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2021 Vol. 46, No. 6
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2021, 46(6): 701-707.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.001
Abstract:
ObjectiveTo investigate the effects and mechanism of metformin on bone destruction in rheumatoid arthritis(RA). MethodsThe adjuvant arthritis(AA) models with complete Freund's adjuvant(CFA) were established in rats.The systemic inflammation score was used to evaluate the effects of different doses of metformin on inflammation in AA rats; the ankle and foot of each group were examined using X-ray imaging; ELISA was used to measure the serum calcium, phosphorus, osteoprotectin(OPG), nuclear factor κB receptor activator ligand(RANKL) in peripheral blood of rats; the expression levels of AMP-activated protein kinase(AMPK), interleukin-6(IL-6) and tumor necrosis factor α(TNF-α) were measured by immunohistochemistry.The effects of metformin on bone destruction in rats was evaluated. ResultsMetformin could improve the systemic inflammatory response, and reduce paw swelling in AA rats, especially at high dose.All dose metformin groups could significantly improve the local bone mineral density and bone destruction in AA rats.The serum levels of calcium and phosphorus ion increased in high-dose metformin group.Different doses of metformin could increase the serum OPG level, and decrease the serum RANKL level.Compared with the model group, metformin could increase the protein expression of AMPK, decrease the protein expression of IL-6 and TNF-α, and the differences of which were statistically significant(P<0.05 to P<0.01). ConclusionsMetformin plays a protective role on the bone destruction of RA.The mechanism of action may be related to the effects of anti-inflammation, regulation of serum bone metabolism index and activation of AMPK signaling pathway to affect the OPG-RANKL-RANK system.
2021, 46(6): 708-712.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.002
Abstract:
ObjectiveTo explore the protective effect of sodium acetate Ringer's solution resuscitation combined with lactic acid bacteria on the intestinal mucosal barrier of rats with traumatic hemorrhagic shock. MethodsThirty SD rats were randomly divided into traumatic hemorrhagic shock without resuscitation group (THS group, n=10), sodium acetate Ringer's solution resuscitation group (AR group, n=10) and sodium acetate Ringer's solution combined with lactic acid bacteria resuscitation group (AL group, n=10).The rats in the AL group were given lactic acid bacteria tablets for 1 week on the basis of normal feeding before the shock model was established (calculated according to the volume area, the rats took 108 mg/kg each time, three times a day).The shock models were established in the THS group, AR group and AL group (average arterial pressure maintained 35±5 mmHg).The AL group and AR group were treated with sodium acetate Ringer's solution for 30 minutes of fluid resuscitation after 60 minutes of shock, and the rats' ileum were observed for 4 hours after resuscitation tissue.THS group was not resuscitated, and ileum tissue was taken 4 hours after shock observation.ELISA was used to detect peripheral blood tumor necrosis factor-α(TNF-α), interleukin(IL)-6, IL-4, and IL-10 concentration.Western blotting method was used to detect the expressions of ileum tissue ZO-1, claudin-1, TLR4, p38 phosphorylation and JNK phosphorylation protein. ResultsCompared with the THS group, the levels of TNF-α and IL-6 in the peripheral blood in the AL group were decreased, and the levels of IL-4 and IL-10 were increased, and the TNF-α concentration in the AR group was decreased, and the differences of which were statistically significant (P<0.05).Compared with the AR group, the level of TNF-α in peripheral blood in the AL group was decreased (P<0.05).There was no statistical difference in the levels of other cytokines between AR group and AL group (P>0.05).Compared with the THS group, the levels of TLR4, P-P38, and P-JNK in the peripheral blood of rats in the AR group were decreased, and the levels of ZO-1 and Claudin-1 were increased in the AL group, and the differences of which were statistically significant (P<0.05).Compared with the AR group, the levels of ZO-1 and Claudin-1 in the AL group were increased, and the levels of TLR4 and P-JNK were decreased (P<0.05).The histopathological results of the ileum showed that the damage of the ileum tissue in the AL group was less than that in the THS group and AR group. ConclusionsOn the basis of sodium acetate Ringer's solution to resuscitate traumatic hemorrhagic shock, the application of lactic acid bacteria may further inhibit the expressions of TLR4-p38MAPK/JNK inflammatory signal pathway and reverse the expression imbalance of pro-inflammatory factors and anti-inflammatory factors caused by shock which reduce the trauma intestinal injury in hemorrhagic shock.
2021, 46(6): 713-717.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.003
Abstract:
ObjectiveTo identify the differentially expressed genes in RUNX1 mutant acute myeloid leukemia(AML) and non-mutant AML and construct a prognostic model derived from RUNX1 mutations. MethodsDifferentially expressed genes in AML were screened from the RUNX1 mutated AML group and non-mutated AML group by univariate Cox, and a multivariate Cox regression prognostic model was constructed.The risk score of the patients was obtained according to the model, which was evaluated by the survival curve and the ROC curve. ResultsA total of 89 differentially expressed genes were screened from the RUNX1 mutant and non-mutant groups, 30 of which were up-regulated and 59 of which were down-regulated.All the differentially expressed genes were screened by univariate Cox regression, and 38 genes were obtained to construct multivariate Cox regression model.Based on the bidirectional stepwise regression method, 10 genes including BIK, APP, MLLT3, C10orf10, PLXNC1, FHL1, CST3, TGLL1, HOXA5 and KIAAO125 were further screened to construct the prognostic gene model.The 10 genes were used to construct a prognostic gene model, and the risk scoring formula was as follows.Risk score=-0.100×(BIK)+ 0.215×(APP)+ -0.232×(MLLT3)+ 0.112×(C10orf10)+ 0.160×(PLXNC1)+ 0.113×(FHL1)+ -0.167×(CST3)+ -0.152×(IGLL1)+ 0.164×(HOXA5)+ 0.084×(KIAA0125).The risk scores of BIK, MLLT3, CST3 and IGLL1 were less than 1, while the risk scores of the other six genes were greater than 1.Survival analysis of the high and low risk rating groups showed that the overall survival rate of high risk rating group was significantly lower than that of low risk rating group(P < 0.01).The AUC predicted by ROC curve for overall survival in 1, 3 and 5 years were 0.709, 0.769 and 0.771, respectively. ConclusionsThe prognostic model of mutant AML differentially genes was successfully constructed.The BIK, MLLT3 CST3 and IGLL1 may be the prognostic protective factors for AML.APP, C10orf10, PLXNC1, FHL1, HOXA5 and KIAAO125 may be the risk factors for prognosis of AML.
2021, 46(6): 717-721.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.004
Abstract:
ObjectiveTo investigate the effects and mechanism of astragaloside Ⅳ on the doxorubicin-induced myocardial injury. MethodsThe 6-week-old ICR male mice were randomly divided into the control group, doxorubicin group, doxorubicin+Astragaloside Ⅳ group.The control group was given a single intraperitoneal injection of 0.9% sodium chloride solution, and the other groups were given a single intraperitoneal injection of 20 mg/kg doxorubicin for modeling.The doxorubicin+astragaloside Ⅳ 80 mg/kg group were given astragaloside Ⅳ once a day by gavage, and the other groups were given a solvent(0.5% sodium carboxymethyl cellulose) by gavage for 10 days.On the 10th day, the mice's myocardial function(ejection fraction and fractional shortening) were detected using the echocardiography, and the heart rate of mice were monitored by the electrocardiogram test.On the 10th day, the serum and heart tissue of mice were collected, and the changes in the myocardial tissue structure were detected using Masson staining, and the levels of lactate dehydrogenase(LDH) and creatine kinase(CK-MB) were detected using biochemistry.The serum levels of interleukin-1β(IL-1β), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in mice were examined using ELISA, and the protein levels of Mer tyrosine kinase(MerTK) in the myocardium were detected using Western blotting. ResultsCompared with the control group, the heart rate and QT interval were significantly slower(P < 0.01), the cardiac ejection fraction and fractional shortening significantly decreased(P < 0.01), the contents of myocardial enzyme CK-MB and LDH significantly increased(P < 0.01), the protein expression lev el of p-MerTK significantly increased(P < 0.01), the levels of IL-1β, IL-6 and TNF-α significantly increased(P < 0.01), and there was severe fibrosis in the interstitium of mouse myocardial cells in adriamycin group.Compared with the doxorubicin group, the QT interval was significantly shortened(P < 0.01), the heart rate was improved almost to the normal level, the decreasing of cardiac ejection fraction and fractional shortening was significantly improved(P < 0.01), the contents of myocardial enzyme CK-MB and LDH significantly decreased(P < 0.01), the expression level of p-MerTK significantly decreased(P < 0.01), the levels of IL-1β, IL-6 and TNF-α significantly decreased(P < 0.01), and the area of myocardial fibrosis was significantly reduced in doxorubicin+astragaloside Ⅳ 80 mg/kg group. ConclusionsAstragaloside Ⅳ may reduce the myocardial injury and cardiotoxicity induced by doxorubicin through inhibiting MerTK cleavage.
2021, 46(6): 722-725, 730.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.005
Abstract:
ObjectiveTo explore the surgical experience and curative effects of the axillary approach without inflation in the treatment of papillary thyroid microcarcinoma. MethodsA total of 80 patients with papillary thyroid microcarcinoma were divided into the endoscope group(35 cases treated with endoscopic surgery) and open group(45 cases treated with open surgery).The perioperative data, complications and following-up data were compared between two groups. ResultsThe average age in endoscope group was younger than that in open group(P<0.05), the average operation time and amount of drainage fluid on the first day after the operation in endoscope group were more than those in open group(P<0.01), and the intraoperative blood loss in endoscope group was less than that in open group(P<0.01).The neck VAS score in endoscope group was lower than that in open group on the third day after operation(P<0.05).The difference of the average number of lymph nodes after central dissection between two groups was not statistically significant(P>0.05).There was no statistical significance in the postoperative hospital stay and postoperative complications between two groups(P>0.05).The postoperative cosmetic satisfaction in endoscope group was higher than that in open group(P<0.01).All cases were followed up for more than 3 months, and no recurrence or metastasis case was found. ConclusionsThe axillary approach without inflation in the treatment of papillary thyroid microcarcinoma is safe and feasible, has better cosmetic effects, and which is comparable to open surgery.
2021, 46(6): 726-730.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.006
Abstract:
ObjectiveTo investigatethe the levels of helper T lymphocyte 17(Th17)/regulatory T lymphocyte(Treg) and related cytokines in children with bronchiolitis, and its correlation with the progress of disease. MethodsEighty-three children with bronchiolitis were divided into the light disease group(42 cases), medium disease group(21 cases) and severe disease group(20 cases), and 30 healthy physical examination children at the same time were set as the control group.The ratio of Th17 and Treg to CD4+T cells were detected using flow cytometry.The serum concentrations of interleukin(IL)-6, IL-10, IL-17 and IL-35 were detected using ELISA, and the differences of above indicators were analyzed among four groups. ResultsThe ratio of Th17 cells and levels of pro-inflammatory factors of IL-17 and IL-6 in case group were significantly higher than those in control group(P<0.05), while the ratio of Treg cells and production of anti-inflammatory factors of IL-10 and IL-35 in case group were significantly lower than those in control group(P<0.05), especially in the severe group.The results of Pearson correlation analysis showed that the level of Th17 was positively correlated with levels of Th17/Treg, IL-17 and IL-6, and the level of Treg was positively correlated with levels of IL-10 and IL-35, and negatively correlated with Th17/Treg.The levels of Th17/Treg, Th17 and IL-17 were negatively correlated with IL-35(P<0.05 to P<0.01).The results of logistic regression analysis showed that the odds ratio of severe bronchiolitis to Th17/Treg, IL-17 and IL-6 were statistically significant(P<0.05 to P<0.01). ConclusionsThe imbalance of Th17/Treg plays an important role in the pathogenesis of bronchiolitis.Th17/Treg, IL-7 and IL-6 are the risk factors of severe bronchiolitis.
2021, 46(6): 731-734.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.007
Abstract:
ObjectiveTo analyze the value of the individual and combined the levels of alpha-fetoprotein(AFP), free estriol(uE3), inhibin A(InhA) and uterine arterial pulse index(PI) in predicting preeclampsia of pregnant women in the first and second trimesters of pregnancy. MethodsA total of 1 000 singleton primiparas were selected, 945 pregnant women diagnosed by preeclampsia were set as the case group, and the case group was matched to the control group in a ratio of 1:4 among pregnant women without preeclampsia.The serim levels of AFP, uE3 and InhA, and PI were detected and recorded. ResultsThe incidence rate of preeclampsia in 945 pregnant women was 3.5%(33/945).There was no statistical significance in the AFP level between two group(P>0.05).The value of InhA and PI in case group were higher than those in control group, and the uE3 value in case group was lower than that in control group(P<0.05 to P<0.01).The sensitivities of InhA, uE3 and PI in predicting preeclampsia of pregnant women were 48.4%, 72.7% and 57.6%, respectively.The specificities of InhA, uE3 and PI in predicting preeclampsia of pregnant women were 78.0%, 69.7% and 84.8%, respectively.The sensitivity and specificity of the combined index for predicting preeclampsia were 75.8% and 76.5%, respectively.The area under the ROC curve of the combined data in predicting preeclampsia was 0.825, which was significantly higher than that of InhA, uE3 and PI, respectively(P<0.05). ConclusionsThe combined value of uE3, InhA and PI in predicting preeclampsia is better than that of single parameter in the first and second trimesters of pregnancy.
2021, 46(6): 735-739.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.008
Abstract:
ObjectiveTo compare the differences of HBsAg clearance between pegylated interferon α-2b(Peg-IFNα-2b) combinated with nucleoside(acid) analogue(NAs) therapy and NAs monotherapy in chronic hepatitis B(CHB) patients with HBsAg<1 500 IU/mL after treatment with NAs. MethodsAmong 55 patients with HBsAg<1 500 IU/mL after NAs treatment, the patients treated with NAs combined with Peg-IFNα-2b, and patients treated with NAs were divided into the combination treatment group and NAs treatment group, respectively, and two groups were treated for 48 weeks.The HBsAg clearance rate and related factors influencing the clearance rate of HBsAg in two groups were observed. ResultsAfter 48 weeks of treatment, the HBsAg clearance rate in combination treatment group was significantly higher than that in NAs treatment group(P<0.01).The HBsAg levels in two groups gradually decreased with the increasing of medication time, and the reduction in combination treatment group was higher than that in NAs treatment group(P<0.05).The baseline HBsAg<327 IU/mL has a predictive effect on the clearance of HBsAg at the end of the 48-week treatment course(P<0.05).The AUC, cut-off value, sensitivity and specificity were 0.828, 327 IU/mL, 75.0% and 87.5%, respectively.The HBsAg clearance rate of patients with abnormal baseline alanine aminotransferase(ALT) was significantly higher than patients with normal ALT(P<0.01). ConclusionsThe treatment of NAs combined with Peg-IFNα-2b in pateints with low serum level of HBsAg can improve the HBsAg clearance rate.The baseline HBsAg<327 IU/mL has a predictive effect on the clearance of HBsAg at the end of 48 weeks treatment, and the HBsAg clearance is more likely to be achieved with baseline ALT levels above the upper normal limit.
2021, 46(6): 739-742, 747.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.009
Abstract:
ObjectiveTo compare the clinical effects of the two flap design in the extraction of horizontal impacted third molars exposed to 1/2 of the distal mandibular adjacent surface. MethodsA total of 200 teeth were selected from patients with horizontal impacted third molars exposed to 1/2 of the distal and middle mandibular surfaces, and the patients were randomly divided into the group A and group B.The group A and group B were treated with intragingival crevicular incision and envelope incision, respectively.The time of tooth extraction, intraoperative and postoperative complications and soft tissue healing were compared between two groups.Each parameter was recorded before and after operation, and the data were statistically analyzed. ResultsThe differences of the operation time, intraoperative complications and pain degree after 1, 3 and 7 days of operation between two groups were not statistically significant(P>0.05).The degree of postoperative facial swelling in two groups decreased with the increasing of time(P < 0.01).The degree of swelling and mouth opening limitation in group A were lighter than those in group B after 1 and 3 days of operation(P < 0.05 to P < 0.01).After 1 day of operation, the bleeding degree in group A was slightly lower than that in group B(P < 0.05), and there was no statistical significance in the bleeding degree between two groups after 2 and 7 days of operation(P>0.05).After 7 days of operation, the healing of soft tissue in group A was better than that in group B(P < 0.05). ConclusionsIn the horizontal impacted third molars with distal adjacent surface exposure ≥ 1/2 of the lower jaw, the method of intra gingival crevicular incision can reduce the postoperative response of patients, facilitate the healing of adjacent tissues, and improve the postoperative life quality of patients, which is worthy of clinical promotion and application.
2021, 46(6): 743-747.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.010
Abstract:
ObjectiveTo analyze the clinical significance of the level changes of interferon(IFN)-λ3 in different clinical stages of hepatitis B virus(HBV) infection, and its relationship with tenofovir(TDF) and entecavir(ETV) treatment. MethodsThe serum levels of IFN-λ3 of 174 HBV-infected patients and 20 HBsAg negative healthy examiners were detected using ELISA, and the clinical indexes of liver function, total bilirubin(TBIL), albumin(ALB) and other related indexes were collected.The distribution trend of IFN-λ3 levels in hepatitis B patients at different clinical stages were observed.The changes of serum levels of IFN-λ3 after regular administration of current first-line antiviral drugs(TDF and ETV), and the relationship between IFN-λ3 and disease progression, different antiviral drugs were analyzed. ResultsThe levels of IFN-λ3 in the control group, chronic hepatitis B group, liver cirrhosis group and hepatocellular carcinoma group decreased successively(P<0.01).Among patients treated with antiviral drugs, the differences of the levels of alanine aminotransferase, aspartate aminotransferase, HBsAg, TBIL, and LogHBV-DNA between before and after ETV or TDF treatment were statistically significant(P<0.01), the difference of the level of IFN-λ3 in patients between before and after ETV treatment was not statistically significant(P>0.05), and the difference of the level of IFN-λ3 in patients between before and after TDF treatment was statistically significant(P<0.01).The serum level of IFN-λ3 was positively correlated with the levels of HBsAg and HBV-DNA in chronic hepatitis B and cirrhosis patients, but not related to the liver function, TBIL, ALB and other clinical indicators. ConclusionsIFN-λ3 is associated with the progression of hepatitis B virus activity, and not with liver function itself.TDF has the additional pharmacological effects of inducing the increase of serum IFN-λ3 level, and the high level of IFN-λ3 can enhance the clearance of HBV by IFN-α.
2021, 46(6): 748-750.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.011
Abstract:
ObjectiveTo investigate the correlation and sensitivity of brain stem auditory evoked potential(BAEP) and cranial magnetic resonance imaging(MRI) in the diagnosis of acute bilimbin encephalopathy(ABE) in the newborn. MethodsThe clinical data of newborn with hyperbilirubinemia and aged >37 weeks were retrospectively analyzed, and divided into the ABE group(37 cases) and non-ABE group(92 cases).The total serum bilirubin level, changes of BAEP and MRI were compared between two groups. ResultsThe total serum bilirubin level, abnormal rates of BAEP and MRI in ABE group were higher than those in non-ABE group(P<0.01). ConclusionsThe total serum bilirubin level, BAEP and cranial MRI can be used as the indicators for the early diagnosis of neonatal ABE, and the BAEP is highly sensitive to ABE diagnosis.
2021, 46(6): 751-754.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.012
Abstract:
ObjectiveTo investigate the application value of urinary podocalyxin(PCX) combined with serum inflammatory factors in the diagnosis of diabetic nephropathy complicated with hyperuricemia. MethodsOne hundred and six patients with diabetic nephropathy were divided into the diabetic nephropathy group(52 cases) and diabetic nephropathy complicated with hyperuricemia group(54 cases).Under the same conditions, the urine and blood tests were implemented in two groups.The urine PCX levels, and serum levels of C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), monocyte chemotactic protein-1(MCP-1) and myeloperoxidase(MPO) were compared between two groups. ResultsThe levels of PCX, CRP, TNF-α, IL-6 and MCP-1 in diabetic nephropathy complicated with hyperuricemia group were higher tahn those in diabetic nephropathy group(P < 0.01), and the difference of MPO level between two groups was not statistically significnat(P>0.05).The results of binary logistic regression analysis showed that the urine PCX, serum CRP, TNF-α, IL-6 and MCP-1 were the independent risk factors of diabetic nephropathy complicated with hyperuricemia, and closely related to diabetic nephropathy complicated with hyperuricemia.The area under the ROC curve of combined detection of PCX, CRP, TNF-α, IL-6 and MCP-1 was better than that of each index alone(P < 0.05 to P < 0.01), and the sensitivity and specificity of combined detection of PCX, CRP, TNF-α, IL-6 and MCP-1 and MCP-1 were better than those of individual diagnosis(P < 0.05). ConclusionsThe urine PCX level combined with serum inflammatory factors(CRP, TNF-α, IL-6 and MCP-1) have high diagnostic value for diabetic nephropathy complicated with hyperuricemia, and broad prospect of clinical application.
2021, 46(6): 755-760.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.013
Abstract:
ObjectiveTo explore the efficacy and safety of early aerosol inhalation of budesonide suspension in the prevention of bronchopulmonary dysplasia(BPD) in preterm infants. MethodsThis prospective randomized cohort study was conducted from November 2017 to May 2020 in the department of neonatology.A total of 102 preterm infants with gestational age < 32 weeks and admission within 3 days after birth received mechanical ventilation or nasal continuous positive airway pressure ventilation.The infants were randomly divided into intervention group(n=50) and control group(n=52).The intervention group received aerosol inhalation of budesonide suspension, and the control group received aerosol inhalation of equivalent volumes of 0.9% sodium chloride solution.The primary and secondary outcome were compared between the two groups. ResultsThe incidence of BPD or death in intervention group was lower than that in control group(P < 0.05), the incidence of BPD in survival infants in intervention group was lower than that in control group(P < 0.05), and there was no significant difference in mortality between the two groups(P>0.05).The incidence of moderate and severe BPD in intervention group was lower than that in control group(P < 0.05), and there was no significant difference in incidence of mild, moderate and severe BPD between the two groups(P>0.05).The duration of atmospheric oxygen therapy and hospital stay in intervention group were significantly lower than those in control group(P < 0.01 and P < 0.05).There were no significant differences in the incidence of complications, body mass change, hemoglobin, platelet, electrolytes of liver and kidney function, and the utilization rate of pulmonary surfactant, caffeine citrate, and dexamethasone between the two groups(P>0.05). ConclusionsEarly aerosol inhalation of budesonide suspension after birth can reduce the incidence of BPD and moderate to severe BPD in preterm infants with mechanically assisted ventilation, and has no significant effect on mortality and no short-term adverse reactions.
2021, 46(6): 760-766.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.014
Abstract:
ObjectiveTo explore the clinical characteristics and related risk factors in patients with primary Sjögren's syndrome(pSS) with infection. MethodsIn this retrospective study, 197 patients with pSS were divided into infection group(n=52) and non-infection group(n=145), the characteristics of their infections including the infection sites and pathogens were investigated.The suspicious risk factors of infection in patients with pSS were assessed by bivariate logistic regression analysis, univariate factor analysis and multivariate factor analysis. ResultsIn this study, infection incidence in pSS in this study was 26.4%(52/197).The most common sites of infection were the respiratory tract(52.7%) and the urinary tract(21.8%), followed by skin and soft tissue(12.7%), septicemia(5.5%), central nervous system(3.6%), digestive tract(1.8%) and reproductive system(1.8%).Bacteria are the most common pathogens of infection(67.3%), followed by viruses(25%), fungi(7.7%), mycoplasma(7.7%), with four cases of mixed infection.Gram-negative bacilli such as Escherichia coli and Klebsiella are the most common bacterial infections, which have the high resistance to antibiotics especially quinolones and cephalosporins.The age, course of disease, serum cholesterol, triglyceride, C reactive protein, EULAR Sjögren's syndrome disease activity index(ESSDAI), EULAR Sjögren's syndrome patient reported index(ESSPRI) score, degree of dryness and degree of fatigue, incidence of lung involvement and the utilization rate of glucocorticoid in the infection group were all higher than those in the non-infection group(P < 0.05 to P < 0.01), and the total protein and albumin level in the infection group were lower than those in the non-infection group(P < 0.01).The infection rate of pSS patient in highly active group was significantly higher than that in the stable group and the mildly active group(P < 0.05).Logistic univariate regression analysis showed that old age, high ESSDAI score, high ESSPRI score, high fatigue degree, high dryness degree, low serum total protein, low albumin, high serum cholesterol, high triglyceride, high C reactive protein, pulmonary involvement were risk factors for pSS complicated with infection(P < 0.05 to P < 0.01).Logistic multivariate regression analysis showed that high ESSDAI score, high dryness degree, high serum triglyceride and pulmonary involvement were independent risk factors for pSS complicated with infection(P < 0.05 to P < 0.01). ConclusionsThe incidence of infection in pSS is high, respiratory and urinary tract are the most common sites of infection in pSS patients.The most common infection pathogens are Escherichia coli and Klebsiella.Moreover, high ESSDAI score, high degree of dryness, high serum triglyceride and pulmonary involvement are the independent risk factors for pSS complicated with infection, which should be attached importance to in clinical works.
2021, 46(6): 767-770, 774.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.015
Abstract:
ObjectiveTo explore the expression frequency of regulatory B cells(Bregs) in peripheral blood of ovarian cancer patients and its relationship with FIGO staging, and analyze its correlation with regulatory T cells(Tregs) and interleukin-10(IL-10). MethodsThe ovarian cancer(23 cases) and benign ovarian tumor patients(26 cases) were investigated.The expression frequency of CD19+CD24hiCD38hiBreg and CD4+CD25+Treg cells in peripheral blood and expression levels of serum IL-10 in all cases were detected using flow cytometry.The correlation between the two kinds of cells and FIGO staging, IL-10 concentration, and the correlation between FIGO staging and IL-10 concentration were analyzed. ResultsThe percentages of Bregs and Tregs in peripheral blood of ovarian cancer patients were higher than those of benign ovarian tumor patients(P < 0.01), and closely related to FIGO stage.The percentages of Bregs and Tregs in peripheral blood of patients with stage Ⅲ+Ⅳovarian cancer were higher than those of patients with stageⅠ+Ⅱovarian cancer(P < 0.01).The serum levels of IL-10 in ovarian cancer patients were significantly higher than that in benign ovarian tumor patients(P < 0.01).The results of correlation analysis showed that the proportion of Bregs in peripheral blood of ovarian cancer patients was positively correlated with the proportion of Tregs(P < 0.05).The serum level of IL-10 was positively correlated with Breg and Treg cells in ovarian cancer patients(P < 0.05). ConclusionsThe proportion of Bregs and Tregs in the peripheral blood of ovarian cancer patients is significantly increased, and they can participate in the immune response of ovarian cancer through secreting IL-10, which may provide a new target for the immunotherapy of ovarian cancer.
2021, 46(6): 771-774.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.016
Abstract:
ObjectiveTo explore the related factors of the recurrence within 2 years of precancerous lesions of cervical cancer after cervical loop electrosurgical excision procedure(LEEP). MethodsThe clinical data of 458 patients with precancerous lesions of cervical cancer were retrospectively analyzed.The LEEP surgery in all patients was successfully completed.After 2 years of postoperative following-up, 31 patients were set as relapsed group, and the remaining 427 patients were set as non-relapsed group.The relapse of patients was analyzed after LEEP, and the risk factors of the recurrence of cervical precancerous lesion within 2 years after LEEP were analyzed. ResultsAmong the 458 patients, 31 cases relapsed within 2 years of following-up, the cure rate and recurrence rate were 93.23% and 6.77%, respectively.Six cases, 8 cases and 17 cases recurred within 6 months, 6 months to 1 year and 1 to 2 years after operation, respeectively.The mean recurrence time was(15.53±4.23) months.The differences of the age, menopause, smoking, involvement of cervical duct, quadrant involvement, preoperative HR-HPV RLU/CO, surgical margin and postoperative persistent infection of same type HPV between two groups were statistically significant(P < 0.05 to P < 0.01).The results of logistic multivariate analysis showed that advanced age, menopause, involvement of cervical duct, preoperative HR-HPV RLU/CO ≥ 1 000, positive surgical margin and postoperative persistent infection of the same type HPV were the risk factors of recurrence within 2 years of precancerous lesions of cervical cancer after LEEP(P < 0.05 to P < 0.01). ConclusionsThe recurrence rate of precancerous lesions of cervical cancer within 2 years after LEEP surgery is 6.77%, and the advanced age, menopause, involvement of cervical duct, preoperative HR-HPV RLU/CO ≥ 1 000, positive incisal margin and postoperative persistent infection of the same type HPV can increase the recurrence rate.Therefore, the clinical monitoring should be strengthened.
2021, 46(6): 775-779.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.017
Abstract:
ObjectiveTo study the risk and countermeasures of contralateral hip refracture after proximal femoral nail anti-rotation(PFNA) and artificial femoral head replacement(FHR) in the treatment of osteoporotic hip fracture in the elderly. MethodsThe clnical data of 71 patients aged more than 75 years old with omminuted intertrochanteric fracture of the femur were retrospectively analyzed.The pateints were divided inton the PFNA group(52 cases) and FHR group(19 cases) according to the different surgical methods.The relative clinical indexes, Harris functional score of the hip joint at different postoperative stages, bone mineral density of the contralateral hip and incidence rate of refracture of the contralateral hip were compared between two groups. ResultsThe length of incision, operative time, intraoperative blood loss, length of hospital stay and hospitalization cost in PFNA group were less than those in FHR group, and the postoperative weight-bearing time in PFNA group was longer than that in FHR group(P < 0.05 to P < 0.01).The Harris scores in FHR group after 1 and 3 months of operation were higher than those in PFNA group(P < 0.05), and there was no statistical significannce in the Harris scores between two groups after 6 and 12 months of surgery(P>0.05).The results of repeated ANOVA showed that the differences of the time of bone mineral density in contralateral hip change and interactions of surgical modalities between two groups were statistically significant after operation(P < 0.01).Comparing two groups at the same time, the changes in the bone mineral density of the opposite hip bone after surgery in the PFNA group were lower than those in the FHR group(P < 0.05 to P < 0.01). ConclusionsThe bone mineral density levels in postoperative patients treated with PFNA and FHR are low, the continuous safety protection and management of osteoporosis after osteoporotic fractures should be emphasized.FHR is more conducive to reduce the risk of refracture of the contralateral hip in patients with severe osteoporosis.
2021, 46(6): 779-782.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.018
Abstract:
ObjectiveTo investigate the curative effects of Dunhill surgery and bilateral subtotal thyroidectomy in the treatment of bilateral nodular goiter(NG), and its effects on prognosis. MethodsThe clinical data of 120 bilateral NG patients were retrospectively analyzed, and the patients were divided into the Dunhill surgery group(55 cases) and bilateral subtotal thyroidectomy group(65 cases) according to different surgical methods.The operation time, intraoperative blood loss, indwelling drainage time, drainage volume, hospitalization time, and incidence rates of complication and recurrence were compared between two groups.The levels of free triiodothyronine(FT3), free thyroxine(FT4) and serum thyroid stimulating hormone(TSH) in two groups before and after surgery were detected using chemiluminescence method. ResultsThe operation time in Dunhill surgery group was significantly longer than that in bilateral subtotal thyroidectomy group(P < 0.01).The differences of the levels of TSH, FT3 and FT4 before and after surgery between two groups were not statistically significant(P>0.05).The incidence rate of hypocalcemia in Dunhill surgery group was higher than that in bilateral subtotal thyroidectomy group(14.55% vs 1.54%)(P < 0.05).The differences of the incidence rates of hoarseness, recurrent laryngeal nerve injury, hand and foot numbness and hypothyroidism were not statistically significant between two groups(P>0.05).The recurrence rate in Dunhill surgery group was lower than that in bilateral subtotal thyroidectomy group(P < 0.05). ConclusionsDunhill surgery has the same effect as bilateral subtotal thyroidectomy in the treatment of nodular goiter.However, Dunhill surgery can better balance the efficacy and safety, and reduce postoperative recurrence rate.
2021, 46(6): 783-785, 790.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.019
Abstract:
ObjectiveTo analyze the difference of the serum levels of Nesfatin-1 in patients with different glucose tolerance, and explore the relationship between Nesfatin-1 level and occurrence, development of type 2 diabetes mellitus(T2DM). MethodsSixty pateints with impaired fasting glucose(IFG) and impaired glucose tolerance(IGT), 60 patients with T2DM and 52 health examinees at the same time were divided into the prediabetes group(PreDM), T2DM group and healthy control group, respectively.The body mass index(BMI), waist hip ratio(WHR), fasting plasma glucose(FPG), fasting insulin(FIns), glycosylated hemoglobin(HbA1c), islet β-cell function index(HOMA-β) and Nesfatin-1 were detected in three groups. ResultsCompared with the healthy control group, the BMI, FPG, FIns, Nesfatin-1 and HbA1c increased significantly, the HOMA-β decreased significantly in PreDM group, and the differences of which were statistically significant between two groups(P < 0.01).Compared with the healthy control group, the BMI, FPG, FIns and HbA1c increased significantly, and the HOMA-β and the Nesfatin-1 decreased significantly in T2DM group, and the differences of which were statistically significant between two groups(P < 0.01).Compared with the PreDM group, the BMI, FPG and HbA1c increased significantly, the HOMA-β, Nesfatin-1 and FIns decreased significantly in T2DM group, and the differences of which were statistically significant between two groups(P < 0.01).The Nesfatin-1 was positively correlated with the WHR, BMI, FIns and HOMA-β, and negatively correlated with the FPG(P < 0.05 to P < 0.01).The results of multiple linear regression analysis showed that the FPG increased with the increasing of BMI, WHR and FIns, and decreased with the increasing of Nesfatin-1(P < 0.05 to P < 0.01). ConclusionsThe serum Nesfatin-1 is one of the factors affecting glucose metabolism.The decrease of Nesfatin-1 level is likely to be involved in the occurrence and development of T2DM.
2021, 46(6): 786-790.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.020
Abstract:
ObjectiveTo explore the clinical value of multi-parameter 3.0T-MRI in the diagnosis of human epidermal growth factor receptor 2(HER-2)positive breast cancer. MethodsThe imaging features and clinical data of 74 patients with breast cancer confirmed by pathology were retrospectively analyzed.The breast MRI in all patients were detected before operation.According to the expression of HER-2 detected by postoperative pathological immunohistochemistry, the patients were divided into the HER-2 positive group(34 cases) and HER-2 negative group(40 cases).The differences of the age, length, diameter, shape and edge of lesions, enhancement mode, apparent diffusion coefficient(ADC) value and time-intensity curve(TIC) curve were compared between two groups, and the MRI features of the HER-2 positive breast cancer were analyzed. ResultsThe difference of the age between the HER-2 positive group[(49.59±9.30) years old] and HER-2 negative group[(45.68±9.01) years old] was not statistically significant(P>0.05).The ADC value of lesions in HER-2 positive group[(1.01±0.23)×10-3mm2/s] was higher than that in HER-2 negative group[(0.90±0.16)×10-3mm2/s](P < 0.05), and the area under ROC curve(AUC) was 0.663(95%CI: 0.538-0.789).The ring enhancement patterns of lesions in HER-2 positive group was more than that in HER-2 negative group(P < 0.01), and AUC was 0.689(95%CI: 0.567-0.811).The differences of the length, diameter, shape and edge of lesions, and MRI characteristic parameters of TIC curve were not statistically significant between two groups(P>0.05). ConclusionsThe MRI findings of the HER-2 positive breast cancer have certain characteristics, which can provide an important reference for the preoperative evaluation, clinical treatment and prognosis of patients.
2021, 46(6): 791-795.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.021
Abstract:
ObjectiveTo investigate the diagnostic value of magnetic resonance cholangiopancreatography(MRCP) combined with the coronal magnetic resonance imaging(MRI) in the biliary obstruction. MethodsSeventy patients with obstructive jaundice confirmed by pathology were selected as the subjects, and all patients were detected using MRCP and coronal MRI(plain scan+ enhancement) scanning before operation.The accuracy of the positioning and qualitative diagnosis of biliary obstruction using MRCP, MRI coronal examination and combination of MRCP and MRI were analyzed. ResultsThere was no statistical significance in the accuracy of positioning diagnosis of biliary obstruction among three groups(P>0.05).The qualitative diagnosis accuracy rate of the MRCP, MRI coronal examination and combination of MRCP and MRI in biliary obstruction were 71.4%, 82.9% and 94.3%, respectively, and the accuracy of combined examination was higher than that of MRCP or MRI coronal exmination alone(P < 0.05).There was no statistical significance in the accuracy of qualitative diagnosis of benign biliary obstruction among three groups(P>0.05).The accuracy of qualitative diagnosis of the MRCP, MRI coronal examination and combination of MRCP and MRI in malignant biliary obstruction were 58.7%, 78.3% and 93.5%, respectively, and the accuracy of combined examination was higher than that of MRCP or MRI coronal exmination alone(P < 0.01). ConclusionsIn the localization diagnosis of biliary obstruction, the diagnostic accuracy of MPCP and MRI coronal imaging are high.The qualitative diagnosis of MRI coronal position in malignant obstruction is better than that of MRCP sequence.The combination of MPCP and MRI coronal imaging can significantly improve the qualitative diagnosis of biliary obstruction, which can provide a valuable reference basis for the clinical determination of the etiology of obstructive jaundice, and is worthy of promotion and use.
2021, 46(6): 796-798, 802.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.022
Abstract:
ObjectiveTo discuss the factors influencing the success or failure of hydraulic enema reduction and its predictive value. MethodsThe clinical data of 126 children with intussusceptions were retrospectively analyzed.The cases were divided into the success group(100 cases)and failure group(26 cases)according to whether the reduction was successful or not.The basic data and ultrasonic performance between two groups were compared.The logistic regression analysis was used to analyze the influencing factors of the reduction of hydraulic enema, and the ROC curve was used to analyze the predictive value of different indicators for the success or failure of reduction. ResultsThe differences of blood stool, pelvic effusion, intusculation location, blood flow distribution, onset time, concentric circle wide diameter, concentric circle thick diameter, sheath thick diameter and sleeve length were statistically significant(P < 0.05 to P < 0.01).The results of logistic regression analysis showed the width diameter of concentric circles, bloody stool, duration of intussusception and length of intussusception were the independent risk factors of reduction(P < 0.01).The specificity, sensitivity and AUC of combined prediction of the above factors were 89.3%, 88.8% and 0.933, respectively, and the specificity and sensitivity were higher than those of separate prediction(P < 0.05). ConclusionsThe ultrasound finding combined with clinical data can effectively predict the outcome of hydraulic enema reduction, and reduce the pain of children and risk of ineffective treatment.
2021, 46(6): 799-802.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.023
Abstract:
ObjectiveTo analyze the application value of ultrasound MicroPure imaging combined with superb microvascular imaging(SMI) in the differential diagnosis of benign and malignant breast nodules. MethodsNinety-five patients(123 nodules) detected by ultrasound were selected as research object.All patients were examined using the two-dimensional ultrasound, ultrasound MicroPure imaging, SMI and the results of which was compared with the pathology results.The sensitivities, specificities and accuracy of the ultrasound MicroPure imaging, SMI and joint inspection of both were analyzed. ResultsThe sensitivity, specificity and accuracy of ultrasound MicroPure imaging in the differential diagnosis of benign and malignant breast nodules were 84.6%, 82.2% and 83.7%, respectively.The sensitivity, specificity and accuracy of SMI in the differential diagnosis of benign and malignant breast nodules were 80.8%, 80.0% and 80.5%, respectively.The sensitivity, specificity and accuracy of ultrasound MicroPure imaging combined with SMI in the differential diagnosis of benign and malignant breast nodules were 94.9%, 95.6% and 95.1%, respectively.The sensitivity, specificity and accuracy of the combined examination were higher than those of the ultrasound MicroPure imaging and SMI alone(P < 0.05 to P < 0.01). ConclusionsThe clinical value of ultrasound MicroPure imaging technique combined with SMI in the differential diagnosis of benign and malignant breast nodules is higher.
2021, 46(6): 803-806.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.024
Abstract:
ObjectiveTo investigate the distribution of high affinity anti-double-stranded DNA(dsDNA) antibodies in patients with systemic lupus erythematosus(SLE), and its correlation with sex, age and lupus nephritis. MethodsA total of 155 serum samples with anti-dsDNA antibody positive in Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2017 to April 2018 were collected, which were divided the SLE group(116 cases) and non-SLE group(39 cases).The levels of total anti-dsDNA antibody and high affinity anti-dsDNA antibody were determined using the enzyme-linked immunosorbent assay(ELISA) and indirect immunofluorescence(IIF).The Kappa analysis was used to investigate the consistency of results among different detection methods.Spearman correlation coefficient was used to analyze the correlation between high affinity dsDNA antibody, and gender, age and other clinical indicators. ResultsThe total anti-dsDNA antibody measured by ELISA(dsDNA-ELISA) was not specific for SLE.The overall compliance rate between dsDNA-IIF and dsDNA-ELISA was 58.7%(91/155), the Kappa was 0.172(< 0.4), and the consistency between two methods was low(P < 0.01).The overall compliance rate between dsDNA-IIF and high affinity dsDNA-ELISA was 61.9%(96/155), the Kappa was 0.514(0.4 < Kappa < 7.5), and the consistency between two methods was moderate(P < 0.01).The high affinity anti-dsDNA level was positively correlated with dsDNA-IIF and dsDNA-ELISA(P < 0.01), and was not related to the gender, age and lupus nephritis(P>0.05).The sensitivity and specificity of combined diagnosis of dsDNA-IIF and high affinity anti-dsDNA were 90.5%(105/116) and 100%(39/39), respectively. ConclusionsThe combined diagnosis of dsDNA-IIF and high affinity antibody levels is more conducive to the diagnosis of SLE.High affinity anti-dsDNA antibodies are not associated with age, gender and lupus nephritis.
2021, 46(6): 807-811.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.025
Abstract:
ObjectiveTo explore the serum levels of fasting C-peptide(FC-P), fasting insulin(FINS), blood glucose indexes[fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1c)] in patients with type 2 diabetes mellitus(T2DM) complicated with non-alcoholic fatty liver disease(NAFLD), and relationship between each index and liver fibrosis. MethodsOne hundred and twenty-six patients with T2DM complicated with NAFLD were set as the study group.One hundred and twenty-six patients with T2DM and 126 healthy medical examinees during the same period were divided into the control group A and control group B, respectively.The serum levels of FC-P, FINS, FPG and HbA1c among three groups were compared, and the above index levels of patients with different NAFLD fibrosis scores(NAFLDFS) in the study group were compared.The predictive value of serum levels of FC-P, FINS, FPG and HbA1c to T2DM patients complicated with NAFLD were investigated, the relationship between each index and NAFLDFS score in T2DM patients complicated with NAFLD were explored, and the influencing factors of T2DM patients complicated with NAFLDFS more than 0.676 were analyzed. ResultsThe serum levels of FC-P, FINS, FPG and HbA1c in the study group, control group A and control group B gradually decreased(P < 0.01).The area under the curve(AUC) predicted by the serum levels combination of FC-P, FINS, FPG and HbA1c in T2DM patients complicated with NAFLD was 0.839, which was greater than the AUC predicted by each indicator alone(0.764, 0.801, 0.757 and 0.729, respectively).The best sensitivity and specificity of the combined prediction were 75.40% and 84.13%, respectively.With the increasing of NAFLDFS score, the body mass index, disease duration, waist-to-hip ratio, and serum levels of FC-P, FINS, FPG, and HbA1c gradually increased in the study group(P < 0.01).There was a positive correlation between the expression levels of serum FC-P, FINS, FPG and HbA1c, and NAFLDFS score in the study group(P < 0.01).The results of logistic regression analysis showed that with the disease course of T2DM patients complicated with NAFLD prolonging, the serum levels of FC-P, FINS, FPG and HbA1c increased, and the risk of NAFLDFS>0.676 gradually increased(P < 0.01). ConclusionsThe high levels of FC-P, FINS and blood glucose indexes in T2DM patients complicated with NAFLD is positively correlated with the liver fibrosis score.The combined detection can predict the risk of NAFLD in T2DM patients, and provide the guiding reference in evaluating the degree of liver fibrosis, and inhibiting the progression of the disease.
2021, 46(6): 812-816.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.026
Abstract:
ObjectiveTo screen the items of the adult nutrition literacy assessment scale, and verify its reliability and validity for providing a tool to assess the nutritional literacy levels of adults. MethodsThe literature review was used to form the item pool, the initial nutrition literacy questionnaire was developed by Delphi consultation, and the results of online questionnaires of 1 718 adults were collected for further filtering entries combined with critical ration method, correction item-total correlation coefficient method and factor analysis method.The reliability of scale was tested using the Cronbach's α coefficient and Split-Half coefficient, and the validity of scale was tested in terms of content validity and structure validity. ResultsThe nutritional literacy assessment scale included the functional nutrition literacy(including knowledge, understanding, obtaining skills and applying skills), interactive nutrition literacy(interactive skills) and critical nutrition literacy(critical skills), a total of 43 items.The Cronbach's α coefficient and Split-half reliability coefficient of total scale were 0.971 and 0.855, respectively.The content validity index at scale level and item level were 0.982 and 0.846-1.000, respectively.The results of confirmatory factor analysis showed that the standardized factor load, AVE value and CR value of the six dimensions were 0.463-0.938, 0.552-0.807 and 0.860-0.961, respectively. ConclusionsThe reliability and validity of the nutrition literacy assessment scale are good, and it can be used to assess the nutritional literacy for adults.
2021, 46(6): 817-821.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.027
Abstract:
ObjectiveTo explore the causal relationship between alcohol consumption and post-stroke cognitive impairment(PSCI) based on Mendelian. MethodsBased on Mendelian randomization inverse-variance weighted(IVW), the causal relationship between drinking-related exposure factors and PSCI was evaluated using instrumental variables such as ALDH2 genotypes, and two-classification logistics analysis was used to test the significance of correlation. ResultsThe differences of the effects of the education level, flush after drinking and history of alcohol consumption on PSCI were statistically significant(P < 0.05).The concentration and purity of DNA in whole blood of patients were(54.88±20.59)ng/μL and(1.7-1.9), respectively.The genotype was determined by the polymorphism of ALDH2 rs671 site, and the G mutated to A.There were 76 cases of wild GG type, 52 cases of mutant heterozygous AG type and 3 cases of mutant pure and AA type, the results of quantitative analysis of Hardy-Weinberg genetic balance showed that this gene locus was stable(P>0.05).The causality between PSCI and history of alcohol consumption was βIVW alcohol consumption history=0.606(OR=3.334, 95%CI: 3.038-3.653), and the causality between PSCI and blush after alcohol consumption was βIVW blush after drinking=0.320(OR=4.908, 95%CI: 4.739-6.475). ConclusionsThere is a positive causality between PSCI, and history of alcohol consumption and blush after drinking in patients with ischemic stroke before admission.
2021, 46(6): 822-825.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.028
Abstract:
ObjectiveTo explore the internal mechanism of the effects of time management tendency on academic procrastination of medical students, and provide theoretical basis for the intervention program of academic procrastination in the future. MethodsFrom March to June 2019, 499 medical students from a university were selected by stratified random sampling method, and investigated using the self-compiled general information questionnaire, time management tendency scale, self-compassion scale and Aitken procrastination scale. ResultsThe academic procrastination score of medical students was (46.19±8.74)points, and which was in the middle level.The differences of the academic procrastination scores among only child, different grades and achievements after entering university were statistically significant(P < 0.01).The time management tendency was negatively correlated with academic procrastination(r=-0.522, P < 0.01), and positively correlated with self-compassion(r=0.334, P < 0.01).There was a significant negative correlation between self-compassion and academic procrastination(r=-0.317, P < 0.01).The relationship between time management tendency, self-compassion and academic procrastination showed that the time management tendency could directly influence the academic procrastination of medical students, and it could also influence academic procrastination of medical students through the partial mediating role of self-compassion(the effect value was 10.46%). ConclusionsTo improve the academic procrastination of medical students can start from improving their time management ability and self-compassion.
2021, 46(6): 826-829.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.029
Abstract:
ObjectiveTo compare the pain caused by peripherally inserted central catheter(PICC) catheterization and number of punctures after local anesthesia at different time. MethodsFrom 2018 to 2019, 90 patients treated with PICC catheterization at a grade A tertiary hospital in Bengbu city were randomly divided into the control group(post-puncture anesthesia) and observation group(pre-puncture anesthesia)(45 cases in each group).The effects of puncture on patients' pain and number of puncture were evaluated in two groups. ResultsThere was no statistical significance in local pain scores between two groups(P>0.05).The number of puncture in observation group was more than that in control group(P < 0.05).The diameter of blood vessels before local anesthesia in observation group was larger than that after local anesthesia(P < 0.05), and there was no statistical significance in the distance from blood vessels to skin between before and after local anesthesia(P>0.05). ConclusionsThe PICC catheterization with modified seldinger technique guided by ultrasound is performed, the pre-puncture anesthesia and post-puncture anesthesia had no effect on the patient's pain, but the pre-puncture anesthesia can lead to the vasoconstriction and increase the difficulty of puncture.
2021, 46(6): 829-832.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.030
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ObjectiveTo investigate the role of gravity feeding combined with oral motor interventions (OMIs) in oral feeding of preterm infants. MethodsSixty preterm infants were randomly divided into the observation group and control group, 30 cases in each group.The control group was treated with conventional tube feeding and injection feeding, and the observation group was treated with gravity feeding combined with 5 min OMIs.The two groups were treated with the self-created atmospheric pressure suction method.The critical time point of oral feeding, the incidence of feeding intolerance, the increase of body mass, and the scores of ready oral feeding were compared between the two groups. ResultsThe first oral feeding gestational age, complete oral feeding gestational age, complete oral feeding weight and discharge weight in the observation group were lower than those in the control group, and the feeding transition time was shorter than that in the control group (P < 0.01).On 14 and 21 days after the intervention, the observation group had higher scores in preparing for oral feeding than the control group (P < 0.01).At each time point before and after intervention, scores in both groups showed an upward trend with time increase (P < 0.01).The incidence of vomiting and milk volume in the observation group was lower than that in the control group (P < 0.01). ConclusionsGravity feeding combined with 5 min OMIs can promote premature infants to achieve complete oral feeding earlier and reduce the rate of feeding intolerance.
2021, 46(6): 833-837, 841.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.031
Abstract:
ObjectiveTo analyze the occurrence of anxiety and depression in breast cancer patients at different time periods, and its related influencing factors. MethodsEighty-two breast cancer patients were investigated using the anxiety self-rating scale, depression self-rating scale and EORTC quality of life measurement scale before surgery, and at the fourth cycle and eighth of chemotherapy. ResultsCompared before operation, the anxiety and depression scores of breast cancer patients significantly increased in the fourth cycle of chemotherapy(P < 0.01), and returned to the preoperative level in the eighth cycle of chemotherapy(P>0.05).Among different time periods, the differences of the emotional function, role function, social function, cognitive function, insomnia, fatigue, loss of appetite, nausea and vomiting, constipation, economic difficulties and overall health status of 11 dimensions of the core quality of life scale were statistically significant(P < 0.05 to P < 0.01), and there was no statistical significance in the four dimensions of physical function, pain, shortness of breath and diarrhea(P>0.05).The results of multiple linear regression analysis showed that the older age, lower education level and poor overall health status were the risk factors of preoperative anxiety(P < 0.05 to P < 0.01), the nausea, vomiting and loss of appetite were the risk factors of anxiety in the fourth cycle of chemotherapy(P < 0.05), and the low cognitive function score, nausea and vomiting were the risk factors of anxiety in the eighth cycle of chemotherapy(P < 0.05).The employment, non-marriage, low educational level and insomnia were the risk factors of preoperative depression(P < 0.01), the constipation, fatigue, low cognitive function and economic difficulties were the risk factors of depression in the fourth cycle of chemotherapy(P < 0.05), and the financial hardship and poor overall health status were the risk factors of depression in the eighth cycle of chemotherapy(P < 0.05 and P < 0.01). ConclusionsMedical staff should strengthen the psychological nursing of breast cancer patients at all stages, especially the fourth cycle of chemotherapy.Taking targeted methods to deal with the adverse symptoms of chemotherapy can reduce the anxiety and depression of patients.
2021, 46(6): 838-841.
doi: 10.13898/j.cnki.issn.1000-2200.2021.06.032
Abstract:
ObjectiveTo study the thematic characteristics of spiritual needs in patients with acute leukemia during the course of disease, and propose countermeasures for positive target intervention. MethodsA total of 80 patients with acute leukemia were investigated using the general data questionnaire and spiritual needs assessment scale(SNAP).Based on the survey results and interview data, the status quo and characteristics of patients' spiritual needs were analyzed, and the reasonable target intervention was implemented from the perspective of spiritual care.The RS-14 resilience scale and SCCS self-congruence scale were used to observe the effects before and after intervention. ResultsThe spiritual needs in patients with acute leukemia were obvious.The total score of SNAP was(54.86±19.20)points, and the proportion of patients with higher than the average score was 54.61%.The top five items for specific spiritual needs, ranking from highest to lowest, were "learning to deal with grief", "finding peace of mind", "sharing your thoughts with those close to you", "discussing the meaning and purpose of life" and "easing your worries about your family." After the targeted intervention was implemented by the nursing team according to the characteristics of spiritual needs, the scores of some items and total scores of the RS-14 resilience scale and SCCS self-concordant scale were significantly improved, and the differences of those between before and after intervention were statistically significant(P < 0.05 to P < 0.01). ConclusionsThe spiritual distress and spiritual needs of acute leukemia patients are significant, and the clinical practice should start from the concept of "whole-person service", give proper play to the spiritual care function, give patients the theme intervention of spiritual development and self-harmonious growth, in order to improve the spiritual health and quality of life.
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