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Quick Search     Adv Search 2024 Vol. 41, No. 9 Published: 2024-09-26 Original Articles          Original Articles 1281 Epidemiological Characteristics of 630 Patients with Novel Coronavirus Pneumonia in Shanghai to Analyze Related Factors Affecting the Time for Negative Nucleic Acid Negative Conversion CHENG Si, ZHANG Jue, SUN Jian, et al DOI: 10.3969/j.issn.1671-7171.2024.09.001 【Objective】To analyze the epidemiological characteristics and the influencing factors of the time of nucleic acid turning negative for patients infected with the new coronavirus pneumonia Omicron variant in Shanghai, and to provide reference for the treatment of patients with new coronary pneumonia. 【Methods】The epidemiological data of 630 new coronary pneumonia cases admitted to Shanghai Huangpu Fangcang Hospital from April to May, 2022 were retrospectively studied. According to the clinical classification criteria, patients were divided into asymptomatic/mild group (n=543) and common group (n=87). Based on the chest CT imaging diagnosis results, the patients were divided into group A (no obvious abnormality in chest CT plain scan, n=208), group B (chest imaging showed multiple small patchy shadows and interstitial changes, n=335), and group C (chest imaging showed multiple ground-glass shadows and infiltration shadows in multiple lungs, n=87). Statistical analysis was carried out based on chest imaging characteristics and nucleic acid detection results. 【Results】There were significant differences in gender, age, nucleic acid gene distribution ratio, N gene Ct value and ORF gene Ct value between the asymptomatic/mild group and the common group (P<0.05). There were significant differences in age, nucleic acid gene distribution ratio, N gene Ct value and ORF gene Ct value among group A, group B and group C (P<0.05). Logistic multivariate regression analysis showed that age, N gene Ct value and ORF gene Ct value were influencing factors for the severity of pneumonia in patients (P<0.05). According to the time of nucleic acid negative conversion, patients were divided into group D (nucleic acid negative conversion time <9 d, n=5) and group E (nucleic acid negative conversion time ≥9 d, n=12). There were significant differences in age, N gene Ct value and ORF gene Ct value of patients in group D and group E (P<0.05). Logistic multivariate regression analysis showed that age, N gene Ct value and ORF gene Ct value at admission were not independent risk factors affecting the time for nucleic acid test to turn negative (all P>0.05).【Conclusion】Epidemiological characteristics of patients with new coronary pneumonia:gender, age and nucleic acid Ct value are meaningful for the clinical classification of new coronary pneumonia, but have no significant effect on the time of viral nucleic acid conversion to negative; The degree of inflammatory changes in the lungs of patients with new coronary pneumonia is related to age and viral nucleic acid content. 2024 Vol. 41 (9): 1281-1284 [Abstract] ( 43 ) HTML (1 KB)  PDF (1211 KB)  ( 15 ) 1285 The Influence of Marital Age on the Pregnancy Outcome of Artificial Insemination with Husband's Sperm ZENG Qianling, ZHU Hailun DOI: 10.3969/j.issn.1671-7171.2024.09.002 【Objective】To explore the effect of age on the pregnancy outcome of artificial insemination by husband(AIH). 【Methods】A retrospective analysis was conducted on 110 couples who underwent AIH at the Reproductive Medicine Center of Hunan People's Hospital from November 2017 to November 2023. The total number of cycles of artificial insemination with husband's sperm was 202. The clinical pregnancy rate and spontaneous abortion rate of AIH in different age groups of the couples were compared, and the proportion of AIH cycles ≥ 3 in different age groups of the female partner and the abnormal sperm quality rate in different age groups of the male partner were compared. 【Results】There was no statistically significant difference (P>0.05) in the duration of infertility, endometrial thickness on trigger day, and serum estradiol (E2) and progesterone (P) levels between patients aged ≥ 35 and those aged<35. The serum E2 level on trigger day in patients with clinical pregnancy age ≥ 35 years old was lower than that in patients with age<35 years old, and the difference was statistically significant (P<0.05); The spontaneous abortion rate during the clinical pregnancy cycle in the age group ≥ 35 years old is higher than that in the age group<35 years old, and the difference is statistically significant (P<0.05). The proportion of AIH cycles ≥ 3 times in the female age group ≥ 35 years old was significantly higher than that in the age group<35 years old, and the difference was statistically significant (P<0.05). The abnormal rate of sperm quality in the male age group ≥ 35 years old is higher than that in the age group<35 years old, and the difference is statistically significant (P<0.05). 【Conclusion】The age of the female partner has a certain impact on the incidence of spontaneous abortion after AIH clinical pregnancy. For infertile patients aged 35 years or older, more active assisted reproductive methods can be considered. The age of the male partner is an important factor affecting sperm quality. 2024 Vol. 41 (9): 1285-1288 [Abstract] ( 33 ) HTML (1 KB)  PDF (1209 KB)  ( 16 ) 1289 The Effect of miR-484 on Gastric Cancer Angiogenesis by Regulating the HIF-1α/VEGF Signaling Pathway LIU Jin, LI Shimeng, CAO Zhugen, et al DOI: 10.3969/j.issn.1671-7171.2024.09.003 【Objective】To investigate whether miR-484 participates in gastric cancer angiogenesis by regulating the HIF-1α/VEGF signaling pathway.【Methods】SCG-7901 gastric cancer cells were transfected with miR-NC, miR-484 mimics, and miR-484 inhibitors separately. The expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) mRNA and protein, as well as the proliferation of gastric cancer cells, were measured in each group. The individual SCG-7901 cells with successfully transfected miR-NC,miR-484 mimics and miR-484 inhibitors were co-cultured with vascular endothelial cells under hypoxic conditions. Then, ELISA was used to detect the expression of HIF-1α and VEGF in the culture medium, and CCK8 was used to assess the proliferation of vascular endothelial cells.【Results】After transfection with miR-484 mimics, the proliferation capacity of SCG-7901 cells was significantly reduced, while the proliferation capacity of cells in the miR-484 inhibitor group was significantly increased. Compared to the miR-NC group, HIF-1α and VEGF mRNA and protein expression levels were downregulated in the miR-484 mimics group (all P<0.01), while the opposite results were observed in the miR-484 inhibitor group. Under hypoxic conditions, the levels of HIF-1α and VEGF in the culture medium of the miR-484 mimics group were much lower than those of the miR-NC group (both P<0.05), while the proliferation of vascular endothelial cells was higher (P<0.05). The results of the miR-484 inhibitor group were the opposite.【Conclusion】The miR-484 inhibits gastric cancer cell proliferation and tumor angiogenesis by downregulating the HIF-1α/VEGF pathway. 2024 Vol. 41 (9): 1289-1292 [Abstract] ( 49 ) HTML (1 KB)  PDF (1214 KB)  ( 26 ) 1293 Clinical Efficacy of Core Stability Training Combined with Low-frequency Electrical Stimulation Rehabilitation in the Treatment of Postpartum Rectus Abdominis Muscle Separation in Women ZHAO Huijuan, WANG Jie DOI: 10.3969/j.issn.1671-7171.2024.09.004 【Objective】To explore the clinical efficacy of a combination of core stability training and low-frequency electrical stimulation therapy in the treatment of postpartum women with rectus abdominis muscle separation.【Methods】 A total of 80 postpartum women with rectus abdominis muscle separation admitted to our hospital from January 2021 to January 2023 were selected and divided into a control group (receiving low-frequency electrical stimulation therapy, n=39) and an observation group (receiving core stability training combined with low-frequency electrical stimulation therapy, n=41) according to the envelope method. The total effective rate of treatment, rectus abdominis distance, abdominal circumference, visual analog scale (VAS) score, muscle fiber strength, root mean square (RMS) of maximum autonomous isometric contraction amplitude of rectus abdominis muscle, symptom disappearance rate, and satisfaction rate were compared between the two groups of women.【Results】The total effective rate of maternal treatment in the observation group was 97.56%, significantly higher than the control group's 84.62%, and the difference was statistically significant (P<0.05). After treatment, the umbilical circumference, umbilical circumference, and rectus abdominis distance in both groups were smaller than before treatment (P<0.05), and the above indicators in the observation group were smaller than those in the control group (P<0.05). After treatment, the back VAS scores of both groups were lower than before treatment (P<0.05), and the back VAS scores of the observation group were lower than those of the control group (P<0.05). After treatment, the maximum muscle strength of type Ⅰ muscle fibers, the average muscle strength of type Ⅱ muscle fibers, and the RMS of rectus abdominis muscle in both groups of parturients were higher than before treatment, and the above indicators in the observation group were higher than those in the control group (P<0.05). There was no statistically significant difference in the satisfaction rate between the two groups of parturients (P>0 05). After one month of treatment, the symptom disappearance rate in the observation group was 92.68%, significantly higher than the 76.92% in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】The combination of core stability training and low-frequency electrical stimulation therapy has a significant effect on the treatment of postpartum rectus abdominis separation in women. It can significantly reduce the abdominal circumference and alleviate back pain in women, and is worthy of clinical promotion and application. 2024 Vol. 41 (9): 1293-1296 [Abstract] ( 28 ) HTML (1 KB)  PDF (1204 KB)  ( 21 ) 1297 Mechanism of Taohong Siwu Decoction in Treating Postmenopausal Osteoporosis of Kidney Deficiency and Blood Stasis Based on Network Pharmacology and Molecular Docking Technology CAI Weiliang, CAI Anlie DOI: 10.3969/j.issn.1671-7171.2024.09.005 【Objective】To investigate the mechanism of Taohong Siwu decoction in the treatment of postmenopausal osteoporosis (PMOP) based on network pharmacology and molecular docking technology. 【Methods】The active ingredients and potential targets of Taohong Siwu decoction were obtained through the screening of Traditional Chinese Medicine (TCM) System Pharmacology database and its analysis llatform (TCMSP) database. The core targets of its treatment were determined by combining the target mining results of multiple databases. And the complex relationship among targets was constructed by PPI network analysis. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and gene ontology (GO) function analysis were performed using R4.1.2; Then key active ingredients were docked with core targets.【Results】 There were 285 active components in Taohong Siwu decoction. The advanced glycosylated end-product-receptor Pathway (AGE-RAGE signaling pathway), TNF signaling pathway and hypoxic-inducible factor receptor pathway (HIF-1 signaling pathway) were involved in Taohong Siwu decoction therapy. Molecular docking analysis showed that luteolin was well bound to interleukin-6 (IL-6), while quercetin had good binding properties with RUNt-associated transcription factor 2 (RUNX2) macromolecular proteins.【Conclusion】The therapeutic effect of Taohong Siwu decoction on PMOP with kidney deficiency and blood stasis involves several key active ingredients, multiple action targets and core signaling pathways. It provides a new perspective and idea for the mechanism of treating PMOP with kidney deficiency and blood stasis. 2024 Vol. 41 (9): 1297-1300 [Abstract] ( 27 ) HTML (1 KB)  PDF (2521 KB)  ( 32 ) 1301 Expression and Clinical Significance of RAGE and LOXL2 Proteins in Renal Cell Carcinoma SONG Zhifeng DOI: 10.3969/j.issn.1671-7171.2024.09.006 Guide::null 【Objective】To investigate the expression and clinical significance of the receptor for advanced glycation end products (RAGE) and lysyl oxidase-like protein 2 (LOXL2) in renal cell carcinoma tissues.【Methods】Clinical data were collected from 152 patients with renal cell carcinoma who were scheduled for surgical treatment. The relationship between the expression of RAGE and LOXL2 in cancer tissues and the clinicopathological characteristics of the patients was analyzed. Patients were divided into a death group and a survival group based on whether they died within 5 years postoperatively. Clinical data between the two groups were compared, and factors influencing death within 5 years postoperatively were analyzed, as well as differences in survival curves between RAGE and LOXL2 positive and negative patients.【Results】The positive rates of RAGE and LOXL2 in renal cell carcinoma tissues were higher than those in adjacent tissues (P<0.05). The expression of RAGE and LOXL2 was related to tumor differentiation, tumor stage, and lymph node metastasis (P<0.05), but not to age, gender, tumor diameter, or renal capsule invasion (P>0.05). The proportion of age, lymph node metastasis, LOXL2 positivity, and RAGE positivity in the death group was higher than that in the survival group (P<0.05). Lymph node metastasis, RAGE positivity, and LOXL2 positivity were influencing factors for death within 5 years after surgery (P<0.05).【Conclusion】The positive rates of RAGE and LOXL2 in renal cell carcinoma tissues are high and they are related to tumor differentiation, tumor stage, and lymph node metastasis. RAGE and LOXL2 are positively correlated, and their detections can help assess patient prognosis. 2024 Vol. 41 (9): 1301-1304 [Abstract] ( 34 ) HTML (1 KB)  PDF (1302 KB)  ( 45 ) 1305 The Characteristics of Hypertension in the Elderly Population and the Role of Dynamic Blood Pressure Monitoring in Disease Management YU Yang, QU Jingquan, GU Haiping DOI: 10.3969/j.issn.1671-7171.2024.09.007 Guide::null 【Objective】To explore the role of dynamic blood pressure monitoring in disease management of elderly patients with hypertension.【Methods】Eighty elderly patients with hypertension who visited our center from October 2020 to September 2022 were selected and divided into three groups based on their blood pressure rhythm characteristics:a spoon shaped group (n=12), a non spoon shaped group (n=42), and a reverse spoon shaped group (n=26). We analyzed the blood pressure rhythm, mean blood pressure, and blood pressure variability of elderly hypertensive patients, and analyzed the risk factors leading to target organ damage. 【Results】The 24-hour diastolic blood pressure coefficient of variation and 24-hour systolic blood pressure coefficient of variation in the non spoon shaped group were significantly different from those in the spoon shaped group (P<0.05); The nighttime systolic blood pressure, nighttime diastolic blood pressure, nighttime systolic blood pressure load value, and nighttime diastolic blood pressure load value of the anti spoon group were significantly different from those of the spoon group (P<0.05). The incidence of target organ damage in the non spoon shaped group and the anti spoon shaped group was higher than that in the spoon shaped group (both P<0.05); There was no statistically significant difference in the incidence of target organ damage between the non scoop group and the anti scoop group (P=0.985). Logistic multiple regression analysis showed that the 24-hour systolic blood pressure coefficient of variation and non arytenoid rhythm were independent risk factors for target organ damage in both arytenoid and non arytenoid groups (P<0.05); The anti scoop blood pressure rhythm is an independent risk factor for target organ damage in both the scoop and anti scoop groups (P<0.05). 【Conclusion】 Elderly individuals with non arytenoid and anti arytenoid blood pressure rhythms are more prone to target organ damage, and dynamic blood pressure monitoring is an effective tool for improving blood pressure management and treatment strategies in elderly hypertensive patients. 2024 Vol. 41 (9): 1305-1307 [Abstract] ( 30 ) HTML (1 KB)  PDF (2231 KB)  ( 48 ) 1308 Effect of ACTED Nursing Model Combined with Nutritional Support on Nutritional Status and Quality of Life in Patients with Irritable Bowel Syndrome YANG Bei, ZHENG Xiaoyan, ZHAO Sunan DOI: 10.3969/j.issn.1671-7171.2024.09.008 【Objective】This study explores the effects of the ACTED nursing model combined with nutritional support on the nutritional status and quality of life in patients with irritable bowel syndrome (IBS). 【Methods】 Eighty-six IBS patients were randomly divided into an observation group and a control group, with 43 patients in each. The control group received routine care, while the observation group was given the ACTED nursing model and nutritional support in addition to routine care. The nutritional status, clinical symptoms, psychological state, and quality of life of the patients were compared before and after the intervention. 【Results】 After the intervention, levels of transferrin (TRE), albumin (ALB), and prealbumin (PAB) in the observation group were higher than those in the control group (P<0.05). Clinical symptom scores were lower in the observation group (P<0.05). Scores on the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were also lower in the observation group (P<0.05), and their quality of life scores were higher compared to the control group (P<0.05). 【Conclusion】 The ACTED nursing model combined with nutritional support significantly improves the nutritional status and various functions of IBS patients and is worthy of clinical application and promotion. 2024 Vol. 41 (9): 1308-1311 [Abstract] ( 28 ) HTML (1 KB)  PDF (1203 KB)  ( 28 ) 1312 Comparison of Accuracy of Computed Tomography-Guided and Fluoroscopic-Guided Joint Aspiration in Preoperation Diagnosis of Hip Joint Periprosthetic Infection Ainiwaerjiang·Damaola, Maidina·Dilixiati, DOU Haiwei, et al DOI: 10.3969/j.issn.1671-7171.2024.09.009 【Objective】The aim of this prospectively randomized study was to compare the sensitivity, specificity, and accuracy of CT-guided hip aspiration and fluoroscopic-guided hip aspiration in the preoperative diagnosis of periprosthetic joint infection (PJI). 【Methods】 Ninety patients who were suspected of hip PJI in our hospital from June 2018 to May 2022 were randomly received fluoroscopic-guided (n=44) or CT-guided (n=46) hip aspiration before revision surgery. The results of culture tests of joint fluid operation and during-surgery (which was considered as golden standard) were compared. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under the ROC curve of the two groups were calculated respectively. 【Results】The sensitivity, specificity, accuracy and area under the ROC curve of the CT puncture group were 94.1%, 85.7%, 93.4% and 0.919, respectively, which were significantly different from those of the X-ray puncture group (62.5%, 93.1%, 77.2% and 0.723, respectively). The differences were statistically significant(P<0.05).【Conclusion】For suspected hip PJI, preoperative CT-guided aspiration seems to be an effective selection for early diagnosis of PJI. In addition, CT-guided aspiration showed a better sensitivity, specificity and accuracy than fluoroscopic-guided aspiration. 2024 Vol. 41 (9): 1312-1314 [Abstract] ( 36 ) HTML (1 KB)  PDF (2343 KB)  ( 26 ) 1315 Effects of Family Participation Nursing Combined with Children's Fun Induction on Treatment Compliance and Disappearance Time of Clinical Symptoms in Children with Acute Bronchitis MI Qinghe DOI: 10.3969/j.issn.1671-7171.2024.09.010 【Objective】To investigate the effects of family participation nursing combined with children's fun induction on treatment compliance and disappearance time of clinical symptoms in children with acute bronchitis. 【Methods】A total of 126 children with acute bronchitis admitted to our hospital from July 2021 to October 2022 were selected as research objects and divided into two groups according to random number table method, with 63 cases in each group. Children in the control group were given children's fun induction intervention, and children in the observation group were given children's fun induction combined with family participation nursing intervention. Symptom disappearance time, lung function index and treatment compliance were compared between the two groups. 【Results】The disappearance time of fever (2.29±0.30)d, lung rale (4.71±0.40)d, cough (5.01±0.24)d, suffocating asthma (3.31±0.82)d and dyspnea (4.25±1.36)h in the observation group were shorter than those in the control group (5.11±1.20)d, (6.54±0.55)d, (6.61±0.47)d, (6.02±1.16)d, and (5.69±1.52)h, respectively. The difference was statistically significant (P<0.05). The maximum expiratory volume (FEV1) index at the first second (4.71±0.45)L/s and the ratio of FEV1 to forced vital capacity (FEV1/FVC) (87.49±7.02)% in the observation group were higher than those in the control group (3.11±0.32)L/s and (75.23±6.94)%, respectively. The difference was statistically significant(P<0.05). The total treatment compliance rate of the observation group was 93.65%(59/63), which was higher than that of the control group [73.02% (46/63)〗, and the difference was statistically significant (P<0.05). 【Conclusion】Family participation nursing combined with children's fun induction intervention can effectively improve the clinical symptoms of children with acute bronchitis, help to improve the treatment compliance and parents' trust, and further promote the improvement of lung function in children with acute bronchitis. 2024 Vol. 41 (9): 1315-1318 [Abstract] ( 26 ) HTML (1 KB)  PDF (1214 KB)  ( 20 ) 1319 Contrast-Enhanced Ultrasonography Combined with Fine-Needle Aspiration Biopsy in Diagnosing TI-RADS 4 Thyroid Nodule and its Correlation with FPG and HbA1c Levels LI Jinsong, TIAN Xiuli DOI: 10.3969/j.issn.1671-7171.2024.09.011 【Objective】To explore the diagnostic efficacy of contrast-enhanced ultrasound combined with fine-needle aspiration biopsy for TI-RADS 4 thyroid nodules, and investigate its association with levels of FPG and HbA1c. 【Methods】A total of 351 patients with TI-RADS 4 nodules from July 2019 to July 2023 were selected and divided into a malignant group (n=194) and a benign group (n=157) according to the pathological results. All patients underwent contrast-enhanced ultrasonography and fine-needle aspiration biopsy. The levels of serum FPG, HbA1c, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were compared between the two groups of patients, and the diagnostic effect of ultrasound contrast-enhanced imaging combined with fine needle aspiration biopsy on TI-RADS 4 thyroid nodules and its correlation with FPG and HbA1c levels were analyzed.【Results】The sensitivity of ultrasound contrast examination was 84.3%, the specificity was 85.6%, the accuracy was 85.4%, the positive predictive value was 95.5%, and the negative predictive value was 62.4%. The sensitivity of ultrasound contrast combined with fine needle aspiration biopsy nodules (the combined examination) was 95.4%, the specificity was 87.9%, the accuracy was 93.2%, the positive predictive value was 95.6%, and the negative predictive value was 85.6%. The sensitivity, accuracy and negative predictive value of the combined examination were higher than those of ultrasound contrast examination alone, and the difference was statistically significant (P<0.05). The serum FPG and HbA1c levels in the malignant group were higher than those in the benign group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the serum LDL-C, HDL-C, TG, and TC levels between the two groups (P> 0.05). Pearson correlation analysis showed that TI-RADS 4 thyroid nodules were positively correlated with the patients' serum HbA1c and FPG levels (r=0.821, 0.800, both P<0.05).【Conclusion】 Ultrasound contrast imaging combined with fine needle aspiration biopsy has high diagnostic value for TI-RADS 4 nodules. The characteristic of the thyroid nodules is correlated with the patient's serum FPG and HbA1c levels. 2024 Vol. 41 (9): 1319-1321 [Abstract] ( 30 ) HTML (1 KB)  PDF (2252 KB)  ( 19 ) 1322 Application Value of Ultrasound, Gene Mutation and Clinical Characteristics in Prognosis Evaluation of Colorectal Cancer Patients with Liver Metastasis WANG Xinrong, YANG Zhihui, QIANG Yan, et al DOI: 10.3969/j.issn.1671-7171.2024.09.012 【Objective】To investigate the prognostic value of ultrasound, gene mutation and clinical features in patients with colorectal cancer liver metastasis (CRLM). 【Methods】A total of 100 patients with CRLM admitted to the Shiguai District Hospital of Baotou City from June 2023 to May 2024 were selected and underwent ordinary ultrasound and contrast-enhanced ultrasound examination. The quantitative parameters of ultrasound [rise time (RT), mean transit time (mTT), peak intensity (PE), area under the inflow phase curve (WiAUC), inflow ratio (WiR) and inflow phase perfusion index (WiPI)] were recorded; The overall survival (OS) and progression free survival (PFS) of crlm patients were recorded at the same time; The influencing factors of PFS and OS in CRLM patients were analyzed by univariate and multivariate analysis, and the prognostic model of CRLM patients was constructed, and the receiver operating characteristic (ROC) curve was drawn for verification. 【Results】Univariate analysis showed that the location of lesion metastasis, the differentiation degree of primary tumor, the depth of primary tumor invasion, Ki-67 expression, PT, WiR, preoperative carcinoembryonic antigen (CEA), the number of lymph node metastasis, the diameter of primary tumor and K-RAS gene, NRAS gene and BRAF gene mutations were associated with poor OS (P<0.05); Multivariate analysis showed that the degree of primary tumor differentiation, depth of primary tumor invasion, Ki-67 expression, preoperative CEA, lymph node metastasis, and K-RAS gene, NRAS gene, and BRAF gene mutations were independent influencing factors for poor OS (P<0.05). Univariate analysis showed that the degree of primary tumor differentiation, depth of primary tumor invasion, Ki-67 expression, PT, WiR, WiPI, preoperative CEA and K-Kas gene, NRAS gene and BRAF gene mutations were associated with poor PFS (P<0.05); Multivariate analysis showed that the degree of primary tumor differentiation, the depth of primary tumor invasion, Ki-67 expression, the number of lymph node metastasis and K-RAS gene, NRAS gene, BRAF gene mutation were the independent influencing factors of poor PFS (P<0.05). According to the results of multivariate analysis, the RFS prognosis model of CRLM patients was fitted as logit (P)=-3.285+0.408×primary tumor differentiation+0.569 × primary tumor invasion depth + 0.674×Ki-67 expression+0.634×K-RAS gene mutation + 0.534×NRAS gene mutation+0.522×BRAF gene mutation. ROC curve analysis showed that the area under the curve was 0.884, the sensitivity was 0.795, and the specificity was 0.800. 【Conclusion】 The prognosis of patients with CRLM is affected by the degree of differentiation of the primary tumor, the depth of invasion of the primary tumor, Ki-67 expression and K-RAS gene, NRAS gene and BRAF gene mutations. The establishment of a prediction model can better judge the prognosis of patients. 2024 Vol. 41 (9): 1322-1326 [Abstract] ( 36 ) HTML (1 KB)  PDF (1266 KB)  ( 21 ) 1327 Clinical Efficacy of Percutaneous Bridging Plate Internal Fixation versus Internal External Fixation for the Treatment of Anterior Pelvic Ring Fractures LIANG Haiqun, SHI Zhiqiang, LYU Xinzhi DOI: 10.3969/j.issn.1671-7171.2024.09.013 【Objective】To investigate the clinical effect of percutaneous bridging plate internal fixation and internal external fixation in the treatment of anterior pelvic ring fracture. 【Methods】A total of 72 patients with anterior pelvic ring fracture treated in our hospital from January 2020 to December 2022 were selected and divided into the internal fixation group (receiving percutaneous bridging plate internal fixation treatment) and the external fixation group (receiving internal external fixation stent treatment) according to random number table method, with 36 cases in each group. The operative indexes, postoperative complications, fracture healing time, excellent rate of fracture reduction, functional recovery status and the levels of osteopalcin (OPG) and osteocalcin (BGP) were compared between the two groups. 【Results】The operative time in the internal fixation group was longer than that in the external fixation group (P<0.05), and the amount of blood loss was higher than that in the external fixation group (P<0.05). There was no significant difference in the number of intraoperative fluoroscopy between the two groups (P>0.05). The rate of fracture reduction in the internal fixation group was higher than that in the external fixation group (P<0.05), and the time of fracture healing and postoperative full weight bearing were shorter than that in the external fixation group (P<0.05). There were no significant differences in standing, sitting, working, sexual function, pain score and total score between the two groups (P>0.05). After operation, the levels of OPG and BGP were higher than those before operation (P<0.05), but there was no significant difference between the two groups (P>0.05). The incidence of postoperative complications in external fixation group was higher than that in internal fixation group (P<0.05). 【Conclusion】Both percutaneous bridging plate internal fixation and internal external fixation scaffold can promote the recovery of limb function in patients with anterior pelvic ring fracture after surgery, but internal external fixation stenting has shorter operation time and less blood loss, while percutaneous bridging plate internal fixation has better fracture reduction effect and shorter healing time. 2024 Vol. 41 (9): 1327-1330 [Abstract] ( 30 ) HTML (1 KB)  PDF (1208 KB)  ( 35 ) 1331 Clinical Effect of Endoscopic Assisted Transforaminal Lumbar Interbody Fusion for the Treatment of Obese Patients with Lumbar Disc Herniation ZHANG Bing, MA Hang DOI: 10.3969/j.issn.1671-7171.2024.09.014 【Objective】To investigate the clinical efficacy of transforaminal lumbar interbody fusion (TLIF) assisted by spinal endoscopy in the treatment of obese patients with lumbar disc herniation (LDH).【Methods】A total of 93 obese patients with LDH admitted to our hospital from February 2020 to May 2022 were selected and divided into the observation group (receiving TLIF treatment assisted by spinal endoscopy, n=47) and the control group (receiving traditional posterior open surgery, n=46) according to different surgical methods. The surgical related indicators, visual analog scale (VAS) scores, lumbar spine function [Japanese Orthopaedic Association (JOA) scores and Oswestry Disability Index (ODI) scores], imaging parameters, collapse rate, fusion rate, and incidence of complications were compared between the two groups. 【Results】The observation group had a longer surgery time than the control group (P<0.05), shorter total hospital stay and first time out of bed after surgery compared to the control group (P<0.05), and less intraoperative bleeding compared to the control group (P<0.05). There was no statistically significant difference in ODI scores, lower limb VAS scores, JOA scores, and lumbar VAS scores between the two groups before surgery, 1 day after surgery, and 12 months after surgery (P>0.05). 12 months after surgery, the displacement distance of the top vertebral center and the Cobb angle of the lumbar coronal plane in both groups were lower than before surgery, and the Cobb angle of the lumbar sagittal plane was higher than before surgery, with statistically significant differences (P<0.05). Moreover, the recovery of the displacement distance of the top vertebral center, Cobb angle of the lumbar coronal plane, and Cobb angle of the lumbar sagittal plane in the observation group was better than that in the control group (P<0.05). The collapse rate of the observation group was significantly lower than that of the control group (P<0.05), and the fusion rate was higher than that of the control group (P<0.05). There was no statistically significant difference in the total incidence of complications between the two groups (P>0.05). 【Conclusion】 Compared with traditional posterior open surgery, TLIF assisted by spinal endoscopy is more effective in treating LDH obese patients, with better improvement in imaging parameters, faster recovery, lower risk of fusion device collapse, and higher fusion rate. 2024 Vol. 41 (9): 1331-1334 [Abstract] ( 24 ) HTML (1 KB)  PDF (2275 KB)  ( 51 ) 1335 The Anesthesia Effect of Dexmedetomidine Combined with Midazolam in Elderly Patients with Moderate to Severe Burns Undergoing Scab Excision and Skin Grafting Surgery WANG Haijun DOI: 10.3969/j.issn.1671-7171.2024.09.015 【Objective】To investigate the anesthetic effect of dexmedetomidine (Dex) combined with midazolam in elderly patients with severe burns undergoing scab excision and skin grafting surgery. 【Methods】A total of 102 elderly patients with moderate to severe burns were randomly divided into the observation group and the control group, with 51 cases in each group. The control group was maintained with propofol anesthesia, while the observation group was maintained with Dex combined with midazolam anesthesia. The heart rate (HR) and mean arterial pressure (MAP) levels were compared between two groups at different time points during and after surgery; Two groups of patients were compared in terms of surgical conditions and plasma cortisol (COR), adrenaline (E), and norepinephrine (NE) levels before and after surgery; Two groups of patients were compared in terms of postoperative pain [visual analog scale (VAS)], sedation effect (Ramsay sedation score), agitation incidence, and incidence of adverse reactions.【Results】The HR of the observation group was lower than that of the control group at the end of surgery, before extubation, and 30 minutes after extubation (P<0.05), while the MAP was higher than that of the control group (P<0.05). At 30 minutes postoperatively, the plasma levels of COR, E, and NE in the observation group were lower than those in the control group (P<0.05). The VAS score of the observation group was lower than that of the control group (P<0.05), the Ramsay sedation score was higher than that of the control group (P<0.05), and the incidence of agitation was lower than that of the control group (P<0.05). The awakening time of the observation group was shorter than that of the control group (P<0.05), and there was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】Dex combined with midazolam can effectively reduce postoperative stress response, stabilize hemodynamics, shorten recovery time, reduce postoperative pain and agitation incidence in elderly patients with moderate to severe burns undergoing scab and skin grafting surgery, and has good safety. 2024 Vol. 41 (9): 1335-1338 [Abstract] ( 22 ) HTML (1 KB)  PDF (1218 KB)  ( 15 ) 1339 Value of Fetal Serum Free Estriol Combined with Middle Cerebral Artery Blood Flow Parameters in Predicting Adverse Outcomes of Mothers and Infants in High-Risk Pregnancies SUN Jinxian, JIAO Shumin DOI: 10.3969/j.issn.1671-7171.2024.09.016 【Objective】To investigate the predictive value of serum free estriol (uE3) and fetal middle cerebral artery blood flow parameters in maternal and infant adverse outcomes in high-risk pregnant women. 【Methods】 A total of 95 high-risk pregnant women (the observation group) who received regular antenatal check-up in our hospital from February 2019 to February 2021 were selected and divided into the poor group and the good group according to pregnancy outcomes. In addition, 88 healthy volunteers who underwent regular birth examination in our hospital during the same period were selected as the control group. The clinical data, serum free estriol (uE3) levels and fetal middle cerebral artery blood flow parameters [middle cerebral artery pulsation index (PI), resistance index (RI), end-systolic peak/end-diastolic peak (S/D)] were compared between the two groups. Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in high-risk pregnant women. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of fetal middle cerebral artery blood flow parameters and maternal serum uE3 level for adverse pregnancy outcomes in high-risk pregnant women. 【Results】Fetal middle cerebral artery PI, RI, S/D and serum uE3 levels in observation group were lower than those in control group (P<0.05). The incidence of adverse pregnancy outcome was 35.79%. The levels of fetal middle cerebral artery PI, RI, S/D and serum uE3 in the adverse group were lower than those in the good group (P<0.05). The history of miscarriage and the proportion of placenta previa in the poor group were significantly different from those in the good group (P<0.05). Logistic multivariate regression analysis showed that fetal PI, RI, S/D, serum uE3 level and placental previa were independent risk factors for adverse pregnancy outcomes in high-risk pregnant women (P<0.05). ROC analysis results showed that the optimal cut-off points for fetal middle cerebral artery PI, RI, S/D and maternal serum uE3 levels to predict adverse pregnancy outcomes were 0.92, 0.42, 3.20 and 0.66 ng/mL, respectively. The area under the curve (AUC) were 0.797, 0.756, 0.708 and 0.766, respectively. and the joint prediction The specificity and AUC of combined measurements of middle cerebral artery and uE3 were 98.33% and 0.838, respectively. 【Conclusion】The levels of fetal middle cerebral artery PI, RI, S/D and serum uE3 of pregnant women with adverse pregnancy outcomes are decreased. Monitoring the levels of PI, RI, S/D in the middle cerebral artery and serum uE3 of pregnant women with high-risk pregnancies has certain predictive value for adverse pregnancy outcomes. 2024 Vol. 41 (9): 1339-1342 [Abstract] ( 27 ) HTML (1 KB)  PDF (1251 KB)  ( 23 ) 1343 Clinical Efficacy of Indapamide Combined with Benazepril in the Treatment of Hypertension Complicated with Heart Failure and its Influence on the Level of Vasoactive Substances in Patients CAO Xuezeng, LIU Keliang DOI: 10.3969/j.issn.1671-7171.2024.09.017 Guide::null 【Objective】To investigate the clinical efficacy of indapamide combined with benazepril in the treatment of hypertension complicated with heart failure and its influence on the level of vasoactive substances. 【Methods】A total of 108 patients with hypertension complicated with heart failure admitted to our hospital from March 2018 to January 2020 were selected and divided into observation group (indapamide combined with benazepril) and control group (hydrochlorothiazide combined with benazepril) according to the treatment method, with 54 cases in each group. The clinical efficacy, vasoactive substances [endothelin (ET), nitric oxide (NO), vasoactive peptide (Apelin), calcitonin gene-related peptide (CGRP)], cardiac function indexes [left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF), N-terminal pro brain natriuretic peptide (NT-proBNP), left ventricular end diastolic diameter (LVEDD), and 6-min walking distance (6MWD)] were compared between the two groups, and the occurrence of adverse reactions was compared between the two groups. 【Results】After treatment, 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 levels of serum CGRP, no and Apelin in the two groups were higher than those before treatment, and ET was lower than that before treatment. The levels of serum CGRP, no and Apelin in the observation group were higher than those in the control group, and ET was lower than that in the control group (P<0.05). After treatment, LVEF and 6MWD in the two groups were higher than before treatment, LVESD, LVEDD and NT-proBNP were lower than before treatment, LVEF and 6MWD in the observation group were higher than those in the control group, LVESD, LVEDD and NT-proBNP 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】Indapamide combined with benazepril has good clinical efficacy in the treatment of hypertension complicated with heart failure, which can improve cardiac function and regulate the expression of vasoactive substances. 2024 Vol. 41 (9): 1343-1345 [Abstract] ( 30 ) HTML (1 KB)  PDF (2237 KB)  ( 82 ) 1346 The Impact of Extended Comfort Care Combined with Tiered Psychological Care on the Psychological Resilience, Cancer-related Fatigue, Coping Strategies, and Hope Levels of Lung Cancer Patients LIU Fang, ZHANG Dan, LUO Shanshan DOI: 10.3969/j.issn.1671-7171.2024.09.018 【Objective】To explore the effects of extended comfort care combined with tiered psychological care on the psychological resilience, cancer-related fatigue, coping strategies, and hope levels of lung cancer patients. 【Methods】A total of 150 lung cancer patients admitted to our hospital from January 2022 to January 2024 were selected and divided into two groups using the touch ball method:odd numbered control group and even numbered observation group, with 75 patients in each group. The control group received routine care, while the observation group received extended comfort care combined with tiered psychological care. The psychological resilience (CD-RISC), cancer-related fatigue [Piper Fatigue Scale (PFS)], coping strategies [Simplified Coping Style Scale (SCSQ)], and Hope Level [Herth Hope Scale (HHI)] scores were compared between the two groups before and after intervention. 【Results】After intervention, the observation group had higher scores in all dimensions of CD-RISC than the control group (P<0.05); The PFS scores in the observation group were lower than those in the control group in all dimensions (P<0.05); The positive coping score in the observation group SCSQ was higher than that in the control group (P<0.05), and the negative coping score was lower than that in the control group (P<0.05); The HHI scores in the observation group were higher than those in the control group in all dimensions (P<0.05). 【Conclusion】The combination of extended comfort care and tiered psychological care can effectively improve the psychological resilience and hope level scores of lung cancer patients, reduce fatigue scores, and encourage patients to adopt more positive coping strategies. It has a significant effect on improving the psychological and physiological status of lung cancer patients. 2024 Vol. 41 (9): 1346-1349 [Abstract] ( 33 ) HTML (1 KB)  PDF (1206 KB)  ( 65 ) 1350 Analysis of the Prevalence and Diagnosis and Treatment Rate of Psychological Disorders in Hospitalized Patients with Chronic Heart Failure GONG Shan, JIN Chao, OU Yali, et al DOI: 10.3969/j.issn.1671-7171.2024.09.019 Guide::null 【Objective】To explore the prevalence of anxiety, depression, and somatic symptoms in patients with chronic heart failure (CHF), as well as the diagnosis and treatment rate of doctors and their influencing factors. 【Methods】A total of 220 hospitalized CHF patients admitted to our hospital from May to October 2018 and September to December 2020 were selected. The Generalized Anxiety Scale (GAD-7), Patient Health Questionnaire Depression Scale (PHQ-9), 15 item Patient Health Questionnaire (PHQ-15), and self-made general and clinical information questionnaires were used to evaluate CHF. The doctors' recognition and treatment of patients' anxiety, depression, and somatic symptoms were observed. 【Results】The prevalence of psychological disorders in CHF patients reached 72.7%, while the prevalence of depression, anxiety, and somatic symptoms were 53.6%, 39.5%, and 71.8%, respectively. Only 27.5% of patients with psychological disorders were identified by physicians, including 23.0% with anxiety, 18.7% with depression, and 16.4% with somatic symptoms. Physicians only provided medication and non medication treatment to 15% of patients. Logistic regression analysis showed that female gender, NYHA classification, and number of hospitalizations within 5 years were influencing factors for CHF inpatients and psychological disorders (P<0.05). A total of 101 CHF patients were followed up for an average of (27±3) months, and only 11.1% of patients with psychological disorders received standardized anti anxiety and depression treatment. Thirteen patients (13.8%) died from heart disease. 【Conclusion】CHF hospitalized patients have a high incidence of psychological disorders, with somatic symptoms being the most common, followed by anxiety and depression; The patient's psychological disorders are influenced by multiple factors such as gender and their own illness; Most CHF patients do not have psychological disorders recognized and treated by clinical physicians. 2024 Vol. 41 (9): 1350-1353 [Abstract] ( 22 ) HTML (1 KB)  PDF (1210 KB)  ( 9 ) 1354 Efficacy of Budesonide-Formoterol Inhalation Aerosol in Treating High-Risk Acute Exacerbations of Chronic Obstructive Pulmonary Disease Patients ZHU Yanjing, CHEN Peijie, JI Xiaoli, et al DOI: 10.3969/j.issn.1671-7171.2024.09.020 Guide::null 【Objective】To investigate the efficacy and safety of Budesonide-Formoterol inhalation aerosol in treating high-risk acute exacerbations of chronic obstructive pulmonary disease (COPD).【Methods】A total of 160 patients with high-risk acute exacerbations of COPD were randomly divided into the observation group (treated with Budesonide-Formoterol inhalation aerosol) and the control group (treated with Indacaterol-Glycopyrronium inhalation powder capsules), with 80 cases in each group. The differences in pulmonary function indicators, blood gas indicators, COPD assessment test (CAT) scores, modified Medical Research Council (mMRC) dyspnea scale scores, exercise endurance [six-minute walk distance (6MWD)] and quality of life (SGRQ) scores before treatment, and at 3 months and 6 months after treatment were compared between the two groups.【Results】 After 3 and 6 months of treatment, the pulmonary function indicators and blood gas indicators of the observation group were significantly better than those of the control group (P<0.05). The mMRC, CAT, and respiratory symptom scores in the SGRQ scale of the observation group were lower than those of the control group (P<0.05), and the 6MWD was higher than that of the control group (P<0.05). However, there was no statistically significant difference in daily activities, disease symptoms, and total scores on the SGRQ scale between the two groups (P>0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 Budesonide-Formoterol inhalation aerosol is effective in treating high-risk acute exacerbations of COPD and it does not increase the incidence of adverse drug reactions. 2024 Vol. 41 (9): 1354-1357 [Abstract] ( 30 ) HTML (1 KB)  PDF (1210 KB)  ( 14 ) 1358 Effect of Hyperbaric Oxygen Therapy on Severe Traumatic Brain Injury in Children DING Wei DOI: 10.3969/j.issn.1671-7171.2024.09.021 【Objective】To explore the effect of hyperbaric oxygen therapy on severe traumatic brain injury in children. 【Methods】A total of 124 children with severe traumatic brain injury, who admitted to our hospital from September 2020 to September 2023, were collected and divided into the control group and the study group using a random number table method, with 62 cases in each group. Patients in the control group received routine treatment, while those in the research group received hyperbaric oxygen treatment on the basis of the control group. The Glasgow coma scale(GCS) score, NIHSS score, percutaneous oxygen saturation, arterial oxygen partial pressure, cerebral blood flow, awakening rate, awakening time, and treatment effectiveness of two groups of children before and after treatment were analyzed. 【Results】After treatment, the GCS scores of the two groups of children were higher than before treatment, while the NIHSS scores were lower than before treatment. The difference between the observation group and the control group was statistically significant (P<0.05). After treatment, the transcutaneous blood oxygen saturation and arterial oxygen partial pressure of the two groups were higher than before treatment, meanwhile the cerebral blood flow was lower than before treatment. The difference between the observation group and the control group was statistically significant (P<0.05). The awakening rate in the observation group was higher than that in the control group, and the awakening time was shorter than that in the control group, with statistically significant differences (P<0.05). The total effective rate of the observation group was higher than that in the control group, with statistically significant differences (P<0.05).【Conclusion】The application of hyperbaric oxygen in the treatment of severe traumatic brain injury in children can effectively improve transcutaneous oxygen saturation and arterial oxygen partial pressure, reduce cerebral blood flow in children, and thus achieve the effect of protecting children's neural cells and improving neural function. 2024 Vol. 41 (9): 1358-1360 [Abstract] ( 24 ) HTML (1 KB)  PDF (2254 KB)  ( 35 ) 1361 Clinical Effect Analysis of Robot Navigation Assisted Deep Brain Hematoma Puncture Drainage for the Treatment of Hypertensive Intracerebral Hemorrhage LI Xinan, YAN Yang, KONG Fangen DOI: 10.3969/j.issn.1671-7171.2024.09.022 Guide::null 【Objective】To explore the clinical effect of robot navigation assisted deep brain hematoma puncture drainage in the treatment of hypertensive intracerebral hemorrhage. 【Methods】A retrospective analysis was conducted on the clinical data of 42 patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2022 to December 2023. According to different surgical methods, they were divided into three groups:craniotomy microscope surgery group (microscope group, n=15), small bone window endoscopic surgery group (endoscope group, n=11), and robot guided puncture drainage group (robot puncture group, n=16). The general information, preoperative Glasgow Coma Scale (GCS), postoperative Glasgow Outcome Scale (GOS), preoperative and postoperative muscle strength, and prognosis of the three groups were compared. 【Results】There was no statistically significant difference in gender, age, hematoma volume, midline deviation, GCS score, preoperative muscle strength, GOS score, preoperative muscle strength, postoperative muscle strength, proportion of bone flap decompression, ICU stay time, general ward stay time, and mortality among the three groups (P>0.05). All three groups of patients had varying degrees of muscle strength damage before surgery, and after different surgical treatments, muscle strength improved significantly. 【Conclusion】Robot navigation assisted deep brain hematoma puncture drainage surgery has good clinical efficacy and high safety in the treatment of hypertensive intracerebral hemorrhage patients with bleeding volume of 20-50 mL. It has a positive effect on promoting the recovery of patients' neurological function, shortening the treatment period, and improving patient prognosis. 2024 Vol. 41 (9): 1361-1364 [Abstract] ( 31 ) HTML (1 KB)  PDF (1492 KB)  ( 39 ) 1365 Application of Perineal Three-Dimensional Ultrasound Examination in Postpartum Pelvic Floor Function Evaluation LIU Qingping, MA Jing DOI: 10.3969/j.issn.1671-7171.2024.09.023 【Objective】To evaluate the application of three dimensional transperineal ultrasonography in the prediction of pelvic floor function in parturient during vaginal delivery. 【Methods】A total of 80 vaginal parturient who gave birth in Xi 'an Jiren Hospital from January 2021 to January 2023 were selected as the study objects. They were divided into normal group (n=63) and disabled group (n=17) according to whether they had pelvic floor dysfunction after delivery. Pelvic floor muscle tension indices [vaginal resting pressure (VRP), vaginal systolic pressure (VSP) and duration of vaginal contraction] and urethral function indices (functional urethral length and maximum urethral closing pressure) were measured in both groups. The parameters related to pelvic floor function [bladder neck position (BNP), bladder neck mobility (BND)] in resting state and maximum Valsalva state were detected by transperineal three-dimensional ultrasound, and the evaluation value of pelvic floor dysfunction in puerperal parturient was analyzed by receiver operating characteristic (ROC) curve. 【Results】The pelvic floor muscle tension and urethral function indexes of the normal group were significantly better than those of the disabled group (P<0.05), and the relevant parameters of the pelvic floor function were significantly different between the two groups (P<0.05). ROC curve analysis results showed that the area under the curve of BNP, BND alone and combined assessment of postpartum pelvic floor dysfunction were all > 0.7, which had a certain evaluation value, and the combined assessment effect was the best. 【Conclusion】Three-dimensional perineal ultrasonography is of high clinical value in evaluating pelvic floor function of parturient after vaginal delivery. 2024 Vol. 41 (9): 1365-1367 [Abstract] ( 23 ) HTML (1 KB)  PDF (2272 KB)  ( 24 ) 1368 Correlation between Serum HbA1c Level of Pregnant Women with Diabetes in the Third Trimester and Fetal Ultrasound Parameters and Pregnancy Outcome WANG Geli, XING Yue, LI Dapeng DOI: 10.3969/j.issn.1671-7171.2024.09.024 【Objective】To investigate the relationship between the serum glycosylated hemoglobin (HbA1c) level, fetal ultrasound parameters and pregnancy outcome in patients with diabetes in the third trimester of pregnancy. 【Methods】From March 2021 to March 2022, 80 pregnant women with diabetes in the third trimester in Baoji People's Hospital (the observation group) were selected, and 50 pregnant women with normal blood glucose who had regular prenatal examination in Baoji People's Hospital during the same period were selected as the control group.Two groups of blood glucose levels and fetal ultrasound parameters were compared, including resistance index (RI), pulsatility index (PI), and systolic to diastolic ratio (S/D) of the umbilical and middle cerebral arteries. The observation group was followed up until after delivery, and was divided into a poor group and a good group based on different neonatal outcomes. We compared the serum HbA1c and ultrasound parameters of different groups of parturients. We selected clinical indicators with statistically significant differences and constructed receiver operating characteristic (ROC) curves for the subjects. Logistic regression was used to analyze the risk factors leading to adverse outcomes in newborns.【Results】The observation group had significantly higher levels of HbA1c, fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG), and umbilical artery S/D than the control group, while the middle cerebral artery S/D was lower than the control group (P<0.05); There was no statistically significant difference (P>0.05) between the two groups in terms of umbilical artery RI, umbilical artery PI, middle cerebral artery RI, and middle cerebral artery PI. The levels of HbA1c, FPG, 2hPG, body mass index, and umbilical artery S/D in the poor group were significantly higher than those in the good group, while the middle cerebral artery S/D was lower than those in the good group (P<0.05); There was no statistically significant difference (P>0.05) between the two groups in terms of umbilical artery PI, umbilical artery PI, middle cerebral artery RI, middle cerebral artery PI, age, and gestational age. The ROC curve analysis results show that body mass index HbA1c、FPG、2hPG、 Umbilical artery S/D and middle cerebral artery S/D can be used to evaluate the adverse pregnancy outcome of diabetes patients in the third trimester of pregnancy. The area under the curve is 0.875, 0.864, 0.901, 0.973, 0.873, 0.838, respectively. The logistic regression model analysis results show that body mass index>26.286 kg/m2 HbA1c＞6.421％,FPG＞6.261 mmol/L,2hPG＞8.651 mmol/L,Umbilical artery S/D>3.472 and middle cerebral artery S/D ≤ 3.496 were risk factors for adverse pregnancy outcomes in pregnant women with diabetes in the third trimester of pregnancy (P<0.05). 【Conclusion】Monitoring the serum HbA1c level, umbilical artery S/D and middle cerebral artery S/D parameters in patients with diabetes in the third trimester of pregnancy has certain clinical significance in judging the intrauterine condition of the fetus and predicting adverse pregnancy outcomes. 2024 Vol. 41 (9): 1368-1371 [Abstract] ( 26 ) HTML (1 KB)  PDF (1242 KB)  ( 21 ) 1372 Comparison of the Therapeutic Effects of Mechanical Thrombectomy and Emergency Intra-arterial Thrombolysis in Patients with Acute Cerebral Infarction XU Weili, WANG Hongyu, ZHANG Yi DOI: 10.3969/j.issn.1671-7171.2024.09.025 Guide::null 【Objective】To compare the efficacy of mechanical thrombectomy (MT) and emergency intra-arterial thrombolysis (IAT) in the treatment of patients with acute cerebral infarction. 【Methods】A retrospective analysis was conducted on the data of 118 patients with acute cerebral infarction treated with MT or IAT in our hospital, including 66 cases in the MT group and 52 cases in the IAT group. The clinical efficacy of two groups of patients was compared, including the National Institutes of Health Stroke Scale (NIHSS) score before and after treatment, puncture to recanalization time, vascular recanalization rate, residual stenosis rate ≤ 30%, incidence of symptomatic intracranial hemorrhage within 24 hours, and 90 days mortality rate after surgery. 【Results】The total effective rate of the MT group was higher than that of the IAT group (P<0.05); After 3 days of treatment, the NIHSS scores of both groups of patients were lower than before treatment (P<0.05), and the MT group was lower than the IAT group (P<0.05); The time from puncture to recanalization in the MT group was shorter than that in the IAT group (P<0.05), and the vascular recanalization rate in the MT group was higher than that in the IAT group (P<0.05); There was no statistically significant difference (P>0.05) in the residual stenosis rate of ≤ 30%, the incidence of symptomatic intracranial hemorrhage within 24 hours, and the mortality rate at 90 days after surgery between the two groups of patients. 【Conclusion】 Compared with IAT, MT can improve vascular recanalization rate and prognosis in patients with acute cerebral infarction. 2024 Vol. 41 (9): 1372-1374 [Abstract] ( 24 ) HTML (1 KB)  PDF (1192 KB)  ( 37 ) 1375 Analysis of 27 Cases of Brain Metastases from Epithelial Ovarian Carcinoma LI Yiting, TANG Dihong, WU Zheng, et al DOI: 10.3969/j.issn.1671-7171.2024.09.026 Guide::null 【Objective】To evaluate the clinical and pathological characteristics, treatment modalities, and outcome of patients with brain metastases from epithelial ovarian carcinoma (EOC) in Hunan Cancer Hospital.【Methods】The clinical and pathological characteristics, treatment modalities, and outcome of 27 patients with brain metastases from EOC were analyzed from January 2010 to December 2019. 【Results】A total of 27 patients were included in this study, with a median survival time of 15 months. Performance status (PS) score, extracranial metastasis, platinum sensitivity, initial FIGO stage, and treatment modalities were related to survival. 【Conclusion】 The prognosis of patients with brain metastases from EOC is poor. Multimodal treatments contribute to improving the prognosis of patients with brain metastases from EOC. 2024 Vol. 41 (9): 1375-1377 [Abstract] ( 20 ) HTML (1 KB)  PDF (2312 KB)  ( 14 ) 1378 Effect of Hydromorphone Combined with Tramadol on Postoperative Intravenous Patient-Controlled Analgesia in Patients with Tuberculous Empyema YE Xia, WANG Lu DOI: 10.3969/j.issn.1671-7171.2024.09.027 Guide::null 【Objective】To explore the effect of hydromorphone combined with tramadol on postoperative intravenous patient-controlled analgesia (PCIA) in patients with tuberculous empyema.【Methods】A total of 104 patients with tuberculous empyema were randomly divided into the control and the observation groups, with 52 cases in each group. Postoperatively, the control group received tramadol for PCIA, while the observation group received hydromorphone combined with tramadol for PCIA. The postoperative analgesic effect, respiratory and circulatory indicators, and cognitive function at different time points were compared between the two groups. Stress indicators [cortisol (Cor), C-reactive protein (CRP)] before and 18 h after surgery and the incidence of adverse reactions were also compared.【Results】The visual analog scale (VAS) pain scores at 6 h, 18 h, and 24 h postoperatively were higher than those at 3 h postoperatively in both groups (P<0.05). In both groups, the VAS scores at 18 h postoperatively were higher than those at 6 h postoperatively (P<0.05), while the VAS scores at 24 h postoperatively were lower than those at 18 h postoperatively (P<0.05). Compared to the control group, the VAS scores at 6 h, 18 h, and 24 h postoperatively were lower in the observation group (P<0.05). The postoperative CRP and Cor levels were higher than the preoperative levels in both groups, with the observation group showing lower levels than the control group (P<0.05). At 12 h postoperatively, the heart rate (HR) and respiratory rate (RR) were lower, and the oxygen saturation (SpO2) was higher in the observation group compared to the control group (P<0.05). Compared to preoperative levels, the Montreal Cognitive Assessment (MoCA) scores at 18 h postoperatively were lower in both groups (P<0.05), while the score of MoCA in the observation group was higher than that in the control group (P<0.05). Compared to MOCA scores at 18 h postoperatively, the MoCA scores at 24 h postoperatively were higher in both groups (P<0.05). There was no statistically significant difference in the MoCA scores between preoperative and 24 h postoperatively in both groups (P>0.05). The total incidence of adverse reactions was lower in the observation group, compared to the control group (P<0.05). 【Conclusion】The application of hydromorphone combined with tramadol for postoperative analgesia in patients with tuberculous empyema helps alleviate pain, reduces the impact on cognitive function, improves stress indicators, and reduces the incidence of adverse reactions. 2024 Vol. 41 (9): 1378-1381 [Abstract] ( 23 ) HTML (1 KB)  PDF (1217 KB)  ( 17 ) 1382 Efficacy of Ambroxol Hydrochloride in Adjuvant Treatment of Neonatal Infectious Pneumonia and its Effect on Arterial Blood Gas and Inflammatory Response LI Yishe DOI: 10.3969/j.issn.1671-7171.2024.09.028 【Objective】To investigate the clinical efficacy of ambroxol hydrochloride in the adjuvant treatment of neonatal infectious pneumonia and its effect on arterial blood gas and inflammatory response in neonates with infectious pneumonia. 【Methods】A total of 100 children with pneumonia treated in the neonatal department of our hospital from July 2019 to May 2021 were selected as the research objects and randomly divided into the observation group and the control group (with 50 cases in each group). The control group was given conventional anti-infective treatment, while the observation group was given ambroxol hydrochloride in addition to conventional anti-infective treatment. The therapeutic efficacy, clinical symptoms and signs, and changes in arterial blood gas indexes [arterial carbon dioxide partial pressure (PaCO2), arterial oxygen partial pressure (PaO2)] and inflammatory factors [procalcitonin (PCT), tumor necrosis factor (TNF-α), C-reactive protein (CRP)] before and after treatment were compared between the two groups.【Results】The total clinical effective rate of the observation group was higher than that of the control group (P<0.05). At the end of treatment, the daily sputum suction times of the observation group were significantly less than the control group(P<0.05). The average length of hospitalization in the observation group, the disappearance time of cough and asthma, the disappearance time of pulmonary rales and antipyretic time in the observation group were significantly shorter than those in the control group ( all P<0.05). After treatment, PCT, TNF-α and CRP in both groups were lower than those before treatment; And levels of PCT, TNF-α and CRP in the observation group were lower than those in the control group( all P<0.05).At the end of treatment, the levels of PaCO2 in the two groups were decreased (all P<0.05), while PaO2 was increased (all P<0.05). After treatment, the PaO2 level in the observation group was higher, while PaCO2 was lower compared to the control group ( P<0.05). 【Conclusion】Ambroxol hydrochloride adjuvant is effective in the treatment of neonatal infectious pneumonia, which can effectively reduce the levels of inflammatory factors in children and improve their lung function. 2024 Vol. 41 (9): 1382-1384 [Abstract] ( 20 ) HTML (1 KB)  PDF (1192 KB)  ( 13 ) 1385 Analysis of Risk Factors for Pressure Injuries in Patients with Traumatic Brain Injury in the Intensive Care Unit LIU Lili, XU Xinzhou DOI: 10.3969/j.issn.1671-7171.2024.09.029 【Objective】To explore the risk factors for pressure injuries in patients with traumatic brain injury (TBI) in the intensive care unit (ICU). 【Methods】A retrospective analysis was conducted on the clinical data of 146 TBI patients treated in the ICU of our hospital. Patients were divided into two groups based on whether they developed pressure injuries:the occurrence group and the non-occurrence group. Clinical data were collected through questionnaires and compared between the two groups to analyze the risk factors for pressure injuries. 【Results】Univariate analysis indicated that age, body mass index (BMI), diabetes, use of vasoactive drugs, use of sedatives, Glasgow Coma Scale (GCS) score, and Sequential Organ Failure Assessment (SOFA) score were the influencing factors for pressure injuries (P<0.05). Multivariate analysis showed that age ≥60 years, diabetes, use of vasoactive drugs, use of sedatives, GCS score ≤12, and SOFA score ≥12 were the independent risk factors for pressure injuries (P<0.05). 【Conclusion】Age ≥60 years, diabetes, use of vasoactive drugs, use of sedatives, GCS score ≤12, and SOFA score ≥12 can induce the occurrence of pressure injuries in ICU patients with TBI. Clinicians can develop corresponding preventive measures based on the specific conditions of the patients. 2024 Vol. 41 (9): 1385-1387 [Abstract] ( 24 ) HTML (1 KB)  PDF (2243 KB)  ( 22 ) 1388 The Effect of Venlafaxine Combined with Levodopa on the Psychological State and Motor Function of Parkinson's Disease Patients with Depression BI Zongqin, WANG Jia DOI: 10.3969/j.issn.1671-7171.2024.09.030 【Objective】To explore the effect of venlafaxine combined with levodopa treatment on the psychological state and motor function of patients with Parkinson's disease accompanied by depression. 【Methods】Ninety-eight Parkinson's disease patients with depression were randomly divided into the observation group and the control group, with 49 patients in each group. The control group received oral levodopa treatment, while the observation group additionally received venlafaxine hydrochloride extended-release capsules. Before the treatment and after 8 weeks of treatment, the psychological state [Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD-24)], motor function [Part Ⅲ of the Unified Parkinson's Disease Rating Scale (UPDRS Ⅲ), Timed Up and Go Test (TUGT), Berg Balance Scale (BBS)], inflammatory factors [serum interleukin-2 (IL-2), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP)], quality of life [Parkinson's Disease Questionnaire (PDQ-39), WHO Quality of Life-BREF (QOL)] were compared between the two groups, as well as the incidence of adverse reactions.【Results】 After treatment, scores of HAMA and HAMD-24 in both groups were significantly lower than before treatment (P<0.05), with the observation group scoring lower than the control group (P<0.05). UPDRS Ⅲ and TUGT scores decreased, while BBS scores increased post-treatment compared to pre-treatment (P<0.05), with the observation group performing better than the control group (P<0.05). IL-2, TNF-α, and CRP levels decreased after treatment in both groups (P<0.05), with lower levels in the observation group (P<0.05). PDQ-39 scores decreased and QOL scores increased post-treatment compared to pre-treatment in both groups (P<0.05), with the observation group performing better (P<0.05). The overall incidence of adverse reactions was similar between the groups (P>0.05).【Conclusion】 Venlafaxine combined with levodopa can effectively improve the depressive state, enhance motor function, and improve the quality of life of patients with Parkinson's disease and depression, warranting further clinical application. 2024 Vol. 41 (9): 1388-1391 [Abstract] ( 31 ) HTML (1 KB)  PDF (1215 KB)  ( 27 ) 1392 Efficacy and Safety Analysis of Ganglioside Combined with Levetiracetam in the Treatment of Secondary Epilepsy in Children with Viral Encephalitis LI Chuanping, LI Huali DOI: 10.3969/j.issn.1671-7171.2024.09.031 【Objective】To investigate the efficacy and safety of ganglioside combined with levetiracetam in the treatment of secondary epilepsy in children with viral encephalitis. 【Methods】A total of 71 children with secondary epilepsy caused by viral encephalitis admitted to our hospital from January 2021 to January 2023 were selected. According to the treatment method, they were divided into the control group (n=35, conventional treatment + levetiracetam) and the observation group (n=36, combined with ganglioside on the basis of treatment in the control group). The clinical efficacy, serum indicators [neuron specific enolase (NSE), serum interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α)], cerebrospinal fluid indicators [pulmonary surfactant protein D (SP-D), galectin-9 (Gal-9)], as well as the frequency and safety of epileptic seizures after treatment were compared between two groups of children. 【Result】After treatment, 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 levels of serum NSE, IL-6, TNF-α, and cerebrospinal fluid Gal-9 in both groups were lower than before treatment, and the observation group was lower than the control group (P<0.05); The levels of SP-D in the cerebrospinal fluid of both groups were higher than before treatment, and the observation group was higher than the control group (P<0.05). After discharge, the observation group showed better results than the control group in terms of no seizures or reduced seizure frequency (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The clinical effect of ganglioside combined with levetiracetam in the treatment of secondary epilepsy in children with viral encephalitis is good, improving their immune response, effectively reducing the frequency of seizures, and ensuring good safety. 2024 Vol. 41 (9): 1392-1394 [Abstract] ( 24 ) HTML (1 KB)  PDF (1190 KB)  ( 15 ) 1395 Efficacy of Butylphthalide Combined with Edaravone Dexborneol in the Treatment of Patients with Large Cerebral Infarction and its Effect on Serum Related Indicators CHEN Xiaoru, LIN Chong DOI: 10.3969/j.issn.1671-7171.2024.09.032 【Objective】To investigate the efficacy of butylphthalide combined with edaravone dexborneol in the treatment of patients with large cerebral infarction (LCI) and its effect on serum neuron-specific enolase (NSE), astrocyte-derived protein (S100B), and glial fibrillary acidic protein (GFAP).【Methods】 A total of 120 patients with LCI were randomly divided into an observation group (treated with butylphthalide combined with edaravone dexborneol) and a control group (treated with edaravone dexborneol alone). The clinical efficacy, NIHSS scores and ADL scores before and after treatment were compared between the two groups. Serum levels of NSE, S100B, and GFAP, as well as whole blood viscosity and plasma viscosity before and after treatment, were measured and compared between the twomgroups. The incidence of adverse reactions in the two groups was also compared.【Results】 The total effective rate in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the NIHSS scores of both groups were significantly lower, and the ADL scores were significantly higher than before treatment (P<0.05). The NIHSS score in the observation group was lower than that in the control group, and the ADL score in the observation group was higher than that in the control group (P<0.05). Post-treatment serum levels of NSE, S100B, and GFAP, as well as whole blood viscosity and plasma viscosity, were significantly lower if compared to pre-treatment levels. And all these measurement levels in the observation group were lower than those in the control group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 The combination of butylphthalide and edaravone dexborneol is effective in treating LCI, improving neurological function, and reducing levels of NSE, S100B, and GFAP, as well as blood viscosity. This treatment enhances the quality of life and has good safety. 2024 Vol. 41 (9): 1395-1397 [Abstract] ( 28 ) HTML (1 KB)  PDF (2250 KB)  ( 20 ) 1398 Effects of Breast-feeding on Growth and Development, Immunity, Nutritional Status and Serum Trace Elements of Neonates HOU Junxia DOI: 10.3969/j.issn.1671-7171.2024.09.033 【Objective】To study the effects of breastfeeding on the growth and development, nutritional status, immune function and serum trace element levels of neonates. 【Methods】A total of 168 cases of pregnant women who gave birth in our hospital from January 2019 to December 2020 were included in this study. According to the feeding method, the newborns were divided into the formula-feeding group and breast-feeding group. The two groups were followed up for 6 months. The levels of various trace elements in the serum of the newborns were compared; The growth and development, immune function and nutritional status of the newborns in the two groups were analyzed; And the incidence of diseases in the two newborns groups within 6 months after birth was conducted statistically. 【Results】The serum trace elements of Copper, Zinc, Magnesium and Iron in the breast-feeding group were higher than those in the formula-feeding group (P<0.05). At birth, there were no statistically significant differences in growth and development indicators, immune function indicators and nutritional status indicators between the two groups (P>0.05). After 6 months of birth, the height and weight of newborns in both groups increased compared to those at birth (P<0.05). However, there was no difference in body weight and height between the two groups (P>0.05). The levels of IgA and IgM of newborns in the two groups at 6 months after birth were all higher than those at birth (P<0.05), while IgG of newborns in the formula-feeding group was lower than that after birth (P<0.05). At 6 months after birth, levels of IgA, IgM and IgG in the breast-feeding group were all higher than those in the formula-feeding group (P<0.05). Levels of CD3+, CD4+, and CD4+/CD8+ in both groups were all higher than those at birth (P<0.05), and the breast-feeding group was higher than that of the formula-feeding group (P<0.05). The Kaup index of the two groups was higher than that at birth, while the LAZ score and WAZ score were lower than those at birth (P<0.05). The Kaup index, LAZ score and WAZ score of the breast-feeding group were higher than those of the formula-feeding group (P<0.05). There was no difference in the incidence of disease within 6 months between the two groups (P>0.05). 【Conclusion】Breastfeeding helps to better maintain newborn serum trace element levels, enhance newborn immune function and improve nutritional status. 2024 Vol. 41 (9): 1398-1401 [Abstract] ( 24 ) HTML (1 KB)  PDF (1213 KB)  ( 15 ) 1402 Clinical Efficacy of Low-Dose Tirofiban Combined with Mechanical Thrombectomy in the Treatment of Acute Cerebral Infarction FENG Jiangwei, WANG Dongmei, LI Haohao DOI: 10.3969/j.issn.1671-7171.2024.09.034 【Objective】To investigate the clinical efficacy of low-dose Tirofiban combined with mechanical thrombectomy in the treatment of acute cerebral infarction (ACI). 【Methods】 A total of 81 ACI patients who underwent vascular thrombectomy were randomly divided into a control group (40 cases) and an observation group (41 cases). The control group underwent mechanical thrombectomy and was treated postoperatively with a loading dose of 300 mg aspirin + 75 mg clopidogrel. The observation group received Tirofiban treatment in addition to the control group's regimen. The modified Thrombolysis in Cerebral Infarction (mTICI) score was used to compare the vascular recanalization rates of the two groups 24 hours after surgery. Serum levels of nitric oxide (NO) and endothelin-1 (ET-1), platelet aggregation rate, neurological function, and recovery were compared between the two groups before and 3 days after surgery. The incidence of adverse reactions was also compared. 【Results】 There was no statistically significant difference in the vascular recanalization rate between the two groups 24 hours after surgery (P>0.05). Three days post-surgery, the observation group had lower serum NO and ET-1 levels and lower platelet aggregation rate compared to the control group (all P<0.05). The observation group also had lower National Institutes of Health Stroke Scale (NIHSS) scores and Rankin scores compared to the control group (both P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Low-dose Tirofiban combined with mechanical thrombectomy for ACI can effectively improve blood flow and vascular endothelial function, alleviate brain tissue damage, and improve neurological function with good safety. 2024 Vol. 41 (9): 1402-1404 [Abstract] ( 24 ) HTML (1 KB)  PDF (1209 KB)  ( 18 )

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