2024 Vol. 22, No. 7

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General Practice Forum
The application prospects and challenges of artificial intelligence in medical education, medical research, and clinical practice
ZHANG Junxiang, LI Chuanfu, LYU Weifu
2024, 22(7): 1085-1089. doi: 10.16766/j.cnki.issn.1674-4152.003572
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Artificial intelligence (AI) is a multidisciplinary collection of theories, technologies, methods, and applications designed to simulate, extend, and expand human intelligence, and can be considered as a tool for enhancing human capabilities. AI has widely penetrated into various industries and people's daily lives, gradually changing the way humans work and live. It will undoubtedly have a profound impact on the development of society and economy. The application of AI in medical education, scientific research, and clinical practice can improve quality, efficiency, effect, and efficiency, and has enormous application potential and bright prospects. In medical education, AI can integrate resources, assist teaching, simulate clinical learning environments, monitor teaching quality, conduct student self-evaluation, and achieve personalized learning. In medical research, AI can mine and process massive data, assist in the research and development of new drugs, predict disease development trends and risks, assist in experimental design, result analysis and paper writing, and play the role of "scientific research assistant". In clinical care, AI has great potential in assisting clinical diagnosis and treatment, supporting clinical decision-making, promoting the "homogeneity" of primary care, patient monitoring, disease prevention, chronic disease follow-up, rehabilitation assistance, health management, and so on. Of course, the current application of AI in the medical field is also facing various challenges and difficulties, such as privacy protection, data security, technology abuse, multidisciplinary integration, cost control, legal and ethical issues, and so forth. It is foreseeable that with the advancement of science and technology, as well as the improvement of relevant supporting laws, regulations, and policies, AI will play an increasingly important role in medical education, scientific research, and clinical practice.
Special Topic/Mycoplasma Pneumoniae Infection In Children
Epidemiological analysis of Mycoplasma pneumoniae infection in children in Gansu Province
YAN Xuanchen, LU Jie, HU Xiaobing, YANG Jingyu, LIU Hongliang, PU Xuhong
2024, 22(7): 1090-1093. doi: 10.16766/j.cnki.issn.1674-4152.003573
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  Objective  In 2023, the number of Mycoplasma pneumoniae infections in northern China has surged. We aim to reveal the epidemic characteristics of Mycoplasma pneumoniae infections in children in Gansu Province by digging big data platform data.  Methods  The medical records of residents from January 2018 to October 2023 were extracted. The big data algorithms and artificial verification were used to complete the cleaning and consistency inspection of data, ArcGIS 10.2 was used to complete the processing of space geographic information, and analysis of data was carried out by using computer software SPSS version 20.0.  Results  From 2018 to 2022, there were 7 486 visits to Mycoplasma pneumoniae in Gansu Province, and 5 774 visits to children, accounting for 77.13% of the total number of visits, making them the main group of patients. From January to October 2023, there were 2 929 visits for Mycoplasma pneumoniae infection in children, the highest level in recent years. Winter is the main season for Mycoplasma pneumoniae infection in children (χ2=522.996, P < 0.001). In the 0-3 year old group, there was a significant difference in the number of visits between male and female children in different years (χ2=12.304, P=0.015). There was also a significant difference in the number of visits between male and female children aged 4-6 years in different years (χ2=11.071, P=0.026), but no difference was found in children aged seven or more (χ2=6.301, P=0.178). There was a clear clustering in space, concentrated in Qingyang and Jiuquan.  Conclusion  In 2023, Mycoplasma pneumoniae infection in children in Gansu Province entered a new epidemic year, with a record high number of visits and a sharp increase in the number of visits in the short term. The seasonal performance in 2023 is not significant, with peak visits occurring in spring, summer, and autumn. The infected population has not changed significantly, and girls are more susceptible than boys. The main infected population is children in the 4-6 age group. Strengthening the monitoring of respiratory diseases in children and the management of childcare institutions.
Exploration of risk factors for severe Mycoplasma pneumoniae pneumonia in children
ZHANG Bo, ZHU Yulin, XIONG Yuhong, QIN Wengang, CHEN Yana, ZHAO Ya, CHEN Mingwu
2024, 22(7): 1094-1097. doi: 10.16766/j.cnki.issn.1674-4152.003574
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  Objective  To explore the high-risk factors of severe Mycoplasma pneumoniae pneumonia (SMPP) in children, and analyze the diagnostic value of C-reactive protein (CRP), D-dimer(D-D), and lactate dehydrogenase (LDH) in SMPP.  Methods  Retrospective analysis of clinical data of 320 children with Mycoplasma pneumoniae pneumonia admitted to the First Affiliated Hospital of the University of Science and Technology of China from June 2023 to November 2023. According to the severity of the condition, they were divided into 85 cases of general Mycoplasma pneumoniae pneumonia (GMPP) and 235 cases of SMPP. Two groups were subjected to univariate analysis, and factors with statistical differences were included in multivariate logistic regression analysis. Draw ROC curves were performed to analyze the diagnostic value of laboratory indicators for SMPP.  Results  The SMPP group had a longer fever and cough times than the GMPP group, and CRP, platelets, platelet volume, fibrinogen, D-D, fibrinolytic products, alanine aminotransferase, serum total bilirubin, γ-Glutamyl transpeptidase, and LDH were higher in the GMPP group than those in the GMPP group (P < 0.05). Multivariate logistic regression analysis showed that CRP, D-D, and LDH were independent risk factors for the occurrence of SMPP, with OR (95% CI) of 1.049 (1.008-1.092), 18.674 (4.184-83.336), and 1.007 (1.001-1.013). ROC curve analysis showed that when the critical values of D-D and LDH were set at 0.69 μg/mL and 291.45 U/L, the sensitivity and specificity for identifying SMPP were 51.5% and 91.8%, 63.0% and 69.4%, respectively.  Conclusion  Elevated levels of CRP, D-D, and LDH are independent risk factors for the occurrence of SMPP, among which D-D and LDH have important clinical value in the diagnosis of SMPP.
Early warning value and bronchoscopic characteristics of experimental indicators such as CRP and LDH in severe Mycoplasma pneumoniae
ZHANG Lixia, ZHU Feng, LI Chuanjing, LIU Xianglei, KAN Yueyue, GUO Qingli
2024, 22(7): 1098-1101. doi: 10.16766/j.cnki.issn.1674-4152.003575
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  Objective  To explore the early warning value of experimental indicators for severe Mycoplasma pneumoniae pneumonia (SMPP) and the clinical characteristics under bronchoscopy, and provide reference for early diagnosis of SMPP.  Methods  The case data of children with Mycoplasma pneumoniae pneumonia (MPP) admitted to Suzhou Hospital Affiliated to Anhui Medical University from January to December 2023 was collected. According to the severity of the condition, they were divided into a severe group and a common group, with 40 cases randomly selected from each group. The differences in general conditions, experimental indicators, and bronchoscopy characteristics between the two groups were compared for statistical analysis.  Results  There was no statistically significant difference in the proportion of neutrophils and procalcitonin (PCT) between the two groups (P>0.05), while the severe group had higher levels of white blood cells (WBC), C-reactive protein (CRP), lactate dehydrogenase (LDH), and D-dimer (D-D) than the normal group (P < 0.05). Multivariate logistic regression analysis showed that WBC, CRP, LDH, and D-D were independent risk factors for SMPP (P < 0.05). ROC curve analysis showed that CRP, LDH, and D-D have high predictive value for the diagnosis of SMPP (P < 0.05), with the optimal thresholds of 19.42 mg/L, 361.00 IU/L, and 1.075 mg/L, respectively. The proportion of bronchoscopy, mucus emboli under bronchoscopy, and neutrophil count in lavage fluid in the severe group were higher than those in the normal group (P < 0.05).  Conclusion  CRP, LDH, and D-D are independent risk factors for SMPP. When CRP>19.42 mg/L, LDH>361.00 IU/L, and D-D>1.075 mg/L, it is helpful for early identification of SMPP. The proportion of mucus embolism under SMPP endoscopy is high, and active bronchoscopy treatment is needed. At the same time, the appearance of the lavage fluid is cloudy and the proportion of neutrophils is high, which can further evaluate the condition.
General Practice Research
Expression of ITGB2 in gastric cancer and its clinical value
ZHANG Zongbing, LE Zhenghong, LIU Mulin, HAO Bo
2024, 22(7): 1102-1107. doi: 10.16766/j.cnki.issn.1674-4152.003576
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  Objective  To investigate the expression of ITGB2 in gastric cancer tissues and its correlation with malignant progression of gastric cancer, and to analyze the possible biological processes of ITGB2 by bioinformatics.  Methods  The expression level of ITGB2 in gastric cancer tissues and its correlation with malignant progression of gastric cancer were analyzed using online database. A total of 107 patients with gastric cancer who received radical gastrectomy in the First Affiliated Hospital of Bengbu Medical University from February 2016 to December 2018 were included. The expression of ITGB2 in gastric cancer tissues and its effect on the prognosis of patients with gastric cancer were analyzed. The biological processes and signaling pathways involved in ITGB2 were analyzed using DAVID database. TIMER2.0 database was used to explore the potential relationship between ITGB2 expression and various immune cell infiltration.  Results  Immunohistochemical results showed that ITGB2 was highly expressed in gastric cancer tissues (3.465±1.037 in gastric cancer tissues and 1.000±0.271 in para-cancerous tissues, t=22.653, P < 0.001). The results of qRT-PCR test confirmed that the mRNA level of ITGB2 in gastric cancer tissue was significantly higher than that in paracancer tissue (P < 0.001). Western blotting test further verified the above experimental results. The survival rate of patients with high ITGB2 expression group was lower than that of patients with low ITGB2 expression group (log-rank χ2=38.394, P < 0.001). Univariate and multivariate analysis showed that high expression of ITGB2 in gastric cancer tissue, CEA≥5 μg/L in peripheral blood, CA19-9≥37 kU/L, clinical T3-T4 and N2-N3 (P < 0.05) were independent risk factors affecting the prognosis of patients with gastric cancer. Bioinformatic analysis showed that ITGB2 was involved in the regulation of immune response.  Conclusion  ITGB2 is highly expressed in gastric cancer and is involved in the malignant evolution of gastric cancer, which is closely related to the poor prognosis and immune cell infiltration of patients with gastric cancer.
Construction and evaluation the prediction model of vascular reocclusion after intravenous thrombolysis in acute ischemic stroke
WANG Yu, LIU Caidan, ZHOU Yunbo, ZHANG Hui, LUO Huanwen
2024, 22(7): 1108-1111. doi: 10.16766/j.cnki.issn.1674-4152.003577
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  Objective  To establish and validate a nomogram prediction model for vessel re-occlusion after intravenous thrombolysis in acute ischaemic stroke (AIS).  Methods  A total of 316 patients with AIS who received intravenous thrombolysis at the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2020 to June 2023 were retrospectively analyzed, and divided into non-occlusion group (264 cases) and re-occlusion group (52 cases) according to the status of re-occlusion after intravenous thrombolysis. The differences in clinical characteristics between the two groups were compared, factors affecting vessel re-occlusion were analyzed by multivariate logistic regression and a nomogram model was created. The degree of discrimination and calibration of the model was assessed by using receiver operating characteristic (ROC) and calibration curves, and the clinical decision curve was analyzed.  Results  Univariate and multivariate logistic regression analysis showed that history of atrial fibrillation, high baseline National Institutes of Health Stroke Scale (NIHSS) score and longer time from onset to treatment were risk factors for re-occlusion after intravenous thrombolysis in AIS patients, whereas Tirofiban was protective factor (P < 0.05). The area under ROC curve (AUC) of the constructed nomogram model was 0.768 (0.701-0.835). The calibration curve showed that there was good agreement between the prediction of vessel reocclusion by the model and the actual probability of occurrence (Hosmer-Lemeshow χ2=8.246, P=0.410). If the risk of vessel re-occlusion after thrombolysis in AIS patients is predicted to be >0.15 using this model, appropriate interventional measures should be taken. It can make patients get better clinical benefit.  Conclusion  There are many factors that influence vessel re-occlusion after intravenous thrombolytic therapy in AIS patients, and the reasonably constructed column diagram model has good discriminatory power and accuracy, which can be used for risk stratification of patients.
Effects of low frequency electric stimulation on diaphragmatic muscle combined with threshold inspiratory muscle training on lung function in patients with sub-acute traumatic cervical spinal cord injury
HUANG Lele, LIU Meng
2024, 22(7): 1112-1115. doi: 10.16766/j.cnki.issn.1674-4152.003578
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  Objective  To observe the effectiveness of low frequency electric stimulation on diaphragmatic muscle combined with threshold inspiratory muscle training on lung function and incidence of lung infections in patients with sub-acute traumatic cervical spinal cord injury.  Methods  A total of 40 patients with sub-acute traumatic cervical spinal cord injury in Department of Critical Care Medicine of the First Affiliated Hospital of Bengbu Medical University from July 2020 to June 2022 were assigned to the control and experimental groups (20 for each group) by the random number table. The control group received threshold inspiratory muscle training on the basis of conventional treatment, and the experimental group was given low frequency electric stimulation on diaphragmatic muscle on the basis of the control group. The patients' lung functions [forceful lung volume (FVC), FVC as a percentage of the predicted value (FVC%pred), first-second forceful expiratory volume (FEV1), and FEV1 as a percentage of the predicted value (FEV1%pred)] were evaluated before and after 3 weeks of treatment. The incidence of pulmonary infections was followed up at 3 months after treatment.  Results  After three-week training, compared with before the training, FVC, FVC%pred, FEVl and FEV1%pred in two groups obviously improved (P < 0.01). Comparing with the control group, FVC, FVC%pred, FEVl and FEV1%pred in experimental group were significantly high (P < 0.01). After 3 months of treatment, the incidence of lung infection was significantly lower in the experimental group than in the control group [50.0% (10/20) vs. 80.0% (16/20), χ2=3.956, P=0.047].  Conclusion  Low frequency electric stimulation on diaphragmatic muscle combined with threshold inspiratory muscle training can significantly improve on lung function in patients with sub-acute traumatic cervical spinal cord injury, and its effect is better than the simple respiratory training.
CRP/ALB combined with lung consolidation in predicting the severity of COVID-19
HONG Jiahui, LIU Yongyang, FANG Yukun, QIU Yiyin, FANG Kai, CHEN Qingyong
2024, 22(7): 1116-1120. doi: 10.16766/j.cnki.issn.1674-4152.003579
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  Objective  Corona Virus Disease 2019 (COVID-19) has become a global pandemic disease, which can lead to multiple organ damage syndrome and high mortality. Therefore, there is an urgent need for reliable biomarkers that can be used for early screening for possible progression to severe infection, which is important for improving clinical prognosis.  Methods  For this retrospective study, basic information and clinical data from December 8, 2022 to January 31, 2023 were extracted from the medical records of patients with COVID-19 admitted to the 903rd Hospital of the People's Liberation Army. On the basis of a new type of coronavirus infection diagnosis and treatment plan 10 (trial version) of parting, after into and exclusion criteria, the patients were divided into two groups, non-severe group (n=57) and severe group (n=37). Univariate analysis was used to screen out statistically significant indicators between the two groups, then multivariate analysis logistic regression was used to screen out independent risk factors affecting the severity of early COVID-19. The receiver operating characteristic curve was used to evaluate and analyze the predictive value of the corresponding indicators for the severity stratification of COVID-19 in the early stage. Finally, a nomogram was used to evaluate the test efficacy of the prediction model.  Results  The C-reactive protein/albumin ratio (CRP/ALB), lung consolidation and coronary heart disease were predictors of severity prediction, the area under the ROC of CRP/ALB was 0.762 (95% CI: 0.663-0.862, P < 0.001), the area under the ROC of lung consolidation was 0.682 (95% CI: 0.573-0.791, P=0.003), and the area under the ROC of coronary heart disease was 0.638(95% CI: 0.520-0.756, P=0.024). The AUC of CRP/ALB and lung consolidation was 0.801(95% CI: 0.708-0.894). The nomogram prediction model and its calibration curve showed that the prediction model had high accuracy with the actual situation.  Conclusion  CRP/ALB combined with lung consolidation can predict the severity of COVID-19.
Application of autologous blood clot technique in flexible ureteroscopic lithotripsy
GAO Wuyue, LIU Beibei, GUO Yuanyuan, SUN Wei, WANG Chengyong, LI Liqiang, XU Liang, LIU Jianmin
2024, 22(7): 1121-1124. doi: 10.16766/j.cnki.issn.1674-4152.003580
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  Objective  To evaluate the suitability and safety of autologous blood clot technique in flexible ureteroscopy combined with the holmium laser lithotripsy.  Methods  A retrospective analysis of 65 patients with ureteral calculi in the First Affiliated Hospital of Bengbu Medical University who underwent flexible ureteroscopy combined with the holmium laser lithotripsy was performed from June 2022 to February 2024. They were divided into two groups according to whether autologous blood clot technology was used or not: 30 cases in observation group and 35 cases in control group. The operative duration, the number of stone removal during operation, duration of hospital stay, the number of residual 2 mm stones, the number of residual 4 mm stones and complications were recorded for statistical analysis.  Results  There were no significant differences in age, sex, BMI, stone number, stone location and cumulative stone size between the two groups (P>0.05). The operation time of the observation group [(54.97±7.06) min] was shorter than that of the control group [(68.14±9.75) min], the number of intraoperative stone removal [(11.50±3.04) times] was significantly less than that of the control group [(20.77±3.36) times], and the number of cases of residual 2 mm stones after operation (8 cases) was significantly less than that of the control group (22 cases), and the differences were all statistically significant (P < 0.05). The number of residual 4 mm stones, duration of hospital stay and complications were insignificantly different (P>0.05).  Conclusion  The use of autologous blood clot technique has good applicability and safety in flexible ureteroscopy combined with the holmium laser lithotripsy. It could shorten the operation time, reduce the number of stone removal during operation, improve the postoperative stone free rate, and minimize the incidence of clinically insignificant residual fragments, potentially reduce stone recurrence.
The risk factors of postoperative prolonged ICU stay for the patients with Stanford type A aortic dissection
LIU Haiyuan, GAO Qingyun, ZHANG Chengxin, GONG Wenhui, GE Shenglin
2024, 22(7): 1125-1128. doi: 10.16766/j.cnki.issn.1674-4152.003581
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  Objective  To explore the risk factors of postoperative prolonged ICU stay for the patients with Stanford type A aortic dissection and assessed the influence on the clinical outcome due to prolonged ICU stay.  Methods  A total of 100 patients with Stanford type A aortic dissection admitted in the Department of Cardiovascular Surgery, the First Affiliated Hospital of Anhui Medical University from December 2018 to September 2022 were enrolled as subjects. The clinical material of all patients was collected and analyzed retrospectively. The preoperative and intraoperative material for the patients in two groups were tested using univariate analysis, regular ICU stay (< 7 days, 65 cases) and prolonged ICU stay (≥7 days, 35 cases) based on the period in ICU and then the obtained significant variates were tested using logistic regression to determine the independent risk factors.  Results  Emergency surgery (P < 0.001), preoperative blood nrea nitrogen (P=0.001), preoperative glucose (P=0.048), cardiopulmonary bypass time (P=0.009) and operating time (P=0.010) were considered as significant variates using univariate analysis. Further, based on the findings of logistic regression, emergency surgery (OR=0.192, P=0.003), preoperative blood urea nitrogen (OR=0.775, P=0.013) and cardiopulmonary bypass time (OR=0.988, P=0.014) were identified as the independent risk factors of postoperative prolonged ICU stay. In the predictive model, the combination of all three factors (AUC=0.810) was more effective than any single factor (AUC=0.308, 0.288 and 0.340). For the clinical outcome assessment, there were significance on the disability of limbs (P < 0.001), severe organic injury (P < 0.001), tracheotomy (P < 0.001), extubation within 72 h after surgery (P < 0.001), awaking within 12 h after surgery (P < 0.001), discharging (P < 0.001) and hospital stay (P=0.037) in two groups.  Conclusion  Emergency surgery, preoperative urea nitrogen and cardiopulmonary bypass time are the risk factors of postoperative prolonged ICU stay and compared with the regular ICU stay group, the incidences of adverse events in the prolonged ICU stay group increase significantly. Risk factors should be handled proactively to reduce ICU stay and improve clinical outcome.
Expression and clinical significance of ALDH8A1 in gastric cancer tissues
ZHAO Meng, XIA Yongsheng, WANG Ziliang, WANG Junhao, GE Sitang, ZUO Lugen, CHEN Deli
2024, 22(7): 1129-1132. doi: 10.16766/j.cnki.issn.1674-4152.003582
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  Objective  To investigate the expression of aldehyde dehydrogenase 8 family member A1 (ALDH8A1) in gastric cancer tissues and its relationship with clinicopathological parameters, and to analyze its effect on the long-term prognosis of patients.  Methods  A total of 109 patients with gastric cancer who underwent radical resection in the First Affiliated Hospital of Bengbu Medical University from March 2012 to April 2018 were enrolled. Immunohistochemistry was used to analyze the expression of ALDH8A1 in gastric cancer tissues and adjacent tissues, and statistical methods were used to analyze its relationship with clinicopathological features. Kaplan-Meier Plotter curve was used to analyze the effect of ALDH8A1 expression on the 5-year survival rate of patients with gastric cancer after surgery.  Results  The expression of ALDH8A1 in gastric cancer tissues was significantly higher than that in adjacent tissues (P < 0.001). The high expression rate of ALDH8A1 was higher in patients with CEA≥5 μg/L, CA19-9≥37 kU/L, adenocarcinoma, T3-4 stage and N2-3 stage (P < 0.05). Kaplan-Meier Plotter curve analysis and multivariate analysis showed that high ALDH8A1 expression (HR=2.674, 95% CI: 1.293-5.533, P=0.008) may increase the mortality of patients with gastric cancer after surgery. ROC curve showed that with 2.555 as the cut-off value, ALDH8A1 had a high predictive value for the prognosis of gastric cancer patients (sensitivity was 68.97%, specificity was 86.27%). GO and KEGG enrichment analysis showed that ALDH8A1 was related to cell meiosis, DNA binding and cell cycle signaling pathways.  Conclusion  ALDH8A1 is highly expressed in gastric cancer tissues and promotes the malignant progression of gastric cancer and is associated with poor prognosis.
Effect of 3D printed titanium interbody fusion device combined with PRP-containing allograft bone in ACDF surgery
WANG Lu, LI Xianhai, LIU Xiancui, XU Hao, ZHANG Liang
2024, 22(7): 1133-1137. doi: 10.16766/j.cnki.issn.1674-4152.003583
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  Objective  This study analyzes the clinical outcomes of the combined application of 3D-printed titanium alloy intervertebral fusion devices and autologous bone treated with platelet-rich plasma (PRP) in anterior cervical discectomy and fusion (ACDF) procedures. It further assesses the potential benefits of this combination in promoting spinal stability and vertebral fusion.  Methods  From August 2021 to May 2023, 110 patients with cervical spondylosis who needed ACDF were selected. Among them, 56 patients with 3D printed interbody fusion cage were classified as Group A, and 54 patients with 3D printed interbody fusion cage combined with PRP allograft were classified as Group B. The operation time, intraoperative blood loss, postoperative drainage, Japanese Orthopedic Association (JOA) score, and visual simulated pain (VAS) score were observed, and the segmental angle (SA), cervical curvature index (CCI), intervertebral disc height (IH) and the fusion rate at each time point after operation were measured.  Results  There was no significant difference in operation time and blood loss between the two groups (P>0.05), and the postoperative drainage in group B was significantly less than that in group A (P < 0.05). There were statistical differences in VAS score and JOA score evaluated at different times (P < 0.05). There were statistical differences in SA, CCI, and IH measured at different times (P < 0.05). The X-ray of the cervical spine showed that the imaging fusion rates of group A and group B were 48.21% (27/56) and 70.37% (38/54) at 3 months after operation, 73.21% (41/56) and 92.59% (50/54) at 6 months after operation, and 100.00% at 12 months after operation. The fusion rates of group B at 3 months and 6 months after operation were significantly higher than those of group A (P < 0.05).  Conclusion  The use of a 3D printed interbody fusion cage combined with PRP-containing allogenic bone in ACDF has the advantage of less postoperative drainage, which can also promote early fusion and improve the success rate of fusion surgery.
Evaluation of prognosis in patients with high-grade non-muscle invasive bladder cancer using systemic inflammatory response index
LING Nengyong, WANG Sheng
2024, 22(7): 1138-1141. doi: 10.16766/j.cnki.issn.1674-4152.003584
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  Objective  The systemic inflammatory response index (SIRI) was used to evaluate the prognosis of high-grade non-muscle invasive bladder cancer (NMIBC) patients, which provided new ideas and theoretical value for the diagnosis and treatment of patients with high-grade NMIBC.  Methods  A total of 40 cases with high-grade NMIBC who underwent transurethral resection of bladder tumor (TURBT) in the First Affiliated Hospital of Bengbu Medical University from January 1, 2019 to January 1, 2020 were analyzed retrospectively. According to whether the patient has a tumor recurrence after surgery, the working subjects operated the characteristic curve (ROC) to determine the best cutoff value of SIRI and divided it into high-value group and low-value group, so as to determine the influence on the prognosis of high-grade NMIBC patients.  Results  The ROC curve of SIRI to predict prognosis (with or without recurrence) is drawn, and the best cut-off value of SIRI was 1.46. According to the optimal cut-off value, patients were divided into high SIRI group (SIRI≥1.46, 18 cases) and low SIRI group (SIRI < 1.46, 22 cases). Tumor size varied in the distribution between the high and low SIRI groups. Patients with high SIRI were more likely to have a 3 cm maximum tumor diameter before surgery. Survival analysis showed that there were significant differences in SIRI, tumor number, and recurrence-free survival (RFS) during different size of tumors. The survival of patients with low SIRI was better than that of patients with high SIRI. Patients with single tumor were better than patients with multiple tumors, and patients with maximum tumor diameter less than 3 cm were better than patients with tumor diameter more than 3 cm. Cox univariate analysis confirmed that SIRI, tumor number, and tumor size were independent influencing factors for postoperative RFS in the advanced group. Cox multivariate analysis confirmed that SIRI more than 1.46 was an independent risk factor for postoperative RFS in NMIBC patients.  Conclusion  SIRI can be used as a risk assessment index for patients with high-grade NMIBC, which can provide new options and directions for the treatment of high-grade NMIBC.
Observation on the effect of Vonoprazan-based dual therapy in radical treatment of Helicobacter pylori
SHANG Yumeng, KE Xiquan, CHU Zhengyang, FANG Chuanfa, HU Dongli, ZHANG Chengbin
2024, 22(7): 1142-1145. doi: 10.16766/j.cnki.issn.1674-4152.003585
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  Objective  To observe the clinical efficacy, safety, compliance, and vonoprazan fumarate tablet (VPZ) combined with amoxicillin capsule for 10 days in the treatment of Helicobacter pylori (Hp) infection.  Methods  A total of 150 Hp infected patients diagnosed in the Second Affiliated Hospital of Bengbu Medical University from October 2021 to February 2023 were randomly divided into a control group (75 cases) and an experimental group (75 cases) by random number table method. The control group was given esomeprazole magnesium enteric-coated tablets combined with amoxicillin capsules, metronidazole tablets, and colloidal bismuth pectin capsules. The experimental group was given the vonoprazan fumarate tablet and amoxicillin capsule. Both groups were treated for 10 days. Hp eradication rate, incidence of adverse reactions, compliance, and cost-effectiveness ratio were compared between the two groups.  Results  There were 5 cases of shedding in the experimental group and 7 cases in the control group, a total of 12 cases of shedding, 70 cases in the experimental group and 68 cases in the control group. According to the protocol (PP) analysis, the eradication rates of Hp in the experimental group and control group were 91.43% (64/70) and 83.82% (57/68), respectively, with no statistical significance (P=0.174). According to intention-to-treat (ITT) analysis, the eradication rates of the experimental group and control group were 85.33% (64/75) and 76.00% (57/75), respectively, with no statistical significance (P=0.148). The incidence of adverse reactions in the experimental group and the control group was 4.29% (3/70) and 14.71% (10/68), respectively, and the difference was statistically significant (P < 0.05). The compliance of the experimental group and the control group was 97.14% (68/70) and 88.24% (60/68), respectively, with no statistical significance (P=0.091). The cost-effectiveness ratio of the experimental group and the control group were 2.22 and 3.64, respectively.  Conclusion  Compared with esomeprazole magnesium enteric-coated tablet combined with two antibiotics and bismuth, Vonolazan fumarate tablet combined with one antibiotic in the radical treatment of Hp infection patients has the same clinical efficacy, high safety and benefit, and good compliance, which is worthy of clinical promotion.
General Clinical Research
Clinical research on the influence of the double hyperboloid mirror system on the ocular axis of children with pre-myopia
RUAN Yimeng, YAO Dongwei, LI Bo
2024, 22(7): 1146-1149. doi: 10.16766/j.cnki.issn.1674-4152.003586
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  Objective  To observe the clinical effect of a double hyperboloid mirror system for extending the viewing distance on the axial growth of pre-myopic eyes in Chinese youth, in order to evaluate its application value in preventing and controlling myopia in children, and provide evidence for more effective eye behavior intervention in children ' s health.  Methods  A total of 120 cases (240 eyes) aged 6-10 years old in a primary school in Ningbo, participated in the study from April 2021 to March 2022. Sixty cases (120 eyes) in the observation group used the double hyperboloid mirror system for near vision work, while another 60 cases (120 eyes) did not use the double hyperboloid mirror system for near vision work in the control group. Follow-up observation were conducted for 1 year, and uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), axial length (AL) and distance and near horizontal eye position were recorded at baseline, 6 months, and 12 months. The changes in SE and AL of students in the two groups at baseline, 6 months, and 12 months were analyzed. Pearson correlation test and linear regression were used to analyze the relationship between the usage duration of the double hyperboloid mirror system and axial length growth.  Results  There were significant differences between the two groups in the changes of SE and AL. After 12 months, the change of SE in the observation group was significantly lower than that in the control group (P < 0.001). Additionally, both eyes in the observation group showed a significantly lower change in AL compared to the control group (P < 0.001). Compared with the control group, the change of AL in the observation group was 0.18 mm lower in the left eye and 0.21 mm lower in the right eye, and the progression of AL was reduced by 43.9% in the left eye and 48.8% in the right eye. There was no significant difference of distance and near horizontal eye position and BCVA in the observation group before and after 12 months (P>0.01). The Pearson correlation test and linear regression analysis revealed a significant negative correlation between the usage duration of the double hyperboloid mirror system and axial length growth (P < 0.001).  Conclusion  The use of the double hyperboloid mirror system can effectively control axial length growth in pre-myopic primary school children, and the longer they used the double hyperboloid mirror system, the lower of the axial length growth. This type of visual aid instrument provides a certain effective basis for behavior intervention related to the prevention and control of myopia in children.
Effects of bendamustine combined with R-CHOP on the efficacy and safety of diffuse large B-cell lymphoma
LIU Yaning, LI Yan, REN Litao, HOU Xiaoxue, WANG Qian
2024, 22(7): 1150-1153. doi: 10.16766/j.cnki.issn.1674-4152.003587
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  Objective  To investigate the effects of bendamustine (BEN) combined with rituximab+cyclophosphamide, doxorubicin, vincristine, methylprednisolone (R-CHOP) regimen on the efficacy, serum factors, and adverse reactions in patients with diffuse large B-cell lymphoma (DLBCL).  Methods  A total of 140 DLBCL patients at Handan First Hospital from January 2018 to June 2020 were selected. Using a random number table, they were divided into 2 groups: the control group receiving R-CHOP and the observation group receiving BEN combined with R-CHOP. Their efficacy and safety of the two groups were then compared.  Results  The objective response rate (ORR) of the observation group was higher than that of the control group [85.71% (60/70) vs. 71.43% (50/70), χ2=4.242, P < 0.05]. Post-treatment, levels of carbohydrate antigen 125 (CA125), lactate dehydrogenase (LDH), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and nuclear transcription face-κB p50 (NF-κB p50) in the observation group were lower than those in the control group [(18.34±2.75) U/L vs. (22.54±3.11) U/L, (227.16±35.12) U/L vs. (282.71±37.46) U/L, (75.08±10.76) ng/L vs. (81.29±12.41) ng/L, (17.29±1.81) ng/L vs. (19.16±2.07) ng/L, (976.58±104.08) μg/L vs. (1 137.19±197.65) μg/L, P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). Furthermore, the cumulative survival rate and progression-free survival rate in the observation group were higher than those in the control group (log-rank χ2=4.243, 3.959, P=0.039, 0.047, respectively).  Conclusion  Combining BEN with R-CHOP improves the short-term and long-term efficacy of DLBCL patients, enhances serum indexes, and ensures safety and effectiveness.
Correlation between EEG characteristics and neuropeptide Y and epilepsy risk after acute stroke
JIANG Ruiting, NI Qichao, WANG Yujia, MIN Jingjing
2024, 22(7): 1154-1157. doi: 10.16766/j.cnki.issn.1674-4152.003588
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  Objective  To explore the influence of EEG characteristics and neuropeptide Y level on the risk of epilepsy after acute stroke, and analyze the related factors.  Methods  A total of 46 patients with epilepsy after acute stroke treated in Huzhou First People' s Hospital from March 2021 to March 2022 were selected as the research object, and 43 patients with non-epilepsy after acute stroke treated in the same period were selected as the observation control. All subjects were given EEG monitoring for at least 2 hours, and their neuropeptide Y levels were detected, and the correlation between their levels and EEG characteristics and the progress of epilepsy after acute stroke was analyzed.  Results  Slow wave index, BSI, and DTABR in the epileptic group were higher than those in the non-epileptic group (P < 0.05). The levels of neuropeptide Y in the epileptic group were lower than those in the non-epileptic group, and the levels of NSE, Hcy, and hs-CRP were higher than those in the non-epileptic group (P < 0.05). Multivariate logistic regression analysis showed that neuropeptide Y (OR=0.671), NSE (OR=1.174), slow wave index (OR=1.124), and BSI (OR=1.344) were independent risk factors for epilepsy after acute stroke (P < 0.05). ROC curve showed that the combined prediction of neuropeptide Y, slow wave index and BSI has the highest prediction efficiency, with AUC of 0.976, sensitivity of 93.48%, and specificity of 97.67%.  Conclusion  Abnormal changes in EEG characteristics and the decrease of neuropeptide Y level are risk factors for epilepsy after acute stroke. Neuropeptide Y level and EEG characteristics can be used to prevent and treat epilepsy after acute stroke.
The effect of serum miRNAs on the recurrence of depression in patients with SSRIs withdrawal during consolidation period
PENG Ling, CHEN Ying, CHEN Jing
2024, 22(7): 1158-1161. doi: 10.16766/j.cnki.issn.1674-4152.003589
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  Objective  Based on the theory that microRNA-134 (miR-134) and microRNA-16 (miR-16) are involved in the gene regulation process of depression, this paper analyzes the effects of two factors in serum on the one-year recurrence risk of patients with first-episode depression who stopped taking selective serotonin reuptake inhibitors (SSRIs) during the consolidation period.  Methods  A total of 125 patients with first-episode depression who were treated with 5-hydroxytryptamine reuptake inhibitors and stopped during the consolidation period from October 2021 to May 2022 in Shaoxing Seventh People ' s Hospital were selected. Kaplan-Meier survival analysis and Cox proportional hazard regression model were used to evaluate the effect of serum miR-134 and miR-16 on one-year recurrence after withdrawal.  Results  K-M survival analysis showed that the distribution of the "non-recurrent state" in patients with high serum miR-134 and miR-16 levels was (11.01±0.27) months and (11.14±0.29) months, respectively. This was significantly longer than that in patients with low serum miR-134 [(9.32±0.42) months] and miR-16 [(9.59±0.36) months, with P < 0.05]. Cox analysis showed that family history of depression was the risk factor for one-year recurrence (HR=2.219). The protective factors included prolonged medication time (HR=0.759), elevated serum level of miR-134 (HR=0.005), elevated level of miR-16 (HR < 0.001), and combined physical therapy (HR=0.188).  Conclusion  The expression levels of serum miR-134 and miR-16 have a good preventive and protective effect on the recurrence of first-episode depression patients after stopping SSRIs for one year in consolidation period.
Value of MR R2* measurement of liver iron concentration for assessing iron metabolism in patients with maintenance dialysis
XU Xingcheng, XU Li, ZHU Huaxia, GUO Kaiqi, MA Peiqi, WANG Zhongqiu, LI Xiaowei
2024, 22(7): 1162-1165. doi: 10.16766/j.cnki.issn.1674-4152.003590
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  Objective  To evaluate the iron metabolism status of patients with chronic kidney disease undergoing dialysis by quantifying liver iron content using magnetic resonance R2* imaging and to compare it with conventional serological assessment methods, thereby assessing the utility of the magnetic resonance R2* method.  Methods  A cohort of 39 patients with chronic kidney disease undergoing dialysis, who visited Fuyang People ' s Hospital of Anhui Medical University between January 2021 and June 2023, was included. Magnetic resonance imaging was utilized to measure liver R2* values and calculate liver iron concentration (LIC). Correlation analyses were conducted between LIC and traditional iron metabolism indicators such as ferritin and transferrin saturation to assess the role of LIC in iron metabolism evaluation.  Results  Among the 39 follow-up visits of patients with chronic kidney disease undergoing dialysis, 23 cases (59.0%) were classified into the LIC deficiency group. Compared to the non-LIC deficiency group, the LIC deficiency group exhibited lower liver R2*, ferritin, while total iron binding capacity, transferrin, and hemoglobin levels were higher (P < 0.05). LIC demonstrated a positive correlation with ferritin, and red blood cell distribution width, and negative correlations with total iron binding capacity, transferrin (r values of 0.505, 0.394, -0.392, -0.415, all P < 0.05). A significant difference was observed between the LIC grouping criteria and traditional serological grouping criteria (P < 0.05). According to the 2021 Chinese Clinical Practice Guidelines for the Diagnosis and Treatment of Anemia in Renal Disease, among the 23 cases in the LIC deficiency group, 15 cases (65.2%) did not have absolute iron deficiency, whereas among the 16 cases in the non-LIC deficiency group, 3 cases (18.8%) had absolute iron deficiency.  Conclusion  The magnetic resonance R2* method for measuring LIC provides insight into the iron storage of patients with chronic kidney disease undergoing dialysis, and when combined with indicators such as ferritin and transferrin saturation, it may enhance the assessment of iron metabolism in these patients.
Application of integrated theory of health behavior change combined with promotion strategy in the health management of patients with hyperuricemia
SHI Limiao, ZHAO Qijiang, XU Jin, ZHANG Manyan
2024, 22(7): 1166-1170. doi: 10.16766/j.cnki.issn.1674-4152.003591
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  Objective   To analyze the impact of the integration theory of health behavior change and the combined promotion strategy on the blood uric acid, glucose and lipid metabolism levels, self-management ability, and lifestyle of patients with hyperuricemia, providing a theoretical basis for the health management of patients with hyperuricemia.   Methods   A total of 156 patients with hyperuricemia conducting health examinations the Affiliated Hospital of Shaoxing University of Arts and Sciences from May 2021 to April 2023 were selected. They were randomly divided into a control group and an observation group, with 78 cases in each group, using a random number table method. The control group received routine health management, while the observation group received integrated theory of health behavior change combined with supportive nursing interventions on the basis of the control group. The changes in blood uric acid (UA) levels, glucose and lipid metabolism indicators, as well as the differences in scores on the chronic disease self-management questionnaire (CDSMQ) and the health promotion lifestyle profile Ⅱ (HPLP-ⅡR) between two groups of patients before and after intervention were compared.   Results   After intervention, the levels of UA, low-density lipoprotein (LDL) and fasting blood glucose (FBG) in the observation group were lower than those in the control group, and the high-density lipoprotein (HDL) index was higher than the control group (P < 0.05). The total scores of the CDSMQ scale and HPLP-ⅡR scale in the observation group were (28.15±2.33) points and (133.41±10.85) points, respectively, which were higher than those in the control team [(22.51±3.79) points and (99.67±8.58) points, P < 0.05].   Conclusion   The combination of integrated theory of health behavior change and promotion strategy can effectively improve the levels of uric acid, blood lipids, and blood glucose in patients with hyperuricemia, enhance their self-management ability, and improve their lifestyle, which is worthy of clinical application.
Analysis of clinical characteristics and influencing factors of children with short stature
YE Shufang, WU Jun, HONG Qiuyue, HE Chunfeng
2024, 22(7): 1171-1174. doi: 10.16766/j.cnki.issn.1674-4152.003592
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  Objective   To understand the clinical characteristics of nanosomia and analyze its influencing factors, so as to provide theoretical basis for the prevention and treatment of short stature.   Methods   A total of 122 children with nanosomia in Lishui Hospital of Traditional Chinese Medicine from August 2021 to March 2023 were selected as the research object, and 124 children with normal development during the same period were selected as the control group. Clinical data of the two groups were compared, and the clinical characteristics and influencing factors of nanosomia were analyzed.   Results   The body weight, BMI, bone age, and bone age index (BAI) of the observation group were (27.25±4.23) kg, 17.52±2.65, (9.61±1.72) years, and 0.91±0.25, respectively, while the control group were (39.36±4.62) kg, 20.85±2.72, (12.89±1.68) years, and 1.26±0.29, respectively. The observation group were significantly lower than those of the control group (P < 0.05). Multivariate logistic regression analysis showed vitamin D deficiency (OR=4.608), accompanied by basic diseases (OR=2.529), family history of short stature (OR=1.931), paternal height less than 160 cm (OR=3.089), maternal height less than 150 cm (OR=3.861), mixed or breast-fed within six months of birth (OR=1.876), family discord (OR=1.966), less bounce exercise per week (OR=4.898), and sleep duration less than 10 h/d (OR=6.651) were independent risk factors affecting the occurrence of nanosomia in children.   Conclusion   The weight and bone age of children with nanosomia are lower than those of normal children. The occurrence of nanosomia is affected by many factors such as environment and heredity. Clinical intervention measures should be taken according to the above-mentioned high-risk factors to reduce the risk of nanosomia.
Study on the effect of dexamethasone and ropivacaine iliac fascia nerve block combined with general anesthesia in corrective surgery for congenital hip dislocation in children
FAN Chao, XU Xiaodong, SUN Quanpeng, YANG Xiaoyu, QUAN Lixin, GAO Junwei, BAI Weijie
2024, 22(7): 1175-1178. doi: 10.16766/j.cnki.issn.1674-4152.003593
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  Objective   To assess the analgesic efficacy of dexamethasone combined with ropivacaine iliac fascial nerve block in pediatric patients undergoing orthopedic surgery for congenital hip dislocation.   Methods   Ninety children who underwent corrective surgery for congenital hip dislocation at Zhengzhou Orthopedic Hospital from February 2019 to August 2022 were selected and divide into three groups (n=30) using a random number table: general anesthesia group (Group C), ropivacaine general anesthesia group (Group L), and dexamethasone + ropivacaine general anesthesia group (Group D). After general anesthesia, group L received an injection of 0.25% ropivacaine 1 mL/kg under ultrasound guidance. Group D received an injection of 0.2 mg/kg dexamethasone and 0.25% ropivacaine 1 mL/kg under ultrasound guidance. Postoperative pain was managed with ketorolac tromethamine and hydromorphone. The dosage and awakening status of anesthesia drugs during surgery, postoperative pain blockade time, and application of remedial drugs were recorded for the three groups of pediatric patients.   Results   Compared to the dosage of propofol and remifentanil in Group C [(336±35) mg, (383±35) μg], the dosages in the Group L [(197±28) mg, (188±22) μg] and group D [(194±32) mg, (187±28) μg] were significantly reduced (P < 0.001). The awakening time, extubation time, and post-anesthesia care unit residence time were also shortened (P < 0.001). The postoperative pain blockade time in Group C [(27.5±11.2) min] and Group L [(357.4±102.7) min] was shorter than that in Group D [(485.2±120.6) min, P < 0.001]. The postoperative use rate of hydromorphone in Group D was lower than that in Group C and Group L (P < 0.001). Additionally, the incidence of nausea and vomiting in Group D was lower than that in Group C and Group L (P < 0.017).   Conclusion   The combination of dexamethasone and ropivacaine in a supra-inguinal fascia iliaca block with general anesthesia is used in the correction surgery for congenital hip dislocation in children. This approach prolongs pain blockade time and suppresses perioperative pain sensitivity reactions, contributing to more comfortable perioperative medical care.
Observation on the efficacy of He's Yiqi Yangxue Decoction in regulating the placenta previa state of spleen and kidney qi deficiency
TIAN Lei, HUANG Yueying, SANG Xiaoqing, CHEN Zhongju
2024, 22(7): 1179-1182. doi: 10.16766/j.cnki.issn.1674-4152.003594
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  Objective   To explore the clinical effects of different methods using He's Yiqi Yangxue Decoction on placenta previa in spleen and kidney qi deficiency.   Methods   A total of 90 patients diagnosed with placenta previa due to spleen and kidney qi deficiency in Department of Traditional Chinese Medicine, Ningbo Women and Children ' s Hospital from January 2020 and December 2022. These patients were randomly assigned into three distinct groups: treatment group A, treatment group B, and a control group, each containing 30 individuals. Those in the control group received conservative management therapy. The treatment group A was given He's Yiqi Yangxue Decoction. On the basis of treatment group A, acupoint application was applied to treatment group B. The comprehensive curative effect, TCM symptom score, placental position at 28 weeks, pregnancy and neonatal outcomes were observed in the three groups.   Results   (1) Comprehensive curative effect: After completing one period of treatment, the number of treatment group B was 86.67% (26/30) in terms of cure rate, which was statistically significant compared with 53.33% (16/30) of treatment group A and 36.67% (11/30) of control group (P < 0.017). After two treatment cycles, the total effective rate was 96.67% (29/30) in treatment group B and 93.33% (28/30) in treatment group A, and none distinction in statistics was between them (P>0.017). (2) TCM symptom score: After two treatment cycles, among treatment group A, treatment group B and control group, the distinction in statistics was significative (P < 0.01). (3) The effective rate of treatment group A and treatment group B was 96.67% (29/30), compared with the control group [66.67% (20/30)], the distinction in statistics was significative (P < 0.017). (4) Regarding pregnancy and neonatal outcomes: Pregnant women ' s postpartum hemorrhage in 24 hours who were assigned to these two treatment groups were both less than those who were assigned to the control group, and their neonatal body mass and neonatal 1min Apgar score were exceed than those who were assigned to the control group (P < 0.05).   Conclusion   He's Yiqi Yangxue Decoction can effectively improve the placental previa, improve the position of the placenta, treat clinical symptoms, and improve pregnancy outcomes and neonatal outcomes in pregnant women with spleen and kidney qi deficiency.
Diagnostic value of neutrophil-to-lymphocyte ratio in elderly patients with community-acquired urinary tract infection
PEI Qianqian, GAO Yun, WANG Chunmei
2024, 22(7): 1183-1187. doi: 10.16766/j.cnki.issn.1674-4152.003595
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  Objective   To investigate the value of the neutrophil to lymphocyte ratio (NLR) in the diagnosis of community-acquired urinary tract infection in the elderly.   Methods   A total of 159 elderly patients with community-acquired urinary tract infection (infection group) were selected from Xuanwu Hospital of Capital Medical University from January 2012 to December 2022. According to whether they progressed to bloodstream infection, they were divided into uro-derived bloodstream infection group (28 cases) and non-bloodstream infection group (131 cases). A total of 172 inpatients were matched for non-infectious diseases during the same period (non-infected group). ROC curve was used to analyze the clinical diagnostic value of NLR in community acquired urinary tract infection.   Results   The AUC of NLR was 0.729, and the optimal threshold, sensitivity and specificity were 3.5, 60% and 84%, respectively. The AUC of the non-bloodstream infection group was 0.684, and the optimal threshold, sensitivity and specificity were 3.7, 47% and 90%, respectively. The AUC of NLR in the diagnosis of community-acquired urinary tract infection in the elderly was 0.935, and the optimal threshold, sensitivity and specificity were 6.0, 86% and 99%, respectively.   Conclusion   (1) NLR has diagnostic value for community-acquired urinary tract infection in elderly people. When NLR≥6.0, the patient should be vigilant of progressing to bloodstream infection according to clinical manifestations and be referred to superior hospital in time. (2) The main pathogens of urinary tract infection are gram-negative bacteria, the most common of which is Escherichia coli. Therefore, early intervention can be performed according to the distribution characteristics of the pathogens.
Study on the treatment of primary osteoporosis of liver and kidney deficiency type with Bugan Qiangshen Zhuanggu Formula
YANG Jun, FAN Xu
2024, 22(7): 1188-1191. doi: 10.16766/j.cnki.issn.1674-4152.003596
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  Objective   To explore the clinical effect of Bugan Qiangshen Zhuanggu Formula in treating primary osteoporosis (liver and kidney deficiency type).   Methods   A total of 130 patients with primary osteoporosis (liver and kidney deficiency type) admitted to Tiantai County People ' s Hospital from April 2020 to October 2023 were studied, and were divided into control group (65 cases) and observation group (65 cases) randomly. The control group were given alendronate sodium tablets and calcium carbonate D3 tablets, while the observation group received additional treatment with Bugan Qiangshen Zhuanggu Formula. The therapeutic effect level of traditional Chinese medicine syndrome in patients were evaluated, the changes in bone density and serum bone metabolism indicators were detected, the differences in VAS score and SF-36 score were compared, and the adverse drug reactions were observed.   Results   The overall effective rate of traditional Chinese medicine syndromes in observation group (93.85%, 61/65) was higher than control group (69.23%, 45/65, P < 0.001). After 12 weeks of treatment, the bone density values of the lumbar spine L2-4, right femoral neck, and left distal radius in the observation group were higher than the control group (P < 0.001). The VAS score of observation group (2.47±0.63) was lower than control group (3.29±0.72, P < 0.001), while the SF-36 score (85.73±6.49) was higher than control group (74.65±6.27, P < 0.001). The levels of serum bone-specific alkaline phosphatase (BALP) and type Ⅰ procollagen amino terminal peptide (P1NP) in observation group was higher than control group, but the levels of serum cross-linked type 1 collagen C-terminal peptide (CTX) and N-telopeptide of type Ⅰ collagen (NTX) were lower than control group (P < 0.001). The incidence of adverse reactions between the two groups was no difference (P>0.05).   Conclusion   Bugan Qiangshen Zhuanggu Formula combined with alendronate sodium and calcium carbonate D3 can effectively improve traditional Chinese medicine symptoms, alleviate pain reactions, and improve quality of life in patients with primary osteoporosis of liver and kidney deficiency type. Its mechanism of action is closely related to enhancing patient bone density and regulating bone metabolism function.
A study on the physical and mental health status of college students during the period of normalization of COVID epidemic prevention and control
ZHOU Ruiying, WANG Fuzhi
2024, 22(7): 1192-1195. doi: 10.16766/j.cnki.issn.1674-4152.003597
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  Objective   To understand the health status and factors influencing college students during the normalization of COVID epidemic prevention and control, to explore the health status of college students before and after prevention and control, and to provide a reference for the closed management of colleges and universities during periods of major public health risk.   Methods   Two cross-sectional surveys were conducted in four universities in Bengbu City, Anhui Province, China, from January 4 to January 19, 2022, and from July 1 to July 16, 2023. The quality of life, anxiety, and depression of students were investigated, the differences in the health status of students with different socio-demographic backgrounds was compared, and multivariate linear regression models was established to analyze the influence factors.   Results   There were some cases of anxiety, depression, and quality of life changes among college students during the period of normalization of epidemic prevention and control, and demographic factors, such as grade level, grade ranking, average monthly cost of living, and having an immediate family member suffering from COVID epidemic, were all influential factors (P < 0.05), and there was a significant difference in the health status of college students. Anxiety and depression were significantly correlated (r=0.799, P < 0.001). The differences between anxiety, depression and quality of life of college students before and after the epidemic control were statistically significant (P < 0.05), and the factors of grade level, grade ranking, average monthly cost of living, and the presence of COVID epidemic in the immediate family led to changes in the health status of the college student population.   Conclusion   The health status of college students varies among different demographic factors, mainly in terms of quality of life, anxiety and depression. The physical and mental health of college students are affected to some extent. This suggests that under major public health events, we should pay attention to the material and psychological needs of college students while strictly preventing and controlling them, and adopt regular psychological interventions to ensure the physical and mental health of college students.
Cognitive function of migraine patients and its correlation with anxiety and depression
WANG Jing, HU Yanli, ZHU Shuyuan, PENG Shushan, YE Xiaofang, CAO Jiang, WANG Tiehu
2024, 22(7): 1196-1198. doi: 10.16766/j.cnki.issn.1674-4152.003598
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  Objective   To analyze the cognitive function of migraine patients and explore the correlation between cognitive dysfunction and anxiety and depression.   Methods   A total of 165 migraine patients admitted to the Department of Psychosomatic of the Second People ' s Hospital of Lishui from Jan.2022 to Jan.2023 were selected. According to the Montreal cognitive function assessment scale (MoCA), the patients were divided into the cognitive function decline group (42 cases, MoCA score < 26 points) and the cognitive function normal group (123 cases, MoCA score ≥26 points). The cognitive function of the two groups and the degree of anxiety and depression were compared, and the correlation between cognitive dysfunction and anxiety and depression was analyzed.   Results   Among the 165 patients, cognitive function decreased in 42 cases, accounting for 25.45%. The MoCA score of the group with declining cognitive function was significantly lower than that of the group with normal cognitive function [(23.52±2.16) points vs. (27.79±2.85) points, t=8.872, P < 0.001]. The scores of the self-rating anxiety scale (SAS), self-rating depression scale (SDS), visual analogue scale (VAS), and headache impact assessment scale-6 (HIT-6) were significantly higher than those of the normal cognitive function group (P < 0.05), respectively. Spearman correlation analysis showed that the MoCA score was positively correlated with the SAS score and SDS score (r values were 0.468 and 0.492, respectively, all P < 0.001).   Conclusion   The proportion of migraine patients with cognitive dysfunction is higher, and the degree of headache is more obvious in patients with cognitive dysfunction and has a greater impact on the quality of daily life. The cognitive dysfunction of migraine is positively correlated with anxiety and depression.
Application of tree of life narrative combined sensorimotor training in chronic stable schizophrenia
MAO Lili, SHEN Yinping, PAN Xiaofang
2024, 22(7): 1199-1203. doi: 10.16766/j.cnki.issn.1674-4152.003599
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  Objective  To explore the effects of the tree of life narration combined with sensorimotor training on psychological status, clinical symptoms, cognitive function, and social function of patients with chronic stable schizophrenia.  Methods  A total of 97 patients with chronic stable schizophrenia treated in Huzhou Third Municipal Hospital from March 2022 to March 2023 were divided into a control group (49 cases, conventional care) and an experimental group (48 cases, tree of life narrative method combined with sensory-motor training+routine care) by random number table method.  Results  The score of general self-efficacy scale (GSES) in the experimental group was higher than that in the control group (P < 0.05). The score of Chinese version of stigma scale for mental illness (SSMI-C) in the experimental group was lower than that of the control group (P < 0.05). The total score of PANSS (36.37±5.35) in the experimental group was lower than that of the control group (46.83±7.44, P < 0.05). The number of persistent errors (7.94±2.11) in the Wisconsin card sorting test (WCST) in the experimental group was lower than that in the control group (9.78±2.56, P < 0.05), the number of correct reactions (51.92±6.34), and percentage of conceptualization (65.77±7.23)% in the WCST in the experimental group were higher than those in the control group [46.71±7.26, (60.33±4.99)%, P < 0.05]. The total score of scale of social function in psychosis inpatients (SSPI) in the experimental group was higher than that in the control group (P < 0.05).  Conclusion  The tree of life narrative combined with sensorimotor training can improve self-efficacy, reduce stigma, improve clinical symptoms and cognitive function, and improve social function in chronic stable schizophrenia patients.
Value of combined exploration of carotid plaque by multiple ultrasound techniques to predict recurrence of ischemic stroke
ZHANG Qian, MIAN Li, WANG Xia
2024, 22(7): 1204-1208. doi: 10.16766/j.cnki.issn.1674-4152.003600
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  Objective  To investigate the value of combined 2D and 3D ultrasound, contrast-enhanced ultrasonography (CEUS) and shear-wave elastography (SWE) for the detection of carotid plaques, and to analyze their value in predicting recurrence of ischaemic stroke (IS).  Methods  A total of 95 patients with first-ever IS and carotid atherosclerotic plaque from October, 2021 to January, 2023 in the Second Affiliated Hospital of Xinjiang Medical University were selected, and divided into a recurrence group and a non-recurrence group according to whether they had recurred or not. Risk factors for relapse in patients with IS were analyzed using logistic regression. Receiver operating characteristic (ROC) curves were used to analyze the value of different ultrasound techniques in predicting the recurrence of IS.  Results  Five cases were lost to follow-up. The recurrence rate was 41.11%, and there were no deaths after treatment. The proportion of hypertension in the recurrent group was higher than that in the non-recurrent group, and the proportion of good medication compliance was lower than that in the non-recurrent group (P < 0.05). The ratio of CEUS blood flow grade Ⅲ to Ⅳ, 2-D intima-media thickness (IMT) and 3-D-TPA in the recurrent group were higher than those in the non-recurrent, while the mean Young's modulus was lower than that in the non-recurrent group (P < 0.05). Multivariate logistic regression analysis showed that CEUS blood flow level Ⅲ to Ⅳ, high 2-IMT, large 3-3D total carotid plaque area (TPA) and low mean Young's modulus were risk factors for recurrence in IS patients, and good medication compliance was a protective factor (P < 0.05). ROC curve analysis showed that the AUC of 2-D IMT, 3-D TPA, mean Young's modulus and CEUS blood flow Ⅲ to Ⅳ in predicting recurrence of in IS patients were 0.674, 0.717, 0.729 and 0.746, respectively. The combined predictive AUC of 0.908 was higher than that of single detection (P < 0.05).  Conclusion  2D, 3D and SWE and CEUS ultrasound techniques have some clinical value in predicting the recurrence of IS by evaluating carotid plaque instability, and the combined value of the four is higher.
Expression and correlation of four kinds of cytokines in patients with Hashimoto's thyroiditis or papillary thyroid carcinoma
ZHOU Lei, HUANG Xueshuang, LI Huimin, JIN Xin, WANG Hai
2024, 22(7): 1209-1211. doi: 10.16766/j.cnki.issn.1674-4152.003601
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  Objective  To analyzed the expression of serum Interleukin-2 (IL-2), Interleukin 12 P70 (IL-12P70), interleukin-10 (IL-10) and interleukin-17 (IL-17) in Hashimoto's thyroiditis carcinoma (HT) and papillary thyroid carcinoma (PTC), to investigate the role of 4 kinds of cytokines in HT and PTC.  Methods  Thirty patients with Hashimoto's thyroiditis, 35 patients with papillary thyroid carcinoma, and thirty healthy individuals were selected from Tongde Hospital of Zhejiang Province from July 2022 to June 2023. They were divided into HT group, PTC group, and healthy control group. The serum levels of IL-2, IL-12P70, IL-10, and IL-17 were detected by flow cytometry.  Results  Compared with the healthy control group, the serum levels of IL-2, IL-12P70, and IL-17 were significantly higher in both the PTC and HT groups (P < 0.05). Compared with the HT group, the serum level of IL-10 was significantly increased in the PTC group [(9.46±2.22) pg/mL vs. (7.44±1.97) pg/mL, P < 0.05]. In the HT group, thyroid peroxidase antibody (TPOAb) levels were negatively correlated with the level of IL-10 and positively correlated with the level of IL-17 (P < 0.05). The level of thyroglobulin antibody (TgAb) was negatively correlated with the level of IL-10 (P < 0.05). The levels of IL-2, IL-12P70, IL-10, and IL-17 in thyroid tumor patients showed no significant differences after total thyroidectomy or thyroid gland with isthmus resection(P>0.05).  Conclusion  The serum levels of IL-2, IL-12P70, and IL-17 elevated in PTC and HT patients, while the serum levels of IL-10 decreased in HT patients and correlated with TPOAb and TgAb levels. There were no significant changes in the levels of these cytokines after total thyroidectomy or thyroid gland with isthmus resection in patients with PTC.
The correlation and research status of coronary heart disease and psychiatric disorders: a literature review
HUANG Wanzhong, SU Qiang
2024, 22(7): 1212-1216. doi: 10.16766/j.cnki.issn.1674-4152.003602
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Summary of the 2022 Report on Cardiovascular Health and Diseases in China: It is estimated that there are 11.39 million cases of coronary heart disease (CHD) in China, and the number is on the rise. Psychological factors such as anxiety and depression are closely related to heart health. Patients with acute coronary syndrome (ACS) combined with anxiety or depression have a risk of non-fatal myocardial infarction and rehospitalization within one year which is approximately doubled and quintupled, respectively. The probability of CHD patients having comorbid anxiety and depression is highest at over 80%. Psychological disorders have a significant impact on the development and prognosis of cardiovascular diseases such as CHD, and comorbidity between the two is a major public health issue affecting the health of Chinese residents. This article reviews the history of psychocardiology and the development of psychocardiology in China, from the proposal of bidirectional medicine to the publication of relevant expert consensus, emphasizing the status and role of psychological factors in the prevention and treatment of cardiovascular diseases in China. It provides an overview of the current research status of psychocardiology, covering aspects such as risk factor assessment, genetic and biological indicators, disease identification and screening, drug therapy, and interdisciplinary collaboration. It introduces evidence-based intervention methods and discusses both Western medicine, traditional Chinese medicine, and integrated approaches. Analyzing the contradictions and limitations of existing research, it proposes directions for future research in psychocardiology. It advocates for the establishment of a lifecycle management concept, investigation of early determinants of psychocardiac health, examination of the impact of interventions at different stages of life, and the development of personalized psychocardiology methods that integrate genetics, environment, and psychosocial factors. This aims to tailor prevention and treatment strategies to individual patients and explore more effective strategies for the prevention and treatment of cardiovascular diseases.
Research progress of amplitude-integrated electroencephalography in neonatal brain function monitoring
LI Xianhong, ZHANG Jian
2024, 22(7): 1217-1221. doi: 10.16766/j.cnki.issn.1674-4152.003603
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Neonatal brain injury is a common neurological disorder in the newborn period, often associated with various factors such as perinatal asphyxia, hypoxic-ischemic events, hyperbilirubinemia, prematurity, and infections. The prognosis can range from early neurobehavioral abnormalities to various degrees of long-term neurodevelopmental disorders. Therefore, early and accurate identification of neonatal brain injury and timely intervention are crucial in preventing adverse neurodevelopmental outcomes. Brainwave monitoring is an important tool for diagnosing, evaluating, and predicting the prognosis of neonatal brain diseases. In recent years, amplitude-integrated electroencephalography (aEEG) as a non-invasive brain function monitoring tool has gradually been used in neonatal intensive care units. Compared to traditional electroencephalography, aEEG signal processing is simplified, focusing mainly on low-frequency waveforms in the spectrum. Its output typically displays as a continuous trend graph, making it easy for clinicians to observe and analyze. Therefore, aEEG is currently widely used for early brain function monitoring in neonatal brain injuries caused by birth asphyxia, hypoxic-ischemic encephalopathy, neonatal hyperbilirubinemia, neonatal seizures, and neonatal infections. Since aEEG can be initiated within a few hours after birth, it can promptly detect abnormal brainwave activity, demonstrating high sensitivity and specificity in the early diagnosis, evaluation, and prognosis prediction of neonatal brain injuries. With further research into aEEG in neonatal clinical settings, continuous improvement of aEEG technology, establishment of standardized aEEG monitoring procedures, and the integration of other brain structure or function assessment tools, will effectively enhance the diagnostic and prognostic value of neonatal brain injuries, enabling early detection of brain injuries and developmental abnormalities, and thereby improving outcomes through early intervention.
A study on the efficacy of transcranial magnetic stimulation combined with rehabilitation training in children with autism spectrum disorders and analysis of low-frequency amplitude
LI Zhang, LYU Jing, ZHAO Xiaoke, XU Hong, ZHANG Ling, ZHU Min
2024, 22(7): 1222-1226. doi: 10.16766/j.cnki.issn.1674-4152.003604
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  Objective  To observe the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on the core symptoms of children with autism spectrum disorders (ASD) by ALFF analysis of resting-state functional magnetic resonance imaging.  Methods  Thirty-four children with ASD from the Department of Rehabilitation of Children's Hospital of Nanjing Medical University from October 2021 to December 2023 were divided into two groups (ASD1 and ASD2) by a randomized numeric table method. The ASD1 group was given regular training and low frequency rTMS stimulation to the dorsolateral prefrontal region (DLPFC), while the ASD2 group was given regular training and sham stimulation. One case was dislodged from each group. Core symptoms were assessed using the autism behavioral scale (ABC), autism rating scale (CARS), repetitive stereotyped behavioral scale-revised (RBS-R), and autism treatment evaluation scale (ATEC) before and after 12 weeks of treatment. Resting-state fMRI scans were performed in both groups before and after treatment, and their resting-state fMRI data were analyzed to observe improvements in core symptoms and changes in ALFF indexes in the resting state.  Results  After 12 weeks of treatment, the CARS, RBS-R, and ATEC scores of children with ASD in both groups were significantly improved compared to those before treatment. The total scores of CARS [(32.50±1.63) points vs. (34.75±3.94) points], RBS-R [7.00 (6.00, 7.00) points vs. 8.00 (7.00, 11.75) points], and ATEC [(60.20±12.29) points vs. (69.80±13.52) points] in the ASD1 group were better than those in the ASD2 group after treatment (P < 0.05). Increased ALFF in the ASD1 group was observed mainly in the superior temporal gyrus, inferior frontal gyrus, and parahippocampal gyrus, while no significant changes were seen in the ASD2 group before and after treatment.  Conclusion  On the basis of conventional rehabilitation intervention, low-frequency rTMS therapy can effectively improve the core symptoms and behavioral evaluation indexes of children with ASD, which is confirmed by the convergence of compensation in related brain regions at rest.
Study on the related mechanisms of Bianxue Formula in improving clinical symptoms of patients with internal hemorrhoids
WANG Qi, WANG Hua, TONG Lei, QIN Mengting
2024, 22(7): 1227-1229. doi: 10.16766/j.cnki.issn.1674-4152.003605
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  Objective  In order to improve the clinical treatment level of internal hemorrhoids and explore a scientifically effective combination of traditional Chinese and Western medicine treatment approach, this study explores the clinical effect and pharmacological mechanism of Bianxue Formula to improve clinical symptoms in patients with internal hemorrhoids.  Methods  A total of 150 patients with grade Ⅰ and Ⅱ internal hemorrhoids admitted to the Department of Anorectal of Jiaxing Hospital of Traditional Chinese Medicine from January 2020 to December 2023 were selected as the research objects. According to the random number table method, they were divided into the control group (75 cases) and the observation group (75 cases). The control group was treated with compound cabbage ester suppository, while the observation group was treated with an additional formula for constipation and bleeding on the basis of compound carrageenan suppositories. The improvement of clinical symptoms such as rectal bleeding, pain, and hemorrhoid mucosal status before and after treatment were observed, the level of clinical efficacy was evaluated, the changes in serum vascular endothelial factor and inflammatory factor levels were detected, and the adverse drug reactions during treatment were followed up.  Results  After treatment, the observation group had lower scores for rectal bleeding, falling pain, and hemorrhoid mucosal status compared to the control group (P < 0.001). The overall effective rate of hemorrhoid treatment in the observation group [93.33% (70/75)] was higher than the control group [74.67% (56/75), P < 0.05]. The levels of vascular endothelial factors in serum such as endothelin 1 (EF-1), intercellular adhesion factor-1 (ICAM-1), vascular cell adhesion factor-1 (VCAM-1), and endothelial nitric oxide synthase (eNOS) in the observation group after treatment was lower than the control group (P < 0.001). The content of inflammatory factors in serum such as IL-1β, IL-6, IL-8, and TNF-α in the observation group after treatment were lower than the control group (P < 0.001).  Conclusion  The combination of Bianxue Formula and compound cabbage ester suppository can effectively alleviate clinical symptoms in patients with internal hemorrhoids, improve clinical efficacy, and the improvement of clinical symptoms is closely related to the pharmacological mechanism of Bianxue Formula in inhibiting vascular endothelial injury and inflammatory response.
The application impact of integrated problem driven teaching method in clinical thinking of medical undergraduate students
SANG Xu, WANG Zhaodong, ZHANG Chao, RUI Yan, CHEN Xin
2024, 22(7): 1230-1233. doi: 10.16766/j.cnki.issn.1674-4152.003606
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  Objective  Exploring the impact of integrated problem-driven teaching method on clinical thinking of medical undergraduate students before clinical internship, and providing theoretical basis for clinical teaching methods.  Methods  A total of 267 undergraduate students majoring in clinical medicine from Bengbu Medical University in 2020 were selected as the research subjects. The study subjects were divided into a PBL group and a control group using an equidistant random sampling method, with 127 cases in the PBL group and 140 cases in the control group. The control group only participated in traditional lecture-based teaching plans, while the PBL group added PBL courses on top of the control group. The classroom performance and clinical thinking ability of the two groups were explored, and the relevant factors that affect clinical thinking ability were analyzed.  Results  During the pre-test, there was no statistically significant difference in the distribution of classroom performance between the PBL group and the control group (P>0.05); During the post-test, there was a statistically significant difference in the distribution of classroom performance between the PBL group and the control group (P < 0.05). During the pre-test, there was no statistically significant difference in the scores of critical thinking ability, systematic thinking ability, evidence-based thinking ability, and total score between the two groups (P>0.05). During the post-test, the total score of clinical thinking ability in the PBL group was higher than that in the control group (73.71±12.65 vs. 66.90±11.01, P < 0.05), and the scores of all dimensions were higher than those in the control group (P < 0.05). The results of multiple linear regression analysis showed that the higher the frequency of reading medical literature (B=6.811, P < 0.001) and the higher the ranking of PBL scores (B=4.014, P=0.010), the stronger the clinical thinking ability.  Conclusion  The integrated problem-driven teaching method has a positive impact on improving the clinical thinking ability of medical students, with the main influencing factors being the frequency of literature reading and PBL course ranking.
Analysis of factors influencing fatigue during the recovery period of COVID-19 infection (Lung-Spleen Qi Deficiency Syndrome)
XU Shanchun, ZHONG Ying, HUANG Hong, TANG Jun, REN Jingjing
2024, 22(7): 1234-1238. doi: 10.16766/j.cnki.issn.1674-4152.003607
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  Objective  To explore the relevant factors influencing fatigue in patients during the recovery period of COVID-19 infection (lung-spleen qi deficiency syndrome).  Methods  Patients who visited the First Affiliated Hospital of Zhejiang Chinese Medical University from January to March 2024 for COVID-19 recovery period (lung-spleen qi deficiency syndrome) outpatient care were selected as the study subjects. Trained investigators distributed and collected electronic questionnaires in the outpatient area, and SPSS 26.0 statistical software was used to analyze the data.  Results  A total of 462 valid samples were obtained in this study, including 366 cases of fatigue (79.2%) and 96 cases without fatigue (20.8%). The results of the univariate analysis showed that fatigue during the recovery period of COVID-19 infection (lung-spleen qi deficiency syndrome) was statistically significant with differences in education level, sleep duration, number of stressful days per week, appetite changes, bowel movements, and number of COVID-19 infections (P < 0.05). Logistic regression analysis indicated that sleep duration, number of stressful days per week, appetite changes, bowel movements, and number of COVID-19 infections were independent influencing factors affecting fatigue during the recovery period of COVID-19 infection (lung-spleen qi deficiency syndrome, P < 0.05).  Conclusion  Due to factors such as sleep duration, number of stressful days per week, appetite changes, bowel movements, and number of COVID-19 infections, the fatigue rate during the recovery period of COVID-19 infection (lung-spleen qi deficiency syndrome) is relatively high. Targeted interventions based on different influencing factors may improve the fatigue status of patients during the recovery period of COVID-19 infection (lung-spleen qi deficiency syndrome) to a certain extent.
Efficacy and safety of Yiqi Yangyin Decoction in treating systemic lupus erythematosus: a meta-analysis
ZHANG Qiang, DENG Weizhe, YI Shihua, SHAO Yingzi, WANG Zhenyu, LU Xiuyun
2024, 22(7): 1239-1245. doi: 10.16766/j.cnki.issn.1674-4152.003608
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  Objective  The application of classic Chinese medicine in rheumatic diseases has been a prominent research focus. Systemic lupus erythematosus (SLE) has a significant patient population in China. The efficacy of integrated Chinese and Western medicine in the treatment of SLE remains controversial. This study explores the effectiveness and safety of the Yiqi Yangyin Decoction in the treatment of systemic lupus erythematosus through meta-analysis.  Methods  A comprehensive search was conducted on multiple databases including PubMed, Medline, EMbase, Cochrane Library, Web of Science, CBM, Wangfang, CNKI, and VIP from the establishment of the database to November 26, 2023. The scope of the search was limited to randomized controlled trial studying the efficacy of Yiqi Yangyin Decoction in the treatment of SLE. The experimental group received Yiqi Yangyin Decoction in combination with Western medicine, while the control group received only Western medicine. The retrieved literature was filtered and managed using EndNote 20.0. Data extraction and quality evaluation were performed using RevMan 5.4. Sensitivity analysis and publication bias analysis were conducted using Stata 15.0.  Results  A total of 24 studies were conducted, including 1 051 patients in the experimental group and 940 patients in the control group. The experimental group showed a higher total effective rate compared to the control group (OR=4.35, 95% CI: 3.11-6.11). Additionally, the experimental group had a lower incidence of adverse reactions compared to the control group (OR=0.17, 95% CI: 0.11-0.26). These differences were statistically significant (P < 0.05). The experimental group showed better scores in traditional Chinese medicine syndrome, systemic lupus erythematosus disease activity index, ds-DNA negative conversion rate, complement3, 24 hour urinary protein quantity, and glucocorticoid maintenance dosage compared to the control group, with all differences being statistically significant (P < 0.05). The ANA negative conversion rate was slightly higher in the experimental group, but the difference was not statistically significant (P > 0.05).  Conclusion  The application of Yiqi Yangyin Decoction in the treatment of SLE can enhance clinical effectiveness, reduce the occurrence of adverse reactions, and yield positive outcomes across multiple aspects.
Potential profile analysis and influencing factors of benefit finding for esophageal cancer caregivers
ZHAO Ling, HE Yunling, ZHANG Yaowen, WEN Hongying
2024, 22(7): 1246-1250. doi: 10.16766/j.cnki.issn.1674-4152.003609
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  Objective  To explore the potential category characteristics of benefit finding by caregivers of esophageal cancer patients and analyze the differences in benefit finding among different categories of caregivers.  Methods  The convenience sampling method was used to select 311 esophageal cancer patients treated in the Department of Thoracic Surgery and Oncology at a tertiary hospital in Nanchong City from November 2020 to June 2021. The caregivers of patients with esophageal cancer were invested in a simplified coping style questionnaire, general self-efficacy scale, and revised Chinese version of the benefit finding scale.  Results  Benefit finding was classified into low benefit finding, moderate benefit finding, and high benefit finding accounting for 17.4% (54 cases), 53.7% (167 cases), 28.9% (90 cases) respectively. Caregivers who tended to adopt a positive coping style were more likely to belong to the high benefit finding than the low benefit finding (OR=1.322, P < 0.001). Caregivers with higher self-efficacy scores were more likely to belong to the high benefit finding (OR=1.341, P < 0.001). The results of regression analysis showed that positive coping style, self-efficacy, caregiver age, payment method of medical expenses, self-care ability, and disease stage were the factors influencing the benefit finding of caregivers of esophageal cancer (P < 0.05).  Conclusion  The benefit findings of caregivers are at a moderate to low level and have distinct classification characteristics. Healthcare professionals can take targeted nursing interventions based on the different categories of caregivers to improve benefit finding.
Construction of standardized nursing system in oncology department based on three-dimensional structural model
HOU Qingmei, YANG Lihua, ZHANG Ziyan, DUAN Peibei, ZHU Chunqin, XIU Minning
2024, 22(7): 1251-1255. doi: 10.16766/j.cnki.issn.1674-4152.003610
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  Objective  To build a standardized nursing system for medical oncology and provide a basis for promoting the standardization, refinement and procedural operation of oncology specialist nursing work.  Methods  Using the three-dimensional structural model of system engineering as the theoretical framework, the first draft of a standardized nursing system for anti-tumor treatment patients in the oncology department was drafted through literature research and repeated discussions among project team members. Twenty-four experts in the field of oncology medical nursing and related fields from 12 tertiary hospitals in Jiangsu Province were selected for two rounds of Delphi expert consultation. Both rounds calculated the positive coefficient of expert inquiry, the authority of expert opinions, and the Kendall coordination coefficient. The research group compiled the results of expert consultations, analyzed the indicator structure and items, and determined the standardized nursing system for anti-tumor treatment patients in the oncology department.  Results  The final construction included 3 primary indicators (time dimension, knowledge dimension, logic dimension), 15 secondary indicators, and 105 tertiary indicators for the standardized anti-tumor treatment patient care system in the oncology department. After two rounds of expert inquiries, the average assigned values of the importance of each indicator were 3.88-4.96, and the coefficient of variation was 0.041-0.244. The effective response rates for both rounds of expert consultation questionnaires were 100.0%. The expert authority coefficients were 0.876 and 0.885, respectively. The Kendall coordination coefficients were 0.216 and 0.198, respectively (P < 0.001).  Conclusion  The construction method of standardized nursing system based on the three-dimensional structural model in the medical oncology is scientific and the items are reliable, which can provide path guidance for the comprehensive and standardized practice of clinical nursing in medical oncology.
Application of failure mode and effect analysis in risk prevention of complications at lithotomy site under general anesthesia
ZHOU Yinchan, XU Xiaojuan, LIU Huirong, LI Chengnyu, LI Ding, ZHANG Leyi
2024, 22(7): 1256-1259. doi: 10.16766/j.cnki.issn.1674-4152.003611
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  Objective  In order to reduce the risk of operation-related complications in patients undergoing lithotomy under general anesthesia, this study applied failure mode and effects analysis (FMEA) to lithotomy under general anesthesia, and explored its clinical value in preventing the risk of complications in lithotomy under general anesthesia.  Methods  From January 2022 to September 2022, 200 patients who underwent lithotomy under general anesthesia in the normal mode at the Health Management Center of Chun ' an Branch of Zhejiang Provincial People ' s Hospital, were selected as the control group. From October 2022 to June 2023, 200 patients who underwent lithotomy under general anesthesia in the FMFA mode were enrolled in the observation group. The incidence of complications related to surgical position, patient comfort, and doctor satisfaction between the two groups were compared.  Results  The incidence rates of venous thrombosis and fascial compartment hypertension in the observation group were 2.00% (4/200) and 1.50% (3/200), respectively, which were lower than those in the control group [6.00% (12/200), 5.50% (11/200), χ2=4.167, 4.737, P < 0.05]. However, the incidence of circulatory system changes and peripheral nerve injury in the observation group were lower than that in the control group, with no significant difference (P>0.05). The comfort level of the patients in the observation group was higher than that in the control group (P < 0.05). The satisfaction score of doctors in the observation group was higher than that in the control group (P < 0.05). There was no significant difference between the observation group and the control group in the satisfaction score of waiting time for surgery (P>0.05).  Conclusion  FMEA nursing mode effectively reduces complications related to the position of lithotomy under general anesthesia, improves the comfort of patients, and boosts the satisfaction of doctors with patient safety during surgery. Its widespread application in clinics is highly recommended.
Application of feed-forward control management in preventing nursing interruption events with negative outcomes in operating room
LOU Chenyan, ZHU Xiajun, YU Lixia, XU Shun
2024, 22(7): 1260-1263. doi: 10.16766/j.cnki.issn.1674-4152.003612
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  Objective  To analyze the preventive effect of feed-forward control management on negative outcome nursing interruption events in the operating room, and provide new ideas for operating room management.  Methods  Convenience sampling was used to select 128 patients who underwent surgery in the operating room of Quzhou Maternal and Child Health Hospital in Zhejiang Province from January to November 2023 as the study subjects. Among them, 64 patients who underwent surgery from January to May 2023 were selected as the control group, and 64 patients who underwent surgery from June to November 2023 were selected as the observation group. The control group patients were treated with conventional nursing mode, while the observation group added the feed-forward control management on the basis of the control group. The incidence, duration, and sources of nursing interruption events with negative outcomes between two groups of patients were compared, and the incidence and quality of nursing adverse events in the operating room between the two groups of patients were compared.  Results  The incidence of negative outcome nursing interruption events in the observation group was 75.9% (88/116), lower than 84.6% (198/234) in the control group, and the duration of the observation group was (2.12±0.76) minutes, lower than (4.83±1.07) minutes in the control group, the comparison between the two groups of patients was statistically significant (P < 0.05). The incidence of adverse events in the operating room nursing of patients in the observation group was 3.1% (2/64), lower than the control group [12.5% (8/64), P < 0.05]. The total score of nursing quality for patients in the observation group was (47.81±1.62) points, which was higher than the control group [(44.68±2.54) points, t=8.312, P < 0.001].  Conclusion  The concept of feed-forward control management plays a positive role in preventing negative outcome nursing interruptions in the operating room. It not only reduces the incidence and duration of nursing interruptions, but also reduces the incidence of adverse nursing events in the operating room. It can also improve the quality of operating room nursing and is worthy of clinical application.
Nursing experience of silver sulfadiazine cream in the treatment of a patient with exposure of intravenous infusion port
WANG Xuehuan, MA Chunhua, LIU Mei
2024, 22(7): 1264-1266. doi: 10.16766/j.cnki.issn.1674-4152.003613
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To summarize the nursing experience of silver sulfadiazine for a patient with exposure of an intravenous infusion port. The treatment process included: preoperative nursing (clarifying the position and integrity of the infusion port tip, infusion port nursing); Postoperative care (silver sulfadiazine cream to promote wound healing and prevent infection); Patients' diet and psychological care; Discharge guidance, cause analysis of port exposure, etc. After 3 weeks of nursing and treatment, the patient's old and new wounds healed completely, and the patient's venous access port was successfully retained.

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