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2025 Vol. 23, No. 4

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General Practice Forum
Research on the impact of the reform of quantitative standards for "relative value" on the service equivalent of community health technicians
YIN Tao, WENG Naijie, CHENG Qiaolu, YIN Delu
2025, 23(4): 539-542. doi: 10.16766/j.cnki.issn.1674-4152.003945
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  Objective  To address the existing issues in the "separate revenue and expenditure lines" system, Changping District, Beijing has implemented a reform of the operational mechanism for the "relative value" quantitative standard in primary health service projects. This study aims to analyze the impact of this reform on the work efficiency of community health service institution personnel, providing decision-making references for further improving policies related to comprehensive primary-level reforms.  Methods  Based on the quantitative standard of "relative value" of 508 primary health service projects in Changping District, we analyzed and compared the annual service equivalents per capita of 18 community health centers in Changping District in different years by using the data of staffing, service volume, and service volume per capita from 2017 to 2021.  Results  From 2017 to 2021, the average annual service equivalents per capita of community health centers in Changping District showed an upward trend, with a five-year increase of 14.69%; among them, the average annual service equivalents per capita of Class Ⅰ community health centers were the highest and had the largest increase, reaching 7 702.65 standard service equivalents and 18.38%, while the average annual service equivalents per capita of Class Ⅲ community health centers were the lowest, at 5 514.25 standard service equivalents. The coefficients of variation of the annual service equivalents per capita of community health service centers in 2018 and 2019 were larger, 0.41 and 0.33, respectively, while the annual service equivalents per capita of each center in the other three years were 0.19.  Conclusion  The implementation of the operation mechanism of Changping District based on the basic project of basic primary health care services "relative value" in 2016 quantitative standard of the operational mechanism reform has continuously mobilized the enthusiasm of primary medical personnel, improved work efficiency, and promoted the supply of primary medical and health care services, and in the future, it is recommended to strengthen the management of personnel service efficiency based on information tracking and analysis.
Diagnosis and Treatment Guidelines
Guidelines for the prevention and treatment of diabetic retinopathy with integrated traditional Chinese and Western medicine
Endocrinology and Metabolic Diseases Committee of the Integrated Traditional Chinese and Western Medicine Physician Branch, Chinese Medical Doctor Association, Endocrinology Committee of Beijing Association of Integrated Traditional Chinese and Western Medicine
2025, 23(4): 543-550. doi: 10.16766/j.cnki.issn.1674-4152.003946
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The Guidelines for the Prevention and Treatment of Diabetic Retinopathy with Integrated Traditional Chinese and Western Medicine were jointly compiled by the Endocrinology and Metabolic Diseases Committee of the Integrated Traditional Chinese and Western Medicine Physician Branch of the Chinese Medical Doctor Association and the Endocrinology Committee of Beijing Association of Integrated Traditional Chinese and Western Medicine, with the participation of clinical experts from key endocrinology specialties and Western medicine endocrinology experts nationwide. Based on the principles of integrated traditional Chinese and Western medicine diagnosis and treatment, this guideline formulates recommendations using the consensus conference method grounded in evidence-based medicine. The content covers the integrated diagnosis of diabetic retinopathy, traditional Chinese medicine syndrome differentiation treatment, Western medicine treatment, and traditional Chinese medicine rehabilitation based on syndrome differentiation. The development of this guideline aims to provide a reference for the standardized diagnosis and treatment of diabetic retinopathy in China and to improve the level of integrated traditional Chinese and Western medicine in the management of this condition.
Special Topic/Complications of Stroke
Construction of a nomogram for predicting malnutrition risk in elderly patients with pharyngeal dysphagia after stroke
HU Lingqin, WANG Xiaohua, REN Yili, WANG Jun
2025, 23(4): 551-554. doi: 10.16766/j.cnki.issn.1674-4152.003947
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  Objective  To construct a nomogram tool for screening malnutrition risk in elderly patients with pharyngeal swallowing disorders after stroke, aiming to improve the accuracy of malnutrition assessment.  Methods  A total of 115 elderly patients with post-stroke pharyngeal dysphagia disorder admitted to Affiliated Hospital of Shaoxing University from December 2020 to December 2023 were selected and divided into a malnutrition group (MNA score < 17 points, n=43) and a non-malnutrition group (MNA score ≥17 points, n=72) according to the micro-nutrition assessment (MNA) score. Multivariate logistic regression analysis was used to screen the risk factors for malnutrition, and R software component nomogram model was used to verify the model.  Results  Among the 115 elderly patients with pharyngeal dysphagia after stroke, 43 (37.39%) were diagnosed with malnutrition. Multivariate logistic regression showed delayed swallowing initiation, aspiration, aCCI score, feeding method, and epiglottic reversion disorder as independent risk factors for malnutrition in elderly patients after stroke (OR>1, P < 0.05). Based on the above five indexes, the malnutrition risk prediction model of dysphagia in elderly stroke was constructed, achieving an area under the ROC curve of 0.959 (95% CI: 0.904-0.987). The calibration curve demonstrated good agreement, with a Hosmer-Lemeshow test result of χ2=8.254, P=0.628.  Conclusion  Elderly patients with laryngeal swallowing dysfunction after stroke have a high incidence of malnutrition. Key risk factors include delayed swallowing initiation, aspiration, aCCI score, feeding method, and epiglottic reentry disorder. The nomogram model established in this study can provide a reliable tool for early warning and identification of malnutrition in elderly patients with laryngeal swallowing dysfunction after stroke.
Factors influencing and predictive value of rehabilitation treatment responsiveness in stroke patients with swallowing disorders
YU Gongxian, HONG Kangjie, LU Liwen, HONG Lingzhi, ZHENG Hongjian
2025, 23(4): 555-558. doi: 10.16766/j.cnki.issn.1674-4152.003948
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  Objective  This study aims to analyze the factors influencing rehabilitation treatment responsiveness in post-stroke dysphagia patients, identify potential risk factors for adverse rehabilitation treatment reactions, and provide a theoretical basis for reducing adverse rehabilitation treatment reactions.  Methods  A total of 314 stroke patients with swallowing disorders who received rehabilitation treatment at the Chun ' an Branch of Zhejiang Provincial People ' s Hospital from January 2021 to January 2023 were selected as the study subjects. They were divided into a good response group and an adverse response group based on their rehabilitation treatment responsiveness. In order to explore the factors influencing rehabilitation treatment responsiveness, the univariate and multivariate analyses were conducted, and ROC curves were used to verify their predictive value.  Results  Among the 314 stroke patients with swallowing disorders who received rehabilitation treatment, 83 patients (26.43%) experienced adverse reactions to rehabilitation treatment, while 231 patients showed good reactions to rehabilitation treatment. The patients in the good response group had a shorter duration of swallowing disorders, higher compliance scores, and lower scores on the National Institute of Health stroke scale (NIHSS) and water swallowing test (WST) compared to those in the poor response group (P < 0.05). Multivariate logistic regression analysis showed that high admission NIHSS score, high WST score, and prolonged swallowing dysfunction were independent risk factors for rehabilitation treatment response, while high compliance was a protective factor for rehabilitation treatment response (P < 0.05). ROC analysis showed that the compliance score had the highest predictive value (AUC=0.706), followed by admission NIHSS score (AUC=0.633), WST score (AUC=0.613), and swallowing disorder course (AUC=0.610).  Conclusion  Compliance, admission NIHSS score, WST score, and duration of swallowing disorders are key factors influencing rehabilitation treatment responsiveness in stroke patients with swallowing disorders.
Study on sleep structure in stroke patients with periodic limb movements during sleep
HE Shengyan, JIANG Shuzhen, JIN Feimei
2025, 23(4): 559-561. doi: 10.16766/j.cnki.issn.1674-4152.003949
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  Objective  To analyze the characteristics of sleep structure in stroke patients with periodic limb movements disorder in sleep (PLMS) and to explore the effect of PLMS on sleep in stroke patients, providing a basis for improving the quality of life in stroke patients with PLMS.  Methods  A total of 99 stroke patients with sleep disorders, diagnosed and treated at Jinhua Central Hospital from April 2022 to June 2023, were selected. According to whether the patients had PLMS, they were divided into the PLMS group (48 cases) and the non-PLMS group (51 cases). General data and PSG data of patients were collected. Sleep structure and related parameters were compared between the two groups, and the correlation between PLMS and sleep parameters was analyzed.  Results  The PLMS groups showed significantly higher values for the awake periodic limb movement of sleep index (PLMI), N1 sleep proportion, N2 sleep proportion, arousal index and periodic limb movement arousal index (PLMAI) with values of (61.45±3.86) times/h, (13.35±2.13)%, (57.42±3.55)%, (29.73±2.68) times/h, and (1.27±0.29) times/h, respectively, compared to the non-PLMS group [(28.85±2.92) times/h, (8.36±2.35)%, (52.51±3.52)%, (15.93±2.59) times/h, and (0.86±0.25) times/h, P < 0.05]. The N3 sleep proportion and sleep efficiency were significantly lower in the PLMS group, at (12.52±2.16)% and (83.79±5.83)%, respectively, compared to the non-PLMS group [(23.25±2.25)% and (95.52±7.73)%, P < 0.05]. PLMS was positively correlated with awake PLMI, N1 sleep proportion, N2 sleep proportion, wake index, and PLMAI (rs=0.529, 0.213, 0.398, 0.251, 0.529, P < 0.05), while negatively correlated with sleep efficiency (rs=-0.329, P < 0.05).  Conclusion  Stroke patients with PLMS often exhibit sleep structure disorders and decreased sleep efficiency. PLMS may serve as a predictor of poor prognosis in stroke patients. Clinical monitoring of sleep status in stroke patients with PLMS is recommended, along with appropriate intervention measures to improve patient quality of life.
General Practice Research
A survey on the psychological fatigue status of military personnel in cold regions and urban areas of Xinjiang
WU Yingqiu, MA Yan, WU Tangxiao, YANG Xi, WU Jili, YIN Ziyi, XI Huaqiang
2025, 23(4): 562-565. doi: 10.16766/j.cnki.issn.1674-4152.003950
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  Objective  This study aims to explore the influence of alpine environments on military fatigue and analyze its influencing factors.  Methods  In February 2023, 706 soldiers from Xinjiang troops were selected by cluster random sampling method, including 190 soldiers in cold areas and 516 soldiers in Urumqi urban area. Participants completed a demographic survey, the Chinese multidimensional fatigue scale, and a work stress questionnaire survey.  Results  Significant differences in fatigue total score, mental fatigue and motivation decrease, work stress frequency, work stress index, work stress intensity, work stress frequency, work stress index, frequency of lack of organization support, and organizational support deficiency index were observed between soldiers in cold areas and Urumqi (P < 0.05). The fatigue scores, both overall and across different dimension scores, varied significantly by service duration, age, gender, education level, marital status, and rank (P < 0.05). Multiple stepwise linear regression analysis showed that environment, service duration, marital status, rank, lack of organizational support index, and work pressure intensity were the main factors influencing soldier fatigue (F=21.157, P < 0.001, R2=0.154, adjusted R2=0.146).  Conclusion  The high-cold environments have a notable negative impact on the fatigue of soldiers. It is necessary to recognize this problem and implement timely interventions to prevent and mitigate fatigue of soldiers in this environment.
Comparison and prognosis of direct thrombectomy and bridging therapy for acute anterior circulation large vessel occlusive stroke
ZHU Dongmei, GE Dongtao, HAN Ruodong, YANG Miao
2025, 23(4): 566-569. doi: 10.16766/j.cnki.issn.1674-4152.003951
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  Objective  To compare the efficacy of direct mechanical thrombectomy (dMT) with bridging therapy (BT) in patients with acute ischaemic stroke with anterior circulation large vessel occlusion (AIS-LVO) and to identify factors influencing their prognosis.  Methods  The present study examined the efficacy of dMT and BT in AIS-LVO patients treated at Bozhou Hospital Affiliated to Anhui Medical University, from January 2020 to July 2023. Patients were stratified into two distinct groups, namely the BT group and the dMT group, based on the respective treatment modalities received. A comprehensive set of clinical data was collected, and a comparative analysis of the efficacy of these two treatment modalities was conducted. The factors influencing the prognosis of AIS-LVO were analyzed by univariate and multivariate logistic regression.  Results  A number of significant differences were identified between the two groups in terms of the time of onset, pre-onset modified Rankin scale score, door-to-puncture time, admission National Institute of Health stroke scale (NIHSS) score, proportion of patients with hypertension, moderate-to-severe disability rate and mortality (P < 0.05). Following the implementation of propensity score matching, no statistically significant differences were observed between the two groups with respect to the 90-day good functional outcome rate, symptomatic intracranial hemorrhage rate, or mortality rate (P>0.05). However, the BT group demonstrated a higher rate of moderate to severe disability in comparison to the dMT group. Multivariate logistic regression analysis revealed that age was 60-80 years old (OR=3.421, 95% CI: 1.809-6.471, P < 0.001), high NIHSS scores upon admission (OR=1.069, 95% CI: 1.017-1.124, P=0.009), and history of diabetes (OR=3.252, 95% CI: 1.531-6.908, P=0.002) were independent risk factors for poor prognosis in AIS-LVO patients.  Conclusion  The present study has demonstrated that bridging therapy and direct mechanical thrombectomy demonstrate comparable clinical efficacy and safety in AIS-LVO patients. Furthermore, it has been demonstrated that elevated NIHSS scores upon admission, advanced age and the presence of concomitant diabetes are independent risk factors for poor unfavourable in AIS-LVO.
Risk factors and prognosis analysis of severe acute pancreatitis complicated with abdominal compartment syndrome
NI Lulu, LI Jiming, YANG Yuying, ZHAO Min, MA Ling, Xiaokelaiti·Huojiahemaiti
2025, 23(4): 570-572. doi: 10.16766/j.cnki.issn.1674-4152.003952
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  Objective  Abdominal compartment syndrome is a common and fatal complication in patients with severe acute pancreatitis, which can lead to multiple organ failure and ultimately result in death. Understanding the relevant risk factors is beneficial for early prevention and treatment of abdominal compartment syndrome. The aim of the present study was to explore the risk factors and prognosis of abdominal compartment syndrome in severe acute pancreatitis patients.  Methods  From January 2020 to June 2022, 287 patients with severe acute pancreatitis admitted to the First Affiliated Hospital of Xinjiang Medical University were retrospectively collected. Based on whether the patients developed abdominal compartment syndrome or not, they were divided into the abdominal compartment syndrome group (n=53) and the control group (n=234). The differences in clinical characteristics between the two groups were compared, and multivariate logistic regression analysis was used to explore the risk factors of abdominal compartment syndrome.  Results  Compared with the control group, the proportion of patients with an APPACHE Ⅱ score>10 in the abdominal compartment syndrome group significantly increased [54.72% (29 cases) vs. 39.32% (92 cases), P=0.040]; The proportion of Ranson scores>4 increased [59.62% (31 cases) vs. 42.74% (100 cases), P=0.027]; The proportion of pancreatic necrosis and infection increased [96.23% (51 cases) vs. 77.78% (182 cases), P=0.002]; The proportion of multiple organ failure increased [86.79% (46 cases) vs. 43.16% (101 cases), P < 0.001]; The proportion of abdominal bleeding increased [20.75% (11 cases) vs. 9.40% (22 cases), P=0.019]; The proportion of biliary tract infections increased [15.09% (8 cases) vs. 6.41% (15 cases), P=0.036]. Pancreatic necrosis infection, multiple organ failure, abdominal bleeding, and biliary tract infection were risk factors for abdominal compartment syndrome in severe acute pancreatitis patients (P < 0.05). Abdominal compartment syndrome and biliary tract infection were risk factors for hospital death in patients with severe acute pancreatitis (P < 0.05).  Conclusion  Pancreatic necrosis infection, multiple organ failure, abdominal bleeding, and biliary tract infection are associated with abdominal compartment syndrome, which is an independent risk factor for poor prognosis in patients with severe acute pancreatitis.
Clinical observations of homoharringtonine with venetoclax and azacitidine in the treatment of FLT3-ITD mutation relapsed/refractory acute myeloid leukemia
ZHANG Wenhui, PEI Xiaohang, KONG Dai, ZHANG Ping, CHEN Xiangli, ZANG Yuzhu, LIU Zhongwen
2025, 23(4): 573-575. doi: 10.16766/j.cnki.issn.1674-4152.003953
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  Objective  To explore the clinical effects of homoharringtonine with venetoclax and azacitidine in the treatment of FLT3-ITD mutation relapsed/refractory acute myeloid leukemia (R/R AML) and to evaluate the survival and prognosis of patients.  Methods  Thirty-nine FLT3-ITD mutation R/R AML patients treated from October 2018 to June 2024 in Henan Provincial People' s Hospital were reviewed. According to the different treatment modes, 20 cases of taking the non-intensive chemotherapy (venetoclax and azacitidine) were included in the control group; 19 cases of taking the intensive chemotherapy (homoharringtonine with venetoclax and azacitidine) were included in the observation group. The hepatic and renal function, short-term effects, treatment prognosis, and toxicity were compared.  Results  (1) In the observation group, complete remission (CR)/ CR with incomplete hematologic recover (CRi) was achieved in 9 out of 19 patients, accounting for 47.37% (9/19) of the total cases in this group; in the control group, CR/CRi was achieved in 4 out of 20 patients, accounting for 20.00% (4/20) of the total cases in this group. The difference between the two groups was not statistically significant (P>0.05). There were no significant between-group differences in the overall response rate [ORR, 73.68% (14/19) vs. 50.00% (10/20), P > 0.05]. (2) The relapse-free survival (RFS) between groups was not significantly different (P > 0.05); the overall survival (OS) in the observation group was longer than the control group, with a statistically significant difference (P < 0.001). (3) There were no significant between-group differences in the haematological toxicity reaction rates [68.42% (13/19) vs. 55.00% (11/20), P > 0.05].  Conclusion  Homoharringtonine with venetoclax and azacitidine can improve the short-term effects, treatment prognosis, and safety for FLT3-ITD mutation relapsed/refractory acute myeloid leukemia patients.
Clinical analysis of small bowel polyps in patients with Peutz-Jeghers syndrome treated with double balloon enteroscopy
DIAO Lei, WU Qiaoling, LIU Hong, LU Jian
2025, 23(4): 576-579. doi: 10.16766/j.cnki.issn.1674-4152.003954
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  Objective  To investigate the efficacy and safety of double balloon enteroscopy (DBE) in the treatment of small intestinal polyps in patients with Peutz-Jeghers syndrome (PJS).  Methods  A retrospective analysis was conducted on PJS patients who underwent DBE at the Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, from June 2020 to November 2023. Clinical data of the patients were collected, and the success rate of small intestinal polyps resection as well as the incidence of intraoperative and postoperative complications were recorded.  Results  A total of 12 patients (7 males, 5 females) with a mean age of (29.94±13.29) years were included in our study. A total of 20 DBE procedures were performed (15 via the oral approach, and 5 via the anal approach). The mean intubation depth were (306.00±126.71) cm and (220.00±34.64) cm, respectively. Among the 12 patients, jejunum polyps were most common (100.0%), with gastric polyps observed in 2 cases (16.7%) and colonic polyps in 2 cases (16.7%). The number and size of small intestinal polyps varied, with the largest measuring approximately 5.0 cm in diameter and the smallest 0.3 cm. The success rate of polypectomy was 100.0%, and no serious complications were associated with endoscopic treatment. Five patients had two or more hospitalizations, with no significant difference in the maximum polyps diameter between the first and second hospitalizations [(1.70±0.98) cm vs. (2.67±0.58) cm, t=1.467, P=0.216], though a decreasing trend was observed. Follow-up results revealed that no cases of intussusception or intestinal obstruction caused by small bowel polyps after DBE.  Conclusion  DBE is an effective and safe method for the removal of small bowel polyps in patients with PJS.
Comparison of the efficacy of rituximab and tacrolimus in the treatment of idiopathic membranous nephropathy
CHEN Bowen, WU Xueping, LIU Lei, CHEN Weidong
2025, 23(4): 580-583. doi: 10.16766/j.cnki.issn.1674-4152.003955
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  Objective  To compare the efficacy and safety of two treatment regimens (rituximab and a small amount of glucocorticoid combined with tacrolimus) for membranous nephropathy in moderate and high risk groups.  Methods  Patients diagnosed with idiopathic membranous nephropathy and phospholipase A2 receptor (PLA2R)-associated membranous nephropathy, who were admitted to the Department of Nephrology at the First Affiliated Hospital of Bengbu Medical University, between January 2020 and June 2023 were selected as medium risk or high risk groups based on clinical manifestations. In accordance with the divergent treatment regimens, the subjects were categorized as follows: the rituximab group underwent rituximab treatment, the tacrolimus group received a low-dose glucocorticoid in combination with tacrolimus. The alterations in serum albumin, 24-hour urinary protein quantity, blood PLA2R antibody, prior to treatment, and at 3 months, 6 months and 12 months following-treatments were observed in both groups. The overall effective rate, recurrence rate, and adverse reactions of the two groups were then compared.  Results  A subsequent investigation revealed no significant difference in the general data between the two groups (P>0.05). The quantitative values of 24-hour urinary protein in the Tacrolimus group after 3 and 6 months of treatment [3.30 (1.46, 4.43) g, 1.35 (0.62, 2.93) g] were superior to those of the RTX group [4.08 (3.05, 4.86) g, 2.19 (1.03, 3.95) g, P < 0.05]. The total remission rate after 12 months of treatment was not statistically significant (P>0.05). The immunological remission rate of 80.43% (37/46) in the rituximab group was marginally higher than 77.61% (52/67) observed in the tacrolimus group; however, this difference did not reach statistical significance. Notably, the recurrence rate in the rituximab group was significantly lower than that observed in the tacrolimus group, with statistical significance (P < 0.05). With regard to adverse reactions, the rate of 8.70% (4 cases) in the rituximab group was lower than the 25.37% (17 cases) observed in the tacrolimus group.  Conclusion  It has been demonstrated that both rituximab and tacrolimus are effective in the treatment of idiopathic membranous nephropathy. However, it is evident that tacrolimus-treated patients exhibit a more rapid treatment effect, while those administered rituximab demonstrate a higher immunological remission rate and longer effective duration of action. Furthermore, rituximab-treated patients exhibit a reduced incidence of side effects and a lower recurrence rate.
Effect of "4 + 3" warm chain dynamic body temperature management combined with family language awakening on patients undergoing thoracoscopic lung surgery
ZHANG Tiantian, CHEN Ruizhe, BAO Yingxue
2025, 23(4): 584-587. doi: 10.16766/j.cnki.issn.1674-4152.003956
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  Objective  To explore the effect of "4+3" warm chain dynamic body temperature management combined with relatives' language awakening on thoracoscopic lung surgery patients under general anesthesia, and to provide a reference for clinical construction of a more perfect perioperative intervention plan.  Methods  From January 2023 to January 2024, 109 patients undergoing thoracoscopic lung surgery under general anesthesia in the First Affiliated Hospital of Wenzhou Medical University were selected and divided into control group and experimental group by random number table method, with 55 and 54 cases respectively. The control group took routine insulation measures in the operating room and woke up by medical staff, and the observation group used "4+3" warm chain dynamic body temperature management combined with relatives ' language to wake up. The temperature, anesthesia recovery, and incidence of adverse reactions of the two groups were compared at different time points.  Results  The body temperature of experimental groups at anesthesia induction (T1), 15 min after anesthesia induction (T2), 30 min after surgery (T3), 60 min after surgery (T4), 90 min after surgery (T5), after surgery (T6) and 10 min after entering anesthesia recovery room (T7) were all higher than those of the control group (P < 0.05). The recovery time of spontaneous consciousness was (15.88±3.24) min, the spontaneous breathing time was (6.44±2.10) min, and the retention time in the anesthesia recovery room was (21.24±4.13) min, which were lower than that of the control group [(22.56±2.78) min, (9.34±2.45) min, and (31.90±4.55) min (P < 0.05)], and the incidence of adverse reactions was 5.56% (3/54), which was lower than that of the control group [(18.18% (10/55), P < 0.05].  Conclusion  The "4+3" warm chain dynamic body temperature management combined with relatives' language awakening intervention can maintain the perioperative temperature stability of patients with thoracoscopic lung surgery under general anesthesia, promote anesthesia recovery, shorten the retention time in the resuscitation room, and reduce the incidence of adverse reactions.
The clinical value of NF-κB, IL-6, IL-10, IFN-α and T cell subsets in peripheral blood in predicting the prognosis of AECOPD patients
LI Yi, NI Weibo, CHI Yi, SHANG Huanxia, GUO Lijuan
2025, 23(4): 588-591. doi: 10.16766/j.cnki.issn.1674-4152.003957
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  Objective  To explore the clinical value of nuclear factor kappa-B (NF-κB), interleukin-6 (IL-6), IL-10, interferon-α (IFN-α) and T cell subset count in peripheral blood in predicting the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), in order to provide reference for the clinical treatment of the disease.  Methods  A total of 204 AECOPD patients admitted to Hebei Chest Hospital from June 2023 to March 2024 were studied and separated into poor prognosis group and good prognosis group by the 6-month prognosis. The levels of NF-κB, IL-6, IL-10, IFN-α and T cell subsets in peripheral blood were compared between the two groups, and the prognostic value of the above indexes was analyzed.  Results  The levels of NF-κB, IL-6, IL-10, IFN-α and CD8+ in peripheral blood in the poor prognosis group were higher than those in the good prognosis group (P < 0.05), while CD3+, CD4+, CD4+/CD8+ were lower (P < 0.05). Logistic regression analysis showed that NF-κB, IL-6, IL-10, IFN-α, CD3+, CD4+, CD8+ and CD4+/CD8+ in peripheral blood were all related factors affecting the prognosis of AECOPD patients (P < 0.05). Receiver operating characteristic curve analysis results showed that the areas under the curve of peripheral blood NF-κB, IL-6, IL-10, IFN-α, CD3+, CD4+, CD8+, CD4+/CD8+ in the prediction of the prognosis of AECOPD patients were 0.804, 0.806, 0.858, 0.842, 0.626, 0.702, 0.724, 0.854, respectively.  Conclusion  NF-κB, IL-6, IL-10, IFN-α and T cell subset count levels in peripheral blood are closely related to the prognosis of of AECOPD patients, and can be used as an important indicator to predict the prognosis of AECOPD patients.
The influence of wet compress of Yanghe Decoction on wound healing in ulcerative-stage lower limb varicose veins under wet healing theory
XIE Licheng, HUANG Haiyan, FAN Libin, WEI Liliang, HONG Jin
2025, 23(4): 592-595. doi: 10.16766/j.cnki.issn.1674-4152.003958
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  Objective  This study aims to evaluate the application of Yanghe Decoction wet dressing based on wet healing theory, promoting wound healing in postoperative patients with lower extremity varicose veins at the ulcer stage.  Methods  A total of 96 patients with ulcerated lower extremity varicose veins, admitted to the Affiliated Hospital of Shaoxing University from September 2022 to August 2024, were selected and divided into an observation group and a baseline group based on a random number table method, with 48 patients in each group. The baseline group received postoperative treatment, while the observation group received Yanghe Decoction wet dressing based on the wet healing theory in addition to the baseline treatment. The treatment efficacy, traditional Chinese medicine (TCM) syndrome scores, ulcer area, postoperative wound healing time, and complication rates were evaluated in both groups. Vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1α (HIF-1α), and transforming growth factor-β1 (TGF-β1) were also measured.  Results  The observation group demonstrated significantly better therapeutic efficacy compared to the baseline group (P < 0.05). After treatment, the scores for the main symptoms of TCM syndromes and the total score in the observation group were lower than those in the baseline group (P < 0.05). The ulcer area and ulcer depth in the observation group after treatment were smaller than those in the baseline group (P < 0.05). The wound healing time in the observation group [(28.33±4.08) days] was shorter than that in the baseline group [(30.25±4.14) days, t=2.289, P < 0.05]. After treatment, the levels of VEGF and TGF-β1 in the observation group were higher than those in the baseline group, while the level of HIF-1αwas lower (P < 0.05). The incidence of complications in the observation group was 6.25% (3/48), which was lower than in the baseline group (20.83%, 10/48, χ2=4.360, P=0.037).  Conclusion  Under the theory of wet healing, the application of Yanghe Decoction wet compress can effectively improve treatment effect, reduce symptoms of patients, promote postoperative wound healing, regulates the levels of VEGF, TGF-β1, and HIF-1α, and reduce complications in patients with ulcer-stage lower extremity varicose veins.
Analyzing the correlation of GLP-1R with blood glucose and lipids and its effect on obese patients with type 2 diabetes mellitus
PAN Ye, JIN Huawei, GAO Qian
2025, 23(4): 596-599. doi: 10.16766/j.cnki.issn.1674-4152.003959
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  Objective  To analyze the effect of glucagon-like peptide-1 receptor (GLP-1R) gene polymorphisms on obese patients with type 2 diabetes mellitus and investigate the correlation between this receptor and glycemic and lipid indices.  Methods  A total of 80 obese patients with type 2 diabetes mellitus admitted to the Affiliated Hospital of Shaoxing University of Arts and Sciences from January 2022 to November 2023 were selected as the observation group, while 80 cases of healthy individuals were selected as the control group. The glycemic and lipid indices, gene distribution, correlation, and multifactorial logistic analysis were compared between the two groups.  Results  The distribution of total cholesterol, triglycerides, fasting blood glucose, glycosylated hemoglobin levels, rs3765467 locus CC genotype and rs2268657 locus GG genotype were higher in the observation group than those in the control group (P < 0.05). The glycated hemoglobin was significantly higher in patients with CC genotype at rs3765467 locus than CT+TT genotype, and HDL was significantly higher in patients with GG genotype at rs2268657 locus than GA+AA genotype (P < 0.05). The CC gene at locus rs3765467 was positively correlated with glycated hemoglobin (r=0.825, P=0.036), and the GG genotype at locus rs2268657 was positively correlated with HDL (r=0.812, P=0.023). The GLP-1R rs3765467 locus and rs2268657 locus were identified as factors influencing the development of type 2 diabetes mellitus (OR=3.414, 3.206, all P < 0.05).  Conclusion  The CC gene at locus rs3765467 was positively correlated with glycated hemoglobin, while the GG genotype at locus rs2268657 was positively correlated with HDL. The GLP-1R rs3765467 and rs2268657 loci are associated with the development of type 2 diabetes.
Application of opioid-free anesthesia combined with Esketamine in elderly laparoscopic surgery
LI Bingqing, SHI Siren, HUANG Changjun, WU Meihua
2025, 23(4): 600-603. doi: 10.16766/j.cnki.issn.1674-4152.003960
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  Objective  To explore the application effect of esketamine combined with dexmedetomidine in the induction of opioid anesthesia in elderly patients, and to analyze its influence on their hemodynamics during laparoscopic surgery.  Methods  In the period spanning April to July 2022, a total of 60 elderly patients who underwent laparoscopic surgery at the First People' s Hospital of Linping District in Hangzhou were methodically divided into two groups. This division was conducted through the utilization of a random number table method, with 30 patients in the opioid-based anesthesia (OBA) group receiving conventional opioid anesthesia and the remaining 30 patients in the opioid-free anesthesia (OFA) group receiving de-opioid anesthesia. The hemodynamics, intraoperative sedation index, visual analogue scale (VAS) and Rasmay scores at varying times of rest and exercise, and the incidence of adverse reactions were then compared between the two groups.  Results  Post-operative extubation time and postanest-hesia care unit (PACU) stay time in the OFA group were found to be significantly found to be significantly longer than those in the OBA group (P < 0.05); this was the case at the following time points: after anesthesia induction (T1), after tracheal intubation (T2), at skin incision (T3), at the beginning of pneumoperitoneum (T4), and 5 minutes after pneumoperitoneum (T5). Heart rate (HR) in the OFA group was higher than that in the OBA group (P < 0.05); mean arterial pressure (MAP) in the OFA group at T2-T5 was lower than that in the OBA group (P < 0.05); bispectral index (BIS) index in the OFA group at T2-T3 was higher than that in the OBA group at T4-T5 was lower than that in the OBA group (P < 0.05); Rasmay score in the OFA group was higher than that in the OBA group at 30 min after surgery (P < 0.05). The VAS score in the OFA group was lower than that in the OBA group at the end of surgery and 30 min after surgery (P < 0.05). Nausea and vomiting occurred in 2 cases in the OFA group (6.67%) compared to 8 cases in the OBA group (26.67%, χ2=4.320, P=0.038).  Conclusion  The use of opioid anesthesia in elderly patients undergoing laparoscopic surgery may better maintain hemodynamic stability, reduce postoperative adverse events, and play a role in postoperative sedation and analgesia.
Application of "5G" emergency management model in trauma emergency treatment
LI Lin, WANG Enzhao, LI Laichun, ZHOU Jiehao, SONG Kun
2025, 23(4): 604-607. doi: 10.16766/j.cnki.issn.1674-4152.003961
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  Objective  To explore the effect of the "5G" emergency management model in trauma treatment, and analyze the factors influencing the success rate of resuscitation.  Methods  A total of 198 trauma patients treated in Fuyang People' s Hospital from January 2021 to August 2023 were retrospectively analyzed. According to the different rescue models, they were divided into observation group (90 cases, treated using 5G emergency management model) and control group (108 cases, treated using routine trauma center rescue process). The rescue effect of the two groups were compared. According to whether the rescue was successful, the patients were divided into an effective group and an ineffective group. Univariate and Multivariate logistic regression analysis were performed to identify the risk factors affecting the success of the rescue, and based on this, a corresponding early warning model was established.  Results  Compared with the control group, the observation group had shorter examination completion time, consultation completion time, first diagnosis confirmation time, blood transfusion waiting time, and surgery waiting time (P < 0.05), the ICU admission rate and mortality rate were low (P < 0.05). Compared with the effective group, the time from injury to admission in the ineffective group was significantly longer, the injure severity score (ISS) score before treatment was higher, and the proportion of patients with abbreviated injury scale (AIS) head and AIS chest scores ≥3 was larger (P < 0.05). Logistic regression analysis showed that high ISS score before treatment, AIS≥3 score and long time from injury to hospital admission were risk factors affecting the treatment effect of trauma patients (OR > 1, P < 0.05), while adopting the "5G" emergency management model was a protective factor to improve the rescue effect of trauma patients (OR < 1, P < 0.05). Early warning model constructed by four factors, including ISS score, ASI score, time from injury to admission, and rescue management model, had high early prediction power on the rescue effect of trauma patients, with ROC-AUC of 0.861.  Conclusion  ISS score, ASI score, and time from injury to admission are factors that affect the treatment effect of trauma patients. Adopting the "5G" emergency management model can improve the rescue efficiency and success rate. The early warning model built based on the influencing factors has good predictive effectiveness for the treatment effect of trauma patients.
Application of CBL education model combined with mind mapping in self-injection of insulin in T2DM patients
LU Sujuan, CONG Wenjie
2025, 23(4): 608-612. doi: 10.16766/j.cnki.issn.1674-4152.003962
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  Objective  To explore the effects of case-based learning (CBL) combined with mind mapping on self-injection insulin knowledge and blood glucose in type 2 diabetes mellitus (T2DM) patients, aiming to improve the quality of health education.  Methods  A total of 101 patients with T2DM treated at the First Affiliated Hospital of Wenzhou Medical University from January 2022 to January 2024 were selected. They were randomly divided into a control group (51 cases, receiving insulin injection education through verbal instructions and brochures) and an experimental group (50 cases, receiving insulin injection education using the CBL education model combined with mind mapping). The education period lasted for 3 months. Insulin injection knowledge and skills, blood glucose level and incidence of adverse reactions were compared between the two groups.  Results  After intervention, the insulin injection knowledge of experimental group was better than that of control group (P < 0.05), and the score of injection technique mastery was higher than that of control group (P < 0.05). HbA1c [(5.68 ± 1.14) % vs. (7.05 ±1.26) %], fasting blood glucose [(6.77±1.25) mmol/L vs. (8.11±2.37) mmol/L], 2 h postprandial blood glucose [(9.01±2.31) mmol/L vs. (10.58±2.57) mmol/L] were lower than those of control group (P < 0.05). The overall incidence of adverse reactions was lower than that of the control group (P < 0.05).  Conclusion  CBL education model combined with mind mapping has positive effects on the improvement of self-injection insulin knowledge and skills, blood glucose control and prevention of adverse reactions in T2DM patients.
Investigation of quality of life in Duchenne muscular dystrophy children in Anhui Province and analysis of influencing factors
WU Jie, CHEN Xin, MAO Huifang, CHENG Jin, WEI Suo, WANG Lihua
2025, 23(4): 613-617. doi: 10.16766/j.cnki.issn.1674-4152.003963
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  Objective  To investigate the oral health-related quality of life and associated factors in children with Duchenne muscular dystrophy (DMD) in Anhui province, providing reference for improving the quality of life in this population and developing relevant health management systems.  Methods  A cross-sectional survey was adopted to select the children with Duchenne muscular dystrophy who met the criteria in Anhui Province from February to August 2023. The pediatric quality of life inventory measurement models (PedsQL) was used to investigate the quality of life of DMD patients, and multiple liner regression analysis was used to explore the factors influencing quality of life scores in DMD patients.  Results  A total of 179 valid questionnaires were collected, with an effective response rate of 90.40%. The average age at diagnosis was 3.00 (2.00, 5.00) years old, with a misdiagnosis rate of 41.90% (75/179) and a long-distance treatment rate of 69.27% (124/179). In addition, the PedsQL quality of life score for children was (42.22±20.38) points. The patient health questionnaire-9 (PHQ-9) showed that 77.65% (139/179) of participants exhibited depressive tendencies. Multiple linear regression analysis identified age, primary place of residence, receipt of hormone therapy, and caregiver depression as significant factors influencing quality of life scores in children with DMD (P < 0.05).  Conclusion  There is still significant potential for improving the quality of life for children with DMD in Anhui Province. The quality of life is influenced by factors such as patient' s place of residence, hormone therapy, and the caregiver' s feelings of depression. Proactive measures should be taken to improve the quality of life for DMD patients, strengthen education on disease prevention and management, and provide humanistic care.
Analysis of changes in gut microbiota structure in neonatal hyperbilirubinemia caused by early-onset sepsis
SHEN Nan, QIAO Jibing, JIANG Yazhou, WU Rang, YU Qiao, ZHU Suyue
2025, 23(4): 618-622. doi: 10.16766/j.cnki.issn.1674-4152.003964
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  Objective  The utilization of high-throughput sequencing technology facilitates the elucidation of the gut microbiota structure and the alterations in neonatal hyperbilirubinemia (NH) occasioned by early onset-sepsis (EOS).  Methods  A total of 25 children diagnosed with NH caused by EOS in Suqian Hospital Affiliated to Xuzhou Medical University from December 2022 to July 2023, and 26 healthy newborns born during the same period were included in the study. The NH group and the control group were defined, respectively. All newborn stool samples were collected and DNA was extracted. 16S rDNA amplicon sequencing was performed after passing the quality inspection. The Shannon index and ace index, which are used to assess diversity, were employed to compare the richness and diversity between the two groups. The structural similarity of microbiota was compared using the weighted unifrac distance in the β diversity analysis. To identify significant differences in bacteria at multiple levels, the linear discriminant analysis (LDA) and LDA Effect Size (LEfSe) analyses were used. Finally, the richness of the top ten strains in the two groups was compared and the biomarkers were screened.  Results  A total of 281 operational taxonomic units (OTUs) were obtained in the two groups, including 157 in the NH group, 124 in the control group, and the same 66 OTUs. The Shannon and Ace indices exhibited an increase in the NH group, with the Shannon index demonstrating statistical significance (P < 0.05). The key bacterial species (biomarkers) in the NH group are characterized by a decrease in the richness of Streptococcus salivarius (P < 0.05), and an increase in the richness of Escherichia (P < 0.05), Klebsiella pneumoniae (P < 0.05), and Streptococcus oralis (P < 0.05).  Conclusion  The diversity of the gut microbiota has been observed to increase in newborns with NH caused by EOS. At the phylum and genus levels, the most significant changes in NH group abundance were observed to be Firmicutes and Escherichia. The shift in key species was characterized by a decrease in beneficial bacteria and an increase in opportunistic pathogenic bacteria.
Application of the real-time fluorescence PCR melting curve method in gene screening for newborn hearing loss
PAN Shuqing, PAN Jiewen, BAO Youwei, PAN Xiaoli, ZHUANG Danyan
2025, 23(4): 623-626. doi: 10.16766/j.cnki.issn.1674-4152.003965
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  Objective  To analyze the accuracy of the fluorescence PCR melting curve method in screening for newborn deafness genes, and to understand the variation types and frequencies of common deafness genes in the local population. It provides reference for gene screening and prevention of deafness in the future.  Methods  A retrospective analysis was conducted on 5 563 newborns and screened for deafness genes at Ningbo Women and Children' s Hospital Affiliated to Ningbo University, from November 2022 to October 2023. Firstly, the fluorescent PCR melting curve method was used to detect 15 mutation sites in four deafness genes (GJB2, SLC26A4, mitochondrial 12S rRNA, and GJB3), followed by Sanger sequencing to verify the positive samples.  Results  Among the 5 563 newborns, 256 cases of deafness gene mutation were detected, yielding a total detection rate of 4.60%. Mutations in the GJB2 gene were found in 156 cases (2.80%), in the SLC26A4 gene in 73 cases (1.31%), in the mitochondrial 12S rRNA gene in 10 cases (0.18%), and in the GJB3 gene in 16 cases (0.29%). Additionally, one case of complex heterozygous mutations was detected (0.02%). The positive samples were verified by Sanger sequencing, revealing 9 cases with inconsistent results. Therefore, the accuracy of the fluorescence PCR melting curve method is 96.48%.  Conclusion  The GJB2 gene and SLC26A4 gene are the main mutations associated with deafness in newborns in this region. Fluorescence PCR fusion curve method combined with Sanger sequencing method accurately detects genetic mutations related to deafness. This mothed is helpful for early detection of congenital, drug-induced, and delayed-onset deafness, playing an important role in the early prevention and treatment of deafness.
Relationship and predictive value of GA/HbA1c levels in late pregnancy and early neonatal hypoglycemia in pregnant women with gestational diabetes mellitus
WANG Lingyan, LI Yun, MO Yun, CHEN Yaning, LU Jiali, YANG Weiwei, CHEN Yan
2025, 23(4): 627-630. doi: 10.16766/j.cnki.issn.1674-4152.003966
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  Objective  This study endeavors to investigate the correlation between the ratio of glycated albumin to glycated hemoglobin (GA/HbA1c) in the third trimester of gestational diabetes mellitus (GDM) pregnancies and the occurrence of early neonatal hypoglycemia, and to investigate the value of this ratio in predicting the risk of neonatal hypoglycemia. This could offer a theoretical foundation for the early clinical identification of high-risk newborns and contribute to reducing complications associated with hypoglycemia.  Methods  A total of 190 pregnant women with GDM were selected from Huzhou Maternity & Child Care Hospital from January 2022 to October 2024. GA and HbA1c levels were detected in the third trimester, and the GA/HbA1c ratio was calculated. The patients with early neonatal hypoglycemia were included in the observation group (n=41), while the remaining patients were included in the control group (n=149). A logistic regression model and forest plot analysis were used to examine the relationship between GA/HbA1c in late pregnancy and early neonatal hypoglycemia. The receiver operating characteristic (ROC) curve was used to assess its predictive value.  Results  The blood glucose level at 30 min, 12 h, and 24 h in the observation group were lower than those in the control group, respectively (P < 0.05). The GA and GA/HbA1c ratio in the observation group were higher than those in the control group (P < 0.05). Without adjustment for confounding factors, each unit increase in GA and GA/HbA1c was associated with a 0.592-fold and 1.087-fold increase in the risk of early neonatal hypoglycemia, respectively. After adjusting for gestational weeks and birth weight of newborns, each unit increase in GA and GA/HbA1c was associated with a 0.641-fold and 0.912-fold, respectively. The AUC values of GA and GA/HbA1c in predicting early neonatal hypoglycemia in the third trimester of GDM were 0.739 and 0.855, respectively. The AUC values for GA/HbA1c in predicting early neonatal hypoglycemia were greater than those for GA alone (Z=2.017, P=0.044).  Conclusion  The increase of GA/HbA1c level in women with GDM in the third trimester is a risk factor for early neonatal hypoglycemia. The GA/HbA1c ratio in the third trimester is expected to be a potential indicator for predicting early neonatal hypoglycemia.
Practice and exploration of developing community specific disease service package based on a community hyperlipidemia treatment service package
LI Qin, JIANG Haixian, LI Yunjia, LI Tianshu, SHEN Fulai, WANG Lei, ZHU Ji
2025, 23(4): 631-635. doi: 10.16766/j.cnki.issn.1674-4152.003967
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The service package is an important tool for community health service organizations to develop connotation and build characteristics, but its connotation, development process, delivery process and specific results are not clear. This study takes the development of the "hyperlipidemia Service Package for the Treatment of Preventive Diseases (in community nursing homes)" as an example, to clarify the connotation of the service package for the health industry, rationalizes the development process and puts forward a framework for the development of the service package. It also points out that, although the service package for the treatment of chronic diseases with hyperlipidemia has been put into operation and received good feedback from service recipients, it is only at the primary stage in comparison with the connotation of the industry and the requirements of the service package, and it needs to be perfected in the future in terms of the embodiment of the health connotation, the form of display, the social publicity, and the terminal output in order to cope with the new demands of the development of the health industry in the new period. This study has a strong reference significance in the methodology of service package development for community health service organizations to rapidly create special diseases and specialities.
Application effect of traditional Chinese medicine sequential exercise program in patients with bipolar disorder in depression
LI Ping, FENG Hong, ZHANG Huiling, YANG Xiaoyan, HE Yuemin
2025, 23(4): 636-639. doi: 10.16766/j.cnki.issn.1674-4152.003968
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  Objective  To analyze the effect of traditional Chinese medicine sequential exercise program in patients with bipolar disorder (BD) in depression, and to provide a new reference for exercise intervention in patients with BD depression.  Methods  A total of 136 patients with bipolar disorder and depression admitted to Shaoxing Seventh People' s Hospital from January 2023 to October 2024 were selected as the research subjects and randomly divided into a control group and an observation group, with 68 patients in each group. The control group received routine nursing care, while the observation group received a sequential exercise regimen based on traditional Chinese medicine on the basis of the control group. The depressive symptoms, emotional status, and sleep quality of two groups of patients before and after intervention were compared.  Results  After intervention, the Hamilton depression scale-24 (HAMD-24) score for the observation group was (7.50±2.28) points, which was lower than that in the control group [(11.23±3.49) points, P < 0.05]. The positive emotion score in the observation group' s positive and negative affect scale (PANAS) was (34.66±3.25) points, which was higher than that in the control group [(30.29±4.10) points], the negative emotion score was (17.12±2.55) points, which was lower than that in the control group [(19.03±3.14) points, P < 0.05]. The total score and seven factor scores of Pittsburgh sleep quality indes (PSQI) in the observation group were lower than those in the control group (P < 0.05).  Conclusion  The application of traditional Chinese medicine sequential exercise program in patients with bipolar disorder depression can effectively alleviate depressive symptoms, improve positive emotional experiences, and enhance sleep quality.
Correlation between carotid hypoechoic plaques and recurrent cerebral infarction based on quantitative analysis of contrast-enhanced ultrasound
SHANG Ruimiao, KONG Mingang
2025, 23(4): 640-642. doi: 10.16766/j.cnki.issn.1674-4152.003969
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  Objective  To evaluate the value of quantitative contrast-enhanced ultrasound analysis in predicting recurrence cerebral infarction by assessing carotid hypoechoic plaques.  Methods  A total of 116 patients diagnosed with cerebral infarction for the first time at Jinhua Municipal Central Hospital Affiliated to Zhejiang University School of Medicine from August 2019 to August 2021 were included in the study. All patients underwent quantitative contrast-enhanced ultrasound analysis and were followed up for 1 year. Based on recurrence, they were divided into a recurrence group (n=17) and a non-recurrence group (n=99). The general clinical data and relevant parameters of contrast-enhanced ultrasound time-intensity curve were compared between the two groups. The diagnostic performance of contrast-enhanced ultrasound time-intensity curve parameters in predicting cerebral infarction recurrence was analyzed by ROC curves.  Results  (1) There were no significant differences in gender, the National Institutes of Health stroke scale (NIHSS) score, and stroke between the two groups (P > 0.05). However, the average age of the recurrence group was higher than that of the non-recurrence group (P < 0.05). (2) There were no significant differences in the risk factors of cerebrovascular disease between the two groups (P > 0.05). (3) The enhanced intensity (EI) value, slope, and ratio value of the recurrence group were significantly higher than in the non-recurrence group (P < 0.05). (4) Multifactorial logistic regression analysis revealed that EI value and ratio value were independent risk factors for recurrence of cerebral infarction. (5) The AUC values of EI value and ratio in predicting the recurrence of cerebral infarction were 0.679 and 0.706, respectively (Z=1.051, P=0.318), with a higher AUC observed when both values were combined.  Conclusion  Quantitative contrast-enhanced ultrasound analysis can effectively detect the neovascularization and density, and provide valuable reference value for predicting the recurrence of cerebral infarction.
Diagnostic Value of Systemic Immune-Inflammation Index in Subacute Thyroiditis
GUO Jieyun, YANG Di, MA Huiqing, XIE Hongxiang, SHEN Yan, ZHANG Rong
2025, 23(4): 643-646. doi: 10.16766/j.cnki.issn.1674-4152.003970
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  Objective  To evaluate the diagnostic value of the systemic immune-inflammation index (SII) in cases of subacute thyroiditis (SAT).  Methods  A retrospective analysis was conducted on the demographic and laboratory data of 127 patients with SAT and 100 healthy controls who were seen in both outpatient and inpatient departments of Zhejiang Provincial People' s Hospital from January 2020 to September 2022. SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), CRP, ESR and TSH were compared between patients with SAT and healthy controls, and the correlation between SII and NLR, PLR, CRP, ESR and TSH was analyzed. Stepwise logistic regression analysis was used to screen for independent predictors, and the area under the ROC curve was used to evaluate the diagnostic value of SII in SAT.  Results  In comparison with the healthy control group, the SAT patient group demonstrated significantly elevated SII, NLR, PLR, CRP and ESR, while TSH was significantly reduced (P < 0.001). A significant positive correlation between SII and NLR (r=0.867, P < 0.001), PLR (r=0.788, P < 0.001), CRP (r=0.415, P < 0.001) and ESR (r=0.414, P < 0.001), while SII demonstrated a significant negative correlation with TSH (r=-0.384, P < 0.001). Multivariate regression analysis demonstrates that SII (OR=1.004, P < 0.001), CRP (OR=1.228, P < 0.001), ESR (OR=1.085, P < 0.001) and FT4 (OR=1.748, P < 0.001) were independently influential factors for SAT. When the SII cut-off point was set at 555.8, the AUC was 0.91 (95% CI: 0.87-0.95), with sensitivity set at 90.0% and specificity at 83.4%.  Conclusion  SII has potential application as a practical marker for the diagnosis of SAT disease.
Research progress in the diagnosis and treatment of medically unspecified disease manifested by dizziness
JIANG Ruijuan, HU Mengjie, ZHU Jiahong, REN Jingjing
2025, 23(4): 647-650. doi: 10.16766/j.cnki.issn.1674-4152.003971
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Dizziness is the most common complaint among patients in general practice clinics. Dizziness can have negative effects on patients' life, social, work, and other aspects, causing functional impairment. The symptom of dizziness is subjective and non-specific, and the cause may involve multiple disciplines. There is still a lack of tools to assess dizziness accurately and rapidly at present. Understanding and treating dizziness correctly is of great significance to patients and their families. The etiology of dizziness is numerous and diverse, and the management of dizziness remains a challenge for general practitioners. For patients manifested by dizziness, the current management methods of general practitioners include cause-based treatment, symptomatic treatment, rehabilitation, and psychotherapy to reduce symptoms, relieve mood, and reduce impairment of daily functioning. Further research is needed on how general practitioners can help some people with dizziness to live with symptoms and find effective interventions and treatments. This article summarizes domestic and international literature on the diagnosis, and treatment of dizziness in recent years, and reviews the epidemiology, clinical characteristics, diagnosis, and treatment of dizziness, in order to provide general practitioners with reference for the management of medically unspecified diseases manifested by dizziness.
The role of the mitochondria-inflammasome pathway in the progression of chronic liver disease
WU Huan, WU Long, ZHANG Baofang
2025, 23(4): 651-655. doi: 10.16766/j.cnki.issn.1674-4152.003972
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Chronic liver disease is a serious global health concern, with increasing incidence and mortality rates. Mitochondrial dysfunction and activation of the inflammasome pathway play key roles in the progression of chronic liver disease. As the energy center of cells, mitochondria are involved not only in energy metabolism but also in apoptosis, oxidative stress, and inflammation. The inflammasome, an intracellular multiprotein complex, is essential for the cell' s response to pathogens and cellular stress. Recent studies have increasingly linked mitochondria and inflammasome activation, revealing that mitochondria play an important role in inflammasome activation. Damaged mitochondria release signaling molecules that promote the formation and activation of inflammasome, triggering the release of inflammatory cytokines such as IL-1β, IL-18, and TNF-α. Additionally, mitochondria-related proteins directly participate in the assembly and activation of inflammasome. Current researches have shed light on the relationship between mitochondria and inflammasomes in chronic liver disease. In this review, we aim to elaborate on the structure, activation signal pathways, regulatory mechanisms, and their relationship with chronic liver diseases. These insights may offer new directions and targets for the treatment of chronic liver diseases.
Research progress on the relationship between glucose variability and pancreatic beta cell function and the intervention targets
DIAO Yingli, ZHANG Yujian, SONG Xuenan, ZHANG Jianbo, CONG Riping, XU Lujia, WANG Wei, TANG Kuanxiao
2025, 23(4): 656-659. doi: 10.16766/j.cnki.issn.1674-4152.003973
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Glucose variability (GV) is more harmful to diabetic patients than sustained high blood glucose levels. Glycemic variability reflects fluctuations in blood glucose, and increasing number of clinical and basic research has shown that glucose variability is closely related to the function of pancreatic beta cell, with a bidirectional influence. GV leads to functional failure of islet beta cells and insulin resistance through pathophysiological mechanisms such as oxidative stress and chronic inflammatory responses. Several indicators are used to evaluate GV, including glycated hemoglobin A1c, glycated albumin, and self-monitoring, each with obvious limitations. Continuous glucose monitoring can provide a reliable tool for studying glucose variability. This article reviews the latest research on the relationship between GV and pancreatic beta cell function, as well as potential intervention targets. Topics covered the definition and monitoring indicators of glucose variability, its harmful effects, the potential mechanisms underlying pancreatic beta cell dysfunction caused by abnormal glucose variability, the correlation between glucose variability and pancreatic beta cell function, and the therapeutic strategies aimed at improving pancreatic beta cell function by targeting glucose variability. This review provides valuable insights for the protection of pancreatic function and for the prevention and treatment of diabetes and its complications.
The curative efficacy of fascial knife technique combined with extracorporeal shock wave and comprehensive rehabilitation training for postpartum low back pain
WU Guangyan, WANG Lu, YU Ge, CHEN Xueli
2025, 23(4): 660-664. doi: 10.16766/j.cnki.issn.1674-4152.003974
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  Objective   To explore the curative effect of fascial knife technique combined with extracorporeal shock wave and comprehensive rehabilitation training on postpartum low back pain, aiming to provide a reference for its clinical treatment.   Methods   A total of 90 postpartum patients with low back pain admitted to the outpatient department of Beijing Tongren Hospital, Capital Medical University from March 2022 to March 2024 were chosen and separated into the control group (n=45, comprehensive rehabilitation training) and the study group (n=45, fascia knife technique + extracorporeal shock wave + comprehensive rehabilitation training) according to random number table method. After 8 weeks of treatment, the efficacy was compared; Pain [visual analogue scale (VAS) score], lumbar function [Oswestry disability index (ODI)], lumbar motion, and quality of life were compared between the two groups before and 8 weeks after treatment.   Results   The study group had a higher total effective rate [91.11% (41/45) vs. 73.33% (33/45), χ2=4.865, P < 0.05]. VAS scores and ODI scores in the study group were lower than the other group after treatment [(1.24±0.27) points and (9.18±2.14) points vs. (2.41±0.50) points and (13.35±3.16) points, F=1 093.908, 580.535, P < 0.05]. After treatment, the motion of left, right, forward, and posterior lumbar flexion in the study group was higher than that in the control group (P < 0.05), and the score of quality of life was also higher (P < 0.05).   Conclusion   The fascia knife technique combined with extracorporeal shock wave and comprehensive rehabilitation training has a definite curative effect in the treatment of postpartum low back pain, which can significantly reduce their pain, improve their low back function, and enhance their quality of life.
Effect of umbilical patch of traditional Chinese medicine on atopic dermatitis in children and its influence on skin barrier function
WANG Yang, LI Yaoyao, LI Changchang, CHEN Xinchun, LIN Xiaoqiong
2025, 23(4): 665-668. doi: 10.16766/j.cnki.issn.1674-4152.003975
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  Objective  Atopic dermatitis (AD) currently lacks specific therapeutic means, and the effect of conventional treatment is limited. This study was to investigate the effect of umbilical patch on children with AD and its effect on skin barrier function.  Methods  A total of 89 children with AD admitted to the dermatology department of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from October 2021 to September 2023 were randomly divided into treatment group and control group, 45 cases and 44 cases, respectively. The control group was given conventional treatment with pimeclimus cream and emollient, and the treatment group was given traditional Chinese medicine (TCM) umbilical patch on the basis of conventional treatment. After 4 weeks of treatment, the therapeutic effect was evaluated by SCORing atopic dermatitis (SCORAD) and symptom score reduction index (SSRI). The changes in laboratory indexes serum immunoglobulin E (IgE), peripheral blood eosinophil count (EOS), skin barrier function [cuticle water content, sebum content, and transcutaneous water loss (TEWL)] were compared.  Results  After treatment, the SCORAD score of both groups decreased compared with that before treatment (P < 0.05), and the treatment group [(11.27±2.64) points vs. (14.01±3.45) points] was lower than that of the control group. SSRI [(53.92±12.79) % vs. (41.23±10.25) %] and total effective rate [95.56% (43/45) vs. 79.55% (35/44)] were higher than those of the control group, the difference was statistically significant (P < 0.05). After treatment, serum IgE, peripheral blood EOS, and TEWL in both groups were decreased compared with that before treatment, and the corneum water content and sebum content in the skin lesions were increased compared with that before treatment (P < 0.05). Serum IgE, peripheral blood EOS, and TEWL in the skin lesions were lower than those in the control group, while the corneum water content and sebum content in the skin lesions were higher than those in the control group. The difference was statistically significant (P < 0.05).  Conclusion  TCM umbilical patch can effectively relieve the symptoms of AD, reduce the level of serum IgE and peripheral blood EOS, improve the skin barrier function, and enhance the clinical effect.
A trinity of psychological crisis warning and counseling for medical master's students
YU Zhan, WANG Nan, SUN Haili
2025, 23(4): 669-672. doi: 10.16766/j.cnki.issn.1674-4152.003976
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Graduate education plays a key role in cultivating high-level innovative talents in China and is an important driving force for national development and social progress. As a profession directly related to public health and safety, doctors demand not only exceptional medical skills but also strong psychological resilience and humanistic care. Clinical professional master's students face enormous academic pressure and psychological challenges in both their professional learning and clinical practice, making early detection and intervention of mental health issues particularly important. Firstly, graduate supervisors play a crucial role in identifying potential psychological issues. By closely monitoring students ' emotional and behavioral changes through regular communication and guidance, they can detect early signs of anxiety and depression, providing timely guidance and assistance. Secondly, as an important force in the daily management and service of students, graduate counselors should establish an effective psychological health monitoring and intervention system. Counselors can enhance students ' awareness of mental health through organizing mental health lectures, workshops, and other activities, while providing professional psychological support for students in need through one-on-one counseling. Finally, as important supporters of students, parents should also participate in the management of students ' mental health. By communicating with mentors and counselors, they can help create a warm and supportive family environment. Through the tripartite collaborative model of mentors, counselors, and parents, a comprehensive mental health support network can be formed. This model can not only detect and intervene in the psychological problems, but also provide more accurate and effective psychological counseling for students, effectively resolve their psychological crises, and help students successfully complete their studies and transit into their professional careers in a mentally healthy manner.
Analysis of clinical pharmaceutical knowledge level and training needs among general practice resident physicians
ZHAO Yazi, JIANG Pin, HUANG Yan, LIU Zuoyuan, FANG Ling
2025, 23(4): 673-676. doi: 10.16766/j.cnki.issn.1674-4152.003977
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  Objective  This study aims to investigate the clinical pharmaceutical knowledge needs of general practice resident physicians in medical institutions, analyze the current problems in their clinical drug therapy practices, and explore the deficiencies and improvement strategies in clinical pharmaceutical education during the residency process.  Methods  A total of 195 general practice resident physicians from 12 general practice resident training bases in many cities of Anhui Province during 2022 to 2024 were selected as the study objects. Questionnaire survey method was adopted, designed by expert survey method and small sample pre-survey. The questionnaire was filled in through the wechat client of "Wenjuanxing" online questionnaire. The main survey contents of the investigation were divided into the following parts: general information of general resident physicians, common issues in clinical medication, awareness of clinical pharmaceutical services, and preferences for clinical pharmaceutical knowledge training methods, etc. The current clinical pharmaceutical knowledge level and training needs of general resident physicians were analyzed comprehensively and statistically from multiple dimensions.  Results  A total of 196 questionnaires were distributed, with 195 valid questionnaires collected. The results showed that clinical pharmaceutical knowledge training during rotations was insufficient, and limited attention to adverse drug reaction reporting and pharmacodynamics/pharmacokinetics (PK/PD) knowledge. Only 49.23% (96 people) of the respondents considered the residency process as an effective way to acquire medication knowledge, while 88.72% (173 people) of the general practice resident physicians expressed a strong demand for clinical pharmaceutical knowledge training, particularly in rational drug use, medication for special populations, and adverse drug reactions.  Conclusion  The current clinical pharmaceutical knowledge training for general practice resident physicians falls short of practical needs, with gaps in coverage, time constraints, and insufficient emphasis from the institutions. It is urgent to establish a practice-oriented long-term training system and assessment system to address the clinical medication issues and improve rational drug use among general practice residents.
The application of the problem-oriented teaching mode integrated mind mapping in clinical ultrasound teaching
WANG Bing, SUI Yang, WU Feng, SUN Chao
2025, 23(4): 677-679. doi: 10.16766/j.cnki.issn.1674-4152.003978
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  Objective  To analyze the impact of the problem-based learning model integrated with mind mapping on the quality of ultrasound clinical teaching.  Methods  Clinical medical students who studied in the Ultrasound Department of the First Affiliated Hospital of Bengbu Medical University from January 2023 to October 2023 were selected and grouped by cluster sampling based on the teaching methods. Class 2 of the clinical experiment was chosen as the control group, receiving conventional teaching, while Class 1 was selected as the research group, implementing the problem-based learning model integrated with mind mapping. The theoretical test scores and teaching effect evaluations were compared between the two groups.  Results  After the implementation of teaching, the research group demonstrated significantly higher scores than the control group in theoretical test (77.41±3.66 vs. 72.47±4.30), teaching effect (229.41±14.99 vs. 203.37±17.55), and comprehensive ability (86.53±6.46 vs. 74.25±5.24, P < 0.05). Additionally, students in the research group reported significantly higher satisfaction in areas such as practical skills, learning interest, communication, teamwork, and problem-solving abilities compared to the control group (P < 0.05).  Conclusion  The problem-based learning model integrated with mind mapping is beneficial for promoting students ' understanding and retention of clinical knowledge, enhancing learning efficiency and skills, and facilitating autonomous learning ability, and improving the satisfaction of teaching.
Systematic review of patient-reported outcome measures for pruritus
JIAO Shuting, ZHAO Yali
2025, 23(4): 680-684. doi: 10.16766/j.cnki.issn.1674-4152.003979
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  Objective  To systematically assess the quality of pruritus-related patient-reported outcome measures (PROMs) and provide a guidance for selecting appropriate tools.  Methods  PubMed, Embase, web of science, CNKI, Wanfang, Whipple, and Chinese Biomedical Literature databases were searched to identify publicly available studies on pruritus-related PROMs both domestically and internationally. Two researchers evaluated the methodological quality and measurement attributes of the included studies using the consensus-based standards for the selection of health measurement instruments (COSMIN).  Results  A total of 27 studies involving 24 pruritus-related PROMs were included. Thirteen PROMs were given a recommendation rating. Among the multidimensional pruritus tools, SIIS (English) and ICQ (English) were rated level A, while FIIQ (Chinese), EIQ (Traditional Chinese), BIQ (Chinese), and Pruritus Evaluation Scale (Chinese) were recommended as level B, and 12-PSS (Chinese) was related level C. Among pruritus-related quality of life tools, the TweenItchyQoL (English) was related level A, while the UP-Dial (11 items in Chinese), SRISS (English), and ItchyQoL (Chinese) were related level B, and the UP-Dial (14 items in Chinese) and KIQoL (English) were related level C.  Conclusion  SIIS (English), ICQ (English), and TweenItchyQoL (English) need to be translated into Chinese before application. ItchyQoL (Chinese) measurement has a relatively comprehensive measurement attribute evaluation and can be used as a Chinese tool for use at present.
Relationship between socioeconomic status and restricted mobility trajectory in the life course of middle-aged and elderly people
QI Dandan, LIANG Xiao, NING Zhenlian, QIAO Mingliang, MENG Yi
2025, 23(4): 685-690. doi: 10.16766/j.cnki.issn.1674-4152.003980
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  Objective  To evaluate the association between socioeconomic status and the trajectory of mobility limitation over the life course, and to provide evidence to support the identification of risk factors for late quality of life in middle-aged and older adults.  Methods  Based on the China Health and Retirement Tracking Survey (CHARLS) data, into the third followed up and observed at least twice limited mobility of 7 714 subjects, the trajectory model based on group to explore mobile capacity constrained optimal trajectory group. Multinomial logistic regression models were used to assess the socioeconomic status of each follow-up and the association between socioeconomic status (SES) trajectories over the life course and mobility limitation trajectories. Mediating effect analysis was used to explore the mediating effect of adult socioeconomic status (ASE) on the association between childhood socioeconomic status (CSE) and the trajectory of mobility limitation.  Results  The participants with low SES in childhood or adulthood were at higher risk of developing into the poor mobility limitation trajectory group. Compared with high-high SES, high-low SES and low-low SES were both associated with an increased risk of persistent moderate and increasing to high mobility limitation trajectories, respectively, and the cumulative risk of exposure to adverse SES was greatest during these two periods. In addition, ASE had a significant indirect effect on the association between CSE and the persistent trajectory group or the increasing trajectory group, and the correlation between the mobility limitation trajectory and CSE could reach 13.68%-35.90%.  Conclusion  Intervention in socioeconomic status exposure in childhood and adulthood can effectively reduce the risk of mobility limitations in later life.
Current situation and influencing factors of recurrence fear in younger aged patients with advanced lung cancer
SUN Caiyun, ZHANG Xiaomei, CHEN Yanfang
2025, 23(4): 691-694. doi: 10.16766/j.cnki.issn.1674-4152.003981
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  Objective  To analyze the current situation of recurrence fear in younger aged patients with advanced lung cancer, and to analyze its influencing factors, so as to provide theoretical basis for improving the overall quality of life of patients.  Methods  A total of 120 younger aged patients with advanced lung cancer admitted to Handan Central Hospital from October 2022 to October 2023 were selected by random sampling method to investigate their recurrence fear. The relevant factors affecting patients ' fear of recurrence were analyzed. Pearson correlation was used to analyze the correlation between recurrence fear and hospice care demand. Multiple linear regression was used to analyze the influencing factors for patients ' recurrence fear.  Results  The scores of the fear of cancer recurrence inventory-Chinese version (FCRI-CV) for younger aged patients with advanced lung cancer ranged from 79 to 131 (97.72±13.49) points. The scores of FCRI-CV were higher in patients with junior high school or below and poor family support than in those with senior high school or above and good family support (P < 0.05). The total scores of the hospice needs assessment scale ranged from 69 to 122 (92.37±8.89) points. Pearson correlation analysis showed that the score and total score of each dimension of FCRI-CV were positively correlated with the total score of hospice needs assessment scale (P < 0.05). Multiple linear regression analysis showed that education level, family support and hospice care demand were all influencing factors for recurrence fear in younger aged patients with advanced lung cancer (P < 0.05).  Conclusion  The fear of cancer recurrence in younger aged patients with advanced lung cancer is at a high level, and the education level, family support and the need for hospice care are all influential factors for the fear of recurrence.
The application of enabling theory combined with rapid rehabilitation surgery in perioperative nursing for patients undergoing radical nephrectomy
WANG Yan, GE Yuzheng, CHENG Jing
2025, 23(4): 695-698. doi: 10.16766/j.cnki.issn.1674-4152.003982
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  Objective  This study aims to investigate the application of the enabling theory combined with the concept of rapid rehabilitation surgery in perioperative nursing for patients undergoing radical nephrectomy, providing theoretical guidance for the selection of optimal clinical nursing programs.  Methods  A total of 102 patients who were expected to undergo radical nephrectomy in Nanjing First Hospital, Nanjing Medical University from January 2021 to December 2023 were chosen and separated into the control group (n=51, perioperative routine nursing) and the study group (n=51, enabling theory combined with the concept of rapid rehabilitation surgery) according to random number table method. Postoperative recovery indexes, psychological status, coping strategies, and complications of the two groups were compared.  Results  The hospitalization time, first feeding time, anal exhaust time, and time to ambulation in the study group were shorter than those in the control group (P < 0.05). SDS and SAS scores after the intervention in the study group were lower than the study group [(48.16±2.97) points and (46.64±3.25) points vs. (53.01±1.05) points and (50.12±1.01) points, P < 0.05]. In contrast to the control group, the yield and avoidance scores after the intervention in the study group were lower [(7.38±0.96) points and (9.25±2.01) points vs. (9.47±1.35) points and (12.73±2.88) points], while the face scores were higher [(21.52±4.09) points vs. (17.41±3.28) points, P < 0.05]. The study group had lower total incidence of postoperative complications compared with the control group [5.88% (3/51) vs. 19.61% (10/51), χ2=4.320, P=0.038].  Conclusion  Enabling theory combined with the concept of rapid rehabilitation surgery in the perioperative nursing of patients undergoing radical nephrectomy is effective, significantly improve psychological well-being, and promotes faster recovery after surgery.
Application effect of task-oriented training combined with stepped rehabilitation training on patients with UBE for lumbar disc herniation
ZHANGYANG Xibei, ZHOU Pinghui, ZHANG Jingjing, ZOU Yang
2025, 23(4): 699-703. doi: 10.16766/j.cnki.issn.1674-4152.003983
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  Objective  To explore the application effect of task-oriented training combined with stepped rehabilitation training on patients with unilateral double-channel endoscope (UBE) for lumbar disc herniation (LDH) and analyze the influence on self-efficacy, exercise compliance, lumbar function and quality of patients.  Methods  A total of 80 patients with LDH who received UBE were selected in the First Affiliated Hospital of Bengbu Medical University from September 2021 to September 2023 and were divided into a control group (40 cases) and an observation group (40 cases) by random number table method. The patients in the control group received routine nursing agent rehabilitation training after surgery. On the basis of the intervention in the control group, the patients in the observation group were given task-oriented training combined with stepped rehabilitation training. Chronic pain self-efficacy scale (CPSS), functional exercise compliance scale for orthopedic patients, Oswestry dysfunction index (ODI), and 36-item short-form health survey (SF-36) were used to evaluate the self-efficacy, exercise compliance, lumbar function and quality of life of patients at 1 day and 1 month after surgery.  Results  The scores of pain management, physical function, and symptom coping of the CPSS scale in the two groups 1 month after surgery were enhanced than those 1 day after surgery (P < 0.05), and the above scores in the observation group were higher than those in the control group (P < 0.05). At 1 month after surgery, the exercise compliance scores of psychological aspect, active learning, and physical aspect and total score were risen in both groups compared with those at 1 day after surgery (P < 0.05), and the observation group had higher scores than those in the control group (P < 0.05). The ODI score in the two groups declined at 1 month after surgery than that at 1 day after surgery (P < 0.05), and the ODI score of (27.05±3.84) points in the observation group was lower compared with (29.18±4.16) points in the control group (F=5.662, P < 0.05). At 1 month after surgery, the SF-36 score in both groups was increased compared with that at 1 day after surgery (P < 0.05), and the score in the observation group with (65.63±10.58) points was higher than (60.70±9.34) points in the control group (F=4.881, P=0.030).  Conclusion  After UBE in LDH patients, task-oriented training combined with stepped rehabilitation training can effectively enhance self-efficacy and exercise compliance, and it is conducive to improving lumbar dysfunction and enhancing the quality of life of patients.
Application of the navigation nurse management model based on ERAS concept in the perioperative period of daytime surgery for adult inguinal hernia
LAI Liya, FAN Xufei, CHEN Jicai, WU Dazhou
2025, 23(4): 704-707. doi: 10.16766/j.cnki.issn.1674-4152.003984
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  Objective  With the increase of the number of day surgery, the quality of day surgery nursing service is also concerned. Based on the concept of ERAS, this study constructs a pilot nurse management model for adult inguinal hernia surgery during the day, providing reference for the standardized management of day surgery.  Methods  A total of 97 patients with inguinal hernia day surgery in the First Affiliated Hospital of Wenzhou Medical University from January to December 2023 were randomly divided into control group (49 cases) and navigation nurse management group (48 cases). The control group was given routine management of day surgery, and the navigation nurse management group gave navigation nurse management based on ERAS concept. All patients were followed up for 3 months to compare the preoperative preparation and completion, temporary surgical cancellation rate, preoperative waiting time, awareness of disease and surgical knowledge, and nursing satisfaction.  Results  The preoperative preparation defect rate in the navigation nurse management group was 29.17% (14/48), which was lower than the control group [59.18% (29/49), χ2=8.853, P=0.003]. The temporary surgical cancellation rate was 4.17% (2/48), which was lower than 18.37% (9/49) of the control group (χ2=4.863, P=0.027). Preoperative waiting time was (65.22±10.23) min, which was shorter than the control group [(90.34±8.17) min, t=13.377, P < 0.001]. Disease and surgical knowledge awareness score was higher than the control group (P < 0.05). The nursing satisfaction score was higher than the control group (P < 0.05).  Conclusion  The navigation nurse management mode based on ERAS concept is positive for improving preoperative preparation, reducing the temporary cancellation rate, shortening preoperative waiting time, and improving patient awareness and nursing satisfaction.
Effect of Orem self-care mode on self-care ability and oral health in patients after radiofrequency thermocoagulation of trigeminal neuralgia
XIA Jianmei, DENG Kang, CHEN Dejian, ZHU Zhihong, XIE Keyue, FANG Li, YAO Ming
2025, 23(4): 708-712. doi: 10.16766/j.cnki.issn.1674-4152.003985
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  Objective  This study aims to address the issue of self-injurious oral ulcers caused by facial numbness in patients following radiofrequency thermocoagulation for trigeminal neuralgia, which contributes to the deterioration in oral health. By applying Orem ' s self-care model, this study explores the clinical value in enhancing self-care abilities and oral health in these patients.  Methods  A retrospective analysis was conducted on 90 patients who underwent radiofrequency thermocoagulation for trigeminal neuralgia at the Pain Department of Affiliated Hospital of Jiaxing University from January 2016 to April 2022. Based on different postoperative nursing models, patients were divided into an observation group and a control group. The observation group consisted of 46 patients who received Orem ' s self-care model, while the control group included 44 patients who received traditional nursing care. The scores for the exercise of self-care agency scale, oral health impact profile, and quality of life scale for trigeminal neuralgia were compared for both groups before and after the intervention.  Results  Three months after the intervention, the scores in all dimensions of the self-care ability scale (self-concept, self-care skills, self-care responsibility, health knowledge level) for the observation group [(28.78±2.11) points, (21.91±2.02) points, (41.83±3.20) points, and (61.13±3.98) points] were significantly higher than those of the control group [(25.25±4.11) points, (19.75±3.29) points, (38.45±6.35) points, and (54.20±9.64) points, P < 0.05]. The total score of the oral health impact profile for the observation group was (13.67±2.87) points, which was significantly better than that of the control group [(17.73±4.23) points, P < 0.05]. The scores in all dimensions of the quality of life scale for trigeminal neuralgia (trigeminal neuralgia attacks, psychological dimension, social dimension) for the observation group [(9.50±2.25) points, (10.70±2.29) points, and (10.16±2.09) points] were significantly better than those of the control group [(7.87±1.64) points, (9.24±2.51) points, and (8.30±1.44) points, P < 0.05].  Conclusion  Orem self-care model effectively improves the self-care ability, oral health status, and quality of life in patients after radiofrequency thermocoagulation for trigeminal neuralgia. Its effectiveness makes it a valuable approach for clinical promotion and application.
Application of intestinal stoma nursing plan based on nursing sensitive quality indicators in neonatal stoma management
LYU Junying, LI Lingyan, LIN Xiaoqing, WANG Zhoujie, CHEN Fangfang
2025, 23(4): 713-716. doi: 10.16766/j.cnki.issn.1674-4152.003986
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  Objective  To construct an intestinal stoma nursing plan based on nursing sensitive quality indicators, analyze its impact on neonatal stoma management pain, incidence of stoma complications, caregiver care ability, and nursing satisfaction.  Methods  A total of 113 newborns with colostomy admitted to the Second Affiliated Hospital and Yuying Children ' s Hospital of Wenzhou Medical University from June 2020 to May 2024 were selected as the research subjects. Among them, 56 newborns admitted from June 2020 to May 2022 were selected as the control group, and routine colostomy nursing was applied. The remaining 57 newborns admitted from June 2022 to May 2024 were selected as the observation group, and nursing sensitive quality indicators were constructed for colostomy nursing. The pain situation, caregiver care ability, incidence of stoma complications, and nursing satisfaction of two teams of newborns were compared.  Results  During the process of replacing the ostomy bag in the observation group, the neonatal pain, agitation and sedation scale (NPASS) scores during and 3 minutes after the operation were lower than those in the control group (P < 0.05). After intervention, the scores and total scores of each dimension of the neonatal caregiver care ability scale in the observation group were higher than those in the control group (P < 0.05). The incidence of fecal dermatitis, skin damage, skin allergy, and rash around the stoma in the observation group of neonatal stoma complications was lower than that in the control group (P < 0.05). The nursing satisfaction rate of the observation group was 96.5% (55/57), which was higher than that of the control group [83.9% (47/56), χ2=5.074, P=0.024].  Conclusion  A nursing plan for colostomy based on nursing sensitive quality indicators is beneficial in reducing adverse stimuli in neonatal colostomy care, reducing pain and complications, and effectively improving caregiver care capabilities.
Four case reports of acute and transient psychotic disorders associated with COVID-19
YANG Yaqin, LIU Na, WANG Fang, HUANG Nan, LI Qingwei
2025, 23(4): 717-720. doi: 10.16766/j.cnki.issn.1674-4152.003987
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Psychiatric symptoms following infection with the novel coronavirus (SARS-CoV-2) are frequently observed and may include delirium, cognitive dysfunction, post-traumatic stress disorder and mood-related disorders. Psychiatric symptoms are uncommon in clinical practice. This article presents the case studies of four patients who developed acute and transient psychotic disorders following novel coronavirus infection. It also review the relevant literature to increase awareness of psychotic symptoms after COVID-19, improve understanding of the disease and the development of symptoms, and achieve early recognition and appropriate treatment.

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