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2022 Vol. 47, No. 9
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2022, 47(9): 1159-1163.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.001
Abstract:
ObjectiveTo explore the application and therapeutic effect of "patch technique" in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF) with rupture of the anterior vertebral body. MethodsA total of 72 OVCF patients with rupture of the anterior vertebral body who underwent PVP were selected.All patients were randomly divided into three groups, 24 cases in each group.Group A: bone cement injection during wet-sand phase, group B: bone cement injection during wire-drawing phase, group C: the "patch technique" was used to seal the fracture of the anterior vertebral body with bone cement in the early dough stage of paste, and then bone cement was injected in wet-sand phase.Both sides were penetrated during the operation, with basically same injection speed and 4-5 mL of bone cement volume for each side.Postoperative X-ray films were taken to observe the diffusion and leakage of bone cement.The pain relief of patients in the three groups was evaluated using the Oswestry disability index (ODI) before and 2 days post operation. ResultsIn group A, the cement in diseased vertebral body was relatively evenly distributed, while type-C leakage occurred in 13 cases (54.17%).In group B, the cement distribution in postoperative diseased vertebral body was relatively scattered, with 5 cases having type-C leakage(20.83%).In the group C, the cement in diseased vertebral body was relatively evenly distributed, there was only 1 case of type-C leakage(4.17%).There was significant difference in leakage rate among the three groups (P < 0.01).There was no significant difference in preoperative ODI scores among the three groups(P>0.05).On the second day after operation, the ODI scores of the three groups were significantly lower than those before operation (P < 0.01), and the ODI scores of group A and group C were significantly lower than those of group B, but there was no significant difference between group A and group C(P>0.05). ConclusionsThe "patch technique" in PVP is beneficial for the even distribution of bone cement in the diseased vertebral body, reducing the occurrence of re-fracture, and alleviating postoperative pain.In addition, due to the lower leakage rate, this technique shows higher safety.
2022, 47(9): 1163-1166.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.002
Abstract:
ObjectiveTo investigate the clinical efficacy of repairing tympanic membrane perforation with different types of tragus cartilage-perichondrium under otoendoscope. MethodsSixty patients (60 ears) who underwent endoscopic surgery were randomly divided into the control group (n=30) and the observation group (n=30).In the observation group, the perforation of tympanic membrane was repaired by semi-thick island of tragus cartilage-perichondrium complex.All patients were followed up for 6-12 months.The healing of tympanic membrane and hearing improvement were compared between the two groups. ResultsThe healing rate of tympanic membrane in the observation group was 100.0% (30/30), which was higher than 80.0%(24/30) in the control group (P < 0.05).There was no significant difference in the air-conductance threshold and air-bone conductance difference between the two groups before operation (P>0.05).The air-conductance threshold and air-bone conductance difference of the observation group were significantly better than those of the control group (P < 0.01), and the intra-group comparison showed that the air-conductance threshold and air-bone conductance difference of the two groups after operation were significantly better than those before operation (P < 0.01). ConclusionsIt is feasible to repair the perforated tympanic membrane under otoendoscope, especially the semi-thick island of auricular cartilage-perichondrium complex, which has a high survival rate, can repair the perforation of tympanic membrane of different sizes, and is beneficial to improve hearing, and the postoperative hearing improvement effect is good.
2022, 47(9): 1167-1171.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.003
Abstract:
ObjectiveTo evaluate the clinical application of glomerular M-type phospholipase A2 receptor(PLA2R), thrombospondin type 1 domain-containing 7A(THSD7A) and their serum antibody levels in membranous nephropathy. MethodsA total of 172 cases of idiopathic membranous nephropathy(IMN) patients diagnosed by renal biopsy were selected as IMN group, and 7 cases of secondary membranous nephropathy(SMN) diagnosed in the same period were selected as SMN group.The expressions of PLA2R and THSD7A antigens in renal tissues were detected by immumofluorescence method, and the level of their serum PLA2R and THSD7A antibodies was measured by ELISA. ResultsA total of 167 cases in the IMN group showed positive for PLA2R alone(97.1%), and 3 cases in the SMN group were positive for PLA2R(42.9%), which showed statistically significant difference(P < 0.01).In the IMN group, 5 cases were positive for THSD7A(2.9%), and 5 cases showed positive for both PLA2R and THSD7A(2.9%); no THSD7A-positive case was detected in the SMN group, and the difference had no statistical significance(P>0.05).In the test of serum PLA2R, 143 cases in the IMN group showed positive result(83.1%), 2 cases in the SMN group were positive(28.6%), and the differences were statistically significant(P < 0.01).No THSD7A antibody was detected in the serum of the two groups.There were no statistically significant differences in sex, age, Alb, 24hUpro, SCr, and eGFR between the two groups(P>0.05).PLA2R-Ab had no correlation with SCr and eGFR(P>0.05), but had a significant negative correlation with Alb(P < 0.01), and a positive correlation with 24hUpro(P < 0.05).The Alb level in the PLA2R antibody-positive group was significantly lower than that in the negative group(P < 0.01), the 24hUpro level in the PLA2R-positive group was significantly higher than that in the negative group(P < 0.05), and the differences were statistically significant. ConclusionsThe detection of PLA2R, THSD7A and their antibodies can contribute to the diagnosis and classification of membranous nephropathy.The level of PLA2R antibody can reflect the disease activity and can be used to evaluate treatment effect.The incidence rate of THSD7A-related MN in membranous nephropathy patients is relatively low.
2022, 47(9): 1171-1175.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.004
Abstract:
ObjectiveTo investigate the incidence and influencing factors of depression and anxiety in maintenance hemodialysis(MHD) patients, and explore the social support and quality of life of MHD patients with anxiety and depression. MethodsA cross-sectional study was conducted on the depression, anxiety, social support and quality of life of MHD patients using the self-rating depression scale, self-rating anxiety scale, social support rating scale and health survey scale. ResultsThe prevalence rates of depression and anxiety in 202 MHD patients were 41.1% and 35.6%, respectively.The results of logistic regression analysis showed that the < 45 years old, unmarried/divorced and drinking were the main influencing factors of depression, and the drinking and small number children were the main influencing factors of anxiety in MHD patients(P < 0.05).The scores of subjective support, support utilization and quality of life of MHD patients with depression and anxiety were lower than those of patients without depression and anxiety(P < 0.05 to P < 0.01). ConclusionsMHD patients have a high prevalence of depression and anxiety, which are affected by a variety of social environmental factors.MHD patients with depression and anxiety have low utilization of social support, and their quality of life is affected.
2022, 47(9): 1176-1179, 1184.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.005
Abstract:
ObjectiveTo investigate the clinical effects of Xuebijing combined with early paracentesis and drainage in the treatment of patients with severe acute pancreatitis(SAP). MethodsSixty SAP patients were selected, and randomly divided into the control group and observation group(30 cases in each group).Both groups were given the conventional SAP treatment.The control group was treated with abdominal puncture alone, while the observation group was treated with abdominal puncture combined with Xuebijing.The white blood cell(WBC) count, C-reactive protein(CRP), serum amyloid protein(SAA), heparin-binding protein(HBP), acute physiology and chronic health score(APACHE Ⅱ), sequential organ failure score(SOFA) and CT severity index(CTSI) were compared between two groups at admission and on the third, fifth and seventh day after admission.The length of EICU stay and hospital stay in two groups were analyzed. ResultsThe differences of the WBC count, CRP, SAA, HBP, APACHE Ⅱ score, SOFA score and CTSI score between two groups were not statistically significant at admission(P>0.05).On the third day of admission, the above indexes of two groups increased compared with those on admission(P < 0.05), and then which decreased on the fifth and seventh day(P < 0.05).On the third day, the difference of the WBC count between two groups was not statistically significant(P>0.05), and the CRP, SAA, HBP, APACHE Ⅱ score, SOFA score and CTSI in observation group were lower than those in control group(P < 0.05 to P < 0.01).On the fifth and seventh day, all the above indexes in observation group were lower than those in control group(P < 0.05 to P < 0.01).The length of stay in EICU and hospital stay in observation group were significantly shorter than those in control group(P < 0.01). ConclusionsThe early application of paracentesis and drainage combined with Xuebijing in SAP patients can help reduce the inflammatory response, improve the prognosis, and shorten the hospitalization time of the patient.
2022, 47(9): 1180-1184.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.006
Abstract:
ObjectiveTo investigate the predictive value of peripheral blood Th1/Th2 and Treg/Th17 cytokines on the short-term prognosis of patients with severe sepsis. MethodsA total of 120 patients with severe sepsis admitted to Suzhou Hospital Affiliated to Anhui Medical University from April 2018 to April 2021 were enrolled as the study group, and 103 healthy examination people in the same period were selected as the control group.The levels of peripheral blood Th1/Th2 cytokines[γ-interferon (IFN-γ) and interleukin-4(IL-4)] and Treg/Th17 cytokines[transforming growth factor β (TGF-β) and interleukin-17(IL-17)] were detected and compared.All patients were followed up for 28 days, and they were divided into death group and survival group according to the survival status in the study group.The levels of peripheral blood IFN-γ, IL-4, TGF-β, IL-17, IFN-γ/IL-4 and TGF-β/IL-17 were compared in the death group and the survival group.The multivariate logistic regression analysis method was used to analyze the relationships between the levels of cytokines and the recent death of patients with severe sepsis.In addition, the receiver operating characteristic(ROC) curve was used to analyze the predictive value of levels of peripheral blood IFN-γ, IL-4, TGF-β, IL-17, IFN-γ/IL-4 and TGF-β/IL-17 on the recent death of patients with severe sepsis. ResultsThe levels of peripheral blood IFN-γ, IL-4, TGF-β and IL-17 in the study group were higher than those of the control group(P < 0.01), but the IFN-γ/IL-4 and TGF-β/IL-17 in the study group were lower than those of the control group (P < 0.05).The 28 days mortality rate of patients was 25.00%.The levels of peripheral blood IFN-γ, IL-4, TGF-β and IL-17 in the death group were higher than those of the survival group(P < 0.01), but the IFN-γ/IL-4 and TGF-β/IL-17 in the death group were lower than those of the survival group(P < 0.01).Age Increases, high APACHE-Ⅱ score and SOFA score, and high levels of serum creatinine, IFN-γ, IL-4, TGF-β, IL-1 were the risk factors affecting the recent death of patients (P < 0.05), and decrease of IFN-γ/IL-4 and TGF-β/IL-17 ratio were the protective factor for the recent death of patients(P < 0.05 to P < 0.01).The sensitivity of the levels of peripheral blood IFN-γ, IL-4, TGF-β and IL-17 in combined prediction the death within 28 days of hospitalization in severe sepsis patients was higher than that of single prediction, and the AUC was higher than that of single prediction(P < 0.01).The sensitivity of IFN-γ/IL-4 combined with TGF-β/IL-17 in predicting of recent death in patients with severe sepsis was higher than that of single prediction, and AUC was higher than that of single prediction(P < 0.01). ConclusionsThe levels of peripheral blood IFN-γ, IL-4, TGF-β and IL-17 of patients with severe sepsis are abnormally increased, but IFN-γ/IL-4 and TGF-β/IL-17 are reduced, and the changes of levels of them are related to the short-term prognosis of patients, which are the influence factors of patients' death within 28 days after hospitalization, and they all have a certain predictive values for patients' death within 28 days, but the combined prediction value of the four indicators is higher.
2022, 47(9): 1185-1188.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.007
Abstract:
ObjectiveTo investigate the clinical characteristics of reflux esophagitis (RE) patients with sleep disorder. MethodsThe sleep status of 105 patients with RE diagnosed by gastroscopy was prospectively investigated.The RE patients were divided into sleep disorder group and normal sleep group according to the Pittsburgh sleep quality index (PSQI) score.The gastroesophageal reflux disease questionnaire (GERDQ), Hamilton anxiety scale (HAMA) and Hamilton depression scale(HAMD) were used to score the reflux symptoms, anxiety and depression status of all patients, respectively.The Los Angeles classification was used to grade all patients with endoscopic esophagitis. ResultsThe symptom score, HAMA score and HAMD score of RE patients with sleep disorder were higher than those of RE patients without sleep disorder(P < 0.05 to P < 0.01).Furthermore, the PSQI score of patients with grade C/D esophagitis was showed to be significantly higher than that of patients with grade A/B esophagitis(P < 0.01).Finally, the GERDQ score of patients with RE was found to be positively correlated with PSQI score (r=0.482, P < 0.01). ConclusionsThe clinical symptoms are more serious in RE patients with sleep disorder.Anxiety and depression are easy to be found, and the severity of esophagitis is showed to be related to sleep quality in this kind of disease.
2022, 47(9): 1188-1191.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.008
Abstract:
ObjectiveTo investigate the effects of esketamine on the postoperative analgesia, inflammatory factors and early mood in patients with breast cancer. MethodsA total of 90 patients scheduled by radical mastectomy were randomly divided into the observation group and control group(45 cases in each group).Two groups were treated with general anesthesia, and the patient-controlled intravenous analgesia pump with 2 μg/kg sufentanil, 0.5 mg/kg esketamine combined with 20 mg azasetron and 2 μg/kg sufentanil combined with 20 mg azasetron were implemented in the observation group and control group after operation, respectively.The visual analogue scale(VAS) score, Athens-insomnia scale(AIS) score, self-rating anxiety scale(SAS) score, self-rating depression scale(SDS) score, incidence rate of adverse reactions and serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) were compared between two groups. ResultsThe VAS scores in observation group at T1(after 6 h of operation), T2(after 24 h of operation) and T3(after 48 h of operation) time points were significantly lower those that in control group(P < 0.05 to P < 0.01).There was no statistical significance in the serum levels of TNF-α and IL-6 between two groups at T0(before 24 h of operation)(P>0.05), and the levels of TNF-α and IL-6 in observation group were significantly lower than those in control group at T1 and T2(P < 0.05).The differences of the scores of AIS, SAS and SDS between two groups at T0 were not statistically significant (P>0.05), and the scores of AIS, SAS and SDS in observation group at T2 and T3 were significantly lower than those in control group(P < 0.05 to P < 0.01).The incidence rate of postoperative analgesic rescue in observation group was significantly lower than that in control group(P < 0.05), and the incidence rate of swirl in observation group was significantly higher than that in control group(P < 0.05). ConclusionsThe application of esketamine in postoperative analgesia of patients treated with radical mastectomy can enhance the postoperative analgesia effects, reduce the postoperative inflammatory reaction, significantly improve the quality of sleep, reduce the anxiety and depression, and improve the quality of rehabilitation of patients.
2022, 47(9): 1192-1195.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.009
Abstract:
ObjectiveTo investigate the correlation between vitamin D level and ovarian reserve function in infertile women. MethodsEighty infertile women were selected.25(OH)D3, anti-Müllerian hormone (AMH), follicular stimulating hormone (FSH) level were detected.Sinus follicle count (AFC) was observed by ultrasonography.The correlation between 25(OH)D3 level and AMH, FSH, AFC was analyzed. ResultsAmong the 80 infertile women, 26 cases(32.50%) were deficient in vitamin D, 19 cases(23.75%) were insufficient in vitamin D, and 35 cases(43.75%) were sufficient in vitamin D.There were no significant differences in age, body mass index, infertility years, infertility reasons and endocrine among the 3 groups of patients with different 25(OH)D3 level (P>0.05).Multiple linear regression showed that 25(OH)D3 level was not correlated with AMH, FSH, AFC(P>0.05). ConclusionsThere was no correlation between vitamin D level and various indicators of ovarian reserve function in infertile women, and vitamin D supplementation may not improve ovarian reserve function in infertile women.
2022, 47(9): 1195-1198.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.010
Abstract:
ObjectiveTo compare the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangial drainage (PTCD) in the treatment of malignant obstructive jaundice (MOJ). MethodsA total of 113 patients with MOJ were retrospectively analyzed.They were divided into ERCP group (n=48) and PTCD group(n=65) according to stent placement route.The success rate of operation, clinical efficacy, postoperative complications, hospitalization days and hospitalization expenses were compared between the two groups. ResultsThere were no significant differences in the overall success rate of surgery, the success rate of high obstruction surgery, the success rate of low obstruction surgery, the overall remission rate of jaundice, the incidence of complications and hospitalization expenses between the ERCP group and PTCD group(P>0.05).The remission rate of high obstruction jaundice and hospitalization days in ERCP group were lower than those in PTCD group(P < 0.05).The remission rate of low obstructive jaundice in ERCP group was higher than PTCD group(P < 0.05). ConclusionsERCP and PTCD have significant clinical efficacy in the treatment of MOJ patients.For the patients with low obstruction, the use of ERCP can provide more advantages, while for the patient with high obstruction, the use of PTCD has more advantages.The appropriate treatment method(ERCP or PTCD) should be chosen by clinicians according to the specific situation of the patient.
2022, 47(9): 1199-1203.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.011
Abstract:
ObjectiveTo evaluate the value of platelet/lymphocyte ratio (PLR)-prognostic nutritional index (PNI) score based on preoperative PLR and PNI in predicting the prognosis of patients with gastric cancer. MethodsThe clinical data of 171 patients undergoing radical gastrectomy for gastric cancer were analyzed retrospectively, and the optimal cut-off values of PLR and PNI were determined according to the 5-year survival rate through the receiver operating characteristic (ROC) curve.According to the cut-off value, they were divided into high PLR group (PLR≥148, 1 point) and low PLR group (PLR < 148, 0 point), high PNI group (PNI ≥47, 0 point) and low PNI group (PNI < 47, 1 point).The prognosis of patients with different scores was evaluated. ResultsThe 5-year overall survival rate of patients with PLR-PNI value of 2 was lower than that of patients with PLR-PNI value of 1 or 0 (11.36% vs 32.79 or 63.64, P < 0.05).Multivariate analysis showed that poor tumor differentiation, late TNM staging, and high PLR-PNI score were independent risk factors for postoperative prognosis of patients with gastric cancer (P < 0.01). ConclusionsPreoperative high PLR-PNI is an independent factor to predict the poor prognosis of gastric cancer.Thus, the scoring system can be used to differentiate high-risk patients in clinical work.
2022, 47(9): 1203-1205.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.012
Abstract:
ObjectiveTo use the predictive analysis model to match the learning curve of hysteroscopic submucosal myomectomy, and provide a reference for learning the process of hysteroscopic submucosal myomectomy in primary hospitals. MethodsClinical data of 66 cases who underwent hysteroscopic submucosal myomectomy was selected.The patients were numbered according to the sequence of the operation time, and the learning curve was plotted according to the intraoperative blood loss and the operation time by the moving average method.The patients were divided into the first stage group (1-20 cases, group A) and the second stage group (21-66 cases, group B), and the operation related indicators of the patients in the two groups were compared. ResultsThe operation time, intraoperative blood loss and hospitalization time of patients in group A were greater than those in group B (P < 0.05 to P < 0.01), and there was no significant difference in postoperative complications between the two groups (P>0.05).There was no significant difference in the recovery time of menstruation, the amount of menstruation, the hemoglobin level in the first month after operation and the pregnancy outcome after follow-up between the two groups(P>0.05). ConclusionsAfter the learning stage of 20 surgeries, the surgical technique is relatively stable for beginners in hysteroscopic submucosal myomectomy.Beginners need to strictly grasp the indications in the first 20 surgeries, master the operation, quickly deal with emergencies, in order to better fully master the technology.
2022, 47(9): 1206-1209.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.013
Abstract:
ObjectiveTo study the correlation between bone mineral density (BMD) level and blood lipid level, body mass index (BMI), menopausal years in postmenopausal women. MethodsA total of 141 postmenopausal women were selected as the research objects.All research objects were tested for BMD (including lumbar L1-4, femoral neck and hip joint, some patients added forearm) in the BMD testing room.According to the results (T value as the standard), the research objects were divided into three groups: group A(osteoporosis, T ≤-2.5), group B(osteopenia, -2.5 < T < -1.0) and group C(normal bone mass, T ≥-1.0).Fasting blood from all subjects were collected to detect the levels of total cholesterol (TC), low density lipoprotein (LDL), triglycerides (TG) and high density lipoprotein (HDL).The height, weight, age, and menopause age of patients were recorded.The BMI and menopause years were calculated. ResultsThe comparison results of LBMD, FBMD and TBMD in the three groups were group C>group B>group A (P < 0.05).There were significant differences in HDL, TG and TC levels among the three groups (P < 0.05 to P < 0.01), and the HDL level in group A was higher than that in group C (P < 0.05);TG levels in group A and group B were lower than those in group C (P < 0.01);TC level in group C was lower than that in group A(P < 0.05).There was no significant difference in LDL levels among the three groups(P>0.05).Correlation analysis showed that age and menopausal years were negatively correlated with BMD values in all parts (P < 0.05 to P < 0.01).Height, body weight and BMI were positively correlated with BMD in all parts (P < 0.05 to P < 0.01).TG level was positively correlated with LBMD, FBMD and TBMD (P < 0.01).TC level was negatively correlated with LBMD (P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that the risk of OP was lower in those with high BMI and TG, and higher in those with old age, long menopause and high TC.The ROC curve was drawn to analyze the value of TC in predicting OP in postmenopausal women, and the area under ROC curve was calculated to be 0.636 (P < 0.05). ConclusionsThe correlation between different blood lipids and BMD in different parts of postmenopausal women is different.The increase of TC is related to the decrease of LBMD.Postmenopausal women with low BMI, old age, long menopause years and high TC are more prone to osteoporosis.
2022, 47(9): 1210-1213.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.014
Abstract:
ObjectiveTo explore the correlation between health literacy, electronic health literacy, chronic obstructive pulmonary disease disease knowledge(COPD) and COPD health-related quality of life (HRQoL). MethodsThis study adopted the cross-sectional investigation method, randomly selected 120 adult patients with COPD, investigated the sociodemographic characteristics, comorbidity status, COPD disease knowledge, health literacy, electronic health literacy and HRQoL using the scale method, and used Spearman rank correlation to analyze the correlation between health literacy, electronic health literacy, COPD disease knowledge and general / lung specific HRQoL.Whether health literacy and electronic health literacy had regulatory effects on COPD disease knowledge and HRQoL was analyzed. ResultsThe average scores of HLSQ, eHEALS, COPD-Q, EQ-5Q, CAT were (4.52±0.62) points, (3.63±0.71) points, (9.81±1.63) points, (0.72±0.18) points, (24.02±6.65) points, respectively.The HLSQ, eHEALS, COPD-Q were positively correlated with EQ-5D (P < 0.01), and negatively correlated with CAT (P < 0.05 to P < 0.01).The score of EQ-5D index was negatively correlated with the score of CAT (P < 0.01).The higher the knowledge level of COPD disease, the lower the lung specific HRQoL.Health literacy and electronic health literacy played a chain intermediary role between COPD disease knowledge and general HRQoL.Health literacy and electronic health literacy played a chain intermediary role between COPD disease knowledge and lung specific HRQoL. ConclusionsWhen COPD patients make quality of life improvement plans, they should not only pay attention to improving the patients′ disease knowledge level, but also consider the importance of health literacy and electronic health literacy level.
2022, 47(9): 1214-1216.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.015
Abstract:
ObjectiveTo explore the characteristics of coronary artery lesions in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD), and to analyze the correlation between the number of coronary artery lesions and the level of oxidative stress. MethodsA total of 198 patients who underwent coronary angiography were divided into two groups according to whether they had T2DM history: 65 patients in T2DM combined with CHD group and 133 patients in CHD group.The clinic-related indexes of the two groups were measured.The correlation between the number of different coronary artery lesions and malondialdehyde (MDA) and superoxide dismutase (SOD) was analyzed according to the results of coronary angiography. ResultsThe level of MDA in the T2DM combined with CHD group was higher than that in the CHD group (P < 0.01), that and the level of SOD was lower than that in the CHD group (P < 0.05).The proportion of two or more coronary artery lesions in the T2DM group with CHD was higher than that in the CHD group(P < 0.01).In the T2DM combined with CHD group, the level of SOD in the group with one coronary artery lesion was higher than that in the group with two or more coronary artery lesions, and the level of MDA was lower than that in the group with two or more coronary artery lesions (P < 0.01). ConclusionsThe oxidative stress level of T2DM patients with CHD is higher than that of CHD alone, and the coronary artery disease is more severe.The oxidative stress level increases with the aggravation of the number of coronary artery lesions.
2022, 47(9): 1217-1221.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.016
Abstract:
ObjectiveTo explore the risk factors of Kawasaki disease complicated with coronary artery lesion(CAL) in children, and provide the guidance for clinical early prevention and intervention. MethodsThe clinical data of 82 children with Kawasaki disease were retrospectively analyzed, 30 patients with CAL and 52 patients without CAL were divided into the observation group and control group, respectively.The risk factors of Kawasaki disease complicated with CAL in children were analyzed using the univariate analysis and logistic multivariate analysis.After the independent risk factors were clarified, the different prediction models based on logistic regression, vector machine and decision tree were established, and the models were optimized and validated to identify the most ideal prediction model. ResultsThe results of the univariate analysis and logstic regression model analysis showed that the heat duration, platelet count, white blood cell count, C-reactive protein and serum sodium were the independent risk factors of CAL in children with Kawasaki disease(P < 0.05 to P < 0.01).The results of the random forest model analysis showed the the risk factors of CAL in children with Kawasaki disease were the white blood cell count, C-reactive protein, platelet count, serum albumin and serum sodium in order of influence weight.The results of XGB model analysis showed that the independent risk factors of CAL in children with Kawasaki disease were the platelet count, serum sodium, serum albumin, white blood cell count and fever duration in order of the influencing weight.The results of logistic regressive model analysis showed that the sensitivity, specificity, Youden index and AUC area of the independent risk factors in predicting CAL children with Kawasaki disease were 86.50%, 80.00%, 0.665 and 0.895, respectively.The results of random forest model analysis showed that the sensitivity, specificity, Youden index and AUC area of the risk factors in predicting CAL children with Kawasaki disease were 86.70%, 73.10%, 0.598 and 0.841, respectively.The results of XGB model analysis showed that the sensitivity, specificity, Youden index and AUC area of the risk factors in predicting CAL children with Kawasaki disease were 100.00%, 80.00%, 0.800 and 0.963, respectively.The prediction efficiency of GB model was better than that of logistic regression model and random forest model. ConclusionsThe logistic regression analysis, random forest model and XGB model can be used in the study of risk factors in CAL children with Kawasaki disease, the prediction efficacy of XGB model is most good, and the influencing factors are the platelet count, serum sodium, serum albumin, white blood cell count and fever duration in order of weigh calculated by XGB model.
2022, 47(9): 1222-1224.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.017
Abstract:
ObjectiveTo analyze the efficacy and safety of transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of prostatic hyperplasia patients with long-term oral anticoagulants. MethodsThe clinical data of 205 patients with prostatic hyperplasia were retrospectively analyzed.One hundred patients with oral anticoagulants were set as the observation group, and 105 patients without oral anticoagulants were set as the control group.The operation time, hemoglobin decrease amount, washing time and indwelling catheter time were compared between the two groups.The patients were followed up for 3 months, and the maximum urine flow rate, residual urine volume, international prostate symptom score, and quality of life score after operation were compared between the two groups. ResultsThe operation in all the patients was successfully completed, and there were no complications such as intraoperative and postoperative blood transfusion, capsule perforation, and electrotomy syndrome.The operation time in the observation group was longer than that in the control group (P < 0.05), and there were no significant differences in the hemoglobin decrease amount, washing time and indwelling catheter time between the two groups after operation (P>0.05).There were no significant differences in the maximum urine flow rate, residual urine volume, international prostate symptom score and quality of life score between the two groups at 3 months after operation(P>0.05). ConclusionsHoLEP is safe and effective in the treatment of prostatic hyperplasia patients with long-term oral anticoagulants, and is worthy of clinical promotion.
2022, 47(9): 1225-1228.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.018
Abstract:
ObjectiveTo explore the expression and significance of serum homocysteine (Hcy) and 25 hydroxy vitamin D [25(OH)D] in patients with diabetic peripheral neuropathy (DPN) and depression. MethodsThe clinical data of 80 patients with DPN and depression were retrospectively analyzed, and they were taken as DPN with depression group, and 60 DPN patients without depression were selected as DPN group, another 50 people undergoing health checkup during the same period were selected as control group.According to the Hamilton depression scale (HAMD) score, 80 patients with DPN and depression were divided into mild depression (32 cases), moderate depression (27 cases) and severe depression (21 cases).The expression levels of Hcy and 25(OH)D in different groups of patients were compared.The correlation between Hcy and 25(OH)D levels and whether DPN was associated with depressive symptoms was analyzed by Pearson correlation. ResultsThe level of Hcy in the DPN with depression group was significantly higher than that in the DPN group and the control group, and the level of 25(OH)D was significantly lower than that in the DPN group and the control group; the level of Hcy in the DPN group was significantly higher than that in the control group, and the level of 25(OH)D was significantly lower than that in the control group (P < 0.01).The Hcy level in the severe depression group was significantly higher than that in the moderate and mild depression groups, and the 25(OH)D level was significantly lower than that in the moderate and mild depression groups; the Hcy level in the moderate depression group was significantly higher than that in the mild depression group, and the level of 25(OH)D was lower than that in the mild depression group (P < 0.05 to P < 0.01).The Pearson correlation analysis showed that the level of Hcy was significantly positively correlated with whether DPN was associated with depressive symptoms (P < 0.01), and the level of 25(OH)D was significantly negatively correlated with whether DPN was associated with depressive symptoms (P < 0.01). ConclusionsThe increase of Hcy level and the decrease of 25(OH)D level are related to the occurrence of DPN with depressive symptoms and the severity of depression, which should be paid attention to in clinic.
2022, 47(9): 1229-1232.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.019
Abstract:
ObjectiveTo explore the risk factors of anastomotic fistula after total endoscopic McKeown technique for esophageal cancer. MethodsThe clinical data of 160 patients with esophageal cancer treated with total endoscopic McKeown technique were selected.The correlation between postoperative anastomotic fistula and gender, age, drinking history, smoking history, diabetes mellitus history, hypertension history, body mass index, tumor diameter, tumor location, preoperative radiotherapy and chemotherapy, operation time, anastomotic mode, making tubular stomach or not, embedding anastomotic site or not, suspending anastomotic site or not, serum albumin content on the third day after, postoperative pulmonary infection, pathological types was analyzed by univariate analysis.The independent risk factors of anastomotic fistula after operation for esophageal cancer were analyzed by multivariate logistic regression analysis. ResultsAmong the 160 esophageal cancer cases, 31 cases had anastomotic fistula, which disappeared after conservative treatment; anastomotic stenosis occurred in 14 cases, and all improved after balloon dilatation; no stent implantation and death cases were found.Univariate analysis showed that the incidence of anastomotic fistula was higher in patients with tumor location of upper segment, no preoperative radiotherapy and chemotherapy, pulmonary infection and serum albumin < 30 g/L on the third day after operation (P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that serum albumin < 30 g/L on the third day after operation and postoperative pulmonary infection were the independent risk factors for anastomotic fistula after esophageal cancer operation (P < 0.05). ConclusionsPostoperative serum content of albumin content < 30 g/L and postoperative pulmonary infection are the independent risk factors for anastomotic fistula after total endoscopic McKeown radical resection for esophageal cancer.The occurrence of anastomotic fistula can be effectively reduced by improving nutritional status and controlling pulmonary infection.
2022, 47(9): 1233-1236.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.020
Abstract:
ObjectiveTo explore the effects of closed-loop target controlled infusion and continuous infusion of cis-atracurium on mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO2) and muscle relaxant dosage in patients undergoing cholecystectomy. MethodsNinety patients with cholecystectomy were divided into the control group (n=45) and observation group (n=45) by lot.The control group was continuously infused with cis-atracurium, and the observation group was infused with cis-atracurium by closed-loop target controlled infusion.MAP, HR, SpO2, ETCO2, muscle relaxation state, postoperative recovery state and incidence of complication before induction (T1), 5 minutes after intubation (T2), 1 minute before extubation (T3), 2 minutes after extubation (T4), 24 hours after extubation (T5) were compared between the two groups. ResultsThe comparison of MAP and HR levels of patients in the same group at different time points showed that compared with T1, the levels of MAP and HR decreased significantly at T2 (P < 0.01), increased at T3 (P < 0.01), and then gradually recovered to the levels at T1 (P>0.05);the comparison between groups showed that there was no significant difference in the levels of the two indicators at different time points (P>0.05).The comparison of SpO2 and ETCO2 levels of patients in the same group at different time points showed that there was no significant change at each time point (P>0.05);the comparison between groups showed that only at T2 time point, the ETCO2 level of patients in the observation group was slightly higher than that in the control group (P < 0.05), and there was no significant difference in SpO2 and ETCO2 levels between the two groups at other time points (P>0.05).The onset time, duration time and recovery time of muscle relaxant in the observation group were shorter than those in the control group (P < 0.01), and there was no significant difference in the extubation time between the two groups (P>0.05). ConclusionsBoth closed-loop target controlled infusion and continuous infusion of cis-atracurium have good effects on cholecystectomy, but the former has less muscle relaxant dosage and is more effective.
2022, 47(9): 1237-1240.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.021
Abstract:
ObjectiveTo compare the efficacy and safety between single stent thrombectomy and intravenous thrombolytic bridging stent thrombectomy in the treatment of intracranial large vessel occlusion. MethodsThe clinical data of 48 patients with acute intracranial large vessel occlusion within 6 h were retrospectively analyzed, and the patients were divided into the stent thrombectomy group and bridge treatment group.The baseline data were compared between two groups.After two groups were treated for 14 d, the efficacy of two groups were analyzed using the National Institutes of Health stroke scale(NIHSS).The prognosis, adverse reactions and death of modified Rankin score(mRS) in two groups at 90 d of treatment were observed. ResultsThe results of comparison of the 14-day effective rate between two groups showed that the cumulative effective rate in two groups were high(77.78% and 85.71%), and the difference of which was not statistically significant(P>0.05).The total proportion of cured and effective rate in bridge treatment group after 14 d of treatment was higher than that in stent thrombolysis group(P < 0.05).The differences of the time from admission to vascular recanalization, times of thrombectomy, prognosis, symptomatic intracranial hemorrhage and one-month all-cause mortality between two groups were not statistically significant(P>0.05), and the good prognosis rate of 90 d in bridging group was higher than that in stent thrombectomy group(P < 0.05). ConclusionsBoth simple stent thrombectomy and intravenous thrombolysis bridging stent thrombectomy can rapidly open the intracranial occluded aorta, and the bridging group has better short-term and long-term efficacy.
2022, 47(9): 1241-1245.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.022
Abstract:
ObjectiveTo investigate the protective effect of two double-J stents placement combined with N-trap stone basket against postoperative ureteral stricture after ureteroscopic Ho: YAG lithotripsy. MethodsInformation of patients with impacted ureteral stones who underwent single F7 or two F6 double-J stents placement during ureteroscopic Ho: YAG lithotripsy was retrospectively reviewed.A total of 97 pairs of patients (n=194) were distributed into two groups (single-F7 stents group and two-F6 stents group) by means of propensity score matching with stone size and impaction period being predictors.Postoperative ureteral stricture rate (with stents in place for 8 to 10 weeks and 1 year follow-up), stone-free rate and stent-related urinary symptom incidence were compared between two groups. ResultsOn the first day after operation, the overall stone free rate of patients reached 88.1% (171/194), and there was no significant difference between the two groups (P>0.05).During follow-up after stent removal, 22 cases of ureteral stricture (overall incidence 11.3%) were diagnosed.The incidence of ureteral stenosis in the single-F7 stents group was significantly higher than that in the two-F6 stents group (P < 0.01).Indwelling two F6 double-J stents was a protective factor for ureteral stricture after ureteroscopic lithotripsy (RR=0.294, 95%CI: 0.113-0.766).Incidence of stent-related urinary symptoms (at least one of gross hematuria, urgency, frequent urination, lower abdominal pain, flank pain) reached almost 100% in both groups, and showed no significant difference(P>0.05). ConclusionsAfter ureteroscopic Ho: YAG lithotripsy for incarcerated ureteral calculi, the placement of two double-J stents combined with N-trap stone basket can safely and reliably reduce the risk of postoperative ureteral stricture.
2022, 47(9): 1246-1249.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.023
Abstract:
ObjectiveTo analyze the vascular characteristics in benign and malignant breast nodules using superb microvascular imaging (SMI), and judge the application prospect and value of this technology. MethodsA total of 75 patients with breast cancer were selected, among them, 45 patients were diagnosed as benign breast tumors, 30 patients with malignant breast cancer.A total of 94 effective lesions and nodules were obtained, there were 45 nodules in benign group, 49 nodules in malignant group.Four pathological vascular characteristics were observed through SMI, including the direction of blood vessels, the angle between main vessels and branches, perforator vessel and vessel number.Taking pathological results as the gold standard, according to the different manifestations of vascular characteristics in benign and malignant breast nodules, ROC curve was used to analyze the cut-off value of SMI technology to identify the internal vascular characteristics of malignant breast nodules, and its sensitivity and specificity were further analyzed. ResultsFrom the perspective of SMI technology, there was significant difference in direction of blood vessels, angle between main blood stream and branch, and perforator vessel number(P < 0.01), however, there was no significant difference in the vascular abundance between the two groups(P>0.05).The area under the ROC curve of SMI in the diagnosis of breast malignant nodules was 0.879, the related indicators were also obtained, including sensitivity (91.84%), specificity(75.56%), accuracy(67.39%), positive predictive value (80.4%), and negative predictive value (89.5%). ConclusionsSMI can well reflect the difference of internal vascular characteristics between benign and malignant breast nodules, and has a good diagnostic value for malignant breast lesions.
2022, 47(9): 1249-1253.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.024
Abstract:
ObjectiveTo explore the feasibility of using various imaging methods to establish the correlation between the severity of cirrhosis and gynecomastia in elderly men. MethodsA total of 123 elderly male patients with liver cirrhosis aged >60 years were selected as the research object.The Child-Pugh grade of patients was determined.According to the breast development, the patients were divided into the breast development group(n=53) and non-breast development group(n=70).The CT, MRI or BUS imaging data were used to estimate the breast volume(Vbreast), body surface area(BSA), normalized breast volume(Rbreast/surface) and normal liver volume(Vliver).The regional growth or volume measurement techniques were used to measure the volume of diseased liver(Vliver disease) and rate of change of liver volume(Rliver), and the imaging grading of smear cirrhosis was used to evaluate the liver images. ResultsThere were 19 cases of unilateral enlargement and 34 cases of bilateral enlargement in the breast development group.The difference of the Rbreast/surface grade between unilateral and bilateral breast hyperplasia patients was statistically significant(P < 0.01).The differences of the Vbreast, Rbreast/surfac, Child-Pugh grade, Child-Pugh score and CT grade of liver cirrhosis between two groups were statistically significant(P < 0.01), while the differences of the Vdisease liver and Rliver were not statistically significant(P>0.05).According to the Child-Pugh grading method, the patients in the two groups were divided into the A, B and C grades, respectively.The Vbreast and Rbreast/surface of patients in the breast development group showed an increasing trend with the increase of liver function grade(P < 0.05 to P < 0.01), and the differences of which was statistically significant compared with those in the non-breast development group(P < 0.01).The Vdisease liver and Rliver of the diseased liver in two groups showed a decreasing trend with the increase of liver function grade(P < 0.01), but there was no statistical significance in the corresponding liver function grade between two groups(P>0.05).There were significant positive correlations among the Vbreast, Rbreast/surface, Child-Pugh grade of liver function and CT grade of smear cirrhosis(P < 0.01), while there were significant negative correlations among the Vdisease liver and Rliver and liver function grade and CT grade of smear cirrhosis(P < 0.01). ConclusionsThe comprehensive use of various imaging methods to measure the enlargement of breast volume in elderly male patients with cirrhosis can help to infer and evaluate the degree of liver function damage and liver atrophy.
Analysis of the nuclear spectrum and karyotype charaeteristics of subjects with antinuclear antibody
2022, 47(9): 1254-1258.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.025
Abstract:
ObjectiveTo investigate the positive detection rate, karyotype and distribution characteristics of antinuclear antibody(ANA) positive spectrum of ANA in different populations. MethodsThe laboratory results of ANA in 331 subjects were collected, and the positive rate, karyotype and distribution characteristics of ANA positive spectrum were analyzed. ResultsThe detection rate of ANA-positive and high-titer in female was higher than that in male, and the highest detection rate appeared in people aged 40-60 years.The positive detection rate of different ANA karyotypes in female was higher than that in male.The karyotypes of subjects at different ages were main nuclear granule type and cytoplasmic granule type.The positive rates of anti-scleroderma 70 and anti-Smith in male were slightly higher than those in female, and the positive rates of other ANA spectra in female were higher than those in male.The top three positive rates of ANA spectrum in female were as follows: anti-SS A, anti-centromeric protein B and anti-dsDNA antibody/anti-SS B.The positive antibodies of ANA spectrum in different age groups were slightly different, which mainly concluded anti-SS A and anti-Smith.The detection rates of ANA in autoimmune diseases ankylosing spondylitis, rheumatoid arthritis, systemic lupus erythematosus and Sjogren′s syndrome were 36.0%, 60.3%, 91.7% and 100.0%, respectively, while the detection rates of ANA among infected and healthy people were 29.4% and 14.6%.As for ANA spectrum, no specific antibodies were found in ankylosing spondylitis, rheumatoid arthritis, infected and healthy people.Anti-SS A, anti-dsDNA antibody and anti-nucleosomes showed high positive detection rates in systemic lupus erythematosus, and anti-ribonucleoprotein/anti-Smith, anti-SS A, anti-SS B and anti-PM-Scl had high positive detection rates in Sjogren′s syndrome. ConclusionsANA karyotype and antibody spectrum have different manifestations in populations with different gender, age and diseases, among which infected and healthy people have a higher positive rate, which suggests that attention should be paid to in clinical differential diagnosis.
2022, 47(9): 1258-1260.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.026
Abstract:
ObjectiveTo analyze the value of serum creatinine(Cr), hypersensitive C-reactive protein(hs-CRP), cystatin C(Cys-C), and superoxide dismutase(SOD) levels in the differential diagnosis of patients with acute and chronic renal failure. MethodsA total of 83 patients with renal failure were selected as research objects, and 101 healthy subjects were selected as control group in the same period.The levels of serum Cr, hs-CRP, Cys-C and SOD were detected.The ROC curve was drawn, and the value of each index in predicting acute and chronic renal failure was analyzed. ResultsThe levels of Cr, hs-CRP and Cys-C in 83 patients with renal failure were significantly higher than those in the control group(P < 0.01), and the level of SOD was significantly lower than that in the control group(P < 0.01).The levels of serum Cr, hs-CRP and Cys-C in patients with acute renal failure were significantly lower than those in patients with chronic renal failure(P < 0.01), and the level of SOD was significantly higher than that in patients with chronic renal failure(P < 0.05).The AUC of Cr and Cys-C in the differential diagnosis of acute and chronic renal failure was 0.73 and 0.82, respectively, the difference of which was statistically significan(P < 0.01).The AUC of hs-CRP and SOD in differential diagnosis of acute and chronic renal failure was 0.40 and 0.38, respectively, the difference of which was not statistically significance(P>0.05). ConclusionsThe value of serum Cr and Cys-C levels in differential diagnosis of acute and chronic renal failure was significantly better than that of hs-CRP and SOD levels.
2022, 47(9): 1261-1265.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.027
Abstract:
ObjectiveTo discusse the development status and frontier hot spots of the research on industry university research collaborative innovation in colleges and universities, so as to provide reference for relevant research. MethodsUsing China National Knowledge Infrastructure(CNKI) as the data source, Citespace5.4R2 was used to analyze 2 484 documents related to the collaborative innovation research of industry, university and research institutions, including cooperation network analysis of institution and author, keyword co-occurrence and cluster analysis, keyword time zone visualization and emergent detection. ResultsThe research clusters of relevant research institutions have not been formed, and the level of collaboratively across institutions is not high; hot subject in the research field of industry university research collaborative innovation include industry university research cooperation, collaborative innovation, scientific and technological innovation, etc; "industry university research application", "social network analysis" and "industry university research integration" were the research hotspots in this field. ConclusionsTo further improve the research level of industry university research collaborative innovation in colleges and universities, it is needed to strengthen policy support, core authors cultivation and the cooperation and exchange between research institutions.
2022, 47(9): 1266-1268.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.028
Abstract:
ObjectiveTo explore the application effect of SPOC teaching model in standardized training of cardiology residents. MethodsA total of 112 resident physicians who received standardized training in Department of Cardiology were selected as the research subjects.They were divided into experimental group (the residents from January 2020 to January 2021) and control group (the residents from January 2019 to January 2020), 56 in each group.SPOC-based teaching mode was used in the experimental group, while traditional teaching mode was used in the control group.The teaching effect was evaluated by theoretical test, skill assessment and questionnaire survey. ResultsThe theoretical and skill test scores of residents in the experimental group were both higher than those in the control group (P < 0.01), and it had a high acceptance of SPOC mode by 92.9% residents in the experimental group. ConclusionsSPOC teaching model is an effective clinical teaching model, which can deepen the understanding of cardiovascular knowledge and improve the clinical practice ability of residents.
2022, 47(9): 1269-1271.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.029
Abstract:
ObjectiveTo explore the influencing factors of clinical medical students′ participation in open teaching of human anatomy laboratory based on back propagation(BP) neural network model. MethodsA questionnaire survey was conducted through online survey, and the univariate analysis and BP neural network model were used to analyze the factors affecting clinical medical students′ participation in the open teaching of human anatomy laboratory. ResultsA total of 595 valid questionnaires were collected from clinical medical students.The results of univariate analysis showed that the desire of opening of clinical medical students affected the participation of clinical medical students in laboratory opening(P < 0.05) and ranked first after the standardization of BP neural network model, and the area under the ROC curve of the model was 0.724. ConclusionsThe desire of clinical medical students to open human anatomy laboratory is an important factor that affects the participation of clinical medical students in the opening of human anatomy laboratory.
2022, 47(9): 1272-1275.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.030
Abstract:
ObjectiveTo analyze the influencing factors of infusion port-related thrombosis in chemotherapy patients with lung cancer, and to propose nursing strategies. MethodsA total of 158 patients with lung cancer from July 2016 to March 2019 were taken as the research objects.The influencing factors of the infusion port-related thrombosis were analyzed by univariate and unconditional multivariate logistic regression analysis.The risk factors of thrombosis related to infusion port were explored, and the predictive effect of logistic regression was verified using ROC curve. ResultsThirty-one cases(19.6%) of infusion port-related thrombosis occurred in lung cancer chemotherapy patients.Univariate and multivariate logistic regression analysis showed that indwelling time, blood hypercoagulability status, tumor classification, and chemotherapy regimens were the main factors of infusion port-related thrombosis(P < 0.05 to P < 0.01).The multivariate logistic regression model predicted the probability P for ROC curve verification, and the AUC was 0.905(95%CI: 0.884-0.927), the sensitivity was 0.861, the specificity was 0.793, and the Youden index was 0.654. ConclusionsInfusion port-related thrombosis in lung cancer chemotherapy patients is related to catheter indwelling time, blood hypercoagulability status, tumor classification, and chemotherapy regimens.Nurses should do a good job in screening and education of venous thromboembolism high-risk groups, establish a follow-up registration system at the infusion port, and strengthen the standardized training of nursing staff in primary hospitals and communities, so as to reduce the incidence of thrombosis in the infusion port.
2022, 47(9): 1276-1279.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.031
Abstract:
ObjectiveTo screen the risk factors of recurrence after laparoscopic conservative surgery for ovarian endometriosis (OEM) and establish the related risk early warning model. MethodsThe clinical data of 174 patients with OEM who underwent laparoscopic conservative surgery were collected.The related factors affecting the recurrence after laparoscopic OEM conservative surgery were analyzed by univariate and multivariate logistic regression, and the nomogram prediction model was established. ResultsYoung age, history of preoperative dysmenorrhea, history of previous medical treatment, posterior fornix tenderness, high r-AFS stage, bilateral lesions, and postoperative no medication were independent risk factors for recurrence after laparoscopic OEM conservative surgery (P<0.05 to P<0.01).A related nomogram model was established based on this, and the model was verified.The results showed that the C-index was 0.817, the calibration curve and the ideal curve fitted well, and the AUC was 0.839 (95%CI: 0.802-0.874), indicating the model had good predictive ability. ConclusionsNomogram model based on risk factors has excellent prediction ability, which is of great clinical significance for early evaluation of recurrence risk after laparoscopic OEM conservative surgery.
2022, 47(9): 1280-1283.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.032
Abstract:
ObjectiveTo explore the relationship between coping style, self-efficacy and health style in elderly stroke patients. MethodsA total of 120 elderly stroke patients were selected as the research objects.General information questionnaire, medical coping style scale (MCMQ), general self-efficacy scale (GSES) and stroke health behavior scale (HBS-SP) were distributed to complete the questionnaire survey.Pearson correlation was used to analyze the coping style, self-efficacy and health style of elderly stroke patients. ResultsThe total score of coping style of the elderly stroke patients was(41.49±4.73) point.The scores of facing dimensions were lower than the national norm (P < 0.01), and the avoidance dimension was higher than the national norm (P < 0.01).The average self-efficacy of the elderly stroke patients was (25.93±3.35) points, and nearly 80% of the patients′ self-efficacy was in the middle and low level.There was a positive correlation between the facing dimension and self-efficacy in elderly stroke patients (P < 0.01), and a negative correlation between avoidance dimension and yielding dimension and self-efficacy (P < 0.05 and P < 0.01).There was a positive correlation between the self-efficacy and the total score of health behavior and each dimension in elderly stroke patients (P < 0.05 to P < 0.01).The facing dimension of the elderly stroke patients was positively correlated with the health behavior and the scores of each dimension (P < 0.05 to P < 0.01), and avoidance and submission were negatively correlated with the total score of health behavior and the scores of each dimension (P < 0.05). ConclusionsThere is a significant correlation among the self-efficacy, coping style and health behavior of elderly stroke patients.Positive coping style and higher self-efficacy are the positive promoting factors of health behavior of elderly stroke patients, and those with higher self-efficacy are more likely to adopt the coping style.
2022, 47(9): 1284-1289.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.033
Abstract:
ObjectiveTo explore the effect of timeliness incentive nursing on postoperative rehabilitation of patients with cervical spondylotic myelopathy (CSM). MethodsNinety patients with CSM treated by surgery were randomly divided into two groups.The control group was given routine nursing, and the observation group was given timeliness incentive nursing on the basis of routine nursing.Age, gender, course of disease, operation time, time of field activity, length of hospital stay, surgical approach, pathological segment, basic disease, visual analogue scale (VAS) score before and after nursing, JOA score, cervical spine activity (ROM), quality of life (QOL), complications and nursing satisfaction in the two groups were recorded. ResultsThe underground activity time and hospital stay in the observation group were significantly shorter than those in the control group (P < 0.01).Compared with that before nursing, VAS score decreased significantly(P < 0.01), JOA score and ROM increased significantly in the two groups after nursing (P < 0.01).Compared with the control group, the improvement of the observation group was more significant (P < 0.01).The incidence of complications in the observation group was significantly lower than that in the control group (P < 0.01).Two months and 6 months after nursing, the scores of physiological function, physiological function, physical pain, overall health, energy, emotional function, social function, and mental health in the observation group were better than those in the control group (P < 0.01).The nursing satisfaction of the observation group was significantly higher than that of the control group (P < 0.05). ConclusionsTimeliness incentive nursing can effectively improve the postoperative rehabilitation level of CSM patients, reduce pain, reduce the incidence of complications, improve QOL index and nursing satisfaction.
2022, 47(9): 1290-1294.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.034
Abstract:
ObjectiveTo provide reference for clinical nursing by analyzing the injury outcome status and influencing factors of patients with pressure injuries (PIs) brought in from outside the hospital. MethodsA total of 118 hospitalized patients with PIs were selected by convenience sampling method for retrospective analysis.And the retated data of cases and PIs were collected to determine the impact of outcome. ResultsA total of 277 PIs were brought into the 118 patients, including 26 in stage 1 (9.38%), 125 in stage 2 (45.13%), 36 in stage 3 (13.00%), 1 in stage 4 (0.36%), 32 in deep injury stage (11.55%) and 57 in non-staging stage (20.58%).There were 82 sacral tail (29.60%), 51 hips (18.41%), 32 buttocks (11.55%), 36 heels (13.00%), 21 back (7.58%), 16 foot (except heel part) (5.78%), 13 external ankle (9.39%) and 26 other parts (4.69%).There were 54 patients (45.76%) with one PIs and 64 patients (54.24%) with multiple PIs.Univariate analysis showed that there were statistically significant differences on length of stay, albumin levels after admission, Braden score, combined with diabetes mellitus and cerebral infarction, body mass index, Barthel index (BI), injury area (P < 0.05 to P < 0.01).The improved group was mainly stage 1 and stage 2 (total component ratio 67.97%), while the non-improved group was mainly stage 3 and above (total component ratio 62.10%).Logistic regression analysis showed that high Braden score, high albumin after admission, long hospital stay and high BI score were protective factors for the outcome of PIs(P < 0.05 to P < 0.01). ConclusionsPressure injuries brought in from outside the hospital are complicated and multiple.Braden score, albumin levels after admission, length of stay and BI are the influencing factors of outcome of PIs brought in from outside the hospital.
2022, 47(9): 1294-1297.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.035
Abstract:
ObjectiveTo explore the application effects of hypothermia risk grading intervention in perioperative period of patients treated with percutaneous nephrolithotomy. MethodsSeventy-six patients treated with percutaneous nephrolithotomy were randomly divided into the observation group and control group(38 in cases each group).The hypothermia risk grading intervention program was given in the observation group for nursing, while the routine nursing was given in the control group.The temperature and incidence rate of shivering in two groups were observed before operation, at 30, 60, 90 and 120 min during operation and after operation. ResultsThere was no statistical significance in the body temperature between two groups before operation and at 30 min during operation(P>0.05).The body temperature in observation group was higher than that in control group at 60, 90 and 120 min during operation and after operation(P < 0.05 to P < 0.01).The incidence rate of postoperative shivering in observation group was 7.89%(3/38), which was lower than that in control group(26.32%)(10/38)(P < 0.05). ConclusionsThe application of hypothermia risk grading intervention in the perioperative period of patients treated with percutaneous nephrolithotomy can early predict the high-risk group with intraoperative hypothermia, and the thermal insulation measures can reduce the occurrence of postoperative hypothermia.
2022, 47(9): 1298-1301.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.036
Abstract:
ObjectiveTo investigate the effect of preoperative enhanced information support combined with progressive muscle relaxation training(PMRT) on anxiety in patients undergoing thoracoscopic pneumonectomy. MethodsPatients who underwent thoracoscopic pneumonectomy were selected as the research objects and randomly divided into the combined group and the control group, with 30 patients in each group.The control group received a routine preoperative operating room visit plan, and the combined group received preoperative enhanced information support combined with PMRT intervention.The changes in anxiety level, sedative-restlessness, blood pressure, heart rate, length of anesthesia recovery room, and hospital stay were compared between the two groups before and after intervention. ResultsThere were no significant differences in anxiety level, heart rate, systolic blood pressure and diastolic blood pressure between the two groups at routine visit 1 day before surgery(P>0.05).Anxiety level, heart rate, systolic blood pressure and diastolic blood pressure in the operating room waiting room and out of the operating room in the combined group were lower than those in the control group(P < 0.01).There were significant differences in anxiety level, heart rate, systolic blood pressure and diastolic blood pressure between the two groups before and after surgery(P < 0.05 to P < 0.01), and all indexes in the combined group showed a trend of increasing in the operating room waiting room and decreasing when leaving the operating room(P < 0.05 to P < 0.01).However, in the control group, all indexes in the operating room waiting room and out of the operating room were higher than 1 day before surgery(P < 0.01), and there was no statistically significant difference between waiting room and exit room(P>0.05).There was no statistically significant differences in the incidence of agitation and hospital stay between the two groups(P>0.05).However, the stay duration in the recovery room in the combined group was significantly lower than that in the control group(P < 0.01). ConclusionsPreoperative enhanced information support combined with PMRT can effectively relieve preoperative and postoperative anxiety in patients undergoing thoracoscopic pneumonectomy.
2022, 47(9): 1302-1306.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.037
Abstract:
ObjectiveTo analyze the application effect of flow chart based on key point control principle in intestinal preparation program for elderly patients. MethodsA total of 120 patients undergoing colonoscopy were selected and randomly divided into control group and observation group, 60 patients in each group.The control group received routine colonoscopy education, and the observation group adopted flow chart based on the key points control principle for intestinal preparation intervention.After the intervention, there were 56 patients in the observation group and 55 patients in the control group.The Boston bowel preparation scale (BBPS) score, bowel preparation compliance rate and incidence of adverse reactions were compared between the two groups. ResultsThe intestinal preparation failure rate in the observation group 17.86% (10/56) was lower than that in the control group [41.82% (23/55)], the differences were statistically significant (P < 0.01).The BBPS score in the observation group was higher than that in the control group (P < 0.01).The compliance of diet preparation, medication preparation and exercise preparation in the observation group was significantly higher than those in the control group (P < 0.01), and the incidence of nausea, abdominal distention and dizziness was significantly lower than those in the control group (P < 0.05). ConclusionsThe application of flow chart based on key point control principle can improve the quality of intestinal preparation in elderly patients, which is worthy of clinical application.
2022, 47(9): 1306-1309.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.038
Abstract:
ObjectiveTo explore the influence of special nursing based on childlike design of children's medical space on children with mycoplasma pneumonia during atomization inhalation period. MethodsOne hundred and fifty children with mycoplasma pneumonia treated by atomization inhalation were selected.Among them, 75 children treated during the period which the pediatric ward has not been transformed were set as control group, while the other 75 children treated after the transformation of ward room were set as observation group.The control group was given routine treatment and nursing.The observation group was given childlike design and special nursing of children's medical space on the basis of the control group.After 1 week of treatment, the changes of pulmonary function indexes, atomization compliance, symptom relief time and clinical efficacy were compared between the two groups. ResultsThere was no significant difference in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) between the two groups before treatment (P>0.05).After treatment, FVC and FEV1 in the two groups were improved compared with those before treatment(P < 0.05), and FVC and FEV1 in the observation group was significantly higher than those in the control group(P < 0.01).The atomization compliance rate of children in the observation group was 93.33%(70/75), which was significantly better than 73.33% (55/75) in the control group (P < 0.01).The fever abatement time, cough disappearance time and lung rale disappearance time of children in the observation group were significantly shorter than those in the control group (P < 0.01).The effective rate of the observation group was 92.00% (69/75), which was significantly better than 82.67% (62/75) of the control group (P < 0.01). ConclusionsThe special nursing based on childlike design of children's medical space can have a positive impact on children with mycoplasma pneumonia during compression atomization inhalation, promote the improvement of pulmonary function, improve the compliance of atomization inhalation, shorten the time of symptom relief, and improve the clinical treatment effect, which is worthy of clinical application.
2022, 47(9): 1310-1314.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.039
Abstract:
ObjectiveTo explore the application of active psychological intervention combined with progressive muscle relaxation training under the guidance of collaborative nursing in the perioperative period of patients with thyroid tumor. MethodsA non-synchronous control study was conducted.A total of 85 patients with thyroid tumor in the department of general surgery of a tertiary grade A public hospital in Huaibei from December 2020 to July 2021 were selected as observation group, who implemented with active psychological intervention combined with progressive muscle relaxation training under the guidance of collaborative nursing.Eighty-six patients with thyroid tumor from April 2020 to November 2020 were used as the control group to implement general surgical routine nursing.The incidence of complications was compared between the two groups, and the mood state of the two groups was evaluated by mood state scale(POMS) before and after intervention, and the satisfaction of the two groups was evaluated by satisfaction questionnaire. ResultsThe total incidence of postoperative complications in the observation group was 7.06%(6/85), significantly lower than 25.58%(22/86) in the control group(P < 0.01).The tension, anger, fatigue, depression and panic dimension of POMS score of the observation group after intervention were significantly lower than those in the control group, while energy and self-esteem were significantly higher than those in the control group(P < 0.01).The nursing satisfaction of patients in the observation group was significantly higher than that in the control group(P < 0.05). ConclusionsActive psychological intervention combined with progressive muscle relaxation training under the guidance of collaborative nursing can reduce the incidence of postoperative complications, improve the bad mood of patients with thyroid tumor and improve their nursing satisfaction.
2022, 47(9): 1314-1317.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.040
Abstract:
ObjectiveTo explore the accuracy and safety of two intracavitary electrocardiographies at different timing combined with extracorporeal measurement for the positioning of peripheral venous catheterization(PICC) tip in tumor patients. MethodsSixty-four tumor patients undergoing PICC and chemotherapy were selected as the study subjects and divided into intervention group and control group according to the random number method, with 32 cases in each group.Patients in the two groups were implanted with PICC by intracavitary electrocardiography combined with extracorporeal measurement.Patients in the control group underwent X-ray examination within 30 minutes after successful placement of PICC by intracavitary electrocardiography, and patients in the intervention group underwent X-ray examination at 3 hours after successful PICC implantation by intracavitary electrocardiography.The success rate of catheter positioning, patient's satisfaction and the incidence of catheter-related complications within 7 days after catheterization were compared between two intracavitary electrocardiographies at different timing combined with extracorporeal measurement. ResultsThere was no significant difference in the success rate of one-time catheterization between the two groups(P>0.05).The patient's satisfaction of catheterization in the intervention group was higher than that in the control group (P < 0.05).The incidence of catheter-related complications was 0.00%(0/32) in the intervention group within 7 days after catheterization, which was lower than that of 18.75%(6/32) in the control group (P < 0.05). ConclusionsIntracavitary electrocardiography positioning can replace X-ray examination at 3 hours after PICC implantation in tumor patients, which does not affect the success rate of one-time catheterization, is helpful to improve patient's satisfaction with catheterization, and reduces the incidence of complications of catheterization.
2022, 47(9): 1318-1323.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.041
Abstract:
ObjectiveTo understand the current status of post-traumatic growth in patients with femoral shaft fractures, and analyze the mediating effect of self-efficacy between family care and post-traumatic growth. MethodsA total of 139 patients after femoral shaft fracture surgery were selected as the research subjects, and surveyed using the general situation questionnaire, general self-efficacy scale, family APGAR index and post traumatic growth inventory.Pearson correlation analysis was used to evaluate the correlation between self-efficacy, family care, and post-traumatic growth, and a structural equation model was established to test the mediating effect. ResultsThe total score of patients' self-efficacy after femoral shaft fracture surgery was(22.64±4.38) points, the total score of family care was(5.12±1.09) points, and the total score of post-traumatic growth was(62.87±7.28) points.Pearson correlation analysis showed that the total score of self-efficacy was significantly positively correlated with the total score of family care and the total score of post-traumatic growth(P < 0.01), the total score of family care was positively correlated with the total score and score of each dimension of post-traumatic growth(P < 0.05 to P < 0.01).The results of structural equation model showed that self-efficacy had a partial mediating effect between family care and post-traumatic growth, and the mediating effect accounted for 41.07% of the total effect. ConclusionsThe scores of self-efficacy, family care and post-traumatic growth in patients after femoral shaft fracture surgery are all at moderate levels.Clinical medical staff should pay attention to the importance of communication, so that patients can maintain a positive and optimistic psychological state to improve the level of post-traumatic growth.
2022, 47(9): 1324-1327.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.042
Abstract:
ObjectiveTo investigate the risk factors of lower extremity deep venous thrombosis(LDVT) in elderly patients with femoral neck fracture after operation. MethodsThe medical records of femoral neck fracture elderly patients treated with surgical treatment were retrospectively analyzed.The independent risk factors of postoperative LDVT were analyzed using the univariate and logistic regression analysis, and the correlation prediction model was established. ResultsThe body mass index ≥24 kg/m2, diabetes mellitus, total cholesterol(TC)>5.69 mmol/L, triacylglycerol(TG) >1.8 mmol/L, operation time ≥60 min, intravenous inhalation combined anesthesia and operation waiting time ≥5 d were the independent risk factor of postoperative LDVT in elderly patients with femoral neck fracture(P < 0.05 to P < 0.01).The results of model verification in predicting postoperative LDVT in elderly patients with femoral neck fracture showed that the results of H-L deviation test were χ2=3.71 and P>0.05, and the C-index was 0.904(95%CI: 0.869-0.939), which indicated that the prediction model of line chart had good accuracy and differentiation. ConclusionsThe independent risk factors of postoperative LDVT in elderly patients with femoral neck fracture.The prediction model has accurate prediction ability and differentiation, and high clinical application value.
2022, 47(9): 1328-1331.
doi: 10.13898/j.cnki.issn.1000-2200.2022.09.043
Abstract:
ObjectiveTo evaluate the effect of aerobic resistance exercise combined with health belief intervention in elderly patients with chronic obstructive pulmonary disease(COPD). MethodsSeventy elderly COPD patients admitted from June 2018 to April 2019 were randomly divided into control group and observation group, with 35 cases in each group.Both groups received conventional treatment and health belief intervention, and the observation group performed aerobic resistance exercise on this basis for 12 weeks of continuous intervention.Cardiopulmonary function and quality of life were compared between the two groups before and after intervention. ResultsAfter intervention, the ratio of forced expiratory volume to forced vital capacity in the first second and the percentage of FEV1 in the predicted value(FEV1% Pred) in the observation group were higher than those in the control group(P < 0.05).After intervention, the maximum oxygen consumption, relative maximum oxygen uptake, peak oxygen pulse and maximum heart rate of two groups were better than those before intervention, and the observation group was higher than the control group(P < 0.05).After intervention, the quality of life score of the revised version of respiratory disease questionnaire scale in the two groups decreased, and that in the observation group was lower than that in the control group(P < 0.05). ConclusionsThe implementation of aerobic resistance exercise combined with health belief intervention in elderly patients with COPD can improve the cardiorespiratory reserve and improve the quality of life.
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