医学临床研究
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2025 Vol. 42, No. 5
Published: 2025-05-26
Original Articles
Original Articles
737
Application of BiPAP Non-Invasive Ventilator in COPD Patients with Acute Exacerbation and Type Ⅱ Respiratory Failure
WANG Xiao, CHEN Gaoying, SHANG Yan
DOI: 10.3969/j.issn.1671-7171.2025.05.001
【Objective】To explore the application of bilevel positive airway pressure(BiPAP) non-invasive ventilator in patients with chronic obstructive pulmonary disease (COPD) experiencing acute exacerbation and type Ⅱ respiratory failure. 【Methods】From January 2022 to June 2023, 84 patients with COPD experiencing acute exacerbation and type Ⅱ respiratory failure were selected and randomly divided into the control group (receiving conventional nasal cannula oxygen therapy) and the observation group (receiving BiPAP non-invasive ventilator treatment), with 42 patients in each group. The levels of pulmonary function indicators [first-second forced expiratory volume (FEV
1
), forced vital capacity (FVC), peak expiratory flow rate (PEFR)], blood gas analysis indicators [arterial blood carbon dioxide partial pressure (PaCO
2
), arterial blood oxygen partial pressure (PaO
2
), arterial blood oxygen saturation (SaO
2
)], and serum inflammatory factors [interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP)] before and after treatment, as well as the occurrence of adverse reactions, were compared between the two groups. 【Results】After treatment, the FEV
1
, FVC, PEFR, PaO
2
, and SaO
2
levels in the observation group were higher than those in the control group, while the PaCO
2
and IL-6, hs-CRP levels were lower than those in the control group (P<0.05). The total incidence of adverse reactions in the observation group was 9.52%, significantly lower than 26.19% in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】Compared with conventional nasal cannula oxygen therapy, BiPAP non-invasive ventilator applied in patients with COPD experiencing acute exacerbation and type Ⅱ respiratory failure can more effectively improve the pulmonary function and blood gas indicators, reduce the levels of serum inflammatory factors, and the total incidence of adverse reactions, and has higher safety.
2025 Vol. 42 (5): 737-739 [
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11
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740
The Application Value of 3.0T Magnetic Resonance Histo Technology and Multi-Echo Dixon Technology in the Quantitative Analysis of Non-Alcoholic Fatty Liver Disease in Obese Children
TANG Jing, LI Chunwang, CAI Qifang, et al
DOI: 10.3969/j.issn.1671-7171.2025.05.002
【Objective】To explore the application value of 3.0T magnetic resonance Histo technology and multi-echo Dixon technology in the quantitative analysis of non-alcoholic fatty liver disease(NAFLD) in obese children. 【Methods】 A total of 137 children aged 7 to 15 years who were diagnosed as obese in the Department of Child Health Care of our hospital from December 2021 to December 2023 were prospectively selected, and 40 non-obese healthy children of the same age group who underwent physical examinations in our hospital during the same period (the healthy control group) were selected. According to the diagnosis and treatment guidelines for non-alcoholic fatty liver disease, obese children were divided into the simple obesity group (n=45), the NAFLD group (n=42), and the non-alcoholic steatohepatitis group (NASH group, n=50). All the research subjects underwent 3.0T magnetic resonance Histo and multi-echo Dixon technique examinations. The magnetic resonance spectroscopy-proton density fat fraction (MRS-PDFF) and magnetic resonance-proton density fat fraction (MRI-PDFF) of different groups were compared. 【Results】The MRS-PDFF and MRI-PDFF in the simple obesity group, NAFLD group and the NASH group showed an increasing trend. Comparisons among the groups showed statistically significant differences (P<0.05). The MRS-PDFF and MRI-PDFF in the simple obesity group, the NAFLD group and the NASH group were significantly higher than those in the healthy control group. The differences were all statistically significant (P<0.05). Pearson correlation analysis showed that MRS-PDFF was significantly correlated with MRI-PDFF in the healthy control group, the simple obesity group, the NAFLD group, and the NASH group (P<0.05). Spearman correlation analysis showed that there was no significant correlation between MRS-PDFFF and MRI-PDF in obese children and BMI or waist circumference/height (all P>0.05). 【Conclusion】 The 3.0T magnetic resonance Histo technique and the multi-echo Dixon technique can quantitatively assess the fat content of the liver more accurately, identify the fat infiltration of the liver at an early stage, and distinguish the degree of liver fat infiltration in different obese children.
2025 Vol. 42 (5): 740-743 [
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10
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744
The Influence of Perioperative Nursing Intervention on Deep Vein Thrombosis of the Lower Extremities after Cesarean Section
CAO Meiting, ZHU Xiaoxiu, KANG Jing
DOI: 10.3969/j.issn.1671-7171.2025.05.003
【Objective】To explore the influence of perioperative nursing intervention on the prevention of deep vein thrombosis of the lower extremities after cesarean section. 【Methods】A total of 100 parturients who underwent cesarean section and were admitted to our hospital from January 2020 to December 2021 were selected as the research objects and divided into the control group and the observation group according to the random number table method, with 50 cases in each group. The coagulation function, platelet level, recovery condition and lower extremity circumference of the two groups of parturients were compared. 【Results】After the intervention, the prothrombin time (PT), D-dimer (D-D) level, fibrinogen (Fbg) level and platelet count (PLT) in the observation group were all better than those in the control group, and the differences were statistically significant (P<0.05). The amount of postpartum hemorrhage in the observation group was less than that in the control group. The time of first getting out of bed, the time of first anal exhaust, and the length of hospital stay in the observation group were all shorter than those in the control group. The differences were statistically significant (P<0.05). After the intervention, the 15 cm diameter above the patellar and the 10 cm diameter below the patellar in the observation group were smaller than those in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】Implementing perioperative nursing for parturients undergoing cesarean section can prevent deep vein thrombosis of the lower extremities, improve the coagulation function indicators of parturients, promote the recovery of parturients, and improve prognosis. It is worthy of promotion and application.
2025 Vol. 42 (5): 744-746 [
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10
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747
Analysis of Risk Factors for Type 2 Diabetic Peripheral Neuropathy
REN Lu, WANG Dongwei, SUN Yangli, et al
DOI: 10.3969/j.issn.1671-7171.2025.05.004
【Objective】To investigate the risk factors of type 2 diabetic peripheral neuropathy (DPN). 【Methods】A total of 163 patients with type 2 diabetes diagnosed and treated in our hospital from June 2021 to June 2023 were selected and divided into the control group (without DPN, n=88) and the observation group (with DPN, n=75) according to whether the patients were combined with DPN. Clinical data were collected. The correlation between the Michigan Peripheral Neuropathy Screening List (MNSI) score and clinical features of the patients was analyzed, and the risk factors of DPN were analyzed by Logistic regression. 【Results】The results of single factor analysis showed that diabetic retinopathy (DR), glomerular filtration rate (eGFR), the proportion of high blood sugar time above range (TAR) and low blood sugar time below range (TBR) within 24 h, homocysteine (Hcy), and disease course were compared between the two groups, The difference was statistically significant (P<0.05). The results of linear regression analysis showed that TAR, disease duration and DR were positively correlated with MNSI score (P<0.05), while eGFR was negatively correlated with MNSI score (P<0.05). Logistic regression analysis showed that eGFR, Hcy and DR were positively correlated with DPN (P<0.05). 【Conclusion】The occurrence and development of DPN are related to blood glucose level, microcirculation and neurodystrophy. Comprehensive management of risk factors is important for the prevention and treatment of DPN.
2025 Vol. 42 (5): 747-750 [
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13
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751
The Influence of Bevacizumab Combined with Conventional Treatment on the Levels of Serum IGF-1 and GFAP in Patients with Distant Recurrence of Glioma
YUAN Xing, WANG Naibing
DOI: 10.3969/j.issn.1671-7171.2025.05.005
【Objective】 To investigate the effect of bevacizumab combined with conventional treatment on the levels of serum insulin growth factor-1 (IGF-1) and glial fibrillary acidic protein (GFAP) in patients with distant recurrence of glioma. 【Methods】A total of 78 patients with distant recurrence of glioma admitted to our hospital from January 2020 to January 2024 were selected and divided into the control group (treated with conventional therapy) and the observation group (treated with bevacizumab combined with conventional therapy) by the random number table method, with 39 cases in each group. The short-term therapeutic effects and long-term survival rates of the two groups of patients were compared. The levels of serum IGF-1 and GFAP before and after treatment, as well as the scores of the Stroke Scale (NIHSS) and the Quality of Life Scale for Cancer Patients (EORTIC QLQ-C30) of the two groups of patients were also compared. 【Results】The total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the expression levels of serum IGF-1 and GFAP in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group, with statistically significant differences (P<0.05). After 1 month and 3 months of treatment, the NIHSS scores of both groups were lower than those before treatment, and the scores of the observation group were lower than those of the control group. The difference was statistically significant (P<0.05). The EORTIC QLQ-C30 scores of the two groups of patients were higher than those before treatment, and the observation group was higher than the control group. The difference was statistically significant (P<0.05). The 2-year and 3-year survival rates of patients in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】 Bevacizumab combined with conventional treatment can significantly improve the long-term survival rate of patients with distant recurrence of glioma, with good clinical efficacy. It can improve the neurological function of patients and enhance their quality of life.
2025 Vol. 42 (5): 751-753 [
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8
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754
The Characteristics of Vitamin D Status and Parathyroid Hormone Level Changes in Girls with Central Precocious Puberty
XU Zihui
DOI: 10.3969/j.issn.1671-7171.2025.05.006
【Objective】To explore the changing characteristics of vitamin D status and parathyroid hormone (PTH) level in girls with central precocious puberty (CPP). 【Methods】A total of 81 girls with CPP who visited our hospital from January 2022 to June 2024 were selected as the observation group, and 81 healthy girls who underwent physical examinations in our hospital during the same period were selected as the control group. The growth rates and the levels of blood calcium, blood phosphorus, 25-hydroxyvitamin D[25(OH)D], and PTH of the two groups were compared. The laboratory indicators of different seasons and different vitamin D status of the two groups were compared. The clinical data of CPP girls with different vitamin D status were compared as well. 【Results】There was no statistically significant difference in the levels of blood calcium, blood phosphorus and blood 25(OH)D between the two groups (P>0.05). The growth rate and blood PTH level in the observation group were both higher than those in the control group (P<0.05). The PTH levels in the two groups in summer were significantly lower than those in the other three seasons (P<0.05), while the 25(OH)D levels of the two groups in summer were significantly higher than those in the other three seasons (P<0.05). The PTH level of the observation group in spring, summer, autumn and winter was significantly higher than that of the control group (P<0.05). There was no statistically significant difference in the levels of calcium and phosphorus between the two groups with different vitamin D status (P>0.05). The PTH levels of children with normal vitamin D in both groups were lower than those of children with vitamin D deficiency and insufficient vitamin D (P<0.05). The PTH levels of children in the observation group with different vitamin D status were all higher than those in the control group (P<0.05). 【Conclusion】The vitamin D level of female children with CPP was comparable to that of healthy girl volunteers, suggesting that there was no correlation between vitamin D status and the occurrence of CPP. The PTH level of children with CPP was significantly increased.
2025 Vol. 42 (5): 754-757 [
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758
Clinical Efficacy of Transarterial Chemoembolization Combined with Targeted Immunotherapy for Primary Liver Cancer
YE Cheng, WANG Jianan, ZHU Xiaoxu
DOI: 10.3969/j.issn.1671-7171.2025.05.007
【Objective】 To explore the clinical efficacy of transarterial chemoembolization (TACE) combined with targeted immunotherapy in the treatment of primary liver cancer.【Methods】 A total of 80 patients with primary liver cancer were divided into the control group (37 cases, treated with TACE alone) and the observation group (43 cases, treated with TACE combined with targeted immunotherapy) based on different treatment modalities. The clinical efficacy, changes in liver function indicators, incidence of complications, and survival outcomes were compared between the two groups.【Results】 The objective response rate and disease control rate in the observation group were higher than those in the control group (P<0.05). After treatment, liver function in both groups improved compared to pre-treatment levels, with the observation group showing a more significant improvement than the control group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The 1-year survival rate, overall survival, and progression-free survival in the observation group were superior to those in the control group (P<0.05).【Conclusion】 TACE combined with targeted immunotherapy can improve the objective response rate and disease control rate, enhance liver function, and prolong survival in patients with primary liver cancer, demonstrating significant clinical value.
2025 Vol. 42 (5): 758-760 [
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761
The Application Effect of Childlike Health Education Based on the Ahmadi Model in Children with Chronic Sinusitis
LI Juan, ZHANG Surui, LI Aihui, et al
DOI: 10.3969/j.issn.1671-7171.2025.05.008
【Objective】To explore the application effect of childlike health education based on the Ahmadi model in children with chronic sinusitis. 【Methods】 A total of 104 children with chronic sinusitis admitted to our hospital from April 2023 to November 2024 were selected and divided into the control group (receiving conventional health education) and the observation group (receiving childlike health education based on the Ahmadi model) according to the random number table method, with 52 cases in each group. The mastery of health knowledge, nasal ventilation function, nasal cavity and paranasal sinus outcome test-20 (SNOT-20) score, levels of inflammatory indicators and treatment compliance of the two groups before the intervention and 4 weeks after the intervention were compared. 【Results】 After 4 weeks of intervention, the score of the health knowledge questionnaire in the observation group was higher than that in the control group. The SNOT-20 score and the levels of interleukin-6(IL-6),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α) in the observation group were all lower than those in the control group, and the treatment compliance was higher than that in the control group. The differences were statistically significant (P<0.05). 【Conclusion】 The childlike health education based on the Ahmadi model can significantly improve the health knowledge level and treatment compliance of children with chronic sinusitis, improve clinical symptoms and enhance the quality of life, and has a good clinical application prospect.
2025 Vol. 42 (5): 761-764 [
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765
The Application of Modified Padua Score in the Implementation of VTE Individualized Protection Scheme for COPD Patients
ZHANG Yamin, WEN Shujing, HUO Yinghui
DOI: 10.3969/j.issn.1671-7171.2025.05.009
【Objective】To explore the effect of modified Padua score on the individualized protection plan for venous thromboembolism (VTE) in patients with chronic obstructive pulmonary disease (COPD).【Methods】A total of 100 COPD patients admitted to our hospital from January 2021 to May 2024 were selected and divided into the observation group (implementing the VTE individualized protection program based on the modified Padua score) and the control group (implementing the VTE individualized protection program based on the Padua score) according to the random number table method, with 50 cases in each group. The coagulation indicators, incidence of VTE and nursing satisfaction of the two groups were compared on the day of admission and at 10 days of hospitalization. 【Results】At 10 days of hospitalization, the activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) of both groups and the two groups of low-risk and high-risk patients were significantly prolonged compared with those on the day of admission, and the fibrinogen (FIB) level was significantly decreased compared with that on the day of admission (P<0.05). Moreover, the APTT, PT and TT of the high-risk and low-risk patients in the observation group were all longer than those in the control group, and the FIB level was lower than that in the control group (P<0.05). However, there was no statistically significant difference in the levels of APTT, PT, TT and FIB between the two groups (P>0.05). There was no statistically significant difference in the incidence of VTE between the two groups (P>0.05). At 10 days of hospitalization, there was no statistically significant difference in the scores of each field and the total score of the Nursing Satisfaction Scale (NSQI) between the two groups (P>0.05). 【Conclusion】 The two VTE individualized protection plans which are based on the Padua score and the modified Padua score can effectively prevent the occurrence of VTE in patients with CODP. The nursing satisfaction is acceptable. However, the individualized protection plan for VTE based on the modified Padua score is more effective in improving the coagulation indicators of high-risk VTE patients.
2025 Vol. 42 (5): 765-768 [
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769
Uncommon Types of Thalassemia Carriers and Related Clinical Features in Hezhou Region
ZHAO Yulan, LIN Qingfang, WANG Chunlian, et al
DOI: 10.3969/j.issn.1671-7171.2025.05.010
【Objective】 To investigate the uncommon (rare) types of thalassemia (thal) carriers and their clinical characteristics in Hezhou, Guangxi, in order to provide better reference for genetic diagnosis and prenatal screening.【Methods】 A total of 5462 thalassemia screening-positive samples collected between 2022 and 2024 underwent routine thalassemia genetic testing. Samples with inconsistent results between screening and routine genetic testing were selected for further study. After excluding iron-deficiency anemia, techniques such as Gap-PCR and gene sequencing were used for further analysis.【Results】 A total of 48 rare thalassemia gene mutations were identified, including 21 cases of α-thalassemia and 27 cases of β-thalassemia. Among α-thalassemia cases, the top three mutation types were: αα/ααα
anti3.7
(6 cases, 28.57%), --
THAI
/αα (Thailand type, 5 cases, 23.81%), and α
IVS-II-55
α/αα (3 cases, 14.29%). For β-thalassemia, β
-50
/β
N
was the most common (11 cases, 40.74%), followed by β
CD37
/β
N
(6 cases, 22.22%).【Conclusion】 Some rare thalassemia mutations in Hezhou, particularly certain severe types, are not actually rare. It is recommended to pay more attention to the detection of β
CD37
/β
N
, β
-50
/β
N
, and αα/ααα
anti3.7
in routine genetic screening, which may help effectively prevent the birth of children with moderate to severe thalassemia.
2025 Vol. 42 (5): 769-772 [
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773
Predictive Value of Epicardial Adipose Tissue Thickness and Inflammatory Factors for Recurrence after Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation
HE Xiuhua, JIA Yadan, ZHAI Huaji, et al
DOI: 10.3969/j.issn.1671-7171.2025.05.011
【Objective】 To investigate the value of epicardial adipose tissue thickness (EATT) and inflammatory factors in predicting recurrence after radiofrequency catheter ablation (RFCA) in patients with atrial fibrillation (AF).【Methods】 A total of 180 AF patients who underwent RFCA in our hospital were included in the study. According to follow-up results, they were divided into the recurrence group (61 cases) and the non-recurrence group (119 cases). The levels of EATT and inflammatory factors [high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8)] were compared between the two groups. Their relationship with AF recurrence and their predictive value were analyzed.【Results】 The recurrence group had significantly higher levels of EATT, hs-CRP, TNF-α, IL-6, and IL-8 than the non-recurrence group (P<0.05). Multivariate logistic regression analysis showed that EATT, hs-CRP, TNF-α, IL-6, and IL-8 were independent risk factors for AF recurrence after ablation (all OR>1, P<0.05). Receiver operating characteristic (ROC) curve analysis indicated that the combination of EATT and inflammatory factors had the highest predictive value for postoperative AF recurrence, with an area under the curve (AUC) of 0.974, sensitivity of 93.4%, and specificity of 96.6%.【Conclusion】 EATT and inflammatory factors are closely associated with AF recurrence after RFCA. Combined detection of EATT and inflammatory factors offers high sensitivity and specificity in predicting recurrence, which has important clinical value.
2025 Vol. 42 (5): 773-775 [
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776
Evaluation System of Quality Sensitive Indicators for Obstetric Interventions in Vaginal Birth after Cesarean Based on Delphi Method
HAN Xiaohui, WANG Dan, LI Li
DOI: 10.3969/j.issn.1671-7171.2025.05.012
【Objective】To explore the establishment of an evaluation system for quality sensitive indicators of obstetric interventions in vaginal birth after cesarean (VBAC) based on the Delphi method. 【Methods】From October 2022 to February 2023, this study adopted literature review, focus group discussion, and Delphi expert consultation to collect and confirm the sensitive quality indicators for obstetric interventions in VBAC. The process involved gathering data from existing research, conducting in-depth interviews with focus group members, and soliciting opinions from experts in various fields via the Delphi method to ensure the comprehensiveness and scientific validity of the identified indicators. 【Results】The positive coefficient of the two rounds of expert consultation was 100%, with authority coefficients of 0.88 and 0.94, and the coefficient of variation ranged from 0.06 to 0.26. The constructed hierarchical indicators for nursing quality sensitivity in VBAC included 3 first-level indicators, 9 second-level indicators, and 33 third-level indicators. 【Conclusion】This study successfully established a system of quality sensitive indicators for obstetric interventions in VBAC, comprising 3 first-level indicators, 9 second-level indicators, and 33 third-level indicators. The Delphi expert consultation method ensured the scientificity, comprehensiveness, and practicality of the indicator system.
2025 Vol. 42 (5): 776-779 [
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780
Loneliness and its Correlation with Self-Defense Style and Aggression among Adolescents with Bullying Experience
FAN Yuanyuan
DOI: 10.3969/j.issn.1671-7171.2025.05.013
【Objective】To explore the relationship of loneliness with self-defense style and aggressiveness in adolescents with bullying experience. 【Methods】The data of 101 adolescents with bullying experience admitted to the hospital from January 2021 to February 2024 were reviewed, and the loneliness of adolescents with bullying experience was assessed according to the third edition of the Loneliness Scale (UCLA-3). UCLA-3 score ≤39 points was considered as low loneliness, and UCLA-3 score > 39 points was considered as high loneliness. The factors influencing the loneliness of bullying victims were analyzed, and Pearson method was used to analyze the relationship of loneliness with self-defense style and aggression. 【Results】In the high loneliness group, the proportion of > 6 months' left-behind experience, the proportion of interpersonal distress and the score of Baker Depression Scale (BDI) were higher than those in the low loneliness group, while the score of Psychological Resilience Scale (CDRISC) and Family Intimacy and Adaptability Scale (FACESCV) in the high loneliness group were lower than those in the low loneliness group (P<0.05). Logistic regression analysis showed that BDI score, interpersonal distress score, CDRISC score were the factors that affected the loneliness of the bullying victims (P<0.05). Pearson correlation analysis showed that the loneliness UCLA-3 score of adolescents with bullying victimization experience was positive correlation with the aggression questionnaire (BPAQ) score and the defense Style Questionnaire (DSQ) -immature defense mechanism score (P<0.05). The score of UCLA-3 was negatively correlated with the score of DSQ-mature defense mechanism (P<0.05). 【Conclusion】BDI score, interpersonal distress and CDRISC score are related to the loneliness of bullying victims, and the loneliness of bullying victims is also related to self-defense style and aggression.
2025 Vol. 42 (5): 780-783 [
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784
Clinical Efficacy of Metformin Combined with Mecobalamin in Treating DPNP Patients and its Impact on Nerve Conduction Velocity
ZHOU Yuanting
DOI: 10.3969/j.issn.1671-7171.2025.05.014
【Objective】To investigate the clinical efficacy of metformin combined with mecobalamin in treating patients with diabetic peripheral neuropathic pain (DPNP) and its effect on nerve conduction velocity. 【Methods】One hundred DPNP patients admitted to our hospital from July to December 2021 were divided into the control group (50 cases, treated with mecobalamin) and the observation group (50 cases, treated with metformin combined with mecobalamin) using a random number table method. General data, biochemical indicators, Visual Analogue Scale (VAS) scores, nerve conduction velocity, and adverse reactions were compared between the two groups. 【Results】There were no significant differences in gender, age, disease duration, or smoking history between the two groups (P>0.05), and no significant differences in body mass index before treatment or after 12 and 24 weeks of treatment (P>0.05). After 12 and 24 weeks of treatment, fasting plasma glucose (FPG), 2-hour postprandial blood glucose, glycosylated hemoglobin (HbA1c) levels, and VAS scores were lower than those before treatment in both groups, with the observation group showing more significant reductions. Fasting C-peptide (FCP) and 2-hour postprandial C-peptide levels were higher than those before treatment in both groups, with the observation group showing higher levels (P<0.05). The motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of the tibial and peroneal nerves were higher than those before treatment in both groups after 12 and 24 weeks of treatment, with the observation group showing faster velocities (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】Metformin combined with mecobalamin can significantly reduce blood glucose levels, alleviate pain, and improve nerve conduction velocity in DPNP patients, with safe and controllable medication.
2025 Vol. 42 (5): 784-787 [
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788
Diagnostic Value of Serum P53, VEGF, TgAb, TPOAb Combined with Contrast-Enhanced Ultrasound Quantitative Parameters in Differentiating Benign and Malignant Thyroid Nodules
WA Zengcheng, JIA Deyan, DU Ting
DOI: 10.3969/j.issn.1671-7171.2025.05.015
【Objective】To investigate the diagnostic value of serum p53, vascular endothelial growth factor (VEGF), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) combined with contrast-enhanced ultrasound (CEUS) quantitative parameters in differentiating benign and malignant thyroid nodules. 【Methods】 A total of 100 patients with thyroid nodules admitted to the Qinghai Red Cross Hospital from April 2020 to April 2023 were selected and divided into the benign group (n=71) and the malignant group (n=29) based on pathological results. Serum levels of p53, VEGF, TgAb, TPOAb, and CEUS parameters [time to peak (TTP), peak intensity (Imax)] were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of the combined markers, and Pearson analysis was performed to assess the correlation between serum markers and malignant thyroid nodules. 【Results】The benign group exhibited lower levels of p53, VEGF, TgAb, and TPOAb, longer TTP, and higher Imax compared to the malignant group. ROC analysis showed that the combination of serum markers and CEUS parameters achieved a sensitivity of 96.6%, specificity of 97.2%, and area under the ROC curve (AUC) of 0.988, outperforming individual indicators. Correlation analysis revealed that serum p53, VEGF, TgAb, and TPOAb were positively correlated with malignant thyroid nodules (P<0.05). 【Conclusion】The combination of serum p53, VEGF, TgAb, TPOAb, and CEUS parameters can effectively improve the diagnostic accuracy for differentiating benign and malignant thyroid nodules, demonstrating high sensitivity and specificity.
2025 Vol. 42 (5): 788-790 [
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791
Diagnostic Value of Free Antibody Test and Direct Antiglobulin Test in Hemolytic Disease of the Newborn
QIU Cui, LI Ya, LI Xiaolei
DOI: 10.3969/j.issn.1671-7171.2025.05.016
【Objective】To explore the diagnostic value of the free antibody test and direct antiglobulin test (DAT) in hemolytic disease of the newborn (HDN).【Methods】 Blood samples were collected from 200 suspected HDN infants and their mothers for free antibody test and DAT. The incidence of HDN was compared across different genders, blood types, maternal-fetal blood type combinations, and antibody titers. The relationship between infant age (counted by days) and the results of free antibody test and DAT was analyzed. The diagnostic efficacy of the combined detection of free antibody test and DAT was evaluated using the receiver operating characteristic (ROC) curve.【Results】 Among 200 suspected HDN cases, 108 were diagnosed with HDN. There was no statistically significant difference in the incidence of HDN between male and female infants (P>0.05). The incidence of ABO HDN was significantly higher than that of Rh HDN (P<0.05). The incidence of O-A type (indicating maternal and infant blood type) HDN was higher than that of O-B type HDN (P<0.05). The incidence of HDN increased with rising antibody titers (<64, 64, 128, 256), and the differences among the groups were statistically significant (P<0.05). The detection rate of HDN by the free antibody test was higher than that of DAT. The effect of infant age on the free antibody test was not statistically significant (P>0.05), whereas it had a significant impact on DAT (P<0.05). The ROC curve analysis showed that the area under the curve for the combined detection of free antibody test and DAT was significantly larger than that for either test alone (P<0.05).【Conclusion】 The free antibody test and DAT have certain diagnostic value for HDN, and their combined detection provides a higher diagnostic value. It is recommended for widespread application.
2025 Vol. 42 (5): 791-794 [
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795
Value of NLR, PLR Combined with Serum Creatinine and Ejection Fraction Score in Predicting MACE Events after PCI in STEMI Patients
LI Yuan
DOI: 10.3969/j.issn.1671-7171.2025.05.017
【Objective】To investigate the value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) combined with serum creatinine and ejection fraction score in predicting major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).【Methods】 NLR, PLR, serum creatinine, and ejection fraction score were measured 24 hours postoperatively in 85 STEMI patients who underwent PCI. Patients were divided into the MACE occurrence group and the MACE non-occurrence group based on whether they experienced MACE within one year postoperatively. The relevant factors associated with MACE and the predictive efficacy of NLR, PLR, serum creatinine, ejection fraction score, and their combination in predicting MACE were analyzed. 【Results】After a one-year follow-up, 19 out of 85 STEMI patients experienced MACE, with an incidence rate of 22.35%, while 66 patients (77.65%) did not. Patients in the MACE occurrence group had significantly higher age, stent length, postoperative 24-hour white blood cell count, high-sensitivity C-reactive protein (hs-CRP), NLR, PLR, serum creatinine, and ejection fraction score compared to the MACE non-occurrence group (P<0.05). Logistic multivariate regression analysis showed that age, postoperative 24-hour NLR, PLR, serum creatinine, and ejection fraction score were influencing factors for MACE occurrence within one year in STEMI patients (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) values for predicting MACE occurrence using postoperative 24-hour NLR, PLR, serum creatinine, ejection fraction score, and their combination were 0.791, 0.802, 0.821, 0.813, and 0.892, respectively, with the combined prediction showing superior efficacy compared to individual predictors (P<0.05). 【Conclusion】 Postoperative 24-hour NLR, PLR, and serum creatinine combined with the ejection fraction score can be used to predict and assess MACE occurrence within one year after PCI in STEMI patients, with their combined use demonstrating higher predictive efficacy.
2025 Vol. 42 (5): 795-798 [
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8
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799
Clinical Efficacy of Pyrotinib Combined with TP Regimen in the Treatment of Breast Cancer
SHI Yushuai, YUE Saichao
DOI: 10.3969/j.issn.1671-7171.2025.05.018
【Objective】 To explore the efficacy of pyrotinib combined with the TP regimen (paclitaxel plus cisplatin) in the treatment of breast cancer patients.【Methods】 A total of 100 breast cancer patients were divided into the control group and the observation group based on different treatment regimens, with 50 cases in each group. The control group received the TP regimen, while the observation group was treated with pyrotinib combined with the TP regimen. The clinical application effects of different treatment regimens were compared between the two groups.【Results】 The disease control rate, post-treatment serum microRNA-22-3P (miR-22-3P) level, immune indicators CD4
+
, CD4
+
/CD8
+
ratio, progression-free survival, and overall survival in the observation group were all higher than those in the control group (P<0.05). Meanwhile, the post-treatment cysteine-rich protein 61 (CYR61) level and CD8
+
level in the observation group were lower than those in the control group (P<0.05).【Conclusion】 Pyrotinib combined with the TP regimen for breast cancer treatment can effectively increase serum miR-22-3P level, reduce CYR61 level, continuously improve immune function, prolong progression-free survival and overall survival, and it has good safety.
2025 Vol. 42 (5): 799-801 [
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12
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802
Diagnostic Value of Multi-Slice Spiral CT Image Texture Feature Analysis for Pulmonary Nodules
LI Chao
DOI: 10.3969/j.issn.1671-7171.2025.05.019
【Objective】To analyze the diagnostic value of multi-slice spiral CT image texture in pulmonary nodules. 【Methods】A total of 83 patients with pulmonary nodules admitted to our hospital from January 2018 to March 2023 were retrospectively analyzed and divided into the benign group (n=20, benign pulmonary nodules) and the malignant group (n=63, malignant pulmonary nodules) according to pathological diagnosis results. All patients were examined by multi-slice spiral CT. The image features of the two groups were compared, and the influencing factors of the occurrence of malignant pulmonary nodules were analyzed by Logistic regression model. The receiver operating characteristic (ROC) curve was drawn to analyze the value of texture features in the differential diagnosis of pulmonary nodules. 【Results】The mean value of multi-slice spiral CT image textures in the malignant group was higher than that in the benign group (P<0.05), and the skewness of the malignant group was lower than that of the benign group (P<0.05). There was no statistical significance in kurtosis and inhomogeneity between the two groups (P>0.05). Logistic regression analysis showed that both mean value and skewness were influencing factors for distinguishing the occurrence of malignant pulmonary nodules (P<0.05).The ROC curve results showed that the cutoff of the driving influencing factor was 15.34, the sensitivity was 88.89%, the specificity was 75.00%, the area under the curve was 0.798 (95%
CI
: 0.697-0.878) (P<0.05), and the Youden index was 0.639.【Conclusion】It is valuable to establish a driving factor model based on mean value and skewness in the texture of multi-slice spiral CT images. This method has high clinical value in the diagnosis of malignant pulmonary nodules.
2025 Vol. 42 (5): 802-804 [
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5
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805
Effect of Bevacizumab Combined with Neoadjuvant Chemotherapy on Tumor Marker Levels and Prognosis in Patients with Locally Advanced Cervical Cancer
KANG Hongmei, GAO Dongmei, WANG Feipeng, et al
DOI: 10.3969/j.issn.1671-7171.2025.05.020
【Objective】 To investigate the effect of bevacizumab combined with neoadjuvant chemotherapy on tumor marker levels and prognosis in patients with locally advanced cervical cancer.【Methods】 A total of 98 patients with locally advanced cervical cancer were randomly divided into the observation group and the control group, with 49 cases in each group. The control group was treated with a neoadjuvant chemotherapy regimen, while the observation group received bevacizumab in addition to the same chemotherapy regimen as control. Clinical efficacy, levels of T lymphocyte subsets (CD4
+
, CD8
+
, CD4
+
/CD8
+
), serum tumor markers [squamous cell carcinoma antigen (SCC), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA)], incidence of adverse reactions, and 1-year survival were compared between the two groups.【Results】 The objective response rate (ORR) and disease control rate (DCR) in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the levels of CD4
+
and CD4
+
/CD8
+
increased, while CD8
+
levels decreased in both groups (P<0.05); moreover, the observation group showed higher CD4
+
and CD4
+
/CD8
+
levels and lower CD8
+
levels compared with the control group (P<0.05). After treatment, serum levels of CEA, CA125, and SCC in both control and observation groups were significantly lower than those before treatment (P<0.05), with the observation group showing significantly lower levels than the control group (P<0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P>0.05). Both groups were followed up for 1 year postoperatively, and Kaplan-Meier survival analysis showed no statistically significant difference in survival rate between the two groups (Log-Rank=1.800, P=0.180).【Conclusion】 Bevacizumab combined with neoadjuvant chemotherapy can effectively improve clinical symptoms and reduce tumor marker levels in patients with locally advanced cervical cancer.
2025 Vol. 42 (5): 805-808 [
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13
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809
Correlation Analysis of DCE-MRI Quantitative Parameters with ER, PR and HER-2 Levels in Patients with Breast Cancer
WU Xuefen
DOI: 10.3969/j.issn.1671-7171.2025.05.021
【Objective】To investigate the correlation between quantitative parameters of dynamic enhanced magnetic resonance imaging (DCE-MRI) and the levels of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) in breast cancer patients.【Methods】A total of 80 breast cancer patients admitted to both chambers from May 2021 to May 2023 were selected. All patients underwent DCE-MRI examination to observe and record tumor characteristics, including tumor size, boundary, enhancement mode and lymph node metastasis. Quantitative parameters, including volume transfer constant (K
trans
), rate constant (K
ep
) and extravascular cell space volume ratio (V
e
), were measured and recorded, and the levels of ER, PR and HER-2 were detected. The differences in tumor characteristics and volume characteristics of patients with different ER, PR and HER-2 expression levels were compared. Spearman correlation was used to analyze the correlation between DCE-MRI quantitative parameters and the expression of ER, PR and HER-2 in breast cancer patients. 【Results】The positive expression rate of HER-2 in tumor diameter <25 mm was lower than ≥25 mm, and the difference was statistically significant (P<0.05). The positive expression rates of ER and PR in irregular borderlines were lower than those in burr borderlines, with statistical significance (P<0.05). The positive expression rates of ER, PR and HER-2 in patients with lymph node metastasis were higher than those without lymph node metastasis, and the difference was statistically significant (P<0.05). There was no significant difference in K
trans
, K
ep
and V
e
among breast cancer patients with different ER expression levels (P>0.05). K
trans
and K
ep
in breast cancer patients with positive expression of PR were higher than those with negative expression of PR, and the difference was statistically significant (P<0.05). The K
ep
of breast cancer patients with positive expression of HER-2 was higher than that of positive and negative expression of HER-2, and the difference was statistically significant (P<0.05). Spearman correlation analysis showed that the expression level of K
trans
and K
ep
was positively correlated with PR (P<0.05), and the expression level of K
ep
was positively correlated with HER-2 (P<0.05). 【Conclusion】DCE-MRI quantitative parameters K
trans
and K
ep
are closely related to the expression level of PR. Clinical DCE-MRI examination can be performed on breast cancer patients, so as to provide references for preliminary clinical assessment of the patient's condition and subsequent comprehensive treatment.
2025 Vol. 42 (5): 809-812 [
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813
Correlation Analysis of Peripheral Inflammatory Cytokine Levels and Unstable Angina Pectoris
ZHANG Jinwei, ZHOU Qian
DOI: 10.3969/j.issn.1671-7171.2025.05.022
【Objective】To investigate the correlation between serum levels of human chondroitin sulfate proteoglycan 40 (YKL-40), high-sensitivity C-reactive protein (hs-CRP), interleukin-17 (IL-17), interleukin-23(IL-23),interleukin-1β(IL-1β), and tumor necrosis factor-α (TNF-α) and unstable angina pectoris (UAP). 【Methods】Eighty-seven UAP patients (UAP group), 60 stable angina pectoris (SAP) patients (SAP group), and 52 healthy controls with normal coronary angiography results during the same period were enrolled from January 2022 to January 2024. Serum levels of YKL-40, hs-CRP, IL-17, IL-23, IL-1β, and TNF-α were compared across groups. The predictive efficacy of these cytokines for UAP was evaluated using receiver operating characteristic (ROC) curves. 【Results】Serum levels of YKL-40, hs-CRP, IL-17, IL-23, IL-1β, and TNF-α were significantly higher in the UAP group than in the SAP group and control group (P<0.05), and significantly higher in the SAP group than in the control group (P<0.05). All cytokines showed certain predictive efficacy for UAP (P<0.05), with areas under the curve (AUC) of 0.903, 0.891, 0.773, 0.801, 0.756, and 0.736, respectively.【Conclusion】 YKL-40, hs-CRP, IL-17, IL-23, IL-1β, and TNF-α may be involved in the progression of UAP and could serve as serum markers for UAP prediction.
2025 Vol. 42 (5): 813-815 [
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816
Predictive Value of Combined Detection of Four Coagulation Indicators for Pregnancy Outcomes in Mid-Pregnancy Patients with Pregnancy-Induced Hypertension
YANG Yuchen
DOI: 10.3969/j.issn.1671-7171.2025.05.023
【Objective】 To explore the predictive value of combined detection of four coagulation indicators-fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT)-for pregnancy outcomes in mid-pregnancy patients with pregnancy-induced hypertension (PIH).【Methods】 A total of 75 mid-pregnancy PIH patients were enrolled and categorized into the mild PIH group (n=32), moderate PIH group (n=23), and severe PIH group (n=20) according to the classification of PIH severity. The four coagulation indicators were measured upon hospital admission. According to pregnancy outcomes, patients were divided into the normal pregnancy group (n=53) and the adverse pregnancy outcome group (n=22). The correlation between the severity of mid-pregnancy PIH and the four coagulation indicators was analyzed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of combined detection of these indicators for adverse pregnancy outcomes in PIH patients.【Results】 PT, TT, and APTT levels in the severe PIH group were significantly lower than those in the moderate and mild PIH groups, while FIB was significantly higher (all P<0.05). Similarly, PT, TT, and APTT levels in the moderate PIH group were lower than those in the mild group, while FIB was higher (all P<0.05). Spearman correlation analysis showed that the severity of PIH was negatively correlated with TT, PT, and APTT (all P<0.05), and positively correlated with FIB (P<0.05). In the adverse pregnancy outcome group, PT, TT, and APTT levels were significantly lower, and FIB level was significantly higher compared to the normal pregnancy group (P<0.05). ROC curve analysis demonstrated that the combined detection of TT, PT, APTT, and FIB had higher sensitivity, specificity, and area under the curve (AUC) in predicting adverse pregnancy outcomes in PIH patients compared to single indicator tests (P<0.05).【Conclusion】 The four coagulation indicators are associated with the severity of PIH, and their combined detection has certain predictive value for pregnancy outcomes in mid-pregnancy PIH patients.
2025 Vol. 42 (5): 816-819 [
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9
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820
Efficacy of Tongue Pressure Resistance Feedback Training Combined with Transcranial Magnetic Stimulation in Treating Swallowing Disorders in Stroke Patients
SHI Wenqian, ZHAO Meiying, CHEN Li, et al
DOI: 10.3969/j.issn.1671-7171.2025.05.024
【Objective】To investigate the efficacy of tongue pressure resistance feedback training combined with transcranial magnetic stimulation (rTMS) in treating swallowing disorders (DAS) in stroke patients.【Methods】A total of 100 stroke patients with DAS were randomly divided into the observation group and the control group, with 55 cases in each group. Patients in the control group received tongue pressure resistance feedback training, while those in the observation group received rTMS in addition to the training, with both treatments lasting for 4 weeks. Clinical efficacy was compared between the two groups, along with the changes in the Videofluoroscopic Swallowing Study (VFSS) scores, Functional Oral Intake Scale (FOIS) scores, Penetration-Aspiration Scale (PAS) scores, levels of neuronal injury markers [visinin-like protein-1 (VILIP-1), neuron-specific enolase (NSE), extracellular matrix glycoprotein (Fibulin-5), neuropeptide Y (NPY)], and hyoid bone movement.【Results】 The total effective rate in the observation group was 98.18%, which was higher than the 87.28% in the control group (P<0.05). After treatment, both groups showed higher VFSS and FOIS scores and lower PAS scores compared to before treatment (P<0.05); And the VFSS and FOIS scores of the observation group were higher than those of the control group, and the PAS score was lower than that of the control group (P<0.05). Post-treatment levels of VILIP-1, NSE, Fibulin-5, and NPY in both groups were lower than those before treatment (P<0.05), while the levels of VILIP-1, NSE, Fibulin-5, and NPY in the observation group were lower than those in the control group (P<0.05). The degrees of hyoid bone elevation and anterior movement were greater in both groups after treatment (P<0.05), with the observation group showing greater than the control group (P<0.05).【Conclusion】Tongue pressure resistance feedback training combined with rTMS is effective in reducing neuronal injury and improving swallowing ability and quality of life in stroke patients with DAS.
2025 Vol. 42 (5): 820-822 [
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7
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823
Clinical Efficacy of Catheter-Directed Thrombolysis Combined with Stent Implantation in Patients with Cockett Syndrome and Lower Limb Deep Vein Thrombosis
LIN Songruo, TANG Wenxian, JIANG Weiqing
DOI: 10.3969/j.issn.1671-7171.2025.05.025
【Objective】To investigate the therapeutic effect of catheter-directed thrombolysis combined with stent implantation in the treatment of patients with Cockett syndrome and lower limb deep vein thrombosis (DVT). 【Methods】A total of 104 patients with Cockett syndrome and lower limb deep vein thrombosis admitted to our hospital from March 2020 to March 2023 were randomly divided into the observation group and the control group using a random number table method, with 52 patients in each group. The control group received catheter contact thrombolysis treatment, while the observation group received catheter contact thrombolysis combined with stent implantation treatment. The thrombus clearance rate, inflammatory factors [tumor necrosis factor-α(TNF-α), C-reactive protein (CRP), interleukin-10 (IL-10)], degree of phlebitis [venous clinical severity scale (VCSS) score], quality of life [quality of life questionnaire (CIVIQ)], incidence of complications and recurrence were compared between the two groups. 【Results】The proportion of thrombus clearance rate of grade Ⅲ in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). One month after surgery, the levels of serum TNF-α, CRP, and IL-10 in both groups of patients were higher than before surgery. The levels of serum TNF-α, CRP, and IL-10 in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The VCSS scores of the two groups were lower than those before surgery, and the CIVIQ scores were higher than those before surgery. The observation group had lower VCSS score than the control group and higher CIVIQ score than the control group, with statistically significant differences (P<0.05). The recurrence rate of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). 【Conclusion】Catheter-directed thrombolysis combined with stent implantation for the treatment of Cockett syndrome with lower limb DVT significantly improves thrombus clearance, reduces inflammatory marker levels, alleviates vein inflammation, enhances quality of life, and lowers recurrence rates, without increasing the incidence of complications.
2025 Vol. 42 (5): 823-826 [
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7
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827
Rehabilitation Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Hydrogel Feeding Training on Patients with Post-Stroke Dysphagia
WANG Xiaojing
DOI: 10.3969/j.issn.1671-7171.2025.05.026
【Objective】 To investigate the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with hydrogel feeding training on patients with post-stroke dysphagia (PSD).【Methods】 A total of 95 patients with PSD were divided into two groups based on different treatment methods. The control group (48 cases) received hydrogel feeding training, while the observation group (47 cases) was treated with high-frequency rTMS combined with hydrogel feeding training. The two groups were compared in terms of swallowing function [Penetration-Aspiration Scale (PAS), Standardized Swallowing Assessment (SSA), Functional Oral Intake Scale (FOIS)], neurological function [B-cell lymphoma 2 (Bcl-2), Caspase-3, and Homocysteine (Hcy)], Swallowing Quality of Life (SWAL-QOL) score, and treatment safety.【Results】 After treatment, both groups showed decreased PAS and SSA scores and increased FOIS scores compared to before treatment (P<0.05). The observation group had lower PAS and SSA scores and higher FOIS scores than the control group (P<0.05). After treatment, Bcl-2 levels increased, while Caspase-3 and Hcy levels decreased in both groups (P<0.05); the observation group had higher Bcl-2 and lower Caspase-3 and Hcy levels than the control group (P<0.05). SWAL-QOL scores increased in both groups after treatment, with the observation group scoring higher than the control group (P<0.05).【Conclusion】 The combined use of high-frequency rTMS and hydrogel feeding training can effectively improve swallowing and neurological function in PSD patients, enhance their quality of life, and is highly safe.
2025 Vol. 42 (5): 827-829 [
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8
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830
Influence of Modified Delorme Procedure Combined with PPH on Anal Function and Serum Stress Indexes in Patients with Rectal Prolapse
MU Lingjie,LIU Xinzheng, LIU Gengsheng
DOI: 10.3969/j.issn.1671-7171.2025.05.027
【Objective】To investigate the influence of modified rectal mucosal sleeve resection and intestinal wall plication(Delorme procedure) combined with procedure for prolapse and hemorrhoids (PPH) on anal function and serum stress indexes in patients with rectal prolapse.【Methods】 A retrospective analysis was performed on the clinical data of 60 patients with rectal prolapse admitted to our hospital from March 2023 to March 2024. The patients were divided into the observation group and the control group according to treatment methods, with 30 cases in each group. The control group received the modified Delorme procedure, while the observation group received the modified Delorme procedure combined with PPH. The curative effect, complications, rectal pressure, serum stress indexes [prostaglandin E
2
(PGE
2
), cortisol (COR), norepinephrine (NE)], and anal function recovery were compared between the two groups at 3 months postoperatively. 【Results】The total effective rate of the observation group was higher than that of the control group (P<0.05). At 3 months postoperatively, the scores of anal distension and fullness, fecal continence ability, and anal moisture in both groups were significantly lower than those before surgery, and the observation group had lower scores than the control group (P<0.05). The maximum resting pressure and maximum systolic pressure in both groups were higher than those before surgery, while the rectal sensory volume was lower than that before surgery. The observation group had higher maximum resting pressure and maximum systolic pressure, and lower rectal sensory volume than the control group (P<0.05). The serum levels of PGE
2
, COR, and NE in both groups were higher than those before surgery (P<0.05), but there was no significant difference between the two groups (P>0.05). The complication rate in the observation group was lower than that in the control group (P<0.05). 【Conclusion】The modified Delorme procedure combined with PPH has a good clinical effect in the treatment of rectal prolapse. It can regulate rectal pressure, improve anal distension and fullness fecal continence ability, and anal moisture, and reduce the incidence of postoperative complications.
2025 Vol. 42 (5): 830-833 [
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8
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834
The Application Effect of the Comprehensive Assessment Tool for Intraoperative Pressure Ulcer Risk in the Nursing of Patients Undergoing Spinal Correction Surgery
PANG Jingping, YAO Xiaojuan
DOI: 10.3969/j.issn.1671-7171.2025.05.028
【Objective】To explore the application effect of the comprehensive assessment tool for intraoperative pressure ulcer risk in the nursing of patients undergoing spinal correction surgery. 【Methods】A total of 118 patients who underwent spinal correction surgery in our hospital from January 2022 to July 2024 were selected and divided into the observation group and the control group by the random number table method, with 59 cases in each group. The observation group conducted risk assessment using the comprehensive risk assessment tool for intraoperative pressure ulcers and implemented standardized nursing measures based on the assessment results. The control group received conventional care. The incidence of pressure ulcers, the incidence of postoperative complications, postoperative functional recovery, postoperative pain score [Visual Analogue Scale (VAS)] and patient satisfaction were compared between the two groups. 【Results】The incidence of pressure ulcers in the observation group was 15.25%, significantly lower than 35.59% in the control group, and the difference was statistically significant (P<0.05). The total incidence of postoperative complications in the observation group was 5.08%, significantly lower than 22.03% in the control group, and the difference was statistically significant (P<0.05). The time to get out of bed for the first time, the time to resume independent walking, and the wound healing time in the observation group were significantly shorter than those in the control group. The rate of delayed healing was significantly lower than that in the control group (P<0.05), and the VAS score was significantly lower than that in the control group. The differences were statistically significant (P<0.05). The scores of each dimension of satisfaction in the observation group were significantly higher than those in the control group (P<0.05). 【Conclusion】The comprehensive assessment tool for intraoperative pressure ulcer risk has a significant application effect in the nursing of patients undergoing spinal correction surgery. It can effectively reduce the incidence of pressure ulcers and postoperative complications, promote the functional recovery of patients, alleviate postoperative pain, and improve patient satisfaction.
2025 Vol. 42 (5): 834-836 [
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837
Clinical Efficacy and Safety of Individualized Dose Optimization of Clozapine in the Treatment of Refractory Schizophrenia
LI Gongquan, CAO Linjia, XIE Qingfang
DOI: 10.3969/j.issn.1671-7171.2025.05.029
【Objective】To explore the clinical efficacy and safety of individualized dose optimization of clozapine in the treatment of refractory schizophrenia. 【Methods】 A total of 136 patients with refractory schizophrenia admitted to Baoshan District Mental Health Center in Shanghai from November 2022 to June 2024 were selected. The patients were randomly divided into the observation group and the control group using a random number table method, with 68 patients in each group. The observation group was treated with adjusted dosage based on the patient's clinical response and drug concentration, while the control group was treated according to the dosage standard specified in the drug instructions. Both groups were treated for 3 months, then the positive and negative symptom scale (PANSS) scores and adverse reactions were compared between the two groups. The blood drug concentration of chlorpromazine was also compared between the two groups of patients. 【Results】 The PANSS scores of the observation group at 1 month, 2 months, and 3 months of treatment were lower than those of the control group, and the difference was statistically significant (P<0.05). The blood drug concentrations of the observation group at 1 month, 2 months, and 3 months of treatment was higher than those of the control group, and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 10.29% (7/68), which was significantly lower than the 25.00% (17/68) in the control group, and the difference was statistically significant (
χ
2
=5.060, P<0.05). One patient in the observation group developed leukopenia, which returned to normal after adjusting the dosage. Two patients in the control group showed leukopenia, and one patient needed to adjust the treatment plan. Both groups had one patient with electrocardiogram changes, but most of them were mild changes that did not lead to serious complications. 【Conclusion】 Individualized dose optimization of chlorpromazine in the treatment of refractory schizophrenia can improve clinical treatment efficacy. By adjusting the dose individually, the incidence of adverse reactions can be reduced while ensuring efficacy.
2025 Vol. 42 (5): 837-840 [
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6
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841
The Influence of Pain Intervention Measures in the Multidisciplinary Team Collaboration Model on the Sleep Quality of Patients after Laparoscopic Gastrointestinal Surgery
KUI Yunqian, WANG Jinxing, WANG Yan
DOI: 10.3969/j.issn.1671-7171.2025.05.030
【Objective】To explore the effect of pain intervention measures based on the multidisciplinary team collaboration model on the sleep quality of patients after laparoscopic gastrointestinal surgery. 【Methods】 A total of 96 patients who underwent laparoscopic gastrointestinal surgery in our hospital from March 2021 to March 2024 were selected. The patients were divided into the observation group (with pain intervention measures based on the multidisciplinary team collaboration model) and the control group (receiving conventional postoperative care) by the random number table method, with 48 cases in each group. The surgical indicators (postoperative ambulation time, hospital stay, postoperative exhaust, recovery of bowel sounds and the time of first defecation), pain degree [Visual Analogue Scale (VAS) score], Self-Rating Depression Scale (SDS) score, Self-Rating Anxiety Scale (SAS) score and Pittsburgh Sleep Quality Index (PSQI) score of the two groups of patients were compared. 【Results】At 12 hours after the operation, 24 hours after the operation and at discharge, the VAS scores of the observation group were all lower than those of the control group, and the difference was statistically significant (P<0.05). The time of getting out of bed for activities, hospital stay, postoperative exhaust, recovery of bowel sounds and the time of the first defecation in the observation group were all shorter than those in the control group, and the differences were statistically significant (P<0.05). At discharge and one month after the intervention, the PSQI scores of the observation group were lower than those of the control group, and the difference was statistically significant (P<0.05). At discharge, the SAS scores and SDS scores of both groups were lower than those before the operation, and those of the observation group were lower than those of the control group,the difference was statistically significant (P<0.05). 【Conclusion】The pain intervention measures of the multidisciplinary team collaboration model can reduce the pain degree of patients after laparoscopic gastrointestinal surgery, improve the postoperative sleep quality of patients, and accelerate the recovery process of patients.
2025 Vol. 42 (5): 841-843 [
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Analysis of the Screening Results of Congenital Heart Disease in Newborns in the Wuzhong District, Suzhou City from 2021 to 2024
YAO Chenhua, SHI Qian
DOI: 10.3969/j.issn.1671-7171.2025.05.031
【Objective】To analyze the screening situation of congenital heart disease (CHD) in neonates in Wuzhong District, Suzhou City from 2021 to 2024. 【Methods】A retrospective analysis was conducted on the relevant general data of 11,816 live newborns and their parturients registered in the Wuzhong District, Suzhou City from January 2021 to December 2024.The number of registered people, the number of screened people and the screening rate, the number of positive screening people and the initial screening positive rate, the number of people diagnosed by cardiac ultrasound and the diagnosis rate, the number of people diagnosed with CHD and the diagnosis rate, as well as the number of people who received surgical treatment and the treatment outcome were statistically analyzed.【Results】There was no statistically significant difference in the general data of neonates and parturients with CHD in the Wuzhong District, Suzhou City from 2021 to 2024 (P>0.05). A total of 11 816 newborns were registered during the four years, and 11 807 were actually screened, with a screening rate of 99.92%. During the period from 2021 to 2024, the screening rate remained basically unchanged, but the positive rate of the initial screening decreased somewhat, and the diagnosis rate of positive pre-existing heart disease in the initial screening increased significantly (P<0.05). The comparison of CHD classification of newborns in Wuzhong District, Suzhou City from 2021 to 2024 showed no statistically significant difference (P>0.05). Among the 105 children with CHD, 25 were cured, 3 underwent surgical treatment, 2 died, and the rest remained uncured by the end of the follow-up. 【Conclusion】The neonatal CHD screening work in Wuzhong District, Suzhou City remained at a high level during the period from 2021 to 2024. The positive rate of the initial screening decreased, while the diagnosis rate of positive CHD in the initial screening and the diagnosis rate by echocardiography remained stable.
2025 Vol. 42 (5): 844-847 [
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