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February 2017, Volume 20, No.6 Abstracts

 Interpretation of Updated NCCN Guidelines for Colon Cancer and Rectal Cancer(Version 1.2017)
  SHAO Qian-qian,LIN Guo-le*
Chinese Academy of Medical Sciences & Peking Union Medical College;Department of General Surgery,Peking Union Medical College Hospital,Beijing 100730,China
*Corresponding author:LIN Guo-le,Chief physician,Professor;E-mail:linguole@126.com
    【Abstract】  This paper interpreted NCCN Guidelines for Colon Cancer and Rectal Cancer(Version 1.2017).Compared with Version 2.2016,the latest guideline made some significant updates,and the most important points included:(1) considering low-dose aspirin as the secondary chemoprevention for colorectal cancer(CRC) survivors;(2) in the first-line targeted therapy of RAS wide-type CRC(mCRC),EGFR inhibitors(cetuximab or panitumumab) should only be offered to patients whose primary tumors originated on the left side of the colon and rectum;(3) the panel recommends against panitumumab and cetuximab in the neoadjuvant chemotherapy of resectable metastatic liver or lung neoplasms;(4) the panel recommends programmed death receptor-1(PD-1) inhibitors as treatment options in mCRC patients with metastatic deficient MMR(dMMR) or MSI-H in second- or third-line therapy.
    【Key words】  Colorectal neoplasms;NCCN guideline;Updates in Version 1.2017
 
Current Status and Content of Clinical Practice Guidelines for the Prevention of Postoperative Breast Cancer-related Lymphedema
  WANG Hui-xue,LI Hui-ping*,YANG Ya-juan,SU Dan,ZHANG Ting 
School of Nursing,Anhui Medical University,Hefei 230601,China
*Corresponding author:LI Hui-ping,Professor;E-mail:hulihuizi@163.com
    【Abstract】  Objective  To summarize and analyze the content of clinical practice guidelines for the prevention of postoperative breast cancer-related lymphedema(BCRL) both at home and abroad in order to provide a reference for developing this kind of clinical practice guidelines suited to breast cancer patients in China.Methods  In June 2016,themes related to the prevention of postoperative BCRL were extracted based on analyzing the contents of relative clinical practice guidelines both at home and abroad included by searching the Internet.Results  A total of 5 clinical practice guidelines for preventing postoperative BCRL〔4 in English(1 has not been revised up to the searching time),and 1 in Chinese〕 were included.Finally 16 recommendations related to the prevention of postoperative BCRL were identified.Of them,4 were mentioned most frequently:exercise(5 times),followed by compression garments(4 times),treatment of infection or prophylactic antibiotic treatment of recurrent infection(4 times),and skin care(4 times).Conclusion  There are no special clinical preventive guidelines and standardized clinical preventive guidance for postoperative BCRL in China yet.And the development of them should be based on the actual medical conditions in China.
    【Key words】  Breast neoplasms;Postoperative complications;Lymphedema;Universal precautions;Health behaviorr;Guidebooks
 
Model of Mobilization of Colorectal Cancer Screening in Rural Area
  YANG Wen-zhen1,WANG Ya-dong1*,WANG Gui-qi2,XU Jun-jie3,LIU Mo1
1.School of Health Management and Education,Capital Medical University,Beijing 100069,China
2.Department of Endoscopy,Cancer Hospital Chinese Academy of Medical Sciences,Beijing 100021,China
3.Community Health Service Centers of Hancunhe Town,Beijing 102423,China
*Corresponding author:WANG Ya-dong,Professor;E-mail:yadong61@ccmu.edu.cn
    【Abstract】  Objective  To explore the model of mobilization of colorectal cancer(CRC) screening that is suitable for the characteristics of rural populations,and to improve the participation rate of CRC screening of the villagers.Methods  By community-based participatory research(CBPR) method,the mobilization model of CRC screening in rural area on the basis of CBPR method was designed under the guidance of knowledge,attitude and practice(KAP) theory,and the theory of community involvement.The model mainly included intervening measures such as establishing the community screening team,identifying the demands by baseline survey,establishing screening models by community leaders,community leaders assisting in promoting education,and community leaders guiding medical staff in offering personalized persuasion for the villagers door to door.Community intervention test was used to evaluate the effectiveness of the model of mobilization of CRC screening.From March to August 2014,two villages(Wuhou Village and Gushankou Village) were selected from 27 administrative villages in Hancunhe Town of Fangshan District in Beijing as research sites by purposive sampling method,and were divided into intervention group(Wuhou Village) and control group(Gushankou Village).The intervention group adopted the model of mobilization based-on CBPR method while the control group used the routine mobilization method.Free CRC screening was carried out by selecting the eligible villagers who had local household registration from the study site as the screening subjects.Researchers recorded the preliminary participation rates,the completion rates of the first round of FOBT and the second round of FOBT,and the screening completion rate of the two groups.Results  There were 911 cases in the intervention group and 936 cases in the control group.The participation rates of preliminary CRC screening for villagers in the intervention group and control group were 35.6%(324/911) and 11.6%(109/936) respectively,the completion rates of the first round of FOBT of the two groups were 85.5%(277/324) and 87.2%(95/109) respectively,the completion rates of the second round of FOBT of the two groups were 71.3%(231/324) and 55.0%(60/109) respectively,the completion rates of preliminary screening of the two groups were 71.3%(231/324) and 55.0%(60/109) respectively.Multivariate Logistic regression analysis showed that the participation rate of preliminary screening,the completion rate of the second round of FOBT and the completion rate of preliminary screening in intervention group after controlling gender and age were higher than those in control group(P<0.05),while the completion rate of first round of FOBT was not significantly different between the two groups(P>0.05).Conclusion  The mobilization model of CRC screening in rural area on the basis of CBPR has effectively improved the participation rate of CRC screening,Being simple and convenient,the model is appropriate for mobilization of CRC screening in rural area.
    【Key words】  Colorectal neoplasms;Screening;Rural area;Community-based participatory research method;Mobilization
 
Effectiveness Evaluation of Mobilization Model of Colorectal Cancer Screening in Rural Area on the Basis of Community-based Participatory Research Method
  YANG Wen-zhen1,WANG Ya-dong1*,WANG Gui-qi2,XU Jun-jie3,LIU Mo1
1.School of Health Management and Education,Capital Medical University,Beijing 100069,China
2.Department of Endoscopy,Cancer Hospital Chinese Academy of Medical Sciences,Beijing 100021,China
3.Community Health Service Centers of Hancunhe Town,Beijing 102423,China
*Corresponding author:WANG Ya-dong,Professor;E-mail:yadong61@ccmu.edu.cn
    【Abstract】  Objective  To evaluate the effectiveness of mobilization model of colorectal cancer screening in rural area on the basis of community-based participatory research(CBPR) method.Methods  From March to August in 2014,two villages(Wuhou Village and Gushankou Village) were selected from 27 administrative villages in Hancunhe Town of Beijing as sampling sites for community intervention by purposive sampling method.The two villages were randomly assigned to intervention group(Wuhou Village) and control group(Gushankou Village) by simple random sampling method.There were respectively 911 and 936 villagers met the screening requirements in the Wuhou Village and Gushankou Village.The high-risk factors questionnaire and fecal occult blood test(FOBT)(two times) were used to perform the preliminary screening among these targeted populations,and colonoscopy was given to high-risk populations.Intervention group adopted the model of mobilization based-on CBPR method while control group used the routine mobilization method for intervention.In March 2014,745 villagers who met the inclusion criteria were selected from Wuhou Village and Gushankou Village as research objects,and the self-made questionnaire was used to conduct baseline survey before intervention.In August 2014,740 villagers of Wuhou Village and Gushankou Village who met the inclusion criteria were selected as the research object,and the final-stage investigation was conducted after self-made questionnaire intervention.The general information,the awareness rate of information,acquiring rate of poster foldout,interest rate of propaganda poster,score of knowledge and score of attitude of colorectal cancer screening,participation rate of preliminary screening and participation rate of electron endoscopy were recorded.Results  A total of 745 questionnaires(363 in control group and 382 in intervention group) were sent out in the baseline survey,and 707(343 in control group and 364 in intervention group) were valid with an effective response rate of 94.9%.A total of 740 questionnaires(359 in control group and 381 in intervention group) were sent out in the final-stage survey,and 696(330 in control group and 366 in intervention group) were valid with an effective response rate of 94.1%.The awareness rate of information,acquiring rate of poster foldout and interest rate of propaganda poster of colorectal cancer screening in intervention group were higher than those in control group(P<0.05).The score of knowledge and score of attitude of colorectal cancer screening after intervention in the control group and intervention group were higher than those before intervention(P<0.05).The scores of knowledge of colorectal cancer screening before and after intervention in intervention group were higher than those in control group(P<0.05).There was no significant difference in the scores of attitude of colorectal cancer screening before intervention between intervention group and control group(P>0.05);the score of attitude of colorectal cancer screening after intervention in intervention group was higher than that in control group(P<0.05).The results of difference-in-differences model of independent pooled cross-sectional data showed that there was no significant difference in score of knowledge of colorectal cancer screening before and after intervention between the two groups(P>0.05);the difference value of score of attitude of colorectal cancer screening before and after intervention in intervention group was greater than that in control group(P>0.05).The binary non-conditional Logistic regression analysis showed that the participation rate of preliminary screening in intervention group was 23.8% higher than that in control group(P<0.05);there was no significant difference between intervention group and control group in participation rate of colonoscopy(P>0.05).Conclusion  The mobilization model of colorectal cancer screening in rural area on the basis of CBPR has greatly improved the awareness of screening information of colorectal cancer screening and participative behaviors of preliminary screening of the villagers,however,due to the low educational level of the villagers,their knowledge and attitude of colorectal cancer screening are less affected.
    【Key words】  Colorectal neoplasms;Rural population;Screening;Effectiveness of intervention;Mobilization
 
Improved Method of Using Dimethicone Powder in Colorectal Cancer Screening
  WANG Zhong,LI-Yang,YIN Xiao-yan*
Digestive Endoscopy Center,the Fifth People′s Hospital of Chongqing,Chongqing 400062,China
*Corresponding author:YIN Xiao-yan,Associate chief physician;E-mail:790493414@qq.com
    【Abstract】  Background  Dimethicone are often wasted while used in colonoscopy for colorectal cancer screening with the conventional method currently.
Objective  To find an economic and effective method of using dimethicone powder in colorectal cancer screening.Methods  Two hundred and seventy-five patients underwent colonoscopy in colorectal cancer screening in the Fifth People′s Hospital of Chongqing during January 2015 to June 2016 were selected as the participants and divided into the experimental group(n=136) and the control group(n=139) by a randomized,double-blind method.While bowel preparation,the experimental group only took PEG 4000 orally,the control group orally took both PEG 4000 and dimethicone powder.Both groups received dimethicone powder diluted with water to wash existed air bubbles while inserting the colonoscope.The grade of existed air bubbles while inserting colonoscope,conditions of existed air bubbles while withdrawing colonoscope,duration of examination and dosage of used dimethicone powder were recorded.Results  According to the exclusion criteria,7 patients were excluded,and finally a total of 268 patients were included in the trial,including 132 in the experimental group and 136 in the control group.The grade of existed air bubbles in the experimental group was higher than that in the control group while inserting the colonoscope(P<0.05).Dosages of used dimethicone powder in the experimental group were less than those in the control group(P<0.05).There was no significant difference in duration of examination between the two groups(P>0.05).The conditions of existed air bubbles while withdrawing colonoscope in both groups were up to standard.Conclusion  The improved method of using dimethicone powder(only for washing air bubbles while inserting colonoscope) can achieve the same effect as the conventional method with no air bubbles existing in colorectal lumen during the examination but applying much less dosage.Furthermore,it is simple and easy to use without prolonging the duration of examination.In view of these,it can be applied to colorectal cancer screening in the future.
    【Key words】  Colorectal neoplasms;Antifoaming agents;Dimethicone powder;Screening;Colonoscopy
 
Effect of Smoking and Its Related Factors on Chinese Male Pure Smokers′ Common Carotid Artery Elasticity
  MA Lin1,KAN Yan-min1,LI Zhi-an2*,GUO Rui-jun3,XIAO Dan4,HUANG Pin-tong5
1.Department of Ultrasound,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China
2.Department of Diagnostic Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China
3.Department of Medical Ultrasonics,Beijing Chao-yang Hospital,Beijing 100020,China
4.Department of Respiratory Medicine,Beijing Chao-yang Hospital,Beijing 100020,China
5.Department of Ultrasound,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310058,China
*Corresponding author:LI Zhi-an,Professor;E-mail:wuxiny_2009@163.com
MA Lin & KAN Yan-min are the first authors of this paper
    【Abstract】  Background  Smoking is one of the main risk factors for atherosclerosis and the decrease of arterial elasticity is the early change,so it is important to analyze the effect of smoking and its related risk factors on arterial elasticity.Echo-tracking(ET) technique can detect the decrease of arterial elasticity before the apparent morphological changes of the blood vessels.
Objective  To explore the effect of smoking and its related factors to Chinese male pure smokers′ common carotid artery(CCA) elasticity.Methods  From the survey data of Chinese pure smokers from 46 hospitals in China,915 male pure smokers who met the inclusion criteria were selected as the smoking group from August 2009 to August 2011.During the same period,1 920 healthy Chinese men without history of smoking were selected as the normal group from the Chinese people′s normal manual.The data of age,elasticity parameters of CCA〔arterial wall stiffness index(β),pressure-strain elasticity modulus(Ep),arterial compliance(AC),augmentation index(AI) and pulse wave velocity(PWVβ)〕 of both groups,and smoking-related factors(average daily cigarette consumption,smoking years,age of smoking initiation,nicotine dependence score),intima media thickness(IMT) of left and right CCA of the smoking group were recorded.Results  In the smoking group,β,Ep,PWVβ of left and right CCA were significantly higher while AC and AI were lower than those in the normal group(P<0.05).The β of left and right CCA in age groups of 20-29,30-39,40-49,50-59 and ≥60 in the smoking group was higher than that in the normal group(P<0.05).Ep of left CCA in 10-19 age group,and Ep of left and right CCA in age groups of 20-29,30-39,40-49,50-59 and ≥60 in the smoking group were higher than those in the normal group(P<0.05).AC of left and right CCA in age groups of 20-29 and ≥60,AC of left CCA in age group of 30-39,AC of right CCA in age group of 50-59 in the smoking group were lower than those in the normal group(P<0.05).AI of left and right CCA in age groups of 10-19 and 20-29,AI of right CCA in age groups of 30-39 and 50-59 in the smoking group were lower than those in the normal group(P<0.05).PWVβ of right CCA in age groups of 10-19 and ≥60,PWVβ of left and right CCA in age group of 20-29,PWVβ of left CCA in age groups of 30-39 and 40-49 in the smoking group were higher than those in the normal group(P<0.05).In the smoking group,average daily cigarette consumption was positively correlated with IMT,β,Ep,PWVβ of CCA,and negatively correlated with AC of CCA(P<0.05);smoking years,age of smoking initiation,nicotine dependence score were positively correlated with IMT,β,Ep,AI,PWVβ of CCA,and negatively correlated with AC of CCA(P<0.05).Multivariate stepwise linear regression analysis showed that average daily cigarette consumption and smoking years were the influencing factors for IMT of CCA(P<0.05);average daily cigarette consumption,smoking years,nicotine dependence score were the influencing factors for β,Ep,AC,PWVβ of CCA(P<0.05);smoking years was the influencing factor for AI of CCA(P<0.05).Conclusion  The CCA elasticity of smokers is significantly lower;the increase of average daily cigarette consumption,smoking years,nicotine dependence are the risk factors for the decrease of CCA elasticity in smoking population.
    【Key words】  Carotid artery,common;Elasticity;Smoking;Men;China
 
Prognostic Value of 18F-FDG SUVmax in Pelvic Lymph Nodes Metastases of Patients with Cervical Cancer
  ZHAO Hong-xia1,DONG Yan-shuang1,CAI You-zhi2,ZHU Ying-jun3*
1.Department of Obstetrics and Gynecology,Tianjin Forth Center Hospital,Tianjin 300143,China
2.Department of Orthopedics,the First Hospital of Zhejiang Province,Hangzhou 310003,China
3.Department of Obstetrics and Gynecology,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300052,China
*Corresponding author:ZHU Ying-jun,Associate chief physician;E-mail:zhuyingjun5009@sina.com
    【Abstract】  Background  Lymph nodes metastasis is the main factor that affects the prognosis of cervical cancer. Early diagnosis can effectively improve the survival rate of patients with cervical cancer. 
Objective  To evaluate the prognostic value of the 18F-FDG maximum standardized uptake value(SUVmax) in pelvic lymph nodes metastases of patients with cervical cancer and analyze the impact factors of survival. Methods  A total of 70 cervical carcinoma patients with pelvic and/or paraaortic lymph nodes metastases confirmed by biopsy in Department of Obstetrics and Gynecology of Tianjin Forth Center Hospital were enrolled in this study from December 2004 to August 2011. All patients accepted PET/CT examination and 18F-FDG SUVmax was recorded. All patients received radiotherapy and chemotherapy. Patients were followed up when the treatment began. The follow-up ended when patients relapsed or died. The deadline of follow-up was 2015-06-30. Results  The AUC of SUVmax for predicting patients′ recurrence was 0.703,95%CI(0.542,0.838),the cut-off value was 7.5,the sensitivity was 85.7%,the specificity was 98.2%,the positive predictive value was 92.3% and the negative predictive value was 96.5%,the Youden index was 0.8. There were 13 cases with SUVmax<7.5 and 57 cases with SUVmax≥7.5. There was no statistically significant differences in overall survival(OS) between patients with SUVmax<7.5 and SUVmax≥7.5(χ2=2.934,P=0.087). The disease-free survival(DFS) of patients with SUVmax<7.5 was higher than that of patients with SUVmax≥7.5(χ2=4.791,P=0.035). Multivariate Cox proportional hazards regression analysis showed that SUVmax,sites of lymph nodes metastases and therapeutic response were the impact factors of OS(P<0.05);SUVmax,sites of lymph nodes metastases and therapeutic response were the impact factors of DFS(P<0.05).Conclusion  SUVmax of 18F-FDG can be used to well evaluate the prognosis of cervical cancer patients with lymph nodes metastases. The survival rate of patients with cervical cancer is poor when they have higher SUVmax of 18F-FDG,pelvic lymph nodes metastases and complete therapeutic response.
    【Key words】  Uterine cervical neoplasms;Lymphatic metastasis;Fluorodeoxyglucose F18;Maximum standardized uptake value
 
Changes of β-endorphin and Gonadotropin Releasing Hormone after Cerebral Hemorrhage and Subarachnoid Hemorrhage
  WANG Guang*,LUO Chao,PENG Xing,JIANG Guang-ming,TAN Jun,WU Hai-bo,JIANG Guang-yuan,XIAO Gang,WU Lin,WU Bin
Department of Neurosurgery,Chongqing Traditional Chinese Medicine Hospital,Chongqing Institute of Traditional Chinese Medicine,Chongqing 400021,China
*Corresponding author:WANG Guang,Associate chief physician;E-mail:wangzi1680@sina.com
    【Abstract】  Objective  To observe the levels of β-endorphin and gonadotropin releasing hormone(GnRH) dynamically after the intracerebral hemorrhage(ICH) and subarachnoid hemorrhage(SAH),and explore difference of thalamus stress reaction between ICH and SAH.Methods  According to the inclusion criteria,38 patients with spontaneous ICH and 26 patients with spontaneous SAH in the Department of Neurosurgery of Chongqing Traditional Chinese Medicine Hospital from May 2014 to May 2016 were respectively selected into ICH group and SAH group.At the same time,20 patients without neurological disease who underwent lumbar puncture anesthesia in the same hospital were selected as control group.The levels of β-endorphin and GnRH in plasma and cerebrospinal fluid of patients at admission in control group,and the levels of β-endorphin and GnRH in plasma and cerebrospinal fluid of patients at the 1st,the 3rd,the 7th,the 14th,and the 30th day of admission in ICH group and SAH group were detected and recorded.Results  According to the exclusion criteria,18 cases were excluded,and finally 20 cases were enrolled in ICH group;while 6 cases were excluded,and finally 20 cases were enrolled in SAH group.The levels of β-endorphin in plasma and cerebrospinal fluid at admission and at the 1st,the 3rd,the 7th,the 14th,and the 30th day of admission in ICH group and SAH group were higher than those in control group(P<0.05);the levels of β-endorphin in plasma and cerebrospinal fluid at admission and at the 1st,the 3rd,the 7th,the 14th,and the 30th day of admission in SAH group were higher than those in ICH group(P<0.05).The levels of GnRH in plasma and cerebrospinal fluid at admission and at the 1st,the 3rd,the 7th,the 14th,and the 30th day of admission in ICH group and SAH group were higher than those in control group(P<0.05);the levels of GnRH in plasma and cerebrospinal fluid at admission and at the 1st,the 3rd,the 7th,the 14th,and the 30th day of admission in SAH group were higher than those in ICH group(P<0.05).Conclusion  β-endorphin and GnRH participate in the hypothalamus stress reaction after SAH and ICH.The hypothalamus stress reaction after SAH is stronger than that after ICH.Monitoring β-endorphin and GnRH levels in blood and cerebrospinal fluid is of important clinical significance in determining the severity of brain injury and assessing its prognosis.
    【Key words】  Cerebral hemorrhage;Subarachnoid hemorrhage;Beta-endorphin;Gonadotropin-releasing hormone
 
Blood Screening for DNA Methylation Sites and Construction of Aberrant Methylation Profile in Kazak Essential Hypertensive Patients
  YOU Shu-ping1,CONG Mei-li2,NI Guo-hua3,ZHAN Huai-feng4,WANG Hong-jun5,JIN Jing6,MA Deng-e7,YELIXIATI4,ZHAO Zhi-qiang1,JIANG Hong1,LIU Tao8*
1.School of Nursing,Xinjiang Medical University,Urumqi 830000,China
2.Medical Laboratory Animal Center,Xinjiang Medical University,Urumqi 830054,China 
3.The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China
4.Gangou Hospital,Urumqi County,Urumqi 830000,China
5.Xiaoquzi Hospital,Urumqi County,Urumqi 830000,China
6.Shuixigou Center Hospital,Urumqi County,Urumqi 830000,China
7.Banfanggou Center Hospital,Urumqi County,Urumqi 830000,China
8.School of Public Health,Xinjiang Medical University,Urumqi 830054,China
*Corresponding author:LIU Tao,Professor;E-mail:xjmult@163.com
    【Abstract】  Objective  To screen aberrant DNA methylation sites of Kazak essential hypertension(EH) by using gene chip technique,and construct Kazak EH aberrant methylation profiles preliminarily,so as to provide a theoretical basis for intensive study of the mechanism of Kazak EH.Methods  From June 2014 to October 2015,using random sampling method,3 042 Kazak herdsmen or semi-nomads were selected as the participants of this study from Urumqi County.Of them,1 487 had EH.And from the 1 487 EH patients,3 were randomly selected as the EH group,and other 3 age-matched healthy volunteers as the control group.Using Illumina Human Methylation 450K BeadChip,we measured the whole blood of all subjects for detecting DNA methylation and screening the aberrant methylation sites of DNA.We analyzed the function of abnormal methylation genes by using Gene Ontology(GO) enrichment analysis and Pathway analysis.Results  There were 427 significantly differential methylated sites in EH and normal groups,where in 148 high methylation sites,279 low methylation sites;these sites were located on different chromosomes;among them,chromosome 1 and chromosome 6 were the most,no differential methylated site was found in Y chromosome.GO enrichment analysis showed that aberrant methylation genes mainly involved in the processes of glycoprotein biosynthesis and metabolism,vascular development,vasculature development,collagen binding and so on.Pathway analysis demonstrated that aberrant methylation genes mainly played a part in chondroitin sulfate biosynthesis,insulin signaling pathway,endocytosis and so forth.Conclusion  The occurrence of EH involves in the changes in DNA methylation status.A number of differential methylated genes are related with EH associated signaling pathway.This study is only the beginning of construction of Kazak EH genome methylation profile,and the obtained aberrant methylation gene can be considered as a candidate early risk molecular marker of EH.However,more comprehensive and accurate study results need the analysis and verification of a larger sample.
    【Key words】  Hypertension;Kazak;DNA methylation;Gene chip
 
Clinical Efficacy of Kangfuxin Liquid Combined with Deproteinised Calf Blood Injection for Acute Radiation Proctitis Caused by Radiotherapy after Surgery for Rectal Cancer and Its Effect on Platelet Function
  XU Zhen-zhen*,JIAO Hong-jun,REN Ming
Department of Traditional Chinese Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450008,China
*Corresponding author:XU Zhen-zhen,Competent pharmacist;E-mail:zz293929@126.com
    【Abstract】  Objective  To explore the clinical efficacy of Kangfuxin liquid combined with deproteinised calf blood injection in the treatment of acute radiation proctitis caused by radiotherapy after surgery for rectal cancer and observe its effect on platelet function.Methods  Sixty-four patients with acute radiation proctitis caused by radiotherapy after surgery for rectal cancer admitted to the Second Affiliated Hospital of Zhengzhou University during March 2011 and October 2014,they were randomly assigned to control group and research group with 32 patients in each.Patients in research group were given intravenous drip of Kangfuxin liquid combined with deproteinised calf blood injection for treatment,while control group were treated by retention enema with Kangfuxin liquid.And comparisons were made in the acute radiation proctitis classification,intestinal pain grading,KPS score,mean platelet volume(MPV) before and after treatment and clinical efficacy between the two groups.Results  There were no statistically significant differences in acute radiation proctitis classification and intestinal pain grading between the two groups before treatment(P>0.05).After treatment,both acute radiation proctitis classification and intestinal pain grading in research group were better than those in control group(P<0.05).Both acute radiation proctitis classification and intestinal pain grading in the two groups after treatment were better than before treatment(P<0.05).There was no statistically significant difference in KPS score and MPV between the two groups before and after treatment(P>0.05).MPV in research group after treatment was bigger than that before treatment(P<0.05).Research group had better clinical efficacy than control group(P<0.05).Conclusion  For acute radiation proctitis caused by radiotherapy after surgery for rectal cancer,intravenous drip of Kangfuxin liquid combined with deproteinised calf blood injection has better clinical efficacy with improvement of platelet function compared with retention enema with Kangfuxin liquid.
    【Key words】   Acute radiation proctitis;Kangfuxin liquid;Deproteinised calf blood injection;Platelet function 
 
Safety of Different Doses of Clopidogrel in CYP2C19 Intermediate Metabolizers with Acute Coronary Syndrome after Percutaneous Coronary Intervention  ZHANG Peng-bo,ZHANG Jin-ying*
Cardiovascular Department,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China
*Corresponding author:ZHANG Jin-ying,Professor,Chief physician,Doctoral supervisor;E-mail:jyzhang@zzu.edu.cn
    【Abstract】  Objective  To compare the incidences of major adverse cardiovascular events and bleeding events in CYP2C19 intermediate metabolizers with acute coronary syndrome(ACS) treated by different doses of clopidogrel after percutaneous coronary intervention(PCI).Methods  Three hundred and thirty-nine ACS patients underwent PCI successfully in Cardiovascular Department,the First Affiliated Hospital of Zhengzhou University in 2014 were enrolled in this study,including CYP2C19 extensive metabolizers(n=120,control group),and CYP2C19 intermediate metabolizers(n=219),and the latter was further divided into single-dose subgroup(n=107) and double-dose subgroup(n=120) based on the parity of admission number.Patients in the control group and single-dose subgroup took clopidogrel 75 mg/d orally,while those in the double-dose subgroup took clopidogrel 150 mg/d.In addition,all the 3 groups were given aspirin and atorvastatin for treatment.And comparisons were made between the groups in terms of platelet aggregation inhibition rate induced by adenosine diphosphate(ADP) receptor signaling pathway at the 3rd day after treatment,incidences of  major adverse cardiovascular events(acute myocardial infarction,cardiac death and recurrence of angina pectoris) at the 1st,3rd and 6th month after PCI,and the cumulative bleeding events(major,minor and mild bleeding events) occurred within 6 months after PCI.Results  Single-dose subgroup had lower platelet aggregation inhibition rate induced by ADP receptor signaling pathway than the control group and double-dose subgroup did(P<0.05).At the 1st month after PCI,the incidences of recurrence of angina pectoris and total major adverse cardiovascular events in the single-dose subgroup were higher than those in the control group and double-dose subgroup(P<0.05),while those showed no statistically significant differences between the control group and double-dose subgroup(P>0.05).There were no statistically significant differences in the incidences of acute myocardial infarction,recurrence of angina pectoris and total major adverse cardiovascular events among the 3 groups at the 3rd,6th month after PCI(P>0.05);no cardiac deaths occurred in all the groups.Within 6 months after PCI,the incidences of cumulative minor,mild and total bleeding events among the 3 groups demonstrated no statistical significance(P>0.05);no major bleeding events occurred in all the groups.Conclusion  For CYP2C19 intermediate metabolizers with ACS,taking clopidogrel 150 mg/d orally can increase the platelet aggregation inhibition rate and decrease the incidence of  major adverse cardiovascular events,the efficacies are similar to those of conventional-dose of clopidogrel administered orally in CYP2C19 extensive metabolizers with ACS without increasing the incidence of bleeding.
    【Key words】  Acute coronary syndrome;Angioplasty,balloon,coronary; CYP2C19 gene; Clopidogrel
 
Impact of Signal Path of Coagulation and Complement Cascades Reaction for AIDS Patients with Syndrome of Interior Dampness-heat
  ZHANG Hai-yan1,ZHANG Miao1,LYU Shun-wu2,GAO Liang1,LI Jian-zhi1,XIE Shi-ping1*
1.Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China
2.Luoyang No.1 Hospital of TCM,Luoyang 471000,China
*Corresponding author:XIE Shi-ping,Professor;E-mail:xspzz@126.com
    【Abstract】  Objective  To make clear the expression differences of the protein levels in the syndrome of interior dampness-heat of AIDS,and explore the role of signal path of coagulaton and complement cascades reaction in the nature of TCM syndrome.Methods  By random cluster sampling principle,48 AIDS patients(25 with syndrome of Qi deficiency of lung and spleen of AIDS was Qi deficiency of lung and spleen of AIDS group,23 with syndrome of interior dampness-heat of AIDS was interior dampness-heat of AIDS group) were enrolled in October 2014,and non HIV infected individuals with similar demographic data in the same area were taken as the control group.The serum samples of all the subjects were studied with iTRAQ techniques,and the differential proteins were annotated by signal pathway.Results  Compared with Qi deficiency of lung and spleen of AIDS group,the expression of  α1-antitrypsin and complement C4bp was down-regulated in interior dampness-heat of AIDS group.Compared with the control group,the expression of α1-antitrypsin,complement C4bp,α-2 macroglobulin and human-binding serine lectin protease 2 was up-regulated and the expression of C1r subcomponent complement,complement factor B,apolipoprotein B variant was down-regulated in interior dampness-heat of AIDS group.These proteins activated in coagulation and complement cascades reaction signal path.Conclusion  The pathogenesis of AIDS patients suffering from syndrome of dampness-heat may be achieved through coagulation and complement cascades reaction signal path,and the differential proteins in this signal path can be used as potential drug targets for clinical treatment of AIDS.
    【Key words】  Acquired immunodeficiency syndrome;Dampness-heat;Proteomics
 
Index Evaluation System of Reputation of Public Hospitals Based on Both Doctors and Patients
    YANG Yi1,TIAN Kan1,2*
1.School of Health Economics and Management,Nanjing University of Chinese Medicine,Nanjing 210023,China
2.Nanjing Branch,Research Center on Health Development at the National Health and Family Planning Commission,Nanjing 210023,China
*Corresponding author:TIAN Kan,Professor,Doctoral supervisor;E-mail:tiankane@aliyun.com
    【Abstract】  Background  At present,the evaluation and examination system of public hospitals in China is very imperfect,and the traditional "top-down" style performance appraisal of hospitals has made little success.
Objective  To construct an index evaluation system of reputation of public hospitals based on both doctors and patients,ease the imbalance of information between doctors and patients and guide the patients to seek medical treatment rationally.Methods  Based on extensive literature research and expert consultation methods,the index evaluation system of reputation of public hospitals based on both doctors and patients was developed.It was divided into two parts,including doctors(7 primary indexes and 30 secondary indexes) and patients(5 primary indexes and 16 secondary indexes).The secondary indexes based on the two parts of doctors and patients were transformed into doctors′ questionnaire(including 7 dimensions,30 items) and patients′ questionnaire(including 5 dimensions and 16 items) respectively.By cluster random sampling method,doctors and patients from two tertiary hospitals(one hospital of western medicine and one hospital of traditional Chinese medicine) in the southern,central and northern areas of Jiangsu Province were selected to take a questionnaire survey from March to May in 2015.The reliability of the index system was evaluated by descriptive analysis,correlation analysis and significance test of difference in extreme group,and the construct validity of the index system was evaluated by KMO test,Bartlett ′s spherical test,principal component analysis and factor maximum rotation.Results  A total of 150 questionnaires were distributed to doctors,and 126 valid questionnaires were received with an effective response rate of 84.0%;and 210 questionnaires were distributed to patients,and 210 valid questionnaires were received with an effective response rate of 100.0%.The average number of total score of doctors′ questionnaire was 3.64,the mean score of each item was between 2.71 and 4.22,the average standard deviation of each item was 0.81,and the score of each item had all included 1 to 5 points;while the average number of total score of patients′ questionnaire was 3.47,the mean score of each item was between 2.57 and 4.05,the average standard deviation of each item was 0.84,and the score of each item had all included 1 to 5 points.The ITC between the scores of each indexes and total scores of the questionnaires of doctors and patients were both greater than 0.400,and the overall Cronbach′s α coefficient of the questionnaires of doctors and patients was 0.950 and 0.938 respectively.According to the 27% extreme area of total score of doctors and patients,they were respectively divided into high-score group(34 doctors and 57 patients) and low-score group(34 doctors and 57 patients),and the score of each item in questionnaires of both doctors and patients in high-score group was higher than that in low-score group(P<0.05).In doctors′ questionnaire,the KMO was 0.808,Bartlett′s spherical test χ2 was 2 920.623,df was 435,and P<0.001;in patients′ questionnaire,the KMO was 0.930,Bartlett′s spherical test χ2 was 1 969.937,df was 120,and P<0.001;both doctors′ and patients′ questionnaire all meet the requirements of principal component analysis.Conducting the principal component analysis on the doctors′ questionnaire,7 common factors were extracted according to the standard of factor eigenvalue greater than or equal to 1.000,they were respectively named as service quality,innovation ability,technology,personnel quality,public relations,cost and social responsibility,the total contribution rate was 72.800% and the load values for each item were all greater than 0.500.The principal component analysis on the patients′ questionnaire was conducted,4 common factors were extracted according to the standard of factor eigenvalue greater than or equal to 1.000,they were named as service quality,cost,technology,and social responsibility respectively,the total contribution rate was 75.079% and the load values for each item were all greater than 0.500.Conclusion  The index evaluation system of reputation of public hospitals based on both doctors and patients is in good reliability and construct validity,which has certain scientific nature and application value.
    【Key words】  Hospitals,municipal;Physician-patient relations;Quality indicators,health care
 
Content Analysis of Xinjiang Cervical Cancer Screening Publicity Materials:A Perspective from Social Marketing Communication Strategy
  DOU Lan1,JING Ming-xia1*,WANG Xiao-li2,ZHANG Mei1,LI Ke1
1.Department of Prevention Medicine,Shihezi University School of Medicine,Shihezi 832002,China
2.The Second Department of Women Health Care,Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China
*Corresponding author:JING Ming-xia,Professor;E-mail:jingmingxia126@126.com
    【Abstract】  Objective    To investigate the features of publicity materials used in Xinjiang cervical cancer screening program so as to provide advice for effective publicity and education of the program.Methods  From December 2014 to October 2015,we collected the cervical cancer screening publicity materials from 40 counties and cities of Xinjiang.After excluding the publicity materials about introduction of the policies of cervical cancer screening and those intending for cervical cancer screening staff,the final sample consisted of 38 publicity materials from 27 counties and cities.From the perspective of social marketing communication strategy,we analyzed the content,explanation order,expression form and type of cervical cancer screening publicity materials.Results  In terms of content,92.1%(35/38) of the publicity materials mentioned cervical cancer screening could prevent the incidence of cervical cancer,71.1%(27/38) elaborated it could block the progression of cervical cancer timely,and 63.2%(24/38) discussed it could early detect cervical lesions;39.5%(15/38) said the techniques for cervical cancer screening were advanced,efficient and effective,and 34.2%(13/38) talked about that it was free.In the explanation order,the benefits of cervical cancer screening were given preferential introduction in 68.4%(26/38) of the publicity materials.With regard to the expression form,only 28.9%(11/38) of the publicity materials introduced cervical cancer screening by listing examples,but the words used mainly tending to be negative in 81.8%(9/11);71.1%(27/38) of the publicity materials used Chinese to elaborate.In the aspect of type of publicity materials,55.3%(21/38) were brochures,18.4%(7/38) were posters and 10.5%(4/38) were leaflets.Conclusion  Traditional information dissemination materials are mainly used in Xinjiang cervical cancer screening program,focusing on describing the benefits brought by cervical cancer screening with less examples.In view of this,it is suggested that the content of publicity materials should be developed based on the needs of women and narrated with more examples,so as to improve the effectiveness of information dissemination.
    【Key words】  Uterine cervical neoplasms;Information dissemination;Marketing;Screening;Content analysis
 
Intervention Effect of Applying Admission Mode of Social Psychological Skills on Patients with Anxiety Tendency after Off-pump Coronary Artery Bypass Grafting
  ZHAO Tie-fu*,WANG Sheng-yu,MA Han- ying,CHEN Hong,ZHANG Chun-xiao,ZOU Xiao-zhao
Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China
*Corresponding author:ZHAO Tie-fu,Associate professor;E-mail:tiefuzhao@163.com
    【Abstract】  Objective  To evaluate the intervention effect of applying admission mode of social psychological skills on patients with anxiety tendency after off-pump coronary artery bypass grafting(OPCAB).Methods  A total of 138 patients,who received treatment in the expert outpatient service of Department of Cardiac Surgery in Beijing Anzhen Hospital,Capital Medical University from September 2014 to March 2015 and were identified with anxiety tendency at the end of the third month after OPCAB by hospital anxiety and depression scale(HAD),were selected as the research objects.
The subjects were divided into intervention group(n=79) and control group(n=59) based on the admission mode of doctors.The admission mode of social psychological skills were applied in the intervention group,the traditional mode of admission was used in the control group.The scores of anxiety in HAD and self-conscious satisfaction of surgical outcomes at the end of the third and the sixth month after surgery were compared between the two groups.Results  There was no significant difference in the score of anxiety in HAD and the score of self-conscious satisfaction of surgical outcomes at the end of the third month after surgery of patients in the two groups(P>0.05).The score of anxiety in HAD at the end of the sixth month after surgery in the intervention group was significantly lower than that in the control group,while the score of self-conscious satisfaction of surgical outcomes was significantly higher than that in the control group(P<0.01).The score of anxiety in HAD at the end of the sixth month after surgery was significantly lower than that at the end of the third month after surgery in the intervention group,while the score of self-conscious satisfaction of surgical outcomes was significantly higher than that at the end of the third month after surgery(P<0.05);the score of anxiety in HAD at the end of the sixth month after surgery was significantly lower than that at the end of the third month after surgery in the control group,while the score of self-conscious satisfaction of surgical outcomes was significantly higher than that at the end of the third month after surgery(P<0.05).Conclusion  The application of admission mode of social psychological skills in patients with anxiety tendency after OPCAB can effectively alleviate the anxiety of patients and improve the patient′s satisfaction of the effects of OPCAB.
    【Key words】  Anxiety;Coronary artery bypass grafting,off-pump;Medical humanities
 
Mediating Effect of Coping Strategies in Relationship between Life Events,Stress Reaction,Coping Strategies and Infertility-related Stress in Infertile Women
  CAI Yan-na,DONG Yue-zhi*
Reproductive Medical Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China
*Corresponding author:DONG Yue-zhi,Co-chief superintendent nurse;E-mail:dyz62295@163.com
    【Abstract】  Objective  To explore the mediating effects of coping strategies in the relationship between life events,stress reaction,coping strategies and infertility-related stress in infertile women.Methods  A cross sectional study was conducted in 310 women initially diagnosed with infertility in Reproductive Medical Center of the First Affiliated Hospital of Zhengzhou University from August 2015 to February 2016 with life event scale(LES),stress reaction questionnaire(SRQ),coping strategies questionnaire(CSQ) and fertility problem inventory(FPI).Finally a total of 298 women returned responsive questionnaires.Structural equation model  was used to analyze the relationship between life events,stress reaction,coping strategies and infertility-related stress,and the mediating effects of positive and negative coping strategies on infertility-related stress in infertile women.Results  The total score of life events was positive correlated with the score of social pressure,marriage relationship and sexual pressure and the total score of infertility-related stress(P<0.05);the total score of coping strategies was positive correlated with the score of social pressure,marriage relationship,children′s lifestyles,the need for parenthood and sexual pressure and the total score of infertility-related stress(P<0.05);the score of positive coping strategies was negative correlated with the score of social pressure,marriage relationship,children′s lifestyles and sexual pressure and the total score of infertility-related stress(P<0.05);the score of negative coping strategies was positive correlated with the score of social pressure,marriage relationship,children′s lifestyles,the need for parenthood and sexual pressure and the total score of infertility-related stress(P<0.05).The fitting degree of structural equation model of life events,stress reaction,positive coping strategies and infertility-related stress was relatively ideal,and the mediating effects of positive coping strategies on infertility-related stress was significant(P<0.05).The fitting degree of structural equation model of life events,stress reaction,negative coping strategies and infertility-related stress was relatively ideal,but the mediating effects of negative coping strategies on infertility-related stress was not significant(P>0.05).Conclusion  Life events,stress reaction,coping strategies can affect  infertility-related stress of infertile women,also life events,stress reaction can affect  infertility-related stress of infertile women through positive and negative coping strategies.But the mediating effect of positive coping strategies is significant,while the mediating effect of negative coping strategies is not significant.
    【Key words】  Infertility,female;Life events;Stress reaction;Infertility-related stress;Coping strategies;Structural equation model
 
Clinical Application of Vasodilators in the Acute Phase of Ischemic Stroke
  JIANG Wei1,2,ZHOU Xue-ying1,2,ZHOU Sheng-nian1,2*
1.Neurology Department,Qilu Hospital of Shandong University,Jinan 250012,China
2.Brain Science Research Institute of Shandong University,Jinan 250012,China
*Corresponding author:ZHOU Sheng-nian,Professor,Master supervisor;E-mail:zhoushengnian126@126.com
    【Abstract】  Ischemic stroke is a kind of disease of brain tissue dysfunction and necrosis due to a variety of reasons leading to cerebral blood flow deficiency,which is one of the most common causes of death in the world.The treatment of acute phase of ischemic stroke should put emphasis on early diagnosis,early treatment,early rehabilitation and early prevention.Current drug treatments mainly include the thrombolytic drugs,anticoagulants,antifibrinogen drugs,and antiplatelet drugs,which can improve the circulation.But the efficacy of vasodilators is still lack of evidence-based support.This article reviewed the clinical application of vasodilators in the acute phase of ischemic stroke,and suggested that using vasodilators to treat acute phase of ischemic stroke should be cautiously,as they can cause intracranial steal phenomenon and aggravate cerebral edema,which is of reference significance in reasonably selecting proper diagnosis and treatment regimens for ischemic stroke,and further standardizing and perfecting the guidelines for the disease.
    【Key words】  Stroke; Vasodilator;Review
 
Clinical Application of Traditional Chinese Medicine Injection in the Treatment of Ischemic Stroke Based on Drug Instructions and Evidence Based Medicine
  KONG Ya-ting1,2,ZHANG Zhao-hui1,2*
1.Yichang Central People′s Hospital,Yichang 443000,China
2.Renmin Hospital of Wuhan University,Wuhan 430000,China
*Corresponding author:ZHANG Zhao-hui,Professor,Master supervisor;E-mail:zhangzhaohuih@163.com
    【Abstract】  Traditional Chinese medicine injection plays a significant role in the treatment of cardiovascular and cerebrovascular diseases.The frequency of using traditional Chinese medicine injections remains high in the drug treatment of ischemic stroke in domestic hospital at varied levels,but irrational drug-use still exists.The traditional Chinese medicine injection is lack of evidence on clinical indications,TCM syndrome differentiation,and solvent selection.The paper summarizes the commonly used medication instructions of traditional Chinese medicine injection in treating ischemic stroke in clinic currently,and analyzes its clinical indications in combination with the relevant evidence-based medicine,in order to promote the standard medication of clinical workers in accordance with drug instructions and reduce adverse drug reactions.
    【Key words】  Injectio;Traditional Chinese pharmacy;Stroke;Brain ischemia;Brain infarction;Prospectuses;Evidence-based medicine
 
Application Value of Magnetic Resonance Spectroscopy,Event Related Potential and Rivermead Post Concussion Syndrome Questionnaire Scores in Mild Traumatic Brain Injury  TAO Jin-de1*,LI Qiu-yu1,QI Qiang1,ZENG Peng2,LIU Xiao1,WU Gui-ping2
1.Department of Radiology,Dongguan Tung Wash Hospital,Dongguan 523110,China
2.Department of Neurosurgery,Dongguan Tung Wash Hospital,Dongguan 523110,China
*Corresponding author:TAO Jin-de,Associate chief technician;E-mail:80297309@qq.com
    【Abstract】  Background  It is common to see mild traumatic brain injury(mTBI) and emergence of post concussion syndrome seriously troubles the life of patients.Because of relatively subjective clinical manifestations and the not high relevant auxiliary examinations,its current clinical diagnosis remains controversial.It is important to explore the effective detection methods for early diagnosis and prognosis evaluation.
Objective  To explore the value of magnetic resonance spectroscopy(MRS),event related potentials(P300) and rivermead post concussion symptoms questionnaire(RPQ) score in mTBI.Methods  According to the inclusion criteria,30 mTBI patients and 30 healthy volunteers after physical examination in Dongguan Tung Wash Hospital from May 2012 to June 2015 were respectively selected as case group and control group.All the subjects were performed with MRI examination,P300 detection and RPQ scores.The levels of metabolites 〔N-acetylaspartate(NAA),creatine(Cr),choline(Cho)〕 in the left and right side of basal ganglia,white matter of frontal lobe,semioval center,genu of corpus callosum,and splenium of corporis callosum were measured respectively.NAA/Cr and Cho/Cr of affected side and healthy side in the case group,and NAA/Cr and Cho/Cr of left side and right side in the control group,amplitude and latency period of P300 and RPQ score of all subjects were recorded.Results  The routine MRI examination in the two groups showed no abnormalities.In case group,NAA peak in affected side of white matter of frontal lobe and semioval center declined and Cho peak increased compared with the healthy side.There was no significant difference in NAA/Cr and Cho/Cr between left side and right side of basal ganglia,white matter of frontal lobe,semioval center,genu of corpus callosum,splenium of corporis callosum in control group(P>0.05);there was no significant difference in NAA/Cr and Cho/Cr between affected side and healthy side of basal ganglia,genu of corpus callosum,splenium of corporis callosum in case group(P>0.05);in case group,NAA/Cr and Cho/Cr in affected side of white matter of frontal lobe and semioval center were lower than and higher than those in the healthy side respectively(P<0.05).Amplitude of P300 of case group was less than that of control group,while latency period of P300 and RPQ score were greater than those of control group(P<0.05).In case group,NAA/Cr in affected side of white matter of frontal lobe and semioval center was positively correlated with amplitude of P300(r=0.874,P<0.001;r=0.883,P<0.001),while negatively correlated with latency period of P300(r=-0.813,P<0.001;r=-0.850,P<0.001) and RPQ score(r=-0.617,P<0.001;r=-0.627,P<0.001);in case group,Cho/Cr in affected side of white matter of frontal lobe and semioval center was negatively correlated with amplitude of P300(r=-0.862,P<0.001;r=-0.749,P<0.001),while positively correlated with latency period of P300(r=0.607,P<0.001;r=0.552,P=0.002) and RPQ score(r=0.786,P<0.001;r=0.558,P=0.001).Conclusion  MRS can reflect the changes of the biochemical and tissue metabolism of brain tissues of mTBI patients after trauma from the molecular level.P300 can objectively reflect the impaired condition of cognitive function of mTBI patients.RPQ score can objectively reflect the severity of post concussion syndrome of mTBI patients.The combination of the three is important significance in the early diagnosis,evaluation and prognosis of mTBI.
    【Key words】  Brain injuries;Magnetic resonance imaging;Event-related potentials,P300;Post-concussion syndrome
 
Application Status and Prospect of Endoscopic Ultrasonography in Pancreatic Neoplasms
  MA Wen-jun1,LIU Xiao-jun2,ZHAO Da2*
1.Department of Internal Medicine,the Third Hospital of Gansu Province,Lanzhou 730000,China
2.Department of Medical Oncology,the First Hospital of Lanzhou University,Lanzhou 730000,China
*Corresponding author:ZHAO Da,Professor;E-mail:zhaodamail@163.com
    【Abstract】  The diagnosis of pancreatic neoplasms is always a big challenge for clinicians.Some examination methods,such as endoscopic ultrasonography(EUS),CT and MRI,can be used for the diagnosis of pancreatic neoplasms.Among them EUS is often taken as a second-line diagnostic method for such diseases.It is conducive to find small pancreatic lesions,and evaluate tumor body size and lymph node metastases.What′s more,it is simple and easy to operate with high sensitivity,and this is other examinations do not have.Moreover,the clinical treatment can be enhanced with improved diagnosis accuracy by pathological results found by endoscopic ultrasonography guided fine-needle aspiration(EUS-FNA).As the incidence of pancreatic neoplasms showing an upward trend,EUS may have a higher application value afterwards.This article systematically and detailedly presented the merits and demerits of many common diagnostic methods for pancreatic neoplasms,focusing on EUS,in the hope of providing a reference for readers.
    【Key words】  Pancreatic neoplasms;Endosonography;Punctures
 
Clinical Application of Fetoscopy in the Prenatal Diagnosis of Albinism Fetuses
  ZHAO Rong,JIANG Hai-li,WANG Xiao-xin,LIU Li-heng,ZOU Li-ying,RUAN Yan,WANG Xin*
Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China
*Corresponding author:WANG Xin,Chief physician;E-mail:wx1501@aliyun.com
    【Abstract】  Background  Prenatal diagnosis of albinism fetuses is a challenge in perinatal medicine.Fetoscopy is an important method to deal with the challenge.However,as the operation is complicated,there is possibility of failed operation and misdiagnosis.
Objective  To evaluate the value of fetoscopy in prenatal diagnosis of albinism fetuses,and to discuss the clinical experience with fetoscopy and to investigate the techniques for operative fetoscopy.Methods  Twenty-eight pregnant women with high risk of albinism fetuses visited the Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2009 to June 2015 were selected as the subjects of this study.During 19 to 27 gestational weeks,all of them underwent fetoscopy for prenatal diagnosis of albinism fetuses via observing the hair color on the fetal head with putting the fetoscope into the deepest place of amniotic cavity under the guidance of B-ultrasound.Results  All the 28 pregnant women completed fetoscopy smoothly.The duration of fetoscopy ranged from 8-42 min,with an average time of 16 min.20 were diagnosed with normal fetuses,but 8 with albinism fetuses.The diagnosis of albinism fetuses with fetoscopy was confirmed by the pathological examination of the aborted foetuses′ tissues,which showed that both the mistake diagnostic rate and failure rate of fetoscopy for prenatal diagnosis of albinism fetuses was 0.Conclusion  The fetoscopy is rapid,accurate,and safe in the prenatal diagnosis of albinism fetuses and other genetic diseases.For pregnant women with oligohydramnios,amnioinfusion given to them during the fetoscopy can shorten the duration of examination.
    【Key words】  Fetoscopes;Prenatal diagnosis;Albinism;Aamniotic fluid perfusion
 
Clinical Characteristics of Patients with Person-to-person Transmission of Severe Fever with Thrombocytopenia Syndrome
  WANG Yan-li,LIU Pei*
Department of Infectious Diseases,the First Hospital of China Medical University,Shenyang 110001,China
*Corresponding author:LIU Pei,Professor,Doctor;E-mail:syliupei2013@163.com
    【Abstract】  Background  In recent years,more and more reports have focused on person-to-person transmission of severe fever with thrombocytopenia syndrome(SFTS),however,there is still lack of a detailed summary.
Objective  To summarize the risk factors,clinical manifestations and results of laboratory testing of patients with person-to-person transmission of SFTS for improving the clinical understanding person-to-person transmission of SFTS,and reducing the person-to-person transmission,misdiagnosis and mistreatment of the disease.Methods  We retrieved Medline,PubMed,Embase,Google Scholar Databases,www.cnki.net,WANFANG DATA,VIP from January 2007 to March 2016,using advanced search,with "发热伴血小板减少综合征""人人间传播" "severe fever with thrombocytopenia syndrome" and "person-to-person transmission".We downloaded and read the full text of all the documents,excluded the articles which were repeatedly collected,published or reported by the same unit or person.And we analyzed the clinical data of the included 56 patients with person-to-person transmission of SFTS retrospectively.Results  From the included 7 articles,a total of 56 patients were retrieved,including 8 index patients and 48 secondary patients.The incubation of secondary patients with person-to-person transmission of SFTS was 6 to 15 days.Forty-five patients infected with SFTS due to blood or bloody discharge contact,2 due to suspected droplet contact,and 1 due to tick bite.The main clinical manifestations were fever,chills,diarrhea,followed by nausea,vomiting,bleeding,abdominal pain,cough,rash,conjunctival congestion,headache,myalgia and so on.All patients had declined in leucocyte and p

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