中华全科医学

Quantitative research of China's contracted family doctor service policy based on a three dimensional analysis framework of "Tool-Element-Strength"

WANG Xinran, ZHAO Jing, LIU Xinyu, LI Yaru, GUAN Yongyi, SU Yunhan

2024, 22(12): 1995-1999. doi: 10.16766/j.cnki.issn.1674-4152.003782

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Abstract:
Objective As a pivotal element of healthcare system reform, China ' s contracted family doctor service system is of paramount importance in achieving national health objectives. Despite the introduction of relevant policies in recent years, there is still a paucity of systematic quantitative research on the content of family doctor policies. The objective of this study is to employ a quantitative analysis of the textual content of China ' s contracted family doctor service policies. This analysis will be conducted in order to summarize the characteristics and shortcomings of the existing policies, and to provide suggestions for further improvement of the system. Methods Collect national level family doctors from January 2011 to June 2024 on the official government website on 1 July, 2024. A three-dimensional analysis framework, based on the "Tool-Element-Strength" model was constructed. The content analysis method was employed, and NVivo was used to encode the included policy text content. The policy text was then analyzed from three dimensions. Results Following the coding of 23 family doctor contract service policies, a total of 133 codes were obtained. There is a notable imbalance in the utilization of policy tools, particularly the underutilization of Inducements (11.28%, 15), symbolic and Hortatory (9.77%, 13), and system-changing (6.02%, 8) tools. The policy elements are also uneven, indicating that the service target (11.28%, 15), content (10.53%, 14) and method (9.02%, 12) require greater focus. The strength of the family doctor policy is at a relatively low level, with an average score of 2.13. Furthermore, there is a dearth of interconnectivity between the three dimensions. Conclusion It is recommended that the application of policy tools be improved and that the different elements internal structure of family doctor policy tools be optimized. It is important to consider the different elements of the policy and to enhance the content of family doctor policies accordingly. Emphasize the synergy between three dimensions and improve the policy system for China ' s contracted family doctor service.

Exploring the syndrome differentiation of lung diseases in traditional Chinese medicine based on the Qihai theory using the Xuanjiang therapy

YE Min, TANG Jie

2024, 22(12): 2000-2003. doi: 10.16766/j.cnki.issn.1674-4152.003783

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The Qihai is the primary Qi of the entire body. When the Qihai is in a state of smoothness, the Qi of lung is able to achieve normalization. Conversely, when the Qihai is in a state of disharmony, the Qi is also disrupted, which can result in the onset of lung diseases. The most effective treatment approach is to employ the method of declaring and descending the Qi movement of Qihai. This method is designed to address the underlying causes of lung diseases. This paper presents a discussion of the theoretical basis and clinical application of the Xuanjiang therapy in the prevention and treatment of lung diseases in traditional Chinese medicine (TCM), based on the theory of Qihai. The theory of Qihai provides a fundamental framework for the identification and treatment of lung diseases in TCM, offering significant theoretical insights and clinical value. From the perspective of Qihai theory, this paper discusses the use of the Xuanjiang therapy in the treatment of common lung diseases. It analyzes the causes and mechanisms of these diseases in detail and proposes that Qi movement of Qihai dysfunction, Xuanjiang lung Qi treatment for cough; phlegm stays in Qihai, Xuanjiang phlegm treatment for croup; Evil heat congestion of the Qihai, Xuanjiang pus treatment for lung carbuncle; Qihai lung ligament loss of nourishment, Xuanjiang nourishing yin treatment for consumption; Qi movement of Qihai congestion, Xuanjiang regulating Qi treatment for pulmonary distension; Qihai fluid loss, Xuanjiang dispering fluid treatment for lung impotence; and Xuanjiang Bujin treatment for lung impotence. The treatment of lung impotence was identified with reference to relevant literature and clinical data, and a summary of the treatment method and efficacy was provided. It is hypothesized that the primary pathological alteration in lung diseases within the context of Chinese medicine is the dysregulation of Qi propagation and descending. The utilization of the propagation and descending method, in conjunction with the guidance of the theory of Qihai and the rational selection of prescription drugs, has the potential to effectively improve the symptoms of the disease, delay its progression, reduce the frequency of episodes and enhance the quality of life for patients. By examining the pathogenesis of Qihai disorders in various lung diseases in detail, it becomes evident that the clinical application of the Qihai theory as a guide to promote and reduce Qi, support the positive and eliminate the evil in lung diseases can fully utilize the efficacy of TCM, and provide a clinical idea for the TCM diagnosis and treatment of lung diseases and the related research.

Effectiveness of Sijunzi Decoction combined with immunochemotherapy in patients with advanced lung cancer and its influence on related cytokines

JING Jingyan, WU Amin, XUE Ya'nan, XU Yanxia, CHU Lei

2024, 22(12): 2004-2007. doi: 10.16766/j.cnki.issn.1674-4152.003784

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Objective Under the premise of immunochemotherapy treatment of advanced lung cancer, Sijunzi Decoction was added to explore the effect of advanced lung cancer on patients, quality of life, T cell subsets, peripheral blood image, health. To provide a basis for clinical improvement of the efficacy of advanced lung cancer, improve the quality of life of patients. Methods A total of 100 patients with advanced lung cancer admitted to Qingdao Central Hospital from August 2022 to August 2023 were included and divided into the observation group (n=50, Sijunzi Decoction combined with immunochemotherapy) and the control group (n=50, immunochemotherapy) by random number table method. The clinical efficacy, quality of life [using function assessment of cancer therapy-lung cancer (FACT-L4.0)], T lymphocyte subsets (CD3⁺, CD3⁺/CD4⁺, CD3⁺/CD8⁺), and peripheral blood parameters [white blood cells (WBC), albumin (ALB), hemoglobin (Hb), platelets (PLT)] were compared before and after treatment. Survival status, such as progression-free survival (PFS), overall survival (OS), and adverse reaction rate were analyzed. Results The two groups had no significant difference in overall effective rate after 12 weeks of treatment [52% (26/50) vs. 44% (22/50)， P>0.05]. After 12 weeks of treatment, physiological status, functional status, CD4⁺/CD8⁺, WBC, ALB, PLT were all higher in 2 groups than before treatment. The level of CD4⁺ in observation group was higher than before treatment, CD8⁺ in observation group was lower than before treatment, and Hb in control group below pre-treatment (P<0.01). After 12 weeks of treatment, the observation group had higher levels of CD4⁺, CD4⁺/CD8⁺, WBC, ALB, Hb, and PLT, but lower CD8⁺ compared to the control group (F=6.047, 18.539, 10.934, 2.218, 7.415, 6.260, 5.895, P<0.05). In terms of PFS, OS or grade 3-4 adverse reactions, the two groups had no significant differences (P>0.05). Conclusion Sijunzi Decoction combined with immunochemotherapy significantly improves the immune function of patients with advanced lung cancer, reduces toxic and side effects, and improves the quality of life in patients with advanced lung cancer.

Effects of traditional Chinese medicine on cancer pain, fatigue, and mental resilience in lung cancer patients with bone metastasis

GUAN Xiaole, DAI Shan, LIU Jian

2024, 22(12): 2008-2011. doi: 10.16766/j.cnki.issn.1674-4152.003785

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Objective The application of traditional Chinese medicine (TCM) emotion and decoction in lung cancer patients with bone metastasis, and in-depth understanding of the role of TCM treatment in alleviating pain, improving quality of life and psychological status of lung cancer patients with bone metastasis, to provide clinical evidence for patients Provide more targeted treatment options. Methods A total of 128 advanced lung cancer patients with bone metastasis, admitted to Hengshui Hospital of Traditional Chinese Medicine from August 2022 to August 2023, were included in the study. They were divided into the observation group (n=64, receiving traditional Chinese medicine emotional intervention combined with Shentong Zhuyu Decoction) and the control group (n=64, receiving standard care) according to random number table method. The analgesic effect, cancer-related fatigue (cancer fatigue scale, CFS), mental resilience (10-item mental resilience scale, CD-RISC10), quality of life (American lung cancer quality of life scale, FACT-L4.0), and pain-related factors (β endorphin, β-EP, substance P) were measured before and 4 weeks after intervention. Results After 4 weeks of intervention, the total remission rate of the observation group was significantly higher [92.19% (59 cases) vs. 78.12% (50 cases), χ²=5.006, P < 0.05]. After 4 weeks of intervention, CFS and P in the observation group were significantly lower than before intervention, while β-EP were significantly higher (P < 0.05). After 4 weeks of intervention, CD-RISC and FACT-L4.0 in the observation group were higher than those before intervention (P < 0.01). Pre-intervention CFS, CD-RISC, FACT-L4.0, β-EP, and P had significant effects on the results after 4 weeks of intervention (P < 0.001). After 4 weeks of intervention, CFS and P in the observation group were lower than those in the control group, while CD-RISC, FACT-L4.0 and β-EP were higher. After adjusting the levels of CFS, CD-RISC, FACT-L4.0, β-EP, and P before intervention, the differences between the two groups were statistically significant (P < 0.01). Conclusion TCM emotional intervention combined with Shentong Zhuyu Decoction improves cancer pain, cancer-related fatigue, mental resilience, and quality of life in patients with advanced lung cancer and bone metastasis. The analgesic mechanism may be mediated through improvements β-EP and P levels.

Mendelian randomization study of eczema and depression

XU Xiaoran, YANG Zihan, NING Jing, SUN Futongyu, TAN Xi

2024, 22(12): 2012-2015. doi: 10.16766/j.cnki.issn.1674-4152.003786

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Objective The relationship between eczema and depression has received much attention, yet the causal association between the two is unclear. Therefore, Mendelian randomization (MR) was used to investigate whether there is a causal relationship between eczema and depression. Methods Genotypic data of eczema and depression were selected from the publicly available pooled dataset of the Genome-wide association study (GWAS), with eczema as the exposure factor and depression as the outcome variable. The selected samples were genotyped using MR, where the instrumental variables were genetic loci with a strong correlation with eczema disease. The odds ratio (OR) was used as an estimator, and the effect value β judged the direction of the association between the two. Heterogeneity test, sensitivity analysis, and horizontal multiple validity test were also performed. Results Inverse variance weighted method analysis showed a positive correlation between eczema and the occurrence of depression and yielded an OR of 1.011, 95% CI: 1.001-1.022, P=0.037; weighted median regression analysis yielded similar results (OR=1.012, 95% CI: 1.001-1.023, P=0.029). Cochran ' s Q test showed significant heterogeneity of the results (P < 0.05), but the analysis of the random effects model yielded P=0.037 and β=0.011, which proved that there was a positive causal relationship. In addition, no horizontal pleiotropy was observed for the funnel plot and Mr-Egger intercept. Conclusion The findings suggest a possible positive causal relationship between eczema and the occurrence of depression.

Prognostic analysis of radiotherapy combined with PD-1 inhibitors in patients with driver-gene negative non-small cell lung cancer and brain metastases

ZHANG Xianwen, SUN Qian, CAI Feng, ZHAO Mengdie, SONG Shilong, CHEN Rujun, JIANG Hao

2024, 22(12): 2016-2019. doi: 10.16766/j.cnki.issn.1674-4152.003787

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Objective Observation of the efficacy and adverse reactions of combined treatment of cranial radiation therapy (RT) and programmed death-1 (PD-1) inhibitors in patients with driver gene negative non-small cell lung cancer (NSCLC) with brain metastases (BMs), and exploration of its clinical application value. Methods A total of 90 NSCLC BM patients who received RT at the First Affiliated Hospital of Bengbu Medical University from January 2021 to July 2023 were included. They were divided into the radiotherapy group (40 cases) and the combination group (50 cases), based on whether they were treated with PD-1 inhibitors. Kaplan-Meier method and Cox regression model were used to evaluate intracranial short-term efficacy, intracranial local progression free survival (iLPFS), intracranial distant progression free survival (iDPFS), and overall survival (OS). Results By July 2024, the intracranial objective response rate (iORR) was 45.0% and 72.0% in the radiotherapy group and the combination group, respectively (P=0.009). The median iLPFS, iDPFS, and OS for the radiotherapy group were 11 months (95% CI: 8.77-13.23), 14 months (95% CI: 7.69-20.31), and 14 months (95% CI: 11.98-16.02), respectively. In the combination group, the corresponding medians were 22 months (95% CI: 18.23-25.77), 21 months (95% CI: 13.24-28.76), and 21 months (95% CI: 17.63-24.37), respectively, with statistically significant differences (P < 0.05). Univariate and multivariate analysis showed that combined PD-1 inhibitor therapy is an independent prognostic factor for iLPFS and iDPFS. Stratified analysis showed that early intervention of RT, especially when synchronized with PD-1 inhibitors (≤ 2 weeks), resulted in significantly improved iLPFS (P=0.007) and iDPFS (P=0.027), though no statistically significant difference was observed in OS (P=0.385). Both groups of patients tolerated adverse reactions. Conclusion The combination therapy of RT and PD-1 inhibitors, especially when administered simultaneously (≤ 2 weeks), improves iLPFS and iDPFS in patients with driver gene-negative NSCLC BMs, contributing to improved OS.

Systemic lupus erythematosus and myasthenia gravis: a bidirectional Mendelian randomization study

ZHENG Qian, YU Caiyao, LI Haoyun, FENG Zhanhui

2024, 22(12): 2020-2024. doi: 10.16766/j.cnki.issn.1674-4152.003788

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Objective Studies have shown that systemic lupus erythematosus (SLE) and Myasthenia gravis (MG) may have concurrent onset clinically. This study aims to explore the potential causal relationship between SLE and MG using a bidirectional Mendelian randomization study to provide a basis for clinical prevention and treatment. Methods Genetic data closely related to SLE and MG were extracted from the summary database of genome-wide association studies (GWAS) as instrumental variables, and the extracted data were all from European samples. MR analysis was conducted using IVW, MR-Egger regression, and WME. The causal relationship between SLE and MG was evaluated by the OR value and 95% CI. The MR-Egger intercept method was used to detect horizontal pleiotropy, and the leave-one-out method was used for sensitivity analysis. Results SLE was associated with an increased risk of MG (OR=1.698, 95% CI: 1.329-2.171, P<0.001); similarly, MG was associated with an increased risk of SLE (OR=1.527, 95% CI: 1.248-1.869, P<0.001). There was no heterogeneity in the two-way results and no horizontal pleiotropy. The sensitivity analysis results of the leave-one-out method were stable. Conclusion There is a bidirectional causal relationship between SLE and MG. SLE patients will increase the risk of MG onset, and MG will also increase the risk of SLE onset.

Study on the prognostic value of PAR combined with NRS 2002 in elderly patients with pulmonary infection under the combined mode of medical care and nursing

AN Wen, LIU Qianqian, ZHOU Qingbo

2024, 22(12): 2025-2028. doi: 10.16766/j.cnki.issn.1674-4152.003789

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Objective To analyze the risk factors of pulmonary infection in the elderly under the combined mode of medical and nursing care, and explore the influence of the ratio of procalcitonin to albumin combined with nutritional status on the prognosis of the elderly, so as to facilitate early intervention and reduce the occurrence of adverse prognosis. Methods The clinical data of 146 elderly patients with pulmonary infection from April 2017 to August 2021 in the Second Hospital of Shandong University were retrospectively analyzed. The elderly were divided into survival group (n=99) and death group (n=47) according to their prognosis at 28 days. SPSS 22.0 statistical software was used for data analysis. Logistics regression analysis was performed on the related factors affecting the prognosis of the elderly with pulmonary infection at 28 d, and an ROC curve was drawn to analyze the predictive value of the related factors on the prognosis. Results Procalcitonin to albumin ratio (PAR) and nutritional risk screening 2002 (NRS 2002) in the death group were significantly higher than those in the survival group (P < 0.05). PAR (OR=1.938, 95% CI: 1.033-3.638), NRS 2002 (OR=2.443, 95% CI: 1.280-4.663) were independent influencing factors affecting the prognosis of lung infection at 28 days. The area under the ROC curve for PAR and NRS 2002 to predict the prognosis of elderly patients with pulmonary infection were 0.719 and 0.613, respectively. PAR ' s optimal cut-off point was 0.031, with a sensitivity of 46.8% and a specificity of 87.9%, and NRS 2002 ' s optimal cut-off point was 5.5, with a sensitivity of 74.5% and a specificity of 47.5%. The combined AUC was 0.732, the sensitivity was 61.7%, and the specificity was 83.7%, which was better than the prediction ability of a single index. Conclusion PCT, ALB, PAR, and NRS 2002 can predict the severity of lung infection in the elderly. PAR and NRS 2002 are independent risk factors for the prognosis of the elderly with lung infection at 28 days, and their combination has high clinical value in predicting the prognosis.

Expression of cuprotosis-related gene LIPT1 in endometrial cancer and its clinical significance

CHENG Cui, GUO Suyang, ZHANG Huihui, WEI Li, LI Yan, WANG Lihua, JIANG Hao

2024, 22(12): 2029-2032. doi: 10.16766/j.cnki.issn.1674-4152.003790

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Objective Lipoyltransferase 1 (LIPT1) is one of the key genes for copper death, and LIPT1 expression and its clinical significance were analysed in endometrial cancer (UCEC) using the TCGA database and clinical samples. Methods The immunohistochemical experimental results of TCGA-UCEC samples and tissue specimens of 59 UCEC patients were employed to substantiate the discrepancies in LIPT1 mRNA and protein expression and their correlation with clinical characteristics, as well as prognostic analyses. Subsequently, the relationship between LIPT1 and immune cells and immune checkpoints was subjected to analysis. Results The results showed that the expression of LIPT1 gene in cancer tissues was significantly lower than that in normal tissues (P < 0.001), and it was highly expressed in the adjacent normal tissues (P < 0.001). Immunohistochemical experiments also showed that the positive expression of LIPT1 protein was lower in cancerous tissues [40.68% (24/59)] than in paracancerous tissues [76.92% (20/26), χ²=9.495, P=0.002]. The differences in age (P=0.025), pathological grade (P=0.004) and pathological type (P < 0.001) of patients with different LIPT1 expression levels were statistically significant. The analysis of the clinical samples showed that the differences in age and pathological grading of patients with different LIPT1 expression levels were statistically significant (P < 0.05). Patients with UCEC who exhibited high LIPT1 expression exhibited poorer OS, DSS and PFI, which were identified as independent poor prognostic factors for OS. LIPT1 expression was found to be correlated with CD8⁺ T-cells, macrophages and neutrophils (P < 0.05). The expression of LIPT1 was correlated with PD-L1 (P < 0.01), but not correlated with PD-1 or CTLA-4. Conclusion LIPT1 is expressed at low levels in UCEC, but high levels are associated with poor prognosis and may be related to cancer cell immune escape. It is anticipated that this will become a new therapeutic target for UCEC.

Clinical characteristics and risk factors of primary Sjögren's syndrome with liver function damage

GAO Guanli, WEI Xiaolong, SHEN Dongbei, ZHANG Yinglu, ZHANG Shurong

2024, 22(12): 2033-2036. doi: 10.16766/j.cnki.issn.1674-4152.003791

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Objective To analyze the clinical characteristics of patients with primary Sjögren's syndrome (pSS) complicated with liver function and multi-system damage, and to explore the risk factors of liver function damage in pSS, so as to provide new basis for clinical diagnosis and treatment. Methods A total of 92 patients diagnosed with PSS and liver function damage admitted to the 920th Hospital of the Joint Logistics Support Force of PLA from January 2020 to October 2023 were selected as liver injury groups, and 92 patients with PSS patients who has no liver damage were selected as non-liver injury groups. The clinical data and auxiliary examination results of the two groups of patients were collated for comparison and analysis. Results The combination of liver damage and blood system involvement (56.5%, 52/92), joint and bone involvement (54.3%, 50/92), and thyroid involvement (23.9%, 22/92) in patients with pSS is significantly higher than in patients with pSS, however, without liver damage [34.8% (32/92), 32.6% (30/92), 8.7% (8/92), P < 0.05]. The proportion of patients with involvement of two or more systems in the liver injury group (73.9%, 68/92) is also significantly higher than that in the non-liver injury group (55.4%, 51/92, P < 0.05). The levels of CRP [6.45 (2.83, 17.10) mg/L] and WBC [6.28 (4.37, 9.51)×10⁹/L] in the pSS liver lesion group were found to be significantly higher than those in the non-liver injury group [2.45 (0.80, 8.40) mg/L, 5.31 (4.14, 6.74)×10⁹/L, P < 0.05]. The positive rates of ANA (84.8%, 78/92) and anti-SSB (50.0%, 46/92) in the pSS liver injury group were significantly higher than those in the pSS non-liver injury group [65.2% (60/92) and 28.3% (26/92), respectively, P < 0.05]. The logistic regression analysis demonstrated that elevated CRP (OR=1.037, 95% CI: 1.003-1.071, P < 0.05) and elevated WBC (OR=1.325, 95% CI: 1.139-1.542, P < 0.01), multi-system involvement (OR=2.262, 95% CI: 1.039-4.925, P < 0.05) were risk factors for liver function damage in pSS patients. Conclusion Patients with pSS who also have impaired liver function are frequently accompanied by multiple system impairment. Elevated CRP and WBC levels, in conjunction with multi-system involvement, constitute risk factors for pSS-related liver dysfunction.

Analysis of clinical features and related factors of systemic lupus erythematosus complicated with cardiovascular disease

ZHAO Yunqi, XIE Changhao, ZHOU Ying

2024, 22(12): 2037-2040. doi: 10.16766/j.cnki.issn.1674-4152.003792

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Objective To examine the clinical characteristics and potential risk factors associated with systemic lupus erythematosus (SLE) patients with cardiovascular diseases. The findings of this study will contribute to the development of more accurate clinical diagnosis and treatment strategies for SLE patients with cardiovascular diseases. Methods The clinical data of 202 patients with SLE, comprising 22 males and 180 females, were collected from the Rheumatology Department of the First Affiliated Hospital of Bengbu Medical University between December 2021 and December 2022. The patients were divided into two groups: a case group comprising 58 patients with cardiovascular diseases and a control group comprising 144 patients without cardiovascular diseases. The clinical data of the two groups were subjected to analysis and comparison. Results There were a total of 58 SLE patients with cardiovascular diseases, with an incidence rate of 28.7%. There were statistically significant differences in age, left common carotid artery resistance index, left common carotid artery maximum blood flow velocity, blood glucose, platelet count, IgG level, C3, total cholesterol, D-dimer, antiphospholipid antibody positive rate, and disease duration between the two groups (P < 0.05). Logistic regression analysis showed that increased age, elevated left common carotid artery resistance index, hyperglycemia, platelet count, and abnormal IgG level were independent risk factors for SLE patients with cardiovascular diseases (P < 0.05). Conclusion The incidence rate of SLE patients with cardiovascular diseases is influenced by multiple factors, among which age increase, positive antiphospholipid antibody status, elevated left common carotid artery resistance index, abnormal blood glucose, platelet count, and abnormal IgG level are potential risk factors. It is therefore recommended that these factors should be taken into account in clinical practice in order to develop comprehensive risk assessment and management strategies which will effectively reduce the risk of cardiovascular disease in patients with SLE.

Risk model construction and decision curve analysis of deep learning thrombosis in orthopedic surgery patients

SHEN Yunxia, YAO Guomei, FU Yueyuan, LU Shenghua, GAO Zhichao

2024, 22(12): 2041-2045. doi: 10.16766/j.cnki.issn.1674-4152.003793

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Objective To establish a deep learning thrombosis risk model for patients undergoing orthopaedic surgery, and to analyze its clinical efficacy by using a decision curve. Methods A total of 180 orthopaedic patients admitted to Linping Campus in School of Medicine, the Second Affiliated Hospital of Zhejiang University from February 2022 to February 2024 were retrospectively selected and divided into training group (n=126) and verification group (n=54) according to the ratio of 7∶3. The patients were subdivided into two groups on the basis of the results of the deep vein thrombosis (DVT) examination. A predictive model for DVT risk in orthopaedic surgery patients was developed using Python software. The clinical efficacy of the model was evaluated through the construction of a decision curve. Results The training group, the age, BMI, operation time and bed rest time of the group with DVT were higher than those of the group without DVT. Furthermore, the proportions of diabetes, hypertension, spinal surgery history, lower limb injury and general anaesthesia were higher than those of the group without DVT (P < 0.05). The independent risk factors for DVT in orthopaedic surgery patients, as identified through statistical analysis, were age, BMI, diabetes, hypertension, disease distribution (lower limb injury) and bed rest time exceeding five days (P < 0.05). The AUC for the training set and verification set is 0.887 and 0.903, respectively. When the threshold probabilities of the training set and verification set are 18%-56% and 19%-58% respectively, the implementation of effective intervention measures can facilitate the optimal clinical benefits for patients undergoing orthopaedic surgery. Conclusion The following factors have been identified as independent risk factors for DVT in patients undergoing orthopaedic surgery: age, BMI, diabetes, hypertension, disease distribution (lower limb injury) and bed rest time exceeding five days. The ANN model constructed using these influencing factors is an effective method for predicting the risk of DVT in orthopedic surgery patients. This is beneficial in order to ensure that the clinical benefits of DVT prevention and treatment are optimized.

The cone-beam CT was used to compare the hardness of enamel between mesiodens and maxillary lateral incisors

GUO Zhenfei, ZHAO Lili, ZHANG Kai

2024, 22(12): 2046-2048. doi: 10.16766/j.cnki.issn.1674-4152.003794

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Objective The cone-beam CT (CBCT) was used to compare the hardness of enamel between mesiodens and maxillary lateral incisors and analyze the relationship between the two teeth, seeking a method of autologous tooth grafting. Methods PLANMECA ROMEXIS Viewer software was used to collect a total of 104 mesiodens from 75 supernumerary tooth patients in the stomatology department of the First Affiliated Hospital of Bengbu Medical University from August 2015 to July 2017. Then, the enamel hardness of mesiodens and maxillary lateral incisors were evaluated by Hounsfield units (HU). The HU values of five tooth surfaces were detected, including the incisal edge (A), the labial midpoint (B1), the midpoint of the cervical margin in the labial surface (B2), the lingual midpoint (L1) and the midpoint of the cervical margin in the lingual surface (L2). Results A total of 104 mesiodens were detected, of which 98 were impacted (94.2%) and 6 were erupted (5.8%). Forty-six (61.3%) had a single mesiodens, while 29 (38.7%) had two mesiodens. No significant difference was observed in the enamel hardness between the right and left maxillary lateral incisors and right and left mesiodenses (A, B1, B2, L1, L2 site, P>0.05). The enamel hardness of L1 and L2 surfaces was similar between mesiodens and the right maxillary lateral incisor (P>0.05). While, there were differences in the enamel hardness of the right maxillary lateral incisor and mesiodens at the A, B1, and B2 surfaces. It is observed that the enamel hardness of the right maxillary lateral incisor were higher than mesiodens (P < 0.001). Conclusion The enamel hardness is similar between mesiodens and maxillary lateral incisor. Mesiodens with normal shapes may be an ideal substitute for missing maxillary incisors.

The role of estrogen-induced DCN gene methylation in the pathogenesis of pelvic organ prolapse

CUI Shuling, LAO Peiwei, SHEN Kewei, ZHANG Yingzhi

2024, 22(12): 2049-2052. doi: 10.16766/j.cnki.issn.1674-4152.003795

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Objective To detect the methylation of estradiol (E2) and decorin (DCN) genes in patients with pelvic organ prolapse (POP) and to study their role in the pathogenesis of POP. Methods A total of 85 POP patients who underwent surgery between January 2023 and January 2024 were selected for the postmenopause group (PSM group, n=44) and menopausal transition period group (TRM group, n=41), additionally, 30 patients with pelvic benign diseases during the same period were selected as the control group. The Primary fibroblasts were treated with 50 nmol/L E2 (H-EST group), 2 nmol/L E2 (L-EST group), and 50 nmol/L E2 in combination with an ER antagonist (ESR siRNA, H-EST+siER group). Detect and compare the methylation differences of the estradiol (E2), DCN, type Ⅰ collagenase (COL Ⅰ), E2 receptor (ER) and DCN genes. Results The expressions of E2, DCN, COL Ⅰ and ER in the PSM group were significantly lower than those in the TRM group and the control group (P < 0.05), Furthermore the DCN methylation rate was significantly higher in the PSM group than in the TRM group and the control group (P < 0.05). In patients with POP in the PSM group and TRM group, E2 was found to be positively correlated with the expression of DCN, COL Ⅰ, and ER (r_s=0.713, 0.654, 0.679, 0.639, respectively, all P < 0.05), and negatively correlated with DCN gene methylation (r_s=-0.821, -0.806, all P < 0.05). The expressions of DCN, COL Ⅰ and ER in cells of the H-EST group and L-EST group were significantly lower than those of the CON group, H-EST+siER group and siER group (P < 0.05). Furthermore, the DCN methylation rate was significantly higher than that of the CON group, H-EST+siER group and siER group (P < 0.05). Conclusion The methylation rate of DCN genes and E2 level is markedly elevated in patients with POP, and there is a negative correlation. E2 may play a role in the development of POP by inducing methylation of the DCN gene.

Analysis of AD7c-NTP levels and cognitive function in patients with early-onset depression and late-onset depression

DAI Yuling, WANG Xiaoquan, WANG Zusen, SONG Chuanfu, ZHANG Jun, ZHU Wenli, CAI Han, WANG Dingxiang, XU Liang, YANG Tao

2024, 22(12): 2053-2056. doi: 10.16766/j.cnki.issn.1674-4152.003796

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Objective To analyze the differences in AD7c-NTP levels and cognitive function among patients with early-onset depression, late-onset depression, and healthy elderly individuals, providing insights for the clinical diagnosis of geriatric depression. Methods A total of 174 elderly patients with depression admitted to Wuhu Hospital, Beijing An'ding Hospital Affiliated to Capital Medical University from January 2022 to January 2024 were selected as the study objects. Based on the age of first onset, depression patients were categorized into the early onset group (EOD, n=105; first onset < 60 years) and the late onset group (LOD, n=69; ≥ 60 years). A control group of seventy-five healthy elderly patients (NC, n=75) were selected from hospital check-ups and community hospital centers. Urinary AD7c-NTP levels of all subjects were detected by ELISA, and the cognitive function of each group was assessed by Montreal cognitive assessment scale (MoCA). AD7c-NTP values and cognitive function scores were compared across the EOD, LOD, and NC groups. Spearman correlation analysis was performed to evaluate the relationship between MoCA scores and urine AD7c-NTP values. Results Significant differences in cognitive function and AD7c-NTP levels were observed among the EOD, LOD, and NC groups (P < 0.01). The cognitive levels were negatively correlated with urine AD7c-NTP levels in all groups (P < 0.01). In addition, depression levels were not associated with AD7c-NTP in the EOD group (P=0.799) and were not associated with AD7c-NTP in the LOD group (P=0.635). Conclusion The AD7c-NTP levels are significantly increased in patients with late-onset depression, who also exhibit cognitive deficits in attention and executive function. While AD7c-NTP levels were not associated with depression severity, they were negatively correlated with cognitive function. AD7c-NTP level can serve as a predictive biomarker for detecting cognitive changes in the elderly.

Effect analysis of high-frequency cerebellar rTMS combined with respiratory muscle training on post-stroke dysphagia patients

MAO Jianhao, ZHENG Hongjian, LEI Bing, DONG Jinjiang

2024, 22(12): 2057-2061. doi: 10.16766/j.cnki.issn.1674-4152.003797

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Objective To analyze the application effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with respiratory muscle training in patients with post-stroke dysphagia (PSD), and provide a basis for clinical rehabilitation training and treatment. Methods A total of 118 PSD patients diagnosed and treated in Chun'an Branch of Zhejiang Provincial People's Hospital from May 2021 to November 2023 were selected retrospectively. They were divided into two groups according to the admission time, with 59 cases in each group. The control group received routine respiratory muscle training, and the research group was treated with high-frequency cerebellar rTMS on the basis of it. The swallowing function, mandibular hyoid muscle motor evoked potential (MEP), brainstem auditory evoked potential (BAEP), aspiration pneumonia, and incidence of aspiration were compared between the two groups. Results After three weeks of intervention, the standardized swallowing assessment (SSA) score of the study group (21.47±2.51) was lower than that of the control group (24.25±2.38), and the grade Ⅰ-Ⅱ (84.75%) of Wadian drinking water test was higher than that of the control group (32.71%), with statistical significance (P < 0.05). The latency of MEP in the study group was lower than that in the control group, and the amplitude of MEP was higher than that in the control group, with statistical significance (P < 0.05). The latency of Ⅰ, Ⅲ, and Ⅴ waves and the latency between the peaks of Ⅰ-Ⅲ, Ⅲ-Ⅴ, and Ⅰ-Ⅴ in the study group were significantly shorter than those in the control group, with statistical significance (P < 0.05). The total incidence of aspiration pneumonia and aspiration in the study group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion High-frequency cerebellar rTMS combined with respiratory muscle training has a certain effect in PSD patients, which can shorten BAEP, regulate MEP of mandibular hyoid muscle, improve swallowing function of patients, and reduce the risk of aspiration pneumonia and aspiration to some extent.

Analysis of the efficacy and safety of Pralofen combined with Emadine in the treatment of allergic conjunctivitis

DU Wei, MA Yingying, FU Leming, LI Jun

2024, 22(12): 2062-2065. doi: 10.16766/j.cnki.issn.1674-4152.003798

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Objective Allergic conjunctivitis (AC) is a common ocular surface disease. Although single-drug treatment can alleviate symptoms, the efficacy is limited, and the recurrence rate is high. Therefore, exploring combination therapy strategies to optimize treatment plans is of great significance. The aim of this study is to investigate the efficacy and safety of Pralofen combined with Emadine in the treatment of AC, providing, reference for clinical treatment planning. Methods A total of 124 patients with AC admitted to the ophthalmology department of our hospital from October 2023 to June 2024 were randomly divided into Group A and Group B. Group A, consisting of 62 patients, was treated with Pralofen, while Group B, consisting of 62 patients, was treated with Pralofen combined with Emadine. The improvement of symptoms, tear film stability, tear index levels, inflammatory factor levels, clinical efficacy, and adverse reactions were observed in both groups. Results The scores of photophobia, tearing, eye itching, and eye secretions in group B were lower than those in group A after treatment (P < 0.05). The BUT of group B after treatment was longer than that of group A (P < 0.05), and the CFS score was lower than that of group A (P < 0.05). The ECP, HA, and LTB4 levels in group B were lower than those in group A after treatment (P < 0.05). The levels of IL-6, TNF-α, and hs-CRP in group B were lower than those in group A after treatment (P < 0.05). The total effective rate of Group B was 91.94% (57/62), which was higher than that of Group A [75.81% (47/62)], with P < 0.05. The incidence of adverse reactions in Group B was 8.06% (5/62), which was slightly lower than that of Group A [12.90% (8/62)], with P>0.05. Conclusion Pralofen combined with Emadine has a good effect on the treatment of AC, which can effectively alleviate patient symptoms, improve tear film stability, improve tear index levels and inflammatory factor levels, and has fewer adverse reactions. It is effective and safe and is worth promoting.

Clinical study of upper fibular osteotomy combined with arthroscopic debridement in the treatment of medial compartment osteoarthritis of knee joint

WANG Xiaocheng, JIA Bo, WANG Yu, WU Yunjian, WANG Qiang

2024, 22(12): 2066-2070. doi: 10.16766/j.cnki.issn.1674-4152.003799

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Objective The theory of uneven settling of the knee joint provides a new idea for the surgical treatment of knee osteoarthritis (KOA). The objective of this study was to investigate the clinical advantages of superior fibular osteotomy combined with arthroscopic debridement in the treatment of medial compartment osteoarthritis of the knee joint compared to arthroscopic debridement alone. Methods The data of 125 patients with medial compartment osteoarthritis of the knee joint who completed treatment in Jinhua Hospital of Traditional Chinese Medicine from January 2021 to June 2023 and were followed up for ≥6 months were collected. According to different treatment methods, they were divided into the control group (72 cases with arthroscopic debridement alone) and the study group (53 cases with superior fibular osteotomy combined with arthroscopic debridement). The changes of femoral tibial angle (FTA), tibial joint space angle, knee range of motion (ROM), hospital for special surgery (HSS) score and synovial fluid interleukin-6 (IL-6) and interleukin-1β (IL-1β) were compared between the two groups, and the incidence of surgery-related complications were analyzed. Results Six months after surgery, the levels of FTA [(180.21±1.90)° vs. (182.89±1.75) °], tibial joint space angle [(1.58±0.37)° vs. (3.09±0.61) °] and IL-6 and IL-1β in synovial fluid of knee joint in the study group were lower than those in the control group. The ROM [(91.23±7.05)° vs. (82.86±6.72)°] and HSS scores [(74.50±7.25) points vs. (65.12±6.37) points] were higher than those of the control group (P < 0.05), and the improvement of knee joint function was better than that of the control group (P < 0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion Upper fibular osteotomy combined with arthroscopic debridement is an effective treatment for medial compartment osteoarthritis of the knee joint, which can significantly improve the lower limb force line, reduce inflammatory injury of the knee joint and improve mobility function, with good safety.

Application effect of diet management based on empowerment theory for patients with maintenance hemodialysis

CHEN Kewei, GE Yuying, WEI Wei, WANG Qiumei, ZHENG Juqing

2024, 22(12): 2071-2074. doi: 10.16766/j.cnki.issn.1674-4152.003800

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Objective The aim of this study was to evaluate the effect of a dietary management model based on empowerment theory on the improvement of nutritional status and dietary treatment attitudes of maintenance haemodialysis (MHD) patients, so as to validate the effectiveness of empowerment theory in enhancing the self-management ability and quality of life of MHD patients. Methods The clinical data of 130 patients with MHD who were treated in Hangzhou First People's Hospital from January 2019 to January 2022 were retrospectively analyzed. The patients were divided into empowering theory intervention group (n=65) and routine intervention group (n=65) according to patient intervention. The patients in the routine intervention group received routine nursing, and the patients in the empowering theory intervention group received diet management based on empowerment theory. The modified quantitative subjective global assessment of nutrition (MQSGN) score, attitude scale for the dietary therapy of hemodialysis patients (ASDTH) score, albumin (ALB), prealbumin (PAB), hemoglobin (Hb), blood phosphorus and blood calcium were compared. Results The MQSGN score of the empowering theory intervention group was less than the routine intervention group [(18.41±4.78) points vs. (21.42±4.31) points, P < 0.05]. The ASDTH score of the empowering theory intervention group was higher than the routine intervention group [(44.07±2.37) points vs. (38.46±2.54) points, P < 0.05]. Compared with routine intervention group, the levels of PAB, ALB and Hb of empowering theory intervention group were increased, and blood phosphorus was decreased, the differences were statistically significant (P < 0.05). There was no difference in blood calcium between the two groups (P>0.05). Conclusion Diet management based on empowerment theory for MHD patients can help improve compliance and nutritional status.

Analysis of cognitive-related behavior differences among preschool children with different auditory processing abilities

ZHOU Jia, LIU Panting, LIN Huanxi, XIAO Zhenglu, SUN Yuying, YU Xinyue, QIAN Jun, CHI Xia, HONG Qin

2024, 22(12): 2075-2079. doi: 10.16766/j.cnki.issn.1674-4152.003801

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Objective To analyze the cognitive-related behaviors of preschool children with different auditory processing abilities, and to explore the relationship between auditory processing ability and cognitive-related behaviors of preschool children. Methods For the 48 children with low risk of auditory processing disorder and the 48 children with high risk of auditory processing disorder identified by the preschool auditory processing assessment scale in the normative study conducted in Nanjing for children aged 4-6 years old in August 2021, who were seen at the Pediatric Healthcare Department of Nanjing Maternal and Child Healthcare Hospital and the children in Nanjing kindergartens, respectively. The Wechsler preschool and primary intelligence scale-Ⅳ (WPPSI-Ⅳ), the kiddie continuous performance test (K-CPT), and the Conners parent symptom questionnaire (PSQ) were used to evaluate the children's intelligence, attention, and behavior problems, and the differences in behavioral performance between the low-risk group and high-risk group and the relationship between behavioral performance and auditory processing ability were compared. Results Compared with the low-risk group, the high-risk group had lower verbal comprehension composite scores on the WPPSI-kiddie continuous performance test (Z=-2.484, P < 0.05), more errors on the K-CPT, more stimulus changes, and higher scores on each behavior problem factor on the PSQ (P < 0.05). Pearson correlation analysis showed that verbal comprehension composite scores on the WPPSI-Ⅳ, total scores and scores on all dimensions except auditory attention on the K-CPT, and scores on all dimensions except communication, visual attention, and auditory processing on the PSQ were correlated with total scores and all dimensions (P < 0.05). Anxiety on the PSQ was correlated with total scores and all dimensions except communication and visual attention (P < 0.05). The results of the multiple linear regression showed that auditory processing scores on the K-CPT were significantly related to verbal comprehension composite scores on the WPPSI-Ⅳ (β=-0.601, P < 0.05). Conclusion The behavioral performance of preschool children with different auditory processing abilities is different, and their auditory processing abilities are related to their behavioral performance.

Risk factors of extubation failure in premature infants with respiratory distress syndrome born before 32 weeks of gestation

WANG Yue, CHEN Xin, ZHANG Zhen, LI Ru'na

2024, 22(12): 2080-2083. doi: 10.16766/j.cnki.issn.1674-4152.003802

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Objective To study the clinical characteristics of premature infants with respiratory distress syndrome (RDS) by tracheal intubation mechanical ventilation, analyze the risk factors and adverse outcomes of extubation failure, and provide evidence for its prevention. Methods The clinical data from preterm infants (< 32 weeks gestational age) admitted to Neonatal Intensive Care Unit (NICU) of the First Affiliated Hospital of Bengbu Medical University from June 2017 to December 2022 were reviewed and analyzed. According to the outcome of tracheal intubation and extubation, they were divided into a successful group and a failed group. The risk factors for extubation failure were analyzed, and the clinical progression and outcomes of the two groups were compared. Results A total of 153 premature infants with RDS were included, with 128 infants in the successful extubation group and 25 infants (16.3%) in the failed extubation group. Logistic regression analysis identified the following significant risk factors for extubation failure: low birth weight (OR=9.215, 95% CI: 1.153-73.611, P < 0.05), and low 5-minute Apgar score (OR=2.769, 95% CI: 1.681-4.563, P < 0.05), no caffeine use (OR=46.353, 95% CI: 3.489-615.792, P < 0.05), high PaCO₂ before extubation (OR=0.871, 95% CI: 0.809-0.938, P < 0.05), and low PaO₂ before extubation (OR=1.058, 95% CI: 1.018-1.101, P < 0.05). The rates of death or abandonment of treatment, ventilator-associated pneumonia (VAP), and bronchopulmonary dysplasia (BPD) were higher in the failed group (P < 0.05). Additionally, the failed group required longer oxygen therapy compared to the successful group (P < 0.05). Conclusion Lower birth weight, lower 5-minute Apgar score, no caffeine use, elevated PaCO₂, and reduced PaO₂ are significant predictors of extubation failure in premature infants with RDS. Extubation failure increases the risk of death and adverse outcomes in these infants.

The choice preferences of community residents and general practitioners for the selection of family doctor contracted services

CHENG Lian, ZHANG Yong, LI Yuanyuan, HUANG Yanfei, LI Qinghui

2024, 22(12): 2084-2087. doi: 10.16766/j.cnki.issn.1674-4152.003803

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The family doctor contracted service is a manifestation of the implementation of health care reform policies, the main mode of grass-roots service at this stage, and an important hand in realizing a healthy China. The aim of family doctor contracted service is to establish a long-term and stable service relationship between general practitioners and contracted residents or families, with a focus on general practitioners and a family doctor team as the pillar. Through signing contracts, we aim to provide comprehensive, high-quality, and convenient health services to contracted individuals, create a health service system at the doorstep, and achieve full lifecycle health management. Although the overall signing rate, knowledge rate, and fulfillment rate of family doctor contracted service have been increasing year by year, there are great geographical differences (such as economy, society, culture, and politics), and some regions of China are still in the low knowledge rate, low signing rate and low fulfillment rate, in addition, due to the mismatch of the selection preferences of the community residents and general practitioners in family doctor contracted service, the low satisfaction of the supply and demand is probably the cause of the current "signing for the sake of signing" "signing without contracting" "pseudo-signing" "service items not being implemented", and so on. There are such phenomena as "signing for the sake of signing" "signing but not contracting" "pseudo-signing" and "failure to implement service programs", which seriously affect the quality of services. In order to better implement the contracted services of family doctors and improve the quality of contracted services, this paper summarizes the studies on the preference of community residents and general practitioners for contracted services of family doctors, exploring the potential factors affecting the supply and demand of family doctor signing services, proposing corresponding strategies to improve their quality and quantity. and provides the basis for the preference of family doctor contracted service from the different perspectives of supply and demand, providing reference for further promoting effective contracting and standardized performance, improving satisfaction of both parties, and strengthening the connotation of contracted service, so as to promote the high-quality development of family doctor contracted service.

Analysis on the factors influencing the loyalty of rural residents to family doctors' "contract first consultation"

SHENG Qing, CAI Liqiang, WANG Zhaoxin

2024, 22(12): 2088-2091. doi: 10.16766/j.cnki.issn.1674-4152.003804

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Objective Using the theory of "customer loyalty" in service marketing, taking "contracted first visit service" as an "important product", investigate and analyze the influencing factors of rural residents' loyalty to family doctor contracted first visit service, and improve the utilization rate of family doctor contracted service. Methods A random sampling method was employed to select 1 000 residents from six rural communities in the Pudong New Area of Shanghai as the subjects of the survey subjects. From May to September 2021, an enhanced American customer satisfaction index (ASCI) model and the SERVQUAL service quality evaluation scale were employed to develop a questionnaire survey on the loyalty of contracted residents to the initial visit service of family doctors using semi-structured interview approach. The survey questionnaires were collated for analysis of the discrepancies and factors influencing the loyalty of family doctors to register for initial visit services. Results A statistically significant discrepancy exists between the anticipated and observed values of the 8 dimensions that affect influence the loyalty of family doctors to the initial consultation service. A total of 58 items were identified as influencing the loyalty of family doctors to contract services. Of these, 6 items exhibited a mean difference of 1.0 or more between their expected and actual values. Furthermore, the differences between the expected and actual values were statistically significant for all 58 items. The regression model revealed that the anticipated values for each dimension had a notable influence on the satisfaction of contracted residents. Furthermore, the anticipated values exerted a more pronounced effect on satisfaction than the actual values. Conclusion The Pudong New Area Rural Community Health Service Center is perceived to have a relatively high level of recognition among contracted residents in terms of the availability of hardware facilities, the quality of family doctor services, and the communication between doctors and patients. Nevertheless, deficiencies exist in the provision of pharmaceuticals and medical technology. It is recommended that the self-management authority of community health service centers be moderately increased, that the drug use system with general hospitals be improved with a view to enhancing its "top-down coordination", that a comprehensive talent training model of "general practice+specialty" be explored, and that the enthusiasm and initiative of family doctors to sign contracts for services be enhanced.

The relationship with Chinese traditional cultural beliefs and mental health of community people

XIONG Jiani, XIAO Rong

2024, 22(12): 2092-2096. doi: 10.16766/j.cnki.issn.1674-4152.003805

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Objective The public in Guangzhou and Shenzhen were investigated, to analyze the Chinese traditional cultural beliefs of the community people and their relationship with mental health. Methods From January 2019 to December 2020, a questionnaire survey was conducted on 567 city community people in Guangzhou and Shenzhen using a convenience sampling method. The Chinese traditional cultural beliefs and mental health status were measured by the self-developed basic information scale, Chinese traditional culture belief scale (CTCBS), flourishing scale (FS), patient health questionnaire-9 (PHQ-9). Results The total average score of CTCBS among the public was (4.18±0.69) points. The scores for each dimension: The average score for cultural admiration was (4.11±0.77) points, the average score for cultural love was (4.30±0.70) points, the average score for cultural esteem was (4.27±0.71) points, and the average score for cultural participation was (4.05±0.76) points. A total of 386 (68.1%) respondents have traditional cultural beliefs. The public of different ages have significant differences in overall cultural belief levels (P < 0.01). There is a significant positive correlation between the cultural belief status of the public and the level of happiness (r=0.468, P < 0.001), and a significant negative correlation between the cultural belief status of the public and the level of depression (r=-0.117, P < 0.01). The four dimensions of cultural beliefs are positively correlated with happiness and significantly negatively correlated with depression levels. Further analysis shows that the traditional cultural beliefs of completely healthy individuals are significantly higher than those of partially ill, susceptible, and diseased individuals. The traditional cultural beliefs of partially ill individuals are significantly higher than those of susceptible and diseased individuals. Conclusion There is a significant relationship between the traditional cultural beliefs of community residents and their mental health. The higher the level of cultural beliefs, the higher the level of happiness, and the milder the symptoms of depression. It is suggested to improve individual mental health by enhancing the traditional cultural beliefs of urban community residents.

The influence of traditional Chinese medicine five element music combined with "triple" relaxation training on insomnia in patients with bipolar affective disorder during maintenance period

LI Ping, FENG Hong, TAO Kewei, ZHANG Huiling

2024, 22(12): 2097-2099. doi: 10.16766/j.cnki.issn.1674-4152.003806

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Objective Insomnia is a common issue in the maintenance period of bipolar disorder and requires attention. This study aimed to evaluate the influence of traditional Chinese medicine (TCM) five elements music combined with "triple" relaxation training on insomnia in these patients and to provide a simple, effective, economical, and feasible nursing method for clinical practice. Methods A total of 101 patients with insomnia during the maintenance period of bipolar disorder, treated at Shaoxing Seventh People's Hospital from March 2022 to March 2023, were divided into 2 groups by random number table method. The control group (50 cases) was given routine nursing intervention, while the experimental group (51 cases) was given traditional Chinese medicine five elements music combined with "triple" relaxation training intervention in addition to routine care. After 6 weeks of intervention, sleep quality, depression, and mania levels were compared between the two groups. Results Finally, a total of 49 cases in each group completed the study. After intervention, the Pittsburgh sleep quality index score of the experimental group was (6.43±1.18), which was lower than that of the control group (9.78±2.11, P < 0.05). Polysomnography results showed that the experimental group had longer total sleep time, non-rapid eye movement duration, and higher sleep efficiency, as well as shorter sleep latency, compared to the control group (P < 0.05). The experimental group also showed lower self-rating depression scale score (SDS: 48.66±5.66 vs. 51.30±4.19, P < 0.05) and Bech Rafaelson's mania rating scale score (10.45±2.39 vs. 14.34±3.08, P < 0.05). Conclusion TCM five element music combined with "triple" relaxation training effectively improve insomnia and relieve depression and mania in patients with bipolar disorder in maintenance period, making it an effective nursing method.

Serum NSE levels in epileptic patients and its correlation with EEG characteristics and recurrence risk

JIANG Ruiting, NI Qichao, WANG Yujia, MIN Jingjing

2024, 22(12): 2100-2103. doi: 10.16766/j.cnki.issn.1674-4152.003807

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Abstract:
Objective To detect the level of serum neuron-specific enolase (NSE) in patients with epilepsy, and analyze their correlation with electroencephalogram (EEG) characteristics, as well as identify predictive factors for epilepsy recurrence. Methods A total of 95 epileptic patients admitted to Huzhou First People's Hospital from January 2021 to February 2023 were selected as the research group and 30 healthy people were selected as the control group during the same period. Serum NSE levels were detected by enzyme-linked immunosorbent assay, and the correlation between serum NSE levels and EEG was analyzed by Kendall's correlation. After a one-year follow-up, patients with epilepsy in the research group were divided into a non-recurrence group (n=41) and a recurrence group (n=52). The influencing factors of epilepsy recurrence were analyzed by multivariate logistic regression. Results The levels of serum NSE, galanin (GAL), and TNF-α in the research group were higher than those in the control group (P < 0.05). The levels of serum NSE, GAL, and TNF-α in different EEG abnormal groups were significantly different (P < 0.05). Kendall's correlation analysis showed positive correlations between NSE, GAL, and TNF-α and the degree of EEG abnormality (P < 0.05). The recurrence group showed significant differences in the number of anti-epileptic drugs taken and the levels of serum NSE, GAL, and TNF-α compared to the non-relapse group (P < 0.05). Multivariate logistic regression analysis showed that higher levels of NSE (OR=1.259) and TNF-α (OR=1.097) were independent risk factors for the recurrence of epilepsy (P < 0.05). The ROC curve analysis showed that the AUC of 0.859 (95% CI: 0.786-0.932) for NSE and 0.703 (95% CI: 0.594-0.811) for TNF-α. Conclusion The higher serum NSE levels are associated with higher EEG abnormalities in epileptic patients. Serum NSE levels have a high predictive value for epileptic recurrence and can serve as an independent predictive index of recurrence risk.

Research progress of quantitative functional magnetic resonance imaging in prostate cancer

ZHU Rong, WANG Guanshun, ZHANG Ya, LI Ruiqian, YANG Yinrui, SHEN Jing, GU Shangwei

2024, 22(12): 2104-2107. doi: 10.16766/j.cnki.issn.1674-4152.003808

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Abstract:
Prostate specific antigen (PSA), MRI examination and ultrasound-guided puncture biopsy are mainly used to diagnose prostate cancer (PCa). PSA is a specific tumor marker for PCa, but PSA is also elevated in prostate hyperplasia, prostatitis, cystoscopy, etc., which is prone to false-positive results. MRI is the main imaging technique for diagnosis, especially functional MRI plays an important value in the diagnosis of PCa. At present, the prostate imaging reporting and data system (PI-RADS) based on diffusion weighted imaging, diffusion weighted imaging (DWI), DCE and T₂WI has been widely used in the clinical diagnosis of PCa. However, the scoring of each sequence still relies on the subjective experience of the imaging physician, especially the PI-RADS score of 3 lesions cannot be determined as benign or malignant, which also leads to the uncertainty of the recommendation of puncture for such lesions. In addition, the prognosis and choice of treatment options for PCa differ among different risk strata. The aggressiveness of PCa is usually reflected by the Gleason score (GS). GS is the sum of the most common histological Gleason grade of the tumor plus the second most common histological Gleason grade. Gleason grading is divided into 1-5 grades according to the degree of differentiation of the cells, and the higher the grade, the worse the degree of cell differentiation and the worse the prognosis. In recent years, various new functional MRI techniques such as amide proton transfer imaging, intravoxel incoherent motion diffusion weighted imaging, diffusion kurtosis imaging, dynamic enhanced magnetic resonance imaging, etc. have been developed, and their quantitative parameters can accurately quantify the cytoarchitecture of prostate foci and cellular diffusion, microcirculation perfusion and angiogenesis, and molecular metabolism changes, which can help to increase the diagnostic accuracy of prostate cancer and have the potential to predict tumor. It also has the potential to predict tumor aggressiveness, which will provide more valuable objective evidence for the correct diagnosis of PCa. This article summarizes the research progress of the above new functional MRI quantitative techniques in the diagnosis of PCa.

Application of meridian warming and scraping therapy combined with moxibustion in patients with pressure sore after stroke

TAO Xiaohong, FAN Li, HU Yeming

2024, 22(12): 2108-2111. doi: 10.16766/j.cnki.issn.1674-4152.003809

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Objective Exploring the application effect of meridian warming and scraping therapy combined with moxibustion in patients with post-stroke pressure ulcers, aiming to provide a theoretical basis for the clinical prevention and treatment of pressure ulcers in traditional Chinese medicine (TCM). Methods A total of 91 patients with post-stroke pressure ulcers treated in Zhejiang Provincial Tongde Hospital from March 2022 to March 2024 were selected and divided into a control group (45 cases) and a traditional Chinese medicine group (46 cases) by random number table method, both of which were given routine care. The control group was given hydrocolloid dressing for external application, and the traditional Chinese medicine group was given the combined intervention of meridian warming and scraping therapy combined with moxibustion on the basis of the control group for 2 weeks. The scores of stress wound healing scale (PUSH) and pain VAS, granulation and wound healing time, wound blood perfusion volume, tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF) levels were compared between the two groups. Results The PUSH scores and VAS scores of the TCM group were (2.81±0.55) points and (1.67±0.43) points, both lower than those of the control group (5.63±1.24) points and (2.58±0.88) points (P < 0.05). The occurrence time of granulation tissue (4.09±1.27) d and wound healing time (19.28±4.10) d were shorter than those of the control group [(6.12±1.34) d and (24.34±3.18) d, P < 0.05]. The blood perfusion volume of wound was higher than that of the control group (P < 0.05). The level of TNF-α was lower than that of the control group (P < 0.05), and the level of VEGF was higher than that of the control group (P < 0.05). Conclusion Meridian warming and scraping therapy combined with moxibustion can relieve wound pain and accelerate wound healing in patients with pressure ulcers after stroke, and its mechanism may be related to accelerating local blood perfusion and regulating the levels of TNF-α and VEGF.

The efects of fire acupuncture combined with Zishen Qinggan Decoction on recovery progress, body inflammation and risk of PHN in patients with acute herpes zoster

WANG Yu, YAN Zhihui, YUAN Pengfei, HE Manman

2024, 22(12): 2112-2115. doi: 10.16766/j.cnki.issn.1674-4152.003810

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Objective To observe the therapeutic effect of fire acupuncture combined with Zishen Qinggan Decoction on acute herpes zoster and the occurrence of postherpetic neuralgia (PHN). Methods From January 2022 to September 2023, 100 patients with acute herpes zoster in the moxibustion Department of Chengde Hospital of Traditional Chinese Medicine were divided into the observation group (n=50, fire acupuncture combined with Zishen Qinggan Decoction) and the control group (n=50, fire acupuncture) by random number table method. The therapeutic effect, traditional Chinese medicine (TCM) syndrome scores, recovery progress, inflammatory indicators [interleukin (IL-2), IL-8, IL-10], and PHN risk were compared. Results The total effective rate in the observation group was higher (88.00% vs. 72.00%, P < 0.05), and the scores of TCM syndrome were lower (P < 0.05). Analgesic time [(2.95±0.46) d vs. (3.57±1.02) d], herpes stopping time [(3.77±0.93) d vs. (4.69±1.47) d], and crusting time [(7.80±1.18) d vs. (8.36±0.61) d] in the observation group was shorter (P < 0.05). After treatment, the serum IL-2 concentration in the observation group was higher (P < 0.05), and the serum IL-8 and IL-10 concentrations were lower (P < 0.05). No adverse reactions occurred in both groups. The incidence of PHN at 1 month (12.00% vs. 28.00%, χ²=4.000, P=0.046) and 2 months (6.00% vs. 20.00%, χ²=4.332, P=0.037) in the observation group was lower than that in the control group. Conclusion Fire acupuncture combined with Zishen Qinggan Decoction can significantly improve the treatment effect of patients with acute herpes zoster, relieve symptoms, and reduce the incidence of PHN.

The application of role-play combined with peer review in the teaching of interns in the operating room

LI Rui, WEI Daoxiang, WANG Ning

2024, 22(12): 2116-2119. doi: 10.16766/j.cnki.issn.1674-4152.003811

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Abstract:
Objective To investigate the implementation effects of the role-playing method combined with peer assessment in the teaching guidance of nursing students during their surgical internship, aiming to provide valuable reference insights for the optimization and improvement of clinical teaching models in the operating room. Methods Sixty intern nursing students rotating in the operating room of the First Affiliated Hospital of Bengbu Medical University from March 2022 to March 2023 were selected as study subjects. Using the random number table method, these 60 nursing students were evenly divided into a control group and an experimental group, with 30 nursing students in each group. The control group continued to use traditional teaching methods in the operating room, while the experimental group received teaching and training through a novel teaching model based on the role-playing method combined with peer assessment. After the study, statistical comparisons and analyses were conducted on the post-teaching assessment scores, overall skill mastery, and teaching satisfaction of the two groups of nursing interns. Results The theoretical examination scores [(80.23±9.56) points] and operational assessment scores [(75.28±6.32) points] of the nursing students in the experimental group were significantly higher than those of the control group [(74.14±10.43) points, (68.36±8.13) points], respectively, with statistically significant differences (P < 0.05). In the comprehensive skills assessment, the experimental group scored higher than the control group in the nursing interview, physical examination, nursing diagnosis, nursing interventions, humanistic care, health counseling, organizational effectiveness, and overall evaluation (P < 0.05). Additionally, the satisfaction levels of the experimental group with theoretical teaching, operational teaching, teaching mode, and learning outcomes were all higher than those of the control group (P < 0.05). Conclusion The teaching strategy employing the role-playing method in conjunction with peer assessment has enhanced the mastery of clinical skills and professional theoretical knowledge among nursing interns in the operating room, thereby improving the quality of teaching. This teaching method has demonstrated favorable educational outcomes and possesses the potential for promotion and application in other specialist fields.

Research on the effectiveness of cardiopulmonary resuscitation training cross different populations and analysis of its influencing factors

LEI Ling, HU Lei, REN Jingjing

2024, 22(12): 2120-2123. doi: 10.16766/j.cnki.issn.1674-4152.003812

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Abstract:
Objective By implementing cardiopulmonary resuscitation (CPR) education and training, we aim to improve the prevalence of CPR and the level of emergency response among healthcare workers. Methods A total of 800 individuals from four categories who received American Heart Association-standardized CPR training courses between 2020 and 2022 were selected as the research subjects. Finally, 312 patients were included in the medical group, 168 in the community group, 120 in the resident training doctor group, and 200 in the public group. General information and training results were collected for each group to analyze the training effectiveness and related factors affecting the training pass rate. Results All four groups exhibited a general lack of mastery in key CPR operational steps. The results of univariate analysis showed that the factors affecting the pass rate of CPR training among the population include age, education level, population category, training experience, pre-training knowledge mastery survey score, and pre-training cognitive implementation intention survey score (P<0.05). Multivariate logistic regression analysis showed that CPR training experience (OR=3.184, 95% CI: 1.893-5.357, P<0.001), pre-training knowledge mastery survey score (OR=1.061, 95% CI: 1.037-1.086, P<0.001), and pre-training cognitive implementation intention survey score (OR=1.839, 95% CI: 1.484-2.279, P<0.001) were independent factors influencing the CPR training pass rate. Conclusion (1) There is a widespread problem of insufficient mastery of the key CPR operational steps among the four groups. Conducting training effectively improve knowledge, skills, cognition, and willingness to perform CPR. (2) Individuals with prior CPR training experience, pre-training CPR knowledge, and higher cognitive awareness and willingness to implement CPR are more likely to pass the training.

Development and validation of nutrition literacy assessment scale for cancer survivors

XIA Juan, SHAO Jian, ZHU Wenyu, MENG Xinyu, LYU Lin, HUAI Xiaozhan, YU Jinming

2024, 22(12): 2124-2128. doi: 10.16766/j.cnki.issn.1674-4152.003813

14 2

Abstract:
Objective Dietary nutrition is a crucial factor affecting the prognosis and quality of life of cancer survivors in China. Current dietary assessment methods have limitations in epidemiological research due to their extensive content. Therefore, this study aims to develop a nutritional literacy assessment scale suitable for cancer survivors in China and provide a scientific and appropriate tool for assessing their nutritional issues rapidly. Methods From January 2022 to March 2023, an initial scale was formed through the literature review, expert consultation, and preliminary surveys. From March to July 2023, a total of 3 857 cancer survivors were recruited based on the previously established cancer survivor cohort by the research group. The multidimensional item response theory (MIRT) model was used to select scale items, and the structural validity of the selected items was verified. Results Based on the discrimination, difficulty, information volume, and factor load of each item, the nutrition literacy scale for cancer survivors was developed, consisting of 4 dimensions and 21 items. The total Cronbach's α coefficient of the scale was 0.83, and the results of the second-order confirmatory factor analysis also indicated a good model fit (χ²/df=1.769, TLI=0.986, CFI=0.988, RMSEA=0.026). The level of nutrition literacy was significantly correlated with cancer survivors' quality of life. Conclusion The nutrition literacy scale for cancer survivors exhibits good reliability and validity, making it suitable for assessing the nutritional literacy level of cancer survivors and related research.

Analysis of the burden and influencing factors affecting caregivers of elderly dementia patients in nursing homes

YU Guoqiang, LIU Xuying, SUN Jingyan, YIN Ruinan, CAO Yi, WU Zhuang, WANG Ting, LIU Yangyue, FENG Qiuju, TENG Jinyan

2024, 22(12): 2129-2133. doi: 10.16766/j.cnki.issn.1674-4152.003814

15 2

Abstract:
Objective To investigate the caregiver burden of dementia patients in elderly care institutions in Heilongjiang Province and analyze the influencing factors on caregiver burden from the perspectives of patients and their caregivers. Methods Using the overall convenience random sampling method, a total of 157 dementia patients and their nursing staff were selected from 4 elderly care institutions in Harbin and Suihua from March to September 2023. The self-made elderly general reality survey scale, clinical dementia rating scale (CDR), quality of life-Alzheimer' s disease (QOL-AD), geriatric depression scale-15 (GDS-15), and Zarit caregiver burden interview (ZBI) were used for the survey, and meta regression analysis was conducted to identify influencing factors. Results The caregivers had a ZBI score of (28.25 ± 12.55) points. The caregiver burden is negatively correlated with QOL-AD score (r=-0.191, P<0.05) The sleep duration of dementia patients, the severity of dementia, the presence of depression, the gender of the caregivers, and whether caregivers received formal training are independent influencing factors of caregiver burden for dementia patients. These factors accounted for a total contribution rate of 32.5% to the control group (F=12.541, P<0.001). Conclusion Caregivers of dementia patients in elderly care institutions generally face protection burdens, with severe burdens accounting for the highest proportion (52.23%). Elderly care institutions should pay more attention to the caregiver gender, provide additional care to female caregivers, organize training to improve caregiving skills, explore new models of medical care and elder care, increase the sleep duration of dementia patients, and address the severity of their condition and depression to alleviate caregiver burden.

Analysis of the current situation of performance willingness and performance arrival of order-directed medical students in Shanxi Province

LIU Hao, WANG Xueyang, YAN Yingying, DUAN Zhaoxia

2024, 22(12): 2134-2138. doi: 10.16766/j.cnki.issn.1674-4152.003815

19 2

Abstract:
Objective This study aims to investigate the willingness to perform and the actual performance of the order-oriented medical students, analyze the influencing factors that may affect their willingness to perform, so as to improve the willingness to perform and the performance rate of the order-oriented medical students, and ultimately improve the quality of training and the effectiveness of the use of primary general practitioners. Methods Adopting the whole cluster sampling method, an online questionnaire survey was conducted from July to September 2021 on 1 024 current order-oriented medical students in Shanxi Province with 45 health and health management departments using Questionnaire Star, and the obtained data were statistically analyzed using SPSS 26.0 statistical software. Results Among the 1 024 school order-oriented medical students, 930 (90.8%) were willing to travel to the contracted place for fulfillment, and 94 (9.2%) were not willing to travel to the contracted place for fulfillment. There was no statistical significance in the willingness of school-based order-oriented medical students to fulfill the contract in terms of gender, place of origin, whether the household registration and the place of fulfillment were in the same city or state, and the level of the place of fulfillment (P>0.05). The differences were statistically significant (P<0.05) in terms of grade level, knowledge of policies, confidence in general medicine, and knowledge of future work. Of the 45 health and health management departments, 35 (77.8%) had a compliance rate greater than 75%, 8 (17.8%) had a compliance rate between 50%-75%, 2 (4.4%) had a compliance rate between 25%-49%, and none had a compliance rate below 25%. Conclusion The overall willingness of order-oriented medical students to fulfill the contract and the actual fulfillment rate still needs to be improved. Active policy propaganda and strengthening school general education are conducive to increasing the willingness of order-oriented medical students to comply; appropriately extending the years of grass-roots service for order-oriented medical students and selecting and sending students from their home countries will improve the current situation of compliance.

The relationship between ceRNA network construction and prognosis of hepatocellular carcinoma based on UCSC database

QIU Tian, QU Xiangyu, LI Haoling, XIA Wenqing, DAI Hengwen, GU Lin

2024, 22(12): 2139-2143. doi: 10.16766/j.cnki.issn.1674-4152.003816

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Abstract:
Objective To construct and investigate a prognostic-related competitive endogenous RNA network in hepatocellular carcinoma and explore its clinical implications. Methods The genetic RNA, mRNA sequencing data, and clinical data for HCC were obtained from the UCSC Xena database. Firstly, differential expression and survival analyses were used to identify high-risk genes. The KS test, logistic regression, and univariate and multivariate Cox regression analyses were used to determine the potential of these genes as independent prognostic factors. The associated biological pathways were analyzed by gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. After that, ENCORI was used to predict miRNA target genes. The ceRNA network was constructed using the Cytoscape tool. Results A direct regulatory relationship was found between hsa-miR-101-3p and 25 lncRNAs, with 6 lncRNAs identified as competitive binders to miRNAs. Among them, GSEC exhibited the strongest correlation with the co-expression of hsa-miR-101-3p and STIP1 (r=-0.380, r=0.490), suggesting its potential role as a regulatory axis in regulating hepatocellular carcinoma proliferation, invasion, and apoptosis. Conclusion The regulatory network of STIP1/hsa-miR-101-3p/lncRNA GSEC identified in hepatocellular carcinoma provides valuable insights into the molecular biological mechanisms of HCC, and lncRNA may serve as a potential prognostic biomarker for HCC patients.

Long-term care needs and influencing factors of 304 disabled elderly in Datong City

ZHAO Yanhua, CHEN Haili, YAN Gaohui, DUAN Aixu

2024, 22(12): 2144-2147. doi: 10.16766/j.cnki.issn.1674-4152.003817

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Abstract:
Objective To investigate the long-term care needs of 304 disabled elderly in Datong City, to analyze its influencing factors, and to provide guidance for the formulation of individualized care programs for disabled elderly. Methods Medical records of 304 disabled elderly people admitted to the Oncology Radiotherapy Department of the Fifth People's Hospital of Datong City from January 2020 to March 2024 were collected. A questionnaire survey was used to investigate their long-term care needs and analyze the influencing factors. Results (1) The score of the long-term care need scale of 304 disabled elderly people in Datong City, the total score of the scale was (122.34±8.83) points, which was in the middle level; (2) The score of the long-term care needs of the disabled elderly with marital status of widowhood/divorce, number of chronic diseases ≥7, duration of stay in nursing institutions ≥4 years, residence mode of living alone, degree of disability as severe disability and frequency of family visits<2 times/month was higher than that of the disabled elderly with marital status of married, number of 1-3 chronic diseases or 4-6 kinds, duration of stay in nursing institutions<1 year or 1-3 years, residence mode of living with other disabled elderly or with their spouse, with mild or moderate disability and the frequency of family visits ≥2 times/month (P<0.05); (3) Living style alone, number of chronic diseases ≥7 and severe disability were the relevant factors affecting the score of long-term care needs of disabled elderly (t=6.082, 5.821, 4.563, P<0.05). Conclusion In Datong City, the long-term care needs of 304 disabled elderly people are at a medium level, which is affected by the living style, the number of chronic diseases, and the degree of disability. In order to meet their long-term care needs, it is suggested to develop a personalized care plan for disabled elderly people to improve their quality of life.

Application of ergonomic rotator cuff protector in patients with rotator cuff injury after shoulder arthroscopy

TAO Aiping, JIA Man, WANG Shuangshuang, LI Qiqi, WANG Yi

2024, 22(12): 2148-2152. doi: 10.16766/j.cnki.issn.1674-4152.003818

19 2

Abstract:
Objective To explore the effects of ergonomics-based rotator cuff protector on pain, sleep, exercise compliance, and shoulder function recovery in patients with rotator cuff injury after shoulder arthroscopy. Methods A total of 92 patients with rotator cuff injury were collected from January 2022 to June 2023 in Department of Orthopedics Trauma, the Second Affiliated Hospital of Wenzhou Medical University. They were divided into a control group and a protection group using the Excel random grouping method, with 46 cases in each group. The control group was given routine rehabilitation nursing after surgery, while the protection group was given an ergonomic rotator cuff protector on the basis of rehabilitation nursing. Postoperative pain, sleep quality, exercise compliance, shoulder motion, and shoulder function were compared between the two groups. Results After 2 weeks of intervention, the VAS score of the brace group was 3.02±0.45, which was lower than that of the control group (4.17±0.68, P<0.05). After 8 weeks of intervention, the total sleep time and sleep efficiency were higher than those of the control group (P<0.05), and the number of awakenings was lower than that of the control group (P<0.05). The exercise compliance score was (65.73±5.10) points, higher than that of the control group [(57.07±8.23) points, P<0.05]. The movements of shoulder flexion, extension, internal rotation, and external rotation were higher than those of the control group (P<0.05). The score of the shoulder joint function scale was 24.88±5.13, which was higher than that of the control group (18.09±4.12, P<0.05). Conclusion The use of ergonomic rotator cuff protector can not only reduce the pain of patients with rotator cuff injury after shoulder arthroscopy, improve sleep quality, but also improve their exercise compliance and restore shoulder joint function.

Research on the application of evidence-based triple prehabilitation strategy in patients undergoing radical resection for oral cancer

JIANG Jie, LIANG Huakun, LIU Lulu, XU Jincheng, LI Jiancheng, LI Xiuchuan

2024, 22(12): 2153-2157. doi: 10.16766/j.cnki.issn.1674-4152.003819

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Abstract:
Objective To investigate the effectiveness of triple prehabilitation in improving physical and psychological functioning and clinical outcomes in patients undergoing radical oral cancer surgery. Methods A total of eighty-four patients undergoing radical resection at the First Affiliated Hospital of Bengbu Medical University were selected by random number table method to either an intervention group (n=42) or a control group (n=42) from March to November 2023. Patients in the control group received routine nursing, while those in the intervention group received triple prehabilitation intervention. Activity levels, nutritional levels, anxiety and depression, and postoperative clinical outcome indicators were compared between the two groups at baseline and post-intervention. Results In the intervention group, the 6-minute walk distance (6MWD) one day preoperatively was significantly higher than on admission day, with significantly higher 6MWD and improvement rates compared to the control group (P<0.05). The serum levels of serum prealbumin (PA), albumin (ALB) and total protein (TP) in the intervention group were increased one day preoperatively and one day before discharge, all indexes were higher than those in the control group (P<0.05). Hospital anxiety and depression scale (HADS) scores in both intervention and control groups increased from admission to one day preoperatively, but were lower in the intervention group compared to the control group, and significantly lower in the intervention group one day before discharge (P<0.05). The intervention group also experienced shorter times to extubation pots-tracheotomy, first ambulation, first oral intake, lower incidence of complications, and shorter total hospital stay compared to the control group (P<0.05). Conclusion The application of triple prehabilitation in oral cancer radical surgery patients can improve preoperative physical function and perioperative nutritional status, relieve anxiety and depression, promote postoperative recovery, and optimize clinical outcomes to a significant extent.

Analysis of risk factors and nursing strategies for sleep disorders in lung cancer chemotherapy patients based on decision tree model

HU Fei, YANG Hua, YANG Ting, LI Lu

2024, 22(12): 2158-2161. doi: 10.16766/j.cnki.issn.1674-4152.003820

23 1

Abstract:
Objective To analyze the influencing factors of sleep disorders in lung cancer chemotherapy patients and develop nursing strategies to reduce the risk of sleep disorders in lung cancer chemotherapy patients. Methods A total of 110 lung cancer patients admitted to the First Affiliated Hospital of Nanchang University from January 2023 to December 2023 were selected as the research subjects. Patients were divided into a sleep disorder group (n=44) and a non-sleep disorder group (n=66) based on the Athens insomnia scale (AIS) score. Baseline data and laboratory indicators were compared between the two groups; Binary logistic regression was used to analyze the influencing factors of sleep disorders in lung cancer chemotherapy patients, build a decision tree model, and draw receiver operating characteristic curves (ROC) to verify the predictive efficiency of the decision tree model. Results The incidence of sleep disorders in lung cancer chemotherapy patients [40.00% (44/110)]; The chemotherapy cycle, visual analog scale (VAS) score, interleukin-6 (IL-6), tumor necrosis factor -α (TNF -α), and C-reactive protein (CRP) in the sleep disorder group were higher than those in the non-sleep disorder group. The proportion of stage Ⅲ-Ⅳ and the use of paclitaxel+platinum chemotherapy regimen was higher in the sleep disorder group than in the non-sleep disorder group (P<0.05); According to binary logistic regression analysis, stages Ⅲ-Ⅳ, paclitaxel+platinum chemotherapy regimen, chemotherapy cycle, VAS score, and IL-6 were the influencing factors of sleep disorders in lung cancer chemotherapy patients (OR>1, P<0.05). A decision tree model was generated by incorporating these factors, and three explanatory variables including VAS score, IL-6, and TNM staging were screened out. VAS score was the most important root node variable and predictor. The AUC of the decision tree prediction model was 0.915, P<0.001, indicating a high predictive value. Conclusion The decision tree model constructed by TNM staging, chemotherapy regimen, chemotherapy cycle, VAS score, and IL-6 has a high predictive value for sleep disorders in lung cancer chemotherapy patients.

The application effect of rapid rehabilitation intervention combined with timeliness incentive theory in patients with scoliosis surgery

WANG Ruiling, SHEN Yong

2024, 22(12): 2162-2166. doi: 10.16766/j.cnki.issn.1674-4152.003821

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Abstract:
Objective Under the guidance of the theory of rapid recovery and timeliness incentive, the corresponding intervention was carried out on the patients with scoliosis surgery, aiming at promoting the good postoperative recovery of the patients. Methods From March 2022 to March 2023, 80 patients with scoliosis who underwent posterior orthopedic internal fixation enrolled in the Third Hospital of Hebei Medical University were chosen and separated into the observation group (n=40, rapid rehabilitation combined with timeliness incentive theory) and the control group (n=40, routine nursing) by random number table method. All patients were followed up for at least 3 months. Pain, mental state, lumbar function, and postoperative complications were compared between the two groups before and after intervention. Results Visual analogue scale (VAS) scores in the observation group were lower than those in the control group after 1/2/3 months of intervention (P<0.05). Compared with the control group, the self-rating depression scale (SDS)/ self-rating anxiety scale (SAS), Oswestry disability index (ODI), and scoliosis research scale (SRS-22) scores in the observation group were lower after intervention and at the last follow-up, while Berg balance scale (BBS) scores were higher (P<0.05). The total incidence of postoperative low back pain in the observation group was lower [(25.00% (10/40) vs. 47.50% (19/40), P<0.05]. There was no statistically significant difference in the incidences of postoperative fever [2.50% (1/40) vs. 10.00% (10/40)], unilateral lower extremity skin temperature abnormality [5.00% (2/40) vs. 15.00% (6/40)], respiratory edema or inflammation [0 vs. 2.50% (1/40)] and hip pain [27.50% (11/40) vs. 47.50% (19/40)] between the two groups (P>0.05). Conclusion Rapid rehabilitation combined with timeliness incentive theory can significantly reduce the postoperative pain of patients undergoing scoliosis surgery, improve emotional response, and promote postoperative rehabilitation.

The effect of personalized comprehensive nursing on endoscopic mucosal resection in patients with colonic polyps

XU Ruixia, HONG Yanling, JIANG Wuxia, ZHOU Yan

2024, 22(12): 2167-2171. doi: 10.16766/j.cnki.issn.1674-4152.003822

18 3

Abstract:
Objective To investigate the effect of personalized comprehensive nursing on endoscopic mucosal resection (EMR) in patients with colonic polyps and analyze surgical-related indicators, postoperative pain, negative emotions, postoperative complications rate, and nursing satisfaction during hospitalization. Methods A total of 118 colonic polyps patients who underwent EMR at Lishui Central Hospital from September 2021 to November 2022 were selected and divided into a control group (59 cases) and an observation group (59 cases) using the digital table method. The control group received the routine procedure, while the observation group received personalized comprehensive nursing. Surgical-related indicators, postoperative pain, negative emotions, postoperative complications rate, and nursing satisfaction were compared between the two groups. Results Compared with the control group, the observation group showed significantly reduced intraoperative blood loss, time to first exhaust, time to first defecation, time to first activity out of bed, and hospitalization time (P<0.05). After nursing, the visual analogue scale (VAS) score [(1.96±0.80) points vs. (3.36±1.37) points], self-rating anxiety scale (SAS) score [(32.61±3.75) points vs. (36.98±4.70) points], and self-rating depression scale (SDS) score [(30.20±4.23) points vs. (34.50±2.69) points] in the observation group were lower than those in the control group (P<0.05). Moreover, the observation group had a significantly lower postoperative complications rate [10.2% (6/59) vs. 27.1% (16/59)] and higher nursing satisfaction rate [89.8% (53/59) vs. 74.6% (44/59)] compared to the control group (P<0.05). Conclusion Personalized comprehensive nursing model can shorten the postoperative recovery time, reduce postoperative pain, promote emotional recovery, reduce postoperative complications, and enhance nursing satisfaction in colonic polyp patients undergoing EMR.

The impact of diversified management led by anesthesia nursing groups on the postoperative recovery of elderly patients undergoing general anesthesia

YING Zhenzhen, TONG Junxia, TONG Qiaoli, LI Yuecui, SHEN Haiping

2024, 22(12): 2172-2176. doi: 10.16766/j.cnki.issn.1674-4152.003823

19 2

Abstract:
Objective To analyze the application effect of diversified management led by anesthesia nursing groups in the management of postoperative recovery in elderly patients undergoing general anesthesia, and to provide reference for improving the quality of clinical postoperative recovery. Methods A total of 130 elderly patients who underwent general anesthesia surgery in the operating room of the First People's Hospital of Yongkang from January 2023 to January 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 65 cases in each group, using a random number table method. The control group received routine care, while the observation group received diversified management led by the anesthesia nursing group on the basis of the control group. The recovery, anesthesia recovery, and incidence of complications between two groups of patients were compared. Results The anesthesia recovery time, tracheal intubation removal time, and exit time of the observation group patients were (68.42±6.41) min, (72.38±7.04) min, and (84.65±9.73) min, respectively, which were shorter than the control group [(71.33±8.03) min, (76.16±8.51) min, and (90.83±11.47) min], and the RASS score of the observation group was (1.13±0.27) points, which was lower than that of the control group [(2.18±0.45) points, P<0.05]. 24 hours after surgery, the total score of the Chinese version of the quality of recovery-40 questionnaire (QoR-40) in the observation group was (133.77±8.46) points, which was higher than that of the control group [(120.34±8.46) points, P<0.05]; the incidence of postoperative agitation and hypothermia in the observation group was 4.6% (3/65) and 1.5% (1/65), respectively, which were lower than those of the control group [15.4% (10/65) and 10.8% (7/65), P<0.05]. Conclusion Diversified management led by anesthesia nursing groups can shorten the recovery time of elderly patients after general anesthesia surgery, improve the quality of recovery during the recovery period, reduce postoperative complications, and improve nursing work efficiency.

About Journal

Current Issue
2024 Vol. 22, No. 12

Submission System

About Journal

Current Issue 2024 Vol. 22, No. 12

Submission System

Current Issue
2024 Vol. 22, No. 12