Objective To analyze the demographic data,clinical characteristics,clinical types and time trends of hospitalized patients with single-center aortic dissection in ten years.Methods The relevant data of 651 patients diagnosed with major arterial dissection in the General Hospital of Ningxia Medical University from January 2011 to December 2020 were retrospectively collected,including socio-demographic data,clinical symptoms,comorbidities,pathogenesis,family genetic history,treatment methods and hospitalization outcomes,etc.The influencing factors of death in Stanford type A and Stanford type B patients were analyzed.Results In the past 10 years,the number of hospitalized patients with aortic dissection showed A gradual upward trend,and Stanford type A patients accounted for 39.63%and Stanford type B patients accounted for 60.37%,with a male-to-female ratio of 3.62∶1 and an average age of (52.88±11.46)years.14.75%of the patients reported definite inducement,mainly physical activity and external impact,10.91%of the patients reported definite family genetic history.In terms of clinical symptoms,96.31%of the patients had obvious pain,among which the chest,back and abdomen were the highest (66.97%,62.83% and 32.26%).There was statistical significance in clinical outcomes of different types of aortic dissection patients in conservative treatment(P＜0.05).Multivariate logistic regression analysis showed that early emergency surgery was A protective factor for the prevention of death in Stanford Type A aortic dissection patients,and drinking was a risk factor for hospital death (P＜0.05).Control of systolic blood pressure within the appropriate range was a protective factor for in-hospital death in Stanford type B aortic dissection patients,and length of stay and conservative treatment were risk factors for in-hospital death (P＜0.05).Conclusion Early emergency surgery is A protective factor for preventing death in Stanford type A aortic dissection patients,and controlled contraction is a protective factor for in-hospital death in Stanford type B aortic dissection patients.Therefore,identifying the risk factors for death of aortic dissection can provide a reference for clinical diagnosis and treatment.

 

 

[Abstract] Objective On the basis of chitosan(CS)/hydroxypropyl methyl cellulose(HPMC)thermosensitive hydrogel,silk fibroin (SF)and CS were cross-linked to construct CS/HPMC/SF hydrogel,and to study the effect of SF on the properties of hydrogel.Methods CS/HPMC mixed solution was prepared by blending method.The 1%,5% and 10% SF solution and cross-linking agent genipin were added into the cylindrical mold,and the solution was heated to 37 ℃,so that the solution was changed to gel state.The morphology,Fourier transform infrared spectrometer (FTIR),X-ray diffraction (XRD),hydrophilicity and mechanical properties of the hydrogel were characterized.Results The hydrogel was porous under scanning electron microscope.With the addition of SF,the pores decreased and cracks appeared.FTIR and XRD results showed that the crystallization degree of CS and HPMC changed after mixing.When SF was added,the chemical crosslinking of SF and CS occurred,and the structure changed,so the hydrophilicity of hydrogel was weakened.The mechanical characterization showed that when the addition of SF was 5%,the resilience of the hydrogel was the best,the elastic modulus was the largest,and basically remained unchanged.Conclusion The cross-linking of SF and CS improves the performance of CS based thermosensitive hydrogel.Compared with other groups of hydrogels,CS/HPMC-5% SF maintains good hydrophilicity and has good mechanical properties.

Objective To investigate the role of lysyl oxidase-like 2(LOXL2)in the diagnosis and prognosis of lung adenocarcinoma by analyzing the expression,genomic changes,prognosis and immune infiltration of LOXL2 in multiple databases.Methods LOXL2 expression was analyzed by TIMER,UALCAN,GEPIA and Kaplan-Meier databases and survival analysis was performed.Genomic changes of LOXL2 in lung adenocarcinoma patients were analyzed using cBioPortal database.The correlation between LOXL2 and immune cell infiltration and immune checkpoint was analyzed by TIMER.The protein expression of LOXL2 in normal lung tissue and lung adenocarcinoma tissue was described using HPA database.Results The mRNA and protein levels of LOXL2 in lung adenocarcinoma were higher than those in normal tissues.High expression of LOXL2 was associated with a later stage and poorer prognosis of lung adenocarcinoma.The rate of genetic change in LOXL2 was 6%.LOXL2 was strongly associated with partial immune cell infiltration and immune checkpoints (programmed cell death protein-1 [PD-1]and cytotoxic T lymphocyte-associated antigen 4 [CTLA-4])in lung adenoma.Immunohistochemistry showed that the protein expression of LOXL2 in lung adenocarcinoma was higher than that in normal lung tissue.Conclusion Through multi-omics data mining,LOXL2 is highly expressed in lung adenocarcinoma tissues,and is associated with immune cell infiltration and poor prognosis of patients.LOXL2 can be used as a novel biomarker for diagnosis and prognosis of lung adenocarcinoma.

Objective To explore the molecular mechanism of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors to slow atherosclerosis(AS).Methods A total of 45 apolipoprotein E gene knockout(ApoE-/-)mice were selected as the study objects,and they were divided into control group,AS model group and PCSK9 inhibitor intervention group by random number table method,with 15 mice in each group.Mice in control group were fed a normal diet.The AS model group was established by high-fat diet induction,and the PCSK9 inhibitor intervention group was fed high-fat diet and injected with PCSK9 inhibitors.After the end of experiment,plasma of mice was collected to determine the concentration of blood lipids.Aortic roots of mice were sliced and stained with oil red O and hematoxylin-eosin (HE) to observe pathological changes.The expression of VCAM-1 in aortic tissues of mice in each group was detected by immunohistochemical assay.The mRNA content and protein expression of VCAM-1 in thoracic aorta were determined by real-time PCR and Western Blot.The concentrations of plasma tumor necrosis factor-α (TNF-α) and plasminogen activator inhibitor-1(PAI-1) were determined by ELISA.Results After intervention,plasma levels of total cholesterol (TC),triglyceride (TG)and low-density lipoprotein cholesterol (LDL-C)in AS model group were higher than those in control group,the level of high density lipoprotein cholesterol (HDL-C) was lower than that in control group,the differences were statistically significant (P＜0.05).There were no significant differences in plasma levels of TC,TG,LDL-C and HDL-C between PCSK9 inhibitor intervention group and control group(P＞0.05).The plasma levels of TC,TG and LDL-C in PCSK9 inhibitor intervention group were lower than those in AS model group,and HDL-C was higher than that in AS model group,with statistical significances (P＜0.05).The relative area of aortic atherosclerotic plaque in AS model group was larger than that in control group,the relative area of aortic atherosclerotic plaque in PCSK9 inhibitor intervention group was smaller than that in AS model group,the differences were statistically significant (P＜0.05).VCAM-1 protein expression and mRNA levels in AS model group and PCSK9 inhibitor intervention group were higher than those in control group,VCAM-1 protein expression and mRNA levels in PCSK9 inhibitor intervention group were lower than those in AS model group,the differences were statistically significant(P＜0.05).Plasma TNF-α and PAI-1 levels in AS model group were higher than those in control group,Plasma TNF-α and PAI-1 levels in PCSK9 inhibitor intervention group were lower than those in AS model group,the differences were statistically significant(P＜0.05).There were no significant differences in plasma TNF-α and PAI-1 content between PCSK9 inhibitor intervention group and control group (P＞0.05).Conclusion PCSK9 inhibitors can reduce VCAM-1 expression in aortic tissues by decreasing the concentrations of inflammatory cytokines TNF-α and PAI-1,thus delaying the progression of atherosclerosis.

Objective Exploring the effects of Qi Stagnation and Stomach Pain Granules on Helicobacter pylori(Hp)clearance rate and gastrointestinal motility in patients with functional dyspepsia (FD)complicated with Hp infection,in order to guide the formulation of clinical treatment measures and promote the clinical benefits of FD patients with Hp infection.Methods A total of 100 FD patients with Hp infection admitted to People's Hospital of Ganzhou City from January to June 2023 were selected as the study objects and divided into the control group and the observation group according to random number table method,with 50 cases in each group.The control group received routine western medicine treatment,while the observation group received additional Qi Stagnation and Stomach Pain Granules on this basis.The efficacy of two groups was evaluted,the Hp clearance rate of the two groups was calculated,the gastrointestinal motility indicators before and after treatment were compared,and the adverse reactions during the treatment period of the two groups were analyzed.Results The total effective rate and Hp clearance rate of the observation group were higher than those of the control group,and the differences were statistically significant (P＜0.05).After 4 weeks of treatment,the levels of leptin,motilin,and gastrin in the observation group were higher than those in the control group,and the levels of corticotropin releasing hormone (CRH)were lower than those in the control group,with statistical significances (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05).Conclusion On the basis of conventional Western medicine treatment,the use of Qi Stagnation and Stomach Pain Granules can improve the Hp clearance rate and gastrointestinal motility of FD patients with Hp infection.The therapeutic effect is significant and does not increase adverse reactions.

 Objective To investigate the correlation between liver and spleen hardness combined with portal vein width and esophageal gastric varices severity of patients with alcoholic cirrhosis.Methods A total of 240 patients with alcoholic cirrhosis in the Fifth People's Hospital of Ganzhou City from January 2020 to December 2022 were selected as the study subjects,they were divided into group A (60 cases,mild esophageal gastric varices),group B (60 cases,moderate esophageal gastric varices),group C (60 cases,severe esophageal gastric varices) and group D (60 cases,without esophageal gastric varices) according to the differences of esophageal gastric varices severity.Then the detection value and abnormal rates of liver hardness value,spleen hardness value and portal vein width,blood flow volume and flow velocity of portal vein and splenic vein of four groups were detected and compared,then the correlation between liver hardness value,spleen hardness value and portal vein width,blood flow volume and flow velocity of portal vein and splenic vein and severity of esophageal gastric varices caused by alcoholic cirrhosis were analyzed with Spearman rank correlation analysis.Results The detection value of liver hardness value,spleen hardness value and portal vein width,blood flow volume and flow velocity of splenic vein of group A,group B and group C were higher than those of group D,the blood flow volume and flow velocity of portal vein were lower than those of group D,the detection value of liver hardness value,spleen hardness value and portal vein width,blood flow volume and flow velocity of splenic vein of group A,group B and group C were compared,the differences were statistically significant (P＜0.05).The abnormal rates of liver hardness value,spleen hardness value and portal vein width of group A,group B and group C were higher than those of group D,the rates of group C were were significantly higher than those of group A and group B,the rates of group B were significantly higher than those of group A,the differences were statistically significant(P＜0.008).The blood flow volume and flow velocity of portal vein of group A,group B and group C were compared,the differences were not statistically significant (P＞0.05).The Spearman rank correlation analysis showed the abnormal rates of liver hardness value,spleen hardness value and portal vein width,blood flow volume and flow velocity of splenic vein were positively correlated with severity of esophageal gastric varices caused by alcoholic cirrhosis,the blood flow volume and flow velocity of portal vein were negatively correlated with severity of esophageal gastric varices caused by alcoholic cirrhosis (rs=0.836,0.819,0.793,0.761,0.802, P＜0.05).Conclusion The liver and spleen hardness and portal vein width in the patients with esophageal gastric varices caused by alcoholic cirrhosis are significant,and they have close relationship with the severity esophageal gastric varices caused by alcoholic cirrhosis.

Objective To investigate the clinical effect of Sulfasalazine combined with Fengliao Changweikang Capsules in the treatment of ulcerative colitis (UC).Methods A total of 76 patients with ulcerative colitis admitted to Tianyou Hospital affiliated to Wuhan University of Science and Technology from January to October 2022 were selected as the study objects.They were divided into treatment group（38 cases）and control group（38 cases）according to random number table method.The treatment group was treated with Sulfasalazine combined with Fengliao Changweikang Capsules,and the control group was treated with Sulfasalazine.The clinical efficacy,serum inflammatory factor levels and disease activity index (DAI)score of the two groups were compared.Results 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).After 8 weeks of treatment,hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α (TNF-α) and interleukin (IL)-10 in the treatment group were lower than those in the control group,the differences were statistically significant (P＜0.05).After 4 weeks of follow-up,hs-CRP,TNF-α and IL-10 in the treatment group were lower than those in the control group,the differences were statistically significant (P＜0.05).After 8 weeks of treatment,DAI score in the treatment group was lower than that in the control group,and the difference was statistically significant(P＜0.05).After 4 weeks of follow-up,DAI score in the treatment group was lower than that in the control group,the difference was statistically significant (P ＜0.05).Conclusion Sulfasalazine combined with Fengliang Changweikang Capsules in the treatment of UC can improve the effective rate,reduce the serum inflammatory factor level and DAI score of patients,which is worthy of clinical application.

Objective To analyze the potential risk factors of cryptogenic ischemic stroke.Methods Fifty inpatients with cryptogenic ischemic stroke from the Department of Neurology of First People's Hospital of Fuzhou from June 2017 to June 2022 were selected as the experimental group,and 50 inpatients with non-ischemic stroke and no previous history of stroke during the same period were selected as the control group.The relationship between general data,blood indexes and cryptogenic ischemic stroke was analyzed by univariate and multifactorial analysis.Results Univariate results showed that age,systolicbloodpressure,bodymassindex(BMI),uricacid(UA),serumcreatinine(SCr),meanplateletvolume(MPV),platelet-larger cell ratio (P-LCR)and red blood cell distribution width (RDW)in experimental group were all higher than those in control group,while total bilirubin(TBil)was lower than that in control group,the differences were statistically significant(P＜0.05).Multivariate analysis showed that high UA (β=0.005, OR=1.005,95%CI=1.001-1.009),high SCr (β=0.021, OR=1.021,95%CI=1.005-1.038),high MPV(β=1.818,OR=6.158.95%CI=2.892-13.113),high P-LCR(β=0.685, OR=1.983,95%CI=1.459-2.694),high RDW (β=0.343, OR=1.410,95%CI=1.165-1.705) were independent risk factors for cryptogenic ischemic stroke(P＜0.05).High TBil(β=-0.375,OR=0.687,95%CI=0.590-0.802)was an independent protective factor for cryptogenic ischemic stroke (P＜0.05).Conclusion UA,SCr,MPV,P-LCR,RDW and TBil are independent influencing factors of cryptogenic ischemic stroke,in which high UA,SCr,MPV,P-LCR and RDW are independent risk factors of cryptogenic ischemic stroke,and high TBil is independent protective factor of cryptogenic ischemic stroke.

Objective To explore the effects of the application of family-based multidisciplinary collaborative model in the management of swallowing disorders after stroke on the intervention effect,emotional status and quality of life of patients.Methods A total of 110 patients with dysphagia after stroke admitted to the Department of Rehabilitation Medicine of Guangdong Provincial People's Hospital Ganzhou Hospital(Ganzhou Municipal Hospital)from December 2021 to June 2023 were selected as the study subjects,and they were divided into intervention group(n=55)and control group(n=55)according to random number table method.The control group carried out routine rehabilitation treatment,and implemented health education intervention,and the intervention group implemented family-based multidisciplinary collaborative model.The intervention effect,swallowing function score,quality of life and emotional status of the two groups were compared.Results The total effective rate of intervention group was higher than that of control group,the difference was statistically significant(P＜0.05).After intervention,the standardized swallowing assessment(SSA)score of the intervention group was lower than that of the control group,the swallowing-quality of life(SWAL-QOL)score was higher than that of the control group,and the scores of the Hamilton anxiety scale (HAMA)and Hamilton depression scale (HAMD)were lower than those of the control group,with statistical significances(P＜0.05).Conclusion The family-based multidisciplinary collaboration model can effectively improve the intervention effect of stroke patients with dysphagia,and improve the emotional status and quality of life.

 Objective To explore the clinical effect of Suhexiang Pills in treating viral encephalitis.Methods A total of 60 patients with viral encephalitis admitted to the Jiujiang NO.1 People's Hospital from May 2022 to May 2023 were selected as study objects.According to the random number table method,they were divided into control group and research group,with 30 cases in each group.The control group received conventional treatment,and the research group received conventional treatment combined with Suhexiang Pills.The clinical efficacy,the expression level of T lymphocytes in cerebrospinal fluid before and after treatment,the related indexes of cerebrospinal fluid,and the occurrence of adverse reactions during treatment were compared between the two groups.Results The clinical response rate of the study group was higher than that of the control group,the ratio of CD3+,CD4+and CD4+/CD8+were higher than those of the control group,and CD8+,cerebrospinal fluid protein quantity,total cell number and total complication rate were lower than those of the control group,with statistical significances(P＜0.05).Conclusion Suhexiang Pills can improve the clinical efficacy,shorten the time of clinical symptom relief,improve the level of cerebrospinal fluid related indexes and reduce adverse reactions in the treatment of viral encephalitis.

Objective To explore the clinical efficacy and impact on cognitive function of patients with bipolar disorder(BD)manic episodes treated with non convulsive electroconvulsive therapy(MECT)combined with sodium valproate.Methods A total of 80 patients with BD manic episodes admitted to Tongling Third People's Hospital from January 2020 to June 2023 were selected as the study objects and they were divided into observation group(40 cases)and control group(40 cases)according to random number table method.The control group was treated with sodium valproate sustained-release tablets,while the observation group was treated with MECT combined with sodium valproate.The clinical efficacy,manic symptoms,mental state,lipid level,and adverse reactions between two groups were compared.Results The total effective rate of the observation group was higher than that of the control group,and the Bech Rafaelsen mania scale (BRMS)and brief psychiatric scale (BPRS) scores after treatment were lower than those of the control group,and the mini mental state examination(MMSE)scores and Wisconsin card sorting test (WCST)scores after treatment were higher than those of the control group,with statistical differences (P＜0.05).There were no statistically significant differences in blood lipid level and incidence of adverse reactions between the two groups after treatment(P＞0.05).Conclusion The combination of MECT and sodium valproate in the treatment of BD manic episodes can alleviate the psychological symptoms and manic episodes of patients,promote cognitive function improvement,and there is no increase in adverse reactions.

Objective To investigate the effect of Sodium Thiosulfate on quality of life and clinical efficacy in hemodialysis patients with refractory uremic pruritus.Methods A total of 102 patients with skin pruritus who were treated with maintenance regular hemodialysis in Beijing Haidian Hospital and Jining No.1 People's Hospital from January 2020 to December 2022 were selected as the research objects.According to the random number table method,they were divided into control group(51 cases)and observation group(51 cases).Patients in the control group were treated with skin moisturization,local cold compress,and oral antihistamine drugs.The observation group received intravenous injection of Sodium Thiosulfate before the completion of dialysis.The serum creatinine (SCr),blood urea nitrogen (BUN),kidney/renal urea clearance multiplied by time divided by volume of distribution of urea(Kt/V),serum calcium(Ca),serum phosphorus(P),parathyroid hormone (PTH)and visual analogue scale (VAS)of skin pruritus were compared between the two groups,and the curative effect was evaluated,the quality of life of the two groups was evaluated,and the side effects and tolerance of the patients were observed.Results After 8 weeks of Sodium Thiosulfate treatment,the SCr,BUN,P and PTH of the observation group were lower than those of the control group,and Kt/V and Ca were higher than those of the control group,and the differences were statistically significant (P＜0.05).After 8 weeks of treatment,the VAS of the observation group was lower than that of the control group,and the difference was statistically significant (P＜0.05).The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).The scores of physical function,role physical,bodily pain,general health,vatality,role emotional,mental health and social function of the observation group were higher than those of the control group,and the differences were statistically significant (P＜0.05).There were no related adverse reactions during treatment in the two groups,and the patients were well tolerated.Conclusion Sodium Thiosulfate can effectively relieve the pruritus of refractory uremia,improve the serum creatinine,urea nitrogen,Kt/V,serum calcium and phosphorus,parathyroid hormone and other indicators of patients,and has a significant positive impact on the quality of life.

Objective To explore the effect of extended dialysis time on cognitive function in maintenance hemodialysis patients.Methods A total of 40 patients with maintenance hemodialysis in Shouguang Hexin Hospital from March 2021 to June 2022 were selected as the research objects.According to the random number table method,they were divided into control group (20 cases)and observation group (20 cases).The control group was treated with hemodialysis for 4 hours each time,and the observation group was treated with extended hemodialysis for 5 hours each time.Both groups were treated for 6 months.The cognitive function (Montreal cognitive assessment [MoCA])and quality of life (quality of life questionnaire[QLQ-C30])were compared between the two groups before treatment and 6 months after treatment.Results After 6 months of treatment,the scores of each item and the total score of MoCA scale in the observation group were higher than those in the control group,and the differences were statistically significant (P＜0.05).The QLQ-C30 scores of the observation group were higher than those of the control group after 6 months of treatment,and the differences were statistically significant(P＜0.05).Conclusion Extending the dialysis time of maintenance hemodialysis patients is beneficial to improving the cognitive function of patients and improving the quality of life.

 Objective To explore the application effect of Qigu Capsules combined with Ibandronate Sodium in treating postmenopausal osteoporosis(PMOP).Methods A total of 100 patients diagnosed with PMOP in Nanchang Hongdu Hospital of TCM from July 2020 to April 2023 were selected as the study objects,and they were divided into Chinese medicine group and control group by random number method,with 50 cases in each group.The Chinese medicine group was treated with Qigu Capsules combined with Ibandronate Sodium,and the control group was treated with Ibandronate Sodium.The clinical efficacy,pain degree,ballistic missile defense (BMD)of lumbar spine and femoral neck,biochemical indexes and incidence of adverse reactions were compared between the two groups.Results The curative effect of Chinese medicine group was better than that of control group,the difference was statistically significant(P＜0.05).The score of visual analogue scale(VAS),level of β-Crosslaps(β-CTX)and alkaline phosphatase(ALP)in Chinese medicine group after treatment were lower than those in control group,and the differences were statistically significant (P＜0.05).The ballistic missile defense (BMD)of lumbar spine and femoral neck,serum calcium(S-Ca)and serum phosphorus(S-P)were higher than those in control group,the differences were statistically significant(P＜0.05).There was no significant difference in the occurrence of adverse reactions between the two groups (P＞0.05).Conclusion Qigu Capsules combined with Ibandronate Sodium has better efficacy in the treatment of PMOP,which can improve bone absorption and bone metabolism,reduce pain and increase BMD,and has certain safety.

Objective To compare the clinical efficacy and safety of endoscopic lumbar interbody fusion (Endo-LIF),minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF),and open lumbar interbody fusion (PLIF) in the treatment of lumbar degenerative diseases (LDD).Methods The clinical data of 150 patients who underwent transforaminal lumbar interbody fusion for LDD in Baise People's Hospital from January 2013 to January 2023 were retrospectively analyzed.According to the surgical method,they were divided into Endo-LIF group,MIS-TLIF group and PLIF group,with 50 cases in each group.Operative time,fluoroscopy times,intraoperative blood loss,length of hospital stay,complications,visual analogue scale(VAS),Oswestry disability index(ODI),vertebral space height index,and range of motion(ROM)were compared between the three groups before and 3 months after surgery.Results The operative time of PLIF group was longer than that of Endo-LIF group and MIS-TLIF group,and the intraoperative fluoroscopy times were less than those of Endo-LIF group and MIS-TLIF group,the differences were statistically significant (P＜0.05).There were no significant differences in operation time and intraoperative fluoroscopy times between Endo-LIF group and MIS-TLIF group (P＞0.05).Intraoperative blood loss in Endo-LIF group was less than that in MIS-TLIF group and PLIF group,and that in MIS-TLIF group was less than that in PLIF group,the differences were statistically significant (P＜0.05).Postoperative bed time and hospital stay in Endo-LIF group were shorter than those in MIS-TLIF group and PLIF group,and MIS-TLIF group was shorter than PLIF group,the differences were statistically significant (P＜0.05).The satisfaction of the three groups was compared,the difference was statistically significant (P＜0.05).The satisfaction of Endo-LIF group was higher than PLIF group,and the difference was statistically significant(P＜0.017).VAS and ODI scores 3 months after operation were lower than those before operation,and the differences were statistically significant (P＜0.01).There were no significant differences in complication rate,vertebral space height index and ROM among three groups (P＞0.05).Conclusion Endo-LIF,MIS-TLI and PLIF had similar prognosis 3 months after operation.PLIF had the least number of intraoperative fluoroscopy,Endo-LIF had less trauma,and had obvious advantages in reducing intraoperative bleeding,shortening postoperative bed time and hospital stay,and had faster postoperative recovery,which was suitable for clinical promotion.

Objective To explore the application value of early atomization inhalation of Budesonide under ventilator in the prevention of bronchopulmonary dysplasia (BPD)in premature infants.Methods The clinical data of 60 premature infants who needed ventilator treatment in Jingdezhen Maternal and Child Health Hospital from January 2020 to January 2023 were retrospectively analyzed.According to the different treatment methods,they were divided into control group (30 cases)and observation group(30 cases).The control group was treated with noninvasive ventilator assisted ventilation,and the observation group was treated with noninvasive ventilator assisted ventilation and early atomization inhalation of Budesonide under ventilator.The occurrence of BPD,treatment effect,pulmonary oxygenation index,inflammatory factors and adverse reactions were compared between the two groups.Results The incidence of BPD in the treatment group was lower than that in the control group,and the total oxygen inhalation time and ventilator use time were shorter than those in the control group,and the differences were statistically significant(P＜0.05).The oxygenation index(OI),alveolar-arterial oxygen partial pressure difference(PA-aO2),arterial partial pressure of carbon dioxide (PaCO2),tumor necrosis factor-α (TNF-α),interleukin(IL) -6,IL-8 and procalcitonin (PCT) in the treatment group were lower than those in the control group after 48 hours of treatment.The arterial partial pressure of oxygen (PaO2)in the observation group was higher than that in the control group,and the difference was statistically significant(P＜0.05).There were no adverse reactions in the two groups during treatment.Conclusion The application of early aerosol inhalation of budesonide under ventilator in premature infants can better improve their lung oxygenation indicators,shorten the total oxygen inhalation time and ventilator use time,reduce the levels of TNF-α,IL-6 and other inflammatory factors,and actively prevent the occurrence of BPD.It is safe and reliable,and has high clinical application value.

Objective To investigate the application effect of traditional Chinese medicine fumigation and washing combined with anal fistula seton in the treatment of children with anal fistula complicated with perianal abscess.Methods A total of 70 children with anal fistula complicated with perianal abscess treated in Ganzhou Women and Children's Health Care Hospital from June 2021 to June 2023 were selected as the research objects,and they were divided into control group and observation group by random number table method,with 35 cases in each group.The control group was treated with anal fistula seton combined with Potassium Permanganate Solution sitz bath,and the observation group was treated with anal fistula seton combined with traditional Chinese medicine fumigation and washing.The mucosal healing time,wound complete healing time,length of hospital stay,pain score,perianal self-control score,traditional Chinese medicine syndrome score,anal function,curative effect,perianal abscess and anal fistula recurrence rate were compared between the two groups.Results The mucosal healing,wound healing and hospitalization time of the observation group were shorter than those of the control group,and the differences were statistically significant (P＜0.05).The pain and perianal self-control scores of the observation group were lower than those of the control group,and the differences were statistically significant (P＜0.05).The scores of perianal swelling and pain,severe pain during defecation and constipation in the observation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The anal function recovery of the observation group was better than that of the control group,the total effective rate (91.43%) was higher than that of the control group(71.43%),the anal fistula recurrence rate(8.57%)and perianal abscess recurrence rate(5.71%)were lower than those of the control group (40.00%,31.43%),and the differences were statistically significant (P＜0.05).Conclusion Traditional Chinese medicine fumigation and washing combined with anal fistula seton treatment can effectively promote anal fistula wound healing,prevent perianal abscess and anal fistula recurrence,relieve pain,promote the recovery of anal function,shorten the length of hospital stay,and promote the return of the disease.It has exact effect and is worthy of promotion.

Objective To investigate the effect of Huaiqihuang Granules combined with Mycophenolate Mofetil Capsules in the treatment of IgA nephropathy in children.Methods Seventy children with IgA nephropathy admitted to the Department of Pediatric,Ganzhou People's Hospital from January 2022 to March 2023 were selected as the study subjects.According to random number table method,they were divided into observation group(35 cases)and control group(35 cases).The control group was treated with western medicine such as Mycophenolate Mofetil Capsules,while the observation group was treated with a combination of Huaiqihuang Granules for 3 months.The clinical efficacy,serum urea nitrogen level,serum creatinine level,urinary β2 microglobulin(β2-MG)level,24 h urinary protein content,urinary red blood cell count and the incidence of adverse drug reactions were compared between the two groups.Results The total effective rate of the observation group(91.4%)was higher than that of the control group (77.1%),and the difference was statistically significant (P＜0.05).After treatment,the serum urea nitrogen,serum creatinine,β2-MG,24 h urinary protein and the number of urinary red blood cells in the observation group were lower than those in the control group,the differences were statistically significant (P＜0.05).The total incidence of adverse reactions in the observation group (20.0%) was lower than that in the control group(57.1%),and the difference was statistically significant (P＜0.05).Conclusion Huaiqihuang Granules combined with Mycophenolate Mofetil Capsules can significantly alleviate the clinical symptoms of children with IgA nephropathy,reduce urinary protein,improve renal function,reduce hematuria,improve clinical efficacy and reduce adverse reactions.

Objective To investigate the incidence of facial nerve dehiscence in patients undergoing modified radical mastoidectomy for middle ear cholesteatoma and to delineate the associated risk factors,thereby furnishing surgical guidelines for clinical practice.Methods A retrospective analysis was conducted on the clinical data of 296 patients (301 ears) who underwent modified radical mastoidectomy for middle ear cholesteatoma in Meizhou People's Hospital between January 2016 and September 2023.Univariate and multivariate logistic regression analyses were employed to assess the relationship between facial nerve dehiscence and variables such as sex,age,disease duration,surgical ear,lateral semicircular canal fistula,dural exposure,sigmoid sinus exposure,external auditory canal posterior wall destruction,mastoid gasification type,stapes destruction,scutum destruction.Results Facial nerve dehiscence was observed in 118 ears (39.2%) of the 301 ears post-modified radical mastoidectomy for middle ear cholesteatoma.The tympanic segment was the most common site of dehiscence (83.1%) (98/118).Univariate analysis identified that there were significant differences in external semicircular canal fistula,dural exposure,stapes destruction,sigmoid sinus exposure,posterior wall destruction of external auditory canal and scutum destruction between facial nerve dehiscence(+)and exposed facial nerve dehiscence(-)(P＜0.05).Multivariate logistic regression analysis revealed that lateral semicircular canal fistula (β=0.993, OR=2.700,95%CI=1.380-5.279),stapes destruction (β=1.794, OR=6.014,95%CI=3.453-10.477),and posterior wall destruction of the external auditory canal (β=1.124,OR=3.078,95%CI=1.587-5.971)were significant risk factors for facial nerve dehiscence.The risk escalated with an accumulation of these risk factors,notably,when lateral semicircular canal fistula,stapes destruction,and posterior wall destruction of the external auditory canal co-occurred,the risk of facial nerve dehiscence amplified by 16.3 times (β=2.791, OR=16.290,95%CI=3.704-71.643).Conclusion The incidence of facial nerve dehiscence in middle ear cholesteatoma was 39.2%,predominantly located in the tympanic segment.Lateral semicircular canal fistula,stapes destruction,and posterior wall destruction of the external auditory canal were discerned as risk factors,with their accumulation markedly escalating the risk of facial nerve dehiscence.

Objective To explore the clinical effect of electroacupuncture at the four points of the mastoid process and Methylcobalamin in patients with idiopathic tinnitus.Methods A total of 90 patients with idiopathic tinnitus admitted in Shandong Chronic Disease Hospital from October 2021 to October 2023 were selected as the study subjects,and they were divided into the study group (45 cases)and the control group (45 cases).The control group was treated with Methylcobalamin,and the study group was treat with electroacupuncture combined with Methylcobalamin.The clinical efficacy,traditional Chinese medicine syndrome score,tinnitus degree,and adverse reactions in both groups were compared.Results The total effective rate of the study group was higher than that of the control group,the difference was statistically significant(P＜0.05).The traditional Chinese medicine syndrome scores of the two groups after treatment was lower than those before treatment,the traditional Chinese medicine syndrome scores of the study group after treatment were lower than those of the control group,with statistical significances (P＜0.05).The scores of the tinnitus evaluation questionnaire (TEQ)and tinnitus handicap inventory (THI)of the two groups after treatment were lower than those before treatment,the TEQ and THI scores of the study group after treatment were lower than those of the control group,with statistical significances (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05).Conclusion The clinical efficacy of electroacupuncture at the four points of the mastoid process and Methylcobalamin treatment for patients with idiopathic tinnitus is relatively high.It can effectively reduce the traditional Chinese medicine syndrome score,alleviate the degree of tinnitus,and do not increase adverse reactions.

 Objective To investigate the clinical effect of Huanglian Jiedu decoction combined with acupuncture in the treatment of patients with carotid atherosclerosis（CAS）.Methods A total of 80 patients with CAS admitted to the Third Affiliated Hospital of Fujian University of Traditional Chinese Medicine from July 2021 to January 2023 were selected as the research objects,and they were divided into control group(40 cases)and treatment group(40 cases)according to the random number table method.The control group was treated with acupuncture,and the treatment group was treated with Huanglian Jiedu decoction combined with acupuncture,and the blood lipid indexes,carotid arteriosclerosis indexes and adverse reactions of the two groups were compared.Results After treatment,the triglyceride (TG),total cholesterol (TC),and low-density lipoprotein cholesterol (LDL-C) in the treatment group were lower than those in the control group,while high-density lipoprotein cholesterol(HDL-C)was higher than those in the control group,with statistical significances(P＜0.05).The carotid intima-media thickness(IMT),plaque area (PA),and plaque score (Course score) of the treatment group were lower than those of the control group after treatment,and the differences were statistically significant (P＜0.05).There was no statistically significant difference in the rate of moderate to severe carotid artery stenosis and adverse reactions between the two groups of patients before and after treatment (P＞0.05).Conclusion Huanglian Jiedu decoction combined with acupuncture in the treatment of CAS can effectively regulate blood lipid levels and improve carotid atherosclerosis,which has a high safety profile and is worthy of clinical promotion.

 Objective To investigate the effect of lifting head and pushing correction combined with traditional Chinese medicine wax therapy on cervical radiculopathy.Methods A total of 60 cases of patients with cervical radiculopathy admitted to Ganzhou Traditional Chinese Medicine Hospital from January 2023 to September were selected as the study objects,and they were randomly divided into control group(30 cases)and observation group(30 cases)according to envelope drawing method.The control group was treated with massage,the patients in the observation group were treated with uplifting head pushing method combined with traditional Chinese wax therapy on the basis of the method of control group.The clinical efficacy,pain,cervical spine movement and cervical spine function were compared between the two groups.Results In the observation group,the clinical efficacy was better than that of control group,and the difference was statistically significant (P＜0.05).In the observation group,the visual analogue scale (VAS)score after treatment was lower than that of the control group,and the difference was statistically significant(P＜0.05).The cervical vertebra left rotation,right rotation,anterior flexion and posterior extension motion of the observation group were higher than those of the control group,and the neck disability index(NDI)score was lower than that of the control group,the differences were statistically significant(P＜0.05).Conclusion The treatment of cervical radiculopathy with uplifted head and traditional Chinese wax therapy is effective,which can further reduce pain,enhance cervical motion,and effectively improve cervical spine function.This program can be actively selected clinically.

 Objective To explore the clinical effect of Xie's acupuncture bloodletting minimally invasive therapy combined with western medicine in the treatment of children with acute tonsillitis (AT).Methods A total of 104 children with AT admitted to Pingxiang People's Hospital from August 2021 to August 2023 were selected as the research objects,and they were divided into control group (52 cases)and observation group (52 cases)by random number table method.The control group was treated with western medicine,and the observation group was treated with Xie's acupuncture bloodletting minimally invasive therapy on the basis of the control group.The clinical efficacy,traditional Chinese medicine syndrome score,laboratory indexes,improvement of clinical symptoms 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,and the difference was statistically significant (P＜0.05).There were no statistically significant differences in traditional Chinese medicine syndrome scores,C-reactive protein(CRP),neutrophil percentage(N%),white blood cell(WBC),and procalcitonin(PCT)levels between the two groups before treatment (P＞0.05).After treatment,the traditional Chinese medicine syndrome scores,CRP,N%,WBC and PCT levels of the observation group were lower than those of the control group,and the differences were statistically significant (P＜0.05).The disappearance time of fever,tonsillar swelling and sore throat in the observation group were shorter than those in the control group,and the differences were statistically significant (P＜0.05).There were no obvious adverse reactions in the two groups.Conclusion Xie's acupuncture bloodletting minimally invasive therapy combined with western medicine is effective in the treatment of children with AT,which is conducive to improving clinical symptoms,promoting the disappearance of symptoms,reducing inflammatory reaction,and has good safety,which is worthy of promotion.

Objective To explore the value of clinical applications of four coagulation tests(activated partial thromboplastin time[APTT],prothrombin time[PT],thrombin time[TT],red blood cell distribution width[RDW])in patients with liver cirrhosis.Methods A total of 125 patients with liver cirrhosis admitted to Wuming Hospital of Guangxi Medical University from January 2020 to June 2023 were selected as the liver cirrhosis group.According to Child-Pugh grading,the patients with liver cirrhosis were divided into 45 cases of grade A,54 cases of grade B,26 cases of grade C,and 116 cases of non-cirrhosis patients during the same period were selected as the control group.All patients underwent four blood coagulation tests and red blood cell distribution width analysis.The differences of all indexes were analyzed and compared.Results The levels of APTT,PT,TT and RDW were higher in liver cirrhotic patients than those in the healthy controls,the levels of FIB were lower than those in the healthy controls,and the statistically significant (P＜0.05).The APTT,PT,TT and RDW value of B and C grade were higher than those of the A grade,and the APTT、PT、TT、RDW value of C grade were higher than those of B grade,and the differences were statistically significant (P＜0.05).The FIB value of the C grade was lower than that of A and B grade,and the difference was statistically significant (P＜0.05).And there were no significant differences between A grade and B grade in the levels of FIB (P＞0.05).Conclusion The APTT,PT,TT,RDW and FIB can be used as indexes to predict the course of liver cirrhosis,and also can be used as an auxiliary index of Child-Pugh classification,which had certain clinical value for diagnosis and treatment.

 Objective In order to establish a ring-mediated isothermal amplification detection system for human H1N1 influenza virus,the nucleic acid amplification efficiency of H1N1 virus was used as an indicator,and to explore optimal reaction conditions for loop mediated isothermal amplification(LAMP)detection of H1N1 influenza virus by response surface analysis optimization.Methods Based on the principle of Box-Benhnken response design,the key factors affecting LAMP reaction (betaine concentration,primer concentration,and reaction temperature) were optimized by the three factors level response surface method.At the same time,60 clinical nucleic acid specimens of confirmed influenza A and 60 nucleic acid samples of healthy people were selected and evaluated by polymerase chain reaction (PCR) assay and LAMP assay comparatively (the evaluation indexes included sensitivity,specificity and accuracy).Results The response surface regression model was able to better predict the relationship between the LAMP detection effect and betaine concentration,primer concentration and reaction temperature,and the optimized LAMP improved the detection sensitivity and shortened the reaction time.Compared with PCR results,the LAMP assay achieved 100% sensitivity,98.9% specificity and 99.2%accuracy,and the lower limit of detection was up to 100 copies/ml.Conclusion The LAMP assay for influenza A (H1N1)established in the present study is a highly efficient,sensitive,and specific assay that does not require complex equipment,and it is suitable for the detection of H1N1 in basic community units or at home,which is useful for the monitoring of H1N1 and the post-outbreak epidemic.It is of great significance for the monitoring of influenza A disease and the emergency detection of outbreaks.

Objective Detection of Mycobacterium species in alveolar lavage fluid using microarray gene chip method to understand the distribution characteristics of Mycobacterium species in patients with pulmonary infection in Guangxi Zhuang Autonomous Region Chest Hospital at different ages and genders.Methods The results of alveolar lavage fluid detection using microarray gene chip method from patients with pulmonary infections admitted to Guangxi Zhuang Automomous Region Chest Hospital from January 2018 to December 2022 were colletced,and the distribution characteristics of Mycobacteria in the patients was analyzed.Results A total of 348 cases of Mycobacterium tuberculosis were detected from 949 lavage fluid samples,with a detection rate of 36.7%(348/949).Among them,the Mycobacterium tuberculosis complex group accounted for 83.6%(291/348),with a detection rate of 33.2%(203/611)in males and 26.0%(88/338)in females.The difference in detection rates between males and females was statistically significant(χ2=5.29,P＜0.05),non tuberculosis Mycobacteria(NTM)accounted for 16.4%(57/348),with the male detection rate was 5.1%(31/611),and the female detection rate was 7.7%(26/338),and there was no statistically significant difference in the detection rate between males and females(χ2=2.64, P＞0.05).In the detected NTM,intracellular Mycobacterium accounted for 35.1% (20/57), Mycobacterium chelonae/abscess accounted for 33.3%(19/57),Mycobacterium avium accounted for 19.3%(11/57),Gordon Mycobacterium accounted for 5.3%(3/57),toad Mycobacterium accounted for 5.3%(3/57),and light yellow Mycobacterium accounted for 1.7% (1/57).There was no statistically significant difference in age groups among lung infection patients who have detected a complex of Mycobacterium tuberculosis(χ2=10.8,P＞0.05),there was a statistically significant difference in the age groups of lung infection patients who detected NTM(χ2=18.7,P＜0.01).Conclusion The pulmonary infection of Mycobacterium tuberculosis in Guangxi Zhuang Automomous Region Chest Hospital is mainly caused by the Mycobacterium tuberculosis complex group.The main prevalent strains of NTM are intracellular Mycobacterium,Mycobacterium chelonae/abscess,and Mycobacterium avium.There is no age difference in pulmonary infection patients with the Mycobacterium tuberculosis complex group,but there is a gender difference.There is no gender difference in pulmonary infection patients with NTM,but there is an age difference and an aging trend,NTM strains are diverse.

 Objective To understand the current situation and relationship of mental health problem and self-esteem of middle school students in Huairou District,and to provide scientific basis for further psychological health education and psychological intervention.Methods From October to December 2022,the online survey of mental health early screening scale and self-esteem scale for children and adolescents was conducted in Huairou District,2 825 valid questionnaires were obtained.Results The incidence of at least one mental health symptom among the middle school students in this survey was 46.7%,the incidence of Internet addiction was relatively high(30.6%),and the incidence of loneliness,depression and anxiety were 25.2%,19.3%and 15.5%.In addition to internet addiction tendency,scores of other dimensions of mental health problem were higher for girls than for boys,the differences were statistically significant (P＜0.01).The score of depression tendency of Grade 3 students was higher than that of Grade 1 and Grade 2 students,and the score of loneliness tendency increased with grade (P＜0.05).The analysis of Pearson correlation and partial correlation in mental health problem and self-esteem showed that self-esteem was negatively correlated with depression tendency,anxiety tendency,loneliness tendency and Internet addiction tendency(P＜0.01).Linear regression analysis results showed that self-esteem negatively predicted anxiety tendency,depression tendency,loneliness tendency and Internet addiction tendency(P＜0.01).Conclusion Local junior high school students have serious mental health problems,and self-esteem has a significant impact on their mental health.We should actively pay attention to the development of junior high school students'self-esteem,and formulate relevant intervention strategies to promote the development of junior high school students'mental health

 Medical device clinical trial institutions have been changed from qualification recognition to record management since 2018.Based on the data of medical device clinical trial institutions registration system on the website of National Medical Products Administration,statistical analysis was made on the registration of medical device clinical trial institutions,including institutions quantity,hospital classification,regional distribution,specialties and principal investigator in Zhejiang Province from January 1,2018 to September 30,2023.Still there is the existence of various problems concerning the current clinical trial institutions in Zhejiang Province,such as uneven distribution of registered institutions,improvement of management understanding,inadequate allocation of full-time staff,and insufficient personnel training.Aiming at promoting the high-quality development of medical device clinical trials in Zhejiang Province,it is suggested that medical device clinical trial institutions should ensure basic configuration,allocate full-time management personnel,strengthen personnel training,enhance knowledge structure of investigators,develop incentive rules,strengthen risk consciousness and whole process quality control,enlarge academic exchanges and cooperation,improve clinical research applications,and other improvement measures.

Objective To explore the research situation in the field of perioperative application of enhanced recovery after surgery in orthopedic patients by bibliometric study.Methods Published literatures on perioperative application of enhanced recovery after surgery in orthopedic patients were retrieved from CNKI,Wanfang database,and CQVIP database from when the database was created to May 31,2023.COOC 12.6 software was used to merge and de-duplicate the data,count the number of annual publications,the number of author publications,and the number of journal publications,construct a year-by-year histogram of keywords,keyword emergence patterns,perform community cluster analysis of keywords,construct a co-occurrence matrix of authors and research institutions,and visualize them using COOC 12.6 software and VOS viewer 1.6.13 software.Results Totally 1 219 articles were included.The number of publications were steady upward in recent years which mainly published in the field of medicine and health science and technology.Six clusters of keywords were formed,elderly patients,perioperative complications in orthopedics and patients'long-term quality of life were new research hotspots in this field.Important scholars include LI Ting,WU Xinbao,QIU Guixing and LI Peifang, etc.The main research institutions were Beijing Jishuitan Hospital,West China Hospital of Sichuan University and Peking University Third Hospital.Conclusion Research on the perioperative application of enhanced recovery after surgery in orthopedic patients has developed steadily,but the research teams in this research area are relatively fixed and single,and the frontier areas need to be further explored and developed.

 Objective To explore the application effect of focus cycle management method (FOCUS-PDCA)in multi-link quality control of pharmacy intravenous admixture service.Methods The occurrence of various errors in Pharmacy Intravenous Admixture Service of East Branch of Zibo Central Hospital during 2016-2022 was tracked.FOCUS-PDCA was used to find the problems,analyze the causes,formulate corresponding goals and measures and make continuous improvement.Mmedication advices before the implementation of FOCUS-PDCA in 2016 were set as the control group,medication advices after the implementation of FOCUS-PDCA from 2017 to 2019 were set as the first round intervention group,medication advices after the implementation of FOCUS-PDCA from 2020 to 2022 were set as the second round intervention group,the change of the rate of unreasonable doctor's advices not reviewed,drug dispensing,labeling,mixing and rechecking packaging unqualified rates before and after the two intervention rounds were analyzed.Results The unqualified rates of drug dispensing,labeling and mixing in the first round intervention group were lower than those in the control group,the differences were statistically significant (P＜0.017).There were no significant differences between the first round intervention group and the control group in rate of unreasonable doctor's advices not reviewed and rechecking packaging unqualified rate (P＞0.05).The unqualified rates of all kinds of quality in the second round intervention group were lower than those of control group,and the differences were statistically significant (P＜0.017).The rate of unreasonable doctor's advices not reviewed,drug dispensing and rechecking packaging unqualified rates of the second round intervention group were lower than those of the first round intervention group,and the differences were statistically significant (P＜0.017).There was no significant difference in the unqualified rate of labeling and mixing in the second round intervention group compared with the first round intervention group(P＞0.05).Conclusion FOCUS-PDCA can significantly reduce the error rate of pharmacy intravenous admixture service and provide guarantee for clinical rational drug use.

Objective To evaluate the application effect of goal management theory in prevention and control of nosocomial infection in rehabilitation hospital.Methods Convalescent patients admitted to the Rehabilitation Hospital for Honorably Discharged Veterans from January 2021 to December 2022 were selected as the study objects,402 patients from January 1 to December 31,2021 were selected as the control group and received routine care,and 427 patients from January 1 to December 31,2022 were selected as the intervention group,and set goals and implement targeted intervention measures on the basis of the control group according to the goal management theory.The hand hygiene compliance,the qualified rate of environmental hygiene monitoring and the incidence of nosocomial infection were compared between the two groups.Results The compliance rate of nurses in the intervention group was 88.54%,higher than that in the control group(69.79%),the difference was statistically significant (P＜0.01).The qualified rate of environmental health monitoring in the intervention group was 96.87%,higher than that in the control group(82.29%),and the difference was statistically significant(P＜0.01).The incidence of nosocomial infection in the intervention group was 5.39%,which was lower than that in the control group(10.94%),the difference was statistically significant (P＜0.05).Conclusion Applying the goal management theory to the prevention and control of nosocomial infection of inpatients in rehabilitation institutions can effectively control the occurrence of nosocomial infection,and is worthy of clinical application.

 High-quality development is the new development requirements put forward by the state for public hospitals.Under the background of the new medical reform,refined management is an important means and way for public hospitals to achieve high-quality development,continuously improve the quality of medical services and improve patients' medical experience.The International Medical Department is one of the important components of the hospital to comply with the needs of social development,provide high-quality,high-end and personalized diagnosis and treatment for patients,enrich the multi-level and multi-angle service channels of the hospital,and comprehensively improve the quality and level of outpatient medical treatment.Taking the Outpatient Department of International Medical Department of the First Affilated Hospital of Dalian Medical University as an example,this study adopts measures such as process optimization as the main line,personnel management as the key,innovation-driven,data utilization as the starting point,and refined management to provide flexible and efficient diagnosis and treatment methods,improve operational efficiency,strengthen information support,and enhance patient satisfaction.To explore the application practice of outpatient refined management in the International Medical Department from the perspective of high-quality development,and provide ideas and references for boosting hospital cost reduction and efficiency,and realizing double gain of economic and social benefits.

 Objective To observe the effect of advance care planning (ACP) with family follow-up in patients with end-stage lung cancer.Methods A total of 110 patients with end-stage lung cancer admitted to Jiangxi Cancer Hospital from January to December 2022 were selected as the study objects and divided into control group(55 cases)and experimental group(55 cases)by drawing lots.Patients in the control group received routine cancer nursing,and patients in the experimental group received ACP intervention with joint family follow-up.The dignity level,life quality and death quality of the two groups were compared.Results There was no significant difference in scores of psychological status,symptom distress,dependence,mental peace and social support between the two groups before intervention (P＞0.05).The scores of psychological status,symptom disturbance,dependence,mental peace and social support of experimental group were lower than those of control group after intervention,and the differences were statistically significant(P＜0.05).There were no significant differences in the role function scores,physical function scores,cognitive function scores,social function scores and emotional function scores of European Organization for Research and Treatment of Cancer quality of life questionnaire(EORTC QLQ-C30)between the two groups before intervention (P＞0.05).The EORTC QLQ-C30 scores of the two groups after intervention were higher than those of the control group,and the difference was statistically significant(P＜0.05).There was no significant difference in good death inventory (GDI)scores between the two groups before intervention (P＞0.05).The GDI score of experimental group was higher than that of control group after intervention,and the difference was statistically significant (P＜0.05).Conclusion Patients with end-stage lung cancer use the ACP intervention model of combined family follow-up,allowing patients to fully express their willingness to care and end-of-life treatment willingness,and walk through their life journey comfortably.

Objective To observe the effect of precise collaborative nutritional nursing on gestational diabetes patients.Methods A total of 90 pregnant women with gestational diabetes who had regular antenatal check-up in Jiangxi Maternal and Child Health Hospital from January 2020 to June 2022 were selected as the study objects.They were divided into control group(n=45)and observation group(n=45)by random number table method.The control group used routine nutritional management for gestational diabetes,the observation group used precise synergistic nutrition management intervention.The score of disease control knowledge,the review rate of oral glucose tolerance test (OGTT),blood glucose control and urinary ketone positive rate of gestational diabetes were compared between the two groups,and the net gain of pregnancy weight,cesarean section rate,macrogynia rate and neonatal hypoglycemia rate were compared between the two groups.Results The score of knowledge mastery,OGTT review rate and blood glucose control rate of gestational diabetes mellitus in observation group were higher than those in control group,and the positive rate of urine ketone,net gain of pregnancy weight,cesarean section rate,macrogynia rate and neonatal hypoglycemia rate were lower than those in control group,with statistical significance(P＜0.05).Conclusion The use of precise collaborative nutrition management can prevent pregnant women with gestational diabetes from causing elevated blood sugar,so as to improve pregnancy outcomes.

Objective To explore the effect of mindfulness behavior training combined with early rehabilitation exercise on disability acceptance of patients with plastic skin grafting after severe upper extremity burn.Methods A total of 60 patients with plastic skin grafting after severe upper extremity burn admitted to the First Affiliated Hospital of Nanchang University from January 2022 to March 2023 were selected as the study objects,and they were divided into control group(30 cases)and observation group (30 cases)according to computer random number grouping method.The control group was received early rehabilitation exercise,and the observation group was received mindfulness behavior training combined with early rehabilitation exercise.The wrist function and ability of daily living,disability acceptance and aesthetic satisfaction scores,anxiety and depression scores and compliance were compared between the two groups.Results After intervention,the scores of Cooney and modified Barthel index (MBI)in two groups were higher than those before intervention,and the scores in the observation group were higher than those in the control group,with statistical significances(P＜0.05).After intervention,the scores of acceptance of disability scale (AODS) and numerical score system (NSS) in two groups were higher than those before intervention,and the scores of observation group were higher than those of the control group,the differences were statistically significant(P＜0.05).After intervention,the scores of self-rating anxiety scale(SAS)and self-rating depression scale (SDS)of the two groups were lower than those before intervention,and the scores of observation group were lower than those of the control group,the differences were statistically significant (P＜0.05).The compliance rate of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Mindfulness behavior training combined with early rehabilitation exercises can improve the wrist joint function and daily living ability of patients with plastic skin grafting after severe upper limb burns,improve disability acceptance and aesthetic satisfaction,and reduce anxiety and depression.

Cancer is one of the diseases that seriously threaten the life and health of Chinese people.With the continuous progress of medical technology,drug development,and treatment concepts,the survival period of cancer patients has been further extended,and the number of follow-up visits has increased.During the follow-up period,the scanxiety has brought tremendous mental pressure,which seriously affects the quality of life of cancer follow-up patients.In recent years,scanxiety has received increasing attention.In order to better understand the nature and related research of scanxiety,this article reviews the causes,common assessment tools and adverse effects of scanxiety.By the research progress of influencing factors of scanxiety from scanning time,demographic characteristics and scanning equipment,it introduces the effects of commonly used clinical interventions on scanxiety.Through reviewing the research status of scanxiety,we hope to provide scientific basis and reference to alleviate anxiety and improve the quality of life of cancer patients during follow-up period.