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2025 Vol. 23, No. 6

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General Practice Forum
Exploring a general practice management model for elderly patients with atrial fibrillation based on the ICCC framework
XU Yankai, SHI Shilin, LYU Fuqiang, LIU Kejian
2025, 23(6): 903-906. doi: 10.16766/j.cnki.issn.1674-4152.004028
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As a chronic disease with high morbidity and disability rates, atrial fibrillation (AF) presents a significant challenge to the primary healthcare system in elderly populations. The Innovative Care for Chronic Conditions (ICCC) framework proposed by the World Health Organization provides a theoretical basis for developing a general practice management model in elderly patients with AF, addressing macro, meso, and micro levels. The global incidence of atrial fibrillation continues to rise, and in China, the disease burden and stroke risk among elderly patients with atrial fibrillation are particular pressing concerns. General practitioners, as the core of community-level health management, are responsible for screening, treatment, and patient management. However, the current management model still faces challenges such as insufficient screening efficiency, unequal resource distribution, and poor health awareness of patients. Based on ICCC framework, this paper discusses the general practice management model for elderly patients with atrial fibrillation across three levels. Firstly, it is necessary to strengthen policy support and guidance at the macro level, encouraging all regions to carry out individualized, practice-wide management approaches supported by the allocation of health resources. Secondly, at the meso level, a multidisciplinary team led by general practitioners should be built to improve the bidirectional referral mechanism. Integrating artificial intelligence technology can further improve the accuracy of treatment and the effective use of resources. Finally, at the micro level, health education for elderly patients with atrial fibrillation and their families should be prioritized, and with a focus on empowering patients through family support, lifestyle intervention, and self-monitoring. In the future, improvements in the management of screening, primary care capacity, and the intervention of lifestyle are necessary to provide more efficient and comprehensive general practice management services for elderly patients with atrial fibrillation.
Special Topic/Type 2 Diabetes
Evidence map analysis of influencing factors of type 2 diabetes mellitus in Mendelian randomization study
LIANG Xiaoxia, GAO Min, LIU Huimin, WANG Jinyang, WANG Xiaohuan
2025, 23(6): 907-911. doi: 10.16766/j.cnki.issn.1674-4152.004029
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  Objective  To systematically identify the potential causal factors of type 2 diabetes mellitus (T2DM) based on the Mendelian randomization (MR) approach, and to construct an evidence map to comprehensively evaluate the characteristics and quality of existing studies.  Methods  China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, and Web of Science were searched for studies on MR related to T2DM influencing factors from the database establishment to April 2024. Excel was used to extract and organize the data of the included studies, and the quality of the included studies was evaluated according to the three major hypotheses of MR research. The line chart of the number of publications, the three-line table of influencing factors, and the evidence map were comprehensively used to visualize the study characteristics, exposion-outcome association, and methodological application.  Results  A total of 152 articles (including 207 MR studies) were included after the screening, which summarized the causal association between 9 types of exposures and T2DM. The quality evaluation showed that 32.37%(67/207) of the studies basically met the three major assumptions of MR research, 91.78% (190/207) of the research objects were European population, and there were not enough studies on the Asian population. In terms of methodology, 86.95% (180/207) of the studies mainly used inverse variance weighting (IVW), and 75.36% (156/207) of the studies used more than 3 MR analysis methods. The evidence map suggested that body mass index, 25-hydroxyvitamin D, low birth weight, insomnia, and sedentary behavior had strong evidence of causal association with type 2 diabetes.  Conclusion  This study systematically summarizes the causal relationship between T2DM and influencing factors. By April 2024, the MR studies of T2DM will mainly focus on blood indicators, living habits, diseases, and other aspects. It is recommended to strengthen research on other aspects, especially MR studies on the Asian population and Chinese population, and formulate unified quality evaluation criteria for MR studies. To standardize the analytical methods of MR analysis and provide a standard for higher quality research, so as to provide a more accurate scientific basis for the prevention and treatment of T2DM.
Relationship between plasma apolipoprotein A1 level and mild cognitive impairment in middle-aged and elderly patients with type 2 diabetes mellitus
ZHAO Qi, ZHU Pinghui, MA Li, LYU Taihong, CHEN Yuru
2025, 23(6): 912-915. doi: 10.16766/j.cnki.issn.1674-4152.004030
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  Objective  In recent years, the relationship between blood lipid level and cognitive impairment has received much attention, but there are few studies on plasma apolipoprotein A1 (APOA1). The objective of this study was to investigate the relationship between APOA1 levels and cognitive function in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).  Methods  A total of 223 T2DM patients admitted to Beijing Tiantan Hospital from October 2023 to March 2024 were enrolled by mini-mental state examination. The patients were divided into mild cognitive impairment (MCI) group (n=81) and normal cognitive (NC) group (n=142) with MMSE. The general condition and blood lipid of the two groups were compared, and analyze the correlation between MCI and plasma APOA1 levels.  Results  Among 223 T2DM patients, 81 cases were in MCI group, accounting for 36.3%. After adjusting for confounders, plasma APOA1 levels plasma APOA1 levels were an independent risk factor for MCI in T2DM patients (OR=6.359, P=0.022), and this association was more significant in people over 60 years of age after age-stratified studies. In addition, among patients with T2DM, significant differences in plasma APOA1 levels were observed across different MMSE score groups (P < 0.001).  Conclusion  Plasma APOA1 concentration is associated with MCI in T2DM patients, and comprehensive management measures should be taken to actively control plasma APOA1 level in T2DM patients.
Clinical study of dapagliflozin in combination with metformin for moderate to severe the type 2 diabetes mellitus
WANG Qingfei, XU Jian, LUO Lingli
2025, 23(6): 916-918. doi: 10.16766/j.cnki.issn.1674-4152.004031
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  Objective  To investigate the clinical effects of treatment with dapagliflozin plus metformin in patients with type 2 diabetes on stable control of blood glucose and reducing complications, to provide a reference for the clinical treatment of type 2 diabetes mellitus.  Methods  A total of 80 patients with type 2 diabetes admitted to the Second Affiliated Hospital of Bengbu Medical University from June 2021 to May 2023 were selected, of which 40 patients received dagaglizin combined with metformin as the experimental group. Another 40 patients were given a single dose, that is, metformin alone, as a control group. The therapeutic effects of the two groups were compared, and the blood glucose control indexes before and after treatment were as follows: glycated hemoglobin A1c (HbA1c), fasting blood glucose (FBG), fasting C-peptide, and 1 h postprandial C-peptide. Renal function indexes of patients were as folows: serum creatinine (Cr), uric acid (UA), cystatin C (CysC). Clinical therapeutic effects and adverse reactions of patients in two groups were observed after different treatment methods.  Results  The effective rate of treatment in the test group was 92.5% (37/40), which was significantly higher than that in the control group [75.0% (30/40), P < 0.05]. The results of HbA1c, FBG, fasting C-peptide, and 1 h postprandial C-peptide in the experimental group were significantly different before and after treatment (P < 0.05). The renal function indexes (Cr, UA, CysC) of the experimental group were significantly different before and after treatment (P < 0.05). The incidence of adverse reactions in the experimental group was significantly lower than that in the control group [17.5% (7/40) vs. 50.0% (20/40), P < 0.05].  Conclusion  In the treatment of type 2 diabetes mellitus, dagaglizin combined with metformin has a better effect than metformin alone, which can reduce blood glucose and adverse reactions in patients and significantly improve kidney function of patients.
General Practice Research
Association of peripheral blood IL-18 levels with the severity of postherpetic neuralgia in herpes zoster patients and its early predictive value
WANG Jing, GAN Zhihui, WANG Yidan, WANG Juan
2025, 23(6): 919-922. doi: 10.16766/j.cnki.issn.1674-4152.004032
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  Objective  To explore the correlation between the expression level of interleukin-18 (IL-18) in the peripheral blood of herpes zoster patients and the severity of postherpetic neuralgia (PHN) and to evaluate its early warning value for PHN.  Methods  A total of 403 herpes zoster patients who visited the Department of Dermatology at Anhui Provincial Hospital from September 2023 to August 2024 were selected as the observation group, and 226 physical examination subjects during the same period were selected as the control group. The patients were followed up for 3 months to evaluate the occurrence and severity of PHN. According to the presence or absence of PHN, the patients were divided into PHN group (n=157) and non-PHN group (n=246), and the difference in peripheral blood IL-18 levels between the two groups was compared. Univariate and multivariate logistic regression analysis were used to screen the risk factors of PHN. Spearman rank correlation analysis was used to explore the correlation between the severity of PHN and IL-18. ROC curve was used to evaluate the predictive value of IL-18 for PHN.  Results  The peripheral blood IL-18 level in the herpes zoster group was significantly higher than that in the healthy control group (P < 0.05). As the severity of PHN increased, IL-18 levels were significantly elevated compared to the non-PHN group (P < 0.001). Multivariate logistic regression analysis showed that high IL-18 level, female, old age, diabetes, cardiovascular disease, and high VAS score were independent risk factors for PHN. Use of analgesics within 14 days was a protective factor against PHN. Spearman ' s analysis showed a positive correlation between PHN severity and IL-18 levels (r=0.661, P < 0.001). The ROC curve showed that the AUC for IL-18 in predicting PHN was 0.857, with a sensitivity of 83.9%, specificity of 76.8%, and an optimal cutoff value of 1 233.6 pg/mL.  Conclusion  Peripheral blood IL-18 levels during the acute phase of herpes zoster are closely associated with the severity of PHN. IL-18 is one of the risk factors for PHN and has good early warning value for PHN.
Analysis of causal relationship between gut microbiota and hyperthyroidism based on Mendelian randomization
FAN Yuyun, WEI Junping, CHE Fengyuan
2025, 23(6): 923-926. doi: 10.16766/j.cnki.issn.1674-4152.004033
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  Objective  To investigate the relationship between human gut microbiota and hyperthyroidism.  Methods  The gut microbiota of the MiBioGen database was used as the exposure factor, and hyperthyroidism was used as the outcome variable. The GWAS data of hyperthyroidism were downloaded from the IEU Open GWAS database. Two-sample Mendelian randomization analysis was performed using regression models such as inverse variance weighting method, MR-Egger regression and weighted median method. The causal relationship between GM and intestinal flora was evaluated by β-value and odds ratio of effect index and so on. The stability and reliability of the results were verified by leave-one-out method, heterogeneity test and horizontal gene pleiotropic test.  Results  Mendelian randomization (MR) analysis revealed that, among 119 gut microbiota at the genus level, three bacterial taxa showed a negative association with hyperthyroidism: Dialister (OR=0.998, 95% CI: 0.996-1.000, P=0.037, β=-0.002), Escherichia. Shigella (OR=0.998, 95% CI: 0.996-1.000, P=0.032, β=-0.002), and Ruminococcaceae UCG014 (OR=0.998, 95% CI: 0.996-1.000, P=0.032, β=-0.002). All three genera exhibited β < 0, OR < 1, and P < 0.05, suggesting they may serve as protective factors against hyperthyroidism risk. The results of heterogeneity test (P>0.05), horizontal gene pleiotropic test (P>0.05) and sensitivity analysis proved that the formal results were reliable.  Conclusion  Dialister, Escherichia. Shigella and Ruminococcaceae UCG014 can reduce the risk of hyperthyroidism, the potential relationship between gut microbiota and hyperthyroidism is found preliminarily.
The correlation between serum protein kinase Cε activity, myocardial injury markers and myocardial infarction in patients with acute chest pain
HAO Cuijun, WANG Rui, HONG Yang, LI Xiaoying, HAN Shaojie, LI Fangjiang
2025, 23(6): 927-929. doi: 10.16766/j.cnki.issn.1674-4152.004034
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  Objective  To explore the correlation between serum protein kinase Cε (PKCε) activity, myocardial injury markers and acute myocardial infarction (AMI) in patients with acute chest pain. The study will provide a reference for the prevention and treatment of AMI in patients with acute chest pain.  Methods  A total of 268 patients with acute chest pain who were admitted to the First Affiliated Hospital of Hebei North University from March 2022 to March 2024 were selected and divided into two groups: the AMI group and the non-AMI group according to the occurrence of AMI. Serum PKCε activity and levels of myocardial injury markers [myoglobin (MB), cardiac troponin Ⅰ (cTnI) and creatine kinase-MB (CK-MB)] were evaluated.  Results  The present study found that the AMI group exhibited a lower level of PKCε [(60.31±11.24) μg/L] in comparison to the control group [(87.25±15.96) μg/L]. Furthermore, the AMI group demonstrated higher levels of Mb, cTnI and CK-MB [(119.85±24.72) μg/L, (1.58±0.30) ng/mL and (33.47±8.19) U/L], with the concentrations of (90.69±18.41) μg/L, (0.91±0.15) ng/mL and (15.36±3.79) U/L being found to be significantly higher (t=16.148, 10.788, 22.494, 22.556, P < 0.05). Spearman correlation analysis demonstrated a negative correlation between PKCε and AMI occurrence in patients with acute chest pain, while Mb, cTnI and CK-MB exhibited a positive correlation with this outcome (r=-0.762, 0.611, 0.841, 0.799, P < 0.05).  Conclusion  Serum PKCε activity and myocardial injury markers have been demonstrated to be closely related to AMI occurrence in patients with acute chest pain, and they which can therefore serve as a means to evaluate AMI occurrence in this patient group to a certain extent.
Clinical observation of PD-1/PD-L1 inhibitor combined with chemotherapy in the first-line treatment of extensive-stage small cell lung cancer
LIU Yang, ZHAO Lun, CHEN Yufo, ZHANG Shanshan, WU Yue, SHI Mengting, WANG Rui
2025, 23(6): 930-932. doi: 10.16766/j.cnki.issn.1674-4152.004035
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  Objective  To investigate the clinical value of programmed death receptor-1 (PD-1)/programmed death ligand-1 (PD-L1) immune checkpoint inhibitor combined with standard chemotherapy in the initial treatment of extensive small cell lung cancer (ES-SCLC), so as to comprehensively verify the clinical benefits and risk characteristics of the combined scheme.  Methods  The newly diagnosed ES-SCLC patients in the First Affiliated Hospital of Bengbu Medical University from January 2021 to June 2023 were analyzed retrospectively. According to different treatment schemes, 32 cases were divided into control group (etoposide+cisplatin/carboplatin) and 28 cases were divided into experimental group (PD-1/PD-L1 inhibitor+etoposide+cisplatin/carboplatin). The clinical therapeutic effect, tumor markers and adverse drug reactions of the two groups were compared.  Results  The objective remission rate [71.43% (20/28) vs. 53.13% (17/32), χ2=2.116, P=0.146] and disease control rate [89.29% (25/28) vs. 75.00% (24/32), χ2=2.036, P=0.154] in the experimental group were significantly higher than those in the control group, but the difference was not statistically significant. By the time of follow-up, the median overall survival (OS) of the experimental group was 4.2 months longer than that of the control group (14.0 months vs. 9.8 months, P=0.002). The median progression-free survival (PFS) in the experimental group was 1.1 months longer than that in the control group (5.6 months vs. 4.5 months, P=0.022). After treatment, there were statistically significant differences in the precursor of gastrin-releasing peptide [(88.55±13.48) pg/mL vs. (105.17±25.64) pg/mL] and neuron specific enolase [(38.85±13.94) ng/mL vs. (48.65±12.71) ng/mL] between the two groups (P < 0.05). There was no statistically significant difference in the incidence of grade 3 and above adverse events between the two groups [46.43% (13/28) vs. 43.75% (14/32), χ2=0.043, P=0.835].  Conclusion  PD-1/PD-L1 inhibitor combined with standard chemotherapy regimen is effective in the first-line treatment of ES-SCLC, which can effectively reduce the level of tumor markers and improve the survival prognosis of patients with good safety.
Bidirectional two-sample Mendelian randomization study on the causal association between gut microbiota and colorectal cancer
ZHANG Qiao, ZHOU Xuezhi, ZHANG Dechong, LIANG Shuqi, WU Xinjun, ZHU Shaohui
2025, 23(6): 933-936. doi: 10.16766/j.cnki.issn.1674-4152.004036
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  Objective  The complex pathogenesis of colorectal cancer (CRC) may be potentially linked to gut microbiota (GM); however, existing observational studies are limited by confounding factors in establishing a clear causal relationship. To explore the causal association between GM and CRC using a bidirectional two-sample Mendelian randomization (MR) method.  Methods  GWAS data on 471 GM species and CRC were collected, and strong instrumental variables (IVs) were selected. The causal effect was evaluated using the inverse variance weighted method (IVW), weighted median method (WME), MR-Egger method, simple mode method, and weighted mode method, with IVW as the primary approach. Bayesian weighted Mendelian randomization (BWMR) was further used for analysis, and the results were presented with ORs and 95% CIs. The reliability and robustness of the results were assessed through Cochran's Q test, MR-Egger intercept test, MR-PRESSO test, and leave-one-out sensitivity analysis. Finally, a reverse MR analysis was performed for GM species positively associated with CRC.  Results  IVW analysis showed that the genus Succinivibrionaceae (OR=0.819, 95% CI: 0.718-0.934, P=0.003), Alistipes shahii (OR=0.731, 95% CI: 0.573-0.933, P=0.012), Psychroserpens (OR=0.643, 95% CI: 0.492-0.840, P=0.001), and Prevotella buccae (OR=0.849, 95% CI: 0.737-0.977, P=0.022) were significantly associated with CRC. BWMR results were consistent with the IVW method, and no significant heterogeneity or horizontal pleiotropy was observed. Reverse MR analysis revealed no significant causal relationship between CRC and these four GM species (P>0.05).  Conclusion  The abundance of Succinivibrionaceae, Alistipes shahii, Psychroserpens, and Prevotella buccae is negatively correlated with the risk of CRC, suggesting that these GM species may be protective factors for CRC. Further research is needed to explore the mechanisms through which GM influences CRC development.
Experimental study on the promotion of bone defect healing by GelMa hydrogel loaded with Puerarin composite scaffold
ZHANG Zhongchuan, XU Zhiyuan, XU Wendi, ZHANG Jingquan, YUAN Lingli
2025, 23(6): 937-941. doi: 10.16766/j.cnki.issn.1674-4152.004037
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  Objective  To prepare a new kind of biomaterial that can promote the healing of bone defect by constructing the GelMa composite hydrogel loaded with Puerarin.  Methods  Scanning electron microscope and Young's modulus were used to analyze the physical characteristics of the composite scaffolds. Gradient concentrations of Puerarin/GelMa scaffolds (20, 40, 80, and 100 μmol/L) were constructed, and the effects of scaffolds on cell proliferation at different time points were investigated by CCK-8. ALP and alizarin red staining were used to investigate the effect of various stents on osteogenic differentiation and select the most suitable stents. A craniotomy defect model was successfully established. Employing a completely randomized design, rats were randomly allocated into four groups by means of a random number table. These four groups were designated as the blank group, the GelMa group, the puerarin group, and the puerarin + GelMa group. Each group consisted of three rats, resulting in a total of twelve rats for the study. Samples were collected 8 weeks after surgery. micro-CT, Western Blotting, HE staining, Masson's staining, and ALP immunohistochemical staining were performed on the skull samples to evaluate the effect of Puerarin+GelMa scaffolding on bone defects in vivo.  Results  The porosity and pore size of the composite scaffold were similar to that of GelMa. Young's modulus showed no significant difference between the composite scaffold [(3.30±0.30) MPa] and the single GelMa [(3.22±0.25) MPa, t=0.359, P=0.738]. CCK-8 experiment showed that Puerarin had the strongest promotion effect on osteoblast proliferation at 80 μmol/L (P < 0.05). ALP and alizarin red staining showed that the positive area percentage of the 80 μmol/L group was the largest (P < 0.05). micro-CT, Western Blotting, HE staining, Masson's staining, and ALP immunohistochemistry showed that the Puerarin+GelMa group had the most new bone tissue growth, and its repair ability for bone defects was significantly higher than that of the blank group (P < 0.05).  Conclusion  Puerarin+GelMa scaffold with a puerarin concentration of 80 μmol/L has the ability to promote osteogenic differentiation of osteoblasts, and can effectively promote bone defect healing in vivo, which can be used as a new biomaterial for bone defect repair.
A qualitative study on the rehabilitation exercise needs of elderly hip arthroplasty patients throughout the entire care continuum from the perspective of cognitive behavioral theory
QU Huiwu, ZHEN Qiyun, SU Zhou, CUI Lili, DAI Tingting, DOU Hongmei
2025, 23(6): 942-945. doi: 10.16766/j.cnki.issn.1674-4152.004038
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  Objective  The occurrence of joint motor limitation, vascular complications such as deep vein thrombosis of the lower extremities, anxiety, depression and other negative emotions in elderly total hiparthroplasty (THA) patients are all closely related to their rehabilitation exercise. Therefore, it is very important to do a good job in managing the rehabilitation exercise nursing management of elderly THA patients. This study conducted interviews from the perspective of cognitive behavioral theory. By exploring the differentiated real experiences of elder THA patients in the process of rehabilitation exercise, it provided a reference for the clinical construction of individualized and full-cycle rehabilitation exercise programs.  Methods  Purposive sampling was used to select elderly THA patients treated at the People's Hospital Affiliated to Jiangsu University from March to April 2023 as research subjects. Semi-structured interviews were conducted with the patients, and 18 patients were eventually interviewed. Directed content analysis was used to analyze the data and refine the themes.  Results  Three themes could be deduced for the full cycle rehabilitation exercise needs of elderly THA patients, (1) bias of cognitive level before surgery (self-cognitive health needs; family and emotional support needs; preparation and use needs of surgery-related items; confidence and belief needs of rehabilitation exercise). (2) Different needs in the initial rehabilitation exercise after surgery (different needs in acquiring knowledge about disease rehabilitation; self-care needs in life; exercise needs). (3) Different needs in home rehabilitation exercise after discharge (networked continuous care needs; external environment support needs).  Conclusion  Elderly THA patients have different problems and needs at in different stages of rehabilitation exercise. Healthcare professionals should take the cognitive-behavioral theory as a guide, provide personalized guidance, pay attention to their physical and mental feelings, and build a tripartite "healthcare professionals-peers-family" rehabilitation exercise support system for elderly THA patients, so as to adapt to the rehabilitation cognition and needs at different stages of the disease, and improve patients' compliance of patients with rehabilitation exercise.
Effect of stellate ganglion block combined with acupuncture and moxibustion on peripheral facial paralysis
XUE Yan, GU Mengting, QIN Xiarong, XIA Yanfei, LIU Tao
2025, 23(6): 946-949. doi: 10.16766/j.cnki.issn.1674-4152.004039
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  Objective  To investigate the efficacy of stellate ganglion block (SGB) combined with acupuncture in the treatment of peripheral facial palsy (PFP) and its effects on facial nerve function and related indicators, thereby providing a reference for clinical treatment strategies.  Methods  A total of 112 patients with PFP admitted to Zhejiang Hospital from January 2020 to October 2024 were selected and divided into group A (72 cases) and group B (40 cases) according to different therapies. Group A was treated with acupuncture and moxibustion, and group B was treated with SGB combined with acupuncture and moxibustion for 4 weeks. The traditional Chinese medicine (TCM) syndrome score, facial nerve function (H-B grading score, Pormann score), facial disability index (FDI score), clinical efficacy, and adverse reactions (nausea, vomiting, loss of appetite, stellate ganglion injury, local hematoma, blood glucose fluctuations, blood pressure fluctuations) of two groups were observed.  Results  The TCM syndrome score of group B after treatment was lower than that of group A (P < 0.05). The H-B grading score of group B after treatment was lower than that of group A (P < 0.05), and the Pormann score was higher than that of group A (P < 0.05). After treatment, the physical function score in the FDI scale of group B was higher than that of group A (P < 0.05), and the social life dysfunction score was lower than that of group A (P < 0.05). The total effective rate of group B was 95.00% (38/40), which was higher than group A [80.56% (58/72), P < 0.05]. The incidence of adverse reactions in group B was 15.00% (6/40), and that in group A was 13.89% (10/72). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).  Conclusion  SGB combined with acupuncture and moxibustion is effective in the treatment of PFP, which can alleviate the symptoms of patients, improve facial nerve function and facial disability index, with less adverse reactions, and has both effectiveness and safety, and is worth promoting.
General Clinical Research
Effect of sacubitril valsartan on preventing ventricular remodeling after radiofrequency ablation for atrial fibrillation and its influence on inflammatory factors
GU Fangfang, PAN Yongkang, LU Kongjie, ZHU Yingwei, DENG Lang
2025, 23(6): 950-953. doi: 10.16766/j.cnki.issn.1674-4152.004040
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  Objective  To investigate the effect of sacubitril valsartan on the prediction of ventricular remodeling after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) and analyze its influence on inflammatory factors, with a view to providing a new strategy for clinical treatment.  Methods  A total of 152 AF patients in Huzhou Central Hospital from January 2022 to October 2023 were selected and received RFCA. After surgery, according to the random envelope method, patients were divided into a conventional group (receiving conventional postoperative treatment) and a treatment group (sacubitril valsartan in addition to the conventional group), with 76 cases in each group. The indicators of ventricular remodeling, inflammatory factors, recurrence of atrial fibrillation, and adverse reactions before and after treatment were compared between the two groups.  Results  After 60 days of treatment, the left ventricular ejection fraction and QRS voltage of patients in the treatment group were higher than those in the conventional group (P < 0.05), while the left ventricular end-diastolic diameter, end-systolic diameter, interventricular wall thickness, P wave dispersion and QRS duration were lower than those in the conventional group (P < 0.05). After 60 days of treatment, the levels of serum C-reactive protein and interleukin-6 in the treatment group with (5.33±1.27) mg/L and (5.44±1.15) pg/mL were lower than (6.38±1.18) mg/L and (7.08±1.44) pg/mL in the conventional group (F=28.281, 61.441, both P < 0.05). No statistical differences were observed in the cumulative recurrence rates of atrial fibrillation at 3, 6, and 12 months after treatment between the two groups (P>0.05). There were no statistical differences in the adverse drug reactions between the two groups (P>0.05).  Conclusion  Sacubitril valsartan can effectively improve ventricular remodeling and reduce the inflammatory response in AF patients after RFCA, and it has high safety.
The prediction model of health-related quality of life after nasal endoscopy constructed based on the Wilson-Cleary model
REN Yanli, ZOU Qirui, YANG Lili, ZHANG Mengmeng, WANG Wenzhong
2025, 23(6): 954-957. doi: 10.16766/j.cnki.issn.1674-4152.004041
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  Objective  To analyze the factors affecting health-related quality of life (HRQoL) of patients after functional endoscopic sinus surgery (FESS) based on Wilson-Cleary model, and construct an individualized nomogram prediction model to provide a reference for improving patients'HRQoL level.  Methods  A total of 172 patients undergoing FESS operation in the Department of Otolaryngology and Head and Neck Surgery of Huaibei People's Hospital from January 2022 to December 2023 were selected as the study objects. According to the HRQoL level one month after discharge, they were divided into high HRQoL group and low HRQoL group. The main influencing factors of HRQoL of patients were analyzed by logistic regression. The nomogram was constructed by rms package in R software and the model was verified.  Results  Lesion range, regular review, depression-anxiety-stress self-rating score, family caring score, disease perception score and nasal subjective symptom score were the main influencing factors of HRQoL in patients after FESS (P < 0.05). Hosmer-Lemeshow goodness of fit test were χ2=2.618, P=0.162, indicating that the regression model was well fitted. The area under ROC curve was 0.933 (95% CI: 0.886-0.979, P < 0.001), the sensitivity was 87.3%, and the specificity was 91.6%, indicating that the model was well distinguished.  Conclusion  The HRQoL of FESS postoperative patients with chronic sinusitis, irregular follow-up review, negative psychology, poor family care, high negative illness perception, and severe subjective nasal symptoms is relatively poor. The HRQoL nomogram model constructed based on Wilson-Cleary model has a good predictive effect, which is helpful for medical staff to predict the HRQoL level of patients after FESS.
Effect of new bioceramic material iRoot SP combined with single cusp root canal filling on periodontal microecology in patients with dental pulp disease
QIU Wei, HU Yangtao, XUAN Guihong
2025, 23(6): 958-962. doi: 10.16766/j.cnki.issn.1674-4152.004042
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  Objective  The present study investigates the efficacy of a newly developed bioceramic material, iRoot SP, in combination with single-pointed root canal fillings.  Methods  In this study, 112 patients diagnosed with dental pulp disease were selected from Zhuji People ' s Hospital, and the study period spanned from December 2023 to June 2024. The subjects were randomly divided into a control group (n=56) and an observation group (n=56) using a random number table method. The control group were treated with a new bioceramic material known as iRoot SP, in combination with cold manometry. In the observation group, patients were treated with the same bioceramic material, iRoot SP, in combination with a single cusp root canal filling. Periodontal microecology, gingival crevicular fluid inflammatory indicators, inflammatory factor levels, along with masticatory efficiency, pain degree as measured by the VAS score, filling condition categorised, and clinical efficacy were compared.  Results  After treatment, the probing depth (PD), probing bleeding index (PBI), tooth mobility (TM), plaque index (PI) of the two groups were decreased, and the observation group was lower than those of the control group (P < 0.05). The matrix metalloproteinase (MMP)-2 and MMP-8 levels of the two groups following treatment were reduced, and the the observation group was lower than those of the control group (P < 0.05). The levels of the hypersensitive C-reactive protein (hs-CRP), TNF-α and IL-1β in both groups decreased following treatment, and the levels of these markers in the observation group was lower than those in the control group (P < 0.05). Following the treatment, there was a marked enhancement in masticatory efficiency between the two groups, and the VAS score exhibited a significant decrease was decreased. The observation group was better than those of the control group (P < 0.05). The filling rate of the observation group was 89.29% (50/56), which was higher than 73.21% (41/56) of the control group (P < 0.05). The total effective rate of the observation group was 96.43% (54/56), which was higher than 83.93% (47/56) of the control group (P < 0.05).  Conclusion  The present study investigates the efficacy of the novel bioceramic material iRoot SP in combination with single-cusp root canal filling as a treatment modality for dental endodontic disease. The findings demonstrate that this approach leads to a favourable improvement in the periodontal microecological level of patients, a reduction in the degree of inflammation and pain, and an enhancement in mastication efficiency and filling efficacy. These observations underscore the merits of adopting this treatment method.
Change curve and analysis of social frailty in maintenance hemodialysis patients
GU Chunyan, ZHANG Xiaomei, ZHOU Yan, KANG Ningsu
2025, 23(6): 963-966. doi: 10.16766/j.cnki.issn.1674-4152.004043
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  Objective  To examine the dynamic trajectories of social frailty in maintenance hemodialysis patients and the factors that influence these trajectories.  Methods  A total of 155 patients receiving maintenance hemodialysis who were admitted to the hospital between April 2020 and October 2022 were selected for inclusion in the study. At different time points, the subjects were asked to complete a basic information questionnaire, and the Chinese version of the social frailty index scale and the social support rating scale were used. These tools were used to identify different trajectories of social decline in patients receiving maintenance hemodialysis. The latent class growth model was then used to identify these trajectories.  Results  The present study posits that three potential categories of social frailty trajectories exist among dialysis patients with the average probability of 0.944, 0.908 and 0.946, respectively, for maintenance hemodialysis patients to belong to each category. The categories are as follows: social faltering plus restructuring (30.3%), social faltering improvement group (51.8%), and social faltering stabilization group (17.9%). The analysis revealed a statistically significant association between age (H=11.773, P=0.019), gender (χ2=7.618, P=0.022), and self-rated personality type (χ2=10.016, P=0.040), whether or not the participant was still working after contracting an illness (χ2=10.512, P=0.005), and the social support score (F=7.362, P < 0.001). The differences were statistically significant.  Conclusion  It is evident that three distinct trajectories of social frailty are observable in maintenance hemodialysis patients, These trajectories are influenced by various factors, including age, gender, self-rated personality type, employment status post-illness and social support. Clinical staff must exercise caution when monitoring dialysis patients exhibiting social frailty in conjunction with recombination, as it is imperative to identify high-risk patients with social frailty in a timely manner to mitigate the repercussions of social frailty. Furthermore, it is crucial to provide active proactive and targeted protective care.
Factors influencing arteriovenous fistula dysfunction in maintenance hemodialysis patients and construction and validation of prediction model
XIA Yuanying, BI Mingming, FANG Xiaojuan, XU Xiuqin, LOU Chengli, WU Mei
2025, 23(6): 967-971. doi: 10.16766/j.cnki.issn.1674-4152.004044
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  Objective  The failure of arteriovenous fistula (AVF) seriously affects the quality of hemodialysis. This study aims to explore the influencing factors of AVF failure in maintenance hemodialysis patients and construct a predictive model to provide guidance for the evaluation, prediction, intervention, and prevention of AVF failure in hemodialysis patients.  Methods  A total of 342 maintenance hemodialysis patients from November 2022 to July 2024 at Jiaxing University Affiliated Hospital of Traditional Chinese Medicine were selected as the research subjects. According to whether hemodialysis patients experience AVF dysfunction, they were divided into a dysfunction group (n=55) and a control group (n=287). Clinical data from two groups of patients were collected, including basic information, dialysis and AVF-related information, and laboratory indicators. Multiple logistic regression analyses was conducted to screen risk factors and construct a predictive model for AVF dysfunction in hemodialysis patients. Another 88 hemodialysis patients were selected for clinical external validation.  Results  Advanced age (OR=1.059), diabetes (OR=3.622), blood stasis syndrome (OR=4.787), high level of D-D (OR=1.011), high level of FIB (OR=4.325) were risk factors for AVF dysfunction in hemodialysis patients (P < 0.05). Prediction model: P=ex/(1+ex), X=-19.897+0.058×age+1.287×diabetes+1.566×blood stasis syndrome+0.011×D-D+1.465×FIB. Clinical external validation showed that the accuracy of the model in predicting AVF failure in hemodialysis patients was 90.91% (80/88), and the consistency between the AVF failure prediction model and clinical actual results was high (Kappa=0.680).  Conclusion  Advanced age, diabetes, blood stasis syndrome, and high levels of D-D and FIB are risk factors for AVF dysfunction in hemodialysis patients. The prediction model constructed on this basis is highly accurate. It is of guiding significance for evaluating and predicting AVF dysfunction in hemodialysis patients.
The necessity study of prenatal diagnosis in fetal nuchal translucency from 2.5 to 2.9 mm
FU Huayu, SU Jiasun, HUANG Jing, XU Juanjuan, LI Meng, HUANG Jinai, DU Juan, LI Jiao
2025, 23(6): 972-976. doi: 10.16766/j.cnki.issn.1674-4152.004045
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  Objective  To estimate the risk of chromosomal abnormalities in cases of fetal nuchal translucency (NT) and explore the necessity of NT from 2.5 to 2.9 mm as an indication for prenatal diagnosis.  Methods  A retrospective analysis was conducted on chromosome-tested results of 2 779 fetuses diagnosed with NT≥ 2.5 mm from January 2016 to June 2021 at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. And follow up on the pregnancy outcome of fetuses with NT values ranging from 2.5 to 2.9 mm. The fetuses were divided into four groups according to different NT values: A (2.5-2.9 mm) 555 cases, B (3.0-3.4 mm) 1 026 cases, C (3.5-3.9 mm) 440 cases, and D (≥4.0 mm) 758 cases.  Results  Among 2 779 cases, 606 of aneuploidy and 2 of triploid were detected; 173 of copy number variation(CNV) were detected. The aneuploidy in groups A, B, C, and D were 45 cases (8.11%), 137 cases (13.35%), 87 cases (19.77%), and 337 cases (44.46%), respectively; The risk of aneuploidy increased with the increase of NT value. And the CNV were 23 cases (4.14%), 61 cases (5.95%), 31 cases (7.05%) and 58 cases (7.65%), respectively. In Group A, the aneuploidy in the cases of increased NT isolated, increased NT with soft marks, and increased NT with structural abnormalities were 22 cases (4.55%), 14 cases (28.57%), and 9 cases (40.91%), respectively. The difference was statistically significant (χ2=67.553, P < 0.001). And the CNV were 20 cases (4.13%), 2 cases (4.08%), and 1 cases (4.55%), respectively. The differences weren ' t statistically significant.  Conclusion  When the NT value is between 2.5-2.9 mm, the risk of chromosomal abnormalities in the fetus is still high. Prenatal diagnosis should be recommended, testing the fetal chromosome karyotype and CNV, in order to reduce the birth defects.
Effect of montelukast sodium on the efficacy of Mycoplasma pneumoniae pneumonia and cytokines
SUN Mingyue, GUO Pu, XIA Qun, PENG Wansheng
2025, 23(6): 977-980. doi: 10.16766/j.cnki.issn.1674-4152.004046
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  Objective  In order to study how to treat Mycoplasma pneumoniae pneumonia (MPP) more effectively, montelukast sodium is added on the basis of anti-infection to study its effects on the efficacy of MPP and serum leukotrienes, interleukin 4 (IL-4), and interferon γ (IFN-γ), and to analyze the relationship between the above cytokines and MPP.  Methods  Ninety cases of children with MPP (57 mild cases, 33 severe cases) admitted to the First Affiliated Hospital of Bengbu Medical University from Aprial to December 2022 were selected and divided into a control group (anti-infective) and a study group (anti-infective add montelukast sodium) according to the single or double number of the order of admission on the day of hospitalization, with 45 cases in each group. The efficacy, adverse effects, and changes in cytokine levels before and after treatment between the two groups were compared, and the relationship between the above cytokines and the severity of MPP was compared.  Results  After 7 days of treatment, the study group showed lower scores in cough assessment, shorter fever resolution time, and reduced hospitalization duration compared to the control group. The clinical effectiveness rate was higher in the study group (43 cases, 95.5%) than in the control group (36 cases, 80.0%), with a statistically significant difference (P < 0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). After 7 days of treatment, both groups showed decreased serum levels of leukotrienes and IL-4 and increased IFN-γ levels compared to pre-treatment values (P < 0.05). Moreover, the study group exhibited significantly lower serum leukotriene and IL-4 levels and higher IFN-γ levels than the control group (P < 0.05). Patients with mild MPP had significantly lower serum leukotriene and IL-4 levels but higher IFN-γ levels compared to those with severe MPP (P < 0.05). Correlation analysis showed that the severity of MPP was positively correlated with the levels of serum leukotrienes and IL-4 (rs=0.725, 0.798, both P < 0.001), and negatively correlated with the level of IFN-γ (rs=-0.746, P < 0.001).  Conclusion  Montelukast sodium has good efficacy in treating MPP, which can regulate Th1/Th2 cytokine imbalance and has high safety. The severity of MPP is positively correlated with serum leukotriene and IL-4 levels, and negatively correlated with IFN-γ levels.
Investigation on the status quo of health literacy and health education needs of caregivers of patients with dysphagia after new stroke before discharge
SU Bencheng, YU Shuangjuan, ZHENG Hongjian
2025, 23(6): 981-985. doi: 10.16766/j.cnki.issn.1674-4152.004047
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  Objective  To investigate the status quo of health literacy and health education needs of caregivers of patients with dysphagia (PSD) after a new stroke before discharge, and analyze the related influencing factors.  Methods  A total of 105 PSD patients and their caregivers admitted to Chun ' an Branch of Zhejiang Provincial People ' s Hospital from February 2023 to August 2024 were selected by convenient sampling method. The general data scale, health literacy scale, and health education demand scale were selected to conduct a questionnaire survey on caregivers of PSD patients, and the influencing factors of health literacy and health education demand of caregivers of PSD patients were analyzed by multiple linear regression.  Results  A total of 105 questionnaires were distributed and 98 valid questionnaires were finally recovered (93.33%). The total score of the health literacy scale for caregivers of 98 PSD patients was (48.75±9.20) points, and the total score of the health education demand scale for caregivers was (204.16±10.36) points. The scores of caregivers of PSD patients with different ages, education levels, working status, and relationships with patients were compared, and the difference was statistically significant (P 0.05). There were significant differences in the scores of PSD caregivers ' health education demand scale among different educational levels, patients with or without gastric tubes, patients ' daily meal frequency, and hospitalization time (P < 0.05). Multiple linear regression analysis showed that age, education level, and working status were the influencing factors of health literacy of caregivers of PSD patients (P < 0.05), and whether patients wore gastric tubes, daily meal frequency and hospitalization time were the influencing factors of health education needs of caregivers of PSD patients (P < 0.05).  Conclusion  The health literacy of caregivers of newly diagnosed PSD patients before discharge is in the lower-middle level, and age, educational level, and working status are related factors. The demand for health education is at a high level, and whether the patient has a gastric tube, the daily meal frequency of the patient, and the hospitalization time of the patient are related factors.
An investigation into the impact of mental health on recovery speed following gynecological surgery
YE Tingting, XIE Xiafei, LI Zhujun, PU Weiwei, ZHANG Zhiguo, LI Hongyan
2025, 23(6): 986-988. doi: 10.16766/j.cnki.issn.1674-4152.004048
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  Objective  This study aims to explore the impact and correlation of mental health on the postoperative recovery of patients undergoing gynecological surgery. Since psychological factors may recovery outcomes, understanding its impact will help optimize postoperative management strategies.  Methods  The study involved 304 gynecological patients treated at the First Affiliated Hospital of Anhui Medical University between May 2024 and November 2024. Mental health data were collected one day before surgery through a questionnaire survey administered one day before surgery, which included assessments of depressive mood [patient health questionnaire-9 (PHQ-9 scale)], psychological resilience [Connor-Davidson resilience scale (CD-RISC scale)], social support (social support rating scale), and self-efficacy [general self-efficacy scale (GSES scale)]. In addition, general patient information and clinical recovery indicators were also recorded, including retention time of urinary catheter, time to first mobilization, time to first anal exhaust, and length of hospital stay. Data were analyzed using Pearson correlation analysis.  Results  Spearman's rank correlation analysis showed significant positive associations between depressive symptoms (measured by PHQ-9 score) and three postoperative recovery indicators: time to first ambulation (r=0.286, P < 0.001), time to first flatus (r=0.316, P < 0.001), and length of hospital stay (LOS, r=0.471, P < 0.001). Conversely, resilience (assessed by CD-RISC score) exhibited significant negative correlations with time to first ambulation (r=-0.282, P < 0.001), time to first flatus (r=-0.288, P < 0.001), and LOS (r=-0.405, P < 0.001). Similarly, self-efficacy (measured by GSES score) was negatively associated with time to first ambulation (r=-0.249, P < 0.001), time to first flatus (r=-0.248, P < 0.001), and LOS (r=-0.411, P < 0.001). Additionally, social support rating scale score was significantly negatively correlated with LOS (r=-0.164, P < 0.05).  Conclusion  The mental health status has a significant influence on postoperative recovery in gynecological patients. Strong psychological resilience, social support, and self-efficacy can effectively facilitate postoperative recovery in patients.
The influence of social support on the well-being and rehabilitation of community-dwelling schizophrenic patients under the Clubhouse model
ZHI Qianna, WU Huijuan, LUO Mingjin
2025, 23(6): 989-991. doi: 10.16766/j.cnki.issn.1674-4152.004049
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  Objective  To explore the impact of social support on the overall well-being and rehabilitation of individuals with schizophrenia living in the community, within the framework of the Clubhouse model. The study aims to provide effective evidence to support more effective recovery and reintegration strategies.  Methods  In August 2023, 200 patients with schizophrenia from eight Ren ' ai Home workshop stations in Xiacheng District, Hangzhou, were selected. The patients were divided into two groups according to different rehabilitation models. The intervention group consisted of 100 patients from the Ren ' ai Home workshop stations who voluntarily and actively participated in the international Clubhouse model and its associated services. The control group included 100 patients from the same workshop stations who received conventional rehabilitation services. The scores of the social support scale, general well-being scale (GWB), self-esteem scale (SES), and social dysfunction screening scale (SDSS) of the two groups of patients were compared to analyze the rehabilitation effect.  Results  There was no statistically significant difference in the total score of the Social Support Scale, the scores of the three dimensions, GWB and SDSS between the intervention group and the control group (P>0.05), while there was a statistically significant difference in the SES score between the groups (t=8.372, P < 0.001). Correlation analysis showed that under the club model, social support was correlated with overall well-being (r=0.179, P < 0.05) and social function (r=-0.209, P < 0.05).  Conclusion  The Clubhouse model effectively enhances the social support among community-dwelling individuals with schizophrenia, which is closely related to improvement in their general well-being and social function. Emphasizing the positive role of social support and strengthening support system are crucial for patient recovery and prognosis.
Effect of preoperative virtual reality technology on anxiety in patients undergoing mandibular impacted wisdom tooth extraction
JIANG Aijun, WANG Xiaodan, XU Dongdong
2025, 23(6): 992-995. doi: 10.16766/j.cnki.issn.1674-4152.004050
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  Objective  With the advancement of medical technology, virtual reality technology is gradually being applied in the medical field. This study aims to evaluate the effect of preoperative application of virtual reality technology on alleviating anxiety in patients undergoing mandibular impacted wisdom tooth extraction, and explore its application value in clinical practice, providing scientific basis for optimizing preoperative psychological intervention.  Methods  Convenience sampling was used to select 111 patients who underwent extraction of impacted mandibular third molars at the Affiliated Stomatological Hospital of Wenzhou Medical University from October 2024 to December as the study subjects. They were randomly divided into a control group (n=55) and an observation group (n=56). The control group received routine nursing care, while the observation group received virtual reality technology on the basis of the control group. The preoperative anxiety level, intraoperative pain level, blood pressure, heart rate and satisfaction with nursing care of two groups of patients were compared.  Results  After the intervention, the preoperative Spielberg state trait anxiety inventory and dental anxiety scale scores of the observation group were lower than those of the control group, and the difference was statistically significant (P < 0.05). At the beginning of tooth extraction, during bone removal and tooth separation, and during suturing, the HR, SBP, and DBP of the observation group were higher than those of the control group, and the differences were statistically significant (P < 0.05). During the operation, the VAS of pain in the observation group was lower than that in the control group [(2.75±0.46) points vs. (3.84±1.01) points, t=7.339, P < 0.001]. After surgery, the nursing satisfaction rate of the observation group was 98.2% (55/56), while that of the control group was 96.4% (53/55), with no statistically significant difference (P>0.05).  Conclusion  Preoperative virtual reality technology can effectively reduce anxiety in patients undergoing obstructed wisdom tooth extraction on the basis of routine care, and is also beneficial for stabilizing the surgical center rate and blood pressure, as well as reducing intraoperative pain in patients.
Effects of health education based on empowerment cognition theory on self-management ability and blood pressure variability in outpatients with hypertension
WU Xiangting, CHAI Qiaoying, YU Jing
2025, 23(6): 996-999. doi: 10.16766/j.cnki.issn.1674-4152.004051
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  Objective  Health education plays a vital role in hypertension management. This study aims to explore the application effects of empowerment theory-based health education in outpatient hypertensive patients.  Methods  A total of 204 hypertensive patients treated at the First Hospital of Handan from June 2022 to June 2024 were randomly divided into either an empowered health education group (n=102, routine health education) and a routine intervention group (n=102, health education based on empowerment cognition theory). The scores of self-management behavior and self-efficacy were compared before and after intervention. Blood pressure was measured, and post-intervention blood pressure variability, satisfaction, and incidence of adverse events were recorded.  Results  After the intervention, the scores of self-management behaviors (e.g., dietary habits) in the empowered health education group was higher [(40.54±4.03) points vs. (36.28±3.91) points, F=4.879, P < 0.05]. Similarly, the scores of self-management ability (e.g., dietary habits) in the empowered health education group was higher [(16.56±1.92) points vs. (14.87±1.26) points, F=4.832, P < 0.05]. Whereas, systolic blood pressure, 24 h diastolic blood pressure, systolic blood pressure standard deviation, and 24 h diastolic blood pressure standard deviation were dramatically decreased in the empowered health education group (P < 0.05). The satisfaction in the empowered health education group was higher than that in the routine intervention group [101 cases (99.02%) vs. 86 cases (84.31%), P < 0.05], while the incidence of adverse events was lower [5 cases (4.90%) vs. 14 cases (13.73%), P < 0.05].  Conclusion  Health education based on empowerment cognition theory can improve self-management ability, enhance blood pressure control, improve the satisfaction, and reduce the occurrence of adverse events in hypertensive outpatients.
Application of multidisciplinary collaborative health education in patients undergoing modified radical mastectomy
MA Xiaolei, WANG Fang, SHI Xinru
2025, 23(6): 1000-1003. doi: 10.16766/j.cnki.issn.1674-4152.004052
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  Objective  To obtain a more favourable prognosis following modified radical mastectomy, patients are required need to maintain a healthy lifestyle and set of beliefs. The present study aims to evaluate the application effect of multidisciplinary collaborative health education in patients undergoing modified radical mastectomy, and to provide a new strategy for health education for patients undergoing surgery for breast cancer.  Methods  A total of 200 patients undergoing modified radical mastectomy at Zhangjiakou First Hospital from August 2020 to July 2022 were selected and divided into observation group (102 patients receiving multidisciplinary cooperative mode of health education) and control group (98 patients receiving conventional health education) according to the health education mode. The scores for exercise of self-care agency scale (ESCA), health promoting lifestyle rating scale (HPLS-Ⅱ), breast cancer survivors self-efficacy scale (BCSES), bad mood and perceived nursing service quality scale (PNSQ) were assessed before and after the intervention.  Results  Following the implementation of the intervention, the total scores of ESCA, HPLS-Ⅱ and BCSES in the observation group were found to be 141.21±10.63, 29.35±3.69 and 45.62±8.36, respectively. These figures were higher than those in the control group (110.70±12.48, 24.84±3.81, 38.83±9.12, F=18.637, 8.504 and 5.492, respectively, P < 0.05), Similarly, the anxiety and depression scores in the observation group were significantly lower than those in the control group (P < 0.05). Following the implementation of the intervention, the scores pertaining to perceived nursing service assurance, responsiveness, care and reliability in the observation group, exhibited a significant increase in comparison with the scores in the control group (P < 0.05).  Conclusion  Multidisciplinary collaborative health education has been demonstrated to enhance the self-care ability of patients undergoing radical mastectomy, promote health behaviors and self-efficacy, and effectively mitigate patients ' negative emotions.
Analysis of the diagnostic efficacy of digital breast tomosynthesis in patients with early-stage breast cancer
YANG Yan, ZHAO Yunian, MAO Changfei, TANG Xiaowen, LI Dongxue
2025, 23(6): 1004-1007. doi: 10.16766/j.cnki.issn.1674-4152.004053
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  Objective  To investigate the diagnostic efficacy of digital breast tomosynthesis (DBT) in detecting early-stage breast cancer and compare its efficacy with that of magnetic resonance imaging (MRI).  Methods  A retrospective analysis was conducted on 50 patients diagnosed with early-stage breast cancer between January 2023 and December 2023. All patients underwent imaging examination, with complete and high-quality imaging data prior to pathological examination. The pathological findings were used as the gold standard to compare detection accuracy, sensitivity, and specificity DBT and MRI, as well as breast cancer staging consistency between imaging and pathology.  Results  The rates of missed diagnoses, misdiagnosis, and accuracy in detecting breast lesions for DBT were 4.00% (2/50), 6.00% (3/50), and 90.00% (45/50), respectively. Compared with MRI [2.00% (1/50), 4.00% (2/50), and 94.00% (47/50)], these differences were not statistically significant. Based on the pathological examination results as the gold standard, there was no statistically significant difference in the diagnostic results of DBT for breast cancer type classification. A total of 87 breast masses (54 malignant and 33 benign) were identified in 50 patients with early-stage breast cancer. DBT demonstrated lower diagnostic sensitivity and negative predictive value than MRI, it exhibited higher specificity and positive predictive value. Overall diagnostic accuracy was comparable between the two modalities. The cost-benefit ratio (CER) for DBT and MRI were 3.25 and 12.17, respectively, and the incremental cost-benefit ratio (ICER) for MRI relative to DBT was 713.91.  Conclusion  Digital breast tomosynthesis offers high accuracy and favorable cost-effectiveness in the diagnosis of patients with breast cancer, making it a valuable tool worthy of broader clinical application.
The relationship of TCM syndrome types with ultrasound hemodynamic and serological indicators in patients with fatty liver
CHEN Yuxiang, YU Haitao, LIU Juan, LI Linjian, YANG Zhifang, XU Jing
2025, 23(6): 1008-1012. doi: 10.16766/j.cnki.issn.1674-4152.004054
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  Objective  To investigate the correlation among the distribution of traditional Chinese medicine (TCM) syndromes, color Doppler ultrasound hemodynamic changes and serological indexes in patients with fatty liver.  Methods  A total of 191 patients with fatty liver disease admitted to Zhangjiakou First Hospital from October 2022 to October 2023 were selected as the study objects. According to TCM syndrome differentiation, the patients were divided into group A (syndrome of liver-qi stagnation, n=41), group B (syndrome of liver-Qi and spleen deficiency, n=32), group C (syndrome of phlegm and dampness internal obstruction, n=51), group D (syndrome of dampness-heat accumulation, n=45), and group E (syndrome of phlegm and blood stasis interassociation, n=22). Another 50 healthy examinee were selected as the control group during the same period and were all given Doppler ultrasound examination. Serological indexes were detected.  Results  There were statistically significant differences in mean portal vein velocity (MPVV), peak portal vein velocity (PPVV), hepatic artery resistive index (HARI), serum ferritin (SF), homocysteine (Hcy) and hypersensitive C-reactive protein (hs-CRP) levels among all groups (P < 0.05). Compared with groups A and B, the levels of MPVV, PPVV and HARI in groups C, D and E showed a gradually decreasing trend (P < 0.05), while the levels of SF, Hcy and hs-CRP showed a gradually increasing trend (P < 0.05). With the aggravation of the severity of fatty liver, the levels of MPVV, PPVV and HARI were gradually decreased (P < 0.05), while the levels of SF, Hcy and hs-CRP were gradually increased (P < 0.05). MPVV, PPVV and HARI showed high sensitivity and specificity in determining phlegm stasis interjunction (P < 0.05). MPVV, PPVV, HARI were negatively correlated with the severity of fatty liver (r=-0.459, -0.436, -0.441, all P < 0.05). The sensitivity and specificity of MPVV, PPVV and HARI in determining severe fatty liver were higher (P < 0.05).  Conclusion  With the progression of fatty liver disease, MPVV, PPVV and HARI in patients decreases, and the levels of SF, Hcy and hs-CRP in the body gradually increases, and the changes are most obvious in patients with turbid phlegm and blood stasis.
Research progress on the application of information-based medical care in monitoring patients with digestive tract tumors
LI Shuang, WANG Shixin, LI Yu, ZHAO Yanxin, LI Xinyu, WANG Yujie, REN Zhen
2025, 23(6): 1013-1017. doi: 10.16766/j.cnki.issn.1674-4152.004055
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For a long time, the standardized diagnosis and treatment of gastrointestinal tumors have faced significant challenges. Limited understanding of tumor pathogenesis hampers the accuracy of early screening, while the lack of effective individualized treatment strategies for patients with advanced stages and the inability to accurately assess prognosis further complicate prevention, diagnosis, and treatment. However, the boom in information-based medical care has brought a breakthrough change to the current medical situation. This information-based medical model effectively utilizes intelligent data models to support clinical diagnosis and treatment for patients with gastrointestinal tumors, significantly enhancing the accuracy of tumor screening. Additionally, the integration of information-based medical care with intelligent auxiliary equipment enables home medication supervision and self-health management, providing a more comprehensive and accurate approach to patient condition monitoring. This paper analyzes the research status of information medicine in the monitoring of patients with digestive tract tumors, both domestically and internationally. It thoroughly discusses the advantages of information medicine model, examines its limitations and challenges, and evaluates the application of information medicine in the future. The aim is to provide a useful reference for improving the treatment and management mode of patients with digestive tract cancer, thereby advancing the overall level of the diagnosis and treatment, and fostering greater hope for better treatment effects to patients.
Advances in the correlation between HLA-B*27 subtypes and clinical phenotypes of spondyloarthritis
HUANG Yue, XU Congying, WANG Saisai, LI Yasong
2025, 23(6): 1018-1021. doi: 10.16766/j.cnki.issn.1674-4152.004056
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Human leukocyte antigen HLA-B*27 (B*27) is closely associated with the development of spondyloarthritis (SpA). Different subtypes of B*27 exhibit structural variations, which may contribute to differences in pathogenic mechanisms and clinical phenotypes. The correlation between B*27 subtypes and SpA clinical phenotypes is as follows, (1) Among the 167 known subtypes of B*27, approximately 16 are strongly associated with SpA. B*2704 and B*2705 are the most common subtypes in SpA patients, followed by B*2702 and B*2707. These subtypes exhibited greater protein misfolding at the molecular level compared to B*2706 and B*2709, which are less associated with SpA. (2) Characterization of SpA clinical forms with B*27 subtypes: ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are primarily associated with B*2704, whereas reactive arthritis (ReA) and undifferentiated spondyloarthritis (uSpA) are predominantly linked to B*2705. Additionally, AS can present with double-positive B*27 subtypes, and B*2705, B*2702 are mostly observed in Reiter ' s syndrome (RS). (3) Correlation between B*27 subtypes and target organs of SpA: patients with B*27 positivity are more likely to develop joint damage, uveitis, and cardiovascular complications than those without it. Patients with B*2705 and B*2702 are associated with early-onset hip ankylosis and enteritis, B*2704 is linked to vision impairment and cardiovascular disease, and B*2715 has a higher association with uveitis. Therefore, understanding the characteristics of different subtypes of clinical phenotypes is of great significance as a guide to the diagnosis and treatment of SpA.
Advances in the study of the role of ketogenic diet in the treatment of breast cancer
LI Yiming, YAO Chang, ZHANG Zihao
2025, 23(6): 1022-1026. doi: 10.16766/j.cnki.issn.1674-4152.004057
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The development of breast cancer (BC) is associated with lifestyle, natural environment and diet. Dietary intake is a significant environmental factor impacting tumor metabolism, with unhealthy dietary habits increasing the risk of BC, while a healthy diet can reduce chronic inflammation and DNA damage, thereby positively impacting human health. The potential of dietary intervention as an adjuvant therapy for breast cancer has garnered considerable attention. Among various dietary intervention methods, the ketogenic diet (KD) has become a research hotspot due to its potential in regulating metabolism, controlling disease progression, and reducing adverse treatment reactions. The KD is characterized by a high fat, medium protein, and extremely low carbohydrate composition. By modifying the patient ' s dietary structure, endogenous ketone bodies are generated, thereby transforming the body from a glucose dependent energy state to a fat dependent energy state and reducing insulin levels. This directly or indirectly affects the energy metabolism of cancer cells, improves the therapeutic effect of targeted drugs, reduces cancer cell proliferation, and improves programmed cell death. KD has been shown to positively impact brain nerve function in breast cancer patients, contributing to an improvement in mood and physical well-being, and enhancing the quality of life. The ketogenic diet, in its capacity as a novel adjuvant treatment strategy for breast cancer, has been shown to possess numerous potential benefits and is anticipated to assume an important role in the treatment of breast cancer in the future. This article will explore the effects of KD on the treatment of breast cancer from multiple perspectives, including its role in immune regulation, metabolic status, gene expression and potential molecular mechanisms. By synthesizing the extant research findings, this study offers a novel perspective and methodology for the comprehensive management of breast cancer and investigates the potential of KD to be integrated into future clinical practice.
Research progress on the correlation between glycemic variability and diabetic kidney disease in type 2 diabetes
WANG Wei, ZHANG Yujian, XU Lujia, SONG Xuenan, TANG Kuanxiao
2025, 23(6): 1027-1030. doi: 10.16766/j.cnki.issn.1674-4152.004058
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In the process of long-term glycemic variation monitoring for patients with diabetic kidney disease (DKD), we typically employ classical indicators such as glycated hemoglobin A1c. However, these indicators may not accurately reflect the true glycemic levels of patients under certain physiological and pathological conditions, such as during pregnancy, anemia, and chronic kidney insufficiency. Glycemic variability (GV) refers to the fluctuations in a patient ' s blood glucose levels. Studies have shown that increased GV can elevate the risk of DKD development. Additionally, the progression of DKD might also cause GV to rise. This implies that we cannot solely focus on the mean blood glucose level and also need to consider its variability. Therefore, the integrated management of both glycemic levels and variability, along with the development of personalized glycemic management plans, is crucial for preventing and deferring the progression of DKD. Continuous glucose monitoring (CGM) provides real-time, continuous blood glucose measurements, thereby offering a more accurate reflection of a patient ' s GV. This paper will review recent research literature on the correlation between GV and DKD, summarize the limitations of HbA1c in assessing GV, and outline the advantages and values of CGM-related indicators in managing GV in DKD patients. The paper also discusses the latest advancements in the application of CGM across different stages of DKD (including hemodialysis and peritoneal dialysis) and reviews the latest research on treatment strategies aimed at improving DKD by targeting glucose fluctuations. The aim of this review is to provide strong evidence for the precise regulation of blood glucose and improving outcomes in DKD patients.
Epidemiological characteristics and risk factors of 1 174 patients transferred between primary healthcare institutions
ZHAO Zichao, HU Bei, JIANG Fengjue, JIANG Zheng, SHI Xiaoyan, LI Linfei
2025, 23(6): 1031-1035. doi: 10.16766/j.cnki.issn.1674-4152.004059
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  Objective  To analyze the epidemiological characteristics and influencing factors of inter-hospital patient transfers at the grassroots level, in order to provide a basis for optimizing regional healthcare capabilities and inter-hospital transfer processes.  Methods  Collected data on all inter-hospital transfers conducted by the Shaodong Emergency Medical Center from January 1, 2021 to December 31, 2023. The data included demographic characteristics, transfer distances, departments involved in sending and receiving, clinical assessments, and treatment measures. Statistical analysis was conducted to evaluate the factors influencing transfer outcomes.  Results  A total of 1 174 patients were included, with 804 males (68.48%) and 370 females (31.52%), and ages primarily concentrated between 50 and 79 years. Short-distance transfers (less than 50 km) accounted for 61.33% of all cases, with a median transfer distance of 45 km. The main sending departments were emergency medicine (16.70%), cardiology (12.95%), and neurology (11.41%), while the main receiving departments were emergency medicine (38.07%), emergency surgery (13.88%), and the intensive care unit (10.39%). Successful transfers were achieved in 97.10% of cases, while 2.90% resulted in transfer failure. There were statistically significant differences in the consciousness status, clinical assessments, respiratory support, and treatment measures of patients with different transfer results. The national early warning score can predict transfer result, with higher scores correlating with lower transfer success rates.  Conclusion  Grassroots inter-hospital transfers predominantly involve middle-aged and elderly male patients, with most transfers being short-distance. There is currently no single reliable tool for assessing transfer risk, necessitating a multifactorial evaluation approach. Future efforts should focus on strengthening regional medical alliances, optimizing resource allocation, and improving information-sharing mechanisms to enhance the efficiency and safety of inter-hospital transfers. Additionally, further development and validation of new transfer risk assessment tools are required to improve risk prediction during the transfer process.
Effect of fire dragon cupping on patients with Qi stagnation and blood stasis swelling after total knee arthroplasty
BAO Yunchun, KAN Yanan, YE Fuying, CHEN Quanquan, HUA Dongxue, SU Qian, LIU Xiulan
2025, 23(6): 1036-1040. doi: 10.16766/j.cnki.issn.1674-4152.004060
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  Objective  To explore the effect of fire dragon cupping in patients with Qi stagnation and blood stasis swelling after total knee arthroplasty (TKA), in order to provide reference for swelling management after TKA.  Methods  A total of 88 patients receiving TKA were hospitalized in the Department of Orthopedics of the First Affiliated Hospital of Zhejiang Chinese Medical University from June 2022 to December 2023. They were divided into fire dragon cupping group and control group using the random number table methods, with 44 cases in each group. The control group was subjected to routine measures for alleviating swelling, and the fire dragon cupping group was subjected to comprehensive moxibustion and routine measures. The lower extremity circumference and change values, range of motion (ROM), pain scores, adverse events, and completion of the intervention program on days 3 and 7 post-intervention were compared.  Results  Three days after the intervention, the upper 15 cm circumference of the middle point of the patella in the fire dragon cupping group was significantly better than that in the control group [(42.7±3.5) cm vs. (44.7±3.5) cm, F=7.073, P=0.009]. The circumference of 10 cm below the midpoint of the patella was significantly improved compared with the control group [(33.0±2.7) cm vs. (35.3±3.4) cm, F=11.554, P=0.001]. Seven days post-intervention, the circumference 15 cm above the midpoint of the patella [(41.6±4.0) cm vs. (43.7±3.3) cm, F=6.775, P=0.011] and the circumference of 10 cm below the midpoint of patella [(32.4±2.8) cm vs. (34.3±3.2) cm, F=7.765, P=0.007] and the change of circumference diameter were significantly better than those in the control group (P < 0.05). The ROM and pain scores of the fire dragon cupping group were better than the control group (P < 0.05). The fire dragon cupping group has completed 43 cases with a completion rate of 97.7%, and no adverse reactions have occurred.  Conclusion  The fire dragon cupping therapy can improve the swelling of the affected limb, improve the range of motion of the knee joint, and alleviate pain after TKA, and it is safe and feasible.
Application of online teaching combined with PBL and CBL in orthopedic teaching
PEI Lijia, WANG Dong, LIU Yang, ZHOU Xinshe
2025, 23(6): 1041-1044. doi: 10.16766/j.cnki.issn.1674-4152.004061
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  Objective  Orthopedic diseases have many branches, involving trauma, spine, joints, and microsurgery, requiring specialized and refined operational skills. There is a need to develop new teaching models to enhance the effectiveness of clinical teaching.  Methods  A total of 60 clinical undergraduates who practiced in the Department of Orthopedics of the First Affiliated Hospital of Bengbu Medical University from June 2023 to September 2024 were selected as the research objects. They were divided into a control group (n=30) and an experimental group (n=30) by random number table method. The control group adopted the traditional teaching mode, that was, the teaching mode of oral explanation by the teacher, while the experimental group adopted the online teaching combined with problem-based learning (PBL) and case-based learning (CBL) teaching mode. The theoretical test, case analysis, doctor-patient communication, physical examination, inquiry skills and humanistic care of the two groups of interns were compared, and the self-evaluation survey after learning was conducted.  Results  There was no significant difference in theoretical test scores between the two groups (P>0.05). The case analysis score and total score of the experimental group were higher than those of the control group (43.6±2.7 vs. 41.8±3.0; 87.0±4.3 vs. 84.4±5.1, P < 0.05). The scores of doctor-patient communication (7.3±1.0 vs. 6.4±0.8), physical examination (7.8±1.1 vs. 6.7±0.9) and inquiry skills (7.6±1.0 vs. 6.8±0.8) in the experimental group were higher than those in the control group (P < 0.05). There was no significant difference in the score of humanistic care between the two groups (P>0.05). The self-evaluation survey after learning showed that the experimental group was better than the control group in improving learning interest in orthopedics, getting familiar with orthopedics related knowledge, and improving overall diagnosis and treatment thinking (P < 0.05).  Conclusion  Using online teaching combined with PBL and CBL teaching methods among orthopedic interns can improve teaching quality, promote a good integration of theory and practice, and enhance interns' abilities in various aspects of diagnosis and treatment.
Investigation of iron metabolism level in adults in ultra-high altitude area
SUN Shuyao, WANG Suyuan, YIN Rong, LI Man, YI Wen, PU Xue, LIU Chunrong, WU Yunhong, ZHANG Chenghui
2025, 23(6): 1045-1048. doi: 10.16766/j.cnki.issn.1674-4152.004062
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  Objective  The low oxygen concentration at high altitudes can affect iron metabolism in the human body. The purpose of this study was to explore the iron metabolism in plateau populations living at ultra-high altitude areas (from 3 500 to 5 500 m).  Methods  Adult volunteers living in Amdo County (4 800 m above sea level) were recruited, and they provided blood samples for analyses. Patients with alcoholism, cirrhosis, acute or chronic infection, and hematological diseases were excluded. General information was recorded, and the detection of blood routine, iron metabolism indicators, and biochemical indicators were completed. Participants were divided into two groups according to serum ferritin levels: the normal group and the iron overload group (serum ferritin ≥ 1 000 ng/mL). Regression analysis was used to screen for causes affecting ferritin.  Results  A total of 361 participants were included, 130 of whom were female, 231 of whom were male. Twenty-eight participants (7.8%) were diagnosed with iron overload, all were male, 23 of whom were Tibetan. Compared with the normal group, age, BMI, altitude residence time, mean corpuscular hemoglobin concentration (MCHC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), erythropoietin (EPO) and C-reactive protein (CRP) in the iron overload group were higher than those in the normal group. LASSO regression analysis suggested that age, high altitude exposure time, BMI, ALT, GGT, EPO, and MCHC were influencing factors of the level of serum ferritin. Multiple linear regression analysis showed that the influencing factors of ferritin levels were gender (β'=-218.094, 95% CI: -301.763 to -134.425), age (altitude exposure time, β'=13.203, 95% CI: 5.850-20.557), MCHC (β'=4.602, 95% CI: 1.130-8.080), ALT (β'=1.910, 95% CI: 0.038-3.782), and EPO (β'=9.908, 95% CI: 5.027-14.790).  Conclusion  Elevated ferritin levels in adults living at ultra-high altitudes may be related to hypoxic adaptation. Whether high ferritin levels have adverse health effects needs further study.
Establishment and evaluation of a model for predicting the risk of hypertension among railroad workers
ZHOU Zhongyun, MA Wenlu, DU Xiaolin
2025, 23(6): 1049-1055. doi: 10.16766/j.cnki.issn.1674-4152.004063
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  Objective  To analyze the risk factors of hypertension among railroad workers and to establish an individualized risk prediction model for hypertension.  Methods  A total of 2 717 railroad workers who underwent the physical examination in the Second Affiliated Hospital of Shandong University of TCM from January 2022 to December 2022 were enrolled in this study, Data collection was done through face-to-face questionnaires, on-site physical examinations, and laboratory tests. According to the ratio of 7∶3, they were randomly divided into a modeling group and a validation group. After preliminary screening by univariate analysis and LASSO regression, the predictive variables were determined by multivariate analysis, and a nomogram model of hypertension was constructed. The predictive models were evaluated using the ROC curve, calibration curve, and decision curve analysis (DCA).  Results  A total of 2 717 railroad workers were enrolled in this study, and 951 railroad workers had hypertension, the incidence of hypertension was 35.0%, After a univariate and multivariate analysis, age, lack of exercise, loss of sleep, high salt diet, family history of hypertension, BMI, heart rate (HR), triglyceride (TG)were included in prediction model. The model showed a better performance, the area under the ROC curve was 0.844 (95% CI: 0.825-0.860), and the AUC for the validation group was 0.869 (95% CI: 0.845-0.896). The calibration curve showed a good agreement. DCA analysis showed that the modeling and validation groups showed large positive yields.  Conclusion  We developed a nomogram for predicting the risk of hypertension among railroad workers, which can be used as a tool to guide future patients.
Efficacy of mesenchymal stem cells in the treatment of fistulas in Crohn's disease: a meta-analysis
HU Minxuan, WANG Yufeng, LI Yuntao, JI Guozhong
2025, 23(6): 1056-1061. doi: 10.16766/j.cnki.issn.1674-4152.004064
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  Objective  To systematically evaluate the effectiveness of mesenchymal stem cells (MSCs) in the treatment of fistulas in Crohn's disease (CD).  Methods  We searched CNKI, Wanfang, PubMed, Web of Science and other databases from inception to August 29, 2024. The eligible trials were independently evaluated and screened by two researchers. RevMan 5.4.1 and R 4.2.2 software were used to perform the meta-analysis.  Results  A total of 14 articles were included in the meta-analysis, all of which were randomized controlled trials (RCTs), encompassing a cumulative sample of 891 patients. results showed that compared with control groups, the fistula healing rate (FHR) induced by MSCs was higher in short-term (P=0.02), medium-term (P=0.02) and long-term (P=0.04) follow-up phases, while there was no statistically significant difference between the two groups in over-long-term (P=0.22). Using combined remission (Z=2.33, P=0.02) or clinical remission (Z=2.19, P=0.03) as the criteria for evaluating FHR, the experimental groups showed a higher FHR compared to the control group. Additionally, no heterogeneity was observed among subgroups (I2=0%, P=0.91). The use of MSCs derived from fat or bone marrow, autologous or allogeneic sources, medium or large doses achieved higher FHR compared to the control group. The FHR of injecting MSCs based on the size of the fistula was higher than that of the control group, while there was no statistically significant difference in the FHR between the two groups when treated in a single injection with a fixed dose.  Conclusion  The use of MSCs offers an emerging and effective approach for fistulizing CD treatment, which can lead to a higher rate of clinical and combined remission. More RCTs need to be performed in the future.
The correlation among error anxiety, fear of no mobile phone and sense of organizational support in nurses in operating room
LUO Lei, WENG Jinhua, LI Fangsu, ZHANG Xiaoling, XIE Dan, LI Jun
2025, 23(6): 1062-1065. doi: 10.16766/j.cnki.issn.1674-4152.004065
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  Objective  To analyze the correlation among error anxiety, fear of no mobile phone and sense of organizational support in the nurses in operating theatre. The study's theoretical basis will provide a framework for the development of psychological support and management strategies.  Methods  In January 2024, a study was conducted in three hospitals in Nanchang City, to investigate the prevalence of anxiety and fear among operating theatre nurses. The study utilized a convenient sampling methods and employed a general data questionnaire, the error anxiety scale, the fear of no mobile phone scale and the sense of organizational support scale to assess the participants' psychological well-being and organizational climate. The present study sought to analyze the influencing factors of error anxiety in operating theatre nurses. To this end, Pearson correlation was used to analyze the correlation among the influencing factors.  Results  In the present study, a total of 125 questionnaires were disseminated, and 123 were successfully retrieved, yielding an effective recovery rate of 98.40%. The mean error anxiety score of 123 nurses in the operating theatre was (55.25±2.11) points, which was above the median level. The scores on the scores of error anxiety scale for nurses aged < 30 years and nurses working in the operating theatre for < 3 years were higher than those for nurses aged ≥30 years and nurses working in the operating room ≥ 3 years (P < 0.05). The mean score of the mobile phone anxiety scale for operating theatre nurses was (71.79±9.47) points; the mean score of the organizational support scale was (39.41±3.22) points. Pearson correlation analysis demonstrated a positive correlation between error anxiety and fear of no mobile phone, and a negative correlation negatively correlated with sense of organizational support (P < 0.05). Multiple linear regression analysis demonstrated that fear of not having a mobile phone and sense of organizational support were both influential factors for error anxiety experienced by operating theatre nurses (P < 0.05).  Conclusion  The present study hypothesizes that error anxiety in operating theatre nurses is positively correlated with fear of no mobile phone and negatively correlated with sense of organizational support. The findings indicate that fear of no mobile phone plays a significant role in error anxiety, while sense of organizational support has a certain easing effect on error anxiety. The detrimental effects of error anxiety can be mitigated by enhancing the sense of organizational support and by attending to the needs of operating theatre nurses with regard to the use of mobile phones.
Best evidence summary of comprehensive rehabilitation management for pediatric spina bifida with bladder dysfunction throughout the full continuum of care
TANG Heshu, ZHOU Ping, ZHU Chunqin, WANG Yan, LI Jing, CHANG Zongge
2025, 23(6): 1066-1070. doi: 10.16766/j.cnki.issn.1674-4152.004066
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  Objective  To systematically summarize the best evidence of comprehensive rehabilitation management for pediatric spina bifida with bladder dysfunction throughout the full continuum of care, thereby providing evidence-based support for clinical nursing.  Methods  A comprehensive search of international and domestic guideline websites and databases, including the BMJ Best Practice, UpToDate, The Cochrane Library, the JBI Evidence-Based Health Care Center, the Wanfang, and the CNKI Database, was conducted to retrieve all related evidence. This search encompassed evidence summaries, clinical guidelines, expert consensus, and systematic reviews published from database inception to January 2024. Two researchers independently appraised literature quality, extracted, summarized, and synthesized the evidence.  Results  The final sample comprised 16 articles, including six clinical guidelines, two expert consensus and eight systematic reviews. A total of 31 best evidence items were extracted from three distinct periods of development: pregnancy and neonatal period, the preschool age and school age period, and the adolescent growth period.  Conclusion  The selection of the most compelling evidence should take into account clinical contexts, individual conditions and professional opinions, with the objective of establishing a localized comprehensive rehabilitation management program for pediatric spina bifida with bladder dysfunction in China.
Effect of focus solution model combined with internet plus continuing nursing on the function and quality of life of hip fracture in the elderly
ZHANG Leyan, SHAO Sufen, XIE Aqun, ZHENG Xuelei, LUO Guogang
2025, 23(6): 1071-1075. doi: 10.16766/j.cnki.issn.1674-4152.004067
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  Objective  On the basis of internet plus continuing nursing, this study applies the combined focus solution model to elderly patients with hip fracture, and analyzes the impact of this intervention program on hip function and quality of life of patients, so as to provide reference for improving postoperative rehabilitation effect.  Methods  According to the random number table method, 100 elderly patients with hip fracture in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from October 2022 to January 2024 were divided into observation group (n=50) and control group (n=50). The control group received internet plus continuing nursing intervention, and the observation group received the internet plus continuing nursing intervention based on focus solution model. The hip function, pain, quality of life and complications were compared between the two groups.  Results  The total score of Harris hip function score (HHS) and scores of all dimensions in the observation group were higher than those in the control group (P < 0.05). After 1 week, 1 month and 3 months of intervention, the scores of numerical rating scale (NRS) were lower than those of the control group (P < 0.05). After the intervention, the scores of short form health survey (SF-36) in the observation group were higher than those in the control group except social function (P < 0.05). The incidence of postoperative wound infection, dislocation and venous thrombosis complications in the observation group was lower than that in the control group, and the difference was statistically significant [2.00%(1/50) vs.14.00%(7/50), χ2=4.891, P=0.027].  Conclusion  The application of focus solution model combined with internet plus continuous nursing in elderly patients with hip fracture after operation is helpful to improve hip joint function, relieve patients' pain, improve patients' quality of life, and reduce the probability of postoperative complications.
Application of emergency green channel optimization combined with multidisciplinary collaborative nursing in the treatment of patients with acute exacerbation of COPD and respiratory failure
DONG Sizhen, ZHU Jianjun, LU Yaer
2025, 23(6): 1076-1080. doi: 10.16766/j.cnki.issn.1674-4152.004068
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  Objective  To explore the application of emergency green channel optimization combined with multidisciplinary collaborative nursing in the treatment of critically ill patients with acute COPD exacerbation (AECOPD) and respiratory failure, which can be life-threatening if not treated in time, so as to provide theoretical reference for improving the survival rate and emergency nursing level of critically ill patients.  Methods  A total of 101 patients with AECOPD and respiratory failure who were treated in the emergency department of the Second People's Hospital of Yuhang District, Hangzhou City from January 2022 to December 2023 were selected as the research subjects. According to the order of admission, 50 patients treated from January 2022 to December 2022 were recorded as the control group Group, implement emergency nursing intervention in the traditional mode; From January 2023 to December 2023, 51 patients treated were recorded as the observation group and implemented the optimization of the emergency green channel combined with multidisciplinary collaborative nursing intervention. The rescue effects, blood gas indicators, nursing quality and the nursing satisfaction of patients' families were compared between the two groups.  Results  The time of venous channel establishment, auxiliary examination, treatment plan determination, rescue intervention, and emergency stay in the observation group were all shorter than those in the control group (P < 0.05). The success rate of rescue was 98.04% (50/51), which was higher than that of the control group [84.00% (42/50), P < 0.05], and the accident rate was 1.96% (1/51), which was slightly lower than that of the control group [14.00% (7/50), P>0.05]. Arterial partial oxygen pressure (PaO2), oxygenation index (PaO2/FiO2), and blood oxygen saturation (SaO2) were higher than those in the control group (P < 0.05). The scores of all dimensions of nursing quality were higher than those of the control group (P < 0.05). The nursing satisfaction of family members was higher than that of the control group (P < 0.05).  Conclusion  Emergency green channel optimization combined with multidisciplinary collaborative nursing can shorten the hospital rescue response time of patients with AECOPD and respiratory failure, improve the treatment effect, improve blood gas index and nursing quality, and enhance the nursing satisfaction of family members.
Combined central and peripheral demyelination: three case reports and literature review
WU Wenjing, CHEN Rong
2025, 23(6): 1081-1084. doi: 10.16766/j.cnki.issn.1674-4152.004069
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The combined central and peripheral demyelination is a rare neurological disorder characterized by combined demyelination in the central and peripheral nervous system. The pathogenesis of this disease is not clear, and clinical diagnosis and treatment are relatively difficult and there are fewer reports on it. In this paper, we reviewed and analyzed the clinical, imaging, and electrophysiological features of three cases of combined central and peripheral demyelination reported by the Department of Neurology, the First Affiliated Hospital of Hainan Medical University, in order to raise the awareness of clinicians and reduce misdiagnosis.

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