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Quick Search     Adv Search 2024 Vol. 41, No. 6 Published: 2024-06-26 Original Articles          Original Articles 801 The Evaluation Value of Three-dimensional Perineal Ultrasound Combined with Shear Wave Elastography in the Rehabilitation Treatment of Female Stress Urinary Incontinence WANG Rongrong, HUANG Lizhen, KANG Yaning, et al DOI: 10.3969/j.issn.1671-7171.2024.06.001 【Objective】To explore the evaluation value of transperineal pelvic floor ultrasound combined with shear wave elastography in the rehabilitation treatment of female stress urinary incontinence(SUI). 【Methods】A total of 70 female SUI patients treated at the Xi'an Hospital of Traditional Chinese Medicine from January 2021 to November 2021 were selected. All patients were treated with thermosensitive moxibustion combined with Kegel training. Clinical scale scores and pelvic floor ultrasound imaging were performed before and 8 weeks after treatment. The bladder urethra posterior(PUVA), levator ani muscle hiatus area(LHA), levator ani muscle hiatus diameter(LHD), and bladder neck movement(BND) were measured under resting state and Valsalva action,The thickness and mean Young's modulus(Emean) of bilateral puborectal muscles were measured using shear wave elastography in both resting and maximum anal contraction states.【Results】The overall effective rate of SUI patients after 8 weeks of thermal moxibustion combined with Kegel exercise treatment was 88.57%(62/70); Compared with before treatment, SUI patients showed a decrease in the Short Form Urinary Incontinence Questionnaire(ICIQ-SF) score after treatment(P<0.05), as well as a decrease in the frequency of 24-hour urinary incontinence and 1-hour urine leakage(P<0.05). In the resting state, the PUVA, LHD, and LHA of SUI patients decreased significantly after treatment compared to before treatment(P<0.05); Under Valsalva maneuver, SUI patients showed a statistically significant decrease in PUVA, BND, LHD, and LHA after treatment compared to before treatment(P<0.05). There was no statistically significant difference in the thickness of bilateral puborectal muscles between SUI patients before and after treatment in both resting and maximum anal contraction states(P>0.05); After treatment, the bilateral puborectal muscle Emean of SUI patients increased compared to before treatment, and the difference was statistically significant(P<0.05). The difference in ICIQ-SF score before and after treatment was positively correlated with the difference in PUVA score before and after treatment(r=0.67, P<0.05). The difference in ICIQ-SF score before and after treatment was negatively correlated with the difference in bilateral puborectal muscle Emean under maximum anal contraction state(r=-0.58, -0.61, P<0.05). 【Conclusion】Perineal pelvic floor ultrasound combined with elastography can dynamically and quantitatively evaluate the therapeutic effect of female SUI thermal moxibustion combined with Kegel training, providing objective and reliable basis for clinical efficacy evaluation of traditional Chinese medicine. 2024 Vol. 41 (6): 801-805 [Abstract] ( 77 ) HTML (1 KB)  PDF (2148 KB)  ( 64 ) 806 Mycoplasma Culture Results and Antimicrobial Resistance Analysis in Patients with Urinary and Genital Tract Infections SUN Zhigang, JIANG Wusong, WU Liangfei,et al DOI: 10.3969/j.issn.1671-7171.2024.06.002 【Objective】To understand and analyze the mycoplasma culture results and antimicrobial resistance of patients with urinary and genital tract infections in our hospital.【Methods】The secretions from the urinary and genital tracts of 188 patients who were treated in our hospital were tested the mycoplasma infection and analyze the related drug sensitivity.【Results】Among 188 mycoplasma culture specimens, the positive rate was 44.68%(84/188), with 16 males and 68 females. Of these, 63 cases(33.51%) were solely infected with Ureaplasma urealyticum(Uu), 6 cases(3.19%) were solely infected with Mycoplasma hominis(Mh), and 15 cases(7.98%) had co-infection with Uu and Mh. The rate of Uu infection alone was higher in females than in males(P<0.05). No significant difference was found in the rate of infection with Mh alone or co-infection with Uu and Mh between males and females(P>0.05). Among the 84 positive cases, the highest proportion was in the age of 20-30 group(34.12%), followed by the age of 31-40 group(16.87%), with fewer cases in the age <20 group(7.62%) and >50 group(8.52%). There was no significant difference in the positive rate of infection across age groups between males and females(P>0.05). Among the 63 cases solely infected with Uu, higher antibiotic sensitivity was observed for minocycline, doxycycline, clarithromycin, and josamycin, with the highest resistance to sparfloxacin, followed by clindamycin. For the 6 cases solely infected with Mh, higher sensitivity was found to josamycin and minocycline, with the highest resistance to roxithromycin, clarithromycin, azithromycin, and erythromycin. For the 15 cases of co-infection with Uu and Mh, higher sensitivity was found to minocycline, doxycycline, with the highest resistance to roxithromycin, erythromycin, and azithromycin.【Conclusion】 Mycoplasma infection in our hospital is predominantly by Uu, most commonly seen in women aged 20-30, which is antibiotic sensitive to minocycline, doxycycline, and josamycin. 2024 Vol. 41 (6): 806-809 [Abstract] ( 50 ) HTML (1 KB)  PDF (1219 KB)  ( 30 ) 810 Clinical Efficacy of Anlotinib Combined with PD-1 Inhibitor in the Treatment of Advanced Non-Small Cell Lung Cancer WANG Hui, JIA Jing, WANG Hui DOI: 10.3969/j.issn.1671-7171.2024.06.003 【Objective】To investigate the efficacy of anlotinib combined with programmed death-1(PD-1) inhibitor in the treatment of patients with advanced non-small cell lung cancer(NSCLC). 【Methods】A retrospective analysis was conducted on the clinical data of 90 NSCLC patients, who were divided into the control group(n=30, treated with anlotinib) and the observation group(n=60, treated with anlotinib combined with PD-1 inhibitor) based on different treatment methods. The short-term efficacy, survival, and drug safety of the two groups were compared. 【Results】After treatment, the objective response rate(ORR) in the observation group was 11.67%(7/60), and the disease control rate(DCR) was 60.00%(36/60), which were higher than those in the control group [ORR: 6.67%(2/30), DCR: 33.33%(10/30)], with statistically significant differences(P<0.05). The median progression-free survival(PFS) in the observation group was 10 months, and the median overall survival(OS) was 13 months. Both PFS and OS in the observation group were longer than those in the control group(median PFS: 7 months, median OS: 11 months), with statistically significant differences(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). 【Conclusion】The combination of anlotinib and PD-1 inhibitors in the treatment of advanced NSCLC can effectively improve the short-term efficacy and extend the survival time of patients. 2024 Vol. 41 (6): 810-812 [Abstract] ( 46 ) HTML (1 KB)  PDF (1296 KB)  ( 95 ) 813 Construction and Reliability and Validity Analysis of a Scale for Evaluating Sarcopenia in Hospitalized Surgical Patients LONG Yanfei, LI Jia, ZHANG Honghui, et al DOI: 10.3969/j.issn.1671-7171.2024.06.004 【Objective】To construct a risk assessment scale for sarcopenia in surgical inpatients and conduct reliability and validity tests, in order to provide a scientific and effective tool for assessing sarcopenia risk in surgical inpatients. 【Methods】On the basis of literature review, a pool of items for the scale was constructed, and the content system of the scale was determined through the Delphi method.The Analytic Hierarchy Process was used to determine the weights of scale items and assign values, forming a test scale. A test scale was used to assess the risk of sarcopenia in 239 patients admitted to the Hepatobiliary Department of Hunan Provincial People's Hospital, and the reliability and validity of the scale were tested. 【Results】A total of 11 experts were consulted through 2 rounds of correspondence, and their positive coefficients were all 100%. The authority coefficients of the experts were 0.88 and 0.89, respectively. The Kendall harmony coefficients were 0.138 and 0.153(P<0.001). A surgical inpatient sarcopenia risk assessment scale was constructed, including 5 primary indicators and 19 secondary indicators. The Cronbach's α coefficient of the scale was 0.829, and the content validity(I-CVI) of each item was 0.8-1.0, with a total content validity(S-CVI) of 0.99. Exploratory factor analysis extracted a total of 6 common factors, with a cumulative variance contribution rate of 63.784%.The area under the curve(AUC) of the ROC scale was 0.74(95%CI:0.666-0.813, P<0.001), the diagnostic threshold was 24 points, the sensitivity was 80%, and the specificity was 61.8%.【Conclusion】The constructed surgical inpatient sarcopenia risk assessment scale has certain scientific validity, practicality, and good reliability and validity, and can be used as a preliminary screening tool for clinical medical staff to evaluate the risk of sarcopenia in surgical inpatients. 2024 Vol. 41 (6): 813-816 [Abstract] ( 39 ) HTML (1 KB)  PDF (1224 KB)  ( 72 ) 817 Clinical Efficacy of Hysterolaparoscopy Combined with Medication for Ovulation Induction in the Treatment of Tubal Infertility Patients SUN Haiyun, ZHAO Tong, HU Yuhong,et al DOI: 10.3969/j.issn.1671-7171.2024.06.005 【Objective】To explore the clinical effect of hysterolaparoscopy combined with medication for ovulation induction in the treatment of patients with tubal infertility. 【Methods】 Sixty patients with tubal infertility treated in our hospital were selected as the study subjects. They were randomly divided into Group A(treated with hysterolaparoscopy combined with Urofollitrophin), Group B(treated with hysterolaparoscopy combined with letrozole), and Group C(treated with hysteroscopy) using a random number table method, with 20 cases in each group. Two groups of patients were compared in terms of ovarian function indicators, postoperative pregnancy time, pregnancy rate, miscarriage rate, delivery rate, and abnormal fetal rate.【Results】 After treatment, the levels of ovarian function indicators such as estradiol(E2), follicle stimulating hormone(FSH), and luteinizing hormone(LH) in groups A, B, and C were higher than before treatment(P<0.05); After treatment, the levels of LH, FSH, and E2 in Group A were significantly higher than those in Group B and Group C(P<0.05); After treatment, the levels of LH, FSH, and E2 in Group B were significantly higher than those in Group C(P<0.05). The pregnancy rates of Group A, Group B, and Group C were 85.00%, 75.00%, and 55.00%, respectively. The differences among the three groups were statistically significant(P<0.05). The postoperative conception time in Group A was shorter than that in Group B and Group C(P<0.05); The postoperative conception time in Group B was shorter than that in Group C(P<0.05). The abortion rates of Group A, Group B, and Group C were 5.88%, 6.67%, and 27.27%, respectively. The difference among the three groups was statistically significant(P<0.05); The delivery rates of Group A, Group B, and Group C were 94.12%, 93.33%, and 72.73%, respectively. The differences among the three groups were statistically significant(P<0.05); The rates of abnormal fetuses in Group A, Group B, and Group C were 0, 0, and 9.09%, respectively. There was no statistically significant difference among the three groups(P>0.05).【Conclusion】 The combination of Hysterolaparoscopy and medication for ovulation induction can effectively improve ovarian function, increase pregnancy and delivery rates, and reduce miscarriage rates in patients with tubal infertility. However, compared to letrozole treatment, the combination of hysteroscopy and urinary follicle stimulating hormone treatment is more effective and worthy of clinical promotion and application. 2024 Vol. 41 (6): 817-819 [Abstract] ( 40 ) HTML (1 KB)  PDF (1275 KB)  ( 15 ) 820 Effects of SGLT-2 Inhibitor on Vascular Endothelial Cells in Diabetes Mice ZHANG Zhigang, HUANG Yangxia, GUO Lisha, et al DOI: 10.3969/j.issn.1671-7171.2024.06.006 【Objective】To investigate the effect of sodium glucose cotransporter 2(SGLT-2) inhibitor on vascular endothelial cells in diabetes mice. 【Methods】Twenty four SPF 8-week old male ICR mice were intraperitoneally injected with low-dose streptozotocin(STZ)(50 mg/kg) to establish a diabetes model. The model was successfully established. They were randomly divided into a model group and a treatment group(Daggligin intervention treatment for 12 weeks). Six mice were used as the control group, and physiological saline was injected subcutaneously. Three groups were all fed with regular feed, and the changes in body weight and blood glucose of mice were dynamically observed every week. The plasma levels of tumor necrosis factor alpha(TNF-α), interleukin-1β(IL-1β), monocyte chemotactic factor-1(MCP-1), superoxide dismutase(SOD), and malondialdehyde(MDA) were compared among the three groups of mice. 【Results】 From the 2nd weekend to the 12th weekend, both the model group and the treatment group had lower body weight than the control group, while the treatment group had higher body weight than the model group, with a statistically significant difference(P<0.05). Compared with the control group, the blood glucose levels in the model group and treatment group were significantly increased, and the difference was statistically significant(P<0.05); Compared with the model group, the blood glucose levels of the treatment group mice significantly decreased from the 3rd to the 12th weekend, and the difference was statistically significant(P<0.05). The plasma levels of TNF-α, IL-1β, and MCP-1 in the model group were significantly higher than those in the control group, while the plasma levels of TNF-α, IL-β, and MCP-1 in the treatment group were significantly lower than those in the model group, with statistical significance(P<0.05). The plasma SOD level in the model group was lower than that in the control group, while the plasma SOD level in the treatment group was higher than that in the model group, with a statistically significant difference(P<0.05); Compared with the control group, the plasma MAD level in the model group was higher than that in the control group, while the plasma MAD level in the treatment group was lower than that in the model group, with a statistically significant difference(P<0.05). 【Conclusion】 SGLT-2 inhibitor can effectively inhibit the release of inflammatory factors from vascular endothelial cells in diabetes mice, and improve the function of vascular endothelial cells. 2024 Vol. 41 (6): 820-823 [Abstract] ( 40 ) HTML (1 KB)  PDF (1485 KB)  ( 12 ) 824 Analysis of Factors Influencing Poor Prognosis in Children with Convulsive Status Epilepticus JIN Na, LIU Danhua, ZHU Yuanyuan,et al DOI: 10.3969/j.issn.1671-7171.2024.06.007 【Objective】To explore the influencing factors of poor prognosis in children with convulsive status epilepticus(CSE). 【Methods】A retrospective analysis was conducted on the clinical data of 347 children with CSE admitted to our hospital from March 2018 to September 2021. Based on their prognosis at discharge, they were divided into a good prognosis group(n=279) and a poor prognosis group(n=68). Two sets of general data and serum levels of neuropeptide Y(NPY), procalcitonin(PCT), alanine aminotransferase(ALT), interleukin-6(IL-6), glial fibrillary acidic protein(GFAP), matrix metalloproteinase-9(MMP-9), and galanin(GAL) were compared. A logistic multiple regression model was used to analyze the risk factors affecting poor prognosis in children with CSE. 【Results】The incidence of poor prognosis in 347 children with CSE was 19.60%(68/347). The age and serum levels of NPY, GFAP, MMP-9, and GAL in the group with poor prognosis were compared with those in the group with good prognosis, and the differences were statistically significant(P<0.05). Logistic regression analysis showed that age<2 years, NPY>201.03 ng/L, GFAP>2.63 ng/L, MMP-9>10.69 ng/mL, GAL>67.53 ng/L were risk factors for poor prognosis in children with CSE(P<0.05). 【Conclusion】The adverse factors affecting the prognosis of CSE patients are age and serum levels of NPY, GFAP, MMP-9, and GAL. Clinicians should pay special attention to patients with these factors and provide timely and effective treatment measures. 2024 Vol. 41 (6): 824-826 [Abstract] ( 41 ) HTML (1 KB)  PDF (1264 KB)  ( 29 ) 827 Detection and Clinical Significance of Peripheral Blood miRNA-218 and Survivin Gene Expression in Patients with Acute Myeloid Leukemia LIANG Qian, LIU Zhenzhen, WANG Qingqing DOI: 10.3969/j.issn.1671-7171.2024.06.008 【Objective】To investigate the detection and clinical significance of peripheral blood miRNA-218 and survivin gene expression in patients with acute myeloid leukemia(AML).【Methods】Eighty-six AML patients admitted to our hospital were selected as the observation group, and 20 healthy individuals undergoing physical examination in our hospital during the same period were selected as the control group. The relative expression levels of miRNA-218 and survivin in peripheral blood were compared between the two groups. The clinical data of the observation group were statistically analyzed to determine the relationship of the levels of miRNA-218 and survivin with the clinical efficacy and survival time of the patients.【Results】The level of miRNA-218 in the observation group was lower than that in the control group, while the level of the survivin gene was higher than that in the control group(both P<0.05). Among the observation group, patients with WBC ≥30×109/L had lower level of miRNA-218 and higher level of survivin compared to patients with WBC <30×109/L, with statistically significant differences(P<0.05). The miRNA-218 level in the remission group was higher than that in the non-remission group, while the survivin level was lower in the remission group compared to the non-remission group(both P<0.05). The median survival times for the high and the low miRNA-218 expression groups were 17.00 months and 14.00 months, respectively, with statistically significant differences in the cumulative survival curves between the two groups(P<0.05). The median survival times for the high and the low survivin expression groups were 18.00 months and 20.00 months, respectively, with statistically significant differences in the cumulative survival curves between the two groups(P<0.05).【Conclusion】 miRNA-218 is lowly expressed and the survivin gene is highly expressed in the peripheral blood of AML patients. Both are important factors associated with poor clinical efficacy and prognosis in AML patients. 2024 Vol. 41 (6): 827-830 [Abstract] ( 38 ) HTML (1 KB)  PDF (1286 KB)  ( 17 ) 831 Correlation of Serum miR-28-3p and miR-23a Levels with Prognosis of Patients with Non-Small Cell Lung Cancer Treated with Radiofrequency Ablation FENG Yanliang, LI Ye, LI Hao DOI: 10.3969/j.issn.1671-7171.2024.06.009 【Objective】 To investigate the correlation between the expression levels of serum miR-28-3p and miR-23a and the prognosis of patients with non-small cell lung cancer(NSCLC) undergoing radiofrequency ablation(RFA) treatment.【Methods】A total of 94 NSCLC patients treated with RFA were included in the study. Based on the survival status of the patients during follow-up, they were divided into a survival group(74 cases) and a deceased group(20 cases). The serum levels of miR-28-3p and miR-23a were compared between the two groups. Spearman correlation was used to assess the relationship between serum miR-28-3p and miR-23a levels and the prognosis of the patients. Receiver operating characteristic(ROC) curves were constructed to analyze the predictive value of combined detection of serum miR-28-3p and miR-23a levels for patient prognosis.【Results】 The serum levels of miR-28-3p and miR-23a in the survival group were lower than those in the deceased group(P<0.05). Spearman analysis showed that serum miR-28-3p and miR-23a levels were positively correlated with poor prognosis in NSCLC patients(P<0.05). ROC analysis indicated that the combined detection of serum miR-28-3p and miR-23a levels had a sensitivity of 95.0% and a specificity of 97.3% for predicting patient prognosis, with an area under the curve(AUC) of 0.986, which was superior to the detection of each marker alone(P<0.05).【Conclusion】 The levels of serum miR-28-3p and miR-23a are positively correlated with poor prognosis in NSCLC patients treated with RFA. Combined detection of these two markers has high sensitivity and specificity for predicting patient prognosis. 2024 Vol. 41 (6): 831-833 [Abstract] ( 41 ) HTML (1 KB)  PDF (1381 KB)  ( 17 ) 834 Correlation Analysis between Perinatal Depression and Newborn Birth Weight in Overweight and Obese Pregnant Women MENG Xianlian, JIANG Lijuan DOI: 10.3969/j.issn.1671-7171.2024.06.010 【Objective】To explore the correlation between perinatal depression and newborn birth weight in overweight and obese pregnant women. 【Methods】 A total of 600 overweight and obese pregnant women admitted to Local maternal and child health care facility from October 2019 to January 2022 were selected as the study subjects. The Edinburgh Postpartum Depression Scale(EPDS) score was used to evaluate the depression status of pregnant women in the later stage of pregnancy. Based on the evaluation results, patients were divided into a control group(EPDS score<13 points, n=418) and an observation group(EPDS score ≥ 13 points, n=182). General information questionnaires were distributed to pregnant women and newborns at the time of admission, delivery, and discharge. General information was collected from both groups of pregnant women and newborns. The influencing factors of newborn birth weight and the correlation between perinatal depression in overweight and obese pregnant women and newborn birth weight were analyzed. 【Results】The birth weight of newborns in the observation group was greater than that in the control group, and the EPDS score of pregnant women was higher than that in the control group, with a statistically significant difference(P<0.05). There was no statistically significant difference in birth length and head circumference between the two groups of newborns(P>0.05). The birth weight of newborns was related to the age, educational level, monthly family income, BMI of pregnant women, weight gain during pregnancy, gestational age, and gender of newborns(P<0.05), while feeding methods were not related to the birth weight of newborns(P>0.05). Pearson correlation analysis showed that there was a positive correlation between perinatal depression in overweight and obese pregnant women and newborn birth weight(r=0.227, P<0.05). 【Conclusion】The occurrence of perinatal depression in overweight and obese pregnant women has a certain impact on newborn birth weight, and the degree of depression is positively correlated with newborn birth weight. Therefore, early intervention should be carried out for perinatal depression in pregnant and postpartum women in a timely manner. 2024 Vol. 41 (6): 834-837 [Abstract] ( 49 ) HTML (1 KB)  PDF (1193 KB)  ( 51 ) 838 Bidirectional Mendelian Randomization Analysis of Genetic Causal Relationships between Gastric Cancer and Sarcopenia XU Hong, CHEN Guanyi, WU Xiaoxin, et al DOI: 10.3969/j.issn.1671-7171.2024.06.011 【Objective】To analyze the potential causal relationship between sarcopenia and gastric cancer at the genetic level using two sample bidirectional Mendelian randomization(MR).【Methods】Significant instrumental variables(IV) were obtained from publicly available genome-wide association studies(GWAS) statistical data for two sample MR analysis. Sensitivity analysis was performed using methods such as Cochran's Q test to ensure that IV met the three major hypotheses. Methods such as inverse variance weighting(IVW) were used to evaluate the bidirectional causal relationship between gastric cancer and sarcopenia.【Results】The positive MR analysis results showed that no causal relationship was found between gastric cancer and limb muscle mass(ALM)(OR=-0.019, P=0.446), left hand grip strength(OR=-0.008, P=0.059), and right hand grip strength(OR=-0.010, P=0.220)(P>0.05); No causal relationship was found between the above indicators in the reverse MR analysis(P>0.05).【Conclusion】There is no direct causal relationship between gastric cancer and sarcopenia at the genetic level. 2024 Vol. 41 (6): 838-841 [Abstract] ( 44 ) HTML (1 KB)  PDF (1287 KB)  ( 30 ) 842 Comparison of Clinical Efficacy between Extracorporeal Aortic Stent Fenestration and Castor Branch Covered Stent TEVAR for LSA Reconstruction in Treatment of Aortic Arch Lesions LI Xiaoheng, LI Yanping, FU Xiaoke, et al DOI: 10.3969/j.issn.1671-7171.2024.06.012 【Objective】To compare the clinical efficacy of extracorporeal aortic stent fenestration and Castor branch covered stent for thoracic endovascular aortic repair(TEVAR) reconstructing the left subclavian artery(LSA) in the treatment of aortic arch lesions. 【Methods】A total of 71 patients with aortic arch lesions admitted to our hospital from January 2020 to January 2023 were selected and divided into an extracorporeal window group(aortic stent extracorporeal window opening, n=51) and an extracorporeal branch group(Castor branch covered stent TEVAR reconstruction LSA, n=21) based on different LSA reconstruction methods. The perioperative indicators, surgical success rate, and postoperative complication incidence of the two groups of patients were compared; The follow-up prognosis after 1 year showed the remodeling of the sandwich cavity and the patient's false lumen thrombosis after the dissection surgery. 【Results】The surgical time, success rate of instrument release, and surgical cost of the external branch group were all higher than those of the external window group(P<0.05). The change rate of true lumen area [R(ATL)] in the L1, L3, and L4 stent segments and the external branch group was higher than that in the external fenestration group(P<0.05); The false lumen area change rate [R(AFL)] and true lumen diameter change rate [R(DTL)] in the L3 external branch group of the stent segment were higher than those in the in vitro fenestration group, while the L4 R(DTL) was higher than those in the in vitro fenestration group(P<0.05). There was no statistically significant difference in the degree of false lumen thrombosis between the two groups of patients in the stent and non stent segments(P>0.05). 【Conclusion】Both extracorporeal stent fenestration and Castor branch coated stent TEVAR for LSA reconstruction in treatment of aortic arch lesions have good safety and effectiveness. Castor branch coated stent TEVAR has a shorter operating time and better proximal stent remodeling effect than extracorporeal fenestration TEVAR. 2024 Vol. 41 (6): 842-845 [Abstract] ( 30 ) HTML (1 KB)  PDF (1194 KB)  ( 73 ) 846 The Efficacy and Mechanism of Itraconazole in the Treatment of COPD Complicated with Pulmonary Fungal Infection HOU Fujian, WEI Zhaohui, ZHAO Yuewei DOI: 10.3969/j.issn.1671-7171.2024.06.013 【Objective】To explore the therapeutic effect and possible mechanism of itraconazole in the treatment of chronic obstructive pulmonary disease(COPD) with fungal infection. 【Methods】A retrospective analysis was conducted on the clinical data of 80 COPD patients with pulmonary fungal infections admitted to our hospital from January 2019 to December 2021. According to different treatment methods, they were divided into the itraconazole group(treated with itraconazole) and the fluconazole group(treated with fluconazole), with 40 cases in each group. We compared the length of hospital stay, mortality rate, incidence of adverse reactions, and serum levels of tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ), interleukin-1β(IL-1β), interleukin-2(IL-2), interleukin-4(IL-4), and interleukin-10(IL-10) before and after treatment between two groups.【Results】The hospitalization time of the itraconazole group was shorter than that of the fluconazole group(P<0.05), and the mortality rate was lower than that of the fluconazole group(P<0.05). Before treatment, there was no statistically significant difference in serum levels of TNF-α, IFN-γ, IL-1β, IL-2, IL-4, and IL-10 between the two groups of patients(P>0.05); After treatment, the serum levels of TNF-α, IL-2, IL-4, and IL-10 in the itraconazole group were lower than those in the fluconazole group(P<0.05), and the levels of IFN-γ were higher than those in the fluconazole group(P<0.05); The incidence of adverse reactions in the itraconazole group was 30.00%, significantly lower than the 37.50% in the fluconazole group, and the difference was statistically significant(P<0.05). 【Conclusion】The use of itraconazole in the treatment of COPD patients with pulmonary fungal infection has a good clinical effect, and its possible mechanism of action is to regulate the level of inflammatory factors. 2024 Vol. 41 (6): 846-848 [Abstract] ( 33 ) HTML (1 KB)  PDF (1230 KB)  ( 21 ) 849 The Effect of Delicate Pulsed Light Combined with Supramolecular Salicylic Acid on Skin Characteristic Score and Skin Barrier Function in Photoaging Patients ZHANG Yan, SHI Qing, ZHAI Ziqi DOI: 10.3969/j.issn.1671-7171.2024.06.014 【Objective】To explore the effects of combined treatment with delicate pulsed light(DPL) and supramolecular salicylic acid on skin characteristics and skin barrier function in photoaging patients. 【Methods】A total of 96 patients with photoaging admitted to Yongcheng People's Hospital from April 2021 to April 2023 were selected. They were randomly divided into an observation group and a control group using a random number table method, with 48 patients in each group. The control group received DPL treatment; The observation group patients received DPL combined with supramolecular salicylic acid treatment. We compared the skin texture [VISIA complex analysis system(VISIA)], barrier function [pH, skin moisture content, transdermal water loss(TEwL), skin oil content], skin improvement degree [global aesthetic improvement scale(GAIS), and global sun damage score(GSDS)] before and after treatment between two groups, and recorded the occurrence of adverse reactions(such as erythema, edema, scar formation, and pigmentation) in both groups.【Results】After treatment, the observation group had significantly lower skin texture, wrinkles, pores, pigmentation, and purple score than the control group; After treatment, the skin pH and TEwL in the observation group were significantly lower than those in the control group, while the skin moisture and oil content were higher than those in the control group; After treatment, the GSDS of the observation group was significantly lower than that of the control group(P<0.05), and the GAIS was significantly higher than that of the control group(P<0.05). The total incidence of adverse reactions in the observation group was significantly lower than that in the control group, and the difference was statistically significant(P<0.05). 【Conclusion】The combination of DPL and supramolecular salicylic acid treatment has a significant effect on improving skin characteristics and enhancing skin barrier function in photoaging patients, and can significantly reduce the incidence of adverse reactions. It is worthy of clinical promotion and application. 2024 Vol. 41 (6): 849-852 [Abstract] ( 35 ) HTML (1 KB)  PDF (1191 KB)  ( 30 ) 853 Relationship of Th1/Th2 Cell Status in Patients with Pulmonary Tuberculosis with Microbial Communities and Expression of Notch2 mRNA and IL-27 mRNA in BALF JIANG Feifei, XU Chao, HUANG Jinhua, et al DOI: 10.3969/j.issn.1671-7171.2024.06.015 【Objective】To investigate the correlation of the Th1/Th2 cell status in patients with pulmonary tuberculosis(TB) with the microbial communities and expression of Notch2 and interleukin-27(IL-27) in bronchoalveolar lavage fluid(BALF). 【Methods】 A total of 776 TB patients were divided into an active group(n=370) and a non-active group(n=406). Additionally, 352 patients with non-TB respiratory diseases were selected as the control group. The microbial levels in the BALF, the mRNA expression levels of Notch2 mRNA and IL-27 mRNA from BALF, and the peripheral blood Th1/Th2 cell ratio were measured to analyze the correlations of Th1/Th2 with microbial communities and Notch2 and IL-27 mRNA expression in BALF. 【Results】Both active and non-active groups had lower cell number in peripheral blood Th1 and Th2 cells, the ratio of Th1/Th2 was also lower if compared to the control group. The active group had a lower proportion of Th1 cells and Th1/Th2 ratio than the non-active group(P<0.05), but there were no statistically significant differences in Th2 cell proportions between the two groups(P>0.05). Both active and non-active groups had higher counts of Haemophilus, Neisseria and higher IL-27 mRNA expression compared to the control group, while Streptococcus counts and Notch2 mRNA expression were lower(P<0.05). Moreover, the active group had higher counts of Haemophilus and Neisseria and higher IL-27 mRNA expression, but lower Streptococcus counts and lower Notch2 mRNA expression than the non-active group(P<0.05). Pearson correlation analysis showed that the Th1/Th2 ratio in TB patients was positively correlated with Streptococcus counts and Notch2 mRNA expression(P<0.05), and negatively correlated with Haemophilus and Neisseria counts and IL-27 mRNA expression(P<0.05). 【Conclusion】 The Th1/Th2 cell ratio is low in TB patients and further decreases with disease progression. This immune imbalance is associated with infections by Haemophilus, Neisseria, and Streptococcus in the BALF and with Notch2 mRNA and IL-27 mRNA expression. 2024 Vol. 41 (6): 853-856 [Abstract] ( 26 ) HTML (1 KB)  PDF (1189 KB)  ( 16 ) 857 Analysis of Bacterial Distribution and Drug Resistance in Sputum Culture of Children with Community-Acquired Pneumonia ZHAO Bo, XIANG Chao, HE Miao, et al DOI: 10.3969/j.issn.1671-7171.2024.06.016 【Objective】To analyze the distribution and drug resistance of bacteria in children with community-acquired pneumonia in our hospital. 【Methods】A retrospective analysis was conducted on the relevant data of hospitalized children with community-acquired pneumonia admitted to the pediatric department of our hospital from January 2017 to December 2021, and the bacterial infection status of the children was analyzed. 【Results】 Out of 7839 sputum samples from children with community-acquired pneumonia, a total of 1753 cases were bacterial positive and qualified, with a total positive detection rate of 22.36%. The main bacteria were Streptococcus pneumoniae(10.14%), Haemophilus influenzae(7.54%), Moraxella catarrhalis(4.38%), and Staphylococcus aureus(2.70%). The positive rates of sputum culture in children with different years, seasons, and ages were compared, and the differences were statistically significant(P<0.01). The detection rates of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in different seasons were compared, and the differences were statistically significant(P<0.01). The detection rates of Streptococcus pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus in children of different ages were compared, and the differences were statistically significant(P<0.01). Streptococcus pneumoniae has a high resistance rate to clindamycin, erythromycin, and tetracycline. Staphylococcus aureus had a high resistance rate to penicillin and erythromycin. The positive rates of β-lactamases produced by Haemophilus influenzae and Moraxella catarrhalis were 78.85% and 94.15%, respectively. 【Conclusion】The main bacteria detected in children with community-acquired pneumonia are Streptococcus pneumoniae, and the detection rates of each bacterium vary in different years, seasons, and ages. 2024 Vol. 41 (6): 857-860 [Abstract] ( 48 ) HTML (1 KB)  PDF (1191 KB)  ( 69 ) 861 Differential Diagnostic Value of the Ratio of Vertebral Cancellous Bone CT Value Combined with Bone Density Value in Fresh and Old Osteoporotic Vertebral Compression Fractures GAO Zengxia, GAO Wenzhi DOI: 10.3969/j.issn.1671-7171.2024.06.017 【Objective】 To explore the differential diagnostic value of the ratio of vertebral cancellous bone CT value combined with bone density of in fresh and old osteoporotic vertebral compression fractures. 【Methods】A total of 82 patients with osteoporotic vertebral compression fractures(82 vertebrae in total) who were treated at Yulin Hospital of Traditional Chinese Medicine from January 2019 to January 2022 were divided into fresh fractures(observation group) based on the results of magnetic resonance imaging(MRI) examination, n=50) and old fractures(control group, n=32), The CT values and bone density ratio of two groups of vertebral cancellous bone were compared; Logistic multiple factor analysis was used to investigate the influencing factors of fresh osteoporotic vertebral compression fractures; The diagnostic efficacy of CT values and bone density ratio of vertebral cancellous bone for fresh and old fractured vertebrae was analyzed using receiver operating characteristic(ROC) curves. 【Results】The CT value of vertebral cancellous bone in the observation group was higher than that in the control group(P<0.05), and the bone density ratio was lower than that in the control group(P<0.05). The results of logistic multivariate analysis showed that CT values and bone density ratio of vertebral cancellous bone were both influencing factors for fresh osteoporotic vertebral compression fractures(P<0.05). The AUC of fresh and old fractured vertebrae was 0.654 and 0.703, respectively, in the differential diagnosis of vertebral cancellous bone CT value and bone density ratio. The AUC of combined differential diagnosis of fresh and old fractured vertebrae was 0.856. 【Conclusion】The CT value and bone density ratio of vertebral cancellous bone have certain differential value for fresh and old fractured vertebrae, and their combined differential diagnosis has higher value for fresh and old fractured vertebrae. 2024 Vol. 41 (6): 861-863 [Abstract] ( 29 ) HTML (1 KB)  PDF (1311 KB)  ( 25 ) 864 Effectiveness of Etaracog Alfa Combined with Clopidogrel in Treating Elderly Patients with Acute Cerebral Infarction HAN Shasha, XIE Pengfang, LI Ning, et al DOI: 10.3969/j.issn.1671-7171.2024.06.018 【Objective】To explore the effectiveness of a combination of Etaracog Alfa injection and clopidogrel in treating elderly patients with acute cerebral infarction(ACI). 【Methods】A total of 82 elderly ACI patients treated were randomly divided into an observation group and a control group, with 41 patients in each group. The control group received clopidogrel treatment, while the observation group was treated with a combination of Etaracog Alfa injection and clopidogrel. The effectiveness of the treatments was compared by measuring various factors before and 14 days after treatment. These included the average blood flow velocity during systole(Vm) and peak blood flow(Vs) in the posterior cerebral artery, resistance index(RI), National Institutes of Health Stroke Scale(NIHSS) scores, and levels of high-sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-alpha(TNF-α), glutathione peroxidase(GPx), and malondialdehyde(MDA). 【Results】 The total effective rate in the observation group was 95.12%(39/41), which was significantly higher than the 80.49%(33/41) in the control group(P<0.05). After treatment, Vm, Vs, and GPx levels were elevated in both groups, with higher increases in the observation group(P<0.05). RI, NIHSS scores, and levels of hs-CRP, TNF-α, and MDA were reduced compared to pre-treatment levels, with greater reductions in the observation group(P<0.05). 【Conclusion】 The combination of Etaracog Alfa injection and clopidogrel in treating elderly ACI patients effectively improves cerebral hemodynamics, inhibits inflammatory stress damage, restores neurological function, and is effective and safe overall. 2024 Vol. 41 (6): 864-867 [Abstract] ( 31 ) HTML (1 KB)  PDF (1192 KB)  ( 31 ) 868 The Predictive Value of Carbon Dioxide Ventilation Equivalent Intercept, C3a, and Inflammatory Factor Levels for the Risk of Disease Exacerbation in COPD Patients WANG Long, CHEN Yu, ZHAO Ke DOI: 10.3969/j.issn.1671-7171.2024.06.019 【Objective】 To explore the predictive value of carbon dioxide ventilation equivalent intercept, C3a, and inflammatory factor levels on the risk of disease exacerbation in patients with chronic obstructive pulmonary disease(COPD). 【Methods】A total of 100 patients diagnosed with COPD for the first time in our hospital from February 2020 to February 2023 were selected and followed up for 1 year. COPD patients were divided into two groups based on the number of disease exacerbations: recombinant group(disease exacerbation≥2 times/year, n=65) and stable group(disease exacerbation<2 times/year, n=35). The carbon dioxide ventilation equivalent intercept, C3a level, inflammatory factors [interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), and C-reactive protein(CRP)] levels were compared between the two groups. The predictive value of carbon dioxide ventilation equivalent intercept, C3a, and inflammatory factor levels on the risk of exacerbation of COPD was analyzed using receiver operating characteristic(ROC) curves and logistic regression.【Results】 The proportion of smoking, carbon dioxide ventilation equivalent intercept, and levels of IL-6, TNF-α, and CRP in the control group were all higher than those in the stable group, while serum C3a levels were lower than those in the stable group, with statistical significance(P<0.05). The ROC curve analysis results showed that the area under the curve(AUC) for carbon dioxide ventilation equivalent intercept, C3a, IL-6, TNF-α, CRP, and combined prediction of the risk of exacerbation of COPD were 0.786, 0.746, 0.851, 0.848, 0.833, and 0.975, respectively. The results of the logistic regression model analysis showed that high carbon dioxide ventilation equivalent intercept, low serum C3a levels, and high levels of inflammatory factors were independent risk factors for exacerbation of COPD(P<0.05). 【Conclusion】Carbon dioxide ventilation equivalent intercept, serum C3a, and inflammatory factor levels have certain predictive value for the risk of exacerbation of COPD. 2024 Vol. 41 (6): 868-870 [Abstract] ( 28 ) HTML (1 KB)  PDF (1318 KB)  ( 17 ) 871 Efficiency Analysis of Magnetic Resonance Perfusion Weighted Imaging combined with Diffusion Weighted Imaging in Distinguishing the Grading of Gliomas GUO Song, SONG Chaohui, ZHANG Shouning DOI: 10.3969/j.issn.1671-7171.2024.06.020 【Objective】To explore the efficacy of magnetic resonance perfusion weighted imaging(PWI) combined with diffusion weighted imaging(DWI) in distinguishing the grading of gliomas. 【Methods】 A retrospective analysis was conducted on 70 patients with surgically and pathologically confirmed gliomas admitted to two hospitals from October 2021 to October 2022(40 cases of low-grade gliomas and 30 cases of high-grade gliomas). The regional cerebral blood flow(rCBF) and apparent diffusion coefficient(ADC) of the tumor parenchyma area, peritumoral edema area, and corresponding normal brain parenchyma on the opposite side were compared, and the relative rCBF(rrCBF) and relative ADC(rADC) of the tumor parenchyma area and peritumoral edema area of patients with different grades of gliomas were compared. The Receiver Operating Characteristic(ROC) curve was drawn to evaluate the efficacy of rrCBF and rADC alone and in combination in distinguishing the grading of gliomas.【Results】The rCBF in the tumor parenchyma area was higher than that in the peritumoral edema area and normal brain parenchyma(P<0.05), while the ADC was lower than that in the peritumoral edema area and normal brain parenchyma(P<0.05); The rCBF in the peritumoral edema area was higher than that in the normal brain parenchyma(P<0.05), and the ADC was lower than that in the normal brain parenchyma(P<0.05). The rrCBF in the tumor parenchyma of low-grade glioma patients was lower than that of high-grade glioma patients(P<0.05), and the rADC was higher than that of high-grade glioma patients(P<0.05). The rrCBF in the peritumoral edema area of low-grade glioma patients was lower than that of high-grade glioma patients(P<0.05), and there was no statistically significant difference in rADC compared to high-grade glioma patients(P>0.05). The ROC curve analysis results showed that both rrCBF and rADC had certain discriminative effects on the grading of gliomas, with areas under the curves of 0.898 and 0.870, sensitivity of 0.867 and 0.900, and specificity of 0.800 and 0.775, respectively; The area under the curve for distinguishing the grading of gliomas using two methods was 0.954, with a sensitivity of 0.933 and a specificity of 0.975. 【Conclusion】PWI and DWI have certain differential efficacy in the grading of gliomas, and their combined differential efficacy is higher, which is worth actively promoting in clinical practice. 2024 Vol. 41 (6): 871-874 [Abstract] ( 31 ) HTML (1 KB)  PDF (1262 KB)  ( 27 ) 875 Application of Retrograde Therapy of Mother-Baby Endoscopy in Diagnosis and Treatment of Appendicitis LIU Xi, SHANG Shu DOI: 10.3969/j.issn.1671-7171.2024.06.021 【Objective】To explore the effects of retrograde therapy of mother-baby endoscopy in diagnosis and treatment of appendicitis. 【Methods】To explore the diagnostic and therapeutic effects of retrograde hysteroscopy on appendicitis. Method: A retrospective analysis was conducted on the clinical data of 21 patients with appendicitis who visited the Endoscopic Diagnosis and Treatment Center of our hospital from April 2022 to January 2023, including 13 males and 8 females. Diagnosis and treatment of patients using retrograde treatment technique with mother-baby endoscopy; The sub endoscopy entered the appendix cavity through the mother mirror channel, and underwent exploration and treatment under the direct view of the sub endoscopy, the treatment results was analyzed.【Results】During the surgery, it was found that the patient had varying degrees of edema of the appendix opening, congestion and swelling of the appendix mucosa, and enlargement of the appendix cavity. The stone removal and treatment process went smoothly, with a treatment time of 15-40(23.3±7.5) minutes, and no complications such as bleeding or perforation were observed. The patient's abdominal pain symptoms can be relieved immediately or within 1 day after treatment, and there was no infection or fever. After surgery, antibiotics are routinely used for 2-3 days before discharge. Complications and follow-up results: 21 patients were followed up for 2-10 months after surgery, with no recurrence of abdominal pain or infection during the follow-up period. 【Conclusion】The retrograde treatment technique of hysteroscopy can directly enter the appendix cavity for observation and operation, without the need for contrast agents and X-rays, making the diagnosis and treatment more accurate. It is effective for the treatment of non complex appendicitis and fecal stones in the appendix, providing a new choice for the diagnosis and treatment of appendiceal diseases. 2024 Vol. 41 (6): 875-877 [Abstract] ( 33 ) HTML (1 KB)  PDF (1442 KB)  ( 26 ) 878 The Effect of Pro-kin Balance System Combined with Blood Flow Restriction Training on Knee Proprioception, Knee Joint Function, and Motor Coordination in Patients after Anterior Cruciate Ligament Reconstruction Surgery JING Qing, WANG Peipei, ZONG Qianqian DOI: 10.3969/j.issn.1671-7171.2024.06.022 【Objective】To explore the effects of Pro-kin balance system combined with blood flow restriction(BFR) training on knee proprioception, knee joint function, and motor coordination in patients undergoing anterior cruciate ligament reconstruction surgery. 【Methods】A total of 82 patients who underwent anterior cruciate ligament reconstruction surgery in 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 41 patients in each group. The control group received postoperative BFR training, while the observation group received postoperative Pro-kin balance system training in addition to the control group. After 3 months of treatment, two groups were compared in terms of quadriceps cross-sectional area, flexor extensor ratio(H/Q), relative peak torque(PT/BW), knee proprioceptive index, knee joint function score, and motor coordination. 【Results】The difference in cross-sectional area of the quadriceps femoris muscle on the affected side between 7 days and 3 months after surgery in the observation group was smaller than that in the control group(P<0.05); The difference in H/Q, PT/BW, 30° position deviation, 60° position deviation, collaborative contraction rate, and average energy frequency between the observation group at 7 days and 3 months after surgery was greater than that of the control group(P<0.05). The difference in knee joint function scores between the two groups at 1 month and 3 months after surgery was significantly higher than that at 1 week after surgery, with statistical significance(P<0.05). In addition, the knee joint function scores in the observation group at 1 month and 3 months after surgery were significantly higher than those in the control group, with statistical significance(P<0.05). The difference in collaborative contraction rate and average energy frequency between the observation group and the control group at 7 days and 3 months after surgery were all statistically significant(P<0.05). 【Conclusion】The combination of Pro-kin balance system and BFR training can inhibit quadriceps atrophy, promote knee joint function recovery, and is worthy of clinical promotion and application. 2024 Vol. 41 (6): 878-881 [Abstract] ( 39 ) HTML (1 KB)  PDF (1195 KB)  ( 53 ) 882 Changes and Clinical Significance of Serum T-AOC, CAT, NO, GSH-Px Levels in Patients with Schizophrenia Complicated by Hospital Infection ZHOU Meiling, LYU Chuange, WANG Weige DOI: 10.3969/j.issn.1671-7171.2024.06.023 【Objective】To explore the changes and clinical significance of serum total antioxidant capacity(T-AOC), catalase(CAT), nitric oxide(NO), and glutathione peroxidase(GSH-Px) levels in patients with schizophrenia(SP) complicated with hospital infection. 【Methods】A total of 114 SP patients(observation group) admitted to our hospital from June 2019 to February 2021 were selected. According to the infection status, the patients were divided into an infected group(n=52) and an uninfected group(n=62). According to the severity of the disease, patients are divided into mild group(n=12), moderate group(n=25), and severe group(n=15). Meanwhile, healthy volunteers who underwent physical examinations at the same time in our hospital were selected as the control group(n=71). A comparative study was conducted on the serum levels of T-AOC, CAT, NO, and GSH-Px in the subjects, and their correlation with the severity of the infection group was analyzed. Receiver Operating Characteristic(ROC) curves were used to analyze their diagnostic value for the occurrence of hospital acquired infections in SP patients. Logistic regression equations were used to analyze the influencing factors of hospital acquired infections in SP.【Results】The white blood cell count, neutrophil count, platelet count, monocyte count, TC, LDL-C, and NO in the observation group were higher than those in the control group, while the lymphocyte count, BDNF, TG, HDL-C, T-AOC, CAT, and GSH-Px levels were lower than those in the control group, with statistical significance(P<0.05). The levels of LDL-C and NO in the infected group were higher than those in the uninfected group, while the levels of BDNF, HDL-C, T-AOC, CAT, and GSH-Px were lower than those in the control group, with statistical significance(P<0.05). Comparison of serum T-AOC, CAT, and GSH Px levels: the severe group<moderate group<mild group, with statistically significant differences(P<0.05); Comparison of serum NO levels: severe group>moderate group>mild group, with a statistically significant difference(P<0.05). Pearson correlation analysis showed that serum levels of T-AOC, CAT, GSH-Px were negatively correlated with the severity of the disease(P<0.01), and serum NO levels were positively correlated with the severity of the disease(P<0.01). Logistic regression equation analysis showed that T-AOC<10.03 U/mL, CAT<5.34 U/mL, NO ≥ 30.31μmol/L, GSH-Px<42.36 U/L were independent risk factors for hospital acquired infections in SP patients(P<0.05). ROC curve analysis showed that the AUC area, sensitivity, and specificity of T-AOC, CAT, GSH-Px, and NO combined detection in diagnosing hospital acquired infections in SP patients were all better than single detection(P<0.05). 【Conclusion】The serum levels of T-AOC, CAT, GSH-Px in patients with hospital acquired pneumonia(SP) decrease, while the serum levels of NO increase, which can serve as biological indicators reflecting the condition and help to timely formulate treatment plans and improve patient prognosis in clinical practice. 2024 Vol. 41 (6): 882-885 [Abstract] ( 35 ) HTML (1 KB)  PDF (1200 KB)  ( 14 ) 886 The Application Effect of Ultrasound Bone Knife Combined with Gelatin Sponge in Minimally Invasive Extraction of Mandibular Low Impacted Wisdom Teeth CHEN Qian, DU Ying DOI: 10.3969/j.issn.1671-7171.2024.06.024 【Objective】To explore the application effect of ultrasound bone knife combined with Gelatin sponge in minimally invasive extraction of mandibular low impacted wisdom teeth. 【Methods】A total of 210 patients with mandibular low impacted teeth who visited the dental extraction clinic of our hospital from January 2020 to October 2022 were selected as the study subjects. They were divided into group A(using turbo drill extraction), group B(using ultrasonic bone knife extraction), and group C(using ultrasonic bone knife combined with Gelatin sponge extraction) according to different treatment methods, with 70 cases in each group. Three groups of patients were compared in terms of bleeding volume in the extraction socket 30 minutes after tooth extraction, visual analogue scale(VAS) score 3 days after surgery, dry socket syndrome, and lower lip numbness. 【Results】 The bleeding rate of the extraction socket in Group C was 11.43%(8/70) at 30 minutes after tooth extraction, significantly lower than 37.14%(26/70) in Group A and 18.57%(13/70) in Group B, with statistical significance(χ2=23.342, 6.389, P<0.05). The bleeding rate of the extraction socket in Group B was significantly lower than that in Group A at 30 minutes after tooth extraction, with statistical significance(χ2=6.667, P<0.05). The VAS score of Group C patients at 72 hours after surgery was significantly lower than that of Group A and Group B; The VAS score of Group B at 72 hours after surgery was significantly lower than that of Group A, and the differences were statistically significant(P<0.05); There was no statistically significant difference in the incidence of dry socket syndrome and lower lip numbness among the three groups of patients(P>0.05). 【Conclusion】 Compared to the simple use of turbo drill or ultrasonic bone knife for tooth extraction, using ultrasonic bone knife combined with Gelatin sponge minimally invasive tooth extraction for patients with mandibular low impacted wisdom teeth may not reduce the incidence of postoperative complications such as dry socket syndrome and lower lip numbness, but it can reduce postoperative bleeding and pain, and is worthy of clinical application and promotion. 2024 Vol. 41 (6): 886-888 [Abstract] ( 30 ) HTML (1 KB)  PDF (1230 KB)  ( 87 ) 889 The Anesthetic Effect and Cognitive Function Impact of Dexmedetomidine Combined with Propofol in Patients Undergoing Gallstone Surgery LYU Xueliang, JIANG Peng, LI Xianhu DOI: 10.3969/j.issn.1671-7171.2024.06.025 【Objective】To investigate the anesthetic effect and cognitive function impact of dexmedetomidine(Dex) combined with propofol anesthesia in patients undergoing gallstone surgery. 【Methods】A total of 160 patients with gallstones were randomly divided into the observation group and the control group, with 80 cases in each group. Both groups underwent laparoscopic cholecystectomy(LC). Patients in the control group received intravenous propofol anesthesia, while the observation group received Dex combined with propofol anesthesia. Surgical-related indicators, hemodynamic parameters before anesthesia and after extubation [mean arterial pressure(MAP), heart rate(HR), and oxygen saturation(SpO2)], intraoperative dosages of remifentanil and propofol, mental state, pain scores, and the occurrence of adverse reactions were compared between the two groups. 【Results】There were no significant differences in surgical time and intraoperative blood loss between the two groups(P>0.05). The onset time of anesthesia, anesthesia recovery time, and recovery time of spontaneous breathing in the observation group were significantly shorter than those in the control group(P<0.05). The MAP and HR levels of both groups after extubation were lower than before anesthesia, and SpO2 level was higher than before anesthesia(P<0.05). Moreover, the MAP and SpO2 of the observation group were higher than those of the control group, while HR was lower than the control group(P<0.05). The dosages of remifentanil and propofol in the observation group were lower than those in the control group(P<0.05). The Mini-Mental State Examination(MMSE) and Visual Analog Scale(VAS) scores at 2 hours post-operation were significantly lower than at 6 hours post-operation in both groups(P<0.05). The MMSE scores at 2 hours and 6 hours post-operation in the observation group were higher than those in the control group, while the VAS scores were lower than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). 【Conclusion】 The combination of Dex and propofol for LC provides significant analgesic effects, characterized by rapid onset, recovery, and spontaneous breathing recovery. It can reduce the dosage of anesthetic drugs, maintain hemodynamic stability, and have a minimal impact on postoperative cognitive function. It is safe. 2024 Vol. 41 (6): 889-892 [Abstract] ( 33 ) HTML (1 KB)  PDF (1195 KB)  ( 36 ) 893 Influence of Calcified Plaque Characteristics on the Diagnostic Results of Vascular Stenosis in CT Coronary Angiography LYU Xiankun, ZHAO Hongwei, LYU Zongchen, et al DOI: 10.3969/j.issn.1671-7171.2024.06.026 【Objective】To investigate the influence of calcified plaque characteristics on the diagnostic results of vascular stenosis in CT coronary angiography. 【Methods】A total of 102 coronary heart disease patients with calcified plaques treated in our hospital were selected as the observation group, and 80 coronary heart disease patients without calcified plaques treated during the same period were selected as the control group. All patients underwent CT coronary angiography and digital subtraction angiography(DSA) to examine the characteristics of calcified plaques.To analyze the impact of different degrees of plaque calcification on the diagnosis of vascular stenosis by CT coronary angiography. 【Results】In the observation group of 102 patients with calcified plaques, 189 sites of stenosis were identified, including 54 sites caused by non-calcified plaques, 78 sites by mildly to moderately calcified plaques, and 57 sites by severely calcified plaques. The diagnostic consistency between CT coronary angiography and DSA was high for non-calcified plaques(Kappa=0.904, P<0.05), relatively high for mildly to moderately calcified plaques(Kappa=0.822, P<0.05), and moderate for severely calcified plaques(Kappa=0.541, P<0.05). In the control group of 80 patients, DSA diagnosed 98 sites of stenosis, including 53 sites of mild stenosis and 45 sites of significant stenosis. The diagnostic consistency between CT coronary angiography and DSA was high(Kappa = 0.979, P<0.05). The sensitivity comparison between mildly to moderately calcified plaques and severely calcified plaques showed no statistical significance(P>0.05); however, there were statistically significant differences in the specificity and accuracy between the two groups(P<0.05). 【Conclusion】In the presence of calcified plaques, CT coronary angiography demonstrates high sensitivity but low specificity in diagnosing vascular stenosis. And the presence of severe calcified plaques has more significantly impact on the specificity. 2024 Vol. 41 (6): 893-895 [Abstract] ( 31 ) HTML (1 KB)  PDF (1231 KB)  ( 17 ) 896 The Application Value of Phaco+LOL Combined with TBL in the Treatment of Patients with Angle Closure Glaucoma and Cataract XUN Zheng, WU Tianli, DAI Pingchun, et al DOI: 10.3969/j.issn.1671-7171.2024.06.027 【Objective】To explore the application value of phacoemulsification (Phaco)+ LOL combined with trabeculectomy(TBL) in the treatment of patients with angle closure glaucoma complicated with cataract. 【Methods】 A total of 82 patients with angle closure glaucoma complicated with cataracts admitted to Tongren Aier Ophthalmology Hospital and Anhua Aier Ophthalmology Hospital from January 2021 to January 2024 were randomly divided into the observation group and the control group, with 41 cases in each group, using a random number table method. Both groups received routine control of intraocular pressure treatment. The observation group received Phaco+LOL combined with TBL treatment simultaneously, while the control group received TBL treatment simultaneously. We compared the visual acuity, intraocular pressure, anterior chamber depth, and incidence of complications between two groups at preoperative, postoperative 3 days, postoperative 1 month, and 3 months. 【Results】At 1 month and 3 months after surgery, the observation group had higher visual acuity than the control group, and lower intraocular pressure levels than the control group, with statistically significant differences(P<0.05). At 3 months after surgery, the anterior chamber depth in the observation group was(2.43±0.20)mm, significantly higher than that in the control group(2.02±0.16)mm, with a statistically significant difference(t=10.50, P=0.000). There was no statistically significant difference in the total incidence of complications between the two groups(P>0.05).【Conclusion】The combination of Phaco+LOL and TBL can effectively reduce intraocular pressure and improve visual acuity in patients with angle closure glaucoma complicated with cataracts. 2024 Vol. 41 (6): 896-899 [Abstract] ( 28 ) HTML (1 KB)  PDF (1189 KB)  ( 96 ) 900 The Predictive Value of Serum Alanine Aminotransferase/Aspartate Aminotransferase Combined with Carcinoembryonic Antigen for Postoperative Prognosis in Patients with Hepatocellular Carcinoma LI Hailin, LIU Dong, TANG Jinyu DOI: 10.3969/j.issn.1671-7171.2024.06.028 【Objective】 To investigate the predictive value of serum alanine aminotransferase/aspartate aminotransferase(ALT/AST) combined with carcinoembryonic antigen(CEA) for postoperative prognosis in patients with hepatocellular carcinoma(HCC).【Methods】 Ninety-one HCC patients treated surgically in our hospital were followed up for three years postoperatively. The survival status was recorded, and clinical data of deceased and surviving patients were compared. Factors influencing mortality and the predictive value of serum ALT/AST combined with CEA for prognosis were analyzed.【Results】 Of the 91 patients, 9 were lost to follow-up. Among the remaining 82 patients, 28 died and 54 survived. The proportion of poorly differentiated tumors, Child-Pugh grade B and distant metastasis in the deceased group were higher than those in the surviving group(P<0.05). The serum CEA levels in the deceased group were higher than that in the surviving group(P<0.05). The ALT/AST ratio in the deceased group was lower than that in the surviving group(P<0.05). Distant metastasis, ALT/AST, and CEA were independent risk factors for mortality(OR=4.158, 4.039, and 4.067, respectively,P<0.05). The specificity and area under the curve(AUC) for predicting postoperative mortality in HCC patients using serum ALT/AST combined with CEA were 96.30% and 0.946, respectively, indicating higher predictive value than using ALT/AST or CEA alone.【Conclusion】 Clinical detection of serum ALT/AST and CEA can serve as sensitive indicators for predicting postoperative mortality in HCC patients, with combined detection offering higher predictive value. 2024 Vol. 41 (6): 900-902 [Abstract] ( 31 ) HTML (1 KB)  PDF (1304 KB)  ( 15 ) 903 Comparison of Multidetector CT Enhanced Scan and Gastrointestinal Radiography for Clinical Staging of Gastric Cancer in the Elderly LI Jinghua, HONG Nianquan, ZHANG Shuhui DOI: 10.3969/j.issn.1671-7171.2024.06.029 【Objective】To compare the diagnostic value of multidetector CT(MDCT) enhanced scan and gastrointestinal radiography for clinical staging of gastric cancer in the elderly. 【Methods】A retrospective analysis was conducted on the clinical data of 105 elderly patients with gastric cancer treated in our hospital. All patients underwent either MDCT or gastrointestinal radiography before surgery. The diagnostic values of MDCT and gastrointestinal radiography for gastric cancer in the elderly were compared. 【Results】The Kappa values for MDCT in determining T and N stages of gastric cancer compared to pathological diagnosis were 0.864 and 0.849, respectively(P<0.05), indicating excellent consistency. The Kappa value for gastrointestinal radiography in determining the T stage was 0.624(P<0.05), indicating a high level of consistency. The accuracy rate of MDCT in diagnosing T stage was 90.00%(45/50), which was higher than that of gastrointestinal radiography at 72.73%(40/55), with a statistically significant difference(P<0.05). 【Conclusion】Compared to gastrointestinal radiography, MDCT enhanced scan has higher accuracy in evaluating T and N stages of gastric cancer in the elderly, indicating better clinical application. 2024 Vol. 41 (6): 903-906 [Abstract] ( 36 ) HTML (1 KB)  PDF (1699 KB)  ( 12 )

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