Objective To explore the effect of Shenglong Jiegu Capsules on postoperative recurrent fractures in elderly patients with osteoporotic thoracolumbar fractures (OTF),and to preliminarily analyze its mechanism of action based on the mechanism of bone morphogenetic protein 2/bone morphogenetic protein 7(BMP-2/BMP-7).Methods A total of 100 elderly OTF patients undergoing percutaneous vertebraplasty (PVP) in Nanchang Hongdu Hospital of TCM from January 2020 to October 2022 were selected as the study objects,and were divided into conventional group (50 cases)and capsule group(50 cases) according to random number table method.The conventional group was treated with conventional PVP,and patients in the capsule group were treated with Shenglong Jiegu Capsules on the basis of the conventional group.The vertebral structure (Cobb angle and anterior margin height ratio),serum BMP-2,BMP-7 levels before and after treatment,bone metabolism indicators (bone specific alkaline phosphatase [BALP],type I procollagen N-terminal peptide [PⅠNP],osteocalcin[OST]),bone mineral density(BMD),rehabilitation status(Oswestry lumbar dysfunction index[ODI])evaluation,Pain rating(visual analogue scale[VAS])score,clinical efficacy rate between,incidence of vertebral refractures and adverse reactions of two groups were compared.Results After treatment,the Cobb Angle of the two groups was improved,the height ratio of the anterior margin of the injured vertebra was better than that before treatment,and the capsule group was better than the conventional group,with statistical significances (P＜0.05).The expression levels of BMP-2 and BMP-7 in the capsule group were higher than those in the conventional group,with statistical significances(P＜0.05).All patients had good recurrence of fracture after operation,and the healing speed of capsule group was faster than that of conventional group,with statistical significances(P＜0.05).After treatment,BALP,PⅠNP and OST in capsule group were higher than those in conventional group,with statistical significances (P＜0.05).BMD in two groups was higher than before treatment and the capsule group was higher than that in conventional group,ODI score and VAS score were lower than before treatment and the capsule group was lower than that in conventional group,with statistical significances(P＜0.05).The total clinical effective rate of capsule group (95.0%) was higher than that of conventional group (80.0%),and the incidence of refracture of capsule group(4%)was lower than that of conventional group(18%),with statistical significances(P＜0.05).No obvious adverse reactions were observed in both groups.Conclusion Shenglong Jiegu Capsules can improve bone mineral density by up-regulating the levels of serum BMP-2 and BMP-7 in patients,thereby preventing postoperative fracture in elderly OTF.The mechanism may be related to Shenglong Jiegu Capsules can stimulate BMP signaling pathway and accelerate osteoblast differentiation.

 Objective To explore the effect of vestibular rehabilitation training on negative emotions and sleep quality in patients with vestibular migraine(VM).Methods A total of 152 VM patients admitted to the Department of Neurology,Nanchang First Hospital from January 2020 to December 2022 were selected as observation objects,and were divided into control group and observation group according to random number table method,with 76 cases in each group.The control group was treated with western medicine+routine nursing,and the observation group was treated with vestibular rehabilitation training in addition.The scores of dizziness handicap inventory (DHI),the number of attacks,the duration of attacks,the score of Hamilton anxiety scale(HAMA),the score of Hamilton depression scale(HAMD),the visual analogue scale(VAS)of pain,the score of Pittsburgh sleep quality index (PSQI),blood nitric oxide (NO),prostaglandin E2 (PGE2),high-sensitivity C-reactive protein (hs-CRP)levels and intervention satisfaction of the two groups were compared.Results After the intervention,the DHI score of the two groups of patients was lower than before the intervention,the frequency of attacks was less than before the intervention,and the duration of attacks was shorter than before the intervention,and the DHI score of the observation group was lower than the control group,the frequency of attacks was less than the control group,and the duration of attacks was shorter than the control group,the differences were statistically significant (P＜0.05).After the intervention,the HAMA and HAMD scores of the two groups were lower than before the intervention,and the HAMA and HAMD scores of the observation group were lower than those of the control group,with statistical significance(P＜0.05).After intervention,VAS and PSQI scores of the two groups were lower than before intervention,and VAS and PSQI scores of observation group were lower than control group,the differences were statistically significant (P＜0.05).After intervention,the levels of NO,PGE2 and hs-CRP in the two groups were lower than before intervention,and the levels of NO,PGE2 and hs-CRP in observation group were lower than control group,with statistical significance(P＜0.05).The intervention satisfaction of observation group was higher than that of control group,the difference was statistically significant(P＜0.05).Conclusion Vestibular rehabilitation training can alleviate the symptoms of VM patients,reduce the frequency and duration of seizures,improve negative emotions and sleep quality,and increase intervention satisfaction.Its mechanism may be related to regulating the levels of NO,PGE2 and hs-CRP.

 Objective To construct a visual atlas of postoperative pain in patients with osteoporotic vertebral compression fractures,to understand the research hotspots and trends in this field,and provide reference for future research.Methods Literatures on postoperative pain in patients with osteoporotic vertebral compression fractures were retrieved from CNKI,Wanfang Database and Web of Science Core Collection Database from the establishment of the database to September 2023.CiteSpace R 5.6 software was used to visually analyze the annual publication volume,authors,institutions,countries,keywords and other content of the literature.Results A total of 1 072 articles were included,including 796 articles in Chinese and 276 articles in English.China was the country with the largest number of publications in this field,and Soochow University and the First Affiliated Hospital of Soochow University were the institutions with the largest number of publications in Chinese and English respectively.Except for the search terms,the most frequent keyword was＂percutaneous vertebroplasty＂.Chinese literature formed 15 key word clusters and 11 burst terms.The burst terms in the past three years were ＂ bone cement distribution＂ ＂Bushen Huoxue decoction ＂ ＂degree of pain＂,etc.The English literature formed 14 keyword clusters and 7 burst terms.The burst term in the past three years was ＂risk factors＂.Conclusion The research in this field is developing and the core authors tend to be concentrated.The research hotspots at home and abroad are slightly different,and the future development trend mainly focuses on three directions: traditional Chinese medicine treatment of postoperative pain,optimization of surgical methods,and exploration of influencing factors and the prevention of them.

 Objective To observe the effect of Toutongning Capsules on cerebral blood perfusion index and quality of life in patients with migraine.Methods A total of 78 migraine patients admitted to Jiujiang NO.1 People's Hospital from May 2022 to May 2023 were selected as research objects,and they were divided into observation group and control group according to random number table method,with 39 cases in each group.The control group was given Flunarizine treatment,on this basis,the observation group was given Toutongning Capsules adjuvant treatment,continuous treatment for 4 weeks.The clinical efficacy,cerebral blood perfusion index,migraine attack,serum index,quality of life and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P＜0.05).After treatment,the average blood flow velocity of anterior cerebral artery(ACA),middle cerebral artery (MCA)and posterior cerebral artery (PCA)in two groups were lower than those before treatment,and average blood flow velocity of ACA,MCA and PCA in observation group were lower than those of control group,the differences were statistically significant(P＜0.05).After treatment,the frequencies of headache attacks in the two groups were lower than those before treatment,and the duration of headache attacks was shorter than that before treatment,and the frequency of headache attacks in the observation group was lower than that in the control group,and the duration of headache attacks was shorter than that in the control group,with statistical significances(P＜0.05).After treatment,the levels of intercellular cell adhesion molecule-1(ICAM-1)and tumor necrosis factor-α (TNF-α) in two groups were lower than those before treatment,and the levels of ICAM-1 and TNF-α in observation group were lower than those of control group,with statistical significances(P＜0.05).After treatment,the scores of functional limitation,dysfunction and emotion in the two groups were lower than those before treatment,and the scores in the observation group 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 The treatment of Toutongning Capsules in migraine patients can reduce inflammation,improve cerebral blood perfusion,improve migraine status,improve quality of life,and have good safety.

 Objective To observe and analyze the clinical manifestations and outcomes of chronic myelogenous leukemia(CML)patients treated with tyrosine kinase inhibitor (TKI)after drug discontinuation criteria.Methods The clinical data of 44 eligible CML patients who discontinued TKI from January 1,2015 to December 31,2017 in the Department of Hematology of Guangdong Huazhong University of Science and Technology Union Shenzhen Hospital and were followed up for a long time were retrospectively analyzed,and the situation of treaty-free remission after discontinuation of TKI and its influencing factors were observed.Results The median time of 44 patients receiving TKI was 59.5 (37,102) months.Among them,40 patients had a history of reduction.All patients obtained the efficacy of major molecular remission(MMR)or above before discontinuation.At a median follow-up of 15(5,30)months,34 patients(77.27%)achieved long-term treatment free remission (TFR).Ten patients (22.73%) lost MMR.In 10 patients who lost MMR,drug therapy was restarted,and 8 of them achieved efficacy above MMR after restart.Kaplan-Meier method was used to analyze the clinical characteristics of 44 patients before drug discontinuation,34 patients finally obtained TFR,and 10 patients relapsed after drug discontinuation,with a recurrence rate of 29.41%.Univariate analysis showed that there were no significant differences in gender,age,MMR acquisition time and Sokal score between the two groups (P＞0.05).The difference was statistically significant in the recurrence rate between patients with MMR maintenance time＜24 months before drug discontinuation and patients with MMR maintenance time≥24 months before drug discontinuation (P＜0.05).Multivariate analysis by logistic regression model showed that MMR maintenance time＜24 months (β=0.519,OR=2.951,95%CI=1.187-7.526) was an independent risk factor for molecular relapse in CML patients (P＜0.05).Conclusion TKI can be stopped only after CML patients meet the criteria for drug discontinuation,and the longer MMR maintenance time before drug discontinuation,the lower the recurrence rate of patients after drug discontinuation.

 Objective To investigate the effect of Xuebijing Injection(XBJ)on Norepinephrine(NE)in early stage of sepsis.Methods A total of 108 patients with sepsis requiring NE from March 2020 to March 2023 in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected as research objects.On the basis of the same fluid resuscitation,they were divided into observation group(n=54)and control group(n=54)according to random number table method.Observation group was treated with XBJ 50 ml+0.9% Sodium Chloride Solution 100 ml,once every 12 hours.The control group was infused with 150 ml 0.9% Sodium Chloride Solution every 12 hours under the condition of basic treatment.NE dosage,procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP),white blood cell count(WBC),neutrophil/lymphocyte ratio(NLR),platelet(PLT),lactate(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health assessment Ⅱ (APACHEⅡ),and length of ICU stay of the two groups were observed.Results There was no significant difference in NE dosage between two groups when MAP≥65 mmHg level was maintained(P＞0.05).However,the total NE consumption in the observation group was lower than that in the control group,and the difference was statistically significant (P＜0.05).The total NE use time of observation group was shorter than that of control group,and the difference was statistically significant (P＜0.05).The scores of PCT,IL-6,CRP,NLR,Lac,SOFA and APACHEⅡin observation group were lower than those in control group,with statistical significances (P＜0.05).There were no significant differences in WBC,PLT and length of ICU stay between the two groups(P＞0.05).Conclusion XBJ in early stage of sepsis can effectively reduce NE dosage,reduce inflammation and improve circulation.

Objective To analyze the expression and clinical significance of 25-hydroxyvitamin D[25 (OH) D] and homocysteine (Hcy)in peripheral blood in elderly patients with schizophrenia (SCH).Methods A total of 140 elderly patients treated in the Veterans Administration Hospital from January 2021 to June 2023 were selected as the study objects,90 elderly SCH patients were included in the observation group,and 50 healthy elderly patients who underwent physical examination during the same period were included in the control group,the 25(OH)D and Hcy levels were compared between the two groups.The 90 elderly SCH patients were analyzed according to gender[male group(49 cases),female group(41 cases)],(age 60-70 years old group [45 cases],＞70 years old group [45 cases]),disease course (group A [＜6 months,27 cases],group B [6 months-5 years,40 cases],group C [＞5 years,23 cases]),positive and negative status scale (PANSS)score(group D [71-80 points,39 cases],group M [81-90 points,30 cases],group H [＞90 points,21 cases])were divided into different subgroups,and the 25 (OH)D and Hcy levels were compared in each subgroup.The correlation between 25(OH)D,Hcy and PANSS score were analyzed,and receiver operating characteristic(ROC)curve was also drawn to analyze the efficacy of 25(OH)D,Hcy and 25(OH)D combined with Hcy in the diagnosis of elderly SCH.Results The 25(OH)D of observation group was lower than that of control group,and the Hcy was higher than that of control group,the 25 (OH)D of the 70-year group was lower than that of the 60-70 year group,and the Hcy was higher than that of the 60-70 year group,the 25(OH)D of group C was lower than that of group B and group A,and the Hcy was higher than that of group B and group A.The 25 (OH)D of group H was lower than that of groups M and D,and the Hcy was higher than that of groups M and D,the differences were statistically significant (P＜0.05).Pearson correlation showed that 25 (OH)D was negatively correlated with PANSS score (r=0.520,P＜0.05);Hcy was positively correlated with PANSS score (r=0.479,P＜0.05).ROC results showed that the area under the curve (AUC),sensitivity and specificity of 25 (OH)D and Hcy combined in the diagnosis of SCH in the elderly were 0.925,98.90%and 92.00%,which were higher than the results of 25(OH)D and Hcy alone.Conclusion 25 (OH)D and Hcy are abnormally expressed in the serum of elderly SCH patients,and the combination of the two has significant effect in the diagnosis of elderly SCH patients,and has high clinical application value.

Objective To investigate the effect of nasal feeding timing on stroke-related pneumonia after intravascular therapy for acute anterior circulation main artery occlusive cerebral infarction.Methods A total of 90 patients with acute anterior circulation main artery occlusive cerebral infarction admitted to the Ganzhou People's Hospital from January 2021 to January 2022 were selected as the study objects,they were divided into group A(n=30),group B(n=30)and group C(n=30)according to random number table method.Gastric tubes were placed in all three groups before,1 and 24 h after surgery.The incidence,National Institutes of Health stroke scale (NIHSS) score and modified Rankin scale (mRS) score were compared among the three groups.Results The occurrence time of pulmonary infection in group A was shorter than that in group B and group C,and the difference was statistically significant (P＜0.05).The incidence of pulmonary infection,gastrointestinal hemorrhage and hypoproteinemia in group A were lower than that in group B and group C,and the differences were statistically significant (P＜0.017).There was no significant difference in NIHSS score on the 7 d after admission among the three groups (P＞0.05).NIHSS score of group A was lower than that of group B and group C after 3 months of admission,and the difference was statistically significant(P＜0.05).The mRS score of group A at 3 months after admission was lower than those of group B and group C,and the difference was statistically significant(P＜0.05).Conclusion In the endovascular treatment of acute anterior circulation great artery occlusive cerebral infarction,nasal feeding before operation can reduce the incidence of lung infection,help to promote the recovery of neurological function and improve life status of patients,and the overall application effect is good,worthy of promotion and application.

Objective To explore the effect of group intervention based on gestalt therapy on depression status,social function,and quality of life in patients with the depressive disorders.Methods A total of 84 patients with depressive disorder admitted to the Zibo Mental Health Center from April 2021 to October 2022 were selected as the study objects,they were divided into control group(n=42)and observation group(n=42)by random number table method.The control group received routine care for depressive disorder,and the observation group received group intervention based on gestalt therapy on the basis of the control group.Depression status,social function and quality of life were compared between the two groups.Results After intervention,the depression score of the observation group patients was lower than that of the control group,and the difference was statistically significant (P＜0.05).The social function score of the observation group patients was higher than that of the control group,and the difference was statistically significant (P＜0.05).The score of physiological domain,psychological domain,social relationship domain,environmental domain and total score in the observation group were higher than those in the control group,and the differences were statistically significant (P＜0.05).Conclusion The application of group intervention based on gestalt therapy can help reduce negative emotions in patients with depression,improve their psychological state and social function,and effectively promote the improvement of their quality of life.

 Objective To investigate the effect of circadian rhythm imbalance of blood pressure on renal tubules in type 2 diabetes mellitus (T2DM) patients without hypertension or renal damage by observing the indexes of urinary renal tubule-related injury.Methods A total of 100 T2DM patients admitted to the Department of Nephrology,Hexin Hospital and Weifang Endocrinology and Metabolic Disease Hospital from January 2022 to October 2023 were selected as research subjects.According to the results of 24 h ambulate blood pressure monitoring,they were divided into arytenotype blood pressure group (45 cases) and non-arytenotype blood pressure group (55 cases).Urinary β2-microglobulin (β2-MG),retinol-binding protein (RBP),N-acetyl-β-D-glucosidase (NAG) to urine creatinine (UCr) ratio,the ratio of diurnal urine volume and urinary specific gravity between the two groups were compared.Results The urinary ratios of β2-MG,RBP,NAG and UCr in non-arytenotype blood pressure group were higher than those in arytenotype blood pressure group,and the differences were statistically significant (P＜0.05).There were no significant differences in the ratio of diurnal urine volume and urinary specific gravity between the two groups (P ＞0.05).Conclusion The circadian rhythm imbalance of blood pressure can damage the proximal renal tubules in T2DM patients,but has no significant effect on the distal renal tubules.The circadian rhythm imbalance of blood pressure can be used as a reference index of early kidney injury in diabetic patients.

 Objective To investigate the effect of Roxadustat in the treatment of renal anemia and its influence on quality of life.Methods A total of 96 patients with renal anemia admitted to the Department of Nephrology,the Central Hospital of Shaoyang from September 2021 to January 2023 were selected as the research subjects,and they were divided into the reference group(48 cases)and the study group(48 cases)according to random drawing method.The reference group was treated with erythropoietin combined with iron sucrose,and the study group was treated with Roxadustat.The quality of life,anemia index,iron metabolism index,incidence of adverse reactions and Montreal cognitive assessment (MoCA) score were compared between the two groups.Results Before medication,there were no significant differences in quality of life,anemia indexes and iron metabolism indexes between two groups(P＞0.05).After medication,the quality of life,anemia indexes and iron metabolism indexes of patients in two groups were higher than those before medication,and the quality of life,anemia indexes and iron metabolism indexes of patients in the study group were higher than those in the reference group,with statistical significances (P＜0.05).The total incidence of adverse reactions in the study group was lower than that in the reference group,and the difference was statistically significant (P＜0.05).After medication,the total effective rate of the study group was higher than that of the reference group,and the difference was statistically significant (P＜0.05).Before medication,there were no significant differences in MoCA scores between the two groups (P＞0.05).After medication,the MoCA scores of the two groups were higher than those before medication,and the MoCA score of the study group was higher than that of the reference group,with statistical significances(P＜0.05).Conclusion Roxadustat can improve the quality of life of patients with renal anemia,and the indexes of anemia and iron metabolism can be improved in a short time,which is conducive to the remission of patients'disease.

 Objective To investigate the effect of moxibustion combined with Irbesartan Tablets on diabetic nephropathy(DKD)patients in stage Ⅲand Ⅳ.Methods A total of 80 DKD patients treated in Jiujiang Hospital of Traditional Chinese Medicine from August 2020 to August 2021 were selected as the study objects,and were divided into control group and observation group by random number table method,with 40 cases in each group.The control group was treated with basic treatment and oral Irbesartan Tablets,and the observation group was added with moxibustion.The clinical efficacy,traditional Chinese medicine syndrome score,blood glucose level,inflammatory factor level,biochemical indexes and adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation 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 observation group after treatment were lower than those of the control group,and the differences were statistically significant(P＜0.05).In terms of blood glucose,fasting blood glucose(FPG)and 2 h postprandial blood glucose(2 hPG)were lower than those in control group,with statistical significances (P＜0.05).In terms of inflammatory factors,the levels of tumor necrosis factor α (TNF-α),hypersensitive C-reactive protein (hs-CRP)and interleukin-6 (IL-6)were lower than those of control group,with statistical significances (P＜0.05).In terms of biochemical indexes,the levels of urea nitrogen (BUN),blood creatinine (Scr),24 h urinary protein quantity (mALB),urinary microalbumin (MAU),urinary albumin/creatinine ratio(ACR)and urinary retinol binding protein(RBP)were lower than those of control group,and the differences were statistically significants (P＜0.05).No obvious adverse reactions were observed in the two groups.Conclusion The application of moxibustion combined with Irbesartan Tablets in the treatment of patients with DKD Ⅲand Ⅳcan improve blood glucose level and renal function,relieve clinical symptoms,reduce inflammatory reaction,with exact effect and good safety,which is worthy of promotion.

Objective To study the impact of 25G type fine target color ultrasound guidance on the satisfaction rate of thyroid nodule puncture specimens under blood rich thyroid nodules.Methods A total of 80 patients who underwent thyroid nodule fine needle puncture in Ganzhou Cancer Hospital from January 2022 to August 2023 were selected as the study objects.All patients underwent thyroid nodule puncture examination guided by color ultrasound.The satisfaction rate of thyroid nodule puncture specimens with 22G and 25G fine needle and the satisfaction rate of thyroid nodule puncture specimens with rich blood supply were compared.Results There was no statistically significant difference in satisfaction rates between 22G and 25G fine needle puncture specimens(P＞0.05).The satisfaction rate of puncture specimens with rich blood supply nodules using 25G fine needles (94.55%) was higher than that using 22G fine needles (81.82%),with a statistically significant difference (P＜0.05).There was no statistically significant difference in the satisfaction rate between 22G and 25G fine needle non blood rich nodule puncture specimens (P＞0.05).Conclusion The use of 25G fine needle puncture for blood rich thyroid nodules under color ultrasound guidance has a higher sample satisfaction rate.

Objective To explore the clinical effect of self-made Gout Fracture Ointment applied externally in the treatment of acute gouty knee osteoarthritis.Methods A total of 90 patients with acute gouty arthritis admitted to Qinzhou Hospital of Traditional Chinese Medicine from January 2022 to August 2023 were selected as the study objects.They were divided into a control group(45 cases)and a study group(45 cases)according to the random number table method.The control group was treated with Vaseline for external application,while the study group was treated with Gout Fracture Ointment for external application.The total effective rate,serum inflammatory factor indicators,pain score,knee joint function score and score of life quality were compared between the two groups.Results 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).After treatment,the average levels of serum C-reactive protein and procalcitonin in the study group were lower than those in the control group,the pain score of the study group was lower than that of the control group,while the knee joint function score and quality of life score of the study group were higher than those of the control group,and the differences were statistically significant (P＜0.05).Conclusion For patients with acute gouty arthritis,applying Gout Fracture Ointment externally can reduce joint inflammation in patients,alleviate pain,improve knee joint function,and have a significant therapeutic effect,which is beneficial for improving their quality of life.

Objective To observe the clinical efficacy of extracorporeal shock wave(ESWT)combined with Mulligan technique in the treatment of early to middle stage knee osteoarthritis(KOA)in elderly patients.Methods From July 2021 to December 2022,a total of 96 elderly patients with KOA admitted to the Rehabilitation Medicine Department of Changzhou Wujin People's Hospital were selected as the study objects.They were divided into the control group and the observation group with 48 cases each according to the random number table method.The control group received extracorporeal shock wave therapy,while the observation group received extracorporeal shock wave therapy combined with Mulligan technique.The visual analogue scales (VAS),joint swelling scores,range of motion (ROM),and The Western Ontario and McMaster Universities(WOMAC)osteoarthritis index scores were observed before and after a course of treatment in both groups.Results After one course of treatment,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).After one course of treatment,the VAS,joint swelling scores,and WOMAC scores in the observation group were lower than those in the control group,and the knee joint ROM was higher than that in the control group,and the differences were statistically significant(P＜0.05).Conclusion The combination of extracorporeal shock wave and Mulligan technology can better improve pain and mobility in the early and middle stages of KOA patients.

 Objective To explore the effectiveness of early treatment of hemodynamically unstable pelvic fractures led by trauma physicians using multidisciplinary team (MDT) approach.Methods A total of 280 patients with hemodynamically unstable pelvic fractures from July 2020 to July 2023 admitted to Beijing Jishuitan Hospital Guizhou Hospital were selected as the study objects.They were divided into observation group (140 cases)and control group (140 cases).The observation group was treated with MDT model guided by trauma physicians,while the control group received traditional treatment.The mortality rate,vital signs at admission and after admission,laboratory indicators,treatment conditions,and diagnostic and treatment times were compared between the two groups.Results The mortality rates within 24 hours after admission between the two groups showed no significant statistical differences(P＞0.05).There were no significant differences in systolic blood pressure,heart rate,hemoglobin,platelet count,and blood lactate levels at admission between the two groups(P＞0.05).At 6 hours and 24 hours after admission,the systolic blood pressure of the observation group was higher than that of the control group,and the heart rate of the observation group was lower than that of the control group,and the differences were statistically significant (P＜0.05).At 24 hours after admission,the hemoglobin and platelet counts of the observation group were higher than those of the control group,and the blood lactate levels of the observation group were lower than those of the control group,and the differences were statistically significant (P＜0.05).The transfusion volume of the observation group was lower than that of the control group,and the ICU stay duration,emergency department throughput time,and early treatment time were shorter than those of the control group,and the differences were statistically significant (P＜0.05).Conclusion The MDT model led by trauma physicians can effectively improve the stability of vital signs in patients with hemodynamically unstable pelvic fractures and shorten related treatment times.

Objective To investigate the effect of cocktail therapy combined with enhanced recovery after surgery (ERAS)concept in the perioperative period of patients with fractures around the knee (FAK).Methods The clinical data of 86 patients with FAK admitted to the Department of Orthopedics,Tianshui Fourth People's Hospital from January 1,2020 to December 31,2022 were retrospectively analyzed,and they were divided into two groups according to time.The patients collected from January 1,2020 to June 30,2021 were included in the control group (n=44),and were given ERAS intervention during the perioperative period and injected with the same dose of normal saline at the same site during the operation.Patients collected from July 1,2021 to December 31,2022 were included in the study group (n=42),and ERAS intervention was given during the perioperative period and cocktail local injection was performed during the operation.The operation related indicators,postoperative complications and postoperative hospital stay were observed and compared between the two groups.The visual analogue scale(VAS)score and knee active range of motion(AROM)at each time point before and after operation were compared between the two groups.The satisfaction of perioperative analgesic effect and the use of opioid analgesia within 12 h after operation were compared between the two groups.Results All patients in the two groups successfully completed the operation,and no serious postoperative complications occurred.The postoperative hospital stay of the study group was shorter than that of the control group,and the difference was statistically significant(P＜0.05).At each time point after operation,the VAS score of the study group was lower than that of the control group,and the AROM was higher than that of the control group,and the differences were statistically significant(P＜0.05).The satisfaction of postoperative analgesia in the study group was better than that in the control group,and the difference was statistically significant (P＜0.05).The rescue of opioid analgesia in the study group was less than that in the control group within 12 h after surgery,and the difference was statistically significant (P＜0.05).Conclusion Cocktail therapy combined with ERAS concept can reduce the use of opioids and effectively relieve the early postoperative pain of FAK patients,which is helpful for early postoperative rehabilitation,accelerated the recovery of knee joint function,and shortened the length of hospital stay.

Objective To discuss and analyze the effects and mechanisms of the Notch1/Hes1 pathway discussing and analyzing the influence and differentiation of lung cancer stem cell proliferation and differentiation.Methods Sixty lung cancer patients admitted to the Respiratory and Critical Care Medicine Department of Xinyu People's Hospital in Jiangxi Province from January 2020 to December 2022 were selected for this clinical practice study.Lung cancer stem cells A549(A549-SCs)were isolated and cultured from the patients,and flow cytometry was used to identify A549 CSCs for detection and screening of lung cancer stem cells.The selected lung cancer stem cells were divided into control group and observation group using random number table method,with 30 cases in each group.The control group was not treated with any treatment,while the observation group was treated with Temozolomide.The inhibition of lung cancer stem cell viability,impact on lung cancer stem cell migration ability,and mRNA levels of cell differentiation ability related factors Sox2 and Oct4 in A549 CSCs were compared between the two groups.Results The mRNA and protein expression levels,Notch1 and Hes1 protein expression levels of lung cancer stem cells in the observation group were lower than those in the control group,and the mRNA levels of cell differentiation ability related factors Sox2 and Oct4 in A549-CSCs in the observation group were lower than those in the control group,and the differences were statistically significant (P ＜0.05).Conclusion From the perspective of the Notch1/Hes1 pathway,Temozolomide,has an effect of inhibiting the proliferation and differentiation of lung cancer stem cells for lung cancer,and the above effect is achieved by inhibition of lung cancer stem cell Sox2,Oct4,and mRNA protein expression.

Objective Based on Zhangjiagang Hospital Affiliated to Soochow University's mobile pharmacist workstation,design and construct an anti-tumor drug adverse reaction risk warning module.Methods A monitoring drug catalog and a knowledge base for adverse reactions of anti-tumor drugs was established.Based on the intelligent management system for rational drug use on mobile pharmacist workstations,an anti-tumor drug adverse reaction risk warning module was added.Laboratory data and disease course descriptions were quickly and accurately captured,and abnormal indicators and issue reminders to clinical pharmacist work stations were identified.Results Implanting a risk warning module for adverse reactions of anti-tumor drugs in mobile pharmacist workstations solved the drawbacks of heavy workload,high professional requirements,and easy omission in monitoring adverse reactions of clinical pharmacists.It helped clinical physicians and nursing staff to timely obtain patient adverse reaction information,so as to closely carry out clinical observation and follow-up.Conclusion The anti-tumor drug adverse reaction risk warning module established helps to improve the ability of quickly responding.Thus，it has clinical promotion value.

 Objective To explore the clinical effect of postoperative synchronous adjuvant chemordiotherapy for breast cancer patients.Methods A total of sixty patients with breast cancer admitted to Heze Peony People's Hospital from February 2020 to August 2022 were selected as the study objects.According to the random number table method,they were divided into the reference group(30 cases)and the study group(30 cases).The reference group was treated with postoperative adjuvant sequential therapy,while the study group was treated with postoperative adjuvant chemoradiotherapy.The rate of distant metastasis,local recurrence rate,disease-free progression rate,duration of radiotherapy and chemotherapy,initiation time of radiotherapy,and total incidence of adverse reactions(gastrointestinal reactions,leukopenia)were compared between the two groups.Results There were no significant differences in the rate of distant metastasis,local recurrence and no disease progression in the study group compared with the reference group (P＞0.05).The whole treatment time of radiotherapy and chemotherapy in the study group was shorter than that in the reference group,and the difference was statistically significant(P＜0.05).The total incidence of adverse reactions (gastrointestinal reactions,leukopenia)in the study group was compared with that in the reference group,and the difference was not statistically significant (P＞0.05).The total effective rate in the study group was higher than that in the reference group,and the difference was statistically significant (P＜0.05).Conclusion Clinical use of synchronous adjuvant chemoradiotherapy for postoperative treatment of breast cancer patients can effectively shorten the whole treatment time of chemoradiotherapy and the start time of radiotherapy compared with conventional sequential therapy,and there are no significant differences in the rate of distant metastasis,local recurrence rate,disease-free progression rate and total incidence of adverse reactions.The value of simultaneous adjuvant chemoradiotherapy in postoperative treatment of breast cancer patients is further explained.

Objective To investigate the clinical observation of low molecular weight heparin(LMWH)combined with Docetaxel in second-line treatment of advanced non-small cell lung cancer(NSCLC)with negative driver genes.Methods A total of 100 patients with advanced NSCLC who met the criteria and were admitted to Yantai Shan Hospital from October 2017 to September 2020 were selected as study objects,and they were divided into study group and control group according to the random number table method,with 50 cases in each group.The study group was treated with Docetaxel chemotherapy combined with LMWH.The control group was treated with Docetaxel monotherapy until disease progression or adverse reactions became intolerable.The therapeutic effect,changes of coagulation function and adverse reactions were compared between the two groups.Results There was no significant difference in the objective remission rate between the two groups after 2 cycles of treatment (P＞0.05).After treatment,the disease control rate of the study group was higher than that of the control group,and the difference was statistically significant (P＜0.05).After treatment,the D-dimer and fibrinogen（FIB）in the study group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The incidence of deep vein thrombosis in the study group was lower than that in the control group,and the difference was statistically significant (P＜0.05).There were no significant differences in the adverse reactions between the two groups (P＞0.05).Conclusion LMWH combined with Docetaxel for second-line treatment of driver gene-negative advanced NSCLC good short-term efficacy,can improve the short-term disease control rate,improve coagulation function,reduce the occurrence of venous thrombosis.

 Objective To explore the clinical value of multidisciplinary team (MDT)diagnosis and treatment mode in improving the maternal and fetal outcomes of placental previa with placental implantation.Methods A retrospective analysis was conducted on the clinical data of 281 patients with placenta previa and placental implantation who delivered at Jiangxi Maternal and Child Health Hospital from January 2017 to December 2022.According to whether MDT was performed before cesarean section,there were 152 cases in the MDT group and 129 cases in the non-MDT group.The diagnostic accuracy of placenta accreta site before cesarean section,preoperative pretreatment,and maternal and fetal pregnancy outcomes were compared between the two groups.Results The preoperative diagnosis coincidence rate of placenta implantation site in the MDT group was higher than that in the non-MDT group,the abdominal aortic balloon occlusion rate and ureteral catheterization rate in the MDT group were higher than those in the non-MDT group,and the intraoperative blood loss,bleeding＞2 000 ml rate,red blood cell transfusion volume and hysterectomy rate in the MDT group were lower than those in the non-MDT group,and the differences were statistically significant (P＜0.05).Conclusion MDT diagnosis and treatment mode can improve the accuracy of preoperative diagnosis of placenta previa with placenta accreta,help surgeons to develop individualized and precise treatment plans,and effectively reduce the amount of intraoperative blood loss,blood transfusion and reduced hysterectomy rate in patients with placenta accreta,which has certain clinical value in improving the pregnancy outcome of mother and child.

Objective To explore the clinical value of laparoscopic percutaneous single channel puncture internal ring high ligation by extradural-puncture needle with double-color suture in the treatment of inguinal hernia in children.Methods A total of 514 cases of inguinal hernia with complete data who underwent percutaneous peritoneal peritoneal circumferential ligation under laparoscopy in the Department of Pediatric Surgery,Pingxiang People's Hospital from July 2019 to July 2022 were selected as the study objects.According to the difference of single and double channel puncture,they were divided into double-channel puncture group(273 cases)and single-channel puncture group (241 cases).From July 2019 to May 2021,epidural needle and thread percutaneous double channel puncture were used to complete epitoneal ligation.From June 2021 to July 2022,patients were treated with epidural needle with bicolor thread and single channel percutaneous puncture to complete epitoneal ligation.Unilateral/bilateral,operation time,puncture point induration,line knot response,groin pain and recurrence rate were compared between the two groups.Results There were no statistically significant differences in the rates of postoperative groin pain and hernia recurrence between the two groups (P＞0.05).The operation time of the single-channel puncture group was shorter than that in the double-channel puncture group,incidence of puncture point indentation and linear knot reaction in the single-channel puncture group were lower than those in the double-channel puncture group,with statistically significant differences (P＜0.05).Conclusion Percutaneous epidural needle with bicolor thread ligation under laparoscope is a safe and effective surgical method for the treatment of inguinal hernia in children,which can simplify operation,shorten operation time,reduce the incidence of puncture point induration and knot reaction,and is beneficial to popularize in basic hospitals.

 Objective To explore the application effect of traditional Chinese medicine fumigation in the treatment of children with elbow dysfunction after humeral supracondylar fracture.Methods A total of 70 children with elbow dysfunction after humeral supracondylar fracture who were treated in Ganzhou Women and Children's Health Care Hospital from May 2022 to May 2023 were selected as the research objects,and they were classified into experimental group (n=35)and control group(n=35)by using the random number table method.The control group received simple manipulation massage combined with elbow function exercise after plaster removal,and the experimental groupwas given traditional Chinese medicine fumigation based on the control group.Both groups were treated for 4 weeks.The elbow function recovery status (Flynn elbow clinical evaluation criteria),scores of traditional Chinese medicine syndromes (elbow pain,elbow stiffness,elbow activity limitation,fatigue and weakness),recovery time(disappearance time of swelling pain,fracture healing time,complete recovery time of elbow function)and occurrence of complications(cubitus varus,forearm ischemic muscle contracture,radial nerve injury)were compared after 4 weeks of treatment.Results After treatment,the excellent and good rate of elbow joint function in experimental group was higher than that in control group,and the difference was statistically significant (P＜0.05).The scores of traditional Chinese medicine syndrome of elbow pain,elbow stiffness,elbow activity limitation,fatigue and weakness in experimental group were lower than those in control group after treatment,and the differences were statistically significant (P＜0.05).After treatment,the disappearance time of swelling pain,fracture healing time,complete recovery time of elbow function of experimental group were lower than those of control group,and the differences were statistically significant(P＜0.05).The total complication rate of experimental group was lower than that of control group,and the difference was statistically significant (P＜0.05).Conclusion Traditional Chinese medicine fumigation can effectively improve the elbow function after humeral supracondylar fracture and reduce the possibility of complications.

Objective To explore the effect of 5-aminolevulinic acid photodynamic therapy(ALA-PDT)combined with interferon suppository on clearance rate of human papilloma virus (HPV)and vaginal microenvironment in patients with persistent high-risk HPV infection.Methods A total of 80 patients with persistent high-risk HPV infection in Jingdezhen NO.1 People's Hospital were enrolled as the research objects from January 2020 to January 2023.According to random number table method,they were divided into control group and observation group,with 40 cases in each group.The control group was treated with interferon suppository,and the observation group was treated with interferon suppository combined with ALA-PDT.The changes in viral load,HPV clearance rate,density and diversity of floras,dominant bacteria,vaginal pH,Nugnet scores,and recurrence rate within 6 months in both groups were observed.Results After treatment,viral load in observation group was lower than that in control group,and HPV clearance rate was higher than that in control group,with statistically significant differences(P＜0.05).After treatment,the normal rate of flora density,the normal rate of flora diversity,and the health rate of dominant flora in the observation group were higher than those in the control group,and the differences were statistically significant (P＜0.05).After treatment,the vaginal pH and Nugnet score in observation group were lower than those in control group,with statistically significant differences (P＜0.05).The recurrence rate within 6 months in observation group was lower than that in control group,with a statistically significant difference (P ＜0.05).Conclusion ALA-PDT combined with interferon suppository can increase HPV clearance rate,improve vaginal microenvironment and reduce recurrence rate in patients with persistent high-risk HPV infection.

 Objective To explore the relationship between the occurrence of post-stroke depression(PSD)and the echogenicity of the brainstem raphe (BR),and exploring the diagnostic value of abnormal echogenicity of the BR for PSD.Methods A total of 240 stroke patients admitted to the Department of Neurology,Luoyang Central Hospital from January to August 2023 were selected as study objects,they were divided into PSD group and non-post stroke depression(NPSD)group according to Hamilton depression scale score.Transcranial ultrasound (TCS) examination was performed respectively,and the general and ultrasonic data between the two groups were compared.Results There was no significant difference in gender,age,disease course,hypertension history,coronary heart disease history,diabetes history,smoking and drinking history,the positive rate of substantia nigra (SN)and the widening rate of the third ventricle (V3)between the two groups (P＞0.05).There were significant differences in education level,stroke frequency,National Institutes of Health stroke scale (NIHSS)score,activity of daily living Barthel index (BI)score and BR positive rate between the two groups (P＜0.05).Multivariate logistic regression analysis showed that BI index (OR=1.847,95%CI: 1.01-2.79,P＜0.001) and BR positive (OR=4.432,95%CI: 1.15-8.96,P＜0.001) were independent risk factors for PSD.ROC curve analysis showed that the AUC of the combined diagnosis of PSD was 0.881 (95%CI:0.83-0.94).Conclusion BR positive can be used as an auxiliary diagnostic index for PSD,and BI index combined can improve the diagnostic efficiency.

Objective To explore the evaluated effect of shear wave elastography (SWE)combined with contrast-enhanced ultrasound on testicular spermatogenic function.Methods Fifty patients with anspermia treated in Guangzhou Panyu Central Hospital from January to December 2022 were included in the anspermia group,and 50 patients with asthenospermia were enrolled as asthenospermia group,and 100 normal healthy males who came to the hospital for physical examination during the same period were collected as control group.SWE and contrast-enhanced ultrasound were performed in all three groups to compare the mean elastic modulus(Emean)and the difference of each contrast-enhanced ultrasound parameter among all groups,and ROC curve was used to analyze the prediction efficiency of Emean and each contrast-enhanced ultrasound parameter on testicular spermatogenic dysfunction.Results The Emean,arriving time(AT)and time to peak(TTP)in anspermia group were higher than those in asthenospermia group and control group,and the peak intensity(PI)was lower than that in asthenospermia group and control group,the differences were statistically significant (P＜0.05).ROC curve analysis showed that the combined detection of Emean,AT,TTP,PI and the above indexes had predictive value for testicular spermatogenic dysfunction(P＜0.05),among which the combined detection had the highest predictive value,with AUC of 0.887,sensitivity of 74.00%and specificity of 94.55%.Conclusion Both SWE and contrast-enhanced ultrasound have predictive value on testicular spermatogenic function,and their combination has a higher predictive value on testicular spermatogenic function abnormality.

Objective To explore the clinical effect of external application of traditional Chinese medicine combined with acupuncture in the treatment of knee osteoarthritis with wind cold dampness type.Methods Sixty patients with wind cold dampness type of knee osteoarthritis in Pingxiang Hospital of Traditional Chinese Medicine from January 2021 to June 2023 were selected as the study objects,and were divided into control group and observation group by random number table method,with 30 cases in each group.The control group was treated with acupuncture,and the observation group was treated with external application of traditional Chinese medicine on the basis of control group.The clinical efficacy,recovery time of joint function,improvement degree of joint pain,and changes of traditional Chinese medicine syndrome scores,Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores before and after treatment were compared between the two groups.Results The total clinical effective rate of the observation group after the end of the treatment course was 96.67%,which was higher than 76.67%in the control group,with statistically significant difference(P＜0.05).The recovery time of joint function in the observation group was shorter than that in the control group,and the difference was statistically significant (P＜0.05).The excellent and good rate of joint pain improvement in the observation group was 86.67%,which was higher than 50.00%in the control group,with statistically significant difference(P＜0.05).After treatment,the scores of limited mobility,joint cold pain,and knee joint pain in the observation group were lower than those in the control group,with statistically significant differences(P＜0.05).After treatment,the pain score,stiffness score,and difficulty score of daily activities in the observation group were lower than those in the control group,with statistically significant differences (P＜0.05).Conclusion The combination of traditional Chinese medicine external application and acupuncture has a significant therapeutic effect on knee osteoarthritis of wind cold dampness type,which can effectively improve the knee joint function of patients and is worthy of clinical recommendation.

Objective To observe the clinical effect of self-made＂Bi Zheng No.1＂ Fumigation Prescription combined with western medicine on early mild and moderate rheumatoid arthritis patients.Methods A total of 140 patients with early mild to moderate rheumatoid arthritis treated in the Department of Rheumatology and Immunology,Dalian Municipal Central Hospital from January 1,2021 to December 31,2022 were selected as the research subjects.They were divided into fumigation group(70 cases)and non-fumigation group(70 cases)according to random number table method.The fumigation group was treated with the ＂Bi Zheng No.1＂ Fumigation Prescription combined with conventional western medicine,while the non-fumigation group was treated with conventional western medicine.The clinical indicators such as joint symptoms,signs,morning stiffness time,visual analogue scale (VAS)score,health assessment questionnaire (HAQ)and the medical outcomes study 36-item short form health survey(SF-36)were compared between the two groups before and after treatment.Rheumatoid factor (RF),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),interleukin-1 (IL-1),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),interleukin-4 (IL-4),interleukin-10 (IL-10),hand joint ultrasound score,disease activity score 28(DAS 28),simplified disease activity index(SDAI),clinical disease activity index(CDAI) and other indicators were detected in the two groups.Results After 12 weeks of treatment,the tender joint counts (TJC),swollen joint counts (SJC),and hand joint ultrasound scores of the fumigation group were lower than those of the non-fumigation group,and the differences were statistically significant (P＜0.05).After 4 and 12 weeks of treatment,the VAS score,HAQ score and DAS 28 score of the fumigation group were lower than those of the non-fumigation group,and the SF-36 score was higher than that of the non-fumigation group,and the differences were statistically significant (P＜0.05).The SDAI and CDAI of the fumigation group were lower than those of the non-fumigation group after 12 weeks of treatment,and the differences were statistically significant (P＜0.05).After 12 weeks of treatment,CRP in the fumigation group was lower than that in the non-fumigation group,and the difference was statistically significant (P＜0.05).There were no statistically significant differences in RF,IL-1,IL-6,TNF-α,IL-4 and IL-10 between the two groups before treatment and at 4 and 8 weeks after treatment (P＞0.05).The total effective rate of the fumigation group was higher than that of the non-fumigation group,and the difference was statistically significant(P＜0.05).Conclusion ＂Bi Zheng No.1＂Fumigation Prescription has significant clinical effect in the treatment of early mild to moderate rheumatoid arthritis,with obvious anti-inflammation,swelling and analgesic effect.

 Objective To explore the effect of acupuncture at different time points on acute peripheral facial paralysis.Methods The clinical data of 97 patients with acute peripheral facial paralysis admitted to the Nantong Fourth People's Hospital from June 2021 to June 2023 were retrospectively analyzed.According to the timing of acupuncture treatment,they were divided into observation group(n=46)and control group(n=51).The observation group received early treatment(within 24 h),and the control group received late treatment (within 1～7 d).The therapeutic effect,symptom score,symptom remission time,quality of life and adverse reactions were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups (P＞0.05).The improvement time of frontal striae disappearance,expression muscle movement,eyelid closure and mouth skew symptom in observation group were shorter than those in control group,the differences were statistically significant(P＜0.05).There were no significant differences in the scores of facial expression,frontal stripe disappearance,mouth skew and eyelid closure between the two groups before treatment (P＞0.05).After treatment,the facial expression and frontal striae disappearance scores of the observation group were lower than those of the control group,and the differences were statistically significant (P＜0.05).There was no significant difference between the two groups in the eight dimensions of 36-item short form survey (SF-36)before treatment (P＞0.05).After 1 month of follow-up,the SF-36 scores of the two groups were higher than those before treatment,with statistical significance (P＜0.05),the scores of physical function,health limitation,vitality and mental health of the observation group were higher than those of the control group,with statistical significance(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05).Conclusion Acupuncture in traditional Chinese medicine is an effective method to treat peripheral facial paralysis,and early treatment is more ideal in improving symptoms and quality of life of patients.

There are variations in the development pace and conceptualizations of medical morphological experimental disciplines across different universities.Each of these disciplines possesses distinct characteristics and focuses on diverse content,leading to certain constraints in separating experiments within each field.However,adopting a systems-based approach makes it evident that integrating various morphological experimental disciplines and establishing a digital slide library organized by organ systems is rational.This meets the concept of＂New Medical Science.＂From the perspective of experimental teaching,this measure reduces the loss of actual slides and provides convenience for preserving rare or difficult-to-obtain slides for future,and plays a supporting role in the development of various disciplines.Additionally,it provides a reference for similar disciplines.Simultaneously,Constructing a digital slice library of medical morphology can achieve the integration of multidisciplinary knowledge such as function and morphology,micro and macro,physiology and pathology,diagnosis and treatment,and help cultivate students' comprehensive qualities.Furthermore,Promoting interdisciplinary integration,integrating basic medicine with clinical practice,leading the development of medical education towards a blended online and offline teaching model,and enhancing the quality of medical education.

Objective To explore the application effect of flipped classroom blended teaching model in the training of community nurses with pressure injury (PI).Methods A total of 100 nurses in the Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Nanchang University from January 2022 to January 2023 were selected as the research objects and divided into the observation group (50 cases)and the control group (50 cases)according to the random number table method.The observation group adopted the blended teaching mode of flipped classroom,while the control group adopted the traditional teaching mode.The PI new stage mastery,assessment results,core competence and teaching satisfaction of the two groups were compared before and after the training.Results There was no significant difference in the mastery of PI new stage between the two groups before training (P＞0.05).The mastery rate of PI new stages in the observation group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The average scores in theory and operation of the observation group were higher than those of the control group,and the difference was statistically significant(P＜0.05).The scores of professional development ability,community nursing practice ability,critical thinking ability,legal ethics practice ability and communication and coordination ability of the observation group were higher than those of the control group,and the differences were statistically significant(P＜0.05).The teaching satisfaction of the observation group was higher than that of the control group,the difference was statistically significant(P＜0.05).Conclusion The implementation of flipped classroom mixed teaching mode for PI training of community nurses can effectively deepen the mastery of PI new stage related knowledge,improve assessment results,core competence,and enhance their teaching satisfaction.

The purpose of this research is to explore the training mode of oral nursing professionals in Chinese-foreign cooperative schools,deeply analyze the problems existing in the current education mode of oral nursing majors in China,and study the current situation of oral nursing majors at home and abroad.Based on the introduction of high-quality international educational resources and oral care professional certification system,this research explores the ideas and methods of oral care professional talent training suitable for China's actual needs,puts forward a new mode of talent training aiming at post skill requirements,optimizes the evaluation of education effects,evaluates the problems arising in the implementation process,and optimizes and adjusts the talent training program.It will better improve the quality of Chinese-foreign cooperation in medical higher vocational colleges and the level of oral nursing talents.

Objective To investigate the nursing effect of extended nursing mode in patients with coronary heart disease(CHD) after percutaneous coronary intervention (PCI).Methods A total of 105 patients with CHD after PCI in the Fifth Ward of Department of Cardiology of Shanxi Cardiovascular Hospital from January to December 2022 were selected as the research objects,and they were divided into observation group(53 cases)and control group(52 cases)according to random number table method.The control group received routine nursing intervention,and the observation group received extended nursing mode intervention.After 6 months,the scores of blood lipid,uric acid,cardiac function,self-care ability and quality of life were compared between the two groups after intervention.Results After intervention,the 6 min walking test(6MWT),exercise of self-care agency scale (ESCA)scores and total scores,and Seattle angina questionnaire (SAQ)indexes(except angina attack frequency score)of observation group were higher than those of the control group,with statistical significances(P＜0.05).The total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) and uric acid (UA) in observation group were lower than those in control group,and the differences were statistically significant (P＜0.05).Conclusion The application of extended nursing mode in CHD patients after PCI is effective,which can effectively improve the patients'heart function,blood lipid,self-care ability and quality of life.

 Objective To analyze the influence of focused solution nursing mode on Psychological resilience level and self-care ability of patients with acute myocardial infarction.Methods A total of 100 first-episode acute myocardial infarction patients admitted to Jiangxi Provincial People's Hospital from February 2022 to March 2023 were selected as the study objects,and they were divided into control group and experimental group according to the order of admission,with 50 patients in each group.The control group adopted the conventional nursing mode,and the experimental group adopted the focused solution nursing mode.The level of psychological resilience,self-care ability,and the incidence of cardiovascular adverse events in the two groups were observed after intervention.Results After intervention,the scores of psychological resilience in experimental group were higher than those in control group,and the difference was statistically significant (P＜0.05).After intervention,the scores of all dimensions of self-care ability in test group were higher than those in control group,and the differences were statistically significant (P＜0.05).The total incidence of cardiovascular adverse events in experimental groups was lower than that in control group,and the difference was statistically significant(P＜0.05).Conclusion Compared with the conventional nursing mode,the focused solution nursing mode can improve the psychological resilience level of the first acute myocardial infarction patients,improve the self-care ability of patients,reduce the incidence of cardiovascular adverse events,and improve the prognosis of patients,which is worthy of clinical application.

Objective To explore the application effect of evidence-based nursing model combined with peer support intervention in patients with acute myocardial infarction (AMI).Methods A total of 172 AMI patients admitted to Liwan Central Hospital of Guangzhou from January 2021 to December 2022 were selected as the study subjects.They were divided into a control group(86 cases)and an observation group(86 cases)by a random number table method.The control group received routine care,while the observation group implemented an evidence-based nursing model combined with peer support intervention.Both groups continued to receive care until the patient was discharged.The nursing outcomes (psychological state,self-efficacy,quality of life,nursing satisfaction) were compared between the two groups.Results The scores of self-rating depression scale(SDS)and self-rating anxiety scale(SAS)in the observation group were lower than those in the control group,and the scores of general self-efficacy scale (GSES) were higher than those in the control group,the differences were statistically significant(P＜0.05).The scores of the MOS item short from health survey(SF-36)in the observation group were higher than those in the control group,the difference was statistically significant(P＜0.05).The nursing satisfaction score of observation group was higher than that of control group,and the difference was statistically significant(P＜0.05).Conclusion The evidence-based nursing model combined with peer support intervention can alleviate the negative emotions of AMI patients,effectively enhance their self-efficacy,improve their quality of life,and thus enhance patient satisfaction.

Objective To explore the application effect of continuous nursing based on Omaha system in patients with bladder cancer undergoing urostomy.Methods From September 2022 to June 2023,a total of 48 patients with bladder cancer who were admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities were selected as the study subjects.They were divided into the control group(24 cases)and the observation group(24 cases)according to random number table method.The patients in the control group received routine care,while the patients in the observation group received continuous nursing based on the Omaha system.Both groups received continuous nursing observation for 3 months.The psychological status,supportive care needs,incidence of complications,and quality of life between two groups of patients were compared.Results The scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)of the observation group after nursing were lower than those of the control group,and the differences were statistically significant (P＜0.05).The supportive care needs survey short-form-34(SCNS-SF34)score and quality of life score 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 complications in the observation group (8.33%)was lower than that in the control group (33.33%),and the difference was statistically significant (P＜0.05).Conclusion Continuous nursing based on Omaha system can provide the corresponding care needs for bladder cancer patients with urostomy,effectively reduce the negative emotions of patients,reduce the incidence of complications,and improve the quality of life of patients.

Objective To explore the application effect of critical full-time nursing combined with improved posture management in patients with chronic obstructive pulmonary disease and respiratory failure(RF)undergoing mechanical ventilation(MV).Methods A total of 61 RF patients with chronic obstructive pulmonary disease admitted to Jiujiang NO.1 People's Hospital from January 2021 to January 2023 were selected as the research objects.According to random number table method,they were divided into control group(30 cases)and observation group(31 cases).Patients in the control group were received critical full-time nursing,while patients in the observation group were received critical full-time nursing combined with improved posture management.The cardiac function,blood gas indexes,clinical indexes,incidence of complications and incidence of ventilator-associated pneumonia (VAP) were compared between the two groups.Results There were no statistically significant differences in left ventricular ejection fraction (LVEF),forced expiratory volume in one second(FEV1),partial pressure of oxygen in arterial blood (PaO2) and partial pressure of carbon dioxide in arterial blood (PaCO2)between the two groups before nursing (P＞0.05).The LVEF,FEV1 and PaO2 of the two groups after nursing were higher than those before nursing,and PaCO2 of the two groups after nursing were lower than those before nursing,and the differences were statistically significant (P＜0.05).The LVEF,FEV1 and PaO2 of the observation group after nursing were higher than those of the control group,and PaCO2was lower than that of the control group,and the differences were statistically significant (P＜0.05).The mechanical ventilation time,ICU stay time and hospitalization time of the observation group were shorter than those of the control group,and the incidence of VAP and complications were lower than those of the control group,and the differences were statistically significant (P＜0.05).Conclusion The application of critical full-time nursing combined with improved posture management in chronic obstructive pulmonary disease and RF patients treated with MV can improve cardiac function and blood gas indexes,shorten the time of mechanical ventilation,ICU admission and hospitalization,and reduce the incidence of complications and VAP,which is worthy of promotion.

Objective To explore the application effect of timed moxibustion at Sanyinjiao on medical students with pre exam tension syndrome.Methods A total of one hundred college students from five different majors,including Clinical Medicine School,School of Pharmacy,School of Medical Imaging,School of Medical Technology,and School of Nursing,who were diagnosed with pre-exam tension syndrome two weeks before the final exam at Jiangxi Medical College in January and June 2022 were selected as the research subjects.They were divided into a control group (50 students)and an observation group (50 students)according to random number table method.The control group received routine care,while the observation group received timed moxibustion for Sanyinjiao care.A 7-day treatment course was used,and both groups were continuously intervened for 2 courses.The levels of exam anxiety,sleep quality,pulse rate,symptom scores,and nursing satisfaction between the two groups were compared.Results The results showed that there were no statistically significant differences(P＞0.05)in the scores of the Sarason test anxiety scale(TAS),Pittsburgh sleep quality index(PSQI),pulse rate,and symptom scores between the two groups before intervention.After intervention,the TAS score,PSQI score,pulse rate,and symptom score of the observation group were lower than those before intervention,and the differences were statistically significant (P＜0.05).And so were the control group.After intervention,the TAS score,PSQI score,pulse rate,and symptom score of the observation group were lower than those of the control group,with statistically significant differences (P＜0.05).The overall nursing satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion The application of timed moxibustion and Sanyinjiao nursing for medical students with pre-exam tension syndrome can improve exam anxiety levels,sleep quality,control pulse rate,alleviate clinical symptoms,and improve nursing satisfaction,which is worth promoting.

Objective To explore the application effect of individualized comprehensive urinary control management based on urodynamics and bladder safety capacity in patients with neurogenic bladder after spinal cord injury.Methods A total of sixty patients with neurogenic bladder after spinal cord injury admitted to Guangdong Provincial Work Injury Rehabilitation Hospital from July 2021 to July 2023 were selected as the study subjects.They were divided into observation group and control group using random number table method,with 30 cases in each group.The control group adopted urine control management based on urodynamics,while the observation group adopted individualized comprehensive urine control management guided by bladder volume scanners on the basis of the control group.Both groups continued to intervene and observe for 4 weeks.Urodynamic indicators,changes in neurogenic bladder symptoms,incidence of adverse events,urinary tract infections,and quality of life between two groups of patients were compared.Results The results showed that after intervention,the maximum urine flow rate,maximum urination volume,and detrusor pressure during filling period in the observation group were higher than those in the control group,while bladder pressure was lower than that in the control group,and the differences were statistically significant (P＜0.05).After intervention,the neurological bladder symptom scores 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 events and urinary tract infections in the observation group were lower than those in the control group,and the differences were statistically significant (P＜0.05).The observation group's health survey summary table（the MOS item short from health survey，SF-36）after intervention showed higher scores than the control group,and the differences were statistically significant (P＜0.05).Conclusion A personalized urine control management plan based on urodynamics and bladder safety capacity can improve urodynamics and neurogenic bladder symptoms in patients with neurogenic bladder after spinal cord injury,reduce the incidence of adverse events and urinary tract infections,and promote the improvement of patient quality of life.

 With the development of global population aging,healthy aging is receiving increasing attention.Heart failure with preserved ejection fraction (HFpEF)is the most common subtype of heart failure in the elderly,with a high morbidity.While frailty is an age-related geriatric syndrome that can exacerbate the occurrence and development of cardiovascular diseases in the elderly.They are heterogeneous syndromes involving multiple system dysfunction,with an increasing prevalence with age,and there is no clear treatment.Moreover,frailty will significantly affect the risk and prognosis of old HFpEF patients,and bring a heavier disease burden to them.As early frailty is dynamic and reversible,early screening,identification and intervention of frailty is of great significance for the comprehensive management of old HFpEF patients.Current studies have found that HFpEF and frailty have similar risk factors and pathophysiological mechanisms.An in-depth study of the correlation between HFpEF and frailty is helpful for clinical evaluation and intervention.

With the increasingly serious problem of population aging,various problems threatening the health of the elderly are also increasing.As a major health killer of the elderly,Alzheimer's disease threatens the life safety of the elderly,and the cause is unknown,and it is difficult to reverse the disease,which brings great psychological,economic and life burden to the patients and their families.Therefore,in order to improve the quality of life of patients with Alzheimer's disease,reduce the economic pressure of patients and their families,and provide their families with appropriate lifestyle care,convenient living environment,and practical and diversified cognitive exercise methods,this paper discusses professional,comprehensive assessment methods and diagnostic methods,diversified cognitive function exercise and other methods,quiet,comfortable and convenient living environment,theoretical models,drug,non-drug and nursing methods based on new nursing technology for patients with Alzheimer's disease are summarized,with a view to guiding clinical nursing work,giving help to patients'families,better nursing patients,and reducing the adverse effects of the disease on patients.