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2019 Vol. 44, No. 7
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2019, 44(7): 841-845.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.001
Abstract:
ObjectiveTo explore the effects and mechanism of norepinephrine in breast cancer under anxiety state. MethodsTwenty C57BL/6 mice were divided into the control group and model group.The mice models with anxiety tumor-bearing were established using inoculation of tumor cells and experimental stimulation.The serum level of norepinephrine was detected, and the tumor volume was measured after modeling.The proliferation, migration, invasion, cell cycle distribution and activation of Akt signaling pathway of MDA-MB-231 breast cancer cells treated with norepinephrine were detected. ResultsThe tumor volume in model group was significantly larger than that in control group (P < 0.05), and the serum concentration of norepinephrine significantly increased (P < 0.01), which was correlated with the anxiety degree (r=0.78).Norepinephrine enhanced the proliferation, migration and invasion of MDA-MB-231 cells, promoted DNA replication, and activated the Akt signaling pathway. ConclusionsNorepinephrine activates the Akt signaling pathway to promote the development of breast cancer under state anxiety.
2019, 44(7): 846-849, 854.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.002
Abstract:
ObjectiveTo investigate the effects of overexpression of SOX7 gene on apoptosis, ractive oxygen species (ROS) level and Wnt/β-catenin signaling pathway in hepatocellular carcinoma (HCC) cells. MethodsThe human hepatoma Huh-7 cells were divided into the blank group, blank plasmid pcDNA3.1 group (vector group) and pcDNA3.1-SOX7 recombinant plasmid group (pcDNA3.1-SOX7 group).The apoptosis rate, ROS content, and expression levels of SOX7, β-catenin, cyclin D1 and cleaved-caspase 3 protein were detected by Annexin V-FITC/PI double staining, DCFH-DA assay and Western blotting at 48 h after transfection, respectively.The cell viability was detected using MTT assay after 24 h, 48 h and 72 h of pcDNA3.1 transfecting. ResultsThe expression level of SOX7 protein in pcDNA3.1-SOX7 recombinant plasmid group was significantly higher than that in blank group (P < 0.05).Compared with the blank group, the cell viability and expression levels of β-catenin and cyclin D1 protein in pcDNA3.1-SOX7 group significantly decreased, while the apoptosis rate, ROS content and cleaved-caspase 3 protein expression level significantly increased (P < 0.05). ConclusionsThe overexpression of SOX7 can induce the apoptosis of HCC cells.The mechanism of apoptosis is related to the increasing of ROS level and inhibition of Wnt/β-catenin signaling pathway.
2019, 44(7): 850-854.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.003
Abstract:
ObjectiveTo investigate the effects of epimedium on the expression levels of bone morphogenetic protein -2(BMP-2) and -4(BMP-4) in cartilage tissue of rabbit model with lumbar intervertebral disc degeneration. MethodsThirty New Zealand white rabbits were divided into the sham operation group, model group and epimedium group (10 rabbits each group), and the lumbar intervertebral disc degeneration rabbit models in other two groups were established except for the sham operation group.The epimedium group and model group were treated with intragastric administration of 10 mg·kg-1·d-1 epimedium solution and same volume of 0.9% sodium chloride injection, respectively.The lumbar cartilage endplate specimens were harvested from each group after 90 d of treatment, and the morphological change of tissue was observed.The expression levels of apoptosis factor fas receptor, and BMP-2 and BMP-4 protein in cartilage endplate were determined using immunohistochemistry and Western blotting, respectively. ResultsThe positive rates of fas receptor in model group and epimedium group were higher than that in sham operation group (P < 0.01), and the positive rate of fas receptor in epimedium group was lower than that in model group (P < 0.01).The expression levels of BMP-2 and BMP-4 protein in model group and epimedium group were lower than those in sham operation group (P < 0.01), the expression level of BMP-2 protein in epimedium group was higher than that in model group (P < 0.01), and there was no statistical significance in the expression level of BMP-4 among three groups (P>0.05). ConclusionsEpimedium can up-regulate the expression level of BMP-2 in cartilage tissue of rabbit model with lumbar intervertebral disc degeneration, promote the proliferation and differentiation of osteoblast, but there is no experimental basis for regulating BMP-4.
2019, 44(7): 855-858.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.004
Abstract:
ObjectiveTo observe the therapeutic effects of purslane extract on oral ulcer, and explore its effects on cellular immunity and inflammatory factors in rats, to provide reference for clinical drug use. MethodsThe rat oral ulcer model was established by antigen emulsion method.The rats were divided into the blank control group, model control group (no medication), oral ulcer powder group (treatment with oral ulcer powder suspension painting) and purslane extract group (treatment with purslane solution gavage) (8 rats each group).The number, duration and therapeutic effect of oral ulcer in all groups were observed.The levels of serum interleukin-2 (IL-2), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ) and T cell subsets were compared among all groups. ResultsThe differences of the number and duration of oral ulcer among all groups were statistically significant (P < 0.01), which in purslane extract group were significantly lower than those in oral ulcer powder group and model control group (P < 0.05 to P < 0.01), and which in oral ulcer powder group was significantly lower than that in model control group (P < 0.01 and P < 0.05).The therapeutic effect in oral ulcer powder group was better than that in model control group, and which in purslane extract group was better than that in oral ulcer powder group and model control group (P < 0.05).The differences of the serum levels of inflammatory factors among all groups were statistically significant (P < 0.01), the serum level of IFN-γ in model control group was significantly lower than that in blank control group, the serum levels of IFN-γ in oral ulcer powder group and purslane extract group were significantly higher than that in model control group, and the serum level of IFN-γ in purslane extract group was higher than that in oral ulcer powder group (P < 0.05 to P < 0.01).The serum levels of TNF-α and IL-2 in model control group significantly increased compared with the blank control group, which in oral ulcer powder group and purslane extract group were lower than those in model control group (P < 0.01), and the differences of the serum levels of TNF-α and IL-2 between oral ulcer powder group and purslane extract group were not statistically significant (P>0.05).The differences of the T lymphocyte subsets levels among all groups were statistically significant (P < 0.01), the levels of CD3+、CD4+ and CD4+/CD8+ in model control group were significantly lower than those in blank control group, and the serum level of CD8+ in model control group was significantly higher than that in blank control group (P < 0.01).The serum levels of CD3+, CD4+ and CD4+/CD8+ in oral ulcer powder group and purslane extract group were higher than those in model control group (P < 0.01), the serum levels of CD8+ in oral ulcer powder group and purslane extract group were lower than that in model control group (P < 0.01), and the serum levels of CD3+, CD4+ and CD4+/CD8+ in purslane extract group were significantly higher than those in oral ulcer powder group (P < 0.05 to P < 0.01). ConclusionsThe purslane extract can effectively shorten the duration of ulcer, reduce the number of ulcers, and improve the efficiency of ulcer treatment.Its mechanism may be retated to enhance the immune function of body.
2019, 44(7): 859-862, 867.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.005
Abstract:
ObjectiveTo evaluate the early and long-term complications and quality of life in patients treated with ileal orthotopic neo-bladder (IN) or cutaneous ureterostomy (CU) after laparoscopic radical cystectomy (LRC), and provide the clinical basis for selecting urinary diversion. MethodsA total of 61 bladder cancer patients treated with LRC combined with urinary diversion were divided into the IN group (15 cases) and CU group (46 cases).The incidence rates of early and long-term complications and quality of life were compared between two groups. ResultsThe operation time, anal exhaust time and postoperative hospital stays in IN group were longer than those in CU group (P < 0.01).The incidence rate of early complications in IN group was lower than that in CU group (P < 0.01), however, there was no statistical significance in long-term complications between two groups (P>0.05).The score of quality of life in IN group was significantly higher than that in CU group (P < 0.01), and the quality of life in patients more than 70 years was significantly higher than that in patients less than 70 years in CU group (P < 0.01). ConclusionsThe patients treated with IN have low incidence rate of complications and high quality of life.The CU is still an alternative method for elderly patients.the suitable urinary diversion method should be chosed according to patients' demand and disease situation, and the mentality of patients should be considered.
2019, 44(7): 863-867.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.006
Abstract:
ObjectiveTo investigate the characteristics of psychological symptoms in patients with inflammatory bowel disease (IBD) and relationship between psychological symptoms and quality of life, and provide certain theoretical basis for the corresponding psychological treatment of IBD patients with mental and psychological disorder. MethodsThe psychological assessment in 159 patients with IBD and 89 healthy people were implemented using the general status questionnaire, symptom check list-90 (SCL-90) scale, inflammatory bowel disease questionnaire (IBDQ) and MOS item short from health survey (SF-36).The effects of the psychological symptoms of IBD patients on their quality of life were evaluated. ResultsCompared with the healthy people, the total score, and positive rates and scores of somatization, depression, hostility, paranoia and other aspects were higher in IBD patients (P < 0.05 to P < 0.01).The SF-36 score and other dimension scores except for mental health in IBD patients were lower than those in healthy people (P < 0.01).Compared with the SCL-90-negative IBD patients, the total score and scores of whole body, gut and emotions in SCL-90-positive IBD patients were lower (P < 0.01).The results of multiple linear regression analysis showed that the depression, interpersonal sensitivity and paranoia were the influencing factors of the quality of life in patients with IBD (P < 0.05 to P < 0.01). ConclusionsThe IBD patients are prone to be complicated with abnormal psychological symptoms such as compulsion, interpersonal relationship, depression, hostility and low quality of life.The quality of life is mainly affected by illness, depression, interpersonal sensitivity and paranoia.The depression, paranoia and interpersonal sensitivity in patients at active phase of disease are severe, and the quality of life of the patient is low.
2019, 44(7): 868-871, 875.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.007
Abstract:
ObjectiveTo examine the status and clinical significance of serum transforming growth factor (TGF)-β1 in peripheral blood from patients with systemic lupus erythematosus (SLE). MethodsA total of 56 SLE patients and 35 healthy individuals were recruited into this study.According to the presence of lupus nephritis (LN), the SLE patients were divided into two groups:those with LN and those without LN.The serum levels of TGF-β1 were measured using ELISA.The associations between these measurements and SLE disease activity index (SLEDAI) or other laboratory parameters were analyzed by correlation analysis. ResultsThe serum TGF-β1 level in the SLE patients with LN was significantly lower than that in the healthy controls (P < 0.05).The serum TGF-β1 level in the SLE patients with lower disease activity was significantly lower than that in patients with higher disease activity (P < 0.05).The serum TGF-β1 level was higher in the patients with arthritis than those without, and was lower in the patients with positive anti-U1RNP or anti-Sm-D1 antibody than those of negative.Correlation analysis showed that the serum TGF-β1 level was not significantly correlated with the SLEDAI score, C3 level, erythrocyte sedimentation rate and C reactive protein (P>0.05), but it was positively correlated with the red blood cell count and negatively correlated with globulin, 24 h urine protein, serum IgM and AST (P < 0.05). ConclusionsTGF-β1 has a two-way immunomodulatory effect and may be involved in the pathology of kidney and joint in SLE patients.
2019, 44(7): 872-875.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.008
Abstract:
ObjectiveTo investigate the therapeutic effects of Shenfu injection in the acute renal injury and other organs injury induced by sepsis. MethodsSeventy-two patients with sepsis were randomly divided into the control group and observation group (36 cases each group).The control group was treated with routine method, and the observation group was treated with Shenfu injection combined with conventional method.The changes of the serum levels of creatinine, blood urea nitrogen and cystatin C in two groups between before and after treatment, and other organ damage and death between two groups were compared. ResultsThe differences of the levels of serum creatinine, blood urea nitrogen and cystatin C between two groups before treatment were not statistically significant (P>0.05), which were significantly higher than those after treatment, and the levels of serum creatinine, blood urea nitrogen and cystatin C in observation group after treatment were significantly lower than those in control group (P < 0.01).The differences the levels of serum alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase and brain natriuretic peptide between two groups before treatment were not statistically significant (P>0.05), which in two groups significantly decreased after treatment, and the levels of serum alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase and brain natriuretic peptide in observation group were lower than those in control group (P < 0.01).The death rate in observation group (2.8%) was significantly lower than that in control group (22.2%) (P < 0.05), and the survival time in observation group was longer than that in control group (P < 0.05). ConclusionsShenfu injection can effectively alleviate the acute kidney injury and other organs injury, and reduce the mortality in sepsis patients.
2019, 44(7): 876-880.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.009
Abstract:
ObjectiveTo investigate the present situation of anxiety and depression in patients with atrial fibrillation (AF), and analyze its influencing factors. MethodsThe clinical data of 116 patients with AF during hospitalization were collected by self-designed general data questionnaire.The patients were investigated using the self-rating anxiety scale, self-rating depression scale and disease uncertainty scale before a day of discharge. ResultsCompared with the domestic norm, the levels of anxiety and depression in patients with AF were higher (P < 0.01).The results of multiple linear regression analysis showed that persistent AF and whether to receive radiofrequency ablation were the common influencing factors of anxiety and depression of patients (P < 0.05 to P < 0.01), the hypertension, educational level and whether to accept relevant knowledge education were the independent influencing factors of anxiety (P < 0.05 to P < 0.01), and the NYHA cardiac function classification and uncertainty of disease were the independent influencing factors of depression (P < 0.05 and P < 0.01).In the anxiety scoring model, 5 independent variables accounted for 56.2% of the variation of anxiety score (R2=0.562, adjusted R2=0.518).In the depression scoring model, 4 independent variables cumulatively explained 47.8% of the variation in depression score (R2=0.478, adjusted R2=0.453). ConclusionsThe levels of anxiety and depression in patients with AF before radiofrequency ablation are significantly higher than those in domestic norm, and the preoperative anxiety and depression are affected by many factors.On the one hand, the medical staff should strengthen the education of patients' disease-related knowledge to reduce the uncertainty of patients' disease, on the other hand, the patients with high negative emotion should be heavily intervened.
2019, 44(7): 880-884.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.010
Abstract:
ObjectiveTo explore the effectiveness of different hemostatic methods in the treatment of refractory postpartum hemorrhage, and the causes of hemostasis failure. MethodsAmong 71 puerpera with refractory postpartum hemorrhage, 35 cases were treated with intrauterine gauze packing, 25 cases were treated with intrauterine vaginal balloon compression, and 11 cases were treated with uterine artery embolization.According to different hemostatic methods, 71 puerpera were divided into the gauze packing group (gauze group), balloon compression group (balloon group) and arterial embolization intervention group (interventional group). Accordingto the method of tamponade treatment (including gauze tamponade and balloon compression), the patients were divided into the tamponade treatment group (tamponade group), tamponade combined with interventional treatment group (tamponade+interventional group), and tamponade combined with hysterectomy group (tamponade+hysterectomy group).The intraoperative condition, postoperative fever and treatment among all groups were compared, and the causes of hemostatic failure were analyzed using multi-factor method. ResultsThe postpartum blood loss in 71 cases was 1 100~8 000 mL, the successful hemostasis in 64 cases was found, and 7 cases were treated with hysterectomy after hemostasis.There was no statistical significance in intraoperative blood loss, postpartum 24 h blood loss, and transfusion of erythrocyte suspension and plasma among three groups with different hemostatic methods (P>0.05).The comparison results among three groups with different tamponade methods showed that the intraoperative blood loss and postpartum blood loss at 24 h in tamponade+hysterectomy group were the most (P < 0.01), followed by the tamponade + intervention group (P < 0.01), and the least in tamponade group (P < 0.01 and P < 0.05).The infusion of RBC suspension and plasma volume in tamponade+hysterectomy group were higher than those in tamponade + intervention group and tamponade group (P < 0.01), and there was no statistical significance of which between tamponade + intervention group and tamponade group (P>0.05).The results of postoperative conditions showed that the postoperative fever time in gauze group was higher than that in balloon group and interventional group (P < 0.05), but there was no statistical significance between balloon group and interventional group (P>0.05).The length of stay, postoperative fever days and duration of antibiotic use gradually increased according to the order of the tamponade group, tamponade + intervention group, tamponade + hysterectomy group (P < 0.05 to P < 0.01).A multi-factor analysis of 64 cases with successful hemostasis showed that the placental implantation and diffuse intravascular coagulation were the risk factors of hemostasis failure (P < 0.01). ConclusionsThere is no significant difference in the hemostatic effect between intrauterine gauze packing and balloon compression, but the balloon compression hemostasis can reduce the incidence rate of puerperal infection.In combination with placenta implantation, abnormal coagulation function and poor hemostatic effect of tamponade and intervention, and the hysterectomy should be implemented as soon as possible.
2019, 44(7): 885-889.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.011
Abstract:
ObjectiveTo explore the influences of restrictive and non-restrictive blood transfusion strategies on blood transfusion and clinical indicators of premature infants, and provide a clinical basis for the transfusion strategy of premature infants. MethodsAccording to the premature infants blood transfusion guidelines of United States in 2008, the clinical data of 171 premature infants with gestational age < 37 weeks were retrospectively analyzed, and divided into the restrictive blood transfusion (group A, 78 cases) and non-restrictive blood transfusion group (group B, 93 cases).According to the gestational age, the premature infants were further divided into the gestational age < 34 weeks group and ≥ 34 weeks group.The differences of the total transfusion, frequency of transfusion, age of first transfusion, body quality recovery, feeding condition, deoxygenation time, time of discharge standard, and incidence rate of brain injury (leuomalacia cerebri/intracranial hemorrhage) between two groups were compared. ResultsAmong the premature infants with gestational age < 34 weeks, the number of blood transfusion in group A was less than that in group B (P < 0.01), the age of first blood transfusion, deoxygenation time, time to recover birth body quality and incidence rate of brain injury in group A were higher than those in group B (P < 0.05 to P < 0.01).Among the premature infants with gestational age ≥ 34 weeks, the age of first blood transfusion and time of adequate milk volume (150 mL/kg) in group A were higher than those in group B (P < 0.01 and P < 0.05).The time of preterm infants with full oral feeding and hospitalization in group A were longer than those in group B (P < 0.05 to P < 0.01), and the difference of the total amount of blood transfusion was not statistically significant between two groups (P>0.05). ConclusionsCompared with the restrictive transfusion strategy, the non-restrictive transfusion strategy does not increase of the quantity of blood transfusion, can be more conducive to the clinical recovery of premature infants, shorten the hospitalization time, promote feeding and weight gain, shorten the time of oxygen uptake, and reduce the occurrence of premature infant brain injury.
2019, 44(7): 890-896, 899.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.012
Abstract:
ObjectiveTo investigate the association between asymptomatic mild hyperuricemia (HUA) and estimated glomerular filtration rate (eGFR), urinary albumin-creatinine ratio (ACR) among community population in South China, and analyze the adverse effects of mild hyperuricemia on kidney. MethodsA cross-sectional study was conducted among 1 276 community residents in Zhuhai Guangdong province.The differences of eGFR and ACR in male, female and the whole population between mild hyperuricemia group and normal group were compared.Whether the mild hyperuricemia leading to the eGFR decreasing and mild ACR increasing or not was explored using the univariate, multivariate and stepwise logistic regression models. ResultsAmong the female and whole population, the eGFR in mild hyperuricemia group was lower than that in normal group, and the results of univariate, multivariate and stepwise logistic regression models analysis showed that the mild hyperuricemia was a risk factor of the eGFR decreasing.The differences of ACR mild between mild hyperuricemia group and normal group among the male, female and whole population were not statistically significant (P>0.05).Among whole population, the results of univariate logistic regression model analysis showed the mild hyperuricemia was a risk factor of mild ACR increasing. ConclusionsThe asymptomatic mild hyperuricemia may have an adverse effect on the glomerular filtration function of the community population, especially the female population in South China.
2019, 44(7): 897-899.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.013
Abstract:
ObjectiveTo explore the related influencing factors of the severity of diabetic foot(Wagner classification). MethodsThe relevant data of 305 hospitalized patients with diabetic foot were analyzed.According to Wagner's classification, grade 1 in 81 cases, grade 2 in 62 cases, grade 3 in 82 cases, grade 4 in 72 cases and grade 5 in 8 cases were identified.The factors influencing Wagner classification of diabetic foot were analyzed. ResultsThe higher the Wagner classification of diabetic foot patients was, the larger the maximum ulcer area was(P < 0.05), the higher the levels of neutrophils, uric acid and hypersensitive C-reactive protein were (P < 0.05 to P < 0.01), the lower the levels of hemoglobin and albumin were (P < 0.05 and P < 0.01), and the higher the frequency of diabetic peripheral neuropathy was (P < 0.05).The results of Spearman grade analysis showed that the degree of Wagner classification was positively correlated with the peripheral neuropathy, maximum ulcer area, neutrophil count and uric acid level, and negatively correlated with the levels of hemoglobin and albumin. ConclusionsFor diabetic foot patients, actively controlling infection, reducing uric acid level, treating neuropathy and maintaining a good nutritional status can prevent further progress of the disease.
2019, 44(7): 900-902, 907.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.014
Abstract:
ObjectiveTo compare the clinical effects between hollow nail locking plate and pressurized hollow screw in the treatment of femoral neck fracture. MethodsSixty-four patients with femoral neck fractures were randomly divided into the hollow nail locking plate group(group A) and pressurized hollow screw group(group B).According to the classification of Garden standard, the time from injury to operation, operation time, blood loss, hospital stay, fracture healing time and complications in two groups were recorded and analyzed. ResultsThe differences of the gender, age, time from injury to operation, hospital stay, open reduction time, operation time and fracture healing time between two groups were not statistically significant(P>0.05).The peroperative bleeding and postoperative Harris score in group A were significantly higher than those in group B(P < 0.01).The incidence rates of postoperative loosening, removal, nail removal and total complications in group A were significantly lower than those in group B(P < 0.05 and P < 0.01). ConclusionsDuring the surgical treatment of femoral neck fracture, compared with the pressurized hollow screw, the hollow nail locking plate of proximal femoral has the advantages of low postoperative complications and good recovery of hip function.
2019, 44(7): 903-907.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.015
Abstract:
ObjectiveTo estimate the efficacy and safety of bile duct stent placement by endoscopic retrograde pancreatic angiography(ERCP) in the treatment of obstructive jaundice caused by malignant biliary stricture, and screen the predictive index of bile duct stent drainage effect. MethodsOne hundred and six patients with unresectable malignant bile duct stricture diagnosed by ERCP were treated with bile duct sent placement.According to the purpose of analysis, the patients were divided into the malignant bile duct stricture liver hilum and distal group, malignant hepatic bile duct stricture Bismuth type Ⅰ and Ⅱ-Ⅳ group and malignant hepatic bile duct stricture Bismuth type Ⅱ-Ⅳ unilateral stent and bilateral group, malignant distal bile duct stricture plastic stent and metal stent group and effective and ineffective stent drainage group.The preoperative, intraoperative and postoperative related indicators were recorded, the preoperative and postoperative drainage effects and postoperative complications in each group were compared, and the related indicators affecting the stent drainage effects were analyzed and screened. ResultsThe serum level of total bilirubin in 106 cases within 1 week after operation was significantly lower than that before operation(P < 0.05), and the effective drainage rate was 70.8%.The effective drainage rates in Bismuth Ⅰ group and metallic stent group were significantly higher than that in Bismuth Ⅱ-Ⅳ and plastic stent group(P < 0.05).The incidence rates of acute pancreatitis and cholangitis patients with malignant hilar bile duct stricture significantly increased compared with patients with distal bile duct stricture(P < 0.05).The preoperative serum albumin level and intraoperative congested bile volume were positively correlated with drainage effect(P < 0.05). ConclusionsBile duct stent placement by ERCP in the treatment of malignant biliary stricture is safe and effective, but Bismuth Ⅱ-Ⅳ cases should be treated with caution because of higher risks of ineffective drainage and complications.The preoperative serum ALB level and amount of congested bile can predict the drainage efficacy.
2019, 44(7): 908-910.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.016
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ObjectiveTo investigate the correlation between glomerular filtration rate estimated by modified simplified MDRD equation(MDRD-eGFR) and pathological damage caused by IgA nephropathy. MethodsThe clinical and pathological data and modified simplified MDRD-eGFR in patients with IgA nephropathy were retrospectively analyzed.The renal pathological injury was graded according to Katafuchi semi-quantitative score standard and Lee's grading standard. ResultsWith the aggravation of pathological injury, the level of modified simplified MDRD-eGFR decreased gradually(P < 0.05).The Katafuchi score, glomerulosclerosis, tubular interstitial injury and renal vasculopathy were correlated with modified simplified MDRD-eGFR(P < 0.01).When the modified simplified MDRD-eGFR was more than or equal to 90 mL·min-1·1.73 m-2, the correlation disappeared, but the patients had some degree of pathological injury. ConclusionsThe modified simplified MDRD-eGFR is closely related to the renal pathological damage in IgA nephropathy.When the modified simplified MDRD-eGFR is less than 90 mL·min-1·1.73 m-2, the prediction value of which in renal tubulointerstitial injury is great.
2019, 44(7): 911-914.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.017
Abstract:
ObjectiveTo investigate the correlation between the number of intracranial artery stenosis and severity of cerebral infarction. MethodsThe clinical data of 100 patients with acute cerebral infarction were retrospectively analyzed.The clinical symptom severity and vascular stenosis of patients were evaluated using the national institutes of health stroke scale(NIHSS) and cervical MRA, respectively.The number of bilateral internal carotid artery and vertebral artery stenosis were counted, and the correlation between the number of intracranial artery stenosis and NIHSS score was analyzed. ResultsThe age, number of intracranial artery stenosis and fasting blood glucose were the risk factors of the severity of ischemic stroke(P < 0.05 to P < 0.01).The difference of the NIHSS score in patients with different number of intracranial artery stenosis was statistically significant(P < 0.01), and which in patients with single branch stenosis was lower than that in patients with multiple branches stenosis(P < 0.01), and the differences of the NIHSS score between single and double branches, and between double and multiple branches were not statistically significant(P>0.05). ConclusionsThe number of intracranial artery stenosis is significantly related to the severity of cerebral infarction, and the independent risk factor of the severity of cerebral infarction.
2019, 44(7): 914-916.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.018
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ObjectiveTo investigate the relationship between the embryonic cerebral artery, and morphology of basilar artery and probability of basilar artery ischemic events using magnetic resonance angiography. MethodsA total of 148 patients with cerebrovascular disease diagnosed by magnetic resonance angiography examination were randomly selected.There were 48 patients with embryonic posterior cerebral artery and 100 patients without embryonic posterior cerebral artery.The openness of the embryonic cerebral artery was observed.The inner diameters of the upper, middle and lower basal artery, and occurrence of posterior circulation ischemic events were measured and analyzed. ResultsThe diameters of the upper, middle and lower basilar artery in embryonic posterior cerebral artery group were smaller than those in non-embryonic posterior cerebral artery group(P < 0.01).In the posterior circulation ischemic event, the diameters of the upper, middle and lower basilar artery were smaller than those in non-disease group(P < 0.05). ConclusionsUnder the presence of the embryonic cerebral artery, the inner diameter of basilar artery is smaller, and the incidence rate of ischemic event increases.
2019, 44(7): 917-920.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.019
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ObjectiveTo explore the clinical features of hyperlipemic acute pancreatitis(HLAP), and value of C reactive protein(CRP) in the evaluation of severity and prognosis of HLAP. MethodsThe clinical data of 103 patients with acute pancreatitis were retrospectively analyzed, the patients were divided into the HLAP group(32 cases) and non-HLAP group(71 cases), and the clinical features between two groups were compared.The HLAP group was subdivided into the HLAP1 group(mild disease, 22 cases) and HLAP2 group(severe disease, 10 cases) according to the severity of disease.The serum levels of CRP in HLAP1 and HLAP2 groups on the 1st, 3rd, 5th and 7th day of admission were detected.The value of CRP level in the evaluation of severity of HLAP was investigated using ROC curve. ResultsCompared with the non-HLAP group, the fasting blood glucose and triglyceride(TG) were higher(P < 0.01), and the levels of CRP, mean age and serum AMY, Ranson score, and Apache Ⅱ score were lower in HLAP group(P < 0.05 to P < 0.01).On the 1st, 3rd, 5th and 7th day of admission, the serum levels of CRP in HLAP1 group were lower than that in HLAP2 group(P < 0.05 to P < 0.01).The serum CRP levels in two groups on the 3rd day of admission were the highest(P < 0.01), and then gradually decreased(P < 0.01).The incidence rate of fatty liver in HLAP group(28.1%) was higher than that in non-HLAP group(11.3%)(P < 0.05).The ROC curve evaluation indicated that the AUC area of CRP in the evaluation of HLAP severity was 0.905(P < 0.01), and the 95% CI was 0.782~1.000. ConclusionsThe onset age of HLAP tends to be younger, and the incidence rate of fatty liver is high.CRP can be used as the evaluation index of the severity of HLAP, and has economy, convenience and feasibility in evaluating the prognosis of HLAP.
2019, 44(7): 920-922, 926.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.020
Abstract:
ObjectiveTo investigate the neuroprotective effects of the intravenous thrombolysis with a small dose alteplase(rt-PA) in the treatment of acute ischemic stroke. MethodsEighty-two patients with acute ischemic stroke was divided into the control group(n=39) and observation group(n=45) according to the administration dosage of rt-PA.The control group were treated with conventional dose(0.9 mg/kg) of rt-PA, and the observation group were treated with small dose(0.6 mg/kg) of rt-PA.The neurological deficit score(NHISS score), CSS score and BI index score before and after treatment, and incidence of adverse reactions between two groups were compared. ResultsAfter treatment, the scores of NHISS and CSS in two groups were significantly lower than those before treatment(P < 0.01), which in observation group was lower than that in control group(P < 0.05 and P < 0.01).After treatment, the scores of BI index in two groups were significantly higher than that before treatment(P < 0.01), and the difference of which between two groups was not statistically significant(P>0.05).The total incidence rates of adverse reactions in control group and observation group after treatment were 10.26% and 11.63%, respectively, and the difference of which between two groups was not statistically significant(P>0.05). ConclusionsBoth small-dose and conventional dose rt-PA in the treatment of acute ischemic stroke are effective, which has a good protective effect on nerve.It should be clinically practiced in order to improve the level of pharmacoeconomics.
2019, 44(7): 923-926.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.021
Abstract:
ObjectiveTo study the effects of dexmedetomidine on hemodynamics in elderly hypertensive patients treated with endotracheal intubation under general anesthesia. MethodsSixty elderly hypertensive patients treated with endotracheal intubation under general anesthesia were divided into the control group(treatment with 0.9% sodium chloride solution) and observation group(treatment with dexmedetomidine)(30 cases each group).The anesthesia time, operation time, recovery time, extubation time, blood pressure and heart rate of different time points, and incidence rate of adverse reactions were compared between two groups. ResultsThere was no statistical significance in anesthesia time and operation time between two groups(P>0.05), and the recovery time and extubation time in observation group were significantly shorter than those in control group(P < 0.05 and P < 0.01).There was no statistical significance in blood pressure and heart rate between two groups before entering room and before 1 min of intubation(P>0.05).The blood pressure and heart rate in observation group at intubation, before and after 1 min of intubation were significantly lower than those in control group(P < 0.01).There was no statistical significance in the incidence rates of dry outlet, hypotension, chills, bradycardia and delayed recovery between two groups(P>0.05). ConclusionsAmong elderly hypertensive patients treated with endotracheal intubation under general anesthesia, the dexmedetomidine anesthesia can reduce the blood pressure and heart rate fluctuation, promote hemodynamic stability, does not cause serious adverse reactions, and is safe.
2019, 44(7): 936-939.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.025
Abstract:
ObjectiveTo investigate the clinical characteristics and imaging signs of malignant solitary pulmonary nodule(SPN) to analyze the malignant risk factors, in order to improve the early detection rate of lung cancer. MethodsThe clinical and imaging data of 43 patients with SPN were analyzed using single factor analysis, and the statistical significance factor between benign and malignant groups was screened.These factors were multiplely analyzed using binary logistic regression analysis, and the independent influencing factors in benign and malignant SPN were screened. ResultsAmong 43 patients with SPN, 18 benign cases(41.9%) and 25 malignant cases(58.1%) were identified.The single factor analysis of benign and malignant solitary pulmonary nodules showed that the malignant rates of nodules with lobulation, burr sign, vascular cluster sign, bronchial sign, pleural indentation sign and no straight edge in CT images in female patients were higher(P < 0.05 to P < 0.01).Multiple-factor logistic regression analysis showed that blur sign was the independent risk factor of malignant SPN(P < 0.01), and the straight edge was the independent protective factor of benign SPN(P < 0.05). ConclusionsThe imaging features of benign and malignant SPN overlap.The blur sign is the independent risk factor of malignant SPN, and the straight edge is the independent protective factor of benign nodules.
2019, 44(7): 940-942, 945.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.026
Abstract:
ObjectiveTo summarize the imaging characteristics of three-dimensional ultrasonography and three-plane orthogonal method for two-dimensional ultrasonography in the examination of fetal cleft lip and palate, and improve the prenatal diagnosis rate of cleft lip and palate. MethodsA total of 12 522 fetal faces were scanned using three-plane orthogonal method(cross-section, coronal incision and sagittal incision) and three-dimensional ultrasonography.The imaging characteristics among the three planes were compared and analyzed, and the results of postpartum and following-up were analyzed. ResultsAmong 68 cases with cleft lip and palate, the prenatal ultrasound diagnosis in 67 cases was identified, and the diagnosis rate of which was 98.5%.Sixty-three(92.6%), 64(94.1%), 44(64.7%) and 56(82.3%) cases with cleft lip and palate were showed in the cross section, coronal section of nasolabial, sagittal section/parasagittal section and three-dimensional imaging, respectively. ConclusionsThe imaging characteristics of fetal cleft lip and palate using three-plane orthogonal method and three-dimensional ultrasonography are special, which can improve the accuracy of diagnosis, and is worthy of wide application.
2019, 44(7): 943-945.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.027
Abstract:
ObjectiveTo investigate the correlation of neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), coefficient of variation of erythrocyte distribution width(RDW-CV) and mean platelet volume(MPV) between normal pregnancy and preeclampsia, and diagnostic value of MPV in preeclampsia. MethodsThe whole blood cell in 34 pregnant women with mild preeclampsia, 57 pregnant women with severe preeclampsia and 54 normal pregnant women(control group) were analyzed.The NLR, PLR, RDW-CV, distribution width of platelet(PDW) and MPV among all patients were analyzed. ResultsThe differences of the levels of MPV among control group, mild preeclampsia group and severe preeclampsia group were statistically significant(P < 0.05).The differences of the age, neutrophil count, lymphocyte count, PDW and MPV between the control group and preeclampsia group were statistically significant(P < 0.05 to P < 0.01).The difference of neutrophil count between mild preeclampsia group and severe preeclampsia group was statistically significant(P < 0.05).The sensitivity and specificity of MPV=10.35 was 68.5% and 87.0%, respectively. ConclusionsMPV is closely correlated with to the occurrence of preeclampsia, and an effective marker for diagnosis of preeclampsia.
2019, 44(7): 946-948.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.028
Abstract:
ObjectiveTo investigate the changes of the serum level of cyclophilin B(CypB) and its auxiliary diagnosis value in patients with early gastric cancer, and provide reference in the clinical diagnosis and treatment of early gastric cancer. MethodsForty-nine patients with early gastric cancer and 45 health examiners were divided into the observation group and control group, respectively.The serum levels of CypB, carcinoembryonic antigen(CEA) and carbohydrate antigen-199(CA-199) in two groups were detected using enzyme linked immunosorbent assay.The early diagnostic value of each index in early gastric cancer patients was evaluated, and the correlation of serum level of CypB with CEA and CA-199 in patients with early gastric cancer was analyzed. ResultsThe difference of general data between two groups was not statistically significant(P>0.05).The serum levels of CypB, CEA and CA-199 in observation group were significantly higher than those in control group(P < 0.01).The serum level of CypB in observation group was significantly positively correlated with CEA and CA-199(P < 0.05).The ROC curve analysis showed that when 4.030 ng/mL was set as the cut-off point, the sensitivity and specificity of CypB in the diagnosis of early gastric cancer were 76.36% and 75.51%, respectively, the area under the curve was 0.766, and the diagnostic efficacy of CypB was better than that of CEA and CA-199. ConclusionsThe serum level of CypB in patients with early gastric cancer increases, which has certain value for auxiliary diagnosis.
2019, 44(7): 949-951.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.029
Abstract:
ObjectiveTo explore the effect of ability-oriented teaching reform in epidemiology course for clinical medicine specialty. MethodsThe main problems in the teaching of epidemiology were analyzed through the data of the National Qualification Examination for Licensed Doctors from 2013 to 2016 and the questionnaire survey of employers.One hundred and ninety-six and 201 students from two large classes of 2016 clinical medicine specialty were randomly divided into experimental class of teaching reform and control class of traditional teaching.Based on the revised teaching plan, the ability-oriented teaching reform was carried out in the experimental class.The teaching effect was analyzed between the two classes. ResultsAt the end of the final examination, the scores of epidemiological methods selection, problem analysis ability and epidemiological investigation design ability in the experimental class were obviously better than those in the control class(P < 0.05).The experimental class was better than the control class in terms of learning interest, selection of epidemiological methods and problem analysis ability, design ability of epidemiological investigation and community communication ability(P < 0.05). ConclusionsThe ability-oriented teaching reform can greatly improve the teaching effect of epidemiology course for the clinical medicine specialty.
2019, 44(7): 954-959.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.031
Abstract:
ObjectiveTo explore the effects of critical incident stress debriefing(CISD) combined with cognitive behavior intervention on psychological rehabilitation in patients with severe burn. MethodsOne hundred and sixteen patients with severe burn were randomly divided into the observation group and control group(58 cases each group).Two groups were treated with conventional intervention, and the observation group was additionally treated with CISD combined with cognitive behavior intervention.The mental health, coping strategies, post-traumatic growth and happiness score between two groups were compared before and after intervention. ResultsBefore intervention, there was not statistical significance in mental health, coping strategies, post-traumatic growth and happiness score between two groups(P>0.05).After intervention, the scores of somatization, interpersonal relationship, depression, anxiety and hostility, and total score of mental health in observation group were lower than those before intervention, and in control group after intervention(P < 0.05 to P < 0.01).After intervention, the score of facing dimension in observation group was higher than that before intervention, and in control group after intervention(P < 0.01), and the scores of avoiding and yielding dimensions in observation group were lower than those before intervention, and in control group after intervention(P < 0.01).After intervention, the total score of interpersonal relationship, new possibilities, spiritual change, appreciation of life and post-traumatic growth, and total score of health concerns, emotional behavior control and happiness in observation group were higher than those before intervention, and in control group after intervention(P < 0.05 to P < 0.01). ConclusionsCISD combined with cognitive behavioral intervention can effectively relieve the psychological disorders, and promote the rehabilitation of patients.It is worthy of promotion.
2019, 44(7): 959-962.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.032
Abstract:
ObjectiveTo observe the effects of postoperative probiotics combined with early enteral nutrition support on the recovery of gastrointestinal function in patients with gastric cancer. MethodsSixty-four patients treated with laparoscopic assisted radical gastrectomy were randomly divided into the observation group(n=31) and control group(n=33).The control group were treated with simple early enteral nutrition group(EEN group), and the observation group were treated with probiotics combined with early enteral nutrition(PEEN group), the recovery of gastrointestinal function and inflammatory marks between two groups were compared before operation, after 1 d and 5 d of the infusion of enteral nutrient solution. ResultsThe incidence rate of EN gastrointestinal complications(abdominal distension, abdominal pain, nausea, vomiting, etc.) in observation group was significantly lower than that in control group(P < 0.05).The first exhaust time, recovery of oral feeding time and postoperative hospital stay in observation group were significantly shorter than that in control group(P < 0.01).There was no statistical significance in preoperative C reactive protein and interleukin-6 levels between two groups(P>0.05).The levels of C reactive protein and interleukin-6 in observation group after 1 day of surgery were significantly lower than those in control group(P < 0.05 to P < 0.01). ConclusionsProbiotics combined with early enteral nutrition can effectively promote the recovery of postoperative gastrointestinal function, reduce the incidence rate of enteral nutrition gastrointestinal intolerance and degree of postoperative stress response in patients with gastric cancer, which is in line with the concept of accelerated rehabilitation surgery.
2019, 44(7): 963-965, 969.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.033
Abstract:
ObjectiveTo investigate the effects of adequate hydration combined with refined care on the prevention of contrast-induced nephropathy(CIN) after percutaneous coronary intervention(PCI). MethodsA total of 62 patients treated with PCI were randomly divided into the intervention group(31 cases) and control group(31 cases).The control group was treated with routine drinking water and nursing after operation, and the intervention group was treated with sufficient drinking water after 3 hours of operation combined with refined care.The levels of serum creatinine(sCr) and cystatin C(Cys-C) in two groups were detected before operation and after 12 h to 72 h of operation.The treatment effects and patients' satisfaction in two groups were observed. ResultsThe differences of the levels of sCr and Cys-C in intervention group among before operation and postoperative 5 time-points were not statistically significant(P>0.05), and the differences of the levels of sCr and Cys-C in control group among all time-points were statistically significant(P < 0.05).The level of sCr after 72 h of PCI was higher than that before operation and after 12 h and 24 h of PCI, and the level of Cys-C after 72 h of operation was higher than that before PCI(P < 0.05 to P < 0.01).The incidence rates of CIN, stomach upset and urinary retention in intervention group were lower than those in control group(P < 0.05 to P < 0.01).The satisfaction rate in intervention group was higher than that in control group(P < 0.05). ConclusionsThe adequate hydration combined with refined care intervention can prevent the CIN occurrence, stomach upset and urinary retention, improve the satisfaction after PCI, and greatly reduce the postoperative discomfort of patients.
2019, 44(7): 966-969.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.034
Abstract:
ObjectiveTo explore the effects of composite insulation measures on intraoperative low body temperature and postoperative resuscitation in patients treated with laparoscopic hysterectomy. MethodsNinety-eight patients treated with laparoscopic hysterectomy were divided into the observation group and control group according to the random digital table method(49 cases each group).The control group was nursed with traditional heat preservation, and the observation group was nursed with composite heat preservation.The rectal temperature at different time points(including at the time of entering operation room, after anesthesia induction, after 30 minutes, 60 minutes, 90 minutes, 120 minutes of anesthesia induction and at the end of operation), anesthesia recovery time, extubation time, and incidence rates of agitation and shivering between two groups were compared. ResultsThere was no statistical significance in rectal temperature between two groups at the time of entering operation room(P>0.05).The rectal temperature in observation group was significantly higher than that in control group after anesthesia induction, after 30 minutes, 60 minutes, 90 minutes, 120 minutes of anesthesia induction, and at the end of operation(P < 0.01).The rectal temperature in observation group after anesthesia induction, after 30 minutes, 60 minutes, 90 minutes, 120 minutes of anesthesia induction, and at the end of operation was significantly higher than that at the time of entering operation room, and which in control group after 60 minutes of anesthesia induction and at the end of operation was significantly lower than that at the time of entering operation room and end of anesthesia induction(P < 0.05 to P < 0.01).The incidence rate of hypothermia in observation group was significantly lower than that in control group(P < 0.01).The time of anesthesia recovery and extubation in observation group was significantly shorter than that in control group(P < .01 and P < 0.05).The incidence rates of agitation and shivering in observation group were significantly lower than those in control group(P < 0.05 and P < 0.01). ConclusionsThe composite insulation measures in patients treated with laparoscopic hysterectomy can effectively reduce intraoperative low body temperature, promote recovery, and reduce the occurrence of agitation and shivering.
2019, 44(7): 970-974.
doi: 10.13898/j.cnki.issn.1000-2200.2019.07.035
Abstract:
ObjectiveTo investigate the status and influencing factors of the care ability of family caregivers for stroke patients. MethodsThe status of 186 family caregivers of stroke patients were investigated using the questionnaires of the Family Caregiver Task Inventory(FCTI) and General Information Questionnaire(GSES). ResultsThe overall mean score of FCTI in the family caregivers of stroke patients was(17.26±2.07), the general self-efficacy was at a moderate level[(25.13±4.76) scores], and the each dimension score of FCTI was negatively correlated with self-efficacy of family caregiver(r=-0.546~-0.395, P < 0.01).The higher the self-efficacy was, the greater the caring ability was.The caring ability of family caregiver was affected by the caregivers' age, duration of care, physical condition, self-efficacy and dependency of patients, the regression coefficient of those was -0.36, -0.51, -0.71, -2.62 and 1.05, respectively(P < 0.05 to P < 0.01).The care abilities of caregivers with old age, longer care duration, high self-efficacy and low dependence on the care of stroke patients, and without chronic diseases were stronger. ConclusionsNursing staff should strengthen the help to family caregivers of patients with high dependence, pay attention to the physical and mental health of family caregiver, and take measures to improve the self-efficacy of caregivers to ensure the quality of care.
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