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Quick Search     Adv Search 2024 Vol. 41, No. 2 Published: 2024-02-26 Original Articles          Original Articles 168 The Effect of Epidural Analgesia at Different Times on the Delivery Process, Delivery Mode, and Maternal and Infant Outcomes in Elderly Parturients YANG Pingge, WANG Huixia, WEI Xiaolei DOI: 10.3969/j.issn.1671-7171.2024.02.003 【Objective】To explore the effects of epidural analgesia at different times on the delivery process, delivery mode, and maternal and infant outcomes in elderly women.【Methods】A total of 114 elderly expectant mothers who were admitted to the two hospitals were randomly divided into Group A and Group B, with 57 cases in each group. Group A received pain relief during the latent period when the mother's cervix was 1 cm open, while Group B received pain relief during the active period when the cervix was 3 cm open. Both groups stopped administering medication when the cervix was opened to 8 cm. We compared the time of each stage of labor experienced by two groups of elderly parturients, including the visual analogue (VAS) scores at 1 cm (T1), 3 cm (T2), 8 cm (T3), during delivery (T4), and after delivery (T5), as well as the heart rate and mean arterial pressure of the parturients; We also compared the delivery methods, maternal and infant outcomes, and newborn 1-minute and 5-minute Apgar scores between two groups of parturients.【Results】The first and total stages of labor in Group A were shorter than those in Group B (P<0.05); There was no statistically significant difference in the second and third stages of labor between the two groups of elderly mothers (P>0.05). The VAS score of T2 in elderly parturients in Group A was lower than that in Group B (P<0.05); There was no statistically significant difference in VAS score, heart rate, and mean arterial pressure between the two groups of elderly parturients at T1, T3, T4, and T5 (P>0.05). There was no statistically significant difference (P>0.05) between the delivery methods, maternal and infant outcomes, and 1-minute and 5-minute Apgar scores of the two groups of elderly mothers. 【Conclusion】The analgesic effects of epidural labor analgesia on elderly parturients during the incubation period and active period are both definite. However, labor analgesia during the incubation period can shorten the duration of labor, accelerate delivery speed, and alleviate the first stage of labor pain in parturients. 2024 Vol. 41 (2): 168-170 [Abstract] ( 42 ) HTML (1 KB)  PDF (1167 KB)  ( 25 ) 171 Identification and Functional Verification of Drug-Resistant Gene Mutations Associated with Breast Cancer Brain Metastasis Based on Cerebrospinal Fluid and Blood Samples YANG Mei, TAN Yue, LI Gang, et al DOI: 10.3969/j.issn.1671-7171.2024.02.004 【Objective】This study aims to investigate the gene mutation profile in cerebrospinal fluid (CSF)/blood-derived samples from patients with brain metastases of breast cancer for screening drug-resistant genes to verify their resistance mechanisms. 【Methods】A total of 70 patients with brain metastases from breast cancer treated in our hospital were selected for the study. Second-generation sequencing technology was used to detect circulating tumor DNA (ctDNA) in CSF and blood samples to understand the gene mutation status, and to screen drug resistance and analyze the association with mutant genes. 【Results】The main gene mutations detected in the 70 patients included TP53, HER2, PIK3CA, BRCA1, and BRCA2. The mutation detection rate in CSF-derived samples was 100% (70/70), which was higher than 65.71% (46/70) in blood-derived samples (P<0.05). Compared to 21 samples without HER2 and PIK3CA mutations (considering as the control group), patients with HER2 mutations showed higher resistance to trastuzumab (P<0.05). Patients with PIK3CA mutations did not show statistically significant differences in resistance to trastuzumab, atezolizumab, paclitaxel, and doxorubicin, if compared to the control group (P<0.05). Similarly, the resistance of HER2 mutation patients to atezolizumab, paclitaxel, and doxorubicin was not significantly different from that of the control group (P<0.05). 【Conclusion】CSF in patients with breast cancer brain metastases can more accurately reflect possible brain metastasis status in comparison to the blood. The detection of HER2 mutations suggests the presence of corresponding drug resistance, which is of significant importance for medication guidance and monitoring of drug resistance. 2024 Vol. 41 (2): 171-173 [Abstract] ( 48 ) HTML (1 KB)  PDF (1225 KB)  ( 48 ) 174 Clinical Efficacy of Combination Therapy of Ranibizumab and Different Doses of Vitipofen Photodynamic Therapy in the Treatment of CSC Complicated with CNV LAI Zhongyan, CAO Wenjie, ZHOU Qun, et al DOI: 10.3969/j.issn.1671-7171.2024.02.005 【Objective】To explore the clinical efficacy of ranibizumab combined with different doses of vitipofen photodynamic therapy in the treatment of chronic central serous chorioretinopathy (CSC) with choroidal neovascularization (CNV). 【Methods】A total of 103 patients with chronic CSC complicated with CNV admitted to Jiading District Central Hospital affiliated with Shanghai Health Medical College from February 2014 to December 2019 were selected. According to different treatment methods, they were divided into a conventional group [58 cases, 58 eyes, treated with ranibizumab and low-dose (1 mg/m2) Vitipofen photodynamic therapy] and an observation group [55 cases, 55 eyes, treated with ranibizumab and half dose (3 mg/m2) Vitipofen photodynamic therapy]. We compared the clinical efficacy, incidence of adverse reactions, height of subretinal fluid protrusion (HPSF), best corrected visual acuity (BCVA), and hemodynamic parameters of the central retinal vein (Vmax and Vmin) between two groups of patients before and after treatment. 【Results】The total effective rate of the observation group was higher than that of the control group (P<0.05). Before treatment, there was no statistically significant difference in HPSF and BVCA between the two groups of patients (P>0.05);After treatment, HPSF was decreased in both groups, and the observation group was lower than the conventional group (P<0.05). After treatment, BCVA increased in both groups, and the observation group was higher than the conventional group (P<0.05). Before treatment, there was no statistically significant difference in Vmax and Vmin between the two groups of patients (P>0.05); After treatment, Vmax and Vmin decreased in both groups of patients, and the observation group was lower than the control group (P<0.05). In the conventional group, there was 1 case of elevated intraocular pressure, 2 cases of nausea and vomiting, and the incidence of adverse reactions was 5.17%; In the observation group, there were 2 cases of elevated intraocular pressure, 2 cases of nausea and vomiting, and the incidence of adverse reactions was 7.27%. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The combination of ranibizumab and half dose vitipofen photodynamic therapy had a significant effect on the treatment of chronic CSC complicated with CNV. It can improve the visual acuity and central retinal vein hemodynamic indicators of patients, and is safe and reliable. 2024 Vol. 41 (2): 174-177 [Abstract] ( 31 ) HTML (1 KB)  PDF (1191 KB)  ( 54 ) 178 Clinical Effects of 3D Printing Guide Plate Technology Combined with Minimally Invasive Internal Fixation for Sacroiliac Joint Complex Injury Treatment CUI Xihu, CHEN Tietie, ZHANG Xiaoyong, et al DOI: 10.3969/j.issn.1671-7171.2024.02.006 【Objective】To explore the clinical application of 3D printing guide plate technology combined with minimally invasive internal fixation technology in the treatment of sacroiliac joint complex injuries. 【Methods】A total of ninety-two patients with sacroiliac complex injuries who were admitted to our hospital between May 2019 and May 2022 were retrospectively analyzed. Patients were divided into two groups according to the surgical methods, with forty-six patients in each group. The control group was treated by traditional surgery, and the study group was treated by 3D printing guide plate technology combined with minimally invasive internal fixation technology. Surgery related indicators, perioperative pain level and recovery were compared between the two groups. 【Results】Compared to the control group, the study group had significantly lower intraoperative fluoroscopy, d intraoperative blood loss and shorter screw placement times(P<0.05). The study group also showed shorter time for operation, hospitalization and injury healing,significantly lower postoperative visual analog scale (VAS), shorter fracture displacement distance, and significantly higher Majeed scores than the traditional surgery group (P<0.05). 【Conclusion】The treatment with 3D printing guide plate technology combined with minimally invasive internal fixation in the clinical treatment of sacroiliac joint complex injury can effectively reduce the surgical trauma and promote postoperative rehabilitation. 2024 Vol. 41 (2): 178-180 [Abstract] ( 26 ) HTML (1 KB)  PDF (1164 KB)  ( 30 ) 181 The Effect of Resistance Breathing Training on Cardiopulmonary Function and Anxiety in Patients with Chronic Heart Failure YANG Nanhua, YANG Shengyong, HONG Wanting, et al DOI: 10.3969/j.issn.1671-7171.2024.02.007 【Objective】To explore the effect of resistance breathing training on cardiopulmonary function and anxiety in patients with chronic heart failure (CHF).【Methods】A total of 128 patients with stable CHF were randomly divided into an observation group and a control group, with 64 patients in each group. Both groups of patients were treated with conventional CHF drugs for 8 weeks, and the observation group received respiratory resistance training in combination with drug treatment. Before and after intervention, patients were tested for lung function (FEV1, FEV1/FVC%), 6-minute walking test (6MWT), dyspnea scale (mMRC), and generalized anxiety disorder (GAD)-7 scale, respectively. The cardiopulmonary function, anxiety state, and adverse reactions of the two groups of patients were compared. 【Results】After intervention, FEV1 and FEV1/FVC in both groups increased compared to before intervention (P<0.05), and the observation group had higher indicators than the control group (P<0.05). The mMRC grading of the observation group improved compared to before intervention (P<0.05); There was no statistically significant difference in mMRC grading between the control group and before intervention (P>0.05), while the observation group had better mMRC grading than the control group (P<0.05). There was no statistically significant difference in 6MWT grading between the two groups compared to before intervention (both P>0.05), and there was no statistically significant difference in 6MWT grading between the two groups (P>0.05); The GAD-7 scores of both groups decreased compared to before intervention (P<0.05), and the GAD-7 scores of the observation group were lower than those of 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).【Conclusions】 The combination of respiratory resistance training and drug therapy can effectively improve the respiratory function and pulmonary ventilation function of CHF patients, alleviate negative emotions, and provide a new therapeutic approach for promoting patient recovery. 2024 Vol. 41 (2): 181-184 [Abstract] ( 31 ) HTML (1 KB)  PDF (1187 KB)  ( 56 ) 185 Application Value of Ultrasonic Backscattering Method in Bone Mineral Density Measurement of Cancellous Bone in Pregnant Women BAI Bo, ZHOU Yuqing, TA Dean DOI: 10.3969/j.issn.1671-7171.2024.02.008 【Objective】To evaluate the feasibility of ultrasonic backscattering method in measuring cancellous bone mineral density parameters of pregnant women by comparing with ultrasonic transmission method. 【Methods】A total of 235 cases of pregnant women were enrolled in this study from June 2017 to July 2018,who came to Shanghai Changing Maternity and Infant Health Hospital for routine examinations. All cases underwent measuring of bone mineral density(BMD) and speed of sound(SOS) by both ultrasonic backscattering method and ultrasonic transmission method. BMD and SOS were compared between the two method groups. All cases were divided into three study groups in terms pregnant phases: first trimester group(<14 gestational weeks),second trimester group(14～28 gestational weeks)and third trimester group(>28 gestational weeks).Both BMD and SOS obtained by ultrasonic backscattering method were compared among the three groups. 【Results】There were no statistic differences of cancellous bone BMD and SOS obtained either by ultrasonic backscattering method or by ultrasonic transmission method(P>0.05). The cancellous bone BMD and SOS values measured by ultrasonic backscattering method of first trimester group were significantly higher than those of second and third trimester group (P<0.05),and the BMD and SOS values of second trimester group were significantly higher than those of third trimester group (P<0.05). 【Conclusion】Cancellous bone BMD and SOS obtained by ultrasonic backscattering method showed no statistic differences from those detected by ultrasonic transmission method. Ultrasonic backscattering method can be used in bone mineral density monitoring in pregnant women, which reflect the changes in different gestational trimesters. 2024 Vol. 41 (2): 185-187 [Abstract] ( 29 ) HTML (1 KB)  PDF (1225 KB)  ( 38 ) 188 Clinical Effect of Xiaoyaosan Jiawei Granule Combined Chinese Medicine for External Use in the Treatment of Hashimoto Thyroiditis WANG Fucun, LI Maolin DOI: 10.3969/j.issn.1671-7171.2024.02.009 【Objective】To investigate the clinical efficacy and application of Xiaoyaosan Jiawei Granule in combination with external application of traditional Chinese medicine (TCM) (named Tazi) in the treatment of Hashimoto's thyroiditis. 【Methods】A total of 66 patients with Hashimoto's thyroiditis treated in Yulin City Traditional Chinese Medicine Hospital and Xi'an Beilin District Traditional Chinese Medicine Hospital from January 2020 to December 2021 were selected as the study subjects. They were randomly allocated into two groups: a control group and a treatment group, each comprising 33 patients. Patients in the treatment group received oral administration of Xiaoyaosan Jiawei (flavor added granules) and external application of TCM (Tazi), while patients in the control group were treated with oral selenium yeast. The clinical efficacy, thyroid function indicators, thyroid-related antibody levels, and TCM symptom and sign scores of the two groups were compared. 【Results】The overall effectiveness rate of the treatment group was significantly greater than the control group (P<0.05). Thyroid-stimulating hormone (TSH) level decreased in both control and treatment groups after treatment; and the TSH level in the tratmentn group was significantly lower than that in the control group (P<0.05). The levels of free triiodothyronine (FT3) and free thyroxine (FT4) increased significantly in both groups after treatment, while levels of FT3 and FT4 in the treatment group were significantly higher those in the control group(P<0.05). Serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) levels significantly decreased after treatment in both groups (P<0.05), with significantly lower levels in the treatment group compared to the control group (P<0.05). Post-treatment, scores of TCM symptoms and signs such as fatigue, shortness of breath, weakness in the waist and knees, dry mouth and throat, weight loss, palpitations, insomnia, irritability, spontaneous and night sweats, and loose stools were significantly higher in the control group than in the treatment group (P<0.05). 【Conclusion】The combined treatment method of oral administration of Xiaoyaosan Jiawei and external application of TCM (Tazi) significantly improved thyroid function and reduced the levels of autoantibodies in patients, and effectively alleviated clinical symptoms and signs, achieving the purpose of treating both the root and the symptoms. 2024 Vol. 41 (2): 188-191 [Abstract] ( 41 ) HTML (1 KB)  PDF (1187 KB)  ( 39 ) 192 Differential Expression of PHOX2B in Four Subtypes of Peripheral Neuroblastoma Tissues TAN Zhiwen, CHEN Weijian, QIN Lei, et al DOI: 10.3969/j.issn.1671-7171.2024.02.010 【Objective】To investigate the differential expression of homologous heterojunction box protein 2B (PHOX2B) in four subtypes of peripheral neuroblastoma (pNTs) tissues. 【Methods】A retrospective analysis was conducted on 65 children with pNTs admitted to our hospital from January 2019 to December 2022. The expression of PHOX2B in four subtypes of pNTs was analyzed using the immunohistochemical comprehensive scoring method,The receiver operating characteristic (ROC) curve was used to evaluate the value of PHOX2B immunohistochemistry comprehensive score in predicting neuroblastoma (NB), ganglionic neuroblastoma (GNB) mixed type (GNBi), ganglionic neuroblastoma nodular type (GNBn), and ganglionic neuroma (GN). 【Results】The number of cases of male and female patients was 33 and 32 respectively, with no significant gender difference; The age distribution was mainly among children under 6 years old, accounting for 75.38%(49/65); The retroperitoneum was a common primary site, followed by the mediastinum and adrenal gland. PHOX2B had the highest comprehensive immunohistochemical score in NB, followed by GNBn, with the weakest expression of GNBi and GN. The comprehensive immunohistochemical score in NB was significantly higher than that of GNBn, GNBi, and GN. The comprehensive immunohistochemical score of GNBn was significantly higher than that of GNBi and GN, and the differences were statistically significant (P<0.05). The ROC curve results showed that a PHOX2B immunohistochemical comprehensive score of 5 could be used as a reference threshold for diagnosing NB, and a PHOX2B immunohistochemical comprehensive score of 3 could be used as a reference threshold for diagnosing GNBn (P<0.05).【Conclusion】There are significant differences in the expression of PHOX2B among different types of pNTs, and its expression intensity can serve as a basis for pathological classification of pNTs. 2024 Vol. 41 (2): 192-194 [Abstract] ( 33 ) HTML (1 KB)  PDF (1699 KB)  ( 35 ) 195 Application of Ultrasound-guided Cricothyroidotomy in Difficult Tracheal Intubation ZHANG Liangcheng, LIU Dan, WU Yu DOI: 10.3969/j.issn.1671-7171.2024.02.011 【Objective】To explore the effect of cricothyroid membrane puncture (cricothyroidotomy) in difficult tracheal intubation guided by ultrasound. 【Methods】A total of 76 patients with intractable tracheal intubation who were hospitalized in Zhenba County People's Hospital and Zhenba Hospital of Traditional Chinese Medicine from January 2018 to January 2020 were selected in the study. According to the random number table method, patients were divided into the control group and the observation group (with 38 cases each). The control group was treated with cricothyroid membrane puncture by body surface positioning method, while the observation group was applied with ultrasound-guided cricothyroidotomy. The success rate of one-time puncture of cricothyroid membrane, intubation comfort and tracheal tube tolerance scores in the two groups of patients were compared. The blood oxygen saturation (SpO2), heart rate (HR), mean arterial pressure (MAP) in both groups, at pre-anesthesia (T0), anesthesia (T1), tracheal intubation (T2) and 5 minutes after intubation (T3) were recorded and postoperative complications was analyzed. 【Results】The success rate of cricothyroid membrane puncture in the observation group was 100%. The observation group had a higher success rate of puncture of the cricothyroid membrane than the control group (100% vs 84.21%) (χ2=6.514, P=0.011). The SpO2, HR, and MAP indexes of T1, T2, and T3 in both groups were higher than those of T0, and those parameters of the observation group were lower than those of the control group (P<0.05).The SpO2, HR, and MAP indexes at T3 were lower than those at T1 and T2 (P<0.05). The observation group's intubation comfort score and tracheal tube tolerance score were lower than the control group (P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (18.42% vs 47.37%) (χ2=7.213,P=0.007). 【Conclusion】Ultrasound-guided cricothyroid membrane puncture can better meet the needs of difficult tracheal intubation patients, improve the success rate of cricothyroid membrane puncture, intubation comfort and tolerance, and reduce the occurrence of complications. 2024 Vol. 41 (2): 195-198 [Abstract] ( 34 ) HTML (1 KB)  PDF (1193 KB)  ( 37 ) 199 The Impact of Phased Functional Exercise on Disease Management Participation and Joint Function Improvement in Total Hip Replacement Patients under Teach Back Health Education LIANG Tingting, MA Chunhui, MENG Fei, et al DOI: 10.3969/j.issn.1671-7171.2024.02.012 【Objective】To explore the prognostic impact of phased functional exercise under Teach Back health education on patients undergoing total hip arthroplasty (THA). 【Methods】Eighty patients with THA were randomly divided into an observation group and a control group, with 40 cases in each group. The control group received routine care, while the observation group received phased functional exercise under Teach Back health education in addition to the control group. Before and 4 weeks after the intervention, two groups of patients were compared in terms of their participation in disease management, hip joint function, and incidence of complications. 【Results】Before intervention, there was no statistically significant difference in various indicators between the two groups of patients (P>0.05). After intervention, the scores of cognitive, skill, action, and belief participation in disease management in both groups of patients were higher than those before intervention (P<0.05), and the scores of the observation group were higher than those of the control group (P<0.05); After intervention, the hip joint function scores of the observation group were higher than those of the control group in terms of joint deformity, joint function, joint pain, and joint activity (P<0.05); The incidence of complications such as pressure ulcers, deep vein thrombosis, lower limb edema, and pulmonary infection in the observation group was lower than that in the control group (P<0.05).【Conclusion】Stage based functional exercise under Teach Back health education effectively enhances the participation of THA patients in disease management, improves hip joint function, and reduces the incidence of complications. 2024 Vol. 41 (2): 199-202 [Abstract] ( 40 ) HTML (1 KB)  PDF (1179 KB)  ( 68 ) 203 The Application Value of Fecal Occult Blood Test, Serum Carcinoembryonic Antigen and Fecal SDC2 Gene Methylation Detection in Early Colorectal Cancer screening HE Wan, YANG Lili, REN Cun, et al DOI: 10.3969/j.issn.1671-7171.2024.02.013 【Objective】To explore the application value of fecal occult blood test, serum carcinoembryonic antigen, and fecal SDC2 gene methylation detection in early screening of colorectal cancer (CRC). 【Methods】A total of 1936 individuals who underwent health examinations in our hospital from October 2019 to November 2023 were selected as the research subjects. They were randomly divided into a serum carcinoembryonic antigen detection group (n=624), a fecal occult blood test detection group (n=655), and a fecal SDC2 detection group (n=657) using a random number table method. If any of the test results are positive, it is recommended that the patient undergo electronic colonoscopy examination, and the screening results will be judged based on the gold standard of colonoscopy and pathological results. The screening value of serum carcinoembryonic antigen, fecal occult blood test, and fecal SDC2 gene methylation detection technology for CRC was evaluated separately. 【Results】Among the 1936 study subjects, 166 cases (8.57%) were initially screened positive, including 49 cases (7.85%) in the serum carcinoembryonic antigen detection group, 60 cases (9.16%) in the fecal occult blood test group, and 57 cases (8.68%) in the fecal SDC2 detection group. The positive predictive value of serum carcinoembryonic antigen detection for intestinal lesions increases with age, and the difference is statistically significant (P=0.033). There was no statistically significant difference (P>0.05) in the positive predictive values of fecal occult blood tests for detecting intestinal lesions, CRC positive predictive values, and CRC and precancerous lesions among individuals of different ages and genders. The positive predictive values of fecal SDC2 detection for CRC, CRC, and precancerous lesions increased with age, and the differences were statistically significant (P=0.014, 0.038). 【Conclusion】Fecal SDC2 gene methylation detection has a higher detection rate and CRC detection rate for all intestinal lesions than fecal occult blood test and serum carcinoembryonic antigen detection. Fecal SDC2 gene methylation detection combined with colonoscopy detection can be the preferred strategy to improve the detection rate of intestinal lesions and early CRC screening. 2024 Vol. 41 (2): 203-206 [Abstract] ( 27 ) HTML (1 KB)  PDF (1188 KB)  ( 48 ) 207 The Value of Serum HbF, AFP Levels, BPS, Apgar Scores in Diagnosing Fetal Maternal Transfusion Syndrome HU Xieying, MA Yali, JIANG Qingqing, et al DOI: 10.3969/j.issn.1671-7171.2024.02.014 【Objective】To explore the value of serum fetal hemoglobin (HbF), alpha fetoprotein (AFP), combined with fetal biophysical score (BPS) and Apgar score in the diagnosis of fetal maternal transfusion syndrome (FMH) in pregnant and postpartum women. 【Methods】A total of 100 pregnant and postpartum women suspected of FMH were selected as the study subjects in our outpatient department. After delivery, the serum HbF and AFP levels of pregnant and postpartum women were measured, and they were divided into FMH group (13 cases) and non FMH group (87 cases) based on the test results; We compared the HbF, AFP levels, BPS, and Apgar scores between two groups of pregnant women. The value of HbF, AFP, BPS, and Apgar scores in predicting FMH was analyzed using Receiver Operating Characteristic (ROC) curves; The multiple factor analysis adopted unconditional logistic stepwise regression analysis. 【Results】The levels of HbF and AFP in the FMH group were significantly higher than those in the non FMH group, and the BPS and Apgar scores were significantly lower than those in the non FMH group (all P<0.05); According to ROC analysis, HbF, AFP, BPS, and Apgar scores can be used to predict the occurrence of FMH. The area under the curve was 0.897, 0.810, 0.829, and 0.941, respectively, and the area under the joint diagnostic curve was 0.980; Multiple logistic regression analysis confirmed that HbF≤3.712%, AFP≤588.359 ng/mL, BPS≥5.865 scores, and Apgar score ≥5.96 scores were risk factors for the occurrence of FMH.【Conclusion】The combination of serum HbF, AFP, BPS, and Apgar score can be used for early diagnosis of FMH, and the combined detection has better evaluation efficacy. 2024 Vol. 41 (2): 207-209 [Abstract] ( 29 ) HTML (1 KB)  PDF (1281 KB)  ( 28 ) 210 The Predictive Value of Serum GFAP and MMP-9 Detection for Neurological Damage in Patients with Hypertensive Intracerebral Hemorrhage HUANG Lina, LI Xianglei, ZHANG Haijun DOI: 10.3969/j.issn.1671-7171.2024.02.015 【Objective】To explore the relationship between glial fibrillary acidic protein (GFAP), matrix metalloproteinase-9 (MMP-9) and the degree of neurological damage in patients with hypertensive intracerebral hemorrhage (HICH).【Methods】A total of 102 HICH patients and 85 hypertensive patients without cerebral hemorrhage were recorded as HICH group and hypertensive group, respectively. Another 80 healthy individuals who underwent physical examination were selected as the health group. Three groups of GFAP and MMP-9 levels were compared; The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological damage in HICH patients, and based on this, they were divided into mild, moderate, and severe groups. We compared the levels of GFAP and MMP-9 in HICH patients with different degrees of neurological deficits. Pearson correlation analysis was used to investigate the correlation between GFAP, MMP-9 levels and the degree of neurological damage in HICH patients. After a 6-month follow-up, the prognosis of HICH patients was evaluated based on the Glasgow Outcome Scale (GOS), and the levels of GFAP and MMP-9 were compared between the group with good prognosis and the group with poor prognosis. A receiver operating characteristic curve (ROC) was created to analyze the predictive value of GFAP, MMP-9, and their combination on the prognosis of HICH patients using area under the curve (AUC).【Results】The levels of GFAP and MMP-9 in patients with hypertension and HICH were higher than those in the healthy group (P<0.05); The levels of GFAP and MMP-9 in the HICH group were higher than those in the hypertension group (P<0.05). The levels of GFAP and MMP-9 in patients in the moderate and severe groups were higher than those in the mild group (P<0.05); The levels of GFAP and MMP-9 in the severe group were higher than those in the moderate group (P<0.05). The levels of GFAP and MMP-9 in HICH patients are positively correlated with the degree of neurological damage (P<0.05). The levels of GFAP and MMP-9 in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The ROC results showed that the AUC of GFAP, MMP-9, and their combination for predicting the prognosis of HICH patients were 0.978, 0.884, and 0.925, respectively. GFAP had the highest predictive value for the prognosis of HICH patients. 【Conclusion】Serum levels of GFAP and MMP-9 are related to the degree of neurological damage and prognosis in HICH patients, and have a high predictive power for patient prognosis. 2024 Vol. 41 (2): 210-213 [Abstract] ( 37 ) HTML (1 KB)  PDF (1326 KB)  ( 20 ) 214 The Relationship between Changes in Electrocardiogram ST-T and Prognosis of Emergency Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction XUE Shanna, WU Yan DOI: 10.3969/j.issn.1671-7171.2024.02.016 【Objective】 To investigate the relationship between the changes of ST-T segment in electrocardiogram and the prognosis of patients with acute myocardial infarction (AMI) undergoing emergency percutaneous coronary intervention (PCI). 【Methods】A total of 244 patients with AMI who underwent PCI treatment in our hospital were followed up for 6 months. According to the prognosis, they were divided into a poor prognosis group and a good prognosis group, Electrocardiographic monitoring was used to record the ST-T elevation before surgery and the degree of ST-T drop at 1 hour and 24 hours after surgery. The risk factors affecting prognosis were analyzed. The predictive value of ST-T drop in electrocardiogram before and after surgery for the prognosis of PCI surgery was evaluated. 【Results】Among the 244 patients, 28 had a poor prognosis. The time from onset to intervention treatment and the level of left ventricular end-diastolic diameter (LVDd) at 1 month after surgery in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The levels of left ventricular ejection fraction (LVEF) at 1 month after surgery and the degree of ST-T drop from pre-to post-1 hour and pre-to post-24 hours were lower than those in the good prognosis group (P<0.05). Logistic regression analysis showed that prolonging the time from onset to intervention treatment, increasing the level of LVDd at 1 month after surgery, reducing the level of LVEF at 1 month after surgery, and reducing the degree of ST-T drop from pre-to post-1 hour and pre-to post-24 hours were all risk factors for a poor prognosis in patients with AMI undergoing PCI surgery (P<0.05). Analysis of receiver operating characteristic curve showed that the area under the curve of ST-T drop in electrocardiogram from pre-to post-1 hour and 24 hours in predicting a poor prognosis after PCI surgery was 0.721 and 0.718, respectively. 【Conclusion】 The evolution of ST-T segment in electrocardiogram is closely related to the prognosis of patients with AMI undergoing PCI surgery, and the degree of ST-T drop in electrocardiogram can be used to predict the prognosis of patients. 2024 Vol. 41 (2): 214-217 [Abstract] ( 45 ) HTML (1 KB)  PDF (1181 KB)  ( 19 ) 218 The Predictive Value of Pelvic Ultrasound Measurement Parameters for Early Pelvic Floor Dysfunction in Primiparous Women after Delivery YANG Xiaoyu, WEI Shirong, XUE Xiaoguang, et al DOI: 10.3969/j.issn.1671-7171.2024.02.017 【Objective】To explore the predictive value of pelvic ultrasound measurement parameters for early pelvic floor dysfunction in primiparous women after delivery.【Methods】 Clinical data of 82 primiparous women who gave birth in Baoji Maternal and Child Health Hospital from February 2018 to February 2021 were collected. They were divided into natural delivery group (n=40) and cesarean section group (n=42) according to different delivery methods. According to whether pelvic floor dysfunction occurred within one year of production, the natural childbirth group can be divided into the dysfunction group (n=17) and the normal group (n=23); The cesarean section group can be divided into the obstructed group (n=13) and the normal group (n=29). All study subjects underwent ultrasound examination before delivery and 6-8 weeks postpartum. Pelvic ultrasound parameters such as bladder urethral posterior angle (PUA), bladder neck mobility (BND), urethral rotation angle (URA), detrusor muscle thickness (DwT), and levator ani muscle rupture area (LHA) were compared. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of pelvic ultrasound measurement parameters for early pelvic floor dysfunction in primiparous women after delivery. 【Results】Postpartum BND, URA, DwT, resting PUA, tile PUA, resting LHA, and tile LHA were all higher in the natural delivery group and cesarean section group than before delivery (P<0.05);The BND, URA, resting LHA, and tile LHA in the postpartum disorders group after natural delivery and cesarean section were higher than those in the normal group (P<0.05); The ROC curve analysis results show that BND, URA, resting LHA, and tile LHA can be used to predict early pelvic floor dysfunction in primiparous women after natural delivery and cesarean section, with areas under the curves of 0.923, 0.872, 0.854, 0.885, and 0.936, 0.817, 0.975, and 0.916, respectively. 【Conclusion】Pelvic ultrasound parameters have high predictive value for early pelvic floor dysfunction in primiparous women after delivery, and have positive significance in preventing pelvic floor dysfunction in primiparous women after delivery. 2024 Vol. 41 (2): 218-221 [Abstract] ( 28 ) HTML (1 KB)  PDF (1325 KB)  ( 48 ) 222 The Diagnostic Value of Dynamic Enhanced Multi-slice Spiral CT Combined with Three-dimensional Imaging Technology for Gastric Cancer YAN Long, WANG Baoqi, LAN Xueqin, et al DOI: 10.3969/j.issn.1671-7171.2024.02.018 【Objective】To explore the diagnostic value of dynamic contrast-enhanced multi-slice spiral CT (MSCT) combined with three-dimensional imaging technology for gastric cancer. 【Methods】A total of 96 gastric cancer patients confirmed by gastroscopy pathology, including 80 cases of advanced gastric cancer and 16 cases of early gastric cancer.All patients underwent MSCT and three-dimensional imaging techniques. We compared the MSCT and three-dimensional imaging findings of patients with advanced and early gastric cancer with pathological diagnosis. 【Results】The MSCT scan results showed that 71 out of 80 patients with advanced gastric cancer had thickening of the gastric wall, abnormal enhancement of the lesion, narrowing of the gastric cavity, irregular depressions and circular protrusions visible on the surface of the lesion, and 9 cases had no obvious enhancement of the lesion. Among 16 early gastric cancer patients, 14 lesions were detected in the arterial phase, and 2 did not show enhancement. The scanning results of three-dimensional imaging technology showed that the lumen stenosis of 80 patients with advanced gastric cancer was more intuitive, and the lesions were moderately to significantly enhanced after enhancement; Among the 16 early gastric cancer patients, 10 lesions were detected in the arterial phase, showing uneven enhancement and a slow in slow out pattern, while 6 cases did not show significant enhancement. In MSCT diagnosis, the coincidence rate between advanced gastric cancer patients and pathological diagnosis was 71.25%(57/80), and the coincidence rate between early gastric cancer patients and pathological diagnosis was 50.00%(8/16), with a total coincidence rate of 67.71%(65/96). In the diagnosis of three-dimensional imaging technology, the coincidence rate between advanced gastric cancer patients and pathological diagnosis was 88.75%(71/80), early gastric cancer patients and pathological diagnosis was 56.25%(9/16), and the total coincidence rate is 83.33%(80/96). The diagnosis of MSCT combined with three-dimensional imaging technology was consistent with the pathological diagnosis results, with a combined diagnostic accuracy of 96.88%(93/96), which was higher than that of individual diagnosis (P<0.05). 【Conclusion】MSCT and 3D imaging techniques can be used for the differential diagnosis of advanced gastric cancer and early gastric cancer patients, and the combination of the two has a better diagnostic effect. 2024 Vol. 41 (2): 222-225 [Abstract] ( 29 ) HTML (1 KB)  PDF (1187 KB)  ( 42 ) 226 Analysis of the Relationship between Cephalosporin Antibiotic Sensitized Red Blood Cell Detection and Hemolytic Anemia CHEN Qi, CHEN Xuan, YOU Lan, et al DOI: 10.3969/j.issn.1671-7171.2024.02.019 【Objective】To explore the relationship between cephalosporin antibioticsensitized red blood cell detection and hemolytic anemia. 【Methods】Blood samples of 996 patients who were hospitalized in our hospital for blood type testing and blood transfusion preparation were collected in the study. Antiglobulin cassette method was used to detect drug-sensitized red blood cells for direct antiglobulin test (DAT) positive status. Statistics of clinical DAT test results with patients' distribution in clinical departments was analyzed. Anti-globulin cassette method was used for antibody typing of DAT positive blood samples, DAT positive intensity distribution, classification, cephalosporin antibiotic sensitized red blood cell detection, and DAT positive antibiotic types. The relationship between cephalosporin antibiotic sensitized red blood cell detection and hemolytic anemia was analyzed by clinically investigating whether patients had hemolytic anemia. The blood group automatic analyzer was used to detect the positive status of the drug-sensitized red blood cell direct antiglobulin test (DAT) and the clinical DAT test results were counted.【Results】The positive detection rate of DAT was 7.83%, and the positive rate of DAT in internal medical department was higher than that in surgical department (P<0.05). The reaction intensities (1+,2+,3+ and 4+) of the blood samples of 78 DAT positive patients in the antiglobulin card accounted for 28.21%, 24.36%, 25.64%, and 21.79%, respectively. While there was no statistical difference in the distribution of the reaction intensity (P>0.05). The proportions of anti-IgG, anti-C3d, and anti-IgG+C3d in DAT positive classification were 39.74%, 33.33%, and 26.92%, respectively. However, there was no significant difference in the composition of DAT positive classification (P>0.05). In the blood samples of 78 DAT positive patients in this study, a total of 9 cases of erythrocytes sensitized to 4 antibiotics were detected; And the proportion of erythrocytes sensitized to cefaclor was higher than that of cefoperazone-sulbactam sodium, cefepime, ceftazidime (P<0.05). There was no significant difference among the other antibiotics (P>0.05). In the blood samples of DAT positive patients in this study, the incidence of clinical hemolytic anemia in antibiotics users was higher than that of no antibiotics users (P<0.05); And the incidence of hemolytic anemia in antibiotics sensitized red blood cells was higher than that of antibiotic unsensitized patients (P<0.05). There was not statistically significant in the incidence of hemolytic anemia between non-sensitized patients who used antibiotics and those who did not use antibiotics (P>0.05).【Conclusion】There is a certain correlation between cephalosporin antibiotic sensitized red blood cell detection and hemolytic anemia. 2024 Vol. 41 (2): 226-229 [Abstract] ( 41 ) HTML (1 KB)  PDF (1186 KB)  ( 36 ) 230 Molecular Mechanism Study on the Resistance of Multidrug-resistant Pseudomonas to Carbapenems and Aminoglycosides Antibiotics WEI Wei, CHEN Qi DOI: 10.3969/j.issn.1671-7171.2024.02.020 【Objective】 To explore the molecular mechanism of resistance of multidrug-resistant Pseudomonas to carbapenems and aminoglycosides antibiotics. 【Methods】Six strains of multidrug-resistant Pseudomonas aeruginosa and Pseudomonas aeruginosa were received from different wards of our hospital from January 2022 to December in the laboratory department. The bacterial species were identified and verified using the Vitek-2 compact fully automated identification instrument and 16s rDNA sequence primers. The E-test drug sensitivity test was used to determine the antibacterial concentration of the strain against clinical antibiotics. The gene subtypes of aminoglycoside and carbapenemase methylases were identified through PCR amplification and sequence comparison. 【Results】Among the 6 strains of Pseudomonas genus bacteria, 4 strains were Pseudomonas aeruginosa and 2 strains were Pseudomonas putida, both of which were Carba NP positive and produced carbapenemase; The strains showed resistance to penicillin, carbapenems, aminoglycosides, cephalosporins, and tetracycline antibiotics. Among the 6 strains, only SY456 was resistant to aflatoxin with a MIC value of 92 μg/mL, while the other strains were mediators or sensitive to aflatoxin resistance. The Carba NP method screened 6 strains of bacteria, all of which produced drug-resistant B-class carbapenemases. The overlap PCR sequence comparison showed that six strains carried armA gene and blaIMP-45 gene, and three strains of Pseudomonas putida SY47, SY153, and SY434 had significantly different pulse field gel electrophoresis (PFGE) bands. 【Conclusion】 There are both Pseudomonas aeruginosa and Pseudomonas aeruginosa carrying both armA and blaIMP-45 in our hospital. Clinical physicians need to adjust their medication strategies in a timely manner based on the type of drug-resistant strains. 2024 Vol. 41 (2): 230-232 [Abstract] ( 37 ) HTML (1 KB)  PDF (1226 KB)  ( 167 ) 233 Expression Characteristics and Clinical Significance of LAG-3 in CD8+T Cells from Patients with Chronic Hepatitis B Virus Infection ZHANG Chuang, SHEN Hong DOI: 10.3969/j.issn.1671-7171.2024.02.021 【Objective】To investigate the expression characteristics and clinical significance of LAG-3 in CD8+T cells from patients with chronic hepatitis B virus (HBV) infection. 【Methods】A total of 60 patients with chronic HBV admitted to our hospital from April 2019 to April 2020 were selected as the HBV group. While 60 health examinees in our hospital during the same period were selected as the control group. Blood samples were collected from both groups. The expression level, intensity and frequency of LAG-3 in CD8+T cells were measured by flow cytometry. The expression levels of interleukin-10 (IL-10), human leukocyte antigen-DR (HLA-DR), interferon-γ (IFN-γ) and transcription factor T-bet (T-bet) were measured. The mechanism of LAG-3 in regulating CD8+T cells was analyzed. 【Results】The expression level and intensity of LAG-3 in the HBV group were higher than those in the control group (P<0.05).The expression of IL-10 in the LAG-3 positive subgroup was higher than that in LAG-3 negative subgroup within HBV group, and the expression of IL-10 in the LAG-3 negative and positive subgroups within HBV group was higher than that in the control group (P<0.05).The expression of HLA-DR in LAG-3 positive subgroup was lower than that in LAG-3 negative subgroup within HBV group, and the expression of HLA-DR in the LAG-3 negative and positive subgroups within HBV group was lower than that in the control group (P<0.05).The expression of IFN-gamma in the LAG-3 positive subgroup within HBV group was lower than that in the LAG-3 negative subgroup, and the expression of IFN-gamma in the LAG-3 negative and positive subgroups within HBV group was lower than that in the control group (P<0.05).The expression of T-bet in the LAG-3 positive subgroup of HBV group was lower than that in the LAG-3 negative subgroup, and the expression of IFN-gamma in negative and positive subgroups of HBV group was lower than that in the control group (P<0.05). 【Conclusion】Chronic HBV infection results in the increase of LAG-3 in CD8+T cells under the action of inflammation. LAG-3 can reduce the secretion of IFN-gamma by affecting the expression of IL-10, HLA-DR, IFN-gamma and T-bet, and increase the consumption of T cells. 2024 Vol. 41 (2): 233-236 [Abstract] ( 29 ) HTML (1 KB)  PDF (1191 KB)  ( 24 ) 237 Clinical Effect of Huatan Quyu Recipe on Acute Attack of Migraine with Type of Phlegm Turbidity and Blood Stasis LI Maolin, LIU Yanju DOI: 10.3969/j.issn.1671-7171.2024.02.022 【Objective】To investigate the clinical effect of Chinese medicine Huatan Quyu decoction on acute attack of migraine with phlegm turbidity and blood stasis type. 【Methods】 A total of 110 patients with migraine admitted to Xi'an Beilin District Hospital of Traditional Chinese Medicine(TCM) were randomly divided into the observation group and the control group with 55 cases each. The patients in the observation group were treated with Huatan Quyu decoction,while the patients in the control group were treated with oral Sibirin. The clinical efficacy, TCM symptom score, hemorheology index, TCD test and the incidence of adverse reactions between the two groups were compared. 【Results】The total clinical effective rate in the observation group was 94.54%, which was higher than that of 81.82% in the control group(P<0.05). After treatment, the plasma specific viscosity, whole blood specific viscosity, hematocrit levels in the observation group were lower(P<0.05). The TCM syndrome score in the observation group after treatment was also lower than that in the control group after treatment(P<0.05). The average blood flow velocity of anterior cerebral artery(ACA), the middle cerebral artery(MCA), posterior cerebral artery(PCA) in the two groups were lower than that before treatment (P<0.05). While The levels of MCA, ACA and PCA in the observation group were lower than that in the control group (P<0.05). The incidence of adverse reactions in the two groups was not statistically different(P>0.05).【Conclusion】Huatan Quyu decoction has a good clinical effect on migraine patients of phlegm turbidity and blood stasis type. It can effectively relieve the clinical symptoms of migraine, reduce blood viscosity, improve brain blood oxygen supply, and has high safety, which is worthy of clinical promotion. 2024 Vol. 41 (2): 237-239 [Abstract] ( 32 ) HTML (1 KB)  PDF (1226 KB)  ( 73 ) 240 Efficacy of Different Doses of Budesonide Combined with Salbutamol in the Treatment of Acute Attack of Bronchial Asthma XU Rui, SONG Dan DOI: 10.3969/j.issn.1671-7171.2024.02.023 【Objective】To analyze the effect of different doses of budesonide combined with salbutamol on patients with acute attack of bronchial asthma. 【Methods】A total of 106 patients with acute attack of bronchial asthma treated in our hospital from October 2019 to October 2020 were selected. Patients with acute attack of bronchial asthma were randomly divided into the control group (with low-dose budesonide combined with salbutamol) and the observation group (with high-dose budesonide combined with salbutamol) by random table method. There were 53 cases in both groups. The curative effect, asthma symptom score before and after treatment, and serum inflammatory factors [hypersensitive C-reactive protein (hs-CRP), hypoxia inducible factor-1α(HIF-1α)] were compared between the two groups. Changes in lung function [forced vital capacity (FVC), forced expiratory volume (FEV1) in the first second, peak respiratory flow rate (PEF)], and adverse reactions were recorded and compared between the two groups. 【Results】The total effective rate of the observation group was 90.57% which was higher than that of the control group (75.47%) (P<0.05). After treatment, the symptom scores of day and night asthma in the observation group were lower than those of the control group (P<0.05). After treatment, the levels of hs-CRP, HIF-1α, TNF-α and IL-6 in the observation group were lower than those in the control group (P<0.05),while the FVC, FEV1 and PEF in the observation group were higher than those in the control group (P<0.05). The incidence of adverse reactions between the two groups were no significant statistical difference (P>0.05). 【Conclusion】The efficacy of high dose of budesonide combined with salbutamol in patients with acute attack of bronchial asthma is satisfactory, which can significantly improve the symptoms of bronchial asthma, down-regulate levels of hs-CRP, HIF-1α, TNF-α, and IL-6, and improve the lung function of patients with safety. 2024 Vol. 41 (2): 240-243 [Abstract] ( 35 ) HTML (1 KB)  PDF (1190 KB)  ( 58 ) 244 Analysis of Factors Influencing Coronary Microcirculatory Resistance Index in Acute Myocardial Infarction XIAO Hongfang, JIANG Yanyan DOI: 10.3969/j.issn.1671-7171.2024.02.024 【Objective】To explore the influencing factors of coronary microcirculation resistance index (IMR) in acute myocardial infarction (AMI). 【Methods】A total of 67 AMI patients admitted to our hospital from March 2019 to June 2021 were selected in the study and they were divided into a normal IMR group (the control group,n=29, IMR≤25) and an observation group (n=38, IMR>25) using a binary classification method with a normal IMR value of 25 as the cutoff. Clinical data of the two groups of patients were compared, using Pearson correlation analysis to analyze the relationship between IMR and various clinical factors and multivariate logistic regression curve to analyze the correlation between various clinical indicators and high-level IMR. 【Results】The results showed that the age, LDL-C (low-density lipoprotein cholesterol), cTnI (cardiac troponin I), CK-MB (creatine kinase isoenzyme), and lesion vessel length of the observation group were higher than those of the control group, while the postoperative TIMI blood flow grade and LVEF (left ventricular ejection fraction) were lower than those of the control group, with statistically significant differences (P<0.05). Pearson correlation analysis showed that IMR was positively correlated with cTnI and age (P<0.05), but negatively correlated with postoperative TIMI blood flow grading and LVEF (P<0.05). There was no significant correlation between IMR and lesion vessel length, and no correlation was seen between IMR and CK-MB (P>0.05). Multivariate logistic regression analysis showed that cTnI, postoperative TIMI blood flow grade, and LVEF were the influencing factors of IMR, with odds ratios(OR)(95%CI) of 2.01 (1.02-3.88), 1.03 (0.87-1.95), and 0.36 (0.07-0.93), respectively, with statistical significance (P<0.05). 【Conclusion】The cTnI postoperative TIMI blood flow grading and LVEF are the influencing factor. 2024 Vol. 41 (2): 244-246 [Abstract] ( 34 ) HTML (1 KB)  PDF (1232 KB)  ( 34 ) 247 The Influence of the Changes of Tibial Posterior Inclination on the Joint Function of Elderly Patients with Diabetes Complicated with Knee Osteoarthritis after Unilateral Condylar Replacement HU Shuhua, ZHAO Yang, LI Jie DOI: 10.3969/j.issn.1671-7171.2024.02.025 【Objective】To investigate the effect of the change of tibial posterior slope (PTS) after unilateral condylar arthroplasty (UKA) in elderly patients with diabetes combined with knee osteoarthritis on joint activity. 【Methods】The clinical data of 96 elderly patients with diabetes combined with knee osteoarthritis who received UKA in our hospital from June 2020 to June 2022 were retrospectively analyzed, and the change value of PTS (△PTS) before and after surgery was calculated. According to △PTS, they were divided into PTS reduction group (△PTS<-2.5°, n=36), PTS slight reduction group (-2.5°≤△PTS<0 °, n=42), and PTS increased group (△PTS≥0°, n=18). All patients were followed up for at least 12 months after surgery, and the postoperative range of motion (ROM), maximum flexion angle (MFD), Knee Society Clinical Score (KSS-C), Knee Society Functional Score (KSS-F), and incidence of postoperative complications were compared among each group of patients; Pearson correlation analysis was used to examine the correlation between △PTS and postoperative ROM, MFD, KSS-C, and KSS-F. 【Results】The postoperative ROM, MFD, KSS-C, and KSS-F of patients in the PTS reduction group were higher than those in the PTS slight reduction group and PTS enlargement group (P<0.05),PTS was negatively correlated with ROM, MFD, KSS-C, and KSS-F (P<0.05). There was no statistically significant difference in the incidence of postoperative complications among patients in each group (P>0.05). 【Conclusion】For the elderly patients with diabetes and knee osteoarthritis, the proper reduction of PTS after UKA can significantly improve the knee joint function and improve the quality of life of patients. 2024 Vol. 41 (2): 247-250 [Abstract] ( 43 ) HTML (1 KB)  PDF (1574 KB)  ( 49 ) 251 Clinical Efficacy of Compound Glycyrrhizic Acid Glycoside Combined with Tacrolimus in the Treatment of Children with Allergic Purpura Nephritis ZHANG Qiong, ZHOU Fang, GUO Yaju DOI: 10.3969/j.issn.1671-7171.2024.02.026 【Objective】To explore the clinical effect of compound glycyrrhizic acid glycoside combined with tacrolimus in the treatment of children with allergic purpura nephritis. 【Methods】A total of 88 children with allergic purpura nephritis admitted to our hospital from January 2020 to January 2023 were selected and randomly divided into an observation group and a control group using a random number table method, with 44 cases in each group. The control group was treated with compound glycyrrhizic acid glycoside, while the observation group was treated with compound glycyrrhizic acid glycoside combined with tacrolimus. The treatment time for both groups was 2 months. Two groups of children were compared in terms of renal function indicators [immunoglobulin G (lgG), immunoglobulin A (lgA)], inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α)], oxidative stress indicators [malondialdehyde (MDA), superoxide dismutase (SOD)], and incidence of adverse reactions. 【Results】After treatment, the levels of lgG and lgA in both groups were lower than before treatment, and the observation group was lower than the control group, with a statistically significant difference (P<0.05); The serum levels of IL-6 and TNF-α in the two groups were lower than before treatment, and the observation group was lower than the control group, with statistical significance (P<0.05). The clinical effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】The combination of compound glycyrrhizic acid glycoside and tacrolimus can improve renal function and alleviate inflammatory reactions in children with allergic purpura nephritis. The clinical treatment effect is good, and the incidence of adverse reactions is low. It is worth promoting and applying. 2024 Vol. 41 (2): 251-253 [Abstract] ( 32 ) HTML (1 KB)  PDF (1228 KB)  ( 36 ) 254 The Effects of Laparoscopic Ovarian Cystectomy on Ovarian Function, Inflammatory Factors and T Lymphocyte Subsets WANG Min, LI Guoyu, WANG Lan DOI: 10.3969/j.issn.1671-7171.2024.02.027 【Objective】To explore the effects of laparoscopic ovarian cystectomy on ovarian function, inflammatory factors, and T lymphocyte subsets in patients. 【Methods】A total of 76 patients with ovarian cysts admitted to the gynecology department of our hospital from January 2019 to January 2023 were selected and divided into a control group and an observation group based on different surgical methods, with 38 cases in each group. The control group underwent open ovarian cystectomy, while the observation group underwent laparoscopic ovarian cystectomy. Ovarian function [estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH)], inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP)], and T lymphocyte subsets (CD3+, CD4+, and CD4+/CD8+) before and after surgery were compared between the two groups. 【Results】FSH and LH increased in both groups 3 months after surgery, but the observation group was lower than the control group (P<0.05); E2 levels decreased in both groups 3 months after surgery, but the observation group was higher than the control group (P<0.05). The postoperative levels of IL-6, TNF-α, and CRP in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in preoperative CD4+ and CD4+/CD8+ between the two groups of patients (P>0.05).On the 1st day after surgery, the serum CD3+, CD4+, CD4+/CD8+ levels in both groups of patients were significantly lower than before surgery, but the observation group was higher than the control group, and the differences were statistically significant (P<0.05).The serum CD3+, CD4+, CD4+/CD8+ levels in the observation group patients returned to preoperative levels 3 days after surgery. 【Conclusion】Laparoscopic ovarian cyst removal surgery can effectively promote the recovery of ovarian function in patients, reduce the body's inflammatory response, increase the level of T lymphocyte subsets, and alleviate the suppression of cellular immune function, which is beneficial for postoperative recovery of patients. 2024 Vol. 41 (2): 254-257 [Abstract] ( 39 ) HTML (1 KB)  PDF (1187 KB)  ( 80 ) 258 The Relationship between Platelet Parameters, Platelet Reactive Protein 1 Levels, and Disease Activity in Patients with Systemic Lupus Erythematosus ZHU Guizhi, WANG Feng, QU Yan, et al DOI: 10.3969/j.issn.1671-7171.2024.02.028 【Objective】To explore the relationship between platelet (PLT) related parameters, PLT reactive protein 1 (TSP-1) levels, and disease activity in patients with systemic lupus erythematosus (SLE). 【Methods】A total of 83 SLE patients admitted to our hospital were selected as the observation group, and 62 healthy individuals who underwent physical examinations during the same period were selected as the control group. Two groups of general information, biochemical indicators, PLT related parameters, and TSP-1 levels were compared; Logistic multiple regression analysis was used to identify the factors influencing disease activity in SLE patients, and receiver operating characteristic (ROC) curve analysis was used to evaluate the value of PLT parameters and TSP-1 in evaluating disease activity in SLE patients. 【Results】 The PLT count, PLT volume, and percentage of large PLT in the observation group were all lower than those in the control group (P<0.05). The average PLT volume (MPV), PLT volume distribution width (PDW), and TSP-1 level in the observation group were higher than those in the control group (P<0.05). Logistic multiple regression analysis showed that IgG, MPV, C3, C4, PLT, and TSP-1 levels were related factors affecting disease activity in SLE patients (P<0.05). ROC curve analysis showed that the sensitivity of MPV, PLT, TSP-1, and their combined evaluation for disease activity in SLE patients were 72.41%, 75.86%, 68.97%, and 79.31%, respectively. The specificity was 70.37%, 79.63%, 77.78%, and 83.33%, respectively. The area under the curve (AUC) was 0.723, 0.751, 0.739, and 0.892, respectively.【Conclusion】 MPV, PLT, and TSP-1 in PLT parameters are related to disease activity in SLE patients, and their combined evaluation of disease activity in SLE patients has good efficacy as evaluation indicators. 2024 Vol. 41 (2): 258-261 [Abstract] ( 45 ) HTML (1 KB)  PDF (1270 KB)  ( 27 ) 262 Dynamic Changes in Hct, LP(a), MPV and their Correlation with Vascular Endothelial Function in Patients with Coronary Heart Disease after CABG Surgery DENG Chuying, WANG Xiaohui, LI Chun DOI: 10.3969/j.issn.1671-7171.2024.02.029 【Objective】To explore the dynamic changes in hematocrit (Hct), lipoprotein (a) [LP(a)], mean platelet volume (MPV), and their correlation with vascular endothelial function in patients with coronary heart disease after coronary artery bypass grafting (CABG). 【Methods】A total of 89 patients with coronary heart disease who underwent non extracorporeal circulation CABG surgery in our hospital from January 2020 to December 2022 were selected. They were divided into an angina group (n=30) and a non angina group (n=59) based on whether angina occurred 90 days after surgery. We compared the changes in Hct, LP(a), MPV levels, and vascular endothelial function indicators [endothelin-1 (ET-1), nitric oxide (NO)] between two groups of patients before surgery, 4 days after surgery, and 14 days after surgery. The correlation between Hct, LP(a), MPV levels and ET-1 and NO was analyzed at postoperative 4 days and 14 days, and the predictive value of Hct, LP(a), and MPV levels for recurrent angina after CABG was analyzed. 【Results】The Hct, LP(a), and MPV levels of the two groups of patients were lower than before surgery on the 4th and 14th postoperative days, and the non angina group was lower than the angina group, with statistical significance (P<0.05). At postoperative 4 days and 14 days, the levels of ET-1 in both groups were lower than before surgery, while the levels of NO were higher than before surgery, and the differences were statistically significant (P<0.05); The levels of ET-1 and NO in the non angina group were significantly different from those in the angina group (P<0.05). Pearson correlation analysis showed that Hct, LP(a), MPV were positively correlated with ET-1 (P<0.05) and negatively correlated with NO (P<0.05) at postoperative 4 days and 14 days. The analysis of the working characteristic curve of the subjects showed that the area under the curve of Hct, LP(a), and MPV combined prediction for postoperative angina pectoris in CABG was greater than that of single prediction (P<0.05). 【Conclusion】The dynamic changes of Hct, LP(a), and MPV in patients with coronary heart disease after CABG are related to vascular endothelial function. The combination of Hct, LP(a), and MPV has high clinical application value in predicting recurrent angina after CABG. 2024 Vol. 41 (2): 262-264 [Abstract] ( 34 ) HTML (1 KB)  PDF (1235 KB)  ( 38 ) 265 The Clinical Efficacy of the Combination of Butylphthalide and Gangliosides in the Treatment of Acute Cerebral Infarction and its Impact on the Neurological Function of Patients LU Hongli, ZHENG Haijing, MA Qi DOI: 10.3969/j.issn.1671-7171.2024.02.030 【Objective】To explore the clinical efficacy of the combination of butylphthalide and gangliosides in the treatment of acute cerebral infarction (ACI) and its impact on the neurological function of patients. 【Methods】A total of 98 ACI patients admitted to our hospital from March 2021 to December 2022 were selected and randomly divided into a control group and an observation group using a random number table method, with 49 cases in each group. The control group received treatment with gangliosides, while the observation group received treatment with a combination of butylphthalide and gangliosides. We compared two groups of clinical total effective rates, related scores [Barthel Index Rating Scale (BI), Stroke Specific Quality of Life Scale (SS-QOL), National Institutes of Health Stroke Scale (NIHSS)], neurological function indicators [Neuron Specific Enolase (NSE), Central Nervous System Specific Protein (S100β), Myelin Basic Protein (MBP)] levels, hemodynamic indicators(WBV, FIB) Blood cell hematocrit (HCT), coagulation factor (PV), and serum levels of vascular endothelial growth factor (VEGF), trimethylamine oxide (TMAO), thromboxane A2 (TXA2), and endothelin 1 (ET-1). 【Results】The total clinical effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the NIHSS score of the two groups of patients was lower than before treatment, while the BI score and SS-QOL score were higher than before treatment. The difference between the observation group and the control group was statistically significant (P<0.05); The levels of NSE, S100β, and MBP in both groups were lower than before treatment, while the observation group was lower than the control group, and the difference was statistically significant (P<0.05); The levels of HCT, WBV, FIB, and PV in the two groups of patients were lower than before treatment, and the observation group was lower than the control group, with statistical significance (P<0.05); The serum VEGF levels of the two groups were higher than before treatment, while the levels of ET-1, TMAO, and TXA2 were lower than before treatment. The difference between the observation group and the control group was statistically significant (P<0.05). 【Conclusion】The combination of butylphthalide and gangliosides has a good therapeutic effect on ACI, and improve the quality of life of patients. 2024 Vol. 41 (2): 265-268 [Abstract] ( 31 ) HTML (1 KB)  PDF (1199 KB)  ( 31 ) 269 Clinical Efficacy of Qingxuan Zhike Granules Combined with Western Medicine in the Treatment of Mycoplasma Pneumoniae Pneumonia and its Impact on Lung and Immune Function in Children QIN Junfeng, XU Guochao, AN Yunying, et al DOI: 10.3969/j.issn.1671-7171.2024.02.031 【Objective】To explore the clinical efficacy of Qingxuan Zhike Granules combined with Western medicine in the treatment of Mycoplasma pneumoniae pneumonia and its impact on lung function and immune function in children. 【Methods】A total of 112 children with Mycoplasma pneumoniae pneumonia admitted to our hospital from September 2020 to October 2022 were selected and randomly divided into an observation group and a control group using a random number table method, with 56 cases in each group. The control group was treated with conventional western medicine, while the observation group was treated with Qingxuan Zhike Granules on the basis of the control group. Both groups were treated for 2 weeks.The two groups were compared in terms of efficacy, symptom disappearance time, and pulmonary ventilation function before and after treatment [forced expiratory volume at 1 second (FEV1), forced vital capacity (FVC), maximum expiratory flow rate L (PEF)], serum immunoglobulin indicators [immunoglobulin M (IgM), immunoglobulin G (IgG), immunoglobulin A (IgA)],Toll like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and nuclear transcription factor-κB (NF-κB) levels. The occurrence of adverse reactions had been counted. 【Results】The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The observation group had shorter fever relief time, disappearance time of shortness of breath, disappearance time of cough, and disappearance time of lung rales compared to the control group, and the differences were statistically significant (P<0.05). After treatment, the FEV1, FVC, and PEF of the two groups of patients were higher than before treatment, and the observation group was higher than the control group, with statistical significance (P<0.05); The serum levels of IgM, IgG, and IgA in the two groups were higher than before treatment, while the observation group was higher than the control group, with statistical significance (P<0.05); The expression levels of TLR4, MyD88, and NF-κB in the serum of the two groups were lower than before treatment, and the observation group was lower than the control group, with statistical significance (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups of children (P>0.05). 【Conclusion】The combination of Qingxuan Zhike Granules and Western medicine has a good clinical efficacy in the treatment of Mycoplasma pneumoniae pneumonia, which can effectively improve the lung and immune functions of children, inhibit the expression of TLR4/MyD88, and is safe. 2024 Vol. 41 (2): 269-272 [Abstract] ( 106 ) HTML (1 KB)  PDF (1189 KB)  ( 81 ) 273 The Correlation between Serum Myocardial Injury Markers and Inflammatory Factors with the Severity of Neonatal Asphyxia SHEN Jie, ZHANG Weixing, WU Junbao DOI: 10.3969/j.issn.1671-7171.2024.02.032 【Objective】To explore the correlation between serum myocardial injury markers and inflammatory factors with the severity of neonatal asphyxia. 【Methods】A total of 120 newborns with asphyxia born in our hospital from September 2019 to September 2022 (observation group) and 50 healthy newborns (control group) were selected. Two groups of study subjects were compared in terms of serum myocardial injury biomarkers [calcin I(cTnI), creatine kinase (CK), and creatine kinase isoenzyme (CK-MB)] and inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α(TNF-α)],and the relationship between serum cTnI, CK, CK-MB, CRP, IL-6, TNF-α levels and the severity of neonatal asphyxia was analyzed. 【Results】The serum levels of cTnI, CK, CK-MB, CRP, IL-6, and TNF-αin the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05).The serum levels of cTnI, CK, and CK-MB in the severe asphyxia group were higher than those in the mild asphyxia group on the 1st and 7th day of birth (P<0.05), and the serum levels of cTnI, CK, and CK-MB on the 7th day of birth were lower than those on the 1st day of birth in the two groups, with statistical significance (P<0.05). The serum levels of CRP, IL-6, and TNF-α in the severe asphyxia group were significantly higher than those in the mild asphyxia group on the 1st and 7th day of birth (P<0.05). The serum levels of CRP, IL-6, and TNF-α in the two groups were lower on the 7th day of birth than on the 1st day of birth, and the difference was statistically significant (P<0.05). Spearman correlation analysis showed that serum levels of cTnI, CK, CK-MB, CRP, IL-6, TNF-αwere positively correlated with the severity of neonatal asphyxia (all P<0.05). 【Conclusion】The levels of myocardial injury markers and inflammatory factors in newborns with asphyxia are abnormally elevated, and the levels of myocardial injury markers and inflammatory factors are positively correlated with the severity of neonatal asphyxia. 2024 Vol. 41 (2): 273-275 [Abstract] ( 30 ) HTML (1 KB)  PDF (1235 KB)  ( 24 ) 276 The Effect of Outdoor Aerobic Exercise Combined with Aripiprazole on Lipid Metabolism and Event-related Potential P300 in Elderly Obese Schizophrenia Patients SHAN Xiaohei, ZHANG Fusong, RUI Jinghua DOI: 10.3969/j.issn.1671-7171.2024.02.033 【Objective】To explore the effects of outdoor aerobic exercise combined with aripiprazole on lipid metabolism and event related potential (P300) in elderly obese patients with schizophrenia (SCH). 【Methods】A total of 114 elderly obese SCH patients admitted to our hospital from July 2019 to July 2021 were selected and randomly divided into a control group and an observation group using a random number table method, with 57 cases in each group. The control group was treated with aripiprazole, while the observation group received outdoor aerobic exercise treatment in addition to the control group. We compared the clinical efficacy, BPRS scores, SSPI scores, P300(latency, amplitude), lipid metabolism indicators [triglycerides (TG), glutamic acid (GLU), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C)], and incidence of adverse reactions between two groups. 【Results】The clinical effective rate of the observation group was 94.74%, which was higher than the control group's 80.70%, and the difference was statistically significant (P<0.05). After treatment, the BPRS scores of both groups were lower than before treatment, and the observation group was lower than the control group (P<0.05); The SSPI scores of the two groups were higher than before treatment, and the observation group was higher than the control group (P<0.05). After treatment, the P300 latency in both groups was lower than before treatment, and the observation group was lower than the control group (P<0.05); After treatment, the amplitude of P300 waves in both groups was higher than before treatment, and the observation group was higher than the control group (P<0.05). After treatment, the levels of GLU, TG, and LDL-C in both groups were higher than before treatment, and the increase in the observation group was smaller than that in the control group (P<0.05); After treatment, the HDL-C levels in both groups were lower than before treatment, and the decrease in the observation group was smaller than that in the control group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 The combination of aripiprazole and outdoor aerobic exercise has a significant effect on the treatment of elderly obese SCH, which can improve clinical symptoms, promote social function reconstruction, regulate lipid metabolism, and is worthy of clinical reference. 2024 Vol. 41 (2): 276-279 [Abstract] ( 27 ) HTML (1 KB)  PDF (1194 KB)  ( 36 ) 280 The Effect of Injecting NGF into Different Parts of the Body on the Hearing and Symptoms of Patients with Sudden Deafness CHAI Xiaoxia, LIU Yujuan DOI: 10.3969/j.issn.1671-7171.2024.02.034 【Objective】To explore the effects of injecting rat nerve growth factor (NGF) into different parts of the body on the hearing and symptoms of patients with sudden deafness. 【Methods】 A total of 70 patients with sudden deafness admitted to the Hancheng People's Hospital from October 2019 to October 2022 were randomly divided into an observation group and a control group, with 35 cases in each group, using a random number table method. The control group received NGF injection into the buttocks, while the observation group received NGF injection under the periosteum of the mastoid process behind the ear. We compared the clinical efficacy, incidence of adverse reactions, disappearance time of clinical symptoms (including tinnitus, ear tightness, and dizziness), and hearing threshold values (including bone conduction and air conduction hearing thresholds) before and after treatment between two groups of patients. 【Results】The total effective rate of clinical efficacy in the observation group was 94.29%, significantly higher than the control group's 74.29%, and the difference was statistically significant (P<0.05). The disappearance time of tinnitus, ear tightness, and dizziness in the observation group was shorter than that in the control group, and the difference was statistically significant (P<0.05). After treatment, the bone conduction and air conduction hearing thresholds of the two groups of patients were lower than before treatment, and the difference was statistically significant (P<0.05); After treatment, the bone conduction and air conduction hearing thresholds in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups of patients (P>0.05).【Conclusion】Compared with the injection of NGF into the buttocks, the injection of NGF into the subperiosteal area behind the ear and mastoid process has better clinical efficacy in the treatment of sudden deafness, with more significant improvement in clinical symptoms, promotion of hearing recovery, and higher safety. 2024 Vol. 41 (2): 280-282 [Abstract] ( 34 ) HTML (1 KB)  PDF (1165 KB)  ( 18 ) 283 The Role of Interest Induced Intervention Model in Improving Compliance in Children with Pneumonia YANG Shuai, ZHAO Yue DOI: 10.3969/j.issn.1671-7171.2024.02.035 【Objective】To explore the application effect of interest induced intervention mode in children with pneumonia. 【Methods】 A total of 96 pediatric patients with pneumonia admitted to the Department of Pediatrics at Shandong Provincial Third Hospital from April 2021 to May 2022 were selected and divided into a reference group and an intervention group using a random number allocation table. The reference group consisted of 48 patients who received routine rehabilitation nursing intervention, while the intervention group consisted of 48 patients who received interest induced rehabilitation nursing intervention. On the first day of admission and one day before discharge, the psychological stress status and symptom improvement of the two groups were evaluated Observe and analyze treatment compliance and other factors. 【Results】Comparison of psychological stress status and treatment compliance between the two groups of children after 1 day of admission (P>0.05); One day before discharge, compared with the control group, the intervention group showed a significant decrease in scores for anxiety, depression, and other disorders (P<0.05); The improvement time of symptoms such as fever relief time, disappearance of shortness of breath, disappearance of cough, and disappearance of lung moist rales in the intervention group was significantly shortened (P<0.05); Compared with the control group during the same period, the intervention group showed a significant improvement in treatment compliance in terms of diet, treatment behavior, examination cooperation, activity level, and sleep (P<0.05). 【Conclusion】 Adopting an interest induced rehabilitation nursing intervention model for pneumonia patients admitted to our hospital is beneficial for alleviating their negative psychological emotions such as panic and resistance, improving their clinical symptoms, and enhancing their compliance with clinical treatment. 2024 Vol. 41 (2): 283-286 [Abstract] ( 30 ) HTML (1 KB)  PDF (1184 KB)  ( 113 )

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