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2025 Vol. 23, No. 2

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General Practice Forum
Development and reflection on the integration of traditional Chinese and Western medicine in public health services under the background of the healthy China strategy
ZHANG An, LUO Xin, LIANG Jingming, BAO Yong
2025, 23(2): 175-178. doi: 10.16766/j.cnki.issn.1674-4152.003861
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The application and development of integrated Chinese and Western medicine in the field of public health services is of great significance for improving the health level of the whole people and realizing a healthy China. This paper discusses the opportunities and challenges of integrated Chinese and Western medicine in the current development of public health, and puts forward some thoughts and prospects for the future development. Chinese medicine theory emphasizes the holistic concept and treatment based on pattern differentiation, focusing on prevention as the mainstay, and the idea of treating the unhealthy in upper medicine, which has distinctive application advantages in public health services. In China' s Action for a Healthy China (2019-2030), which focuses on the prevention and control strategies of four major chronic diseases, namely cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases and diabetes, it is particularly important to integrate traditional Chinese medicine into the prevention and control of chronic diseases and health management. This paper summarizes and analyzes the important position and inevitability of the development of integrated Chinese and Western medicine in China' s health policy in various historical periods since the founding of New China, as well as the important achievements and practical experience in the field of public health. In the context of the strategy of healthy China, the importance of integrated Chinese and Western medicine in disease prevention, control and chronic disease health management has become increasingly prominent, and it also faces challenges such as how to better integrate traditional Chinese and Western medicine resources, improve service continuity, and enhance service convenience and comfort. By effectively dealing with the current challenges, the deepening and development of integrated Chinese and Western medicine can be further promoted. This paper proposes that to achieve high-quality development of public health, we must focus on the concept of combining Chinese and Western medicine, give full play to the inherent characteristics of traditional Chinese and Western medicine theory and discipline, combine modern information technology and artificial intelligence technology, improve the ability of accurate health management of public health, and train public health talents with the characteristics of integrated Chinese and Western medicine in a new era. It will provide important support and lasting impetus for achieving universal health and promoting a healthy China.
Expert Consensus
Expert consensus on traditional Chinese and Western medicine rehabilitation strategy and clinical application for spastic paralysis after stroke
2025, 23(2): 179-185. doi: 10.16766/j.cnki.issn.1674-4152.003862
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Stroke is known as a " four-high" disease, characterized by a high incidence, high mortality, high disability rate, and high recurrence rate. The incidence of spastic paralysis after stroke reaches 50%. If improperly treated or left untreated, the spastic state may become permanently fixed. This not only leads to pain and stiffness in the affected limbs but also results in muscle atrophy, joint contractures, deformities, and limited range of motion, ultimately causing disability (with a disability rate as high as 75%). Relieving spasticity is the key and difficult point in the rehabilitation of stroke-induced hemiplegia, and it directly influences the effectiveness of recovery outcomes. In order to address this key and difficult point, the Writing Group of Expert Consensus on traditional Chinese and Western medicine rehabilitation for stroke formulated this expert consensus based on clinical practice, combining holistic treatment with individualized rehabilitation. The rehabilitation of spastic paralysis of limbs after stroke should be centered on integrated traditional Chinese and Western medicine, combined with multidisciplinary teams such as rehabilitation department and acupuncture and moxibustion department, and comprehensively managed from diagnosis, western medical treatment, traditional Chinese medicine treatment, acupuncture therapy, massage therapy, rehabilitation therapy, evaluation indicators, and prevention and regulation, fully drawing on both domestic and international clinical practice experience to leverage the distinctive features and advantages of traditional Chinese medicine, which has demonstrated clear clinical efficacy and holds significant potential for further development.
Special Topic/ Chronic Obstructive Pulmonary Disease
Association of uric acid with COPD and pulmonary ventilation based on Mendelian randomization method
YAN Jiawen, JI Junzhu, HAN Ruiting, YU Haibin
2025, 23(2): 186-189. doi: 10.16766/j.cnki.issn.1674-4152.003863
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  Objective   Relevant studies have indicated a correlation between blood uric acid (UA) levels and the occurrence and progression of chronic obstructive pulmonary disease (COPD) and pulmonary obstruction; In this study, Mendelian randomization analysis is used to further explore the causal relationship between them.  Methods   The gene loci related to COPD, blood uric acid, and pulmonary ventilation were screened from the aggregated data of genome-wide association studies and used as instrumental variables to conduct Mendelian randomization analysis using various analysis methods such as IVW. MR-PRESSO, MR-Egger intercept and, leave-one-out methods were used to analyze the sensitivity of relevant gene loci.  Results   IVW results showed no causal relationship between UA and the occurrence of COPD (OR = 1. 053, 95% CI: 0. 932-1. 189, P = 0. 406), and neither MR-PRESSO nor MR-Egger observed horizontal polymorphism and heterogeneity. No significant association between UA and first second forced expiratory volume ratio of the measured value to the predicted value (FEV1%) changes (β = -0. 006, P = 0. 686), No significant association between UA and FEV1 / forced vital capacity (FVC) changes (β = -0. 004, P = 0. 323), and horizontal polymorphism and heterogeneity were observed for MRPRESSO and MR-Egger, however, after excluding SNPs with horizontal pleiotropy, the results still showed no significant association (UA-FEV1% P = 0. 412, UA-FEV1 / FVC P = 0. 303). No significant changes in the above causal relationships were observed after the relevant gene loci were removed one by one by the leave-one-out method.  Conclusion   The results of this study show that UA is positively correlated with the development of COPD and negatively correlated with changes in FEV 1% and FEV1 / FVC, but none of these is a correlate causal relationship.
Predictive value of hs-CRP to albumin ratio for weaning failure in COPD patients with respiratory failure
XU Xiaomin, YU Hongyan, XU Maohua, HAN Lifeng
2025, 23(2): 190-193. doi: 10.16766/j.cnki.issn.1674-4152.003864
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  Objective   By analyzing the relationship between high-sensitivity C-reactive protein (hs-CRP) and albumin (Alb) and the failure of weaning in patients with respiratory failure and chronic obstructive pulmonary disease (COPD), the predictive value of weaning failure in this disease is analyzed.  Methods   A retrospective analysis was conducted on 242 patients with respiratory failure COPD at Chun ' an Branch of Zhejiang Provincial People ' s Hospital from October 2022 to October 2023. The cases were were divided into a successful weaning group (180 cases) and a failed weaning group (62 cases) based on the weaning outcome. Univariate analysis was used to analyze the general information of two groups of patients, and multiple logistic regression analysis was used to analyze the influencing factors of weaning failure in COPD patients with respiratory failure. ROC curves were plotted to analyze the predictive value of hsCRP to Alb ratio for weaning failure in COPD patients with respiratory failure.  Results   The age, acute physiology and chronic health score (APACHE Ⅱ), hs-CRP, hs-CRP to Alb ratio, incidence of gastrointestinal dysfunction, mechanical ventilation time, and Alb level of patients in the successful weaning group were lower than those in the failed weaning group (P < 0. 05), the duration of mechanical ventilation was shorter than that of the failed weaning group and the Alb levels were higher than that of the failed weaning group (P < 0. 05). Older age, high APACHE Ⅱ score, and high hs-CRP to Alb ratio are all risk factors for failed weaning in COPD patients with respiratory failure. The ROC curve results showed that age, APACHE Ⅱ, hs-CRP to Alb ratio had AUC values of 0. 735, 0. 716, and 0. 927 for the failure of weaning in COPD patients with respiratory failure, among them, the hs-CRP to Alb ratio had the highest predictive value.  Conclusion   The occurrence of weaning failure in COPD patients with respiratory failure is related to the increase in the ratio of hsCRP to Alb, which can serve as an early predictor of weaning failure.
Prioritizing lung health: Achieving effective prevention and treatment of chronic obstructive pulmonary disease
WANG Yan, YAN Wei
2025, 23(2): 194-197. doi: 10.16766/j.cnki.issn.1674-4152.003865
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Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease. It is characterized by high incidence, disability, and mortality rates. It is considered to be one of the main causes of morbidity and mortality worldwidely. It contributes significantly to the economic and caregiving burdens on individuals, families, and society. The substantial burden of COPD has been widely recognized as a major global public health issue. However, the widespread lack of diagnosis and misdiagnosis lead to many patients either not receiving treatment or receiving inappropriate care, further complicating the prevention and control of COPD. Chronic obstructive pulmonary disease is a common, preventable, and treatable disease. It is currently believed that early detection, diagnosis, and intervention are crucial in the prevention and treatment of COPD, and can lead to significant improvements in public health. However, with the aging population and the increasing incidence of COPD in recent years, the current global diagnosis and treatment of COPD remains concerning. In China, public awareness of chronic obstructive pulmonary disease is low, and primary healthcare providers lack the necessary knowledge and prevention skills related to COPD. This significantly hampers the early, standardized prevention and treatment of COPD. This article discusses the current situation of prevention and treatment of chronic obstructive pulmonary disease in China and advocates for increased attention to lung health. Early screening, diagnosis, and intervention should be carried out for individuals with respiratory symptoms, such as chronic cough and shortness of breath, as well as high-risk factors for COPD. Timely referrals should be made, and in collaboration with respiratory specialists at tertiary hospitals, closed-loop management should be completed to established to ensure optimal lung health. The aim is to provide a framework for early prevention, diagnosis, and timely, appropriate treatment and intervention of COPD, ultimately opening new opportunities for improved care.
General Practice Research
Application of interprofessional shared decision-making model for twin pregnancy
WANG Fengying, ZHANG Chong, YIN Zongzhi, JIANG Nan, QIAN Yue, ZHAO Baojing, SI Fangyuan
2025, 23(2): 198-202. doi: 10.16766/j.cnki.issn.1674-4152.003866
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  Objective  To explore the effectiveness of interprofessional shared decision-making model for pregnant women with twins and to provide reference for promoting shared decision-making in clinical practice.  Methods  A total of 108 cases of pregnant women with twins in the Second Ward of Obstetrics, the First Affiliated Hospital of Anhui Medical University were selected as research objects and divided into a control group and an observation group randomly, with 54 cases in each group. The control group was guided by conventional intervention methods during pregnancy, while the observation group participated in the interprofessional shared decision-making model in addition to the standard care. The adverse outcomes of perinatal infants, level of participation in clinical decision-making, satisfaction with medical decisionmaking, and hospital anxiety and depression were compared between the two groups.  Results  After the intervention, the incidence of inconsistent twin growth, low birth weight, and hypoglycemia showed significant differences between the two groups (P < 0. 05). The SDM-Q-9 scores were significantly higher in the observation group (40. 50±6. 25) than in the group (25. 24±4. 18, P < 0. 001). The satisfaction score of medical decision-making participation in the observation group was also significantly higher, with a score of 68. 17±9. 50 compared to 45. 83±11. 38 in the control group (P < 0. 001). The hospital anxiety and depression scores were significantly lower in the observation group [3. 00(2. 00, 4. 00)] compared to the control group [7. 00(6. 00, 8. 00), P < 0. 001].  Conclusion  Participation in the interprofessional shared decision-making model can improve perinatal adverse outcomes, increase participation in clinical decision-making and satisfaction in medical decisions, and reduce anxiety and depression in pregnant women.
Expression of LncRNA-DGCR5 in non-small cell lung cancer and its correlation with radiotherapy efficacy and prognosis
HAN Kang, JING Wenjiang, WU Yongsheng, LI Yuan, FAN Zhigang
2025, 23(2): 203-206. doi: 10.16766/j.cnki.issn.1674-4152.003867
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  Objective  To investigate the expression and clinical significance of LncRNA-DGCR5 in non-small cell lung cancer (NSCLC).  Methods  A total of 105 NSCLC patients admitted to 3201 Hospital from January 2020 to January 2021 were collected. The expression levels of LncRNA-DGCR5 were detected, and the patients were divided into a low expression group (n = 41) and a high expression group (n = 64). The relationship between the expression level of LncRNADGCR5, the radiotherapy efficacy, and prognosis of patients was analyzed.  Results  The expression level of LncRNADGCR5 in cancer tissues was significantly lower than that in adjacent tissues (1. 21±0. 45 vs. 4. 02±0. 89, t = 28. 872, P < 0. 05). Compared with the high expression group, the proportion of poorly differentiated tumor and TNM stage Ⅲ to Ⅳ in the low expression group was higher (63. 41% vs. 17. 19%, 56. 10% vs. 32. 81%, χ2 = 23. 401, 5. 566, P < 0. 05). In contrast to the high expression group, the objective response rate was lower (46. 34% vs. 87. 50%, χ2 = 27. 648, P < 0. 05), and the 3-year disease-free survival (DFS) was shorter (27. 00 months vs. 31. 00 months, log-rank χ2 = 10. 120, P < 0. 05) in the low expression group. Additionally, patients with low tumor differentiation, TNM stage Ⅲ to Ⅳ, and lymph node metastasis had lower median DFS (28. 15, 28. 66, 27. 45 months, respectively, χ2 = 9. 074, 5. 105, 12. 116, all P < 0. 05). Tumor differentiation, TNM stage, lymph node metastasis, and LncRNA-DGCR5 expression were all significantly associated with median DFS in NSCLC patients (P < 0. 05).  Conclusion  LncRNA-DGCR5 is expressed at low levels in NSCLC tissues and is closely related to the radiotherapy efficacy and patient prognosis.
Correlations between miR-223/ mTOR/ S6K pathway and the activity of rheumatoid arthritis and antibody levels
BAI Wenhua, LI Xiangpei, LIU Juan, LIU Yan, JIANG Zhen
2025, 23(2): 207-210. doi: 10.16766/j.cnki.issn.1674-4152.003868
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  Objective  To investigate the expression levels of miR-223 and the mTOR / S6K pathway in synovial tissues of rheumatoid arthritis (RA) and their correlation with disease activity and antibody levels.  Methods  A total of 17 RA patients who were hospitalized in the Department of Rheumatology and Immunology of Huaian First People' s Hospital from January 2016 to December 2017 with moderate to severe disease RA were selected, along with 9 patients hospitalized for knee osteoarthritis (OA) surgery as controls. The synovial tissue from the knees of RA patients was obtained under the guidance of ultrasound, while tissue from OA patients were obtained by orthopedic surgeons. The expression levels of mTOR, S6K, RPS6 mRNAs, and miR-223 level in the synovial tissue were detected by qRT-PCR. Differences in miR-223 level and mRNA levels of mTOR, S6K, and RPS6 between the two groups were compared. The correlations between the level of miR-223 and the mRNA levels of mTOR, S6K, and RPS6, as well as anti-CCP antibody and disease activity indicators, were analyzed in the RA group.  Results  The miR-223 level in the RA group was significantly increased compared with the OA group (P < 0. 001), while the mRNA levels of S6K and RPS6 in the RA group were significantly decreased compared with the OA group (P < 0.05), There was no statistically significant difference in the expression level of mTOR mRNA between the RA group and the OA group. The miR-223 level in the RA group was negatively correlated with the mRNA levels of S6K and RPS6 (P < 0.05), but no significant correlation was found between miR-223 level and the level of mTOR mRNA. The levels of miR-223 and mTOR mRNA in the RA group were negatively correlated with the serum antiCCP antibody level (P < 0.05), while the level of RPS6 mRNA was positively correlated with the anti-CCP antibody level (P=0.009). The miR-223 level in the RA group was positively correlated with the serum CRP level (P=0.043), There was no correlation between the mRNA levels of RPS6, mTOR, and S6K and the CRP level.  Conclusion  An abnormal miR-223/ mTOR / S6K pathway exists in the synovial tissue of RA knee joints, correlating with the levels of anti-CCP antibody and CRP, indicating the potential pathways for further research into the pathogenesis of RA.
Construction and validation of a Nomogram model for assessing the risk of multidrug-resistant pulmonary tuberculosis infection in young people
HE Fang, WANG Shu, XIA Wenjuan, HUANG Pengfei, WANG Hua
2025, 23(2): 211-214. doi: 10.16766/j.cnki.issn.1674-4152.003869
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  Objective  This study aims to explore the risk factors for multidrug-resistant infections in young tuberculosis patients and construct a risk Nomogram model for assessing the incidence risk of multidrug-resistant tuberculosis.  Methods  From January 2019 to December 2021, 203 young patients with pulmonary tuberculosis were admitted to Anhui Chest Hospital, and their clinical data were collected. Using a random number table, the patients were divided into a validation group of 67 patients and a modeling group of 136 patients. Among them, there were 75 drug-resistant cases and 61 non-drug-resistant cases. Lasso regression and logistic regression were employed to analyze the risk factors for drug resistance in young pulmonary tuberculosis patients, following which a Nomogram prediction model was constructed and validated.  Results  Logistic regression analysis showed pulmonary cavitary lesions, innutrition, elevated glycosylated hemoglobin, positive sputum smear microscopy, and low income as independent risk factors for multidrug-resistant infection in young pulmonary tuberculosis patients. Using these risk factors, a Nomogram predictive model was constructed, with an area under the curve of 0. 904 for the modeling group and 0. 743 for the validation group, indicating good diagnostic accuracy. Hosmer-Lemeshow test results indicated no significant difference between the observed and model-predicted risks in both the modeling and validation datasets (P = 0. 438, 0. 733), suggesting good model fit and consistency with actual infection risks.  Conclusion  The Nomogram model, established using Lasso logistic regression analysis, exhibits high predictive capability for multidrug-resistant infection in young pulmonary tuberculosis patients. This enables prompt implementation of early intervention measures, ultimately improving prognosis.
Analysis of clinical characteristics and risk factors of severe COVID-19 patients in the post-epidemic stage
ZHANG Lingling, WANG Muqun, GUO Feng
2025, 23(2): 215-218. doi: 10.16766/j.cnki.issn.1674-4152.003870
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  Objective  To analyze the clinical features of patients infected with Coronavirus disease 2019 (COVID-19), and to explore reliable clinical indicators for predicting high-risk populations that are likely to progress to severe cases.  Methods  A retrospective analysis was conducted on 85 patients with confirmed diagnosis of SARS-CoV-2 infection treated at the Department of Respiratory and Critical Care Medicine at the Suzhou Hospital of Anhui Medical University from December 2022 to February 2024. Patients were categorized according to the severity of their clinical symptoms, resulting in the formation of two distinct groups: the non-severe group (n = 47) and the severe group (n = 38). The differences in clinical characteristics, blood routine, C-reactive protein (CRP) and T lymphocyte subsets between the two groups were compared. Logistic regression analysis was applied to identify the risk factors of the severe group and a predictive model was constructed. The receiver operating characteristic (ROC) curve was used to compare the predictive value of each risk factor and their combined application in predicting severity.  Results  A comparison of the non-severe group with the severe group revealed a higher incidence of comorbidities in the latter, including diabetes. Additionally, the severe group exhibited significantly lower levels of eosinophils, CD4+T lymphocytes and CD8+T lymphocytes (P > 0.05). Furthermore, a notable difference was observed in the mean BMI between the two groups. The results of the stepwise logistic regression analysis indicated that CD4+T lymphocytes, diabetes, and BMI were significant risk factors for the severe group. The area under the receiver operating characteristic curve (AUC) for CD4+T lymphocytes, BMI and diabetes were 0. 877, 0. 748 and 0. 663, respectively. The sensitivity of CD4+T lymphocytes, BMI and diabetes were 81. 6%, 60. 5% and 36. 8%, respectively; and the specificity were 85. 1%, 93. 6% and 95. 7%, respectively. The AUC for the model constructed by combining the three factors was 0. 928, the sensitivity was 97. 4% and the specificity was 76. 6%.  Conclusion  A reduced count of CD4+T lymphocytes can effectively predict the clinical severity of patients with COVID-19 alone or in conjunction with a high BMI and comorbid diabetes.
A study on the correlation between FGFR3 and TERT gene mutations and the pathological grade of urethral epithelial carcinoma
REN Ying, HE Yu, LI Ping
2025, 23(2): 219-222. doi: 10.16766/j.cnki.issn.1674-4152.003871
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  Objective  To investigate the correlation between FGFR3and TERT gene mutations and the pathological grade of urethral epithelial carcinoma, aims to provide some reference for exploring the publication mechanism of the disease.  Methods  A total of 150 patients with urothelial carcinoma hospitalized in the department of Urology at the Affiliated People's Hospital of Ningbo University from January 2021 to March 2023 were selected as the study subjects.Fifteen healthy subjects were selected as the control group.Genomic DNA was extracted, and FGFR3 and TERT gene polymorphisms were analyzed by real-time PCR.The relationship between the cytopathological diagnostic grade was explored.  Results  The DNA content of FGFR3 exons 7, 10, and 15 was higher in the experimental group than the control group (P < 0.05).The HIT group (T1, T2, T3, T4, and Tis) showed higher DNA content than the LIT group (Ta, P < 0.05).The DNA content of FGFR3 exons 7, 10, and 15 increased gradually with rising tumor malignancy in the experimental group.For the TERT promoter, the proportion of wild type in C228T and C250T polymorphisms decreased as tumor malignancy increased: Ta (5/8, 62.5%), T1(11/29, 37.9%), T2(9/40, 22.5%), T3(7/28, 25.0%), T4(7/27, 25.9%), and Tis (4/18, 22.2%).The HIT group (T1, T2, T3, T4 and Tis) showed C228T mutations, C250T mutations, and C228T+C250T double mutations.  Conclusion  The DNA content of FGFR3 exons 7, 10, and 15, along with the C228T and C250T polymorphisms of the TERT promoter, correlates with the pathological grade of urothelial carcinoma pathological grade.These markers can be used as biomarkers for assessing pathological grade of urothelial carcinoma.
To investigate the efficacy of idebenone combined with sertraline in the treatment of elderly patients with post-stroke depression, and its effect on cognitive function and oxidative stress
PAN Fei, XU Tong, ZHANG Jingdan, ZHAO Zheng, LI Yadi, XU Yanan, XU Yahui
2025, 23(2): 223-226. doi: 10.16766/j.cnki.issn.1674-4152.003872
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  Objective  To investigate the efficacy of idebenone combined with sertraline in elderly patients with post-stroke depression (PSD), and to analyze its effect on cognitive function and oxidative stress.  Methods  A total of 104 cases elderly patients with PSD were Seleeted and divided into a control group and study group, 52 cases in each group, and were treated with sertraline, edbenquinone combined with sertraline for 8 weeks, respectively.The Hamilton depression scale (HAMD) scores of the two groups were observed before treatment, 4 and 8 weeks after treatment.The clinical efficacy, cognitive function[mini-mental state examination (MMSE), Webster's adult memory scale (WMS-RC)], oxidative stress index[superoxide dismutase (SOD) activity, malondialdehyde (MDA) level, glutathione peroxidase (GSH-PX) activity]before and after treatment and safety were evaluated.  Results  After 4 and 8 weeks of treatment, the inter-group effect, time effect, and interaction effect were significant (P < 0.05).The HAMD score of the study group was lower than that of the control group after 4 and 8 weeks of treatment, and the HAMD score of the study group had a more obvious decreasing trend with the extension of time.The total clinical effective rate was 96.15%(50 cases) in the study group and 82.69%(43 cases) in the control group, and the study group was higher than the control group (χ2=4.981, P=0.026).Compared with before treatment, MMSE scores, long-term memory, short-term memory, immediate memory, memory quotient, serum SOD and GSH-PX activities were increased in both groups after treatment, and higher in the study group (P < 0.05).The MDA levels in the 2 groups after treatment were decreased compared with before treatment, especially in the study group (P < 0.05).There was no significant difference in the incidence of adverse reactions between the study group (9.61%, 5 cases) and the control group (5.77%, 3 cases, P>0.05).  Conclusion  The use of idbenquinone combined with sertraline in elderly PSD patients is safe and reliable in alleviating depressive symptoms, improving clinical efficacy, improving cognitive function, and alleviating oxidative stress damage.
The effect of catheter radiofrequency ablation on cardiac structure and long-term prognosis in patients with heart failure and persistent atrial fibrillation
LI Qi, LUO Guiquan, LIU Lei, TAN Zhen, REN Hongqiang
2025, 23(2): 227-230. doi: 10.16766/j.cnki.issn.1674-4152.003873
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  Objective  To investigate the impact of catheter radiofrequency ablation (RFA) on cardiac structure and long-term survival in patients with heart failure and persistent atrial fibrillation (AF).  Methods  A retrospective analysis was conducted on 379 patients with heart failure and persistent AF who were hospitalized in the Atrial Fibrillation Center of Suining Central Hospital from January 2017 to May 2019.Based on whether they underwent RFA during their hospitalization, they were further divided into two groups: the RFA group (n=33) and the control group (n=126).The baseline data of both groups were compared.All patients were followed up, and some echocardiographic indicators were compared during hospitalization and follow-up to assess the improvement of cardiac structure.Kaplan-meier survival analysis was used to evaluate the long-term survival of the RFA group and the control group.Multivariate Cox regression analysis was used to correct for confounding factors and assess the impact of RFA on long-term prognosis.  Results  The baseline data of the RFA group and the control group showed comparable results.Compared with admission, the left ventricular end-diastolic diameter and left ventricular ejection fraction in the echocardiographic indicators of the RFA group improved significantly during follow-up, with statistically significant differences (P < 0.05).Among the 4 patients in the RFA group (12.1%) and 39 patients in the control group (31.0%), events occurred at the end of follow-up.Kaplan-meier survival analysis showed that the long-term prognosis of theRFA group was better than that of the control group (P=0.049).Through multivariate Cox regression analysis, adjusting for gender, age, body mass index, left ventricular ejection fraction, and implantable cardioverter defibrillator, it was found that RFA remained an independent factor affecting long-term prognosis (HR=0.335, 95%CI: 0.116-0.964, P=0.043).  Conclusion  RFA can improve the left ventricular structure and ejection fraction in patients with heart failure andpersistent AF, and is an important factor in improving prognosis.
The correlation between IL-33, TIMP-1, MMP-2 and prognosis of chronic hepatitis B cirrhosis
ZHANG Yuting, SHEN Wei, GU Jiaping
2025, 23(2): 231-234. doi: 10.16766/j.cnki.issn.1674-4152.003874
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  Objective  To investigate the changes of serum interleukin-33(IL-33), matrix metalloproteinase-1(TIMP-1), and matrix metalloproteinase-2(MMP-2) in patients with chronic hepatitis B cirrhosis (HBC).The relationship between IL-33, TIMP-1, and MMP-2 levels and different degrees of cirrhosis and their prognostic value were analyzed.  Methods  From January 2021 to December 2022, 60 patients with HBC compensation (compensation group), 60 patients with HBC decompensation (decompensation group), and 60 patients with chronic hepatitis B without liver cirrhosis (chronic group) were selected.To analyze the relationship between serum levels of IL-33, TIMP-1, and MMP-2 and the occurrence of cirrhosis.The value of serum IL-33, TIMP-1, and MMP-2 on the prognosis of patients with chronic hepatitis B cirrhosis was evaluated by the ROC curve.  Results  The serum levels of IL-33, TIMP-1, and MMP-2 in the decompensated group were higher than those in the compensated and chronic groups (P < 0.05).The levels of IL-33, TIMP-1, and MMP-2 in the compensated group were higher than those in the chronic group (P < 0.05).Serum levels of IL-33, TIMP-1, and MMP-2 in 180 patients with chronic hepatitis B were positively correlated with cirrhosis (r=0.784, 0.691, 0.698, all P < 0.001).ROC results showed that the sensitivity of serum IL-33, TIMP-1, and MMP-2 levels to detect poor prognosis in patients with chronic hepatitis B cirrhosis were 81.25%, 81.25%, and 84.37%, and the specificity were 69.32%, 68.18%, and 71.59%, respectively.The AUC were 0.762, 0.734, and 0.830, respectively.  Conclusion  Serum IL-33, TIMP-1, and MMP-2 are highly expressed in patients with chronic hepatitis B cirrhosis, and they are positively correlated with the occurrence of cirrhosis.Especially, serum MMP-2 has a higher predictive value for poor prognosis in patients.
General Clinical Research
Impact of platelet transfusion on the prognosis of patients with sepsis: a propensity score matching analysis
WANG Qiaohong, CHEN Xingxing, ZHU Weimin, GAN Huiling, XU Xianxian, BIAN Bingbing, LI Ping, YANG Peng, SHAN Renfei, JIANG Yongpo
2025, 23(2): 235-238. doi: 10.16766/j.cnki.issn.1674-4152.003875
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  Objective  Thrombocytopenia is one of the common complications in patients with sepsis.Platelet transfusions are frequently administered to increase platelet counts, however, their clinical impacts in sepsis-induced thrombocytopenia remains unclear.This article discusses the impact of platelet transfusion on the prognosis of patients with sepsis.  Methods  Patients with sepsis admitted to the ICU of Taizhou Hospital from January 2019 to December 2021 were selected as the study subjects.According to the platelet transfusion at ICU admission, septic patients were divided into two groups: a platelet transfusion group (PT group) and a non-platelet transfusion group (NPT group).Propensity score matching (PSM 1:1) was used to balance the groups.Cox logistic regression model and Kaplan-Meier survival analysis were used to analyze the impact of platelet transfusion on the prognosis in patients with sepsis.  Results  A total of 274 patients with sepsis were included in the study, with 57 patients in the platelet transfusion group.After PSM, 38 patients were matched in each group.The primary outcomes were 28-day and 90-day mortalities, which were 31.6%(12/38) and 36.8%(14/38) in the PT group, respectively, compared to 36.8%(14/38) and 39.5%(15/38) in the NPT group, with no significant difference (P>0.05).Kaplan-Meier survival analysis showed no significant difference in the 28-day and 90-day cumulative survival rates of patients between the platelet transfusion group and the NPT group (P>0.05).The Cox logistic regression model showed the APACHE Ⅱ score (HR=1.138, 95%CI: 1.066-1.215, P < 0.05) as an independent factor influencing prognosis in sepsis patients, while platelet transfusion (HR=0.457, 95%CI: 0.182-1.146, P>0.05) was not a significant factor.  Conclusion  This study found that the APACHE Ⅱ score is an independent factor for 28-day mortality in septic patients, while platelet transfusion does not improve the prognosis of patients with sepsis.
Analysis of the progression and factors influencing postoperative acute pain in patients with thoracolumbar fracture
ZHENG Yonghong, ZHENG Mingjun, FENG Fabo
2025, 23(2): 239-242. doi: 10.16766/j.cnki.issn.1674-4152.003876
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  Objective  This study aims to analyze the progression of postoperative acute pain in patients with thoracolumbar fracture, analyze the variability in postoperative acute pain profiles, and explore factors affecting the patterns of different acute pain progression.  Methods  From April 2020 to September 2023, a total of 180 postoperative patients with thoracolumbar fractures underwent percutaneous vertebro plasty (PVP) in Chun'an Branch of Zhejiang Provincial People's Hospital were enrolled in this study.These patients were assessed using a general information questionnaire and a visual analogue pain scale.The study analyzed the potential profiles of acute pain after thoracolumbar fracture and identified the factors affecting acute pain through multivariate ordered logistic regression.  Results  The mean score of acute pain after thoracolumbar fracture operation was (6.78±1.13) points.When the number of categories is 3, the decline in AIC, BIC, and aBIC became gradual, and the P-value of LMRT exceeded 0.001, indicating that three potential profiles are appropriate: mild pain (35.54%), moderate pain (43.98%), and severe pain (20.48%).Patients with severe pain had a significantly higher proportion of BMI≥24, more than two fractured vertebral bodies, unsatisfied bone cement distribution, concurrent osteoporosis, high vertebral body recovery, and lumbar spine fracture sites compared to those in the mild pain group and moderate pain group (P < 0.05).Multivariate logistic analysis showed that more than two fractured vertebral bodies, BMI≥24, unsatisfactory bone cement distribution, lumbar vertebrae fracture sites, and high vertebral body recovery were significant factors influencing severe pain after thoracolumbar fractures (P < 0.05).  Conclusion  The level of acute pain in patients with thoracolumbar fracture after operation is high and exhibits heterogeneity.Notably, factor such as fracture vertebral bodies>2, BMI≥24, unsatisfactory body cement distribution, lumbar vertebrae fracture sites, and vertebral body recovery are significant contributors to severe pain in patients with thoracolumbar fractures after operation.
The influence of diet management under Roy adaptation theory on dietary behavior and nutritional status of maintenance peritoneal dialysis patients
PENG Dandan, CHE Tengteng, ZHOU Cong, ZHANG Ti, HAN Yeqing
2025, 23(2): 243-247. doi: 10.16766/j.cnki.issn.1674-4152.003877
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  Objective  Scientific and rational diet management is very important for patients with maintenance peritoneal dialysis.In this study, the diet management scheme of peritoneal dialysis patients was constructed based on Roy's adaptation theory, aiming to open up a new path for the diet management of dialysis patients.  Methods  A total of 189 patients receiving regular peritoneal dialysis in the Eastern Theater General Hospital from June 2020 to June 2023 were selected and divided into the control group (94 cases with conventional diet management) and the Roy group (95 cases with diet management under Roy's adaptation theory) by random number table method.The dietary knowledge, behavior, and nutritional status of the two groups were compared.  Results  The post-intervention dietary knowledge score in the Roy group was 17.88 ± 3.09, which was higher than that in the control group (14.56±3.45, P < 0.05);The scores of the renal disease adherence behavior questionnaire (RABQ), daily protein and total calorie intake, and the qualified rates of restricted water and salt were better than those of control group (P < 0.05).Serum albumin (ALB), hemoglobin (Hb) and transferrin (TRF) were (40.02±5.63) g/L, (109.31±8.22) g/L, (2.38±0.56) g/L, which were higher than that of control group[(33.56±8.09) g/L, (96.44±16.78) g/L, (1.92±0.34) g/L, P < 0.05];There was no significant difference in anthropometric indexes between the Roy group and control group (P>0.05).The incidence of malnutrition was 25.33%(19/75), which was lower than that of the control group[41.33%(31/75), P < 0.05].  Conclusion  Diet management under Roy's adaptation theory can improve the knowledge level of diet control in maintenance peritoneal dialysis patients, help to form a good diet compliance behavior, and is conducive to the improvement of nutritional status and reduce the occurrence of malnutrition.
Study on the effect of Danhu Tongbi Decoction on the improvement of glucose and lipid metabolism and heart function in type 2 diabetes patients with angina pectoris of coronary heart disease
JIA Lili, CHEN Yan
2025, 23(2): 248-252. doi: 10.16766/j.cnki.issn.1674-4152.003878
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  Objective  To explore the clinical effect of Danhu Tongbi Decoction in the treatment of type 2 diabetes with coronary heart disease (CHD) angina pectoris (accompanied by qi and yin deficiency and heart blood stasis syndrome), and its effect on the metabolism of glucose and lipid and heart function of patients.  Methods  Ninety cases of type 2 diabetes patients with CHD angina pectoris (accompanied by qi and yin deficiency and heart blood stasis syndrome) admitted from March 2021 to March 2024 were randomly divided into the control group (45 cases) and the observation group (45 cases).The control group was given Western medicine, and the observation group was given Danhu Tongbi Decoction, the efficacy of traditional Chinese medicine syndromes after treatment were evaluated, the frequency and duration of angina pectoris were recorded, the changes of blood glucose, blood lipids, myocardial injury and cardiac function indicators before and after treatment were detected, and the adverse drug reactions during treatment were observed.  Results  The overall effective rate of traditional Chinese medicine syndrome treatment in the observation group[93.33%(42/45)]was higher than the control group[73.33%(33/45), P < 0.05].After treatment, the frequency of angina attacks in the observation group decreased compared to the control group, and the duration of a single attack[(3.23±0.54) min]was shortened compared to the control group[(4.18±0.69) min, F=16.134, P < 0.001].After treatment, the fasting blood glucose (FPG), 2-hour postprandial blood glucose (PBG), and glycated hemoglobin (HbA1c) in the observation group were all lower than those in the control group (P < 0.001).After treatment, the total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) in the observation group were all lower than those in the control group (P < 0.001).After treatment, the left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) in the observation group were lower than those in the control group, while the left ventricular ejection fraction (LVEF) was higher than that in the control group (P < 0.001).After treatment, the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and homocysteine (Hcy) in the observation group were lower than those in the control group (P < 0.001).  Conclusion  On the basis of Western medicine, Danhu Tongbi Decoction can effectively relieve the traditional Chinese medicine syndromes and clinical symptoms of angina pectoris in type 2 diabetes patients with CHD angina pectoris, and improve the level of glucose lipid metabolism and cardiac function.
Analysis of therapeutic effect of added flavor of Maxing Shigan Decoction combined with acupoint application in the treatment of Mycoplasma pneumoniae pneumonia in children
ZHOU Fangfang, SHANG Lili, WANG Jiejie
2025, 23(2): 253-256. doi: 10.16766/j.cnki.issn.1674-4152.003879
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  Objective  To explore the clinical efficacy and safety of combing traditional Chinese medicine internal treatment and external treatment (Maxing Shigan Decoction combined with acupoint application) in the treatment of Mycoplasma pneumoniae pneumonia in children.  Methods  A retrospective analysis was conducted on 108 children with Mycoplasma pneumoniae pneumonia admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine between January 2023 and May 2024.The participants were divided into an observation group and a control group using the random number table method, with 54 cases in each group.The children in each group were treated with conventional Western medicine.The observation group was treated with Maxing Shigan Decoction combined with Feishu acupoint application on the basis of the control group for 7-14 days.The study assessed the improvement in traditional Chinese medicine (TCM) syndrome scores, clinical symptoms (cough, fever, and lung rales), length of hospital stay, clinical efficacy, incidence of RMPP and SMPP, adverse drug reactions, and serum inflammatory factor levels.  Results  The observation group showed a significantly lower TCM syndrome score compared to the control group (P < 0.05).The observation group also showed shorter remission time of cough, disappearance of pulmonary rales, duration of fever, and a shorter length of hospital stay, compared to the control group (P < 0.05).There was significant difference in clinical efficacy between the two groups (Z=-2.392, P=0.017).The observation group showed higher levels of IL-6, CRP, and PCT compared to the control group (P < 0.05).There was no significant difference in the occurrence of RMPP and SMPP between the two groups (P>0.05).No statistically significant difference was observed in the incidence of adverse drug reactions between the two groups (P>0.05).  Conclusion  The combined application of Maxing Shigan Decoction and acupoint application in the treatment of Mycoplasma pneumoniae pneumonia in children effectively reduces inflammation in the body, improves clinical symptoms, lowers TCM syndrome scores, with a significant therapeutic effect and good safety profile.
The correlation between uterine artery ultrasound parameters, serum PIGF level and the risk of preeclampsia during pregnancy
LI Min, ZHENG Shumin, ZHANG Hongxia, DAI Chengcheng, LIU Chao, YU Peng
2025, 23(2): 257-260. doi: 10.16766/j.cnki.issn.1674-4152.003880
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  Objective  To analisis significance of uterine artery ultrasound parameters and serum placental growth factor (PIGF) levels in preeclampsia patients.  Methods  A total of 80 pregnant women with preeclampsia admitted to Dezhou Hospital of Qilu Hospital of Shandong University from January 2022 to December 2023 were included as the observation group and were divided into mild/severe preeclampsia subgroup, and 30 healthy pregnant women during the same period were included as the control group.The ultrasonic parameters of uterine artery[resistance index (RI), pulse index (PI), systolic to diastolic flow velocity ratio (S/D)]and serum PIGF levels were compared; The correlation between uterine artery ultrasound parameters, PIGF, and preeclampsia was analyzed by logistic regression; The receiver operating characteristic curve (ROC) were used to evaluate the value of uterine artery ultrasound parameters and PIGF in the severity of preeclampsia.  Results  RI (0.62±0.12), PI (1.64±0.32) and S/D (0.58±0.18) in the observation group were higher than those in control group (0.56±0.10, 1.30±0.17, 0.46±0.18), but serum PIGF[(33.24±7.36) pg/mL]was lower (P < 0.05);RI, PI, and S/D were risk factors for preeclampsia, and PIGF was a protective factor (P < 0.05).There were 25 mild cases and 55 severe cases in the observation group.RI, PI, and S/D in the severe preeclampsia subgroup were significantly higher, and PIGF was significantly lower (P < 0.05);The area under the curve (AUC) of RI and PI in evaluating the severity of preeclampsia were 0.565 and 0.568(P>0.05), and those of S/D, PIGF, and combined detection were 0.685, 0.648, and 0.774, respectively (P < 0.05).  Conclusion  RI, PI, and S/D in pregnant women with preeclampsia increase, but serum PIGF levels decrease, which is associated with the onset of preeclampsia, and the combined detection can assess the severity of preeclampsia.
Expression changes and clinical significance of CST1 in children with asthma
LI Ling, YANG Min, LIU Wenchun
2025, 23(2): 261-264. doi: 10.16766/j.cnki.issn.1674-4152.003881
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  Objective  To investigate the expression of cysteine protease inhibitor SN (CST1) in peripheral blood of childhood asthma and its clinical significance.  Methods  Fifty-two asthma children (observation group) and 52 health were selected in Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi from May 2021 to September 2022. Peripheral venous blood was taken in the observation group and control group on the day after admission, and the expression of serum CST1, IFN-γ, IL-33, IL-4, and IL-13 was detected by ELISA. Spearman correlation analysis was used to analyze the correlation between serum CST1 expression and children-asthma control test (C-ACT) score, IL-33, IL-4, and IL-13 levels. The ROC curve was used to evaluate the diagnostic efficacy of CST1 expression in asthma children.  Results  Compared with the control group, the expression of CST1 protein in the serum of the observation group was significantly increased (P < 0.01). Spearman correlation analysis showed that CST1 expression was negatively correlated with C-ACT score in the observation group (r=-0.601, P < 0.001) and was negatively correlated with IFN-γ expression (r=-0.413, P=0.002). The expression of CST1 was positively correlated with the levels of serum IL-33 (r=0.416, P=0.002), IL-4 and IL-13 (r=0.542, P < 0.001; r=0.425, P=0.002). ROC curve analysis showed that the AUC of serum CST1 expression in the diagnosis of childhood asthma was 0.876 (95% CI: 0.807-0.945), and its cut-off value was 944 pg/mL, with a sensitivity of 90.4% and specificity of 61.5%. The AUC of predicting the severity of the disease by CST1 expression in serum was 0.711 (95% CI: 0.568-0.854), and the cutoff value was 1 404 pg/mL, with a sensitivity of 70.4% and a specificity of 68.0%.  Conclusion  The expression of CST1 protein in the serum of asthma children is increased, and it is correlated with C-ACT score, serum IL-33, IL-4, and IL-13. Serum CST1 expression can be used as a biological indicator for the diagnosis and severity of childhood asthma.
Improvement effect of manual lactation combined with Fire Dragon Jar on pain levels and inflammatory responses in patients with acute mastitis during lactation
ZHOU Jie, ZHANG Binbin, YU Lili, ZONG Yanyan
2025, 23(2): 265-268. doi: 10.16766/j.cnki.issn.1674-4152.003882
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  Objective  This study aims to explore the therapeutic effect of manual lactation combined with Fire Dragon Jar on acute mastitis during lactation, focusing on improvements in pain and inflammatory response to provide a reference for clinical treatment.  Methods  A total of 117 patients with acute mastitis during lactation at Tiantai Traditional Chinese Medicine Hospital from January 2023 to June 2024 were randomly divided into the group A (58 cases) and the group B (59 cases). The group A received simple manual lactation treatment, while the group B received manual lactation combined with Fire Dragon Jar. The study measured traditional Chinese medicine (TCM) syndrome scores (including skin redness, breast pain, lump size and number, number of abscesses, and body temperature), pain severity (VAS score), inflammatory response (white blood cell count, neutrophil count, C-reactive protein), TCM syndrome efficacy, and overall efficacy of two groups.  Results  After treatment, TCM syndromes decreased significantly in both groups (P < 0.05), with group B exhibiting lower scores than group A (P < 0.05). VAS scores also decreased in both groups (P < 0.05), and the VAS scores of the group B were lower than those of the group A after treatment (P < 0.05). Additionally, the white blood cell count, neutrophil count, and C-reactive protein in both groups decreased (P < 0.05), and the white blood cell count, neutrophil count, and C-reactive protein in the group B were lower than those in the group A after treatment (P < 0.05). The total effective rate for traditional Chinese medicine syndrome treatment in the group B was 96.61% (57/59), significantly higher than the group A of 84.48% (49/58, P < 0.05). The total effective rate for the group B comprehensive therapeutic effect was 93.22% (55/59), also higher than the group A of 79.31% (46/58, P < 0.05).  Conclusion  The combination of manual lactation and Fire Dragon Jar is effective in treatment of acute mastitis during lactation, alleviating symptoms, reducing pain, and decreasing inflammatory reactions. This approach is recommended for clinical practice.
Clinical observation of fiberoptic bronchoscopy bronchoalveolar lavage in the treatment of refractory Mycoplasma pneumonia pneumonia in children
JIANG Meihong, YUAN Chen
2025, 23(2): 269-272. doi: 10.16766/j.cnki.issn.1674-4152.003883
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  Objective  The treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children is difficult. In order to improve the prognosis of children, this study explores the clinical effect of fiberoptic bronchoscopy bronchoalveolar lavage in the treatment of RMPP in children.  Methods  A total of 90 children with RMPP admitted to Changxing County People ' s Hospital from June 2020 to June 2024 were selected as the research objects. The children were divided into the control group (45 cases) and the observation group (45 cases) by the random number table method. The two groups received the same basic treatment, with the observation group receiving treatment with fiberoptic bronchoscopy and bronchoalveolar lavage. The clinical efficacy, improvement of clinical symptoms, levels of serum inflammatory markers and lung injury markers of RMPP were evaluated, and RMPP related complications within one month after the end of treatment was followed up.  Results  The overall treatment efficacy rate of RMPP in the observation group [97.78% (44/45)] was significantly higher than that in the control group [82.22% (37/45), χ2=4.444, P=0.035]. The duration of clinical symptoms such as fever, cough, and wet rales in the observation group were significantly shorter than those in the control group (P < 0.001). The serum SF and LDH levels in the observation group after treatment were significantly lower than those in the control group. The serum levels of TNF-α, hs-CRP, PCT, and IL-6 in the observation group after treatment were significantly lower than those in the control group (P < 0.001). The overall incidence of RMPP related complications within one month after treatment in the observation group [4.44% (2/45)] was significantly lower than that in the control group [20.00% (9/45), P < 0.05].  Conclusion  Fiberoptic bronchoscopy bronchoalveolar lavage is used to treat RMPP in children, by clearing airway inflammatory secretions, reducing inflammatory reactions and lung damage, promoting rapid improvement of clinical symptoms, and enhancing efficacy.
The effect of four handed operation combined with LEARNS model health education on disease cognition and cooperation in patients undergoing impacted tooth extraction surgery
JIANG Aijun, XU Dongdong
2025, 23(2): 273-276. doi: 10.16766/j.cnki.issn.1674-4152.003884
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  Objective  The increase in the number of patients undergoing impacted tooth extraction surgery has resulted in higher demands being placed on nursing services in clinical practice. The present study employs a combination of four-handed operation and the LEARNS model of health education to analyze its impact on the disease cognition level and cooperation of patients undergoing impacted tooth extraction surgery.  Methods  The present study selected 113 patients who underwent impacted tooth extraction surgery at the Affiliated Stomatological Hospital of Wenzhou Medical University from November 2022 to February 2024 as the subjects for its investigation study subjects. The subjects were randomly divided into two groups: a control group (56 cases) and an observation group (57 cases). The randomization was performed using a random number table method. The control group received routine nursing care in combination with four-handed handed operation, while the observation group received LEARNS model health education in addition to the control group. A comparison should be made of the cognitive level and psychological status from two groups of patients before and after intervention, and the treatment cooperation and postoperative complications in the two groups of patients should be calculated.  Results  Following the intervention, a statistically significant difference was observed in the disease cognitive level score of the observation group in comparison to the control group (P < 0.05). Furthermore, post-intervention, the observation group demonstrated lower scores on both the dental fear scale (DFS) and the dental anxiety scale (DAS) when compared to the control group (P < 0.05); The treatment cooperation rate of patients in the observation group was 98.2% (56/57), which was higher than 85.7% (48/56) in the control group (P < 0.05); Following the extraction of impacted teeth, the incidence of complications in the observation group was 3.5% (2/57), which was lower than that in the control group [17.9% (10/56), χ2=6.127, P=0.013].  Conclusion  The findings of this study demonstrate that a four-handed operation in combination with the LEARNS model health education program is beneficial for improving the disease awareness and cooperation level of patients undergoing impacted tooth extraction surgery. The results of this study indicate that this combination effectively alleviates dental anxiety and fear and is worthy of clinical application.
Application of multidisciplinary collaboration lifestyle management model in schizophrenia patients with metabolic syndrome
YAO Guoli, CHEN Linxia, MA Lingya
2025, 23(2): 277-281. doi: 10.16766/j.cnki.issn.1674-4152.003885
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  Objective  To analyze the impact of a multidisciplinary lifestyle management model on the lifestyle intervention of patients diagnosed with both schizophrenia and metabolic syndrome. In addition, the study will observe its effects on patients ' mental symptoms, metabolic indicators and quality of life. And to provide a theoretical basis for lifestyle management plans for patients diagnosed with both schizophrenia and metabolic syndrome.  Methods  A total of 152 patients admitted to Shaoxing Seventh People ' s Hospital, from January 2023 to June 2024 were randomly divided into a control group and an observation group, with 76 patients in each group. The control group received routine lifestyle intervention methods, while the observation group adopted a multidisciplinary collaborative lifestyle management model. The study will compare the mental symptoms, metabolic indicators, and quality of life of the two groups of patients before and the after intervention.  Results  Following a period of three months, the total score of the positive and negative symptom scale (PANSS) in the observation group was found to be (37.96±4.27) points, which was lower than that of the control group [(49.64±5.04) points]. This difference was found to be statistically significant (P < 0.05); Furthermore, the main metabolic indicators of the observation group, including BMI, waist circumference, fasting blood glucose (FBG), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), were superior to those of the control group, and the differences were statistically significant (P < 0.05); The total score of the schizophrenia quality of life scale (SQLS) in the observation group was (68.13±6.00) points, which was lower than that in the control group [(85.15±8.27) points], and the difference was statistically significant (F=12.886, P < 0.001).  Conclusion  A multidisciplinary lifestyle management model has been shown to promote the recovery of patients diagnosed with both schizophrenia and metabolic syndrome. Furthermore, improvements in metabolic indicators and an enhancement in quality of life have been observed.
Texture characteristics of high frequency ultrasound in patients with carpal tunnel syndrome and its diagnostic value
ZOU Qingguo, XU Huajun, FAN Huihui, JIN Qiang, JI Guofei
2025, 23(2): 282-285. doi: 10.16766/j.cnki.issn.1674-4152.003886
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  Objective  To analyze the texture features of patients with carpal tunnel syndrome by high-frequency ultrasound, and to analyze the diagnostic value of high-frequency ultrasound texture features for carpal tunnel syndrome, so as to provide a better method for the diagnosis of this disease.  Methods  From January 2021 to December 2023, 148 patients with carpal tunnel syndrome in Huzhou Central Hospital were taken as the case group, and 100 patients with non-carpal tunnel syndrome who were treated for other factors during the same period were included as control group. Compare the texture features of high-frequency ultrasound between the two groups, draw the ROC curve, and analyze the diagnostic value of high-frequency ultrasound texture features in carpal tunnel syndrome.  Results  The mean value, standard deviation, coefficient of variation, and histogram entropy of the case group were lower than those of the control group, while the skewness, peak value, brightness entropy, and median value were higher than those of the control group (P < 0.05). The average ratio of pixels, average ratio of the same depth, median ratio, median ratio of the same depth, Q0.5, Q0.6, Q0.7, Q0.8, Q0.9, and Q1 in the case group were lower than those in the control group, while Q0, Q0.05, Q0.1 and Q0.15 were higher than those in the control group (P < 0.05). The maximum thickness, median thickness, average thickness, maximum length, median length, average length, lesion area, major axis, minor axis, eccentricity, and lesion circumference in the case group were all lower than those in the control group (P < 0.05). The AUC (0.934) of gray level co-occurrence matrix, morphological features, and first-order statistics in the diagnosis of elbow syndrome was significantly higher than that of single and gray level co-occurrence matrix AUC (0.762), morphological features AUC (0.884) and first-order statistics AUC (0.753).  Conclusion  Gray-level co-occurrence matrix, morphological features, and first-order statistics in texture feature analysis of high-frequency ultrasound have high diagnostic value for patients with carpal tunnel syndrome, and the combination of the three is more valuable.
Research progress of near-infrared fluorescence imaging in the diagnosis and treatment of urinary system diseases
ZHANG Weijie, Abudureheman·Zebibula, QIAO Bingzhang, Mulati·Rexiati
2025, 23(2): 286-291. doi: 10.16766/j.cnki.issn.1674-4152.003887
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Traditional examinations for urinary diseases are of great importance in the clinical diagnosis and treatment of patients. However, these methods entail a number of potential risks, including lengthy test times, excessive exposure to X-rays or radioisotopes due to the frequency of tests, and the possibility of an allergic reaction to contrast media. Optical imaging is a radiation-free, high-spatiotemporal-resolution, and high sensitivity real-time imaging technology with a wide range of potential applications. In comparison to visible light, near-infrared light has the capacity to significantly enhance both the penetration depth and fluorescence intensity, while simultaneously providing a high signal-to-noise ratio imaging effect. In addition to providing a clear image of urinary system anatomy, this method can also be employed for the early, non-invasive assessment of renal function. Furthermore, due to their advantageous renal clearance rate and specific binding to tumors, certain probes can be employed to assess intraoperative repair of damaged ureters, direct tumor resection and ascertain the characteristics of incisal margins, and possess the capacity for surgical navigation. As a topic of considerable current interest in the scientific community, near infrared fluorescence imaging has demonstrated considerable potential in the diagnosis and treatment of urinary diseases. The objective of this review is to provide a comprehensive summary of the preparation strategies for relevant fluorescent probes along with their research progress in the field of urinary system structure, function, and tumor imaging. Additionally, it will highlight the limitations associated with NIR fluorescence imaging and offer insights into potential future applications.
Research progress on iron death in Parkinson ' s disease
ZHANG Chunli, LI Hongyan
2025, 23(2): 292-295. doi: 10.16766/j.cnki.issn.1674-4152.003888
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Parkinson ' s disease (PD) is an age-dependent late-onset neurodegenerative disorder characterized by classic motor and non-motor symptoms. At present, the etiology and mechanism of PD are not fully understood, but in addition to the degeneration of dopaminergic neurons in the substantia nigra densa and the abnormal deposition of α-synuclein in their cells, it has been gradually discovered that a variety of new cell death modes are involved in the development of PD, including pyroptosis, autophagy, and iron death. Cell iron death, as a new type of programmed cell death, is overdriven by lipid peroxidation and regulated by iron dependence, which has common pathophysiological features with PD. Cellular iron death is mainly caused by excessive iron deposition, imbalance of amino acid metabolism, lipid peroxidation, and mitochondrial damage, which lead to nerve cell toxicity, and eventually lead to neuronal cell death and loss. Therefore, some related drugs, such as iron chelating agents, iron death inhibitors, and lipophilic antioxidants, can inhibit cell iron death by inhibiting metal ion reaction, reducing iron metabolism imbalance and oxidative stress damage, so as to intervene in the pathogenesis and progression of PD. Based on this, this paper summarized the potential pathogenic mechanism of iron death in PD and the molecular mechanism of selective inhibition of cell iron death in the remission and treatment of PD, laying a foundation for further development of targeted intervention and treatment of iron death. At the same time, studying the mechanism of cell iron death can provide new ideas and directions for future drug development, help improve the quality of life of PD patients, delay the progression of the disease, and provide more possibilities for the treatment and management of PD.
Research progress of hyperhomocysteinemia and general practice
FAN Tiansong, WANG Peidong, PENG Yanyan, HANG Weihong, MA Xiao
2025, 23(2): 296-299. doi: 10.16766/j.cnki.issn.1674-4152.003889
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Hyperhomocysteinemia is a disease state defined by elevated plasma concentrations of homocysteine. Hyperhomocysteinemia has the potential to cause damage to numerous systems within the human body, including the cardiovascular, cerebrovascular, nervous and endocrine systems. Additionally, it has been linked to adverse pregnancy outcomes and fetal malformations. The field of general practice encompasses the study of all diseases affecting all organ systems in all populations. Consequently, general practice must address health issues at all stages of the life cycle. The impact of hyperhomocysteinemia on the human body is extensive, encompassing diseases of different systems in all age groups and being inextricably linked to numerous areas of general practice. In accordance with the primary ailments addressed in general medical practice as outlined in the 2022 Edition of the Content and Standards for Standardized Residency Training, published by the Chinese Medical Doctor Association, the following conditions are of particular relevance: the early stages of disease and health issues, prevalent, and recurrent illnesses within primary care, and clinical scenarios involving multiple concurrent diseases. This paper presents a comprehensive overview of the latest developments in the field of hyperhomocysteinemia and their implications for general practice. The objective is to enhance the awareness of hyperhomocysteinemia among General Practitioners and the wider community. This will facilitate the avoidance or reduction of the occurrence and development of diseases caused by hyperhomocysteinemia through the implementation of early prevention and intervention strategies, and the maintenance of population health through the provision of regular follow-up care for high-risk groups, This will enable general practitioners to assume the role of "gatekeepers" of population health. It is recommended that relevant departments and social organizations devote greater attention to hyperhomocysteinemia when formulating corresponding policies, guidelines and consensus. Furthermore, they should advocate for high-risk groups to enhance health management, cultivate positive lifestyles, prioritize disease prevention and proactively maintain and promote residents ' health. In the meantime, the research value of hyperhomocysteinemia must be further developed. This paper provides a new research direction for the continued study of hyperhomocysteinemia.
Clinical and imaging advances in hereditary hemorrhagic telangiectasia
HE Jingyi, XIA Juan, MA Xiaojing
2025, 23(2): 300-304. doi: 10.16766/j.cnki.issn.1674-4152.003890
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Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant hereditary vascular disease characterized by skin and mucosal telangiectasia, leading to different degrees of bleeding syndrome and arteriovenous malformations (AVMs) in lung, liver, and nervous system. The most common clinical manifestation is recurrent nasal bleeding, while AVMs may lead to serious complications, including pulmonary hypertension, high output heart failure, liver failure, portal hypertension, brain abscess, and stroke. The clinical manifestations of HHT vary widely, with symptoms worsening with age. It is important to use the Curacao criteria and to perform genetic analysis of genes such as ENG, ACVRL1, and SMAD4. Due to the potential vascular hazards and complications of the disease, and the individual variability, effective management relies on recognizing clinical manifestations and early signs of the disease, as well as long-term clinical and imaging follow-up. Multimodal imaging, including transthoracic echocardiography, CT, and MRI, is crucial for detecting visceral involvement of the disease, which can serve as an important way to early screen HHT vascular lesions. Angiography is an important tool for both the diagnosis and interventional treatment of HHT, especially for lung and central nervous system. Recently, progresses have been made in the molecular pathway of drug action on angiogenesis, and a better understanding of the pathophysiology of angiogenesis has been achieved. Imaging also helps to understand the clinical response, hemostatic efficacy and safety of new therapies, and is expected to reduce the occurrence of serious complications. It is very important for the diagnosis and treatment of HHT visceral arteriovenous malformations. This article reviews the clinical manifestations of HHT combined with echocardiography, CT, MRI, angiography, and other imaging techniques in diagnosis and management, along with the latest research progress.
Director Zhou Lan ' s experience in treating middle and late stage ovarian cancer based on the conclusion of phlegm and blood stasis interaction
CHENG Huijuan, ZHOU Lan
2025, 23(2): 305-308. doi: 10.16766/j.cnki.issn.1674-4152.003891
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Ovarian cancer is a malignant tumor with a high incidence in women. Due to the unclear etiology and the lack of effective methods for early detection, it is mostly diagnosed in the late stage. The recurrence rate of advanced ovarian cancer is high and the survival rate is low. The main treatment modalities for advanced ovarian cancer are surgery and chemotherapy. Platinum or non-platinum chemotherapy can be classified according to the sensitivity of patients to platinum drugs, combined with anti-angiogenesis targeted drugs, and poly (ADP-ribose) polymerase (PARP) inhibitors and immunotherapy can be considered according to genetic testing. The traditional Chinese medicine of ovarian cancer refers to "lump" and "accumulation". Director Zhou Lan believes that the cause and pathogenesis of this disease are the interformation of phlegm and blood stasis. Combining the basic methods of promoting blood circulation and removing blood stasis with the methods of clearing heat and detoxification, soothing the liver and promoting qi, invigorating the spleen and nourishing the blood, regulating Chong Ren, nourishing Yin and moistening dryness, the traditional Chinese medicine treatment of the complications after surgery, chemotherapy, targeting, and PARP. The survival period of patients was greatly extended, the quality of life of patients was improved, and the clinical effect was good.
Exploring the medication patterns of gastroesophageal reflux disease and the application of toxic traditional Chinese medicine using data mining of ancient Chinese medicine texts
YU Jiajia, LIU Meng, WANG Xiaoqiang, QIU Sha, ZHANG Yunjie
2025, 23(2): 309-313. doi: 10.16766/j.cnki.issn.1674-4152.003892
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  Objective   To investigate the medicinal concepts and compatibility principles in ancient Chinese medicine for treating gastroesophageal reflux disease, and to explore the application of toxic traditional Chinese medicine (TCM) in the treatment of gastroesophageal reflux disease based on ancient Chinese medicine prescriptions.   Methods   A total of 13 211 references were reviewed, and 988 prescriptions were selected, including 315 TCM flavors, with a cumulative usage frequency of 8 375. Twenty-eight drugs were used more than 80 times, with 41 drugs in total. Of these, 598 prescriptions containing toxic TCM were used, accounting for 60.53% of all prescriptions. The four qualities (Qi) are mainly warming. The five flavors (Wei) are mainly pungent. The spleen and stomach were the main channels targeted, followed by the lung, heart, and liver. the efficacy of the drugs was the highest in tonifying deficiency drugs, followed by qi-regulating drugs and warming interior drugs. According to the association rules, 5 pairs of medicines and 10 groups of corner medicines were identified, among which Chenpi, Banxia, ginger, licorice, Poria cocos, Atractylodes macrocephala, and ginseng are the core medicines in ancient texts to treat gastroesophageal reflux disease. Cluster analysis identified 6 new drug groups in prescriptions.   Conclusion   In ancient times, doctors primarily used warming and pungent medications for treating gastroesophageal reflux disease, focusing on tonifying qi, strengthening spleen, and warming the middle. Treatment targeted regulating qi, promoting qi circulation, and eliminating dampness and phlegm. In the later stages of the disease, alongside tonifying deficiency, the application of traditional Chinese medicines for attacking toxins, breaking up accumulation, and eliminating toxic tumors was emphasized.
Analysis of the therapeutic effect of enhanced recovery after surgery for elderly patients with total knee arthroplasty
WANG Chongjia, GU Chunjiang, ZHANG Zhiwang, WANG Chun, ZHENG Chunlei
2025, 23(2): 314-317. doi: 10.16766/j.cnki.issn.1674-4152.003893
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  Objective   To explore the effect and safety of enhanced recovery after surgery (ERAS) management in elderly patients with total knee arthroplasty (TKA).   Methods   Elderly patients over 70 years old who underwent TKA surgery in Tongxiang First People's Hospital from January 2018 to February 2022 were included. They were randomized to ERAS and traditional groups and received different perioperative management programs. Patient demographic data, operation time, intraoperative blood loss, blood transfusion rate, length of hospital stay, and postoperative complications were recorded. The Oxford University knee score (OKS) and knee active range of motion (ROM) were recorded before the surgery and on day 3, 1 month, and 1 year postoperatively. Comparisons between the two groups were performed using the t-test, chi-square test, or Fisher ' s exact probability method.   Results   A total of 202 elderly patients were included in this study, with 106 patients in the ERAS group and 96 patients in the traditional group. Compared with the traditional group, the intraoperative blood loss in the ERAS group was significantly lower [(151.2±9.3) mL vs. (133.7±10.5) mL, P < 0.001], and the length of hospital stay was significantly shorter [(8.8±1.3) d vs. (10.2±1.7) d, P < 0.001]. The complication rate was significantly lower [45.8% (44/96) vs. 30.2% (32/106), P=0.022], and the OKS score was higher on the 3rd day after surgery [(21.6±4.5) vs. (26.8±3.6), P < 0.05]. Activity was significantly higher on the 3rd day [(67.8±10.5)° vs. (71.8±7.0)°, P < 0.001] and 1 month [(80.7±8.3)° vs. (85.1±7.6)°, P < 0.001] after the surgery. There was no significant difference in 1-year follow-up mortality between the two groups (P>0.05).   Conclusion   For elderly TKA, ERAS can improve postoperative pain and accelerate postoperative recovery of joint function without increasing mortality.
Research on a three-dimensional evaluation model for assessing the competency of general practitioners in the revolutionary old areas of western Anhui
ZHANG Jun, JIANG Pin, TANG Huan, ZHANG Yang, PENG Xiangxiang, CHEN Fengyu, ZHANG Chunming, YANG Hui, SUN Liangye
2025, 23(2): 318-322. doi: 10.16766/j.cnki.issn.1674-4152.003894
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  Objective   To provide a reference for improving the abilities, performance assessment, and evaluation of general practitioners in the western Anhui, this study constructs a three-dimensional competency evaluation model from the perspectives of employers, general practitioners, and patients.   Methods   A job competency item pool and a preliminary model draft were created using literature research and surveys from February to May 2023. A total of 13 consulting experts were picked from three categories: those with experienced clinical practice, those familiar with general theory education, and those engaged in hospital management. From May to August 2023, two rounds of surveys were conducted using the Delphi method, and the competency model for general practitioners in the western Anhui region was modified based on expert feedback. The weights of each indicator in the job competency model were calculated using the Analytic Hierarchy Process.   Results   The response rates for the two rounds of expert questionnaires were 100.00% and 84.62%, respectively. The professional familiarity, judgment, and authority coefficients in the first round were 0.88, 0.93, and 0.91, respectively. The final three-dimensional evaluation model for the competency of general practitioners in the revolutionary old area of western Anhui was established, including 5 first-level indicators, 12 second-level indicators, and 41 third-level indicators. The first-level indicators, ranked by combined weight from highest to lowest, are "basic medical service capability" (0.341 0), "public service capability" (0.254 7), "humanistic practice ability" (0.164 1), "communication and collaboration ability" (0.141 3), and "continuing education and learning ability" (0.099 1). Among the second-level indicator, "medical prevention integration ability" (0.194 0) has the highest combined weight. "providing timely, effective, and safe two-way referrals" (0.029 2) is the third-level indicator with the highest weight.   Conclusion   The study established a three-dimensional competency evaluation model for general practitioners in the revolutionary old areas of western Anhui. The model is targeted and provide a solid foundation for the future training of general practitioners in the western Anhui region.
Construction and practice of non-degree continuing education curriculum system of traditional Chinese medicine colleges and universities under the concept of "five techniques" medical talent cultivation
GUO Dandan, WANG Dongyan, LI Zhuying, LI Jiazhuo, WANG Jinhe, YU Siming
2025, 23(2): 323-326. doi: 10.16766/j.cnki.issn.1674-4152.003895
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  Objective   In the context of national continuing education reform and the construction of a learning society, this paper considers the construction and practice of the non-degree continuing education curriculum system of traditional Chinese medicine colleges and universities under the concept of "five techniques" medical personnel training.   Methods   The non-degree continuing education students of four majors at Heilongjiang University of Traditional Chinese Medicine, namely Chinese medicine rehabilitation, acupuncture and massage, traditional Chinese medicine and traditional Chinese and Western medicine integration, were selected as the subject of the study. A series of reforms have been implemented in the curriculum system of Chinese medicine colleges with regard to the teaching concept, teaching content, teaching process, teaching mode and teaching evaluation. The result is an innovative curriculum system, comprising the following elements: one concept, two horizontal integration, three vertical integration, five-dimensional cultivation and multiple evaluation".   Results   The new curriculum system was found to be practical by 90.55% (115/127) of the trainees, with 88.98% (113/127) believing that it could improve their ability to think dialectically and to integrate with the integration of basic and clinical knowledge was identified as enhanced by 92.13% (117/127) of the trainees, and the knowledge became three-dimensional. Furthermore, 66.14% (84/127) of the trainees expressed the opinion that it could improve their ability to innovate, while 89.76% (114/127) of the trainees indicated that their professional capabilities had been enhanced, and their self-confidence in Chinese medicine and job competence had increased.   Conclusion   In comparison with the conventional continuing education curriculum system, this innovative curriculum system has the capacity to enhance students' independent learning ability, dialectical thinking ability in the field of Chinese medicine, integrative ability, scientific research quality cultivation ability, civic and political shaping ability, and innovation ability. This is conducive to the cultivation of high-quality talents.
A preliminary study on the application of multimodal data in diagnosing and treating anal leakage
LIU Yicheng, YE Qianqian, XU Jin, ZHAO Wenjun, WU Chuang, WANG Qingming
2025, 23(2): 327-330. doi: 10.16766/j.cnki.issn.1674-4152.003896
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Anal fistula is a common perianal disease, with surgical treatment being the only effective treatment approach. However, it is often associated with high recurrence, incontinence, and teratogenicity after surgery. The information provided by preoperative quadruple diagnosis and participation in auxiliary examinations can improve the treatment planning, guide precise surgical pathway, and improve clinical prognosis. In recent years, the multimodal approaches have advanced rapidly and are increasingly applied in medical research. This includes the diagnosis and treatment of anal fistula, where multimodal data analysis enhances objectivity. In this paper, we explores the intersection of Chinese and Western multimodal research and anal fistula, analyzing the current status and limitations of the research from two perspectives: (1) Traditional multimodal imaging, including magnetic resonance imaging (MRI) and ultrasound, with preliminary explorations of the above techniques in the preoperative, intraoperative, and prognostic assessment of anal fistula. (2) The application of four diagnostic multimodalities "looking, smelling, questioning, and feeling" in the diagnosis and treatment of anal fistula, with a review of current practices in these diagnostic techniques. By comparing the multidimensional applications of traditional and four-diagnosis multimodal data, examining the latest advancements in multimodal data in other disease areas, and comparing the multilevel integration of machine learning and deep learning techniques, we hope to expand research perspectives in the diagnosis and treatment of anal fistula. Additionally, this paper will provide references for the application of multimodal and intermodal research in clinical practice to improve the prognosis of anal fistula.
Current situation analysis on the construction and application of post competency model for chinese general practitioners
XU Xiaona, WU Hongjie, CAO Xu, DU Wei
2025, 23(2): 331-334. doi: 10.16766/j.cnki.issn.1674-4152.003897
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  Objective   To analyze the construction and application research status of post competency model of general practitioners in China, and to provide basis for systematic evaluation of post competency of general practitioners.   Methods   The relevant literature on the construction and application of general practitioner post competency index system in CNKI, Wanfang, Vipu and Zhonghua Medical Data Knowledge Service Platform was searched from October 1 to 31, 2023.   Results   After a preliminary search of 893 literatures, 66 were included in the analysis. Among the 66 literatures, 41 (62.1%) used a variety of research methods to construct the system, the most used were literature research method (37, 56.1%) and Delphi method (32, 48.5%). Nine articles referred to the WONCA tree model. The post competency system was characterized by multiple items, among which the number of first-level indicators ranges from 3 to 8, with an average of 5.8, the last level of entries ranged from 12 to 123, with an average of 34.3. The research objects involved in the literature include: general practitioners in residence, community general practitioners, rural general practitioners, rural order medical students, family doctors, rural physicians, assistant general practitioners, general practitioners in charge, and general practitioners in transfer training. The top five first-level indicators were professional ethics, basic public health services, communication skills/interpersonal skills, basic medical services in general, and education and learning ability.   Conclusion   The research on the post competence of general practitioners in China is mainly based on model construction, and the empirical research and applied research are increasing gradually. Different from foreign classical models, the basic public health service capacity is emphasized.
Effects of one-core-multiple hospice care on cancer-induced fatigue, hope level, and depression in advanced patients with lung cancer
DU Xiaoxia, SUN Yuanyuan, LU Degan, ZHAO Xinyue, XU Huanyu, SU Shufen
2025, 23(2): 335-339. doi: 10.16766/j.cnki.issn.1674-4152.003898
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  Objective   To investigate the effects of one-core-multiple hospice care on cancer-induced fatigue, hope level, and depression in patients with advanced lung cancer.   Methods   From September 2021 to September 2023, 60 patients with advanced lung cancer were enrolled at the First Affiliated Hospital of Shandong First Medical University. They were randomly assigned to the observation group (n=30, receiving one-core-multiple hospice care) and the control group (n=30, receiving routine care). Cancer-induced fatigue (cancer fatigue scale, CFS), hope level (Herth hope inventory, HHI), anxiety and depression (Hamilton depression scale score, HAMD; Hamilton anxiety scale score, HAMA), meaning of life (meaning of life scale, MiLS), and quality of life (international quality of life for cancer patients, QOL-C30) were compared between the two groups before and 6 weeks after intervention.   Results   After 6 weeks of intervention, both groups showed reduced CFS, HAMD, and HAMA scores. The observation group had a significant increase in MiLS scores after intervention than before (P < 0.01). CFS in the observation group was lower than that in the control group, while MiLS was higher after 6 weeks of intervention, after adjustment for baseline values (P < 0.01). After 6 weeks of intervention, the medium to high level proportion of hope and life meaning in the observation group was 66.67% (20/30) and 53.33% (16/30), respectively. In contrast, the control group had 36.67% (11/30) for hope and 26.67% (8/30) for life meaning. The medium to high level proportion of hope and life meaning in the observation group were higher than those in the group (Z=2.237, 4.444, P=0.025, 0.035).   Conclusion   One-core-multiple hospice care for advanced lung cancer patients can reduce the level of cancer-related fatigue, anxiety and depression, while improving the level of hope, life meaning, and life quality.
Study on the effect of phased rehabilitation care based on the Green model in patients with unstable pelvic fractures
YE Yang, CHEN Hezhen, WANG Yi, WANG Jianshun
2025, 23(2): 340-343. doi: 10.16766/j.cnki.issn.1674-4152.003899
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  Objective   To explore the application effect of the phased rehabilitation care based on the Green model, and improve the rehabilitation effect of patients with unstable pelvic fractures.   Methods   A total of 62 patients with unstable pelvic fractures hospitalized in the Orthopedic Trauma Department of the 2nd Affiliated Hospital of Wenzhou Medical University hospital from July 2021 to July 2022 were collected as the control group, and 71 patients hospitalized from October 2022 to December 2023 were taken as the observation group. The control group implemented routine rehabilitation guidance, and the observation group adopted phased rehabilitation care based on the Green model. The time of first ambulation, hospital stay, incidence of lower extremity deep vein thrombosis during hospitalization, activities of daily living, and recovery of pelvic function were compared between the two groups.   Results   The first postoperative ambulation time and hospitalization time in the observation group were significantly less than those in the control group (P < 0.01). The incidence of deep vein thrombosis was 6/62 (9.7%) in the control group and 1/71 (1.4%) in the observation group, which was significant (χ2=4.539, P=0.033). There was no significant difference in the activities of daily living, and pelvic function of the two groups before discharge (P>0.05), and both in the observation group were significantly higher than that of the control group in 3 months and 6 months after surgery (P < 0.05).   Conclusion   The phased rehabilitation care based on the Green model can shorten the first ambulation time and hospitalization time, reduce the incidence of deep vein thrombosis, and improve the ability of daily living activities and the recovery status, which is worthy of clinical promotion and application.
Application of self-transcendence and guided imaginative music intervention in the nursing care of lung cancer patients
LIU Jinghui, DAI Hong, BAO Lili, LU Haiyan
2025, 23(2): 344-347. doi: 10.16766/j.cnki.issn.1674-4152.003900
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  Objective   To construct a self-transcendence joint guided imaginative music intervention scheme aimed at enhancing the nursing quality of lung cancer patients.   Methods   A total of 101 lung cancer patients diagnosed and treated in Hangzhou Red Cross Hospital from January 2022 to January 2024 were divided into a control group (50 cases) and an experimental group (51 cases) using computer random number grouping method. The control group received routine nursing intervention, while the experimental group received self-transcendence combined guided imaginative music intervention in addition to routine care. Negative emotion, hope level, coping style, lung function exercise compliance, and lung function were compared between the two groups.   Results   The scores of self-rating anxiety scale and self-rating depression scale in the experimental group were lower than those in the control group (P < 0.05).The score of Herth hope scale was higher than that of the control group (P < 0.05), as well as the "face" dimension score on the medical coping modes questionnaire (P < 0.05). Compliance of lung function exercises was higher than that of the control group (P < 0.05). Furthermore, the forced vital capacity [(2.90±0.35) L], percentage of forced vital capacity to predicted value in 1 second (79.09±4.66), and peak expiratory flow [(7.58±1.37) L/s] were higher than those of the control group [(2.57±0.47) L, 73.45±5.22, and (6.90±1.24) L/s; F=19.091, 16.782, 15.681, all P < 0.001].   Conclusion   Self-transcendence combined guided imaginative music intervention effectively reduced anxiety and depression in patients with lung cancer, improves the level of hope, promotes positive coping styles, improves the degree of cooperation with lung function exercise, and contributes to better lung function.
A survey on the influence of work environment perception on job burnout among 3 300 clinical nurses in western Anhui Province
ZHANG Ying, SHI Xuezhi, TONG Xueyin, WANG Zhengyun, WU Yao
2025, 23(2): 348-352. doi: 10.16766/j.cnki.issn.1674-4152.003901
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  Objective   To understand the current situation of working environment perception and job burnout of clinical nurses in secondary and tertiary public hospitals in western Anhui, and to explore the influence of nurses' perceived working environment on job burnout, so as to provide reference for improving nurse practice environment and reducing job burnout.   Methods   From August 2023 to September 2023, 3 300 clinical nurses from 18 secondary and 8 tertiary hospitals in western Anhui were investigated by using the general data questionnaire, the Chinese version of nurses' working environment perception scale, and the Chinese version of Maslach burnout scale, and the scores were analyzed by correlation analysis and hierarchical regression analysis.   Results   The entries on nurses' perception of working environment scored (2.97±0.63) points, and the entries on job burnout scored (3.23±0.33) points. The results of hierarchical regression analysis showed that different gender (t=2.182, P=0.029), departments (t=2.073, P=0.038), income satisfaction (t=-2.164, P=0.030), whether nurses are specialists (t=-2.163, P=0.031), nurses' perception of human and material resources in the work environment (t=-4.508, P < 0.001), nursing management (t=-4.917, P < 0.001), and professional practice (t=-6.355, P < 0.001)were the influence factors of nurses' burnout.   Conclusion   The total incidence of nurse burnout in western Anhui was 66.55%, and nurses' perceived practice environment had a significant impact on the sense of burnout. Managers should base on the quality of hospital nursing service and organization management, improve nurses' satisfaction with the practice environment, reduce the level of nurse burnout, and stabilize the development of nurse team.
Fluoroacetate poisoning with ventricular fibrillation as the prominent clinical manifestation: a case report
XIE Pengxin, SUN Lijie, REN Chuan, HAN Jiangli, CHEN Shaomin, LI Dan, CHEN Baoxia, ZHANG Yuan
2025, 23(2): 353-356. doi: 10.16766/j.cnki.issn.1674-4152.003902
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Ventricular fibrillation (VF) is a common critical disease. The reason for VF is crucial for subsequent treatment. The common reasons for VF include acute coronary syndrome, heart failure, cardiomyopathy, and ion channel disease. This paper reports a case of VF caused by fluoroacetate poisoning. The patient, a 35-year-old man, was admitted to Peking University Third Hospital on September 21st, 2022 due to "chest tightness for 10 hours and loss of consciousness for 2 hours". After exposure to the suspected poison, the patient developed chest tightness, accompanied by slurred speech, fatigue, and subsequent sudden loss of consciousness. The electrocardiogram indicated VF, ventricular tachycardia, and ST segments elevation in some leads, elevated markers of myocardial injury. And the echocardiography showed the decline of left and right ventricular systolic function. A series of examinations indicated that the above manifestations were caused by fluoroacetate poisoning, and the patient recovered through hemofiltration and acetamide treatment. The case suggests that poisoning should be included in the differential diagnosis of the cause of VF, especially when patients have suspected exposure to toxic substances.

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