Journal of Hebei Medical College for Continuing Education

Establishment of nanovaccines for dual-delivery of antigens and CpG nucleic acid

LI Zhenhua, YIN Xuan, WANG Yelian, ZHAO Baocheng, DUAN Fei

2016, 33(4): 1-6. DOI: 10.3969/j.issn.1674-490X.2016.04.001

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Objective To establish effective nonvaccines to solve the problems of low internalized efficiency by antigen presenting cell, low immune activity and easy to be degraded in vivo. Methods Mesoporous silica nanoparticles(MSN)were chosen as the core for antigens(ovalbumin, OVA)loading. Then metal organic frameworks(MOFs)formed by Eu³⁺ and guanine nucleotide(GMP)were coated on the surface of MSN. After adsorption of CpG oligonucleotides, we constructed pH-responsive nanovaccines for dual-delivery of antigens and CpG. Results The loading capability of mesoporous silica was 20%, and the release rate of antigens could reach to 55% after incubation for 24 h under acidic conditions. The results of transmission electron microscope indicated that MOFs were coated on the surface of MSN, the loading capability of nanocarriers for CpG was 1.8×10^-6 mol of nucleic acid per mg of nanoparticles,nanocarriers showed low cytotoxicity analyzed by MTT. Conclusion A novel nanovaccine is constructed and the introduction of MOFs can protect the antigens from degradation and enhance the adsorption rate of nanocarriers. Furthermore, antigens can be released under acidic conditions, which can enhance the immune response in the future.

Clinical observation of treating canaliculus laceration with consequent lacrimal intubation

CHEN Guang,LU Yanjun,LI Dan,PENG Xinming,CHEN Jianying

2016, 33(4): 7-10. DOI: 10.3969/j.issn.1674-490X.2016.04.002

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Objective To investigate and discuss the safety and effectiveness of consequent lacrimal intubation on the treatment of canaliculus laceration. Methods In this retrospective cases series,patients with traumatic canaliculus laceration were treated with lacrimal canalicular anastomosis combined with consequent lacrimal intubation in Affiliated Hospital of Hebei University from October,2011 to August,2014,whose medical records and follow-up datas were collected.The safety of the wearing tube was evaluated according to the tolerance and complications of the patients during the follow-up.Effectiveness was evaluated according to the symptoms and syphilis of lacrimal passages at 6 months after tube removal. Results A total of 84 complete medical records and follow-up datas were collected.Severe complications were not found during the follow-up.The cure rate of the operation was 96.43%(81/84)at 6 months after tube removal. Conclusion Consequent lacrimal intubation is an effective and nontraumatizing procedure in the lacrimal canalicular anastomosis.

Health economic evaluation of two treatment modalities for femoral shaft fractures in adults

LI Yawei,TIAN Yue

2016, 33(4): 11-16. DOI: 10.3969/j.issn.1674-490X.2016.04.003

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Objective To compare the advantages of minimally invasive percutaneous internal fixation of plate versus interlocking intramedullary nail for femoral shaft fractures in adults from the point of health economics，providing a rationale for treating femoral shaft fractures.Methods Seventy adult patients with freshly closed femoral shaft fractures（AO classification：A to B type） who were admitted to No.2 Hospital of Baoding between January 2014 and March 2015 were selected in a retrospective，matching(1:1) and controlled manner.Based on different surgical procedures，patients who received minimally invasive percutaneous plate fixation and interlocking intramedullary nail internal fixation were assigned to the MIPPO group and the intramedullary nail group respectively.Those patients enrolled were recorded in Excel regarding health (total incision length，operation time，intraoperative blood loss，postoperative hospital stay，union time and complications) and economic parameters (postoperative hospitalization expenses and rates of returning to work at 6 and 12 months postoperatively).Differences in intergroup data were compared with SPSS 20.0. Results (Ⅰ) Completion of cases:The patients enrolled were followed up for (12-25) months;four patients were excluded from the MIPPO group and three the intramedullary nail group，respectively.(Ⅱ) Comparison of health parameters:Both groups showed comparative clinical response rate (93.55% vs 90.63%)，incidence of complications，total incision length，and postoperative hospital stays (all P＞0.05).the MIPPO group showed shorter operation time，lower intraoperative blood loss and faster union than the intramedullary nail group (P＜0.05).(Ⅲ) Comparison of economic parameters:The MIPPO group had a higher rate of returning to work at 6 months than the intramedullary nail group (61.29% vs 40.63%，P＜0.05).Both groups showed comparative postoperative hospitalization expenses and rate of returning to work at 12 months (P＞0.05). Conclusion Both minimally invasive percutaneous internal fixations of plate and interlocking intramedullary nail can effectively treat adult patients with freshly closed femoral shaft fractures（A to B type）,minimally invasive percutaneous plate fixation is characterized by less bleeding，short operation time，fast union and a high rate of early returning to work.

“Yinyang and Wuxing” theory in traditional Chinese medicine on the point of biomedical research

CHEN Song

2016, 33(4): 17-23. DOI: 10.3969/j.issn.1674-490X.2016.04.004

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“Yinyang and Wuxing” theories are the characteristics of Traditional Chinese Medicine(TCM), however, they are also the major hindrances impeding people to understand and accept TCM. Actually, "Yinyang" theory had been widely adopted to describe the positive and negative feedack mechanisms in biomedical research. In this paper, the author proposed that the “Wuxing theory” may also be explained using scientific language. If we looked “Wuxing” in TCM theory as five most fundamental and primary functions, instead of internal organs, we could understand TCM theory better on the point of modern sciences. Movever, "Yinyang and Wuxing” theory may help researchers to understand the essential pathogenesis of disease better, and prompt the modern medical research development to an integral direction.

Analysis on traditional Chinese medicine’s syndrome differentiation and medication rule of postoperative carcinoma of colon based on medical records data

LIU Jingwei, LI Yuan, ZHAO Yongchen,QI Xiangmei,CHEN Huangzhen

2016, 33(4): 24-30. DOI: 10.3969/j.issn.1674-490X.2016.04.005

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Objective Through the analysis of related medical records for treatment of postoperative colorectal carcinoma to explore the rules of TCM syndrome differentiation and medication of postoperative colorectal cancer. Methods Screening of Chinese medicine treatment of postoperative colorectal carcinoma cases, and then inputing syndrome differentiation and medication one by one with the method of software integration to data mining. Analysis of syndrome differentiation and medication rules were selected. Results Through the analysis of 105 cases to determine the basis often witness type, the main treatment, commonly used traditional Chinese medicine(TCM)occurrence frequency, and the association rules between drugs, the type was mainly spleen and stomach qi deficiency syndrome, intestinal stagnation syndrome, spleen and kidney deficiency syndrome, commonly used for strengthening spleen and supplementing qi, blood stasis, tonifying kidney, digging out 47 core compatibility and 9 new prescription. Conclusion Chinese medicine treatment of postoperative colorectal carcinoma has certain regularity, mining from the traditional Chinese medicine medical records of postoperative colorectal carcinoma has certain directive significance to the clinical research.

Clinical observations on the curative effects of patients with post-stroke depression treated with traditional Chinese medicine combined emotional care with ear pressure beans

LIU Juan,YANG Xincai,HOU Yanxue,SHI Cuixia,LIU Xiyan

2016, 33(4): 31-34. DOI: 10.3969/j.issn.1674-490X.2016.04.006

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Objective To investigate the efficacy of traditional Chinese medicine combined emotional care with ear pressure beans in treating depression after stroke. Methods 80 patients with depression after stroke were randomly divided into treatment group and control group, 40 cases in each group. The control group was treated with antidepressant drugs and rehabilitation therapy. The experimental group was given traditional Chinese medicine combined emotional care with ear pressure beans except the therapy applied as that of the control group,the course of treatment was 8 weeks. The effects before and after the intervention were evaluated with the Hamilton Depression Scale(HAMD)and Zung Self-Rating Depression Scale(SDS)score. Results Both HAMD score and SDS score of the two groups after treatment were decreased compared with that before treatment, and the results of the treatment group were decreased more significantly compared with that of the control group. Conclusion Traditional Chinese medicine combined emotional care with ear pressure beans therapy has obvious therapeutic effects on depression after stroke.

Soft contact lenses before surgery indwelling ureteral home management during double J tube

PAN Xiumin,LI Hongmei,GAO Yanjun,ZHOU Bin,LI Yue

2016, 33(4): 35-37. DOI: 10.3969/j.issn.1674-490X.2016.04.007

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Objective To provide nursing intervention for the patients at home undergoing flexible ureteroscope who are indwelling double J tube. Methods We evaluated patients and provided health education for them before and after departuring from the hospital by setting up a professional team and establishing archives of management, so that we could master their medical behavior and implement standard home management for them. Results The patients recuperating at home could receive the same care management as hospitalization, so we could ensure the safety of them. Conclusion We can make up for the lack of care of patients during recuperation at home, and ensure that the patients can undergo surgery as expected.

Application of pathway management mode to caring for disabled elders in old-age care institutions

DU Xiaojing,JING Kunjuan,WANG Yan,SONG Hongxia,LYU Yajing

2016, 33(4): 38-41. DOI: 10.3969/j.issn.1674-490X.2016.04.008

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Objective To study the effects of pathway management mode applied to caring for disabled elders in old-age care institutions. Methods 60 elders were selected from old-age care institutions, who have been cared according to the pathway management map for 6 months. After intervention, the effects were compared with that before the treatment. The observational indexes were the status of emotion and nutrition, and the degree of satisfaction. Results After caring for 6 months, the elders' scores of GDS and HAMA were lower than that before intervention. The status of skin and nutrition were better, and their degree of satisfaction was enhanced compared with before. These results indicated there was a statistical significance(P<0.05). Conclusion Caring disabled elders by pathway management mode which was the best care to them can improve those status of motion, skin, and nutrition, enhance those degree of satisfaction and advance the quality of care and management level in old-age care institutions.

Application of the bundle care in PICC tube

ZHANG Nan,ZHANG Chunfang,ZHOU Jinna

2016, 33(4): 42-46. DOI: 10.3969/j.issn.1674-490X.2016.04.009

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Peripherally inserted central catheter(PICC)is currently widely used in clinical practice,although it provides a safe venous access for patients,it also has the risk of different kinds of complications.Through analysis and summary of the previous studies,the authors review the clinical application of PICC,PICC catheter complications,PICC catheter problems that exist,cluster nursing advantages of PICC,in order to provide the better guiding for use of PICC in patients.

The double-edged sword in the pathogenesis of T1D—iNKT cells

LIU Shaochuan,LOU Yongfu,HU Hongpeng,YANG Fei,MENG Ming

2016, 33(4): 47-51. DOI: 10.3969/j.issn.1674-490X.2016.04.010

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Type 1 diabetes(Type 1 diabetes,T1D)is a disorder caused by immune,genetic and environmental factors.Due to the dysfunction of the immune system and regulation of abnormal,impaired islet beta cells,leading to the lack of insulin,glucose metabolism disorders.Invariant nature killer T(iNKT)cells are a kind of special T cell subsets in adaptive immunity and innate immunity.In recent years iNKT cells is closely related to the pathogenesis of T1D,but many reports disagree,this review aims to elaborate the research progress in this field.

The pathogenesis of perioperative hyperglycemia and research progress

WANG Chunliang,ZHANG Le,ZHAO Haige,WANG Hongjie

2016, 33(4): 52-56. DOI: 10.3969/j.issn.1674-490X.2016.04.011

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Stress hyperglycemia is a matabolic reaction when the body come across severe trauma、anesthesia、operation and other stress in perioperative.It is also considered an important factor of perioperative complication and death.The mechanism is related to increase counter hormone,release of cytokines and insulin resistance.Because of the mechanism of perioperative hyperglycemia,we discuss the regulation of blood glucose from anesthesia and intensive insulin therapy.The management of stress hyperglycemia should be individualized,it is important to control blood sugar stable.

Research progress on Orem theory of self-care in the aged patient with chronic disease

LI Chaoqun,JING Kunjuan

2016, 33(4): 57-61. DOI: 10.3969/j.issn.1674-490X.2016.04.012

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Orem self-care theory has been widely applied in the care of elderly with chronic diseases.With a review of the related papers,authors summarize the application of self-care ability measurement tools,the factors influencing self-care ability in elderly with chronic diseases,the effects of applying Orem self-care theory in different care places,and put forward one’s own suggestions.

Application of belended teaching in nuclear medicine education

LI Xiaodong,CAO Yanxia,ZHENG Xiaomeng,FAN Ruyi

2016, 33(4): 62-65. DOI: 10.3969/j.issn.1674-490X.2016.04.013

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Objective To improve the medical students' interesting in learning nuclear medicine and its clinical application. Methods The traditional teaching method was applied in the students in grade of 2013 and the new teaching method was used in the students in grade of 2014,by the end of the semester,the theory test and the actual case of the assessment and the students' satisfaction survey were evaluated in the two grade students. Results In the theory test there was no significant difference between the two grades(t=0.91,P>0.1).The ability of solving clinical case of the experimental group of 2014 was significantly higher than that of students in the grade of the 2013(t=4.65,P<0.05),and there was significant difference between the two grades concerning with he satisfaction degree(t=3.43,P<0.05). Conclusion The results indicate that reduce the number of theory courses and increase the number of training courses and applying PBL and other teaching methods in the training courses can improve the students' ability to solve clinical problems and improve students' initiative in learning nuclear medicine.

Application of PBL combined with MDT in clinical teaching of bone tumor

ZHOU Yang,ZHANG Zhen,LIU Zhiyun

2016, 33(4): 66-70. DOI: 10.3969/j.issn.1674-490X.2016.04.014

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Objective To explore the teaching effects of application of PBL combined with MDT(multidiciplinary treatment,MDT)pattern in clinical teaching of bone tumor. Methods 75 Medical imaging specialty students who were in Affiliated Tumor Hospital of Xinjiang Medical University performing bone tumor clinical practice were selected.Then they were divided into control group(the traditional teaching group,LBL group)and experimental group(PBL+MDT group)according to their classes.Each group received training of clinical bone tumor respectively according to the corresponding teaching method.The teaching effects and students' satisfaction about teaching in the two groups were compared. Results(1)The theoretical test results in PBL+MDT group did not significantly differ from those in the control group(43.13±4.12 vs 42.76±3.05,P>0.05).However,the experimental group significantly outperformed the control group in score of comprehensive case analysis(40.28±3.52 vs 36.13±2.88,P<0.05).(2)Investigation and analysis showed that the students in the experimental group had significantly greater satisfaction than those in the control group in terms of classroom atmosphere,self-learning ability,language competence,oral communication skill and self-confidence(P<0.05). Conclusion PBL combined with MDT pattern applied in clinical teaching of bone tumor has good effects,and it suits the modern concept of medical education.Therefore,it is worth popularizing in clinical teaching of bone tumor.

Exploration and practice of a blending teaching model of Biochemistry and Molecular Biology in English

WANG Ting,CHEN Lixiang,KANG Qiaozhen,LIU Xin,QI Yuanming

2016, 33(4): 71-74. DOI: 10.3969/j.issn.1674-490X.2016.04.015

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Cellular and Molecular Immunology is an essential major course for the specialties of Biology and Medicine,which is a very fast-growing interdisciplinary frontier research fields.Through practice of teaching Biochemistry and Molecular Biology in English,we have explored all aspects of the reform of English teaching and established an innovative blending teaching mode.The innovation measures include construction of teaching teams,selection of original textbook,teaching methods and assessment mode.These innovations not only enrich the course and diversify the evaluation system,but also inspire students’interest in Immunology and provide more opportunities to foster their comprehensive ability and scientific literacy.Characteristic full English blending teaching mode has improved the teaching quality,obtained good teaching effects,and become one of important way for talents training with higher education internationalization.

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