Journal of Hebei Medical College for Continuing Education

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Medical Reserch and Education 2019, 36 (1): 1-5. DOI: 10.3969/j.issn.1674-490X.2019.01.001

Abstract （557）

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Apoptosis detection is an important means in the study of anti-tumor mechanism of drugs. With the development of modern science and technology, various apoptosis detection technologies(such as mor-phological detection of apoptotic cells, DNA ladder electrophoresis, flow cytometry, enzyme-linked immu-nosorbent assay, immunohistochemistry or immunocytochemistry and immunoblotting)are being improved day by day. Pharmacological studies have confirmed that stellera chamaejasme has a clear inhibitory activity in vitro and in vivo for a variety of tumor cells, and promoting apoptosis of tumor cells is one of its important mechanisms. This article begins with the anti-tumor research of stellera chamaejasme, and summarizes the commonly used methods, basic principles and current status of apoptosis detection.

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Medical Reserch and Education 2019, 36 (1): 6-12. DOI: 10.3969/j.issn.1674-490X.2019.01.002

Abstract （538）

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Toll-like receptors(TLRs)are critical regulators of innate immunity and inflammatory response in cerebral ischemic injury. In recent years, with a deeper understanding of the signaling mechanisms of TLRs during the onset of stroke, targeting TLRs have become a promising therapy for cerebral ischemic stroke. Medication or compounds can inhibit the inflammatory reaction in cerebral ischemia via directly acting on TLRs, modulating MyD88 or TRIF signaling pathways, and TLRs ligand preconditioning or postconditioning. This review will focus on promising therapies which exert neuroprotective effects against ischemic injury by acting on TLRs.

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Medical Reserch and Education 2019, 36 (1): 13-16. DOI: 10.3969/j.issn.1674-490X.2019.01.003

Abstract （424）

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Objective To investigate the correlation between serum bilirubin and homocysteine(Hcy)and the stability of carotid atherosclerotic plaques in patients with acute cerebral infarction. Methods 192 patients with acute ischemic stroke were selected to collect peripheral venous blood on the second early morning in the hospital. The serum bilirubin were detected by chemical oxidation and Hcy were detected by fluorescence polarization immunoassay. Two groups of carotid artery intima-media thickness(IMT)were measured by IU-22 color Doppler ultrasonography, and the correlation of serum bilirubin and Hcy levels with carotid atherosclerotic plaques in patients with acute cerebral infarction was analyzed. Results The serum bilirubin(especially direct bilirubin)in vulnerable plaque group was significantly lower than that of the stable plaque group(P <0.05), and the level of Hcy in vulnerable plaque group was significantly higher than that of the stable plaque group(P < 0.05). Conclusion The stability of carotid atherosclerotic plaque in patients with acute cerebral infarction may be negatively correlated with the level of blood Hcy, and is positively correlated with the level of serum total bilirubin and direct bilirubin to some degree.

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Medical Reserch and Education 2019, 36 (1): 17-23. DOI: 10.3969/j.issn.1674-490X.2019.01.004

Abstract （416）

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Endothelial microparticles are a hotspot in recent years. They are a class of subcellular-level membrane microparticles released by endothelial cells under the stimulation of activation and apoptosis. Their composition and biological characteristics are different due to external stimuli. The meaning is different in the process of disease development. Endothelial particles are associated with information transmission, coagulation, inflammation, vascular injury, and regeneration. Under pathological conditions, the concentration of endothelial particles in the blood is significantly elevated and can be detected in many kidney diseases. Therefore, endothelial particles are associated with kidney disease, which may play a role in the diagnosis and treatment of kidney disease.

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Medical Reserch and Education 2019, 36 (1): 24-27. DOI: 10.3969/j.issn.1674-490X.2019.01.005

Abstract （497）

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Objective To explore the locking plate and acromioplasty in the treatment of greater tuberosity fractures of humerus. Methods 18 cases with fractures of greater tuberosity of humerus treated with locking plate and acromioplasty were retrospectively analyzed. Neer standard was applied to evaluate the recovery of shoulder function, and the X-ray was carried to observe the fracture healing. Results The incisions of all the cases were healed by first intention. All 18 patients were followed up for an average period of 12.5 months(6-18 months)and all patients gained bone union without internal fixation breakage, looseness, shoulder peak impingement syndrome. In the 6-month follow-ups after operation, the shoulder joints of the patients lifting and outstretch were not limited, the patients had not any pain and tenderness in shoulder joints. The functional recovery of shoulder joints on the basis of Neer scoring system was: excellent in 15, good in 3, fair in 0, poor in 0. The excellent and good rate was 100%.Conclusion Using locking plate and acromioplasty in the treatment of greater tuberosity fractures of humerus is an effective technique to prevent shoulder peak impingement syndrome after surgery, at the same time it can promote shoulder joint function recovery.

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Medical Reserch and Education 2019, 36 (1): 28-33. DOI: 10.3969/j.issn.1674-490X.2019.01.006

Abstract （489）

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The species and quantity of aquatic plants in Baiyangdian Lake are abundant,which have vast prospect of exploitation and potential value for further development. This paper mainly summarizes the research progress on development and exploitation of aquatic medicinal plant resources in Baiyangdian Lake from four aspects, including medicinal value, edible value, ecological landscape value and other values, which will provide reference and support for the further development and exploitation of plant resources in Baiyangdian Lake.

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Medical Reserch and Education 2019, 36 (1): 34-36. DOI: 10.3969/j.issn.1674-490X.2019.01.007

Abstract （449）

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Butterfly Chuanxiong is one of the traditional processing techniques of Anguo. It is a typical representativeness of Anguo's traditional Chinese medicine processing and its culture. Based on the data of traditional processing techniques of Chuanxiong, this paper explores its origins of Anguo Pharmaceutical City, explores the processing technology culture of special Chinese medicine in Anguo, and promotes the culture of Anguo pharmaceutical city.

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Medical Reserch and Education 2019, 36 (1): 37-45. DOI: 10.3969/j.issn.1674-490X.2019.01.008

Abstract （408）

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Objective To explore the effect of Huji Jianpi Decoction on weight inhibition and reproductive function injury caused by obesity in male mice with spleen deficiency dampness resistance. Methods An animal model of obesity was established then given treatment with traditional Chinese medicine and western medicine, the body weight was examined. The effects of obesity on reproductive function were evaluated from the aspects mentioned below, weight and histomorphology of testicular and epididymal, and semen parameters such as sperm concentration, sperm viability and sperm motility. The therapeutic effect of Chinese medicine were also measured by the above parameters. Results The weight and wet weight of epididymis in model blank mices were obviously higher than that of normal group and drug group. Compared with the model group, the problem including the testicular moisture and its coefficient, epididymal coefficient and semen parameters decreased, and the phenomenon containing the loose and detached structures of testicle and epididymis were improved in both the Chinese medicine experimental group and orlistat control group. However, the effects of traditional Chinese medicine were outstanding in improving testicular moisture weight and semen parameters. Conclusion Huaji Jianpi Decoction can effectively inhibit the rapid growth of weight and has a certain therapeutic effect on obesity-induced reproductive damage in obese mice.

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Medical Reserch and Education 2019, 36 (1): 46-52. DOI: 10.3969/j.issn.1674-490X.2019.01.009

Abstract （739）

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Advance care planning(ACP)can fully respect the patient's medical autonomy and help the dying to achieve "dignified death" in accordance with their wishes. This article reviews the clinical practice of advance care planning in mainland China under the background of Chinese culture. This paper expounds the practical significance; cognition, attitude and influencing factors of ACP among doctors, nurses, patients and their family members; the practical activities to promote the discussion of ACP; and the research on the effect of clinical practice of ACP in order to provide a theoretical basis for the follow-up research, provide practical guidance for clinical workers to carry out advance care planning in medical practice and promote the development of hospice care in China.

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Medical Reserch and Education 2019, 36 (1): 53-57. DOI: 10.3969/j.issn.1674-490X.2019.01.010

Abstract （368）

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Objective To explore the effects of health education on the recovery of sudden deafness. Methods A total of 90 patients with sudden deafness admitted into Baoding Second Hospital from August 2016 to August 2017 were randomly selected. The observation group and the control group were divided into two groups. The observation group was implemented systematic health education according to the plan, and the control group was in accordance with the medical system, implement routine care.The degree of disease knowledge, improvement of living habits and satisfaction of nursing services between the two groups were observed and compared, the patients in the observation group were significantly improved. Results The degree of disease knowledge, improvement of living habits and satisfaction of nursing services in the observation group were significantly better than those in the control group, and the difference was statistically significant(P<0.05). Conclusion Health education for patients and their families can enable patients to master the causes of disease and daily protection knowledge, develop good living habits, and significantly improve patient care service satisfaction and promote rehabilitation.

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Medical Reserch and Education 2019, 36 (1): 58-62. DOI: 10.3969/j.issn.1674-490X.2019.01.011

Abstract （644）

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This paper summarized the status of long-term care needs, evaluation tools and influencing factors of the disabled elderly, and put forward some suggestions on long-term care services of the disabled elderly in order to provide reference for research.

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Medical Reserch and Education 2019, 36 (1): 63-67. DOI: 10.3969/j.issn.1674-490X.2019.01.012

Abstract （350）

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Objective To explore the effects of the blending instructional teaching mode in the standardized training of gynecological residents. Methods 54 residents were randomly divided into blending instructional teaching groups and traditional teaching groups, each with 27 people, who were trained as the standardization of resident physicians in the gynecology department of Shengjing Hospital affiliated China Medical University in 2017. The teaching effects of different teaching methods were evaluated with objective performance measurement, subjective assessment of students and self-evaluation of teachers. Results The average scores of theory examination, practical skill and clinical intellectual in the blending instructional teaching group were significantly higher than that of the traditional teaching group.The satisfaction rate of students in the blending instructional teaching to the evaluation of teaching methods was significantly higher than that of the traditional teaching group,the difference was statistically significant; The questionnaire survey showed that all teachers believed that the blending instructional teaching had more advantages than traditional teaching. Conclusion With its advantages of strong integration and combination of theory and practice, the blending instructional teaching brings more space to clinical practice teaching, and adapt to the current trend of teaching development, which can effectively improve the effectiveness of standardized training for gynecological residents.

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Medical Reserch and Education 2019, 36 (1): 68-71. DOI: 10.3969/j.issn.1674-490X.2019.01.013

Abstract （396）

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Objective This study analyzed and summarized the advantages and disadvantages of senior students' cultivation process through the whole-course clinical tutorial teaching system jointly implemented by medical college of hebei university and affiliated hospitals.Methods Five clinical students in grade 2014 of Medical College of Hebei University were randomly divided into research group(n=60)and control group(n=60), 30 teachers were selected as the whole clinical tutor. Questionnaires and objective structured clinical examination were conducted. Results There were statistically significant differences between the research group and the control group(P<0.05)in improving students' satisfaction, promoting the motivation of clinical course learning, and cultivating clinical thinking and practical ability(P<0.05). Conclusion The whole process of clinical guidance system can promote the cultivation of senior clinical medical students.

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Medical Reserch and Education 2019, 36 (1): 72-76. DOI: 10.3969/j.issn.1674-490X.2019.01.014

Abstract （497）

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The discipline construction is the key work of the development and reform of a hospital. The level of the discipline construction can objectively reflect the comprehensive strength of the hospital. Under the background of medical reform and hospital construction in the new era, improving the construction of key clinical disciplines is very significant for maintaining the comprehensive competitiveness of hospitals and realizing the sustainable development of hospitals. The authors discuss the construction and management of the key clinical subjects in the new era from the aspects of technical projects, personnel training, scientific research, humanistic quality and management innovation.

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Medical Reserch and Education 2019, 36 (1): 77-80. DOI: 10.3969/j.issn.1674-490X.2019.01.015

Abstract （355）

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New lesson inducting in the process of teaching plays a role in targeting, stimulating students’ learning interest and thirst for knowledge, creating active and pleasant atmosphere and so on. According to the course content and the professional characteristics of the students we use different lesson inducting methods to stimulate students’ learning passion, enlighten students’ thinking, guide students to explore actively and active participationso as to improve classroom teaching effects.

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Medical Reserch and Education 2019, 36 (2): 1-7. DOI: 10.3969/j.issn.1674-490X.2019.02.001

Abstract （1416）

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Atherosclerosis(AS)is a chronic inflammatory disease caused by an imbalance in lipid metabolism and an adaptive immune response driven by the accumulation of cholesterol-containing macrophages in the arterial wall. In recent years, research on the mechanism of AS mainly includes lipid hypothesis, inflammation hypothesis and so on. This review mainly summarizes the mechanism of AS in recently years and briefly discusses the drug treatment of AS.

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Medical Reserch and Education 2019, 36 (2): 8-12. DOI: 10.3969/j.issn.1674-490X.2019.02.002

Abstract （484）

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Human apolipoprotein A-Ⅳ(ApoA-Ⅳ)is a 46 ku glycoprotein containing 376 amino acids mainly synthesized by the small intestine and hypothalamus, which participates in the composition of HDL or exists in plasma in a free state. Among the genetic polymorphisms of ApoA-IV, two subtypes of Q360H and T347S are the most common;ApoA-Ⅳ not only mediates reverse cholesterol transport, but also has antioxidant and anti-inflammatory properties, so circulating ApoA-Ⅳ is a lipid antioxidant and anti-inflammatory protein that acts in anti-AS important role.

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Medical Reserch and Education 2019, 36 (2): 13-16. DOI: 10.3969/j.issn.1674-490X.2019.02.003

Abstract （367）

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Objective To investigate the miR-30a expression in epithelial ovarian cancer(EOC)and its relationship with the clinicopathological features and prognosis. Methods The miR-30a expressions in 139 cases of EOC tissues were detected with RT-PCR assay. The correlations between miR-30a expressions and clinicopathological features of EOC were analyzed. Survival curves for patients with different miR-30a expressions were plotted using the Kaplan-Meier method and compared using the log-rank test. Results The miR-30a expressions elevated significantly in EOC tissues compared with that in adjacent normal tissues(P<0.05). High miR-30a expressions significantly correlated with lower histological grade, lymph node metastasis, peritoneal metastasis and higher FIGO stage(P<0.05). Kaplan-Meier analysis with log-rank test revealed that high miR-30a expressions were correlated with short survival time of patients with EOC. Multivariate analysis showed that miR-30a expressions were an independent rognostic factor for the overall survival, HR=2.702. Conclusion The miR-30a expression is an independent prognostic factor of patients with EOC,which can serve as a diagnostic and prognostic marker in clinical practice.

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Medical Reserch and Education 2019, 36 (2): 17-22. DOI: 10.3969/j.issn.1674-490X.2019.02.004

Abstract （485）

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Objective To investigate the expression level of filamin A(FLNa)and vascular endothelial growth factor(VEGF)in gastric carcinoma tissue before evaluating the correlation between the resultant level and microvascular density(MVD)and discover its clinical significance. Methods The expressions of FLNa, VEGF and CD34 in gastric carcinoma tissue and normal gastric tissues of 51 cases were examined immunohistochemically and the correlation between the expression level of those three proteins and the clinicopathologic features were analyzed too. Results The positive expressions of FLNa in gastric carcinoma tissues were lower than that in normal gastric tissues［47.06%(24/51)vs 90.20%(46/51), P=0.000］. The positive expressions of VEGF in gastric carcinoma tissues were higher than that in normal gastric tissues［92.16%(47/51)vs 31.37%(16/51), P=0.000］. The MVD values in cancer tissues was higher than that in normal tissues(18±3 vs 5±1, P=0.001). Expressions of FLNa, VEGF and MVD value were correlated with the depth of tumor invasion,lymph node metastasis, and liver metastasis, but not with patient's age, gender, lesion site of cancer, tissue types and Borrmann typing. Expressions of FLNa were negatively related with expression of VEGF in cancer tissues(r=-0.490,P=0.000). The mean MVD in group with FLNa positive was lower than in that with FLNa negative(4±1 vs 17± 3, P=0.001), while the mean MVD in group with VEGF positive was higher than in that with VEGF negative( 16±1 vs 3±1, P=0.000). Conclusion During the occurrence and development of gastric carcinoma, there is a close relationship between the expression level of FLNa, VEGF and MVD. The mechanism may be that FLNa inhibits the formation of tumor angiogenesis by cutting down the expression level of VEGF, and therefore inhibits local recurrence and distant metastasis of gastric cancer cells.

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Medical Reserch and Education 2019, 36 (2): 23-27. DOI: 10.3969/j.issn.1674-490X.2019.02.005

Abstract （406）

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Objective To investigate the clinical long-term effect of posterolateral laminar bone grafting combined with posterolateral bone grafting in the treatment of thoracolumbar burst fractures. Methods From January 2014 to November 2016, 25 cases of posterior short segment pedicle screw fixation combined with posterolateral laminar bone graft fusion were performed in our department(group A). 19 cases were treated with transpedicular bone grafting combined with posterolateral laminar fusion(group B). All patients were underwent thoracolumbar X-ray and CT examination before surgery, 1 week after surgery, before and 1 year after internal fixation. Results There was no significant difference in anterior compression ratio and Cobb angle between the two groups before operation, 1 week after operation and before internal fixation(P>0.05). 1 year after internal fixation, there were significant differences in anterior vertebral compression ratio and Cobb angle between the two groups(P<0.05). Conclusion Posterior short segment pedicle screw fixation combined with transpedicular bone grafting combined with posterolateral laminar bone grafting is an effective method for the treatment of thoracolumbar burst fractures and is worthy of clinical application.

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Medical Reserch and Education 2019, 36 (2): 28-32. DOI: 10.3969/j.issn.1674-490X.2019.02.006

Abstract （519）

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Objective To analyze the clinical efficacy and safety of Shenyankangfupian combined with glucocorticoid in the treatment of children with Henoch-Schönlein purpura nephritis. Methods 80 children with Henoch-Schönlein purpura nephritis admitted to Affiliated Hospital of Hebei University from January 2018 to November 2018 were divided into control group(n=39)and observation group(n=41)according to the order of admission.The patients of the two groups were given symptomatic treatment such as anti-allergy, the patients in the control group were given glucocorticoid therapy, and the patients in the observation group were given Shenyankangfupian on the basis of the control group, and the treating. results of the two groups were compared. The clinical effect, clinical symptoms subsidence time, urinary protein excretion in 24-hour collections, serum IgA and adverse reactions of the patients were examined. Results There was statistically significant difference between the control group and the observation group in the clinical effect(Z=1.688, P=0.046). Compared with the control group, the clinical symptom regression time of the observation group was shortened(P<0.05). Before treatment, compared with the control group, there was no statistically significant difference in the urinary protein excretion in 24-hour collections and serum IgA level of the observation group(P>0.05). After treatment, compared with the control group, the urinary protein excretion in 24-hour collections and serum IgA level of the observation group were significantly improved. Compared with the control group(20.51%), the incidence of adverse reactions in the experimental group(2.45%)was reduced(P<0.05). Conclusion Shenyankangfupian given to children with Henoch-Schönlein purpura nephritis on the basis of glucocorticoid therapy can improve the therapeutic effect and reduce adverse reactions, improve urinary protein excretion in 24-hour collections and serum IgA shorten the time of clinical symptoms subsidence.

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Medical Reserch and Education 2019, 36 (2): 33-38. DOI: 10.3969/j.issn.1674-490X.2019.02.007

Abstract （364）

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Objective To observe the clinical effects of early application of the detoxification method in the treatment of pneumonia after cerebral infarction. Methods 146 patients with cerebral infarction were randomly divided into treatment group and control group(n=73), then, the differences between the treatment group and the control group after 7 days of treatment were compared. In the treatment group, western medical treatment and Qingrehuatanjiedutang were applied simultaneously. The patients of the control group were treated only by western medicine. The changes of inflammatory factors such as CPIS score, TNF-α, PCT and CRP in the two groups were observed. Results After statistical analysis, the effects of the treatment group on post-stroke pneumonia were statistically significant, P<0.05 or P<0.01. Conclusion Early application of the detoxification method can be used to treat the pneumonia associated with cerebral infarction and improve the quality of life of patients.

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Medical Reserch and Education 2019, 36 (2): 39-47. DOI: 10.3969/j.issn.1674-490X.2019.02.008

Abstract （421）

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Objective To appraise the clinical effects of the Yiqi Yangyin method in the treatment of chronic atrophic gastritis. Methods Domestic and foreign related databases for literature about precancerous conditions of CAG were examined to evaluate the efficacy of TCM treating way, and Meta-analysis was performed by the software Rev Man 5.3. Results 17 RCTs including 1586 patients accorded with criteria were included. Compared with western medicine, Yiqi Yangyin methods were more effective in improving clinical efficacy, endoscopic efficacy,lower untoward effect and the difference was significant(P<0.000 01). Conclusion The literature included in this system evaluation indicates that the therapeutic effect of Yiqi Yangyin method is more effective in clinical efficacy, endoscopic efficacy than that of western medicine. Since the evidence intensity of this Meta-analysisis are limited, the above conclusions are still validated by more high-quality studies.

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Medical Reserch and Education 2019, 36 (2): 48-53. DOI: 10.3969/j.issn.1674-490X.2019.02.009

Abstract （342）

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Objective To investigate the current status and factors related to resilience among MSM. Methods We investigated 312 MSM living with HIV in one infectious disease hospital using connor-davidson resilience scale(CD-RISC), perceived social support scale(PSSS), kessler psychological distress scale(K10). Results The total score of CD-RISC was 62.66±14.84, the resilience was positively correlated with social support(r=0.358,P<0.001)and negatively related to psychological distress(r=-0.380,P<0.001). Multiple regression analysis showed that economic status, other support in social support and depression in psychological distress were significant predictors of resilience, which explained 25.0% of the variance. Conclusion Resilience of HIV-positive MSM was at moderate level. Good social support system and better economic conditions would help improve their resilience. In addition, medical staff should focus on the mental health state of patients and improve the depression of them.

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Medical Reserch and Education 2019, 36 (2): 54-61. DOI: 10.3969/j.issn.1674-490X.2019.02.010

Abstract （479）

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Maintaining the dignity of patients is a basic tenet of palliative care. A series of studies on dignity in palliative care were synthesized in this paper. The concept of dying with dignity and its influencing factors were summarized; levels of loss of dignity in Chinese patients with cancer and the predictive factors were reported; the model of dignity in terminally ill was introduced; the developments of two dignity psychotherapeutic interventions, dignity therapy and dignity talk, based on the model of dignity, were introduced; and finally, the preliminary model of dignity management in hospice and the A, B, C, and D of dignity conserving care were introduced, aiming to guide healthcare providers to provide dignity conserving care in palliative care clinical practice.

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Medical Reserch and Education 2019, 36 (2): 62-66. DOI: 10.3969/j.issn.1674-490X.2019.02.011

Abstract （421）

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Objective To investigate the effects of painless childbirth combined with midwife delivery escort services on the delivery mode, labor duration and postpartum depression of parturients. Methods 165 parturients of hospital delivery in the hospital from January 2017 to June 2017 were retrospectively collected. They were divided into midwifery group(midwife delivery escort, 78 cases)and combination group(painless childbirth combined with midwife delivery escort, 87 cases)according to different intervention methods. Muleteer analgesia score was used to evaluate the pain of parturients during delivery. The delivery mode, total labor duration and maternal and neonatal outcomes were recorded. The edinburgh postnatal depression scale(EPDS)was used in the investigation at 7 days and 28 days after delivery. Results The Muleteer analgesia score and total labor duration of the combination group were significantly less than those of midwifery group(P<0.05). The vaginal delivery rate of the combination group(83.91%)was significantly higher than that of midwifery group(60.26)(P<0.05). The EPDS scores of the combination group at 7 days and 28 days after delivery were significantly lower than those of midwife group(P<0.05). There was no significant difference in the incidence of postpartum hemorrhage, postpartum urinary retention, neonatal asphyxia or fetal distress among all groups(P>0.05). Conclusion Painless childbirth combined with midwife delivery escort services can significantly reduce the pain of parturients, decrease the cesarean section rate, shorten the total labor duration, and improve maternal postpartum depression.

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Medical Reserch and Education 2019, 36 (2): 67-70. DOI: 10.3969/j.issn.1674-490X.2019.02.012

Abstract （481）

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Continuing medical education is an important way to improve the ability of medical professionals and enhance the core competitiveness of medical institutions. Through literature research and interview investigation, it can be seen that China's continuing medical education is faced with such problems as unbalanced development, relatively lagging information construction and imperfect supervision and evaluation system. To strengthen the development of continuing medical education, the establishment of standard of continuing medical education, promotion of distance continuing medical education and improvement of the supervision and evaluation system of continuing medical education should be put into emphasis and implemented.

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Medical Reserch and Education 2019, 36 (2): 71-74. DOI: 10.3969/j.issn.1674-490X.2019.02.013

Abstract （523）

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With the rapid development of reproductive medicine, thetraining of post-gruaduate student of reproductive medicine becomes one of the most important keys in the development of this field. It involves in many other subjects and requires high level of moral principles, so teaching and training become more and more difficult. A training model named “training on stage” created by our centers on PBL-TBL, SP teaching, in order to enhance the clinical ability and communication skills and improve teaching quality and efficiency.

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Medical Reserch and Education 2019, 36 (2): 75-80. DOI: 10.3969/j.issn.1674-490X.2019.02.014

Abstract （290）

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Objective To understand the status of technology awards of the key medical disciplines at provincial level in a provincial capital city, and to explore the existing problems and countermeasures. Method The paper mainly used literature research, descriptive research, rank sum test to analyze the present situation of technology awards for key disciplines. Results The number of technology awards was relatively stable from 2012 to 2014, but declined in 2015. The number and level of technology awards in clinical medicine is higher than those in basic science of medicine, preventive medicine and hygienics. Among the leaders of technology awards, 51.8% aged ranging from 35 to 44; 48.74% were senior professional titles, 43.88% have master's degree, 42.81% have doctoral degree. Conclusion The number of science and technology awards is decreasing, and theaward level is low. Technology awards are concentrated in the dominant disciplines. The leaders of technology awards have higher professional titles.The leaders are mainly young and middle-aged, but those in high-level awards are older. Suggestions: Strengthen the management of scientific research, improve the enthusiasm of rewarding scientific research achievements and the writing level of rewarding materials. Make horizontal comparison with key disciplines in the same field and major disciplines, select leading disciplines for key investment. Actively cultivate young and middle-aged scientific research talents, and improve the scientific research level of young and middle-aged talents.

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Medical Reserch and Education 2019, 36 (3): 1-7. DOI: 10.3969/j.issn.1674-490X.2019.03.001

Abstract （447）

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Objective To investigate the effects of ultrafine-nano zinc particles on cardiac structure and function in mice with myocardial infarction(MI). Methods 36 ICR mice were randomly divided into control group, MI group and the inhalation group, 12 mices in each group. After two weeks of successful MI, the inhalation group was placed in an atomized box containing 500 μg/m³ for particle inhalation. 8 weeks later, the heart function of mice was measured with vevo2100, then all mice were sacrificed. Heart tissue were collected. Cardiomyocyte size were assessed by immunofluorescence. TUNEL method was used to detect the apoptosis of cardiac cells. The changes of collagen content in the heart were detected with Marsson trichrome staining. Results Compared with control group, the EF values in the inhalation group and MI group were significantly decreased(P＜0.05), and the decrease in the inhalation group was more obvious. The results of immunofluorescence showed that cardiomyocyte size and the number of apoptotic cells in the inhalation group increased significantly(P＜0.05). In addition Marsson trichrome staining results showed that the collagen content of cardiomyocyte in the inhalation group increased significantly(P＜0.05). Conclusion Inhalation of nano-zinc powder particles can aggravate ventricular remodeling and functional changes and exacerbate myocardial cell apoptosis of myocardial infarction.

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Medical Reserch and Education 2019, 36 (3): 8-14. DOI: 10.3969/j.issn.1674-490X.2019.03.002

Abstract （388）

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Objective To construct the theory of the fluid state of the blood flow of symmetrical narrow parts of artery and the distribution of the red blood cell mass. This theory is the basis of revealing the formation mechanism and the abundant connotation of the spectrum of doppler ultrasound signals from blood flow. Methods The methods used in the research include the observation of the fluid state of similar ditches, and scientific verification with mathematical theory. Results The consequence of the research includes the establishment of the theoretical model which explains the fluid state of the blood flow of the symmetrical narrow parts of artery, and the summary of the distribution rules of the numbers of the red blood cell in the red blood cell mass according to its flow velocity. Conclusion The research results indicate that in this essay, not only the theoretical basis for the explanation of the formation mechanism and the connotation of the spectrum of doppler ultrasound signals from blood flow, but also the references for the explanation of the fluid state of other parts of the artery are provided.

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Medical Reserch and Education 2019, 36 (3): 15-18. DOI: 10.3969/j.issn.1674-490X.2019.03.003

Abstract （1822）

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Objective To compare and evaluate the effectiveness of four methods of intubation in isolated frog heart perfusion. Methods Isolated frog heart specime were prepared by Straub method, BAMU-HARTUNG'S method, right aortic intubation and posterior vena cava+left aorta intubation method, to analyze the differences of four methods in the time of cannulation, time of heart ex vivo, successful rate, survival rate, heart survival time and rate of coagulation. Results Compared with the traditional intubation-Straub method, the two kinds of double-cannula method were increased in the successful rate, survival rate and heart survival time, decreased in the rate of coagulation, and there were significant difference(P＜0.05),but increased in the time of cannulation and isolated heart, and there were significant difference(P＜0.05). Compared with Straub method, right aortic intubation was increased in the successful rate, survival rate and heart survival time, decreased in coagulation rate and the time of cannulation, and there were significant difference(P＜0.05).But the time of isolated heart was no significant difference(P＞0.05). Compared with the two kinds of double-cannula method, right aortic intubation was decreased in successful rate, the time of cannulation and isolated heart, increased in coagulation rate,and there were significant difference(P＜0.05), but heart survival time and survival rate had no significant difference(P＞0.05).Conclusion The comprehensive evaluation showed that the right aortic intubation method had a great advantage in the isolated frog heart perfusion experiment.

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Medical Reserch and Education 2019, 36 (3): 19-26. DOI: 10.3969/j.issn.1674-490X.2019.03.004

Abstract （413）

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Objective To investigate whether intravenous administration nicorandil can protect renal function in ACS patients with type 2 diabetes mellitus after PCI and the possible mechanism. Methods The ACS patients with DM who were selected for PCI were randomly divided into the control group(intravenous hydration treatment)and the observation group(intravenous hydration treatment + intravenous administration nicorandil treatment 0.1 mg/kg·h from 5 h before PCI to 24 h after PCI). All patients underwent blood sampling at 24 h before PCI and 6 h, 24 h, 48 h and 72 h after PCI to detect indicators related to renal function, inflammation and cardiac function. The main endpoint was the incidence of CIN. Results The levels of SCr, β₂-MG and CysC in the observation group at 48 h and 72 h after PCI were lower than those in the control group, the difference was statisticallysignificant(P＜0.05). The eGFR in the observation group at 48 h and 72 h after PCI was significantly higher than that in the control group, and the difference was statistically significant(P＜0.05). The level of hs-CRP, SAA, NLR and NT-ProBNP in the observation group were significantly lower than those in the control group at 24 h after PCI, there was significant difference between two groups(P＜0.05). Conclusion Intravenous administration nicorandil can not reduce the incidence of CIN, but can protect renal function and cardiac function in ACS patients with DM after PCI. The possible mechanism is to inhibit the inflammatory response and increase renal perfusion.

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Medical Reserch and Education 2019, 36 (3): 27-32. DOI: 10.3969/j.issn.1674-490X.2019.03.005

Abstract （490）

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Objective To investigate the correlation between cerebral microhemorrhage(CMBs)in patients with cerebral infarction(CI)and the markers of vascular endothelial injury: intercellular adhesion molecule-1(ICAM-1), endothelial nitric oxide synthase(eNOS)and soluble thrombokinin(sTM), and its clinical significance.Methods A total of 106 CI patients admitted to the Neurology Department of the Affiliated Hospital of Hebei University from July 2017 to June 2018 were collected.After craniocerebral SWI examined and confirmed no CMBs 37 cases(groupⅠ)and merge CMBs 69 cases(group II). Basic data and serum of patients in the two groups were collected, and the contents of ICAM-1, eNOS and sTM were quantitatively determined by ELISA to discuss the relationship between them and CMBs after CI.Results The levels of eNOS, ICAM-1 and sTM in groupⅡof patients were significantly higher than the levels of group Ⅰ. Three months later, group Ⅱ patients of cerebral infarction convalescence serum ICAM-1 and sTM level was still higher than the group of patients, for group I patients recovery of serum eNOS level higher than group Ⅱ.Conclusion The increased plasma ICAM-1, eNOS and sTM are closely related to CMBs after CI, and the changes in their contents have a certain predictive effect on the occurrence of CMBs.

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Medical Reserch and Education 2019, 36 (3): 33-38. DOI: 10.3969/j.issn.1674-490X.2019.03.006

Abstract （511）

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Objective To investigate the clinical effect of retrograde occult nerve flap in repairing distal calf and ankle wound by cross-leg displacement.Methods 100 cases of patients with distal calf and ankle wound treated by Tangshan Second Hospital from January 2015 to January 2018 were selected and divided into observation group and control group according to different treatment methods, 50 cases in each group.The observation group was treated with retrograde occult nerve flap, and the control group was repaired by traditional methods(conventional pressurized bandaging and flap transplantation), and the excellent healing rate, healing time and pain score of 2 groups were compared. Results The excellent healing rate in the observation group(74%)was significantly higher than that in the control group(58%), the healing time(33.47±6.52)d was significantly shorter than that in the control group, and there was statistically significant between the 2 groups(P＜0.05).The pain level score of 6, 12, 24, 48 and 72 h in the observation group was significantly lower than that in the control group(P＜0.05). The vascular distribution score(1.16±0.34), softness score(0.88±0.39), color score(1.51±0.75), thickness score(1.27±0.38)were significantly lower in the observation 15 d group than that of the control group, and ankle function score(82.52±4.39)significantly higher than the control group(P＜0.05). Conclusion The effect of retrograde occult nerve flap on the displacement of the distal calf and ankle wound is ideal, which can effectively promote wound healing and improve ankle joint function.

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Medical Reserch and Education 2019, 36 (3): 39-44. DOI: 10.3969/j.issn.1674-490X.2019.03.007

Abstract （559）

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Non-alcoholic fatty liver disease(NAFLD)is the most common cause of chronic liver disease in adults and children. NAFLD, nonalcoholic steatohepatitis(NASH)and fatty liver cirrhosis have been associated with a variety of chronic diseases. Correct awareness and diagnosis of the disease has become a problem that clinical needs to pay attention to, but the gold standard for the diagnosis of the disease is still biopsy, imaging examination because of its non-invasive, repeatability and other advantages and conducive to the diagnosis of patients and follow-up observation. In this paper, the advances on the qualitative and quantitative diagnosis of nonalcoholic fat by ultrasound, CT and MR are reviewed.

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Medical Reserch and Education 2019, 36 (3): 45-49. DOI: 10.3969/j.issn.1674-490X.2019.03.008

Abstract （408）

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The increase of fetal cardiothoracic ratio often indicates fetal cardiac insufficiency, the decrease of cardiothoracic ratio indicates compression of the heart, obstruction of venous reflux, and the critical condition of the fetus. A clear prenatal diagnosis is essential for pathogenesis search, prognosis evaluation and intrauterine treatment. Ultrasound as a economic, noninvasive, real-time, convenient technology, has always been the preferred imaging method for prenatal diagnosis of fetuses, but it has many limitations. With the development of technology, MRI can provide more information for the etiological diagnosis and prognosis assessment of abnormal cardiothoracic ratio fetus.

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Medical Reserch and Education 2019, 36 (3): 50-54. DOI: 10.3969/j.issn.1674-490X.2019.03.009

Abstract （476）

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Objective To explore mindfulness of first-year students in university and its associates with demographic characteritics, self-esteem and mental health. Methods FFMQ,SES,SCL-90 were administered to 589 randomly selected students. Results(1)Gender differences, only-one-child, and education level, income, and mental health of parents were influencing factors for mindfulness.(2)Pearson correlation analysis showed that mindfulness, self-esteem and mental health were correlated with each other(r=0.231-0.495,P＜0.001). Self-esteem played partial mediating role between mindfulness and mental health. Conclusion Mindfulness could not only directly influence mental health, but also influence mental health indirectly through changing the level of their self-esteem.

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Medical Reserch and Education 2019, 36 (3): 55-61. DOI: 10.3969/j.issn.1674-490X.2019.03.010

Abstract （457）

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The problem of life and death of the elderly is the fundamental problem of the protection of the rights and interests of the elderly. Peaceful care aims to alleviate the afflictions of patients at the end of clinical practice, do our utmost to respect, conform to and fulfill my wishes, greet death naturally, it is the embodiment of respecting the basic rights of citizens' life and health. Personal dignity should be sacred and inviolable, the authority should actively respect and protect the dignity of citizens, establish the legal effect of living will, improve the supply of hospice care services, establish a national social security system for hospice care, improve healthy and orderly development of hospice care services, protect the legitimate rights and interests of the elderly and the dignity of the human person.

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Medical Reserch and Education 2019, 36 (3): 62-66. DOI: 10.3969/j.issn.1674-490X.2019.03.011

Abstract （419）

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Objective To explore the sense of peace of in-patients to nurses' nursing behavior and its influencing factors so as to provide a basis for strengthening nurses' trust and optimizing nursing behavior. Methods “Nurse-patient relationship trust scale” was used to investigate and analyze the sense of peace and influencing factors of in-patients in grade IIIA hospitals. Results Patients' scores of “sense of peace” were 3.34 ± 0.42, “I am more natural in front of the nurse”(3.63 ± 0.55)scored highest on the item that made the patient feel comfortable. “Nurses don't blame them for doing things they shouldn't”(2.84 ±0.98)and “I barely manage to be a good patient in front of nurses”(2.85 ±1.08)scored the lowest. Different patients in internal medicine or surgery, the occupation and family income of the patients are the influencing factors of their sense of peace of mind. Conclusion Patients' sense of security plays a lower role than their trust in nurses' skills and behaviors and confidence in the future in the process of building patients' trust in nurses. Surgical non-public officials and middle-income patients feel less comfortable about nursing behavior, nurses should pay more attention to this part of patients in nursing work, and promote their sense of peace of mind with more positive attitude and behavior.

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