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Quick Search     Adv Search 2016 Vol. 33, No. 5 Published: 2016-06-25   833 Study on the Changes of PostStroke Apathy Within Six Months and Predictors of PostStroke Apathy WANG Jun，WANG Zhengze，GAO Lianbo，et al 【Objective】The aim of this study was to clarify the changes of poststroke apathy (PSA) within six months and to examine the predictors for poststroke apathy (PSA). 【Methods】220 patients with acute cerebral infarction were recruited for the study and divided into group Ⅰ (acute and 6months apathy),Ⅱ (acute apathy but 6months nonapathy), Ⅲ (acute nonapathy but 6months apathy) and Ⅳ (acute and 6momths nonapathy) . They completed assessments at the acute stage and after six months followup. The Apathy Scale (AS) was used to assess PSA. MiniMental State Examination (MMSE) was used to assess cognitive function and the National Institutes of Health Stroke Scale (NIHSS) was used to assess stroke severity. Functional outcome was assessed with the modified Rankin Scale (mRS). Functional outcome in daily living activities was assessed with the Barthel Index（BI）at acute stage and six months followup. The serum levels of homocysteine (Hcy), uric acid (UA), highlysensitive Creactive protein (hsCRP), lipid spectrum, glycated hemoglobin (HbA1c), and fibrinogen of patients were determined at admission and six months follow up. 【Results】At the six months follow up: age, NIHSS score, mRS score, hsCRP level, and Hcy levels in Group A were significant higher than in other groups. Education，MMSE score，BI score，HbA1c level, and UA levels, however, were significant lower than in other groups. The comparison of clinical data in the four groups of patients at the acute stage were as follows: compared with group Ⅰ, MMSE score, HbA1c level in group Ⅱ,Ⅲ and Ⅳ were lower than in group Ⅰ. However, hsCRP levels in the Ⅱ,Ⅲ and Ⅳ groups were higher than in group Ⅰ(P<0.05). 【Conclusion】The study found independent associations of age, education, NIHSS score, MMSE score, mRS score, BI score, HbA1c level, hsCRP level, Hcy level, and UA levels with PSA at six months follow up. Furthermore, MMSE score, HbA1c level, and hsCRP level during the acute of stroke may be the predictors of PSA. 2016 Vol. 33 (5): 833-837 [Abstract] ( 112 ) HTML (1 KB)  PDF  (0 KB)  ( 27 ) 838 Comparative Study of Laparoscopy and Hysteroscopy on the Treatment of Uterine Fibroids on Ovarian Function, Immune Function and Quality of Sexual Life YAO Xiuling,LIU Xiuyun,ZHAO Wei，et al 【Objective】To investigate the influence of laparoscopic and hysteroscopic treatment of uterine fibroids on ovarian function, immune function and quality of sexual life. 【Methods】From June 2014 to February 2016, 210 cases of patients with submucosal myoma of uterus in our hospital were selected and randomly divided into two groups according to the digital table method: laparoscopic group and hysteroscopy group, 105 cases in each group. The laparoscopic group were treated with laparoscopic uterine fibroids, and hysteroscopy group with hysteroscopy resection for the treatment of uterine fibroids. The operation time, blood loss, postoperative exhaust time, hospital stay and postoperative analgesic use were observed and compared between the two groups. At the same time, 3month changes of ovarian reserve function indexes ［luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2)］ quality of sex life and immune function of the two groups of patients before and after surgery were compared.【Results】There was no statistical difference at operation time, intraoperative blood loss, postoperative analgesic use rate in the two groups (P>0.05). The postoperative exhaust time and hospitalization time of the hysteroscopy group were significantly shorter than that of the laparoscopic group (P<0.01); No significant difference in E2 and LH between the two groups before and 3 months after operation; The FSH was significantly increased in the 3 months after operation in the laparoscopic group (P<0.01). There was no significant difference in the quality of sex life between the two groups before and 3 months after opeartion(P>0.05); There was no significant decrease in cellular immune function and humoral immune function in the hysteroscopy group before and after operation in 3 months, while the cell immune function of the laparoscopic group was significantly decreased (P<0.01), but the humoral immune function decreased significantly (P>0.05).【Conclusion】Compared with the laparoscopic uterine fibroid removal, the uterine fibroids resection by hysteroscopy in the treatment of submucosal myoma of uterus takes less trauma with faster postoperative recovery, and have no significant effect on ovarian reserve function, sexual function and immune function. 2016 Vol. 33 (5): 838-845 [Abstract] ( 144 ) HTML (1 KB)  PDF  (0 KB)  ( 31 ) 842 Correlation Study of Plasma 5HT of IBS Patients and the Status of Anxiety and Depression Associated LIU Lini,ZHANG Xianghui,ZHOU Hejun,et al 【Objects】 To explore 5hydroxytryptamine (5HT) and its metabolite 5 hydroxyindoleacetic acid (5HIAA) of patients with different subtypes of irritable bowel syndrome (IBS) and the possible relationship with anxiety and depression . 【Methods】 Patients diagnosed as constipation type IBS (IBSC) and diarrhea type IBS (IBSD) in the Department of Internal Medicine, Xiangya No.2 Hospital, Central South University from April 2014 to April 2015 were selected as the observation group, and those who underwent removal of single colon polyps at least one year ago and showed Normal through colonoscopy examination were selected as the control group. The Hamilton anxiety scale and depression scale were used to evaluate the mental and psychological evaluation of the study subjects, and peripheral blood was taken to detect the concentration of plasma 5HT and 5HIAA. The changes of plasma 5HT and 5HIAA concentrations in IBSC group, IBSD group and the control group were compared, and the changes of plasma 5HT and 5HIAA concentrations in IBS patients with anxiety and depression were analyzed.【Results】 The percentages of associated anxiety of IBSC, IBSD and the control group were 14.3%, 61.1%, 9.5%, and depression associated with were 42.9%,22.2%, 9.5% respectively; The proportion of associated anxiety and depression in the IBS group was higher than that in the control group, the proportion of IBSC with depression was higher than that in control group, and the proportion of IBSD with associated anxiety was higher than that in the control group (P<0.05). The plasma 5HT levels in IBSC group and IBSD group were significantly higher than those in the control group (P<0.05). There was no significant difference in plasma 5HIAA concentration between the three groups. Plasma concentrations of 5HT in IBS patients associated with depression were higher than those without it (P<0.05). There was no significant difference in plasma 5HT concentration between IBS patients associated with or without anxiety (P>0.05) .【Conclusions】The proportion of IBS patients with anxiety and depression is higher than that in normal subjects. The plasma 5HT concentration in IBS patients is higher than that in the normal subjects, and their the state of 5HT increased obviously. 2016 Vol. 33 (5): 842-845 [Abstract] ( 73 ) HTML (1 KB)  PDF  (0 KB)  ( 35 ) 846 Anesthetic Management for Infants Undergoing Rapid TwoStage Arterial Switch Operation HUANG Yue,SONG Yunan,ZHANG Jianwei,et al 【Objective】To collect and summarize the perioperative data and information of infants undergoing rapid twostage arterial switch operation (ASO).【Methods】The data we retrospectively reviewed included 14 infants who had undergone the rapid twostage arterial switch operation (ASO). Anesthesia was maintained with sufentanil, propofol, and rocuronium infusion combined with sevoflurane inhalation during ASO. Cardiac function was maintained by dopamine, milrinone, and adrenaline infusion after the release of the aortic crossclamp. The patients were then rewarmed to 36oC, improving coagulation function and maintaining acidbase balance, before weaning off the cardiac pulmonary bypass (CPB). 【Results】Of the 14 patients who undergone the firststage preparatory operation, two died of low cardiac output syndrome (LCOS). The other 12 patients underwent the secondstage ASO. The vasoactiveinotrope score before and after ASO were 16.75 (P25, P75: 12.625, 28.375) and 22.5 (P25, P75: 15.375, 29.375), respectively. There were an additional two deaths (2/12, 16.7%) after ASO. The incident of postoperative LCO and hypoxemia were 58.3% (7/12) and 16.7% (2/12), respectively. No patients died of anesthesia.【Conclusion】The key to successful anesthesia management in rapid twostage ASO is maintaining and improving left ventricular function. It is essential to use appropriate anesthetics intraoperation as well as to strengthen myocardial contractility, to decrease afterload and pulmonary vascular resistance, and to improve coagulation function. 2016 Vol. 33 (5): 846-848 [Abstract] ( 61 ) HTML (1 KB)  PDF  (0 KB)  ( 39 ) 849 Etiological Analysis of Neurological Outpatients with Vertigo/Dizziness ZHAO Yong，FU Wei，HUI Juan，et al 【Objective】To explore the common etiologies and their respective proportions in patients visiting the Neurology Department with the chief compliant of vertigo/dizziness. 【Methods】Patients who visited the Vertigo Clinic of the Neurology Department of our hospital with the chief compliant of vertigo/dizziness were collected continuously from January 2014 to June 2015. The etiology of vertigo/dizziness was determined in accordance with the current international recognized diagnostic criteria for the specific disease, and the proportion of various etiologies of vertigo/dizziness was analyzed. 【Results】A total 1615 patients were enrolled, including 630 males and 985 females, with the male/female ratio 1:1.6. The 5 most common etiologies were benign paroxysmal positional vertigo, migrainous vertigo, bilateral vestibular hypofunction, vestibular neuritis, and central vertigo, accounting for 28.3%, 10.5%, 8.0%, 5.8% and 5.6% of all etiologies, respectively. Psychogenic dizziness was diagnosed in only 5.3% of the patients, and the proportion of patients with unknown etiology was as high as 18.7%. 【Conclusion】Benign paroxysmal positional vertigo and Migrainous vertigo are the most common etiologies of vertigo/dizziness; females are more susceptible to vertigo than males; the proportion of psychogenic dizziness is relatively low; the proportion of vertigo/dizziness of unknown etiology is relatively high. 2016 Vol. 33 (5): 849-852 [Abstract] ( 89 ) HTML (1 KB)  PDF  (0 KB)  ( 32 ) 853 Analysis of the Influencing Factors of Chronic Pain in Patients after Thoracotomy via Thoracoscope ZHAO Qiaoyan,ZHANG Yijie,WANG Na 【Objective】To discuss the influencing factors of chronic pain in patients after thoracotomy via thoracoscope. 【Methods】One hundred and eighty patients treated by thoracotomy via thoracoscope in our hospital from January, 2012 to January, 2015 were chosen as the study subjects. The preoperation data, data during operation, preoperation acute pain assessment, and postoperation and followup status on pain postdischarge were analyzed. The influencing factors of patients with chronic pain after thoracotomy via thoracoscope were analyzed by single factor and Logistic regression analysis. 【Results】One hundred and eighty patients treated by thoracotomy via thoracoscope were brought into the study; 164 patients finished the 3 months followup and were divided into an observation group and a control group according to the presence or lack of chronic pain after thoracotomy via thoracoscope. Some differences in data between two groups were statistically significant (P<0.05). This data included sex ratio, time of circulation assistance and aorta occlusion, time of operation, postoperative analgesia, NRS score at rest and during activity 1~5 days after surgery, and so on. Other differences of data between two groups were not statistically significant (P>0.05). These included age, BMI, smoking, drinking, dosage of fentanyl during surgery, time of thoracic close drainage, and hospital stays after surgery. The results of Logistic regression analysis showed that being female, receiving postoperative analgesia, and the pain degree during activity 1~5 days after surgery were the significant influence factors for patients with chronic pain after thoracotomy via thoracoscope. 【Conclusion】Pain degree during activity 1~5 days after surgery is the most preventable factor for chronic pain after surgery. The control of acute pain after surgery can help to reduce the occurrence of chronic pain after surgery. 2016 Vol. 33 (5): 853-856 [Abstract] ( 73 ) HTML (1 KB)  PDF  (0 KB)  ( 37 ) 856 Expression of MiR21 and TGFβ1 in Pulmonary Fibrosis of Inflammatory Mass and Its Significance DENG Yanling，WANG Yichun,GUO Qulian 【Objective】To examine the levels of expression of microRNA21(miR21) and transforming growth factor β1(TGFβ1)in lung tissues with fibrosis and its adjacent nonfibrosis tissues.【Methods】Specimens of pulmonary fibrosis tissue and adjacent tissues were collected from 10 patients. Their miR21 and TGFβ1 expression levels were detected by Realtime PCR. 【Results】High sensitivity, specificity, and precision of RTPCR allowed for direct analysis of expression of miR21 and TGFβ1 expression in pulmonary fibrosis tissues and adjacent tissues. The expression miR21 and TGFβ1 in pulmonary tissues was significantly higher than in adjacent tissues (P<0.001). 【Conclusions】 Elevated expression of miR21 and TGFβ1 play an important role in the pathogenesis of diseases related to fibrogenic reactions in pulmonary inflammatory mass patients. 2016 Vol. 33 (5): 856-858 [Abstract] ( 71 ) HTML (1 KB)  PDF  (0 KB)  ( 32 ) 859 Comparison of the Effects of Surgery and Combinatory Chemotherapy in the Treatment of Primary Esophageal Small Cell Carcinoma DONG Huaqiong，ZHOU Qiang，LIU Li,et al 【Objective】To study the clinical treatment methods and respective treatment effects of primary esophageal small cell carcinoma, and to provide the basis for improving the cure rate. 【Methods】 According the hospital data, 84 cases of patients with primary esophageal small cell carcinoma were analyzed according to different therapeutic measures, and the patients were divided into the control group of 42 cases and the experimental group of 42 cases. The control group was treated with surgical treatment, whereas the experimental group was additionally treated with chemotherapy on the basis of surgical treatment. The treatment effects were compared between the two groups. 【Results】The total efficiency of treatment in the experimental group was 40.5%, which was significantly higher than that of the control group of 35.7% (P<0.05). The physiological condition, somatic symptoms, anxiety, depression, compulsive behavior, vitality, sleep, sexuality, hostility, working status, and interpersonal relationship scores of the patients in both groups before treatment were not significantly different (P>0.05). After the treatment, the living conditions, somatic symptoms, vitality, and working condition scores were significantly higher in the control group (P<0.05). After treatment, the sexuality, hostility, and interpersonal scores were not significantly different between the two groups (P>0.05). 【Conclusion】The surgical combined with chemotherapy treatment of patients with primary esophageal small cell carcinoma turned out better results; it can prolong the survival time of the patients, and is worthy of popularization and application. 2016 Vol. 33 (5): 859-864 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 30 ) 861 Protective Effects of Paeoniflorin on Acute Liver Injury in Experimental Rats with Sepsis ZHOU Lifang，PENG Huiyun,OUYang Wenxian,et al 【Objective】To investigate the protective effects of paeoniflorin (PF) on acute liver injury (ALI) in experimental rats with sepsis.【Methods】Cecal ligation puncture (CLP ) was used to induce acute liver injury in rats with sepsis, 36 male SD rats were randomly divided into sham operation group, model group and PF intervention group, with 12 rats in each group. The sham operation group underwent only open abdominal surgery, the model group was given CLP, the PF intervention group received PF intraperitoneal injection immediately after CLP. 48 h after mold processing, the survival situation of rats in each group was observed, the survival curve was drawn. Serum alanine aminotransferase levels were detected in each group; xanthine oxidase method was used to detect superoxide dismutase (SOD) activity. The content of malondialdehyde (MDA) was detected by using the method of the content of MDA; HE staining was used to observe the pathological changes of liver tissue.【Results】The survival rate of the sham operated group was 100%, significantly higher than that in the model group and 66.7% in the PF intervention group (P<0.05), while the survival rate of the intervention group was significantly higher than that in the model group (P<0.05); Compared with the sham operation group, the serum ALT level of the model group was significantly higher, and the difference was statistically significant (P<0.05); Compared with the model group, the serum level of PF in the ALT intervention group was decreased, and the difference was statistically significant (P < 0.05). Compared with the sham operation group, the content of MDA and the activity of SOD were decreased in the model group (P<0.05); Compared with the model group, the content of MDA in the PF intervention group was decreased, and the SOD activity was enhanced, and the difference was statistically significant (P<0.05). Pathological sections showed no significant changes in liver structure of sham operated rats, The liver cells in model group showed focal necrosis and a large number of inflammatory cell infiltration. Compared with the model group, the pathological injury in the PF intervention group was significantly improved.【Conclusion】 PF has a protective effect on CLP induced sepsis in rats with ALI . The mechanism may be oxidation reaction. 2016 Vol. 33 (5): 861-864 [Abstract] ( 69 ) HTML (1 KB)  PDF  (0 KB)  ( 42 ) 865 Analysis of Pathogenic and Drug Resistance of Lower Respiratory Tract in COPD Patients Underwent Invasive Mechanical Ventilation YAO Jiankun 【Objective】To investigate the composition and drug resistance of pathogens in lower respiratory tract in patients with chronic obstructive pulmonary disease (COPD) with invasive mechanical ventilation. 【Methods】 The 380 patients with COPD who were treated with invasive mechanical ventilation in our hospital from January 2011 to December 2014 were selected as the study subjects. The lower respiratory tract secretions of patients were collected and cultured, The pathogenic bacteria composition ratio and main sensitivity results of pathogenic bacteria drug were analyzed. 【Results】 In 380 cases of lower respiratory tract secretions, 342 strains of pathogenic bacteria were detected, including 223 gram negative bacteria (65.20%), 92 strains of gram positive bacteria (26.90%) and 27 strains of fungi (7.89%). Among the gram negative bacteria, 53 strains of Acinetobacter Bauman (23.77 %), 48 strains of Stenotrophomonas maltophilia (21.52%), 42 strains of verdigris pseudomonas (18.83%) and 34 strains of Klebsiella pneumonia (15.25%). Among the gram positive bacteria, 31 strains of Staphylococcus aureus (9.06%), 24 strains of Streptococcus pneumonia (7.02%), 16 strains of Staphylococcus haemolyticus (4.68%) and 14 strains of Staphylococcus epidermidis (4.09%). 11 strains of Candida albicans (3.22%), 8 strains of Tropical Candida (2.34%) and 6 strains of Aspergillus (1.75%). Bauman Acinetobacter was sensitive to gentamicin, Amikacin, tobramycin and minocycline. Stenotrophomonas maltophilia was sensitive to ciprofloxacin and levofloxacin. Pseudomonas aeruginosa was sensitive to ciprofloxacin, levofloxacin and tobramycin and minocycline. Klebsiella pneumoniae was sensitive to imipenem, Amikacin, tobramycin, ciprofloxacin and levofloxacin. The gram positive bacteria were sensitive to vancomycin and teicoplanin, rifampicin, linezolid and sulfamethoxazole compound. Except for Aspergillus, Candida albicans and Tropical Candida were more sensitive to antifungal agents. 【Conclusion】 The infection rate and drug resistance rate of COPD are high. To understand the distribution and drug resistance of pathogenic bacteria in our hospital can provide the basis for clinical rational use of antibiotics, reduce drug resistance rate and improve the cure rate and shorten the treatment time. 2016 Vol. 33 (5): 865-869 [Abstract] ( 77 ) HTML (1 KB)  PDF  (0 KB)  ( 31 ) 869 TExpression Level and Significance of Serum Leptin, hsCRP and Adiponectin in Patients with T2DM SUN Dianjing，DAI Xiaoru，MIAO Huiling，et al 【Objective】To investigate the expression level and significance of serum leptin, high sensitive C reactive protein (hsCRP) and adiponectin in patients with type 2 diabetes mellitus (T2DM). 【Methods】 From September 2013 to August 2015, 120 patients with T2DM were chosen as study group. At the same time, 60 nonT2DM patients were chosen as control group. The clinical features were collected, and the disease history, BMI, blood lipid, FPG and HOMAIR were recorded. All patients were detected with leptin, hsCRP and adiponectin. 【Results】 The adiponectin was negatively related to leptin（P＜0.05）; the adiponectin was negatively related to BMI, blood lipid, HOMAIR and hsCRP（P＜0.05）; the leptin was positively related to BMI, blood lipid, HOMAIR and hsCRP（P＜0.05; hsCRP was positively related to HOMAIR（P＜0.05）.The course of disease was positively related to leptin and hsCRP （P＜0.05）, and it was negatively related to adiponectin （P＜0.05）. 【Conclusion】 Serum leptin, hsCRP and adiponectin levels were significantly correlated with course of disease , BMI and blood lipid levels in patients with T2DM. 2016 Vol. 33 (5): 869-872 [Abstract] ( 124 ) HTML (1 KB)  PDF  (0 KB)  ( 41 ) 873 Early Clinical Observation on Effect of the Treatment of Femoral Neck Fracture in Young Adults with Maguxujin Capsule SHAO Mingxing，WANG Feng，SHI Jing,et al 【Objective】To observe the early clinical effect of Maguxujin capsule on the treatment of femoral neck fracture in young adults. 【Methods】 Fiftyfive cases of young adult femoral neck fracture patients in our hospital from February 2014 to February 2015 were selected and randomly divided into the treatment group (28 cases) and control group (27 cases). The control group were given with conventional therapy(Closed reduction and hollow screw fixation); the treatment group were treaded with Maguxujin capsule on the basis of routine treatment. 42 days after treatment, the time of subjective pain disappearance and swelling , callus growth and the serum calcium decreased level of the two groups on d14, d21, d42 were evaluated and compared. 【Results】Patients were scored in accordance to the severity of symptoms method . The results showed that in the observed group d21、d42 score was 0.902 ± 0.302, 0.082 ±0.324, which were significantly lower than those of the control group 1.105 ± 0.213, 0.113 ± 0.34, the difference had statistical significance (P<0.05)；In the observation group, the subjective pain disappearance time averaged (6.056 ±1.779) d ,which was significantly lower than that in control group (8.035 ± 1.093) d, the difference had statistical significance (P<0.05). In the observation group, on d14, d21, d42 after taking Maguxujin capsules, callus growth score was 0.664 ± 0.021, 196.5 ±0.121, 2.983 ±0.122, which were significantly higher than those of the control group 0.521 ± 0.015, 1.654 ±0.123, 275 ± 0.111, the difference had statistical significance (P<0.05);In the observation group, on d14, d21, d42 after taking Maguxujin capsules, the serum calcium concentration were 2.562 mmol / L, 2.325 mmol, 2.176 mmol/L respectively;while in the control group, they were 2.563 mmol/L、2.545 mmol/L、2.400 mmol/L, the serum calcium level of the two groups of patients were decreased during the previous14 days, but difference had no statistical significance (P> 0.05); the serum calcium level of d21, d42 in the observation group decreased faster than that of the control group, the difference was statistically significant (P>0.05).【Conclusion】 Maguxujin capsule can shorten the patient's time of subjective pain, promote the lesion of bone callus growth, active blood circulation and remove blood stasis with sound detumescence effect. It is expected to improve femoral neck fracture healing 2016 Vol. 33 (5): 873-875 [Abstract] ( 91 ) HTML (1 KB)  PDF  (0 KB)  ( 28 )

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