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2017-03-22

长江大学学报(自科版) 2017年12期

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1 Effects of Yiqi Wenyang Herbs on the Treatment of Knee Osteoarthritis and on Inflammatory Cytokines and NO LevelsZhangHengwen,YuWangui(MedicalschoolofYangtzeUniversity,Jinghzou434023,China)Abstract:Objective:To investigate the effects of Yiqi Wenyang herbs on the treatment of knee osteoarthritis and on inflammatory cytokines and NO levels. Methods: 100 patients with knee osteoarthritis from January 2013 to June 2016 had been randomly divided into the control group (50 cases) and the study group (50 cases) in which traditional Chinese medicine and Western treatment had been integrated. In the control group only glucosamine sulfate had been applied, glucosamine sulfate plus Yiqi Wenyang herbs in the study group. Clinical curative effects had been observed, traditional Chinese medicine (TCM) symptom scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis indexes had been tested before and after treatment, and some fluid factors such as TNF-alpha, IL-1 beta, IL-6 and NO levels had been measured. Results: The clinical curative effects were significantly better in the study group than the control group (P<0.05); TCM syndrome scores and WOMAC osteoarthritis indexes were significantly lower than in the control group or before treatment (P<0.05); TNF-alpha, IL-1 beta and IL-6 were more significantly decreased (P<0.05); and NO levels also more decreased than the control group or before treatment (P<0.05). Conclusion: Yiqi Wenyang herbs can effectively relieve symptoms and signs, improve joint function of the patients with knee osteoarthritis, inhibit inflammatory reactions, and help reduce NO levels. Key words:Chinese herbs;knee osteoarthritis;inflammatory cytokines;NO levels

8 Influences of Digitalis on Left Atrial Mechanical Dysfunction after Cardioversion of Chronic Atrial FibrillationZhouZhongquan,WangYujing,YiXuying,MaSha,YangShaning,YangXuexin,DenShibing(DepartmentofCardiology,theFirstHospitalofYangtzeUniversity,Jingzhou434000,China)Abstract:Objective:To investigate whether administration of digitalis can improve mechanical function of left atrial appendage (LAA) and left atrium prospectively in patients with atrial stunning after cardioversion of chronic atrial fibrillation(AF). Methods:54 patients in whom atrial stunning had been observed immediately after cardioversion of chronic AF had been randomly divided into the digitalis group and the control group. Digitalis had been used for the former group, the placebo for the latter for 1 week following cardioversion. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) had been performed prior to, immediately following, 1 day after and 1 week after cardioversion to measure transmitral flow velocity and LAA flow velocity. Results:Immediately after successful cardioversion of AF both left atrial appendage peak emptying velocity (LAA-PEV) and peak filling velocity (LAA-PFV)became significantly slower in both the groups. 1 day after cardioversion, there were no significant differences in transmitral E wave(73.0±16.8cm/svs77.1±22.8cm/s,P>0.05),Awave(63.0±14.0cm/svs51.7±12.6cm/s,P>0.05),E/A ratio(1.7±0.7vs1.7±0.8,P>0.05), LAA-PEV (23.7±8.4cm/svs21.7±9.8cm/s,P>0.05), LAA-PFV (26.2±9.9cm/svs24.4±8.4cm/s,P>0.05) and LAA-EF (31.4%±9.0%vs30.2%±10.7%,P>0.05) between 2 groups. 1 week after cardioversion, no significant differences were found in transmitral E wave(72.8±16.9cm/svs72.0±18.8cm/s,P>0.05), A wave(64.7±16.6cm/svs61.0±15.6cm/s,P>0.05), E/A ratio(1.3±0.4vs1.5±0.7,P>0.05), LAA-PEV(40.7±10.0cm/svs33.9±12.9m/s,P>0.05), LAA-PFV (43.0±14.2cm/svs35.3±11.0cm/s,P>0.05) and LAA-EF(42.4%±12.4%vs39.3%±11.3%,P>0.05) between the two groups. The occurrence rates of spontaneous echo contrast were not significantly different between the digitalis and the control group one day and one week after cardioversion.Conclusion:Digitalis cannot improve mechanical dysfunction of LAA and left atrium following cardioversion of chronic AF. Digitalis also cannot prevent the development of spontaneous echo contrast in left atrium, since digitalis can aggravate intracellular calcium overload and have a negative effect on the ventricular rate.Key words:digitalis;atrial fibrillation;cardioversion;atrial stunning

12 Meta-analysis of Pregabalin in the Treatment of Restless Legs SyndromeYangYan(HubeiCollegeofChineseMedicine,Jingzhou434020,China)HuXiaohui(theCentralHospitalofJingzhou,Jingzhou434020,China)LiuLinghua(HubeiCollegeofChineseMedicine,Jingzhou434020,China)Abstract:Objective:To systematically evaluate the efficacy and safety of pregabalin in treating restless legs syndrome (RLS). Methods: A search for randomized, placebo-controlled clinical trials of pregabalin in treating RLS in Pubmed, Medline(1966-), EMBASE(1980-, OVID, CNKI and Cochrane library database had been carried out. A meta-analysis of included clinical trials had been performed with RevMan 5.0 software. The International RLS Study Group rating scale(IRLS) scores, the weighted mean difference(WMD) of changes in total sleep time(TST)and the relative risk (RR) of response based on the Clinical Global Impression-Improvement(CGI-I) scale scores had been calculated for efficacy evaluation. Safety had been assessed with RR of the adverse events (AE). Results: A total of 3 clinical trials were included in this meta-analysis, in which 556 patients were randomly assigned (326 on pregabalin, 220 on placebo).Overall WMD for the changes in IRLS scores and TST were 3.85(Z=5.47,P<0.00001) and 44.57(Z=6.07,P<0.00001) respectively, and RR of response based on CGI-I were 1.35(Z=4.76,P<0.00001).The overall RR of pregabalin versus placebo were 1.25(Z=0.93,P=0.35) for AE. Conclusion: Pregabalin is an effective and safety drug for the treatment of RLS.Key words:pregabalin;restless legs syndrome;andomized controlled trials;Meta-analysis

29 Influences of Different Intravenous Injection Rates of Remifentanil Combined with Propofol on Breathing of Elderly PatientsTangXia(DepartmentofAnesthesiology,thePeople’sHospitalofGonganCounty,Gongan434300,China)YinHong(DepartmentofAnesthesiology,theFifthPeople’sHospitalofChengdu,Chengdu611130,China)LiWei(DepartmentofAnesthesiology,thePeople’sHospitalofGonganCounty,Gongan434300,China)HongShuwen(SchistosomiasisControlHospitalofGonganCounty,Gongan434300,China)Abstract: Objective:To observe effects of 2 different intravenous injection rates of Remifentanil combined with Propofol on breathing of elderly patients Methods:all of the elderly patients treated with painless intravenous injection from Jan.2015 to Dec.2016 had been collected, with the rate of 0.3mL/s for 45 cases in the group A and the rate of 0.5mL/s for 45 cases in the group B. The pulse, respiratory movement and SPO2of all the patients during surgery had been observed. Results: The SPO2in 2 groups were above 90% and the pulses were higher than 50bpm. There were 10 apnea cases during surgery in the group A, the incidence 10%; there were no apnea cases in the group B. Conclusion:The rate of 0.3mL/s is safer and has less influences on breathing of the elderly patients during painless intravenous injection of Remifentanil combined with Propofol.Key words:remifentanil; propofol; intravenous injection rate; elderly patients; breathing

36 Effects of Early High-dose Intravenous Injection of Gamma Globulin in the Treatment of 23 Cases of Neonatal Hemolytic DiseaseHuXiaohua,FuJianping(DepartmentofPediatrics,XinyuMaternalandChildHealth-CareCenter,Xinyu338025,China)Abstract:Objective: To observe the clinical efficacy of high-dose gamma globulin in the treatment of hemolytic disease of the newborn. Methods: 46 cases of neonatal hemolytic disease from January 2015 to January 2016 had been randomly divided into the experimental group and the control group, all the patients had been treated with early intravenous immunoglobulin therapy, the dose of 1g/kg (high dose) for the experimental group and the dose of 0.5g/kg for the control group. The curative effects had been compared between 2 groups. Results: Before treatment, there were no significant differences in the serum total bilirubin level, the hemoglobin level and the jaundice time between the two groups (P>0.05). 1 day or 3 days after treatment the serum total bilirubin levels in the experimental group were significantly lower than those in the control group (P<0.05); 1 months after treatment, the hemoglobin levels in the experimental group were higher than the control group (P<0.05); the average jaundice time in the experimental group was shorter in the control group (P<0.05). Conclusion: Early application of high-dose gamma globulin in the treatment of neonatal hemolytic disease can prevent the destruction of red blood cells, reduce the delay of oxyhemoglobin, effectively reduce the total bilirubin level, and accelerate regression of jaundice.Key words: neonatal hemolytic disease; high-dose gamma globulin; ABO blood type

44 The Problems existing in SPECT Scan and CountermeasuresLiuChunyan,SuShicang(DepartmentofNuclearMedicine,theCentralHospitalofJingzhou,Jingzhou434020,China)SunXun(DepartmentofNuclearMedicine,UnionHospitalAffiliatedtoTongjiMedicalCollegeofHuazhongUniversityofScienceandTechnology,Wuhan430022,China)LiuXiaolin(DepartmentofNuclearMedicine,theCentralHospitalofJingzhou,Jingzhou434020,China) Abstract:To improve the accuracy of SPECT scan and reduce the radiation level.The working experience of the authors for many years and the further study experience in the superior hospitals had been summarized and analyzed. The problems existed in all the steps of SPECT scan and all the problems were summed up and analyzed for the countermeasures.The quality of SPECT scan can become higher and the radiation level can be reduced only by normalizing the reservation process, complying with the operation procedures, improving skills and diagnosis, strengthening the quality control and emphasizing the communication with the patients.Key Words:SPECT scan; analysis of problems; countermeasures

47 The Clinical Curative Effect Analysis and Nursing Experience in the Treatment of bladder calculi by Pyeloscopy Holmium Laser Lithotripsy Assisted with Modified Resectoscope SheathLinLi,YuanLongmei(EndoscopicOperatingRoominDepartmentofUrology,theCentralHospitalofJingzhou,Jingzhou434020,China)Abstract:Objectives:To evaluate the clinical curative effects of common pyeloscopy holmium laser lithotripsy assisted with modified resectoscope sheath on urinary bladder calculi and to summarize the nursing experience related to the modified method.Methods:168 patients with bladder calculi had been divided into 2 groups, 84 patients in the modified group with common pyeloscopy holmium laser lithotripsy assisted with modified resectoscope sheath and 84 patients in the common group with common pyeloscopy holmium laser lithotripsy.Then the clinical curative effects between two groups had been compared and the nursing experience related to the modified method had been explored. Results:The curative effects in the modified group were obviously better than the common group with less lithotripsy time, less blood loss volume during surgery, less continuous bladder irrigation time, less catheter residence time, less hospitalization days and lower bladder mucosal damage rate, while the modified group was obviously better than the common group in the success rate of lithotripsy on one session (P<0.05).Conclusion:The pyeloscopy holmium laser lithotripsy assisted with modified resectoscope sheath is a safe modified method with small trauma and speedy recovery for treatment of bladder calculi while good preoperative nursing preparation, nursing assistance during operation and postoperative guidance are important guarantees for the smooth completion of the modified method.Key words: resectoscope sheath; pyeloscopy; bladder calculi; curative effect; nursing

50 Effects of Psychological Intervention Combined with Drugs on Postoperative Sedation of Cesarean SectionZhaoXiaoyu(DiseasePreventionandControlCenterofXiantao,Xiantao433000,China)ZhaoQiongping(OperatingRoom,theFirstPeople’sHospitalofXiantao,Xiantao433000,China) Abstract:Objective:To observe the effects of psychological counseling combined with the drug therapy on the sedative effect of cesarean section. Methods:200 cases of primiparas with cesarean section had been randomly divided into the group A and the group B. Psychological intervention had been carried out and intravenous injection of midazolam had been used before and after cesarean section for the group A, routine nursing and intravenous injection of midazolam for the group B. The mean arterial pressure (MAP), the heart rate(HR) and the blood oxygen saturation(SpO2) had been monitored and recorded. The sedative depth of midazolam had been evaluated according to the criteria of OAA/S (OAA/S),and the irritability degree of primiparas had been recorded. Results:The MAP and HR of the patients in the group A were significantly lower than those in the control group (P<0.05). There were no significant differences in the operation time and SpO2between the two groups. The depth of sedation was significantly higher in the group A than in the group B (P<0.05). There were 12 cases of restlessness in the group B and 5 cases in the group A. There were 25 cases of polylogia in the group B, repeating questions on the operation and neonatal situation, falling asleep with the appropriate comfort and sobering with minor irritation; there were 5 cases in the group A (P<0.05). Conclusion:Psychological counseling combined with sedative drug treatment can help to alleviate the anxiety of cesarean section patients and increase the efficacy of sedative drugs.Key words:cesarean section;psychological counseling;sedation treatment

55 Effects of Comprehensive Nursing on Hyperbaric Oxygen in the Treatment of Menopausal SyndromeChenXiaojing,LiuLihua,LiLingyun(DepartmentOfGynaecologyAndObstetrics,thePeople’sHospitalofJinxianCounty,Nanchang331700,China)Abstract:Objective: To investigate the effects of comprehensive nursing on hyperbaric oxygen in the treatment of menopausal syndrome. Methods: 90 cases of patients with menopausal syndrome treated in the People’s Hospital of Jinxian County from April 2015 to April 2017 had been selected and randomly divided into the research group and the control group with 45 cases each. The control group had been given conventional hormone therapy and routine nursing, the research group hyperbaric oxygen therapy and comprehensive nursing. The nursing satisfaction and the levels of E2、FSH and LH had been compared between two groups. Results: The E2 levels increased and the FSH and LH levels decreased in both the groups after treatment (P<0.05); however, the E2 levels in the research group were higher than those in the control group, the FSH and LH levels were both lower than those in the control group (P<0.05); The nursing satisfaction in the research group (97.78%) was significantly higher than that in the control group (86.67%) (P<0.05). Conclusion: Hyperbaric oxygen can effectively improve hormone levels in the patients with menopausal syndrome and the curative effects are remarkable. At the same time, scientific and rational comprehensive nursing is the key to ensure the smooth treatment.Key words: hyperbaric oxygen; menopausal syndrome; nursing

80 Evaluation of Three Plans of Intraperitoneal Injection to Set Up Adriamycin Cardiomyopathy ModelsWangQingtao,WangYujing(DepartmentofCardiology,theFirstHospitalofYangtzeUniversity,Jingzhou434000,China)Abstract: Objective:To evaluate three plans to set up DCM models by intraperitoneal injection of adriamycin. Methods: Male SD rats had been randomly divided into 4 groups, in which the model groups had been injected with different concentrations of Adriamycin, the control group with normal saline. Pathological changes of the myocardial tissue and brain natriuretic peptide(BNP) of serum sodium had been evaluated. Results:Compared with the control group, the cardiac index of the model group A increased (P<0.05) while the cardiac indexes of the model group B and C decreased (P<0.05). Compared with the model group A, the cardiac indexes in the model group B and C decreased (P<0.05); there was no significant difference between the model group B and C. Compared with the control group, BNP of the model group A increased (P> 0.05); BNP of the model group B and C increased (P<0.05); there was no statistically significant difference in BNP between the model group B and C. Compared with the control group, collagen volume fraction(CVF) of the model group A, B and C increased (P<0.05); compared with model group A, CVF of the model group B and C increased (P<0.05); there was no statistically significant difference in CVF between the model group B and C. Conclusion: The cardiomyopathy heart failure model can be set up by multiple continuous intraperitoneal injection of a certain dose of adriamycin, but it is necessary to reach the cumulative dose of adriamycin.Key words: adriamycin; dilated cardiomyopathy; modeling

84 Analysis of the Status of Health Human Resources in the County General Hospitals and Township Health Centers in 20 Impoverished Counties of Anhui ProvinceWangYuanYuan,ZhuLin,WuXiaohong,WuJun(DepartmentofPublicHealth,AnhuiMedicalCollege,Hefei230061,China)ChenXuegang,XieXiaowen(DepartmentofAccount,HealthandFamilyPlanningCommissionofAnhuiProvince,Hefei230002,China)Abstract:Objective:To investigate the health human resources status of county general hospitals and township health centers in 20 impoverished counties in Anhui province, such as the personnel structure and numbers, to provide advice for the construction of talent teams. Methods:A questionnaire survey had been adopted and the trainees had carried out the survey in the field. Results: The ratio of hospital beds to nurses was 1∶ 0.42 and the ratio of doctors to nurses was 1∶1.3 in the county general hospitals, respectively 1∶0.07 and 1∶0.53 in the township health centers.The total number of nurses was 14272 in the 20 counties whose total resident population was 1786.44 million, with 0,79 nurses in 1000Most of the medical personnel had primary professional titles or below. The medical personnel with intermediate professional titles in the hospitals and centers were respectively 28.66% and 17.35%, bachelor’s degree or above 19.38% and 4.33%. Conclusion:The construction of nursing staff in primary health institutions in those poor areas should be stressed. The proportion of primary health human resources needs to be further optimized.In addition, it is necessary to take measures to attract more highly-educated and high-level talent to those primary health-care institutions and therefore there will be enough health manpower to promote health care.Key words:county general hospital; township health center; health human resources; status

Translated & Edited by Li Zejuan(李泽娟)