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Quick Search     Adv Search 2024 Vol. 41, No. 10 Published: 2024-10-26 Original Articles          Original Articles 1457 Application Value of SuperPATH and MDAA in Hip Replacement in Elderly Patients CHEN Xiaobo, LI Shuailei, LIU Aibin, et al DOI: 10.3969/j.issn.1671-7171.2024.10.001 【Objective】To evaluate the value of modified direct anterior approach (MDAA) and SuperPATH approach in elderly patients undergoing hip replacement. 【Methods】A total of 104 elderly patients undergoing hip arthroplasty in Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital) from July 2020 to July 2023 were selected and divided into the observation group (SuperPATH hip arthroplasty, n=54) and the control group (MDAA hip arthroplasty, n=50) according to different treatment methods. The postoperative indexes, Harris hip function score, anterior inclination and abduction Angle of the affected acetabular cup, pain degree score, complication rate and the levels of interleukin-6(IL-6), norepinephrine (NE) and aldosterone (ALD) were compared between the two groups. 【Results】The operation time and the first time of getting out of bed in the observation group were shorter than those in the control group (P<0.05), and the length of incision in the observation group was shorter than that in the control group (P<0.05). One week and one month after surgery, the hip function scores of the observation group were higher than those of the control group (P<0.05). One month after operation, the abduction Angle of the affected acetabular cup in the observation group was lower than that in the control group (P<0.05). One week after surgery, the pain degree score of the observation group was lower than that of the control group (P<0.05). 24 h after operation, IL-6, NE and ALD were increased in both groups, but the observation group was lower than the control group (P<0.05). There was no significant difference in the incidence of lateral femoral cutaneous nerve injury between the two groups (P>0.05). 【Conclusion】 MDAA and SuperPATH can promote the recovery of hip function in elderly patients with good safety, but SuperPATH can shorten the length of the intraoperative incision, reduce the postoperative acetabular epitaxy Angle, improve the postoperative hip function and reduce postoperative pain. 2024 Vol. 41 (10): 1457-1460 [Abstract] ( 60 ) HTML (1 KB)  PDF (1272 KB)  ( 41 ) 1461 Relationship of Serum Levels of ALT, HBsAg, and HBeAb with Liver Function and Prognosis in Patients with Chronic HBV Infection WU Liangfei, SUN Zhigang, YI Benxi DOI: 10.3969/j.issn.1671-7171.2024.10.002 【Objective】To explore the relationship of serum levels of alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), and hepatitis B e antibody (HBeAb) with liver function and prognosis in patients with chronic hepatitis B virus (HBV) infection. 【Methods】A retrospective analysis of clinical data from 116 patients with chronic HBV infection was conducted. The patients were divided into two groups based on the progression of HBV infection: the good prognosis group with simple chronic HBV infection (n=60) and the poor prognosis group with progression to cirrhosis and liver cancer (n=56). General data, ALT, HBsAg, and HBeAb levels were compared between the two groups. The value of ALT, HBsAg, and HBeAb in predicting poor prognosis and the influencing factors of poor prognosis, as well as the relationship between these three indicators and liver function, were analyzed. 【Results】The proportion of patients with liver function graded as B and C, and the levels of serum ALT, HBsAg, and HBeAb were higher in the poor prognosis group compared to the good prognosis group (P<0.05). Receiver Operating Characteristic (ROC) curve analysis showed that ALT, HBsAg, and HBeAb levels were able to use to predict poor prognosis in patients, with the area under the curve being 0.984, 0.926, and 0.956, respectively (all P<0.05). Multivariate Logistic regression analysis revealed that liver function grades B and C, ALT≥235.67 U/L, HBsAg≥708.45 IU/mL, and HBeAb≥56.153 INH% were risk factors for poor prognosis in patients with chronic HBV infection (P<0.05). Correlation analysis indicated that serum levels of ALT, HBsAg, and HBeAb were positively correlated with liver function grading (P<0.05). 【Conclusion】Serum levels of ALT, HBsAg, and HBeAb are positively correlated with liver function grading in patients with chronic HBV infection. Liver function grades B and C, ALT≥235.67 U/L, HBsAg≥708.45 IU/mL, and HBeAb ≥ 56.153 INH% are risk factors for poor prognosis in patients with chronic HBV infection. These indicators can serve as important markers for monitoring the condition of chronic HBV infection patients, providing references for clinical diagnosis and treatment. 2024 Vol. 41 (10): 1461-1464 [Abstract] ( 28 ) HTML (1 KB)  PDF (1267 KB)  ( 9 ) 1465 Analysis of Influencing Factors of Readmission within 30 Days after Laparoscopic Resection of Acute Appendicitis in Children LIAO Siqi, JI Chunyi, YUAN Miaoxian, et al DOI: 10.3969/j.issn.1671-7171.2024.10.003 【Objective】To explore the influential factors affecting readmission within 30 days after laparoscopic appendectomy (LA) in children. 【Methods】The clinical data of 53 children with acute appendicitis who were readmitted within 30 days after LA in Hunan Children&apos;s Hospital from January 2019 to March 2024 were selected, and they were divided into the reoperation group (n=7) and non-reoperation group (n=46) according to whether they underwent reoperation or not. Age, sex, appendicitis inflammatory response score (AIR) at first admission, duration of first disease, duration of first hospital stay, pathological type, duration from first onset to admission, and duration of symptoms before readmission were collected. White blood cell (WBC) count, neutrophil lymphocyte ratio (NLR), and C-reactive protein (CRP) at first discharge and readmission, and risk factors associated with readmission within 30 days after LA were analyzed. 【Results】Among the 53 readmitted children, 22 cases (41.51%) were diagnosed with abdominal abscess, 19 cases with intestinal obstruction (35.85%), 6 cases with intestinal obstruction combined with abdominal abscess (11.32%), 5 cases with abdominal abscess combined with wound infection (9.43%), and 1 case with appendicitis (1.89%). At readmission, WBC count and NLR were higher than those at the first discharge (P<0.05), and CRP level was not significantly different from that at the first discharge (P>0.05). The rehospitalization time between the reoperation group and the non-reoperation group was statistically significant (P<0.05). There was no significant difference in AIR at first admission, time from first onset to admission, time of first hospitalization and duration of symptoms before readmission between the two groups (P>0.05). All 53 cases were discharged after treatment. 【Conclusion】The main readmission factors of appendicitis in children are abdominal abscess and intestinal obstruction. Early intervention can reduce the incidence of postoperative complications and the proportion of readmission children. 2024 Vol. 41 (10): 1465-1467 [Abstract] ( 27 ) HTML (1 KB)  PDF (1261 KB)  ( 16 ) 1468 CT Imaging Features of Pleuropulmonary Blastoma in Children LI Chunwang, LI Shuming, TANG Jing DOI: 10.3969/j.issn.1671-7171.2024.10.004 【Objective】To analyze the CT imaging features of pleuropulmonary blastoma (PPB) in children. 【Methods】Clinical and CT imaging data of 10 children with PPB confirmed by puncture biopsy or surgical pathology admitted to the Department of Radiology of Hunan Children&apos;s Hospital from August 2016 to July 2022 were retrospectively analyzed. All cases underwent plain and enhanced CT scan. Among them, 5 were male and 5 were female. The ages ranged from 1 year 2 months to 4 years 11 months, with a median age of 3 years 2 months. The main symptoms of non-specific respiratory tract infection were fever, cough, shortness of breath and chest pain. 【Results】All the 10 cases were single, 6 cases on the right side and 4 cases on the left side. Among the 10 cases, 1 case was type Ⅰ, 2 cases were type Ⅱ, and 7 cases were type Ⅲ. In 8 cases, the masses were located in the periphery of the lung and pressed the lung tissue and mediastinum to the healthy side, 1 in the lung lobe and 1 around the lung hilum. The tumors were all larger than 6.5 cm in diameter, and in 6 cases, the mass occupied almost half of the thoracic cavity. One case was complicated with left renal cystic tumor. CT findings: Type Ⅰ presented as a multilocular cystic mass filled with fluid and containing a small amount of gas. Type Ⅱ was a solid cystic mass with soft tissue density in the plain scan, uneven mild enhancement, and no enhancement in the cystic mass. Type Ⅲ was a pure solid mass with clear boundaries, uneven enhancement, and multiple tumor-nourishing vessels. Rib destruction and mediastinal lymph node enlargement were not observed in all cases, with or without a small amount of pleural effusion, and only 2 cases had a small amount of calcification. 【Conclusion】In children aged 2 to 4 years old, CT found a huge mass close to the chest wall on one side of the chest, but no obvious involvement in the chest wall and no bone destruction of the ribs. The possibility of PPB should be considered first. 2024 Vol. 41 (10): 1468-1471 [Abstract] ( 23 ) HTML (1 KB)  PDF (1610 KB)  ( 28 ) 1472 Comparison of Clinical Efficacy of Different Formulations of Leuprorelin in the Treatment of Central Precocious Puberty in Girls ZHOU Yuanyuan, ZHAO Sha DOI: 10.3969/j.issn.1671-7171.2024.10.005 【Objective】To compare the clinical efficacy of dosage form 3M and 1M of leuprorelin in the treatment of central precocious puberty (CPP) in girls. 【Methods】A total of 35 children with CPP admitted to the Department of Child Health Care of our hospital from July 2022 to August 2023 were retrospectively analyzed and divided into the observation group (n=17) and the control group (n=18) according to different treatment methods. Sex hormone levels [luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2)], uterine length, ovarian volume, height, weight, bone age/chronological age of the two groups before and after treatment were compared, and the occurrence of adverse reactions between the two groups were compared. 【Results】There were no significant differences in uterine length, left ovarian volume, right ovarian volume, bone age/actual age, height and body weight index (BMI) between the two groups before and after treatment (P>0.05). After 3 months of treatment, the peak levels of LH and FSH in 2 groups were lower than before treatment, and the difference was statistically significant (P<0.05). After 3 and 6 months of treatment, the levels of serum LH, FSH and E2 in the two groups were lower than before treatment, and the differences were statistically significant (P<0.05). After 3 months of treatment, serum LH and FSH levels in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The two formulations of leuprorelin have similar clinical efficacy and safety in the treatment of CPP girls, and the long-acting formulations are economical and convenient. 2024 Vol. 41 (10): 1472-1474 [Abstract] ( 24 ) HTML (1 KB)  PDF (1253 KB)  ( 14 ) 1475 Application Value of Acetylcysteine-Assisted Noninvasive Ventilator in Elderly Patients with COPD and Respiratory Failure LI Xianming DOI: 10.3969/j.issn.1671-7171.2024.10.006 【Objective】To investigate the clinical effect of acetylcysteine-assisted noninvasive ventilator in the treatment of elderly patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. 【Methods】A total of 92 elderly patients with COPD and respiratory failure diagnosed and treated in our hospital from December 2020 to April 2023 were selected and divided into the control group and the observation group according to stratified random sampling method, with 46 cases in each group. The control group was treated with noninvasive ventilator, and the observation group was treated with acetyl cysteine combined with noninvasive ventilator. The two groups were compared in terms of respiratory dynamics parameters [respiratory rate (f), tidal volume (VT), inspiratory time (Ti)/ total respiratory cycle time (Ttot)], blood gas indicators [Oxygenation index (OI), oxygen saturation (SaO2), partial arterial pressure of carbon dioxide (PaCO2)], pulmonary function indicators [peak respiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1)], serum indicators [MRpro-ADM), Growth-regulated oncogene α (GRO-α), interleukin-6 (IL-6), C-reactive protein (CRP)] levels, quality of life [St. George&apos;s Respiratory Questionnaire (SGRQ) score]. 【Results】After 14 days of treatment, f in the observation group was lower than that in the control group, VT and Ti/Ttot were higher than that in the control group (P<0.05). OI and SaO2 in observation group were higher than those in the control group, while PaCO2 was lower than those in the control group (P<0.05). PEF, FVC and FEV1 in the observation group were higher than those in the control group (P<0.05). The levels of MRpro-ADM, GRO-α, IL-6 and CRP in the observation group were lower than those in the control group (P<0.05). The SGRQ score of the observation group was lower than that of the control group (P<0.05). 【Conclusion】Acetylcysteine-assisted non-invasive ventilator is an effective treatment for elderly patients with COPD complicated with respiratory failure, which can significantly improve the oxygenation and ventilation function, enhance lung function, reduce the level of inflammatory factors, and improve the quality of life of patients. 2024 Vol. 41 (10): 1475-1478 [Abstract] ( 24 ) HTML (1 KB)  PDF (1217 KB)  ( 14 ) 1479 Influencing Factors of Refractive Development of Adolescents in Maqiao Area of the Minhang District and Intervention Effect of Visual Function Adjustment Training on Ocular Dysregulation JIN Yiping, KANG Jiaqing, CHEN Chen, et al DOI: 10.3969/j.issn.1671-7171.2024.10.007 【Objective】To analyze the influence factors of refractive development and the effect of visual function adjustment training on eye dysregulation in adolescents in Maqiao area of Minhang District. 【Methods】 A total of 520 primary and secondary school students who participated in school refraction screening in Maqiao area of the Minhang District from January 2018 to January 2022 were selected by cluster sampling method and divided into the normal refraction group (n=273) and the abnormal refraction group (n=247) according to the results of the refraction test. General information such as age, sex, height, family history, time spent outdoors and use of video media were collected by daily eye questionnaire. Logistic regression model was used to analyze the influencing factors of adolescent refractive development. 45 of the participants were treated with different video media (tablet computer, desktop computer, TV screen) for 30 minutes after intervention, the occurrence of abnormal eye regulation in different intervention groups was compared, and visual function adjustment training intervention was applied to those with abnormal eye regulation. The improvement of visual function in different age groups (> 12 years old, ≤12 years old) was analyzed before, 3 months and 6 months after visual function adjustment training.【Results】Logistic regression analysis showed that age > 12 years old, outdoor activity time < 4 h, close eye time > 6 h and tablet use were the influencing factors for refractive development of adolescents in Maqiao area of Minhang District (P<0.05). After the intervention of different video playback media, the rate of eye dysregulation in tablet group was significantly higher than that in desktop group and TV projection group, and the difference was statistically significant (P<0.05). After the intervention of visual function adjustment training, the adjustment lag value of all participants decreased, and the adjustment sensitivity increased. The adjustment lag value of ≤12 years old group was lower than that of > 12 years old group (P<0.05), and the adjustment sensitivity was higher than that of > 12 years old group (P<0.05). 【Conclusion】 Age, outdoor activity time, close eye use time and electronic products use type are the influencing factors of refractive development of adolescents in Maqiao area of the Minhang District. The larger the screen and the less time of video playback media used, the lower the adjustment lag value, and the better the effect of eye adjustment function training on the adjustment lag of adolescents ≤12 years old. 2024 Vol. 41 (10): 1479-1482 [Abstract] ( 27 ) HTML (1 KB)  PDF (1266 KB)  ( 45 ) 1483 Analysis of Changes in Blood Glucose and Serum Metrnl Protein Levels in Patients with Type 2 Diabetes Complicated with Coronary Heart Disease and their Correlation with Prognosis CHEN Jiuming DOI: 10.3969/j.issn.1671-7171.2024.10.008 【Objective】The purpose of this study was to investigate the changes in blood glucose, serum Metrnl protein levels, and their correlation with prognosis in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD). 【Methods】A total of 102 patients with T2DM and CHD admitted to our hospital from March 2021 to March 2023 were selected and divided into the high-risk group (n=25), moderate-risk group (n=37), and low-risk group (n=40) according to the severity of the disease. The patients were further divided into a good prognosis group (n=79) and an unfavorable prognosis group (n=23) based on the prognosis. The baseline data, 24 h blood glucose, blood glucose fluctuation amplitude, and serum Metrnl protein levels of the groups were compared. The correlation between each indicator and prognosis was analyzed by Pearson correlation analysis. The factors affecting the prognosis of patients with T2DM and CHD were analyzed by Logistic regression analysis and a Receiver Operating Characteristic (ROC) curve was used to analyze the predictive ability of blood glucose and serum Metrnl protein levels in predicting the prognosis of patients with T2DM and CHD. 【Results】There were significant differences in 24 h blood glucose, blood glucose fluctuation amplitude, and serum Metrnl protein levels among the high-risk group, moderate-risk group, and low-risk group (P<0.05). The 24 h blood glucose, blood glucose fluctuation amplitude, and serum Metrnl protein level of the good prognosis group were lower than those of the unfavorable prognosis group (P<0.05). Pearson correlation analysis showed that the serum Metrnl protein level was negatively correlated with blood glucose fluctuation amplitude and 24 h blood glucose (P<0.05). The Logistic multivariate analysis results showed that 24 h blood glucose, blood glucose fluctuation amplitude, and serum Metrnl protein were influencing factors for the prognosis of patients with T2DM and CHD (P<0.05). The results of ROC curve analysis showed that the combined prediction of 24 h blood glucose, blood glucose fluctuation range and Metrnl protein in predicting the prognosis of patients with T2DM and CHD was significantly better than that of 24 h blood glucose, blood glucose fluctuation range and Metrnl protein alone. 【Conclusion】The blood glucose and serum Metrnl protein levels in patients with T2DM and CHD changed significantly with the severity of the disease and were significantly correlated with the prognosis of the patients. 2024 Vol. 41 (10): 1483-1486 [Abstract] ( 25 ) HTML (1 KB)  PDF (1343 KB)  ( 7 ) 1487 Screening Results and Influencing Factors of Retinopathy of Prematurity in Ankang City HE Haiyan, ZHANG Binyu, LIU Rongfang, et al DOI: 10.3969/j.issn.1671-7171.2024.10.009 【Objective】To analyze the screening results of retinopathy of prematurity and its influencing factors in Ankang City. 【Methods】A total of 836 preterm infants who underwent fundus screening in the Ankang Maternal and Child Health Hospital from June 2018 to December 2021 were selected and grouped according to gestational age and birth weight according to diagnostic criteria to study the detection rate of retinopathy of prematurity and its influencing factors in each group. 【Results】The detection rate of retinopathy of prematurity in 836 cases was 13.88%(116/836), among which 8 cases were severe retinopathy of prematurity, accounting for 6.90%(8/116). There were significant differences in the detection rate of retinopathy of prematurity among different gestational age, birth weight, oxygen inhalation time and red blood cell transfusion history (P<0.05). 【Conclusion】 The detection rate of retinopathy of prematurity is high in Ankang City, and preterm infants with small gestational age, low birth weight, oxygen duration longer than 7 days and red blood cell transfusion history should be paid attention to. 2024 Vol. 41 (10): 1487-1489 [Abstract] ( 26 ) HTML (1 KB)  PDF (1243 KB)  ( 12 ) 1490 The Application Effect of Home-based Habit Reversal Training in Patients with Bronchial Asthma CAI Silian, PAN Jing DOI: 10.3969/j.issn.1671-7171.2024.10.010 【Objective】To explore the application value of habit reversal training in patients with bronchial asthma. 【Methods】 A total of 80 patients with bronchial asthma admitted to our hospital from May 2020 to April 2021 were selected and divided into observation group and control group according to different intervention measures, with 40 groups in each group. The control group was given routine nursing measures, and the observation group was combined with the habit reversal training based on the control group. The mastery of inhaled corticosteroid (ICS) inhalation technique, bronchial asthma Quality of Life Scale (AQLQ) score, tidal volume, respiratory rate and peak expiratory flow rate (PEF) before and after intervention were compared between the two groups, and the treatment compliance was compared between the two groups. 【Results】After intervention, the activity restriction, asthma symptoms, psychological status, environmental stimulus response and self-health scores of the two groups were higher than before intervention, and the observation group was higher than the control group, the difference was statistically significant (P<0.05). After intervention, the ICS inhalation skill mastery score in both groups was higher than before intervention, and the observation group was higher than the control group, the difference was statistically significant (P<0.05). After intervention, tidal volume of the two groups was higher than before intervention, respiratory rate and PEF were lower than before intervention, and the difference between the observation group and the control group was statistically significant (P<0.05). After intervention, the treatment compliance of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05).【Conclusion】The habit reversal training with family as the rehabilitation site can effectively improve the quality of life and treatment compliance of patients with bronchial asthma, and is worthy of clinical application. 2024 Vol. 41 (10): 1490-1493 [Abstract] ( 20 ) HTML (1 KB)  PDF (1204 KB)  ( 14 ) 1494 Effect of Self-made Matrine Sit-Bath Fumigation-washing Formula on Postoperative Anal Wound Recovery and Serum Inflammatory Factor Levels in Patients with Mixed Hemorrhoids ZHAO Yun, JI Shunxiang, CHEN Xiaoping, et al DOI: 10.3969/j.issn.1671-7171.2024.10.011 【Objective】To investigate the effect of matrine sit-bath fumigating decoction on postoperative anal wound recovery and serum inflammatory factors in patients with mixed hemorrhoids.【Methods】The clinical data of 80 patients with mixed hemorrhoids admitted to our hospital from June 2022 to June 2024 were retrospectively analyzed, and they were divided into the observation group and the control group according to treatment methods, with 40 cases in each group. Both groups received mixed hemorrhoid external stripping and internal ligation. The control group was treated with potassium permanganate solution anal wound bath after operation, and the observation group was treated with self-designed matrine sat bath after operation for 4 weeks. The clinical efficacy, pain degree [visual analogue of pain (VAS) score], anal wound recovery (wound efflux score, wound area score, wound healing time) and serum inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] were compared between the two groups. 【Results】The total effective rate of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05). Compared with the same group 1 day after surgery, the VAS scores at 3 and 7 days after surgery were significantly decreased, and the observation group was lower than the control group, the difference was statistically significant (P<0.05). Compared with the same group 1 day after surgery, the wound permeability score and wound area score of the two groups were significantly decreased at 3 and 7 days after surgery, and the observation group was lower than the control group (P<0.05). The wound healing time in the observation group was significantly shorter than that in the control group, and the difference was statistically significant (P<0.05). After treatment, serum levels of IL-6, CRP and TNF-α in 2 groups were lower than before treatment, and the observation group was lower than control group, the difference was statistically significant (P<0.05). 【Conclusion】The Self-made matrine sit-bath fumigation can significantly promote the healing of anal wounds in patients with mixed hemorrhoids, reduce inflammation, and is an effective adjuvant treatment. 2024 Vol. 41 (10): 1494-1496 [Abstract] ( 22 ) HTML (1 KB)  PDF (1248 KB)  ( 29 ) 1497 Clinical Efficacy of Kangfuxin Solution Combined with Adenosine Monophosphate and Lysozyme in the Treatment of Herpes Stomatitis in Children LIANG Xiaoyan, HAO Yuqiao, LI Caihong DOI: 10.3969/j.issn.1671-7171.2024.10.012 【Objective】 To investigate the clinical effect of Kangfuxin solution combined with adenosine monophosphate and lysozyme in the treatment of herpes stomatitis in children.【Methods】 A total of 68 children with herpetic stomatitis admitted to our hospital from March 2018 to March 2021 were selected and divided into observation group (treated with conventional treatment combined with convalescent new solution) and control group (treated with conventional treatment) according to random number table method. Both groups were treated for 1 course of continuous treatment (5 days). The clinical effect, temperature recovery time, herpes resolution time, ulcer disappearance time, inflammatory factors [(hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8)] levels, immune function indexes (CD3+, CD4+, CD8+, CD4+/CD8+) and adverse reactions were compared between the two groups Should be the case. 【Results】The total effective rate of the observation group was 97.06%, significantly higher than that of the control group (79.41%), and the difference was statistically significant (P<0.05). The temperature recovery time, herpes regression time and ulcer disappearance time in the observation group were significantly shorter than those in the control group (P<0.05). After treatment, hs-CRP, TNF-α, IL-8 and CD8+ in the observation group were significantly lower than those in the control group (P<0.05), and CD3+, CD4+ and CD4+/CD8+ were significantly higher than those in control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05).【Conclusion】Kangfuxin solution can significantly improve the therapeutic effect of children with herpetic stomatitis, reduce the level of serum inflammatory factors, and improve the immune function of children. 2024 Vol. 41 (10): 1497-1500 [Abstract] ( 27 ) HTML (1 KB)  PDF (1208 KB)  ( 36 ) 1501 Clinical Efficacy of Noninvasive Ventilator Combined with Recombinant Human Brain Natriuretic Peptide in the Treatment of Acute Heart Failure Patients with Severe Dyspnea WANG Lijuan, LI Chuan DOI: 10.3969/j.issn.1671-7171.2024.10.013 【Objective】To investigate the clinical effect of noninvasive ventilator combined with recombinant human brain natriuretic peptide in the treatment of acute heart failure complicated with severe respiratory disorders. 【Methods】A total of 84 patients with acute heart failure combined with severe dyspnea who were treated in the Intensive Care Department of the Anqing Municipal Hospital from January 2018 to January 2023 were selected and divided into the observation group (noninvasive ventilator combined with recombinant human brain natriuretic peptide treatment) and the control group (noninvasive ventilator treatment) according to random number table method, with 42 cases in each group. The two groups were compared in terms of cardiac function [left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), central venous pressure (CVP), velocity time integral (VTI)], lung B-line integral and blood gas index (PaCO2), blood oxygen saturation (SaO2), partial arterial oxygen pressure (PaO2), arterial oxygen saturation (SpO2), myocardial injury markers [cardiac troponin T(cTnT), cTnI and brain natriuretic peptide (BNP)], dyspnea index [Chronic obstructive Pulmonary disease score (mMRC)]; The correlation between cardiac function indexes and mMRC was analyzed by Pearson. 【Results】After treatment, LVESD, LVEDD, lung B-line score, CVP, PaCO2, myocardial injury markers and mMRC in observation group were lower than those in control group, while LVEF, VTI, SaO2, PaO2 and SpO2 were higher than those in control group(P<0.05). The results of Pearson analysis showed that mMRC was positively correlated with LVESD, LVEDD and CVP, and negatively correlated with LVEF (P<0.05). 【Conclusion】The combination of noninvasive ventilator and recombinant human brain natriuretic peptide therapy in patients with severe dyspnea with AHF can reduce the burden on the heart and respiratory muscles, and optimize the cardiopulmonary function and gas exchange. 2024 Vol. 41 (10): 1501-1504 [Abstract] ( 22 ) HTML (1 KB)  PDF (1212 KB)  ( 22 ) 1505 Effects of Dexmedetomidine Combined with Butorphanol on Postoperative Analgesia and Oxidative Stress Response in Patients Undergoing Esophagectomy LI Xianhu, GUO Cong, WANG Yuyao DOI: 10.3969/j.issn.1671-7171.2024.10.014 【Objective】 To explore the effects of dexmedetomidine (Dex) combined with butorphanol on postoperative analgesia and oxidative stress response in patients undergoing esophagectomy.【Methods】 A total of 102 patients undergoing esophagectomy were randomly divided into a control group and an observation group, with 51 patients in each group. The control group received postoperative analgesia with butorphanol and sufentanil, while the observation group received butorphanol combined with Dex. Awakening time, hemodynamic parameters [heart rate (HR), mean arterial pressure (MAP)], stress response markers [adrenaline (Adr), cortisol (Cor)], pain levels, and adverse reactions were compared between the two groups.【Results】The awakening time and postoperative recovery room stay in the observation group were shorter than those in the control group (P<0.05). In both groups, HR and MAP at 6 minutes after anesthesia (T1) and 2 minutes after surgery (T2) were higher than those before anesthesia (T0) (P<0.05), while HR and MAP at T2 were lower than those at T1 (P<0.05). HR and MAP at T1 and T2 were significantly lower in the observation group compared to the control group (P<0.05). Adr and Cor levels at 24 hours and 36 hours postoperatively were higher than preoperative levels in both groups (P<0.05), with levels at 36 hours showing lower than those at 24 hours (P<0.05). The observation group had significantly lower Adr and Cor levels at 24 hours and 36 hours postoperatively compared to the control group (P<0.05). Visual Analog Scale (VAS) scores at 3, 9, 24, and 36 hours postoperatively were higher than preoperative levels in both groups (P<0.05), showing an initial increase followed by a decrease. The VAS scores of the observation group at each time period after surgery were lower than those of the control group (P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 Dex combined with butorphanol in esophagectomy stabilizes postoperative hemodynamic parameters, accelerates patient recovery, suppresses perioperative stress response, reduces postoperative pain, and demonstrates good safety. 2024 Vol. 41 (10): 1505-1507 [Abstract] ( 22 ) HTML (1 KB)  PDF (1255 KB)  ( 11 ) 1508 The Efficacy of Endoscopic Papillary Mini-incision Combined with Balloon Dilation in the Treatment of Patients with Bile Duct Stones and Impact on Serum Levels of CCK-A and SREBP-2 TANG Wenjun, QIN Xianju DOI: 10.3969/j.issn.1671-7171.2024.10.015 【Objective】To explore the efficacy of endoscopic papillary mini-incision combined with balloon dilation in the treatment of bile duct stones and its impact on serum levels of cholecystokinin type A receptor (CCK-A) and cholesterol regulatory element binding protein 2 (SREBP-2). 【Methods】A total of 196 patients with bile duct stones admitted to our hospital from January 2019 to December 2023 were selected and divided into the observation group and the control group based on a random number table method, with 98 cases in each group. The patients in the control group underwent endoscopic sphincterotomy for gallstone surgery, while the patients in the observation group underwent endoscopic papillary mini-incision combined with balloon dilation. The operation time, blood loss, hospitalization, time to get-out-of bed, and gastrointestinal function recovery time were compared between the two groups. The stone removal rate, stone recurrence rate, and postoperative complication incidence were compared between the two groups as well. 【Results】The observation group had significantly lower operation time, blood loss,hospitalization time, time to get-out-of bed, and gastrointestinal function recovery time compared to the control group (P<0.05). The success rate for one time of stone removal in the observation group was higher than that in the control group (P<0.05), while the mechanical lithotripsy rate and stone recurrence rate in the observation group were lower than those in the control group (P<0.05). There was no statistically significant difference in the residual stone rate between the observation group and the control group (P>0.05). After surgery, the CCK-A of the two groups of patients was higher than that before surgery, and the SREBP-2 was lower than that before surgery. The postoperative CCK-A in the observation group was higher than that in the control group, while the postoperative SREBP-2 level was lower than that in the control group, with a statistically significant difference (P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】The combination of endoscopic papillary mini-incision and balloon dilation for the treatment of bile duct stones has advantages such as short surgical time, quick postoperative recovery, good postoperative gallbladder function recovery, and fewer complications. 2024 Vol. 41 (10): 1508-1511 [Abstract] ( 22 ) HTML (1 KB)  PDF (1215 KB)  ( 17 ) 1512 Changes of Intestinal Flora in Children with Bronchopneumonia before and after Antibiotic Treatment and its Clinical Significance ZHONG Yujie, ZHANG Yanan, HU Shuaijuan DOI: 10.3969/j.issn.1671-7171.2024.10.016 【Objective】To investigate the changes and clinical significance of intestinal flora in children with bronchial pneumonia before and after antibiotic treatment. 【Methods】A total of 112 children with bronchopneumonia treated in our hospital from October 2020 to October 2022 were selected as the observation group and given macrolide antibiotics for 14 days. In addition, 60 healthy children who underwent physical examination in our hospital during the same period were selected as the control group. The intestinal flora of children with bronchopneumonia of different severity were compared between the two groups and the observation group. The imbalance of intestinal flora in children of different age groups after treatment was analyzed. 【Results】Shigella, Salmonella and pathogenic Escherichia coli in observation group were significantly higher than those in control group (P<0.05). Shigella, salmonella and pathogenic Escherichia coli increased successively in mild, moderate and severe children in the observation group, and the differences were statistically significant (P<0.05). After treatment with antibiotics, the contents of Shigella, Salmonella and pathogenic Escherichia coli in children with bronchopneumonia were higher than those before treatment (P<0.05). The proportion of children < 3 years old with intestinal flora disorder was higher than that of children ≥3 years old (χ2=11.479, P<0.05). 【Conclusion】The intestinal flora of children with bronchopneumonia is dysregulated, and antibiotic treatment can further affect the intestinal flora. Children < 3 years old are prone to intestinal flora dysregulation. 2024 Vol. 41 (10): 1512-1514 [Abstract] ( 18 ) HTML (1 KB)  PDF (1244 KB)  ( 12 ) 1515 Effect of CICARE Communication Mode Nursing on Visual Recovery in Patients with Macular Edema Treated by Intravitreal Injection of Arbocept LU Ningjie DOI: 10.3969/j.issn.1671-7171.2024.10.017 【Objective】To investigate the effect of CICARE communication mode nursing on visual recovery in patients with macular edema treated by intravitreal injection of arbocept. 【Methods】A total of 100 patients with macular edema who received vitreous injection of arbocept in our hospital from April 2023 to April 2024 were selected and divided into groups by touch ball method, with an odd number as the control group (receiving routine care) and an even number as the observation group (receiving CICARE communication mode care), with 50 cases in each group. Visual acuity recovery, negative emotion [Hospital Anxiety and Depression Scale (HADS)], visual function quality of life (VAQ) and complications were compared between the two groups before and after intervention. 【Results】After intervention, the best corrected visual acuity (BCVA) value of the observation group was higher than that of the control group, and the central macular thickness (CMT) value was lower than that of the control group. The scores of HADS anxiety and HADS depression in the observation group were lower than those in the control group; The scores of visual function, quality of life and total score of the observation group were lower than those of the control group. The total incidence of complications in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】CICARE communication mode nursing can significantly improve the visual recovery effect of patients with macular edema, alleviate negative emotions, improve the quality of life of visual function, and effectively reduce the incidence of complications. 2024 Vol. 41 (10): 1515-1518 [Abstract] ( 16 ) HTML (1 KB)  PDF (1204 KB)  ( 18 ) 1519 Impact of Concomitant Hyperuricemia on Thrombolytic Prognosis in Elderly Patients with Cerebral Ischemic Stroke ZHANG Ling, WANG Jia DOI: 10.3969/j.issn.1671-7171.2024.10.018 【Objective】This study aims to investigate the impact of concomitant hyperuricemia on the thrombolytic prognosis in elderly patients with Cerebral Ischemic Stroke (CIS). 【Methods】 A retrospective analysis of the clinical data of 100 elderly CIS patients was conducted. Upon admission and after 7 days of thrombolytic treatment, patients were grouped based on the National Institutes of Health Stroke Scale (NIHSS): with scores ≥5 indicating severe cerebral infarction and scores <5 indicating mild cerebral infarction. Initially, 52 patients were classified as the severe group and 48 as the mild group. After 7 days of thrombolytic treatment, there were 31 cases in the severe group and 69 cases in the mild group. The modified Rankin Scale (mRS) was used to evaluate patient outcomes 90 days post-thrombolysis, with outcomes categorized as mRS scores≤2 (n=63) and mRS scores>2 (n=37). Factors influencing changes in patient conditions and thrombolytic prognosis were analyzed. 【Results】 At admission, there were no statistically significant differences between the two groups in terms of general data, presence of hyperuricemia, total cholesterol, and triglycerides (P>0.05). After 7 days of thrombolysis, the proportion of patients without hyperuricemia and with high total cholesterol in the severe group was greater than that in the mild group (P<0.05). Multivariate logistic regression analysis revealed that high total cholesterol was a risk factor for the severity of condition post-thrombolysis, while hyperuricemia acted as a protective factor (P<0.05). In the mRS scores>2 group, a higher proportion of patients had a history of smoking, hyperuricemia, NIHSS scores ≥5 at admission and NIHSS scores ≥5 at 7 days of thrombolysis than that in the mRS scores≤2 group (P<0.05). Multivariate logistic regression confirmed that concomitant hyperuricemia, smoking history, NIHSS scores ≥5 at admission, and NIHSS scores ≥5 at 7 days of thrombolysis were risk factors for poor 90 days outcomes in elderly CIS patients (P<0.05). 【Conclusion】 Uric acid can act as a protective factor in the early stage of thrombolysis in elderly CIS patients, but it may adversely affect the 90-day prognosis post-thrombolysis. Therefore, managing uric acid levels appropriately at different stages of treatment can effectively improve the treatment and prognosis of elderly CIS. 2024 Vol. 41 (10): 1519-1522 [Abstract] ( 16 ) HTML (1 KB)  PDF (1211 KB)  ( 9 ) 1523 Anesthetic Effects of Remimazolam and Propofol Combined with Opioid Analgesics in ERCP Procedures CUI Xiangqian, HOU Hexi DOI: 10.3969/j.issn.1671-7171.2024.10.019 【Objective】 To explore the anesthetic and analgesic effects of remimazolam and propofol combined with opioid analgesics in endoscopic retrograde cholangiopancreatography (ERCP) procedures.【Methods】 A total of 202 patients undergoing general anesthesia for ERCP in our hospital were randomly divided into the observation group and the control group, with 101 patients in each group. In the control group, anesthesia was administered with propofol in combination with sufentanil and remifentanil for analgesia. In the observation group, remimazolam was added to the anesthetic protocol of the control group. The sleep induction time, wake-up time, and room exit time were observed in both groups. Blood pressure, heart rate, oxygen saturation (SaO2), bispectral index (BIS), and postoperative adverse reactions were recorded at different time points: before anesthesia (T1), during endoscope insertion (T2), 5 minutes after the operation (T3), and at the end of the procedure (T4).【Results】 The observation group had shorter sleep induction and room exit times compared to the control group (P<0.05). At T2, systolic blood pressure, diastolic blood pressure, heart rate, SaO2, and BIS were lower in both groups compared to T1, with the observation group showing higher values than the control group (P<0.05). In the control group, systolic and diastolic blood pressure, heart rate, SaO2, and BIS were higher at T3 and T4 compared to T2 (P<0.05), and these values were higher at T4 than those at T3 (P<0.05). At T3, systolic and diastolic blood pressure, heart rate, and SaO2 in the observation group were higher than those in the control group (P<0.05). The total incidence of adverse reactions in the observation group (3.96%) was lower than that in the control group (11.88%) (P<0.05).【Conclusion】 The combination of remimazolam and propofol with opioid analgesics in ERCP procedures provides effective anesthesia and analgesia. It reduces the incidence of adverse reactions, which makes worthy of clinical application. 2024 Vol. 41 (10): 1523-1525 [Abstract] ( 24 ) HTML (1 KB)  PDF (1254 KB)  ( 18 ) 1526 Clinical Efficacy and Survival Analysis of Tislelizumab Combined with Sunitinib in the Treatment of Metastatic Renal Cancer WANG Mengjie, GUO Xiaofang DOI: 10.3969/j.issn.1671-7171.2024.10.020 【Objective】 To investigate the clinical efficacy and survival outcomes of tislelizumab combined with sunitinib in the treatment of metastatic renal cancer.【Methods】 Forty-two patients with metastatic renal cancer were randomly divided into the observation group and the control group, with 21 patients in each group. The observation group was treated with oral sunitinib combined with intravenous tislelizumab, while the control group was treated with oral sunitinib combined with intravenous saline. After six treatment cycles, the efficacy, incidence of adverse reactions, and survival prognosis were compared between the two groups. Additionally, CD3+, CD4+, CD4+/CD8+, matrix metalloproteinase-2 (MMP-2), vascular endothelial growth factor (VEGF), and tissue inhibitor of metalloproteinases-1 (TIMP-1) levels were measured before and after treatment and compared between the two groups.【Results】 The disease control rate in the observation group was 90.48%, which was significantly higher than that of 61.90% in the control group (P<0.05). After treatment, CD3+, CD4+, and CD4+/CD8+ levels increased in both groups, with the observation group showing higher levels than the control group (P<0.05). MMP-2, VEGF, and TIMP-1 levels decreased in both groups post-treatment, with lower levels in the observation group compared to the control group (P<0.05). The incidence of adverse reactions between the two groups showed no statistically significant difference (P>0.05). The median progression-free survival (PFS) was 11 months in the control group and 15 months in the observation group, with a statistically significant difference between the PFS curves of the two groups (P<0.05).【Conclusion】 Tislelizumab combined with sunitinib is effective and safe in the treatment of metastatic renal cancer. 2024 Vol. 41 (10): 1526-1529 [Abstract] ( 16 ) HTML (1 KB)  PDF (1261 KB)  ( 25 ) 1530 Comparison of Heart Rate Variabilities in Dynamic Electrocardiogram between Patients with Hypertension Combined with Coronary Heart Disease and those with Simple Coronary Heart Disease JIANG Danma, WANG Qingqing DOI: 10.3969/j.issn.1671-7171.2024.10.021 【Objective】To compare the differences of heart rate variabilities (HRV) in dynamic electrocardiography between patients with hypertension complicated with coronary heart disease and those with simple coronary heart disease. 【Methods】 A total of 83 elderly patients with hypertension complicated coronary heart disease admitted to our center from January 2020 to June 2022 were selected as the observation group, and 60 elderly patients with simple coronary heart disease admitted to our hospital during the same period were selected as the control group. Clinical baseline data, blood biochemical indicators [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FPG)], and HRV time-domain parameters [standard deviation of all sinus rhythm R-R intervals (SDNN), root mean square difference of adjacent R-R intervals (RMSSD), mean standard deviation of R-R intervals every 5 minutes (SDANN), percentage of adjacent R-R intervals with a difference of more than 50 ms to the total number of R-R intervals (pNN50), mean standard deviation of sinus RR intervals every 5 minutes (SDNN Index)], HRV frequency-domain parameters [low-frequency power (LF), high-frequency power (HF)] and low frequency power/high frequency power (LF/HF) were compared between the two groups.【Results】 There were no statistically significant differences in TC, TG, LDL-C, HDL-C, and FPG between the two groups of patients (P>0.05). The time-domain parameters SDNN, RMSSD, SDANN, pNN50, and SDNN Index of HRV in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The frequency domain parameters LF, HF, and LF/HF of the observation group were lower than those of the control group, and the difference was statistically significant (P<0.05). 【Conclusion】 Compared with patients with simple coronary heart disease, hypertensive patients with coronary heart disease have significantly reduced HRV time-domain and frequency-domain parameters, and their autonomic nervous system dysfunction is more severe. 2024 Vol. 41 (10): 1530-1532 [Abstract] ( 26 ) HTML (1 KB)  PDF (1250 KB)  ( 21 ) 1533 Effect of Incentive Psychological Intervention Combined with Rational Emotive Therapy on Relieving Emotional Distress and Pain Management in Children with Fracture HU Dan, YUAN Lili, ZHANG Penghui DOI: 10.3969/j.issn.1671-7171.2024.10.022 【Objective】To explore the effect of incentive psychological intervention combined with rational emotive therapy on relieving emotional distress and pain management in children with fracture.【Methods】A total of 92 children with fracture treated in our hospital from June 2021 to May 2023 were selected and divided into the control group (routine nursing intervention) and the observation group (incentive psychological intervention combined with rational emotive therapy on the basis of control group) according to random number table method, 46 cases in each group. The negative emotions [Children's Mental Health Scale (MHS-CA)], stress response (CSDC), pain degree and recovery status of the two groups were compared before and after intervention. 【Results】 After intervention, the score of MHS-CA in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). After intervention, CSDC scores in the observation group were lower than those in the control group, with statistical significance (P<0.05). After intervention, the proportion of moderate and severe pain in observation group was lower than that in control group, and the difference was statistically significant (P<0.05). After intervention, the time of local detumescence and fracture healing in observation group were shorter than those in control group, and the difference was statistically significant (P<0.05). 【Conclusion】Incentive psychological intervention combined with rational emotive therapy can significantly improve the negative emotions of children with fracture, reduce the stress response and pain degree, and promote the rehabilitation of children. 2024 Vol. 41 (10): 1533-1536 [Abstract] ( 18 ) HTML (1 KB)  PDF (1205 KB)  ( 17 ) 1537 Evaluation of TCM Hot Compress Combined with Tendon and Bone Setting Traction in Patients with Severe Cervical Radiculopathy LI Huan, XIANG Jie, CHEN Hui DOI: 10.3969/j.issn.1671-7171.2024.10.023 【Objective】To investigate the clinical efficacy of Chinese medicine hot compress combined with tendon and bone setting traction therapy in the treatment of severe cervical radiculopathy patients. 【Methods】A total of 98 patients with severe cervical radiculopathy who were admitted to our hospital from January 2018 to January 2020 were selected and divided into the observation group (n=49) and the control group (n=49) by random number table method. The control group was treated with Chinese medicine hot compress, while the observation group was treated with Chinese medicine hot compress combined with tendon and bone setting traction. After 3 months of treatment, the clinical symptom scores and pain rating index(PBI ) scores of the two groups were compared. 【Results】The scores of cervical pain, upper limb numbness, dizziness, and nerve root compression in the observation group were significantly lower than those in the control group, with statistically significant differences (P<0.05); the scores of stabbing pain, tearing pain, burning pain, jumping pain, and pulling pain in the PBI of the observation group were lower than those in the control group, with statistically significant differences (P<0.05). 【Conclusion】The combined treatment of Chinese medicine hot compress with tendon and bone setting traction therapy for severe cervical radiculopathy patients can improve the clinical symptoms and reduce pain in the lesion and surrounding areas. It is worth clinical promotion and application. 2024 Vol. 41 (10): 1537-1539 [Abstract] ( 19 ) HTML (1 KB)  PDF (1185 KB)  ( 23 ) 1540 Effects of Vitamin D on Obesity in Children and its Effects on Leptin and Insulin Resistance HU Huizhong, LIU Yuyang, GUO Gailing DOI: 10.3969/j.issn.1671-7171.2024.10.024 【Objective】To investigate the effect of vitamin D in the treatment of childhood obesity and its effect on leptin and insulin resistance. 【Methods】The clinical data of 150 obese children admitted to our hospital from January 2022 to January 2023 were retrospectively analyzed, and they were divided into observation group (vitamin D treatment on the basis of control group) and control group (conventional treatment) according to treatment methods, with 75 cases in each group. Body weight indexes, 25 hydroxyvitamin D[25(OH)D], leptin, insulin resistance index (HOMA-IR), inflammatory factors [interleukin-8 (IL-8), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], oxidative stress indexes [superoxide dismutase (SOD), malondialdehyde (MDA) and reactive oxygen species (ROS)] of the two groups were compared. 【Results】There was no significant difference in height between the two groups before and after treatment (P>0.05). After treatment, the BMI of the two groups was lower than before treatment, and the observation group was lower than the control group, the difference was statistically significant (P<0.05). After treatment, 25(OH)D in both groups was higher than before treatment, leptin and HOMA-IR were lower than before treatment, 25(OH)D in the observation group was higher than the control group, leptin and HOMA-IR were lower than the control group, the difference was statistically significant (P<0.05). After treatment, serum levels of IL-8, IL-6, TNF-α, SOD, MDA and ROS in 2 groups were lower than before treatment, and the observation group was lower than the control group, the difference was statistically significant (P<0.05). 【Conclusion】Vitamin D can reduce the body mass index of obese children, improve the inflammatory response and oxidative stress response of children, increase the level of leptin, reduce HOMA-IR, and the application effect is good. 2024 Vol. 41 (10): 1540-1542 [Abstract] ( 18 ) HTML (1 KB)  PDF (1253 KB)  ( 28 ) 1543 The Effects of Remimazolam Combined with General Anesthesia on Hemodynamics and Cognitive Function in Elderly Patients Undergoing Laparoscopic Surgery YAO Ying, LI Qiannan DOI: 10.3969/j.issn.1671-7171.2024.10.025 【Objective】To explore the effects of remimazolam combined with general anesthesia on hemodynamics and cognitive function in elderly patients undergoing laparoscopic surgery.【Methods】A total of 82 elderly patients undergoing laparoscopic surgery were randomly divided into the observation group and the control group, with 41 patients in each group. The control group received propofol for anesthesia induction, while the observation group received remimazolam. Heart rate (HR) and mean arterial pressure (MAP) changes before and after induction were compared between the two groups. Additionally, the Mini-Mental State Examination (MMSE) scores before and after surgery, anesthesia conditions, and the incidence of adverse reactions in both groups were compared as well. 【Results】 Compared to pre-induction, both groups showed a significant decrease in HR and MAP immediately before intubation and at 1 minute and 3 minutes after intubation (P<0.05). The HR and MAP values at these time points in the observation group were significantly higher than those in the control group (P<0.05). The MMSE scores in both groups significantly decreased from 1 day before surgery to 24 hours after surgery (P<0.05), then significantly increased from 24 hours to 72 hours postoperatively (P<0.05). The MMSE scores in the observation group at 24 hours and 72 hours postoperatively were lower than those in the control group at 24 hours and 72 hours postoperatively (P<0.05),respectively. The time to achieve anesthesia in the observation group was longer than that in the control group (P<0.05), while the recovery time was shorter than that in the control group (P<0.05). There was no statistically significant difference in the length of stay in the post-anesthesia care unit (PACU) between the two groups (P> 0.05). The incidence of hypotension, bradycardia, hypoxemia, and injection pain in the observation group was lower than that in the control group (P<0.05).【Conclusion】 Remimazolam combined with general anesthesia can effectively maintain stable hemodynamics, improve cognitive function, and reduce the incidence of adverse reactions in elderly patients undergoing laparoscopic surgery. It is worthy of clinical promotion and application. 2024 Vol. 41 (10): 1543-1546 [Abstract] ( 21 ) HTML (1 KB)  PDF (1214 KB)  ( 38 ) 1547 Clinical Effect of Neuroendoscopic Hematoma Removal in the Treatment of Chronic Subdural Hematoma in Adults BAO Jing, SUN Rui, WEI Shepeng, et al DOI: 10.3969/j.issn.1671-7171.2024.10.026 【Objective】To investigate the clinical effect of neuroendoscopic hematoma removal in the treatment of chronic subdural hematoma (CSDH) in adults. 【Methods】 The clinical data of 80 adult patients with CSDH admitted to our hospital from June 2021 to June 2023 were retrospectively analyzed. According to different treatment methods, the patients were divided into the control group (irrigation and drainage of single-pore hematoma via parietal tuberculum, n=38) and the observation group (removal of subdural hematoma by neuroendoscopy, n=42). The modified Rankin Scale (mRS) and Barthel index (BI) were used to evaluate the neurological function and daily living ability of the patients before and after surgery, and the length of hospital stay and recurrence rate of the two groups were compared. 【Results】Before operation, there was no statistical significance in the distribution of mRS Scores between the two groups (P>0.05). After operation, the improvement of mRS Score in the observation group was significantly better than that in the control group, and the difference was statistically significant (P<0.05). Before operation, there was no significant difference in BI index classification between the two groups (P>0.05). After operation, BI index improvement in the observation group was significantly better than that in the control group, and the difference was statistically significant (P<0.05). The duration of hospitalization in the observation group was shorter than that in the control group, and the postoperative recurrence rate was lower than that in the control group, the difference was statistically significant (P<0.05).【Conclusion】Neuroendoscopic surgery can better improve the neurological function and daily living ability of patients, shorten the length of hospital stay, and have a lower postoperative recurrence rate, which has high clinical application value. 2024 Vol. 41 (10): 1547-1549 [Abstract] ( 21 ) HTML (1 KB)  PDF (1250 KB)  ( 18 ) 1550 Relationship between of Golgi Protein 73 and Myeloperoxidase 3 with the Prognosis of Chronic Hepatitis B-related Hepatocellular Carcinoma Related to Chronic Hepatitis B SONG Zhifeng DOI: 10.3969/j.issn.1671-7171.2024.10.027 【Objective】 To explore the relationship between of Golgi protein 73 (GP73) and myeloperoxidase 3 (MPO3) with the prognosis of hepatocellular carcinoma (HCC) related to chronic hepatitis B (CHB).【Methods】 The study involved included 104 patients with CHB-related HCC as the observation group and 90 healthy volunteers as the control group. Serum levels of GP73 and MPO3 were compared between the two groups. A two-year follow-up was conducted to track the survival of the observation group. Based on survival outcomes, patients of the observation group were divided into the death group (21 cases) and the survival group (80 cases). Clinical data between the death and survival groups were compared, and risk factors affecting patient prognosis were analyzed. The predictive efficiency of GP73, MPO3, and their combined detection for patient prognosis was evaluated.【Results】 The GP73 level in the observation group was higher than that in the control group, while the MPO3 level was lower (P<0.05). The mortality rate of CHB-related HCC patients was 20.79% (21/101). The death group had higher proportions of patients in stage Ⅲ~Ⅳ, poorly differentiated tumors, maximum tumor diameter >5 cm, multiple tumors (>2), lymph node metastasis compared to the survival group, and elevated the level of GP73 was higher levels, with and lower MPO3 levels was lower in the death group than those in the survival group (P<0.05). Logistic regression analysis showed that clinical stage, GP73, and MPO3 were factors influencing patient prognosis (P<0.05). Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) for predicting patient prognosis using GP73, MPO3 alone, and their combined detection was 0.803, 0.717, and 0.913, respectively.【Conclusion】 Serum GP73 and MPO3 levels are correlated with the prognosis of CHB-related HCC patients. The combined detection of these two markers shows a higher predictive efficiency for patient prognosis. 2024 Vol. 41 (10): 1550-1553 [Abstract] ( 19 ) HTML (1 KB)  PDF (1214 KB)  ( 8 ) 1554 Application and Safety of Alfentanil Combined with Midazolam in Fiberoptic Bronchoscopy Intubation WANG Lu, YE Xia DOI: 10.3969/j.issn.1671-7171.2024.10.028 【Objective】 To investigate the application and safety of alfentanil combined with midazolam in fiberoptic bronchoscopy intubation.【Methods】 A total of 104 patients undergoing fiberoptic bronchoscopy intubation in our hospital were randomly divided into the observation group and the control group, with 52 patients in each group. The observation group received alfentanil combined with midazolam anesthesia, while the control group received midazolam combined with sufentanil anesthesia. The examination time, awakening time, Ramsay score, hemodynamic parameters, and incidence of adverse reactions were compared between the two groups.【Results】 The examination time and awakening time in the observation group were shorter than those in the control group (P<0.05). The Ramsay score after examination in the observation group was lower than that in the control group (P<0.05). The mean arterial pressure (MAP) and heart rate (HR) levels in both groups gradually increased from before surgery (T1) to immediately after anesthesia induction (T2) and 10 minutes after the start of surgery (T3), then decreased at the end of surgery (T4). The MAP and HR at T3 and T4 in the observation group were lower than those in the control group (P<0.05). The overall incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05).【Conclusion】 The use of alfentanil combined with midazolam in fiberoptic bronchoscopy intubation can shorten the patient&apos;s awakening time, achieve moderate sedation depth, stabilize hemodynamic parameters, and reduce the overall incidence of adverse reactions. It is worthy of clinical promotion and application. 2024 Vol. 41 (10): 1554-1556 [Abstract] ( 18 ) HTML (1 KB)  PDF (1251 KB)  ( 13 ) 1557 Value of General Anesthesia Combined with Ultrasound-guided Paravertebral Nerve Block in Thoracic Laparoscopic Surgery for Esophageal Cancer ZHE Tiantian, TIAN Longfei, SUN Yifei DOI: 10.3969/j.issn.1671-7171.2024.10.029 【Objective】 To investigate the value of general anesthesia combined with ultrasound-guided paravertebral nerve block (USG-PVB) in thoracic laparoscopic surgery for esophageal cancer. 【Methods】 A total of 86 patients who underwent thoracic laparoscopic surgery for esophageal cancer were randomly divided into the observation group and the control group, 43 cases in each group. Both groups underwent thoracic laparoscopic surgery, the control group was given general anesthesia, and the observation group was given general anesthesia combined with USG-PVB anesthesia. Intraoperative drug dosage and perioperative indexes were compared between the two groups. At 4 h(T1), 24 h(T2) and 48 h(T3), restlessness was assessed by Ricker sedation-agitation score (SAS) and pain was assessed by visual analog scale (VAS). The levels of immune function [CD3+, CD4+, natural killer cells (NK)] were compared between the two groups at different time points. The incidence of complications was compared between the two groups. 【Results】The intraoperative dosage of propofol, remifentanil and sufentanil in the observation group was significantly lower than that in the control group (P<0.05), and the dosage of deoxyadrenaline was significantly higher than that in the control group (P<0.05). There was no statistical significance in the dosage of ephedrine and nicadipine between two groups (P>0.05). The extubation time, waking time and postoperative hospitalization time in the observation group were significantly shorter than those in the control group (P<0.05), and there was no statistical significance in the operation time between the two groups (P>0.05). The SAS and VAS scores of the observation group at T1, T2 and T3 were significantly lower than those of the control group (P<0.05). The levels of CD3+, CD4+ and NK were significantly higher than those of the control group (P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05). 【Conclusion】The application of general anesthesia combined with USG-PVB anesthesia in thoracic laparoscopic surgery for esophageal cancer can effectively reduce the use of intraoperative drugs, which is conducive to postoperative recovery of patients, and can alleviate postoperative agitation and pain of patients, with little impact on immune function and fewer complications, which is worthy of clinical promotion and application. 2024 Vol. 41 (10): 1557-1560 [Abstract] ( 14 ) HTML (1 KB)  PDF (1216 KB)  ( 19 ) 1561 Clinical Effect of Danggui Fuling Jiawei Decoction Combined with Morphine Hydrochloride Sustained-release Tablets on Moderate and Severe Pain of Primary Liver Cancer LI Fang, QIAO Purong DOI: 10.3969/j.issn.1671-7171.2024.10.030 【Objective】To investigate the clinical effect of Danggui Fuling Jiawei Decoction combined with morphine hydrochloride sustained-release tablets in the treatment of moderate and severe pain of primary liver cancer. 【Methods】A total of 60 patients with moderate and severe pain of primary liver cancer treated in our hospital from June 2021 to June 2023 were selected and divided into the observation group (treated with Danggui Fuling Jiawei Decoction combined with morphine hydrochloride sustained-release tablets) and the control group (treated with morphine hydrochloride sustained-release tablets for pain) by random number table method, with 30 cases in each group. The analgesic efficiency, numerical Pain Assessment Scale (NRS) score, plasma D-dimer level, incidence of adverse reactions and comfort level were compared between the two groups after treatment.【Results】After treatment, NRS scores in the two groups were lower than before treatment, and the observation group was lower than the control group, the difference was statistically significant (P<0.05). On the 14th day of treatment, the GCQ score in both groups was higher than that on the 4th day, and the observation group was higher than the control group, the difference was statistically significant (P<0.05). The effective rate of analgesia in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05). After treatment, plasma D-dimer level in 2 groups was lower than before treatment, and the observation group was lower than the control group, the difference was statistically significant (P<0.05). The incidence of adverse reactions in observation group was lower than that in control group, and the difference was statistically significant (P<0.05). 【Conclusion】Danggui Fuling Jiawei Decoction combined with morphine hydrochloride sustained release tablets has good clinical efficacy in the treatment of moderate and severe pain of primary liver cancer, which can improve the hypercoagulable state of patients and alleviate morphine related side effects, and is worthy of clinical application. 2024 Vol. 41 (10): 1561-1563 [Abstract] ( 19 ) HTML (1 KB)  PDF (1249 KB)  ( 45 ) 1564 Effect of Five-Step Nutritional Support on the Nutritional Status and Chemotherapy Side Effects in Patients Undergoing Postoperative Adjuvant Chemotherapy for Gastric Cancer CHE Shuai, LU Lunjie, JIANG Xiao, et al DOI: 10.3969/j.issn.1671-7171.2024.10.031 【Objective】 To investigate the impact of five-step nutritional support on the nutritional status and side effects in patients undergoing postoperative adjuvant chemotherapy for gastric cancer. 【Methods】 Eighty patients undergoing postoperative adjuvant chemotherapy for gastric cancer were randomly divided into two groups, with 40 patients in each group. The observation group received five-step nutritional support, while the control group received conventional nutritional support. The nutritional status, blood biochemical indicators, chemotherapy side effects, and quality of life were compared between the two groups before and after the intervention. 【Results】After the intervention, the overall nutritional status subjective scoring (PG-SGA) decreased, while body mass index (BMI) and maximum calf circumference increased in both groups (P<0.05). The PG-SGA score in the observation group was lower than that in the control group, while both BMI and maximum calf circumference were higher in the observation group compared to the control group (P<0.05). After the intervention, hemoglobin (Hb), serum albumin (Alb), and serum prealbumin (PA) levels increased in both groups compared to before the intervention (P<0.05), and levels of Hb, Alb and PA in the observation group were higher than those in the control group (P<0.05). The overall incidence of chemotherapy side effects in the observation group (17.50%) was lower than that in the control group (45.00%) (P<0.05). At 3 and 6 months after the intervention, the scores of the Quality of Life Questionnaire for Gastric Cancer Patients in both groups were lower than those before the intervention, and the observation group&apos;s scores were lower than those of the control group (P<0.05). 【Conclusion】 The application of five-step nutritional support in patients undergoing postoperative adjuvant chemotherapy for gastric cancer can improve nutritional status, enhance blood biochemical indicators, reduce side effects, and improve the quality of life, making it worthy of clinical promotion and application. 2024 Vol. 41 (10): 1564-1567 [Abstract] ( 19 ) HTML (1 KB)  PDF (1210 KB)  ( 24 ) 1568 Effects of Jiawei Changpu Yujin Decoction Combined with Acupuncture on Sleep Quality, Depression and Anxiety in Cardio-renal Incompatibility Insomnia YAO Mo, LI Peihuan DOI: 10.3969/j.issn.1671-7171.2024.10.032 【Objective】To investigate the effects of Jiawei Changpu Yujin Decoction combined with acupuncture on sleep quality, anxiety and depression in patients with cardio-renal incompatibility insomnia. 【Methods】 The clinical data of 150 patients with cardio-renal in conformal insomnia admitted to our hospital from January 2022 to June 2023 were retrospectively analyzed. According to the treatment methods, they were divided into the control group (receiving conventional western medicine combined with acupuncture treatment) and the observation group (on the basis of the control group, receiving Jiawei Changpu Yujin Decoction treatment), with 75 cases in each group. The two groups were treated continuously for 3 courses, and the clinical efficacy, TCM syndrome score, sleep quality [Pittsburgh Sleep Quality Index (PSQI) score, sleep latency, rapid eye movement sleep time, total sleep time], anxiety state [Self-rating Anxiety Scale (SAS) score] and depression state [Self-rating Depression Scale (SDS) score] were compared between the two groups. 【Results】The total clinical effective rate of observation group was higher than that of the control group, the difference was statistically significant (P<0.05). After treatment, the scores of sleepless all night, easy to wake up after sleeping, five upset heat, waist and knee tenderness were lower than before treatment, and the observation group was lower than the control group, the difference was statistically significant (P<0.05). The sleep latency and REM sleep time of the two groups were shorter than before treatment, the total PSQI score was lower than before treatment, and the total sleep time was longer than before treatment, and the differences between the observation group and the control group were statistically significant (P<0.05). The SAS scores and SDS scores of the two groups were lower than before treatment, and the observation group was lower than the control group (P<0.05). 【Conclusion】Jiawei Changpu Yujin Decoction combined with acupuncture treatment can effectively improve the sleep quality of patients and alleviate the symptoms of anxiety and depression. 2024 Vol. 41 (10): 1568-1570 [Abstract] ( 16 ) HTML (1 KB)  PDF (1252 KB)  ( 13 ) 1571 Application Value of Deep Learning-based AI Software in CT Diagnosis of Fresh Rib Fractures LYU Dan, GAO Kaibo, DENG Shijie, et al DOI: 10.3969/j.issn.1671-7171.2024.10.033 【Objective】 To explore the application value of deep learning-based artificial intelligence (AI) software in the diagnosis of CT of fresh rib fractures.【Methods】A total of 259 qualified fresh fracture patients admitted to our hospital from June 2022 to September 2023 were selected and their imaging data were introduced to the AI workstation; Based on a 8-year attending physician in the department of radiology and AI software to diagnose rib fractures, the group A was diagnosed separately by AI software, and the group B and the group AB were diagnosed by physician combined with AI software. The number, site, and classification of fracture lesions were recorded in the three groups; The results of the three groups were analyzed with the reference standard to compare the sensitivity, misdiagnosis rate and detection rate of incomplete fractures in the three groups; Mean time of diagnosis was compared between the groups B and the group AB. 【Results】There were 563 fractures in 259 patients; There were 385 complete fractures and 178 incomplete fractures. The sensitivity of fracture detection in the group A, the group B and the group AB was 91.47%, 83.13%, and 92.54%, respectively. The sensitivity comparison of the three groups showed statistically significant differences (P<0.05).The sensitivity of fractures in the group A and the group AB was higher than that in the group B, significant (P<0.05). The misdiagnosis rates in the group A, the group B and the group AB were 20.03%, 13.17% and 12.58%, respectively, which was statistically significant (P<0.05).The group A had the highest misdiagnosis rate, significantly higher than that of the group AB and the group B, with a statistically significant difference (all P<0.05). The detection rate of incomplete fractures in the group A, the group B and the group AB was 75.28%, 50.56% and 76.40%, respectively, and the difference was statistically significant (P<0.05).The mean diagnosis time in the group AB was shorter than that of the group B , with significant difference(P<0.05).【Conclusion】The joint diagnosis between doctors and AI improves the sensitivity of the detection of fresh rib fractures, which is mainly reflected in the detection rate of incomplete fractures, and can also significantly shorten the diagnosis time and improve the work efficiency. 2024 Vol. 41 (10): 1571-1574 [Abstract] ( 22 ) HTML (1 KB)  PDF (1557 KB)  ( 12 )

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