Author Login
Experts Review
Academic Editor
Editor-in-chief
2021 Vol. 46, No. 8
Display Method:
2021, 46(8): 989-993.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.001
Abstract:
ObjectiveTo study the effects of exosomal miR-5585-5p derived from paclitaxel-resistant breast cancer cells on the migration, apoptosis and drug resistance of breast cancer cells. MethodsThe exosomes were obtained by ultracentrifugation, and the expression levels of miR-5585-5p in breast cancer cell line(SKBR-3), paclitaxel-resistant breast cancer cell line(SKBR-3/PR) and exosomes were detected using qRT-PCR.The inhibitor of miR-5585-5p was transfected into paclitaxel-resistant breast cancer cells, the migration ability of cells was detected using Transwell assay, and the apoptosis of cells was detected using flow cytometry.The qRT-PCR and western blotting were used to detect the expression levels of drug-resistant gene. ResultsCompared with SKBR-3 cell line, the expression levels of miR-5585-5p in drug-resistant SKBR-3/PR cell line and exosomes were up-regulated(P < 0.01 and P < 0.05).After the miR-5585-5p inhibitor was transfected into the drug-resistant cell line, the results of Transwell assay and flow cytometry showed that the drug resistance and biological activity in the inhibitor group decreased compared with the control group(P < 0.01).The co-cultured drug-resistant cell-derived exosomes with breast cancer cells could induce the drug-resistant phenotype, enhance the ability of migration and inhibit the apoptosis rate of SKBR-3 cells(P < 0.01).However, the exosomes derived from drug-resistant breast cancer cells transfected with miR-5585-5p inhibitor could reduce the effects. ConclusionsThe paclitaxel-resistant breast cancer cells can deliver the highly expressed miR-5585-5p to the parent cells through exosomes, and induce the parent cells to produce drug-resistant phenotypes.The exosome miR-5585-5p can provide new molecular targets for the treatment of breast cancer drug-resistance, and provide new biomarkers for the prognosis assessment of breast cancer.
2021, 46(8): 994-999.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.002
Abstract:
ObjectiveTo explore the effects of chrysophanol on pyroptosis of human gastric cancer cells and its possible mechanism. MethodsThe human gastric cancer MKN28 cells were treated with chrysophanol at different concentrations(0, 5 and 10 μmol/L), NLRP3 inhibitor and caspase-1 inhibitor.The pyroptosis was detected using CCK-8 method, clone formation experiment and flow cytometry.The mRNA levels of pyroptosis and NLRP3 inflammasome-related proteins detected using real-time PCR.The protein expression levels of pyroptosis and NLRP3 inflammasome-related proteins were detected using Western blotting. ResultsThe different concentrations of chrysophanol(0, 5 and 10 μmol/L) could decrease the cell viability and promote the occurrence of pyroptosison of MKN28 cells(P < 0.01).In a dose-dependent manner, the chrysophanol increased the mRNA and protein expression levels of NLRP3, caspase-1 and IL-1β in MKN28 cells(P < 0.01).The caspase-1 inhibitor VX-765 and NLPR3 inhibitor MCC950 were used to inhibit the expression of NLPR3 inflammasome, which could reduce the induced effect of chrysophanol on pyrotosis(P < 0.01). ConclusionsThe chrysophanol can inhibit the proliferation, promote the release of LDH, increase the caspase-1 activity and induce the pyroptosis of gastric cancer MKN28 cells, and which might be related to the NLRP3/caspase-1 pathway.
2021, 46(8): 1000-1003.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.003
Abstract:
ObjectiveTo explore the correlation of visceral fat area and serum cystatin C with carotid atherosclerosis in type 2 diabetes mellitus. MethodsAccording to whether having carotid artery aterosclerosis, 127 patients with type 2 diabetes mellitus were divided into the simple diabetes mellitus group(control group, 40 cases) and type 2 diabetes mellitus complicated with carotid atherosclerosis(sclerosis group, 87 cases).The visceral fat area, serum cystatin C and other indexes were detected, and the correlation of visceral fat area and serum cystatin C with carotid atherosclerosisin type 2 diabetes mellitus were analyzed. ResultsThe age, body mass index, systolic blood pressure, course of disease, cystatin C and visceral fat area in sclerosis group were greater than those in control group(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the cystatin C, visceral fat area and age were the risk factors of carotid atherosclerosis in patients with type 2 diabetes mellitus. ConclusionsThe cystatin C and visceral fat area are related to the carotid atherosclerosis in type 2 diabetes mellitus, which may provide a reference for early diagnosis of carotid atherosclerosis in type 2 diabetes mellitus.
2021, 46(8): 1003-1006.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.004
Abstract:
ObjectiveTo observe the occurrence of colorectal polyps in patients with gastric polyps, and know the correlation between gastric polyps and colorectal polyps. MethodsThe clinical data of 150 patients detected by gastrointestinal endoscopy were analyzed.The patients with gastric polyps and patients without gastric polyps were divided into the observation group and control group, respectively.The multiple test indexes and clinical features were compared between two groups, and the correlation between gastric polyps and colorectal polyps was analyzed. ResultsThe gastric polyps were more common in women(P < 0.05).In clinical symptoms, the acid reflux in observation group was more than that in control group(P < 0.01), and the constipation was more common in the control group(P < 0.01).The most common gastric polyps were hyperplastic polyps(35.0%, CI 0.19-0.43) and fundus gland polyps(52.7%, CI 0.72-0.89).The positive rate of HP-IgG in observation group was higher than that in control group(P < 0.01).The diffeence of the detection rate of colorectal polyps between two groups was statistically significant(P < 0.01).The proliferative polyps and adenomatous polyps were the most common colorectal polyps, and there was no statistical significance in the detection rate of colorectal polyps among different pathological types of colorectal polyps(P>0.05).The results of multiple logistic regression analysis showed that the gastric hyperplastic polyps, gastric fundus gland polyps and HP-IgG positive were correlated with colorectal polyps. ConclusionsThere is a positive correlation between gastric polyps and colorectal polyps.It is suggested that colonoscopy should be performed routinely in patients with gastric polyps.
2021, 46(8): 1007-1010.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.005
Abstract:
ObjectiveTo investigate the safety and feasibility of early oral nutrition in patients with gastric cancer after total gastrectomy. MethodsThe gastric cancer patients treated with laparoscope-assisted radical gastrectomy were divided into the early oral nutrition group(no nutrition tube group, 25 cases) and enteral nutrition via jejunal feeding tube group(nutrition tube group, 23 cases) according to different enteral nutrition modes.The incidence rate of postoperative complications, postoperative stress response indexes, postoperative nutrition indexes, postoperative intestinal barrier function indexes, postoperative exhaust time and postoperative hospital stay were analyzed and compared between two groups. ResultsThere was no statistical significance in postoperative nutrition index, postoperative exhaust time and hospital stay between two groups(P>0.05).The incidence rates of postoperative throat pain and diarrhea in no nutrition group group were significantly better than those in nutrition tube group(P < 0.01 and P < 0.05), meanwhile the levels of C-reactive protein, D-lactic acid and I-FABP in feeding group were lower than those in nutrition tube group(P < 0.05 to P < 0.01). ConclusionsFor gastric cancer patients treated with total gastrectomy, compared with enteral nutrition via nasal jejunal feeding tube, the early oral nutrition is safe, and can reduce the incidence rates of pharyngeal discomfort and diarrhea, reduce the stress response of the body, and promote the recovery of intestinal barrier function.
2021, 46(8): 1011-1013.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.006
Abstract:
ObjectiveTo explore the correlation between serum cystatin C(CysC) level and severity of white matter lesions(WMLs). MethodsOne hundred and twenty-three WMLs patients confirmed by MRI were divided into the mild, moderate and severe groups according to the Fazekas scale, and the serum levels of CysC and other clinical indicators in all cases were collected.The risk factors of WMLs were analyzed using logistic regression analysis, and the correlation between CysC level and WMLs severity were analyzed among three groups. ResultsThe level of CysC in severe group was significantly higher than that in mild and moderate groups(P < 0.01).The results of multivariate logistic regression analysis showed that the older age, hypertension and high serum CysC level were all independent risk factors of WMLs(P < 0.05 to P < 0.01).The results of Spearman correlation analysis revealed that the CysC level was positively correlated with the severity of WMLs(r=0.410, P < 0.05). ConclusionsThe serum level of CysC is closely related to the severity of WMLs.
2021, 46(8): 1014-1016, 1022.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.007
Abstract:
ObjectiveTo study the relationship between the serum level of cyclophilin A(CyPA) and severity of coronary artery disease in patients with coronary heart disease(CHD). MethodsA total of 121 patients with CHD diagnosed by coronary angiography were divided into the single-vessel lesion group, double-vessel lesion group and multiple-vessel lesion group according to the results of coronary angiography, and the patients were divided into the mild lesion group(Gensini score ≤ 30 points), moderate lesion group(Gensini score 30-60 points) and severe lesion group(Gensini score ≥ 60 points) according to the Gensini score.The serum levels of CyPA, matrix metalloproteinase-9(MMP-9) and C-reactive protein(CRP) among three groups were compared. ResultsWith the increasing of the number of coronary artery lesion, the levels of CyPA, MMP-9 and CRP in CHD patients increased(P < 0.05).With the increasing of Gensini score in coronary artery disease, the levels of CyPA, MMP-9 and CRP in CHD patients increased(P < 0.05).The serum level of CyPA was positively correlated with the MMP-9, CRP and Gensini coronary lesion score in CHD patients. ConclusionsThe more the number of coronary lesion and higher the Gensini score of coronary lesions in CHD patient, the higher the CyPA level is.The CyPA can indirectly reflect the severity of coronary artery disease to some extent, and its mechanism may be involved in inflammatory response.
2021, 46(8): 1017-1022.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.008
Abstract:
ObjectiveTo investigate the effects of B-ultrasound-guided lumbar plexus block("clover" method) combined with bispectral index(BIS) in monitoring the laryngeal mask general anesthesia with different depths of anesthesia in the perioperative period of elderly total hip arthroplasty(THA) patients. MethodsA total of 82 elderly patients treated with THA were divided into the group A and group B according to the random number table method(41 cases in each group).On the basis of ultrasound-guided lumbar plexus block("clover" method), the BIS value in group A and group B were maintained at 55-65 and 40-50, respectively.The resting pain score and movement pain score(VAS) before and after 6, 12, 24 and 48 h of operation, perioperative stress levels[including the heart rate(HR), respiratory rate(RR) and mean arterial pressure(MAP)], self-control analgesia after surgery(including the postoperative first application time, times of use, effective compression rate and sufentanil dosage), postoperative recovery(including waking time, extubation time and directional force recovery time), preoperative and intraoperative cognitive function(MMSE) score before and after 1, 3 and 7 days of operation in two groups were counted. ResultsFor pain and self-controlled analgesia, the resting VAS and movement VAS scores in two groups after 6, 12, 24 and 48 h of surgery were decreased compared with before operation, and the difference of which between two groups was not statistically significant(P>0.05).The differences of the first application time, times of use after 0-24 h and 24-48 h of operation, effective press rate and sufentanil dosage between two groups were not statistically significant(P>0.05).For surgical stress, the levels of RR, HR and MAP in two groups at T1, T2, T3 and T4 were lower than those at T0(P < 0.05), but the difference of which between two groups was not statistically significant(P>0.05).For postoperative recovery, the reults of postoperative statistical results showed that the recovery time, extubation time and orientation recovery time in group A were shorter than those in group B(P < 0.01).For cognitive function, the MMSE scores in two groups decreased at 1 day after operation compared with before opertaion(P < 0.05).The differences of the MMSE scores after 1, 3 and 7days of operation between two groups were not statistically significant(P>0.05).For pulmonary infection and adverse reactions of anesthesia, the differences of the incidence rates of lung infection and adverse reactions between two groups were not statistically significant after operation(P>0.05). ConclusionsThe "clover" method B-ultrasound-guided lumbar plexus block combined with implementation of BIS monitoring shallow laryngeal mask general anesthesia can achieve the same anesthetic analgesia effect as deep laryngeal mask general anesthesia.It does not increase the risk of cognitive impairment, pulmonary infection and adverse reactions to anesthesia, and is conducive to postoperative recovery of patients.It can be used appropriately according to the actual situation.
2021, 46(8): 1023-1026.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.009
Abstract:
ObjectiveTo study the correlation between liver cirrhosis combined with upper gastrointestinal bleeding and blood lipid levels. MethodsThe general data of 205 patients with liver cirrhosis were retrospectively analyzed, and the patients were divided into the observation group(liver cirrhosis combined with upper gastrointestinal bleeding, 82 cases) and control group(liver cirrhosis, 123 cases) according to with or without complicated with upper gastrointestinal bleeding.The general data and blood lipid levels[triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C)] were compared between two groups, and the ROC curve analysis was performed.The observation group was subdivided into the mild group and severe group according to the amount of upper gastrointestinal bleeding, and the correlation between blood lipid levels and disease severity was analyzed. ResultsThere was no statistical significance in TG level between two groups(P>0.05), but the levels of TC, LDL-C and HDL-C in observation group were significantly lower than those in control group(P < 0.01).The area under the curve, sensitivity and specificity of the combined diagnosis were greater than those of the single index diagnosis.When TC ≤ 2.69 mmol/L, HDL-C ≤ 0.98 mmol/L, LDL-C ≤ 1.61 mmol/L, the probability of upper gastrointestinal bleeding in patients with liver cirrhosis would increase(P < 0.01).There was no statistical significance in TG level between two groups(P>0.05), but the levels of TC, LDL-C and HDL-C in mild group were significantly higher than those in severe group(P < 0.05 to P < 0.01).The results of Spearman correlation analysis showed that the TG level was not correlated with disease severity(P>0.05), while the levels of TC, LDL-C and HDL-C were negatively correlated with the disease severity(P < 0.05). ConclusionsThe blood lipid levels in patients with liver cirrhosis complicated with upper gastrointestinal bleeding significantly decrease, and all are negatively correlated with the severity of bleeding, which can be used as a predictive factor of upper gastrointestinal bleeding in patients with liver cirrhosis.
2021, 46(8): 1027-1032.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.010
Abstract:
ObjectiveTo compare the survival prognosis of the transjugular intrahepatic portosystemic shunt(TIPS) in the treatment of pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome(PA-HSOS) and decompensated cirrhose-related refractory ascites. MethodsThe clinical data of 141 patients with PA-HSOS and 42 patients with decompensated cirrhose-related refractory ascites were retrospective analyzed.The survival rates in two groups after TIPS were calculated using the Kaplan-Meier analysis, and the results of which was compared using log-rank test.The propensity score matching(PSM) was used, the caliper value was set to 0.2.The age, end-stage model of liver disease(MELD) score, preoperative dominant hepatic encephalopathy, preoperative portal venous thrombosis and portal venous blood flow velocity were matched by 1:1. ResultsThe median survival time in all cases was 16.57 months.The preoperative Child-Pugh grade and MELD score in PA-HSOS patients were higher than those in decompensated cirrhosis patients(P < 0.01).There was no statistical significance in the survival time after TIPS between two groups[16.63 (10.67-26.60) months vs 16.47 (9.40-41.53) months] (P>0.05).After propensity score matching, 24 cases with PA-HSOS were successfully matched with 24 cases with decompensated cirrhosis.The survival time of PA-HSOS patients was longer than that of decompensated cirrhosis patients[15.17(10.27-27.03) months vs 13.75(10.67-21.07) months] (P < 0.01). ConclusionsThe TIPS can treat the PA-HSOS or decompensated cirrhose-related refractory ascites.Although the former has poorer preoperative liver function and portal hemodynamics, the PA-HSOS patients do not have worse postoperative survival compared with the decompensated cirrhose-related refractory ascites patients.
2021, 46(8): 1033-1036.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.011
Abstract:
ObjectiveTo investigate the value of risk calculator and neutrophil/lymphocyte ratio(NLR) in the prediction of the neonatal early-onset sepsis(EOS). MethodsThe clinical and laboratory data of 43 patients diagnosed by EOS(sepis group) and 43 hospitalized patients with non-infectious diseases(control group) were retrospectivly analyzed.The risk of EOS was assessed using the sepsis risk calculator, and the diagnostic efficacy of the sepsis risk calculator and NLR were assessed using the receiver operating characteristic(ROC) curve. ResultsThe NLR value in the sepsis group and control group was(3.89±3.11) and (1.82±0.73), respectively, and the difference of which between two groups was statistical significant(P < 0.01).The incidence risk coefficient per thousand children in the sepsis group and control group was(4.03±10.31) and (0.02±0.06), respectively, and the difference of which between two groups was statistical significan(P < 0.05).The area under the curve, diagnostic sensitivity and specificity of the risk calculator, NLR and their combination were (0.857, 0.710 and 0.910, respectively), (74.4%, 62.8% and 83.7%, respectively) and (97.7%, 90.7% and 97.7%, respectively), respectively.The diagnostic efficiency of the risk calculator combined with NLR was higher than that of NLR alone(P < 0.01). ConclusionsBoth the sepsis risk calculator and NLR have high predictive value for EOS, and the combination of the two is helpful for the early diagnosis and treatment of EOS.
2021, 46(8): 1037-1040,1044.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.012
Abstract:
ObjectiveTo investigate the effects of the vascular interventional embolization therapy at different time on the clinical effects and cognitive function of the patients with intracranial aneurysms. MethodsThe clinical data of 63 patients with intracranial ruptured aneurysms were retrospectively analyzed, and the patients were divided into the early group(34 cases) and delayed group(29 cases) according to different operative opportunity.The Montreal cognitive assessment(MoCA) scale scores before and after operation, postoperative immediate embolization rate, incidence rate of complications, and GOS evaluation results after 3 months of postoperative following up were compared between two groups. Results After operation, the complete embolism rate in early group was significantly higher than that in delayed group(P < 0.05).The scores of MoCA scale in two groups at all time points were lower than those before surgery(P < 0.05), and the scores of MoCA scale in early group were higher than those in delayed group(P < 0.05).The incidence rate of postoperative complications in early group was significantly lower than that in delayed group(P < 0.05).The results of GOS evaluation after 3 months of postoperative following up showed that the recovery of patients in early group was better than that in delayed group(P < 0.05). Conclusions Early vascular interventional embolization therapy can significantly improve the clinical efficacy and prognosis of patients with intracranial ruptured aneurysms, and more effectively improve the postoperative cognitive function.It is conducive to the recovery of patients, and worthy of clinical reference and promotion.
2021, 46(8): 1041-1044.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.013
Abstract:
Objective To explore the correlation between thyroid hormones and metabolic indexes in type 2 diabetes mellitus patients with normal thyroid function. Methods Three hundred type 2 diabetes patients with normal thyroid function were divided into the normal body weight group, overweight group and obesity group according to the body mass index(BMI).The levels of TSH, FT3, FT4, HbA1c, TG, TC, LDL-C, HDL-C, SCR, UA and BMI in three groups were investigated, and the correlation between thyroid hormone and metabolic syndrome indicators were analyzed. Results The levels of TSH, TG, LDL-C, SCR, UA, SBP and DBP in normal weight group, overweight group and obesity group increased gradually in turn(P < 0.05 to P < 0.01), while the levels of HDL-C, FT3 and FT4 in three groups decreased gradually in turn(P < 0.05 to P < 0.01), , and the differences of the levels of HbA1c and TC among three groups were not statistically significant(P>0.05).The results of correlation analysis showed that the level of TSH was positively correlated with the BMI, LDL-C, TG, TC, Scr and UA(P < 0.01), negatively correlated with HDL-C(P < 0.01), and not significantly correlated with SBP, DBP and HbA1c(P>0.05);the level of FT3 was positively correlated with SBP, DBP, Scr, UA and BMI(P < 0.01), and not significant correlated with LDL-C, HDL-C, TG, TC and HbA1c(P>0.05);the level of FT4 was positively correlated with Scr and UA(P < 0.01), negatively correlated with TC(P < 0.01), and not significantly correlated with BMI, LDL-C, TG, LDL-C, HDL-C, SBP, DBP and HbA1c(P>0.05).The results of multiple regression analysis showed that the BMI, TG and UA were significantly correlated with TSH levels(P < 0.01), and not significantly correlated with hypertension(P>0.05). ConclusionsThe changes of thyroid hormone levels and metabolic index in type 2 diabetes mellitus patients with normal thyroid function should be closely paid attention to.
2021, 46(8): 1045-1049,1053.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.014
Abstract:
ObjectiveTo observe the efficacy and safety of anlotinib capsule combined with vinorelbine soft capsule in the treatment of advanced non-small cell lung cancer(NSCLC). MethodsThe patients with stage ⅢB/Ⅳ NSCLC confirmed by pathology were treated with anlotinib capsule(12 mg) once a day for 14 days, and combined with vinorelbine soft capsule(60 mg/m2) orally on day 1 and day 8, 21 days for a cycle, and until disease progression or toxicity became intolerant.The objective response rates, disease control rates, progression-free survival, overall survival and adverse reactions were recorded. ResultsA total of 30 patients were included in this study, which included no complete response cases, 4 partial response cases, 21 stable disease cases and 5 progressive disease cases.The objective remission rate was 13.3%, and the disease control rate was 83.3%.The median progression-free survival was 6.5(6.3-6.9) months, and the median overall survival was 9.9(7.7-11.7) months.In the univariate analysis affecting progression and death, the median progression-free survival time and median survival time in patients with≥60 years old, PS score for 0-1, no smoking history and pathological type of adenocarcinoma were higher than those in patients with age < 60 years old, PS score for 2, smoking history and pathological type of squamous cell carcinoma(P < 0.05 to P < 0.01).The nausea and vomiting(36.7%), fatigue(33.3%) and diarrhea(30%) were the most common adverse reactions, but most of them were grade 1 or 2, which could be improved after symptomatic treatment. ConclusionsThe anlotinib capsule combined with vinorelbine soft capsule in the treatment of NSCLC can better control the disease progression, achieve the purpose of prolonging the patient′s survival time, and the adverse reactions can be controlled.
2021, 46(8): 1050-1053.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.015
Abstract:
ObjectiveTo explore the incidence rate and risk factors of the avascular necrosis of femoral head after femoral neck fracture. MethodsThe clinical data of 272 femoral neck fracture patients treated with closed reduction and compression screw fixation were retrospectively analyzed.The patients were divided into the necrosis group(37 cases) and healing group(235 cases) according to whether having femoral head necrosis or not.The time from injury to operation, fracture side, operation time, preoperative traction, preoperative complications, preoperative Garden classification, Garden index after reduction, Harris hip score, blood lipid level and postoperative activity time were compared between two groups.The logistic regression analysis was used to investigate the risk factors of postoperative femoral head necrosis. ResultsThe differences of the preoperative Garden classification, Garden index after reduction, Harris hip score, total cholesterol and triglyceride between two groups were statistically significant(P < 0.05 to P < 0.01).The high Garden index before surgery, high Garden index after reduction, high total cholesterol and triglyceride were the independent risk factors of avascular necrosis of femoral head(P < 0.05). ConclusionsThe risk factors of femoral head necrosis after femoral neck fracture include the high levels of total cholesterol and triglyceride, high preoperative Garden classification and poor quality of fracture reduction.In order to reduce the incidence rate of the femoral head necrosis, the intraoperative anatomic reduction should be achieved as far as possible, and the perioperative lipid should be actively controlled.
2021, 46(8): 1054-1057, 1061.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.016
Abstract:
Objective To explore the application feasibility of 3D printing and virtual surgery design in the treatment of acetabular fractures from both basic and clinical aspects. MethodsThirty-six patients with acetabular fractures were selected in the basic part, and 13 patients with acetabular fractures were selected in the clinical part.The 3D printing combined with preoperative virtual surgery design was applied.The three-dimensional reconstruction, virtual fracture fragments separation, virtual surgical reduction and virtual internal fixation implantation were performed according to pelvic thin-slice CT scan data of acetabular fracture patients to simulate acetabular fracture surgery for developing a personalized surgical plan for patients to conduct clinical surgical treatment. Results A high-precision virtual reduction model was successfully obtained according to the patient′s pelvic thin-slice CT scan data.The fracture block separation, reduction, internal fixation implantation and other steps were virtually simulated to determine the plate placement position, screw implantation direction and screw implantation length.The individualized and optimized surgical program were drawn up, the 3D simulation surgery was completed by combining with virtual surgery design.In the basic experimental part, the patient′s steel plate position and screw direction were highly consistent with the digital design.The difference of the screw length between virtual surgery design and 3D simulation surgery was not statistically significant(P>0.05).In the clinical experiment, the operations in some patients were successfully completed according to the virtual surgery design, the positions and quantities of the plates and screws were highly consistent with the virtual surgery design, and the difference in the length of screw between the virtual surgery design and clinical operation was not statistically significant(P>0.05). ConclusionsThe 3D printing and virtual surgery design can provide the optimal and personalized surgical solutions for patients with acetabular fractures, which can effectively improve the accuracy and safety of surgery, the application feasibility is high.
2021, 46(8): 1058-1061.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.017
Abstract:
ObjectiveTo explore the clinical effects of APL bioanatomical fixation of femoral stem prosthesis artificial total hip arthroplasty(THA). MethodsAmong 60 patients with aseptic necrosis of femoral head, 28 cases were treated with APL bioanatomical fixation of femoral stem prosthesis THA(observation group), and 32 cases were treated with bone cement-type prosthesis THA(control group).The operation-related indicators and complications were recorded in two groups.The visual analog scale(VAS), Harris hip functional score(HHS) and osteoarthritis score(WOMAC) were evaluated before surgery, after 1 month of surgery and at the last follow-up. ResultsThe operation time and unequal length of both lower limbs in observation group were significantly lower than those in control group(P < 0.01).There was no statistical significance in the intraoperative blood loss and hospital stay between two groups(P>0.05).For the two groups after 1 month of surgery and at last follow-up, the VAS scores were significantly lower than those before surgery, and the HHS score and WOMAC score were significantly higher than those before surgery(P < 0.01).The VAS score at the last follow-up was lower than after 1 month of surgery, while the HHS score and WOMAC score were higher than after 1 month of surgery in two groups(P < 0.01).The VAS score, HHS score and WOMAC score between two groups before surgery and after 1 month of surgery were not statistically significant(P>0.05).At the last follow-up, the difference of VAS scores between two groups was not statistically significant(P>0.05), and the HHS score and WOMAC score in observation group were significantly higher than those in control group(P < 0.01).There was no statistical significance in the incidence rate of complications between two groups(P>0.05). ConclusionsThe APL bioanatomical fixed femoral stem prosthesis THA is feasible in the treatment of aseptic necrosis of femoral head, and the short-term curative effect is significant.The postoperative prosthesis is stable, and the lower limbs are of good equal length.
2021, 46(8): 1062-1065, 1068.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.018
Abstract:
ObjectiveTo develop a model for predicting the 28-day death risk in patients with abdominal surgery using support vector machine algorithm. MethodsThe preoperative general conditions, preoperative visits, laboratory tests and other indicators of patients treated with abdominal surgery from July 2015 to June 2017 were collected.The logistic regression model was compared to evaluate the performance of support vector machine model. ResultsA total of 1 512 surgical patients were included, including 911 males(60.25%) and 601 females(39.75%).In both of the training set and validation set, the predicted probability of death in death group was significantly higher than that in survival group(P < 0.01).In the training set, the area under ROC curve of support vector machine model was larger compared with the logistic regression model, but the difference of which was not statistically significant(0.97 vs 0.95, P>0.05).In the validation set, the area under the ROC curve of support vector machine was significantly higher than that of logistic regression model(0.98 vs 0.91, P < 0.05).The sensitivity(training set 68.57% vs 62.86%, validation set 79.78% vs 77.78%) and positive predictive value(training set 80.00% vs 65.75%, validation set 83.33% vs 77.13%) of support vector machine model were better than those of traditional logistic regression model. ConclusionsThe support vector machine model can accurately predict the risk of 28-day death in patients with abdominal surgery, and its performance is better than that of traditional logistic regression model.
Application value of percutaneous trans foraminal arthroscopic tip shaping in lumbar disc herniation
2021, 46(8): 1066-1068.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.019
Abstract:
ObjectiveTo investigate the application effects of percutaneous trans foraminal arthroscopic tip shaping in lumbar disc herniation. MethodsEighty patients with lumbar disc herniation were treated with percutaneous trans foraminal arthroscopic tip shaping.The clinical efficacy, operation time, intraoperative bleeding, hospitalization time, complications, comparison of visual analogue score(VAS) and Oswestry disability index(ODI) in the pateints between before and after treatment were analyzed. Results After treatment, the obvious effect in 35 cases, valid in 37 cases and invalid in 8 cases were identified, and the effective rate of which was 90.0% (72/80).The operative time, intraoperative blood loss.hospital stay and complication rate of patients were (75.5±13.3)min, (38.6±14.8)mL, (3.5±1.1)d and 8.8%(7/80), respectively.The VAS score in patients after treatment was less than that before treatment(P < 0.05 to P < 0.01);the ODI patients after treatment was less than that before treatment(P < 0.01). ConclusionsIn the treatment of lumbar intervertebral disc herniation, the percutaneous trans foraminal arthroscopic tip shaping has significant clinical effects.
2021, 46(8): 1069-1073.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.020
Abstract:
Objective To investigate the clinical application value of uterine balloon compression, uterine artery ligation and B-Lynch suture in refractory postpartum hemorrhage after cesarean section. MethodsA total of 115 women with refractory postpartum hemorrhage after cesarean section were treated with three different surgical methods of uterine balloon compression, uterine artery ligation and B-Lynch suture.When one surgical method could not effectively stop bleeding, the operators chose the combined method to treat postpartum bleeding according to their experience.According to the surgical method, the patients were divided into the single surgery group(including uterine balloon compression group, uterine artery ligation group and B-Lynch suture group) and combined surgery group(including uterine artery ligation+B-Lynch suture group, uterine artery ligation+balloon compression group and balloon compression+B-Lynch suture group).The clinical effects between the single surgery group and combined surgery group were analyzed and compared. ResultsThe success rate of hemostasis of uterine balloon compression(92.31%) was greater than that of uterine artery ligation(63.49%) and B-Lynch suture(61.54%) (P < 0.05).The operative time of uterine balloon compression was less than that of uterine artery ligation and B-Lynch suture(P < 0.01).There was no statistical significance in the intraoperative hemorrhage, 24-hour hemorrhage, length of stay, and 24-hour hemoglobin change among three single groups(P>0.05).The operation time, intraoperative bleeding, 24-hour total bleeding, postoperative hospital stay, blood transfusion rate, combined diffuse intravasc ular coagulation and shock in three single surgery groups were lower than those in three combined surgery group(P < 0.01).However, there was no statistical difference in the 24-hour hemoglobin change, hysterectomy, postoperative transfer to ICU, puerperal infection, lochia duration and uterine involution between two groups(P>0.05). ConclusionsBalloon compression hemostasis has high success rate and short operation time, so it can be considered as the first choice for refractory postpartum hemorrhage.When a surgical option is not effective in hemostasis, the combined surgical protocols should be timely used, which does not increase the risk of late maternal complications.
2021, 46(8): 1073-1076.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.021
Abstract:
ObjectiveTo explore the effects of direct visualization induced abortion system on endometrium after intrauterine operation. Methods One hundred induced abortion women with the first pregnancy, embryonic arrest detected by ultrasound, ASA class Ⅰ, age18 to 35 years old, pregnant time G1P0, menopause time 55-75 d, were investigated.According to the sequence of numbers randomly generated by computer and parity of numbers, the cases were divided into the ultrasound-guided induced abortion group(B group) and direct vision abortion system group(group V) (50 cases in each group).The endometrial thickness, operative complications and menstrual cycle recovery after abortion were compared between two groups. ResultsCompared with the group B, the deeper endometrial thickness, less intraoperative blood loss, shorter postoperative bleeding time, shorter postoperative menstrual recovery time and higher proportion of normal menstruation in group V were found(P < 0.05 to P < 0.01).The differences of the duration of surgery and anesthesia, abortion syndrome, uterine perforation and cervical adhesions between two groups were not statistically significant(P>0.05). ConclusionsCompared with the ultrasound-guided abortion, the direct visualization induced abortion system can protect the endometrium, the intraoperative bleeding significantly reduces, the postoperative bleeding time is significantly shortened, the menstrual recovery time is significantly shortened, the endometrium is thicker after surgery, the proportion of normal menstrual volume is higher, and which does not increase the incidence rates of intraoperative and postoperative complications.
2021, 46(8): 1077-1080.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.022
Abstract:
ObjectiveTo evaluate the effects of femoral nerve block combined with obturator nerve block on postoperative analgesia in patients with total knee arthroplasty. Methods Forty patients scheduled by unilateral total knee arthroplasty, any gender, age 55-75 years old and ASA class Ⅰ or Ⅱ were randomly divided into the femoral nerve block group(group A, 20 cases) and femoral nerve block combined with obturator nerve block group(group B, 20 cases).After anesthesia induction, two groups were treated with the femoral nerve blocking guided by ultrasound and 20 mL of 0.5%ropivacaine injection.The group B was treated with lateral obturator nerve block guided by ultrasound, and injected with the 10 mL of 0.5 % ropivacaine.When the postoperative visual analog scale(VAS) score was ≥3 points, the 0.1 mg/kg of nalbuphine was intravenously injected with 3 mL/h and locking time for 25 min.If the VAS score was still ≥3 points, the intravenous naboo was injected with 0.1 mg/kg to remedy the analgesia.The time to start using analgesics, total naboo dosage after 24 h and 48 h of surgery, incidence rate of neuroblock-related complications, and occurrence of pruritus, nausea and vomiting of adverse reactions were recorded. ResultsCompared with the group A, the time to start using analgesics in group B prolonged, and the total naboo dosage in group B after 24 h and 48 h of surgery were less than those in group A(P < 0.01).The differences of the incidence rates of nausea, vomiting and itching between two groups were not statistically significant(P>0.05).No nerve block-related complication was found in two groups. Conclusions The postoperative analgesia effects of femoral nerve combined with obturator nerve block is better than that of femoral nerve block alone in patients with total knee arthroplasty.
2021, 46(8): 1080-1082.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.023
Abstract:
ObjectiveTo investigate the effects of epidural analgesia delivery on pregnancy outcome of primiparas. MethodsThe clinical data of 436 primiparas were analyzed retrospectively.The 184 cases treated with epidural anesthesia painless delivery and 252 cases tretaed with normal delivery were divided into the observation group and control group, espectively.The two groups were compared before and after delivery. ResultsThe differences of the third stage of labor, postpartum blood loss and neonatal Apgar score between two groups were not statistically significant(P>0.05).The time of the first stage of labor, time of the second stage of labor, degree of pain, rate of cesarean section, length of hospital stay and rate of maternal and infant complications in observation group were lower than those in control group(P < 0.05 to P < 0.01).The rate of cesarean section in the observation group was 5.98%, which was lower than that in control group(14.29%) (P < 0.01). ConclusionsEpidural analgesia can improve the delivery outcome of primipara.
2021, 46(8): 1089-1092.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.026
Abstract:
ObjectiveTo analyze the effectiveness of colloidal gold immunochromatography for rapid detection of carbapenemase-resistant Enterobacteriaceae(CRE) carbapenemase. MethodsA total of 80 CRE strains isolated from The First Affiliated Hospital of Bengbu Medical College and 21 strains of Enterobacteriaceae susceptible to carbapenem antibiotics were collected.PCR was used to detect blaKPC, blaNDM, blaIMP, blaVIM and blaOXA-48 genes as gold standard.Colloidal gold immunochromatography was used to detect the carbapenemase produced by CRE, which was conducted by the consistency analysis and efficiency evaluation combined with PCR results. ResultsAmong 80 CRE strains, 79 strains expressing carbapenemase genes were all positive for the detection of carbapenemase by colloidal gold immunochromatography, which includes 61 strains producing KPC, 10 strains producing NDM, 6 strains producing IMP and 2 strains producing VIM enzymes, the colloidal gold test results of 21 sensitive strains were negative.Compared with the PCR results, the sensitivity and specificity of the four enzymes by colloidal gold immunochromatography were both 100%, and the Kappa value was 1. ConclusionsColloidal gold immunochromatography can be applied as a simple, rapid, sensitive and specific diagnostic method for the detection of CRE carbapenemase, which is significant to the rationalization in the clinical use of antibiotics.
2021, 46(8): 1093-1095, 1098.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.027
Abstract:
ObjectiveTo investigate the clinical value of the combined detection of urinary exosome dipeptidyl peptidase 4(DPP-4), α1-microglobulin(α1-MG), cystatin C(Cys C) and transferring(TRU) in patients with diabetic nephropathy. MethodsThe levels of DPP-4, α1-MG, Cys C, TRU, IgG, microalbuminuria in 120 diabetic patients[including normal proteinuria group(40 cases), microalbuminuria group(40 cases) and massive proteinuria group(40 cases)] and healthy control group(40 cases) were detected.The Pearson correlation analysis was used to evaluate the correlation among the items.The receiver operating characteristic curve was used to evaluate the value of DPP-4, Cys C, α1-MG, TRU and IgG in the diagnosis of diabetic nephropathy. ResultsThe contents of DPP-4 and α1-MG in urine exosomes of diabetic nephropathy patients were higher than those in control group(P < 0.05), and increased with the increasig of urine protein content(P < 0.05 to P < 0.01).The differences of the levels of Cys C, TRU and IgG between normal albuminuria group and control group were not statistically significant(P>0.05), and the levels of Cys C, TRU and IgG in microalbuminuria group and massive albuminuria group were higher than those in control group(P < 0.05 to P < 0.01).The urinary exosome DPP-4 was positively correlated with α1-MG, Cys C, TRU and IgG(P < 0.05).The areas under the receiver operating characteristic curve of DPP-4, α1-MG, Cys C, TRU, IgG, and combined DPP-4, α1-MG, Cys C and TRU were 0.742, 0.736, 0.843, 0.868, 0.836 and 0.899, respectively.The sensitivity, specificity, positive predictive value and negative predictive value of the combined detection of DPP-4, α1-MG, Cys C and TRU were 93.42%, 86.90%, 86.59% and 93.59%, respectively. ConclusionsThe combined detection of urinary exosome DPP-4, urinary Cys C and urinary α1-MG and TRU has high clinical value in the early diagnosis of diabetic nephropathy.
2021, 46(8): 1096-1098.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.028
Abstract:
ObjectiveTo analyze the antibody detection results of three hemolysis tests in 215 neonates with hyperbilirubinemia(NHB), and explore the clinical significance of early detection. MethodsThe venous blood in 215 neonates diagnosed with NHB within 3 days after birth were collected, the blood group test, direct resistance test, free test and release test were performed, and the results were analyzed. ResultsAmong 215 children with NHB, 97 cases were diagnosed with hemolytic disease of the newborn(HDN).The percentages of type A, type B and type O in the HDN group were 52.58%(51/97), 45.36%(44/97) and 2.20%(2/97), respectively, and the differences of composition ratio of type A, type B and type O between HDN group and non-HDN group were statistically significant(χ2=61.49, P < 0.01).The positive rates of the release test, free test and direct resistance test were 100%(97/97), 78.35%(76/97) and 16.50%(16/97), respectively.The differences of the detection rates among three methods were statistically significant(χ2=160.04, P < 0.01), and which in release test, free test and direct resistance test gradually decreased in turn. ConclusionsThrough rapid detection of HDN microcolumn gel card, the timely diagnosis can be made, so as to select appropriate methods for positive symptomatic treatment.
2021, 46(8): 1099-1102.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.029
Abstract:
ObjectiveTo analyze diagnostic value of American College of radiology thyroid imaging reporting and data system(ACR TI-RADS) risk grading combined with multimodal ultrasonography in benign and malignant thyroid lesions. MethodsSixty-one patients were detected using superb microvascular imaging(SMI) and shear wave elastography(SWE), and divided into benign group and malignant group according to the pathological results.The ACR TI-RADS risk grading and quantitative scoring in two groups were implemented, and the SMI blood flow grading and SWE elastic parameters in two groups were detected and analyzed. ResultsThe ACR TI-RADS risk grading in two groups were divided into 2-5 classes, and the difference of risk grading was statistically significant(P < 0.01).The quantitative scores in malignant group were higher than those in benign group(P < 0.01).The differences of the SMI blood flow grading and SWE elastic parameters between two groups were statistically significant(P < 0.01).The sensitivity and specificity of combined diagnosis of malignant nodules were better than that of single diagnosis. ConclusionsThe risk stratification of ACR TI-RADS, SMI and SWE are all valuable in the diagnosis of thyroid lesions alone, and the efficacy of combined diagnosis can be significantly improved.
2021, 46(8): 1103-1108.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.030
Abstract:
ObjectiveTo explore the predictive efficacy of CT radiomics combined with clinical features in predicting EGFR mutation in lung adenocarcinoma. MethodsThe clinical data of 125 patients with lung adenocarcinoma were retrospectively analyzed, the patients were divided into the training group(n=74) and verification group(n=51).The radiomics features were extracted based on CT radiomics.The support vector machine(SVM) classifier was used to construct the clinical model, radiomics model and joint model, respectively.The receiver operating characteristic curve(ROC) and area under the curve(AUC) were used to evaluate the predictive efficacy of model. ResultsThe AUC of clinical model, radiomics model and joint model in training group were 0.749(0.653-0.843), 0.818(0.711-0.898) and 0.860(0.760-0.930), respectively.The AUC of clinical model, radiomics model and joint model in verification group were 0.753(0.612-0.863), 0.797(0.661-0.896) and 0.855(0.728-0.938), respectively. ConclusionsFor the prediction of EGFR mutation status in lung adenocarcinoma, the CT radiomics features are superior to clinical factors and CT signs.The radiomics combined with clinical factors and CT signs can further improve the prediction efficiency.
2021, 46(8): 1109-1115.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.031
Abstract:
ObjectiveTo investigate the health status, analyze the incidence of perimenopausal syndrome, pelvic floor dysfunction and their influencing factors, and explore the health needs of perimenopausal women in Bengbu city. MethodsUsing the multi-stage random group sampling method, 957 women aged 40-60 years in Bengbu city were selected to carry out a questionnaire survey, and the general demographic and health information were analyzed. ResultsThe incidence rate of perimenopausal syndrome was 42.11%(403/957).The differences of the perimenopausal syndromes among women with different ages, education levels, body mass index, marital status, partner health status, relationship with children, sleep quality, exercise habit, dysmenorrhea history, times of vaginal delivery and menstrual status in the past 1 year were statistically significant(P < 0.05 and P < 0.01).The results of multivariate logistic regression analysis showed that the incidence rates of mild and moderate perimenopausal syndrome in those with normal menstruation were lower compared with the patients with menopause for 1 year(P < 0.05 and P < 0.01).In the group of moderate perimenopausal syndrome, the incidence rates of perimenopausal syndrome in women with 40-44 years old and dysmenorrhea were higher than those in 55-60 years old and without dysmenorrhea(P < 0.05 to P < 0.01).The incidence rates of perimenopausal syndrome in women with good sleep quality and no experience of vaginal delivery or women with one vaginal delivery were lower than in women with poor sleep quality and more than three times of vaginal delivery(P < 0.05 to P < 0.01).In severe perimenopausal syndrome group, the incidence rate of perimenopausal syndrome in women with good sleep quality was lower than in women with poor sleep quality(P < 0.01), and the incidence rates of perimenopausal syndrome in women with primary school education and below were higher than in women with junior college education and above(P < 0.01).The differences of the pelvic floor dysfunction scale scores of perimenopausal women with different ages, body mass index, education level, marital quality, relationship with children, sleep quality, dysmenorrhea history and menstrual status in the past 1 year were statistically significant(P < 0.05 to P < 0.01).The high education level, good family relationship and no history of dysmenorrhea were the protective factors of pelvic floor dysfunction in perimenopausal women, while the emaciation, childbirth and menstrual disorder were the risk factors of pelvic floor dysfunction(P < 0.05 to P < 0.01). ConclusionsThe detection rate of perimenopausal syndrome and other uncomfortable symptoms in perimenopausal women in Bengbu area is relatively high, the demand for relevant knowledge and degree of understanding are not balanced, and the health care for perimenopausal women should be paid attention to.
2021, 46(8): 1116-1118.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.032
Abstract:
ObjectiveTo investigate the application effects of free position combined with freehand rotation of fetal head in the second stage of labor in the cross-occipital and retrooccipital pregnant women, and its effects on maternal and infant outcomes. MethodsOne hundred puerpera with single birth were divided into the control group(50 cases) and observation group(50 cases) by random number table method.The free posture delivery in the control group were adopted throughout the second labor process, and the free posture combined with freehand rotation of fetal head in the observation group were adopted during the second labor process.The differences of the second labor process, 2 h postpartum blood loss, translocation success rate, delivery mode, maternal and infant complications were compared between two groups. ResultsCompared with the control group, the duration of the second stage of labor was shortened, and the postpartum 2 h blood loss decreased in the observation group, and the difference of which between two groups was statistically significant(P < 0.01).The rate of vaginal delivery in observation group was higher than that in control group(P < 0.05), but there was no statistical significance in the success rate of translocation between two groups(P>0.05).The differences of the total incidence rates of postpartum hemorrhage, cervical laceration, neonatal distress and asphyxia were not statistically significant between two groups(P>0.05). ConclusionsThe free positon combined with freehand rotation of fetal head in the application of the second stage of labor can corret the transverse and posterior occipital positions, help to shorten the labor time and improve the rate of vaginal delivery.
2021, 46(8): 1119-1122.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.033
Abstract:
ObjectiveTo explore the application effects of segmental administration of celuna anal combined with position management in patients with cerebral hemorrhage complicated with constipation. MethodsFifty-three patients with cerebral hemorrhage complicated with constipation were randomly divided into the observation group and control group.Two groups were treated with the general treatment and routine care according to the condition.On this basis, the control group was additionally treated with routine anal prescription seruna, and the observation group was additionally treated with segmental administration of celuna anal combined with position management.The clinical treatment effects, defecation time, perfusion fluid overflow and perianal bleeding, and blood pressure and heart rate changes during treatment and defecation were compared between two groups. ResultsThe clinical treatment effects of constipation in observation group was significantly better than that in control group(P < 0.05), the defecation time in observation group was significantly shorter than that in control group(P < 0.05), and the incidence rates of enteral effusion and perianal bleeding in observation group were lower than those in the control group(P < 0.05).During the treatment, there was no statistical significance in the changes of blood pressure and heart rate acceleration between two groups(P > 0.05), while the phenomenon of blood pressure and heart rate acceleration in observation group during defecation were significantly lower than those in control group(P < 0.05). ConclusionsCompared with the conventional method, the application of segmental administration of celuna anal combined with position management in patients with cerebral hemorrhage complicated with constipation has good clinical effects, short defecation time, low incidence rate of adverse reactions and little effect on vital signs.
2021, 46(8): 1122-1125.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.034
Abstract:
Objective To explore the influence of nursing model based on quality management tools on quality of life and adverse cardiovascular events in patients with coronary heart disease. Methods One hundred patients with coronary heart disease who underwent percutaneous coronary intervention (PCI) were selected and randomly divided into the observation group and control group.The control group received routine nursing management.The observation group adopted a nursing model based on quality management tools.The results of 6-min walking test, quality of life score and compliance score of nursing intervention were compared between the two groups before intervention (the day of admission) and after intervention (followed up for 3 months), and the incidence of cardiovascular adverse events was compared between the two groups during follow-up. Results The results of walking test and compliance score of nursing intervention in the observation group were significantly higher than those in the control group after intervention, and the scores of quality of life were significantly lower than those in the control group after intervention(P < 0.01).The total incidence of cardiovascular adverse events in the observation group was significantly lower than that in the control group during the follow-up period (P < 0.05). Conclusions The quality management tools can analyze the factors influencing the management objectives, which helps to improve the prognosis of the disease and shows great significance to the rehabilitation of patients with coronary heart disease after PCI.
2021, 46(8): 1126-1130.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.035
Abstract:
ObjectiveTo evaluate the effects of simplified facial muscle function training in children after adenotonsillectomy. MethodsA total of 26 children treated with adenotonsillectomy in 2020 were randomly selected as the observation group, and 30 children treated with adenotonsillectomy in 2019 were selected as the control group.The control group received the conventional nursing intervention, and the observation group received simplified facial muscle function training intervention.The compliance of simplified facial muscle function training was observed, and the total score and score of each dimension of obstructive sleep disorder questionnaire(OSA-18) before and after the intervention were compared between two groups. ResultsIn the observation group, 8 patients(26.9%) had poor compliance, and 18 patients(73.1%) had good compliance.The total score of OSA-18 and scores of all dimensions in two groups at 3 and 6 months after discharge were higher than those before operation(P < 0.05 to P < 0.01), and there was a decreasing trend in the total score, sleep disturbance, physical symptoms and daytime function in the observation group(P < 0.05).There was no statistical significance in the total score of OSA-18 and scores of each dimension between two groups before intervention(P > 0.05).After 3 months of discharge, the scores of sleep disturbance, physical symptoms and effects on caregivers in observation group were lower than those in control group(P < 0.05 to P < 0.01), while there was no statistical significance in the dimension scores of depressed mood and daytime function between the two groups(P > 0.05).At 6 months after discharge, there was no statistical significance in other dimension scores between two groups except for daytime function(P > 0.05), and the scores of other dimensions in observation group were lower than those in control group(P < 0.05 to P < 0.01). ConclusionsThe simplified facial muscle function training can improve sleep disturbance, physical symptoms and emotional problems in children after adenotonsillectomy, which is worthy of popularization and application in clinical nursing intervention.
2021, 46(8): 1130-1132, 1137.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.036
Abstract:
ObjectiveTo explore the application effects of establishing the standardization of hospital safe transport for acute stroke patients. MethodsFifty acute stroke patients transported by conventional nursing from January 2017 to January 2018 were set as the control group, and 50 acute stroke patients transported by standardized transport process from February 2018 to February 2019 were set as the observation group.The effect of transport between two groups was compared. ResultsA total of 8 adverse events occurred in the observation group, and 24 adverse events occurred in the control group.The total incidence rate of technical adverse events in observation group(16.00%) was lower than that in control group(48.00%), and the satisfaction rate of patients' experience in medical treatment in observation group(93.30%) was higher than that in control group(73.30%) (P < 0.05 and P < 0.01). ConclusionsStandardized transport process can effectively reduce the incidence rate of intrahospital adverse events in patients with acute stroke, ensure the safety of patients, and improve the patients and their families's feeling of seeing a doctor.
2021, 46(8): 1133-1137.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.037
Abstract:
ObjectiveTo establish the recurrence risk model after minimally invasive surgery for kidney stones to analyze the influencing factors of recurrence related to health behavior in patients with kidney stones from Fuyang Second People's Hospital for providing the evidence-based strategies in clinical nursing intervention. MethodsThe data of disease at first onset and recurrence after minimally invasive surgery related to disease in 148 kidney stones patients treated with minimally invasive surgery were retrospectively analyzed.The health behavior ability of pateints after the first minimally invasive surgery for calculi were assessed using the health behavior ability self-rating scale.The calculus recurrence model was established by univariate analysis and multivariate logistic regression analysis. ResultsThe number of hypertensive and diabetic patients in recurrent group were higher than that in non-recurrent group, and the proportion of patients with body mass index(BMI) > 30.0 kg/m2 in recurrence group was higher than that in non-recurrence group(P < 0.05 to P < 0.01).The differences of the daily intake of water, nature of regular drinking water, frequent use of fish oil, frequent consumption of preserved foods and intake of protein sources between two groups were statistically significant(P < 0.05 to P < 0.01).The total score of healthy behavior ability, and scores of nutritional dimension, psychological comfort dimension and health responsibility dimension in non-recurrent group were higher than those in recurrent group(P < 0.05).The model recurrence equation was LogitP=6.122-0.633X1(1)-2.512X1(2)+1.351X2-4.124X3-1.888X4-2.111X5-0.996X6.The results showed that the 1.5-3 L/d water intake, healthy behavior ability, frequent use of fish oil, intake mainly plant protein were the protective factors of stone recurrence, and the water intake less than 0.5 L/d, BMI > 30.0 kg/m2 and frequent consumption of preserved food were the risk factors of stone recurrence.According to the coefficient of the equation, the proportion from large to small were healthy behavior ability, daily water intake, pickled food, BMI and protein source in turn. ConclusionsTo prevent recurrence of kidney stones after operation, the nursing intervention should focus on improving patients' healthy behavior ability and forming healthy lifestyle.
2021, 46(8): 1138-1140, 1145.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.038
Abstract:
ObjectiveTo observe the application effects of puzzle mind mapping education method in patients using insulin injection device for the first time. MethodsA total of 110 patients treated with insulin therapy for the first time from June 2019 to June 2020, and still needed self-injection after discharge were selected.The control group was hospitalized from June to December 2019, and the insulin injection skills were taught by the routine methods of our department.The observation group was hospitalized from January to June in 2020, and the insulin injection skills were taught by puzzle mind mapping.The standardization of insulin injection skills before 1 day of discharge, and injection-related complications after 3 months of treatment were compared between two groups. ResultsBefore discharge, the results of the self-injection examination in two groups using insulin pen showed that the score in observation group was higher than that in control group(P < 0.05).The results of 20 specific items of insulin pen self-injection technology analysis showed that the differences of the accuracy rates of 14 items were statistically significant between two groups(P < 0.05 to P < 0.01), and which included correct positioning method, checking the injection site, right checking technique, disinfection range, insulin blending, blending method, pinch of skin, timing of the loose skin fold, residence time, enough the release timing, injection site rotation, use of insulin in store, unopened insulin storage and disposal of needles.After 3 months of discharge, the incidence rates of redness, swelling or induration at injection site, fat hyperplasia and pain in observation group were lower than those in control group(P < 0.05 to P < 0.01). ConclusionsThe application of puzzle mind mapping education method in patients using insulin injection device for the first time can significantly standardize their injection skills, and reduce the complications caused by injection, which can be popularized and applied in other patient education.
2021, 46(8): 1141-1145.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.039
Abstract:
ObjectiveTo investigate the status of social support, level of hope, negative emotion and compliance behavior of patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI), and further explore the relationship between social support, and level of hope, negative emotion and compliance behavior. MethodsA total of 93 CHD patients treated with PCI were selected using simple random sampling method.The patients were investigated, which included the general information, social support rating scale(SSRs), Herth hope index(HHI), self-rating anxiety scale(SAS), self-rating depression scales(SDS) and compliance behavior.The correlation between social support, and level of hope, negative emotion and compliance behavior of CHD patients treated with PCI was analyzed. ResultsThe scores of social support scale, level of hope, anxiety, depression and compliance behavior in CHD patients treated with PCI were(41.15±6.48) points, (35.75±5.84) points, (45.25±5.64) points, (48.35±6.12) points and(4.38±0.87) points, respectively.The results of univariate analysis showed that the differences of the scores of social support rating scale among different levels of family monthly income CHD patients treated with PCI were statistically significant(P < 0.05).The results of Pearson correlation analysis showed that the social support rating score and each dimension score were negatively correlated with the scores of anxiety and depression(P < 0.01), and positively correlated with the scores of level of hope and each dimension and compliance behavior score(P < 0.05 to P < 0.01).The results of multiple linear regression analysis indicated that the level of hope, anxiety, depression and compliance behavior could affect the social support of CHD patients treated with PCI(P < 0.05 to P < 0.01). ConclusionsThe social support, level of hope and compliance behavior of CHD patients treated with PCI are at a moderate level.The anxiety and depression in part of patients also occur, and the level of hope, anxiety, depression and compliance behaviors are associated with social support.
2021, 46(8): 1146-1148.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.040
Abstract:
ObjectiveTo explore the application value of visualized ultrasound technology in difficult vascular puncture of severe patients. MethodsOne hundred and twenty patients with difficult vascular puncture in ICU were randomly divided into the control group and observation group(60 cases in each group).The control group was treated with traditional puncture method, and the observation group was treated with Doppler ultrasound guiding peripheral vein puncture method.The puncture time, one-time success rate and incidence rate of complication were observed and compared between two groups. ResultsCompared with the control group, the one-time success rate and total success rate of puncture in observation group were higher, the incidence rates of complications such as subcutaneous hematoma, local infection and nerve injury were lower, and the time of successful puncture was less in observation group(P < 0.01). ConclusionsThe application of visualized ultrasound technology in difficult vascular puncture of severe patients can significantly improve the success rate of puncture, shorten the time of puncture, reduce the pain of patients.
2021, 46(8): 1148-1151.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.041
Abstract:
ObjectiveTo explore the application effects of the small private online courses(SPOC) combined with flipped classroom teaching mode in the teaching of internal medicine under the background of "Internet+". MethodsUnder the background of "Internet +", the teaching of internal medicine in 60 students from the clinical experiment class of grade 2017(observation group) were taught by the SPOC combined with flipped classroom teaching mode, and the teaching course was implemented according to the "before class+in class+after class" mode.The teaching of internal medicine in the students from the affiliated hospital class of grade 2017(control group) were taught by the traditional teaching mode combined with MOOC.Two groups were taught for a semester.After studying end, the teaching effects in two groups were evaluated using the theoretical examination, questionnaire survey and student symposium. ResultsThe score of the theoretical test in observation group[(84.43±4.58) points] was significantly higher than that in control.group[(81.27±4.71) points](t=3.98, P < 0.05).The learning efficiency, interactive ability of classroom learning, autonomous learning ability, ability of combining theory with practice, mastery of basic knowledge, clinical innovative thinking ability and teamwork ability in observation group were significantly better than those in control group(P < 0.05).The understanding of teaching content, stimulating learning interest in class, consulting literature after class and final satisfaction in observation group were better than those in control group(P < 0.05). ConclusionsThe mixed teaching mode of SPOC combined with flipping classroom under the background of "Internet+" is conducive to improve students' academic achievement and interest, exercise clinical thinking and improve their autonomous learning ability, and which plays an important role in improving the MOOC platform, constructing and cultivating clinical practical medical talents.
2021, 46(8): 1152-1155.
doi: 10.13898/j.cnki.issn.1000-2200.2021.08.042
Abstract:
ObjectiveTo comprehensively evaluate the implementation process and effects of small private online course(SPOC) teaching of physiology for undergraduates. MethodsA total of 363 undergraduate students from various majors who received physiology theory teaching in the second semester of 2019-2020 academic year in Bengbu Medical College were selected.The participation of SPOC teaching was evaluated from the three dimensions of curriculum resource utilization, mutual evaluation of assignments and forum interaction.The students were divided into three groups according to the high, medium and low student participation, and the teaching effectiveness in three groups were evaluated through teaching process, teaching content evaluation and examination results. ResultsThe participation of SPOC showed that there was no statistical significance in document browsing, in-class quizzes, posting or replying and receiving replies or likes among different genders students(P > 0.05).However, the differences of the use of course resources, evaluation of others' work, evaluation of work by others and course discussion were statistically significant(P < 0.05).The results of teaching effects showed that there was no statistical significance in teaching content evaluation(P > 0.05), but the differences of teaching organization evaluation, final score and comprehensive score among three groups were statistically significant(P < 0.05).Compared with the students with low participation in the evaluation of teaching organization, the final score and comprehensive score in students with high participation in the evaluation of teaching organization were higher(P < 0.05). ConclusionsThe application of SPOC teaching is an important way to enhance teaching effectiveness of physiology.In particular, it is beneficial to improve students' subjective initiative, innovation capability and professionalism.
Email
RSS