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Quick Search     Adv Search 2022 Vol. 29, No. 28 Published: 2022-10-08   5 Application value of cardiac magnetic resonance imaging combined with myocardial strain analysis in apical hypertrophic cardiomyopathy DAI Weibin1 LIU Tingting1 SHI Yongyan2 MENG Yanfeng Objective To explore the application value of cardiac magnetic resonance imaging combined with myocardial strain analysis in apical hypertrophic cardiomyopathy (AHCM),and to compare the differences of left ventricular morphology,function and apical myocardial strain between AHCM patients and normal people.Methods Ten AHCM patients diagnosed in the magnetic resonance room of Taiyuan Central Hospital from September 2017 to July 2021 were retrospectively selected as AHCM group,and 20 healthy volunteers in the same period were selected as control group.Cardiac magnetic resonance images were obtained and analyzed using cvi42 image software to compare the differences between the two groups in left ventricular function parameters,apical angle and apical myocardial strain parameters.Results The apical angle in AHCM group was smaller than that in control group,the difference was statistically significant (P＜0.01).The left ventricular ejection fraction (LVEF),end diastolic volume/body surface area (EDV/BSA),stroke volume/body surface area (SV/BSA) and left ventricular mass/body surface area (LVM/BSA) in AHCM group were higher than those in control group,while end systolic volume/body surface area (ESV/BSA) in AHCM group was lower than that in control group,the differences were statistically significant (P＜0.01).The longitudinal peak strain and longitudinal peak strain rate in AHCM group were lower than those in control group,and the peak strain rate in the systolic period was higher than that in control group,the differences were statistically significant (P＜0.01).There were no significant differences in radial peak strain rate,the longitudinal peak strain rate in systolic phase,the radial peak strain rate in systolic phase,the radial peak strain rate in diastolic phase and the radial peak strain rate in diastolic phase between the two groups (P＞0.05).Conclusion Cardiac magnetic resonance imaging and myocardial strain analysis can quantitatively evaluate the left ventricle morphology and function of AHCM.It is helpful to deeply understand the mechanism of pathophysiology abnormal cardiac function and provide basis for diagnosis,treatment and prognosis evaluation of the disease. 2022 Vol. 29 (28): 5-08转18 [Abstract] ( 22 ) HTML (1 KB)  PDF  (0 KB)  ( 7 ) 9 Effects of glycyrrhetinic acid on proliferation,apoptosis,invasion and migration of endometrial cancer cells and its mechanism YUAN Jianhui FAN Yanyan HU Xiaoqing Objective To explore the effects and mechanism of glycyrrhetinic acid on proliferation,apoptosis,invasive and migration of endomic cancer cells.Methods Endometrial cancer cell lines Ishiawa were cultured in vitro,intervening with different concentrations of licoriceic acid,using MTT proliferation experiments,flow cytometry experiments and Transwell cells,respectively,different concentrations of glycyrrhetinic acid to proliferation,apoptosis and apoptosis of cervical cancer cells The effect of invasion and migration;the expression of Caspase-9 in the endometrial cancer cell treated endometrial cancer cells was detected by protein blotting,analysis of the expression of Caspase-9 level and the rate of cell apoptosis,proliferation and correlation,and the expression of Caspase-9 was observed.Results Under the effect of glycyrrhetinic acid,the proliferation ability of endometrial cancer Ishiawa cells decreased,the apoptosis rate increased,and the invasion and migration ability were weakened,but they were higher than those in the control group,and the differences were statistically significant (P＜0.05).The inhibition rate and apoptosis rate of 320 μmol/L glycyrrhetinic acid were higher than those of other cadmium concentrations,and cell migration and invasion were lower than those of other cadmium concentrations,with statistically significant differences (P＜0.05).The expression of Caspase-9 in Ishiawa cells treated with glycyrrheidic acid was lower than that in the control group,and the difference was statistically significant (P＜0.05).Caspase-9 expression was lower at 320 μmol/L of glycyrrhetinic acid than at other concentrations,with statistically significant differences (P＜0.05).Pearson correlation analysis showed that caspase-9 expression level was negatively correlated with cell apoptosis rate,and positively correlated with cell proliferation rate and invasion rate,with statistically significant differences (P＜0.05).Conclusion Glycyrrhetinic acid has an impact on endometrial cancer cell proliferation,apoptosis,and invasive migration,and its mechanism may be achieved by regulating expression of Caspase-9. 2022 Vol. 29 (28): 9-12 [Abstract] ( 24 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 13 Effect of exercise intervention on patients with non-alcoholic fatty liver disease: a meta-analysis FU Yangyang YAN Yingchun XIA Shuai ZHANG Min LI Na Objective To evaluate the application of training in non-alcoholic fatty liver disease (NAFLD).Methods PubMed,Embase,EBSCO,Cochrane Library,JBI,China National Knowledge Infrastructure,WanFang Database,VIP and Chinese Biomedical Literature Database in recent ten years were searched on the effect of exercise intervention on related indicators in patients with NAFLD.After independent literature screening,data extraction and literature quality evaluation,RevMan 5.3 statistical software was used for meta-analysis of the included data.Results A total of 11 randomized controlled trials (RCT) were included,and the results showed that alanine aminotransferase (ALT)(MD=-5.77,95%CI [-10.53,-1.00],P=0.02),aspartate aminotransferase (AST) (MD=-4.22,95%CI [-7.68,-0.76],P=0.02),low-density lipoprotein cholesterol (LDL-C) (MD=-7.20,95%CI [-13.10,-1.30],P=0.02),visceral adipose tissue(VAT) (MD=-0.51,95%CI [-0.91,-0.11],P=0.01) and subcutaneous adipose tissue (SAT) (MD=-0.54,95%CI [-0.76,-0.33],P＜0.01) of the exercise intervention group were lower than those in conventional treatment group,and the differences were statistically significant (P＜0.05).There were no statistically significant differences in high density lipoprotein cholesterol (HDL-C) (MD=0.02,95%CI [-0.06,0.10],P=0.60),serum total cholesterol (TC) (MD=-0.14,95%CI [-0.75,0.46],P=0.64),triglyceride (TG) (MD=0.04,95%CI [-0.12,0.20],P=0.62) between the two groups (P＞0.05).Conclusion Exercise intervention can be used as the first choice for non-drug treatment of NAFLD patients,which is safe and reliable. 2022 Vol. 29 (28): 13-18 [Abstract] ( 23 ) HTML (1 KB)  PDF (1264 KB)  ( 25 ) 19 Expression and diagnostic value of serological anti-neutrophil cytoplasmic antibody in inflammatory bowel disease ZHONG Xuanfang1 ZHOU Xiao2 ZHANG Like Objective By detecting the expression levels of serum perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA),cytoplasmic ANCA (c-ANCA),proteinase 3 (PR3) -ANCA,myeloperoxidase (MPO) -ANCA serological autoantibodies in inflammatory bowel disease (IBD),to investigate the clinical significance of single and combined detection of four antibodies in the diagnosis and differential diagnosis of IBD.Methods A total of 123 patients with IBD diagnosed in Huizhou First People's Hospital from May 2018 to February 2021 were selected as the research objects.According to the disease type,they were divided into ulcerative colitis (UC) group (n=78) and Crohn's disease (CD) group (n=45).Fifty-six patients with non-IBD intestinal diseases were selected as the disease control group,and 30 healthy subjects were selected as the normal control group.The expression levels of p-ANCA and c-ANCA were detected by indirect immunofluorescence (IIF) method,and the expression levels of PR3-ANCA and MPO-ANCA were detected by enzyme-linked immunosorbent assay (ELISA).The difference of antibody expression in each group was compared,and the diagnostic efficacy of the four antibodies for IBD and the expression of p-ANCA in UC patients with different clinical characteristics were analyzed.Results There were significant differences in the positive rates of p-ANCA,c-A NCA,PR3-ANCA,MPO-ANCA and the combined detection of four antibodies among the four groups (P＜0.01).P-ANCA of UC group was higher than that of CD group,disease control group and normal control group,c-ANCA,PR3-ANCA and combined detection were higher than those of disease control group and normal control group,and MPO-ANCA was higher than that of disease control group,and the differences were statistically significant (P＜0.008).The c-ANCA and combined detection in CD group were higher than those in disease control group and normal control group,and MPO-ANCA was higher than that in disease control group,and the differences were statistically significant (P＜0.008).The sensitivity and accuracy of the combined detection of four antibodies in the diagnosis of IBD were the highest,which were 66.7% and 75.1%,respectively.PR3-ANCA and MPO-ANCA had the highest specificity (95.3%).The positive predictive values of p-ANCA,c-ANCA,PR3-ANCA and MPO-ANCA were 91.2%,89.9%,87.9%,88.9% and 88.2%,respectively.The negative predictive values were 53.3%,60.0%,46.6%,47.4% and 64.7%,respectively.PR3-ANCA has the highest specificity in the diagnosis of UC,but the sensitivity is only 26.9%.p-ANCA has a good diagnostic efficiency in the diagnosis of UC,and combined detection can improve the sensitivity of UC,but the specificity is decreased.C-ANCA has a low sensitivity and specificity in the diagnosis of CD,and the differential diagnostic efficiency is low.The positive rate of p-ANCA in patients with moderate to severe UC was higher than that in patients with mild UC,and the proportion of patients with lesions in extensive colon was higher than that in other parts,and the differences were statistically significant (P＜0.05).Conclusion PR3-ANCA,p-ANCA,c-ANCA and MPO-ANCA have certain auxiliary value in the diagnosis and differential diagnosis of IBD,and the combined detection is more valuable than the single detection.p-ANCA may be beneficial to the differential diagnosis of UC and CD.The expression of p-ANCA is related to the severity and lesion location of UC,and has a potential auxiliary role in the evaluation of UC,which is worthy of further study. 2022 Vol. 29 (28): 19-23 [Abstract] ( 24 ) HTML (1 KB)  PDF (570 KB)  ( 25 ) 24 Analysis of factors influencing the development of kidney stones based on dietary inflammatory index HU Kaiguo1 LIU Bide2 HUO Yujie2 HUANG Yulong2 TIAN Yuan2 DONG Qiang2 LI Jiuzhi Objective To explore the factors influencing the development of kidney stones based on the dietary inflammatory index (DII) analysis.Methods A total of 192 patients with kidney stones diagnosed with the urology center of the People's Hospital of Xinjiang Uygur Autonomous Region from August 2020 to July 2021 were selected as the stone group,and 192 participants with healthy physical examination in the People's Hospital of Xinjiang Uygur Autonomous Region during the same period were selected as the non-stone group.The gender,age,body mass index,DII score and other factors were compared between the two groups to analyze the influencing factors of kidney stone incidence.Results DII scores of all participants were 0.91 (-4.36,4.85),and the pro-inflammatory diet participants in the stone group(DII＞0.91) were more than those in the non-stone group,the difference was statistically significant (P＜0.05).The result of univariate analysis showed that there were statistically significant differences in energy intake,smoking or not,drinking or not,water intake and DII score between the stone group and the non-stone group (P＜0.05).The result of multifactorial logistic regression analysis showed that energy intake (β=0.622,OR=1.980,95%CI=1.631-5.019),body mass index＞28 kg/m2 (β=0.854,OR=2.349,95%CI=1.328-4.155) and DII score＞0.91 (β=0.544,OR=1.740,95%CI=1.126-2.687) were risk factors for the development of kidney stones.Water intake＞2 000 ml/d (β=-0.885,OR=0.413,95%CI=0.199-0.856) was protective factors for the development of kidney stones.Conclusion It is suggested that the population should adjust their diet to a low DII state,namely,anti-inflammatory diet.Meanwhile,it is suggested that the population should control their body mass index and increase their water intake to＞2 000 ml/d,which may play an important role in the prevention of kidney stones. 2022 Vol. 29 (28): 24-27 [Abstract] ( 22 ) HTML (1 KB)  PDF (554 KB)  ( 23 ) 28 Research progress in quality evaluation of massive open online course and its application in medical field HAO Yanping ZHANG Ying Massive open online course (MOOC) has the characteristics of "large-scale,open and repetitive",and plays an incomparable advantage in teaching activities compared with traditional teaching resources.As a new teaching method,MOOC has triggered a huge reform in teaching mode.At the same time,MOOC has some drawbacks.In the context of the urgent need to solve problems such as the control of MOOC learning effect and course quality,domestic and foreign scholars have carried out researches on MOOC quality dimensions and evaluation system based on different fields and perspectives.In the medical field,Chinese and foreign scholars have also carried out exploration and research on the quality evaluation of MOOC,but there is still a lack of research on the quality evaluation of MOOC in the medical field so far.It is urgent for scholars to explore and study the construction of MOOC evaluation standard by referring to evaluation standards and systems of MOOC in other fields and combining the characteristics of medical courses,so as to help train medical talents more comprehensively. 2022 Vol. 29 (28): 28-32转37 [Abstract] ( 20 ) HTML (1 KB)  PDF (640 KB)  ( 40 ) 33 Research status and ideas of modern traditional Chinese medicine fermentation XIONG Yanxia DONG Mengyi LIU Wenjun SUN Min ZHU Xiaojuan WANG Chengyuan Based on traditional Chinese medicine fermentation,modern traditional Chinese medicine fermentation is a Chinese medicine biotransformation technology combined with fermentation engineering,microbial engineering and bioengineering.In essence,it refers to the decomposition and metabolism of traditional Chinese medicine components by microorganisms under controllable conditions,for altering the drug properties or efficacy of traditional Chinese medicine.Modern traditional Chinese medicine fermentation has the advantages of not being restricts by natural conditions,strong ability of microbial transformation,rich products of fermentiaon and wide rang of application.It is one of the hot research directions of traditional Chinese medicine.Based on the current research status of fermented traditional Chinese medicine,this paper summarizes the traditional Chinese medicine fermentation methods,strains and the application,in order to provide ideas of further traditional Chinese medicine fermentation research,expecting to provide references for deeper research and development and utilization of fermetation. 2022 Vol. 29 (28): 33-37 [Abstract] ( 20 ) HTML (1 KB)  PDF (613 KB)  ( 144 ) 38 Summary of clinical research progress and mechanism of TCM treatment of endometriosis YU Wenting1 XU Jing2 WU Feihua1▲ YAN Yanfang2 YIN Pingping2 Endometriosis belongs to one of the common benign diseases of gynecology with tumor characteristics,manifested as pelvic pain,infertility and other symptoms.Modern medicine believes that it is closely related to neovascularization,immunity,inflammation,hormones and other aspects,but the exact pathogenesis is still being explored.Traditional Chinese medicine (TCM) treatment of endometriosis has rich experience and obvious clinical effect.Over the years,with the in-depth study of endometriosis,more and more powerful experiments have proved that TCM can achieve clinical efficacy by adjusting different mechanisms.Therefore,the author collected in recent years,traditional Chinese medicine in the rate of change of new blood vessels and balanced immune factor,modulate inflammatory factor,lower estrogen levels,improve ovarian function,regulate blood rheology and blood high condensation state,change the expression of apoptosis related factor under different forms such as the research progress of treatment of endometriosis,provide ideas and reference for clinical. 2022 Vol. 29 (28): 38-41 [Abstract] ( 22 ) HTML (1 KB)  PDF (611 KB)  ( 99 ) 42 Application of lateral cheastwall perforator flap in breast conserving surgery LI Jialun1 HUANG Shengchao2 LI Jianwen Breast-conserving surgery for breast cancer is an important surgical method for breast cancer treatment,but conventional breast-conserving surgery is limited by various factors and has great limitations.On the basis of conventional breast-conserving surgery,lateral chest wall perforator flaps are used for local reconstruction improves its limitations and improves milk conservation.In view of the current situation of breast-conserving surgery for breast cancer,this paper analyzes and organizes domestic and foreign literatures,and believes that breast-conserving surgery with lateral chest wall perforator flap is safe,reliable,and has a good surgical effect.This article reviews the application of the lateral chest wall perforator flap in breast-conserving surgery for breast cancer by the development of the lateral chest wall perforator flap,the indications and contraindications of surgery,the anatomy,advantages and disadvantages of the lateral chest wall perforator flap,surgical methods,surgical complications and perioperative care,aiming to increase the understanding of the application of contralateral chest wall perforator flaps in clinical breast cancer surgery. 2022 Vol. 29 (28): 42-46 [Abstract] ( 22 ) HTML (1 KB)  PDF (644 KB)  ( 11 ) 47 Study on optimization of extraction technology and antimicrobial activity of total flavonoids from the aerial part of Bupleurum chinense by orthogonal design HAO Caiqin LI Jun CHEN Haiyan LENG Xiaohong Objective To optimize the extraction process of total flavonoids from the aerial part of Bupleurum chinense by orthogonal experiment design and determining its bacteriostatic activity.Methods Based on one factor test，an orthogonal experimental design was employed,with total flavonoids extract ratio as an index,to optimize four extraction factors: solid-liquid ratio,soaking time,extraction time and times of extraction,the antimicrobial activities of four kinds of bacteria and four kinds of fungi were determined by 96-well plate method.Results The optimum technology conditions of extraction total flavonoids from the aerial part of Bupleurum chinense were as follows: ratio of solid to liquid of 1∶10,soaking time of 60 min,extraction time of 72 min,extraction times 3 times.The extraction rate of total flavonoids from the aerial part of Bupleurum chinense was 2.702% by these conditions.The results showed that the total flavonoids in the aerial part of Bupleurum chinense had certain antimicrobial activity against four bacteria and four fungi tested.Conclusion The extraction process is simple,reliable,reasonable and feasible.The total flavonoids in the aerial part of Bupleurum chinense had certain bacteriostatic activity. 2022 Vol. 29 (28): 47-50 [Abstract] ( 27 ) HTML (1 KB)  PDF (486 KB)  ( 42 ) 51 Determination of metal elements in Buguzhi by flame atomic absorption spectroscopy ZHANG Xiaohong Objective To establish a method for the determination of Ca,Mg,Cu,Zn,Mn and Fe in Buguzhi by flame atomic emission spectrometry.Methods The standard solutions of Ca,Mg,Cu,Zn,Mn and Fe were prepared,and the optimum working conditions were obtained through many experiments,the samples of Buguzhi were digested by HNO3-HClO4-H2O2,and the contents of Ca,Mg,Cu,Zn,Mn and Fe in Buguzhi were determined by flame atomic absorption spectroscopy.Results Buguzhi was rich in metallic elements.The content of metallic elements from high to low is Ca,Fe,Mg,Mn,Zn,Cu,the correlation coefficient of the standard curve was 0.997 2-0.999 9,and the recovery was 91.0%-105.0%,the relative standard deviation of precision test was 0.41%-1.35%,the repeatability test RSD was 0.35%-1.56%.Conclusion The sample was digested by HNO3-HClO4-H2O2,and the determination by flame atomic absorption spectroscopy was simple,stable and accurate.The results of this study can provide a reasonable reference for the rational use and development of Buguzhi. 2022 Vol. 29 (28): 51-53转57 [Abstract] ( 19 ) HTML (1 KB)  PDF (828 KB)  ( 18 ) 54 Clinical effect of Ursodeoxycholic Acid Capsules combined with Almagate Suspension in the treatment of bile reflux gastritis CHEN Lianhuan HE Chang YAN Jiajia Objective To study the clinical effect of Ursodeoxycholic Acid Capsules combined with Almagate Suspension in the treatment of bile reflux gastritis (BRG).Methods The clinical data of 92 patients with BRG treated in Ruichang Hospital of Traditional Chinese Medicine from December 2020 to November 2021 were retrospectively analyzed.According to different treatment methods,they were divided into observation group (47 cases) and control group (45 cases).The observation group was treated with Ursodeoxycholic Acid Capsules combined with Almagate Suspension,while the control group was treated with Almagate Suspension.Propensity score matching (PSM) was used to match the two groups of patients,and 1∶1 nearest neighbor matching method was used to match.After matching,there were 40 pairs of patients,40 cases in the observation group and 40 cases in the control group.The scores of vasoactive intestinal peptide (VIP),plasma motilin (MTL),gastroesophageal reflux disease self-rating scale (GERD-Q)and adverse reactions were compared between the two groups.Results Before treatment,there were no significant differences in VIP,MTL levels and GERD-Q score between the two groups (P＞0.05).After treatment,the VIP and GERD-Q scores of the two groups were lower than those before treatment,and the MTL levels were higher than those before treatment,the VIP and GERD-Q scores of the observation group were lower than those of the control group,and the MTL level was higher than that of the control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05).Conclusion After PSM,Ursodeoxycholic Acid Capsules combined with Almagate Suspension in the treatment of BRG is beneficial to regulate VIP and MTL levels,relieve the symptoms of gastroesophageal reflux,and the toxic side effects do not increase,which can be used as a safe and effective treatment for BRG. 2022 Vol. 29 (28): 54-57 [Abstract] ( 19 ) HTML (1 KB)  PDF (828 KB)  ( 31 ) 58 Relationship between different degrees of visual impairment and clinical rehabilitation needs WANG Wenmei YU Lei LIU Jianzhen YANG Pengfei WANG Shuyin LI Linlin YIN Jiangbo Objective By means of eye examination and questionnaire survey,the demographic characteristics,diseases causing visual impairment and quality of life of patients with visual impairment were investigated.Methods A total of 263 patients with visual impairment diagnosed and treated at Linyi Centre for Rehabilitation of Persons With Disabilities from May 2014 to October 2020 were selected as research objects,check the naked eye vision,the best corrected vision,slit lamp examination,fundus examination,optometry and so on,to make clear the cause of the disorder,and to fill in the general condition questionnaire and the Chinese version of low vision quality of life scale,demographic characteristics,epidemiological characteristics and quality of life were statistically analyzed.Results The main causes of the disease were congenital genetic abnormality or developmental disorder,eye injury,cataract and so on.There were significant differences in the visual impairment grades among different age groups (H=46.022,P＜0.05).There were significant differences in the quality of life among different grades of patients with visual impairment (P＜0.05).Conclusion The combination of clinical rehabilitation and quality of life assessment is helpful to establish individualized rehabilitation program and improve quality of life in new medical model. 2022 Vol. 29 (28): 58-61 [Abstract] ( 24 ) HTML (1 KB)  PDF (674 KB)  ( 144 ) 62 Efficacy and safety of Itraconazole and Griseofulvin in the treatment of tinea capitis in children TU Sheng'an LIU Linghua ZHOU Mi Objective To compare the efficacy and safety of Itraconazole and Griseofulvin in the treatment of tinea capitis in children.Methods From January 2020 to January 2022,a total of 70 children with tinea capitis who were admitted to Jiujiang Third People's Hospital and Affiliated Hospital of Jiujiang University were selected as the research objects and divided into group A (35 cases,treated with Itraconazole) and group B (35 cases,treated with Griseofulvin)by random number table method.The clinical efficacy and fungal clearance rate of the two groups at the 4th,6th and 8th weeks of treatment were compared.The serum cystatin C (Cys-C),the improvement time of tinea capitis symptoms,retinol binding protein (RBP),adverse reactions and β2 microglobulin（β2-MG) level of the two groups were compared.Results After treatment,the levels of RBP and Cys-C in group A were lower than those in group B,and the differences were statistically significant (P＜0.05).There was no significant difference in β2-MG level between the two groups after treatment (P＞0.05).The improvement time of erythema,alopecia,yellow scab and pustule in group A were shorter than that in group B,and the total incidence of adverse reactions in group A was lower than that in group B,and the differences were statistically significant (P＜0.05).There were no significant differences in the fungal clearance rate and the total effective rate of clinical efficacy at the 4th,6th and 8th weeks of treatment between the two groups (P＞0.05).Conclusion The clinical efficacy of Itraconazole in the treatment of tinea capitis in children is consistent with Griseofulvin,but Itraconazole can effectively shorten the time for the improvement of clinical symptoms in children with lichen capitis and has higher drug safety. 2022 Vol. 29 (28): 62-65 [Abstract] ( 24 ) HTML (1 KB)  PDF (684 KB)  ( 27 ) 66 Application effect of the intensive insulin intervention on critically ill patients in ICU ZHANG Menghuan1 YANG Lihua2 HU Yue3 Objective To investigate the application effect on the intensive insulin intervention on critically ill patients in Emergency ICU.Methods A total of 60 ICU critically ill patients with stress hyperglycemia admitted to ShangRao People's Hospital from January to December 2021 were selected as research objects.They were randomly divided into routine treatment group (target blood sugar controlled at 6.1-8.1 mmol/L) and intensive treatment group (target blood sugar controlled at 4.1-6.1 mmol/L),with 30 patients in each group.The routine treatment group was treated with conventional insulin treatment intervention,and the intensive treatment group was treated with insulin intensive therapy.The disease indicators,blood glucose management effect before and after treatment and prognosis were compared between the two groups.Results The ICU stay time,electrocardiogram monitoring time,insulin pumping time and discharge time in intensive treatment group were shorter than those in conventional treatment group,with statistically significant differences (P＜0.05).After treatment,the fasting plasma glucos (FPG) level of the two groups was lower than that before treatment,and the insulin sensitivity index (ISI) and insulin resistance index (HOMA-IR) levels were higher than those before treatment,with statistically significant differences (P＜0.05).After treatment,the FPG level in intensive treatment group was lower than that in conventional treatment group,and the ISI and HOMA-IR levels in intensive treatment group were higher than those in conventional treatment group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the total incidence of poor prognosis such as hypoglycemia,dyspnea,nosocomial infection and death between the two groups (P＞0.05).Conclusion Intensive insulin intervention can improve stress hyperglycemia and prognosis of critically ill patients in ICU. 2022 Vol. 29 (28): 66-68转72 [Abstract] ( 22 ) HTML (1 KB)  PDF (698 KB)  ( 18 ) 69 Clinical effect of high-flow nasal oxygen therapy in sequential treatment of patients with acute respiratory failure YAO Yun SUN Panbo XU Lijing Objective To investigate the clinical effect of high-flow nasal oxygen (HFNO) therapy in sequential treatment of patients with acute respiratory failure.Methods Clinical data of 60 patients with acute respiratory failure who were admitted to the Respiratory Intensive Care Unit (RICU) of Shangrao Municipal Hospital from September 2019 to December 2020 were retrospectively analyzed.The patients were divided into control group (n=30) and test group (n=30) according to the treatment method.The control group underwent non-invasive ventilator-assisted ventilation after extubation,and the test group underwent sequential HFNO therapy after extubation.Vital signs before treatment and 2 h after treatment,blood gas indicators before treatment and 1 and 3 d after treatment,and treatment conditions (secondary intubation,post-extubation respiratory failure,length of RICU stay) were compared between the two groups.Results After 2 h of treatment,the respiratory rate (RR) in two groups was lower than that before treatment,but the RR of the test group was higher than that of the control group,with a statistically significant difference (P＜0.05).The partial pressure of blood oxygen (PaO2) and blood oxygen saturation (SaO2) in two groups at 1 and 3 d after treatment were higher than those before treatment,and the PaO2 and SaO2 in the test group were higher than those in the control group,with statistically significant differences (P＜0.05).The length of RICU stay of test group was shorter than that of the control group,and the difference was statistically significant (P＜0.05).Conclusion Applying sequential HFNO therapy to patients with acute respiratory failure after extubation can improve blood gas indicators. 2022 Vol. 29 (28): 69-72 [Abstract] ( 24 ) HTML (1 KB)  PDF (633 KB)  ( 19 ) 73 Selection of endoscopic surgeries for large gastric stromal tumors and the analysis of their effectiveness ZOU Huan1 HE Bin1▲ QU Xiao1 QIU Hongqing1 LI Rui2 Objective To discuss the selection of endoscopic surgery for large gastric stromal tumors and evaluate the clinical efficacy of endoscopic surgery in the treatment of large gastric stromal tumors.Methods The clinical data of 51 patients with gastric stromal tumors who underwent endoscopy in the First Affiliated Hospital of Soochow University and Zhangjiagang First People's Hospital from January 2014 to December 2019 were retrospectively analyzed.According to different surgical methods,they were divided into endoscopic submucosal dissection (ESD) group,endoscopic full-thickness resection (EFR) group and submucosal tunneling endoscopic resection (STER) group.Tumor characteristics,surgical data and follow-up data of the three groups were analyzed and statistically analyzed.Results The tumors in ESD group were distributed in cardia,fundus,body and antrum.In the EFR group,the tumors were mainly located in the fundus of the stomach,rarely in the body and antrum of the stomach.In the STER group,tumors were found in the greater curvature of the gastric body and the cardia.The distribution of tumor sites in the three groups was significantly different (P＜0.05).The maximum diameter of tumors in the STER group was smaller than those in the EFR and ESD group,the difference was statistically significant (P＜0.05).The tumors in ESD group originated from muscularis and submucosa,the tumors in EFR group and STER group originated from muscularis propria,and there were significant differences in the origin of tumors among the three groups (P＜0.05).The tumors in ESD group and STER group were all intraluminal growth,and the tumors in EFR group were mainly extraluminal growth,there were significant differences in tumor growth patterns among the three groups (P＜0.05).There was no significant difference in the complete tumor resection rate among the three groups (P＞0.05).The complication rate of EFR group was higher than that of ESD and STER group,the difference was statistically significant (P＜0.017).All patients were followed up for one year after operation.The wound healing rate of the three groups was 100%,and there was no recurrence or metastasis.Conclusion ESD,EFR and STER have good clinical effects in the treatment of large gastric stromal tumors.Different endoscopic treatments can be selected according to tumor location,size,tumor origin and growth pattern 2022 Vol. 29 (28): 73-77 [Abstract] ( 22 ) HTML (1 KB)  PDF (643 KB)  ( 17 ) 78 Clinical effect of respiratory function exercise combined with Terbutaline atomization on elderly patients with acute exacerbation of chronic obstructive pulmonary disease XIE Wuming LIU Yuan Objective To investigate the efficacy of respiratory function exercise combined with Terbutaline nebulization in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 86 elderly patients with AECOPD who were admitted to Ganzhou People's Hospital during the period from August 2020 to August 2021 were selected as the research subjects.According to the random throwing method,the control group (43 cases) and the observation group (43 cases).The control group were given Terbutaline atomization ＋conventional treatment.The observation group were given respiratory function exercise combined with Terbutaline atomization＋conventional treatment.The treatment effects 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 modified Medical Research Council scale questionnaire grading performance of the observation group after treatment was better than that of the control group,and the differences were statistically significant (P＜0.05).After treatment,the arterial oxygen partial pressure (PaO2) in the observation group was higher than that in the control group,the arterial carbon dioxide partial pressure (PaCO2) and Creactive protein (CRP) levels in the observation group were lower than those in the control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Respiratory exercise combined with Terbutaline Atomization can not only effectively improve blood gas index,improve the total effective rate,reduce symptom score,but also have no serious adverse reactions in elderly patients with AECOPD. 2022 Vol. 29 (28): 78-81 [Abstract] ( 23 ) HTML (1 KB)  PDF (631 KB)  ( 16 ) 82 Correlation between NOD-like receptor protein 3 expression and coagulation function in patients with ulcerative colitis LIU Nannan Objective To investigate the correlation between NOD-like receptor protein 3 (NLRP3) expression and coagulation function in patients with ulcerative colitis.Methods From January 2019 to October 2020,95 cases of patients with ulcerative colitis diagnosed and treated in Fuxin Mine General Hospital of Liaoning Health Industry Group were selected as the case group,and 95 cases of healthy people who underwent colonoscopy during the same period were selected as the control group.Immunohistochemistry was used to detect the expression level of NLRP3 in colonic mucosa,and to detect the coagulation function,and to analyze the correlation between them.Results The expression level of NLRP3 in case group was higher than that in control group,and the difference was statistically significant (P＜0.05).Prothrombin time (PT) and activated partial thrombin time (APTT) of case group were longer than those in the control group,while fibrinogen (FIB) was lower than those in the control group,the differences were statistically significant (P＜0.05).Pearson analysis showed that NLRP3 was positively correlated with FIB,and negatively correlated with PT and APTT (P＜0.05).Multiple linear regression analysis showed that PT,APTT and FIB were the important factors affecting NLRP3 expression (P＜0.05).Conclusion Patients with ulcerative colitis mostly show high expression levels of NLRP3,accompanied by abnormal coagulation function.PT,APTT,FIB are important factors affecting the expression levels of NLRP3 in patients. 2022 Vol. 29 (28): 82-84 [Abstract] ( 19 ) HTML (1 KB)  PDF (681 KB)  ( 17 ) 85 Application effect of guided extension catheter in interventional treatment of complex coronary artery diseases TONG Yifan LI Shunhui HUANG Xin Objective To investigate the Application effect of guided extension catheter in interventional treatment of complex coronary artery diseases.Methods A total of 120 patients with complex coronary artery disease admitted to First Hospital of Nanchang City from March 2020 to December 2020 were selected as the research objects.They were divided into observation group (n=60) and control group (n=60) according to the random lottery method.The control group was treated with interventional therapy,while the observation group was guided to extend the catheter on the basis of the control group.The operation success rate and complication rate were compared between the two groups.Results The success rate of operation in the observation group was significantly higher than that in the control group,with a statistically significant difference (P＜0.05).The incidence of complications in the observation group was lower than that in the control group,with a statistically significant difference (P＜0.05).Conclusion The implementation of guided catheter extension in the interventional treatment of complex coronary artery diseases can achieve significant results,significantly improve the success rate of operation,reduce complications and improve the prognosis of patients. 2022 Vol. 29 (28): 85-87 [Abstract] ( 22 ) HTML (1 KB)  PDF (542 KB)  ( 23 ) 88 Clinical efficacy and safety of Ivabradine in the treatment of chronic obstructive pulmonary disease complicated with heart failure CHEN Ming1 GAO Yanfeng2 ZHONG Jingmin1 HUANG Taiguang Objective To investigate the clinical effect and safety of Ivabradine in the treatment of chronic obstructive pulmonary disease (COPD) complicated with heart failure.Methods A total of 80 patients with COPD and heart failure who were admitted to Maoming People's Hospital from January 2018 to January 2021 were selected as research objects,and they were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was given conventional anti-heart failure treatment,and the observation group was additionally given Ivabradine on the basis of the control group.The two groups were treated for 3 months.The cardiac function (left ventricular ejection fraction [LVEF],cardiac output [CO] and stroke volume [SV]),resting heart rate changes,and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels,6 min walking distance and pulmonary function (peak expiratory flow rate [PEF],forced vital capacity [FVC] and forced expiratory volume in 1 second[FEV1]) were compared between the two groups,and the occurrence of adverse reactions were record between the two groups.Results There were no significant differences in the levels of LVEF,CO and SV between the two groups before treatment (P＞0.05).The levels of LVEF,CO and SV in the two groups after treatment were higher than those before treatment,and the differences were statistically significant (P＜0.05).The levels of LVEF,CO and SV in the observation group after treatment were higher than those in the control group,and the differences were statistically significant (P＜0.05).There were no significant differences in the resting heart rate,the level of NT-proBNP and 6-min walking distance between the two groups before treatment (P＞0.05).The resting heart rate and the level of NT-proBNP in the two groups after treatment were lower than those before treatment,and the 6-min walking distance in the two groups after treatment was longer than that before treatment,the differences were statistically significant (P＜0.05).The resting heart rate and the level of NT-proBNP in the observation group after treatment were lower than those in the control group,the 6-min walking distance in the observation group after treatment was longer than that in the control group,and the differences were statistically significant (P＜0.05).There were no significant difference in the levels of PEF,FVC,FEV1 between the two groups before treatment (P＞0.05).The levels of PEF,FVC in the two groups after treatment were higher than those before treatment,the differences were statistically significant (P＜0.05).The levels of PEF,FVC,FEV1 in the observation group after treatment were higher than those in the control group after treatment,the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions in the two groups (P＞0.05).Conclusion Ivabradine can enhance the therapeutic effect of COPD complicated with heart failure,correct the abnormal cardiopulmonary function,reduce the level of NT-proBNP,and stabilize the resting heart rate,which is safe and reliable. 2022 Vol. 29 (28): 88-91转95 [Abstract] ( 25 ) HTML (1 KB)  PDF (579 KB)  ( 21 ) 92 Effect of ultrafiltration combined with Injection of Yiqi Fumai in the treatment of refractory heart failure WANG Jing1 PENG Bo1 WANG Haicun1 CUI Jing1 TAN Liye Objective To analyze the effect of ultrafiltration combined with Injection of Yiqi Fumai in the treatment of refractory heart failure.Methods A total of 120 patients with refractory heart failure hospitalized in the Second Affiliated Hospital of Mudanjiang Medical College from June 2017 to May 2020 were selected as the research objects.According to the random number table method,they were divided into control group and study group,with 60 cases in each group.The control group was treated with Enalapril Tablets,Spironolactone Tablets and Metoprolol Succinate Sustained-Release Tablets,while the study group was treated with heart failure ultrafiltration combined with Injection of Yiqi Fumai.The 6-min walking distance,cardiac function improvement and treatment safety were compared between the two groups before and after treatment.Results After treatment,6 min walking distance of the two groups were longer than those before the treatment,left ventricular ejection fraction (LVEF),stroke volume (SV),cardiac output (CO)levels were higher than those before the treatment,and the 6 min walking distance of the study group was longer than that of the control group,LVEF,SV,CO levels were higher than those of the control group,the differences were statistically significant (P＜0.05).There were no significant differences in systolic blood pressure,heart rate,sodium ion concentration,potassium ion concentration,bicarbonate,hemoglobin,platelet count,serum creatinine and blood urea nitrogen levels between the two groups before and after treatment (P＞0.05).Conclusion Ultrafiltration combined with Injection of Yiqi Fumai has significant clinical effect and high safety in the treatment of refractory heart failure. 2022 Vol. 29 (28): 92-95 [Abstract] ( 23 ) HTML (1 KB)  PDF (527 KB)  ( 10 ) 96 Correlation between QRS duration,real-time three-dimensional echocardiography parameters and clinical cardiac function LI Xing LI Zhiyong LEI Liqin ZHU Wanhong Objective To investigate the correlation between QRS duration (QRSd),real-time three-dimensional echocardiography parameters and clinical cardiac function.Methods A total of 30 patients with left heart failure treated in the Second People's Hospital of Jingdezhen City from January to July 2021 were selected as the study group.According to the classification standard of New York Heart Association (NYHA),they were divided into the grade Ⅱgroup,the grade Ⅲgroup and the grade Ⅳgroup,with 10 cases in each grade.At the same time,30 patients with hypertensive non left heart failure were selected as the control group.QRSd and real-time three-dimensional echocardiography parameters were measured,and the correlation between each parameter and clinical cardiac function was analyzed.Results The levels of QRSd,LVEDV,LVESV in the study group were higher than those in the control group,and the level of LVEF in the study group was lower than that in the control group,the differences were statistically significant(P＜0.05).The levels of QRSd,LVEDV and LVESV in the grade Ⅳgroup of NYHA were higher than those in the gradeⅢgroup of NYHA and the grade Ⅱgroup of NYHA,and the level of LVEF in the grade Ⅳgroup of NYHA was lower than that in the grade Ⅲgroup of NYHA and the grade Ⅱgroup of NYHA,the differences were statistically significant(P＜0.05).The levels of QRSd,LVEDV and LVESV in the grade Ⅲgroup of NYHA were higher than those in grade Ⅱgroup of NYHA,and LVEF in the grade Ⅲgroup of NYHA was lower than those in grade Ⅱgroup of NYHA,the differences were statistically significant (P＜0.05).Pearson correlation analysis showed that QRSd was positively correlated with LVEDV and LVESV (r=0.291,0.352,P＜0.05),and inversely correlated with LVEF (r=-0.397,P＜0.05).Conclusion QRSd,LVEDV,LVESV are abnormally increased in patients with left heart failure,which is related to cardiac function.QRSd prolongation has certain clinical value in suggesting left heart failure. 2022 Vol. 29 (28): 96-98 [Abstract] ( 23 ) HTML (1 KB)  PDF (558 KB)  ( 10 ) 99 Influencing factors of left ventricular thrombosis in acute anterior wall myocardial infarction LIU Zeyu1 FENG Yingjun1 LIU Xuanxuan Objective To investigate the influencing factors of left ventricular thrombosis (LVT) in patients with acute anterior wall myocardial infarction.Methods Clinical data of 132 patients with acute anterior wall myocardial infarction confirmed in Yuebei People's Hospital from April 2017 to April 2021 were retrospectively analyzed.They were divided into the thrombus group (n=46) and the non-thrombus group (n=86) according to the occurrence of LVT.Logistic regression was used to analyze the factors affecting LVT formation,and ROC curve was used to analyze the value of neutrophil lymphocyte ratio (NLR) in predicting LVT.Results Univariate analysis showed that the increase of ventricular aneurysm ratio,White blood cells (WBC),neutrophil count (NEU),NLR,platelet lymphocyte ratio (PLR),monocyte lymphocyte ratio (MLR),percutaneous coronary intervention (PCI),left ventricular ejection fraction (LVEF),lymphocyte count (LYM) and albumin (ALB) were related to the formation of LVT after acute anterior wall myocardial infarction,There was significant difference (P＜0.05).Multivariate logistic regression analysis showed that the formation of ventricular aneurysm (β=2.028,OR=7.602,95%CI =2.003-28.857),Alb decreased (β=0.152,OR=1.165,95%CI =1.015-1.337) was an independent risk factor for LVT after acute anterior wall myocardial infarction (P＜0.05).ROC curve showed that the optimal cut-off point of NLR for predicting left ventricular thrombosis after acute anterior wall myocardial infarction was 8.071,the area under ROC curve was 0.751,and its sensitivity was 0.587 and specificity was 0.837.Conclusions The formation of ventricular aneurysm and decreased albumin level were independent risk factors for LVT in acute anterior wall myocardial infarction.NLR is related to the occurrence of LVT,and the risk of LVT increases with the increase of NLR level. 2022 Vol. 29 (28): 99-102 [Abstract] ( 19 ) HTML (1 KB)  PDF (553 KB)  ( 16 ) 103 Rehabilitation effect of Pramipexole combined with Dopashydrazine Tablets and standardized rehabilitation therapy on Parkinson's disease FAN Chi WANG Ruiping Objective To explore the effect of Pramipexole combined with Dopashydrazine Tablets and standardized rehabilitation therapy on patients with Parkinson's disease.Methods A total of 80 patients with Parkinson's disease admitted to the Department of Neurology of Jinqiu Hospital from May 2017 to February 2022 were selected as the study subjects,and they were divided into the comparison group (40 cases) and the experimental group (40 cases) according to the random number table method.The comparative group was treated with the combination of Dopasehydrazine Tablets and standardized rehabilitation.The experimental group was treated with the combination of Pramipexol,Dopasehydrazine Tablets and standardized rehabilitation.The clinical efficacy,mental status (mini-mental state examination [MMSE]),cognitive function (Montreal cognitive assessmen [MoCA]),motor function (Part Ⅲof unified Parkinson's disease rating scale [UPDRS Ⅲ]),inflammatory indicators (C-reaction protein [CRP],tumor necrosis factor-α[TNF-α]) before and after treatment and incidence rate of adverse reactions of two groups were compared.Results The total effective rate of the experimental group was higher than that of the comparative group,the difference was statistically significant (P＜0.05).There were no significant differences in the scores of MMSE,MoCA,UPDRSⅢ,the levels of CRP,TNF-α of two groups before treatment (P＞0.05).After 2 months of treatment,the scores of MMSE,MoCA in the experimental group were higher than those in the comparative group,the scores of UPDRSⅢand CRP,TNF-α in the experimental group were lower than those in the comparative group,and the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence rate of adverse reactions of two groups before treatment(P＞0.05).Conclusion Prasol combined with Dopashydrazine Tablets can improve the mental state,cognitive function and motor function of patients with Parkinson's disease and reduce inflammatory damage. 2022 Vol. 29 (28): 103-106 [Abstract] ( 22 ) HTML (1 KB)  PDF (472 KB)  ( 22 ) 107 Effect of Jiawei Tongluo Recipe on patients with acute cerebral infarction of Qi deficiency and blood stasis combined with Yin deficiency LI Zhaosheng1 NA Lisha2▲ JIA Qian1 QU Na2 GUAN Yaxin Objective To investigate the effect of Jiawei Tongluo Recipe on patients with acute cerebral infarction of Qi deficiency and blood stasis combined with Yin deficiency,and the effect of Jiawei Tongluo Recipe on patients with mercaptopyruvate thiotransferase-3 (3-MST),vascular endothelial growth factor (VEGF),angiotensin Ⅱ(AngⅡ),National Institutes of Health Stroke scale (NIHSS) and transcranial Doppler (TCD) indicators.Methods A total of 100 patients with acute cerebral infarction of Qi deficiency and blood stasis combined with Yin deficiency admitted to Hongqi Hospital Affiliated to Mudanjiang Medical University from January to December 2021 were selected as the research objects.They were divided into observation group and control group by random number table method,with 50 cases in each group.The patients in the observation group were treated with Jiawei Tongluo Recipe,while the patients in the control group were treated with conventional Western medicine.The NIHSS scores,the levels of 3-MST,AngⅡand VEGF before and after treatment were compared between the two groups.The levels of TCD indexes before and after treatment were compared between the two groups.Results Before treatment,there were no significant differences in serum 3-MST levels between the two groups (P＞0.05).The serum 3-MST level of the observation group after treatment was higher than that of the control group,and the difference was statistically significant (P＜0.05).There were no significant differences in serum VEGF and AngⅡlevel between the two groups before treatment (P＞0.05).The serum VEGF level of the observation group after treatment was higher than that of the control group,the AngⅡlevel of the observation group after treatment was lower than that of the control group,and the difference was statistically significant (P＜0.05).There was no significant difference in NIHSS score between the two groups before treatment (P＞0.05).The NIHSS score of the observation group after treatment was lower than that of the control group,and the difference was statistically significant (P＜0.05).Before treatment,there were no significant differences in blood flow spectrum morphology (Vs),mean blood flow velocity (Vm) and pulsitility index (PI) between the two groups (P＞0.05).After treatment,the Vs and Vm levels of the observation group were lower than those of the control group,and PI of the observation group was higher than that of the control group,and the differences were statistically significant (P＜0.05).Conclusion Jiawei Tongluo Recipe has obvious effect on on patients with acute cerebral infarction of Qi deficiency and blood stasis combined with Yin deficiency.It can effectively regulate and establish cerebral collateral compensatory vessels and further control various serum levels. 2022 Vol. 29 (28): 107-110 [Abstract] ( 21 ) HTML (1 KB)  PDF (518 KB)  ( 22 ) 111 Status quo and correlation analysis of social support in patients with recurrent schizophrenia WANG Zhenyan Objective To explore the status quo of social support in patients with recurrent schizophrenia and analyze the correlation between the status quo of social support and various factors.Methods A total of 60 patients with recurrent schizophrenia admitted to the Third People's Hospital of Shangrao City from January 2016 to January 2021 were selected as the research subjects.The social support rating scale (SSRS),insight treatment attitude questionnaire (ITAQ),self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to investigate the status quo of social support in patients with recurrent schizophrenia.Results The total scores of SSRS was (32.76±9.16) points in patients with recurrent schizophrenia,ITAQ,SAS and SDS were (5.37±3.29),(50.63±8.96) and (51.76±9.77) points,respectively.There were no significant differences in the total score of social support among recurrent schizophrenic patients with different gender,age,education level and marital status (P＞0.05).Pearson correlation analysis showed that the total score of social support and subjective support were positively correlated with ITAQ score in patients with recurrent schizophrenia (r=0.989,0.969,P＜0.05),support utilization was negatively correlated with SDS score in patients with recurrent schizophrenia (r=-0.228,P＜0.05).There was no correlation between SSRS and SAS score in patients with recurrent schizophrenia (P＞0.05).Conclusion Insight,treatment attitude,and depression affect the social support of patients with recurrent schizophrenia.Therefore,it is necessary to take comprehensive measures to improve the social support level,so that the patients can recover as soon as possible and return to society as soon as possible. 2022 Vol. 29 (28): 111-113转121 [Abstract] ( 25 ) HTML (1 KB)  PDF (761 KB)  ( 27 ) 114 Effect of modified prone split-leg position combined with bi-endoscopy lithotripsy in the treatment of complicated renal calculi HUANG Youfeng HUANG Xinghua XIAO Zhenghao LIU Changming Objective To explore the application effect of modified prone split-leg position combined with bi-endoscopy lithotripsy in the treatment of complex renal calculi.Methods A total of 83 patients with complex renal calculi admitted to Mindong Hospital of Ningde City affiliated to Fujian Medical University from January 2019 to August 2021 were selected as the research objects.They were divided into the control group (n=41) and the observation group (n=42)according to random number table method.The control group was treated with conventional percutaneous nephrolithotomy (PCNL) in prone position,and the observation group was treated with modified prone split-leg position percutaneous nephrolithotomy combined with retrograde intrarenal surgery (RIRS).The preoperative general data,perioperative indicators,stone clearance rate,complications and reoperation rate were compared between the two groups.Results Both groups successfully completed the operation without conversion to open surgery.The operation time,preparation time before lithotripsy in the observation group were shorter than those in the control group,the number of percutaneous renal channels,and postoperative hemoglobin decline in the observation group were less than those in the control group,and the differences were statistically significant (P＜0.05).There were no significant difference between the two groups in postoperative renal function index and postoperative hospitalization time (P＞0.05).The stone clearance rate of the observation group was higher than that of the control group,and the reoperation rate of the observation group was lower than that of the control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the postoperative complications between the two groups (P＞0.05).Conclusion The modified prone split-leg position combined with bi-endoscopy lithotripsy in the treatment of complicated renal calculi is safe and effective,it has the advantages of short operation time,high stone clearance rate,and low reoperation rate.This is worthy of clinical promotion and application. 2022 Vol. 29 (28): 114-117 [Abstract] ( 20 ) HTML (1 KB)  PDF (443 KB)  ( 22 ) 118 Application effect of Mupiroxacin Ointment applied to incision and sterile gauze wrapping in patients after circumcision LI Kui1 WANG Fengyao2 SUN Yanbo Objective To explore the application effect of Mopirocin Ointment applied to incision and sterile gauze wrapping in patients after circumcision.Methods A total of 123 patients who underwent circumcision with disposable circumcision suture device in the Affiliated Hospital of Qingdao Binhai University and the Third People's Hospital of Qingdao from September 2019 to September 2021 were selected as the research objects for retrospective analysis.They were divided into the control group (58 cases) and the observation group (65 cases) according to different local treatment methods of incision.The incision of patients in the control group were wrapped with Vaseline gauze lined with sterile gauze,the incision of patients in the observation group were coated with Mupirocin Ointment and wrapped with sterile gauze.Both groups were wrapped with self-adhesive bandages.The pain score and time of dressing change on the second day after operation,edema score on the 10th day after operation,the incidence of postoperative hematoma,the incidence of postoperative infection,the rate of nail removal at 1 month after operation and patient satisfaction score at 3 months after operation were compared between the two groups.Results The dressing change time of the patients of the observation group on the second day after operation was shorter than that of the control group,the pain score of dressing change,the edema score on the 10th day after operation,and the incidence of postoperative infection of the observation group were lower than those of the control group,the differences were statistically significant (P＜0.05).There were no significant differences between the two groups in the incidence of postoperative hematoma,the nail removal rate at 1 month after operation and the patient satisfaction score at 3 months after operation (P＞0.05).Conclusion The application of Mopirocin Ointment applied to incision and sterile gauze wrapping after circumcision can significantly alleviate the pain of patients,reduce the probability of infection and reduce edema,which is worthy of clinical application and promotion. 2022 Vol. 29 (28): 118-121 [Abstract] ( 26 ) HTML (1 KB)  PDF (464 KB)  ( 158 ) 122 Effect of intelligent self-controlled analgesia on postoperative rehabilitation of women undergoing caesarean section ZHOU Fang ZHANG Baohua GU Wan ZHANG Qing Objective To study the effect of intelligent self-controlled analgesia on the postoperative rehabilitation of women undergoing caesarean section.Methods A total of 120 women who underwent post-cesarean analgesia in Jiujiang Maternal and Child Health Hospital from January to May 2021 were selected as the research objects.They were divided into I group and P group according to random number table method,with 60 cases in each group.Group I received intelligent management combined with intelligent patient-controlled analgesia (IMPA-Ai-PCA),and group P received conventional patient-controlled analgesia (PCA).The visual analogue scale (VAS) scores at 6,12,24 and 48 hours after the operation,adverse reactions,puerpera satisfaction,postoperative walking time and exhaust time were compared between the two groups.Results The highest level of pain occurred 12 h after operation,the VAS score of the two groups at 12 h after operation was higher than that at 6,24 and 48 h after operation,and the differences were statistically significant (P＜0.05).The VAS score of group I at 24 and 48 h after operation was lower than that of group P,and the difference was statistically significant (P＜0.05).The total incidence of adverse reactions in group I was lower than that in group P,and the difference was statistically significant (P＜0.05).The satisfaction score of group I was higher than that of group P,and the difference was statistically significant (P＜0.05).The walking time and exhaust time of parturients in group I were earlier than those in group P,and the differences were statistically significant (P＜0.05).Conclusion The implementation of IMPA-Ai-PCA program in postoperative analgesia of cesarean section can achieve good analgesic effect,with less adverse reactions,high satisfaction rate of puerpera,promote the ambulation and exhaust after labor,and promote the rapid recovery after cesarean section. 2022 Vol. 29 (28): 122-125 [Abstract] ( 21 ) HTML (1 KB)  PDF (481 KB)  ( 18 ) 126 Application of laryngeal mask combined with inhalation anesthesia in thoracoscopic surgery LI Yaoyao LI Dafeng ZENG Qiugu CEN Xiangru YANG Huajun Objective To analyze the clinical effect of combined anesthesia with laryngeal mask under spontaneous breathing during thoracoscopic surgery.Methods Clinical data of 80 patients who underwent thoracoscopic surgery in Yangjiang People's Hospital from May 2020 to January 2022 were retrospectively analyzed.They were divided into control group and observation group according to different anesthesia methods,with 40 cases in each group.The control group received double-lumen endotracheal intubation under general anesthesia,and the observation group received combined anesthesia with laryngeal mask under spontaneous breathing.The anesthesia time,recovery time,hospital stay,operation time,postoperative complications,mean arterial pressure (MAP) and heart rate (HR) at different time periods,and minimum intraoperative oxygen saturation(SpO2)and maximum intraoperative partial pressure of end-tidal carbon dioxide (PetCO2) were compared between the two groups.Results The anesthesia time,hospital stay,recovery time and operation time in the observation group were shorter than those in the control group,with statistically significant differences (P＜0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group with a statistically significant difference (P＜0.05).The minimum intraoperative SpO2 and maximum intraoperative PetCO2 in the observation group were higher than those in the control group,with statistically significant differences (P＜0.05).The MAP level at T2 and T3 and HR level at T2,T3 and T4 in the observation group were lower than those in the control group,and the differences were statistically significant (P＜0.05).Conclusion The application of laryngeal mask static aspiration combined anesthesia with spontaneous breathing in thoracoscopic surgery can significantly reduce the dosage of anesthetics,shorten the operation time and hospital stay,reduce side effects,have higher safety,and have little impact on the body.Therefore,it can be safely applied in clinical thoracoscopic surgery. 2022 Vol. 29 (28): 126-129转134 [Abstract] ( 21 ) HTML (1 KB)  PDF (527 KB)  ( 23 ) 130 Application of Esketamine combined with femoral nerve block laryngeal mask general anesthesia in knee arthroscopy ZENG Huali ZHU Jianbin JIANG Minying Objective To investigate and analyze the application of Esketamine combined with femoral nerve block laryngeal general anesthesia in knee arthroscopic surgery.Methods A total of 72 patients with knee arthroscopy in the First Hospital of Nanping City from March 2020 to May 2021 were selected as the research subjects.The patients were divided into control group and observation group by random number table method,36 cases in each group.The control group adopted ultrasound-guided femoral nerve block after the onset of laryngeal general anesthesia,and the observation group adopted Esketamine on the basis of the control group.The heart rate (HR) and mean arterial pressure (MAP)of the two groups were compared before anesthesia (T0),before skin incision (T1),immediately after skin incision (T2),intraoperative exploration (T3) and after surgery (T4).The duration of sensory block and motor block were compared between the two groups.Visual analogue scale (VAS) scores were compared between the two groups immediately after extubation and 0.5,8,and 24 h after operation.Perioperative adverse reactions were compared between the two groups.Results There were no significant differences in HR and MAP at T0 between the two groups (P＞0.05).HR of T1,T2,T3 and T4 in the observation group were higher than those in the control group,and MAP of T1,T2 and T3 were higher than those in the control group,and the differences were statistically significant (P＜0.05).In the control group,the HR of T1,T2,T3 and T4 was lower than that of T0,and the MAP of T1,T2 and T3 was lower than that of T0.In the observation group,MAP of T3 was lower than that of T0,and the differences were statistically significant (P＜0.05).There was no significant difference in the duration of sensory block and motor block between the two groups (P＞0.05).The VAS scores of the observation group immediately after extubation,0.5 and 8 h after operation were lower than those of the control group,and the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Ultrasound-guided femoral nerve block and laryngeal mask general anesthesia with the addition of Esketamine in knee arthroscopy to ensure more stable hemodynamics,and the postoperative pain level is low,doesn't increase perioperative adverse reactions,and has higher safety. 2022 Vol. 29 (28): 130-134 [Abstract] ( 21 ) HTML (1 KB)  PDF (494 KB)  ( 47 ) 135 Application effect of different interventional methods combined with internal and external application of traditional Chinese medicine in cystic thyroid nodules under ultrasound guidance XU Dajin CHEN Tingting LIU Fei DENG Wenwen ZENG Wenge GUO Yan Objective To explore the application effect of different interventional methods under ultrasound guidance combined with internal and external application of traditional Chinese medicine in cystic thyroid.Methods A total of 60 patients with thyroid cystic nodules treated in Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to December 2021 were selected as the research objects,According to the random number table method,the patients were divided into the observation group and the control group,all of which had 30 cases.Both groups were treated with oral and external application of traditional Chinese medicine,the control group was treated with microwave ablation under the guidance of ultrasound,and the observation group was treated with ultrasound-guided lauromacrogol injection sclerotherapy.The curative effect,thyroid function and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant (P＜0.05).The size of thyroid capsule at 6 and 12 months of the two groups after operation was smaller than that in 3 months after operation,and the size of thyroid capsule in 12 months after operation was smaller than that in 6 months after operation,the difference was statistically significant (P＜0.05).The size of the capsule in the observation group was smaller than that in the control group at 3,6 and 12 months after operation,the difference was statistically significant (P＜0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant (P＜0.05).Conclusion Ultrasound-guided lauromacrogol injection sclerotherapy combined with oral administration and external application of traditional Chinese medicine can significantly improve the curative effect and thyroid function of thyroid cystic nodules,and has good clinical application value. 2022 Vol. 29 (28): 135-138 [Abstract] ( 24 ) HTML (1 KB)  PDF (568 KB)  ( 25 ) 139 Value of ultrasonography combined with CT in the diagnosis of acute appendicitis ZHAO Baolin Objective To study the value of ultrasound combined with CT in the diagnosis of acute appendicitis.Methods A total of 60 patients with suspected appendicitis who received medical treatment in People's Hospital of Gongqingcheng City from September 2020 to October 2021 were selected as the research objects,and all of them completed the corresponding ultrasonic examination,CT examination and combined examination.The consistency,receiver operating characteristic(ROC) curve and imaging manifestations of different detection methods in the diagnosis of acute appendicitis were compared and analyzed.Results The detection accuracy of CT examination,ultrasound examination and combined examination were 88.33%,83.33% and 95.00% respectively,and the accuracy of combined detection was higher.The Kappa test consistency of CT examination,ultrasound examination and combined examination with pathological diagnosis of acute appendicitis was 0.691,0.556,0.864,and the Kappa test consistency of combined diagnosis was higher.The ROC curve was used to analyze the detection value of different detection methods.The results showed that the ROC curve of CT examination,ultrasound examination and combined examination in the diagnosis of acute appendicitis were 0.891,0.781,0.913,and the standard error was 0.028,0.064,0.031 respectively (P＜0.05).Among the main signs of acute appendicitis,the incidence of periappendicitis and peritonitis showed by combined detection were higher than those by CT and ultrasound examination,and the differences were statistically significant (P＜0.017).The average hospital stay was ranged from 5 to 20 d,with an average of (9.32±1.11) d.The hospitalization cost of patients ranged from 2 thousand to 15 thousand yuan,with an average of (5.11±0.71) thousand yuan.Conclusion Ultrasonic examination combined with CT diagnosis can improve the diagnostic accuracy. 2022 Vol. 29 (28): 139-142 [Abstract] ( 25 ) HTML (1 KB)  PDF (615 KB)  ( 27 ) 143 Evaluation of the degree of liver fibrosis in patients with chronic hepatitis B by two-dimensional ultrasonic shear-wave elastography LIU Xiaowei QIN wenling CHEN Min CHEN Xuemei▲ GU Wen YANG Lihua Objective To explore the diagnostic value of two-dimensional ultrasound shear-wave elastography for liver fibrosis in patients with chronic hepatitis B.Methods A total of 66 patients with chronic hepatitis B treated in Ji'an Hospital of Shanghai Oriental Hospital from January to December 2021 were retrospectively selected as the research objects.All patients were diagnosed by pathological examination,and underwent conventional ultrasound imaging and two-dimensional ultrasound shear wave elastography.Liver biopsy was taken as the gold standard.The degree of liver fibrosis of patients was divided into F0,F1,F2,F3 and F4 stages according to the METAVIR score standard.The patients were divided into groups according to the pathological grade,with F0＋F1 as non-significant liver fibrosis (nonsignificant group) and F2＋F3＋F4 as significant liver fibrosis (significant group).The age,cell,body mass index (BMI),Young's modulus,aspartate aminotransferase (AST),glutamyltransferase (GGT),alanine aminotransferase (ALT) and other indicators were collected,and liver fibrosis-4 factor index (FIB-4) and aspartate aminotransferase/platelet ratio index(APRI) were calculated.Univariate and multivariate logistic analysis were used to analyze the relevant data of patients,and ROC curve was used to evaluate the diagnostic efficacy of Young's modulus,FIB-4 and APRI in the significant degree of liver fibrosis in patients.Results The results of needle biopsy showed that among the selected 66 pa tients with chronic hepatitis B,5 cases were F0 stage,19 cases were F1 stage,23 cases were F2 stage,12 cases were F3 stage,and 7 cases were F4 stage.Therefore,F0＋F1 stage had non-significant liver fibrosis (non-significant group of 24 cases) and significant liver fibrosis (significant group of 42 cases).Univariate analysis showed that there were no significant differences in gender,age,BMI,AST,GGT,ALT,alkaline phosphatase (ALP),albumin and total bilirubin(TBil) between the two groups (P＞0.05).There were significant differences in Young's modulus,serum liver fibrosis indexes (laminin [LN],hyaluronic acid [HA],collagen Ⅳ[Ⅳ-C],pro-collagen Ⅲ[PⅢP]),FIB-4 and APRI between the two groups (P＜0.05).Multivariate logistic analysis showed that Young's modulus,LN,HA,Ⅳ-C,PⅢP,FIB-4 and APRI were independent risk factors for liver fibrosis (P＜0.05).ROC results showed that the AUC of Young's modulus value was 0.864,the diagnostic sensitivity was 82.6% and the specificity was 84.5%,the AUC of FIB-4 was 0.789,the diagnostic sensitivity was 80.7% and the specificity was 72.4%,and the AUC of APRI was 0.857 and the diagnostic sensitivity was 81.5%.The specificity was 83.8%,the combined AUC of the three groups of indicators was 0.935,the diagnostic sensitivity was 92.8%,and the specificity was 93.2%.Conclusion Two-dimensional shear wave elastography can be used to detect the significance of liver fibrosis in patients with chronic hepatitis B in a non-invasive manner,and the diagnostic efficiency is good. 2022 Vol. 29 (28): 143-147 [Abstract] ( 20 ) HTML (1 KB)  PDF (589 KB)  ( 13 ) 148 Application value of 3.0T multi-parameter magnetic resonance imaging in neoadjuvant chemotherapy for breast cancer XIONG Shuhong RUAN Jiugen XIAO Qiong DING Yao Objective To explore the application value of 3.0T magnetic resonance imaging (MRI) multiparameter imaging in the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer.Methods The clinical data of 60 patients with breast cancer admitted to Xinyu People's Hospital from January 2020 to January 2022 were retrospectively analyzed.According to the efficacy of NAC,the patients were divided into significant effect group (n=23) and non-significant effect group (n=37).Both groups underwent multi-parameter MRI examination.The changes of maximum diameter (LD),apparent diffusion coefficient (ADC),early enhancement rate (E) and maximum enhancement rate (PE) (ΔLD,ΔADC,ΔE,ΔPE) were compared between the two groups.The ROC curve was used to analyze the application value of MRI multi-parameter change rate in NAC efficacy.Results After NAC,ΔLD,ΔADC,ΔE,and ΔPE in the significant effect group were higher than those in the non-significant effect group,and the differences were statistically significant (P＜0.05).ROC curve analysis showed that the area under the curve (0.871) and sensitivity (91.30%) of the combined prediction of MRI multi-parameter change rate were the highest,and the specificity of ΔADC prediction was the highest(91.89%).Conclusion The clinical value of 3.0T magnetic resonance multiparameter imaging in evaluating the efficacy of neoadjuvant chemotherapy for breast cancer patients is high,and it is an important clinical predictor. 2022 Vol. 29 (28): 148-150 [Abstract] ( 22 ) HTML (1 KB)  PDF (581 KB)  ( 13 ) 151 Diagnostic efficacy of ultrasound venography and endography in benign and malignant endometrial lesions after menopause CHEN Shuhua GONG Wei LIANG Qianhong Objective To investigate the diagnostic value of ultrasonography venography and endovascular angiography in postmenopausal benign and malignant endometrial lesions.Methods A total of 90 patients with suspected postmenopausal endometrial benign and malignant lesions who were admitted to Panyu Maternal and Child Care Service Centre of Guangzhou from May to November 2021 were selected as the subjects.All patients completed ultrasound venography and endovascular angiography after admission.The physical diagnosis was taken as the "gold standard",and the detection rate and diagnostic efficacy of ultrasonography and endovascular angiography in postmenopausal benign and malignant endometrial lesions were analyzed.According to the results of pathological examination,they were divided into benign group and malignant group.Endometrial thickness and contrast-enhanced ultrasound parameters were compared between the two groups.Results Of the 90 suspected patients,61 were confirmed by pathological examination,and 52 were finally confirmed by intracavitary ultrasonography,the accuracy was 70.00%,the sensitivity was 70.49%,and the specificity was 68.97%.57 cases were finally diagnosed by contrast-enhanced ultrasonography,and the accuracy was 82.22%,the sensitivity was 83.61%,and the specificity was 79.31%.The rise time and peak time of malignant group were lower than those of benign group,peak intensity,endometrial thickness were higher than that of the benign group,the differences were statistically significant (P＜0.05).Conclusion Ultrasound venography and endovascular angiography have higher detection rates in postmenopausal benign and malignant endometrial lesions,but ultrasound venography can obtain higher diagnostic sensitivity and specificity,which can guide clinical diagnosis and treatment. 2022 Vol. 29 (28): 151-154 [Abstract] ( 22 ) HTML (1 KB)  PDF (540 KB)  ( 13 ) 155 Analysis and thinking on the citation of papers in the comprehensive journal of clinical medicine Chinese Journal of Clinical Research WANG Yu WANG Na'na Objective To provide a reference for further improving the academic quality and influence of the journal by analyzing the citations of papers in the comprehensive journal of clinical medicine Chinese Journal of Clinical Research.Methods According to the data provided by China National Knowledge Infrastructure (CNKI),the papers published in Chinese Journal of Clinical Research from 2015 to 2019 was sorted according to the cited frequency from high to low,and papers with a cited frequency of ≥15 was classified as highly cited papers according to the limited citation frequency method.The citation situation,the top 20 papers by cited frequency,the top 10 subjects by cited frequency,and the highly cited and zero-cited papers were sorted and analyzed.Results From 2015 to 2019,the amount of literature gradually decreased,and the total cited frequency increased year by year.The top 20 papers by cited frequency was mainly clinical research,nursing and review,and was mainly concentrated in 2016 and 2017 years.The subject with the highest cited frequency was clinical medicine,followed by obstetrics and gynecology,endocrine glands and systemic diseases.The highly cited literature column mainly focused on clinical research,nursing,and original research.The zero-cited literature column mainly focused on short reports,experimental research,survey research,medical technology,etc.Conclusion It is necessary to strengthen the planning of key topics and the drafting of excellent papers,adjust the column settings in a timely manner,strengthen peer review,and strictly check the quality of the papers,so as to improve the cited frequency of papers and the academic level of journals,and also provide reference for related research. 2022 Vol. 29 (28): 155-158 [Abstract] ( 20 ) HTML (1 KB)  PDF (499 KB)  ( 49 ) 159 Correlation analysis of bone mineral density T value and lifestyle in the elderly RAO Shumei TIAN Rong Objective To investigate the correlation between bone mineral density T value and lifestyle in the elderly,so as to seek a way to prevent osteoporosis in the elderly.Methods A total of 432 elderly patients hospitalized in the General Hospital of Tianjin Medical University from February 2020 to January 2022 were selected as the study subjects,and the patients' socio-demographic data,medication consumption,lifestyle habits,and osteoporosis indexes were collected.SPSS 22.0 statistical software was used to analyze the correlation between bone mineral density T value and lifestyle in the elderly.Results The T value of bone mineral density in elderly female patients was lower than that in male patients,the T value of bone mineral density in elderly patients with body mass index ≤18.4 kg/m2 was lower than that in elderly patients with body mass index＞18.4 kg/m2,the T value of bone mineral density in elderly patients≥80 years old was lower than that in elderly patients＜80 years old,and the T value of bone mineral density in elderly patients with milk intake＜3 times/week was lower than that in elderly patients with milk intake ≥3 times/week,the T value of bone mineral density in elderly patients who used Statins was higher than that in those who did not use Statins,and the T value of bone mineral density in elderly patients who used Calcium Tablets containing Vitamin D3 was higher than that in those who did not use Calcium Tablets containing Vitamin D3,and the differences were statistically significant (P＜0.05).Pearson correlation analysis showed that there was a negative correlation between bone mineral density T value and age in elderly patients (r=-0.327,P＜0.05).The T value of bone mineral density in elderly patients was positively correlated with body mass index,milk intake frequency,Statin use,and Calcium Tablets containing Vitamin D3(r=0.284,0.317,0.296,0.247,P＜0.05).Conclusion Patients with lower body mass index and older age have lower bone mineral density T value and are more likely to develop osteoporosis.Clinical attention should be paid to it,and effective measures such as drinking more milk and taking Calcium Tablets containing Vitamin D3 should be taken to strengthen the intervention,so as to improve the prevention and treatment effect of osteoporosis. 2022 Vol. 29 (28): 159-162 [Abstract] ( 21 ) HTML (1 KB)  PDF (527 KB)  ( 13 ) 163 Analysis and intervention measures of medication errors in a hospital from 2014 to 2020 DONG Hui Objective To understand the situation of medication errors reported in Gejiu People's Hospital,and provide analysis and preventive measures for the hospital.Methods The medication error reports reported in Gejiu People's Hospital from January 2014 to December 2020 were collected.The classification,error content,triggering factors,cases and composition of triggering and discovering personnel were statistically analyzed.Results Among the 253 medication errors reported,the proportion of men and women was equal (52.17% for men and 47.83% for women).Patients over 60 years old caused the most medication error reports,accounting for 152 cases (60.08%).The top three reported quantities of medication errors were dosage of 33 cases (13.04%),interaction of 28 cases (11.07%) and contraindications of 26 cases (10.28%).More than 150 kinds of drugs were involved,and the dosage form was mainly injection.Conclusion The classification of medication errors in Gejiu People's Hospital is mainly Grade B,and the content of errors is mainly dosage errors.The main personnel and factors causing medication errors are the lack of professional knowledge and training of residents.Pharmacists play an important role in finding and correcting errors in time. 2022 Vol. 29 (28): 163-166 [Abstract] ( 19 ) HTML (1 KB)  PDF (499 KB)  ( 21 ) 167 Nursing care of a patient with severe skin rash,heart failure,catheterrelated bloodstream infection and thrombosis after immunotherapy DONG Shan1 LI Shanping1▲ YUAN Ling2 YUAN Wanyan To summarize the nursing experience of a lung cancer patient with severe rash,heart failure and other immune-related adverse events after treatment with immune checkpoint inhibitors,as well as port catheter-related bloodstream infection and thrombosis.Immediately after the patient is admitted to the hospital,the multidisciplinary team cooperates to quickly identify the source of infection,control systemic and local infection,pay attention to rash changes and strengthen skin care,and the specialist nurse in intravenous therapy is responsible for the maintenance and removal of the implanted venous infusion port,while strictly controlling access volume,maintain negative fluid balance,and maintain effective circulating blood volume.After 21 days of multidisciplinary team treatment,the implanted venous infusion port was removed,the systemic and local infection was controlled,the vital signs were stable,the rash subsided,and there was no abnormality in the follow-up for 30 days after discharge.Rapid identification of the cause,control of infection,maintenance of negative fluid balance,and enhanced skin care through a multidisciplinary team are effective measures to treat and care for such multiple immune-related adverse reactions with catheter-related bloodstream infection and thrombosis. 2022 Vol. 29 (28): 167-170 [Abstract] ( 18 ) HTML (1 KB)  PDF (486 KB)  ( 22 ) 171 Paraduodenal pancreatitis: 1 case report with review of literature LIANG Chenfei CHENG Yanli Paraduodenal pancreatitis (PP) is a rare type of focal chronic pancreatitis located in the groove area between dorsal pancreatic head and duodenum.The mechanisms of PP involve the obstruction of the accessory pancreatic duct and pseudocyst formation.Alcohol,cigarettes and ectopic pancreas in the duodenum are the causes of PP.The main symptoms include abdominal pain,nausea and vomit.Radiological findings as duodenal wall thickening,disappearance of accessory pancreatic duct and pseudocyst indicate PP.Meanwhile,differential diagnosis with malignant diseases in pancreatic head,bile duct and duodenum is challenging and very important.Improving the understanding and diagnosis of PP helps to reduce unnecessary operations.Few cases and researches of PP are reported worldwide.This article reports one case of PP diagnosed in the Department of Gastroenterology in the First Hospital of Tsinghua University,characterized by duodenal ulcer with bleeding,obstruction and ascites.A review of literature is also provided in this article. 2022 Vol. 29 (28): 171-174 [Abstract] ( 22 ) HTML (1 KB)  PDF (673 KB)  ( 15 ) 175 Effect of information sharing platform combined with feedforward control intervention on emotion and recurrence of patients undergoing glioma surgery LIU Huahong FAN Zhangjin LI Huan YUAN Chunyan KE Lili Objective To investigate the effect of information sharing platform combined with feedforward control on emotion and recurrence of patients undergoing glioma surgery.Methods A total of 60 eligible patients for glioma surgery admitted to the Second Affiliated Hospital of Nanchang University from January 2020 to March 2021 were selected as the research subjects,they were divided into control group (30 cases) and observation group (30 cases) according to random number table method.The control group received routine nursing,and the observation group received information sharing platform combined with feedforward control intervention.The satisfaction,mood,complications,recurrence and quality of life were compared between the two groups to analyze the nursing effect.Results The total satisfaction of observation group was higher than that of control group,the difference was statistically significant (P＜0.05).The improvement of negative emotion in the observation group was better than that in the control group,the difference was statistically significant (P＜0.05).The total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant (P＜0.05).All patients were followed up for 6 months,and the recurrence rate in the observation group was lower than that in the control group,the difference was statistically significant (P＜0.05).The score of quality of life in the observation group was higher than that in the control group,the difference was statistically significant (P＜0.05).Conclusion The application effect of information sharing platform combined with feedforward control intervention in patients undergoing glioma surgery is significant,which can effectively reduce the recurrence rate and improve the psychological state and emotion of patients,and is worth promoting. 2022 Vol. 29 (28): 175-178 [Abstract] ( 17 ) HTML (1 KB)  PDF (610 KB)  ( 23 ) 179 Construction and application effect of cluster nursing strategy in operating room in otoendoscopic tympanoplasty PAN Yan YI Meilian YAO Xiaoyan FU Jinping ZHOU Yuan CHEN Weibin LU Fang Objective To explore the construction and application effect of cluster evidence-based nursing strategy in operating room under otoendoscopic tympanoplasty.Methods A total of 60 patients with otoendoscopic tympanoplasty treated in Yichun People's Hospital from January 2020 to January 2022 were selected as the research objects.They were divided into control group and observation group by random number table method,with 30 cases in each group.The control group received routine nursing in the operating room,and the observation group established and implemented cluster evidence-based nursing.The operation time,intraoperative bleeding,hospitalization time,and total complication rate and nursing quality of the two groups were compared.Results The operation time and hospital stay in the observation group were shorter than those in the control group,and the amount of intraoperative bleeding was less than that in the control group,and the differences were statistically significant (P＜0.05).The incidence of complications in the observation group was 3.33%,which was lower than 23.33% in the control group,and the difference was statistically significant (P＜0.05).The score of nursing quality in the observation group was higher than that in the control group,and the difference was statistically significant (P＜0.05).Conclusion In the operating room nursing of patients with otoendoscopic tympanoplasty,the construction and implementation of cluster evidence-based nursing can shorten the operation time and hospital stay,reduce the amount of intraoperative bleeding,reduce the incidence of complications and improve the quality of nursing. 2022 Vol. 29 (28): 179-181 [Abstract] ( 21 ) HTML (1 KB)  PDF (564 KB)  ( 14 ) 182 Application effect of mobile terminal health service platform management in young and middle-aged patients with type 2 diabetes HU Rong PENG Xuewei PENG Danping Objective To explore the application effect of mobile terminal health service platform management in young and middle-aged patients with type 2 diabetes.Methods A total of 136 middle-aged and young patients with type 2 diabetes received by Department of Ji'an Central People's Hospital from January 2020 to June 2021 were selected and divided into study group and control group according to random number table method,with 68 cases in each group.The control group adopted routine nursing,and the research group adopted mobile terminal based health service platform management based on the control group.Blood glucose index,self-management ability,satisfaction and other indicators were compared between the two groups.Results Before management,there were no significant differences in fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin between the two groups (P＞0.05).After management,fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the two groups were lower than those before management,and the study group was lower than the control group,the differences were statistically significant (P＜0.05).The scores of blood glucose monitoring,compliance with medical drugs,diet control and regular exercise in the study group were higher than those in the control group,the differences were statistically significant (P＜0.05).The satisfaction of the study group was higher than that of the control group,the difference was statistically significant (P＜0.05).Conclusion The management effect based on the mobile terminal health service platform is significant,which has positive significance for the blood sugar control of young and middle-aged patients with type 2 diabetes.It can improve the patients' blood sugar indicators,enhance the patients' self-health management ability,and increase their nursing satisfaction. 2022 Vol. 29 (28): 182-184转188 [Abstract] ( 23 ) HTML (1 KB)  PDF (598 KB)  ( 104 ) 185 Application effect of nursing intervention based on FMEA in patients with malignant tumor undergoing PICC catheter chemotherapy HE Huan WU Jing TANG Lulu LIU Li LIU Xiaoling Objective To explore the effect of nursing intervention based on failure mode and effect analysis (FMEA) in patients with malignant tumor treated by peripherally inserted central venous catheter (PICC).Methods A total of 80 patients with malignant tumors treated in the Affiliated Cancer Hospital of Chongqing University from January 2020 to June 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,40 cases in each group.The control group received routine nursing,and the observation group received nursing intervention based on FMEA.The occurrence of deep vein thrombosis,blood flow velocity before and after nursing and nursing satisfaction were compared between the two groups.Results The incidence of deep vein thrombosis in the observation group was lower than that in the control group,and the difference was statistically significant (P＜0.05).There was no significant difference in the maximum and average axillary blood flow velocity between the two groups before nursing (P＞0.05).After nursing,the maximum and average axillary blood flow velocity of the two groups were faster than those before nursing,and the observation group was faster than the control group,and the difference was statistically significant (P＜0.05).The overall nursing satisfaction of the observation group was better than that of the control group,and the total nursing satisfaction was higher than that of the control group,and the differences were statistically significant (P＜0.05).Conclusion FMEA nursing intervention can effectively improve axillary blood flow velocity,prevent deep venous thrombosis and improve nursing satisfaction of patients with malignant tumor after PICC catheter chemotherapy. 2022 Vol. 29 (28): 185-188 [Abstract] ( 20 ) HTML (1 KB)  PDF (583 KB)  ( 27 ) 189 Application effect of optimized admission process in nursing of patients with acute myocardial infarction LIN Li1 YIN Ruiyan1 GAO Lingjiao1 LI Ruiqing Objective To discuss application effect of optimized admission process in nursing of patients with acute myocardial infarction.Methods A total of 178 patients with acute ST-segment elevation myocardial infarction (STEMI) admitted to the Department of Cardiology,Jiangmen People's Hospital were enrolled in this study.A total of 108 patients admitted from July 2018 to June 2019 were selected as the control group,and routine admission processing process was implemented.A total of 70 patients admitted from July 2020 to June 2021 were selected as the observation group,and the optimized admission processing process was implemented.The time from the first medical contact to the completion of the first electrocardiogram,the time from the completion of the first electrocardiogram to the diagnosis,the time of door to wire passage (D-to-W) of percutaneous coronary intervention (PCI),and the satisfaction of patients with nursing work were compared between the two groups.Results The time from the first medical contact to the completion of the first ECG,the time from the completion of the first electrocardiogram to the diagnosis,and the D-to-W time of PCI in the observation group were shorter than those in the control group,and the differences were statistically significant (P＜0.05).The nursing satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).Conclusion Optimized flow of admission is beneficial for STEMI patients to obtain the most efficient care at the optimal timing while improving the quality of medical care of STEMI patients. 2022 Vol. 29 (28): 189-192 [Abstract] ( 21 ) HTML (1 KB)  PDF (610 KB)  ( 20 ) 193 Application value of 3+1 holistic rehabilitation nursing in patients with Alzheimer's disease WU Lihua1 ZHENG Limei2 ZOU Chunhui3 ZHANG Weiwei4 LI Jie Objective To explore application value of 3＋1 holistic rehabilitation nursing in patients with Alzheimer's disease.Methods A total of 97 patients with Alzheimer's disease admitted to the Department of Geriatrics of Shenyang Jing'an Mental Health Hospital from January 2019 to December 2021 were retrospectively selected as the study objects.According to different nursing methods,they were divided into the 3＋1 holistic rehabilitation nursing group (50 cases)and the routine nursing group (47 cases).The routine nursing group was given the routine nursing measures,the 3＋1 holistic rehabilitation nursing group implemented the 3＋1 holistic rehabilitation nursing measures on the basis of the routine nursing group.The dementia scores,cognitive function scores,depression status scores,daily living ability scores and emotional apathy status scores of the patients in the two groups were compared.Results Before intervention,there were no significant differences in the dementia scores,cognitive function scores,depressive state scores between two groups (P＞0.05).After intervention,the dementia scores,cognitive function scores,depressive state scores of two group patients were lower than those before intervention,and dementia score,cognitive function score,depressive state score of 3＋1 holistic rehabilitation nursing group were lower than those of routine nursing group,the differences were statistically significant (P＜0.05).Before intervention,there were no significant differences in the daily living ability scores and emotional apathy scores between two groups (P＞0.05).After intervention,the daily living ability scores of two groups were higher than those before intervention,the emotional apathy scores of two groups were lower than those before intervention,and the daily living ability score of 3＋1 holistic rehabilitation nursing group was higher than that of routine nursing group,emotional apathy score of 3＋1 holistic rehabilitation nursing group was lower than that of routine nursing group,the differences were statistically significant (P＜0.05).Conclusion The application of 3＋1 holistic rehabilitation nursing in patients with Alzheimer's disease can improve clinical symptoms and bad emotions,improve cognitive function and daily living ability,and alleviate emotional apathy,which is worthy of clinical promotion and application. 2022 Vol. 29 (28): 193-196 [Abstract] ( 19 ) HTML (1 KB)  PDF (620 KB)  ( 33 )

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