Author Login
Experts Review
Academic Editor
Editor-in-chief
2020 Vol. 45, No. 3
Display Method:
2020, 45(3): 281-285.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.001
Abstract:
ObjectiveTo explore the effect of sodium acetate Ringer's solution on inflammatory mediators and NF-κB, MAPK signaling pathway in myocardial tissue of traumatic hemorrhagic shock rats. MethodsThirty two healthy SD rats were randomly divided into shock without resuscitation group (CR group), resuscitation with 0.9% sodium chloride solution group (NR group), resuscitation with sodium lactate Ringer's solution group (LR group), and resuscitation with sodium acetate Ringer's solution group (AR group) (eight rats in each group).The shock model was made in each group (the average arterial pressure maintained at 30 mmHg).CR group was not resuscitated, NR, LR and AR group were resuscitated with corresponding solution at 60 min after shock, and observed for 4 h after resuscitation.The myocardial tissue of rats in each group was taken for morphological observation, and the expression level of related cytokines and proteins was detected. ResultsThe expression level of TNF-α mRNA of myocardial tissue in AR, LR and NR group was significantly lower than that in CR group (P < 0.01), the expression level of IL-10 mRNA in AR and LR group was significantly higher than that in CR group (P < 0.01 and P < 0.05), and the expression level of IL-4 mRNA in AR group was significantly higher than that in LR, NR and CR group (P < 0.01).The relative expression of p65 (Ser536) phosphorylation, p65(Lys310) acetylation and JNK phosphorylation protein in AR, LR and NR group was lower than that in CR group (P < 0.05 to P < 0.01), and which in AR group was lower than that in NR and LR group (P < 0.05 to P < 0.01).The relative expression of MKP-1 acetylation protein in AR, LR and NR group was higher than that in CR group (P < 0.05 to P < 0.01), and which in AR and LR group was significantly higher than that in CR group (P < 0.01). ConclusionsSudium acetate Ringer's solution for resuscitating hemorrhagic shock rats may protect myocardial tissue by regulating the expression of NF-κB and MAPK signaling pathway, and reduce the inflammatory response of myocardial tissue to a certain extent.
2020, 45(3): 286-290, 295.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.002
Abstract:
ObjectiveTo investigate the effects of ulinastatin on the miR-146a and TLR4/NF-κB signaling pathways based on sodium acetate Ringer's solution to further weaken the inflammatory damage of renal tissue in hemorrhagic shock rats. MethodsThe hemorrhagic shock model in 24 healthy SD rats were established, and divide into the shocked non-resuscitation group(SR group, n=8), sodium acetate Ringer's solution resuscitation group(AR, n=8) and ulinastatin combined with sodium acetate Ringer's solution resuscitation group(UR, n=8).The mRNA expression levels of miR-146a and inflammatory factors(TNF-α, IL-1, IL-4, IL-6 and IL-10) in the kidney tissue in three group were detected using the real-time quantitative PCR technology, the expression levels of TLR4 and NF-κB protein were detected using Western blot, and the pathological changes of the kidney tissues of rats in each group were observed under light microscope. ResultsCompared with the SR group, the expression levels of miR-146a mRNA in the renal tissues of the AR group and UR group significantly increased(P < 0.01), and compared with the AR group, the expression level of miR-146a mRNA in the UR group increased(P < 0.01).Compared with the SR group, the expression levels of TNF-α mRNA in the AR group and UR group significantly decreased(P < 0.01), while the expression level of TNF-α mRNA in the UR group still significantly decreased compared with the AR group(P < 0.01).Compared with the SR group, the expression levels of IL-1 and IL-6 mRNA in the AR group and UR group significantly decreased(P < 0.01), and there was no statistical significance in the expression levels of IL-1 and IL-6 mRNA between the UR group and AR group(P>0.05).Compared with the SR group and AR group, the expression levels of IL-4 and IL-10 mRNA in the UR group significantly increased(P < 0.01), and the differences of those between SR group and AR group were not statistically significant(P>0.05).Compared with the SR group, the expression levels of TLR4 and NF-κB protein in the AR group and UR group significantly decreased(P < 0.01).Compared with the AR group, the expression levels of TLR4 and NF-κB protein in the UR group still significantly decreased(P < 0.01).Under the light microscope, compared with the SR group, the pathological damage degree of kidney tissue in the AR group and UR group significantly alleviated, and the relieving degree of kidney tissue injury in UR group was more significant than that in AR group. ConclusionsUlinastatin may play a further protective role on the basis of sodium acetate Ringer's solution alleviating the inflammatory injury of renal tissue in rats with traumatic hemorrhagic shock, and the mechanism of which may be related to the up-regulation of miR-146a, inhibition of the TLR4/NF-κB signaling pathway and regulation of the expression of inflammatory factors.
2020, 45(3): 291-295.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.003
Abstract:
ObjectiveTo investigate the effect and clinical significance of different fluid resuscitation in patients with hemorrhagic shock on the percentage of helper T cell 17(Th17) and regulatory T cell(Treg) in peripheral blood and related cytokines, and to provide reference for clinical screening of relatively ideal resuscitation fluid. MethodsFifty-six patients with traumatic hemorrhagic shock were enrolled as the trauma group.All patients were randomly divided into sodium acetate Ringer's solution (AR) group.And the sodium lactate Ringer's solution (LR) group, 28 cases in each, 18 cases of our hospital health physician volunteers were selected as the control group.Peripheral blood was collected and the ratio of Th17 and Treg in peripheral blood was detected by flow cytometry.The levels of IL-17, IL-6 and IL-23 TNF-α level in peripheral blood of each group were detected by enzyme-linked immunosorbent assay (ELISA). ResultsCompared with the control group, the peripheral blood Th17 and Treg ratios and the levels of IL-17, IL-6, IL-23 and TNF-α in the trauma group (LR group+AR group) were significantly increased (P < 0.01).Before resuscitation, there was no significant difference in the peripheral blood Th17, Treg ratio and cytokine levels between the two groups of patients in the trauma group (P>0.05).Thirty minutes after resuscitation, the increase in Th17 ratio and IL-6 and TNF-α levels in the LR group were greater than those in the AR group (P < 0.05 to P < 0.01);there was no significant difference in the level of Treg ratio, IL-17, and IL-23 in the two groups(P>0.05).One hour after resuscitation, there was no statistically significant difference in the changes of the two groups (P>0.05). ConclusionsCompared with sodium lactate Ringer's solution, the early resuscitation with sodium acetate Ringer's solution further inhibits the release of Th17 cells and IL-6 and TNF-α in peripheral blood of patients with traumatic hemorrhagic shock, thereby reducing the patient's body inflammation.
2020, 45(3): 296-299.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.004
Abstract:
ObjectiveTo explore the rescue effect of different restrictive fluid resuscitation on traumatic hemorrhagic shock patients (HS) and the effects on coagulation function (prothrombin time, activated partial thrombin time) and thromboelastic diagram (K, R, MA, etc.). MethodsForty HS patients were randomly divided into sodium acetate linge fluid group(AR group) and sodium lactate linge fluid group(LR group), with 20 cases in each group.AR group recovery liquid using sodium acetate ringer's solution, LR group recovery liquid using sodium lactate ringer's solution, adopt restrictive liquid recovery, recovery method respectively and recovery for 1 hour prior to the recovery after extracting peripheral venous blood samples, by comparing the two groups of patients with peripheral blood coagulation function and thrombus elastic figure, to observe the recovery effect of two kinds of liquid. ResultsBefore the onset of resuscitation, there was no statistically significant difference between the two groups in peripheral blood clotting function and thromboelastic diagram (P>0.05).One hour after resuscitation, compared with the LR group, there were statistically significant differences in parameters related to thrombin time and kinetics time in the AR group(P < 0.05). ConclusionsCompared with sodium lactate ringer's solution, sodium acetate ringer's solution for resuscitation of HS patients can better control the coagulation function of patients and related parameters of thromboelastic diagram, so that the liquid resuscitation of HS patients can achieve curative effect in the early stage.
2020, 45(3): 300-305.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.005
Abstract:
ObjectiveTo explore the effects of the enzymatic glycosylation product modified by enzymatically non-benzoquinone geldanamycin(GA) on the proliferation and apoptosis of breast cancer cells. MethodsA new non-benzoquinone GA glucoside was prepared using enzymatic glycosylation in vitro.The product was characterized by ESI-MS and nuclear magnetic resonance(NMR) analysis.The anti-cancer activities of the compound were evaluated using malachite green-molybda colour reaction, MTT assay and flow cytometry with PI staining in vitro.The effects of the compound on expression levels of Akt, Bcl-2 and heat shock protein 90(Hsp90) were detected using Western blot. ResultsThe structure of novel non-benzoquinone GA glucoside was characterized as 17-demethoxy-reblastatin-18-O-β-D-glucopyranoside(1).Compound 1 could significantly inhibit the activity of Hsp90 ATPase, the IC50 value of which was 8.98 μmol/L.Compound 1 could inhibit the proliferation, and induce apoptosis in MCF-7 cells of human breast cancer in a concentration-dependent manner.The results of Western blot showed that, with the increasing of compound 1 concentration, the induced degradation of Akt and bcl-2 protein was more obvious, while the expression of Hsp90 protein was not affected. ConclusionsThe new Hsp90 inhibitor, compound 1, can inhibit the proliferation, and induce apoptosis of MCF-7 cells, the mechanism of which may be by inhibiting the activity of Hsp90 ATPase, and inducing the degradation of Hsp90 client protein Akt and Bcl-2.
2020, 45(3): 306-310.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.006
Abstract:
ObjectiveTo investigate the protective effects of N-acetylcysteine(NAC) on ethanol-induced Chang hepatocellular injury. MethodsThe Chang hepatocytes were cultured in vitro, and divided into the control group, ethanol treatment group, and high, medium and low dose NAC protection groups.The cell survival rate of ethanol-induced hepatocellulars injury model by NAC pretreatment was determined, and the effects of aspartate aminotransferase(AST), alanine aminotransferase(ALT), intracellular reactive oxygen species(ROS), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) were evaluated.The protective effects of NAC on ethanol-induced Chang hepatocellular injury were analyzed. ResultsAfter NAC pretreatment, the cell survival rate was higher than that of the ethanol-treated group(P < 0.05).The results of cell morphology showed that the cellular morphology in NAC intervention group was better than that in ethanol-treated group.The NAC pretreatment could significantly reduce the contents of TNF-α and IL-6 in cell supernatant, and levels of AST, ALT and ROS in cells(P < 0.05). ConclusionsThe NAC intervention can alleviate the Chang hepatocellular injury induced by ethanol treatment in vitro, and reduce the levels of intracellular ROS and inflammatory factors.
2020, 45(3): 311-314.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.007
Abstract:
ObjectiveTo study the effect of sulforaphane on the proliferation of colon cancer HT-29 cells and its potential mechanism. MethodsCCK8 was used to detect the effect of sulforaphane on the proliferation of HT-29 cells.Flow cytometry was applied to determine the apoptosis of HT-29 cells.ELISA was performed to measure the levels of transforming growth factor β1 (TGF-β1).Western blotting was carried out to analyze the expression of p-Smad3, Smad4, Cyclin D1 and c-Myc protein. ResultsCCK8 results showed that the inhibitory effect of sulforaphane on the proliferation of HT-29 cells increased with the increase of drug concentration and time (P < 0.05 to P < 0.01).The apoptosis rate of HT-29 cells treated with 10, 20, 40 μmol/L sulforaphane was higher than that in control group (P < 0.05 to P < 0.01).The results of ELISA showed that the level of TGF-β1 in cell culture medium in 10, 20, 40 μmol/L sulforaphane group was lower than that in control group (P < 0.05 to P < 0.01).The expression of p-Smad3, Smad4, Cyclin D1 and c-Myc protein in HT-29 cells after treatment with 10, 20, 40 μmol/L sulforaphane was decreased compared with control group (P < 0.05 to P < 0.01). ConclusionsSulforaphane can inhibit the proliferation of colon cancer HT-29 cells, the mechanism of which might be related to the regulation of TGF-β1/Smad signaling pathway.
2020, 45(3): 315-319.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.008
Abstract:
ObjectiveTo investigate the effects of inhibiting the miR-31 expression on the proliferation and apoptosis of human keratinocyte cells, and its mechanism. MethodsThe HaCaT cells were cultured, and transfected using transient transfection method.These cells were divided into the antisense oligonueleotide(ASO) group(treatment with miR-31 ASO), control ASO group(treatment with control ASO) and blank control group(treatment with blank plasmid).The cell proliferation, apoptosis, cell cycle and Rho related domain BTB protein 1(RhoBTB1) expression in three groups were detected using MTT assay, Annexin V-FITC/PI double staining, PI single staining and Western blotting, respectively. ResultsThe expression level of miR-31 in ASO group were significantly lower than that in ASO control group and blank control group(P < 0.01).The absorbance values in ASO group at 24 h, 48 h, 72 h and 96 h were significantry lower than that in ASO control group and blank control group(P < 0.05 to P < 0.01), and the absorbance values in three groups gradually increased as time went on(P < 0.01).The apoptotic rate, proportion of G0/G1 phase cells and expression level of RhoBTB1 protein in ASO group were significantly higher than those in ASO control group and blank control group(P < 0.01), while the proportion of S/G2 phase cells in ASO group were significantly lower than those in ASO control group and blank control group(P < 0.01). ConclusionsmiR-31 may be involved in the proliferation and apoptosis of human keratinocyte cell lines HaCaT cells, which may achieve this biological process by regulating the expression of RhoBTB1 protein.
2020, 45(3): 319-322.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.009
Abstract:
ObjectiveTo compare the therapeutic effects, blood drug concentration and prognosis between empirical and non-empirical use of vancomycin in patients with severe Gram-positive(G+) cocci infection, and analyze the clinical related factors of affecting patient death. MethodsAccording to the exact etiological evidence, the patients without etiological evidence were treated with vancomycin, and set as the group E; the patients with etiological evidence were treated with vancomycin, and set as the group P.The valley concentration, cure rate of 7 d anti-infection, 28 d survival rate, renal function and curative effects were compared between two groups.The clinical related factors of death in two groups were analyzed using multivariate logistic regression. ResultsAmong 60 patients with severe infection, 39 cases in group E and 21 cases in group P were identified.There was no statistical significance in age, body mass, biochemical index, disease severity and valley concentration between two groups(P>0.05), but the differences of body temperature and 28 d survival rate between two groups after 72 h of tretament with vancomycin were statistically significant(P < 0.05).The results of multivariate logistic regression analysis of related clinical factors showed that the cocci infection was associated with patient death confirmed by ancomycin valley concentration, urea nitrogen and culture. ConclusionsCompared with the non-experimental use of vancomycin, the empirical use of vancomycin can decrease the 28 d survival rate, and affect the patient's anti-infection efficacy, while there is not difference in blood drug concentration between two groups.The clinical patient's kidney function, urea nitrogen and culture confirm that the cocci infection is related to the poor prognosis and death of patients, so it is recommended that vancomycin be administered after the diagnosis of G+ cocci infection, and that renal function should be monitored.
2020, 45(3): 323-326.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.010
Abstract:
ObjectiveTo investigate the clinical, imaging and pathological features of mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes syndrome(MELAS). MethodsThe clinical, imaging and pathological data of 4 cases with MELAS were retrospectively analyzed. ResultsThere were 1 case of seizure, 2 cases of headache and 1 case of fever complicated with disturbance of consciousness.The results of cranial MRI showed that the parietal, occipital and/or temporal lobes lesions were long or slightly longer T1WI/T2WI and FLAIR hyperintensity, gyri-like changes, and not enhancement.The disappearance or fracture of transverse striations and irregular red edge fibers(RRF) under the muscle membrane were found in 3 cases detected by muscle biopsies.One case with mitochondrial DNA A3243G site mutation was found by routine gene testing, and the muscle biopsy in 1 case was not be done during the multiple hospitalizations. ConclusionsThe strokelike episodes complicated with seizures, visual and hearing loss, and cognitive impairment are the major performance of MELAS.The imaging features show that the lesions are mainly involved in the posterior cortex of both cerebral hemispheres, and gyri-like changes.The RRF can be found using the muscle biopsy, and the mutations in mitochondrial DNA A3243G can be found using gene testing.
2020, 45(3): 327-330, 334.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.011
Abstract:
ObjectiveTo investigate the mutation of DNA methyltransferase 3A(DNMT3A) R882 in patients with acute myeloid leukemia(AML), and analyze the characteristics of related clinical data. MethodsThe mutations of DNMT3A R882 in 116 patients with AML and 30 patients with iron deficiency anemia were detected using DNA gene sequencing. ResultsAmong 116 patients with AML, 16 cases with DNMT3A R882 mutation were identified, which included 9 cases with R882H mutation and 7 cases with R882C mutation, all mutations were heterozygous mutations, while there was not mutation in benign control group.The number of patients with normal karyotype AML(NK-AML), and M4 and M5 in DNMT3A R882 mutation AML(Mut-DNMT3A) group were significantly higher than that in DNMT3A wild type AML(Wild-DNMT3A) group(P < 0.05).The patient age, and white blood cell amount and platelet amount in peripheral blood in Mut-DNMT3A group were significantly higher than those in Wild-DNMT3A group(P < 0.05).The overall survival rate and disease-free survival rate in Mut-DNMT3A group were significantly lower than those in Wild-DNMT3A group(P < 0.05). ConclusionsDNMT3A R882 mutation is easy to occur in AML patients, especially NK-AML, M4 and M5 patients, and complicated with risk factors of old age and high white blood cell amonut.DNMT3A R882 mutation is a biological marker of poor prognosis in AML patients.
Application value of balloon dilation guided by color doppler ultrasound in vascular access stenosis
2020, 45(3): 331-334.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.012
Abstract:
ObjectiveTo compare the efficacy between balloon dilatation guided by color ultrasound and surgical reconstruction in the treatment of hemodialysis autogenous fistula anastomotic proximal stenosis(within 2 cm from the anastomosis). MethodsThe clinical data of 69 patients with arteriovenous fistula anastomotic proximal stenosis were retrospectively analyzed.The patients were divided into the group A(36 cases treated with percutaneous transluminal angioplasty(PTA) and group B(33 cases treated with revascularization surgery).The patency rates in two groups at 1, 3 and 6 months of after treatment were evaluated. ResultsThe dialysis time, clinical success rate and technical success rate in group A were(4.11±3.06) years, 97% and 100%, respectively.The dialysis time, clinical success rate and technical success rate in group B were (3.85±2.81) years, 94% and 100%, respectively.The patency rates in A group at 1, 3 and 6 months after treatment were higher than that in group B(P < 0.05).There was no statistical significance in the incidence rate of complications between two groups(P>0.05).There was no statistical significance in the intravascular diameter of internal fistula stenosis and brachial artery blood flow between two groups before operation and after 1 month of operation(P>0.05).The blood vessel diameter and blood flow in two groups after operation were significantly greater than those before operation(P < 0.01). ConclusionsThe effects of balloon dilatation guided by color ultrasound and surgical reconstruction in the treatment of hemodialysis autogenous fistula anastomotic proximal stenosis are the same.The balloon dilatation guided by color ultrasound is simple, the patients can be dialysed after operation, the vascular resources can be preserved, so which can be recommended as the preferred treatment for arteriovenous fistula anastomotic proximal stenosis.
2020, 45(3): 335-337, 341.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.013
Abstract:
ObjectiveTo observe the effects of electroacupuncture on the expression level of microRNA-133a in sepsis patients complicated with myocardial injury. MethodsSixty sepsis patients complicated with myocardial injury were randomly divided into the electroacupuncture group and control group(30 cases in each group).Two groups were treated with routine method, and the electroacupuncture group were additionally treated with electroacupuncture for 7 d.The expression level of microRNA-133a, APACHE Ⅱ score, and levels of caspase-3, Bcl-2, TNF-α, IL-6, cTnT and LVEF in two groups were compared between before and after treatment. ResultsAfter treatment, the obvious changes of the APACHEⅡscore, levels of microRNA-133a, caspase-3, Bcl-2, TNF-α, IL-6, cTnT and LVEF were found in two groups, and those in electroacupuncture group were significantly better than those in control group(P < 0.01).There were the linear relationships between microRNA-133a, and APACHEⅡscore, caspase-3, Bcl-2, TNF-α, IL-6 and cTnT. ConclusionsThe effect of electroacupuncture in treating sepsis patients complicated with myocardial injury is good, and microRNA-133a can be used as an indicator in diagnosing sepsis complicated with myocardial injury.
2020, 45(3): 338-341.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.014
Abstract:
ObjectiveTo analyze the related factors of pathological escalation after endoscopic submucosal dissection(ESD) in patients with low-grade intraepithelial neoplasia(LGIN) of esophagus. MethodsThe clinical data of 83 patients with esophageal LGIN diagnosed by pathology before ESD from March 2013 to March 2018 were retrospectively analyzed.The univariate and multivariate logistic regression analysis were used to analyze the related factors of pathological escalation after ESD. ResultsAmong 83 cases with esophageal LGIN, there were 44 cases(53.01%) with pathological escalation after ESD, which included 8 cases of early esophageal squamous cell carcinoma and 36 cases of high-grade intraepithelial neoplasia(HGIN).The results of postoperative pathology showed that 35 cases(42.17%) were esophageal LGIN, and 4 cases(4.82%) were chronic esophageal inflammation.Thirty-five cases were diagnosed using narrow-band imaging magnifying endoscopy before ESD, the depth of invasion in 30 cases were accurately judged, and the accuracy rate of which was 85.71% (30/35).The results of univariate analysis showed that the incidence rate of the pathological escalation in patients with nodular changes and reddening of mucosal surface was significantly higher than that in patients without nodular changes and redness of mucosal surface(P < 0.01 and P < 0.05), but there was no statistical significance in the incidence rate of pathological escalation in patients with different gender, ages, endoscopic classification, lesion ranges, lesion location and lesion morphology(P>0.05).The results of multivariate logistic regression analysis showed that nodular changes(OR=3.86, 95%CI:1.63-9.14) and mucosal surface rednes(OR=2.95, 95%CI:1.60-5.41) were the influencing factors of pathological escalation in patients with esophageal LGIN after ESD(P < 0.01). ConclusionsThe postoperative pathological escalation of esophageal LGIN is common, and the nodular changes and redness of mucosal surface are the risk factors of pathological escalation.In clinical practice, we should pay more attention to this kind of patients.It is of great clinical significance to improve the accuracy of preoperative pathological evaluation using narrow-band imaging magnifying endoscopy diagnosis and auxiliary pathological examination.
2020, 45(3): 342-344, 347.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.015
Abstract:
ObjectiveTo evaluate the effects of pelvic floor rehabilitation training on the incidence rate and electrical stimulation of pelvic organ prolapse(POP). MethodsA total of 1 629 patients with delivery, pelvic floor muscle strength screening and treatment were divided into the control group(795 cases) and observation group(834 cases).In the control group, the regular pregnancy examination was conducted, no intervention during pregnancy was carried out, and the pelvic floor rehabilitation were implemented in patients with postpartum POP.In the observation group, the regular pregnancy examination and intervention during pregnancy(including health education, diet guidance, quality management and pelvic floor muscle training) were carried out, and the postpartum rehabilitation treatment, electrical stimulation combined with biofeedback therapy and maternal pelvic floor muscle function exercise were implemented.In two groups, the incidence of disease were analyzed at postpartum 42 d, and the improvement of puerpera POP were observed at postpartum 6 months. ResultsAt postpartum 42 d, compared with the observation group, the proportion of the grade Ⅰ and Ⅱ muscle tension in the control groups was higher, and the results of POP-Q showed that the prevalence rate of SUI in control group(38.23%) was significantly higher than that in observation group(28.89%) (P < 0.05).At postpartum 6 moths, the results of the muscle tension test showed that the proportion of the grade Ⅰ and Ⅱmuscle tension in two groups significantly decreased.At postpartum 6 months, the results of POP-Q showed that the prevalence rate of SUI in two groups significantly decreased, and which in control group was higher than that in observation group(P < 0.05).After 6 months of treatment, the improvement of POP-Q in observation group was significantly better than that in control group(P < 0.05). ConclusionsThe maternal pelvic floor rehabilitation training can effectively reduce the incidence rate of POP, and improve the effects of the electrical stimulation treatment.
2020, 45(3): 345-347.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.016
Abstract:
ObjectiveTo analyze the role of CRUSADE score in assessing the risk of gastrointestinal bleeding in patients with coronary heart disease treated with antiplatelet therapy. MethodsA total of 145 patients with coronary heart disease treated with antiplatelet drug for more than one year were selected and divided into gastrointestinal bleeding group(n=45) and non-gastrointestinal bleeding group(n=100) according to whether the patients had gastrointestinal bleeding or not.The clinical characteristics were compared, and the risk of gastrointestinal bleeding in two groups was evaluated by CRUSADE score. ResultsThe age of the patients in gastrointestinal bleeding group was significantly higher than that in non-gastrointestinal bleeding group(P < 0.01).The proportion of peptic ulcer and bleeding history in patients in gastrointestinal bleeding group was significantly higher that in non-gastrointestinal bleeding group(P < 0.01).There was no significant difference in gender, smoking history, Helicobacter pylori infection history, abnormal history of liver and kidney function, oral clopidogrel bisulfate tablet, aspirin enteric-coated tablet and the combination rate of the two drugs in two groups(P>0.05).The result of CRUSADE score showed that the risk degree of patients in gastrointestinal bleeding group was significantly higher than that in non-gastrointestinal bleeding group(P < 0.01). ConclusionsThe use of CRUSADE score in patients with coronary heart disease treated with antiplatelet therapy is beneficial to assess the risk of gastrointestinal bleeding.For patients with CRUSADE score of high risk and very high risk of gastrointestinal bleeding, proton pump inhibitor can be used to reduce the risk of gastrointestinal bleeding caused by long-term use of antiplatelet drug.
2020, 45(3): 348-350, 354.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.017
Abstract:
ObjectiveTo explore the integrated chemotherapy in the treatment of locally advanced gastric cancer in the elderly. MethodsSixty elderly cases with locally advanced gastric cancer were randomly divided into observation group and control group (30 cases in each group).The observation group was treated with interventional therapy of 5-fluorouracil 1.0 g/m2 plus oxaliplatin 130 mg/m2, and oral tegiol 40 mg each time at one week after surgery, bid, for 4 weeks, rest for 2 weeks, which was a cycle.The treatment efficacy was evaluated after two cycles.The control group was treated with oral tegiol following the same dose and course of treatment as the observation group, and oxaliplatin 150 mg/m2 was used intravenously.The short-term efficacy, adverse reactions and prognosis in two groups were compared. ResultsThe objective response rate and disease control rate in observation group were 50.0% and 83.3%, respectively, which were 26.6% and 50.0% in control group, respectively.There was a significant difference in treatment efficacy between two groups (P < 0.01).The adverse reactions in two groups were mostly mild to moderate, and were alleviated after symptomatic treatment, the difference of which was not statistically significant (P>0.05).The median progression-free survival was 17 months, with 95%CI of 16.53 to 25.28 in observation group, which were 13 months and 10.98 to 14.18 in control group, and the survival time in observation group was significantly longer than that in control group (P < 0.01).Univariate analysis showed that the survival time of patients was correlated with the location of tumor, duration of disease, surgery or not, and postchemotherapy (P < 0.05 to P < 0.01), and was not significantly correlated with the gender, pathological type and gross type (P>0.05).Multivariate analysis showed that grouping was an independent prognostic factor (P < 0.01, 95%CI=19.89-21.54). ConclusionsThe application of integrated chemotherapy in treating locally advanced gastric cancer in elderly patients can improve the prognosis with good safety.
2020, 45(3): 351-354.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.018
Abstract:
ObjectiveTo investigate the characteristics of carve of labour duration in the first labour stage by analyzing 1 913 cases of nulliparous women. MethodsA total of 1 913 cases of nulliparous women with singleton, full-term and cephalic presentation were selected and divided into natural parturient group (n=1 523) and oxytocin group (n=390).The age, birth gestational age, body mass, height, neonatal birth mass, dilatation and duration of uterine cervix, the time required for uterine cervix dilatation per 1 cm in two groups were collected and retrospectively analyzed. ResultsThe birth gestational age in natural parturient group and oxytocin group was (39.6±0.9) weeks and (39.9±1.1) weeks, respectively, the difference of which was statistically significant (P < 0.05).There was no significant difference in age, body mass, height, body mass index and neonatal birth mass between two groups (P>0.05).The carve of labour duration of nulliparous women showed a slowly rising trend in the first stage of labour, and the carve of labour duration presented ascending trend after the cervix opened 5 cm in two groups.The duration of uterine opening at 3-4, 4-5, 5-6 and 7-8 cm in natural parturient group was longer than that in oxytocin group (P < 0.05 to P < 0.01), and there was no significant difference in the duration of uterine opening at 6-7, 8-9 and 9-10 cm between two groups (P>0.05).There was no significant difference in the starting point distribution of active phase between two groups (P>0.05). ConclusionsBoth Friedman labour curve and the new obstetrics labor standard can not exactly describe the characteristics of labor in China.More maternal labor data in China should be further collected, and a suitable curve of labor duration should be drawn to guide the labor process.
2020, 45(3): 355-359, 362.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.019
Abstract:
Objective:To analyze the short and mid-term effects of beraprost sodium combined with cyclophosphamide in the treatment of nephrotic syndrome(NS). MethodsNinety-six patients with NS from January 2015 to May 2017 were randomly divided into the control group and observation group(48 cases in each group).The control group was treated with the routine comprehensive method, and the observation group was additionally treated with beraprostis sodium combined with cyclophosphamide based on control group.The disease control rate, recurrence rate, renal function index[creatinine clearance(CCR), albumin (ALB), creatinine (Scr), 24h urinary protein excretion rate(UAER) and urea nitrogen (BUN)], blood lipid indicators[triglyceride(TG) and total cholesterol(TC)], coagulation parameters[D-dimer(D-D) and fibrinogen(FIB)], P-glycoprotein 170(P-gp170) and incidence arte of adverse reactions were compared between two groups. ResultsThe disease control rate(93.75%) in observation group was better than that in control group(68.75%)(P < 0.01).After 6 months and 1 year of treatment, the recurrence rates in observation group(2.08% and 4.17%) were lower than those in control group(16.67% and 18.75%), respectively(P < 0.05).After treatment, the CCR and ALB levels in observation group were significnatly higher than those in control group, while the levels of Scr, UAER and BUN in observation group were significnatly lower than those in control group(P < 0.05).After treatment, the levels of TG and TC in observation group were significnatly lower than those in control group(P < 0.05), and the levels of TG and TC in two groups were significnatly lower than those before treatment(P < 0.05).After treatment, the P-gp170 levels in two groups increased compared with before treatment, but the increasing degree of which in observation group was smaller than that in control group(P < 0.05).There was no statistical significance in the incidence rate of adverse reactions between the observation group(4.17%) and control group(8.33%) (P>0.05). ConclusionsThe bereprost sodium combined with cyclophosphamide in the treatment of NS can improve the multidrug resistance, optimize blood lipid metabolism, improve renal function and coagulation function, increase disease control rate, reduce the recurrence of the disease, and is safe and reliable.
2020, 45(3): 360-362.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.020
Abstract:
ObjectiveTo explore the value of transient evoked otoacoustic emissions (TEOAE) combined with automatic auditory brainstem response (AABR) in hearing screening in high-risk newborns. MethodsA total of 140 high-risk newborns with hearing impairment factors were selected and divided into two groups according to whether their two ears passed the TEOAE primary screening.Sixty newborns who failed to pass the primary screening were set as the control group, and 80 newborns who passed the primary screening were set as the observation group.The re-screening was performed at 42 days and 3 months after birth, respectively.The passing rate of newborns in primary screening and re-screening by TEOAE, AABR, and TEOAE combined with AABR were compared between the two groups. ResultsThe passing rate in the primary screening and re-screening at 42 days and 3 months after birth by TEOAE, AABR, and TEOAE combined with AABR in observation group was significantly higher than that in control group (P < 0.01).The passing rate in the primary screening and re-screening at 42 days after birth by TEOAE and AABR was significantly higher than that by TEOAE combined with AABR (P < 0.01), but there was no significant difference in the passing rate of re-screening at 3 months after birth (P>0.05). ConclusionsThe combination of TEOAE and AABR has high values in hearing screening in high-risk newborns, which can reduce the incidences of missed diagnosis and false-positive rates, and is worthy of clinical application.
2020, 45(3): 363-366.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.021
Abstract:
ObjectiveTo explore the effects of different types of hypertensive disorder complicating pregnancy(HDCP) on pregnancy outcome. MethodsOne hundred and sixty-eight pregnant women with different types of HDCP were selected using simple sampling, and set as the observation group.One hundred and sixty-eight normal pregnant women in the same period were set as the control group.The adverse outcomes of pregnant womanl, fetus and neonate were recorded, counted and analyzed in two groups. ResultsThe total incidence rates of adverse outcomes in perinatal stage in observation group and control group were 48.81% and 3.57%, respectively.Except for the HDCP, the difference of the incidence rate of other complications between two groups was not statistically significant(P>0.05).The incidence rate of placenta abruption complications in observation group was higher than that in control group(P < 0.05 to P < 0.01).The incidence rate of two kinds of complications in observation group was higher than that in control group(P < 0.01), and the difference of the incidence rate of three kinds of complications between two groups was not statistically significant(P>0.05).The incidence rate of adverse outcomes of fetuses in observation group and control group were 58.42% and 6.90%, respectively.The incidence rates of fetal death, fetal distress and fetal growth restriction of fetus in observation group were higher than those in control group(P < 0.05 to P < 0.01).The incidence rate of two kinds of complications in fetuses of observation group was higher than that in control group(P < 0.01), and the difference of the incidence rate of three kinds of complications in fetuses between two groups was not statistically significant(P>0.05).The incidence rate of neonatal adverse outcomes during perinatal period in observation group and control group were 46.55% and 4.93%, respectively.The incidence rates of the neonatal asphyxia and SGA in observation group were higher than those in control group(P < 0.01).The incidence rate of two kinds of complications in neonates in observation group was higher than that in control group(P < 0.01), and the differences of the incidence rates of death and three kinds of complications of neonates were not statistically significant(P>0.05).The differences of the incidence rates of gestational hypertension, preeclampsia, eclampsia, pregnancy complicated with chronic hypertension, chronic hypertension complicated with preeclampsia perinatal placental abruption, fetal death and neonatal death between two groups were not statistically significant(P>0.05). ConclusionsHDCP can seriously impact on the maternal and infant prognosis, and the effects gradually increase with the development of disease.Strengthening the screening, early detection and intervention should be done to improve the quality of maternal and infant prognosis.
2020, 45(3): 367-370.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.022
Abstract:
ObjectiveTo evaluate the effect of modified percutaneous intramedullary fixation with Kirschner wire for treatment of the fifth metacarpal neck fracture. MethodsA total of 24 patients with closed fracture of the fifth metacarpal neck were selected and divided into control group(n=11) and operation group(n=13) according to the treating method.The control group was treated with traditional reduction and plaster external fixation, and the operation group was treated with closed reduction and modified percutaneous intramedullary fixation with Kirschner wire.The total active movement(TAM) system was used to evaluate the functional recovery of the two groups. ResultsThe operation time of closed reduction and modified percutaneous intramedullary fixation with Kirschner wire was 15 to 25 minutes.The X-ray examination after operation indicated that the fracture was restored well.The results of TAM system showed that there were 10 excellent cases and 3 good cases in operation group, and 3 excellent cases, 4 good cases and 4 fair cases in control group, and the difference of the therapeutic effect between two groups was statistically significant (uc=2.40, P < 0.05).There was no irritation or injury of the dorsal branch of the ulnar nerve after operation in operation group. ConclusionsClosed reduction and improved percutaneous intramedullary fixation with Kirschner wire for the treatment of the fifth metacarpal neck fracture is simple and easy to operate, with short external fixation time, minimal trauma, fewer complications and satisfactory results, which is worth popularizing.
2020, 45(3): 371-374.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.023
Abstract:
ObjectiveTo translate the Oxford Knee Score (OKS) to form the Chinese version of OKS and validate its reliability and validity, to improve the quality of diagnosis and treatment of knee osteoarthritis. MethodsThe English version of OKS was translated, cross-culturally adapted and revised to form the Chinese version of OKS.Then one hundred patients with knee osteoarthritis were selected for initial test, and 30 patients of them were selected for retest to evaluate the reliability and validity of the scale. ResultsThe Chinese version of OKS had good retest reliability and internal reliability.The intraclass correlation coefficient and Cronbach's α coefficient both in initial test and retest was above 0.8.The scale had good content validity and structure validity.Spearman correlation analysis showed that the correlation coefficient was above 0.7 in all items of this scale, the correlation coefficient was above 0.4 between this scale and corresponding sub-items of SF-36 scale, and the correlation coefficient was also above 0.4 between this scale and VAS scale. ConclusionsThe Chinese version of OKS has good reliability and validity, which can be used to evaluate the knee joint function of patients with knee osteoarthritis in mainland China.
2020, 45(3): 375-377.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.024
Abstract:
ObjectiveTo analyze the trend and risk factors of single drug-resistance in tuberculosis(TB) patients in recent years, and provide a reference for the early detection of drug-resistance tuberculosis. MethodsThe clinical data of the TB patients from the Fuyang Infectious Disease Hospital from 2015 to 2017 were collected, the single drug-resistance trend of four kinds of first-line anti-TB drug was analyzed, and the clinical characteristics and risk factors associated with single drug-resistance were further investigated. ResultsThe drug-resistance rates of isoniazid, rifampicin, ethambutol and streptomycin of the first-line anti-TB drugs did not increase or decrease within 3 years(P>0.05).The farmers, history of TB exposure, pulmonary cavities, bilateral lung involvement, complicated with chronic obstructive pulmonary disease and long-term hormone use could increase the risk of drug-resistance in TB patients(P < 0.05 to P < 0.01), and the concomitant diabetes was a protective factor in the development of drug-resistance TB(P < 0.01). ConclusionsThe drug-resistance in the farmers, history of TB exposure, pulmonary cavities, bilateral lung involvement, complicated with chronic obstructive pulmonary disease and long-term hormone use patients should timely be detected, and the targeted treatment for single drug-resistance TB patients should be implemented.
2020, 45(3): 378-381.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.025
Abstract:
ObjectiveTo explore the clinical application value of digital radiography (DR) combined with dual-energy subtraction (DES) in the diagnosis of pneumoconiosis. MethodsA total of 102 patients with pneumoconiosis were selected and underwent both DR combined with DES and film-screen radiography (FSR) to take the whole chest radiography.The image quality and diagnostic information of the two techniques were compared. ResultsThe rate of excellent film, fine film, poor film and waste film of DR combined with DES was 96.08%, 3.92%, 0.00% and 0.00%, respectively; which of FSR was 72.55%, 16.67%, 7.84% and 2.94%, respectively; the rate of excellent film of DR combined with DES was significantly higher than that of FSR (P < 0.01).Eighty-one cases of pneumoconiosis above stage one were detected by DR combined with DES, the detection rate of which was 79.41%;sixty-one cases of pneumoconiosis above stage one were detected by FSR, the detection rate of which was 59.80%;the detection rate of DR combined with DES for pneumoconiosis was higher than that of FSR (P < 0.05).The detection rate of DR combined with DES for mediastinal lymphadenopath, pulmonary infection, emphysema and pleural thickening was higher than that of FSR (P < 0.05 to P < 0.01).At the same time, the small shadow distribution of the same stage pneumoconiosis detected by DR combined with DES was larger than that by FSR. ConclusionsDR combined with DES has better image quality and detection rate, which can be applied to the examination and diagnosis of pneumoconiosis.
2020, 45(3): 381-383, 387.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.026
Abstract:
ObjectiveTo investigate the effects of pure aortic regurgitation on the vertebral artery blood flow spectrum. MethodsSixty-three patients with aortic regurgitation from January 2014 to April 2017 were set as the observation group, and subdivided into the mild, moderate and severe aortic insufficiency(AR) (21 cases in each group).Twenty-one cases with normal transthoracic echocardiography and cervical artery ultrasound were set as the control group.The bilateral vertebral artery spectrum curves and spectrum morphology in two gorups were observed, and the hemodynamic parameters(including PSV, EDV and RI) in two groups were analyzed. ResultsThe systolic heavy wave with similar or equal peaks appeared in the mild, moderate and severe AR groups, the occurrence rates of which were 24%, 62% and 81%, respectively.Five cases with diastolic blood flow reaching baseline and 3 cases with reverse in moderate AR group, and 4 cases with diastolic blood flow reaching baseline and 11 cases with reverse in severe AR group were identified.Fourteen cases with systolic heavy wave complicated with diastolic blood reaching baseline or diastolic blood flow reverse were found.The differences of the PSV, EDU and RI of vertebral artery were not statistically significant between the control group and mild AR group(P>0.05).In observation group, the EDV decreased, and RI increased with the increase of AR(P < 0.01). ConclusionsThe systolic heavy wave can occur in patients with mild, moderate and severe AR, and the diastolic blood flow reaching baseline or reverse only occurs in moderate and severe AR.AR is highly suspected when the vertebral artery presents the above changes in the blood flow spectrum.
2020, 45(3): 384-387.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.027
Abstract:
ObjectiveTo investigate the infection rate of human papilloma virus (HPV) among women in Baoshan district of Shanghai and its relationship with age, as well as the distribution of various subtypes, so as to provide the theoretical basis for the prevention and treatment of cervical cancer in this region. MethodsTwenty-seven HPV genotypes were detected by flow fluorescence hybridization in the samples of cervicalexfoliatedcells from 7 709 women.The relationship between HPV infection rate and age, and the distribution characteristics of HPV subtype infection were analyzed. ResultsIn the 7 709 cases, 1 237 cases were HPV-positive with the infection rate of 16.05%, and all the 27 HPV subtypes were found.Among them, 833 cases were high-risk genotype with the infection rate of 10.81%, and the top five high-risk genotypes were HPV 52, 16, 53, 58, 39;254 cases were low-risk genotype with the infection rate of 3.29%, and the top five low-risk genotypes were HPV61, 43, 55, 81, 6.HPV infection was mainly distributed in 41-50 and 31-40 years old groups, and the difference of infection rate among different age groups was statistically significant(P < 0.01).In the 1 237 cases with HPV infection, it was mainly the single genotype infection, followed by double infection, and a few multiple infection. ConclusionsHPV infection is mainly single high-risk genotype, and the common high-risk genotypes are HPV52, 16, 53, 58, 39.The peak age of HPV infection is between 41 and 50 years old.HPV genotype and age should be taken into account in the screening, prevention and treatment of cervical cancer as well as the development and application of vaccines.
Value of molecular biology method in detection of Mycobacterium tuberculosis and its drug resistance
2020, 45(3): 388-391.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.028
Abstract:
ObjectiveTo explore the value of molecular biology method in the detection of Mycobacterium tuberculosis (MTB) and its drug resistance. MethodsThe accuracy, minimum detection limit and detection period of Xpert MTB/RIF assay, gene chip assay, modified Roche culture assay and proportion assay in detecting MTB were analyzed using standard MTB strain H37Rr as control, and single-drug resistant and multi-drug resistant MTB diluted gradiently as the test sample. ResultsThe minimum detection limit of modified Roche culture assay and Xpert MTB/RIF assay was 3×102 cfu/mL, which was 3×104 cfu/mL for gene chip assay.Xpert MTB/RIF assay resulted in false-positive rifampicin resistance when the concentration was 3×102 cfu/mL, and could not detect isoniazid resistance.The detection period of Xpert MTB/RIF assay was ≤ 2 h, which was ≤ 8 h for gene chip assay, and five to eight weeks for modified Roche culture assay and proportion assay. ConclusionsIn the detection of MTB and its drug resistance, molecular biology methods have obvious advantages in detection period, and each method has its own advantages in the minimum detection limit and accuracy.The economic level and critical degree of patients should be considered in the clinical diagnosis, so to choose appropriate detecting method.
2020, 45(3): 391-397.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.029
Abstract:
ObjectiveTo explore the role of self-management in the relationship between parental expectations and college students' achievement motivation based on the ecological systems theory and self-determination theory. MethodsA total of 1 436 college students were surveyed by the parental expectation questionnaire, achievement motivation scale and college students self-management questionnaire. ResultsThere were significant differences in achievement motivation among college students in terms of gender, grade, parenting style, training level and family monthly income.Parental expectation and its dimensions were positively correlated with success and failure avoidance(P < 0.01), personality maturity of parental expectation was positively correlated with achievement motivation(P < 0.01), and relationship dimension was negatively correlated with achievement motivation(P < 0.01);self-management and its dimensions were positively correlated with success and achievement motivation(P < 0.01), and negatively correlated with failure avoidance(P < 0.01).Parental expectations could significantly predict behavior management, cognitive management and time management, while behavior management, emotional management and cognitive management could significantly predict achievement motivation.Behavior management and cognitive management partially mediated between parental expectations and achievement motivation(P < 0.05 to P < 0.01). ConclusionsThe internalization of parental expectations is the key mechanism affecting achievement motivation.Self-management is the nearest factor affecting achievement motivation.Good self-management can help college students weaken and restrain the negative influence of unreasonable parental expectations.
2020, 45(3): 398-402.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.030
Abstract:
ObjectiveTo explore the correlation between anxiety symptom, mobile phone dependence and sleep quality of students in a higher vocational college. MethodsA total of 1 826 higher vocational college students from grade one to grade three in Lu'an Anhui were selected.The mobile phone dependence behavior, anxiety symptom and sleep quality of the research objects were evaluated by the self-rating questionnaire for adolescent problematic mobile phone use (SQAPMPU), self-rating anxiety scale (SAS) and Pittsburgh sleep quality index (PSQI). ResultsThe detection rate of sleep quality problems in higher vocational college students was 15.6% (285/1 826).Anxiety (OR=3.343, 95%CI:2.545-4.390) and mobile phone dependence (OR=1.910, 95%CI:1.448-2.519) were the independent risk factors of sleep quality problems.The results of stratified analysis showed that the students who had both anxiety symptom and mobile phone dependence had the highest risk of sleep quality problems (OR=4.642, 95%CI:3.315-6.501), compared with those who had anxiety symptom and non-mobile phone dependence (OR=2.100, 95%CI:1.794-2.525), or who had mobile phone dependence and non-anxiety symptom (OR=2.011, 95%CI:1.465-2.759). ConclusionsThe detection rate of sleep quality problems in higher vocational college students is higher.Anxiety symptom and mobile phone dependence are the risk factors of sleep quality problems.Students with both anxiety symptom and mobile phone dependence have higher risk of sleep quality problems.
2020, 45(3): 402-405.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.031
Abstract:
ObjectiveTo explore the relationship between clinical nurses' work value and job performance, and dual mediating effect of intrinsic motivation and self-efficacy. MethodsA total of 409 clinical nurses were investigated using self-designed general information questionnaire, work value scale, intrinsic motivation scale, self-efficacy scale and job performance scale, and the results of which was analyzed to construct the structural equation model. ResultsThe Work value, work performance, intrinsic motivation and self-efficacy were positively correlated(P < 0.01).The structural equation model showed that the work value, intrinsic motivation and self-efficacy had direct effects on job performance, and the work value was also mediated by motivation and self-efficacy, which had indirect effects on job performance(P < 0.05).The standardized path coefficients of work value, intrinsic motivation and self-efficacy on job performance were 0.18, 0.42 and 0.16, respectively(P < 0.01), and the total standardized effect of work value on job performance was 0.48.External variable work value, intrinsic motivation and self-efficacy could explain 40% of the total variation of job performance of internal variable. ConclusionsHospital and nursing managers should actively mobilize nurses' intrinsic motivation and self-efficacy, and improve the job performance system and management system of nurses.
2020, 45(3): 406-409.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.032
Abstract:
ObjectiveTo explore the application effects of improved and traditional prone position nursing strategies in patients with acute respiratory distress syndrome(ARDS). MethodsFrom June 2017 to May 2019, 47 ARDS patients with prone position were divided into the control group(27 cases) and observation group(20 cases).The control group and observation group were nursed with traditional prone position(head and chest pad prone position and pillow elevation) and improved prone position nursing strategy based on mechanical distribution, respectively.The occurrence of complications(pressure injury and vomiting), changes of hemodynamics[heart rate(HR), mean arterial pressure(MAP) and central venous pressure(CVP)] and changes of respiratory mechanics[airway resistance(R), chest and lung compliance(Cst)] before and after prone position were compared between two groups. ResultsThe incidence rate of stress injury in observation group was lower than that in control group(P < 0.05).There was no statistical significance in the incidence of vomiting and accidental detubation between two groups(P>0.05).The differences of the HR and CVP between two groups were not statistically significant before prone position and after 1h, 2h and 4h of prone position(P>0.05).The MAP in observation group before prone position was higher than that in control group(P < 0.05), and the differences of MAP between two groups were not statistically significant after 1h, 2h and 4h of prone position(P>0.05).The R in observation group before and after 1 h of prone position were higher than that in control group(P < 0.05 and P < 0.01), while there was no statistical significance in R between two groups after 2 h and 4 h of prone position(P>0.05).The differences of the Cst between two groups were not statistically significant before and after 1h, 2h and 4h of prone position(P>0.05). ConclusionsCompared with the traditional prone position nursing strategy, the improved prone position ventilation nursing strategy can reduce the incidence of complications in ARDS patients, which is worthy of clinical promotion.
2020, 45(3): 410-413.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.033
Abstract:
ObjectiveTo observe the effects of the cognitive behavioral intervention and muscle relaxation training on psychological stress level and well-being in patients treated with in-vitro fertilization and embryo transfer(IVF-ET). MethodsOne hundred and sixteen patients treated with IVF-ET from May 2017to July 2018 were were divided into the observation group and control group by random number table method(58 cases in each group).The control group was treated and nursed with routine method after admission.The observation group was treated with cognitive behavioral intervention and muscle relaxation training on the basis of the control group.Before and after treatment(completing embryo transfer), the anxiety and depression, and sleep condition in two groups were evaluated using self-rating anxiety scale(SAS) and self-rating depression scale(SDS), and self-rating scale of sleep(SRSS), respectively.The serum levels of cortisol in two groups were detected using chemiluminescent immunoassay.The well-being in two groups after treatment were assessed using Memorial University of Newfoudland Scale of Happiness(MUNSH), and the pregnancy in two groups after 1 month of treatment were identified using ultrasound examination. ResultsBefore treatment, the differences of the scores of SDS and SAS were not statistically significant between two groups(P>0.05).After treatment, the scores of SDS and SAS in two groups were significantly lower than those before intervention, and the SDS and SAS scores in observation group were significantly lower than those in control group(P < 0.01).Before treatment, the difference of the sleep quality score was not statistically significant between two groups(P>0.05).After treatment, the sleep quality in observation group was significantly better than that in control group(P < 0.01).Before treatment, the difference of the cortisol level was not statistically significant between two groups(P>0.05).After treatment, the cortisol level in observation group was significantly lower than that in control group(P < 0.01).The pregnancy rate in observation group was higher than that in control group(P < 0.05).The negative score of the MUNSH scale in observation group was significantly lower than that in control group, and the positive score and total score in obseravtion group were significantly higher than those in control group(P < 0.01). ConclusionsThe cognitive behavioral intervention combined with muscle relaxation training can effectively alleviate anxiety and depression, improve sleep quality and well-being, reduce psychological stress and improve pregnancy success rate in patients treated with IVF-ET.
2020, 45(3): 414-417.
doi: 10.13898/j.cnki.issn.1000-2200.2020.03.034
Abstract:
ObjectiveTo determine the influencing factors of discharge readiness in patients with ischemic stroke. MethodsA total of 381 ischemic stroke patients were investigated using general data questionnaire and readiness for hospital discharge scale, and the factors influencing the discharge readiness were analyzed. ResultsIn the 381 patients, 224 (58.8%) patients were adequately ready for discharge, and 157 (41.2%) patients were inadequately ready for discharge.Univariate analysis showed that age, gender, educational level, living alone or not, having nursing care or not after discharge and hospital stay were related to the discharge readiness in ischemic stroke patients (P < 0.05 to P < 0.01).The results of multivariate logistic regression analysis showed that age, gender, education level, having nursing care or not after discharge and hospital stay were the independent influencing factors of the discharge readiness in ischemic stroke patients (P < 0.05 to P < 0.01). ConclusionsHealth care professionals should focus on the discharge readiness in older, female, less educated, unattended and long-hospitalized patients, and actively take personalized and targeted intervention measures to improve the discharge readiness of ischemic stroke patients.
Email
RSS