabetes mellitus(T2DM) patients. MethodsAccording to the serum level of 25 hydroxyvitamin[25(OH)D], 151 patients with T2DM were divided into the normal group(≥ 30 ng/mL), insufficient group(20~30 ng/mL), deficient group(10~20 ng/mL) and severely deficient group(< 10 ng/mL).The relationship between the serum level of 25(OH)D and clinical indicators, thyroid function was compared. ResultsThe proportion of patients with serum vitamin D deficiency was 89.40% among the T2DM patients.The differences of the correlations of serum levels of vitamin D with FT3, TSH and TGAb and TMAb among four groups were statistically significant(P < 0.05).Logistic regression analyses indicated that the serum level of vitamin D was negatively correlated with TSH in T2DM patients. ConclusionsThe serum vitamin D deficiency is negatively correlated with TSH in patients with T2DM.Supplementing vitamin D and monitoring thyroid function should be considered in patients with T2DM.
2019, 44(6): 752-755.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.015
Abstract:
ObjectiveTo investigate the changes of serum thyroid hormone(TH) and thyroid stimulating hormone(TSH) levels in patients with type 2 diabetes mellitus(T2DM) and their influencing factors. MethodsSeventy-five patients with T2DM(T2DM group) and 75 healthy persons(control group) were selected to compare the levels of TH and TSH in serum of the two groups.The levels of TH and TSH in serum of the two groups were also compared according to sex, age, course of disease, HbAlc and FBG. ResultsThe level of serum free triiodothyronine(FT3) in patients with T2DM was significantly lower than that in control group(P < 0.01).There was no significant difference in the levels of free thyroxine(FT4) and TSH between the two groups(P>0.05).There was no significant difference in serum FT3, FT4 and TSH levels between different sexes, taking metformin of not in T2DM patients(P>0.05).There were significant differences in serum FT3 levels between patients of different age groups and course of disease.With the increase of age and course of disease, the level of FT3 decreased(P < 0.05 to P < 0.01).There were statistical differences in FT3 and FT4 levels between patients with different HbAlc.The levels of FT3 and FT4 decreased with the increase of HbAlc(P < 0.05 to P < 0.01), and the levels of FT3 and FT4 in patients with FBG ≥ 7.0 mmol/L were significantly lower than those in patients with FBG < 7.0 mmo/L(P < 0.01).Spearman correlation analysis showed that FT3 level was negatively correlated with age, course of disease, HbAlc and FBG in patients with T2DM(P < 0.05), and FT4 was negatively correlated with HbAlc and FBG(P < 0.05). ConclusionsCompared with healthy adults, patients with T2DM have abnormal thyroid function, which is mainly manifested by the decrease of FT3.The changes of FT3 level in patients with T2DM are closely related to age, course of disease, HbA1c and FBG.
2019, 44(6): 755-757.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.016
Abstract:
ObjectiveTo explore the clinicopathologic characteristics of multifocal papillary thyroid carcinoma(MPTC), and its relationship with invasion. MethodsA total of 367 papillary thyroid carcinoma(PTC) cases confirmed by pathology treated with total or subtotal thyroidectomy from 2013 to 2018 were divided into the multifocal group and single focal group.The clinical pathological characteristics in two groups were retrospectively analyzed. ResultsCompared with the single focal group, the proportions of male and non-simple micro cancer cases with tumor lesion ≥ 1 cm, rate of cervical lymph node metastasis, and proportion of cases with extra-glandular tissue invasion were higher in multifocal group(P < 0.05 to P < 0.01).The proportion of cases with simple micro cancer was lower(P < 0.01), and the differences of the proportion of cases with ≥ 45 years old complicated with or without nodular goiter and Hashimoto's thyroiditis were not statistically significant(P>0.05). ConclusionsThe multiple lesion is one of the clinical features of PTC, which is more likely to happen cervical lymph node metastasis and extrathyroid invasion, and more aggressive.
2019, 44(6): 758-760, 764.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.017
Abstract:
ObjectiveTo explore the relationships between the serum levels of hypersensitive troponin T(hs-cTnT), hypersensitive C-reactive protein(hs-CRP), homocysteine(Acy) and degree of coronary artery disease in patients with acute coronary syndrome(ACS). MethodsOne hundred and twenty patients with ACS were set as the observation group, which included the unstable angina pectoris group(UAP group, 60 cases) and acute myocardial infarction(AMI group, 60 cases), and 60 physical examiners were set as the control group at the same time.The serum levels of hs-cTnT, hs-CRP and HCY in observation group were detected after 24 h of admission, and compared with the control group.The correlations of serum levels of hs-cTnT, hs-CRP and HCY with degrees of coronary artery disease were analyzed. ResultsThe differences of the serum levels of hs-cTnT, hs-CRP and HCY among three groups were statistically significant(P < 0.01), the above three indexes in AMI group were significantly higher than those in UAP group and control group(P < 0.01), and the above three indexes in UAP group were significantly higher than those in control group(P < 0.01).With the disease degree aggravating, the serum levels of hs-cTnT, hs-CRP and HCY increased gradually, and the difference of which was statistically significant(P < 0.01).The level of hs-cTnT was positively correlated with that of hs-CRP(P < 0.01), the level of hs-cTnT was positively correlated with that of HCY(P < 0.01), and the level of hs-CRP was positively correlated with that of HCY(P < 0.01). ConclusionsThe serum levels of hs-cTnT, hs-CRP and HCY have certain value in the clinical diagnosis of ACS, and clinical guiding significance in identifying the degree and range of coronary artery lesions, which is worthy of clinical promotion and application.
2019, 44(6): 761-764.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.018
Abstract:
ObjectiveTo observe the cytotoxic drugs on the morphology of hematologic tumor cells, and its clinical significance. MethodsThe bone marrow smears of 58 patients with hematological tumors treated with cytotoxic drugs were collected.Bone marrow smears were stained using Wright's staining, and observed under low power microscopy to judge the degree of proliferation.The morphological changes of cells and abnormal cells were observed under oil microscopy. ResultsAmong 58 patients treated with cytotoxic drugs, the morphological changes in one or more lines of bone marrow cells in 52 cases(89.66%) were found, which included the morphological changes of erythrocyte in 36 cases(62.07%), the morphological changes of granulocyte in 49 cases(84.48%), the morphological changes of mega-cell in 22 cases(37.93%) and no significant change in 6 cases(10.34%).The results of hematology examination in 58 patients showed that the complete remission in 39 cases(67.24%), partial remission in 12 cases(20.69%) and no remission in 7 cases(12.07%) were identified.The cell morphology changes in one or more lines in patients with complete remission and partial remission were found, and no cell morphology change in 1 case with no remission was detected. ConclusionsAfter the hematological tumor patients were treated with cytotoxic drugs, the adverse reactions can be detected as early as possible through the effects and changes of cell morphology, which has certain clinical significance in developing more scientific and effective treatment schemes and improving the quality of life in hematological tumor patients.
2019, 44(6): 765-768.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.019
Abstract:
ObjectiveTo explore the effects of clopidogrel complicated with biaspion in the treatment of acute cerebral infarction, and on the expression levels of alpha granule membrane glycoprotein(CD62p) and lysosomal granule membrane glycoprotein(CD63). MethodsThe positive rates of CD62p and CD63 in two groups were detected before and after treatment, and the clinical efficacy was evaluated. ResultsThe differences of the positive rates of CD62p and CD63 between two groups before treatment were not statistically significant(P>0.05), and the differences of the positive rates of CD62p and CD63 in two groups between before treatment and after 1 week of treatment were not statistically significant(P>0.05).The differences of CD62p, CD63 and NIHSS scores in two groups between after and before treatment, and between after 3 and 2 weeks of treatment were statistically significant(P < 0.01).There was no statistical significance in total incidence rate of adverse event between two groups(P>0.05). ConclusionsThe overall efficacy of 100 mg baiaspirin combined with 50 mg clopidogrel in the treatment of cerebral infarction of elderly patients is better than that of 150 mg baiaspirin.The monitoring of CD63 and CD62p can be an important index for anti-platelet therapy.
2019, 44(6): 771-773, 777.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.021
Abstract:
ObjectiveTo assess the significance of ultrasonic refined scoring method based on thyroid imaging reporting and data system(TI-RADS) combined with serum thyroid stimulating hormone(TSH) level in the differentiation diagnosis of benign and malignant thyroid nodules. MethodsThe refined scoring of the boundary, aspect ratio, echo and calcification of thyroid nodules in ultrasonoscopy in patients treated with operation based on TI-RADS grading system combined with serum level of TSH on admission were analyzed to draw the receiver operating characteristic(ROC) curve and calculate the area under ROC curve(AUC).The value of serum level of TSH, ultrasonic refined scoring method and both combination in the differentiation diagnosis of benign and malignant thyroid nodules were evaluated. ResultsThe ROC analysis showed that the sensitivity and specificity of ultrasonic refined scoring method in differentiating benign and malignant thyroid nodules were 88.6% and 83.9%, respectively.The AUC was 0.779(95%CI:0.718 to 0.839).When the Youden's index was the largest, the optimal critical value of ultrasonic refined scoring method was 9 points, and the nodules with score ≥ 9 and < 9 points were malignant and benign, respectively.The sensitivity and specificity of serum level of TSH in distinguishing benign and malignant thyroid nodules were 71.1% and 50.9%, recpectively, and the AUC was 0.703(95%CI:0.624 to 0.782).When the Youden's index was the largest, the optimal critical value was 2.31 mIU/L, and the sensitivity, accuracy and specificity of ultrasonic refined scoring method combined with serum TSH value in distinguishing benign and malignant thyroid nodules were 90.1%, 84.5% and 84.3%, respectively. ConclusionsThe ultrasonic refined scoring method based on TI-RADS combined with serum level of TSH in the differentiation diagnosis of benign and malignant thyroid nodules can further improve the diagnostic coincidence rate, and reduce the rate of thyroid nodule biopsy or operation.
2019, 44(6): 774-777.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.022
Abstract:
ObjectiveTo investigate the relationships between the angle of the endometrium of two sides of the septum, and mediastinal residue after transcervical hysteroscopic resection of septum(TCRS) and pregnancy outcome. MethodsThe mediastinal uterus in 80 patients with infertility or abortion were diagnosed using 3DTVU, and the patients were treated with hysteroscopy combined with TCRS.According to the results of 3DTVU, the patients were divided into the large angle group(the angle of the endometrium of two sides of the septum ≥ 90°) and small angle group(the angle of the endometrium of two sides of the septum < 90°).The postoperative mediastinal length more than 0.5 cm was set as the criteria of mediastinal residue.All patients were reviewed and followed up. ResultsThe results of TCRS and preoperative diagnosis of 3DTVU were the same.At 3 months after surgery, no mediastinal residue or no more than 0.5 cm residue in 59 cases, and mediastinal residue more than 0.5 cm in 21 cases were found.The residue rate in large angle group(43.48%) was significantly higher than that in small angle group(15.79%)(P < 0.01).The mediastinal length more than 1 cm in 1 case in large angle group and 1 case in small angle group was found, and two cases were treated with operation again.Three cases with intrauterine adhesion in large angle group were found, and treated with adhesion lysis.The follow-up rate of patients was 80.00%.The cumulative pregnancy rate and cumulative live birth rate in large angle group and small angle group were(52.63% and 44.44%) and(21.05% and 33.33%), respectively, and the differences of those between two groups were not statistically significant(P>0.05).One case with spontaneous abortion in large angle group and 3 cases with spontaneous abortion in small angle group were found, and the difference of which between two groups was not statistically significant(P>0.05). ConclusionsThe effects of the angle of the endometrium of two sides of the septum on the pregnancy outcome after TCRS may be related to the incidence rate of postoperative complications, which need to be further studied.
2019, 44(6): 778-781.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.023
Abstract:
ObjectiveTo establish a nanofiber-packed solid-phase extraction-high performance liquid chromatography to determine the serum level of ligustrazine. MethodsThe sample was diluted by 1% ammonia solution for 3 times, purified and enriched with activated PCAX composite anion exchange nanofiber solid-phase extraction column, eluted with deionized water, eluted with 50 μL methanol, and 20 μL sample was detected.The methanol-1% acetic acid solution(45:55, V/V) was used as mobile phase for separation on Shimazu ODS-2 column(250 mm×4.6 mm, 5 μm) with flow rate for 1.0 mL/min and detection wavelength for 295 nm. ResultsThe linear range of this method was from 0.01 to 2.00 μg/mL, the detection limit was 0.003 μg/mL, the recovery rate was from 94.88% to 103.11%, and the relative standard deviations was from 2.6% to 4.3%. ConclusionsThe method has the advantages of simple operation, low sample requirement and high sensitivity, and can be used to determine the content of ligustrazine in human plasma.
2019, 44(6): 781-783.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.024
Abstract:
ObjectiveTo explore the ways to improve the management level of traditional Chinese medicine injections with light-protecting/shading. MethodsThe Chinese medicine pharmacy injections in dispensary of traditional chinese medicine and intravenous preparation center in a hospital were examined, the distribution of nonconforming drugs were analyzed, the problem types with high proportion of unqualified drugs in TCM injections were identified and analyzed, and the corresponding management system and measures were formulated and reexamined. ResultsA total of 37 cases of unqualified TCM injections were detected, and the main reason for the unqualified drugs was that the drugs failed to effectively avoid the light(25/37, 67.57%).One case of unqualified TCM injections without effective shading was detected by review after the intervention measure targeting at effective avoiding the light was implemented, and no effective protection from light in dismantling of traditional Chinese medicine injections significantly decreased.According to the actual situation of hospital, some light-shielding box with appropriate size and material were made, and the design patent of the shading box was applied(ZL 2015 3 0420142.9). ConclusionsBased on the characteristics and problems of light-protecting/shading in the management of TCM injections, some practical management systems and safeguard measures are formulated, which significantly improve the management level of light-protecting/shading of Chinese medicine injections.
2019, 44(6): 784-786, 791.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.025
Abstract:
ObjectiveTo investigate the development of mental resilience and its influencing factors for providing the basis in maintaining mental health and formulating intervention measures in empty-nester in a city of Anhui province. MethodsThree hundred and eighty-nine empty-nesters were selected from Bengbu city of Anhui province using randomly sampling method, and investigated using the self-compiled general condition questionnaire and resilience scale. ResultsThe total score of mental resilience of empty-nesters was(120.29±16.46), and the overall level was good.The results of univariate analysis showed that the differences of the scores of the mental resilience in empty-nesters with different age, education levels, family annual income, number of children and physical condition were statistically significant(P < 0.05 to P < 0.01).The results of multivariate linear regression analysis showed that the education level, family annual income and physical condition were the independent influencing factors of mental resilience level in empty-nesters.The better the physical condition and higher the levels of education and family income were, the higher the level of mental resilience of empty-nesters was(P < 0.05 to P < 0.01). ConclusionsThe mental resilience of empty-nesters is the result of the comprehensive action of many factors.The society and family should take joint efforts to improve the mental resilience level of empty-nesters.
2019, 44(6): 787-791.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.026
Abstract:
ObjectiveTo investigate the incidence of anxiety and depression in college students, explore its correlation with psychological adaptability, and provide the basic data for the intervention of anxiety and depression. MethodsThe sociodemographic characteristics, anxiety, depression, psychological resilience, self-compassion, and forgiveness in 825 college students were investigated using a questionnaire, and these data were analyzed using SPSS version 21.0 software. ResultsThe prevalence rates of anxiety and depression were 44.36% and 39.88%, respectively.The differences of the prevalence rates of anxiety and depression among different genders students, whether the only child student, different self-assessment of family economic status students and mothers with different education levels of students were not statistically significant(P>0.05).The differences of the prevalence rates of depression among different grades and fathers with different education levels of students were not statistically significant(P>0.05), and the differences of the prevalence rates of anxiety among different grades students, and fathers with different education levels of students were statistically significant(P < 0.01 and P < 0.05).The prevalence rates of depression and anxiety in students with left-behind experience were higher than those in students without left-behind experience(P < 0.01 and P < 0.05).The differences of total scores of the mental resilience scale, self-compassion scale and forgiveness scale, and each dimension score between college students with, and without depression and anxiety were statistically significant(P < 0.01).The strength dimension of resilience scale, self-kindness and mindfulness dimension of self-compassion scale and forgiveness dimension of forgiveness scale were the protective factors of the depression of college students(P < 0.05 to P < 0.01).The resilience dimension of the mental resilience scale was a risk factor of depression in college students(P < 0.05).The strength dimension of mental resilience scale, self-kindness dimension of self-compassion scale, forgiveness dimension of forgiveness scale were the protective factors of anxiety in college students(P < 0.05 to P < 0.01). ConclusionsThe current state of mental health of college students is not optimistic, and the psychological adjustment ability is closely related to the anxiety and depression of college students.
2019, 44(6): 792-794, 797.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.027
Abstract:
ObjectiveTo design the physical crestraint checklist for critical patients, and observe its application effect in intensive care unit(ICU). MethodsThe physical crestraint checklist in critical patients was designed by consulting the guide and related literature.Thirty inpatients from October to December 2017 and 30 patients from January to March 2018 were divided into the control group and observation group, respectively.In the control group, the responsible nurses predictably selected suitable restraint tools and restraint sites for the patients according to their work experience, indwelling pipelines, patients' agitation and other actual conditions.In the observation group, the responsible nurses assessed the basic situation of the patients according to the checklist, and then gave the patients standardized and rationalized physical restraint.The usage rate of physical restraint, skin injury at restraint site and duration of physical restraint between two groups were compared. ResultsAfter the effects of using checklist was assessment, the usage rate of physical restraint, skin injury at restraint site and duration of physical restraint in observation group decreased compared with the control group(P < 0.05). ConclusionsThe application of physical restraint checklist in the quality management of ICU patients' physical restraint can reduce the time of physical restraint, occurrence of skin injury at restraint site and usage rate of physical restraint in critical patients, which is worthy of clinical promotion and application.
2019, 44(6): 795-797.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.028
Abstract:
ObjectiveTo explore the effects of risk assessment nursing on critical patients in respiratory department. MethodsThirty critical patients from November 2016 to November 2017 and 30 cases from December 2017 to November 2018 in respiratory department were divided into the control group and observation group, respectively.The control group was nursed with routine care measures, and the observation group was additionally nursed with risk assessment nursing based on control group.The nursing effect was compared between two groups. ResultsThe compliance and satisfaction in observation group were better than those in control group(P < 0.05), and the difference in the mastery of nursing knowledge between two groups was not statistically significant(P>0.05).The pulmonary function indexes in observation group were significantly better than those in control group(P < 0.01), and the differences of the gastric, urinary and thoracic drainage tubes falling off were not statistically significant(P>0.05). ConclusionsThe risk assessment nursing is helpful to improve pulmonary function index, compliance and satisfaction of patients in respiratory department, which is worthy of promotion.
2019, 44(6): 798-800.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.029
Abstract:
ObjectiveTo investigate the effects of the recovery massage on the galactosis and swell pain of breast after cesarean section. MethodsA total of 220 primiparas with single pregnancy treated with cesarean section were divided into the observation group and control group according to the random number table(110 cases each group).The control group was nursed with routine measure, and guided in early sucking and breastfeeding.The observation group was additionally nursed with breast massage within postpartum 12 h based on the control group.The swell pain, lactation time and volume of breast, and breast-feeding rate in two groups were observed. ResultsThe pain scores of breast in observation group after 24, 48 and 72 h of delivery were significantly lower than those in control group(P < 0.01), the difference of which between two groups among postpartum each time-point was statistically significant(P < 0.01), and which at postpartum 24, 48 and 72 h gradually decreased(P < 0.05 to P < 0.01).The lactation volume in observation group at postpartum 2, 3 and 7 d was significantly higher than that in control group(P < 0.01), the difference of which between two groups among postpartum each time-point was statistically significant(P < 0.01), and which at postpartum 1, 2, 3 and 7 d gradually increased(P < 0.01).The mean time of lactation in observation group[(16.2±3.8)h] was shorter than that in control group[(28.3±4.8)h](P < 0.01).The breastfeeding rates in observation group at postpartum 24, 48, 72 h and 42 d were significantly higher than those in control group(P < 0.01). ConclusionsThe recovery massage of breast can promote the breast duct patency, reduce the swell pain of breast, and improve the success rate of breastfeeding.
2019, 44(6): 801-804.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.030
Abstract:
ObjectiveTo incestigate the self-care ability and influencing factors in the tumor patients treated with peripherally inserted central catheter(PICC). MethodsThe general information, social support, psychology and self-nursing ability of 113 tumor patients were investigated. ResultsThe score of self-care ability was 81-140 points, and the mean score of which was (114.5±2.6) points.The low, medium and high levels in 0 case(0.00%), 48 cases(42.78%) and 65 cases(57.52%) were indentified, respectively.The score of health behavior was 96-169 points, and the mean score of which was (129.8±3.6) points.The low, medium and high levels in 0 case(0.00%), 62 cases(54.87%) and 51cases(45.13%%) were indentified, respectively.The differences of the self-nursing ability scores in different gender, marital status, time of indwelling PICC, disease type, occupation, number of indwelling patients were not statistically significant(P>0.05). ConclusionsThe self-care ability of malignant tumor patients treated with PICC is related to the age, culture level, residence and depression, all factors are the important influencing factors, which should be paid attention to in clinical nursing.
2019, 44(6): 814-816.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.034
Abstract:
ObjectiveTo explore the application effects of the formative assessment-oriented comprehensive assessment system in the teaching of diagnostics. MethodsSixty-one students from clinical medicine undergraduates and 58 students from the experimental class in grade 2015 in Bengbu Medical College were divided into the control group and experimental group, respectively.The control group and experimental group were evaluated using the summative assessment, and comprehensive assessment system composed of summative assessment, diagnostic assessment and formative assessment, respectively.The teaching effects and questionnaire survey were compared between two groups. ResultsThe number of excellent students in experimental group was significantly higher than that in control group(P < 0.01), and the number of failing students in experimental group was less than that in control group (P < 0.01).The results of questionnaire survey showed that the clinical thinking ability, self-learning ability, teamwork ability, doctor-patient communication ability and learning effect in experimental group were better than those in control group (P < 0.05 to P < 0.01), and the average number of browsing mobile phone in experimental group was significantly less than that in control group(P < 0.01). ConclusionsThe comprehensive assessment system oriented by formative assessment can improve the achievement, increase the learning enthusiasm, and effectively improve teaching quality of students.
2019, 44(6): 817-819, 824.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.035
Abstract:
ObjectiveTo investigate the clinical internship satisfaction of medical interns in a medical college under the cooperation of medical education. MethodsThe literature review and questionnaire survey were conducted to investigate the satisfaction of 1 123 undergraduate interns from the Clinical Medicine Speciality, Anesthesiology Speciality, Stomatology Speciality and Medical Imaging Speciality in a university in 2019 on the teaching hardware condition, teaching quality, teaching management and service level of the internship unit. ResultsThe differences of the satisfaction scores among interns with different genders, different majors and different provinces on the teaching hardware condition meeting with the teaching requirement, teaching quality and teaching management, score of service level, and were statistically significant(P < 0.05).The results of multiple linear regression analysis showed that the gender, majors and province of training hospital were the influencing factors of the satisfaction scores of the teaching hardware condition and teaching management, total satisfaction score of interns, and the major and province of training hospital were the influencing factors of the satisfaction score of teaching quality. ConclusionsAfter the collaboration of medical education, the satisfaction of interns with teaching hospital ranges from the basic satisfaction level to partly satisfaction level.The interns' satisfaction with the teaching hospitals of different provinces varies greatly.The hospitals still have room to improve the living and learning environment of interns to different degrees.
2019, 44(6): 820-824.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.036
Abstract:
ObjectiveTo understand the effects of standardized training of rheumatology and immunology department in internal medicine students, and provide a basis for further improving the effects of training. MethodsIn this study, the convenience sampling method was adopted.From December 2018 to January 2019, the residential training students from the medical professional base of Anhui Provincial Hospital were investigated using self-filling questionnaire survey of self-designed questionnaire. ResultsA total of 195 participants were investigated.Before the rotation of rheumatology and immunology department, 87.18% of participants encountered rheumatic patients in clinical work.Eighty-eight students had participated in the rotation of rheumatology and immunology department, and 107 students had not.Compared to non-rotating students, the 79.55%, 77.27% and 80.68% of the rotating students understood the diagnostic criteria, differential criteria and treatment methods of three or more common diseases in rheumatology and immunology department, respectively, the ratio of those in rotating students was higher than those in non-rotating students(P < 0.01).The understanding degree of anti-rheumatism drugs and clinical skills of rheumatology and immunology department in rotating students were significantly better than those in non-rotating students(P < 0.01).Most of the students thought that the teaching rounds and case discussions were good method of rotation training in rheumatology and immunology department, the daily performance assessment was good the assessment method, and the professional title of the teacher was physician for more than three years. ConclusionsThe standardized training of rheumatology and immunology department can significantly improve the students' knowledge, clinical skills, diagnosis and treatment of rheumatic immune disease, and professional skills and level of diagnosis and treatment.
2019, 44(6): 831-833.
doi: 10.13898/j.cnki.issn.1000-2200.2019.06.040
Abstract:
ObjectiveTo observe the effects of modified Chinese medicine specimen preservation solution on tissue clarity, color and antibacterial activity of rabbit specimens. MethodsThe fixed effects of the modified solution mixed with honeysuckle extract, formaldehyde, ethanol and water, and traditional formaldehyde and ethanol were tested.The tissue structure clarity, tissue muscle color, anticorrosion and antibacterial effect and irritation of specimens after fixation with two methods were observed and compared. ResultsThe effects of two specimen preservation solutions were similar, and the advantages of the modified solution in keeping the color of the specimen, maintaining the tissue structure and having little irritation were distinct. ConclusionsThe modified specimen preservation solution has a good fixation effect, and can be used to display specimens.
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