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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 1-10.   DOI: 10.3969/j.issn.1674-490X.2023.04.001
    Abstract266)      PDF(pc) (830KB)(223)       Save
    As a hormone secreted by white fat cells, leptin acts as a peripheral signal linking adipose tissue and the central nervous system networks, affecting feeding, energy balance, endocrine and immune functions. Through the analysis and summary of molecular structure and intracellular distribution of leptin and its receptor(LEPR), the recent developments on the regulation of lipid metabolism, inflammation and immunity, wound healing and tumor development are reviewed.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 67-74.   DOI: 10.3969/j.issn.1674-490X.2023.04.011
    Abstract163)      PDF(pc) (796KB)(87)       Save
    Objective To summarize and analyze the application of transitional caring in discharged patients with diabetic foot. Methods According to methodology framework. PubMed, Cochrane Library, CINAHL, Web of Science, Embase, CNKI, Wanfang, VIP, and CBM databases were searched until December 5, 2022. To sum up and analyze the included literature. Results A total of 1934 articles were screened, and 21 articles were finally included. The main forms of transitional nursing include telephone follow-up, home follow-up, outpatient follow-up and Internet-based follow-up. The content covers self-management guidance, disease knowledge and skills guidance, psychological support, peer support, contact with medical staff. The main outcome types were health clinical outcome, health economic outcome, patient satisfaction and psychological status. Conclusion Transitional nursing plays an active role in the discharge of patients with diabetic foot. In future studies, intervention programs should be constructed based on patient needs and theoretical framework, the division of labor and authority of team members should be clarified when multidisciplinary teams would be established, the hospital-community-family linkage nursing mode should be advocated, and the training of nurses specialized in diabetic foot wound should be increased to provide support for the out-of-hospital health management of Chinese diabetic foot patients.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 46-54.   DOI: 10.3969/j.issn.1674-490X.2023.03.007
    Abstract150)      PDF(pc) (531KB)(101)       Save
    Gait is the main factor that determines the quality of life of patients with stroke, so in rehabilitation training of patients with hemiplegia, improving walking ability is one of the most important purposes. In recent years, more and more rehabilitation methods have been applied to improve the walking ability of stroke patients with hemiplegia, but there is no one best rehabilitation treatment plan. This review aims to summarize the practicability and effectiveness of various types of gait training on the improvement of lower limb motor function in stroke patients, explore the latest progress in the rehabilitation of walking ability in stroke patients with hemiplegia, and provide reference for clinical practice.
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    Advances on the pharmacological effects and molecular mechanisms of Icaritin
    WU Di, MI Tian, WANG Hedong, WANG Junfei, LI Wenjuan
    Journal of Hebei Medical College for Continuing Education    2023, 40 (6): 1-11.   DOI: 10.3969/j.issn.1674-490X.2023.06.001
    Abstract132)      PDF(pc) (1195KB)(110)       Save
    Icaritin, as a single active ingredient of the Chinese herbal medicine Epimedium, shows a wide range of pharmacological activities, such as anti-inflammatory, immunomodulatory, cardiovascular protection, bone protection and antioxidant, etc. Meanwhile, Icaritin has an inhibitory effect on different tumors through blocking the cell cycle, promoting apoptosis, metastasis inhibition and immunomodulation. This paper reviews the chemical composition of icaritin and the latest research progress at home and abroad in anti-tumor activity, non-anti-tumor pharmacological effects. This review focus on the chemical composition of icaritin and the latest research progress in anti/non-anti-tumor pharmacological effects to provide a theoretical basis for the further development of Epimedium and its precise clinical application.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 25-30.   DOI: 10.3969/j.issn.1674-490X.2023.04.004
    Abstract129)      PDF(pc) (505KB)(52)       Save
    By reviewing the literature on the application of three-dimensional finite element in orthodontics over the years, the paper analyzes the construction and transformation of three-dimensional finite element model, data processing and clinical application in orthodontic biomechanics. The results of literature review show that three-dimensional finite element analysis has its clinical application value in fixed correction, functional correction and invisible correction. It has unique advantages and good application prospect in simulating tooth movement and skeletal reconstruction. However, the current three-dimensional finite element analysis still has some limitations. More targeted medical research and exploration are needed in three-dimensional finite element analysis.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 55-60.   DOI: 10.3969/j.issn.1674-490X.2023.03.008
    Abstract126)      PDF(pc) (457KB)(22)       Save
    LI Fuhai, my teacher, inherits the theory of Shi in the north advocated by LU Zhizheng, a master of traditional Chinese medicine, and the thought of Yishui school. In treating Shi in clinical practice, he takes the theory of Liujing as a whole, combines the Zangfu, attaches importance to the problem of Taiyin and Yangming, takes Piwei as the center, “holds the central position and transports the four sides”, and at the same time “delights in emotions and adjusts Shengjiang”, and gives full play to Yishui school's “opening Guimen, cleaning Jingfu”.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 37-40.   DOI: 10.3969/j.issn.1674-490X.2023.04.006
    Abstract114)      PDF(pc) (379KB)(24)       Save
    Yishui school is an important school of TCM in China, which emerged during Jin and Yuan dynasties. People have always believed that the Yishui school is good at treating internal injuries and miscellaneous diseases, and treating exogenous diseases with treatise on febrile diseases and epidemic febrile disease. Through the recent observation of the treatment of COVID-19, it is found that the treatment concept of the Yishui school also has a very important guiding significance for the treatment of exogenous febrile diseases. This paper analyzes the curative effect of TCM in the treatment of COVID-19 since the epidemic combining the theoretical characteristics of the Yishui school, such as Zangfu Bianzheng, Zangqi Fashi, Piwei thought, and precision medicine, with the purpose of providing reference for TCM to play a greater role in anti-epidemic in the future.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 28-37.   DOI: 10.3969/j.issn.1674-490X.2023.03.005
    Abstract105)      PDF(pc) (550KB)(62)       Save
    The clinical characteristics of acute lung injury(ALI)are decreased oxygenation index, refractory hypoxemia and then further development of acute respiratory distress syndrome in critically ill patients with high morbidity and mortality. The etiology of ALI is varied, such as direct lung injury and indirect lung injury. Each etiology leads to a different treatment for ALI, especially the use of glucocorticoids. However, the use strategy of ALI is different, and there are serious complications after long-term use, so its use should be cautious. Therefore, understanding the application progress and potential mechanism of glucocorticoids is helpful to better use glucocorticoids and reduce their side effects. This article provides an overview of summary about using glucocorticoids in ALI of different etiology, including the experimental application of animal models and the methods commonly used in clinical practice, and the mechanism behind it, providing reference for efficient treatment.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 75-80.   DOI: 10.3969/j.issn.1674-490X.2023.04.012
    Abstract98)      PDF(pc) (443KB)(40)       Save
    Objective To explore the application effect of ADDIE teaching mode in ultrasound diagnosis. Methods A total of 153 imaging students who studied in the Department of Ultrasound in the First Hospital of Lanzhou University from September 2020 to June 2022 were selected as the research objects. According to the method of random number table, they were divided into the conventional group and the observation group. The students in the conventional group received the teaching of ultrasonic diagnostics in the conventional teaching mode(n=73). Students in the observation group received ultrasonic diagnostics teaching under the ADDIE teaching model(n=80), the differences between the two groups of students in the course assessment results were compared, the two groups of students' satisfaction with the teaching content were examined with questionnaire, the teacher's satisfaction with the students were evaluated and compared. Results The results of the observation group were significantly higher than those of the conventional group(P<0.05). The scores of students in the observation group were significantly higher than those in the conventional group in the aspects of ideology and politics, teaching content, teaching method, teaching management and teaching effect(P<0.05). The scores of students in the observation group in independent learning, classroom activity, learning interest, class notes and homework completion were significantly higher than those in the conventional group(P<0.05). Conclusion The application of ADDIE teaching model in the teaching of ultrasound diagnosis can achieve better teaching results, help improve students' academic performance and teaching satisfaction, and also significantly improve the satisfaction of teachers to students.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 77-80.   DOI: 10.3969/j.issn.1674-490X.2023.03.011
    Abstract91)      PDF(pc) (413KB)(67)       Save
    Objective To evaluate the effects of the use of digital orthopaedic technology for teaching in orthopedics of Chinese Wedicine. Methods 60 residents who had joined the standardized training were selected and randomly divided into experimental and control groups which were consisted of 30 people respectively. Traditional teaching method was utilized in control group, while the experimental group was taught by combining with 3D printing model and virtual simulation technology. Satisfaction questionnaire and clinical test were used to comprehensively evaluate the teaching effects. Results The experimental group behaved better than the control group students both in satisfaction survey and clinical test, the difference was statistically significant(P<0.05). Conclusion The novel teaching approach integrated conventional teaching method with 3D printing and virtual simulation technology could enhance the interns' understanding of the characteristics of common fracture deformities and the understanding of Chinese medicine bone-setting technique, improve learning initiative and efficiency, thus can promote the quality of internship.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 8-13.   DOI: 10.3969/j.issn.1674-490X.2023.03.002
    Abstract87)      PDF(pc) (417KB)(62)       Save
    The clinical features of influenza A H1N1 pneumonia are complex and changeable, imaging features are diverse, the disease develops rapidly, critically ill patients can cause respiratory failure and even death. At present, X-ray, CT and radiomics provide new methods and ideas for the diagnosis, condition monitoring and curative effect judgment of the disease. This article reviews the latest advances on imaging diagnosis of influenza A H1N1 pneumonia and differential diagnosis with corona virus disease 2019.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 1-7.   DOI: 10.3969/j.issn.1674-490X.2023.05.001
    Abstract80)      PDF(pc) (1198KB)(41)       Save
    Objective To investigate the relationship between signal characteristics in enhanced-MRI hepatobiliary phase(HBP)and pathological grade of intrahepatic mass cholangiocarcinoma(IMCC). Methods Patients diagnosed with IMCC were retrospectively analyzed, and the signal characteristics of lesions in HBP were analyzed. Statistical analysis was performed by Chi-square test. Results 49 patients were diagnosed with IMCC. There were 5 cases with well-differentiated, 26 cases with moderately-differentiated and 18 cases with poorly-differentiated. 11 patients with lesion length less than 3 cm; 18 patients with lesion length between 3 cm and 6 cm, 20 patients with lesion length more than 6 cm. In HBP, 21 patients had target sign, 20 patients had multilayer target sign, and 8 patients had low signal. 41 cases had peripheral low. The difference of lesion size between different signal in HBP, and the difference of peripheral low signal ring integrity between different pathological grades were statistically significant(χ2=18.937, P=0.001; χ2=6.618, P=0.037). Conclusion Incomplete peripheral low signal ring in HBP is more common in poorly-differentiated IMCC, and the larger the lesion is, the more it shows multilayer target sign.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 8-14.   DOI: 10.3969/j.issn.1674-490X.2023.05.002
    Abstract79)      PDF(pc) (866KB)(16)       Save
    Objective To investigate the diagnostic accuracy of 3.0 T MRI in the diagnosis of the medial and lateral meniscal posterior root tears. Methods 326 cases of knee joint confirmed by arthroscopy and with complete MRI data were collected. Under the premise of unknown arthroscopic results, the two physicians jointly evaluated the MRI images and analyzed the accuracy of posterior root tear of meniscus, including the sensitivity, specificity and accuracy of diagnosis. Results Fifty six of the 326 patients were diagnosed with meniscus posterior root tears by arthroscopy, including 41 cases of medial posterior root tears and 15 cases of lateral posterior root tears. The sensitivity, specificity and accuracy of 3.0 T MRI were 97.56%, 94.39% and 94.79%, respectively. The sensitivity, specificity and accuracy of 3.0 T MRI were 73.33%, 88.42% and 87.73%, respectively. The diagnostic sensitivity, specificity, and accuracy of posterior root tear of the medial meniscus are higher than those of the lateral meniscus(χ2=5.228,P=0.022;χ2=6.636,P=0.010;χ2=10.170,P=0.001). Conclusion 3.0 T MRI has high accuracy in the diagnosis of posterior root tears of meniscus.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 61-67.   DOI: 10.3969/j.issn.1674-490X.2023.03.009
    Abstract79)      PDF(pc) (482KB)(13)       Save
    The incidence of low back pain is high, which brings a burden to society and personal life. Breathing training, as a convenient, effective and low-cost treatment method, has been gradually applied to the field of rehabilitation of low back pain. Breathing training programs include diaphragmatic breathing, abdominal breathing, reverse abdominal breathing, and resistance breathing. They improve back pain by activating core muscle groups, enhancing intraabdominal pressure, improving proprioceptive input, and regulating nerves and blood vessels. The effects and limitations of these intervention programs were comprehensively analyzed to provide reference for further formulating respiratory training programs in patients with low back pain.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 11-18.   DOI: 10.3969/j.issn.1674-490X.2023.04.002
    Abstract79)      PDF(pc) (1480KB)(40)       Save
    Objective To understand the emerging research spots and trend in the field of psychiatric rehabilitation from 2012 to 2022. Methods We retrieved the literatures about psychiatric rehabilitation from the databases of Web of Science from 2012 to 2022. The authors, institutions, and keywords of psychiatric rehabilitation research literatures were visualized and analyzed with CiteSpace. Results A total of 3045 articles were examined. The international research hotspots in the field of psychiatric rehabilitation focused on exploring the patient-centred model of psychiatric rehabilitation, such as community-based rehabilitation, occupational rehabilitation, and addressing the issue of stigma. Conclusion In order to promote the development of research in the field of psychiatric rehabilitation in China, in future, scholars can strengthen innovative research ideas and methods on the basis of learning from international research hotspots and research frontiers, and develop new areas of psychiatric rehabilitation.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 1-7.   DOI: 10.3969/j.issn.1674-490X.2023.03.001
    Abstract78)      PDF(pc) (985KB)(10)       Save
    Objective To explore the subcellular localization of denticleless protein homolog(DTL)and determine the possible biological role of DTL. Methods The subcellular localization of DTL was detected with immunofluorescence(IF)and immunohistochemistry(IHC). Cell fraction extraction and Western blotting(WB)in a variety of cells and tissues were used to verify. Results It was confirmed the subcellular localization of DTL during mitosis was around chromatin in all cells. In addition, our study firstly found the subcellular localization of DTL in different cells and tissues was also different. DTL was mainly expressed in nucleus in normal cells, normal tissues, sperm cells and mouse spermatocytes, and in cytoplasm in most cancer cells, cancer tissues and spermatogonia. Conclusion The subcellular localization of DTL would change not only in the cell cycle, but also in different types of cells and tissues. DTL has the translocation between cytoplasm and nuclear with cell proliferation and differentiation, suggesting that DTL may play a role in cell proliferation and differentiation by changing subcellular localization.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 61-66.   DOI: 10.3969/j.issn.1674-490X.2023.04.010
    Abstract78)      PDF(pc) (459KB)(26)       Save
    This review summarizes the application and effects of virtual reality technology in nursing rehabilitation training, communication training, symptom management and nursing education and other nursing fields. Nursing staff play an important role in the interdisciplinary cooperation between nursing and virtual reality technology: designers, implementers, influencer and implementer. It also puts forward the challenges and prospects of the current application of virtual reality technology in the field of nursing. Nursing staff should give full play to their professional dominance and subjective initiative to provide more opportunities for transdisciplinary collaboration between nursing and virtual reality technology.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 68-76.   DOI: 10.3969/j.issn.1674-490X.2023.03.010
    Abstract77)      PDF(pc) (1210KB)(61)       Save
    Objective To analyze the research hotspots and trends of international telenursing from 2007 to 2023, so as to provide reference for the further development of this field in China. Methods The core collection of Web of Science was searched to obtain literature of telenursing, CiteSpace was used to analyze the co-occurrence of countries, journals, keywords, and draw relevant visual knowledge map. Results A total of 1602 effective literatures were included. The research hotspot focuses on telecare medicine information system and the application in chronic disease patients, and the forefront of research is virtual care. Conclusion Domestic telenursing is in the exploratory stage, with less international cooperation. In the future, it is necessary to expand international cooperation, strengthen learning and exchange, and promote the better development of telenursing in China.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 22-27.   DOI: 10.3969/j.issn.1674-490X.2023.03.004
    Abstract76)      PDF(pc) (474KB)(18)       Save
    Objective To analyze the clinical data of cracked teeth, describe the distribution of cracked teeth and analyze the five-year survival rate of teeth after different treatment methods, so as to provide reference for the clinical treatment of cracked teeth. Methods 141 cases of cracked teeth treated in our hospital from January 2015 to December 2016 were selected as the research subjects. The clinical data, treatment methods and therapeutic effect of the patients were analyzed retrospectively. Results The average age of the patients was 47.61±11.82 years old. The incidence of cracked teeth in maxillary first molars was high(53.19%), and cracks were common in far hidden cracks(37.59%). 69 teeth with hidden cracks deeping into the pulp cavity were treated with root canal therapy. The 5-year survival rate was 85.51%,Total crown restoration was performed in 55 cases, and the 5-year survival rate was 92.73%. 14 cases did not undergo total crown restoration, and the 5-year survival rate was 57.14%. For 72 teeth with unextended hidden cracks and pulp cavity, 55 cases were treated with filling, and the 5-year survival rate was 92.73%. 17 cases were treated with descending treatment, and the 5-year survival rate was 70.59%. Conclusion For the cracked teeth with unextended hidden cracks and pulp cavity, the five-year survival rate of the cracked teeth treated with filling was relatively higher than that of the cracked teeth treated with filling. Root canal therapy and crown repair were mostly used for cracked teeth with deep lines reaching the pulp cavity.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 46-52.   DOI: 10.3969/j.issn.1674-490X.2023.05.007
    Abstract75)      PDF(pc) (501KB)(13)       Save
    Hebei Province Outpatient Department of Traditional Chinese Medicine of Baoding, founded in December 1950, was the earliest provincial-level Traditional Chinese medicine clinic in the province since liberation. By employing doctors from all over the country and accepting graduates from traditional Chinese medicine colleges and universities, the clinical strength had rapidly increased, and the scale of the hospital had rapidly expanded due to the remarkable curative effects, at the same time, QIAN Letian, ZENG Zhongshu, TANG Pinqing, HOU Tingxiu, QIAN Qiguang and other famous TCM doctors emerged. It was revoked in August 1965. The history of Hebei Province Outpatient Department of Traditional Chinese Medicine of Baoding had witnessed the development of the province's earliest traditional Chinese medicine hospitals since liberation, and the early evolution of the province's traditional Chinese medicine practice. From its creation to its abolition over a decade ago, it had a far-reaching influence on the development of traditional Chinese medicine in Hebei province, and its exploration on the development of traditional Chinese medicine hospitals had certain enlightenment and research value for the development of traditional Chinese medicine at present.
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    Application of external treatment of TCM in relieving fever in patients with exogenous fever
    MA Wenjing, LI Chaojun, XU Haixia, LIU Nina
    Journal of Hebei Medical College for Continuing Education    2023, 40 (6): 54-60.   DOI: 10.3969/j.issn.1674-490X.2023.06.008
    Abstract74)      PDF(pc) (499KB)(21)       Save
    Fever is not only the first symptom of many diseases, but also the only symptom of some diseases. In recent years, there has been a significant increase in the number of consultations for fever due to external evils, as a result of the frequent occurrence of infectious diseases caused by viruses and bacteria. Modern medicine is based on antipyretic, antiviral and/or antibiotic medication, which is effective in reducing fever, but also requires acceptance of its side effects and repeated medication when fever tends to recur. In contrast, the external treatment methods of Chinese medicine are not only highly effective, simple, with few side effects, but are also more acceptable to patients and their families and easy to use at home. This paper reviews the effectiveness and characteristics of the application of common TCM external treatment methods to reduce fever, such as guasha, cupping, bloodletting, acupressure, acupoint application, herbal baths and herbal enemas, in the care of patients with exogenous fever in recent years to provide reference for clinical formulation of fever reduction protocols.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 45-52.   DOI: 10.3969/j.issn.1674-490X.2023.04.008
    Abstract73)      PDF(pc) (515KB)(22)       Save
    Objective To analyze the risk factors associated with recurrence in patients with benign paroxysmal positional vertigo(BPPV)and provide targeted prevention of recurrence of BPPV and improve the quality of life of patients. Methods The medical records of 255 patients with BPPV who were admitted to the Department of Otolaryngology, Affiliated Hospital of Hebei University from January, 2018 to January, 2019 were collected. All patients successfully completed manual reduction treatment. Gender, age, frequency of incidence and previous medical history(including hypertension, diabetes, hyperlipidemia, sleep quality, etc.)of all patients were recorded in detail. All patients' hospital anxiety and depression scale(HADS)scores were recorded to assess whether they had anxiety or(and)depression, and serum calcium ion concentration and serum homocysteine(HCY)concentration were recorded. The recurrence of BPPV patients was recorded in clinical or telephone follow-up for 1 year. The baseline data of patients in the relapsing group and the non-relapsing group were analyzed and compared. The risk factors of BPPV recurrence were analyzed by multiple linear regression. Results After strict inclusion and exclusion criteria, a total of 255 patients with BPPV were included in this study, and all patients completed the manual repositioning and were followed up clinically or by telephone for 1 year, 31 patients were lost, and a total of 224 patients completed the follow-up, including 52 patients in the recurrence group and 172 patients in the non-recurrence group, with a recurrence rate of about 23.2%. By comparing the two groups by one-way ANOVA, the differences were not statistically significant(P>0.05)for gender, age, hyperlipidemia, and blood calcium concentration, and statistically significant(P<0.05)for hypertensive disease, diabetes, sleep quality, anxiety or(and)depression, and blood HCY concentration. Further binary logistic regression analysis revealed that anxiety or(and)depression was an independent risk factor for recurrence in patients with BPPV. Conclusion Anxiety and/or depression are closely related to BPPV recurrence.
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    Advances on self-regulation in disease management of patients with chronic diseases
    HE Xiaoge,LU Qian,ZHU Fei,KE Sangsang,WANG Jingwei,LIU Chunlei
    Journal of Hebei Medical College for Continuing Education    2023, 40 (6): 61-68.   DOI: 10.3969/j.issn.1674-490X.2023.06.009
    Abstract71)      PDF(pc) (485KB)(27)       Save
    Self-regulation is a key variable of disease self-management in patients with chronic diseases and influences the establishment of health behaviors. This article reviews the related theories, assessment tools, influencing factors, and interventions of self-regulation in patients with chronic diseases, aiming to enhance the attention of domestic researchers to self-regulation in patients with chronic diseases and help patients to manage their diseases effectively by improving the level of self-regulation and provide reference for future research.
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    Pressure-controlled volume guaranteed ventilation in clinical application
    WANG Jianlong, GUO Haoyuan, GONG Zhexuan, ZHANG Yin'en, WU Guangyi
    Journal of Hebei Medical College for Continuing Education    2023, 40 (6): 28-33.   DOI: 10.3969/j.issn.1674-490X.2023.06.004
    Abstract67)      PDF(pc) (438KB)(30)       Save
    Perioperative mechanical ventilation-induced lung injury has become a globally recognized issue, and enhancing perioperative lung protection can significantly reduce the occurrence of pulmonary complications and promote early patient recovery. There have been studies indicating a close relationship between intraoperative mechanical ventilation strategies and perioperative lung injury. Pressure-Controlled Volume Guaranteed Ventilation(PCV-VG)is an emerging ventilation mode that can provide stable tidal volumes without being affected by changes in airway pressure. It achieves appropriate ventilation and oxygen supply by ensuring that the airway pressure remains within a predetermined limit. This review is to comprehensively evaluate the impact of PCV-VG mode on perioperative lung injury and outcomes, including hemodynamics, respiratory mechanics, inflammatory mediators, oxygenation indices, and postoperative complications, among other key factors. It also aims to compare the application effects of different ventilation modes in specific patient populations, providing more reliable evidence for clinicians in choosing ventilation strategies.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 14-21.   DOI: 10.3969/j.issn.1674-490X.2023.03.003
    Abstract62)      PDF(pc) (480KB)(13)       Save
    Gastric cancer is a common malignant tumor of the digestive system, with high morbidity and high mortality. There is still no effective method for its screening and early diagnosis. Long non-coding RNA(lncRNA)is a kind of non-coding RNAs with a length of more than 200 nucleotides, which is abnormally expressed in a variety of malignant tumors. Exosomes are membranous vesicles with a diameter of about 40-100 nm, which are widely distributed in various body fluids. They play an important role in intercellular communication, containing various biologically active substances such as nucleic acid, protein. More and more studies have shown that exosomal lncRNA plays an important regulatory role in the proliferation, invasion, metastasis and treatment resistance of gastric cancer cells. Regulating its expression level can promote or inhibit the progress of gastric cancer. In addition, some exosomal lncRNA have promising potential as diagnostic and prognostic markers for gastric cancer, and even as therapeutic targets for gastric cancer. Combined with the relevant research reports at home and abroad in recent years, this paper reviews the research developments of exosomal lncRNA in gastric cancer.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 41-44.   DOI: 10.3969/j.issn.1674-490X.2023.04.007
    Abstract61)      PDF(pc) (365KB)(20)       Save
    People infected with COVID-19 belong to the category of “epidemic” in traditional Chinese medicine. Their pathogenesis and course of disease are extremely complex, and the pathogenesis of infection in acute stage, symptom retention stage and recovery stage are different, and the treatment should also be different. The patients in Baoding, as the first city to be affected by the epidemic in 2022, were treated with Puji Disinfection Drink, Chaige Jieji Decoction and Sangxing Decoction respectively according to its syndrome types and symptoms at each stage, with remarkable effects. A typical medical case is attached.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (3): 38-45.   DOI: 10.3969/j.issn.1674-490X.2023.03.006
    Abstract58)      PDF(pc) (512KB)(15)       Save
    Acute ST-segment elevation myocardial infarction(STEMI)is the cause of death for patients with cardiovascular disease worldwide, for which timely and effective opening of infarct related vessels is the most important treatment. Early restoration of culprit vessel patency by primary percutaneous coronary intervention(PCI)represents the reperfusion strategy of choice for patients with STEMI. However, about half of the patients still cannot get sufficient blood perfusion to the distal coronary microvasculature after PCI, which is closely related to the occurrence of adverse cardiovascular events. This situation is called no-reflow phenomenon(NRP). This article reviews recent treating progress of drug therapy and non-drug therapy for NRP after PCI.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 38-45.   DOI: 10.3969/j.issn.1674-490X.2023.05.006
    Abstract55)      PDF(pc) (503KB)(11)       Save
    The theory of Yinjing Baoshi originated from ZHANG Yuansu of Jin Dynasty, which paid special attention to the meridian tropism of drugs and was the first to summarize the attribution relationship between medicines and Zangfus. It had a great influence on later generations and was widely used in clinical practice. ZHANG Yuansu, with excellent medical skills, established the Yishui School of medicine, and played a part in the history of the development of herbal theory. At present, the research of this theory is mainly focusing on the collation of ancient books, clinical trials and laboratory research. This paper traces the historical course of the Yinjing Baoshi of traditional Chinese medicine, expounds the clinical application, matters for attention and the results of modern experimental research, and summarizes the problems in the research of the related traditional Chinese medicine, and the theoretical innovation of the verification of the Yinjing Baoshi of traditional Chinese medicine in order to better verify the scientific connotation of the theory of the Yinjing Baoshi of traditional Chinese medicine, and guide the rational use of the Yinjing drugs in clinical practice.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 29-37.   DOI: 10.3969/j.issn.1674-490X.2023.05.005
    Abstract54)      PDF(pc) (512KB)(19)       Save
    Gorham disease is a rare syndrome, which is considered as type Ⅳ osteolysis in hardegger classification. The etiology and pathogenesis are unclear. The orthopaedic clinical features of Gorham disease depend on the affected bones. It is characterized by massive osteolysis affecting one or more bones and replaced by bone lymphatic vessels, which may be life-threatening. The diagnosis of the disease is very challenging and is an exclusive diagnosis. In addition, imaging examination is also a necessary condition for diagnosis. The disease is mainly treated by comprehensive treatment, sirolimus can inhibit cell proliferation and angiogenesis; bisphosphonates has anti-osteolytic activity and inhibits osteolysis caused by osteoclasts; radiotherapy may prevent the progression of osteolysis by inhibiting the proliferation of endothelial cells; surgery is mainly used to treat complications. Because the prognosis of chylothorax and other complications is often poor, further research is very necessary to obtain more in-depth insights into the disease and guide the most appropriate clinical treatment strategy.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 53-60.   DOI: 10.3969/j.issn.1674-490X.2023.04.009
    Abstract53)      PDF(pc) (509KB)(17)       Save
    Objective To evaluate the feasibility of the practice programme for upright positions in the second stage of labour. Methods The practice programme for upright positions in the second stage of labour was implemented in the birth position management in a tertiary hospital in Hebei province. The feasibility analysis was conducted by assessing maternal participation and compliance, cost input, experience and suggestions of midwives, obstetricians, and parturients. Results For maternal participation and compliance, a total of 20 parturients were recruited, and 16 of which agreed to participate in this study. Twelve parturients completed the whole study. In terms of cost input, midwives spent less time attending to parturients, the demand for midwifery human resources was relatively high, and the equipment and materials could meet the needs. As for experience and suggestions of midwives and obstetricians, the implementation process was feasible, and the practice programme was well accepted. However, some contents needed to be refined, and the content and form of the training program needed to be improved. For maternal experience and suggestions, the implementation can improve childbirth experience, and parturients accepted the use of upright positions. However, the education on upright positions should be available for more pregnant women. Conclusion The feasibility of this practice programme in preliminary application is good.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 76-80.   DOI: 10.3969/j.issn.1674-490X.2023.05.012
    Abstract52)      PDF(pc) (431KB)(32)       Save
    Objective To explore the design and application of micro-class combined with flipped teaching in teaching clinical blood transfusion in interns. Methods A total of 207 interns from May 2020 to May 2022 were selected and randomly divided into the control group and the experimental group, with 100 interns in the control group and 107 interns in the experimental group. The interns in the control group were managed by traditional teaching methods, while those in the experimental group were taught by micro-class combined with flipped teaching mode, and a questionnaire survey on subjective learning experience was designed. Daily content completion rate of students in the experimental group was monitored according to feedback on wechat platform. The two groups of interns were compared in theoretical assessment, operational assessment, satisfaction with teaching results and the evaluation of blood transfusion department staff. Results The theoretical test score of interns in the experimental group was(88.08±7.21)points, which was higher than that in the control group(72.35±5.43)points, and the difference was statistically significant(P<0.05). By comparing the scores of the two groups of interns, the scores of the experimental group(90.45±5.82)were higher than those of the control group(74.92±7.51), and the difference was statistically significant(P<0.05). Comparing the two groups of interns' satisfaction with teaching, including teaching method satisfaction, mastery, problem-solving ability, analytical ability and initiative, the experimental group interns' satisfaction was significantly higher, and the difference was statistically significant(P<0.05). Compared with the evaluation of blood transfusion department staff on the two groups of interns, the satisfaction of the experimental group interns was significantly higher than that of the control group interns, the difference was statistically significant(P<0.05). Conclusion Teaching clinical blood transfusion in interns through micro-class combined with flipped teaching mode can significantly improve students' enthusiasm, improve practical operation ability, increase satisfaction, promote teacher-student relationship, reduce disputes, and is worth popularizing.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 53-59.   DOI: 10.3969/j.issn.1674-490X.2023.05.008
    Abstract52)      PDF(pc) (489KB)(26)       Save
    Pelvic floor dysfunction has become a common post-operative complication of cervical cancer patients, mainly manifesting as bladder dysfunction, rectal dysfunction, sexual dysfunction and pelvic organ prolapse, which seriously affects patients' physical and mental health and quality of life, and affects the prognosis of the disease. Early, professional and personalized pelvic floor rehabilitation treatment for postoperative cervical cancer patients will reduce the occurrence and severity of pelvic floor dysfunction. There are many non-surgical measures for pelvic floor dysfunction after cervical cancer surgery. It is reviewed with a view to providing a basis for the rehabilitation of patients' pelvic floor function, improvement of their physical and mental health and quality of life.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 31-36.   DOI: 10.3969/j.issn.1674-490X.2023.04.005
    Abstract50)      PDF(pc) (423KB)(23)       Save
    Acute respiratory distress syndrome is a condition of varied etiology characterized by the acute onset of hypoxemia, reduced lung compliance, noncardiogenic pulmonary edema and diffuse exudative lesions of both lungs. Although protective ventilation strategy has been implemented in clinical practice, an estimated 10%-15% of the deaths in ARDS are caused due to refractory hypoxemia. In these cases, clinicians may resort to “salvage therapies”. These include prone position ventilation, application of early neuromuscular blockers, various recruitment maneuvers, unconventional ventilation modes, inhaled pulmonary vasodilators, and extracorporeal membrane oxygenation. All the salvage therapies have been associated with improved oxygenation, but whether to reduce mortality and improve prognosis is controversial. Each of the salvage therapiesis associated with its own risks and benefits, specific treatment strategies should be adopted according to the individual situation of patients.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (4): 19-24.   DOI: 10.3969/j.issn.1674-490X.2023.04.003
    Abstract43)      PDF(pc) (441KB)(20)       Save
    Objective To investigate the correlation between MRI burden score and early deterioration of neurological function in patients with mild stroke. Methods Retrospective analysis of 395 inpatients with ischemic stroke in June, 2018 to December, 2020 were conducted. According to the early neurological deterioration, the patients were divided into the worsening group(n=36)and the conventional group(n=359). The relationship between gender, age, past history(hypertension, diabetes,et al), nuclear magnetic resonance score, baseline systolic blood pressure,blood lipids, homocysteine and other neurological deterioration were analyzed. Results The MRI burden score in the early neurological deterioration group was higher than that in the routine group(P<0.05). Logistic regression analysis found that MRI burden score were independent risk factors for early neurological deterioration in patients with mild stroke(P<0.05). Conclusion The higher the MRI burden score, the higher risk of early neurological deterioration in patients with mild stroke.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 15-21.   DOI: 10.3969/j.issn.1674-490X.2023.05.003
    Abstract40)      PDF(pc) (867KB)(17)       Save
    Objective To measure the contractive response of different receptor agonists on the endothelium-denuded caudal artery rings in rats and evaluate the function of different receptors in peripheral resistant vessels. Methods The rat isolated caudal artery rings were prepared, and the vasoconstriction induced by various concentrations of noradrenaline(NA), α,β-MeATP and uridine adenosine tetraphosphate(Up4A)was measured. Results The three receptor agonists could produce concentration-dependent contraction, and the response intensity was NA>α, β-MeATP>Up4A, the values of contraction induced by 10 μmol/L NA, α, β-MeATP and Up4A in caudal artery rings were(95.26 ±14.57)%,(62.28 ±6.98)% and(12.16 ±2.19)% of the maximum contraction induced by KCl, respectively. Conclusion Adrenergic receptors and purinergic receptors may play important roles in the regulation of peripheral resistant vascular tension. The dinucleotide Up4A with pyrimidine and purine structures has the weaker role in mediating peripheral resistant vascular tension. The different vascular tension mediated by different receptors on the peripheral resistance vascular smooth muscle may have significant implications for blood redistribution and ensuring blood supply to important organs.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 72-75.   DOI: 10.3969/j.issn.1674-490X.2023.05.011
    Abstract38)      PDF(pc) (409KB)(23)       Save
    Objective To explore the correlation between resident physician satisfaction, training cognition and training effect. Methods A questionnaire was used to investigate the satisfaction, training cognition and training effect of 135 resident physicians in a hospital affiliated to an university in Tianjin, and the difference between satisfaction, training cognition and training effect of resident physicians in different identity categories and the correlation between satisfaction, training cognition and training effect were understood. Results The comparison results of training cognition, satisfaction and training effect of the type of regular training physicians were better than that of the professional master's degree students. There was a significant positive correlation between training cognition, satisfaction and training effect. Training cognition had a direct predictive effect on training effect, training cognition had an impact on training effect through satisfaction, and satisfaction played a complete mediating role between training cognition and training effect. Conclusion In the training of resident physicians, the external and internal protective conditions should be fully considered, and the intervention of satisfaction and training awareness should be strengthened to achieve the purpose of improving the training effect.
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    Study on the differences between teaching film-reading and case discussion in standardized resident training
    LI Wei, LI Wen, JIANG Shuqin, ZHANG Rusen, ZHANG Linqi, PENG Hao
    Journal of Hebei Medical College for Continuing Education    2023, 40 (6): 75-80.   DOI: 10.3969/j.issn.1674-490X.2023.06.011
    Abstract35)      PDF(pc) (352KB)(27)       Save
    In the standardized resident training, clinical instruction teachers in the medical imaging profession have obvious confusion about how to carry out teaching film-reading, with the main confusion is how to accurately distinguish between teaching film-reading and teaching case discussion. Deeply considering this and constructing the key points for distinguishing between them is beneficial for the standardized development of standardized resident training in medical imaging majors. Based on the differences in the core ideas between teaching film-reading and case discussion, the differences in teaching content, case sources, image analysis, classroom performance are discussed. This will help clinical instruction teachers to correctly understand and carry out teaching film-reading and avoid confusion with case discussion
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    Advances on the role of iron and vitamin D in children's growth and development
    WANG Yuru, JI Rui, ZOU Jingwen, YUAN Bo, BAI Jinxiu
    Journal of Hebei Medical College for Continuing Education    2023, 40 (6): 21-27.   DOI: 10.3969/j.issn.1674-490X.2023.06.003
    Abstract34)      PDF(pc) (477KB)(32)       Save
    Children are at the most important stage of growth and development in a person's life, and the most commonly used indicators to evaluate physical development in children are height, weight and BMI. Iron and vitamin D play a vital role in children's growth and development. However, there are relatively few articles about the role of iron and vitamin D in children's growth and development. This article provides a systematic review of the current role of iron and vitamin D in childhood height growth and obesity,aiming to provide a scientific basis for the monitoring of iron and vitamin D levels and nutritional supplementation in the future, and to make clinicians pay more attention to the role of iron and vitamin D in children's growth and development.
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    Journal of Hebei Medical College for Continuing Education    2023, 40 (5): 22-28.   DOI: 10.3969/j.issn.1674-490X.2023.05.004
    Abstract34)      PDF(pc) (478KB)(21)       Save
    The proximal segment of myocardial bridge is prone to coronary atherosclerosis. This may lead to myocardial ischemia, which can result in angina, acute coronary syndrome(ACS), left ventricular dysfunction, syncope and even sudden cardiac death. However, there is lack of mechanisms and robust data. This article reviews the recent advances of patented technology in China, including coronary artery and heart pump simulation devices, myocardial bridge simulation and image acquisition equipment, traditional Chinese medicine, pulsed field ablation and stent implantation equipment of myocardial bridge.
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    Differentical analysis of serum amino acid and acylcarnitine levels in late preterm infants
    XIANG Jingjing, YANG Dongfei, ZHONG Xiaoyi, WANG Yu
    Journal of Hebei Medical College for Continuing Education    2023, 40 (6): 12-20.   DOI: 10.3969/j.issn.1674-490X.2023.06.002
    Abstract32)      PDF(pc) (481KB)(17)       Save
    Objective To study the relationship between gestational age, birth mass and nutritional support modalities of late preterm infants and their blood amino acid and acylcarnitine levels and provide targeted guidance for the nutritional management of preterm infants at this stage of life. Methods 202 late preterm babies hospitalized from January 2017 to December 2021 were selected for the study. According to the relationship between gestational age and body mass at birth, they were divided into appropriate for gestational age(AGA), small for gestational age(SGA)and large for gestational age(LGA)groups. Nutritional support on the day of sampling was categorised as total parenteral nutrition(TPN), partial parenteral nutrition(PPN)and total enteral nutrition(TEN). Determination and comparison of amino acid and acylcarnitine levels in their peripheral blood were conducted by tandem mass spectrometry techniques Results There were statistically significant differences in the levels of valine, leucine, methionine, phenylalanine, tyrosine, citrulline, and proline between the AGA, SGA, and LGA groups, with the levels of these amino acids being generally higher in the LGA than in the AGA and SGA groups. The differences in acylcarnitine levels were not statistically significant among the three groups.The differences in the levels of glycine, ornithine, leucine, methionine, and citrulline between TPN, PPV, and TEN were all statistically significant, with ornithine, leucine, methionine, and citrulline being relatively low in the TPN approach and glycine being relatively high in the TEN approach.The levels of various short-chain, long-chain and some medium-chain acylcarnitines showed statistically significant differences among the different nutritional modalities, with the highest levels in TEN. Conclusion In late preterm infants, there were differences in the blood amino acid profiles of the AGA, SGA and LGA groups, and SGA could be supplemented with branched-chain amino acids, sulphur-containing amino acids and aromatic amino acids in moderation at an early stage. Blood amino acid and acylcarnitine levels are susceptible to nutritional support modalities. Nutrient ratios should be reasonably adjusted to appropriately increase glycine and carnitine levels in parenteral nutrition solutions, and leucine, methionine, ornithine and glutamine should be added as appropriate in enteral nutrition.
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