Objective To observe the clinical effect of Qiye Shenan tablet combined with sumatriptan in the treatment of middle-aged and elderly patients with chronic migraine.MethodsA total of 124 elderly patients with chronic migraine treated in our hospital from July 2015 to December 2015 were selected.The patients were divided into two groups according to the principle of randomization, with 62 cases in each group.The control group was treated with sumatriptan, The observation group was treated with Qiye Shenan tablet on this basis.The curative effect of the two groups, the relevant indicators and adverse reactions were analyzed.ResultsThe effective rate was 95.16% in the observation group, which was higher than that in the control group (80.65%, P<0.05).After treatment, the VAS score and the main symptom scores of the observation group were (1.86±0.42,3.48±0.59), respectively, which were lower than those in the control group (3.19±0.50,5.06±0.64) (P<0.05).The level of nitric oxide (NO) in the observation group was (33.04±3.86)μmol/L, which was lower than that in the control group (40.92±4.28)μmol/L(P<0.05).The adverse reaction rate was 11.29% in the observation group, which was lower than that in the control group (17.74%), but there was no significant difference between the two groups.ConclusionQiye Shenan tablet can improve the therapeutic effect of chronic migraine in the elderly, reduce the pain of the patients and improve the related symptoms, and the safety of medication.

Objective To evaluate the curative and prophylactic effects of pulmonary surfactant (PS) on neonatal respiratory distress syndrome (NRDS) by two different administration means. Methods 35 neonates with NRDS were divided into groups Ⅰ and Ⅱ randomly, prophylactic group were randomly divided into groups Ⅲ and Ⅳ, the means of administration in all patients was through tracheal tube. Neonates in group Ⅰ and Ⅲ, were given curosurf in several times with different posture, group Ⅱ and IV were given in one time with supine position. Blood gas analysis, index of mechanical ventilation, the duration of mechanical ventilation, hours of oxygen requirement and hospitalization between Ⅰ and Ⅱ group, the incidence of NRDS between Ⅲ, and IV group were analyzed and compared before and after treatment. Results After treatment for 6 and 24 hours, the oxygenation and lung function of group Ⅰ and Ⅱ improved respectively (P<0.05), the total times of assisted ventilation, Supplemental oxygen therapy and hospitalization were significantly decreased, the differences of those index were no significant between Ⅰ and Ⅱ group (P0.05), the incidence of NRDS have no different between Ⅲ and IV group. Conclusion Pulmonary surfactant is effective and safe for treating and prophylacting NRDS, and have no relationship with the means of administration.

Breast cancer is one of the most common cancers in China. With increasing of the incidence and mortality, the harm to women is becoming much serious. Estrogen positive patients need to take 5-10 years′ endocrine drugs to prolong survival and prevent recurrence. Endocrine therapy has become one of the most common and effective methods in the treatment of breast cancer. In order to achieve the desired effect of cancer treatment, reduce cancer metastasis and recurrence rate, good compliance is essential. In conclusion, this review summarizes the evaluation of compliance, various evaluation tools and their use.

Objective To examine the effectiveness of self-efficacy training on fluid intake in maintenance hemodialysis patients.Methods Fifty-four hemodialysis patients participated in the study.The intervention was based on Bandura's self-efficacy theory.The outcome measure was self-efficacy for managing chronic disease,the mean interdialysis weight gain,dialysis-related complications and patient satisfaction.Data were collected at baseline and 3 months after the intervention.Results The mean score of selfefficacy,the mean interdialysis weight gain,dialysis-related complications and patient satisfaction after the intervention were all statistically significant compared with those bcfore the intervention.Conclusions The study supports the effectiveness of the self-efficacy training in improving the fluid intake compliance in maintenance hemodialysis patients.So it is worth being popularized in clinic.

Objective:To explore the effect of multi disciplinary team (MDT) combined with call-out nursing on postoperative recovery time and complications of patients with multiple injuries during perioperative period.Methods:A total of 87 patients with multiple injuries admitted to our hospital from April 2018 to April 2020 were selected as the research objects. The patients were randomly divided into the control group (43 cases) and the observation group (44 cases) using a random number table method. The control group received routine care, and the observation group used MDT mode combined with call-out nursing based on routine care. The surgical awake rate and recovery time of the two groups were compared, and the scores of Glasgow Coma Scale(GCS), Disability Rating Scale(DRS) and the incidence of postoperative complications of the two groups were analyzed.Results:A total of 36 cases (81.82%) in the observation group were awake, which was significantly more than 22 cases (51.16%) in the control group. There was a statistical difference between the two groups ( χ2 value was 9.197, P<0.05). The recovery time of the observation group was (15.52±8.48) days, shorter than (27.13±10.35) days of the control group with significant difference ( t value was 5.729, P<0.01). Seven cases (15.91%) of complications occurred in the observation group after nursing, which was significantly less than 15 cases (34.88%) of the control group. There was a statistical difference between the two groups ( χ2 value was 4.144, P<0.05). After 1, 3, and 6 months of intervention, the GCS and DRS scores of the two groups of patients were lower than the previous point in time, and the observation group was lower than those of the control group, the difference was statistically significant ( t value was 2.003-11.039, P<0.05). Conclusions:The use of MDT combined with call-out nursing for patients with multiple injuries during the perioperative period can increase the postoperative wakefulness rate, reduce the patients' wakefulness time and the probability of complications, and also effectively reduce the patient's coma during nursing and improve their physiological state. It is worthwhile being promoted in related nursing work.

Objective:To analyze the application of path quality inspection combined with "zero defect" service management in nursing quality management of orthopedic ward.Methods:From January 2018 to December 2019,196 patients admitted to the Department of Orthopaedics of Panzhihua Central Hospital, Sichuan Province. Ninety-eight patients from January to December 2018 were as control group, 98 patients from January to September 2019 were as observation group. The control group adopted the routine nursing management mode, while the observation group adopted the path type quality inspection combined with the "zero defect" service management mode. The differences in the incidence of nursing adverse events, quality of life scores and nursing satisfaction were compared between the two groups.Results:The incidence of nursing adverse events during hospitalization in observation group and control group was 6.12% (6/98) and 15.31% (15/98), the difference was statistically significant ( χ 2 value was 4.320, P<0.05). Mental score, sleep score, diet score, mental health score, total score were (94.38±8.36), (93.28±8.33), (95.37±8.43), (91.89±10.48), (377.12±20.08) points in observation group, significantly higher than (85.65±10.74), (81.01±9.48), (87.69±7.97), (85.47±12.02), (331.09±13.39) points in the control group, the difference between the two groups was statistically significant ( t value was 3.118-18.880, P<0.01). The nursing satisfaction of observation group and control group was 92.86% (91/98), 82.65% (81/98), the difference was statistically significant ( χ 2 value was 4.749, P<0.05). Conclusion:The application of path quality inspection combined with "zero defect" service management in the nursing quality management of orthopedic ward is conducive to reducing the incidence of nursing adverse events, improving the quality of life of patients after surgery, and improving patients' satisfaction with nursing services.

This paper is based on the theory of"internal diseases will be presented externally"in Traditional Chinese Medicine, combined with the idea of syndrome differentiation and grasping the main symptoms, and proposes the concept of"virtual special disease". It is extracted from ancient books and expert experience, and it is believed that it is widespread and can be tested by clinical practice. The application of virtual syndrome to diagnosis can achieve the purpose of simplifying the complexity TCM syndrome differentiation. On the one hand, it provides a new exploration for enriching the TCM syndrome differentiation system; on the other hand, it provides new ideas for supplementing the biological research of syndromes and developing the diagnosis of integrated traditional Chinese and Western medicine.

Objective: To observe the changes of Notch signaling pathway related molecule expression in hippocampus of rats with stagnation of liver qi and spleen deficiency syndrome and to explore the regulatory effect of Xiaoyaosan. Methods: Male SD rats were randomly divided into four groups: normal group, model group, model+xiayaosan group and model+fluoxetine group, each group had 12 rats. The stagnation of liver qi and spleen deficiency model was established by chronic immobilization stress for 21 days. Detection of Nissl bodies by Nissl staining, expression of NICD, Hes1, Hes5 and Jad1 were detected by Fluorescent quantitative PCR and Western-blot method. Results: Compared with the normal group, the number of Nissl bodies in the model group decreased significantly (P ＜ 0.01), which showed that Xiaoyaosan and fluoxetine could reverse it (P ＜ 0.01). The expression of Notch signaling pathway-related protein in model group was significantly lower than that in normal group (P ＜ 0.01), which showed that Xiaoyaosan and fluoxetine could reverse the expression of NICD, Hes5 and Jag1 protein (P ＜ 0.05, P ＜ 0.01). Compared with the normal group, the expression of each gene in the model group decreased (P ＜ 0.01), which showed that Xiaoyaosan and fluoxetine could reverse the expression of NICD, Hes1 and Hes5 mRNA (P ＜ 0.05, P ＜ 0.01). Conclusion: The hippocampal neurons of rats with stagnation of liver qi and spleen deficiency syndrome were damaged and the Nissl bodies were reduced, the expression of each protein and gene in Notch signaling pathway decreased. Xiaoyaosan may play a therapeutic role by regulating the expression level of hippocampal related molecules to protect neurons.

Objective To discuss the safety and the application of the self-designed multifunctional inflatable pelvis and hip-joint fixator (MIPHF) in damage control in pelvic fracture patients.Methods The MIPHF was subjected to pressure test and quality inspection.From September 2016 to June 2017,61 pelvic-fracture patients were treated with our self-designed MIPHF as pre-hospital first-aid care according to the concept of damage control orthopedics (DCO) (MIPHF group).The control group consisted of 69 pelvic-fracture patients who had not received pre-hospital first-aid care with the self-designed MIPHF from December 2015 to August 2016.There were no statistically significant differences between the two groups in gender,age,types of pelvic fracture,and preoperative injure severity score (ISS).The study compared the two groups for the case fatality rate,volume of blood transfused during surgeries,early complication rates,fracture reduction (Matta standards),and long-term efficacy (Cole scores).Results The pressure test showed that the MIPHF had a good fixation effect on the pelvis.And the quality inspection showed that the material used for the MIPHF was in line with national standards and the safety was guaranteed.The MIPHF group had 1 death (1.6％) and the control group had 8 deaths (11.6％),which was a significant difference (x2=4.979,P=0.026).All survival patients in both groups were followed up.The MIPHF group (61 cases) received 3.0 to 18.0 months follow-up,with an average of 9.0 months.And the control group (69 cases) had 18.0 to 30.0 months follow-up,with an average of 21.9 months.In the MIPHF group,23 cases were treated conservatively,and 37 cases were treated with surgery.Among them,3 cases were fixed with external fixator,20 cases with anterior open reduction and internal fixation,9 cases with posterior open reduction and internal fixation,and 5 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 20 days after injury,with an average of 4.1 days.The volume of blood transfused in the MIPHF group during surgery was 200 to 1500 ml,with an average of 628.6 ml.In the control group,27 patients were treated conservatively,and 42 patients were treated with surgery.Among them,2 cases were fixed with external fixator,24 cases with anterior open reduction and internal fixation,10 cases with posterior open reduction and internal fixation,and 6 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 15 days after injury,with an average of 3.l days.The volume of blood transfused in the control group during surgery was 200 to 4000 ml,with an average of 1 707.1 ml.There was a significant difference between the two groups in intraoperative blood transfusion(Z=-2.330,P=0.020).The MIPHF group had 10 (16.4％) cases of early serious complications and the control group had 22 (31.9％) cases,which had a significant difference (x2=4.187,P=0.041).According to the criteria proposed by Matta et al.,the good rate of results for treating fractures was 82.0％ in the MIPHF group and 60.9％ in the control group,which got a significant difference (x2=6.967,P=0.008).The MIPHF group and the control group also differed significantly in their mean long-term Cole scores (27.2±4.0 versus 25.1 ±5.6,t=2.457,P=0.015).Conclusion MIPHF,which reflects the DCO concept,may be recommended as pre-hospital first-aid care for patients with pelvic fracture because it can lessen bleeding and prevent secondary pelvic injury,thus reduce case fatality rate and the incidence of complications.It can also improve the success rate of treating pelvic fracture,which will positively affect long-term outcomes.

OBJECTIVETo evaluate the clinical value of multicolor melting curve analysis(MMCA) for detecting genetic mutations in G6PD deficiency.

METHODSA total of 402 peripheral blood samples(256 males and 146 females) were collected from suspected patients or their relatives at the Prenatal Diagnosis Center of Liuzhou Maternal and Child Health Hospital between March 2012 and May 2012. The samples were screened by G6PD/6PGD quantitative ratio testing. The reliability of the assay was evaluated by multiplex probe melting curve assay(which can detect 16 G6PD mutations) and DNA sequencing through a double blind study.

RESULTSOne hundred seventy cases with G6PD/6PGD ratio < 1.0 and 232 cases with G6PD/6PGD ratio ≥ 1.0 were detected by the enzymological method. DNA sequencing has identified 182 wild type samples, 151 hemizygous mutation samples, 5 female homozygous mutation samples, 54 female heterozygous mutation samples and 10 female double heterozygous mutation samples. Multicolor melting curve analysis has detected 185 wild type samples, 148 hemizygous mutation samples, 5 female homozygous mutation samples, 55 female heterozygous mutation samples and 9 female double heterozygous mutation samples. The specificity and sensitivity of G6PD gene mutation detection by multicolor melting curve analysis were 100%(182/182) and 98.6%(217/220), respectively. The positive predictive value and negative predictive value were 99.5%(216/217) and 98.4%(182/185), respectively, and the Youden's index was 0.986. The concordance rate of the sample detection between the melting curve assay and DNA sequencing was 99.0%(398/402). Twenty-one different genotypes were detected by the multicolor melting curve analysis and 24 different genotypes were detected by DNA sequencing. Four samples containing mutations(c.196T>A or c.406C>T) were not detected by multicolor melting curve analysis, which can be attributed to different technical settings of the two methods.

CONCLUSIONMulticolor melting curve analysis for G6PD gene mutation detection is a simple, rapid, sensitive and specific method, which can be used for clinical diagnosis of G6PD deficiency.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Glucosephosphate Dehydrogenase ; genetics ; Humans ; Infant ; Infant, Newborn ; Male ; Mutation ; Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA