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Impact of transitional empowerment education on quality of life of patients with inflammatory bowel dis-ease

The Journal of Practical Medicine.2017;33(15):2593-2597. doi:10.3969/j.issn.1006-5725.2017.15.044

Objective To assess the effect of transitional empowerment education on the quality of life of patients with inflammatory bowel disease (IBD) and to analyze the factors affecting the quality of life, so as to pro-vide clinicians with information on effective intervention strategy. Methods From January 2015 to June 2016, 155 IBD patients were randomly divided into traditional care group (n=78) and transitional empowerment educa-tion group (n=77). The patients in the traditional care group received clinic outpatient follow-up, and the patients in the transitional empowerment education group received follow-up led by IBD management team. IBD patients in the two groups were investigated with self-management ability questionnaire, self-efficacy scale, and quality of life questionnaire before discharge and the six month after intervention. Results After the sixth month, the total scores on self-management ability (t=7.219, P=0.000), self-efficacy (t=2.845, P=0.005) and quality of life (t=7.705, P=0.000) in the transitional empowerment education group were higher than those of the traditional care group. Conclusion The transitional empowerment education can improve self-management ability, self-efficacy, quality of life of IBD patients.

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Loss of expression of succinate dehydrogenase subunit A and B in renal cell carcinoma

Weijie LUO ; Yuanhua CHENG ; Hui LIU

The Journal of Practical Medicine.2017;33(15):2545-2549. doi:10.3969/j.issn.1006-5725.2017.15.032

Objective To investigate the expression of succinate dehydrogenase subunit A(SDHA)and subunit B (SDHB) in patients with renal cell carcinoma (RCC),and its relationship with the clinicopathologic characteristics. Methods The expression of SDHA and SDHB was detected in 179 cases of RCC by immunohisto-chemistry and the relationship between the SDHA ,SDHB expression and the clinicopathologic characteristics of RCC were analyzed. Results In 179 cases of RCC,18 cases(10.1%)were shown with negative or suspicious-negative expression of SDHA and SDHB,including 2 cases(1.1%)with suspicious-negative expression of SDHA and SDHB. 12 cases(66.7%)had tumor located in left kidney and 6 cases(33.3%)had tumor located in right kidney. The well-differentiation group contained 15 cases(83.3%),moderate-differentiation group contained 1 case (5.6%)and poor-differentiation group contained 2 cases(11.1%). Most of SDH negative and suspicious negative RCC had the following characteristics that the normal renal tubule could be seen within the tumor. The tumor was composed of polygonal cells arranged in nest ,and the polygonal cells were separated by a fine fibrovascular stroma. The nuclei were shown around with vesicular chromatin. The eosinophilic flocculet material ,vacuole and eosino-philic inclusion body could be seen in the cytoplasm of tumor cells. Conclusion The RCC cases with negative expression of SDHA and SDHB protein have unique histological features ,with significantly higher incidence in the left kidney than that in the right kidney.

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The comparison of intermittent epidural bolus and continuous epidural infusion mode on labor analgesia

Xue LI ; Jing XU ; Yuan QU

The Journal of Practical Medicine.2017;33(15):2542-2545. doi:10.3969/j.issn.1006-5725.2017.15.031

Objective To compare the difference between intermittent epidural bolus(IEB) combined with patient controlled epidural analgesia(PCEA)and continuous epidural infusion(CEI)combined with PCEA mode in labor analgesia. Methods It was a retrospective cohort study ,which subjects were assigned to CEI+PCEA and IEB + PCEA group. Correlated data were collected to compare the effect of the two analgesic mode on perinatal events. Results There were less consumption of ropivacaine and sufentanil per hour ,less PCEA request and actual bolus in IEB + PCEA group. There were no significant difference between the delivery mode and the percentage of low Apgar score in neonates. Conclusion IEB+PCEA mode has better analgesic effect ,meanwhile doesn't disturb the delivery mode has no effect on the neonate outcome.

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The clinical application and learning curve of endoscopic thyroidectomy via chest-areolar approach

Kaifu LI ; Hua KANG ; Yajun WANG ; Tao HAI

The Journal of Practical Medicine.2017;33(15):2514-2516. doi:10.3969/j.issn.1006-5725.2017.15.023

Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.

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Treatment analysisin early postoperative inflammatory small bowel obstruction after abdominal surgery

Lu LU ; Wu TANG ; Wei LAI ; Yujie ZENG ; Zhonghua CHU

The Journal of Practical Medicine.2017;33(15):2511-2513. doi:10.3969/j.issn.1006-5725.2017.15.022

Objective To discusses the clinical features of early inflammatory bowel obstruction (EPIS-BO) after abdominal surgery,and analyze diagnosis and treatment. Methods The clinical data of 48 patients with early inflammatory bowel obstruction after abdominal surgery were analyzed retrospectively from July 2005 to July 2015. Results 45 patients were recovered after non-operative treatment including gastrointestinal decompression , total parenteral nutrition (TPN),antibiotics,glucocorticoid and somatostatin. The average time of treatment was 17.45 days. The other 3 patients underwent laparotomy respectively on 16,19 and 20 days after conservative treat-ment.Two cases were turned to intestinal fistula after operation ,and one of them died after reoperation because of severe abdominal infection 9 days later. Conclusion Conservative treatment should be regarded as the first choice for EPISBO in clinical practice due to less complications and better effect than operative treatment.

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Expression of microRNA-218 in breast cancer and its clinical significance

Bo LIU ; Like ZHANG ; Zengren ZHAO ; Yanfeng TIAN ; Fang LI ; Xiaodong HAN

The Journal of Practical Medicine.2017;33(15):2508-2511. doi:10.3969/j.issn.1006-5725.2017.15.021

Objective To investigate the expression of miR-218 (microRNA-218) in breast cancer tissues and its clinical significance. Methods Totally 45 tissue biopsies gained from breast cancer patients and the adjacent normal tissue were collected. Real-time qPCR was used to detect the miR-218 expressions. The correlations of miR-218 expression with clinicopathological characteristics and prognosis of breast cancer patients were analyzed. Results The average expression level of miR-218 in breast cancer tissues was significantly lower than that in control tissues (P = 0.001). The average expression level of miR-218 in PR negative breast cancer tissues was significantly lower than that of PR positive breast cancer tissue (P = 0.037). The average expression level of miR-218 in Ki-67 positive breast cancer tissues was significantly lower than that in Ki-67 negative breast cancer tissue (P=0.018). Conclusion The expression of miR-218 is closely related to carcinogenesis ,progres-sion and prognosis of breast cancer ,so it may be served as a diagnostic biomarker and a prognostic predictor in breast cancer patients,which provides a new way for the treatment of breast cancer.

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Inhibitory effects of high mobility group chromosomal protein N2 on growth ofbladder cancer T24 cells and ectopic tumor growth of nude mice

Guixia WU ; Jinqiao YUE ; Jing LI ; Junhong LI ; Gale MENKE ; Dongyu LEI ; Ping JIANG

The Journal of Practical Medicine.2017;33(15):2474-2477. doi:10.3969/j.issn.1006-5725.2017.15.012

Objective To investigate the inhibitory effects of high mobility group chromosomal protein N2 (HMGN2)on growth of human bladder cancer T24 cells and ectopic tumor growth of nude mice. Methods MTT and flow cytometry assay were conducted to detect cell growth of bladder epithelial cells(T24)cells in vitro. The transplantation tumor models in nude mice were constructed by injecting T24 cells in vivo. The para-tumorswere injected with PBS,HMGN2 protein and cisdichlorodiamineplatinum(DDP),respectively. Tumor volume and weight were calculated. The expression of cell proliferation-related proteins was detected by Western blot assay. Results MTT assay proved that HMGN2 could significantly inhibit the growth of T24 cells. Flow cytometry assay verified that HMGN2 could block T24 cells in S stage of the cell cycle. The average tumor volume and weight in the HMGN2 group and DDP positive control group were smaller than those in the PBS group(P<0.05,respectively), with the tumor inhibitory rate of 25% and 23%,respectively. The results of Westernblot showed that HMGN2 could decrease Bcl-2 expression and increase Bax expression in tumor. Conclusion HMGN2 has a significant antitumor effect on T24 cells and bladder carcinoma in nude mice,which may be associated with the induction of the apoptosis of carcinoma cells and the regulation of the cell cycle.

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The effect analysis of nuclear factor related factor 2 gene polymorphism and the correlation between COPD and tiotropium bromide powder combined with budesonide inhalation

Xiaoguo ZHOU

The Journal of Practical Medicine.2017;33(15):2448-2452. doi:10.3969/j.issn.1006-5725.2017.15.006

Objective To investigate the correlation between nuclear factor-associated factor 2 gene polymorphism and COPD and the effect of tiotropium bromide combined with budesonide/formoterol inhalation. Methods Seventy-nine patients with chronic obstructive pulmonary disease and 54 healthy subjects were enrolled to determine the NRF2-617C/A(rs6721961)polymorphism by PCR-RFLP and to analyze the relationship between different genotypes and COPD ,and then to observe the therapeutic effect of different genotypes. Results The frequency of A allele in NRF2-617C/A(rs6721961)was a risk factor for COPD(OR=2.312,95%CI:1.517 to 6.824,P<0.05). The total effective rate of AA was lower than that of CC and CA(χ2=8.65,7.24,P<0.05). After treatment,FEV1% pred,FEV1/FVC in the AA type were significantly lower in the CC type(t=6.48,5.62, P<0.05),while IL-8,TNF-αand hs-CRP were significantly higher than those in the CC type(t=6.07,9.21, 4.79,P<0.05). Conclusion NRF2-617C/A(rs6721961)gene polymorphism has a certain correlation with COPD,on which it has a significant effect to tiotropium combined with budesonide treatment and has a moderating effect on inflammatory response and pulmonary function in COPD patients.

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The short-term efficacy of inhaled steroids combined with long-acting beta2-agonists for asthma-COPD overlap syndrome

Yuanyuan LIU ; Tuerxun KELIBIENA ; Wen AN

The Journal of Practical Medicine.2017;33(15):2439-2442. doi:10.3969/j.issn.1006-5725.2017.15.004

Objective To evaluate the short-term efficacy of inhaled corticosteroids(ICS)combined with long-acting beta2-agonists(LABA)for asthma-COPD overlap syndrome(ACOS). Methods The patients with stable COPD or ACOS who had been treated during the period of March 2012 to March 2015 were selected and divided into COPD group(88 patients)and ACOS group(36 patients). Pulmonary function,chest X-ray,and blood eosinophil count were detected;and mMRC scale was measured. Both groups received ICS combined with for 3 months. ACOS was defined as the patients had a self-reported survey and positive responses on bronchodilator. Results After a 3-month treatment with ICS and LABA ,an increase in forced expiratory volume in 1 second (FEV1)was significantly greater in ACOS patients than in those with COPD alone(250 ± 42.9 and 63.1 ± 25.3, P=0.003). According to the severity of baseline FEV1,the ACOS group showed a significant difference in patients with severe to very severe airflow limitation. Conclusions Inhaled steroids combined with long-acting beta2-agonists is more efficacious in the treatment of ACOS than COPD. Lung function improves more evidently in ACOS patients with mild-to-moderate airflow limitation after treatment.

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Feasibility of body surface electrodes instead of multipair esophageal electrodes for assessment of neural re-spiratory drive in COPD patients

Yinhuan LI ; Xin CHEN ; Rui XIAO ; Jinlun HUANG ; Rongchang ZHI ; Zeguang ZHENG

The Journal of Practical Medicine.2017;33(15):2435-2438. doi:10.3969/j.issn.1006-5725.2017.15.003

Objective To analyze the feasibility of body surface electrodes instead of multipair esophageal electrodes for the evaluation of neural respiratory drive in patients with COPD. Methods Diaphragm electromyo-gram(EMG)from body surface electrodes and multipair esophageal electrodes,was recorded in 29 patients with stable COPD recruited from outpatient clinic. Changes of neural respiratory drive of two kinds of electrodes during resting and maximal isocapnic ventilation (MIV) were observed before and after inhalation of bronchodilators. Results Ventilation significantly improved ,RMS-sur and RMS-eso significantly decreased after the inhalation of bronchodilators during resting and MIV. RMS-sur and RMS-eso were significantly correlated(r=0.660,P<0.01). Conclusion EMG from the surface electrodes may be a useful and noninvasive technique to evaluate neural respi-ratory drive in patients with COPD.

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