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2016 Vol. 39, No. 3
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2016, 39(3): 205-208.
doi: 10.3969/j.issn.1674-4500.2016.03.01
Abstract:
Objective To assess the advantage and value of Mammotome minimally invasive biopsy system under the guide of ultrasound on Nonpalpable Breast Lesions. Methods We counted 341 patients with nonpalpable breast lesions who diagnosed by ultrasound, all the patients obtained Mammotome minimally invasive biopsy guided by ultrasound, 146 of also obtained BARD biopsy needle aspiration biopsy ,and then analyzed by pathological examination，the cause for complications was analysed and the control strategy was studied. Results The success ratios of sample choosing for Mammotome minimally invasive biopsy system and BARD biopsy needle were 100％ and 82.19％, respectively．The coincident ratios of pathological diagnosis of Mammotome minimally invasive biopsy system and BARD biopsy were 100％ and76.1％, respectively. In the 341 patients, only 5 patients with slight subcutaneous ecchymosis and 3 patients with hematoma. Conclusions For the nonpalpable breast lesions, Mammotome minimally invasive biopsy system under the guide of ultrasound has the advantages of minimally invasive, safe, high success rate and less complications, so it has an important significance in diagnosis and treatment of nonpalpable breast lesions
2016, 39(3): 209-211.
doi: 10.3969/j.issn.1674-4500.2016.03.02
Abstract:
Objective To study diagnosis application value comparison of intestinal obstruction by abdominal plain film radiography and CT. Methods We retrospectively reviewed 32 cases of intestinal obstruction after surgical treatment, from January 2013 - December 2015 in our hospital, including abdominal plain film and CT scan and enhanced scan, and to evaluate the accuracy of the diagnosis of intestinal obstruction by the two methods. Results In the 32 patients with intestinal obstruction, the accuracy of radiography and CT was 81.25%(24/32) and 93.75%(30/32) in determining the existence; The accuracy of radiography and CT was 53.13%(17/32) and 87.50% (28/32) in determining the causes of intestinal obstruction; The accuracy of radiography and CT was 20% (1/5) and 80% (4/5) in 5 patients was strangulate intestinal obstruction. Conclusions CT scanning has high value of determining the existence, causes, locations of intestinal obstruction, and diagnosis of strangulation obstruction, it was worth clinical promoting.
2016, 39(3): 212-214.
doi: 10.3969/j.issn.1674-4500.2016.03.03
Abstract:
Objective To study the effects of Double-plates fixation for complex fractures of the distal humerus. Methods According to the AO/OTA classification system, 7 cases were belonged to type C1, 5 to type C2,6 to type C3. The study involved 18 patients with complex distal humeral fractures undergone double-plate fixation from January 2009 and January 2014.In addition, regular follow-up were carried out Strictly and the data was analyzed with statistical methods. Results Eighteen patients were treated with double plating internal fixation successfully and followed up for 12-48 (18±1.1)months. All of the cases were healed, No infection, nonunion and posttraumatic arthritis had been reported. The function of the elbow according to Cassebaum score system showed excellent in 13 cases, good in 3, fair in 2, the excellent-good rate was 89.0%. Conclusions The surgical procedure of Double-plate fixation is feasible and useful clinically for complex fractures of the distal humerus, and further prospective study should be carried out to elucidate the efficient of this surgical procedure.
2016, 39(3): 215-217.
doi: 10.3969/j.issn.1674-4500.2016.03.04
Abstract:
Objective To assess the usage of external ventricular drainage in the ventricular abdominal shunt replacement in children. Method We analyzed retrospectively 155 patients who needed ventricular abdominal shunt replacement in the past 10 years. And we assessed the effect of external ventricular drainage on postoperative complications, including obstruction, bleeding, and infection. Results The study showed that ventricular abdominal shunt replacement is safe and effective. 105 cases had replaced the ventricular abdominal shunt directly, among them 20 patients had postoperative complications (19%). While in another group who were given external ventricular drainage firstly because of some difficult situations, only one patient had postoperative obstruction. The external ventricular drainage could decrease dramatically the postoperative complications. Conclusions External ventricular drainage placement firstly, and then a new ventricular abdominal shunt placement is safer and could decrease dramatically the postoperative complications in the cases whose shunt pulling was difficult, bleeding or had unclear cerebral spinal fluid.
2016, 39(3): 218-220.
doi: 10.3969/j.issn.1674-4500.2016.03.05
Abstract:
Objective To explore the therapeutic effect of ultrasound guided percutaneous biliary drainage in patients with malignant obstructive jaundice. Methods A total of 97 cases with malignant obstruction jaundice underwent percutaneous transhepatic cholangioma drainge (PTCD) using the guidance of ultrasound in our hospital since April 2013 to September 2015. All clinical data before PTCD were retrospectively compared with those after PTCD, including TBIL, DBIL, TBA, AST, ALT, GGT, ALP, ALB and PA. Postoperative complications and prognosis were also observed. Results All cases were performed PTCD using the guidance of ultrasound successfully. Nausea, vomiting, abdominal distension, loss of appetite, skin itching and jaundice significantly improved. In 97 cases, there were two cases of biliary tract infection（the incidence rate of 2.06%）and one case of acute pancreatitis(the incidence rate of 1.03%), which were cured with medicine. The levels of all the laboratory index including TBIL, DBIL, TBA, AST, ALT, GGT, ALP, ALB and PA after treatment were significantly improved in comparison with those levels before treatment (P<0.05). Conclusions PTCD using ultrasound guidance in patients with malignant obstructive jaundice can not only reduce the serum bilirubin level and improve liver function, but also has merits of accuracy, safety and reliability.
2016, 39(3): 221-224.
doi: 10.3969/j.issn.1674-4500.2016.03.06
Abstract:
Objective To explore the curative effect of axillary midline transthoracic approach for treatment of upper and middle thoracic tuberculosis. Methods 21 patients with upper and middle thoracic tuberculosis underwent one-stage debridement and bone grafting with internal fixation via axillary midline transthoracic approach. There are 13 men and 8 women aging 35 to 77 year-old, with the average age of 45.5 years old. All patients had various degrees with tuberculosis poisoning symptoms and thoracic kyphotic deformity. Seventeen of the patients have different degrees of nerve compression symptoms. Results All patients recover well during the follow-up period. 1 case got pain, numbness in surgical site after operation, but rapidly alleviated after the treatment. 21 patients were followed from 15 to 30 months, with the average period of 20.8 months. The kyphosis Cobb's angle corrected with the average angle of 1.58° , visual analogue scale (VAS) have improvement with an average score of 4.14. And at the last follow-up, those 17 cases of patients with neurological symptoms impoved in varying degrees. Erythrocyte sedimentation rate (ESR) declined in varying degrees. Conclusions Axillary midline transthoracic approach can achieve the goal of treatment of upper and middle thoracic tuberculosis.
2016, 39(3): 225-228.
doi: 10.3969/j.issn.1674-4500.2016.03.07
Abstract:
Objective To study the wide QRS wave and heart are not synchronized movement in the value of chronic heart failure. Methods We choosed 71 cases of ecg examination for patients with wide QRS wave, according to the supersonic and enchanted the graph is divided into two groups, namely, 25 cases LVEF≤45%, LVFS ≤25% (heart failure group) and 46 cases LVEF >45%, LVFS >25% (cardiac function or mild damage to normal group), analysis of two groups of patients with left ventricular ejection fraction (LVEF), left ventricular shortening fraction (LVFS) short axis with heart not synchronous movement and the relationship between QRS duration. Results After statistics analysis, the heart failure group (LVEF≤45%, LVFS≤25%) or less heart not synchronous movement and QRS duration and cardiac function in normal or slight damage group (LVEF>45%, LVFS>25%) of the results there were significant differences (P<0.01). Conclusions Cardiac motion is not synchronous and QRS>140 ms exist at the same time can use as a good indicator to evaluation of chronic heart failure, has important clinical value.
2016, 39(3): 229-231.
doi: 10.3969/j.issn.1674-4500.2016.03.08
Abstract:
Objective To understand GDM women ketones and inositol content changes and fetal deformity correlation to achieve in the first trimester of fetal malformations for the purpose of prevention. Methods Gestational diabetes (GDM) and pregnant women giving birth in hospital outputs 19 patients with fetal malformations collected from January 2010 to June 2013 in our hospital were set as GDM group. 19 cases with routine examination and normal healthy pregnan were set as control group. Study groups within 3 months of pregnancy when measured in vivo ketone, inositol and fasting blood glucose levels, and tracking statistics fetal malformation type analysis GDM women ketones and inositol content change effects on fetal deformity. Results Subjects in age, gestational age, BMI and other general information had no significant difference (P>0.05). After an analysis for the detection of indicators found, GDM group of pregnant women ketones and fasting plasma glucose levels were significantly higher, while the levels of inositol lower than the control group. The difference between the two groups was statistically significant (P<0.05). GDM group of pregnant women delivered a major fetal malformations or without brain child, spina bifida, kidney malformations and other central nervous system defects. Conclusions GDM women ketone levels and inositol metabolism can affect the normal development of the fetus in the first trimester of fetal malformations forecast whether there has a certain value, as a possible indicator for gestational diabetes in pregnant women clinically timely remedy or termination of pregnancy, to reduce the incidence of fetal malformations.
2016, 39(3): 232-235.
doi: 10.3969/j.issn.1674-4500.2016.03.09
Abstract:
Objective To understand the relationship of patients with chronic obstructive pulmonary disease(COPD) between plasma Ghrelin level , degree of malnutrition and severity of disease. Methods Test plasma Ghrelin level of 80 COPD patients of stable stage were divided into malnutrition group 42 cases and normal nutrition group 38 cases and 32 healthy controllers were analysed by the method of radioimmunoassay. Enzyme-linked immunosorbent assay method was used to test tumor necrosis factor-1, Leukocyte interleukin-1, and bioelectrical impedance was used to test body adipose composition analysis. Body mass index, triceps skin fold thickness ,middle arm circumference and serum albumin were tested. The relationship of plasma Ghrelin level, nutrition and cytokines were analysed. Results The plasma Ghrelin of malnutrition COPD group was higher than that of normal nutrition group and healthy controls(P<0.01), so was to the cytokines level(P<0.01). The plasma Ghrelin level was negatively related to most nutritional index(P<0.01), and positively related to the level of cytokines without significant statistical meaning(P>0.05). Conclusions The higher level of Ghrelin of COPD patients, the more severe the patient was and the worse nutrition with more severer inflammation response.
2016, 39(3): 236-240.
doi: 10.3969/j.issn.1674-4500.2016.03.10
Abstract:
Objective To explore the role of interleukin 18(IL-18) on the osteoarthritis (OA) patients' chondrocytes. Methods Knee cartilage samples were obtained from osteoarthritic patients, and the primary cells were cultured. After stimulated by IL-18 (0, 50, 150, 300 ng/mL), chondrocytes were collect to obtain the total RNA, and the supernatant were extracted, too. The mRNA’s expression of COX-2 and TNFα were detected by quantitative RT-PCR and the level of PGE2 and TNFα were investigated using ELISA. Besides IL-18, IL-1 receptor inhibitor (IL-1Ra) was also added into the medium of cell culture. COX-2 mRNA and PGE2 were respectively determination. IL-18 receptors in chondrocytes were detected by RT-PCR. Results mRNA expression of COX-2 and TNFα in 150 and 300 ng/mLwere both significantly higher than that in control group (P<0.05). The level of in 50 and 300 ng/mL group were higher than that in control group (P<0.01). While the concentration of TNFα in 150 and 300 ng/mL groups appeared more than that in control group significantly (P<0.01). And the density of PGE2 in IL-Ra group was significantly more than that in control group, but less than that of IL-18 group. IL-18R can be detected on chondrocytes. Conclusions IL-18 induces inflammatory responses in osteoarthritic chondrocytes and that this effect was related with, although not entirely dependent on, IL-1β.
2016, 39(3): 241-244.
doi: 10.3969/j.issn.1674-4500.2016.03.11
Abstract:
Objective The preliminary analysis about the effect of different rewarming speed on mild hypothermia therapy for HIE. Method Research on 36 cases of mild hypothermia therapy of neonate with HIE, which randomly divided into the Group Ⅰ(n=12, rewarming speed 0.2 ℃/h), the GroupⅡ(n=12, rewarming speed 0.3 ℃/h) and the GroupⅢ (n=12, rewarming speed 0.4 ℃/h). Heart rate, blood pressure and pulse oxygen saturation are dynamically detected during the therapeutic process. Blood glucose, hemogram, hepatorenal function and serum potassium are daily measured. Short-term efficacy is evaluated in accordance with NABA Score when 7, 14 and 28 days after treatment. Also the medium-term efficacy is accessed according Bayley Scales of Infant Development at 3-month-old and 6-month-old. Results 1. The blood glucose of the Group Ⅲ is apparently higher than the others when having a good control (P<0.05) with statistical significance.2. The mean arterial pressure fluctuation: The Group Ⅲ is apparently higher than the others (P<0.05) with statistical significance. 3. NABA Score: The NABA Score of the Group Ⅰand the Group Ⅱ of a postnatal baby at 7-day-old, 14-day-old and 28-day-old are higher than the Group Ⅲ (P<0.05) with statistical significance.4. The MDI and PDI of the Group Ⅰare higher than the others when babies are at 3-month-old and 6-month-old (P<0.05) with statistical significance. Conclusions The slowly rewarming speed can maintain the mean arterial pressure and blood glucose level steadily on mild hypothermia therapy, which is in favor of improving brain perfusion and metabolism, especially protecting neurological function and HIE prognosis, while faster rewarming speed may result the blood pressure fluctuation and hyperglycemia.
2016, 39(3): 245-247.
doi: 10.3969/j.issn.1674-4500.2016.03.12
Abstract:
Objective To evaluate the hemoglobin (Hb) and platelets (PLT) ratio in the prediction of emergency gastrointestinal bleeding (GIB) in patients with sensitivity and sensitivity. Methods 103 patients with collecting GIB, observe whether during the period of school once again GIB (RGIB), compare the Hb, PLT and Hb/PLT in predicting the RGB difference. Results The patients of 22 cases with RGIB, rate of 21.4%. Hb no significant correlation with RGIB (P=0.682); PLT and Hb/PLT and RGIB exist significant correlation (P=0.007, 0.007). PLT area under curve (AUC) was 0.160 (95% CI: 0.058~0.058); Significantly lower than that of Hb/PLT AUC value of 0.860 (95% CI: 0.657~0.657). When Hb/PLT ratio is 2.660, the predicted RGIB sensitivity of 0.840, 0.857. Conclusions Hb/PLT RGIB ratio prediction is better than that of pure Hb or PLT, and the sensitivity of this ratio and specific degree is high, is expected to be simplified and practical indicator of prevention and treatment of patients with emergency GIB.
2016, 39(3): 248-250.
doi: 10.3969/j.issn.1674-4500.2016.03.13
Abstract:
Objective To observe the sensitivity and specificity of combination with clinical pulmonary infection score (CPIS), C-reactive protein (CRP) and neutrophile granulocyte(NEU) to predict ventilator associated pneumonia. Methods 29 patients with VAP were as observation group, with VAP in mechanical ventilation patients as control group, using the receiveroperating characteristic curve (ROC) evaluation CPIS, CRP and NEU predict the sensitivity of the VAP and specific degrees. Results The group of patients with VAP CPIS, CRP and NEU were significantly higher than the control group (P=0.023, 0.039 and 0.023). CPIS corresponds to the area under the curve (AUC) was 0.669, 95% confidence interval (CI) to (0.507, 0.507); CRP corresponding AUC 0.643, 95% CI (0.487, 0.487); NEU corresponding AUC 0.661, 95% CI (0.507, 0.507). CPIS with NEU both with VAP exist significant correlation (P=0.034, 0.043), but the CRP and VAP has no significant differences (P=0.074). When the CPIS values of 7 points, the predict the sensitivity of the VAP (positive) was 89.66%, 93.26%; When the CRP values for 14 mg/L, the prediction of VAP sensitivity was 79.31%, 87.74%; When the NEU values is 83%, and its prediction of VAP sensitivity was 96.55%, 91.45%. Conclusions Comprehensive CPIS >7 points, CRP >14 mg/L and NEU >83%, the forecasting can significantly increase the sensitivity of the VAP and specific degrees.
Effects of acupuncture via Tianshu and Zusanli point on the regulatory T cells for patients with IBS
2016, 39(3): 251-253.
doi: 10.3969/j.issn.1674-4500.2016.03.14
Abstract:
Objective To observe effects of Tianshu point and Zusanli point on IBS patients, and the levels of CD4+ CD25-Treg, CD8 + CD28-Treg, TGF-β and IL-10 in plasma. Methods 30 patients were qualified for inclusion, with 10 in each group randomly, included Tianshu group and Zusanli group and Tianshu+Zusanli group.Besides,a normal group with 10 patients were included. The acupuncture group were given electroacupuncture for 7 days, while the normal group was done nothing. Results Compared with before treatment after treatment, the detection index had a statistically significant difference (P<0.01 ); No statistical significance between healthy group and experimental group（P>0.05）；Compared with Zusanli group, except for the CD8+CD28-T（%）of Tianshu group (P>0.05), other groups were significantly different(P<0.05); Compared with Tianshu group and Tianshu+ Zusanli group , it had a significant difference(P<0.05). Conclusions Electroacupuncture the Tianshu and Zusanli can regulate the CD4+ CD25-Treg、CD8+ CD28-Treg、TGF-β and IL-10 in plasma obviously which can finally enhance body ' s immune.
2016, 39(3): 254-256.
doi: 10.3969/j.issn.1674-4500.2016.03.15
Abstract:
Objective To investigate the changes of ⅢA chronic prostatitis (CP) in patients with total prostate specific antigen (TPSA) concentrations before and after antibiotic therapy，Which take the role of development and evaluation of the efficacy in chronic prostatitis. Methods A total of 68 patients suffered chronic prostatitis and 38 cases of non-CP patients, CP patients before and after treatment were detected by chemiluminescence electricity TPSA concentration before digital rectal examination and analyzing the expression levels, analysis the differences TPSA expression levels between the two groups. Results Six cases were lost follow-up. 49 cases of chronic prostatitis treatment was effective, TPSA serum concentrations after treatment than before treatment significantly decreased (P>0.05), and 13 cases of ineffective treatment,compared with before treatment decreased serum concentrations of TPSA obvious(P>0.05). Conclusions ⅢA Chronic prostatitis treatment before serum TPSA concentration after treatment with inflammation disappears, TPSA concentration can gradually return to normal, PSA concentrations can be used as an indicator of ⅢA chronic prostatitis evaluation.
2016, 39(3): 257-259.
doi: 10.3969/j.issn.1674-4500.2016.03.16
Abstract:
ObjectiveTo investigate the relationship between expression levels of serum miR-409-3P after Hyperthemic Intraperitoneal Chemotherapy (HIPEC) and prognosis of gastric cancer. MethodsThe serum expression levels of miR-409-3p after HIPEC was examined using real-time reverse transcription polymerase chain reaction and analyze the relationship between levels and prognosis of gastric cancer. ResultsThe high expression group tended to have longer median survival time, compared with the low expression group, P=0.003. ConclusionsThe expression levels of serum miR-409-3P after HIPEC may become biomarkers of evaluate prognostic of gastric cancer.
2016, 39(3): 260-262.
doi: 10.3969/j.issn.1674-4500.2016.03.17
Abstract:
ObjectiveTo investigate the Clinical Effect of Tea Polyphenols and Tinidazole Buccal for Adjuvant therapy to chronic periodontitis. MethodsA total of 73 patients with chronic periodontitis from Sep 2013 to April 2015 were divided into control group and observation group.38 cases in control group were treated with Tinidazole, and 33 cases in observation group were combined with Tea Polyphenols. The total efficacy, PLI, PD, AL, TM and occurrence of adverse reactions of two groups were compared. ResultsAfter treatment the total efficacy of observation group (91.4%) higher than that in control group (76.3%) with no significance (P>0.05). The excellent efficacy of observation group (42.9%) significantly higher than that in control group (21.1%) (P<0.05). The PLI, PD, AL, TM of observation group significantly lower than that in control group. The occurrence of adverse reactions of observation group (5.7% ) lower than that in control group (21.1% )with no significance(P>0.05). ConclusionsThe treatment of Tea Polyphenols and Tinidazole for Adjuvant therapy to chronic periodontitis has excellent efficacy and can inhibit the development of dental plaque, which is worthy to popularizing in clinical.
2016, 39(3): 263-264.
doi: 10.3969/j.issn.1674-4500.2016.03.18
Abstract:
2016, 39(3): 265-267.
doi: 10.3969/j.issn.1674-4500.2016.03.19
Abstract:
ObjectiveTo evaluate different time of using Clomifene Citrate on the clinical outcome of patients with polycystic ovary syndrome after pretreatment of drospirenone and ethinylestradiol tablets(Yasmin). MethodsA toyal of 120 cases in the gynecological endocrinology and infertility clinic of Changan Hospital of Dongguan City from Jan. 2014 to May 2015 who undergone drospirenone and ethinylestradiol tablets for three months to six so as to adjust the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) to the normal were chosen.All cases were randomly divided into observation group(A group) which took Clomifene Citrate for three months at the time of the second menstrual cycle day 5 to day 9 after Yasmin was stopped and control group (B group) which took it for three months at the time of the first. The hormone levels of the patients, incidence of regular menstruation, stimulating ovulation condition and clinical pregnancy outcomes between two groups were compared. ResultsThere were no significant differences in the hormone levels between A group and B group (P>0.05). The incidence of regular menstruation of A group was 78.3% , B group 58.3% . There were significant differences in the incidence of regular menstruation between A group and B group (χ2=5.546, P<0.05).The ovulation rates of A group and B group were 78.3% and 58.3%. There were significant differences in the ovulation rate between A group and B group (χ2=5.546, P<0.05). The pregnancy rates of A group and B group were 46.7% and 26.7%. There were significant differences in the pregnancy rate between A group and B group (χ2=5.17，P<0.05). ConclusionsMost natural ovulation when stop the medicine for first month in Yasmin treatment of polycystic ovary syndrome and infertility. Clomiphene ovulation time can significantly improve the pregnancy rate from the beginning of the second month.
2016, 39(3): 268-270.
doi: 10.3969/j.issn.1674-4500.2016.03.20
Abstract:
Objective To discuss the success rate and the safety of the scarred uterus becoming pregnant again in Trial of Labour (TOL) via Vagina. Methods The clinical data of the 200 women with scarred uterus becoming pregnant again in TOL appropriately in the observation group from 2015 to 2016 in our hospital were retrospectively analyzed. Another 200 pregnant women with unscarred uterus in TOL were recruited at the same time in the hospital as comparison group. The types of delivery were analysed. Results In the Observation Group there were total of 200 in TOL, in which 97 were successful; the success rate was 48.5%. It was found that, compared to the Comparison Group, there were no significant differences (P ＞0.05) in the length of delivery, the amount of perinatal blood loss, the puerperal infection, the prognosis of the neonates and the length of hospitalization. The rate of caesarean sections and the rate of assisted vaginal deliveries were increased, however there was no single case with ruptured uterus. Conclusion Under the appropriate condition, it is successful, safe and practical in TOL in scarred uterus becoming pregnant again. It decreases the rate of caesarean section, to a certain degree, but the criteria of TOL needs to be strictly controlled in order to reduce the complications of the mother and the baby.
2016, 39(3): 271-272.
doi: 10.3969/j.issn.1674-4500.2016.03.21
Abstract:
Objective To explore the effect of Integrated Chinese and Western medicine for treatment of Helicobacter Pylori affection. Methods Eighty Helicobacter Pylori(HP) affected patients were randomly divided into 2 groups by tossing a coin, and were labeled with therapy group and control group, with 40 patients in each group. Western medicine was used in the control group, and Integrated Chinese and Western medicine was used in the therapy group. The clinical effect was compared between two groups. Results Eradication rate of HP in the therapy group was 95.0% after therapy,and the control group was 70.0%, respectively, with a significant difference(P ＜0.05). The commodity rate such as nausea, lower appetite in therapy group was 20.0%, which was 52.5% in the control group, the difference between two groups was significant(P ＜0.05). Conclusion Integrated Chinese and Western medicine for HP treatment can elevate clinical treatment effect, improve the eradication rate of HP,and lower the adverse effect, and deserve popularizing in clinical works.
2016, 39(3): 273-275.
doi: 10.3969/j.issn.1674-4500.2016.03.22
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Objective To investigate the clinical value of evidence-based examination of medical principles under the guidance of a number of detection performance in the identification of pleural effusion. Methods Serum and chemiluminescence immunoassay, optical assay, solid phase enzyme immunoassay, skin test method and blood sedimentation method was used to international standards that were diagnosed with lung cancer, tuberculosis, pleural effusion, pulmonary infection in 100 patients pleural effusion simultaneous CEA, CA199, CF211, NSE, SCCAg, LDH, ADA, PPD, TBAb-IgG, ESR and other 10 test. Results The tumor markers and LDH: lung cancer group were significantly higher than tuberculosis and infection, pleural effusion there are significant differences (P＜0.05); ADA: The positive rate of 92% of tuberculosis, lung cancer and infection group were normal; PPD: TB -positive group was 62% , the infected group was 50%, lung cancer group was 19.2%; TBAb-IgG: TB group was 4%, while the lung cancer group and infection group were negative; ESR increased rate: tuberculosis group 94% of lung cancer group was 84.6, the infected group was 83.3% . Conclusion Under the guidance of the principles of evidence-based laboratory medicine, diagnostic tests with the eigenvalues of cancer, tuberculosi, inflammation of the pleural effusions make an objective evaluation and provide the basis for the clinician to select pilot projects. Pleural effusion detection of tumor marker levels and activity of the sensitivity, specificity is significantly higher than the serum used to identify three kinds of fluid nature of the more valuable.
2016, 39(3): 276-277.
doi: 10.3969/j.issn.1674-4500.2016.03.23
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Objective To explore the clinical effect of Long Shi Ridge way in the treatment of cervical vertigo. MethodsNity-eight cervical vertigo patients were selected and randomly divided into 2 groups. The observation group was treated with Long Shi ridge way and control group was treated with usual way 5 times each week and 10 times were 1 course. Two groups were treated with correlated way for 1 course. The clinical effect was measured with cervical vertigo symptoms and functional assessment scale, with the scores compared between two groups. Results Total response rate in the observational group was 97.96%(48/49), which was higher than the control group 71.43%(35/49). The difference was significant between two groups(P＜0.05). The score of cervical vertigo symptoms and functional assessment scale in two groups were improved(P＜0.05), and the observational group was more obvious than the control group. Cervical curvature symptom in both groups were improved and the satisfaction rate in the observational group was higher than that of control group, with significant difference (P＜0.05). Conclusion Long Shi Ridge way in the treatment of Cervical Vertigo was of definite effect and was a safe, effective method.
2016, 39(3): 278-279.
doi: 10.3969/j.issn.1674-4500.2016.03.24
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Objective To investigate the clinical application of non-invasive prenatal gene detection for fetal chromosomalaneuploidy. Methods We recruited 920 pregnant women who visited the Obstetrics Department of our hospital from January 2015 to December 2015. The experimental group were consisted of who received non-invasive prenatal gene detection. The control group were consisted of those who are determined as high-risk and medium-risk pregnant woman by non-invasive prenatal gene detection and received chromosome karyotype analysis of amniotic fluid and umbilical cord blood. Pregnant women whose test results were both negative were followed up after giving birth, in order to determine whether there is missed diagnosis. The Diagnostic accuracy and clinical application value of non-invasive prenatal gene detection for fetal chromosomal aneuploidy is determined by comparison of positive results in both group and the follow-up after birth. ResultsA total of 920 cases received non-invasive prenatal gene detection, 5 positive results(3 cases of trisomy 21 syndrome, 1 case of trisomy 18 syndrome, 1 case of trisomy 13 syndrome) and 915 negative results. The results of chromosome karyotype analysis of amniotic fluid and umbilical cord blood as gold standard, comparison study were carried out. There was a false positive in trisomy 21 syndrome and no false positive in trisomy 18 syndrome and trisomy 13 syndrome. Follow-up study showed no missed diagnosis for negative results. Conclusion Non-invasive prenatal gene detection for fetal chromosomal aneuploid can improve the efficiency of prenatal diagnosis and reduce the birth of defective baby. The technology has characteristics of best detection time, non-invasive sampling, no abortion risk, high sensitivity and accuracy, which are more suitable for primary hospital.
2016, 39(3): 280-282.
doi: 10.3969/j.issn.1674-4500.2016.03.25
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Objective To investigate the feasibility of low dose CT (LDCT) combined with serum tumor markers in lung cancer at high risk for early diagnosis of lung cancer. Methods A total of 1020 patients with lung cancer in our hospital were divided into 2 groups according to the random number method: 420 cases of LDCT+ serum tumor marker group and 600 cases of CXR group. Comparison of two groups of inspection results. Results (1) In the group that 600 cases examined by CXR, 12 cases (2%) were found to have different numbers of non calcified nodules. The CXR, final diagnosed with lung cancer in 2 cases (0.33%); in the group with 420 subjects, 56 patients (13.33%) found that there is a different number of non calcified nodules by LDCT, significantly higher than that of CXR group (P＜0.01); (2) LDCT+ serum tumor signs in groups, diagnosed lung cancer group (n=5), screening positive group (n=56) and screening negative group (n=359) three groups of serum tumor markers compared to CEA levels between the three groups there was significant difference (P＜0.01). Conclusion LDCT combined with serum tumor markers in lung cancer high-risk population is feasible in the early diagnosis of lung cancer, and the clinical value is high.
2016, 39(3): 283-285.
doi: 10.3969/j.issn.1674-4500.2016.03.26
Abstract:
Objective To make the Kaplan - Meier analysis evaluation under arthroscopy recurrent patellar dislocation (PD) thejoint prosthesis of long-term outcome. Methods We selected 69 patients with PD PD patients were randomly divided into observation group (n=36) and control group (n=33), were given under the arthroscope sanlian repair and ordinary double beam anatomic reconstruction of the medial patellofemoral ligament in the treatment of PD. For patients with more than 5 years of long-term follow-up, compared before and after operation of the lateral patellofemoral Angle, Lysholm scale effect and maintain. Results The two groups before treatment of the lateral patellofemoral Angle and Lysholm scale are no difference between groups (P ＞0.05); At the time of the last follow-up, two groups of patients of the lateral patellofemoral Angle and Lysholm score were significantly greater than/higher than before the operation, observation group had a significantly greater than/the above both higher than that of control group (P＜0.05). Two groups there were 3 and 4 cases with delete, delete loss rate was no statistical difference (P ＞0.05). Two groups of curative effect to maintain time longest respectively in 75 and 68 months; The curative effect of observation group of arithmetic mean and the median time of 58 and 54 months respectively, and the control group of 48 and 42 months respectively. Kaplan and Meier analysis showed that the cumulative effect of two groups of patients maintain rate differences statistically significant (χ2=3.481, P=3.481). Conclusion The joint prosthesis under arthroscopy recurrent patellar dislocation long-term effect is superior to the ordinary double beam anatomic reconstruction of the medial patellofemoral ligament method.
2016, 39(3): 286-291.
doi: 10.3969/j.issn.1674-4500.2016.03.27
Abstract:
Objective To discuss miR-17, miR-92 and let-7 expression in non small cell lung cancer and cisplatin resistance and clinical application. To provide experimental data for prediction of lung cancer patients as a sign of cisplatin chemotherapy sensitivity. Methods Non small cell lung cancer cell line A549 and its resistant strain A549/DDP were used as the cell research object. The expression level of miR-17, miR-92 and let-7 in the cell was detected by RT-PCR method. CCK8 was used to detect the survival of the transfected cells after Cisplatin maintenance culture compare to untransfected cells. After transfection, cell proliferation was detected by Cell plate cloning experiments and apoptosis rate was measured by Flow cytometry. Result (1) The expression level of miR-17 in A549/DDP cells was (2.11 ± 0.25) times (P＜0.05) of A549 cells, and the expression level of miR-92 in A549/DDP cells was (7.40±1.05) times of A549 cells (P＜0.05). However, the expression of let-7 in A549/DDP cells was (26.54 ± 2.90)% (P＜0.05) of A549 cells; (2) A549 cells transfected with mir-17b, 92a mimic and let-7 microRNA inhibitor, compared to control group, showed a lower sensitivity to cisplatin (P＜0.05); while the sensitivity to cisplatin of A549/DDP cells transfected with mir-17b, 92a inhibitor and let-7 miRNA increased(P＜0.05); (3) A549 transfected with mir-17b, 92a mimic and let-7 microRNA inhibitor, the cells formed colony number is greater than that of the control group, the difference is statistically significant (P＜0.05); and A549/DDP transfectd with mir-17b, 92a inhibitor and let-7 miRNA, the cells formed clones colony quantity less than that of the control group, the difference is statistically significant (P＜0.05); (4) The apoptosis rate of A549 cells transfected with mir-17b, 92a mimic and let-7 microRNA inhibitor, apoptosis rate was significantly lower than the control group, the difference has statistical significance (P＜0.05); For A549/DDP cells transfected with mir-17b, 92a inhibitor and let-7 miRNA, the apoptosis rate was significantly higher than that of the control group, the difference was statistically significant (P＜0.05). Conclusion Mir-17, miR-92 expression level increased, let-7 expression level decreased, can promote the proliferation of lung cancer cells, inhibit apoptosis, as well as the decrease of lung cancer cell sensitivity to cisplatin.
2016, 39(3): 292-296.
doi: 10.3969/j.issn.1674-4500.2016.03.28
Abstract:
Objective To investigate the effects of astragalus injection on the mRNA and protein expression of β-catenin and E-cadherin in HEC-1-Bendometrial carcinoma cells. Methods Cell climbing slices of HEC-1-B cells were prepared for the intervening experiment of astragalus injection on endometrial carcinoma cells, then their mRNA and protein expression of β-catenin and E-cadherin detected by RT-PCR and immunohistochemistry. Results RT-PCR results showed that with the incubation time of endometrial cancer cells in conditioned medium containing astragalus injection increased, E-cadherin gene expression of the cells gradually increased (P＜0.05), while the β-catenin gene expression gradually decreased (P＜0.05). The immunocytochemistry result indicated thatastragalus could significantly decrease β-catenin expression and increase E-cadherin expression in HEC-1-B cells（P＜0.05）. Moreover, accompanied by elevated concentration and treatment time of astragalus injection, β-catenin expression dropped progressively (P＜0.05), meanwhile with the concentration of astragalus injection raised, E-cadherin expression gradually increased (P＜0.05). Conclusion Astragalus injection could significantly inhibit WNT signaling pathway by promoting mRNA andprotein expression of E-cadherin,decreasing mRNA and protein expression ofβ-cateninin a dose- and time-dependent manner, which might be one of the mechanisms for its anti-tumor effect.
2016, 39(3): 297-301.
doi: 10.3969/j.issn.1674-4500.2016.03.29
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Objective To investigate the effect of baicalein on tendon healing in bone tunnel and reveal its related molecular mechanism. Methods In vivo, 40 Sprague Dawley male rats were used to establish rat extra-articular tendon-to-bone transplanting healing, then randomly divided into 2 groups. Experiment group was treated with baicalein 10 mg/(kg·d），while control group was treated by normal saline (0.9%) with the same volume. Biomechanical testing and histological detection were tested at 3 weeks and 6 weeks after surgery. In vitro, tendom stem cells were isolated from rat Achilles tendon, and being treated with various concentrations of baicalein for 14 days. The expression of alkaline phosphatase（ ALP）and mineralized nodule was detected by ALP activity/staining assays and Alizarin red staining respectively，while the expression of Runx2, OSX, OCN, Collagen I were tested by Q-PCR and the expression of Runx2, OSX, OCN and β-catenin were evaluated by Western Blot assay. Results Tendon bone healing strength of experiment group was obviously stronger than control group in 3 weeks as well as in 6 weeks. In experiment group,there were more mature fibroblasts, more Sharphey fibers, and larger new bone formation area compared with control group.After intervention for 14 days,the expression of ALP,Runx2,OCN and VEGF were up-regulated，and WNT/β-catenin signaling were enhanced in vitro. Conclusion Baicalein can promotes osteogenic differentiation of tendon stem cells through WNT/β-catenin signaling in vitro, and stimulate tendon-bone healing in bone tunnel and enhance the connection between tendon and bone.
2016, 39(3): 302-305.
doi: 10.3969/j.issn.1674-4500.2016.03.30
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Objective To discusse the expression of β-catenin proten and its significance in mouse intestinal mucosa, and β-catenin was colse related to the proliferation of intestinal stem cells. Methods A total of 70 C57/BL mice were divided two goups randomly, 30 of them were in control group (group A), and other 40 mice were in experimental group. The mice in experimental group were treated with introperitoneal injection of large dose of 5-FU (150 mg/kg body weight for 5 consecutive days), the 30 mice were divied 3 groups, 10 of them were kill at the 1st the 3rd day and the 5th day after the injection was finished. The middle of intestine from these mice was fixed for HE straining and immunohistochemical techniques. The experession of β-catenin in the intestinal sample was detected by immunohistochemical techniques.The mice in control group were introperitoneal injected saline for five days as control, and them were treated as the mice in experimental group. Results After injectin hight dose of 5-FU, the intestine of the mice suffered severe damage: the mucosa was shown as inflammatory oedema, the villi and cryptes disappared, and the mucosa repaired minimally with time. The expression of β-catenin proten in intestianl mucosa of the mice after injecting hight dose of 5-FU increased significantly comparied with control the mice in control group, and percentage of β-catenin proten positive cells in intestinal mucosa gradually decreased with time in mice of experimental group. Conclusion The expression of β-catenin in intestinal mucosa increased when the mice were injected hight dose of 5-FU, meaning the proten could promote the proliferation of intestinal stem cells and finish the regeneration of intestinal mucosa.
2016, 39(3): 306-308.
doi: 10.3969/j.issn.1674-4500.2016.03.31
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Objective To explore the effects of PRDM1gene expression on the reproductive ability of Non-Hodgkin Lymphoma cells SUDHL-4． Methods Non-Hodgkin Lymphoma cells SUDHL-4 was chosed to show the biology behavior changes after overexpressing PRDM1 gene, through the MTT test, and cell cycle analysis. Results After overexpressing PRDM1 gene, the proliferation of SUDHL-4 cell were significantly decreased, and cell cycle arrested at G2/M (P<0.05). Conclusion The loss of PRDM1 gene may be related to the occurrence and development of lymphoma, and it may become the molecular diagnostics and new therapy target of lymphoma.
2016, 39(3): 309-311.
doi: 10.3969/j.issn.1674-4500.2016.03.32
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2016, 39(3): 312-314.
doi: 10.3969/j.issn.1674-4500.2016.03.33
Abstract:
Objective To analyze the difference of 2 staff allocation by contrasting the employee satisfaction and the rate of packaging defect when medical staff package hospital surgical instruments. Methods We compared the employee satisfaction and the rate of packaging defect from experimental group with staff allocation in August 2014 to January 2015 and control group with staff allocation in February 2014 to July 2014. Results Employee satisfaction of the experimental group was 96.2% while the control group was 61.5%. There was a significant difference (P<0.05); the rate of packaging defect in the experimental group was 8.4/ten thousand while in the control group wa 23/ten thousand, the difference was significant (P<0.05). Conclusion Optimizing the staff allocation could effectively decrease the rate of packaging defect and increase the employee satisfaction, eventually improve the work efficiency.
2016, 39(3): 315-316.
doi: 10.3969/j.issn.1674-4500.2016.03.34
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Objective To investigate the clinical effect of correcting occipitoposterior position by changing maternal body position during laboring. Methods We selected 172 cases of mature primigraida who visited the Obstetrics Department of our hospital from May 2014 to May 2015. All the primigraidas were in incubation period or active period and were confirmed as occipitoposterior position by physical examination and ultrasonography. The experimental group and the control group were divided according to the wishes and requirements of the primigraidas. The control group received routine treatment and the the experimental group received position intervention in addition to routine treatment. Retrospective comparison of the two groups was carried out in aspects of maternal natural labor rate, cesarean section rate, labor time, maternal and infant complications. Results There were significant differences between the two groups in aspects of maternal natural labor rate (61.6% vs 34.9%, experimental group vs control group), cesarean section rate(27.9% vs 37.2%, experimental group vs control group), labor time, maternal and infant complications(P<0.05). Conclusion Correcting occipitoposterior position by changing maternal body position during laboring plays an important role in ensuring the life safety of mother and infant, for it is helpful to vaginal delivery and it reduces dystocia as well as improves the quality of delivery.
2016, 39(3): 317-319.
doi: 10.3969/j.issn.1674-4500.2016.03.35
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Objective To investigate the effect of PDCA circulation method applied in operation room management on the implementation rate of hand hygiene and nursing quality of personnel. Methods A total of 120 cases of medical staffs in 10 key operation sections were selected as study subjects between May 2014 and June 2015. By the random number table method, they were divided into observation group and control group, 60 cases in each. The control group implemented routine operation room management. On the basis, the observation group adopt PDCA circulation method to manage the operation room. The implementation rate of hand hygiene, awareness rate of hand hygiene, incidence of adverse events and patients' satisfaction to nursing were compared between the two groups. Results After intervention, the implementation rate and awareness rate of hand hygiene in the observation group (83.3%, 81.7%) were significantly higher than those in the control group (66.7%, 65.0%) (P<0.05); The incidence rate of adverse events in the observation group (23.3%) was lower than that in the control group (40.0%) (P<0.05); The patients’satisfaction to nursing in observation group (88.3%) was significantly higher than that in the control group (73.3% ) (P<0.05). Conclusion The application of PDCA circulation method in operation room management can effectively improve the implementation rate and awareness rate of hand hygiene, and improve the nursing quality, which is worthy of clinical promotion.
2016, 39(3): 320-322.
doi: 10.3969/j.issn.1674-4500.2016.03.36
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Objective To analyze the stress of paediatric patients's families in neonatal intensive care unit and implementing intervention. Methods A total of 300 paediatric patients's families during hospitalization between 2013. 06 and 2014. 06 were selected as object. Psychological factors was analysed with self-rating anxious scale(SAS) and self-rating depression scale(SDS). Implement intervention were performed on stressors. Families pre-intervention were performed as control group and post-intervention as experimental group. The psychological factors of 300 families of post-intervention with that pre-intervention were compared. Results By intervention to the stressors of paediatric patients's families, patients' families got an increased knowledge of disease, environment of neonatal intensive care unit and work of medical personnel. The negative emotions of anxiety and depression were significantly less than pre-intervention(P<0.05). Conclusion Recognization stressor of paediatric patients's families, decreasing stressors of families, implementing nursing care and providing emotional support, meeting relations' requirements, and optimizing the service will reduce doctor-patients' disputs, harmonize the doctor-patient relationship and elevate the degree of satisfaction of paediatric patients's families.
2016, 39(3): 323-325.
doi: 10.3969/j.issn.1674-4500.2016.03.37
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Objective To explore the nursing path of invasive diagnosis of early cirrhosis with combined detection. Methods A total of 80 cases of patients with suspected early cirrhosis who were admitted in our hospital between May 2013 and December 2014 were selected as study objects. The noninvasive diagnosis was performed under combined detection. The patients were divided into observation and control group by random number table, 43 cases in each. The control group received routine nursing while the observation group received clinical nursing path intervention. The average hospitalization time, medical expenses and nursing satisfaction were compared between the two groups. Meanwhile, the incidence of complications and rate of readmission within 1 year were recorded. Results The hospitalization time [(10.2±2.04) d] and medical expenses [(6.7± 2.6) thousand yuan] of the observation group was significantly less than that of the control group (P<0.05). The nursing satisfaction score (84.29±5.18) in the observation group was higher than that of the control group (P<0.05); The incidence rate of complications (12.5%) and the rate of readmission in 1 year (10.0%) in the observation group were lower than those in the control group (P<0.05). Conclusion The value of clinical nursing path applied in invasive diagnosis of early cirrhosis is relatively higher. It can reduce the medical expenses and shorten length of hospital stay. It is of positive significance in improving the long-term prognosis.
2016, 39(3): 326-327.
doi: 10.3969/j.issn.1674-4500.2016.03.38
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2016, 39(3): 328-330.
doi: 10.3969/j.issn.1674-4500.2016.03.39
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Objective To explore the factors influencing family decision to offer the relative organ donation and the solution by the interview work of the donation after the citizen's death(DCD), providing the basis for alleviate the shortage of organ in the clinical supply plan. Methods A total of 62 cases with the potential DCD who were treated and analyzed in the transplantation medicine center from Jan. 2015 to Jan. 2016 were recruited as the study objects, the influence factors were explored on the decision analysis of the families to relatives organ donation and counter measures, of DCD case analysis, interview time, investigators professional degree, by the interview work of the DCD, the family acceptance for organ donation, the family structure, and the impact of family members to DCD decided. Results The key success factors of the DCD :(1) Interview time were chosed when the all family members gived up after the treatment; (2)the concept and process of the clinical DCD and the usage of DCD system would not be questioned; (3)investigators were performed the skills training of the DCD interview;(4) the patient's family structure was nuclear family, the participants in the DCD discussion only were the core members of the family. Conclusion The DCD decision of family is influenced by many factors,the DCD system need to be standardized by the government and medical institutions , the professional training to the investigators can be strengthened, the DCD knowledge should spread,the social public opinion of the DCD have to improve,the national DCD registration and distribution platform can be established,the organ shortage must be alleviated and the quantity and donation rates of DCD can be improved in the important clinical significance.
2016, 39(3): 331-332.
doi: 10.3969/j.issn.1674-4500.2016.03.40
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Objective To explore the influence of standard operation and work procedure in the process of medical waste disposal on the prevention of needle stick injury. Methods A total of 105 cases in hemodialysis room in 2014 were collected. We made the standard procedure and work process of medical waste disposal and enforce the standard procedure in the 9471 hemodialysis cases in 2015. Observe and analyze the effect to prevent needle stick injury on medical staff during the medical waste disposal procedure. Results The incidence rate of needle injury during the procedure of medical waste disposal in 2014, to nurse was 0.3‰, care worker was 0.5‰ and worker was 0.5‰, the part of procedure that injury occurred was transport of medical waste,medical waste disposal and carriage. Against this result make the standard procedure and enforced it, the rate of needle stick injury was 0 in nurse,care worker and workers. Conclusion Standard operation and work procedure can decrease the rate of needle stick injury effectively.
2016, 39(3): 333-335.
doi: 10.3969/j.issn.1674-4500.2016.03.41
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Objective To study the holistic nursing in painless gastroscopy examination for elderly patients with arrhythmia. Methods From January 2010 to March 2014, 217 elderly outpatients and inpatients received painless gastroscopy examination. The patients aged from 60~78 years, average 67.5 years old. Arrhythmia types: 33 cases with Sinus tachycardia, 16 cases with sinus bradycardia, 71 cases with ST-T changes, 14 cases with premature ventricular contractions, 29 cases with Supraventricular premature beats, 23 cases with atrial premature beats, 19 cases with premature ventricular contractions combined ST-T changes, 12 cases with atrial premature beats combined ST-T changes. All patients have received holistic nursing respectively before painless gastroscopy inspection, the inspection process and after the inspection. Results All patients have been successfully in painless gastroscopy examination, 24 cases with transient speed up or slow down the heart rate, blood pressure drop, 45 cases with transient slow down the SpO2. Vital signs back to normal after anesthesiologists processed promptly. There is no serious arrhythmias, myocardial ischemic changes in all patients, overall satisfaction of patients by telephone or survey was 95.4%, 80.6% of patients were willing to accept the same examination again. Conclusion Painless gastroscopy examination has potential risks, holistic nursing intervention can significantly improve safety and patient satisfaction in painless gastroscopy examination.
2016, 39(3): 336-338.
doi: 10.3969/j.issn.1674-4500.2016.03.42
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Objective To observe the effect of nursing care for pain of postoperative of acromioclavicular joint dislocation. Methods We selected 200 patients of acromioclavicular joint dislocation who were conducted open reduction and internal fixation,and randomly divided into group A and B. patients of group A were given antalgesic follow the doctors'advice, and patients in group B were given nursing intervention such as environment control, psychological nursing, posture nursing, guiding functioning training, auricular point sticking apart from basic conventional disposal, observed the number rating scale (NRS) at 1st, 2nd, 3rd day postoperation of both groups. Results The score of NRS at 1st, 2nd, 3rd day of group B were significantly better than group A respectively(P<0.05). Conclusion Nursing intervention to the postoperative patients of acromioclavicular joint dislocation can effectively relief pain and improve the quality of life during hospitalization.
2016, 39(3): 339-341.
doi: 10.3969/j.issn.1674-4500.2016.03.43
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Objective To reduce the difficuty and cost incurred to small and medium sized hospitals in their construction of PACS system. Methods Based on SaaS model incorporated with cloud algorithms, Cloud PACS was proposed of which cloud PACS was designed in three parts: cloud displaying, cloud flow chart and cloud doc-filing. Results Flexible use of cloud PACS was believed to be capable of reducing both the cycles and costs caused by small and medium sized hospitals in maintenance of PACS construction. Conclusion Cloud algorithms based PACS is believed to represent The development of new generation of PACS, a forthcoming new guideline for small and medium sized hospitals, regional medical treatment and group hospitals in building up their PACS
2016, 39(3): 342-344.
doi: 10.3969/j.issn.1674-4500.2016.03.44
Abstract:
