Objective To observe the histological changes of cartilage in weight-bearing and non weight-bearing areas of the femoral condyle in patients with knee osteoarthritis,and to explore the pathological process of cartilage degeneration in knee osteoarthritis.Methods From August 2021 to September 2022,56 patients with primary osteoarthritis of the knee and varus deformity who were treated with total knee arthroplasty in the People's Hospital of Ningxia Hui Autonomous Region were selected as research objects.The femoral condyles were collected as clinical specimens,the articular cartilage with severe wear of the femoral condyle was used as the weight bearing area (observation group),and the articular cartilage with less wear of the femoral condyle was used as the non weight bearing area (control group),HE staining and safranine O staining were performed to observe the histopathological morphology of observation group and control group under microscope.The ultrastructural characteristics of the surface of observation group and control group were observed and compared by scanning electron microscopy.Results Macroscopic observation showed that in the observation group,the cartilage surface of the femoral condyle was obviously defective,rough and uneven,with some osteophytes formed at the edges,and cancellous bone sclerosis was visible in the subchondral bone.In the control group,the cartilage surface of the femoral condyle was smooth and flat,with clear and uniform color,and no osteophytes formed at the edges.HE staining showed that the number of chondrocytes in the observation group decreased significantly,the arrangement was irregular,the cell proliferation was abnormal,and the cells appeared in clusters.In the control group,the articular cartilage matrix was stained evenly,the number of chondrocytes was normal,the shape was complete and full,and the nucleus and cytoplasm were clearly visible.Safranine O staining showed that the morphology of chondrocytes in the observation group was significantly changed,the cartilage layer was fibrotic,and the cartilage matrix was lightly stained.The size and morphology of chondrocytes in the control group were normal,and the arrangement was relatively neat.The cartilage matrix was evenly stained,and the tide line was normal;Scanning electron microscope observation:In the observation group,the surface structure of articular cartilage was not clear,a large number of pores of different sizes were visible,collagen fibers were not shaped,and normal chondrocytes were rare;In the control group,the surface of articular cartilage was relatively flat,collagen fibers were in bundles and orderly arranged,and normal chondrocytes were visible.Conclusion The normal physiological function of chondrocytes requires a stable level of chondrocyte matrix metabolism.KOA patients have degenerative changes of knee joint cartilage due to changes in cartilage matrix caused by a variety of reasons.

 Objective To explore the application effect of different fluid resuscitation strategies in rats with severe craniocerebral injury combined with hemorrhagic shock.Methods A total of 100 experimental rats were randomly divided into Group Ⅰ,Group Ⅱ,Group Ⅲand Group Ⅳaccording to random number table method,with 25 cases in each groups.Group Ⅰwas given 10%hypertonic sodium chloride injection for liquid resuscitation with a target of 80 mmHg,Group Ⅱwas given 10% hypertonic sodium chloride injection for liquid resuscitation with a target of 60 mmHg,and Group Ⅲwas given 7.5% hypertonic sodium chloride injection with a target of 80 mmHg for liquid resuscitation,Group Ⅳwas treated with 7.5%hypertonic sodium chloride injection and liquid resuscitation with 60 mmHg target.Each group was treated with hypertonic sodium chloride injection with different concentration values through jugular vein slowly until the target value of resuscitation.The mean arterial pressure and cerebral perfusion pressure before and after model establishment and resuscitation were measured,and the indexes of central venous pressure (CVP),intracranial pressure (ICP),mean arterial pressure(MAP),cerebral perfusion pressure(CPP),arterial blood sodium concentration,plasma osmotic pressure,and brain tissue water content of rats before model establishment (T0),after model establishment (T1),20 minutes after resuscitation(T2),40 minutes after resuscitation (T3),1 hour after resuscitation (T4),2 hours after resuscitation (T5),3 hours after resuscitation (T6),and 4 hours after resuscitation (T7) were compared.Results The level of MAP in group Ⅳat T7 were higher than those in the other three groups,and the differences were statistically significant (P<0.05).There were no significant differences in the level of MAP among the four groups at T1-T6 (P＞0.05);There were no statistically significant differences in the concentration of arterial blood sodium at T0 in each group (P＞0.05).The concentration of arterial blood sodium at T7 in group Ⅳwere significantly lower than those in the other three groups (P＜0.05).There were no statistically significant difference in the osmotic pressure between the each groups in each period (P＞0.05).The water content of brain tissue in the injured hemisphere of group Ⅰ,Ⅱand Ⅲwere higher than those in the healthy hemisphere at T1,with statistically significant differences(P＜0.05).The water content of brain tissue in group Ⅳat T7 were lower than those in the other three groups,with statistically significant differences (P＜0.05).Conclusion The treatment of severe brain injury combined with hemorrhagic shock with small volume fluid resuscitation can better restore the circulating blood volume of brain tissue in rats,and has a better effect on improving neural function.

[Key words] Hemorrhagic shock;Severe craniocerebral injury;Liquid resuscitation;Central venous pressure;Intracranial pressure

Objective The Java PK for Desktop (JKPD)was used to predict the application of Teicoplanin in the Chinese population by using a one-room model,and to verify the clinical effect.Methods A total of 16 patients treated with Teicoplanin at various infection sites from December 2021 to December 2022 in Xiangtan Central Hospital were selected as research objects,based on the Teicoplanin pharmacokinetic model,the Teicoplanin pharmacokinetic model was defined in the JPKD customized module,and the pharmacokinetic parameters of Teicoplanin were estimated by the Baysian method.Hospitalized patients with gram-positive bacteria who received Teicoplanin in Xiangtan Central Hospital were collected,and those who received continuous renal replacement therapy were excluded.The dose of Teicoplanin in patients,relative demographic information and steady-state blood concentration measured for the first time were entered into JPKD.The Baysian method was used to estimate the individual pharmacokinetic parameters of patients.Based on pharmacokinetic parameters and the proposed adjustment of Teicoplanin administration schedule,blood concentration data for Teicoplanin after adjustment of prescription records was predicted.The deviation between the predicted concentration and the measured concentration was calculated,and its prediction ability was investigated.Results The actual steady-state valley concentration was(17.35±11.05)mg/L using Teicoplanin and(19.36±11.81)mg/L predicted by JPKD,with a deviation of(14.73±19.81)%.Conclusion The use of JPKD by a one-room model has good predictive ability for the blood concentration of Teicoplanin in the Chinese population.It is of great significance for individual clinical use of Teicoplanin and helpful for rational clinical use of Teicoplanin.

Objective To investigate whether reproductive lactation can reduce the probability of dimethylbenz anthrancence (DMBA)induced breast cancer in female SD rats.Methods Forty 8-week-old female SD rats were divided into two groups by using random number table method,20 in the unfertilized control group and 20 in the unfertilized DMBA group.Eighty 36-week-old female SD rats were randomly divided into fertile and non-lactating control group,fertile and non-lactating DMBA group,fertile and lactating control group,and fertile and lactating DMBA group with 20 rats each.The sterile DMBA group,fertile non-lactating DMBA group and fertile lactating DMBA group were given 10 mg/100 g DMBA by gavage (the interval between the two doses was 2 weeks).Non-fertility control group,childbearing non-lactation control group and childbearing and lactation control group were given the same dose of normal saline by gavage as parallel control.After the administration of DMBA for 24 weeks,the experimental group and the corresponding control group were all sacrificed,and the mammary glands were dissected to observe,stained and counted with argyrophilic nucleolar organizer region (AgNOR),and the expressions of proliferating cell nuclear antigen (PCNA),Ki-67,human epidermal growth factor receptor (C-erb B-2),minichromosome maintenance proteins (MCM)2 in rat mammary epithelial cells were detected,and comparisons were made between the groups over the same period.Results The incidence and incubation period of DMBA group were lower than the DMBA group and DMBA group,and the differences were statistically significant (P＜0.05).The incidence and incubation period of DMBA group were lower than the DMBA group,and the differences were statistically significant (P＜0.05).There was no significant difference in tumor diameter among the three groups (P＞0.05).The AgNOR count of lactating DMBA group and non lactating DMBA group was lower than the non lactating DMBA group,the difference was statistically significant (P＜0.05).The positive expression rates of C-erb-2,PCNA,Ki-67 and MCM2 in the lactating DMBA group were lower than the non lactating DMBA group and the non lactating DMBA group,and the differences were statistically significant (P＜0.05).Conclusion Fertility and lactation can effectively reduce the probability of dimethylbenzthracene-induced breast cancer in female SD rats.

Objective The medical record diagnostic texts of obstetrics are essentially important for scientific research but are difficult to extract.This paper presents a combinatorial algorithm to automatically extract standard diagnostic terms from the diagnostic texts and can be applied in different hospitals' obstetrics.Methods A combined algorithm was proposed as method.First,the MC-BERT model was trained based on the labeled corpus,and the trained model was used to standardize the terms.Then,the Louvain algorithm was used to classify redundant terms and automatically output scientific research diagnostic terms.Result The term normalization of the combined algorithm achieved an F1 of 0.923 5 on the test set,and could automatically cluster 1 107 standard diagnostic terms into 106 scientific research diagnostic terms.The combined algorithm was also validated on the validation set of another hospital,and the F1 of the term normalization algorithm reached 0.909 4.Conclusion This method can efficiently obtain scientific research diagnostic terms in batches from the diagnostic texts of medical records,and the trained model can be applied in many hospitals'obstetrics.

Ankle sprain is one of the most common sports injury in clinic.The treatment of acute sprain is very important.If it is not handled properly,it is easy to leave chronic pain,ankle instability and habitual sprain.In clinical treatment,traditional Chinese medicine has summarized the treatment principle of"emphasizing both muscles and bones,and treating both internal and external diseases",established a dialectical approach of"promoting blood circulation and resolving stasis,promoting qi circulation and unblocking collaterals",including "manipulation,fixation,medicine,acupuncture and moxibustion,practice",etc.Western medicine follows the"RICE"principle,which is the standard strategy for the treatment of acute ankle sprain (AAS)advocated by the American Academy of Orthopaedic Surgeons (AAOS),including "rest,ice,compression and elevation".The treatment methods are rich and diverse,but lack systematicity.This article reviews the traditional Chinese and western medicine treatment plans for acute ankle sprain,and explores the cutting-edge knowledge of the multidisciplinary and multi means comprehensive treatment of AAS by combining Chinese and western medicine,providing valuable reference for clinical diagnosis,treatment and rehabilitation.

The experimental research on short stature is insufficient,and the standardized animal model has not been structured yet.At present,intrauterine growth retardation model is used instead.As a common method to establish intrauterine growth retardation model,smoking conditions are different.The experimental conditions of intrauterine growth retardation caused by smoking,such as the concentration of smoke,the volume of smoke box,the duration of smoking in pregnant rats,and the smoking cycle,lack of unified standards.In order to establish a simple,economical and repeatable short stature animal model,we searched Chinese BioMedical Literature Database（CBM）,CNKI,Vip,Wanfang data and PubMed database to prepare the literature of intrauterine growth retardation by smoking,sorted out the data,summarized the establishment method of intrauterine growth retardation model in rats caused by smoking,collected data and briefly summarized and analyzed them.It is considered that the success rate of building intrauterine growth retardation by smoking is high,and some fetal rats are consistent with the diagnosis of short stature.At present,the proper size of the exposure box is 0.3-0.6 m3,and the concentration of CO,CO2 and total suspended particulates（TSPs）needs to be monitored.This article reviews the research progress in establishing intrauterine growth retardation animal models by smoking to simulate animal model of short stature.

Bipolar disorder is a serious chronic emotional disorder characterized by recurrent depression and(mild)mania.The quality of life of patients decreases,and the disability rate and mortality rate increase.The emotional,sleep,and neurocognitive symptoms of patients seriously affect the prognosis and social function of patients,and even affect the disease process of patients,speeding up disease recurrence.Research shows that these symptoms have a negative impact on the course of disease and quality of life of patients even if there is no serious episode of mood disorders.Many studies show that the cure rate of patients with bipolar disorder is still low despite the use of multiple drug interventions.The current evidence shows that patients with bipolar disorder usually adopt a sedentary lifestyle,and their normal activities are reduced.Compared with the general population,the amount of exercise of patients is reduced,and it is lower than the amount of exercise before the illness,Therefore,exercise may be a way to improve the symptoms,quality of life and social function of patients with bipolar disorder.This article will review the research progress of the effects of exercise on mood,sleep and neurocognitive symptoms of bipolar disorder.

Objective To investigate the effect of Bufei Huoxue Capsules combined with Umeclidinium Bromide and Vilanterol Trifenatate on stable chronic obstructive pulmonary disease (COPD).Methods Sixty patients with stable COPD admitted to the outpatient department of Jiangxi Chest Hospital from June 2021 to November 2022 were selected as the study objects,and were divided into control group (30 cases) and study group (30 cases) according to random number table method.The control group was treated with Umeclidinium Bromide and Vilanterol Trifenatate,while the study group was treated with Bufei Huoxue Capsules combined with Umeclidinium Bromide and Vilanterol Trifenatate.Lung function,exercise tolerance,quality of life and acute exacerbation of symptoms were compared between the two groups after continuous treatment for 3 months.Results Before treatment,there were no statistical significances in total lung volume(TLC),forced expiratory volume at 1 second(FEV1),forced vital capacity(FVC)and one-second rate(FEV1%)between two groups (P＞0.05).After treatment,the levels of FEV1,FVC and FEV1% in the study group were higher than those in the control group,and the level of TLC was lower than that in the control group,the differences were statistically significant(P＜0.05).Before treatment,there were no significant differences in 6-minute walking distance (6MWT),St.George's breathing questionnaire(SGRQ),COPD self-assessment questionnaire(CAT)between control group and study group(P＞0.05).After treatment,the 6MWT of the study group was longer than that of the control group,but the SGRQ score and CAT score were lower than those of the control group,the differences were statistically significant (P＜0.05).The acute aggravation times of cough,expectoration,chest tightness and asthma in the study group were less than those in the control group,and the differences were statistically significant (P＜0.05).Conclusion For stable COPD patients,the treatment of Bufei Huoxue Capsules combined with Umeclidinium Bromide and Vilanterol Trifenatate can significantly improve the symptoms of patients,reduce the number of acute exacerbations,improve lung function,quality of life,improve the exercise ability of patients,and can be widely used.

Objective To explore the effect of repetitive transcranial magnetic stimulation combined with Butylphthalide Soft Capsules in the treatment of Parkinson's disease with cognitive impairment.Methods A total of 100 patients with Parkinson's disease combined with cognitive dysfunction admitted to Liaoning Jinqiu Hospital from July 2019 to August 2022 were selected and divided into study group(50 cases)and control group(50 cases)according to random number table method.The control group was treated with Butylphthalide Soft Capsules,and the study group was treated with repetitive transcranial magnetic stimulation on the basis of the control group.The clinical efficacy of the two groups was compared.Results After treatment,the Montreal cognitive assessment (MoCA)and Brathel index (BI)scores of the study group were higher than those of the control group,and the National Institutes of Health stroke scales(NIHSS)and modified Rankin scale(MRS) scores were lower than those of the control group,with statistically significant differences (P＜0.05).Conclusion Repetitive transcranial magnetic stimulation combined with Butylphthalide Soft Capsules has a good effect on the early rehabilitation of patients with Parkinson's disease complicated with cognitive dysfunction,which can significantly promote the recovery of nervous system and cognitive function,and improve clinical symptoms and prognosis.It has good clinical application value.

Objective To investigate the clinical effect of Regorafenib combined with programmed cell death receptor 1(PD-1) in the treatment of recurrent and metastatic colorectal cancer.Methods A total of 50 patients with recurrent and metastatic colorectal cancer (patients with advanced colorectal cancer who had received ≥2 lines of systemic therapy)admitted to the Department of Oncology,Xinyu People's Hospital from January to June 2022 were selected as the research objects.According to the random number table method,they were divided into observation group(25 cases)and control group(25 cases).The control group was treated with Regorafenib,and the observation group was treated with Regorafenib combined with Camrelizumab.The efficacy,carcinoembryonic antigen (CEA),carbohydrate antigen 72-4 (CA72-4),carbohydrate antigen 19-9 (CA19-9),endothelial growth factors (vascular endothelial growth factor [VEGF],matrix metalloproteinase 9 [MMP-9],epidermal growth factor receptor [EGFR],human epidermal growth factor receptor-2[HER-2]),and adverse reactions were compared between the two groups.Results There was no significant difference in response rate (RR)and disease control rate (DCR)between the two groups (P＞0.05).Before intervention,there were no statistically significant differences in the levels of CEA,CA72-4 and CA19-9 between the two groups (P＞0.05).After intervention,the levels of CEA,CA72-4 and CA19-9 of the two groups were lower than those before intervention,and the levels of CEA,CA72-4 and CA19-9 of the observation group were lower than those of the control group,and the differences were statistically significant (P＜0.05).Before intervention,there were no statistically significant differences in the levels of VEGF,MMP-9,EGFR and HER-2 between the two groups(P＞0.05).After the intervention,the levels of VEGF,MMP-9,EGFR and HER-2 in the two groups were lower than those before the intervention,and the levels of VEGF,MMP-9,EGFR and HER-2 in the observation group were lower than those in the control group,and the differences were statistically significant (P ＜0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant (P＜0.05).Conclusion Regorafenib combined with PD-1 preparation is effective in the treatment of recurrent and metastatic colorectal cancer,which can improve the levels of CEA,CA72-4,CA19-9 and endothelial growth factor,and does not increase the incidence of adverse reactions.

Objective To explore the clinical effect of bedside ultrasound-guided bronchoalveolar lavage in the treatment of pneumonia complicated with atelectasis.Methods A total of 56 patients with pneumonia and atelectasis admitted to the Department of Critical Care Medicine of the People's Hospital of Jiangmen from September 2020 to September 2022 were selected.The patients were divided into control group and treatment group by random number table method,with 28 cases in each group.The control group was treated with routine treatment and bronchoalveolar lavage.The treatment group received routine treatment and bedside ultrasound-guided bronchoalveolar lavage.The changes of oxygen partial pressure (PaO2),carbon dioxide partial pressure (PaCO2),lung ultrasound score (LUS),white blood cell (WBC),procalcitonin (PCT),and mechanical ventilation time were compared between the two groups after treatment.Results Before treatment,there were no statistically significant differences in PaO2,PaCO2 and LUS score between the two groups(P＞0.05).After treatment,PaO2 of the two groups was higher than that before treatment,PaCO2 and LUS score were lower than those before treatment,and PaO2 of the treatment group was higher than that of the control group,LUS score was lower than that of the control group,the differences were statistically significant(P＜0.05).After treatment,there were no statistically significant differences in WBC and PCT between the two groups (P＞0.05).The time of mechanical ventilation in the treatment group was shorter than that in the control group,and the difference was statistically significant (P ＜0.05).Conclusion The application of bedside ultrasound-guided alveolar lavage in the treatment of pneumonia complicated with atelectasis can effectively improve the partial pressure of oxygen,promote the lung segment recruitment of atelectasis,and shorten the time of mechanical ventilation.

 Objective To investigate the clinical efficacy of Rabeprazole combined with Flupentixol and Melitracen in the treatment of chronic gastritis.Methods Sixty patients with chronic gastritis admitted to Zaozhuang Traditional Chinese Medicine Hospital from May 1,2019 to June 1,2022 were selected as the research objects,and they were divided into control group (30 cases)and study group (30 cases)according to random number table method.Moxapride was taken orally in both groups,on the basis of which Rabeprazole was added to control group,and Rabeprazole combined with Flupentixol and Melitracen was given to study group.Symptom score,comprehensive treatment effect,depression,anxiety,health status and sleep disorder were compared between the two groups.Results Symptom score of the study group after treatment was lower than that of the control group,and the difference was statistically significant (P＜0.05).The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P＜0.05).The score of anxiety and depression in the study group after treatment was lower than that in the control group,and the difference was statistically significant (P＜0.05).The health level of the study group after treatment was higher than that of the control group,and the difference was statistically significant (P＜0.05).The sleep disorder score of the study group was lower than that of the control group after treatment,and the difference was statistically significant (P＜0.05).Conclusion In patients with chronic gastritis,Rabeprazole combined with Flupentixol and Melitracen can significantly improve depression,anxiety and sleep disorders,relieve symptoms of chronic gastritis,and improve comprehensive treatment effect,health level and quality of life.

 Objective To explore the application effect of Sacubitril Valsartan in elderly patients with chronic heart failure(CHF).Methods A total of 83 elderly CHF patients admitted to the Department of General Practice and Geriatric of Shaodong People's Hospital from January 2021 to April 2022 were selected as the study subjects,and they were divided into Group A(41 cases)and Group B(42 cases)according to the random number table method.Patients in Group A were treated with Candesartan,while patients in Group B were treated with Sacubitril Valsartan.The total effective rate of treatment,ventricular remodeling indicators,N-terminal pro-brain-type natriuretic peptide (NT-proBNP) levels and incidence of adverse reactions were compared between the two groups of patients.Results The total effective rate of treatment in Group B was higher than that in Group A,the difference was statistically significant (P＜0.05).After treatment,the interventricular septal thickness(IVST)and left ventricular posterior wall thickness(LVPWT)of the two groups were lower than those before treatment,the left ventricular mass index(LVMI)was higher than that before treatment,the IVST and LVPWT of patients in Group B after treatment were lower than those in Group A,the LVMI was higher than that in Group A,the differences were statistically significant (P＜0.05).The levels of NT-proBNP in both groups of patients after treatment was lower than that before treatment,the NT-proBNP levels of patients in G roup B after treatment was lower than that in Group A,the differences were statistically significant (P＜0.05).The total incidence of adverse reactions in Group B patients was lower than that in Group A,the difference was statistically significant (P＜0.05).Conclusion The clinical effect of Sacubitril Valsartan in the treatment of elderly CHF is significant,which can effectively improve ventricular remodeling indicators in patients,reduce the occurrence of adverse reactions and have high safety.

 Objective To analyze the quality of life and related factors after transcatheter aortic valve replacement（TAVR）in patients with severe aortic valve stenosis (AS).Methods A total of 92 severe AS patients admitted to Fujian Provincial Hospital from January 2020 to January 2022 were selected as the study subjects,all patients were treated with TAVR surgery.The quality of life of patients before and after surgery were assessed using the Chinese questionnaire of quality of life in patients with cordiovascular disease(CQQC),based on the survey questionnaire results of general patient information,after surgery quality of life scores of different types of patients were analyzed and stepwise regression analysis was used to summarize the influencing factors of after surgery quality of life in severe AS patients with TAVR.Results The CQQC scores of patients at 3,6,and 12 months after surgery were higher than those before surgery,the differences were statistically significant (P＜0.05).The CQQC scores of the patients at 3,6,and 12 months after surgery were compared,pairwise comparison,the differences were statistically significant (P＜0.05).There were no statistically significant differences in CQQC scores between patients of different genders,body mass index and after surgery complications and non complications(P＞0.05).The CQQC scores of patients with different age,marital status,educational level,before surgery cardiac function grading,and before surgery Chalson's basic disease weighting index (WIC) score were compared,the differences were statistically significant (P＜0.05).The results of stepwise regression analysis showed that age,marital status and before surgery cardiac function grading were the influencing factors of after surgery quality of life in severe AS patients with TAVR(P ＜0.05).Conclusion The quality of life of patients with severe AS after TAVR surgery has significantly improved compared to before surgery,but with the prolongation of after surgery time,the quality of life of patients will also decrease.age,marital status and before surgery cardiac function grading are all factors that affect the quality of life in patients with severe AS after TAVR surgery.It is recommended to take active measures to improve the quality of life of patients after surgery.

 Objective To explore the effect of Ginkgo Biloba Leaves Extract assisted with Metoprolol in the treatment of coronary atherosclerotic heart disease (CHD) with unstable angina pectoris (UAP).Methods A total of 120 patients with CHD and UAP admitted to the Heze Traditional Chinese Medicine Hospital from January 2020 to January 2022 were selected as the research subjects,and they were divided into a control group and an observation group according to random number table method,with 60 patients in each group.The control group patients were treated with Metoprolol,while the observation group patients were treated with Ginkgo Biloba Leaves Extract in addition to the control group.The incidence of angina pectoris,cardiac function related indicators,laboratory related indicators,total effective rate of treatment and total incidence of adverse reactions were compared between the two groups of patients.Results Before treatment,there were no statistically significant differences in the incidence of angina pectoris,cardiac function related indicators,and laboratory related indicators between the two groups of patients (P ＞0.05).After treatment,the frequency of angina attacks,left ventricular end-systolic diameter (LVESD),left ventricular end-diastolic diameter (LVEDD),serum monocyte chemoattractant protein-1 (MCP-1),soluble intercellular adhesion molecule-1 (sICAM-1)and hypersensitive C-reactive protein (hs CRP) in both groups of patients were lower than those before treatment,the onset time was shorter than that before treatment,the left ventricular ejection fraction (LVEF) was higher than that before treatment,the differences were statistically significant (P＜0.05).The frequency of angina attacks,LVESD,LVEDD,MCP-1,sICAM-1 and hs CRP in the observation group were lower than those in the control group after treatment,the onset time was shorter than that of the control group,LVEF was higher than that of the control group,the differences were statistically significant (P＜0.05).The total effective rate of treatment in the observation group was higher than that in the control group,the difference was statistically significant (P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups of patients(P＞0.05).Conclusion The application of Metoprolol and Ginkgo Biloba Leaves Extract to treat CHD patients with UAP can improve their cardiac function,reduce the frequency of angina attacks,and have a good therapeutic effect,which is worthy of clinical promotion and application.

Objective To explore the effect of Bushen Jianpi Jiangzhuo Decoction combined with Recombinant Human Erythropoietin Injection on renal anemia in hemodialysis patients and its influence on erythropoietin reactivity.Methods A total of 50 maintenance hemodialysis and renal anemia patients admitted to Zhejiang Xiaoshan Hospital Blood Purification Center from May 2021 to September 2022 were selected as research objects.They were divided into control group (n=25) and observation group (n=25) according to the random number table method,the control group received a subcutaneous injection of Recombinant Human Erythropoietin Injection for 8 weeks,while the observation group was treated additionally with Bushen Jianpi Jiangzhuo Decoction on the basis of the treatment of control group.Then respectively compared the red blood cell count (RBC),hemoglobin (HGB)and hematocrit (HCT)of the two groups before treatment,after 4,6,8 weeks' treatment,as well as serum ferritin (SF),transferrin saturation (TSAT) and erythropoietin(EPO) of pre-treatment and after 8 weeks of treatment.Results Before treatment,there were no significant differences in EPO and SF between the two groups (P＞0.05).After 8 weeks of treatment,the EPO in the observation group was higher than that in the pre-treatment and control group,and the SF was lower than that before treatment,with statistically significant differences (P＜0.05).There were no statistically significant differences between and within groups in the comparison of TSAT between the two groups before and after treatment (P＞0.05).Overall analysis found that there were statistical significances in RBC,HCT and HGB in comparison between groups,comparison at timepoints and interaction (P＜0.05).RBC,HCT and HGB in the two groups after 4,6 and 8 weeks'treatment were higher than those before treatment,the RBC,HCT and HGB in the observation group after 6 and 8 weeks'treatment were higher than those at 4 weeks after treatment,the RBC,HCT and HGB in the observation group after 8 weeks'treatment were higher than those at 6 weeks after treatment,the differences were statistically significant(P＜0.05).Comparison between two groups found that RBC,HCT and HGB in the observation group were higher than those in the control group at 8 weeks after treatment,and the differences were statistically significant (P＜0.05).Conclusion For patients with renal anemia on maintenance hemodialysis,Bushen Jianpi Jiangzhuo Decoction combined with Recombinant Human Erythropoietin Injection can improve the level of EPO in the body,reduce the resistance of recombinant human erythropoietin,keep the utilization of stored iron,so as to better correct anemia.

Objective To explore the application effect of external application of Fushen Powder combined with high colon dialysis in chronic renal failure.Methods The clinical data of 60 patients with chronic renal failure diagnosed and treated in the Department of Nephrology,the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from January 2020 to May 2022 were retrospectively explored.The patients treated with high colon dialysis were set as the control group(30 cases),and the patients treated with Fushen Powder combined with high colon dialysis were set as the observation group(30 cases).The total effective rate and the levels of blood urea nitrogen(BUN),serum creatinine(Scr),uric acid(UA)of the two groups were compared.Results After treatment,the total effective rate of the observation group was higher than that of the control group,the difference was statistically significant (P ＜0.05).The levels of BUN,Scr and UA in the observation group were lower than those in the control group,the differences were statistically significant (P ＜0.05).Conclusion The clinical effect of external application of Fushen Powder combined with high colon dialysis is better than that of high colon dialysis.External application of Fushen Powder combined with high colon dialysis is an effective method for the treatment of chronic renal failure.

Objective To investigate the influencing factors of hyperuricemia in maintenance peritoneal dialysis patients.Methods The clinical data of 74 peritoneal dialysis patients from January 2015 to December 2018 were retrospectively selected from the Department of Nephrology,People's Hospital of the Ningxia Hui Autonomous Region,they were divided into 39 cases in the hyperuricemia group and 35 cases in the normal blood uric acid group according to the serum uric acid level.The laboratory and clinical data of the two groups were compared,and the influencing factors were analyzed by logistic regression.Results The incidence of diabetes in normal uric acid group was lower than that in hyperuricemia group,and the difference was statistically significant (P ＜0.05).There were no significant differences in age,gender,incidence of hypertension and incidence of coronary heart disease between the two groups(P＞0.05).The levels of plasma albumin(Alb),prealbumin (pAlb),blood urea nitrogen (BUN),serum creatinine (Scr),serum phosphorus (P),parathyroid hormone (iPTH)and triglyceride (TG)in the normal uric acid group were lower than those in the hyperuricemia group,and the differences were statistically significant (P＜0.05).The level of high density lipoprotein cholesterol (HDL-C)in the normal uric acid group was higher than that in the hyperuricemia group,and the difference was statistically significant(P＜0.05).There were no significant differences in the hemoglobin (Hb),total protein (TP),total bilirubin (TBil),alkaline phosphatase (ALP),β2-microglobulin (β2-MG),calcium (Ca),high-sensitivity C-reactive protein (hs-CRP),vitamin D (VD),erythrocyte sedimentation rate(ESR),blood cholesterol(TC),low density lipoprotein cholesterol (LDL-C) between the two groups (P＞0.05).The result of multifactorial logistic regression analysis showed that TG(OR=3.650,95%CI:1.072-12.431,P＜0.05)was an independent risk factor for hyperuricemia in peritoneal dialysis patients.HDL-C(OR=0.066,95%CI:0.005-0.878,P＜0.05)was a protective factor for hyperuricemia in peritoneal dialysis patients(P＜0.05).Conclusion The incidence of hyperuricemia in peritoneal dialysis patients is high.TG is an independent risk factor for the development of hyperuricemia in peritoneal dialysis patients,and HDL-C is a protective factor for the development of hyperuricemia in peritoneal dialysis patients.Therefore,the management of serum uric acid in peritoneal dialysis patients should be given high priority.

Objective To investigate the factors that affect all-cause mortality in maintenance hemodialysis(MHD)patients.Methods A total of 83 MHD patients admitted to the Department of Blood Purification in Fujian Provincial Hospital from January 2020 to June 2022 were selected as the study objects.According to the survival status of the patients,they were divided into a survival group (62 cases)and a death group (21 cases).The basic data,blood routine,biochemical and other indicators of the two groups were compared to analyze the influencing factors of all-cause death in MHD patients.Results The age,white blood cell count,neutrophil count,red blood cell distribution width (RDW),platelet distribution width,neutrophil-to-lymphocyte ratio(NLR),alkaline phosphatase and blood calcium in the death group of MHD patients were all higher than those in the survival group,and the dialysis time was longer than that in the survival group,lymphocyte count,hematocrit,hemoglobin,albumin,high-density lipoprotein and creatinine were all lower than those in survival group,with statistical significances (P＜0.05).Multivariate logistic regression analysis showed that NLR (OR=1.486,95%CI=1.049-2.107,P=0.026),RDW (OR=2.231,95%CI=1.055-4.716,P=0.036),white blood cell count (OR=1.767,95%CI=1.082-2.887,P=0.023),dialysis time (OR=1.023,95%CI=1.004-1.041,P=0.017) were independent risk factors for all-cause death in MHD patients,albumin (OR=0.76,95%CI=0.623-0.928,P=0.007)was a protective factor for all-cause death in MHD patients.Conclusion NLR,RDW,white blood cell count and duration of dialysis are risk factors for all-cause mortality in patients with MHD,and albumin is a protective factor against all-cause mortality in patients with MHD.

Objective To analyze the relationship between cognitive dysfunction and glomerular filtration rate(eGFR)in elderly patients with type 2 diabetic nephropathy (T2DN) through a cross-sectional study.Methods One hundred and eighty-six elderly patients with type 2 diabetes mellitus (T2DM)admitted to the Department of Endocrinology of the Second People's Hospital of Nantong City from January 2018 to December 2021 were selected for the study,and were divided into 81 cases in the control group(eGFR≥60 ml/[min·1.73 m2])and 105 cases in the T2DN group(eGFR＜60 ml/[min·1.73 m2])according to eGFR values,and the patients were collected general information (including age,gender,duration of diabetes,blood pressure,years of education,creatinine,glycated haemoglobin,triglycerides,high-density cholesterol and low-density cholesterol)was collected,together with the Montreal cognitive assessment(MoCA)scale and the repeatable battery of mental status (RBANS),to compare whether there were differences in cognitive function between the two groups.Results The course of diabetes in T2DN group was longer than that in control group,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin,creatinine and eGFR were higher than those in control group,and the incidence of mild cognitive impairment(MCI)was higher than that in control group,with statistical significances (P ＜0.05).There were no significant differences in age,sex,years of education,MoCA score,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol between the two groups(P＞0.05).eGFR level in T2DN patients was positively correlated with immediate memory score,visual span score,attention score,delayed memory score and RBANS total score(P＜0.05),but not significantly correlated with speech function score(P＞0.05).After controlling for covariates with partial correlation coefficient,eGFR level in T2DN patients was the influencing factor for RBANS total score and immediate memory score,visual span score,attention score,and delayed memory score.Conclusion Patients with T2DN are at higher risk of cognitive impairment,and their eGFR levels may affect cognitive function.

 Objective To analyze the clinical effect of vitamin B12 injection at Zusanli acupoint in the treatment of diabetic peripheral neuropathy.Methods A total of 60 patients with diabetic peripheral neuropathy admitted to Leping Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected.They were divided into the control group and the observation group by random number table methods,with 30 cases in each group.The control group received regular monitoring,diet and exercise intervention on the basis of drug control of blood glucose,while the observation group was given vitamin B12 injection at Zusanli acupoint on the basis of conventional treatment intervention.The changes of blood glucose level,treatment effective rate and adverse reactions before and after treatment were compared between the two groups,and statistical analysis was conducted.Results The levels of fasting blood glucose (FPG)and blood glucose 2-hour postprandial glucose (2 h PG)in the two groups after treatment were lower than before treatment,and the levels of FPG and 2 h PG in the observation group after treatment were lower than those in the control group,with statistical significance (P＜0.05).The traditional Chinese Medicine syndrome score of the two groups after treatment was lower than that before treatment,and the traditional Chinese Medicine syndrome score of the observation group after treatment was lower than that of the control group,with statistical significance (P＜0.05).The motor conduction velocity and sensory conduction velocity of common peroneal nerve,plantar nerve and tibial nerve in the two groups after treatment were higher than those before treatment,and the motor conduction velocity and sensory conduction velocity of common peroneal nerve,plantar nerve and tibial nerve in the observation group after treatment were higher than those in the control group,with statistical significance(P＜0.05).The effective rate of the observation group was significantly higher than that of the control group,with statistical significance (P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion Zusanli acupoint injection of vitamin B12 in the treatment of diabetic peripheral neuropathy has reliable clinical effect,which is helpful to control the blood sugar level of patients,reduce the traditional Chinese Medicine symptom score,improve the motor nerve and sensory nerve conduction velocity,and improve the clinical therapeutic effect.The treatment method is simple,safe,and worthy of clinical promotion and application.

 Objective To explore the effect of chronic disease health care model in elderly patients with diabetes mellitus(DM).Methods From January 2020 to January 2021,150 elderly patients with DM who were admitted to Zhongshan Hospital,Xiamen University were selected as the research objects.They were divided into control group (75 cases) and observation group (75 cases) by random number table method.The control group was under routine management,and the observation group was under the management of chronic disease health care model,with continuous intervention for 1 year.The awareness rate of DM related knowledge and glucose metabolism indexes were compared between the two groups.Results Before intervention,there was no significant difference in the awareness rate of DM related knowledge between the two groups (P＞0.05).After intervention,the awareness rate of DM related knowledge in the observation group was higher than that in the control group,the difference was statistically significant (P ＜0.05).Before intervention,there were no significant differences in fasting plasma glucose(FPG)and 2 h postprandial blood glucose(2 h PG)between the two groups(P＞0.05).After intervention,FPG and 2 h PG in the observation group were lower than those in the control group,the differences were statistically significant (P＜0.05).Conclusion Through the management of chronic disease health care model,elderly DM patients can effectively improve their awareness of disease related knowledge,improve glucose metabolism,and have high clinical application value.

Objective To investigate the clinical situation and risk factors of hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease.Methods The general clinical data and laboratory test results of patients with Graves disease initially diagnosed in Affiliated Hospital of Qingdao University from January 2017 to January 2022 were collected,including gender,age,course of Graves disease,smoking history,drinking history,family history,past disease history,thyroid function and antibody levels,and liver function were used,the risk factors of hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease was compared.Data analysis was performed using independent samples t test,chi-square test,and multivariate Logistic regression analysis.Results A total of 261 patients were collected,included 66 males and 195 females,with an average age of(38.63±12.68)years.The incidence of hyperthyroidism-induced liver injury in newly diagnosed Graves disease patients was 45.59%,and the most common abnormal liver function was elevated alanine aminotransferase(ALT),which accounted for 29.89%.According to whether the patients had hyperthyroidism liver injury or not,there were 142 cases in the normal liver function group and 119 cases in the abnormal liver function group.Univariate analysis showed that the age,female proportion,new atrial fibrillation rate,free triiodothyronine 3 (FT3),free tyroxine 4(FT4),thyroid peroxidase antibody(TPOAb),thyrotropin receptor antibody(TRAb)levels in the abnormal liver function group were higher than those in the normal liver function group,and the differences were statistically significant(P＜0.05).There were no significant differences in the course of Graves' disease,smoking history,drinking history,family history,diabetes history,the levels of thyroid stimulating hormone(TSH)and thyroglobulin antibody(TGAb)between the two groups (P＞0.05).The Logistic regression model showed that the results of multivariate analysis showed that age(β=0.039,OR=1.040,95% CI: 1.016-1.065),FT4(β=0.019,OR=1.019,95% CI: 1.019-1.003),TPOAb(β=0.006,OR=1.006,95%CI:1.004-1.009),TRAb (β=0.030,OR=1.031,95%CI:1.001-1.061)were an independent risk factor for hyperthyroidism-induced liver injury in patients with newly diagnosed Graves disease.Conclusion Among the newly diagnosed patients with Graves disease,those with older age and higher levels of FT4,TPOAb and TRAb are more likely to develop hyperthyroidism-induced liver injury.

Objective To evaluate the clinical efficacy and adverse reactions of gonadotropin-releasing hormone agonist(GnRH-a)combined with Levonorgestrel Intrauterine Sustained-release System(LNG-IUS)in the treatment of adenomyosis.Methods A total of 80 patients with adenomyosis admitted to Dezhou Maternal and Child Health Hospital from October 2019 to October 2021 were selected as research objects,and they were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with LNG-IUS.Observation group was treated with GnRH-a and LNG-IUS.Uterine volume,hemoglobin level,carbohydrate antigen 125(CA125)level,visual analogue scale(VAS)score and adverse reactions were compared between the two groups.Results The uterine volume of the observation group after treatment was smaller than that of the control group,and the hemoglobin level,VAS score and CA125 level were lower than that of the control group,with statistical significances(P＜0.05).There were no significant differences in the incidence of weight gain,mood depression,sleep disorders and IUD downshift/detachment between two groups (P＞0.05).The incidence of hot flashes,sweating and vaginal dryness in the observation group was higher than that in the control group,and the incidence of irregular vaginal bleeding was lower than that in the control group,the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions between two groups (P＞0.05).Conclusion GnRH-a combined with LNG-IUS has a good therapeutic effect on adenomyosis and has high clinical application value.The adverse reactions of the combined use of GnRh-A and LNG-IUS are mainly related to menopause symptoms.

Objective To explore the effect of Shenqu Xiaoshi Oral Liquid combined with acupoint application and massage on children with functional constipation.Methods A total of 70 children with functional constipation who were treated in Ganzhou Maternal and Child Health Hospital from January 2020 to December 2021 were selected as research objects,and they were divided into control group and treatment group according to different treatment schemes,with 35 cases in each group.The control group were treated with acupoint application and massage,the treatment group were treated with traditional Chinese medicine acupoint application,massage and Shenqu Xiaoshi Oral Liquid.The recovery time of defecation and the total treatment time,adverse reactions,level of gastrointestinal hormones and inflammatory reaction related indicators before and after treatment,and the total effective rate of disease control were compared between the two groups.Results The recovery time and total treatment time for bowel movements in the treatment group were shorter than those in the control group,with statistically significant differences (P＜0.05).The total incidence of adverse reactions in the treatment group was lower than that in the control group,with statistically significant difference(P＜0.05).Before treatment,there were no significant differences in the levels of serum motilin,vasoactive intestinal peptide and growth hormone between the two groups(P＞0.05).After treatment,the serum motilin of the two groups was higher than that before treatment,and the serum motilin of the treatment group was higher than that of the control group,the levels of vasoactive intestinal peptide and growth hormone of the two groups were lower than those before treatment,and the levels of vasoactive intestinal peptide and growth hormone of the treatment group were lower than those of the control group,with statistically significant differences (P＜0.05).Before treatment,there were no significant differences in interleukin-6 (IL-6),white blood cell(WBC)and C-reactive protein(CRP)between the two groups(P＞0.05).After treatment,the levels of IL-6,WBC and CRP in the two groups were lower than those before treatment,and the levels of IL-6,WBC and CRP in treatment group were lower than those in the control group,with statistically significant differences (P＜0.05).The total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant (P ＜0.05).Conclusion The combination of acupoint application,massage and Shenqu Xiaoshi Oral Liquid can help improve the levels of gastrointestinal hormone and gastric function related indicators,control inflammatory reaction,shorten the time of disease control,reduce adverse drug reactions,and significantly improve the treatment effect of patients with functional constipation.

Objective To investigate the effect of body weight and body composition management on pregnancy outcomes in obese pregnant women.Methods A total of 161 obese pregnant women who visited Dalian Women and Children's Medical Group from January 2020 to October 2021 were selected as the research objects.According to the random number table method,they were divided into the experimental group(80 cases)and the control group(81 cases).The body weight gain and body composition before and after intervention,and pregnancy outcome were compared between the two groups.Results The weight gain,body fat percentage and fat mass of pregnant women in the experimental group after intervention were lower than those in the control group,and the differences were statistically significant (P＜0.05).The incidence of gestational diabetes mellitus,gestational hypertension,cesarean section,neonatal birth weight,macrosomia,postpartum hemorrhage,prolonged or stalled labor,premature rupture of membranes,and fetal distress in the experimental group were lower than those in the control group.The neonatal Apgar score of the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).Conclusion Combined intervention during pregnancy can improve the weight gain and body composition of obese pregnant women,reduce the incidence of pregnancy complications,and improve pregnancy outcomes.

Objective To observe the clinical effect of acupuncture on infertility of polycystic ovary syndrome (PCOS)with kidney deficiency and liver depression.Methods A total of 60 patients with PCOS infertility of kidney deficiency and liver depression from June 2020 to June 2022 were divided into control group (n=30)and observation group (n=30)by random number table method.The control group was given treatment with Letrozole to promote ovulation,and the observation group was given Letrozole combined with acupuncture therapy.The mean uterine artery pulse index (PI),resistance index (RI),endometrial thickness (ET),self-rating anxiety scale (SAS),self-rating depression scale (SDS)scores,ovulation rate and pregnancy rate of the two groups were compared before and after treatment,and the clinical efficacy was evaluated.Results There were no significant differences in PI,RI,ET,SAS and SDS between the two groups before treatment (P＞0.05).The ET of the observation group after treatment was higher than that of the control group,while the PI,RI,SAS and SDS scores of the observation group were lower than those of the control group,and the differences were statistically significant (P＜0.05).The ovulation rate,pregnancy rate and total effective rate of the observation group were higher than those of the control group after treatment,and the differences were statistically significant (P ＜0.05).Conclusion Acupuncture combined with letrozole in the treatment of the patients with PCOS infertility can effectively improve clinical symptoms,increase the ovulation rate and pregnancy rate.

Objective To explore the clinical effect of maxillary protraction combined with maxillary labial block in the treatment of maxillary hypoplasia.Methods A total of 60 children with maxillary hypoplasia admitted to Ganzhou Women and Children's Health Care Hospital from March 2021 to May 2022 were selected as the research objects,they were divided into study group and control group by random number table method,with 30 cases in each group.The control group was treated with simple maxillary protraction,the study group was treated with maxillary protraction combined with maxillary labial block.The included angle of sella-nasion-subspinale (SNA),the included angle of subspinale-nasion-supramental(ANB),the distance between the anterior nasal spine and the menton(ANS-Me),the angle between the long axis of the upper central incisor and the SN plane(U1-SN),the included angle of sella-nasion-supramentale(SNB),the the anterior,superior and posterior space of temporomandibular joint and the depth of joint fossa were compared between the two groups before and after treatment.Results The SNA,ANB and U1-SN of the two groups after treatment were greater than those before treatment,the SNA and ANB of the study group after treatment were greater than those of the control group,the differences were statistically significant(P＜0.05).The anterior joint space after treatment in both groups were higher than those before treatment,while the superior articular space and posterior space were lower than those before treatment,the differences were statistically significant (P＜0.05).There were no significant differences in anterior,superior and posterior joint space and fossa depth between the two groups before and after treatment (P＞0.05).Conclusion Maxillary protraction combined with maxillary labial block can stimulate maxillary development and improve the therapeutic effect.

Objective To evaluate the effect of lacrimal duct lithiasis curettage combined with Gatifloxacin Eye Gel injection in the treatment of canaliculitis.Methods A total of 60 patients(60 eyes)with canaliculitis treated in Jiujiang First People's Hospital from January 2021 to June 2022 were selected and divided into group A and group B according to random number table method,with 30 cases (30 eyes) in each group.Group A was treated with lacrimal duct lithiasis curettage+0.9% Sodium Chloride Injection rinse,group B was treated with lacrimal duct lithiasis curettage+0.9% Sodium Chloride Injection rinse+Gatifloxacin Eye Gel injection,and the patients were followed up for 3 months.The curative effect was compared between the two groups and the complications were observed.Results The total effective rate was 80%in group A and 100% in group B,the clinical treatment effect and recurrence rate of group B were better than group A,and the differences were statistically significant (P＜0.05),and there were no adverse complications during follow-up.Conclusion The effect of lacrimal duct lithiasis curettage combined with Gatifloxacin Eye Gel injection in the treatment of canaliculitis is accurate,without adverse complications,lower relapse rates,it is worthy of clinical promotion.

Objective To investigate the effects of pulp revascularization with platelet-rich fibrin(PRF)and apexification in the treatment of immature permanent teeth with pulp necrosis.Methods A total of 80 children with pulp necrosis of immature permanent teeth who were admitted to the Department of Stomatology,Pingxiang People's Hospital from January 2019 to June 2021 were selected as the research subjects.According to random number table method,the subjects were divided into induction group(n=40,40 affected teeth)and reconstruction group(n=40,40 affected teeth).Children in the induction group were treated with apexification,while children in the reconstruction group were treated with pulp revascularization with PRF.Compare the root length,root area and root canal wall thickness of the two groups before treatment,6 months after treatment and 12 months after treatment,as well as the satisfaction score and curative effect of the children's family members.Results After 6 months of treatment and 12 months of treatment,the root length of children in the reconstruction group and the induction group was longer than that before treatment,the root area was larger than that before treatment,and the thickness of root canal wall was higher than that before treatment,the differences were statistically significant (P＜0.05).After 6 months of treatment and 12 months of treatment,the root length of the reconstruction group was longer than that of the induction group,the root area was larger than that of the induction group,and the root canal wall thickness was higher than that of the induction group,and the differences were statistically significant (P＜0.05).The satisfaction scores of the family members of the children in the reconstruction group on the degree of occlusion,masticatory function,color and overall beauty were higher than those of the family members in the induction group,and the differences were statistically significant(P＜0.05).The total effective rate of the reconstruction group was higher than that of the induction group,and the difference was statistically significant (P＜0.05).Conclusion Compared with apexification,pulp revascularization with PRF is more effective in treating immature permanent teeth pulp necrosis.The latter is beneficial to promote teeth development and improve the satisfaction of children's families.

 Objective To explore the effect of Yuping Fengsan Granules combined with Montelukast Sodium and Mometasone Furoate Nasal Spray in treating adenoid hypertrophy.Methods Eighty children with adenoid hypertrophy who were treated in Department of Otolaryngology of Boai Hospital of Zhongshan,Guangdong Province from July 2020 to September 2021 were selected as the study subjects,and were divided into treatment group(40 cases)and control group(40 cases) by the random number table method.The treatment group was given Yuping Fengsan Granules combined with Montelkast Sodium and Mometasone Furoate Nasal Spray,while the control group was given Montelkast Sodium and Mometasone Furoate Nasal Spray.The relief time of each clinical symptom,sleep quality,the ratio of adenoid thickness to nasopharyngeal maximum anteroposterial diameter(A/N),improvement status of interleukin-2 (IL-2),interleukin-6 (IL-6)and incidence rate of adverse reactions were compared between the two groups before treatment and after 3 months of treatment.Results After 3 months of treatment,the clinical symptoms of the two groups were effectively relieved,and the time needed for each symptom relief in treatment group was shorter than that in control group,and the children's sleep habits questionnaire score,A/N value and serum IL-2 and IL-6 levels indicators in treatment group were lower than those in control group,the differences were statistically significant (P ＜0.05).There was no statistically difference in the total incidence rate of adverse reactions between the two groups(P＞0.05).Conclusion Yuping Fengsan Granules combined with Montelukast Sodium and Mometasone Furoate Nasal Spray in the treatment of adenoid hypertrophy in children can effectively promote the reliefs of clinical symptoms,improve the adenoid hypertrophy and enhance the sleep quality,and its anti-inflammatory effect is better than that of montelukast sodium and mometasone furoate nasal spray.The regimen has good safety and is available in clinical promotion and application.

Objective To investigate and analyze the medical ethics education and students' cognition of medical ethics in three medical colleges in Shandong Province so as to provide reference for medical colleges to carry out medical ethics education,cultivate medical students'medical ethics and promote the harmonious development of doctor-patient relationship.Methods From May to September 2022,62 senior students of clinical medicine major in Qingdao University,123 senior students of Traditional Chinese Medicine major in Shandong University of Traditional Chinese Medicine,and 105 sophomore students of clinical medicine major in Heze Medical College were randomly selected to conduct questionnaire survey.Results For medical humanities courses,Medical Ethics offered the most,followed by Doctor-Patient Communication Skills,followed by Medical History and Ancient Literature of Medicine,and most of these courses were included in the compulsory courses for medical students.In addition to the curriculum,the schools also enriched the medical ethics education through the introduction of specialized courses,the holding of voluntary services or free medical treatment activities,the regular publicity of the advanced deeds of outstanding doctors and the construction of campus culture.Most students thought that medical ethics education had great impact on their professional values,they could choose to study medicine from the perspective of saving the dying and healing the wounded,and loved the medical career.The students had a correct understanding of the current doctor-patient relationship and their satisfaction degree of medical ethics education was 88.19%.However,it was also common for medical students to study the specific classical knowledge of medical ethics without depth and fail to find the reasons for the contradictions between doctors and patients from their own perspective.Conclusion The development of medical ethics education in medical colleges and universities in Shandong Province is generally good,and the medical students'medical ethics level has been continuously improved,which is generally in line with the standards of professional ethics.In order to further strengthen medical ethics education,it is urgent for medical colleges to strengthen cooperation,create a number of core medical ethics courses,and jointly build a training system of medical ethics education.

Objective To investigate the current condition of occupational burnout and stress among psychiatric clinical nurses.Methods A total of 101 nurses working in the psychiatric departments of 3 Shanghai Psychiatric hospitals (Qingpu District Mental Health Center,Minhang Hospital District of Shanghai Mental Health Center,and Shanghai Civil Affairs First Mental Health Center)from June to December 2021 were selected as the observation group.A total of 100 nurses working in 3 general hospitals (Qingpu Branch of Zhongshan Hospital,Zhujiajiao People's Hospital,Hongqiao Hospital District of Huashan Hospital Affiliated to Fudan University) were selected as the control group.General situation questionnaire,Chinese nurses job stressor scale,Maslach burnout scale,generalized anxiety disorder-7 (GAD-7),and patient health questionnaire-9 (PHQ-9)were used to investigate the two groups of nurses.Results The scores of nurses in the observation group were lower than those in the control group on emotional exhaustion and depersonalization,and the differences were statistically significant(P＜0.05).There was no significant difference in the score of low achievement between the two groups(P ＞0.05).The score of nurses in the observation group was higher than that in the control group in term of working environment and resources,and the difference was statistically significant(P＜0.05).There were no significant differences in the scores of workload and time allocation,nursing specialty and work,patient care,management and interpersonal relationship between the two groups (P＞0.05).Occupational stress was correlated with all dimensions of job burnout (P＜0.05).There was no significant difference in GAD-7 scores between the two groups (P＞0.05).The PHQ-9 score of nurses in the observation group was lower than that in the control group,and the difference was statistically significant (P＜0.05).Anxiety and depression were found in more than half of the nurses in both groups.Conclusion Psychiatric nurses have significant occupational burnout and stress.The administration of hospital should take active intervention to promote their physical and mental health.

Objective To explore the effect of PDCA circulation management combined with detailed management on the quality of nursing care of patients undergoing knee arthroscopic surgery.Methods A total of 60 patients with knee arthroscopic surgery admitted to Jiujiang University Affiliated Hospital from January to December 2021 were selected as the study subjects.They were divided into the control group (30 cases)and the observation group (30 cases)according to the random number method.The control group adopted the detailed management method,the observation group adopted the PDCA circulation management combined with the detailed management method.The knee function score,pain and anxiety score,complication rate and nursing quality score of the two groups were compared.Results After nursing,the score of knee function in the observation group was higher than that in the control group,the score of pain and anxiety was lower than that in the control group,the total incidence of complications was lower than that in the control group,and the score of nursing quality was higher than that in the control group,the differences were statistically significant (P＜0.05).Conclusion PDCA circulation management combined with detailed management can improve the knee function of patients,improve their physical and mental comfort,reduce the incidence of complications,and then significantly improve the quality of surgical care,which is worthy of application.

Objective To explore the effect of staged rehabilitation nursing intervention model on improving the joint function of femoral shaft fracture.Methods The clinical data of 76 children with femoral shaft fracture admitted to the Department of Orthopedics,Jiangxi Provincial Children's Hospital from July 2020 to June 2021 were retrospectively analyzed.According to different nursing methods,they were divided into control group (33 cases)and observation group(43 cases).Patients in the control group received routine nursing,while patients in the observation group received routine nursing combined with staged rehabilitation nursing.The joint function and mental state of children before and after the intervention and the exercise compliance after the intervention were compared between the two groups.Results The bone healing time and clinical healing time of the observation group were shorter than those of the control group,and the differences were statistically significant (P＜0.05).There was no statistically significant difference in the active flexion activity between the two groups before intervention(P＞0.05).After intervention,the active flexion activity of the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).After intervention,the total compliance rate of exercise and the scores of quality of life (mental state,stomach absorption,limb pain and sleep)of the observation group were higher than those of the control group,and the differences were statistically significant (P＜0.05).The total incidence of fracture complications in the observation group was lower than that in the control group,and the nursing satisfaction scores (communication style,nursing technology,admission education,medication guidance of the parents of the children were higher than those of the control group,and the differences were statistically significant (P＜0.05).Conclusion The implementation effect of staged rehabilitation nursing intervention in children with femoral shaft fracture is significant,which can significantly improve the joint function of children.

 Objective To observe the nursing effect of intestinal creep adhesive on improving gastrointestinal function in patients with long-term bed rest in orthopedics department.Methods From January 2022 to October 2022,80 patients who needed to stay in bed in the Department of Orthopedics,the First Affiliated Hospital of Nanchang University were selected as the research objects.They were divided into the glue patch group and the routine group by random number table method,with 40 cases in each group.The glue patch group was treated with medical glue patch nursing,and the routine group was given routine nursing.The recovery time of gastrointestinal function,occurrence of adverse symptoms,nursing satisfaction and quality of life scores of the two groups were recorded.Results The first defecation time and defecation interval time of the glue patch group were shorter than those of the conventional group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the total incidence of adverse symptoms between the two groups(P＞0.05).The scores of nursing satisfaction and generic quality of life inventory-74 (GQOL-74) in the adhesive patch group were higher than those in the conventional group,and the scores of self-rating anxiety scale (SAS) and self-rating depression scale(SDS)in the adhesive patch group were lower than those in the conventional group,and the differences were statistically significant (P ＜0.05).Conclusion Intestinal creep medical adhesive can shorten the recovery time of gastrointestinal function in long-term bedridden patients in orthopedics department,reduce the incidence of adverse symptoms,improve patients'nursing satisfaction and quality of life,and improve their psychological status.

Objective To explore the effect of continuous nursing based on health belief in endocrine therapy of thyroid cancer patients after operation.Methods A total of 100 patients with thyroid cancer admitted to Pingxiang People's Hospital from January 2020 to May 2022 were selected as the study subjects.They were divided into the control group(50 cases)and the study group (50 cases) according to the method of random number table.The control group used conventional nursing methods,and the study group used continuous nursing methods based on health beliefs.The thyroid stimulating hormone(TSH)level,health belief questionnaire(HBQ)score,Morisk drug compliance questionnaire(MMAS-8)score and quality of life scale (EORTC QLQ-30)score of the two groups were compared.Results The compliance rate of TSH level in the study group was higher than that in the control group 1,3 and 6 months after intervention,and the differences were statistically significant (P＜0.05).HBQ scores at 1,3 and 6 months after intervention were lower in both groups than those before intervention,the differences were statistically significant (P＜0.05).The HBQ score of the study group was lower than that of the control group at 1,3 and 6 months after intervention,and the differences were statistically significant (P＜0.05).MMAS-8 scores in two groups at 1,3 and 6 months after intervention were higher than those before intervention,and the differences were statistically significant(P＜0.05).The MMAS-8 score of the study group was higher than that of the control group at 1,3 and 6 months after intervention,and the differences were statistically significant(P＜0.05).Before intervention,there were no significant differences in cognitive,emotional,role,social and physical scores between the two groups (P＞0.05).After intervention,the cognitive,emotional,role,social and physical scores of the two groups were higher than those before intervention,and the cognitive,emotional,role,social and physical scores of the study group were higher than those of the control group,the differences were statistically significant (P＜0.05).Conclusion The application of continuous nursing strategy based on health belief in the endocrine therapy of thyroid cancer patients after surgery can improve the rate of reaching the standard of TSH level,improve health belief and compliance with medication,and improve the quality of life.

Objective To explore the effect of continuous nursing with Omaha system in discharged elderly patients with stroke.Methods A total of 72 elderly patients with stroke admitted to First People's Hospital of Fuzhou from January 2021 to June 2022 were selected as research objects,they were divided into two groups according to random number table method,with 36 patients in each group.The control group was given routine nursing,and the observation group was given continuous nursing intervention with Omaha system.Both groups were given continuous nursing for 6 months.The self-management ability,limb function,neurological function,daily living ability,quality of life and nursing satisfaction of the two groups were compared.Results The score of self-management ability in the observation group after nursing was higher than that in the control group,the difference was statistically significant (P＜0.05).After nursing,the Fugl-Meyer assessment scale(FMA)scores of upper limb function and lower limb function in the observation group were higher than those in the control group,with statistically significant differences(P＜0.05).After nursing,the National Institute of Health stroke scale(NIHSS)score of the observation group was lower than that of the control group,while the Barthel index (BI)score was higher than that of the control group,with statistically significant differences (P ＜0.05).After nursing,the scores of the World Health Organization on quality of life brief scale (WHOQOL-BREF)in the observation group were higher than those in the control group,the differences were statistically significant (P＜0.05).The nursing satisfaction of the observation group was 97.22%(35/36),higher than 83.33% (30/36) of the control group,with statistically significant difference (P＜0.05).Conclusion Continuous nursing intervention with Omaha system can improve the self-management ability of elderly patients with stroke,promote the improvement of quality of life,and thus enhance the satisfaction of patients.

 Objective To analyze the application effect of family-centered tender childbirth management model in delivery of primiparae.Methods A total of 150 primiparae admitted to Quanzhou Maternal and Child Health Hospital·Children's Hospital from February 2020 to May 2022 were selected as research objects,they were divided into the control group(n=75)and the observation group(n=75)according to the random number table method.The control group received routine nursing,and the observation group received family-centered tender childbirth management model on this basis.The total stage of labor,2 h postpartum bleeding volume,pain degree,psychological status and the general self efficacy scale (GSES)scores were compared between the groups.Results The total stage of labor in the observation group was shorter than that in the control group,and 2 h postpartum bleeding volume was smaller than that of the control group,the differences were statistically significant (P＜0.05).The visual analogue scale (VAS)score of the observation group in the first and second stages of labor was lower than that of the control group,the difference was statistically significant (P＜0.05).There were no statistically significant differences in the self-rating anxiety scale (SAS)score and self-rating depression scale (SDS)score between the groups before nursing (P＞0.05).After nursing,the SAS scores and SDS scores of the two groups were lower than those before nursing,and the scores of observation group were lower than those of the control group,the differences were statistically significant(P＜0.05).There was no statistically significant difference in the GSES score between the groups before nursing (P＞0.05).After nursing,the GSES score of the two groups was higher than those before nursing,and the score of observation group was higher than that of the control group,the difference was statistically significant (P＜0.05).Conclusion Family-centered tender childbirth management model is effective for primiparae.It can relieve pain,reduce postpartum bleeding,and improve their psychological status and self-efficacy.

Objective To investigate the application effect of continuous nursing mode in the treatment of adenomyosis with high-focus ultrasound.Methods A total of 100 patients with adenomyosis from June 2021 to June 2022 were selected as research objects.All patients received high-focus ultrasound ablation (HIFUA) and were divided into two groups with 50 cases in each group by random number table method.The control group received routine nursing,and the experimental group was combined with the "Internet +" continuous nursing mode.The psychological stress,quality of life,treatment compliance and satisfaction of the two groups were compared.Results The self-rating anxiety scale (SAS) and self-rating depression scale(SDS)scores of the observation group were lower than those of the control group at 6 months after discharge,and the differences were statistically significant (P＜0.05).The physical health,physical pain,general health,physical role function,energy,emotional role function,social function and mental health scores of the observation group were higher than those of the control group at 6 months after discharge,and the differences were statistically significant(P＜0.05).Six months after discharge,the compliance treatment,medication on time,regular review of compliance and service attitude,medical experience and recovery effect satisfaction in observation group were higher than those in the control group,the differences were statistically significant(P＜0.05).Conclusion Continuous nursing mode used in high-focus ultrasound ablation for the treatment of adenomyopathy patients,can reduce psychological stress response,improve the quality of life of patients,obtain higher treatment compliance and satisfaction,worthy of promotion and application.

Objective To explore the effects of Bobath concept guided rehabilitation nursing combined with multi-mode analgesia on postoperative knee function and pain score of patients with knee injury.Methods Sixty patients with knee injury admitted to the First Affiliated Hospital of Gannan Medical College from June 2020 to June 2021 were selected as the research objects.According to the random ball touch method,they were divided into observation group (n=30)and control group (n=30).The control group adopted conventional rehabilitation nursing,and the observation group adopted Bobath concept guided rehabilitation nursing combined with multi-mode analgesia intervention.The knee function,pain score,nursing satisfaction and complication were compared between the two groups.Results After intervention,the score of knee function scale of Hospital for Special Surgery (HSS) was higher than that before intervention,and the HSS knee function score of observation group was higher than that of control group,the differences were statistically significant (P＜0.05).Visual analogue scale (VAS) scores of two groups after intervention were lower than those before,and VAS score of observation group after intervention was lower than that of control group,the differences were statistically significant (P＜0.05).Nursing satisfaction in the observation group was higher than that in the control group,and the difference was statistically significant (P＜0.05).The total complication rate in the observation group was lower than that in the control group,and the difference was statistically significant (P＜0.05).Conclusion Bobath concept guided rehabilitation nursing combined with multi-mode analgesia applied in postoperative intervention of patients with knee joint injury can improve knee joint function,relieve pain,improve nursing satisfaction and reduce complication rate.

 Objective To explored the influence of incentive nursing on negative emotion and self-nursing ability of hemodialysis patients.Methods A total of 100 hemodialysis patients admitted to the Second Affiliated Hospital of Fujian Medical University from June 2021 to June 2022 were selected as the research objects,they were divided into the conventional group and the observation group by random number table method.The conventional group was given the traditional nursing mode,and the observation group was given the incentive nursing mode.The negative emotions,self-care ability and quality of life were compared between the two groups before and after nursing.Results There was no significant difference between the two groups in the score of negative emotion before nursed (P＞0.05).The scores of anxiety and depression in the observation group after nursed were lower than those in the conventional group,with statistically significances(P＜0.05).There was no statistical significance in the scores of self-care ability between the two groups before nursed (P＞0.05).While the scores of self-concept,health knowledge level,self-care skills and self-care responsibility in the observation group after nursed were higher than those in the conventional group,with statistical significances (P＜0.05).There was no statistical significance in the life quality score of the two groups before nursed (P＞0.05).The scores of physical function,general health,emotional function,mental health of the observation group after nursed were higher than those in the conventional group,with statistically significances (P＜0.05).Conclusion The application of incentive nursing in hemodialysis patients can improving their negative emotions,improving their self-care ability and quality of life.

Objective To explore the intervention effect of traditional Chinese medicine(TCM)cluster nursing based on day ward mode in patients with chronic atrophic gastritis(CAG).Methods A total of 76 patients with CAG who were admitted in Weihai Hospital of Traditional Chinese Medicine from June 2021 to April 2022 were selected as research objects,and they were divided into the intervention group (38 cases)and the control group (38 cases)by random number table method.The control group used routine nursing intervention,the intervention group used TCM cluster nursing based on day ward mode.The depression degree,quality of life and nursing satisfaction of the two groups were compared.Results The self-rating depression scale (SDS)scores of patients in the two groups after intervention were lower than those before intervention,and the SDS scores of patients after intervention in the intervention group were lower than those in the control group,there were statistically significant differences(P＜0.05).The scores of generic quality of life inventory-74(GQOL-74)after intervention in the two groups were higher than those before intervention,the scores of GQOL-74 after intervention in the intervention group were higher than those in the control group,there were statistically significant differences(P＜0.05).The total nursing satisfaction of patients in the intervention group was higher than that in the control group,and there was statistically significant difference (P＜0.05).Conclusion The application of TCM cluster nursing based on the day ward model in the intervention of CAG patients can improve the depression,and improve the quality of life and nursing satisfaction.