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2020 Vol. 45, No. 1
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2020, 45(1): 1-4.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.001
Abstract:
ObjectiveTo explore the method of isolation, identification and three-dimensional culture system of bronchioalveolar stem cells (BASCSs) from C57BL6 mouse in vitro, so as to lay an experimental foundation for further study of related characteristics of BASCs. MethodsThe lung tissue of adult male C57BL6 mice was completely isolated, lavaged by 1×PBS, digested by Elastase solution perfused through the trachea.The lung tissue was cut up with a sharp instrument, the cells were better dispersed using DNA enzymes, and the undigested tissue was removed with 75 μm sieve.The cells suspensions were stained using the fluorescent labeled CD31, CD34, CD45, SCA-1 and EpCAM antibody.The CD31-CD34-CD45-SCA-1+ EpCAM+ cells were sorted out using flow cytometry, and mixed with Mlg2908 cells (mouse lung fibroblast cell line) at the ratio of (1×103):(1×106) to construct a three-dimensional culture system based on the Matrigel as matrix. ResultsThe lung tissue was obstained by Elastase digesting, the 1.6×107 to 1.8×107 nucleated cells were obtained from a mouse.The results of flow cytometry showed that the CD34- CD45- SCA-1+ EpCAM+ cells accounted for about 22% of EpCAM+ cells.BASCSs, Mlg2908 cells and Matrigel were mixed and cultured.After 4 d, the clone was observed.With the extension of culture time, the number of clones decreased gradually.After 8 days, most of the clones were 50 μm in diameter, differentiated in morphology, and could sustain for 14 d. ConclusionsA simple and efficient method for isolation, identification and three-dimensional culture of mouse BASCSs is successfully established.
2020, 45(1): 5-8.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.002
Abstract:
ObjectiveTo observe the regulating effects of montelukast sodium (MK) on the balance of Th1Th2 cells and levels of related cytokines in rats with bronchopulmonary dysplasia (BPD). MethodsSixty healthy SPF SD rats, 3 weeks of gestation and weighing 200-250g, were randomly selected for the experiment, and 60 natural born SD rats and newborn rats were divided into the BPD model treated with MK group (MK group), BPD model group (BPD group) and normoxia feeding control group (control group) (20 rats in each group), respectively.The MK group and BPD group were fed in 95% hyperoxia environment, the MK group was intraperitoneally injected with 10mg·kg-1·d-1 of MK, and the BPD group was injected with the same volume of 0.9% sodium chloride solution.The control group was injected with the same volume of 0.9% sodium chloride solution, and fed in the normoxic environment.The lung function, macrophage subsets, Th cell subsets and levels of pro-inflammatory and anti-inflammatory cytokines were compared among three groups. ResultsThe levels of Ri, Re, Th1, Th1/Th2, IFN-γ, TNF-α, IL-1β, IL-6, IL-4, IL-10 and IL-13 in BPD group were higher than those in MK group and those in MK group were higher than those in control group (P < 0.05).The levels of Cl, MVV, FEV1/FVC, Th2 in BPD group were lower than those in MK group, and those in MK group were lower than those in control group (P < 0.05). ConclusionsMK can regulate the balance of Th1Th2 cells, and reduce the levels of related cytokines in rats with BPD.
2020, 45(1): 9-13.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.003
Abstract:
ObjectiveTo study the effects of paeonol on the radiosensitivity of esophageal squamous carcinoma cell lines KYSE450 and TE10, explore its molecular mechanism, and provide a new basis for the comprehensive treatment of esophageal squamous cell carcinoma with paeonol as radiotherapy sensitizing drug. MethodsEsophageal cancer cell lines were stably cultured.After the cells were treated with different concentrations of paeonol, the CCK8 method was used to detect the proliferation of cells, the ability of colony formation was detected using colony formation assay, the apoptosis was detected using flow cytometry, and the expression of apoptosis-related protein was detected using Western blotting. ResultsPaeonol could inhibit the proliferation of esophageal cancer cells at a concentration-dependent manner, inhibit the colony-forming ability of tumor cells after radiotherapy, and increase the apoptosis rate of tumor cells.The results of Western blotting analysis showed that the radiotherapy combined with paeonol could reduce the expression of Bcl-2, and increase the expression levels of Bax, caspase-3, cleaved caspase-3 and PARP. ConclusionsPaeonol combined with radiation therapy can inhibit the expression of Bcl-2, up-regulate the expression levels of Bax, caspase-3, cleaved caspase-3 and PARP, and the growth of esophageal cancer cells in vitro is inhibited to improve the radiosensitization.
2020, 45(1): 14-17.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.004
Abstract:
ObjectiveTo study the expression of Wilms gene (WT-1) in bone marrow cells of patients with acute myeloid leukemia (AML), and analyze the relationship between the expression level of WT-1 and clinical efficacy. MethodsThe clinical data of 66 AML patients, which included 8 patients with acute promyelocytic leukemia (APL) and 58 patients with acute non-lymphocytic leukemia (ANLL, except APL), were collected.Twenty healthy people were set as the control group.The expression levels of WT-1 in bone marrow cells of AML patients were detected using real-time quantitative PCR.The median level of WT-1 was set as the clinic value, the 58 newly diagnosed as ANLL patients were divided into the high-expression WT-1 group and low-expression WT-1 group.The relationship between the expression level of WT-1 and sex, age, ratio of progenitor cells, count of peripheral white blood cells, hemoglobin, platelets, lactate dehydrogenase (LDH), C-reactive protein (CRP), calcitonin (PCT), complete remission rate (CR) and relapse rate were analyzed, and the relationship between WT-1 gene expression level and prognosis of AML patients was revealed. ResultsThe difference of the expression rate of WT-1 between cases group and control group was statistically significant (P < 0.01), and the difference of the expression level of WT-1 among each group was statistically significant (P < 0.05).Compared with the control group, the expression levels of WT-1 in APL patients and M1 group were higher (P < 0.05).The difference of the expression level of WT-1 among ANLL patient subtypes was statistically significant (P < 0.05).Compared with the M1 group, the expression levels of WT-1 in M2 and M3 group were relatively low (P < 0.05).Compared with the low WT-1 expression group, the proportion of bone marrow progenitor cells and number of peripheral blood white blood cells in high WT-1 expression group significantly increased (P < 0.05).There was no statistical significance in gender, age, hemoglobin, platelet count, LDH, CRP, and PCT between low and high WT-1 expression groups (P>0.05), and there was no statistical significance in prognosis between two groups (P>0.05).The CR rate of AML patients in high WT-1 expression group was lower than that in low WT-1 expression group (P < 0.05). ConclusionsThe expression level of WT-1 in bone marrow cells of patients with AML can be used as an index to evaluate the prognosis and curative effect of the disease.
2020, 45(1): 18-23.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.005
Abstract:
ObjectiveTo investigate the role of bone morphogenetic protein 2 (BMP-2) in inducing the osteoclast activation in mice, and its related mechanisms. MethodsTwenty mice were randomly divided into the control group and experimental group (10 mice in each group), and treated with intertransverse fusion surgery through the posterolateral approach of the spine.The experimental group was implanted with bone fragments combined with BMP-2, the control group was only implanted with bone fragments, and the postoperative bone changes in two groups were evaluated.The bone marrow-derived macrophages (BMMs) were extracted from the tibia of the mice, induced into osteoclasts using RANKL and M-CSF reagents, and co-cultured with different concentrations of BMP-2.The osteoclasts, mRNA levels of Smad1 and p65 and protein levels of Smad1 and p65 were detected using TRAP staining, RT-PCR and Western blot, respectively. ResultsThe results of image examination of micro-CT showed that the spinal fusion in experimental group was stronger than that in control group.The trabecular bone volume and trabecular thickness in two groups showed an increasing trend after 1, 2 and 4 weeks of operation, and the trabecular bone gap showed a decreasing trend, and the difference of which was statistically significant (P < 0.05).The volume of trabecular bone in experimental group was higher than that in control group at 1, 2, and 4 weeks after operation, and the trabecular space in experimental group was lower than that in control group at 2 and 4 weeks after operation (P < 0.01).The total number and total area of osteoclasts at the 60 ng/mL, 90 ng/mL and 120 ng/mL of BMP-2 were higher than those at 0 ng/mL and 30 ng/mL of BMP-2 (P < 0.01).The differences of the expression levels of Smad1 and p65 mRNA in osteoclasts induced by different concentrations of BMP-2 were statistically significant (P < 0.01), and the expression level of Smad1 mRNA was linearly correlated with p65 (P < 0.01).The differences of the expression levels of Smad1 and p65 protein in osteoclasts induced by different concentrations of BMP-2 were statistically significant (P < 0.01), and the expression level of Smad1 protein was linearly correlated with p65 (P < 0.05). ConclusionsBMP-2 can promote the fusion of mouse spinal surgery model.BMP-2 is involved in the process of osteoclast activation, and may mediate osteoclast activation via Smad1/p65 signaling pathway.
2020, 45(1): 23-25.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.006
Abstract:
ObjectiveTo investigate the effect of sesamin on the expression of Toll-like receptor 2 (TLR2) in experimental brain injury. MethodsA model of craniocerebral injury was established using free fall method, and 45 mice were randomly divided into the sham surgery group, craniocerebral injury group and sesamin treatment group after brain trauma.The change of brain edema was observed by measuring the dry and wet weight of brain tissue.The expression level of TLR2 protein in brain tissue of mice was detected using Western blotting.The expression levels of inflammatory factors in tissues surrounding brain injury were detected using real time fluorescence quantitative PCR. ResultsThe levels of brain water, TLR2 expression and inflammatory factor in craniocerebral injury group were significantly higher than those in sham surgery group (P < 0.05 to P < 0.01).The levels of brain water, TLR2 protein expression and inflammatory factor expression in sesame treatment group were lower than those in craniocerebral injury group (P < 0.05 to P < 0.01). ConclusionsThe TLR2 expression and inflammatory response in traumatic brain injury brain tissue strengthen, and sesamin can inhibit inflammatory response and protect brain tissue from further injury.
2020, 45(1): 26-30, 34.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.007
Abstract:
ObjectiveTo analyze the relationship between the mutation of epidermal growth factor receptor (EGFR) gene and clinicopathological features in patients with lung cancer. MethodsThe tissue samples in seventy patients with advanced or locally advanced inoperable lung cancer were collected by lung puncture or bronchoscopy biopsy, and the EGFR gene mutations were detected using polymerase chain reaction (PCR).According to the test results, the patients were divided into the mutation group and no mutation group, and two groups were treated with nituzumab combined with docetaxel and cisplatin.The age, sex, smoking history, degree of differentiation, histological type, lymph node metastasis and tumor diameter characteristics were analyzed using multivariate logistic regression model, and the disease control rate (DCR) was compared between two groups. ResultsThe mutation rates of EGFR gene in both peripheral blood and biopsy specimen were 42.86% (30/70), and the consistency was good.The differences of age, sex, smoking history, degree of differentiation and histological type between two groups were statistically significant (P < 0.01), and the differences of lymph node metastasis and tumor diameter between two groups were not statistically significant (P>0.05).The mutation rate of EGFR gene in patients aged older than 50 years was higher than that in patients younger than 50 years (P < 0.01).The mutation rates of EGFR gene in female patients with lung cancer and patients without smoking history were higher than that in males and patients with smoking history, respectively (P < 0.01).The differences of the mutation rate of EGFR among patients with non-differentiated, low-differentiated and high-differentiated lung cancer were significant, and the higher the degree of differentiation was, the higher the mutation rate was (P < 0.01).The mutation rates of EGFR gene in patients with adenosquamous carcinoma and adenocarcinoma were higher than that in patients with large cell carcinoma and squamous cell carcinoma (P < 0.01).The results of multivariate analysis showed that EGFR gene mutation was independently related to the differentiation degree and histological type (P < 0.05 and P < 0.01). The efficacy in EGFR mutation group was significantly better than that in no mutation group (P < 0.01). ConclusionsEGFR gene mutations are frequently found in exons 19 and 21, and most of them are in women over 50 years old, the female, no smoking history, high differentiation, adenosquamous carcinoma, adenocarcinoma, degree of tumor differentiation and histological classification are independently related to EGFR gene mutation.The DCR of patients with EGFR gene mutation is high, which is conducive to the screening of clinical targeted therapy.
2020, 45(1): 31-34.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.008
Abstract:
ObjectiveTo study the effects of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration on the curative effect and infection of patients with severe pneumonia complicated with type Ⅱ respiratory failure. MethodsA total of 146 patients with severe pneumonia complicated with type Ⅱ respiratory failure were randomly divided into the combination treatment group and conventional treatment group (73 cases each group).The conventional treatment group were treated with conventional anti-infectin and corrected respiratory failure, and the combined treatment group were treated with fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration based on the conventional treatment group.The total effective rate, time of fever, time of mechanical ventilation, time of hospitalization, use of antibiotics and pulmonary infection between two groups before and after treatment were compared. ResultsThe total effective rate in combined treatment group (93.15%) was significantly higher than that in conventional treatment group (78.08%) (P < 0.01).The fever time, mechanical ventilation time and hospitalization time in combined treatment group were significantly lower than that in conventional treatment group (P < 0.01).The use ratio of triple antibiotics in combined treatment group (8.22%) was significantly lower than that in conventional treatment group (45.21%) (P < 0.01).The difference of the CPIS score between two groups before treatment was not statistically significant (P>0.05), which in combined treatment group after 5d and 14d of treatment were significantly lower than that in conventional treatment group (P < 0.01). ConclusionsThe effect of fiberoptic bronchoscopy sputum suction irrigation combined with vibration expectoration in treating severe pneumonia complicated with type Ⅱ respiratory failure is good, which can significantly shorten the course of disease, effectively control infection, and reduce the use of antibiotics.It is worthy of clinical promotion.
2020, 45(1): 35-39, 43.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.009
Abstract:
ObjectiveTo analyze the effect of dexmedetomidine on the recovery quality and serum neuron-specific enolase (NSE) and S100β protein levels in patients undergoing neonatal intestinal atresia surgery. MethodsSixty neonates with intestinal atresia surgery were selected and divided into observation group (n=30) and control group (n=30) according to the random number table method.During the operation, both groups received continuous intravenous infusion of remifentanil and sevoflurane inhalation to maintain anesthesia.After intubation, the observation group received continuous intravenous infusion of dexmedetomidine, and the control group received the same amount of 0.9% sodium chloride solution in the same way.The hemodynamic parameters[heart rate (HR), diastolic pressure (DBP), systolic pressure (SBP)] and bispectral index (BIS) were compared before anesthesia, 5 min after tracheal intubation, time of incision and extubation.The Ramsay sedation score of preoperation, 3 min, 15 min and 30 min after extubation, the serum level of NSE and S100β protein at preoperation, 6 h, 1 d and 3 d after operation, and the incidence rate of adverse reactions were compared in two groups. ResultsThe levels of HR, DBP and SBP before anesthesia, 5 min after tracheal intubation, time of incision and extubation in observation group were lower than those in control group (P < 0.05 to P < 0.01).The BIS value at 5 min after tracheal intubation, time of incision and extubation in two groups was lower than that of before anesthesia, and which in observation group was significantly lower than that of control group (P < 0.01).The Ramsay score at 3 min, 15 min and 30 min after extubation in two groups was higher than that of before operation (P < 0.05), and which in observation group was significantly higher than that in control group (P < 0.01).The serum level of NSE and S100β protein at 6 h, 1 d and 3 d after operation in two groups was higher than that of before operation (P < 0.05), and which in observation group was lower than that in control group (P < 0.05 to P < 0.01).The total incidence rate of adverse reactions in observation group (10.00%) was lower than that in control group (33.33%) (P < 0.05). ConclusionsThe application of dexmedetomidine in anesthesia for neonatal intestinal atresia surgery can improve the BIS value, increase the sedative effect, stabilize the hemodynamics during surgery, improve the quality of postoperative recovery, alleviate the damage to the brain nerve function, and reduce the incidence of adverse reactions.
2020, 45(1): 40-43.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.010
Abstract:
ObjectiveTo compare the clinical outcomes between RS-type lacrimal duct drainage tube and single chamber silicone lacrimal duct drainage tube in the repair of lacrimal canalicular rupture. MethodsThirty-eight patients with lacrimal canalicular rupture were divided into the observation group and control group according to the types of lacrimal duct support.The lacrimal duct supports in the observation group and control group were RS-type lacrimal tube and single chamber silicone lacrimal drainage tube, respectively.The operation time, postoperative complications and clinical effect between two groups were compared. ResultsThe operation time in observation group[(45.17±5.80) min] was significantly lower than that in control group[(57.07±5.09) min] (P < 0.01).One case with postoperative nosebleed and 1 case with lacrimal tear were identified in the observation group, and 1 case with eyelid valgus, 2 cases with catheterization and 3 cases with lacrimal tear were identified in the control group.There was statistical significance in the total incidence of postoperative complications between two groups (P < 0.05).After 3 months of extubation, the difference of the postoperative effect between two groups was not statistically significant (P>0.05). ConclusionsThe effect of RS-type lacrimal tube in the repair of lacrimal canaliculus injury is good, and the operation time and postoperative complications of which are shorter and less compared with the single chamber silicone lacrimal duct drainage tube.It is worthy of clinical application.
2020, 45(1): 44-47.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.011
Abstract:
ObjectiveTo investigate the efficacy and safety of aripiprazole in the treatment of hyperprolactinemia induced by typical or atypical antipsychotics. MethodsAccording to the prospective open-label, randomized and controlled study, 120 schizophrenic patients with hyperprolactinaemia caused by typical (chlorpromazine) or atypical antipsychotics (risperidone) were randomly divided into the chlorpromazine combined with aripiprazole groups (5 mg or 10 mg by oral), and risperidone combined with aripiprazole groups (5 mg or 10 mg by oral) (30 cases in each group), and the total treatment period was 12 weeks.The levels of prolactin before treatment and after 4, 8 and 12 weeks of treatment were detected.The efficacy and adverse reactions of antipsychotics were evaluated using positive and negative symptom scale (PANSS) and side effect scale (TESS). ResultsThe differences of the serum levels of prolactin and PANSS scores among four groups before intervention were not statistically significant (P>0.05), and there was no statistical significance in the serum levels of prolactin and PANSS scores at all time-points (P>0.05).The differences of the incidence rates of adverse reaction among four groups were not statistically significant (P>0.05). ConclusionsLow-dose aripiprazole can reverse the hyperprolactin induced by typical and atypical antipsychotics, improve the psychotic symptoms, and does not increase adverse event.
2020, 45(1): 48-50, 56.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.012
Abstract:
ObjectiveTo investigate the changes of the serum levels of tumor necrosis factor-α (TNF-α), hypersensitive Creactive protein (hs-CRP) and high mobility protein B1 (HMGB1) in patients with type 2 diabetes mellitus complicated with coronary heart disease, and its clinical significance. MethodsThirty-two patients with type 2 diabetes mellitus, 38 patients with coronary artery disease, 40 patients with type 2 diabetes mellitus complicated with coronary artery disease, and 40 healthy examiners were divided into group A, group B, group C and control group, respectively.The levels of TNF-α, hs-CRP and HMGB1 were measured by ELISA and scatter turbidimetric method. ResultsThe differences of the serum levels of hs-CRP, TNF-α and HMGB1 among four groups were statistically significant (P < 0.01), which in group C was significantly higher than that in group B, which in group B was significantly higher than that in group A, and which in group A was significantly higher than that in control group (P < 0.01).With the number of coronary artery lesions increasing, the serum levels of TNF-α, hs-CRP and HMGB1 increased, the differences of the serum levels of TNF-α, hs-CRP and HMGB1 between single-branch lesion group and double-branch lesion group were not statistically significant (P>0.05), and the differences of various indexes among other groups were statistically significant (P < 0.01).After treatment, the serum level of FPG was positively correlated with hs-CRP and TNF-α levels (P < 0.01), the serum levels of HMGB1 and hs-CRP were positively correlated with TNF-α level (P < 0.05), and the Gensini score was positively correlated with the serum level of HMGB1 (P < 0.05). ConclusionsTNF-α, hs-CRP and HMGB1 are all involved in the occurrence and development of atherosclerosis in patients with type 2 diabetes mellitus complicated with coronary heart disease.The expression levels of three indicators have guiding significance in the diagnosis of disease and treatment of patients.
2020, 45(1): 51-56.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.013
Abstract:
ObjectiveTo summarize the characteristics of SCN1A gene mutation, and clinical characteristics of related epilepsy. MethodsThe positive mutations of SCN1A gene in epilepsy children from Anhui Children's Hospital were investigated using gene sequencing, and the characteristics of SCN1A gene mutation and clinical characteristics of related epilepsy were summarized and analyzed. ResultsAmong 19 cases with SCN1A gene mutations, 8 cases with missense mutation, 7 cases with nonsense mutation, 1 case with frameshift mutation, 2 cases with shear point mutation and 1 case with non-frameshift deletion were identified.Three cases with genetic mutation and 16 cases with neonatal mutation were found.The onset age of epilepsy in 17 cases were less than 6 months.The cluster seizures in 14 cases, status epilepticus in 16 cases, and developmental retardation in 14 cases were found.Eleven cases with Dravet syndrome were diagnosed, and which included 8 cases with newborn mutations.The results of following-up showed that the seizure reduction in 6 cases were less than 50%, the seizure reduction in 11 cases were greater than 50%, 1 case died, and 1 case lost following-up. ConclusionsThe onset age of epilepsy in children with SCN1A mutation is early, and the Dravet syndrome is the most serious and common newborn mutations.Early diagnosis is helpful to choose the appropriate treatment scheme, and improve the prognosis.
2020, 45(1): 57-60.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.014
Abstract:
ObjectiveTo detect the levels of D-dimer (D-D) and fibrinogen (FIB) in patients with fracture, and analyze the relationship between the levels of D-D and FIB, and fracture site, severity and deep vein thrombosis (DVT). MethodsThree hundred and fifty fracture patients were set as the observation group, and subdivided into the group A (ISS ≤ 16 points, n=178), group B (16 points < ISS < 25 points, n=62) and group C (ISS ≥ 25 ponts, n=110) according to the severity of injury.The patients were divided into the DVT group (32 cases) and non-DVT group (318 cases) according to the DVT formation.One hundred health people were set as the control group.The levels of D-D and FIB in observation group and control group were detected. ResultsCompared with the control group, the levels of D-D and FIB in observation group significantly increased (P < 0.01).The levels of D-D in patients with multiple fractures, spine fracture, tibia and fibula fractures, foot fracture, femoral fracture, humeral fracture, ulna and radius fractures were different, and gradually decreased.The levels of FIB in patients with multiple fractures, tibiofibula fractures, foot bone fracture, spine fracture, humerus fracture, femur fracture and ulnar radius fractures gradually decreased.With the injury aggravating, the levels of D-D and FIB in all cases gradually increased (P < 0.01), and the levels of D-D and FIB in DVT group were significantly higher than those in non-DVT group (P < 0.01).The results of logistic regression analysis showed that the levels of D-D and FIB were correlated with the incidence of DVT (P < 0.01 and P < 0.05). ConclusionsThe levels of D-D and FIB can help to determine the patient's coagulation condition, severity of disease and incidence of DVT, which is the important indicators of fracture patients.
2020, 45(1): 60-63.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.015
Abstract:
ObjectiveTo evaluate the prognostic value of procalcitonin (PCT) in the early stage of continuous renal replacement therapy (CRRT) of septic-associated acute kidney injury (AKI). MethodsTwenty-five sepsis-associated AKI patients treated with CRRT were divided into the survival group (n=10) and death group (n=15) according to 28 days prognosis.At different time points after CRRT treatment, the serum PCT, white blood cell ount (WBC), C reactive protein (CRP) levels in two groups were detected, and the PCT clearance (%) was calculated.The general clinical data in two groups were recorded, and the difference of which was compared between two groups.The receiver operating curve (ROC) was used to evaluate its prognostic value. ResultsThere was no statistical significance in the levels of serum PCT, WBC and CRP between two groups at different time points (P>0.05), but the difference of serum PCT clearance between two groups was statistically significant after 24 h of CRRT shutdown (P < 0.01).The area under the ROC curve of the clearance rates of 12 h and 24 h PCT after starting CRRT were 0.620 and 0.693, respectively.The area under the ROC curve of the clearance rate of 24 h PCT after CRRT was 0.980 (95% CI:0.934-1.000).Using 21.5% as the cut-off value, the sensitivity was 90.0%, and the specificity was 100.0%. ConclusionsIn the early CRRT stage of sepsis-associated AKI patients, inflammatory indicators (PCT, WBC and CRP) have limited prognostic value.The clearance rate of 24 h PCT after CRRT shutdown has a high prognostic value.
2020, 45(1): 64-66, 70.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.016
Abstract:
ObjectiveTo investigate the differences of anesthesia effects between lumbar plexus-sciatic nerve block and combined spinal-epidural anesthesia in elderly patients treated with femoral head replacement. MethodsA total of 78 patients treated with femoral head replacement were divided into two groups according to different anesthesia methods.Thirty-nine patients treated with combined lumbar-epidural anesthesia and 39 cases treated with lumbar plexus-sciatic nerve block were divided into the spinal-epidural group and nerve block group, respectively.The hemodynamic changes and VAS score before and after anesthesia, intraoperative vasoactive drugs and analgesic drugs were observed in two groups. ResultsThere was no statistical significance in blood pressure and heart rate between two groups before anesthesia (P>0.05).After anesthesia, the difference of the heart rate and diastolic blood pressure between two groups were not statistically significant (P>0.05), and the level of systolic pressure in nerve block group was higher than that in spinal-epidural group (P < 0.01).After anesthesia, the blood pressure levels in two groups decreased compared with before anesthesia (P < 0.05 to P < 0.01), the heart rate in spinal-epidural group decreased compared with before anesthesia (P < 0.05), and the difference of the heart rate in nerve block group was not statistically significant between before and after anesthesia (P>0.05).After anesthesia, the VAS score in spinal-epidural group was significantly lower than that in nerve block group (P < 0.01), and the VAS scores in two groups were significantly lower than those before anesthesia (P < 0.01) The amount of intraoperative ephedrine and fluid supplementation in spinal-epidural group were significantly higher than those in nerve block group (P < 0.01), and the amount of intraoperative analgesic drugs in spinal-epidural group was lower than that in nerve block group (P < 0.05). ConclusionsLumbar plexus-sciatic nerve block and combined spinal-epidural anesthesia can be used in elderly patients treated with femoral head replacement.The two anesthesia methods have not significant effects on the hemodynamics of patients, the amount of analgesic drugs in combined spinal-epidural anesthesia is less, and the analgesic effect is significant.In the actual clinical anesthesia, we should fully consider the actual situation of patients to choose the appropriate anesthesia.
2020, 45(1): 67-70.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.017
Abstract:
ObjectiveTo investigate the relationships between the promoter methylation status of connective tissue growth factor (CTGF) gene and diabetic retinopathy, and its effects on the serum levels of CTGF. MethodsOne hundred and twenty hospitalized diabetic patients in endocrinology department in addition select 58 normal examined subjects in physical examination center from the Affiliated Zhongshan Hospital of Dalian University were investigated.According to the international clinical classification standards of diabetic retinopathy (2002), the diabetic retinopathy in all cases were identified using the fundus examination or fluorescein angiography.The subjects were divided into the diabetic retinopathy group (DR group, n=57), diabetes without retinopathy group (NDR group, n=63), and normal control group (NC group, n=58).The DNA was extracted from the peripheral white blood cells, the promoter methylation status of CTGF gene was detected using the methylation-specific PCR (MSP), and the serum levels of CTGF in three groups were analyzed using ELISA. ResultsThe results of statistic analysis of the MSP showed that the CTGF gene promoter methylation rate in DR group was 24.45%, which was lower than that in NDR group (42.86%) and NC group (78.95%) (P < 0.05 and P < 0.01).The serum level of CTGF in DR group was signifcantly higher than that in NDR group and NC group (P < 0.01). ConclusionsIn term of epigenetics, the promoter hypomethylation status of CTGF gene can lead to the increasing of serum level of CTGF, which may be one of the mechanisms in the occurrence and development of the diabetic retinopathy.
2020, 45(1): 71-73, 77.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.018
Abstract:
ObjectiveTo compare the clinical effectiveness between laparoscopy combined with choledochoscopy and traditional open surgery in the treatment of common bile duct stones. MethodsEighty patients with common bile duct stones treated with operation were selected.Forty cases treated with laparoscopy combined with choledochoscopy and 40 cases treated with traditional open operation were divided into the minimally invasive group (MIE group) and control group, respectively.The operation effects were compared between two groups. ResultsAll surgeries of 80 cases were successful.The difference of the operation time between two groups was not statistically significant (P>0.05).The bleeding volume, postoperative exhausting time and time of hospitalization MIE group were significantly better than those in control group (P < 0.01), and the difference of the incidence rate of complications was not statistically significant (P>0.05). ConclusionsThe laparoscopy combined with choledochoscopy in treating common bile duct stones is less bleeding volume, short postoperative gastrointestinal exhaustion time, less hospitalization time and less postoperative complications, which is a safe and effective method in the treatment of common bile duct stones in clinic
2020, 45(1): 74-77.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.019
Abstract:
ObjectiveTo investigate the effects of dual blocked RAS system with angiotensin-converting enzyme inhibitors (ACEI) combined with AT1 receptor blocker (ARB) in the treatment of elderly diabetic nephropathy. MethodsOne hundred forty-one elderly patients with diabetic nephropathy were randomly divided into the ACEI group, ARB group and combined group (47 cases in each group).The ACEI group, ARB group and combined group were treated with benazepril, valsartan and benazepril combined with valsartan for 6 months, respectively.The levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose (PBG2h), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine (SCr), blood urea nitrogen (BUN) and 24 h urinary microalbumin protein (UAER) before and after treatment, and incidence rate of adverse reactions in three groups were observed. ResultsCompared with before treatment, the levels of SBP and DBP in three groups were significantly improved (P < 0.01), the levels of FPG and HbA1c in combined group were significantly improved (P < 0.01), and the levels of PBG2h in ARB group and combined group were significantly improved after treatment (P < 0.01).After treatment, the differences of the levels of PBG2h, HbA1c, SBP and DBP among three groups were statistically significant (P < 0.05 to P < 0.01), and the improvement degrees of PBG2h, HbA1c, SBP and DBP in combined group were better than that in ACEI group and ARB group (P < 0.05 to P < 0.01).Compared with before treatment, the levels of BUN, SCr and UAER in three groups were significantly improved after treatment (P < 0.01).After treatment, the differences of the levels of BUN, SCr and UAER among three groups were statistically significant (P < 0.01), and the improvement degrees of BUN, SCr and UAER in combined group were better than that in ACEI group and ARB group after treatment (P < 0.01).One case in ACEI group and 2 cases in combined group with intractable dry cough quitted the experiment, the other cases completed experiment.The incidence rates of adverse reactions in ACEI group, ARB group and combined group were 4.24%, 4.24% and 6.36%, respectively, and the difference of which was not statistically significant (P>0.05). ConclusionsThe dual blocked RAS system with ACEI combined with ARB in treating elderly diabetic nephropathy has good effects and low incidence rate of adverse reactions, which can effectively control blood glucose, blood pressure and significantly improve the renal function, and is better than that of single ACEI or ARB and worthy of promotion.
2020, 45(1): 78-80, 84.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.020
Abstract:
ObjectiveTo compare the effects of different resin binders on the bond strength and edge microleakage of IPS e.max CAD all-ceramic crowns. MethodsA total of 63 premolars were selected as the research objects.The IPS e.max CAD all-ceramic crowns and shear strength samples were routinely prepared, and divided into the A group (21 cases), B group (21 cases) and C group (21 cases) according to the different resin adhesives.The A group was bonded with Duo-Link resin adhesive, the B group was bonded with Variolink N resin adhesive, and the C group was bonded with Kerr NX3 resin binder.The shear strength and edge microleakage length among three groups were compared and analyzed using the hot and cold cycle, micro-osmosis and shear strength tests. ResultsThere was statistical significance in the shear strength among A, B and C groups (P < 0.05).There was no statistical significance in pairwise comparisons between three groups (P>0.05).Among the marginal micro-leakage grades, the 0 to 3 grades in three groups were found, the grade 0 was mostly in A group, the grade 0 and grade 1 were mostly B group, and the grade 1 and grade 2 were mostly in C group.The difference between the three groups was statistically significant (P < 0.05);The differences between A group and B group, A group and C group, and B group and C group were statistically significant (P < 0.05). ConclusionsThe bonding strength and edge microleakage of IPS e.max CAD all-ceramic crowns are different among the application of the Duo-Link, Variolink N and Kerr NX3.The cutting strength and edge micro-leakage of the application of Kerr NX3 are the highest and lightest, respectively, which has good bonding and good edges.
2020, 45(1): 81-84.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.021
Abstract:
ObjectiveTo compare the serum lipid level between patients with benign breast disease and invasive breast cancer, and between positive hormone receptor (HR) and human epidermal growth factor receptor-2 (HER-2) -positive patients, and analyze the correlation between the level of lipid, and occurrence and development of breast cancer. MethodsOne hundred patients with invasive breast cancer (including 50 cases with HR-positive and 50 cases with HER-2-positive) and 100 patients with benign breast disease were divided into the observation group and control group, respectively.The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in two groups were detected, the relationship between the level of serum lipid and invasive breast cancer was analyzed, and the difference of the blood lipid level between HR-positive and HER-2-positive breast cancer patients was analyzed. ResultsThe serum levels of TC, TG and LDL-C in observation group were significantly higher than those in control group (P < 0.05 to P < 0.01), and the HDL-C level in observation group was significantly lower than that in control group (P < 0.01).According to the stratified analysis of pre-menopause and post-menopause, except for the LDL-C, the differences of other indicators were statistically significant (P < 0.05).The levels of TC, TG and LDL-C in HER-2-positive breast cancer patients were significantly higher than those in HR-positive patients (P < 0.05), and the level of HDL-C in HER-2-positive breast cancer patients was significantly lower than that in HR-positive patients (P < 0.05). ConclusionsThere is a certain correlation between serum lipid level and breast cancer risk for women.The high levels of TC, TG, LDL-C and low level of HDL-C may be related to the occurrence, development and molecular classifications of breast cancer, which suggests that the lipid analysis is a new direction of molecular classifications.
2020, 45(1): 85-88.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.022
Abstract:
ObjectiveTo understand the physical development of children aged 0-3 years, and provide the reference for the guidance and intervention of children's health care. MethodsThe survey objects were selected from the permanent residents in the development zones of Anqing city using the means of stratified random sampling.The valid data of 2 793 cases were obtained from the last physical examination records of children aged 0-3 years from 2014 to 2016 according to the age ratio of nearly 1:1 in different age groups.Compared with the WHO standards for child growth and development, the Z-score recommended by WHO was used for evaluation. ResultsThe body mass and body length of boys and girls were higher than that of WHO standards, and the growth trend was consistent with the reference standards.The body mass in boys at each month were higher than that in girls (P < 0.05 to P < 0.01).Except for 9 and 30 months, the height of boys in other months was greater than that of girls (P < 0.01).The middle and upper middle proportions of height body mass and age body mass in girls were higher than those in boys (P < 0.01).The wasted rate, low body mass rate, development delay rate, overweight rate and obesity rate in 0-3 years old children were 0.7%, 1.8%, 0.6%, 7.4% and 8.2%, respectively.The obesity and overweight rates in boys were higher than those in girls (P < 0.01). ConclusionsThe overall physical development of children is better, and the girl's development are more reasonable than that in boys.Malnutrition remains, and the obesity and overweight are the prominent problems of children care.
2020, 45(1): 89-93.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.023
Abstract:
ObjectiveTo investigate the prevalence and risk factors of diabetic retinopathy (DR) in patients with diabetic mellitus (DM) in a suburb of Shanghai. MethodsA population-based cross-sectional study was used.In July 2017, the registration information of 889 DM residents were obtained from the resident health archives of Baihe Center for Disease Prevention and Control.The information of blood and urine samples were analyzed, and the DR information was collected using the fundus images in all cases.The fundus images were analyzed according to the 2002 DR international clinical grading standard. ResultsThe response rate in 698 residents was 92.46%, and 743 cases (90.4%) were diagnosed by fundus images.A total of 115 DR patients were diagnosed, and the prevalence of DR was 15.5%.Among them, the mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR and proliferative DR accounted for 26.09%, 52.17%, 14.78% and 6.96%, respectively.The results of multivariate logistic regression analysis showed that the high fasting blood glucose, high glycosylated hemoglobin, and low urine creatinine were the independent risk factors of DR (P < 0.05 to P < 0.01).The diabetic macular edema (DME) in 19 patients was found, and the prevalence of which was 2.56%.The DME distribution was associated with the DR grading, and the frequency of DME increased with the increasing of DR severity (P < 0.01). ConclusionsThe prevalence of DR in DM patients in Baihe town, a suburb of Shanghai, is 15.5%.The NPDR is the main, and still in the early stage of the disease.Therefore, the diagnosis and intervention should timely be taken to prevent and control the development of DR.
2020, 45(1): 94-97.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.024
Abstract:
ObjectiveTo study the variation trend of common multi-drug resistant bacteria in a tertiary hospital, and provide the evidence for the rational use of antimicrobial drugs and prevention and control of nosocomial infections. MethodsThe data of pathogenic bacteria and drug-resistance in a hospital from 2015 to 2017 were retrospectively analyzed, and analyzed using the WHONET5.6 and SPSS20.0 software. ResultsThe composition ratio of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus in the hospital analyzed an upward trend (P < 0.05 to P < 0.01).The extended-spectrum β-lactamase (ESBLs) Escherichia coli, ESBLs-producing Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus, carbapenem-resistant large intestine Escherichia coli, carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa were the common multiple drug resistant bacteria in the hospital.Among common multi-drug resistant bacteria from 2015 to 2017, the composition ratio of ESBLs Escherichia coli, carbapenem-resistant Acinetobacter baumannii and ESBLs-producing Klebsiella Pneumoniae, methicillin-resistant Staphylococcus aureus decreased (P < 0.05 to P < 0.01), while the composition ratio of carbapenem-resistant Klebsiella, methicillin-resistant Staphylococcus aureus, and carbapenem-resistant Pseudomonas aeruginosa increased (P < 0.05 to P < 0.01).The drug-resistance of klebsiella Pneumoniae and Pseudomonas aeruginosa to carbapenems increased (P < 0.01). ConclusionsThe resistance of common pathogens in the hospital is serious.The drug-resistance of Klebsiella pneumoniae and Pseudomonas aeruginosa to carbapenems increases rapidly, the hospital should strengthen the supervision of antimicrobial agents and multi-drug resistant bacteria to control the infection and spread of multi-drug resistant bacteria.
2020, 45(1): 98-101, 105.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.025
Abstract:
ObjectiveTo investigate the application value of tumor specific growth factor (TSGF) in evaluating the severity of pneumonia, and compare it with the neutrophil (N) -lymphocyte (L) ratio (NLR), hypersensitive C-reactive protein (hs-CRP) and fibrinogen (FIB). MethodsThe clinical data and laboratory index of 79 pneumonia patients from department of respiratory medicine (pneumonia group) and 40 physical examination people from the physical examination center (control group).According to the scoring system of CURB-65, 79 patients with pneumonia were subdivided into the low-risk pneumonia group (42 cases, CRUB-65 score ≤ 1) and medium-high risk pneumonia group (37 cases, CRUB-65 score ≥ 2).The serum levels of TSGF, hs-CRP, NLR and FIB were detected.The Pearson correlation analysis was used to analyze the correlations between TSGF, and NLR, hs-CRP and FIB, the Spearman correlation analysis was used to analyze the correlation between TSGF and CURB-65 score, and the logistic regression analysis was used to analyze the correlations between TSGF, NLR, hs-CRP, FIB, N, L, age and sex, and severity of pneumonia.The predictive efficacy of the comparison the area under the curve (AUC) of TSGF with NLR, hs-CRP and FIB in the diagnosis of pneumonia was evaluated. ResultsThe TSGF level in pneumonia patients was significantly higher than that in control group (P < 0.05), the TSGF in low-risk pneumonia patients was significantly higher than that in control group (P < 0.05), and the TSGF level in medium-high risk pneumonia group further increased compared with the low-risk pneumonia group (P < 0.05).The TSGF was positively correlated with the scores of hs-CRP, FIB, NLR and CRUB-65 score (P < 0.05).In the ROC curve for predict pneumonia, the AUC of TSGF was significantly greater than that of NLR, hs-CRP and FIB (P < 0.05).TSGF was significantly correlated with the risk of pneumonia severity increasing (P < 0.01). ConclusionsTSGF may be a new biomarker for evaluating the severity of pneumonia, which is rapid, with high diagnostic efficiency, easy to analyze, and worthy of clinical application.
2020, 45(1): 102-105.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.026
Abstract:
ObjectiveTo analyze the relationship between human papillomavirus (HPV) infection, and vaginal microecology and inflammatory reaction. MethodsOne hudred and eighty-two patients with HPV infection complicated with negative cervical cytology and 160 patients with negative HPV complicated with negative cervical cytology were divided into the infection group and control group, respectively.The vaginal microecology and inflammatory response were compared between two groups.The relationship between HPV infection, and vaginal microecology and inflammatory response was analyzed using logistic regression analysis. ResultsThe differences of the proportion of leukocytes >10/HPF, and levels of tumor necrosis factor-α, interleukin-6 (IL-6) and IL-10 between two groups were not statistically significant (P>0.05).The bacterial vaginosis, vaginal candidiasis, positive aerobic vaginitis, pH>4.5, lactobacillus reduction ratio and IL-4 level in infection group were higher than those in control group (P < 0.05 to P < 0.01).The levels of IL -2, IFN-γ, IFN-γ/IL-4 and IL-2/IL-4 in infection group were lower than those in control group (P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the bacterial vaginal disease, vaginal candidiasis and aerobic vaginitis, pH, lactobacilli, IL-2, IFN-γ, IFN-γ/IL-4, IL-2/IL-4 were closely related to the HPV infection (P < 0.05 to P < 0.01). ConclusionsThe HPV infection is closely related to vaginal microecology and inflammatory reaction, which should be clinically paid attention to.
2020, 45(1): 106-109, 112.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.027
Abstract:
ObjectiveTo investigate the application value of 18F-FDG PET/CT in patients with suspected recurrence and metastasis after cervical cancer surgery. MethodsThe clinical data of 56 female patients with suspected recurrence and metastasis of cervical cancer were collected.All patients were detected using 18F-FDG PET/CT whole-body imaging, and the results were determined by semi-quantitative analysis and visual examination. ResultsAmong 56 patients, the recurrence and/or metastasis in 50 patients were found.The SUVmax of local recurrence focus ranged from 3.45 to 18.69, with an average SUVmax of 8.96.The sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of 18F-FDG PET/CT in the diagnosis of recurrence and metastasis of cervical cancer after operation were 98.0%, 83.3%, 92.1%, 96.0% and 80.0%, respectively.The sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of CT were 69.7%, 78.9%, 73.2%, 86.7% and 57.6%, respectively.The differences of the sensitivity, negative predictive value and diagnostic accuracy between two methods were statistically significant (P < 0.05).The results of 18F-FDG PET/CT imaging diagnosis were consistent with the histopathological or clinical following-up results. ConclusionsThe 18F-FDG PET/CT imaging has important clinical practical value for suspected recurrence and metastasis of cervical cancer after operation, and can provide the important information for making correct treatment plan.
2020, 45(1): 110-112.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.028
Abstract:
ObjectiveTo explore the accuracy and application value of ultrasonographic examination after bladder filling in evaluating fetal weight during postpregnancy. MethodsOne hundred and eight normal head position single fetal maternal were examined using 2D ultrasound in bladder filling and unfilling within 1 week before delivery, the fetal growth parameters were observed, and the estimation fetal weight (EFW) was measured using the Hadlock formula. ResultsThe standard shear rates of fetal double top diameter and head circumference at bladder filling and unfilling were 91/108 and 68/108, respectively, and the difference of which was statistically significant (P < 0.01).The differences of the fetal head circumference and body weight in puerperal with bladder unfilling between fetus and actual birth were statistically significant (P < 0.01), and the differences of the fetal head circumference and body weight in puerperal with bladder filling between fetus and actual birth were not statistcially significant (P>0.05).The fetal head circumference and body weight in puerperal with bladder unfilling were significantly lower than those in puerperal with bladder filling and actual birth (P < 0.01). ConclusionsThe 2D ultrasonographic examination in puerperal with bladder filling can effectively improve the accuracy of the standard section of fetal double top diameter and head circumference, the fetal body quality estimated is closer to the actual quality of birth, which can provide the help in clinicians to judge and estimate fetal body weight.
2020, 45(1): 113-117.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.029
Abstract:
ObjectiveTo further explore the current situation of medical humanities curriculum in medical college, reform the medical humanities curriculum, deepen medical humanistic education reform, and improve the quality of medical talent cultivation. MethodsThe field interview and telephone and email consultation were carried out for investigating the current situation of medical humanities curriculum setting for five-year undergraduates majoring in clinical medicine in 4 medical colleges in Anhui province, and the survey data were statistically analyzed. ResultsThe problems of great randomness, scattered disorganization, low proportion of curriculum, unreasonable structure, weak core curriculum and failure to focus on post competence were identified in medical humanities curriculum setting. ConclusionsStrengthening the unity and standardization of medical humanities curriculum setting, optimizing the curriculum structure, highlighting the core curriculum, and building a medical humanities curriculum system based on post competence should be emphasized for improving the cultivation of prominent doctors.
2020, 45(1): 120-123.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.031
Abstract:
ObjectiveTo investigate the validity of the Caprini thrombosis assessment scale in predicting the risk of venous thromboembolism (VTE) in liver failure patients treated with artificial liver. MethodsOne hundred liver failure patients treated with artificial liver were divided into the VTE group (25 cases) and control group (75 cases without VTE).The clinical data (including medical history, clinical symptoms, treatment plan and laboratory examination) were retrospectively analyzed.The risk scale of Caprini and risk grading of VET were analyzed using the Caprini thrombosis risk assessment scale.The relationship between Caprini score and onset of VTE in liver failure patients treated with artificial liver were analyzed using multivariate logistic regression model. ResultsThe Caprini score in VTE group (4.280±1.948) was higher than that in control group (2.947±2.155) (P < 0.01), and the risk grading in VTE group was lower than that in control group (P < 0.05).The results of multivariate logistic regression analysis showed that the year > 60 years, bedridden or brake > 72 h, obesity (BMI>25 kg/m2), hormone therapy and lower extremity edema were the major high-risk factors of the onset of VTE in liver failure patients treated with artificial liver.The onset risk of VTE in the extremely high-risk patients was 8.667 times of that in low risk patients. ConclusionsThe Caprini thrombosis risk assessment scale is a good risk predictor for VTE in liver failure patients treated with artificial liver.
2020, 45(1): 123-127.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.032
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ObjectiveTo investigate the cognition, source of knowledge and demand of the cluster sedation and analgesia strategis (ABCDEF bundle) of the ICU nurses from 5 grade Ⅱ and above general hospitals. MethodsA total of 200 ICU nurses in Bengbu were investigated using self-designed questionnaire. ResultsThe score of nurses' knowledge of ABCDEF bundle was (4.87±0.97), and the cognitive levels of "pain management", "sedation and analgesic scale" and "risk factors of delirium" were lower.The differences of the scores of nurses in different ICUs and working years were statistically significant (P < 0.05).The results of pairwise comparison showed that the scores of nurses in surgical and general ICU were higher than that in internal medicine department (P < 0.05 and P < 0.01), and the score of nurses working in ICU for 6 to 10 years was higher than that in nurses working in ICU for 1 to 2 years (P < 0.05).The department lectures, class training and self-research were the main approaches of ICU nurses acquiring the knowledge of ABCDEF bundle.The implementation of early activities, use of sedative and analgesic scales, delirium assessment and intervention knowledge were the greatest needs of ICU nurses. ConclusionsThe knowledge level of ABCDEF bundle in ICU nurses from 5 grade Ⅱ and above general hospitals in Bengbu is low, which cannot meet with the clinical needs.It may be related to the lack of school education and clinical continuing education, and inadequate training.It is suggested to increase the knowledge and skills of ABCDEF bundle in school curriculum and clinical training, improve the professional level of ICU nurses, standardize the clinical operation of ABCDEF bundle, so as to improve the clinical outcome of ICU patients.
2020, 45(1): 128-130.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.033
Abstract:
ObjectiveTo explore the effects of the modified shoulder delivery in the application of shoulder dystocia. MethodsA total of 84 cases with shoulder dystocia were divided into the control group (41 cases) and observation group (43 cases) according to different methods of delivery.The control group was treated with conventional delivery, and the observation group was treated with modified shoulder delivery.The incidence rate of maternal complications, degree of maternal perineal laceration, neonatal Apgar score and incidence rate of neonatal birth injury were compared between two groups. ResultsThe total incidence rate of postpartum complication in observation group was lower than that in control group (P < 0.05).There was no statistical significance in the degree of perineal laceration between two groups (P>0.05).The Agpar score and neonatal asphyxia rate in observation group were higher and lower than that in control group, respectively (P < 0.05).The total incidence rate of birth injury in observation group was lower than that in control group (P < 0.05). ConclusionsThe modified shoulder delivery can significantly reduce the incidence rates of postpartum complications and neonatal asphyxia, minimize the incidence of neonatal birth injury, and ensure the smooth delivery of childbirth.It is worthy of promotion.
2020, 45(1): 131-133.
doi: 10.13898/j.cnki.issn.1000-2200.2020.01.034
Abstract:
ObjectiveTo evaluate the clinical effects and safety of autonomic position and movement delivery in puerpera. MethodsOne hundred and ninety-two parturient women planned by vaginal delivery were divided into the observation group and control group.The observation group was treated with autonomic position and movement delivery midwifery, and the control group was treated with traditional supine or lateral position.The labor course and neonatal condition were compared between two groups. ResultsThe cesarean section and perineal incision rates in observation group were significantly lower than those in control group (P < 0.05), the vaginal delivery rate in observation group was higher than that in control group (P < 0.01), and the difference of the rate of vaginal midwifery between two groups was not statistically significant (P>0.05).The first, second and total labor time in observation group were significantly shorter than those in control group (P < 0.01).The VAS score of labor pain, postpartum 2 h blood loss and Apgar score of newborn in observation group were significantly less than those in control group (P < 0.01). ConclusionsThe autonomic position and movement delivery can transfer the maternal attention, relieve emotion, reduce labor pain, shorten labor and improve the success rate of vaginal delivery.
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