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2019 Vol. 49, No. 2 Published: 2019-02-25   79 The role of microparticles in inhibiting hypoxia and serum deprivation induced apoptosis of bone marrow mesenchymal stem cells JIN Peifeng1, JIANG Sheng, WENG Jiakan, WANG Lei, Ding Lu, ZHAO Kaixiang, SUN Chengchao DOI: 10.3969/j.issn.2095-9400.2019.02.001 Objective: To investigate the effects of myocardial infarction plasma-derived microparticles (MPs) on the hypoxia and serum deprivation induced apoptosis of bone marrow mesenchymal stem cells (BMSCs). Methods: Myocardial infarction (MI) was created by left anterior descending artery ligation in Lewis rats. The plasma-derived MPs were isolated 24 hours later from the blood. In order to study the protective effects of MPs on BMSCs under the conditions of hypoxia and serum deprivation (hypoxia/SD). BMSCs were pretreated with different concentrations (0.5 μg/mL, 1 μg/mL, and 2 μg/mL) of MPs before the apoptosis was induced. Cell apoptosis was evaluated by using flow cytometry of Annexin V/PI staining, Hoechst staining and the Tunel assay. Expression of cleavage of caspase-3 were assessed by Western blotting. The Akt pathway inhibitor AZD5363 was used to reveal the mechanism of MPs inhibiting BMSCs apoptosis. Results: The MPs derived from the myocardial infarction rats could remarkably prevent BMSCs from Hypoxia/SD induced apoptosis through activating Akt signaling pathway, and its anti-apoptosis effect showed a concentration dependence (0.5-2 μg/mL) (P<0.01). Conclusion: MPs derived from myocardial infarction could effectively inhibit hypoxia/SD induced apoptosis of BMSCs. 2019 Vol. 49 (2): 79-84 [Abstract] ( 898 ) HTML (1 KB)  PDF (1532 KB)  ( 1260 ) 85 The biological effects of kidney injury molecule-1 in lipopolysaccharide mediated HK-2 cell inflammatory response JIANG Yingying, CHEN Longwang, LIN Yue, CHEN Xinguo, ZHEGN Yanyan, LU Zhongqiu DOI: 10.3969/j.issn.2095-9400.2019.02.002 Objective: To investigate the expression of kidney injury molecule-1 (KIM-1) in lipopolysaccharide (LPS)-induced HK-2 cells and explore the biological process it maybe involved. Methods: Human renal tubular epithelial HK-2 cells were treated with LPS to establish the sepsis-induced renal cell inflammatory model. CCK-8 assay was used to detect the growth inhibition effect of LPS on HK-2 cells. The mRNA and protein expression levels of KIM-1 were detected by RT-PCR and Western blot respectively. The siRNA sequences targeted on KIM-1 gene were designed and tranfected to HK-2 cells, and then the effects of LPS on the growth inhibition of transfected HK-2 cells were detected by CCK-8 assays. Hoechst33342/PI staining was performed to detect the apoptosis in siRNA and control groups. Results: The proliferation of HK-2 cells was inhibited after treatment with LPS at final concentration of 50 μg/mL and 100 μg/mL for 24 h and 48 h, and the differences were statistically significant compared with the control group (P<0.05). The mRNA and protein levels of KIM-1 and IL-6 gene were greatly up-regulated after treatment with LPS in a dose-dependent manner, the differences being statistically significant (P<0.05). The proportion of Hoechst3342 positive cells in LPS treatment group was significantly higher than that in control group. The expression levels of KIM-1 and IL-6 genes in siRNA groups were significantly lower than that in siRNA-NC group, with significant differences (P<0.05); The proliferation rate was significantly higher in siRNA transfection group, compared with the siRNA-NC group, and the differences were statistically significant (P<0.05). The fluorescence intensity of Hoechst3342 staining in siRNA transfection groups was lower than that in siRNA-NC group, suggesting that siRNA transfection targeting on KIM-1 gene could inhibit the apoptosis induced by LPS. Conclusion: LPS can induce the proliferation inhibition and apoptosis of HK-2 cells, and up-regulate the expression of KIM-1 and IL-6 genes. KIM-1 may participate in the inflammatory reaction by regulating the process of apoptosis and cell growth inhibition. 2019 Vol. 49 (2): 85-90 [Abstract] ( 1332 ) HTML (1 KB)  PDF (1595 KB)  ( 1522 ) 91 Risk factors of methicillin-resistant staphylococcus aureus nasal colonization among infants in pediatric respiratory department HANG Shuanghong, JIA Xiaohui, WU Yujie, LYU Junying, ZHANG Liping DOI: 10.3969/j.issn.2095-9400.2019.02.003 Objective: To investigate risk factors of methicillin-resistant staphylococcus aureus (MRSA) nasal colonization in pediatric respiratory department, and to provide reference for clinical intervention. Methods: The cross-sectional study started from April 2017 to March 2018 in pediatric respiratory department of the Second Affiliated Hospital of Wenzhou Medical University. Newly admitted patients were screened daily for their eligibility. For enrolled patients, specimens from nasal vestibule were taken and cultured. The nasal colonization of MRSA and its risk factors were analyzed. Results: A total of 759 infantswere successfully collected specimens. Finally, 492 infants met the entrollment criteria and 46 were found with colonization MRSA (6.1%). Univariate analysis results indicated that MRSA nasal colonization was associated with months of age, delivery mode, history of hospitalization of the family members over the past year and whether any of family members is healthcare provider (P<0.05). Multi-variant logistic regression analysis indicated that over six months of age (OR=0.164, 95%CI: 0.049-0.545) was protective factor, and one of the family members is healthcare provider (OR=9.428, 95%CI: 2.635-33.731), length of hospitalization stay (OR=1.099, 95%CI: 1.008-1.197) were independent risk factors of MRSA nasal colonization. Conclusion: There is a high morbidity of MRSA nasal colonization in patients less than six month of age. The risk factor of colonization is healthcare provider in the family. MRSA nasalcolonization will increase the length of hospitalization stay. 2019 Vol. 49 (2): 91-95 [Abstract] ( 832 ) HTML (1 KB)  PDF (1265 KB)  ( 886 ) 96 The effect of CD56 positive on prognosis of patients with acute promyelocytic leukemia CHEN Yuemiao, YU Kang, ZHENG Cuiping, ZHOU Wenjin, LIU Zhen DOI: 10.3969/j.issn.2095-9400.2019.02.004 Objective: To investigate the expression of CD56 antigen in de-novo acute promyelocytic leukemia (APL) and to analyze the immuno-features and surviva1 of patients with positive CD56 expression.Methods: The expression of CD56 in bone marrow was detected by flow cytometry. Patients of de-novo acute promyelocytic leukemia who visited Wenzhou Central Hospital from May 2007 to October 2012 were followed up and their clinical data were analyzed. Immuno-features and prognosis were compared between patients expressing and nonexpressing CD56. Results: Of 64 patients, 12 (18.75%) were positive for CD56. There were no statistical differences in terms of CD9, CD11b, CD15, CD19, CD117, HLA-DR surface antigen markers between CD56+ and CD56- groups (P>0.05). Expressions of CD56 were significantly associated with coexpression of CD2 and CD34 (25.00% vs. 3.85%, P=0.042; 41.67% vs. 3.85%, P=0.001). The complete remission, relapse rate, 3-year median overall survival (OS) period and 3-year overall survival rate showed no significant differences between CD56+ and CD56- groups (P>0.05), while extramedullary relapse rate (27.27% vs. 4.55%, P<0.05), 3-year disease free-survival (DFS) rate (54.55% vs. 86.36%, P<0.05) indicated significant differences. Conclusion: The expression of CD56 appeared to be one of adverse prognostic factors in de-novo APL. 2019 Vol. 49 (2): 96-99 [Abstract] ( 1056 ) HTML (1 KB)  PDF (1256 KB)  ( 1033 ) 100 Effects of β-Ecdysterone on serum biochemical indexes of bone metabolism and bone mineral density in rats with glucocorticoid osteoporosis TANG Yanghua, XIN Dawei, LI Guosong, YUE Zhenshuang, ZENG Linru DOI: 10.3969/j.issn.2095-9400.2019.02.005 Objective: To observe the effects of β-Ecdysterone (β-Ecd) on serum biochemical indexes and bone mineral density (BMD) in rats with glucocorticoid-induced osteoporosis. Methods: A total of 30 male Wistar rats were randomly divided into five groups: control group, prednisolone (Pred) group, Pred+β-Ecd (5 mg/kg) group, Pred+β-Ecd (10 mg/kg) group and Pred+alendronate (ALN) group (3 mg/kg) with 6 rats in each group. The concentration of calcium and phosphorus, the activities of antitartrate phosphatase (TRAP) and alkaline phosphatase (ALP) in serum of rats in each group were determined by automatic biochemistry analyzer. An analysis of bone structure and BMD of the fifth lumber vertebra of rats in each group was made by Micro-CT. Results: Compared with the control group, the serum calcium and phosphorus levels in Pred group significantly increased and the serum ALP activity and TRAP activity increased. Compared with Pred group, Pred+ALN group and Pred+β-Ecd (10 mg/kg) group had lower serum calcium and phosphorus levels, lower serum ALP activity and lower TRAP activity. In Pred+β-Ecd (5 mg/kg) group, the activity of ALP and the level of TRAP decreased, but the levels of calcium and phosphorus were not significantly affected. Bone structure and BMD Micro-CT results showed that different degree of bone loss was observed in all Pred treated rats. In the Pred group, the BMD value of the fifth lumbar vertebra was significantly lower than that of the control group. Micro-CT evaluation showed that the ratio of bone surface area to tissue volume (BS/TV) in Pred group was lower than that in control group. Three-dimensional model analysis showed that the number of trabecular bone (Tb.N) and bone volume fraction (BV/TV) in prednisolone group were significantly lower than those in control group. The trabecular separation degree (Tb.Sp) was significantly increased in prednisolone group. However, there was no significant difference in bone trabecular thickness (Tb.Th) and structural model index (SMI). Compared with Pred group, BMD, BS/TV, BV/TV and Tb.N levels in Pred+ALN group and Pred+β-Ecd (10 mg/kg) group significantly increased, but Tb.Sp and SMI levels decreased. Compared with Pred group, the levels of BMD, BS/TV, BV/TV and Tb.N in Pred+β-Ecd (5 mg/kg) group were significantly higher, but Tb.Th and Tb.Sp levels were lower. Conclusion: β-Ecd may be applied to the treatment of glucocorticoid osteoporosis by prohibiting bone loss and improving bone metabolism. 2019 Vol. 49 (2): 100-103 [Abstract] ( 842 ) HTML (1 KB)  PDF (1297 KB)  ( 752 ) 104 Establishment of modified microcolumn gel method for detection of ABO variant blood type ZHU Suiyong, JIN Fangsi, SHI Shunqiu, QIU Xiaole, ZHENG Tingting DOI: 10.3969/j.issn.2095-9400.2019.02.006 Objective: To establish a modified microcolumn gel method for the detection of ABO variant blood type. Methods: From November 2016 to May 2018, 12 patients with ABO blood group agglutination intensity change or inconsistent positive and negative stereotypes were selected from the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou People’s Hospital and Rui’an People’s Hospital. The ABO blood type of the specimens was confirmed by blood type serogy test and blood type gene test combined with clinical manifestations. The known blood group specimens were detected by microcolumn gel method. A modified microcolumn gel method was established by using 1% O, A3 subtype and A antigen weakened erythrocytes to adjust the way of centrifugation of microcolumn gel method, which was used to detect all the samples. Results: Of the 12 cases, there was 1 case of A3 subtype, 3 cases of B(A) type, 3 cases of Mumbai type and 5 cases of ABO blood group antigen with weak expression. The sensitivity of microcolumn gel method was similar to that of saline tube test. Only 2 of 12 specimens were detected, with the detection rate being 2/12. The centrifugation method of the modified microcolumn gel method was 900 r/min centrifugation 2 min, 30 min incubated at 4 °C and 1 800 r/min centrifugation 3 min. Only 1 case of the 12 specimens could not be detected by the modified microcolumn gel method, the detection rate being 11/12. Conclusion: The modified microcolumn gel method established in this study improves the detection sensitivity by changing the centrifuge mode and increased incubation time and incubation temperature of the microcolumn gel blood type card. It is suitable for screening ABO variant blood groups. 2019 Vol. 49 (2): 104-107 [Abstract] ( 866 ) HTML (1 KB)  PDF (1221 KB)  ( 1170 ) 108 Intraocular lens power calculation by ray-tracing using sirius internal software Wei Liqing, Nie Li, Chen Yu, Qian Zhenbin, Liu Guifang, Fu Yinghui DOI: 10.3969/j.issn.2095-9400.2019.02.007 Objective: To detect the factors that influence postoperative refractive error by ray-tracing using sirius internal software in comparison with IOL-Master method and to explore the scope of the application. Methods: Sixty-four patients (80 eyes) with cataract who underwent phacoemulsification and intraocular lens (IOL) implantation in the Eye Hospital of Wenzhou Medical University from July 2016 to August 2018 were included. Axial length (AL), corneal refractive power (K) and preoperative anterior chamber depth (ACD) were measured by IOL-Master preoperatively. At the same time, the eyes were checked by sirius and the anterior chamber angle was obtained. The SRK/T, Haigis and Hoffer Q formulas were used in patients with short AL (<22 mm). The SRK/T and Haigis formulas were used in patients with normal AL between 22 mm to 26 mm and long AL (≥26 mm). The IOL calculation of all eyes was carried out by ray-tracing using sirius internal software simultaneously. Monofocal foldable IOLs were then implanted during surgery. Refractions were measured with a phoropter three months postoperatively. Refractive errors and absolute errors (AE) of the four calculation approaches were calculated based on the results of postoperative and predictive refraction. Results: Refractive errors of ray-tracing were different from SRK/T, Haigis and Hoffer Q formulas only in short AL group and long AL group (P<0.05), and AEs were different from IOL calculation formulas in all groups (P<0.05). Significant statistics difference of the refractive error of ray-tracing in multiple comparison with IOL-Master formulas was found in each AL groups (P<0.01). AE by ray-tracing was statistically different between normal AL group and long AL group, between short AL group and long AL group. Refractive error of ray-tracing was positively correlated with AL (r=0.68, P<0.01), ACD (r=0.44, P<0.01) and anterior chamber angle (r=0.34, P<0.01), but negatively correlated with K (r=-0.38, P<0.01). Conclusion: Compared with IOL-Master method, postoperative refractive error exhibits a more obvious myopic shift for eyes with a short AL while a more obvious hyperopic shift for eyes with a long AL by ray-tracing using sirius internal software. A more accurate prediction of postoperative refractive error is considered in IOL calculation formulas, especially in eyes with abnormal ALs. As AL is increased, the acd, the K is decreased the angle of anterior chamber widens and hyperopic shift increases (myopic shift decreases). 2019 Vol. 49 (2): 108-112，116 [Abstract] ( 829 ) HTML (1 KB)  PDF (1361 KB)  ( 1210 ) 113 Measurement and analysis of Betatrophin level in cord blood of macrosomia ZHENG Junhu, PAN Yicong, KE Rushu, CHEN Hong, HU Xiaona, WANG Dahua DOI: 10.3969/j.issn.2095-9400.2019.02.008 Objective: To investigate the 1evel of cord serum Betatrophin and its clinical significance in macrosomia. Methods: A cross-sectional study was conducted. Totally 30 macrosomias and 30 normal birth weight (NBW) infants were enrolled in the study. Puerpera and cord serum Betatrophin was determined.The correlation between cord serum Betatrophin and indexes of macrosomia development, lipid metabolic parameters and serum adiponectin were analyzed. Results: The serum Betatrophin in cord blood of macrosomia (1 088.338±67.749 ng/L) was significantly higher than that of in NBW (929.487±80.949 ng/L) (t=8.242, P<0.001). The blood fat showed no statistical difference between the two groups (P>0.05). According to Pearson correlation analysis, the serum Betatrophin level in cord blood had positive correlations with birth weight, lengh, ponderal index (PI) of neonates and triglyceride (TG) in cord blood (r=0.894, 0.632, 0.860, 0.767, P<0.001). There was negative correlation between serum betatrophin and adiponectin level in cord blood (r=-0.398, P<0.05). The serum Betatrophha level in cord blood was not correlated with Betatrophin in maternal blood, body mass before pregnancy and delivery, pre-pregnancy BMI or BMI increase during pregnancy (P>0.05). Conclusion: Alteration in serum Betatrophin is correlated with macrosomia. The Betatrophin level can reflect the status of feta1 development. 2019 Vol. 49 (2): 113-116 [Abstract] ( 802 ) HTML (1 KB)  PDF (1276 KB)  ( 815 ) 117 Evaluation of radioguided occult lesion localization in the diagnosis of non-palpable breast lesions: a Meta-analysis WU Juan, XU Xinjian, ZHU Rui, JI Wenbin DOI: 10.3969/j.issn.2095-9400.2019.02.009 Objective: To evaluate the diagnostic value of radio-guided occult lesion localization (ROLL)  for non-palpable breast lesions against wire-guided localization (WGL). Methods: The databases included PubMed, EMBASE, Cochrane Library database, CNKI, WANFANG database. The retrieval time was from the construction of the database to April 2017. In addition, reference documents of related articles were also searched manually. OR(95%CI) were used to evaluate the difference between ROLL group and WGL group, and mean difference (MD) and 95%CI were used to evaluate the difference between ROLL group and WGL group. A subgroup analysis was made according to the type of study design (randomized or nonrandomized study). Sensitivity analysis was performed by the sequential omission of each individual study, and to explore the cause of heterogeneity in the studies. The Egger method was used to test whether there was publication bias. Results: 18 studies (9 RCTs, 9 non-randomized studies) were eligible with ROLL versus WGL compared. Of the trials we included in the meta-analysis, there were a total of 2 370 participants with non-palpable breast lesions [1 297 participants (ROLL); 1 073 participants (WGL)]. The results showed ROLL favorable results in positive excision margins (OR=0.54, 95%CI=0.42-0.70, 1 864 participants, 16 trials), intra-operative re-excision (OR=0.56, 95%CI=0.40-0.79, 1 132 participants, 10 trials) and re-operation rates (OR=0.66, 95%CI=0.48-0.90, 1 569 participants, 11 trials) versus WGL. There were no significant differences in localization complication (OR=0.61, 95%CI=0.24-1.52, 1 375 participants, 11 trials), successful excision (OR=1.13, 95%CI=0.54-2.38, 2 370 participants, 18 trials), postoperative complications (OR=0.82, 95%CI=0.50-1.34, 1 467 participants, 9 trials), specimen volume (MD=-0.76, 95%CI=-6.00-4.47, 686 participants, 4 trials) and operation time (MD=-0.05, 95%CI= -1.07-0.98, 849 participants, 6 trials). Conclusion: Based on this review of the published trials, ROLL may be a method of NPBLs diagnosis in place of WGL. 2019 Vol. 49 (2): 117-127 [Abstract] ( 702 ) HTML (1 KB)  PDF (1666 KB)  ( 929 ) 128 The value of layer-specific strain in identifying complex coronary artery disease YANG Xing’an, ZHU Jia, ZHENG Jiehuai. DOI: 10.3969/j.issn.2095-9400.2019.02.010 Objective: To apply layer-specific strain (LSS) to assess the left ventricular of patients with suspected coronary artery disease (CAD) to identify whether myocardial strain can predict the presence of complex multi-vessel disease of the coronary artery. Methods: A total of 116 patients with suspicious CAD in Taizhou Hospital from January 2014 to December 2015 were included. All patients were underwent coronary angiography and were divided into 3 groups: control group (no significant coronary stenosis was considered as a <50% reduction of vessel diameter in every coronary artery and its main branch, n=29), 1-2 vessel disease group [1-vessel disease (1VD) or 2-vessel disease (2VD) was defined as a ≥50% reduction of lumen diameter in 1 or 2 major coronary artery n=43] and complex CAD group (left main branch and/or 3VD of each coronary lesion with ≥50% stenosis, n=44). Endocardial, mid-myocardial, epicardial global longitudinal (GLS) and circumferential stain (GCS) of left ventricules were measured by LSS. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of GLS and GCS for complex multivessel disease. Results: Compared with controls, endocardial, mid-myocardial, epicardia GLS and GCS in complex CAD were all statistically reduced (P<0.01). Compared with 1-2VD, endocardial, mid-myocardial, epicardial GLS and endocardial, mid-myocardial GCS in complex CAD were all significantly reduced (P<0.05). By ROC analysis, GLS showed better diagnostic accuracy for identifying complex CAD: the cutoff value of endocardial GLS was -21.00%; the sensitivity and specificity were 75.0% and 75.0% respectively; the cutoff value of mid-myocardial GLS was -18.65%; the sensitivity and specificity were 72.2% and 70.5% respectively; the cutoff value of epicardial GLS was -15.95%; the sensitivity and specificity were 73.6% and 70.5% respectively. However,endocardial GLS demonstrated the highest value with 0.50 in Youden index. Conclusion: The measurement of GLS, especially endocardial GLS, might be a non-invasive method to identify complex CAD. 2019 Vol. 49 (2): 128-131，136 [Abstract] ( 733 ) HTML (1 KB)  PDF (1359 KB)  ( 824 ) 132 The family-centered nursing care model for NICU preterm infants based on evidence-based practice FENG Xiaofang, HUANG Xiaoxia, QIAN Xiaorong, ZHANG Liping, SHAO Xiaowei, HU Weijie, SUN Caixia DOI: 10.3969/j.issn.2095-9400.2019.02.011 Objective: To construct the family-centered care (FCC) nursing model in neonatal intensive care unit (NICU) based on the best evidence-based practice, and to evaluate the effect of its application in clinical practice. Methods: A total of 119 cases of premature infants hospitalized in the NICU of the First Affiliated Hospital of Wenzhou Medical University from August 2016 to March 2017 were selected as control group. A total of 146 cases of premature infants hospitalized in our department from April to November 2017 were selected as observation group, and FCC nursing mode was adopted. Through searching literature to determine the best evidence, the FCC medical nursing team was set up, and the FCC scheme was constructed based on the best evidence: ①the FCC facilities; ②the training of medical personnel; ③the investigation of family needs and the selection of appropriate time for parents to participate in FCC; ④the training of family members of premature infants; ⑤using the failure mode and effect analysis (FMEA) to prevent nosocomial infection; ⑥an assessment of care ability of family members and the formulation of discharge plan. To compare the two groups in terms of growth rate of body mass, length of stay, breastfeeding rate, the ability of family members to participate in FCC for the first time and nursing before discharge, and the incidence of nosocomial infection before and after FCC. Results: Compared with the control group, the growth rate of body mass in the observation group increased significantly (P<0.01), hospitalization days shortened by 3.12 days (P<0.01), breastfeeding rate increased significantly (P<0.01), parental care ability improved significantly (P<0.01), and there was no significant difference (P>0.05) in the incidence of nosocomial infection before and after FCC. Conclusion: The construction and implementation of FCC can effectively improve the growth and development of premature infants, short hospitalization days, improve breast feeding rate, and improve the care ability of family members, which improved the continuing care quality after discharge. 2019 Vol. 49 (2): 132-136 [Abstract] ( 1013 ) HTML (1 KB)  PDF (1296 KB)  ( 1055 ) 137 Clinical study of leukocyte and lymphocyte subsets of peripheral blood in old sarcopenia patients WANG Yidong, CHEN Yan, WANG Shuangshuang, DU Wenling, ZHENG Yongke DOI: 10.3969/j.issn.2095-9400.2019.02.012 Objective: To explore preliminarily the role of immune cells in pathogenesis of sarcopenia by detecting leukocyte, lymphocyte subsets and CRP of peripheral blood in patients with sarcopenia. Methods: A total of 120 old patients including 48 patients with sarcopenia and 72 patients without sarcopenia were selected in our study for the detection of leukocyte, lymphocyte subsets and CRP. Results: Leukocyte count of peripheral blood was (6.7±0.9)×109/L in sarcopenia group, and (5.5±0.8)×109/L in control group; NK cell was (30.4±6.6)% in sarcopenia group, and (25.4±7.2)% in control group; CRP was (6.3±1.2) mg/L in sarcopenia group, and (3.8±0.6) mg/L in control group. There were statistical differences between sarcopenia group and control group. However, the levels of total lymphocytes, CD4+T cells, CD8+T cells, B cells, NK like cells (CD3+CD56+), memory T cells (CD4+CD45RO+), naive T cells (CD4+CD45RA+), double negative T cells (CD3+CD4-CD8-) were not significantly different between sarcopenia group and control group. Conclusion: Leukocyte count, NK cells and CRP of sarcopenia patients are higher than the controls, which indicates micro-inflammatory and hypersensitivity of innate immunity in sarcopenia patients. 2019 Vol. 49 (2): 137-139，142 [Abstract] ( 845 ) HTML (1 KB)  PDF (1273 KB)  ( 763 ) 140 Comparative study of ambulatory and conventional laparoscopic cholecystectomy based on enhanced recovery after surgery ZHUANG Bo, JIN Ruyan, LI Xuemin, YU Shi’an DOI: 10.3969/j.issn.2095-9400.2019.02.013 Objective: To investigate the characteristics of ambulatory and conventional laparoscopic cholecystectomy based on enhanced recovery after surgery. Methods: A total of 99 patients underwent laparoscopic cholecystectomy based on ERAS from April 1, 2017 to March 30, 2018, were divided into two groups: ambulatory laparoscopic cholecystectomy group (ALC, n=43) and conventional laparoscopic cholecystectomy (CLC, n=56). The data of the patients’ operation time, readmission cases and the related expenses were analyzed. Results: In ALC group, the operation time was (38.55±11.52) min, hospitalization expense was (9 692±1 279) Yuan, the cost for medicine was (1 628±515) Yuan, and the cost for tests and treatment was (8 064±1 070) Yuan. In CLC group, the operation time was (42.03±18.82) min, hospitalization expense was (12 184±3 576) Yuan, the costs for medicine was (2 610±806) Yuan, and the tests and treatment was (9 574±3 345) Yuan. There was no significant difference in the operation time (min) and re-hospitalization (cases) (P>0.05) between the two groups, but there was significant difference in the cost for hospitalization, medicine, tests and treatment (P<0.01). Conclusion: These findings indicate that ALC does not increase postoperative complications, and could significantly reduce the relevant expenses. 2019 Vol. 49 (2): 140-142 [Abstract] ( 690 ) HTML (1 KB)  PDF (1220 KB)  ( 811 ) 143 The nursing effect of noninvasive-invasive mechanical ventilation on COPD patients with severe respiratory failure HUANG Ying, GE Jihui, MAO Yanjun DOI: 10.3969/j.issn.2095-9400.2019.02.014 Objective: To evaluate the nursing effect of withdrawing artificial airway catheter in the sequential treatment by invasive or non-invasive mechanical ventilation on chronic obstructive pulmonary disease (COPD) patients with severe respiratory failure. Methods: Two groups of patients (76 cases) were given the same dose of anti-infection, cough and phlegm treatment and stable water electrolyte acid-base balance. The control group (38 cases) was treated with invasive mechanical ventilation (IPPV), and the sequential group (38 cases) was used as an noninvasive-invasive mechanical ventilation (NIPPV) when catheter was removed. Results: The time of ICU hospitalization, the number of cases of mechanical ventilation associated pneumonia (VAP), the vigor of the two groups, the time of invasive ventilation, and the total mechanical ventilation time were found to be significantly different between the two groups. Conclusion: The invasive and noninvasive sequential mechanical ventilation using PIC window as a switching point for patients with COPD with respiratory failure can shorten the duration of invasive mechanical ventilation, the number of VAP cases and the time of ICU occupancy. 2019 Vol. 49 (2): 143-145，153 [Abstract] ( 712 ) HTML (1 KB)  PDF (1269 KB)  ( 817 )

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