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Quick Search     Adv Search 2023 Vol. 40, No. 5 Published: 2023-05-26 Original Articles          Original Articles 648 Effect of Acupoint Catgut Embedding on Chemotherapy Related Nausea and Vomiting in Lung Cancer Patients XU Ran, HU Zi-xin, PENG Sha, et al DOI: 10.3969/j.issn.1671-7171.2023.05.003 【Objective】 To explore the effect of acupoint catgut embedding on chemotherapy related nausea and vomiting in lung cancer patients. 【Methods】 A total of 120 lung cancer chemotherapy patients admitted to the Cancer Chemotherapy Department and Respiratory Oncology Department of Xiangya Hospital in Hunan Province from January to December,2021 were selected. Convenient sampling method was used to select patients from the Cancer Chemotherapy Department (control group,60 cases) and Respiratory Oncology Department (observation group,60 cases). The control group patients were treated with a conventional antiemetic regimen,while the observation group patients were treated with a conventional antiemetic plus acupoint catgut embedding antiemetic regimen. One day before chemotherapy,acute phase,delayed phase,and duration,respectively,the Chinese version (MASCC) antiemetic evaluation tool was used to evaluate the nausea score and vomiting frequency of two groups of patients. The vomiting life function index(EILE) scale was used to evaluate the quality of life of two groups of patients,while observing the occurrence of adverse reactions after acupoint catgut implantation. 【Results】 The observation group showed lower scores of nausea severity and frequency of vomiting in the acute,delayed,and persistent stages compared to the control group,with statistically significant differences (P<0.05). The observation group had significantly higher scores on FILE scale in the acute,delayed,and persistent stages compared to the control group,with a statistically significant difference (P<0.05). This study did not find any patient experiencing needle sickness,and 60 acupoint thread embedding patients did not experience discomfort such as subcutaneous bleeding,induration,pain,or infection at the embedding site. 【Conclusion】 Acupoint catgut embedding can effectively alleviate chemotherapy related nausea and vomiting symptoms in lung cancer patients,improve their quality of life,be safe and feasible,and be worthy of clinical promotion. 2023 Vol. 40 (5): 648-651 [Abstract] ( 67 ) HTML (1 KB)  PDF (1579 KB)  ( 227 ) 652 Influence Factors for Noninvasive Ventilation Failure in Acute Respiratory Failure with Pneumocystis Jirovecii Pneumonia in Patients without HIV Infection WANG Ming-ming, SONG Li-qiang, YANG Xue-min, et al DOI: 10.3969/j.issn.1671-7171.2023.05.004 【Objective】To investigate the influencing factors of non-invasive mechanical ventilation (NIV) failure in acute respiratory failure (ARF) patients with non-HIV pneumococcal Jirovecii pneumonia (NH-PJP). 【Methods】Retrospective analysis was performed on all patients with ARF caused by NH-PJP (non-NIV pneumococcal Jirovecii pneumonia) from January 2019 to December 2021 in our hospital. General data,immunosuppressant use,clinical symptoms,laboratory tests,NIV use,length of hospital stay and prognosis were collected to analyze the influencing factors of NIV failure. 【Results】A total of 38 eligible patients were collected in the study and NIV failed in 27 patients (71.05%). At 1 h and 24 h after NIV,the PaO2/FiO2 in NIV failure group was significantly lower than that in NIV success group.The acute physiology and chronic health (APACHEⅡ) score of patients in the NIV failure group was significantly higher than that in the NIV success group. In multivariate analysis showed that APACHEⅡ at the beginning of NIV and PaO2/FiO2 at 24 h after NIV were risk factors for NIV failure.NIV failure was significantly associated with hospital mortality (P<0.05). 【Conclusion】APACHEⅡ score and PaO2/FiO2 at 24 h after NIV might predict NIV failure in NH-PJP patients,and the mortality rate was high in NH-PJP patients with NIV failure. 2023 Vol. 40 (5): 652-655 [Abstract] ( 39 ) HTML (1 KB)  PDF (1131 KB)  ( 51 ) 656 Analysis of Serum Homocysteine Levels,Blood Pressure and Myocardial Injury Markers in Patients with Gestational Hypertension XUE Bao-yao, ZHANG Xiao-shan DOI: 10.3969/j.issn.1671-7171.2023.05.005 【Objective】To investigate the changes and correlation of serum homocysteine (Hcy) levels,blood pressure,and myocardial injury markers in patients with gestational hypertension. 【Methods】A total of 68 patients with gestational hypertension admitted to our hospital from October 2018 to October 2021 (observation group) were selected,and 68 normal pregnant women who underwent regular prenatal examinations in our hospital were also selected. We compared the general information and levels of Hcy,daytime systolic blood pressure (SBP),daytime diastolic blood pressure (DBP),nighttime SBP,nighttime DBP,and troponin I(cTnI),creatine kinase isoenzyme (CK-MB),N-terminal B-type brain natriuretic peptide precursor(NT-proBNP),and lactate dehydrogenase (LDH) between two groups of pregnant women,and analyzed the correlation between Hcy levels,blood pressure,and myocardial injury markers. 【Results】 There was no statistically significant difference in general information between the two groups of pregnant women (P>0.05); The Hcy levels,daytime SBP,daytime DBP,nighttime SBP,and nighttime DBP in the observation group were significantly higher than those in the control group (P<0.05); The levels of cTnI, NT-proBNP,CK-MB,and LDH in the observation group were significantly higher than those in the control group (P<0.05); Correlation analysis showed that Hcy,SBP,DBP were positively correlated with cTnI,CK-MB,NT-proBNP,and LDH (P<0.05). 【Conclusion】 The levels of serum Hcy and blood pressure are correlated with myocardial injury in patients with gestational hypertension,and have certain reference value in the diagnosis of myocardial injury in patients with gestational hypertension. Clinicians should pay more attention. 2023 Vol. 40 (5): 656-658 [Abstract] ( 40 ) HTML (1 KB)  PDF (1165 KB)  ( 31 ) 659 Evaluation Value of H2FPEF Score, NT-proBNP and LVDF in the Risk of DCM in Type 2 Diabetes Patients with Ejection Fraction Preserved LIU Xue-ting, DENG Jian-xin, LI Hai-yan, et al DOI: 10.3969/j.issn.1671-7171.2023.05.006 【Objective】 To investigate the effects of H2FPEF score, N-terminal B-type natriuretic peptide precursor (NT-proBNP) combined with left ventricular diastolic function (LVDF) on the evaluation value of risk degree of diabetes cardiomyopathy (DCM) in patients with type 2 diabetes (T2DM) with ejection fraction (EF) preserved. 【Methods】 A retrospective analysis was conducted on the clinical data of 593 T2DM patients with EF ≥ 50% who were treated at the Shenzhen Second People's Hospital from February 2014 to April 2019. Using H2FPEF score, NT-proBNP and LVDF as key indicators ,the cluster analysis was first used to classify the DCM risk level of the study population and obtain the DCM risk staging; Then Fisher discriminant analysis on the above stages was perform to obtain a method for determining the risk stage of DCM. 【Results】Through cluster analysis, the study subjects were divided into four phases of DCM risk: the Phase 1 was a low-risk stage of DCM, with 98 cases (16.52%) having a low H2FPEF score of (0.52 ± 0.50), an NT-proBNP score of (38.98 ± 24.80) pg/mL, and a normal LVDF; the Phase 2 was a moderate risk stage for DCM, with 469 cases (79.09%) having a low H2FPEF score of (1.47 ± 0.92), normal NT-proBNP [(61.79 ± 54.22) pg/mL], and reduced LVDF; the Phase 3 was a high-risk period for DCM, with 17 cases (2.87%) having a low H2FPEF score of (1.53 ± 1.18), an increase in NT-proBNP[(344.18 ± 106.94) pg/mL], and a decrease in LVDF; the Phase 4 was a very high-risk period, with 9 cases (1.52%), with an H2FPEF score of (2.89 ± 1.17), an increase in NT-proBNP [(550.44±153.87) pg/mL] and a decrease in LVDF. Four Bayesian discriminant functions were obtained through Fisher discriminant analysis on the above four periods, with accuracy rates greater than 90%. This discriminant function could be used to determine the DCM risk staging for T2DM patients with EF ≥ 50%. 【Conclusions】The H2FPEF score, NT-proBNP combined with LVDF provide a new method for evaluating the risk of DCM in T2DM patients with EF preservation. 2023 Vol. 40 (5): 659-663 [Abstract] ( 35 ) HTML (1 KB)  PDF (1227 KB)  ( 51 ) 664 Analysis of Clinical Characteristics and Treatment Experience of Consultations on Inpatient Diabetes Mellitus in Non-endocrinology HE Yi-zhi, ZHANG Wei, HAN Fei-fei, et al DOI: 10.3969/j.issn.1671-7171.2023.05.007 【Objective】To summarize and analyze the clinical characteristics and medication of inpatients with diabetes in non-endocrinology department of our hospital. 【Methods】The data of inpatient diabetes cases consulted by endocrinology department from July 2020 to December 2020 in our hospital were statistically analyzed. 【Results】A total of 702 cases of consultation in the study included 139 cases from surgical departments and 563 cases from non-surgical departments. The department with the largest consultation volume was cardiology department. Among the consultation patients,86 cases underwent surgical operation,57 cases underwent angiography and 67 cases underwent interventional operation,115 cases were infected and treated with intravenous antibiotics,25 cases were treated with glucocorticoids. There were 24 cases with hepatic insufficiency,54 cases with renal insufficiency,37 cases with hypertriglyceridemia,and 21 cases with hypoglycemia. After consultation,303 cases were treated with oral hypoglycemic drugs alone,163 cases with insulin alone and 181 cases with oral hypoglycemic drugs combined with insulin,and 55 cases had no hypoglycemic program after consultation (only diet and exercise education). The proportion of oral hypoglycemic drugs used alone in non-surgical departments was higher than that in surgical departments (P<0.05),and the proportion of insulin used alone in surgical departments was higher than that in non-surgical departments (P<0.05). After consultation,the combination of two drugs was the most common used in oral hypoglycemic drugs,and the usage of metformin was the highest among drug types. The intensive regimen was the most used in insulin hypoglycemic programs,and the usage rate of basal insulin was the highest among insulin types.【Conclusion】Diabetic consultation patients were mainly treated with oral hypoglycemic drugs in non-surgical departments,while insulin treated was mainly used in surgical departments. The emphasis of hypoglycemic drugs selection was different in different departments due to patients in different departments were with special conditions. In-depth understanding of the diagnosis and treatment characteristics of diabetes consultation patients is of great significance to improve the diagnosis and treatment level of diabetes in general hospitals. 2023 Vol. 40 (5): 664-668 [Abstract] ( 32 ) HTML (1 KB)  PDF (1135 KB)  ( 131 ) 669 Serum Levels of Hypersensitive Troponin T and its Correlation with Myocardial Thickness in Patients with Acute ST Segment Elevation Myocardial Infarction and Left Ventricular Hypertrophy GUO Ying, SUN Yu-min, CAO Bin, et al DOI: 10.3969/j.issn.1671-7171.2023.05.008 【Objective 】To analyze the serum levels of hypersensitive troponin T (hs-TnT) and its correlation with myocardial thickness in patients with acute ST segment elevation myocardial infarction and left ventricular hypertrophy. 【Methods】 A total of 90 patients with acute ST segment elevation myocardial infarction admitted to the Department of Cardiovascular Medicine of our hospital from July 2019 to May 2021 were selected and divided into an observation group (with left ventricular hypertrophy,n=45) and a control group (without left ventricular hypertrophy,n=45) based on whether left ventricular hypertrophy was present. The levels of hs-TnT,serum creatine kinase isoenzyme (CK-MB),and N-terminal brain natriuretic peptide precursor (NT-proBNP) were compared between two groups of patients. The changes of left ventricular end diastolic diameter,left ventricular posterior wall thickness,interventricular septum thickness and left ventricular myocardial mass were compared between the two groups. The correlation between serum hs-TnT and myocardial thickness was analyzed. 【Result】 The serum NT-proBNP levels in the observation group were higher than those in the control group,with a statistically significant difference (P<0.05). The serum levels of hs-TnT and CK-MB in the observation group were higher than those in the control group,with statistical significance (P<0.05). The left ventricular end diastolic diameter,left ventricular posterior wall thickness,interventricular septum thickness and left ventricular myocardial mass index in the observation group were significantly higher than those in the control group (P<0.05). Pearson correlation analysis showed that serum hs-TnT was significantly positively correlated with left ventricular end diastolic diameter,left ventricular posterior wall thickness,interventricular septum thickness,and left ventricular myocardial mass index (r=0.459,0.572,0.537,0.738,all P<0.05). The serum levels of CK-MB and hs-TnT in the death group were higher than those in the survival group (P<0.05),and there was no statistically significant difference in serum NT-proBNP levels between the two groups (P>0.05). Logistic regression analysis showed that serum hs-TnT levels were an independent risk factor for death in patients with myocardial infarction and myocardial hypertrophy (P<0.05). 【Conclusion】 There is a significant correlation between serum hs-TnT levels and myocardial thickness. Patients with acute ST segment elevation myocardial infarction and myocardial hypertrophy have a significant increase in serum hs-TnT levels,and the risk of short-term death is increased. Serum hs -TnT levels are an independent risk factor for mortality in such patients. 2023 Vol. 40 (5): 669-672 [Abstract] ( 32 ) HTML (1 KB)  PDF (1125 KB)  ( 55 ) 673 Effect of Daggligin on β-cell Function and Renal Function Indexes in Patients with Diabetic Nephropathy WU Xiao-xue, XU Rong, TIAN Jiang-kun DOI: 10.3969/j.issn.1671-7171.2023.05.009 【Objective】To explore the effect of daggligin on β-cell function and renal function indexes in patients with diabetic nephropathy (DN). 【Methods】A total of 100 DN patients admitted to two hospitals were randomly divided into the observation group and the control group,with 50 patients in each group. Both groups received routine treatment,including lifestyle adjustments,low-fat and low salt diet,exercise,and insulin injections. The control group received oral administration of irbesartan and atorvastatin,while the observation group received treatment with daggliflozin in addition to the treatment of the control group. Both groups were treated for 3 months. The clinical efficacy of two groups was compared,including blood urea nitrogen (BUN),urinary protein quantification (UTP),and serum creatinine (Scr) levels. Levels of fasting C-peptide (FC-P) and 2-hour postprandial C-peptide (2hC-P) in patients were measured; And β cell function index (HOMA-β)、 insulin resistance index (HOMA-IR) were calculated and compared in the two groups of patients.. The occurrence of adverse reactions between the two groups was analyzed as well. 【Results】The total effective rate of the observation group was 84.00% (42/50),which was significantly higher than that of the control group 64.00% (32/50),and the difference was statistically significant (P<0.05). Before treatment,there were no statistically significant differences in the levels of various indicators between the two groups (P>0.05). After treatment,the levels of UTP,BUN,and Scr in both groups decreased,if compared to before treatment (P<0.05); And all three indicators above in the observation group were lower than those in the control group (P<0.05). After treatment, the levels of 2hC-P and HOMA-β in the two groups got improved compared to those before treatment,while HOMA-IR decreased (P<0.05). The level of HOMA-β in the observation group was higher than that in the control group,while HOMA-IR level was lower than that in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The treatment of DN with daggliflozin is beneficial for improving clinical efficacy,β cell function and renal function indicators. It is a safe way,which has promotional value. 2023 Vol. 40 (5): 673-675 [Abstract] ( 43 ) HTML (1 KB)  PDF (1169 KB)  ( 97 ) 676 Effect of Applying EPO at Different Times to Treat Anemia in Premature Infants and its Impact on Blood Routine Indicators ZHANG Lei, JIA Yang, AN Ting-ting, et al DOI: 10.3969/j.issn.1671-7171.2023.05.010 【Objective】 To explore the effect of using erythropoietin (EPO) at different time points in the treatment of anemia in premature infants and its impact on blood routine indicators. 【Methods】A total of 90 premature infants with anemia admitted to two hospitals from July 2020 to July 2022 were selected and divided into an observation group and a control group based on different treatment times,with 45 cases in each group. The observation group received EPO treatment after the second week of birth,while the control group received EPO treatment after the third week of birth. Both groups were treated until the fifth week of birth. The levels of anemia indexes [hemoglobin (Hb),hematocrit (HCT),reticulocyte count (Ret)] in the two groups were measured before and after treatment. The levels of blood routine indicators (RBC,MCHC and BPC) were measured before and after treatment in both groups. Before and after treatment,the levels of hematopoietic substances [folic acid,vitamin B12 and ferritin (SF)] in two groups were tested,and the number of blood transfusions during the treatment period was recorded and compared. The blood transfusion rate was calculated,and the occurrence of adverse reactions in the two groups was observed and compared.【Results】After treatment,there was no significant change in Hb and HCT levels in the observation group compared to before treatment (P>0.05),while Ret levels in the observation group were higher than before treatment (P<0.05). The Hb,HCT,Ret levels in the control group were lower than before treatment (P<0.05),and the Hb,HCT,Ret levels in the observation group were higher than those in the control group (P<0.05). After treatment,there was no significant change in the RBC level in the observation group compared to before treatment (P>0.05). The MCHC level in the observation group and the RBC and MCHC levels in the control group decreased significantly compared to before treatment. The BPC level in the observation group and the control group increased significantly compared to before treatment (P<0.05),and the RBC level in the observation group was significantly higher than that in the control group (P<0.05). There was no statistically significant difference in the levels of MCHC and BPC between the observation group and the control group (P>0.05). After treatment,the levels of folic acid,vitamin B12,and SF in the observation group and the levels of folic acid and vitamin B12 in the control group showed no statistically significant difference compared to before treatment (P>0.05). The SF levels in the control group were lower than before treatment (P<0.05),and the SF levels in the observation group were higher than those in the control group (P<0.05). There was no statistically significant difference in blood transfusion rates between the two groups (P=0.398). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). 【 Conclusion 】 Applying EPO to treat anemia in premature infants at the second week of birth may not significantly reduce the transfusion rate,but it can effectively improve the anemia status of the children and has high safety. 2023 Vol. 40 (5): 676-679 [Abstract] ( 41 ) HTML (1 KB)  PDF (1137 KB)  ( 184 ) 680 Expression and Value of miRNA-21 and its Related Clinical Indicators in Lupus Nephritis with Renal Failure SUN Ying, ZHUANG Li, SUN Li-ping, et al DOI: 10.3969/j.issn.1671-7171.2023.05.011 【Objective】To analyze the expression and value of miRNA-21 with related clinical indicators in lupus nephritis (LN) with renal failure. 【Methods】A total of of 85 patients with LN were selected in our hospital. Patients with renal failure were included in the observation group (n=19),the others were grouped as the control group (n=66). Levels of miRNA-21 and its related clinical indicators in serum were detected and compared between two groups,then receiver operating characteristic (ROC) curve analysis was used to evaluate the value of miRNA-21 in renal failure. Meanwhile,the influencing factors of renal failure were analyzed by using logistic regression analysis. 【Results】The estimate glomerular filtration rate (eGFR) and complement C3 levels in the observation group were lower than those in the control group,while the SLE disease activity index (SLEDAI)-2000 score,blood urea nitrogen (BUN),serum creatinine (Scr),erythrocyte sedimentation rate (ESR) and miRNA-21 in the observation group were significantly higher in the control group. The difference between the two groups was statistically significant (P<0.05).SLEDAI-2000 score,ESR and miRNA-21 were closely related to renal failure in LN,whose odds ratios (OR) (95%CI) were 3.137 (1.775-5.543),4.894 (2.472-9.687) and 1.227 (1.091-1.531),respectively.The area under the curve (AUC)(95%CI) of miRNA-21 in diagnosis of renal failure with LN was 0.78(0.65-0.91). 【Conclusion】The level of miRNA-21,SLEDAI-2000 score and ESR are higher in LN with renal failure,and miRNA-21 may be a useful indicator for diagnosing renal failure in LN. 2023 Vol. 40 (5): 680-682 [Abstract] ( 28 ) HTML (1 KB)  PDF (1237 KB)  ( 74 ) 683 Comparative Observation and Diagnostic Value of Gastroscopy Staining and Magnifying Endoscopy in Screening Gastric Cancer Patients SHI Rui, LI Juan, XIAO Lin-ping, et al DOI: 10.3969/j.issn.1671-7171.2023.05.012 【Objective】 To explore the screening effect and diagnostic value of gastroscopy staining and magnifying endoscopy in gastric cancer patients. 【Methods】A total of 146 suspected gastric cancer patients admitted to Air Force 986 Hospital from April 2016 to September 2018 were selected as the subjects. All patients were confirmed by pathological tissue examination. Before diagnosis,the patients were subjected to gastroscopy staining and magnifying endoscopy,and the results of the two examinations were compared with the final results. The screening effect of staining under gastroscopy and magnifying endoscopy in gastric cancer was analyzed; The diagnostic sensitivity and specificity of staining and magnifying endoscopy under gastroscopy in gastric cancer patients were analyzed.【Results】 Among the 146 suspected gastric cancer patients enrolled,94 were diagnosed with gastric cancer through pathological tissue examination,and 52 were diagnosed with benign gastric diseases. All patients completed gastroscopy staining and magnifying endoscopy examination. 84 cases of gastric cancer were confirmed by gastroscopy staining,and 89 cases were finally confirmed by magnifying endoscopy staining. There was no statistically significant difference in the detection rate of gastric cancer among different examination methods (P>0.05). There was no statistically significant difference in sensitivity and specificity between staining under a single gastroscopy and magnifying endoscopy in the diagnosis of gastric cancer (P>0.05). The sensitivity and specificity of gastroscopy staining combined with magnifying endoscopy in the diagnosis of gastric cancer were higher than those of single gastroscopy staining and magnifying endoscopy (P<0.05). 【Conclusion】The use of gastroscopy combined with magnifying endoscopy in screening gastric cancer patients can improve the accuracy of gastric cancer diagnosis,and its diagnostic efficacy is high. It can provide reference for patient diagnosis and treatment,and is worth promoting and applying. 2023 Vol. 40 (5): 683-685 [Abstract] ( 31 ) HTML (1 KB)  PDF (1107 KB)  ( 17 ) 686 Clinical Efficacy of Lysine Inositol Vitamin B12 as Auxiliary Nutritional Support and Health Guidance in the Treatment of Malnutrition in Children CHEN Bei-lei, ZHAO Xiao-dan DOI: 10.3969/j.issn.1671-7171.2023.05.013 【Objective】To study the clinical efficacy of lysine inositol vitamin B12 as auxiliary nutritional support and health guidance in the treatment of malnutrition in children. 【Method】 A total of 96 children with malnutrition admitted to our hospital from February 2017 to March 2021 were selected and divided into an observation group and a control group based on different treatment methods,with 48 cases in each group. The control group received routine nutritional support and health guidance,while the observation group received treatment with lysine inositol vitamin B12 oral solution on the basis of the control group. Both groups were treated for three months. The clinical efficacy and serum indicators [hemoglobin (Hb),albumin (ALB),total protein (TP)],and trace elements (calcium,iron,zinc) before and after treatment were compared between the two groups. The occurrence of adverse reactions in the observation group was recorded. 【Result】 The total effective rate of the observation group was 97.92% (47/48),which was higher than 83.33% (40/48) of the control group,and the difference was statistically significant (P=0.036). After treatment,the Hb,ALB,and TP of the two groups of children were higher than those before treatment,and the observation group was higher than the control group,with a statistically significant difference (P<0.05); The levels of calcium,iron,and zinc in both groups of children were higher than those before treatment,and the observation group was higher than the control group,with a statistically significant difference (P<0.05). The observation group experienced 1 case of diarrhea and 2 cases of nausea,with an adverse reaction rate of 6.25% (3/48),which was mild and improved without special treatment. 【Conclusion】 L-Lysine Inositol Vitamin B12 oral solution can effectively treat malnutrition in children and promote the absorption of trace elements such as calcium,iron,and zinc,which is worthy of clinical reference. 2023 Vol. 40 (5): 686-688 [Abstract] ( 36 ) HTML (1 KB)  PDF (1126 KB)  ( 133 ) 689 To Analyze Clinical Diagnostic Indicators and Risk Factors of Diabetic Nephropathy SHEN Ai-ning, CHANG Xiong, GAO Li-li, et al DOI: 10.3969/j.issn.1671-7171.2023.05.014 【Objective】To analyze of clinical diagnostic indicators and related risk factors in patients with diabetic nephropathy (DN). 【Methods】The medical records of 89 patients of type 2 diabetes mellitus (the T2DM group) and 80 diabetic nephropathy (DN) patients who were diagnosed in the department of endocrinology were collected. Levels of HbA1c,hs-CRP,TNF-α,IL-6,Cr and random blood glucose at admission were recorded to analyze DN clinical diagnostic indicators and related risk factors. 【Results】 Levels of hs-CRP,IL-6,TNF-α,Cr,random blood glucose and HbA1c in the T2DM group were significantly lower than those in the DN group (P<0.05). HbA1c was linearly and positively correlated with TNF-α,Cr and IL-6 (P<0.05).The ROC curve showed that HbA1c was a potential clinical indicator for the diagnosis of DN and the area under the curve (AUC) (95%CI)was 0.86 (0.81-0.92).Binary logistic regression analysis showed that HbA1c,IL-6 and TNF-α were closely related to DN,their odds ratio (OR) (95%CI) were 3.70 (2.29-5.96),1.04 (0.92-1.18) and 1.10 (0.93-1.31),respectively. 【Conclusion】Poor blood glucose control exacerbates the inflammatory response of diabetic patients. and HbA1c,IL-6 and TNF-α were independent risk factors and potential diagnostic indicators for DN. 2023 Vol. 40 (5): 689-691 [Abstract] ( 33 ) HTML (1 KB)  PDF (1230 KB)  ( 77 ) 692 Effect of Ketorolac Tromethamine Combined with Dexmedetomidine on Preemptive Analgesia in Patients Undergoing Cesarean Section GAO Huai-xin, JIANG Liu-qin DOI: 10.3969/j.issn.1671-7171.2023.05.015 【Objective】To investigate the effect of ketorolac tromethamine (KT) combined with dexmedetomidine (Dex) on preemptive analgesia in patients undergoing cesarean section. 【Methods】A total of 180 patients with cesarean section in our hospital were divided into two groups according to the order of admission. The 90 cases in the control group were given Dex plus equal volume normal saline for preemptive analgesia,and 90 cases in the observation group were given KT combined with Dex for preemptive analgesia. The incidence of postoperative shivering,postoperative pain,perioperative stress hormone levels,adverse reactions,and neonatal Apgar score were compared between the two groups. 【Results】The total incidence of postoperative shivering in the observation group was lower than that in the control group (P<0.05). The visual analogue scale (VAS) scores of the observation group at 6 h,12 h and 24 h after operation were lower than those of the control group at the same time points (P<0.05). The levels of renin (Rn),cortisol (Cor) and adrenocorticotropic hormone (ACTH) in the two groups at 2h after operation (T1) were higher than those before epidural puncture (T0) (P<0.05),and the levels of Rn,Cor and ACTH in the observation group at T1 were lower than those in the control group at T1 (P<0.05). After surgery,Rn,Cor,and ACTH levels of the two groups at T2 (8:00 am the next day post-operation) were higher than those at T0 (P<0.05). The levels of Rn,Cor and ACTH in the control group were higher than those at T1 (P<0.05),while the levels of Rn,Cor and ACTH in the observation group at T2 were lower than those in the control group at T2 (P<0.05). The incidence of nausea and vomiting in the observation group was lower than that in the control group (P<0.05). There was no significant difference in newborn Apgar score at 1 min and 5 min between the two groups (P>0.05). 【Conclusion】KT combined with Dex for preemptive analgesia in cesarean section can prevent postoperative shivering,enhance postoperative analgesic effect,inhibit perioperative stress reaction and reduce adverse reactions,while it does not affect the neonatal Apgar score. 2023 Vol. 40 (5): 692-694 [Abstract] ( 42 ) HTML (1 KB)  PDF (1165 KB)  ( 26 ) 695 Effects of Dexmedetomidine on Short-term Prognosis and Th1/Th2 Balance in Patients undergoing Thoracoscopic Pulmonary Nodule Surgery XU Ting, YAO Yu-liang, LAN Xia DOI: 10.3969/j.issn.1671-7171.2023.05.016 【Objective】To investigate the effect of dexmedetomidine on short-term prognosis and Th1/Th2 balance in patients undergoing thoracoscopic pulmonary nodules. 【Methods】A total of 88 patients with pulmonary nodules admitted to our hospital were divided into the observationy group and the control group,with 44 cases in each group. Patients in two groups underwent thoracoscopic pulmonary nodule surgery with general anesthesia. In the observation group,dexmedetomidine 0.5 μg/kg was injected intravenously 15 minutes before induction of anesthesia and continuously pumped at 0.2-0.4 μg/(kg?h) intraoperative dexmedetomidine during the operation. The control group received normal saline instead of dexmedetomidine. After surgery,both groups used intravenous patient-controlled analgesia pump:sufentanyl 0.05 μg/(kg?h)+dexmedetomidine 3.5 μg/kg in the observation group and sufentanyl 0.05 μg/(kg?h) in the control group. These drugs were diluted in 100 mL of normal saline. The hemodynamic cardiac output (CO),mean arterial pressure (MAP) changes,Th1/Th2 cytokine,interleukin-2 (IL-2),interleukin-4 (IL-4) levels,quality of recovery,postoperative complications,and safety before and after surgery were compared in the two groups. 【Results】The levels of both CO and MAP at 2 h during the operation were lower than before anesthesia in the two groups (P<0.05). And levels of CO and MAP in the observation group were lower than those in the control group (P<0.05). There were no significant differences in IL-2 and IL-4 levels between the two groups before anesthesia (P> 0.05),however,at 3 h after the surgery, the peripheral blood IL-2 level was higher than those before surgery in both groups (P<0.05). And the IL-2 level in the observation group was significantly higher than that in the control group (P<0.05). Compared to pre-anesthesia,levels of IL-4 at 3 h after surgery in both groups were lower (P<0.05); And IL-4 level in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in operation time and recovery time between the two groups (P>0.05). The incidence of complications and adverse reactions in the observation group were lower than those in the control group (P<0.05).【Conclusion】Dexmedetomidine in patients undergoing thoracoscopic pulmonary nodules surgery can improve the Th1/Th2 immune balance and improve the short-term outcome. 2023 Vol. 40 (5): 695-698 [Abstract] ( 34 ) HTML (1 KB)  PDF (1129 KB)  ( 49 ) 699 Recent Antiplatelet Efficacy and Incidence of Adverse Reactions in Patients with Acute ST Segment Elevation Myocardial Infarction Treated with Tigrillo WANG Li-jie, HAN Dan-ning DOI: 10.3969/j.issn.1671-7171.2023.05.017 【Objective】To investigate the recent antiplatelet efficacy and adverse reactions of Tigrillo in the treatment of acute ST segment elevation myocardial infarction (STEMI) patients. 【Methods】A retrospective analysis was conducted on the clinical data of 85 patients with acute STEMI who underwent emergency PCI treatment in our hospital from January 2018 to June 2020. They were divided into two groups based on different antiplatelet treatment drugs:the Tigrillo group and the clopidogrel group. We compared the general clinical data,platelet related indicators,platelet inhibition rate,TIMI grading,corrected TIMI frame count,as well as the occurrence of major adverse reactions and endpoint events between two groups of patients. 【Results】There was no significant difference in the inhibition rate of arachidonic acid (AA%) and residual platelet activity (MAAA) in the AA induction pathway between the two groups at admission,24 hours after taking the drug,and 7 days after taking the drug (P>0.05). 24 hours after administration and 7 days after administration,the inhibition rate of adenosine diphosphate (ADP%) in the Tigrillo group was higher than that in the clopidogrel group,and the residual platelet activity (MAADP) in the ADP induction pathway was lower than that in the clopidogrel group,with a statistically significant difference (P<0.05). After 7 days of medication,the proportion of patients with TIMI grade III in the Tigrillo group was higher than that in the clopidogrel group,and the corrected TIMI frame counts of the anterior descending branch,circumflex branch,and right coronary artery were all lower than those in the clopidogrel group,with statistically significant differences (P<0.05). There was no statistically significant difference in the incidence of adverse reactions such as dyspnea,bradycardia,skin ecchymosis,and bleeding between the two groups of patients (P>0.05); There was no statistically significant difference in endpoint events such as cardiac death,recurrent myocardial infarction,and emergency coronary revascularization between the two groups of patients (P>0.05). 【Conclusion】 The application of Tigrillo in STEMI patients undergoing PCI treatment has a better inhibitory effect on platelet aggregation than clopidogrel,and can reduce the occurrence of no/slow reflux without increasing the incidence of adverse reactions and primary endpoint events. The safety is good. 2023 Vol. 40 (5): 699-702 [Abstract] ( 30 ) HTML (1 KB)  PDF (1129 KB)  ( 54 ) 703 Correlation Analysis of Peripheral Blood Th9 Cell Level with Liver Function in Patients with Hepatitis B Cirrhosis FENG Qiong, WANG Ni-juan DOI: 10.3969/j.issn.1671-7171.2023.05.018 【Objective】To investigate the correlation between liver function and Th9 cells in peripheral blood of patients with hepatitis B cirrhosis.【Methods】A total of 140 patients with hepatitis B cirrhosis admitted to two hospitals,including 56 patients with compensatory cirrhosis (A group) and 84 patients with decompensated cirrhosis (B group). While 60 healthy people during the same period were selected as the control group. The expression of Th9 cells in peripheral blood and the serum levels of aspartate aminotransferase (AST),alanine aminotransferase (ALT),alkaline phosphatase (ALP),gamma-glutamyl transpeptide (γ-GT) as well as total bilirubin (TBIL) were measured in all three groups.Pearson correlation was used to analyze the correlation between liver function indexes and Th9 cell expression in peripheral blood.【Results】The percentage of Th9 cell subsets in peripheral blood of patients with B group was significantly higher than that of A group and the control group (P<0.05); The percentage of Th9 cell subsets in peripheral blood of A group was significantly higher than that of the control group(P<0.05). Compared with the control group,the levels of AST,ALT,ALP,γ-GT and TBIL in patients with A group and B group were increased (P<0.05),and the above indexes in patients with B group were higher than those in A group(P<0.05). The levels of serum AST,ALT,γ-GT and TBIL in patients with hepatitis B cirrhosis were positively correlated with Th9 cell expression in peripheral blood (r=0.562,0.536,0.574,and 0.504,respectively,P<0.05).【Conclusion】Th9 cells in peripheral blood of patients with hepatitis B cirrhosis are highly expressed,and Th9 cell level is positively correlated with AST,ALT,γ-GT and TBIL,suggesting that Th9 cells may be involved in the development of hepatitis B cirrhosis. 2023 Vol. 40 (5): 703-705 [Abstract] ( 25 ) HTML (1 KB)  PDF (1164 KB)  ( 33 ) 706 Effects of Post-Tracheotomy Sequential Transnasal High-flow Humidification and Oxygenation Therapy on Respiratory Tract Infection and Clinical Outcomes in Elderly Patients with Chronic Obstructive Pulmonary Disease Complicated with Type Ⅱ Respiratory Failure SI Yan, ZHANG Na-na DOI: 10.3969/j.issn.1671-7171.2023.05.019 【Objective】To explore the effect of post-tracheotomy sequential transnasal high-flow humidification and oxygen therapy on respiratory tract infection and clinical outcomes in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. 【Methods】A total of 96 elderly patients with COPD and type Ⅱ respiratory failure,who were admitted to the hospital for tracheotomy from May 2018 to May 2020,were selected and divided into the observation group and the control group. According to the random number table method,there were 48 cases in each group. The control group was treated with non-invasive positive pressure ventilation,while the observation group was treated with sequential nasal high-flow humidification and oxygen therapy. The average sputum suction times,sputum viscosity,respiratory tract infection,spontaneous breathing time,ICU stay time,clinical efficacy,respiratory dynamics,blood gas analysis,pulmonary function and adverse reactions were compared between the two groups. 【Results】The average number of sputum suctions,spontaneous breathing time,ICU stay time,and incidence of respiratory tract infection in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the 28-day mortality between the observation group and the control group (P>0.05). The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment,the average airway pressure and airway resistance of the observation group were lower than those of the control group (P<0.05). After treatment,the blood partial pressure of oxygen (PaO2) in the observation group was higher than that in the control group (P<0.05),and the blood carbon dioxide partial pressure (PaCO2) in the observation group was lower than that in the control group (P<0.05). After treatment,the forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity (FVC) of the observation group were higher than those of the control group. There was no significant difference in the incidence of adverse reactions between the observation group and the control group (P>0.05). 【Conclusion】 Sequential nasal high-flow humidification and oxygenation therapy after tracheotomy in elderly patients with chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure can reduce the rate of respiratory tract infection,improve clinical outcomes,and improve lung function at the same time,which is safe and reliable. 2023 Vol. 40 (5): 706-709 [Abstract] ( 35 ) HTML (1 KB)  PDF (1131 KB)  ( 117 ) 710 Clinical Effects and Maternal and Fetal Outcomes of Synchronous Surgery in Patients with Pregnancy Complicated with Uterine Fibroids SU Yan-zi, LI Lian, PANG Ni DOI: 10.3969/j.issn.1671-7171.2023.05.020 【Objective】To explore the clinical effects and maternal and infant conditions of synchronous surgery for patients with pregnancy complicated with uterine fibroids. 【Method】 A total of 200 patients with pregnancy complicated with uterine fibroids admitted to Xi'an Angel Obstetrics and Gynecology Hospital from January 2020 to June 2022 were randomly divided into an observation group (undergoing cesarean section and uterine fibroidectomy simultaneously) and a control group (undergoing simple cesarean section),with 100 cases in each group. The operation time,intraoperative blood loss,anal exhaust time,hospital stay,postpartum blood loss,lochia clean time,menstrual recovery time,incidence of complications (incision infection,constipation,puerperal infection,pain,urinary retention),neonatal asphyxia rate,length of newborn,weight of newborn,Apgar score were compared between the two groups.【Result】There was no statistically significant difference (P>0.05) between the two groups in terms of intraoperative bleeding volume,anal exhaust time,hospital stay,postpartum bleeding volume,lochia cleaning time,and menstrual recovery time. The observation group had a longer surgical time than the control group (P<0.05); There was no significant difference in the incidence of incision infection,constipation,puerperal infection,pain,and urinary retention between the two groups (P>0.05); There was no statistically significant difference between the two groups in terms of neonatal asphyxia rate,neonatal length,neonatal weight,and Apgar score (P>0.05). 【Conclusion】Simultaneous cesarean section and myomectomy for pregnant women with uterine fibroids will not only prolong the surgical time,but also have no impact on the surgical effect,postpartum recovery,postoperative complications,and newborn health. It is relatively safe and feasible. 2023 Vol. 40 (5): 710-712 [Abstract] ( 29 ) HTML (1 KB)  PDF (1158 KB)  ( 81 ) 713 Application of Perioperative Disease Management Model Supported by Information Cooperation Platform in Patients with Endometriosis CAO Yue, ZHU Yin, HU Wen-jin DOI: 10.3969/j.issn.1671-7171.2023.05.021 【Objective】To explore the application of perioperative disease management model supported by information cooperation platform in patients with endometriosis.【Methods】A simple random sampling method was used to select 142 patients with endometriosis admitted to the Obstetrics and Gynecology Hospital affiliated to Fudan University from January 2022 to December as the study subjects. They were divided into two groups by random number table method,with 71 patients in each group. The control group implemented the conventional perioperative disease management model,while the observation group implemented the perioperative disease management model supported by the information cooperation platform. The coping styles and perioperative stress reactions of the two groups were compared on the day of admission and 1 day before operation.【Results】On the day of admission,there were no significant differences in the scores of positive and negative coping on the Simplified Coping Style Questionnaire (SCSQ) between the two groups (P>0.05). One day before operation,the SCSQ positive coping scores of patients in both groups were higher than those on the day of admission,while the SCSQ negative coping scores were lower than those on the day of admission (P<0.05). The SCSQ positive coping score of patients in the observation group was higher than that in the control group,and the SCSQ negative coping score was lower than that in the control group (P<0.05). The levels of HR,SBP and DBP of patients in the two groups were higher than those on the day of admission (P<0.05),and the postoperative levels of HR,SBP and DBP in the control group were higher than those on the day of admission (P<0.05). There were no significant differences in the levels of HR,SBP and DBP between the two groups on the day of admission (P>0.05). The levels of HR,SBP and DBP in the observation group were lower than those in the control group on the first day before operation,the first day after operation,the first day after operation and the third day after operation (P<0.05).【Conclusion】The perioperative disease management model supported by the information collaboration platform can provide a wealth of disease and surgical related knowledge during the perioperative period,and facilitate the acquisition and mastery of relevant knowledge by patients,which not only helps improve the coping style of patients with endometriosis,but also has a positive role in reducing their perioperative stress response. 2023 Vol. 40 (5): 713-716 [Abstract] ( 28 ) HTML (1 KB)  PDF (1126 KB)  ( 31 ) 717 Risk Factors of Stress Ulcer after Intracerebral Hemorrhage Surgery WANG Qiu-ya, SUN Xiao-xu, MING Shuai DOI: 10.3969/j.issn.1671-7171.2023.05.022 【Objective】To explore the risk factors of stress ulcer (SU) after intracerebral hemorrhage surgery. 【Methods】 A retrospective analysis was conducted on the clinical data of 374 patients with cerebral hemorrhage who underwent surgical treatment at the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2022. They were divided into an SU group (n=42) and a non SU group (n=332) based on whether they had postoperative complications. The baseline data of two groups of patients were compared and the logistic multiple factor regression model was used to analyze the risk factors of postoperative complications of cerebral hemorrhage. The ROC curve was used to analyze the value of logistic multivariate regression model in evaluating postoperative complications of cerebral hemorrhage.【Results】 There were significant differences in age,serum potassium,Gastrin and lactic acid between the two groups (P<0.05). Logistic regression analysis showed that age (≥ 60 years old),serum potassium (≤ 3.84 mmol/L),Gastrin (>73.17 ng/L),and lactic acid (>2.70 mmol/L) were the risk factors for SU after intracerebral hemorrhage surgery (P<0.05). The AUC of the logistic regression model for evaluating postoperative complications of cerebral hemorrhage with SU was 0.878 (95%CI:0.824-0.936),with a sensitivity of 82.13% and a specificity of 83.66%.【Conclusion】Age,serum potassium,Gastrin and lactic acid levels are important influencing factors for postoperative SU after intracerebral hemorrhage. Clinicians can formulate corresponding intervention measures to reduce the risk of postoperative SU. 2023 Vol. 40 (5): 717-719 [Abstract] ( 38 ) HTML (1 KB)  PDF (1167 KB)  ( 105 ) 720 Effect of Intravenous Immunoglobulin Injection on the Levels of T Lymphocyte Subsets in Children with Kawasaki Disease JIN Jing-jing, DENG Fang, LU Song-jian, et al DOI: 10.3969/j.issn.1671-7171.2023.05.023 【Objective】 To investigate the effect of intravenous immunoglobulin injection on the levels of T lymphocyte subsets in children with kawasaki disease (KD) before and after treatment. 【Methods】A total of 96 children with KD admitted to our hospital from October 2018 to October 2020 were selected and divided into a poor prognosis group and a good prognosis group based on their coronary artery injury three months after onset. The serum levels of immunoglobulin A (IgA),immunoglobulin G (IgG),and immunoglobulin M (IgM) were measured using immune scattering turbidimetry. The peripheral blood T lymphocyte subpopulations were measured using flow cytometry. The predictive value of T lymphocyte subpopulations on the prognosis of KD children was analyzed using receiver operating characteristic curve (ROC). 【Results】 The serum levels of IgG,IgA,and IgM in KD patients after treatment were lower than before treatment,with statistically significant differences (P<0.05). After treatment,the peripheral blood CD3+,CD3+CD4+,CD3+CD8+,and CD4+/CD8+ levels in KD patients were lower than those before treatment (P<0.05). After treatment,there were 28 cases (29.17%) of KD patients with coronary artery injury,which was lower than those of the 62 cases (64.58%) before treatment,and the difference was statistically significant (P<0.001). The CD3+,CD3+CD4+,CD3+CD8+,and CD4+/CD8+ levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The AUC of CD3+,CD3+CD4+,CD3+CD8+ and CD4+/CD8+ combined detection was higher than that of their individual detection (P<0.05). 【Conclusion】Intravenous immunoglobulin therapy can regulate the level of T lymphocyte subsets,and detecting the level of T lymphocyte subsets in children with KD has good predictive value in evaluating the prognosis of KD. 2023 Vol. 40 (5): 720-723 [Abstract] ( 30 ) HTML (1 KB)  PDF (1218 KB)  ( 36 ) 724 Dynamic Changes and Clinical Significance of Blood FGF10,NLR,CRP/ALB in Patients with Urinary Tract Infection after Prostatic Hyperplasia Surgery LIU Tao, ZHANG Feng-hua DOI: 10.3969/j.issn.1671-7171.2023.05.024 【Objective】 To investigate the dynamic changes of fibroblast growth factor 10 (FGF10),neutrophil/lymphocyte ratio (NLR),and C-reactive protein (CRP)/albumin (ALB) in patients with urinary tract infection after prostatectomy for benign prostatic hyperplasia (BPH). 【Methods】 A total of 164 patients with BPH admitted to our hospital from January 2018 to March 2021 were selected,all of whom underwent transurethral plasma bipolar resection of the prostate. They were divided into an infected group (n=33) and an uninfected group (n=131) based on whether urinary tract infection occurred after the surgery. Compare the baseline data of two groups,FGF10,NLR,CRP/ALB before and after surgery,analyze the influencing factors of urinary tract infection after BPH surgery,and evaluate the diagnostic value of FGF10,NLR,CRP/ALB for urinary tract infection after BPH surgery. 【Results】There were significant differences between the two groups in terms of age,operation time,proportion of prophylactic use of antibiotics before operation,and proportion of catheterization due to urinary retention before operation (P<0.05). The FGF10,NLR,CRP/ALB levels in both groups showed a trend of first increasing and then decreasing on the 1st,3rd,and 5th postoperative days,and both reached their peak on the 3rd postoperative day (P<0.05); The FGF10,NLR,CRP/ALB levels in the infected group were higher than those in the non infected group at 1 day,3 days,5 days after surgery (P<0.05). Multivariate logistic regression analysis showed that age,operation time,preoperative prophylactic use of antibiotics,preoperative catheterization due to urinary retention,and FGF10,NLR,CRP/ALB 3 days after operation were the important influencing factors for urinary tract infection after BPH (P<0.05). ROC curve analysis showed that the area under the curve of FGF10,NLR,CRP/ALB combined diagnosis of postoperative urinary tract infection in BPH at 3 days after surgery was 0.913,significantly better than a single indicator (P<0.05). The FGF10,NLR,CRP/ALB levels in patients with Gram negative bacteria were significantly higher than those with Gram positive bacteria (P<0.05). 【Conclusion】Patients with urinary tract infections after BPH surgery have elevated levels of FGF10,NLR,and CRP/ALB. Dynamic combined monitoring of these three factors can provide reference for clinical diagnosis and treatment,as well as differentiation of pathogenic bacteria types. 2023 Vol. 40 (5): 724-727 [Abstract] ( 32 ) HTML (1 KB)  PDF (1150 KB)  ( 44 ) 728 Analysis of Risk Factors of Deep Vein Thrombosis in Patients with Rib Fracture and Other Fractures PEI Yan-jiang, QI Bin DOI: 10.3969/j.issn.1671-7171.2023.05.025 【Objective】 To explore the risk factors of deep vein thrombosis (DVT) in patients with rib fracture and other fractures. 【Methods】 A retrospective analysis was conducted on the clinical data of 283 patients with rib fractures combined with fractures in other parts. The patients were divided into two groups based on whether DVT occurred after surgery:the group with DVT and the group without DVT. We compared clinical data,surgical indicators,and laboratory indicators between two groups of patients,and used multivariate logistic regression to analyze the independent risk factors for postoperative DVT in patients. 【Results】 Out of 283 patients,105 (37.10%) developed DVT after surgery,with 1 patient complicated with acute pulmonary embolism and no deaths. There was no statistically significant difference between the two groups in terms of gender,chest comorbidities,comorbidities with internal medicine,and comorbidities with other injuries (P>0.05); Compared with the group without DVT,the group with DVT had older age,more rib fractures,bilateral rib fractures,and multiple site fractures (P<0.05). There was no statistically significant difference in intraoperative blood loss and whether intraoperative blood transfusion was performed between the two groups of patients (P>0.05),but the difference in surgical time between the two groups was statistically significant (P<0.05). Compared with the group without DVT,the group with DVT showed a decrease in hemoglobin content and prothrombin time,while the D-dimer content increased (P<0.05). Logistic multivariate regression analysis showed that the number of rib fractures,combined multiple site fractures,prothrombin time,and D-dimer content were independent risk factors for DVT in patients with rib fractures combined with other site fractures. 【Conclusion】 The high-risk factors for postoperative DVT in patients with rib fractures combined with other site fractures include the number of rib fractures,multiple site fractures,prothrombin time,and D-dimer content. 2023 Vol. 40 (5): 728-730 [Abstract] ( 27 ) HTML (1 KB)  PDF (1161 KB)  ( 58 ) 731 Analysis of Ocular Surface Changes in Patients with Refractive Error Treated with FS-LASIK and SMILE LI Hong, ZHU Fei DOI: 10.3969/j.issn.1671-7171.2023.05.026 【Objective】 To investigate the changes of ocular surface in patients with ametropia after femtosecond laser flap excimer laser laser in situ keratomileusis (FS-LASIK) and small incision stroma lens extraction (SMILE). 【Methods】A total of 38 patients with refractive errors who underwent FS-LASIK correction in our hospital from January 2021 to January 2022 were selected as the FS-LASIK group. In addition,38 patients with refractive errors who underwent SMILE correction in our hospital during the same period were selected as the SMILE group. The two groups were compared in terms of preoperative,postoperative 1 week,postoperative 1 month,postoperative 3 months,and postoperative 6 months,including the Eye Surface Disease Index (OSDI) questionnaire score,corneal fluorescence staining score,central lacrimal height (TMH),meibomian gland function score (LMS),and lipid layer thickness. 【Results】 Six months after surgery,the OSDI score of the FS-LASIK group was higher than that of the SMILE group (P<0.05),and the OSDI score increased at 1 week,1 month,and 3 months after surgery compared to those before surgery (P<0.05); The corneal fluorescein staining scores of both groups increased at 1 week and 1 month after surgery compared to before surgery (P<0.05); TMH in both groups increased at 1 week and 1 month after surgery compared to before surgery (P<0.05); There was no statistically significant difference in LMS and lipid layer thickness between the two groups before surgery,1 week after surgery,1 month after surgery,3 months after surgery,and 6 months after surgery (P>0.05). The lipid layer thickness of the two groups at 6 months after surgery decreased compared to that before surgery (P<0.05). 【Conclusion】 Both FS-LASIK and SMILE surgeries can have an impact on the ocular surface of ametropia patients,leading to dry eye symptoms. However,dry eye symptoms are more severe after FS-LASIK surgery. 2023 Vol. 40 (5): 731-734 [Abstract] ( 27 ) HTML (1 KB)  PDF (1130 KB)  ( 281 ) 735 Value of NEDD9 for Diagnosis and Prediction of Prognosis in Pancreatic Cancer XU Yu, HE Hai-tao, WEI Zhi-li, et al DOI: 10.3969/j.issn.1671-7171.2023.05.027 【Objective】 To investigate the value of neuronal expression developmentally downregulated gene 9(NEDD9) for diagnosis and prediction of prognosis in pancreatic cancer. 【Methods】A total of 80 patients with pancreatic cancer,who were treated for the first time in our hospital and confirmed by rapid pathological biopsy,were enrolled in the study. The pancreatic cancer tissues and normal tissues adjacent to the cancer were collected. The expression of NEDD9 in pancreatic cancer tissues and normal tissues was detected by both immunohistochemistry and qPCR. The relationship between NEDD9 and clinical features of pancreatic cancer was analyzed. And the effect of NDEE9 on clinical prognosis of patients with pancreatic cancer was discussed. 【Results】Compared to normal tissues,the expression rate of NEDD9 in pancreatic cancer tissues was significantly higher (71.25% vs 51.25%,P<0.05); And the level of NEDD9 mRNA was also significantly higher than that of normal tissue (0.92±0.17) vs (0.33±0.09),P<0.05). The clinical stage (stage Ⅰ-Ⅱ) and degree of differentiation (high differentiation) in patients with low expression of NEDD9 were significantly better than those who had higher expression level of NEDD9.Follow-up results showed that the expression level of NEDD9 in patients with poor prognosis (1.21±0.31) was significantly higher than that in the group with good prognosis (0.73±0.25) (P<0.05).Binary logistic regression analysis found that high expression of NEDD9 was an independent risk factor for negative prognosis of pancreatic cancer,and its odds ratio was 2.18 (1.16-4.01).【Conclusion】 NEDD9 was highly expressed in pancreatic cancer tissues and it was associated with clinical stage and pancreatic cancer grading. The high expression of NEDD9 was an independent risk factor for negative prognosis in patients with pancreatic cancer. 2023 Vol. 40 (5): 735-737 [Abstract] ( 36 ) HTML (1 KB)  PDF (1103 KB)  ( 30 ) 738 Expression Changes and Clinical Significance of Serum miRNA-182 in Patients with Systemic Lupus Erythematosus ZHOU Fang, ZHANG Qiong DOI: 10.3969/j.issn.1671-7171.2023.05.028 【Objective】 To investigate the expression changes and clinical significance of miRNA-182 in serum of patients with systemic lupus erythematosus (SLE). 【Method】 A total of 110 SLE patients who visited our hospital were assigned to the SLE group,while 110 healthy individuals who underwent physical examinations at the same time in our hospital were assigned to the control group; After all subjects were enrolled in the group,fasting venous blood was drawn to detect the level of miRNA-182 antibody,calculate the SLEDAI score of SLE patients,analyze the expression changes of miRAN-182 in SLE patients and evaluate the value of disease activity.【Results】The relative expression level of miRNA-182 in peripheral blood of SLE patients was significantly higher than that of the control group (P<0.05);Compared with patients in remission stage,the level of miRAN-182 in patients with active SLE was significantly increased (P<0.05). Pearson correlation analysis found a positive correlation between miRNA-182 and SLEDAI score (r=0.627,P<0.05);The concentration of miRNA-182 in active phase patients decreased significantly after treatment compared to before treatment (P<0.05);The receiver operating characteristic curve (ROC) showed that miRNA-182 had high clinical efficacy in identifying active SLE patients,with an area under curve (AUC) (95%CI) of 0.88 (0.81-0.96).【Conclusion】miRNA-182 is elevated in SLE and closely related to disease activity. 2023 Vol. 40 (5): 738-740 [Abstract] ( 30 ) HTML (1 KB)  PDF (1167 KB)  ( 61 ) 741 Clinical Significance in Detecting Serum Changes of Th1/Th2 Related Cytokines in OSAHS Patients with Allergic Rhinitis HE Hai-yan, XU Jian, GU Xiao-jing, et al DOI: 10.3969/j.issn.1671-7171.2023.05.029 【Objective】To explore the clinical significance of changes in serum helper T cell subsets (Th1/Th2) related cytokines in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with allergic rhinitis. 【Methods】A total of 105 OSAHS patients who admitted to the hospital from October 2019 to January 2021 were selected for the study,and 94 healthy volunteers who came to the hospital for physical examination during the same period were selected. The levels of serum interferon-γ (IFN-γ),interleukin-2 (IL-2),interleukin-4 (IL-4) and interleukin-13 (IL-13) in OSAHS patients and healthy individuals were measured and compared. As the situation of OSAHS with allergic rhinitis was considered,the factors affecting OSAHS patients with allergic rhinitis was analyzed. Thus,the value of serum IFN-γ,IL-2,IL-4,and IL-13 levels in predicting OSAHS patients with allergic rhinitis was investigated. 【Results】Serum levels of both IFN-γ and IL-2 in OSAHS patients were lower than those in healthy people (P<0.05),and serum IL-4 and IL-13 levels were higher than those in healthy people (P<0.05). The levels of serum IFN-γ and IL-2 in patients with allergic rhinitis were lower than those without allergic rhinitis group (P<0.05),while the levels of serum IL-4 and IL-13 were higher than those without allergic rhinitis group (P<0.05). Compared to OSAHS patients without allergic rhinitis,the composition ratio of the apnea/hypopnea classification and pathological adenoid hypertrophy in patients with allergic rhinitis were significantly different (P<0.05).The levels of IFN-γ,IL-2,IL-4,IL-13 and pathological adenoid hypertrophy were related factors affecting OSAHS patients with allergic rhinitis (P<0.05). The area under the curve (AUC) of serum IFN-γ,IL-2,IL-4 and IL-13 levels in predicting OSAHS patients with allergic rhinitis were 0.846,0.768,0.778,and 0.853,respectively. 【Conclusion】Clinical detection of serum IFN-γ,IL-2,IL-4,and IL-13 levels can be used as sensitive indicators to predict OSAHS patients with allergic rhinitis. 2023 Vol. 40 (5): 741-743 [Abstract] ( 29 ) HTML (1 KB)  PDF (1272 KB)  ( 31 ) 744 Prognostic Value of Coagulation Index and Cystatin C for AKI Occurrence at 24 h after cardiac surgery DENG Wei-ning, LI Jing-yuan DOI: 10.3969/j.issn.1671-7171.2023.05.030 【Objective】To investigate the value of coagulation index and cystatin C (Cys C) in predicting AKI occurrence at 24 h after cardiac surgery. 【Methods】A total of 118 patients in our hospital received cardiac surgery were enrolled in the study.According to whether AKI occurred at 24 h after the operation,the patients were divided into the occurrence group (with AKI) and the non-occurring group (without AKI).The two groups of patients were compared with prothrombin time (PT),activated partial thromboplastin time (APTT),D-dimer (DD) and fibrinogen (FIB) at 2 h after surgery. The clinical data of two group were compared. Logistic multivariate regression analysis was used to evaluate the risk factors of AKI in patients. The predictive value of ROC at 2 h postoperatively in the occurrence of AKI in patients was analyzed. 【Results】Of the 118 patients,36 cases of AKI occurred 24 h after surgery,and the incidence was 30.51%.The levels of GFR,BUN,PT,APTT,DD,and Cys C at 2 h after the operation in the occurrence group were higher those in the non-occurring group,while the FIB level in the occurrence group was lower than that in the non-occurring group at 2 h after the operation (P<0.05).Logistic regression analysis showed that APTT,FIB,Cys C,and GFR at 2 h after the operation were all risk factors for AKI occurrence at 24 h after cardiac surgery (P<0.05).The ROC curve results showed that the area under the curve (AUC) of APTT,FIB,Cys C and the combination of the three in patients with cardiac surgery at 24 h after the operation were 0.819,0.760,0.757,and 0.902(P<0.05),respectively. 【Conclusion】Indicators of APTT,FIB and Cys C at 2 h postoperation have certain value in predicting the occurrence of AKI in patients with cardiac surgery 24 h postoperatively,and the combination of the three has even higher predictive value. 2023 Vol. 40 (5): 744-747 [Abstract] ( 32 ) HTML (1 KB)  PDF (1161 KB)  ( 25 ) 748 MTHFR C677T and A1298C Gene Polymorphisms in Han Population of the Baoji City WANG Hua, DOU Shu-yuan, DANG Li-jun, et al DOI: 10.3969/j.issn.1671-7171.2023.05.031 【Objective】To explore the distribution characteristics of genetic polymorphism in the folate metabolism related genes 5,10-Methylenetetrahydrofolate Reductase (MTHFR) C677T and A1298C locus in the health examination population of the Baoji City.【Method】A total of 486 Han women and 438 Han men in the Baoji City were selected as the study subjects. The distribution of MTHFR C677T and A1298C loci genes in all study subjects was detected,and the distribution characteristics of gene polymorphism in different genders and regions were analyzed. 【Results】The proportions of CC,CT,and TT genotypes at the MTHFR C677T locus in the 924 Han population in the Baoji City were 22.0%,47.2%,and 30.8%,respectively; The proportions of AA,AC,and CC genotypes at the MTHFR A1298C locus were 67.4%,26.6%,and 6.0%,respectively. There was no statistically significant difference in the distribution of MTHFR C677T and A1298C polymorphisms between male and female Han population in the Baoji City (P>0.05). 【Conclusion】The distribution of MTHFR C677T polymorphism in healthy Han population in the Baoji City is not affected by gender,but has certain regional characteristics. Genetic factors should be included as one of the key factors in personalized clinical diagnosis,treatment,and health management. 2023 Vol. 40 (5): 748-750 [Abstract] ( 31 ) HTML (1 KB)  PDF (1100 KB)  ( 44 ) 751 Application Effect of Mifepristone in Induced Abortion of Scarred Uterine Placenta Previa LI Wen-ting, CAO Xiao-rong DOI: 10.3969/j.issn.1671-7171.2023.05.032 【Objective】 To explore the application effect of mifepristone in induced abortion of scar uterine placenta previa. 【Methods】 A total of 80 induced abortion pregnant women with scar uterine placenta previa admitted to the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from May 2019 to May 2021 were randomly divided into an observation group and a control group,with 40 cases in each group. The observation group received oral mifepristone,and on the third day,100 mg of ethacridine lactate injection was injected into the amniotic cavity under ultrasound localization to induce labor; The control group was induced labor by injecting 100 mg of ethacridine lactate injection into the amniotic cavity through intrauterine injection. Two groups of pregnant women were compared in terms of induction effect,induction status,preoperative and postoperative sex hormone levels,prognosis,and incidence of adverse reactions.【Results】The success rate of induced abortion in the observation group was 97.50%,significantly higher than 82.50% in the control group,with a statistically significant difference (P<0.05); The observation group had less surgical time and bleeding volume than the control group,and the postoperative VAS score was lower than that of the control group,with statistical significance (P<0.05); The levels of sexual hormones in both groups of pregnant women decreased after surgery,and the levels of sexual hormones in the observation group were lower than those in the control group (P<0.05); The proportion of postoperative disseminated intravascular coagulation and postpartum disease in the observation group was lower than that in the control group,while the time for bloody lochia and menstrual recovery was shorter than that in the control group (P<0.05). However,there was no statistically significant difference in the rate of hysterectomy and incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 The use of mifepristone in induced abortion of scar uterine placenta previa has a significant effect,reducing surgical time and bleeding,alleviating patient pain,improving patient sex hormone levels and prognosis,and does not significantly increase the incidence of adverse reactions. It is worth promoting and applying in clinical practice. 2023 Vol. 40 (5): 751-753 [Abstract] ( 25 ) HTML (1 KB)  PDF (1163 KB)  ( 60 ) 754 Application Effect of Group Mindfulness Yoga Training Combined with Emotion-focused Cognitive Behavioral Intervention in Primiparous Women with Postpartum Depression LI Ying-yun, SHENG Jia, MIN Hui, et al DOI: 10.3969/j.issn.1671-7171.2023.05.033 【Objective】This study aimed to explore the effects of group mindfulness yoga training combined with emotion-focused cognitive behavioral intervention in postpartum depression among primiparous women.【Methods】Clinical data of 125 PPD patients treated in our hospital from July 2018 to February 2021 were retrospectively analyzed and divided into observation group (n=68) and control group (n=57) according to different intervention methods. The control group underwent emotion-focused cognitive behavioral intervention,while the observation group had additional group mindfulness yoga training. The depression symptoms,social functions,and mindfulness levels of the patients in the two groups were observed before and after the intervention.【Results】After the intervention,the scores of all areas and the total score of the Postpartum Depression Screening Scale (PDSS) in both groups were lower than before the intervention,and the observation group had lower scores than the control group (P<0.05). The Social Disability Screening Schedule (SDSS) scores of the two groups were lower than before the intervention,and the observation group had lower scores than the control group (P<0.05). The scores of all areas and the total score of the Five Facet Mindfulness Questionnaire (FFMQ) in both groups were higher than before the intervention,and the observation group had higher scores than the control group (P<0.05).【Conclusion】The combined implementation of group mindfulness yoga training and emotion-focused cognitive behavioral intervention in primiparous women with PPD can effectively alleviate depression symptoms,improve social function and mindfulness perception level,and can positively affect the improvement of patient's quality of life. 2023 Vol. 40 (5): 754-757 [Abstract] ( 36 ) HTML (1 KB)  PDF (1124 KB)  ( 196 ) 758 Observation on the Effects of Different Combined General Anesthesia Methods on Serum Pain and Inflammatory Factors in Laparoscopic Vaginal Surgery WEI Jin-li, LI Bing DOI: 10.3969/j.issn.1671-7171.2023.05.034 【Objective】To explore the effects of different combined general anesthesia methods on serum pain and inflammatory factors in laparoscopic vaginal surgery. 【Methods】A study was conducted on 74 patients with benign uterine diseases who underwent laparoscopic vaginal surgery in two hospitals were randomly divided into the observation group and the control group,with 37 patients in each group. The control group received combined spinal-epidural anesthesia,while the observation group received improved sacral canal block combined with intravenous general anesthesia. Anesthesia related indicators,levels of serum pain factor indicators [dopamine (DA),norepinephrine (NE),and 5-hydroxytryptamine (5-HT)] before and 5 days after surgery, the levels of inflammatory factors [interleukin-6 (IL-6),C-reactive protein (CRP),and Calcitonin (PCT)] before and 3 days after operation,and the adverse reaction rates were compared between the two groups. 【Results】The observation group had shorter onset of anesthesia,complete block time,and postoperative recovery time compared to the control group (P<0.05). There was no statistically significant difference in the duration of surgery between the two groups of patients (P>0.05).The postoperative serum levels of DA,NE,and 5-HT on 5 days after operation in the two groups of patients were significantly higher than those in the same group before surgery (P<0.05). The postoperative serum levels of DA,NE,and 5-HT in the observation group were significantly lower than those in the control group (P<0.05).The levels of serum inflammatory factors IL-6,CRP,and PCT in the two groups of patients on 3 days after surgery were significantly higher than those in the same group before surgery (P<0.05),while the levels of serum inflammatory factors in the observation group were significantly lower than those in the control group (P<0.05). There was no statistically significant difference in the incidence of intraoperative adverse reactions between the two groups of patients (P>0.05). 【Conclusion】In laparoscopic vaginal surgery for the treatment of benign uterine diseases in women,the use of modified sacral canal block combined with intravenous general anesthesia causes less inflammation,faster onset time,and higher safety in patients. 2023 Vol. 40 (5): 758-760 [Abstract] ( 30 ) HTML (1 KB)  PDF (1165 KB)  ( 39 )

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