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March 2017, Volume 20, No.9 Abstracts

 Relationship between Heart-kidney Interaction and Renal Function Deterioration in Patients with Acute Heart Failure
  LUO Lei-ming
Department of Cardiovascular,Chinese PLA General Hospital,Beijing 100853,China 
    【Abstract】  In the physiological process,the heart and kidney work together,complement and compensate for the function of the other organ,and they are the two most important organs in maintaining the stability of the circulatory system.At this point,the other organ is bound to be affected if the function of any of the two organs changes.The maintenance of this stability is very complex and involves the fine regulation between cardiac and renal functions and the control of neuroendocrine activity,including the natriuretic peptide family,rennin angiotensin aldosterone system and sympathetic nervous system.The dysfunction or diseases of an organ can cause,aggravate,or directly participate in the functional damage and disease progression of another organ and form a vicious circle(mutual damage).In addition,the interaction between the heart and kidney is also affected simultaneously by some diseases or risk factors,including aging,hypertension,diabetes,atherosclerosis,etc.(co-morbidity).Only taking arteriosclerosis as an example,the large arteriosclerosis itself caused by the changes of the aging mechanical stress can independently involved in the occurrence of dysfunction and disease of the two organs.However,in the progressive stage of nephropathy,the stability of hemodynamics and neuroendocrine is damaged,the capacity load and pressure load increases significantly,and the risk of heart and kidney injury increases.At the same time,some of the drug clearance and metabolism are also affected.All these factors contribute to the risk of the coexistence of heart and kidney diseases,especially in the elderly.When the two kinds of disease coexist,the effect of pathological damage will significantly enlarge,which indicates a poor prognosis,and medication should be cautious.Therefore,the concept of prevention of heart and kidney disease and integration of diagnosis and treatment needs to be extensively promoted and popularized.
    【Key words】  Cardio-renal syndrome;Heart failure;Acute kidney injury;Editorial
 
Comparative Study on Management Models of Chronic Diseases at Home and Abroad
  TANG Xing-yue,ZHANG Qing*
School of Nursing,Tianjin Medical University,Tianjin 300000,China
*Corresponding author:ZHANG Qing,Professor;E-mail:18940116735@163.com
    【Abstract】  Chronic disease can be prevented and treated.Reinforcing the management of chronic disease effectively can release pain of patients and increase their quality of life.At present,the exploration on the management of chronic disease is in its infancy,the models are not perfect and lack of relative theoretical support.By comparing management models of chronic disease in the UK,the US,Australia and China in detail,the author summarizes successful experience of abroad in this respect,and on this basis puts forward the enlightenment to the management of the chronic disease in our country,perfects the model under the background of new healthcare reform.
    【Key words】  Chronic disease;Disease management;Home and abroad
 
Enlightenment of the Long-term Care System in Taiwan to the Development of Mode of Home-based Care for the Elderly in Mainland China
  CHEN Xing-zi,ZENG Zhi*,SHEN Yong-jian
School of Health Economics and Management,Nanjing University of Chinese Medicine,Nanjing 210023,China
*Corresponding author:ZENG Zhi,Associate professor,Master supervisor;E-mail:zengzhinju@163.com
    【Abstract】  With further population aging,family structure transitioning and social structure changing,the elderly care problem has increasingly become the focus of global attention.At present,the model of home-based care for the elderly is carried out in mainland China.However,the development of this mode is facing some challenges,such as there is a lack of aging-related mature supporting systems and policies,the operation and evaluation systems for the mode need to be improved,there are not enough caregivers and the quality of them is required to be enhanced,the overall level of social organizations participating in elderly care services is unsatisfactory and so on.Currently,the elderly care mode implemented in Taiwan is "aging in place",which has a lot of common points with the mode of home-based care for the elderly practised in mainland China.As mainland China and Taiwan have the same cultural venation and tradition,it is suggested to draw lessons for solving elderly care problems in mainland China from the concrete ways in some aspects covered in Long-term Care 2.0 implemented in Taiwan currently,such as the formulation and enaction of aging related laws and policies,resources integration,development of caregivers and involvement of all sectors of society.
    【Key words】  China;Taiwan;Home care service; Long-term care
 
Clinical Characteristics and Influencing Factors of Vascular Cognitive Impairment Not Dementia after Lacunar Infarction
  HE Dan1,DU Lei1,MA Jian-hua1*,ZHANG Xiao-ning2,HAO Chen-guang1
1.Department of Neurology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China
2.Department of Neurology,Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine,Urumqi 830054,China
*Corresponding author:MA Jian-hua,Professor,Chief physician,Master supervisor;E-mail:mjh9191@163.com
    【Abstract】  Objective  To explore the clinical characteristics and influencing factors of vascular cognitive impairment not dementia(VCIND) after lacunar infarction(LI).Methods  According to the diagnostic criteria of LI,135 patients from Department of Neurology,the First Affiliated Hospital of Xinjiang Medical University from December 2015 to June 2016 were recruited to be scored in reference to related cognitive neural scale.76 patients with VCIND and 44 patients in normal cognitive state were screened out into VCIND group and control group(NC group) respectively.Age,gender,years of education,history of hypertension,history of diabetes mellitus,history of hyperhomocysteinemia,history of transient ischemic attack,smoking history,drinking history,grading of intracranial and carotid artery stenosis,score of white matter lesion and score of cognitive function of patients in the two groups were compared,and the relationship between the above factors and VCIND after LI was analyzed.Results  There were significant differences in age,years of education,history of hypertension,the score of mini-mental state examination(MMSE) and Montreal cognitive assessment(MoCA) of patients between the two groups(P<0.05).The grading of intracranial and carotid artery stenosis and the score of DWMHs in NC group were better than those in VCIND group(P<0.05).The vascular stenosis degree of 3rd and 4th grade,and  DWMHs of 3 scores were the risk factors of VCIND after LI,and years of education was the protective factor of VCIND after LI(P>0.05).Conclusion  The cognitive impairment of patients with VCIND after LI is manifested in visual space,executive function,naming,attention,abstraction,and ability of delayed recall,and vascular stenosis degree of 3rd and 4th grade in head and neck,and deep white matter lesion are associated with cognitive impairment of patients with VCIND after LI.
    【Key words】  Infarction,lacunar;Cognition disorders;Dementia,vascular;Neuropsychological test
 
Roles for Heart-type Fatty Acid-binding Protein and N-terminal Probrain Natriuretic Peptide in Myocardium Injury in Sepsis
  QI Hong-na1*,ZHANG Jian-jun2,HE Jia-qi1,WANG Wei-zhan1,LI Ya-qin1
1.Department of Emergency,Harrison International Peace Hospital Affiliated to Hebei Medical University,Hengshui 053000,China
2.Department of Intensive Care Unit,Harrison International Peace Hospital Affiliated to Hebei Medical University,Hengshui 053000,China
*Corresponding author:QI Hong-na,Attending physician;E-mail:894582067@qq.com
    【Abstract】  Objective  To investigate the expressions and clinical values of heart-type fatty acid-binding protein (H-FABP) and N-terminal probrain natriuretic peptide (NT-proBNP) in myocardium injury in sepsis.Methods  The subjects enrolled in this study were 98 sepsis patients(50 diagnosed with severe sepsis,and 48 with septic shock on admission) who were treated in Emergency Intensive Care Unit(EICU) and Intensive Care Unit of Harrison International Peace Hospital Affiliated to Hebei Medical University from June 2014 to March 2016 and 50 controls underwent physical examination in this hospital during the same period.The 98 sepsis patients were divided into myocardium injury group(62 with value of LVEF≤50%) and non-myocardium injury group(36 with value of LVEF>50%) based on the value of left ventricular ejection fraction (LVEF) obtained from the ultrasound cardiogram(UCG) performed on admission.The measurement of H-FABP,NT-proBNP,troponin I(cTnI),creatine kinase isoenzyme (CK-MB) and creatine kinase(CK) in venous blood samples of 3 ml was performed in sepsis patients at 1 h,6 h and 24 h after admission,and in the controls during the physical examination,respectively.And changes in scores of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) of all groups were recorded.Results  At 1 h after admission,the levels of H-FABP,NT-proBNP and APACHEⅡscore in septic shock group were significantly higher than those in severe sepsis group (P<0.05).At 6 h after admission,the levels of H-FABP,NT-proBNP,cTnI and APACHEⅡscore were higher in septic shock group than in severe sepsis group (P<0.05).At 24 h after admission,septic shock group had higher levels of NT-proBNP,cTnI and APACHEⅡscore than severe sepsis group(P<0.05).In both severe sepsis and sepsis shock groups,the levels of H-FABP,NT-proBNP,cTnI,CK-MB,CK and APACHE Ⅱ scores measured at 1 h after admission differed significantly from those measured at 6 h after admission(P<0.05),and those measured at 6 h after admission also differed remarkably from those measured at 24 h after admission (P<0.05).At 1 h after admission,there were significant differences in the levels of H-FABP,NT-proBNP and APACHEⅡscore between myocardium injury group and non-myocardium injury group (P<0.05).At 6 h after admission,significant differences in the levels of H-FABP,NT-proBNP,cTnI,CK-MB,CK and APACHEⅡscore were observed between myocardium injury group and non-myocardium injury group (P<0.05).At 24 h after admission,the levels of NT-proBNP,cTnI,CK-MB,CK and APACHE Ⅱ score in myocardium injury group differed significantly from those in non-myocardium injury group (P<0.05).In myocardium injury group,there were significant differences in the levels of H-FABP,NT-proBNP,cTnI,CK-MB,CK and APACHE Ⅱ score between 6 h and 1 h after admission(P<0.05),and between at 24 h and 6 h after admission(P<0.05).In non-myocardium injury group,APACHE Ⅱ score measured at 6 h after admission was lower than that measured at 1 h after admission (P<0.05),and that measured at 24 h after admission was lower than that measured at 6 h after admission (P<0.05).In sepsis patients,positive correlations were found between level of H-FABP and APACHE Ⅱ score measured both at 1 h and 6 h after admission (r1 h=0.353,P1 h<0.001;r6 h=0.256,P6 h=0.011);and positive relationship existed between level of NT-proBNP and APACHE Ⅱ score measured both at 1 h and 6 h after admission (r1 h=0.254,P1 h=0.011;r6 h=0.263,P6 h=0.009).Conclusion  Values of H-FABPand NT-proBNP are of important reference significance in the early diagnosis and reasonable prescription for myocardium injury in sepsis.
    【Key words】  Sepsis;Shock,septic;Myocardium injury;Fatty acid-binding proteins;N-terminal probrain natriuretic peptide 
 
Clinical Efficacy Observation of Comprehensive Therapy on Patients with Acute Respiratory Failure Induced by Chronic Obstructive Pulmonary Disease
  AN Fu-cheng
Department of Pneumology,Beijing Mentougou District Hospital,Beijing 102300,China
    【Abstract】  Objective  To investigate the clinical efficacy of comprehensive therapy on patients with acute respiratory failure induced by chronic obstructive pulmonary disease (COPD).Methods  Ninety patients with acute respiratory failure induced by COPD who were admitted into Beijing Mentougou District Hospital from July 2011 to August 2013 were enrolled in the study.Using random number table,the patients were divided into non-invasive therapy group,sequential therapy group and comprehensive therapy group,with 30 patients in each group.The three groups were given non-invasive ventilation therapy,invasive and non-invasive ventilation sequential therapy and comprehensive therapy respectively based on conventional treatment.Before treatment,and 4 h,2 d and 12 d after treatment,APACHEⅡ score,CRIS score,RR,HR,MAP,results of arterial blood gas analysis (PaO2 and PaCO2) and WBC of the three groups were recorded.After treatment,the occurrence time of pulmonary infection control (PIC) window,the occurrence time of ventilator-associated pneumonia (VAP),duration of invasive ventilation,total duration of mechanical ventilation,length of stay in ICU,total length of hospitalization,the incidence of VAP and the case fatality rate during hospitalization were recorded.Before admission and 30 days after treatment,FEV1 and FVC of the patients in spontaneous breathing state were measured,and comparison was made among the three groups in FEV1% and FEV1/FVC.Results  On 2 d and 12 d after treatment,sequential therapy group and comprehensive therapy group were lower in RR,HR,PaCO2 and WBC than non-invasive therapy group (P<0.05);on 2 d after treatment,sequential therapy group and comprehensive therapy group were higher in PaO2 than non-invasive therapy group (P<0.05);on 12 d after treatment,comprehensive therapy group was higher in PaO2 than non-invasive therapy group (P<0.05);on 2 d and 12 d after treatment,comprehensive therapy group was lower in RR,PaCO2 and WBC and higher in PaO2 than sequential therapy group (P<0.05);on 2 d after treatment,comprehensive therapy group was lower than sequential therapy group in HR (P<0.05).On 2 d and 12 d after treatment,APACHEⅡ score,CRIS score,RR,HR,PaCO2 and WBC of the three groups were lower than those before treatment,and PaO2 of the three groups was higher than that before treatment (P<0.05);at 4 h after treatment,WBC of sequential therapy group and comprehensive therapy group was lower than that before treatment (P<0.05);on 2 d and 12 d after treatment,APACHEⅡ score,CRIS score and PaCO2 of the three groups were lower than those at 4 h after treatment,and PaO2 of the three groups was higher than that at 4 h after treatment (P<0.05);on 12 d after treatment,RR,HR and WBC of the three groups were lower than those at 4 h after treatment (P<0.05);on 2 d after treatment,HR and WBC of sequential therapy group and comprehensive group were lower than those at 4 h after treatment (P<0.05);on 12 d after treatment,APACHEⅡ score,CRIS score,RR,HR,PaCO2 and WBC of the three groups were lower than those on 2 d after treatment (P<0.05);on 12 d after treatment,PaO2 of the three groups was higher than that on 2 d after treatment (P<0.05).Duration of invasive ventilation,and the incidence of VAP of sequential therapy group were higher than those of non-invasive therapy group (P<0.05);total duration of mechanical ventilation,length of stay in ICU,and total length of hospitalization of sequential therapy group were lower than those of non-invasive therapy group (P<0.05).Duration of invasive ventilation,and the incidence of VAP of comprehensive group were higher than those of non-invasive therapy group (P<0.05);total duration of mechanical ventilation,length of stay in ICU,and total length of hospitalization of comprehensive group were lower than those of non-invasive therapy group (P<0.05).Duration of invasive ventilation,total duration of mechanical ventilation,length of stay in ICU,total length of hospitalization,and the incidence of VAP of comprehensive group were lower than those of sequential therapy group (P<0.05).On 30 d after treatment,FEV1% and FEV1/FVC of sequential therapy group and comprehensive therapy group were higher than those of non-invasive therapy group (P<0.05).On 30 d after treatment,FEV1% and FEV1/FVC of comprehensive therapy group were higher than those of sequential therapy group (P<0.05).On 30 d after treatment,FEV1% and FEV1/FVC of the three groups were higher than those before treatment (P<0.05).Conclusion  The clinical efficacy of comprehensive therapy on acute respiratory failure induced by COPD is better than non-invasive therapy and invasive and non-invasive ventilation sequential therapy.The comprehensive therapy could improve the lung function,shorten the duration of mechanical ventilation and hospitalization,thus reducing mortality.
    【Key words】  Pulmonary disease,chronic obstructive;Respiratory insufficiency;Non-invasive therapy;Invasive and non-invasive sequential therapy;Comprehensive therapy
 
Effect of Angelica Naphtha on the Expression Levels of miR-155 and Target Genes in Spontaneously Hypertensive Rats
  JI Lu-feng1,2,SHI Xiang-hui1,WANG Li-hong1,YI Lin1*
1.School of Integrated Chinese and Western Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China
2.Key Laboratory of Integrated Chinese and Western Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China
*Corresponding author:YI Lin,Associate professor;E-mail:yxxxlyyy@163.com
    【Abstract】  Objective  To study the effect of angelica naphtha on the expression levels of miR-155 and target genes in spontaneously hypertensive rats(SHR),and to investigate the influence and mechanism of action of angelica naphtha on lowering the blood pressure in SHR from the perspective of renin angiotensin aldosterone system(RAAS).Methods  This study was conducted between October 2015 and April 2016.We randomized 48 SPF male SHR rats aged 8 weeks old into model group,low-dose angelica naphtha group,medium-dose angelica naphtha group,high-dose angelica naphtha group,ligustilide group,valsartan group with 8 SHR rats in each group,and selected 8 SPF male Wistar rats with normal blood pressure as the normal group.Low-dose angelica naphtha group,medium-dose angelica naphtha group,high-dose angelica naphtha group,ligustilide group,valsartan group were given intragastric administration of angelica naphtha emulsion 12.6 mg·kg-1·d-1,37.0 mg·kg-1·d-1,100.0 mg·kg-1·d-1,ligustilide solution 0.8 mg·kg-1·d-1,valsartan solution 51.4 mg·kg-1·d-1,respectively,once a day,for 4 weeks,while both the normal group and model group were not given any drugs during this period.All the groups had standard diet,and they could drink water freely during this period of intervention.Systolic blood pressure(SBP) was measured in each group before the intervention,at the 1st,2nd,3rd,and 4th weeks of intervention.All the rats were sacrificed and the heart was taken at the end of intervention.HE staining was used to recognize the morphologic changes in cardiac tissue.Western blotting was employed to determine the expression levels of angiotensin Ⅱ type 1 receptor(AT1R),extracellular signal-regulated kinase 1/2(ERK1/2) and phosphorylated ERK 1/2(p-ERK1/2).And RT-qPCR was adopted to measure the expression level of miR-155.Results  There was interaction on SBP in rats among different treatment ways and time(P<0.05).There was significant effect on SBP in rats among different treatment ways and time(P<0.05).Before the intervention,and at the 1st,2nd,3rd weeks of intervention,the SBP was lower in the normal group than in other groups(P<0.05).The 4th week of intervention,the SBP in model group was higher than nomal group(P<0.05).The SBP was lower in the model group than in other groups except the normal group before the intervention(P<0.05),while it was higher in the model group than in other groups except the normal group at the 1st,2nd,3rd,4th weeks of intervention(P<0.05).HE staining showed that,the model group had unclear myocardial stripes with erythrocytes crowded in the cardiac tissue,which suggested that myocardial hyperemia and right ventricular dysfunction occurred in the group;low-dose,medium-dose,and high-dose angelica naphtha groups had clear myocardial stripes.The model group had higher expression levels of AT1R,ERK1/2,and p-ERK1/2 than low-dose,medium-dose,and high-dose angelica naphtha groups,ligustilide group,and valsartan group(P<0.05).The expression level of miR-155 did not differ significantly between all the groups(P>0.05).Conclusion  Angelica naphtha could significantly inhibit the expression of AT1R gene;by adjusting the ERK1/2 signaling pathway,it could lower the blood pressure;it did not affect the cardiac function via the expression of miR-155.
    【Key words】  Hypertension;Angelica naphtha;miR-155;Angiotensin Ⅱ type 1 receptor blockers
 
Ratio of Th17 Cells and the Changes of Expression Levels of Its Related Cytokines in Patients with Type 1 Diabetes Mellitus
  ZHAO Cheng-yu*,HUANG Xiang-li,LI Zhan-quan,CUI Sen
Qinghai University Affiliated Hospital,Xining 810001,China
*Corresponding author:ZHAO Cheng-yu,Associate chief physician;E-mail:xnzhcy@126.com
    【Abstract】  Objective  To investigate the ratio of helper T cells 17(Th17 cells) and the changes of the expression levels of its related cytokines in patients with type 1 diabetes mellitus(T1DM).Methods  According to the inclusion criteria,20 patients with T1DM(T1DM group) and 21 patients with type 2 diabetes mellitus(T2DM group) hospitalized in Qinghai University Affiliated Hospital from January 2012 to October 2014 were selected,and 22 healthy people underwent physical examination in this hospital at the same period were enrolled as the control group.The proportion of Th17 cells in peripheral blood was detected by flow cytometry,the serum concentrations of interleukin 17A(IL-17A),IL-23,IL-6,IL-1β were measured by Enzyme-linked immunosorbentassay(ELISA).The general information 〔the body mass index(BMI),age,systolic blood pressure(SBP),diastolic blood pressure(DBP),globulin(GLB),white blood cell count(WBC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),creatinine(Cr),total cholesterol(TC),triacylglycerol(TG),fasting plasma glucose(FBG)〕 of subjects in the three groups,clinical indicators of patients in T1DM group and T2DM group 〔the urine ketone body,fasting C-peptide(FCP),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),insulin antibody(INS-Ab),glutamate acid decarboxylase antibody(GAD-Ab),course of disease〕,the ratio of Th17 cells and levels of IL-17A,IL-23,IL-6 and IL-1β of subjects in the three groups were compared.The correlation between the ratio of Th17 cells and the levels of IL-17A,IL-23,IL-6,IL-1β of subjects in the three groups were analyzed.Multiple linear regression analysis was used to analyze the relationship of Th17 cells ratio,levels of IL-17A,IL-23,IL-6,and IL-1β with the general information and the clinical indicators.Results  The BMI and FBG of patients in T2DM group were higher than those in control group,while SBP was lower than that in control group(P<0.05).The BMI,SBP,DBP,Cr,TC of patients in T1DM group were lower than those in T2DM group and control group,while FBG were higher than that in T2DM group and control group(P<0.05).The TG in T1DM group was lower than that in T2DM group(P<0.05).The HbA1c,INS-Ab,GAD-Ab in T1DM group were higher than those in T2DM group,while urine ketone body,FCP,FINS were lower than those in T2DM group(P<0.05).There was no significant difference in IL-6 level of subjects in the three groups(P>0.05).The ratio of Th17 cells and IL-17A in T2DM group were higher than those in control group(P<0.05).The ratio of Th17 cells and levels of IL-17A,IL-23 and IL-1β in T1DM group were higher than those in T2DM and control group(P<0.05).The ratio of Th17 cells was positively correlated with the levels of IL-17A,IL-23 and IL-6 in T1DM group(r=0.813,0.912,and 0.862 respectively,P<0.001).The ratio of Th17 cells was positively correlated with the level of IL-17A in the T2DM group(r=0.637,P<0.05).The multiple linear regression analysis showed that Th17 cells ratio was linearly correlated with INS-Ab level(B=0.121,SE=0.085,t=2.862,P=0.007);there was a linear regression relationship between IL-17A level and INS-Ab level(B=0.315,SE=0.042,t=3.696,P=0.001);there was a linear regression relationship between IL-23 level and GAD-Ab level(B=20.115,SE=0.519,t=3.403,P=0.002);IL-6 level was linearly related to GAD-Ab level(B=1.451,SE=0.478,t=3.032,P=0.004);there was a linear regression relationship between IL-1β level and age(B=-0.037,SE=0.013,t=-2.878,P=0.006).Conclusion  Compared with patients with T2DM and healthy people,the ratio of Th17 cells in peripheral blood,and the levels of IL-17A,IL-23 and IL-1β are increased in patients with T1DM,and the ratio of Th17 cells in peripheral blood are positively correlated with the levels of IL-17A,IL-23 and IL-6.
    【Key words】  Diabetes mellitus,type 1;Th17 cells;Cytokines
 
Effects of Intense Exercise Therapy of Anaerobic Threshold on Patients with Cardiac Syndrome X
  CHEN Fang1,XU Yu2,TIAN Tian2,ZHANG Xin-yu2,WANG Zhong-min2,ZHU Zhong-yu2*
1.School of Basic Medicine,Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China
2.Department of Cardiology,Henan Provincial People′s Hospital,Zhengzhou 450007,China
*Corresponding author:ZHU Zhong-yu,Chief physician;E-mail:zhuzhongyu@live.cn
    【Abstract】  Objective  To investigate the clinical effect of intense exercise therapy of anaerobic threshold on patients with cardiac syndrome X(CSX).Methods  Twenty-one eligible patients in Henan Provincial People′s Hospital from July 2013 to April 2014 were enrolled.On the basis of drug therapy in criteria,all the patients received cardiopulmonary exercise testing(CPET),and according to the anaerobic threshold(AT),the individual aerobic exercise prescription was developed for intervention.CPET was reexamined after 3 months,and the cardiopulmonary parameters 〔oxygen consumption of anaerobic threshold value(VO2 AT),peak oxygen consumption(VO2max),aerobic exercise load(LAT),peak exercise load(Lmax)〕,frequency of angina pectoris,times of sublingual nitroglycerine,duration of angina pectoris,controlling status of angina pectoris(Seattle Angina Questionnaire) and quality of life 〔36-item short form health survey(SF-36)〕 before and after intervention were compared.Results  A total of 20 patients completed the exercise intervention.The VO2 AT,VO2max,and LAT of patients after intervention were higher than those before intervention(P<0.05);there was no significant difference in Lmax of patients before and after intervention(P>0.05).The frequency of angina pectoris and times of sublingual nitroglycerine of patients after intervention were less than those before intervention,and duration of angina pectoris was shorter than that before intervention(P<0.05).The scores of physical limitation,stability of angina pectoris,frequency of angina pectoris,satisfaction of treatment and subjective feelings of patients after intervention were higher than those before intervention(P<0.05).The scores of physical function,mental health,bodily pain,vitality/energy and comprehensive health of patients after intervention were higher than those before intervention(P<0.05).There was no significant difference in scores of role limitation,social function and role mentality of patients before and after intervention(P>0.05).Conclusion  The intense exercise therapy of anaerobic threshold can significantly improve the angina symptoms of CSX patients,improve their quality of life,and improve exercise load capacity.
    【Key words】  Syndrome X,cardiac;Anaerobic threshold;Exercise therapy
 
Effect of Lard and Margarine on the Expression of MCP-1 in Different Adipose Tissues of Rats
  WANG Nan-nan1,LIU Fu-ding2,BAI Ying-long1*,JIA Li-hong1,ZHAI Ling-ling1,WEI Wei1
1.Department of Child and Adolescent Health and Material and Child Hygiene,School of Public Health,China Medical University,Shenyang 110122,China
2.Department of Quality Management,Huangshi Central Hospital,Edong Healthcare,Huangshi 435000,China
*Corresponding author:BAI Ying-long,Associate professor;E-mail:ylbai@cmu.edu.cn
    【Abstract】  Objective  To discuss the effects of lard and margarine on the expression level of monocyte chemoattractant protein 1(MCP-1) in different adipose tissues of rats.Methods  From April to June 2015,49 healthy SPF-grade male Wistar rats in early weaning were assigned randomly into three groups:control group(CON group,n=7),lard group(L group,n=21) and margarine group(M group,n=21).Rats in CON group were fed with basal forage,rats in L group were provided with high-fat diet containing lard and rats in M group were given high-fat diet containing margarine.At the end of the 8-week feeding of rats in the three groups,rats in L group and M group were further divided into two groups according to the increasing amount of body weight,rats in the top one-third of growth were taken as L-OP group(n=7),M-OP group(n=7),rats in the bottom one-third of growth as L-OR group(n=7),M-OR group(n=7),and the left were excluded from this study.The increasing amount of body weight,epididymal and perinephric fat coefficients and the expression level of MCP-1 in subdermal,epididymal and perinephric adipose tissues of rats in the 5 groups were compared.Results  The increasing amount of body weight of rats in L-OP group and M-OP group was greater than that in CON group(P<0.05).The epididymal fat coefficients in L-OP group,M-OP group and M-OR group were both greater than those in CON group(P<0.05).The perinephric fat coefficients in L-OP group,L-OR group,M-OP group and M-OR group were all greater than those in CON group(P<0.05).There was no significant difference in the expression level of MCP-1 in epididymal adipose tissues of rats in the 5 groups(P>0.05);the expression level of MCP-1 in subdermal adipose tissues of rats in L-OP group,L-OR group,M-OP group and M-OR group was higher than that in CON group(P<0.05);the expression level of MCP-1 in perinephric adipose tissues of rats in M-OP group and M-OR group was higher than that in CON group(P<0.05).Conclusion  Compared with lard,margarine are more likely to cause the increasing of the expression level of MCP-1 in subdermal and perinephric adipose tissues.
    【Key words】  Lard;Margarine;Adipose tissue;Monocyte chemoattractant protein 1
 
Mechanism of Erlotinib Resistance Induced by Hepatocyte Growth Factor in Sensitive Non-small-cell Lung Cancer Cells in Vivo
  CUI Qing-song,PIAO Hong-mei,CUI Jing-gang,WANG Fu-jia,AN Chang-shan*
Department of Respiratory Medicine,Yanbian University Hospital,Yanji 133000,China
*Corresponding author:AN Chang-shan,Chief physician;E-mail:cs_an2003@aliyun.com
    【Abstract】  Objective  To study the mechanism of erlotinib resistance induced by hepatocyte growth factor(HGF) in non-small-cell lung cancer(NSCLC) cells and to investigate whether c-Met and its downstream signaling pathway proteins participate in the HGF-induced erlotinib resistance of NSCLC cells with different genetypes in vivo.Methods  This study was conducted from January 2014 to January 2015.We selected NSCLC cell lines with different EGFR genes(PC-9:EGFR-mutation type,sensitive;H292:EGFR-wild type,sensitive) and human embryonic lung fibroblasts MRC-5.The HGF level in cell culture supernatants secreted by PC-9,H292 and MRC-5 cells was quantified by ELISA.PC-9 and H292 cells were induced by MRC-5 cell culture supernatant;the expressions of c-Met and its downstream signaling pathway proteins were examined by Western blotting.Fifty-six female and SPF BALB/c nude mice were randomly divided into 8 groups,with each group containing 7.In building the PC-9 cell-induced model,the control group(group C) and erlotinib treatment group(group E) were subcutaneously inoculated PC-9 cell suspension and MRC-5 induced group(group H),MRC-5 and erlotinib treatment group(group HE) were inoculated PC-9+MRC-5 cell suspension subcutaneously.In establishing the H292 cell-induced model,group C and group E were inoculated H292 cell suspension subcutaneously while group H and group HE were inoculated H292+MRC-5 cell suspension subcutaneously.When the tumor diameter reached 4 mm in all groups,group C and group H were lavaged with 0.9% sodium chloride solution while group E and group HE were lavaged with erlotinib,respectively,in both built models.Mice were euthanized at after dosing.Comparisons of the weight of transplanted tumor were made between all groups in models induced by PC-9 and H292 cells.The expressions of c-Met and its downstream signaling pathway proteins in transplanted tumor tissues in nude mice were determined via immunohistochemistry.Results  The concentration of HGF was not detected in PC-9 and H292 cell culture supernatants,while that in the supernatant of MRC-5 cells was(1 262 ±90) pg/ml.Western blotting results showed that HGF in the MRC-5 cell culture supernatant could stimulate the expression of p-Met,p-Akt,p-Stat3 and phosphorylated extracellular regulated protein kinase 1/2(p-Erk1/2) in PC-9 and H292 cells.The weight of transplanted tumor in group E was less than that in group C(P<0.05) in PC-9 cell-induced model;the weight of transplanted tumor in group HE was less than that in group H,but was greater than that in group E(P<0.05) in PC-9 cell-induced model.The weight of transplanted tumor in group E was less than in group C(P<0.05) in H292 cell-induced model;the weight of transplanted tumor in group HE was less than that in group H,whereas it was greater than that in group E(P<0.05) in H292 cell-induced model.c-Met and p-Met were localized in the cell membrane and cytoplasm,respectively.In both models,expressions of c-Met did not differ significantly between groups of C,H,E,and HE(P>0.05);group H had higher expressions of p-Met than group C(P<0.05),and group HE had higher expressions of p-Met than group E(P<0.05).Stat3 was localized in cytoplasm and p-Stat3 in nucleus.In both models,no distinct differences in the expressions of Stat3 were noted between groups of C,H,E and HE(P>0.05);group H had higher expressions of Stat3 than group C(P<0.05),and group HE showed higher expressions of Stat3 than group E(P<0.05).Akt and p-Akt were located in cytoplasm.In both models,the differences in the expressions of Akt were not prominent between groups of C,H,E and HE(P>0.05);expressions of p-Akt in group H were higher than those in group C(P<0.05);expressions of p-Akt were found to be higher in group HE than in group E(P<0.05).Erk1/2 was localized in cytoplasm and p-Erk1/2 was localized in nucleus.In both models,expressions of Erk1/2 demonstrated no significant differences between groups of C,H,E and HE(P>0.05);the expressions of p-Erk1/2 in H group were higher than those in group C(P<0.05);expressions of p-Erk1/2 in group HE were higher than those in group E(P<0.05).Conclusion  HGF secreted by MRC-5 cell induces Erlotinib resistance in PC-9 and H292 cells in sensitive NSCLC cells.The HGF-induced activation of c-Met and its downstream signaling pathway proteins phosphorylation may be an important mechanism of Erlotinib resistance in sensitive NSCLC cells with different genetypes.
    【Key words】  Carcinoma,non-small-cell lung;Hepatocyte growth factor;Drug resistance,neoplasm
 
Development and Application of A Precision Sputum Meter
  SUN Yi,FU Gui-fen*,TANG Xiao-yan,ZHEN Hong,HU Qiong-yan
The People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China
*Corresponding author:FU Gui-fen,Chief superintendent nurse;E-mail:1174803394@qq.com
    【Abstract】  Objective  To develop a metering device for precise single measurement of sputum volume,which is applied to clinical observation and provide accurate reference for diagnosis and treatment.Methods  This study was conducted between May and September 2015.The precision sputum meter used in this study was developed by our research group in March 2015(patent number:ZL 2015 2 0346561.7).The subjects enrolled in this study were some patients(new born babies,infants,elder children and adults) hospitalized in the ICU,PICU and Neonatal Ward of The People′s Hospital of Guangxi Zhuang Autonomous Region during the period of study.We used precision sputum meter,pure naked-eye observation and sputum meter with the same frequency,to measure the sputum volume of the patients of the above 4 age groups with normal oral and nasal suctioning versus those with endotracheal suctioning during mechanical ventilation(each method of measurement was used 20 times for every age group with normal oral and nasal suctioning versus endotracheal suctioning during mechanical ventilation).In this way,we obtained the data about the accuracy of these 3 methods of measurement.In September 2015,we conducted a survey about the accuracy of precision sputum meter and sputum meter of measurement in 160 nurses who used them using the self-developed questionnaire.All the nurses returned valid questionnaires,suggesting that the response rate of the survey was 100.0%.The accuracy scores of 2 methods of measurement assessed by the nurses were recorded for making a comparison.Results  Precision sputum meter as well as sputum meter has higher overall accuracy than pure naked-eye observation in measuring the sputum volume of the patients aspirated by normal oral and nasal suctioning or by endotracheal suctioning during mechanical ventilation(P<0.05).The accuracy of pure naked-eye observation was lower than that of precision sputum meter and sputum meter in respectively measuring the sputum volume of the patients of 4 different age groups aspirated by normal oral and nasal suctioning or by endotracheal suctioning during mechanical ventilation(P<0.05).Precision sputum meter had higher scores than sputum meter in the aspects of operability,washability,portability,easy-observation,easy-fixation and cost-effectiveness(P<0.05).Conclusion  Precision sputum meter is good for clinical application for its accuracy,easy operation and convenience,and helpful for diagnosis and adjustment of treatment.
    【Key words】  Sputum;Sputum suction;Meter
 
Identification and Screening of Proteins Associated with Gastric Adenocarcinoma by Proteomics Based on Liquid Chromatography-mass Spectrometry
  LIU Yu1,LI Zhao-xing1,TAN Bi-bo1,FAN Li-qiao1,ZHAO Qun1,ZHANG Meng2,XU Zhi-bin3,LI Yong1*
1.The Third Department of General Surgery,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China
2.Department of Hepatobiliary Surgery,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China
3.Department of Endoscopy,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China
*Corresponding author:LI Yong,Professor;E-mail:li_yong_hbth@126.com
    【Abstract】  Objective  To identify and screen the proteins associated with gastric adenocarcinoma by proteomics based on liquid chromatography-mass spectrometry(LC-MS),and to explore the functions of these proteins.Methods  Sixteen consecutive patients diagnosed as gastric adenocarcinoma and treated with surgery in Fourth Hospital of Hebei Medical University from April 2011 to September 2012 were selected.The differentially expressed proteins in human gastric adenocarcinoma tissues and adjacent normal tissues taken intraoperatively were identified and screened by proteomics based on LC-MS,and then tested by immunohistochemistry.Results  As the results of proteomics based on LC-MS showed,3 000-4 000 proteins were identified in gastric adenocarcinoma tissues and adjacent normal tissues,including 12 significantly differentially expressed proteins.The results were compared with the relative data in GO database.Of the second-level nodes,the structural proteins classified as cellular component were ruled out,and in nodes of "molecular function" and "metabolic process",4 proteins probably associated with gastric adenocarcinoma were selected,which included glutathione S-transferase-π-1(GST-π-1),Cu/Zn superoxide dismutase(Cu/Zn-SOD),pyruvate kinase M2(PK-M2),P120-catenin(P120-ctn).Results of immunohistochemistry revealed that positive rates of GST-π-1,PK-M2,and P120-ctn were higher in gastric adenocarcinoma tissues than in adjacent normal tissues(P<0.001),whereas positive rates of Cu/Zn-SOD were lower in gastric adenocarcinoma tissues than in adjacent normal tissues(P<0.001),which were in accordance with proteomics based on LC-MS.Conclusion  Proteins associated with gastric adenocarcinoma(GST-π-1,Cu/Zn-SOD,PK-M2,and P120-ctn) identified with proteomics based on LC-MS,are considered to be related to the multiple cell biological activities of gastric adenocarcinoma via preliminary analysis,which suggests that it is valuable to identify gastric adenocarcinoma associated proteins with proteomics based on LC-MS.
    【Key words】  Stomach neoplasms;Gas chromatography-mass spectrometry;Proteomics
 
Influence of Zhengan Xifeng Decoction on the Expression of Peptide Tyrosine Tyrosine in Spontaneously Hypertensive Rats
  JIN Hua1,2*,LIU Zhi-jun1,ZHANG Qiu-ju1,YAN Chun-lu1,LIU Feng-lin1,CHEN Li1,XU Hou-qian1,HU Ji-hong1,DOU Rong-hai1,WEN Xin-yang1,CAO Qiang1,SU Li-li1
1.Gansu University of Chinese Medicine,Lanzhou 730000,China
2.Gansu Province Key Laboratory of Traditional Chinese Medicine Prescription Excavation and Innovation and Transformation,Lanzhou 730000,China
*Corresponding author:JIN Hua,Professor;E-mail:lanzhoujinhua@126.com
    【Abstract】  Objective  To investigate the influence of Zhengan Xifeng decoction on the expression of peptide tyrosine tyrosine(PYY) in spontaneously hypertensive rats(SHRs).Methods  We randomly assigned 75 SHRs(14 weeks old,male) into model group(n=15),Benazepril group(n=15),Zhengan Xifeng decoction high,medium,and low dose groups(15 SHRs in each group),and set 15 WKY rats as the WKY group between June 2012 and April 2015.During the intervention period of 8 weeks,six rats died in model group,WKY group,Zhengan Xifeng decoction high, medium, and low dose group,seven rats died in Benazepril group.The rats in model group and WKY group were given the same volume of distilled water every day,Benazepril group were fed with Benazepril 0.90 mg·kg-1·d-1,Zhengan Xifeng decoction high,medium,and low dose groups were fed with Zhengan Xifeng decoction 15,30,60 g·kg-1·d-1,respectively.At the end of intervention,the level of PYY in serum was detected by ELISA,the expression of PYY and its mRNA in colon was detected by immunohistochemistry and RT-PCR.Results  The serum PYY levels in model group were significant higher than those in WKY group(P<0.05).Zhengan Xifeng decoction high dose group had lower serum PYY levels than model group(P<0.05).Compared with the model group,the expression of PYY in colon was lower in the WKY group(P<0.05) as well as in Benazepril group,and Zhengan Xifeng decoction high,medium,and low dose groups(P<0.05).The expression of PYY in colon in Zhengan Xifeng decoction high dose group was lower than that in Benazepril group(P<0.05).WKY group had lower expression of PYY mRNA in colon than model group(P<0.05),likewise,Benazepril group,and Zhengan Xifeng decoction high,medium dose groups possessed lower expression of PYY mRNA in colon than model group(P<0.05).Zhengan Xifeng decoction high dose group displayed a lower expression of PYY mRNA in colon in comparison to Benazepril group(P<0.05).Conclusion  SHRs have regulation disorder of PYY in colon.The antihypertensive effect of Zhengan Xifeng decoction may be realized by regulating the expression of PYY.
    【Key words】  Rats,inbred SHR;Zhengan Xifeng decoction;Peptide tyrosine tyrosine
 
Identification of Deactivated Brain Regions by Real and Non-penetrating Sham Acupuncture Stimulation on Waiguan:An fMRI Study in Normal Versus Pathological Conditions
  ZHANG Gui-feng1,2,HUANG Yong2*,TANG Chun-zhi3,LAI Xin-sheng3,CHEN Jun-qi2
1.School of Traditional Chinese Medicine,Zhaoqing Medical College,Zhaoqing 526020,China
2.School of Traditional Chinese Medicine,Southern Medical University,Guangzhou 510515,China
3.Clinical Medical College of Acupuncture,Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine,Guangzhou 510405,China
*Corresponding author:HUANG Yong,Professor,Chief physician,Doctoral supervisor;E-mail:nanfanglihuang@163.com
    【Abstract】  Objective  To study the law of identification of deactivated brain regions by real and non-penetrating sham acupuncture stimulation on Waiguan(Point te5) in normal versus pathological conditions based on fMRI.Methods  The subjects enrolled in this study were 24 normal controls selected from Southern Medical University between August and December 2013,and 20 ischemic stroke patients from Nanfang Hospital and the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January and June 2014.We conducted real and non-penetrating sham acupuncture stimulation on the right Point te5 in all the subjects,respectively and collected the signal data of brain deactivations with blood oxygenation level-dependent(BOLD) fMRI and processed the data using SPM2(P≤0.001,uncorrected,number of biotin K>30).Results  In the normal controls,the brain regions deactivated by real acupuncture stimulation on Point te5 were as follows:left superior parietal lobule(BA7),left inferior parietal lobule(BA40),left precuneus(BA7,19),left superior frontal gyrus(BA6),left precentral gyrus(BA6,10),left postcentral gyrus(BA3,7),left occipital lobe(BA19),right precentral gyrus(BA6),right postcentral gyrus(BA3),right precuneus(BA19,7),right cuneus(BA19);the brain regions deactivated by non-penetrating sham acupuncture stimulation on Point te5 were left precentral gyrus(BA10),left postcentral gyrus(BA3,5),and right superior frontal gyrus(BA10).In the ischemic stroke patients,the brain regions deactivated by real acupuncture stimulation on Point te5 were as follows:left medial frontal gyrus(BA6,10),left postcentral gyrus(BA3),left middle temporal gyrus(BA21),right postcentral gyrus(BA3,5),right precentral gyrus(BA4),right medial frontal gyrus(BA10);the brain regions deactivated by non-penetrating sham acupuncture stimulation on Point te5 were left and right precuneuses(BA7).Conclusion  Real acupuncture stimulation on Point te5 can deactivate the functional brain regions in both the normal controls and ischemic stroke patients,which suggests that the stimulation of Point te5 may be associated with the deactivation of brain regions;the deactivated functional brain regions in the normal controls are different from those in the ischemic stroke patients when the same kind of acupuncture stimulation given to them is disturbed or interrupted.
    【Key words】  Acupuncture;Point te5(waiguan);Magnetic resonance imaging;Brain deactivation
 
Prevalence of Four Major Chronic Diseases and Their Impact on Quality of Life among Rural Residents in Yunnan Province
  LI Qing1,2,CAI Le1*,WANG Wen-li3,LIU Yue-cui4,CUI Wen-long1,LI Shao-mei3
1.School of Public Health,Kunming Medical University,Kunming 650500,China
2.Department of Nephrology,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China
3.Department of Medical Administration,the First People′s Hospital of Yiliang,Yiliang 652100,China
4.Dayao County Health Bureau,Dayao 675400,China
*Corresponding author:CAI Le,Professor,Doctoral supervisor;E-mail:caile002@hotmail.com
    【Abstract】  Objective  To study the prevalence of four chronic diseases(hypertension,diabetes,coronary heart disease and stroke) in rural residents of Yunnan and analyze their impact on quality of life(QOL) of the residents.Methods  From January to September in 2015,a multistage stratified random sampling method was used to select 5 040 rural residents who met the inclusion criteria from 12 administrative villages in Yunnan province as the research objects.Physical examination and one-to-one interview questionnaire survey were carried out respectively.The questionnaire survey included the demographic characteristics(gender,age,educational level,family income per capita,marital status),obesity(generalized obesity,central obesity) and quality of life(SF-36 scale was used to evaluate,the scores of 8 dimensions including physiological function,physiological role,bodily pain,general health,vitality,social function,emotional function and mental health,2 comprehensive scores including comprehensive scores of physical health and mental health),prevalence of the four chronic diseases;and multiple linear regression was used to analyze the influencing factors of quality of life of rural residents.Results  A total of 5 040 questionnaires were sent out and 4 979 valid questionnaires were returned.The total effective response rate was 98.8%.Of the 4 979 residents,there were 1 757(35.3%) with hypertension,491(9.9%) with diabetes,191(3.8%) with coronary artery disease,83(1.7%) with stroke and 2 911(58.5%) healthy people.The scores of physiological function,physiological role,bodily pain,general health,social function,emotional function,and the comprehensive scores of physical health and mental health of patients with hypertension were lower than those of healthy people(P<0.05).The scores of physiological function,physiological role,physical pain,overall health,vitality,emotional function and comprehensive scores of physical health of diabetic patients were lower than those of healthy people(P<0.05).The scores of physiological function,physiological role,physical pain,overall health,vitality,social function,emotional function and mental health and comprehensive scores of physical health and mental health of patients with coronary heart disease and stroke were lower than those of healthy people(P<0.05).Gender,age,educational level,family income per capita,developing hypertension,diabetes mellitus,coronary heart disease and stroke were influencing factors of comprehensive scores of physical health of rural residents(P<0.05).Gender,educational level,family income per capita,obesity,developing coronary heart disease and stroke were influencing factors of comprehensive scores of physical health of rural residents(P<0.05).Conclusion  The prevalence rate of hypertension is the highest,followed by diabetes mellitus and coronary heart disease among the four chronic diseases in rural residents in Yunnan province,and the quality of life of patients with chronic diseases significantly declines compared with that of the healthy people.Therefore,we need to strengthen the intervention and health management of patients with chronic diseases,and improve their quality of life.
    【Key words】  Chronic diseases;Quality of life;Rural population;Data collection
 
Symptom Clusters of Patients with Cervical Cancer during Concurrent Chemoradiation Therapy
  HE Ming-yu1,LIU Gui-hong2*,XU Ji-cheng1
1.School of Public Health,Xuzhou Medical University,Xuzhou 221000,China
2.Department of Radiotherapy,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China
*Corresponding author:LIU Gui-hong,Associate professor;E-mail: xzmcxjc@sina.com
    【Abstract】  Objective  To explore the symptom clusters and symptoms distribution of patients with cervical cancer during concurrent chemoradiation therapy.Methods  From November 2015 to June 2016,according to the inclusion criteria,137 patients with cervical cancers during concurrent chemoradiation therapy in radiation therapy center from 3 tertiary hospitals: the Affiliated Hospital of Xuzhou Medical University,Xuzhou Central Hospital and General Hospital of Xuzhou Coal Mining Group were selected by convenient sampling method.One-to-one interview was conducted to all the subjetcs.The questionnaire included demographic data,clinical data and the Memory Symptom Assessment Scale in Chinese version(MSAS-Ch).Results  In this study,137 questionnaires were sent out and 124 valid questionnaires were collected.The effective response rate was 90.5%.The average age of the 124 patients with cervical cancer was(51.5±8.6).The symptoms of the top five incidence in the concurrent chemoradiation period of the patients with cervical cancer were fatigue(97.6%,121/124),loss of appetite(87.9%,109/124),dry mouth(83.9%,104/124),skin change(81.5%,101/124),and nausea(80.6%,100/124).There was a positive correlation between the incidence of fatigue and loss of appetite,between the incidence of loss of appetite and changing of taste,between the incidence of dry mouth and diarrhea,between the incidence of skin change and abdominal distension,between the incidence of nausea and changing of taste,between the incidence of nausea and diarrhea,and between the incidence of changing of taste and diarrhea(P<0.05).Seven symptom clusters including gastrointestinal symptom clusters,energy deficiency symptom clusters,perimenopausal symptom clusters,self-image impaired symptom clusters,somatic-related symptom clusters,nervous system-related symptom clusters,psychological symptom clusters were got by exploratory factor analysis method.The total variance contribution rate was 56.985%.The variance contribution rate of each symptom cluster was 9.972%,9.117%,8.256%,8.214%,7.376%,7.033% and 7.017%,respectively.The Cronbach′s α of each symptom cluster was 0.853,0.812,0.798,0.870,0.775,0.846,0.913,respectively.Conclusion  There are various symptom clusters in cervical cancer patients during concurrent chemoradiation therapy,so clinical nurses should actively promote symptom management,and improve the quality of life of patients during treatment. 
    【Key words】  Uterine cervical neoplasms;Chemoradiotherapy;Symptoms & signs
 
Clinical Analysis of Anti-N-methyl-D-aspartate Receptor Encephalitis in Children
  KANG Qing-yun*,YANG Li-ming,CHEN Bo,ZHANG Jie,NING Ze-shu
First Department of Neurology,Hunan Children′s Hospital,Changsha 410007,China
*Corresponding author:KANG Qing-yun,Attending physician;E-mail:84315287@qq.com
    【Abstract】  Objective  To explore the clinical characteristics,diagnosis,treatment and outcomes of anti-N-methyl-D-aspartate receptor(anti-NMDAR) encephalitis in children to improve the awareness of this disease in people.Methods  We conducted a retrospective analysis of the clinical characteristics,auxiliary examination findings,treatment and follow-up outcomes of 11 children with anti-NMDAR encephalitis confirmed in First Department of Neurology of Hunan Children′s Hospital from June 2014 to June 2016.Results  Of the 11 patients,7 cases had convulsion at the onset of disease,the other 4 started with psychiatric symptoms.Psychiatric symptoms occurred in all the patients,specifically,10 cases exhibited impaired consciousness,10 cases had dyskinesias,9 cases had speech disorders,9 cases had developed sleep disorders,8 cases had convulsion,and 6 cases had dysautonomia.EEG abnormalities occurred in 10 cases,with slowed background rhythm as the main performance,probably mixed with limited epileptic discharge.The results of MRI examination were normal or broadening and deepening in cerebral sulcus and fissure in 10 cases.Specific anti-NMDAR antibody was positive in cerebrospinal fluid in 10 cases,and it was positive in serum in 3 cases.All patients received pulse therapy with intravenous immunoglobulin(IVIG) and methylprednisolone,of them,3 cases received combined therapy with rituximab additionally.Results of the follow-ups lasting for 2 to 12 months showed that,6 patients had clinical recovery,and 5 cases were found with varying degrees of neurological sequelae.Conclusion  Convulsions or psychiatric symptoms,impaired consciousness,extrapyramidal symptoms,language disorders and sleep disorders are the common symptoms of anti-NMDAR encephalitis in children.Detecting the anti-NMDAR antibody in the serum and cerebrospinal fluid may help the diagnosis of anti-NMDAR encephalitis in children as early as possible.In treating this disease,immunotherapy proves effective,and the prognosis of anti-NMDAR encephalitis in children is optimistic.
    【Key words】  Anti-N-methyl-D-aspartate receptor encephalitis;Child;Signs and symptoms
 
Value of Electrocardiogram Abnormalities in Predicting Chronic Cardiotoxicity Induced by Anthracycline Chemotherapy in Invasive Breast Ductal Carcinoma Patients
  QI Chuan-chuan,CHEN Jian-zhong*,CHAI Li-jun
Department of Breast Surgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China
*Corresponding author:CHEN Jian-zhong,Chief physician;E-mail:526978090@qq.com
    【Abstract】  Objective  To investigate the value of electrocardiogram(ECG) abnormalities in predicting chronic cardiotoxicity induced by anthracycline chemotherapy in invasive breast ductal carcinoma patients.Methods  This study enrolled 123 consecutive patients,who were admitted to Department of Breast Surgery of the Second Affiliated Hospital of Zhengzhou University from May 2013 to May 2015 and diagnosed with invasive breast ductal carcinoma confirmed pathologically.According to cardiotoxicity during follow-up,they were divided into cardioxicity group(n=21) and non-cardioxicity group(n=102).The ECG consequence between the two groups were observed,the influnce factor of chronic cardiotoxicity occured after chemotherapy of invasive breast ductal carcinoma patients.Results  Significant difference in age was found between the two groups(P<0.05).Compared with the non-cardioxicity group,the cardioxicity group had a higher percentage of ECG,ST-T segment and T-wave abnormalities during chemotherapy(P<0.05).ECG abnormalities occurred more frequently in the cardioxicity group than in the non-cardioxicity group(P<0.05).Multivariate Logistic regression analysis found that age,frequency of ECG abnormalities,ST-T segment and T-wave abnormalities were correlation factors for chronic cardioxicity in invasive breast ductal carcinoma after chemotherapy(P<0.05).Conclusion  Age and ECG abnormalities occurred during anthracycline chemotherapy,have a clear relationship with the chronic cardioxicity in women with invasive breast ductal carcinoma.This has tremendous clinical significance in the early prevention and treatment of chronic cardioxicity due to chemotherapy.
    【Key words】  Electrocardiography;Anthracyclines;Breast neoplasms;Chronic cardioxicity
 
Feasibility Study of Dual-source Coronary CT Angiography under "Double Low Scheme"
  ZHANG Hui-qing*,QIU Xiao-hui,LIU Yi-chao,XIA Jun-li,LIU Hai-yan
Medical Imaging Center,People′s Hospital of Bozhou,Bozhou 236800,China
*Corresponding author:ZHANG Hui-qing,Associate chief physician;E-mail:zhq7611@sohu.com
    【Abstract】  Objective  To evaluate the feasibility of low tube voltage and low concentration of contrast agent(double low) in dual-source coronary CT angiography(CTA).Methods  Fifty people suspected with and diagnosed with coronary heart disease and body mass index(BMI) less than 30.0 kg/m2,who underwent coronary CTA examination in People′s Hospital of Bozhou from September 2014 to June 2015,were selected and randomly divided into group A and group B and each group had 25 cases.Group A used 100 kV tube voltage and contrast material Iodixanol of 320 mgI/ml;and group B used 80 kV tube voltage and contrast material Iodixanol of 270 mgI/ml.All the coronary CTA examination was performed with dual-source CT of second-generation Definition Flash of SIEMENS,scanning range was 135 mm,automatic mAs technology,contrast dose was 50 ml and the flow rate was 5.0 ml/s.The quality of the image was scored and objectively evaluated.The CT value and image noise of the ascending aortic root(AO) were measured,the signal to noise ratio(SNR) of the image was calculated,the contrast to noise ratio(CNR) of left main coronary artery(LM),proximal left anterior descending coronary artery(LAD) and proximal left circumflex coronary artery(LCX) and proximal right coronary artery(RCA) was measured and calculated.The effective radiation dose(ED) of the two groups was recorded.Results  There was no significant difference in the score of the image quality and the total score of vascular segments between the two groups(P>0.05).The CT value of AO,LM,proximal LAD,proximal LCX,and proximal RCA in group B was significantly higher than that in group A(P<0.05).The image noise of group B was bigger than that of group A(P<0.05);there was no significant difference in the SNR of the images and CNR of LM,proximal LAD,proximal LCX,and proximal RCA between two groups(P>0.05).ED of group B was significantly lower than that of group A(P<0.05).Conclusion  Coronary CTA under conditions of 80 kV and 270 mgI/ml can obviously reduce the effective radiation dose and iodine intake of the patients,at the same time the quality of the image can meet the requirement of clinical diagnosis.For patients with BMI no more than 30.0 kg/m2,the dual-source coronary CTA scanning under "double low scheme " is feasibility and clinically useful.
    【Key words】  Angiography;Coronary artery disease;Dual-source;Tomography,X-ray computed;Radiation dosage;Iodine contrast agent;Low concentration
 
Relationship between the Blood Flow of Uterine Spiral Artery Monitored by Color Doppler Ultrasound and the Prognosis of Early Threatened Abortion
  WANG Bao-jin1,WANG Xin-yue1,FU Xi-ling1,WANG Meng-meng1,LI Xia1,LUO Zhen2
1.The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China
2.Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450052,China
*Corresponding author:WANG Bao-jin,Associate professor,Associate chief physician;E-mail:307797362@qq.com
    【Abstract】  Objective  To explore the relationship between parameter values of blood flow of uterine spiral artery monitored by color Doppler ultrasound and the prognosis of patients with early threatened abortion.Methods  A total of 114 women with early threatened abortion,who were in 5 to 8 weeks pregnancy and admitted to the outpatient of the Third Affiliated Hospital of Zhengzhou University from July 2015 to January 2016,were selected as the research group(group A),and 63 pregnant women with normal uterine pregnancy in early stage during the same peri

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