2024 Vol. 22, No. 5

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General Practice Forum
Analyzing the health-related quality of life among the elderly with multiple chronic conditions
ZHOU Shan, LIU Yanli, LI Na, MA Li
2024, 22(5): 721-724. doi: 10.16766/j.cnki.issn.1674-4152.003488
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  Objective  To investigate the status and factors influencing health-related quality of life (HRQoL) in elderly patients with multiple chronic conditions (MCC), in order to provide a basis for further health management.  Methods  Patients hospitalized in the internal medicine ward of the Beijing Tiantan Hospital between November 2022 and June 2023 were included as the study population.A self-developed questionnaire was used to collect the basic information.The Apriori algorithm was used to analyze the chronic disease comorbidity.The EuroQol 5-dimension 5-level was used to assess HRQoL, and the Tobit regression model was employed to analyze the factors influencing HRQoL.  Results  Among the 214 elderly patients with MCC, the most common chronic comorbidity patterns were hypertension+diabetes and hypertension+diabetes+chronic renal insufficiency.The health utility value for these patients was 0.89(0.67, 1.00).The self-reported problem of anxiety/depression was the lowest, while the problem related to daily activities was the highest.The Tobit regression results showed that better HRQoL was associated with younger age, fewer chronic diseases, active participation in exercise, and urban employee medical insurance (P < 0.05).  Conclusion  The HRQoL of elderly patients with MCC was found to be poor.It is suggested to focus on factors such as age, the number of chronic diseases, exercise participation, and medical insurance.It is essential to strengthen scientific lifestyle guidance and enhance the ability for comprehensive management of MMC.
Special Topic/Diagnosis and Treatment of Lumbar Disease
Preoperative assessment of bone mass in patients with lumbar internal fixation by MRI VBQ score
LIU Deguo, XU Tianbo, ZHANG Jiehong, LYU Ao, ZHENG Yuxiang, HOU Zhenhai, LU Yisheng
2024, 22(5): 725-728. doi: 10.16766/j.cnki.issn.1674-4152.003489
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  Objective  To evaluate the value of MRI vertebral bone quality (VBQ) score in preoperative bone mass assessment of patients with lumbar internal fixation surgery provides a basis for clinical preoperative evaluation of bone mass in such patients.  Methods  We selected and evaluated clinical data from 83 patients who underwent lumbar internal fixation at the 903rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from February 2019 to August 2022.The patients were categorized into two groups based on whether the lowest value was less than-1.0:the low-density group (T value < -1.0), including cases with osteopenia and osteoporosis (51 cases), and the normal group (T value ≥-1.0, 32 cases).Prior to surgery, all patients underwent dual-energy X-ray absorptiometry (DEXA) and MRI.We compared the clinical characteristics (age, gender, BMI) and imaging data between the two groups.Pearson correlation was used to analyze the relationship between the VBQ score and various DEXA T value.Additionally, we constructed a receiver operating characteristic (ROC) curve to assess the predictive value of VBQ scores for osteopenia.  Results  There was no significant differences in age, BMI, gender, history of diabetes, and other clinical characteristics between the normal group and the low-density group (P>0.05).The low-density group exhibited lower DEXA femoral neck T values and DEXA overall hip T values compared to the normal group, while the VBQ score was higher in the low-density group (P < 0.05).A negative correlation was observed between the VBQ score and the DEXA femoral neck T value as well as the overall hip T value (P < 0.05).The ROC curve analysis showed that the VBQ score had an AUC area of 0.842(95%CI: 0.754-0.930) for predicting abnormal bone mass (osteopenia and osteoporosis), with a sensitivity of 70.60% and specificity of 68.80%.  Conclusion  The VBQ score demonstrates effective differentiation between patients with normal bone mass and those with osteopenia, while also exhibiting correlation with the DEXA T score of patients.This provides a valuable reference for preoperative bone mass assessment in patients undergoing clinical lumbar internal fixation.
Effect of indwelling drainage tube on wound healing and infection indexes in patients after posterior lumbar decompression and internal fixation surgery
ZHANG Nan, WANG Miao, ZHANG Peng, MA Chao, GAO Shunxing, LIU Hongzheng, TAO Xiaobing
2024, 22(5): 729-732. doi: 10.16766/j.cnki.issn.1674-4152.003490
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  Objective  The incision drainage tube of posterior lumbar spinal canal fixation has an important impact on the postoperative recovery of patients.In this study, the incision indwelling drainage tube scheme was adopted, aiming to further improve the prognosis of patients with posterior lumbar decompression and internal fixation.  Methods  A total of 98 patients who underwent posterior lumbar decompression and internal fixation surgery in the Department of Radiotherapy and Chemotherapy in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province from June 2019 to May 2022 were selected, among which 50 patients had their drainage tube removed more than 48 hours and less than one week after surgery (group A), and the other 48 patients had their drainage tube removed within 48 hours after surgery (group B).The general data, intraoperative indexes, postoperative incision healing, infection indexes and complications were compared between the two groups.  Results  There were no statistically significant differences in general data between the two groups (P>0.05).The postoperative drainage volume in group A was higher than that in group B[(183.04±47.36) mL vs.(164.01±29.68) mL, P < 0.05], and the frequency of dressing change within 5 days after surgery was lower than that in group B[(2.01±0.62) times/d vs.(2.69±0.72) times/d, P < 0.05].There was no difference in postoperative ground activity time and total hospital stay between the two groups (P>0.05).There was no difference in incision healing between the two groups at the last follow-up (P>0.05), and the total incidence of drainage tube related complications in group A was lower than that in group B (12.00%vs.29.17%, P < 0.05).The body temperature, white blood cell count (WBC), neutrophil (NEU) concentration and C-reactive protein (CRP) in group A were all lower than those in group B on the third day after surgery (P < 0.05).  Conclusion  The indwelling of drainage tube in the incision after posterior lumbar decompression and internal fixation surgery for more than 48 hours and less than one week is conducive to reducing the infection indicators and the incidence of complications, and has no significant effect on the wound healing of patients.
Therapeutic effect on the treatment of lumbar intervertebral disc herniation with the acupuncture method of Huayu Lijin combined with the traditional Chinese medicine Reyan Bao
WANG Zhaoping, HE Jia, YANG Yajun, WANG Lina, WANG Hui
2024, 22(5): 733-737. doi: 10.16766/j.cnki.issn.1674-4152.003491
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  Objective  To study the clinical efficacy of the Huayu Lijin acupuncture method combined with traditional Chinese medicine Reyan Bao in the treatment of lumbar disc herniation, and to evaluate the effects of this therapy on the degree of pain, lumbar function, and inflammatory response in patients.  Methods  A total of 80 patients with lumbar disc herniation admitted to Tangshan Fengrun People's Hospital in Tangshan City from June 2020 to June 2022 were randomly divided into two groups using a random number table method: the Huayu Lijin acupuncture group and the combination group, with 40 cases in each group.The Huayu Lijin acupuncture group received treatment with the Huayu Lijin acupuncture method, while the combination group received treatment with the Huayu Lijin acupuncture method combined with traditional Chinese medicine heat therapy.Both groups were treated for 2 weeks as a course of treatment, with 2 courses of treatment.The therapeutic effects, the changes in lumbar spine function, pain level, electromyography, and pro-inflammatory factor levels between two groups before and after treatment were compared.  Results  The total effective rate of the combined group was 92.50%(37/40), the total effective rate of the Huayu Lijin acupuncture group was 70.00%(28/40), and the difference was statistically significant (P < 0.05).After treatment, the Oswestry disability index of the combined group was lower than that of the Huayu Lijin acupuncture group (P < 0.05).After 2 weeks, 1 month, and 3 months of treatment, the VAS scores of the combination group were lower than that of the Huayu Lijin acupuncture group (P < 0.05).After combined treatment, the left mean power frequency (MPF), right MPF, left electromyographic (EMG), and right EMG in the combination group were higher than those in the Huayu Lijin acupuncture group (P < 0.05).After treatment, the serum levels of IL-23 and prostaglandin E2 in the combination group were lower than those in the Huayu Lijin acupuncture group (P < 0.05).  Conclusion  For patients with lumbar disc herniation, the acupuncture method of Huayu Lijin combined with traditional Chinese medicine Reyan Bao has a prominent effect in treating lumbar disc herniation.It can effectively alleviate lumbar pain, improve lumbar function and electromyographic indicators of the lumbar extensor muscle group, reduce body inflammatory reactions, and is worthy of promotion and application.
General Practice Research
Comparative analyses of long-term complications and aquality of life of ileal new bladder and Bricker bladder after laparoscopic radical surgery for bladder cancer
LIU Beibei, GUO Yuanyuan, CHEN Mengjie, GAO Wuyue, SUN Wei, WANG Jinxing
2024, 22(5): 738-741. doi: 10.16766/j.cnki.issn.1674-4152.003492
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  Objective  To compare and analyze the long-term complications and quality of life in bladder cancer patients who suffered laparoscopic cystectomy and urinary diversion of in situ ileal neobladder (IN) or Bricker ileal orthotopic neobladder (Bricker), providing a basis for selecting individualized urinary diversion.  Methods  A total of 60 male patients who underwent radical cystectomy were collected in the Urology Department of the First Affiliated Hospital of Bengbu Medical University from January 2020 to December 2022.All patients were divided into the IN group (n=34) and the Bricker group (n=26) according to the methods of urinary diversion.The long-term complications and quality of life were analyzed at 6 months and 12 months after operation.  Results  There was no significant difference in both operation time and intraoperative blood loss between two groups (P>0.05), but the intestinal recovery time and hospital stay time of patients in IN group were significantly longer than those in Bricker group (P < 0.05).There was no significant difference in the 6-month total complications between the 2 groups (22 cases vs.14 cases), P>0.05, but there was significant difference in the 12-month total complication rates (19 cases vs.23 cases), P < 0.05.However, the upper urinary tract hydronephrosis was better in patients from IN group than those from Bricker group at 12 months (4 cases vs.9 cases, P < 0.05).There was no significant difference IN QOL between the two groups at 6 months (P>0.05), and QOL in the 12 months group was significantly higher than that in the Bricker group (142.82±6.42 vs.118.69±9.92, F=11.128, P < 0.001).  Conclusion  Fewer long-term complications and higher quality of life are demonstrated in IN, which should be considered seriously when choosing urinary diversion methods.
Study on cardiovascular disease risk prediction model for hemodialysis patients
ZHAO Xin, LIU Qianqian, LI Hangyu
2024, 22(5): 742-745. doi: 10.16766/j.cnki.issn.1674-4152.003493
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  Objective  To evaluate the derivation and validation of cardiovascular disease risk prediction scores in hemodialysis patients and to provide a reference for clinical diagnosis and treatment.  Methods  A total of 388 patients who underwent routine hemodialysis for more than 3 months from January to December 2020 were selected and followed up until May 2023.All participants were used as the training dataset to obtain the predicted scores, and the guided validation dataset was used for validation.Evaluate the discriminative ability of predicted scores using the area under the subject's work characteristic curve (AUC).  Results  Among 388 patients without cardiovascular disease at baseline, 132 had a first cardiovascular event during a mean follow-up of (3.27±1.01) years.Among the 26 clinical parameters, age, hypertension, diabetes and abnormal WBC count were identified as significant predictors and included in the prediction model.Compared with those without these risk factors, those with scores of 1, 2, and 3-4 had an increased risk of cardiovascular disease.The adjusted hazard ratio and 95%CI were 3.293(1.174-9.260), 7.429(2.681-20.516) and 15.434(5.441-43.759), respectively.The model shows good discriminative ability on both training and validation data sets[AUC values of 0.703(95%CI: 0.652-0.753) and 0.688(95%CI: 0.655-0.720), respectively].  Conclusion  We have derived and validated a predictive model for cardiovascular risk in hemodialysis patients.With the rapidly increasing number of hemodialysis patients, this simple model can be used to identify high-risk individuals in clinical practice for more accurate and effective personalized treatment.
The effect of childhood trauma on somatization symptoms in depressed patients
ZHOU Ruochen, YE Mengting, YU Fengqiong, ZHOU Xiaoqin
2024, 22(5): 746-749. doi: 10.16766/j.cnki.issn.1674-4152.003494
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  Objective  To observe the effects of childhood trauma on patients with different types of depression, and explore whether childhood trauma affects the somatic symptoms of depressed patients.  Methods  A total of 121 depressed patients who attended outpatient clinics and were hospitalized in the psychiatry department of Chaohu Hospital Affiliated with Anhui Medical University and the Psychiatry Department of the Second Affiliated Hospital of Anhui Medical University from October 2022 to December 2023 were selected to assess the short version of the childhood trauma questionnaire short form (CTQ-SF) childhood trauma inventory, the somatization subscale of the SCL90 symptom self-assessment checklist, and the 17-item Hamilton depression inventory.  Results  Depressed patients with somatization symptoms had higher CTQ-SF total scores than depressed patients without somatization symptoms[46.50(39.25, 58.25)vs.39.50(34.00, 50.00), Z=-2.662, P < 0.01];depressed patients with somatization symptoms had higher levels of somatic neglect[8.00(7.00, 10.00)vs.7.00(5.00, 9.00), Z=-2.683, P < 0.01]and emotional abuse[9.50(7.00, 15.00)vs.8.00(6.00, 11.50), Z=-2.317, P < 0.05]scores.The severity of childhood trauma was positively associated with the severity of somatization symptoms in depressed patients (P < 0.01), and this association persisted after controlling for the severity of depressive symptoms (P < 0.01);somatization symptoms were associated with all childhood traumas except sexual abuse (P < 0.01);and after controlling for the severity of depressive symptoms, somatization symptoms remained associated with somatic neglect (P < 0.01) and emotional abuse (P < 0.05) were positively associated.  Conclusion  Depressed patients with somatization symptoms experienced more severe childhood trauma, and a history of childhood trauma, including physical neglect and emotional abuse, had an impact on somatization symptoms in depressed patients.
Influencing factors analysis of systemic lupus erythematosus with osteonecrosis
LEI Jiamin, HOU Ruihong, MI Liangyu, ZHANG Liyun, GAO Jinfang, XU Ke
2024, 22(5): 750-753. doi: 10.16766/j.cnki.issn.1674-4152.003495
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  Objective  To analyze the factors associated with osteonecrosis (ON) in patients with systemic lupus erythematosus (SLE) in order to reduce the impact on patients'quality of life.  Methods  A total of 65 SLE patients with ON (ON group) and 65 SLE patients without ON (non-ON group) who hospitalized in the Department of Rheumatology and Immunology of Shanxi Bethune Hospital from January 2013 to December 2022 were selected.The clinical symptoms, laboratory examination and treatment were compared between the two groups.Logistic regression was used to analyze the risk factors for SLE complicated with ON.  Results  Among the case groups, 53 cases (81.5%) were bilateral ON; There were 29 cases (44.6%) of bone pain and 18 cases (27.6%) of complex multiple symptoms.In univariate analysis, there were statistically significant differences in disease course, hormone accumulation time, menopausal history, nervous system involvement and myalgia muscle weakness, and there were statistically significant differences in white blood cell count, percentage of total T cells and suppressor T (Ts) cells, percentage and absolute value of natural killer T (NKT) cells, standardized dilute Russell's viper venom time (dRVVT) ratio, activated partial thromboplastin time, and history of aspirin, statins, bisphosphonates, hydroxychloroquine and immunosuppressants in medication use (P < 0.05).Multivariate logistic regression analysis showed that the percentage of total T cells and the ratio of standardized dRVVT were the influencing factors of SLE with ON.  Conclusion  Appropriate use of immunosuppressants, attention to balancing medication interactions in SLE treatment, and special attention to patients with nervous system involvement and muscle pain and weakness.Ts cells in the lymphocyte subpopulation play an important regulatory role in ON.Individuals with higher standardized dRVVT ratios are more likely to have ON or may predict the occurrence of ON.Therefore, caution should be used in clinical diagnosis and treatment.
Association between air pollution and the number of emergency visits for acute upper respiratory infections in Hefei city, Anhui, 2016-2020
YANG Jidan, SUN Haoxiang, HU Yue, ZHAO Shuang, KANG Ruihan, HU Huaqing
2024, 22(5): 754-758. doi: 10.16766/j.cnki.issn.1674-4152.003496
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  Objective  To evaluate the association between air pollutants and acute upper respiratory tract infections (AURTI) in the emergency department of Hefei City.  Methods  Emergency hospital visits for AURTI in public hospitals in Hefei from January 1, 2016 to December 31, 2020, meteorological data and air pollutants data for the same period were collected for the study.After controlling for confounding factors such as meteorological factors, day-of-week effects and holiday effects, the distribution lag nonlinear model was used to quantify the association between daily air pollutants and daily emergency visits.The results were then stratified by gender and age.  Results  The total number of AURTI emergency department visits in Hefei from 2016 to 2020 was 55 902, and it is higher in the cold season than in the warm season.Among all pollutants, SO2 had the greatest effect on AURTI, with its lag effect reaching a maximum at lag07, with a RR and 95%CI of 1.194(1.072-1.330).The relative risks (RR) of gaseous pollutants (SO2, NO2) were higher than those of particulate matter (PM2.5, PM10).Gender stratification showed that females seemed to be more vulnerable to exposure to SO2 and NO2, while males were more vulnerable to PM2.5, PM10 and O3.In the age stratification, people aged >65 years were more sensitive to PM2.5, PM10 and NO2, people aged 18-65 years were more sensitive to SO2.  Conclusion  Elevated concentrations of air pollutants in Hefei all increased the risk of emergency admissions for AURTI, with different patterns of effects by gender and age.
Influence factors and countermeasures of cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients
HU Lei, REN Jingjing, QIU Yan
2024, 22(5): 759-763. doi: 10.16766/j.cnki.issn.1674-4152.003497
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  Objective  To analyze the clinical characteristics of patients with out-of-hospital cardiac arrest (OHCA) and identify the factors affecting the success of cardiopulmonary resuscitation (CPR).Additionally, explore the current treatment problems and propose rational and effective improvement strategies.  Methods  A total of 229 patients with OHCA and concurrent CPR, who received emergency treatment at the First People's Hospital of Lin'an District, Hangzhou City from January 1, 2019 to December 31, 2022, were selected as the research subjects.According to the resuscitation outcomes, they were categorized into a successful resuscitation group (71 cases) and a failed resuscitation group (158 cases).The Utstein model was used to retrospectively analyze the relevant factors affecting the success of OHCA patient resuscitation.By comparing it with current domestic research data, we aim to identify the existing problems in treatment and propose reasonable and effective solutions.  Results  Univariate analysis showed that several risk factors affecting the success rate of return of spontaneous circulation (ROSC) in OHCA patients.These factors included the pre-hospital emergency response time, presence or absence of witnesses, immediate CPR, presence or absence of CPR within 6 minutes, presence or absence of pre-hospital emergency, type of first monitored heart rhythm, frequency of defibrillation, duration of defibrillation, and total duration of CPR (P < 0.05).Multivariate logistic regression analysis showed that both pre-hospital emergency response time (P=0.020) and the presence or absence of CPR within 6 minutes (P=0.002) were independent risk factors for successful resuscitation in OHCA patients.Specifically, an increase in pre-hospital emergency response time was associated with a decrease in the success rate of resuscitation by approximately 27.3% per unit increase (95%CI: 0.557-0.950).Individuals who received CPR within 6 minutes had a significantly higher success rate compared to those without timely intervention, approximately 8.8 times higher odds for successful resuscitation were observed among this group (95%CI: 2.226-34.804).  Conclusion  Shortening the response time of pre-hospital first aid and performing high-quality CPR as soon as possible after the occurrence of cardiac arrest can effectively improve the success rate of ROSC in out-of-hospital cardiac arrest patients.
Preliminary study of SPECT-CT imaging with 99Tcm-MIBI nanoparticles in evaluating the drug resistance of breast cancer to neoadjuvant chemotherapy
LI Weipeng, LI Hui, HU Yongquan, TAO Xinquan, SHEN Yong, SUN Jingqiu, YUAN Chao
2024, 22(5): 764-767. doi: 10.16766/j.cnki.issn.1674-4152.003498
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  Objective  To explore the value of SPECT-CT imaging with 99Tcm-MIBI nanoparticle in evaluating the drug resistance of breast cancer to neoadjuvant chemotherapy, to find a non-invasive evaluation method to predict the efficacy of neoadjuvant chemotherapy.  Methods  The imaging agent 99Tcm-MIBI nanoparticle was prepared and the nude mouse model of carcinoma of breast was established. The nude mouse model was treated with combination chemotherapy of epirubicin and docetaxel (ET) as follows: on the 1st day, epirubicin 40 mg/(m·d) was administered via tail vein for two days, then on the 3rd day, docetaxel 60 mg/m2 was administered via tail vein, 3 weeks per cycle, with a total of 3 cycles of chemotherapy. 99Tcm-MIBI nanoparticles SPECT-CT imaging was used before and after chemotherapy to observe the image changes. The ratio of tumor to surrounding background (T/B) of each nude mouse model of breast cancer was calculated by ROI technology.  Results  According to UICC solid tumor efficacy evaluation criteria, the efficacy of combined chemotherapy in nude mice with human breast cancer was evaluated, In 40 nude mouse models of human breast cancer, 27 partial remission (PR), 12 disease stability (SD), and 1 disease progression (PD); The T/B of 99Tcm-MIBI nanoparticles SPECT-CT imaging before chemotherapy in nude mouse model of human breast cancer was 2.98±0.73, The T/B value of 99Tcm-MIBI nanoparticle SPECT-CT imaging after chemotherapy in the partially relieved (PR) nude mouse model was 1.52±0.59, and there was a significant difference in T/B value compared to before chemotherapy (P<0.05); The T/B of 99Tcm-MIBI nanoparticle SPECT-CT imaging in the disease stable (SD) nude mouse model after chemotherapy was 3.12±1.09, and the difference was not significant compared to before chemotherapy (P>0.05).  Conclusion  For breast cancer patients, 99Tcm-MIBI nanoparticles SPECT-CT imaging is expected to evaluate the therapeutic effect of neoadjuvant chemotherapy drugs, which is a non-invasive method to evaluate the drug resistance of breast cancer to neoadjuvant chemotherapy.
Application of intermittent cytoreductive surgery + hyperthermic intraperitoneal chemotherapy in the treatment of advanced ovarian cancer
ZHANG Ying, YANG Bo, YIN Tian, ZHAO Yue, ZHANG Xinyi, LI Ying
2024, 22(5): 768-771. doi: 10.16766/j.cnki.issn.1674-4152.003499
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  Objective  To explore the efficacy and safety of intermittent cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of advanced ovarian cancer.  Methods  Patients diagnosed with advanced ovarian cancer in the First Affiliated Hospital of Bengbu Medical University from November 2020 to September 2021 were selected. According to whether to use HIPEC, the patients were divided into an experimental group and a control group, with 45 cases in each group. The short-term outcomes and incidence of adverse effects after surgery and chemotherapy in two groups of patients were compared.  Results  The objective response rate (ORR) was 86.7% in the experimental group and 68.9% in the control group (P=0.043). The 2-year survival rate was 86.7% in the experimental group and 64.4% in the control group (P=0.014). The average progression-free survival (PFS) of the experimental group was (29.03±1.07) months, which was significantly higher than the control group [(16.60±1.12) months, P<0.001]. The adverse reactions after chemotherapy in the two groups were statistically significant in nausea/vomiting (P<0.05), and liver function injury (P<0.05). The incidences of abdominal distension and hypoproteinemia were 57.8% and 37.8% in the experimental group, and 2.2% and 2.2% in the control group, respectively (P<0.05). Conclusion The use of intermittent cytoreductive surgery combined with HIPEC is expected to improve the short-term treatment effect of patients with advanced ovarian cancer within a controlled range and ensure the safety of treatment.
Diagnostic performance of serum pepsinogen in asymptomatic patients with persistent Helicobacter pylori infection
ZHOU Taomei, LIU Siyu, DAI Mugen
2024, 22(5): 772-775. doi: 10.16766/j.cnki.issn.1674-4152.003500
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  Objective  This study aimed to explore serum pepsinogen (PG) detection results in asymptomatic patients with persistent Helicobacter pylori (H. pylori) infection, with the potential application of serum PG detection for screening high-risk gastric cancer patients.  Methods  A total of 583 patients who underwent gastroscopy at the Fifth Affiliated Hospital of Wenzhou Medical University between January 2021 and December 2022 were included in this study. Among them, asymptomatic individuals who underwent 13C urea breath test (13C-UBT) and serum PG detection for cancer screening on the same day of gastroscopy were enrolled.  Results  Out of the 583 subjects, 206 patients (35.33%) tested positive for the 13C-UBT, exhibiting higher levels of serum PG Ⅰ and PG Ⅱ compared to the uninfected population. Additionally, their PG Ⅰ/Ⅱ ratios were lower than those observed in the uninfected population (P<0.05). Univariate logistic regression analysis showed that H. pylori infection was associated with PG Ⅰ, PG Ⅱ, and PG Ⅰ/Ⅱ ratio (P<0.05), as well as age and diabetes (P<0.001). In the multivariate analysis, only serum PG Ⅱ (OR=1.293, 95% CI: 0.932-2.085, P<0.001) and PG Ⅰ/Ⅱ ratio (OR=0.594, 95% CI: 0.343-0.978, P<0.001) remained as independent risk factors for persistent H. pylori infection. A serum PG Ⅱ level > 13.59 μg/L (AUC=0.934, sensitivity 87.5%, specificity 91.7%) and a PG Ⅰ/Ⅱ ratio<4.85 (AUC=0.890, sensitivity 86.8%, specificity 81.6%) are associated with H. pylori infection. Further, the PG Ⅰ/Ⅱ ratio showed an inverse correlation with age (r=-0.167, P=0.041). Notably, the cut-off value of PG Ⅰ/Ⅱ ratio in elderly subjects aged 50 (<4.27; AUC=0.865, sensitivity 80.7%, specificity 88.2%) was lower than that in young subjects under 50 (<4.85; AUC=0.903, sensitivity 87.4%, specificity 82.9%).  Conclusion  Serum PG Ⅱ level > 13.59 ng/mL, PG Ⅰ/Ⅱ ratio<4.85 indicates persistent infection in asymptomatic subjects, and consideration should be given to conducting Helicobacter pylori 13C-UBT confirmation testing. Compared to young subjects, elderly subjects aged ≥ 50 years require stricter standards (PG Ⅰ/Ⅱ ratio<4.27) to detect persistent infections.
Application of the FRQ and MFS in assessing the fall risk in postmenopausal osteoporosis
SHENG Jingxin, LIANG Bing, WANG Tao, QIAN Rong, ZHAO Ping
2024, 22(5): 776-780. doi: 10.16766/j.cnki.issn.1674-4152.003501
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  Objective  To compare the value of the self-rated fall risk questionnaire (FRQ) and the Morse fall scale (MFS) in assessing fall risk in postmenopausal osteoporosis (PMOP), and to inform the selection of fall risk assessment tools for this population.  Methods  A total of 193 postmenopausal women with a confirmed diagnosis of osteoporosis were selected from the First Affiliated Hospital of Bengbu Medical University from September 2020 to January 2022 by convenience sampling method, and were invited to attend a survey of their fall risk assessed by the FRQ and MFS and follow-up on falls. The group was divided into a fall group (n=32) and a non-fall group (n=161) according to whether they fell or not during the follow-up period, and the scale was evaluated by means of ROC curve, sensitivity, specificity and Bayes discriminant analysis.  Results  The scores of both scales in the fall group were higher than those in the non-fall group, and the difference was statistically significant (P<0.001); the AUC of the FRQ and MFS were 0.865 and 0.737, respectively, and the difference was statistically significant (P=0.003); the Youden ' s index was 0.546 and 0.360 at critical values of 4 and 40 for the FRQ and MFS, respectively, when the sensitivity was 0.844 and 0.813, and specificity was 0.702 and 0.547, respectively. The positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 0.360, 0.958, 2.830, 0.223 and 0.263, 0.936, 1.792, 0.343, respectively. The cross-check accuracy of the FRQ and MFS was 72.5% and 60.6%, respectively.  Conclusion  Both FRQ and MFS can effectively predict the risk of falls in postmenopausal osteoporosis, while, FRQ shows a higher predictive value compared to MFS.
Effect of PPARγ agonists on microglia polarization around hematoma after cerebral hemorrhage in male rats
XU Yingning, MU Qiong
2024, 22(5): 781-785. doi: 10.16766/j.cnki.issn.1674-4152.003502
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  Objective  A model of intracerebral hemorrhage (ICH) was established to study the effect of PPARγ agonist (rosiglitazone) on the polarization of microglia (M1 and M2) around the hematoma after intracerebral hemorrhage in male SD rats.  Methods  A total of 48 male SD rats were divided into four groups according to the random number table method, including the normal group (Control), the intracerebral hemorrhage model group (ICH), the sodium chloride intervention group (NaCl), and the rosiglitazone intervention group (RSG), with 12 rats in each group. The ICH model of male rats was established by autologous blood. The neurological function of all groups of male rats was scored at the time points of 6 h, 24 h, 48 h, and 72 h. The expressions of CD16 and CD206 in the peripheral tissues of hematoma were detected by immunohistochemistry.  Results  The Longa scores of the ICH group were higher than those of the NaCl group at all time points (P<0.05). The Longa scores of the RSG group were lower than those of the ICH group at all time points (P<0.05). At 6 hours after intracerebral hemorrhage modeling, the CD16 level in the RSG group (0.226±0.004) was higher than that in the control group (0.210±0.004), the ICH group (0.221±0.004), and the NaCl group (0.220±0.005) expression was significantly increased, and the differences were statistically significant(P<0.05). The CD206 in the RSG group (0.204±0.004) was significantly higher than that in the control group (0.184±0.005), the ICH group (0.195±0.005), and the NaCl group (0.190±0.006) at 24 hours after intracerebral hemorrhage modeling(P<0.05).  Conclusion  PPARγ agonist rosiglitazone can enhance the expression of M1 and M2 microglia around hematoma after ICH, especially promoting the transformation of microglia into M2.
Role of the transmembrane protein TMEM88 in acute liver injury induced by LPS/D-GaIN
HE Cuixia, ZHU Minhui, XU Yuanyuan, WANG Xuefeng, DING Jiaxiang, ZHOU Huan
2024, 22(5): 786-790. doi: 10.16766/j.cnki.issn.1674-4152.003503
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  Objective  This study aims to investigate the changes of TMEM88 expression in mice with acute liver injury induced by lipopolysaccharide (LPS) combined with D-galactosamine (D-GaIN), and investigate the effect of high and low TMEM88 expression on the secretion of inflammatory factors in AML-12 cells induced by LPS.  Methods  In vivo, 20 mice were randomly divided into normal and model groups with 10 mice in each group according to random number table method. The model group was induced by LPS/D-GaIN combination, and liver tissues and blood of mice were collected. In vitro, AML-12 cells were stimulated by LPS and transfected with TMEM88 to access the changes in the expression of TMEM88 and inflammatory factors.  Results  The model group exhibited significant liver tissue, with a successful ALI modelling rate of 80%. In addition, the hepatic TMEM88 expression level was significantly increased in the model group (P<0.05). In AML-12 cells, the optimal condition for LPS stimulation was determined to be 100 ng/mL for 24 h. pEGFP-C1-TMEM88 and TMEM88-siRNA were verified to be successfully transfected into LPS-stimulated AML-12 cells (P<0.05). Furthermore, overexpression of TMEM88 resulted in an upregulation of inflammatory factors IL-1β, IL-6, and TNF-α (P<0.01), while knockdown of TMEM88 reduced the secretion of inflammatory factors (P<0.05). These experimental results suggest that the expression level of TMEM88 may influence the inflammatory process.  Conclusion  The expression level of TMEM88 plays an important role in the LPS/D-GaIN-induced acute liver injury model.
Correlation between preoperative serum osmotic pressure level and hospitalization time and complication risk of elderly patients with femoral neck fracture
ZHOU Wujie, JIN Yingying, LUO Guogang
2024, 22(5): 791-794. doi: 10.16766/j.cnki.issn.1674-4152.003504
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  Objective  To analyze the preoperative serum osmotic pressure level of elderly patients with femoral neck fracture, and to explore the relationship between its level and hospitalization time and the risk of complications.  Methods  A total of 120 patients with femoral neck fracture who were treated in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2020 to December 2021 were selected as the research object. According to the preoperative serum osmotic pressure level of patients, patients were divided into high-level group and low-level group. The clinical data of patients were collected and followed up for one year to record all-cause deaths. Spearman correlation was used to analyze the correlation between preoperative serum osmotic pressure level and hospitalization time and complications, and Cox regression was used to analyze the influencing factors of survival rate of elderly patients with femoral neck fracture.  Results  Forty-one patients were included in the high-level group and 79 in the low-level group. Preoperative serum osmotic pressure level was positively correlated with MPI score (r=0.501), hospital stay (r=0.496) and postoperative complications (r=0.383), P<0.05. Cox regression analysis showed that gender (HR=17.404), serum osmolality level (HR=1.136), MPI score (HR=1.294) and GPS score (HR=0.114) were all influencing factors for postoperative death in elderly patients with femoral neck. Cox regression analysis after adjusting for gender, MPI score and GPS score found that preoperative serum osmolality level (HR=1.071) was an independent determinant of postoperative death in elderly femoral neck patients (P<0.05).  Conclusion  The hospitalization time and complications of elderly patients with femoral neck fracture are related to the preoperative serum osmotic pressure level and the degree of weakness. Preoperative examination of serum osmotic pressure level is helpful for more adequate perioperative fluid management to reduce the risk of postoperative death.
Evaluate the abnormal white matter blood perfusion by 3D-ASL technique and its correlation with cognitive function in patients with cerebral infarction
HAO Qiaomei, ZHANG Haisan, MA Xiaojing, NIU Zhen, ZHANG Yong
2024, 22(5): 795-799. doi: 10.16766/j.cnki.issn.1674-4152.003505
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  Objective  Three-dimensional arterial spin labeling (3D-ASL) is used to assess the white matter blood perfusion status of cerebral infarction patients, the Montreal cognitive assessment (MoCA) is used to assess the cognitive function of patients, and the relationship between white matter blood perfusion status and cognitive function is analyzed.  Methods  Clinical data of 123 patients with cerebral infarction admitted to Anyang Regional Hospital in Puyang City from March 2020 to March 2023 were collected, and cerebral blood flow (CBF) in each white matter region was detected by MRI 3D-ASL. Patients were divided into control group (74 cases) and cognitive dysfunction (CD) group (49 cases) according to whether CD occurred 3 months after discharge. Logistic regression analysis model was used to determine the factors affecting the occurrence of cerebral infarction CD. Pearson correlation was used to analyze the correlation between white matter CBF and MoCA score in patients with cerebral infarction. Receiver operating characteristic curve (ROC) was used to analyze the predictive effect of CBF in white matter region on CD occurrence in patients with cerebral infarction.  Results  Among the 123 patients, the incidence of CD was 39.84% (49/123), and the MoCA score of CD group was lower than that of control group (P<0.05). Logistic regression analysis showed that high level of Hcy and low level of CBF in frontal, parietal and occipital white matter areas were independent risk factors for the occurrence of cerebral infarction CD (P<0.05). Pearson correlation analysis showed that CBF values in frontal, parietal and occipital lobes were positively correlated with MoCA scores (P<0.05). ROC analysis results showed that the CBF value of frontal, parietal and occipital lobes and the AUC of the CBF value combined with the CBF value of the three lobes were 0.542, 0.634, 0.633 and 0.793, respectively, and the predictive efficiency of the CBF value combined with the CBF value of the three lobes was higher than that of the single detection (P<0.05).  Conclusion  There is abnormal white matter blood perfusion in patients with cerebral infarction CD. The CBF values of frontal, parietal and occipital lobes are positively correlated with MoCA scores. The combination of the three has high predictive value for the occurrence of CD after cerebral infarction.
Influence of guided education and training on self-management ability of adolescents with type 1 diabetes
WANG Su, ZHANG Li, QIU Jinlyu
2024, 22(5): 800-804. doi: 10.16766/j.cnki.issn.1674-4152.003506
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  Objective  To analyze the application effect of guided education and training in adolescents with type 1 diabetes, explore its impact on patients ' self-management ability, and provide new ideas for clinical adolescents with type 1 diabetes in self-management.  Methods  A total of 116 adolescents with type 1 diabetes who were admitted to Hangzhou Children ' s Hospital from 2021 to October 2023 were selected, and they were randomly divided into control team and by random number table method. The control team received routine education, while the observation team received guided education and training on the basis of the control team. Blood glucose levels, self-management abilities, and psychological resilience of patients were compared between the two teams.  Results  After the intervention, the fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels in the observation team were (6.65±0.84) mmol/L, (7.58±0.67) mmol/L, and (6.50±0.67)%, respectively, which were lower than those in the control team [(7.12±1.33) mmol/L, (9.66±1.14) mmol/L, and (7.82±1.03)%, respectively], with statistical differences (P<0.05). Furthermore, the scores of self-report measure of self-management of type 1 diabetes for adolescents (SMOD-A) in the observation team were higher than those in the control team (P<0.05). Additionally, the total score of diabetes strengths and resilience measure for adolescents (DSTAR-Teen) in the observation team was (48.90±5.72) scores, higher than that of the control team [(36.52±6.46) scores, P<0.05].  Conclusion  Guided education and training is beneficial to control the blood sugar level of adolescents with type 1 diabetes, improve their self-management ability and psychological resilience, and is worth popularizing.
The impact of targeted training led by self-efficacy theory on motor function and daily living ability of stroke patients
ZHANG Ru, ZHANG Xiaohua, FU Guoping, YU Dihong, HE Rui
2024, 22(5): 805-808, 832. doi: 10.16766/j.cnki.issn.1674-4152.003507
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  Objective  Analyze the application of targeted training led by self-efficacy theory in the rehabilitation of stroke patients, and explore its impact on their motor function and daily living ability.  Methods  A total of 140 discharged stroke patients admitted from June 2021 to January 2023 were selected as the research subjects at the Medical Community Headquarters of Shaoxing Second Hospital. They were randomly divided into a control group and an observation group, with 70 patients in each group. The control group received routine continuing care, while the observation group received additional targeted training led by self-efficacy theory. Compare the motor function, daily living ability, and self-efficacy of patients in the two groups before and after intervention, and assessed the rehabilitation exercise compliance of both group.  Results  After intervention, the simplified Fugl-Meyer motor function assessment (FMA) and modified Barthel index (MBI) scores of the observation group patients were (66.33±5.24) points and (70.41±5.96) points, respectively, which were higher than those of the control group [(60.43±6.17) points and (63.89±4.83) points], with a significance level of P<0.05. The general self-efficacy scale (GSES) score of the observation group patients was (33.62±2.95) points, significantly higher than that of the control group [(25.79±4.66) points, P<0.05]. The compliance rate of rehabilitation exercise in the observation group was 92.86% (65/70), which was higher than that of the control group [80.00% (56/70)], with a significance level of P<0.05.  Conclusion  Targeted training led by self-efficacy theory can effectively improve the motor function and daily living ability of stroke patients, enhance their self-efficacy and rehabilitation exercise compliance, and promote patient prognosis.
Current status of dietary behavior and social emotion in 1-3-year-old children with food allergy
JIANG Xiaoyan, LI Sisi, YAN Xiumei, WU Weiwei, XU Zhang
2024, 22(5): 809-812. doi: 10.16766/j.cnki.issn.1674-4152.003508
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  Objective   To explore the current status of dietary behavior and social emotion of 1-3-year-old children with food allergy, and provide some reference and basis for the care and management of children with food allergy.   Methods   A total of 157 children aged from 1 to 3 years old with food allergy were recruited by convenience sampling from Pediatric Digestive Department of the 2nd Affiliated Hospital and Yuying Children ' s Hospital of Wenzhou Medical University from January 2021 to November 2023. The survey was conducted using the basic information questionnaire, children dietary behavior questionnaire and emotional and social assessment scales for children aged 12 to 36 months.   Results   Sixty-nine point four percents (109/157) of food allergic children had one or more dietary behavior problems, with 40.8% (64/157) special preference for a food, 34.4% (54/157) poor appetite, 32.5% (51/157) parents overconcerned, 31.2% (49/157) having bad eating habits, 9.6% (15/157) fear of eating, 4.5% (7/157) potential disease status. The T scores of externalization domain, implicit domain, disorder domain and competence domain were 54.32±10.76, 49.63±10.13, 52.46±10.64, and 46.84±10.12, respectively. The differences between the normal dietary behavior group, and the dietary behavior problem group in the externalization, implicit, disorder and competence domain were significant (P < 0.05).   Conclusion   Medical staff should guide the caregivers to actively cultivate children ' s good dietary behavior habits, create a harmonious family environment, and promote the development of their emotional and social behaviors.
Predictive value of serum levels of estrone and estriol for pregnancy outcomes in patients with threatened abortion
WANG Yi, LIU Huilan, QING Bilan, LI Mingfang
2024, 22(5): 813-816. doi: 10.16766/j.cnki.issn.1674-4152.003509
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  Objective   This study aims to investigate the serum levels of estrone (E1) and estriol (E3) in pregnant women with threatened miscarriage and evaluate their predictive value for adverse pregnancy outcomes. The findings will provide valuable reference for early clinical intervention and treatment.   Methods   A total of 122 pregnant women with threatened abortion who were admitted to Guangyuan Maternal and Child Health Hospital from January 2020 to December 2021 were selected. Based on whether they experienced a miscarriage, the pregnant women with threatened abortion were divided into two groups: the good pregnancy outcome group (n=80) and the poor pregnancy outcome group (n=42). Additionally, 70 normal pregnant women of the same age who delivered in our hospital were selected as the control group. The levels of E1 and E3 in serum were compared among the different groups. Pearson analysis was used to evaluate the correlation between E1 and E3 levels and other related hormones in serum. Furthermore, we conducted binary logistic analysis to analyze the factors contributing to poor pregnancy outcomes. Lastly, we used ROC curve analysis to assess the diagnostic value of E1 and E3 levels in predicting poor pregnancy outcomes.   Results   The serum levels of β-human chorionic gonadotropin (β-HCG), progesterone (P), estradiol (E2), E1, and E3 in the poor pregnancy outcome group were lower than those compared to both the control group and the good pregnancy outcome group (P < 0.05).Conversely, the levels of high sensitivity C-reactive protein and cancer antigen 125 in serum were higher compared to the control group and the good pregnancy outcome group (P < 0.05). There was a positive correlation between the serum levels of E1, E3, β-HCG, P, and E2 were positively correlated (P < 0.05). Binary logistic regression analysis showed that elevated E1 and E3 were influencing protective factors against adverse pregnancy outcomes (P < 0.05). The ROC curve demonstrated that the combined diagnosis of E1 and E3 (0.841) had a significantly higher area under the curve (AUC) compared to using E1 (0.745) or E3 (0.735) alone. The sensitivity and specificity of the combined diagnosis were 85.71% and 86.00%, respectively.   Conclusion   The levels of E1 and E3 in serum decreased in pregnant women experiencing poor pregnancy outcomes. The combined diagnosis of E1 and E3 has a good diagnostic efficiency for identifying poor pregnancy outcomes, offering a valuable foundation for early clinical intervention and treatment.
Efficacy analysis of the Needle-perc system in pediatric renal stone treatment without artificial hydronephrosis
Zhaxidajie, Pingcuosangbu, Ciwang, YU Hongliang, WANG Jiangzhong, HAO Zongyao, GONG Binbin
2024, 22(5): 817-819. doi: 10.16766/j.cnki.issn.1674-4152.003510
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  Objective   This study aims to evaluate the efficacy and safety of percutaneous nephrolithotripsy assisted by the needle-perc system without artificial hydronephrosis in the treatment of pediatric renal stones.   Methods   A total of 11 pediatric patients with renal stones treated underwent percutaneous nephrolithotripsy using the visualized needle-perc system were enrolled in Shannan People ' s Hospital during August 2021 to October 2022. The cohort included 7 males and 4 females aged 5-16 years, with 4 patients on the right side and 7 patients on the left side. Among them, 5 patients had single renal pelvis stone and 6 patients had multiple calculi. The maximum mean diameter of calculi was (18.46±6.52) mm, with a mean CT value of (835.04±135.74) HU. All of them underwent percutaneous holmium laser lithotripsy under general anesthesia using a visualized needle-perc system, with the target calyx punctured by a 4.5Fr visualized puncture needle under ultrasound guidance. Subsequently, F16 percutaneous renal access was established, and lithotripsy was completed using a 550 μm holmium laser. After the operation, an F12 fistula was maintained in place, following a needle-perc nephrolithotripsy procedure without the need for an indwelling nephrostomy tube. The operation duration, complications, hospital stay, and stone clearance post-surgery were evaluated.   Results   All children were successfully operated, with 3 cases undergoing complete needle-perc nephrolithotripsy and 8 cases using a visualized needle-perc system. The average operation duration was (79.55±10.76) min, postoperative hemoglobin decreased by (10.09±5.25) g/L, and the average postoperative hospitalization period was (5.54±1.07) days. The stone clearance rate was 100% at the 4-week postoperative follow-up. No serious complications such as access loss, postoperative infection, severe bleeding, or injury to the kidney or adjacent organs during and after the surgery.   Conclusion   Needle-perc system assisted percutaneous nephrolithotomy without artificial hydronephrosis is safe and effective in the treatment of pediatric renal stones. It demonstrates a low incidence of surgical complications and can achieve a satisfactory stone removal rate, making it suitable for individualized pediatric renal stone treatment. Furthermore, this technique holds clinical significance in regions with a high incidence of kidney stones among children living on plateau.
The status and its influencing factors of community rehabilitation treatment for osteoarthritis among general practitioners in Beijing
CAO Yu, MA Li, HE Xufang, ZHAO Yali, WANG Jiaxin
2024, 22(5): 820-823. doi: 10.16766/j.cnki.issn.1674-4152.003511
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  Objective   To understand the knowledge and awareness of community rehabilitation for osteoarthritis (OA) among general practitioners, the current situation and influencing factors of their participation in community rehabilitation treatment, and to provide strategies for promoting comprehensive community rehabilitation.   Methods   A stratified cluster sampling method was used to select general practitioners from the general clinics of community health service centers in the six districts and suburbs of Beijing as the research subjects. A questionnaire survey was conducted from October to December 2022. Chi square test and logistic regression were used to analyze the influencing factors of general practitioners participating in OA community rehabilitation treatment.   Results   Among the 200 general practitioners, males accounted for 29.5% (59/200) and females accounted for 70.5% (141/200). The average age was (38.10±9.11) years old. 99.5% (199/200) of general practitioners were aware of the clinical symptoms of OA, 48.5% (97/200) were aware of community rehabilitation equipment, and 22.5% (45/200) of general practitioners participated in OA community rehabilitation treatment. Gender, age, daily outpatient volume, years of work, participation in rehabilitation training, awareness of rehabilitation assessment, and awareness of rehabilitation equipment were the influencing factors for general practitioners to participate in OA community rehabilitation treatment (P < 0.05). Women, working experience of 30 years or more, age of 40 years or more, knowledge of rehabilitation efficacy evaluation methods, knowledge of rehabilitation equipment, and participation in rehabilitation training were favorable factors for general practitioners to participate in OA community rehabilitation treatment. According to the OR value, whether to participate in rehabilitation training was the most influential factor.   Conclusion   General practitioners have a low awareness rate of OA community rehabilitation knowledge and a low rate of community rehabilitation training. Relevant training and promotion should be strengthened to improve the awareness and ability of general practitioners in rehabilitation services, which is beneficial for them to carry out OA community rehabilitation treatment.
The effectiveness of modified Xiaochaihu Decoction in the treatment of acute herpes zoster and its preventive effect on postherpetic neuralgia
LI Tianfang, XIE Wei, ZHANG Shuhong, YAO Yajun, ZHU Lin, WU Yuyu, YE Hong
2024, 22(5): 824-827. doi: 10.16766/j.cnki.issn.1674-4152.003512
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  Objective   To explore the therapeutic effect of modified Xiaochaihu Decoction on acute herpes zoster (AHZ) and its preventive effect on postherpetic neuralgia (PHN), aiming to find an effective and safe treatment.   Methods   A total of 186 AHZ patients admitted to Longyou County People ' s Hospital from January 2019 to June 2023 were divided into Group A and Group B according to random number table method. Group A (93 cases) were treated with conventional Western medicine, while Group B (93 cases) were treated with modified Xiaochaihu Decoction. Two groups of the degree of pain and sleep quality, T cell subsets, cytokines, disease control time, clinical efficacy, utilization rate of oxycodone hydrochloride sustained-release tablets, recurrence rate, and incidence of PHN were observed.   Results   After treatment, the numerical rating scale (NRS) and Pittsburgh sleep quality index (PSQI) scores of patients in group B (3.43±0.52, 7.78±0.97) were lower than those in group A (4.15±0.67, 10.06±1.22), P < 0.05. The levels of CD3+, CD4+, CD4+/CD8+in Group B were higher than those in Group A, while CD8+ was lower than that in Group A. TNF-α and IL-1β in Group B were lower than those in Group A, while IL-2 and IL-10 were higher than those in Group A, with statistical differences (P < 0.05). The time for preventing blisters, scabbing, scabbing, and pain relief in Group B were shorter than those in Group A. The total effective rate of group B (96.77%, 90/93) was higher than that of group A (83.87%, 78/93), with statistical difference (P < 0.05). The utilization rate of roxycodone hydrochloride sustained-release tablets, recurrence rate, and PHN incidence rate in Group B were lower than those in Group A (P < 0.05).   Conclusion   The modified Xiaochaihu Decoction is effective in treating AHZ, It can relieve pain, improve sleep quality, enhance immune function, and reduce inflammatory reactions. The time of disease control is relatively shorter, and the utilization rate of oxycodone hydrochloride, recurrence rate and the incidence of PHN are lower.
Clinical significance of thyroid hormones, sex hormones, and cortisol levels in assessing the severity of first-episode female depression disorder
LI Xin, SUN Yan, CHEN Wei, MA Wenyou, YU Zhenjian, ZHANG Shun, LIANG Xiaoliang, LEI Rong
2024, 22(5): 828-832. doi: 10.16766/j.cnki.issn.1674-4152.003513
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  Objective   This study aims to investigate the distribution differences of thyroid hormones, sex hormones, and cortisol levels in first-episode female patients with depression across varying severity levels. The goal was to deepen the understanding of the hormonal regulation mechanisms in depression and identify potential biomarkers for clinical diagnosis.   Methods   A total of 150 first-episode female patients with depression hospitalized at the Kailuan Mental Health Center from June 2022 to June 2023 were selected. General information of the patients was collected, and the levels of thyroid hormones (T4, T3, TSH, FT3, FT4), sex hormones (T, PRL, P, E2), adrenocorticotropic hormone (ACTH), and cortisol (COR) were measured. The severity of depression was assessed using the Zung self-rating depression scale (SDS). Based on the SDS scores and clinical diagnosis, patients were divided into a mild-to-moderate depression group (70 patients) and a severe depression group (80 patients). Logistic regression and ROC curve analysis were employed for data analysis.   Results   Patients in the mild-to-moderate depression group exhibited higher levels of FT3 and FT4, while lower levels of TSH, testosterone (T), estradiol (E2), ACTH, and COR compared to the severe depression group (P < 0.05). Low levels of FT3 and high levels of T were identified as potential risk factors for severe episodes in first-episode female patients with depression. The area under the curve (AUC) for diagnosing severe episodes in first-episode female patients with depression based on FT3 and T levels were 0.687 (95% CI: 0.602-0.773, P < 0.001) and 0.654 (95% CI: 0.563-0.744, P=0.001), respectively. At an FT3 level of 3.165 pg/mL, the sensitivity for diagnosing severe episodes was 82.5% with a specificity of 51.4%. Similarly, at a T level of 0.221 ng/mL, the sensitivity was 75.0% with a specificity of 62.9%.   Conclusion   Variations in FT3 and T levels are significantly correlated with the severity of first-episode depression in female patients, providing a new perspective on the study of biomarkers in depressive disorders.
Effect of AIDET communication complex nursing on anxiety and gastroscopy quality in patients undergoing initial painless gastroscopy
XU Yan, HUANG Xiaolin, ZHUANG Zhaomeng
2024, 22(5): 833-835. doi: 10.16766/j.cnki.issn.1674-4152.003514
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  Objective   The extensive development of painless gastroscopy has put forward higher requirements for clinical nursing services. This study constructed a nursing scheme of acknowledge introduce duration explanation and thank you (AIDET) communication mode combined intervention and discussed the application effect on the initial patients.   Methods   A total of 98 outpatients who planned to undergo painless gastroscopy in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2021 to June 2023 were divided into control group (49 cases, traditional communication mode + lying on the left side after oral strepase protease) and experimental group (49 cases, AIDET communication mode+postural care after oral strepase protease) by random number table method. The intervention effect of the two groups was compared.   Results   The Hamilton anxiety scale (HAMA) score was lower than that of the control group (P < 0.05). The coordination score of awareness and position activity of the examination was higher than that of the control group (P < 0.05). The visual field resolution of the fundus of the stomach (2.45±0.46), the body of the stomach (2.55±0.41), the antrum (2.67±0.31), and the whole stomach (2.65±0.32) were higher than those of control group (1.96±0.34), (2.03±0.34), (1.90±0.45) and (1.97±0.47) score (t=5.996, 6.834, 9.864, 8.372, P < 0.05). Intraoperative irrigation ≥1 time in 6 cases was less than that in the control group in 15 cases (χ2=4.909, P < 0.05). The time of gastroscopy (7.46±2.10 min) was shorter than that of the control group (12.89±2.34 min), t=11.354, P < 0.05. The detection rate of microlesion was 93.88% (46/49), which was slightly higher than that of the control group 85.71% (42/49), P>0.05.   Conclusion   The application of AIDET communication combined with oral streptase protease postural care can significantly relieve the anxiety of patients undergoing initial painless gastroscopy, and improve the cooperation of the examination and the quality and efficiency of the gastroscopy.
Correlation and diagnostic value of high frequency ultrasound and SWE quantitative parameters with ulnar nerve electrophysiology in patients with cubital tunnel syndrome
Elifia Gilili, LI Wenjuan, MIAO Xu, WANG Xia
2024, 22(5): 836-839. doi: 10.16766/j.cnki.issn.1674-4152.003515
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  Objective   To explore the correlation of quantitative parameters of high frequency ultrasound and shear wave elastography (SWE) with ulnar nerve electrophysiology in patients with cubital tunnel syndrome (CTS) and the diagnostic value of CTS.   Methods   A total of 49 patients with CTS admitted to the Second Affiliated Hospital of Xinjiang Medical University from December 2021 to December 2022 were included in the CTS group. A total of 49 healthy volunteers were included in the control group. All patients underwent high-frequency ultrasonography, SWE and ulnar nerve electrophysiological examination. Pearson method was used to analyze the correlation between high-frequency ultrasound examination [medial epicondylar cross-sectional area (CSA), maximum transverse diameter and circumference of ulnar nerve], SWE quantitative parameters [mean elastic modulus (EI), shear wave velocity (V)] with ulnar nerve electrophysiological examination results [motor conduction velocity (MCV) and sensory conduction velocity (SCV)] in CTS patients. ROC curve was used to analyze the diagnostic value of high-frequency ultrasonography and SWE quantitative parameters for CTS.   Results   The levels of CSA, EI and V in CTS group were significantly higher than those in control group (P < 0.05), and there was no significant difference in the maximum transverse diameter and circumference of ulnar nerve between two groups (P>0.05). The levels of MCV and SCV in CTS group were lower than those in control group (P < 0.05). The results of Pearson correlation analysis showed that CSA, EI and V were negatively correlated with MCV and SCV (P < 0.05). ROC analysis results showed that the AUC (95% CI) were 0.679 (0.577-0.770), 0.718 (0.618-0.804), and 0.720 (0.620-0.806) for CSA, EI and V in the diagnosis of CTS alone, respectively, and the value was 0.893 (0.815-0.947) when combined. The diagnostic efficiency of the three combined tests was higher than that of each single test (Z=3.065, 2.899, 2.734, P < 0.05).   Conclusion   In patients with high CTS, high-frequency ultrasound and SWE quantitative parameters are significantly correlated with the ulnar nerve electrophysiological indexes, among which CSA, EI and V can be used in the diagnosis of CTS, and the combination of the three has high diagnostic value.
Application and value of corneal confocal microscopy in early evaluation and monitoring of diabetic peripheral neuropathy
YAO Caixia, WU Bing, LI Jianbo
2024, 22(5): 840-844. doi: 10.16766/j.cnki.issn.1674-4152.003516
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Cornea is the most innervated organ of human body, which is responsible for the maintenance of corneal nutrition and homeostasis. Corneal innervation is impaired in diabetes, and it has been widely proved that diabetic neuropathy affects the corneal sub-basal nerve plexus, including corneal nerve fibers morphology, length and density. These changes seem to prior to the clinical onset of diabetic neuropathy. Corneal confocal microscopy (CCM) is a rapid, non-invasive, reproducible, and simple ophthalmic imaging technique that allows for the study of different layers of the cornea at a cellular level. It enables the in vivo assessment of corneal nerve loss in patients with diabetes. Corneal nerve loss has demonstrated excellent diagnostic value for somatic and autonomic diabetic neuropathy and can be used to monitor its progression. Recently, an increasing number of studies have utilized corneal confocal microscopy to detect diabetic neuropathy. This review summarized the corneal nerve alterations in patients with diabetes and the relationship between the extent of these changes and the duration and severity of diabetes. It also provided an overview of the relevant evidence regarding the utility of CCM in the early evaluation and monitoring of diabetic peripheral sensorimotor polyneuropathy. We believe that the information about the corneal nerve fibers obtained from the in vivo investigation of the sub-basal nerve plexus using CCM is crucial for the early detection and monitoring of diabetic peripheral neuropathy and its progression.
The role of GSDME-dependent pyroptosis in renal diseases
DENG Tianyu, WANG Xiaoyan
2024, 22(5): 845-849. doi: 10.16766/j.cnki.issn.1674-4152.003517
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Pyroptosis is a newly discovered form of programmed cell death that relies on caspase-1 and inflammasome activation to initiate the cell death process. This pathway is characterized by compromised membrane integrity and the release of numerous pro-inflammatory factors. Gasdermin E (GSDME), a member of the gasdermin family, plays a pivotal role in pyroptosis induction. It is widely expressed in normal tissues and can convert apoptosis into pyroptosis. Kidney diseases pose significant health risks to humans. In recent years, researchers have gradually revealed and confirmed the involvement of GSDME-dependent pyroptosis in the pathogenesis of kidney diseases. A comprehensive understanding of the role of GSDME-dependent pyroptosis in renal disease will facilitate the identification of novel targets for diagnosing and treatment. To provide valuable references for clinical and basic researchers, we present a review and summary of studies investigating the association between GSDME-dependent pyroptosis and renal diseases, including acute kidney injuries, diabetic nephropathy, renal carcinoma, obstructive nephropathy, and lupus glomerulonephritis.
Research progress on mitochondrial pyroptosis mechanism in ischemic stroke
CAI Ke, WANG Qinpeng, WEI Yangyang, LI Tingting, WANG Guojuan, LIANG Cheng
2024, 22(5): 850-854. doi: 10.16766/j.cnki.issn.1674-4152.003518
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As the most common cerebrovascular disease, ischemic stroke has the characteristics of high incidence, high mortality, high disability rate, and high recurrence rate, which brings a heavy burden to patients, families, and society. The main purpose of its treatment is to timely open blood vessels to restore perfusion, rescue ischemic penumbra, and improve neurological function. Research on the pathophysiological mechanism and treatment of ischemic stroke has always been a hot spot. A large number of studies have shown that neuroinflammation is an important mechanism of ischemic stroke. As an inflammatory cell death mode, pyroptosis is closely related to a variety of diseases and injury mechanisms, including the occurrence and development of ischemic stroke. There are a variety of key proteins in the process of pyroptosis, such as inflammasome, caspase-1, and Gasdermin D (GSDMD). GSDMD, as the executive protein of pyroptosis, can punch holes in the cell membrane, causing inflammatory factors such as IL-1β and IL-18 to be released into the extracellular space to produce an inflammatory response. Recent studies have found that GSDMD can not only punch holes in the cell membrane but also destroy the mitochondrial membrane by punching holes, leading to impaired mitochondrial function and release of mitochondrial content. The mitochondrial membrane damage occurs before the cell membrane damage, which not only expands the pyroptosis process but also induces cell death through other pathways. Therefore, inhibiting the perforating function of GSDMD and improving the mitochondrial function of ischemic cells through mitochondrial transplantation can effectively inhibit the inflammatory response and improve the function of the ischemic penumbra, thus playing a neuroprotective role. In this review, we briefly introduce the process of pyroptosis and the mechanism of GSDMD drilling in the process of pyroptosis, focusing on the process of mitochondrial pyroptosis and its related research progress in ischemic stroke, and looking for new ideas for the treatment of ischemic stroke.
Research progress of non-coding RNAs in intrauterine adhesion
WANG Jiwen, CHEN Xing, DAI Huihua
2024, 22(5): 855-858. doi: 10.16766/j.cnki.issn.1674-4152.003519
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Intrauterine adhesion (IUA), also known as Asherman' s syndrome, is a common reproductive system disorder in women of reproductive age, often occurring as a result of postpartum infection, uterine surgery, or genital tuberculosis. IUA is a fibrotic disease caused by tissue damage. When the trauma to the endometrial basement membrane leads to repair disorder, excessive deposition and reorganization of extracellular matrix and proliferation of fibrous connective tissue replace the normal endometrium. This can ultimately cause partial or complete obstruction of uterine cavity or cervical canal, which may lead to various complications, including cyclical pelvic pain, menstrual disturbance, and disminished fertility, seriously affecting the physical and mental health of women. Transcervical resection of adhesion is the current method for IUA treatment, but the high recurrence rate of postoperative adhesion and subsequent infertility make the treatment of IUA still a significant challenge. Non-coding RNAs (ncRNAs), a class of RNA molecules that lack protein-coding capacity, are integral to the regulation of gene expression and are significant contributors to the metabolic life activity of organisms and the development of diseases. Recent studies have identified associations between TGF-β1/Smad, Wnt/β-catenin, and NF-κB signaling pathways and the development of IUA. ncRNAs potentially modulate endometrial fibrogenesis by targeting key components within these pathways. ncRNAs mainly include microRNA (miRNA), long non-coding RNA (lncRNA), and circular RNA (circRNA), which are expected to be therapeutic targets and diagnostic markers for IUA. This review summarizes the progress of research on ncRNAs and IUA, to offer novel insights for the prevention and treatment of IUA, ultimately enhancing patients' quality of life.
Observation on the curative effect of acupuncture combined with Zusanli acupoint injection in the treatment of persistent hiccups
ZHANG Rumeng, WU Ming, XU Peng, CHEN Yuhua
2024, 22(5): 859-862. doi: 10.16766/j.cnki.issn.1674-4152.003520
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  Objective  To explore the efficacy and safety of acupuncture combined with Zusanli acupoint injection of metoclopramide in the treatment of persistent hiccups, and to compare the differences in the therapeutic effects of this method on central and peripheral persistent hiccups.  Methods  A total of 48 patients with persistent hiccups were selected from the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from July 2018 to August 2022, including 36 patients in the central treatment group and 12 patients in the peripheral treatment group. The two groups were treated with acupuncture at Cuanzhu, Danzhong, Zhongwan, Geshu, Neiguan, Zusanli and other points, and the needles were retained for 30 min. After taking the needle, 1ml metoclopramide hydrochloride was injected into the right Zusanli (ST36), and the same dose was injected into the left Zusanli 4-6 hours later, for a total of 3 treatments. Hiccups assessment instrument (HAI) was used to assess the severity of hiccups in the two groups after each treatment and after the end of the treatment. The total effective rate of the two groups was compared after treatment. The total effective rate of the two groups was compared after treatment.  Results  After treatment, there were statistically significant differences in HAI scores between before treatment and after the first, second and third treatment, between after the first treatment and after the second and third treatment, and between after the second and third treatment in two groups (all P<0.05). After the first, second and third treatment, the HAI scores of the peripheral treatment group were significantly lower than that of the central treatment group (4.25±2.60 vs. 6.69±2.07, 1.96±1.75 vs. 3.64±3.08, 0.45±0.36 vs. 2.18±2.06, P<0.05). The total effective rate of the peripheral treatment group was significantly higher than that of the central treatment group (91.67% vs. 52.78%, χ2=4.267, P=0.039).  Conclusion  The method of acupuncture combined with Zusanli acupoint injection is effective for persistent hiccups caused by both central and peripheral causes, and the therapeutic effect is better for peripheral causes.
Investigation of knowledge, attitudes, and behaviors regarding ventilator-associated pneumonia prevention measures and influencing factors among ICU nurses
HUANG Qidong, ZHENG Leilei, ZHANG Qixia, WEI Qing, CHEN Yu
2024, 22(5): 863-866. doi: 10.16766/j.cnki.issn.1674-4152.003521
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  Objective  To understand the knowledge, attitude, behavior status, and influencing factors of ventilator-associated pneumonia among nurses in a tertiary A medical intensive care unit in Zhejiang Province, and to provide a theoretical basis for improving the nursing skills of nurses in intensive care units for ventilator-associated pneumonia.  Methods  In May 2023, a self-made survey questionnaire was used to cluster select 148 nurses from the intensive care unit of a tertiary A hospital in Zhejiang Province for investigation.  Results  ICU nurses from a tertiary A hospital in Zhejiang Province scored 16.16±1.82 in terms of VAP knowledge in the knowledge dimension, 100.01±13.86 in the attitude dimension, and 31.33±4.28 in the behavior dimension. The results of multiple linear regression analysis showed that in terms of knowledge dimension, management positions showed a positive correlation trend with knowledge scores compared to responsibility positions (P<0.05), while education level and years of working in ICU nursing showed a negative correlation trend with knowledge scores (P<0.05); In terms of attitude dimension, there is a positive correlation between years of experience in ICU nursing work and attitude scores (P<0.05); In terms of behavioral dimensions, management and teaching positions show a negative correlation with behavioral scores compared to responsibility positions (P<0.05).  Conclusion  The knowledge of ventilator-associated pneumonia among nurses in the intensive care unit of a tertiary A hospital in Zhejiang Province is at a high level, but their attitudes and behavioral levels still need to be improved. Suggest increasing education on the prevention measures for ventilator-associated pneumonia.
Exploration and application of CBL combined with flipped classroom model in clinical teaching of internal medicine
LIU Lin, LI Jiajia, WU Yanping, SHEN Ji, YUAN Yuan
2024, 22(5): 867-870. doi: 10.16766/j.cnki.issn.1674-4152.003522
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  Objective  This study aims to explore the integration of case-based learning (CBL) with the flipped class mode in internal medicine clinical teaching, comparing its differences and advantages with traditional clinical teaching modes, and exploring the application prospects of its combined approach in internal medicine clinical teaching.  Methods  A total of 80 medical students from Bengbu Medical University undergoing clinical internships between June 2022 and December 2023 were selected as research subjects. They were randomly grouped into two groups: 40 students in the research group received instruction using a teaching reform method combined with the flipped class model, and the remaining 40 students in the control group were taught using traditional teaching methods. The study assessed the comprehensive assessment scores of the two groups of clinical abilities, individual comprehensive ability, and teaching satisfaction.  Results  In the comprehensive evaluation, the study group demonstrated higher scores across various metrics: theoretical knowledge (89.90±3.50), case writing (92.25±2.49), clinical thinking ability (86.05±3.46), and the average score (89.40±2.67), compared to the control group (82.95±4.06, 86.63±2.41, 83.38±2.10, 84.40±2.41), with statistically significant differences (P < 0.05). The self-evaluation score of personal comprehensive abilities of the study group was higher than that of the control group (P < 0.05). The satisfaction of the control group and the study group were 67.5% (27/40) and 87.5% (35/40), respectively. The satisfaction of the study group was significantly higher than that of the control group (χ2=4.588, P=0.032).  Conclusion  The integration of CBL with the flipped classroom mode has a positive application effect in the clinical teaching of internal medicine, improving the comprehensive evaluation scores and teaching satisfaction of medical students. This approach merits further promotion and application in the clinical teaching of internal medicine.
Application of Mini-CEX and DOPS scales for formative evaluation in pediatric practice nurses
FANG Shanshan, RONG Daoxiang, LIU Jixiu, XU Bing, DAI Feng
2024, 22(5): 871-873. doi: 10.16766/j.cnki.issn.1674-4152.003523
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  Objective  To explore the application effects of formative evaluation for mini-clinical evaluation exercise (Mini-CEX) and direct observation of procedural skills (DOPS) in the teaching evaluation of pediatric practice nurses, in order to provide a quantitative evaluation method for improving the teaching quality of practice nurses.  Methods  A total of 60 clinical nursing students from the pediatrics department of the First Affiliated Hospital of Bengbu Medical University participated in this study from December 2021 to December 2022. They were randomly divided into the control group (n=30) and the observation group (n=30). During a 4-week internship in pediatrics, the control group was given the conventional teaching mode and the formative scale was tested once before graduation, while the observation group was given two formative assessments within one week of admission and at the end of the third week.  Results  After the practice teaching, the number of qualified people evaluated by Mini-CEX scale was 18 in the control group, and 25 in the observation group. The disparity between the two groups was found to be statistically significant (P<0.05). The feedback time of the control groups was (9.37±1.59) minutes, while the observation group was shorter [(7.63±1.33) minutes], with significant difference (P<0.001). The Mini-CEX scores of the observation group were higher than those of the control group (P<0.05). For the DOPS scale evaluation, 18 individuals in the control group and 26 in the observation group were qualified, and the difference between the two groups was statistically significant (P<0.05). The feedback time of the control groups was (8.83±1.76) minutes, while the observation group had a shorter feedback time of (7.33±1.32) minutes, with statistically significant (P<0.001). Except for 3 items of clarifying operation purpose and precautions, humanistic care, and overall performance, the remaining 7 scores of the DOPS scale in the observation group were higher than those in the control group (P<0.05). Except for 1 item of clarifying operation purpose and precautions, the other 9 scores of DOPS were significantly better than those at admission (P<0.05).  Conclusion  The formative evaluation of Mini-CEX and DOPS scales has demonstrated a significant enhancement in the professional knowledge, clinical skills, and professional accomplishment of practice nurses, indicating their readiness for clinical promotion.
Exploring the application of flipped classroom combined with multidisciplinary teaching model in obstetrics clinical teaching
ZHANG Yan, CHEN Huilei, XUAN Ling, CHEN Jiasheng, SHI Yan, LU Guoyu
2024, 22(5): 874-877. doi: 10.16766/j.cnki.issn.1674-4152.003524
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  Objective  To research the feasibility and value of flipped classroom (FC) combined with multi-disciplinary treatment (MDT) teaching mode in obstetrics clinical teaching.  Methods  A total of 84 interns in the First Affiliated Hospital of Bengbu Medical University who came from the same grade were selected. According to random number table method, the students were divided into experimental group (n=44, FC with MDT) and control group (n=40, traditional teaching mode). The theoretical assessment scores, practical skills assessment scores between two groups were compared. The teaching effectiveness and satisfaction were evaluated through a questionnaire survey from 10 aspects: learning interest, self-learning ability, mastery of basic theories, basic operational ability, adaptability to clinical practice, improvement of team collaboration ability, active classroom atmosphere, literature search and analysis ability, interdisciplinary knowledge application ability, and willingness to continue accepting the teaching mode.  Results  The theoretical assessment scores of students in the experimental group were 90.58±2.99, significantly higher than those in the control group by 83.10±4.34 (P<0.001). The practical skills assessment score of the experimental group was 90.76±1.78, significantly higher than the control group by 79.03±2.45 (P<0.001). The teaching effect of the experimental group was significantly better than that of the control group (P<0.05). The total teaching satisfaction rate in the experimental group was 93.18%, which was higher than 55.00% in the control group (P<0.001).  Conclusion  Flipped classroom combined with MDT teaching mode in obstetrics clinical teaching has significant teaching effect, which can stimulate students' enthusiasm and initiation, and improve their theoretical knowledge level and clinical practical ability.
Chain mediating effect of negative evaluation fear and self-esteem between body image and social appearance anxiety in adolescent idiopathic scoliosis
CHEN Weiying, LI Huiping, SONG Guiqi, FANG Jihong, LI Guoyuan
2024, 22(5): 878-881. doi: 10.16766/j.cnki.issn.1674-4152.003525
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  Objective  This study aims to investigate the relationship between self-esteem and negative evaluation fear between body image and social appearance anxiety in adolescent idiopathic scoliosis patients, as well as the chain mediating effects among these variables.  Methods  This study investigated a sample of 101 hospitalized adolescent idiopathic scoliosis patients, who were admitted from September 2019 to May 2022. Data were collected using a general data questionnaire, the scoliosis version of the body image interference questionnaire, the self-esteem scale, the concise fear of negative evaluation scale, and the social appearance anxiety scale.  Results  The level of body image level in adolescent idiopathic scoliosis patients showed significant statistical differences based on age, weight, and treatment methods. Fear of negative evaluation was positively predicted by body image (r=0.302, P<0.001). While body image (r=-0.348, P<0.001) and fear of negative evaluation (r=-0.349, P<0.001) had negative predictive effects on self-esteem. Additionally, body image (r=0.422, P<0.001) and fear of negative evaluation (r=0.766, P<0.001) had positive predictive effects on social appearance anxiety, while self-esteem negatively predicted social appearance anxiety (r=-0.483, P<0.01). Both fear of negative evaluation and self-esteem demonstrated valid indirect effects. Fear of negative evaluation and self-esteem partially mediated the relationship between body image and social appearance anxiety, with a mediating effect ratio of 62.96%.  Conclusion  The age, weight, and treatment methods of adolescent idiopathic scoliosis patients have predictive effects on body image, while fear of negative evaluation and self-esteem act as chain mediator in the relationship between body image and social appearance anxiety in these patients. When providing psychological care, healthcare professionals should assist patients in developing a healthy body perception, enhancing their self-esteem, and reducing fear of negative evaluation, thereby mitigating the onset and progression of social appearance anxiety.
Latent class analysis of symptom characteristics of nasopharyngeal carcinoma patients receiving intensity modulated radiation therapy during rehabilitation periodone
ZHU Yunxia, YANG Can, WANG Hemei, CHEN Zengli, FEI Zhenzhen
2024, 22(5): 882-886. doi: 10.16766/j.cnki.issn.1674-4152.003526
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  Objective  To understand the current status of symptom distress and potential categories of symptom characteristics in nasopharyngeal carcinoma patients after radiation therapy by a one-year follow-up of symptoms in nasopharyngeal carcinoma patients after intensity-modulated radiation therapy, and to explore the differences in symptom characteristics among different types of patients to provide strategies for clinical nurses to develop targeted and sustained symptom management.  Methods  Nasopharyngeal carcinoma patients undergoing intensity-modulated radiation therapy and completing radiation therapy after one year were selected in Zhejiang Cancer Hospital from January 2020 to December 2022. General information questionnaire and QLQ. H&N35 were utilized as the investigating tools. Latent class analysis (LCA)was used to explore the latent classes of the symptom characteristics of nasopharyngeal carcinoma patients, and the general characteristics of different types of patients were analyzed.  Results  A total of 156 patients were selected. The symptoms with a high incidence rate were hyposexuality (52.6%), dry mouth (50.6%), and dental problems (39.7%) one year after radiotherapy in nasopharyngeal carcinoma patients. Among them, the severity of dry mouth [2.00 (1.0, 2.0) points] and hyposexuality [1.5 (1.0, 2.0) points] were higher. The symptom characteristics of nasopharyngeal carcinoma patients could be divided into three latent classes, which were named low symptom response group (77.56%), high physical symptoms response group (12.18%), and emotional psychological distress group (10.26%). One-way ANOVA showed that there were significant differences in education level, BMI, and radiation therapy methods among the three types.  Conclusion  The symptoms of nasopharyngeal carcinoma patients receiving intensity-modulated radiation therapy during home rehabilitation include three latent classes. Medical workers should identify the latent class to provide continuous symptom follow-up management and psychological counseling intervention for patients, reduce the physical and mental symptoms of patients and psychological counseling interventions, improve the quality of life of patients during home rehabilitation, and promote rehabilitation.
Effect of teamwork nursing based on the Green model in gallbladder surgery
JIANG Hanyan, WU Keren
2024, 22(5): 887-891. doi: 10.16766/j.cnki.issn.1674-4152.003527
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  Objective  To explore the application value of team collaboration nursing based on the Green model in gallbladder surgery, in order to provide theoretical guidance for the selecting clinical nursing plans for clinical gallbladder surgery.  Methods  A total of 90 patients with gallbladder diseases admitted to the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2021 to July 2023 were included in the study. Among them, 8 patients were diagnosed with gallbladder cancer, and all patients underwent gallbladder surgery. The patients were randomly divided into a control group (45 cases) and a study group (45 cases) using a random number table method. They received routine nursing in the control group, and routine nursing combined with team cooperation nursing following the Green model in the study group. The exercise of self-care agency scale (ESCA) scores, nutritional index levels serum albumin (ALB), transferrin (TRF), total serum protein (TSP), psychological state scores self-rating anxiety scale (SAS), and self-rating depression scale (SDS), were compared between the two groups before and after nursing.  Results  Before nursing, there was no statistically significant difference in the ESCA scores in all dimensions between the two groups (P>0.05). After nursing, both groups showed increased ESCA scores in all dimensions compared to before nursing (P<0.05), with the study group demonstrating higher scores than the control group (P<0.05). Before nursing, there was no statistically significant difference in ALB, TSP and TRF between the two groups (P>0.05). After nursing, the ALB, TSP and TRF in the study group were higher than those in the control group (P<0.05). Before nursing, there was no statistically significant difference in SAS and SDS scores between the two groups (P>0.05). After nursing, the study group had lower SAS [(20.98 ±5.27) points] and SDS [(23.67±4.75) points] compared to the control group SAS, SDS [(33.04±6.94) points, (35.35±6.64) points, P<0.05].  Conclusion  The team collaboration nursing of the Green model can enhance the patient' s knowledge, belief and practice levels, improve their nutritional index levels and negative psychological states. It possesses significant comprehensive application value and is recommended for clinical promotion.
The construction of sensitive index of nursing specialty is to prevent gynecological malignant tumor in perioperative period application effect in venous thromboembolism
SHI Huihui, PENG Zhengyan, YANG Bo, HOU Senmei, YUAN Yuan, GUI Guan, YUAN Tingting, SONG Qianjie
2024, 22(5): 892-895. doi: 10.16766/j.cnki.issn.1674-4152.003528
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  Objective  To explore the application value of nursing specialty quality-sensitive indexes in the prevention of perioperative venous thromboembolism (VTE) in gynecological malignant tumors, and to provide evidence for the clinical prevention of venous thromboembolism.  Methods  A total of 219 patients requiring surgery for gynecological malignant tumors admitted to the First Affiliated Hospital of Bengbu Medical University from January to December 2022 were selected as the study objects, and 111 patients admitted from January to June were selected as the control group. Traditional methods were used to perform VTE preventive measures in perioperative patients to implement nursing quality control. A total of 108 patients admitted from July to December were assigned to the observation group. The sensitive indexes of specialized nursing quality were established for VTE preventive measures to implement quality control. The effect of perioperative VTE prevention in the two groups of patients was evaluated, and the accuracy of VTE standard screening, VTE knowledge awareness, functional exercise implementation, physical prevention implementation, anticoagulant drug implementation, VTE incidence and satisfaction of patients were compared between the two groups.  Results  Control group and observation group VTE standard screening accuracy rate (75.68% vs. 87.96%), VTE-related knowledge awareness rate (78.38% vs. 88.89%), functional exercise implementation accuracy rate (83.78% vs. 91.67%), physical prevention implementation accuracy rate (72.97% vs. 86.11%). The correct rate of anticoagulant drug execution (81.08% vs. 91.67%), the incidence of VTE (9.91% vs. 1.85%), and patient satisfaction (76.58% vs. 91.67%) were statistically significant differences between the two groups (P<0.05), and the results of various indicators in the observation group were better than those in the control group.  Conclusion  The construction of a nursing specialty quality sensitive index has a good effect in preventing perioperative VTE of gynecological malignant tumors, which can reduce the incidence of VTE, improve patient satisfaction and optimize clinical nursing quality, and recommend clinical application.
Effect of sucrose solution combined with non nutritive sucking on pain response of premature infants undergoing venipuncture
LIN Ling, WU Longyan
2024, 22(5): 896-899. doi: 10.16766/j.cnki.issn.1674-4152.003529
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  Objective  To explore the effect of non nutritive sucking combined with sucrose solution on alleviating pain response during venous puncture in premature infants, providing a convenient and effective analgesic strategy for improving clinical care of premature infants.  Methods  A total of 114 premature infants admitted to the neonatal department of Children' s Hospital of Nanjing Medical University from October 2021 to October 2022 were selected and randomly divided into two groups using a random number table method, with 57 cases in each group. Both groups were subjected to venous puncture for blood collection, while the control group was subjected to non nutritive sucking intervention before puncture, and the study group was combined with sucrose solution intervention on this basis. The changes in pain degree, heart rate, blood oxygen saturation, salivary catecholamine concentration and salivary cortisol concentration before and after puncture were compared between the two groups.  Results  The pain score during puncture in the study group was (5.67±1.02) points, which was lower than that of the control group [(9.73±1.28) points, P<0.05]. The heart rates of the study group during puncture and 5 minutes after puncture were (150.74±5.16) beats/min and (145.17±7.29) beats/min, respectively, which were lower than those of the control group [(165.09±5.33) beats/min and (160.75±9.36) beats/min, P<0.05]. The blood oxygen saturation during puncture and 5 minutes after puncture in the study group were (94.40±0.23)% and (94.48±0.37)%, respectively, which were higher than those in the control group [(94.02±0.44)% and (94.16±0.25)%, P<0.05]. There was no statistically significant difference in the concentration of salivary catecholamines or salivary cortisol between the study group and the control group at the time of puncture, 5 minutes after puncture, and 20 minutes after puncture (P>0.05).  Conclusion  Sucrose solution combined with non nutritive sucking effectively alleviate the pain response to venous puncture in premature infants and stabilize the vital signs.
Acquired hemophilia following haploidentical hematopoietic stem cell transplantation for acute lymphoblastic leukemia in children: one case report and literature review
JING Zhaohe, WANG Yingjie, MAI Yumiao, SUN Pan, DONG Pengpeng, LIU Jian
2024, 22(5): 900-902. doi: 10.16766/j.cnki.issn.1674-4152.003530
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Acquired hemophilia (AH) is a rare disease caused by autoantibodies against factors. We reported a case of acute lymphoblastic leukemia (T-lineage, high-risk) in a child who developed acquired hemophilia after haploidentical hematopoietic stem cell transplantation (paternal donor, HLA 5/10) and reviewed the relevant literature. Laboratory tests showed decreased coagulation factor Ⅸ activity (FⅨ: C), FⅪ: C, and FⅫ: C, and an elevated FⅨ inhibitor titer, which is rare the clinic. After diagnosis, the child was treated with methylprednisolone in combination with cyclosporine A. With improvement of symptoms, the patient was discharged and continued to take cyclosporine A and methylprednisolone regularly. Four months after discharge, symptoms recurred, and the treatment regimen was changed to double-dose methylprednisolone combined with cyclosporine A immunosuppressive therapy, and the child was discharged with improvement. There was no recurrence of symptoms until March 2023.

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