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September 2017, Volume 20, No.27 Abstracts

Recent Developments in Neutrophil Gelatinase-Associated Lipocalin and Cardiovascular Disease  CHEN Wen,ZHU Ji-hong*
Department of Emergency,Peking University People′s Hospital,Beijing 100044,China
*Corresponding author:ZHU Ji-hong,Professor,Chief physician;E-mail:zhujihong64@sina.com
    【Abstract】  Cardiovascular disease(CVD)seriously endangers public health.Therefore,it is of great significance to study the predictive markers of CVD.Recent studies showed that neutrophil gelatinase-associated lipocalin (NGAL) is an important marker for CVD.NGAL is directly involved in the pathogensis of CVD,and it also can independently predict the prognosis of acute myocardial infarction(AMI)and heart failure (HF).In this paper,the recent studies on NGAL and coronary heart disease (CHD),NGAL and AMI,NGAL and HF were respectively summarized and analyzed.We concluded that NGAL has clinical value in evaluating the severity of CVD and predicting the prognosis of CVD.
    【Key words】  Cardiovascular diseases;Neutrophil gelatinase-associated lipocalin;Coronary disease;Myocardial infarction;Heart failure
 
Impact of Smoking on Cardiovascular Disease and Its Recent Progress  GUO Jian-jun1,GUO Hang-yuan2,CHI Ju-fang2,PAN Sun-lei2,YU Yu2*
1.Medical Research Center,Shaoxing People′s Hospital,Shaoxing 312000,China
2.Department of Cardiovascular,Shaoxing People′s Hospital,Shaoxing 312000,China
*Corresponding author:YU Yu,Nurse-in-charge;E-mail:1711266748@qq.com
    【Abstract】  In recent years,the prevalence of cardiovascular disease has been increased gradually in China.Smoking,obesity,hypertension,dyslipidemia and abnormal glucose metabolism are risk factors for cardiovascular disease.We introduced the nicotine in tobacco and carbon monoxide that play an important role in the development of cardiovascular diseases,described their effects on cardiovascular diseases such as hypertension,coronary heart disease,heart failure,cardiomyopathy,arrhythmia,summarized the harm of smoking to cardiovascular diseases,put forward that stop smoking can effectively reduce the occurrence rate of cardiovascular disease,and called on the whole society to stop smoking and to create a smoke-free environment.
    【Key words】  Smoking;Cardiovascular diseases;Review
 
Recent Developments in Mechanical Thrombectomy for the Treatment of Acute Cerebral Infarction  ZHANG Feng*,LI Peng,JING Shan-quan,GAO Jin-ling
Department of Neurosurgery,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China
*Corresponding author:ZHANG Feng,Associate chief physician,Associate professor;E-mail:494101763@qq.com
    【Abstract】  With the change of people′s lifestyle and dietary structure,acute cerebral infarction has become an important cause of death and disability in elderly patients,and it is very easy to cause a series of complications such as paralysis,which not only increases the patient′s financial burden,but also brings harm to their body and mind.The current clinical treatments are mainly intra arterial thrombolysis,mechanical thrombectomy and intravenous thrombolysis.This paper mainly introduces the research status of mechanical thrombectomy in the treatment of acute cerebral infarction,and analyzes the therapeutic effect of mechanical thrombectomy and intra arterial thrombolysis,the results showed that compared with intra arterial thrombolysis,the therapetutic effect of mechanical thrombectomy was better,and the possibility of the occurrence of secondary cerebral embolism,postoperative cerebral hemorrhage and cerebral vasospasm and other complications was reduced greatly,especially for better patients with acute cerebral infarction.
    【Key words】    Brain Infarction;Stent;Mechanical thrombolysis;Treatment outcome
 
Effect of Intervention on Type 2 Diabetic Patients with Central Obesity in the Community through Joint Management Mode between the Community Health Service Center and the Tertiary Grade A Hospital  WANG Hong-xiu1,ZHAO Hai1,YANG Xue-yun1,GAO Li-wei1,ZHANG Xue-lian2*,ZHU Liang-xiang2,WAN Gang3,YUAN Shen-yuan2
1.Yuyuantan Community Health Service Center,Beijing 100142,China
2.Department of Endocrinology,Beijing Tongren Hospital,CMU,Beijing 100730,China
3.Medical Records and Statistics Department,Beijing Ditan Hospital Capital Medical University,Beijing 100015,China
*Corresponding author:ZHANG Xue-lian,Associate chief physician;E-mail:trxlzhang@126.com
    【Abstract】  Objective  To investigate the effect of intervention on type 2 diabetic patients with central obesity in the community through joint management mode between the Yuyuantan Community Health Service Center(YCHSC) and Beijing Tongren Hospital,CMU(hereafter referred to as a tertiary grade A hospital),which might be of great significance for the delivery of community health services.Methods  This study is a sub-project of the Beijing Community Diabetes Study(BCDS).Totaled 119 subjects with type 2 diabetes mellitus were recruited from YCHSC between October 2012 and February 2013.Based on body mass index(BMI) and waist to height ratio(WHtR),central obesity was found in 74 cases of them(diabetes with central obesity group),but not in other 45 cases(diabetes without central obesity group).The study was implemented under the instructions of the endocrinology chief physicians of a tertiary grade A from the beginning to the end.Patient management standards were formulated by endocrinology chief physicians of a tertiary grade A and general practitioners(GPs) of YCHSC based on China Guideline for Type 2 Diabetes(2010 edition).All the participants received a 36-month multifactorial intervention delivered by the appointed chief general practitioner.The physical measurements and biochemical indicators〔body weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and uric acid〕 were measured before and after intervention.And prognostic endpoints occurred after intervention were recorded.The effect of the intervention was assessed after the intervention by evaluating and comparing the improvement achieved in both groups and between the groups,and comparing the incidence of prognostic endpoints between the groups.Results  Before the intervention,body weight,SBP and TG in diabetes with central obesity group were higher than those in diabetes without central obesity group(P<0.05),while there were no significant differences in DBP,FPG,HbA1c,TC,HDL-C,LDL-C,and uric acid between the two groups(P>0.05).However,after the intervention,except the average value of FPG was higher in the diabetes with central obesity group(P<0.05),other indicators were similar in both groups(P>0.05).After the intervention,SBP,FPG and LDL-C were found to be decreased significantly but the average value of HDL-C increased obviously in the diabetes without central obesity group(P<0.05);in the diabetes with central obesity group,body weight,SBP were identified to be declined substantially but the average value of HDL-C increased notably(P<0.05).There were no significant differences in the incidence of stroke,coronary heart disease,diabetic nephropathy,diabetic retinopathy,and carotid plaque between the two groups after intervention(P>0.05).Conclusion  Bad control of blood pressure and lipid profiles could be seen in type 2 diabetic patients with central obesity.Joint management mode between the community health service center and the tertiary grade A hospital for these patients can effectively improve the values of metabolic markers,and reduce the incidence of prognostic endpoints.
    【Key words】  Diabetes mellitus,type 2;Community health services;Obesity,abdominal
 
Impact of Community Nurse-led New Team Model of Community-based Chronic Disease Management on the Medication Adherence Self-efficacy and Medication Adherence in Hypertensive Patients  WANG Sha1,YANG Hong-hua2,WANG Xiu-hua3*,LIU Dan3
1.No.1(31ward),General Surgery Department,the Third Xiangya Hospital of Central South University,Changsha 410013,China
2.Geriatrics Cardiology Department,Xiangya Hospital Central South University,Changsha 410008,China
3.Nursing School,Xiangya School of Medicine,Central South University,Changsha 410013,China
*Corresponding author:WANG Xiu-hua,Professor;E-mail:xiuhua203@163.com
    【Abstract】  Objective  To explore the impact of community nurse-led team model of community-based chronic disease management on the medication adherence self-efficacy and medication adherence in hypertensive patients,in order to offer support for community-based management of chronic disease in the future.Methods  We carried out this study between December 2014 and December 2015.The study sample comprised 180 participants who were divided equally into two groups:90 from the Wangyuehu Community Health Service Center(intervention group) and other 90 from the Hexinyuan Community Health Service Center(control group).All of them were selected from those hypertensive patients whose medical records were established and maintained in the above centers by systematic random sampling.Patients in the intervention group received nurse-led team model of community-based chronic disease management services,and those in the control group received the conventional community-based health services.The medication adherence self-efficacy was assessed by Medication Adherence Self-efficacy Scale(MASES),and medication adherence was assessed by Eight-Item Morisky Medication Adherence Scale(MMAS-8) before intervention,at the end of 6-month intervention,and at the end of 1-year intervention,respectively.And the results of the three assessments of medication adherence self-efficacy and medication adherence were compared between the two groups.Results  Total 175 cases(88 in the intervention group,and 87 in the control group) completed the intervention,the other 5 cases were lost to follow up.The method and duration of intervention exerted interaction effects on the scores of MASES and MMAS-8(P<0.05).Moreover,they produced significant main effects on the scores of MASES and MMAS-8(P<0.05).Before intervention,both groups had similar scores of MASES and MMAS-8(P>0.05).However,the scores of MASES and MMAS-8 were much higher in the intervention group at the end of 6-month intervention and 1-year intervention(P<0.05).The score of MASES in the intervention group before intervention was lower than that the end of 6-month intervention,and the end of 1-year intervention(P<0.05);and the score of MASES in the 1 years after the intervention was higher than that in the end of 6-month intervention(P<0.05).With view to the scores of MMAS-8 for the intervention group,the latter two assessment results were both higher than the first assessment result(P<0.05),but the third assessment result was lower than the second assessment result(P<0.05).Conclusion  The nurse-led team model of community-based chronic disease management can significantly improve the medication adherence self-efficacy and medication adherence in patients with essential hypertension.However,the intervention effect on the medication adherence of these patients could decrease over time.
    【Key words】  Hypertension;Community medicine;Nurses;Group management;Self-efficacy;Medication adherence
 
Role of Family Doctor Service Team in Community-based Integrated Management of Diabetes  WEI Xue-juan1,WU Hao1,YU Hai-yang1,CUI Shu-qi2,GE Cai-ying1,JIA Hong-yan1,WANG Li1,GAO Wen-juan2,HUANG Wen3,LIANG Wan-nian2*
1.Fangzhuang Community Health Service Center,Capital Medical University,Beijing 100078,China
2.School of General Practice and Continuing Education,Capital Medical University,Beijing 100069,China
3.Beijing Tongren Hospital,CMU,Beijing 100730,China
*Corresponding author:LIANG Wan-nian,Professor,Doctoral supervisor;E-mail:medicalscience@yeah.net
    【Abstract】  We elaborated the role of the family doctor service team built by Fangzhuang Community Health Service Center in Fangzhuang District,Beijing in community-based integrated management of diabetes from the aspects of its building,service pattern,service contents,and service effect assessed from the rate of signing a contract with a family doctor,rate of blood glucose under control,rate of standardized health management,and health-seeking behavior in diabetic patients.Based on this,we explored and developed a service pattern that is suitable for the integrated management of type 2 diabetic patients in urban communities,which is contribute to the community-based chronic disease management,prevention and treatment in China.
    【Key words】  Community health services;Diabetes mellitus,type 2; Family physicians′ service team;Integrated management
 
Prognosis Analysis of Colorectal Cancer by Three Predictive Models Based on Clinical and Pathological Indexes  YIN Ming-ming1,2,QIN Huan-long1,2*
1.Shanghai Clinical College of Anhui Medical University,Shanghai 200072,China
2.Department of Gastroenterological Surgery,Shanghai Tenth People′s Hospital,Shanghai 200072,China
*Corresponding author:QIN Huan-long,Professor,Doctoral supervisor;E-mail:huanlong_qin@live.cn
    【Abstract】  Objective  To investigate the value of clinical and pathological indexes integrated with support vector machine model(SVM) in the prediction of the prognosis of patients with colorectal cancer(CRC).Methods  We enrolled 2 951 patients undergoing resection of colorectal cancer in Department of Gastroenterological Surgery of Shanghai Tenth People′s Hospital from 2002 to 2011,and collected their clinical indexes(sex,age,tumor size,tumor site,histopathological type,T stage,N stage,M stage,G stage) and pathological indexes(CEA,PCNA,P53,CD34,S-100,NM23,CerB-b2,P21,and Ki-67).We divided the patients into 2 groups according to whether they lacked follow-up information.Group 1 had sufficient clinical data but lacked follow-up information,with a total of 2 747 cases.Group 2 had complete clinical data and follow-up information,with a total of 204 cases.The survival situation of the patients was recorded.In group 1,if a patient had more than 4 indicators missing,the patient was eliminated;among the remaining patients,if any index had a loss rate of >30.0%,the index was excluded;further,patients with fewer pathological types were excluded.The association of clinical indicators and pathological indicators was calculated,and then the resulting association was verified in patients in group 2.If the association was present in group 2,the patients of group 2 would be included in group 3 directly;if the association did not exist in group 2,the SVM internal algorithm was used to remove some patients until the association was established and the remaining patients of group 2 were included in group 3.The pathological indexes of group 2 were statistically analyzed,if the missing rate of an index was >50.0%,the index was eliminated.Based on SVM,data of group 3 was processed,and 3 prediction models were established:SVM1 based on clinical indexes,SVM2 based on pathological indexes,SVM3 based on clinical and pathological indexes.Results  In group 1,a total of 834 patients had missing indexes <4.The loss rates of 9 indexes(sex,age,tumor site,histopathological type,P53,CD34,S-100,CerB-b2 and Ki-67) were less than 30.0%,and they were remained.After excluding 5 patients with rare tumors,a total of 829 patients remained in group 1.There was a correlation between age and expression of CerB-b2 in group 1(P<0.05).After eliminating 105 patients,the age of the 99 remaining patients was related to the expression of CerB-b2(P<0.05),and the 99 patients were included in group 2,the loss rates of 5 indexes(PCNA,P53,CD34,S-100,CerB-b2) were less than 50.0%,and they were remained.Age correlated with the expression of S-100 as well as with the expression of CerB-b2 in group 3(P<0.05);there was correlation between the M staging and the expression of PCNA in group 3(P<0.05).The survival curve of the patients in group 3 significantly varied by T stage and N stage(P<0.05).SVM1 included 9 clinical indicators(sex,age,tumor size,tumor location,histopathological type,T stage,N stage,M stage,G stage),the accuracy rate was 83.4%.SVM2 included 5 pathological indexes(PCNA,P53,CD34,S-100,CerB-b2),the accuracy rate was 78.8%.The initial SVM3 included the above 9 clinical indicators and 5 pathological indicators,the accuracy rate was 74.8%.The index was further screened by MRMR method to obtain the final SVM3,which included 4 clinical indexes(tumor location,histopathological type,T stage,N stage) and 2 pathological indexes(CD34,CerB-b2),and the accuracy rate was 81.8%.The survival curves of patients with different risk SVM1,SVM2 and SVM3 were statistically significant(P<0.05).Conclusion  There was a certain correlation between pathological indexes such as CerB-b2,S-100 and PCNA and clinical indexes such as age and M stage;SVM model can be used to integrate the pathological and clinical indexes and to effectively predict the prognosis of patients with colorectal cancer.
    【Key words】  Colorectal neoplasms;Prognosis;Prediction model
 
Correlation of the Expressions of E-cadherin and Vimentin with the Clinicopathological Factors and Prognosis of Colon Cancer  ZENG Xiang-yue1,SUN Zhen-qiang2,WANG Qi-san1,GE Lei1,WANG Hai-jiang1*
1.Department of Gastrointestinal Surgery,Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China
2.Department of Anorectal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China
*Corresponding author:WANG Hai-jiang,Professor,Chief physician;E-mail:wanghaijiang@medmail.com.cn
    【Abstract】  Objective  The development of tumor is a complex pathophysiological process involving many interrelated factors.The purpose of this study was to investigate the correlation of the expressions of epithelial mesenchymal transition(EMT) markers(E-cadherin and Vimentin) with the clinicopathological factors and prognosis of colon cancer.Methods  Immunohistochemistry with SP method was performed to detect the expressions of E-cadherin and Vimentin in the colon cancer and adjacent tissue specimens taken from 116 stage Ⅲ colon cancer patients who underwent radical resection of colon cancer in Department of Gastrointestinal Surgery of Affiliated Tumor Hospital of Xinjiang Medical University from January 1,2009 to January 1,2014 and pathologically diagnosed as colon cancer postoperatively.The patients were followed up by outpatient or ward review,telephone and so on with a deadline of January 1st 2015.Totaled 92.2% of the participants(107/116) were followed up for 4.1-63.0 months with a median follow-up of 46.0 months.Overall survival(OS) and disease-free survival(DFS) of patients were recored.Multivariate Logistic regression analysis was performed to investigate the correlation of the expressions of E-cadherin and Vimentin with the clinicopathological factors of colon cancer.Kaplan-Meier survival analysis was conducted to estimate the survival function.Survival rate was compared with the Log-rank test.Results  The positive rate of E-cadherin and Vimentin expressions in all the participants was 79.3%(92/116),15.5%(18/116),respectively.The positive rates of E-cadherin of carcinoembryonic antigen(CEA),tumor diameter,vascular invasion,differentiation degree of colon cancer cells,lymphatic metastasis showed significant differences(P<0.05).The positive rates of Vimentin of tumor diameter,vascular invasion,perineural invasion,differentiation degree of colon cancer cells,lymphatic metastasis showed significant differences(P<0.05).Multivariate Logistic regression analysis found that CEA,vascular invasion and differentiation degree of colon cancer cells were significantly associated with the expression of E-cadherin(P<0.05).Vascular invasion,nerve invasion and differentiation degree of colon cancer cells were significantly associated with the expression of vimentin(P<0.05).Notable differences were found in the cumulative OS and DFS between E-cadherin positive group and negative group(P<0.05).The cumulative OS and DFS differed significantly between Vimentin positive group and negative group(P<0.05).Conclusion  CEA,vascular invasion and the differentiation degree of colon cancer cells are the associated factors for the expression of E-cadherin.Vascular invasion,nerve invasion and the differentiation degree of colon cancer cells are the associated factors for the expression of Vimentin.E-cadherin and Vimentin are important adverse prognostic factors in colon cancer.
    【Key words】  Colonic neoplasms;Epithelial-mesenchymal transition;Cadherins;Vimentin;Prognosis
 
Value of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS Scoring System in Predicting Postoperative Mortality Risk of Colorectal Cancer Patients  LIU Ting-ting,ZHANG Ao,HU Fang*
Department of General Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China
*Corresponding author:HU Fang,Associate chief superintendent nurse;E-mail:hxc5286@sina.com
    【Abstract】  Objective  To evaluate the value of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems in predicting postoperative mortality risk of colorectal cancer patients.Methods  The clinical data of 550 patients with colorectal cancer treated in Tianjin Medical University General Hospital from 2010 to 2015 were retrospectively analyzed.The relevant indicators were collected according to Physiological and Operative Severity Score for Enumeration of Mortality and morbidity(POSSUM),Portsmouth-POSSUM(P-POSSUM),Colorectal POSSUM(Cr-POSSUM)and Estimation of physiologic ability and surgical stress(E-PASS)scoring systems andresearchneeds.The POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems were used to predict the postoperative mortality rate of 30 days in patients with colorectal cancer.The predictive value of the scoring system was evaluated by receiver operating characteristic(ROC) curve and observed to expected ratio(O/E).Results  The best cutoff value of POSSUM,P-POSSUM,Cr-POSSUM and E-PASSscoring systems were 54.29%,55.39%,31.68% and 56.31%,respectively.The sensitivity of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems were 83.3%,83.3%,33.3% and 83.3%,respectively.The specificity of POSSUM,P-POSSUM,Cr-POSSUM and E-PASSscoring systems were 29.0%,27.9%,1.6% and 27.0%,respectively.The area under ROC curve of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems were 0.733〔95%CI(0.500,0.966)〕,0.713〔95%CI(0.479,0.948)〕,0.751〔95%CI(0.570,0.932)〕,and 0.781〔95%CI(0.607,0.955)〕,respectively.The O/E were 0.128,0.414,0.248,0.712,respectively.Conclusion  POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems all have an overestimation of the postoperative mortality of colorectal cancer.E-PASS scoring system has a good consistency in the predicting postoperative mortality and actual mortality.
    【Key words】  Colorectal neoplasm;Mortality;Forecasting
 
Serum Protein Expression in Tibetan and Han Chinese College Students with Unwell Symptoms after Migration to the Inland Region of China from Tibet  LI Wen-hua,LI Yu-xiang*,ZHANG Xin-long,GUO Yi-jiao
School of Medicine,Xizang Minzu University,Xianyang 712082,China
*Corresponding author:LI Yu-xiang,Associate professor;E-mail:xzmzxyli@163.com
    【Abstract】  Background  As the people living in the plateau move back and forth between the plateau and the plain more and more frequently,the adaptation of the plateau hypoxia population to the oxygen enriched environment of the plain has gradually attracted wide attention.11111111Objective  To analyze the serum protein expression in Tibetan and Han Chinese college students with unwell symptoms who migrated to the inland region of China from Tibet based on serum proteomics,in order to provide an accurate and simple method for early diagnosis of the diseases due to maladjustment in such a population,and to offer molecular targets for the related clinical treatment.Methods  The participants met the inclusion criteria were 32 Tibetan and Han college students〔Tibetan group(n=16) and Han group(n=16)〕 with unwell symptoms who enrolled in Xizang Minzu University during the periods of October to November 2013,October to November 2014 and October to November 2015.Serum samples were collected and the serum protein-derived polypeptide was captured by magnetic bead-based weak cation-exchange chromatography(MB-WCX).The expression of serum proteins was analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF-MS) technique and compared between the two groups.Results  MALDI-TOF-MS analysis of single sample found that,the polypeptide curves of serum protein with molecular weight of 1 000-10 000 m/z in the 3 samples from the same individual in the Tibetan group tended to be consistent,and similar results were obtained in the Han group;there were significant differences in serum protein levels between Tibetan group and Han group.The results of the MALDI-TOF-MS analysis of overall sample showed that there were significant differences in expression levels of serum protein with the molecular weight of 1 000-10 000 m/z between the Tibetan group and Han group;the analysis of its protein polypeptide components showed that a phenomenon of mutual aggregation and less overlap;there were significant differences in the peak expression of serum proteins with molecular weights of 905.65,1 062.10,1 078.11,2 138.79,2 313.40,4 094.67,4 172.89,4 213.96,5 910.71 m/z between Tibetan group and Han group(P<0.05).Conclusion  There are some differences in the expression of serum proteins between Tibetan and Han college students with unwell symptoms after migration to the inland region of China from Tibet,and the differences are significant in the expression of serum proteins with molecular weights of 4 094.67,2 138.79 and 905.65 m/z,which can be used as a basis for further identification and localization of the sequences and genes of differential proteins.
    【Key words】  Social adjustment;Proteomics;Mass spectrometry;Zang nationality;Han nationality;Students;Migrating to the inland region of China from Tibet
 
Dynamic Changes in IL-8 and IFN-γ in Cerebrospinal Fluid of Patients with Tuberculous Meningitis  ZHANG Shuai-jie,WANG Man-xia*,LI Xiao-ling,WANG Qi
Neurology Department,Lanzhou University Second Hospital,Lanzhou 730000,China
*Corresponding author:WANG Man-xia,Professor,Attending physician;E-mail:wmx322@aliyun.com
    【Abstract】  Objective  To observe the dynamic changes of IL-8 and IFN-γ in cerebrospinal fluid(CSF) of tuberculous meningitis(TBM),and to investigate their significance for the diagnosis and prognosis of TBM.Methods  The subjects enrolled in this study were 30 inpatients with TBM(TBM group),30 inpatients with viral meningitis(viral meningitis group),30 inpatients with noninfectious neurologic diseases(noninfectious neurologic diseases group) treated in Lanzhou University Second Hospital from December 2014 to August 2016.There were 12 patients of stage Ⅰ,11 patients of stage Ⅱ,7 patients of stage Ⅲ in the TBM group.The changes of IL-8,IFN-γ levels in CSF of TBM group before antituberculosis treatment,1 week and 2 weeks after antituberculosis treatment were analyzed.The IL-8 and IFN-γ levels in CSF of TBM group before antituberculosis treatment,viral meningitis group and noninfectious neurologic diseases group before treatment were compared.The relation between the level of IL-8 and IFN-γ in CSF and the severity of the disease in TBM group was analyzed.Results  The levels of IL-8 in CSF 1 week after antituberculosis treatment(t=15.710,P<0.001) and 2 weeks after antituberculosis treatment(t=21.268,P<0.001) were significantly lower than those before antituberculosis treatment in TBM group;the levels of IL-8 in CSF 2 weeks after antituberculosis treatment were significantly lower than those 1 week after antituberculosis treatment in TBM group(t=12.554,P<0.001).The levels of IFN-γ in CSF 1 week after antituberculosis treatment(t=10.793,P<0.001) and 2 weeks after antituberculosis treatment(t=14.357,P<0.001) were lower compared with those before antituberculosis treatment in TBM group;the levels of IFN-γ in CSF 2 weeks after antituberculosis treatment were lower compared with those 1 week after antituberculosis treatment in TBM group(t=17.979,P<0.001).The levels of IL-8 and IFN-γ in CSF of TBM group before antituberculosis treatment were significantly higher than those of viral meningitis group and noninfectious neurologic diseases group before treatment(P<0.05),and the levels of IL-8 and IFN-γ in CSF of viral meningitis group before treatment were significantly higher than those of noninfectious neurologic diseases group before treatment(P<0.05).The level of IL-8(rs=0.509,P=0.004) and that of IFN-γ(rs=0.665,P<0.001) in CSF were positively correlated with the severity of TBM in TBM group.Conclusion  Both the levels of IL-8 and IFN-γ in CSF of TBM group gradually decrease with the progress of treatment,and they are positively related to the TBM stage,so they may be used as the predictors for the assessment of the response rate and prognosis of the disease.
    【Key words】  Tuberculosis,meningeal;Interleukins;Interferon-gamma;Cerebrospinal fluid
 
Expression of Cyclooxygenase-2 in Oral Squamous Cell Carcinoma and Its Influence on the Prognosis  WU Xun1,YU Da-hai2,MENG Ning1,SU Ji-ping3*
1.Department of Oral & Maxillofacial Surgery,College of Stomatology Guangxi Medical University,Nanning 530021,China
2.Department of Stomatology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China
3.Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China
*Corresponding author:SU Ji-ping,Professor,Chief physician,Doctoral supervisor;E-mail:ymsu2@163.com
    【Abstract】  Objective  To investigate the expression of cyclooxygenase-2(COX-2) in patients with oral and maxillofacial squamous cell carcinoma(OSCC) and its influence on prognosis,in order to provide a valuable molecular biological marker for the diagnosis and treatment of the disease.Methods  The enrolled participants were 238 OSCC patients who received surgical treatment in Department of Oral & Maxillofacial Surgery of College of Stomatology Guangxi Medical University from September 2013 to December 2015 and met the inclusion criteria of this study.We collected the clinical data of them and obtained their overall survival(OS) and disease-free survival(DFS) during the follow-up between October 2013 and September 2016.Immunohistochemistry was used to identify the expression level of COX-2,real-time quantitative PCR was employed to measure the expression level of COX-2 mRNA and Western blotting was adopted to detect the expression level of COX-2 in the histological sections of specimens of solid tumor tissues,tissues located 1 cm away from the tumor edge,normal tissues located over 2 cm away from the tumor edge and lymph node tissues in Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴregions after neck dissection taken from the OSCC patients.Results  The distribution of positive granules showed a gradual decrease in tumor tissues,tumor adjacent tissues,lymph node tissues in Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ regions,while they were barely found in the normal tissues.The expression levels of COX-2 and COX-2 mRNA in tumor tissues,tumor adjacent tissues,lymph node tissues in Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ regions were higher than those in normal tissues(P<0.05).The expression levels of COX-2 and COX-2 mRNA in tumor adjacent tissues,lymph node tissues of Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ regions were lower than those in tumor tissues(P<0.05).The expression levels of COX-2 and COX-2 mRNA in lymph node tissues inⅠ,Ⅱ,Ⅲ,Ⅳ and Ⅴ regions were higher than those in tumor adjacent tissues(P<0.05).The expression level of COX-2 mRNA in lymph node tissues in Ⅱ region was higher than that in lymph node tissues in Ⅰ region(P<0.05).Lower expression level of COX-2 mRNA was found in lymph node tissues in Ⅲ,Ⅳ and Ⅴ regions than in Ⅰ and Ⅱ regions(P<0.05).COX-2 mRNA was downexpressed in lymph node tissues in Ⅳ and Ⅴ regions compared with it in those tissues in Ⅲ region(P<0.05).The expression level of COX-2 decreased successively in lymph node tissues in Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ regions(P<0.05).The positive rate of COX-2 expression in patients with pathological grade 3 OSCC was lower than that of patients with grade 1 and 2 OSCC(P<0.05).The positive rate of COX-2 expression in patients with T3-4 OSCC was higher than that of patients with T1-2 OSCC(P<0.05).Patients with N1 and N2 OSCC presented higher positive rate of COX-2 expression than those with N0 OSCC(P<0.05).Lower positive rate of COX-2 expression was observed in patients with N2 OSCC than in those with N1 OSCC(P<0.05).The OS and DFS were shorter in COX-2 positive patients than in COX-2 negative patients(P<0.05).Univariate and multivariate Cox regression analysis showed that the expression of COX-2,pathological grading,T staging and N staging were the factors influencing the OS and DFS of OSCC patients(P<0.05).Conclusion  COX-2 is highly expressed in OSCC and is closely related to lymph node metastasis and survival time.It is a biological marker of poor prognosis in patients with OSCC.
    【Key words】  Mouth neoplasms;Neoplasms,squamous cell;Cyclooxygenase 2;Prognosis
 
Value of Red Blood Cell Distribution Width for the Diagnosis of Endometriosis  WU Bai-xiu*,XIE Hong-ying
Liuzhou Worker′s Hospital,Liuzhou 545005,China
*Corresponding author:WU Bai-xiu,Primary nurse;E-mail:360328467@qq.com 
    【Abstract】  Objective  To investigate the value of red blood cell distribution width(RDW) in the diagnosis of endometriosis,in order to provide a reference for clinical diagnosis of the disease.Methods  We enrolled 85 patients with endometriosis confirmed by histopathological examination who received treatment in Ward 2,Department of Gynaecology of Liuzhou Worker′s Hospital from January to September in 2016,and other 41 females(control group) underwent physical examination in this hospital during the same period and had normal results.According to the American Society for Reproductive Medicine(ASRM) classification of endometriosis,the endometriosis patients were divided into mild group(stage Ⅰ-Ⅱ,n=47) and severe group(stage Ⅲ-Ⅳ,n=38).RDW and carbohydrate antigen(CA) 125 of three groups were detected and the correlation between the two indexes was analyzed.The value of RDW and CA125 in the diagnosis of endometritis was also compared.Results  RDW in the control group was lower than that in the mild group and severe group,RDW in the mild group was lower than that in severe group(P<0.05).The concentration of CA125 was lower in the mild group than in the severe group(P<0.05).RDW had moderately positive correlation with CA125 in the mild group(r=0.664,P<0.05);and it presented highly positive correlation with CA125 in the severe group(r=0.860,P<0.05).RDW had higher diagnostic accuracy of endometriosis than CA125〔92.1%(116/126) vs.81.7%(103/126)〕(P<0.05).Conclusion  Increased RDW is found in endometriosis patients.RDW is positively associated with CA125 and is of significance in the diagnosis of endometriosis.
    【Key words】  Endometriosis;Diagnosis;Red blood cell distribution width;Carbohydrate antigen 125
 
Correlation of Glasgow Coma Scale Score and Full Outline of Unresponsiveness Score with Bispectral Index and Ventilator-associated Pneumonia  CHEN Zhi-qiang1,WANG Ying2*,YU Zi-qiao1
1.Graduate School of Tianjin University of Traditional Chinese Medicine,Tianjin 300073,China
2.Tianjin First Center Hospital,Tianjin 300192,China
*Corresponding author:WANG Ying,Chief superintendent nurse;E-mail:wangy2009@sina.com
    【Abstract】  Objective  To investigate the correlation of Glasgow Coma Scale(GCS) score and Full Outline of Unresponsiveness(FOUR) score with bispectral index(BIS) and ventilator-associated pneumonia(VAP),in order to give a hand for clinical prevention of VAP.Methods  We carried out a study in 40 patients with artificial airway and mechanical ventilation who receiving inpatient treatment in the ICU of Tianjin First Center Hospital from July to December 2015.Within 12 hours after admission to the ICU,they were respectively evaluated by GCS and FOUR,and given BIS monitoring for 24 hours.And the values were recorded.A standard used in China or clinical pulmonary infection score(CPIS) were used to diagnose VAP.And the data about the incidence of VAP of patients were obtained by follow-up.Pearson correlation coefficient and Spearman rank correlation coefficient were used to evaluate the correlation of GCS score and FOUR score with BIS and incidence of VAP.Results  The GCS score was(8.3±4.0),FOUR score was(8.3±3.7) and BIS value was (69.7±17.6).The GCS score and FOUR score were positively correlated with BIS value(r=0.761,0.821,P<0.01).There was no linear correlation between GCS score and early-onset VAP(rs=0.885,P>0.05) ;the correlation of GCS score and late-onset VAP was highly negative(rs= -0.994,P<0.01).FOUR score had a highly positive correlation with early-onset VAP(rs=0.992,P<0.01);but it had a highly negative correlation with late-onset VAP(rs=-0.958,P<0.05).Conclusion  Compared with the GCS score,FOUR score is more significantly associated with BIS,VAP,which can provide moderately accurate assessment of the level of disorder of consciousness and prediction of the incidence of VAP.Moreover,it is easy to use and memorize,so it may could be used as a simple and effective tool for assessing the level of disorder of consciousness and predicting the incidence of VAP.
    【Key words】  Pneumonia,ventilator-associated;Consciousness disorders;Glasgow Coma Scale;Full Outline of Unresponsiveness
 
Effects of Black Wolfberry Water Extracts on Proliferation and Apoptosis and Apoptosis-related-protein Expression Level of HaCaT Cells after UVB Radiation  JIA Yang-e,REN Li-cuan,YAN Hua-ling*
Department of Dermatology,Qinghai University Affiliated Hospital,Xining 810001,China
*Corresponding author:YAN Hua-ling,Professor,Chief physician;E-mail:yhlckw@163.com
    【Abstract】  Objective  To research the effect of black wolfberry water extracts on proliferation and apoptosis and P38 mitogen activated protein kinase(P38MAPK), P53, cysteine proteinase 8(caspase-8), cysteine proteinase 3(caspase-3) and B cell lymphoma factor 2(Bcl-2) expression of HaCaT cells after ultraviolet B(UVB) radiation,in order to explore the mechanism of black wolfberry water extracts reducing the damage of HaCaT cells after UVB radiation.Methods  From March 2015 to January 2016, black wolfberry water extracts was extracted and HaCaT cells were cultured in vitro.HaCaT cells in logarithmic growth phase were collected and randomly divided into 3 groups by random number table method:control group(without radiation), UVB group(30 mJ/cm2 UVB radiation for 40 min) and black wolfberry water extracts group(30 mJ/cm2 UVB radiation for 40 min+black wolfberry water extracts 2 mg/ml).Cell proliferation in each group was detected by MTS, apoptotic rate in each group was assessed by flow cytometry.The expression levels of P38MAPK, P53, caspase-8, caspase-3 and Bcl-2 in each group were detected by Western blotting.Results  Cell proliferation in UVB group was lower than that in control group(P<0.05);cell proliferation in black wolfberry water extracts group was lower than that in control group but higher than that in UVB group(P<0.05).Apoptotic rate in UVB group was higher than that in control group(P<0.05);apoptotic rate in black wolfberry water extracts group was higher than that in control group but lower than that in UVB group(P<0.05).The expression levels of P38MAPK, P53, caspase-8, caspase-3 in UVB group were higher than those in control group, but the expression level of Bcl-2 in UVB group was lower than that in control group(P<0.05);the expression levels of P38MAPK, P53, caspase-8, caspase-3 in black wolfberry water extracts group were lower than those in UVB group, but the expression level of Bcl-2 in black wolfberry water extracts group was higher than that in UVB group(P<0.05).Conclusion  The black wolfberry water extracts can promote the proliferation of HaCaT cells after UVB radiation and prevent their apoptosis.The mechanism might be that the black wolfberry water extracts can down-regulate the expression levels of P38MAPK, P53, caspase-8 and caspase-3 and up-regulate the expression level of Bcl-2, so as to reduce the radiation damage of HaCaT cells.
    【Key words】  Lycium barbarum;Ultraviolet rays;Cell proliferation;Apoptosis;P38 mitogen activated protein kinase;Tumor suppressor protein p53;Cysteine proteases;B cell lymphoma factor 2
 
Reliability and Validity of Self-rated Health Measurement Scale Version 1.0 in Measuring Health Status of Elderly People  XIA Cong1,YANG Xiao-nan2,XU Jun1*,HUANG Shan3,WU Wei-xuan1,LIN Yuan-qi1
1.Department of Health Economic Management,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China
2.School of Business,Macau University of Science and Technology,Macau 999078,China
3.Administrative Office,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China
*Corresponding author:XU Jun,Doctoral supervisor;E-mail:drugstat@163.com
    【Abstract】  Objective  To analyze the reliability and validity of Self-rated Health Measurement Scale Version 1.0(SRHMS V1.0) for health assessment of elderly people.Methods  From November 2015 to July 2016,we selected 700 elderly people aged 60 or over from 5 cities(Guangzhou,Maoming,Shantou,Shaoguan and Shenzhen) of Guangdong Province by stratified random sampling with a sample size of 200,100,100,100 and 200,respectively.We surveyed them with SRHMS V1.0 and analyzed the reliability and validity of the scale.Results  A total of 700 questionnaires were distributed and 599 valid questionnaires were collected,the effective recovery rate was 85.6%.The Cronbach′s ɑ of SRHMS V1.0 and its three subscales(physical health,mental health,and social functioning) were respectively 0.946,0.901,0.889 and 0.899.The spilt-half coefficient of SRHMS V1.0 was 0.875.The item-domain correlation coefficients were all greater than 0.600 except that the correlation coefficients of SR4,SR5,SR6 with physical symptom and organ function domain(B1) and the correlation coefficient of SR27 with mental symptom and negative mood domain(M2) were less than 0.600(P<0.01).The domain-subscale correlation coefficients ranged from 0.511 to 0.926(P<0.01).The χ2/df,IFI,TLI,CFI,RMSEA of the initial model of confirmatory factor analysis(CFA) were respectively 3.850,0.854,0.840,0.854,0.069,which demonstrated that the fitting effect did not achieve the desired effect according to good adaptation scope of each index.The standardized path coefficients of "SR4←B1" "SR5←B1" "SR7←B1" "SR27←M2" were respectively 0.30,0.28,0.38,0.32 in initial CFA model.And these four items were deleted because their standardized path coefficients were all less than the preset criteria of 0.50.We adjusted the CFA model by deleting SR4,SR5,SR7 and SR27,and the fitting results were χ2/df=3.891,IFI=0.875,TLI=0.861,CFI=0.875,RMSEA=0.070,which indicated that the relative indexes were slightly improved but still not ideal for the absolute index and parsimony index.Therefore,it was necessary to establish the following contacts to adjust the model constantly in the order of modification index(MI) from high to low:"e8e9" "e38e43" "e16e17" "e15e16" "e36e41" "e23e24" "e37e38".And the final model after modification had a good fitting effect:χ2/df=2.790,IFI=0.924,TLI=0.914,CFI=0.923,RMSEA=0.055.Conclusion  SRHMS V1.0 has a good reliability and validity in measuring the health status of elderly people.Therefore,it can be used to explore the impacting factors and targeted intervention measures further.
    【Key words】  Geriatric assessment;Cities;Self-rated Health Measurement Scale Version 1.0;Reliability;Validity
 
Prediction Model of Premature Ovarian Failure Based on Artificial Neural Network  WU Yan*,YAO Lei,SHENG Wen-li,LIU Ming-juan
Department of Obstetrics and Gynecology,the Second Worker′s Hospital of China Resources and WISCO,Wuhan 430085,China
*Corresponding author:WU Yan,Associate chief physician;E-mail:jzg100@126.com
    【Abstract】  Objective  To establish a multilayer forward neural network model based on artificial neural network(ANN) for predicting premature ovarian failure(POF),in order to increase the total coincidental rate of clinical diagnosis.Methods  Three hundred and forty-one women met the inclusion criteria were selected as the study subjects,who lived in six communities under the jurisdiction of Baiyushan Street in Wuhan City during January to March 2011.From May 2011 to June 2016,each case was conducted to hospital follow-up once every four months until the age of 40.During the follow-up,2 cases underwent hysterectomy,2 cases received sex hormone treatment,21 cases were lost,all these cases were excluded,and finally 316 cases were included in the study.Using unbiased randomized allocation method,316 subjects were divided into training sample(177 cases),test sample(44 cases) and persistent sample(95 cases).The input parameters were set as the type A behavior,mumps history,history of gynecological surgery,history of ovulation induction drugs use,marriage and birth history,follicle stimulating hormone(FSH),FSH/luteinizing hormone(LH) and anti mullerian hormone(AMH),inhibin B(INHB),the number of antral follicles(AFC),systolic peak velocity(PSV) and resistance index(RI);the output parameter was "whether POF occured".The model was constructed by training sample,and corrected by the test sample.The stability of the model was tested by persistent sample.Results  After eliminating the "redundancy",ANN automatically constructed model of input unit(12),single hidden layer(six nodes) and activation function(hyperbolic tangent),output unit(2) and activation function(softmax).The cross entropy error value of the training sample was 53.236.Abort testing when the prediction error did not decrease,and the test time was 0.42 s.The input parameters affecting the weights in the top 5 were AMH(26.3%),INHB(24.1%),AFC(21.7%),type A behavior(7.2%),and history of gynecological surgery(6.5%).The sensitivity of multilayer forward neural network model predicting POF in the training sample,test sample and persistent sample was 97.8%,91.7% and 92.0%,respectively;the specificity was 92.4%,84.4% and 80.0%,respectively,and the total coincidental rate was 93.8%,86.4% and 83.2%,respectively.On the basis of training sample and test sample,the AUC of multilayer forward neural network model predicting POF was 0.972.Conclusion  The multilayer forward neural network model based on ANN for predicting POF has a high total coincidental rate of clinical diagnosis.It not only provides a theoretical basis and method support for the clinical efficient diagnosis and optimization examination,but also provides an opportunity to realize early prevention and early treatment,and is worthy of clinical promotion.
    【Key words】  Primary ovarian insufficiency;Ovarian failure,premature;Neural networks(computer);Forecasting
 
Effects of Syndrome Differentiation-based Nursing Based upon TCM Theories for Blood Pressure and Clinical TCM Symptoms on Patients with Hypertension  XU Min1*,TAN Xiao-xue2,WEI Ye-hong1
1.The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,China
2.Zhejiang Chinese Medical University College of Nursing,Hangzhou 310005,China
*Corresponding author:XU Min,Associate chief superintendent nurse;E-mail:yudi1212@163.com
    【Abstract】  Objective  To explore the effects of syndrome differentiation-based nursing based upon Traditional Chinese Medicine(TCM) theories for blood pressure and clinical TCM symptoms on patients with hypertension,in order to improve the quality of life in this population.Methods  We enrolled 100 participants who received inpatient treatment in Cardiovascular Department or Geriatrics Department of the Second Affiliated Hospital of Zhejiang Chinese Medical University from January to December 2015 and equally divided them into the experimental group and the control group with 50 cases in each.Both groups received the conventional nursing,the experimental group additionally received syndrome differentiation-based nursing based upon TCM theories for health maintenance for 30 days.The 24 h ambulatory blood pressure monitoring(24 h systolic and diastolic blood pressures) and quantitative classification of TCM symptoms were assessed before treatment,and after 10,20,30 days of treatment.And these results were compared between the two groups.Results  The method and duration of nursing produced interaction effects on the mean 24 h systolic and diastolic blood pressures(P<0.05).The duration of nursing exerted obvious main effect on the mean 24 h systolic and diastolic blood pressures(P<0.05).The method had significant main effect on the mean 24 h systolic and diastolic blood pressures(P<0.05).The mean 24 h systolic and diastolic blood pressures measured after 20 days of treatment as well as those measured after 30 days of treatment were much lower in the experimental group than in the control group(P<0.05).There were some interactive effects of the method and duration of nursing on the scores of quantitative classification of TCM symptoms(P<0.05);the main effect of the duration of nursing on the scores of quantitative classification of TCM symptoms was significant(P<0.05);the main effect of the method of nursing on the scores of quantitative classification of TCM symptoms was significant(P<0.05).The scores of quantitative classification of TCM symptoms assessed after 10,20,30 days of treatment were all lower in the experimental group than in the control group(P<0.01).Conclusion  For hypertensive patients,the syndrome differentiation-based nursing based upon TCM theories for health maintenance could effectively control the blood pressure,ease the clinical TCM symptoms,and improve the quality of life.
    【Key words】  Hypertension;Health promotion science(TCM);Syndrome differ nursing;Treatment outcome
 
Clinical Efficacy and Optimal Frequency of High Colonics Combined with Retention Enema with Preferred Recipe of Traditional Chinese Medicine for Non-dialysis Patients with CKD 3-5 Stage  CHENG Xiao-ping*,YANG Shu-bin,ZHANG Yu,YAN Pei,SHI Jian
Department of Nephrology,Shaanxi ProvincialHospital of Traditional Chinese Medicine,Xi′an 710003,China
*Corresponding author:CHENG Xiao-ping,Associate chief physician;E-mail:chengxiaoping2006@163.com
    【Abstract】  Objective  To study the efficacy and optimal frequency of high colonics combined with retention enema with preferred recipe of traditional Chinese medicine(TCM) for non-dialysis patients with chronic kidney disease(CKD) 3-5 stage.Methods  A total of 150 non-dialysis patients with CKD 3-5 stage receiving hospitalized treatment in Department of Nephrology of Shaanxi Provincial Hospital of Traditional Chinese Medicine from January 2015 to July 2016 were selected and divided into the control group,treatment group 1 and treatment group 2 according to the random number table,with 50 in each.The control group received the treatment with western medicine and high colonics once every other day,for a total of 7 times.The treatment group 1 and treatment group 2 received the treatment with western medicine and high colonics combined with retention enema with preferred recipe of TCM once every other day,for a total of 7 times,and 10 times,respectively.At the end of treatment,the serum creatinine(SCr),blood urea nitrogen(BUN),uric acid(UA) and estimated glomerular filtration rate(eGFR),serum calcium,serum phosphorus,hemoglobin(HGB) and neutrophil fraction were compared between the control group and treatment group 1,and between the treatment group 1 and treatment group 2,respectively.The adverse reactions were observed.Results  To taled 129 cases completed the study,including 46 in treatment group 1(4 dropped out of the study),41 in treatment group 2(9 dropped out of the study)and 42 in the control group(8 dropped out of the study).Before treatment,the values of SCr,BUN,UA,eGFR,serum calcium,serum phosphorus,HGB and neutrophil fraction did not differ significantly between the control group and treatment group 1(P>0.05),and between the treatment group 1 and treatment group 2(P>0.05).After treatment,compared with the control group,the values of SCr,neutrophil fraction decreased while eGFR and phosphorus increased in the treatment group 1(P>0.05);however,two groups showed no significant differences in the values of BUN,UA,serum calcium,and HGB(P>0.05).The treatment group 1 and treatment group 2 had similar values of SCr,BUN,UA,eGFR,serum calcium,serum phosphorus,HGB,neutrophil fraction after treatment(P<0.05).Before treatment,in the control group BUN,serum calcium and phosphorus compared with after treatment,the difference was statistically significant(P<0.05);before treatment,in the treatment group 1,SCr,BUN,eGFR,serum calcium and phosphorus,neutrophil fraction compared with after treatment,the difference was statistically significant(P<0.05);before treatment,in the treatment group 2,SCr,BUN,eGFR,serum calcium,neutrophil fraction compared with after treatment,the difference was statistically significant(P<0.05).No severe adverse reactions were found in all the patients.One case in the control group,1 in the treatment group 1,and 2 in treatment group 2 had perianal burning,but all recovered after stopping the treatment without special treatment.Conclusion  For non-dialysis patients with CKD 3-5 stage,high colonics combined with retention enema with preferred recipe of TCM is a safe and effective treatment,which can obviously improve the renal function and mild inflammatory conditions.Moreover,optimal frequency is 7 times.
    【Key words】  Renal insufficiency,chronic;Enema;Drugtherapy(TCD);Highcolonics;Treatment outcome
 
Protective Effect and Mechanism of Wuzi-Yanzong Prescription Against the Liver Injury Induced by Cyclophosphamide  LIU Zhen-cai,ZHAO Hai-xia,CHEN Qian,LIU Guang-yao,YUAN Ding,ZHANG Chang-cheng*
Medical College of China Three Gorges University,Yichang 443002,China
*Corresponding author:ZHANG Chang-cheng,Professor;E-mail:greatwall@ctgu.edu.cn
    【Abstract】  Objective  To study the protective effect and mechanism of Wuzi-Yanzong prescription(WP) against the liver injury induced by cyclophosphamide(CTX),so as to provide a reference for clinical treatment of the disease.Methods  From September 2015 to June 2016,40 8-week-old SPF grade male BALB/c mice were randomly divided into normal control group,model control group,WP low-dose group,and WP high-dose group,with 10 mice in each.Flavonoids solution was made by dissolving the flavonoids extracted from WP in 1% CMC-Na.WP low-dose and high-dose groups were respectively intragastrically administered with flavonoids solution 140 mg/kg,280 mg/kg,once a day for 30 days from the 1st day of intervention.For modeling,from the 3rd day of intervention,mice in the control group were given intraperitoneal injection of 0.9% sodium chloride solution,while those in the other groups received intraperitoneal injection of CTX 50 mg/kg,once three days for 10 times.Successful modeling was considered when the levels of serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) in the model control group were statistically different from those in the normal control group.Twelve hours after the last time of injection,all the mice were sacrificed by cervical dislocation after taking blood from the eyeball.The serum levels of ALT and AST were detected,the liver was obtained to calculate the liver index,to observe the tissue morphology changes after HE staining and to determine the levels of superoxide dismutase(SOD) and malondialdehyde(MDA) in liver tissues.Results  The serum ALT and AST levels in the model control mice were higher than those in the normal control group(P<0.01).The serum ALT and AST levels in the WP low-dose and high-dose groups were lower than those in the model control group(P<0.05).The liver index in the model control group was higher than that in the other 3 groups(P<0.01).In the model control group,the hepatic lobules and hepatic cords were disordered,and the hepatocytes were swollen and accompanied by necrosis and cytoplasm loose.However,in the WP low-dose and high-dose groups,liver lobules arranged neatly,liver cell swelling and cytoplasmic extent were significantly reduced compared with those in the model control group,liver cell morphology was uniform,and arranged in regular.The SOD level of liver tissue in the model control group was lower while the MDA level was higher than in the normal control group(P<0.01).WP low-dose group,WP high-dose group had higher SOD level but lower MDA level than the model control group(P<0.05).Conclusion  WP has good protective effects on liver injury caused by CTX and its mechanism is probably related to the scavenging of free radical and increasing of cell anti-oxidative function.
    【Key words】  Drug-induced liver injury;Cyclophosphamide;Molecular mechanisms of pharmacological action;Wuzi-yanzong prescription
 
Survey on Quality of Life of Elderly Patients with Chronic Obstructive Pulmonary Disease and Intervention Strategies  CHEN Xu1,YANG Xiao-yun2,LIU Shu-min1*,ZHANG Ting1,YONG Jia-hui2
1.School of Nursing,Ningxia Medical University,Yinchuan 750000,China
2.Department of Respiratory Medicine,Ningxia People ′s Hospital,Yinchuan 750001,China
*Corresponding author:LIU Shu-min,Professor;E-mail:746720948@qq.com
    【Abstract】  Objective  To survey the quality of life of elderly patients with chronic obstructive pulmonary disease(COPD),analyze its influencing factors,put forward targeted intervention measures to improve the quality of life of patients.Methods  According to the inclusion criteria,150 elderly patients with COPD treated in the outpatient of Ningxia People′s Hospital from January 2015 to December 2015 were selected.The patients were investigated with general information questionnaires and St Georges Respiratory Questionnaire(SGRQ),and their nutritional status and pulmonary function classification were measured.Influencing factors of SGRQ score for elderly patients with COPD were assessed by univariate and multivariate linear regression analysis.Results  A total of 147(98.0%) patients finished the investigation,whose SGRQ total score was(41.5±19.9)points.Univariate analysis indicated that family per capita monthly income,health insurance,smoking situation,occupational dust or smoke exposure history,disease duration,the number of hospitalization due to COPD in last one year,pharmacotherapy,pulmonary rehabilitation exercises,nutritional status and classification of pulmonary function affected SGRQ score(P<0.05).Multivariate linear regression analysis indicated that pulmonary rehabilitation exercise,nutritional status and classification of pulmonary function were the influence factors for SGRQ score(t=-4.599,-3.755,18.702,P<0.05).Conclusion  The quality of life of elderly patients with COPD was not high.The pulmonary rehabilitation exercise,nutritional status and pulmonary function classification were the factors affecting the quality of life of elderly patients with COPD.The patients with COPD should be strengthened with guidance of pulmonary rehabilitation exercises and nutrition to slow down the declination of lung function and improve quality of life of the patients.
    【Key words】  Pulmonary disease,chronic obstructive;Questionnaires;Quality of life
 
Analysis on the Two-week Prevalence Rate and Chronic Disease Prevalence Rate of the Residents and Their Influencing Factors in Severely Affected Disaster Areas and Slightly Affected Disaster Areas in Sichuan Province after Wenchuan Earthquake  XIA Xiao-hong1,KE Xiong1*,LIU Si-si2
1.School of Management,North Sichuan Medical College,Nanchong 637000,China 
2.Lezhi County of Traditional Chinese Medicine,Ziyang 641300,China
*Corresponding author:KE Xiong,Associate professor;E-mail:drkex@126.com
    【Abstract】  Objective  To explore the two-week prevalence rate and chronic disease prevalence rate of the residents and their influencing factors in severely affected disaster areas and the slightly affected disaster areas in Sichuan Province after Wenchuan earthquake in order to provide the theoretical basis for the government to formulate the health policy.Methods  Using the degree of damage as the hierarchical factor,600 respondents(age>45) from severely affected disaster areas(Wenchuan county,An county,Shifang county,Mao county) and 550 respondents(age>45) from slightly affected disaster areas(Shunqing district,Gaoping district,and Jialing district of Nanchong City,Guang′an district of Guang′an City and Anju district of Suining City) were selected.The primary self-designed questionnaire The Demand and Utilization of Health Service for Residents Questionnaire was adopted to collect data with adjuvant face-to-face interviews from October to December in 2016.The questionnaire was mainly composed of the general information of residents,the two-week prevalence rate,the chronic disease prevalence rate and self-rated health status.It also analyzed the factors influencing the two-week prevalence rate and the chronic disease prevalence rate in those areas.Results  In severely affected disaster areas,600 questionnaires were distributed and 532 questionnaires were collected.The recovery rate was 88.7%.There were 521 valid questionnaires and the effective recovery rate was 86.8%.A total of 550 questionnaires were distributed in slightly affected disaster areas and all of them were collected.The recovery rate was 100.0%,the valid questionnaires were 516 and the effective recovery rate was 93.8%.In severely affected disaster areas,the two-week prevalence rate was 41.8% and the chronic disease prevalence rate was 26.5%.In slightly affected disaster areas,the two-week prevalence rate was 27.3% and the chronic disease prevalence rate was 37.2%.The two-week prevalence rate of severely affected disaster

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