Objective To investigate the impacts of Morroniside on oxidative stress injury of sciatic nerve in diabetic peripheral neuropathy (DPN) rats.Methods A total of 48 rats were grouped into a control group,DPN group,Morroniside group,Morroniside+Brusatol group,each group consisted of 12 rats.The changes in fasting blood glucose,mechanical pain threshold,thermal pain threshold,and sciatic nerve conduction velocity were detected.Transmission electron microscopy observe the ultrastructural changes of the sciatic nerve.ELISA method detect the levels of interleukin -6 (IL-6),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),and superoxide dismutase(SOD)activity in the sciatic nerve.Western blot detect nuclear factor erythroid 2 related factor 2 (Nrf2),silent mating-type information regulation 2 homolog 1(SIRT1),and forkhead box class o3(Foxo3)proteins in the sciatic nerve.Results Sciatic nerve myelin in DPN group,Morroniside group,Morroniside+Brusatol group were significantly damaged,fasting blood glucose,heat pain threshold,contents of IL-6,TNF-α and MDA in sciatic nerve were higher than those in control group,mechanical pain threshold,sensory and motor nerve conduction velocity,SOD activity in sciatic nerve and expression of Nrf2,SIRT1 and Foxo3 protein were lower than those in control group(P＜0.05).The ultrastructural damage of sciatic nerve tissue in Morroniside group was improved,and the contents of fasting blood glucose,heat pain threshold,IL-6,TNF-α and MDA in sciatic nerve were lower than those in DPN group.The mechanical pain threshold,sensory and motor nerve conduction velocity,SOD activity and Nrf2,SIRT1,Foxo3 protein expression in sciatic nerve were higher than those in DPN group (P＜0.05).The protective effect of Morroniside was reversed when Brusatol,an Nrf2 inhibitor,was given in addition to Morroniside group.Conclusion Morroniside may improve oxidative stress injury of the sciatic nerve in DPN rats by activating the Nrf2/SIRT1/Foxo3 pathway.

 Objective The aim of this study was to investigate the diagnostic value of combined detection of neutrophil and lymphocyte ratio (NLR),monocyte and lymphocyte ratio (MLR),platelet and lymphocyte ratio (PLR) and carcinoembryonic antigen (CEA)in patients with gastric cancer.Methods Blood routine and CEA were retrospectively collected and analyzed from 209 patients who were first admitted and admitted to Wuming Hospital of Guangxi Medical University and diagnosed with gastric cancer by postoperative pathological biopsy from January 2015 to September 2020 and 209 healthy people who underwent health checkups during the same period.ROC curve was used to analyze the diagnostic value of NLR,MLR,PLR and CEA alone and in combination for gastric cancer.In addition,the continuous variables of each index between different characteristic subgroups of gastric cancer were compared.Results The values of NLR,MLR,PLR and CEA were higher in gastric cancer patients than in healthy controls,and the differences were statistically significant(P＜0.05).The sensitivity of NLR,MLR,PLR and CEA alone in the diagnosis of gastric cancer were 37%,60%,39%,43%,and the specificity were 92%,88%,91%,78%,respectively,and the area under the ROC curve (AUC) were 0.65,0.80,0.69,0.63.The sensitivity,specificity and AUC of combined NLR,MLR,PLR and CEA increased to 69%,88.00%,0.84,respec-tively.Gastric cancer patients with distant metastasis of the tumor had higher values of NLR,MLR,PLR,and the difference was statistically significant(P＜0.05).Conclusion The combined detection of NLR,MLR,PLR and CEA has high sensitivity and specificity in the diagnosis of gastric cancer,which can improve the correct rate of diagnosis of gastric cancer,and at the same time can predict the migratory changes of the tumor,which can help the early detection and diagnosis of gastric cancer patients.

Objective To investigate the expression and clinical significance of programmed death receptor-1 (PD-1)and lymphocyte activation gene-3 (LAG-3) in the tumor microenvironment of follicular lymphoma (FL).Methods A total of 22 patients with FL diagnosed by pathology in the First Affiliated Hospital of University of Science and Technology of China from 2017 to 2022 were included.The expression levels of PD-1,LAG-3,programmed cell death-ligand 1 (PD-L1),cell surface chemokine receptor 4 (CCR4),cell surface chemokine receptor 3B (CXCR3B) and forkhead protein P3 antibody(FOXP3)in FL patients were detected by immunohistochemistry.The relationship between PD-1,LAG-3 and clinicopathological features and prognosis of FL patients was analyzed,and the correlation between each factor was analyzed.Results The levels of β2 microglobulin (β2-MG)in PD-1 high expression group and LAG-3 high expression group were higher than those in low expression group,and the differences were statistically significant (P＜0.05).The levels of lactate dehydrogenase (LDH)and β2-MG in PD-1/LAG-3 double high expression group were higher than those in PD-1/LAG-3 single high expression group and PD-1/LAG-3 double low expression group,and the differences were statistically sig-nificant (P＜0.05).Correlation analysis showed that in FL tissues,the expression level of PD-1 was positively correlated with the expression levels of LAG-3,CCR4 and CXCR3B (r=0.432,0.440,0.506,P＜0.05),but not with the expression levels of PD-L1 and FOXP3(P＞0.05).The CD8+T cell count in PD-1 high expression group,LAG-3 high expression group and PD-1/LAG-3 co-high expression group was less than that in the corresponding low expression group,and the differences were statistically significant(P＜0.05).Further correlation analysis results showed that PD-1 expression,LAG-3 expression and PD-1/LAG-3 co-expression were negatively correlated with CD8+T cell count(r=-0.631,-0.425,-0.552,P＜0.05).The results of survival analysis showed that the progression-free survival(PFS)and overall survival(OS)of LDH low expression group were better than those of LDH high expression group,and the PFS and OS of PD-1 low expression group,LAG-3 low expression group and PD-1/LAG-3 double low expression group were better than those of high expression group,and the differences were statistically significant (P＜0.05).Conclusion The high expression of PD-1 and LAG-3 is related to the higher level of clinical test indexes and poor survival prognosis of FL patients.Immune checkpoints such as PD-1 and LAG-3 are co-expressed in the tumor microenvironment and affect T cell counts.

Objective To investigate the correlation between rashes caused by antiepileptic drugs and human leukocyte antigen (HLA)genes in children with epilepsy in Maternity and Child Health Care of Zaozhuang,so as to promote clinical rational drug use.Methods A total of 3 800 children diagnosed with epilepsy and taking aromatic antiepileptic drugs admitted to Maternity and Child Health Care of Zaozhuang from May 2019 to January 2023 were selected as the study objects.According to whether the children had cutaneous adverse drug reactions within 12 weeks of medication,the children were divided into rash group(21 cases)and tolerance group(100 cases were randomly selected out of 3 779 cases without dermal adverse drug reactions).The whole genome of HLA genes was sequenced by targeted sequencing technology.HLA genotypes were analyzed and compared among the rash group,the tolerance group and the general population.Results The positive rates of HLA-A*31∶01 and HLA-C*04∶01 genes between the rash group and the tolerance group were statistically significant (OR=6.75,95%CI=1.47-30.99,P＜0.01;OR=5.44,95%CI=5.44-25.52,P＜0.05).Conclusion HLA-A*31∶01 and HLA-C*04∶01 genes may be risk alleles for rashes induced by aromatic antiepileptic drugs.

Objective To explore the risk and risk factors of adverse cardiac events in elderly patients with type 2 diabetes and coronary heart disease.Methods A total of 182 elderly patients with type 2 diabetes complicated with coronary heart disease admitted to Shangrao People's Hospital from January 2019 to December 2022 were selected by simple random sampling as the study objects.They were divided into occurrence group(28 cases)and un-occurred group(154 cases)according to the occurrence of adverse cardiac events.After symptomatic treatment,the patients were followed up for 90 days after discharge to record the risk of adverse cardiac events,and the general clinical data,laboratory indicators,and ultrasonic electrocardiogram (ECG)indicators of the patients were collected and compared in the two groups.The multiple logistic regression analysis was used to identify risk factors for adverse cardiac events.Results After 90 days of follow-up,28 of 182 patients with type 2 diabetes combined with coronary heart disease had adverse cardiac events,and the incidence rate was 15.38%,there were significant differences (P ＜0.05) in the incidence of left main coronary artery disease,glycated hemoglobin(HbA1c),language acquisition device(LAD),left ventricular ejection fraction(LVEF),and New York Heart Association (NYHA)cardiac function grading among different groups of adverse cardiac events.The results of multiple logistic factor analysis showed that the left main trunk lesion（β=2.321,OR=10.186,95%CI:2.464-42.100),HbA1c（β=2.482,OR=11.968,95%CI:2.436-58.763),LAD（β=3.183,OR=24.119,95%CI:6.989-83.239),cardiac function classification（β=1.287,OR=3.622,95%CI:1.775-7.392),type C lesions（β=3.254,OR=25.894,95%CI:7.285-92.303)were the risk factors for adverse cardiac events in patients with type 2 diabetes and coronary heart disease.Conclusion Left main artery disease,HbA1c,LAD,LVEF,cardiac function classification,and type C disease are the risk factors for adverse cardiac events in patients with type 2 diabetes combined with coronary heart disease.

Objective To explore the effect of high-flow nasal cannula oxygen therapy(HFNC)combined with conventional therapy on blood gas analysis and pulmonary function in patients with acute exacerbation of bronchiectasis and type Ⅱrespiratory failure.Methods A total of 40 patients with acute exacerbation of bronchiectasis and type Ⅱrespiratory failure admitted to the Department of Respiratory and Critical Care Medicine,Guangxi Zhuang Autonomous Region National Hospital from July 2020 to January 2023 were selected as the study objects,and they were divided into traditional oxygen therapy group (20 cases) and HFNC group (20 cases) according to random number table method.The traditional oxygen therapy group was treated with nasal catheter,and the HFNC group was treated with HFNC.The changes of arterial blood gas analysis indexes(arterial partial pressure of oxygen[PaO2],arterial partial pressure of carbon dioxide[PaCO2]and Oxygenation index [PaO2/FiO2])were compared in the two groups before treatment,2 and 24 hours after treatment and before discharge.The changes of pulmonary function indexes(forced expiratory volume in one second[FEV1],the percentage of forced expiratory volume in one second [FEV1%],forced vital capacity [FVC],forced expiratory volume in one second/forced vital capacity [FEV1/FVC]) and modified British Medical Research Council (mMRC) dyspnea questionnaire scores before and after treatment were compared in the two groups.Results At 2 hours,24 hours after treatment and before discharge,the PaO2 and PaO2/FiO2 of two groups were higher than those before treatment in the same group,and the PaO2 and PaO2/FiO2 in the HFNC group were higher than those in the traditional oxygen therapy group,and the differences were statistically significant(P＜0.05).At 24 hours after treatment and before discharge,the PaCO2 of the traditional oxygen therapy group was lower than that before treatment of the same group,and the difference was statistically significant (P＜0.05).At 2 hours,24 hours and before discharge,the PaCO2 of HFNC group was lower than that before treatment in the same group,and the PaCO2 in the HFNC group was lower than that in the traditional oxygen therapy group,and the differences were statistically significant(P＜0.05).Before discharge,the FEV1,FEV1%,FVC,and FEV1/FVC in two groups were higher than those before treatment in the same group,and the FEV1,FEV1%,FVC,and FEV1/FVC in the HFNC group were higher than those in the traditional oxygen therapy group,and the differences were statistically significant (P＜0.05).Before discharge,the mMRC scores of two groups were lower than those before treatment in the same group,and the mMRC score in the HFNC group was lower than that in the traditional oxygen therapy group,and the differences were statistically significant(P＜0.05).Conclusion HFNC is effective in the treatment of patients with acute exacerbation of bronchiectasis and type Ⅱrespiratory failure.Compared with traditional oxygen therapy,HFNC can improve the blood gas analysis index and lung function index of patients faster and better,and alleviate the symptoms of dyspnea.

Objective To explore the application effect of Dong's unique acupoint combined with conventional rehabilitation treatment in patients with cervical spondylotic radiculopathy.Methods A total of 72 patients with cervical spondylotic radiculopathy treated in Ganzhou Municipal Hospital from August 2022 to July 2023 were selected as the research objects.According to the random number table method,they were divided into the observation group(36 cases)and the control group(36 cases).The control group was treated with routine rehabilitation treatment,and the observation group was treated with Dong's unique acupoint on the basis of routine rehabilitation treatment.The pain,cervical function,vertebral artery blood flow,quality of life and clinical efficacy were compared between the two groups.Results There were no significant differences in pain score,cervical function score,vertebral artery blood flow velocity,blood flow,and quality of life score between the two groups before treatment (P＞0.05).After treatment,the pain and cervical function scores of the observation group were lower than those of the control group,and the differences were statistically significant(P＜0.05).After treatment,the blood flow velocity of vertebral artery in the observation group was faster than that in the control group,the blood flow was greater than that in the control group,and the quality of life score was higher than that in the control group,and the differences were statistically significant(P＜0.05).The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).Conclusion Dong's unique acupoint combined with conventional rehabilitation therapy can effectively reduce the pain of patients with cervical spondylotic radiculopathy,improve the function of cervical spine,improve the quality of life and clinical efficacy.

Objective To investigate the application effect of external diaphragm pacemaker (EDP)combined with manual hyper inflation (MHI) in pulmonary function rehabilitation of patients with cervical spinal cord injury after tracheotomy.Methods A total of 50 patients with cervical spinal cord injury who underwent tracheotomy in the Ganzhou People's Hospital from April 2021 to April 2022 were selected as the research objects.They were divided into observation group(n=25)and control group (n=25)by random number table method.The control group was given routine breathing training,and the observation group was given EDP and MHI intervention on the basis of the control group.The changes of lung function before and after treatment were compared between the two groups.Results The pulmonary infection scores of the observation group 7,14,21 and 28 days after treatment were lower than those of the control group,and the levels of forced vital capacity(FVC)were higher than those of the control group,and the differences were statistically significant (P＜0.05).The diaphragm mobility and thickness of the observation group were higher than those of the control group 28 days after treatment,and the differences were statistically significant(P＜0.05).Conclusion For patients with cervical spinal cord injury after tracheotomy,the application of EDP combined with MHI can effectively improve the lung function of patients,reduce the risk of lung infection,and the overall effect is significant,which is worthy of promotion.

Objective To investigate the effect of 3M liquid dressing combined with Ostomy Powder on neonatal diaper dermatitis.Methods A total of 100 children with neonatal diaper dermatitis admitted to The People's Hospital of Cenxi from January 2022 to December 2023 were selected as the study objects by random number table method,they were divided into observation group (50 cases) and control group (50 cases).The observation group was treated with 3M liquid dressing combined with Ostomy Powder,and the control group was treated with Zinc Oxide Ointment.The disappearance time,recovery time,clinical efficacy and complications were compared between the two groups.Results The disappearance time of flush in observation group was shorter than that in control group,the difference was statistically significant(P＜0.05).The recovery time in observation group was shorter than that in control group,and the difference was statistically significant(P＜0.05).The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).The complication rate in observation group was lower than that in control group,and the difference was statistically significant (P＜0.05).Conclusion The 3M liquid dressing combined with Ostomy Powder in the treatment of neonatal diaper dermatitis can reduce symptoms more quickly,accelerate the fading of rash and wound healing,effectively reduce the disappearance time of flushing in children and the long treatment time,reduce the incidence of complications,the clinical effect is obvious,worthy of promotion.

Objective To explore the effect of modified Shentong Zhuyu Decoction on the levels of inflammatory factors and pain in patients with lumbar disc herniation (LDH).Methods A total of 93 patients with LDH treated in Nanchang Hongdu Traditional Chinese Medicine Hospital in Nanchang from March 2022 to July 2023 were selected as the research subjects and randomly divided into test group (n=47)and control group (n=46)using a random number table method.The control group was treated with Celecoxib,and on this basis,the test group was treated with modified Shentong Zhuyu Decoction for 3 weeks.The pain severity,lumbar function,inflammatory factor levels,oxidative stress response,and quality of life were compared between the two groups.Results After treatment,the visual analog scale (VAS)score and Oswestry disability index (ODI)score in the test group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The levels of interleukin-1β,tumor necrosis factor-α,malondialdehyde,and interleukin-6 in the test group were lower than those in the control group,while the level of superoxide dismutase (SOD)was higher than that in the control group,and the differences were statistically significant(P＜0.05).The MOS 36-item short from health survey(SF-36)score in the test group after treatment was higher than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion The modified Shentong Zhuyu Decoction can reduce inflammation and oxidative stress reactions,alleviate pain severity,improve lumbar function and quality of life in the treatment of LDH.

Objective To explore the efficacy of Vonoprazan based quadruple therapy in refractory Helicobacter pylori infection.Methods A total of 92 refractory Helicobacter pylori(Hp)positive patients who failed to cure with standard quadruple therapy in the Department of Gastroenterology,Nantong Haimen People's Hospital from January to December 2021 were selected as the study objects and they were divided into observation group (47 cases) and control group (45 cases) using stratified randomization.Observation group were treated with Vonoprazan,Amoxicillin,Levofloxacin,Bismuth Potassium Citrate,and control group were treated with Esomeprazole,Amoxicillin,Levofloxacin,Bismuth Potassium Citrate.The treatment course was 14 days in two groups.The 13C-urea breath was retested,and the eradication rate of Helicobacter pylori,improvement of digestive symptoms and incidence of adverse reactions were compared of the two groups after 4 weeks of withdrawal.Results A total of 85 patients (44 cases were in observation group and 41 cases were in control group)completed the experiment.According to the intention-to-treat (ITT),the Hp eradication rates were 87.2%in observation group and 57.8%in control group.According to the per-protocol (PP),the Hp eradication rates were 93.2%in observation group and 63.4%in control group.The Hp eradication rate in the observation group was higher than that in the control group,and the difference was statistically significant (P＜0.05).The gastrointestinal symptom scores of the two groups after successful Hp sterilization were lower than those before treatment in the same group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P＞0.05).Conclusion Vonoprazan based quadruple therapy has better curative effect on eradication of refractory Helicobacter pylori infection,obviously relieve the symptom of digestive tract and has no severe adverse reactions.

Objective To investigate the application effect of acupoint massage combined with reading therapy in rehabilitation of schizophrenic patients.Methods A total of 60 patients with schizophrenia admitted to Jiangxi Mental Hospital from July 2022 to June 2023 were selected as the research subjects.They were divided into the control group and the experimental group by random number table method,with 30 patients in each group.The control group received schizophrenia rehabilitation therapy plus acupoint massage,while the experimental group received reading therapy on the basis of the control group.Before and after treatment for 8 weeks,the positive and negative symptom scale (PANSS) was used to evaluate the symptoms of schizophrenia in patients,the Chinese version of the Connor-Davidson resilience scale(CD-RISC)was used to evaluate the level of resilience in patients,the repeatable battery for the assessment of neuropsychological status (RBANS)was used to evaluate the cognitive ability of patients,and the general quality of life index-74 scale (GQOLI-74)was used to evaluate the quality of life of patients.Results After treatment,the PANSS scores of positive symptoms,negative symptoms,and neuropathological symptoms in both groups were lower than those before treatment,and the PANSS score in the experimental group after treatment was lower than that in the control group,with a statistically significant difference(P＜0.05).After treatment,the CD-RISC,RBANS,and GQOLI-74 scores in both groups were higher than those before treatment,and the CD-RISC,RBANS,and GQOLI-74 scores in the experimental group after treatment were higher than those in the control group,with a statistically significant difference(P＜0.05).Conclusion Acupoint massage combined with reading therapy can improve psychological resilience,cognitive ability and quality of life of schizophrenic patients,thereby promoting recovery.

Objective To observe the clinical effectiveness of diaphragmatic electrical stimulation combined with swallowing function training in patients with post-stroke dysphagia.Methods A total of 60 patients with post-stroke dysphagia admitted to the Rehabilitation Department of Dalian Central Hospital from January to October 2023 were selected as the research subjects.They were divided into an observation group(30 cases)and a control group(30 cases)according to random number table method.The control group received conventional swallowing function training,while the observation group received diaphragmatic electrical stimulation on top of the conventional training for two weeks.The clinical efficacy,standard swallowing assessment scale (SSA),swallowing disorder-specific quality of life (SWAL-QOL)score,water swallowing test grades,and diaphragmatic ultrasound parameters(diaphragmatic thickness and range of motion)were compared between the two groups.Results The overall clinical efficacy of the observation group was better than that of the control group after 2 weeks of treatment,with a statistically significant difference(P＜0.05).There was no significant difference in the total effective rate between the two groups (P＞0.05).The SSA scores of both groups were lower after 2 weeks of treatment than before treatment,and the scores of the observation group were lower than those of the control group,with significant differences(P＜0.05).The SWAL-QOL scores of both groups were higher after 2 weeks of treatment than before treatment,and the scores of the observation group were higher than those of the control group,with significant differences (P＜0.05).The ratings of the water swallowing test were better after treatment than before treatment in both groups,and the ratings of the observation group were better than those of the control group,with significant differences(P＜0.05).The diaphragmatic activity and thickening rate during forced breathing were higher after treatment than before treatment in both groups,and the values of the observation group were higher than those of the control group,with significant differences(P＜0.05).Conclusion Diaphragmatic electrical stimulation combined with swallowing function training is effective in treating post-stroke dysphagia,improving diaphragmatic activity,and enhancing swallowing function.

Objective To explore the clinical efficacy of the"Jin San Needle"combined with early start Denver model(ESDM)in children with global developmental delay(GDD)and autistic spectrum disorder(ASD).Methods A total of 123 children with GDD and ASD treated in Ganzhou Maternal and Child Health Hospital from April to August 2023 were selected as the study objects,and they were divided into routine rehabilitation group,ESDM group and"Jin San Needle"+ESDM group according to random number table method,with 41 cases each.The clinical efficacy,Gesell development diagnosis scale(GDDS)score,autism behavior checklist(ABC)score,childhood autism rating scale (CARS) score and adverse reactions of the three groups were compared.Results The total clinical effective rate of GDD with ASD in "Jin San Needle"+ESDM group was higher than that in ESDM group and conventional rehabilitation group,the difference was statistically significant(P＜0.017).After treatment,the scores of gross motor,adaptation,fine motor,personal-social,language and GDDS in "Jin San Needle"+ESDM group were higher than those in ESDM group and conventional rehabilitation group,and the differences were statistically significant(P＜0.05).The AD,PS scores and GDDS scores in ESDM group were higher than those in conventional rehabilitation group,and the differences were statistically significant(P＜0.05).After treatment,the total scores of ABC and CARS in "Jin San Needle"+ESDM group were lower than those in ESDM group and conventional rehabilitation group,and the differences were statistically significant (P＜0.05).The total scores of ABC and CARS in ESDM group were lower than those in conventional rehabilitation group,and the differences were statistically significant (P ＜0.05).There were no adverse reactions in the ESDM group and the conventional rehabilitation group,and only two cases of bleeding at the acupuncture site occurred in the"Jin San Needle"+ESDM group,there was no statistical significance in the incidence of adverse reactions among the three groups (P＞0.017).Conclusion "Jin San Needle"combined with ESDM in the treatment of GDD with ASD has a good overall effect,which can effectively promote the improvement of developmental delay and ASD behavioral symptoms in children,reduce the severity of the disease,and improve the overall development level,with high safety.

Objective To investigate the pelvic floor surface electromyograpy of deuteripara,and to provide relevant clinical basis for promoting the rehabilitation of pelvic floor.Methods A total of 7 629 deuteripara who received pelvic floor screening in Fujian Maternity and Child Health Hospital from December 2019 to January 2022 were selected as the study objects.The pelvic floor electromyography values were collected using Glazer pelvic floor surface electromyography evaluation scheme,and they were divided into vaginal delivery-cesarean section group (631 cases,numbered "group 1"),cesarean delivery-cesarean section group (158 cases,numbered "group 2"),cesarean delivery-cesarean section group (2 202 cases,numbered "group 3") and vaginal delivery-cesarean section group (4 638 cases,numbered "group 4") according to the delivery mode.The characteristics of pelvic floor electromyography values in the four groups were compared.Results The mean value of the pre-resting stage,the maximum value of rapid contraction,the mean value of tension contraction stage,the mean value of endurance contraction stage and the mean value of post-resting stage in group 1 were higher than those in group 2 and group 4,but lower than those in group 3,with statistical significances (P ＜0.05).The mean value of the pre-resting stage,the maximum value of rapid contraction,the mean value of tension contraction stage,the mean value of endurance contraction stage and the mean value of post-resting stage in group 3 were higher than those in group 2 and group 4,with statistical significances (P＜0.05).Conclusion The characteristics of pelvic floor surface electromyography of deuteripara are mainly related to the delivery mode of deuteripara.Vaginal delivery has greater damage to the pelvic floor muscle than cesarean section,which has a protective effect on the pelvic floor muscle,but easily leads to an increase in resting potential.

Objective To investigate the effect of self-made Jianpi Chushi Zhidai Recipe combined with interferon on patients with dampness toxin accumulation syndrome of high-risk human papilloma virus (HPV)infection of cervix.Methods A total of 100 patients with high-risk cervical HPV infection admitted to Jiujiang Hospital of Traditional Chinese Medicine of Jiangxi Province from June 2020 to June 2022 were selected as the study objects and they were divided into control group(50 cases)and observation group (50 cases)according to random number table method.The control group was treated with human Interferon α2b Vaginal Effervescent Tablets,and the observation group was treated with Human Interferon α2b Vaginal Effervescent Tablets+self-made Jianpi Chushi Zhidai Recipe,all of which were treated for consecutive 3 menstrual cycles.The clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,negative HPV conversion rate and the total incidence of adverse reactions were compared between the two groups.Results The total clinical effective rate of observation group was higher than that of control group,and the negative conversion rate of HPV in observation group was higher than that in control group,and the TCM syndrome scores after treatment in observation group were lower than those of the same group before treatment,and TCM syndrome scores after treatment in observation group were lower than those in control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05).Conclusion The combination of self-made Jianpi Chushi Zhidai Recipe and interferon can improve the negative conversion rate of HPV and improve the condition of patients with cervical high-risk HPV infection of dampness toxin accumulation syndrome.The effect is significant and the safety is good,which is worthy of reference.

Objective To explore the application effect of eyeball movement combined with auricular point pressing with beans+periocular massage on pseudomyopia in children.Methods A total of 80 pediatric patients with pseudomyopia admitted to Maternity&Child Health Center of Xinyu from May 2021 to May 2023 were selected as the study objects and they were divided into combined group(40 cases)and conventional group(40 cases) according to random number table method.The conventional group was given periocular massage intervention,and the combined group was given intervention with eyeball movement combined with auricular point pressing with beans on the basis of the conventional group.The uncorrected visual acuity,diopter,axial length,eye adjustment function (ocular accommodation amplitude,accommodation sensitivity),asthenopia and quality of life(College of Optometrists in Vision Development Quality of Life questionnaire[COVD-QOL])of the two groups were compared before and after intervention.Results After intervention,the uncorrected visual acuity in the two groups were lower than those before intervention in the same group,and the uncorrected visual acuity of combined group was lower than that in conventional group,and the differences were statistically significant(P＜0.05).There were no significant differences in diopter and axial length of the two groups after intervention (P＞0.05).After intervention,the ocular accommodation amplitude,accommodation sensitivity and COVD-QOL score of the two groups were higher than those in the same group before intervention,and the ocular accommodation amplitude,accommodation sensitivity and COVD-QOL score in combined group were higher than those in conventional group,and the differences were statistically significant(P＜0.05).Conclusion Eyeball movement combined with auricular point pressing beans+periocular massage intervention is helpful to enhance the uncorrected visual acuity,accommodation amplitude and accommodation sensitivity and optimize the visual quality in pediatric patients with pseudomyopia.

Objective To explore the clinical effect of thoracic paravertebral nerve block(TPVB)treatment on patients with moderate to severe pain after thoracoscopic surgery.Methods A total of 72 patients with moderate to severe pain after thoracoscopic surgery at Xinyu City People's Hospital from April 2020 to April 2022 were selected as the study subjects.They were divided into control group and observation group (36 cases in each group) using the mechanical sampling method of admission number.The control group received sufentanil treatment,while the observation group received ultrasound guided TPVB treatment.The pain scores,postoperative vital signs,dosage of sufentanil,duration of anesthesia recovery,levels of pain and inflammatory factors,and incidence of adverse reactions were compared between the two groups.Results The visual analogue scale (VAS)score of the observation group at 1 hour,8 hours,24 hours,and 48 hours after surgery were lower than those of the control group,with statistically significant differences(P＜0.05).The blood oxygen saturation at 1 hour after surgery in the observation group was higher than that in the control group,while the systolic and diastolic blood pressure were lower than those in the control group,with statistically significant differences(P＜0.05).There was no statistically significant difference in heart rate between the observation group and the control group at 1 hour after surgery (P＞0.05).The dosage of sufentanil in the observation group was lower than that in the control group,with statistically significant difference(P＜0.05).However,there was no statistically significant difference in the stay time in the anesthesia recovery room between the observation group and the control group (P＞0.05).The levels of interlenkin 6 and prostaglandin E2 in the observation group at 48 hours after surgery were lower than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group (P＞0.05).Conclusion Implementing TPVB treatment in patients with moderate to severe pain after thoracoscopic surgery can significantly alleviate acute postoperative pain,reduce the use of opioids,and smoothly pass the pain period.

Objective To analyze the effect of Sevoflurane combined with Esketamine in the high ligation of the hernia sac in children with oblique inguinal hernia under endoscopy.Methods Eighty-two children with 2021 hernia inguinal hernia underwent high ligation from March to July 2022 in Jiangxi Children's Hospital,they were divided into control group(n=41)and observation group (n=41)according to random number table method.The control group was anesthetized with Propofol combined with Esketamine,and the observation group was anesthetized with Sevoflurane combined with Esketamine.The hemodynamic changes,postoperative recovery,postoperative agitation and nausea were compared between the two groups at each time point.Results The mean arterial pressure and heart rate in the observation group were lower than those in the control group 5 min after anesthesia(T1),5 min after surgery(T2),and after surgery(T3)(P＜0.05).The dosage of Esketamine,anesthesia time and recovery time in the observation group were lower than those in the control group,and the difference was statistically significant(P＜0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group (24.39%),and the difference was statistically significant (P＜0.05).Conclusion Sevoflurane combined with Esketamine is more effective in the management of inguinal hernia hernia sac in children undergoing laparoscopic high ligation.It has less effect on blood pressure and heart rate,and is beneficial to the stability of Hemodynamics,it has high application value to shorten the time of waking up and reduce the incidence of restlessness in waking period.

Objective To investigate the clinical effect of preemptive analgesia with Yuanhu Zhitong Dropping Pills in knee arthroscopic exploration surgery.Methods Seventy patients who underwent elective knee arthroscopic exploration surgery in Shangrao City People's Hospital from January 2020 to December 2022 were selected as the research objects and divided into a control group (35 cases)and an observation group (35 cases)using random number table method.The control group received routine analgesia during the perioperative period,while the observation group received advanced analgesia with Yuanhu Zhitong Dropping Pills in addition to the control group.The vital signs,postoperative pain,frequency of relief analgesia within 48 hours,knee joint range of motion,and incidence of adverse reactions between two groups at different time points were compared.Results The average arterial pressure(MAP)and heart rate(HR)levels at the time of entry,10 minutes of anesthesia,30 minutes of anesthesia,and completion of surgery were significant between the two groups,with statistically significant differences (P＜0.05).There was no statistically significant difference in blood oxygen saturation (SpO2)levels at each time point between the two groups(P＞0.05).The visual analogue scale(VAS)scores at rest and activity in the observation group were lower than those in the control group at 2,6,12,and 24 hours after surgery,in the comparison of the number of people receiving relief analgesia within 48 hours after surgery between the two groups,the number of people in the observation group was lower than that in the control group,with statistically significant differences (P＜0.05).There was no statistically significant difference in knee joint range of motion between the observation group and the control group at 2 hours before surgery,upon entry,2 hours,24 hours,and 48 hours after surgery(P＞0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P＞0.05).Conclusion Yuanhu Zhitong Dropping Pills for Advanced Analgesia can stabilize patient life and improve postoperative pain during knee arthroscopic exploration surgery,without any other serious adverse reactions.

Objective To investigate the effects of pharmaceutical service intervention on the effectiveness,safety,and economy of medication administration in patients with type 2 diabetes nephropathy.Methods A total of 60 patients with type 2 diabetic nephropathy admitted to Department of Pharmacy of Huizhou Hospital of Traditional Chinese Medicine from March 2022 to March 2023 were selected as research objects.They were divided into control group (n=30)and intervention group (n=30) according to random number table method.Fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin level,medication compliance,incidence of adverse reactions and drug cost were compared between the two groups.Results The levels of fasting blood glucose,2 h postprandial blood glucose and glycated hemoglobin in the intervention group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Medication compliance in the intervention group was better than that in the control group,and the difference was statistically significant(P＜0.05).The total incidence of adverse reactions in the intervention group was lower than that in the control group,the difference was statistically significant (P＜0.05).The medication cost in the intervention group was lower than that in the control group,and the difference was statistically significant (P＜0.05).Conclusion After patients with type 2 diabetic nephropathy participate in pharmaceutical service intervention through pharmacists,drug efficacy is improved,the incidence of adverse drug reactions or events is decreased,patients'compliance is improved,and drug treatment costs are reduced.

Objective To investigate the effect of Duloxetine combined with non-steroidal anti-inflammatory drugs on pain and quality of life in patients with chronic osteoarthritis.Methods A total of 150 patients with chronic osteoarthritis treated in Xinyi People's Hospital from August 2022 to August 2023 were selected as the research objects,and they were divided into observation group(75 cases)and control group(75 cases)by random number table method.The control group was treated with non-steroidal anti-inflammatory drugs alone,and the observation group was treated with Duloxetine combined with non-steroidal anti-inflammatory drugs.The clinical efficacy,pain,mental state,quality of life and adverse reactions were compared between the two groups.Results After 8 weeks of treatment,the total effective rate of the observation group was higher than that of the control group,the difference was statistically significant (P＜0.05).After 8 weeks of treatment,visual analogue score(VAS),present pain intensity(PPI)and pain rating index(PRI)in observation group were lower than those in control group,and the differences were statistically significant (P＜0.05).After 8 weeks of treatment,the scores of Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)in the observation group were lower than those in the control group,and the differences were statistically significant (P＜0.05).After 8 weeks of treatment,the short form 36-item health survey(SF-36)scores in the observation group were higher than those in the control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions such as gastrointestinal discomfort,appetite loss,lethargy and sweating between the two groups after 8 weeks of treatment (P＞0.05).Conclusion Duloxetine combined with non-steroidal anti-inflammatory drugs is effective in the treatment of chronic osteoarthritis,which can effectively relieve pain,improve psychological state and quality of life,and have good safety.

 Objective To explore the effect of systematic prescription review combined with pharmaceutical care on the rate of prescription failure and adverse events.Methods A total of 246 patients who received treatment in Affiliated Hospital of Jiangsu University from January 2019 to January 2020 were selected as the study objects,among which 123 patients who had not used systematic prescription review and clinical pharmaceutical care from January to June 2019 were selected as the control group,and the routine antibiotic use guidance of Affiliated Hospital of Jiangsu University was adopted.A total of 123 patients who received systematic prescription review and clinical pharmaceutical care after June 2019 were included in the observation group,and they were given systematic prescription review and clinical pharmaceutical care.The rate of prescription failure,the occurrence of adverse events,the rate of medication error and compliance,and the satisfaction of patients in the two groups were compared.Results The total compliance of patients in observation group was higher than that in control group,the difference was statistically significant (P＜0.05).The total incidence of medication errors in the observation group was lower than that in the control group,and the difference was statistically significant (P＜0.05).The failure rate of prescription in observation group was lower than that in control group,the difference was statistically significant(P＜0.05).The total incidence of adverse reactions and adverse events in observation group was lower than that in control group,and the difference was statistically significant (P＜0.05).The total satisfaction of the observation group was higher than that of the control group,the difference was statistically significant (P＜0.05).Conclusion Systematic prescription review combined with pharmaceutical care can effectively improve patients'compliance,reduce the rate of prescription failure and the incidence of adverse events caused by prescription,effectively improve clinical drug safety,and greatly improve patients'satisfaction,which is worthy of clinical promotion and application.

Objective To investigate the effect of Wenxin Granules on qi-yin deficiency type chronic heart failure.Methods A total of 120 patients with chronic heart failure (qi-yin deficiency type) admitted to Yueyang People's Hospital from January 2021 to December 2022 were selected as the research objects,and they were divided into control group and study group according to random number table method,with 60 cases in each group.The control group was treated with conventional drugs,and the study group was treated with Wenxin Granules on this basis.The clinical effect and adverse reactions,multidimensional fatigue scale score,left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group,the difference was statistically significant (P＜0.05).No serious adverse reactions occurred in both groups.After treatment,the scores of multidimensional fatigue scale,left ventricular end-diastolic diameter and left ventricular end-systolic diameter of the two groups were lower than those before treatment,and the above indexes of the study group were lower than those of the control group,with statistical significances(P＜0.05).The left ventricular ejection fraction of the two groups were higher after treatment than those before treatment,and the left ventricular ejection fraction of the study group was higher than that of the control group,with statistical significances(P＜0.05).Conclusion Wenxin Granules has high efficacy and safety in treating qi-yin deficiency type chronic heart failure,which can effectively reduce fatigue and improve heart function.

Objective To explore the correlation and influencing factors analysis of homocysteine (Hcy),lipid ratio,and blood glucose (GLU) detection in acute ischemic stroke (AIS).Methods A total of 154 patients with AIS who visited Traditional Chinese Medicine Hospital of Yulin from July 2020 to December 2022,as well as the 154 healthy individuals who underwent physical examinations during the same period were selected as the study subjects.The AIS patients were included in the AIS group,and the healthy people were included in the control group.The differences in Hcy,blood lipid ratio and GLU levels between the two groups were compared.Pearson analysis was used to analyze the correlation between items,and multiple factor binary logistic regression was used to analyze the influencing factors of AIS occurrence.Results The levels of Hcy,total cholesterol (TC),triglycerides (TG),and low-density lipoprotein cholesterol (LDL-C)in the AIS group were higher than those in the control group,while the level of high-density lipoprotein cholesterol(HDL-C)in the AIS group was lower than that in the control group,with statistically significant differences(P＜0.05).The blood lipid TC/HDL-C,TG/HDL-C,LDL-C/HDL-C ratio,and GLU levels in the AIS group were higher than those in the control group,and the differences were statistically significant(P＜0.05).Pearson analysis showed that Hcy was negatively correlated with TC,TG,HDL-C,LDL-C,and GLU (r=-0.086,-0.038,-0.055,-0.060,-0.038;P＜0.001).The results of the multivariate binary logisticregressionanalysis showed that high Hcy(β=0.381,OR=1.464,95%CI=1.444-1.483),high TG (β=1.001,OR=2.720,95%CI=2.567-2.882),high LDL-C(β=0.356,OR=1.428,95%CI=1.374-1.483),high GLU (β=0.343,OR=1.409,95%CI=1.370-1.449),TC/HDL-C increase(β=0.540,OR=1.715,95%CI=1.344-2.189),TG/HDL-C increase (β=1.113,OR=3.044,95%CI=1.941-4.773),LDL-C/HDL-C increase(β=0.776,OR=2.172,95%CI=1.553-3.038)were risk factors for AIS (P＜0.001),while high HDL-C(β=-1.608,OR=0.200,95%CI=0.183-0.219)was a protective factor for AIS (P＜0.001).Conclusion The levels of Hcy,blood lipids,lipid ratios,and GLU levels in the AIS patients were closely related to the occurrence of AIS.The Hcy,TG,LDL-C,GLU,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C may be risk factors for AIS,while the HDL-C may be a protective factor for AIS,which has important reference value for clinical diagnosis,treatment,and evaluation of influencing factors.

Objective To investigate the correlation between T helper-17 (Th-17 cells),interleukin-17 (IL-17),interleukin-35(IL-35)and atopic dermatitis.Methods Eighty children with atopic dermatitis who were admitted to Dermatology Hospital of Jiangxi Province from September 2021 to December 2022 were selected as research objects and set as the observation group.According to the scoring atopic dermatitis index,they were divided into severe,moderate,and mild three subgroups.Meanwhile,80 healthy children were selected as the control group.The levels of Th-17,IL-17 and IL-35 in the observation group and the control group were measured.The levels of Th-17,IL-17 and IL-35 in children with different severity of dermatitis were compared.Univariate analysis and multivariate logistic analysis were conducted to identify the independent factors affecting the condition of atopic dermatitis.Pearson correlation analysis was conducted to evaluate the correlation between the three indicators and the condition.Results The levels of Th-17 and IL-17 in the observation group were higher than those in the control group,and the level of IL-35 was lower than that in the control group,with statistically significant differences(P＜0.05).Univariate analysis showed that there were no statistically significant differences in gender,age,or length of hospital stay among the mild dermatitis group,the moderate dermatitis group,and the severe dermatitis group (P＞0.05),while there were statistically significant differences in the levels of Th-17,IL-17 and IL-35 among the three groups (P＜0.05).Multivariate logistic analysis showed that the levels of Th-17,IL-17,and IL-35 were independent influencing factors of atopic dermatitis (β=1.157,2.143,1.793;OR=3.180,8.525,6.007;95% CI=1.166-8.676,1.157-62.818,1.064-33.909;P＜0.05).The severity of atopic dermatitis was positively correlated with the levels of Th-17 and IL-17,and negatively correlated with the level of IL-35 (r=0.404,0.402,-0.405;P＜0.05).Conclusion The levels of Th-17,IL-17,and IL-35 are independent influencing factors affecting the severity of atopic dermatitis.Besides,there is certain correlation between the three indicators and the severity of atopic dermatitis.If Th-17 and IL-17 level decrease or IL-35 level increases,it is necessary to take targeted intervention measures to prevent decrease in immune function and disease progression.

 Objective To analyze the rationality of clinical use of antitumor related drugs,and to provide reference for regulating physicians'prescribing behavior and promoting rational drug use.Methods In 2023,90 medical records of hospitalized patients using antitumor drugs in Yiyang Central Hospital were selected every quarter,and a total of 360 medical records were reviewed to analyze and evaluate their use.Results There were irrational use of antitumor drugs and their auxiliary drugs.Patients over 50 years old accounted for 72.12%of the unreasonable medical orders,and the departments were mainly distributed in the First Tumor Area,the Second Tumor Area and the Third General Surgery Department,accounting for 73.08%.According to the distribution of drug varieties,the top four irrational rates were Palonosetron (27.92%),Docetaxel (17.53%),Paclitaxel (albumin-bound) (11.04%) and Foxapitant (7.79%).The existing problems mainly include five aspects: inappropriate pretreatment,inappropriate usage and dosage,inappropriate route of administration,inappropriate anti-vomiting intensity and inappropriate solvent volume.Through the combination of real-time intervention by clinical pharmacists and medical quality evaluation,the unreasonable rate of medical orders (based on medical records)decreased from 35.56%in 2022 to 28.89%in 2023.Conclusion The deficiencies of clinical drug use can be found through the review of medical orders,and timely intervention measures can improve the level of clinical rational drug use.

Objective To understand the cognition degree of medical insurance policy among medical insurance related staff in Hebei Province,China,and find out the factors affecting the cognition degree,so as to provide scientific basis for promoting the implementation and development of medical insurance policy in China.Methods A total of 12 541 in-service staff engaged in medical insurance related work in provincial and municipal hospitals,medical security department and municipal medical insurance bureau in Shijiazhuang City of Hebei Province from July to August 2021 were randomly selected as the research objects to understand their cognition degree of medical insurance knowledge,and analyze and explore the factors affecting the cognition degree of medical insurance policy.Results A total of 9 417 qualified questionnaires were collected,with a passing rate of 75.1%.The results of single factor analysis showed that there were no statistically significant differences in the influence of gender,age and length of service on the degree of medical insurance cognition (P＞0.05).There were statistically significant differences in the influence of different work units,educational backgrounds,majors,professional and technical positions,and different training frequencies of medical insurance related staff on the degree of medical insurance cognition (P＜0.05).The results of multivariate analysis suggested that the working unit was a first-level hospital(β=0.329,OR=1.390,95%CI=1.239-1.559),a second-level hospital(β=0.147,OR=1.158,95%CI=1.004-1.336),and the major was clinical (β=0.243,OR=1.275,95%CI=1.122-1.449),pharmacy(β=0.228,OR=1.256,95%CI=1.071-1.474)and nursing (β=0.262,OR=1.299,95%CI=1.115-1.514),the training frequency was once a week(β=0.503,OR=1.653,95%CI=1.319-2.071),and once a month (β=0.257,OR=1.293,95%CI=1.116-1.499) were the positive factors influencing the cognition level of medical insurance.Conclusion The working unit,the major and the frequency of training are the factors that affect the cognition degree of medical insurance related staff.The relevant units should increase the frequency of training for relevant personnel,so as to improve the awareness of medical insurance related staff and promote the implementation and development of medical insurance policies.

 Objective In order to understand the oral health status and cognitive situation of middle-aged people aged 35-60 in Wenzhou City,provide reference for local health authorities to formulate medical and health policies and allocate resources for hospitals,and strive to promote the scientific development of oral health of middle-aged people.Methods In March 2023,middle-aged people aged between 35-60 in Wenzhou City were selected by sampling survey method,and a questionnaire survey was conducted from the perspectives of oral health status,daily oral habits,cognitive concepts of oral diseases and medical choices.Results A total of 300 questionnaires were issued,and 289 valid questionnaires were actually collected.Most of the respondents had oral diseases,147 people had received dental fillings,194 people were more likely to seek medical treatment in public hospitals,and only 44 people had regular oral examinations.A total of 103 people learned about oral health through oral doctors and 263 people didn't know about Pap brushing.Conclusion The survey population has poor oral health,lack of understanding of oral knowledge,and still have many bad oral health habits.The allocation of relevant medical resources need to be improved urgently,and the intensity of oral health publicity and education need to be strengthened.

Objective To study the improvement of clinical teaching quality in obstetrics and gynecology by combining scenario simulation teaching with action learning method under the guidance of direct observation of procedural skills(DOPS).Methods A total of 60 clinical medical students who practiced in obstetrics and gynecology department at the Clinical College,Affiliated Hospital of Xiangnan University from January to December 2022 were selected as the study objects and divided into control group(n=30)and observation group(n=30)according to random number table method.The control group implemented the traditional teaching method,and the observation group implemented the situational simulation teaching combined with action learning under the guidance of DOPS.The scores of the critical thinking disposition inventory-chinese version (CTDI-CV)and the students'position competency assessment scale of the two groups were compared.Results The test scores,CTDI-CV scores and students' post competency assessment scale scores of the observation group were higher than those of the control group,and the differences were statistically significant (P＜0.05).Conclusion The implementation of scenario simulation teaching combined with action learning under the guidance of DOPS in the clinical teaching of obstetrics and gynecology can effectively improve the teaching quality,and promote the improvement of assessment results,critical thinking ability and post competency of clinical medical students.

Since the introduction of the holistic nursing concept in China,psychological nursing,as part of the nursing process,has been increasingly valued.It has made certain progress in clinical practice,academic research,and theoretical construction.The government has also specifically approved the establishment of National Centers for Mental Health.The public,especially patients,have an increasing demand for psychological nursing.However,in the training of nursing professionals at the university level,there is a lack of investment in psychological nursing education,a disconnect between teaching content and clinical practice,and the quality of psychological nursing training conducted in hospitals is not high,leading to a significant supply-demand contradiction.Therefore,setting up a psychological nursing direction in the nursing programs of some medical colleges and universities is beneficial.It can shorten the training time for student nurses in psychological care after entering clinical practice,improve the quality of psychological nursing,and align with the trend of nursing education reform and development in the new era.This paper suggests adopting a talent training model for psychological nursing oriented towards societal needs;setting up a professional curriculum system centered on job competency;and aiming to ensure teaching quality by building a team of both full-time and part-time teachers.The goal is to provide an approach for the training of psychological nursing talents in universities and offer a valuable exploration for the country to improve nursing quality and build a social psychological service system.

Objective To assess the application and effect of framework for simulation teaching of Jeffries'simulation theory in fundamental of nursing practice teaching.Methods Two natural classes of undergraduate nursing in the class of 2021 were selected for the study using the whole cluster sampling method and were divided into 34 cases in the simulation teaching group and 34 cases in the traditional teaching group.The simulation group was taught using a simulation based on Jeffries simulation theory framework;the traditional teaching group was taught using the traditional theory followed by experimentation approach.The results of basic nursing operation,final theoretical results and critical thinking ability were compared between the two groups.At the same time,the teaching effect of simulation design and simulation practice was evaluated by nursing students in the simulation teaching group.Results The mean scores of the students' theoretical and skill test scores in the simulation teaching group were higher than those in the traditional teaching group,and the differences were statistically significant (P＜0.05).Nursing students in the simulation teaching group had a total score of (282.72±20.72)point on the critical thinking skills measurement scale,and their total scores and scores on all dimensions were higher than those of the traditional teaching group,the differences were statistically significant (P＜0.05).The highest mean score for the High Expectations dimension of the educational practices in simulation scale was (4.71±0.55) point,the highest mean score for the fidelity dimension of the simulation design scale was (4.53±0.64) point,and the mean scores for the students' satisfaction and self-confidence dimensions were (4.41±0.41) point and (4.24±0.40) point.Conclusion Simulation based on Jeffries Simulation Theory Framework improves learning outcomes and critical thinking skills in fundamentals of nursing.

Clinical studies of the adverse reactions of Propafenone mostly ignore gastrointestinal reactions,and there are no reports of adverse events such as severe constipation or mixed hemorrhoid incarceration.A case of arrhythmia was reported in this paper.The patient was treated with Propafenone Hydrochloride Tablets for three times,and the symptoms of constipation were repeated.According to the correlation between the patient's clinical manifestations and the duration of medication,it was considered that Propafenone Hydrochloride Tablets caused severe constipation and mixed hemorrhoid incarceration.It is suggested that the clinical application of Propafenone Hydrochloride Tablets should be started with a small dose according to the instructions,and the patients should be informed of the possible adverse reactions.If the adverse reactions still occur and can not be tolerated,the drug should be stopped in time or added with traditional Chinese medicine.

Recurrent pyogenic cholangitis is a serious disease with sudden onset and rapid progression,which can lead to chills,high fever,abdominal pain,shock and other symptoms.The condition is complex and changeable,which brings great threat to the life and health of patients.In recent years,with the development of imaging,the diagnosis rate and treatment success rate of recurrent pyogenic cholangitis have gradually increased.However,due to the initial disease manifestations of recurrent pyogenic cholangitis are sometimes atypical,and easy to overlap with other diseases,leading to aggravation of the disease and even life-threatening patients.Therefore,how to diagnose the disease in a short time and give early intervention to improve the prognosis of patients is still a great challenge for clinicians.A case of acute exacerbation of chronic obstructive pulmonary disease was reported in the Affiliated Hospital of Weifang Medical College,after admission to hospital,after admission to the hospital,the patient was diagnosed as acute obstructive suppurative cholangitis according to the changes of his condition and the results of auxiliary examination,the successful cases of endoscopic retrograde cholangiopanchography and anti-infective treatment for recurrence after improvement of the condition provide treatment ideas for clinicians to diagnose and treat recurrent suppurative cholangitis.

Objective To explore the effects of multi-mode heat preservation combined with cluster intervention on intraoperative hypothermia,stress response and rehabilitation of patients undergoing laparoscopic surgery.Methods A total of 60 patients undergoing laparoscopic surgery in Shangrao Municipal Hospital from January to December 2022 were selected as the study objects and divided into control group(n=30)and study group(n=30)according to random number table method.The control group received multi-mode heat preservation.On the basis of the control group,the study group combined with hypothermia cluster nursing strategy.The nursing satisfaction,temperature change(10 min after entry,10 min before pneumoperitoneum,ipsilateral tympanal temperature after operation),stress response (cortisol [Cor],epinephrine [E],norepinephrine[NE]),incidence of postoperative chills,recovery time,fever rate three days after surgery and postoperative complications were compared between the two groups.Results The nursing satisfaction of the study group was higher than that of the control group,the difference was statistically significant(P＜0.05).The body temperature of two groups before 10 min of pneumoperitoneum was higher than that of 10 min after entry,and the body temperature of two groups after operation was higher than that of 10 min before pneumoperitoneum,the differences were statistically significant (P＜0.05).There were no significant differences in body temperature between the two groups 10 min after entry and 10 min before pneumoperitoneum(P＞0.05).The body temperature of the study group was higher than that of the control group after operation,and the difference was statistically significant (P＜0.05).There were no significant differences in preoperative Cor,E and NE levels between the two groups (P＞0.05).The levels of Cor,E and NE in the study group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The postoperative chills rate,postoperative fever rate and postoperative complications rate of the study group were lower than those of the control group,the differences were statistically significant (P＜0.05).The recovery time of the study group was shorter than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Multi-mode heat preservation combined with cluster intervention can reduce the incidence of intraoperative hypothermia,reduce the degree of stress reaction and promote the recovery of patients undergoing laparoscopic surgery.

Objective To explore the effect of the"Internet+"health education model in obese patients with diabetes mellitus after weight loss.Methods A total of seventy obese patients with diabetes admitted to Department of General Surgery,the First Affiliated Hospital of Nanchang University from January 2022 to June 2023 were retrospectively selected as the study objects.All patients underwent sleeve gastrectomy.The patients were divided into the control group (35 cases) and the experimental group (35 cases) according to the order of discharge time.The control group adopted the routine follow-up mode,and the experimental group adopted the follow-up mode of"Internet+"health education mode.The body mass index(BMI),glucose metabolism related indicators[glycated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)],scores of Dutch eating behavior scale(DEBQ),and quality of life scale(SF-36)scores between two groups of patients at admission and 3 months after discharge were collected and compared.Results The BMI and scores of DEBQ in the experimental group at 3 months after surgery were lower than those in the control group,and the differences were statistically significant (P＜0.05).The score of SF-36 at 3 months after surgery in the experimental group was higher than that in the control group,and the difference was statistically significant (P＜0.05).There were no significant differences in glycosylated hemoglobin and insulin resistance index between the two groups at three months after surgery(P＞0.05).The glycosylated hemoglobin and insulin resistance index of the two groups three months after surgery were lower than those of the same group before surgery,and the differences were statistically significant(P＜0.05).Conclusion The"Internet+"health education model can improve postoperative weight loss indicators,healthy eating behaviors and quality of life in obese patients with diabetes,but the impact on glucose metabolism indicators remains to be studied.

Objective To explore the application effect of information platform based on Caprini risk assessment in patients with hip fracture and its influence on postoperative deep vein thrombosis.Methods A total of 120 patients with hip fracture admitted to the Second Affiliated Hospital of Nanchang University from January 2020 to January 2023 were selected as the study objects and they were divided into two groups using random number table method.Patients in the control group (60 cases)were given routine nursing measures,while patients in the observation group (60 cases)were given nursing measures based on the information platform and their own conditions after Caprini risk assessment classification.Relevant data of patients in both groups were collected from 1 day before intervention to 4 weeks after intervention.The Harris hip score(HHS),Barthel index (BI),white blood cell (WBC),procalcitonin (PCT),C-reactive protein (CRP),platelet (PLT),activated partial thromboplastin time(APTT),thrombin time(TT),D-dimer(D-D),patient satisfaction score,incidence of deep vein thrombosis and maximum width of thrombus in patients with deep vein thrombosis were compared between the two groups.Results After intervention,the satisfaction and postoperative recovery index (HHS,BI) of patients in observation group were higher than those in control group,the differences were statistically significant (P＜0.05).The inflammation index (WBC,PCT,CRP),the incidence of deep vein thrombosis,and the maximum width of thrombus in patients with deep vein thrombosis in observation group were lower than those in control group,with statistical significances (P＜0.05).After intervention,PLT,APTT,D-D in observation group were higher than those in control group,and TT was lower than those in control group,with statistical significances (P＜0.05).Conclusion The nursing measures constructed by the information platform based on Caprini risk assessment have good effects on the postoperative recovery of patients with hip fracture and the prevention of deep vein thrombosis.

Objective To explore the application effect of the traditional Chinese medicine (TCM)nursing model based on the combination of medical care and nursing care in elderly patients after hip replacement surgery.Methods A convenience sample of 63 patients who underwent hip replacement surgery in the joint surgery department of Foshan Hospital of Traditional Chinese Medicine from April 2021 to April 2022 was selected as the control group,and 64 patients who underwent hip replacement surgery from May 2022 to May 2023 were selected as the observation group.The control group received routine rehabilitation nursing training after surgery,while the observation group received a TCM rehabilitation nursing program based on the combination of medical care and nursing care on top of the control group.After 1 and 3 months of intervention,the hip joint function,agoraphobia,and daily activity ability scores of both groups were evaluated.Results After 1 and 3 months of intervention,the hip joint function score,agoraphobia score,and daily activity ability score of the observation group were higher than those of the control group,and the differences were statistically significant (P＜0.05).Conclusion The traditional Chinese medicine nursing mode based on the combination of medical and nursing can improve the hip function level of elderly patients after hip replacement and reduce the level of kinetophobia，which worthy of clinical promotion.

Objective To explore the implementation strategy of nutritional care in elderly patients with lung cancer and pulmonary tuberculosis.Methods A total of 90 elderly patients with lung cancer combined with tuberculosis admitted to the Department of Cancer Oncology,Jiujiang Third People's Hospital from January 2020 to January 2023 were selected as the study objects.They were divided into control group and observation group by random number table method,with 45 cases in each group.The control group received routine nursing,and the observation group received nutritional nursing intervention on the basis of this.The nutritional indexes,immune indexes and quality of life scores of the two groups were compared.Results The body weight of the observation group after nursing was higher than that of the control group,the difference was statistically significant (P＜0.05).There were no significant differences in levels of albumin,hemoglobin and prealbumin after nursing between the two groups (P＞0.05).The levels of CD3+and CD4+in the observation group after nursing were higher than those in the control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the quality of life score between the two groups before and after nursing(P＞0.05),and the quality of life score of the observation group after nursing was higher than that of the control group,the difference was statistically significant (P＜0.05).Conclusion For elderly patients with lung cancer and pulmonary tuberculosis,nutritional nursing interventions can improve nutritional indicators,immune function,and quality of life,and are worthy of clinical adoption.

The concept of modern clinical medicine tends to be precise and minimally invasive.Because of its special anatomical location,adjacent to important blood vessels and nerves,spinal surgery requires more safety and accuracy in clinical practice.3D printing technology takes 3D image data as the basic data,designs and plans the required 3D digital model through special 3D printing computer software.After importing the printer,a variety of materials can be used for physical printing.3D printing technology is a combination of digital information technology,digital industrial technology,biochemical materials and other cutting-edge technologies,widely used in aerospace materials,industrial manufacturing,biological research and clinical medical fields,involving digital anatomical model construction,organ physical printing,artificial prosthesis replacement,navigation board design and other aspects of clinical medical applications.3D printing guide plates technology can pre-plan and design intraoperative navigation channels according to clinical needs,and has the characteristics of accurate navigation and safe positioning,which has great development prospects in spinal surgery.This article reviews the research progress of 3D printing guide plates in spinal surgery.

 Diabetic microangiopathy possesses typical clinical manifestations such as microvascular basement membrane thickening,microangioma formation,and microcirculation disorders,and is one of the most common diabetic complications.The disease not only adversely affects the quality of life of patients,but also aggravates the economic burden of patients,and has become a major lethal factor for diabetic patients.Diabetic microangiopathy most often attacks the kidneys,retina,and nervous system.Leech,as an insect medicine with significant efficacy in activating blood circulation and removing blood stasis,its main component hirudin has the strongest thrombin inhibitor to date,which can significantly improve microcirculation,prevent platelet aggregation and play the role of lipid regulation and stabilization of plaque.The efficacy in diabetic vasculopathy is remarkable and also provides reference for its comprehensive prevention and treatment.In this paper,the application and current research status of leech and its extracts in diabetic microangiopathy are reviewed to provide more hints for further research on leech and its extracts in related diseases.

Chronic obstructive pulmonary disease (COPD),the most common chronic airway disease,occurs frequently in China,and its pathogenesis is still unclear.COPD,as a psychosomatic disease,not only affects the physical and mental health of patients,but also causes sleep disorders.As a common concomitant symptom of COPD patients,the incidence of sleep disorders is high,and the main influencing factors are disease factors,environmental factors,psychological factors and treatment factors.COPD patients are complicated with sleep disorders,which affect the sleep quality of patients,but also bring anxiety and depression and other emotions,affecting the prognosis of patients.In recent years,more and more scholars have conducted research on patients with COPD accompanied by sleep disorders,and given relevant interventions,which have achieved certain effects,including psychological intervention,exercise therapy,music therapy,general therapy and Chinese medicine treatment.This article reviews the current research status of COPD with sleep disorders in recent years,and provides reference and new ideas for the treatment and nursing of these patients in the future.

Xiangju preparation is the general name of Xiangju tablets,Xiangju drops and Xiangju capsules.It is a Chinese patent medicine with different dosage forms developed by the same prescription,has the effect of clearing heat and detoxifying,dispelling wind,and is one of the commonly used drugs in ear,nose and thoat department.On the basis of previous literature studies,this paper systematically reviewed the chemical composition,pharmacological activity,clinical efficacy and medication nursing of Xiangju preparation in sinusitis and otitis media in recent years by literature induction method.There are 137 chemical components identified in the preparation,mainly flavonoids,phenyl-propanoids and organic acids,etc.Its pharmacological activity is mainly through phenols,flavonoids,alkaloids and volatile oils and other compounds to play efficacy,and then show anti-inflammatory,deswelling and antibacterial effects.In terms of clinical application,Xiangju preparation can be combined with a variety of therapeutic means to improve the total effective rate and significant efficiency of the treatment of sinusitis and otitis media,with safety and effectiveness,and appropriate medication nursing intervention can improve the therapeutic effect of patients.The pharmacodynamic substances,pharmacological activities and clinical application of Xiangju preparation in the treatment of sinusitis and otitis media were systematically described in this paper,which can provide scientific basis for the clinical application and promotion of Xiangju preparation.