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    15 October 2016, Volume 19 Issue 29
    Research Progress and Inspiration of Informatization Strategy for Stroke Prevention and Control Abroad
    YANG Li-min, LIU Yue-xing, YAN Fei, HAN Lu
    2016, 19(29):  3513-3516.  DOI: 10.3969/j.issn.1007-9572.2016.29.001
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    There is a severe prevalence of stroke globally.In order to control and reverse the continuous growing trend of stroke,developed countries have taken a series of strategies for disease prevention,management and monitoring.To investigate the hygiene information strategies and experience(including disease monitoring,tele-medicine and clinical decision support) that related with the prevention and control of stroke internationally through literature review,and hope to provide references for the promotion of hygiene information strategies construction of stroke prevention and control in China.
    Thematic Discussion of Specialists on "Chronic Disease Management"
    ZENG Xue-jun, WANG Fang, SHA Yue, SHEN Qiang, YU Guo-yong, LI Guang-shun, ZHAO Chun-shan, CUI Dian-zhu, ZHAO Hui, WANG Hai-long
    2016, 19(29):  3517-3523.  DOI: 10.3969/j.issn.1007-9572.2016.29.002
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    This paper shows a theme discussion on chronic disease management between several general practice specialists. In the discussion, Prof. ZENG Xue-junthought general practitioner should play the role "Health Gatekeeper" to promote chronic patient centered hierarchical diagnosis and treatment; Director WANG Fanggave her opinion on integrated mode of chronic disease prevention and control in hierarchical medical system; SHA Yue made a point that chronic disease management was a health management from disease to individual; SHEN Qiang analyzed informatization management for chronic disease; YU Guo-yong made an analysis on chronic disease management under integrated traditional and Western medicine; LI Guang-shun presented the challenges of chronic disease management to community health service centers and the corresponding strategies; ZHAO Chun-shan proposed raising national health consciousness and implementing education first; CUI Dian-zhu analyzed how to strengthen chronic disease prevention and control, and develop community health services; ZHAO Hui gave his idea of how to help hierarchical diagnosis and treatment relying on chronic disease management; WANG Hai-long put forward reflections on specialty development of chronic disease prevention and control in community health service centers. The discussion aims to promote effective development of chronic disease management in community health service institutions, explore the working mode of chronic disease management that adapt to the new medical reform, and improve the chronic disease management effects in community health service institutions.
    Correlation between the Area of the Inferior Pole of the Perirenal Fat and Insulin Resistance among Patients with Metabolic Syndrome
    ZHOU Mei-yang, GONG Wei-kun, CHEN Shu-ting, TONG Hong-zhang, SHAN Ai-qin, HE Yong-ping
    2016, 19(29):  3524-3527.  DOI: 10.3969/j.issn.1007-9572.2016.29.003
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    Objective To investigate the relationship between color Doppler ultrasound measured the area of the inferior pole of the perirenal fat(AIPPF) and insulin resistance index of homeostasis model assessment(HOMA-IR) among patients with metabolic syndrome(MS).Methods From April 2008 to April 2009,72 cases who met the diagnostic criteria of MS from physical examination center of Yinzhou People’s Hospital,were selected as study subjects. Body mass index(BMI),waist circumference and biochemical indicators were measured,AIPPF and IAF were measured by color Doppler ultrasound,VAT was measured by magnetic resonance imaging(MRI).The correlation between clinical/laboratory parameters and HOMA-IR was analyzed by Pearson correlation analysis and stepwise linear regression analysis.Results For 72 patients with MS,the mean age was (49.0±9.2)years old,the mean stature was(165.8±8.8) cm,the mean body mass was(75.8±10.6)kg,the mean BMI was(27.6±2.9) kg/m2,the mean waist circumference was(95.8±8.4) cm,the mean level of fasting blood glucose was(6.3±0.9) mmol/L,the mean level of fasting insulin was(15.4±10.1) mU/L,the mean HOMA-IR was (1.2±0.7),the mean AIPPF was (10.2±2.8)cm2,the mean IAF was (10.0±0.9)cm,the mean VAT was (112.6±15.5)cm2. According to Pearson correlation analysis results,there were no linear correlation between age,height,and HOMA-IR(P>0.05),and there were positive correlation between body mass,BMI,waist circumference,fasting blood glucose level,fasting insulin level,AIPPF,IAF,VAT and HOMA-IR(P<0.05). Stepwise linear regression analysis results showed that AIPPF,age and BMI entered the regression equation,the regression equation was HOMA-IR=-0.493+0.001 AIPPF-0.20 age+0.51 BMI,the difference was statistically significant(F=16.155,P<0.001).Conclusion AIPPF is significantly related to HOMA-IR among patients with MS.
    Relationship between Platelet Count and Prognosis of Newly Diagnosed Patients with Acute Myeloid Leukemia after Initial Induction Chemotherapy
    ZHU Hai-bo, ZHAO Ming-feng, LI Yu-ming, DENG Qi, GENG Li, CUI Rui, LIU Peng-jiang
    2016, 19(29):  3528-3533.  DOI: 10.3969/j.issn.1007-9572.2016.29.004
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    Objective To analyze the platelet count of newly diagnosed patients with acute myeloid leukemia(AML) after initial induction chemotherapy for the first time,and to access its relationship with prognosis and importance,and to explore simple and easy indices of predicating AML prognosis.Methods 110 AML patients who received explicit diagnosis and treatment initially in Tianjin First Central Hospital from May 2011 to December 2014 were selected,all of them accepted classic DA or similar chemotherapy regimens to perform remission induction chemotherapy.Three weeks after the first time of induction chemotherapy,platelet count was detected.The patients were divided into four groups according to platelet count:45 patients with platelet count <100×109/L group,19 patients with platelet count of(100-150)×109/L group,25 patients with platelet count of(151-300)×109/L group,and 21 patients with platelet count >300×109/L group.Gender,age,white blood cell count during initial treatment,poor prognostic chromosomes,whether obtained complete remission of bone marrow after initial induction chemotherapy or not,and recurrence rate of patients in 4 groups were compared.Taking patients’ age of 60 as a dividing line,there were 41 patients aged ≥60 and 69 patients aged<60;taking patients’ white blood cell count of 30×109/L during initial treatment as a dividing line,there were 28 patients with white blood cell count ≥30×109/L,and 82 patients with white blood cell count<30×109/L;taking patients had poor prognosis chromosomes,16 patients had poor prognosis chromosomes and 94 patients no poor prognosis chromosomes;taking patients had obtained complete remission of bone marrow after initial induction chemotherapy or not,70 patients had obtained complete remission and 40 patients had obtained non-complete remission;taking patients’ platelet count of 300×109/L after initial induction chemotherapy as a dividing line,21 patients with platelet count >300×109/L,and 89 patients with platelet count ≤300×109/L.Kaplan-Meier survival curve was applied,and overall survival and disease-free survival were taken as the end point of observation respectively.Log-rank test and multivariate Cox proportional hazards regression model was used to analyze the influencing factors of prognosis.Results There was no significant difference in gender,the proportion of poor prognosis chromosomes and obtaining complete remission of bone marrow after initial induction chemotherapy among groups of different platelet count after initial induction chemotherapy(P>0.05);the age of patients in platelet count <100×109/L group and platelet count of(100-150)×109/L group was greater than that in platelet count >300×109/L group(P<0.05).The proportion of white blood count ≥30×109/L during initial treatment and recurrence rate of patients in platelet count <100×109/L group during initial treatment were higher than those in platelet count >300×109/L group(P<0.007).Log-rank test showed that there were significant difference in overall survival and disease-free survival among patients of different ages,white blood count during initial treatment,with or without obtaining of complete remission and different platelet count after initial induction chemotherapy(P<0.05);there were no significant difference in overall survival and disease-free survival between patients with or without poor prognosis chromosomes(P>0.05).Multivariate Cox proportional hazards regression analysis revealed that there were regression correlation between age,the obtaining of complete remission and platelet count after initial induction chemotherapy and overall survival,disease-free survival of patients(P<0.05).Conclusion The increasing of platelet count of AML patients after initial induction chemotherapy leads to relatively good prognosis of patients and can independently affect prognosis of AML patients.
    Correlation between Hepatitis C Virus Infectors of Different Transmission Routes and Distribution of Genotypes in Guangxi
    ZHU Ming-yue, SU Ming-hua, JIANG Jian-ning, LIAO Bai-ming, WEI Zhi, CHEN Xu, LIU Zhi-hong, WEI Qi, TENG Chun-ling, HE Li-xia
    2016, 19(29):  3534-3538.  DOI: 10.3969/j.issn.1007-9572.2016.29.005
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    Background Hepatitis C virus(HCV)infection did serious harm to human health.HCV genotypes had close relationship with response to interferon therapy.The frequency distribution of HCV genotypes varied according to different geographical regions.Objective To investigate the correlation between HCV infectors of different transmission routes and HCV genotypes in Guangxi.Methods Serum samples of 230 HCV RNA positive patients who admitted to Department of Infectious Diseases,First Affiliated Hospital of Guangxi Medical University were collected from February 2011 to December 2014.The transmission routes were recorded including blood transfusions,injection drug use(IDU),sexual contact,others(such as tattoo,ears pierced,oral treatment etc.)and unknown,etc.The HCV NS5B region was subjected to nested RT-PCR amplification and sequenced.The sequences were compared with the complete genome sequences of standard strains registered in GenBank to find out their exact genotypes and subtypes.The correlation between HCV transmission routes and genotypes were analyzed respectively.Results The PCR products amplified from the NS5B region were separated by agarose gel electrophoresis and produced band of 377 bp.Electrophoretic bands appeared relatively clearly.The complete NS5B region was successfully amplified and classified from 222 out of 230 samples.There were 27 cases(12.16%)of subtype 1a,102 cases(45.95%)of subtype 1b,11 cases(4.95%)of subtype 2a,15 cases(6.76%)of subtype 3a,29 cases(13.06%)of subtype 3b,34 cases(15.32%)of subtype 6a,1 case(0.45%)of subtype 6d,and 1 case(0.45%)of subtype 6e,2 cases(0.90%)of hybrid subtype 1b+6c.There were 93 patients with blood transmission,56 patients with IDU transmission,21 patients with sexual transmission,36 patients with other routes of transmission,16 patients with unknown transmission.There were no statistically significant difference among the genotypes with other routes of transmission(P>0.05).There were statistically significant difference among the genotypes with IDU,blood and sexual transmission(P<0.05).The most common genotypes with blood transmission was type 1.The most common genotypes with IDU were type 1,3 and 6.The most common genotypes with sexual transmission were type 1 and 3.Conclusion The frequency distributions of HCV genotypes change with the change of transmission routes.The major infection mode of genotype 1b is blood transfusion.Most of genotype 1a,3b and 6a patients have a history of IDU.Genotype 1a and 3b mostly appeared in sexual transmission.
    Value of 18 MHz High Frequency Color Doppler Ultrasound to Predict the Diabetic Foot in Patients with Type 2 Diabetes
    2016, 19(29):  3539-3544.  DOI: 10.3969/j.issn.1007-9572.2016.29.006
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    Background One of the major causes for disability in patients with T2DM was low extremity artery problem.It was very important for decreasing the incidence of diabetic foot and slowing down the development to early detect vascular disease in patients with T2DM.High frequency ultrasound probe could clearly demonstrate the superficial vascular structures and be used to quantitatively analysis of small artery stenosis.Objective To explore the value of high frequency ultrasound to predict the occurrence of diabetic foot in T2DM,we examinated the dorsal artery in patients with T2DM using 18 MHz high frequency color Doppler ultrasound.Methods A total of 240 patients with T2DM were involved in this study,which accepted routine examination in Huinan Community Health Service Center of Pudong New District of Shanghai city from January 2014 to June 2015.The patients were divided into diabetic foot group(69 cases) and T2DM group(171 cases) according to whether they had diabetic foot or not.The medical history and laboratory tests of the patients were collected,including inflammatory markers,blood glucose and lipid levels.The dorsal artery diameter(ZBD),intima-media thickness(IMT),blood flow,end diastolic velocity(EDV),peak systolic velocity(PSV) and pulsatility index(PI) were measured and calculated using 18 MHz high frequency color Doppler ultrasound.Results The difference of the diabetes duration,the levels of WBC,CRP,HbA1c,and 2 hPG were statistically significant(P<0.05) between the two groups.The difference of ZBD,IMT,blood flow and EDV were not statistically significant(P>0.05) between the two groups.The PSV and PI in diabetic foot group were lower than those in T2DM group(P<0.05).Then the correlation analysis was performed between the parameters which were statistically different between the two groups,including clinical data and 18 MHz high frequency color Doppler ultrasound indicators.There were no relationship between PSV and diabetes duration,WBC,CRP and 2 hPG(r=-0.314,0.129,0.352,-0.103;P>0.05).A negative relationship was found between PSV and HbA1c(r=-0.642,P<0.05).There were no relationship between PI and diabetes duration and 2 hPG(r=0.273,-0.117;P>0.05).A negative relationship were found between PI and WBC,CRP and HbA1c (r=-0.413,-0.518,-0.307;P<0.05).The correlation coefficient between PSV and HbA1c was larger.ROC curves were analyzed to evaluate the value of PSV and HbA1c in predicting diabetic foot in T2DM patients.The area under the ROC curve for HbA1c predicting diabetic foot in T2DM patients was 0.683.The HbA1c had a sensitivity of 68.6% and a specificity of 42.4% at a cut-off level of 8.1%.The area under the ROC curve for PSV predicting diabetic foot in T2DM patients was 0.886.The PSV had a sensitivity of 87.1% and a specificity of 76.3% at a cut-off level of 46.34 cm/s.The area under the ROC curve for HbA1c predicting diabetic foot in T2DM patients was lower than PSV,and the difference was statistically significant(Z=2.156,P<0.05).Conclusion 18 MHz high frequency color Doppler ultrasound has better clinical value in the diagnosis of dorsal foot artery disease in T2DM patients,and can predict the occurrence of diabetic foot.
    Relationship between Anti-C1q Antibody in Kidney Tissue of Lupus Nephritis Patients and Disease Activity
    GUZAILINUER·Sailaiajimu, WANG Mei-hong, MINAWAER·Yunuosi, SANG Xiao-hong
    2016, 19(29):  3545-3548.  DOI: 10.3969/j.issn.1007-9572.2016.29.007
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    Background With the accelerated development of medical technology,the experts at home and abroad have conducted a lot of research on the anti-C1q antibody(anti-C1qAb)and lupus nephritis(LN) disease activity.Unfortunately,the medical technology is weak in Xinjiang region,and the lack of research personnel is serious,this issue has not been carried out systematically and completely.Objective To study the correlation between anti-C1qAb in kidney tissue of LN patients and disease activity.Methods 129 cases of LN patients who underwent renal biopsy in Department of Nephrology of the First Affiliated Hospital of Xinjiang Medical University from July 2006 to July 2013,were selected as study subjects.According to whether anti-C1qAb in the kidney tissue existed,cases were divided into anti-C1qAb positive group(n=64)and anti-C1qAb negative group(n=65).According to expression level of anti-C1qAb in the kidney tissue,anti-C1qAb positive patients were divided into mild group,moderate group and severe group.The clinical manifestations of patients were recorded,the blood was extracted,erythrocyte sedimentation rate(ESR),levels of globulin,hemoglobin(Hb),serum creatinine(Scr),blood urea nitrogen(BUN),albumin(Alb),complement C3 and C4 were measured.Estimated glomerular filtration rate(eGFR),the SLE disease activity(SLEDAI),and LN activity index(AI)were calculated.Results There were no significant difference in gender,age,course of the disease,SBP,DBP,ESR,levels of serum globulin,Scr and BUN between two groups of patients(P>0.05).Levels of Hb,Alb,C3,C4,and eGFR in anti-C1qAb positive group were significantly lower than those in anti-C1qAb negative group,and the SLEDAI score of anti-C1qAb positive group was significantly higher than that of anti-C1qAb negative group(P<0.05).There were no significant difference in incidences of fever,malar rash,ulcers,arthritis pain/joint inflammation,pericarditis,pleurisy,tube type urine,aleucocytosis and thrombocytopenia between two groups of patients(P>0.05);the incidences of protein urine,decreased Hb,low levels of C3 and C4 in anti-C1qAb positive group were significantly higher than those in anti-C1qAb negative group(P<0.05).There were significant differences in serum levels of C3 and C4,eGFR,SLEDAI and AI score among groups with different anti-C1qAb degree(P<0.001).Serum C3 and C4 level in mild group,moderate group and severe group were significantly lower than those in anti-C1qAb negative group respectively,AI score in mild group,moderate group and severe group was significantly higher than that in anti-C1qAb negative group respectively;eGFR in moderate group and severe group was significantly lower than that in anti-C1qAb negative group respectively and SLEDAI score in moderate group and severe group was significantly higher than that in anti-C1qAb negative group respectively;serum C3 level in severe group was significantly lower than that in mild group;eGFR in moderate group was significantly lower than that in mild group;AI score in moderate group and severe group was significantly higher than that in mild group respectively(P<0.05).Conclusion Anti-C1qAb in LN patients plays an important role in the development of renal damage,and it correlates closely with the degree of kidney disease and disease activity.
    Rapid Development Period and Gender Difference of the Component of Effortful Control in 3-6 Years Old Children
    HU Fei-li, WU Li-yun, ZHANG Xing-li, SHI Jian-nong
    2016, 19(29):  3549-3553.  DOI: 10.3969/j.issn.1007-9572.2016.29.008
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    Objective To explore the rapid development period and gender difference of effortful control and the component of effortful control in 3-6 years old children so as to lay a theoretical foundation for the training or intervention of children’s effortful control.Methods In this study,we enrolled 130 3-6 years old children from two kindergartens in Beijing and chose five tasks including Walk-a-line,Turtle and Rabbit,Gift-in-Bag,Tower and Whisper to assess children’s effortful control in gross motor control,fine motor control,delay of gratification,suppressing/initiating activity to signal and controlling and adjusting voice with 4×2×5 mixed design from July to August in 2014.Results The results of repeated measurement ANOVA showed:the interaction between age and every component of effortful control was significant(F=2.131,P=0.015);the interaction between gender and every component of effortful control was significant(F=3.068,P=0.019).The results of multivariate analysis of variance showed that age had significant effect on the score of each component and the total score of effortful control(P<0.05).The score of gross motor control of 3 years old children was significantly lower than that of 5,6 years old children,and 4 years old children was significantly lower than 5 years old children(P<0.05).The score of fine motor control of 3,4 years old children was significantly lower than that of 5,6 years old children(P<0.05).The score of delay of gratification and suppressing/initiating activity to signal of 3 years old children was significantly lower than that of 4,5,6 years old children(P<0.05).The score of controlling and adjusting voice of 3 years old children was significantly lower than that of 4,5,6 years old children,and 4 years old children was significantly lower than that of 5,6 years old children(P<0.05).The total score of effortful control of 3 years old children was significantly lower than that of 4,5,6 years old children,and 4 years old children was significantly lower than that of 5,6 years old children(P<0.05).The results of independent samples t test showed that boys’ score was significantly higher than girls’ score in fine motor control(t=2.244,P=0.027).Conclusion The effortful control competence and every component are increasing with age,but the rapid developmental speeds are different for the different components.The competence of gross and fine motor control are in 4-5 years old,and the competence of delay of gratification and suppressing/initiating activity to signal are in 3-4 years old,while the competence of controlling and adjusting voice is in 3-5 years old.Boys’ performance is higher than girls’ only in the competence of fine motor control.
    Clinical Effect of Conventional Antitubercular Agents Combined with Bronchoscopic Cryotherapy on Ndobronchial Tuberculosis and Its Influence on Immune Function
    ZHAO Lei, DI Yan, WANG Yu-ling, XUE Jian, RONG Yan-xiao, CAO Jin-feng, KANG Shu-hui
    2016, 19(29):  3554-3557.  DOI: 10.3969/j.issn.1007-9572.2016.29.009
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    Objective To investigate the clinical effect of conventional antitubercular agents combined with bronchoscopic cryotherapy on endobronchial tuberculosis(EBTB),and to analyze the changes in patients’ immune function before and after treatment.Methods 50 patients who were diagnosed with EBTB in the Fifth Hospital of Shijiazhuang from 2013 to 2015 were selected as research objects.Patients were conventionally given anti-tuberculosis scheme of 2HRZE(S)/10HRE;tracheal secretions were cleared under bronchofiberscopy,0.3 g isoniazide was locally injected in region of lesion,freezing probe was applied to freeze lesions with a freezing time of about 60 s each time,and self-melting of 1 minute,and each lesions repeated for 3 to 5 times.Bronchoscope was reexamined after 1 week,and frozen and necrotic tissue were cleaned.According to the situation of patient tolerance and severity of lesions,cryotherapy could be performed for many times.Occurrence of adverse reactions was recorded during treatment;the clinical effect was evaluated 2 months after treatment,and T-lymphocyte subsets and immune globulin levels were detected before and 2 months after treatment.Results Patients received cryotherapy of 3 to 11 times with an average time of(4.0±2.5).2 months after treatment,there were 41 cases(82.0%) with remarkable effects,8 cases(16.0%) with effects,1 case(2.0%) with no effects,and the total effective rate was 98.0%(49/50).Cough occurred in 5 patients,slight bleeding in 3 patients,without other serious adverse reactions and complications.The proportion of CD+3 T cells,CD+4 T cells and CD+4 /CD+8 after treatment were higher than those before the treatment,and proportion of CD+8 T cells was lower than that before treatment(P<0.05).There were no significant difference in immunoglobulin IgA,IgG,IgM levels before and after treatment(P>0.05).Conclusion Conventional antitubercular agents combined with bronchoscopic cryotherapy can obtain good treatment effects on EBTB,and improve the disordered status of T-lymphocyte subsets of patients.
    Expression of miR-145 in Gastric Cancer and Lymph Nodes Tissues and Its Clinical Association
    WANG Li-li, LI Yong, TAN Bi-bo, FAN Li-qiao, ZHAO Qun, WANG Dong, LIU Yu, LIU Qing-wei
    2016, 19(29):  3558-3561.  DOI: 10.3969/j.issn.1007-9572.2016.29.010
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    Background MicroRNAs have been reported as key regulators of various cancers,and miR-145 is one of these microRNAs.However,the mechanism and clinical significance of miR-145 in metastases of gastric cancer remain unknown.Objective To detect the expression of miR-145,matrix metalloproteinase 9(MMP-9),matrix metalloproteinase inhibitor 1(TIMP-1)in gastric cancer tissues,adjacent normal tissues and metastatic lymph node,non-metastatic lymph nodes tissues and explore the expression and clinical significance of miR-145 in gastric cancer tissues.Methods From January 2014 to October 2015,120 patients with gastric cancer were included in the study,who accepted radical gastrectomy in Third Department of Surgery of the Fourth Hospital of Hebei Medical University.The expression of miR-145,MMP-9,TIMP-1 mRNA were examined in gastric cancer tissues,adjacent normal tissues and metastatic lymph node,non-metastatic lymph nodes tissues used quantitative real time polymerase chain reaction(qPCR).Results There were statistically significant difference in the expressions of miR-145,MMP-9,TIMP-1 mRNA in gastric cancer tissues,adjacent normal tissues and metastatic lymph node,non-metastatic lymph nodes tissues(P<0.001).The expressions of miR-145,TIMP-1 mRNA in adjacent normal tissues were higher than gastric cancer tissues,and the expression of MMP-9 mRNA in adjacent normal tissues was lower than gastric cancer tissues(P<0.05).The expression of miR-145 mRNA in non-metastatic lymph nodes tissues was lower than gastric cancer tissues and adjacent normal tissues.The expressions of MMP-9 mRNA in non-metastatic lymph nodes tissues was lower than gastric cancer tissues.The expression of TIMP-1 mRNA in non-metastatic lymph nodes tissues was higher than gastric cancer tissues.The expression of miR-145,TIMP-1 mRNA in metastatic lymph node tissues were lower than gastric cancer tissues,adjacent normal tissues and non-metastatic lymph nodes tissues.The expressions of MMP-9 mRNA in metastatic lymph nodes was higher than gastric cancer tissues,adjacent normal tissues and non-metastatic lymph nodes tissues(P<0.05).A positive relationship was found between the expression of miR-145 mRNA in gastric cancer tissues and adjacent normal tissues(rs=0.302,P<0.001).A positive relationship was found between the expressions of miR-145 mRNA in metastatic lymph node tissues and their corresponding gastric cancer tissues(rs=0.346,P=0.003).There was no relationship between the expressions of miR-145 mRNA in non-metastatic lymph nodes tissues and their corresponding gastric cancer tissues(rs=0.264,P=0.070).A negative relationship was found between the expressions of miR-145 and MMP-9 mRNA in gastric cancer tissues(rs=-0.403,P<0.001).A positive relationship was found between the expressions of miR-145 and TIMP-1 mRNA in gastric cancer tissues(rs=0.294,P=0.001).A negative relationship was found between the expressions of miR-145 and MMP-9 mRNA in metastatic lymph node tissues(rs=-0.323,P<0.001).There was no relationship between the expressions of miR-145 and TIMP-1 mRNA in metastatic lymph node tissues(rs=0.165,P=0.072).There were no relationship between the expressions of miR-145 and MMP-9,TIMP-1 mRNA in non-metastatic lymph nodes tissues(rs=-0.119,P=0.197;rs=0.096,P=0.295).Conclusion The expression of miR-145 mRNA was significantly down-regulated in gastric cancer and lymph nodes tissues.The miR-145 might be involved in metastases of gastric cancer by regulating MMPs family.
    Effects of PTEN Overexpression and Mutation on FAK Signal Transduction in Activated Hepatic Stellate Cells
    WEI Yue, HAO Li-sen, REN Chang-zhen, ZHANG Guang-ling, CHEN Jing, WANG Jing, MO Yan-bo, ZHANG Ming-ting
    2016, 19(29):  3562-3566.  DOI: 10.3969/j.issn.1007-9572.2016.29.011
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    Objective To investigate the overexpression of wild-type PTEN and its mutant G129E on focal adhesion kinase(FAK) signal transduction in activated hepatic stellate cells(HSC) in vitro.Methods Using transient transfection technique,the wild-type PTEN gene and G129E gene were transduced into the cultured activated HSC mediated by adenoviral vector from December 2014 to June 2015.Cells were grouped as follows:control group,activated HSC were transfected with DMEM basal medium instead of adenovirus.Ad-GFP group,activated HSC were infected with adenovirus expressing green fluorescent protein(GFP).Ad-PTEN group,activated HSC were infected with the recombinant adenovirus containing both wild type PTEN and GFP gene.Ad-G129E group,activated HSC were infected with adenovirus harboring both PTEN mutant G129E and GFP gene.The protein expression of PTEN,FAK and phosphorylated FAK〔p-FAK(Tyr397)〕 in activated HSC were detected by Western blotting.PTEN and FAK mRNA levels were detected by real-time fluorescent quantitation PCR.Results At 48 hours after adenovirus transfection,there were statistically significant difference in the expressions of PTEN protein and mRNA in activated HSC among 4 groups(P<0.05),the expressions of PTEN protein and mRNA in activated HSC in Ad-PTEN group and Ad-G129E group were higher than those in control group and Ad-GFP group(P<0.05),there were no statistically significant difference in the expressions of PTEN protein and mRNA in activated HSC between control group and Ad-GFP group or Ad-PTEN group and Ad-G129E group(P>0.05).There were no statistically significant difference in the expressions of FAK protein and mRNA in activated HSC among 4 groups(P>0.05).There was statistically significant difference in the expression of p-FAK(Tyr397)in activated HSC among 4 groups(P<0.05),the expression of p-FAK(Tyr397)in activated HSC in Ad-PTEN group and Ad-G129E group was lower than that in control group and Ad-GFP group(P<0.05),but there were no statistically significant difference in the expression of p-FAK(Tyr397)in activated HSC between control group and Ad-GFP group or Ad-PTEN group and Ad-G129E group(P>0.05).Conclusion The overexpression of wild-type PTEN and its mutant G129E can negatively regulate FAK signaling transduction by inhibiting phosphorylation of FAK in activated HSC in vitro.
    Biological Activity of Growth Hormone Based on BAF/GM Cell Line
    LUO Yan-fei, REYILANMU·Baoerhan, MIREGULI·Maimaiti, LI Jing, SHI Zhao-long
    2016, 19(29):  3567-3570.  DOI: 10.3969/j.issn.1007-9572.2016.29.012
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    Objective To investigate the feasibility of using BAF/GM cell line method to detect the biological activity of GH,and to provide referential methods for clinical detect biological activity of GH.Methods 42 children with ISS who received treatment in the Department of Pediatrics,the First Affiliated Hospital of Xinjiang Medical University from July 2011 to December 2013 were selected(ISS group),other 52 healthy children after physical examination in the Department of Prevention and Health Care of this hospital were also selected as control group.BAF/GM cell line was established,which was routinely cultured in DMEM high glucose medium.The BAF/GM cell line after washed was transferred into the culture medium containing 10% horse serum for 16 hours cultivation.10% horse serum was adopted to culture the resuspension cells,the cell concentration was adjusted to 3×105/ml,and 100 μl after mixing was dropped into the 96-hole micro pore plate.Diluted the standard GH to a final concentration of 0.01-1 000.00 μg/L,took 10 μl standard GH and dropped it into the 96-hole micro pore plate,and cultured for 22 hours.We added 22 μl reaction liquid into each hole and further cultured for 3 hours,and detected the OD value at the wavelength of 490 nm.The standard curve of the equivalent relationship between GH biological activity equivalent and OD value was made.We used the culture medium containing 10% horse serum to make up thyroid-stimulating hormone(100 mU/L),luteinizing hormone(10 000 U/L),follicle-stimulating hormone(10 000 U/L),prolactin(100 U/L),fibroblast growth factors(1 000 μg/L),epidermal growth factors(100 μg/L),IGF-1(10 μg/L),hydrocortisone(100 μg/L),Novolin R(1.0 U/L),and L-thyroxine sodium(643.5 nmol/L),intervention test was made by adding 5 μl(20 μg/L) standard GH solution into each hole.We collected fasting venous blood of the two groups,and adopted IRMA method to measure the level of serum GH,inactivated serum samples,and through MTS method to obtain OD value at the wavelength of 490 nm,and then substituted it into the standard curve to calculate the biological activity equivalent of the serum GH.Results The standard curve of GH biological activity equivalent and the OD value relation was Y=0.852 0ln(X)+0.498 8,R2=0.969 8.X was the GH biological activity equivalent,and Y was the OD value.After the addition of thyroid-stimulating hormone,luteinizing hormone,follicle-stimulating hormone,prolactin,fibroblast growth factors,epidermal growth factors,IGF-1,hydrocortisone,Novolin R,and L-thyroxine sodium,there were no significant difference between the detected OD value and the standard GH(P>0.05).There was no significant difference in GH level between the two groups(P>0.05).The biological activity equivalent of GH and the GH biological activity in ISS group were lower than those in the control group,which showed significant differences(P<0.05).Conclusion BAF/GM cell line is the potential method for detecting biological activity of GH,and has certain anti-interference ability.
    Death Status and Fulfillment Index among Community Residents in Xihu District of Nanchang in 2014
    YANG Jiao, ZHOU Xiao-jun, LI Lei, WU Ming-yang, YANG Li-li, WU Wei, JIANG Jiang, RUAN Shi-ying
    2016, 19(29):  3571-3575.  DOI: 10.3969/j.issn.1007-9572.2016.29.013
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    Objective To explore the level and causes of death and its characteristics among community residents in Xihu district of Nanchang in 2014,in order to provide a scientific basis for appropriate disease prevention and control strategies and improve the level of life and health.Methods We obtained deaths and population data for community residents in Xihu district in 2014 from Xihu District Center for Disease Control and Prevention.The international classification of diseases(ICD-10) was adopted to classify the underlying causes of death.Using indicators such as mortality,proportion of deaths,and etc,for descriptive analysis on level and causes of death cis-position.Fulfillment index was calculated based on abridged and cause-eliminated life tables.Results A total of 2 428 deaths occurred among community residents of Xihu district of Nanchang in 2014.The figure translated into a crude mortality rate of 535.40/100 000 and a standardized mortality rate of 463.06/100 000,respectively.The top 5 causes of death were circulatory diseases,cancer,respiratory diseases,accidents and endocrinology and nutrition and metabolic diseases,which accounted for 2 210 residents deaths.This figure represented 91.02% of all deaths.The leading cause of death were some certain conditions originating in the perinatal period and accidents in the 0-14 year-old age group,tumors and accidents in the 15-44 year-old age group,tumors and circulatory diseases in the 45-64 year-old age group,circulatory diseases,tumors and respiratory diseases in the age 65 and older group.Fulfillment index distribution was as follows:circulatory diseases mainly occurred at age 65 and older,Fulfillment index was more than 30.00%.The occurrence of tumors focused on the age of 20 to 69 year-old,Fulfillment index was 18.17% to 44.78%.Respiratory diseases focused on age 60 and older,Fulfillment index was 9.30% to 17.76%.Accidents mainly occurred in 10-24 year-old group,Fulfillment index was up to 66.66% in the 15-19 year-old group.Fulfillment index of endocrinology and nutrition and metabolic diseases was up to 49.99% at the age of 10-14 year-old.Circulatory diseases mainly included cerebrovascular disease,heart disease and hypertension,which accounted for 99.01% of all circulatory diseases.As for the tumors,the top 3 most frequent malignancies were cancer of lung,liver and gastric,which accounted for 56.63%.Respiratory diseases were mainly chronic obstructive pulmonary diseases,which accounted for 67.73%.Accidents were mainly traffic accidents,falls or drops,which accounted for 65.93%.The diabetes was the most frequent endocrinology and nutrition and metabolic diseases and accounted for 87.69%.Conclusion Chronic non-communicable diseases and accidents are major conditions that affected the health of residents in Xihu district of Nanchang city.It is suggested to intervene mainly different types of diseases for different population age groups in order to reduce the morbidity and mortality of the whole residents and improve population health.
    Mortality Trend of Malignant Tumors in Weifang Community of Shanghai in 2006—2015
    2016, 19(29):  3576-3579.  DOI: 10.3969/j.issn.1007-9572.2016.29.014
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    Objective  To explore the mortality trend of malignant tumors among community residents through reviewing the information about death of malignant tumors in Weifang community of Shanghai in 2006—2015,in order to provide a theoretical basis for formulating better cancer prevention and rehabilitation strategies.Methods Population data of Weifang community of Shanghai in 2006—2015 were obtained from the Public Security Bureau.Information about patients died from cancer were collected from cards ‘a new cancer case report in Shanghai’ registered by the responsible person of the Community Health Service Center and cancer information were collected in the life statistics.The mortality rate was standardized by national population in the same period.Results From 2006 to 2015,a total of 916 163 person-years were observed.There were 2 202 cases died from malignant tumors.The crude mortality rate of all malignant tumors was 240.35/100 000,and the standardized mortality rate was 136.81/100 000.The male cancer standardized mortality rate was higher than the female,except in 2014,and the difference was statistically significant(P<0.05).Both the male and female cancer standardized mortality rate showed the trend of first increase and subsequent decrease.The peak of death occurred in 2010.The male cancer standardized mortality rate was lower than the female in the 25-year-old population,while the male cancer standardized mortality rate was higher than the female in the 40-year-old and age 50 and older population(P<0.05).From 50-year-old,the male and female cancer standardized mortality rate increased fast with the increasing of age.The male cancer standardized mortality rate increased fast until age 85 and older.The female cancer standardized mortality rate increased slowly after 85 year-old.During the observation period,the four most frequently diseased sites in community male residents were the lung,stomach,colorectum and liver,and the standardized mortality rates were 41.24/100 000,17.58/100 000,16.54/100 000 and 16.23/100 000,respectively.The four most frequently diseased sites in community female residents were the lung,stomach,colorectum and breast.The standardized mortality rates were 15.91/100 000,13.54/100 000,11.16/100 000 and 7.33/100 000,respectively.The mortality rates of lung neoplasms caused by the death was the first types of malignant tumors in the Weifang community,and standardized mortality rate of gastric cancer showed changing moderated and slightly decreased.The standardized mortality rate of colorectal cancer was peaked in 2013,and then gradually decreased.ConclusionThe mortality rate in Weifang community residents in 2006—2015 showed the trend of first increase and subsequent decrease.After 50 year-old,the residents cancer standardized mortality rate increased fast with age increasing.Cancer of the lung was the leading cause of deaths among residents.
    Epidemiological Analysis of Japanese Encephalitis Outbreak in Shijiazhuang City in 2013
    LIU Li, WANG Huan-yu, ZHANG Shi-yong, ZHAO Wan-jia, HOU Yu-feng, ZHAI Shi-yong, XU Bao-hong, ZHANG Hong, ZHANG Shuang-zhai
    2016, 19(29):  3580-3583.  DOI: 10.3969/j.issn.1007-9572.2016.29.015
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    Objective To analyze the epidemiological and clinical characteristics of the Japanese encephalitis outbreak cases in Shijiazhuang city in 2013,so as to provide a basis for early warning of Japanese encephalitis outbreak.Methods The clinical data and follow-up data of Japanese encephalitis patients were collected,and healthy residents in the villages of Gaocheng,Wuji,Pingshan and Jingxing County were selected as study subjects,Japanese encephalitis cases were found in these villages,serum Japanese encephalitis antibody level of subjects was detected during Japanese encephalitis.The Japanese encephalitis antibody data in Shijiazhuang in 2003 were collected as historical control.Mosquito monitoring was conducted by the mosquito lure lamp in the county which had outbreak of an epidemic,and adult mosquitoes were collected for counting and classification identification.Results From 26 August to 5 November in 2013,a total of 121 Japanese encephalitis cases were reported by medical institutions in Shijiazhuang city,there were 101 cases(83.5%) and 20 cases(16.5%) from rural area and urban area respectively,male-to-female sex ratio was 0.92∶1.96 cases(79.3%) were 20 years of age or older,73 cases(60.3%) were farmers.Median time from disease onset to hospital admission was 2 days,and median time from disease onset to diagnosis was 17 days.Serum of 94 cases were collected to detect Japanese encephalitis IgM antibody,among which 79 were positive,the positive rate was 84.0%.50.0% of cases or more presented with acute onset,fever,depression,disturbance of consciousness.105 cases were followed up,among whom 35 cases(33.3%) had sequelae,11 cases(10.5%) died.Only 6 cases(5.0%) had a history of Japanese encephalitis vaccination.The positive rate of Japanese encephalitis antibody among healthy people in Shijiazhuang in 2013〔13.4%(114/850)〕 was significantly lower than that in 2003〔30.9%(122/395)〕(P<0.05).The positive rate of Japanese encephalitis antibody among healthy people of 10-19 years old and 20-29 years old in 2013 was significantly lower than that in 2003 respectively(P<0.05).641 mosquitos,we collected,included 600(93.6%) culex pipiens pallens,25(3.9%) armigeres subalbatus,and 16(2.5%)patton malaria mosquitos.Conclusion The characteristics of Japanese encephalitis outbreak in Shijiazhuang in 2013 includ more adult cases,high risks of sequela and death,and low Japanese encephalitis antibody positive rate among healthy people.Close attention should be paid to population’s antibody levels and mosquito density variations,epidemic surveillance of Japanese encephalitis should be strengthened for early detection and effective control.
    Diagnosis of Consistency between Three CKD-EPI and Modified MDRD Equations for Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus
    CHENG Ying, LI Ning-na, YOU Zhi-qing, GUO Wei, AI Zhi-hua
    2016, 19(29):  3584-3588.  DOI: 10.3969/j.issn.1007-9572.2016.29.016
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    Objective To evaluate the consistency between three chronic kidney disease epidemiology collaboration(CKD-EPI)equations and modified modification of diet in renal disease(MDRD)equation for estimated glomerular filtration rate(eGFR).Methods From December 2014 to October 2015,178 adult patients with type 2 diabetes mellitus admitted to Department of Endocrinology,Chengdu Military General Hospital were recruited.The eGFR was calculated using CKD-EPI2009Scr,CKD-EPI2012Cys-C,CKD-EPI2012Scr-Cys-C and modified MDRD equations,respectively.Consistency between the three CKD-EPI and modified MDRD equations was evaluated.Chronic kidney disease(CKD)was staged according to eGFR calculated using modified MDRD equation.The differences were compared among CKD-EPI2009Scr,CKD-EPI2012Cys-C,CKD-EPI2012Scr-Cys-C and modified MDRD equations.Diabetic kidney disease was defined as eGFR less than 60 ml·min-1·(1.73 m2)-1,calculated using modified MDRD equation.The cut points of CKD-EPI2009Scr,CKD-EPI2012Cys-C and CKD-EPI2012Scr-Cys-C for diagnosing diabetic kidney disease were evaluated by receiver operating characteristic(ROC)curve.Results The eGFR calculated using CKD-EPI2009Scr,CKD-EPI2012Cys-C,CKD-EPI2012Scr-Cys-C and modified MDRD equations were(88±29)ml·min-1·(1.73 m2)-1,(85±33)ml·min-1·(1.73 m2)-1,(88±32)ml·min-1·(1.73 m2)-1and (112±49)ml·min-1·(1.73 m2)-1,respectively.There were statitically significant difference between the eGFR calculated using CKD-EPI2009Scr,CKD-EPI2012Cys-C and CKD-EPI2012Scr-Cys-C and modified MDRD equations(t=5.564,5.945,5.267,P<0.001).Bland-Altman plots illustrated the eGFR calculated by the three CKD-EPI equations had poor agreement with modified MDRD equation.The difference between modified MDRD and three CKD-EPI equations in calculating eGFR reduced with elevating serum creatine(Scr)(R2=0.239,0.186,0.195).There were statistically significant difference among eGFR calculated by the 4 equations in CKD stage 1 and stage 2(P<0.05).The eGFR determined by modified MDRD equation was higher than the three CKD-EPI equations,respetively(P<0.05).There were no statistically significant difference among eGFR calculated by the 4 equations in CKD stage 3,stage 4 and stage 5(P>0.05).Diagnostic cut points of CKD-EPI2009Scr,CKD-EPI2012Cys-C,CKD-EPI2012Scr-Cys-C were 61,65,61 ml·min-1·(1.73 m2)-1.Area under ROC curve were 0.992,0.937 and 0.977,respectively.Conclusion The three CKD-EPI equations are found to underestimate eGFR when compared with modified MDRD equation.The difference between modified MDRD and CKD-EPI equations decreased with elevated Scr.More diabetic kidney disease is diagnosed by eGFR calculated using CKD-EPI equations than modified MDRD equation.
    Reliability and Validity of Arthritis Self-efficacy Scale-8 in Application of Patients with Rheumatoid Arthritis
    GAO Lei, ZHANG Xiao-cui, LI Miao-miao, SHI Bao-xin
    2016, 19(29):  3589-3592.  DOI: 10.3969/j.issn.1007-9572.2016.29.017
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    Objective To translate and evaluate reliability and validity of the arthritis self-efficacy scale-8(ASES-8)when applied to patients with rheumatoid arthritis(RA).Methods A total of 101 RA patients treated in the Department of Rheumatism and Immunology of Tianjin Medical University General Hospital from September to December 2015 were selected as the subjects through convenience sampling method.ASES-8 was translated and revised to generate a Chinese version of ASES-8.Investigations were performed on the patients.Item analysis,exploratory factor analysis,and correlation analytical methods were used to evaluate the reliability and validity of the Chinese version of ASES-8.Results Item analysis showed that the Chinese version of ASES-8 could discriminate the high score group from the low score group.The correlation index of item-item and item-total scores ranged from 0.338 to 0.952.Based on the analysis of main components,one common factor was extracted.The factor loading was equal or greater than 0.652 and cumulative variance proportion of the factor was 66.24%,thereby indicating good construct validity.The Chinese version of ASES-8 was positively correlated with scores of SF-36 physiological function(r=0.529,P<0.01)and FACIT-F(r=0.660,P<0.01)and negatively correlated to the scores of HADS-depression(r=-0.625,P<0.01),HADS-anxiety(r=-0.612,P<0.01),and pain-VAS(r=-0.610,P<0.01).The internal consistency of the Chinese version of ASES-8 Cronbach’s α coefficient was 0.920.The coefficient ranged from 0.897 to 0.926 when one item was deleted,and the reevaluated reliability was 0.986.Conclusion The Chinese version of ASES-8 has high validity and reliability.It is a reliable evaluation tool for future intervention studies on self-efficacy improvement.
    Effect Evaluation of Health Management Model that Taking Family as Units on Diabetes
    BAI Ya-ting, HAN Lin, LIU Jin-ping, CAO Jian-xun
    2016, 19(29):  3593-3597.  DOI: 10.3969/j.issn.1007-9572.2016.29.018
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    Objective To evaluate the application effect of health management model that taking family as units on diabetes.Methods 82 patients,who came from two community health service centers of similar size and scale,and were admitted into Gansu Provincial Hospital due to type 2 diabetes from February to June in 2015 and discharged from the hospital in a stable state of illness,were selected by convenience sampling method.In accordance with the community health service center they belonged to,they were divided into experimental group and control group,and each group had 41 cases with a family group of 58 cases.Patients in two groups received routine health management,including the process of diabetes,clinical manifestations and hazard,tertiary prevention strategies,five indispensable items in the treatment of diabetes,and prevention and treatment of complications;the experimental group adopted synchronous participation mode of family groups,both groups were intervened for 12 months.The self-management skills of patients in two groups and the improvement condition of unhealthy lifestyles of family groups were observed before and after intervention.Results Before intervention,there were no significant difference in scores of diet control,regular exercise,taking medicine as advised by doctors,foot care,dealing with high and low blood glucose and total scores of patients between two groups(P>0.05);before intervention,score of self-monitoring of patients in experimental group was significantly lower than that in control group(P<0.05);after intervention,scores of diet control,regular exercise,taking medicine as advised by doctors,self-monitoring,foot care,dealing with high and low blood glucose and total scores of patients in experimental group were significantly higher than those in control group(P<0.05).Before intervention,there were no significant difference in uneven intake rate of staple and non-staple food,score of fagerstrom test for nicotine dependence(FTND),score of alcohol use disorder identification test(AUDIT) and score of physical activities rating scale(PARS-3) of family groups between two groups(P>0.05);after intervention,there was no significant difference in FTND score of family groups between two groups(P>0.05);after intervention,the uneven intake rate of staple and AUDIT score of family groups in experimental group were lower than those in control group,while PARS-3 score was higher than that in control group(P<0.05).Conclusion Health management model that taking family as units can obviously facilitate the improvement of self-management skills of type 2 diabetes,meanwhile can strengthen concept of prevention and treatment of diabetes of high-risk population and help correct their unhealthy lifestyles,thus reduce occurrence risk of diabetes.
    Construction of Community Health Management Model Based on PDCA Cycle Quality Management Theory
    CUI Hua-qian, ZHOU Guang-qing, FU Jing, LI Hai-yan, ZHANG Long-sheng
    2016, 19(29):  3598-3600.  DOI: 10.3969/j.issn.1007-9572.2016.29.019
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    The concept of health management is consistent with that of PDCA cycle quality management,PDCA community health management model utilizes community health service center,a primary medical service platform that facing to all the residents,to combine the four links of community health management with the four process of PDCA cycle quality management,and formulates targeted interventions for groups and individuals respectively,then passes into the next cycle of health management after solving one health problem so as to comprehensively guarantee residents’ health.Based on analyzing health management models at home and abroad,the paper selects community health service center of Chebei Street in Tianhe District in Guangzhou city as the experiment unit,constructs a community health management model that based on PDCA cycle quality management theory,and then makes a feasibility analysis,puts forward existing problems and suggestions,and offers advices and suggestions to the improvement of community health service contents.
    Service Quality Evaluation of Revised SERVQUAL Scale Based on PZB Model in Health Management Service for Community Hypertension and Type 2 Diabetes Patients
    HE Yan-hong, XU Qin-er, HUANG Zheng, DING Jing-ying, JIN Mei-hua
    2016, 19(29):  3601-3606.  DOI: 10.3969/j.issn.1007-9572.2016.29.020
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    Objective To establish revised SERVQUAL scale based on PZB model,to evaluate their medical service quality of physician teams of community responsibility and improve service quality and provide tools;to understand overall evaluation of community hypertension and type 2 diabetes patients on health management,identify factors that affect service quality of health management,put forward specific recommendations and provide references for effectively evaluating service quality and raising management level.Methods 360 hypertension and type 2 diabetes patients,receiving standardized health management in the community health service station that under administration of Donglin Town in Wuxing District of Huzhou,were selected as research objects.SERVQUAL scale was revised by literature review,focus group interviews,Delphi expert consultation,pre-investigation methods.Reliability and validity of revised SERVQUAL scale were assessed,and common factors were extracted by principal component analysis method.5-point Likert scale was applied to evaluate service expectation,service perception,scores of quality of service=scores of perceived service-scores of service expectation.The score of overall evaluation of service quality of each index and score of hundred-mark system were calculated.The differences between service quality scores of patients with different basic conditions were compared.Results 360 questionnaires were sent out and 346 valid questionnaires were recovered with a response rate of 96.11%.Among the 346 patients,265 patients with simple hypertension,accounting for 76.59%,32 with simple type 2 diabetes,accounting for 9.25%,and 49 with hypertension combined with type 2 diabetes,accounting for 14.16%.The 5 dimensions of revised SERVQUAL scale were tangible,responsiveness,reliability,assurance and empathy.Cronbach’s α coefficient of revised SERVQUAL scale was 0.802.KMO value was 0.708,Bartlett’s test of sphericity χ2=3 556.00,a five common factors were extracted in total,contribution rate of cumulative variance was 71.14%.5 factors were consistent with 5 dimensions of the index system,and there was good construct validity in questionnaire.There were no significant difference in scores of service quality of propaganda and instruction of health knowledge,intervention effects,keeping commitments,service security,communication,trust,and respect of secondary indicators in revised SERVQUAL scale(P>0.05);there were significant difference in scores of service quality of medical environment,appearance of medical personnel,high quality service,timeliness of service,answering questions,medical morals and ethics,considering special needs of patients,personalization,applicability,comprehensiveness,proactive care,and convenience services of secondary indicators in revised SERVQUAL scale(P<0.05).Results of scores in overall evaluation of service quality showed that,empathy in first-grade indicators was reverse scoring,score in overall evaluation of service quality of tangible was positive value,scores in overall evaluation of service quality of responsiveness,reliability,and assurance were negative value;among all the secondary indicators,only scores in overall evaluation of service quality of propaganda and instruction of health knowledge,medical environment,intervention effects,and trust were positive values,the others were negative values;results of scores in hundred-mark system showed that,scores in hundred-mark system of all the first-grade and secondary indicators were less than 100.00.There were no significant difference in scores of service quality among patients with different gender,ages,occupations,educational levels,family annual incomes,numbers of children(P>0.05);there was significant difference in score of service quality among patients with different diseases(P<0.05).Conclusion The revised SERVQUAL scale based on PZB model provides methodological support for examining quality of service of existing chronic health management;community health service centers are still insufficient in providing health management services for hypertension and type 2 diabetes patients,thus they should offer personalized care and guidance according to the specific condition of patients to improve service quality in the future follow-up.
    Clinical Characteristics and Pathogenesis of Acute Non-traumatic Chest Pain in Different Gender
    WEN Xin-qiang, ZHENG Bing, TANG Ying-li
    2016, 19(29):  3607-3610.  DOI: 10.3969/j.issn.1007-9572.2016.29.021
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    Objective  To explore the clinical characteristics and pathogenesis of acute non-traumatic chest pain in different gender.Methods From June 2013 to July 2015,384 patients admitted to the 521 Hospital of Ordnance Industry for acute non-traumatic chest pain were collected.These patients were divided into male group(206 cases)and female group(178 cases)according to gender.The clinical data of the two groups were compared,included general data,chest pain characteristics(included incentives of pain,sites of pain,nature of pain,duration of pain,with or without radiating pain or complications,etc.),the causes of chest pain(included cardiac,pulmonary,aortic dissection,gastrointestinal,shingles,or unexplained etc.),electrocardiogram(ECG),echocardiography and etc.Results There were no statistically significant difference in history of hypertension,diabetes and hyperlipidemia between the two groups(P>0.05).There were statistically significant difference in age,smoking history and drinking history between the two groups(P<0.05).There were no statistically significant difference in sites of pain and with or without radiating pain between the two groups(P>0.05).There were statistically significant difference in incentives of pain,nature of pain,duration of pain and with or without complications between the two groups(P<0.05).The causes of chest pain in male group were cardiac 84 cases(40.78%),pulmonary 62 cases(30.10%),aortic dissection 9 cases(4.37%),gastrointestinal 37 cases(17.96%),shingles 3 cases(1.46%)and unexplained 11 cases(5.33%).The causes in female group were cardiac 61 cases(34.27%),pulmonary 53 cases(29.78%),aortic dissection 7 cases(3.93%),gastrointestinal 20 cases(11.24%),shingles 4 cases(2.25%)and unexplained 33 cases(18.53%).There was statistically significant difference in cause constitute of chest pain between the two groups(χ2=27.228,P<0.05).There were no statistically significant difference in ST-T change on ECG,decreased left ventricular diastolic function,reduced left ventricular ejection fraction,the incidence of ventricular wall motion abnormalities on echocardiography(P>0.05).The main cause of chest pain was gastrointestinal in 18-30 year-old male group(66.67%),cardiac in 31-50,51-70 and 71-82 year-old male group(37.10%,50.67% and 53.85%,respectively).The main cause of chest pain was gastrointestinal in 18-30 year-old female group(29.41%),unexplained in 31-50 year-old female group(31.33%),cardiac in 51-70 and 71-82 year-old female group(45.10% and 51.85%).ConclusionThe cardiac chest pain is the main cause of acute non-traumatic chest pain both in men and women.The age of male patients is older than female,and most of the male patients have a history of smoking and drinking.The prompt and accurate treatment should be performed to these patients according to the characteristics of diseases in the clinical diagnosis and therapy.
    Clinical Features of Measles Combined with Cytomegalovirus Infection
    ZHANG Juan-juan, TANG Zhi-yuan, LIU Wen-zhen, AN Yun-zheng, LIU Xue-dan
    2016, 19(29):  3611-3614.  DOI: 10.3969/j.issn.1007-9572.2016.29.022
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    Objective To explore the clinical features of measles combined with cytomegalovirus infection in order to provide references for the treatment and the improvement of prognosis.Methods We enrolled 57 patients who were definitely diagnosed with measles combined with cytomegalovirus infection from January to June in 2014 in Baoding Infectious Diseases Hospital,for each of whom we enrolled 2 to 4 patients with only measles who had matched age, gender and body mass(±0.5 kg).A total of 188 patients with only measles were included.Clinical data were collected, including gender, place of residence, age, body weight, onset time, history of prophylactic inoculation, clinical manifestations, complications,laboratory examination,treatment and prognosis.Results The age of patients with measles combined with cytomegalovirus infection ranged from 1 month to 20 years old, with patients aged 3 months to 1 year old accounting for a large proportion (n=50,87.6%).The onset time was mainly from February to April(n=43, 75.4%), with April accounting for the majority (n=21,36.8%).All the patients had fever, with a maximum body temperature of (39.3±2.3)℃ and a fever time of (7.6±1.6)d;rash occurred (2.4±0.9)d after fever occurred, with a length of (4.7±1.4)d;43 patients(75.4%) were in the normal order of symptoms;56 patients(98.2%) had cough, expectoration and other respiratory catarrh symptoms;52 patients(91.2%)had mouth rash(Koplik spot);27 patients(47.4%) had photophobia and tears, conjunctival redness and eye secretion increase;32 patients(56.1%)had diarrhea, mostly with yellow diluted feces and without grume and pus blood feces.The complications of patients with measles combined with cytomegalovirus infection were mainly bronchitis(n=53, 93.0%),myocardial damage(n=46,80.7%),laryngitis(n=42,73.7%),diarrhea(n=32,56.1%)and conjunctivitis(n=27, 47.4%).The patients with only measles and the patients with measles combined with cytomegalovirus infection were significantly different (P<0.05) in place of residence, fever time, rash time, length of hospital time and the incidence rates of diarrhea, abnormal liver function, anemia, mycotic stomatitis and lymphocyte count elevation.Conclusion Measles combined with cytomegalovirus infection is more likely to happen in infants.This kind of patients have longer fever time and measles time and higher incidence rates of diarrhea,abnormal liver function,anemia, mycotic stomatitis and lymphocyte count elevation.
    Pathogen Constitute,the High-risk Factors and Clinical Manifestations of Pulmonary Fungal Disease in Guangxi from 2004 to 2013:A Retrospective Study
    JIANG Ling-yu, QIN Zhi-qiang, DUAN Shi-huan, FENG Guang-hong, CHEN Gui-rong, WEI Cai-zhou, FENG Zong-lian
    2016, 19(29):  3615-3618.  DOI: 10.3969/j.issn.1007-9572.2016.29.023
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    Objective To investigate the pathogen constitute,the high-risk factors and clinical manifestations of pulmonary fungal disease in Guangxi,in order to improve the clinical diagnosis and treatment.Methods We conducted a single-center retrospective study of histologically verified 89 cases of pulmonary fungal disease in the People’s Hospital of Guangxi Zhuang Autonomous Region from 2004 to 2013.Pulmonary fungal disease questionnaire was designed.The general information,pathogen constitute,underlying diseases,high-risk factors,clinical manifestations,outcome and etc.were collected.Results The top 2 pathogens were pulmonary aspergillosis(37 cases,41.6%)and pulmoanry cryptococcosis(32 cases,36.0%),followed by pulmonary candidasis(6 cases,6.7%),pulmoanry nocardiosis(5 cases,5.6%),pulmonary penicillium marneffei(5 cases,5.6%),pulmonary mucormycosis(3 cases,3.4%),and pneumocystis jirovecii pneumonia(1 case,1.1%)in the pathogen constitute of all 89 cases of pulmonary fungal disease.Fifty-six cases(62.9%)had underlying diseases,which were mainly pulmonary diseases(41 cases,46.1%)and 11 cases(12.4%)had high-risk factors.The most common clinical symptoms were cough(62 cases,69.7%),expectoration(59 cases,66.3%),fever(14 cases,15.7%),hemoptysis(13 cases,14.6%),chest pain and dyspnea(both 9 cases,10.1%).The medical signs of lungs included crakles(30 cases,33.7%),dry rales(19 cases,21.4%)and wheeze(6 cases,6.7%).Conclusion Pulmonary aspergillosis and pulmonary cryptococcosis are the most common pulmonary fungal pathogens.Most of the pulmonary fungal disease patients have underlying diseases and high-risk factors,mainly pulmonary diseases.The most common clinical manifestations are respiratory symptoms and without obvious specificity.
    Research Progress of Status of Medication Compliance among Elderly Hypertensive Patients and Interventions
    YANG Lian-zhao, YANG Yong, ZHANG Ying, MO Xin-shao, HU Yan-ning, CHEN Ling, TANG Rong-ying, GAO Hui, LI Wen, LI Peng, WEI Yu-juan, LIAO Hai-fen
    2016, 19(29):  3619-3623.  DOI: 10.3969/j.issn.1007-9572.2016.29.024
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    Hypertension that is complicated with various cardiovascular diseases is often one of the leading factors increasing the death and hospitalization rates of the elderly,thereby adding to the economic burden of society.According to foreign and domestic reports,poor medication compliance is a common phenomenon among hypertensive patients,which leads to low hypertension control rate.Improving medication compliance is important in regaining health and cost saving during hypertension drug therapy.This study summarized the status and influence factors of medication compliance among foreign and domestic elderly hypertensive patients and the interventions recommended for improving medication compliance.
    Research Progress of the Relationship between Type 2 Diabetes and Polychlorinated Biphenyls
    JIANG Chun-xia, XU Yong
    2016, 19(29):  3624-3628.  DOI: 10.3969/j.issn.1007-9572.2016.29.025
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    Polychlorinated biphenyls(PCBs) are persistent organic pollutants and have persistent residuals,bioaccumulation,semi-volatility,and high toxicity.The severe damages PCBs exert on human health and the environment have made these pollutants a research hotspot in recent years.Numerous studies have shown that PCBs have reproductive toxicity,neurotoxicity,carcinogenicity and teratogenicity,and can cause disruption in the endocrine system.According to these studies,type 2 diabetes is a clinical syndrome caused by genetic and environmental factors;the incidence of type 2 diabetes is increasing annually,and the incidence and development of type 2 diabetes and diabetic complications may have a close relationship with PCBs.In the present study,new references for the prevention and treatment of type 2 diabetes were provided by reviewing considerable research on the relationship between PCBs and type 2 diabetes,diabetes complications,and other metabolic diseases.The possible pathogenesis of type 2 diabetes was also discussed.
    Research Progress of Multi-modality Imaging of Vascular Cognitive Disorders
    YU Yang, YIN Chang-hao
    2016, 19(29):  3629-3633.  DOI: 10.3969/j.issn.1007-9572.2016.29.026
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    Vascular cognitive disorders(VCD) includes all levels of cognitive loss from mild deficits in one or more cognitive domains to a broad dementia syndrome due to cerebral vessel disease or the risks of vascular diseases.Vascular diseases themselves may be related to brain imaging changes,and there are many studies about the relationship between these changes and cognitive impairment,but the research conclusion is inconsistent.Multi-modality imaging technique can assess the structure and function of brain of patients with VCD,which is beneficial to the further study of early diagnosis and pathophysiology of VCD,and it plays a more and more important role in the diagnosis and differential diagnosis of VCD. Here is a review about the research advances of VCD using structural imaging(such as sMRI and DTI),functional imaging(such as fMRI,MRS and PET) and imaging combined with brain network analysis.Multi-modality imaging is an important method which can be used to explore the brain structure,the brain function and the relationship between cognitive behaviors and brain. The application prospect of this emerging interdisciplinary combination technique is wide,and the technique will bring benefit to the establishment of uniform diagnostic criteria and early diagnosis of VCD.
    Insulinoma Combined with Type 2 Diabetes Mellitus:A Case Report and Literature Review
    GAO Hai-na, TANG Yong, HE Xue-feng, CHEN Shu-chun, SONG Guang-yao
    2016, 19(29):  3634-3637.  DOI: 10.3969/j.issn.1007-9572.2016.29.027
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    Insulinoma is a neuroendocrine tumor originating from pancreatic beta cells,which clinically manifests Whipple’s triad,especially recurrent hypoglycemia.Insulinoma accompanied by diabetes mellitus is very rare.The hypoglycemia,is often wrongly attributed to the effects of hypoglycemic agents,which makes diagnosis particularly challenging.This article reported the case of a diabetic patient with two years’ recurrent hypoglycemia,without injecting exogenous insulin.Whipple’s triad accompanied by hyperinsulinemia and high C-peptide levels kept existing after discontinuation of hypoglycemic agents.The pancreatic imaging and postoperative histopathology confirmed the diagnosis of insulinoma.The patient had persistent hyperglycemia and required long-term insulin treatment after operation.
    Childhood Dissociative Disorder:A Case Report and Literature Review
    CHANG Guo-sheng, NI Ju, ZHANG Rui-xing, GENG Yao-guo
    2016, 19(29):  3638-3640.  DOI: 10.3969/j.issn.1007-9572.2016.29.028
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    Dissociative disorders refer to the patients with partial or complete loss of past memory and identity,and resulting in difficulties in psychological function integration.The clinical data and the diagnosis differentiation of a case with dissociative fugue was reported in this article,and the pathologic psychological mechanism was also discussed.The analysis manifested that it is useful to use psychotherapy to guide patients to eliminate inner conflict,regulate the psychological defense style and approach,also use medication to eliminate mental symptoms,and it is significant for the patients’ comprehensive mental rehabilitation to orgnize a therapeutic alliance including patients,parents,physicians,psychotherapists to confront the disorders.