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Quick Search     Adv Search 2018 Vol. 35, No. 8 Published: 2018-08-30   1457 Study on the Relationship between Middle Cerebral Artery Morphology and Aneurysm Formation WANGJuan, ZHANGWei, LITing DOI: 10.3969/j.issn.1671-7171.2018.08.001 【Objective】 To investigate the relationship between (MCA) geometry and aneurysm formation in middle cerebral artery (MCA).【Methods】 Fifty-eight MCA aneurysms in Hunan Brain Hospital from January 2014 to March 2017 were retrospectively analyzed (including 15 cases as proximal aneurysm group, 35 cases as bifurcation aneurysm group and 8 cases as distal aneurysm group),and 50 patients underwent CTA with no aneurysm as control group. The angle between MCA and the ipsilateral internal carotid artery (α) and the ipsilateral anterior cerebral artery (β) were measured respectively in the aneurysm group and the control group, and the vascular diameter and branch diameter of the branched artery in the branched aneurysm group and the control group were measured. The angle between coarse branch and trunk (γ 1), the angle between branch and trunk (γ 2), the angle of bifurcation (γ 3), the ratio of angle between two branches (larger branch angle / smaller branch angle) and the diameter ratio of branch tube (wider branch / smaller branch) are calculated.【Results】 There was no significant difference in α, β between the proximal aneurysm group and the control group (P>0.05), The β of distal aneurysm group was significantly lower than that of control group (P<0.05), but α was not significantly different from that of control group (P>0.05). There were significant differences in γ 1, γ 2, γ 3 and branch diameter between the bifurcation aneurysm group and the control group (P<0.01), but there was no significant difference between the α, β, branch diameter ratio and the two-branche angle (P>0.05). The area under the curve of the distal aneurysm group β, branched aneurysm group γ 2, γ 3 and diameter of branched aneurysms was greater than 0.7. The area under curve of bifurcation aneurysm group γ 1 was 0.672. When β=110.5°, the sensitivity and specificity were the highest.【Conclusion】 There were significant differences in γ 1, γ 2, γ 3 between the bifurcation aneurysm group and the control group, in bifurcation diameter and β between the distal aneurysm group and the control group. The MCA geometric parameters mentioned above can be used as a sensitive index to evaluate the aneurysms. 2018 Vol. 35 (8): 1457-1460 [Abstract] ( 49 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1461 The Clinical Study of Ibandronate Administration in the Treatment of Metastatic Bone Pain in the Patients of Malignant Cancer YANGLu-lu, DENGWeng-ying, LUOSu-xia DOI: 10.3969/j.issn.1671-7171.2018.08.002 【Objective】 To observe the curative effect and safety of the first dose loading and the repeated loading dose of ibandronate in the treatment of metastatic bone pain of malignant tumors. 【Methods】 Forty patients with malignant bone metastases from 2012 to 2017 were selected, including 20 cases in the first dose loading group (group A) and 20 cases in the repetitive loading dose group (group B). The pain score, quality of life KPS score, onset time of analgesia, duration of analgesia maintenance, and adverse reactions were observed and recorded before and after the application of ibandronate. 【Results】 The effective rate of pain relief was 55% (11/20) in the group A and 90% (18/20) in the group B (P<0.05). The scores of quality of life (QOL) in the group A (83±10.89) were lower than those in the group B (91.00±7.88), and the difference was significant (P<0.05). The time of analgesic effect and maintenance were (3.60 ±0.50) days and (20.35 ±1.87) days in the group A, lower than those in the group B (2.70±0.40) days and (23.30±1.34) days, respectively (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 Repeated administration of ibandronate has a good analgesic effect and could improve metastatic bony pain rapidly, the kidney of the patients has good tolerance and mild adverse reaction, which is worth popularizing. 2018 Vol. 35 (8): 1461-1463 [Abstract] ( 41 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1464 Effect of Cognitive-behavioral Therapy on Emotional State and Life Quality in Patients Undergoing Laparoscopic Radical Prostatectomy LUODian-qing DOI: 10.3969/j.issn.1671-7171.2018.08.003 【Objective】 To investigate the effect of cognitive-behavioral therapy on emotional state and life quality in patients undergoing laparoscopic radical prostatectomy(LRP). 【Methods】 From July 2013 to June 2017, 74 patients undergoing LRP were selected as study subjects. They were divided into observation group and control group (37 cases in each group) according to the random number table method. The control group was given routine care and the observation group performed cognitive behavioral therapy. After 12 weeks of follow-up, the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) were used to evaluate the emotional status of the two groups of patients. The life quality of the patients was evaluated by the Expanded Prostate Cancer Index Composite (EPIC). 【Results】 The SAS and SDS score of the observation group was significantly lower than that of the control group (P<0.05). Sexual dysfunction, urinary symptoms, and intestinal symptom scores were significantly lower than those of the control group (P<0.05). 【Conclusion】 Cognitive-behavioral therapy can alleviate the negative emotional state of patients undergoing LRP and significantly improve their quality of life. 2018 Vol. 35 (8): 1464-1466 [Abstract] ( 31 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1467 Alteration of Serum Resistin and Its Relationship to Vascular Endothelial Function in Type 2 Diabetic Patients with Diabetic Nephropathy LIUWei, LIAIMei-zheng, GUOShun-hua, et al DOI: 10.3969/j.issn.1671-7171.2018.08.004 【Objective】 To investigate the level of plasma resistin in patients with type 2 diabetic nephropathy (DN) and its relationship with vascular endothelial function. 【Methods】 According to the amount of 24-hour urinary albumin excretion (UAE), sixty-two type 2 diabetic patients without clinical macrovascular complications were divided into 3 groups: normal albuminuria group (NAU),microalbuminuria group (MAU) and macroalbuminuria group (CAU). Fasting plasma resistin plus other biochemical indexes (blood lipid and sugar level, hepatic and renal function, etc.), endothelial function, and ventricular structure were measured. Endothelial function indicators including brachial artery endothelium-dependent diastolic function flow-mediated vasodilation (FMD), nitroglycerin vasodilation (NID), and carotid intima-media thickness (IMT) were recorded. Ventricular structure indicators like left ventricular internal diameter (LVD), left ventricular posterior wall thickness (LVPWT), and interventricular septal thickness (IVST) were detected as well. The changes of the above indicators between the groups were compared and the correlation between resistin and each index was analyzed. 【Results】 1. In CAU group, plasma concentration of resistin was as twice as that in NAU group, which was higher than that in MAU group(P<0.01 and P<0.05). 2. FMD and NID were significantly decreased along with the increase of plasma resistin level (P<0.05), while LVD,LVPWT and IVST values increased significantly with the increase of ressitin level (P<0.05).IMT had a tendency to increase with the plasm resistin level; however, the difference was not statistically significant(P>0.05).3. Fasting resistin was positively correlated with UAE, SCr, ApoB, FIN, and IVST( r values were 0.281,0.805,0.399,0.33,0.335, respectively,P<0.05), while resistin level was negatively correlated with FMD、NID (r values were －0.445,－0.338,respectively, P<0.05). 【Conclusion】 Resistin in patients with diabetic nephropathy increased with 24-hour urinary microalbumin and was positively correlated with vascular endothelial function damage. Resistin can be used as an early predictor of vascular risk in patients with diabetic nephropathy. 2018 Vol. 35 (8): 1467-1470 [Abstract] ( 42 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1471 Effects of Canopy Splitting Combined with Large Bone Flap Decompression on Serum Tissue Plasminogen Activator and Cerebrospinal Fluid Dynamics in Patients with Severe Head Injury HEXi-wu, ZHANGQiang, LIYa-dong, et al DOI: 10.3969/j.issn.1671-7171.2018.08.005 【Objective】 To investigate the effect of large bone flap decompression combined with canopy splitting on serum tissue plasminogen activator and cerebrospinal fluid dynamics in patients with severe head injury. 【Methods】 A total of 192 patients with severe craniocerebral injury who were treated in our hospital from January 2012 to January 2017 were randomly divided into observation group and control group, with 96 cases in each group. The control group was treated with large bone flap decompression. The observation group was treated with canopy splitting combined with large bone flap decompression. The changes of serum and cerebrospinal fluid tissue plasminogen activator (tPA), postoperative intracranial pressure changes, and cerebrospinal fluid dynamics were compared between the two groups[(SS), (SS/RI), (SC/RI), (SE), (SC), R-R interval (RI) and (MSV), (MDV)]. 【Results】 Before the operation, there was no significant difference in intracranial pressure between the two groups (P>0.05). After operation, the intracranial pressure of both groups showed a downward trend. The intracranial pressure of the observation group was lower than that of d1, d3 and d7. Control group (P<0.05). After operation, serum and cerebrospinal fluid t-PA and plasma plasminogen activator inhibitor-1 (PAI-1) levels decreased in both groups. Serum and cerebrospinal fluid levels of t-PA and PAI-1 were observed in group d1 after operation. There was no significant difference (P>0.05). The levels of t-PA and PAI-1 in serum and cerebrospinal fluid of the observation group were lower than those of the control group (P<0.05). Before operation, there was no significant difference in the level of immune function between the two groups (P>0.05). After operation, the levels of IgG, IgA and IgM in the two groups were higher than those before operation (P<0.05), and the level of IgG, IgA and IgM in observation group was significantly higher than that in the control group (P<0.05). There were no significant differences in SS, SS/RI and SC/RI between the two groups (P>0.05). The SE, SC, RI and MSV in the observation group were larger than those in the control group, and the MDV was smaller than the control group. The difference was statistically significant (P<0.05). There was a positive correlation between t-PA and PAI-1 expression in cerebrospinal fluid and plasma in the control group and the observation group. 【Conclusion】 Large bone flap decompression has a good effect in treating patients with severe craniocerebral injury. It can effectively improve the serum tissue plasminogen activator level in patients, and has a good influence on cerebrospinal fluid dynamics. It is worthy of clinical application. 2018 Vol. 35 (8): 1471-1473 [Abstract] ( 31 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1474 Factors Influencing Survival of Patients with Hilar Cholangiocarcinoma FANFang-yong, CHANGHui-xian, YULian-jun, et al DOI: 10.3969/j.issn.1671-7171.2018.08.006 【Objective】 To investigate the survival status and related factors of patients with hilar cholangiocarcinoma(HC).【Methods】 The clinical data of 93 patients with HC admitted in our hospital from June 2011 to June 2012 were analyzed retrospectively. The general data of all patients were collected and followed up. The factors affecting the survival status of HC patients were analyzed by univariate and multivariate analysis.【Results】 The 1-year, 3-year and 5-year survival rates of patients with radical resection were 84.78%, 45.65% and 23.91% respectively, which were significantly higher than those of patients with the palliative treatment group (P<0.05).There was no significant difference in 5-year survival rate among HC patients of different genders and ages (mean P>0.05). The 5-year survival rates of HC patients with different TNM stages, surgical schemes, preoperative carcinoembryonic antigen levels and the highest preoperative serum total red gallstone levels were significantly different (P<0.05). TNM stage Ⅲ~Ⅳ, palliative treatment regimen, preoperative carcinoembryonic antigen level higher than 5.0 ng/mL and preoperative highest serum total erythrocholine level above 342.0 mol/L were independent risk factors for 5-year survival rate of HC patients (P<0.05).【Conclusion】 The long-term survival status of patients with HC undergoing radical resection is good. TNM stage Ⅲ~Ⅳ, palliative therapy, preoperative carcinoembryonic antigen level higher than 5.0 ng/mL and preoperative highest serum total erythrocholine level above 342.0 mol/L are independent risk factors for poor long-term survival of patients. 2018 Vol. 35 (8): 1474-1476 [Abstract] ( 51 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1477 Effect of Analgesia Mode in Childbirth on Stress status, Immune Function and Pregnancy Outcome JIANGRong, YANGMong-chang, LIPeng DOI: 10.3969/j.issn.1671-7171.2018.08.007 【Objective】 To analyze the effect of analgesia mode during childbirth on stress status, immune function and pregnancy outcome. 【Methods】 A total of 164 pregnant women were randomly divided into two group according to the different ways of labor analgesia. The control group was given the analgesic measures of epidural delivery, and the observation group was given a combination of lumbar and hard epidural anesthesia for labor analgesia. The analgesic effect, postpartum stress, immune function before and after delivery and pregnancy outcome were compared and analyzed in the two groups. 【Results】 The total analgesic rate of the observation group was 87.80% (72/82), which was significantly higher than that of the control group, which was 69.51% (57/82) (P<0.05). The anxiety self-rating scale (SAS) score and depression self-rating scale (SDS) score of the observation group were all lower than those of the control group, which showed the incidence of anxiety and depression were lower than those of the control group (P<0.05). There was no significant difference in the level of immune function between the two groups (P>0.05). After delivery, levels of CD4+, CD8+, and CD4+/CD8+ in the two groups decreased, while IL-6 increased (P<0.05). The levels of CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, however, the levels of CD8+ and IL-6 were lower than those in control group (P<0.05). The cesarean section rate in the observation group was 6.10%, which was significantly lower than that in the control group (20.73%) (P<0.05). The incidence of total adverse reactions in the observation group was significantly lower than the control group (P<0.05). 【Conclusion】 Combined spinal epidural anesthesia for labor analgesia can significantly improve the analgesic effect, improve postpartum stress and immune function, and improve safety. 2018 Vol. 35 (8): 1477-1479 [Abstract] ( 43 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1480 Clinical Effect of Ultrasound-guided Percutaneous Transhepatic Gallbladder Drainage in Treatment of Acute Cholecystitis in Critically ill Elderly Patients LEIYan-jun, XIAOYan, PANXiao-ji DOI: 10.3969/j.issn.1671-7171.2018.08.008 【Objective】 To investigate the clinical effect of ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) in the treatment of acute cholecystitis in critically ill elderly patients. 【Methods】 The clinical data of 56 patients with acute cholecystitis treated with PTGD in Hunan Provincial people's Hospital from January 2012 to January 2018 were analyzed retrospectively. The puncture complications (bleeding, bile leakage, intestinal perforation, hemopneumothorax) were recorded. Body temperature, white blood cell count, (WBC), procalcitonin (PCT), alanine aminotransferase (ALT) and Apache Ⅱ score were recorded before and 1 day ,3days , 5 days after operation, followed up 3 months after operation, and the postoperative condition and mortality were recorded and counted.【Results】 All the 56 patients were successfully punctured at one time, and no complications occurred. There was no significant difference in body temperature between before and after operation (t=0.78,P<0.194), but the body temperature decreased to normal on the 3rd ,.5th day after operation (P<0.05). On the 5th day after operation ,WBC and PCT returned to normal; on the 3rd day after operation, ALT returned to normal; WBC,PCT and ALT were significantly lower than those before operation on the 1st ,3rd and 5th day after operation (P<0.05). The scores of APACHE Ⅱ decreased gradually on the 5th day after operation, which were significantly lower than those before operation (P<0.05). The hospitalization period was 5~17 (9.2 ±3.8) days. No bleeding, bile leakage, intestinal perforation and hemopneumothorax were found in all patients within 3 months after puncture and drainage. There was no recurrent cholecystitis in 3 cases at the time of 3- month follow-up even with the tube. One patient was accidentally extubated 1 month after surgery and underwent open cholecystectomy. One patient died of multiple organ failure within 1 month after operation.【Conclusion】 In the early critical elderly patients with acute cholecystitis, timely treatment with PTGD can effectively alleviate the condition and reduce the perioperative risk. It has the advantages of simple operation, less postoperative complications and good clinical effect. 2018 Vol. 35 (8): 1480-1482 [Abstract] ( 41 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1483 Analysis of Clinical Features of Hematochezia in Newborns (A Report of 292 Cases) XUGuang, ZHOUChong-gao, WANGHai-yang, et al DOI: 10.3969/j.issn.1671-7171.2018.08.009 【Objective】 To explore the clinical features and prognosis of hospitalized neonates with hematochezia, and to provide ideas for early diagnosis and treatment.【Methods】 From October 2014 to June 2017, 292 cases of neonatal hematochezia were selected and analyzed, including sex, age, body weight, symptoms, signs, auxiliary examinations, treatment methods and prognosis, etc. The characteristics of hematochezia between preterm infants and full-term infants were compared.【Results】 Among the 292 neonates with hematochezia, there were 46 cases of bright red blood stool, 212 cases of dark red blood stool, 34 cases of tar stool, 98 cases of anemia, 8 cases of hemorrhagic shock, 105 cases of vomiting (36.0%) and 77 cases of abdominal distension (26.4%). 228 cases of term infants, the main diseases are milk protein allergy (CMPA), infectious enteritis and neonatal necrotizing enterocolitis (NEC). There were 64 premature infants. The main diseases were NEC-CMPA and stress ulcer. The mean onset age of full-term infants was (10.16 ±8.70) days, and that of premature infants was (8.93 ±8.18) days. There was no significant difference between the two groups (t=1.019,P=0.309). 242 cases were treated conservatively, 50 cases were operated, 262 cases were cured (89.7%), 20 cases were improved (6.8%), 10 cases died (3.4%). There was no significant difference in mortality between full-term infants and premature infants (χ2=0.290). The main causes of death were delayed operation and severe infection leading to most necrosis of the small intestine. The main diseases were intestinal malrotation and NEC.【Conclusion】 Hematochezia is more common in male infants than in full-term infants, and CMPA, NEC and infectious enteritis are common diseases. For those complicated with abdominal distension and vomiting, surgical diseases should be observed, and timely diagnosis and correct treatment could improve the cure rate. 2018 Vol. 35 (8): 1483-1486 [Abstract] ( 45 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1487 Effect of Dexmedetomidine on Analgesia, Hemodynamics and Postoperative Recovery in Patients undergoing Orthopedics Surgery with General Anesthesia YANGDe-jun DOI: 10.3969/j.issn.1671-7171.2018.08.010 【Objective】 To investigate the effect of dexmedetomidine(Dex) on analgesia, hemodynamics and postoperative recovery in patients undergoing orthopedics surgery with general anesthesia. 【Methods】 A total of 90 patients with spinal stenosis who underwent elective lumbar decompression and pedicle screw fixation plus bone graft fusion surgery were selected and randomly divided into two groups:, with 45 cases in each group. Before induction of anesthesia, patients in the observation group received intravenous infusion of Dex at 0.5 μg/kg, followed by 0.2 g/(kg·h) for maintenance, while patients in the control group was injected with the same volume of normal saline. The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) before anesthesia induction (T0), at anaesthesia induction (T1), 1 min (T2) and 5 min (T3) after endotracheal intubation, 1 min (T4) and 5 min (T5) after extubation of trachea, were recorded. The VAS scores at 2, 4, 8, 12, 24, and 48 hours after surgery, and the incidence of adverse reactions were compared in both groups. 【Results】 The HR, SBP and DBP values at T1 in the two groups were lower than those at T0 (P<0.05). The HR, SBP and DBP values at T2, T3 and T4 were higher than those at T1(P<0.05). The HR, SBP and DBP in the observation group were lower than those in the control group at T3, T4 and T5 (P<0.05). The VAS score, remifentanil dosage and 24 h morphine dosage in the observation group were lower than those in the control group at 2, 4, 8, 12, 24 and 48 h after operation (P<0.05). The incidence of adverse reactions such as cough, nausea, vomiting and respiratory depression in the observation group was lower than those in the control group (P<0.05). 【Conclusion】 Dexmedetomidine can maintain hemodynamic stability in patients with general anesthesia, reduce the dosage of anesthesia drugs and postoperative analgesic drugs, improve postoperative analgesic effect, and have less adverse reactions. 2018 Vol. 35 (8): 1487-1489 [Abstract] ( 37 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1490 Analysis of Emotional Status and Its Related Factors in Patients with Acute Coronary Syndrome LIDi, HEYuan-jun, PANXue-qin DOI: 10.3969/j.issn.1671-7171.2018.08.011 【Objective】 To investigate the emotional status and emotion-related factors in patients with acute coronary syndrome (ACS). 【Methods】 The clinical data of 310 ACS patients admitted to our hospital from January 2016 to January 2017 were retrospectively analyzed. According to the Hamilton Anxiety Scale (HAMA), patients were divided into the observation group (n=154, anxious patients with HAMA score ≥14) and the control group (n=156, non-anxiety patients with HAMA <14). All patients underwent neuropsychological testing. The main tests included Minimental State Examination (MMSE), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Vocabulary Fluency Test (VFT), and color-code interference experiment test (ST). The testing scores were recorded and compared between the two groups. Patient's economic status, medical history and marriage history were also investigated by our hospital's "Basic Information Questionnaire". 【Results】 The scores of HAMA and HAMD were higher in the observation group than in the control group; the differences were statistically significant (P<0.05). There was no difference in MMSE, VFT or ST scores between the two groups (P>0.05). The proportion of patients >70 years old in the observation group was lower than that in the control group (P<0.05). The proportions of patients who had suffered the loss of loved one (widowhood), death of immediate family members with heart disease, chest pain, and coronary heart disease in the observation group were higher than those in the control group (P<0.05). The economic status, risk factors of ACS and types of chronic disease complications of the two groups showed statistically significant difference (P<0.05). Logistic multivariate regression analysis showed that age, widowhood, chest pain, history of hypertension, history of diabetes, and types of chronic diseases were independent risk factors for anxiety in patients with ACS. 【Conclusion】 Patients with acute coronary syndromes are prone to anxiety and depression. The loss of loved one, death of immediate family members with heart disease, chest pain, and economic conditions are the main factors. Among them, the widowhood, chest pain, and history of hypertension are independent risk factors. 2018 Vol. 35 (8): 1490-1492 [Abstract] ( 42 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1493 Efficacy of Irbesartan Combined with Enhanced External Counterpulsation in the Elderly Patients with Early Diabetic Nephropathy LIUChun-tian, WANGXiao-juan, FENGJian-jun DOI: 10.3969/j.issn.1671-7171.2018.08.012 【Objective】 To investigate the efficacy of irbesartan combined with enhanced external counterpulsation in the treatment of senile early diabetic nephropathy (DN) and its effect on endothelial cell function.【Methods】 A total of 90 elderly patients with early diabetic nephropathy treated in our hospital were selected and randomly divided into the control group(45 cases)and the observation group(45 cases). Patients in the control group received routine hypoglycemic and lipid-lowering treatment plus a daily 150 mg irbesartan administered orally. Meanwhile, the observation group was given enhanced external counterpulsation (once daily for 45 minutes) on the basis of the conventional treatment received by the control group.All patients were treated for 8 weeks. The changes of serum creatinine (Scr), blood urea nitrogen (BUN), microalbuminuria (MA), beta2 microglobulin (β2-MG), N acetyl D glucosamine enzyme (NAG), serum cystatin C (Cys-C), endothelin -1 (ET-1) and nitric oxide (NO) were compared between the two groups before and after treatment.【Results】 After treatment, the levels of SCr, BUN, MA, β2-MG, NAG, and Cys-C in the blood of both groups' patients were decreased; the decrease in the observation group was significantly lower than in the control group (P<0.05). The level of ET-1 in the observation group after treatment was significantly lower than that before treatment, and it was lower than that of the control group as well (P<0.05).The level of NO in the observation groups was significantly higher than that in the control group before treatment. The difference was statistically significant (P<0.05). 【Conclusion】 Irbesartan combining with enhanced external counterpulsation in the treatment of elderly patients with DN can effectively reduce the excretion of urinary protein and improve renal function.The mechanism may be related to the improvement of endothelial cell function. 2018 Vol. 35 (8): 1493-1495 [Abstract] ( 38 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1496 Efficacy of GnRHa Combined Kuntai Capsule on Endometriosis XIEShan-li DOI: 10.3969/j.issn.1671-7171.2018.08.013 【Objective】 To evaluate the effect of gonadotropin releasing hormone agonist (GnRHa) combined with kuntai capsule on the sex hormone and humoral immunity of endometriosis patients. 【Methods】 A total of 150 patients with endometriosis in our hospital from April 2015 to February 2017 were selected and randomly divided into two groups: the control group (75 cases) and the observation group (75 cases). The control group was treated with GnRHa, and the observation group was treated with Kuntai capsule on the basis of the control group. The changes of sex hormones, humoral immunity index, Kupperman score and bone mineral density before and after treatment were compared between the two groups, and the clinical efficacy and medication safety of the two groups were evaluated.【Results】 The total effective rate of the observation group was 90.67% (68/75), which was significantly higher than that of the control group 70.67% (53/75). The adverse reaction rate of the observation group was 5.33% (4/75),which was lower than that of the control group of 16.00% (12/75). The difference was statistically significant (P<0.05). After treatment, the levels of serum estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), complement 3 and 4 (C3 and C4) in the observation group were lower than those in the control group; the difference were statistically significant (P<0.05). There were no statistically significant differences in serum immunoglobulin G (IgG), IgM and bone density between the two groups before and after treatment (P>0.05). After treatment, the C4 levels and complement were lower than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the Kupperman score in the observation group was lower than that in the control group; and the differences were statistically significant (P<0.05). 【Conclusion】 The treatment of GnRHa combined Kuntai capsule for endometriosis patients has better curative effect. It can adjust body sex hormone levels, improve humoral immune function, and alleviate or eliminate clinical symptoms with medication safety. 2018 Vol. 35 (8): 1496-1498 [Abstract] ( 26 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1499 Therapeutic Effect of Probucol Combined with Rosuvastatin in the Treatment of Carotid Atherosclerotic Plaque in Patients with Cerebral Infarction Complicated with Diabetes SHUDan, CHENTing-yan, LIANGDan DOI: 10.3969/j.issn.1671-7171.2018.08.014 【Objective】 To investigate the efficacy of probucol combined with rosuvastatin in the treatment of carotid atherosclerotic plaques in patients with cerebral infarction complicated with type 2 diabetes mellitus (T2DM). 【Methods】 A total of 126 patients with cerebral infarction combined with T2DM who were treated in our hospital from February 2016 to August 2014 were selected as the research subjects. The patients were randomly divided into the observation group and the control group, with 63 cases in each group. Patients in the control group received rosuvastatin alone, while patients in the observation group received ropucol combined with rosuvastatin. Patients in both groups were treated for 1 year. The results of carotid artery ultrasound examination, the indexes of blood lipid and inflammatory factors, protein S100 beta, microalbuminuria, and neurological status determination (NIHSS evaluation) between the two groups were compared before and after treatment. The incidence of adverse reactions was recorded at the same time. 【Results】 After treatment, the carotid intima-media thickness (CAIMT), endometrial plaque area and the detection rate of vulnerable plaque were lower in both groups than those before treatment (P<0.05), and those in the observation group decreased more significantly (P<0.05). After treatment, total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were lower than those before treatment (P>0.05), while the level of high-density lipoprotein cholesterol (HDL-C) was higher than that before treatment. The changes in the observation group were more remarkable with statistical significance (P<0.05). Levels of protein S100 beta, urinary microalbumin and stroke scale (NIHSS) score, high-sensitivity C-raction protein )hs-CRP), interleukin 6 (IL-6) and tumor necrosis factor (TNF-α) in both groups decreased after treatment (P<0.05), and the decrease in the observation group was more obvious than those in the control group (P<0.05). The incidence of adverse reactions such as headache, dizziness, rash, nausea and vomiting, myalgia, hepatorenal dysfunction and gastrointestinal reactions in the two groups were not statistically different (P>0.05). 【Conclusion】 Probucol combined with rosuvastatin is more effective in the treatment of cerebral infarction with diabetes mellitus. It is worthy of clinical application. 2018 Vol. 35 (8): 1499-1501 [Abstract] ( 45 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1502 Levels of Serum miR21, CK19 and TSGF in Patients with Cervical Cancer and Their Clinical Significance ZHANGQun-zhen, OUYi-xue, XIEHui-ying DOI: 10.3969/j.issn.1671-7171.2018.08.015 【Objective】 To detect the expression levels of micro-RNA21 (miR21), cytokeratin 19 (CK19) and malignant tumor specific growth factor (TSGF) in patients with cervical cancer and explore the relationship with the prognosis of the patients 【Methods】 A total of 70 cases of cervical cancer from March 2013 to March 2016 in our hospital were selected as the observation group, and 40 healthy women volunteers were chosen as the healthy control group. The levels of serum miR21, CK19, and TSGF in both groups were detected and their relationship with the clinicopathological features of cervical cancer were analyzed.【Results】 The levels of miR21, CK19 and TSGF in the serum of the observation group were significantly higher than those of the control group (P<0.05). The expression levels of CK19 and TSGF were significantly correlated with tumor differentiation, FICO stage and lymph node metastasis in cervical cancer patients, and miR21 was only significantly associated with lymph node metastasis (P<0.05).【Conclusion】 The expression levels of miR21, CK19 and TSGF in the serum of patients with cervical cancer are significantly increased, which are related to cancer differentiation, FICO stage and lymph node metastasis. It has important clinical value for cervical cancer. 2018 Vol. 35 (8): 1502-1504 [Abstract] ( 47 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1505 Effect of Muscle Relaxation on Surgical Conditions of Uterine Leiomyoma in Elderly Women WANGHui-de, ZHONGQing, WENGYan DOI: 10.3969/j.issn.1671-7171.2018.08.016 【Objective】 To investigate the effect of muscle relaxation on the surgical conditions of elderly women with uterine fibroids (leiomyoma). 【Methods】 A total of 86 patients who underwent laparoscopic myomectomy in our hospital from January 2010 to November 2017 were selected and divided into the control group and the observation group according to random number table, with 43 cases each. Both groups of patients underwent continuous infusion of cis-atracurium to maintain muscle relaxation. In the observation group, the target muscle relaxation degree was TOF1-2 (moderate muscle relaxation, i.e. four series of stimulation can maintain 1-2 muscle twitch). In the control group, the target degree of muscle relaxation was PTC1-2 (deep muscle relaxation, i.e. 1-2 monostimulatory twitch after tetanic stimulation). Operating conditions, endotracheal intubation conditions, recovery of muscle relaxants, surgeon score, and incidence of adverse reactions were compared between the two groups. 【Results】 There was no significant difference in operative time and surgeon score between the observation group and the control group (P>0.05). The mean pneumoperitoneal pressure and the extubation time in the observation group were higher than those in the control group. The ratios of 4 string stimulations (TOFr) recovery to 0.7 and 0.9 in the observation group were shorter than those in the control group (P<0.05) . The excellent and good rate of tracheal intubation was 100.00% in both groups. The total incidence of adverse reactions in the two groups was 6.96% and 4.64%, respectively, with no significant difference (P>0.05). 【Conclusion】 The treatment of TOF1-2 muscle relaxant in elderly women with uterine fibroids can obtain better operating conditions and tracheal intubation conditions. The recovery time of muscle relaxant is short. There were no obvious adverse reactions, which can be further popularized and used in clinical practice. 2018 Vol. 35 (8): 1505-1507 [Abstract] ( 31 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1508 Therapeutic Effect of Intrauterine Balloon Compression on Postpartum Hemorrhage LIUQing-xiu, LUOLi-ping, HAORong, et al DOI: 10.3969/j.issn.1671-7171.2018.08.017 【Objective】 To explore the effect of intrauterine balloon compression in the treatment of postpartum hemorrhage. 【Methods】 A total of 48 cases of postpartum hemorrhage admitted to our hospital from January 2014 to January 2016 were randomly divided into the observation group and the control group, with 24 cases in each group.Patients in the control group were given intrauterine gauze packing to stop the bleeding, while patients in the observation group were given intrauterine balloon compression hemostasis. The therapeutic effects of the two groups were observed and analyzed. 【Results】 The effective rate of hemostasis in the observation group was 100% and the effective rate of hemostasis in the control group was 62.50% (15/24). The effective rate of the observation group was significantly higher than that of the control group (P<0.05). The packing material placed time, dwelling time and removal time in observation group were (4.57±0.41) min, (10.74±2.58) h and (1.33±0.43) min, respectively, which were significantly shorter than those of the control group. The differences were statistically significant (P<0.05). The difference in postoperative normal activity time and hospitalization between the observation group and the control group patients showed no statistical significance (P>0.05). No infection and other complications were found in the observation group; however, there were 3 cases of infection in the control group after operation. 【Conclusion】 The effect of intrauterine balloon compression in the treatment of postpartum hemorrhage is better, and the method is simple and easy to use. It is worthy of clinical application. 2018 Vol. 35 (8): 1508-1509 [Abstract] ( 37 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1510 Effect of Epidural Anesthesia on Postoperative Cognitive Function in Elderly Patients HANJia DOI: 10.3969/j.issn.1671-7171.2018.08.018 【Objective】 To explore the effect of epidural anesthesia and general anesthesia on postoperative cognitive function in elderly patients. 【Methods】 A total of 116 elderly patients were randomly divided into two groups during preoperative anesthesia stage, with 58 cases in each group. Patients in the observation group received epidural anesthesia, while patients in the control group were given general anesthesia. The progress of postoperative cognitive dysfunction( POCD)was evaluated by the mini mental state examination (MMSE) scores at different time points in both groups. The results were analyzed by repeated measures of variance analysis at different time points between the two groups of patients. 【Results】 The MMSE scores of the two groups before anesthesia were the highest, and the MMSE scores of postoperative 3h decreased to the lowest, then increased gradually. However, there were no significant differences in MMSE scores between the control group and the observation group by using the repeated measures analysis of variance(P>0.05). There was also no interaction between anesthesia mode and time (P>0.05). The incidence rates of POCD in the observation group at 3h and 6h were 13.8% and 5.2%, respectively, which were lower than those in the control group (29.3% and 17.2%, respectively) (P<0.05). There was no statistically significant difference in the POCD incidence of postoperative 1d between the two groups (P>0.05). 【Conclusion】 The incidence of POCD in patients with epidural anesthesia is lower than that in the general anesthesia. the MMSE score of patients in early stage after epidural anesthesia is lower than that in the general anesthesia, which indicates epidural anesthesia has lower effect on POCD in elderly patients.it is worthy of clinical application. 2018 Vol. 35 (8): 1510-1512 [Abstract] ( 44 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1513 Effect of Human C- reactive Protein Induced by Anti-CD32 Antibody on Autophagy of Acute Kidney Injury in Mice JIJin-ling, TANGQian-qiu, ZHANGXiao-yun DOI: 10.3969/j.issn.1671-7171.2018.08.019 【Objective】 To invest the effect of human C- reactive protein on autophagy in acute kidney injury . 【Methods】 In order to induce the production of human CRP in mice, 25 μ g/mL body volume was injected intraperitoneally 2 hours before operation (body blood volume was equal to the gram weight of mice multiplied by 0.08 ) of anti CD32 antibody, then the acute renal ischemia-reperfusion injury model was established in mice. The mice were divided into Sham group, wild type mice group (CRP-Wt-I/R group) and transgenic mice expressing human CRP gene group(CRP-Tg-I/R group); the changes of CRP in mice before and after renal ischemia-reperfusion injury 2 hours before and 0h、24h、72h after operation were compared, Kidney specimens were obtained at 24 h and 72 h after operation. After HE staining, the pathological changes of renal tissue were observed, the expression of autophagy associated protein Beclin-1 was detected by immunohistochemical method, and the autophagy of renal tissue was observed under transmission electron microscope.【Results】 At 24 hours and 72 hours after renal ischemia-reperfusion injury, the expression of Beclin-1 protein in renal tubular epithelial cells of the CRP-Tg-I/R group decreased significantly (P<0.01), and no autophagy was observed.【Conclusion】 Human CRP down-regulated autophagy activity in renal tissue of AKI. 2018 Vol. 35 (8): 1513-1516 [Abstract] ( 31 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1517 Effect of Individualized Medical Nutrition on Body weight, Blood Glucose Control and Pregnancy Outcome in Patients with Gestational Diabetes YUHong-mei DOI: 10.3969/j.issn.1671-7171.2018.08.020 【Objective】 To explore the effect of individualized medical nutrition on the weight, blood glucose control and pregnancy outcome of gestational diabetes patients. 【Methods】 A total of 92 cases gestational diabetes patients who were diagnosed by department of obstetrics and gynecology and endocrinology in our hospital from Dec. 2013 to Jan. 2018 were randomly divided into the control group and the observation group according to order of admission, with 46 cases in each group. The control group was given traditional diet guidance, and the observation group was given personalized medical nutrition treatment scheme formulated by a professional nutrition doctor. All interventions in both groups were applied to childbirth. The weight increase, blood glucose control effect and the pregnancy outcomes of the two groups were assessed and compared.【Results】 The increase in body weight and body mass index (BMI) during pregnancy in the observation group were lower than those in the control group (P<0.01). Compared to before treatment, the blood glucose levels of the two groups were significantly lower at 2 hours after breakfast and dinner (P<0.05), and the above indexes in the observation group were lower than those in the control group (P<0.05). The fasting blood-glucose (FPG) in the observation group decreased significantly after individual nutrition intervention (P<0.05); however, there was no significant difference in the control group before and after traditional diet intervention (P>0.05). There was no perinatal death in either group, but the occurrence rates of premature delivery, premature rupture of membrane, caesarean section and neonatal weight in the observation group were lower than those in the control group (P<0.05). 【Conclusion】 Individualized medical nutrition treatment can effectively control the body weight of gestational diabetes patients, reduce the blood glucose level and the occurrence of pregnancy complications, and improve the pregnancy outcome, decrease. 2018 Vol. 35 (8): 1517-1519 [Abstract] ( 33 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1520 Correlation of Serum Cys-C, HCY and BTP Levels with Severity in Patients with Pregnancy-Induced Hypertension SUNXiu-li, CHENSi, HUMeng DOI: 10.3969/j.issn.1671-7171.2018.08.021 【Objective】 To explore the correlation of serum cystatin-C (Cys-C), homocysteine (HCY) and beta-trace protein (BTP) levels with the severity in patients with pregnancy-induced hypertension. 【Methods】 A total of 82 patients with diagnosis of pregnancy-induced hypertension disease from July 2013 to June 2017 in our hospital were selected as the observation group (group A). According to the severity of the disease, patients were divided into three subgroups: 29 cases of gestational hypertension group (A1), 28 cases of mild preeclampsia group (A2), and 25 cases of severe preeclampsia group (A3). In the same period, 82 healthy pregnant women admitted in our hospital were enrolled as the control group (group B). The levels of serum Cys-C, HCY and BTP, were detected in patients of all groups. The severity of pregnancy-induced hypertension in correlation with the levels of Cys-C, HCY and BTP were analyzed . 【Results】 The levels of serum Cys-C, HCY and BTP in the observation group (A) were higher than those of control group (B) (P<0.05). The levels of serum Cys-C, HCY and BTP in the severe preeclampsia group (A3) were higher than those of mild preeclampsia group (A2) and gestational hypertension group (A1). The levels of group A2 were higher than those of group A1 (P<0.05). Furthermore, the serum levels of Cys-C, HCY and BTP were significantly positively correlated with the severity of pregnancy-induced hypertension. 【Conclusion】 The levels of serum Cys-C, HCY and BTP positively reflected the severity of pregnancy-induced hypertension. Detection of these three serum indicators can help the clinical diagnosis and treatment of pregnancy-induced hypertension . 2018 Vol. 35 (8): 1520-1523 [Abstract] ( 39 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1524 Correlation between Different Depths of Anesthesia and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Orthopaedic Surgery XIABing-chun, CHENCi-bo, ZHAOChun-yan, et al DOI: 10.3969/j.issn.1671-7171.2018.08.022 【Objective】 To observe the correlation between different depths of anesthesia and postoperative cognitive dysfunction (POCD) in elderly patients undergoing orthopaedic surgery, and to find the most suitable bispectral index (BIS) monitoring interval under total intravenous anesthesia for elderly patients. 【Methods】 A total of 120 elderly patients undergoing orthopedic surgery under total intravenous anesthesia were randomly divided into group A (BIS value of 41~50) and group B (BIS value of 51~60). The anesthesia method for all patients was propofol combined with remifentanil and vecuronium bromide. By adjusting the plasma concentration of propofol and remifentanil,the patient's anesthesia depth was maintained within the predetermined range. Surgical indexes, anesthesia effects MMSE scores at different time points, and the incidence of adverse reactions were compared between the two groups.【Results】 There were no significant differences between the two groups in HR or MAP before surgery (T0), at skin incision (T1), at fracture exploration (T2) or at the end of surgery (T3) (P>0.05). There was no significant difference in the target concentration of propofol between the two groups (P>0.05), while the target concentration of remifentanil was higher in group A than in group B (P<0.05). The recovery time and extubation time of group A were longer than those of group B (P<0.05). The MMSE scores of both groups at 2h and d1 after surgery were lower than those at d1 before surgery (P<0.05), and the scores of group A were significantly lower than group B (P<0.05). The incidence rates of POCD in group A at 2h and d1 after surgery were higher than group B (P<0.05). There was no significant difference in the incidence of POCD between the two groups on the d3 or d7 after surgery (P>0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 The BIS value (51～60) can significantly reduce the incidence of POCD in elderly patients at 2h and d1 after orthopaedic surgery. 2018 Vol. 35 (8): 1524-1526 [Abstract] ( 37 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1527 Observation of Perioperative Related Indicators and Short-term Curative Effect of PCNL and RIRS in the Treatment of Isolated Kidney Stone YiNing, HANPing, LIYong-hong DOI: 10.3969/j.issn.1671-7171.2018.08.023 【Objective】 To compare the perioperative related indicators and short-term efficacy of percutaneous nephrolithotomy (PCNL) and ureteroscopy (RIRS) in the treatment of isolated kidney stones. 【Methods】 A total of 96 patients with isolated kidney stones were random divided into group A(PCNL) and group B(RIRS),with 48 cases in each group. Levels of serum interleukin 6 (IL-6), C-reactive protein (CRP), white blood cell count (WBC), and cortisol (Cor) in the morning before surgery and on the 1th day after surgery were detected. The procedure of operation was monitored. The VAS pain scores of resting state and active state at different time points after surgery, primary stone clearance rate, total clearance rate, and total incidence of complications were compared between two groups. 【Results】 The operation time of group A was shorter than that of B group (P<0.05), while the intraoper-ative blood loss, gastrointestinal function recovery time and hospitalization time were higher than those in B group (P<0.05). The levels of serum IL-6, CRP, WBC and Cor in group B were lower than those in group A (P<0.05). The VAS scores of resting state and active state in the group B at 1d, 2d and3d after surgery were lower than those in the A group (P<0.05). The one-time primary stone clearance rate , total clearance rate and the total incidence of complications in group A were 81.25%, 93.75% and18.75%, respectively, which were not significantly different in comparison with those in group B, which were 72.92%、85.42% and 20.83%, respectively (P>0.05). 【Conclusion】 RIRS can achieve the equivalent overall effect of PCNL; however, RIRS has less intraoperative bleeding , shorter hospital stay, and reduced pain and inflammation. It can be used as a preferred treatment under the premise of grasping the surgical indications. 2018 Vol. 35 (8): 1527-1529 [Abstract] ( 38 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1530 Early Diagnostic Value of C-reactive Protein and D-dimer Levels in Hyperlipidemic Acute Pancreatitis LIJia, YINGQing-xia DOI: 10.3969/j.issn.1671-7171.2018.08.024 【Objective】 To investigate the clinical value of serum C-reactive protein (CRP) and D-dimer levels in the early differential diagnosis of hyperlipidemic acute pancreatitis (HLAP). 【Methods】 The blood lipids, CRP and D-dimer levels of 70 patients with HLAP (group A) and 70 patients with non-hyperlipidemic acute pancreatitis (NHLAP,group B) were examined and compared. The receiver's working curve (ROC) was used to obtain the clinical value of differential diagnosis of HLAP and NHLAP patients.【Results】 The levels of total cholesterol (TC),triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in the peripheral blood of group A were significantly higher than those of group B (P<0.05). The level of CRP in group A was significantly higher than that in B group (P<0.05). There was no significant difference in D-dimer levels between the two groups (P>0.05). The ROC curve was drawn from the CRP levels of two group, and the optimal diagnostic threshold for the differential diagnosis was 118.5mg/L. The difference between the two groups was statistically significant (P>0.05). The sensitivity of the corresponding point was 84.61%, the specificity was 89.27%, the missed diagnosis rate was 15.39%, the misdiagnosis rate was 10.73%, and the area under the ROC curve (AUC) was 0.867. 【Conclusion】 Serum CRP has a certain clinical value for the differential diagnosis of HLAP and NHLAP patients, D-dimer is not meaningful for the differential diagnosis of NLAP and NHLAP patients. 2018 Vol. 35 (8): 1530-1532 [Abstract] ( 31 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1533 Characters of MRI and CT of Orbital Neurogenic Tumors MUXing, ZHAOChen, ZHANGYu-xin DOI: 10.3969/j.issn.1671-7171.2018.08.025 【Objective】 To investigate the characters of MRI and CT of orbital neurogenic tumors. 【Methods】 The clinical and imaging data of 53 patients with orbital neurogenic tumors admitted to our department from January 2013 to June 2017 were collected, the characteristics of MRI and CT were analyzed retrospectively. 【Results】 Among 53 cases of orbital neurogenic tumors, there were 18 cases of glioma, 15 cases of optic nerve sheath meningioma, 11 cases of neurilemmoma and 9 cases of neurofibroma. There were significant differences in age of onset, visual impairment, fundus compression T1WI and T2WI signal, sharp edge and calcification in the four kinds of tumors (P<0.05). 【Conclusion】 Neurogenic tumors are the most common orbital tumors, MRI and CT examination can show the location, size, shape, border, internal structure, calcification of tumor and its relationship with adjacent tissues, which is of great significance for the clinical diagnosis and treatment plan formulation. 2018 Vol. 35 (8): 1533-1535 [Abstract] ( 41 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1536 Effect of Solution Focused Approach (SFA) on Negative Emotions and Living Quality of Patients with Meniere's Disease (MD) ZHANGLi DOI: 10.3969/j.issn.1671-7171.2018.08.026 【Objective】 To investigate the effect of solution focused approach (SFA) on anxiety, depression and living quality of patients with Meniere's disease (MD). 【Methods】 A total of 96 cases of MD patients admitted to hospital from January 2015 to December 2016 were randomly divided into observation group and control group, There were 48 cases in each group, Patients in the control group were performed routine nursing, and based on this, patients in the observation group were performed SFA. After one week of intervention, the anxiety and depression state of the patients was assessed by the self-rating anxiety scale (SAS) and self-rating depression scale (SDS), and the symptom onset status of the patients was evaluated with the vestibular symptoms index rating scale (VSI). After 3 months of follow-up visit, the living quality of the patients was assessed by the Chinese edition of short form 36 health survey scale (SF-36). 【Results】 Three cases were dropped off in both groups. After one week of intervention, The scores of SAS and SDS in the observation group were significantly lower than those in the control group (P<0.01); the VSI scores of symptom onset were significantly lower than those in the control group (P<0.01); After 3 months of follow-up visit, the scores of various dimensions of living quality in the observation group were significantly higher than those in the control group (P<0.01,P<0.05). 【Conclusion】 SFA can help to ease the anxiety and depression state of MD patients, relieve symptom onset and improve the living quality. 2018 Vol. 35 (8): 1536-1538 [Abstract] ( 31 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1539 Influence of Diversified Intervention Model on Cognition and Behavior of Nursing Staff in Reporting Nursing Adverse Events HUANGChang-hui DOI: 10.3969/j.issn.1671-7171.2018.08.027 【Objective】 To investigate the influence of diversified intervention model on cognition and behavior of nursing staff in reporting nursing adverse events. 【Methods】 A total of 365 nurses who served in our hospital from January 2017 to June 2017 were selected as the research objects. The management system of nursing adverse events was adopted and the "knowledge-attitude-practice(KAP)" training of nursing adverse event reporting was carried out, the incentive system for reporting nursing adverse events was constructed and other diversified intervention models were adopted. The scores of cognition and behavior of nursing staff in reporting nursing adverse events, and the occurrence and reporting situations before and after intervention were compared. 【Results】 After the intervention, the scores of cognitive and behavior dimensions of nursing staff in reporting nursing adverse events were significantly higher than those before intervention (P<0.01); the incidence rate of nursing adverse events was 0.1064% and significantly lower than that before intervention 0.1551% (P<0.05), and the reporting rate and reporting accuracy were significantly higher than those before intervention (75.00% vs 59.30%, 93.75% vs 80.39%)(P<0.05). 【Conclusion】 Diversified intervention model can help to promote the development of cognitive and behavioral abilities of nursing staff in reporting nursing adverse events, reduce the incidence rate of nursing adverse events, and improve the recognition capability of nursing adverse events as well as the reporting enthusiasm. 2018 Vol. 35 (8): 1539-1541 [Abstract] ( 30 ) HTML (1 KB)  PDF  (0 KB)  ( 1 ) 1542 Clinical Efficacy of Escitalopram Combined with Electrical Stimulation Aversion Therapy on Refractory Obsessive-compulsive Disorder:31 Cases of Clinical Report ZHENGLin, TIANYue, CHENGAO-bo, et al DOI: 10.3969/j.issn.1671-7171.2018.08.028 【Objective】 To investigate the effect of escitalopram combined with electrical stimulation aversion therapy on refractory obsessive-compulsive disorder. 【Methods】 From January 2017 to January 2018, 62 cases of patients with refractory obsessive-compulsive disorder were studied in our hospital. According to the simple random method, they were divided into two groups, 31 cases in each group; the control group was treated with escitalopram, and the observation group was treated with escitalopram combined with electric stimulation aversion therapy. The therapeutic effects, the Yale-Brown compulsion scale, HAMA scale score, and the incidence of adverse reactions during treatment were compared between the two groups. 【Results】 The effective rate of the control group was 74.29%, the effective rate of the observation group was 93.55%, and the effective rate of the observation group was higher than that of the control group (P<0.05). The scores of the Yale-Brown and HAMA scales in the two groups were lower than those before the treatment (P<0.05), and the score of the Yale-Brown compulsion scale in the observation group was lower than that of the control group (P<0.05), and there was no statistical difference between the two groups after the treatment (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Escitalopram combined with electrical aversion therapy is effective in treating obsessive-compulsive disorder. It can effectively improve the clinical symptoms of patients with high safety. 2018 Vol. 35 (8): 1542-1545 [Abstract] ( 43 ) HTML (1 KB)  PDF  (0 KB)  ( 1 )

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