Objective To observe the effects of different doses of calcium-sensing receptor inhibitors on the osteolysis and the expression inflammatory factor induced by wear particles, so as to investigate its effect of preventing aseptic loosening of artificial joints. Methods Forty C57BL/6J male mice aged 8-10 weeks were divided into control group,particle group, low dose group and high dose group according to the random number table, with 10 mice in each group.Wear particle-induced mouse calvaria osteolysis model were established in the particle group, low-dose group and high-dose group, then the control group was treated with sham operation. From the second day after operation, mice in low-dose group and high-dose group were given 0.2 mg/kg and 2.0 mg/kg NPS2390 intraperitoneally every other day.The control group and particle group were replaced by the same amount of normal saline. After 14 days, the skull specimens were taken and the skull bone mineral density, bone volume fraction, bone porosity, skull bone area, the number of osteoclast and the expression of the inflammatory factor tumor necrosis factor-α (TNF-α) and interleukin-1β(IL-1β) were compared between the groups. Results In particle group, the number of osteoclasts, the bone porosity and the expression of inflammatory factor TNF-α and IL-1β were higher than that in control group,however,the bone mineral density,the bone volume fraction,and the bone area of the skull in particle group were lower than those of control group,the differences were statistically significant (P＜0.05). In low dose group, the bone mineral density was higher than that in particle group, the number of osteoclast and the expression of inflammatory factor TNF-α and IL-1β in low dose group were lower than those in the particle group, the differences were statistically significant (P＜0.05). The bone mineral density, bone volume fraction and bone area of the high-dose group were higher than those of the granule group, while the bone porosity, the number of osteoclasts, the expression of inflammatory factors TNF-α and IL-1β were lower than those of the granule group, the differences were statistically significant(P＜0.05).The bone mineral density and bone volume fraction of the high dose group were higher than those of the low dose group, and the number of osteoclasts and the expression of inflammatory factors TNF-α and IL-1β were lower than those of the low dose group,and the differences were statistically significant (P＜0.05).Conclusion The calcium-sensing receptor inhibitor (NPS2390) can effectively inhibit osteolysis and the expression of inflammatory induced by wear particles, and provides new ideas for prevention aseptic loosening of artificial joints.

Objective To study the effect of mindfulness decompression therapy combined with respiratory exercise therapy on postoperative perceived stress,anxiety and depression in patients with lung cancer.Methods A total of 100 lung cancer patients treated in Coast Guard Hospital of Chinese People′s Armed Police Force from January to December 2021 were selected as the research objects and divided into control group and observation group by random number table method, with 50 cases in each group. Patients in the control group received routine nursing intervention, while patients in the observation group received mindfulness-based stress reduction therapy combined with respiratory exercise therapy on the basis of the control group. The scores of self-rating anxiety scale (SAS), self-rating depression scale(SDS), the Chinese version of perceived stress scale (CPSS), the cancer fatigue scale (CFS), strategies used by people to promote health (SUPPH), pulmonary function indexes (forced expiratory volume in one second [FEV1], forced vital capacity [FVC], FEV1/FVC), and 6-min walk test (6MWT) were compared between the two groups. Results The scores of SAS, SDS, CPSS and CFS in the observation group at 8 weeks after operation were lower than those in the control group, and the differences were statistically significant (P＜0.05). The SUPPH score, FEV1, FVC, FEV1/FVC and 6MWT of the observation group were higher than those of the control group at 8 weeks after operation, and the differences were statistically significant (P＜0.05). Conclusion The implementation of mindfulness decompression therapy combined with respiratory exercise therapy in patients with lung cancer can help to improve their anxiety and depression, cancer-related fatigue and perceived stress level, improve self-efficacy, lung function and exercise endurance.

Objective To investigate the diagnostic efficacy of circulating tumor cells (CTC) combined with CT in the nature of pulmonary nodule lesions. Methods From March 2019 to August 2021, 82 patients with suspected pulmonary nodule lesions in Bao′an Central Hospital Affiliated to Guangdong Medical College were selected as the subjects. After admission, they underwent chest CT imaging examination and CTC examination. The pathoiogical tissue examination was used the "gold standard" to analyze the diagnostic efficacy of CTC and combined CT, and to determine the nature of small pulmonary nodules. Results Among 82 patients with suspected pulmonary nodule lesions, 61 patients were diagnosed with pulmonary nodule lesions by histopathological examination, and the diagnosis rate was 74.39%. Among them, there were 16 cases (26.23%) of benign nodules and 45 cases (72.77%) of malignant nodules. 57 cases of small pulmonary nodules were diagnosed by CTC combined with CT examination, there were 20 benign nodules and 37 malignant nodules, and the accuracy was 85.37%, the diagnostic sensitivity was 86.89% (53/61), the specificity was 80.95% (17/21), the positive predictive value was 92.98% (53/57), the negative predictive value was 68.00% (17/25),and the AUC was 0.894. Conclusion CTC examination has a higher detection rate in small pulmonary nodule lesions,and the examination accuracy is higher than that of CT imaging results, and the combined examination of the two can improve the diagnostic efficiency and provide a reference for clinical diagnosis and treatment.

Objective To investigate the effect of anti-angiogenic drug Bevacizumab and programmed cell death protein-1 (PD-L1) inhibitor Tislelizumab in the treatment of advanced non-small cell lung cancer (NSCLC). Methods From August 2019 to December 2020, 86 patients with advanced non-small cell lung cancer (NSCLC) treated in the third Department of Oncology, Xintai People′s Hospital were selected as subjects, the patients were divided into experimental group (43 cases) and control group (43 cases) according to the odd-even grouping method of admission number.Patients in the control group were treated with routine chemotherapy, while those in the experimental group were treated with Bevacizumab, an anti-angiogenic drug, and Tirizumab, a PD-L1 inhibitor. Before treatment and after 2 courses of treatment, the serological indexes (vascular endothelial growth factor [VEGF], insulin-like growth factor-1 [IGF-1],threonine kinase [AMPK]) and tumor markers (carcinoembryonic antigen [CEA], cytokeratin 19 soluble fragment[CYFRA21-1], alpha-fetoprotein [AFP]) were compared between the two groups. Before treatment and at 1, 2, and 3 weeks of treatment, the tumor volume (TV) was compared between the two groups. The survival conditions (median progression-free survival [mPFS], median overall survival [mOS]) and clinical treatment effect were compared between the two groups. Results After 2 courses of treatment, VEGF levels in the two groups were lower than those before treatment, IGF-1 and AMPK were higher than those before treatment in both groups, and VEGF and IGF-1 in the experimental group were lower than those in the control group,and AMPK was higher than that in the control group,and the differences were statistically significant (P＜0.05). After 2 courses of treatment, the levels of CEA, CYFRA21-1 and AFP in the two groups were lower than those before treatment, and CEA, CYFRA21-1 and AFP of the experimental group were lower than those of the control group, and the differences were statistically significant (P＜0.05). There were significant differences in time, intergroup and interaction between the two groups (P＜0.05). At 1, 2, and 3 weeks after treatment, the TV levels of the two groups were lower than those before treatment, and the TV of the experimental group was lower than that of the control group, and the differences were statistically significant (P＜0.05). PFS and OS of the experimental group were longer than those of the control group, and the differences were statistically significant (P＜0.05). There was no significant difference in ORR between the experimental group (46.51%) and the control group(27.90%) (P＞0.05). The DCR of experimental group (72.09%) was higher than that of control group (48.84%), and the difference was statistically significant (P＜0.05). Conclusion The combination therapy of advanced NSCLC with anti-angiogenic drug and PD-L1 inhibitors can reduce the level of tumor markers, improve serum parameters, reduce TV and prolong the survival time of patients.

Objective To explore the effect of Fuzheng Yangyin Prescription on immune function and quality of life of postoperative chemotherapy patients with gastrointestinal tumors. Methods A total of 64 patients with deficiency of Qi and Yin after chemotherapy of gastrointestinal tumors treated in Changshu No.1 People′s Hospital from August 2018 to December 2019 were selected as the research objects. They were divided into control group and Fuzheng Yangyin Prescription group according to random number table method, with 32 cases in each group. The control group was treated with first-line chemotherapy, Fuzheng Yangyin Prescription group was treated with Fuzheng Yangyin Prescription on the basis of the control group.The changes of Karnofsky performance score(KPS),traditional Chinese medicine syndrome score and cellular immune indexes were compared between the two groups before and after treatment. Results There was no significant difference in CD3+ between the two groups before treatment (P＞0.05). After treatment, CD3+ in the two groups were higher than those before treatment, and the CD3+ in the Fuzheng Yangyin Prescription group was higher than that in the control group, and the differences were statistically significant (P＜0.05). There was no significant difference in CD4+between the two groups before treatment (P＞0.05). After treatment, CD4+in the two groups were lower than those before treatment, and the CD4+in the Fuzheng Yangyin Prescription group was lower than that in the control group, the differences were statistically significant (P＜0.05). There was no significant difference in CD4+/CD8+ratio between the two groups before treatment (P＞0.05). After treatment, the CD4+/CD8+ ratios of the two groups were higher than those before treatment, and the CD4+/CD8+ ratio in the Fuzheng Yangyin Prescription group was higher than that in the control group, the differences were statistically significant (P＜0.05). There was no significant difference in KPS score between the two groups before treatment (P＞0.05). After treatment, the KPS scores of the two groups were higher than those before treatment, the KPS score of Fuzheng Yangyin Prescription was higher than that of the control group,the differences were statistically significant (P ＜0.05). There was no significant difference in traditional Chi nese medicine syndrome score between the two groups before treatment (P＞0.05). After treatment, the traditional Chinese medicine syndrome scores of the two groups were lower than those before treatment, the traditional Chinese medicine syndrome score of the Fuzheng Yangyin Prescription group was lower than that of the control group, the differences were statistically significant (P＜0.05). Conclusion Fuzheng Yangyin Prescription can improve the immune function and quality of life of patients with gastrointestinal tumors after chemotherapy.

In recent years, the incidence of thyroid cancer has been increasing in China. Differentiated thyroid cancer(DTC) is a kind of thyroid cancer, among which postoperative DTC combined with 131 iodine (131I) treatment has become a routine treatment for patients with middle and high risk of recurrence. Normal thyroid cells have the ability of iodine uptake, can selectively ingests 131I from the blood into normal thyroid follicular cells, using the physical decay of 131I to produce β-ray radiobiological effects, remove normal residual thyroid tissue, to reduce the purpose of tumor recurrence and metastasis. Although the clinical value of 131I in removing residual thyroid tissue is widely recognized,the ionizing radiation from the physical decay of 131I may cause ionizing damage to patients and the public, and clinicians should be fully aware of the risks. At present, there are few studies on the safety of different doses of 131I for patients and the public, and the long-term effects of 131I on patients are still controversial. In this paper, the safety of 131I removal of residual thyroid tissue after DTC on hematopoietic system, reproductive system, secondary tumor and public radiation are briefly described.

 In recent years, the incidence of thyroid cancer has been increasing in China. Differentiated thyroid cancer(DTC) is a kind of thyroid cancer, among which postoperative DTC combined with 131 iodine (131I) treatment has become a routine treatment for patients with middle and high risk of recurrence. Normal thyroid cells have the ability of iodine uptake, can selectively ingests 131I from the blood into normal thyroid follicular cells, using the physical decay of 131I to produce β-ray radiobiological effects, remove normal residual thyroid tissue, to reduce the purpose of tumor recurrence and metastasis. Although the clinical value of 131I in removing residual thyroid tissue is widely recognized,the ionizing radiation from the physical decay of 131I may cause ionizing damage to patients and the public, and clinicians should be fully aware of the risks. At present, there are few studies on the safety of different doses of 131I for patients and the public, and the long-term effects of 131I on patients are still controversial. In this paper, the safety of 131I removal of residual thyroid tissue after DTC on hematopoietic system, reproductive system, secondary tumor and public radiation are briefly described.

 Hypertensive disorders during pregnancy (HDP) represent a major cause of maternal, fetal and neonatal mortality and identifies women at risk for cardiovascular and other chronic diseases later in life. Treatment of HDP concerns both the mother and the fetus and depends on blood pressure (BP) level, gestational age, and presence of associated maternal and fetal risk factors. This article reviews the effect of antihypertensive drugs on mother and fetus when administered during pregnancy and/or post-partum. Treatment of mild hypertension and no end-organ damage during pregnancy remains controversial and there is no agreement about when to initiate antihypertensive therapy, optimal BP targets or recommended drugs. In severe hypertension the goal is to reduce BP to ＜160/105 mmHg over minutes to hours and then to achieve a sustained BP of 140-150/90-100 mmHg, and most guidelines recommend antihypertensive therapy with labetalol, methyldopa, or nifedipine. Nifedipine, labetalol and some angiotensin-converting enzyme inhibitors (captopril and enalapril) can be used safely during breastfeeding. This review could provide clinical references for treating HDP patients safety and effectively by describing antihypertensive drugs in details.

Objective To investigate the effect of hyperbaric oxygen (HBO) combined with external diaphragm pacing(EDP) in off-line treatment of patients of acute cervical spinal cord injury with respiratory failure. Methods A total of 50 patients with acute cervical spinal cord injury and semi-respiratory failure admitted to Mingzhou Rehabilitation Hospital of Nanchang from May 2019 to January 2022 were selected as the study subjects, and they were divided into the control group and the observation group according to random number table method, with 25 cases in each group.The control group was given conventional treatment, and the observation group was treated with HBO combined with EDP. Both groups were treated for 3 weeks. The off-line success rate, diaphragmatic mobility, lung function indexes(forced vital capacity [FVC], forced expiratory volume in one second [FEV1]) and mechanical ventilation time were compared between the two groups. Results The off-line success rate of the observation group was higher than that of the control group, and the difference was statistically significant (P＜0.05). There were no significant differences in the indexes of diaphragm movement and lung function between the two groups before treatment (P＞0.05). After treatment,the levels of diaphragm mobility, FVC and FEV1 in the observation group were higher than those in the control group,and the differences were statistically significant (P＜0.05). The mechanical ventilation time of the observation group was shorter than that of the control group, and the difference was statistically significant (P＜0.05). Conclusion HBO combined with EDP can improve the diaphragm mobility and lung function indexes of patients with acute cervical spinal cord injury and respiratory failure, effectively relieve respiratory failure, thereby increasing the success rate of weaning and shortening the mechanical ventilation time.

Objective To investigate the application effect of intelligent risk assessment before gastric tube insertion in the prevention of aspiration in neurology patients. Methods The clinical data of 90 patients with gastric tube indwelling in the Department of Neurology of Pingxiang City People′s Hospital from October 2020 to September 2021 were retrospectively analyzed, and they were divided into the control group and the observation group according to whether information-based aspiration risk assessment was adopted, with 45 cases in each group. The control group used routine aspiration risk assessment, and the observation group used information-based aspiration risk assessment. The incidence of aspiration, gastric tube indwelling time, hospital stay and swallowing function were compared between the two groups.Results There was no significant difference in the score of swallowing function between the two groups before intervention (P＞0.05). The incidence of aspiration in the observation group was 8.89%, which was lower than 26.67% in the control group, and the difference was statistically significant (P＜0.05). The gastric tube indwelling time ([17.89±3.20] d)and the hospitalization time ([20.82±2.76] d) in the observation group were shorter than those in the control group([21.78±3.24] d and [25.64±3.16] d), and the differences were statistically significant (P＜0.05). The swallowing function score of the observation group after intervention was (2.21±0.05) points, which was lower than that of the control group([3.24±0.10] points), and the difference was statistically significant (P＜0.05). Conclusion Intelligent risk assessment before gastric tube insertion can effectively prevent aspiration in neurology patients, improve patients′ swallowing function, and effectively shorten gastric tube indwelling time and hospital stay.

Objective To investigate the influence of low flow oxygen inhalation on cognitive function and quality of life in patients with maintenance hemodialysis (MHD). Methods A total of 62 outpatients with maintenance hemodialysis in Changle Traditional Chinese Medicine Hospital and Weifang Xiashan Hospital from March 2020 to June 2021 were selected as the research objects, and they were divided into the treatment group (n=31) and the control group (n=31) according to random lottery. Both groups received routine hemodialysis 3 times a week for 4 h each time. The treatment group was given low-flow oxygen inhalation for 4 h during hemodialysis, while the control group was not given oxygen inhalation. The scores of Montreal cognitive assessment scale (MoCA), World Health Organization quality of life-BREF(WHOQOL-BREF) were compared between the two groups before treatment and after 6 months of treatment. Results The total score of MoCA scale and the scores of visuospatial and executive ability, naming, attention, delayed recall and orientation sub items in the treatment group after 6 months of treatment were higher than those before the oxygen inhalation treatment, and the differences were statistically significant (P＜0.05). The total score of MoCA scale and the scores of visuospatial and executive ability, naming, abstraction, attention, delayed recall and orientation sub items in the treatment group after 6 months of treatment were higher than those in the control group at the same period, and the differences were statistically significant (P＜0.05). The total score of MoCA scale and the scores of visuospatial and executive ability, attention, delayed recall and orientation sub items of the control group after treatment were lower than those of the control group before treatment,and the differences were statistically significant (P＜0.05). The WHOQOL-BREF scores in all fields and the overall sensory scores of the patients in the treatment group after 6 months of oxygen inhalation treatment were higher than those before treatment and in the control group, and the differences were statistically significant (P＜0.05). Conclusion Low flow oxygen inhalation can improve cognitive function and quality of life in patients with maintenance hemodialysis.

Objective To explore the clinical value of gastric background mucosal examination under scaled digestive endoscopy in judging Helicobacter pylori (Hp) infection. Methods Ninety-seven patients who underwent gastroscopy in the outpatient and inpatient clinics of Yangjiang Traditional Chinese Medicine Hospital from October 1, 2019 to September 1, 2021 were selected as research objects. The entered study cases were examined by the Endoscopic Background Mucosal Examination Scale and 13C-urea breath test (13C-UBT), histological examination of gastric mucosa, with the results of gastric mucosal histological examination as the gold standard, compared the diagnostic performance of the two methods.Results Among the 97 patients,88 were pathologically confirmed to be positive for Hp infection,and 9 were non-positive for Hp infection. 13C-UBT detection results confirmed that 85 patients were positive for Hp infection, and 3 were negative. Endoscopic Background Mucosal Examination Scale detection results confirmed that 83 patients were positive for Hp infection, and 5 were negative. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the Endoscopic Background Mucosal Examination Scale were 94.32%, 77.78%, 97.65%, 58.33%and 92.78%, while the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 13CUBT were 96.59%, 88.89%, 98.84%, 72.73% and 95.88%, and the differences were not significant (P＞0.05). Conclusion The gastric background mucosal examination under the scaled digestive endoscopy has good diagnostic performance in judging Hp infection, the score is clear, the standard is easy to grasp, and the practicability is strong.

Objective To investigate the clinical efficacy and safety of Trimebutine Maleate combined with Esomeprazole in the treatment of gastroesophageal reflux disease (GERD). Methods A total of 75 patients with gastroesophageal reflux disease admitted to the Department of Gastroenterology and Nephrology of the Second People′s Hospital of Guangshui City from August 2019 to August 2020 were selected as the research subjects, and divided into observation group (n=38) and control group (n=37) by random touch ball method. The control group was treated with Esomeprazole,and the observation group was treated with Esomeprazole and Trammebutine Maleate. The clinical efficacy of the two groups was compared. The motor function indexes of distal esophageal smooth muscle (distal contraction integral [DCI],perperistaltic contraction ratio, lower esophageal sphincter relaxation ratio [LESRR] and low esophageal sphincter pressure [LESP]), gastroesophageal reflux disease health-related quality of life scale (GERD-HRQL) and gastroesophageal reflux disease quality scale (GerdQ) scores were compared between the two groups before and after treatment. Results The total effective rate of the observation group after treatment was higher than that of the control group, and the LESP,perperistaltic contraction ratio, LESRR and DCI of the observation group after treatment were all lower than those of the control group, with statistically significant differences (P＜0.05). The GERD-HRQL scores of each dimension of the observation group after treatment were lower than those of the control group, and the GerdQ score of the observation group after treatment was lower than that of the control group, with statistically significant differences (P＜0.05). There was no adverse reaction in the two groups during treatment. Conclusion Trimebutine Maleate combined with Esomeprazole can improve the therapeutic effect of patients with gastroesophageal reflux disease, improve the smooth muscle movement function of patients with lower esophagus, and improve the symptoms and quality of life of patients,which is safe and reliable.

Objective To study the effect of Terbutaline combined with Aminophylline, Budesonide in the treatment of elderly patients with chronic obstructive pulmonary disease and the influence on pulmonary functione. Methods From January 2020 to January 2021, 70 elderly patients with chronic obstructive pulmonary disease who were admitted to People′s Hospital of Yunyang District of Shiyan City in Hubei Province were selected as the research objects, and they were divided into the control group and the experimental group by tossing coin method. The control group was treated with Budesonide and Terbutaline, the experimental group was treated with Terbutaline combined with Aminophylline and Budesonide. The pulmonary function indexes (forced expiratory volume in one second [FEV1], forced vital capacity[FVC], peak expiratory flow [PEF]), clinical effect and symptom relief time (disappearance time of lung infection, disappearance time of cough and disappearance time of rale) were compared between the two groups before and after treatment. Results The total clinical effective rate of the experimental group was 94.29%, which was higher than that of the control group (60.00%), and the difference was statistically significant (P＜0.05). There were no significant differences in the levels of FEV1, FVC and PEF between the two groups before treatment (P＞0.05). The levels of FEV1, FVC and PEF in the experimental group were higher than those in the control group, and the differences were statistically significant(P＜0.05). The disappearance time of lung infection, disappearance time of cough and disappearance time of rale in the experimental group were shorter than those in the control group, and the differences were statistically significant (P＜0.05). Conclusion Terbutaline, Aminophylline and Budesonide have better clinical effects in the treatment of elderly patients with chronic obstructive pulmonary disease, and the recovery of various indexes of lung function is better after treatment, and the treatment time is shorter, which is worth popularizing and promoting in clinical treatment.

Objective To explore the current situation and influencing factors of quality of life in patients with obstructive sleep apnea hypoventilation syndrome (OSAHS). Methods From January 2016 to October 2020, 46 patients with OSAHS in the Department of Otolaryngology of Nantong Tongzhou People′s Hospital were selected as the research object. The quality of life-obstructive sleep apnea hypoventilation syndrome (QOL-OSAHS) scale was used to evaluate the quality of life of patients, the score of the scale was observed, and the influencing factors affecting the quality of life of OSAHS patients was analyzed. Results The QOL-OSAHS scores of 46 patients were excellent in 1 case, good in 6 cases, fair in 14 cases and poor in 25 cases. The excellent rate of quality of life was 15.22%, and the poor rate of quality of life was 54.35%. Univariate analysis showed that there were no significant differences in gender, age, culture,marriage, smoking history, drinking history, smoking and alcohol history, family snoring history and disease course (P＞0.05). There were significant differences in body mass index, chronic history of respiratory system and the severity of the disease (P＜0.05). The results of multivariate linear regression analysis showed that overweight and obesity, chronic respiratory history and moderate and severe disease were independent risk factors for the quality of life of OSAHS patients (P＜0.05). Conclusion OSAHS patients generally have low quality of life, which is related to factors such as excessive weight, severity of illness, and respiratory chronic disease. Strengthening the comprehensive treatment and intervention of OSAHS has a positive effect on improving the quality of life of patients.

 Objective To investigate the safety and efficacy of dental floss traction in endoscopic submucosal dissection(ESD) of laterally developing colorectal tumors (LST). Methods A total of 78 patients with sigmoidous colon or rectal LST treated in Jiujiang No.1 People′s Hospital from July 2018 to December 2021 were selected as the research objects.They were divided into routine group (40 cases) and traction group (38 cases) by stratified randomization according to the location of the lesions. The routine group was treated with ESD, and the traction group was treated with dental floss traction assisted ESD. The diameter of stripping lesion, mean time of lesion removal, en bloc resection rate, complete resection rate and complication rate were compared between the two groups. Results The mean time of lesion removal in traction group was shorter than that in routine group, the difference was statistically significant (P＜0.05). The en bloc resection rate of traction group was higher than that of routine group, the difference was statistically significant (P＜0.05). There were no significant differences in the complete resection rate of lesions and the incidence of related complications between the two groups (P＞0.05). Conclusion The dental floss traction can significantly shorten the removal time of ESD for colorectal laterally spreading tumor, it has strong secunity and effectiveness.

Objective To investigate the application effect of single hole thoracoscopic resection in patients with spontaneous pneumothorax and pulmonary bullae, and further analyze its clinical safety. Methods The clinical data of 80 patients with spontaneous pneumothorax and pulmonary bullae admitted to Central Hospital of Zhuanghe City from January 2018 to January 2021 were retrospectively analyzed. They were divided into single hole group and three hole group according to envelope method, with 40 cases in each group. The single hole group was treated with single hole thoracoscopic resection, and the three hole group was treated with three hole thoracoscopic resection. The amount of intraoperative bleeding, operation time, hospital stay, incidence of complications, serum white blood cell (WBC) and Creactive protein (CRP) were compared between the two groups. Results The intraoperative blood loss of the single hole group was less than that of the three hole group, and the operation time and hospital stay of the single hole group were shorter than those of the three hole group, the differences were statistically significant (P＜0.05). The postoperative complication rate and the 1 year recurrence rate in the single hole group were lower than those in the triple hole group, the differences were statistically significant (P＜0.05). Postoperative serum WBC and CRP levels were higher than preoperative levels in both groups, and postoperative serum WBC and CRP in the one hole group were lower than those in the three hole group, the differences were statistically significant (P＜0.05). Conclusion Thoracoscopy resection has a significant effect on spontaneous pneumothorax complicated with pulmonary bullae. The efficacy, recovery efficiency and safety of single hole thoracoscopic resection are better than three hole thoracoscopic resection, which is worthy of further popularization.

Objective To investigate the effect of free supracarpal perforator flap of ulnar artery with tendon in the repair of small and medium-sized dorsal digital skin and soft tissue combined with extensor tendon defect. Methods A total of 60 patients with small and medium-sized dorsal digital skin and soft tissue combined with extensor tendon defect treated in People′s Hospital of Heshan City from January to October 2020 were selected as the research objects.They were divided into the research group and the control group according to random number table method, with 30 cases in each group. The control group was repaired with composite flap, the research group was treated with free supracarpal perforator flap of ulnar artery with tendon. The perioperative indexes, clinical efficacy and complications 12 months after operation were compared between the two groups. Results The operative time, time to get out of bed for the first time and length of hospital stay in the research group were shorter than those in the control group. The intraoperative blood loss in the research group was less than that in the control group, the excellent and good efficacy rate 12 months after operation in the research group was higher than that in the control group, the total complication rate 12 months after operation in the research group was lower than that in the control group, the differences were statistically significant (P＜0.05). Conclusion The repair of free supracarpal perforator flap of ulnar artery with tendon is simple and has few postoperative complications, which can effectively improve the extension and flexion function of fingers in patients with small dorsal digital skin and soft tissue combined with extensor tendon defect.

 Objective To investigate the application of 3D printing combined with wrist arthroscopy in treatment of distal radius fracture involving articular surface with fully minimally invasive precise reduction and percutaneous internal fixation. Methods From January to December 2020, 30 patients with distal radius fracture involving articular surface admitted to Foshan Shunde Heping Surgical Hospital, Guangdong Province were selected as the research objects. They were divided into control group and observation group by random number table method, with 15 cases in each group. Patients in the control group were treated with open reduction and internal fixation, while patients in the observation group were treated with 3D printing combined with wrist arthroscopy for total minimally invasive precise reduction and percutaneous internal fixation. The clinical indicators of treatment (length of hospital stay, surgical treatment cost, fracture healing time), wrist function (Gart-Land-Werley score, wrist range of motion) and postoperative pain (visual analogue scale [VAS] score) were compared between the two groups. Results The hospital stay and fracture healing time of the observation group were shorter than those of the control group, and the cost of surgical treatment was lower than that of the control group, and the differences were statistically significant (P＜0.05). There were no significant differences in preoperative Gart-land-Werley score and wrist range of motion between the two groups (P＞0.05). At 6 months after operation, the Gart-land-Werley score of wrist in the observation group was lower than that in the control group, and the wrist range of motion was higher than that in the control group, and the differences were statistically significant (P＜0.05). The VAS score of the observation group was lower than that of the control group 3 d after operation, and the difference was statistically significant (P＜0.05). Conclusion The clinical treatment of distal radius fracture involving articular surface can be combined with 3D printing and fully minimally invasive precise reduction of wrist and percutaneous internal fixation. The surgical operation is more accurate, and the length of hospital stay can be shortened. The medical expenses of patients can be reduced, and the wrist function can recover better. The therapeutic effect of this method can be ensured.

Objective To explore the effect of Sodium Hyaluronate combined with Compound Betamethasone Injection in the treatment of knee osteoarthritis. Methods A total of 84 patients with knee osteoarthritis admitted to the Department of Joint Surgery, the Second Affiliated Hospital of Inner Mongolia Medical University from January 2020 to December 2021 were retrospectively selected as the research subjects. According to medication regimen, they were divided into a reference group (42 cases) and a study group (42 cases). The reference group received Sodium Hyaluronate Injection. The study group was treated with Sodium Hyaluronate+Compound Betamethasone Injection. The efficacy,knee function, pain degree and disease symptom score were compared between the two groups. Results The total effective rate of the study group (95.24%) was higher than that of the control group (79.19%), hospital for special surgery(HSS) score after treatment was higher than that of the control group, the visual analogue scale (VAS) score was lower than that of the control group, joint pain, swelling, morning stiffness and other symptoms scores were lower than those of the control group, the differences were statistically significant (P＜0.05). Conclusion Sodium hyaluronate combined with Compound Betamethasone Injection in the treatment of knee osteoarthritis can improve the curative effect, relieve pain, and improve the disease symptoms and knee joint function.

Objective To explore the application effect of hydrogel dressing and vacuum sealing drainage (VSD) technique in patients with open fractures of extremities (OFOE) and the effect on postoperative wound healing, interleukin-4 (IL-4), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) levels. Methods A total of 100 OFOE patients admitted to Shenyang Jishuitan Hospital from May 2018 to March 2020 were selected as research subjects and divided into control group (50 cases) and observation group (50 cases) by random number table method. Patients in the control group were treated with VSD technology, and patients in the observation group were treated with hydrogel dressing on the basis of the control group. The postoperative wound healing effect, levels of IL-4, IL-10, TNF-α and clinical efficacy were compared between the two groups. Results The frequency of dressing change in the observation group was less than that in the control group, the wound recovery time was shorter than that in the control group, and the flap formation rate was higher than that in the control group, and the differences were statistically significant (P＜0.05). Before treatment, there were no significant differences in the levels of IL-4, IL-10 and TNF-α between the two groups (P＞0.05). The levels of IL-4, IL-10 and TNF-α in the two groups after treatment were lower than those before treatment,and the levels of IL-4, IL-10 and TNF-α in the observation group after treatment were lower than those in the control group, and the differences were statistically significant (P＜0.05). The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P＜0.05). Conclusion Combining functional hydrogel dressing and VSD technology in OFOE patients can improve IL-4, IL-10 and TNF-α levels, which is worth promotion.

 Objective To observe the clinical significance of myeloid-derived suppressor cells (MDSCs) on epithelial ovarian cancer. Methods A total of 203 patients with epithelial ovarian cancer admitted to Jiangxi Provincial People′s Hospital from January 2019 to January 2021 were selected as the study group, and 115 healthy volunteers were selected as the control group. 5 ml peripheral venous blood of the two groups was collected and the expression level of MDSCs characterized by CD33+HLA-DR-/low was detected by flow cytometry. The patients in the study group were divided into a good prognosis group(162 cases)and a poor prognosis group(41 cases)according to the prognostic outcome.The expression levels of CD33+HLA-DR-/low MDSCs were compared between the two groups, and the clinical value of CD33+HLA-DR-/low MDSCs expression in predicting the prognosis of epithelial ovarian cancer was analyzed by receiver operating characteristic(ROC) curve. The correlation between the expression level of MDSCs and clinical indicators and prognosis of epithelial ovarian cancer was analyzed based on the age, tumor stage, tumor size, differentiation degree and pathological type of the patients in the study group. Results The expression level of CD33+HLA-DR-/low MDSCs in the study group was higher than that in the control group, the difference was statistically significant (P＜0.05). The expression level of CD33+HLA-DR -/low MDSCs was higher in poor prognosis group than that in good prognosis group, the difference was statistically significant(P＜0.05).The area under the curve (AUC), specificity and sensitivity of expression level of CD33+HLA-DR-/low MDSCs were 0.713 (95%CI=0.646-0.775), 53.70% and 82.93% in judging the prognosis of epithelial ovarian cancer. The expression level of CD33 +HLA-DR -/low MDSCs had no correlation with age, tumor size and pathological type of patients (P＞0.05), but was positively correlated with tumor stage (r=0.458, P＜0.05) and was negatively correlated with the degree of differentiation(r=-0.342, P＜0.05). Conclusion MDSCs can have a high expression level in patients with epithelial ovarian cancer, which is closely related to the tumor stage and differentiation degree of patients, and can be used for early prognosis evaluation to guide clinical diagnosis and treatment.

Objective To investigate the effect of Albumin-bound Paclitaxel combined with Bevacizumab in patients with advanced ovarian cancer who failed second-line therapy. Methods From January 2020 to April 2021, 136 patients with advanced ovarian cancer who had failed second-line treatment admitted to the No.908 Hospital, Joint Logistics Support Force were selected as the research subjects. According to computer random number method, the patients were divided into control group (68 cases) and observation group (68 cases). The control group were treated with Albuminbound Paclitaxel, and the observation group was treated with Albumin-bound Paclitaxel combined with Bevacizumab.The treatment effect, serum carcinoembryonic antigen (CEA), serum glucose chain antigen 125 (CA125) levels and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of observation group was higher than that of control group, and the difference was statistically significant (P＜0.05). After treatment, the levels of CEA and CA125 in the observation group were lower than those in the control group, and the differences were statistically significant (P＜0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P＞0.05). Conclusion For patients with advanced ovarian cancer who failed the secondline treatment, the treatment with Albumin-bound Paclitaxel combined with Bevacizumab has a good effect, can effectively improve the CEA and CA125 levels of patients, and has high safety and can be reasonable promotion and use should be carried out in combination with actual clinical needs.

Objective To explore the incidence, clinical characteristics and risk factors of patients with tumor lysis syndrome(TLS)in patients with hematological malignancies.Methods The clinical data of 182 patients with hematological malignancies admitted to the Department of Hematology, Fujian Provincial Hospital from January 2019 to June 2021 were retrospectively analyzed, and the occurrence and risk factors of TLS were analyzed. Results Among 182 patients,28 patients were complicated with TLS, with an incidence of 15.4%. All patients with TSL had elevated serum uric acid,elevated serum lactate dehydrogenase(LDH)in 25 cases(89.3%),hyperphosphatemia in 21 cases(75.0%),hypocalcemia in 16 cases (57.1%), elevated urea nitrogen and creatinine in 9 cases (32.1%), and hyperkalemia in 7 cases (25.0%).Univariate analysis showed that age, white blood cell count, mass diameter, creatinine, uric acid and serum lactate dehydrogenase were associated with TLS (P＜0.05). Multivariate logistic analysis showed that white blood cell count≥50×109/L (β=1.260, OR=3.500, P=0.012, 95%CI: 1.862-7.144) and mass diameter ≥5 cm (β=0.094, OR=1.986, P=0.028, 95%CI: 1.357-6.553), creatinine ≥123 μmol/L (β=1.370, OR=3.742, P=0.011, 95%CI: 1.195-5.832), uric acid≥476 μmol/L (β=0.071, OR=1.934, P=0.036, 95%CI: 1.580-4.748) and lactate dehydrogenase ≥245 U/L (β=2.890,OR=6.843, P=0.009, 95%CI: 1.468-8.748) were independent risk factors. Conclusion TLS is a common and serious complication of hematological malignancies. It is necessary to closely monitor and guard against its risk factors during treatment.

Objective To analyze the clinical effect of integrated traditional Chinese and Western medicine in the treatment of cancer pain in patients with advanced malignant tumors. Methods A total of 90 patients with cancer pain of advanced malignant tumors admitted to Xiamen Fifth Hospital from June 2017 to December 2020 were selected as the research objects. According to the order of admission, they were divided into routine group (45 cases) and observation group(45 cases).Patients in the conventional group were treated with conventional therapy, while patients in the observation group were treated with integrated traditional Chinese and Western medicine on the basis of the conventional group. The cancer pain score and the total incidence of adverse reactions after treatment were compared between the two groups.Results After treatment,the cancer pain score of the observation group was lower than that of the conventional group, and the difference was statistically significant (P＜0.05). The total incidence of adverse reactions in the observation group was lower than that in the conventional group, and the difference was statistically significant (P＜0.05).Conclusion The implementation of integrated traditional Chinese and Western medicine in the treatment of cancer pain patients with advanced malignant tumors can further improve the clinical treatment effect on the basis of conventional treatment and effectively reduce the pain caused by the disease to the human body. It has significant application value.

Objective To explore the application effect of information-motivation-behavior skills model in the education of parents′ intelligent nursing training of very low birth weight infants. Methods A total of 100 cases of very low birth weight infants and their parents treated in the neonatal intensive care unit of Ganzhou Maternal and Child Health Hospital from April to September 2021 were selected as the research objects. They were divided into control group (50 cases) and observation group (50 cases) by random number table method. The parents of the children in the control group received conventional intelligent nursing training and education, while the parents of the children in the observation group received intelligent nursing training and education based on the information motivation behavior skill model.The mastery of intellectual nursing training knowledge, the compliance of intellectual nursing training and the physical,intellectual and neurobehavioral development of very low birth weight infants 6 months after birth were compared between the two groups. Results The total awareness rate of the parents of the observation group was higher than the control group at discharge, and the difference was statistically significant (P＜0.05). At 1, 3 and 6 months after birth, the compliance of wisdom nursing training of parents in the observation group was higher than the control group, and the difference was statistically significant (P＜0.05). At 6 months after birth, the growth rate of body weight, body length and head circumference in the observation group were higher than the control group, and the differences were statistically significant (P＜0.05). The Gesell score and neonatal behavioral neurological assessment (NBNA) score in the observation group were higher than the control group, the differences were statistically significant (P＜0.05). Conclusion The application of information motivation behavior skill model to the education of intellectual nursing training for the parents of very low birth weight children can greatly promote the parents to master the knowledge of intellectual nursing training and improve the compliance of intellectual nursing training, which is helpful to promote the physical, intellectual and neural development of children, which is worthy of popularization and application.

Objective To compare the efficacy of self-cutting mesh laparoscopic vaginal sacral fixation combined with vaginal posterior wall repair and traditional vaginal surgery in the treatment of pelvic organ prolapse. Methods A total of 112 patients with pelvic organ prolapse admitted to Jiujiang Maternal and Child Health Hospital from September 2019 to June 2021 were retrospectively selected as the research objects, and were divided into observation group (62 cases) and control group (50 cases) according to different surgical methods. The observation group underwent self-cutting mesh laparoscopic vaginal sacral fixation combined with vaginal posterior wall repair. The control group received traditional total vaginal hysterectomy combined with vaginal wall repair. Operation time, length of hospital stay, intraoperative blood loss, postoperative vaginal length, surgical complications and recurrence rate were compared between the two groups to evaluate the surgical efficacy, and POP-Q values of each point one year after surgery were compared to evaluate the improvement of postoperative pelvic floor function of the two groups. Pelvic floor dysfunction questionnaire (PFDI-20) and pelvic organ prolapse/urinary incontinence questionnaire (PISQ-12) scores were performed 6 months after surgery to evaluate the improvement of postoperative quality of life in both groups. Results The operation time in the observation group was longer than that in the control group, with statistical significance (P＜0.05). There was no significant difference in the length of hospital stay between the two groups (P＞0.05). The amount of intraoperative blood loss in the observation group was less than that in the control group, the length of postoperative vagina in the observation group was longer than that in the control group, and the rate of surgical complications and recurrence was lower than that in the control group, with statistical significances (P＜0.05). There was no significant difference in the quantitative values of POP-Q sites Aa, Ba, Ap, Bp 12 months after operation between the two groups (P＞0.05). The quantitative value of POP-Q site C in the observation group was longer than that in the control group, and the difference was statistically significant (P＜0.05). Six months after surgery, the PFDI-20 score of the observation group was lower than that of the control group, and the PISQ-12 score of the observation group was higher than that of the control group, with statistical significance (P＜0.05). Conclusion Compared with traditional total vaginal hysterectomy combined with anterior and posterior vaginal wall repair, self-cutting mesh laparoscopic vaginal sacral fixation combined with posterior vaginal wall repair is more safe and effective in the treatment of pelvic organ prolapse, which is beneficial to the repair of pelvic floor function and the improvement of sexual quality, while reducing the recurrence rate.

 Objective To explore the influence of different body mass index (BMI) of female patients on clinical outcome with assisted reproductive sperm artificial insemination by husband sperm technology. Methods The clinical data of the patients and her husband who received artificial insemination by husband sperm (AIH) in the Reproductive Medicine Center of Fujian Maternal and Child Health Hospital from January 2018 to December 2020 were retrospectively analyzed, and they were divided into the low body weight group (BMI＜18.5 kg/m2), the normal body weight group (18.5 kg/m2≤BMI＜24 kg/m2), the overweight group (BMI≥24 kg/m2) based on their BMI. The basic data and clinical outcomes of AIH assisted pregnancy in the three groups were statistically analyzed. Results There were significant differences in the abortion rate and premature birth rate among the three groups (P＜0.05). After Bonferroni′s correction, the rate of abortion and premature birth in the overweight group were higher than those of the normal weight group, and the differences were statistically significant (P＜0.017). Patients with BMI≥24 kg/m2 underwent AIH ovulation induction program, and the pregnancy rate of ovulation induction cycle was higher than that of natural cycle (15.9% vs. 10.0%), the difference was statistically significant (P＜0.05). There were no significant differences in the abortion rate, premature birth rate and full term birth rate between ovulation induction cycle and natural cycle (P＞0.05). Conclusion AIH assisted pregnancies of overweight women have higher pregnancy loss rate and preterm delivery rate than those of low weight and normal weight women. AIH assisted pregnancies may be helpful to improve their pregnancy outcomes.

 Objective To investigate the preventive effect of Caffeine on bronchopulmonary dysplasia (BPD) in premature infants and its influence on the level of vascular endothelial growth factor (VEGF). Methods A total of 42 premature infants treated in the Department of Neonatal Pediatrics of the First Affiliated Hospital of Shaoyang University from May 2020 to April 2021 were selected as the research objects, according to random number table method, they were divided into the treatment group and the control group, with 21 cases in each group. The control group was treated with routine symptomatic treatment, and the treatment group was treated with Caffeine on the basis of the control group. The hospitalization time, weight growth rate, aerobic time, incidence rate of BPD, mortality rate, and the expression level of VEGF in peripheral blood serum on 1, 3, 7, 14, 21 d after birth of the two groups were compared. Results The hospitalization time and aerobic time of the premature infants in the treatment group were shorter than those in the control group, the weight growth rate in the treatment group was faster than that in the control group, he incidence rate of BPD in the treatment group was lower than that in the control group, the differences were statistically significant (P＜0.05).There was no significant difference in mortality between the treatment group and the control group (P＞0.05). At the three time points of 7, 14, 21 d, the expression level of VEGF in the serum of premature infants in the treatment group were lower than those in the control group, the differences were statistically significant (P＜0.05). Conclusion The expression level of VEGF is related to the time of Caffeine treatment of BPD, which has a certain clinical significance

Objective To investigated the application effect of Sevoflurane inhalation induction combined with Fentanyl-Propofol general anesthesia methods in the resection of chalazion in children. Methods A total of 94 children who underwent the resection of chalazion (ASA grade Ⅰor Ⅱ) in Guangzhou Panyu Maternal and Child Health Hospital were selected as the study subjects, and they were divided into the control group (47 cases) and the study group (47 cases) according to random number table methods. The patients in the control group were anesthetized with 3% Sevoflurane and oxygen flow of 2 L/min after induction, and the patients in the study group were anesthetized with Fentanyl 1 μg/kg intravenously 10 and 5 minutes before the operation, and Propofol 10 mg/kg was continuously pumped to maintain anesthesia. The vital signs, recovery time, number of body movements, restlessness rate in recovery period and clinical satisfaction of operators were compared between the two groups. Results All the patients were completed the operation successfully. There were no significant differences in the age, gender, height and weight between the two groups (P＞0.05). There were no significant differences in the blood oxygen, respiratory depression and recovery time between the two groups (P＞0.05). The number of body movements in the study group was less than that in the control group,and the difference was statistically significant (P＜0.05).The restlessness time in recovery period of the patients in the study group was shorter than that of the control group, and the difference was statistically significant (P＜0.05). The clinical satisfaction of operators in the study group was higher than that in the control group, and the difference was statistically significant (P＜0.05). Conclusion The anesthesia effect of Sevoflurane induction combined Fentanyl-Propofol in the resection of chalazion in children is better,which is more easily accepted by operators,and is worthy of promotion.

Objective To investigate the effect of Clostridium Butyricum Powder combined with interferon in the treatment of children with Rotavirus (RV) infectious diarrhea and its influence on the levels of lactic acid and inflammatory factors. Methods A total of 86 children with RV infectious diarrhea who were admitted in Heze Maternal and Child Health Hospital from December 2020 to November 2021 were selected as the research objects. They 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 interferon, and the observation group was treated with Clostridium Butyricum Powder combined interferon. The clinical efficacy, the levels of lactic acid and inflammatory factors were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group, and the difference was statistically significant (P＜0.05). After treatment, the levels of D-lactic acid (D-LAC) in the two groups were lower than those before treatment, and the levels of D-LAC after treatment in the observation group were lower than those in the control group, and the differences were statistically significant (P＜0.05). After treatment, the levels of interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in the two groups were lower than those before treatment, and the levels of IL-6, IL-10, TNF-α after treatment in the observation group were lower than those in the control group, and the differences were statistically significant (P＜0.05). Conclusion The treatment of children with RV infectious diarrhea by Clostridium Butyricum Powder combined with interferon can improve the clinical efficacy and improve the levels of lactic acid and inflammatory factors.

Objective To investigate the value of plain magnetic resonance imaging combined with diffusion-weighted imaging (DWI) sequence in preoperative evaluation of middle ear cholesteatoma. Methods A total of 26 patients with suspected middle ear cholesteatoma admitted to Luoding People′s Hospital from April 2020 to October 2021 were selected as the research objects. Preoperative magnetic resonance plain scan combined with DWI sequence and temporal bone CT+ 3D reconstruction were used for imaging examination. The diagnostic efficiency was evaluated by comparing with postoperative pathological results. Results Among 26 patients, 20 cases were pathologically confirmed as middle ear cholesteatoma. The sensitivity, specificity and accuracy of Mr Combined with DWI sequence in the diagnosis of middle ear cholastatoma were 95.0% (19/20), 83.3% (5/6) and 92.3% (24/26), respectively, which were consistent with postoperative pathological diagnosis (Kappa=0.783, P＜0.05). The sensitivity, specificity and accuracy of temporal bone CT+3D reconstruction in the diagnosis of middle ear cholastatoma were 55.0% (11/20), 50.0% (3/6) and 53.8% (14/26),and the consistency with postoperative pathological diagnosis was poor (Kappa=0.037, P＞0.05). The sensitivity of preoperative MRI combined with DWI sequence in the diagnosis of middle ear cholesteatoma was higher than that of preoperative temporal bone CT+3D reconstruction, and the difference was statistically significant (P＜0.05). Conclusion Magnetic resonance combined with DWI examination method has good qualitative diagnostic value for middle ear cholesteatoma, and also has certain reference value for localization diagnosis, which is of great significance for making a reasonable surgical plan before operation.

Objective To compare the effects of modified meibomian gland pressing method and spontaneous meibomian gland massage in the treatment of meibomian gland dysfunction (MGD). Methods A retrospective analysis was performed on the clinical data of 58 patients (58 eyes) with meibomian gland dysfunction who were treated in the Department of Ophthalmology, Army 73rd Group Military Hospital from March 2018 to December 2019. According to treatment methods, they were divided into self-massage group(n=28) and improved group (n=30). The meibomian gland massage method was used in the self-massage group, and the modified meibomian gland pressing method was used in the modified group. The ocular surface disease index score (OSDI), break-up time (BUT), Schirmer Ⅰtest (SⅠT) and corneal fluorescein sodium staining (FL) were compared between the two groups before and after treatment. Results There were no significant differences in OSDI, BUT, SⅠT and FL between the two groups before treatment (P＞0.05). After treatment, the OSDI and FL scores of the two groups were lower than those before treatment, BUT and SⅠt were longer than those before treatment, and the OSDI and FL scores of the modified group were lower than those of the self-massage group, BUT and SⅠt were longer than those of the self-massage group, the differences were statistically significant (P＜0.05). Conclusion The modified meibomian gland pressing method and meibomian gland massage can effectively relieve the ocular symptoms caused by MGD and improve the quality of tear film. The modified meibomian gland pressing method is easy to operate, and the therapeutic effect is better than that of the patients with meibomian gland massage at home.

The theory of lucid Yang and clear orifices is based on the theory of ascending and descending, Qi, blood,body fluid and Zang Fu organs. It is an important theory to study the physiology and pathology of head and facial features and used for clinical prevention and treatment. The theory of lucid Yang and clear orifices sprouted in the Spring and Autumn Period and Warring States Period, developed greatly in the Jin and Yuan Dynasties, improved in the Ming and Qing Dynasties, and has made great progress so far. It is one of the basic theories of ophthalmology, otolaryngology. Lucid Yang has the functions of nourishing, warming and protecting the eyes, which is particularly important in the clinical treatment of ophthalmology. It is widely used in both internal and external eye diseases, and has definite clinical curative effect. The clinical symptoms of ophthalmology need to regulate the Qi machine, promote Yang and strengthen the spleen, and pay attention to nourishing, protecting and promoting Yang. This paper makes an analysis of lucid Yang, hoping to show its profound meaning and hope to be beneficial to clinical practice.

Objective To observe the therapeutic effect of long round needle on knee osteoarthritis (KOA). Methods A total of 60 patients with KOA admitted to Beijing Hepingli Hospital from February 2020 to February 2021 were selected as research objects, and devided into the control group and the study group by the envelope method, with 30 patients in each group. Patients in the control group were treated with conservative treatment or joint cavity injection according to the results of the floating patella test, while the study group was treated with long circular needles to untie the knots at the transversal tendon lesion points on top of the control group. The scores of KOA severity, TCM evidence and Tegner knee motion were compared between the groups before and after treatment. Results Before treatment, there were no significant differences in KOA severity score, TCM syndrome score and Tegner knee motion score between the two groups (P＞0.05). After treatment, the scores of Tegner knee movement in the study group was higher than that in the control group, and the socores of KOA severity and TCM syndrome in the study group were lower than those in the control group, with statistically significant differences (P＜0.05). Conclusion The long round needle has a significant effect on knee osteoarthritis, and can improve the TCM syndrome and motor function of patients.

Objective To analyze the changes of liver and kidney function, blood routine and adverse reactions in patients with active pulmonary tuberculosis before and after anti-tuberculosis drug treatment, and to find out the monitoring indicators that can be used for the efficacy of anti-tuberculosis treatment. Methods A total of 55 patients with active pulmonary tuberculosis who received anti-tuberculosis drug treatment in Loudi Central Hospital from January 2019 to January 2020 were selected as case group, and 55 healthy people in the same period were selected as control group.The related clinical data and test results were collected, and the adverse reactions during anti-tuberculosis drug treatment in the case group were recorded. The dynamic changes of blood routine and liver and kidney function before and after treatment in the case group and the control group were detected. Results Before treatment, there were no significant differences in white blood cell count (WBC) and platelet/lymphocyte ratio (PLR) between case group and control group (P＞0.05). The red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) in the case group were higher than those in the control group, and the differences were statistically significant (P＜0.05). The incidence of liver function damage was the highest in the case group, among which the incidence of alanine aminotransferase (ALT)and/or aspartate aminotransferase (AST) increased was 18.18%, the incidence of bilirubin (TBil) increased was 10.91%, followed by gastrointestinal reaction (14.55%).The incidence of elevated uric acid (UA), allergic reaction, leukopenia and thrombocytopenia were 9.09% ,3.64%, 7.27% and 3.64%, respectively. There were no significant differences in WBC, PLR and TBil before and after treatment in the case group (P＞0.05). RDW and NLR were lower after treatment than before treatment, ALT and/or AST and UA were higher than before treatment, and the differences were statistically significant (P＜0.05). Conclusion Patients undergoing antituberculosis therapy need regular evaluation of blood routine and liver and kidney function, close attention to adverse reactions, and timely and effective intervention. RDW, NLR and other parameters have important clinical application value in monitoring the therapeutic effect of active pulmonary tuberculosis.

 Objective Detection and drug resistance of Carbapenem-resistant Organism (CRO) in Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine from 2016 to 2020. Methods The detection of Carbapenem-resistant Acinetobacter Baumannii (CRAB), Carbapenem-resistant Pseudomonas Aeruginosa (CRPA) and Carbapenem-resistant Klebsiella Pneumoniae (CRKP) collected from the clinical specimens of inpatients in the Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine from January 2016 to December 2020 were counted,and the distribution and drug resistance of the above bacteria were analyzed. Results From 2016 to 2020, a total of 766, 816, 1038, 1027, and 586 bacterial strains were detected in Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, and a total of 4233 bacterial strains were detected. From 2016 to 2018, the detection rate of CRO showed an upward trend, and the difference was statistically significant (P＜0.05). From 2018 to 2020, there was no significant difference in the detection rate of CRO (P＞0.05). Except Tobramycin, Cotrimoxazole, Piperacillin/Tazobactam, Tegacyclin and Levofloxacin, the drug resistance rates of CRAB to other commonly used antibiotics were more than 90.00%. Except Tobramycin, Cotrimoxazole, Piperacillin/Tazobactam and Tegacyclin, the resistance rates of CRKP to other commonly used antibiotics were more than 90.00%. Except Imipenem, the resistance rate of CRPA to other commonly used antibiotics was less than 50.00%. Conclusion From 2016 to 2018, the detection rate of CRO in Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine showed an upward trend. The overall level of CRO detection rate in five years was relatively high, especially the highest detection rate of CRKP. Moreover,CRAB and CRPA have higher resistance to a variety of commonly used antibiotics, while CRKP has lower resistance to commonly used antibiotics. Active measures should be taken to strengthen the monitoring of different types of CROs and improve the rationality of antimicrobial use.

Objective To analyze the infection status and drug susceptibility of urogenital mycoplasma in Tianjin Second People′s Hospital in the past five years, so as to provide reference for rational clinical diagnosis and treatment.Methods A total of 1448 patients admitted to outpatient or inpatient clinics of Tianjin Second People′s Hospital from January 2017 to December 2021 were selected retrospectively as research objects, and their secretions were tested and analyzed by Mycoplasma culture identification counting drug sensitivity kit. Results Among 1448 patients admitted to the clinic in the past 5 years, the number of positive cases was 406, the total detection rate was 28.04%, and the difference of the annual detection rate was statistically significant (P＜0.001), showing a downward trend year by year. The detection rate of single ureaplasma urealyticum (Uu) was the highest in 5 years (20.93%), followed by mixed infection of Uu and mycoplasma hominis (Mh) (5.59%). The positive detection rate of males was 16.7%, and the positive detection rate of females was 51.93%. There were statistically significant differences between males and females in the total detection rate and the detection rate of a single Uu, Uu+Mh infection type (P＜0.001) , and the age with the highest proportion was 19-30 years old (37.68%). The drug susceptibility results showed that the differences in the drug susceptibility results of different infection types were statistically significant (P＜0.05). But Minocycline, Doxycycline and Josamycin were still effective drugs for the treatment of the disease. Analysis of the susceptibility rate of main antibiotics in 5 years showed that the susceptibility rate of Erythromycin and Clarithromycin had a significant upward trend,and the susceptibility rate of Levofloxacin had an obvious downward trend. Conclusion Uu infection was the main mycoplasma positive infection in urogenital tract, and females are susceptible. There are also differences in the medication for different types of infection, and the medication can be individualized according to the drug susceptibility results.Although Minocycline, Doxycycline and Josamycin are the first-choice drugs for treatment, the sensitivity of these three drugs has declined in the past five years, indicating that drug-resistant strains frequently appear, and the rational use of antibiotics should be standardized in clinical practice.

Objective To analyze the value of feedforward control theory in the management of laparoscopic surgical instruments. Methods A total of 40 patients who underwent laparoscopic surgery in the Second People′s Hospital of Yichun City between March 2019 and February 2020 were selected as the control group, and 40 patients who underwent laparoscopic surgery between March 2020 and February 2021 were selected as the observation group. The control group received routine management of laparoscopic surgical instruments, and the observation group received feedforward control management mode. The incidence of adverse instrument events, average time of taking instruments, loss of instruments, satisfaction with instrument management and medical care were compared between the two groups. Results The total incidence of adverse device events in the observation group was 5.00%, which was lower than 20.00% in the control group, and the difference was statistically significant (P＜0.05). The average time of instrument taking in the observation group was shorter than that in the control group, and the difference was statistically significant (P＜0.05). The total loss rate of the observation group was 2.50%, which was lower than that of the control group (25.00%), and the difference was statistically significant (P＜0.05). The satisfaction scores of each device management in the observation group were higher than those in the control group, and the differences were statistically significant (P＜0.05). The total satisfaction rate of doctors and nurses in the observation group was 96.67%, which was higher than 73.33% in the control group, and the difference was statistically significant (P＜0.05). Conclusion Applying feedforward control theory in the management of laparoscopic surgical instruments can effectively reduce the occurrence of adverse events and loss of instruments, shorten the time of taking instruments, and improve the effectiveness of instrument use as well as medical staff′s satisfaction.

In recent years, the layout and structure of clinical disciplines in Tianjin have been continuously optimized,and the clinical professional level has been significantly improved. A number of domestic leading and world-class high-level disciplines have been formed, and a number of high-quality expert resources have been gathered, which has played an important role in ensuring the life and health of the people and effectively supported the prosperity and development of regional economy and society. Taking the construction of clinical special disease research center carried out by Tianjin Medical University as an example, starting from the necessity of deepening the development of clinical disciplines, this paper explores the construction ideas and strategic choices suitable for the development of clinical discipline of Tianjin Medical University by constructing SWOT matrix model, that is to actively serve the national strategy,meet the development needs of the industry, focus the discipline construction on optimizing the layout of discipline resources, open up the cooperation channel between universities and hospitals, encourage the main specialty of specialized diseases, form close cooperation with other supporting specialties with complementary advantages, promote the deep integration of basic medicine and clinical medicine, and promote the construction of ecological group of clinical specialized diseases, improve the reputation and overall competitiveness of the university system. All fields of discipline development are integrated and interconnected, so the research ideas and strategic design of this paper have vital reference significance.

Objective To investigate the application effect of self-massage at home and family-assisted eyeball massage in patients with glaucoma after trabeculectomy. Methods A total of 50 glaucoma patients admitted to Jiujiang University Affiliated Hospital from December 2020 to January 2022 were selected as the research objects, and they were divided into the control group and the observation group according to random number table method, with 25 cases in each group. The control group received family-assisted eyeball massage, while the observation group received selfmassage eyeball at home. Both groups continued massage for 3 months. The surgical success rate, nursing compliance and nursing satisfaction were compared between the two groups. Results The operation success rate and total nursing compliance rate of the observation group were higher than those of the control group, the differences were statistically significant (P＜0.05). The scores of eye feeling, operation technique, massage method and health guidance in the nursing satisfaction of the observation group were higher than those of the control group, the differences were statistically significant (P＜0.05). Conclusion After glaucoma trabeculectomy, the patients themselves have higher compliance with home self-massage nursing, which can effectively control the patient′s intraocular pressure level, help to improve the success rate of surgery, and promote postoperative rehabilitation and nursing satisfaction of patients.

Objective To analyze the effect of chest pain center optimized pre-hospital emergency nursing measures in the treatment of patients with acute myocardial infarction (AMI). Methods The clinical data of 38 patients with AMI admitted to Yingtan People′s Hospital from April to December 2020 were selected as the control group for retrospective analysis, and routine pre-hospital emergency measures of chest pain center were implemented. In addition, the clinical data of 38 patients with AMI admitted to Yingtan People′s Hospital from January to December 2021 were selected as the observation group, and the optimized pre-hospital emergency nursing measures of chest pain center were implemented. The treatment time, complications, recurrence of AMI in hospital and the recovery of cardiac function after treatment were compared between the two groups. Results The evaluation time of emergency triage, arrival time of visit,total treatment time in the observation group were shorter than those in the control group, with statistically significant differences (P＜0.05). The total incidence of complications and the recurrence rate of AMI in the observation group were lower than those in the control group, with statistically significant differences (P＜0.05). The improvement of cardiac function in the observation group was better than that in the control group, the difference was statistically significant(P＜0.05). Conclusion Optimized pre-hospital emergency nursing measures in pain center can shorten the pre hospital treatment time of AMI patients, promote the improvement of cardiac function, and reduce the risk of complications and recurrence of AMI in hospital.

Objective To explore the clinical characteristics of acute Entoloma omiense poisoning, and to provide scientific basis for clinical diagnosis, treatment and nursing of this kind of mushroom poisoning in the future. Methods The clinical data of 31 patients with acute Entoloma omiense poisoning treated in Guangzhou Twelfth People′s Hospital from June 2016 to July 2021 were analyzed retrospectively. The clinical characteristics and nursing of poisoning patients were retrospectively analyzed. Results The clinical characteristics of 31 patients were consistent with gastroenteritis type mushroom poisoning. All patients had acute gastroenteritis. The poisoning latency was 20 min to 5 h, with an average of (1.18±1.16) h. The main symptoms were nausea in 31 cases, vomiting in 30 cases, diarrhea in 31 cases and abdominal pain in 19 cases. The increase of peripheral blood leukocyte count in laboratory examination accounted for 93.5%（29/31）. There were no abnormalities in liver function, renal function and myocardial related biochemical indexes. After gastric lavage, adsorption, catharsis, symptomatic support and nursing. All patients recovered in a short time. The hospital stay was 1-4 days, with an average of (2.58±1.06) days. Conclusion Acute Entoloma omiense poisoning is gastroenteritis type, generally does not cause liver and kidney damage, and the prognosis is good. In case of poisonous mushroom poisoning, the types of poisonous mushrooms should be found out as soon as possible and the clinical types of poisonous mushrooms should be clarified. Accurate treatment and nursing measures were taken according to the types of virus causing mushrooms and poisoning types.

Objective To discuss the application effect of Pender′s health promotion model combined with operating room comprehensive thermal insulation nursing in elderly patients undergoing spinal surgery. Methods A total of 83 elderly patients who underwent spinal surgery in Guangzhou Liwan District Orthopedic Hospital from November 2019 to May 2020 were selected as research projects. According to the random number table method, the patients were divided into control group (42 cases) and observation group (41 cases). The control group was intervened with routine nursing combined with operation routine thermal insulation measures, while the observation group was intervened with Pender health promotion model combined with comprehensive thermal insulation nursing in operating room. The nasopharyngeal temperature, incidence of postoperative shivering, cognitive level and negative emotion changes before and after intervention were compared between the two groups during perioperative period (30 min before operation, 30 and 60 min during operation, 30 min after operation). Results There were statistically significant differences in nasopharyngeal temperature time, inter-group and interaction effects between the two groups (F=22.157, 25.803, 39.175, P＜0.05). The nasopharyngeal temperature at 30 and 60 min during opertation, and 30 min after operation in the control group were lower than that at 30 min before operation, with statistically significant differences (P＜0.05). While, there were no significant differences in the temperature of nasopharynx in the observation group at 30 and 60 min and 30 min after operation compared with that at 30 min before operation(P＞0.05). And the nasopharyngeal temperature at 30 and 60 min and 30 min after operation in the observation group were higher than those in the control group, with statistically significant differences (P＜0.05). There were 9 cases of postoperative shivering in the control group and 2 cases in the observation group, and the incidence of postoperative shivering in the observation group was lower than that in the control group, with a was statistically significant difference(P＜0.05). After intervention, the score of mini mental sate examination (MMSE) in the observation group was higher than that in the control group, and the score of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in the observation group were lower than those in the in the control group, with statistically significant differences (P＜0.05). Conclusion Pender′s health promotion model combined with operating room comprehensive thermal insulation nursing is conducive to body temperature of patients during spinal surgery, which can significantly reduce the incidence rates of postoperative chills and postoperative cognitive dysfunction, and relieve the patients′ negative emotions.

Objective To investigate the effect of multi-maintenance management intervention based on empowerment theory in patients with decompensated liver cirrhosis. Methods A total of 78 patients with decompensated liver cirrhosis who were admitted in the First Affiliated Hospital of Fujian Medical University from November 2020 to November 2021 were selected as research objects, and they were divided into the intervention group (n=39) and the control group(n=39) by touching the ball randomly. The control group received routine nursing intervention, while the intervention group received multidimensional nursing intervention based on empowerment theory. The self-care ability, quality of life and the incidence of complications were compared of the two groups. Results After intervention, the self-care ability scale (ESCA) scores of the two groups were higher than those before intervention, and the ESCA score of the intervention group was higher than that of the control group, and the differences were statistically significant (P＜0.05). After intervention, the scores of the comprehensive assessment questionnaire for quality of life-74 (GQOL-74) in the two groups were higher than those before intervention, and the scores in the intervention group were higher than those in the control group, and the differences were statistically significant (P＜0.05). The total incidence of complications in the intervention group was lower than that in the control group, the difference was statistically significant (P＜0.05). Conclusion Multi-maintenance nursing based on empowerment theory can improve the self-care ability and quality of life of patients with decompensated cirrhosis, and reduce the incidence of complications.

Objective To explore the application effect of multidisciplinary teamwork eating management model based on smart nursing in elderly stroke patients with dysphagia. Methods From April 2020 to April 2021, 216 elderly stroke patients with dysphagia who were admitted to Dongguan Houjie Hospital affiliated to Guangdong Medical University were selected as the research subjects, and they were divided into control group and observation group by random number table method. There were 108 cases in each group.The control group was given the routine eating management model, and the observation group was given the multidisciplinary team-based eating management model based on smart nursing. Before and after intervention, the two groups of patients were compared in terms of their swallowing function, and the results of the 7-level evaluation method of Caiteng′s swallowing disorder. The number of gastric tubes inserted, the duration of gastric tube indwelling, and the success rate of gastric tube removal during the intervention were also compared. Results Before intervention, the results of drinking water and field water test were compared between the two groups, and the differences were not statistically significant (P＞0.05). After intervention, the results of the drinking water and field water test in the two groups were lower than those before intervention, and the observation group was lower than the control group, and the difference was statistically significant (P＜0.05). Before intervention, the results of Caiteng′s swallowing disorder 7-level evaluation method were compared between the two groups, and the differences were not statistically significant (P＞0.05). After intervention, the results of Caiteng′s 7-level assessment of dysphagia in the two groups were better than those before intervention, and the observation group were better than the control group, and the differences were statistically significant (P＜0.05). The number of gastric tubes in the two groups was compared, and the difference was not statistically significant (P＞0.05). The indwelling time of gastric tube in the observation group was shorter than that in the control group, and the success rate of gastric tube removal was higher than that in the control group, with statistical significances (P＜0.05). Conclusion The multidisciplinary team cooperative feeding management model can improve patients′ swallowing function, increase the success rate of gastric tube removal, and reduce the indwelling time of gastric tube.

Objective To explore the application effect of clinical operation nursing in laparoscopic hernia repair. Methods A total of 64 patients undergoing laparoscopic hernia repair in Hongqi Hospital Affiliated to Mudanjiang Medical University from January 2020 to December 2021 were selected retrospectively as the research objects. According to different nursing methods,they were divided into reference group(32 cases)and study group(32 cases).The reference group received routine nursing services, the study group carried out clinical operation nursing and intervention on the basis of routine nursing, compare the operation situation, complication rate and the impact on the quality of life of the two groups of patients. Results The operative time, postoperative ambulation time and length of stay of patients in the study group were shorter than those in the reference group, the intraoperative blood loss was less than that in the reference group, and the complication rate was lower than that in the reference group, the differences were statistically significant(P＜0.05). After nursing, the quality of life scores of physiological, psychological, environmental and social in the study group were higher than those in the reference group, the differences were statistically significant (P＜0.05). Conclusion The clinical operation nursing cooperation for patients undergoing laparoscopic hernia repair can improve their perioperative conditions, quality of life scores, and reduce the incidence of complications.

 Objective To explore the application effects of psychological resilience support combined with cognitive nursing on patients with schizophrenia complicated with insomnia. Methods A total of 60 patients with schizophrenia complicated with insomnia who were treated in Shangrao Third People′s Hospital between January 2020 and December 2021 were selected as the study subjects,and they were divided into the control group(n=30)and the observation group (n=30) according to the random number table method. Routine nursing was performed on both groups, and cognitive nursing on the basis of routine nursing was given to the control group, while psychological resilience support nursing on the basis of the control group was adopted in the observation group. The sleep quality, mental state, quality of life and total nursing satisfaction of patients before and after intervention were compared between the two groups. Results After intervention, the scores of Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI) in the observation group were lower than those in the control group, and the differences were statistically significant (P＜0.05). The scores of dimensions of brief psychiatric rating scale (BPRS) in the observation group after intervention were lower than those in the control group, and the differences were statistically significant (P＜0.05). After intervention, the scores of aspects of quality of life in the observation group were higher than that in the control group, and the differences were statistically significant (P＜0.05). The nursing satisfaction of the observation group was higher than of the control group after intervention, and the difference was statistically significant (P＜0.05). Conclusion Psychological resilience support combined with cognitive nursing can effectively improve the sleep quality, mental state and quality of life, and can also enhance the nursing satisfaction of patients.