Journal of Hebei Medical College for Continuing Education

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Initial study on effection of different processing methods on the Stellera chamaejasme chemical constituents

JIANG Zhifeng, MA Xiaoli, HAN Bo, CAO Songyun, GENG Yuanyuan

Medical Reserch and Education 2015, 32 (1): 1-6.

Abstract （299）

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Objective To study the effects of different processing methods on chemical constituents of Stellera chamaejasme. Methods The systematic preliminary tests were used including physical and chemical identification and thin layer chromatography(TLC) identification to detect the differences and similarities of chemical components of Stellera chamaejasme and processed products. Results (1) Stellera chamaejasme and processed products all contain ingredients of carbohydrate, glycoside, phenols, tannin, organic acid, saponins, flavonoids, steroid, triterpenes and coumarin lactone, and may contain volatile oil and cerolein. In water extraction, there were differences on phenols, tannin and saponins. (2) In water extraction, the flavonoids of dairy products was low. In ethanol extraction, the flavonoids of Stellera chamaejasme and three processed products were essentially the same. (3) In water extraction, the coumarin lactone of processing with vinegar was high. In ethanol extraction, the coumarin lactone of dairy products was low. (4) In water extraction, the terpenoid of Stellera chamaejasme was high. In ethanol extraction, the terpenoid of Stellera chamaejasme and dairy products were low. Conclusion Different processing methods all have an impact on the chemical constituents of Stellera chamaejasme.

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Experimental study of total flavonoids in Net Cliffbean affecting the mechanical allodynia in CCI rats

LIU Yangbin, ZHANG Zhihua, CHEN Yayun

Medical Reserch and Education 2015, 32 (1): 7-11.

Abstract （331）

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Objectivev To study the effects of total flavonoids in Net Cliffbean on the mechanical allodynia and glutamate contents in spinal of chronic constriction injury of the sciatic(CCI) rats. Methods 40 rats were randomly divided into 4 groups: control group, sham operation group, CCI group and Net Cliffbean treatment group, with NomralSaline or drugs, once a day, for 4 weeks. Mechanical withdrawal threshold (MWT) was measured as the sign of mechanical allodynia for 3, 7, 10, 14, 21, 28 day. The lumbar segment of the spinal cord was removed for determination of glutamate contents by high pressure liquid chromatography (HPLC) for 14, 28 day. Results Total flavonoids in Net Cliffbean significantly increased the mechanical withdrawal threshold (MWT) compared with model group (P＜0.05 or P＜0.01), and obviously decreased the content of glutamate in the spinal cord (P＜0.01). Conclusion Total flavonoids in Net Cliffbean can relieve the mechanical allodynia in neuropathic pain rats, its mechanism maybe reduced glutamate content in the spinal cord.

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Catalytic discoloring spectrophotometry determination of trace element germanium in Chinese herbal medicine (herba hedyotis)

YANG Hui, DING Liang, ZHANG Baolin, YUAN Liyun, DONG Xiaodong

Medical Reserch and Education 2015, 32 (1): 12-15. DOI: 10.3969/j.issn.1674-490X.2015.01.003

Abstract （402）

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Objective To explore a catalytic spectrophotometic method for the quantitative determination of trace elements germanium in Chinese herbal medicine (herba hedyotis). Methods Extraction of trace element germanium in herba hedyotis was examined by using ultrasonic cleaning equipment, and the content was determined by catalytic discoloring spectrophotometry. The reaction was studied, trace germanium (IV) could accelerate potassium bromate and hydrogen peroxide oxidize neutral red in H2SO4 medium, the established method could be used to determine catalytic spectrophotometric determination of trace germanium (IV). Results The results of this experiment indicated that inorganic germanium (IV) content in Chinese herbal medicine spreading herba hedyotis was 0.024 8 μg/g. Conclusion The sensitivity, the precision can meet the needs of the testing work well.

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Application of DTI and DTT in the evaluation of prognosis in patients with acute middle cerebral artery infarction

LI Yan, GAO Juan, SU Likai, YIN Xiaoping, LI Huimin, ZHAO Yongxia, CUI Lei, LI Weibin

Medical Reserch and Education 2015, 32 (1): 16-20. DOI: 10.3969/j.issn.1674-490X.2015.01.004

Abstract （596）

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Objective To investigate the correlation between different damage degrees of CST and prognosis in patients with acute middle cerebral artery infarction by using MR diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT). Methods Twenty patients with middle cerebral artery infarction were prospectively examined with 1.5T diffusion tensor imaging and diffusion tensor tractography within a 72-hour mean interval onset. The fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) in ischemic lesion and the oppsite area in nonaffected hemisphere, the fringe area of infarcts, cerebral peduncle were measured. According to the extent of CST destruction , the affacted CST was divided into three grades The twenty patients were graded by NIHSS and FMS. Spearman correlation analysis was applied to reveal the relationships between the extent of CST destruction and clinical prognosis. Results FA and ADC values notably decreased in infraction lesions verses non-affected hemisphere (P<0.001), which revealed that the tissue in infarction lesions had been damaged in different extent. Negative correlation was found between the extent of CST destruction and motor dysfunction grading according to FMS(r=-0.843, P<0.001), which revealed that the more serious CST was damaged, the lower motor dysfunction grading, the heavier degree of motor impairment, the worse prognosis. Positive correlation was found between the extent of CST destruction and recovery of neurological function according to NIHSS (r=0.819, P<0.001), which revealed that the more serious CST was damaged, the lower neurological function score, the worse prognosis of neurological function. Conclusion DTI and DTT provide a way for the quantitative analysis of acute middle cerebral artery territory lesions and the degree of CST damage, and provide reliable basis for early accurately judge the clinical prognosis and guide clinical treatment.

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Predictive value of fibrinogen concentration on post procedural myocardial injury and clinical prognosis following selective percutaneous coronary intervention

ZHANG Wei, CUI Xingxian, LI Jing, ZHANG Caihong, LI Haitao, XU Zhanwen

Medical Reserch and Education 2015, 32 (1): 21-25. DOI: 10.3969/j.issn.1674-490X.2015.01.005

Abstract （420）

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Objective To explore whether the fibrinogen (FIB) level can predict post procedural myocardial injury and clinical prognosis after percutaneous coronary intervention (PCI). Methods FIB level was measured preopratively in patients scheduled to undergo PCI to analyze its predictive value of postoperative myocardial injury. ROC analysis was performed to determine the cutoff point, at which sensitivity and specificity would be maximal. Based on the boundary value, the study subjects were divided into two groups. Compared the incidence of postoperative myocardial injury and cTnI concentration between two groups, and observed if there any differences. Follow-up of 1 year, surveyed if the adverse cardiovascular events had any differences. Results The preoperative FIB level had predictive value for myocardial injury of post-PCI (Area Under Curve, AUC =0.782, P<0.001). FIB boundary value was 3.85 g/L, sensitivity 65.53%, specificity 78.54%. The incidence of myocardial injury had a significant difference between the FIB <3.85 g/L group and FIB≥3.85 g/L group(13.93% VS 52.81%, χ²=36.959, P<0.001). The cTnI levels of postoperative was higher in the FIB≥3.85 g/L group[(0.25±0.67) ng/mL vs (0.55±0.65) ng/mL, t=-3.129, P=0.002]. The incidence of adverse cardiovascular events had statistical differences between the two groups(Log Rank P=0.025). FIB≥3.85 g/L led to a significant increase in adverse cardiovascular events (HR=2.069, 95%CI: 1.056-4.054). Conclusion The preoperative fibrinogen concentration has predictive values on post procedural myocardial injury and clinical outcomes on patients underwent selective PCI.

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Ductal carcinoma in situ of the breast (Report of 78 cases)

LIN Xiaomeng, SHI Jianwei, WANG Jian, LI Zhong

Medical Reserch and Education 2015, 32 (1): 26-30. DOI: 10.3969/j.issn.1674-490X.2015.01.006

Abstract （378）

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Objective To explore the clinical and pathological characteristics of ductal carcinoma in situ (DCIS) with tumor size examination. Methods We retrospectively analyzed 78 DCIS cases in Affiliated Hospital of Hebei University from Feb. 2011 to Sep. 2013. A comparative analysis was conducted with the cut-off points of 1.0 cm and 3.0 cm tumor size. Results When tumor size≤1.0 cm and tumor size between 1.0-3.0 cm, the clinical characteristics had no significant difference, when tumor size>3.0 cm, the characteristics were significantly different from the above two (P<0.05) shown as micro infiltration, high multifocal proportion, and high sentinel lymph node positive rate. The variance analysis of pathological indicators of DCIS and IDC showed that the positive expression of ER, PR, Ki67 was relatively low, while the positive expression of HER-2 was relatively high (P<0.05), this difference was significant. When tumor size >3 cm, all the indicators had no significant difference. Conclusion When tumor size>3.0 cm, the DCIS is more aggressive and its biology characteristics are similarly to IDC. The IDC treatment is recommended.

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Effects of calcium channel blockers on the distribution of blood vessels around the scar after nerve injury

LIU Chong, LIU Xiaofeng, CHEN Taoping, WANG Yunfei, REN Bao, GUO Zhao, XUE Jinwei, LIU Shuangli

Medical Reserch and Education 2015, 32 (1): 31-35. DOI: 10.3969/j.issn.1674-490X.2015.01.007

Abstract （459）

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Objective To investigate the correlation between the calcium channel blockers on the distribution of blood vessels scar after sciatic nerve injury in rats. Methods 96 SD rats were divided into 4 group at random, 24 rats in each group. The experimental rats were made sciatic nerve injury model, the experimental group and control group were given respectively a intraperitoneal injection of verapamil and physiological saline(4 mg/kg), in 4, 8 weeks after surgery immunohistochemical staining and vascular perfusion were conducted to observe the scar after injury of vascular distribution. Results In 4, 8 weeks after surgery, the blood vessel numbers were increased and the density of the nerve lesions became higher, the vascular distributions were more uniform in the rats of the experimental group. However, the results of the controls indicated that the blood vessels numbers were decreased, the density of the nerve lesions became lower, the vascular distributions were in the state of disorder. Conclusion Calcium channel blockers can be used to reduce the formation of collagen fibers to soften the scars, and thus improve the distribution of the lesions of blood vessels and promote the blood supply of nerve tissue damage, and make the damaged nerve bundle membrane and blood capillary hyperplasia of outer membrane recovered to accelerate the nerve regeneration and speed up the recovery of neural functions.

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Observation of the efficacy of butyiphthalide and nimodipine in the treatment of vascular dementia

SUN Juping, DAI Ruiting, XU Jine, AN Di

Medical Reserch and Education 2015, 32 (1): 36-39. DOI: 10.3969/j.issn.1674-490X.2015.01.008

Abstract （461）

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Objective To observe the efficacy and safety of butyiphthalide and nimodipine in the treatment of vascular dementia(VD). Methods Ninety cases with VD were randomly divided into group A(30 cases), group B(30 cases), and group C (30 cases). On the basis of conventional treatment, patients of group A were given 0.2 g butyiphthalide and 30 mg nimodipine for three times a day, group B were given 0.2 g butyiphthalide for three times a day, and group C were given 30 mg nimodipine for three times a day. All the patients were assessed with Montreal cognitive assessment scale (MoCA) and Activities of Daily Living (ADL) for comparison. The adverse events were recorded in the process of treatment. Results The MoCA and ADL Scores of three groups after treatment were better than scores before treatment, the differences were statistically signifucant (P<0.05). Group A could prominently improve the cognitive function of patients with VD, better than group C, the differences were statistically signifucant (P<0.05). Group A and B could prominently improve the cognitive function of patients with VD, better than group C, thedifferences were statistically signifucant (P<0.05). There was no statistically significant difference between A and B group (P>0.05). There were no significant differences in incidence rate of side effect among these groups. Conclusion Butyiphthalide and nimodipine can prominently improve the cognitive function of patients with vascular dementia and better than butyiphthalide or nimodipine alone. Combination therapy and given butyiphthalide alone can prominently improve the ability of daily living of patients with VD, which are better than nimodipine alone. Morever, their securities are good.

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Research of Butylphthalide Soft Capsules combined with exercise therapy on the motor functional rehabilitation of unilateral spatial neglect in patients with stroke

WEN Huixin, AN Di, TIAN Wenyan, CHEN Liying, LING Li

Medical Reserch and Education 2015, 32 (1): 40-43. DOI: 10.3969/j.issn.1674-490X.2015.01.009

Abstract （422）

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Objective To discuss the effect of Butylphthalide Soft Capsules combined with exercise therapy on the motor functional rehabilitation of unilateral spatial neglect(USN) in patients with stroke. Methods 120 cases of USN were randomly divided into two groups, 60 for each. Two groups were both treated with exercise therapy, the experimental group given Butylphthalide on the basis of exercise therapy. After 6 weeks, using 4 kinds of USN method to check the effective number and Barthel index and assessed the score. Results After 6 weeks, the effective number and Barthel index of most check methods were significantly improved in the experimental group thanthat of the control group. There was statistical differences(P>0.05), but not in the Clock Drawing Task CDT group. Conclusion Butylphthalide Soft Capsules combined with exercise therapy can improve the symptoms of USN in patients with stroke and improve their ability to act daily life.

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Clinical study of general anesthesia for lower limb operation dezocine preemptive analgesia

WU Qian, SUN Guoming

Medical Reserch and Education 2015, 32 (1): 44-47. DOI: 10.3969/j.issn.1674-490X.2015.01.010

Abstract （421）

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Objective To investigate the clinical research of general anesthesia for lower limb operation dezocine preemptive analgesia. Methods 78 cases of lower limb surgery under general anesthesia patients were selected from May, 2013 to May, 2014 in our hospital as the research object, the patients were randomly divided into observation group (40 cases) and control group (38 cases), two group patients were all taken surgery under general anesthesia, the patients of the observation group meanwhile given dezocine preemptive analgesia. The occurrence of pain, analgesia and the adverse reaction of patients after operation were compared between the two groups. Results The postoperative 4 h, VAS in the two groups were not statistically different (P>0.05), and after operation for 6 h, postoperative 12 h and after operation for 24 h, patients in group VAS score were significantly lower than that of the control group, with significant difference (P<0.05), after operation for 4 h, 24 h, two groups of patients sedation score was not significant difference (P>0.05), after operation for 8 h, postoperative 12 h, sedation score of observation group was significantly lower than that of the control group, with statistically significant difference (P<0.05), 10 cases of patients in the observation group occurred adverse reactions (25%), 18 patients in the control group occurred adverse reactions (47.37%), compared with two groups, there was statistically differences (P<0.05). Conclusion Applying dezocine preemptive analgesia in patients with lower extremity anesthesia before the operation are beneficial to the patients to improve pain, relieve patients postoperative sedation and reduce the incidence of adverse reaction operation, which is worthy of clinical application.

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Research on the relation of NT-proBNP, pulmonary artery pressure with TCM syndrome

JIA Enxia, CAO Xuebin, MA Minkai

Medical Reserch and Education 2015, 32 (1): 48-50. DOI: 10.3969/j.issn.1674-490X.2015.01.011

Abstract （378）

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Objective To study the feasibility of NT - pro BNP concentration and the pulmonary artery pressure as the objective indicator of traditional Chinese medicine (TCM) syndrome differentiation of heart failure due to chronic pulmonary heart disease. Methods 100 cases of heart failure due to chronic pulmonary heart disease were divided into groups according to TCM syndrome differentiation. The NT - pro BNP concentration and the pulmonary artery pressure were also observed. The difference between TCM syndrome type and NT-pro BNP concentration or the pulmonary artery pressure was studied using the statistical software SPSS 16.0 software. Results There was a statistical significance difference between TCM syndrome type and NT - pro BNP concentration or the pulmonary artery pressure. Conclusion Plasma NT - pro BNP concentration and pulmonary artery pressure likely become the objective indicator of TCM syndrome differentiation of heart failure due to chronic pulmonary heart disease.

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Clinical study on the serum levels of thyroid stimulating hormone of patients with thyroid cancer

CHEN Na, JIN Xiaoshi, JIAO Zhengwei

Medical Reserch and Education 2015, 32 (1): 51-54. DOI: 10.3969/j.issn.1674-490X.2015.01.012

Abstract （372）

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Objective To study the correlation between serum levels of thyroid stimulating hormone(TSH) and thyroid cancer. Methods A retrospective analysis of 200 case patients with thyroid disease were examined including sex, age, serum levels of thyroid stimulating hormone, pathological reports and other clinical date. Results The preoperative TSH level of patients with differentiated thyroid cancer were obviously higher than the patients with nodular goiter; the level of TSH in patients older than 60 with differentiated thyroid cancer increased significiently. Conclusion Preoperative TSH level can be used as an auxiliary diagnosis index of differentiated thyroid cancer.

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The methylation and mRNA expression of PAQR3 in colorectal cancer

SONG Yanmin, LI Riheng, ZHANG Tao, JIA Jia, MA Fang, ZHAO Lihua

Medical Reserch and Education 2015, 32 (1): 55-60. DOI: 10.3969/j.issn.1674-490X.2015.01.013

Abstract （377）

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Objective To investigate the relationship between the methylation level of PAQR3 and colorectal cancer, the methylation level and mRNA expression of PAQR3 gene in colorectal cancer were detected. Methods 54 colorectal cancers and 54 colorectal normal tissues were collected to detect the expression of mRNA level by reverse transcriptase PCR(RT-PCR), the methylation level of PAQR3 gene were detected by Methylation Specific PCR(MSP), which were used to analyze the relationship between methylation of PAQR3 and clinical data. Results Expression of PAQR3 mRNA in 54 normal tissues were significantly higher than that in 54 colorectal cancer tissues , the expression rates were 18.5%(10/54) and 57.4%(31/54), there was significant difference between cancer and normal tissues(P= 0.000).The PAQR3 gene promoter methylation rate of colorectal cancer and colorectal normal tissues were 33.3%(18/54)and 5.6 %(3/54), there was significant difference between cancer and normal tissues(P= 0.000).There was significant difference in age, differentiation, infiltration, clinical stage and the metastasis of lymph node in colorectal cancer, but not in sex and location. Conclusion PAQR3 expression can be reduced in colorectal cancer, PAQR3 gene promoter hypermethylation may play an important role in oncogenesis of colorectal cancer.

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Discussion on nursing patients experienced thyroid nodule fine needle aspiration cytological examination

ZHANG Caifen, GONG Jianping, JIA Siyue, YANG Jiuyi, WANG Lijuan

Medical Reserch and Education 2015, 32 (1): 61-63. DOI: 10.3969/j.issn.1674-490X.2015.01.014

Abstract （415）

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Objective To investigate the nursing intervention of the thyroid nodule fine needle aspiration cytological examination. Methods The preoperative, intraoperative and postoperative care of 86 patients with thyroid nodule fine needle aspiration cytological examination were retrospectively analyzed, and the nursing efficacy was observed. Results The operations of the 86 patients were smooth, with one case with syncope who was out of danger after the emergency treatment, one case with local hematoma who healed after conservative treatment. No other complication was found. Conclusion With effective nursing, paramedics can relieve the thyroid nodule fine needle aspiration patients’ tension, improve the puncture efficiency, and reduce the postoperative complications.

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Research of continuity of midwifery services in improving the quality of maternal natural childbirth

NIE Jin, XIE Suyong, DONG Wenjing

Medical Reserch and Education 2015, 32 (1): 64-66. DOI: 10.3969/j.issn.1674-490X.2015.01.015

Abstract （399）

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Objective To explore the establishment of continuity of midwifery service model to improve the quality of maternal natural childbirth. Methods 100 cases of low-risk primipara accepting midwife outpatient health education randomly were selected as the observation group, at the same time, 100 cases of low-risk early maternal accepting obstetrics regular check-general as control group. Natural birth rate, maternal weight before labor, birth weight, and satisfaction of maternal and their families with childbirth were compared between the two groups. Results Natural birth rate and satisfaction of observation group were significantly increased than that of control group. However, maternal weight before labor and neonatal weight were lower than that of control group, apparently (P<0.05). Conclusion Midwife outpatient service plays a positive role in improving pregnancy health knowledge, reducing the incidence of great children, and decreasing the rate of cesarean section. It is worth promoting in clinical.

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Study on diagnosis and treatment of cesarean scar pregnancy

CHEN Qingxian, ZHAO Han, NIE Jin, YU Suxiang, XIE Suyong

Medical Reserch and Education 2015, 32 (1): 67-69. DOI: 10.3969/j.issn.1674-490X.2015.01.016

Abstract （338）

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Objective To study diagnosis and treatment of CSP (cesarean scar pregnancy, CSP). Methods 180 cases diagnosed CSP were collected between March 2012 to September 2014 in our hospital , and the patients were divided into two groups according to different treatments. 150 cases in group A were conducted direct line of ultrasound-guided curettage. 30 cases in group B were conducted ultrasound-guided curettage followed methotrexate (MTX) and mifepristone treatment. Color ultrasound, β-HCG, success rate, bleeding and hospital stay time were compared between the two groups. Results 168 of 180 patients were diagnosed before treatment, and the other 12 patients were diagnosed by bleeding during or after surgery. Open surgery was the best clinical treatment method, and it had shorter hospital stay, the difference was statistically significant (P<0.05). Conclusion Color ultrasound is applied in clinical diagnosis of CSP mainly, once CSP is diagnosed, pregnancy requires immediate termination. Crtettage followed MTX and mifepristone are used for patients with stable conditions, while patients with serious illness can use open surgery.

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Common alarm analysis and treatment of ventilator

WANG Xinping, CAO Guohui

Medical Reserch and Education 2015, 32 (1): 70-75. DOI: 10.3969/j.issn.1674-490X.2015.01.017

Abstract （1391）

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Mechanical ventilation is an effective means of life support and respiratory therapy, has been widely applied in clinic fields. Especially in recent years, the construction of the emergency in two level of first-class hospital and ICU established, ventilator applications gain popularity. Ventilator alarm is a frequent problem in mechanical ventilation, if handled improperly, not only affect the ventilator’s using, but also endanger the patient's life. So correct judgment and timely remove alarm is very important. Clinical medical staff who are not very familiar with ventilator application will feel the tension and pressure on ventilator alarm, even feel be at a loss, they can not be quickly make sure the reasons and perform the correct treatment .This paper analyzes the reasons of ventilator alarm in order to help doctors and nurses to handle the common reasons ,and further improve the success rate of resuscitation of critically ill patients.

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Analysis of the antibiotic in the patients with community-acquired pneumonia

NAN Kai, ZHU Taiping, LIU Siwen, LIU Sumei, LI Xiaowei, HAO Lifeng

Medical Reserch and Education 2015, 32 (1): 76-79. DOI: 10.3969/j.issn.1674-490X.2015.01.018

Abstract （371）

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It is a conventional medical treatment of antibiotic in the patients with community-acquired pneumonia, according to the incidence of CAP, how to choose anti-infective drugs become a public health problem. This paper mainly analyzes the pathogen, drug resistance and anti-infective drug of CAP in order to provide the basis of applying medicine.

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The pathogenesis, prevention and nursing of critically ill patients complicated with stress ulcer

ZHENG Pei, GAO Wei, CHEN Ying

Medical Reserch and Education 2015, 32 (1): 80-84. DOI: 10.3969/j.issn.1674-490X.2015.01.019

Abstract （317）

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The stress ulcer, one of the most serious complications of critical diseases, is acute gastric mucosal lesions occurring in the body under stress. It has complicated pathogenesis and high incidence. Therefore, effective prevention and proper nursing care play a key role in saving life of those critical patients, and providing a better prognosis. This paper summarized the causes of stress ulcer, its preventive measures and nursing, emphasized the application of acid suppression drugs and nursing to provide some references.

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Prospect of sperm DNA damage and assisted reproductive technology research

HE Dandan, LI Shaopeng, LI Yan, ZHAO Xiaorui, WANG Zelan, PAN Xiao

Medical Reserch and Education 2015, 32 (1): 85-91. DOI: 10.3969/j.issn.1674-490X.2015.01.020

Abstract （348）

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There are multiple factors which cause sperm DNA damage,such as radiotherapy or chemotherapy, smoking, electromagnetic radiation and temperature of the testis/epididymis. Improving the methods of sperm DNA damage detection is still necessary. A number of studies have reported that sperm DNA damage is associated with reproductive outcome. For the sake of succeeding in ART and the reducing of sperm DNA damage, some treatments are taken into consideration, such as exterminating the causes, oral antioxidant drugs, traditional Chinese medicine and ICSI /IMSI with testis sperm. This review focuses on the mechanism and detection of sperm DNA damage, it’s association with reproductive outcomes, and relevant treatment strategies in assisted reproductive technology.

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Application of diversified teaching modes in endocrinology

LU Yanhui, LI Chunlin

Medical Reserch and Education 2015, 32 (1): 92-94. DOI: 10.3969/j.issn.1674-490X.2015.01.021

Abstract （360）

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More and more kinds of diseases are emerging with the rapid development of endocrinology, so teaching and training of related knowledge become quite important. The application of diversified teaching mode, which includes case-based learning, problem-based learning, concept mapping and clinical pathways, can help deal with the link between the theory and clinical practice, and establish a scientific clinical thinking, and cultivate advanced medical workers.

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The application of PBL teaching in cardiac surgery

ZHOU Cheng, LIU Fulin, ZHOU Xiaodong, XU Jinpeng

Medical Reserch and Education 2015, 32 (1): 95-99. DOI: 10.3969/j.issn.1674-490X.2015.01.022

Abstract （379）

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Objective To investigate the effect of the application of PBL teaching in cardiac surgery. Methods The control group and the experimental group were taught with traditional teaching mode and teaching of PBL, the teaching effectiveness were determined by examining the basics concepts of assessment, clinical analytical reasoning capabilities, IT and document retrieval usage, actively involved in clinical practice, clinical practice skills, self-psychological assessment. Results The achievements of the experimental group were better than that of the control group. Conclusion PBL teaching method in Cardiac Surgery can improve teaching effects significantly.

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Investigation on raining needs of clinical nurses in the second level hospitals

JIA Lina, YAN Xingna, WANG Yunmei, ZHANG Lina, LIU Fang

Medical Reserch and Education 2015, 32 (1): 100-104. DOI: 10.3969/j.issn.1674-490X.2015.01.023

Abstract （373）

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Objective To investigate the training needs of clinical nurses in the second level hospitaland provide reference for making scientific training programs. Methods 1000 copies of questionnaires were conducted intwo medical institutions in the city to investigate the willingness of training, training courses, training time, training methods in the clinical nurses. Results 94.06% of the nurses will require urgent training, different professional titles and different degrees of nursing staffs demand different training contents and methods, specialknowledge, scientific knowledge, medical developments were the top three rows of training courses, training time required in the afternoon, evening and weekend accounted for 76.78%, 69.25% and 62.14% of the total number of valid questionnaires, respectively. 67.97% trainings required in one’s own department, 65.01% wanted to get training in hospital, 61.40% were willing to go out to participate in training in the training class. Conclusion Clinical nurses in two hospitals need urgent training in the knowledge and skills, a long effect mechanism for the training of nurses at different levels should be established to meet the demands according to the level of practical training needsto ensure the effectiveness of training.

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Medical Reserch and Education 2015, 32 (1): 105-107. DOI: 10.3969/j.issn.1674-490X.2015.01.024

Abstract （359）

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Medical Reserch and Education 2015, 32 (1): 108-109. DOI: 10.3969/j.issn.1674-490X.2015.01.025

Abstract （438）

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Medical Reserch and Education 2015, 32 (1): 110-112. DOI: 10.3969/j.issn.1674-490X.2015.01.026

Abstract （378）

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Effect of AM fungi and selenium content on seeding quality of Salvia miltiorrhiza Bge

QIAO Yajun, GAO Ying, LAN Dandan, LIANG Jie, LI Jianheng

Medical Reserch and Education 2015, 32 (2): 1-5.

Abstract （381）

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Objective To explore the effects of AM fungi on the quality of Salvia miltiorrhiza under different selenium levels.Methods Salvia miltiorrhiza seedlings under different conditions were obtained by pot experiment, and the content of polysaccharide, selenium and tanshinone II_A were determinated to evaluate the quality of plants.Results Inoculation of AM fungi significantly increased polysaccharide and selenium content of Salvia miltiorrhiza under the same selenium level. It can be seen AM fungi can promote the accumulation of nutrients, improve the uptake of nutrient elements. The contents of tanshinone II_A in inoculated plants were higher than non inoculated plants. While the selenium concentration was 40 μg/mL, the content of tanshinone II_Ain inoculated plants was highest, that was 0.272%. On the different selenium levels, the content of polysaccharide and tanshinone II_Aincreased firstly and then decreased with increasing selenium concentration, but the contents of inoculated plants were higher than non inoculated plants, they reached the maximum at Se₁(20 μg/mL)-Se₂(40 μg/mL), showed that high selenium inhibited the accumulation of medicinal components. From that proper concentration of selenium was cooperated with AM fungi on improving the accumulating of polysaccharide and medicinal components of Salvia miltiorrhiza. Selenium content in Salvia miltiorrhiza Bge was positively correlated with selenium concentrations, but no obvious linear relationship, the distribution was more in the leaf than root. Conclusion Inoculation of AM fungi on the Salvia miltiorrhiza had the best effects when the selenium concentration was 20-40 μg/mL.

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Anti-injury effect of scutellarin on the hypoxic ischemic brain damage of neonatal rats and the expression of p38 MAPK

WANG Lin, NIU Pei, WU Bianying

Medical Reserch and Education 2015, 32 (2): 6-10.

Abstract （352）

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Objective To study the effects of scutellarin treat HIBD in neonatal rats and the expression of p38 MAPK signal pathway following HIBD and its mechanism. Methods 45 healthy 7-day-old neonatal SD rats were randomly divided into sham operation group, HIBD group, and scutellarin group(25 mg/kg). After medication, each group respectively executed 5 rats in 24 h, 3 d, 7 d, and took brain tissue slice . The neuronal apoptosis was detected using TUNEL assay. The highest expression and expressional tendencies of p38 MAPK was determined by the method of immunohistochemistry. Results The apoptotic neurons, actived p38 MAPK increased after HIBD in the hippocampal CA1 region. The expression level of p38 MAPK and apopotic neurons in scultellarin group were significantly lower than HIBD group (the differences of the same time point were statistically significant P<0.05 ). Conclusion Scultellarin could reduce the apoptosis through inhibiting the p38 MAPK signal pathway with cerebral hemorrhage.

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Effects of Disobulbin B on proliferation of human gastric carcinoma cell line SGC-7901

DING Xiaoxu, CHENG Shujie

Medical Reserch and Education 2015, 32 (2): 11-15.

Abstract （358）

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Objective To investigate effects of Disobulbin B (DB) on the proliferation of human gastric carcinoma cell line SGC-7901 and explore the possible mechanism. Methods SGC-7901 cells were treated with different concentration (0～160 μg/mL) of DB. Cell proliferation was detected by CCK-8 assay; cell morphology changes were observed under optical microscopy; The expression of CyclinD1 was detected by Western blot. Results DB inhibited the growth of gastric cancer cells in a does-dependent manner and the highest inhibition rate was 57.26%.The structure of SGC-7901 cells changed greatly. The protein expression level of cyclinD1 was reduced. The effects were increased with the increase of the DB concentration. Conclusion DB could inhibit cell proliferation in SGC-7901 cells by down-regulating the expression of CyclinD1.

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Short-term results of ARCH plate in expansive open door laminoplasty (EOLP)

HAN Ye, GAO Wenshan, WU Xiaoming

Medical Reserch and Education 2015, 32 (2): 16-19.

Abstract （337）

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Objective To evaluate the short-term results of ARCH plate in EOLP for CSM. Methods From July 2012 to July 2014, 35 patients with multilevel CSM who underwent EOLP via ACTH plate were involved in this study, including 20 males and 15 females. Clinical symptoms were evaluated with Japanese Orthopaedic Association(JOA)scores. Results The follow-up time ranged from 7 to 24 months, with an average of 13.3 months, JOA score were improved from 6.1±2.6 pre-operation to 9.6±2.8 post- operation(P＜0.01). Conclusion For CSM, EOLP using ARCH plate fixation bring less occurrence of re-close of door, slight postoperative neck AS, and satisfactory clinical outcomes.

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Comparison of the priming principle of cisatracurium and increasing the dose in duration of anesthesia effect

WU Yi, LI Yongle, WANG Hongjie

Medical Reserch and Education 2015, 32 (2): 20-23.

Abstract （310）

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Objective To study the effects of the priming principle of cisatracurium and increasing the dose on the onset time and the clinical duration. Methods 90 patients ASAⅠ-Ⅱ, aged 18-55 years, scheduled for elective gynecologic surgery were randomly allocated to three groups with 30 cases each. GroupⅠ received cisatracurium 0.15 mg/kg (3ED95). Group Ⅱ received cisatracurium 0.015 mg/kg four minutes before induction and then cisatracurium 0.135 mg/kg. Group Ⅲ received cisatracurium 0.2 mg/kg(4ED95). Neuromuscular block was monitored by a TOF Watch SX accelerograph. The onset time and the clinical duration were recorded.Results The onset times for groupⅠ , Ⅱ and Ⅲ were (184±56) s、 (141±31) s、 (135±45) s seconds respectively. Compared with group I , there was significant difference in group Ⅱ, Ⅲrespectively (P<0.05); the clinical effective time were (41±8) min, (44±6) min, (53±8) min respectively. Compared with that of group Ⅲ, there was a remarkable difference in groupⅠand group Ⅱ(P<0.05). Conclusion The priming principle can significantly shorten cisatracurium onset time of intubation. Compared with increasing the dose, its clinical duration is shorter.

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Application research on BNP in acute myocardial infarction patients with primary percutaneous coronary intervention

TIAN Zhiyu, ZHAO Wenping, JIA Xinwei, XU Jingjing, PAN Huanjun, LI Ya, ZHAO Shujun

Medical Reserch and Education 2015, 32 (2): 24-29.

Abstract （372）

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Objective To investigate the relationship between plasma Brain natriuretic peptide(BNP) level and left ventricular wall motion score index (LVWMSI) in patients with acute ST-segment elevation myocardial infarction (STEMI), and the short term prognosis within 180 days. Methods Sixty four patients with STEMI were treated with primary percutaneous coronary intervention (p-PCI) within 12 h of onset. The BNP level was measured on admission. Based on the BNP level, all patients were divided into four groups (according to the 4 percentile): group A (BNP≤P25: BNP≤115.25 pg/mL), group B(P26≤BNP≤P50: 115.26-200.5 pg/mL), group C(P51≤BNP≤P75: 200.6 -409 pg/mL)and group D(BNP≥P76: BNP≥409 pg/mL). The relationship of BNP level with LVWMSI was analysised. The major adverse cardiac events (MACE) within 180 days were also analyzed. Results The difference of left ventricular wall motion score index among different groups were statistical significant (P<0.05). The levels of BNP and LVWMSI was positively related(r=0.73, P<0.01).Along with the increase of plasma BNP level, major adverse cardiac events increased significantly (P<0.05). Conclusion Plasma BNP level provides information about the change of heart function and short term prognosis for acute myocardial infarction patients.

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Evaluation of neurophysiological examination for cerebral function prognosis in severe cerebrovascular disease

WANG Qian, SU Likai

Medical Reserch and Education 2015, 32 (2): 30-34.

Abstract （313）

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Objective To investigate the value of electroencephalography, somatosensory evoked potential and brainstem auditory evoked potential on the evaluation of cerebral function of patients with severe cerebrovascular disease. Methods In 24 hours after admitted to hospital, the patients with severe cerebrovascular disease were examined by electroencephalography, somatosensory evoked potential and brainstem auditory evoked potential. The prognosis of cerebral function were evaluated 3 months after the onset of severe cerebrovascular disease or when the patients died in 3 months. Analyze the relationships between the results of the exams above and cerebral function prognosis. Results Ordinal logistic regression analysis found that electroencephalography(P=0.002), somatosensory evoked potential(P＜0.001) and brainstem auditory evoked potential(P=0.002) have a significant effect on the prediction of cerebral function prognosis of severe cerebrovascular disease patients. Conclusion By using electroencephalography, somatosensory evoked potential and brainstem auditory evoked potential exams can make a prediction of prognosis of severe cerebrovascular disease. This is of great importance in evaluating the illness, predicting prognosis, diagnosing and treating severe cerebrovascular disease.

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Changes of retrobulbar vascular hemodynamics in patients with diabetes at different periods

WANG Jing, WEI Xu

Medical Reserch and Education 2015, 32 (2): 35-39.

Abstract （337）

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Objective To study the changes of retrobulbar vascular hemodynamics in patients with diabetic retinopathy (DR) by using color Doppler imaging technology (CDI). Methods The diagnosed patients withdiabetic mellitus (DM) were divided into non-diabetic retinopathy (NDR) group, non-proliferative diabetic retinopathy (NPDR) group and proliferative diabetic retinopathy (PDR) group. The healthy patients were servedas control (HC) group. The states of carotid artery (CA), ophthalmic artery (OA), central retinal artery (CRA) and central retinal vein (CRV) blood flow parameters were examined with CDI and the results were analyzed. Results Compared with HC group, the blood flow of carotid artery(CA), ophthalmic artery(OA) and the intimamedia thickness (IMT) changes were not obvious in the patients with non-diabetic retinopathy(NDR), but the appearance of CRA peak systolic velocity (PSV) and end diastolic velocity (EDV)increased (P<0.05); phase NDR, CRV increased velocity (P<0.05). In NPDR group and PDR group, PSV, EDV in CA, OA and CRA decreased (P<0.05), resistance index (RI) and pulsatility index (PI) increased (P<0.05). Conclusion There is a reference value for the early diagnosis of DR using color Doppler imaging, but it has limitations in the accurate judgment of retinal blood circulation, however, it can be applied to provide some important information for prognosis and analysis of the degree of lesion.

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Risk classification of plasma β₂-microglobulin, high-CRP, HCY and peripheral atherosclerosis disease

JI Jinggang, LIU Haiyong, SUN Liwei, ZHAO Junqing, GU Xuechang, ZUO Ruiju, CAO Liqiu, BU Yuhui

Medical Reserch and Education 2015, 32 (2): 40-43.

Abstract （419）

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Objective To investigate the peripheral atherosclerotic disease (PAD) risk classification and plasma β2-microglobulin (β2-microglobulin, β2-MG) high-sensitivity C-reactive protein (H-CRP) of homocysteine (HCY) relationship. Methods From January, 2010 to May, 2013 96 PAD patients were graded and treated in our hospital. According to the ABI value they were divided into: low risk group (0.7≤ABI≤0.9, n=25), medium risk group (0.4≤ABI＜0.7, n=52), and the high risk group (ABI＜0.4, n=19). 40 healthy persons served as the controls the concentration of β2-microglobulin, high CRP, HCY and their correlation were analyzed. Results The concentration of serumβ2-MG, H-CRP, HCY increased with the ABI stage and the progress, the concentrations were negatively correlated with ABI value with a beta 2-microglobulin H-CRP HCY. Conclusion PAD with the severity of the condition, in the plasma β2-MG H-CRP HCY concentration increased gradually,the joint determination of β2-MG H-CRP HCY and ABI combined with a hierarchical diagnosis and prognosis of patients with PAD is helpful to make sound diagnosis

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Analysis on induced abortion among adolescents (Report of 167 cases)

ZHANG Xiaoju, LU Zhiru

Medical Reserch and Education 2015, 32 (2): 44-46.

Abstract （334）

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Objective To study the current situations of 167 teenagers induced abortion and try to find out effective intervention measures to protect the physical and mental health of teenagers. Methods From January 2009 to December 2013 in the Outpatient Department of Laiyuan Maternal and Child Health-Care Hospital,3 013 cases voluntarily required abortion, off those 167 cases under the age of 19 were analyzed. Results (1) Adolescent abortion number increased year by year during the past five years, compared with 2009,the numbers in 2013 had doubled, in which drug induced abortion accounted for 58.08%. (2) 19 year olds accounted for the highest proportion (41.23%), hospitality workers accounted for(36.53%). Junior High School graduates(35.33%). Recurrent abortions nearly halved(48.50%). (3) 167 adolescents who had abortions suffered from poor self-esteem average (28.84±3.24), including 81 who had multiple abortions(27.91±3.28), among 86 cases of artificial abortion the first time was below the average teen (29.21±3.17), the difference was statistically significant (P<0.01). Conclusion We should promote the sex education for teenagers and take some steps to improve adolescent female self esteem. Better sex education and psychological counselling after artificial abortions will help avoid a repetition to protect the physical and mental health of teenagers, good and honest sex education campaigns are crucial.

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Case analysis on the treatment of congenital dacryocystocele by probing of lacrimal passage

WANG Fengxian, HAN Lipo, ZHANG Yu, LIU Zhenpo, ZHANG Jianli, LIU Xiuping, WANG Zheng

Medical Reserch and Education 2015, 32 (2): 47-49.

Abstract （312）

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Objective To discuss the treatment and the time of congenital dacryocystocele through the analysis of clinical manifestations and characteristics of congenital dacryocystocele. Methods Retrospective analysis of congenital dacryocystocele 18cases (20 eyes) treated in our hospital from June 2011 to June 2013 were conducted to summarize the clinical manifestations and characteristics of congenital dacryocystocele and analyze the treatment of congenital dacryocystocele and time choice. Results In 18 cases (20 eyes) of congenital dacryocystocele children, 10 cases of male patients (11 eyes), 8 female children (9 eyes), with an average age of 10.6 days. 6 eyes were cured by dacryocyst massage, irrigation of lacrimal passage, application of antibiotic eye drops and other conservative method. 12 eyes were cured by the one probing of lacrimal passages. 2 eyes were cured by the two probing of lacrimal passages. Conclusion Probing of lacrimal passage can be used to treat congenital dacryocystocele. To a large extent, early operation treatment can prevent severe complications.

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Analysis of the clinical effect of acetate ringers in correcting metabolic acidosis in patients with hemorrhagic shock

LIU Dong, CAO Zhiran, LIU Bin

Medical Reserch and Education 2015, 32 (2): 50-53.

Abstract （506）

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Objective To compare the effects of acetate ringers solution and lactated ringers solution on metabolic acidosis in patients with hemorrhagic shock. Methods 50 patients with hemorrhagic shock were divided equally into 2 groups randomly(n=25): the acetate ringers solution(group A) and lactated ringers group(group L). Changes of arterial blood gas and volume of NaHCO₃ before and 1, 2, 3, 4h after induction respectively were observed. Results There were no statistics difference in the ASA grade, operation time, the volume of transfusion during operation and hemorrhage volume of both groups(P>0.05). pH in group A changed at time point of T3 respectively compared to group L(P<0.05). Serum lactate level(LAC) decreased at T₂ compared to T0 time in group A(P<0.05). LAC level increased at T₂, T₃, T₄ compared to T0 time in group L(P<0.05). LAC level in group L increased at time point of T₂, T₃, T₄ compared to group A(P<0.05). Volume of NaHCO₃ in group A decreased compared to group L (P<0.05). Conclusion Acetate ringers solution changes pH, decreases serum lactate level and decreases volume of NaHCO₃ during fluid resuscitation in hemorrhagic shock.

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Blood rheology changes during hysteroscopic resection of submucous uterine fibroids

SHEN Yan

Medical Reserch and Education 2015, 32 (2): 54-57.

Abstract （292）

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Objective To investigate the blood rheology changes during hysteroscopic resection of submucous uterine fibroids and provide a theoretical basis for clinical treatment. Methods From January to December, 2014, 45 cases with submucous uterine fibroids were conducted hysteroscopic surgery in Dingxing hospital, before perfusion 10 min (T₁), perfusion 30 min (T₂), after surgery , blood rheology index level (T₃) were detected. Results All cases were successfully conducted the operation, T₃, T₂ point blood rheology index of whole blood low-cut, middle cut high cut, low-cut reduction of whole blood, blood high shear reduced, plasma viscosity, etc.,erythrocyte rigidity index, aggregation index, deformation index and maximum platelet aggregation compared with the index at T₁, the difference was statistically significant (P<0.05). T₂ point hematocrit compared with T₁point indicator, the difference was statistically significance (P<0.05). T₃ point high shear whole blood, plasma viscosity, etc., hematocrit, erythrocyte rigidity index, maximum platelet aggregation compared with T₂ each index point, the difference was statistically significant (P<0.05). Conclusion Perioperative blood rheology indicators for monitoring is necessary when longer operative time, more fluid absorption to reduce blood viscosity in patients with uterine fibroids after operation and protect red blood cells , reduce cardiovascular events and deep venous thrombosis.

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Nursing and observations on the complications of patients with continuous central venous pressure

BAI Guoxin, GAO Ping, ZHANG Peihua

Medical Reserch and Education 2015, 32 (2): 58-60.

Abstract （348）

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Objective To analyze the reasons of complication for patients using continuous central venous pressure (CVP) monitoring and explore the best nursing method. Methods Based on the retrospective analysis the CVP monitoring results of one hundred and thirty-two patients using the data from March 2013 to October 2014 in our hospital, we can judge the level of center venous catheter obstruction, infection, detached catheter and perform nursing intervention based on the analysis of the reasons. Results The results showed that five in one hundred and thirty-two patients in CVP monitoring were completely blocked and the incidence rate was 3.79%; at the same time, two patients were found to be infected and the incidence rate was 1.52%; one patient was found to be detached catheter and the incidence rate was 0.76%. Conclusion Intensive nursing interventions will effectively decrease the rate of complication for patients using CVP monitoring.

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