Journal of Hebei Medical College for Continuing Education

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 1-11. DOI: 10.3969/j.issn.1674-490X.2021.01.001

Abstract （740）

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Objective To establish two models for atherosclerosis(AS)and compare their establishment methods. Methods Eighteen SD rats with SPF grade were randomly divided into normal group(SDN)and model group(SDM).Twelve C57BL/6J rats and 24 ApoE^-/- rats were divided into C57BL/6J blank control group(CN), ApoE^{^-/-} blank control group(AN)and ApoE^-/- model group(AM). The AS model was established by inducting high-fat feed. The basic conditions of each group were compared and the serum lipid, inflammatory factors and fatty acids contents were detected. Immunohistochemistry of the aortic sinus was performed. Oil red O staining and haematoxylin and eosin staining were performed on the whole aorta of the experimental mice. Results There were significant changes in body mass, food intake and water intake between the model(SDM,AM group)mice and the normal(SDN,CN,AN group)mice(P<0.05). Compared with the normal group, the serum levels of TC, TG and LDL-C in the model group were significantly increased(P<0.05), while the levels of HDL-C were significantly decreased(P<0.05). CRP、MCP-1、IL-1β、IFN-γ、TXB2、DPP-4 levels were significantly increased(P<0.05 ), and PGF-1α and GLP-1 levels were significantly decreased(P<0.05). The contents of palmitoleic acid and linoleic acid decreased(P<0.05), while the contents of palmitoleic acid, oleic acid and stearic acid increased(P<0.05). In the model group, TNF-α was increased in the aortic sinus, while the expressions of StAR and PPAR-γ were negative. The atherosclerosis index(AI)of AM group mice was 1.67 times that of SDM group rats. The intima of SDM group was thickened and local uplifted, the elastic fibers of the medium membrane were disordered, and the external model showed mild inflammatory cell infiltration, presenting early AS pathological changes, while the AM group had a large amount of red plaque deposition. Conclusion The degree of AS lesions in ApoE^-/- mice is more obvious than that in SD rats. Moreover, compared with SD rats, AS has less damage to the organs of ApoE^-/- mice. Therefore, ApoE^-/- mice are more suitable for the construction of AS model.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 12-16. DOI: 10.3969/j.issn.1674-490X.2021.01.002

Abstract （403）

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The current diagnostic criteria of ARDS is based on the Berlin definition, chest radiography, oxygenation index and other parameters are used to define patients. However, there are some defects in this standard, such as the subjectivity of chest radiography interpretation, the inconformity of pathological changes and clinical symptoms, so the accuracy of the standard is questioned. Increase in pulmonary vascular permeability accompanied with accumulation of excess extravsscular lung water(EVLW)is the hallmark of ARDS. EVLW and pulmonary vascular permeability index(PVPI )can be quantitatively measured using the transpulmonary thermodilution technique, which can provide basis for accurate diagnosis and treatment of ARDS. EVLW more than 10 mL/kg is a reasonable criterion for pulmonary edema, meanwhile PVPI more than three suggests increased vascular permeability of ARDS. EVLW and PVPI measurement will provide accurate indicators for clinical practice and research of ARDS.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 17-22. DOI: 10.3969/j.issn.1674-490X.2021.01.003

Abstract （521）

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Objective To observe the application of propofol combined with etomidate in painless gastrointestinal endoscopy for the elderly, and evaluate the clinical effect and safety of the two drugs combined. Methods A prospective, randomized, controlled study was conducted among 96 elderly patients selected and randomly divided into two groups according to different anesthesia methods admitted to the Second People's Hospital of Fengrun District, Tangshan City, Hebei Province for painless gastroscopy from January 2019 to January 2020. 48 cases in the group A were given propofol combined with etomidate anesthesia, while 48 cases in the group B were given propofol anesthesia. After the examination, the anesthetic effect(anesthesia induction time, recovery time, directional recovery time), serological indicators(epinephrine, norepinephrine, cortisol)and adverse reactions were compared between the two groups. Results(1)Anesthesia induction time, recovery time and orientation recovery time of group B were significantly lower than those of group A(P<0.05).(2)Compared with that before examination in the same group, the serum cortisol, epinephrine and norepinephrine levels in the two groups were significantly increased(P<0.05)and the serum levels of epinephrine, norepinephrine and cortisol in group B were lower than those in group A(P<0.05).(3)The incidence of adverse reactions in group B was significantly lower than that in group A(P<0.05). Conclusion The application of propofol combined with etomidate anesthesia in elderly patients with painless gastroenteroscopy can improve the anesthetic effect, improve the stress reaction and reduce the incidence of adverse reactions.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 23-31. DOI: 10.3969/j.issn.1674-490X.2021.01.004

Abstract （360）

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Objective To compare the clinical efficacy and pregnancy outcomes of the excision of uterine adenomyoma through laparotomy and laparoscopic, and high intensity focused ultrasound(HIFU). Methods The clinical data of postoperative patients with adenomyosis who had fertility requirements were treated with those three ways in Baoding Maternal and Child Heath Hospital from October 2015 to April 2019 were analyzed retrospectively. Among them, group A was treated with laparotomy(group A)(n=50), group B was treated with laparoscopic(n=45), and group C was treated with high intensity focused ultrasound ablation(n=32). All the patients were followed up for 4 years. The operative indexes, treatment efficiency, pregnancy and outcome of each group were investigated and analyzed. Results The effective rate of group A and group B reached 100%, while that of group C was 96.88%, but there was no significant difference between treatment groups(P>0.05). Compared with groups A and B, group C had the longest operation time(P<0.05), but the intraoperative blood loss, the time to get out of bed and the number of hospital stay after operation were significantly lower than those in group A and B(P<0.05). The average hospitalization cost in group A was less than that in group B and C, but there was no significant difference between the three groups(P>0.05).The pregnancy rate was the highest in group C(59.38%), followed by group A(52.00%)and lowest in group B(48.89%), but the difference was not statistically significant(P>0.05). The spontaneous abortion rate, premature delivery rate did not differ significantly among the three groups. Compared with group A and B, group C had the shortest pregnancy interval(P<0.05). The vaginal delivery rate of group C was the highest(52.94%), which was significantly higher than that of group A and B(P<0.05). However, there was no significant difference in the average gestational age, pregnancy complications and complication rate, Apgar score and the time of menstrual resuscitation(P>0.05). Conclusion HIFU treatment of uterine fibroids and adenomyosis is effective and safe, can improve the pregnancy rate without significant adverse effects. Compared with hysteromyoma resection by laparotomy and laparoscopic, HIFU treatment has certain advantages, it is worth in-depth study and promotion.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 32-36. DOI: 10.3969/j.issn.1674-490X.2021.01.005

Abstract （331）

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Objective To explore the diagnostic value of serum lipoprotein(a)［Lp(a)］ and adipokinetic leptin in acute cerebral infarction. Methods 220 patients with acute cerebral infarction admitted to the Department of Neurology of Baoding First Central Hospital were selected as the case group, and 100 healthy patients who received physical examination in this hospital during the same period were selected as the control group. The serum Lp(a)and leptin of the cerebral infarction group and healthy people were compared and analyzed. The ROC curve was used to evaluate the diagnostic value of leptin and lipoprotein(a). Results Compared with the control group, the case group had higher Lp(a)and leptin, and the difference was statistically significant(P<0.05). ROC curve analysis showed that the area under curve Lp(a)was 0.698, and the area under curve leptin was 0.924. Conclusion Serum Lp(a)and leptin have a certain correlation with acute cerebral infarction and have certain clinical diagnostic value.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 37-44. DOI: 10.3969/j.issn.1674-490X.2021.01.006

Abstract （461）

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This paper introduces YANG Shaobo's experience in diagnosis and treatment of gynecological diseases. YANG Shaobo worked in Affiliated Hospital of Hebei Medical College for Continuing Education(Affiliated Hospital of Hebei University nowadays).He is one of the first 500 instructors of Traditional Chinese Medicine(TCM)academic inheritance in China. YANG Shaobo is good at diagnosis and treatment of internal medicine and gynecological diseases. A batch of effective prescriptions of YANG Shaobo were found. At present, YANG Shaobo's works on gynecological experience are rare. From them, some experiences of gynecological disease therpy are selected. It includes common diseases, emergencies and difficult diseases which reflects the characteristics of YANG Shaobo's academic experience and serves for clinical reference.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 45-52. DOI: 10.3969/j.issn.1674-490X.2021.01.007

Abstract （358）

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Objective To analyze the prevalence and related risk factors of fatty liver disease in a population undergoing physical examination in Xi'an city and provide basis for targeted prevention and treatment of fatty liver in the future. Methods 9 096 healthy adults who had physical examination with complete clinical records in Xi'an No.3 hospital were enrolled, identified with FLD. At the same time, anthropometry, biochemical immune indicators and disease history were collected, and the disease status was studied with age and gender stratification. Data analysis was performed using the χ² test, t-test, and logistic regression analysis. Results Among the 9 096 cases, a total of 2 290 cases of FLD were detected with ultrasound examination, with a prevalence rate of 25.18%. The prevalence was significantly higher in males than that in females(P<0.01). The prevalence was highest in females aged 60-69 years(22.67%)and highest in males aged 30-39 years(41.29%). The mean levels of body mass index, total cholesterol, triglyceride, low-density lipoprotein, fasting blood glucose, blood uric acid, systolic blood pressure and diastolic blood pressure in the fatty liver group were significantly higher than those in the non-fatty liver group, while the high-density lipoprotein was significantly lower than those in the non-fatty liver group(P<0.01). Multivariate logistic regression analysis showed that age, body mass index, diastolic blood pressure, fasting blood glucose, triglyceride, total cholesterol, blood uric acid, gallbladder disease were risk factors for fatty liver. Conclusion The prevalence of FLD is higher in males than in females among the physical examination population in xi'an city. Overweight and obesity, dyslipidemia, hypertension, hyperglycemia, hyperuricemia and gallbladder disease were the main risk factors.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 53-57. DOI: 10.3969/j.issn.1674-490X.2021.01.008

Abstract （378）

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Intravenous amiodarone is an important treating therapy for arrhythmias, but peripheral infusion is associated with direct irritation of vessel walls and phlebitis, manifested as local redness, swelling, heat and pain, which increases the pain of patients. This article reviews the criteria of phlebitis, the causes of phlebitis and the prevention and treatment measures in order to provide the basis for clinical nursing work.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 58-63. DOI: 10.3969/j.issn.1674-490X.2021.01.009

Abstract （390）

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With the development of the aging population, the number of people suffering from cardiovascular diseases has soared, so that cardiac rehabilitation in China is facing a huge social demand. However, it is accompanied by the reality of poor patient compliance for a long time. To meet this severe situation, it is necessary to focus on the mechanism affecting the patient's maintain rehabilitation behavior, enhance the patient's confidence in the process of behavior management and stimulate the motivation of the patient to consciously adhere to the recommended behavior. Therefore, this paper summarizes the overview of cardiac rehabilitation behavioral compliance, the overview of self-efficacy and motivation, and the application of self-efficacy and motivation in cardiac rehabilitation behavioral compliance in order to establish a new idea of cardiac rehabilitation behavioral compliance education and provide personalized and more long-term health education methods for cardiovascular patients.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 64-69. DOI: 10.3969/j.issn.1674-490X.2021.01.010

Abstract （355）

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Objective To identify the effects of couple-based psychological interventions on psychological status of patients with breast cancer by using meta-analysis. Methods We performed a systematic search in Web of Science, PubMed, Cochrane Library, CNKI and Wanfang to collect studies about effects of couple-based psychological interventions on psychological status in patients with breast cancer from inception to May 2020. Meta-analysis was performed by using RevMan 5.3 software after two independent reviewers conducted independent literature screening, data extraction, and literature quality evaluation according to inclusion and exclusion criteria. Results Seven studies were recruited, including 1 093 patients. Descriptive result displayed that couple-based psychological interventions had a positive effect on fear of cancer recurrence of patients with breast cancer. The results of meta-analysis showed that couple-based psychological interventions had no significant effect on anxiety (SMD=0.04,95%CI=-0.11~0.19,P=0.63)or depress(SMD=0.05,95%CI=-0.20~0.10,P=0.54)of patients with breast cancer. Conclusion Couple-based psychological interventions have a positive effect on fear of cancer recurrence of patients with breast cancer, but have no significant effect on anxiety or depress. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 70-75. DOI: 10.3969/j.issn.1674-490X.2021.01.011

Abstract （371）

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Scientific thinking is the essential core quality for medical practitioners. As otorhinolaryngology-head and neck surgery is a multidisciplinary and highly specialized clinical discipline, doctors need strong scientific thinking ability, thus scientific thinking training is an essential and important part of its teaching. In the clinical teaching, we have explored and practiced a variety of teaching methods based on inspiring students to discover questions to provide systematic scientific thinking training for students, stimulate their interest in scientific research and improve their scientific thinking level and clinical decision-making ability.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (1): 76-80. DOI: 10.3969/j.issn.1674-490X.2021.01.012

Abstract （334）

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Online teaching is the first large-scale use for Internet technologies in the history of China's higher education during the new epidemic. This study randomly selected 221 online courses of Hebei Medical University, from the perspective of social cognitive theory, elaborated the overall status of online teaching, and analyzed the problems of online teaching from students, teachers and experimental teaching. Suggestions: schools should provide comprehensive services and give full of support for online teaching; teachers should change the concept, methods, strategies and skills of “teaching”. Students should cultivate the thinking and should have abilities for autonomous “learning”.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 1-7. DOI: 10.3969/j.issn.1674-490X.2021.02.001

Abstract （1311）

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Objective To provide a reliable primary hepatocyte steatosis cell model for the pathogenesis, prevention and treatment of non-alcoholic fatty liver disease(NAFLD).Methods Primary mouse hepatocytes were isolated by Seglen two-step perfusion method and its improved method.After cultured in vitro for 48 hours, different concentrations of free fatty acid(FFA)mixture ［oleic acid(OA)∶palmitic acid(PA)=2∶1］ were induced for 24 hours.The lipid droplet deposition in hepatocytes was observed by oil red O staining and the content of triglyceride(TG)in cells was determined by automatic biochemical analyzer.Results Compared with the control group, there were red lipid droplets in hepatocytes in the model group, and the concentration of FFA mixture was dose-dependent, and the content of TG in hepatocytes in the model group was significantly higher than that in the control group(P<0.05), and increased with the increase of the concentration of FFA, suggesting that the lipid deposition in hepatocytes increased with the increase of FFA concentration.Conclusion The primary hepatocyte steatosis cell model is successfully established, which provides a reliable cell model for the study of non-alcoholic fatty liver disease.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 8-13. DOI: 10.3969/j.issn.1674-490X.2021.02.002

Abstract （749）

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Cardiovascular disease(CVD)is the leading cause of death in our country.However,its pathogenesis is still unclear.Studies have found that RhoA/ROCK signaling pathway is closely related to the occurrence and development of hypertension,coronary heart disease,heart failure,arrhythmia and other diseases.ROCK inhibitors also provide new ideas for the treatment of cardiovascular diseases.The research on RhoA/ROCK signaling pathway in cardiovascular diseases is reviewed.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 14-20. DOI: 10.3969/j.issn.1674-490X.2021.02.003

Abstract （543）

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Klotho gene was originally thought to be an anti-aging gene.In recent years, its’ anti-inflammatory response, anti-oxidative stress, anti-apoptosis, regulation of tissue autophagy, calcium and phosphorus metabolism and other functions have been gradually discovered.Related studies have shown that Klotho can participate in the occurrence and development of a variety of kidney diseases, among which Klotho is closely related to the diagnosis and treatment of acute kidney injury(AKI), which is expected to become not only a biomarker for early diagnosis of AKI, but also a therapeutic target.This article reviews the research progress of Klotho in the diagnosis and treatment of AKI in detali.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 21-25. DOI: 10.3969/j.issn.1674-490X.2021.02.004

Abstract （787）

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Depression is the most common complication of ischemic stroke, which has a great negative impact on the functional recovery and quality of life of survivors.About 1/3 people are affected by post-stroke depression, which makes it a serious social and public health problem.Reasonable prevention and treatment of post-stroke depression requires a comprehensive understanding of the pathophysiological factors of the disease.A detailed review of the etiology and pathogenesis of post-stroke depression can provide a more comprehensive and systematic scientific basis for the prevention and treatment of this disease in the future.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 26-31. DOI: 10.3969/j.issn.1674-490X.2021.02.005

Abstract （811）

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Spasticity is caused by the motor neuron damage on one of the most common movement dysfunction, the speed increased muscle tone as the main form of expression, which is one of the major complications of stroke patients with hemiplegia.Because of the persist for cramps, joint deformity caused by cerebral stroke patients, decreased activity, and body contracture, leaving patients walking ability and ability of daily life of the recovery of severely hindered, the final result is the patient's quality of life is reduced.In order to improve this situation, there are numerous clinical methods for the treatment of muscle spasm in stroke hemiplegia patients with different effects.This paper mainly reviews the developments in the diagnosis and treatment of limb muscle spasticity in stroke hemiplegia patients in recent five years in detail.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 32-35. DOI: 10.3969/j.issn.1674-490X.2021.02.006

Abstract （706）

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Objective To analyze the coincidence of platelet aggregation alarm information of Sysmex XN-1000 blood cell analyzer(hereafter referred to as XN-1000)and explore its treatment method.Methods A total of 123 inpatients with platelet aggregation alarm value >100 in whole blood cell analysis were collected, which were the high value group.123 cases with similar platelet values of age and gender and alarm value of platelet aggregation 0-100 were randomly selected as the low value group.Blood smear was used to determine platelet aggregation and manual platelet count.Results In the high value group, there were 53 positive and 70 negative cases of platelet aggregation, while in the low value group, there were 1 positive and 122 negative cases.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of platelet aggregation alarm were 98.15%, 63.54%, 43.09%, 99.19% and 71.14%, respectively.Conclusion XN-1000 platelet aggregation alarm information can well screen out platelet aggregation and is not easy to miss diagnosis, but it's accuracy needs to be further verified by manual microscopic examination.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 36-40. DOI: 10.3969/j.issn.1674-490X.2021.02.007

Abstract （465）

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Objective To evaluate the effects of three local anesthesia methods on tooth extraction in elderly patients with hypertension. Methods Sixty elderly patients with hypertension were randomly divided into three groups: syringe group( anesthesia with syringe), Easy-II group(anesthesia with Easy-II local anesthesia booster)and STA group(anesthesia with STA local anesthesia injection device). After injection and extraction, the degrees of pain of the patients were evaluated by visual analog scale(VAS). Their systolic blood pressure(SBP), diastolic blood pressure(DBP)and heart rate(HR)were recorded before, in the course and 3 minutes later after injection for tooth extraction. The modified dental anxiety scale(MDAS)was used to evaluate the MDAS of patients pre- and post-operation. Results There was no statistical significance in the injection pain and anesthetic effect between Easy-II group and STA group, but they were better than those of syringe group(P<0.05). SBP and DBP of syringe group fluctuated significantly(P<0.05), while Easy-II group and STA group were stable during operation. The HR during tooth extraction was increased in the syringe group and Easy-II group, while it was more stable in STA group. The postoperative MDAS value in the syringe group was higher than preoperative value(P<0.05), while the postoperative MDAS value in STA group was lower than preoperative value(P<0.05). Conclusion Easy-II local anesthesia booster and STA local anesthesia injection device can reduce patients' pain, keep the physiological indexes stable, and reduce the risk.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 41-45. DOI: 10.3969/j.issn.1674-490X.2021.02.008

Abstract （294）

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Objective To investigate the correlation between transient amaurosis and serum inflammatory factors, carotid stenosis. Methods 60 patients with transient amaurosis in ophthalmic outpatient department and ward of the Third People's Hospital of Luoyang from March 2018 to March 2020 and 60 patients without transient amaurosis in the physical examination center at the same time were selected as the research objects, which were divided into the experimental group and the control group. The levels of serum inflammatory factors(high-sensitivity C-reactive protein, TNF-α, IL-6)in the two groups were measured, and carotid artery color ultrasound examination was carried out. The differences of serum inflammatory factors and carotid atherosclerosis between the two groups were compared. Results(1)Serum inflammatory factors: the levels of hs-CRP, TNF-α and IL-6 in the experimental group were higher than those in the control group(P<0.05).(2)Carotid atherosclerosis: the degree of carotid atherosclerosis in the experimental group was higher than that in the control group, and the plaque was mostly unstable plaque and mixed plaque, the difference was statistically significant(P<0.05). The degree of carotid artery stenosis in the experimental group was higher than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Serum inflammatory factors, degree of carotid atherosclerosis, nature of plaque and degree of carotid artery stenosis are closely related to transient amaurosis.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 46-53. DOI: 10.3969/j.issn.1674-490X.2021.02.009

Abstract （334）

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This paper introduces professor MA Yuchen's clinical experience in the diagnosis and treatment of diabetes mellitus by using Zangxiang Qihua.Nowadays diabetes mellitus is becoming a common clinical disease.Through using the Zangxiang Qihua to regulate Shaoyin, Jueyin, and Taiyin fanction,using Wuxing Shengke to rugulate Zangfu Qiji,applying the combination of “body type”,“tongue”,“pulse condition”,using “Ke”,“Hua”and“Li”three ways to reduce blood suger can achieve significant treating effects in clinical practices.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 54-60. DOI: 10.3969/j.issn.1674-490X.2021.02.010

Abstract （607）

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HPV infection is the most common sexually transmitted disease,causing a significant disease burden.HPV vaccination is a major public health intervention, which provides an ideal way to reduce the burden of HPV related diseases. Its promotion and implementation affect the long-term budget and health outcomes of the country.This paper summarized the research status of cognition, vaccination and health education of HPV vaccine, and analyzed the influence of different health education methods on cognition and vaccination of HPV vaccine from three levels of school, community and society.Health education should be carried out according to cultural background,and diversified and systematic health education mode should be adopted to improve the cognition level of HPV vaccine and promote the promotion of HPV vaccine.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 61-65. DOI: 10.3969/j.issn.1674-490X.2021.02.011

Abstract （335）

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Objective To investigate the effect of white noise intervention on the dosage of sedative drugs in ICU patients. Methods A total of 96 patients admitted to the Emergency Intensive Care Unit(EICU)of a level-III first-class hospital in Hebei province from January 1, 2019 to June 30, 2019 were randomly divided into a test group and a control group, 48 patients in each group. During the observation period, the observation group was given 50-60 decibels of white noise for intervention at 22:00-06:00 daily. Patients in the control group were exposed to normal ambient sounds. Results The maintenance dose of dexmedetomidine was(0.34±0.07)μg/(kg·h)in the observation group and(0.40±0.10)μg/(kg·h)in the control group, and the difference between the two groups was statistically significant(P<0.05). Conclusion White noise intervention can enhance the sedative effect of sedative drugs and reduce the dosage of sedative drugs.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 66-70. DOI: 10.3969/j.issn.1674-490X.2021.02.012

Abstract （306）

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Objective To discuss the application of internet+3D printing model in basic skills training of laparoscopic surgery.Methods Twenty-four trainees of standardized training of surgical residents were randomly divided into 4 groups.Group A, B, C, and D received basic laparoscopic skills training with traditional model, animal tissue, 3D printing model, internet+3D printing model.After training, animal tissue sample and objective structured assessment of technical skills(OSATS)were used to evaluate the training effects.After evaluation, groups A, B and C adopted additional training of other models, then Likert five-category scale was used to evaluate the similarity between traditional models, 3D printed models and real organizations.Results The 3D printing model is better than the traditional model and similiar to the real tissue in terms of vision, touch, toughness,needle insertion force, and knot tension.The OSATS scores in groups A, B, C and D were 17.92±0.74, 22.17±1.60, 21.92±1.20, 21.58±1.07, respectively(F=22.5, P<0.01).Conclusion The internet+3D printing model is significantly better than the traditional model, and can achieve a training effect equivalent to that during face-to-face training using animal tissue or 3D printing model.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 71-75. DOI: 10.3969/j.issn.1674-490X.2021.02.013

Abstract （409）

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Objective To explore the practice and effect of the combined application of micro class and flipped class in the clinical education of pediatricians.Methods A total of 100 pediatric physicians were randomly divided into the conventional group and the combined group.The conventional group(50 students)was given the conventional teaching method, while the combined group(50 students)was given the micro-class combined with flipped classroom.The teaching quality of the two groups was evaluated from two aspects of teaching content assessment and teaching effect questionnaire survey.Results The total score and theoretical score of the combined group were higher than those of the conventional group, and the difference was statistically significant(P<0.05).The satisfaction of the combined group was higher than that of the conventional group in stimulating learning interest, understanding and deepening knowledge of courses, improving autonomous learning ability and improving learning efficiency, with statistically significant differences(P<0.05).Conclusion The combination of micro class and flipped class can improve the teaching quality, fully mobilize students' learning ability and stimulate their interest in learning, which is more suitable for clinical training.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (2): 76-80. DOI: 10.3969/j.issn.1674-490X.2021.02.014

Abstract （324）

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Objective To explore the application value of massive open online courses(MOOC)teaching method combined with case-based learning(CBL)in the standardized residency training of medical imaging and the advanced training of radiologists.Methods From March 2016 to June 2020,65 students for standardized residency training and 73 radiologists for advanced training were enrolled in this study.They were divided into MOOC combined with CBL group, MOOC only and CBL only group.After 6 months training, theoretical assessment and practical ability(reading films)assessment were conducted to compare the learning results between different teaching groups of the students for standardized residency training and radiologists for advanced training.Results There were significant differences in theoretical assessment and practical ability between different groups of standardized training students(P<0.01); the MOOC combined with CBL group showed best theoretical assessment and practical ability, which were significantly better than MOOC only group(P<0.01)and CBL only group(P<0.01).There were significant differences in theoretical assessment and practical ability between different groups of advanced training radiologist(P<0.01); besides, the theoretical assessment scores showed no significant difference between MOOC combined CBL group and MOOC only group(P=0.21), and the practical ability showed no significant difference between MOOC combined CBL group and CBL only group(P=0.29).Conclusion The combination of MOOC and CBL teaching showed great advantage in standardized residency training and advanced training of radiologists.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 1-6. DOI: 10.3969/j.issn.1674-490X.2021.03.001

Abstract （569）

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Umbilical cord blood has gradually become an important source of stem cells in allogeneic stem cell transplantation.Although the post-transplantation infective fatality rate is higher, the survival rate of cord blood transplantation is comparable to other types of stem cell transplantation due to the advantages of easy access and lower incidence of GVHD(graft-versus-host diseases, GVHD).The improvement of cord blood transplantation technology has also brought better curative effect to the patients. The clinical application of umbilical cord blood provides a new method for the treatment of many refractory diseases.This article reviews the improvement of cord blood transplantation in recent years, the selection of cord blood for transplantation and the application of umbilical cord blood in other related diseases.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 7-11. DOI: 10.3969/j.issn.1674-490X.2021.03.002

Abstract （336）

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Objective To explore risk factors for cerebral microbleeds(CMB)in patients without hypertension and diabetes.Methods Patients hospitalized in the Department of Neurology,Baoding NO.1 Central Hospital from April 2019 to March 2020 without hypertension and diabetes were retrospectively recruited.Each patient underwent MRI check including susceptibility-weighted imaging(SWI).They were divided into two groups according to the existence of CMBs named CMB group(with CMBs, n=35)and NCMB group(without CMBs, n=114)respectively.Clinical and neuroimaging information was collected.Statistical analysis was conducted thereafter.Results It was demonstrated by univariate analysis that age, systolic blood pressure and systolic-to-diastolic pressure were associated with CMBs(P<0.05).Multivariate Logistic regression analysis showed that the older of the patient,the results of the experimental subjects would become(OR=1.535,95%CI=1.089-2.165,P=0.014)and the higher systolic blood pressure(OR=1.715, 95%CI=1.077-2.506, P=0.019), the higher risk of CMB.Conclusion Age and systolic blood pressure were independent risk factors for CMBs in patients without hypertension and diabetes.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 12-17. DOI: 10.3969/j.issn.1674-490X.2021.03.003

Abstract （702）

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Objective To analyze the effect of correcting mouth breathing and the variation of facial hard and soft tissue of class II malocclusion with mouth breathing by Twin-block in the growth peak.Methods 30 cases in growth peak with class II malocclusion and mouth breathing were selected.They were treated with Twin-block appliance, the treatment lasted for 12 months.The correction rate of mouth breathing was counted at 3, 6, 9 and 12 months after treatment respectively,the re-examination was conducted 6 months after treatment.Lateral cranial radiographs or models were measured before treatment, after treatment and 6 months after treatment.The results were analyzed with SPSS 26.0.Results The effective correction rate of mouth breathing increased with time, SNB, NP-FH, L1-MP increased, ANB, Y axis, U1-SN decreased, B'Li-FH, LiB'Pg', NsPg'-FH, GSnPg' increased, NsLs-FH, NsLi-FH decreased, these differences were statistically significant(P<0.05).After treatment for 6 months, the anterior overbite overjet remained stable.Conclusion The mouth breathing were corrected effectively, the growth of the mandible was stimulated, and the soft tissue profile was improved in growth peak by Twin-block appliance.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 18-22. DOI: 10.3969/j.issn.1674-490X.2021.03.004

Abstract （232）

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Objective To explore the changes of blood urea nitrogen(BUN)in the monitoring of stress ulcer bleeding in critically ill patients and its correlation with the amount of bleeding. Methods Retrospective collection of critically ill patients in Tangshan Hongci Hospitals complicated with stress ulcer bleeding of clinical data(30 cases)and the same number of clinical data without stress ulcer bleeding were randomly selected as the experimental group and the control group, the clinical information of the monitoring of two groups of patients with BUN and creatinine(Cr), BUN/Cr ratio, white blood cell(WBC)count, hemoglobin(Hb), and the variable difference analysis were examined.Results In the bleeding group, BUN, BUN/Cr and WBC at 1 week and 2 weeks after admission were higher than those in the control group and this group at 24 hours after admission(P<0.001), Hb was lower than those in the control group and this group at 24 hours after admission(P<0.001).There was no significant change in Cr between the two groups(P<0.05).Conclusion BUN, BUN/Cr and WBC can be used as simple and effective indexes for early detection of stress ulcer bleeding and prediction of bleeding degree in critical patients.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 23-28. DOI: 10.3969/j.issn.1674-490X.2021.03.005

Abstract （320）

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Objective To investigate the relationship between serum vitamin D levels in pregnant women and early pregnancy-related diseases, including bacterial vaginosis and spontaneous abortion.Methods A total of 60 women with early spontaneous abortion who were admitted to Baoding NO.1 Central Hospital were selected as the early spontaneous abortion group.A total of 50 early pregnancy women with bacterial vaginosis were enrolled as the bacterial vaginosis group.And 80 cases of healthy early pregnant women during the same period were collected as normal control group.Peripheral blood samples of all subjects were collected to detect the content of 25-hydroxyvitamin D in serum, and the deficiency rate of vitamin D in each group was analyzed and compared.Results The levels of vitamin D in the early spontaneous abortion group and the bacterial vaginosis group was significantly higher than those in the control group, and the differences were statistically significant(P<0.05).The vitamin D deficiency rate of early spontaneous abortion group(43.33%)was significantly higher than that of normal control group(22.50%), with statistical significance among the two groups(χ²=6.905, P=0.009).The vitamin D deficiency rate in the bacterial vaginosis group(42.00%)was significantly higher than that in the normal control group(22.50%), and the difference between groups was statistically significant(χ²=5.571, P=0.018).Conclusion Pregnant women with serum vitamin D deficiency may be more prone to early spontaneous abortion, and vitamin D deficiency in early pregnancy may also increase the risk of bacterial vaginosis infection.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 29-33. DOI: 10.3969/j.issn.1674-490X.2021.03.006

Abstract （527）

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Objective To investigate the difference in the efficacy of atomized inhalation of nitroglycerin and sildenafil in the treatment of neonatal pulmonary hypertension.Methods All of 54 cases of PPHN were randomly divided into nitroglycerin group(n=27)and sildenafil group(n=27), and all children received general treatments such as oxygen inhalation, acidosis correction, electrolyte balance maintenance and so on.On the basis of the above treatment,the patients of nitroglycerin group were treated with atomized inhalation of nitroglycerin, and those of sildenafil group were given nasal feeding or oral sildenafil.The efficacy and safety after treatment were compared and analyzed.Results Before treatment, there were no significant differences in the heart rate(HR), respiratory rate(RR), systolic pulmonary artery pressure(SPAP)and arterial oxygen partial pressure(PaO₂)between two groups(P>0.05).After treatment, HR, RR and SPAP in the nitroglycerin group and the sildenafil group decreased significantly, while the index value of PaO₂ increased significantly.Compared with before treatment, HR, RR, SPAP and PaO₂ in the two groups showed statistically significant differences(P<0.05), indicating that the treatment was effective.There was no significant difference in the clinical cure rate between the two groups(P>0.05).Conclusion Atomized nitroglycerin inhalation, nasal feeding or oral sildenafil are both effective in the treatment of neonatal mild to moderate pulmonary hypertension, with strong practicability, good safety, cheap and there was no difference in efficacy, which are ideal schemes for the treatment of this disease.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 34-40. DOI: 10.3969/j.issn.1674-490X.2021.03.007

Abstract （501）

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In order to deeply explore the academic thoughts,professional achievements,formation context and academic contribution of Yanzhao family of Traditional Chinese medicine,Professor GE Shaoqin,dean of school of Traditional Chinese Medicine of Hebei University,conducted academic exchanges and in-depth interviews with MENG Xiangjun,the inheritor of traditional Chinese medicine,on the inheritance context of Meng's traditional Chinese medicine,nine needle medicine and integrity innovation,and scientific nature of nine needle medicine,and put forward the idea of cooperation between folk doctors and universities the nine needle medical thought of research.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 41-49. DOI: 10.3969/j.issn.1674-490X.2021.03.008

Abstract （576）

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This paper discusses the origin and application method of the theory of the blood-Qi and the blood-Qi in the six Meridians combined with clinical practice.The theory of the number of blood-Qi in the six Meridians is a multi-level method of syndrome differentiation combining the differentiation of six Meridians and blood-Qi.The six Meridians Syndrome differentiation is beneficial to the accurate location of the disease from the anatomical point of view,and the blood-Qi Syndrome differentiation is beneficial to the accurate determination of the disease from the physiological point of view.The dynamic physiological changes and the characteristics of the six Meridians and the Qi can be reflected through the differentiation of blood-Qi.Yang produces the motion,Yin produces the matter.Through the local shape,quality and movement into the concept of blood-Qi,by the blood-Qi number,not only can the blood-Qi characteristics of the six Meridians be highlighted,but also the local microscopic blood-Qi changes can be inferred from this.Thus diseases can be analyzed from the pathological changes of blood-Qi,forming syndrome differentiation of the blood-Qi,reflect the microscopic level of physiological and pathological changes,as an important method of syndrome differentiation.The combination of six Meridians Syndrome differentiation and blood-Qi Syndrome differentiation can qualitatively locate the disease from multi-level and multi-angle,and can improve the rationality and accuracy of disease diagnosis and treatment.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 50-55. DOI: 10.3969/j.issn.1674-490X.2021.03.009

Abstract （363）

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To analyze the necessity of general hospital participating in hospice care service system and the functional orientation of general hospital and community health service center in regional hospice care service system,this paper reviews the exploration and practice of “1 + 11” hospice care service system in Putuo District from the perspective of tiered medical services.The effectiveness and necessity of the establishment of the service system are demonstrated through the preliminary effectiveness analysis, providing reference for the exploratory work of hospice care in other pilot areas.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 56-61. DOI: 10.3969/j.issn.1674-490X.2021.03.010

Abstract （300）

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Objective To investigate the subjective well-being status and influencing factors of elderly patients with myocardial infarction in the community and explore effective intervention measures.Methods A total of 110 elderly patients with myocardial infarction from May 2020 to February 2021 in a community in Luoyang City were selected as the research objects.The general information questionnaire and the overall well-being scale developed by the existing literature research were used to investigate the research objects.The status of their subjective well-being were examined and the influencing factors analyzed to provide nursing intervention measures.Results The overall subjective well-being scores of elderly patients with myocardial infarction in the community were lower than the Chinese norm.Male scores and female scores were lower than the Chinese norms of men and women(P<0.05).Gender,occupation,living environment,economic pressure,and complications were all influencing factors of the subjective well-being of elderly patients with myocardial infarction in the community(P<0.05).After Logistic multi-factor analysis,living with their children was a protective factor for the subjective well-being of elderly patients with myocardial infarction in the community.Poor conditions and comorbidities were risk factors for the subjective well-being of elderly patients with myocardial infarction in the community(P<0.05).Conclusion Community elderly patients with myocardial infarction have low subjective well-being.Gender,female,poor economic status,comorbidities,and farmers are all risk factors that affect their subjective well-being.Based on this,formulating the best nursing measures can improve the subjective well-being of elderly patients with myocardial infarction. The sense of happiness is conducive to the improvement of his condition.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 62-69. DOI: 10.3969/j.issn.1674-490X.2021.03.011

Abstract （1098）

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Objective To analyze the research hotspot, frontier and future development trends in the field of nursing psychology in the past six years, and provide reference suggestions for the development and application of related research in the field of nursing psychology.Methods Through the CNKI database, using “psychology” as the search term, retrieve the papers published in ten core nursing journals from 2015 to 2020, and use the CiteSpace visualization software to perform metrological analysis of authors, institutions, and keywords.Results A total of 2 341 papers on nursing psychology published in ten core nursing journals from 2015 to 2020 were included.The number of papers published in the past 6 years has shown a slight fluctuation trend.The publishing organizations are relatively concentrated, mostly from major universities, and there is little cooperation between authors.Key words such as qualitative research,quality of life, influencing factors, and have been the research hotspots of nursing psychology in the past six years, and ICU Nurses,psychological distress,psychological perplexity and mediation effect are the research frontiers.Conclusion Visualized analysis of nursing psychology papers published in core nursing journals in the past six years can help us to understand the research hotspot and frontier trends of nursing psychology related research, and promote the further development of nursing psychology research in teaching, clinical, and management levels.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (3): 70-80. DOI: 10.3969/j.issn.1674-490X.2021.03.012

Abstract （516）

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Objective To analyze the international research status of self-compassion in recent 11 years, so as to understand the research basis, hot spots and frontier of self-compassion related literature, help nursing and educators to enhance their understanding of self-compassion, and provide basis for further improving nursing and teaching concepts.Methods Using the core collection of web of science database as the platform, CiteSpace software was used to analyze the self compassion literatures collected from January 2010 to June 2020.Results A total of 1 677 articles were searched, and the number of published articles increased year by year.The research level of nursing and education should be improved, Classic literature on self compassion focuses on self compassion theory, intervention methods and scale research.The research focuses are self-compassion theory research, intervention measures and scale use.The future research frontier is randomized controlled trials of self-compassion measurement and interventionmethods in different types of people.Conclusion Self-compassion as a positive psychological quality, and its measurement and intervention are important ways to improve the level of individual mental health.In the future nursing and teaching work, we should pay attention to measuring the level of self-compassion of different groups, and formulate intervention strategies to improve the level of self-compassion as the core in nursing work and daily teaching, so as to enhance the quality of nursing and teaching.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (4): 1-7. DOI: 10.3969/j.issn.1674-490X.2021.04.001

Abstract （353）

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Objective To establish a mouse model of RA with hGPI325-339 and hGPI469-483 mixed peptides and observe the frequency and mature status of cDC in RA mice.Methods The frequency of cDC and the expression of CD80 and CD86 in spleen and lymph nodes of RA model mice were detected by flow cytometry.Results The frequency of cDC in spleen of RA mice was significantly lower than that of normal control group during the four stages of inflammation.The expression of CD80 was significantly higher than normal control group in the initial stage, peak stage and remission stage of inflammation, and was significantly lower than normal control group in the progressive stage of inflammation.The expression of CD86 was significantly higher than normal control group in all four stages of inflammation.The frequency of cDC in lymph nodes was significantly higher than normal control group in all four stages of inflammation.The expression of CD80 was significantly higher than normal control group at the initial stage of inflammation and lower than normal control group at other three stages.The expression of CD86 was significantly lower than normal control group in the initial, progressive and remission stages of inflammation, and higher than normal control group in the peak of inflammation.Conclusion The antigen presenting role of splenic cDC may be more important than that of lymph nodes in RA.The cDC maturity of spleen and lymph node in RA show a fluctuating phenomenon that increases at first and then decreases.

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Journal of Hebei Medical College for Continuing Education 2021, 38 (4): 8-17. DOI: 10.3969/j.issn.1674-490X.2021.04.002

Abstract （732）

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Coronary artery bifurcation lesions are common in coronary intervention. Due to the greatly individual differentiation of coronary artery bifurcation lesions, complex surgical procedures, high intraoperative risk, many postoperative complications, and poor long-term prognosis, a standard process is hard to follow to solve all bifurcation lesions. The classification rules, evaluation methods, and treatment strategies of coronary bifurcation lesions are systematically reviewed in order to get more comprehensively understanding of coronary bifurcation lesions.

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