Risk factors for and the prediction of cognitive dysfunction early after a stroke in some hospital of Qinghai Province / 中华物理医学与康复杂志

Objective:To explore the local prevalence of early cognitive dysfunction after a stroke in some hospital of Qinghai province, analyze its risk factors and construct a risk factor model.Methods:A prospective cross-sectional survey was conducted among 854 stroke patients at 3 hospitals in Qinghai Province. The survey solicited demographic data, clinical data, and information about the respondents′ diet and leisure activities. Within 14 days after stroke onset, all of the participants′ cognitive performance was quantified using the Mini-Mental State Examination (MMSE). Those with scores ≤27 formed the cognitive impairment group ( n=569), while the rest were the normal cognition group ( n=285). Through univariate analysis and multivariate logistic regression analysis, the relationship between each factor and the outcome was clarified, and a prediction model was established in the form of a regression equation. The model′s receiver operating characteristics (ROC) curve was computed. Results:The incidence of acute cognitive impairment after stroke was 66.6%. Univariate analysis showed that there were significant differences between the two group in terms of age, sex, ethnicity, education, occupation, altitude, living with a spouse and social support. Stroke type, hemiplegia, a history of hypertension, and triglyceride and D-2 polymer levels were significant predictors, as were ADL score, leisure activity level, and weekly consumption of fruits, nuts and salt. The multivariate logistic regression analysis showed that age, being female, hemorrhagic stroke, hypertension, and living at high altitude were independent risk factors for cognitive impairment at the acute stage of stroke. However, education, occupation, leisure activity and consumption of triglycerides and nuts were independent protective factors. The prediction model showed an area under the ROC curve of 0.832, with sensitivity of 0.698 and specificity of 0.814.Conclusions:The prevalence of cognitive dysfunction in the acute stage of stroke is high in some hospital of Qinghai province. Age, being female, hemorrhagic stroke, hypertension and high altitude living are independent risk factors for stroke, while education, an occupation, leisure activity and triglyceride and nut consumption are protective factors. The risk factor model established in this study has good predictive ability with this population, with whom it can be used to formulate interventions to improve the life quality of stroke survivors.

Correlation between peak viral load and liver function damage in children with infectious mononucleosis induced by Epstein-Barr virus / 中国基层医药

Objective:To investigate the relationship between the peak load of Epstein-Barr virus (EPV) and live function damage in children with infectious mononucleosis caused by EPV.Methods:Eighty children with infectious mononucleosis caused by EPV who received treatment in Pingxiang People's Hospital from January 2018 to December 2021 were included in this study. Five mL of venous blood was taken from each child for detecting the peak load of EBV-DNA and liver function indicators. These children were divided into a low-load group ( n = 25, EBV-DNA load < 10 4 copies/mL), a medium-load group ( n = 34, EBV-DNA load of 10 4-10 5 copies/mL), and a high-load group ( n = 21, EBV-DNA load > 10 5 copies/mL) according to the peak EBV-DNA load. The relationships between different peak loads of EBV-DNA and live function, age, and sex were analyzed. Results:The rate of liver dysfunction in the high-load group [85.71% (18/21)] was significantly higher than [38.24% (13/34)] in the medium-load group and [20.00% (5/25)] in the low-load group ( χ2 = 11.90, 19.71, P = 0.001, P < 0.001). Alanine aminotransferase and aspartate aminotransferase levels in the high-load group were (156.24 ± 13.21) U/L and (171.69 ± 13.49) U/L, respectively, which were significantly higher than (125.89 ± 10.54) U/L and (143.26 ± 10.29) U/L in the medium-load group and (89.64 ± 6.75) U/L and (64.89 ± 5.74) U/L] in the low-load group (all P < 0.001). There was no significant difference in the peak load of EBV-DNA between children of different ages and between children of different sexes (both P > 0.05). Conclusion:Children with infectious mononucleosis caused by EPV have a high EBV-DNA peak load. A higher peak load of EVB-DNA indicates a higher risk of liver function damage. More attention should be paid in clinical practice. Effective diagnosis and treatment should be performed in time to control the patient's condition as early as possible.

Processing evolution and modern research progress of Artemisia argyi / 中国药房

Artemisia argyi is the leaves of compositae plants of A. argyi Lévl. et Vant.， which is a traditional Chinese medicine commonly used in China. The analysis was carried out by consulting traditional medical classics， modern standard norms and literature， and using Cytoscape software to sort out and visualize the evolution of the processing and the efficacy of processed products. The processing of A. argyi was first made in the Han dynasty and was popular in the Song and Ming dynasties. There were many processing methods in ancient times， including net processing， cutting， frying， processing with auxiliary material （vinegar， wine， salt， charcoal， rice water， sulfur， medicinal juice， jujube mud processing） and other processing methods （baking， winching， making herbs into wool）. Modern common processing methods included purification， vinegar processing， charcoal processing and making herbs into wool， which are relatively simple compared with ancient processing methods. There were obvious differences in the efficacy and application of raw and processed products of A. argyi. Although the processing effects of A. argyi in ancient and modern times were mainly to reduce toxic side effects and enhance the effects of warming meridians and hemostasis， only the purified A. argyi， vinegar-processed A. argyi and vinegar-processed A. argyi charcoal could be seen in the present studies， other processed products had not been inherited and studied， and the processing mechanism was still unclear. It is suggested that in the later exploration and research， researchers can establish a multi-dimensional standard research system based on the characteristics of the medicinal plant A. argyi and the processing characteristics of A. argyi decoction pieces in order to systematically explore the transformation rules before and after processing， and clearly explain the scientific connotation.

Mortality and potential years of life lost of major kidney diseases among residents in Wuhan in 2014 -2019 / 公共卫生与预防医学

Objective To investigate the epidemiological characteristics of major kidney disease deaths and the potential years of life lost among residents in Wuhan from 2014 to 2019, and to provide a scientific basis for the prevention and treatment of kidney diseases. Methods The major kidney diseases deaths among residents in Wuhan during 2014-2019 were collected from the population-based Mortality Surveillance System. The standardized mortality rate and potential years of life lost rate (PYLLR) of major kidney diseases among residents in different ages and genders were calculated, and the epidemiological characteristics and trends were analyzed. Results There were 4 100 deaths (2 380 in male and 1 720 in female) from major kidney diseases among residents in Wuhan between 2014 to 2019, with an age-standardized mortality rate of 6.22/100 000. The mortality rate of major kidney diseases showed an upward trend with the increasing age groups. The age-standardized mortality rate and the age-standardized potential years of life lost rate (SPYLLR) in glomerular disease and tubulo-interstitial diseases were significantly decreased (P＜0.05). The age-standardized mortality rate of the kidney failure was significantly increased (P＜0.05), especially in the male (APC=25.10% , P＜0.05). Conclusion From 2014 to 2019, there was no significant change in the overall mortality rate of major kidney diseases among residents in Wuhan. The death burden and disease burden of glomerular diseases and tubulo-interstitial diseases were significantly decreased, while the mortality rate of male kidney failure was significantly increased, indicating the need for targeted prevention and treatment of kidney diseases.

Effect of ultra-early postoperative rehabilitation on hospital stay, complications and cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage: a meta-analysis / 国际脑血管病杂志

Objective:To conduct a meta-analysis for the effects of ultra-early postoperative rehabilitation on hospital stay, complications and vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods:PubMed, Embase, Cochrane Library, WOS, CNKI, CBM and Wanfang databases were searched by computers to collect control studies on ultra-early rehabilitation of aSAH. The retrieval time limit was from the establishment of the databases to August 2021. The methodological quality of the included literature was evaluated according to Cochrane Handbook Systematic Reviews Interventions, and the Revman 5.2 software was used for meta-analysis.Results:A total of 5 articles were obtained, with a total of 413 patients. The methodological quality of the 5 studies was lower (grade C). The results of the meta-analysis showed that the average length of stay in the intervention group (mean difference –4.14, 95% confidence interval [ CI] –10.69-2.42; P=0.22] and the incidence of complications (odds ratio 0.86, 95% CI 0.40-1.83; P=0.70) were lower than those in the control group, but there was no significant difference. The incidence of cerebral vasospasm in the intervention group was lower than that in the control group, and there was significant difference (odds ratio 0.31, 95% CI 0.18-0.53; P<0.001). Conclusions:Postoperative ultra-early rehabilitation in patients with aSAH can reduce the incidence of cerebral vasospasm without increasing the incidence of complications. Therefore, the ultra-early rehabilitation can be considered. The methodological quality of the literature included in this study is lower, and high-quality randomized controlled trials are needed to further verify the effects of ultra-early rehabilitation on hospital stay, complications, and cerebral vasospasm.

Inhibiting silence information regulator 2 and glutaminase in the amygdala can improve social behavior in autistic rats / 浙江大学学报·医学版

OBJECTIVE@#To investigate the underlying molecular mechanisms by which silence information regulator (SIRT) 2 and glutaminase (GLS) in the amygdala regulate social behaviors in autistic rats.@*METHODS@#Rat models of autism were established by maternal sodium valproic acid (VPA) exposure in wild-type rats and SIRT2-knockout ( SIRT2 -/-) rats. Glutamate (Glu) content, brain weight, and expression levels of SIRT2, GLS proteins and apoptosis-associated proteins in rat amygdala at different developmental stages were examined, and the social behaviors of VPA rats were assessed by a three-chamber test. Then, lentiviral overexpression or interference vectors of GLS were injected into the amygdala of VPA rats. Brain weight, Glu content and expression level of GLS protein were measured, and the social behaviors assessed.@*RESULTS@#Brain weight, amygdala Glu content and the levels of SIRT2, GLS protein and pro-apoptotic protein caspase-3 in the amygdala were increased in VPA rats, while the level of anti-apoptotic protein Bcl-2 was decreased (all P<0.01). Compared with the wild-type rats, SIRT2 -/- rats displayed decreased expression of SIRT2 and GLS proteins in the amygdala, reduced Glu content, and improved social dysfunction (all P<0.01). Overexpression of GLS increased brain weight and Glu content, and aggravated social dysfunction in VPA rats (all P<0.01). Knockdown of GLS decreased brain weight and Glu content, and improved social dysfunction in VPA rats (all P<0.01).@*CONCLUSIONS@#The glutamate circulatory system in the amygdala of VPA induced autistic rats is abnormal. This is associated with the upregulation of SIRT2 expression and its induced increase of GLS production; knocking out SIRT2 gene or inhibiting the expression of GLS is helpful in maintaining the balanced glutamate cycle and in improving the social behavior disorder of rats.

Association between air pollution and death from respiratory diseases in Wuhan from 2014 to 2019 / 上海预防医学

ObjectiveTo determine the association between air pollutants （PM2.5， PM10， SO2， NO2） and death from respiratory diseases in Wuhan. MethodsDaily air pollutants， meteorological data and mortality from respiratory disease between 2014 and 2019 were collected for a descriptive analysis. A time series semi-parametric generalized additive model （GAM） was used to determine the exposure-effect relationship between atmospheric pollutants and daily mortality from respiratory diseases，and the excess risk （ER） was used to quantify the effects of air pollutants on death from respiratory diseases. ResultsThere was significant effect of PM2.5， PM10， SO2 and NO2 on respiratory diseases mortality. In the period with strongest effect， the ER of death from respiratory diseases were 2.803%（95%CI：2.151%‒3.460%）， 1.878%（95%CI：1.477%‒2.281%）， 10.210%（95%CI：7.922%‒12.549%）， 4.564%（95%CI：3.530%‒5.608%）， along with an incremental 10 μg·m-3 of PM2.5，PM10，SO2 and NO2， respectively. Furthermore， females were more sensitive to PM2.5， SO2 and NO2， while males were more sensitive to PM10. Residents aged less than 65 years were more sensitive to PM2.5 and NO2， and those older than 65 years were more sensitive to PM10 and SO2. ConclusionAir pollutants （PM2.5， PM10， SO2， and NO2） in Wuhan are associated with the death from respiratory diseases. Therefore， at-risk groups should be considered for formulating local policies against air pollution.

Analysis of cognitive dysfunction and its influencing factors in elderly inpatients in Qinghai / 中华老年医学杂志

Objective:To evaluate the cognitive function of elderly inpatients in Qinghai and analyze the influencing factors in this prospective study.Methods:A total of 1077 elderly inpatients were enrolled for general information investigation, including the Mini Nutritional Assessment-Short form(MNA-SF), Geriatric Depression Scale 15(GDS-15), FRAIL Scale, activities of daily living(ADL), instrumental ability of daily living(IADL)and the Mini-Mental State Examination(MMSE).Results:The 1077 elderly inpatients being subjected in this study, included 470 in the cognitive impairment(CI)group and 607 in the normal group.The prevalence of CI in hospitalized elderly patients was 43.64%(470/1077). The results of univariate analysis showed that as compared with the normal group, the proportion of cognitive impairment was higher in female, elder patients, and boiling tea-drinker, otherwise the proportion of CI was lower in patients living with the spouse, normal sleep, often eating beef and mutton( P<0.01 or P<0.05); FRAIL Scale, ADL total score, and IADL total score were higher in the normal group than in the CI group( P<0.01); the elderly depression score and frailty score were higher in the CI group than in the normal group( P<0.01). The results of logistic regression analysis showed that the risk of CI was higher in female and people frequently drinking boiling tea than in male and people not frequently drinking boiling tea( OR=0.740, 1.211, both P<0.05), and that frequent consumption of beef and mutton, and reasonable levels of nutrition, ADL, and IADL were protective factors for CI in elderly hospitalized patients( OR=0.780, 0.938, 0.956, 0.895, all P<0.05). Conclusions:The incidence of cognitive impairment in hospitalized elderly patients in Qinghai is relatively high.Female and often drinking boiling tea may increase the risk of cognitive impairment.Regularly eating beef and mutton, reasonable levels of nutrition, maintaining good daily life ability can delay cognitive impairment.

Overexpression of mitofusion 2 inhibits acute respiratory distress syndrome pulmonary fibrosis and its mechanism / 中华危重病急救医学

Objective:To study the inhibitory effect of overexpression of mitofusion 2 (Mfn2) protein on acute respiratory distress syndrome (ARDS) pulmonary fibrosis and its mechanism.Methods:Human embryo lung fibroblasts (HELF) were cultured in vitro, and digested and passaged when the adherent rate of HELF reached 80%, and then the cells in good condition were selected for experiment. The ARDS cell model was reproduced by 5 mg/L of lipopolysaccharide (LPS, LPS group); 75 mol/L adenovirus vector carrying mitofusion 2 (Adv-Mfn2) was transfected into HELF (Adv-Mfn2+LPS group); at the same time, blank control group (complete medium culture) and Adv-vector+LPS group were set as controls. The cell proliferation was observed by sulforhodamine B (SRB) method at 0, 12, 24, 36 and 48 hours. After Hoechst 33342 staining, the morphological changes were observed under confocal microscope. Western blotting was used to detect the protein expressions of Bcl-2 and caspase-3. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to detect the gene expressions of Bcl-2 and caspase-3. Results:After LPS stimulation for 12-48 hours, the cell proliferation rates in the LPS group increased gradually, which were significantly higher than those in the blank control group [12 hours: (10.75±1.51)% vs. (0.73±1.22)%, 24 hours: (20.09±1.71)% vs. (1.15±1.12)%, 36 hours: (20.58±1.55)% vs. (1.20±1.12)%, 48 hours: (21.30±1.51)% vs. (1.23±1.10)%, all P < 0.01]. There was no statistically significant difference in the cell proliferation rate between the LPS group and the Adv-vector+LPS group. After overexpression of Mfn2, the cell proliferation rates at 12, 24, 36, 48 hours in the Adv-Mfn2+LPS group were (8.93±1.14)%, (10.52±1.24)%, (10.72±1.30)%, and (10.91±1.20)%, which were significantly lower than those in the LPS group (all P < 0.05). Confocal microscopy showed that some cells in the blank control group had nuclei of different sizes, and some nuclei fragmented or shrank to form apoptotic bodies. The nuclei of the cells in the LPS and Adv-vector+LPS groups were round or oval in size, and only a few apoptotic cells appeared. When Mfn2 was overexpressed, there were more apoptotic cells in the visual field in the Adv-Mfn2+LPS group than LPS group. Western blotting and RT-qPCR results showed that Bcl-2 expressions increased significantly after LPS stimulation in the LPS group as compared with the blank control group [Bcl-2 protein (Bcl-2/GAPDH): 0.68±0.01 vs. 0.29±0.01, Bcl-2 mRNA (2 -ΔΔCT): 2.23±0.34 vs. 1.00±0.00, both P < 0.01], and caspase-3 expressions decreased significantly [caspase-3 protein (caspase-3/GAPDH): 0.37±0.02 vs. 0.66±0.02, caspase-3 mRNA (2 -ΔΔCT): 0.31±0.05 vs. 1.00±0.00, both P < 0.01]. Compared with LPS group, the expressions of Bcl-2 after overexpression of Mfn2 in the Adv-Mfn2+LPS group were down-regulated [Bcl-2 protein (Bcl-2/GAPDH): 0.46±0.01 vs. 0.68±0.01, Bcl-2 mRNA (2 -ΔΔCT): 1.45±0.14 vs. 2.23±0.34, both P < 0.01], and the expressions of caspase-3 were up-regulated [caspase-3 protein (caspase-3/GAPDH): 0.54±0.02 vs. 0.37±0.02, caspase-3 mRNA (2 -ΔΔCT): 0.88±0.10 vs. 0.31±0.05, both P < 0.01]. Conclusion:Mfn2 protein is involved in ARDS pulmonary fibrosis, which may be related to mitochondrial mediated inhibition of cell proliferation.

Effect of dexmedetomidine mixed with dexamethasone on efficacy of ropivacaine for popliteal sciatic nerve block in patients undergoing ankle surgery / 中华麻醉学杂志

Objective:To evaluate the effect of dexmedetomidine mixed with dexamethasone on efficacy of ropivacaine for popliteal sciatic nerve block in the patients undergoing ankle surgery.Methods:A total of 120 patients of either sex, aged 30-64 yr, with body mass index of 19.6-29.7 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective ankle surgery, were divided into 4 groups ( n=30 each) by a random number table method: control group (group C), dexmedetomidine group (group DD), dexamethasone group (group DM), and dexmedetomidine plus dexamethasone group (group DD+ DM). In group C, 0.5% ropivacaine 30 ml was injected around the popliteal sciatic nerve guided by ultrasound combined with a nerve stimulator.Dexmedetomidine 1 μg/kg, dexamethasone 10 mg and dexmedetomidine 1 μg/kg plus dexamethasone 10 mg were added to 0.5% ropivacaine in group DD, group DM and group DD+ DM, respectively.The analgesic time, consumption of sufentanil and adverse reactions were recorded after popliteal sciatic nerve block. Results:Compared with group C, the analgesic time was significantly prolonged, the consumption of sufentanil was reduced, and the incidence of nausea and vomiting was decreased in group DD, group DM and group DD+ DM ( P<0.05). Compared with group DD and group DM, the analgesic time was significantly prolonged, and the consumption of sufentanil was reduced in group DD+ DM ( P<0.05). No itching, drowsiness, hypotension, bradycardia or respiratory depression occurred in each group. Conclusion:Dexmedetomidine mixed with dexamethasone can effectively enhance the efficacy of ropivacaine for popliteal sciatic nerve block in the patients undergoing ankle surgery.

Clinical characteristics of chronic total occlusion in elderly patients of different genders / 中国综合临床

Objective To investigate the metabolic characteristics of chronic total occlusion (CTO) in different sex elderly patients. Methods A retrospective analysis was performed on three hundred and sixty-two cases from Beijing Anzhen Hospital with CTO,including 226 cases in the male group and 136 cases in the female group. The characteristics of metabolic risk factors were compared and analyzed between the two groups. Results (1)The level of the systolic blood pressure (SBP)((135. 62±19. 67)mmHg vs. (129. 08±14. 13)mmHg), total cholesterol (TC)((4. 39±0. 95) mmol/ L vs. (3. 91±0. 93) mmol/ L)、low density lipoprotein cholesterol (LDL-C)((2. 56±0. 80) mmol/ L vs. (2. 23±0. 70) mmol/ L) in the female group were significantly higher than those of the male group,the differences were statistically significant (t = -2. 594,P = 0. 010;t = -3. 341,P= 0. 001;t= -2. 893,P = 0. 004) . (2) The level of urea acid (UA) ((368. 95±75. 96) μmol/ L vs. (326. 20 ±83. 27)μmol/ L) and ratio of smoking ( 61. 95% ( 140/ 226) vs. 5. 88% ( 8/ 136)) in the male group were significantly higher than those in the female group(t= 3. 440,P= 0. 001;χ2 = 55. 211,P= 0. 000). Conclusion The higher levels of systolic pressure,total cholesterol and low density lipoprotein cholesterol are the metabolic clinical characteristics of elderly female CTO patients,and the elevated uric acid and smoking are metabolic clinical characteristics of elderly male CTO patients.

Comparison of safety between continued warfarin therapy and bridging anticoagulation therapy in patients undergoing coronary intervention / 中华心血管病杂志

Objective@#To compare the safety of continued warfarin therapy and bridging anticoagulation therapy during hospital stay in patients undergoing percutaneous coronary intervention (PCI). @*Methods@#We retrospectively analyzed patients on warfarin therapy referred for PCI in Beijing Anzhen Hospital from January 2008 to December 2016. The patients were divided into continued warfarin therapy (n=195) or bridging anticoagulation therapy (n=311) groups. After Propensity Score Matching, data from matched patients (n=123 in each group) were analyzed. Bleeding complications and major adverse cardiac events including death, myocardial infarction, target vessel revascularization, and stent thrombosis were assessed. @*Results@#There were no significant difference in the rate of death (2.4%(3/123) vs. 1.6%(2/123),P=0.54), acute myocardial infarction (4.1%(5/123) vs. 4.9%(6/123), P=0.78),re-revascularization (0.8%(1/123) vs. 1.6%(2/123),P=0.16), stent thrombosis (1.6%(2/123) vs. 1.6%(2/123),P=1.00) and stroke between the two groups. Prevalence of minor bleeding complications was significantly higher in the bridging therapy group (15.4%(19/123) vs. 9.8%(12/123),P=0.01). Rate of access-site complications (hematoma:4.1%(5/123) vs. 2.4%(3/123),P=0.20; pseudoaneurysm:2.4%(3/123) vs. 2.4%(3/123),P=1.00; arteriovenous fistula:0.8%(1/123) vs. 1.6%(2/123),P=0.09; and retroperitoneal hematoma:0(0/123) vs. 0.8%(1/123),P=0.23) were similar between the two groups. @*Conclusion@#For patients receiving chronic warfarin therapy, the uninterrupted oral anticoagulant treatment is as safe as bridging therapy in PCI patients.

The Effect of Electroacupuncture at Baliao on Chronic Pelvic Pain Syndrome / 浙江中医药大学学报

[Objective]To observe the effect of electroacupuncture at Baliao on a chronic pelvic pain syndrome. [Method] Choice in March 2014 to January 2016 in our hospital clinic of 103 patients with chronic pelvic pain syndrome, according to the order of the patient, with reference to random number table, divided the patients into the treatment group and control group, the treatment group patients with 50 cases, control group 53 cases. Treatment group patients given cuppingBaliaopoint treatment, control group patients give Tensorosin hydrochloride sustained-release capsules, one time a day, 0.2 mg each time, after meals, a total of two groups of patients in the treatment of 4 weeks, observe two groups of patients with prostatic inflammation at the end of the treatment of NIH-CPSI score, clinical curative effect and clinical relapse over 3 months of treatment. [Results] (1)After the treatment, two groups of patients with pain or discomfort, micturition abnormal, the quality of life score and NIH-CPSI total score were improved significantly, the difference was statistically significant;Comparison between the two ways, found that the treatment group patients in pain or discomfort, the quality of life, and the NIH-CPSI total integral comparison, obviously improved compared with control group, difference had statistical significance( P0.05); (2) the treatment group patients clinical total effective rate was 85.4%, the control group was 74.5%, two groups of clinical curative effect comparison, had no statistically significant difference( P>0.05); (3) 3 months after treatment, the treatment group patients there were 7 cases of recurrence of patients with recurrence(17.1%), the control group 14 cases of recurrence of patients with recurrence(36.8%), compared two groups of clinical relapse rate, difference had statistical significance( P<0.05), recurrence of clinical treatment group was obviously less than the control group. [Conclusion] Take electroacupuncture at Baliao point can obviously improve clinical symptoms in patients with the disease, improve patient's quality of life and reduce recurrence forward, but in the future it's a worthy research to adopt a more scientific research design, including evaluationBaliaopoint for the clinical curative effect of treatment of the disease.

Discussion on the Common Ethical Issues in Clinical Pharmacy / 中国医学伦理学

This paper summarized the common medical ethical issues in clinical pharmacy service and analyzed them from the perspective of medical ethics.It put forward some countermeasures to solve these problems,such as helping clinical pharmacists to establish a patient-centered service mode,improving their occupation accomplish-ment,and avoiding moral issues and medical disputes caused by ethical issues under the premise of ensuring pa-tients' safety and rational use of drugs,and thus to comprehensively improve service level of clinical pharmacists.

Value of five tumor markers in the diagnosis of lung cancer / 国际检验医学杂志

Objective To analyze the value of carbohydrate antigen(CA)153,CA125,neuron specific enolization enzyme(NSE) and carcinoembryonic antigen(CEA),cytokeratin(CYFRA)21-1 in the diagnosis of lung cancer.Methods From October 2014 to April 2016,60 patients were selected into lung cancer group,60 patients were selected into lung cancer group,60 healthy persons recruited into control group,blood specimens from all subjects received chemiluminescence immunoassay detection and analyzed.Results Five tumor markers for lung cancer detection had certain difference in sensitivity and specificity,the specific of NSE and CA153,the sensitivity of CEA and CYFRA21-1 in 5 tumor markers were the highest.The combination of 5 tumor markers could make the diagnosis of lung cancer more accurate,the differences of the specific and sensitivity between the combined detection and single detection were significant (P<0.05).Conclusion The combination detection of these five tumor markers could improve the diagnosis ability in patients with lung cancer.

Application of Diversified Teaching Method in Nursing Teaching Mode of Pharmacy Intravenous Admixture Services / 中国医学伦理学

Objective:To explore the application effect of diversified teaching methods in the Pharmacy Intravenous Admixture Services (PIVAS),thus to improve the quality of nursing teaching in PIVAS.Methods:Intemship students from PIVAS in a top three hospital in Xi’an from July to December 2015 and July to December 2016 were randomly divided into control group with 42 cases and experimental group with 40 cases.The control group used conventional teaching method and the experimental group adopted the diversified teaching method.the practical work of the students in the two groups was compared.Results:After intervention,the experimental group had marked improvement in the drug configuration error,the mastery of aseptic technology,the passing rate of theoretical achievement and operational achievement,significantly higher than that of the control group (P ＜ 0.01);the frequency of labels and warehousing errors of the experimental group was significantly lower than that of the control group (P ＜0.01).Conclusion:The application of diversified teaching methods in PIVAS is very important at several dimensions:helping students to be familiar with the work of PIVAS as soon as possible,reducing the occurrence of errors,improving the nursing teaching level of PIVAS and ensuring the quality of dispensing fluid.

Application of FOCUS-PDCA Cycle Management in Reducing the Incidence of Irrational Medical Orders of Parenteral Nutrition / 中国药房

OBJECTIVE:To reduce the incidence of irrational medical orders for parenteral nutrition,and promote the rational use of parenteral nutrition. METHODS:The medical orders for parenteral nutrition of the first quarter of 2016 in general surgery de-partment of our hospital were collected,and the number and types of its irrational medical orders were summed up. Then FO-CUS-PDCA(Find-organize-clarify-understand-select-plan-do-check-act)cycle management was adopted to analyze and improve the existing problems in issuing medical orders for parenteral nutrition. The improved(the third quarter of 2016)medical orders for par-enteral nutrition were collected,the number and types of its irrational medical orders were summed up,and management effect was evaluated. RESULTS:Establishing nutrition support group,strengthening the training and communication of medical staff,adding prescription evaluation module for parenteral nutrition in hospital information system and a number of measures had made the inci-dence of irrational medical orders for parenteral nutrition in general surgery department declined from 48.25%(1433/2970)before improvement to 5.67%(120/2118)after improvement. The incidences of cation excess,inappropriate selection of drugs and inap-propriate compatibility in irrational types were 0. CONCLUSIONS:FOCUS-PDCA cycle management can reduce the irrational rate of medical orders for parenteral nutrition and promote the rational use of parenteral nutrition in hospital.

Ovarian nonspecific steroid cell tumor:A case report and literature review / 吉林大学学报(医学版)

Objective:To study the clinical features, experiences of diagnosis and treatment, and treatment process of ovarian nonspecific steroid cell tumor. Methods:The clinical materials of one case of ovarian nonspecific steroid cell tumor were retrospectively analyzed,and the related literaturels were reviewed. Results:The patient displayed amenorrhea and masculine characteristics.Preoperative ultrasonography demonstrated the solid tumor of 53 mm ×39 mm on the right ovary,consideration for the right side of ovarian malignant tumor,and laparotomy was performed.The pathologic results showed that the tumor cells were arranged in nests,and the cytoplasm was bright or eosinophilic, and the nucleus were round or oval with nucleolus.The immunohistochemical staining results revealed that calretinin,vimentin and inhibin were positive in the tumor cells.The patient was diagnosed with ovarian nonspecific steroid cell tumor.The postoperative follow-up of 3 months was performed,and there was no recurrence.Conclusion:The diagnosis of ovarian nonspecific steroid cell tumor should be combined with the clinical manifestation and pathologic results,and operion is the main treatment method.

Discussion on the Ethical Issues in Pharmacy Intravenous Admixture Services / 中国医学伦理学

In order to improve the staff′s ability to combine professional level and moral quality in pharmacy in-travenous admixture services and implement it in nursing practice, this paper discussed the common ethical issues and its importance in pharmacy intravenous admixture services. It analyzed the problems, found the causes out, put forward the countermeasures, and thus to promote the further development of pharmacy intravenous admixture serv-ices and offer high quality clinical services, avoid medical disputes, and provide safer pharmacy service to patients.

Relationship between glycated albumin and extent of coronary lesions,GRACE score in patients with a-cute non-ST segmentelevation myocardial infarction / 中国综合临床

Objective To investigate the relationship between glycated albumin ( GA ) and extent of coronary lesions, GRACE score in patients with acute non?ST segmentelevation myocardial infarction ( NSTEMI) . Methods A total of 226 NSTEMI patients who successfully underwent coronary angiography ( CAG) were enrolled in the study. Groups:( 1) According to GA level,the patients were divided into 3 groups:GA17. 0% group. ( 2) According to the extent of coronary le?sions,the patients were divided into 2 groups:single or double branch lesion group,three and/or left main lesion group. ( 3) According to the GRACE score,the patients were divided into 3 groups:Low?risk GRACE score≤108 points group,Medium?risk 108 points140 points group. The extent of coronary lesions was evaluated by Gensini score. The clinical characteristics and Gensini score,GRACE score of each group were compared. Pearson/Spearman correlation analysis and logistic regression were used to analyze the association of GA with the severity of coronary artery disease and GRACE score. Results With glycated albumin increasing,the Gensini score(56. 51±38. 57,68. 30±35. 57,77. 38±36. 52),GRACE score(139. 43±29. 96,149. 77±38. 33,170. 75±27. 52) increased significantly,and significant differences were found between groups( F=5. 587,16. 006,P=0. 004,0. 000) . The ejection fraction( EF) of 3 groups were signif?icantly decrease((58. 30±13. 95)%,(56. 45±10. 79)%,(53. 06±12. 51)%;F=3. 126,P=0. 046). Proportion of severe coronary lesions of 3 groups were increase significantly( 59. 5%( 44/74) ,68. 2%( 60/88) ,87. 5%( 56/64),χ2=13. 528,P=0. 001). The level of GA in three and/or left main lesion group was higher than that in sin?gle or double branch lesion group((13. 92±3. 14)% vs. (16. 80±3. 58)%,t=-5. 693,P=0. 000). The level of GA in High?risk group was higher than that in Low?risk group ( ( 14. 70 ± 1. 54 )% vs. ( 16. 63 ± 4. 02 )%, t=6. 512,P=0. 002) . Correlation analysis showed that the level of GA had significant positive correlation with Gensini score and GRACE score(r=0. 309,0. 265;P=0. 000,0. 000),while had a negative correlation with LVEF(r=-0. 149,P=0. 034). Logistic regression analysis indicated that GA was independent risk factors for severity of coronary artery disease in patients with NSTEMI who successfully underwent CAG( OR=1. 441,95%CI:1. 160?1. 790,P=0. 001) . Conclusion GA level is increase in NSTEMI patients with severe coronary ar?tery disease and risk stratification high. GA is the independent risk factors for severity of coronary artery disease in patients with NSTEMI;GA has significant correlation with dangerous degree in patients with NSTEMI.