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2020 Vol. 45, No. 8
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2020, 45(8): 993-996.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.001
Abstract:
ObjectiveTo investigate the effectiveness and safety of multi-point axillary flap fixation and small incision reduction of chest wall in the improvement of subcutaneous hydrops after modified radical mastectomy, and analyze the related risk factors of subcutaneous effusion. MethodsA total of 66 patients treated with modified radical mastectomy were divided into the control group(n=40) and intervention group(n=26) according to the surgical methods.The control group was treated with the routine axillary lymph node dissection combined with retained two drainage tubes in the axillary and chest wall.The intervention group was treated with strengthening the suturing and fixing the axillary skin flap with chest wall combined with subtensive incision on both sides of the border on the basis of the control group.The time of catheterization, length of stay and subcutaneous effusion were compared between two groups. ResultsThe volume of drainage, indwelling catheter time, length of stay and incidence rate of subcutaneous hydrops in intervention group were significantly lower than those in control group(P < 0.05 to P < 0.01).In the control group, the differences of the incidence rates of subcutaneous hydrops in patients with different axillary lymph nodes, diabetes mellitus and gelfoam application were statistically significant(P < 0.05).After surgery, there was no statistical significance in the incidence rate of subcutaneous hydrops in different age and body mass index in control group(P>0.05). ConclusionsThe positive axillary lymph nodes, diabetes mellitus and gelatin spongee use are the influencing factors of subcutaneous hydrops.The improved surgical method is of great significance to reduce subcutaneous effusion in axillary and chest wall.
2020, 45(8): 997-1000.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.002
Abstract:
ObjectiveTo investigate the effects of oxycodone combined with ropivacaine in the transverse abdominal fascia plane block(TAPB) on the enhanced recovery after abdominal surgery. MethodsNinety patients with abdominal gastrointestinal tumors, aged 35 to 69 years, body mass index < 30 kg/m2 and ASA grade Ⅰ to Ⅱ, were treated with open surgery, and the patients were divided into the observation group and control group(45 cases in each group).The control group was treated with oxycodone intravenously combined with ropivacaine incision, and the observation group was treated with oxycodone intravenously combined with TAPB.The pain scores, sedation scores, postoperative complications, anal exhaustion time, first feeding time, getting out of bed time and length of hospital stay was recorded in two groups at the time of leaving operating room, and postoperative 6 h, 12 h and 24 h. ResultsThe VAS scores of the resting after 6 h and 12 h of operation and exercise after 6 h, 12 h and 24 h of operation in observation group were significantly lower than those in control group(P < 0.01).The differences of the sedation scores at each time-point between two groups were not statistically significant(P>0.05).The anal exhaust time, first drinking water time and get out of bed time in observation group were significantly shorter than those in control group(P < 0.01).The incidence rate of postoperative anesthesia-related complications in observation group was few compared with that in control group, but the difference of which was not statistically significant(P>0.05). ConclusionsThe oxycodone combined with TAPB can improve the postoperative analgesic effects and improve the gastrointestinal function, reduce the incidence rate of postoperative complications and accelerate the postoperative recovery of patients.
2020, 45(8): 1001-1004.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.003
Abstract:
ObjectiveTo investigate the changes of serum levels of cortisol(COR), adrenocorticotropic hormone(ACTH), free triiodothyronine(FT3), free thyroxine(FT4) and thyroid stimulating hormone(TSH) in children with severe hand, foot and mouth disease(HFMD), and their evaluation value. MethodsNinety-three childrens with severe HFMD were divided into group A (31 cases with stage 2), group B (31 cases with stage 3) and group C (31 cases with 4 stage) according to the disease condition and clinical stage.The fasting venous blood in the early morning in three groups after two days of admission were extracted, and the serum levels of COR, ACTH, FT3, FT4 and TSH in three groups were measured using chemoluminescence detection. ResultsThe serum levels of TSH, FT3 and FT4 in group B and group C were significantly lower than those in group A, and the levels of TSH, FT3 and FT4 in group C were significantly lower than those in group B (P < 0.01).The differences of the number of leukocytes, C-reactive protein, time of blood pressure returning to normal, duration of fever, time of mechanical ventilation, days of hospitalization and cure rate among three groups were statistically significant(P < 0.05 to P < 0.01).Among three groups, the clinical stage was positively correlated with the levels of ACTH and COR (P < 0.05), and negatively correlated with levels of TSH, FT4 and FT3(P < 0.05). ConclusionsWith the exacerbation of HFMD, the serum levels of COR and ACTH increase, but the serum levels of FT3, FT4 and TSH decrease.
2020, 45(8): 1004-1007.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.004
Abstract:
ObjectiveTo analyze the related factors of acute radiation gastritis induced by intensity-modulated radiotherapy after esophageal cancer surgery. MethodsThe maximum dose(Dmax), mean dose(Dmean), intrathoracic stomach volume in different locations, illuminated volume percent(V5, V10, V20, V30, V40, V45 and V50), intrathoracic stomach illuminated volume(aV5, aV10, aV20, aV30, aV40 aV45 and aV50) in 60 esophageal cancer patients treated with postoperative intensity modulated cancer radiotherapy were calculated using the dose volume histogram.The differences of intrathoracic stomach volume in different locations were analyzed.The optimal critical value was determined by ROC curve, and the predictive index was determined by logistic multivariate analysis. ResultsThe differences of the intrathoracic stomach volume between the right side and left side, mediastinum were statistically significant(P < 0.05).The V50 and aV50 were the indicator to predict acute radioation gastritis(P < 0.01). ConclusionsIn the evaluation of postoperative induced by intensity-modulated radiotherapy plan for esophageal cancer, the evaluation of V50 and aV50 in pleural and gastric areas should be greatly focused on.
2020, 45(8): 1008-1012.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.005
Abstract:
ObjectiveTo study the effects of sevoflurane combined with remifentanil anesthesia on stress response and hemodynamics in patients treated with laparoscopic hysteromyomectomy. MethodsOne hundred patients scheduled by laparoscopic hysteromyomectomy were divided into the observation group and control group according to random number table method (50 cases in each group).The control group was intravenously anesthetized with propofol combined with remifentanil, while the observation group was anesthetized with sevoflurane combined with remifentanil.The differences of stress response and hemodynamic changes at 5 minutes before anesthesia(T1), 30 minutes after pneumoperitoneum(T2) and at the end of operation(T3), cognitive function at 1 day before and after operation, and adverse reactions were compared between two groups. ResultsAt T2 and T3, the levels of cortisol, adrenaline, noradrenaline and blood glucose in observation group were lower than those in control group(P < 0.01), and the heart rate, mean arterial pressure and blood oxygen saturation in observation group were lower than those in control group(P < 0.01).On the first day after operation, the score of mini-mental state examination in observation group was higher than that in control group(P < 0.01), while the completion time of trail making test in observation groupp was shorter than that in control group(P < 0.01).The incidence of adverse reactions in observation group was lower than that in control group(P < 0.05). ConclusionsThe application of sevoflurane combined with remifentanil anesthesia in patients with laparoscopic hysteromyomectomy can significantly reduce the body's stress response, maintain hemodynamic stability, reduce cognitive impairment, and help to avoid adverse reactions.
2020, 45(8): 1013-1016, 1019.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.006
Abstract:
ObjectiveTo investigate the value of recombinant human endostatin injection combined with EP chemotherapy(etoposide and cisplatin) and intensity-modulated radiotherapy in the treatment of advanced non-small cell lung cancer(NSCLC). MethodsNinety-eight patients with advanced NSCLC were divided into the observation group and control group according to the random number table method (49 cases in each group).The control group was treated with the EP chemotherapy combined with intensity-modulated radiotherapy, and the observation group was additionally treated with the recombinant human endostatin injection on the basis of control group.The response rate, disease control rate, serum levels of cytokeratin 19 fragment 21-1(CYFRA21-1), carbohydrate antigen 50(CA50) before and after treatment and quality of life were compared between two groups.All cases were followed up for 2 years, and the survival between two groups was compared. ResultsThe effective rates of treatment in observation group and control group were 63.27% and 51.02%, respectively, and the difference of which was not statistically significant(P>0.05).The disease control rate in observation group(89.80%) was higher than that in control group(71.43%)(P < 0.05).After treatment, the serum levels of CYFRA21-1 and CA50 in observation group were lower than those in control group(P < 0.01), and the improvement rate of survival quality in observation group(61.22%) was higher than that in control group(40.82%)(P < 0.05).The median survival time in observation group and control group were 14 months and 11 months, respectively.The 1-year and 2-year survival rates in observation group and control group were 59.57%, 34.04% and 47.83%, 26.09%, respectively, and the difference of which between two groups was not statistically significance(P>0.05). ConclusionsThe EP chemotherapy, intensity-modulated radiotherapy combined with recombinant human endostatin injection in the treatment of advanced NSCLC can effectively improve the disease control rate, down-regulate the serum levels of CYFRA21-1 and CA50, and improve the quality of life of patients, but it can not significantly improve the survival rate of patients.
2020, 45(8): 1017-1019.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.007
Abstract:
ObjectiveTo explore the influencing factors, clinical manifestations and pregnancy outcomes of premature delivery complicated with placental abruption. MethodsOne hundred and eleven patients with placental abruption were divided into the preterm delivery group(n=43) and full-term pregnancy group(n=68) according to the gestational weeks.The related causes, clinical manifestations, and maternal and infant outcomes were compared between two groups. ResultsThe differences of the age and whether primipara or not between two groups were not statistically significant(P>0.05), and the differences of the scar uterine and mediastinal uterine rates between two groups were statistically significant(P < 0.05).The vaginal bleeding, abdominal pain and abnormal rate of ultrasound examination in preterm delivery group were higher than those in full-term pregnancy group(P < 0.05 to P < 0.01), and the hemorrhagic amniotic fluid rate in preterm delivery group was lower than that in full-term pregnancy group(P < 0.05).The incidence rates of neonatal asphyxia and perinatal death in preterm delivery group were higher than those in full-term pregnancy group(P < 0.05 and P < 0.01). ConclusionsThe influencing factors and clinical manifestations of placental abruption are diverse, and the comprehensive judgment, early recognition and intervention are needed to improve the maternal and infant outcomes.
2020, 45(8): 1020-1023, 1028.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.008
Abstract:
ObjectiveTo investigate the influence of the levels of blood lipid, blood glucose and uric acid on the stage of liver fibrosis in patients with chronic HBV infection. MethodsThe clinical data of 169 patients with chronic hepatitis B(CHB), which included the age, gender, blood routine examination, liver function, uric acid, blood lipid, blood glucose, prothrombin time, hepatitis B two fifty-fifty, alpha fetoprotein and HBV DNA were collected, and their correlations with the occurrence of liver fibrosis were analyzed. ResultsThe abnormal rates of total cholesterol(CHO) and low density lipoprotein(LDL) in patients with fibrosis stage < S2(23.91% and 15.22%) were higher than those in patients with fibrosis stage ≥S2(9.68% and 5.19%), respectively (P < 0.05), while the abnormal rates of high density lipoproterin and aplipoprotein A (APOA) in patients with fibrosis stage < S2(10.87% and 3.26%) were lower than those in patients with fibrosis stage ≥ S2(24.68% and 18.18%), respectively(P < 0.05 and P < 0.01).The results of logistic regression analysis showed that AST(OR=1.034, P < 0.05), prothrombin time (OR=1.981, P < 0.01), LDL (OR=0.499, P < 0.01), APOA(OR=0.375, P < 0.05) were the independent predictors of moderate and severe fibrosis in CHB patients. ConclusionsThe serum lipid level of patients with chronic HBV infection can reflect the severity of liver fibrosis to some extent, while the blood glucose and uric acid levels have no significant predictive significance for the stage of liver fibrosis.
2020, 45(8): 1024-1028.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.009
Abstract:
ObjectiveTo evaluate the analgesia effects between magnesium sulfate or dexmedetomidine combined with ropivacaine in superficial cervical plexus block after cochlear implantation. MethodsEighty-eight patients scheduled by cochlear implantation were randomly divided into the group R(29 cases), group RD(29 cases) and group RM(30 cases) according to digital table method.The superficial cervical plexus block in group R was implemented using 13 mL of 0.25% ropivacaine combined with 2 mL of 0.9% sodium chloride solution, the superficial cervical plexus block in group RD was implemented using 13 mL of 0.25% ropivacaine combined with 0.75 mg/kg dexmedetomidine diluted to 2 mL, and the superficial cervical plexus block in group RM was implemented using 13 mL of 0.25% ropivacaine combined with 4 mg/kg magnesium sulfate diluted to 2 mL.Three groups were treated with static aspiration combined general anesthesia.The VAS scores in three groups after 1, 6, 12, 18 and 24 h of operation were recorded.The Ricker sedation-agitation score in the wake period during extubation, time of the first remedial analgesia, dosage of the remedial analgesia drugs, incidence rate of perioperative adverse reactions and satisfaction scores of patients among three groups were compared. ResultsThe differences of the VAS scores among three groups after 1, 6 and 24 h of operation were not statistically significant(P>0.05), the VAS scores in group RM and group RD after 12 h of operation were lower than those in group R, and the VAS score in group RD after 12 h of operation was lower than that in group RM and group R(P < 0.05).The Ricker sedation-agitation scores in group R, group RD and group RM during extubation gradually decreased, the time of the first remedial analgesia in group RD and group RM prolonged compared with group R, the dosage of the remedial analgesia drugs in group R, group RD and group RM gradually decreased, and the satisfaction score in group R was lower than that in group RD and group RM(P < 0.05 to P < 0.01).There was no statistical significance in the vomiting rate among three groups(P>0.05).The incidence rate of bradycardia in group RD was higher than that in group R and group RM(P < 0.05). ConclusionsBoth magnesium sulfate and dexmedetomidine combined with ropivacaine ultrasonic-guided superficial cervical plexus block can prolong the duration of postoperative analgesia, reduce the use of intravenous analgesia drugs and incidence rate of agitation during anaesthesia recovery, and improve satisfaction in patients treated with cochlear implantion.Compared with magnesium sulfate, the duration of postoperative analgesia is relatively long, and the agitationnd postoperative bradycardia rate are high in patients treated with dexmedetomidine.
2020, 45(8): 1029-1032, 1036.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.010
Abstract:
ObjectiveTo analyze the causes of hypoparathyroidism after total thyroidectomy and effects of calcium supplement. MethodsThe clinical data of 80 cases treated with total thyroidectomy were retrospectively analyzed.According to the treatment with or without calcium supplement, the patients were divided into the treatment group and observation group (40 cases in each group).The levels of parathyriod hormone(PTH) and Ca2+ between two groups were compared before and after 1 month and 1 week of operation.The PTH recovery time, Ca2+ recovery time, disappearance time of hypocalcemia, incidence rate of hypocalcemia and incidence rate of permanent hypocalcemia were compared between two groups.The patients with and without hypoparathyroidism in observation group were evaluated using single factor analysis.The factors with significant difference were included in the logistic regression analysis model to identify the risk factors of hypoparathyroidism. ResultsThe levels of PTH and Ca2+ in two groups after 1 month and 1 week of operation, and before operation gradually decreased, and the difference of which was statistically significant(P < 0.01).The levels of PTH and Ca2+ in treatment group after 1 month and 1 week of operation and before operation were significantly higher than those in observation group(P < 0.05 to P < 0.01).The PTH recovery time, Ca2+ recovery time, hypocalcemia disappearance time and hypocalcemia incidence in treatment group were significantly lower than those in observation group(P < 0.05 to P < 0.01).The proportions of hypoparathyroidism patients with malignant pathological type, from outside to inside surgical approach, tumor ≥4 cm, tumor locating the back membrane, lymph node cleaning, parathyroid gland miss cutting and using nano carbon tracer were significantly higher than those of the patients without hypoparathyroidism(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the malignant pathological type, from outside to inside surgical approach, tumor ≥4 cm, tumor locating the back membrane, lymph node cleaning, parathyroid gland miss cutting and using nano carbon tracer were the risk factors of hypoparathyroidism after total thyroidectomy(P < 0.05 to P < 0.01). ConclusionsThe hypoparathyroidism is affected by many factors, so the preventive calcium supplement should be performed.
2020, 45(8): 1033-1036.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.011
Abstract:
ObjectiveTo explore the effects and safety of the new technique of pterygium excision combined with pedicled conjunctival flap transplantation. MethodsOne hundred patients(103 eyes) with pterygium surgery were divided into the observation group and control group according to the random number table(50 cases in each group).The observation group(53 eyes) was treated with the modified pterygium excision combined with pedicled conjunctival flap transplantation(the shape of pedicled conjunctival flap was made into trapezoid, which was consistent with the shape of surgical defect area, the amount of conjunctival cutting reduced, the suture was less.The control group(50 eyes) was treated with simple resection combined with stem cell transplantation.Two groups were followed up for 6 months, and the operation time, conjunctival flap healing time, recurrence rate, best corrected visual acuity after 4 weeks of operation and postoperative complications were compared between two groups. ResultsCompared with the control group, the operation time and conjunctival flap healing time were shorter, and the postoperative irritation symptoms was lighter in the observation group(P < 0.05 to P < 0.01), the difference of the recurrence rate between two groups was not statistically significant within 6 months of following-up(P>0.05), and there was no statistical significance in the best corrected visual acuity and symblepharon complications after 4 weeks of operation between two groups(P>0.05). ConclusionsThe new technique of pterygium excision combined with pedicled conjunctival flap transplantation has ideal clinical effects, high safety and certain clinical promotion value.
2020, 45(8): 1037-1040.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.012
Abstract:
ObjectiveTo analyze the influencing factors of selective intubation difficulties in endoscopic retrograde cholangio-pancreatography(ERCP). MethodsA total of 345 patients treated with ERCP were investigated, and 40 cases with selective intubation difficulties and other 305 cases were divided into the observation group and control group, respectively.The data of diverticulum distribution, ERCP indications, age and gender between two groups were analyzed using the single factor method, and the differences of which with statistical significance were analyzed using logistic regression method.The independent risk factors of ERCP selective intubation difficulties were investigated. ResultsAmong 345 patients with ERCP, 40 patients with selective intubation difficulties were identified, and the intubation difficulty rate of which was 11.59%.The differences of the gender, age, emergency ERCP and ERCP were not statistically significant between two groups(P>0.05), and the differences of the distribution of diverticulum, loose and long duodenal papilla, common bile duct bending angle, biliopancreatic duct confluence, nipple shape and stenosis of the lower segment of common bile duct were statistically significant between two groups(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the loose and long duodenal papilla(OR=3.126), common bile duct bending angle(OR=2.811), internal nipple of diverticula(OR=2.703) and asymmetric diverticula at the center of the nipple(OR=2.033) were the independent risk factors of ERCP selective intubation difficulties. ConclusionsThe incidence rate of ERCP selective intubation difficulties is high, and the loose and long duodenal papilla, diverticulum distribution and common bile duct angle can affect the success rate of intubation.
2020, 45(8): 1040-1043.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.013
Abstract:
ObjectiveTo explore the clinical value of β2 microglobulin in diffuse large B cell lymphoma. MethodsThe clinical data of 102 patients with diffuse large B cell lymphoma were retrospectively analyzed.The age at first diagnosis, gender, Ann Arbor stage, serum levels of lactate dehydrogenase and hypoglobulin, with and without group B symptoms and ECOG scores of patients were recorded.According to the international prognostic index(IPI) and national comprehensive cancer cefter international prognostic index(NCCN-IPI) scoring criteria, the data of patient were statistically analyzed. ResultsThe difference of the number of cases with increasing microglobulin level among different groups was statistically significant(P < 0.01).With the increasing of prognostic risk level, the level of β2 microglobulin increased gradually, and the level of β2 microglobulin in high-risk group was significantly higher than that in low-risk group and medium-risk group(P < 0.01).The results of logistic regression analysis showed that the increasing of β2 microglobulin level was a risk factor of IPI and NCCN-IPI prognosis grouping(P < 0.01).The correlation analysis showed that β2 microglobulin was not correlated with lactic dehydrogenase and external node involvement(P>0.05), and β2 microglobulin was correlated with the age, tumor stage and ECOG score(P < 0.05). ConclusionsThe level increasing of β2 microglobulin may be one of the risk factors of patients with diffuse large B lymphoma, and the related mechanism of which needs to be further studied.
2020, 45(8): 1044-1047.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.014
Abstract:
ObjectiveTo explore the clinical effects of vacuum sealing drainage(VSD) combined with ozone water in the treatment of orthopedic infectious wounds. MethodsForty patients with infection wound were divided into the observation group and control group according to the random number table.The observation group was treated with VSD combined with ozone water, while the control group was treated with the conventional VSD.The wound healing, granulation tissue colony count between two groups were compared after 7 d of operation.The treatment outcome was compared between two groups. ResultsThe wound healing area and bacteria clearance rate in observation group were higher than those in control group on the seventh day after operation, and the colony count of granulation tissue in observation group was significantly lower than that in control group(P < 0.01).Compared with the preoperative level, the levels of inter interleukin 1(IL-1) and tumor necrosis factor α(TNF-α) in the wound surface of two groups significantly reduced, the vascular endothelial growth factor labeling index significantly increased(P < 0.01), and the levels of IL-1 and TNF-α in the wound surface of the observation group were significantly lower than those of the control group(P < 0.05 and P < 0.01).The healing time of the wound surface in observation group was significantly shorter than that in control group(P < 0.01).The total effective rates in the observation group and control group were 95.00% and 70.00%, respectively, and the difference of which was not statistically significant (P>0.05). ConclusionsVSD combined with ozone water in treating orthopedic infectious wounds can effectively reduce the bacterial colony count, promote wound healing, and reduce the risk of infection.
2020, 45(8): 1048-1050.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.015
Abstract:
ObjectiveTo observe the prognostic value of the levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α), and acute physiology and chronic health score(APACHE)Ⅱ score in elderly patients with severe infection in intensive care unit(ICU). MethodsSeventy-eight elderly patients were divided into the sepsis group(n=35), severe sepsis group(n=24) and septic shock group(n=19) according to the severity of the disease.According to the prognosis, the patients were divided into the survival group(n=60) and death group(n=18).Receiver operating characteristic (ROC)curve was used to evaluate the prognostic value of each index. ResultsThe levels of IL-6 and TNF-α, and APACHEⅡ score of patients in the sepsis group, severe sepsis group and septic shock group gradually increased(P < 0.05 to P < 0.01).The IL-6 level and APACHEⅡ score in survival group were significantly lower than those in death group(P < 0.01), and there was no statistical significance in the TNF-α level between two groups(P>0.05).The levels of IL-6 and TNF-α, and APACHEⅡ score were all positively correlated(P < 0.05 to P < 0.01).The area under the ROC curve of the combined detection of IL-6, TNF-α and APACHE Ⅱ scores was 0.854, which was significantly higher than that of the three alone(0.678, 0.600 and 0.691, respectively) (P < 0.05). ConclusionsThe levels of IL-6 and TNF-α, and APACHE Ⅱ score have certain values in evaluating the prognosis of elderly patients with severe infection in ICU, and the combined detection can improve the prognosis value.
2020, 45(8): 1051-1054.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.016
Abstract:
ObjectiveTo investigate the effects of endoscopic submucosal lesion resection with electric snare assisted by single ligator in the treatment of upper gastrointestinal submucosal lesions. MethodsForty patients with submucosal lesions of the muscularis propria in upper gastrointestinal tract diagnosed by endoscopic ultrasonography were randomly divided into the observation group(20 cases) and control group(20 cases).The observation group was treated with endoscopic submucosal lesion resection with electric snare assisted by single ligator, and the control group was treated with conventional endoscopic mucosal dissection.The operative time, intraoperative blood loss, intraoperative perforation and site of perforation were observed in two groups.The first endoscopic following up was conducted after 3 months of operation, and the follow-up time and recurrence were recorded. ResultsThe lesions in 40 patients were one-time resected.The operative time and intraoperative blood loss in observation group were significantly less than those in control group(P < 0.01).No intraoperative perforation case was found in the observation group, and one patient with intraoperative perforation was found in the control group.All patients were followed up for 3-36 months, and no residual or recurrence was found. ConclusionsEndoscopic submucosal lesion resection with electric snare assisted by single ligator in the treatment of upper gastrointestinal submucosal lesions is simple, safe, with few complications, and high efficient.It is worthy of clinical application.
2020, 45(8): 1055-1059.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.017
Abstract:
ObjectiveTo compare the clinical efficacy of the treatment of anterior cruciate ligament(ACL) injury between with and without preservation stump single bundle reconstruction under arthroscopy. MethodsA total of 30 patients treated with ACL reconstruction under arthroscopy were randomly divided into the preservation group and unpreservation group(15 cases in each group).The preservation group and unpreservation group were treated with and without ACL reconstruction, respectively.The Lysholm score, IKDC score and Tegner score in two groups between before operation and after 6 months of surgery, and postoperative knee joint mobility and stability between two groups were compared.The propensity indicators after 6 months of operation between two groups were compared. ResultsThere was no statistical significance in the preoperative Lysholm score, IKDC score and Tegner score between two groups(P>0.05), and the Lysholm score, IKDC score and Tegner score in preservation group after 6 months of operation were significantly higher than those in unpreservation group(P < 0.05).There was no statistical significant difference in the side-to-side difference value of KT-1000 and ROM angle in two groups between before operation and after 6 months of operation(P>0.05).The passive angle regeneration test angle and passive activity detection threshold in preservation group after 6 months of operation were lower than those in unpreservation group(P < 0.01). ConclusionsThe preservation stump single bundle reconstruction of ACL can better promote the recovery of postoperative knee function and proprioception, and the clinical effect of which is better than that of unpreservation stump single bundle reconstruction.
2020, 45(8): 1060-1063.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.018
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ObjectiveTo investigate the clinical effects and safety of tripterygium polyglycoside in the treatment of proteinuria in kidney transplantation patients taking sirolimus. MethodsAmong 214 kidney transplantation patients treated with sirolimus, the proteinuria(>1.5 g/24 h) in 68 cases was found, and the patients were randomly divided into the control group and observation group(34 cases in each group).The control group was intravenously injected with 1 000 mg of cyclophosphamide combined with 250 mL of 0.9% sodium chloride solution, once a month, and the observation group was treated with 40 to 60 mg/d of tripterygium polyglycoside.Two groups were treated for 6 months.The levels of α1-microglobulin(α1-MG), β2-microglobulin(β2-MG), urinary albumin(MAU) and 24 h protein in urine in two groups were detected, and the clinical therapeutic effect and adverse reaction were compared between two groups. ResultsAfter treatment, the urine indicators in two groups significantly decreased(P < 0.01), and the levels of α1-MG, β2-MG and 24 h urinary protein in observation group were significantly lower than those in control group(P < 0.05).The differences of the serum levels of Scr, BUN, TG and ALT in two groups between before and after 6 months of tretament were not statistically significant(P>0.05).After 6 months of treatment, the differences of the serum levels of Scr, BUN, TG and ALT between two groups were not statistically significant(P>0.05).The difference of the incidence rate of adverse reaction between two groups was not statistically significant(P>0.05). ConclusionsTripterygium polyglycoside in the treatment of proteinuria in kidney transplantation patients taking sirolimus has good effect, and can improve the prognosis of pateints.
2020, 45(8): 1064-1067.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.019
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ObjectiveTo investigate the correlation between carotid plaque characteristics, risk factors, and neutrophil-to-lymphocyte ratio(NLR) in patients with acute ischemic stroke. MethodsThe clinical data of 205 hospitalized patients with acute ischemic stroke were retrospective analyzed.According to the results of cervical vascular ultrasound, the patients were divided into the plaque group(including hard plaque group, soft plaque group and mixed plaque group) and non-plaque group.The patient's clinical data, laboratory test indicators, and neutrophil-to-lymphocyte ratio were compared, and the independent risk factors of carotid plaque formation were analyzed using logistic regression. ResultsThe smoking composition ratio, endometrial thickness, total cholesterol, low density lipoprotein, blood glucose, white blood cells, neutrophils and NLR in plaque group were higher than those in non-plaque group(P < 0.05 to P < 0.01).The results of multivariate logistic regression analysis showed that the blood glucose, white blood cells, neutrophils, intimal thickness and NLR were the independent risk factors of carotid plaque formation(P < 0.05 to P < 0.01).The differences of the gender, low-density lipoprotein, white blood cells, neutrophils, intimal thickness and NLR among the hard plaque group, mixed plaque group and soft plaque group were statistically significant(P < 0.05 to P < 0.01). ConclusionsThe smoking, hyperlipidemia and blood glucose are related to the carotid plaque and nature, and the NLR is also related to the formation and nature of carotid plaque as a new inflammatory indicator.
2020, 45(8): 1068-1071.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.020
Abstract:
ObjectiveTo investigate the effects of esmolol on cardiovascular reaction caused by endotracheal intubation and extubation in general anesthesia patients. MethodsSixty-one patients scheduled by operation with endotracheal intubation were divided into the control group(31 cases) and observation group(30 cases) according to simple random number method.The control group was treated with routine general anesthesia, and the observation group was slowly injected with l mg/kg of esmolol before and after conventional anesthesia.The systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) before anesthesia(T0), before endotracheal intubation(T1), immediately after endotracheal intubation(T2), after endotracheal intubation(T3), before extubation(T3), immediately after extubation(T5) and after 3 min of extubation(T6) were analyzed in two groups.The serum levels of epinephrine(Ad) and norepinephrine(NA) at T0, T3 and T6, and occurrence of perioperative adverse reactions were detected in two groups. ResultsThe results of repeated measurement ANOVA showed that the differences of the interaction of SBP, DBP and HR at time factor, and time factor and grouping were statistically significant(P < 0.01).The results of multiple post-mortem comparisons showed that the levels of SBP, DBP and HR in two groups at T1 were lower than those at T0(P < 0.05), the levels of SBP, DBP and HR in two groups at T2 and T3 were higher than those at T1(P < 0.05), the levels of SBP, DBP and HR in control group at T5 and T6 were higher than those at T4(P < 0.05), and the level of HR in observation group at T5 was higher than that at T4(P < 0.05).The results of comparison among groups showed that the levels of SBP, DBP and HR in observation group at T2 and T3 were lower than those in control group(P < 0.05), the level of HR in observation group at T4 were lower than that in control group(P < 0.05), and the levels of DBP and HR in observation group at T5 and T6 were lower than those in control group(P < 0.05).The results of repeated measure ANOVA showed that the differences of the interaction of Ad and NA at time factor, and time factor and grouping were statistically significant(P < 0.05 to P < 0.01).The results of multiple post-mortem comparisons showed that the levels of Ad and NA in observation group at T3 and T6 were lower than those in control group(P < 0.05), the levels of Ad and NA in control group at T3 and T6 were significantly higher than those at T0(P < 0.05), and differences of the levels of Ad and NA in observation group among T0, T3 and T6 were not statistically significant(P>0.05).The incidence rate of cough during extubation in control group(77.42%) was significantly higher than that in observation group(43.33%)(P < 0.01). ConclusionsEsmolol can effectively relieve the cardiovascular response caused by tracheal intubation and extubation under general anesthesia, has good safety, and is worthy of clinical popularization.
2020, 45(8): 1072-1076.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.021
Abstract:
ObjectiveTo observe the clinical analgesic effects of rectus sheath block and its effect on postpartum depression after cesarean section. MethodsSixty puerperas with ASA level Ⅰ to Ⅲ, treated with cesarean section were randomly divided into the control group(group N) and rectus sheath block group(group R)(30 cases in each group).The combined lumbar and epidural anesthesia in two groups were performed.After the operation, the bilateral rectus sheath block guided by ultrasound in group R was performed, while the rectus sheath block was not performed in group N.Two groups were treated with intravenous controlled analgesia pump after obstetric operation.The incision pain(resting and coughing), uterine contractile pain, postpartum depression and adverse reactions were observed after 6(T1), 12(T2), 24(T3) and 48(T4) of operation. ResultsAt different time points after surgery, the NRS scores of incision pain at rest and coughing in group R were significantly lower those in group N(P < 0.01).The NRS score of uterine contractile pain in group R was lower than that in group N(P < 0.01).The incidence rates of adverse reactions and postpartum depression in group R were lower than those in group N(P < 0.05 to P < 0.01). ConclusionsThe analgesia effects and maternal satisfaction after cesarean section in bilateral rectus sheath block combined with intravenous analgesia pump is better than that in simple intravenous analgesia pump, and which can reduce the incidence rate of postpartum depression within 48 h after surgery.
2020, 45(8): 1076-1079.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.022
Abstract:
ObjectiveTo explore the application value of funnel compression suture in the treatment of the lower uterine segment(LUS) bleeding. MethodsTen cases with LUS bleeding caused by placental factors were treated with uterine contractions drug, massage, local compression and suture.The hemostatic effect, safety and feasibility of operation, and short-term and long-term complications in LUS bleeding patients were observed. ResultsAfter suturing, the bleeding of LUS in 10 cases was improved, and the bleeding stopped within 2 to 10min.There was not other auxiliary hemostasis measures in 9 patients, one patient was treated with uterine artery embolization, and the successful hemostasis and uterus preservation in 10 patients were idnetified.No complications occurred during postoperative following-up. ConclusionsWhen the conservative treatment in patients with lus bleeding is ineffective, the funnel compression suture can be used as early as possible.The method is safe, effective, simple and easy to operate and has no short-term and long-term complications.The funnel compression suture has a certain value of popularization and utilization as a hemostasis method for lus bleeding.
2020, 45(8): 1082-1085, 1090.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.024
Abstract:
ObjectiveTo investigate and analyze the prevalence of chronic disease and chronic disease related behavior in rural elderly population in Anhui province for providing a scientific basis for the prevention and intervention of chronic disease. MethodsA multistage stratified cluster sampling method was used for the survey.Northern Anhui, Western Anhui and Southern Anhui regions were selected, five administrative villages were sampled from each region, and no less than 100 people were surveyed from each administrative village.A questionnaire survey was conducted among 1 781 elderly people aged 60 years and above. ResultsIn this survey, the prevalence rate of chronic diseases was 82.5%.The prevalence rate of 14 kinds of chronic diseases from high to low:the top three were hypertension, arthritis or rheumatism and abnormal blood lipids, and the prevalence of hypertension was the highest among male and female groups.The results of univariate analysis showed that the differences of the gender, education degree, occupation, residence status, active or passive smoking frequency, alcohol consumption, exercise type, exercise frequency, and parens healthy were statistically significant(P < 0.05 to P < 0.05).The results of multivariate logistic regression analysis showed that no passive smoking, smoking(once quit), passive smoking frequency for 1-2 days each week, 0-2 exercise types and father alive were the risks of common chronic diseases among the elderly(P < 0.05 to P < 0.01). ConclusionsThe prevalence of cardiovascular disease and osteoarthropathy are relatively high among the elderly in rural areas of Anhui province.The prevention and treatment strategies of chronic diseases should be developed according to relevant behaviors to improve the quality of life of the elderly.
2020, 45(8): 1086-1090.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.025
Abstract:
ObjectiveTo explore the effects of internet+ "two-card system" on the management of chronic disease in community. MethodsA total of 1603 chronic disease patients in Tongling Yangguang community health service center from January 2018 to March 2019 were investigated.The chronic disease control rate, standard management rate and control rate of patients were compared between before and after the application of the "two-card system".The questionnaire survey "two-card system" satisfaction were implemented by medical staffs from Yangguang community health service center and 4 health stations belonging to the center. ResultsCompared with the fourth quarter of 2018, the health management rate of chronic diseases increased in the first quarter of 2019, but the difference of which was not statistically significant(P>0.05).In the first quarter of 2019, the management rate and control rate of chronic diseases decreased significantly compared with the previous quarter, the standardized management rate and control rate of hypertension decreased from 67.78% to 26.28 and from 90.39% to 72.66%, respectively(χ2=479.97, 143.40, P < 0.01), and the standard management rate and control rate of diabetes decreased from 63.64% to 26.05% and from 52.39% to 39.74%, respectively(χ2=124.60, 14.03, P < 0.01).The score of chronic disease management was positively correlated with the total number of patients, and the score of hypertension disease management was positively correlated with the number of hypertension disease patients (r=0.992, P < 0.01).The score of diabetes mellitus management was positively correlated with the number of diabetes mellitus patients (r=0.881, P < 0.05), and the score of chronic disease management was not correlated with standard management rate or number of patients of standard management(P>0.05).The dissatisfaction rate of grassroots medical staff to the "two-card system" was 73.47%.The most satisfied with the two-card system was pragmatic, while the least satisfied with the "two-card system" was the cumbersome operation of mobile phone and tablet apps and work score system. ConclusionsThe implementation of "two-card system" has a milestone significance, which changes the phenomenon of fraud in the management of chronic diseases files at the grassroots, and provides a real basis for the future public health management.The effects of "two-card system" in continuing to improve the quality and enhancing the strength of primary medical service still needs further observation and evaluation.
2020, 45(8): 1091-1093.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.026
Abstract:
ObjectiveTo analyze the drug-resistant genes and epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae. MethodsFourteen strains of carbapenem-resistant Klebsiella pneumoniae were collected from January to August 2018, and the strain identification and drug susceptibility test were implemented using the VITEK Compact system.The modified Hodge test was used to detect the carbapenems, the PCR test was used to detect the drug-resistant genes, and the homology of the strains was analyzed using intergene repeated sequence polymerase chain reaction(ERIC-PCR). ResultsFourteen strains of carbapenem-resistant Klebsiella pneumoniae were highly resistant to penicillins, carbapenems, aztreonam and cephalosporins.Eleven strains of Klebsiella pneumoniae were positive in the modified Hodge test.The positive KPC-2 gene in 12 strains of Klebsiella pneumoniae were identified by PCR.The 14 strains could be classified into 3 genotypes, the type A was main, which was mainly isolated from ICU and neurosurgery. ConclusionsThe carbapenem-resistant Klebsiella pneumoniae shows the severe multi-drug resistance, mainly producing KPC enzyme and type A.
2020, 45(8): 1094-1096.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.027
Abstract:
ObjectiveTo explore the value of glycosylated hemoglobin(HbA1c) level in the diagnosis of type 2 diabetes mellitus complicated with microcytic anemia. MethodsThe levels of HbA1c, FPG, Hb and MCV in 34 patients with type 2 diabetes mellitus complicated with microcytic anemia(microcytic anemia group), 34 patients with type 2 diabetes mellitus complicated with normocytic anemia(normocytic anemia group), 48 patients with type 2 diabetes mellitus complicated without anemia(simple type 2 DM group) and 68 healthy people(healthy control group) were detected.The correlation between HbA1c and FPG was analyzed. ResultsThe differences of the levels of HbA1c, FPG, Hb and MCV among four groups were statistically significant(P < 0.01).The HbA1c level was positive correlation with FPG in normocytic anemia group and single type 2 DM group(r=0.708, r=0.773, P < 0.05), but the HbA1c level was not correlation with FPG in microcytic anemia group(r=0.302, P>0.05). ConclusionsThe HbA1c level in type 2 diabetes mellitus patients with microcytic anemia can not accurately reflect the real level of blood glucose.
2020, 45(8): 1097-1099, 1103.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.028
Abstract:
ObjectiveTo investigate the plain CT and enhanced imaging features of pulmonary sclerosing peumocytoma(PSP). MethodsThe CT features in 27 patients with PSP were retrospectively analyzed.The relative CT value of plain CT and enhanced imaging in 22 cases with PSP and control group were analyzed. ResultsThe regular shape, main soft tissue density, partial calcification, air-gap, overlying vessel and halo sign were the main symptoms in most PSP, the relative CT value of PSP was (0.77±0.41), which was less than that after 50 s and 90 s of enhance[(1.30±0.43) and (1.45±0.46)] (P < 0.05 and P < 0.01).The differences of the relative CT value at each time-point between two groups were not statistically significant(P>0.05). ConclusionsThe CT plain scan can show the characteristics of PSP, which combined with obvious enhancement of lesions can help the PSP diagnosis.
2020, 45(8): 1100-1103.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.029
Abstract:
Objective To measure the fat content and degree of muscle atrophy in patients with supraspinatus tendon injury, and study the correlations between the degree of supraspinatus tendon injury, and degrees of fat infiltration and muscle atrophy. Methods Forty patients with supraspinatus tendon injury of shoulder joint and 14 healthy examinees (control group) were investigated.The routine shoulder joint MRI examination and fat quantitative scan(mDixon-Quant) were performed.The fat fraction diagram of supraspinatus and relative size of supraspinatus were obtained.According to the different manifestations of MRI, the patients were divided into the degeneration group, partial tear group and complete tear group.The supraspinatus fat content and relative value, and its correlation with degree of supraspinatus tendon injury among four groups were analyzed and compared. Results Among four groups, the FF value in the control group, degeneration group and complete tear group, and in the control group, partial tear group and complete tear group gradually increased in turn, and the difference of which was statistically significant(P < 0.01).The difference of the FF value between degeneration group and partial complete tear group was not statistically significant(P>0.05).Among four groups, the supraspinatus volume in the control group, degeneration group and complete tear group, and in the control group, partial tear group and complete tear group gradually decreased in turn, and the difference of which was statistically significant(P < 0.05 to P < 0.01).The difference of the supraspinatus volume between degeneration group and partial complete tear group was not statistically significant(P>0.05).The FF value was positively correlated with the degree of supraspinatus tendon injury(rs=0.95, P < 0.01), the relative size of supraspinatus was negatively correlated with the degree of supraspinatus tendon injury(rs=-0.80, P < 0.01), and the relative size of supraspinatus was negatively correlated with the FF value (r=-0.73, P < 0.01). Conclusions 3.0T MRI can quantitatively evaluate the degree of fat infiltration and atrophy of supraspinatus and show the relationship between the degrees of fat infiltration and atrophy and degree of tendon injury.
2020, 45(8): 1104-1106.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.030
Abstract:
Objective To discuss the value of the ratio of internal jugular vein(IJV) to common carotid artery(CCA) cross-sectional area measured by bedside ultrasound in the evaluation of volume responsiveness in critical patients. Methods Fifty critical patients were divided into the negative volume response group(ΔCO < 15%, n=20) and positive volume response group(ΔCO≥15%, n=30) according to the cardiac output change(ΔCO) after passive leg lift (PLR) test.The diameter and cross-sectional area of IJV and CCA in two groups were measured by bedside ultrasound, and the ratio of IJV to CCA cross-sectional area was calculated, and the correlation between IJV/CCA cross-sectional area ratio and ΔCO after PLR test was analyzed.The accuracy and threshold of the ratio of IJV/CCA cross-sectional area and ΔCO value in predicting the volumetric reactivity were evaluated by ROC curve. Results The diameter and cross-sectional area of IJV[(14.03±4.877)mm and (100.40±60.91)mm2] were negatively correlated with the ΔCO value(P < 0.05), and the diameter and cross-sectional area of CCA[(8.35±1.60)mm and (57.64±18.50)mm2] were not correlated with the ΔCO value(P>0.05).The ratio of IJV/CCA cross-sectional area in positive volume response group was significantly less than that in negative volume response group(P < 0.01), and the ratio of IJV/CCA cross-sectional area was negatively correlated with the ΔCO value(P < 0.01).At the IJV/CCA cross-sectional area ratio of 1.66, the sensitivity and specificity was 87.1% and 79.6%, respectively, and the areas under the ROC curve was 0.836(95%CI:0.710-0.952). Conclusions The bedside ultrasound measuring the ratio of IJV/CCA cross-sectional area is a noninvasive, convenient and reliable method to evaluate the volume responsiveness of critical patients.
2020, 45(8): 1107-1109, 1113.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.031
Abstract:
Objective To explore the value of the Waterlow pressure injury scale and Braden stress scale in predicting the prevention of pressure ucler in ICU. Methods The Waterlow scale and Braten scale were used to predict the pressure ulcers of 724 patients, the predictive value of two scales were compared with the final pressure ulcers, and the predictive value of two scales were analyzed. Results The true positive in 44 cases and true negative in 600 cases were identified using the Waterlow rating scale, and the sensitivity and specificity of which were 100.00% and 88.23%, respectively.The true positive in 44 cases and true negative in 178 cases were identified using the Braden rating scale, and the sensitivity and specificity of which were 100.00% and 73.82%, respectively.The specificity and negative predictive value of Waterlow rating scale were significantly higher than those of Braden rating scale(P < 0.01), and the differences of the sensitivity and positive predictive value bewteen the two scales were not statistically significant(P>0.05).The area under the Waterlow rating scale curve(0.770) was slightly higher than that of Braten rating scale curve(0.704) (P < 0.05). Conclusions During the process of pressure ulcer prevention in ICU patients, the specificity of Waterlow rating scale is better than that of Braden rating scale.In clinical practice, the nursing staff should take specific nursing measures according to the scale.
2020, 45(8): 1110-1113.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.032
Abstract:
Objective To investigate the effects of abdominal functional exercise based on stomatostomy location on the complications of enterostomy and quality of life of patients. Methods Ninety-three patients treated with enterostomy were divided into the observation group(48 cases) and control group(45 cases) according to random number table method.The control group was treated with preoperative stomatostomy location and postoperative routine nursing, and the observation group was additionally treated with postoperative abdominal function exercise on the basis of routine nursing.The general condition, nursing satisfaction, postoperative complications, stoma function score(DET score) and quality of life were compared between two groups. Results The incidence rate of postoperative complications and DET score in observation group were significantly lower than those in control group(P < 0.01).The life quality and nursing satisfaction in observation group were significantly better than those in control group(P < 0.05 to P < 0.01).There was no statistical significance in postoperative hospital stay between two groups(P>0.05), but the first postoperative anal exhaust time in observation group was significantly shorter than that in control group(P < 0.01). Conclusions The postoperative abdominal functional exercise can not only significantly reduce the incidence of complications after enterostomy and improve the quality of life of patients, but also effectively shorten the anal exhaust time and improve the satisfaction of patients for nursing work.
2020, 45(8): 1114-1117.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.033
Abstract:
Objective To explore the effects of the individualized functional exercise during recovery in patients treated with minimally invasive total hip arthroplasty. Methods Thirty one patients treated with minimally invasive total hip arthroplasty total hip arthroplasty were randomly divided into the control group(14 cases) and intervention group(17 cases).The control group was nursed with conventional rapid rehabilitation nursing measures, and the intervention group was nursed with individualized functional exercise.The postoperative daily life self-care ability(ADL) score, hip joint function(Harris) score, satisfaction rate, incidence rate of postoperative complications, length of stay and hospitalization expense were compared between two groups, which was used to evaluate the nursing effects. Results The ADL scores in intervention group on the first, third and fifth day after surgery were higher than those in control group at corresponding time points(P < 0.05 to P < 0.01), the Harris score in intervention group on the day of discharge was higher than that in control group(P < 0.01), but there was no statistical significance in ADL score and Harris score between two groups after 1 month of surgery(P>0.05).There was no statistical significance in the incidence rate of perioperative complications between two groups(P>0.05).The hospitalization satisfaction in intervention group was higher than that in control group(P < 0.05), and the length of hospitalization and total cost of hospitalization per capita in intervention group were lower than those in control group(P < 0.05). Conclusions The application of individualized functional exercise in minimally invasive total hip arthroplasty can promote the early recovery of hip function, reduce the length of stay, save medical resource and improve patients' satisfaction, which is worthy of clinical promotion.
2020, 45(8): 1118-1122.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.034
Abstract:
Objective To evaluate the clinical effects of spouse participatory attention training and speech auditory feedback training in cognitive rehabilitation of patients with stroke. Methods Ninety patients with ischemic stroke complicated with cognitive dysfunction were randomly divided into the observation group(n=48) and control group(n=42).The control group was trained using conventional rehabilitation program, and the observation group was trained using the spouse participatory attention training and speech auditory feedback training.The Montreal cognitive assessment(MoCA) score and SCL-90 score in two groups were evaluated before and after intervention. Results The median of MoCA in observation group(23.0) was higher than that in control group(19.5) after 3 months of discharge(P < 0.05 to P < 0.01).The differences of the anxiety, depression, somatization, obsessive-compulsive symptoms and interpersonal relationship sensitivity scores after intervention between two groups were statistically significant, and the scores of the above dimensions decreased more obviously in the observation group after intervention(P < 0.05 to P < 0.01). Conclusions The spouse participatory attention training and speech auditory feedback training can significantly promote the cognitive function rehabilitation and improve neuropsychological symptoms in patients with stroke.It has high application value.
2020, 45(8): 1122-1124.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.035
Abstract:
Objective To investigate the effects of body position simulation in patients treated with holmium laser lithotripsy before anesthesia. Methods Fifty-eight patients treated with holmium laser lithotripsy were randomly divided into the observation group and control group(29 cases in each group).The control group was subjected to lithotomy position, and the observation group was subjected to postural simulation before anesthesia.The occurrence of postoperative postural complications, comfort of patients, postural placement time and surgeon satisfaction were compared between two groups. Results The incidence of postoperative 48 h postural complications in observation group was lower than that in control group, and the comfort level in observation group was better than that in control group(P < 0.01).The position placement time in observation group was lower than that in control group, and the satisfaction of surgeons to the position placement in observation group was higher than that in control group(P < 0.01). Conclusions The body position simulation in patients treated with holmium laser lithotripsy before anesthesia can effectively improve the patient's autonomous comfort, shorten the operative position placement time, improve the surgeon's satisfaction with the operative position placement, and reduce the incidence of postoperative complications.It is worthy of clinical promotion.
2020, 45(8): 1132-1135.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.039
Abstract:
Objective To analyze the developmental and evolutionary process of the Journal of Bengbu Medical College(hereinafter referred to as "Journal") in the past 10 years, explore the current development trends and direction of the Journal, and hope to provide a basis for the development of the Journal. Methods Six thousand one hundred and thirty-seven articles published in the Journal from 2009 to 2018 were statistically analyzed and visualized using the Bicomb2 bibliographic analysis system and information visualization analysis software CiteSpace 5.4R2. Results A total of 11 049 authors and 1 783 institutions participated in the creation of 6 137 articles.There were 53 authors with ≥15 articles, YANG Xiu-mu, Qi Yu-long and ZHANG Li were in the forefront, who issued 41, 39, 39 articles, respectively.The top three organizations in the number of publications were the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, and Anhui Medical University.The higher medical institutions and clinical institutions above the municipal level were the main publications of the Journal.The plasmodium vivax, immunohistochemistry, analgesia, nursing teaching reform, Parkinson's disease and systemic lupus erythematosus had become the subject of the Journal, and a research team with core scholars and gradient had been formed around each research hotspot. Conclusions The Journal presents the scientific research achievements and clinical experience of Bengbu Medical College, including the affiliated hospitals, and also provides an important platform for peer exchange.
2020, 45(8): 1136-1138, 1141.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.040
Abstract:
Objective To explore the application value of "Micro-course combined with flipped classroom" in clinical teaching of ICU nursing students. Methods Thirty nursing students from June to August 2019, and 30 nursing students from September to November 2019 of ICU in The First Affiliated Hospital of Bengbu Medical College were divided into the control group and observation group, respectively.The control group and observation group were taught using the raditional method and micro-class combined with flipped classroom teaching method, respectively.The theory test, skill performance, comprehensive ability and teaching satisfaction were compared between two groups, and the effects of micro-class combined with flipped classroom was evaluated. Results The scores of theory test, skill test, comprehensive ability and teaching satisfaction in observation group were higher than those in control group(P < 0.05 to P < 0.01). Conclusions The teaching mode of "micro-course combined with flipped classroom" can effectively improve the comprehensive ability of clinical practice of nursing students in ICU.
2020, 45(8): 1139-1141.
doi: 10.13898/j.cnki.issn.1000-2200.2020.08.041
Abstract:
Objective To explore the application of day surgery unit in clinical teaching of postgraduate students. Methods Thirty orthopedic postgraduate students were randomly divided into day surgery group and control group (15 students in each group), which received six-month clinical skills training in day surgery unit and general ward, respectively.The basic information and curative effect of 356 cases of arthroscopic meniscus surgery participated by two groups of graduate students were compared, and the clinical skills of the two groups were evaluated. Results The hospitalization time and operative costs of patients in day surgery group were less than those in control group (P < 0.05).The knee function scores at 6 months after operation were improved in two groups (P < 0.05), but there was no significant difference in Lysholm score between the two groups (P>0.05).There was no significant difference in theoretical knowledge, physical examination and total score between the two groups (P>0.05).The intraoperative operation score in day surgery group was better than that in control group (P < 0.05). Conclusions The day surgery unit has achieved good teaching effects in clinical teaching of postgraduate students, which is worthy of further promotion.
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