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2017 Vol. 23, No. 8
Published: 2017-08-20
1233
The Relationship between MICA Gene Expression of Bladder Cancer and Mutation of p53 and K-ras Gene
GU Jingfeng, WANG Guiqi, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.001
Objective:
To investigate the relationship between the expression of MICA gene in bladder cancer and the mutation of p53 gene and K-ras gene.
Methods:
66 cases of bladder cancer patients with clinical data in our hospital from March 2014 to March 2016 were analyzed. Semi quantitative PCR-SSCP technique was used to detect the expression of MDR1 gene and p53 and K-ras in cancer tissues, and analyzed the relationship between the expression of MICA gene in colorectal cancer and the mutation of p53 and K-ras genes.
Results:
The study found that there was no correlation between the expression of MICA and the location, age and sex of the patients with colorectal cancer (P > 0.05). In 66 patients, the mean expression of MICA in 22 lymph node metastasis patients was higher than that without lymph node metastasis, and the difference was statistically significant (P < 0.05). 8 cases of K-ras and p53 gene expression of the MICA gene mutation combined with average weight is higher than non mutation, the difference was statistically significant (P < 0.05), 12 cases of K-ras gene mutation MICA average expression was slightly higher than that without mutation, but the difference was not statistically significant (P > 0.05), 16 cases of p53 gene mutation MICA expression was significantly better than the average mutation in the p53 gene, the difference was statistically significant (P < 0.05).
Conclusion:
The high expression of MICA gene has become a key indicator for the detection of bladder cancer, and the correlation between K-ras and p53 gene and its high expression.
2017 Vol. 23 (8): 1233-1235 [
Abstract
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149
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1236
Correlation between Plasma Levels of MicroRNA-17-5p and microRNA-20 and Prognosis of Pulmonary Arterial Hypertension
ZHANG Yan, WANG Congxia, LI Yongqin, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.002
Objective:
To investigate the correlation between the level of plasma MicroRNA-17-5p and microRNA-20 and the severity and prognosis of pulmonary arterial hypertension (PAH).
Methods:
A microarray screen was performed on total plasma RNA from 112 patients with PAH and 100 healthy control subjects Quantitative polymerase chain reaction commend increased microRNA-17-5p and microRNA-20a concentrations and was then used to measure microRNA-17-5p and microRNA-20a levels in cohort of patients with PAH's circulating microvesicles and blood cells.
Results:
Fifty-eight miRNAs showed differences in plasma concentration. MicroRNA-17-5p and microRNA-20a are the largest up-regulation in PAH. Receiver-operator-characteristic analysis showed both raw and normalized plasma microRNA-17-5p and microRNA-20a levels correlated with 2-year survival in patients with PAH. Cox regression analysis confirmed that miRNA-17-5p and miRNA-20a levels were important predictors of PAH survival. Age, baseline cardiac index, World Health Organization functional class, 6-minute walk distance, disease duration, and red cell distribution width also predicted survival. Entering these covariates in a multivariable model veried plasma microRNA-17-5p and microRNA-20a levels as independent predictoras of survival in PAH.
Conclusion:
Increased circulating microRNA-17-5p and microRNA-20a levels are associated with poor survival in PAH.
2017 Vol. 23 (8): 1236-1241 [
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124
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1242
The Influence on WOMAC Score and TNF-a in Arthritic on the method of fire Needles High Selectivity to cut off Articular Branches of Nervus Saphenus and Common Peroneal Nerve combined with Taking Celecoxib by Mouth
LIU Yanwei, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.003
Objective:
To observe the influence on WOMAC score and TNF-a in arthritic on the method of fire needles high selectivity to cut off articular branches of the nervus saphenus and common peroneal nerve combined with taking Celecoxib by mouth.
Methods:
60 patients with knee osteoarthritis were randomly divided into treatment group and control group. The treatment group used acupuncture to selective saphenous nerve and common peroneal nerve branch joint articular branch combined with celecoxib orally, the control group celecoxib oral evaluation before treatment and TNF-a content of 3 and 5 weeks and WOMAC score in the synovial fluid were recorded during the treatment of complications.
Results:
Fire needle therapy combined with celecoxib was better than that of the scores of WOMAC and TNF-a in synovial fluid of the control group (P<0.05), and the treatment of 1-3 weeks was significantly changed after 3-5 weeks treatment remained relatively stable level.
Conclusion:
The influence on WOMAC score and TNF-a in arthritic on the method of fire needles high selectivity to cut off articular branches of the nervus saphenus and common peroneal nerve combined with taking Celecoxib by mouth is better than taking Celecoxib by mouth merely.
2017 Vol. 23 (8): 1242-1244 [
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110
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1245
Effect and Prognosis of Cannulated Screw Decompression Combined with Interventional Therapy on Early Avascular Necrosis of Femoral Head
SUN Zewen, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.004
Objective:
To investigate the efficacy of cannulated screws combined with interventional therapy in the treatment of aseptic necrosis of femoral head.
Method:
65 early aseptic necrosis of femoral head in our hospital were selected and randomly divided into the control group and the experiment group.34 cases in the experimental group was treated with cannulated screws combined with interventional therapy; 31 cases in the control group were treatedwith interventional therapy. 6 months after surgery, two groups of patients were using questionnaires, including the evaluation of patients with hip joint function recovery, the pain is better, and improve the quality of life score indexes such as blood flow distribution were compared and analysis weather.
Results:
The total effective rate of the experimental group was higher than that of the control group, and the difference was statistically significant (χ
2
=5.795,P<0.05). The improvement of blood flow in the femoral head of the experimental group was higher than that of the control group, and the difference was statistically significant (χ
2
=16.277,P<0.05) .After treatment, the two groups of patients with Harris score and limb motor function score were increased. Compared with the control group, the experimental group Harris score and limb motor function score was higher, the difference was statistically significant (P<0.05);After treatment, the quality of life score of the experimental group was higher, the difference was statistically significant (P<0.05).
Conclusion:
The early avascular necrosis of the femoral head were treated with cannulated screw, decompression combined with interventional therapy, can make the femoral head blood supply has been effectively improved, and increase the support function of the weight-bearing area of the femoral head, improve joint function, suitable for application.
2017 Vol. 23 (8): 1245-1248 [
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133
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1249
The Value of Fasting Blood Glucose and Serum Lipid Level in the Diagnosis of GDM at 7~15 Weeks of Gestation
SHI Xin, DU Lan, SU Qing, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.005
Objective:
To explore the value of the diagnosis of gestational diabetes mellitus by using fasting plasma glucose and lipid profiles between 7 and 15 gestational weeks.
Methods:
A retrospective analysis was carried out on the clinical data of 1480 pregnant women who had prenatal care from May 2012 to December 2016. Based on the result of oral glucose tolerance test, pregnant women were divided into two groups: GDM group (n=152) and the control group (n=1328). The risk factors of GDM were compared. Area under curve (AUC) was calculated according to receiver operator characteristic (ROC) curve to evaluate the diagnostic value of independent risk factor.
Results:
The result of univariate analysis showed that the age (30.78±3.28), BMI (22.55±2.87), gravidity (2.12±1.08), FPG (4.98±0.37), TG (1.51±0.68), TC (4.71±0.76), LDL-C (2.12±0.49) in GDM group were significantly higher than those in control group (P<0.05). The level of HDL-C (1.99±0.35) in the GDM group was lower than the control group (P<0.05). Multiple factors analysis showed that age, BMI, gravidity, FPG, TG were the independent risk factors. ROC curve analysis indicated that the AUC of BMI, FPG, TG was 0.811, 0.792, 0.729, respectively.
Conclusion:
Pregnant women with old age, or with the high level of BMI, FPG and TG are the risk factors of GDM. The diagnostic value of BMI is higher than FPG and TG, and the value of FPG is higher than TG. Monitor these factors to help the doctor determine whether the pregnant women have high risk of GDM. Thus have a better guide to clinicians, and reduce the occurrence of GDM.
2017 Vol. 23 (8): 1249-1252 [
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101
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1253
The Effect of Misoprostol Combined with Oxytocin in the Treatment of Postpartum Uterine Contractions
MA Xiaoyun, CHEN Zhilian
DOI: 10.3969/j.issn.1006-6233.2017.08.006
Objective:
To investigate the effect of misoprostol combined with oxytocin in the treatment of postpartum uterine contractions.
Methods:
A total of 100 patients with postpartum uterine bleeding were enrolled from January 2016 to January 2017 were randomly divided into two groups. The control group received oxytocin therapy. In the experimental group, patients were treated with misoprostol, patients of two groups related to clinical indicators, clinical events, vital signs, uterine recovery, symptomatic quantification score and overall treatment.
Results:
The incidence of fever and chills was significantly higher in the experimental group than in the control group. After treatment, the incidence of RBC, HGB, HCT, SBP and DBP were significantly higher than those in the control group, the uterus was significantly lower than the control group; vaginal bleeding, blood clots, blood color, residues, abdominal ventilate, fatigue, spontaneous sweat score and total score (P <0.01). The total effective rate was significantly higher than that of the control group (P <0.05). There was significant difference between the two groups (P <0.05).
Conclusion:
Misoprostol combined with oxytocin is effective in the treatment of postpartum uterine contraction hemorrhage, but it can occur fever and chills. It needs clinical attention and has reference significance.
2017 Vol. 23 (8): 1253-1256 [
Abstract
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127
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1257
Heart Rate Variability Analysis in Diagnosis and Treatment of Hypertensive Target Organ Damage in Young Patients
WANG Jing, LIU Yanli, WANG Yajing, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.007
Objective:
To explore the significance of heart rate variability (HRV) analysis in diagnosis of target organ damage in young patients with hypertension.
Methods:
A total of 100 young patients with hypertension admitted in our hospital were included in the study and divided into the observation A group and observation B group with 50 cases in each group according to whether being accompanied by other diseases or organic damage. The patients in the observation A group had primary hypertension accompanied by organic damage, while the patients in the observation B group had pure primary hypertension. A total of 50 young people who came for physical examination were served as the control group. 24h dynamic vital signs and ECG monitoring were performed for patients in the three groups. The changes of related indicators were compared and analyzed.
Results:
SDNN, TRIA, SDNN5, and PNN50 in the observation A and B groups were significantly lower than those in the control group (P<0.05). SDNN, SDNN5, TRA, and SDANN in the observation A group were significantly lower than those in the observation B group (P<0.05). HRV indicators in the observation B group were significantly lower than those in the control group (P<0.05). The comparison of PNN50 between the observation A and B groups was not statistically significant (P>0.05).
Conclusion:
Application of HRV analysis can make an early diagnosis of target organ damage in young patients with hypertension, and contribute to enhance the clinical efficacy.
2017 Vol. 23 (8): 1257-1259 [
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148
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1260
Analysis of Vertebroplasty Combined with Bone Cement on Pedicle Screw Fixation for Severe Osteoporotic Vertebral Compression Fractures
DU Fan, LIU Zhibin, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.008
Objective:
To investigate the curative effect of vertebroplasty combined with cement-reinforced pedicle screw fixation in the treatment of severe osteoporotic spondylolisthesis (OVCF).
Methods:
80 patients with severe OVCF, who were enrolled from May 2014 to May 2016, were randomly divided into two groups. The patients in the control group received conservative treatment. The patients in the experimental group were treated with vertebroplasty combined with bone cement fixation, comparison of the two groups of patients with fracture-related parameters, hospital economics benefits, fracture rate, quality of life, imaging grade and satisfaction.
Results:
Compared with the control group, the VAS score, the height loss rate of the vertebral body, the score of the analgesic drug used in the experimental group were significantly higher than those in the control group (P <0.05) .The bone mineral density (BMD), the cost of hospitalization and drug cost were significantly higher than those of the control group, the cost of rehabilitation, the cost of escort, the cost of rehabilitation, the cost of rehabilitation, the time of hospitalization and the rate of recurrence were all significantly lower than those of the control group (P <0.05). The imaging grade was significantly better than that of the control group (P <0.05). There was significant difference between the two groups (P <0.05).
Conclusion:
The treatment of severe OVCF with vertebroplasty combined with bone cement for pedicle screw fixation is significant and has reference significance.
2017 Vol. 23 (8): 1260-1263 [
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153
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1264
Treatment of Heart Failure Caused by Chronic Pulmonary Heart Disease with Tonifying the Lung and Tonifying Kidney Decoction
LIU Xuelin, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.009
Objective:
To study of strengthening lung and benefiting kidney soup decoction of the clinical value of treatment of chronic cor pulmonale heart failure.
Methods:
From February 2015 to July 2016, 94 patients with chronic pulmonary heart disease and heart failure treated in our hospital were selected. According to the random number table method, the patients were divided into observation group and control group, with 47 cases in each group. The patients in the control group received routine western medicine treatment, while the observation group was treated with tonifying kidney and kidney decoction on the basis of the control group. The clinical effects of the two groups were compared. The changes of arterial blood gas index, lung function and quality of life were observed before and after treatment.
Results:
The total effective rate of the observation group was 93.62% (44/47), significantly higher than that of the control group 78.72% (37/47), the difference was statistically significant (P < 0.05). After treatment, two groups of patients with arterial blood gas index were improved in varying degrees, and the observation group PaO
2
and SaO
2
were significantly higher than the control group, while PaCO
2
was significantly lower than the control group, the differences were statistically significant (P < 0.05). After treatment, the levels of FEV1 and FVC in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.05). Group of physiological function, physiological function, body pain, vitality, social function, emotional function, mental health and general health scores were significantly higher than the control group, the differences were statistically significant (P < 0.05).
Conclusion:
The clinical effect of Yishen Decoction in treating chronic cor pulmonary heart failure is significant, which can significantly improve the arterial blood gas index and pulmonary function, and improve the quality of life of patients.
2017 Vol. 23 (8): 1264-1267 [
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144
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1268
Different Selivery Methods Combined with Electrical Stimulation on Pelvic Floor Function and Pelvic Floor Muscle Rehabilitation
ASIYE·abula, MINAWAER·abulizi
DOI: 10.3969/j.issn.1006-6233.2017.08.010
Objective:
To investigate the effect of electrical stimulation combined with pelvic floor function training on the recovery of pelvic floor muscles in different delivery modes.
Methods:
134 cases of postpartum pelvic floor dysfunction were selected in our department of Obstetrics and Gynecology, according to the mode of delivery, and divided into the natural delivery group (n=71) and the cesarean section group (n=63). 2 groups were given basic nursing, pelvic floor muscle training and electrical stimulation, and the two groups were treated for 8 weeks. The sata of the first class of muscle fiber contraction, muscle contraction, pelvic floor muscle pressure and sexual function score were compared before and after treatment.
Results:
There was no significant difference between the two groups in the treatment of the first class of muscle fiber sustained systolic blood pressure, duration and the number of muscle fiber contraction (P>0.05), compared with the cesarean section group, the rapid contraction pressure was higher in the natural delivery group (P<0.05), the resting pressure of pelvic floor muscles was lower in natural delivery group, and the systolic pressure was lower(P<0.05), compared with the cesarean section group, the score of sexual desire, the score of orgasm, the degree of vaginal lubrication and sexual satisfaction scores were lower in the natural delivery group(P<0.05). After 8 weeks of treatment, the maternal systolic blood pressure and duration of both groups increased (P<0.05), systolic blood pressure (SBP) and the number of contractions increased(P<0.05), there was no difference between the two groups (P>0.05), 2 groups of maternal pelvic floor muscle resting pressure and systolic pressure increased(P<0.05), compared with the cesarean section group, the pelvic floor muscle resting pressure in the natural delivery group was lower(P<0.05), there was no difference in pelvic floor systolic pressure(P>0.05). After 8 weeks of treatment, the scores of the sexual function score, the score of sexual orgasm, the degree of vaginal lubrication and the degree of sexual satisfaction were higher in both groups(P<0.05), there was no significant difference between the two groups(P>0.05).
Conclusion:
Electrical stimulation combined with pelvic floor function training can significantly improve the postpartum pelvic floor dysfunction, improve the level of sexual life, compared to cesarean section, natural childbirth parturient with electrical stimulation combined with pelvic floor function training has better effect.
2017 Vol. 23 (8): 1268-1271 [
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124
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1272
Superior and Middle Gluteal Nerve Neurolysis Combined with Neurotropin Close Treatment for LDH Postoperative Remaining Nerve Neuralgia
XU Kun, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.011
Objective:
To observe the clinical curative effect of superior and middle gluteal nerve neurolysis combining with neurotropin close treatment for LDH (protrusion of lumbar intervertebral disc) postoperative remaining nerve neuralgia.
Methods:
90 LDH cases of the age between 40~59 years old (45 female cases and 45 male cases) who were insensitive to four weeks of regular conservative treatment, VAS 5 and still got lower limb pain or (and) numbness at the second week after undergoing waist 4~5 or waist 5- sacrum 1 removal of nucleus pulposus, intervertebral fusion surgery were randomly divided into three groups, 30 cases in each group: group A (testing control group), group B (shinbone tube seal), group C (superior and middle gluteal nerve neurolysis combining with neurotropin close treatment). After 24 weeks of treatment, observed the clinical curative effect of group C treating LDH postoperative remaining nerve neuralgia and VAS, JOA,clinical periodscore.
Results:
The clinical curative effect and VAS, JOA,Clinical periodscore score of group C (superior and middle gluteal nerve neurolysis combining with neurotropin close treatment) were significantly better than that of group A and group B,the differences was statistically significant (P＜0.05).
Conclusion:
Superior and middle gluteal nerve neurolysis combining with neurotropin close treatment can significantly relieve symptoms of LDH postoperative remaining nerve neuralgia and reduce patients'clinical pain, so it is of significant clinical curative effect and treatment significance.
2017 Vol. 23 (8): 1272-1274 [
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118
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1275
The Application of Umbilical Single Channel Laparoscopic Hook Insertion to the Patent Sheath Process in Children
ZHANG Binbin, WANG Feng, GUO Wei, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.012
Objective:
To evaluate the feasibility, efficacy and safety of single channel laparoscopic needle insertion for pediatric patients with patent closure without closure of the sheath.
Method:
A retrospective analysis of 65 males from January 2016 to April 2017 was performed. There were 32 cases of needle insertion under the umbilicus and 33 cases of traditional open surgery. The clinical data of the two groups were compared. The operation time, bleeding volume, incision length, hospitalization time, treatment cost, scrotal swelling and postoperative complications were recorded.
Results:
Transumbilical single channel laparoscopic Crochet in the operation time, bleeding volume, incision length and hospitalization time were better than the open group, but the cost of hospitalization was higher than that of the traditional open surgery group, the differences were statistically significant (P<0.05). The postoperative complications compared with no significant difference (P>0.05).
Conclusion:
In addition to the advantages of traditional laparoscopic surgery, the new technique has the advantages of simple operation, no special equipment, easy popularization and so on. It has great clinical practical value.
2017 Vol. 23 (8): 1275-1277 [
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159
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1278
Clinical Value of the Diagnosis of Autoimmune Diseases by Antinuclear Antibody Combined and Antinuclear Antibody
CHEN Xianghua, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.013
Objective:
To analyze and explore the clinical value of combined detection of antinuclear antibodies and antinuclear antibodies in the diagnosis of autoimmune diseases.
Method:
1103 blood samples were submitted to our hospital, antinuclear antibody detection and antinuclear antibody spectrum detection were simultaneously tested. Antinuclear antibodies were detected by indirect immunofluorescence, and antinuclear antibodies were detected by Western blot. The data of patients with positive results were collected and analyzed statistically.
Results:
The positive results of antinuclear antibody test accounted for 6.32% of all patients, and the diagnosis accuracy was 78.21%; Detection of antinuclear antibody spectrum of blood test positive patients accounted for 4.78% of all patients, the diagnosis results showed that antinuclear antibody spectrum diagnosis rate was 91.32%, and the two methods were both positive patients for inspection, found that the highest accuracy is 94.67%.
Conclusion:
Simultaneous detection of antinuclear antibodies and antinuclear antibody spectrum can effectively improve the accuracy of the detection results, and is worthy of promotion.
2017 Vol. 23 (8): 1278-1280 [
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115
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1281
Efficacy of Hedgehog Fungus Extract Granules in the Treatment of Children with Spleen Deficiency Syndrome after Infection
ZHAO Min, GENG Wenjing, LI Xue, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.014
Objective:
To study the clinical efficacy of hedgehog fungus extract granules in the treatment for spleen deficiency syndrome after infection in children.
Method:
The 106 children patients with spleen deficiency syndrome after infection in our hospital during the period from Jan 2016 to Dec 2016 were randomized into the control group (treatment of live combined Bifidobacterium and Lactobacillus tablets, 48 patients) and the observation group (addition to control group, treatment of hedgehog fungus extract granules, 58 patients) according to the random number method. The total clinical efficacy, improvements of symptom scores, and curative effect of main symptoms in two groups were compared.
Results:
Compared with the control group, the total effective rate of treatment was significantly increased in the observation group with statistical difference (96.6% vs 75.0%, P<0.05); compared with the control group, the symptom scores after treatment were obviously decreased in the observation group with statistical difference (0.3±0.1 vs 4.2±0.6, P<0.05); compared with the control group, the total effective rates of treatment for main symptoms such as anorexia (96.6% vs 70.8%), loose stools (100.0% vs 83.3%), abdominal pain (100.0% vs 68.75%) were significantly increased in the observation groupwith statistical difference (P<0.05).
Conclusion:
The treatment of hedgehog fungus extract granules can significantly increase the clinical efficacy of spleen deficiency syndrome after infection in children, improve the children's clinical symptoms, and is worthy of clinical promotion.
2017 Vol. 23 (8): 1281-1283 [
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196
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1284
Effect of Sodium Tanshinone IIA Sulfonate in Perioperative Period on the Prognosis of Patients with CHD and Angina Pectoris after Interventional Therapy
ZHU Yujiang, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.015
Objective:
To study the effect of application of sodium tanshinone IIA sulfonate in perioperative period on the prognosis of patients with coronary heart disease (CHD) and angina pectoris after interventional therapy.
Methods:
94 cases of CHD with coronary intervention (PCI) treated by coronary intervention (PCI) were divided into the control group and the study group with 47 cases each by random number table in March 2013 to March 2017. The control group was treated with conventional therapy such as clopidogrel and aspirin during the perioperative period. The study group was treated with routine treatment with tanshinone IIA A sulfonate. Blood rheology, platelet membrane glycoproteins, inflammatory factors and brain natriuretic peptide (BNP) levels, short-term prognosis and adverse drug reactions were compared between the two groups before and after treatment.
Results:
After treatment, the blood rheological indicators were significantly decreased in the two groups (P < 0.05), and the blood viscosity, high / low shear blood viscosity, the maximum platelet aggregation rate and fibrinogen levels were significantly lower in the study group than in the control group (P < 0.05); the levels of CD62p, CD63, PAC-1, CRP, IL-6 and BNP were significantly decreased, and CD42b levels were increased significantly in the two groups (P < 0.05), and the above levels in the study group were lower than those in the control group (P < 0.05). The recurrence rate of angina pectoris in the study group was significantly lower than that in the control group during follow-up period (P < 0.05), and there was no significant difference in the incidence of adverse drug reactions between the two groups (P > 0.05).
Conclusion:
The application of sodium tanshinone IIA sulfonate in perioperative period of PCI can effectively improve the blood rheological indexes, play an antiplatelet role, promote the recovery of tissue injury, relieve inflammation, and improve the cardiac function in patients with coronary heart disease and angina pectoris, without increasing adverse reactions, and the short-term prognosis is good.
2017 Vol. 23 (8): 1284-1287 [
Abstract
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117
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1288
Clinical Observation on Treatment of Tarsus Joint Fracture and Dislocation Combined with Severe Soft Tissue Injury by jie gu qi li pill Combined with Negative Pressure and Drainage
XUE Chaoya, LIU Xuehui, GAO Huaiyin
DOI: 10.3969/j.issn.1006-6233.2017.08.016
Objective:
To observe the clinical effect of jie gu qi li pill combined with negative pressure occlusion technique (VSD) in the treatment of tarsal joint fractures with severe soft tissue injury.
Methods:
70 patients with severe tarsus joint fracture and dislocation combined with severe soft tissue injury were randomly divided into control group and treatment group (35 cases for each group). Both groups were treated by anatomical reduction and internal fixation. The control group were treated with conventional wound dressing and anti-infection, while The patients in the treatment group were treated with jie gu qi li pill and negative pressure occlusion technique (VSD).
Results:
The two groups' scores of pain, swelling and ecchymosis were significantly lower than those before operation (P<0.05).and the plasma viscosity of the two groups was lower than that before operation (P<0.05). The effective rate of pain, swelling and ecchymosis, such as ESR and CRP, in the treatment group was significantly higher than that in the control group (P<0.05). The total effective rate was lower than that of the control group at 28 days after fracture and dislocation (P<0.05).
Conclusion:
The combination of jie gu qi li pill combined with negative pressure occlusion technique can significantly improve the clinical symptoms and clinical physical and chemical indexes of tarsal metatarsal joint fracture and dislocation with severe soft tissue injury and help to promote the recovery of soft tissue injury.
2017 Vol. 23 (8): 1288-1291 [
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117
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1292
Clinical Observation of Individualized Interventional Embolization for treatment of Acute Renal Hemorrhage
MAO Xuequn, TAN Zhongbao, DI Zhenhai, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.017
Objective:
To discuss the clinical efficacy of individualized renal arterial embolization in the treatment of renal hemorrhage based on renal arteriography.
Methods:
Renal arteriography was performed on 18 patients with renal hemorrhage to determine the origin, diameter of the bleeding vascular and its position. Individualized renal arterial embolization was performed based on the result of renal arteriography: using single material or with multiple materials (Gelatin sponge particles embolization (700~1000 um), PVA (500-700-um), coils). The effects, complications and bleeding recurrence after renal arterial embolization were evaluated.
Results:
Technical success rate was 100% in 18 cases. Clinical success was achieved in 17 cases. The recurrence of renal bleeding after renal arterial embolization in one case and the patient was underwent successfully a second renal arterial embolization. One patient died because of MODS. During the followed up, one patient appeared microscopic haematuria in one year after embolization. The other patients did not appear again renal rupture bleeding during followed up. Postoperative renal function reducing did not happen in all of the patients.
Conclusions:
Renal arterial embolization is an effective method in the treatment of renal hemorrhage. Individualized renal arterial embolization can improve the clinical success rate of renal hemorrhage and the greatest degree of protection of renal function.
2017 Vol. 23 (8): 1292-1293 [
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115
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1294
Efficacy and Safety of Low-dose Spironolactone in Elderly Patients With Refractory Hypertension
LU Xu, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.018
Objective:
To evaluate the efficacy and safety of low- dose spironolactone in elderly patients with refractory hypertension.
Methods:
In the hospital, 85 patients with RH were enrolled from May 2015 to December 2015, including 45 males and 40 females, aged 72.12 ± 6.34 years. They were randomly divided into test group and control group. On the basis of A + C + D regimen, the patients in the experimental group were treated with spironolactone 20mg / day, the control group was given placebo. Followed up for 8 weeks to observe the changes in blood pressure, serum potassium and serum creatinine.
Results:
In the experimental group, there were 2 cases of adverse reactions, 1 case of lost visit, a total of 3 cases of withdrawal test, the control group 1 case lost. The mean value of systolic blood pressure and diastolic blood pressure decreased significantly after 8 weeks follow-up. The difference was statistically significant (P <0.05); Potassium ion, serum creatinine increased significantly was statistically significant P <0.05; but not yet exceeded the normal reference value of the maximum.
Conclusion:
In elderly patients with refractory hypertension in the A + C + D treatment program based on the addition of low-dose spironolactone can effectively reduce systolic and diastolic blood pressure, and tolerance is better.
2017 Vol. 23 (8): 1294-1300 [
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143
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1301
Clinical Study of Percutaneous Coronary Intervention(PCI) on Cardiac Function of Elderly Patients with Acute Myocardial Infarction complicated with Diabetes Mellitus
WANG Wenfeng, JIN Dapeng, JU Mingfei, et al
DOI: 10.3969/j.issn.1006-6233.2017.07.019
Objective:
Objective: To observe the effect of percutaneous coronary intervention(PCI)on cardiac function of elderly patients with acute myocardial infarction complicated with diabetes mellitus.
Methods:
The elderly patients with acute myocardial infarction complicated with diabetes mellitus were divided into two groups, PCI group and control group. The patients were given anti-neurohormone drug and then were followed up 6 months. The heart function and changes of ventricular remodeling were compared in statistical aspect between two groups.
Results:
The improvement of heart function and change of ventricular remodeling were significantly different in statics between two groups.
Conclusion:
PCI can significantly improve heart function and inhibit ventricular remodelling of the elderly patients with acute myocardial infarction complicated with diabetes mellitus.
2017 Vol. 23 (8): 1301-1303 [
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113
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1304
Application of Xingnaojing Injection in Patients with Cerebral Infarction and Its Safety
WU Wanyu, LIAO Jun, HUANG Jie, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.020
Objective:
To analyze the effect and safety of Xingnaojing injection in patients with cerebral infarction.
Methods:
100 patients with acute cerebral infarction from December 2016 to June 2017 were randomly divided into observation group and control group according to the number table method. The control group was treated with conventional western medicine. The observation group was treated with Xingnaojing injection on the basis of the control group. The clinical efficacy of the two groups was observed and the changes of the neurological deficits (NIHSS score) and the daily life ability score (Barthel index) were compared before and after treatment for two months before treatment, and the two groups Patient during the treatment of adverse reactions.
Results:
The clinical efficacy of the observation group and the control group was 92.0% and 82.0%, the observation group was better than the control group (P <0.05); before and after treatment NIHSS score and Barthel index and after treatment, were statistically significant (P <0.05). However, the improvement rate of the observation group was significantly higher than that of the control group (P <0.05). No serious adverse reactions occurred during the treatment period, which indicated that the brain was safe.
Conclusion:
Xingnaojing injection has a good effect in patients with cerebral infarction, which can effectively improve the neurological deficits of patients and improve the daily life ability of patients. It can effectively improve the quality of life of patients and has few adverse reactions. Promote the use of clinical.
2017 Vol. 23 (8): 1304-1306 [
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150
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1307
Study on the Relationship between Blood Uric Acid and Sex Hormones in Male Patients with Type 2 Diabetes Mellitus
LI Huiguang, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.021
Objective:
To observe the changes of blood sex hormone levels in male patients with type 2 diabetes, and to analyze the relationship between blood sex hormone levels and blood uric acid levels.
Methods:
100 cases of male patients with type 2 diabetes in our hospital from February 2014 to January 2016 were selected as observation group, 110 healthy males in our hospital were selected as control group, and the levels of blood sex hormones were compared between the two groups, the general indexes, glucose metabolism indexes and sex hormone levels in observation group of patients with different levels of serum uric acid were compared.
Results:
The total serum testosterone level in the observation group was lower than that in the control group, while the levels of estradiol and SHBG in the observation group were higher than those in the control group, and the difference was statistically significant (P＜0.05); Compared with blood uric acid level in 159-251 mol/l group, the levels of FINS and PINS in blood uric acid level in 385-688 mol/l group were significantly increased, and the levels of total testosterone and SHBG were significantly lower, and the difference was statistically significant (P＜0.05). There was no significant difference in age, BMI, other glucose metabolism and sex hormones (P＞0.05). And there were no significant differences in age, BMI, glucose metabolism and sex hormones between the other groups (P＞0.05).
Conclusion:
In male patients with type 2 diabetes mellitus, there is a disorder of sex hormones such as testosterone, E2, SHBG, and low plasma SHBG levels are significantly correlated with the level of serum uric acid.
2017 Vol. 23 (8): 1307-1309 [
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139
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1310
Predictive Value of N-terminal Brain Natriuretic Peptide Precursor for Atrial Fibrillation after Coronary Artery Bypass Grafting
WANG Zhaodong
DOI: 10.3969/j.issn.1006-6233.2017.08.022
Objective:
To investigate the diagnostic value of N- terminal brain natriuretic peptide (BNP) in patients with atrial fibrillation after coronary artery bypass grafting (CABG).
Methods:
132 cases in our hospital underwent coronary artery bypass grafting were selected in September 2011 to January 2015 were the observation of outcomes were atrial fibrillation events after operation, 39 cases divided into AF group and 93 cases into sinus rhythm group, the basic data of all patients were collected, including age BMI, EuroScore, NYHA, gender, grade, basic diseases (hypertension, diabetes), oral drugs (beta blockers, calcium channel blockers, statins), intensive care time, ventilator time, record cardiac ultrasound (LAD, LVESD, IVST, LVEDD, LVEF (NT-proBNP) and biochemical examination ALT, AST, hs-CRP, Cr, RBC, RDW), the dependent variable of postoperative atrial fibrillation, using single factor analysis of the difference between indicators as independent variables, multivariate regression analysis for Logistic.
Results:
The incidence of postoperative atrial fibrillation was 29.55% (39/132), the incidence of atrial fibrillation in CCABG group (46.94%) was higher than that of OPCAB group (19.28%), there are differences (P<0.05). AF group and sinus rhythm group in average age, EuroScore, NYHA grade, intensive care time, ventilator time, beta receptor antagonist, difference (P<0.05). AF group and sinus rhythm group in postoperative 24h LAD, after 24h LVEF, there are differences (P<0.05). AF group and sinus rhythm group at NT-proBNP, 24h after surgery and postoperative 24h hs-CRP RDW, there are differences (P<0.05). age, postoperative 24h LAD, NT-proBNP after surgery as an independent predictor of coronary artery bypass grafting with atrial fibrillation (P<0.05).
Conclusion:
Age, postoperative 24h, LAD, and NT-proBNP were independent predictors of atrial fibrillation after coronary artery bypass grafting.
2017 Vol. 23 (8): 1310-1315 [
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118
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1316
Analysis of the Effect of Interventional Catheter Thrombolysis Combined with Anticoagulation in the Treatment of Postpartum Deep Venous Thrombosis
JING Yang, DING Meng, FU Jiuyuan, et al
DOI: 10.3969/j.issn.1006-6233.2017.07.023
Objective:
Objective: To observe the therapeutic effect of interventional catheter thrombolysis combined with anticoagulation therapy and simple anticoagulant therapy for postpartum lower extremity deep venous thrombosis (DVT).
Methods:
34 cases of postpartum with central type or mixed type lower extremity deep venous thrombosis were collected in our hospital from January 2006 to February 2016, divided into anticoagulation group and intervention treatment group, the anticoagulation group 23 cases, intervention treatment group 11 cases. The clinical therapeutic effect and the incidence of PTS with 6 to 14 months follow-up of the two groups were compared.
Results:
There was significance statistical between the two groups about the difference of thigh and calf circumference before and after treatment(P<0.05); After treatment, compared with anticoagulation group, there was significance statistical between thigh circumference and calf circumference in the intervention group (P<0.05). During the follow-up period, compared with the simple anticoagulation group, the Villalta score and the distribution of patients class number in the intervention group the difference were statistically significant(P<0.05).
Conclusion:
The therapeutic effects of interventional catheter thrombolysis combined with anticoagulant therapy is better than simple anticoagulant therapy in the treatment of postpartum deep vein thrombosis, Worthy of clinical promotion.
2017 Vol. 23 (8): 1316-1318 [
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102
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1326
Predictive Value of New Injury Severity Score in Stress Ulcer of Shock Patients with Multiple Trauma
LUO Xiaomin, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.026
Objective:
To explore the predictive value of new injury severity score (NISS) in stress ulcer of shock patients with multiple trauma.
Methods:
Clinical data of 92 ICU shock patients suffered from multiple trauma were retrospectively reviewed between August 2015 and September 2016. The patients were divided into two groups with either stress ulcer present (20 cases) or absent (72 cases). Some clinical characteristics were compared between two groups. Multivariate logistic regression and receiver operating characteristic curve (ROC) were performed to identify independent risk factors of stress ulcer and the predictive accuracy.
Results:
The difference in shock degree and mechanical ventilation were statistically significant between two groups (P＜0.05), while that in gender, age, ratio of glucocorticoid usage or operative treatment between two groups didn't reach significant level (P＞0.05). The scores of NISS, ISS and APACHE Ⅱ were obviously higher in the stress ulcer group than non-stress ulcer group (29.00±5.26 vs.23.32±4.04, 26.25±5.48 vs.21.72±3.74 and 18.10±4.29 vs.15.42±3.73, respectively, P＜0.05 for all). Multivariate logistic regression analysis showed that only NISS was correlated with the incidence of stress ulcer. The area under the cure for NISS was 0.825 by ROC analysis. The best boundary value of NISS was 26.5 with the sensitivity, specificity, positive predictive and negative predictive values of 85.0%, 77.8%, 51.5% and 94.9%, respectively.
Conclusions:
NISS is an independent risk factor for stress ulcer in shock patients suffered from multiple trauma. NISS can predict stress ulcer with a good accuracy in this population.
2017 Vol. 23 (8): 1326-1329 [
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93
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1378
Effects of Continuous Plasma Adsorption combined with Plasma Filtration Therapy on Immune Function and Prognosis in Patients with Acute Kidney Injury Induced by Sepsis
LEI Qiuyu, WANG Yiqin, WANG Daihong, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.042
Objective:
To investigate the effect continuous plasma adsorption combined with plasma filtration therapy on immune function and prognosis of patients with acute renal injuryinduced by sepsis.
Methods:
A total of 64 patients with acute renal injury were randomly divided into treatment group and control group, 32 cases each. All the patients were treated with anti infection, mechanical ventilation, liquid resuscitation, blood glucose control, correct acidosis and electrolyte disturbance, nutritional support. The control group was treated with continuous renal replacement therapy (CRRT), and the treatment group was treated with continuous plasma filtration (CPFA), the levels of serum inflammatory factors, immune function, biochemical indexes and the 30 survival rate and ICU stay time were compared between the two groups.
Results:
Before treatment, the immune function of two groups of patients with serum levels of inflammatory factors, and biochemical indexes such as the level of comparison, the difference was not statistically significant (P>0.05).After treatment, two groups of patients with serum hs-CRP, IL-6, IL-1 and TNF- levels were significantly decreased (P < 0.05);Serum IgG, IgA, IgM levels were significantly higher in the experimental group, the level of CD4
+
increased obviously, the level of CD8
+
was significantly decreased (P < 0.05);Serum WBC, urea, creatinine levels decreased, patients in the experimental group PLT and N levels than before treatment significantly (P < 0.05)。Comparison between groups of patients in the experimental group, serum hs-CRP, IL-6, IL-1 and TNF- levels significantly lower than the control group (P < 0.05);Serum IgG, IgA, IgM levels significantly higher than the control group (P < 0.05);Serum WBC, urea, creatinine level was significantly lower than that of the control group (P < 0.05)。The control group of 30 patients with D survival rate was 62.50% (20/32) lower than the experimental group 30 d survival rate was 84.38% (27/32) (P>0. 05), ICU residence time (15.31 + 2.21) d was significantly higher than the patients in the experimental group ICU retention time (11.22 + 2.84) d (P < 0.05).
Conclusions:
Continuous plasma filtration adsorption combined with plasma has good clinical curative effect on acute kidney injury and sepsis, it can significantly improve the immune function of patients, reduce serum inflammatory factors, improve the prognosis, has better clinical significance.
2017 Vol. 23 (8): 1378-1382 [
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176
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1395
Clinical Efficacy of the Tonifying qi huoxue Soup Combined Gua Sha in the Treatment of Hospital Acquired Pneumonia
WANG Yueyue, JIANG Hongru, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.047
Objective:
To study the clinical efficacy of the tonifying qi huoxue soup combined Gua Sha in the treatment of hospital acquired pneumonia.
Methods:
128 cases of severe pneumonia patients were collected from January 2015 to December 2015,and randomly divided into treatment group and control group,64 cases in each group. The control group given intravenous infusion piperacillin-tazobactam, treatment group on the basis of control group to give the tonifying qi huoxue soup combined Gua Sha .Compare two groups of patients with the clinical curative effect of treatment for 14 days, test before and after treatment C-reactive protein (CRP), oxygenation index (PaO
2
/FiO
2
) mechanical ventilation time, antibiotic use time, bacterial clearance rate and the level of inflammatory cytokines, record the occurrence of adverse reactions.
Results:
After treatment,the total effective rate was 78.12% in treatment group was significantly higher than 56.26% (P < 0.05);;each observed indicators in two groups and levels of inflammatory cytokines were improved than before treatment (P <0.05), and the degree of improvement in the treatment group was significantly greater than in the control group, the difference was statistically significant (P<0.05). The incidence of adverse reactions were very low in both groups (P>0.05).
Conclusion:
the tonifying qi huoxue soup combined Gua Sha in the treatment of hospital acquired pneumonia, can improve the clinical curative effect, improve the symptoms and promote recovery, and less adverse reactions, worthy of clinical promotion.
2017 Vol. 23 (8): 1395-1397 [
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132
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1404
Analysis of Antimicrobial Drugs Directory Varieties of Ten Secondary General Hospitals in Chengde
SONG Limin, et al
DOI: 10.3969/j.issn.1006-6233.2017.08.050
Objective:
To understand the rationality of the implementation of the restriction and the variety structure of antibacterial drugs in the two grade general hospitals in Chengde after the special clinical practice of the national antibacterial drugs in 2015
Methods:
The catalogue and specifications of antimicrobial drugs were collected, counted and analyzed in 10 hospitals of grade two and grade 2 in Chengde.
Results:
There are more than 35 kinds of antibiotics in 10 hospitals of grade two and 6, among which the most is 56 kinds. Each hospital had the largest number of beta lactam antibiotics, accounting for 45.95% of the total number of hospitals, with a maximum of 64.86%, with an average of 56.77%.
Conclusion:
To the end of June 2015, the Chengde area of at least 6 grade two general hospital has not fully implemented scheme provisions of the special rectification activities of clinical application of antibacterial drugs on varieties, varieties of structure part of the hospital is not reasonable.
2017 Vol. 23 (8): 1404-1408 [
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101
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