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2021 Vol. 46, No. 9
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2021, 46(9): 1155-1157.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.001
Abstract:
ObjectiveTo explore the relationship between post-stroke depression(PSD) and blood lipid level, and provide the guidance for clinical intervention of stroke. MethodsTwo hundred patients with stroke were randomly selected, and divided into the PSD group(88 cases) and non-PSD group(112 cases) according to the occurrence of PSD.The serum levels of triglyceride(TG), total cholesterol(TC), high density lipoprotein(HDL-C) and low density lipoprotein(LDL-C) in two groups were detected, and compared between two groups.The correlation among clinical indicators and depression score of stroke patients were analyzed. ResultsThe serum level of HDL-C in PSD group was significantly higher than that in non-PSD group(P < 0.01), and the differences of the levels of TG, TC and LDL-C between two groups were not statistically significant(P>0.05).The HAMD and HAMA scores were positively correlated with the NIHSS scores, stroke times, TC and HDL-C levels(P < 0.05 to P < 0.01), and negatively correlated with the ADL score(P < 0.01).The ADL score and HDL-C level were the independent influencing factors of HAMD score in stroke patients(P < 0.01). ConclusionsThe abnormal lipid metabolism is associated with PSD to a certain extent.In the course of lipid regulation therapy for stroke patients, the occurrence of PSD should be vigilant, and the PSD should be identified and intervened as early as possible in order to improve the prognosis of stroke.
2021, 46(9): 1158-1160.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.002
Abstract:
ObjectiveTo analyze the clinical effects of radical radiotherapy in the treatment of locally advanced hypopharyngeal cancer, and evaluate the prognostic factors. MethodsThe clinical data of 25 patients with locally advanced hypopharyngeal carcinoma from October 2016 to December 2018 were retrospectively analyzed.The overall survival of patients was calculated using Kaplan-Meier method.The Cox model was used for univariate analysis and multivariate analysis. ResultsThe recent effective rate was 100%.The median surviual time was 25 months.The 2-year surviual rate was 32.0%.The results of univariate analysis indicated that the N stage, clinical stage, recent effective rate and concurrent chemotherapy were the prognostic factors(P < 0.01).The results of multivariate analysis showed that the clinical stage and concurrent chemotherapy were the independent prognostic factors(P < 0.01 and P < 0.05). ConclusionsThe short-term effects of radical radiotherapy for locally advanced hypopharyngeal carcinoma is definite.The clinical stage and concurrent chemotherapy are the independent prognostic factors.
2021, 46(9): 1161-1164.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.003
Abstract:
ObjectiveTo investigate the correlation between the changes of serum neuron-specific enolase (NSE), T cell subsets, inflammatory cytokines and pain in patients with herpes zoster. MethodsA total of 66 patients with acute herpes zoster were set as the observation group, which were divided into mild pain group, moderate pain group and severe pain group according to visual analogue scale(VAS) score.Another 30 healthy people in the same period were set as the control group.The serum levels of NSE, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the ratios of CD3+, CD4+, CD8+ T lymphocytes and CD4+/CD8+ in venous blood were compared among the groups.The correlation between the above indexes and VAS score in the observation group was analyzed. ResultsThe serum levels of NSE and TNF-α in observation group were significantly higher than those in control group (P < 0.01).The serum levels of NSE, TNF-α, IL-6 increased gradually among mild pain group, moderate pain group and severe pain group (P < 0.05).The ratios of CD3+, CD4+, CD8+ T lymphocytes in venous blood in observation group were significantly lower than those in control group(P < 0.01), and the ratio of CD4+/CD8+ was markedly higher than that in control group (P < 0.01).The ratios of CD3+, CD4+, CD8+ T lymphocytes and CD4+/CD8+ decreased gradually among mild pain group, moderate pain group and severe pain group (P < 0.01).The VAS score in observation group was positively correlated with the serum levels of NSE, TNF-α and IL-6(r=0.695, 0.718, 0.726, P < 0.05), and negatively correlated with the ratios of CD3+, CD4+, CD8+ T lymphocytes and CD4+/CD8+ in venous blood (r=-0.624, -0.674, -0.524, -0.445, P < 0.05). ConclusionsPatients with herpes zoster have low immune function, increased inflammatory reaction and certain degree of nerve injury, which are closely related to the occurrence of pain.
2021, 46(9): 1164-1168.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.004
Abstract:
ObjectiveTo study whether intravenous thrombolysis combined with interventional thrombectomy can effectively improve the prognosis of patients with acute cerebral infarction. MethodsThirty-three patients with acute cerebral infarction were selected and randomly divided into intravenous thrombolysis group (group A, 17 cases) and intravenous thrombolysis combined with interventional thrombectomy group (group B, 16 cases) according to different treatment methods.Relevant clinical data of all patients before and after treatment, including gender, age, smoking history, blood pressure, blood sugar level, total cholesterol level, waiting time for thrombolytic therapy and so on were collected.The risk factors of acute cerebral infarction and the changes of the National Institutes of Health stroke scale (NIHSS) score and Barthel index score between before and after treatment were analyzed, and the prognosis and living ability of patients were compared. ResultsThe levels of blood pressure, blood glucose, total cholesterol, plasma D dimer, fibrinogen degradation products and smoking history were positively correlated with the NIHSS score after admission to the hospital (P < 0.05 to P < 0.01).Pearson correlation analysis found that the patient's blood pressure and blood glucose level were the key factors affecting the occurrence of acute cerebral infarction(r=0.768, 0.559).The treatment effect and prognosis of patients with acute cerebral infarction were closely related to the waiting time and treatment methods for treatment.The changes of NIHSS score of patients in group A at 7 days after treatment, and at 24 hours after treatment and 7 days after treatment in group B were tightly related to the length of waiting time for treatment, i.e.the improvement of NIHSS score was more obvious with shorter waiting time for treatment (P < 0.05).There was no significant correlation between the changes of NIHSS score of patients in group A and the waiting time for treatment at 24 h after treatment (P>0.05), while which in group B had different degrees of improvement.At the same time, the improvement of the patient's Barthel score was more obvious with shorter the waiting time for thrombolysis (P < 0.01).At 24 h and 7 d after receiving treatment, the improvement of NIHSS score and Barthel score of patients in group B was more obvious than that in group A(P < 0.01). ConclusionsThe better the recovery of patients with acute cerebral infarction can be obtained with shorter time from onset to thrombectomy.Intravenous thrombolysis combined with interventional thrombectomy has better recovery effect for patients with acute cerebral infarction than intravenous thrombectomy alone.
2021, 46(9): 1169-1172, 1177.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.005
Abstract:
ObjectiveTo investigate the analgesic effect of transversus abdominis plane block with combination of dexmedetomidine and ropivacaine after radical resection of colorectal cancer. MethodsSixty patients undergoing elective open radical resection of colorectal cancer were randomly divided into general anesthesia group(group G), ropivacaine combined with general anesthesia group(group R+G) and dexmedetomidine combined with ropivacaine group(group DR+G), 20 cases in each group.Group G was given general anesthesia, group R+G was given general anesthesia combined with transversus abdominis plane block on both sides separately using 20 mL 0.25% ropivacaine, and group DR+G was given general anesthesia combined with transversus abdominis plane block on both sides separately using 20 mL 1 μg/kg dexmedetomidine and 0.25% ropivacaine.All patients received sufentanil via patient-controlled introvenous analgesia after operation.The operation time, intraoperative infusion volume, the dosage of propofol and remifentanil, and the dosage of sufentanil 24 h after operation in three groups were observed.The resting visual analog scale(VAS) score and cough VAS score were compared at 2 h(T1), 6 h(T2), 12 h(T3), 24 h(T4) after operation, and the adverse reactions were recorded. ResultsThere were significant differences in the dosage of propofol, remifentanil and sufentanil among the three groups(P < 0.05 to P < 0.01);the dosage of propofol and remifentanil in group DR+G was lower than that in group G(P < 0.05);the dosage of sufentanil in group DR+G, group R+G and group G increased gradually, and the difference of which was statistically significant(P < 0.05 to P < 0.01).At T1, T2 and T3, there was no significant difference in the resting VAS score and cough VAS score among the three groups(P>0.05);at T4, the resting VAS score and cough VAS score in group DR+G were lower than those in group R+G and group G(P < 0.05 to P < 0.01).The incidence of skin itching, nausea and vomiting in group DR+G was lower than that in group G(P < 0.05). ConclusionsTransversus abdominis plane block with combination of dexmedetomidine and ropivacaine can reduce the dosage of general anesthesia during and after operation, improve the analgesic effect after radical resection of colorectal cancer, relieve pain and reduce adverse reactions.
2021, 46(9): 1173-1177.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.006
Abstract:
ObjectiveTo evaluate the utility of lymph node ratio(LNR) in the staging assessment of patients over 45 years old with gastric cancer. MethodsThe patients aged 45 years or older treated with radical gastrectomy were investigated, the clinicopathological data of recovered lymph nodes(LN) and metastatic lymph nodes(LNs) were collected, and the LNR values were obtained(LNR=LNs/LN).The LNR group with 0.1 intervals was divided into four phases based on the cutoff point of increased hazard ratio(HR).The survival analysis was performed to assess the prognostic value of LNR. ResultsThe four LNR levels included the LNR0(n=89), LNR1(n=47), LNR2(n=90) and LNR3(n=10).In the multivariate analysis, both N staging and LNR staging showed the significant prognostic value, and which could predict the survival outcome.The incremental changes in the HR among successive stages of LNR staging were greater than those of N staging(HR: the N staging was 1.583, 2.789 and 4.581, and the LNR staging was 1.469, 3.837 and 8.572). ConclusionsThe LNR staging, a novel and simple marker, has certain clinical application value in predicting the prognosis and recurrence of gastric cancer in patients over 45 years old.
2021, 46(9): 1178-1182.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.007
Abstract:
ObjectiveTo investigate the changes of serum levels of cholinesterase(CHE), γ-glutamyl transpeptidase(GGT) and lactate dehydrogenase(LDH) expression in patients with hypertensive disorder complicating pregnangcy(HDCP), and their correlation with the degree of disease. MethodsEighty patients with HDCP were selected, and divided into the severe preeclampsia group(21 cases), non-severe preeclampsia group(34 cases) and simple HDCP group(25 cases) according to the progress of HDCP, and 68 normal pregnant women in the same period were selected as the control group.The serum levels of CHE, GGT and LDH in four groups were measured and compared.The relationship between the serum indicators, and levels of SBP and DBP, occurrence of preeclampsia in HDCP patients were analyzed, and the value of serum indexes in predicting adverse pregnancy outcome in HDCP patients was investigated. ResultsThe levels of SBP and DBP in the severe preeclampsia group, non-severe preeclampsia group, HDCP group and control group gradually decreased in turn(P < 0.05 to P < 0.01).The levels of CHE in the severe preeclampsia group, non-severe preeclampsia group, HDCP group and control group gradually increased in turn(P < 0.05 to P < 0.01).The levels of GGT and LDH in severe preeclampsia group, non-severe preeclampsia group, HDCP group and control group gradually decreased in turn(P < 0.05 to P < 0.01).The serum levels of CHE in HDCP patients was negatively correlated with the levels of SBP and DBP(P < 0.01), and the serum levels of GGT and LDH were positively correlated with the levels of SBP and DBP(P < 0.01).After controlling the age, prepregnancy body weight, gestational age and maternal type, the serum level of CHE was negatively correlated with the onset of preeclampsia(P < 0.01), and the levels of GGT and LDH were positively correlated with the onset of preeclampsia(P < 0.01).During follow-up to delivery, the expression of CHE in HDCP patients with adverse pregnancy outcome was lower than that in HDCP patients without adverse pregnancy outcome(P < 0.01), while the expression of GGT and LDH in HDCP patients with adverse pregnancy outcome were higher than that in HDCP patients without adverse pregnancy outcome(P < 0.01).The best cutoff values of CHE, GGT and LDH in predicting adverse pregnancy outcomes in HDCP patients were ≤ 2.83 kU/L, >32.16 U/L and>256.06 IU/L, respectively, and the areas under the curve were smaller than that in combined prediction. ConclusionsThe abnormal expression of serum CHE, GGT and LDH is an important influencing factor for the occurrence of preeclampsia, has a certain correlation with the degree of illness in HDCP patients, and the combination of the three is better in predicting adverse pregnancy outcomes in patients with HDCP.
2021, 46(9): 1183-1186, 1191.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.008
Abstract:
ObjectiveTo investigate the effects of CT-guided Hook-wire positioning assisted thoracoscopic surgery in the treatment of early non-small cell lung cancer(NSCLC), and its influence on the serum tumor markers and postoperative recurrence. MethodsNinety-eight patients with early NSCLC were selected, and divided into the observation group and control group according to the random number table method(49 cases each group).The observation group were treated with CT-guided Hook-wire positioning assisted thoracoscopic surgery, and the control group were treated with thoracoscopic surgery.The operation status, serum tumor marker indicators[cytokeratin 19, fragment antigen 21-1(CYFRA21-1), carcinoembryonic antigen(CEA) and carbohydrate antigen 50(CA50)] and lung function indexes[forced vital capacity(FVC), maximum ventilation(MVV), forced expiratory volume in the first second(FEV1)] before and afteroperation, and complications were compared between two groups.All patients were followed up for 12 months, and the recurrence rates in two groups were counted. ResultsThe intraoperative blood loss, postoperative drainage, thoracic catheter drainage time and hospitalization time in observation group were significantly less than those in control group(P < 0.01).After 1 d of operation, the serum levels of CEA, CYFRA21-1 and CA50 in two groups decreased compared with those before surgery(P < 0.05), but there was no statistical significance between two groups(P>0.05).After 2 weeks and 1 month of operation, the MVV, FVC and FEV1 in two groups decreased compared with those before operation(P < 0.05), but which in observation group was significantly higher than that in control group(P < 0.01).The incidence rates of complications in the observation group and control group were 6.12%(3/49) and 10.20%(5/49), respectively, and the difference of which was not statistically significant(P>0.05).After 12 months of surgery, the recurrence rate of disease in observation group[2.04%(1/49)] was lower than that in control group[14.29% (7/49)] (P < 0.05). ConclusionsThe use of CT-guided Hook-wire positioning assisted thoracoscopic surgery in the treatment of early NSCLC is accurate, little damage to lung function, quick recovery, and can reduce the risk of disease recurrence.
2021, 46(9): 1187-1191.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.009
Abstract:
ObjectiveTo investigate the correlation between serum neurofilament light chain (NfL) and post-stroke cognitive impairment (PSCI) and its clinical significance. MethodsSixty health-examination people, 60 patients with acute ischemic stroke (AIS) and 60 patients with PSCI by Montreal congnitive assessment scale(MoCA) were selected.Electrochemiluminescence was used to detect the NfL content in peripheral blood for health control (HC) group, AIS group, and PSCI group.National Institutes of Health stroke scale (NIHSS), MoCA, Barthel index(BI) and biochemical indexes, and modified rankin scale(mRS) were measured in the three groups. ResultsThere were significant differences in the levels of serum NfL in HC group, AIS group, and PSCI group.The NfL content increased with the increase of nervous system damage and NIHSS score(r=0.724, P < 0.01), increased with with the decrease of self-care ability and BI score(r=-0.670, P < 0.01), and increased with the decrease of cognitive function and MoCA score(r=-0.707, P < 0.01).The NfL content of mild cognitive impairment was lower than that of moderate and severe cognitive impairment.There was also a positive correlation between serum NfL and mRS(r=0.501, P < 0.01), The NfL content increased with the decrease of nerve recovery function.In three groups, there were significant differences in hyperlipidemia, hypertension history, diabetes, and stroke history(P < 0.01), and the difference of biochemical indicator homocysteine was statistically significant(P < 0.01).The area under receiver operating characteristic curve of NfL in PSCI was 0.810(P < 0.01). ConclusionsNfL content can be used as a biomarker for early diagnosis of PSCI and a novel predictor of the severity of PSCI, which has positive clinical significance for early detection and prevention of PSCI.
2021, 46(9): 1192-1197.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.010
Abstract:
ObjectiveTo investigate the clinical efficacy of posterior lumbar interbody fusion(PLIF) combined with different intervertebral fusion in the treatment of single-segment lumbar spondylolisthesis(LS) complicated with lumbar spinal stenosis(LSS). MethodsThe clinical data of 60 patients with LS complicated with LSS were retrospectively analyzed, and the patients were divided into the observation group(31 cases treated with tantalum cage combined with autograft bone) and control group(29 cases treated with autograft bone).The operation time, intraoperative blood loss, postoperative drainage and postoperative duration for bed rest in two groups were recorded.The visual analogue score(VAS), Oswestry dysfunction index(ODI), degree of spondylolisthesis, height of posterior margin of lumbar space and angle of lumbar lordosis in two groups were recorded throughout the treatment process. ResultsThere was no statistical significance in the height of posterior margin of intervertebral space between two groups before and immediately after surgery(P>0.05), but the differences of which between two groups after 3 and 12 months were statistically significant(P < 0.01).There was no statistical significance in the lumbar lordosis angle between two groups before and immediately after surgery(P>0.05), but the differences of which between two groups after 3 and 12 months were statistically significant(P < 0.01).The degree of lumbar spondylolisthesis, posterior margin height of intervertebral space and lumbar lordosis angle in two groups were significantly improved immediately after operation, 3 months after operation and 12 months after operation(P < 0.01).There was no statistical significance in the waist VAS score in two groups between postoperation, and before and immediately after surgery(P>0.05), but the differences of which in two groups between after 3 and 12 months were statistically significant(P < 0.01).There was no statistical significannce in the leg VAS score in two groups among before operation, immediately after surgery and after 3 and 12 months of operation(P>0.05).There was no statistical significance in the ODI in two groups among before operation, immediately after operation and after 3 and 12 months of operation(P>0.05).The waist VAS score, leg VAS score and ODI score in two groups immediately after surgery, after 3 months and 12 months of surgery were significantly better than those before operation(P < 0.01). ConclusionsThe PLIF combined with tantalum cage and autologous bone transplantation can maintain the lumbar lordosis angle and lumbar posterior margin height, and the long-term relief effects of lumbar pain of which is better than that of autologous bone transplantation alone.
2021, 46(9): 1197-1200.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.011
Abstract:
ObjectiveTo analyze the correlation between lactate level and blood glucose, oxygenation index in low-month-old and low-weight congenital heart disease children treated with cardiopulmonary bypass. MethodsOne hundred and twenty-nine congenital heart disease children treated with cardiopulmonary bypass were divided into the high lactate group(n=43) and normal lactate group(n=85) according to the lactate level after 6 h of surgery.The operation-related indexes, and levels of glucose, and oxygenation indexes were compared between two groups.The multivariate logistic regression model was used to analyze the influencing factors of lactate level in children after operation.The Pearson correlation model was used to analyze the correlation between lactate level and glucose, oxygenation index in children after 6 hours of operation. ResultsThe extracorporeal circulation time, aortic occlusion time, glucose and lactate levels in high lactate group were higher than those in normal lactate group(P < 0.05 to P < 0.01).The differences of arterial oxygen saturation(SaO2) and venous oxygen saturation(SvO2) (SaO2-SvO2) levels and incidence rate of ketosis were not statistically significant between two groups(P>0.05).The results of multivariate logistic regression analysis showed that the older age was a protective factor to prevent the increasing of lactate level after cardiopulmonary bypass(P < 0.05), the extracorporeal circulation time, aortic occlusion time and high glucose level were the independent risk factors of the increasing of lactate level after cardiopulmonary bypass(P < 0.05 to P < 0.01).The results of Pearson correlation analysis showed that the lactate level was significantly positively correlated with glucose(P < 0.01), but had no significant correlation with(SaO2-SvO2) level(P>0.05). ConclusionsThe lactate level in low-month-old and low-weight children after 6 h of cardiopulmonary bypass is correlated with the glucose level, but not with oxygen intake.
2021, 46(9): 1201-1203, 1207.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.012
Abstract:
ObjectiveTo analyze the influencing factors of carbapenem-resistant Klebsiella pneumoniae(CRKP) infection in adult inpatients. MethodsThe clinical data of adult inpatients infected with Klebsiella pneumoniae were collected.According to whether Klebsiella pneumoniae was resistant to carbapenem antibiotics, the patients were divided into the CRKP group and carbapene sensitive Klebsiella pneumoniae(CSKP) group.The influencing factors of CRKP infection were analyzed. ResultsThe results of univariate analysis showed that the differences of CRKP infection in the admission to intensive care unit, use of carbapenem antibacterial drugs, use of ventilator and use of catheter were statistically significant(P < 0.01).The results of multivariate analysis showed that the admission to intensive care unit and use of ventilator were the independent risk factors of CRKP infection(P < 0.01). ConclusionsIt is helpful to control the spread of CRKP by strengthening the monitoring of drug resistance in intensive care units, carrying out screening for colonization, standardizing the use of antibiotics, paying attention to aseptic operation and hand hygiene of medical staff, and strictly implementing disinfection and isolation measures.
2021, 46(9): 1204-1207.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.013
Abstract:
ObjectiveTo compare the clinical efficacy of locking plate through tarsal sinus approach and lateral extended "L" approach in the treatment of calcaneal fractures. MethodsThe clinical data of 62 patients with calcaneal fractures(Sanders Ⅱ, Ⅲ and Ⅳ) were retrospectively analyzed.Thirty-two cases treated with locking plate through tarsal sinus approach and 30 cases treated with lateral extended "L" approach were divided into the observation group and control group, respectively.The operation time, incision length, postoperative complications, incision and fracture healing time, and AOFAS score, Bohler angle, Gissane angle and calcaneal width before and after operation were compared between two groups. ResultsThe differences of the operation time, fracture healing time and postoperative complications between two groups were not statistically significant(P>0.05).The length length and healing time of incision in observation group were less than those in control group(P < 0.05);The differences of the Bohler angle, Gissane angle and calcaneal width between two groups before and after operation were not statistically significant(P>0.05).The AOFAS score in observation group after 3 months of operation was better than those in control group(P < 0.05), and the differences of the AOFAS scores in two groups between after 6 and 12 months of operation were not statistically significant(P>0.05).After operation, the Bohler angle and Gissane angle in two groups were greater than those before operation, and the calcaneal width in two groups was less than that before operation(P < 0.05). ConclusionsThe locking plate through tarsal sinus approach in the treatment of calcaneal fractures has the advantages of less trauma and complications, and it is an ideal form of therapy.
2021, 46(9): 1208-1211, 1215.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.014
Abstract:
ObjectiveTo analyze the relationship between preoperative inflammatory indicators and clinicopathological features in patients with breast cancer. MethodsA total of 49 breast cancer patients treated with mastectomy and 48 benign proliferative breast disease patients treated with quadrant resection were divided into the observation group and control group, respectively.The red blood cell distribution width(RDW), neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR) and systemic immune inflammation index(SII) were compared between two groups.The diagnostic value of RDW, NLR, PLR and SII in breast cancer were analyzed using receiver operating characteristic(ROC) curve, and the relationship between RDW, NLR, PLR and SII, and clinicopathologic features were analyzed. ResultsThe levels of RDW, NLR, PLR and SII in observation group were higher than those in control group(P < 0.05 to P < 0.01).The results of ROC curve analysis showed that the AUC of RDW, NL and SII were higher than that of PLR(P < 0.05), and the differences of the AUC between RDW and NLR, SII were not statistically significant(P>0.05).According to the optimal cut-off value, when the RDW was higher than 12.89%, the sensitivity and specificity of which were 79.6% and 91.7%, respectively.When the NLR was higher than 1.78, the sensitivity and specificity of which were 69.4% and 9.6%, respectively.When the PLR was higher than 143.57, the sensitivity and specificity of which were 34.7% and 97.9%, respectively.When the SII was higher than 392.42, the sensitivity and specificity of which were 65.3% and 91.7%, respectively.The NLR and PLR were correlated with the axillary lymph node metastasis(P < 0.05 and P < 0.01), and the PLR was correlated with the clinical stage of breast cancer(P < 0.05). ConclusionsThe levels of RDW, NLR, PLR and SII in breast cancer patients are high, which has some auxiliary diagnostic value for breast cancer.The NLR is associated with axillary lymph node metastasis, and the PLR is associated with axillary lymph node metastasis and clinical stage of breast cancer.
2021, 46(9): 1212-1215.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.015
Abstract:
ObjectiveTo investigate the clinical features of hyperlipidemic acute pancreatitis(HLAP), and effects of triglyceride on the severity of disease. MethodsThe clinical data of 68 patients with HLAP and 50 patients with biliary acute pancreatitis(BAP) were retrospectively analyzed.According to the TG level, the HLAP patients were divided into the TG increasing group(TG < 22.4 mmol/L) and severe TG increasing group(TG ≥ 22.4 mmol/L), and the combined disease and severity of disease were compared between two groups. ResultsThe ratios of male, complicated with obesity, diabetes, fatty liver and relapse in HLAP group were significantly higher than those in BAP group(P < 0.05 to P < 0.01), and the age in HLAP group was lower than the BAP group(P < 0.05).There was no statistical significance in the proportion of SAP and length of hospital stay between two groups(P>0.05).The levels of TG, blood glucose(Glu), total cholesterol(TC) and uric acid(UA) in HLAP group were significantly higher than those in BAP group(P < 0.05), and the levels of blood calcium(Ca), alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL) and direct bilirubin(DBIL) in HLAP group were lower than those in BAP group(P < 0.05 to P < 0.01).There was no statistical significance in the ratios of age, combined obesity, diabetes, fatty liver, hypertension and recurrence between the TG increasing group and TG severe increasing group(P>0.05).There was no statistical significance in the TG level and severity of HLAP patients between two groups(P>0.05). ConclusionsThe incidence of HLAP is more common in middle-aged men, which is easy to be combined with obesity, diabetes, fatty liver, relapse and serum calcium level decreasing.The serum level of TG significantly increases, and there was no significant correlation with the severity of disease in HLAP patients.
2021, 46(9): 1216-1219.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.016
Abstract:
ObjectiveTo analyze the risk factors of perioperative complications in patients treated with radical gastrectomy and their effects on long-term prognosis. MethodsThe clinical data of 106 patients treated with radical gastrectomy were analyzed, and the patients were divided into the perioperative complication group(27 cases) and no perioperative complication group(79 cases) according to the occurrence of perioperative complications The independent risk factors affecting the occurrence of complications were analyzed using multivariate logistic regression analysis, and the influence of perioperative complications on the long-term prognosis of patients were analyzed using Cox regression analysis. ResultsThe incidence rate of perioperative complications in patients treated with gastric cancer radical was 25.47%(27/106), and there was no statistical significance in general information(gender, smoking and drinking) between two groups.The results of multivariate logistic regression analysis showed that the age ≥ 65, TNM staging and combined visceral resection(P < 0.01) were the independent risk factors of perioperative complications in patients treated with radical gastrectomy.A total of 98 patients(92.45%) were followed up for 22-86 months, and the 5-year survival rate was 39.80%.The 5-year survival rates of patients with and without perioperative complications were 60.37% and 32.00%, respectively, and the difference of which was statistically significant(P < 0.05).The results of multivariate Cox regression analysis showed that the tumor size, TNM staging, combined visceral resection and perioperative complications were the independent factors affecting the prognosis of patients treated with radical gastrectomy for gastric cancer(P < 0.05 to P < 0.01). ConclusionsThe age, TNM staging and combined visceral resection are high risk factors of perioperative complications in patients with gastric cancer.The clinical measures should be taken to reduce the incidence of perioperative complications, so as to improve the postoperative quality of life and survival rate of patients.
2021, 46(9): 1220-1222.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.017
Abstract:
ObjectiveTo evaluate the efficacy and safety of Hem-o-lok clip for closing appendix stump in laparoscopic appendectomy. MethodsEighty-two patients treated with laparoscopic appendectomy were randomly divided into the Hem-o-lok group(n=41) and control group(n=41).The appendiceal stump in the Hem-o-lok group and control group were clamped using Hem-o-lok and simple ligation or ligation combined with sewing using silk thread, respectively.The operation time, operation related complications, length of stay and hospitalization cost were compared between two groups. ResultsThe operation time, intraoperative blood loss and postoperative anal exhaust time in Hem-o-lok group were significantly lower than those in control group(P < 0.01), but the differences of the hospitalization time and total hospitalization cost were not statistically significant(P>0.05).There was not reoperation patients in the Hem-o-lok group, and two patients were transferred to open surgery.There were not reoperation patients in the control group, and the difference of the patients transferring to open surgery between two groups was not statistically significant(P>0.05).The total incidence rate of complications in Hem-o-lok group was slightly lower than that in control group, but the difference of which was not statistically significant(P>0.05). ConclusionsThe Hem-o-lok clip is effective and safe in the treatment of appendiceal stump, and it is simple to operate, and can effectively shorten the operation time.
2021, 46(9): 1223-1226.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.018
Abstract:
ObjectiveTo investigate the methylation and protein expression of Ras specific guanylate releasing factor 1(RASGRF1) in gastric cancer and its clinical significance. MethodsThe clinical data of 80 patients with gastric cancer were collected.The expression levels of RASGRF1 protein in 80 gastric cancer tissues and corresponding adjacent tissues were detected using immunohistochemistry.The methylation status of RASGRF1 gene was detected by methylation specific PCR.Spearman correlation was used to analyze the correlation of methylation with protein expression levels of RASGRF1 in gastric cancer tissues.The relationship between the methylation status and protein expression levels were observed. ResultsThe RASGRF1 protein expression and gene methylation expression were different between gastric cancer tissues and adjacent tissues(P < 0.05).The results of Spearman correlation analysis showed that the RASGRF1 protein expression was negatively correlated with the gene methylation in gastric cancer tissues(P < 0.01).The RASGRF1 protein expression in gastric cancer tissues was not related to the gender, age, tumor diameter, histological differentiation degree and distant metastasis(P>0.05), but was related to tumor stage(P < 0.05).The RASGRF1 gene methylation in gastric cancer tissues was not related to the gender, age, tumor diameter and histological differentiation(P>0.05), but was related to the tumor stage and distant metastasis(P < 0.05 and P < 0.01). ConclusionsThere is a negative correlation between RASGRF1 gene methylation and protein expression in gastric cancer tissues.The RASGRF1 gene methylation and protein expression have a certain correlation with tumor stage and distant metastasis.
2021, 46(9): 1226-1228.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.019
Abstract:
ObjectiveTo investigate the value of ultrasonic semi-quantitative scoring of 7 joints(US7) in the evaluation of the rheumatoid arthritis(RA) disease activity. MethodsThirty-seven patients with RA were divided into the hypersensitive C-reactive protein(hs-CRP) normal group(14 cases) and hs-CRP increasing group(23 cases) according to the level of hs-CRP.The severe side wrist joint, second and third metacarpophalangeal joints and proximal interphalangeal joints, and second and fifth metatarsophalangeal joints in two groups were examined by gray-scale ultrasound and energy Doppler ultrasound.The scores were compared between two groups, and the correlation between US7 score and hs-CRP was analyzed. ResultsThe synovial hyperplasia, synovial blood flow scoring and total US7 score in hs-CRP increasing group were higher than those in hs-CRP normal group(P < 0.05 to P < 0.01).The differences of the scores of joint effusion and bone erosion between two groups were not statistically significant(P>0.05).Among the 37 RA patients, the synovium blood flow, bone erosion and US7 total score were positively correlated with the level of hs-CRP.The synovial hyperplasia and joint effusion were not correlated to the level of hs-CRP(P>0.05). ConclusionsThe US7 score can be used to evaluate the disease activity of RA, and it is a simple and effective imaging method to monitor the disease activity of RA.
2021, 46(9): 1229-1231.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.020
Abstract:
ObjectiveTo explore the application value of ultrasonic elasticity contrast index(ECI) in the diagnosis of thyroid nodules, and compare the efficacy among different measurement methods. MethodsA total of 31 patients with thyroid nodules(36 nodules) were investigated, and the ECI was measured using the sketching the cross-sectional junction boundary, measurement of inhomogeneous areas within nodules in cross section and cross-sectional junction boundary, respectively.The ROC curve was drawn, and the diagnostic effects of thyroid nodules were compared among different measurement methods. ResultsAmong the three methods, the area under the ROC curve of the measurement of inhomogeneous areas within nodules in cross section was the largest(0.82), and the corresponding ECI cut-off value was 2.93.The sensitivity, specificity and accuracy of the measurement of inhomogeneous areas within nodules in cross section in evaluating the malignant risk of thyroid nodules were 82.0%, 76.4% and 75.3%, respectively.Using the measurement of inhomogeneous areas within nodules in cross section, the ECI value of malignant nodules is high than that of benign nodules (P < 0.05). ConclusionsThe measurement of inhomogeneous areas within nodules in cross section has a high diagnostic effect on thyroid nodules.
2021, 46(9): 1232-1235.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.021
Abstract:
ObjectiveTo investigate the clinical application value of ultrasound elastography combined with molybdenum target in the breast conserving surgery of breast cancer. MethodsEighty-four breast cancer patients scheduled by breast conserving surgery were detected using ultrasound elastography and mammography alone and in combination before operation.The imaging findings and accuracy of breast ultrasound elastography combined with mammography and mammography alone were determined by comparing with the postoperative pathological results. ResultsThe detection rate of breast lesions detected by ultrasound elastography combined with molybdenum target X-ray was significantly higher than that detected by ultrasound elastography alone and mammography alone(P < 0.05 and P < 0.01).The detection rates of axillary lymph node metastasis of ultrasound elastography, mammography and ultrasound elastography combined with mammography were 60.98%, 53.31% and 70.73%, respectively, but the difference of which was not statistically significant(P>0.05).The ultrasound elastography combined with mammography in evaluating the feasibility of breast conserving surgery was more accurate than the other two methods(P < 0.05). ConclusionsThe application of ultrasound elastography combined with mammography in breast conserving surgery is more helpful to improve the accuracy of the disease, and provide more reference value for clinical practice.
2021, 46(9): 1236-1239.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.022
Abstract:
ObjectiveTo analyze the accuracy of ultrasound in the diagnosis of ectopic pregnancy and its influencing factors. MethodsThe clinical data of 156 patients with ectopic pregnancy diagnosed by ultrasound were retrospectively analyzed.The results of surgical pathology were followed up to verify the consistency between the ultrasound diagnosis and pathological report diagnosis, and the factors influencing the accuracy of ultrasound diagnosis were analyzed. ResultsAmong 156 cases, 125 patients were confirmed by pathology, and the diagnostic accuracy of which was 80.13%.The pregnancy sac in 144 cases were clearly detected using ultrasound, and the unknown location of pregnancy sac in 12 cases were not detected by initial ultrasound.The results of multivariate logistic regression analysis showed that the pelvic inflammation, serum human chorionic gonadotropin(HCG) and menopause time >6 weeks were the independent influencing factors of ultrasonic diagnosis accuracy of ectopic pregnancy(P < 0.01). ConclusionsDuring the clinical diagnosis and treatment of ectopic pregnancy, the early ectopic pregnancy and pelvic inflammatory disease should be paid attention to.For undiagnosed patients, the accuracy of ultrasonic diagnosis of ectopic pregnancy can be improved as far as possible by combining serum human chorionic gonadotropin level, clinical symptoms and follow-up of patients.
2021, 46(9): 1239-1243, 1247.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.023
Abstract:
ObjectiveTo explore the value of chest enhanced CT radiomics in the prediction of lymph node metastasis in patients with non-small cell lung cancer(NSCLC). MethodsThe clinical and chest enhanced CT data of 143 NSCLC patients confirmed by pathologically were retrospectively analyzed.The patients were randomly divided into the training group(n=100) and verification group(n=43) according to the ratio of 7:3.The venous phase images were used to extract the radiomics features.The least absolute shrinkage and selection operator(LASSO) logistic regression was used for data dimension reduction and feature selection.Two predictive models were constructed using the radiomics features and clinical-imaging characteristics(the maximum meridian and burr sign).The AUCs of ROC was used to evaluate the predictive effectiveness of model.The ROC curve of model was tested by Delong test.The predictive efficacy was evaluated in validation group. ResultsA total of 939 radiomics features were extracted, 6 optimal features were finally selected, and the prediction model was established.In the training group, the AUC of the radiomics model was 0.864(95%CI: 0.781~0.924), which was higher than that of the clinical model[0.662 (95%CI: 0.561~0.754)](P < 0.01).In the validation group, the AUC of the radiomics model was 0.860(95%CI: 0.720~0.964), which was greater than that of the clinical model[(0.664 (95%CI: 0.504~0.880)](P < 0.05). ConclusionsBased on the image omics features extracted from the chest CT enhanced images and constructing the prediction model, the efficacy of the radiomics model was higher than that of the clinical model.The CT radiomics can be used as an auxiliary tool to predict lymph node metastasis in patients with non-small cell cancer, which has a good clinical application prospect.
2021, 46(9): 1244-1247.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.024
Abstract:
ObjectiveTo explore the application value of low-tube-voltage combined with iterative model reconstruction(IMR) technique in the contrast-enhanced CT of gastric cancer. MethodsThe upper abdominal CT scanning and dynamic enhanced scan in 54 gastric cancer patients were examined, and the 26 patients treated with IMR reconstruction and 28 patients treated with filtered back projection(FBP) reconstruction were divided into the observation group and control group, respectively.The portal vein phase scan data in two groups were collected, and the subjective evaluation, objective evaluation and effective dose comparison of the images in two groups were carried out.The postoperative pathology results were set as the gold standard, the coincidence rate of CT enhanced T staging was compared between two groups. ResultsThe CT volumetric dose index, CT dose-length product and effective dose in observation group were significantly lower than those in control group(P < 0.01), and the image signal-to-noise ratio and contrast-to-noise ratio in observation group were significantly higher than those in control group(P < 0.01).The differences of the low contrast resolution and lesion edge sharpness between two groups were statistically significant(P < 0.05), while there was no statistical significance in image distortion between two groups(P>0.05).The coincidence rate of CT enhanced T staging in observation group(88.46%) was higher than that in control group(64.29%) (P < 0.05). ConclusionsThe low-tube-voltage combined with IMR in the contrast-enhanced CT of gastric cancer can not only reduce the radiation dose and improve the image quality, but also help to improve the preoperative T-stage diagnosis coincidence rate of gastric cancer.
2021, 46(9): 1248-1251.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.025
Abstract:
ObjectiveTo investigate the effectiveness of interventional therapy in patients with traumatic splenic rupture and the effect of the amount of blood loss. MethodsA total of 68 patients with traumatic splenic rupture were selected as subjects, and randomly divided into the control group(n=34) and the observation group(n=34) using a double-blind randomized method.The control group received surgical treatment, while the observation group received selective interventional embolization.The effect of the two groups was evaluated at 5 days after operation, and the patients were followed up for 6 months after operation.Surgical indicators, VAS scores, inflammatory factors, and quality of life were compared between the two groups. ResultsNo laparotomy or reoperation occurred.There was no statistical significance in the operation time between the two groups(P>0.05).In the observation group, anal exhaust, hospital stay, intraoperative blood loss, hospital expenses and postoperative feeding time were shorter (less) than those in the control group(P < 0.01).Postoperative scores of 1, 3, 5 and 7 d VAS in both groups were lower than those before surgery (P < 0.01).Postoperative scores of 1, 3, 5 and 7 d VAS in the observation group were all lower than those in the control group(P < 0.01).White blood cell count, CRP, Cor and EP levels were higher in both groups at 5 d after operation than before(P < 0.05).The white blood cell count, CRP, Cor and EP levels in the observation group were all lower than those in the control group 5 days after operation(P < 0.01).The 5 d QOL score after operation was higher in both groups than before nursing(P < 0.05 to P < 0.01).The scores of 5 d PH, RP, BP, GH, VT, SF, RE and MH in the observation group were all higher than those in the control group(P < 0.01). ConclusionsInterventional therapy can reduce the amount of bleed loss in patients with traumatic splenic rupture, relieve the pain, reduce the level of inflammatory factors, and contribute to the improvement of patients' quality of life.Moreover, this treatment method is safe and can reduce the postoperative recurrence rate, which is worthy of popularization and application.
2021, 46(9): 1252-1254.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.026
Abstract:
ObjectiveTo investigate the effect of Helicobacter pylori(HP) infection on metabolic levels in patients with type 2 diabetes mellitus (T2DM). MethodsA total of 175 patients with T2DM were included in this study.These patients were divided into two groups as HP infection-positive or -negative.For each patient, the following data were collected or measured: age, gender and laboratory parameters including total cholesterol (TC), triglyceride(TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), lipoprotein-a (LP-a), fasting blood glucose (Glu) and glycosylated hemoglobin (HbA1c).The influence of HP infection on the metabolic levels of T2DM patients was analyzed by comparing the results between the two groups. ResultsAmong 175 T2DM patients, 91 patients (52%) were HP positive and 84 patients (48%) were HP infection-negative.T2DM patients infected by HP showed significantly increased Lp-a and higher HbA1c than non-infected patients (P < 0.01).Additionally, 65.9% of the patients with HbA1c >8% were found to be HP positive, 55.6% of the patients with HbA1c ≤ 8% were HP positive.The levels of other parameters were not significantly different between two groups (P>0.05). ConclusionsHP infection affects blood glucose and lipid metabolism in patients with T2DM, which may be involved in the occurrence and development of metabolic disorder associated diseases.
2021, 46(9): 1255-1257.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.027
Abstract:
ObjectiveTo explore the significance of lipase(LPS), amylase(AMS) and C-reactive protein(CRP) in the diagnosis of acute pancreatitis(AP). MethodsThe levels of peripheral blood LPS, AMS and CRP in 70 AP patients and 30 non-AP patients were detected using dry chemical analyzer(VITROS 5600), and the data in two groups were analyzed. ResultsThe serum levels of LPS, AMS and CRP in AP group were higher than those in control group(P < 0.01).The sensitivity and specificity of the combined detection of the two indicators were higher than that of the single detection.When the three indicators of AMS, LPS and CRP were combined, the diagnostic sensitivity and specificity of which reached 95.7% and 98.0%, and the area under the ROC curve of serum LPS and AMS was relatively high. ConclusionsThe combined detection of serum LPS, AMS and CRP can effectively improve the diagnostic effects of AP, and which is worthy of clinical application.
2021, 46(9): 1258-1261.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.028
Abstract:
ObjectiveTo investigate the relationship between hepatitis C virus core antigen(HCV-cAg) and hepatitis C virus RNA(HCV-RNA), and association between levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and glutamyl transpeptidase(GGT), and HCV-RNA viral load. MethodsSeventy-eight patients with positive HCV antibody or suspected hepatitis C were divided into the observation group, and another 20 healthy examinees were set as the control group during the same period.The serum levels of HCV-cAg, HCV-RNA, ALT, AST and GGT in two groups were determined by ELISA and fluorescence quantitative PCR, and the relationship among the above parameters were compared. ResultsIn the observation group, the positive detection rate of HCV-cAg was 41.0%(32/78), the positive detection rate of HCV-RNA was 53.8%(42/78), the difference of which was statistically significant(P < 0.01), and there was a good consistency between the two groups(κ=0.747).The levels of ALT, AST and GGT levels in observation group were significantly higher than those in control group(P < 0.01), but there was no significant correlation with HCV RNA viral load(P>0.05). ConclusionsThe HCV-cAg and HCV-RNA have good consistency and correlation in the detection of hepatitis C, and can provide valuable basis for the clinical diagnosis of hepatitis C.
2021, 46(9): 1261-1263.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.029
Abstract:
ObjectiveTo analyze the results of noninvasive DNA prenatal testing(NIPT) in 2 932 pregnant women in Huaibei area, and its related influencing factors. MethodsThe high-throughput sequencing method was used to analyze the chromosome of fetal free DNA.The positive results were confirmed by amniotic fluid puncture.The chromosome microarray analysis in fetus with copy number variation(CNV) was performed. ResultsThe overall high risk detection rate of NIPT in 2 932 pregnant women was 1.43%(42/2 932).Among different ages pregnant women, the differences of the trisomy syndrome, sex chromosome abnormalities and total high risk detection rate were statistically significant(P < 0.05 to P < 0.01), and the difference of the CNV was not statistically significant(P>0.05).There was no statistical significance in the detection rates of trisomy syndrome and sex chromosome abnormality between rural and urban pregnant women(P>0.05).The detection rates of CNV and total high risk in rural pregnant women were higher than those in urban pregnant women(P < 0.05 and P < 0.01). ConclusionsIn Huaibei area, the main NIPT is trisomy syndrome, abnormalities and the risks of sex chromosome and CNV are relatively high.
2021, 46(9): 1264-1266.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.030
Abstract:
ObjectiveTo investigate and analyze the physical health status and influencing factors of school-age children(6-12 years old) in Bengbu city Anhui province under the influenza prevention and control environment, and propose improvement measures for the reference of relevant functional departments. MethodsUsing the method of stratified fixed ratio and random sampling, 1 759 school-age children were investigated using questionnaire. ResultsThe prevalence of influenza among school-age children in the survey area accounted for about 20%.The dietary status, study burden, physical activity and sleep status were significantly associated with the incidence rate of influenza in children(P < 0.05).The results of logistic multivariate regression analysis showed that the diet, learning load, physical activity and sleep were the independent factors of influenza in children(P < 0.05 to P < 0.01). ConclusionsThe physical health status of school-age children in Bengbu city needs to be improved, especially in terms of reasonable diet mix, healthy physical exercise and advanced education, teaching concepts, etc.The school needs to cooperate with parents to carry out targeted physical health education and health promotion activities in order to improve children's physique and reduce the incidence rate of influenza.
2021, 46(9): 1267-1270, 1275.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.031
Abstract:
ObjectiveTo compare the direct economic loss caused by nosocomial infection in patients with spontaneous intracerebral hemorrhage and the cost, benefit and effect after implementing the infection prevention and control program. MethodsThe patients with first diagnosed spontaneous intracerebral hemorrhage among the patients discharged from January 1, 2019 to December 31, 2019 were set as the control group, and the patients with spontaneous intracerebral hemorrhage discharged from January 1, 2020 to December 31, 2020 after implementing the infection control program were set as the observation group.The changes in the risk of nosocomial infection in patients with intracerebral hemorrhage was compared before and after implementing the infection control program.At the same time, patients with spontaneous intracerebral hemorrhage with nosocomial infection in the past two years were selected as the infection group, and patients without nosocomial infection were selected as the control group (non-infection group) according to the 1:1 matching method.The differences of hospitalization time and various hospitalization costs between the two groups were compared. ResultsIn 2019 and 2020, there were 215 and 189 patients with spontaneous intracerebral hemorrhage, respectively, and there were 25 and 11 patients with nosocomial infection, respectively.The incidence of nosocomial infection in 2020 was significantly lower than that in 2019(P < 0.01).Combined with the occurrence of nosocomial infection in patients with intracerebral hemorrhage for 2 years, a total of 27 pairs of case controls meeting the requirements were matched.The median hospitalization time of patients in the infection group and non-infection group was 26 days and 17 days, respectively, which was extended in the non-infection group(P < 0.01).The median hospitalization costs were 79 889.03 yuan and 18 662.37 yuan in the infection group and non-infection group, respectively, and the direct economic loss of the total hospitalization cost was 61 226.66 yuan(P < 0.05).The cost of medicine, examination, laboratory test, diagnosis, bed, surgery, treatment and nursing in the infection group were higher than those in the control group(P < 0.05). ConclusionsNosocomial infection in patients with spontaneous intracerebral hemorrhage causes the prolongation of hospitalization time and significant increase of hospitalization costs.The implementation of infection control program can achieve good benefits and effects.
2021, 46(9): 1271-1275.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.032
Abstract:
ObjectiveTo study the effect of the nutrition education and health consultation on dietary patterns and blood lipids in middle-aged and elderly populations with dyslipidemia. MethodsOne hundred and sixteen middle-aged and elderly patients with dyslipidemia were divided into nutrition education group and control group (58 cases in each group).The nutrition education group was treated with group teaching and nutrition health consultation for six months, while the control group was not treated with any intervention measures.The changes of blood lipid indicators, dietary patterns, diet and related nutrition indicators in the two groups before and after nutrition education were analyzed. ResultsAfter the intervention, there were significant differences in the intakes of vitamin C, calcium, iron and dietary fiber between the two groups (P < 0.05 to P < 0.01), there were significant differences in the frequency of eating milk, fruits and beans between the two groups (P < 0.05), and there were also significant differences in body mass, body mass index, cholesterol and triglyceride between the two groups (P < 0.05). ConclusionsThe combination of nutrition education and health consultation can promote the reasonable dietary intake of dyslipidemia patients in community, improve their health status and therapeutic effect.
2021, 46(9): 1276-1279, 1284.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.033
Abstract:
ObjectiveTo discuss the self-management behavior and its influencing factors of type 2 diabetic foot patients under the health ecology model. MethodsSelect 90 patients with type 2 diabetic foot who were treated in our hospital from February 2017 to November 2020, according to the personal factors, policy environment, interpersonal network, living environment and working conditions, and behavior characteristics under the health ecology model In 5 areas, using the Diabetes Foot Knowledge Questionnaire, Diabetes Problem Scale, Diabetes Self-Efficacy Scale, General Information Questionnaire, Social Support Rating Scale, and Diabetic Foot Patient Self-Management Behavior Scale to analyze their self-management behaviors and influencing factors. ResultsGender, family history of diabetes, method of payment of medical expenses, social support, number of children, place of residence, work status, education level, smoking, knowledge of diabetic foot and hospitalizations due to diabetic foot are self-management behaviors of patients with type 2 diabetic foot The main influencing factor(P < 0.05). ConclusionsThe self-management behavior of patients with type 2 diabetic foot needs to be strengthened.Clinical measures can be made based on the above influencing factors.
2021, 46(9): 1280-1284.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.034
Abstract:
ObjectiveTo explore the application effect of eCASH concept combined with early graded rehabilitation training in ICU patients with mechanical ventilation. MethodsA total of 81 ICU patients with mechanical ventilation were selected as the study objects, of which 40 patients collected from April 2019 to November 2019 were set as the control group, and 41 patients collected from December 2019 to July 2020 were set as the experimental group.The control group was given routine analgesia, sedation and nursing in grade A tertiary hospital of Anhui province, and the experimental group was given comfortable shallow sedation management based on eCASH concept combined with early graded rehabilitation training.The occurrence of delirium, time of sedative use, time of mechanical ventilation and time of admission to the ICU were compared between the two groups. ResultsThe incidence of delirium, duration of delirium, time of sedative use, time of admission to the ICU and time of mechanical ventilation in experimental group were lower than those in control group (P < 0.05 to P < 0.01). ConclusionsThe application of eCASH concept combined with early graded rehabilitation training in ICU patients with mechanical ventilation has a good clinical practicability and is worthy of clinical application.
2021, 46(9): 1285-1287.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.035
Abstract:
ObjectiveTo explore the application value of closed-loop management model in safety and quality continuous improvement management of gynecological nursing. MethodsThe closed-loop management model was applied in the continuous improvement management of gynecological nursing from March to August 2020, the problems were found through the nurses themselves, quality control nurses and head nurses three-level quality control, inpatient satisfaction survey and telephone return visit.The root cause of problems were discussed and analyzed, the rectification measures were formulated and implemented, the effects of the rectification measures were evaluated, and the modified measures were carried out.The six months before management application from September 2019 to February 2020 were set as the control group, and the six months after management application from March 2020 to August 2020 were set as the observation group.The incidence rate of nursing adverse events, patient satisfaction with nursing work, unplanned extubation rate and other safety sensitive indicators of gynecology were compared between two groups. ResultsThrough closed-loop management, the incidence rate of nursing adverse events in observation group was significantly lower than that in control group(P < 0.01), the satisfaction of patients with nursing work in observation group was significantly better than that in control group(P < 0.01), and the accuracy of patient identification in observation group was higher than that in control group(P < 0.01).There was no statistical significance in the incidence rates of unplanned extubation and fall between two groups(P>0.05). ConclusionsThe application of closed-loop management model in continuous improvement management of gynecological nursing quality can effectively improve the patients' satisfaction with nursing work, reduce the occurrence of nursing adverse events, and improve the safety and quality indicators of gynecological nursing.
2021, 46(9): 1288-1291, 1294.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.036
Abstract:
ObjectiveTo investigate the incidence rate and risk factors of peripherally inserted central catheter(PICC) catheter-related thrombosis(CRT) in patients with hepatobiliary malignant tumors. MethodsThe clinical data of 102 patients with hepatobiliary malignancies were retrospectively analyzed.The incidence rate of CRT was counted.The relationship between the baseline data, placement of PICC and CRT were analyzed using the single factor method, and the factors with statistical significance were included in the logistic regression model for analysis. ResultsThe incidence rate of CRT was about 31.37%.The results of univariate analysis showed that no antiplatelet or anticoagulation history, smoking history, infection, distant metastasis, bone marrow suppression, abnormal rate of puncture site, BMI and catheter diameter in CRT group were higher tahn those in nonCRT group(P < 0.05 to P < 0.01).The results of multiple-factor analysis showed that the smoking, catheter diameter less than 4-F/5-F, myelosuppression, phlebitis and high BMI were the independent risk factors in patients with hepatobiliary malignant tumor complicated with CRT(P < 0.05 to P < 0.01). ConclusionsThe CRT occurs predominantly in hepatobiliary malignancies patients treated with PICC for a long time, and the smoking, bone marrow suppression, abnormal puncture sites, phlebitis and catheter diameter less tahn 4-F/5-F are the independent risk factors of CRT in patients with hepatobiliary malignancies.
2021, 46(9): 1292-1294.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.037
Abstract:
ObjectiveTo explore the effectiveness of a new type of indwelling needle application in the peripheral vein indwelling needle fixation. MethodsA total of 208 inpatients in oral and maxillofacial surgery were investigated, and the patients were divided into the experimental group (103 cases) and control group (105 cases) according to odd and even numbers. The control group were treated with 3M transparent application, while the experimental group were treated with a new type of indwenting-needle fixation application. The average indwelling time of indwelling needle, cumulative curling rate and cumulative replacement rate of the application in different time periods were compared between two groups. ResultsThe cumulative curling value of venous indwelling needle at different time periods in experimental group was significantly lower than that in control group (P < 0.01).The mean indwelling time in the experimental group was (60.63±22.51) h, which was significantly lower than that in control group [(90.17±5.82) h](P < 0.01). The cumulative replacement rate of the application in experimental group in different time periods was significantly lower than that in control group (P < 0.01). ConclusionsThe new type of indwelling needle fixation application is convenient to use, low in price, and it can effectively reduce the curling rate and replacement rate, and prolong the indwelling time of indwelling needle.It is worthy of further promotion and application in clinical practice.
2021, 46(9): 1295-1299.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.038
Abstract:
ObjectiveTo investigate the effects of the combined mode of timely physiological rehabilitation and active psychological adjustment on the self-efficacy of emotion regulation in the nursing intervention of bronchial asthma patients. MethodsA total of 82 patients with non-acute asthma were randomly divided into the control group (42 cases) and observation group (40 cases). The control group was given the relevant knowledge guidance and drug use training on the first day of admission, and required timely return visit. The observation group was given the conventional nursing intervention combined with timely physiological rehabilitation and active psychological adjustment mode. The emotional self-regulation efficacy scale (RES-C), inhaled glucocorticoid technical score, abbreviated asthma quality of life questionnaire (miniAQLQ) and lung function indexes were compared between two groups after 3 months and 6 months of nursing intervention. ResultsAfter 3 and 6 months of intervention, the RES-C, inhaled glucocorticoid technical score, ACT score and miniAQLQ score in observation group were higher than those in control group (P < 0.05), and the levels of FEV1% pred, FVC% pred and FEV1/FVC in observation group were higher than those in control group (P < 0.05). ConclusionsThe combined mode of timely physiological rehabilitation and active psychological adjustment can improve the self-efficacy of emotion regulation in patients with asthma, and at the same time, it is more conducive to the patients' mastery of inhalation technology, and can achieve the effects of controlling asthma symptoms and improve the quality of life and lung function.
2021, 46(9): 1300-1303.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.039
Abstract:
ObjectiveTo investigate the clinical application effects of T-tube combined with Venturi warm humidifying oxygen therapy in patients with tracheotomy offline. MethodsFifty-eight patients aged ≥ 18 years old treated with tracheotomy offline were investigated, and divided into the observation group (28 cases, from January to December 2019) and control group (30 cases, from January to December 2018) according to the time of admission. The observation group was treated with T-tube combined with Venturi warm humidifying oxygen therapy, and the control group was treated with conventional airway humidification. The respiratory rate, oxygenation index (PaO2/FiO2), blood oxygen saturation (SpO2), arterial partial pressure of carbon dioxide (PaCO2), viscosity of sputum, times of sputum suction, decline of SpO2 during sputum suction, duration of SpO2 decline during sputum aspiration, ICU residence time and incidence rate of complications were compared between two groups at offline and after 1 and 5 days of offline. ResultsAfter 1 day and 5 days of offline, the respiratory rate in observation group was lower than that in control group (P < 0.01), the value of PaO2/FiO2 in observation group was higher than that in control group (P < 0.01), and the sputum viscosity in observation group was better than that in control group (P < 0.05 and P < 0.01). The number of sputum aspiration, decreasing degree of SpO2 during sputum aspiration, decreasing duration of SpO2 during sputum aspiration and ICU stay time in observation group were lower than those in control group (P < 0.01). The incidence rates of irritating cough (3.57%), phlegm scab formation (0.00%), pulmonary infection (0.00%) and airway bleeding (7.14%) ine observation group were lower than those in control group (33.33%, 20.00%, 20.00%, and 26.67%) (P < 0.05 to P < 0.01). ConclusionsThe application of Venturi oxygen therapy in patients with tracheotomy offline can meet the physiological needs of human body temperature humidification, avoid the patient's cough and discomfort, improve sputum viscosity and respiratory parameters and reduce the occurrence of complications, and it is worthy of clinical promotion.
2021, 46(9): 1304-1308.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.040
Abstract:
ObjectiveTo evaluate the application effects of continuous nursing based on the King's interactive attainment theory in the rehabilitation of elderly patients after hemi-hip replacement. MethodsEighty patients treated with hemi-hip replacement were randomly divided into the study group (n=40) and control group (n=40). The control group was treated with conventional continuous programme, and the study group was treated with multi-disciplinary team continuous nursing based on the King's interactive attainment theory. The medication compliance, joint function rehabilitation, activities of daily living and complications were compared between two groups. ResultsThe ratio of high compliance at 1 month and 3 months after operation in study group were higher than that in control group (P < 0.05). The Harris score and self-care ability Barthel index in study group were significantly higher than those in control group after 3 months and 6 months of discharge (P < 0.01). The difference of the cumulative incidence rate of DVT, dislocation of the prosthesis and infection after discharge between the study group(5.0%) and control group (12.5%) was not statistically significant (P>0.05). ConclusionsThe continuous nursing based on the King's interactive attainment theory can improve the rehabilitation effects of the elderly after hemi-hip replacement.
2021, 46(9): 1309-1311.
doi: 10.13898/j.cnki.issn.1000-2200.2021.09.041
Abstract:
ObjectiveTo analyze the temperature measurement accuracy and differences of the vital-sign thermometer, red external ear thermometer and infrared frontal body thermometer in the pre-examination and triage of emergency patients. MethodsA total of 175 patients were selected from the emergency department of a grade A tertiary hospital.The temperature of each patient was measured and recorded using the vital signs monitor, red external ear thermometer and frontal thermometer, respectively, and the accuracy and differences of three methods were compared. ResultsThe results of the temperature measurement among three methods were statistically significant (P < 0.01), and the temperature measured by red outer ear thermometer and infrared frontal body thermometer was significantly lower than that measured by vital signs detector (P < 0.01). Among the patients with normal body temperature (36-37.2℃), the differences of the temperature measured by three methods were statistically significant(P < 0.05), and the temperature measured by red external ear thermometer and vital signs detector were higher than that by infrared frontal body thermometer (P < 0.05). ConclusionsWhen the body temperature of emergency patients is measured, the frontal thermometer should only be used as preliminary screening, and the ear thermometer and vital sign thermometer have are good accuracy, little difference, and are suitable for clinical use in emergency patients.
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