2016 Vol. 37, No. 07

Characteristic of Liver Injury Induced by Simvastatin Combined with HRZ in SD Rats
Li Sheng Hao
2016, 37(07)
Abstract(2062) PDF(120)
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[Abstract]Objective To study the characteristics of liver injury induced by simvastatin combined with HRZ ( Isoniazid, Rifampicin and Pyrazinamide ) in SD rats. Methods Fifty-four 8-week-old SD rats were randomly divided into 3 groups: group A( control ), group B ( HRZ ) and group C ( simvastatin combined to HRZ ), half of each group were male. We calculated the accurate dose respectively before those rats were given intragastrical administration of corresponding drugs. Six rats were killed in each group on 10th , 20th and 40th day, respectively. Before this, blood was fastened from femoral of every rat that would be killed to test liver function, liver tissue slices were made in order to observe the pathological characteristic. Results Alanine amiotransferase of group C elevated in line with time and reached statistic difference on 40th day, furthermore, it was significantly higher than group A( P<0.05). Total bilirubin and direct Bilirubin of group C were significantly higher than those of group A from the beginning to the end(P<0.05), however, they declined rapidly on 10th day, this trend also had statistic difference(P<0.05). At the end of this experiment, hepatic cords was disordered slightly,but swelling liver cells and vacuolar degeneration were observed, the nuleus of cell condensed. Soakage of monocytes, neutrophils, and lymphocytes occurred in the portal and lobule regions,or even spotty necrosis occasionally. Conclusion Cholestasis occurs at the early stage when simvastatin is combined with HRZ in SD rats,however,it has a rapidly degressive trend. In contrast,Alanine amiotransferase elevates,furthermore,pathological injury or even spotty necrosis can emerge in liver tissue slices.
Changes and Mechanisms of Immunodepression after Ischemic Stroke in Mice
Xie Shu 姮
2016, 37(07)
Abstract(2975) PDF(137)
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[Abstract]Objective To investigate the changes and mechanisms of immune function after ischemic stroke by studying the reaction of C57BL/6mice's lung and spleen after ischemic stroke. Methods Sixteen mice C57BL/6 were randomly assigned to experiment group(n=8) and control group(n=8). The acute ischemic stroke model was established in experiment group by Middle Cerebral Artery Occlusion(MCAO)and no stroke was performed in control group. Then we observed the lung inflammation by HE staining of the lung. And we measured the spleen weight,spleen weight index,the count and the apoptosis index of spleen cells of mice in two groups. Results Compared with the control group,the count of the inflammatory cells in lung of mice in the experiment group was higher,the spleen weight,spleen weight index and spleen cells count of the experiment group were decreased and the apoptosis index of spleen cells of the experiment group was higher. Conclusion The mice in the experiment group have inflammatory reaction in lung, the spleen atrophied and the apoptosis index of spleen cells is increased, which suggest that stroke-induced apoptosis of immunocytes may cause immunodepression after ischemic stroke and easily lead to the infection.
The Research of Quality of Life in Higher Medical College Freshman
Gao Jia Le
2016, 37(07)
Abstract(3564) PDF(86)
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[Abstract]Objective To understand the life quality status of freshmen in higher medical colleges, and discuss the factors influencing the quality of life, in order to improve their life quality,and put forward the countermeasures and suggestions. Methods We randomly selected a higher medical colleges and universities in Yunnan, the grade one students were investigated with SF-36 scale investigation,the data were analyzed by t test and multiple linear regression analysis. Results The quality of life scores(PCS,MCS)of freshmen in this medical college are lower than the national norm,the segmentation in the field of eight only GH is higher than the national norm, and the RP,BP,VT,RE are lower than the national norm. There are six factors into the regression equation of the quality of life: health, insomnia, life pressure, communicating with people,life rule. Conclusions The QOL of freshmen in higher medical colleges and universities is low,relevant departments should be caused to take seriously. To improve the QOL, the government,society,school,personal must make joint efforts in many ways,and take targeted measures.
Study on the Equity of Health Human Resource Allocation in Public Hospitals of Zhaotong City
Chen Ying
2016, 37(07)
Abstract(2538) PDF(88)
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[Abstract]Objective To analyze the equity of health human resource allocation in public hospitals of Zhaotong city during 2008-2012,and to provide theoretical basis for the reasonable allocation of health resources. Methods The statistical description was used to analyze the number of the medical health resource, and Gini coefficient and Theli index were used to analyze the equity of health resource allocation in public hospitals of Zhaotong city.Results The amount of medical health resource showed an increasing tendency with low speed,and gaps among different areas were still existed. From 2008 to 2012, Gini coefficients of three medical health resources including the doctors,nurses and health technicians were all under 0.3. And the fluctuant tendency of the Theli Indexes and Gini coefficients were accordant with no significant increase or decrease as a whole.The combination of differences within region and difference between regions leaded to the inequity of health human resource allocation in Zhao tong city,and within region in the contribution rate of the total Theil index was greater than the difference between regions. Conclusions The quantity of health human resource is not enough in Zhaotong. The equity fluctuation of three health resources has no significatnt change.The differences within region mainly cause the inequity of health resource allocation in public hospitals of Zhao tong city.
Expressions of Let-7 in Normal Breast Tissue and Breast Cancer Tissue
Yu Jian
2016, 37(07)
Abstract(3157) PDF(93)
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[Abstract]Objective To study the expression characteristics of Let-7 genes in breast cancer. Methods Twenty-eight patients with breast cancer were randomly selected,and their cancer tissue and adjacent normal tissue were collected. TRIzol was used to extract the total RNA and real-time quantitative PCR was used to detect the relative gene expression levels. Results The expression of precursor Let-7 in cancer tissue was(9.65±2.31),which was lower than that in normal tissue(10.05±2.81 ),P = 0.048. Precursor Let-7 had dependence relationship with the long menstruation(b = 0.816,P = 0.029). The menarche age showed a positive correlation with precursor Let-7 in normal tissue(r = 0.502,P = 0.048)and a negative correlation in cancer tissue(r = -0.484,P = 0.049). Conclusions The expression of precursor Let-7 in cancer tissue is lower than that in normal tissue. The period of menstruation is a protective factor to breast cancer.
The Clinical Application of Laparoscopic Extralevator Abdominoperineal Excision in Treatment of Low Rectal Cancer
Wen Zheng Qi
2016, 37(07)
Abstract(2702) PDF(95)
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[Abstract]Objective To investigation the clinical effect of treatment for low rectal cancer by Laparoscopic extralevator abdominoperineal excision(LELAPE). Method We retrospectively analyzed the clinical data of 42 patients with low rectal cancer who underwent LELAPE from January 2013 to January 2016.Results This 42 cases all successfully completed the operation,The mean operative time(min)was 323.78 min(185~473),and the mean intraoperative blood loss(mL)was 168.81 mL(20~800). No intestinal perforation and tumor perforation occurred during the operation,and no secondary injury occurred in the prostate, seminal vesicle gland,vagina,urethra and nerve. Circumferential resection margin (CRM)was negative in 41 cases(97.6%),positive in 1 case (2.4%),pelvic floor reconstruction in 39 cases(92.9%),and no pelvic floor reconstruction in 3 cases(7.1%). Postoperative complications: intestinal obstruction due to small bowel falling into the pelvic floor occurred in 1 case of no pelvic floor reconstruction; dysfunction of urination occurred in 1 case, delayed healing due to fat liquefaction of perineal incisionoccurred in 4 cases(9.5%),includingn 2 cases complicated with pelvic effusion and infection (who received preoperative chemoradiotherapy during the same period), the rest of the patients were healed; the time of postoperative removal of drainage tube was 10.9 days(6~20),the postoperative extubation time was 7 days (5-14), the postoperative hospitalization time was 15.2 days(6-31). Postoperative pathological staging:there was no cases of stage I, 20 cases of stage II(47.6%), 21 cases of stage III(50%), 1 case of stage IV(2.4%). The postoperative follow up time was 3-36 months, there were 3 cases of local recurrence in perineal area, local the recurrence rate was 7.1%. Conclusion LELAPE in surgical treatment of low rectal cancer can reduce the positive rate of CRM, the incidence of intraoperative secondary injury such as rectal perforation, the incidence of postoperative complications, reduce the postoperative local recurrence rate, which may improve the patient's prognosis and improve the survival rate of patients, so LELAPE in surgical treatment of low rectal cancer should be safe and feasible , and is worth further clinical application.
Application of 13 High-risk HPV infection Test Combined with Thinprep Cytologic Test on Screening Cervical Carcinoma in Dali Region, Yunnan Province
Li Zheng Jin
2016, 37(07)
Abstract(3006) PDF(104)
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[Abstract]Objective To investigate relativity between the epidemiology of HPV and cervical carcinoma in Dali region,Yunnan province,through detecting the 13 high-risk human papillomavirus infection and Thinprep cytologic test in 2153 cases. Methods Real-time PCR was used to detect the 13 high-risk HPV(16,18,31,33,35,39,45,51,52,56,58,59,68)in 2153 cases and 1604 cases were checked with Thinprep cytologic test. Results In 2153 samples, 260 cases were infected with HPV, with the positive rate of 12.08%. The highest positive rates were >60 years old(18.18%), then >20 and ≤30 years old (14.41%); there was no significant difference in the positive rate among the various age groups (P =0.384).There were 1465 negative for intraepithelial lesion ormalignancy(NILM)cases(91.33%), 86 atypical squamous cells of undetermined significance(ASC-US)and atypical squamous cells cannot exclude HSIL(ASC-H) cases(5.36%), 32 low-grade squamous intraepithelial lesion cases(LSIL) cases(2.00%), 21 high-grade squamous intraepithelial lesion cases(1.31%)through Thinprep cytologic test. The correlation coefficient is 0.893.Conclusions The infection rate of HPV in Dali region, Yunnan Province, has no significant difference among the various age groups.Application of 13 high-risk HPV infection test combined with Thinprep cytologic test could be more effective in screening cervical carcinoma.
Application of Double Contrast-enhanced Ultrasonography in the Diagnosis of Gastric Cancer
Luo Xiao Mao
2016, 37(07)
Abstract(2873) PDF(69)
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[Abstract]Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS) for the diagnosis of gastric cancer. Methods A retrospective analysis was performed to review the DCUS data of 26 patients which were diagnosed as gastric cancer by pathology in the third affiliated hospital of Kunming Medical University from October 2014 to July 2015. The analysis results were compared with postoperative pathology to get accuracy rates. Results The located accuracy, qualitative accuracy and accuracy at T phase of DUCS was 100%(26/26),100%(26/26)and 88.5% (23/26), respectively. Compared with color doppler flow imaging (CDFI),the qualitative accuracy of DUCS was much higher(P < 0.05). The accuracy of DUCS at T phase was higher than that of CDFI with no statistical significance(P > 0.05). Conclusion DUCS has an important application value in the diagnosis of gastric cancer.
Clinical Effects of Cisplatin Combined with Temozolomide and Radiotherapy in Treatment of Glioblastomas after Surgery
Lu Xi Wei
2016, 37(07)
Abstract(3503) PDF(107)
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[Abstract]Objective To investigate the clinical effect of cisplatin combined with cisplatin and radiotherapy in the treatment of glioblastomas patients receiving surgery. Methods 68 cases of glioblastomas patients with surgery were divided into control group(n=36) and treatment group(n=32). The control group was treated with temozolomide and radiotherapy;the treatment group was treated with cisplatin combined with temozolomide and radiotherapy. Short-term efficacy, adverse reactions, and survival time were documented during following up in both groups. Results The efficiency in the treatment group (87.5%) was significantly higher than that in the control group (66.67%),P<0.05. There were no significant difference of adverse reaction including bone marrow inhibition, digestive tract symptoms, and psychiatric symptoms among the two groups,P>0.05. The medium survival time of the treatment group (26.0 month) was significantly longer than that of the control group (17.5 month), P<0.05. There was no significant difference of 1-year survival rate between the treatment group (81.25%) with control group (63.89%), P>0.05; however, 2- and 3-year survival rate in treatment group (52.13%, 31.25%) were significantly higher than that in the control group(27.78%,11.11%),P<0.05. 1-year progression free survival (PFS) rate of treatment group (68.75%) was significantly higher that of control group (41.67%),P<0.05. Conclusion Cisplatin combined with temozolomide and radiotherapy can significantly improve the treatment efficiency without leading to higher rate of adverse reactions and significantly improve the 2-, 3-year survival rate as well as 1-year progression free survival(PFS)rate in patients with glioblastomas,it is worth being promoted in clinical application.
The Correlation of ACE I/D Gene Polymorphisms with the Antihypertensive Efficacy of Irbesartan Among Hypertensive Patients
Huang Hong
2016, 37(07)
Abstract(2641) PDF(127)
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[Abstract]Objective To analyze the correlationship of ACE I/D gene polymerphisms with the anti-hypertensive efficacy of irbesartan among essential hypertension(EH) patients in Yunnan han people. Methods One hundred EH patients hypertension were treated with irbesartan 150mg once daily for 4 weeks, and anti-hypertensive efficacy were monitored during the treatment. Results There was a significant difference between anti-hypertensive efficacy of irbesartan among different genotype groups, DD group>ID group>II group(P <0.05).Conclusions There is different therapy responsiveness in diffenent genotypes. ACE I/D polymorphism may be an important hereditary factor that impacts the efficacy of irbesartan.
Multi-Factor Analysis of Influencing Factors of Youth Carotid Artery Thrombosis
Deng Yue Qing
2016, 37(07)
Abstract(2795) PDF(69)
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[Abstract]Objective To research the risk factors of youth carotid artery thrombosis, to provide some basis for its clinical prevention and treatment. Methods Twenty-three patients of youth carotid artery thrombosis (experimental group),40 patients without youth carotid artery thrombosis (control group) were selected, and we collected the data including age,sex,body mass index, smoking, drinking history, hypertension, neck trauma,C reactive protein, total cholesterol, triglyceride, LDL-C, HDL-C, uric acid, syphilis antibody, HIV antibody, then we did statistical analysis. Results The basic situation of the two groups: there were statistical differences in sex and BMI(P<0.05); past medical history and personal history of patients in two groups: diabetes,high blood pressure, smoking, drinking, history of neck injury, syphilis antibody had statistical differences(P<0.05);biochemical indicators of two groups of patients: there were statistical differences in HDL and uric acid(P<0.05);multi factor analysis: risk factors were hypertension (0R=6.43), smoking (OR=4.63) and neck injury history(OR=3.13). Conclusions The risk factors of youth carotid artery thrombosis are hypertension,smoking,neck injury history, the prevention and cure of hypertension, smoking and neck injury should be strengthened,so as to reduce the incidence of carotid artery thrombosis.
Influence of 256-slice Spiral CT Perfusion Imaging on the Cerebral Blood Flow before and after Cranioplasty
Zhu Jian Ping
2016, 37(07)
Abstract(2197) PDF(78)
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[Abstract]Objective To evaluate changes in cerebral blood flow before and after cranioplasty by 256-slice Spiral CT perfusion imaging, and evaluate the effect of cranioplasty on the cerebral blood flow in patients with skull defect. Methods 256-slice spiral CT scan was performed in 20 cases with early cranioplasty surgery, CTP check time points were 1 to 2 days before and 10 to 14 days after cranioplasty surgery. We recorded the the CBF and CBV of the cortex, basal ganglia, and thalamus and other parts, MTT on rCBV, parameter values rCBF, MTT and 1TrP etc. and analyzed and compared. (RCBF, rCBV, MTT and TTP) Results The CBF of cortex after cranioplasty at injured side had statistically significant increase(P<0.05). The CBF of cortex,basic nuclei,thalamus on contrateral had no statistically significant difference. The cerebral blood flow on both sides of the basal ganglia and the thalamus was increased after surgery, but there was no significant difference between before and after surgery(P>0.05) Conclusion Cranioplasty can significantly improve the ipsilateral cortex cerebral blood flow, and CT brain perfusion can accurately assess changes in brain tissue blood flow before and after cranioplasty.
Study on the Correlation Factors for Active Vitamin D3 Intervention for Elderly Patients with Sarcopenia in Plateau Regions
Zhang Li
2016, 37(07)
Abstract(2893) PDF(110)
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[Abstract]Objective To observe the correlation between active vitamin D3 level and sarcopenia development in elderly patients in plateau regions and the changes in the correlation factors for sarcopenia under the invention of active vitamin D3 (Calcitriol, Cal ), and to observe whether Cal could improve the muscle function. Methods 90 patients were assigned to the normal control (Con) arm, and 120 patients with sarcopenia were assigned to the sarcopenia (Sar) arm to receive different oral doses of Cal as intervention (0.25 ug/d for low dose group including 60 patients and 0.25ug bid for high dose group including 60 patients). Before and after the intervention, levels of 1,25-(OH)2D3 and the inflammatory factors TNF-α,IL-6, IL-10,and hs-CRP were detected using ELISA; HOMA-IR, BMI, and ASMI were calculated; and walking speed and grip strength were measured to observe the correlation between 1,25-(OH)2D3 level and sarcopenia, the changes in these indicators from before to after intervention, and the efficacy and safety of oral Cal for sarcopenia. Results Prior to intervention, compared with the Con arm, 1,25-(OH)2D3 level, IL-10 level, ASMI, walking speed and grip strength were significantly reduced(P<0.01), and HOMA-IR, IL-6, TNF-α and hs-CRP were significantly elevated(P<0.01) in both dose groups; intervention with Cal produced significant increases in 1,25-(OH)2D3 and IL-10 levels,significantly improved walking speed and grip strength(P<0.05), significant decreases in HOMA-IR,IL-6, TNF-α,and hs-CRP(P<0.05), which were more marked with higher dose, but no significant changes in ASMI. From before to after intervention,there were no significant changes in BMI or hepatic/renal function,blood calcium,or blood phosphorus in either group. Conclusions The development of sarcopenia is associated with reduced 1,25-(OH)2D3 level. Cal can lower the inflammatory factors IL-6, TNF-α,and hs-CRP,and elevate IL-10, providing anti-inflammatory and immunoregulatory actions; improve muscle function and strength;and improve insulin resistance. BMI is irrelevant to the management of sarcopenia. Cal is safe at the oral dose up to 0.5 μg/d.
Effect of Dexmedetomidine on the Serum Concentrations of S-100β Protein and NSE in Elderly Patients Undergoing Surgery
Yang Yun Li
2016, 37(07)
Abstract(2324) PDF(71)
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[Abstract]Objective To investigate the effect of dexmedetomidine on the serum concentrations of S-100β protein and neurone specific enolase (NSE) in elderly patients undergoing surgery. Methods One hundred ASAⅡor Ⅲ patients, aged 65~75 yr with a body mass index of <25 kg/m2, scheduled for elective hip joint replacement surgery under general anesthesia, were randomly divided into 2 groups(n =50): control group (group C) and dexmedetomidine group (group D). Dexmedetomidine 0.5 μg/kg was infused intravenously over 15 min before anesthesia induction in group D and was maintained 0.4 μg/(kg·h) until 30 min before operation end, while the same volume of normal saline was infused in group C. Anesthesia was induced by iv injection of sufentanil 0.4 μg/kg and propofol 1~2 mg/kg until loss of consciousness. Tracheal intubation was facilitated with 0.6 mg/kg rocuronium bromide and the patients were mechanically ventilated. Anesthesia was maintained with sevoflurane by target controlled inhalation (TCI) (end-tidal concentration set at 1 %~3%) and sufentanil 0.2 μg/(kg·h) in both groups. BIS was maintained at 40~60 during operation.Venous blood samples were obtained for determination of serum concentrations of S-100β protein and NSE before anesthesia (baseline),operation end and at 12h after operation. Patients were sent to Intensive Care Unit when operation end. All the patients were assessed for the development of delirium by experience research staff using Confusion Assessment Method for Intensive Care Unit. The incidence of postoperative delirium within 24h after operation were recorded, and compared between the two groups. Results The serum concentrations of S-100β protein and NSE was significantly increased at T1~2 than at T0 in two groups. The total dose of each anesthetic (propofol, sevoflurane), the serum concentrations of S-100β protein and NSE, and the incidence of postoperative delirium were significantly lower in group D than in group C(P<0.05). Conclusions Dexmedetomidine can reduce the serum concentrations of S-100β protein and NSE, and can also reduce the occurrence of postoperative delirium in elderly patients undergoing hip joint replacement surgery. Dexmedetomidine can provides cerebral protection in elderly patients undergoing surgery.
Effect of Intravenous Injection of Dezocine on the Incidence of Adverse Reactions during the Operation of Cesarean Delivery
Liu Ping
2016, 37(07)
Abstract(3269) PDF(80)
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[Abstract]Objective To observe the effect of Dezocine in preventing the adverse reactions during the operation of cesarean delivery. Methods We selected 60 pregnant women in the ASA levelⅠwho were going to undergo the operation of cesarean delivery. Then we divided them into two groups in random: group A (studying group) and group B( control group), each group had 30 patients. After the fetus were delivered, the patients in group A were given intravenous injection of 1mg of dezocine, and the patients in group B were only given 1 ml saline. Then we observe the heart rate(HR),systolic blood pressure(SBP) and the degree of blood oxygen saturation (SpO2) in seven time points, and analyzed the incidence of contraction pains,chills,nausea and vomiting during the operation in both groups. The time points were when patients entered the operation room (T0), the level of anesthesia was established (T1), 5 minutes after fetus were delivered (T2), 10 minutes after fetus were delivered (T3),15 minutes after fetus were delivered (T4), 30 minutes after fetus were delivered (T5) and the end of operation (T6). Results Compared with group A, the SBP at T2, T3 and T4 were obviously higher than those in group B (P<0.05). And the HR increased at T2 to T6 in control group (P<0.05) as compared with group A. The incidence of contraction pains were milder in group A than group B (P<0.05). In group A, the incidence of chills was13.3%, and in group B, the rate was 30%.Conclusion Dezocine can prevent the adverse reactions during the operation of cesarean delivery.
Clinic Evaluation of Medical Thoracoscopy in the Diagnosis of 180 Cases of Pleural Sffusions
Yu Tao
2016, 37(07)
Abstract(2987) PDF(85)
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[Abstract] Objective To evaluate the clinical value of medical thoracoscopy in the diagnosis of exudative pleural effusions with unknown etiology.Methods We analyzed retrospectively the clinical data of 180 patients with undiagnosed pleural effusions who underwent medical thoracoscopy and appraised clinical value regarding validity,effectivity and applicability of thoracoscopy.Result In 180 cases of pleural effusion,there were 178 cases of patients with a clear diagnosis,including 87 cases of tuberculous pleurisy,28 cases of malignant tumor,malignant breast bildes mesothelioma in 2,lung cancer in 24,bile duct carcinoma in 1,cercival cancer in 1),pneumonia 58 case fo pyothorax,5 caseso of pyothorax,and 2 cases withou clear diagnosis.No check failure and terminate,the 95%CI was 5 cases of 97.78%-99.98%.Conclusions Medical thoracoscopy is a safe and effective method in the diagnosis of exudative pleural effusions with unknown aetiology .The early application of this method is very helpful for the management of the pleural diseases in suitable patients.
Levels of Interleukin-4,Interleukin-6 and Interferon-gamma in Bronchoalveolar Lavaga Fluid of Children with Refractory Mycoplasma Pneumoniae Pneumonia and the Features of Bronchoscopy
Tan Li
2016, 37(07)
Abstract(2303) PDF(105)
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[Abstract]Objective To explore the interleukin-4(IL-4), interleukin-6(IL-6), interferon-gamma(IFN-γ)levels in bronchoalveolar lavage fluid(BALF)of children with refractory mycoplasma pneumoniae pneumonia, and the features of bronchoscopy. Methods A total of 47 children with refractory mycoplasma pneumoniae pneumonia were selected as the observation group, 28 children with bronchial foreign body in GAN zhengyan were chosen as controls during the same period. ELISA method was used to detect the IL-4, IL-6, IFN-γ levels in the BALF,and compared them in these two groups. The bronchoscope features of the observation group were observed. Results The IL-4, IL-6, IFN-γ levels in the BALF of children in the observation group were(8.3±3.1)pg/mL,(62.3±18.4)pg/mL,(76.5±21.9)pg/mL, and they were significantly higher than those of the controls(3.1±1.2)pg/mL,(30.0±1.5)pg/mL,(31.3±24.9)pg/mL(P<0.05,respectively). In the observation group, the bronchial mucosa congestion and edema were observed in all patients, there were variable amounts of mucus secretions. There were other changes include: microtubule reductus(68.1%),bronchial mucosal follicle-like hyperplasia(38.3%), mucosal erosions(8.5%), airway inflammatory stenosis, mucus plug blocking(59.6%), granulation proliferation(14.9%), bronchial obliteration(4.3%). Conclusions The IL-4,IL-6,IFN-γ levels in the BALF of children with RMPP significantly increased. This indicates a significant local inflammatory response in children with RMPP. Mycoplasma pneumoniae pneumonia (MPP) has certain features of bronchoscope, these features are helpful to the diagnosis and treatment of MPP.
Effect of Depression on the Incidence of Osteoporosis in Patients with Maintenance Peritoneal Dialysis
Bai Yi Hua
2016, 37(07)
Abstract(3713) PDF(84)
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[Abstract]Objective To investigate the effect of depression on the incidence of osteoporosis in patients with maintenance peritoneal dialysis(MPD). Methods We enrolled 80 MPD patients, who underwent peritoneal dialysis in our dialysis center. The clinical data and biochemical parameters of all patients were collected, bone mineral density was detected and the Self-rating depression scale was used to evaluate depression state. Results Among the 80 enrolled MPD patients, 34 patients had osteoporosis(42.5%), 48 patients had the presence of depression(60%). Logistic regression analysis showed that age, dialysis age, gender, diabetes history and depression state were the risk factors for osteoporosis in MPD patients, the depression state was negatively correlated with BMD of lumbar and femoral neck(r=-0.347,r=0.426,P<0.05). Conclusion Depression state may be a risk factor for osteoporosis in clinic, it is of great significance to focus on the psychological state of MPD patients in the prevention and treatment of osteoporosis.
Influence of Autologuous Blood Transfusion on Hemorheology and Fracture Healing in Patients Undergoing Spinal Operation
Tang Jia Hua
2016, 37(07)
Abstract(2500) PDF(81)
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[Abstract]Objective To explore and evaluate the changes of hemorheology and fracture healing in patients undergoing spinal operation with intraoperative autologuous blood transfusion. Methods A total of 80 patients underwent internal fixation of spine in our hospital from January 2012 to December 2014 were selected in this study. Digital random table method were utilized for dividing them into two groups. Autologous blood transfusion was used in group A,allogeneic blood transfusion was applied in group B. Blood viscosity, plasma viscosity, hematocrit, fibrinogen,erythrocyte sedimentation rate(ESR)and the level of sICAM-1,sVCAM-1 were collected and compared 1,4,8,12 weeks after the operation. Results Concentrated red cell and plasma volume infusion in group A was lower than that in group B, the level of sICAM-1,sVCAM-1 1,4,8,12 weeks after operation in group A were significantly lower than that in group B. There was no delayed fracture healing patients in group A, but there was 3 patients with delayed fracture healing in group B(P<0.05).Blood viscosity, plasma viscosity, hematocrit, fibrinogen, erythrocyte and ESR 1, 4, 8, 12 weeks after the operation compared in both group were not statistically significant(P>0.05).Conclusion Autologous blood transfusion is not only a safe and effective method for blood transfusion, but also can improve the tissue blood supply, reduce inflammation, and conducive to fracture healing.
Comparative Analysis of Two Different Fixation Methods for Treatment of the Intercondylar Eminence Fractures of Tibia
Zheng Yun Jiang
2016, 37(07)
Abstract(2858) PDF(73)
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[Abstract]Objective To compare the effect of hollow screw and double suture anchors for the treatment of the intercondylar eminence fractures of tibia. Methods The data of 68 patients with intercondylar eminence fractures of tibia from January 2006 to January 2012 were retrospectively reviewed. 33 patients of them received treatment of hollow screw,35 patients received double suture anchors. All patients had X-ray films before operation. After follow-up of 3,6,12 and 36 months, they all were examined by X-ray eminence in an appropriate position. Union time was from 6 to 12 weeks and evaluated by Lysholm system. Results After a follow-up for 24 to 43 months and the average period was 36 months. A total of 68 patients turned up. The outcome of treatment was evaluated on the basis of X-ray and clinical findings in hollow screw group and double suture anchors group. Union and average time was 8 weeks. During the follow-up time, clinical evaluation included the range of motion and knee joint stability was examined and no knee joint instability and abnormal activity were found. During the 3 months and 6 months, there were significant differences between hollow screw group and double suture anchors group(P > 0.05). But during the follow-up from 12 to 24 months, there were significant differences between hollow screw group and double suture anchors group(P>0.05)according to Lysholm system,clinical evaluation including range of motion and knee pain was examined and knee pain and abnormal activity were found in this two groups. Conclusion Clinical characteristics of patients and individual requirement should be considered comprehensively before an individual treatment choice is made for the treatment of the intercondylar eminence fractures of tibia.
Application of a Pressure-measuring and Stone-extracting Ureteral Access Sheath in Flexible Ureteroscopy For Renal Stones
Duan Kang
2016, 37(07)
Abstract(3160) PDF(111)
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[Abstract]Objective To investigate the application value of a pressure-measuring and stone-extracting ureteral access sheath (UAS) used together with negative pressure suction system during flexible ureteroscopy in the treatment of renal caculus.Methods A retrospective analysis was performed on the 98 cases of renal caculus who received flexible ureteroscopic holmium laser lithotripsy (FURS)in the Department of Urology of the Kunming General Hospital of Chengdu Military Command from November 2014 to September 2015, and the enrolled cases were divided into two groups: group A and group B. The new UAS was used in group A combined with vacuum suction during lithotripsy, and simple manometry type UAS was used in group B. The infusion pump flow rate of 0.2 L /min was set in the operation, the perfusion pressure limit was set to 100 mmHg, the suction pressure of group A was 10 kPa. Perfusion flow rate and pressure was adjusted in a timely manner based on the clear vision and the internal pressure force on the kidney. Then we recorded and compared the internal pressure and variation trend of renal and perfusion time of two groups. Results Two groups of patients were successfully completed surgery .The renal pressures in group A were adjusted duly and were lower than the that in group B in the whole process of operation. The average renal pressure in group A was 10.88±5.911mmHg. The average renal pressure in group B was 20.10±7.68 mmHg,the pressure control was difficult and unsteady.Conclusion The new type of UAS in the flexible ureteroscopic holmium laser lithotripsy(FURS)can make the renal pressure in surgery controllable and is safe for the FURS.
Therapeutic Effects and Mechanism of Umbilical Cord Derived Mesenchymal Stem Cell Transplantation for Lupus Nephritis
Tang Bang Li
2016, 37(07)
Abstract(3434) PDF(93)
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[Abstract]Objective To study the clinical effects of umbilical cord derived mesenchymal cell transplant on patients with lupus nephritis,and to elucidate the clinical effects and mechanisms of action.Methods We conducted a random, double blind,contrast control that involved 12 SLE patients(1)control team: standard treatmen(2)hUC-MSC treatment team: weekly intravenous pulse for two weeks. We investigated the clinical symptoms, physical signs and adverse effects before treatment,two months and six months after infusion of hUC-MSC.Data on serum biological markers of renal damage(anti-C1q,Osteopontin(OPN),cellular inflammatory markers(IL-4,IL-6,Il-10,IL-17,IL-18,INF-Y,TGF-β1) as well as flow cytometry measurements of T cell sub groups(CD3,CD4, CD8)were taken at baseline,then again at 2 weeks and 6 weeks post treatment.Results(1)Clinical manifestations and physical signs : the clinical manifestations and physical signs of patients in two groups were improved 2 and 6 months after treatment, and the cases of remission in treatment team were more than the control team, but there was no statistically significant difference(P>0.05). (2)SLIDAI score: there was a statistically significant difference in SLIDAI between the treatment teamand the control team(P<0.05). (3)Mechanisms of action: the levels of inflammatory (INF-Y, IL-4, IL-10, IL-6, IL-18) and renal injury markers (anti C1q and osteopontin) at 2 and 6 months after treatment in both groups decreased compared to baseline, but there was no statistically significant difference between two teams(P>0.05). (4)T-Lymphocyte Subsets: there were statistically significant differences in CD4+T and CD8+T cells between before treatment and 2 and 6 monthsafter treatment in both teams(P<0.05), but there was no statistically significant difference between two teams(P>0.05). Conclusions(1)The clinical symptoms and laboratory examination results of patients in two teams were all improved, but there is no statistically significant difference between two teams. (2)There is no statistically significant difference in the inflammatory cytokines and renal injury markers between before and after treatment in two teams, Huc-MSC for treatment of LN still needs more clinical data.(3)Whether the Huc-MSC could reconstruct the balance of the T cell subgroups still needs further exploration.
Radical Cystectomy and Orthotopic Urinary Diversion with 3D Laparoscopy
Hu Xin Yi
2016, 37(07)
Abstract(2767) PDF(86)
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[Abstract]Objective To study the clinical effect of radical cystectomy and orthotopic urinary diversion with 3D laparoscopy. Methods We adopted 3D laparoscopy to do 6 cases of radical cystectomy and orthotopic urinary diversion from September 2014 to November 2015. After creating the channels,we isolated the ureter first, after ligating the branches of internal iliac artery we did the pelvic lymph node dissection,cut off the lateral bladder ligaments, lateral prostate vascular pedicles and dorsal vein complex, then reconstructed the new bladder and anastomose. Results The operation time was 290 ~ 350 min,in which the radical surgery time was 145 ~ 170 min and the bleeding was 40 ~ 150 ml without blood transfusion. No serious complications such as pelvic vascular injury and rectal injury occurred during operation. No intestinal anastomotic fistula, the new bladder fistula, intestinal obstruction, and wound infection occurred after the surgery. Conclusions Three-dimensional imaging completed by the 3D laparoscopy can effectively eliminate the vision disparity compared with 2D laparoscopy, and make the operation more accuracy. Therefore it can effectively shorten the operation time and learning curve.
Clinical Study on Autologous Peripheral Blood Stem Cells Transplantation for Myocardial infarction
Li Qiang
2016, 37(07)
Abstract(2781) PDF(98)
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[Abstract]Objective To study the clinical efficacy of autologous peripheral blood stem cell transplantation for the treatment myocardial infarction,in the same period of coronary artery bypass grafting(CABG). Methods From January 2012 to January 2015, 76 patients with myocardial infarction were selected. Patients were divided into transplantation group(n=46) and control group(n=30) on the basis of whether being treated by autologous peripheral blood stem cell transplantation. After myocardial infarction patients were taken to the hospital with the therapy of conventional drug,5 days before CABG, transplantation group was given the autologous peripheral blood stem cell mobilization and expansion, 24 hours before CABG, taking autologous peripheral blood stem cell collection. 76 patients took CABG with non-cardiopulmonary by pass,transplantation group was given autologous peripheral blood stem cell via transplantation vessels and subepicardial,while the control group was not given the injection of autologous peripheral blood stem cell. The LV morphology,wall motion score index(WMSI) and index of cardiac function before and after the operation in both groups were evaluated by echocardiography. Results Six months after CABG, there was a significant decrease in Left ventricular end-diastolic diameter and wall motion score index, Left ventricular ejection fraction was increased. The indexes of cardiac function in the transplantation group were better than the control group. Conclusion Autologous peripheral blood stem cell transplantation for the treatment myocardial infarction can improve the heart function, and has obvious recent clinical curative effect in the same period of CABG.
Comparison of Three Identification Tests of Vulvovaginal Candidiasis' Candida Strains
Li Chun Mei
2016, 37(07)
Abstract(2748) PDF(120)
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[Abstract]Objective To compare the advantages and disadvantages of three methods of yeast-like fungi identification of vulvovaginal candidiasis(VVC) . Methods The pathogenic candida strains were identified by CHROM agar chromogeinc culture medium, the chromogenic medium of Autobio and VITEK 2 system, and the result of VITEK 2 system was the gold standard. Results All candida strains were appraised. By VITEK2 system, 217 candida isolates were identified as candida albicans,and 26 were detected as non-candida albicans. 214 isolates were identified as candida albicans and 13 isolates were identified as non-candida albicans by Autobio . 214 isolates were appraised as candida albicans,16 isolates were identified as non-candida albicans. The coincidence rate of identification of CHROMagar and the chromogenic medium of Autobio were 94.7% and 95.06%. Compared with VITEK 2 system,there was no significant difference between these two chromogeinc culture medium identifying candida albicans and non-candida albicans. Conclusion The chromogenic medium of Autobio has higher cost-effectiveness, higher color discrimination and simpler technical operation, and is worthy of promotion in identifying candida species in clinic.
The Effect of Theophylline Retard-20 Tablet for the Treatment of Infantile Asthma
Luo Yang
2016, 37(07)
Abstract(1882) PDF(78)
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[Abstract]Objective To explore the clinical efficacy of theophylline retard-20 tablet in pediatric asthma treatment. Methods From April 2010 to December 2014 in our hospital 136 cases of children with infantile asthma were selected and divided into observation group and control group. Patients in the observation group were treated with sulfate aerosol inhalation therapy,patients in the control group were given oral theophylline retard-20 tablet treatment. After treatment,the treatment results were analyzed. Results In the observation group,functional recovery was found in 37 cases,significant progress in 20 cases,on effect in 11 cases,the total effective rate was 83.82%;Adverse reactions such as pharyngeal discomfort was found in 3 cases,upset stomach in 0 cases,heartburn in 0 cases,the incidence was 4.41%. In the control group,68 functional recovery was found in 19 cases,and remarkable progress in 26 cases,on effect in 23 cases, the total effective rate was 66.18%;Adverse reactions such as pharyngeal discomfort occurred in,4 cases,upset stomach in 3 case, heartburn in 4 cases,the incidence was 14.71%. The effect effective treatment was better than that of control group(P < 0.05),the incidence of adverse reactions in observation group was significantly lower than the control group (P < 0.05). Conclusion The treatment of infantile asthma with salbutamol sulfate aerosol therapy is very effective and has,clinical significance,is worth further promotion and application.
Clinical Observation of 50 Cases of Intracranial Infection after Neurosurgery
Guo Hong Wei
2016, 37(07)
Abstract(3123) PDF(82)
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[Abstract]Objective To explore the clinical therapeutic effects of postoperative intracranial infection in neurosurgery. Methods Between January 2014 and January 2014, 50 patients with postoperative intracranial infection in the department of neurosurgery in our hospital were selected in this study. Among the 50 patients, 25 patients were treated by intravenous antibiotic therapy,15 patients were treated with intrathecal and intravenous antibiotics treatment,10 cases were treated by intrathecal injection, intravenous antibiotics and lumbar pool catheter drainage way for treatment, and then we observed the clinical therapeutic effect of three groups of patients. Results In 50 patients, 37 patients were cured, 3 cases had marked effect, 8 patients had effect, 2 patients had no effect. Conclusion For patients with neurosurgical operations, to maximally reduce the risk of intracranial infection, it is necessary to take antibiotics according to the actual situation of patients, and make different treatment schemes according to the difference of infection.
Characteristics of Fungus Colony in Oral Cavity of HIV-infected Patients with Highly Active Antiretroviral Therapy (HAART)
Yang Jia
2016, 37(07)
Abstract(3333) PDF(97)
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[Abstract]Objective To identify the characteristics oral fungus in HIV- infected patients with HAART in Kunming. Methods Oral mucosal swab samples were collected from 99 patients with HIV infection with or without HAART. The fungi were isolated and cultured, and were identified by using API 20 C AUX yeast identification system. Results The positive rate of oral Candida in was significantly higher in HIV-infected patients without HAART(53.3%) than those with HAART(20.4%) (χ2=11.669,P<0.01) . In 41 strains of isolated candida, C. albicans was the most prevalent (78.0%), followed by C parapsilosis (9.8%) , C.glabrata (9.8%)and C tropicalis(2.4%). Conclusions HAART can decrease the positive rate of oral Candida in patients with HIV infection, but has little effect on asymptomatic HIV carrier.
Research Advance in the Role of Toll-like Receptors in Hepatocarcinogenesis
Liu Xing
2016, 37(07)
Abstract(2550) PDF(90)
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[Abstract]Hepatocellular carcinoma(HCC) is the second largest cause of cancer deaths worldwide. TLRs signal transduction pathways are related to the progress of HCC. As an innate immune recognition receptors on the surface of the cell, TLRs are involved in the ligand-mediated activation of various cells and the secretion of cytokines in liver through signal transduction,which is part of the cause and development of HCC.A better understanding of TLRs and these signaling pathways in the liver will help us understand the mechanism of hepatocarcinogenesis and provide a new therapeutic target for HCC.
Research Progress of Galectin in Mchanism of Venous Trombosis
Zhang Fu Hou
2016, 37(07)
Abstract(3310) PDF(105)
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[Abstract]Galectins are a family of carbohydrate-binding proteins that have a high affinity to galactosides on cell surfaces and extra cellular glycoproteins. They are involved in a variety of biological functions, including modulation of cell apoptosis, cell activation and inflammation. Our laboratory has recently identified galectin-3 binding protein(Gal-3BP)as being up-regulated in a microparticle proteomics analysis for deep venous thrombosis(DVT) patients compared to negative controls. P-selectin,another glycoprotein involved in thrombus propagation, has been proved as a promising target for DVT management and has been widely studied by our group. Galectins are involved in P-selectin expression and can potentially be implicated in the venous thrombogenesis process.Interleukin-6,as an important cytokine of body,which have been found in the study of inflammation for venous thromboembolism,may be an important factor for the frmation of VT. Research shows gal3bp:gal3 plays a critical role in VT, likely via IL-6 Promote thrombosis.The function of galectins, their role in inflammation and thrombosis as well as their potential implications as a new pharmacological target for DVT management are reviewed in this manuscript.
Primary Exploration of Full English Teaching in Medical Imagology for International MBBS Students
Li Zong Fang
2016, 37(07)
Abstract(3325) PDF(324)
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[Abstract]Objective To probe how to ensure and improve the teaching quality of full-English- teaching in Medical Imagology for international MBBS students. Methods 144 MBBS international students and 13 full-English-teaching teachers in Kunming Medical University (KMU) were enrolled. Nationality of international students, development of teaching staff and teaching mode were studied by analysis of basic data and questionnaire. Results MBBS students of KMU are mainly from South Asia countries where students' pronunciation is different to England and America; the full-English-teaching staff of Medical Imagology are excellent teachers with good English and professional knowledge, but professional communicative ability in English is still needed to be improved; most students regarded inspiring-teaching-method as a useful way to enhance interesting and efficiency and teachers were sure that this method could improve teachers' comprehensive ability. Conclusion Inspiring-teaching- method is worth of further developing and extending because it is useful in promoting the communication between teachers and international students, in developing the teachers' professional communicative competence in English, and in improving students' learning interesting and efficiency.
Application of Advanced Simulation Human in Clinical Practice of Medical Nursing
Yu Shan
2016, 37(07)
Abstract(2568) PDF(68)
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[Abstract]Objective To explore the effect of comprehensive experiments on clinical practice of internal medicine nursing in the patients with advanced simulation human Simman3G. Methods Two grades of nursing students were selected by random cluster sampling and divided into the experimental group and the control group. The control group used the traditional clinical probation method to carry out clinical probation teaching in Department of internal medicine,the experimental group used the advanced simulation human Simman3G to conduct a comprehensive simulation of teaching before clinical probation. After the completion of the internship the self compiled questionnaire was given to two groups of students to investigate their opinion on the clinical probation. Then we compared, the semester examination results between two groups. Results In the experimental group,the grade of internal medicine nursing was higher than the control group at the end of the semester,P < 0.05. The results of questionnaire survey showed that there was no significant difference between the two groups in the promotion of theoretical knowledge and the two dimensions of the survey of nursing work environment. In the training of clinical thinking, improve nursing skill,communication skill, and the learning interest.At the great harvest of 5 dimensions of probation,the experimental group of students' recognition degree was significantly higher than the control group,P < 0.01. Conclusion Before clinical probation of internal medicine nursing,the application of high-end analog teaching can significantly improve the effectiveness of clinical probation.
Application of High Quality Nursing for Super- selective Renal Artery Embolization In Treating Bleeding after Percutaneous Nephrolithotomy
Han Lei
2016, 37(07)
Abstract(2142) PDF(91)
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[Abstract]Objective To evaluate the clinical application of high quality for super-selective renal artery embolization(SRAE)in treating bleeding after percutaneous nephrolithotomy(PCNL). Methods 134 patients received percutaneous nephrolithotomy were divided into control group (67 patients) and observation group(67 patients). All of patients with serious bleeding after PCNL were given SRAE in the Second Affiliated Hospital of Kunming Medical College from June 2010 to June 2015. At the same time,we gave high quality nursing to observation group. The patients in control group received routine nursing. The effect of nursing was observed. Results The degree of hematuria disappear of the patients in observation group was higher than that in control group(P<0.05). There were fewer complications in observation group. In the sixth month after discharge, none of them had obvious renal impairment. No recurrence of hematuria, pus kidney and urinary cyst was tested. All cases were satisfied with the treatment. Conclusion It's the key to prevent serious complications and cure successfully with effective and timely supervision and high quality nursing care during the perioperation of SRAE in treating bleeding after PCNL.
The Application Effect of Optimization Design of County-level Hospitals Electronic Admission Nursing Evaluation Table
Lou Qing Mei
2016, 37(07)
Abstract(2732) PDF(82)
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[Abstract]Objective To study the application effect of optimization design of electronic admission nursing evaluation table. Methods We investigated the nursing staff satisfaction,hospitalized patients satisfaction and nursing quality sensitive indicators(expected pressure sores,pipe slips, falls / falling bed) before and after optimization design,and compared the difference between them. Results The nursing staff satisfaction was significantly higher than that before optimization design (P<0.05), patient satisfaction was significantly higher than that before optimization design (P<0.01),nursing quality sensitive indicators was significantly lower than that before optimization design (P<0.05). Conclusion The optimized design of electronic admission nursing evaluation table is detailed, objective,simple to use,and more objective and scientific in quality sensitive indicators control, and has good clinical practibility.
The Application of PDCA Circulation in the Management of Oral Instruments
Jiang Yu
2016, 37(07)
Abstract(2712) PDF(115)
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[Abstract]Objective To analyze the effect of the application of PDCA circulation in the management of oral instruments. Methods From January to June 2015,the head nurses analyzed problems of instruments management according to the outpatient instrument management and requirement standards in the department of stomatology. They followed the "PDCA" circulation principle,put a continuous improvement, and compared the changes in the management of oral instruments before and after 4 months(from March to June and from July to October). Results After the implementation of the PDCA circulation,the abnormal loss of equipment,numbers of instrument loss and equipment failure rate had significantly decreased,while equipment utilization rate had significantly increased, with significant statistical differences(P < 0.05). Conclusion The application of PDCA circulation in the management of oral instruments could help reduce the problems of abnormal waste,loss,failure and so on,resulting in improving the instrument utilization rate.