中国当代医药

Effect of Oseltamivir on platelet and coagulation function in patients with sepsis

Objective To investigate the effect of Oseltamivir on platelet and coagulation function in patients with pyemia.Methods From January 2108 to February 2020,a total of 59 patients with sepsis admitted to the Third Affiliated Hospital of Nanchang University were selected as the research objects,and divided into the control group(n=29)and the Oseltamivir group(n=30)according to the random number table method.The control group was treated with conventional comprehensive,while the patients in the Oseltamivir group received Oseltamivir on the basis of routine treatment.The platelet parameters(activated clotting time of whole blood[ACT],clot rate[CR],platelet count[PLT],platelet function[PF])and coagulation function indicators(prothrombin time[PT],activated partial prothrombin time[APTT],fibrinogen[FBG])were compared between the two groups when entered the department and 1,3,5,7 days after treatment.Results After the treatment,the PLT and PF of the Oseltamivir group were higher than those of the control group,the differences were statistically significant(P＜0.05).After the treatment,the ACT,PF,PT,APTT and FBG of the Oseltamivir group were lower than those of the control group,the differences were statistically significant(P＜0.05).There was no statistically significant difference in the total incidence of adverse events between the two groups(P＞0.05).Conclusion Oseltamivir can improve platelet and coagulation function significantly in patients with sepsis,which is worthy of clinical promotion.

Clinical application effect comparison of direct anterior approach and posterior approach in one-stage bilateral total hip arthroplasty

Objective To compare the clinical effect of direct anterior approach(DAA)and posterior approach(PA)in one-stage bilateral total hip arthroplasty.Methods The clinical data of 61 patients underwent primary total hip arthroplasty in Fuzhou Second Hospital,Affiliated Hospital of Xiamen University from January 2015 to December 2019 were retrospectively analyzed.Among the patients,32 cases were in DAA group and 29 cases were in PA group.The anesthesia time,intraoperative blood loss,postoperative hospital stay,the mean absolute error of cup anteversion and abduction angle,lower limb length discrepancy,Harris hip joint function scale(HHS)and postoperative complications were compared between the two groups.Results The anesthesia time and postoperative hospital stay in DAA group were shorter than those in PA group,the differences were statistically significant(P＜0.05).The HHS scores of the two groups at 1,3 and 6 months after surgery were higher than those before surgery,and the differences were statistically significant(P＜0.05).The HHS scores of DAA group at 1 and 3 months after surgery were higher than those of PA group,and the differences were statistically significant(P＜0.05).There was no significant difference in HHS score between the two groups at 6 months after surgery(P＞0.05).There was no significant difference in intraoperative blood loss between the two groups(P＞0.05).In postoperative imaging evaluation,acetabular inclination error,acetabular abduction angle error and absolute length difference of lower limbs in DAA group were all smaller than those in PA group,with statistical significances(P＜0.05).In DAA group,there were 4 cases of unilateral femoral lateral cutaneous nerve symptoms and 2 cases of unilateral femoral prosthesis.In the PA group,there was 1 case of unilateral femoral prosthesis.Conclusion The clinical application effect of direct anterior approach in one-stage bilateral total hip arthroplasty is better than that of posterior approach in total hip arthroplasty,which is worthy of clinical application.

Clinical analysis of 29 cases of eosinophilic dermatitis

Objective To investigate the clinical characteristics,the laboratory examinations and the treatment methods of the eosinophilic dermatitis.Methods The clinical data of 29 patients with eosinophilic dermatitis admitted to the Department of Dermatology,Air Force Special Medical Center,PLA from January 2012 to December 2019 were retrospectively analyzed.Results Among the 29 patients,the male to female ratio was 3.1∶1,and the average age was(61.3±14.18)years old.Twenty-eight patients had generalized rashes,which could be mainly manifested in two types.One was infiltrated or swollen erythema,accounting for 41.4%;the other was generalized firm papules,nodules,with or without moss-like changes and dry desquamation,accounting for 31.0%.The laboratory examination showed that besides an obvious increase in eosinophils,85.2% of patients presented with elevated lactate dehydrogenase,and 63.0%of patients with elevated alpha-hydroxybutyrate decarboxylase.Through oral administration of low to medium dose of glucocorticoids alone or low to medium dose of glucocorticoids combined with immunosuppressive agents,the rashes were visibly improved.Conclusion The rash of eosinophilic dermatitis has no obvious specificity,and the treatment effect of low to medium dose of glucocorticoids or low to medium dose glucocorticoids combined with immunosuppressive agent obtains a preferable effect.

Clinical value of combined detection of cystatin-C,neutrophil gelatinaseassociated lipocalin and kidney injury molecule-1 in patients with pregnancy-induced hypertension and nephropathy

Objective To explore the clinical value of combined detection of cystatin-C(Cys-C),neutrophil gelatinaseassociated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)in patients with pregnancy-induced hypertension and nephropathy.Methods A total of 180 patients with pregnancy-induced hypertension who were admitted to Bao′an Central Hospital of Shenzhen City from February 2018 to August 2020 were randomly selected as the research subjects,based on the urine albumin/creatinine ratio(uACR),the patients were divided into simple pregnancy-induced hypertension group(group A,uACR＜30 mg/g,90 cases),early pregnancy-induced hypertension syndrome combined with acute kidney injury group(group B,30 mg/g≤uACR＜300 mg/g,50 cases),clinical pregnancy-induced hypertension nephropathy group(group C,ACR≥300 mg/g,40 cases),and 100 normal pregnant women were selected as the control group during the same period.The dynamic changes of serum NGAL,KIM-1 and Cys-C concentrations in each group were compared,the correlation between serum NGAL,KIM-1,Cys-C levels and uACR was analyzed,and the receiver operating characteristic(ROC)curve was used to analyze each various indicators to determine the efficacy of early renal injury in patients with pregnancy-induced hypertension.Results The serum NGAL,KIM-1 and Cys-C levels of the group A,the group B and the group C were higher than those of the control group,and the group C＞the group B＞the group A,the differences were statistically significant(P ＜0.05).According to Spearman correlation analysis,serum NGAL,KIM-1,Cys-C levels of patients in group B and C were positively correlated with uACR(r=0.651,0.673,0.563, P＜0.05).ROC curve analysis showed that the AUCs of NGAL,KIM-1,Cys-C and the combined test of the three to diagnose early renal injury in patients with pregnancy-induced hypertension were 0.754(95%CI:0.685-0.908),0.804(95%CI:0.689-0.913),0.763(95%CI:0.683-0.907)and 0.923(95%CI:0.858-0.998);the best cut-off values for NGAL,KIM-1,and Cys-C were 44.5 ng/mL,37.8 ng/L and 1.3 mg/L,respectively,the sensitivity of NGAL,KIM-1,Cys-C and the combination of the three was 74.57%,81.25%,73.01% and 95.61%,respectively,and the specificity of NGAL,KIM-1,Cys-C and the combination of the three was 76.03%,72.34%,82.24% and 98.64%,respectively.Conclusion Serum NGAL,KIM-1 and Cys-C levels are significantly positively correlated with the degree of renal impairment in patients with pregnancy-induced hypertension.The combined detection of NGAL,KIM-1 and Cys-C has good clinical diagnostic value in predicting the diagnostic efficacy of acute kidney injury in pregnancy-induced hypertension syndrome.

Comparative analysis of the value of 6 cores and 10+x cores ultrasoundguided transrectal prostatic biopsy in the diagnosis of prostate cancer

Objective To compare the diagnostic value of ultrasound-guided transretal prostatic biopsy with 6 cores and 10+x(x is several cores,and ＜10)cores in the diagnosis of prostate cancer.Methods Databases including PubMed,Embase,Web of science,SCI,China Biomedical Literature Database,CNKI,WanFang Database and VIP Database were searched from 2009 to 2019.According to the established inclusion and discharge criteria，the relevant literature was searched,and the documents that meet the standards were selected as the final included literature and extracted data and assessed the risk of bias of eligible studies.The included literatures were statistically analyzed using Review Manager 5.3 software.Results A total of 16 literatures were included,including 1 randomized controlled study and 15 case-control studies.Among them,5 studies were intergroup controls.A total of 674 patients were included in the intergroup controls,including 320 patients in the 6 cores group and 354 patients in the 10+x cores group.And another 11 studies were self-control which consists of 3730 patients.Meta-analysis showed that the detection rate of prostate cancer in the 6 cores group guided by transrectal ultrasound prostatic biopsy was lower than that in the 10+x cores group(OR=0.53,95%CI:0.37～0.74, P=0.0002[inter group control], OR=1.44,95%CI:1.30～1.59, P＜0.000 01[intragroup self control]).There was no significant difference in the incidence of complications between the two groups(OR=0.60,95%CI:0.26～1.36, P=0.22).Conclusion Ultrasound-guided transretal prostatic biopsy with 10+x cores has a high detection rate for prostate cancer,which is worthy of clinical application.

Objective To observe the detection rate of patients with carotid artery and fundus arteriosclerosis in the physical examination population,and analyze the risk factors.Methods A total of 647 employees and retired employees from Northern Company who came to the Beifang Section of Peking University Third Hospital from May to December 2018 to participate in physical examination were selected.Sex,age,history of hypertension,coronary heart disease,and diabetes were recorded.Systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),bone mineral density(BMD),abdominal color ultrasound,carotid artery ultrasound and fundus vessels were examined.According to the results of carotid ultrasound,they were divided into non carotid atherosclerosis group(n=437)and carotid atherosclerosis group(n=210).According to the results of fundus examination,they were divided into non fundus arteriosclerosis group(n=534)and fundus arteriosclerosis group(n=113).The clinical datas of non carotid atherosclerosis group and carotid atherosclerosis group,non fundus arteriosclerosis group and fundus arteriosclerosis group were compared. Logistic regression was used to analyze the risk factors of carotid arteriosclerosis and fundus arteriosclerosis. Results The detection rate of carotid arteriosclerosis was 32.5% and fundus arteriosclerosis was 17.5% in 647 patients.Univariate analysis showed that the proportion of men,age,history of hypertension,history of coronary heart disease,history of diabetes,decreased bone mineral density,SBP,DBP,FBG,UA and TC levels in the carotid atherosclerosis group were higher than those in the non carotid atherosclerosis group,and the level of HDL-C was lower than that in the non carotid atherosclerosis group,with statistical significances(P＜0.05).Univariate analysis showed that the proportion of men,age,history of coronary heart disease,history of diabetes,decreased bone mineral density,SBP,DBP,FBG and UA levels in the fundus arteriosclerosis group were higher than those in the non fundus arteriosclerosis group,and the level of HDL-C was lower than that in the non fundus arteriosclerosis group,with statistical significances(P＜0.05). Logistic multivariate analysis showed that male(β=0.673, OR=0.510,95%CI= 0.263-0.991),age(β=0.128, OR=1.136,95%CI=1.110-1.163),decreased bone mineral density(β=0.735, OR=2.085,95%CI=1.212-3.587)and SBP(β=0.031, OR=1.031,95%CI=1.008-1.056)were risk factors for carotid atherosclerosis(P＜0.05).HDL-C(β=-1.326, OR=0.265,95%CI=0.107-0.661)was a protective factor for carotid atherosclerosis(P＜0.05). Logistic multivariate analysis showed that age(β=0.091, OR=1.095,95%CI=1.071-1.120),diabetes mellitus(β=0.900,OR=2.460,95%CI=0.981-6.167)and SBP(β=0.034, OR=1.035,95%CI=1.014-1.056)were risk factors for fundus arteriosclerosis(P＜0.05).According to the age group analysis of the occurrence of atherosclerosis,the results showed that,with the growth of age,the incidence of all atherosclerosis increased,carotid atherosclerosis occurred earlier than fundus artery.Conclusion The occurrence of carotid and fundus arteriosclerosis is related to gender(male),age,diabetes,high systolic blood pressure and decreased bone density.People should have regular physical examination and actively control the risk factors.

Research process of traditional Chinese medicine moxibustion in nursing primary dysmenorrhea

Primary dysmenorrhea refers to dysmenorrhea without organic lesions in reproductive organs,which is a frequently-occurring disease in women.The pain attack seriously affects the work and life of patients.Traditional Chinese medicine moxibustion is a traditional Chinese medicine treatment method.The methods of nursing primary dysmenorrhea include suspension moxibustion,ginger-separated moxibustion,medicine-separated moxibustion and comprehensive therapy,all of which have significant clinical effect on relieving primary dysmenorrhea.This article analyzed the current situation of moxibustion nursing primary dysmenorrhea from the aspects of etiology,pathogenesis,harm,application methods and application effect through searching the relevant literature in China National Knowledge Internet,Wanfang and VIP databases.The aim is to explore the curative effect of moxibustion in relieving primary dysmenorrhea and to provide new ideas and directions for moxibustion nursing primary dysmenorrhea.

The decision-making for the treatment of breast lesions is affected by the pathological results,but the underestimation of puncture pathology occurs frequently.In order to improve the detection rate of lesions and the pathological coincidence rate,it is necessary to evaluate types of lesions which are easily missed or underestimated.This paper analyzed the underestimation rates of different types of breast lesions by ultrasound-guided needle biopsy in recent years,possible causes of underestimation,and high-risk factors for underestimation.Auxiliary methods could be used to improve the detection rate and evaluation accuracy of ultrasound-guided needle biopsy in the diagnosis of non-mass and small-volume breast lesions.The evaluation accuracies of intraductal papillary lesions and invasive breast cancer were relatively high.However,due to the tumor heterogeneity and tumor center necrosis,it was necessary to conduct multi-point selection of cancer materials for invasive breast cancer to improve the coincidence rate of immunohistochemical conclusions.The evaluation accuracies of atypical hyperplasia,lobular carcinoma in situ,and ductal carcinoma in situ were not ideal,and follow-up close monitoring or surgical treatment was required.For breast lesions that might be malignant,a puncture sheath should be used during puncture to avoid the occurrence of puncture needle implant transfer,or radiotherapy should be used in subsequent treatment to reduce the chance of implant transfer.In summary,ultrasound-guided hollow-core needle biopsy is currently the preferred method for diagnosing breast lesions.Nuclear magnetic-guided needle biopsy and vacuum-assisted biopsy can become new choices for material selection.

Holmium laser lithotripsy has been widely used in the treatment of biliary calculi.Compared with traditional surgical methods,holmium laser lithotripsy has obvious advantages such as simple operation,accurate lithotripsy,safe and effective,small trauma and rapid recovery,which can effectively shorten the operation time,reduce the intraoperative blood loss,reduce the postoperative residual stone rate and postoperative complications.The author reviewed the theoretical knowledge,equipment preparation,technical operation specification and complications treatment of clinical application of holmium laser in the treatment of bile duct stones,so as to popularize and standardize the use of the technology in order to maximize the benefit to patients and provide reference for subsequent research.

Difficulty in urination caused by benign prostatic hyperplasia is a common urological disease.Androgens and age are the main known pathogenic factors.Obesity,hyperlipidemia,and diabetes are also closely related.The screening methods for prostate tumors are anal diagnosis,total prostate specific antigen test,and ultrasound.Urodynamic tests can help identify neurogenic bladder,overactive bladder,etc.Most patients can improve their symptoms with medications,and prostate resection is the standard treatment.Strict surgical indications are the prerequisite to ensure the curative effect of the operation.Appropriate surgical method can enhance the curative effect and improve postoperative complications.This article reviews the progress of diagnosis and treatment of prostate hyperplasia,such as etiology,diagnosis,screening methods,drug efficacy,surgical indications,minimally invasive treatment and postoperative complications.

Objective To investigate the significance of mRNA expression of specific tumor markers in peripheral blood in micro-metastasis of non-small cell lung cancer(NSCLC).Methods The mRNA expressions of CK19,LUNX and CEA in peripheral blood of 52 NSCLC patients and 30 normal subjects(the reference group)who were admitted to the Department of Pathology of Jiangxi Chest Hospital from January 2019 to November 2020 were detected by reverse transcription polymerase chain reaction(RT-PCR)technique.The relationship between micro-metastatic markers and pathological types,degree of differentiation and clinical stages in NSCLC patients was analyzed.Results The mRNA positive rates of CK19,LUNX and CEA in NSCLC group were 38.46%,57.69% and 44.23%,respectively,which were higher than those in the control group(0.00%,0.00% and 0.00%),and the differences were statistically significant(P＜0.05).The positive rate of LUNX mRNA in stage Ⅲof NSCLC patients was higher than that of the patients in stage Ⅰand Ⅱ,and the difference was statistically significant(P＜0.0167).The positive rate of LUNX mRNA in highly differentiated NSCLC patients was lower than that in poorly differentiated and moderately differentiated NSCLC patients,and the difference was statistically significant(P＜0.0167).Conclusion The positive rate of LUNX mRNA expression increases with the increase of TNM stage in NSCLC patients,and decreases with the increase of differentiation degree,which is closely related to the micro-metastasis of NSCLC patients,and can be used as a molecular marker for the detection of micro-metastasis in NSCLC patients,which is of great significance for the early diagnosis of lung cancer metastasis and the guidance of clinical staging and treatment.

Objective To investigate the expression of epidermal growth factor receptor(EGFR)and vascular endothelial growth factor receptor(VEGFR)in triple-negative breast cancer(TNBC)and their correlations with pathological characteristics.Methods A total of 200 breast cancer patients who underwent surgeries in Foshan Chancheng Central Hospital from March 2018 to March 2020 were retrospectively selected as the research subjects,including 100 TNBC patients and 100 non-TNBC patients.The clinicopathological data of all patients were collected,including age,menstrual status,pathological type,clinical stage,histological grade,lymph node metastasis, etc.The postoperative pathological tissues were collected to detect the expression of EGFR and VEGFR,and the differences in expression and their correlations with the clinicopathological characteristics of TNBC were analyzed.Results The positive expression rates of EGFR and VEGFR in the TNBC group were higher than those in the non-TNBC group,with statistically significant differences(P＜0.05).The expression of EGFR in TNBC patients was related to lymph node metastasis,while the expression of VEGFR was related to clinical stage,histological grade,and lymph node metastasis(P＜0.05). Spearman correlation analysis showed that there was a positive correlation between the expression of EGFR and VEGFR in TNBC patients(r=0.306, P＜0.05).Conclusion High expression of EGFR and VEGFR are existed in TNBC patients,and there is a correlation between their expression and pathological characteristics,which has certain significance on evaluating the condition and prognosis of TNBC.

Objective To explore the application effect of three-dimensional visualization and 3D data measurement in the treatment of esophageal gastric varices(EGV).Methods A total of 40 esophageal and gastric variceal bleeding patients suitable for endoscopic treatment who were admitted to the First Affiliated Hospital of Gannan Medical University from October 2018 to October 2019 were selected and divided into routine treatment group and 3D auxiliary group according to random number table method,with 20 cases in each group.The routine treatment group was given ultrasonic endoscopy combined with enhanced CT auxiliary treatment,while 3D auxiliary group was given three-dimensional observation and 3D measurement on basis of control group.The clinical curative effect was evaluated at 1 week after the end of treatment.The postoperative complications were observed.The two groups were followed up at 3,6 months and 1 year after treatment.The re-bleeding rate and mortality were statistically analyzed.Results There were no statistically significant differences between the two groups in the total effective rate of esophageal varices and esophageal varices(P＞0.05).The incidence of fever and chest pain in 3D auxiliary group was lower than that in routine treatment group,and the differences were statistically significant(P＜0.05).The incidence of re-bleeding at 1 year after treatment in 3D auxiliary group was lower than that in routine treatment group,and the difference was statistically significant(P＜0.05).Conclusion The application of three-dimensional visualization and 3D data measurement in the guidance of endoscopic EGV treatment is beneficial to reduce the occurrence risk of re-bleeding and complications.

Objective To study and analyze the clinical characteristics of patients with acute stroke and myocardial injury.Methods Clinical data of 106 patients with acute stroke admitted to the Department of Cardiology of Baiyun Hospital Affiliated to Guizhou Medical University from May 2017 to May 2019 were analyzed retrospectively,and divided into the acute stroke group and the acute stroke combined with myocardial injury group according to the type of disease,with 53 cases in each group.Examined the patients by routine electrocardiogram and myocardial enzyme spectroscopy,and the results of the evaluation were compared and analyzed based on the symptoms.Results The total diagnosis rate of abnormal in the acute stroke combined with myocardial injury group was higher than that in the acute stroke group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the lactate dehydrogenase(LDH)index results between the two groups(P＞0.05).The aspartate aminotransferase(AST),creatine phosphokinase(CK)and creatine kinase isoenzymes(CK-MB)indexes of patients in the acute stroke combined with myocardial injury group were higher than those in the acute stroke group,and the differences were statistically significant(P＜0.05).Conclusion The clinical characteristics of patients with acute stroke and myocardial injury are negative,conduction abnormality,and elevated myocardial enzyme spectrum,which can provide scientific basis for later treatment and prognosis.

Objective To investigate the clinical effect of hyaluronic acid repairing biofilm in the treatment of adult eczema.Methods A total of 66 cases of adult eczema patients in the Department of Dermatology,the Seventh People′s Hospital of Shenyang City from September 2017 to September 2019 were selected as the research objects and divided into the control group and observation group according to the dynamic random grouping method,with 33 cases in each group.The control group was treated with Hydrocortisone Butyrate Cream,and the observation group was treated with Hydrocortisone Butyrate Cream+hyaluronic acid repair biofilm.The treatment effect,clinical symptom disappearance time,complication rate and quality of life of the two groups were compared.Results 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 disappearance time of pruritus,skin lesions and erythema of the observation group were shorter than those of the control group,and the differences were statistically significant(P＜0.05).The total incidence of complications of the observation group was lower than that of the control group,and the difference was statistically significant(P＜0.05).After the intervention,the quality of life scores of the observation group were higher than those of the control group,and the differences were statistically significant(P＜0.05).Conclusion Hyaluronic acid repairing biofilm is effective in the treatment of adult eczema.

Objective To explore the application effect of different doses of Formoterol in moderate to severe chronic obstructive pulmonary disease(COPD).Methods A total of eighty-four moderate and severe COPD patients admitted to Fengcheng People′s Hospital from June 2019 to June 2020 were selected as the research subjects and divided into group A(42 cases)and group B(42 cases)by random number table method.Group A was treated with conventional dose of Formoterol,and group B was treated with double dose of Formoterol.The lung function(forced expiratory volume in the first second[FEV1]and FEV1 as a percentage of predicted value[FEV1%]and FEV1/forced vital capacity[FVC]),endothelial function(vascular endothelial growth factor[VEGF]and endothelin-1[ET-1],nitric oxide[NO])and the total incidence of adverse reactions of two groups were compared.Results Before and after treatment,there were no significant differences in FEV1,FEV1% and FEV1/FVC between the two groups(P＞0.05).After treatment,FEV1% and FEV1/FVC levels in both groups were higher than those before treatment,with statistical significance differences(P＜0.05).Before and after treatment,there were no significant differences in VEGF,ET-1 and NO between the two groups(P＞0.05).After treatment,the levels of VEGF,and NO in both groups were higher than those before treatment,ET-1 level was lower than that before treatment,the differences were statistically significant(P＜0.05).The total incidence of adverse reactions in group B was higher than that in group A,and the difference was statistically significant(P＜0.05).Conclusion Formoterol treatment for patients with moderate to severe COPD has significant therapeutic effects.Large doses of Formoterol will increase the incidence of adverse reactions.

Objective To explore the effect of resistance exercise combined with aerobic exercise in the cardiac rehabilitation of patients with chronic heart failure(CHF).Methods A total of 90 CHF patients admitted to People′s Hospital of Zhongshan City from August 2019 to December 2019 were selected as the research objects and divided into aerobic exercise group,resistance exercise group and combined exercise group according to the random number table method,with 30 cases in each group.The aerobic exercise group used aerobic training,the resistance exercise group used resistance exercises,and the combined exercise group used resistance training combined with aerobic training.Cardiac function(left ventricular ejection fraction[LVEF],left ventricular diastolic diameter[LVEDD]),physical function(Chinese version mini-physical performance test[CM-PPT])and quality of life(China questionnaire of quality of life in patients with cardiovascular diseases[CQQC])scores were compared between the three groups before intervention and 12 weeks after intervention.Results Before intervention,there was no statistically significant differences in the LVEF,LVEDD,CM-PPT and CQQC in the three groups(P＞0.05).After intervention,the LVEF,CM-PPT and CQQC in the combined exercise group were higher than those in the resistance exercise group and the aerobic exercise group,the LVEF,CM-PPT and CQQC in the resistance exercise group were higher than those in the aerobic exercise group,and the differences were statistically significant(P＜0.05).After intervention,the LVEDD of the combined exercise group was lower than that of the resistance exercise group and the aerobic exercise group,and the LVEDD of the resistance exercise group was lower than that of the aerobic exercise group,and the differences were statistically significant(P＜0.05).Conclusion Resistance exercise combined with aerobic exercise can improve the heart function of patients with CHF,improve the physical function of patients,and promote the quality of life.

[Key words]Chronic heart failure;Resistance exercise;Aerobic exercise;Cardiac rehabilitation;Quality of life

Application research of resistance exercise combined with aerobic exercise in cardiac rehabilitation of patients with chronic heart failure

LU Xiao-qian ZHU Xiu-xian TIAN Shao-xin ZENG Xi-lian RAO Xiao-ling
CCU,People′s Hospital of Zhongshan City,Guangdong Province,Zhongshan 528400,China

[Abstract]Objective To explore the effect of resistance exercise combined with aerobic exercise in the cardiac rehabilitation of patients with chronic heart failure(CHF).Methods A total of 90 CHF patients admitted to People′s Hospital of Zhongshan City from August 2019 to December 2019 were selected as the research objects and divided into aerobic exercise group,resistance exercise group and combined exercise group according to the random number table method,with 30 cases in each group.The aerobic exercise group used aerobic training,the resistance exercise group used resistance exercises,and the combined exercise group used resistance training combined with aerobic training.Cardiac function(left ventricular ejection fraction[LVEF],left ventricular diastolic diameter[LVEDD]),physical function(Chinese version mini-physical performance test[CM-PPT])and quality of life(China questionnaire of quality of life in patients with cardiovascular diseases[CQQC])scores were compared between the three groups before intervention and 12 weeks after intervention.Results Before intervention,there was no statistically significant differences in the LVEF,LVEDD,CM-PPT and CQQC in the three groups(P＞0.05).After intervention,the LVEF,CM-PPT and CQQC in the combined exercise group were higher than those in the resistance exercise group and the aerobic exercise group,the LVEF,CM-PPT and CQQC in the resistance exercise group were higher than those in the aerobic exercise group,and the differences were statistically significant(P＜0.05).After intervention,the LVEDD of the combined exercise group was lower than that of the resistance exercise group and the aerobic exercise group,and the LVEDD of the resistance exercise group was lower than that of the aerobic exercise group,and the differences were statistically significant(P＜0.05).Conclusion Resistance exercise combined with aerobic exercise can improve the heart function of patients with CHF,improve the physical function of patients,and promote the quality of life.

Objective To explore the changes and clinical significance of soluble urokinase plasminogen activator receptor(SuPAR)levels in adults with severe pneumonia.Methods A total of 60 adult patients with pneumonia admitted to Qingyuan People′s Hospital were selected as the research subjects from May 2018 to February 2021.According to the severity of the disease,the patients were divided into group B(patients with common pneumonia,30 cases)and group C(patients with severe pneumonia,30 cases).Meanwhile,thirty healthy individuals were selected as group A.Serum SuPAR levels of the three groups were compared.The pneumonia severity index(PSI)scores of group B and group C were compared.Univariate analysis and multiple linear regression analysis were performed to screen the prognostic factors of patients with severe pneumonia,and the ROC curve was used to analyze the value of serum SuPAR level in predicting severe pneumonia.Results There were significant differences in serum SuPAR levels among the three groups(P＜0.05).The serum SuPAR level of group C was higher than that of group A and B,and the serum Su-PAR level of group B was higher than that of group A,the differences were statistically significant(P＜0.05).The PSI score of group C was higher than that of group B,with statistically significant difference(P＜0.05).The mortality of critically ill patients in 1 month after admission was 20%.Upon admission,the acute physiology and chronic health evaluation Ⅱ(APACHEⅡ),serum SuPAR,procalcitonin(PCT)and receptor of advanced glycation end products(RAGE)were risk factors for severe pneumonia(P＜0.05).The area under the ROC curve of SuPAR for predicting symptomatic pneumonia was 0.932(95%CI=0.866-0.999, P＜0.05).Conclusion Serum SuPAR level is significantly elevated in adults with severe pneumonia,which can be used for severity assessment and prognosis,with certain sensitivity and specificity.It′s clinical value is high.

Objective To investigate the clinical effect of Compound Glycyrrhizin and Diammonium Glycyrrhizinate in the treatment of drug-induced liver injury.Methods A total of 120 patients with drug-induced liver injury admitted to the Department of Psychiatry,Brain Hospital Affiliated to Nanjing Medical University from June 2019 to June 2020 were selected and divided into the observation group and the control group according to random number table method,with 60 cases in each group.The observation group was given oral administration of Diammonium Glycyrrhizinate Enteric Coated Tablets and Tiopronin,combined with other conventional treatment;the control group was given oral administration of Compound Glycyrrhizin and Tiopronin,combined with other conventional treatment.Liver function indexes,inflammatory cytokine levels and the incidence of adverse reactions in the two groups were compared before and after treatment.Results Before treatment,there were no statistically significant differences in alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)levels between the two groups(P＞0.05).After treatment,The levels of ALP,ALT,AST and TBil in the two groups were lower than those before treatment,and the levels of ALP,ALT,AST and TBil in observation group were lower than those in control group,and the differences were statistically significant(P＜0.05).Before treatment,there were no statistically significant differences in interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)levels between the two groups(P＞0.05).After treatment,The levels of IL-6,IL-1β and TNF-α in the two groups were lower than those before treatment,and the levels of IL-6,IL-1β and TNF-α in observation group were lower than those in control group,and the differences were statistically significant(P＜0.05).The incidence of digestive system symptoms and pseudo aldosteronism in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the incidence of cardiovascular system symptoms between the two groups(P＞0.05).Conclusion Diammonium Glycyrrhizinate Enteric Coated Tablets,Tiopronin combined with other conventional treatment regimens have definite curative effect in the treatment of drug-induced liver injury,which can effectively improve the liver function indexes of patients,reduce liver injury,reduce the incidence of adverse reactions,promote bile acid metabolism,and have higher safety,which is worthy of clinical promotion.

Objective To explore the effect of Danshen Ligustrazine in the treatment of chronic heart failure.Methods A total of 78 patients with chronic heart failure admitted to Wuyi Traditional Chinese Medicine Hospital of Jiangmen City from January 2019 to August 2020 were selected as the research objects and divided into the cintrol group and the observation group according to the random number table method,with 39 cases in each group.The control group received routine symptomatic treatment,and the observation group was treated with Danshen Ligustrazine in the basis of the cintrol group.The clinical efficacy,cardiac function,serum inflammatory factors,and neuroendocrine hormone levels of the two groups were compared.Results The total clinical effective rate of the observation group(94.87%)was higher than that of the control group(79.49%),and the difference was statistically significant(P＜0.05).After treatment,the left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular end diastolic anteroposterior diameter(LVEDD),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),aldosterone(ADL),plasma renin(PRA),angiotensin Ⅱ(Ang Ⅱ),norepinephrine(NE)and serum N-terminal pro-brain natriuretic peptide(NT-proBNP)of the observation group were lower than those of the control group,the levels of left ventricular ejection fraction(LVEF)and interleukin-10(IL-10)were higher than those of the control group,and the differences were statistically significant(P＜0.05).Conclusion Adjuvant treatment of patients with chronic heart failure with Danshen Ligustrazine can improve heart function indicators,reduce myocardial energy consumption and improve the therapeutic effect by regulating the levels of serum inflammatory factors and neuroendocrine hormones.

Objective To investigate the clinical effect of Azithromycin combined with bronchoscopy alveolar lavage(BAL)in the treatment of bronchiectasis(BE)and its influence on lung function.Methods A total of 84 BE patients with admitted to Machang People′s Hospital from June 2018 to June 2020 were selected as subjects and divided into control group(42 cases)and observation group(42 cases)by random number table method.The control group was treated with Azithromycin,and the observation group was additively treated with BAL.The clinical efficacy,pulmonary function indexes,inflammation levels and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group(95.24%)was higher than that in the control group(80.95%),and the difference was statistically significant(P＜0.05).Before treatment,there were no significant differences in lung function and inflammatory factor levels between the two groups(P＞0.05).After treatment,forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and FEV1/FVC in the two groups were all higher than those before treatment,and FVC,FEV1 and FEV1/FVC in observation group were all higher than those in control group,with statistically significant differences(P＜0.05).The white blood cell count(WBC)and high-sensitivity C-reactive protein(hs-CRP)levels in the two groups after treatment were lower than those before treatment,and the WBC and hs-CRP levels in observation group after treatment were lower than those in control group,with statistically significant differences(P＜0.05).No serious adverse reactions occurred in the two groups.Conclusion Azithromycin combined with BAL can enhance the therapeutic effect of BE patients,reduce the body′s inflammatory response,accelerate the recovery of lung function in patients,safe and reliable,worthy of clinical application

Objective To investigate the clinical effect of orthopedic incision and dissection integrated needle knife in the treatment of stenosis tenosynovitis of flexor tendon of finger.Methods A total of 40 patients with tenosynovitis stenosis of flexor finger tendon admitted to Yangzhou Affiliated Hospital of Nanjing University of Chinese Medicine from January 2018 to January 2019 were selected as the research subjects.They were divided into treatment group and control group by random number table method,with 20 cases in each group.Patients in the treatment group were treated with acupotomy combined with orthopedic dissection,and patients in the control group were treated with ordinary small acupotomy.Clinical efficacy and visual analogue scale(VAS)scores at 1,3 and 6 months after treatment were compared between the two groups.Results All patients were followed up for 6 months after surgery,and no infection cases were found.The total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in VAS score between the two groups before treatment(P＞0.05).The VAS scores at 1,3 and 6 months after treatment in thetwo groups were lower than those before treatment,and the differences were statistically significant(P＜0.05).The VAS scores in the treatment group were lower than those in the control group at 1,3 and 6 months after treatment,and the differences were statistically significant(P＜0.05).Conclusion Compared with the traditional small acupotomy,the integration of orthopedic dissection and dissection in the treatment of tenosynovitis stenosis of flexor finger tendon has better dissection and dissection effect,which is worthy of clinical promotion and application.

Objective To investigate the clinical effect of red and blue light combined with electromagnetic wave in the treatment of upper limb closed fracture.Methods A total of 210 patients with closed fracture of upper limb who were admitted to Dongguan Hospital Affiliated to Guangzhou University of Chinese Medicine from January to December 2018 were selected as the research objects.According to the random number table method,they were divided into the control group(n=70),observation group 1(n=70)and observation group 2(n=70).The control group were given cephalosporin class II antibiotics 0.5-1 hour before operation,and the wounds were treated with regular dressing and hand hygiene.On the basis of the control group,observation group 1 received red and blue light photon irradiation on the surgical site.On the basis of the control group,the two groups were given red and blue light photon therapy combined with electromagnetic wave therapy device to irradiate the surgical site.The wound infection rate,suture removal time,postoperative hospital stay,1 day before operation,3,5 days after operation were compared among the three groups.Results The infection rate of observation group 1 and observation group 2 was lower than that of control group,the difference was statistically significant(P＜0.05);the infection rate of observation group 2 was lower than that of observation group 1,the difference was statistically significant(P＜0.05).The suture removal time and postoperative hospital stay of observation group 1 and observation group 2 were shorter than those of control group,the differences were statistically significant(P＜0.05);the suture removal time and postoperative hospital stay of observation group 2 were shorter than those of observation group 1,the differences were statistically significant(P＜0.05).The VAS score of observation group 1 was higher than that of control group and observation group 2 on the first day before operation,the difference was statistically significant(P＜0.05).Conclusion Red and blue light photon therapy combined with electromagnetic wave therapy can effectively prevent incision infection in patients with upper limb fracture,shorten the time of suture removal and hospitalization days,and promote the rehabilitation of patients.

Objective To analyze the clinical effect of osteotomy around the knee joint in the treatment of knee osteoarthritis.Methods From January 2018 to May 2020,60 patients with knee osteoarthritis admitted to the Hongqi Hospital of Mudanjiang Medical College were selected as the research objects.According to the random envelope method,they were divided into the control group(30 cases)and the observation group(30 cases).The control group received total knee arthroplasty,and the observation group received osteotomy around the knee joint.The basic operation conditions,femoral tibial angle(FTA),hip-knee-ankle angle(HKA),and preoperative and postoperative pain levels of the two groups were compared.Results The operation time and hospital stay of the observation group were shorter than those of the control group,and the intraoperative blood loss was less in the control group,the differences were statistically significant(P＜0.05).The FTA and HKA of the two groups at 6 weeks,3 months and 6 months after operation were lower than those before operation,and the differences were statistically significant(P＜0.05).The FTA and HKA of the observation group were lower than those of the control group,the differences were statistically significant(P＜0.05).The visual analogue scale(VAS)scores of the two groups at 6 weeks,3 months,and 6 months after operation were lower than those before operation,and the differences were statistically significant(P＜0.05).The VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Peripheral knee osteotomy is effective in treating knee osteoarthritis.It can replace total knee arthroplasty to a certain extent and retain the original knee joint structure.

Effect of manual reduction splint combined with plaster external fixation in treatment of triplane fracture of distal tibia in adolescents

Objective To explore the effect of manual reduction splint combined with plaster external fixation in the treatment of triplane fracture of distal tibia in adolescents.Methods The clinical data of 58 adolescent patients with triplane fracture of the distal tibia who were admitted to Guangzhou Bone Setting Hospital from January 2015 to December 2018 were retrospectively analyzed,and they were divided into the treatment group and the control group according to different treatment method,with 29 cases in each group.The treatment group was treated with manual reduction splint combined with plaster external fixation,while the control group was treated with open reduction and internal fixation.Clinical efficacy,adverse reactions and fracture healing time were compared between the two groups.Results All patients were followed up for 6 to 18 months,with an average of 11 months.There was no statistically significant difference in the excellent and good rate of treatment between the two groups(P＜0.05).The incidence of adverse reactions in the treatment group was lower than that in the control group,and the difference was statistically significant(P＜0.05).The fracture healing time in the treatment group was shorter than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Manual reduction splint combined with plaster external fixation in the treatment of triplane fracture of distal tibia has significant clinical effect and is worthy of clinical promotion and application.

Influence of sagittal parameters of the spine and pelvis on the therapeutic effect of degenerative lumbar spondylolisthesis

Objective To investigate the effect of sagittal parameters of spine and pelvis on the treatment of degenerative lumbar spondylolisthesis.Methods A total of 62 patients with degenerative lumbar spondylolisthesis and who treated in Zhongshan Hospital Traditional Chinese Medicine from February 2018 to February 2020 were retrospectively analyzed as the observation group,and 62 healthy volunteers were selected as the control group.The changes of sagittal parameters of spine and pelvis before and after treatment were compared between the two groups,including pelvic tilt angle(PT),pelvic incidence angle(PI),sacral tilt angle(SS),intervertebral height(DH),lumbar lordosis angle(LL),spondylolisthesis(SP),and the correlation between the changes of the above indexes and the visual analogue scale(VAS)and Oswestry disability index(ODI)were analyzed.Results Before treatment,the PI and PT of the observation group were higher than those of the control group,and the SS,LL,and DH were lower than those of the control group,the differences were statistically significant(P＜0.05).After 6 months of follow-up,the PI of the observation group was greater than that of the control group,the difference was statistically significant(P＜0.05).There were no significant difference in PT,SS,LL and DH between the two groups(P＞0.05).After 6 months of follow-up,PT and SP in the observation group were lower than before treatment,while SS,LL and DH in the observation group were higher than before treatment,with statistical significance(P＜0.05).There was no significant difference between PI before treatment and 6 months of follow-up(P＞0.05).After 6 months of follow-up,the VAS score and ODI score of the observation group were lower than before treatment,and the differences were statistically significant(P＜0.05).Correlation analysis showed that PT,SS,LL,DH were positively correlated with VAS score and ODI score(P＜0.05).Conclusions The sagittal parameters of spine and pelvis are important indexes to measure lumbar function in patients with lumbar spondylolisthesis,and the changes of PT,SS,ll and DH are closely related to pain and lumbar function,by measuring Pt,SS,LL and DH,the treatment effect of patients can be analyzed by measuring PT,SS,LL and DH.

Objective To investigate the clinical effect of self-made splint fixation in supination position in the treatment of extended distal radius fracture with distal radioulnar joint injury.Methods A total of 64 patients with extended distal radius fracture with distal radioulnar joint injury admitted to Guangzhou Integrated Traditional Chinese and Western Medicine Hospital from May 2016 to May 2019 were selected as the research objects,and they were divided into the plaster group and the splint group according to random number table method,with 32 cases in each group.The plaster group was fixed with long-arm plaster in supination position,and the splint group was fixed with self-made splint in supination position.The time to fracture healing,the total incidence of complications,the Garland-Werley wrist score and the incidence of radioulnar joint instability were compared between the two groups.Results There were no statistically significant differences in fracture healing time and the excellent and good rate of Garland-werley wrist score between the two groups(P＞0.05).The incidence of radioulnar joint instability in the splint group was lower than that of the plaster group,and the difference was statistically significant(P＜0.05).The total incidence of complications in the splint group was lower than that in the plaster group,and the difference was statistically significant(P＜0.05).Conclusion The self-made splint fixation in supination position is more conducive to maintaining the stability of the distal radioulnar joint.It has the advantages of simple operation,fewer complications,and good recovery of wrist joint function,which is more worthy of clinical promotion.

Objective To explore the clinical efficacy of using needle-shaped electrodes to treat bladder tumors with precision transurethral bladder tumor resection.Methods A total of 56 patients with bladder tumors included in Department of Urology,Yichun People′s Hospital from July 2019 to July 2020 were selected and divided into a control group and an observation group according to the random number table method,with 28 cases in each group.The control group underwent traditional plasma resection,and the observation group underwent precision resection with needle electrodes.The tumor pathological stage,perioperative indexes,complications and recurrence rate of the two groups were recorded and observed.Results The number of tumor tissues in the control group was 18 in Ta stage,8 in T1 stage,1 in T2 stage and 1 in T3 stage.The number of tumor tissues in the observation group was 10 in Ta stage,5 in T1 stage,9 in T2 stage and 4 in T3 stage,and the differences were statistically significant(P＜0.05).The tumor resection time,catheter time and hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,the differences were statistically significant(P＜0.05).The total incidence of complications in the observation group was lower than that in the control group,and the tumor recurrence rate was lower than that in the control group,the difference was statistically significant(P＜0.05).Conclusion Needle electrode precision resection can quickly remove tumors from patients with bladder tumors,obtain complete tumor specimens,and make accurate pathological staging,reduce bleeding,promote rapid recovery,reduce complications,and reduce tumor recurrence rate.

Objective To analyze the clinical effect of thyroid stimulating hormone suppressive therapy in postoperative differentiated thyroid carcinoma.Methods A total of 66 patients with differentiated thyroid carcinoma admitted to People′s Hospital of Shanting District in Zaozhuang City from March 2018 to April 2019 were selected as the study subjects.Random number table method was used to divide them into study group and routine group,with 33 cases in each group.The routine group was treated with thyroid hormone replacement therapy,while the study group was treated with thyroid stimulating hormone suppressive therapy.The total incidence,recurrence rate and metastasis rate of adverse reactions were compared and analyzed in the two groups.The contents of triiodothyronine,thyroxine,free triiodothyronine and free thyroxine before and after treatment were compared between the two groups.Results The total incidence of adverse reactions in the study group was lower than that in the routine group,the difference was statistically significant(P＜0.05).The recurrence rate and metastasis rate of the study group were lower than those of the routine group,the differences were statistically significant(P＜0.05).Before treatment,there were no statistical significances in the contents of triiodothyronine,thyroxine,free triiodothyronine and free thyroxine between the two groups(P＞0.05).After treatment,the contents of triiodothyronine,thyroxine,free triiodothyronine and free thyroxine in study group were higher than those in routine group,the differences were statistically significant(P＜0.05).After treatment,the contents of triiodothyronine,free triiodothyronine and free thyroxine in the two groups were lower than those before treatment,the differences were statistically significant(P＜0.05).After treatment,the thyroxine content in the study group was higher than that before treatment,and that in the routine group was lower than that before treatment,with statistical significances(P＜0.05).Conclusion Thyroid stimulating hormone suppression therapy in postoperative differentiated thyroid carcinoma can reduce patients′ adverse reactions,reduce the recurrence rate,and the metastasis rate is low,which is worthy of popularization and wide application in clinic.

Objective To explore the influencing factors of quality of life in patients with colorectal cancer after laparoscopic radical resection.Methods A Total of 103 patients with colorectal cancer undergoing laparoscopic radical operation in Songzi People′s Hospital from September 2017 to September 2019 were selected as the research objects.The patients were followed up for 12 months by telephone and outpatient reexamination.The quality of life was evaluated by Karnofsky Performamce Status(KPS)score.Multivariate Logistic regression analysis was used to analyze the risk factors of postoperative quality of life.Results Univariate analysis showed that there were no significant differences in KPS scores of gender,family history,TNM stage,basic diseases,preoperative carcino-embryonic antigen(CEA),preoperative carbohydrate antigen 19-9(CA19-9),depth of invasion and intraoperative blood loss(P＞0.05);KPS score of patients aged ＞60 were lower than those of patients ≤60 years old,KPS scores of patients with low differentiation were lower than those of patients with high and moderate differentiation,and KPS scores of patients with tumor diameter＞5 cm was lower those of patients with tumor diameter ＜5 cm,the KPS scores of patients with intestinal obstruction were lower than those without intestinal obstruction,and the KPS score of patients with lymph node metastasis were lower than those without lymph node metastasis(P＜0.05).Multivariate Logistic regression analysis showed that age,differentiation degree,tumor diameter,preoperative intestinal obstruction and lymph node metastasis were independent risk factors for postoperative quality of life(P＜0.05).Conclusion Age,differentiation degree,tumor diameter,preoperative intestinal obstruction and lymph node metastasis are independent risk factors for postoperative quality of life in patients with laparoscopic radical resection of colorectal cancer.

Objective To explore the effect of laparoscopic complete mesocolectomy in the treatment of colon cancer.Methods Eighty-eight colon cancer patients admitted to the Fifth People′s Hospital of Jianli City,Hubei Province from September 2015 to November 2019 were selected as subjects.The patients were divided into two groups by random number table method,with 44 patients in each group.The control group underwent open surgery,and the study group underwent laparoscopic complete mesocolectomy.The perioperative indicators,postoperative pathological results,complications and follow-up results were compared between the two groups.Results The operation time of the study group was(159.84±20.33)min,longer than that of the control group of(142.06±23.64)min,the difference was statistically significant(P＜0.05).The intraoperative blood loss and postoperative drainage in the study group were(87.93±15.05)mL and(194.85±60.19)mL,both were lower than those in the control group of(220.64±34.39)and(310.58±65.38)mL,with statistical significances(P＜0.05).The length of hospital stay in the study group was(13.81±4.92)d,shorter than that in the control group of(16.98±6.33)d,and the difference was statistically significant(P＜0.05).The anal exhaust time was(3.16±0.85)h in the study group and(3.34±0.81)h in the control group.There was no significant difference in the anal exhaust time between the two groups(P＞0.05).The number of lymph node dissection in the study group was(21.89±4.63),which was higher than that in the control group of(18.17±2.94),and the difference was statistically significant(P＜0.05).The tumor diameter was(4.18±1.12)cm in the study group and(4.22±1.25)cm in the control group.There was no statistical significance in the tumor diameter between the two groups(P ＞0.05).The number of lymph node metastasis was(4.52±0.61)in the study group and(4.71±0.63)in the control group.There was no significant difference in the number of lymph node metastasis between the two groups(P＞0.05).The total incidence of complications in the study group was 4.55%,which was lower than that in the control group(20.45%),the difference was statistically significant(P＜0.05).The recurrence rate,metastasis rate and mortality rate in the study group were 4.55%,2.27% and 0%,respectively,while those in the control group were 9.09%,6.82% and 2.27%.There were no significant differences in the recurrence rate,metastasis rate and mortality between the two groups(P＞0.05).Conclusion The use of laparoscopic complete mesocolectomy for the treatment of colon cancer has the advantages of less trauma,less bleeding,low complications and low recurrence rate,and can achieve good tumor eradication effect.It plays an important role in improving the prognosis of patients,and is worthy of clinical application .

Influence of support intervention based on network platform on breastfeeding effect of primipara

Objective To explore the effect of support intervention based on network platform on breastfeeding effect of primipara.Methods The clinical data of 100 cases of primiparas treated in Jiangxi Maternal and Child Health Hospital from February 2019 to February 2020 were retrospectively analyzed,they were divided into the control group(48 cases)and the observation group(52 cases)according to different intervention methods,the control group was treated with conventional intervention method,the observation group was treated with conventional intervention+support intervention based on web platform.The breastfeeding effect and breastfeeding scores were compared between the two groups.Results The exclusive breastfeeding rate of the observation group after nursing was higher than that of the control group,and the difference was statistically significant(P＜0.05);after nursing,the breastfeeding knowledge score and breastfeeding operation score of the observation group were higher than that of the control group,the differences were statistically significant(P＜0.05).Conclusion Supportive interventions based on the web platform can increase the rate of exclusive breastfeeding in primiparas,improve breastfeeding knowledge and operation scores.

Objective To explore the application effect of non-invasive high frequency oscillation ventilation(NHFOV)in preventing neonatal extubation failure.Methods A total of 60 newborns who were admitted to Jiangxi Provincial Children′s Hospital from June 2017 to June 2020 who needed non-invasive assisted ventilation after tracheal intubation were selected as the research subjects.According to the random number table method,they were divided into the control group(n=30)and the observation group(n=30).The experimental group used NHFOV,and the control group used nasal continuous positive airway pressure(NCPAP)ventilation.The number of days of noninvasive ventilator use,days of oxygen inhalation,hospital stay were compared between the two groups.The changes of partial pressure of carbon dioxide(PaCO2)and partial pressure of oxygen(PaO2)/concentration of inhaled oxygen(FiO2)were observed at different time after weaning between the two groups.The incidence of complications,adverse events and failure rate of extubation were recorded between the two groups.Results The number of days of non-invasive ventilator use,days of oxygen inhalation,and hospital stay in the experimental group were shorter than those in the control group,the differences were statistically significant(P＜0.05).There were no statistical differences in the levels of PaCO2 and PaO2/FiO2 index between the two groups before treatment(P＞0.05).There were no statistical differences in the levels of PaCO2 and PaO2/FiO2 index of children between the two groups at 72 h after weaning(P＞0.05).The indexes of PaCO2 and PaO2/FiO2 of the experimental group at 24 h and 48 h after weaning were higher than those of the control group,the differences were statistically significant(P＜0.05).The indexes of PaO2,PaO2/FiO2 at 72 h after treatment in the two groups were different from those before treatment,the differences were statistically significant(P ＜0.05).The total incidence of complications,adverse events,and failure rates of extubation in the experimental group were lower than those of in the control group,with statistical significances(P＜0.05).Conclusion The application of NHFOV can prevent the failure of neonatal extubation,improve the oxygen supply of children,and reduce the incidence of complications and adverse events,which is worthy of promotion.

Objective To compare the effects of breast-conserving surgery and mastectomy in the treatment of breast cancer.Methods A total of 60 breast cancer patients who were admitted to Shangrao People′s Hospital from March 2015 to March 2016 were selected as the research objects,and they were divided into the control group(30 cases)and the test group(30 cases)according to different surgical methods.The control group received mastectomy,and the test group received breast conserving surgery.Both groups were followed up for 4 years.The operation related indexes,quality of life before and 4 years after operation and the incidence of complications were compared between the two groups.Results The intraoperative blood loss of the test group was less than that of the control group,and the length of hospitalization and operation time of the test group were shorter than those of the control group,the differences were statistically significant(P＜0.05).There was no significant difference in the quality of life scores between the two groups before surgery(P＞0.05).The environmental status and mental status scores of the two groups were higher than those before surgery,the differences were statistically significant(P＜0.05).The quality of life scores in the test group at 4 years after surgery were higher than those in the control group,including environmental conditions and psychological status,and the differences were statistically significant(P＜0.05).The total incidence of postoperative complications in the test group was 3.33%,which was lower than that in the control group(20.00%),and the difference was statistically significant(P＜0.05).Conclusion The implementation of breast-conserving surgery can effectively shorten the hospital stay and operation time of breast cancer patients,and reduce the amount of intraoperative blood loss,improve the longterm quality of life,and reduce the occurrence of postoperative complications,with good safety,and the treatment effect is remarkable.

Objective To explore the relationship between left atrium and left ventricular diastolic function and hypertension during pregnancy in different stages.Methods A total of 66 patients diagnosed with hypertension in pregnancy who were admitted to Yichun People′s Hospital from November 2019 to November 2020 were selected as the research objects,according to the diagnostic classification standard of Obstetrics and Gynecology,they were divided into the gestational hypertension group(32 cases)and the preeclampsia group(34 cases),and another 30 healthy pregnant women in the same period were selected as the control group.The plasma levels of N-terminal pro-brain natriuretic peptide(NT-proBNP)in the three groups were measured,and the end-diastolic left ventricular volume(LVEDV),end-systolic left ventricular volume(LVESV),left ventricular ejection fraction(LVEF),left atrial volume were measured by two-dimensional echocardiography in the three groups,the left atrial volume index(LAVI)was calculated.Ea values of three groups were measured by tissue Doppler and E/Ea ratio was calculated.The two-dimensional spot tracking technique was used to determine Left atrial global longitudinal peak strain(LA-GLPS),the left atrial strain rate during systole(LASRs),the early diastolic left atrial strain rate(LASRe),and the peak value of the left ventricular longitudinal strain(LV-GLPS).The left ventricle and left atrium echocardiographic structural indicators of the 3 groups of patients were compared,and the Pearson correlation coefficient was used to determine the left atrial strain rate and left ventricular torsion angle indicators,as well as LAVI,LA-GLPS,LASRs,LASRe and E/Ea,N terminal pro B type natriuretic paptide(NT-ProBNP)performs correlation analysis.Results The LVESV,LAVI,E/Ea ratios of the control group were lower than those of the gestational hypertension group and the preeclampsia group,the LVESV,LAVI,E/Ea ratios of the gestational hypertension group were lower than those of the preeclampsia group,and the differences were statistically significant(P＜0.05).The control group,the pregnancy-induced hypertension group,and the preeclampsia group showed a decreasing trend in LVEDV.There was no significant difference in LVEDV among the three groups(P＞0.05).The LA-GLPS,LV-GLPS,LASRs and LASRe in the control group were higher than those in the pregnancy-induced hypertension group and the preeclampsia group,the LA-GLPS,LV-GLPS,LASRs and LASRe in the gestational hypertension group were higher than those in the preeclampsia group,the differences were statistically significant(P＜0.05).LAVI,LA-GLPS,LASRs,LASRe were positively correlated with E/Ea and NT-proBNP(r=0.881,0.599,0.601,0.499,0.899,0.801,0.598,0.602, P＜0.05).Conclusion For patients with hypertension in pregnancy at different stages,there are differences in the degree of cardiac function damage.Preeclampsia damage is more significant,mainly manifested as left atrium and left ventricular diastolic dysfunction,which can be used as an aid to assess hypertension in pregnancy at different stages tool.

Objective To observe the effects of montelukast sodium combined with azithromycin on T lymphocyte subsets and inflammatory factors in children with mycoplasma pneumonia(MPP).Methods A total of 86 cases of MPP children admitted to Poyang County People′s Hospital from June 2019 to February 2021 were selected as the research objects,and were divided into the observation group(43 cases)and the control group(43 cases)according to random number table method.The control group was treated with Azithromycin and the observation group was treated with Montelukast Sodium on the basis of the observation group.T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)and inflammatory factors[interleukin-2(IL-2),interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)]were compared between the two groups.Results After treatment,CD3+,CD4+,CD4+/CD8+),IL-2 in the observation group were higher than those in the control group,with statistical significances(P＜0.05).CD8+,IL-6,IL-10,TNF-α were lower than those in the control group,with statistical significances(P＜0.05).There was no significant difference in the incidence of ADR between the two groups(P＞0.05).Conclusion Montelukast Sodium combined with Azithromycin can improve inflammatory symptoms and immune function in the treatment of MPP,with less adverse reactions.

Objective To compare the clinical effect of recombinant human follicle stimulating hormone,recombinant human luteinizing hormone and urinary gonadotropin in long protocol ovulation induction in follicular phase.Methods The clinical data of 140 patients indergoing in vitro fertilization(IVF)with long follicular phase ovulation induction in Ganzhou Maternal and Child Health Hospital from May 2018 to December 2019 were retrospectively analyzed.According to the different treatment schemes,they were divided into group A(73 cases)and group B(67 cases).Group A was treated with recombinant human luteinizing hormone combined with recombinant human follicle stimulating hormone,and group B was treated with urinary gonadotropin combined with recombinant human follicle stimulating hormone.The clinical observation indexes,treatment outcome and physiological indexes of the two groups were compared.Results There was no significant difference in the total amount of gonadotropin(Gn),days of Gn use,normal fertilization rate,high-quality embryo rate,blastocyst formation rate and pregnancy rate between the two groups(P＞0.05).There was no significant difference in endometrial thickness,estradiol,progesterone and luteinizing hormone(LH)levels between the two groups before treatment(P＞0.05).The levels of endometrial thickness,LH,progesterone and estradiol of the two groups after treatment were higher than those before treatment,and the differences were statistically significant(P＜0.05).Conclusion For ovulation induction patients with long follicular period regimen,recombinant human follicle stimulating hormone combined with recombinant human luteinizing hormone or recombinant human follicle stimulating hormone combined with urinary gonadotropin can effectively assist pregnancy and have clinical application value.The urinary gonadotrophin is cheap,and can reduces the amount of recombinant human follicle-stimulating hormone,and reduces the economic burden of patients,so it can be popularized in clinical application.

Objective To analyze the measures to reduce the risk of long-distance transport in critically ill pregnant women.Methods The clinical date of 60 cases of critical and critical pregnant women in Ganzhou Medical Emergency Center from December 2016 to December 2020 for long-distance transportation were selected as the research objects.According to the different nursing mode of long-distance transportation,they were divided into study group and control group,with 30 cases in each group.The study group took intervention measures long-distance transportation,and the control group did not take intervention measures during long-distance transportation.The incidence of complications and adverse events,the rate of disease change,the perinatal mortality rate,and the total incidence of adverse pregnancy outcomes of pregnant women and fetuses during the transfer process of the two groups of acute and critically ill pregnant women were compared between the two groups.Results The incidence of complications and adverse events in the study group was lower than that in the control group(P＜0.05),and the rate of change and perinatal mortality in the study group were lower than those in the control group(P＜0.05).The total incidence of adverse pregnancy in the study group was lower than that in the control group(P＜0.05).Conclusion Implementing intervention countermeasures to reduce the critical patients in maternal and fetal complications of long distance transport and adverse events,and effectively reduce the disease rate of change,and further improve maternal transfer success rate of critical patients to treat the critical maternal provide better transport conditions,to further improve the cure rate of critical patients maternal,worth clinical promotion.

Objective To explore the method and effect of improving the monitoring stability of infant blood oxyhemoglobin saturation(SpO2).Methods A total of 60 children who needed continuous ECG monitoring in the pediatric intensive care unit(PICU)of Yichun Maternal and Child Health Hospital from February to June 2020 were selected as the subjects.According to random number table method,they were divided into the control group and the observation group,with 30 cases in each group.The control group was fixed by conventional blood oxygen probe,and the observation group was fixed by external blood oxygen probe with black cloth.The blood SpO2 was continuously monitored for more than 8 hours in both groups.During the monitoring process,registration was performed every 30 minutes.SpO2 level,frequency of probe dropping,frequency of nurse rework,standard rate and family satisfaction were compared between the two groups.Results There were no statistically significant differences in SpO2 levels between the two groups at the time of immediate monitoring,4 and 8 h monitoring(P＞0.05).The frequency of probe dropping and nurse rework in the observation group were less than those in the control group,and the differences were statistically significant(P＜0.05).The standard rate of SpO2 monitoring in the observation group and the satisfaction of the children′s families on the monitoring method,monitoring effect and service attitude were higher than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion The method of black cloth external fixed blood oxygen probe has a high stability in the monitoring of blood SpO2 of infants,which can reduce the frequency of probe dropping and nurse rework,and improve nursing satisfaction,it is worthy of popularization and application.

Objective To explore the influence of the change of pregnant women′s position and the choice of uterine incision on the second stage of cesarean section.Methods A total of 100 pregnant women hospitalized in Xinyu Maternity and Child Health Hospital who had entered the labor process and could not deliver naturally and who needed cesarean section were selected as the research subjects.According to the random number method,they were divided into study group(50 cases)and control group(50 cases).The study group was treated with cesarean section with new maternal position and uterine incision,while the control group was treated with cesarean section with traditional method.The intraoperative and 2 h postoperative uterine bleeding,the operation time,the time of fetal delivery,and the occurrence of adverse reactions of the neonates and the puerperae were compared between the two groups.Results The amount of uterine bleeding in the study group during and 2 h after operation was less than that of the control group,with statistical significance(P＜0.05).The operation time and delivery time of the fetal head in the study group were shorter than those in the control group,with statistical significance(P＜0.05).The total incidence of adverse reactions in neonates and puerperae in the study group was lower than that in the control group,with statistical significance(P＜0.05).Conclusion Adopting the new posture of pregnant women and the choice of uterine incision can reduce the amount of bleeding during cesarean section in the second stage of labor,shorten the operation time and the time of fetal delivery,and meanwhile can improve the overall adverse reaction rate of puerperae and the adverse reaction rate of the neonates.

Objective To study the effects of fine nursing of flat responsibility system on patients with laparoscopic myomectomy.Methods A total of 86 patients undergoing myomectomy in Department of Obstetrics and Gynecology of Shangrao Fifth People′s Hospital from March 2019 to June 2020 were selected as the research subjects,and they were divided into study group(n=43)and control group(n=43)according to the random number table method.The study group applied fine nursing of flat responsibility system while control group was given regular nursing.The exhaust time,abdominal distension disappearance time,ambulation time,hospital stay,nursing quality after nursing,psychological status before and after nursing,occurrence of adverse reactions after nursing were compared between the two groups.Results After nursing,the exhaust time,abdominal distension disappearance time,ambulation time and hospital stay in study group were all shorter than those in control group,the differences were statistically significant(P＜0.05).The nursing quality scores of health education,basic nursing,prevention of complications,medication guidance and disease education in study group were all higher than those in control group,the differences were statistically significant(P＜0.05).Before nursing,there were no significant differences in the scores of self-rating depression scale(SDS)and selfrating anxiety scale(SAS)between the two groups（P＞0.05）.The scores of SDS and SAS after nursing in study group were higher than those in control group,the differences were statistically significant(P＜0.05).The total incidence rate of adverse reactions in study group was lower than that in control group,the difference was statistically significant(P＜0.05).Conclusion Fine nursing of flat responsibility system can effectively promote the recovery,shorten the hospital stay,improve the poor psychological emotions and reduce the occurrence of adverse reactions of patients undergoing laparoscopic myomectomy.

Objective To investigate the effect of glaucoma drainage device implantation in the treatment of glaucoma.Methods From January 2018 to January 2020,40 patients with primary open-angle glaucoma(60 eyes)treated in Fuzhou Ophthalmic Hospital were selected as the subjects.They were divided into the control group(18 cases,26 eyes)and the study group(22 cases,34 eyes)by the different operation methods.The control group were treated with trabeculectomy,and the study group was treated with glaucoma drainage implantation.The changes of intraocular pressure,best corrected visual acuity and macular fovea thickness before operation and 3 d,1,3,6 months after operation were analyzed.The surgical complications of the two groups were compared.Results The macular fovea thickness at 3 d,1 month after operation in the two groups were higher than those before operation(P＜0.05).However,there was no significant difference in macular fovea thickness between the two groups at different time points(P＞0.05).The intraocular pressure at different time points after operation in both groups was all lower than those before operation,the differences were statistically significant(P＜0.05).There was no significant difference in the intraocular pressure at different time points after operation between the two groups(P＞0.05).There was no significant difference in the best corrected visual acuity at different time points after operation and before operation in the two groups(P＞0.05),and there was no significant difference in the best corrected visual acuity between the two groups after operation different time points(P＞0.05).The total incidence of complications in the study group were lower than those in the control group,the difference was statistically significant(P＜0.05).Conclusion In the treatment of primary open-angle glaucoma,the effect of glaucoma drainage mplantation is similar to trabeculectomy,and its surgical complications are less,which is worthy of clinical promotion.

Objective To investigate the effect of periodontal tissue regeneration combined with orthodontics in the treatment of periodontitis.Methods A total of 80 patients with periodontitis admitted to the Jingchu Institute of Technology Affiliated Central Hospital from September 2018 to April 2020 were selected as the research objects,and they were divided into the experimental group(40 cases)and the control group(40 cases)according to the cluster random method.The experimental group was treated with orthodontics combined with periodontal tissue regeneration,and the control group was treated with periodontal tissue regeneration.The effective rate,gingival sulcus bleeding index(SBI),plaque index(PLI),clinical attachment loss(CAL),periodontal probing depth(PPD),the total incidence rate of adverse reactions and the recurrence rate were compared between the two groups.Results The effective rate after treatment of the experimental group was higher than that of the control group,the difference was statistically significant(P＜0.05).The SBI after treatment of the experimental group was lower than that of the control group,the difference was statistically significant(P＜0.05).The PLI after treatment of the experimental group was 0.79±0.08,which was lower than that of the control group(1.17±0.21),the difference was statistically significant(P＜0.05).The CAL after treatment of the experimental group was(4.32±0.45)mm,which was lower than that of the control group(4.97±0.73)mm,the difference was statistically significant(P＜0.05).The PPD after treatment of the experimental group after treatment was(3.42±0.17)mm,which was lower than that of the control group(4.18±0.38)mm,the difference was statistically significant(P＜0.05).The total incidence rate of adverse reaction of the experimental group after treatment was lower than that of the control group,the difference was statistically significant(P＜0.05).The recurrence rate of the experimental group after treatment was lower than that of the control group,the difference was statistically significant(P＜0.05).Conclusion Orthodontics combined with periodontal tissue regeneration is helpful to improve the periodontal condition of patients with periodontitis,improve the curative effect and overall safety.

Objective To investigate the effect of acupuncture assisted anesthesia on pain and hemodynamics in patients undergoing laparoscopic cholecystectomy.Methods A total of 72 patients who underwent laparoscopic cholecystectomy in Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2019 to January 2020 were selected as the research subjects,and were divided into control group(36 cases)and experimental group(36 cases)according to random number table method.The control group was given general anesthesia,and the experimental group was given acupuncture as auxiliary general anesthesia.The surgical conditions,the pain degree before and 12 and 24 h after surgery,the hemodynamics before anesthesia(T0),endotracheal intubation(T1),15 min after pneumoperitoneum establishment(T2),and at the end of anesthesia(T3)of the two groups were compared.Results There were no significant differences in the intraoperative blood loss,pneumoperitoneum time and anesthesia time between the two groups(P＞0.05).The visual analogue scale(VAS)scores at 12 and 24 h after surgery in both groups were lower than those before surgery,and the VAS scores in the experimental group were lower than those in the control group at 12 and 24 h after surgery,the differences were statistically significant(P＜0.05).Heart rate(HR)and mean arterial blood pressure(MAP)in experimental groups at T1-T3 were lower than those in control group,the differences were statistically significant(P＜0.05).There was no significant difference in blood oxygen saturation(SpO2)between the two groups at each time point(P＞0.05).Conclusion Acupuncture assisted anesthesia can improve hemodynamics and alleviate pain in patients undergoing laparoscopic cholecystectomy,and has no side effect on the operation process.

Objective To observe and explore the application effect of Dexmedetomidine combined with Sufentanil in painless intestinal endoscopic submucosal dissection(ESD).Methods A total of 60 patients who underwent selective ESD in Pingxiang People′s Hospital from January 2019 to December 2020 were selected as the research subjects.According to the random number table method,they were divided into a control group and an observation group,with 30 cases in each group.Patients in the control group were given traditional intravenous anesthesia of Propofol combined with Sufentanil;while in the observation group,intravenous anesthesia of Dexmedetomidine combined with Sufentanil was used.The respiration(RR),heart rate(HR),mean arterial pressure(MAP),and pulse blood oxygen saturation(SpO2)of the two groups before induction of anesthesia(T0),2 min after administration(T1),5 min after administration(T2),10 min after administration(T3),30 min after administration(T4),and at the end of surgery(T5)were monitored.The operation time,anesthesia induction time and postoperative recovery time were recorded.The occurrence of adverse reactions during the operation and the analgesic effect of patients were observed.Results The RR,HR,and MAP of the two groups at T1-T5 were lower than those of this group at T0,and the differences were statistically significant(P＜0.05).There were no significant differences in SpO2 between T1-T5 and T0 between the two groups(P＞0.05).The MAP levels of the observation group at T1-T4 were higher than those of the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in MAP between the two groups at T5(P＞0.05).There were no statistically significant differences in RR,HR and SpO2 between the two groups at T1-T5(P＞0.05).There was no statistically significant difference in the operation time between the two groups(P＞0.05).The observation group had longer anesthesia induction time than the control group,while the recovery time of the observation group was shorter than that of the control group,and the analgesic effect of patients was also better than that of the control group,with statistical significance difference(P＜0.05).The incidence of hypotension,respiratory depression and body movement reactions and total incidence of averse reactions in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion In painless intestinal ESD surgery,application of Dexmedetomidine combined with Sufentanil has great analgesic effect,little impact on hemodynamics,quick wake up,and few adverse reactions with a favorable application effect.

Objective To explore the application effect of intra-spinal anesthesia and analgesia in vaginal trial delivery after cesarean section.Methods A total of 156 pregnant women undergoing vaginal trial delivery after cesarean section in Maternity and Child Health Hospital of Yangdong District in Yangjiang City from August 2019 to December 2020 were selected and divided into analgesia group(n=78)and non-analgesia group(n=78)by random envelope method.In the analgesic group,intra-spinal anesthesia was performed at 2 to 3 cm from the uterine orifice,and the non-analgesic group was not given any drugs or equipment for labor analgesia.The labor methods,labor progress,postpartum hemorrhage,and postpartum urinary retention,neonatal Apgar scores,NICU occupancy rate,and visual analogue scale(VAS)score when the uterine opening reached 5,8,10 cm were compared between the two groups.Results There were no significant differences in the progress of labor,postpartum hemorrhage,postpartum urinary retention,newborn Apgar scores(at 1,5 minutes of birth),and NICU occupancy rate between the two groups(P＞0.05).The Apgar scores of newborns in the two groups at 5 minutes of birth were higher than those at 1 minute of birth,the differences were statistically significant(P＜0.05).The VAS scores of the analgesia group were lower than those of the non-analgesia group when the uterine opening was 5,8,and 10 cm,and the differences were statistically significant(P＜0.05).The VAS score of the non-analgesic group when the uterine opening was 10 cm was higher than that at 8 cm and 5 cm,and the VAS score was higher than that at 5 cm when the uterine opening was 8 cm,the differences were statistically significant(P＜0.05).The VAS score of the analgesia group was higher than that at 5 and 8 cm when the uterine orifice opened to 10 cm,the difference was statistically significant(P＜0.05).There was no statistically significant difference in the VAS score when the uterine opening was 8 cm and 5 cm in the analgesia group(P＞0.05).Conclusion It is safe and feasible to apply intra-spinal anesthesia in vaginal trial delivery after cesarean section.It can significantly reduce the pain of labor and is worthy of application and promotion.

Objective To analyze the effect of general anesthesia with laryngeal mask ventilation in patients with middle and lower ureteral calculi during surgery.Methods From June 2019 to July 2020,68 patients with middle and lower ureteral calculi admitted to Yingde People′s Hospital of Guangdong Province were selected,all of whom underwent transurethral ureteroscopic holmium laser lithotripsy.They were divided into two groups in 1∶1 ratio by combining the computerized random number table method.The local anesthesia group(34 cases)received combined spinal-epidural anesthesia and the laryngeal mask group(34 cases)received general anesthesia with laryngeal mask ventilation.The two groups were compared in terms of anesthetic effect,adverse effects,pain degree([numerical rating scale]NRS)at 6,12 and 24 h after surgery,and hemodynamics indicators(mean arterial pressure[MAP]and heart rate[HR])before anesthesia,10 min of anesthesia and 10 min of surgery.Results The anesthetic effect of the laryngeal mask group was better than that of the local anesthesia group,and the difference was statistically significant(P＜0.05).The NRS scores of the laryngeal mask group were lower than those of the local anesthesia group at 12 h and 24 h after surgery,with statistically significant differences(P＜0.05).The MAP and HR in the laryngeal mask group were higher than those in the local anesthesia group at 10 min of anesthesia and 10 min of surgery,with statistically significant differences(P＜0.05).The total incidence of adverse reactions in the laryngeal mask group was 5.88%(2/34),lower than that in the local anesthesia group accounting for 26.47%(9/34),and the difference was statistically significant(P＜0.05).Conclusion General anesthesia with laryngeal mask ventilation can improve the anesthetic effect,reduce the degree of postoperative pain,maintain hemodynamic stability,and reduce the occurrence of adverse reactions when used in patients with middle and lower ureteral calculi.

Objective To investigate the clinical effect of Sacubitril Valsartan in the treatment of patients with chronic heart failure and its effect on cardiac function.Methods The clinical data of 80 patients with chronic heart failure admitted to the People′s Hospital of Gaozhou from August 2019 to May 2020 were retrospectively analyzed,and they were divided into observation group(40 cases)and control group(40 cases)according to treatment methods.The control group was treated with Metoprolol Sustained-Release Tablets,and the observation group was treated with Sacubitril Valsartan.The clinical efficacy,cardiac function indexes,serum hypersensitive troponin(hs-TnT)and N-terminus brain natriuretic peptide precursor(NT-proBNP)before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 95.00%,which was higher than that of the control group(72.50%),the difference was statistically significant(P＜0.05).After treatment,left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LA)of the two groups were lower than those before treatment,while left ventricular ejection fraction(LVEF)of the two groups was higher than that before treatment,LVEDD and LA of the observation group were lower than those of the control group,while LVEF of the observation group was higher than that in the control group,the differences were statistically significant(P＜0.05).After treatment,the levels of hs-TNT and NT-Pro BnP in both groups were lower than those before treatment,and the observation group was lower than that in the control group,the differences were statistically significant(P＜0.05).Conclusion Compared with conventional treatment methods,Sacubitril Valsartan in clinical treatment of chronic heart failure has better cardiac function improvement,which is worthy of clinical promotion and application.

Objective To investigate the clinical application of angiotensin receptor neprilysin inhibitor Sacubitril/Valsartan in patients with heart failure(HF)，and to provide reference for its standardized use.Methods The electronic medical records of inpatients with HF using Sacubitril/valsartan in cardiovascular medicine department of hospital were collected from hospital information system during Jun.to Sep.2019.Those medical records were analyzed statistically in drug application.Results A total of 73 HF patients were given Sacubitril/valsartan,of which 24 cases(32.88%)were used without indications and 3 cases(4.11%)had contraindications.11 cases(15.07%)had an unreasonable initial treatment dose,9 cases(12.33%)of unreasonable dosing frequency,31 cases(42.47%)of unreasonable conversion with angiotensin converting enzyme inhibitors(ACEI),16 cases(21.92%)of unreasonable conversion with angiotensin receptor blockers(ARB).Conclusion There is a certain gap between clinical application of Sacubitril/Valsartan in HF patients and the requirements of drug instructions and related guidelines for HF,mainly involving indication,usage and dosage,drug conversion.It is recommended to further standardized the clinical application of the drug through pre-prescription review,regular special reviews,strengthening of pharmaceutical care and medical training.

Objective To investigate the clinical effect of thrombolysis with Alteplase in stroke patients and the changes of coagulation function and hemorheology.Methods A total of 120 cases of stroke patients in a hospital from October 2016 to October 2019 were selected as the research objects and randomly divided into control group and observation group,with 60 cases in each group.The therapeutic effects of the two groups were evaluated 10 days after treatment.The coagulation function(including fibrinogen[FIB],thrombin time[APTT],prothrombin time[PT]and platelet[PLT]),hemorheology indexes(plasma specific viscosity,whole blood high shear viscosity,erythrocyte aggregation index,blood cell volume)and incidence of complications(cerebral hemorrhage,gingival bleeding,rash or allergy,liver and kidney dysfunction and hematuria)were compared between the two groups.Results After treatment,Pt and APTT of the observation group were longer than those of the control group,the difference was statistically significant(P＜0.05),FIB and PLT levels of the observation group after treatment were lower than those of the control group,the differences were statistically significant(P＜0.05).After treatment,the plasma specific viscosity,whole blood high shear viscosity,erythrocyte aggregation index,blood cell volume of the observation group were lower than those of the control group,the differences were statistically significant(P＜0.05).There was no significant difference in the incidence various of complications between the two groups during treatment(P＞0.05).Conclusion alteplase thrombolysis can improve the coagulation function and hemorheology indexes of stroke patients,and has high safety,which is worthy of clinical promotion.

Objective To evaluate the application value of metagenomics next generation sequencing(mNGS)in the detection of pathogens of patients with sepsis.Methods The clinical data of 118 patients with sepsis admitted to the Department of Critical Care Medicine of Shenzhen People′s Hospital from October 2017 to September 2019 were retrospectively analyzed.The pathogen detection rate and coverage of mNGS and traditional microbial culture of two detection methods in blood samples were compared,and the influence of the use of antibiotic before sampling on the detection of both was further analyzed.Results The pathogen detection rate of mNGS pathogens in blood samples was 35.59%,which was higher than 16.10% of traditional microbial culture(P＜0.05).The use of antibiotics before sampling had little effect on the detection rate of mNGS(37.9% vs.29.03%, P=0.374),but which significantly reduced the detection rate of microbial culture(9.19% vs. 35.48%, P=0.002).Using blood culture results as the gold standard for bacteremia,the sensitivity,specificity,and Youden index of mNGS were calculated to be 78.95%,72.73%,and 51.68%,respectively.Conclusion The application of mNGS technology can improve the detection rate and coverage of pathogens,and has high sensitivity and specificity,of which could provide a more valuable reference for early targeted anti-infective therapy in patients with sepsis.

Objective To analyze the Mycoplasma genitalium(Mg)and Chlamydia trachomatis(CT)infection in male patients with non-gonococcal urethritis(NGU)in Foshan area.Methods A total of 602 patients with non-gonococcal urethritis who were admitted to the Department of Urology,Department of Dermatology and Male Specialist Department of Nanhai District People′s Hospital of Foshan City from January 2016 to March 2019 were selected as the case group.A total of 200 healthy subjects who underwent physical examinations in the Physical Examination Center of Nanhai District People′s Hospital of Foshan City from January 2016 to March 2019 were selected as the control group.The Mg and CT nucleic acid assays of urinary tract secretions in male NGU patients and healthy subjects in Foshan area were performed by using SAT-RNA detecting technique.The infection rates of Mg and CT in the two groups were compared,and the infection rates of Mg and CT in different age groups in the case group were compared to analyze the relationship between Mg,CT infection and male NGU.Results The detection rates of Mg and CT in the case group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The infection rates of Mg and CT in the ＞30-40 years old group were the highest.No significant differences were observed in the distribution of Mg and CT infection in different age groups(P＞0.05).According to Pearson correlation analysis,reproductive tract Mg and CT infection were positively correlated with male NGU(r=0.14,0.16, P＜0.05).Conclusion Male NGU is associated with Mg and CT infection,which clinicians should pay attention to.As routine examination items for urinary tract infection,Mg and CT have important clinical significance in the detection of male NGU.

Objective To investigate the diagnostic value of serum procalcitonin(PCT)in bacteremia.Methods A total of 80 patients with suspected bacteremia admitted to the Clinical Laboratory of Baicheng City Hospital of Jilin Province from January to June 2019 were selected as the research objects,and they were divided into control group and observation group according to the method of lot,with 40 cases in each group.The control group was given blood bacterial culture,and the observation group was given serum PCT detection.The diagnostic efficacy of the two methods was compared with the gold standard of pathological detection.Results By pathological examination,38 patients in the observation group and the control group were diagnosed with bacteremia.The diagnostic accuracy of the observation group was 90.00%,which was higher than that of the control group(70.00%),the difference was statistically significant(P＜0.05).There was no significant difference in sensitivity,specificity,positive predictive value and negative predictive value between the two detection methods(P＞0.05).Conclusion Compared with blood bacterial culture,serum PCT detection can improve the diagnostic accuracy,and has higher clinical diagnostic value in patients with bacteremia.

By collecting,sorting out and analyzing typical cases of drug price monopoly in China from 2011 to 2020,this paper summarized the characteristics of current drug monopoly in China.Since China liberalized drug price control in 2005,the number of monopoly cases had increased.The monopoly subjects were mainly small and medium-sized enterprises,the bulk drug price monopoly was the majority,and the traditional abuse of dominant market position and horizontal monopoly agreements were the main monopolistic behaviors.The price monopoly of drug industry in China should adopt a variety of punishment mechanisms to deter the monopolist,increase the types of legal liability and strengthen the punishment,and strengthen the intervention of administrative subjects in monopoly behavior.

Objective To evaluate the medication burden of patients with severe mental disorders who participated in medication subsidy in a district of Shenzhen,and to provide guidelines for patients′ assistance.Methods Through the hospital information management system,relevant data of medication subsidy of 7 hospitals in a district of Shenzhen from 2016 to 2020 were retrospectively collected,the times of patients picking up medicine,the price of commonly used antipsychotic medicine,the rate of "zero out-of-pocket" and the level of outpatient expenses were calculated.The linear regression was used to analyze the relationship among medication price,policy adjustments and "zero out-ofpocket" rate.Results A total of 4006 patients with 81 589 times of medication subsidies were included in the analysis,including 601 registered patients whose median level of prescribing medicine was 24 times/person,and 3405 non-registered patients whose median level of prescribing medicine was 15 times/person,there was statistically significant difference in the number of times of prescribing medicine between registered patients and non-registered patients for medication subsidy(P＜0.01).The rate of "zero out-of-pocket" of both registered and non-registered patients showed an increasing trend(P＜0.01).The total outpatient expenses per time and the amounts of subsidies per time for both registered and non-registered patients were negatively correlated with time(P＜0.01);the self-payment per time for non-registered patients was negatively correlated with time(P＜0.01).The linear regression equations of medication price and "zero out-of-pocket" rate of registered and nonregistered resident patients were respectively Yregistered=-0.006X+109.020(R2=0.93), Ynon-registered=-0.004X+90.221(R2=0.89).Conclusion There still exists clinic visit irregularities among patients with medication subsidy.30% patients need to pay part of their own expenses to prescribe medicine at clinics.It is thus necessary to further reduce the medication burden of patients and promote their regular medical treatment.

Objective To analyse the use of glucocorticoids in 210 hospitalized patients and its rationality.Methods Clinical data of 210 inpatients treated with glucocorticoids in the Zhanjiang Second Hospital of Traditional Chinese Medicine from April 2018 to March 2020 were retrospectively analyzed,and the types,distribution and irrational drug use of Glucocorticoids were statistically analyzed.Results The top three glucocorticoids in 210 hospitalized patients were Dexamethasone Sodium Phosphate Injection,accounting for 31.90%,Budesonide Suspension for Inhalation,accounting for 23.33%,Triamcinolone Acetonide Acetate Injection,accounting for 10.95%.Among 210 inpatients,the top three departments of glucocorticoids use were the first department of orthopedics,accounting for 34.29%,the fourth department of orthopedics,accounting for 24.29%,the department of respiratory medicine,accounting for 19.05%.There were 15 cases of irrational drug use among 210 inpatients,and the rate of irrational drug use was 7.14%.Irrational drug use included 6 cases of unreasonable indications(40.00%),4 cases of unreasonable usage and dosage(26.67%),3 cases of unreasonable combined drug use(20.00%),and 2 cases of unreasonable drug selection(13.33%).Conclusion The use of glucocorticoids in inpatients of Zhanjiang Second Hospital of Traditional Chinese Medicine was mainly distributed in the department of orthopedics and the department of respiratory medicine,and there were still many irrational situations.Therefore,it is necessary to strengthen supervision and professional knowledge training of clinicians,so as to reduce the rate of irrational use and improve the overall level of drug use in the hospital.

Objective To investigate the current situation and related factors of humanistic care quality of ICU nurses in 8 class A general hospitals in Shenzhen.Methods In April 2020,525 ICU nurses from 8 class A general hospitals in Shenzhen were selected as the research objects,and the humanistic care quality was investigated through questionnaire and WeChat platform.Results Among 525 ICU nurses,487 questionnaires were valid,with effective recovery of 92.8%.The overall score rate of humanistic care quality was 80.0%.Univariate analysis showed that there were statistically significant differences in nurse scores among different ages,first education,working years,professional titles,positions,marital status,family or colleagues′ concern for nurses(P＜0.05).Multivariate Logistic regression analysis showed that the humanistic care quality of nurses aged 30 and above,nurses or charge nurses,head nurses or teaching officers,family members and/or colleagues who cared more about nurses were better(P＜0.05).Conclusion The quality of humanistic care of Shenzhen ICU nurses still needs improvement.The independent factors related to the quality of humanistic care in nurse group include age,professional title,post,care from family members and colleagues.

Objective To analyze the regularity of adverse reactions of Chinese patent medicines,to improve the rate of clinical rational use of drugs.Methods Data of 115 cases of adverse reactions(ADR)of Chinese patent drugs collected from Guangzhou First People′s Hospital from January to December 2019 were retrospectively selected to analyze the types of Chinese patent drugs,route of drug administration,and the main clinical manifestations of ADR.Results In the data report table of 115 cases of ADR of Chinese patent medicine,68 cases were female,accounting for 59.10%,and 47 cases were male,accounting for 40.90%.The patients ranged from 18 months to 84 years old,among which 74 patients were ＞60 years old,accounting for 64.40%.The analysis of drug types showed that there were 25 drugs in total,mainly 6 kinds of drugs,among which 36 cases were cardiovascular drugs,accounting for 31.30%,ranking the first.Analysis of drug administration routes showed that 41 cases were given by injection,accounting for 36.50%,62 cases were given by oral administration,accounting for 53.90%,and 12 cases were given by external preparations,accounting for 10.40%.The majority of adverse reactions involving systems and organs were skin and its accessories,with a total of 48 cases,accounting for 42.57%.The main clinical manifestations of patients were rash and pruritus.Conclusion There are many adverse reactions in the use of Chinese patent medicines,so the clinical use should be cautious,and the rational clinical use rate should be improved to reduce the occurrence of adverse drug reactions as far as possible.

In recent years,the problem of drug safety has gradually become the focus of social attention.Scientific and standardized use of drug standards is particularly important to ensure drug safety.At present,there are many problems in drug standard management,such as many standards,difficult to query,delay in becoming a regular,multiple standards for one product and so on.The standard management system needs to be further improved.Based on the analysis of the problems existing in the management and implementation of drug quality standards,this paper puts forward the optimization measures of quality standard management in view of the related problems,and further ensures the safety and effectiveness of drugs and improves the work efficiency of functional departments with accurate standards and scientific management methods.

Objective To explore the application of continuous quality improvement in hospital infection care.Methods A total of 53 patients without continuous quality improvement in Xinyu People′s Hospital from June 2018 to June 2019 were selected as the control group,and 53 patients with continuous quality improvement in Xinyu People′s Hospital from July 2019 to July 2020 were selected as the research group.The intervention effect,infection management quality score and satisfaction of patients in two groups were observed and analyzed.Results The incidence of infection events and the omission rate of infection events in the study group were lower than those in the control group,and the hand washing compliance rate in the study group was higher than that in the control group,the differences were statistically significant(P＜0.05).The scores of disinfection and isolation,hand hygiene,medical guidance and supervision review in the study group were higher than those in the control group,with statistical differences(P＜0.05).The satisfaction of the study group was higher than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Continuous quality improvement is applied in a more significant effect of hospital infection in nursing,reduce the occurrence of infection and omission,improve patient compliance of hand washing,disinfection and isolation,hand hygiene and improve quality of infection management and clinic guidance,is conducive to further improve their satisfaction and worth application.

Objective To explore the effect of standardization management of foreign medical equipment by using information traceability system in disinfection supply center.Methods A total of 2400 foreign medical instruments and 600 pieces of new medical textiles from Jiangxi Provincial People′s Hospital from January to December 2020 were retrospectively selected and divided into observation group and control group according to different operating procedures.Each group contained 1200 foreign medical instruments and 300 pieces of new medical textiles.The observation group was treated with standardized management for medical devices and textiles,while the control group was treated with conventional management.The return washing rate of foreign medical instruments and the loss rate of new medical textiles were compared between the two groups.Results The washback rate of foreign medical instruments in the observation group was 91.00%,which was higher than 48.00% in the control group,the difference was statistically significant(P＜0.05).The loss rate of new medical textiles in the observation group was 10.00%,which was lower than 50.00% in the control group,the difference was statistically significant(P＜0.05).Conclusion Disinfection supply center information tracing system for the implementation of standardized management of medical equipment,can improve the foreign medical equipment after use,return rate and turnover rate,reduce medical new textiles is worthy of popularization in the hospital.

Objective To explore the epidemic trend and influencing factors of hepatitis C among people who donate blood without compensation in Inner Mongolia.Methods Retrospectively analyzed the relevant data of 1860 unpaid blood donors in Inner Mongolia from January 2016 to December 2020.The data was from the China Information System for Disease Control and Prevention,and the data of unpaid blood donation population was from the Big Data of Public Opinion on Unpaid Blood Donations in My Country.According to hepatitis C infection,they were divided into infected group(324 cases)and uninfected group(1536 cases).The prevalence rate of hepatitis C and the influencing factors of hepatitis C complication in non-remunerated blood donors were analyzed.Results In 2020,the prevalence of hepatitis C was the highest among unpaid blood donors,which was 6.45%,followed by 2019(4.62%),2018(3.60%),2017(2.10%)and 2016(0.65%).There was statistically significant difference in the prevalence of hepatitis C in different years(P＜0.05).Univariate analysis showed that there were differences between the two groups in family history of hepatitis disease,history of hospitalization,history of sharing glass syringes,history of sharing razors,and history of blood transfusion(P＜0.05).Multivariate Logistic regression analysis showed that family history of hepatitis disease,history of hospitalization,history of using glass syringes,history of sharing razors,and history of blood transfusion were risk factors for hepatitis C complication in unpaid blood donors(P＜0.05).Conclusion From 2016 to 2020,the non-remunerated blood donors in Inner Mongolia who have a family history of hepatitis disease,hospitalization,sharing of glass syringes,sharing of razors and blood transfusions have a higher possibility of hepatitis C infection,and attention should be paid to these risk factors.

Mesenteric cyst,refers to a rare benign intra-abdominal lesion,with limited domestic and foreign researches on it with pregnancy.It is easy to be misdiagnosed because of its non-specific characteristics and lack of knowledge among clinicians.To explore the diagnosis and management of pregnancy complicated with abdominal mass,a misdiagnosis case of pregnancy complicated with giant mesenteric cyst was reported in this study,which summarized the clinical experience by analyzing the causes of misdiagnosis mainly from two aspects,ultrasound diagnosis and clinical thinking.In the diagnosis and treatment of pregnancy complicated with abdominal mass,clinicians should form a rigorous clinical thinking and make differential diagnosis based on the imaging data,so as to make a correct clinical diagnosis.