October 2017, Volume 20, No.29 Abstracts

 Interpretation of 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure  XU Ding-li*,BAI Yu-jia
Department of Cardiovascular,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China
*Corresponding author:XU Ding-li,Professor,Chief physician,Doctoral supervisor;
    【Abstract】  The ACC,AHA and Heart Failure Society of America(HFSA) updated the 2013 ACCF/AHA Guideline for the Management of Heart Failure in 2017.The focused update involved the revision of the sections on biomarkers,new therapies including ARNI and Ivabradine demonstrated for stage C heart failure(HF) with reduced ejection fraction(HFrEF) and so on.
    【Key words】  Heart failure;Case management;Guideline
Effects of Aerobic versus Resistance Exercise on Fasting Plasma Glucose and Insulin Resistance in Patients with Impaired Glucose Regulation  MA Xiao-jun1,DAI Xia1*,LU Li-rong2,LUO Zu-chun1,WEI Chun3
1.Department of Internal Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China
2.Department of Nursing,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530021,China
3.Department of Science Education,Guangxi Medical University Nursing College,Nanning 530021,China
*Corresponding author:DAI Xia,Chief superintendent nurse;
    【Abstract】  Objective  To study the effects of aerobic versus resistance exercise on fasting plasma glucose(FPG) and insulin resistance in patients with impaired glucose regulation(IGR) in order to provide an evidence for preventing and delaying the progression of diabetes mellitus.Methods  From June to August 2015,143 IGR patients who were managed for a long time by Diecai,Nanmen and Xiufeng Community Health Service Center in Guilin were selected and divided into the control group(n=47),aerobic group(n=48),and resistance group(n=48) based on the random number table.Patients in the control group,aerobic group and resistance group were respectively treated with one follow-up every 3 months without other intervention measures,50-min moderate intensity aerobic exercise(rhythmic exercise,fit aerobics and so on),once every other day,50-min moderate intensity resistance exercise(mainly training lumbar and abdominal muscles,leg and hip muscles,and upper limb muscles via using elastic rope to complete the assigned actions with 60%-70% of one repetition maximum ),once every other day,respectively.The FPG and fasting insulin(FINS) of the participants were measured before intervention,at the end of third,sixth and 12th months of intervention,respectively.The homeostatic model assessment of insulin resistance index(HOMA-IR) and insulin action index(IAI) were calculated.Results  Thirty-eight patients in the control group,39 in the aerobic group and 38 in the resistance group completed the intervention.Intervention duration and mode exerted significant interaction on the FPG,FINS,HOMA-IR and IAI values(P<0.05),and they had obvious main effect on FPG,FINS,HOMA-IR and IAI values(P<0.05).When the third month of intervention ended,FPG values in the aerobic and resistance groups were lower than in the control group(P<0.05);FPG and HOMA-IR values decreased but IAI increased in both the aerobic and resistance groups compared with those before intervention(P<0.05).At the end of the sixth month of intervention,compared with the control group,both aerobic and resistance groups had lower FPG and FINS and HOMA-IR values but higher IAI(P<0.05);the resistance group had lower FPG values than aerobic group(P<0.05);FPG,FINS and HOMA-IR values declined while IAI increased in both the aerobic and resistance groups compared with those before intervention(P<0.05).At the conclusion of the 12th month of intervention,both aerobic and resistance groups had lower FPG and FINS and HOMA-IR values but higher IAI than the control group did(P<0.05);FPG values dropped in both the aerobic and resistance groups(P<0.05);FINS and HOMA-IR values lowered but IAI rose in all groups compared with those before intervention(P<0.05).Conclusion  Both aerobic and resistance exercise produce similar effects on significantly improving the FPG and FINS levels and insulin resistance and sensitivity in patients with IGR.
    【Key words】  Prediabetic state;Aerobic exercise;Resistance training;Blood glucose;Insulin resistance
Incidence of Cardiac Vascular Disease and Its Risk Factors of Patients with Diabetic Kidney Disease  JIANG Qian1,ZHOU Rong1*,LIU Ying2,SHEN Jie1,WANG Ya-nan1,FENG Xue-fang1,XU Ya-hong1
1.Department of Nephrology,Yangpu Hospital,Tongji University,Shanghai 200090,China
2.Health Station of 802 Research Institute of Shanghai Space Agency,Shanghai 200090,China
*Corresponding author:ZHOU Rong,Chief physician,Main research directions:diagnosis and treatment of acute and chronic glomerulonephritis,acute and chronic renal insufficiency,diabetic nephropathy,heavy metal poisoning nephropathy;
    【Abstract】  Objective  To investigate the prevalence of cardiac vascular disease and its influencing factors of patients with diabetic kidney disease.Methods  A total of 256 patients with diabetic kidney disease who had not received renal replacement therapy in Yangpu Hospital,Tongji University from January 2014 to October 2015 were selected.Detection of patients with cardiovascular disease was collected.The patients were divided into group combined with cardiac vascular disease(n=159) and group combined without cardiovascular disease(n=97) according to whether they were combined with cardiac vascular disease or not.The general information and laboratory test results including gender,age,body mass,height,history of hypertension,smoking history,hemoglobin,albumin,fasting blood glucose,glycosylated hemoglobin(HbA1c),serum creatinine,serum uric acid,total cholesterol,triglyceride,low density lipoprotein cholesterin,high density lipoprotein cholesterol,lipoprotein(a),calcium,phosphorus,parathyroid hormone,C-reactive protein,brain natriuretic peptide,24-hour urinary protein quantitation,homocysteine,and serum β2-microglobulin levels of patients were collected.Multivariate Logistic regression analysis was used to analyze the influencing factors of diabetic kidney disease patients combined with cardiac vascular disease.Results  Among the 256 patients with diabetic kidney disease,159(62.11%) were detected with cardiac vascular disease,and the detection rates of coronary artery disease(CAD),left ventricular hypertrophy(LVH),congestive heart failure(CHF),cerebral vascular accident(CVA),and large atherosclerosis(LA) were 21.09%(54/256),8.20%(21/256),8.59%(22/256),23.44%(60/256),and 49.22%(126/256) respectively.The detection rates of cardiac vascular disease in patients with chronic kidney disease(CKD) from the first stage to the fifth were 48.94%(46/94),59.18%(29/49),69.70%(46/66),74.07%(20/27),and 80.00%(16/20) respectively.There was significant differences in the detection rate of cardiac vascular disease among patients in different stages of CKD(χ2=12.920,P=0.012).There were significant differences in the gender,age,body mass index(BMI),history of hypertension,rate of smoking,HbA1c,serum creatinine,serum uric acid,total cholesterol,low density lipoprotein cholesterin,lipoprotein(a),parathyroid hormone,homocysteine,and serum β2-microglobulin levels of patients between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age,serum uric acid,lipoprotein(a),homocysteine,and serum β2-microglobulin levels were independent influence factors of diabetic kidney disease patients combined with cardiac vascular disease(P<0.05).Conclusion  The prevalence of cardiac vascular disease is high among the patients with diabetic kidney disease.The age of patients,and the levels of serum uric acid,lipoprotein(a),homocysteine and serum β2-microglobulin have a significant impact on the incidence of cardiac vascular disease in patients with diabetic kidney disease.
    【Key words】  Diabetic nephropathies;Cardiovascular diseases;Root cause analysis
Effect of Sympathetic and Vagal Tone on Resting Heart Rate among Essential Hypertensive Patients  LU Jia-jia*,SONG Kuang-rong,ZHANG Shuo,DENG Yu-ying,ZHAO Liang-qiao,HUANG Han-qin,LENG Yong-qun,YE Jing,TU Wan-hua
Department of ECG Diagnosis,Wuhan No.1 Hospital,Wuhan 430030,China
*Corresponding author:LU Jia-jia,Attending physician;
    【Abstract】  Objective  To investigate the effects of sympathetic and vagal tone changes on resting heart rate(RHR) in patients with essential hypertension.Methods  404 cases of essential hypertension outpatients and hospitalized patients were selected as the subjects from Wuhan No.1 Hospital in 2013.Recorded the standard 12-lead ECG,calculated the RHR using the average RR interval.The patients were divided into RHR-L group(<60 times/min),RHR-M group(60-<75 times/min) and RHR-H group(≥75 times/min) according to RHR.Followed by 24 h dynamic electrocardiographic recording,the value of very low frequency band(VLF),low frequency band(LF),high frequency band(HF) and heart rate deceleration force(DC) were calculated using off-line application of dynamic ECG recording and analysis system.Results  The VLF,LF,HF,DC,LF/HF of each group were compared,and the differences were statistically significant(P<0.05).Among them,VLF,LF and HF in RHR-M group were lower than those in RHR-L group.VLF,LF,HF,and DC in RHR-H group were lower than those in RHR-L group and RHR-M group.LF/HF in RHR-H group was higher than RHR-L group and RHR-M group(P<0.05).The RHR was negatively correlated with VLF〔r=-0.436,95%CI(-0.501,-0.369)〕,LF〔r=-0.290,95%CI(-0.378,-0.205)〕,HF〔r=-0.394,95%CI(-0.468,-0.315)〕,DC〔r=-0.219,95%CI(-0.310,-0.123)〕(P<0.001),and it was positively correlated with LF/HF〔r=0.248,95%CI(0.158,0.332)〕(P<0.001).Multivariate linear regression analysis showed that VLF,HF and LF/HF were the influencing factors of RHR in patients with essential hypertensive(P<0.05).Conclusion  RHR in essential hypertension patients with RHR of 60-<75 times/min are mainly affected by vagal disturbances,while RHR in patients with RHR ≥75 times/min are mainly affected by sympathetic nervous system disorders.
    【Key words】  Hypertension;Heart rate;Sympathetic nervous system;Vagus nerve
Analysis on the Problem Behaviors and Influencing Factors in Children with Attention-deficit Hyperactivity Disorder  LI Yang,YANG Jin-wei,ZHOU Yu-qiu,CAO Jian-qin,YANG Jun,JIA Xiang-rui*
Harbin Medical University(Daqing),Daqing 163319,China
*Corresponding author:JIA Xiang-rui,Lecturer;
    【Abstract】  Objective  To study the problem behaviors and their influencing factors in children with attention deficit hyperactivity disorder(ADHD).Methods  From October 2013 to June 2014,a questionnaire survey was conducted to the children of Grade 1 to 4 from five public primary schools in a city of Heilongjiang Province by means of the convenient extraction method.The general situation questionnaire,Conners parents questionnaire(PSQ),children′s temperament questionnaire,Ruteer children′s behavior questionnaire (parental questionnaire),Chinese version of the children′s sleep habits questionnaire(CSHQ),and parental rearing scale were used to investigate.It was judged positive for ADHD screening according to the score of PSQ hyperactivity index ≥1.5 points.And ADHD was diagnosed by ICD-10 as experimental group.132 cases were matched as control group according to the principle of homogeneity.Multivariate Logistic regression was used to analyze the influencing factors of ADHD.Results  A total of 6 280 questionnaires were distributed and 5 742 valid questionnaires were collected.The recovery efficiency was 91.4%.352 cases were positive for ADHD screening,and the screening positive rate was 6.1%.132 cases were diagnosed as ADHD and the prevalence rate was 2.3%.There were no statistically significant differences in the avoidance and emotional nature scores between the two groups(P>0.05);the scores of activity,regularity,adaptability,reaction intensity,persistence,attention dispersion and reaction threshold in the temperament questionnaire of the experimental group were higher than those in the control group(P<0.05).The score of Ruteer children′s behavior questionnaire in the control group was lower than that in the experimental group(t=47.98,P<0.001).There were no statistically significant differences in sleep anxiety,night wakening,abnormal sleep,sleep apnea,daytime sleepiness and total scores between the two groups CSHQ(P>0.05);the sleep habits,sleep latency and sleep duration scores of CSHQ in the experimental group were lower than those in the control group(P<0.05).The father′s severely punishment,refused to deny,over-protection and mother′s over-interference,refused to deny,severely punishment scores in the control group were lower than those in the experimental group(P<0.05).Mother ′s emotional warmth score was higher than that of the experimental group(P<0.05).Multivariate Logistic regression analysis showed that the birth weight,activity,avoidance,intensity of reaction,attention dispersion,severe father′s punishment,mother′s emotional warmth,and severe mother′s punishment were influencing factors of ADHD(P<0.05).Conclusion  Children with ADHD have more problem behaviors,and there are risk factors in terms of family upbringing.
    【Key words】  Attention deficit disorder with hyperactivity;Child behavior;Root cause analysis
Sex-specific Difference in the Effects of Dexamethasone versus Tropisetron for the Prevention of PONV in Patients with Laparoscopic Surgery  YANG Ji1,LI Yue-xiang1*,YU Yong-hao2
1.Department of Anesthesiology,Tianjin Xiqing Hospital,Tianjin 300380,China
2.Department of Anesthesiology,Tianjin Medical University General Hospital,Tianjin 300052,China
*Corresponding author:LI Yue-xiang,Chief physician;
    【Abstract】  Objective  To investigate the sex-specific difference in the effects of dexamethasone and tropisetron for the prevention of postoperative nausea and vomiting (PONV) in patients with laparoscopic surgery.Methods  The initially enrolled participants were 382 consecutive patients who underwent the laparoscopic surgery (laparoscopic cholecystectomy or laparoscopic appendectomy or laparoscopic hysterectomy and annexectomy) in Tianjin Medical University General Hospital from December 2014 to December 2015.After excluding 22 cases who did not meet the inclusion criteria during and after the surgery,the rest 360 cases were equally divided into male dexamethasone (MD) group,male tropisetron (MT) group,male control (MC) group,female dexamethasone (FD) group,female tropisetron(FT) group,female control (FC) group.Immediately before anesthetic induction,MD and FD groups received intravenous drip of dexamethasone 0.15 mg/kg,MT and FT groups received intravenous drip of tropisetron 5 mg,and MC and FC groups received intravenous drip of 0.9% sodium chloride solution 5 ml.The incidence and degree of PONV,prevalence of treatment with antiemetic drugs,the first-occurrence time of PONV from the extubation to within 24 h after the surgery were recorded in all the groups.Results  Within 24 h after the surgery,MC group had more severe PONV and higher overall incidence of PONV and higher prevalence of treatment with antiemetic drugs than both MD and MT groups(P<0.01);FC group had more severe PONV and higher overall incidence of PONV and higher prevalence of treatment with antiemetic drugs than FT group(P<0.01);the degree and overall incidence of PONV and prevalence of treatment with antiemetic drugs did not differ significantly between FD and FC groups(P>0.01);PONV occurred earlier in MC group than in MD and MT groups(P<0.05),and it occurred earlier in FC group than in FT group(P<0.05),but the first-occurrence time of PONV was similar in FD and FC groups(P>0.05).Conclusion  The incidence of PONV can be reduced and the first-occurrence time of PONV can be delayed by intravenous drip of dexamethasone before anesthetic induction in only males with laparoscopic surgery,whereas similar effects like those described above can be achieved by intravenous drip of tropisetron before anesthetic induction in both males and females with laparoscopic surgery.
    【Key words】  Postoperative nausea and vomiting;Gender;Dexamethasone;Tropisetron;Laparoscopes
Clinical Efficacy of Postoperative Chemotherapy of SOX versus XELOX in Treating Colorectal Cancer  ZUO Fu-yi*,YU Bo,NIE Yu-hui
General Surgery Center of PLA,General Hospital of PLA,Beijing 100700,China
*Corresponding author:ZUO Fu-yi,Associate chief physician;
    【Abstract】  Objective  To compare the clinical efficacy and side effects of postoperative chemotherapy of S-1 combined with oxaliplatin(SOX) with those of capecitabine combined with oxaliplatin(XELOX) in the treatment of colorectal cancer.Methods  A total of 92 patients with colorectal cancer treated in the General Hospital of PLA from 2008 to 2013 were selected and divided into the treatment group(50 cases) receiving postoperative 8 cycles of SOX chemotherapy and control group(42 cases) receiving postoperative 8 cycles of XELOX chemotherapy by drawing lot.The follow-up was carried out from starting chemotherapy to December 31st,2016 with death as the end event by regular telephone or correspondence.The occurrence and severity of side effects(myelosuppression,digestive tract reactions,toxicity in heart,liver and kidney,peripheral neuritis,hyperpigmentation) during chemotherapy were recorded.Results  During the follow-up period,the recurrence or metastasis rate in the treatment group was similar to that in the control group〔30.0%(15/50) vs. 31.0%(13/42)〕(χ2=2.513,P=0.816).The median survival time in the treatment group and the control group was 24.2 and 25.6 months respectively,and there was no significant difference between the two groups in the survival curve(χ2=1.005,P=0.601).There were no significant differences in the incidence of digestive tract reactions,toxicity in heart,liver and kidney,peripheral neuritis and pigmentation between the two groups(P>0.05).No statistically significant differences in the severity were found between the groups in the severity of bone marrow suppression,digestive tract reactions,toxicity in heart,liver and kidney,peripheral neuritis,and pigmentation(P>0.05).Conclusion  For colorectal cancer patients,SOX chemotherapy can achieve similar effects as the XELOX chemotherapy does,without increasing or aggravating the incidence and severity of toxic and side effects,so it can be used as an alternative first-line chemotherapy for colorectal cancer.
    【Key words】  Colorectal neoplasms;S-1;Capecitabine;Antineoplastic combined chemotherapy protocols;Drug toxicity
Padua Prediction Score Combined with D-dimer Testing for the Identification of Venous Thromboembolism in Medical Inpatients with Type 2 Diabetes Mellitus  DUN Xiao-yi1,LIU Zhi-ying2,WU Qin-fen1*
1.The 474th Hospital of Chinese People′s Liberation Army,Urumqi 830011,China
2.Shihezi University School of Medicine,Shihezi 832000,China
*Corresponding author:WU Qin-fen,Chief physician,Master supervisor;
    【Abstract】  Objective  To investigate the value of Padua prediction score combined with D-dimer testing in the identification of venous thromboembolism(VTE) in medical inpatients with type 2 diabetes mellitus(T2DM).Methods  We did a review of the data of 305 T2DM patients who were suspected with VTE 〔176(VTE group) were diagnosed confirmedly with VTE later while 129(non-VTE group) were not〕 and admitted to Department of Endocrinology,the 474th Hospital of Chinese People′s Liberation Army from January 2013 to March 2016.The receiver operating characteristic(ROC) curve analysis was used to evaluate the probability of T2DM patients with VTE assessed by the Padua prediction score,D-dimer testing and the Padua prediction score combined with D-dimer testing.Results  Compared with the non-VTE group,VTE group were older,and they had higher glycosylated hemoglobin levels,Padua prediction scores and plasma D-dimer levels,higher incidences of cardiovascular and cerebrovascular diseases,acute infection,chronic lung disease,malignant tumor,and higher proportion of patients with VTE history,but lower triacylglycerol levels(P<0.05).For the identification of VTE in medical inpatients with T2DM,the optimal cut-off point for Padua prediction score was 4,and it was 0.5 mg/L for D-dimer testing;the sensitivity,specificity,the Youden′s index and area under the ROC curve(AUC) for Padua prediction score for assessing the VTE risk respectively were 53.41%, 89.15%, 0.426,and 0.713〔95%CI(0.655,0.771)〕 when the cut-off point ≥4;and they were 84.12%, 51.94%, 0.361,0.683〔95%CI(0.618,0.743)〕,respectively for D-dimer testing when the cut-off point ≥0.5 mg/L;and they were 93.75%,51.94%,0.457,0.801〔95%CI(0.748,0.852)〕 respectively,for Padua prediction score ≥4 combined with D-dimer ≥0.5 mg/L testing.Padua prediction score combined with D-dimer testing had greater AUC than Padua prediction score did(Z=5.768,P<0.001) or than D-dimer testing did(Z=5.624,P<0.001),but the AUC did not differ significantly between Padua prediction score and D-dimer testing(Z=0.932,P>0.05).Conclusion  The Padua prediction score combined with D-dimer testing is a simple but effective method for the risk assessment of VTE in medical inpatients with T2DM,which is conducive to the early identification of high-risk T2DM population clinically.
    【Key words】  Diabetes mellitus;Venous thromboembolism;Padua prediction score;D-dimer
Synchronized Intermittent Positive Pressure Ventilation versus Synchronized Intermittent Mandatory Ventilation on Cardiac Function of Premature Infants with Hyaline Membrane Disease  DING Lu,YAN Xu-dong*,HUANG Jin-jie,CHEN Li,WU Ben-qing 
Department of Neonatology,Shenzhen People′s Hospital,Shenzhen 518020,China
*Corresponding author:YAN Xu-dong,Attending physician,Main research directions:neonatal respiratory disorders;
    【Abstract】  Objective  To compare the effect of synchronized intermittent positive pressure ventilation(SIPPV) with that of synchronized intermittent mandatory ventilation(SIMV) at the same level of parameters on the cardiac function in premature infants with hyaline membrane disease(HMD).Methods  One hundred premature infants with HMD admitted in Department of Neonatology,Shenzhen People′s Hospital from March 2013 to March 2015 were randomized into SIPPV group(50 cases) and SIMV group(50 cases).Both groups were treated with invasive mechanical ventilation,with the Maquet SERVO-i respirator produced in Sweden,appropriate tracheal catheter and the same level of parameters,but different ventilation mode,SIPPV group adopted SIPPV mode,SIMV group adopted SIMV mode.Other 50 healthy premature infants with matched sex,gestational age,mode of delivery and birth weight were selected as the control group.The mean airway pressure(MAP),tidal volume(VT),respiratory rate(RR),blood pressure,pH value,carbon dioxide(PCO2),oxygen partial pressure(PO2) of the SIPPV and SIMV groups were recorded.In all groups,color Doppler echocardiography was used to determine the indexes for evaluating left ventricular pump blood function,including left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),stroke volume(SV),heart rate(HR),and cardiac output(CO),and to measure the blood flow velocity at the valve orifices,covering peak flow rate at the aortic valve orifice(AV),and peak flow rate at the pulmonary valve orifice(PV),mitral ratio of early to late diastolic filling velocities(M-E/A) and tricuspid ratio of early to late ventricular filling velocities(T-E/A).Results  MAP and VT in the SIMV group were lower than those in the SIPPV group(P<0.05).Blood pressure,pH value,PCO2,PO2 between SIPPV group and SIMV group had no significant difference(P>0.05).RR in the SIMV group was lower than that in the SIPPV group(P<0.05).LVEF,LVFS,LVEDV,LVESV,SV,CO,AV,M-E/A among the three groups did not differ significantly(P>0.05).Notable differences in HR,PV,T-E/A were found among the three groups(P<0.05).Compared with the control group,the SIPPV group had higher HR but lower PV and T-E/A(P<0.05).SIMV group had lower HR but higher PV and T-E/A than the SIPPV group did(P<0.05).And it had lower PV and T-E/A than the control group did(P<0.05).MAP and VT were negatively correlated with PV and T-E/A in both the SIPPV group and SIMV group(P<0.05).Conclusion  Right ventricular diastolic function and PV decreased in both the SIPPV and SIMV groups at the same level of parameters,but they decreased more in the former group;while left ventricular pump function and diastolic function in both groups had no obvious changes.
    【Key words】  Hyaline membrane disease;Infant,premature;Intermittent positive-pressure ventilation;Ventricular function
Expression of IL-5 and TNFRSF13B in Deep Infiltrating Endometriotic Milieu and Its Clinical Significance  YANG Mei1,2,JIANG Chun-fan3,HA Chun-fang4*
1.Department of Obstetrics and Gynecology,Xiangyang Central Hospital/Affiliated Hospital of Hubei University of Arts and Science,Xiangyang 441021,China
2.Ningxia Medical University,Yinchuan 750001,China
3.Department of Pathology,Xiangyang Central Hospital/Affiliated Hospital of Hubei University of Arts and Science,Xiangyang 441021,China
4.Department of Gynecology,General Hospital of Ningxia Medical University;Key Laboratory of Fertility Preservation,Ningxia Medical University,Yinchuan 750001,China
*Corresponding author:HA Chun-fang,Chief physician;
    【Abstract】  Objective  To investigate the difference in the expressions of IL-5 and TNFRSF13B in deep infiltrating endometriosis(DIE) versus those in the normal endometrium.Methods  The enrolled participants were 30 cases who received inpatient treatment in Department of Gynecology,Xiangyang Central Hospital from December 2015 to December 2016,including 15 cases with surgery due to DIE(experimental group),and 15 cases with laparoscopic or open surgery due to fallopian tube recanalization(control group).cDNA microarray,RT-PCR,ELISA,immunohistochemistry and Western blotting were used to detect the expressions of IL-5 and TNFRSF13B in both the DIE and the normal endometrium.Results  Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis of the cDNA microarray results was performed to screen the genes which expressed in DIE differently from in the normal endometrium,and the results demonstrated that intestinal immune network for IgA production(hsa04672) associated with immune response expressed more highly in DIE,and IL-5 and TNFRSF13B genes in this pathway were chosen for in-depth study.The mRNA expression levels of IL-5 and TNFRSF13B in endometrium epithelium cells(EECs) measured by RT-PCR were much higher in the experimental group than in the control group(P<0.05).The protein expression levels of IL-5 in both the peritoneal fluid and epithelial cells supernatant detected by ELISA were higher in the experimental group than in the control group(P<0.05).The protein expression levels of TNFRSF13B in EECs measured by immunohistochemistry was higher in the experimental group than in the control group(P<0.05).The experimental group had higher protein expression levels of TNFRSF13B in EECs measured by Western blotting than the control group did(P<0.05).Conclusion  Increased expressions of IL-5 and TNFRSF13B in DIE may be associated with the abnormal immune system of DIE patients.The pro-inflammatory and tolerant state of the immune system coexisted in the endometriotic milieu.It can promote the implantation and growth of EECs in abdominal cavity.
    【Key words】  Endometriosis;Interleukin-5;Transmembrane activator and CAML interactor protein
Relationship between Blood and Expiration Alcohol Concentration and Establishment of Mathematical Model  ZHANG Yan1,2,ZHAO Zhi-dong1,SHI Xiao-ling1,2,ZHANG Xian-qiang1,2*
1.Guizhou Police Officer Vocational College,Guiyang 550005,China
2.Guizhou Province Road Traffic Accident Engineering Research Center,Guiyang 550005,China
*Corresponding author:ZHANG Xian-qiang,Postdoctoral scholar,Professor;
    【Abstract】  Objective  To study the relationship between concentration of alcohol in the exhaled breath at end-exhalation (BrAC) determined by breathalyzer and blood alcohol concentration (BAC) determined by HS-GC and to establish a linear model in order to achieve the prediction of BAC by BrAC.Methods  From February to December in 2016,53 healthy drivers who were suspected of drunk driving in Guiyang were selected.The BrAC and BAC were determined.A scatter plot was drawn and a linear model was established with BrAC as the independent variable X and BAC as the dependent variable Y.Results  The curve equation was obtained by fitting the data of BrAC and BAC:Y=1.298 2X-5.017 5,R2=0.95.A simple random sampling method was used to extract 11 samples.The linear model was used to predict the samples,and the results were compared with the samples′ real values.The predicted values were in great deviation from the true ones.Removed the constant,modified the model,and got the curve equation:Y=1.229 4X,R2=0.99.The predicted values of 2,3 and 8 samples differed greatly from the true values,and the sum of squared errors of prediction(SSE)=621.70.Took the logarithm of BAC and got the linear equation:lnY=0.016 6X+3.218 5,R2=0.93.There was little difference between the predicted and the true values,SSE=239.06.Conclusion  The model lnY=0.016 6X+3.218 5 can be used to achieve the prediction of BAC by BrAC.
    【Key words】  BrAC;BAC;Correlation;Mathematical model
Efficacy and Safety of Secukinumab for Rheumatic Arthritis:a Meta-analysis  YU Bin1,FENG Bi-min2,ZHONG Xiao-yan2,ZHOU Hong3,WU Zhen4,HUANG Yi-lan2*
1.School of Pharmacy,Southwest Medical University,Luzhou 646000,China
2.Department of Pharmacy,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China
3.Clinical Medicine College,Southwest Medical University,Luzhou 646000,China
4.Chengdu Foreign Languages School,Chengdu 610054,China
*Corresponding author:HUANG Yi-lan,Professor,Master supervisor;
    【Abstract】  Objective  To systematically evaluate the effect and safety of Secukinumab for the treatment of rheumatic arthritis(RA).Methods  We searched and selected and assessed the articles about randomized controlled trials(RCTs) of evaluating the efficacy and safety of Secukinumab for patients with RA published up to August 31,2016 from PubMed,Medline,EMBase,Web of Science,the Food and Drug Administration(FDA) Website,Clinical Trials Website,Cochrane Library,CNKI,Wanfang Data and VIP.Meta-analysis of data was performed by the RevMan 5.2 software and Stata 12.0 software.Results  Six RCTs involving 903 patients were included.Compared with placebo,Secukinumab was more effective in achieving ACR20〔RR=1.56,95%CI(1.31,1.87),P<0.000 01〕,ACR50〔RR=2.11,95%CI(1.51,2.93),P<0.000 01〕,ACR70〔RR=2.75,95%CI(1.39,5.43),P=0.004〕.Secukinumab significantly reduced DAS28-CRP〔WMD=-0.48,95%CI(-0.67,-0.29),P<0.000 01〕,DAS28-ESR〔WMD=-0.43,95%CI(-0.69,-0.16),P=0.001〕,HAQ-DI〔WMD=-0.16,95%CI(-0.24,-0.08),P=0.000 1〕.In aspect of safety,the risks of severe adverse events〔RR=1.97,95%CI(1.10,3.52),P=0.02〕 and gastrointestinal disorder〔RR=1.81,95%CI(1.15,2.86),P=0.01〕 caused by Secukinumab were higher than those by placebo.Egger testing found that,there was no publication bias in the included articles about RCTs of evaluating the efficacy and safety of Secukinumab for RA patients(P=0.205).Conclusion  Secukinumab is safe and effective for the treatment of RA.However,due to the small sample size of studies included,it is necessary to develop higher quality RCTs data with larger sample size to evaluate its effectiveness and safety.
    【Key words】  Arthritis,rheumatoid;Secukinumab;Meta-analysis
Efficacy and Safety of Sodium Valproate Combined with Lamotrigine in Epilepsy:a Meta Analysis  HU Xue-fei1,ZHANG Yong-jun2*,WEI Li-hong2,ZHANG Zhi-hui2
1.College of Pharmacy,Shihezi University,Shihezi 832002,China
2.The First Affiliated Hospital of the Medical College,Shihezi University,Shihezi 832002,China
*Corresponding author:ZHANG Yong-jun,Chief pharmacist;
    【Abstract】  Objective  To systematically evaluate the overall efficacy and safety of sodium valproate(VPA) combined with lamotrigine(LTG) in epilepsy,so as to provide evidence-based reference for the combined medication for the disease.Methods  We did a literature review of PubMed,Cochrane Library,EMBase,Wanfang Data,VIP,CNKI and CBM to identify studies published as of December 2015,in which randomized controlled trials(RTCs) of evaluating the efficacy and safety of VPA combined with LTG for patients with epilepsy were reported.We extracted the data of the articles′ first author,time of publication,sample size,patients′ age,medication,course of treatment,type of epilepsy,observation indexes and so on.The modified Jadad scale was used to assess the methodological quality of the included articles.Results  A total of 16 articles were included,including 15 in Chinese and one in English,involving 1 687 patients.The methodological quality of the included articles was unsatisfactory due to unknown risks existing in the allocation concealment,blind method,and selective reporting.Results of meta-analysis showed that the efficacy of VPA combined with LTG was significantly better than that of VPA〔OR=5.76,95%CI(3.78,8.78),P<0.001〕 or that of LTG〔OR=2.80,95%CI(1.83,4.28),P<0.001〕,while the adverse reactions in nervous system〔RD= -0.04,95%CI(-0.06,-0.02),P=0.002〕,digestive system〔RD=-0.05,95%CI(-0.08,-0.02)〕,blood system〔RD= -0.03,95%CI(-0.05,-0.01),P=0.040〕,and skin attachment system〔RD= -0.04,95%CI(-0.06,-0.01),P=0.008〕 were less compared with those of VPA or LTG.Conclusion  The effect of VPA combined with LTG is better than VPA or LTG along in epilepsy,and it has good tolerance.Due to limitations related to methodology of included studies,large-scale and high-quality RCTs are required for further validation of the conclusion.
    【Key words】  Epilepsy;Valproic acid;Lamotrigine;Drug synergism;Effectiveness;Drug toxicity;Meta-analysis
General Well-being and Associated Factors in Elderly People Receiving Integrated Medical and Nursing Care from Different Types of Institutions  HE Yan1,QIN Ri-ying1,QUAN Xu-hong2*
1.Department of Social Medicine and Healthcare Management,College of Public Health,Zhengzhou University,Zhengzhou 450001,China
2.Henan Provincial Rehabilitation Hospital for Old Cadres,Zhengzhou 450008,China
*Corresponding author:QUAN Xu-hong,Associate chief physician;
    【Abstract】  Objective  To investigate the general well-being and associated factors in elderly people receiving integrated medical and nursing care from different types of institutions,so as to provide a scientific basis for solving the problem of aging in China.Methods  From February to May 2016,using typical sampling and stratified cluster sampling,we selected all the elderly persons aged 60 or over receiving integrated medical and nursing care from Henan Provincial Rehabilitation Hospital for Old Cadres and Zhengzhou Central Hospital(hospital group),Henan Provincial Apartment for the Aged(beadhouse group) and the Ninth People′s Hospital of Zhengzhou and its cooperating elderly care institutions(hospital + beadhouse group).The demographic data,ADL and general well-being of them were investigated by a questionnaire survey.Results  Sex,age,educational attainment,marital status and prevalence of chronic diseases were not associated with the scores of general well-being(P>0.05).The scores of general well-being significantly varied by monthly income per capita,type of institution delivering integrated medical and nursing care and scores of ADL(P<0.05).The scores of general well-being and life satisfaction dimension of the elderly in the hospital group were higher than those in the other two groups(P<0.05).The scores of general well-being of the elderly were positively related to the monthly income per capita and the scores of ADL in all the groups(P<0.05).The scores of general well-being of the elderly in the hospital group were positively related to the marital status(P<0.05),specifically speaking,those who had a spouse showed a higher sense of happiness.The scores of general well-being of the elderly in hospital + beadhouse group were negatively correlated with the prevalence of chronic diseases(P<0.05),that was,those who had no chronic diseases demonstrated higher subjective well-being.The results of multiple linear regression analysis showed that the type of institution delivering integrated medical and nursing care,marital status,monthly income per capita,and scores of ADL were significantly associated with the general well-being of the elderly(P<0.05).Conclusion  In order to improve the wellbeing and quality of life of the elderly,national and social efforts should be made to increase their healthcare level,ADL and economic status,reduce their physical health problems and relieving the anxiety caused by medical and nursing care cost.
    【Key words】  Happiness;Combination of medical and health care;Aged;Data collection;Root cause analysis
Prevalence and Associated Factors of Cardiovascular Disease in Community-dwelling Residents Aged 35 Years or Over in Shiyan City  XU Xiang-lei1,LI Hong-yu2*,LIU Bing3*,KE Li1,LIN Zi1,DU Hai-xia4
1.Jinzhou Medical University Graduate School,Jinzhou 121001,China
2.Jinzhou Medical University Medical Research Institute,Jinzhou 121001,China
3.Health Management and Health Development Research Center,Hubei University of Medicine,Shiyan 442000,China
4.Department of Otorhinolaryngology,Taihe Hospital,Shiyan 442000,China
*Corresponding authors:LI Hong-yu,Professor,Master supervisor;
LIU Bing,Professor,Master supervisor;
    【Abstract】  Objective  To study the prevalence and associated factors of cardiovascular disease(CVD) in community-dwelling residents aged 35 years or over in Shiyan city,Hubei province,so as to provide an evidence for the prevention of CVD.Methods  This study was conducted between August and October 2013.The initially enrolled participants were 1 388 community-dwelling residents selected from Shiyan by stratified multistage random sampling.The survey achieved a response rate of 99.35%(1 379/1 388).A questionnaire was used to survey them,which covered the demographic data,lifestyle,daily habits(smoking prevalence,alcohol prevalence,diet habit and physical activity prevalence),physical examination(height,weight,blood pressure,blood fat and so on),prevalence of CVD(hypertension,hyperlipidemia,chronic heart failure,coronary heart disease and other types of heart disease ).Unconditional univariate and multivariate Logistic regression analyses were performed to investigate the associated factors for CVD.Results  Of the 1 379 final participants,the prevalence of CVD,hypertension,hyperlipidemia,chronic heart failure,coronary heart disease and other types of heart disease was 46.56%(642/1 379),35.53%(490/1 379),19.80%(273/1 379),1.38%(19/1 379),1.23%(17/1 379),and 2.61%(19/1 379),respectively.No sex-specific differences were found in the prevalence of hyperlipidemia,coronary heart disease and other types of heart disease (P>0.05).Males had higher prevalence of hypertension but lower prevalence of chronic heart failure than females (P<0.05).Multivariate Logistic regression analysis showed that age,alcohol consumption and obesity were significantly associated with the prevalence of CVD (P<0.05).Conclusion  The prevalence of CVD,especially the prevalence of hypertension,is high in community-dwelling residents in Shiyan,which may be related to the unhealthy lifestyle of them.Therefore,in order to control the prevalence of CVD,the health education related to CVD and the prevention and treatment of CVD should be done well by the local community institutions.
    【Key words】  Cardiovascular diseases;Prevalence;Root cause analysis
Quantitative Analysis of Breastfeeding & Maternal and Infant Health Care Conditions in Different Fetal Times of Multiparas under the Two-child Policy  LI Cong-rui1,DU Ya-ping2*
1.School of Medicine,Zhejiang University,Hangzhou 310058,China
2.Institute of Social Medicine and General Practice,School of Medicine,Zhejiang University,Hangzhou 310058,China
*Corresponding author:DU Ya-ping,Associate professor;
    【Abstract】  Objective  To analyze the different conditions of breastfeeding and implementations of maternal and infant health care services between the first and second fetal time of multiparas,in order to explore the methods to promote breastfeeding & maternal and infant health care conditions under the two-child policy.Methods  From January to March 2017,using the method of multistage stratified sampling,11 cities of Zhejiang Province was divided into 3 layers by economic levels ranking from high to low.This study randomly selected one city every layer,2 districts in each selected city,and one community health service center in each selected district.In all selected community health service centers,healthy mothers who had registered in community health service centers with no organic diseases and had a second baby aging from 6 months to 3 years old without birth defects were selected.The self-administered questionnaire was used and it contained basis information of respondents,main family members who took care of babies and pregnancy assessment conditions.This study compared and analyzed the different feeding patterns within 6 months of the first and second fetal times,different exclusive breastfeeding duration,different weaning reasons,whether having experienced breastfeeding difficulties and the source of the most effective help,different participation rates of pregnancy schools and postpartum visit situations between the first and second fetal times.Results  There were 41 multiparas in the economic development classⅠ,73 multiparas in the economic development class Ⅱand 54 in the economic development class Ⅲ.There were significant differences of pregnancy assessment rates before the second pregnancy among different gestational ages(χ2=7.816,P<0.01).The consistency in feeding patterns of different fetal times was poor(Kappa=0.292,P<0.01),while there were statistically significant differences of feeding patterns in two fetal times(W=24.997,P=0.035).Exclusive breastfeeding duration and the whole breastfeeding duration of the second fetal time were longer than the first fetal time(P<0.05).The consistency in breastfeeding difficulties of different fetal times was general(Kappa=0.499,P<0.01) with statistical differences(χ2=4.45,P=0.034).′Experienced relatives or friends′ and ′searching by myself′ were the two most effective ways for help when meeting breastfeeding difficulties.The participation rates of pregnancy schools were about 50.0% in two fetal times with general consistency(Kappa=0.502,P<0.01) and no significant difference was found(W=1.097,P=0.778).There were 81(48.2%) multiparas required the educations and instructions about breastfeeding skills after the second delivery.The consistency in postpartum visit situations was general in two fetal times(Kappa=0.431,P<0.01) with statistically significant differences(W=18.964,P<0.01).Conclusion  The exclusive breastfeeding rate is raised in the second fetal time and the whole breastfeeding duration of the second fetal time is longer than the first fetal time.The participation rates of pregnancy schools in two fetal times are lower than 50.0%.There are gaps of times and contents of postpartum visit between the implementation and national requirements.General practitioners could offer relevant guidance to the elderly residents who take care of babies within general practitioners contract system in order to promote the breastfeeding situation.
    【Key words】  Two-child policy;Multiparas;Fetal times;Breastfeeding;Maternal and infant health care
Reliability and Validity of the Chinese Version of Community′s Self-efficacy Scale in Community-dwelling Older People  JIN Jia-yao,ZHANG Hui-jun*
School of Nursing,Jinzhou Medical University,Jinzhou 121000,China
*Corresponding author:ZHANG Hui-jun,Professor;
    【Abstract】  Objective  To translate the Community′s Self-efficacy Scale(CSES) into Chinese and assess its reliability and validity in community-dwelling older people,in order to offer a reference for the prevention of social isolation in this population.Methods  From January to April 2017,a random sample of 1 023 community-dwelling older people aged 60 or above were selected from 6 cities(Shenyang,Jinzhou,Anshan,Liaoyang,Panjin,Dalian) in Liaoning province,China.All the participants were administered the Chinese version of CSES,Chinese version of Lubben Social Network Scale-6(LSNS-6),and General Self-efficacy Scale(GSES) for assessing the reliability and validity of the Chinese version of CSES.Results  One thousand and twenty-three returned the questionnaires,982 of them responded the survey effectively,with a response rate of 96.0%.Its criterion-related validity coefficients for LSNS-6 and GSES were 0.79(P<0.001) and 0.83(P<0.001),respectively.The CVI of each item ranged from 0.750 to 1.000,averaged 0.910.Two domains were extracted by principal component analysis,which contributed 67.67% to the total variance.The results of confirmatory factor analysis were RMSEA=0.041,GFI=0.985,AGFI=0.972,CFI=0.990.The average item-total correlation coefficient was 0.71.Cronbach′s alpha for the entire CSES,community network and neighborhood watch were 0.86,0.84,0.83 respectively.The test-retest correlation coefficient was 0.90.Conclusion  The Chinese version of CSES is proved to be a reliable and valid tool for the assessment of self-efficacy in community-dwelling older people to provide support for preventing social isolation among such a population.
    【Key words】  Self-efficacy;Social isolation;Aged;Reliability;Validity
Disease Cognition and Self Management of Diabetics in Community Based on Structural Equation Model  ZHENG Sen-shuang1,CHENG Juan1,WANG Yuan1,DONG Yan-min2,LI Yuan-yuan3,LU Wen-li1*
1.Department of Epidemiology and Health Statistics,School of Public Health,Tianjin Medical University,Tianjin 300070,China
2.Community Health Association of Tianjin,Tianjin 300020,China
3.Tianjin Medical College,Tianjin 300222,China
*Corresponding author:LU Wen-li,Doctor,Professor,Research direction:the application of statistical methods in medical research,data mining and health decision making;
    【Abstract】  Objective  To explore the relationship among cognitive level,self-management behavior and self-health cognition of diabetics in community,and to provide support for the improvement of health management of diabetes.Methods  Using stratified cluster sampling,a total of 1 310 diabetics from 16 community health service centers or hospitals in Tianjin were selected from July to December in 2014 to investigate their demographic data,self-management situation of diabetes(healthy diet lifestyle,physical exercise,self-monitoring frequency of blood glucose,medication),medication and treatment satisfaction score,diabetes knowledge score,VAS score and symptom score.The structural equation model was used to analyze the relationship among diabetics′ financial capacity,cognitive level of diabetes,daily self-management behavior and self-evaluation of health status.Results  Excluding diabetics with incomplete investigation information,a total of 1 038 diabetics were included in this study.The results of structural equation model showed that there was a positive relationship between education level(β=0.067,P=0.038),household per capita monthly income(β=0.083,P=0.012)and diabetes knowledge score.A positive relationship was found between diabetes knowledge score and healthy diet lifestyle(β=0.079,P=0.011) as well as self-monitoring frequency of blood glucose(β=0.098,P=0.002).A positive relationship was found between healthy diet lifestyle and medication and treatment satisfaction score(β=0.187,P<0.001) as well as VAS score(β=0.065,P=0.038),while a negative relationship was found between healthy diet lifestyle and symptom scores(β=-0.099,P=0.001).Self-monitoring frequency of blood glucose was significantly negatively related to medication and treatment satisfaction score(β=-0.144,P<0.001) and VAS score(β=-0.067,P=0.032),but there was a positive relationship between self-monitoring frequency of blood glucose and symptom score(β=0.143,P<0.001).A positive relationship was found between household per capita monthly income and education level(β=0.370,P<0.001).Symptom score was significantly negatively related to VAS score(β=-0.270,P<0.001).A positive relationship was found between medication and treatment satisfaction score and VAS score(β=0.187,P<0.001),while a negative relationship was found between medication and treatment satisfaction score and symptom scores(β=-0.207,P<0.001).The result of model test of fit goodness was acceptable〔χ2=206.419,df=38,P<0.001;GFI=0.971,AGFI=0.921;RMSEA=0.065,90%CI(0.051,0.074)〕.Conclusion  The higher level of cognitive level of diabetes,the higher attention diabetics pay to healthy diet lifestyle and self-monitoring of blood glucose in community.Paying attention to daily self-management behavior is helpful to improve patients′ self-health awareness and alleviate the symptoms of diabetes,while excessive medical behavior may enhance patients′ attention of diabetes symptoms and reduce their subjective satisfaction.
    【Key words】  Diabetes mellitus;Community health services;Models,structural;Self management
Mechanism of Action of Chemokines and Their Receptors in the Pathogenesis of Pain  LI Hong-yan1,2,3,LI Tong4,NI Jia-xiang1*
1.Department of Pain Management,Xuanwu Hospital,Capital Medical University,Beijing 100053,China
2.Department of Central Laboratory,Xuanwu Hospital,Capital Medical University,Beijing 100053,China
3.Comprehensive Liver Cancer Center,302 Military Hospital of China,Beijing 100039,China
4.Department of Pain Management,Lanzhou Maternal and Child Health Care Hospital,Lanzhou 730030,China
*Corresponding author:NI Jia-xiang,Chief physician,Professor,Doctoral supervisor;
    【Abstract】  Chemotaxis is a common response of non-excitable cells stimulated by chemokine.The chemokine receptor of neurons often transducts cascade via activating the heterotrimeric G protein downstream signals and further triggers molecular signal transduction pathway.Chemokines and their receptors play an important role in the occurrence and maintenance of pain.By analyzing the relationship between chemokines and nerve systems,the relationship between chemokines/chemokine receptors and pain,we demonstrated the mechanism of action of chemokines and their receptors in the pathogenesis of pain,suggesting that chemokines and their receptors are potential targets for the development of novel drugs and options for pain management.
    【Key words】  Pain;Chemotactic factors;Receptors,chemokine
Research Progress of Mechanism of Cell Cycle Arrest in Chronic Renal Disease after Acute Renal Injury  GAO Zhao,CHEN Xing-hua,DING Guo-hua*
Department of Nephrology,Renmin Hospital of Wuhan University,Wuhan 430060,China
*Corresponding author:DING Guo-hua,Professor,Main research direction:the pathophysiology mechanisms of podocyte disease;
    【Abstract】  Acute renal injury(AKI) is one of the most common severe acute diseases.Some patients with AKI may be likely to develop chronic kidney disease(CKD).However,the specific mechanism of CKD after AKI is not clear,which is associated with many factors,such as glomerular sclerosis after compensatory hyperplasia,renal interstitial inflammation and fibrosis,endothelial dysfunction,peritubular capillary rarefaction,oxidative stress and tubular epithelial cell abnormal repair.In recent years,it has been found that tubular epithelial cells abnormal repair after AKI plays a crucial role in developing CKD,and cell cycle arrest of tubular epithelial cells is one of the important mechanisms of epithelial cell abnormal repair.In this review,we summarized the recent advances in how cell cycle arrest links AKI to CKD.
    【Key words】  Acute kidney injury;Chronic kidney disease;Cell cycle;Review
Research Progress of Impact of Acute High Altitude Hypoxia on the Resting-state EEG Power  LIU Bing1,2,HAN Bu-xin1,2,AN Xin1,2,WANG Yan1,2*
1.Key Laboratory of Mental Health,Institute of Psychology,CAS,Beijing 100101,China
2.University of Chinese Academy of Sciences,Beijing 100049,China
*Corresponding author:WANG Yan,Associate researcher;
    【Abstract】  Resting-state EEG can be divided into five bands according to the frequency.High altitude hypoxia environment reduces the total power of resting-state EEG and decreases the electric activity of brain,but the power change of each frequency band has its own rules:the power of alpha wave decreases in acute hypoxia stage but then enhances with the prolonged dwelling duration in the hypoxia environment;those who enter the high altitudes first time exhibit enhanced activity of beta waves;the powers of low frequency waves of delta and theta enhance in simulated hypoxia,but decrease in real plateau environment.Future research can be carried out in three aspects:first,the spatial and temporal characteristics of cognitive processes are worthy of studying through variety of cognitive neuroscience technology in the hypoxia environment;second,exploring how the altitude influences the resting-state EEG power;third,the abnormal EEG power in low altitude immigrant groups in long-term chronic hypoxia conditions needs to be tested.
    【Key words】  Hypoxia;Altitude sickness;Brain waves;Review
Successful Treatment of Delayed Intestinal Perforation after Endoscopic Mucosal Resection of Transverse Colon Polyp:Report of One Case and Literature Review  CAO Yuan,SHI Yi-hai*
Department of Gastroenterology,Shanghai Pudong Gongli Hospital,the Second Military Medical University,219 Miaopu Road,Shanghai 200135,China
*Corresponding author:SHI Yi-hai,Chief physician;
    【Abstract】  Endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)are widely used for the treatment of superficial mucosal lesions of the digestive tract.Although both electrocoagulation syndrome and delayed intestinal perforation are common complications after endoscopic surgical treatment with similar early clinical manifestations,the treatment and prognosis of them are significantly different.The conservative treatment for delayed intestinal perforation is generally poorer.In order to provide a reference for the conservative treatment of delayed intestinal perforation,we reported one case of delayed intestinal perforation after EMR for transverse colonic polyps who recovered well after anti-infection,abdominal puncture and drainage and other conservative treatment.
    【Key words】  Colonic polyps;Endoscopic mucosal resection;Intestinal perforation;Electrocoagulation syndrome
Primary Lymphoma of the Prostate:One Case Report and Literature Review  WANG Ning,YU Tian-qiang,HE Jia,DUAN Yue*
Department of Urology,Zhejiang Rongjun Hospital,Jiaxing 311400,China
*Corresponding author:DUAN Yue,Chief physician;
    【Abstract】  Objective  Primary lymphoma of the prostate is quite rare.In this paper we reviewed the clinical data of one case with primary lymphoma of the prostate,aimed to investigate the diagnosis,treatment and prognosis of the disease.Methods  We reviewed the clinical data of one case with primary lymphoma of the prostate admitted in Department of Urology,Zhejiang Rongjun Hospital on March 26th,2010,and analyzed the clinical manifestations,laboratory findings,diagnosis and treatment.Results  The serum prostate specific antigen(PSA) of this case was lower than 4 μg/L;non-contrast-enhanced pelvic CT scanning found obviously enlarged prostate and prostate mass,contrast-enhanced pelvic CT scanning demonstrated no obvious enhancement of the prostate mass;color Doppler ultrasound scanning indicated significantly enlarged prostate,low level echoes in some prostate lesions with abundant blood flow signals;histopathological examination diagnosed that the patient had diffuse large B-cell lymphoma of the prostate.The tumor of prostate was obviously decreased after subsequent radiation therapy.Conclusion  Laboratory and imaging testing can demonstrate characteristic manifestations of primary lymphoma of the prostate,so they are contribute to the clinical diagnosis of the disease.Radiation therapy is effective for the disease,for it can relieve the urinary obstruction,and it can be used in combination with chemotherapy when necessary.
    【Key words】  Lymphoma;Prostatic neoplasms;Case reports;Historical article
Clinical Diagnostic Efficacy,Reliability and Accuracy of Portable 12-lead ECG Device versus Conventional 12-lead ECG Device  YANG Yi,MA Zhi-min,LI Yan-ming,WANG Ji-yun*
Department of Cardiovascular Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China
*Corresponding author:WANG Ji-yun,Chief physician;
    【Abstract】  Objective  To evaluate the efficacy,reliability and accuracy of a portable 12-lead ECG device compared to a conventional 12-lead ECG device.Methods  We enrolled 40 healthy volunteers and 110 patients who received inpatient treatment in Department of Cardiovascular Center,Beijing Tongren Hospital,Capital Medical University from July to October 2016.ECG monitoring was performed at the same time in both groups by the portable 12-lead ECG device and the conventional 12-lead ECG device,respectively.The automatically measured values of heart rate(HR),width of PR interval,QRS interval,QT interval,and corrected QT(QTc) interval monitored by the two types of devices were recorded and compared.And the diagnostic accuracy of the two types of devices was compared.Results  The HR and width of QTc interval on the ECG monitored by the two types of devices were significantly different(P<0.05),while the width of PR interval,QRS interval and QT interval on the ECG were not(P>0.05).The monitoring results for the healthy controls,patients with atrial fibrillation + atrial flutter,patients with acute ST-segment elevation myocardial infarction(STEMI),patients with acute non-ST-segment elevation myocardial infarction(NSTEMI) + unstable angina pectoris,patients with Ⅱ degree atrioventricular block+ Ⅲ degree atrioventricular block and patients with other types of cardiac diseases by the two types of devices were similar(P>0.05).Conclusion  The portable 12-lead ECG device monitoring results show good accuracy and reliability,and they are basically similar to the conventional 12-lead ECG device monitoring results.Therefore,this portable 12-lead ECG device could be widely applied in the future.
    【Key words】  Electrocardiography,ambulatory; Electrocardiography; Remote consultation; Diagnosis
Facial Nerve Monitoring for the Protection of Facial Nerve during the Acoustic Neuroma Surgery  SONG Hai-min,WU Zhi-wu,FENG Kai-ming,LUO De-fang,JIANG Qiu-hua*
Department of Neurosurgery,Ganzhou Hospital Affiliated to Nanchang University,Ganzhou People′s Hospital,Ganzhou 314000,China
*Corresponding author:JIANG Qiu-hua,Chief physician,Master supervisor;
    【Abstract】  Objective  To investigate the effect of facial nerve monitoring by preoperative facial nerve imaging(FNI) via diffusion tensor imaging(DTI),combined with intraoperative electrophysiologic facial nerve monitoring for the protection of facial nerve during the acoustic neuroma surgery.Methods  The enrolled participants were 11 consecutive cases of acoustic neuroma who received treatment in Ganzhou Hospital Affiliated to Nanchang University from January 2016 to January 2017.All of them underwent DTI for examining the ubiety between the facial nerve and acoustic neuroma preoperatively,and facial nerve dynamic electromyography(ECG) and electrical stimulation-evoked facial nerve EMG intraoperatively.The position of the facial nerve detected by DTI was tested during the surgery.And the function of the facial nerve was assessed postoperatively.Results  By using DTI,it was found that,the facial nerve of all the cases was at the ventral side of the acoustic neuroma,specifically,it was at the middle part of the acoustic neuroma in 7 cases,at the lower part in 2 cases and at the upper part in 2 cases,all these were the same as those found in the surgery.Ten cases achieved total resection,but 1 case had internal auditory canal tumor residues.Intraoperative facial nerve dynamic EMG monitoring indicated the facial nerve and it′s position.The facial nerve of all the patients were anatomically preserved in the surgery with a preservation rate of 100%.The results of 1-12-month follow-up showed that,there were 4 cases of House-Brackmann grade Ⅰ,6 cases of grade Ⅱ and 1 case of grade Ⅲ.Conclusion  Preoperative FNI via DTI combined with intraoperative electrophysiologic facial nerve monitoring are helpful to locate and protect the facial nerve during surgery,and improve the anatomical and functional preservat


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