Table of Content

25 August 2015, Volume 32 Issue 4

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Changes and clinical significance of carotid atherosclerosis and soluble intercellular adhesion molecules-1 in cerebral infarction patients with obstructive sleep apnea-hypopnea syndrome

ZHAO Huixin, ZHANG Xinghong, LI Weibin, WANG Chuhan, DI Weiying

2015, 32(4):  1-4.  DOI: 10.3969/j.issn.1674-490X.2015.04.001

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Objective To investigate the relationship between carotid atherosclerosis and soluble intercellular adhesion molecules-1（sICAM-1）in middle-aged and young patients of cerebral infarction（CI）with obstructive sleep apnea-hypopnea syndrome(OSAHS) . Methods 68 middle-aged and young patients of CI were divided into two groups according to whether with OSAHS，CI group （35）and CI with OSAHS group （33） . All patients were checked carotid artery through color doppler ultrasound and record intima-media thickness (IMT) .The serum sICAM-1 of all patients were assayed by means of double antibody sandwich method and enzyme linked immunosorbent assay (ELISA). Results The IMT in middle-aged and young patients of CI with OSAHS were (1.333±0.185)mm，significantly higher than that of CI group (P<0.01), the serum levels of sICAM-1 were also significantly higher than that of CI group. IMT were correlated positively with sICAM-1(P<0.01). Conclusion The IMT of carotid artery in middle-aged and young patients of CI with OSAHS are probably correlated with sICAM-1.

Clinical effect analysis of the Furongtongmai capsule in the treatment of diabetic peripheral neuropathy

JIANG Xu, WANG Yuansong, ZHANG Liying, YANG Jingchao, XING Lijun, ZHANG Ailing, SUN Wenliang

2015, 32(4):  5-9.  DOI: 10.3969/j.issn.1674-490X.2015.04.002

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Objective To investigate the clinical efficacy of Furongtongmai capsule in the treatment of diabetic peripheral neuropathy. Methods 97 cases of patients with diabetic peripheral neuropathy were diagnosed from January 2013 to January 2015, which were randomly divided into observation group(n=49)and control group(n=48). The control group were treated with western medicine treatment and the observation group were treated with Furongtongmai capsule on the basis of the treatment in the control group.Two sets of treatments were three months. A comparison of the clinical efficacy, symptom score before and after the treatment, TCSS score, nerve conduction velocity and Security in both groups were made. Results The total effective rate in the observation group was 83.67% and that in the control group ws 64.58%, there was a statistical significance(P<0.05); after the treatments, the symptom score and TCSS score in both groups were significantly better than that of the before treatment, and the symptom score and TCSS score in the observation group were significantly superior to that of the control group(P<0.05). There was no difference in bilateral peroneal nerve motor nerve and sensory nerve of transmission speed before the treatment(P>0.05). The NCV in both groups were significantly improved after the treatment(P>0.05), and the mend matters in the observation group were significantly superior to the control group(P<0.05). Conclusion The clinical efficacy of the Furongtongmai capsule combined with western medicine for nourishing the nerves and improving micro-circulation of conventional scheme is significant, which can significantly improve the clinical symptoms and neuropathy, it is worthy to be popularized and applied.

Clinical observation of Chinese medicine in treating thyroid nodule（52 cases）

ZHANG Caifeng, JIA Siyue, WANG Lingjuan, GONG Jianping, WU Lingqiao, YANG Jiuyi

2015, 32(4):  10-12.  DOI: 10.3969/j.issn.1674-490X.2015.04.003

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Objective To observe the clinical curative effect of Chinese medicine in treating thyroid nodule. Methods 52 patients with thyroid nodule admitted into hospital from January 2014 to June 2014, was given oral Chinese medicine. One dose a day, decocted with water, taken twice daily in the morning and evening. One curse of treatment lasted four weeks, and the patients were treated for 3 curse of treatment. Results After the treatment, the maximum diameter of the thyroid nodule was decreased (P＜0.05). 19 patients were cured, accounting for 36.54%. 25 patients were effectual treated, accounting for 48.08%. The treatment of 8 patients was invalid, accounting for 15.38%. Conclusion The curative effect of traditional Chinese medicine in the treatment of thyroid nodules is exact. It is safe and effective.

Observation on clinical effects of alpha hydroxy acid in the treatment of facial mild and moderate acne

FENG Min, QIE Yongtao, WANG Yanjun, ZHANG Weina

2015, 32(4):  13-16.  DOI: 10.3969/j.issn.1674-490X.2015.04.004

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Objective To investigate the clinical efficacy and safety of alpha hydroxy acid in the treatment of acne. Methods 64 cases of acne patients were randomly divided into treatment group and control group with 32 cases in each group. The patients in the treatment group were treated with alpha hydroxy acid four times of, once every other week. While Topical clindamycin and metronidazole liniment were given to the patients in control group twice a day lasting for eight weeks. The results of the two groups were comparied after treating for 10 weeks. Results The effective ratio of treating group was 84.4%, while that of the control group was 50.0%. The cure ratio of treating group was 43.8%, while control droup was 18.8%. The cure ratio and effective ratio of the treatment group and the control group were satistically significant. Conclusion Alpha hydroxy acid is an effective, safety and convenient method for mild to moderate acne vulgaris, which has higher satisfaction.

Clinical observation on anestheitic effects of propofol with different dosage of fentanyl for artificial abortion

NIE Jin, XIE Suyong, WANG Yifang, SHAO Wei

2015, 32(4):  17-19.  DOI: 10.3969/j.issn.1674-490X.2015.04.005

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Objective To observe the anesthetic effects and satety of the fentanyl and propofol in painless artificial abortion. Methods 120 cases with ASA Ⅰ-Ⅱ artificial abortion were randomly divided into two groups. Group A (60 cases) was anesthetized with fentanyl 1.0 μg/kg and group B (60 cases) was anesthetized with fentanyl 2.0 μg/kg. The changes of blood pressure, heart rate, breath rate and oxygen saturation were observed during the anesthesia. The dose of propofol, the time for recovery and leaving hospital and the incidence of abdominal pain after operation were recorded. Results Effective analgesia were induced in 2 groups. The results indicated that the effects in group A were better than that in group B, dosage of propofol decreased obviously, with quicker postoperative recovery, less adverse reactions and higher satisfaction (P<0.05). There was statistical significance between the 2 groups. Conclusion Suitable increasing the dose of fentanyl in painless abortion have some advantages of safety and effects, the results of 2.0 μg/kg is superior to that of 1.0 μg/kg.

Control study of Wujibaifeng pills and aripiprazole in the treatment of female schizophrenia patients with hyperprolactinemia split caused by risperidone

YU Liyan，DING Liang，LI Yuxin

2015, 32(4):  20-23.  DOI: 10.3969/j.issn.1674-490X.2015.04.006

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Objective To explore the efficacy and safety of Wujibaifeng pills and aripiprazole in the treatment of female hyperprolactinemia caused by risperidone. Methods 67 female schizophrenia patients with hyperprolactinemia caused by risperidone and aripiprazole were randomly assigned into Wujibaifeng pills group and aripiprazole group treated for 4 weeks. Results In Wujibaifeng pills group 28 cases were completed the treatment, in aripiprazole group 30 cases completed. In Wujibaifeng pills group, the serum prolactin was significantly lower than before treatment (t=7.624, P=0.000), serum prolactin in aripiprazole group was significantly lower than that before treatment (t=8.278, P=0.000). The serum prolactin levels in the two groups had no significant difference (t=1.965, P=0.054) .Conclusion Wujibaifeng pills and aripiprazole can reduce risperidone induced hyperprolactinemia level with good safety.

Analysis on the influencing factors of treatment outcome of systemic lupus erythematosus

ZHANG Hongjie, CHANG Jin, CHEN Meng, HUANG Shuaishuai, XU Minghua

2015, 32(4):  24-28.  DOI: 10.3969/j.issn.1674-490X.2015.04.007

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Objective To explore the influencing factors of treatment outcome of SLE. Methods Data about the patients with SLE was collected by copying the information from the medical records during 2010 to 2013 in a comprehensive hospital, and the influencing factors of treatment outcome of SLE were analyzed. Results 350 medical records were collected. Univariate analysis showed that patients with middle-and-old, positive C-reactive protein, C3 decreased, serious disease and relapsed patients had a poor outcome. Multivariate Logistic regression analysis showed that age and whether relapse were independent influencing factors of treatment outcome in patients with SLE, OR were 2.017 and 2.517 respectively. Conclusion The treatment outcome of elderly patients (≥45 years old) and relapsed patients was poor, and more attention should be given while clinical treatment.

Discussion on nursing the elderly patients with community acquired pneumonia

QI Xinrong, LI Jialin, WANG Ruxin, SU Hong, CHEN Xing, ZHANG Jiawei

2015, 32(4):  29-32.  DOI: 10.3969/j.issn.1674-490X.2015.04.008

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Objective To explore the clinical nursing care of elderly community acquired pneumonia in the elderly to improve the nursing level of community acquired pneumonia in the elderly patients. Methods 35 patients aged 80 and over community acquired pneumonia and nursing care of patients with clinical data were retrospectively analyzed. Results 32 cases were cured, 3 cases died, the length of hospital stay was 6 to 46 days. Conclusion Elderly community acquired pneumonia in patients with underlying disease are common, and the clinical symptoms are not typical but with dangerous condition. Care should be focused on management environment and diet managing clinostats. Environmental management, diet and position management, airway management, basic nursing, psychological nursing, prevention of hospital cross infection should be focused on. Besides, we should pay attention to the respiratory rate and blood pressure changes, disturbance of consciousness risk factors assessment, and carry out the implementation of scientific individualized holistic nursing care to promote the rehabilitation of patients.

Study on the mechanism of apoptosis and angiogenesis in promoting the development of fibrosis

QU Penghuan, SHI Jianhong

2015, 32(4):  33-37.  DOI: 10.3969/j.issn.1674-490X.2015.04.009

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Fibrosis is usually seen in the liver, lung, heart, kidney and skin. Apoptosis has been identified as a potential initiator and propagator of fibrosis. The occurrence of apoptosis has an important effect on fibroblast phenotype and collagen metabolism. Simultaneously, fibrosis in these models is generally preceded by robust angiogenesis and vascular regression, suggesting that the vascular apoptotic burden may be important to fibrotic outcomes. Angiogenesis inhibitors in the experimental research has shown good curative effect against liver fibrosis. This review considers the emerging evidence that angiogenesis or vascular regression contributes to fibrosis and identifies initial vascular outgrowth or vascular apoptotic cell presence as possible regulators of fibrosis.

Influence on medicinal plants secondary metabolites accumulation of nutritional factors

ZHANG Le, ZHU Hong, FANG Huiyong, ZHANG Chunhong, LI Minhui

2015, 32(4):  38-43.  DOI: 10.3969/j.issn.1674-490X.2015.04.010

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Plant secondary metabolites are non-essential compounds with the function of cell life activities and normal operation of growth and development, which are produced by secondary metabolism. The effective components of medicinal plant are usually the plant secondary metabolites. With the increase of medicinal plant market demand, wild plant reduced year by year, getting secondary metabolites from callus is the most effective way to solve the short supply situation. In this paper, through consulting the literatures at home and abroad in recent years, the nutritional factors on accumulation of secondary metabolites in medicinal plant callus are reviewed to provide a basis for further study and development.

The latest progress of treatment and reconstruction of energy metabolism in heart failure

LI Li，GUO Xintong， CUI Yan，REN Yali，MA Ning，LI Xinbao，NIU Pei

2015, 32(4):  44-49.  DOI: 10.3969/j.issn.1674-490X.2015.04.011

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Recently the reconstruction of energy metabolism has become a focus in researching the mechanism of heart failure. Reconstruction of energy metabolism is a series of complicated biochemical reactions including the transformation of energy substrates’ utilization, the abnormity of the mitochondria’s structure and function ,and changes of high-energy phosphates’ metabolism. During the further study of the complex reactions, we have found a new target and new direction for the treatment of heart failure.

The hard road to regenerating the human heart

JU Hailong，LIANG Lu，BIAN Jianfei，ZHANG Bing

2015, 32(4):  50-55.  DOI: 10.3969/j.issn.1674-490X.2015.04.012

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Regenerating the human heart is a challenge that has engaged researchers and clinicians around the globe for nearly a century. From the repair of the first septal defect in 1953, followed by the first successful heart transplant in 1967, and later to the first infusion of bone marrow-derived cells to the human myocardium in 2002, significant progress has been made in heart repair. However, chronic heart failure remains a leading pathological burden worldwide. Why has regenerating the human heart been such a challenge, and how close are we to achieve clinically relevant regeneration? Exciting progress has been made to establish cell transplantation techniques in recent years, and new preclinical studies in large animal models have shed light on the promises and challenges that lie ahead. In this review, we will discuss the history of cell therapy approaches and provide an overview of clinical trials using cell transplantation for heart regeneration. Focusing on the delivery of human stem cell derived cardiomyocytes, current experimental strategies in the field will be discussed as well as their clinical translation potential.

Study on depression and cognitive dysfunction after stroke

ZHANG Qincong, LI Huimin, LIU Xiyan

2015, 32(4):  56-60.  DOI: 10.3969/j.issn.1674-490X.2015.04.013

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Depression and cognitive dysfunction after stroke are the most common complications of stroke, both of them often are associated with each other . Some patients with PSD often appear in low spirits, lack of interest, sleep disorders, disuse and guilt feeling, other symptoms, and the severe patients may even commit suicide. Understanding the pathogenesis of PSD, the correlation of depression and cognitive dysfunction after stroke, taking early clinical intervention will speed up the patient's physical and mental rehabilitation and promote the improvement of quality of life. This paper focuses on discussing the correlation of depression and cognitive dysfunction after stoke which will provide the basis for clinical treatment and prognosis.

Discussion on Orem self-care theory in elderly patients with diabetes

LI Ying, JING Kunjuan

2015, 32(4):  61-65.  DOI: 10.3969/j.issn.1674-490X.2015.04.014

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Diabetes is a common disease in the elderly, which has increased more and more people’s attention in improving the self-care ability and quality of life of elderly patients with diabetes. Through 27 literatures review, this paper summarizes the application of Orem self-care in hospitalized and community elderly patients with diabetes, and puts forward some suggestions , aiming at providing a theoretical basis for elderly diabetes care and indicating the direction for future research.

Summary on the new research methods of attributive channel theory of Chinese herbal medicine

CHEN Ying, MA Xiaoli

2015, 32(4):  66-70.  DOI: 10.3969/j.issn.1674-490X.2015.04.015

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Attributive channel theory of Chinese herbal medicine is one of the important part of nature theory of drugs ,and it is one of the important theory to state the role of traditional Chinese medicine characteristics and guide clinical drug use. In this paper, we generality describe the history of attributive channel theory of Chinese herbal medicine, and expound the modern research methods ,new methods and the existing problems, this paper puts forward the ideas of using the study of pulse-taking to research attributive channel theory of Chinese herbal medicine to further deepen the research attributive channel theory of Chinese herbal medicine.

Application of training group in training junior nurses from department of internal medicine

YAN Xingna, WANG Yunmei, WU Limin

2015, 32(4):  71-75.  DOI: 10.3969/j.issn.1674-490X.2015.04.016

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Objective To investigate the application of training group in training junior nurses from department of internal medicine. Methods 118 cases of nurses working in the internal medicine less than 5 years were selected as the experimental subjects according to their departments to determine the training objectives and training content, all required target of nurses were qualified as the end of the training. The changes of critical thinking of the junior nurses before and after training, the changes of total points, the evaluation of the doctors and patients to the junior nurses in every job contents before and after training were compared. Results After training, the open-mindedness, seeking truth, systematization capacity, analytical skills, self-confidence, curiosity, maturity and the total score of CTDI-CV of junior nurses were significantly higher than that of before training, which showed statistical significance (P<0.05); the job satisfaction of the doctors and patients to the junior nurses was significantly higher than that of before training, which indicated statistical significance (P<0.05). The results indicated the facts that after training, the examined grade of the theoretical knowledge, professional skills, emergency coordination and communication skills were significantly higher than that of before training with statistical significance (P<0.05). Conclusion Establishing raining group mode in training junior nurses has contributed to the exertion of the various operation skills for the junior nurses, improving the nursing competence so as to avoid the disputes of medical treatment.

Science education and the cultivation of high-quality medical talents

KUANG Baoping, MIAO Lihua, ZHANG Chaohui, SHEN Xiaoyan, LI Yusheng, SUN Huizhe, ZHU Qiwen

2015, 32(4):  76-81.  DOI: 10.3969/j.issn.1674-490X.2015.04.017

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Objective To explore the important role of the reinforcement of the science subjects in medical colleges as to the cultivation of high-quality medical talents. Methods Through the on-the-spot and remote survey of the basic science education in different medical colleges and universities of higher learning in our country, the current status of the basic science education of medical colleges and universities in our country were summarized, and the influence of science marks on the general academic achievement of 787 students graduated from 2012 to 2013 in our medical colleges were statistically analyzed. The necessity to strengthening the basic science education of the medical students and the measures to be taken were discussed. Results The development of medical science resulted in the new requirements of the structure of knowledge for medical talents. The existing view of the basic science education and the curriculum system couldn’t completely meet the requirements of the training goal. Conclusion We must strengthen the basic science education of medical students; improve the methods of scientific thinking, creative ability and self-education ability of medical students so as to adapt to the 21st century needs for high quality medical talents.

Study on prevention and control in emergency of medical practice teaching

CHEN Chujie, PAN Huafeng, YAN Yan, YE Xiaoxian, REN Jinling, WANG Zheng, LAI Qiuhua

2015, 32(4):  82-85.  DOI: 10.3969/j.issn.1674-490X.2015.04.018

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This paper reviewed the current status of medical practice teaching and common clinical practice teaching of emergency in our country and probed into the main causes of emergency in the teaching process. From the perspective of universities, the clinical practice teaching standards need to be refined and practice supervision needs to be strengthened. From teachers’ aspect, they need to intensify their responsibilities. From students’ level, strengthening service consciousness and humanism care education and other measures could be used in emergency prevention and control.

Analysis of medical students’ intention on bilingual education in internal medicine

ZHANG Mingchen, CHEN Wei, ZENG Xiaoyun, NA Lima, DU Guoli, QUAN Li, ZHUN Jun

2015, 32(4):  86-90.  DOI: 10.3969/j.issn.1674-490X.2015.04.019

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Objective To obtain satisfactory effect of bilingual teaching, the third grade medical students in Xinjiang Medical University were surveyed on their cognitive demands of internal medical bilingual teaching. Methods A cross-sectional survey was conducted in 190 clinical medical students with questionnaire. Results More than 80% medical students had reached or exceeded the four level national English test, but only 10.05% of them occasionally read professional English. Meanwhile 25.14% students could understand more than 50% professional English, 39.10% students only could understand less than 30% professional English. 70.29% students supported to carry out bilingual teaching in internal medicine. The main factors affecting the bilingual teaching were: (1) the English level of the students (83.18%); (2) the teachers teaching quality (78.64%); (3) teachers teaching mode and methods accounted for 57.23%. Conclusion Improving medical English levels of medical students and cultivating bilingual teaching quality are the dominant factors for promoting bilingual education of medical students.

Survey on health management courses and attitudes of students majoring in general medicine

WANG Qiao, LIU Zaoling, SUN Yong, YAO Hua

2015, 32(4):  91-94.  DOI: 10.3969/j.issn.1674-490X.2015.04.020

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Objective To understand the general practitioner students demand for health management courses and attitude to provide basis for health management science curriculum reform. Methods Census questionnaire investigation on “health management” opened the first time was conducted in students of grade 2010 majoring in clinical medicine in Clinical Medical College of Xinjiang Medical University (general practitioner). Results At present, only 29.30% of the students said that they could understand health management related contents; Health management course content setting was more reasonable, in the teaching process, there were 34.70% of the students were not satisfied with the current approaches of teaching, mainly in the aspect of practice teaching. The vast majority of students believed that health management courses were helpful to the development of the future work and personal Conclusion To strengthen student's understanding of health management and optimization of health management of teaching content, based on the current practice teaching methods, we should further improve the practice teaching methods, increase the proportion of the field practiceso as to improve students’ interest in learning and realize the concept of “students-centered” to promote the all-round development of students.

Influence of budget emphasis, equity fairness perception and incentives on physicians’ job performance

LIU Xia

2015, 32(4):  95-101.  DOI: 10.3969/j.issn.1674-490X.2015.04.021

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Based on contingency theory and mediating effects, this study aims to explain how incentives improve physicians’ job performance and modify. The results showed the facts that: financial and nonfinancial incentives positively affect physicians’ job performance at a significance level, which cannot be accounted for by the mediating effects of equity fairness perceptions. The positive effects of nonfinancial incentives on equity fairness perceptions is much more evident with high budget emphasis. The positive effects of equity fairness perceptions on physicians’ job performance are also more evident with high budget emphasis

Practice and results of clinic nursing performance resolution

WANG Yan, TAN Qiming

2015, 32(4):  102-106.  DOI: 10.3969/j.issn.1674-490X.2015.04.022

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Objective To improve the enthusiasm of nursing in work and prompte nursing service by all means. Methods By investigating and allocating different nursing jobs, according to different sections and different jobs in pediatrics, we divided nursing performance into five modules, （special position bonus, minimum performance bonus, position index and job performance）, which reflect excellent merit pay, equity and justice. We could do prefer the good ones by summarizing the total performance at the end of year. Results During the evolution progress, the differences of performance bonus became smaller, the bonus level of low-income nurses increased distinctly, the satisfactory of nurses improved significantly, the responsibility enhanced and the adverse events decrease, severe defects decreased significantly. Conclusion The allocation of performance preferred to the high risk and high difficult jobs, which could lower nursing risk and heighten nurses’ satisfaction; the revolution reflects the equity, publicity and justice, which can prompts superior nursing, strengthen continuing learning and improve comprehensive quality.