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Table of Content

    05 November 2016, Volume 19 Issue 31
    Implementation Experience of Construction of Teachers Team of Health Education in Foreign Countries and Its Enlightenments to China
    SHEN You-qing, XU Xiang-feng, DAI Hui-ying
    2016, 19(31):  3769-3772.  DOI: 10.3969/j.issn.1007-9572.2016.31.001
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    Health education is an important way to disseminate health knowledge and skills,promote the development of individual and public health,and is also an important strategy to solve today’s public health problems,and construction of teachers team is the inherent requirement and the key to health education development.Countries such as the United States,England and New Zealand and other have formed a comparatively mature theory and practice system in the aspect of construction of teachers team in health education,and have provided important guarantee for the development of health education work.The paper summarizes the basic experiences of construction of teachers team in health education of foreign countries,and analyzes the current situation and insufficiencies of health education in China.Based on foreign development ideas and implementation experiences of countries,the author puts forward certain enlightenments to the construction of teachers team of health education in China.
    Application of Two-sided Matching Theory in Dual Referral
    YAO Ling-ling, CHENG Wei, MAN Xiao-wei
    2016, 19(31):  3773-3775.  DOI: 10.3969/j.issn.1007-9572.2016.31.002
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    At present,there are still some problems in the construction of dual referral system in China,the lightening of economic burden of residents is not obvious,the number of patients transferring from primary health care institutions to higher-level medical institutions is greater than that of patients transferring from higher-level medical institutions to primary health care institutions,unclear referral procedures,and not-uniform referral standards.The two-sided matching theory is a new development of modern economics,and has been applied into many fields.The paper selects 3 ophthalmologists and 15 patients from A hospital in December 2015.Preference ordering is tested according to degree of deviation between patients’ status and services that doctors could provide,and deferred algorithm is applied to construct the dual referral model of two-sided matching.Two-sided matching theory has great application potential in improvement of dual referral model of China.It can solve the problem that there is no workable management procedure in dual referral system currently,avoid the problem that large hospitals retaining patients in rehabilitation and mild conditions,and help to reduce the unit cost provided by medical treatment.
    Standardized Construction of Studio of Family Physicians and Its Service Effectiveness
    LU Ping, ZHU Jie, JIN Min-jie, WENG Li-li, LIU Mei-ling
    2016, 19(31):  3776-3780.  DOI: 10.3969/j.issn.1007-9572.2016.31.003
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    The paper introduces the plan of standardized construction of family physicians’ studio in Jiading District of Shanghai,and makes an unification and standardization of it from aspects of hardware,software and services contents.From the perspective of running conditions,family physicians’ studio establishes the learning benchmarking for family physicians,improves residents’ awareness and satisfaction of family physicians,and increases the number of residents signing heath care agreements of family physicians and the management and control rate of hypertension and diabetes patients.Thus family physicians’ studio constructs a fixed communicative,cooperative and service platform for family physicians and residents who sign health care agreement,improves capacity level of their services.The studio can promote the further integration of community residents into community,which is a helpful support for family physician system.
    Allocation Differences and Fairness of Community General Practitioners in Districts and Counties of Beijing from 2011 to 2014
    LIN Chun-mei, ZHANG Xing, YANG Xiao-qian, QIN Jiang-mei
    2016, 19(31):  3781-3785.  DOI: 10.3969/j.issn.1007-9572.2016.31.004
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    Objective To discuss allocation differences and fairness of communities general practitioners in districts and counties of Beijing from 2011 to 2014.Methods The number of community general practitioners,and number of resident population in Beijing and 16 districts and counties from 2011 to 2014 were collected.According to different functions of areas in Beijing,they were divided into 4 types of areas:core functions areas of capital(Dongcheng District,Xicheng District),urban functional expansion areas(Chaoyang District,Fengtai District,Shijingshan District,Haidian District),new districts of urban development(Fangshan District,Tongzhou District,Shunyi District,Changping District,Daxing District) and ecological conservation development areas(Mentougou District,Huairou District,Pinggu District,Miyun County,Yanqing County).The allocation differences and fairness of community general practitioners per 10 thousand in each district and county were analyzed by adopting maximum/minimum values(times),relative difference coefficient,and it was further analyzed by using Theil index.Results From 2011 to 2014,the number of community general practitioners per 10 thousand in Beijing were 2.76,2.80,2.80 and 2.73 respectively.The maximum/minimum value of the number of community general practitioners per 10 thousand in each district and county increased from 4.03 in 2011 to 4.82 in 2014,the relative difference coefficient increased from 38.5% in 2011 to 41.7% in 2014;the Gini coefficient increased from 0.161 7 in 2011 to 0.178 3 in 2014;the differential index increased from 0.111 8 in 2011 to 0.123 0 in 2014;the overall Theil index increased from 0.019 3 in 2011 to 0.024 0 in 2014,and the inter-area Theil index increased from 0.007 9 in 2011 to 0.011 3 in 2014,while the proportion of inter-area Theil index in the overall Theil index decreased from 59.1% in 2011 to 52.9% in 2014,of which the proportion of new districts of urban development in inter-area Theil index increased from 78.1% in 2011 to 82.7% in 2014.Conclusion The overall fairness of allocation of community general practitioners in Beijing is good.However,the unfairness of allocation of community general practitioners in each district and county is increasing year by year,and this is mainly caused by the increasing differences between areas,moreover,the allocation of community general practitioners within new districts of urban development is not so good.
    Research Progress of Application of Big Data in Health Management
    FAN Lu-ming, LIANG Gui-xian
    2016, 19(31):  3786-3789.  DOI: 10.3969/j.issn.1007-9572.2016.31.005
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    The big data that is the data set that beyond the obtaining,storing,managing and analyzing capabilities of the conventional database tools,and its application into health management is the inevitable trend of development of the times.The study elaborates the connotation of big data and health management,and the current applicative status of international and domestic big data in health management,puts forward the difficulties in the application of big data in health management and discusses the countermeasures,and aims at providing references for promoting the application of big data in health management.
    The "Ubiquitousness" of Chronic Disease Prevention and Control and A Mobile Service Platform for Community Health Management Based on Cloud Computing
    LIU Zhi-han
    2016, 19(31):  3790-3794.  DOI: 10.3969/j.issn.1007-9572.2016.31.006
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    With the gradual maturing of technologies such as cloud computing,high-speed mobile Internet and Internet of Things,to realize the "Ubiquitous Healthcare" in the health field is not only an irresistible trend,but also a realistic possibility.According to the community health management theory and service-oriented system structure,the study proposed the designing scheme and implementation method of a management service platform for health information collection and big data analysis of mobile community of chronic disease based on cloud computing.With this platform,community residents can enjoy the convenient and quick self-management service of health,and community healthcare staff can provide timely and efficient service to the chronic disease patient or those potentially high-risk individuals precisely.The paper hopes to provide theoretical references for researches of ubiquitous healthcare and “be ubiquitous” of chronic disease prevention and control.
    Construction and Application of Internet-based Trinity Health Management Model of Hospital-Community-Family for Patients with Type 2 Diabetes Mellitus
    BAI Ya-ting, HAN Lin, LIU Jin-ping, CAO Jian-xun
    2016, 19(31):  3795-3798,3802.  DOI: 10.3969/j.issn.1007-9572.2016.31.007
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    Objective To explore construction of Internet-based trinity health management model of hospital-community-family for patients with type 2 diabetes mellitus and to evaluate its application effects.Methods 110 patients with type 2 diabetes mellitus from two different community health service centers of similar size and scale,who were hospitalized in endocrinology department of Gansu Provincial Hospital from January to April in 2015 and left hospital with stabilized condition,were selected.They were divided into experiment group and control group according to their community,each had 55 cases.The patients in control group received routine health management from the community health service center after discharge;the patients in experiment group received Internet-based trinity health management of hospital-community-family.Before and one year after the management,the application effect was evaluated.The blood glucose control status of patients was evaluated by fasting blood glucose and glycosylated hemoglobin;the level of self-management behavior of the patients was evaluated by self-management behavior scale of type 2 diabetes mellitus.Results Before management,there was no significant difference in fasting blood glucose and glycosylated hemoglobin levels of patients in two groups(P>0.05);after management,there was significant difference in fasting blood glucose and glycosylated hemoglobin levels of patients in two groups(P<0.05).Before management,there were no significant differences in the three dimensional scores of diet control,regular exercise and medication compliance and total scores of patients in two groups(P>0.05);the scores of self-monitoring and prevention of complications in control group were significantly higher than those in experiment group(P<0.05).There were significant differences in the 5 dimensional scores of diet control,regular exercise,medication compliance,self-monitoring,prevention of complications and total scores of patients in two groups after management(P<0.05).Conclusion The Internet-based trinity health management model of hospital-community-family for patients with type 2 diabetes mellitus can effectively improve patients’ blood glucose levels and self-management behavior levels,and can achieve advantages complementation and resources integration.
    Discussion of Application of Network Auxiliary Diagnosis and Treatment Platform of Chronic Obstructive Pulmonary Disease
    LU Hao-nan, ZHENG Ze-guang, LIU Ni, WANG Xin-ni, ZHOU Ri-xing, CHEN Rong-chang
    2016, 19(31):  3799-3802.  DOI: 10.3969/j.issn.1007-9572.2016.31.008
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    Objective To establish network auxiliary diagnosis and treatment platform of chronic obstructive pulmonary disease(COPD) based on the website(www.copdchina.com),and to explore the application effect of this platform and provide ideas for how to hierarchical management of COPD patients.Methods 100 COPD voluntary patients who claimed themselves in stable stage were recruited in the Outpatient of Guangzhou Institute of Respiratory Disease/the First Affiliated Hospital of Guangzhou Medical University from January to June in 2015,volunteers registered by website of COPD(www.copdchina.com) filled in their medical history information and relevant screening questionnaires by themselves on the network auxiliary diagnosis and treatment platform of COPD;volunteers with or without COPD were confirmed by return visits of the Outpatient;patients diagnosed with COPD made online doctor-patient communications,online doctors made condition judgments based on the interrogation and uploaded data by patients(heart rate,blood oxygen,chest X-ray/CT,sputum photos) and give treatment advice;patients then consulted community doctors about the rationality of the advice on network diagnosis and treatment;community doctors finally determined diagnosis and treatment plan and uploaded to the website,and analyzed the differences between network diagnosis and treatment opinions and the final diagnosis and treatment plan.Results Of the 100 volunteers,6 were out of touch due to various reasons,and 94 were actually involved in the study.Based on medical history information and related screening questionnaires,of the 94 volunteers,70(74.5%) were diagnosed with COPD,14(14.9%) were in exclusion of COPD,and the diagnosis of 10(10.6%) were failed.By return visits of the Outpatient Clinic of Guangzhou Institute of Respiratory Disease,finally 34(36.2%) were diagnosed with COPD,5(5.3%) with asthma,1(1.1%) with interstitial lung disease,and 54(57.4%) with other diseases.The 34 patients confirmed with COPD had put forward 192 questions online within three months,of which 162(84.4%) could be solved according to patients’ self-report and network interaction;18(9.4%) needed to be solved in the outpatients as patients were unable to provide complete information,and 12(6.2%) had no association with COPD.Conclusion The application of COPD network auxiliary diagnosis and treatment platform can screen and remotely manage patients with COPD,but diagnostic accordance rate of COPD is not high,the network questionnaires are needed to be optimized and lung function terminal devices of patients are needed to be developed.
    Influence Factors of Quality of Life of the Elderly with Type 2 Diabetes Based on Diabetes Quality of Life Questionnaire
    CHEN Huang-hui, CHAO Jian-qian, XU Hui, YU Qing, YANG Liang, WU Zhen-chun
    2016, 19(31):  3803-3807.  DOI: 10.3969/j.issn.1007-9572.2016.31.009
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    Objective To study influence factors of quality of life of the elderly with type 2 diabetes based on diabetes quality of life questionnaire.Methods 240 aged patients with type 2 diabetes,who received physical examination in a community hospital in Nanjing from March 2013 to December 2014,were selected.Face to face interview surveys were made to patients by investigators with self-designed questionnaires,240 questionnaires were sent out and 224 were effectively recovered,and the effective response rate was 93.3%.The questionnaire contents were divided into two parts:general condition and diabetes quality of life scale.Based on Diabetes Specific Quality of Life Scale(DSQL) and Short Form Health Survey Scale(SF-36),diabetes quality of life scale was modified on the basis of the elderly own characteristics,and Cronbach’s α coefficient of its internal consistency was 0.850,four common factors were extracted,and the cumulative variance contribution rate was 43.65%.Multiple linear regression analysis was applied in analyzing influence factors.Results The scores of physical function and mental function and the total scores of patients with different genders were significantly different(P<0.05);the scores of social function of patients with different educational levels were significantly different(P<0.05);scores of physical function and social function of patients with different living conditions were significantly different(P<0.05);scores of physical function of patients with different BMI were significantly different(P<0.05);and scores of specific module and total scores between patients with or without hypertension were significantly different(P<0.05).Multiple linear regression analysis showed that gender and BMI were influence factors of scores of physical function(P<0.05);gender and living conditions were influence factors of scores of psychological function(P<0.05);educational levels and living conditions were influence factors of scores of social function(P<0.05);hypertension was influence factors of scores of specific module(P<0.05);gender and hypertension were influence factors of the total scores of quality of life(P<0.05).Conclusion The scale can effectively evaluate the quality of life of aged patients with type 2 diabetes,and moreover gender,BMI,living conditions,educational levels and hypertension are influence factors of their quality of life.
    Influence of Metabolic Syndrome on Prospective Memory in Patients with Obstructive Sleep Apnea-hypopnea Syndrome
    FU Ye, JING Pan, HE Jin-cai, WANG Xiao-jia
    2016, 19(31):  3808-3811.  DOI: 10.3969/j.issn.1007-9572.2016.31.010
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    Objective To explore influence of metabolic syndrome(MS)on prospective memory(PM) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods 116 OSAHS patients who received treatment in the First Affiliated Hospital of Wenzhou Medical University and Sleep-Related Breathing Disorder Specialist of Ningbo Kangning Hospital from December 2011 to December 2013 were selected.They were divided into MS group(n=44) and non-MS group(n=72) according to whether combined with MS.Patients in both groups were monitored by polysomnography(PSG),and overall cognitive and PM functions were assessed by using mini mental state examination(MMSE) and PM testing.Results There was no significant difference in gender,average age and education duration between patients in two groups(P>0.05).BMI of patients in MS group was significantly higher than that in non-MS group,and abdominal circumference was significantly larger than that in non-MS group(P<0.05).The apnea hyponea index(AHI) and time of oxygen saturation(SO2) <90% in MS group were higher than those in the non-MS group,and the lowest SO2 was lower than that in the non-MS group.There was significant difference(P<0.05).There was no significant difference in scores of MMSE and time-based prospective memory(TBPM) between patients in two groups(P>0.05).Event-based prospective memory(EBPM) scores of combined with MS group were significantly lower than those in non-MS group(P<0.05).With or without MS,AHI had significant effects on EBPM(P<0.05),but MS had no significant effects on EBPM(P>0.05),the two had no interactive effects(P>0.05).Multivariate linear stepwise regression analysis showed that age,education duration and time of SO2<90% were the influencing factors of EBPM scores of OSAHS patients(P<0.05).Conclusion Combined with MS is not the independent risk factor of OSAHS patients developing PM damage,but it may affect PM function of patients with OSAHS by increasing nighttime hypoxia state.
    Impact of Enalapril Maleate Folic Acid Tablets on Prethrombotic State in Patients with H-type Hypertension
    SONG Zhi-fang, ZHENG Ze-qi
    2016, 19(31):  3812-3816.  DOI: 10.3969/j.issn.1007-9572.2016.31.011
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    Objective To investigate the impact of enalapril maleate folic acid tablets on prethrombotic state in patients with H-type hypertension.Methods From June 2014 to September 2015,126 level-one hypertension patients who received treatment in the First Affiliated Hospital of Nanchang University were selected.According to the serum homocysteine(Hcy) levels,the included subjects were divided into simple hypertension group(Hcy<10 μmol/L,n=35) and H-type hypertension group(Hcy≥10 μmol/L,n=91);H-type hypertension patients were divided into control group(n=46) and experiment group(n=45) by random number table method.Patients in simple hypertension group and control group were treated with enalapril maleate tablets orally,patients in experiment group were treated with enalapril maleate folic acid tablets orally,and both of them took continuously for six months.Results The platelet a granule membrane glycoprotein(CD62p),platelet lysosome membrane protein(CD63),von willebrand factor(vWF),fibrinogen(Fg),thromboxane B2(TXB2),plasminogen activator inhibitor-1(PAI-1) of patients in H-type hypertension group were significantly higher than those in simple hypertension group,and its tissue-type plasminogen activator(t-PA) was significantly lower(P<0.05).The comparison of CD62p,CD63,vWF,Fg,TXB2,t-PA and PAI-1 between patients in control group and experiment group before treatment was not significantly different(P>0.05);CD62p,CD63,vWF,Fg,TXB2,and PAI-1 of patients after treatment in experiment group were significantly lower than those in control group,while t-PA was significantly higher(P<0.05).After treatment,CD62p,CD63,vWF,Fg,TXB2,and PAI-1 of patients in experiment group were significantly lower than those before treatment,while t-PA was significantly higher(P<0.05);while CD62p,CD63,vWF,Fg,TXB2,t-PA,and PAI-1 of patients in control group compared with those of patients before treatment were not significantly different(P>0.05).Conclusion H-type hypertension patients have presented even more severe prothrombotic state,and enalapril maleate folic acid tablets can effectively reduce the blood pressure of H-type hypertension patients and improve their prethrombotic state at the same time,which helps prevent the occurrence of cardiovascular and cerebrovascular events.
    Establishment of Predicted Value Equation of Pulmonary Ventilation Function in Middle-aged and Elderly People
    REN Ai-hong, JI Qiao-hong, HU Zhi-hong, YAN Jun-bao, FAN Ling-ling, HU Yong-mei
    2016, 19(31):  3817-3821.  DOI: 10.3969/j.issn.1007-9572.2016.31.012
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    Methods 300 middle-aged and elderly people(122 males,178 females) were selected from 4 districts and counties(Jianxi District,Xigong District,Mengjin County and Yanshi County) by using multistage stratified cluster sampling method from March to July 2014. The functional indexes of pulmonary ventilation such as forced vital capacity(FVC) and forced expiratory volume at the first second(FEV1) and FEV1/FVC were measured by using Japan PM-81 chest scanning apparatus,and each actual index was analyzed by multiple linear stepwise regression method to get the predicted value equation. Results There were significant differences in FVC and FEV1 among the middle-aged and elderly people of different genders(P<0.05);but there was no significant difference in FEV1/FVC(P>0.05). There were significant differences between FVC and FEV1 among the male middle-aged and elderly people of different ages(P<0.05);but there was no significant difference in FEV1/FVC(P>0.05). There were significant differences in FVC and FEV1 among the female middle-aged and elderly people of different ages(P<0.05);but there was no significant difference in FEV1/FVC(P>0.05). With FVC as the dependent variable,the results of multiple linear stepwise regression analysis showed that age and stature ultimately entered the regression equation,FVC=-2.369-0.019 age+3.488 stature in terms of male middle-aged and elderly people(R2=0.203,F=15.121,P<0.001);for female middle-aged and elderly people,age,stature,and body mass ultimately entered the regression equation,FVC=-0.941-0.021 age+2.842 stature-0.008 body mass(R2=0.222,F=16.542,P<0.001). With FEV1 as the dependent variable,the results of multiple linear stepwise regression analysis showed that age and stature ultimately entered the regression equation,FEV1=-0.203-0.022 age+2.012 stature in terms of male middle-aged and elderly people(R2=0.220,F=16.761,P<0.001);for female middle-aged and elderly people,age and stature ultimately entered the regression equation,FEV1=1.340-0.025 age+0.986 stature(R2=0.213,F=23.638,P<0.001). Conclusion Age and stature are the main factors that affect pulmonary ventilation function;and body mass has less effects on pulmonary ventilation function. The predicted value equation of pulmonary ventilation function that originates from Luoyang area in 300 middle-aged and elderly people is established,and this equation is suitable for the middle-aged and elderly people in Luoyang area.
    Relationship between Platelet Microparticle Level and Carotid Atherosclerosis
    TONG Qiao-wen, TONG Yu, ZHANG He-hui, ZHENG Li-fen, YANG Xiao-kai, WANG Yao-guang
    2016, 19(31):  3822-3825.  DOI: 10.3969/j.issn.1007-9572.2016.31.013
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    Objective To discuss the relationship between platelet microparticle(PMP) level and carotid atherosclerosis,and assess the role of PMP in the development of carotid atherosclerosis.Methods 187 outpatients and inpatient who received treatment in Department of Neurology of Wenzhou People’s Hospital from September 2014 to February 2016 were selected,according to results of carotid ultrasonography,they were divided into normal group of carotid intima-media thickness(IMT)(n=52),IMT thickening group(n=70) and carotid atherosclerotic plaque group(n=65).Serum PMP level was measured by flow cytometry,and in the meanwhile fasting blood-glucose(FPG),serum total cholesterol(TC),plasma fibrinogen(FG),platelet count(PLT) and other indicators were also measured;multiple Logistic stepwise regression analysis was used to analyze the influencing factors of carotid atherosclerosis.Results There was no significant difference in sex,smoking rate and PLT among the three groups(P>0.05),but there was significant difference in age,SBP,FPG,TC,FG and PMP(P<0.05).Multiple Logistic stepwise regression analysis showed that age 〔OR=1.387,95%CI(1.195,1.610)〕,FPG 〔OR=5.597,95%CI(1.695,18.469)〕,TC 〔OR=10.241,95%CI(2.727,38.455)〕,PMP 〔OR=14.918,95%CI(3.145,70.765)〕 were the independent risk factors of carotid atherosclerosis(P<0.05).Conclusion PMP is the independent risk factor of carotid atherosclerosis,and it plays an important role in the pathological process of carotid atherosclerosis.
    Relationship between Female Menarche Age and Prediabetes and Type 2 Diabetes Mellitus
    XIE Qian, WAN Qin, BAI Xue
    2016, 19(31):  3826-3830.  DOI: 10.3969/j.issn.1007-9572.2016.31.014
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    Objective To study the relationship between female menarche age and prediabetes and type 2 diabetes mellitus.Methods Based on the "epidemiological investigation of risk of cancer of diabetic patients in twenty communities of China(Luzhou Region)" launched by Endocrinology branch of Chinese Medical Association from April to November,2011,women aged over 40 were selected as the research objects.The prevalence rate of prediabetes and of type 2 diabetes mellitus of subjects at different menarche ages were compared,and the influence of female menarche age on the risk of diabetes was investigated.Results Finally 3 966 subjects were enrolled with an average menarche age of(14.8±1.8).There was significant difference in the waistline and systolic blood pressure of the subjects at different menarche ages(P<0.05);while no significant differences were found in the average age,BMI,diastolic blood pressure,fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C,P>0.05).The prevalence rate of prediabetes and type 2 diabetes mellitus of subjects at different menarche ages showed no significant differences(P>0.05).After adjusting BMI,there was no significant difference in the prevalence rate of prediabetes at the different menarche ages among normal weight subjects,overweight subjects and obese subjects(P>0.05);there was significant difference in the prevalence rate of type 2 diabetes mellitus at the different menarche ages of subjects with normal BMI(P<0.05);there was no significant difference in the prevalence rate of type 2 diabetes mellitus at the different menarche ages between overweight subjects and obese subjects(P>0.05).Multivariate Logistic regression analysis results showed that age,TC,TG,LDL-C,HDL-C significantly affected the risk of type 2 diabetes mellitus in females(P<0.05);the female menarche age had no significant effects on developing type2 diabetes mellitus(P>0.05),but the risk of developing type 2 diabetes mellitus decreased by 3.8% as the menarche age increased every one year〔OR(95%CI)=0.963(0.902,1.008)〕.Conclusion The menarche age is not the influencing factors of females developingpre diabetes and type 2 diabetes mellitus,but premature menarche may increase the risk of having type 2 diabetes mellitus.
    Expression of miR-145 and Myocardin in Vascular Injuries of Children with Lupus Nephritis and Their Clinical Significance
    NING Chun-yan, DANG Xi-qiang, SONG Fang, YI Zhu-wen, HE Xiao-jie
    2016, 19(31):  3831-3836.  DOI: 10.3969/j.issn.1007-9572.2016.31.015
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    Objective To examine the expression of miR145 and myocardin in vascular injuries of children with lupus nephritis(LN),and to discuss their roles in the development of vascular injuries of LN children.Methods 49 systemic lupus erythematosus(SLE) inpatients who were diagnosed with LN in the Department of Pediatrics in the Second Xiangya Hospital from January 2008 to September 2015 were enrolled in this study.All patients underwent renal biopsy.Immunofluorescence,light microscopic and electron microscopic examination were given to biopsy tissues routinely.According to 2002—2003 typing criteria of LN that jointly revised by International Society of Nephrology(ISN)/Renal Pathology Society(RPS),pathological typing was conducted,and there were 5 cases in type Ⅱ,7 in type Ⅲ,9 in type Ⅲ+Ⅴ,17 in type Ⅳ and 11 in type Ⅳ+Ⅴ.The degree of vascular injury was evaluated by the proportion of tunica media,and the subjects were divided into 14 mild cases,19 moderate cases,and 16 severe cases.According to KATAFUCHI and other methods of evaluation,semi-quantitative scores of glomerular damage and renal interstitial injury were made;the level of serum myocardin was measured by double antibody sandwich method;and the expression of miR-145 was detected by in situ hybridization method.Results There were significant differences in the scores of glomerular damage and renal interstitial injury among children of different pathological types(P<0.05).There was a positive linear correlation between the score of glomerular damage and the score of renal interstitial injury(r=0.961,P<0.01).The level of serum myocardin was significantly different between children with different vascular injury degrees and pathological types(P<0.05).The expression of miR-145 in renal blood vessels was significantly different between children with different vascular injury degrees and pathological types(P<0.05).There was a positive linear correlation between the level of serum myocardin and the expression of miR-145 in renal blood vessels(r=0.782,P<0.01);andthe level of serum myocardin and the expression of miR-145 in renal blood vessels were negatively correlated with the degree of vascular injuries(values of r were -0.728,and -0.790 respectively;P<0.01).Conclusion With the increase of the degree of vascular injuries,the level of serum myocardin and the expression of miR-145 in renal blood vessels were both decreased,the two can not only be used to assess the degree of renal vascular lesions(RVLs) of children with LN,but also may be a new target for the treatment of renal vascular injury in LN.
    Systematic Evaluation of General Practitioners’ Attitudes Towards Point-of-care Testing in Primary Health Care
    HUANG Ya-fang, WANG Hui-li, JIN Guang-hui, SHAO Shuang, ZHAO Ya-li, LIU Xiao-ping, DU Juan, LU Xiao-qin, GUO Ai-min
    2016, 19(31):  3837-3841.  DOI: 10.3969/j.issn.1007-9572.2016.31.016
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    Objective To systematically evaluate attitudes of general practitioners(GPs) toward application of point-of-care tests(POCTs) in communities.Methods In January 2016,literature relevant to GPs’ attitudes toward application of POCTs in communities was searched systematically in PubMed(1978—2016),EMbase(1978—2016),CNKI(1980—2016) and Wanfang Database(1980—2016),and references included in the literature were searched manually.EPPI-Reviewer 3.0 was used and statistical analysis was conducted for qualitative data through thematic synthesis.Results Finally,six qualified studies were included,all being qualitative studies;they covered 204 interviewees in total,all being GPs.Three analytic themes were generated,each including both their positive and negative attitudes:(1)Influence of POCTs on shared decision making,diagnosis,and treatment between doctors and patients,positive aspects including helping clarifying diagnostic results and making effective schemes,and negative ones including doubt in precision,less help for individual diagnosis and treatment,over-reliance on test results;(2)Influence of POCTs on other aspects of diagnosis and treatment,positive aspects including reducing times of visiting and telephone counseling,prevention of information disclosure,optimization of chronic disease management,and enhancement of GPs’ working satisfaction,and negative ones including rise of medical examination,cost rise brought by equipment maintenance and increasing items for examination,narrow usage,and imperfect quality control;(3)Influence of POCTs on doctor-patient relationship,and patients’ satisfaction,positive aspects including promotion of communication between doctors and patients,establishment of patients’ confidence,improvement of patients’ compliance in treatment,enhancement of patients’ self-management of chronic diseases,optimization of shared decision making pattern by doctors and patients,and increase of patients’ satisfaction,and negative ones including increase of patients’ nervousness,and possible increase of patients’ resistance toward examination.Conclusion Application of POCTs has become increasingly popular in communities,promoting shared decision making and communication between doctors and patients;but various evidences proving the accuracy of POCTs should be further provided to evaluate practical and economic effectiveness of applying POCTs in primary health care.
    Application and Exploration of 5W1H Method in the Training for General Practitioners
    HAN Yi-ping, ZHAO Jia-yi, SHEN Lu, YUAN Peng-qun, KE Jun, YAO Wen-hua, CHEN Xi-hui, DING Hong
    2016, 19(31):  3842-3844.  DOI: 10.3969/j.issn.1007-9572.2016.31.017
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    Although there are a large number of primary health care institutions in China currently,the service capacity and levels provided by them,especially the quality and technical level of general practitioners(GPs) need to be improved.By means of 5W1H method exploratively,Changhai Hospital,the Second Military Medical University trains general practitioners from six sections such as why,what,who,when/procedure,where and how.The results show that 5W1H method can better promote the implement of the training,and improve the interest of learning and ability of practice of GPs.It also contributes to enhancing the quality of the training.
    Workplace-based Assessment and Trainee ePortfolio in UK General Practice Training and Its Revelation to China
    YAO Mi, QI Jian-guang, ZHOU Guo-peng, HU Lin, DONG Ai-mei, SUN Wei, CHI Chun-hua
    2016, 19(31):  3845-3849.  DOI: 10.3969/j.issn.1007-9572.2016.31.018
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    The Royal College of General Practitioners(RCGP) implements the assessments of general practitioners(GPs) in the UK,which comprises three separate components:applied knowledge test(AKT),clinical skills assessment(CSA) and workplace-based assessment(WPBA).In China,however,WPBA is insufficiently used.WPBA is designed to collect evidence related to 13 items of core professional competences of GPs with 6 assessment tools covering different fields of abilities.Trainee ePortfolio in RCGP website is the electronic recording system of WPBA,which includes the trainees’ self-reflection study,personal growth plan and 6 sets of assessment tools.This paper emphatically introduces how WPBA and trainee ePortfolio are implemented in UK general practice training and puts forward suggestions for improving the evaluation and assessment system of general practice training based on the current general practice training situation of China.
    Relationship between Attachment Styles,Satisfaction Degree of Intimate Relationships and Depression of College Students
    GAO Lan, WANG Ke-xin, CHEN Chen, ZHOU Yi-xin, JIN Ling, ZHOU Ming-jie
    2016, 19(31):  3850-3854.  DOI: 10.3969/j.issn.1007-9572.2016.31.019
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    Objective To explore the relationship between attachment styles,satisfaction degree of intimate relationship and depression of college students.Methods 180 pairs of male and female college students who were in love were selected from 3 universities of Shanghai from March to May in 2015 by convenience sampling method.By questionnaire survey,male and female college students in love were recruited to enroll in the investigation,a total of 360 questionnaires were sent out(180 pairs),336 were valid questionnaires(168 pairs),and the effective response rate was 93.3%.The revised simple version of Experiences in Close Relationship Scale(ECR),Perceived Relationship Quality Components Scale(PRQC) and Center for Epidemiological Studies Depression Scale(CES-D) were adopted to measure the attachment styles,satisfaction degree of intimate relationships and depression respectively.Pearson correlation analysis was used in correlation analysis between different measurement data;unitary linear regression analysis was applied in analyzing influencing factors.Results The scores of boys in attachment anxiety,attachment avoidance,intimacy satisfaction degree,depression scores were(2.5±0.7),(2.1±0.6),(5.8±0.9),and(1.6±0.4) respectively,while the scores of girls in the above aspects were(2.6±0.7),(2.3±0.6),(5.6±1.0),(1.6±0.4) respectively.There was a linearly negative correlation between boys’ scores of attachment anxiety,attachment avoidance and satisfaction scores of their own intimate relationships(P<0.05),a linear positive correlation was found in attachment anxiety and attachment avoidance scores and their own depression scores(P<0.05),and there was a linearly negative correlation between satisfaction scores of intimate relationship and their own depression scores(P<0.05).There was a linearly negative correlation between girls’ scores of attachment avoidance and satisfaction scores of intimate relationships(P<0.05),a linear positive correlation was found in attachment anxiety and attachment avoidance scores and their own depression scores(P<0.05),and there was a linearly negative correlation between satisfaction scores of intimate relationship and their own depression scores(P<0.05).There was a linearly negative correlation between boys’ scores of attachment avoidance and girls’ satisfaction scores of intimate relationship(P<0.05),and there was a linearly positive correlation between attachment anxiety as well as attachment avoidance scores and depression scores of girls(P<0.05).There was a linearly negative correlation between girls’ attachment avoidance scores and boys’ satisfaction scores of intimate relationships(P<0.05),and there was a linearly positive correlation between attachment anxiety and attachment avoidance scores of girls and depression scores of boys(P<0.05).Unitary linear regression analysis showed that attachment anxiety and attachment avoidance scores of boys were influence factors of their own satisfaction scores of intimate relationships and depression scores(P<0.05);attachment avoidance scores of girls were influence factors of their own satisfaction scores of intimate relationships(P<0.05);scores of attachment anxiety and attachment avoidance were influence factors of their own depression scores(P<0.05);boys’ scores of attachment avoidance were influence factors of girls’ satisfaction scores of intimate relationships(P<0.05),scores of attachment anxiety and attachment avoidance were influence factors of depression scores of girls(P<0.05);girls’ scores of attachment avoidance were influence factors of boys’ satisfaction scores of intimate relationships(P<0.05),scores of attachment anxiety and attachment avoidance were influence factors of depression scores of boys(P<0.05).Conclusion Secure attachment style can not only decrease individual depression degree,but also improve the satisfaction degree of their intimate relationships,and lower their partner’s depression level.
    Comparison of Mental Health Status of Middle School Students with Different Types of Custodial Care in Poor Districts and Counties of Chongqing
    WANG Ya, WANG Hong, LI Jian-qiao, LIU Qin, CAO Xing-hou
    2016, 19(31):  3855-3860.  DOI: 10.3969/j.issn.1007-9572.2016.31.020
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    Objective To compare the differences of mental health status of middle school students with different types of custodial care in poor districts and counties of Chongqing and to provide references for further intervention measures.Methods From September to October in 2011,with multi-stage random cluster sampling method,one county was randomly selected from 11 poor districts and counties in Chongqing,then three township middle schools were randomly selected from this district or county and finally students graded one of junior middle school and senior middle school of four to six classes were randomly selected from the above each middle school.By collective survey method,questionnaires were unified issued by trained investigators.The contents were divided into two parts:general demographic information questionnaire and middle school student mental health scale(MSSMHS).A total of 2 401 questionnaires were distributed,2 171 were valid questionnaires with an effective response rate of 90.4%.Results Among 2 171 middle school students,there were 1 072 females(49.4%) and 1 099 males(50.6%);1 114 junior high school students graded one(51.3%),and 1 057 senior high school students graded one(48.7%);468 with custodial care of single parent(21.6%),756 with cross-generation custody(34.8%),101 with custodial care of the former generation(4.7%),215 with peer custody(9.9%),and 631 with custodial care of parents(29.0%).The scores of obsessive-compulsive symptoms,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning stress,maladjustment,emotional imbalance and psychological imbalance dimensions of middle school students with different types of custodial care were significantly different(P<0.05),while there was no significant difference in the scores of paranoid dimension(P>0.05).There were significant differences in obsessive-compulsive symptoms,paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning stress,emotional imbalance and psychological imbalance dimensions among middle school students of different genders(P<0.05),but there was no significant difference in the score of maladjustment dimension(P>0.05).There were significant differences in obsessive-compulsive symptoms,paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning stress,maladjustment,emotional imbalance and psychological imbalance dimensions of middle school students at different grades(P<0.05).There were no significant differences in scores of obsessive-compulsive and learning stress dimensions among female middle school students with different types of custodial care(P>0.05),while the scores of paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,maladjustment,emotional imbalance and psychological imbalance dimensions were significantly different(P<0.05);there were no significant differences in obsessive-compulsive symptoms,paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning tensions,maladjustment,emotional imbalance and psychological imbalance scores among male middle school students with different types of custodial care(P>0.05).There were no significant differences in scores of obsessive-compulsive symptoms,paranoia,anxiety,learning stress and emotional imbalances among junior high school students graded one with different types of custodial care(P>0.05),but hostility,interpersonal sensitivity and tensions,depression,maladjustment and psychological imbalance dimensions were significantly different(P<0.05);there were no significant differences in scores of obsessive-compulsive symptoms,paranoid,hostility,interpersonal sensitivity and tensions,learning stress and psychological imbalance dimensions among senior high school students graded one with different types of custodial care(P>0.05),while the scores of depression,anxiety,maladjustment and emotional imbalance dimensions were significantly different(P<0.05).Conclusion There are many psychological problems in middle school students featured by female,senior class,custodial care of the former generation and peer custody in poor districts and counties of Chongqing.It is necessary for the government,the school and the guardian to make a concerted effort to reduce the mental health problems of middle school students.
    Relationship between Pressure of Infertility Patients from Social Concern and Mental Health and Subjective Well-being:Moderating Effect of Tradition-modernity
    HUO Ya-fen, WANG Ke-xin, ZHOU Yi-xin, WANG Hao, HUO Kai-fang, ZHOU Ming-jie
    2016, 19(31):  3861-3865.  DOI: 10.3969/j.issn.1007-9572.2016.31.021
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    Objective To explore relationship between pressure of infertility patients from social concern and mental health and subjective well-being:moderating effect of tradition-modernity.Methods 216 infertility patients,who received treatment in Outpatient of Reproductive Center of two first-class hospitals at grade three in Beijing from September to December in 2014,were investigated by questionnaire survey,216 questionnaires were distributed and 215 valid questionnaires were returned with an effective response rate of 99.5%.The level of mental health of infertility patients was measured by Mental Health Index(MHI-5);their subjective well-being was measured by using Satisfaction with Life Scale(SWLS);their tradition-modernity was measured by Tradition-Modernity Scale;their pressure brought by social concern was measured by Social ConcernDimension.Pearson correlation analysis was applied in correlation analysis;hierarchical regression analysis was used in influence factors analysis.Results The scores of 215 patients in mental health,subjective well-being,tradition-modernity,pressure brought by social concern were(4.4±0.9),(4.1±1.2),(3.6±0.7),(3.0±0.7) respectively.There was a linearly positive correlation between mental health scores and subjective well-being scores(r=0.208,P<0.05),and a linearly negative correlation between mental health scores and pressure of social concern scores(r=-0.315,P<0.05),but there was no linear correlation between mental health scores and tradition-modernity scores(r=-0.013,P>0.05);subjective well-being scores was linearly and negatively correlated with scores of pressure brought by social concern(r=-0.272,P<0.05),but not linearly correlated with tradition-modernity scores(r=0.094,P>0.05);tradition-modernity scores and pressure brought by social concerns scores were not linearly correlated(r=0.105,P>0.05).When the demographic variables were controlled,scores of pressure brought by social concern and interactive effects between scores of pressure brought by social concern and scores of tradition-modernity were the influencing factors of scores of mental health and subjective well-being(P<0.05).The scores of mental health and subjective well-being among patients with low scores of tradition-modernity and high scores of pressure brought by social concern were the lowest;high scores of tradition-modernity eased the negative correlation between scores of pressure brought by social concern and scores of mental health and subjective well-being.Conclusion The greater social pressure the infertility patients can feel,the worse their mental health status is and the lower subjective well-being is.Tradition can relax the negative correlation between worry of patients in social concern and their mental health and subjective well-being.
    Design of O2O Platform of Community Disability Rehabilitation Services and Its Application Effect
    JIA Shu-lei, FANG Xiao-qun, FENG Qiong, LIU Meng
    2016, 19(31):  3866-3869.  DOI: 10.3969/j.issn.1007-9572.2016.31.022
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    Objective To design O2O platform of community rehabilitation services and to explore its application effects.Methods 120 disabled patients,who accepted O2O platform rehabilitation services in 6 communities of Nanchang in 2015,were selected as the experimental group,and another 120 disabled patients who accepted routine rehabilitation services in 6 similar communities of Nanchang at the same time were conveniently taken as the control group.O2O platform rehabilitation services——patients and their families got online rehabilitation guidance from resident doctors,customized community rehabilitation services,and offline professional rehabilitation services for patients provided by volunteers from Medical College in community through O2O platform.The two groups were intervened for one year;results were evaluated by using Symptom Check List-90(SCL-90),Modified Barthel Index(MBI),and World Health Organization Quality of Life-100(WHOQOL-100).Results The scores of somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoid and psychosis between two groups before intervention were not significantly different(P>0.05);the scores of somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoid and psychosis in experimental group after intervention were significantly lower than those in control group(P<0.05).There was no significant difference in total score of MBI and WHOQOL-100 scores of physiology,psychology,independence,social relations,environment and emotional support and total score between two groups before intervention(P>0.05);total score of MBI and WHOQOL-100 scores of physiology,psychology,independence,social relations,environment and emotional support and total score in experimental group after intervention were significantly higher than those in control group(P<0.05).Conclusion The design and development of O2O platform for community disability rehabilitation services are completed.This platform has positive effect on improving activities of daily living,mental health and quality of life of disabled patients.
    Intervention Effects of Multidimensional Rehabilitation Model on Community Patients with Schizophrenia
    YAN Hui-yu, RAN Rui-zhen, ZHONG Zi-han, JIANG Jing, BI La-mei, DIAO Ya-hong
    2016, 19(31):  3870-3873.  DOI: 10.3969/j.issn.1007-9572.2016.31.023
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    Objective To investigate the intervention effects of multidimensional rehabilitation model on community patients with schizophrenic,and to further explore the suitable rehabilitation model for Chinese patients with schizophrenia.Methods 103 patients with schizophrenia who received treatment in Yulin Community Health Service Center and outpatient clinic of Huaxi Mental Health Center from June 2010 to September 2012 were selected.All the patients were divided into study group(n=59) and control group(n=44) by random number table method.Control group adopted conventional community rehabilitation mode,while study group used multidimensional rehabilitation model.Two groups were intervened for 2 years.Positive and Negative Syndrome Scale(PANSS),Social Disability Screening Schedule(SDSS) and Family Interview Schedule(FIS) were applied to evaluate the results.Results During the experiment,the duration of 5 patients’ participation was less than 50% and thus they were excluded;subjects in control group had all completed follow-up and psychological assessment.Therefore,98 patients were finally included in the study,including 54 patients in study group and 44 in control group.The effective recovery rate of social function in study group after intervention was significantly higher than that in control group(P<0.05).PANSS,SDSS and FIS scores were not significantly different between two groups before intervention(P>0.05);PANSS,SDSS and FIS scores in study group after intervention were significantly lower than those in control group(P<0.05).Conclusion The multidimensional rehabilitation model has obtained good effects on rehabilitation of patients with schizophrenia(including improvement of psychiatric symptoms,rehabilitation of social function,reducing of family burden).At the same time,in order to implement localized multidimensional rehabilitation model,comprehensive considerations of local policies,local characteristics,and the quality and ability level of rehabilitation workers are needed.
    Impact of Solution-focused Brief Group Therapy on Self-efficacy of Patients with Schizophrenia in Rehabilitation Stage
    LI Jiang-chan, ZHU Zheng-ren, YUAN Shui-lian, LI Wei-hong, ZHONG Hua, HE Zhu-fa, LIU Wang-lin
    2016, 19(31):  3874-3877.  DOI: 10.3969/j.issn.1007-9572.2016.31.024
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    Objective To explore the impact of solution-focused brief group therapy on self-efficacy of patients with schizophrenia in rehabilitation stage.Methods 100 patients with schizophrenia who were hospitalized in Third People’s Hospital of Ganzhou in Jiangxi Province from May 2014 to May 2015 were selected and divided into research group and control group by random number table method,each group had 50 cases.The research group was treated with solution-focused brief group therapy;and the control group received routine group psychology counseling.Self-efficacy level was assessed by general self-efficacy scale(GSES),and psychiatric symptoms were assessed by using brief psychiatric rating scale(BPRS).Results There was significant difference in scores of self-efficacy between two groups(P<0.05),there were also significant differences in scores of self-efficacy at different time points(P<0.05),but treatment method and time had no significant interactions on self-efficacy scores(P>0.05).The scores of anxiety-depression,lack of vitality,thinking disorder,and hostile suspicion factor were negatively linear correlated with scores of self-efficacy(P<0.05),while the scores of active factor were positively linear correlated with self-efficacy scores(P<0.05).The results of multiple linear stepwise regression analysis showed that the score of anxiety-depression factor and the total score were the influencing factors of self-efficacy scores(P<0.05).Conclusion The solution-focused brief group therapy can obviously improve the self-efficacy level of patients with schizophrenia in rehabilitation stage,and the level of self-efficacy is related to factors as anxiety and depression.
    Clinical Effects of Acupuncture with Liuwei Dihuang Pill onType 2 Diabetes Lipidmetabolic Disorder and Its Influence on Insulin Resistance
    WANG Bin
    2016, 19(31):  3878-3882,3887.  DOI: 10.3969/j.issn.1007-9572.2016.31.025
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    Objective To explore clinical effects of acupuncture with liuwei dihuang pill on type 2 diabetes lipidmetabolic disorder and to investigate its influence on insulin resistance.Methods 225 patients with type 2 diabetes lipidmetabolic disorder who received treatment in Chun’an Chinese Traditional Medicine Hospital from June 2013 to March 2014 were selected,and were divided into 5 groups——groups of A,B,C,D and E by random number table method,45 cases per group.Patients in group A were given conventional treatment,based on which patients in group B took liuwei dihuang pill orally and patients in group C accepted acupuncture therapy,group D based on group A’s method took liuwei dihuang pill orally combined with acupuncture therapy,and group E used the same method as group D except for taking rosuvastatin capsule orally.Four weeks were taken as a course of treatment,and three courses of treatment was given to patients in the five groups.The related laboratory test index,blood rheology index,and traditional Chinese medicine syndrome score were compared among the five groups before and after the treatment.Results A total of 215 patients finished the treatment as required.(1)Before treatment,there was no significant difference in fasting plasma glucose(FPG),2 h postprandial glucose(2 hPG),glycated hemoglobin(HbA1c),insulin resistance index(Homa-IR) of patients in five groups(P>0.05).There was significant difference in FPG,2 hPG,HbA1c,and Homa-IR of patients in five groups after treatment(P<0.05);of which Homa-IR of patients in group B was significantly lower than that in group A(P<0.05);Homa-IR of patients in group C was significantly lower than that in group A and B(P<0.05);FPG,2 hPG,HbA1c,Homa-IR of patients in group D and E were significantly lower than those in group A,B,and C(P<0.05).(2)Before treatment,there was no significant difference in total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C) of patients in five groups(P>0.05).There was significant difference in TC,TG,LDL-C,and HDL-C of patients in five groups after treatment(P<0.05);of which TC,TG and LDL-C of patients in group B and C were significantly lower than those in group A,while their HDL-C was significantly higher than that in group A(P<0.05);TC,TG and LDL-C of patients in group D and E were significantly lower than those in group A,B and C,while their HDL-C was significantly higher than that in group A,B and C(P<0.05).(3)Before treatment,there was no significant difference in whole blood viscosity,plasma viscosity,fibrinogen,and hematocrit of patients in five groups(P>0.05).There was significant difference in whole blood viscosity,plasma viscosity,fibrinogen and hematocrit of patients in five groups after treatment(P<0.05);of which whole blood viscosity,plasma viscosity,fibrinogen and hematocrit of patients in group C,D and E were lower than those in group A and B(P<0.05).(4)Before treatment,there was no significant difference in traditional Chinese medicine syndrome score of patients in five groups(P>0.05).there was significant difference in traditional Chinese medicine syndrome score of patients in five groups after treatment(P<0.05);of which the traditional Chinese medicine syndrome score of patients in group B and C was significantly lower than that in group A(P<0.05);the traditional Chinese medicine syndrome score of patients in group D and E was significantly lower than that in group A,B and C(P<0.05).Conclusion Acupuncture with liuwei dihuang pill can effectively lower the blood glucose level of patients with type 2 diabetes lipidmetabolic disorder,and can adjust dyslipidemia,reduce blood viscosity,improve status of insulin resistance.It also can be used alone without combining with conventional treatment of Western medicine.
    Treatment Effect of Kangfuxin Solution on Ammoniac Halitosis and Burning Pain in Oral Mucosa of Hemodialysis Patients with End-stage Renal Disease
    FENG Jin-hong, ZHAO Ying
    2016, 19(31):  3883-3887.  DOI: 10.3969/j.issn.1007-9572.2016.31.026
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    Objective To discuss the treatment effect of kangfuxin solution on ammoniac halitosis and burning pain in oral mucosa of hemodialysis patients with end-stage renal disease(ESRD).Methods Among the 110 ESRD patients who received hemodialysis in the Affiliated Hospital of Xuzhou Medical University,63 patients with ammoniac halitosis(OS≥2) were selected from January to October of 2013.The patients were divided into control group(n=31) and experiment group(n=32) by random number table method.Patients in both of the two groups received oral hygiene instruction and training of using mouthwash,patients in control group used compound chlorhexidine gargle,while patients in experiment group chose kangfuxin solution,and the treatment time lasted for 2 weeks.The ammoniac halitosis indicators〔including OS,oral ammonia value(OAV),pH value of saliva〕,other oral examinations conditions〔including thickness of the tongue(Tt),area of the tongue(Ta),staining index(SI)〕 of patients in two groups,and pain index〔including pain rating scale(PRI),visual analogue scale(VAS),present pain index(PPI)〕 of those patients with burning pain in the oral mucosa(PPI≥1) were detected and compared before and after treatment in both groups.Results There was no significant difference in OS,OAV and pH of saliva between patients in two groups before and after treatment(P>0.05).The number of patients with PPI≥1 were 41 in total,the difference before and after treatment of PRI and VAS of patients with PPI≥1 in experiment group were significantly higher than that in control group(P<0.05).There was no significant difference in the PPI difference before and after treatment of patients in two groups(P>0.05).The differences before and after treatment of Ta,Tt and SI were not significantly different(P>0.05).Conclusion Kangfuxin solution can alleviate burning pain in oral mucosal of ESRD hemodialysis patients with ESRD,and its effect is better than chlorhexidine solution;but it has no advantage in the treatment of ammonia halitosis compared with chlorhexidine solution.
    Pituitary Adrenocorticotrophic Hormone Adenomawith Severe Low Blood Potassium as Initial Symptom:A Case Report and Literature Review
    NING Cui-li, LIU Kuan-zhi
    2016, 19(31):  3888-3890.  DOI: 10.3969/j.issn.1007-9572.2016.31.027
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    The paper retrospectively analyzes the clinical diagnosis and treatment process of one patient of pituitary adrenocorticotrophic hormone(ACTH) adenoma with severe low blood potassium as initial symptom.The patient is misdiagnosed for two years due to ignorance of his signs;the patient after admission was given suppression test of small-dose and large-dose dexamethasone,pituitary MRI enhancement scan test and was finally diagnosed with Cushing’s disease;after transsphenoidal pituitary micro-adenomas surgery,patients’ hypertension,blood potassium,blood glucose,cortisol and ACTH were reexamined and all were in the reference range.Besides considering as primary aldosteronism,clinician should also taking Cushing’s disease,into consideration when encounter hypertension patients combined with severe low blood potassium.
    Myocardial Infarction Caused by Non-obstructive Atherosclerosis of Coronary Artery:A Case Report and Literature Review
    FU Ming-wei, CHEN Wei, GUO Yan-song
    2016, 19(31):  3890-3892.  DOI: 10.3969/j.issn.1007-9572.2016.31.028
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    Coronary angiography examination of part of patients with myocardial infarction(MI) shows that coronary stenosis is lower than 50%,or even lower,which is clinically defined as non-obstructive coronary atherosclerosis-induced myocardial infarction(MINOCA).At present,it is still lack of treatment guidelines for such diseases,so the etiology of patients in clinical treatment should be made clear in order to implement the best treatment plan.This paper reports the clinical diagnosis and treatment process of one MINOCA patient,and analyzes its etiology in combination with the previous literatures.
    Case Studies of Mental Health in Chinese Community(20)——Female Sexual Dysfunctions
    ZHENG Ya-nan, HU Wen, WEI Ze-hong, LI Jian-zhong
    2016, 19(31):  3893-3896.  DOI: 10.3969/j.issn.1007-9572.2016.31.029
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    Sexual dysfunction is the inability to have normal sexual behavior,or needs in normal sexual behavior cannot be met. Most sexual dysfunction has no organic disease,that is to say there is no abnormality or lesion in sexual organs,but because of psychological factors. The paper reports the psychological treatment process for nearly a year of a 37-year-old female patient,being difficult to be moist in vaginal when having sex with her lover and unable to maintain her sexual life at a satisfactory level,and hopes to improve the ability of community physicians in applying a variety of psychological counseling and psychotherapy methods.