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RSS2020 Vol. 41, No. 12
2020, 41(12): 60-67.
doi: 10.12259/j.issn.2095-610X.S20201215
Abstract:
Objective To evaluate the clinical efficacy of chemotherapy combined with CIK （cytokine-induced killer）cell immunotherapy on early and advanced stages non small cell lung cancer （NSCLC）patients. Methods A total of 122 NSCLC patients admitted to the Third Affiliated Hospital of Kunming Medical University from 2013 to 2016, according to the course of disease, the patients divided into early stage （stage I-II）and late stage （stage III-IV）; and were randomly divided into four groups: chemotherapy a group （n = 30）, combined with CIK a group （n = 31）, chemotherapy B group （n = 30）, combined with CIK B group （n = 31）. Among them, gemcitabine combined with cisplatin （GP）was used in all the groups. The clinical efficacy, quality of life and changes of peripheral blood lymphocytes and cytokines were evaluated. Results Compared with the chemotherapy group, the ORR and DCR values were significantly increased （67.74%, 45.16%）and （74.19%, 64.52%）respectively （P < 0.05）, KPS and ECOG scores were significantly increased （80.65%, 58.06%）and （80.65%, 70.97%） respectively （ P < 0.05）, in the combined CIK groups. The ratio of CD3 +, CD8+ lymphocytes and CIK cells in patients' peripheral blood was significantly increased （P < 0.05）and the expression level of IFN - γ, TNF - α, IL-4 and IL-6 cytokines in patients' peripheral blood was significantly increased （ P < 0.05）and the survival period of patients was prolonged （ P < 0.05）in the combined CIK groups. Compared with the combined CIK A group （early stage）, the ratio of CD3 +, CD4+, CD8+, CD4+/CD8+ T lymphocytes, NK cell ratio and CIK cell ratio in the peripheral blood of the patients were significantly increased, and the expression levels of IFN - γ, TNF - α, IL-2, IL-4 and IL-6 cytokines in the peripheral blood were maintained and enhanced in the combined CIK B group （advanced stage）（P < 0.05）. Conclusion Chemotherapy combined with CIK cell therapy can significantly improve the clinical efficacy, prolong the survival period, and improve the short-term quality of life of NSCLC patients in different stages, and significantly improve the ability of immune cells in vivo to continuously resist tumor cytotoxicity and immune response, especially for patients in advanced stage.
2020, 41(12): 80-84.
doi: 10.12259/j.issn.2095-610X.S20201223
Abstract:
Objective To explore the diagnostic efficacy of serum Protein induced by vitamin K absence or antagonist-Ⅱ（PIVKA-Ⅱ）in Primary hepatocellular carcinoma. Methods 150 patients who diagnosed and treated in Qujing Affiliated Hospital of Kunming Medical University were divided into chronic hepatitis B group（HBV, n = 50）, chronic hepatitis C group（HCV, n = 50）and Hepatocellular carcinoma group（HCC, n = 50）, and 50 healthy people were selected as normal control group. Serum PIVKA-Ⅱ concentration were detected by Fujirebio-Lumipulse G1200 system and alpha fetoprotein（AFP）concentration were detected by Roche Cobas e601 immunoassay system. Results The serum PIVKA-Ⅱ and AFP concentrations in HCC group were significantly higher than those in chronic liver disease groups and normal control group（P < 0.05）. The sensitivity and specificity of PIVKA-Ⅱ in the diagnosis of HCC were 94.0% and 95.3%, compared with AFP’ s 76.0% and 90.0% for specificity, respectively. Subjects operating characteristic curve（ROC）showed that the areas under curve of PIVKA-Ⅱ and AFP were 0.963 and 0.848, respectively. Conclusions The diagnostic efficacy of Serum PIVKA-Ⅱ is better than AFP in diagnosing Primary Hepatocellular Carcinoma and can be used in clinical practice.
2020, 41(12): 99-103.
doi: 10.12259/j.issn.2095-610X.S20201227
Abstract:
Objective To analyze the clinical efficacy of narrow-spectrum UVB in the treatment of psoriasis and the effect on peripheral blood cytokines. Methods 109 patients with psoriasis treated in the First Affiliated Hospital of Kunming Medical University from May 2018 to March 2020 were selected and randomly divided into experimental group（n = 55）and control group（n = 54）. The control group was treated with capotriol ointment, and the experimental group was treated with narrow-spectrum UVB combined with capotriol ointment. The clinical efficacy and the changes of cytokines in peripheral blood of patients in the two groups were compared. Results The total effective rate of clinical treatment in the experimental group was higher than that of control group, and the difference was statistically significant（P < 0.05）. After treatment, Th17, Treg and Th17/Treg in the experimental group were statistically significant in control group（ P < 0.05）. After treatment, TNF- radiation and il-10 in the experimental group were compared with those in the control group, and the difference was statistically significant（ P < 0.05）. Conclusion Narrow spectrum UVB treatment of psoriasis can improve the clinical outcomes, which may be related to the inhibition of serum TNF- beam and Th17 levels in patients with psoriasis, and the improvement of 1l-10 and Treg cell levels. UVB in narrow spectrum may play a role in improving Th17/Treg imbalance ratio and cytokine levels in patients with psoriasis, which has great potential in clinical practice.
2020, 41(12): 112-118.
doi: 10.12259/j.issn.2095-610X.S20201230
Abstract:
Objective To investigate the efficacy and side effects of different doses of amphotericin B intrathecal injection in the treatment of cryptococcal meningitis. Methods 69 cases of cryptococcal meningitis admitted in the Third People's Hospital of Kunming city from January 2017 to December 2019, were enrolled in this study. In the induction period, continuous drainage through the lumbar cisterm was performed to replace cerebrospinal fluid on the basis of intravenous amphotericin B and oral fluorocytosine, and different doses of amphotericin B were injected intrathecally. All the cases were randomly divided into 4 groups, 17 cases in A0, A1, A2 group respectively, 18 cases in A3 group. Experimental groups were A1（amphotericin intrathecal injection B dose 0.2 mg）, A2（amphotericin intrathecal injection B dose 0.3 mg）and A3（amphotericin intrathecal injection B dose 0.5 mg）. A0 was control group（intravenous amphotericin B and oral fluorocytosine only, no intrathecal injection）. Clinical symptoms, cerebrospinal fluid biochemical indicators, pathogens in CSF, imaging, and adverse reactions were observed at 1, 2, and 4 weeks after treatment. Results The adverse reactions in group A1 were significantly lower than those in group A2 and A3（P < 0.001）; After 4 weeks of treatment, the positive rate of CSF ink staining in A2 and A3 groups was significantly lower than that in A1 group（ P < 0.05）; The positive rate of cerebrospinal fluid ink staining in A2 and A3 groups has no statistic significance（ P > 0.05）. MRI showed that the ratio of obvious absorption of lesions in Group A2 was significantly higher than that in group A1 and Group A3（ P < 0.05）; Comparison of the ratio of obvious absorption of lesions in A1 and A3 groups by MRI showed no statistically significant difference（ P > 0.05）. There were fewer adverse reactions in group A1, but the efficacy was not as good as that in group A2 and A3; The adverse reactions in group A2 were slightly higher than that in group A1 and lower than that in group A3, but A2 has the best efficacy. Due to the intolerance of some patients to adverse reactions, the patients in A3 group could not receive intrathecal injection every day. After treatment, the recovery of cerebrospinal fluid protein and sugar and the absorption of lesions in imaging examination were not as good as those in A2 group. Conclusion When using amphotericin B intrathecal injection in treatment of cryptococcal meningitis, if the dosage was increased quickly in order for rapid improvement, or long-term use of large dose of amphotericin B intrathecal injection, the adverse reactions instead of improvement would bring negative effect on subsequent treatment. Most patients can tolerate lower, moderate dosage of amphotericin B intrathecal injection.
2020, 41(12): 133-137.
doi: 10.12259/j.issn.2095-610X.S20201237
Abstract:
Objective To explore the significance of T-SPOT.TB test for monitoring the therapeutic effect of tuberculosis. Methods Using T-SPOT.TB kit, changes in response to ESAT-6 and CFP-10 were compared in 79 patients with active pulmonary tuberculosis before and after 2 months of treatment. Results In 79 patients with active pulmonary tuberculosis, The spot number of ESAT-6 and CFP-10 responses decreased significantly at the end of 2 months and at the end of treatment compared with the beginning of treatment, and the difference was statistically significant（P < 0.05）. The negative rates of ESAT-6 and CFP-10 at the end of 2 months and at the end of treatment were higher than those at the beginning of treatment, but there was no significant difference between them（ P > 0.05）. The T-SPOT.TB negative conversion rate of all patients was 3.8%.There was a statistical difference in ESAT-6 response between the end of 2 months and the end of treatment（ χ2 = 4.635, P = 0.031 < 0.05）.There was no significant difference in CFP-10 response at the end of treatment 2 and at the end of treatment（ χ2 = 1.272, P = 0.259 > 0.05）. Conclusion There were significant differences in ESAT-6 and CFP-10 of T-SPOT.TB responses before and after treatment. T-SPOT has a certain significance in evaluating of the therapeutic effect of tuberculosis, but its negative conversion ration can not be used as the indicator of ending the TB treatment.
2020, 41(12): 160-163.
doi: 10.12259/j.issn.2095-610X.S20201243
Abstract:
Objective To explore the efficacy of case-based teaching in medical genetics course. Method The whole class majoring Pediatrics in 2018 batch was the experimental class, and the clinical medicine students in 2018 batch are the control class. Case-teaching was carried out in experimental class and traditional classroom teaching was carried out in control class. Evaluation of the teaching effect was conducted through the examination result analysis and the questionnaire survey. Results The final exam scores of experimental class was significantly higher than that of control class（P < 0.0001 ）. The questionnaire survey results showed that the majority of students were satisfied with the effect of case-teaching. 93.04% respondents thought it helped them to understand and apply knowledge about genetic diseas flexibly, 93.04% respondents thought their problem-solving skill were improved; 95.65% respondents thought their reasoning ability improved; 94.78% respondents reported they were more motivated in learning. Conclusion Case-based teaching is suitable for medical genetics course; it improves the teaching efficacy and outcomes.
2020, 41(12): 1-5.
doi: 10.12259/j.issn.2095-610X.S20201204
Abstract:
Objective To establish a good, reliable, and stable radiation-induced heart disease （RIHD）model, and to determine the miRNA-21 expression trend in plasma. Methods 27 adult male healthy New Zealand rabbits were randomly divided into control group （3） and irradiation group （24）. After anesthetized with 3% pentobarbital sodium （a dose of 0.8-1.0 ml/kg）, the rabbits were scanned by CT to determine target area by sketch the front wall of the left ventricle for the irradiation. Linear accelerator （Elekta Precise）, 6 MV high-energy X-ray, 5 Gy/F, 2 F/W irradiation, every 3 days until the total dose is 30 Gy. Rabbits in the control group were given sham irradiation after anesthesia. At 6, 24, 72 hours and 1, 2, 4, 8, and 24 weeks after irradiation, plasma was collected from the marginal ear vein to detect the expression of miRNA-21 by RT-PCR, and the heart tissue was collected to examine heart damage by HE staining. Results The inflammatory cells infiltrated between myocardial fibers after irradiation were mainly mononuclear cells. The edema of myocardial cells was obvious and the arrangement was disordered. The nucleus of myocardial cells was slightly contracted and the staining darkened. A few heterotypic nuclei were present, which was consistent with cardiac injury model lesions. miR-21 detection by RT-PCR was elevated and statistically significant at each time point compared with the control group （P < 0.05）. With the irradiation time course at 6 h, 24 h, 72 h, 1 w, 2 w, and 4 w, respectively, miR-21 expression continued to increase gradually and reached the peak expression at 4 w; miR-21 expression decreased in 8 w and 24 w indicates expression was reducing with irradiation time （ P < 0.05）. Conclusion Multiple doses and large doses of irradiation can build a good, reliable, and stable RIHD ladder model, which can better simulate the evolution of the occurrence and development of RIHD. Detection of miR-21 expression in plasma can initially predict the progression of RIHD fibrosis.
2020, 41(12): 6-10.
doi: 10.12259/j.issn.2095-610X.S20201207
Abstract:
Objective To characterize the difference of body mass and body composition among women in pre-pregnancy period and different pregnant stages in Longyang District, Baoshan city. Methods The body composition of 10 913 pregnant women were measured by multi-frequency biological resistance method. The subjects were divided into three groups based on gestational age: the early gestational group （5616 cases）, the mid gestational group （4396 cases）and the late gestational group （901 cases）; according to the Chinese BMI reference standard, based on the pre-pregnancy body mass index the subjects were divided into thin group （2490 cases）, normal weight group （6399 cases）, overweight group （1507 cases）and obesity group （517 cases）. According to whether or not the subject is in the primary reproductive age, subjects were divided into 4 groups: < 23 years old （3757 cases）, 23～28 years old （4803 cases）, 29～34 years old （1830 cases）and ≥35 years old （523 cases）. Body composition data were collected and compared between each group. Results The body composition of the three groups in early, middle and late pregnancy was statistically significant （P < 0.05）. There were statistically significant differences in basal metabolic rate, total water, intracellular fluid, body fat percentage, fat weight, lean body weight and muscle weight in the groups with normal weight group, thin group, overweight group and obesity group （ P < 0.05）, all of which increased with the increase of body weight. Among the four age groups, the differences in intracellular fluid, percentage of body fat and fat weight were statistically significant （ P < 0.05）and increased with the increase of pregnancy age. Conclusion The nutritional status of pregnant women was evaluated according to the changes of body composition during pregnancy, and reasonable nutrition guidance was given to provide clinical and epidemiological basis for reducing the incidence of pregnancy complications and adverse pregnancy outcomes.
2020, 41(12): 11-17.
doi: 10.12259/j.issn.2095-610X.S20201208
Abstract:
Objective To investigate the incidence and related influencing factors of neck pain in medical students, as well as the symptoms of neck pain and their impact on daily life. Methods A self-designed questionnaire was used to survey medical students at Kunming Medical University from September 2018 to October 2019. A random sampling survey was used to select 850 medical students for survey（836 valid questionnaires）, including general conditions, neck pain related conditions and their impact on daily life, and analyse related factors of neck pain. Results In the 12-month survey, 658 out of 836 medical students reported they have had neck pains（78.71%）, the rest 178 reported they did not have neck pains（21.29%）. The occurrence of neck pain was correlated with the time of using mobile phones, the time of reading and writing at the desk every day, backpack habits, psychological status, and whether they did daily neck exercises（P < 0.05）. Multivariate logistic regression analysis showed that the likelihood of neck pain increased by 1.392 times with each increase in daily cell phone use（OR = 1.392）; those respondents who did not do regular neck exercise were 1.183-fold more likely to have neck pain than those who did regular neck exercise（OR = 1.943）. The overwhelming majority of medical students with cervical pain were assessed as mildly dysfunctional by cervical spine dysfunction index NDI. Conclusion Medical students have a high incidence of neck pain, which is caused by many factors, including the time they use mobile phones every day, the time they read and write at the desk, backpack habits, psychological status, and daily neck exercise. Regular neck exercise can reduce the incidence of neck pain. It is recommended that medical students take regular neck exercise. The impact on daily life are mild among those students with neck pain.
2020, 41(12): 18-22.
doi: 10.12259/j.issn.2095-610X.S20201210
Abstract:
Objective To compare the effect of retrieving foreign bodies for the self-made foreign body retrieval device and the traditional foreign body retrieval device in simulated human blood vessels. Methods Under the simulated general anesthesia, the models were made by placing waste guidewires, waste catheters, waste stents and waste coilings as the foreign bodies in simulated human blood vessels through the guiding catheter. The foreign bodies in the simulated human blood vessels were retrieved by using the self-made foreign body retrieval device and the traditional foreign body retrieval device, which were recorded as the self-made retrieval device group and the traditional retrieval device group. The foreign bodies of each group were retrieved 80 times respectively, and one-time success rate of foreign bodies retrieval, three-time success rate of foreign bodies retrieval, overall success rate of foreign bodies retrieval and average time for retrieving each foreign body were compared between these two groups. Results The self-made retrieval device group had higher one-time success rate, three-time success rate and overall success rate of foreign bodies retrieval than the traditional retrieval device group （96.25% VS 87.50%） （χ2 = 4.103, P = 0.043）. The difference was statistically significant （P < 0.05）. The self-made retrieval device group had shorter average time for retrieving foreign body than the traditional retrieval device group （7.42±1.68）min VS （13.21±5.25）min,（t = 9.192, P = 0.000）. Conclusion Compared with the traditional retrieval device group, The self-made retrieval device group can retrieve intravascular foreign bodies in simulated human more effectively, with higher success rate and shorter operation time.
2020, 41(12): 23-28.
doi: 10.12259/j.issn.2095-610X.S20201211
Abstract:
Objective To explore the clinical features of interstitial pneumonia （IPAF） patients with autoimmune characteristics, and to compare the clinical difference between IPAF and non-IPAF-IIP （idiopathic interstitial pneumonia） and IPF （idiopathic pulmonary fibrosis）. Methods Patients （n = 130） diagnosed with IIP consecutively in Department of Respiratory Medicine and Department of Rheumatology and Immunology of the Second Affiliated Hospital of Kunming Medical University from January 2014 to December 2019 were included, including 66 cases of IPAF, 64 cases of IIP that could not be diagnosed as IPAF （non-IPAF-IIP）; and in the non-IPAF-IIP group, 42 patients in the IPF group were found to meet the IPF diagnosis. The demographics, clinical symptoms and signs, lab results and other clinical data of the patients were collected, and statistical analysis was conducted on the data of different indicators in each group to differentiate their characteristics. Results Among 130 IIP patients, 66 （50.8%） were reclassified as IPAF, and 42 （32.3%） were reclassified as IPF among non-IPAF-IIP （64 （49.2%））. IPAF diagnosis is mainly based on criteria in morphology and serology. Inflammatory arthritis or multi-joint morning stiffness ≥60 min, ANA and NSIP were the main manifestations in the three fields. Compared with non-IPAF-IIP and IPF, IPAF is more commonly seen in non-smoking female patients, with higher hormone using rate and higher DLCO, FVC and lower pulmonary artery pressure. The clinical manifestations of the three groups are similar, making it difficult to differentiate. Female, multiple chest lesions and clinical signs may be helpful for differential diagnosis. There is no significant difference in survival rate among the three groups （P > 0.05）, but the median survival time of IPAF is higher than non-IPAF-IIP and IPF. Conclusion （1） IPAF diagnosis is mainly based on criteria in morphology and serology; （2） NSIP is the main type of HRCT, and ANA is the main serological type; （3） The hormone using rate of IPAF was significantly higher than non-IPAF-IIP and IPF.
2020, 41(12): 29-35.
doi: 10.12259/j.issn.2095-610X.S20201212
Abstract:
Objective To evaluate the incidence and risk factors for anxiety and/or depression in patients with chronic obstructive pulmonary disease（COPD）, and to explore the correlation between the anxiety depression symptoms and CAT score of patients with COPD; to provide scientific evidence for the negative emotion intervention of COPD patients in the future. Methods A total of 313 patients with COPD were enrolled in this study from the Second People's Hospital of Jinning District and the First Hospital of Kunming from July 2019 - October 2019. We used the Hospital Anxiety and Depression Scale（HADS）and COPD Assessment Test（CAT）to conduct the questionnaire survey and collect data of the patients, and then use SPSS 24.0 for analysis. Results Among the 312 patients, COPD patients with anxiety accounted for 49.2%（154 cases）, COPD with depression accounted for 37.2%（116 cases）, COPD with both anxiety and depression accounted for 22.8%（71 cases）. COPD patients with anxiety were associated with paying method of medical expenditure, hospitalization frequency, complications and CAT score（P < 0.05）, and patients with depression were associated with hospitalization frequency and CAT score（ P < 0.05）. CAT score and anxiety depression symptoms are interrelated. Conclusion The prevalence of COPD complicated with anxiety and depression is high. And frequent hospitalization and CAT scores are the high risk factors. The degree of anxiety and depression was positively correlated with the severity of the patient's condition.
2020, 41(12): 36-41.
doi: 10.12259/j.issn.2095-610X.S20201213
Abstract:
Objective To analyze the composition and diversity of intestinal microflora in patients with coronary heart disease in Yunnan, and to explore the differences of intestinal microflora among different types of coronary heart disease and those without coronary artery disease. Methods 67 patients with acute myocardial infarction（group A）, 91 patients with unstable angina（group B）, 47 patients with stable angina（group C）, 64 patients without abnormal coronary arteries（group D）and 37 patients with coronary atherosclerosis（group E）were enrolled. Faeces sample DNA was extracted. Specific primers were designed according to 16SrRNA v3-v4 sequence of bacteria, PCR amplification was carried out, and sequenced with Illumina hiseq PE250. The sequencing results were analyzed by species composition statistics, Alpha diversity, intergroup difference analysis, and finally get the species information of the faeces sample. Results There were differences in the composition of intestinal flora among groups（P < 0.05）. Compared with group D, there were more Clostridium in group A, less Bacteroides, more Proteus and actinomycetes in group B, less Bacteroides, more Proteus and Clostridium in group C, and more Proteus in group E（ P < 0.05）. The alpha diversity of AMI patients was higher than that of other groups（ P < 0.05）. Conclusion The composition, diversity and abundance of intestinal flora in coronary atherosclerotic group, stable angina group, unstable angina group, acute myocardial infarction group and control group were different in Yunnan, and they had intestinal flora disorder at various degrees.
2020, 41(12): 42-48.
doi: 10.12259/j.issn.2095-610X.S20201214
Abstract:
Objective To screen differentially expressed lncRNAs in invasive pituitary adenomas by second-generation sequencing, and to explore their potential role in the pathogenesis of invasive pituitary adenomas. Methods The expressions of lncRNA and mRNA in 4 patients with invasive pituitary adenoma and 3 patients with non-invasive pituitary adenoma were analyzed by RNA sequencing to single out the differentially expressed lncRNA and mRNA. Accordingly, lncrNA-mRNA co-expression networks were constructed and GO and KEGG pathways were analyzed. Results A total of 35 differentially expressed lncRNAs and 463 differentially expressed mRNAs were obtained by analyzing the differentially expressed lncRNAs and mRNAs in both invasive and non-invasive pituitary tumors. The co-expression network showed that FAM66A, TPTEP1, AC017116.11, RP11-1114A5.4 and RP11-246K15.1 were in a key position in the network. Conclusion Through the establishment of co-expression network of lncRNA-mRNA, we found that some new lncRNA may play a key role in the pathogenesis of invasive pituitary adenomas and may be used as novel biomarkers of invasive pituitary adenomas.
2020, 41(12): 49-54.
doi: 10.12259/j.issn.2095-610X.S20201216
Abstract:
Objective To investigate the expression of serum H-FABP, platelet activating factor （PAF） and ischemia-modified albumin （IMA） in patients with coronary heart disease and its clinical implications. Methods 168 patients who reported chest pain and underwent coronary angiography in Qingdao 8th People's Hospital from April 2017 to October 2019 were enrolled as subjects. Based on the results of coronary angiography, subjects were divided into control group （n = 30）, SAP group （n = 55）, UAP group （n = 51） and AIM group （n = 32）. Serum H-FABP, PAF and IMA levels in each group were compared. Influencing factors of coronary heart disease were analyzed by multivariate logistic regression. The correlation between GRACE score and serum H-FABP, PAF and IMA levels was analyzed by Pearson method. The receiver operating Characteristic curve （ROC） was used to analyze the diagnostic value of each indicator for coronary heart disease. Results GRACE score and serum H-FABP, PAF and IMA levels were the highest in AMI group, followed by UAP group, SAP group, and control group （P < 0.05）. GRACE scores and serum H-FABP, PAF, and IMA levels were independent risk factors for coronary heart disease （ OR = 1.993, 2.325, 1.741, and 2.208, P < 0.05）. GRACE score was positively correlated with serum H-FABP, PAF and IMA levels （ r = 0.9023, 0.8967 and 0.9364, P < 0.05）. In diagnosing coronary heart disease, the diagnostic value of serum H-FABP, PAF and IMA combined was significantly higher than that of each indicator alone. Conclusion Elevated serum H-FABP, PAF and IMA levels are major risk factors for coronary heart disease, and serum H-FABP, PAF and IMA levels are positively correlated with GRACE scores. Detection of serum H-FABP, PAF and IMA combined are of value in the clinical diagnosis of coronary heart disease.
2020, 41(12): 55-59.
doi: 10.12259/j.issn.2095-610X.S20201217
Abstract:
Objective To evaluate the diagnostic efficacy of alveolar lavage fluid（1, 3）-beta-D-glucan（G）test and galactomannan（GM）test in early diagnosis of acute exacerbations of chronic obstructive pulmonary disease（AECOPD）complicated with invasive pulmonary fungal infection（IPFI）. Methods A total of 26 AECOPD patients with pulmonary fungal infection admitted to the Department of Emergency and Intensive Care Medicine, the Second Affiliated Hospital of Kunming Medical University from October 2018 to October 2019 were randomly selected as the experimental group, and another 26 AECOPD patients admitted in the same period only with bacterial infection were selected as the control group. The serum and BALF G and GM test results of the two groups, as well as the diagnostic efficacy of G and GM tests were analyzed. Results In the observation group, 22 cases were alveolar lavage fluid G test positive, 18 cases were GM test positive; 20 cases were serum G test positive, 16 cases were serum GM test positive; 23 cases were positive for G combined with GM test in alveolar lavage fluid, and 22 cases were positive for serum G combined GM test. The sensitivity, specificity, positive predictive value, negative predictive value, false positive rate and false negative rate of alveolar lavage fluid G test combined with GM test were 88.5%、92.3%、93.5%、93.2%、7.7%和11.5%, respectively, P < 0.05. Conclusion G and GM test in alveolar lavage fluid has a high diagnostic efficacy in the early diagnosis of AECOPD complicated with invasive pulmonary fungal infection, with G and GM test in alveolar lavage fluid better than G and GM test in serum.
2020, 41(12): 68-72.
doi: 10.12259/j.issn.2095-610X.S20201219
Abstract:
Objective To explore the potential of HPV16E6 and IDO as a tumor markers of cervical cancer, the expression of high-risk HPV-infected normal cervical tissue, cervical precancerous lesions, cervical cancer tissue HPV16E6 and IDO, the correlation between HPV16E6 and IDO in the progression of cervical lesions were analyzed. Methods 120 cases of cervical lesions with high-risk HPV infection detected by HPV DNA in the second generation hybrid capture（HC-2）method were used as experimental subjects, 40 cases each in normal cervical tissue group, cervical precancerous lesions group and cervical cancer tissues group, respectively. The expression of HPV16E6 and IDO in each tissue group was detected by immunohistochemical staining. Results The expression rates of HPV16E6 and IDO in 40 cases of normal cervical tissues were 7.5% and 0%, respectively. The expression rates of HPV16E6 and IDO in 40 cases of cervical precancerous lesions were 37.5% and 22.5%, respectively. The positive expression rates of HPV16E6 and IDO in 40 cases of cervical cancer tissues were 90% and 80%, respectively. The positive expression of HPV16E6 and IDO was positively correlated in the progression of cervical lesions（rs = 0.710, P = 0.000）. Conclusion The expression of HPV16E6 and IDO showed a positive trend with the progress of cervical lesions. HPV16E6 and IDO have the potential of tumor markers for predicting the progression cervical lesions.
2020, 41(12): 73-79.
doi: 10.12259/j.issn.2095-610X.S20201222
Abstract:
Objective By investigating the influence of chronic pruritus patients' lifestyle and behavior on skin physiological function, this paper provides basis and measures for the health management of patients with pruritus. Methods Lifestyle and behavior of patients with chronic pruritus were investigated, including five common factors: alcohol consumption, smoking, water intake, diet, dietary Balance Index（DBI）, and exercise. The measurement of transepidermal water loss（TEWL）, capacitance（CAP）, sebum（SEB）and erythema index of skin lesions were completed to evaluate the pruritus degree of the patients, and correlation between the lifestyle and behavior patterns of the patients and their skin physiology were analyzed. Results There were 91 smokers（44.4%）and 18 drinkers（8.78%）; the average daily water intake was（1211.90 ± 520.28）ml, which was significantly lower than the health standard（P < 0.05）. the lower bound score（DBI-LBS）was significantly higher than the higher bound scores（DBI-HBS）, and the dietary quality was significantly deviated from the standard value（ P < 0.05）. 196 patients（95.6%）did not get enough exercise. Smoking could increase the degree of pruritus, while lifestyle was correlated with skin physiological function indexes（ P < 0.05）. Dietary structure and quality have complex effects on diseases. Conclusion The lifestyle of pruritus patients deviates from the health standards, despite the lifestyle also affects the physiological function of the skin. Therefore, in the management of pruritus patients, individualized guidance, intervention and management of life behavior, should be identified as important measures of pruritus prevention and treatment.
2020, 41(12): 85-88.
doi: 10.12259/j.issn.2095-610X.S20201224
Abstract:
Objective To observe the effect of dexmedetomidine on respiration in postoperative patients undergone general anesthesia at high altitude areas. Methods 60 patients who received laparoscopic cholecystectomy under tracheal general anesthesia, and all the patients had been living in high altitude area (altitude: 2000 m～3000 m) for at least one year. The patients were randomly assigned into two groups. The dexmedetomidine group received a 10-minute- infusion of dexmedetomidine 0.6 μg/kg, while the control group was given a volume-matched normal saline in same dose. After operation, the tracheal tube was removed and then oxygen 3 L/min was given. A rapid arterial blood gas examination was performed one hour after operation. At the time points of 1 hour, 3 hours, 6 hours and 12 hours after operation, we examined the blood oxygen saturation and the respiratory rate, and recorded the number of patients with hypoxemia in both groups (Hypoxemia was considered to be present when blood oxygen saturation was ≤ 85%). Results The oxygen partial pressure at each postoperative point in both groups was higher than that before surgery (P < 0.05), and there was no statistically significant difference in oxygen partial pressure at each postoperative point in the two groups ( P > 0.05). Oxygen saturation at each time point after operation in both groups was higher than that before operation ( P < 0.05), and oxygen saturation at 3 h after operation in the dexmedetomidine group was lower than that in the control group ( P < 0.05). The respiration rate of the dexmedetomidine group at 1 h, 3 h and 12 h after operation was lower than that of the control group ( P < 0.05). No oxygen saturation below 85% was found in both groups after operation. Conclusion The administration of dexmedetomidine to patients under tracheal general anesthesia at high altitude areas will reduce the number of breaths and blood oxygen saturation at some time points, but it will not reduce the partial pressure of oxygen at 1 min after surgery, and will not cause postoperative hypoxemia.
2020, 41(12): 89-93.
doi: 10.12259/j.issn.2095-610X.S20201225
Abstract:
Objective To evaluate the condition of dry eyes in children with vernal keratoconjunctivitis in spring, and to explore the clinical characteristics as well as correlation with the severity of the disease. Method 65 children who were diagnosed with VKC in outpatient department from January to June in 2015 were recruited as the observation group. The control group consisted of 65 normal children matched in age and sex. Dry eye questionnaire, slit-lamp examination, break-up time test（BUT）, fluorescein staining（FL）and Lid-wiper staining of Lid-wiper epitheliopathy（LWE）were performed in both groups. Statistical analyses were used to assessing these data. Results （1）The dry eye symptom scores of children with vernal keratoconjunctivitis in spring were significantly higher than those of normal children（Z = -8.589 P < 0.01）. Photophobia（23.59%）, foreign body sensation（18.08%）, frequent blinking（14.49%）and uncomfortable in windy conditions（20.90%）are the most common symptoms in VKC children.（2）The score of slit-lamp examination in VKC children was significantly higher than that in the normal group（Z = -9.902, P < 0.01）.（3）The BUT was significantly shorter in VKC children（7.06±3.51）than in normal children（13.34±4.82）（Z = -6.729 P < 0.01）. FL score（1.82±1.69）was significantly higher than that of normal children（0.23±0.46）（Z = -6.355 P < 0.01）. The score of LWE（1.03±1.00）was significantly higher than that of normal children（0.31±0.50）（Z = -4.463 P < 0.01）.（4）For VKC children, the severity of dry eye symptoms is correlated with slit-lamp checking scores（ r = 0.259 P < 0.05）; FL scores are also correlated with slit-lamp checking scores（r = 0.269 P < 0.05）; these children's BUT scores are correlated with FL（ r = -0.283 P < 0.05）and LWE（ r = -0.252 P < 0.05）scores; FL scores are correlated with LWE scores（ r = 0.307 P < 0.05）. Conclusion Dry eyes do exist in VKC children. The severity of dry eye is correlated with the severity of VKC inflammation. This study provides a basis for further study on pathophysiology of dry eye in VKC children, as well as a reason for the use of artificial tears in acute stage of VKC.
2020, 41(12): 94-98.
doi: 10.12259/j.issn.2095-610X.S20201226
Abstract:
Objective Based on the fact that Yunnan is a remote and bordering area with multiple ethnic minorities, Wechsler intelligence Scale and Raven standard Reasoning test were used to compare the difference of cognitive function in patients with different degrees of depression. Methods The cognitive function of 100 ICD-10 patients with depression （at admission and 6 weeks after admission） and 100 healthy individuals admitted to Yunnan Psychiatric Hospital from August 2019 to December 2019 were assessed using Raven Standard Reasoning Test and Wechsler Adult Intelligence Scale. Seventeen items of the Hamilton Depression Scale were used to assess the severity of depression （at the time of admission and 6 weeks after admission）, and the patients were divided into 3 groups: severe, modest and mild groups. The data were analyzed by SPSS17.0 statistical software package. Results （1） In normal group, there was no significant difference between RIQ and FIQ （P > 0.05）. In the depression group, FIQ was significantly higher than RIQ both at admission and 6 weeks after admission of antidepressant treatment （ P < 0.05）. （2） The results of RIQ, VIQ, PIQ and FIQ at 6 weeks of admission between control group, depression group and the normal control group were as follows: The depression group had the lowest score at admission, followed by the 6-weeks after treatment, and the normal control group had the highest score （ P < 0.05）. （3） The comparison results of RIQ, VIQ, PIQ and FIQ between the depression group admitted to hospital and the depression group at 6 weeks were: severe depression was the lowest, followed by moderate depression, and mild depression was the highest （ P < 0.05）. Conclusion （1） There was no significant difference between Wechsler's IQ and Raven's IQ in the normal group; however, in the depression group, Wechsler's IQ was significantly higher than Ravin's IQ, and Ravin's IQ was related to performance IQ, so the impairment of performance IQ was more obvious in depression patients. （2） The cognitive function of patients with depression was impaired. After antidepressant treatment, the cognitive function was improved, but still could not reach the normal level. （3） As the degree of depression increases, the severity of cognitive impairment also increase, both at the time of admission and six weeks after treatment,
2020, 41(12): 104-107.
doi: 10.12259/j.issn.2095-610X.S20201228
Abstract:
Objective To analyze the efficacy of deside cream combined with compound polymyxin B ointment in the treatment of moderate-severe atopic dermatitis in children. Methods A total of 82 children with severe atopic dermatitis in the dermatology department of Kunming Children's Hospital from January 2019 to March 2020 were selected and divided into control group（41 cases）and experimental group（41 cases）randomly. Deside cream was administered in control group, while deside combined with compound polymyxin B ointment were administer in experimental group. The disappearance time of dry skin, itching, eczema like rash, EASI level, eosinophil level, total effective rate and adverse reactions of children before and after treatment were compared between the two groups. Results The disappearance time of dry skin, itching and eczema-like rash in the experimental group was shorter than that in the control group（P < 0.05）. After treatment, EASI level and eosinophil level were lower than those of the control group（ P < 0.05）. The total effective rate of the experimental group was higher than that of the control group（ P < 0.05）. There was no difference in adverse reactions between the two groups（ P > 0.05）. Conclusion Deside cream combined with compound polymyxin B ointment is effective in treating moderate-severe atopic dermatitis in children. It can accelerate the disappearance of symptoms, improve skin lesions and hematological indicators, with fewer adverse reactions and high safety.
2020, 41(12): 108-111.
doi: 10.12259/j.issn.2095-610X.S20201229
Abstract:
Objective To explore the neutrophil elastase（neutrophil elastase, NE）, total antioxidant capacity（total antioxidative capability, T - AOC）in chronic obstructive pulmonary disease（chronic obstructive pulmonary diseases, COPD）high-resolution CT（high-resolution computed tomography, HRCT）in different HRCT phenotypes. Methods HRCT was used for typing 78 patients with out-patient COPD into phenotype A, phenotype M and phenotype E; NE and T-AOC of the three groups of patients were tested. Results The serum NE concentration of phenotype M in COPD patients was higher than that of control group, phenotype A and phenotype E（P < 0.05）. The serum NE concentration of phenotype E was higher than that of control group and phenotype A（ P < 0.05）. There was no significant difference in T-AOC between the three groups and the control group（ P > 0.05）. The NE in serum was negatively correlated with FEV1 and FEV1% pred.（ P < 0.05）, and positively correlated with CAT score（ P < 0.05）. Conclusion The expression of NE in COPD patients with different HRCT phenotypes is up-regulated and correlated with lung function indicators, and NE may be involved in airway inflammation and airway remodeling in COPD and cause airflow obstruction.
2020, 41(12): 119-122.
doi: 10.12259/j.issn.2095-610X.S20201233
Abstract:
Objective To investigate the molecular epidemiological characteristics of human rhinovirus (HRV) infection in hospitalized children with acute lower respiratory tract infection (ALRTI) in Kunming. Methods A total of 2260 children with ALRTI who were hospitalized in Kunming children's Hospital from January 2019 to December 2019 were selected. HRV was detected by reverse transcription polymerase chain reaction (RT-PCR) in nasopharyngeal aspirates or sputum. 40 HRV positive samples were randomly selected to amplify VP4 / VP2 gene fragment, and the amplified products were sequenced and their types were identified. Results The positive rate of HRV was 6.50% (147 / 2260). There was no significant difference in HRV positive rate among different age groups (χ2 = 3.240, P = 0.356). The positive rate of HRV in children with ALRTI was significantly different in different seasons, the peak is in summer, followed by autumn (χ2 = 37.674, P < 0.05). Among the 40 positive samples, 23 were HRV-A, 5 were HRV-B and 12 were HRV-C. There was no significant difference in fever and cough between HRV positive and HRV negative children ( P > 0.05), but there was significant difference in wheezing ( P < 0.05). Conclusion HRV is one of the pathogens of acute lower respiratory tract infection in Kunming area. The epidemic season is summer and autumn and HRV-A is the main type. Children infected with HRV are more likely to have wheezing.
2020, 41(12): 123-127.
doi: 10.12259/j.issn.2095-610X.S20201235
Abstract:
Objective To investigate the correlation between OSA with different severity and coagulation function and sleep respiratory monitoring index by detecting the level of coagulation function in OSA patients with different severity. Methods A total of 184 patients undergoing sleep breathing monitoring in the Department of Respiratory Medicine of the Second Affiliated Hospital of Kunming Medical University from January 2018 to January 2020 were selected. According to apnea Hypopnea index（AHI）, patients were divided into 3 groups, including 50 patients in the normal control group（group A）, 45 patients in the mild OSA group（group B）, and 86 patients in the moderate-severe OSA group（group C） . The differences of coagulation function indexes and sleep respiratory monitoring indexes in the normal control group, the mild OSA group and the moderate and severe OSA group were compared, and the correlation between coagulation function indexes and AHI, LSaO2 and LAT were analyzed. Results There were no statistically significant differences in APTT, INR, PTR, FIB, TT, d-dimer, AT and FDPs between group A, B and C（P > 0.05）, no statistically significant differences in PT between group A and B（ P > 0.05）; The PT value of group C was significantly higher than that of group A and B（ P < 0.05）. Compared with group A and Group B, the AHI and LAT values of group C were significantly higher than those of group B and Group A, while those of group B were higher than those of group A. LSaO2 in group A and B was significantly different from that in group C; and FDPs of OSA group was negatively correlated with LSaO2（r = -0.157, P < 0.05）. There was no significant difference in LSaO2 between group A and group B（ P > 0.05）; In OSA group, FDPs was negatively correlated with LSaO2（R = -0.157, P < 0.05）. Conclusion PT prolonged among moderate-severe OSA patients, and FDPs is negatively correlated with LSaO2 in OSA patients, thus affecting coagulation function.
2020, 41(12): 128-132.
doi: 10.12259/j.issn.2095-610X.S20201236
Abstract:
Objective To investigate the association between the ratio of C-reactive protein to albumin（HS-CRP/Alb）and long-term prognosis in elderly patients with heart failure. Methods A total of 125 aged 65-70 patients with heart failure were enrolled as the research subjects, and retrospective cohort analysis was conducted. Subjects were divided into 2 groups based on prognosis as good prognosis group（n = 75）, and poor prognosis group（n = 50）. We compared hs CRP/propagated ratio, NYHA heart function classification, brain natriuretic peptide and blood sodium, total cholesterol, hemoglobin and other general information of the two groups; and usd multiariable COX regression and Logistic regression analysis of CRP/propagated ratio of capacity to evaluate the prognosis of patients with senile heart failure as well as the related factors affecting the ratio. Results The hs-crp/Alb ratio in the good prognosis group was significantly lower than that in the poor prognosis group（P > 0.05）. In the poor prognosis group; the hs-crp/Alb ratio of > 0.38 was an independent risk factor for poor prognosis, while ageing, high level of brain peptide, high NYHA grade of heart function, low serum sodium, low total cholesterol and low level of hemoglobin were independent risk factors for low hs-crp/Alb ratio. Conclusion C-reactive protein/albumin ratio is a good indicator of prognosis in patients with heart failure.
2020, 41(12): 138-141.
doi: 10.12259/j.issn.2095-610X.S20201238
Abstract:
Objective To analyze the difference between PCR-reverse dot hybridization drug resistance gene detection and BD960 Mycobacterium tuberculosis drug sensitivity test in identifying drug resistance of Mycobacterium tuberculosis, and to discuss its clinical efficacy. Methods The drug sensitivity of isoniazid (H), rifampicin (R), ethambutanol (E) and streptomycin (S) in sputum and lavage samples of 356 hospitalized TB patients were collected in The 3rd People's Hospital of Kunming were detected simultaneously by two testing methods. The results were compared and analyzed by correction χ2 test. Results Single drug resistance, multi-drug resistance and MDR were detected by the two testing methods. On the 99% confidence interval, the adjusted chi-square values are all P < 0.01. Conclusion The two methods have differences in the detection of three kinds of resistance. The multidrug resistance PCR-reverse dot blot hybridization method of Mycobacterium tuberculosis drug sensitivity test is better than BD960 detection. The drug sensitivity of single drug resistance and multi-drug resistance BD960 is better than PCR-reverse dot hybridization.
2020, 41(12): 142-147.
doi: 10.12259/j.issn.2095-610X.S20201240
Abstract:
Ischemia-reperfusion injury is temporary tissue ischemia caused by pathological factors or treatments. After restoring blood flow, it causes tissue damage, which can lead to related organ dysfunction. This injury is closely related to the inflammatory injury occurring in the cells in each organ. Pyroptosis is a type of programmed cell death associated with inflammation that is morphologically similar to apoptosis. In recent years, a number of studies demonstrated that the pathogenesis of ischemia-reperfusion injury may be related to pyroptosis. The activation of various inflammatory factors during pyroptosis plays a key role in this process. This paper provides a review on the association between pyroptosis and ischemia-reperfusion injury of heart, brain, liver and kidney.
Ischemia-reperfusion injury is temporary tissue ischemia caused by pathological factors or treatments. After restoring blood flow, it causes tissue damage, which can lead to related organ dysfunction. This injury is closely related to the inflammatory injury occurring in the cells in each organ. Pyroptosis is a type of programmed cell death associated with inflammation that is morphologically similar to apoptosis. In recent years, a number of studies demonstrated that the pathogenesis of ischemia-reperfusion injury may be related to pyroptosis. The activation of various inflammatory factors during pyroptosis plays a key role in this process. This paper provides a review on the association between pyroptosis and ischemia-reperfusion injury of heart, brain, liver and kidney.
2020, 41(12): 148-154.
doi: 10.12259/j.issn.2095-610X.S20201241
Abstract:
The incidence of Hashimoto Thyroiditis（HT）has been on the rise, especially in young and middle-aged women. Th1 T helper lymphocytes, cytotoxic T lymphocytes, natural killer cells（NK）, monocytes, plasma cells are the most important agents involved in this process. The etiology of Hashimoto thyroiditis is complicated, involving environmental factors, genetic factors and immune disorders, among others. In recent years, the relationship between Hashimoto thyroiditis and viral infection has attracted many researchers. Human parvovirus B19, human herpesvirus 6（HHV-6）, hepatitis C（HCV）, EB virus, herpes simplex virus（HSV）, human acquired immunodeficiency virus（HIV）and other microorganism infections may be the pathogenesis of Hashimoto thyroiditis. This article provides a comprehensive review of relationship between the Hashimoto thyroiditis and viral infection.
The incidence of Hashimoto Thyroiditis（HT）has been on the rise, especially in young and middle-aged women. Th1 T helper lymphocytes, cytotoxic T lymphocytes, natural killer cells（NK）, monocytes, plasma cells are the most important agents involved in this process. The etiology of Hashimoto thyroiditis is complicated, involving environmental factors, genetic factors and immune disorders, among others. In recent years, the relationship between Hashimoto thyroiditis and viral infection has attracted many researchers. Human parvovirus B19, human herpesvirus 6（HHV-6）, hepatitis C（HCV）, EB virus, herpes simplex virus（HSV）, human acquired immunodeficiency virus（HIV）and other microorganism infections may be the pathogenesis of Hashimoto thyroiditis. This article provides a comprehensive review of relationship between the Hashimoto thyroiditis and viral infection.
2020, 41(12): 155-159.
doi: 10.12259/j.issn.2095-610X.S20201242
Abstract:
Colorectal neuroendocrine tumors were previously considered to be very rare intestinal tumors. However, with the raising of people's awareness of physical examination and the popularity of colonoscopy, the number of cases detected has been increasing rapidly. Colorectal neuroendocrine tumors are mostly inert tumors with no special symptoms; patient is not aware of it, so these tumors are easily missed or even misdiagnosed by less experienced doctors. The treatment of this disease relies more on surgical treatment. Many new technologies have been developed in recent years, such as minimally invasive technology, bio-therapy, targeted therapy. It is the common demand of both doctors and patients to reduce the incidence of complications on the basis of improving therapeutic effect. Making the diagnosis and treatment of this disease requires more attention and research by surgeons.
Colorectal neuroendocrine tumors were previously considered to be very rare intestinal tumors. However, with the raising of people's awareness of physical examination and the popularity of colonoscopy, the number of cases detected has been increasing rapidly. Colorectal neuroendocrine tumors are mostly inert tumors with no special symptoms; patient is not aware of it, so these tumors are easily missed or even misdiagnosed by less experienced doctors. The treatment of this disease relies more on surgical treatment. Many new technologies have been developed in recent years, such as minimally invasive technology, bio-therapy, targeted therapy. It is the common demand of both doctors and patients to reduce the incidence of complications on the basis of improving therapeutic effect. Making the diagnosis and treatment of this disease requires more attention and research by surgeons.
2020, 41(12): 164-167.
doi: 10.12259/j.issn.2095-610X.S20201244
Abstract:
objective To investigate the efficacy of scenario simulation combined with PBL teaching in orthopaedic nursing teaching. Methods From March 2019 to March 2020, 120 nursing students who practiced in the orthopaedic department of The Third people's Hospital of Yunnan Province were randomly divided into experimental group （60）and control group （60）.The students in the experimental group completed the practice teaching process by using the situational simulation and PBL teaching method, while the students in the control group accepted the traditional clinical teaching method, compare the teaching satisfaction between two groups, and compare the scores of CTDI scaling,medical students communication skills and attitude scaling、theory and skill operation assessment. Result The degree of satisfaction, score of the critical thinking ability scale, the score of the communication skill attitude scale, and the score of the theory and skill operation assessment of the medical students experimental group were all better than those of the control group （P < 0.05）. Conclusion The application of situation simulation combined with PBL teaching in orthopedic nursing interns is worth replicating in clinical teaching.
Family Burden in Elderly Hip Fracture Patients with Cognitive Impairment and Its Influencing Factors
2020, 41(12): 168-172.
doi: 10.12259/j.issn.2095-610X.S20201246
Abstract:
Objective To explore the burden status and influencing factors of family caregivers in elderly patients with hip fracture and cognitive impairment. Methods Using the convenient sampling method and Zarit Caregiver Burden Scale to investigate the family caregivers of the elderly hip fracture patients with cognitive impairment admitted to the orthopaedic department of a tertiary hospital in Chengdu, Sichuan Province. Results The family caregivers' care burden score of elderly hip fracture patients with cognitive impairment was（39.65±13.89）. The results of multiple stepwise regression analysis showed that the main influencing factors of care burden were whether the caregivers had chronic diseases and Barthel index（R2 Conclusion More than 59.9% of the elderly patients with hip fracture and cognitive impairment are in the middle or above level of family caregiver burden. The caregiver's own chronic disease and Barthel Index（BI）of the caregiver are the influencing factors of caregiver burden level. Therefore, medical staff should not only pay attention to the elderly hip fracture patients with cognitive impairment, but also understand the burden level and influencing factors of caregivers, and take personalized nursing measures to decrease the burden level of caregivers, in order to further improve the function of family care and the quality of their life.
2020, 41(12): 173-178.
doi: 10.12259/j.issn.2095-610X.S20201248
Abstract:
Objective To explore the effect of bedtime music therapy on breast cancer patients' sleep quality and cancer-induced fatigue during radiotherapy. Methods Eighty breast cancer patients in a radiotherapy department of a tertiary hospital in Kunming were divided into an intervention group（n = 40）and a control group（n = 40）by random control grouping. Both groups of patients were given routine radiotherapy department nursing care; the patients in the intervention group received music therapy before bed during radiotherapy and within 3 months after discharge. The fatigue and sleep quality of the two groups were evaluated by Piper Fatigue revised scale and Pittsburgh sleep quality index; data collection were conducted before the intervention, at the time of discharge and 3 months after discharge. Results The Piper fatigue scale of the control group was significantly higher than the intervention group in behavior/severity, emotion, feeling, cognition/emotion scores and total scores（P < 0.05）at discharge and 3 months after discharge; Pittsburgh sleep quality scores of control group patients, except for the use of hypnotic drugs, subjective sleep quality, time to fall asleep, sleep time, sleep efficiency, sleep disorders, daytime dysfunction components scores and total PSQI scores were significantly higher than In the intervention group（ P < 0.05）. Conclusion Music therapy before going to bed is of positive significance in improving sleep quality and fatigue in breast cancer patients undergoing radiotherapy.
