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2017 Vol. 23, No. 7 Published: 2017-07-20 1057 Correlation of Pulmonary Hypertension and Plasma NT-proBNP in Patients with COPD WEI Jun, SUN Jun, CHEN Xuedong, et al DOI: 10.3969/j.issn.1006-6233.2017.07.001 Objective: To investigate the relationship between pulmonary arterial hypertension (PH) and plasma levels of N terminal B type brain natriuretic peptide (NT-proBNP) in patients with chronic obstructive pulmonary disease (COPD). Methods: 120 cases of patients with COPD treated in our hospital were selected as the study objects, and 60 cases of acute exacerbation of COPD patients were as group A, the other 60 cases of COPD patients complicated with PH were as group B. At the same time, pulmonary systolic pressure (PASP) was detected in group B, and grouped according to the test results. PASP level less than 30mmHg were as the control group, between 30mmHg and 50mmHg were as the mild group, and more than or equal to 50mmHg were as the moderate and severe group. Plasma NT-proBNP levels and correlation with PH were observed and recorded of all the study objects. Results: Plasma NT-proBNPC level in group B was much higher than that in group A (P< 0.05). The level of NT-proBNP in moderate and severe group was significantly higher than that in the control group and the mild group, with statistically significant differences between every two groups of the three groups (P< 0.05). Plasma NT-proBNP level was positively correlated with PASP (P< 0.05). Conclusion: NT-proBNP level is positively correlated with the severity of PH, and it has certain reference value in judging the severity of PH. 2017 Vol. 23 (7): 1057-1059 [Abstract] ( 187 ) HTML (1 KB)  PDF (1328 KB)  ( 209 ) 1060 Effect of Long Term Insulin Combined with Short Term Insulin on Blood Glucose Management of Continuous Infusion of Enteral Nutrition Fluid in Patients with DM CHEN Yuefen, CHEN Caifang, LUO Juan DOI: 10.3969/j.issn.1006-6233.2017.07.002 Objective: To investigate the effect of three different schemes on blood glucose management of continuous infusion of enteral nutrition fluid in patients with diabetes mellitus:subcutaneous injection with long term and short term insulin (MSII), continuous intravenous infusion of insulin, insulin pump continuous subcutaneous injection (CSII). Methods: A total of 48 patients with type 2 diabetes mellitus received continuous infusion of enteral nutrition fluid in our hospital from January 2016 to March 2017 were selected as research objects. All of the patients were randomly assigned into MSII group (n=18), continuous intravenous infusion group (n=16) and CSII group (n=14). Patients in the MSII group received subcutaneous injection with long term and short term insulin, patients in the continuous intravenous infusion group received continuous intravenous infusion of insulin, patients in the CSII group received insulin pump continuous subcutaneous injection. Comparison of three groups of patients of enteral nutrition on blood glucose of third calorie feeding target average blood glucose (MBG), standard deviation (SD), maximum blood glucose fluctuations (LAGE), the incidence of hypoglycemia and blood glucose management costs (insulin medicines and supplies fees, nursing fees). The following indicators of the three groups were compared: the average blood glucose (MBG), the standard deviation of blood glucose (SD), the maximum fluctuation of blood glucose (LAGE), the incidence of hypoglycemia and the related costs of blood glucose management (insulin, drug costs, supplies costs, nursing costs). Results: The blood sugar of the three groups decreased obviously after treatment. The average blood glucose (MBG) in continuous intravenous infusion group was the smallest (P＜0.05), and there was no statistical difference between the MSII group and the CSII group (P＞0.05). The standard deviation of blood glucose (SD) and the maximum blood glucose fluctuations (LAGE) in continuous intravenous infusion group were higher than those in the MSII group and CSII group (P＜0.05), and the MSII group was higher than the CSSII group (P＜0.05). The incidence of hypoglycemia of the continuous intravenous infusion group was higher than that in the MSII group and CSII group , and there was no statistical difference between the MSII group and the CSII group. Conclusion: Continuous intravenous infusion of insulin is ideal for controlling average blood glucose (MBG), but the incidence of hypoglycemia is the highest. The insulin pump continuous subcutaneous injection is ideal for controlling standard deviation of blood glucose, but the cost is the highest. Subcutaneous injection with long term and short term insulin can achieve the same effect of continuous intravenous infusion of insulin and insulin pump continuous subcutaneous injection. The incidence of hypoglycemia is low and the cost is the lowest. It is a safe, effective and economical glycemic management program. 2017 Vol. 23 (7): 1060-1063 [Abstract] ( 145 ) HTML (1 KB)  PDF (1370 KB)  ( 298 ) 1064 Analysis of Insulin Resistance and Anticardiolipin Antibodies in Patients with Essential Hypertension WU Xiaomei, ZHU Ling, WU Linna DOI: 10.3969/j.issn.1006-6233.2017.07.003 Objective: To explore the association of insulin resistance and anticardiolipin antibodies in patients with essential hypertension. Methods: 120 patients with essential hypertension in our hospital from February 2015 to February 2016 were selected as experimental group. 56 healthy subjects were selected at the same time in our hospital as the control group. The body mass index, fasting insulin and fasting blood glucose were compared between the two groups. Insulin resistance indexes were calculated in two groups. Anticardiolipin antibodies (ACA-IgG, ACA-IgM) levels of the two groups were compared. Assosiations between insulin resistance and ACA-IgG and ACA-IgM were analyzed. Results: The fasting insulin level and insulin resistance index in the experimental group were significantly higher than those in the control group (P<0.05).The serum ACA-IgG and ACA-IgM in the experimental group were significantly higher than those in the control group (P<0.05).Serum ACA-IgG level was positively correlated with insulin resistance (P<0.05), but there was no correlation between serum ACA-IgM level and insulin resistance (P>0.05). Conclusion: There's significant insulin resistance in patients with essential hypertension, and there's a positive correlation between the level of serum ACA-IgG and the level of resistance. It suggests that there is a tendency to thrombosis in patients with essential hypertension. 2017 Vol. 23 (7): 1064-1066 [Abstract] ( 121 ) HTML (1 KB)  PDF (1348 KB)  ( 289 ) 1067 Dexmedetomidine Combined with Bispectral Index Monitoring on Hemodynamics during General Anesthesia Recovery and Extubation in Patients Undergoing Radical Resection of Lung Cancer CHEN Meng, HE Huan, LI Dechun, et al DOI: 10.3969/j.issn.1006-6233.2017.07.004 Objective: To investigate the effects of dexmedetomidine combined with bispectral index applied on hemodynamics of patients with lung cancer effects during anesthesia recovery period and pull. Methods: 60 patients admitted in our hospital from January to December 2016 enrolled in this study were the need for radical lung cancer, were given the same dose of dexmedetomidine and other drugs for induction of anesthesia, surgery according to the clinical experience of infusion of propofol, remifentanil and intermittent intravenous injection of CIS atracurium to maintain the depth of anesthesia. In the observation group, 30 cases maintained bispectral index (BIS) between 40 and 60, and adjusted the amount of propofol according to the monitoring results. The respiratory and consciousness recovery time and the total amount of narcotic drugs were compared between the 2 groups. The hemodynamic indexes of the 2 groups were observed during the extubation, and the incidence of adverse reactions in the 2 groups was counted. Results: The hemodynamics observation group' is more stable (P<0.05); The total amount of remifentanil, were significantly lower than the control group (P <0.05); the observation group breathing recovery time, extubation time, orientation recovery time was significantly lower than the control group (P<0.05); the incidence of adverse reaction the observation group during the extubation was significantly lower than the control group (P<0.05). Conclusion: Dexmedetomidine combined with bispectral index in lung cancer patients blood flow dynamics is stable, can reduce the total use of narcotic drugs, recovery time shortened, and safety. 2017 Vol. 23 (7): 1067-1069 [Abstract] ( 119 ) HTML (1 KB)  PDF (1346 KB)  ( 210 ) 1070 Application of One-station Low Dose Imaging of 128-Slice Spiral CT in Chest Pain Triad WANG Shuquan, WANG Jiawei, WANG Yajie DOI: 10.3969/j.issn.1006-6233.2017.07.005 Objective: To explore the clinical value of 128 slice spiral CT low dose imaging in patients with chest pain. Methods: The clinical and imaging data of 93 patients with acute chest pain admitted in our hospital from June 2014 to December 2016 received 128 slice spiral CT with one station imaging examined were analyzed. According to body mass index (BMI) of different tube voltage, all the patients were divided into group A and B, group A, BMI < 24kg/m2 (49 cases), 100kV tube voltage, using prospective ECG gated scan; group B, BMI = 24kg/m2 (44 cases), 120kV tube voltage, using retrospective ECG gated scanning. The effective radiation dose and image quality of two groups were compared and analyzed. Results: The two groups obtained satisfactory images, and there was no significant difference in image quality between group A and group B (P > 0.05). The average effective dose of group A was significantly different from that of group B (P < 0.05). Conclusion: For patients with acute chest pain, heart rate in the state is relatively stable, using prospective ECG gating technology and the combination of low tube voltage scanning, image quality can meet the requirement of diagnosis, and significantly reduce the radiation dose, is worthy of promotion. 2017 Vol. 23 (7): 1070-1073 [Abstract] ( 109 ) HTML (1 KB)  PDF (1720 KB)  ( 325 ) 1077 CT Features and CD147 and VEGF-C Expression in Peripheral Non-small Cell Lung Cancer MA Changshun, CUI Shixin DOI: 10.3969/j.issn.1006-6233.2017.07.007 Objective: To study the CT imaging in the diagnosis of non-small cell lung cancer in a variety of signs and CD147, vascular endothelial growth factor C (VEGF-C) correlation of positive expression. Methods: 60 cases of non-small cell lung cancer in our hospital were selected, and the signs of CT examination and positive results of VEGF-C and CD147 were analyzed. Results: VEGF-C and CD147 positive expression and the tumor size, deep lobulation, spine and pleural position fat line disappeared and mediastinal lymph nodes were related (P < 0.05), positive CD147 and pleural indentation sign were related (P<0.05); VEGF-C and vascular bundle were positive related (P < 0.05). Conclusion: VEGF-C and CD147 expression in non-small cell lung cancer patients with tumor size, spines, deep lobulated, mediastinal lymph nodes, and pleural no correlation between fat line and so on, can provide effective basis for disease diagnosis. 2017 Vol. 23 (7): 1077-1079 [Abstract] ( 133 ) HTML (1 KB)  PDF (1340 KB)  ( 170 ) 1080 The Delivery Mode of Scar Uterus in Term Pregnancy after Cesarean Section FU Juanjuan, ZHANG Yu, WANG Wenyan DOI: 10.3969/j.issn.1006-6233.2017.07.008 Objective: To investigate the feasibility of vaginal birth after cesarean section scar pregnancy (VBAC). Methods: 90 cases with vaginal delivery after cesarean uterine scar pregnancy from January 2009 to August 2016 were selected as the observation group; 50 cases of uterine scar pregnancy underwent cesarean section again as control group 1, the other in our hospital from January June, 2016 to 50 primiparaes in delivery as control group 2. The hospital stay, the amount of postpartum hemorrhage, the amount of postpartum hemorrhage and the duration of labor in 3 groups were analyzed, and the menstrual abnormalities after cesarean section of two groups were compared between the 24 groups. At the same time, the number of cases of abnormal menstruation after cesarean section was compared. Results: Compared with control group 1, the hospitalization time was significantly shorter, the postpartum hemorrhage and postpartum hemorrhage of 24h decreased significantly in the observation group. There was significant difference between the two groups, but there was no puerperal infection and urinary retention in the two groups. Postpartum lochia and menstruation followed up by telephone, 8 cases of observation group had postpartum lochia long and prolonged postpartum period and increased menstrual volume, which significantly less than control group 1. The difference was statistically significant. Compared with the time of labor and the amount of intrapartum hemorrhage, postpartum hemorrhage of 24 hours, there was no significant difference between the observation group and the control group 2. Conclusion: For the scaruterus pregnant women, it is feasible to implement VBAC after control completely and evaluation during pregnancy and prenatal care, under the same condition compared with the recesarean section, there is more advantages inVBAC than cesarean section. 2017 Vol. 23 (7): 1080-1082 [Abstract] ( 106 ) HTML (1 KB)  PDF (1347 KB)  ( 291 ) 1086 Budesonide Inhalation on Children with Asthma and Peripheral Inflammatory Factors and Pulmonary Function Index GUO Mei, WANG Wei DOI: 10.3969/j.issn.1006-6233.2017.07.010 Objective: To analyze aerosol inhalation of budesonide in children with clinical changes in patients with asthma and peripheral inflammatory factors and pulmonary function index. Methods: 100 cases of children with asthma admitted in our hospital from January 2015 to February 2016 were randomly divided into observation group and control group, the control group with routine intervention, the observation group in the control group on the basis of budesonide inhalation; after a week before and at the end of treatment, TNF-α in peripheral blood and IL-8, IL-4, immune immunoglobulin levels in children with asthma, were detected FEV1, FVC, PEF% records, and to evaluate the clinical symptoms in children. Results: After treatment, the symptom scores of patients of two groups were significantly reduced, and the difference was statistical significance (P<0.05); and symptom score of the patients in the observation group after treatment was significantly lower than the control group ( P<0.05); after treatment, FVC, FEV1 and PEF of two groups were significantly improved, and the difference was statistical significance (P<0.05); after treatment, the observation group with FVC, FEV1 and PEF were significantly higher than those in the control group ( P<0.05); after treatment, peripheral blood IL-4, TNF-α and IL-8 level of two groups of children were decreased, and the difference is statistical significance (P<0.05); peripheral blood IL-4, TNF-α and IL-8 level of the observation group with after treatment was significantly lower than the control group (P<0.05); after treatment, IgA and IgE were decreased significantly (P<0.05); IgG and IgM levels were significantly higher (P<0.05), statistically significant differences between the two groups of children with peripheral blood immunoglobulin level and survival after treatment (P<0.05). Conclusions: Budesonide can effectively improve the level of inflammatory factor in children with asthma in peripheral blood and improve lung function, it has high value in clinical application. 2017 Vol. 23 (7): 1086-1090 [Abstract] ( 120 ) HTML (1 KB)  PDF (1367 KB)  ( 242 ) 1091 Apoptosis Induced by Recombinant Human Endostatin and Paclitaxel in Breast Cancer Cell Line SK-BR-3 WANG Xiaoli, WANG Xiaocheng, XU Xiaoming, et al DOI: 10.3969/j.issn.1006-6233.2017.07.011 Objective: To observe the growth and apoptosis rate of recombinant human endostatin combined with paclitaxel in breast cancer cell line SK-BR-3. Methods: The growth of cells was observed under light microscope. The apoptosis rate of breast cancer cell SK-BR-3 was detected by flow cytometry. The expression of apoptosis related protein Bcl-2/Bax was observed by Realtime PCR method. The apoptosis inducing effects of different administration protocols on breast cancer cell line SK-BR-3 were compared. Results: Apoptosis of Endostar 1 g/ml after 48h was 11.6% (P<0.05), Bcl-2 expression, and the expression of Bax was not changed. The rate of apoptosis was 12.4% (P<0.05) after paclitaxel was 1 g/ml, and the expression of Bcl-2 was down regulated, while the expression of Bax was increased by 24h. Paclitaxel and sequential administration of Endostar respectively, the apoptosis rates were 16.50% and 14.18% (P<0.05), and can down regulate the expression of Bcl-2, increase the expression of Bax. The apoptosis rate of SK-BR-3 cells was 22.74%, which was significantly higher than that of other administration group (P<0.05), and the expression of Bcl-2 was down regulated and the expression of Bax was elevated at the same time when the two groups were combined and administered at the same time. Conclusion: Both endostar and paclitaxel can inhibit the growth of breast cancer cell line SK-BR-3 and induce apoptosis. The two drugs simultaneously produced the best effect. 2017 Vol. 23 (7): 1091-1093 [Abstract] ( 129 ) HTML (1 KB)  PDF (1845 KB)  ( 281 ) 1094 Changes of Placental Protein 13 in Serum and Urine of Women with Early-onset Preeclampsia RAN Xuelian, LIN Bin, YIN Hang DOI: 10.3969/j.issn.1006-6233.2017.07.012 Objective: To study the early-onset preeclampsia (PE) in placenta of pregnant women serum and urine protein 13 (PP13) test results. Methods: 160 pregnant women with preeclampsia were divided into 80 cases of early-onset preeclampsia and 80 cases of late onset preeclampsia according to the gestational age. 50 normal pregnant women were selected as the control group. Results: Serum and urine of pregnant women in preeclampsia placental protein 13 levels of two groups were significantly higher than those of normal pregnant women (P < 0.05), early onset preeclampsia placental protein 13 levels in serum and urine was significantly higher than that of late onset preeclampsia (P < 0.05). Conclusion: The levels of placental protein 13 in serum and urine increased significantly in severe preeclampsia women, and the increase of early onset patients was more obvious. Placental protein 13 could be an important indicator of early onset preeclampsia. 2017 Vol. 23 (7): 1094-1096 [Abstract] ( 90 ) HTML (1 KB)  PDF (1352 KB)  ( 174 ) 1097 Midazolam closed-loop Target Controlled Infusion with Bispectral Index Feedback Control in ICU Sedation CHEN Bo, DENG Qian DOI: 10.3969/j.issn.1006-6233.2017.07.013 Objective: To analyze the application value of midazolam CLTCI with BIS feedback control in ICU sedation. Methods: 120 patients admitted in ICU of Suizhou Affiliated Hospital to Hubei Medicine University from January 2015 to December 2016 selected as the research objects, were randomly divided into group A of 40 cases using micro pump continuous infusion, group B of 40 patients with target controlled infusion, (target controlled, infusion, TCI) group C of 40 cases using the closed-loop target controlled infusion (CLTCI) and APACHE were performed within 24h after admission II score. The data of HR, RR, MAP before sedation, BIS and sedation effect were recorded and compared. Results: Compared with the basic values of MAP and HR, the MAP of three groups decreased obviously after sedation, but there was no statistical significance (P > 0.05); The BIS values corresponding to the different Ramsay scores were negatively correlated in the three groups (correlation coefficient, r=-0.856). With the depth of sedation, BIS values of patients in three groups were significantly decreased. Among them, the BIS value corresponding to 3 points, 4 points, 5 points and 6 branches was significantly lower than the corresponding BIS value of the 1 branche. The corresponding BIS values of 4 points and 6 branches were significantly lower than the corresponding BIS values of the 2 branches, all of which were statistically significant (P < 0.05). The corresponding values of the 5 branches were statistically significant (P < 0); There was significant difference between the three groups in maintaining ideal sedation time, 60~80 range, BIS value, time percentage and average dosage of midazolam in 24h, and statistically significant (P < 0.05); Group C maintain ideal sedation time and the percentage reached 60 ~ 80 BIS value of the percentage of time was significantly higher than that of group A, group B, group C 24h, the average amount of midazolam significantly less than group A and group B were statistically significant (P < 0.05). Conclusions: Compared with the continuous infusion and TCI infusion, the CLTCI can effectively reduce the dosage of midazolam while maintaining sedation, and it is worthy of clinical application. 2017 Vol. 23 (7): 1097-1100 [Abstract] ( 118 ) HTML (1 KB)  PDF (1363 KB)  ( 370 ) 1101 Incidence and Correlation of Thyroid Nodules in People with Different Glucose Tolerance SHANGGUAN Haiyan, GUO Wen, XIN Bing, et al DOI: 10.3969/j.issn.1006-6233.2017.07.014 Objective: To compare the prevalence of thyroid nodules among people with different glucose tolerance, and to investigate the relationship between insulin resistance and the incidence of thyroid nodules. Methods: three groups of subjects were collected in this study, 342 patients with type 2 diabetes (T2DM), 145 normal glucose tolerance (NGT), and 180 patients with impaired glucose regulation (IGR), to compare between the three groups of thyroid nodule detection rate, HOMA - IR and Matsuda index. Divided into the nodules group and non-nodules group,and compared the differences between the two groups of gender, age, BMI, HOMA - IR and Matsuda index and correlation. Results: Thyroid nodules prevalence in T2DM group was significantly higher than in IGR and NGT group (P < 0.05);At the same time, the BMI, HOMA IR and TSH levels in T2DM group were higher than the other two groups (P < 0.05); The Matsuda index of T2DM group was lower. The BMI, FPG, HOMA-IR in Thyroid nodule group were higher than those in non- nodules group, P < 0.05; While the Matsuda index is lower than the non-nodule group, P < 0.05. Logistic regression analysis was carried out on the thyroid nodules, and the results showed that thyroid nodule and age, BMI, fasting glucose, HOMA-IR were positively correlated (OR =1.061,1.121,1.114,1.225,95％CI =1.015～1.079,1.057～1.324,1.142～ 1.416,1.112～ 1.428), and negatively correlated with Matsuda index (OR=0.385,95％CI =0.298～0.479). Conclusion: The prevalence of thyroid nodules significantly is higher in the diabetic population, age, gender, fasting glucose, BMI and insulin resistance are independent risk factors for the development of thyroid nodules disease. 2017 Vol. 23 (7): 1101-1104 [Abstract] ( 163 ) HTML (1 KB)  PDF (1374 KB)  ( 273 ) 1105 Intravitreal Injection of Monoclonal Antibody on Postoperative Visual Acuity in Patients with Proliferative Diabetic Retinopathy ZHANG Yonghong, ZHANG Xiaomei, FU Peng DOI: 10.3969/j.issn.1006-6233.2017.07.015 Objective: To investigate the effect of intravitreal injection of monoclonal antibody on the postoperative visual acuity in patients with proliferative diabetic retinopathy. Methods: 110 patients with proliferative diabetic retinopathy treated by minimally invasive incision treatment of vitreous body were randomly divided into two groups, 55 cases, 96 eyes of patients in the experimental group, the control group of 55 cases, 102 eyes of two patients underwent minimally invasive vitreous body incision, the patients in the experimental group before surgery given ranibizumab. The vascular endothelial growth factor (VEGF),visual acuity,the operation time, bleeding, and the efficiency of clinical treatment between the two groups before and after treatment were observed and compared. Results: Compared with before treatment, the level of VEGF decreased and visual acuity increased in the two groups after treatment, and the difference was statistically significant (P<0.05); Compared with the control group, the patients in the experimental group had lower VEGF levels and higher visual acuity, and the difference was statistically significant (P<0.05); Compared with the control group, the operation time of the experimental group was shorter, the rate of operation bleeding was lower, and the effective rate of clinical treatment was higher, the difference was statistically significant (P<0.05). Conclusion: Intravitreal injection can significantly improve the postoperative VEGF and visual acuity in patients with proliferative diabetic retinopathy, the bleeding rate is low, and the clinical effect is better. 2017 Vol. 23 (7): 1105-1107 [Abstract] ( 114 ) HTML (1 KB)  PDF (1345 KB)  ( 200 ) 1108 The Value of Ultrasonic Elastography Strain Rate Ratio in Grading of Breast BI-RADS 4 DING Huajie, LIU Yangyang, LIU Huiling, et al DOI: 10.3969/j.issn.1006-6233.2017.07.016 Objective: To evaluate the value of strain rate ratio of ultrasound elastography in grading of breast BI-RADS 4 grade tumors. Methods: The data of 120 cases of breast tumor resection patients admitted in the affiliated hospital of Chengde Medical College from January 2014 to June 2016 were collected. BI-RADS grading of all tumors before operation was 4 grade, and the grading rate was revised after ultrasonic elastography, strain rate ratio, and the correction rate of BI-RADS grading was analyzed by pathological elastography as the gold standard. Results: 120 cases of breast masses BI-RADS 4 ultrasound elastography strain ratio after correction, including 46 cases of BI-RADS grade 4 to maintain unchanged, 59 cases dropped to BI-RADS Level 3, 15 cases of up to BI-RADS level 5, and pathology, ultrasound elastography strain ratio before and after correction of the sensitivity, specificity and accuracy were 100%, 0%, 45%, 90.7%, 81.8% and 85.5%; the specificity and accuracy was statistically significant differences before and after correction (P<0.05), there was no significant difference before and after the sensitivity correction (P>0.05). Conclusion: The ratio of strain rate of ultrasonic elastography is of certain clinical value for grading correction of BI-RADS 4 grade tumor. 2017 Vol. 23 (7): 1108-1110 [Abstract] ( 132 ) HTML (1 KB)  PDF (1350 KB)  ( 325 ) 1111 Effect of Vaginal Bleeding in Early Pregnancy on the Development of Full-term Infants WANG Xuedong DOI: 10.3969/j.issn.1006-6233.2017.07.017 Objective: To investigate the effect of vaginal bleeding in early pregnancy on the development of full-term infants. Methods: 240 cases of maternal birth in our hospital were selected, including 82 cases of maternal vaginal bleeding in the early pregnancy, as the observation group; 158 cases of maternal vaginal bleeding during pregnancy, as the control group. The birth conditions, physical development, intelligence and mental development of the two groups were compared. Results: The incidence of fetal distress in the observation group was higher than that in the control group, and the birth weight was lower than that of the control group (P <0.05). There were no significant differences in physical development, mental development and mental development index between the two groups (P> 0.05). Conclusion: Pregnancy vaginal bleeding can affect the birth weight of infants born in full term, leading to fetal distress, its physical and mental and mental development were no significant impact. 2017 Vol. 23 (7): 1111-1112 [Abstract] ( 102 ) HTML (1 KB)  PDF (1324 KB)  ( 145 ) 1113 Comparison of Clinical Effects of Vacuum Sealing Drainage and Traditional Packing and Compression Techniques in the Treatment of Foot Skin Avulsion WANG Wei, PAN Zhaohui, ZHAO Yuxiang DOI: 10.3969/j.issn.1006-6233.2017.07.018 Objective: To discuss the advantages and disadvantages of the two treatment methods, by comparing and analyzing the clinical effects of skin replantation in situ combined with vacuum sealing drainage (VSD) and skin in situ replantation combined with packing skin grafting for the treatment of foot skin avulsion injury. Methods: 50 cases with foot skin avulsion injury were treated with emergency skin in situ replantation combined with VSD technique and in situ replantation combined with skin grafting from January 2011 to September 2016. 25 cases were underwent VSD combined with in situ skin replantation as experimental group, and other 25 cases were accepted the traditional package with in situ skin replantation as control group. The percentage of skin grafting, the rate of wound infection, the rate of subcutaneous hematoma, the time of operation, the length of hospital stay, the number of dressing change and the reoperation rate were observed in two groups. Result: After the emergency operation, the per patient's survival rate of skin graft of VSD group is 97.2±5.97% and the traditional packaging technology group is 87.2±13.61 %.(p＜0.05). The hospitalization time, operative time, and the times of postoperative dressing change of experimental group were significantly shorter than those of control group(p＜0.05). The reoperation rate and the occurrence rates of infection and subcutaneous hematoma of experimental group were lower than those of control group (p＜0.05) . Conclusions: The emergency use of skin in situ replantation in situ skin with VSD suction treatment of foot skin avulsion injury compared to traditional replantation combined with packing pressure method, can improve the individual patients with skin graft survival percentage, reduce the skin wound infection and subcutaneous hematoma rate, reduce the probability the second stage operation to repair and reduce the need to repair the wound area, shorten the operation time, hospitalization time, dressing change times. 2017 Vol. 23 (7): 1113-1117 [Abstract] ( 120 ) HTML (1 KB)  PDF (2859 KB)  ( 325 ) 1118 Analysis of Risk Factors leading to Amputation of Popliteal Artery Injury ZHANG Lichao, et al DOI: 10.3969/j.issn.1006-6233.2017.07.019 Objective: To reduce the amputation rate by analysis of risk factors of amputation in patients with popliteal artery injury. Methods: The data of patients with popliteal artery injury were collected and analyzed from January 2005 to January 2014. The detailed information should included basic information, injury mechanism, hemodynamic characteristics, physical activity, associated injuries, surgical methods and the amputation rate. Results: Two hundred and twelve patients with popliteal artery injuries were identified. Penetrating and blunt trauma accounted for 20 and 192 injuries, respectively. Associated injuries included fractures in 132 patients, kneed islocations in 22 and popliteal vein injuries in 118. Forty patients presented with a compartment syndrome. Arterial injuries were treated with reversed vein grafting in 110 patients, primary anastomosis in 80 cases, and primary amputationin 10 cases, who had extent of soft tissue damage. Forty patients underwent delayed amputation, giving an overall amputation rate of 23.6%. Three of 40 delayed amputations were performed due to uncontrolled infection complicated by haemorrhage or thrombosis. The presence of a compartment syndrome (OR=15.518, p<0.001) and associated with fractures (OR=19.029, p<0.001) were significantly associated with an increased amputation rate. Conclusions: The most significant risk factors associated with the high amputation rate of23.6% were the mechanism of injury, an ischaemic time longer than 6 hours, the presence of a compartment syndrome and associated with fractures around the knee joint. 2017 Vol. 23 (7): 1118-1120 [Abstract] ( 150 ) HTML (1 KB)  PDF (1345 KB)  ( 316 ) 1121 Clinical Effect and Complications of Endoscopic Transnasal Lacrimal Fossa Approach in treatment of Maxillary Sinus Diseases XU Chunlai, ZOU Hengying DOI: 10.3969/j.issn.1006-6233.2017.07.020 Objective: To discuss the clinical effects of patients with maxillary sinus diseases accepted with endoscopic anterior prelacrimal recess surgery and its complications. Methods: 70 patients with maxillary sinus disease from June 2014 to June 2016 were retrospectively analyzed, according to the different operation paths, 34 patients of them accepted with windowing of middle nasal meatus combined with inferior nasal meatus were taken as control group. 36 patients of them accepted with endoscopic anterior prelacrimal recess surgery were taken as research group. The patients in the study group underwent endoscopic anterior lacrimal recess approach, while the control group underwent endoscopic sinus approach through the lower nasal meatus. The intraoperative blood loss, operation time and length of stay were recorded in the two groups. The follow-up period was 12 months. The postoperative complications and recurrence of the two groups were observed. Results: The intraoperatve blood loss, operative time and hospital stays were (65.28±6.37) mL,(48.72±5.46) min and (5.86±0.68) d in research group, which were lower than that in control group, differences were statistically significance (P＜0.05). The complication occurrence rate and recurrence rate were 5.56% and 2.78% in research group, while that in control group were 26.47% and 20.59%,differences were statistically significance (P＜0.05). Conclusions: Patients with maxillary sinus diseases in treatments of endoscopic anterior prelacrimal recess surgery with less operative time, less intraoperative bleeding, lower complication occurrence rate and recurrence rate, which is worthy of clinical use. 2017 Vol. 23 (7): 1121-1123 [Abstract] ( 142 ) HTML (1 KB)  PDF (1346 KB)  ( 588 ) 1124 Study on Detection Effect of Left Ventricular Torsion in patients with Type 2 Diabetes Mellitus by two Dimensional Strain Imaging KONG Xuejun, NI Jun, DAI Yujie, et al DOI: 10.3969/j.issn.1006-6233.2017.07.021 Objective: To study the clinical significance of detection of left ventricular torsion in patients with type 2 diabetes mellitus by two dimensional strain technique. Methods: 75 patients with T2DM in our hospital from March 2015 to September 2016 were selected, they were divided into simple diabetic group with 39 cases (group A) and diabetic complications group with 36 cases (group B) according to whether carrying vascular complications in clinical. In addition,35 healthy persons were selected as group C. The conventional echocardiographic parameters of subjects in three groups were measured, then two-dimensional high-frequent dynamic images were collected, and the peak value of left ventricular short axis base, apical systolic rotation angle (Rot-base, Rot-apex) and left ventricular systolic torsion angle (LV-tor) were obtained using two-dimensional strain software. Results: There was no significant difference in gender, age, heart rate, height and LVEF between the three groups (P>0.05), E/A in group B was lower than that in group A and group C (P<0.05). Rot-base, Rot-apex and LV-tor in group A were higher than those in group C (P<0.05), Rot-base, Rot-apex and LV-tor in group B were lower than those in group A and group C (P<0.05). Conclusion: When the left ventricular systolic function is normal in patients with diabetes mellitus, the left ventricular short axis torsional motion is abnormal. Left ventricular myocardial torsion angle in patients with diabetes mellitus can be exactly detected by two dimensional strain technique, and it can be used to assess whether the left ventricular function is impaired. 2017 Vol. 23 (7): 1124-1127 [Abstract] ( 119 ) HTML (1 KB)  PDF (1348 KB)  ( 280 ) 1128 Predictive Value of Fetal Distress by combined Detection of Hemodynamic Parameters of three arteries before and after Fetal Neck Bypass WU Qiao, TIAN Rui, SI Lihua DOI: 10.3969/j.issn.1006-6233.2017.07.022 Objective: To analyze the hemodynamic parameters of the main artery before fetal labor around the umbilical cord, predict the clinical value of fetal distress, and provide the basis for the diagnosis of the appropriate timing and mode of delivery. Methods: The clinical data of maternal fetal distress of 206 patients were collected and retrospective studied. According to the specific situation, all the patients were divided into normal group (159 cases) and hypoxia group (47 cases). The fetal birth renal artery (RA), middle cerebral artery (MCA) and umbilical artery (UA) differences in hemodynamic parameters of the two groups were contrasted, and the incidence of fetal distress and the blood flow dynamics parameters of regression equation were fitted. Results: The difference of S/DRA, PIRA and RIRA between the two groups was statistically significant (P<0.05); the middle cerebral artery S/DMCA, PIMCA(P<0.05). There were statistically significant differences in the levels of S/DUA and PIUA in umbilical artery(P<0.05). Multivariate analysis of nine arterial hemodynamics parameters affecting the incidence of fetal distress in the umbilical cord entered the regression equation. The influence size (Exp) was S/DMCA(9.30)、S/DRA(6.49)、PIUA(4.95)、PIMCA(4.76)、S/DUA(3.90)、PIRA(3.46)、RIRA(2.94 )、RIUA(2.27)、S/DMCA(1.55). Conclusions: There are significant differences in RA, MCA and UA blood flow parameters of umbilical cord around rabbits with different distress, and the use of color Doppler to monitor the specific parameters of RA, MCA and UA, and the establishment of multivariate regression model is important for predicting the occurrence of fetal distress Value. 2017 Vol. 23 (7): 1128-1131 [Abstract] ( 128 ) HTML (1 KB)  PDF (1283 KB)  ( 238 ) 1132 Effect of Qingrejiedu prescription on the Level of IFN-γ IL-4 and IL-6 of Children with Refractory Mycoplasma Pneumonia ZHU Haiyan DOI: 10.3969/j.issn.1006-6233.2017.07.023 Objective: To investigate the effect of Qingrejiedu prescription on the level of IFN-, IL-4 and IL-6 of children with refractory mycoplasma. Methods: 90 patients with RMPP were enrolled in this study during January 2015 to June 2016. All the patients were divided into control group and observation group, 45cases in each group according to the number of random table method. 45 healthy children who were admitted to our hospital for the same period were selected as health group. The children in control group were treated with azithromycin. The children in the observation group were treated with Qingrejiedu on the basis of the control group. The levels of CD4+, CD8+, CD4+ / CD8+, IL-6, IFN-γ, IL-4 in serum and IL-6, IFN-γ and IL-4 in BALF were measured before and after treatment. Results: The levels of CD4+, CD4+ / CD8+ in the control group and the observation group were significantly lower than those in the healthy group (P<0.05), and the levels of CD8 + were significantly higher than those in the healthy group (P<0.05) before treatment. After treatment, the levels of CD4+, CD8+, CD4+/CD8+ in the two groups were significantly improved (P<0.05), and the observation group was significantly better than that of control group (P<0.05). The levels of IFN-γ, IL-4 and IL-6 in the serum and BALF of the control group and the observation group were significantly higher than those in the healthy group before treatment (P<0.05) before treatment. After treatment, the serum and BALF of the two groups were significantly improved (P<0.05), and the observation group was significantly lower than those of control group (P<0.05). Conclusion: Qingrejiedu can effectively improve the level of cytokines and inflammatory factors in children with RMPP, improving immunity system of children. 2017 Vol. 23 (7): 1132-1134 [Abstract] ( 130 ) HTML (1 KB)  PDF (1350 KB)  ( 215 ) 1135 The Efficacy of Glucocorticoid in the treatment of Children with Mycoplasma Pneumonia and Lobar Pneumonia YANG Lindong, ZHANG Yanfeng DOI: 10.3969/j.issn.1006-6233.2017.07.024 Objective: To investigate the therapeutic effect of glucocorticoid therapy on mycoplasma pneumoniae pneumonia in children. Methods: A total of 100 children with mycoplasma pneumoniae pneumonia were enrolled from January 2016 to December 2016 were randomly divided into two groups. The control group was given routine treatment. The patients in the experimental group were treated with glucocorticoid therapy, The clinical indexes, drug side effects, lung function, inflammatory index, markedly effective rate and total effective rate were compared between the two groups. Results: The time of fever, cough remission, X-ray recovery time, rales disappearance and hospitalization time were significantly lower in the experimental group than in the control group. After treatment, FEF50, FEF75 and FEF25-75 were significantly The levels of IL-1β, IL-2, IL-4, IL-6, CRP, ESR, TNF-α and INF-γ were significantly lower than those of the control group In the control group, there was significant difference (P <0.01). Conclusion: Glucocorticoid therapy is effective in the treatment of mycoplasma pneumoniae lobular pneumonia in children. 2017 Vol. 23 (7): 1135-1138 [Abstract] ( 119 ) HTML (1 KB)  PDF (1361 KB)  ( 318 ) 1139 Application of NK cells in Transplantation of Multiple Myeloma ASCT LIU Yuanyuan, et al DOI: 10.3969/j.issn.1006-6233.2017.07.025 Objective: To observe the safety and efficacy through the application of autologous NK cells in MMASCT transplantation. Methods: 8 cases of MM patients, including 7 males and 1 female, aged 42-62 years, the median age of 51 years, before transplantation CR2 cases, PR6 cases. NK cell culture method: Membrane chimeric activity factor culture system. The pretreatment program is based on the standard melphalan or Baihuaan or fludarabine-based regimen. Two of the NK cells were transfused 6-7 days after stem cell infusion, and six of the NK cells were used as part of the transplant pretreatment program, 48 hours after chemotherapy and 24 to 48 hours before the stem cell was returned. Stem cell infusion: CD34 + cells 2.2-4.0x10 ^ 6 / kg, mononuclear cells 4.3-5.8x10 ^ 8 / kg. NK cell infusion: 16-160 * 10 ^ 6 / kg. Observe the adverse reactions, blood cell recovery time and efficacy .Results: 8 cases of fever in 6 patients, body temperature 38-39 degrees, the clinical consideration of lung infection, 1 case of oral mucositis (grade II), anti-infection symptomatic treatment after remission, no rash, diarrhea and other adverse reactions The recovery time of hematopoietic cells were as follows: granulocyte (more than 0.5 * 10 ^ 9 / L continuous 3d) 7-14d, median time 9 days, platelet (greater than 30 * 10 ^ 9 / L continuous 3d) 9-34 days Bit time 11 days. 8 patients were successfully completed ASCT. 3 months after transplantation, 3 cases of CR, 5 cases of PR. Eight patients were given thalidomide maintenance therapy. The follow-up period was 3 to 29 months, with a median follow-up of 11 months and no deaths during follow-up. Conclusion: Autologous NK cells in the MMASCT transplantation during the application, no inflammatory factor storm effect occurs, return safety, the treatment is effective. To further expand the number of cases of clinical studies to observe its long-term adverse reactions and efficacy. 2017 Vol. 23 (7): 1139-1142 [Abstract] ( 139 ) HTML (1 KB)  PDF (1374 KB)  ( 360 ) 1143 Analysis of Children Bronchial Asthma 80 Cases with KangZhiTangJiang Treatment LI Zhijun, et al DOI: 10.3969/j.issn.1006-6233.2017.07.026 Objective: To observe the clinical effect of KangZhiTangJiang for the treatment of children bronchial asthma. Methods: 80 children with bronchial asthma were randomly divided into treatment group and control group, each group 40 cases. The control group was treated with western medicine, such as relieving spasm, relieving asthma and resolving phlegm. The treatment group was treated with antispasmodic, antiasthmatic, expectorant and other conventional western medicine combined with anti syrup therapy. The two groups were treated for 7 days. TCM syndromes, pulmonary function changes, clinical efficacy evaluation and adverse reactions and other aspects of the difference of the two groups before and after treatment were compared. Result: The treatment group was better than the control group in the comprehensive efficacy (including the rate of display and control and the total effective rate), the improvement of TCM syndrome score, the difference was statistically significant (P<0.05). In the improvement of lung function, the treatment group was better than the control group, but there was no statistical significance. Conclusion: The clinical efficacy of the anti syrup in the treatment of bronchial asthma in children is accurate, relatively safe and small side effects, so it is worthy of clinical application. 2017 Vol. 23 (7): 1143-1146 [Abstract] ( 289 ) HTML (1 KB)  PDF (1367 KB)  ( 371 ) 1209 Observe the Effect of Pituitrin combined with Reptilase and Hydrochloric Acid Alkali treatment of Lung Shan Lang Dang nuclear hemoptysis LI Wenhong, LI Wei, GAO Jian, et al DOI: 10.3969/j.issn.1006-6233.2017.07.045 Objective: To observe the curative effect of pituitrin combined with Reptilase and hydrochloric acid alkali treatment of Lung Shan Lang Dang nuclear hemoptysis. Methods: 51 cases of pulmonary tuberculosis with massive hemoptysis in our department were randomly divided into the control group of 25 patients and the experimental group of 26 patients. The control group was used pituitrin; and the experimental group was used pituitrin, Reptilase, hydrochloric acid alkali treatment of mountain Lang dang. The efficacy and side effects of the two groups were compared. Results: The efficacy and side effects of the experimental group was better than that of the control group, and the difference was statistically significant, p<0.05. Conclusion: Pulmonary tuberculosis massive hemoptysis patients with pituitrin, vertical hemostatic and race anisodamine Hydrochloride curative effect is distinct, the side effects significantly reduced, worthy of clinical promotion.     2017 Vol. 23 (7): 1209-1210 [Abstract] ( 126 ) HTML (1 KB)  PDF (1321 KB)  ( 271 ) 1211 Application of Staged Nursing Intervention on Percutaneous Endoscopic Nephrolithotomy of Renal Calculi Larger than 20mm WANG Yuxia, et al DOI: 10.3969/j.issn.1006-6233.2017.07.046 Objective: To investigate the application of staged nursing intervention in the treatment of diameter >20mm kidney stone through percutaneous nephrolithotomy. Methods: Total 40 patients with renal calculi larger than 20mm treated with ercutaneous endoscopic nephrolithotomy in our hospital from January 2015 to December 2016 were selected and divided into control group and observation group according to the randomization method, 20 cases in each group. The control group received the routine nursing intervention, the observation group received the phased nursing intervention. The anxiety and complications in the two groups were compared. Results: After nursing intervention, observation group SAS score was significantly lower than the control group, the difference was statistically significant (P < 0.05). Observation group complications, the total incidence was 30.00% (6/20), significantly lower than the control group 80.00% (16/20), the difference was statistically significant (χ2=10.10, P<0.05). Conclusion: The phased nursing intervention can effectively improve the patient's bad mood, reduce complications, thus worth of further promotion in clinical practice 2017 Vol. 23 (7): 1211-1213 [Abstract] ( 102 ) HTML (1 KB)  PDF (1341 KB)  ( 247 ) 1217 Analysis on the Effect and Feasibility of Anti-tuberculosis and Anti-tumor Concurrent Treatment of Pulmonary Tuberculosis Complicated with Lung Cancer REN Jianhua, LI Ningxiu, et al DOI: 10.3969/j.issn.1006-6233.2017.07.048 Objective: To explore the clinical effect and feasibility of anti-tuberculosis and anti-tumor concurrent treatment of pulmonary tuberculosis complicated with lung cancer. Methods: A retrospective analysis of clinical data was carried out in 84 patients with pulmonary tuberculosis complicated with lung cancer admitted to our hospital from March 2010 to June 2015, they were divided into single anti-tuberculosis group (single group for short, n=28), anti-tuberculosis and anti-tumor intermittent treatment group (intermittent group for short, n=26), anti-tuberculosis and anti-tumor concurrent treatment group (concurrent group for short, n=30) according to different treatment modalities, intervention effects of different treatment modalities on pulmonary tuberculosis and lung cancer were compared, flow cytometry was used to determine changes of CD3+, CD4+, CD8+ lymphocytes subsets levels changes before and after the intervention, adverse drug reactions in all groups were recorded, lung cancer quality of life rating form (FACT-L) was used to evaluate improvement of survival treatment of patients before and after the intervention. Results: ①efficacy of anti-tuberculosis in the three group was similar, there was no significant difference (P>0.05); ②there was no significant difference in overall remission rate of anti-tumor in single group and intermittent group (P>0.05), overall remission rate of concurrent group was higher than single group and intermittent group (P>0.05); ③before the treatment, there was no significant difference in lymphocytes subsets indexes in the three groups (P>0.05), after the treatment, CD3+, CD4+, CD8+ of intermittent group and concurrent group were significantly increased compared with the same group before the treatment and single group after the treatment (P<0.05), rising range of all indexes of concurrent group were significantly higher than intermittent group (P<0.05); ④there was no significant difference in quality of life scores before the treatment (P>0.05), 3 and 6 months after the treatment, scores of three groups were significantly increased (P<0.05), rising range of intermittent group was significantly higher than single group (P<0.05), rising range of concurrent group was significantly higher than intermittent group (P<0.05); ⑤gastrointestinal reactions and arrest of bone marrow were mainly adverse reactions of three groups, there was no significant difference in adverse reaction rate (P>0.05). Conclusion: Anti-tuberculosis and anti-tumor concurrent treatment of pulmonary tuberculosis complicated with lung cancer can optimize anti-tumor effect, improve immune function of patients, improve quality of life of patients, and does not increase adverse reaction rate, is safe and feasible. 2017 Vol. 23 (7): 1217-1220 [Abstract] ( 108 ) HTML (1 KB)  PDF (1365 KB)  ( 207 ) 1227 Investigations on the Stalts of Chengde Medical and Narsing Institution ZHANG Juan, GUO Jianfeng, MA Lan, et al DOI: 10.3969/j.issn.1006-6233.2017.07.051 Objective: Analysis the present situation of Integrating pension service with medical service, find out the problems in medical-nursing institutional care model, research the standard system and put forward a perfect suggestion. In order to promote effective industry provides the basis for management and supervision. Methods: Analysis the basic situation of pension agency in chengde city. Combing the relevant policies and current standards of medical-nursing institutional care model.Investigation of typical endowment institutions.Adopt questionnaire investigation of chengde city endowment agencies, analysis, summary, research and discussion. Results: In 45 endowment institutions, there are 27 Integrating pension service with medical service. Among them, six endowment institutions established medical institution, four medical institutions established within the endowment agencies, 15 endowment institutions and medical institutions open a green channel to sign the agreement.Check-in endowment institutions, a 70 - year - old or older (71%), elderly (more than 80 - year - old old man) accounted for 37%; In the elderly part of the endowment agencies cannot provide for oneself and completely unable the elderly accounted for 29% and 31% respectively. Conclusion: To develop the health management of chengde city endowment institutions are work standards and specifications, including the establishment of medical institutions, medical services, sanitation, food safety, the safety of drinking water, the prevention and treatment of infectious diseases, health education and health promotion. Proposed to pension institutions into the hygiene license and scope of supervision and management,.Strengthen and improve the level of pension services, health management. Push forward the development of medical-nursing institutional care model steadily. 2017 Vol. 23 (7): 1227-1232 [Abstract] ( 137 ) HTML (1 KB)  PDF (1366 KB)  ( 221 )

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