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Quick Search     Adv Search 2023 Vol. 40, No. 6 Published: 2023-06-26 Original Articles          Original Articles 801 The Impact of a Mini Program for Esophageal Nutrition Management on the Nutritional Status,Quality of Life and Nutritional Pipeline Complications of Discharged Patients after Minimally Invasive Esophageal Cancer Resection WANG Qian, LU Jing, SONG Wei-an, et al DOI: 10.3969/j.issn.1671-7171.2023.06.001 【Objective】 To explore the impact of the WeChat mini program for esophageal nutrition management on the nutritional status,quality of life,and its complications of the nutrition pipeline of discharged patients after minimally invasive esophageal cancer resection. 【Methods】 A total of 96 patients who underwent minimally invasive esophageal cancer resection in our hospital from November 2021 to September 2022 were selected and randomly divided into an observation group (followed up using the esophageal nutrition management WeChat mini program,n=50) and a control group (followed up using phone or WeChat,n=46). On the day of discharge (before intervention) and three months after discharge (after intervention),the body mass index (BMI),grip strength,skin fold thickness,quality of life (QLQ-C30) score of tumor patients,and KPS score of two groups of patients were compared. The serum albumin (Alb),hemoglobin (Hb),prealbumin (PAB),and creatinine (Scr) of the two groups of patients were reviewed and compared,and the incidence of postoperative complications in the jejunal nutrition pipeline was recorded. 【Results】 After intervention,the BMI,grip strength,QLQ-C30 score,and KPS score of both groups of patients were higher than those before intervention,and the observation group was higher than the control group,with statistical significance (P<0.05); The serum levels of Alb,Scr,Hb and PAB in both groups of patients were higher than those before intervention,and the observation group was higher than the control group,with a statistically significant difference (P<0.05). The incidence of jejunal nutrition tube complications in the observation group was 8.00% (4/50),lower than the control group's 15.22% (7/46),with a statistically significant difference (P<0.05). 【Conclusion】 The application of the WeChat mini program for esophageal nutrition management after minimally invasive esophageal cancer resection can improve the quality of life of patients,improve malnutrition status and dietary habits,reduce the incidence of nutritional pipeline complications,and is worthy of clinical reference. 2023 Vol. 40 (6): 801-804 [Abstract] ( 70 ) HTML (1 KB)  PDF (1130 KB)  ( 141 ) 805 Comparison of Therapeutic Effects between Percutaneous and Open Intramuscular Pedicle Screw Non Fusion Fixation for the Treatment of A3/A4 Type Thoracolumbar Fractures without Neurological Dysfunction LIN Kai-feng, ZHONG Zhen-ye, CHEN Jin-shui, et al DOI: 10.3969/j.issn.1671-7171.2023.06.002 【Objective】 To explore the clinical efficacy of percutaneous and open intramuscular pedicle screw non fusion fixation in the treatment of A3/A4 type thoracolumbar fractures without neurological dysfunction. 【Methods】 A prospective Cohort study design was used to select 46 patients with A3/A4 thoracolumbar fractures without neurological dysfunction who were admitted to The 900th Hospital of Joint Logistics Support Force from January 2018 to December 2020. The patients were randomly and alternately included in the transmuscular space screwfixation (PPSF) group and the open transmuscular space pedicle screwfixation(OPSF) group. The Cobb angle before and after surgery,corrected loss,blood loss,surgical time,and cumulative radiation time after 12 months were compared between two groups.【Results】 There was no statistically significant difference in Cobb angle before and after surgery and correction loss after 12 months between the OPSF group and the PPSF group (P>0.05). Compared with the OPSF group,the PPSF group had shorter surgical time,less perioperative blood loss,and higher average cumulative radiation time,with statistically significant differences (P<0.05). 【Conclusion】 The efficacy of percutaneous and open intramuscular pedicle screw fixation in the treatment of A3/A4 type thoracolumbar fractures without neurological dysfunction is equivalent,but pedicle screw fixation has shorter surgical time,less blood loss,and higher average cumulative radiation time. 2023 Vol. 40 (6): 805-807 [Abstract] ( 40 ) HTML (1 KB)  PDF (1303 KB)  ( 117 ) 808 The Impact of Gestational Hypertension on Perinatal Outcomes,Delivery Outcomes and Pregnancy Complications in Single and Twin Pregnancy Women GUO Lin-qiong, JI Ting, TENG Wei, et al DOI: 10.3969/j.issn.1671-7171.2023.06.003 【Objective】 To explore the impact of gestational hypertension on the perinatal outcomes,delivery outcomes,and pregnancy complications of single and twin pregnancy women. 【Methods】 A total of 50 twin pregnant women with hypertensive disorder complicating pregnancy (twin hypertension group),50 singleton pregnant women with hypertensive disorder complicating pregnancy (singleton hypertension group),and 50 healthy pregnant women at the same time in our hospital were selected as the control group. The incidence of complications of pregnancy (anemia,hypothyroidism,severe edema,diabetes,Hypoproteinemia) in three groups were selected The delivery outcome (premature delivery,full term delivery,vaginal delivery,caesarean section,severe Postpartum bleeding) and perinatal outcome (Low birth weight,fetal distress,neonatal asphyxia,perinatal death,hypoproteinemia) were compared.【Results】 The incidence of anemia,the total incidence of complications of pregnancy,low birth weight,premature delivery,caesarean section,and severe postpartum bleeding in the twin hypertension group were significantly higher than those in the singleton hypertension group and the control group,and the singleton hypertension group was higher than the control group,with statistical significance (P<0.05); The incidence of full-term delivery and Vaginal delivery in the twin hypertension group was significantly lower than that in the singleton hypertension group and the control group,and the singleton hypertension group was lower than that in the control group,with a statistically significant difference (P<0.05). 【Conclusion】 Twin pregnancy and singleton pregnancy with hypertensive disorder complicating pregnancy have a negative impact on the delivery outcome and perinatal outcome,increase the incidence of Complications of pregnancy,and twin pregnancy has a higher risk. 2023 Vol. 40 (6): 808-811 [Abstract] ( 44 ) HTML (1 KB)  PDF (1139 KB)  ( 111 ) 812 Intervention Effects of Different Diet and Exercise Strategies on Type 2 Diabetes Patients Living in the Community WEI Ping, GONG Ding-hong DOI: 10.3969/j.issn.1671-7171.2023.06.004 【Objective】 To evaluate the difference of intervention effects of different diet and exercise strategies on type 2 diabetes patients living in the community. 【Methods】 According to the questionnaire filled in by 300 chronic type 2 diabetes patients who met the inclusion criteria during recruitment,the patients were divided into five groups with 60 cases in each group,referring exercise,meal replacement,meal order,separate meals,and routine diet control. The corresponding groups of patients were trained with five different non-drug blood glucose control programs,and the management self-efficacy and compliance of the intervention subjects were assessed with the scale questionnaire before the intervention,at the first month of the intervention,and at the second month of the intervention. The blood biochemical indicators [fasting blood glucose (FPG),glycosylated hemoglobin (HbA1c),triglycerides (TG),serum total cholesterol (TC)] were compared in each group. 【Results】 There were significant differences in the total score of DMSES (Diabetes Management Self-Efficacy Scale) scale,fasting blood glucose,glycosylated hemoglobin and other factors before and after intervention in different groups(P<0.05). There were significant differences in the mean score of the compliance questionnaire,the total score of the DMSES scale,fasting blood glucose,glycosylated hemoglobin and other factors at different intervention time points as well(P<0.05).【Conclusion】 On the basis of being able to load and adapt to the intensity of exercise program,exercise can be the first choice for diabetes patients to control glucose without drugs. For patients who are not suitable for exercise programs,substitute meals are the second choice for achieving better glucose control effects. 2023 Vol. 40 (6): 812-815 [Abstract] ( 32 ) HTML (1 KB)  PDF (1137 KB)  ( 108 ) 816 The Application Effect of Ear Acupuncture Combined with Baduanjin on Depression in Perimenopausal Women GAO Jing, WANG Xiao-ying, ZHANG Wei-long, et al DOI: 10.3969/j.issn.1671-7171.2023.06.005 【Objective】 To explore the application effect of ear acupuncture combined with Baduanjin in the treatment of depression in perimenopausal women.【Methods】 A total of 160 perimenopausal women were selected from the Traditional Chinese Medicine Clinic of Pujiang Community Health Service Center in Minhang District,Shanghai from March 2021 to January 2022. They were randomly divided into the ear acupuncture group (Group A),the Baduanjin group (Group B),the ear acupuncture combined with Baduanjin group (Group C),and blank control group (Group D) using a district grouping method,with 40 cases in each group. The ear acupuncture and Baduanjin groups were treated with the corresponding intervention method twice a week,while the group C was treated with both intervention methods twice a week. The treatment in all groups were for a duration of 12 weeks. All patients receive health follow-up and education from family doctors. The Self Rating Depression Scale (SDS),Modified Kupperman Score,and levels of endocrine and metabolic indicators such as estradiol (E2),follicle stimulating hormone (FSH),and luteinizing hormone (LH) in each group of patients before enrollment and after 12 weeks of treatment were compared.【Results】 Before treatment,there was no statistically significant difference in SDS score,modified-Kupperman score,and various endocrine indicators among the groups compared (P>0.05). After treatment,the reduction of SDS score,Kupperman score,and endocrine indicators in each group showed statistical significance (P<0.05). The SDS scores of group A,B,and C after intervention were significantly lower than that of group D; the SDS score of group C after intervention was significantly lower than that of group A (P<0.05),but the SDS scores between group C and B,and SDS scores between group A and B were no significantly different lower than those of group B and A (P>0.05). Compared to before intervention,the Kupperman scores of groups A,B,and C were significantly lower after intervention (P<0.05). The Kupperman score of group C was significantly lower than that of group B after intervention (P<0.05). The Kupperman scores were no statistically significant differences between group A (post-treatment) and group C,and between group A and group B (P>0.05). There was no significant difference in Kupperman score before and after intervention in group D (P>0.05). The levels of E2,FSH,and LH in groups A,B,and C before and after the intervention showed statistically significant differences (P<0.05). Compared with before the intervention,the LH level in group D decreased after the intervention (P<0.05),while E2 and FSH levels was not statistically significant (P>0.05). After the intervention,the FSH level in group C was lower than that in group B (P<0.05),while the E2 levels in groups A,B,and C after intervention were all higher than that in group D (P<0.05). The LH level in group C was significantly lower than that in group D (P<0.05). The total effective rates of group A,group B,group C,and group D were 82.5% (33/40),80.0% (32/40),87.50% (35/40) and 75.0% (30/40),respectively. There were statistically significant differences in the total effective rate among the four groups of patients (χ2=5.542,P=0.002),which showed that the total effective rate in group C was the highest. During the treatment period,no serious adverse reactions occurred in the patients in each group,and the overall safety of the treatment plan was good.【Conclusion】 The comprehensive intervention plan of ear acupuncture combined with Baduanjin has a positive therapeutic effect on depression,perimenopausal symptoms,and endocrine and metabolic levels in perimenopausal women. 2023 Vol. 40 (6): 816-819 [Abstract] ( 44 ) HTML (1 KB)  PDF (1142 KB)  ( 119 ) 820 The Effects of Smoking,Drinking and Chewing Betel Nuts on the Survival of Oral Cancer Patients Aged 65 Years and Over who Treated only by Surgery ZHU Lei, ZHONG Rui, QIU Yan-fang, et al DOI: 10.3969/j.issn.1671-7171.2023.06.006 【Objective】 To investigate the effects of smoking,drinking and chewing betel nut on the survival of patients aged 65 years and over with oral cancer who were treated only by surgery. 【Methods】 The clinical data of oral cancer patients aged 65 years and over who were treated by surgery for the first time in The Hunan Cancer Hospital from October 2013 to January 2021 were retrospectively analyzed. Their smoking,drinking and chewing betel nuts were analyzed,and their survival was obtained through telephone follow-up. Kaplan Meier method was used to draw the survival curve,and Cox proportional hazard regression model was used to analyze the factors affecting the survival of Oral cancer patients after surgery alone. 【Results】 The median age of 224 patients with oral cancer was 67.00 years old,the total median survival period was 85 months,and the 5-year survival rate was 60.3%. The univariate survival analysis showed that age >70 years old,pain,degree of pathological differentiation,tumor stage,tumor size,invasion range,lymph node metastasis,and the number of lymph node metastasis were the related factors affecting the survival time of patients with Oral cancer who were 65 years old or older after simple surgical treatment (P<0.05). Multivariate survival analysis showed that age,degree of differentiation,and tumor stage Ⅳ were independent risk factors affecting the survival of patients with Oral cancer who were 65 years old or older after surgery alone (all P<0.05). 【Conclusion】 Smoking,drinking,chewing betel nut behavior,lymph node metastasis and the number of metastasis are not independent factors affecting the survival of elderly patients with oral cancer treated by surgery alone. Age>70 years old,poor differentiation,and late tumor stage are risk factors affecting the survival of elderly patients with oral cancer. When patients aged 65 years and above have lymph node metastasis,surgical treatment may still be a better choice. 2023 Vol. 40 (6): 820-823 [Abstract] ( 41 ) HTML (1 KB)  PDF (1348 KB)  ( 57 ) 824 Analysis of Influencing Factors of Osteoporosis in Newly Diagnosed Type 2 Diabetes Patients ZHONG Ru-yi, QIU Xin-wen, CHEN Sheng, et al DOI: 10.3969/j.issn.1671-7171.2023.06.007 【Objective】 To explore the influencing factors of osteoporosis in newly diagnosed type 2 diabetes patients. 【Methods】 A total of 300 newly diagnosed patients with type 2 diabetes from March 2020 to March 2022 were selected. Bone mineral density (BMD) of lumbar spine (L1-4) was measured by dual energy X-ray absorptiometry. According to the BMD value of patients,they were divided into normal bone mass group (n=59),osteopenia group (n=158),and osteoporosis group (n=83). The influencing factors of osteoporosis in newly diagnosed type 2 diabetes patients were analyzed. 【Results】 Among 300 newly diagnosed type 2 diabetes patients,158 cases had bone mass reduction (52.67%),and 83 cases had osteoporosis (27.67%). The age of osteoporosis group was higher than that of osteopenia group and normal bone mass group,while high-density lipoprotein cholesterol (HDL-C) was lower than that of osteopenia group and normal bone mass group. Logistic regression analysis showed that age was significantly positively correlated with the occurrence of osteopenia and osteoporosis in newly diagnosed type 2 diabetes (P<0.05),and HDL-C was significantly negatively correlated with the occurrence of osteopenia and osteoporosis in newly diagnosed type 2 diabetes (P<0.05). 【Conclusion】 The incidence rate of osteoporosis and osteopenia in newly diagnosed type 2 diabetes patients is significantly increased. Age and HDL-C are the influencing factors of osteoporosis in newly diagnosed type 2 diabetes patients. 2023 Vol. 40 (6): 824-826 [Abstract] ( 45 ) HTML (1 KB)  PDF (1115 KB)  ( 41 ) 827 The Diagnostic Value of STIC-TUI Technology in Fetal Congenital Heart Disease in Early-Middle Pregnancy YANG Bin, WU Dong, ZHAO Zhi-zhi DOI: 10.3969/j.issn.1671-7171.2023.06.008 【Objective】 To exploring the diagnostic efficacy of four-dimensional ultrasound spatiotemporal correlation imaging and ultrasound tomography (STIC-TUI) technology for fetal congenital heart disease in the second trimester of pregnancy (early-middle pregance). 【Methods】 A total of 80 pregnant women who underwent ultrasound screening in our hospital from January 2020 to January 2022 were selected as the research subjects. All of them received both STIC-TUI and conventional two-dimensional ultrasound imaging examinations.Using the output review results as the gold standard,We used the Kappa to analyze the efficacy of STIC-TUI alone,conventional two-dimensional ultrasound alone,and the combination of the two methods in diagnosing fetal congenital heart disease in the second trimester. Time consumption and image quality scores between STIC-TUI and conventional two-dimensional ultrasound examination were also compared. 【Results】 Among 80 fetuses,7 cases were found to have cardiac abnormalities. Of which,6 cases were detected using STIC-TUI technology,and 1 was missed in the diagnosis of atrial septal defect; Routine two-dimensional ultrasound detected 5 cases,while missed diagnosis in 2 cases of atrial septal defect. Postpartum follow-up confirmed 7 children with heart disease. The postnatal follow-up result showed there was no significant difference between STIC-TUI technology and conventional two-dimensional ultrasound(P>0.05). However,the STIC-TUI examination time was significantly shorter than the conventional two-dimensional ultrasound examination time,and the difference was statistically significant (P<0.05). There was no significant difference in image quality scores between STIC-TUI and conventional two-dimensional ultrasound (P>0.05). After consistency analysis,the sensitivity of STIC-TUI in diagnosing fetal congenital heart disease was 0.714,the specificity was 0.986,the accuracy was 0.962,and the Kappa value was 0.748; The sensitivity,specificity,accuracy,and Kappa value of conventional two-dimensional ultrasound in diagnosing fetal congenital heart disease are 0.571,0.986,0.950,and 0.640,respectively; The sensitivity,specificity,accuracy,and Kappa value of the combination of STIC-TUI and conventional two-dimensional ultrasound in the diagnosis of fetal congenital heart disease are 0.857,0.986,0.975,and 0.843,respectively. 【Conclusion】 STIC-TUI can be used to diagnose fetal congenital heart disease in the second trimester of pregnancy with good diagnostic efficacy. Moreover,the combination of STIC-TUI and conventional two-dimensional ultrasound can improve the sensitivity of diagnosis. 2023 Vol. 40 (6): 827-829 [Abstract] ( 33 ) HTML (1 KB)  PDF (1363 KB)  ( 63 ) 830 The Correlation between AST/ALT and Unresponsiveness to Intravenous Immunoglobulin and Coronary Artery Lesion in Children with Kawasaki Disease GUO Xiao-jun, GAO Dong-lian DOI: 10.3969/j.issn.1671-7171.2023.06.009 【Objective】 To investigate the relationship between Aspartate transaminase (AST)/alanine aminotransferase (ALT) and non response of intravenous immunoglobulin and coronary artery lesion (CAL) in children with Kawasaki disease (KD). 【Methods】 A total of 218 children with KD admitted to Xianyang Rainbow Hospital from June 2018 to May 2021 were selected. According to the treatment status of IVIG,the children were divided into a sensitive group (those who were initially effective in IVIG) and a non responsive group (those who were unresponsive to IVIG treatment). AST,ALT,and AST/ALT were compared between the two groups. KD patients were divided into occurrence and non occurrence groups based on whether they experienced CAL. The influencing factors for the occurrence of CAL in KD patients were analyzed,and the efficacy of AST/ALT in predicting the occurrence of CAL in KD patients was evaluated using the receiver operating characteristic (ROC) curve. 【Results】 The ALT level in the unresponsive group was higher than that in the sensitive group,while AST/ALT was lower than that in the sensitive group,with a statistically significant difference (P<0.05). After 8 weeks of treatment,the incidence of CAL in KD patients was 22.48% (49/218). The duration of fever before IVIG treatment,the ratio of IVIG unresponsive types,PCT,ALT in the occurrence group were higher than those in the non occurrence group (P<0.05),while AST/ALT was lower than those in the non occurrence group (P<0.05). The results of multivariate logistic analysis showed that IVIG treatment without response,ALT,and AST/ALT were all influencing factors for the occurrence of CAL in children with KD (P<0.05). The Receiver operating characteristic analysis showed that the best cut-off point for AST/ALT to assess the incidence of CAL in KD children was 0.63,and the sensitivity,specificity and AUC were 83.67%,68.05% and 0.803,respectively. 【Conclusion】 ALT is higher in IVIG unresponsive KD patients,while AST/ALT is lower. AST/ALT has a higher clinical value in predicting the occurrence of CAL in KD patients. 2023 Vol. 40 (6): 830-833 [Abstract] ( 41 ) HTML (1 KB)  PDF (1169 KB)  ( 48 ) 834 Risk Factors for Early Left Ventricular Thrombosis in ST Segment Elevation Myocardial Infarction CHEN Yong-guo, ZHOU Lei, FANG Li DOI: 10.3969/j.issn.1671-7171.2023.06.010 【Objective】 To investigate the risk factors of early left ventricular thrombosis (LVT) in ST segment elevation myocardial infarction (STEMI). 【Method】 A retrospective analysis was conducted on the clinical data of 121 STEMI patients admitted to two hospitals. According to whether the patients had early LVT,they were divided into LVT group (16 cases) and no LVT group (105 cases).The general information of all patients,including total ischemic time (TIT) and Killip grading,was collected; Coronary angiography,echocardiography,blood routine examination,etc. were performed,and isoserological indicators of N-terminal pro-brain natriuretic peptide (NT-proBNP),creatine kinase isoenzyme (CK-MB) peak,cardiac troponin (cTnl) peak,and lipoprotein (α)[Lp(α)] were detected. The value of predicting STEMI combined with early LVT using relevant indicators was analyzed using the receiver operating characteristic (ROC) curve,and the risk factors of STEMI combined with early LVT were analyzed using unconditional logistic stepwise regression. 【Result】 Compared with the non LVT group,the LVT group had a higher proportion of patients with Killip grades Ⅲ-Ⅳ,myocardial infarction thrombolysis (TIMI) blood flow grades<3,no collateral circulation,and left ventricular ejection fraction (LVEF)<40%. Additionally,the LVT group had longer TIMs. The levels of serum CK-MB peak,Lp(α)were relatively high (all P<0.05). According to the ROC analysis,TIT ≥ 10.265 hours,CK-MB peak ≥ 224.128 ng/mL,Lp(α)≥ 308.595 mg/L was the optimal cutoff value for STEMI combined with early LVT (all P<0.05); Logistic regression analysis showed that Killip grade Ⅲ-Ⅳ,TIMI blood flow grade<3,no collateral circulation,LVEF<40%,TIT ≥ 10.265 hours,CK-MB peak ≥224.128 ng/mL,Lp(α)≥ 308.595 mg/L were risk factors for STEMI combined with early LVT (P<0.05).【Conclusion】 The excessive levels of Killip grade Ⅲ-Ⅳ,TIMI blood flow grade<3,no collateral circulation,decreased LVEF,peak serum CK-MB,and Lp(α) may be risk factors for STEMI patients with early LVT. 2023 Vol. 40 (6): 834-837 [Abstract] ( 40 ) HTML (1 KB)  PDF (1199 KB)  ( 25 ) 838 The Effect of Targeted Drug Penetration of Dihuang Yinzi on the Efficacy and Quality of Life in Patients with Dysphagia after Stroke with Kidney Deficiency and Phlegm Stasis Type ZHU Hua-zhen, WANG Ping, CHEN De-xing, et al DOI: 10.3969/j.issn.1671-7171.2023.06.011 【Objective】 To explore the effect of the Dihuang Yinzi (Rehmannia Decoction),a traditional Chinese medicine compound,on the efficacy and quality of life of patients with Dysphagia after stroke of kidney deficiency and phlegm stasis type. 【Methods】 A total of 64 patients with dysphagia after stroke were randomly divided into two groups,with 32 cases in each group. The control group received swallowing training,while the observation group received Dihuang Yinzi treatment on the basis of swallowing training. The efficacy of two groups of patients was compared,and the quality of life was evaluated using the WHOQOL-BREF scale as an evaluation tool. The differences in the total quality of life score and four domain scores between the two groups of patients were observed. 【Results】 The total effective rate of the observation group was 84.38% (27/32),which was higher than the control group's 62.5% (20/32). There was a statistically significant difference between the two groups (P<0.05),and no adverse events occurred in either group of patients. There was no statistically significant difference in the quality of life scores between the two groups of patients before treatment (all P>0.05); After treatment,the quality of life scores of both groups of patients were higher than that before treatment,and the difference was statistically significant (P<0.05). After treatment,the overall quality of life score and environmental and physiological scores of the observation group were higher than those of the control group (P<0.05); There was no statistically significant difference in the scores of social relations and psychology between the two groups (P>0.05). 【Conclusions】 Targeted drug penetration of Dihuang Yinzi combined with swallowing training can significantly improve the quality of life of patients with Dysphagia after stroke,with good safety. 2023 Vol. 40 (6): 838-840 [Abstract] ( 45 ) HTML (1 KB)  PDF (1176 KB)  ( 95 ) 841 Comparison of Different Ultrasound-guided Sciatic Nerve Block Approaches for Knee Replacement BAI Xiao-bo, MIN Li-yuan, JIA Ben-zhi DOI: 10.3969/j.issn.1671-7171.2023.06.012 【Objective】 To compare the effects of different sciatic nerve block approaches guided by ultrasound on knee replacement (TKA). 【Methods】 A total of 108 patients with TKA who were admitted to our hospital were enrolled in the study. According to the different sciatic nerve block approaches,the patients were divided into four groups,with 27 cases in each group. The four groups were group A (inferior gluteal space approach),group B (anterior mid-thigh approach),group C (inferior lateral greater trochanter approach) and group D (upper lateral popliteal fossa approach). The related indexes of sciatic nerve block,hemodynamic indexes [mean arterial pressure (MAP),diastolic blood pressure (DBP),heart rate (HR)] at different time points,visual analog score (VAS) of resting and active pain at different time points after surgery,and the incidence of complications in the four groups were observed and compared. 【Results】 In terms of operation time,the procedure length was in the order of group B < group D < group C < group A,and there were statistically significant differences among all groups (P<0.05). The number of puncture times in groups B and D were less than those in groups A and C,and the difference was statistically significant (P<0.05). The puncture depth of group D was less than that of group A,C,and B,while the puncture depth of group A and C was less than that of group B (P<0.05). There were no significant differences in the onset time and duration among the four groups (P>0.05). The success rate of nerve block in group D was higher than that in groups A,B and C (P<0.05),however,there was no statistical significance among groups A,B and C (P>0.05). There were no significant differences in hemodynamic indexes at different time points and VAS scores at both resting and active time points among the four groups (P>0.05). There was no significant difference in the total incidence of postoperative complications among the four groups (P>0.05). 【Conclusion】 In TKA,the sciatic nerve block effects under the middle thigh anterior approach and the upper lateral approach of popliteal fossa guided by ultrasound are better approaches,which can be used as an optimization scheme for clinical anesthesia. 2023 Vol. 40 (6): 841-844 [Abstract] ( 39 ) HTML (1 KB)  PDF (1143 KB)  ( 64 ) 845 The Application Effect of Nasenteral Tube Nutrition Support in Mechanically Ventilated Patients YU Xiao-jie, QIAO Rui DOI: 10.3969/j.issn.1671-7171.2023.06.013 【Objective】 To explore the application effect of nasogastric nutrition support in mechanically ventilated patients. 【Methods】 From December 2020 to July 2022,50 patients receiving mechanical ventilation and requiring enteral nutrition support treatment in the emergency department of the Shandong Provincial Third Hospital were selected and divided into the control group and the observation group according to the random number table. The control group used Nasogastric intubation nutrition support,and the observation group used nasenteral canal nutrition support,with 25 cases in each group. The levels of total protein (TP),albumin (ALB),hemoglobin (Hb),white blood cell count (WBC),C-reaction protein (CRP),procalcitonin (PCT) and the incidence of adverse reactions within 7 days were compared between the two groups before and 7 days after catheterization. 【Results】 Before catheterization,there was no statistically significant difference in serum TP,ALB,Hb,WBC,CRP,and PCT levels between the two groups of patients (all P>0.05); After 7 days of catheterization,the serum levels of TP,ALB,and Hb in the observation group were higher than those in the control group,while the levels of WBC,CRP,and PCT were lower than those in the control group (all P<0.05). Within 7 days of catheterization,the incidence of adverse reactions in the observation group was 4.00%,significantly lower than the 24.00% in the control group (P<0.05). 【Conclusion】 The application of nasenteral tube nutrition support in mechanically ventilated patients can significantly improve their nutritional status,reduce the levels of inflammatory factors,and reduce the incidence of adverse reactions during intubation,which is worthy of clinical promotion and application. 2023 Vol. 40 (6): 845-847 [Abstract] ( 36 ) HTML (1 KB)  PDF (1176 KB)  ( 160 ) 848 Predictive Value of Coagulation Factor Ⅷ Combined with Thromboelastography on Bleeding Risk of Patients with Acute Leukemia Chemotherapy and Myelosuppression LIU Ren-mei, ZHANG Xin-bin DOI: 10.3969/j.issn.1671-7171.2023.06.014 【Objective】 To explore the predictive value of coagulation factor Ⅷ (FⅧ) combined with thromboelastography (TEG) on the bleeding risk of patients with acute leukemia chemotherapy and myelosuppression. 【Methods】 A total of 86 patients with acute leukemia chemotherapy and myelosuppression were tested for the coagulation FⅧ level and TEG parameters [coagulation time (K value),reaction time (R value),maximum thrombosis (MA value) and blood clot aggregation rate (Angle value)]. According to the bleeding within 48 hours after bone marrow suppression,patients were divided into the bleeding group and no bleeding group. Logistic multivariate regression analysis was used to explore the related factors of bleeding in patients with acute leukemia chemotherapy for myelosuppression,and receiver operating characteristic curve (ROC) was used to determine the predictive value of TEG-related indicators and FⅧ levels in patients.【Results】 Among 86 patients with acute leukemia bone marrow suppression during chemotherapy,51 patients had bleeding (the bleeding group),accounting for 59.30% (51/86); the remaining 35 patients had no bleeding (non-bleeding group),accounting for 40.70% (35/86). The proportion of infected cases in the bleeding group was higher than that in the non-bleeding group,and the MA value and FⅧ level were lower than those in the bleeding group (P<0.05). Logistic multivariate regression analysis showed that co-infection and reduced-MA value and FⅧ level were risk factors for bleeding in patients (P<0.05). ROC analysis showed that the bleeding risk by the area under the curve (AUC) of MA value,FⅧ level and the combination of the two parameters were 0.744,0.724,and 0.848,respectively. MA value and FⅧ level alone predict the bleeding risk in patients,however,their predictive powers were lower than the combination of the two (P<0.05). 【Conclusion】 With the decrease of MA value and FⅧ level,the incidence of bleeding in acute leukemia myelosuppressed patients with co-infection increased significantly; MA value and FⅧ level have a certain clinical predictive value for bleeding in patients. 2023 Vol. 40 (6): 848-851 [Abstract] ( 37 ) HTML (1 KB)  PDF (1238 KB)  ( 92 ) 852 The Application Value of Risk Grading Nursing Based on SSA Assessment in Preventing Aspiration in Elderly Patients LI Na, SHE You-qin, SHEN Yun-xia, et al DOI: 10.3969/j.issn.1671-7171.2023.06.015 【Objective】 To evaluate the application value of risk grading nursing based on the Standard Swallowing Function Assessment Scale (SSA) in preventing misaspiration in elderly patients. 【Methods】 A total of 88 elderly hospitalized patients admitted to the psychiatric department of our hospital from March 2021 to March 2022 were selected and randomly divided into an observation group and a control group using a random number table method,with 44 patients in each group. The control group received routine nursing intervention,while the observation group received risk graded nursing under SSA assessment. The quality of life,risk of aspiration,and changes in swallowing function were compared between the two groups on the day after admission and 6 weeks after hospitalization.【Results】 After 6 weeks of hospitalization,the DHI scores of the two groups of patients were lower than the day after admission,and the observation group was lower than the control group,with a statistically significant difference (P<0.05); The SSA scores of the two groups of patients were lower than those on the day after admission,the observation group was lower than the control group,and the risk of misaspiration in the observation group was lower than the control group,with a statistically significant difference (P<0.05). The incidence of aspiration pneumonia and reflux esophagitis in the observation group was lower than that in the control group,with a statistically significant difference (P<0.05). 【Conclusion】 Risk graded nursing based on SSA assessment can prevent the occurrence of misaspiration in elderly patients,improve their swallowing function,and improve their quality of life. 2023 Vol. 40 (6): 852-854 [Abstract] ( 32 ) HTML (1 KB)  PDF (1172 KB)  ( 147 ) 855 Differentially Diagnostic Value of DCE-MRI Parameters in Patients with Uterine Fibroids with Different Pathological Results WU Zong-yan, WU Zong-xia DOI: 10.3969/j.issn.1671-7171.2023.06.016 【Objective】 To explore the differentially diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters in patients with uterine fibroids with different pathological results. 【Methods】 A total of 164 patients with uterine fibroids admitted to Ankang Central Hospital Affiliated Hospital of Ankang Vocational and Technical College from February 2017 to February 2022 were divided into group A (77 cases of ordinary type),group B (49 cases of cellular type),and group C (38 cases of degenerative type) based on pathological diagnosis. Using a magnetic resonance diagnostic instrument for scanning,the volume fraction of extracellular space (Ve),volume fraction of vascular space (Vp),capillary surface permeability (PS),and plasma perfusion volume (Fp) among three groups were recorded. The values of Ve,Vp,and Fp in diagnosing cellular uterine fibroids through ROC analysis were evaluated. We also used pathological diagnosis results as the gold standard to analyze the efficacy of Ve,Vp,and Fp combined in diagnosing cellular uterine fibroids. 【Results】 There were significant differences in Ve,Vp,and Fp among the three groups,with values of Ve,Vp,and Fp showing in Group B>Group A>Group C (P<0.05). PS in Group B was higher than that in Group A and C (P<0.05). ROC analysis confirmed that Ve,Vp,and Fp could be used for the diagnosis of cellular uterine fibroids,with areas under the curve of 0.779,0.836,and 0.808,respectively. The results of consistency analysis showed that the sensitivity,specificity,and accuracy of the combined diagnosis of Ve,Vp,and Fp for cellular uterine fibroids were 83.67%,92.17% and 89.63%,respectively. 【Conclusion】 DCE-MRI parameters can be used to distinguish uterine fibroids of different pathological types,and the combination of Ve,Vp,and Fp has a more prominent diagnostic efficacy for cellular uterine fibroids,which can be used for clinical diagnosis. 2023 Vol. 40 (6): 855-858 [Abstract] ( 35 ) HTML (1 KB)  PDF (1440 KB)  ( 70 ) 859 Expression and Significance of LncRNA MEG3 in Hepatocellular Carcinoma HE Hai-tao, XU Yu, WEI Zhi-li, et al DOI: 10.3969/j.issn.1671-7171.2023.06.017 【Objective】 To investigate the expression and value of LncRNA MEG3 in hepatocellular carcinoma (HCC). 【Methods】 A total of 78 patients who were diagnosed with HCC and underwent surgical treatment in our hospital were included in this study. The liver cancer tissues and adjacent normal tissues were collected during operation. At the same time period,78 patients who underwent surgical treatment of "hepatic hemangioma" in our department were enrolled and the intraoperative specimens of them were collected. RT-PCR was used to detect the expression level of LncRNA MEG3 in all subjects and the difference of LncRNA MEG3 levels was compared among different groups. The value of LncRNA MEG3 for diagnosis of HCC was analyzed and the correlation of LncRNA MEG3 with clinical pathological of HCC and alpha fetoprotein (AFP) was studied as well. 【Results】 The expression level of LncRNA MEG3 in HCC tissues was 0.43±0.16,which was lower than that of adjacent normal tissues(1.18±0.35) and hepatic hemangioma(1.21±0.27)(P<0.05).The area under the value curve (AUC)(95%CI) of LncRNA MEG3 for the diagnosis of HCC was 0.85(0.80-0.91),and the best diagnostic cutoff value was 0.91,the sensitivity was 89% and the specificity was 76%.LncRNA MEG3 had a linear positive correlation with AFP (r=0.632,P=0.030).The low expression of LncRNA MEG3 had a correlation with HCC clinical stage,differentiation and distant metastasis of liver cancer (χ2 were 3.93,6.59 and 4.43,respectively,P<0.05). 【Conclusion】 LncRNA MEG3 has low expression in HCC,and it is closely related to the clinicopathology of HCC,which can be severed as a potential target for diagnosis and treatment of HCC. 2023 Vol. 40 (6): 859-861 [Abstract] ( 30 ) HTML (1 KB)  PDF (1238 KB)  ( 18 ) 862 The Effect of PFNA-Ⅱ Intramedullary Nail Treatment on Hip Joint Function and Serum Inflammatory Related Factors in Patients with Intertrochanteric Fractures of the Femur ZHANG Lei, YANG Meng-guo DOI: 10.3969/j.issn.1671-7171.2023.06.018 【Objective】 To investigate the effects of proximal femoral anti rotation intramedullary nail (PFNA-Ⅱ) on hip joint function and serum inflammatory factors in patients with intertrochanteric fractures. 【Methods】 A total of 160 patients with intertrochanteric fractures of the femur admitted to our hospital from January 2019 to January 2022 were randomly divided into an observation group and a control group using a random number table method,with 80 patients in each group. The observation group was treated with PFNA-Ⅱ intramedullary nails,while the control group was treated with dynamic hip screws (DHS). We compared the surgical conditions of two groups of patients [surgical time,incision length,bleeding volume,hospital stay,and fracture healing time],the incidence of postoperative complications,the levels of inflammatory factors before and after surgery,and the Harris score of the hip joint at 1,3,6,and 12 months after surgery. 【Results】 The surgical time,incision length,and bleeding volume in the observation group were all lower than those in the control group (P<0.05); However,there was no statistically significant difference in hospital stay and fracture healing time between the two groups of patients (P>0.05). At 1 month,3 months,and 6 months after surgery,the Harris score of the hip joint in the observation group was higher than that in the control group (P<0.05); At 12 months after surgery,there was no statistically significant difference in Harris scores between the two groups of hip joints (P>0.05). The levels of postoperative interleukin-1β(IL-1β),Interleukin 6 (IL-6),interleukin-18 (IL-18) and tumor necrosis factor-α (TNF-α) in the observation group were lower than those in the control group (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). 【Conclusion】 PFNA-Ⅱ intramedullary nail treatment for intertrochanteric fractures of the femur can effectively improve hip joint function,reduce serum inflammatory factor levels,alleviate postoperative pain,and have a low incidence of postoperative complications,which is worthy of clinical promotion and application. 2023 Vol. 40 (6): 862-865 [Abstract] ( 33 ) HTML (1 KB)  PDF (1139 KB)  ( 99 ) 866 The Clinical Value of Recurrent Nerve Monitoring in Radical Thyroid Cancer Surgery LIU Yun-han, WANG Lin-lin, SUN Ning-ning, et al DOI: 10.3969/j.issn.1671-7171.2023.06.019 【Objective】 To explore the clinical value of Recurrent laryngeal nerve monitoring in radical thyroidectomy. 【Methods】 A total of 112 patients with thyroid cancer admitted to Shandong Provincial Third Hospital from January 2018 to January 2020 were selected and randomly divided into an observation group (with intraoperative use of a neural monitor) and a control group (without intraoperative use of a neural monitor) using a random number table method,with 56 patients in each group. Both groups of patients underwent unilateral or bilateral thyroidectomy combined with lymph node dissection,while the observation group used a neuromonitor during surgery. The operation related indexes of the two groups were recorded,the blood potassium concentration of patients at different time points was detected,and the Recurrent laryngeal nerve injury,Recurrent laryngeal nerve recognition rate,recognition time,and complication rate of the two groups were recorded. 【Results】 The observation group had shorter surgical time,drainage tube removal time,and hospital stay compared with the control group. The intraoperative bleeding volume and postoperative drainage volume were lower than those of the control group,and the difference was statistically significant (P<0.05). At 0.5 hours,1 hour,and 3 hours after surgery,the blood potassium levels of both groups of patients were higher than those before surgery,and at 0.5 hours after extubation,they were significantly lower than at 3 hours after surgery. The blood potassium levels of the observation group at 1 hour,3 hours after surgery,and 0.5 hours after extubation were higher than those of the control group,and the difference was statistically significant (P<0.05). The identification time of recurrent laryngeal nerve in the observation group was lower than that in the control group,and the identification rate of recurrent laryngeal nerve was higher than that in the control group,with a statistically significant difference (P<0.05). Compared with the control group,the total incidence of postoperative complications in the observation group was 16.07% (9/56),lower than 46.43% (26/56) in the control group,with a statistically significant difference(χ2=12.01,P<0.05). 【Conclusion】 Recurrent laryngeal nerve monitoring can protect Recurrent laryngeal nerve in patients with thyroid cancer during radical surgery,and can effectively improve the safety of surgery. 2023 Vol. 40 (6): 866-868 [Abstract] ( 47 ) HTML (1 KB)  PDF (1177 KB)  ( 47 ) 869 Factors Influencing the Efficacy of Endovascular Angioplasty in the Treatment of Lumbar Degenerative Related Iliac Vein Compression Syndrome WANG Hui, LI Shi-cheng DOI: 10.3969/j.issn.1671-7171.2023.06.020 【Objective】 To explore the factors influencing the efficacy of endovascular angioplasty in the treatment of lumbar degenerative related iliac vein compression syndrome (IVCS). 【Methods】 The factors influencing the efficacy of 110 patients with lumbar degenerative related IVCS treated with endovascular angioplasty in our hospital were analyzed. The patient's age,sex,course of disease,body mass index (BMI),combined diseases,blood lipids [triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),total cholesterol (TC)],coagulation indicators [thrombin time (TT),D-dimer (D-D),prothrombin time (PT),activated partial thromboplastin time (APTT)] and other general data were counted. Multiple logistic regression analysis was used to analyze independent risk factors that affect patient efficacy. 【Results】 Among the 110 patients,34 cases(30.91%) failed treatment and were included in the ineffective group; The remaining 76 cases (69.09%) were successfully treated and included in the effective group. There was no statistically significant difference in age,BMI,blood lipid index levels,coagulation index levels,comorbidities composition ratio,and gender composition ratio between the two groups of patients (P>0.05); The ineffective group had a longer course of disease,higher thrombus density,and higher proportion of popliteal vein involvement compared to the effective group (P<0.05). Multivariate logistic regression analysis showed that course of disease (OR=2.754),thrombus density (OR=2.402),and involvement of popliteal vein (OR=1.896,) were independent risk factors affecting patient efficacy (P<0.05). 【Conclusion】 There is a certain risk of ineffectiveness in the treatment of lumbar degenerative related IVCS patients with endovascular angioplasty,among which the course of disease,thrombus density,and involvement of the popliteal vein are risk factors that affect the treatment effect. 2023 Vol. 40 (6): 869-872 [Abstract] ( 29 ) HTML (1 KB)  PDF (1140 KB)  ( 29 ) 873 Analysis of Influencing Factors for Severe Mitral Regurgitation in Patients with Atrial Fibrillation DING Xiao-tong, LIU Yan DOI: 10.3969/j.issn.1671-7171.2023.06.021 【Objective】 To explore the influencing factors of severe mitral regurgitation (MR) in patients with atrial fibrillation. 【Methods】 A retrospective analysis was conducted on the clinical data of 98 patients with atrial fibrillation complicated with MR admitted to the cardiology department of our hospital from August 2018 to March 2020. They were divided into severe MR group (n=19),moderate MR group (n=46),and mild MR group (n=33) based on the severity of MR. We compared the differences in cardiac ultrasound indicators and clinical data among three groups of patients,and used multivariate logistic regression analysis to investigate the correlation between related indicators and the occurrence of severe MR in patients with atrial fibrillation. The clinical value of the occurrence of severe MR in patients with atrial fibrillation was evaluated using receiver operating characteristic curve (ROC) analysis of related indicators.【Results】 The duration of atrial fibrillation and B-type brain natriuretic peptide (BNP) levels in the severe MR group were significantly higher than those in the moderate and mild MR groups,with statistically significant differences (P<0.05). The left atrial diameter (LAD),mitral valve velocity (MV) and right atrial volume (RAV) in the severe MR group were significantly higher than those in the moderate MR group and the mild MR group,and the left ventricular Ejection fraction (LVEF) was significantly lower than those in the moderate MR group and the mild MR group (P<0.05). Multivariate logistic regression analysis showed that LAD,duration of atrial fibrillation,and BNP were the influencing factors for the occurrence of severe MR in patients with atrial fibrillation (P<0.05). The Receiver operating characteristic analysis showed that the area under the curve (AUC) of LAD in evaluating severe MR in patients with atrial fibrillation was significantly higher than the duration and BNP of atrial fibrillation (P<0.05),and the duration and BNP of atrial fibrillation were equivalent (P>0.05). 【Conclusion】 LAD,BNP,and duration of atrial fibrillation are influencing factors for the occurrence of severe MR in AF patients,and are also potential indicators for identifying severe MR. 2023 Vol. 40 (6): 873-875 [Abstract] ( 33 ) HTML (1 KB)  PDF (1264 KB)  ( 147 ) 876 Correlation Analysis between the Level of Serum β2-Glycoprotein Ⅰ Antibody and the Severity of Gestational Hypertension LIU Qing, ZHONG Rong DOI: 10.3969/j.issn.1671-7171.2023.06.022 【Objective】 To investigate the correlation between serum β2-glycoprotein Ⅰ antibody (β2GPⅠ) and the severity of gestational hypertension. 【Methods】 A total of 156 patients with hypertensive disorder complicating pregnancy admitted to the Gaoling District Hospital of Xi'an from June 2018 to June 2020 were selected as the observation group. According to the severity of the patients,they were divided into pre eclampsia group (n=78),severe pre eclampsia group (n=42),and eclampsia group (n=36); 134 normal pregnant women in the same period in the Gaoling District Hospital of Xi'an were selected as the control group. The serum β2GPⅠ levels of each group were compared; The correlation between serum β2GPⅠ levels and the severity of gestational hypertension was analyzed using Spearman analysis; Logistic regression analysis was used to analyze the influencing factors of preeclampsia in pregnant women during pregnancy,and the predictive value of serum β2GPⅠ levels on the onset of preeclampsia in pregnant women was analyzed using the receiver operating characteristic (ROC) curve.【Results】 The serum β2GPⅠ levels in the control group,preeclampsia group,severe preeclampsia group,and preeclampsia group increased sequentially,and there was a statistically significant difference between the groups (P<0.05). Spearman analysis showed a positive correlation between serum β2GPⅠ levels and the severity of gestational hypertension (rs=0.752,P<0.05). The pre pregnancy BMI of the eclampsia group was ≥ 26 kg/m2,the proportion of cases with a family history of hypertension,and the serum β2GPⅠ level was significantly higher than that of the preeclampsia group and severe preeclampsia group (P<0.05). The results of logistic multiple factor regression analysis showed that pre pregnancy BMI≥26 kg/m2,family history of hypertension,and serum β2GPⅠ levels were all influencing factors for the onset of preeclampsia in pregnant women (P<0.05). Receiver operating characteristic analysis showed that the best cut-off point for serum β2GPⅠ level to predict eclampsia in pregnant women was 10.35 mIU/mL,the sensitivity was 83.33%,the specificity was 86.11%,and the area under the curve (AUC) was 0.795 (P<0.05). 【Conclusion】 There are differences in the expression of serum β2GPⅠ levels among patients with different severity of gestational hypertension,and there is a positive correlation between serum β2GPⅠ levels and the severity of gestational hypertension. 2023 Vol. 40 (6): 876-879 [Abstract] ( 36 ) HTML (1 KB)  PDF (1206 KB)  ( 56 ) 880 Comparison of the Effect of Different Breast Repair Procedures after Breast-conserving Surgery for Early Breast Cancer CHANG Han-feng, WANG Xiao-qi DOI: 10.3969/j.issn.1671-7171.2023.06.023 【Objective】 To compares the clinical effect of immediate scarless latissimus dorsi breasts repair and traditional latissimus dorsi breast repair after breast-conserving surgery for early breast cancer. 【Methods】 A total of 102 patients with early breast cancer who underwent breast-conserving surgery in our hospital from May 2017 to May 2022 were selected for the study. Patients were randomly divided into 51 cases in the control group and 51 cases in the observation group. Traditional latissimus dorsi breast repair and non-scar latissimus dorsi breast repair (non-scar pedicled latissimus dorsi muscle flap repair) were done in the control group and in the observation group,respectively with 18 months of post-operation follow-up. The volume of mastectomy,intraoperative margin,operative time,intraoperative blood loss,length of hospital stay,postoperative complications,postoperative cosmetic effect,postoperative patient satisfaction and follow-up results were compared between the two groups. 【Results】 The operation time and hospital stay in the observation group were significantly shorter than those in the control group (P<0.05),and there were no statistical differences in the volume of mastectomy,intraoperative blood loss and intraoperative resection margin between the observation group and the control group (P>0.05). The incidence of postoperative complications in the observation group was 27.45%,significantly lower than 58.82% in the control group (P<0.05). The excellent and good rate of the observation group was 92.16%,which was significantly higher than 76.47% of the control group (P<0.05). The postoperative patient satisfaction in the observation group was 94.12%,which was significantly higher than 74.51% in the control group (P<0.05). All patients were followed up for 18 months that showed the local recurrence rate,distant metastasis rate and cumulative survival rate were no statistical difference between the two groups (P>0.05). 【Conclusion】 Compared to the traditional latissimus dorsi breast repair,the patients with early breast cancer after breast-conserving surgery have a more effective treatment of scar free latissimus breast repair,which can significantly shorten the operation time and hospital stay,reduce the risk of postoperative complications,improve the cosmetic appearance and patient satisfaction of breast shape,but have no significant effect on short-term prognosis. 2023 Vol. 40 (6): 880-883 [Abstract] ( 33 ) HTML (1 KB)  PDF (1260 KB)  ( 87 ) 884 The Effect of Physical Vibration Lithotripsy Combined with X-ray Guided Extracorporeal Shock Wave Lithotripsy on Stone Clearance,Symptom Improvement,and Renal Function Indicators in Patients with Upper Urinary Tract Stones PENG Jun-feng, SHU Tao DOI: 10.3969/j.issn.1671-7171.2023.06.024 【Objective】 To investigate the effects of physical vibration lithotripsy combined with X-ray guided extracorporeal shock wave lithotripsy (ESWL) on stone clearance,symptom improvement,and renal function indicators in patients with upper urinary tract stones. 【Methods】 A total of 126 patients with upper urinary tract stones admitted to the Xi'an Baoshi Hua Changqing Hospital from February 2019 to March 2021 were selected and divided into a control group (treated with ESWL under X-ray localization,n=62) and an observation group (treated with physical vibration lithotripsy on the basis of the control group,n=64) according to different treatment plans. The curative effect,stone clearance,symptom improvement and complications of the two groups were compared. The serum levels of β2-microglobulin (β2-MG),Cystatin C (Cys C) and neutrophil Gelatinase related lipid transporter (NGAL) were compared before and 3 days after surgery. 【Results】 The total effective rate of the observation group was 95.31% (61/64),which was higher than 83.87% (52/62) of the control group,with a statistically significant difference( χ2 = 4.455,P<0.05). The stone clearance rate in the observation group was higher than that in the control group at 1 day,1 week,and 2 weeks after surgery,with a statistically significant difference (P<0.05). On the 3rd day after surgery,the serum levels of β2-MG,Cys C,and NGAL in both groups were higher than before surgery,and the observation group was lower than the control group,with statistically significant differences (P<0.05). Two weeks after surgery,the scores of hematuria,abdominal pain,urinary frequency,urgency,nausea,and vomiting in both groups were lower than before surgery,and the observation group was lower than the control group,with a statistically significant difference (P<0.05). The incidence of complications in the observation group was 10.94% (7/64),higher than the control group's 6.45% (4/62),but the difference was not statistically significant(χ2=0.795,P>0.05). 【Conclusion】 The application of physical vibration lithotripsy combined with X-ray localization ESWL in the treatment of upper urinary tract stones can improve the stone clearance rate and clinical efficacy,promote symptom improvement,accelerate renal function recovery,and have good safety. 2023 Vol. 40 (6): 884-887 [Abstract] ( 38 ) HTML (1 KB)  PDF (1144 KB)  ( 160 ) 888 Correlation between Changes in Levels of sPD-L1,IL-8,and T Cell Subsets and Postoperative Intracranial Tumor Resection WEI Chang-jie, ZHANG Jin-qiao DOI: 10.3969/j.issn.1671-7171.2023.06.025 【Objective】 To investigate the correlation between interleukin-8 (IL-8),soluble programmed death ligand 1 (sPD-L1),T cell subpopulation levels,and intracranial infection after intracranial tumor resection. 【Methods】 A total of 126 patients who underwent intracranial tumor resection in our hospital from July 2019 to September 2021 were selected and divided into an infected group (n=84) and an uninfected group (n=42) based on whether infection occurred 7 days after surgery. We compared the levels of sPD-L1,IL-8,T cell subpopulations,neurological impairment indicators,and oxidative stress indicators between two groups and patients with different infection types. We used Spearman correlation coefficient to analyze the correlation between sPD-L1,IL-8,T cell subpopulations,intracranial infection types,neurological impairment indicators,and oxidative stress indicators. 【Results】 Compared with the uninfected group 7 days after surgery,the infected group had higher levels of sPD-L1,IL-8,and CD8+ in serum at the time of confirmed infection,while lower levels of CD3+ and CD4+ were observed,with statistically significant differences (P<0.05). The comparison of serum sPD-L1,IL-8,and CD8+ levels during infection was confirmed:bacterial intracranial infection group>tuberculous intracranial infection group>viral intracranial infection group (P<0.05); Comparison of CD3+ and CD4+ levels:the Bacterial intracranial infection group < the tuberculous intracranial infection group < the viral intracranial infection group (P<0.05). Comparison of serum S-100β,NSE,and SOD levels during infection:bacterial intracranial infection>tuberculous intracranial infection>viral intracranial infection (P<0.05) was diagnosed; MDA levels were compared:bacterial intracranial infection < tuberculosis intracranial infection < viral intracranial infection (P<0.05). The serum levels of sPD-L1,IL-8,and CD8+ were positively correlated with S-100β,NSE,and SOD (P<0.05),and negatively correlated with MDA (P<0.05); The levels of CD3+ and CD4+ were negatively correlated with S-100β,NSE,and SOD (P<0.05),and positively correlated with MDA (P<0.05).【Conclusion】 The serum levels of sPD-L1,IL-8,and T cell subpopulations after intracranial tumor resection are closely related to the occurrence of intracranial infection,which can provide reference for early clinical diagnosis of infection types and evaluation of the condition,and is conducive to formulating treatment plans. 2023 Vol. 40 (6): 888-891 [Abstract] ( 40 ) HTML (1 KB)  PDF (1135 KB)  ( 59 ) 892 Efficacy of Moxifloxacin Combined with HRZE Chemotherapy Regimen in the Treatment of Pulmonary Tuberculosis and its Impact on Serum PCT and hs-CRP Levels DING Ling, LYU Heng-yi, TIAN Yan-ru DOI: 10.3969/j.issn.1671-7171.2023.06.026 【Objective】 This study aimed to investigate the efficacy of moxifloxacin combined with isoniazid,rifampicin,pyrazinamide,and ethambutol (HRZE) chemotherapy regimen in the treatment of pulmonary tuberculosis and explore effects of the therapy on serum procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) levels in patients. 【Methods】 A total of 80 patients with pulmonary tuberculosis admitted to our hospital were randomly divided into an observation group and a control group,with 40 patients in each group. Both groups received HRZE anti-tuberculosis chemotherapy regimen,while the observation group received additional moxifloxacin treatment. The treatment duration for both groups was 4 months. The sputum smear conversion rate and chest CT evaluation were compared between the two groups. Additionally,the levels of PCT and hs-CRP,immune function markers [CD8+ T cells,CD4+ T cells,immunoglobulin G (IgG),immunoglobulin A (IgA)],and occurrence of adverse reactions were compared between the two groups. 【Results】 The sputum smear conversion rate in the observation group was 92.50% (37/40),significantly higher than that in the control group (75.00%,30/40) (P<0.05). The total absorption rate on chest CT in the observation group was 97.5% (39/40),which was significantly higher than that in the control group (77.50%,31/40) (P<0.05). After treatment,the serum levels of PCT and hs-CRP in both groups were significantly lower than before treatment (P<0.05),and the observation group had significantly lower levels of PCT and hs-CRP compared to the control group (P<0.05). The levels of CD4+,IgG,and IgA were significantly higher,and CD8+ level was lower in both groups after treatment compared to before treatment,with statistical significance (P<0.05). Moreover,the observation group had significantly higher levels of IgA,CD4+ and IgG and lower CD8+ level compared to the control group (P<0.05). The overall incidence of adverse reactions after treatment showed no significant difference between the two groups (P>0.05). 【Conclusion】 Moxifloxacin combined with HRZE chemotherapy regimen demonstrates significant efficacy in the treatment of pulmonary tuberculosis,effectively improves clinical outcomes,enhances patient immune capacity,and is clinically safe. Therefore,it can be widely applied in clinical practice. 2023 Vol. 40 (6): 892-894 [Abstract] ( 31 ) HTML (1 KB)  PDF (1180 KB)  ( 70 ) 895 Clinical Efficacy of Topiramate Combined with Chuanxiong Qingnao Granules and Zhengtian Pills in the Treatment of Childhood Migraine ZHANG Peng-lie, SHEN Ying-chun DOI: 10.3969/j.issn.1671-7171.2023.06.027 【Objective】 To explore the therapeutic effect of topiramate combined with Chuanxiong Qingnao Granules and Zhengtian Pills on children with migraine. 【Methods】 A total of 84 children with migraine admitted to two hospitals were randomly divided into two groups,with 42 cases in each group. The control group was treated with topiramate combined with Zhengtian Pills,while the observation group was treated with Chuanxiong Qingnao Granules in addition to the control group. The clinical symptoms and efficacy,the abnormal rate of Transcranial Doppler ultrasound (TCD) and the score of Pediatric Quality of Life Scale 4.0 (PedsQLTM 4.0) were compared between the two groups before treatment,2 months after treatment and 6 months after treatment,and the drug safety was recorded. 【Results】 The degree,frequency,and duration of migraine in both groups were lower than before treatment 2 months and 6 months after treatment (P<0.05). The degree,frequency,and duration of migraine in both groups were lower than 2 months after treatment (P<0.05),and the observation group was lower than 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). The abnormal rates of TCD at 2 months and 6 months after treatment in both groups were lower than before treatment (P<0.05). The abnormal rates of TCD at 6 months after treatment were lower than those at 2 months after treatment (P<0.05). The abnormal rates of TCD in the observation group were lower than those in the control group at 6 months after treatment (P<0.05). The PedsQLTM 4.0 scores of both groups were higher than before treatment at 2 months and 6 months after treatment (P<0.05). The PedsQLTM 4.0 scores of the observation group were higher than those of the control group at 6 months after treatment (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Topiramate combined with Chuanxiong Qingnao Granules and Zhengtian Pills can alleviate symptoms,enhance efficacy,improve cerebral blood flow status,improve quality of life,and have good safety in treating children with migraine. 2023 Vol. 40 (6): 895-898 [Abstract] ( 47 ) HTML (1 KB)  PDF (1140 KB)  ( 60 ) 899 The Application Value of GLS in Evaluating Left Ventricular Diastolic Function in Hypertensive Patients DUAN Lan, LUO Hui, PENG Han-wu, et al DOI: 10.3969/j.issn.1671-7171.2023.06.028 【Objective】 To explore the application value of left ventricular longitudinal long axis strain (GLS) in evaluating left ventricular diastolic function in hypertensive patients. 【Methods】 A total of 55 patients with primary hypertension who visited our outpatient department from June 2017 to November 2019 and were followed up were selected,and appropriate antihypertensive drugs were selected based on their initial blood pressure levels. Before treatment and one month after treatment,echocardiography was performed to record the patients' early diastolic peak velocity/early diastolic mitral annulus peak velocity (E/e '),early diastolic peak velocity/late diastolic peak velocity (E/A),e',GLS,Mean arterial pressure (MAP),pulse pressure (PP),left atrial volume index (LAVI),left ventricular mass index (LVMI),and left ventricular end diastolic pressure (LVEDP) through cardiac catheters,Pearson correlation analysis was used to analyze the correlation between LVEDP and other echocardiographic indicators.【Results】 After one month of treatment,SBP,DBP,PP,MAP,E/e ',GLS of hypertensive patients were lower than those before treatment,and e' was higher than those before treatment,with a statistically significant difference (P<0.05). After one month of antihypertensive treatment,the amplitude of changes in various indicators of cardiac echocardiography was tested using paired rank sum test. The results showed that the amplitude of changes in GLS was significantly higher than that in LAVI,e ',E/e',and the difference was statistically significant (P<0.05). Pearson correlation analysis showed that LVEDP was significantly positively correlated with GLS and E/e '(P<0.05),while LVEDP was negatively correlated with e' (P<0.05). LVEDP was not significantly correlated with LAVI and E/A (P>0.05). 【Conclusion】 GLS has a high value in evaluating left ventricular diastolic function in hypertensive patients after antihypertensive treatment. 2023 Vol. 40 (6): 899-901 [Abstract] ( 34 ) HTML (1 KB)  PDF (1205 KB)  ( 59 ) 902 Relationship of Immunoglobulin Level with Prognosis in Patients with Chronic Hepatitis B Complicated with Associated Chronic Acute Liver Failure WANG Jie, ZHANG Cui-cui DOI: 10.3969/j.issn.1671-7171.2023.06.029 【Objective】 To study the relationship between short-term prognosis and immunoglobulin (Ig) level in patients with chronic hepatitis B (CHB) with associated chronic acute liver failure (ACLF). 【Methods】 A total of 160 patients with CHB-related ACLF admitted to our hospital were enrolled in the study. The general information,clinical complications and laboratory test indexes of IgG,IgM and IgA at admission were collected. According to the disease outcome within 3 months after admission,patients were divided into the death group (63 cases) and the survival group (97 cases). The efficacy of serum immunoglobulin level in predicting short-term prognosis of patients with CHB-related ACLF was evaluated by receive operating characteristic (ROC),and the independent risk factors for short-term prognosis of patients with CHB-related ACLF were analyzed by multivariate Logistic regression. 【Results】 The age,MELD score,percentage of neutrophil (NEUT%),total bilirubin,IgG,IgM and IgA in the survival group were significantly lower than those in the death group (P<0.05). And alpha-fetoprotein in the survival group was also significantly higher than that in the death group (P<0.05). ROC curve analysis showed that IgG,IgM and IgA had certain predictive valuation for short-term prognosis of CHB-related ACLF patients,and the areas under the curve for IgG,IgM and IgA were 0.780,0.746 and 0.771,respectively. Multivariate Logistic regression analysis showed that the NEUT%,IgG,IgM and IgA were independent risk factors for short-term prognosis inpatients with CHB-related ACLF (P<0.05),while alpha fetoprotein was independent protective factor for short-term prognosis of CHB-related ACLF patients (P<0.05). 【Conclusion】 Levels of IgG,IgM and IgA are potential biomarkers for predicting short-term prognosis in CHB patients:the elevated serum levels are closely associated with poor short-term prognosis in patients with CHB-related ACLF. 2023 Vol. 40 (6): 902-905 [Abstract] ( 33 ) HTML (1 KB)  PDF (1224 KB)  ( 25 ) 906 Current Situation of Anxiety and Depression in Patients with Prediabetes in Shaanbei Area and its Correlation with the Knowledge of Diabetes Prevention and Treatment LIU Juan-juan, JIA Qiu-li DOI: 10.3969/j.issn.1671-7171.2023.06.030 【Objective】 To investigate the current status of anxiety and depression in prediabetic patients in Shaanbei area,and to analyze the correlation with the knowledge of diabetes prevention and treatment. 【Methods】 Through the method of cluster sampling,479 patients with prediabetes in Shaanbei area from March 2019 to July 2021 were investigated. Anxiety and depression status of 479 patients with prediabetes was counted. Among them,patients with anxiety and/or depression symptoms were recorded as the anxiety and depression group,and the rest were recorded as the non-anxiety and depression group. The general data of the anxiety-depression group and the non-anxiety-depression group were compared. Logistic multivariate regression was used to analyze the influencing factors of anxiety and depression in patients with prediabetes. 【Results】 Among the 479 patients with prediabetes,138 patients(28.81%) were anxiety and depression patients,including 72 patients(15.03%) mild anxiety and depression patients,56 moderate anxiety and depression patients (11.69%),and 10 severe anxiety and depression patients (2.09%). The remaining 341 cases were non-anxiety and depression patients (71.19%). The age,education level of high school or below,family monthly income < 5000 yuan,obesity,living alone,divorced or widowed cases,proportion of cases with family history of diabetes,waist circumference in the anxiety and depression group were higher than those in the non-anxiety and depression group (P<0.05). The total cognitive score of diabetes prevention and treatment knowledge in the anxiety and depression group was lower than that in the non-anxiety and depression group (P<0.05). Logistic multivariate regression analysis,the results showed that age,family monthly income < 5000 yuan,divorced or widowed,family history of diabetes,and total cognitive scores of diabetes prevention and treatment knowledge were all associated with anxiety and depression in patients with prediabetes Influencing factors (P<0.05). 【Conclusion】 The current situation of anxiety and depression in diabetic patients in Shaanbei area is not optimistic,and the total score of knowledge and awareness of diabetes prevention and treatment is an influencing factor of anxiety and depression in patients with prediabetes. 2023 Vol. 40 (6): 906-908 [Abstract] ( 36 ) HTML (1 KB)  PDF (1176 KB)  ( 54 ) 909 The Impact of Video Laryngoscopy-Guided Endotracheal Intubation on Resuscitation Time and Prognosis in Prehospital Emergency Care Patients YANG Zhong-lin, XIONG Xiao-fei, ZHANG Yao DOI: 10.3969/j.issn.1671-7171.2023.06.031 【Objective】 To investigate the impact of video laryngoscopy-guided endotracheal intubation on resuscitation time and prognosis in prehospital emergency care patients. 【Methods】 A total of 112 prehospital emergency care patients requiring artificial airway establishment were included in this study. They were divided into an observation group and a control group,with 56 patients in each group. The control group received conventional laryngoscopy-guided tracheal intubation,while the observation group received video laryngoscopy-guided tracheal intubation. The number of intubation attempts,intubation time,time to successful intubation,glottis exposure time,and resuscitation time were compared between the two groups. Blood glucose,oxygen saturation (SaO2),and blood pressure levels were compared at 3 minutes after intubation. Intubation success rate,resuscitation success rate,24 hours survival rate,and incidence of complications were also compared. 【Results】 The observation group had significantly fewer intubation attempts,shorter intubation time,time to successful intubation,glottis exposure time,and resuscitation time compared to the control group (P<0.05). At 3 minutes after intubation,the observation group had higher SaO2 levels,systolic blood pressure,and diastolic blood pressure compared to the control group (P<0.05). There was no significant difference in blood glucose levels at 3 minutes after intubation between the two groups (P>0.05). The observation group had higher intubation success rate (94.64%),resuscitation success rate (37.50%),and 24 hours survival rate (25.00%) compared to the control group (80.36%,19.64% and 10.71%,respectively) (P<0.05). The incidence of complications was significantly lower in the observation group (3.57%) compared to the control group (16.07%) (P<0.05). 【Conclusion】 Video laryngoscopy-guided endotracheal intubation in prehospital emergency care patients can shorten intubation and resuscitation time,improve 24 hours survival rate,and enhance short-term prognosis. 2023 Vol. 40 (6): 909-912 [Abstract] ( 34 ) HTML (1 KB)  PDF (1140 KB)  ( 65 ) 913 Observation on the Efficacy and Complications of Different Bone Transplantation Techniques for Endochondroma of the Hand DING Rui, BI Wen-chao, YANG Rui-ze DOI: 10.3969/j.issn.1671-7171.2023.06.032 【Objective】 To explore the efficacy and incidence of complications of different bone transplantation techniques for hand enchondroma. 【Methods】 A total of 80 patients with hand enchondroma admitted to the Second Affiliated Hospital of Air Force Military Medical University from May 2018 to May 2021 were selected and divided into the observation group and the control group according to a random number table method,with 40 patients in each group. The observation group underwent ipsilateral distal and dorsal radial bone harvesting with lesion scraping and bone grafting,while the control group received autologous ipsilateral iliac bone harvesting. Treatment efficacy,surgical time,hospital stay,hospitalization costs,hand function scores,and donor site complications were compared between the two groups. 【Results】 The excellent and good rate of the observation group was 90.00%,which was significantly higher than the 70.00% of the control group (P<0.05). The surgical time,hospitalization time,and hospitalization expenses in the observation group were significantly lower than those in the control group (P<0.05). The activity,sensation,appearance,work ability,and total score of the observation group were significantly higher than those of the control group (P<0.05). The incidence of donor site complications in the observation group was 7.50%,which was significantly lower than the 25.00% in the control group (P<0.05). 【Conclusion】 Autologous ipsilateral distal and dorsal radial bone extraction for hand enchondroma has advantages over iliac bone extraction in terms of simplicity and economy,which makes it a highly effective treatment method. 2023 Vol. 40 (6): 913-915 [Abstract] ( 41 ) HTML (1 KB)  PDF (1547 KB)  ( 84 ) 916 Application of Brighton PEWS in Children with Severe Hand-Foot-and-Mouth Disease Complicated with Neurological Impairment LI Juan, HUANG Xiao-feng DOI: 10.3969/j.issn.1671-7171.2023.06.033 【Objective】 To explore the application value of Brighton Pediatric Early Warning Score for Children (Brighton PEWS) in children with severe hand-foot-and-mouth disease complicated with neurological impairment. 【Methods】 A retrospective analysis was conducted on the clinical data of 98 children with severe hand-foot-and-mouth disease complicated with neurological impairment admitted to our hospital from June 2018 to May 2020. They were divided into a control group (with routine intervention) and an observation group (Brighton PEWS application in addition to routine intervention) based on different intervention methods,with 49 cases in each group. The levels of neutrophils,serum Creatine kinase (CK),specific neuron Enolase (NSE),and Creatine kinase Isozyme (CK-MB) were compared before and after the intervention in the two groups. And the antipyretic time,herpes regression time,aphthous stomatitis healing time,and the duration of nerve damage were compared between the two groups. The incidence of pulmonary edema,severe encephalitis and circulatory failure were recorded. 【Results】 The antipyretic time,herpes regression time,aphthous stomatitis healing time and nerve damage duration in the observation group were shorter than those in the control group (P<0.05). After intervention,the levels of neutrophils,CK,NSE,and CK-MB in both groups were lower than those before intervention. And these parameter's levels of the observation group was lower than those of the control group with a statistically significant difference (P<0.05). The incidence of complications in the observation group was 4.08% (2/49),which was lower than the control group's 14.29%(7/49) with a statistically significant difference (χ2=4.009,P<0.05). 【Conclusion】 Brighton PEWS intervention on the basis of routine intervention can effectively shorten the disappearance time of clinical symptoms,effectively reduce the damage of myocardial cells and brain cells,and reduce the incidence of complications in children with severe hand-foot-and-mouth disease complicated with neurological damage. 2023 Vol. 40 (6): 916-919 [Abstract] ( 28 ) HTML (1 KB)  PDF (1139 KB)  ( 38 ) 920 The Correlation between the Expression of HDGF and VEGF and the Risk of Lesion Infiltration and Metastasis in Liver Cancer Patients WANG Xiao-feng, WANG Jing-jing DOI: 10.3969/j.issn.1671-7171.2023.06.034 【Objective】 To investigate the correlation between the expression of hepatoma derived growth factor (HDGF),Vascular endothelial growth factor (VEGF) and the risk of invasion and metastasis of liver cancer. 【Methods】 A retrospective analysis was conducted on the clinical data of 82 liver cancer patients who underwent surgical resection treatment at the Northwest University Affiliated Hospital of Xi'an Third Hospital from July 2019 to July 2022. Liver cancer tissue samples and adjacent tissues were collected from the patients. Immunohistochemical staining was used to detect the expression of HDGF and VEGF in liver cancer tissue and adjacent tissues,and to compare the expression of HDGF and VEGF in liver cancer patients with different clinical and pathological characteristics. Multivariate logistic regression analysis was used to analyze the risk factors affecting the expression of HDGF and VEGF in liver cancer tissue. 【Results】 The positive expression rates of HDGF and VEGF in liver cancer tissues were higher than those in adjacent tissues,and the difference was statistically significant (P<0.05). There was a statistically significant difference in the expression of HDGF and VEGF in liver cancer tissues with different AJCC stages,capsule integrity,and tumor metastasis (P<0.05). Multivariate logistic regression model analysis showed that AJCC stage,capsule integrity,and tumor metastasis were influence factors affecting the expression of HDGF and VEGF in liver cancer tissue (P<0.05). 【Conclusions】 HDGF and VEGF are highly expressed in liver cancer tissue,and are related to AJCC staging,capsule integrity,and tumor metastasis,which has certain reference value for evaluating liver cancer progression. 2023 Vol. 40 (6): 920-923 [Abstract] ( 30 ) HTML (1 KB)  PDF (1133 KB)  ( 74 )

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