Table of Content

20 September 2016, Volume 19 Issue 27

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Interpretation of NCCN Clinical Practice Guidelines in Oncology:Cervical Cancer （Version 1.2016）

GONG Jing, ZHANG Jun

2016, 19(27):  3261-3264.  DOI: 10.3969/j.issn.1007-9572.2016.27.001

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National Comprehensive Cancer Network （NCCN） is an academic institution that composed of 21 authoritative cancer research centers in United States. Every year NCCN regularly publishes a variety of clinical practice guidelines of malignant tumor. NCCN Clinical Practice Guidelines in Oncology:Cervical Cancer developed by NCCN is the using standard of clinical decision of gynecological tumor in America,and also recognized by gynecologic oncologists worldwide and becomes the most widely used guideline around the world. In our country,because of the differences in health care system,medical level and patient factors,it has certain degree of difficulty in directly applying this guideline,but it can also be used as an important reference of clinical diagnosis and treatment of cervical cancer patients. The paper makes a brief interpretation and explanation of NCCN Clinical Practice Guidelines in Oncology:Cervical Cancer （Version 1.2016）,and mainly combines it with medical practice and clinical practice in our country. The purpose is to help clinicians better understand,inquire and apply of the content of NCCN Clinical Practice Guidelines in Oncology:Cervical Cancer （Version 1.2016）.

Synergy and Security Research of Rosuvastatin with Oxycodone Hydrochloride Controlled Release Tablets in Treating Advanced Non-small Cell Lung Cancer Patients’ Cancer Pain

GAO Yan-li, ZHANG Bao-qi

2016, 19(27):  3265-3269.  DOI: 10.3969/j.issn.1007-9572.2016.27.002

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Objective　To investigate the synergy and security of rosuvastatin with oxycodone hydrochloride controlled release tablets in treating advanced non-small cell lung cancer patients’ cancer pain.Methods　From January 2014 to January 2015,we enrolled 160 patients with advanced non-small cell lung cancer who accorded with the inclusion criteria from the Oncology Department of Yishui Central Hospital of Linyi.These patients were assigned into treatment group and control group by random number table method,with 80 patients in each group.On the basis of conventional chemotherapy,control group was given oxycodone hydrochloride controlled release tablets,and treatment group was given oxycodone hydrochloride controlled release tablets plus rosuvastatin calcium tablets for analgesia.Before treatment and one week after treatment,the levels of IL-6 and TNF-α were detected.One week after treatment,the effective doses of the two groups were recorded;the times of breakthrough pain,NRS score and the effective rate of cancer pain treatment of the two groups were recorded when they were given the average effective dose of oxycodone hydrochloride controlled release tablets of the treatment group;the incidence rates of adverse reaction （constipation,nausea and vomiting,liver function damage and respiratory depression） of the two groups were recorded when the two groups were given effective doses of oxycodone hydrochloride controlled release tablets respectively.Results　Before treatment,the two groups were not significantly different in the levels of IL-6 and TNF-α （P>0.05）;after treatment,treatment group was lower than control group in the levels of IL-6 and TNF-α （P<0.05）.Treatment group had lower IL-6 and TNF-α levels after treatment than those before treatment （P<0.05）.Treatment group was lower than control group in effective dosage,the times of breakthrough pain and NRS score （P<0.05）.The effective rate of cancer pain treatment of treatment group was 97.5% （78/80）,higher than that of control group which was 80.0% （64/80） （χ2=12.269,P<0.01）.Treatment group was lower than control group in the incidence of constipation （P<0.05）;the two groups were not significantly different in the incidence rates of nausea and vomiting,liver function damage and respiratory depression （P>0.05）.Conclusion　Rosuvastatin plus oxycodone hydrochloride controlled release tablets has synergistic effect in the treatment of patients with advanced non-small cell lung cancer pain,and the incidence rates of adverse reactions can be lowered by reducing the dosage of oxycodone hydrochloride controlled release tablets.

Factors Related to Insulin Resistance in IgA Nephropathy

LIN Zi-qi, SUN Guang-ping, LI Li-ou, YUN Yang, LI De-tian, ZHANG Bei-ru, WANG Yan-qiu

2016, 19(27):  3270-3274.  DOI: 10.3969/j.issn.1007-9572.2016.27.003

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Background　Insulin resistance （IR） is the central link and the pathogenic basis of metabolic syndrome as well as the independent risk factor leading to kidney damage and eventually renal failure.Objective　To discuss the occurrence of IR and the relationship between IR and basic clinical indexes of IgAN,activity of renin-angiotensin-aldosterone system （RAAS） and pathological severity.Methods　94 patients who met inclusion criteria and visited the First Nephrology Department of Shengjing Hospital of China Medical University from June 2013 to December 2014 were retrospectively selected as objects of study.According to the results of final diagnosis,they were divided into IgAN group （44 cases）,membranous nephropathy （MN） group （26 cases） and minimal change disease （MCD） group （24 cases）.General data of patients were collected,including gender,age,body mass index （BMI）,systolic pressure,diastolic pressure,24 h urinary protein quantitative,albumin,hemoglobin,creatinine,glomerular filtration rate （eGFR）,uric acid,fasting blood glucose （FBG）,fasting insulin （FINS）,rennin,AngⅡ,aldosterone,triglycerides,cholesterol,low density lipoprotein,c-reactive protein（CRP）.The HOMA-IR was calculated and the incidence of IR was recorded.The pathological severity of IgAN was evaluated,including MEST score,glomerular sclerosis rate and crescent rate.Results　MN group was significantly higher in the levels of BMI,24 h urinary protein quantitative,eGFR,triglycerides,cholesterol and low density lipoprotein and lower in the levels of albumin,creatinine and AngⅡ than those of IgAN group （P<0.05）.MCD group was significantly higher in the levels of 24 h urinary protein quantitative,eGFR,triglycerides,cholesterol and low density lipoprotein and lower in the levels of albumin,creatinine and AngⅡthan those of IgAN group （P<0.05）.The HOMA-IR and incidence rate of IR in MN group and MCD group were lower than those of IgAN group （P<0.05）.There was no linear correlation between HOMA-IR and age,24 h urinary protein quantitative,albumin,hemoglobin,eGFR,renin,aldosterone,cholesterol,low density lipoprotein,MEST score,glomerular sclerosis rate and crescent rate （P>0.05）.HOMA-IR was positively correlated with BMI,systolic pressure,diastolic pressure,creatinine,uric acid,AngⅡ,triglycerides and CRP （P<0.05）.The results of linear regression analysis showed that there was a linear regression relationship between HOMA-IR and BMI,systolic pressure,diastolic pressure,creatinine,uric acid,AngⅡ,triglycerides and CRP （P<0.05）.Conclusion　Most IgAN patients have IR,which is positively correlated with basic clinical indexes （BMI,systolic pressure,diastolic pressure,creatinine,uric acid,triglycerides,CRP） and the activity of RAAS,but has nothing to do with pathological severity.

Reaction of Paricalcitol Inhibition on Kidney Tissue Inflammation in Mice with Diabetic Nephropathy

LU Cong-qun, LIU Zhang-suo, ZHANG Fang-xing, GUO Jia

2016, 19(27):  3275-3280.  DOI: 10.3969/j.issn.1007-9572.2016.27.004

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Objective　To investigate the inhibiting effects of vitamin receptor agonist-parlicalcitol on the inflammatory reaction of kidney tissue in diabetic nephropathy mice by exploiting the db/db mouse model of type 2 diabetic nephropathy.Methods　From January to November in 2015，under the method of random number table，we divided the 60 male five-week C57BLKS/J db/db mice of SPF level into three groups：db/db-control group（N group，n=20），db/db-dimethyl sulfoxide group（D group，n=20），and db/db-paricalcitol group（P group，n=20），and we enrolled db/m mice of littermate as the normal control group（C group，n=20）.At the age of 10 weeks，mice in P group were given intraperitoneal injection of paricalcitol at a dose of 0.3 μg/kg qod，the same amount of dimethyl sulfoxide as P group plus 0.9% sodium chloride solution were injected into D group，N and C group were not intervened.After 12-week intervention，we measured the body mass index，the fasting blood-glucose，24-hour urine protein quantitation；we retained the kidney tissue to make a renal histopathological examination.The expression of real-time fluorescent quantitative PCR，Western blotting，and immunohistochemical detection of inflammatory factor interleukin（IL）-6，and tumor necrosis factor-α（TNF-α）mRNA and the protein expression levels were applied.Results　After 12-week medical intervention，the comparison of body mass，fasting blood-glucose，and the 24-hour urine protein quantitation in the four groups showed significant differences（P<0.01）；the body mass，fasting blood-glucose，the 24-hour urine protein quantitation of N group，D group and P group were higher than those of C group，the 24-hour urine protein quantitation of P group was lower than that of N group and D group（P<0.05）.Pathological examination showed that the structure of the glomerulus and the renal tubular of C group was complete and clear；while there was partially inflammatory cell infiltration in renal tubulointerstitial in subjects of N group and D group，the inflammatory reaction was evident compared with C group；compared with N group and D group，the renal pathologic changes of P group reduced，and the inflammatory reaction alleviated.The IL-6，TNF-α mRNA and the protein expression level of the four groups were significantly different（P<0.01）；the expression levels of IL-6，TNF-α mRNA and protein of N group，D group and P group were all higher than those of C group，and the expression levels of IL-6，TNF-α mRNA and protein of P group were lower than those of N group and D group（P<0.05）.Immunohistochemical results showed that compared with C group，the renal tissue expression of IL-6，TNF-α of N group and D group increased，and those of P group decreased compared with N group and D group.Conclusion　Paricalcitol can alleviate the inflammatory reaction in diabetic nephropathy mice kidney tissue，and the effect may not rely on reducing blood glucose.

Relationship between c-junN Terminal Kinase 1 and Early Injury in the Myocardium of Diabetic Rats

CHEN Xin-ming, LIU Xiao-liang, WU Wei

2016, 19(27):  3281-3286.  DOI: 10.3969/j.issn.1007-9572.2016.27.005

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Objective　To investigate the relationship between c-jun N terminal kinase 1 （JNK1） and early injury in the diabetic myocardium（DM） rats.Methods　From October 2013 to July 2014,after one-week adaptive feed of the 80 female Sprague-Dawley （SD） rats at SPF levels,60 rats were selected by random number table method.They were established as DM model group by four-week high glucose and high fat diet and a one-time left lower quadrant intraperitoneal injection of streptozotocin （STZ） at a dose of 35 mg/kg.The other 20 rats,one-time intraperitoneally injected of citrate buffer solution of same volume,were regarded as the control group （group A） with four-week normal diet.In the end,modeling of the 48 rats was established successfully.They were divided into group B,group C and group D with 16 rats in each group by random number table method.Rats in group C were given an intraperitoneal injection of SP600125,rats in group D were subcutaneously implanted with an osmotic pump to infuse angiotensin Ⅱ （Ang Ⅱ） and 0.9% sodium chlo-ride,rats in group A and group B were given an intraperitoneal injection of 0.9% sodium chlo-ride.After six-week feeding,10 rats were selected from each group through random number table method.The heart/body weight ratio （H/B） and left ventricular mass index （LVMI） were detected.The Hematoxylin and Eosin staining were used to observe the myocardial pathological changes.Immunohistochemistry SABC method was used to measure the expression level of JNK1,phosphorylation JNK1 （p-JNK1）,transient receptor potential canonical channels （TRPC） 6 and collagen Ⅰ.Results　The H/B in group B,group C and group D was higher than that in group A,and LVMI in group B and group D was higher than that in group A （P<0.05）;H/B and LVMI of rats in group C were lower than those in group B and group D （P<0.05）.The myocardial cells of rats in group A arranged in neat rows with tight junctions and clear myocardial texture;while the myocardial cells of rats in group B,group C and group D had hypertrophic changes of different degrees,characterized by dilated intercellular space,disordered cell arrangement and less clear myocardial texture.The expression level of JNK1,p-JNK1,TRPC6,and collagen Ⅰ of rats in group B,group C and group D was higher than that in group A （P<0.05）;the expression level of JNK1,p-JNK1,TRPC6,and collagen Ⅰ of rats in group C was lower that in group B （P<0.05）;the expression level of p-JNK1,TRPC6,and collagen Ⅰ of rats in group D was higher than that in group B and group C,the expression level of JNK1 in group D was higher than that in group C （P<0.05）.Conclusion　High glucose environment may induce JNK1 phosphorylation,and affect the expression of TRPC6,which will lead to an increased collagen deposition,and finally result in cardiomyocyte hypertrophy and fibrosis,and cause the occurrence and development of diabetic cardiomyopathy.

Detection Analysis of Serum Anti-Keratin Antibody,Anti-Cyclic Citrullinated Peptide Antibody and Rheumatoid Factor in Rats with Type Ⅱ Collagen-induced Arthritis

LUO De-mei, LI Wen-hong, WANG Qian, DU Wen-jing, MENG Yan, LI Hui-jun, YAN Yi, FENG Ning, MA Xiu-min, LUO Li

2016, 19(27):  3287-3290.  DOI: 10.3969/j.issn.1007-9572.2016.27.006

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Objective　To detect serum anti-keratin antibody （AKA）,anti-cyclic citrullinated peptide （Anti-CCP） antibody and rheumatoid factor （RF） in rats type Ⅱ collagen-induced arthritis （CIA）,and to analyze whether they are similar with serum immunology of human rheumatoid arthritis （RA）.Methods　After one-week adaptive feed,among 15 healthy female Wistar rats （SPF level） aged 7 to 8 weeks,5 were selected as blank control group by random number table method,and 10 for building type Ⅱ CIA model from November 2014 to March 2015,and finally 8 rats’ modeling was successfully built（CIA model group）.After successful modeling,femoral artery blood of rats in CIA model group and blank control group was collected,and serum was routinely separated,serum AKA of rats in two groups and Anti-CCP antibody and RF-IgM antibody were detected by indirect immunofluorescence （IIF） method and enzyme-linked immunosorbent assay （ELISA） method respectively;40 g/L paraformaldehyde fixation was used as pathological specimens to isolate synovium of knee joint.The pathological specimens were conducted with HE staining.Results　Serum AKA of 5 cases （5/8） were positive in CIA model group,all were negative in blank control group.There was no significant difference in levels of serum Anti-CCP antibody and RF-IgM antibody between rats in blank control group and CIA model group （P>0.05）.Pathological HE staining observation of joint synovium of rats in blank control group presented clear arrangement of synovial cells,normal histology structure,no hyperplasia,no significant accumulation and infiltration of inflammatory cells;pathological HE staining observation of joint synovium of rats in CIA model group showed disordered arrangement of synovial cells,capillary proliferation,significant synovial hyperplasia,synovial infiltration of large amount of inflammatory cells.Conclusion　Serum of CIA rats group in shows positive AKA,which is similar with serum immunology of human RA,and suits for basic research of RA.

Correlation between the Direct Ultrasonic Signs of Breast Infiltrating Ductal Carcinoma and the Expression of Estrogen Receptor and Progestrone Receptor

JIA Zhi-ying, AI Xiu-qing, ZHANG Yin-hua, MA Fu-cheng

2016, 19(27):  3291-3295.  DOI: 10.3969/j.issn.1007-9572.2016.27.007

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BackgroundThe treatment and prognosis of breast cancer has close correlation with the expression of molecular biological markers.Objective　To investigate the correlation between the direct ultrasonic signs of breast infiltrating ductal carcinoma and the expression of estrogen receptor（ER） and progestrone receptor（PR）.Methods　A retrospective analysis was made on the clinical data of 109 patients with breast infiltrating ductal carcinoma who accorded with inclusion criteria and received the first diagnosis and underwent operation in the Affiliated Tumor Hospital of Xinjiang Medical University from December 2014 to April 2015.General data,immunohistochemical results（expression of ER and PR）,and ultrasound examination results（number,sites,size,stages of nidi and spicule signs,lobulated sign,internal microcalcification,posterior acoustic attenuation,aspect ratio,and Adler grade internal blood flow） were collected.Results　The number of patients with ER（+）,PR（+）,ER（-） and PR（-） was 75（68.8%）,67（61.5%）,34（31.2%） and 42（38.5%） respectively.There were 93 patients who had one nidus and 16 patients who had multiple nidi（the number of nidi ≥2）;48 patients had nidi on the right breast,and 61 patients had nidi on the left breast;the number of patients who had nidi in the out upper quadrant,the inner upper quadrant,the out lower quadrant,the inner lower quadrant was 51,27,16 and 15 respectively;the maximum diameter of nidus was 0.9-8.0 cm,and the average maximum diameter of nidus was（2.8±1.4） cm;the number of patients in T1,T2,T3 and T4 phrase was 28,62,19 and 0.Patients with ER（-）+PR（-） and patients without ER（-）+PR（-） were significantly different in the maximum diameter of nidus（P<0.05）.The direct ultrasonic signs of breast cancer showed that there were 90（82.6%）patients with Adler gradeⅡ-Ⅲ of internal blood flow,58（53.2%） patients who had lobulated sign,58（53.2%） patients who had internal microcalcification,49（45.0%）patients who had spicule signs,49（45.0%） patients who had posterior acoustic attenuation,and 41（37.6%） patients who had aspect ratio≥0.71.Spicule signs,lobulated sign,internal microcalcification and posterior acoustic attenuation had correlation with the expression of ER and PR（P<0.05）;aspect ratio and Adler grade of internal blood flow had mutual dependence from the expression of ER and PR（P>0.05）.Conclusion　Direct ultrasonic signs of breast infiltrating ductal carcinoma has correlation with the expression of ER and PR,and ultrasound can make pre-treatment assessment and prognostic evaluation of breast carcinoma.

Effect of Acute Moderately Severe Organophosphorus Pesticides Poisoning on Cognitive Function

YANG Qin, TIAN Yang-hua, ZHOU Shu, LI Jing-rong, CHENG Jing-lin

2016, 19(27):  3296-3299.  DOI: 10.3969/j.issn.1007-9572.2016.27.008

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Objective　To investigate the effect of acute moderately severe organophosphorus pesticides poisoning on cognitive function.Methods　29 patients with acute moderately severe organophosphorus pesticides poisoning,who had been hospitalized in Department of Emergency Internal Medicine of the Second Hospital of Anhui Medical University from November 2010 to October 2014 and met the inclusion criteria,were selected as the research group,and 29 healthy volunteers after physical examination in the same hospital during the same period were also enrolled as the control group.Patients in research group received corresponding treatment like timely gastric lavage.All patients’ cognitive function were evaluated by the Montreal Cognitive Assessment （MoCA）.The MoCA various dimensional score and total score of control group at the enrolling time and of research group 1 week,1 month and 6 months after treatment were compared in this study.Results　The MoCA total score of 1 month and 6 months after treatment was higher than that of 1 week after treatment in the research group （P<0.05）;the MoCA total score of 6 months after treatment was higher than that of 1 month after treatment in the research group （P<0.05）.The MoCA total score of the research group 1 week and 1 month after treatment was lower than that of the control group （P<0.05）;there was no significant difference in the MoCA total score between the research group 6 months after treatment and the control group （P>0.05）.In the research group,the scores of naming,attention,abstraction,delayed recall and orientation of 1 month and 6 months after treatment were higher than those 1 week after treatment,and the scores of visual space and executive function and language 6 months after treatment were higher than those 1 week after treatment （P<0.05）;the scores of visual space and executive function,attention,language,abstraction,delayed recall and orientation 6 months after treatment were higher than those 1 month after treatment （P<0.05）.The scores of visual space and executive function,naming,attention,language,abstraction,delayed recall and orientation in the control group were higher than those in the research group 1 week after treatment （P<0.05）;the scores of attention,language,delayed recall and orientation in the control group were higher than those in the research group 1 month after treatment （P<0.05）;the scores of attention and delayed recall of the control group were higher than those of the research group 6 months after treatment,while their score of language was lower than that of the research group 6 months after treatment （P<0.05）.Conclusion　The acute moderately severe organophosphorus pesticide poisoning will lead to cognitive function impairment.Although the MoCA total scores of 6 months after treatment return to normal state,their cognitive function of attention and delayed recall are still poor.

Correlation between CpG Island Methylation in IL-17 Gene Promoter and Cervical Cancer

YUAN Lu, ZHANG Li-jie, LI Ou, YANG Yan-yan, ZHANG Qi, WANG Xin-yue, GENG Mei-li, JIANG Chun-yang, WANG Yang, MA Dong

2016, 19(27):  3300-3305.  DOI: 10.3969/j.issn.1007-9572.2016.27.009

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Objective　To investigate the correlation between CpG island methylation of IL-17 gene promoter and cervical cancer,and to provide new ideas for clinical diagnosis and immunotherapy of cervical cancer.Methods　43 cervical cancer patients （cervical cancer group） and 62 patients with precancerous lesions〔23 cases with CINⅠ（CINⅠ group）,39 cases with CINⅡ~Ⅲ（CINⅡ~Ⅲ group）〕 who received treatment in Inpatient Department of Tangshan Gongren Hospital from March 2011 to May 2012 were selected,and another 43 patients who had undergone total abdominal hysterectomy in this hospital at the same period due to uterine fibroids were enrolled as control group.Cervical tissue specimens of patients in four groups were obtained by surgery.DNA in cervical tissue of patients in four group was extracted to make a detection of HPV16 DNA,CpG island methylation status in IL-17 gene promoter was detected by using CpG island methylation specific PCR （MSP）,IL-17 mRNA expression levels were detected by semi-quantitative reverse transcription PCR （RT-PCR）,correlation between CpG island methylation rate of IL-17 gene promoter and IL-17 mRNA expression levels,and the relevance of this rate to the positive rate of HPV16 DNA were analyzed,and CpG island methylation status of IL-17 gene promoter in cervical cancer patients of different ages and clinical features were also analyzed.Results　HPV16 DNA positive rates in four groups were significantly different （P<0.001）.CpG island methylation rate of IL-17 gene promoter in CINⅡ~Ⅲ group and cervical cancer group was significantly lower than that in control group（P<0.01）;CpG island methylation rates of IL-17 gene promoter in CINⅠ group and control group,CINⅠ group,CINⅡ~Ⅲ group,cervical cancer group were not significantly different （P> 0.05）;CpG island methylation rates of IL-17 gene promoter between CINⅠgroup and CINⅡ~Ⅲ group were not significantly different （P>0.05）.The expression levels of IL-17 mRNA in CINⅠ group,CINⅡ~Ⅲ group and cervical cancer group were higher than those in control group （P<0.05）;the expression levels of IL-17 mRNA in CINⅠgroup,CINⅡ~Ⅲ group and cervical cancer group was not significantly different （P>0.05）;the expression level of IL-17 mRNA between CINⅡ~Ⅲ group and cervical cancer group was not significantly different （P>0.05）.According to the detected results of CpG island methylation in IL-17 gene promoter,all patients were divided into patients with CpG island methylation of IL-17 gene promoter （93 cases） and non-methylation patients （55 cases）,IL-17 mRNA expression level of patients with CpG island non-methylation in IL-17 gene promoter was higher than that in methylation patients （P<0.05）.In all patients’ cervical tissues,CpG island methylation rate of IL-17 gene promoter was negatively correlated with its mRNA expression level（rs=-0.627,P<0.05）.There was correlation between CpG island methylation rate of IL-17 gene promoter in all patients’ cervical tissue and infection positive rates of HPV16 DNA （χ2=33.209,P<0.05,r=-0.474）.CpG island methylation rate of IL-17 gene promoter in cervical cancer patients at Ⅱ and Ⅲ clinical stages were lower than that of patients at Ⅰ clinical stage （P<0.05）;CpG island methylation rates of IL-17 gene promoter among cervical cancer patients of different ages,pathological grading,tumor diameter,and with or without lymph node metastasis were not significantly different （P>0.05）.Conclusion　CpG island methylation of IL-17 gene promoter is related with high-risk HPV16 infection,CpG island methylation of IL-17 gene promoter may be associated with the occurrence and development of cervical cancer.

Expression of Interleukin-10,E26 Transformation Factor-1 and Tumor-associated Macrophages in Cervical Cancer

ZHANG Qi, MA Dong, CHANG Ling-ya, ZHANG Li-jie, YAN Xi-zhao, WANG Yang, CHEN Li-rong, LI Ou

2016, 19(27):  3306-3310.  DOI: 10.3969/j.issn.1007-9572.2016.27.010

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Background　Cervical cancer is one of the women malignant tumors with high incidence.Interleukin 10 （IL-10）,as a kind of cytokine with immunosuppressive effects,plays an important role in the occurrence and development of cervical cancer.Both tumor-associated macrophages （TAM） and E26 transcription factor 1 （Ets1） can promote tumor growth,invasion and migration.Objective　To investigate the expression of IL-10,Ets1 and TAM in cervical carcinoma tissues and their correlation with cervical cancer.Methods　72 cervical intraepithelial neoplasia （CIN） patients,76 cervical squamous cell carcinoma （SCC） patients and 40 benign uterine lesion patients underwent total hysterectomy,who were under treatment in Inpatient Department of Tangshan Gongren Hospital from September 2014 to March 2016,were selected into CIN group,SCC group and normal group separately.3 subjects with cervical tissues in SCC group and 3 with cervical tissues in normal group were selected to make microarray hybridization sequencing by simple random sampling method;the expression levels of IL-10 and Ets1 mRNA in cervical tissues were detected by RT-qPCR method in all patients,the status and expression of TAM and TAM that IL-10 and Ets1 levels expressed by TAM （IL-10+ TAM,Ets1+ TAM） were detected by double immunofluorescence colocalization method,and the relationship between levels of IL-10+ TAM,Ets1+ TAM and clinical data was analyzed.Results　Comparing with cervical tissues of normal group,the expression of IL-10 in cervical tissues of SCC group upregulated 3.4 times,and Ets1 upregulated 2.9 times （P<0.05）.Expression levels of IL-10 and Ets1 mRNA in CIN group and SCC group were higher than those in normal group （P<0.05）;expression levels of IL-10 and Ets1 mRNA in SCC group were higher than those in CIN group （P<0.05）.The expression level of IL-10 mRNA in CIN group and SCC group was positively correlated with the expression level of Ets1 mRNA （r=0.453,P<0.01;r=0.456,P<0.01）.TAM increased gradually in cervical tissues in normal group,CIN group and SCC group.The levels of IL-10+ TAM and Ets1+ TAM in CIN group and SCC group were higher than those in normal group （P<0.05）;the levels of IL-10+ TAM and Ets1+ TAM in SCC group were higher than those in CIN group （P<0.05）.The levels of IL-10+ TAM and Ets1+ TAM in patients of SCC group were not related to age and tumor size （P>0.05）;the levels of IL-10+ TAM and Ets1+ TAM in patients of SCC group were related to differentiated degree,clinical stage of cervical cancer and lymph node metastasis （P<0.05）.Conclusion　The expression level of IL-10,Ets1 and TAM increases with the progression of cervical lesions,TAM and its secreted IL-10 and Ets1 may be related to cervical cancer and clinical prognosis.

Value of 18F-FDG PET/CT and SCC Antigen in the Detection of Cervical Cancer after Treatment

ZHANG Zhao-qi, ZHAO Xin-ming, WANG Jian-fang, ZHANG Jing-mian, WANG Ying-chen, HE Ling-yan

2016, 19(27):  3311-3316.  DOI: 10.3969/j.issn.1007-9572.2016.27.011

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Objective　To assess the value of 18F-FDG PET/CT and serum squamous cell carcinoma （SCC） antigen in the detection of residual,recurrent or metastasis in patients with cervical squamous cancer after treatment.Methods　From January 2008 to April 2014,155 patients with cervical squamous cancer suspected residual,recurrent or metastasis after treatment,which had undergone 18F-FDG PET/CT scans and SCC antigen measurement in Fourth Hospital of Hebei Medical University were retrospectively analyzed.Diagnostic efficiency of 18F-FDG PET/CT and SCC antigen were analyzed according to pathology and follow-up results.Results　Of the 155 patients included in this study,128 patients were malignant,while 27 were benign.The overall patient-based sensitivity,specificity,accuracy,positive predictive value （PPV） and negative predictive value （NPV） of 18F-FDG PET/CT for the detection of malignancy were 99.2%,85.2%,96.8%,96.9% and 95.8%,while SCC antigen were 80.5%,70.4%,78.7%,92.8% and 43.2%,respectively.All the 4 false-positive 18F-FDG PET/CT results were associated with negative SCC antigen except one,and 1 false-negative PET/CT results was positive SCC antigen，8 false-positive SCC antigen were associated with 7 negative on 18F-FDG PET/CT，while 25 false-negative SCC antigen were all positive 18F-FDG PET/CT results.The sensitivity,specificity,accuracy,PPV and NPV of combination index for the detection of malignancy were 100.0%,59.3%，92.9%,92.1% and 100.0%,respectively.The area under ROC curve of 18F-FDG PET/CT，SCC antigen and combination index were 0.918〔95%CI（0.838,0.998）〕，0.754〔95%CI（0.646,0.862）〕 and 0.796〔95%CI（0.678,0.914）〕.Conclusion　18F-FDG PET/CT imaging and Serum SCC antigen,which have important value in cervical squamous cancer,can be complementary method in cases of suspected malignant focus exist after treatment.

Effect of Qigesan on the Cell-cell Adhesion of Esophageal Cancer

SHI Hui-juan, GAO Jing, SHI Dong-xuan, LI Jing.

2016, 19(27):  3317-3321.  DOI: 10.3969/j.issn.1007-9572.2016.27.012

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Background　The incidence of esophageal cancer has distinct geographical characteristics,with approximately 50% of all newly diagnosed cases occurring in China annually.Objective　To investigate the effects and mechanism of Qigesan on the cell-cell adhesion of esophageal carcinoma.Methods　From March to June in 2015,the human esophageal carcinoma cell lines Eca109,TE13 and TE1 were cultured in vitro.Eca109,TE13 and TE1 were treated with the different dose of Qigesan （0 μg/ml in control group,50 μg/ml in low dose group,100 μg/ml in high dose group）,the cell-cell adhesion was tested by mechanical method,the expression level of Cx32 in Eca109,TE13 and TE1 was detected by Western blotting method.The expression of E-cadherin in Eca109,TE13 and TE1 with different dose of Qigesan （0 μg/ml in control group,100 μg/ml in Qigesan group） was detected by SP immunohistochemistry method.The metastatic abilities of Eca109,TE13 and TE1 with different dose of Qigesan （0 μg/ml in control group,50 μg/ml in low dose group,100 μg/ml in high dose group） were detected by scratch-wound assays.Results　The cell-cell adhesion of Eca109,TE13 and TE1 in low dose group and high dose group was higher than that in control group respectively （P<0.05）;the cell-cell adhesion of Eca109,TE13 and TE1 in high dose group was higher than that in low dose group （P<0.05）.The expression level of Cx32 of TE1 in low dose group was higher than that in control group （P<0.05）;the expression level of Cx32 of Eca109,TE13 and TE1 in high dose group was higher than that in control group and low dose group respectively （P<0.05）.The expression of the E-cadherin was negative in control group and Qigesan group.At 12 h and 24 h,the scratch of Eca109,TE13 and TE1 in low dose group and high dose group was wider than that in control group respectively （P<0.05）.At 12 h,the scratch of Eca109 in high dose group was wider than that in low dose group （P<0.05）.At 12 h and 24 h,the scratch of TE13 and TE1 in high dose group was wider than that in low dose group （P<0.05）.Conclusion　Qigesan can improve the expression level of Cx32,then improve the cell-cell adhesive ability and reduce the migratory ability of esophageal carcinoma cells.

Impact of Jinkui Shenqi Pills on Behavioral Genetics and Dopamine of Offspring from Pregnant Rats with Post-traumatic Stress Disorder Syndrome

PENG Si-han, LIU Xiang-min, JIANG Xiao-jing, CAO Jun, LONG Yu-jun, ZHANG Xian-geng.

2016, 19(27):  3322-3325.  DOI: 10.3969/j.issn.1007-9572.2016.27.013

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Background　The incidence rate of post-traumatic stress disorder （PTSD） syndrome has increased in recent years.Western medicine treatment of PTSD leads to adverse drug reactions,uncertainties of curative effect and treatment,and other problems that are especially harmful for pregnant women.Objective　To observed the effect of Jinkui Shenqi pills on growth and development,behavior capacity,and serum dopamine （DA） level of offspring from pregnant rats with post-traumatic stress disorder （PTSD）.Methods　From July 2014 to March 2015,36 pregnant rats were divided into:control group （CG）,PTSD group （PG）,and herbal group（HG） by random number table method.There were 12 rats in each group.The pregnant metaphase rats in PG and HG were transformed to PTSD models via single-prolonged stress （SPS）,which has been extensively applied in PTSD research.After the models were established,the rats in HG were given Jinkui Shenqi pills.The body and tail lengths of rats were measured 5,15,and 25 days after birth to observe growth and development status.Behavioral ability was evaluated by different behavioral tests at different times,including light box defecation test （15 days after birth） and saccharose consumption test （26 days after birth）.Femoral arterial blood of the offspring was sampled on the 30 days after birth,and serum dopamine level was detected by enzyme-linked immune sorbent assay （ELISA）.Results　There was significant effect on body length and tail length among different treatment ways and time （P<0.05）,there was interaction on body length and tail length between treatment ways and time （P<0.05）. The positive rate in light box defecation test of PG was higher than that of CG and HG （P<0.05）,whereas the sucrose preference rate in PG was significantly lower than that of CG and HG（P<0.05）.However,no statistically significant differences were observed between CG and HG （P>0.05）.The serum level of dopamine in PG was lower than that in CG and HG （P<0.05）,but no statistically significant differences were observed between CG and HG （P>0.05）.Conclusion　Jinkui Shenqi pills could alleviate growth retardation,abnormal behavior,and serum dopamine level disturbance of the offspring caused by PTSD-induced fetal injury.The regulation of offspring neurobiology disorder can be achieved by supplying kidney essence,thereby warming and invigorating the kidney yang,filling the marrow,and nourishing the cerebral spirit.

Effectiveness and Safety of Traditional Chinese Medicine Injection Combined with CF Chemotherapy Regimen in the Treatment of Breast Cancer:Network Meta-analysis and Trial Sequential Analysis

TIAN Jin-hui, GE Long, LOU Li-li, XIE Wen, GAN Yu-hong, PEI Gai-qin, WANG Quan, LIU Rui-feng, ZHANG Qiu-ning, WANG Xiao-hu, ZHANG Hong.

2016, 19(27):  3326-3335.  DOI: 10.3969/j.issn.1007-9572.2016.27.014

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Objective　To assess the efficacy and safety of traditional Chinese medicine injection（TCMI） combined with CF chemotherapy（TCMI + CF） for breast cancer.Methods　In October 2014,a computer-based retrieval was performed including CNKI,CBM,Wangfang Data knowledge Service Platform,VIP database,ISI Web of Knowledge,EMBase,PubMed and Cochrane Library,to include RCTs that comparing TCMI + CF and pure CF chemotherapy for breast cancer.Two evaluators conducted data extraction and quality evaluation separately.Stata 12.0,WinBUGS 1.4 and TSA were used to conduct network Meta analysis and trial sequential analysis.Results　We included 26 RCTs involving 1 884 patients and 6 kinds of TCMI （Fufang Kushen injection，Kang’ai injection,Kanglaite injection，Aidi injection,Huachansu injection,Shenqifuzheng injection）.The results of network Meta-analysis showed that Fufang Kushen and Kanglaite combined with CF chemotherapy were better than other injections in the improvement of overall effectiveness index and quality of life.However,Shenqifuzheng and Aidi combined with CF chemotherapy were better in reducing nausea and vomiting （grade Ⅲ-Ⅳ） and decrease in white blood cell count（grade Ⅲ-Ⅳ）.Conclusion　At present,there is still no strong evident that TCMI + CF is the best therapy in effective rate,improving quality of life,reducing nausea and vomiting,and inhibiting decrease in white blood cell count.Therefore,rational choice of drug should be made for patients in clinical practice.

Reliablity and Validity of Chinese Version of the Breast Cancer Survivors Self-efficacy Scale

LIU Yan-jin, WANG Min, DONG Xiao-fang, LYU Pei-hua.

2016, 19(27):  3336-3340.  DOI: 10.3969/j.issn.1007-9572.2016.27.015

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Background　Self-efficacy contributes to symptom management of cancer survivors,ultimately overall quality of life can be improved.Objective　To translate the Breast Cancer Survivors Self-efficacy Scale （BCSES） into Chinese and to test the reliability and validity of the Chinese version of BCSES （C-BCSES）.Methods　By using convenience sampling method,250 breast cancer survivors who met inclusion criteria in the First Affiliated Hospital of Zhengzhou University were selected as study subjects.The BCSES was translated into Chinese version by using Brinslin’s translation model.From July 2015 to November 2015,the C-BCSES and the Chinese version of general self-efficacy scale （GSES） were used to conduct a survey among the breast cancer survivors.The reliability and validity of C-BCSES were analyzed.Results　A total of 250 questionnaires were distributed,and 242 questionnaires were returned with an effective recovery rate of 96.8%.Patients were sorted according to the score of the C-BCSES in descending order,31.0% （75/242） of patients who got the highest score were included in high score group,and 31.4% （76/242） of patients who got the lowest score were included in low score group.The score of each item in low score group was significantly lower than that in high score group （P<0.05）.The average content validity index of C-BCSES was 0.913,the content validity index of items ranged from 0.821 to 1.000.The total score was positively correlated with each item score （P<0.05）.The KMO was 0.825,and Bartlett’s test was also acceptable with P<0.001 （χ2=530.692）,thus exploratory factor analysis can be performed.One factor with eigenvalue equal to or greater than 1.000 was extracted by exploratory factor analysis,the cumulative contribution rate of which was 47.362%,and the load value of each item was greater than 0.40.Confirmatory factor analysis was performed to support the results,with an acceptable fit （χ2/df =1.228,goodness-of-fit index=0.915,adjusted goodness-of-fit index=0.901,root-mean-square error of approximation=0.042,comparative goodness-of-fit index=0.923）.The score of C-BCSES was positively correlated with score of Chinese version of GSES （r=0.518,P<0.01）.The Cronbach’s α coefficient of C-BCSES was 0.912,the split half reliability coefficient was 0.845,the test-retest coefficient was 0.706.Conclusion　The C-BCSES has been proved to be reliable and valid,which can be used to evaluate self-efficacy of breast cancer survivors.

Development of Parkinson’s Disease Patients Self Health Management Questionnaire and Test of Reliability and Validity

YUE Li-chun, TANG Lang-juan, CHEN Mi, PENG Yu-yan, LIU Cong-xiang

2016, 19(27):  3341-3345.  DOI: 10.3969/j.issn.1007-9572.2016.27.016

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Background　Parkinson’s disease （PD） has different motor symptoms and non motor symptoms in diffenent patients,thus many unknown factors exist in its management,the quality of life of patients and their families is affected seriously.Therefore,it is particularly important to improve PD patients’ self health management ability.Objective　To develop a questionnaire for measuring PD patients’ ability of self health management and to test its reliability and validity.Methods　Through literature research method and unstructured interview,the contents of the questionnaire including item pool and dimensions were formulated,Delphi expert inquiry method was applied to formulate PD patients self health management questionnaire.By using convenience sampling method,64 cases of PD patients from the Fourth Affiliated Hospital of Nanchang University were investigated,37 cases of whom were reinvestigated again 1 week later.The expert authority coefficient （Cr） was used to judge the degree of expert authority;the variation coefficient and Kendall coefficient of concordance was used to judge the degree of coordination of expert opinion;the coefficient of internal consistency,test-retest reliability was used to evaluate questionnaire’s reliability;content validity index （CVI） and single and comprehensive correlation analysis method were used to evaluate the content validity;the factor analysis method was used to evaluate the structure validity.Results　Two rounds expert consultation’s Cr was 0.85 and 0.91 respectively.Two rounds of expert enquiry’s total variation coefficient was 0.141,0.049 respectively,and Kendall coefficient of concordance was 0.152,0.160 respectively.The Cronbanch’s α coefficient was 0.972,Guttman split half reliability coefficient was 0.863.Cronbanch’s α coefficient for dimension of emotion management,daily life management,medical management,and sports management was 0.923,0.964,0.916 and 0.991 respectively.Test-retest reliability was 0.899,the consistency coefficient Kappa value was 0.741,P=0.001.The CVI was 0.937,each item’s CVI ranged from 0.873 to 1.000.In 64 PD patients,emotional management dimension score was positively correlated with score of each item of emotional management dimension （P<0.05）:daily life management dimension score was positively correlated with score of each item of daily life management dimension （P<0.05）:medical management dimension score was positively correlated with score of each item of medical management dimension （P<0.05）:sports management dimension score was positively correlated with score of each item of sports management dimension （P<0.05）.Exploratory factor analysis showed that,KMO=0.903 and Bartlett’s test of sphericity χ2=1 137,P<0.01,which showed that data was suitable for factor analysis.Principal component analysis was used to extract the common factor,one factor with eigenvalue equal to or greater than 1.000 was extracted.Combined with the scree plot,a total of four common factors were produced,which could explain 60.629% of the total variation.Conclusion　The PD patients self health management questionnaire has good reliability and validity in the measurement of PD patients’ self health management.

Comparison on the Safety of Intracoronary Eptifibatide Only and Intracoronary Tirofiban Only during Primary Percutaneous Coronary Intervention of Acute ST-segment Elevation Myocardial Infarction Patients

SHANG Zhuo, ZHENG Xiao-qun, DENG Gen-qun, SUI Chun-xing, JIANG Yang, HUI Hui, SUN Shi-ze, ZHAO Yan

2016, 19(27):  3346-3350.  DOI: 10.3969/j.issn.1007-9572.2016.27.017

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Background　Continuous intravenous infusion of small molecule platelet glycoprotein （GP） Ⅱb/Ⅲa receptor antagonist （GPI） can improve the prognosis of patients with acute ST-segment elevation myocardial infarction （STEMI） who had undergone primary percutaneous coronary intervention （PCI）.However,this treatment method can increase bleeding events.Therefore,the safety of the intracoronary eptifibatide only strategy and the intracoronary tirofiban only strategy are worth exploring.Objective　To compare the safety of intracoronary eptifibatide only strategy or intracoronary tirofiban only strategy during primary PCI of acute STEMI patients.Methods　A total of 135 cases of acute STEMI patients admitted into Dalian Municipal Center Hospital from March 2014 to September 2015 and in line with the inclusion standards retrospectively，which were divided into eptifibatide group （n=62） and tirofiban group （n=73） according to the intracoronary eptifibatide or tirofiban during primary PCI.The baseline characteristics of patients in the two groups were collected,including age,gender,body mass index,smoking,diabetes,hypertension,premature family history of coronary artery disease,Killip Ⅱ class and above,postoperative drug（β receptor blocker and ACE inhibitor） application,anterior wall myocardial infarction,infarct-related artery （left anterior descending,left circumflex artery,right coronary artery）,baseline thrombolysis in myocardial infarction （TIMI） flow grade of 0 or 1,the time from onset to balloon dilatation and thrombus aspiration.The TIMI flow grade,corrected TIMI frame count（cTFG）,ST-segment resolution,left ventricular ejection fraction （LVEF）,left ventricular end diastolic diameter （LVEDD）,ventricular wall motion abnormalities,the incidence of bleeding events and thrombocytopenia in hospital,as well as the incidence of major adverse cardiac events （including all-cause death,stent thrombosis,emergency coronary revascularization,myocardial infarction） on 30 days after PCI of patients were compared between the two groups after completion of primary PCI.Results　The difference between the two groups in age,gender,body mass index,smoking,diabetes positive rate,hypertension positive rate,positive rate of premature family history of coronary artery disease,incurrence of Killip Ⅱ class and above,postoperative drug application （β receptor blocker and ACE inhibitor）,anterior wall myocardial infarction,infarct related artery,baseline TIMI flow grade of 0 or 1,time from onset to balloon dilatation and thrombus aspiration were not statistically significant （P>0.05）.The difference between the two groups in TIMI flow grade,cTFG,ST-segment resolution,LVEF,LVEDD and ventricular wall motion abnormalities of patients after completion of primary PCI were not statistically significant （P>0.05）.The incidence of thrombocytopenia in tirofiban group was higher than eptifibatide group（P<0.05）.The difference between the two groups of incidence of bleeding events in hospital and major adverse cardiac events on 30 days after PCI were not statistically significant （P>0.05）.Conclusion　The intracoronary eptifibatide only strategy and the intracoronary tirofiban only strategy have satisfactory curative effect during primary PCI of acute STEMI patients，however，the intracoronary eptifibatide only strategy seems to be safer.

Comparison of Effects of Simple Low-potassium Diet and Low-potassium Diet Combined with Small Doses of Calcium Polystyrene Sulfonate on Treating Hyperkalemia of Maintenance Hemodialysis Patients

ZHOU Ling-hui, PEI Juan, HOU Xiang-hua, ZHANG Heng-yuan, ZHANG Yang-lin

2016, 19(27):  3351-3355.  DOI: 10.3969/j.issn.1007-9572.2016.27.018

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Background　Hyperkalemia is a common complication of maintenance hemodialysis patients,and its excessive volatility of serum potassium during hemodialysis interphase is likely to increase the risk of adverse cardiovascular events,therefore,how to maintain stable serum potassium level during hemodialysis interphase is very important.Objective　To compare the clinical effects of simple low-potassium diet and low-potassium diet combined with small doses of calcium polystyrene sulfonate on treating hyperkalemia of maintenance hemodialysis patients.Methods　According to inclusion criteria,52 patients who underwent maintenance hemodialysis in Hemodialysis Room of the First Affiliated Hospital of Xiamen University from December 2015 to January 2016 were retrospectively selected with serum potassium level≥5.0 mmol/L before hemodialysis.Patients were assigned into control group with 21 cases and research group with 31 cases based on their medication status.Patients in control group received simple low-potassium diet,based on which patients in research group were treated with oral medication of small doses of calcium polystyrene sulfonate.With continuous treatment,patients in two groups were given relevant checks one month after treatment.Serum potassium levels before and after hemodialysis and their difference value,serum calcium before hemodialysis and albumin （Alb） levels of petients in two groups were recorded before and after treatment.Results　Serum potassium levels of all patients before and after hemodialysis and their difference value after treatment were lower than those before treatment （P<0.05）;serum calcium before hemodialysis and Alb levels of all patients before and after treatment were not significantly different （P>0.05）.Before treatment,serum potassium level before and after hemodialysis and their difference value,serum calcium before hemodialysis and Alb levels among patients in two groups were not significantly different （P>0.05）;after treatment,serum potassium level before hemodialysis and difference value of serum potassium levels before and after hemodialysis of patients in research group were significantly lower than those in control group （P<0.05）;after treatment,serum potassium level after hemodialysis,serum calcium before hemodialysis and Alb levels of patients in two groups were not significantly different （P>0.05）.Serum potassium level before hemodialysis and difference value of serum potassium levels before and after hemodialysis of patients in control group after treatment were lower than those before treatment （P<0.05）;there were no significant differences in serum potassium level after hemodialysis,and serum calcium before hemodialysis and Alb levels of patients in control group before and after treatment （P>0.05）;serum potassium levels before and after hemodialysis and their difference value of patients in research group after treatment were lower than those before treatment （P<0.05）;serum calcium before hemodialysis and Alb levels of patients in research group before and after treatment were not significantly different （P>0.05）.Conclusion　Simple low-potassium diet or low-potassium diet combined with small doses of calcium polystyrene sulfonate can reduce hemodialysis patients’ serum potassium level before hematodialysis and reduce potassium volatility,moreover the effects of low-potassium diet combined with small doses of calcium polystyrene sulfonate on lowering potassium is better than those of simple low-potassium diet without increasing calcium load of patients.

Self-rated Health Status of Elders in Shiyan and Its Influencing Factors and Path Analysis

ZHONG Sen, WANG Wen-xin, CHAI Yun, LU Zu-xun

2016, 19(27):  3356-3360.  DOI: 10.3969/j.issn.1007-9572.2016.27.019

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Objective　To investigate the self-rated health status of elders in Shiyan and explore its influencing factors,influencing characters and effective size,in order to provide references for the policies of improving self-rated health level and healthy aging.Methods　At December 2012,firstly,all counties,cities and districts of Shiyan were ranked in accordance with the proportion of elders in a high-to-low order.Bailang Development Zone with a proportion of elders aged 60 and above close to the average proportion of Shiyan（14.1%） was chosen.All the housing estates in Bailang Development Zone were numbered,and by random number table method,three housing estates were selected,including Jian’er,Ji’an and Erjidian housing estate.All elders aged 60 or above in the three housing estates were numbered according to gender and age,and 1 091 elders were selected as subjects.According to the actual health status of elders in Shiyan,a self-designed questionnaire was made with reference to the Scale of Elderly Health Status and Relevant Factors made by the Institute of Psychology of University of Liverpool.The questionnaire content included the general data and self-rated health status of elders.A total of 1 091 questionnaires were distributed,and 1 001 effective questionnaires were collected with an effective recovery rate of 91.8%.Results　Among the 1 001 elders,the number of elders with very good,good,barely good and poor self-rated health status was 114（11.4%）,499（49.8%）,302（30.2%）and 86（8.6%） respectively.Significant differences existed in self-rated health status between elders with different status of smoking,alcohol consumption,chronic diseases,satisfaction with economic income and life,optimistic attitude,change in health status,economic difficulties,events that make people sad（P<0.05）.Logistic regression analysis showed that smoking,change in health status,chronic diseases,satisfaction with economic income and life and optimistic attitude were influencing factors for the self-rated health status of elders（P<0.05）.Path analysis showed that satisfaction with life was the most important influencing factors for self-rated health status of elders.Conclusion　Elders in Shiyan have favorable self-rated health status.Smoking,change in health status,chronic diseases,satisfaction with economic income and life and optimistic attitude are influencing factors for the self-rated health status of elders,and satisfaction with life has great influence on the satisfaction degree with life.

Current Situation of Delivery of Tibetan Women of Childbearing Age in Qinghai Pastoral Area

2016, 19(27):  3361-3366.  DOI: 10.3969/j.issn.1007-9572.2016.27.020

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Objective　To investigate the delivery status of Tibetan pastoral women of childbearing age,and analyze its influencing factors.Methods　In line with the inclusion criteria for the survey,204 women of childbearing age who participated in service activities that benefited the people in Zeku County,Qinghai University from June 19 to 23 in 2014 were selected as the research objects.Among them,80 （39.2%） were from Qiakeri township,79 （38.7%） from Zequ township,and 45 （22.1%） from other townships.The basic information of 204 women of childbearing age was collected,including educational level,marital status,occupation,pregnancy and delivery history;the delivery situation of women who had production history was further investigated,including the selection of midwives,the choice of delivery location,the choice of delivery mode,discomfort symptoms during pregnancy,frequency of prenatal examination,pregnancy-related education receiving status of pregnant women,pregnancy-related education receiving status of the spouse,modern means of transport,economic status;and the influenicing factors of pregnant women choosing different midwives and delivery locations were analyzed.Results　Among the 204 women in childbearing period,their educational level:155 （76.0%） were illiteracy,32（15.7%） were primary school level,10 （4.9%） were junior high school level,and 7 （3.4%） of were high school level or above;marital status:20 （9.8%） of them were unmarried,160 （78.5%） were married,17 （8.3%） were divorced,and 7 （3.4%） of were widowed;occupation:118 （57.8%） were in animal husbandry,25 （12.3%） were housewives,25 （12.3%） were temporary workers,12 （5.9%） of individual busiess households,and 24（11.7%） with others occupations;11 （5.4%） cases with no pregnancy history,193（94.6%） had pregnancy and delivery history.Among the 193 women who had pregnancy and delivery history,191 had production history （including 26 uniparas and 165 multiparas）,and 2 have no history of production.The rate of uniparas choosing medical midwives and institutions was higher than that of multiparas （P<0.05）.There was no significant difference between uniparas and multiparas in the choice of selecting different delivery modes （P>0.05）.Among the uniparas,6 （23.1%） were unmarried,16 （61.5%） married,3 （11.5%） divorced,and 1 （3.9%） widowed;19 （73.1%） owned animal husbandry assets,7 （26.9%） had no animal husbandry assets.The rate of uniparas with the number of antenatal visits was 1 to 4 in selecting midwives was higher than that of uniparas with zero antenatal visit （P<0.05）.There was significant difference in the selection status of midwives and delivery locations between uniparas with or without modern means of transport （P<0.05）;there was no significant difference in the selection status of delivery locations among uniparas with different times of prenatal examination （P>0.05）;there was no significant difference in the selection status of midwives and delivery locations among uniparas of different ages,with or without discomfort symptoms during pregnancy,receiving or not receiving pregnancy-related education,whether their spouses receiving or not receiving pregnancy-related education,and of different economic conditions （P>0.05）.Among the multiparas,4 （2.4%） were unmarried,142 （86.1%） married,13 （7.9%） divorced,and 6 （3.6%） widowed;117 （70.9%） owned animal husbandry assets,48 （29.1%） had no animal husbandry assets.The rate of multiparas with the fetal times≥3 in selecting midwives and delivery locations was lower than that of multiparas with fetal times were 2,the rate of multiparas with the number of antenatal visits≥1 in selecting midwives and delivery locations was higher than that of multiparas with zero antenatal visit （P<0.05）.There was significant difference in the selection status of midwives among multiparas and their spouses receiving or not receiving pregnancy-related education （P<0.05）;there was significant difference in the selection status of delivery locations among multiparas of different economic conditions （P<0.05）;there was no significant difference in the selection status of midwives among multiparas of different economic conditions （P>0.05）;there was no significant difference in the selection status of delivery locations among multiparas and their spouses receiving or not receiving pregnancy-related education （P>0.05）;there was no significant difference in the selection status of midwives and delivery locations among multiparas of different ages and modern means of transport （P>0.05）.Conclusion　The delivering rate of selecting medical institutions and midwifery rate of medical personnel of Tibetan women of childbearing age in Qinghai pastoral area were rather low,and in the choice of medical personnel in midwifery and medical institutions in the delivery of many reasons,families having modern means of transport,fetal times,discomfort symptoms occur during pregnancy,and prenatal examination are the influence factors of delivering in selecting medical midwives and institutions.Therefore,health education targeted at women of childbearing age should be developed according to the actual situation of pastoral areas,and the obstetrics construction of maternity and child care institutions and township hospitals should be strengthened to promote implementation of such health promotion measures.

Effect of TOMATIS Audio Training on Memory Function of Patients with Stroke

ZHANG Jing-jing, CHEN Chang-xiang, LI Shu-xing, ZHANG Min, DOU Na

2016, 19(27):  3367-3370.  DOI: 10.3969/j.issn.1007-9572.2016.27.021

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Background　Memory disorders after stroke are common.There are not enough effective targeted rehabilitation to improve memory disorders.A new method that improves memory function after stroke is necessary.Objective　To explore the effect of TOMATIS audio training on memory function of patients with stroke.Methods　80 stroke patients meeting the inclusion criteria were recruited from Tangshan Rehabilitation Medical Center from June to December 2015.The patients were divided into experiment group （n=40） and control group （n=40） by random table method.Both groups received conventional rehabilitative treatment;control group received music training with conventional frequency,and experiment group received TOMATIS audio training.The general data of patients were collected,and scores of the Rivermead behavioral memory test second edition （RBMT-Ⅱ） and its dimension before and after intervention were recorded and compared.Results　There was no significant difference in gender,age,education,marital status,occupation,course of disease,nature of disease,side of disease,location of disease,and memory function between both groups （P>0.05）.The scores of name recall,appointment recall,picture recognition,face recognition,immediate recall of a story,delayed recall of a story,directional,immediate route recall,delayed route recall and information recall,and total score of RBMT-Ⅱ after intervention in control group were lower than those in experiment group （P<0.05）:there was no significant difference in the scores of hidden object recall and date after intervention between the two groups （P>0.05）.Conclusion　TOMATIS audio training can effectively improve the memory function of patients with stroke.

Impact of Enhanced Video Interactive Training on Patients with Vascular Cognitive Impairment No Dementia after

Cerebral Apoplexy PANG Hai-yun, MU Jing-song, NI Chao-min, WANG Cheng

2016, 19(27):  3371-3374.  DOI: 10.3969/j.issn.1007-9572.2016.27.022

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Objective　To observe the effects of enhanced video interactive training on patients with vascular cognitive impairment no dementia (VCIND)after cerebral apoplexy.Methods　60 patients with VCIND after cerebral apoplexy in line with inclusion standards in Department of Rehabilitation Medicine,Anhui Provincial Hospital from November 2013 to September 2015 were selected.They were divided into the research group and the control group with random number table method,each of 30 cases.Patients in both groups were treated with conventional therapy,including drug therapy such as trophic nerve and improvement of brain function,and regular exercise functional rehabilitation training;besides the regular therapy,patients in the research group also received enhanced video interactive cognitive training guided by professionals,and their relatives also received professional training and guide to participate in the training.The enhanced video interactive cognitive training was conducted 60 min each time,1 time per day,and 5 times per week.The Montreal Cognitive Assessment (MoCA)scores and Barthel Indexes (BI) scores of patients in the two groups before the training and one month after the training were compared.Results MoCA scores of the control group and the research group were (19.1±2.4)and (19.5±2.5)respectively before the training,which became (21.4±2.4)and (23.7±2.3)respectively one month after the training;BI scores of the control group and the research group were (73.2±11.9)and (74.3±13.2)respectively before training,which became (77.7±11.3)and (85.8±8.2) respectively one month after the training;there was no significance difference in the MoCA and BI scores between the two groups (tMoCA=0.633,tBI=0.359,P>0.05);after training,the MoCA and BI scores of the research group were significantly higher than those of the control group (tMoCA=3.774,tBI=3.215,P<0.01).Conclusion　Enhanced video interactive training could improve cognitive function and mobility in daily life of patients with VCIND after cerebral apoplexy.

Effect of sST2 in the Assessment of the Disease Condition and Prognosis of Patients with Heart Failure

HU Zhen, ZHANG Xin-chao

2016, 19(27):  3375-3379.  DOI: 10.3969/j.issn.1007-9572.2016.27.023

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Soluble human stromelysin-2 （sST2） is an important serum marker for cardiovascular disease.Studies have shown that sST2 plays a certain role in the pathophysiology of heart failure,and it is an index for reflecting myocardial fibrosis and a new biomarker for heart failure.In this review,multiple relevant studies were reviewed,and the analysis showed that there is close correlation between sST2 level and heart failure risk stratification and prognosis.sST2 can independently predict the prognosis of heart failure,and has certain clinical application value.

Relationship between Thyrotoxic Periodic Paralysis and KCNJ18,KCNJ2

YE Yan, YAO Yu, TIAN Hao-ming

2016, 19(27):  3380-3384.  DOI: 10.3969/j.issn.1007-9572.2016.27.024

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Thyrotoxic periodic paralysis （TPP） is one of the complications of thyrotoxicosis,which is characterized by reversible acute quadriplegia and hypokalemia.Asian young men are at high risk of developing TPP,and therefore genetic background is suspected to be involved in the pathogenesis.Studies have shown that there are a large number of inwardly rectifying potassium ion （Kir） channels in skeletal muscle.Kir2.6 and Kir2.1 are two of important members of Kir channels,they are encoded by KCNJ18 and KCNJ2 gene,and are closely related to TPP.This review summarizes the research progress of TPP,KCNJ18 and KCNJ2,and relationship between TPP and KCNJ18,KCNJ2,which can provide latest evidence for the search of pathogenic gene of TPP.