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2020 Vol. 45, No. 6
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2020, 45(6): 701-703.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.001
Abstract:
ObjectiveTo investigate the clinical application value of the single and combined detection of the neutrophil to lymphocyte ratio(NLR), lymphocyte(LY) and C reactive protein(CRP) in the early diagnosis of corona virus disease 2019(COVID-19). MethodsFifty-three patients with COVID-19 and 90 patients with other respiratory diseases were divided into the COVID-19 group and control group, respectively.The levels of NLR, LY and CRP between two groups were retrospectively analyzed and compared.The ROC curve was used to analyze the application value of the single and combined detection of NLR, LY and CRP in the early diagnosis of COVID-19. ResultsThe levels of NLR and CRP in COVID-19 group were higher than those in control group, and the level of LY in COVID-19 group was significantly lower than that in control group(P < 0.01).The area under the ROC curve of the single and combined detection of NLR, LY and CRP in the diagnosis of COVID-19 were 0.610, 0.705, 0.833 and 0.817, respectively.The sensitivities and specificities of the single and combined detection of NLR, LY and CRP in the diagnosis of COVID-19 were 31.0%, 69.8%, 67.9%, 58.5% and 96.7%, 62.2%, 80.0%, 92.2%, respectively.The diagnosis value of the combined detection of NLR, LY and CRP were higher than that of the single detection of NLR, LY and CRP. ConclusionsThe combined detection of NLR, LY and CRP can increase the specificity and sensitivity of early diagnosis of COVID-19, which can guide the clinical treatment as soon as possible, and improve the cure rate of COVID-19.
2020, 45(6): 704-707.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.002
Abstract:
ObjectiveTo investigate the clinical significance and correlation of the serum levels of D-dimer, C reactive protein(CRP) and interleukin-6(IL-6) in corona virus disease 2019(COVID-19). MethodsThe clinical data of 128 COVID-19 patients were retrospectively analyzed, and the patients were divided into the ordinary group(102 cases), severe group(22 cases) and critical group(4 cases) according to the clinical classification.Ninety non-COVID-19 and non-severe community-acquired pneumonia patients were set as the control group.The differences of the serum levels of D-dimer, CRP and IL-6 between the control group and ordinary group, and among the ordinary group, severe group and critical group were compared.The correlation between the serum levels of D-dimer and CRP, IL-6 in patients with COVID-19 were analyzed. ResultsThe serum levels of D-dimer and CRP in ordinary group were lower than those in control group(P < 0.05), and there was no statistical significance in the serum level of IL-6 between two groups(P>0.05).There were statistical significance in the serum levels of D-dimer, CRP and IL-6 among the ordinary group, severe group and critical group(P < 0.01).The serum levels of D-dimer, CRP and IL-6 in severe group and critical group were higher than those in ordinary group(P < 0.05), and the serum levels of D-dimer in COVID-19 patients were positively correlated with the serum levels of CRP and IL-6(P < 0.01). ConclusionsThe serum levels of D-dimer, CRP and IL-6 are conducive to assess the severity and prognosis of patients with COVID-19.
2020, 45(6): 708-711.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.003
Abstract:
ObjectiveTo analyze the clinical characteristics of 11 children with corona virus disease 2019(COVID-19). MethodsThe epidemiology, clinical manifestations, laboratory examinations, chest imaging, treatment and prognosis of 11 children with COVID-19 were retrospectively analyzed. ResultsThe children with COVID-19 were mostly mild or normal, with asymptomatic infection, and the fever and cough were the most common clinical manifestations.The results of laboratory examination showed that the white blood cell count and absolute value of lymphocytes decreased, the serum levels of amyloid A and interleukin-6 increased, the serum levels of C reactive protein and procalcitonin were normal, and the levels of CD4+ and CD8+ decreased.The prognosis was good. ConclusionsThe COVID-19 of children mostly presents familial aggregation of disease, the mild disease is more common.There is not definitely effective drug at present, and the prognosis of children is good.
2020, 45(6): 711-713.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.004
Abstract:
ObjectiveTo observe the relationship between the test indexes of patients with corona virus disease 2019(COVID-19) and disease severity, and identify the critical patients early. MethodsThe data of 86 patients with COVID-19 were collected.The patients were divided into the non-severe group(n=68) and severe group(n=18) according to the severity of illness.The results of laboratory test in two groups were analyzed using SPSS 18.0.software. ResultsThe differences of the gender, age, and history of residence in Wuhan between two groups were not statistically significant(P>0.05).The lymphocyte count and percentage, and total T lymphocytes, CD4+ lymphocytes and CD8+ lymphocytes in the T-cell subset of severe group were lower than those of non-severe group, while the levels of lactate dehydrogenase(LDH), C reactive protein, serum amyloid A, and interleukin-6 in severe group were higher than those in non-severe group(P < 0.01).The results of logistic regression analysis showed that the LDH level increasing was a risk factor in the exacerbation of patients with COVID-19, and the CD4+ lymphocytes decreasing was the protective factors. ConclusionsThe changes of many laboratory indexes in patients with COVID are significant, which has some reference value in the assessment of the disease severity, especially for the severe patients with the LDH increasing and CD4+ lymphocytes decreasing.
2020, 45(6): 714-719.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.005
Abstract:
ObjectiveTo investigate the role of mitochondrial fusion and fission regulated by AMPK in the protective effects of inhibiting P2X7 receptor against hypoxia/reoxygenation injury in neurons. MethodsThe primary neurons were cultured, and randomly divided into the Control group, hypoxia/reoxygenation(H/R) group, H/R+Bright Blue G(BBG) group, H/R+BBG+Dorsomorphin group.The viability of neurons was assessed using Calcein-AM/PI kit, the ROS level was detected using ROS kit, the morphology of mitochondrial morphology was detected using Mito Tracker TM Green FM kit, and the expression levels of p-AMPK, p-Drp1 and Mfn2 were detected using Western blotting. ResultsCompared with Control group, the death rate, mitochondrial fission and level of ROS in neurons increased significantly in H/R group.After pretreated with BBG, the death rate, fission of mitochondrial and level of ROS in neurons with H/R injury decreased significantly, while the protective effects of inhibitor of AMPK Dorsomorphin on neurons with H/R injury were attenuated(P < 0.01).Compared with the Control group, the results of Western blotting showed that the expression levles of p-AMPK and Mfn2 decreased significantly, while the expression level of p-Drp1 increased markedly in H/R group(P < 0.01).After pretreated with BBG, the expression levels of p-AMPK and Mfn2 increased significantly, while the expression level of p-Drp1 decreased markedly.The inhibitor of AMPK Dorsomorphin weakened the BBG increasing the expression levels of p-PMAK and Mfn2 in H/R injured neurons and decreas the expression level of p-Drpl(P < 0.01). ConclusionsThe inhibition of P2X7 receptor can reduce the damage of neurons induced by H/R injury through inhibiting mitochondrial fission to promote mitochondrial fusion, which may be involved in the activation of AMPK.
2020, 45(6): 720-724.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.006
Abstract:
ObjectiveTo explore the expression level of Fhit gene in endometrial carcinoma, and observe its effects on the proliferation, invasion and migration of endometrial carcinoma cells through the RNA activation up-regulating the expresson of Fhit. MethodsThe expression levels of Fhit protein in 135 endometrial carcinoma tissues and 40 normal endometrial tissues were detected using immunohistochemistry and Western blotting.The correlation between Fhit expression and clinicopathological features was analyzed.The Fhit-saRNA expression vector was constructed, and transfected into endometrial carcinoma ISK cell line, and the endometrial carcinoma cell line with Fhit up-regulating expression was established.The transfection effects were verified using Western blotting and RT-PCR.The differences of the proliferation, migration and invasion abilities between before and after transfection were analyzed using CCK-8 and Transwell assays. ResultsThe results of immunohistochemistry and Western blotting showed that the expression levels of Fhit in endometrial carcinoma tissue significantly reduced or even missed compared with normal endometrial tissue(P < 0.01).The results of CCK-8 showed that the growth of endometrial carcinoma significantly slowed down after the up-regulating of Fhit expression, and the difference of which between transfection group and non-transfection group was statistically significant(P < 0.01).The results of Transwell assay showed that the migration and invasion abilities of endometrial carcinoma cells after the level of Fhit up-regulating significantly weakened, and the number of transmembrane cells in blank control group were significantly higher than that in transfection group(P < 0.01). ConclusionsCompared with normal endometrial tissues, the expression level of Fhit in endometrial carcinoma tissues is lower, and related to the clinicopathological features.After up-regulating the Fhit expression by RNA activation in endometrial carcinoma cell line, the abilities of proliferation, migration and invasion of cells are significantly inhibited.
2020, 45(6): 725-730.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.007
Abstract:
ObjectiveTo investigate the effects and molecular mechanism of Epimedium herb(EH) on islet β cells injury induced by high glucose and lipid. MethodsThe model of high glucose and lipid injury of islet β cells RINm5F was established.The cells were divided into the control group(treatment with 5 mmol/L glucose), high glucose and lipid(treatment with 25 mmol/L glucose and 0.25 mmol/L PA), low dose EH group(treatment with 25 mmol/L glucose, 0.25 mmol/L PA and 10 μmol/L EH), high dose EH group(treatment with 25 mmol/L glucose, 0.25 mmol/L PA and 100 μmol/L EH).After 48 h of treatment, the cell proliferation and apoptosis were detected using MTT assay and flow cytometry, respectively.The expression levels of CyclinD1, P21, B cell lymphoma/lewkmia-2(Bcl-2) and Bcl-2 associated X(Bax) protein were analyzed using Western blotting.The expression level of miR-19a-3p mRNA in RINm5F cells was detected using real-time quantitative PCR(qPCR).The high glucose and lipid damaged RINm5F cells were transfected using anti-miR-19a-3p or miR-19a-3p in the high dose EH group, and the proliferation and apoptosis of the cells were observed. ResultsCompared with the control group, the cell proliferation activities at 48 h and 72 h, CyclinD1 and Bcl-2 protein levels significantly decreased(P < 0.05), and the apoptosis rate, miR-19a-3p expression, P21 and Bax protein expression levels significantly increased in high glucose and lipid group(P < 0.05).The intervention of different doses of EH could significantly improve the proliferation capacity and levels of CyclinD1 and Bcl-2 protein of cells under high glucose and lipid environment, and significantly reduced the apoptosis rate and expression levels of P21 and Bax protein(P < 0.01), and the difference between which and effect of inhibiting miR-19a-3p was not statistically significant(P>0.05).The overexpression of miR-19a-3p could reverse the EH promoting effect on proliferation and inhibiting apoptosis of RINm5F cells stimulated by high glucose and lipid(P < 0.01). ConclusionsEH protects islet β cells damage induced by high glucose and lipid through miR-19a-3P, improves cell proliferation activity and inhibits apoptosis.
2020, 45(6): 731-734, 738.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.008
Abstract:
ObjectiveTo explore the clinical value of serum betatrophin level in patients with type 2 diabetic nephropathy. MethodsA total of 45 healthy outpatients were enrolled as the control group.Eighty-two patients with T2DM were set as the T2DM group, and were subdivided into the normal albuminuria group [urinary albumin creatinine ratio(UACR) < 30 mg/g], microalbuminuria group(UACR at 30-300 mg/g) and macroalbuminuria group(UACR>300 mg/g).The serum level of betatrophin was measured using enzyme linked immunosorbent assay, and the levels of blood glucose and blood lipid were measured simultaneously. ResultsThe levels of betatrophin, FPG, FIns, HOMA-IR, HbA1c and TG in T2DM group were significantly higher than those in control group(P < 0.05), and the levels of betatrophin, FPG, FIns, HOMA-IR and FCP in macroalbuminuria group were significantly higher than those in normal albuminuria group(P < 0.05).The serum level of betatrophin in T2DM patients was positively correlated with the TG(r=0.425), FPG(r=0.287), UACR(r=0.319) and HOMA-IR(r=0.292) (P < 0.01).The results of stepwise multiple regression analysis showed that betatrophin and LDL-C were the independent relevant factors affecting UACR, and the UACR and TG were the independent relevant factors affecting betatrophin level. ConclusionsThe serum level of betatrophin in patients with type 2 diabetic nephropathy increases significantly, and gradually increases with the aggravation of the disease, which suggest that betatrophin may be involved in the occurrence and development of diabetic nephropathy.
2020, 45(6): 735-738.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.009
Abstract:
ObjectiveTo investigate the clinical value of nano carbon tracing sentinel lymph node(SLN) in laparoscopic surgery for early endometrial cancer. MethodsForty patients with early endometrial cancer were treated with laparoscopic double appendages combined with pelvic and/or paraaortic lymphadenectomy.During the operation, the SLN were identified using nano carbon tracer, and the detection of black stained SLN was recorded.The pathological examination of the removed lymph nodes after the operation was performed. ResultsAmong 40 patients, 142 black stained lymph nodes in 37 cases were detected, with an average of 3.8 per patient, and the detection rate was 92.5%.There was no statistical significance in the SLN detection rate of different injection sites, phases and tumor diameters(P>0.05).The SLN of endometrial carcinoma was mainly distributed in external iliac lymph nodes(32.4%, 46/142) and obturator lymph nodes(25.7%, 37/142).The sensitivity of nano carbon tracing SLN was 100%, and the negative predictive value was 100%. ConclusionsThe technique of nano carbon tracing SLN in early endometrial carcinoma under laparoscopy is feasible, which provides an effective basis for the determination of lymph node metastasis and selection of surgical scope.
2020, 45(6): 739-741.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.010
Abstract:
ObjectiveTo detect the expression levels and clinical significance of matrix metalloproteinase-7(MMP-7) and vascular endothelial growth factor(VEGF) in gastric cancer tissues of patients with Helicobacter pylori(Hp) infection. MethodsThe gastric cancer tissues were collected from Department of General Surgery and Tumor Surgery Operating Rooms of the First Affiliated Hospital of Bengbu Medical College from January 2015 to November 2018, and were divided into two groups according to whether with Hp infection.The expression levels of MMP-7 and VEGF were detected using the fluorescence quantitative PCR and immunohistochemistry. ResultsAmong 60 cases of gastric cancer tissues, the mRNA expression levels of MMP-7 and VEGF in Hp-positive group, patients with serous layer infiltration and lymph node metastasis were higher than in Hp-negative group, patients without serous layer infiltration and lymph node metastasis(P < 0.01).There was a positive correlation between MMP-7 and VEGF mRNA expressions(r=0.498, P < 0.01).The Hp was positively correlated with MMP-7 and VEGF expression levels, and the expression level of MMP-7 was positively correlated with VEGF(P < 0.05 to P < 0.01). ConclusionsMMP-7 and VEGF may be related to the occurrence and development of gastric cancer, and Hp, MMP-7 and VEGF may play a synergistic role in the occurrence and development of gastric cancer.The expression level of MMP-7 is positively correlated with VEGF.
2020, 45(6): 742-744, 747.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.011
Abstract:
ObjectiveTo estimate the bone graft effect after modified alveolar bone grafting(ABG). MethodsThe clinical data of 44 patients with unilateral alveolar cleft were retrospectively analyzed.The patients were divided into the modified ABG approach group(group A, 22 cases) and conventional ABG group(group B, 22 cases), and followed up for 12 months.The successful rate of bone graft and recovery of bone volumen between two groups after operation were compared. ResultsThe successful rate of operation in group A (82.8%) was higher than that in group B(50.0%) (P < 0.05).After 3, 6 and 12 month, the survival of graft in defect region in group A was higher than that in group B(P < 0.05).The survival of graft in defect region in two groups after 3 months were higher than that after 6 and 12 months(P < 0.01), and the difference of survival of graft in defect region bewteen 6 and 12 months in two groups were not statistically significant(P>0.05). ConclusionsFor patients with unilateral alveolar cleft, the modified alveolar bone grafting can effectively improve the survival rate of bone graft, and the recovery of bone mass obviously increases after operation.The postoperative bone resorption mainly occurs in the first 6 months of operation, and is basically stable at 6 to 12 months.
2020, 45(6): 745-747.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.012
Abstract:
ObjectiveTo explore the effects of single-nucleotide polymorphism of the FTO gene on laparoscopic Roux-en-Y gastric bypass. MethodsSixty fat patients were treated with the laparoscopic Roux-en-Y gastric bypass.The body mass index(BMI), serum fasting plasma glucose(FPG) and blood glucose at 2 hours after meal(2hPG) before operation, and after 1, 3, 6 and 12 months of operation were measured, and recorded, and the single-nucleotide polymorphism of FTO gene were detected in all cases. ResultsThe TT(46 cases, 76.67%), TA(13 cases, 21.67%) and AA(1 case, 1.67%) genotypes were identfied.Due to the small number of AA individuals, the AA group and TA group was put together for analyzing.The differences of the sex, age, BMI and FBG at preoperative and postoperative time points were not statistically significant between two groups(P>0.05).The 2hPG in TA+AA group before operation and postoperative 3 months were significantly higher than that in TT group(P < 0.05), while the differences of 2hPG between two groups after 6 and 12 months of operation were not statistically significant(P>0.05). ConclusionsThe potential type 2 diabetes patients may exists the rs9939609 A allele, the laparoscopic Roux-en-Y gastric bypass should be implemented regardless of whether their blood glucose is normal, and the sleeve gastrectomy in simple obesity patients with rs9939609 T allele may be performed.
Effect of different tidal volume on lung injury in patients with acute respiratory distress syndrome
2020, 45(6): 748-752, 756.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.013
Abstract:
ObjectiveTo investigate the effects of different tidal volume on lung injury in patients with acute respiratory distress syndrome(ARDS). MethodsThe respiratory system compliance(C)=0.6 mL·cmH2O-1·kg-1 was set as the critic point, the patients were divided into the C≥0.6 group[9 cases with (C)≥0.6 mL·cmH2O-1·kg-1 and C < 0.6 group(10 cases with C < 0.6 mL·cmH2O-1·kg-1).At different tidal volume (6 mL/kg.IBW, 8 mL/kg.IBW, 10 mL/kg.IBW, 12 mL/kg.IBW), the end-expiratory lung volume(EELV) was detected, the pulmonary strain was calculated, and the changes of peak pressure(Ppeak) and plateau pressure(Pplat) were observed. ResultsWith the increasing of tidal volume, the Ppeak and Pplat increased, and the Pplat was ≤30 cmH2O.The differences of the Pplat between the tidal volume of 6 mL/kg.IBW and 8 mL/kg.IBW, 10 mL/kg.IBW, 12 mL/kg.IBW were statistically significant(P < 0.05).When the tidal volume increased gradually from 6 mL/kg.IBW to 12 mL/kg.IBW, the the pulmonary strain increased from (0.31±0.27) to (0.52±0.46), and the tidal volume was positively correlated with pulmonary strain(r=0.978, P < 0.01).Compared with 6 mL/kg.IBW, the pulmonary strain in C≥0.6 group significantly increased under 12 mL/kg.IBW tidal volume ventilation, and the difference of which was statistically significant(P < 0.05).Under 10 mL/kg.IBW and 12 mL/kg.IBW tidal volume ventilation, the pulmonary strain was more than 0.27.Compared with VT=6 mL/kg.IBW, the differences of the pulmonary strain in C < 0.6 group among 8 mL/kg·IBW, 10 mL/kg·IBW and 12 mL/kg.IBW tidal volume ventilation were not statistically significant(P>0.05), and the pulmonary strain under different tidal volumes was more than 0.27. ConclusionsFor the ARDS patients with C≥0.6mL·cmH2O-1·kg-1, the tidal volume increasing to 8 mL/kg.IBW does not aggravate lung injury.For the ARDS patients with C < 0.6mL·cmH2O-1·kg-1, the ventilation with 6 mL/kg.IBW tidal volume can still aggravate lung injury.
2020, 45(6): 753-756.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.014
Abstract:
ObjectiveTo investigate the incidence rate and risk factors of premature white matter injury. MethodsThe gestational age and birth weight of 568 premature infants were analyzed, and the incidence rate of premature white matter injury and its high-risk factors were investigated. ResultsThe incidence rate of white matter injury in premature infants was 22.2%.In terms of gestational age, the incidence rate of white matter injury in premature infants with gestational age < 28 weeks was the highest.In terms of body mass, the incidence rate of white matter injury in preterm infants with birth weight less than 1.0 kg was the highest.The results of univariate analysis showed that the sepsis, hypoxemia, mechanical ventilation, threatened preterm delivery, intrauterine infection, intrauterine distress, acidosis, history of asphyxia, high blood pressure during pregnancy, prenatal hormones, gestational age and body weight at birth significantly affected the brain white matter injury(P < 0.05).The results of multivariate regression analysis showed that infection during pregnancy, history of asphyxia, cesarean section, and acidosis were the independent risk factors of the occurrence of white matter injury(P < 0.05). ConclusionsThe lower the gestational age is, the lower the birth weight of premature infants is, and the higher the probability of white matter injury is.The infection during pregnancy, asphyxia history, cesarean section and acidosis are the independent risk factors of white matter injury.
2020, 45(6): 757-759, 763.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.015
Abstract:
ObjectiveTo study the the correlations between the level of aquaporin 4 and inflammatory factors, nerve injury indexes in children with hand, foot and mouth disease(HFMD) complicated with encephalitis. MethodsForty children with HFMD complicated with nerve system involvement were set as the observation group, 40 children with rashes of HFMD were set as the simple HFMD group, and 36 febrile convulsion children without HFMD and encephalitis were set as the control group.The level of aquaporin 4 in cerebrospinal fluid, serum levels of inflammatory factors[(including the interleukin(IL)-1β, IL-6, IL-18, C reactive protein(CRP), procalcitonin(PCT) and tumor necrosis factor(TNF)-α] and nerve injury index levels[including the myelin basic protein(MBP), nerve specific enolase(NSE) and S-100B proteins] in peripheral blood were detected.The correlations between the level of aquaporin 4 and inflammatory factors, nerve injury indexes in peripheral blood were analyzed. ResultsThe level of aquaporin 4 of cerebrospinal fluid in observation group on the second day of admission was higher than that in simple HFMD group and control group(P < 0.01).The level of aquaporin 4 in observation group on the seventh day of admission was higher than that on the second day of admission, and in simple HFMD group and control group(P < 0.01).The differences of the levels of inflammatory factors and nerve injury indexes among three groups were statistically significant(P < 0.01).The results of correlation analysis showed that the level of aquaporin 4 of cerebrospinal fluid in the observation group on the second day of admission was positively correlated with the peripheral inflammatory factors and nerve injury indexes(P < 0.05 to P < 0.01). ConclusionsThe level of aquaporin 4 in children with HFMD complicated with encephalitis increases in the acute phase, decreases in the recovery phase, and is positively correlated with the inflammatory factors and nerve injury indexes.
2020, 45(6): 760-763.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.016
Abstract:
ObjectiveTo investigate the therapeutic effects of Xiongfu Tongbi decoction combined with traditional Chinese medicine fumigation on knee osteoarthritis(KOA) and serum levels of inflammatory factors. MethodsOne hundred and twelve patients with bilateral KOA were randomly divided into the observation group and control group(56 cases each group).The control group was treated with glucosamine sulfate by oral, and the observation group was treated with Xiongfu Tongbi decoction combined with traditional Chinese medicine fumigation.The degree of joint function and pain were evaluated using Lysholm score and VAS score before treatment and after 8 weeks of treatment.The serum levels of matrix metalloproteinase(MMP)-3, tumor necrosis factor(TNF)-α and interleukin-17 were measured using enzyme-linked immunosorbent assay(ELISA), and the therapeutic effects were observed. ResultsThe therapeutic response rate in observation group(91.1%) was significantly higher than that in control group(75.0%) (P < 0.05).Before treatment, the differences of Lysholm score and VAS score, and serum levels of MMP-3, TNF-α and IL-17 were not statistically significant between two groups(P>0.05).After treatment, the Lysholm score and VAS score in two groups increased and decreased, respectively(P < 0.01).After treatment, the Lysholm score and VAS score in observation group were higher and lower than that in control group, respectively(P < 0.01).After treatment, the serum levels of MMP-3, TNF-α and IL-17 in two groups decreased(P < 0.05 to P < 0.01), and the serum levels of MMP3, TNF-α and IL-17 in observation group were lower than those in control group(P < 0.05 to P < 0.01). ConclusionsThe effects of Xiongfu Tongbi decoction combined with traditional Chinese medicine fumigation on KOA is significant, and which can significantly improve the joint function, pain level and serum levels of inflammatory factors.
2020, 45(6): 764-767.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.017
Abstract:
ObjectiveTo explore the application value of early warning score system in the diagnosis and treatment of critical children. MethodsOne hundred and twenty hospitalized children included 80 cases of bronchopneumonia and 40 cases of sepsis, and divided into the low-risk group(49 cases), medium-risk group(41 cases) and high-risk group(30 cases) according to the early warning score system of children's critical illness.The levels of serum procalcitonin(PCT), blood glucose(G), lactic dehydrogenase(LDH), white blood cell count(WBC), platelet count(PLT), C reactive protein(CRP) and other indexes were measured and compared among three groups.The corresponding treatment measures were applied according to different scores.At the same time, the hospitalization time among three groups were compared. ResultsThe differences of the levels of serum PCT, G, LDH, WBC, PLT and CRP among three groups were statistically significant(P < 0.01).There were statistical significances in PCT, LDH, WBC, PLT and CRP between low-risk group and middle-risk group(P < 0.01).The difference of the hospitalization time in high-risk group was longer than that in other two groups, and the hospitalization time in medium-risk group was longer than that in low-risk group(P < 0.01). ConclusionsThe early warning score system of children's critical illness has a strong application value in the diagnosis and treatment of critical illness.It can identify the critical children in time, guide the effective treatment and prognosis evaluation of critical children.
2020, 45(6): 768-770.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.018
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ObjectiveTo evaluate the effects of par plana vitrectomy, inverted limiting membrane(ILM) packing and vitreous cavity disinfected air filling in the treatment of large-aperture idiopathic macular hole. MethodsTwenty-eight eyes with large-aperture idiopathic macular hole were divided into the group A and group B (14 cases each group).Group A was treated with PPV, ILM packing and vitreous cavity disinfected air filling, and group B was treated with autogenous blood blocking macular hole based on ILM packing.All cases were followed up for 6 months, the best corrected visual acuity, slit lamp examination, ophthalmoscopy and optical coherence tomography before operation and after 1, 3 and 6 months of surgery were recorded.The difference of the curative effect between two groups was analyzed. ResultsThe scores in group A after 1, 3, and 6 months of surgery decreased compared with those before surgery(P < 0.05 to P < 0.01).The scores in group B after 1, 3, and 6 months of surgery significantly decreased compared with those before surgery(P < 0.01), and which in group B after 6 months of surgery decreased compared with that after 1 month of surgery(P < 0.05).The hole closure rates in group A and group B were 92.6% and 100%, respectively.No high intraocular pressure or retinal detachment occurred in all patients. ConclusionsThe postoperative visual acuity in two groups increases gradually, the hiatus closure rate after autologous blood occlusion is improved compared with that of simple inner boundary membrane filling, and the treatment of large-aperture idiopathic macular hole is safe and effective.
2020, 45(6): 771-773.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.019
Abstract:
ObjectiveTo explore the risk factors of ovarian cancer. MethodsNinety patients with ovarian cancer and 270 healthy volunteers were divided into the observation group and control group, respectively.The clinical data in two groups were investigated. ResultsThe differences of the age, marital status and educational level between two groups were not statistically significant(P>0.05).The ratios of the no delivery, menstrual cycle >30 days, menarche age < 13 years old, abortion history and ovarian cancer family history in observation group were 56.67%, 46.67%, 62.22%, 36.67% and 23.33%, respectively, and which were significantly higher than those in control group(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the delivery times ≥2 and menarche age ≥13 years were the protective factors of ovarian cancer(P < 0.01), and the menstrual cycle >30 days, abortion history and family history of ovarian cancer were the risk factors of ovarian cancer(P < 0.01). ConclusionsThe occurrence of ovarian cancer is influenced by many factors, and the preventive measures should be made according to the relevant risk factors.
2020, 45(6): 774-776.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.020
Abstract:
ObjectiveTo study the related factors in patients with type 2 diabetes mellitus complicated with hyperuricemia. MethodsFive hundred patients with type 2 diabetes were selected, and divided into the HUA group(89 cases complicated with hyperuricemia) and NUA group(411 cases with normal blood uric acid) according to the simple random method.The multivariate logistic analysis was used to analyze the risk factors of hyperuricemia. ResultsThere was no statistical significance in the course of diabetes, systollic pressure, diastollic pressure, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol between two groups(P>0.05), but the body mass index, triglyceride, fasting insulin and insulin resistance index, ratio of urinary albumin/creatinine and serum creatinine in HUA group were higher than those in NUA group, the age, HbA1c and estimated glomerular filtration rate(eGFR) in HUA group were lower than those in NUA group, and the differences of the ratios of obesity, smoking, drinking and hyperlipidemia were statistically significant(P < 0.05 to P < 0.01).The high ratio of urinary albumin/creatinine and drinking were the independent risk factors for diabetes mellitus complicated with hyperuricemia, and the eGFR was a protective factor(P < 0.01). ConclusionsThe hyperuricemia can aggravate the hyperinsulinemia and insulin resistance, dyslipidemia, and renal impairment in patients with type 2 diabetes mellitus.The ratio of urinary albumin/creatinine and drinking are the independent risk factors for diabetes mellitus complicated with hyperuricemia.
2020, 45(6): 777-780.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.021
Abstract:
ObjectiveTo evaluate the clinical efficacy of staged minimally invasive surgery in restoring coronal and sagittal balance in adult patients with severe degenerative scoliosis(SDS). MethodsThe clinical data of 20 adult SDS patients treated with staged surgery were retrospectively analyzed.The operative time, intraoperative blood loss and perioperative complications were recorded.The parameters of coronal plane, sagittal plane and pelvis at standing position before and after operation were evaluated using EOS imaging system.All patients were followed up for 3 to 5 years.The parameters in all cases between before and after operation were compared. ResultsThe operative time and intraoperative blood loss were(231±48)min and(253±80)mL in one-stage lumbar interbody fusion via lateral approach, respectively.The operative time and intraoperative blood loss were (155±33)min and(326±99)mL in two-stage percutaneous pedicle screw fixation, respectively.The interval between two operations was 7 to 42 d.The imaging parameters were significantly improved after one-stage lumbar interbody fusion via lateral approach, and the parameters were further improved after two-stage minimally invasive posterior fixation.On the coronal plane, the Cobb angle decreased from(43.1±7.3)° to (11.4±4.0)° after one-stage operation(P < 0.01), and(5.5±1.9)° after two-stage operation(P < 0.01).On the sagittal plane, the lumbar lordosis angle increased from(16.8±8.4)° to(30.2±6.8)° after one-stage operation(P < 0.01), and was restored to(37.1±4.0)åfter two-stage operation(P < 0.01).The vertical axis of sagittal plane decreased from(10.5±2.4)cm to (5.3±2.1)cm after one-stage operation(P < 0.01), and decreased to(3.1±1.5)cm after two-stage operation(P < 0.01).In terms of pelvic parameters, the matching degree of pelvic projection angle and lumbar lordosis angle decreased from(33.6±9.6)° to (7.8±4.5)åfter one-stage operation(P < 0.01) and(9.9±3.7)° after two-stage operation(P < 0.01).The visual analogue score and scores of low back pain, leg pain and Oswestry dysfunction index during following-up were significantly improved compared with before treatment(P < 0.01). ConclusionsFor severe adult degenerative scoliosis, the lateral lumbar interbody fusion can correct the balance of coronal and sagittal planes at the same time, and the effect of staged minimally invasive surgery is reliable.
2020, 45(6): 781-785.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.022
Abstract:
ObjectiveTo investigate the depression condition and related influencing factors in patients with maintenance hemodialysis(MHD). MethodsA tolal of 219 uremic patients treated with hemodialysis were investigated, and 216 healthy people were set as the control.The depression condition was evaluated using the self-rating depression scale(SDS) made by W.K.Zuang and general condition questionnaire.The disease related laboratory indicators were detected and analyzed. ResultsThe incidence rate of the depression in MHD patients was significantly higher than that in control group.The differences of the effects of family income, course of illness, complications and social support on the SDS score in MHD patients were statistically significant(P < 0.05 to P < 0.01).Among MHD patients, the levels of blood urea nitrogen(BUN), serum creatinine(SCr), serum phosphorus and thyroid hormone(PTH) in depression group were higher than those in non-depression group(P < 0.05 to P < 0.01).The results of Pearson correlation analysis showed that the levels of BUN, SCr, blood phosphorus and PTH in patients were positively correlated with the SDS score of depression(P < 0.05 to P < 0.01).The MHD patients with low family income, long course of disease, complications and lack of social support were more likely to develop depression(P < 0.05 to P < 0.01).The results of multiple regression analysis of the significantly relevant factors showed that the family income, social support, blood phosphorus level and thyroid hormone level were the independent influencing factors of depression in MHD patients. ConclusionsThe related influencing factors of depression in MHD patients should be emphasized in clinic, the early intervention should be given to reduce the occurrence of depression, and improve the quality of life of patients.
2020, 45(6): 785-787,791.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.023
Abstract:
ObjectiveTo investigate the effects of Tongqiao Huoxue decoction combined with swallowing function training on the advanced esophageal cancer(EC) complicated with dysphagia. MethodsNinety-eight patients with advanced EC complicated with dysphagia were divided into group A (40 cases) and group B(58 cases) according to their willingness.All patients were treated with radiotherapy using linear accelerator.After one course of radiotherapy, group A was treated with swallowing function training, and group B was additionally treated with Tongqiao Huoxue decoction on the basis of group A.According to the standard of water drinking test of Watian Junfu, the clinical efficacy in two groups was evaluated.The traditional Chinese medicine symptom score, Karnofsky performance status (KPS) score and quality of life(QOL-30) score were compared between two groups before and after 4 weeks of treatment. ResultsAfter treatment, the total effective rate in group B(91.38%) was higher than that in group A (72.50%)(P < 0.05).The scores of anorexia, swallow obstruction and pain of traditional Chinese medicine symptoms in group B were lower than those in group A(P < 0.01), and the scores of KPS and QOL-30 in group B were higher than those in group A(P < 0.01). ConclusionsTongqiao Huoxue decoction combined with swallowing function training can effectively improve the clinical efficacy, recovery of swallowing function, various traditional Chinese medicine symptoms and quality of life of patients with EC complicated with dysphagia.
2020, 45(6): 788-791.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.024
Abstract:
ObjectiveTo investigate the effects of tiotropium bromide combined with budesonide inhalation on the levels of cystatin C(Cys-C), procalcitonin(PCT), and blood gas analysis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). MethodsOne hundred and twenty patients with AECOPD were randomly divided into the observation group and control group(60 cases in each group).The control group was treated with budesonide aerosol, and the observation group was treated with tiotropium bromide combined with budesonide.The exercise tolerance, lung function index, dyspnea score, Cys-C and PCT levels, blood gas analysis before and after treatment, and adverse reactions were compared between two groups. ResultsAfter treatment, all indexes in two groups significantly increased(P < 0.05 to P < 0.01), and the indexes in observation group were significantly higher than those in control group(P < 0.05 to P < 0.01).After treatment, the scores of dyspnea in two groups significantly decreased(P < 0.01), and which in observation group was lower than that in control group(P < 0.01).After treatment, the serum levels of Cys-C and PCT in two groups decreased(P < 0.01), and the indexes in observation group were lower than those in control group(P < 0.01).After treatment, the levels of SaO2 and PaO2 in two groups increased(P < 0.05 to P < 0.01), and the indexes in observation group were higher than those in control group(P < 0.01).After treatment, the level of PaCO2 in two groups decreased(P < 0.01), and which in observation group was lower than that in control group(P < 0.01).The difference of the incidence rate of complications between two groups was not statistically significant(P>0.05). ConclusionsTiotropium bromide combined with budesonide can effectively alleviate the inflammatory reaction, reduce the levels of serum Cys-C and PCT, and improve respiratory function in patients with AECOPD, which is worthy of promotion.
2020, 45(6): 792-794,798.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.025
Abstract:
ObjectiveTo analyze the influencing factors of adverse pregnancy outcomes in 200 elderly pregnant women. MethodsThe pregnancy outcomes data of 200 elderly pregnant women were collected, the occurrence of adverse pregnancy outcomes was statistically analyzed, and the influencing factors of adverse pregnancy outcomes of elderly pregnant women were analyzed. ResultsThe incidence rate of adverse pregnancy outcomes in 200 elderly pregnant women was 19.00%, followed by low birth weight infants(31.58%), preterm infants(26.32%), neonatal asphyxia(15.79%), macrosomia(15.79%), neonatal malformations(5.26%) and neonatal death(5.26%).The history of miscarriage, adverse pregnancy habits, planned pregnancy, pregnancy complications, pregnancy complications, passive smoking, multiple pregnancy and disease history before pregnancy were the single factor of affecting adverse pregnancy outcomes in elderly pregnant women(P < 0.05 to P < 0.01).The results of multivariate logistic regression analysis showed that the abortion history, pregnancy complications, pregnancy complications, passive smoking, multiple pregnancies, and pre-pregnancy disease history were the risk factors of adverse pregnancy outcomes in elderly pregnant women(P < 0.05 to P < 0.01). ConclusionsThe incidence rate of adverse pregnancy outcomes in elderly pregnant women is high.The history of abortion, pregnancy complications, passive smoking, multiple pregnancies, and pre-pregnancy disease history are the risk factors of adverse pregnancy outcomes in elderly pregnant women.
2020, 45(6): 795-798.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.026
Abstract:
ObjectiveTo study the clinical value of thermal biopsy forceps combined with snare-assisted traction in endoscopic submucosal dissection(ESD) treating stomach tumors. MethodsThe clinical data of 120 stomach tumor patients treated with ESD were analyzed, and the patients were randomly divided into the observation group and control group(60 cases in each group).The observation group was treated with hot biopsy forceps combined with snare-assisted traction technique, and the control group was not treated with any assisted traction technique.The rate of one-time complete removing tumor, operation time, incidence rates of intraoperative bleeding and perforation, and postoperative following-up were compared between two groups.The clinical efficacy and safety in two groups were evaluated. ResultsThe rate of one-time complete removing tumor in observation group was significantly higher than that in control group(P < 0.05).The operation time, intraoperative bleeding and incidence rate of complication in observation group were significantly lower than those in control group(P < 0.01).The difference of the postoperative pathology results between two groups was not statistically significant(P>0.05). ConclusionsThe thermal biopsy forceps combined with snare-assisted traction has the advantages of convenient operation, less tissue damage and good traction effects, etc., which can effectively ensure the clear vision field of ESD operation, shorten the operation time, and reduce the incidence rates of intraoperative complications such as bleeding, perforation, lesion residue and tumor strapping into the chest and abdominal cavity.
2020, 45(6): 799-802.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.027
Abstract:
ObjectiveTo explore action mechanism of serum inflammatory factors and oxidative stress factors in the pathogenesis of preeclampsia and its correlation. MethodsThirty preeclampsia pregnant women were set as the observation group, which included 18 cases of mild preeclampsia(mild group) and 12 cases of severe preeclampsia(severe group).Meanwhile, 30 normal pregnant women with delivering at the same time were set as the control group.The serum levels of hs-CRP, TNF-α, IL-6 and ox-LDL, MDA and 8-isoprostane were compared among three groups, and the correlations of hs-CRP, TNF-α, IL-6 and ox-LDL and MDA with 8-isoprostane in preeclampsia pregnant women were analyzed. ResultsThe serum levels of inflammatory factors hs-CRP, TNF-α and IL-6, and serum levels of oxidative stress factors ox-LDL, MDA and 8-isoprostane in severe group were higher than those in mild group and control group, respectively(P < 0.01).The serum levels of ox-LDL, MDA and 8-isoprostane were positively correlated with the levels of hs-CRP, TNF-α and IL-6(P < 0.01). ConclusionsThe serum inflammatory and oxidative stress factors may play an important role in the pathogenesis of preeclampsia.Intervening the inflammation and oxidative stress response can help prevent the occurrence and development of preeclampsia.
2020, 45(6): 803-808.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.028
Abstract:
ObjectiveTo investigate the status quo and influencing factors of oral health knowledge, attitude and behavior among medical college students in Hefei city. MethodsA total of 801 students from 3 medical colleges and universities in Hefei city were selected using cluster random sampling method, and investigated using a self-designed questionnaire. ResultsThe total awareness rate of oral health knowledge was 66.09%, the total positive attitude rate of oral health was 70.37%, and the total formation rate of oral health behavior was 44.25%.The oral health scores of knowledge, attitude and behavior in female students were higher than those in male students(P < 0.01), and the oral health scores of knowledge, attitude and behavior in urban students were higher than those in rural students(P < 0.01).The oral health scores of knowledge, attitude and behavior did not increase with the increasing of grades, but the difference of which was statistically significant(P < 0.01).The knowledge, attitude and behavior of oral health among students were positively correlated to each other(P < 0.01).The oral health scores of knowledge, attitude and behavior in students majoring in stomatology were higher than those in other major students(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that gender, place of origin, grade, profession and self-assessment were the main influencing factors of oral health knowledge, the gender, place of origin, grade, self-assessment of oral health status and oral health education were the influencing factors of the oral health attitude, and the gender, place of origin, profession and self-assessment of oral health status were the influencing factors of oral health behavior(P < 0.05 to P < 0.01). ConclusionsThe knowledge and attitude of oral health among medical college and university students in Hefei city are at a medium level, but the behavior of oral health is at a low level.Therefore, it is necessary to strengthen oral health education work to improve the oral health literacy level of the students in colleges and universities.
2020, 45(6): 809-811.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.029
Abstract:
ObjectiveTo analyze the 4977bp sperm mitochondrial DNA(mtDNA) deficiency in patient with varicocele infertility. MethodsThe semen samples of 60 infertile patients with clinical varicocele and 90 normal men were collected.The total DNA of all cases were extracted, and the 4977bp sperm mtDNA deficiency was detected using the Gap-PCR. ResultsThe 4977 bp DNA deficiency in 81.66% of patients with varicocele infertility and 4.44% of healthy people was identified.The DNA missing frequency in infertile patients with varicocele was more(OR=139.80, 95%CI=40.08-487.30). ConclusionsThe varicocele may induce the mtDNA deficiency of sperm and infertility.The 4977 bp mtDNA deficiency of sperm is correlated with the infertility caused byvaricocele.
2020, 45(6): 812-814.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.030
Abstract:
ObjectiveTo compare the effects between immunovelocity nephelometry and immunofluorescence chromatography in the detection of serum amyloid protein A(SAA). MethodsThe serum levels of SAA of inhospital patients(observation group) and healthy physical examinees(control group) were detected using the full-automatic specific protein detector(immunovelocity nephelometry) and fluorescence immunoquantitative analyzer (immunofluorescence chromatography), and the detection results were compared between two methods. ResultsThe serum levels of SAA deetcted by two methods in observation grop were higher than those in control group(P < 0.01).The serum level of SAA in observation group detected by immunovelocity nephelometry was higher than that of immunofluorescence chromatography(P < 0.01), while the difference of the serum level of SAA in control group was not statistically significant between two detection methods(P>0.05).The sensitivities and specificities of immunovelocity nephelometry and immunofluorescence chromatography were 53.00% & 57.00% and 92.00% & 93.00%, respectively, and the differences of those were not statistically significant between two methods(P>0.05).The lower limit probability of SAA detected by fluorescence immunochromatography in control group(83.00%, 83/100) was higher that of immunovelocity nephelometry(42.00%, 42/100) (χ2=35.86, P < 0.01).The fluorescence immunochromatography in the detection of low value was more stable. ConclusionsThe immunovelocity nephelometry and immunofluorescence chromatography can be used for clinical detection, the latter has better stability.
2020, 45(6): 815-817.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.031
Abstract:
ObjectiveTo study the relationship between homocysteine(Hcy) level and cognitive function in late-onset depression. MethodsThe cognitive function in 98 patients with late-onset depression(observation group) and 88 healthy olders(control group) was detected using case-control study method, and the serum levels of Hcy in two groups were enzymatically tested. ResultsThe Hcy level in observation group was higher than that in control group(P < 0.05).The cognitive function scores in observation group were lower than that in control group(P < 0.01).The results of correlation analysis showed that the Hcy level was not correlated with HAMD score(P>0.05), and the Hcy level was negatively correlated with the total score of MMSE(P < 0.05). ConclusionsThe levels of Hcy in patients with late-onset depression increase.Compared with the normal elderly population, the cognitive deficits in attention, short-term memory, speech, and executive function in patients with late-onset depression are obvious.
2020, 45(6): 818-820, 824.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.032
Abstract:
ObjectiveTo explore the effects of teaching mode of gastrointestinal endoscopy based on cognitive load theory in the standardized training of resident physicians. MethodsSixty-six residents with standardized training in the gastrointestinal endoscopy room were randomly divided into the traditional group and research group.The research group was trained with the teaching mode based on cognitive load theory, while the traditional group was trained with the traditional teaching mode.The teaching effects between two groups were compared with basic knowledge test, clinical case test and questionnaire evaluation. ResultsIn terms of the basic knowledge test, the total score, and scores of operational knowledge and clinical application in research group were significantly higher than those in traditional group(P < 0.01), while the difference of the score of basic theory between two groups was not statistical significant(P>0.05).The difference of the score of clinical case test between two groups was not statistically significant(P>0.05).The results of questionnaire showed that the degrees of satisfaction of learning interest and motivation, independent learning ability, clinical thinking establishment, medical humanistic feelings cultivation, interaction with teachers, and team spirit cultivation in research group were significantly higher than those in traditional group(P < 0.05 to P < 0.01). ConclusionsThe application of the teaching mode based on cognitive load theory in the teaching of gastrointestinal endoscopy can effectively strengthen the basic and clinical knowledge of digestive endoscopy of resident physicians, improve their satisfaction with the standardized training and teaching process, and promote the effect and quality of standardized training.
2020, 45(6): 821-824.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.033
Abstract:
ObjectiveTo explore the effects of pediatric teaching ward-round based on constructivism. MethodsForty-six undergraduate interns majoring in five-year clinical medicine were randomly divided into the observation group(26 students) and control group(20 students).The traditional mode of teaching rounds was implemented in control group, namely, the teacher was the center, the students were taught with interrogation and physical examination skills, the teacher analyzed and and explained the key points and difficulties, and summarized the teaching rounds.The student-centered mode of teaching ward-round in observation group was implemented, namely, under the guidance of constructivism theory, the teaching ward-round was designed according to the four elements of situation, cooperation, conversation and meaning construction.The whole teaching ward-round was conducted by students, the students conducted their own teaching ward-rounds according to the prearranged roles, and the teacher only gave the necessary guidance.Before the end of the internship, the students were tested with case analysis questions, and the teaching ward-rounds were analyzed and evaluated. ResultsThe test results of case analysis questions showed that the difference of the achievement between the observation group(85.12±21.23) points and control group(81.80±19.33) points was not statistically significant(P>0.05).The evaluation of learning interest, ability to communicate with patients, clinical thinking ability, autonomous learning ability, humanistic care spirit and team spirit in observation group were better than those in control group(P < 0.01). ConclusionsThe flexible application of constructivism theory in clinical teaching to create a learning situation conducive to knowledge construction can significantly improve the clinical teaching effect and praise rate.
2020, 45(6): 825-827.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.034
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ObjectiveTo investigate the application value of Seminar teaching model in standardized training for residents in hepatobiliary and pancreatic surgery department. MethodsForty students receiving standardized training in hepatobiliary and pancreatic surgery department in our hospital were randomly divided into the observation group(n=20) and control group(n=20).The Seminar teaching model was conducted concerning one theme each week in the observation group, and the students prepared PPT concerning the theme combined with the patient's medical records, then reported and discussed on the spot.The traditional teaching method was used in the control group.Theoretical examination, clinical practice assessment and trainee questionnaire survey were used to evaluate the teaching effect. ResultsThe scores of theoretical examination in students in two groups(92.90±3.007 points in observation group, 91.90±1.997 points in control group) were not statistically significant(P>0.05).The scores of clinical practice assessment and trainee questionnaire survey in students in observation group(89.35±3.265 points and 81.65±2.907 points, respectively) were significantly higher than those in control group(81.30±2.774 points and 70.25±2.712 points, respectively) (P < 0.01). ConclusionsThe Seminar teaching model is helpful to improve the quality of training for residents in hepatobiliary and pancreatic surgery department, which is worth popularizing.
2020, 45(6): 828-831.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.035
Abstract:
ObjectiveTo explore the clinical curative effects of the nursing intervention based on health empowerment theory in elderly patients with brittle fracture. MethodsOne hundred and four patients with brittle fracture were divided into the observation group and control group according to the random number table method(52 cases each group).The control group were nursed with routine orthopedic nursing care, while the observation group was nursed with the mothod based on the health empowerment theory.The levels of health empowerment and self-efficacy in the observation group were evaluated.The postoperative lower limb venous thrombosis, joint stiffness, incision infection and fracture healing rates at 3, 6 and 9 months after discharge were assessed in two groups. ResultsThe total score of health empowerment in the observation group was (3.01±0.87)points.The highest score of each dimension was the total mean score of the support dimension(3.17±0.66)points, while the lowest score was the reconstruction of the self-dimension(2.92±0.45)points.The total score of self-efficacy was (53.23±11.67)points, the exercise dimension was (19.78±8.12)points, and the calcium intake dimension was (33.45±5.72)points.After 3 and 6 months of nursing intervention, the total score of health empowerment and each dimension score in the observation group increased compared with those before intervention(P < 0.05 to P < 0.01), and the total score of self-efficacy, exercise dimension and feed calcium dimension were higher than those before intervention(P < 0.05 to P < 0.01).The total score of self-efficacy and exercise dimension in the observation group after 6 months of intervention were significantly higher than those after 3 months of intervention(P < 0.01).There was no statistical significance in the incidence of lower limb venous thrombosis, joint stiffness and incision infection between two groups(P>0.05).The fracture healing rate in observation group was significantly higher than that in control group after 3 and 6 months of discharge(P < 0.05). ConclusionsThe nursing intervention based on health empowerment theory can enhance the self-efficacy and health empowerment levels of elderly patients with brittle fracture, which is beneficial to the early healing of postoperative fracture.
2020, 45(6): 832-835, 839.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.036
Abstract:
ObjectiveTo discuss the application value of monitoring nursing sensitive indicators on nursing quality management in intensive care unit(ICU). MethodsThe monitoring group for nursing sensitive indicators was established in July 2014.The nursing sensitive indicators were screened, the staffs of the department were trained, and the data were collected.The collected data were linked to the nursing quality, the nursing problems were attributed to the analysis, and the nursing measures were actively adjusted to improve the nursing quality of the department. ResultsThe average 24 h nursing time per inpatient in 2018 was shorter than that in 2017(P < 0.01).In 2016, 2017 and 2018, the head elevation rates of ICU patients were lower than that in 2015(P < 0.01), and the oral cleanliness of patients were higher than that in 2015(P < 0.01).The physical restraint rate and unplanned extubation of gastric tube in inpatients decreased year by year(P < 0.01).The incidence rate of ICU ventilator-related pneumonia in 2018 was higher than that in 2017(P < 0.01). ConclusionsThe application of monitoring nursing sensitive indicators in nursing quality management can effectively improve the quality of care in ICU.
2020, 45(6): 836-839.
doi: 10.13898/j.cnki.issn.1000-2200.2020.06.037
Abstract:
ObjectiveTo investigate the application effects of the improved blunt separation technique in peripherally inserted central catheter(PICC) in thrombocytopenia patients. MethodsA total of 44 normal clotting function patients with platelet count less than 100×109/L treated with PICC were randomly divided into the observation group(23 cases) and control group(21 cases).The control group was cathetered with the tearable sheath and dilator to assemble blunt separation method to expand the skin, and the observation group was cathetered with the improved blunt separation technique.The success rate of primary sheath delivery, pain degree at the puncture site after 1, 3 and 5 days of cathetering, bleeding volume after 24 h of cathetering and maintenance times within 7 days were compared between two groups. ResultsThe success rates of primary sheath delivery in observation group and control group were 95.65%(22/23) and 85.71%(18/21), respectively, and the difference of which was not statistically significant(P>0.05).The pain degree in observation group was lower than that in control group(P < 0.05).The number of layers of errhysis gauze at puncture point within 24 h of cathetering and times of dressing change within 7 d of cathetering in observation group were less than those in control group(P < 0.05 and P < 0.01). ConclusionsImproved blunt separation technique can significantly reduce the bleeding volume at the puncture point and number of catheter maintenance, relieve the pain and tension, and improve satisfaction of thrombocytopenia patients.It is worthy of promotion.
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