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2022 Vol. 47, No. 11
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2022, 47(11): 1479-1483.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.001
Abstract:
ObjectiveTo investigate the killing effect of Vγ9Vδ2 T immune cells combined with cisplatin(CDDP) on nasopharyngeal carcinoma cells. MethodsThe CCK8 method was used to observe the effect of low-concentration of CDDP and zoledronate(ZOL) combined with Vγ9Vδ2 T cells on the proliferation activity of nasopharyngeal carcinoma cells.Flow cytometry was applied to determine the secretion of tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ) and CD107a in Vγ9Vδ2 T cells, and the expression of MICA and MICB on the surface of nasopharyngeal carcinoma cells.Western blotting was employed to detect the protein expression of MICA and MICB in nasopharyngeal carcinoma cells. ResultsThe survival rate of nasopharyngeal carcinoma CNE2Z cells decreased with the increase of CDDP concentration, the killing effect of CDDP combined with Vγ9Vδ2 T cells on CNE2Z cells was better than that of CDDP alone(P < 0.05).ZOL promoted the proliferation of Vγ9Vδ2 T cells, and the killing effect of ZOL combined with Vγ9Vδ2 T cells on CNE2Z cells increased with the increase of ZOL concentration(P < 0.05).Low-concentration of CDDP and ZOL combined with Vγ9Vδ2 T cells enhanced the killing effect on nasopharyngeal carcinoma cells, the killing effect of combined treatment was the best at the effect-target ratio of 10:1, and the difference of which was statistically significant(P < 0.05).Nasopharyngeal carcinoma cells treated with low-concentration of CDDP and ZOL could increase the secretion of immune factors CD107a, TNF-α and IFN-γ in Vγ9Vδ2 T cells(P < 0.05).Low-concentration of CDDP combined with Vγ9Vδ2 T cells significantly up-regulated the expression of MICA and MICB on the surface of nasopharyngeal carcinoma cells(P < 0.01). ConclusionsCDDP can enhance the killing effect of Vγ9Vδ2 T cells on nasopharyngeal carcinoma cells, which may be related to the enhanced expression of MICA and MICB on the surface of nasopharyngeal carcinoma cells and the increased secretion of TNF-α and IFN-γ in Vγ9Vδ2 T cells.
2022, 47(11): 1484-1487.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.002
Abstract:
ObjectiveTo investigate the effect of v-maf musculoaponeurotic fibrosarcoma oncogene homologue A(MafA) on the proliferation of mouse islet β cells Min6, and the mRNA and protein expression of insulin-related genes. MethodsThe experiment was divided into MafA siRNA transfected MafA interference group A, MafA interference group B, MafA interference group C, and non-transfected control group D, control group E, control group F.MafA interference group A and control group D were treated with 5.6 mmol/L glucose, MafA interference group B and control group E were treated with 10 mmol/L glucose, and MafA interference group C and control group F were treated with 25 mmol/L glucose.The expression of mRNA and protein was detected by real-time PCR and Western blotting.The proliferation of islet cells was detected by MTT assay.The concentration of insulin was determined by ELISA. ResultsThere were significant differences in the expression of MafA mRNA and protein between MafA interference group B and control group E, MafA interference group C and control group F(P < 0.05).The proliferation level of Min6 cells in MafA interference group C was lower than that in control group F(P < 0.05).The relative expression levels of Insulin-1 and Insulin-2 mRNA in MafA interference group C were lower than those in control group F(P < 0.05).The insulin concentration in MafA interference group C was lower than that in control group F(P < 0.05). ConclusionsMafA gene is related to the proliferation and insulin secretion of mouse islet β cells, which may be related to the concentration of blood glucose.
2022, 47(11): 1492-1496.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.004
Abstract:
ObjectiveTo explore the mechanism of circ_0001178 targeting miR-1179 to regulate the proliferation and apoptosis of gastric cancer AGS cells. MethodsThe expression levels of circ_0001178 and miR-1179 in 33 samples of gastric cancer tissue and adjacent tissues were detected using the real-time fluorescent quantitative PCR.The gastric cancer cell line AGS was randomly divided into the si-NC group, si-circ_0001178 group, miR-NC group, miR-1179 group, si-circ_0001178+anti-miR-NC group and si-circ_0001178+anti-miR-1179 group.The number of clone formation was detected using the clone formation experiment, and the cell viability was detected using MTT assay.The apoptosis and protein expression were detected using the flow cytometry and Western blotting, respectively.The dual luciferase reporter assay was used to detect the targeting relationship between circ_0001178 and miR-1179. ResultsThe expression level of circ_0001178 in cancer tissue was higher than that in adjacent tissues, while the expression level of miR-1179 in cancer tissue was lower than that in adjacent tissues(P < 0.01).The inhibition of circ_0001178 expression or overexpression of miR-1179 could reduce the number of AGS cell clone formation, decrease the cell activity, increase the AGS cell apoptosis rate, and increase the expression levels of cleaved-caspase3 and cleaved-caspase9(P < 0.05). ConclusionsInhibiting the expression of circ_0001178 may inhibit the proliferation of gastric cancer AGS cells, and induce cell apoptosis by targeting up-regulation of miR-1179.
2022, 47(11): 1496-1503.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.005
Abstract:
ObjectiveTo analyze the disease characteristics and prognostic factors of adult neuroblastoma (NB) using tumor epidemiological data collected from the SEER database. MethodsWe extracted data of primary NB patients diagnosed by positive histology during 1975-2016 from the SEER database.Patients were grouped into adults and adolescents according to the age of diagnosis.The competing-risk model and Kaplan-Meier plot were used to compare survival rates.Cox regression model was used to identify prognostic factors in adult patients.According to the multivariate model, a nomogram was developed to assist clinical diagnosis and treatment. ResultsThe prognosis of adult patients was worse than that of adolescents (P < 0.01).Univariate analysis of adult NB revealed that age ≥ 50 years old, surgical treatment, the primary tumor site of nasopharynx, peripheral nervous system, histological subtypes, and chemotherapy were all prognostic factors (P < 0.05 to P < 0.01).The adjusted multivariable analysis showed that age, surgery, and the location of the primary tumor had statistically significant effects on the survival rate of patients (P < 0.05 to P < 0.01).The established nomogram was used to predict the 3-year and 5-year survival rates of adult NB patients.The internal validation of the nomogram showed that the prediction method could distinguish high-risk patients from low-risk patients. ConclusionsThe prognostic factors of adult patients with NB are complex and diverse.Early diagnosis and timely surgical treatment can improve their survival rate.
2022, 47(11): 1504-1508.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.006
Abstract:
ObjectiveTo investigate the expression of polymeric immunoglobulin receptor (pIgR) regulated by microRNA (miR)-5585-5p and the differential expression of pIgR in breast cancer tissue (BRCA) and non-cancer tissues (NCT). MethodsBioinformatics method was used to analyze the regulatory effect of miR-5585-5p on pIgR, the expression of pIgR in breast cancer and its effect on survival and prognosis of patients.Fluorescence quantitative PCR was used to detect the regulatory effect of miR-5585-5p on pIgR.Immunohistochemical method was used to detect the expression of pIgR in tumor tissues of breast invasive ductal carcinoma patients and normal breast tissues of non-cancer patients, and to analyze the relationship between the expression of pIgR and the clinicopathological characteristics of patients in BRCR group. ResultsmiR-5585-5p down-regulated the expression of pIgR (P < 0.01).Bioinformatics analysis showed that the expression of pIgR was low in breast cancer patients (P < 0.01).Immunohistochemical results showed that there were significant differences in the expression of pIgR among patients with different histological grades, lymph node metastasis numbers and HER-2, ER expression (P < 0.05 to P < 0.01). ConclusionsmiR-5585-5p targets to regulate the expression of pIgR and is associated with the prognosis of breast cancer patients, suggesting that it may be used as a biomarker to help molecular typing, prognosis judgment and treatment scheme selection of breast cancer.
2022, 47(11): 1509-1512.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.007
Abstract:
ObjectiveTo investigate the serum levels of soluble ST2(sST2), activin A(ACT-A), and N-terminal brain natriuretic peptide precursor(NT-proBNP), and its clinical significance in the occurrence and development of chronic heart failure(CHF). MethodsA total of 149 patients with CHF and 50 healthy people were divided into the CHF group and control group, respectively.The differences of the serum levels of sST2, ACT-A, NT-proBNP between two groups, and correlation between three indicators and clinical parameters were analyzed.The ROC curves were used to analyze the predictive value of serum sST2, ACT-A and NT-proBNP in cardiovascular events of patients with CHF. ResultsCompared with the control group, the serum levels of sST2, ACT-A, NT-proBNP in patients with CHF were significantly higher(P < 0.01), while the Left Ventricular Ejection Fractions(LVEF) was significantly lower(P < 0.01).The serum levels of sST2, ACT-A, NT-proBNP in patients with NYHA grade Ⅳ were significantly higher than those in grade Ⅲ, and which in patients with grade Ⅲ was significantly higher than grade Ⅱ(P < 0.05).The serum levels of sST2, ACT-A, NT-proBNP in patients with CHF were significantly positively correlated with NYHA classification, and negatively correlated with LVEF(P < 0.05), but which were not related to the age, TC, TG, hsCRP, HDL-C, and LDL-C, hs-CRP and HbA1c(P>0.05).The ROC curve analysis results showed that the area under the curve(AUC) of sST2, ACT-A, and NT-proBNP was 0.803, 0.715, and 0.692, respectively.The combined detection AUC of all three was 0.891, and the predicted value of which was higher than that of any single indicator. ConclusionsThe serum levels of sST2, ACT-A, NT-proBNP in patients with CHF increase, and the expression levels of the three are significantly positively correlated with NYHA classification, and negatively correlated with LVEF.The combined detection in CHF patients has a high predictive value in cardiovascular events.
2022, 47(11): 1513-1517.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.008
Abstract:
ObjectiveTo investigate the effects of vertical holding appliance(VHA) combined with physiological anchorage spee's wire system correction technique on the change of jaw plane angle and chin morphology in children with maxillary protrusion. MethodsSeventy-six children with maxillary protrusion were divided into the VHA group and non-VHA group according to the random number table method.Two groups were treated with PASS correction, and the VAH group was additionally treated with vertical holding appliance. ResultsThe VHA anchorage significantly improved the lip protuberance of the upper central incisor(P < 0.01).The holding appliance combined with VHA had better control on the vertical growth of teeth after orthodontic treatment(P < 0.05 to P < 0.01), could make the patient's mandible rotate from the front to the top counter clockwise to make mandible rotate forward, and the difference of which between before and after treatment was statistically signfiicant(P < 0.05 to P < 0.01). ConclusionsFor the treatment of pediatric maxillary protrusion, especially for the more difficult cases of correction, and it is often necessary to use a variety of treatment measures to strengthen the anchorage.It is particularly important to have a simple and efficient way to enhance the anchorage(such as vertical holding appliance), which can improve the therapeutic effect, and make the patients satisfied.
2022, 47(11): 1518-1520.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.009
Abstract:
ObjectiveTo explore the correlation between the simple obesity and levels of brain natriuretic peptide(BNP), insulin-like growth factor 1(IGF-1) and 25-hydroxy vitamin D3[25-(OH)D3] in children. MethodsOne hundred children with simple obesity followed up in department of pediatrics were divided into the mild and moderate obesity group(50 cases) and severe obesity group(50 cases).Meanwhile, 50 healthy children with normal weight of physical examination were set as the control group.The serum levels of BNP, IGF-1 and 25-(OH)D3 in three groups were determined using radioimmunoassay and ELISA, the diagnostic value of which in simple obesity was identified, and their correlation were analyzed. ResultsThe difference of the serum level of BNP between the mild and moderate obesity group and severe obesity group was not statistically significant(P>0.05), and the serum levels of BNP in mild and moderate obesity group and severe obesity group were higher than that in control group(P < 0.01).The serum levels of IGF-1 in obesity group were higher than that in control group(P < 0.01), and which increased with the increasing of the degree of obesity(P < 0.01).The serum levels of 25-(OH)D3 in obesity group were lower than that in control group(P < 0.01), and which decreased with the increasing of the degree of obesity(P < 0.05).The area under the diagnostic curve of serum 25-(OH)D3, IGF-1 and BNP was 0.872, 0.816 and 0.685, respectively.The sensitivities of serum BNP, IGF-1 and 25-(OH)D3 to simple obesity were 55.24%, 62.56%, 78.36%, respectively, and the specificities of serum BNP, IGF-1 and 25-(OH)D3 to simple obesity were 67.21%, 78.28%, 82.38%, respectively.The results of correlation analysis showed that the serum level of 25-(OH)D3 was negatively correlated with the degree of simple obesity(r=-0.614, P < 0.05), and the serum levels of IGF-1 and BNP were positively correlated with simple obesity in children(r=0.427, 0.244, P < 0.05). ConclusionsThe serum levels of BNP, IGF-1 and 25-(OH)D3 are closely correlated with the degree of simple obesity.
2022, 47(11): 1521-1526.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.010
Abstract:
ObjectiveTo investigate the effect of deep neuromuscular blockade on postoperative rehabilitation of patients undergoing laparoscopic colorectal-carcinoma surgery. MethodsSeventy-eight patients undergoing laparoscopic colorectal-carcinoma surgery were randomly divided into two groups as moderate neuromuscular blockade group(Group A, n=39) and deep neuromuscular blockade group(Group B, n=39).Patients in group A were pumped with cisatracurium under muscle relaxation monitoring to maintain the level of modern neuromuscular blockade.Other patients in group B were pumped with cisatracurium under muscle relaxation monitoring to maintain the level of deep neuromuscular blockade.Goal-directed fluid therapy was performed for intraoperative volume management in both groups.After entering the postanesthesia care unit, neuromuscular blockade monitoring was continued for patients in both groups.Then, muscle relaxation antagonists and extubation of endotracheal tubes were performed in both groups under the guidance of neuromuscular monitoring.The surgical field score, mean pneumoperitoneum pressure, and mean airway pressure were recorded; the time of recovery index, the time of removing the tracheal intubation, and the stay time in the postanesthesia care unit were recorded; the scores of postoperative pain, nausea, and vomiting were recorded; the score of recovery quality scale, recovery of gastrointestinal function, and hospital stay were recorded. ResultsThe mean artificial pneumoperitoneum pressure and mean airway pressure in group B were lower than those in group A(P < 0.01).The usage of cisatracurium, the time of TOF ratio from 0.25 to 0.75, and the time of removing the tracheal intubation in group B were higher than those in group A(P < 0.01).The shoulder pain scores of patients in group B were lower than those in group A at all postoperative periods(P < 0.01).At 6 and 24 hours after operation, the scores of visceral pain, nausea, and vomiting in group B were lower than those in group A(P < 0.01).At 1 and 3 days after operation, the score of recovery quality in group B was higher than that in group A(P < 0.01).The exhaust time, defecation time, bowel sound recovery time and hospital stay in group B were shorter than those in group A(P < 0.01). ConclusionsThe application of deep neuromuscular blockade in laparoscopic colorectal-carcinoma surgery can reduce the pneumoperitoneum pressure under the premise of ensuring the surgical field, improve the early postoperative recovery quality of patients, promote the gastrointestinal function recovery, and benefit the postoperative rehabilitation of patients, providing ideas for perioperative anesthesia management.
2022, 47(11): 1526-1529.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.011
Abstract:
ObjectiveTo investigate the therapeutic effect of methylprednisolone sodium succinate on sudden sensorin eural hearing loss. MethodsA total of 322 patients with sudden sensorin eural hearing loss were divided into intravenous methylprednisolone sodium succinate group(group A, n=208), intratympanic injection of methylprednisolone sodium succinate group(group B, n=114) and intratympanic injection of methylprednisolone sodium succinate group(group C, n=67).The hearing threshold, therapeutic effect and adverse reaction rate among the three groups were compared, and the influence of basic disease on the therapeutic effect was analyzed. ResultsThere was no significant difference in hearing threshold among the three groups before treatment(P>0.05).After treatment, the hearing threshold was significantly lower than that before treatment(P < 0.01), and the hearing threshold in group A and group B was lower than that in group C(P < 0.05).The total effective rate in group A and group B was higher than that in group C(P < 0.05), but there was no significant difference between group A and group B(P>0.05).The total adverse reaction rate in group B was significantly lower than that in group A and group C(P < 0.01).The total effective rate in group without basic disease was significantly higher than that in group with basic disease(P < 0.01). ConclusionsIntratympanic injection therapy is better than intravenous therapy.The type and degree of hearing loss and basic disease have great impacts on the prognosis.Therefore, it is necessary to evaluate the patient's condition in detail for taking reasonable treatment method.
2022, 47(11): 1530-1533.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.012
Abstract:
ObjectiveTo study the correlation between serum neutrophil-lymphocyte ratio (NLR) and lower extremity vascular lesion in type 2 diabetes mellitus (T2DM). MethodsA total of 148 T2DM patients were selected and divided into simple T2DM group (group T, n=76) and complicated with lower extremity vascular lesion group (group L, n=72) according to the color Doppler ultrasonography of lower extremity vessels.The clinical indexes of patients in the two groups were collected and NLR was calculated.The relationship between NLR and lower extremity vascular lesion was analyzed. ResultsThe age, systolic blood pressure (SBP), neutrophil count (NEUT) and NLR in group T were significantly lower than those in group L (P < 0.05 to P < 0.01).The lymphocyte count in group T was significantly higher than that in group L (P < 0.01).The correlation analysis showed that NLR was positively correlated with age and SBP (r=0.206, 0.211, P < 0.05).Logistic regression analysis showed that NLR and age were risk factors for lower extremity vascular lesion in T2DM patients(P < 0.01). ConclusionsNLR is a risk factor for lower extremity vascular lesion in T2DM patients, which has suggestive significance and predictive value for the disease.
2022, 47(11): 1533-1538.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.013
Abstract:
ObjectiveTo construct and validate a nomograph model for portal vein thrombosis(PVT) risk after esophagogastric variceal rupture and bleeding in patients with cirrhosis based on multi-dimensional indicators. MethodsA total of 448 patients with liver cirrhosis complicated with esophagogastric variceal rupture and bleeding were selected and divided into the study cohort(n=336) and test cohort(n=112) at the ratio of 3:1.The two cohorts were subdivided into the thrombus group and non-thrombus group according to whether PVT occurrence.The main risk factors of PVT in the study cohort after esophagogastric variceal rupture and bleeding in patients with cirrhosis were screened by univariate analysis and multivariate regression analysis, and a nomograph model was constructed using rms package in RStudio software and verified. ResultsIn the study cohort, 77 cases(22.92%) developed PVT, in which the fastest PVT formation after bleeding took two weeks, 49.35%(38/77) developed PVT within one year, and 79.22%(61/77) combined with PVT within two years.In the test cohort, 26 cases(23.21%) developed PVT, in which the fastest PVT formation after bleeding took 12 days, 50%(13/26) developed PVT within 1 year, and 80.77%(21/26)combined PVT within 2 years.Univariate analysis showed that there were significant differences in Child-Pugh liver function grade, portal vein diameter, platelet count, D-dimer, P-selectin and triacylglycerol between PVT group and non-PVT group(P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that Child-Pugh liver function grade, portal vein diameter, platelet count, D-dimer, P-selectin and triacylglycerol were the risk factors for PVT after esophagogastric variceal rupture and bleeding in patients with cirrhosis(P < 0.01).ROC curve analysis showed that the area under the curve(AUC) of the risk nomogram prediction model in the study cohort was 0.953(95%CI: 0.931-0.976), the sensitivity was 81.8%, and the specificity was 94.2%.ROC curve analysis showed that the AUC of the risk nomogram prediction model in the test cohort was 0.944(95%CI: 0.904-0.984), the sensitivity was 98.9%, and the specificity was 81.4%. ConclusionsChild-Pugh liver function grade, portal vein diameter, platelet count, D-dimer, P-selectin and triacylglycerol are the risk factors of PVT in patients with liver cirrhosis complicated with esophagogastric variceal rupture and bleeding.The nomogram prediction model based on the above indicators has good diagnostic performance, and can provide a reference for development of targeted treatment plans in clinic.
2022, 47(11): 1539-1542.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.014
Abstract:
ObjectiveTo investigate the effects of cardiac positioner device in off-pump coronary artery bypass grafting. MethodsA total of 80 patients with multi-vessel coronary artery disease diagnosed by angiography were randomly divided into the cardiac positioner group and control group(40 cases in each group).The apical aspirator was used to assist the coronary artery bypass grafting in the apical aspirator group, while the conventional cardiac exposure was used in the control group.The mean arterial pressure, heart rate, central venous pressure and pulmonary artery wedge pressure in two groups were recorded at the beginning of surgery(T0), before coronary artery bypass(T1), when the heart position was changed(T2) and when the heart was placed back into the pericardial cavity(T3).The levels of the cardiac markers troponin I(cTnI), troponin T(cTnT) and N-terminal pro-brain natriuretic peptide(NT-probNP), time of bypass and operation, success rate of one anastomosis, amount of norepinephrine during bypass, incidence of arrhythmia, bleeding volume during operation, amount of intraoperative and postoperative complications in two groups were recorded before operation and after 24 h of operation. ResultsWhen the target vessel in the lateral wall and inferior wall in the cardiac positioner group were anastomosed, the hemodynamics was more stable, the arrhythmia was lower incidence and the dosage of norepinephrine was less(P < 0.01), and the target vessels were well exposed, the bleeding was less and the bypass time was short(P < 0.01).At 24 h after operation, the cardiac function indexes of two groups increased(P < 0.01), and the cTnT and NT-probNP in apical suction group were lower than those in control group(P < 0.05).Compared with the control group, the mechanical ventilation time and ICU stay time were shorter, and the incidence rate of adverse reactions was lower in the cardiac positioner group(P < 0.05 to P < 0.01). ConclusionsThe application of apical positioner device in off-pump coronary artery bypass grafting is beneficial to the exposure and accurate anastomosis of target vessels, and can improve the intraoperative hemodynamics and postoperative cardiac function.
2022, 47(11): 1543-1545.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.015
Abstract:
ObjectiveTo predict the value of matrix metalloproteinases(MMPs) in the early diagnosis of viral encephalitis by analyzing the correlation between the serum levels of MMPs and white blood cells in cerebrospinal fluid(CSF) of children with viral encephalitis. MethodsForty hospitalized children with viral encephalitis were selected.The serum and CSF levels of MMP-2 and MMP-9 were detected by ELISA in 20 children with abnormal CSF cell count and 20 children with normal CSF cell count. ResultsThe differences of the levels of MMP-2 and MMP-9 in peripheral blood and CSF between two groups were statistically significantly(P < 0.05 to P < 0.01).The serum levels of MMP-2 and MMP-9 in peripheral blood were positively correlated with the number of white blood cells in CSF(P < 0.01).The levels of MMP-2 and MMP-9 in CSF were positively correlated with the number of white blood cells in CSF(P < 0.01).The sensitivity and specificity of MMP-2 and MMP-9 in peripheral blood to the number of CSF cells showed that the area under the curve was 0.860 and 0.725, respectively(P < 0.01 and P < 0.05).The sensitivity and specificity analysis of MMP-2 and MMP-9 in CSF to the number of CSF cells showed that the area under the curve was 0.950 and 0.980, respectively(P < 0.01). ConclusionsThe levels of MMP-2 and MMP-9 in peripheral blood can reflect the concentrations of MMP-2 and MMP-9 in CSF, which can be used as biomarkers of viral encephalitis and predictors of early diagnosis.
2022, 47(11): 1546-1549.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.016
Abstract:
ObjectiveTo observe the effect of pre-pumping norepinephrine on hemodynamics of cesarean section patients under combined spinal-epidural anesthesia. MethodsSixty ASA Ⅰ-Ⅱ patients with elective cesarean section after combined spinal-epidural anesthesia were randomly divided into the observation group and control group, with 30 cases in each group.All patients were infused with mL/kg hydroxyethyl starch 30 min before anesthesia.At the beginning of combined spinal-epidural anesthesia, the patients in the control group were continuously pumped with 0.75 mL·kg-1·h-1 of 0.9% sodium chloride solution, and the patients in the observation group were continuously pumped with 0.75 mL·kg-1·h-1 (0.05 μg·kg-1·min-1) of noradrenaline until delivery of the fetus.The mean arterial pressure (MAP), heart rate (HR), 1 min and 5 min Apgar score of neonate, and adverse reactions were compared between the two groups at the time of admission (T0), after volume expansion (T1), 1 min after anesthesia (T2), 3 min after anesthesia (T3), at the time of fetal delivery (T4), and at the end of operation (T5). ResultsThere was no significant difference in operation time, anesthesia time and bleeding volume between the two groups (P>0.05).There was no significant difference in MAP and HR between the two groups at T0 (P>0.05);the MAP in the observation group at T2 was higher than that in the control group (P < 0.05), and the HR at T2 and T3 was lower than that in the control group (P < 0.01 and P < 0.05);compared with T0, the MAP in the control group decreased after anesthesia, but the difference was not statistically significant (P>0.05), and the HR increased at T2 and T3 (P < 0.05);there was no significant difference in MAP and HR between each time point and T0 in the observation group (P>0.05).There was no significant difference in the incidence of hypotension, hypertension, nausea and vomiting, and bradycardia between the two groups (P>0.05).There was no significant difference in 1 min and 5 min Apgar score between the two groups (P>0.05). ConclusionsPre-pumping 0.05 μg·kg-1·min-1norepinephrine before anesthesia can stabilize the maternal hemodynamics, and has no effect on the neonate, which can improve the safety of the mother and baby in cesarean section.
2022, 47(11): 1550-1553.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.017
Abstract:
ObjectiveTo investigate the occurrence and related risk factors of gestational diabetes mellitus in women with gestational diabetes during re-pregnancy. MethodsA total of 100 cases were randomly selected as the study subjects from women who had two consecutive deliveries, and had gestational diabetes mellitus in the first pregnancy.According to the results of 75 g oral glucose tolerance test at the time of the second pregnancy of the study subjects, pregnant women with abnormal blood glucose were set as the abnormal blood glucose group and those with normal blood glucose were set as the normal blood glucose group.Univariate analysis was used to compare body mass index, age, pre-pregnancy body mass, islet function, blood glucose level at first pregnancy, whether insulin was used at first pregnancy, interval between pregnancies, and insulin resistance index at first pregnancy between the two groups of pregnant women.Multivariate logistic regression analysis was used to analyze the risk factors for the development of gestational diabetes mellitus in women with gestational diabetes mellitus when they became pregnant again. ResultsThe prevalence of abnormal glucose in women with gestational diabetes mellitus at the time of second pregnancy was 72.00%.Univariate analysis showed that body mass before second pregnancy, body mass index before second pregnancy, fasting insulin level at first pregnancy, insulin level 1 h after meal at first pregnancy, insulin resistance index at first pregnancy and rate of insulin treatment at first pregnancy were higher in the abnormal glucose group than those in the normal glucose group, ant the differences were all statistically significant (P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that body mass >55 kg before re-pregnancy, body mass index >24 kg/m2 before re-pregnancy, insulin therapy at first pregnancy, and insulin resistance index >2.7 at first pregnancy might be risk factors for the development of gestational diabetes mellitus at re-pregnancy in women with gestational diabetes mellitus(OR=2.184, 12.147, 7.767, 7.448, P < 0.05 to P < 0.01). ConclusionsThe incidence of gestational diabetes mellitus is higher in women with gestational diabetes mellitus who become pregnant again.Excess body mass before pregnancy, high body mass index, insulin resistance, and use of insulin therapy in the first pregnancy are risk factors for the development of gestational diabetes mellitus during re-pregnancy.
2022, 47(11): 1554-1559.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.018
Abstract:
ObjectiveTo compare the diagnostic value of NICE typing under water injection and gas injection colonoscopy plus non-magnifying narrow-band imaging (NBI) in small colorectal polyps. MethodsA total of 449 small colorectal polyps were enrolled in this study.Among them, 176 cases were found by water injection colonoscopy(water injection group), and 273 cases were found by gas injection colonoscopy(gas injection group).Each lesion was observed by non-magnifying NBI, and the histology was predicted and compared according to NICE typing system. ResultsThere was no statistically significant difference in the examination results in the colorectal adenoma detection rate between the two groups(P>0.05), and the detection rate of flat polyps in the water injection group was higher than that in the gas injection group(P < 0.05).Experienced endoscopists had a high consistency in the diagnosis results of NICE typing(κ=0.807).The sensitivity, specificity and accuracy of NICE typing under non-magnifying NBI in the water injection group and the gas injection group were 97.0%(128/132), 81.8%(36/44), 94.3%(166/176) and 98.6%(216/219), 72.0%(39/54) and 93.4%(255/273), respectively.For novice endoscopists, the sensitivity, specificity and accuracy of NICE typing diagnosis under non-magnifying NBI in water injection group and gas injection group were 51.5%(68/132), 72.7% (32/44), 56.8% (100/176), 46.1%(101/219), 63.0%(34/54), 49.5%(135/273), respectively.The agreement of highly experienced endoscopists and novice endoscopists was low in two groups respectively(κ=0.199, 0.076). ConclusionsBetween whatever water or gas injection colonoscopy, NICE typing under non-magnifying NBI is effective in distinguishing neoplastic from non-neoplastic small colorectal polyps for highly experienced endoscopists, which has high diagnostic value and is instructive for treatment strategy of small colorectal polyps in ambulatory ward.
2022, 47(11): 1560-1563.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.019
Abstract:
ObjectiveTo explore the feasibility of laparoscopic totally extra-peritoneal(TEP)in patients with a history of lower abdominal surgery. MethodsAmong 387 patients scheduled by TEP from January 2018 to December 2018, 64 patients with a history of lower abdominal surgery were selected, and the perioperative situation and postoperative following-up were analyzed. ResultsSixty-four patients(53 males and 11 females)were selected, the operative time and intraoperative blood loss were(50.05±19.28)min and(7.27±5.64)mL, respectively.The TEP in 60 cases were successfully completed.Three cases were converted to open repair, 1 case was converted to laparoscopic trans-abdominal preperitoneal hernia repair, and the 4 cases had a history of prostate cancer.The postoperative hospitalization duration of patients was(1.17±0.68)d, 1 case of seroma, 1 case of umbilical cord incision infection and 5 cases of urinary retention were identified.No chronic pain, patch infection, intestinal adhesion and recurrence in all cases were found. ConclusionsTEP is safe and feasible for the majority of inguinal hernia patients with a historyof lower abdominal surgery.Before surgery, the surgeon should carefully evaluate the impact of previous surgery on the anatomical level and surgical field, and master the anatomy of the inguinal region and application of laparoscopy.
2022, 47(11): 1563-1566.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.020
Abstract:
ObjectiveTo explore the risk factors affecting the operation time of primary total knee arthroplasty(TKA) and revision of deep infection. MethodsThe patients treated with TKA for the first time were included in the study.The risk factors and independent risk factors influencing the operation time of primary TKA and revision of deep infection were analyzed using the χ2 test, Pearson correlation test and multivariate logistic regression. ResultsThe results of multivariate analysis showed that the male, ASA grade Ⅲ~Ⅳ and body mass index >28 kg/m2 were the independent factors affecting the operation time(P < 0.01), and the age ≥ 75 years, diabetes mellitus, albumin < 30 g/L, operation time ≥ 110 min and gender were the independent factors influencing the revision of deep infection after operation(P < 0.05 to P < 0.01).The correlation coefficients of age, diabetes mellitus, postoperative albumin and gender with deep infection revision were 0.287, 0.265, -0.297 and 0.302, respectively(P < 0.05). ConclusionsThe male, ASA grade Ⅲ-Ⅳ, body mass index >28 kg/m2 are the independent factors influencing the operation time of primary TKA, and the age ≥ 75 years, diabetes mellitus, postoperative albumin < 30 g/L, operation time ≥ 110 min and gender are the independent factors influencing the revision of deep infection.The operation time of primary TKA and revision of deep infection are the results of multiple factors, which should be fully identified in clinical work, and the targeted interventions should be formulated to improve the prognosis.
2022, 47(11): 1567-1569.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.021
Abstract:
ObjectiveTo investigate the risk factors of recurrence of lumbar disc herniation(LDH) after percutaneous transforaminal endoscopic discectomy(PTED). MethodsA total of 186 patients with LDH treated with PTED were followed up for 2 to 4 years.The recurrence rates of patients were compared among the different clinical characteristics, and the logistic regression analysis was used to investigate the independent risk factors of postoperative recurrence. ResultsTwenty cases of 186 LDH patients recured after PTED, the recurrence rate of which was 10.75%.The differences of the postoperative recurrence rates among the patients with different sizes of fibrous ring rupture, long-term smoking, LDH type, postoperative activity, age, postoperative segmental mobility and body mass index were statistically significant(P < 0.05 to P < 0.01), and the differences of the postoperative recurrence rates among the patients with different genders, combined diabetes and course of disease were not statistically significant(P>0.05).The results of logistic regression analysis showed that the long-term smoking after surgery, fibrous ring rupture more than 5 mm, free-out LDH, postoperative activity score more than 6 points and age more than 70 years were the independent risk factors of recurrence of LDH after PTED(P < 0.05). ConclusionsThe recurrence of LDH after PTED is obviously correlated with the fibrous ring rupture size, LDH type, postoperative activity degree and age.The preoperative examination should be strengthened, and the intraoperative procedures and postoperative rehabilitation should be paid attention to reduce LDH recurrence.
2022, 47(11): 1573-1575.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.023
Abstract:
ObjectiveTo detect the expression level of FBXO22 gene in bone marrow cells of patients with acute myeloid leukemia (AML), and analyze its correlation with clinical indications. MethodsA total of 92 AML cases were collected, including 41 cases in the primary group, 28 cases in the complete remission (CR) group, 23 cases in the partial remission (PR) group, and 30 cases with renal anemia and iron deficiency anemia in the control group.The relative expression of FBXO22 mRNA in bone marrow cells was detected by real-time fluorescence quantitative PCR.The correlation between the expression of FBXO22 mRNA and the patient's gender, age, blood routine parameters and clinical classification of patients were analyzed in the primary group. ResultsThere was a statistically significant difference in the expression level of FBXO22 mRNA among patients in each group (P<0.01).The levels of FBXO22 mRNA in the PR group and primary group were lower than those in the control group and CR group (P<0.05), but there was no statistically significant difference between the control group and CR group, PR group and primary group (P>0.05).There was significant difference in the expression level of FBXO22 mRNA among patients with different platelet counts in the primary group (P<0.05).Correlation analysis showed that there was a significant positive correlation between the platelet count and the relative expression level of FBXO22 mRNA in the primary group (r=0.492, P<0.01). ConclusionsThe expression of FBXO22 in bone marrow of patients with AML is decreased, and positively associates with platelet count.
2022, 47(11): 1576-1579.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.024
Abstract:
ObjectiveTo investigate the prevalence of human papillomavirus(HPV) and its subtype distribution in Huaibei city, and provide reference for the prevention and treatment of cervical cancer in clinical women. MethodsFrom March 2017 to June 2018, 3 536 samples of cervical shedding cells were screened in Huaibei Miners General Hospital, and the gene subtypes of HPV were detected by PCR-reverse pot hybridization for statistical analysis. ResultsAmong the 3 536 samples, 655 cases were positive samples, and the detection rate of which was 18.52%.The infection rate of single subtype(12.30%) was significantly higher than that of multiple infection rate(6.22%)(P<0.01).The infection rate of high-risk subtypes was 11.59%, which was significantly higher than that of low-risk subtypes(3.62%) and mixed high-risk subtypes(3.31%)(P<0.01).Among different age groups, the highest infection rate was found in the 51-60 age group(20.39%), and the difference between single infection and multiple infection rates was statistically significant(P<0.05).The positive rate of 41-50 years old group was the highest(single for 42.07%, multiple for 34.09%).The dominant subtypes of HPV were 52, 16, 58, 44 and 40 in turn. ConclusionsThe HPV infection rate of women in Huaibei city is 18.52%, which is mainly caused by single high-risk infection.The HPV 52, 16, and 58 are the most common infection subtypes.The women aged 41-60 years are the key objects for HPV screening.
2022, 47(11): 1580-1581.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.025
Abstract:
ObjectiveTo investigate the correlation between hemodynamic indexes and lymph node metastasis in patients with thyroid cancer using Doppler ultrasound. MethodsA total of 68 patients with thyroid cancer were selected as the observation group.The healthy subjects from the outpatient clinic were randomly selected as the control group.Doppler ultrasound was performed to evaluate the hemodynamic indexes, and the lymph node enlargement was detected and correlation analysis was performed. ResultsThe systolic peak value, peak systolic velocity(PSV) and the end-diastolic blood flow velocity of the affected side in the observation group were significantly higher than those in the healthy side and the control group, while the pulsation index and blood flow resistance index(RI) were lower than those in the healthy side and the control group(P<0.01).The PSV, RI and blood flow signal grades of patients with lymph node metastasis were higher than those of patients without lymph node metastasis(P<0.01). ConclusionsDoppler ultrasound diagnosis of thyroid cancer patients shows that hemodynamic indexes are closely related to lymph node.metastasis, and it is also an important reference index for preoperative evaluation of thyroid cancer.
2022, 47(11): 1582-1586.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.026
Abstract:
ObjectiveTo investigate the value of multimodal dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) in predicting the risk of axillary lymph node metastasis(ALNM) in breast cancer patients. MethodsThe preoperative clinical and imaging data of 54 patients with breast cancer confirmed by surgical pathology were retrospectively analyzed.The multimodal DCE-MRI scan in all cases were detected before surgery.The patients were divided into the axillary lymph node metastasis group(ALNM+, n=19) and the non-axillary lymph node metastasis group(ALNM-, n=35) according to the presence or absence of ALNM.The correlation between the clinical and DCE-MRI features and ALNM were analyzed in two groups. ResultsThe general clinical data of 54 breast cancer patients(including age, menopausal history, fertility history, mass texture and mass activity) were not related to ALNM(P>0.05).In terms of multimodal DCE-MRI features, the proportion of patients with blurred mass edges in ALNM positive group was significantly higher than that in ALNM negative group(P < 0.01).The ADC in ALNM positive group was significantly lower than that in ALNM negative group(P < 0.01).The proportion of ALN ≥ 0.5 cm in ALNM positive group was significantly higher than that in ALNM negative group(P < 0.05).The results of multivariate analysis showed that the ADC value and tumor margin were the independent risk factors of ALNM in breast cancer(P < 0.01).In addition, the AUC, sensitivity, specificity and cut-off values of ADC values were the 0.743, 78.9%, 71.4% and 0.912×10-3mm2/s, respectively.The AUC, sensitivity and specificity of mass margin were the 0.750, 84.2% and 65.6%, respectively. ConclusionsThe marginal features of multimodal DCE-MRI, ADC value and risk factors of ALNM in breast cancer are helpful for the development of treatment plan and prognosis evaluation of breast cancer patients.
2022, 47(11): 1587-1590.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.027
Abstract:
ObjectiveTo analyze the status of fear of cancer recurrence and its relationship with couple support and quality of life in breast cancer patients undergoing surgery. MethodsA total of 769 postoperative patients with breast cancer were selected as the research object.The patients were investigated by using the fear of progression questionnaire-short form (FoP-Q-SF), couple support questionnaire (CSQ), and functional assessment of cancer therapy-generic scale (FACT-G), and the relationship between FoP-Q-SF score and CSQ score or FACT-G score was also analyzed. ResultsThe questionnaire survey results showed that the incidence of fear of cancer recurrence was 52.67% (405/769) in patients with breast cancer undergoing surgery.Pearson correlation analysis revealed a significant negative correlation between FoP-Q-SF score and CSQ score or FACT-G score (P < 0.01), and a significant positive correlation between CSQ score and FACT-G score(P < 0.01).Logistic regression analysis further showed that age < 40 years old(OR=3.674), clinical stage Ⅲa(OR=3.115), CSQ score ≤ 49.29 points(OR=3.843), and FACT-G score ≤ 41.36 points(OR=2.774) were independent risk factors for fear of cancer recurrence in postoperative breast cancer patients(all P < 0.01). ConclusionsPostoperative patients with breast cancer have a high level of fear of cancer recurrence, which is correlated with couple support and quality of life.Therefore, clinical intervention targeting these factors could be helpful in reducing the fear of cancer recurrence for postoperative breast cancer patients.
2022, 47(11): 1591-1593.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.028
Abstract:
ObjectiveTo investigate the application and effect of ECG positioning catheter tip technique in peripherally inserted central catheters(PICC) placement through lower extremity vein in neonates. MethodsA retrospective analysis was performed to select 39 neonates with PICC from January 2014 to December 2017 as control group, and 42 neonates with PICC from January 2018 to December 2020 as observation group.In the control group, PICC catheter was fixed and chest X-ray was taken after successful catheterization.In the observation group, when the catheter was sent to 2 cm longer than the predetermined length, the limbs on the puncture side of the children were in abducting flexion, the ECG monitor was connected, and normal saline was injected.The ratio of P wave to QRS wave appeared on the ECG monitor was 40%-50%.Then the catheter was slowly pulled out until the P wave was consistent with the P wave of the body surface electrocardiogram.According to the X-ray results, the accuracy of one-time placement of PICC and the completion rate of treatment were observed in the two groups. ResultsThe accuracy of one-time placement of PICC in the observation group was 95.23%(40/42), which was higher than that of the control group(76.92%, 30/39)(P < 0.05).There was no significant difference in the treatment completion rate between the two groups(P>0.05). ConclusionsECG can be used to assist the positioning of the tip of PICC catheter placement through the lower extremity vein in neonates, and the operation is simple, easy to master, safe and feasible, and worthy of clinical application.
2022, 47(11): 1594-1596.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.029
Abstract:
ObjectiveTo explore the clinical effect of multi-mode breathing training in Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MRI scanning. MethodsWe selected 240 patients who underwent hepatic gadolinium disodium enhanced MRI examination in our hospital.They were divided into control group (n=64) and observation group (n=176).The control group used routine voice prompt breathing training during MRI examination, and the observation group used the best personalized breathing training of three different modes according to the specific situation of the subjects before MRI examination.The extravasation of contrast medium, the incidence of adverse reactions, the successful completion rate of examination, image quality and the time required to complete the examination were compared between the two groups. ResultsNo extravasation of contrast medra and adverse reactions occurred in both groups.Both groups successfully completed the examination.The image quality qualification rate of the observation group was higher than that of the control group (P < 0.05), and the examination time was shorter than that of the control group (P < 0.01). ConclusionsMulti-mode personalized breathing training can improve the image quality of patients with liver Gd-EOB-DTPA enhanced MRI, increase the completion rate and shorten the examination time.
2022, 47(11): 1597-1601.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.030
Abstract:
ObjectiveTo analyze the effect of Internet platform-based peer support education on pregnancy outcome in nursing management of gestational diabetes mellitus (GDM) complicated with reproductive tract infection (RTI). MethodsA total of 96 patients with GDM and RTI were divided into two groups according to the method of drawing lots, with 48 patients in each group.The control group received routine health education, and the observation group received peer support education based on Internet platform on the basis of the control group.Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, blood glucose indicators, pregnancy outcomes, and patient satisfaction were compared between the two groups. ResultsAfter nursing intervention, the HAMA score, HAMD score, fasting blood glucose, glycated hemoglobin, and 2 h postprandial blood glucose in the observation group were all lower than those in the control group (P < 0.01).The total incidence of adverse pregnancy outcomes of the observation group was lower than that of the control group(2.08% vs 8.33%)(P < 0.05), and the patient satisfaction in the observation group was higher than that in the control group (95.83% vs 72.92%)(P < 0.01). ConclusionsPeer support education based on Internet platform can effectively reduce the bad mood of patients with GDM and RTI, improve blood glucose level and pregnancy outcome, and improve patient satisfaction.
2022, 47(11): 1602-1607.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.031
Abstract:
ObjectiveTo investigate the pain catastrophizing level in patients undergoing total knee arthroplasty (TKA) at different stages before and after operation, and to analyze its influencing factors. MethodsOne hundred and twenty TKA patients were selected by convenience sampling method.A longitudinal study was designed to measure the pain catastrophizing level, pain degree, social support, family care, anxiety and depression, and sleep status of the patients at 5 time points: 1 day before operation(T1), 3 days after operation (T2), 2 weeks after operation(T3), 1 month after operation(T4), and 3 months after operation(T5). The differences of the 5 measurements were compared, and the influencing factors of the patient' pain catastrophizing were analyzed. ResultsThe pain catastrophizing scores at five time points were (26.17±8.84), (25.80±7.54), (15.75±3.66), (10.08±3.00), and (7.60±2.54), respectively.The analysis results of multi-factor linear regression showed that the measured time, sex, occupation, education degree, pain degree, social support, family care, anxiety and depression, and sleep were all influencing factors of pain catastrophizing in TKA patients (P < 0.05 to P < 0.01). ConclusionsTKA patients have a high pain catastrophizing level which dynamically changes.Clinical medical staff should timely assess the dynamic changes of patients' pain catastrophizing; pay attention to the impact of demography, diseases, psychology, society, and other factors on the pain catastrophizing level of patients; and develop intervening measures.
2022, 47(11): 1607-1610.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.032
Abstract:
ObjectiveTo understand the status quo of the transition shock of new nurses, explore its relationship with job burnout and organizational support, provide theoretical basis for nursing managers to formulate corresponding organizational support strategies to reduce the transition shock of new nurses and job burnout to the greatest extent. MethodsOne hundred and seventy-two new nurses from three tertiary hospitals in Hunan province were investigated using the transition shock assessment scale, job burnout scale and organizational support questionnaire. ResultsThe total score of transition shpck in new nurses was(41.73±19.94) points, and the score rate of which was 67.95%.The transition shock was closely positively correlated with job burnout(P < 0.05), and negaively correlated with the sense of organizational support(P < 0.05).The organizational support played a partial intermediary role in the relationship between transition shock and job burnout, and the intermediary effect was 0.12, accounting for 15.7% of the total effect. ConclusionsThe transition shock of new nurses is generally on the middle and high level, and closely related to the job burnout and organizational support.The transition shock can directly predict the job burnout, and indirectly predict the job burnout through organizational support.The organizational support can buffer the impact of transition shock on job burnout.
2022, 47(11): 1611-1614.
doi: 10.13898/j.cnki.issn.1000-2200.2022.11.033
Abstract:
ObjectiveTo explore the mediating effect of depression between restricted diet and control status of diabetes mellitus. MethodsConvenience sampling was used in this study.The self-designed general information questionnaire, self-rating depression scale(SDS), three-factor eating questionnaire(TFEQ) and control status scale for diabetics(CSSD70) were filled out by all participants. ResultsFor all the participants, the overall score of SDS, TFEQ, and CSSD70 were(40.39±7.78), (9.58±3.06) and(43.84±9.59) points, respectively.Pearson correlation analysis showed that depression was positively correlated with restricted diet(r=0.233, P < 0.01) and negatively correlated with control status of diabetes mellitus(r=-0.237, P < 0.01).The mediating effect test showed that depression had a complete mediating effect between restricted diet and control status of diabetes mellitus, and the mediating rate was 51.81%. ConclusionsThe depression was an intermediary variable mediating the relationship between restricted diet and control status of diabetes mellitus.
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