April 2019, Volume 22，No.12 Abstracts(A)
Author：尹鹏 Source：CGP Published： [04-30] views： 324
Difficulties and Countermeasures of Cardiac Rehabilitation in China GUO Hangyuan
Department of Cardiology，Shaoxing Hospital of Zhejiang University/Shaoxing People's Hospital，Shaoxing 312000，China
【Abstract】 With the continuous development of society and the increasing work pressure，the incidence of cardiovascular diseases is rising gradually and people develop this disease at a younger age.It is no exaggeration to say that cardiovascular disease has now become the "head" of diseases.For the diagnosis and treatment of cardiovascular diseases，China is in full swing.Either in physical examination of ECG，cardiac echocardiography or surgical stent implantation，pacemaker installation，most hospitals in China have well-developed diagnosis and treatment process while we still face a large difficulty in heart rehabilitation.Although the concept of cardiac rehabilitation has been proposed for many years，and its influence has been continuously improved in recent years，it is still unsatisfactory in terms of current coverage and implementation.The importance of cardiac rehabilitation is self-evident in the recovery of cardiovascular diseases.Meanwhile，in order to raise the awareness of cardiac rehabilitation in the whole country and corporate the concept of cardiac rehabilitation into clinics and life for all people，this study summarized some characteristics of cardiac rehabilitation and its current advantages and disadvantages in our country，hoping to attract more people's attention and participation and finally have better，bigger and stronger cardiac rehabilitation.
【Key words】 Cardiology；Rehabilitation；Cardiovascular diseases
Risk Assessment Procedures and Management of Clinical Practice for Venous Thromboembolism in Gynecologic Patients GAO Hong1，WANG Jiandong2*，TONG Tong1
1.Department of Internal Medicine，Beijing Obstetrics and Gynecology Hospital，Capital Medical University，Beijing 100026，China
2.Gynecological Oncology Department，Beijing Obstetrics and Gynecology Hospital，Capital Medical University，Beijing 100026，China
*Corresponding author：WANG Jiandong，Professor，Chief physician；E-mail：firstname.lastname@example.org
【Abstract】 As the aging of society and the increasing prevalence of obesity，the incidence rate of venous thromboembolism（VTE） is growing.Although VTE has become a serious complication that threatens the safety of patients during the treatment of gynecological diseases，it can be prevented clinically by effective ways.Scientific risk assessment，reasonable preventive measures，and risk stratification of the severity of VTE disease can help reduce the incidence rate of and mortality from VTE in gynecologic patients.Based on the existing evidence-based studies in combination with relevant subject guidelines and expert opinions，as well as our daily clinical practices，we summarized the risk assessment process and clinical practice for VTE in gynecologic patients，aiming to help general practitioner and gynaecologists quickly assess VTE risk and make correct treatment decisions.
【Key words】 Venous thromboembolism；Risk assessment；Guidebooks；Diagnosis；Therapy；Gynecology
Advantage Analysis of Chinese and Western Medicine Integration in Cardiac Rehabilitation ZHANG Jie1，GUO Hangyuan1，2，CHI Jufang2*
1.The First Clinical Medical College，Wenzhou Medical University，Wenzhou 325000，China
2.Department of Cardiology，Shaoxing People's Hospital，Shaoxing 312000，China
*Corresponding author：CHI Jufang，Chief physician；E-mail：email@example.com
【Abstract】 Cardiovascular diseases have become the number one killer of human health.At present，although more attention has been paid on its treatment in clinical practice，little was paid on its rehabilitation and prevention.Thus，the research on accelerating cardiac rehabilitation is needed urgently.Currently，the guidelines for cardiac rehabilitation in China mostly refer to the ones in foreign countries，but the implementation of some foreign guidelines requires a great deal of equipment and professional guidance，sometimes with a huge investment，which is not suitable to real situation in our country.Therefore，the medical model of cardiac rehabilitation in our country must be fully considered the national conditions.We can utilize the advantage of traditional Chinese medical rehabilitation therapy，while drawing upon and integrating foreign advanced science and human civilization achievement，to finally form a Chinese-Western medical model with Chinese characteristics，and do a good job in cardiac rehabilitation.
【Key words】 TCM rehabilitation；Cardovascular diseases；Integrated TCM WM；Cardiology
Role of Family and Community in Cardiac Rehabilitation LUO Hangqi1，CHI Jufang2，GUO Hangyuan2*
1.Zhejiang University School of Medicine，Hangzhou 310016，China
2.Department of Cardiology，Shaoxing People's Hospital/Shaoxing Hospital of Zhejiang University，Shaoxing 312000，China
*Corresponding author：GUO Hangyuan，Chief physician，Professor；E-mail：firstname.lastname@example.org
【Abstract】 With the arrival of the rising tide of China's aging population，the number of patients with severe cardiovascular disease such as acute myocardial infarction and heart failure has increased significantly.Early cardiac rehabilitation training using community and family support reasonably，is not only conducive to delaying the disease progression，and improving prognosis，but also avoiding the waste of medical resources and reducing national health expenditures.At present，China's health system offering cardiac rehabilitation only consists of some tertiary hospitals，and cardiac rehabilitation services have not been paid enough attention throughout the country，which make a considerable number of patients with severe cardiovascular disease be separated from the normal work and social lives after leaving the hospital，preventing them from returning to society.This article briefly reviews cardiac rehabilitation and the role of community and family in cardiac rehabilitation.
【Key words】 Cardiovascular diseases；Rehabilitation；Community health services；Home care services
Cardiac Rehabilitation Model under the Medical Treatment Partnership System NI Tingjuan1，GUO Hangyuan2*
1.Zhejiang University School of Medicine，Hangzhou 310016，China
2.Department of Cardiology，Shaoxing People's Hospital/Shaoxing Hospital of Zhejiang University，Shaoxing 312000，China
*Corresponding author：GUO Hangyuan，Chief physician，Professor；E-mail：email@example.com
【Abstract】 Cardiac rehabilitation benefits patients with cardiovascular diseases，but cardiac rehabilitation in China is still in its infancy.This paper explores the application，analysis and construction of cardiac rehabilitation model under the background of medical treatment partnership system，which is of great significance to the development of cardiac rehabilitation.
【Key words】 Cardiovascular diseases；Rehabilitation；Medical association
Analysis between Indoor Environment and Childhood Asthma and Family Nursing Interventions in Chongqing WANG Ling，GUO Rong，YANG Huan，YUAN Xiaoping*
Respiratory Center，Children's Hospital of Chongqing Medical University/The Ministry of Education Key Laboratory of Child Development Disease Research/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics，Chongqing 400014，China
*Corresponding author：YUAN Xiaoping，Co-chief superintendent nurse；E-mail：firstname.lastname@example.org
【Abstract】 Background Bronchial asthma（asthma） is widely considered to be caused by gene and environment，while environmental factors are the major ones in the rising incidence of asthma because gene changes slowly.World Health Organization（WHO） reported that 44% of asthma diseases were caused by environmental factors，such as indoor fuel and second-hand smoking.Family history and allergens are well-known risk factors for asthma.Other factors triggering asthma has been rarely studied，such as indoor humidity，indoor air pollution，bedding，pillow core material and cleanliness，application of range hood and dust cover.Objective To investigate the influence of indoor environment on the incidence of asthma in children in Chongqing，and to provide evidence for interventions in family nursing.Methods Children with asthma diagnosed and treated in respiratory center of Children's Hospital of Chongqing Medical University from May to July 2017 were selected.Controls（being diagnosed with no asthma） were matched with cases（being diagnosed with asthma） for age and sex accorded to 1∶1 ratio.This study developed“Questionnaire of Related Factors of Children with Asthma”from Swedish Dampness in Buildings and Health（DBH） with adjustment and supplement of Chinese residential features.Questionnaire included general data，indoor environment（material of pillow core and quilt，cleaning frequency of pillow core and sheet，cleaning of dust cover，frequency of flowers contact，mold growth，water leakage，condensed water，frequency of humidifiers use，passive smoking during pregnancy and in kids，material of ground and wall，ventilation frequency，kitchen fuel，lampblack machine cleaning，air-conditioning filter cleaning，pets feeding，contact frequency of stuffed toys，and exposure frequency of cockroaches and mice）．Logistic regression were used to analyze the correlation variables.Results We totally distributed 750 questionnaires，730 returned and 18 unqualified，resulting in a 94.9% of valid recovery rate，and with 356 cases in each group.The results of statistical analysis indicated that material of pillow core and quilt，cleaning frequency of pillow core and sheet，contact frequency of flowers，mold growth，water leakage，condensed water，passive smoking during pregnancy and in kids，contact frequency of stuffed toys，and exposure frequency of cockroaches and mice were significantly correlated with the incidence of asthma（P<0.05）．Conclusion Unfavorable indoor environment（material of pillow core and quilt，cleaning frequency of pillow core and sheet，contact frequency of flowers，mold growth，water leakage，condensed water，passive smoking during pregnancy and in kids，contact frequency of stuffed toys，and exposure frequency of cockroaches and mice） would bring negative impact on respiratory health in children.More attention is needed and active interventions should be taken to improve the existing risk factors and reduce the incidence of asthma in children by lessening indoor environmental pollution.
【Key words】 Asthma；Child；Indoor environment；Correlation study；Chongqing
Factors Affecting Treatment Outcomes of Pulmonary Tuberculosis in Xinjiang Uygur Population YANG Dan1，WEN Jin2，LIU Nianqiang3，AYINUER·Mohemaiti3，QIMANGULI·Wushouer1，HU Xin1，HAO Yanyan1，WANG Jing1*
1.No.1 Department of Respiratory，First Affiliated Hospital of Xinjiang Medical University，Urumqi 830000，China
2.No.2 Department of Critical Care Medicine，the Second Affiliated Hospital of Xinjiang Medical University，Urumqi 830000，China
3.Tuberculosis Prevention and Control Center，Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention，Urumqi 830000，China
*Corresponding author：WANG Jing，Chief Physician，Professor；E-mail：email@example.com
【Abstract】 Background Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis infection，which is one of the major public health problems in the world.According to the analysis of Chinese Center for Disease Control and Prevention，the reported incidence of tuberculosis in Xinjiang ranked first in China in 2015.Objective To analyze the factors affecting treatment outcomes of pulmonary tuberculosis in Xinjiang Uygur Population，providing a theoretical basis for the prevention and treatment of pulmonary tuberculosis in Xinjiang.Methods From March to April 2016，Uygur tuberculosis patients in Xinjiang registered in the National Tuberculosis Network Special Reporting System from July 2014 to June 2015 were selected.General demographic data （age，gender，place of residence，hukou location，occupation） and clinical data （patient source，sputum smear results，type of tuberculosis，type of treatment，treatment outcomes） of the patients were collected retrospectively，and the factors affecting treatment outcomes were analyzed.Results Of the 24 298 cases registered，29 had a diagnosis change，889 had no reported treatment outcomes，the remaining 23 380 were eventually included in the study.Among the 23 380 cases，1 490 （6.4%） had failed treatment，and 564 died（2.4%） from tuberculosis.Multivariate Logistic regression analysis showed that age ≥60 years〔OR=1.550，95%CI（1.386，1.733）〕，living in rural areas〔OR=1.241，95%CI（1.065，1.446）〕，professional，technical and managerial workers〔OR=2.031，95%CI（1.038，3.974），retirees〔OR=2.050，95%CI（1.073，3.915）〕，referral receivers〔OR=1.812，95%CI（1.190，2.758），follow-up receivers〔OR=1.624，95%CI（1.047，2.517）〕，positive sputum smear results〔OR=1.622，95%CI（1.420，1.854）〕 and retreatment〔OR=1.859，95%CI（1.545，2.237）〕 were risk factors of tuberculosis treatment failure（P<0.05）．Age≥60 years〔OR=2.462，95%CI（2.038，2.975）〕，male〔OR=1.394，95%CI（1.174，1.656）〕，living in rural areas〔OR=1.265，95%CI（1.002，1.598）〕，positive sputum smear results 〔OR=2.027，95%CI（1.652，2.486）〕，retreatment〔OR=1.606，95%CI（1.216，2.121）〕 were risk factors of death due to tuberculosis（P<0.05）．Conclusion Age，place of residence，occupation，patient source，sputum smear results and treatment type are the influencing factors of tuberculosis treatment failure.Age，gender，place of residence，sputum smear results and treatment type are the influencing factors of death due to tuberculosis.In view of this，relevant departments in Xinjiang should take measures to strengthen the prevention and treatment of tuberculosis in Uygur population，especially the elderly，persons living in rural areas，retirees，tuberculosis referral receivers，tuberculosis follow-up receivers，persons with positive sputum smear results，or those with tuberculosis retreatment.
【Key words】 Tuberculosis，pulmonary；Treatment outcome；Root cause analysis；Xinjiang
Particulate Matters（PM2.5/PM10）and COPD Mortality in Pudong New Area of Shanghai CHEN Yichen，LI Xiaopan，SUN Lianghong，CHEN Hanyi，QU Xiaobin，ZHANG Ge，CHEN Hua，ZHOU Yi*，LIN Tao，SUN Qiao
Office of Research and Information Affairs，Shanghai Pudong New Area Center for Disease Control and Prevention/Fudan University Pudong Institute of Preventive Medicine，Shanghai 200136，China
*Corresponding author：ZHOU Yi，Associate chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Background The health hazards of chronic obstructive pulmonary disease（COPD）has caused widespread concern around the world due to its high prevalence rate and high mortality rate，but the study about the relationship between the concentration of particulate matters and daily COPD mortality was still rare.Objective To explore the relationship between the concentration of particulate matters（PM2.5，PM10）and daily COPD mortality in Pudong New Area，so as to provide a reference to establish intervention measures.Methods The daily COPD mortality data between 1 January 2013 and 31 December 2017 was originated from the local death surveillance database.The data of air pollution in Shanghai including the concentration of particulate matters（PM2.5，PM10，SO2，NO2）were offered by Shanghai Environmental Monitoring Center，and the data of meteorology in Pudong New Area including temperature，relative humidity，atmospheric pressure and wind speed were received from Meteorological Bureau of Pudong New Area.A generalized additive model（GAM）based on Poisson distribution was performed to analyze the association between particulate matters（PM2.5，PM10）and daily COPD death，and the COPD death data was stratified according to age（young group <80 years，old group≥80 years）and education level（the low educated group without the middle school education，the highly educated group with middle school education and above）．The concentration of particulate matters（PM2.5，PM10）at the day that the COPD death happen，one day before，two days before and three days before the death and the average concentration of particulate matters in the four days were presented as lag0，lag1，lag2，lag3 and lag03，respectively.Results The concentration of PM2.5 was positively correlated with the concentration of PM10，SO2，NO2 and atmospheric pressure，and negatively correlated with temperature，relative humidity and wind speed
（P<0.05）；the concentration of PM10 was positively correlated with the concentration of SO2，NO2 and atmospheric pressure，and negatively correlated with temperature，relative humidity and wind speed（P<0.05）；the concentration of SO2 was positively correlated with the concentration of NO2 and atmospheric pressure，and negatively correlated with temperature，relative humidity and wind speed（P<0.05）；the concentration of NO2 was negatively correlated with air temperature and relative humidity，and positively correlated with atmospheric pressure and wind speed（P<0.05）．Temperature was positively correlated with relative humidity，and negatively correlated with atmospheric pressure（P<0.05）．Relative humidity was negatively correlated with atmospheric pressure and wind speed（P<0.05）．The results of the single pollutant model showed that the effect of PM2.5 on daily COPD mortality was significant at lag0，lag1，lag2 and lag03（P<0.05），and not significant at lag3（P>0.05）；the effect of PM10 was significant at lag0，lag1，lag2，lag3 and lag03（P<0.05）．After stratification according to age，the effect of PM2.5 and PM10 on daily COPD death count was not significant at lag0，lag1，lag2，lag3 and lag03 among young group（P>0.05）；the effect of PM2.5 on daily COPD mortality among the old group was significant at lag0，lag1，lag2 and lag03（P<0.05），and not significant at lag3（P>0.05）；the effect of PM10 was significant at lag0，lag1，lag2，lag3 and lag03 among the old group（P<0.05）．After stratification according to education level，the effect of PM2.5 and PM10 on daily COPD mortality among low educated group was significant at lag0，lag1，lag2 and lag03（P<0.05），and not significant at lag3（P>0.05）；the effect of PM2.5 was significant on daily COPD mortality among highly educated group at lag1（P<0.05），and not significant at lag0，lag2，lag3 and lag03（P>0.05）；the effect of PM10 was significant on daily COPD mortality among highly educated group at lag1 and lag03（P<0.05），and not significant at lag0，lag2 and lag3（P>0.05）．The results of multi-pollutant model showed that the effect of PM2.5 was not significant on the daily COPD mortality among the whole crowd，old group，young group，low educated group and highly educated group after the effect of SO2 and NO2 had been controlled separately and simultaneously（P>0.05）．The effect of PM10 was not significant on the daily COPD mortality among the whole crowd，old group，young group，low educated group and highly educated group after the effect of SO2 had been controlled or the effect of SO2 and NO2 had been controlled simultaneously（P>0.05）．When the effect of NO2 had been independently controlled，the effect of PM10 was not significant among the whole crowd，young group，low educated group and highly educated group（P>0.05），and its effect was significant among the old group（P<0.05）．Conclusion Increased concentrations of atmospheric particulate matters（PM2.5，PM10）have a significant impact on the mortality of chronic obstructive pulmonary disease（COPD）in Pudong New Area.The old group and the low educated group of patients with chronic obstructive pulmonary disease were more sensitive to the concentration change of particulate matters（PM2.5，PM10），and relative measures should be enhanced to protect the sensitive population from the hazard of particulate matters（PM2.5，PM10）．
【Key words】 Pulmonary disease，chronic obstructive；Death；Particulate matter；Atmosphere；Generalized additive model；Time-series analysis
Curative Effect of Tripterygium Glycosides Combined with Irbesartan on IgA Nephropathy with Increased Urinary Podocyte Excretion LIANG Yan*，ZHANG Xiaoling，LIU Bing，ZHU Qing，SHAO Fengmin
Department of Nephropathy，Rheumatoid and Immunology，Henan Provincial People's Hospital，Zhengzhou 450003，China
*Corresponding author：LIANG Yan，Attending physician；E-mail：email@example.com
【Abstract】 Background IgA nephropathy is the most common primary glomerular disease in the world and a common cause of end-stage renal failure.Currently，Tripterygium glycosides（TG），irbesartan and other immunosuppressants are major drugs used for clinical treatment，but it has not been proved that whether the combination of TG and irbesartan has synergistic effects in thoroughly alleviating the progress of IgA nephropathy.Objective To discuss the curative effect of TG and irbesartan on IgA nephropathy with increased urinary podocyte excretion.Methods From Henan Provincial People's Hospital from January 2014 to December 2016，128 IgA nephropathy patients were enrolled according to the inclusion and exclusion criteria of this study，and were divided into the TG group（n=42），irbesartan group（n=40）and combination group（n=46），receiving TG tablets（20 mg，three times a day），irbesartan tablets（150 mg，twice a day），and TG tablets（20 mg，three times a day）combined with irbesartan tablets（150 mg，twice a day），respectively，for 12 weeks.The general information，data concerning blood pressure（systolic and diastolic pressure），laboratory indices〔serum creatinine（Scr），blood urea nitrogen（BUN），serum uric acid（SUA），serum albumin（Alb），total cholesterol（TC），estimated glomerular filtration rate（eGFR），24-hour urinary protein level〕and the number of urinary podocytes before and after the treatment of all participants were collected.Post-treatment improvement in 24-hour urinary protein and adverse reactions caused by treatment were also obtained.Results Intergroup comparisons demonstrated that combination group presented much higher Alb level and much lower 24-hour urinary protein level compared with other two groups（P<0.05）．Compared with baseline，all groups showed significantly decreased Scr and 24-hour urinary protein levels and obviously increased Alb and eGFR levels after treatment（P<0.05）．The combination group also showed much lower BUN and SUA levels（P<0.05）．The number of urinary podocytes decreased significantly in all groups after treatment（P<0.05）．The combination group had much less urinary podocytes than other two groups after treatment（P<0.05）．The combination group had a notable higher clinical response than other groups（P<0.05）．There was no difference in the incidence of adverse reactions among the three group（P>0.05）．Conclusion For IgA nephropathy with increased urinary podocyte excretion，TG combined with irbesartan is superior to TG or irbesartan alone.The combination treatment can produce a synergistic effect in reducing the injury of renal podocytes，thereby delaying the progression of the disease.
【Key words】 Glomerulonephritis，IGA；Tripterygium；Irbesartan；Treatment outcome；Podocytes
Different Regimens of Polyethylene Glycol Electrolyte Solution in Bowel Preparation before Colonoscopy for Elderly Patients：a Randomized Controlled Study LIU Miao，WANG Hongbo*，CHEN Qingbo
Endoscopy Department，Hubei Cancer Hospital，Wuhan 430079，China
*Corresponding author：WANG Hongbo，Attending physician；E-mail：firstname.lastname@example.org
【Abstract】 Background Elderly patients are prone to adverse reactions and poor intestinal preparation when taking oral drugs for intestinal preparation before electronic colonoscopy.Objective To compare effects of 3 regimens of polyethylene glycol electrolyte solution on elderly patients for bowel preparation before colonoscopy.Methods Two hundred and twenty-one elderly Patients undergoing colonoscopy from January 2016 to January 2018 in Hubei Cancer Hospital were divided into 3 groups by using random number table method.Group A（n=74）：patients took 205.68 g of polyethylene glycol （3 bags） dissolved in
3 000 ml of water at onetime on the morning before receiving colonoscopy.Group B（n=74）：patients took 274.24 g of polyethylene glycol（4 bags） dissolved in 4 000 ml of water on the night before and the morning of colonoscopy separately，with 2 000 ml each time.Group C（n=73）：patients took 274.24 g of polyethylene glycol（4 bags） dissolved in 4 000 ml water on the night before and the morning of colonoscopy separately，2 000 ml each time，combined with mosapride citrate dispersible tablets，5 mg/tab，tid for one day，only one day.The colonoscopy examination was performed within 4 hours after the end of the taking medicine in all three groups. Intestinal cleaning score，gastrointestinal adverse reaction，detection rate of bowel polyps，the time from the colonoscopy to ileocecal part among 3 groups were compared.Results The total Ottawa score of A，B and C groups were（3.80+1.22），（3.88+1.26） and （1.16+0.69），respectively.Group C had higher score than Group A and Group B（P<0.05），and there was no significant difference between Group A and Group B（P>0.05）．Gastrointestinal adverse reaction in Group C and Group B was milder than that of Group A（P<0.05）．The intestinal preparation tolerance rate of Group B and Group C was significantly higher than that of group A（P<0.05）．There was no significant difference about detection rate of bowel polyps and the time from the colonoscopy to ileocecal part among 3 groups（P>0.05）．Conclusion Polyethylene glycol given two times does not affect intestinal cleaning in elderly patients，but can improve their intestinal preparation tolerance rate and reduce their gastrointestinal adverse reaction.Polyethylene glycol combined with Mosapride is an optimal regimen for intestinal cleansing in elderly patients.
【Key words】 Colonoscopy；Bowel preparation；Polyethylene glycol；Aged
Clinical Values of Transvaginal Color Doppler Sonography Combined with Serum miRNA-18a and miRNA-92a in the Diagnosis of Cervical Carcinoma SUN Mingxia1*，JIANG Pengcheng2，YU Feng3，LIU Caixia4，FAN Guilian4，ZHANG Hui5
1.Department of Obstetrics and Gynecology，Beijing Chaoyang Hospital（West Branch），Capital Medical University，Beijing 100043，China
2.Department of Ultrasound，Beijing Chaoyang Hospital（West Branch），Capital Medical University，Beijing 100043，China
3.Department of Obstetrics and Gynecology，Affiliated Hospital of Jining Medical University，Jining 272000，China
4.Department of Obstetrics and Gynecology，Qidu Hospital，Zibo 255400，China
5.Department of Obstetrics and Gynecology，Fourth Hospital of Hebei Medical University，Shijiazhuang 050011，China
*Corresponding author：SUN Mingxia，Associate chief physician；E-mail：email@example.com
【Abstract】 Background Approaches for the screening and early diagnosis of cervical carcinoma（CC）include ultrasound，colposcopy，HPV-DNA testing，and thin-layer liquid-based cytology.How to choose an inexpensive，easy-to-use and mini-invasive examination with ideal diagnostic accuracy for CC，is a closely watched clinical issue.Objective To explore the clinical values of transvaginal color Doppler sonography（TVCDS）combined with serum miRNA-18a and miRNA-92a in the diagnosis of CC.Methods We enrolled 362 cases from Department of Obstetrics and Gynecology，Beijing Chaoyang Hospital，Capital Medical University，from March 2015 to July 2017，including 122 with a postoperative pathological diagnosis of CC（CC group），120 with a pathological diagnosis of cervical intraepithelial neoplasia（CIN）（CIN group），and 120 with benign uterine lesions（normal group）．Three groups' general data，TVCDS test results and serum miRNA-18a，miRNA-92a were compared.Multivariate Logistic regression analysis was used to analyze the influencing factors of CC.ROC curves of blood flow resistance index（RI），miRNA-18a，and miRNA-92a，either alone or in combination，for the diagnosis of CC were drawn and analyzed.And their diagnostic accuracy was evaluated by comparing the gold standard，postoperative pathological diagnosis results.Results The incidence of HR-HPV infection in CIN group and CC group was higher than that in normal group（P<0.05），and it was higher in CC group than that in CIN group（P<0.05）．The incidence of menopause in CIN group was lower than that of other two groups（P<0.05）．Cervical manifestations of suspected carcinogenesis were observed in both CC and CIN groups.The margin of the cervix was not complete.The blood flow was richer in CC group than those of the CIN group.The blood flow RI in CIN group and CC group was lower than that in the normal group（P<0.05），and it was lower in CC group than that of the CIN group（P<0.05）．There were no pathological manifestations in the uterine body，ovary and para-uterine tissues among three groups.The serum miRNA-18a and miRNA-92a in CIN group and CC group were higher than those in the normal group（P<0.05）．The serum miRNA-18a and miRNA-92a in CC group were higher than those of the CIN group（P<0.05）．Multivariate Logistic regression analysis showed that age，HR-HPV infection，menopause，blood flow RI，serum miRNA-18a，and serum miRNA-92a were the influencing factors of CC（P<0.05）．The area under the ROC curve of blood flow RI，serum miRNA-18a，serum miRNA-92a，blood flow RI combined with serum miRNA-18a，blood flow RI combined with serum miRNA-92a and blood flow RI combined with serum miRNA-18a and miRNA-92a in diagnosing CC was 0.844，0.880，0.763，0.936，0.886，and 0.940，respectively.The sensitivities were 80.8%，78.7%，64.8%，87.7%，82.8%，and 94.3%，respectively.And the specificities were 68.0%，83.7%，81.8%，85.8%，78.3%，and 81.3%，respectively.Conclusion The blood flow RI of TVCDS in CC patients decreased, and serum microRNA-18a and microRNA-92a increased.The blood flow RI of TVCDS combined with serum miRNA-18a and miRNA-92a has higher diagnostic accuracy for CC than the blood flow RI of TVCDS，serum miRNA-18a and miRNA-92a alone，and it is easy to perform，which can improve the early diagnosis rate of CC，and is worthy of clinical promotion.
【Key words】 Uterine cervical neoplasms；Ultrasonography，Doppler，color；Colposcopy；MicroRNAs；Diagnosis
Therapeutic Effect of Intraoperative Intrathecal and Perithecal Injection of Nerve Blocks on Reducing the Radicular Pain Following Surgery for Lumbar Disc Herniation LI Yijun1，TANG Fubo2，ZHANG Jiali2*，YANG Hui1，CHEN Deqiang1，DENG Wenshi1，HUANG Guozhu1，WEI Weibing1，CHEN Zhen1
1.Graduate School，Guangxi University of Chinese Medicine，Nanning 530000，China
2.No.1 Department of Orthopedics，the First Affiliated Hospital of Guangxi University of Chinese Medicine，Nanning 530000，China
*Corresponding author：ZHANG Jiali，Chief physician；E-mail：firstname.lastname@example.org
LI Yijun and TANG Fubo are co-first authors.
【Abstract】 Background Traditional sacral canal or intraoperative injection of nerve blocks is an effective treatment for radicular pain caused by lumbar disc herniation（LDH）or inflammation-induced edema soon after the surgery for LDH.However，this treatment has a short duration of action and limited efficacy，and there is still a need for further research.Objective To explore the clinical efficacy of intraoperative intrathecal and perithecal injection of nerve blocks for reducing the pain following surgery for LDH.Methods According to the inclusion and exclusion criteria，90 LDH patients who underwent open discectomy for the removal of herniated nucleus pulposus and nerve root canal decompression with foraminal enlargement in the First Affiliated Hospital of Guangxi University of Chinese Medicine from March 2015 to March 2018 were selected.By a random number table，they were divided into group A（n=30，receiving intraoperative intrathecal and perithecal injection of nerve blocks），group B（n=30，receiving intraoperative intrathecal injection of nerve blocks），group C（n=30，receiving no intraoperative injection of nerve blocks）．General data，postoperative bedridden time，postoperative hospital stay，postoperative radicular pain，Visual Analogue Scale（VAS）scores assessed before surgery and on the 1st，3rd，6th，and 10th days after surgery，Japanese Orthopedic Association（JOA）scores assessed before surgery and on the 3rd，6th，and 10th days after surgery，were collected.The incidence of adverse reactions was also obtained.Results Group A showed much shorter postoperative bedridden time and postoperative hospital stay，and much lower incidence of postoperative radicular pain than groups B and C（P<0.05），as did group B when compared with group C（P<0.05）．Both the treatment method and duration had a significant interaction on the VAS score（P<0.05）．And they produced significant main effects on the VAS score（P<0.05）．The VAS scores on the 1st，3rd，6th，and 10th days after surgery were all significantly lower than the baseline level in all groups（P<0.05）．Group A demonstrated much lower VAS scores on the 1st，3rd，6th，and 10th days after surgery compared with groups B and C（P<0.05），as did group B when compared with group C（P<0.05）．There was an interaction between the treatment method and duration on the JOA score（P<0.05）．The main effects of the treatment method and duration on the JOA score were significant（P<0.05）．The JOA scores on the 3rd，6th，and 10th days after surgery in all groups increased significantly compared with the baseline level（P<0.05）．Group A demonstrated much higher JOA scores on the 6th and 10th days after surgery compared with groups B and C（P<0.05），as did group B when compared with group C（P<0.05）．There were no significant adverse reactions in all groups.Conclusion Intraoperative intrathecal and perithecal injection of nerve blocks for LDH can achieve a longer duration of pain relief via extending the duration of action of the drugs，which in turn significantly promotes early postoperative recovery，relieves the postoperative radicular pain，and shortens the postoperative bedridden time and postoperative hospital stay，thus increasing the overall efficacy.
【Key words】 Intervertebral disc displacement；Injections，spinal；Neurilemma；Gelatin sponge，absorbable