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Quick Search     Adv Search 2024 Vol. 41, No. 4 Published: 2024-04-26 Review and lecture Original Articles          Original Articles 484 An Evidence-based Summary of Nutritional Management in Hospice Care for Terminally Ill Cancer Patients XIANG Yuqiong, LUO Tingwei, SONG Qingqing, et al DOI: 10.3969/j.issn.1671-7171.2024.04.002 【Objective】To search and evaluate relevant evidence on nutritional management in hospice care for terminally ill cancer patients both domestically and internationally, providing evidence-based support for clinical workers. 【Methods】A literature search was conducted based on the evidence resource "6S" model, with a search period from database establishment to December 2022. Two researchers evaluated the quality of the included literature and extracted evidence. 【Results】A total of 13 articles were included, and 28 evidence were extracted, including 24 A-level recommendations and 4 B-level recommendations. Building a nutrition support team was a solid foundation for the nutrition management of terminally ill cancer patients. Providing medication and non medication interventions was a key link in the nutrition management of terminally ill cancer patients, and adopting enteral and parenteral nutrition was a supplementary means of nutrition management for terminally ill cancer patients. 【Conclusion】Clinical staff can refer to the best evidence of nutritional management in hospice care for terminally ill cancer patients, and fully consider the personal wishes of patients and their families to develop personalized nutritional support plans for patients. 2024 Vol. 41 (4): 484-488 [Abstract] ( 60 ) HTML (1 KB)  PDF (1220 KB)  ( 106 ) 489 Clinical Effect of Photodynamic Therapy in the Treatment of Moderate Chronic Periodontitis LI Xianing, ZHANG Mengxue, WANG Zhi, et al DOI: 10.3969/j.issn.1671-7171.2024.04.003 【Objective】To investigate the clinical effect of photodynamic therapy (PDT) in the treatment of moderate chronic periodontitis. 【Methods】A total of 26 patients with moderate chronic periodontitis diagnosed and treated in SATH Hospital of Stomatology Henan University from January 2021 to September 2023 were selected. Two teeth with the same name with similar damage degree of bilateral periodontal tissue were selected from each patient. They were divided into the observation group (treated with SRP combined with PDT) and the control group (treated with SPR alone) according to random number table method, with 26 capsules in each group. Oral hygiene education and supragingival cleaning were performed in both groups. Periodontal probing depth (PD), bleeding index (BI) and probing bleeding (BOP) were recorded 1 week later (before treatment), and SRP was performed on all teeth with PD≥4 mm. The positive rates of PD, BI and BOP were compared between the two groups before treatment, 6 weeks after treatment and 12 weeks after treatment. 【Results】Before treatment, there was no significant difference in the positive rates of PD, BI and BOP between two groups (P>0.05). The positive rates of PD, BI and BOP after 6 weeks and 12 weeks of treatment were significantly lower than before treatment, with statistical significance (P<0.05). The positive rates of PD, BI and BOP in the observation group were significantly lower than those in the control group after 6 weeks and 12 weeks of treatment, with statistical significance (P<0.05). 【Conclusion】PDT, as an adjunct therapy for SPR, can reduce PD in the short term, relieve gingival inflammation and gingival bleeding. It has better clinical effect than SPR alone. 2024 Vol. 41 (4): 489-491 [Abstract] ( 58 ) HTML (1 KB)  PDF (1140 KB)  ( 18 ) 492 Effects of Hysteroscopic Electroendometrial Resection Combined with Levonorgestrel Intrauterine Birth Control System on Endometrial Thickness, Sex Hormone Levels and AUB Recurrence Rate in Perimenopausal AUB Patients TIAN Xingfang, YANG Ziping DOI: 10.3969/j.issn.1671-7171.2024.04.004 【Objective】To investigate the effects of hysteroscopic electroendometrial resection combined with levonorgestrel intrauterine birth control system on endometrial thickness, sex hormone levels and recurrence rate in patients with perimenopausal abnormal uterine bleeding (AUB). 【Methods】A total of 90 patients with perimenopausal AUB admitted to our hospital from February 2020 to March 2023 were selected and divided into the observation group (n=46) and the control group (n=44) by random envelope method. The control group was treated with hysteroscopic electrohysterectomy, while the observation group was treated with levonorgestrel intrauterine birth control system combined with hysteroscopic electrohysterectomy. The therapeutic effect, menstrual blood loss chart (PBAC) score, endometrial thickness, hemoglobin (Hb), sex hormone level, complications, menstrual status, and recurrence of the two groups were compared. 【Results】The total effective rate of the observation group was 95.65%, which was significantly higher than that of the control group (81.82%, P<0.05). After treatment, the PBAC score and endometrial thickness of both groups decreased with the observation group showing lower than the control group (P<0.05). After treatment, Hb increased in both groups, and Hb in the observation group was higher than that in the control group (P<0.05). After treatment, estradiol (E2), progesterone (P), follicle stimulating hormone (FSH) and luteinizing hormone (LH) decreased in both groups, while E2,P,FSH and LH levels in the observation group were lower than those in the control group (P<0.05). After 6 months of treatment, there was no significant difference in the incidence of infection, uterine adenomyosis and tubal sterilization syndrome between the two groups (P>0.05). The incidence of uterine adhesion in the observation group was lower than that in the control group (P<0.05). There was no significant difference in amenorrhea and normal menses between the two groups(P>0.05). The decrease rate of menstrual volume in observation group was higher than that in control group (P<0.05). The recurrence rate of bleeding in observation group was lower than that in control group (P<0.05). 【Conclusion】Hysteroscopic electroendometrial resection combined with levonorgestrel intrauterine birth control system is effective in the treatment of patients with abnormal uterine bleeding in perimenopausal period, which can reduce the amount of blood loss, sex hormone level and endometrial thickness. It has good safety and low recurrence rate. 2024 Vol. 41 (4): 492-495 [Abstract] ( 36 ) HTML (1 KB)  PDF (1162 KB)  ( 17 ) 496 The Application Effect of Improved Electroconvulsive Therapy Combined with High-frequency rTMS in Patients with Schizophrenia and its Impact on Cognitive Function DU Tiantian, LIANG Xuejun, SHI Zhenjuan, et al DOI: 10.3969/j.issn.1671-7171.2024.04.005 【Objective】To explore the application effect of modified electroconvulsive therapy (MECT) combined with high-frequency repetitive transcranial magnetic stimulation (rTMS) in patients with schizophrenia (SCH) and its impact on cognitive function. 【Methods】A total of 88 patients with schizophrenia admitted to our hospital from January 2021 to June 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. Both groups were given conventional drugs, the control group was given MECT +high-frequency rTMS non irritating treatment, and the observation group was given MECT+ high-frequency rTMS treatment. We compared the efficacy, Montreal Cognitive Assessment Scale (MoCA), Positive and Negative Symptom Scale (PANSS), serum neurotransmitters [Y-aminobutyric acid (GABA), dopamine (DA), norepinephrine (NE), 5-hydroxytryptamine (5-HT)], GQOLI-74 scores, and incidence of adverse reactions between two groups. 【Results】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). After treatment, the positive symptom score, negative symptom score, general psychopathological symptom score, and total score of the two groups decreased compared to before treatment. The observation group was lower than the control group, and the difference was statistically significant (P<0.05). After treatment, the GQOLI-74 and MoCA scores of both groups were higher than before treatment, and the observation group was higher than the control group, with a statistically significant difference (P<0.05). After treatment, the serum levels of NE, GABA, 5-HT, and DA in both groups were higher than before treatment, and the observation group was higher 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 patients (P>0.05). 【Conclusion】High frequency rTMS has a significant therapeutic effect on schizophrenia, regulating neurotransmitter expression, improving cognitive function, alleviating psychiatric symptoms, and improving quality of life. 2024 Vol. 41 (4): 496-499 [Abstract] ( 38 ) HTML (1 KB)  PDF (1163 KB)  ( 34 ) 500 The Effect of CKIP-1 on Microfilament Changes in Osteoblasts Induced by Simulated Weightlessness WANG Maitao, SONG Weihong, ZHOU Hua, et al DOI: 10.3969/j.issn.1671-7171.2024.04.006 【Objective】To investigate the effect of CKIP-1 on microfilament changes induced by simulated weightlessness in osteoblasts.【Methods】We selected mouse osteoblast like cell line (MC3T3-E1) for the study, simulated microgravity environment with a gyrator, and constructed a CKIP-1 overexpression model through lentivirus infection. The cells were divided into group a (microgravity group), group b (empty lentivirus and microgravity group), group c (CKIP-1 overexpression lentivirus and microgravity group), and group d (CKIP-1 overexpression lentivirus group). Fluorescence staining was performed on cells using FITC labeled ghost pen cyclic peptides, and changes in cell microfilaments were observed under laser confocal microscopy. The expression of CKIP-1 mRNA, ALP mRNA, and RUNX2 mRNA was also measured using qRT-PCR technology. 【Results】The microfilament structure of each group of cells showed varying degrees of depolymerization, and the tension fibers were disorderly arranged and the number decreased. The most significant changes were observed in the simulated microgravity group of osteoblasts infected with CKIP-1 overexpression lentivirus. The expression level of CKIP-1 mRNA in the group c and the group d was higher than that in the group a and the group b, and the difference was statistically significant (P<0.05). The expression levels of RUNX2 mRNA and ALPL mRNA in bone cells composed of the group c were lower than those in the group a, the group b, and the group d, with statistical significance(P<0.05). There was no statistically significant difference in the expression levels of RUNX2 mRNA and ALPL mRNA in bone cells between the group a, the group b, and the group d (P>0.05). 【Conclusion】Overexpression of CKIP-1 may further exacerbate the depolymerization of cytoskeletal microfilaments in osteoblasts under microgravity conditions, thereby inhibiting the proliferation and differentiation of osteoblasts. 2024 Vol. 41 (4): 500-503 [Abstract] ( 39 ) HTML (1 KB)  PDF (1609 KB)  ( 23 ) 504 The Therapeutic Effect of Vitapex Paste Root Canal Filling in the Treatment of Pediatric Primary Pulpitis and its Impact on IL-1β and IL-18 Levels ZHANG Bo, SONG Zhenzhen DOI: 10.3969/j.issn.1671-7171.2024.04.007 【Objective】To explore the therapeutic effect of Vitapex paste root canal filling on pulpitis of primary teeth in children and its impact on the levels of interleukin-1β (IL-1β) and interleukin-18 (IL-18). 【Methods】A total of 92 children with primary pulpitis treated at the Third Hospital of Xi'an City from March 2020 to March 2022 were selected and randomly divided into an observation group (n=46, 52 affected teeth) and a control group (n=46, 56 affected teeth) using a random number table method. The observation group received root canal filling with Vitapex paste, while the control group received treatment with zinc oxide clove oil paste. We compared the swelling disappearance time, pain relief time, degree of tooth pain, success rate of root canal treatment, and IL-1β and IL-18 levels between two groups of pediatric patients. 【Results】The swelling disappearance time and pain relief time in the observation group were shorter than those in the control group (P<0.05). Before treatment, there was no statistically significant difference in IL-1β and IL-18 levels between the two groups (P>0.05); After treatment, the levels of IL-1β and IL-18 in both groups decreased (P<0.05), and the observation group was lower than the control group (P<0.05). 2 days after surgery, the visual analog scale (VAS) scores of both groups were significantly lower than before surgery (P<0.05), and the observation group was lower than the control group (P<0.05); After 3 days of surgery, the VAS scores of both groups significantly decreased compared to preoperative and postoperative 2 days, and the observation group was lower than the control group (P<0.05). Follow up for 1 year showed that in the control group, 10 apical inflammations occurred, with a treatment success rate of 82.14%(46/56); Two apical inflammations were observed in the observation group, with a treatment success rate of 96.15%(50/52). The success rate of root canal treatment in the observation group was higher than that in the control group, and the difference was statistically significant (χ2=5.359,P=0.021). 【Conclusion】Vitapex paste root canal filling has a significant therapeutic effect on children with primary pulpitis and can reduce IL-1β and IL-18 levels , alleviate postoperative tooth pain in pediatric patients and improve the success rate of root canal treatment. 2024 Vol. 41 (4): 504-506 [Abstract] ( 33 ) HTML (1 KB)  PDF (1137 KB)  ( 45 ) 507 Diagnostic Value of Three-Dimensional Volumetric Ultrasound Combined with Two-Dimensional Ultrasound in Female Voiding Disorders HE Lixia, HE Jing DOI: 10.3969/j.issn.1671-7171.2024.04.008 【Objective】To explore the diagnostic value of three-dimensional volume ultrasound combined with two-dimensional ultrasound in female voiding disorders. 【Methods】From March 2021 to October 2022, 105 female patients with dysuria treated in our hospital were selected as the observation group, and 105 healthy women who underwent physical examination in our hospital were selected as the control group. All the candidates were given three-dimensional volumetric ultrasonography combined with two-dimensional ultrasonography to record the ultrasonic characteristics and determine the diagnostic value. 【Results】In the resting state, the two-dimensional ultrasound examination indicators of bladder detrusor muscle thickness, the posterior Angle of bladder and urethra and internal urethral orifice funnel formation rate in the observation group were significantly higher than those in control group (P<0.05). In the resting state, the three-dimensional volume ultrasound examination indicators of the position of the bladder neck on the X-axis (X1) and the posterior angle of the bladder and urethra (α1) in the observation group were significantly higher than those in the control group (P<0.05). The position of the bladder neck on the Y axis (Y1) and the length of the proximal functional urethra (h1) in the observation group were significantly lower than those in the control group (P<0.05).ROC curve analysis showed that the maximum area under the curve of 2D ultrasound, 3D volumetric ultrasound, and 3D volumetric ultrasound combined with 2D ultrasound for the diagnosis of female urinary disorder was 0.650, 0.720 and 0.775, respectively. Unconditional logistic regression analysis showed that the thickness of bladder detrusor muscle, the posterior Angle of bladder and urethra, the rate of funnel formation, X1, α1, Y1 and h1 were all important factors affecting the occurrence of female voiding disorder (P<0.05). 【Conclusion】Three-dimensional volumetry ultrasound combined with two-dimensional ultrasound has great potential, which is of great value in the diagnosis of female voiding disorders and worthy of promotion and application. 2024 Vol. 41 (4): 507-510 [Abstract] ( 38 ) HTML (1 KB)  PDF (1229 KB)  ( 39 ) 511 Differential Diagnostic Value of Peripheral Blood miR-200b-3p and miR-181b-5p Combined with Multi-Slice Spiral CT Perfusion Scan for Benign Prostatic Hyperplasia and Prostate Cancer MENG Shengjin DOI: 10.3969/j.issn.1671-7171.2024.04.009 【Objective】To explore the differential value of multi-slice spiral CT (MSCT) perfusion scan combined with serum microRNA-200b-3p (miR-200b-3p) and microRNA-181b-5p (miR-181b-5p) in benign prostatic hyperplasia (BPH) and prostate cancer. 【Methods】A total of 249 patients with prostate lesions admitted to our hospital from May 2021 to September 2023 were selected and divided into BPH group (n=144) and prostate cancer group (n=105) based on pathological results. Logistic regression analysis was used to investigate the relationship between serum miR-200b-3p, miR-181b-5p, and MSCT perfusion parameters with prostate cancer. A receiver operating characteristic curve was plotted to analyze the diagnostic value of MSCT perfusion parameters combined with serum miR-200b-3p and miR-181b-5p for prostate cancer. 【Results】The serum miR-200b-3p levels in the prostate cancer group were higher than those in the BPH group, while the serum miR-181b-5p levels were lower than those in the BPH group (P<0.05). The rBF and PS of patients in the prostate cancer group were significantly higher than those in the BPH group (P<0.05). The area under the curve of rBF, PS, miR-200b-3p, and miR-181b-5p for single and combined diagnosis of prostate cancer were 0.780, 0.760, 0.763, 0.801, and 0.932, respectively. The results of logistic regression analysis showed that rBF>50.54 mL/(min?100 g), PS>28.82 mL/(min?100 g),miR-200b-3p>1.23 were independent risk factors affecting the occurrence of prostate cancer (P<0.05); MiR-181b-5p<0.90 is a protective factor affecting the occurrence of prostate cancer (P<0.05). 【Conclusion】 The combination of MSCT perfusion imaging parameters and serum miR-200b-3p and miR-181b-5p detection can provide reliable basis for the differential diagnosis of BPH and prostate cancer. 2024 Vol. 41 (4): 511-514 [Abstract] ( 40 ) HTML (1 KB)  PDF (1234 KB)  ( 23 ) 515 Prognostic Value of Cardiac Ultrasound Parameters and Laboratory Indexes in Short-Term Prognosis of STEMI Patients after PCI DOU Pan, ZHOU Xueliang, ZHENG Deliang DOI: 10.3969/j.issn.1671-7171.2024.04.010 【Objective】To investigate the value of cardiac ultrasound parameters and laboratory indexes in predicting short-term prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). 【Methods】A total of 80 STEMI patients admitted to Xi&apos;an Gaoxin Hospital from April 2019 to April 2022 were selected. All patients underwent PCI and were followed up for 1 month. They were divided into good prognosis group and poor prognosis group according to whether adverse cardiovascular events (MACE) occurred. General data, cardiac ultrasound parameters[left ventricular wall thickness (LVPW), left atrial volume (LAV), cardiac output (CO), left ventricular ejection fraction (LVEF)], laboratory indicators [hemoglobin (Hb), neutrophil to lymphocyte ratio (NLR), interleukin-6 (IL-6), amyloid protein (SAA)] of the two groups were compared. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of each index in STEMI patients after PCI. Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in STEMI patients after PCI. 【Results】The proportion of killip grade ≥Ⅲ and lesion number ≥2 in the good prognosis group was significantly lower than that in the poor prognosis group. Levels of LVPW, LAV, IL-6, SAA and NLR in the good prognosis group were significantly lower than those in the poor prognosis group, while scores of CO and LVEF were significantly higher than those in the poor prognosis group, with statistical significance (P<0.05). ROC curve analysis results showed that the area under the curve of LVPW, LAV, CO, LVEF, IL-6, SAA and NLR to evaluate the short-term prognosis of STEMI patients after PCI were 0.646, 0.772, 0.704, 0.822, 0.901, 0.818 and 0.729, respectively. Multivariate Logistic regression analysis showed that: killip grade ≥Ⅲ, number of lesions ≥2, LVPW≥6.835 mm, LAV≥56.495 mL, CO≤4.610 L/min, LVEF≤ 55.535%, IL-6≥5.665 ng/L, SAA≥4.890 mg/L and NLR≥3.005 were risk factors for poor short-term prognosis after PCI in STEMI patients (P<0.05).【Conclusion】LVPW, LAV, CO, LVEF, IL-6, SAA, NLR can affect the short-term prognosis of STEMI patients after PCI. Thus, the short-term prognosis of STEMI patients after PCI can be evaluated clinically by the above indicators. 2024 Vol. 41 (4): 515-518 [Abstract] ( 41 ) HTML (1 KB)  PDF (1232 KB)  ( 20 ) 519 Clinical Effect of Anti-Rotation Intramedullary Nail Fixation on Femoral Intertrochanteric Fracture with Spiral Blade GOU Wei, CUI Xihu DOI: 10.3969/j.issn.1671-7171.2024.04.011 【Objective】To investigate the clinical effect of proximal femoral anti-rotation intramedullary nail (PFNA) with spiral blade in the treatment of femoral intertrochanteric fracture (FIF). 【Methods】The clinical data of 108 patients with FIF admitted to the Baoji Sixth People&apos;s Hospital, Shaanxi Province from June 2017 to May 2022 were retrospectively analyzed. According to different treatment methods, they were divided into PFNA group (PFNA internal fixation, n=57) and dynamic hip screw (DHS) group (DHS internal fixation, n=51). The surgical indexes, hip function, imaging indexes (femoral neck trunk Angle, femoral anterior inclination Angle), lower extremity function, life ability score and complication rate were compared between the two groups. 【Results】The operative time and blood loss in the PFNA group were less than those in the DHS group (all P<0.05). There was no significant difference in the first weight-bearing time and fracture healing time between the two groups (all P>0.05). The good and excellent rate of hip joint Harris score in PFNA group was higher than that in DHS group (P<0.05). There was no significant difference in femoral neck trunk Angle and femoral anterior inclination Angle between the two groups 6 months after operation (P> 0.05). The lower limb Function Scale (LEFS) score and Barthel index score of both groups at 6 months after surgery were higher than those before surgery (both P<0.05). There was no significant difference in LEFS score and Barthel index score between the two groups 6 months after surgery (P>0.05). There was no significant difference in the total incidence of postoperative complications between the two groups (P>0.05). 【Conclusion】Spiral blade PFNA internal fixation is effective in the treatment of FIF, which can improve the quality of life of patients. It has good safety, which is worthy of clinical application. 2024 Vol. 41 (4): 519-521 [Abstract] ( 37 ) HTML (1 KB)  PDF (1138 KB)  ( 50 ) 522 Anesthetic Effect of Dexmedetomidine in Elderly Patients with Intertrochanteric Femur Fractures and its Impact on Postoperative Cognitive Function YANG Liangmin, XIE Xiaojuan, MA Ligang DOI: 10.3969/j.issn.1671-7171.2024.04.012 【Objective】To investigate the anesthetic effects of dexmedetomidine in elderly patients undergoing surgery for intertrochanteric femur fractures and its impact on postoperative cognitive function.【Methods】In this study, 78 elderly patients undergoing surgery for intertrochanteric femur fractures were randomly divided into two groups: the control group received propofol anesthesia and sedation, while the observation group received dexmedetomidine anesthesia and sedation. Comparisons were made between the two groups in terms of surgery duration, time for sedative effect to begin, and time to recover from anesthesia; heart rate and mean arterial pressure at pre-anesthesia (T0), 10 minutes after anesthesia (T1), end of surgery (T2), and 1 hour post-surgery (T3);Mini-Mental State Examination (MMSE) scores before surgery and 3 days after surgery; levels of serum norepinephrine (NE), cortisol (COR), malondialdehyde (MDA), and superoxide dismutase (SOD) before and 3 days after surgery. 【Results】 There was no significant difference in surgery duration between the two groups (P>0.05). The onset time of sedation and recovery time after surgery in the observation group were shorter than those in the control group (P<0.05). The heart rate and mean arterial pressure at T1, T2, and T3 were lower in the observation group compared to the control group (P<0.05). Three days post-surgery, there was no significant difference in MMSE scores in the observation group compared to pre-surgery (P>0.05), while the control group showed a decrease in MMSE scores compared to pre-surgery (P<0.05). The MMSE scores of 3 days post-surgery in the observation group were higher than those in the control group (P<0.05). Three days post-surgery, the levels of serum NE, COR, MDA, and SOD in the observation group were lower than those in the control group (P<0.05).【Conclusion】 Dexmedetomidine anesthesia in elderly patients undergoing surgery for intertrochanteric femur fractures can reduce cognitive function impairment. And it is safe and reliable. 2024 Vol. 41 (4): 522-525 [Abstract] ( 30 ) HTML (1 KB)  PDF (1162 KB)  ( 24 ) 526 Effects of Remifentanil Combined with Propofol or Sevoflurane in Gastrectomy for Elderly Gastric Cancer Patients ZHU Hongkuan, CHEN Yonglun, LI Chao DOI: 10.3969/j.issn.1671-7171.2024.04.013 【Objective】To explore the application of sevoflurane combined with propofol and remifentanil in elderly patients undergoing gastrectomy for gastric cancer.【Methods】A total of 100 elderly patients undergoing gastric cancer surgery at our hospital were randomly divided into two groups, with 50 patients in each group. The observation group received anesthesia with sevoflurane combined with remifentanil, while the control group received anesthesia with propofol combined with remifentanil. Vital signs, stress indicators, analgesic effects, postoperative recovery, and adverse reactions were compared between the two groups. 【Results】There were no significant differences in systolic blood pressure, diastolic blood pressure, and mean arterial pressure levels between the two groups before anesthesia induction (P>0.05). At the time of skin incision, the levels of all three indicators decreased compared to before induction in both groups (P<0.05), with even lower level in the control group than in the observation group (P<0.05). The levels of all three indicators rebounded at the time of extubation, but there were no significant differences between the two groups (P>0.05). Preoperative levels of cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) showed no significant differences between the two groups (P>0.05). During surgery, both indicators increased compared to before induction (P<0.05), with lower levels in the observation group than in the control group (P<0.05). The observation group had lower visual analogue scale (VAS) pain scores at 6 hours, 12 hours, and 24 hours postoperatively compared to the control group (P<0.05). The observation group also had shorter extubation time, awakening time, and time to resume out-of-bed activities compared to the control group (P<0.05). The incidence of adverse reactions in the observation group was lower than in the control group (P<0.05). 【Conclusion】Sevoflurane combined with remifentanil provides good anesthetic effects in elderly gastric cancer patients, with minimal impact on blood gases and stress indicators. It also offers a short awakening time, effective analgesia, and high safety. 2024 Vol. 41 (4): 526-529 [Abstract] ( 30 ) HTML (1 KB)  PDF (1150 KB)  ( 46 ) 530 The Levels and Significance of CL, phIGFBP-1, fFN, and Vaginal Microbial Metabolites in Preterm Pregnant Women TANG Lin, SHAO Xiulan DOI: 10.3969/j.issn.1671-7171.2024.04.014 【Objective】To investigate the expression levels and significance of hyperphosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1), fetal fifinexin (fFN), cervical tube length (CL) and vaginal microbial metabolites in cervical secretions in preterm pregnant women. 【Methods】A total of 92 non-full-term single pregnant women with contractions admitted to our hospital from September 2020 to October 2021 were selected and divided into preterm group (n=50) and full-term group (n=42) according to pregnancy outcomes. The positive rates of phIGFBP-1, fFN, CL and vaginal microbial metabolites in cervical secretions of the two groups were compared. The correlation among CL, fFN and phIGFBP-1 was analyzed. The predictive efficacy of phIGFBP-1, fFN, and CL in pregnant women with premature delivery was evaluated. 【Results】The levels of phIGFBP-1 and fFN from cervical secretions in preterm delivery group were significantly higher than those in full-term delivery group (P<0.05), while the level of CL was significantly lower than that in full-term delivery group (P<0.05). There was a negative correlation of phIGFBP-1 and fFN with CL in cervical secretions (r=-0.320, -0.387, P<0.05). There were no significant differences in the positive rates of vaginal microbial metabolites hydrogen peroxide (H2O2), leucocyte esterase (LE) and sialidase (SNA) between preterm and full-term groups (P>0.05). The area under receiver operating characteristic (ROC) curve of phIGFBP-1, fFN, CL and their combination for predicting preterm birth were 0.721, 0.757, 0.841 and 0.976, respectively. 【Conclusion】Compared to full-term pregnant women, the levels of phIGFBP-1 and fFN in preterm pregnant women were significantly higher, CL was lower, and vaginal microbial metabolites were not significantly different. The phIGFBP-1, fFN and CL have a good predictive effect on preterm delivery. 2024 Vol. 41 (4): 530-532 [Abstract] ( 35 ) HTML (1 KB)  PDF (1187 KB)  ( 21 ) 533 Factors Influencing Disease-Free Survival in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy Combined with Modified Radical Mastectomy TIAN Bo, GAI Zhongren, Bai Ge, et al DOI: 10.3969/j.issn.1671-7171.2024.04.015 【Objective】To explore the factors influencing disease-free survival in breast cancer patients treated with neoadjuvant chemotherapy combined with modified radical mastectomy.【Methods】A total of 150 breast cancer patients treated in our hospital, who underwent modified radical mastectomy combined with neoadjuvant chemotherapy, were followed up for 3 years. The endpoint of follow-up was tumor metastasis, recurrence, or death. Patients with disease-free survival of less than 3 years were classified as the poor prognosis group (n=29), while those with disease-free survival of 3 years or more were classified as the good prognosis group (n=121). General data of the two groups were collected, and univariate and multivariate analyses were used to identify factors influencing disease-free survival. 【Results】 During the 3-year follow-up of 150 patients, 16 deaths were recorded, giving an overall survival rate of 89.33%(134/150). There were 6 cases of recurrence and 7 cases of metastasis, resulting in a disease-free survival rate of 80.67%(121/150). The proportion of patients aged ≤45 years, premenopausal status, tumor size >5 cm, clinical stage T3 or T4, positive vascular tumor embolvs, absence of postoperative radiotherapy, negative estrogen receptor (ER)/progesterone receptor (PR) status, and Ki67 index>30% were significantly higher in the poor prognosis group compared to the good prognosis group (P<0.05). Multivariate logistic regression analysis confirmed that these factors above were risk factors affecting postoperative disease-free survival (P<0.05). 【Conclusion】 Age ≤45 years, premenopausal status, tumor size >5 cm, clinical stage T3 or T4, positive vascular tumor thrombus, absence of postoperative radiotherapy, negative ER/PR status, and Ki67 index >30% are risk factors affecting disease-free survival in breast cancer patients treated with neoadjuvant chemotherapy combined with modified radical mastectomy. 2024 Vol. 41 (4): 533-536 [Abstract] ( 33 ) HTML (1 KB)  PDF (1159 KB)  ( 31 ) 537 Clinical Efficacy and Survival Analysis of Chidamide Combined with R-DHAP Regimen in the Treatment of Relapsed/Refractory Diffuse Large B-cell Lymphoma WANG Xiaowei, LI Ning, LIU Ting, et al DOI: 10.3969/j.issn.1671-7171.2024.04.016 【Objective】To explore the efficacy of chidamide combined with R-DHAP regimen in the treatment of relapsed/refractory diffuse large B-cell lymphoma(DLBCL). 【Methods】A total of 78 patients with relapsed/refractory DLBCL were selected and randomly divided into the observation group and the control group. The control group was treated with R-DHAP regimen, and the study group was treated with chidamide combined with R-DHAP regimen. The ECOG score, clinical efficacy, serum vascular endothelial growth factor (VEGF), β2-microglobulin (β2-MG) levels, adverse drug, and progression-free survival time reactions were compared between the two groups. 【Results】After 3 courses of treatment, the ECOG scores of both groups were lower (P<0.05), which the study group showed lower than the control group(P<0.05). The objective remission rate of the observation group was higher than that of the control group (P<0.05). After 3 courses of treatment, the levels of serum VEGF and β2-MG in both groups were lower than those before treatment (P<0.05); And the levels of serum VEGF and β2-MG in the observation group were lower than those in the control group (P<0.05). The incidence of adverse reactions in both groups was not statistically significant (P>0.05). The median progression-free survival curves between the observation group and the control group was 20.60 months and 15.18 months, respectively, which was statistically significant difference (P<0.05). 【Conclusion】Chidamide combined with R-DHAP regimen in the treatment of patients with relapsed/refractory DLBCL can improve clinical symptoms and enhance the curative effect.It can reduce the levels of serum VEGF and β2-MG, prolong the survival time of patients, and it is safe and reliable. 2024 Vol. 41 (4): 537-539 [Abstract] ( 31 ) HTML (1 KB)  PDF (1193 KB)  ( 14 ) 540 Efficacy of Dual Antiplatelet Therapy in Patients with Acute Cerebral Infarction and H-type Hypertension BAI Guanbing, PAN Bo, PAN Na DOI: 10.3969/j.issn.1671-7171.2024.04.017 【Objective】To investigate the efficacy of dual antiplatelet therapy in patients with acute cerebral infarction (ACI) associated with H-type hypertension.【Methods】 A total of 100 patients with H-type hypertension related ACI, who received treatment in our hospital, were randomly divided into an observation group and a control group, with 50 patients in each group. Both groups received conventional ACI treatment. The control group was treated with aspirin enteric-coated tablets for antiplatelet therapy, while the observation group received a combination of clopidogrel hydrogen sulfate tablets in addition to the control group's treatment. Both groups maintained the treatment for 8 weeks. The NIH Stroke Scale (NIHSS) scores before and after treatment, the modified Rankin Scale (mRS) scores after treatment, platelet-related parameters, clinical efficacy, and drug-related adverse events were compared between the two groups.【Results】After treatment, the NIHSS scores of both groups were significantly lower than before treatment (P<0.05), and the observation group had even lower scores than the control group (P<0.05). The total effective rate of treatment in the observation group was higher than that in the control group (P<0.05). The mRS scores of patients in the observation group were lower than those in the control group after treatment (P<0.05).Compared with before treatment, the levels of homocysteine (Hcy), mean platelet volume (MPV), and platelet distribution width (PDW) significantly decreased in both groups after treatment (P<0.05), and the levels of Hcy, MPV, and PDW in the observation group were significantly lower than those in the control group after treatment (all P<0.05).There was no significant difference in the total incidence of bleeding between the observation group and the control group (P>0.05).【Conclusion 】The combination of aspirin and clopidogrel hydrogen sulfate tablets for the treatment of ACI patients with concurrent H-type hypertension can reduce neurological deficits, improve the treatment effective rate, and is relatively safe. 2024 Vol. 41 (4): 540-543 [Abstract] ( 32 ) HTML (1 KB)  PDF (1166 KB)  ( 27 ) 544 Analysis of the Current Situation of Unintended Pregnancy in Women of Gestational Age within 2 Years after Induced Abortion XIA Chun, XU Juhong DOI: 10.3969/j.issn.1671-7171.2024.04.018 【Objective】To investigate the current situation of unintended pregnancy in pregnant women within 2 years after induced abortion. 【Methods】A total of 875 pregnant women who underwent induced abortion in Department of Obstetrics and Gynecology of Zhen &apos;an County Hospital from March 2017 to May 2019 were selected by cluster sampling method. We investigated the demographic characteristics of pregnant women who underwent induced abortionto analyze the incidence of unintended pregnancy within 2 years after induced abortion. The causes of unintended pregnancy within 2 years after induced abortion were further analyzed. Cox regression model was used to reveal the risk factors of unintended pregnancy in pregnant women within 2 years after induced abortion. 【Results】Among 875 pregnant women who underwent induced abortion, married women accounted for 74.51%, women aged 25-30 accounted for 43.66%, first-time mothers accounted for 52.00%, women who had a history of cesarean section accounted for 40.11%, and women who had induced abortion ≥2 times accounted for 65.80%. Among 875 pregnant women who underwent abortion, 92 (10.51%) had unintended pregnancy within 2 years after abortion. The rates of unintended pregnancy within 2 years after induced abortion were significant differences in aspect of age, birth time, number of induced-abortion, education level and professional women (P<0.05). There was no significant difference in the rate of unintended pregnancy within 2 years after abortion among women with different marital status, gestational times, cesarean section history and gestational weeks (P>0.05). Among 92 cases of women with unintended pregnancy within 2 years after induced abortion, 52.17% did not take contraceptive measures; And the failure rate of contraception was 34.78%, of which 19.57%, 6.52%, 4.35%, 3.26% and 1.09% were condoms, emergency contraceptives, safe periods, intrauterine devices (IUD) and compound oral contraceptives, respectively; The rest 12 cases were missing reasons, accounting for 13.04%.Cox results showed that the risk of unintended pregnancy was higher in pregnant women aged 19-24 years, who did not give birth and induced abortion ≥3 times within 2 years after abortion. 【Conclusion】The incidence of unintended pregnancy within 2 years after induced abortion is high in pregnant women, and the risk of unintended pregnancy within 2 years after induced abortion is higher in pregnant women aged 19-24 years, who have not given birth and have more induced abortions. 2024 Vol. 41 (4): 544-547 [Abstract] ( 33 ) HTML (1 KB)  PDF (1151 KB)  ( 26 ) 548 Analgesic Efficacy and Safety of Sufentanil Combined with Parecoxib Sodium for Secondary Cesarean Section JIANG Xiangrong, HU Yanmei DOI: 10.3969/j.issn.1671-7171.2024.04.019 【Objective】To explore the analgesic effect and safety of Sufentanil combined with Parecoxib Sodium in secondary cesarean section. 【Methods】A total of 94 parturients scheduled for secondary cesarean section were randomly divided into an observation group and a control group, with 47 cases in each. The control group received Sufentanil for analgesia, while the observation group was given a combination of Sufentanil and Parecoxib Sodium for pain relief. Perioperative parameters of both groups were compared, including operation time, blood loss, fluid replenishment, and oxytocic types. The Visual Analog Scale (VAS) was used to assess and compare the pain level of the parturients in both groups at 3 min (T1), 5 min (T2), 10 min (T3), 20 min (T4), 30 min (T5) post-analgesia, and at the end of surgery (T6). Hemodynamic parameters [oxygen saturation (SPO2), heart rate (HR), respiratory rate (RR)] were monitored and compared at 1 h, 6 h, 24 h, and 48 h postoperatively. Adverse reactions during the medication period were calculated. 【Results】There were no significant differences in operation time, blood loss, fluid replenishment, and oxytocic types between the observation and the control groups (P>0.05). At T1, T2, T3, T4, T5, T6, the VAS scores of the observation group were significantly lower than those of the control group (P<0.05). At 1 h, 6 h, 24 h, and 48 h postoperatively, there were no significant differences in SPO2, HR, and RR levels between the observation and control groups (P>0.05). The incidence of adverse reactions was not significantly different between the two groups (P>0.05). 【Conclusion】The analgesic effect of Sufentanil combined with Parecoxib Sodium in secondary cesarean section is superior to that of Sufentanil alone. It can maintain stable hemodynamics and has a high safety profile, making it clinically valuable. 2024 Vol. 41 (4): 548-550 [Abstract] ( 31 ) HTML (1 KB)  PDF (1137 KB)  ( 18 ) 551 Influencing Factors of Chronic Cardiotoxicity in Patients with Malignant Tumors Treated with Anthracycline Chemotherapy PENG Meiling, ZHANG Xuemei DOI: 10.3969/j.issn.1671-7171.2024.04.020 【Objective】To explore the influencing factors of chronic cardiotoxicity in patients with malignant tumors treated with anthracycline chemotherapy. 【Methods】The clinical data of 64 patients with malignant tumors treated with anthracyclines in two hospital were collected. According to whether the patients had chronic cardiotoxicity within 1 year of chemotherapy, they were divided into toxic group (25 cases) and non-toxic group (39 cases). The baseline data, ECG abnormalities, cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) levels of patients in the two groups were compared. The influencing factors of chronic cardiotoxicity in patients were analyzed by using receiver operating characteristic (ROC) curve and multivariate logistic regression. 【Results】The levels of cTnI, CK-MB and LDH in the toxic group were higher than those in the non-toxic group, and the incidence of ECG abnormalities in the toxic group was higher than that in the non-toxic group (P<0.05). ROC analysis showed that cTnI, CK-MB and LDH could be used to evaluate the occurrence of chronic cardiotoxicity in patients, and the areas under the curve were 0.746, 0.889 and 0.785, respectively (P<0.05). Multivariate logistic regression analysis confirmed that cTnI>84.430 ng/mL, CK-MB>28.692 IU/L, LDH>203.292 IU/L, ST-T segment changes, T wave abnormalities, sinusachycardia, atrioventricular block were the risk factors of chronic cardiotoxicity (P<0.05).【Conclusion】 cTnI>84.430 ng/mL, ST-T segment changes, CK-MB>28.692 IU/L, LDH>203.292 IU/L, T wave abnormalities, sinus tachycardia, atrioventricular block are the risk factors of chronic cardiotoxicity in patients treated with anthracycline chemotherapy, which can provide a reliable reference for early clinical intervention. 2024 Vol. 41 (4): 551-554 [Abstract] ( 39 ) HTML (1 KB)  PDF (1211 KB)  ( 23 ) 555 The Clinical Value of miRNA-208b in Predicting Left Ventricular Remodeling after AMI NIU Hongmei DOI: 10.3969/j.issn.1671-7171.2024.04.021 【Objective】To explore the clinical value of miRNA-208b (miR-208b) in predicting left ventricular remodeling after acute myocardial infarction (AMI). 【Methods】A total of 167 AMI patients admitted to our hospital from November 2018 to September 2020 were selected, and they were divided into a remodeling group (n=62) and a non remodeling group (n=105) based on whether there was left ventricular remodeling during follow-up. The clinical indicators and expression of miR-208b, as well as the correlation between miR-208b and left ventricular remodeling, were analyzed in two groups of patients. The receiver operating characteristic (ROC) curve analysis was used to evaluate the value of miR-208b in left ventricular remodeling in AMI patients. 【Results】The final left ventricular end diastolic volume (LVEDV), left ventricular end diastolic volume increase (LVEDV), low-density lipoprotein cholesterol (LDL-C), cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) levels of patients in the reconstruction group were higher than those in the non reconstruction group, and the expression level of miR-208b was lower than that in the non reconstruction group, with statistical significance (P<0.05). Pearson correlation analysis showed that miR-208b was negatively correlated with BNP and final LVEDV (P<0.05), and positively correlated with cTnI (P<0.05). ROC curve analysis showed that miR-208b had a high value in predicting left ventricular remodeling after AMI, with an area under the curve (AUC) (95%CI) of 0.80(0.73-0.87) and an optimal diagnostic threshold of 3.17. Binary logistic regression analysis showed that miR-208b, cTnI, LVEDV, and BNP were closely related to left ventricular remodeling (P<0.05). 【Conclusion】miR-208b is a potential clinical indicator for diagnosing left ventricular remodeling after AMI, and clinical physicians can estimate the risk of left ventricular remodeling in AMI patients based on miR-208b expression. 2024 Vol. 41 (4): 555-557 [Abstract] ( 46 ) HTML (1 KB)  PDF (1160 KB)  ( 17 ) 558 Establishment and Validation of a Logistic Regression Model for Premature Delivery in Twin Pregnancies ZHAO Jiawen, ZHAO Yuying, CHANG Yanling DOI: 10.3969/j.issn.1671-7171.2024.04.022 【Objective】By analyzing the relevant data of twin pregnancy delivery patients, a logistic regression model is constructed to screen and predict high-risk factors for premature birth in twin pregnancy, and to reduce the risk of premature birth in twin pregnancy.【Methods】A retrospective analysis was conducted on the clinical data of 215 twin pregnant women delivered in our hospital. They were divided into premature delivery group (102 cases) and full-term group (113 cases) according to different delivery times. A single factor analysis was used to identify factors related to preterm birth, and factors with statistical differences were included in the logistic regression analysis. A logistic regression model for twin pregnancy preterm birth was established, and its predictive performance was verified.【Results】Univariate analysis showed that there were significant differences between the two groups in body mass index (BMI), education level, pregnancy times, the incidence of pregnancy hypertension, pregnancy diabetes, the length of cervix in the second trimester and the incidence of premature rupture of membranes(P<0.05). Logistic regression showed that high BMI, low pregnancy times, low education level, premature rupture of membranes, pregnancy hypertension and pregnancy diabetes, and low cervical length in the second trimester were independent risk factors for preterm twin pregnancy. The receiver operating characteristic (ROC) curve analysis showed that the sensitivity of the predictive model was 80.4%, the specificity was 92.0%, the area under the curve was 0.940, and the 95%CI was 0.910-0.970.【Conclusion】This study established a logistic regression model that can effectively predict the risk of premature birth in twin pregnancies. It can evaluate the pregnancy and perinatal conditions of twin pregnant women, identify high-risk factors for premature birth, and is of great significance for the prevention of premature birth risk in twin pregnancies. 2024 Vol. 41 (4): 558-561 [Abstract] ( 32 ) HTML (1 KB)  PDF (1179 KB)  ( 44 ) 562 The Efficacy of Shenmai Injection Combined with Entecavir in Treating Patients with Hepatitis B-Related Compensated Cirrhosis LI Xiaomei, HUANGFU Duojuan DOI: 10.3969/j.issn.1671-7171.2024.04.023 【Objective】To explore the efficacy of Shenmai Injection combined with Entecavir in the treatment of patients with hepatitis B-related compensated cirrhosis and its impact on immunological indicators.【Methods】 Seventy-eight patients with hepatitis B-related compensated cirrhosis were randomly divided into an observation group and a control group, each consisting of 39 patients. The control group received Entecavir treatment, while the observation group was treated with Shenmai Injection combination with Entecavir. The efficacy of the treatments was compared between the two groups, along with liver fibrosis indicators [Type Ⅳ Collagen (Ⅳ-C), Laminin (LN)], liver function indicators [Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT)], immunological indicators before and after treatment, and the incidence of adverse reactions.【Results】 The total effective rate in the observation group was 94.87% (37/39), which was higher than the 76.92% (30/39) in the control group, with a statistically significant difference (P<0.05). After treatment, the levels of Ⅳ-C, LN, AST, and ALT in both groups were reduced compared to before treatment (P<0.05), and the levels in the observation group were lower than those in the control group (P<0.05). The levels of both Th17/Treg and CD8+ in two groups decreased after treatment compared to before treatment (P<0.05), and the Th17/Treg and CD8+ levels in the observation group were lower than those in the control group (P<0.05). After treatment, the level of CD4+ increased in both groups (P<0.05), while CD4+ level in the observation group was higher than that in the control group (P<0.05). The overall incidence of adverse reactions was not significantly different between the two groups (P>0.05).【Conclusion】 The combination of Shenmai Injection with Entecavir is significantly effective in treating patients with hepatitis B-related compensated cirrhosis. It can improve liver function and it is safe and reliable, making it worthy of clinical application and promotion. 2024 Vol. 41 (4): 562-564 [Abstract] ( 35 ) HTML (1 KB)  PDF (1138 KB)  ( 23 ) 565 The Clinical Efficacy of Lamotrigine Combined with Topiramate in the Treatment of Children with Epilepsy and its Impact on Cognitive Function and Neurotrophic Factor Levels in Patients CHEN Jing, YANG Juping, JIN Hongguang, et al DOI: 10.3969/j.issn.1671-7171.2024.04.024 【Objective】To explore the clinical efficacy of lamotrigine combined with topiramate in the treatment of children with epilepsy and its impact on cognitive function and neurotrophic factor levels in patients.【Methods】A retrospective analysis was conducted on the clinical data of 56 children with epilepsy admitted to our hospital from February 2021 to December 2022. According to different treatment plans, the children were divided into a control group (treated with lamotrigine) and an observation group (treated with lamotrigine and topiramate), with 28 cases in each group. Two groups were compared in terms of clinical efficacy, electroencephalogram efficacy, pre-treatment and post-treatment seizure status, neurokine levels [neuropeptide Y (NPY), insulin-like growth factor-1 (IGF-1), brain-derived neurotrophic factor (BDNF), intercellular adhesion molecule-1 (ICAM-1)], cognitive function [Wechsler Intelligence Scale (WISC-Ⅳ) score], anxiety and depression [Hamilton Anxiety Scale (HAMA) and Depression Scale (HAMD) score].【Results】The clinical effective rate and total effective rate of EEG in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the frequency and duration of seizures 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). After treatment, the WISC-Ⅳ score of the observation group was higher than that of the control group, and the HAMA and HAMD scores were lower than those of the control group (P<0.05). After treatment, the serum levels of NPY, IGF-1, BDNF, and ICAM-1 in both groups were lower than before treatment, and the observation group was lower than the control group, with statistical significance (P<0.05). 【Conclusion】The combination of lamotrigine and topiramate has a good clinical efficacy in the treatment of pediatric epilepsy, which can reduce the number of seizures, promote neurological function recovery, improve cognitive function, and alleviate anxiety and depression. 2024 Vol. 41 (4): 565-568 [Abstract] ( 32 ) HTML (1 KB)  PDF (1162 KB)  ( 26 ) 569 The Effect of Ultrasound-guided Nerve Block Combined with General Anesthesia for Elderly Lower Limb Fracture Surgery ZHANG Yanping, LI Xianhu, LI Kang DOI: 10.3969/j.issn.1671-7171.2024.04.025 【Objective】To explore the effect of ultrasound-guided nerve block and general anesthesia combined for elderly lower limb fracture surgery. 【Methods】A total of 268 elderly patients who underwent lower limb fracture surgery were randomly divided into an observation group (using ultrasound-guided nerve block combined with general anesthesia, 134 cases) and a control group (using general anesthesia, 134 cases). Comparisons were made between two groups in terms of anesthesia effectiveness, dosage of anesthetic drugs, awakening time, removal time of laryngeal mask, pain visual analogue scale (VAS), and adverse reactions; The average arterial pressure (MAP), heart rate (HR), prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT) levels were compared between two groups at different time points.【Result】 The excellent anesthesia rate in the observation group was higher than that in the control group (P<0.05); The observation group used less anesthesia, had shorter awakening time and removal time of the laryngeal mask, and had lower postoperative VAS scores than the control group (P<0.05); There was no statistically significant difference (P>0.05) in the MAP and HR of the observation group at the insertion (T1), incision (T2), and removal (T3) of the laryngeal mask compared to before anesthesia (T0). The MAP and HR of the control group were significantly higher at T1, T2, and T3 than at T0, while the MAP and HR of the observation group were significantly lower at T1, T2, and T3 than those of the control group (P<0.05); The PT, TT, and APTT of the observation group were significantly higher than those of the control group at time points T2 and T3 (P<0.05); The total incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05).【Conclusion】 Ultrasound guided nerve block combined with general anesthesia has a relatively small impact on hemodynamics in elderly patients undergoing lower limb fracture surgery, better anesthesia effect, stable signs during surgery, and high clinical application value. 2024 Vol. 41 (4): 569-571 [Abstract] ( 31 ) HTML (1 KB)  PDF (1137 KB)  ( 26 ) 572 Effects of Using Recombinant Human Interferon α2b Gel in Combination with Azithromycin in Patients with Chronic Cervicitis Accompanied by HPV Infection XIE Fei, LI Shuang DOI: 10.3969/j.issn.1671-7171.2024.04.026 【Objective】To explore the application effect of recombinant human interferon α2b gel combined with azithromycin in patients with chronic cervicitis with HPV infection. 【Methods】A total of 110 patients with chronic cervicitis with HPV infection who were admitted to the XD Group Hospital from March 2021 to March 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 55 cases in each group. The control group was treated with recombinant human interferon α2b gel, while the observation group was treated with recombinant human interferon α2b gel combined with azithromycin. Both treatments were for a course of 2 weeks. The clinical efficacy, Lactobacillus reduction rate, leukocyte esterase (LE) test and coagulase (GADP), vaginal pH value, inflammation factors [tumor necrosis factor-α (TNF-α), interleukin-1β(IL-1β), interleukin-8(IL-8)]level, HPV virus load, conversion rate, and recurrence rate of the two groups were compared. 【Results】The total effective rate of the study group was higher than that of the control group, and the difference was statistically significant (P<0.05). The reduction rate of Lactobacillus, positive rate of LE, positive rate of GADP, and proportion of vaginal pH value >4.5 in the observation group were all higher than those in the control group, and the differences were statistically significant (P<0.05). Before treatment, there was no statistical significance in the comparison of inflammation factors between the two groups (P>0.05). After treatment, the levels of TNF-α, IL-1β, and IL-8 in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05). After treatment, the virus load of both groups decreased, while the virus load of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). The HPV negative conversion rate of the observation group was higher than that of the control group, the HPV recurrence rate and the disease recurrence rate in the observation were lower than those in the control group, and the differences were statistically significant (P<0.05). 【Conclusion】Recombinant human interferon α2b gel combined with azithromycin has significant effects in patients with chronic cervicitis with HPV infection. It can reduce inflammation, reduce HPV virus load, promote HPV negative conversion, which is worth promoting. 2024 Vol. 41 (4): 572-575 [Abstract] ( 49 ) HTML (1 KB)  PDF (1162 KB)  ( 39 ) 576 Clinical Efficacy of Rh-bFGF Preparation Combined with Sodium Hyaluronate Patch in the Treatment of Traumatic Tympanic Membrane Perforation YUAN Qian, XU Yali DOI: 10.3969/j.issn.1671-7171.2024.04.027 【Objective】To explore the clinical effect of recombinant human basic fibroblast growth factor (Rh-bFGF) preparation combined with sodium hyaluronate patch in the treatment of traumatic tympanic membrane perforation. 【Methods】A total of 82 patients (82 ears) with traumatic tympanic membrane perforation admitted to Yulin City Hospital of Traditional Chinese Medicine from June 2020 to June 2022 were selected and randomly divided into a control group and an observation group using a random number table method, with 41 cases in each group. The control group received treatment with sodium hyaluronate patches, while the observation group received treatment with Rh-bFGF formulation combined with sodium hyaluronate patches. The healing of tympanic membrane perforation in patients was evaluated after 2 weeks and 4 weeks of treatment, respectively; We compared the air bone conduction difference and air guided hearing valve between two groups before treatment and 3 months after treatment; We also compared the severity of tinnitus and ear pain between two groups of patients after 4 weeks of treatment.【Results】The healing rate of the tympanic membrane in the observation group was higher than that in the control group after 2 weeks and 4 weeks of treatment (P<0.05). After 3 months of treatment, the air bone conduction difference and air guided hearing valve in both groups were lower than before treatment, and the observation group was lower than the control group (P<0.05). After 4 weeks of treatment, the severity of tinnitus and ear pain in both groups was lower than before treatment, and the observation group was lower than the control group (P<0.05). 【Conclusion】The combination of Rh-bFGF preparation and sodium hyaluronate patch in the treatment of traumatic tympanic membrane perforation can help improve the patient's hearing level and tympanic membrane healing rate, and improve symptoms of tinnitus and ear pain. 2024 Vol. 41 (4): 576-578 [Abstract] ( 45 ) HTML (1 KB)  PDF (1133 KB)  ( 28 ) 579 Clinical Efficacy of Guizhi Gancao Decoction Combined with Conventional Western Medicine in the Treatment of Patients with Chronic Heart Failure ZHAO Lichen DOI: 10.3969/j.issn.1671-7171.2024.04.028 【Objective】To investigate the clinical efficacy of Guizhi Gancao Decoction Combined with conventional western medicine in the treatment of patients with chronic heart failure. 【Methods】A total of 102 patients with chronic heart failure were selected and divided into observation group and control group according to the random number table method, with 51 cases in each group. The control group was treated with conventional western medicine, and the observation group was treated with Guizhi Gancao Decoction on the basis of the control group. After one month of treatment, the clinical efficacy, the occurrence of adverse reactions, and the laboratory indexes [high-sensitivity C-reactive protein (hs-CRP), N-terminal pro brain natriuretic peptide (NT-proBNP), red blood cell distribution width (RDW)], TCM syndrome score, and cardiac function indexes [left ventricular end diastolic internal diameter (LVEDD), left ventricular end systolic diameter (LVESD), and left ventricular ejection fraction (LVEF)] before and after treatment were compared between the two groups. 【Results】The total effective rate of the observation group was higher than the control group, and the difference was statistically significant (P<0.05). After treatment, the scores of shortness of breath, palpitation, cough, expectoration, and less breath and lazy words in the two groups were lower than those before treatment, and the observation group was lower than that in the control group, the difference was statistically significant (P<0.05); The levels of NT-proBNP, hs-CRP and RDW in the observation group were significantly lower than those before treatment and after treatment in the control group (P<0.05); LVEDD and LVESD of the two groups were lower than before treatment, LVEF was higher than before treatment, LVEDD and LVESD of the observation group were lower than those of the control group, LVEF was higher than that of the control group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】On the basis of conventional western medicine treatment, the application of Guizhi Gancao Decoction in the treatment of chronic heart failure can improve the clinical treatment effect,improve cardiac function, with high safety, which is worthy of clinical application. 2024 Vol. 41 (4): 579-582 [Abstract] ( 36 ) HTML (1 KB)  PDF (1165 KB)  ( 45 ) 583 The Effect of the Combination of Alprazolam and Five Tone Therapy in the Treatment of Coronary Heart Disease with Insomnia and its Impact on Sleep Status and Heart Rate Variability in Patients ZHENG Nannan, LI Jun, ZHANG Xiaodong DOI: 10.3969/j.issn.1671-7171.2024.04.029 【Objective】To explore the effect of alprazolam combined with five tone therapy in the treatment of coronary heart disease with insomnia and its impact on sleep status and heart rate variability in patients. 【Methods】A total of 98 patients with coronary heart disease and insomnia admitted to our hospital from April 2021 to December 2022 were selected. They were randomly divided into a control group and an observation group using a random number table method, with 49 cases in each group. Both groups were treated with basic coronary heart disease, the control group was treated with aprazolam, and the observation group was treated with aprazolam combined with five tone therapy. Two groups were compared in terms of efficacy, cardiovascular adverse events, disease-related scores before and after treatment [total score of traditional Chinese medicine syndrome, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Hamilton Anxiety Scale (HANA)], heart rate variability indicators [mean square difference between adjacent normal RR intervals (RMSSD), 24-hour sinus rhythm RR interval standard deviation (SDNN), mean standard deviation between RR intervals (SDANN)], and laboratory indicators [leptin, melatonin (MT), angiotensin Ⅱ (Ang Ⅱ)]. 【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). After treatment, the total score of traditional Chinese medicine syndromes, ISI score, PSQI score, and HANA score in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the RMSSD, SDNN, and SDANN of the two groups were higher than before treatment, while the observation group was higher than the control group, with statistical significance (P<0.05). After treatment, the MT levels in both groups were higher than before treatment, while the levels of leptin and Ang Ⅱ were lower than before treatment. The difference between the observation group and the control group was statistically significant (P<0.05). The total incidence of cardiovascular adverse events 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 alprazolam and five tone therapy has a good therapeutic effect on patients with coronary heart disease and insomnia. It can effectively improve sleep status, increase heart rate variability, promote disease recovery, and reduce the incidence of cardiovascular and cerebrovascular adverse events. 2024 Vol. 41 (4): 583-586 [Abstract] ( 30 ) HTML (1 KB)  PDF (1156 KB)  ( 41 ) 587 The Feasibility and Impact on Recurrence of Multiple Uterine Fibroids Removal Using Finger Assisted Method Combined with Modified Single Port Laparoscopic Surgery via Umbilical Cord ZHOU Ning, YAN Jialing, HU Xiaoning, et al DOI: 10.3969/j.issn.1671-7171.2024.04.030 【Objective】To explore the feasibility of finger assisted method combined with transumbilical modified single port laparoscopic removal of multiple uterine fibroids and its impact on recurrence. 【Methods】A total of 72 patients with multiple uterine fibroids admitted to our hospital from April 2020 to April 2022 were selected and randomly divided into a control group (who underwent modified single port laparoscopic multiple uterine fibroid removal via umbilical cord) and an improved group (who underwent finger assisted method combined with modified single port laparoscopic multiple uterine fibroid removal via umbilical cord) using a random number table method, with 36 cases in each group. Two groups of perioperative conditions, ovarian secretion function indicators, pain scores, and incidence of complications were statistically analyzed. The recurrence rate within one year after surgery was also calculated for both groups. 【Results】The improved group had longer surgical time, postoperative exhaust time, and hospital stay than the control group, and had more intraoperative blood loss than the control group (P<0.05). There was no statistically significant difference in the levels of luteinizing hormone (LH), estradiol (E2), progesterone (P), and follicle stimulating hormone (FSH) between the two groups (P>0.05). After 1 day of surgery, the visual analog score (VAS) of the improved group was higher than that of the control group (P<0.05); After 3 days of surgery, there was no statistically significant difference in VAS scores between the two groups (P>0.05). There was no statistically significant difference in the total incidence of complications between the two groups (P>0.05). The recurrence rate of the improved group was lower than that of the control group (P<0.05). 【Conclusion】The combination of finger assisted method and modified single port laparoscopic removal of multiple uterine fibroids through the navel has a relatively small impact on ovarian function in patients, does not increase the incidence of complications, is feasible, and can reduce the recurrence rate. It is worthy of clinical promotion. 2024 Vol. 41 (4): 587-589 [Abstract] ( 35 ) HTML (1 KB)  PDF (1136 KB)  ( 17 ) 590 Clinical Efficacy of High Frequency Oscillatory Ventilation Combined with Budesonide Atomization Inhalation in the Treatment of Neonatal Severe Pneumonia ZHANG Na, XUE Rui DOI: 10.3969/j.issn.1671-7171.2024.04.031 【Objective】To investigate the clinical effect of high frequency oscillatory ventilation combined with budesonide atomization inhalation in the treatment of neonatal severe pneumonia. 【Methods】A total of 81 cases of neonatal severe pneumonia in our hospital from September 2016 to June 2021 were selected and randomly divided into observation group (n=41) and control group (n=40). The control group was treated with high-frequency oscillatory ventilation on the basis of basic treatment, and the observation group was treated with budesonide atomization inhalation on the basis of the control group. The disappearance time of pulmonary wet rales, cough, fever, asthma and other symptoms and the time of high-frequency oscillatory ventilation were recorded in the two groups after treatment. The pulmonary function indexes [peak expiratory flow rate (PEF), peak volume ratio (VPEF/VE), and peak time ratio (TPTEF/TE)] and hematological indexes [serum Clara cell protein 16 (CC16), type Ⅱ alveolar surface antigen 6 (KL-6)] before and 10 days after treatment were compared between the two groups. The occurrence of adverse reactions during treatment was recorded. 【Results】The disappearance time of wet rales, cough, asthma and fever in the observation group were shorter than those in the control group, and the high-frequency oscillation ventilation time in the observation group was shorter than that in the control group, with statistical significance (P<0.05). After treatment, the levels of TPTEF/TE, PEF and VPEF/VE in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group, with statistical significance (P<0.05); The serum levels of KL-6 and CC16 in the two groups were lower than those before treatment, and the observation group was lower than that in the control group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】High frequency oscillatory ventilation combined with budesonide atomization inhalation therapy can effectively shorten the time of clinical symptoms improvement and high frequency oscillatory ventilation in children with severe pneumonia, improve the lung function of children, and reduce the serum levels of KL-6 and CC16, with good safety. 2024 Vol. 41 (4): 590-593 [Abstract] ( 31 ) HTML (1 KB)  PDF (1162 KB)  ( 33 ) 594 Comparison of Clinical Efficacy between Pipeline Embolization Device and Stent Assisted Coil Embolization in the Treatment of Large Cerebral Aneurysms JIANG Ling, YAO Huijuan, WANG Chaochao, et al DOI: 10.3969/j.issn.1671-7171.2024.04.032 【Objective】To explore the clinical efficacy of Pipeline embolization device (PED) and stent assisted coil placement (SAC) in the treatment of large cerebral aneurysms. 【Methods】A retrospective analysis was conducted on the clinical data of 82 patients with intracranial aneurysms with a diameter of ≥ 10 mm admitted to our hospital from December 2017 to December 2021. Among them, 43 patients received PED treatment (PED group) and 39 patients received SAC treatment (SAC group). We compared the surgical results of two groups of patients, and compared the results of immediate digital subtraction angiography (DSA) and modified Rankin Scale (mRS) scores at admission and discharge between the two groups. Two groups of patients were followed up 12 months after surgery, and the mortality, recurrence, DSA examination results, and mRS score distribution were compared between the two groups at 6 and 12 months after discharge. 【Results】In this study, 82 patients successfully completed surgery, including 45 PEDs implanted in the PED group, 16 pure PEDs implanted, 25 PEDs combined with spring coil filling, and 2 double PEDs implanted. There was no statistically significant difference in the dense embolism rate between the two groups of immediate postoperative DSA examination results(P>0.05). There was no statistically significant difference in the distribution of mRS scores between the two groups at admission and discharge (P>0.05). There was no statistically significant difference in the incidence and mortality of perioperative complications between the two groups (P>0.05). At the 6-12 month follow-up after discharge, the dense embolism rate in the PED group was higher than that in the SAC group, and the differences were statistically significant (all P<0.05). The proportion of mRS scores ≤ 2 in the PED group for follow-up at 6 and 12 months after discharge was higher than that in the SAC group, and the differences were statistically significant (all P<0.05). 【Conclusion】The clinical efficacy and short-term prognosis of PED treatment for large intracranial aneurysms are comparable to those of SAC, but PED shows certain advantages in improving long-term prognosis. 2024 Vol. 41 (4): 594-597 [Abstract] ( 44 ) HTML (1 KB)  PDF (1155 KB)  ( 39 )

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