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2023 Vol. 48, No. 10
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2023, 48(10): 1329-1332.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.001
Abstract:
ObjectiveTo investigate the effect of abdominal paracentesis drainage (APD) against liver injury in rats with severe acute pancreatitis (SAP). MethodsThirty SD rats were randomly divided into SAP untreated group (SAP group), SAP APD group (APD group) and sham operation group (SHAM group), with 10 rats in each group.Sodium taurocholate was used to induce SAP model, ELISA method was used to detect the expression of tumor necrosis factor- α (TNF-α), interleukin (IL)-6 and IL-10 in rat peripheral blood; Western blotting was used to detect protein expression levels of TLR4, p-IκB, IRAK-4, TRAF6 and NF-κB p65 in liver tissue; morphology of liver tissue under microscope was observed. ResultsThe liver histopathological results showed that the degree of liver tissue damage in the APD group was lighter than that of the SAP group and heavier than that of the SHAM group.In peripheral blood, compared with SHAM group, the expression levels of TNF-α, IL-6 and IL-10 in APD group were significantly increased (P < 0.01);compared with SAP group, the expression levels of TNF-α and TL-6 in APD group decreased (P < 0.01), and the expression level of IL-10 increased significantly (P < 0.01).In liver tissue, compared with SHAM group, the expression levels of TLR4, p-IκB, IRAK-4, TRAF6 and NF-κB p65 protein in APD group increased significantly (P < 0.01);compared with SAP group, the expressions level of TLR4, p-IκB, IRAK-4, TRAF6 and NF-κB p65 protein in APD group decreased significantly (P < 0.01). ConclusionsEarly application of APD in rats with SAP combined with liver injury can reduce liver cell damage, and APD inhibits liver damage in SAP rats may be achieved by inhibiting the expression of TLR4/NF-κB signaling pathway.
2023, 48(10): 1333-1338.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.002
Abstract:
ObjectiveTo investigate the effects of gypenosides (Gyp) on hippocampal neuron autophagy and pathway of mammalian target of rapamycin (mTOR)/autophagy-activated kinase 1 (ULK1)/autophagy-related protein 13 (ATG13) in depression rats. MethodsSD rats were randomly divided into normal control group, model group, Gyp low (25 mg/kg), high (100 mg/kg) dose group, autophagy activator-rapamycin (Rap) group (1 mg/kg), and Gyp+Rap group (100 mg/kg+1 mg/kg), with 10 rats in each group.Chronic mild unpredictable stress was used to prepare rat depression models, and each group was administered for 4 weeks, once daily.Open field, sugar water preference and forced swimming tests were used to assess depression-like behavior in rats, transmission electron microscope was used to observe the changes in hippocampal neuron structure and the formation of autophagosomes and autophagolysosomes.TUNEL method was used to detect neuronal apoptosis.Immunohistochemical staining was used to detect the phosphorylation level of ULK1 (p-ULK1) and the positive expression level of p-ATG13 in the hippocampus.Western blotting was used to detect the total mTOR, p-mTOR, ribosomal S6 protein (S6), p-S6, ULK1 specific site Ser757 protein (ULK1 Ser757) and p-ULKl Ser757, autophagy-related protein Beclin1, microtubule-related protein Light chain 3 (LC3) protein, apoptosis-related protein-Caspase-3 (Caspase-3) and polyadenylic acid diphosphate ribose polymerase (PARP) protein expression levels. ResultsCompared with the normal control group, the central exploration time in the open field experiment and the percentage of sugar water intake in the model group were reduced, the time of forced swimming immobility was prolonged, the depressive behavior was severe, the nuclear membrane of hippocampal neurons was severely damaged, and autophagosomes were formed more, the apoptosis rate, apoptosis-related protein, Beclin1 and LC3 protein expression were increased, the phosphorylation level of mTOR/ULK1/ATG13 pathway protein was decreased, and the changes of each index were significantly different (P < 0.01).Compared with the model group, with the Gyp dose increased, the depressive behavior of rats was relieved, and the hippocampal neuronal apoptosis and level of autophagy were decreased, the phosphorylation level of mTOR/ULK1/ATG13 pathway protein was increased (P < 0.01);the phosphorylation level of mTOR/ULK1/ATG13 pathway protein in the hippocampus tissue of the Rap group was further reduced, the levels of hippocampal neuron apoptosis and autophagy were further increased, and the depression-like behavior in rats was further aggravated (P < 0.01).The changes of the above indicators in the Gyp+Rap group were opposite to those in the Gyp group (P < 0.01). ConclusionsGyp may inhibit autophagy by activating the activity level of mTOR phosphorylation and promoting the phosphorylation of ULK1 and ATG13, so as to prevent autophagic death of neurons, and exert antidepressant effect.
2023, 48(10): 1339-1345.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.003
Abstract:
ObjectiveTo investigate the effect of an injectable gelatin methacrylamide (GelMA) hydrogel scaffold loaded with CD271 and PDGF in the repair of skull defects in SD rats. MethodsThe GelMA/PDGF scaffold was jointly constructed by using a 5% GelMA hydrogel and PDGF, and then the scaffold was modified with the CD271 antibody.The experiments were divided into four groups: GelMA, GelMA/PDGF, GelMA/CD271, and GelMA/PDGF/CD271.The biocompatibility of the cells and the expression of osteogenic-related proteins were examined by co-culturing hydrogel scaffolds with male SD rat bone marrow mesenchymal stem cells (BMSCs) in vitro.The skull defect model was established in SD male rats weighing about 350 g and implanted with hydrogel scaffolds.Micro-CT of the rat skull was performed at 8 weeks after surgery to assess repair efficacy. ResultsBMSCs and GelMA hydrogel scaffold loaded with CD271 and PDGF had good biocompatibility, could upregulate the expression of osteogenic-related proteins (alkaline phosphatase, collagen Ⅰ, osteocalcin, and osteopontin), and promoted the repair of cranial defects in vivo. ConclusionsMixed hydrogel scaffold loading CD271 and PDGF has good biocompatibility and promotes the osteogenic differentiation of BMSCs, and has great application potential in bone tissue engineering.
2023, 48(10): 1346-1350.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.004
Abstract:
ObjectiveTo investigate the expression and clinical significance of long non-coding RNA Fez family zinc finger protein 1 antisense RNA1 (lncRNA FEZF1-AS1) and insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) in liver cancer tissues. MethodsThe liver cancer tissue and para-cancerous tissue specimens were collected from 60 patients with primary liver cancer.The expression of lncRNA FEZF1-AS1 and IGF2BP1 at mRNA levels in liver cancer tissues and adjacent tissues was detected with real-time fluorescent quantitative PCR (qRT-PCR) method, the expression of IGF2BP1 at protein level was detected with immunohistochemical staining method, the relationship between the expression levels of lncRNA FEZF1-AS1 and IGF2BP1 in liver cancer tissues and the clinicopathological characteristics were analyzed, the relationship between the expressions of lncRNA FEZF1-AS1 and IGF2BP1 in liver cancer tissues and the survival rate of liver cancer patients were analyzed with Kaplan-Meier survival analysis, and the correlation between lncRNA FEZF1-AS1 and IGF2BP1 mRNA expression levels in liver cancer tissues was analyzed with Pearson method. ResultsThe expression of lncRNA FEZF1-AS1, IGF2BP1 at mRNA level and the positive expression rate of IGF2BP1 protein in liver cancer tissues were significantly higher than those in adjacent tissues (P < 0.01), and the expression of lncRNA FEZF1-AS1 and IGF2BP1 at mRNA level in liver cancer tissues were positively correlated (r=0.602, P < 0.01).There was no significant differences in the expressions of lncRNA FEZF1-AS1 and IGF2BP1 among different ages, genders, tumor sizes, cirrhosis or not, and hepatitis B antigen negative and positive levels (P>0.05).The expression levels of lncRNA FEZF1-AS1 and IGF2BP1 were higher in patients with clinical stage Ⅲ-Ⅳ, low and moderate differentiation and lymph node metastasis (P < 0.05).Kaplan-Meier survival analysis showed that the 3-year cumulative survival rate of patients in lncRNA FEZF1-AS1 high expression group was significantly lower than that in lncRNA FEZF1-AS1 low expression group (31.45% vs 61.40%, P < 0.01), the 3-year cumulative survival rate of patients in IGF2BP1 positive expression group was significantly lower than that in IGF2BP1 negative expression group (31.18% vs 58.25%, P < 0.01). ConclusionsLncRNA FEZF1-AS1 and IGF2BP1 are highly expressed in liver cancer tissues, and their expressions are related to the pathological characteristics and prognosis of liver cancer patients, which may serve as potential prognostic markers for liver cancer patients.
2023, 48(10): 1351-1355.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.005
Abstract:
ObjectiveTo explore the clinical significance of the coagulation function index levels in patients with active multiple sclerosis(MS). MethodsForty-four patients with active MS and 88 healthy people were divided into the MS group and control group, respectively.The 5 mL of fasting venous blood in two groups were collected.The levels of fibrinogen, D-dimer, activated partial thromboplastin time, plasma prothrombin time and thrombin time were compared between two groups.The correlation between the EDSS score and levels of fibrinogen, D-dimer, activated partial thromboplastin time, plasma prothrombin time, thrombin time, serum alanine aminotransferase, aspartate aminotransferase, platelets and creatinine were analyzed using Spearman correlation analysis.The multiple regression analysis was used to further prove the correlation between the EDSS score and above blood indicators.The ROC curve was used to evaluate the sensitivity and specificity of fibrinogen and activated partial thromboplastin time to active MS. ResultsThe levels of plasma fibrinogen and D-dimer in MS group were higher than those in control group(P < 0.01).The activated partial thromboplastin time in MS group was lower than that in control group(P < 0.01).The fibrinogen level was positively correlated with EDSS score(B=0.623, P < 0.05), and the activated partial thromboplastin time level was negatively correlated with EDSS score(B=-0.187, P < 0.05).The sensitivity and specificity of the fibrinogen and activated partial thromboplastin time in predicting the activity of MS were 47.73% & 70.45% and 60.47% & 80.68%, respectively. ConclusionsIncreased fibrinogen and shortened activated partial thrombin time may be the risk factors of the severity of MS.The coagulation function indicators in patients with MS should be regularly tested, and patients with high levels of fibrinogen, D-dimer and activated partial thromboplastin time should be vigilant against MS activity.
2023, 48(10): 1356-1360.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.006
Abstract:
ObjectiveTo investigate the effect of celecoxib on serum interleukin-1β (IL-1β), interleukin-2 receptor (IL-2R) and lymphocyte subsets in patients with ankylosing spondylitis (AS). MethodsEighty-two AS patients were selected and divided into the control group and observation group randomly, with 41cases in each group.The control group was treated with etanercept injection, and the observation group was combined with celecoxib capsules on the basis of the control group.Both groups were given the continuous administration for 3 months.The serum IL-1β, IL-2R, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), lymphocyte subsets (CD3+CD4+, CD3+CD8+, CD3-CD19+, CD16+CD56+ accounted percentage of total lymphocytes), spinal function indexes (BASDAI score, BASFI score, Schober test distance, finger-to-ground distance for before and after treatment) and adverse reactions were compared between the two groups. ResultsThe serum IL-1β, IL-2R, CRP and ESR after treatment in the two groups were lower than those before treatment (P < 0.01).After treatment, the serum IL-1β, IL-2R, CRP, ESR in the observation group were lower than those in the control group (P < 0.01).After treatment, CD3+CD4+ cells and CD3-CD19+ cells were lower than those before treatment, and CD3+CD8+ cells and CD16+CD56+ cells were higher than those before treatment (P < 0.01).After treatment, CD3+CD4+ cells and CD3-CD19+ cells in observation group were lower than those in control group, and CD3+CD8+ cells and CD16+CD56+ cells were higher than those in control group (P < 0.01).After treatment, the BASDAI score, BASFI score and finger-to-ground distance were lower than those in the two groups after treatment, and the Schober test distance was higher than those before treatment (P < 0.01).After treatment, the BASDAI score, BASFI score and the finger-to-ground distance in observation group were lower than those in control group (P < 0.01), and there was no significant difference in the Schober test distance between the two groups (P>0.05).There was no statistically significant difference in the total incidence of adverse reactions (7.32% vs 9.76%) between the two groups (P>0.05). ConclusionsThe celecoxib in the treatment of AS patients can effectively reduce the serum IL-1β and IL-2R levels and improve the imbalance of lymphocyte subsets in patients, thereby promoting the recovery of patients' spinal function with few adverse reactions.Therefore, the treatment of celecoxib combined with etanercept in AS patients is safe and effective.
2023, 48(10): 1361-1365.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.007
Abstract:
ObjectiveTo investigate early detection methods for acute mesenteric ischemia (AMI), measures to improve efficacy, and risk factors affecting prognosis. MethodsA total of 139 patients with acute occlusive mesenteric ischemia were selected as the study subjects, and divided into cure group (n=104) and death group (n=35) based on prognosis.Their clinical data such as onset characteristics, diagnostic methods, treatment effects, and prognosis were retrospectively analyzed. ResultsAmong the 139 patients in this study, 40 cases were diagnosed with mesenteric artery embolism, 75 cases with mesenteric vein thrombosis, and 24 cases with mesenteric artery thrombosis.Among them, 18 cases underwent CTA/CTV examination, and 15 cases were directly diagnosed with AMI, with a sensitivity rate of 83.33%; 2 cases underwent digital subtraction angiography (DSA) examination, both were diagnosed with AMI.One hundred and three patients underwent surgical treatment, of which 26 cases died postoperatively, with a postoperative mortality rate of 25.24%; 34 patients underwent conservative treatment, of which 9 cases died, and the mortality rate after conservative treatment was 26.47%;2 patients undergoing intervention treatment were cured; the overall mortality rate of 139 patients was 25.18% (35/139).The influencing factors of prognosis were analyzed, and the results showed that increased age (OR=1.089, 95%CI: 1.004-1.182), elevated C-reactive protein levels (OR=1.015, 95%CI: 1.004-1.026), and elevated lactate levels(OR=4.302, 95%CI: 2.276-8.132) were all independent risk factors for death in AMI patients. ConclusionsCTA/CTV and DSA examinations are helpful for the early diagnosis of AMI.Targeted treatment including surgery, conservative treatment, and intervention therapy, as well as comprehensive treatment are very important.Early intervention therapy can improve survival rates for eligible patients.Increased age and elevated levels of C-reactive protein and lactate are important factors in predicting poor prognosis of AMI.
2023, 48(10): 1366-1369.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.008
Abstract:
ObjectiveTo investigate the relationship between serum 25-hydroxyvitamin D (25-OH-VD) level and thyroid function and thyroid autoantibodies in patients with type 2 diabetes mellitus. MethodsA total of 181 patients with type 2 diabetes mellitus were selected, including 101 patients with vitamin D deficiency, 62 patients with vitamin D insufficiency, and 18 patients with vitamin D sufficiency.The correlations between 25-OH-VD and total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), fasting blood glucose, glycosylated hemoglobin (HbA1c) and blood lipids among the three groups were analyzed. ResultsThere was no significant difference in thyroid function between the vitamin D deficient group and the vitamin D sufficient group (P>0.05), but the levels of TgAb, TPOAb, Cholesterol (TC), triglyceride (TG) and HbA1c in the vitamin D deficient group were higher than those in the vitamin D sufficient group (P < 0.05).Correlation analysis showed that 25-OH-VD was negatively correlated with HbA1c, TT3, TgAb, TPOAb, TG, TC and sex (P < 0.05).Logistic regression results found that sex and 25-OH-VD were the influencing factor of TPOAb positivity. ConclusionsVitamin D deficiency is common in type 2 diabetes mellitus.The level of vitamin D deficiency is correlated with the level of HbA1c, moreover, high 25-OH-VD level is a protective factor for TPOAb positivity.
2023, 48(10): 1370-1373.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.009
Abstract:
ObjectiveTo explore the prenatal diagnostic value of chromdsome microarray (CMA) in analyzing the thickening of nuchal translucency (NT) of fetus. MethodsA total of 139 women with gestational 11-14 weeks whose fetuses were detected with increased NT (NT≥2.5 mm) were selected.They were divided into four groups with NT value of 1 mm as an interval, including 2.5-3.4 mm, 3.5-4.4 mm, 4.5-5.4 mm, and ≥5.5 mm groups.Fetal specimens were performed for karyotype analysis and copy number variants (CNV) sequencing. ResultsWith the increase in NT thickness, the live birth rate tended to decrease (P < 0.01) and the corresponding abnormal CNV detection rate tended to increase (P < 0.01).Among the 139 cases, 35 cases (25.2%) had abnormal karyotype, 45 cases (32.3%) had abnormal CNV.Among the 12 cases with abnormal CNV and normal karyotype, 2 cases were pathogenic CNV, 7 cases were CNV of unknown clinical significance, and 3 cases were possibly benign CNV.There was no statistically significant difference in CNV abnormalities between elderly and non-elderly pregnant women (P>0.05).The rate of abnormal CNV in NT alone was lower than that of NT combined with other ultrasound (P < 0.05), and the rate of abnormal CNV was lower than that of induced labor in those with live births (P < 0.01). ConclusionsNT thickened fetuses should be combined with CMA karyotype analysis to provide the basis for genetic counseling, which is of great significance for prenatal diagnosis.
2023, 48(10): 1374-1377.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.010
Abstract:
ObjectiveTo observe the relationship between the serum levels of pentraxin 3 (PTX3) and C-reactive protein (CRP) and the severity and prognosis of elderly patients with acute cerebral infarction. MethodsThe levels of PTX3 and CRP in 120 patients were detected and divided into two groups according to NIHSS and BI score 2 months after discharge.Spearman correlation analysis and ROC curve were used to evaluate the correlation and predictive value of PTX3 and CRP with disease condition and prognosis. ResultsThe serum levels of PTX3 and CRP in the high NIHSS score group were significantly higher than those in the low NIHSS score group, PTX3 and CRP level in the good prognosis group were significantly lower than those in the poor prognosis group(P < 0.05 to P < 0.01).The levels of PTX3 and CRP were positively correlated with NIHSS score, and negatively correlated with BI (P < 0.01).The levels of PTX3 and CRP had good predictive value for disease condition and prognosis, and PTX3 was the best. ConclusionsPTX3 and CRP may be useful indicators to predict the severity and prognosis of elderly patients with acute cerebral infarction.
2023, 48(10): 1378-1383.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.011
Abstract:
ObjectiveTo investigate the effects of dexmedetomidine and midazolam on postoperative cerebral oxygen metabolism in patients with severe brain injury. MethodsA total of 30 postoperative patients with severe brain injury were randomly divided into dexmedetomidine group (n=15) and midazolam group (n=15).The heart rate (HR), mean arterial pressure (MAP), Glasgow coma score (GCS), Richmond restless sedation score (RASS), cerebral oxygen uptake rate and cerebral arteriovenous oxygen content difference before sedation and from the first to the fifth day of sedation were monitored, as well as the mechanical ventilation time, ICU hospital stay, total hospital stay, and 28-day Glasgow prognosis score. ResultsThere were no differences in age, gender, type of brain injury, Acute Physiology Age and Chronic Health Evaluation II score, GCS score and postoperative RASS score between the two groups (P>0.05).Before sedation, there were no significant differences in all indexes between the two groups (P>0.05).Compared with the midazolam group, the HR decreased on the first to fifth day in the dexmedetomidine group, and the MAP decreased on the fourth and fifth day (P < 0.05 to P < 0.01).Compared with that before sedation, HR decreased from the third day to the fifth day after sedation and MAP decreased from the first day to the fifth day after sedation in the dexmedetomidine group (P < 0.05 to P < 0.01).Compared with the midazolam group, the oxygenation index, jugular bulb venous oxygen pressure and jugular bulb venous oxygen saturation were increased in the dexmedetomidine group on the first day and second day after sedation (P < 0.05 to P < 0.01), and there was no statistical difference between cerebral oxygen uptake rate and cerebral arteriovenous oxygen content (P>0.05).The duration of mechanical ventilation was shortened in the dexmedetomidine group compared with that in the midazolam group (P < 0.05). ConclusionsCompared with midazolam, dexmedetomidine sedation can improve early cerebral oxygen metabolism, reduce HR and MAP, and shorten mechanical ventilation time in patients with severe craniocerebral injury.
2023, 48(10): 1383-1386.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.012
Abstract:
ObjectiveTo study the relationship between MAL protein and acute coronary syndrome (ACS) and the severity of coronary arteries. MethodsA total of 122 patients diagnosed as ACS were selected as the study group, and then divided into subgroups: acute myocardial infraction (AMI) group, including 60 patients; unstable angina(UA) group, including 62 patients.Patients who underwent coronary angiography that without markable coronary artery straitness were selected as control group.ELISA was used to evaluate the MAL protein of each group.The clinical significance and difference of MAL protein between groups were evaluated.Gensini score was used to evaluate the relationships between MAL protein and the straitness of acute coronary disease. ResultsThe level of serum MAL protein in AMI group and UA group was significantly higher than that in control group (P < 0.01), but there was no significant difference between UA group and AMI group (P>0.05).There was no significant correlation between serum MAL protein level and Gensini score in UA group and AMI group (P>0.05).Serum MAL protein level had a certain diagnostic reference value in the diagnosis of ACS.AUC of serum MAL protein for AMI was 0.863, 95%CI was 0.794-0.932, and AUC for UA was 0.768, 95%CI was 0.684-0.852. ConclusionsSerum MAL protein level in ACS patients is notably higher than that in people with with a normal coronary angiography result.The protein may be useful for the diagnosis of ACS in the future.
2023, 48(10): 1387-1391.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.013
Abstract:
ObjectiveTo investigate the clinical effect of complete neuroendoscopic microvascular decompression in the treatment of idiopathic trigeminal neuralgia. MethodsA total of 60 patients with idiopathic trigeminal neuralgia were retrospectively analyzed and divided into observation group and control group according to the treatment methods, 30 cases in each group.The observation group was treated with complete neuroendoscopic microvascular decompression, and the control group was treated with traditional microscopic vascular decompression.The clinical therapeutic effects of the two groups were compared. ResultsThe total effective rate of the observation group was higher than that of the control group (P < 0.05);there was a statistically significant difference in the detection rate of responsible vessels between two groups (P < 0.05);there was no significant difference in postoperative complications between the two groups (P>0.05). ConclusionsThe clinical effect of complete neuroendoscopic microvascular decompression in the treatment of idiopathic trigeminal neuralgia is significant, which has a high rate of discovery of responsible vessels, and improve the success rate of surgery.
2023, 48(10): 1391-1394.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.014
Abstract:
ObjectiveTo investigate the effects of different minimally invasive surgical methods in the treatment of previous cesarean scar defect(PCSD) after cesarean section. MethodsOne hundred and forty-four hospitalized patients with PCSD were selected.According to different surgical methods, the patients were divided into the vaginal surgery group(group A, 36 cases), hysteroscopic surgery group(group B, 71 cases) and hysteroscopic combined with surgery group(group C, 37 cases).The length of hospital stay, hospitalization cost, intraoperative blood loss, postoperative vaginal bleeding time, postoperative incidence rate of disease, postoperative symptom recovery and other indicators were compared among three groups. ResultsThe length and cost of hospitalization in group C were higher than those in group A and group B; the duration of postoperative vaginal bleeding in group C was higher than that in group A and group B, the amount of intraoperative bleeding in group A was higher than that in group B and group C, and the postoperative incidence rate of disease in group A was higher than that in group B and group C; the therapeutic effects of group B and group C were significantly higher than that in group A; and the differences of which were statistically significant (P < 0.05 to P < 0.01). ConclusionsThe three different surgical methods have different advantages and certain clinical effects.The short hospitalization time, low hospitalization cost and short postoperative vaginal bleeding time are the advantages of vaginal surgery, while its disadvantages are relatively large amount of intraoperative blood loss, high postoperative incidence rate of disease rate and low postoperative cure rate.The short hospitalization time, low hospitalization cost, short postoperative vaginal bleeding time, relatively low postoperative incidence rate of disease and high postoperative cure rate are the advantages of hysteroscopic surgery.The highest postoperative cure rate is the advantage of hysteroscopy combined with surgery, but its disadvantages are high hospitalization cost, hospital stay and long postoperative vaginal bleeding time.
2023, 48(10): 1395-1398.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.015
Abstract:
ObjectiveTo explore the relationship between the serum levels of homocysteine(Hcy), retinol binding protein(RBP) and urine microalbumin-creatinine ratio(ACR) in patients with type 2 diabetes mellitus. MethodsAccording to the urine ACR, 490 diabetic patients were divided into the normal albuminuria group(NA group, 378 cases with ACR < 30 mg/g), microalbuminuria group(MA group, 71 cases with ACR 30-300 mg/g) and large amount of albumin group(LA group, 41 cases with ACR >300 mg/g).The height, weight and body mass index(BMI) in all cases were measured, the serum levels of blood urea nitrogen(BUN), creatinine(Cr), Hcy, RBP, ACR, total cholesterol(TC), triglycerides(TG), low-density lipoprotein(LDL), high-density lipoprotein(HDL), fasting plasma glucose(FPG) and glycosylated hemoglobin(HbA1c) in three groups were examined, and the correlation between the serum levels of Hcy, RBP, Cr, BUN and ACR among three groups were analyzed. ResultsThere was no statistical significance in the age, BMI, HbA1C, FPG and TG among three groups(P>0.05).The course of disease and LDL level in NA group was lower than those in MA group and LA group, and which in MA group was lower than that in LA group; the level of HDL in NA group was higher than that in MA group and LA group, and which in MA group was higher than that in LA group; the TC level in LA group was higher than that in MA group and NA group(P < 0.05 to P < 0.01).The serum levels of Hcy, RBP, Cr and BUN in LA group increased compared with MA group and NA group, the serum levels of RBP, Hcy, Cr and BUN in MA group increased compared with the NA group, and the differences of which were statistically significant(P < 0.01).The serum levels of Cr, BUN, Hcy and RBP in patients were positively correlated with the urinary ACR level(P < 0.01). ConclusionsThe serum levels of Hcy and RBP can reflect the early diabetic kidney injury, and are positively correlated with urinary ACR, the serum RBP sensitivity is higher, and both of which have important value for early diagnosis of type 2 diabetic nephropathy.
2023, 48(10): 1398-1402.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.016
Abstract:
ObjectiveTo investigate the relationship between early morning blood pressure and neurological function and arterial elasticity in patients with non-disabling acute ischemic stroke. MethodsA total of 126 patients with acute non-disabling ischemic stroke were selected as the research object, and 100 healthy people who had physical examination during the same period were selected as the control group.Blood pressure, arterial elasticity index and neurological function score were detected and compared between the two groups, and the correlation between early morning blood pressure and arterial elasticity and neurological function was analyzed. ResultsThe mean systolic blood pressure and mean diastolic blood pressure in the morning in the case group were significantly higher than those in the control group (P < 0.01).The indexes of arterial elasticity, such as carotid radial pulse wave velocity (CrPWV), carotid intima-media thickness (IMT) and stiffness index β were significantly higher than those in the control group (P < 0.01).NIHSS score was also significantly higher than that of the control group (P < 0.01).According to the early morning systolic and diastolic blood pressure levels, the patients in the case group were divided into low-level group, medium-level group and high-level group.The differences of CrPWV, IMT, stiffness index β and NIHSS score of each group were statistically significant (P < 0.01).Correlation analysis showed that early morning blood pressure level was significantly positively correlated with CrPWV, IMT, stiffness index β and NIHSS score (P < 0.01).Multiple linear regression analysis showed that age and early morning systolic blood pressure were the independent influencing factors for CrPWV (P < 0.01 and P < 0.05);LDL-C and early morning systolic blood pressure were the independent influencing factors for IMT (P < 0.01);age, BMI, early morning systolic blood pressure and morning diastolic blood pressure were independent influencing factors for stiffness index β and WIHSS score (P < 0.05 to P < 0.01). ConclusionsEarly morning blood pressure is related to the degree of neurological impairment and arterial elasticity in patients with non-disabling acute ischemic stroke.
2023, 48(10): 1403-1406.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.017
Abstract:
ObjectiveTo investigate the correlation between Helicobacter pylori (Hp) infection and inflammatory response and leukocyte count in patients with chronic cor pulmonale. MethodsOne hundred and thirty-four in-patients with chronic cor pulmonale from February 2018 to July 2020 were selected as study subjects, who were divided into Hp-infected chronic cor pulmonale(n=82) and non-Hp-infected chronic cor pulmonale group(n=52) according to their Hp infection status.The 336 patients without chronic cor pulmonale were selected as the control group, who were divided into Hp-infected control group(n=88) and non-Hp-infected control group(n=248) according to their Hp infection or not.The blood gas indexes, interleukin(IL)-6, IL-8, tumor necrosis factor-α(TNF-α), hypersensitive C reactive protein(hs-CRP) levels and peripheral blood leukocytes were detected and compared, and the correlations were analyzed by multi-factor regression analysis. Results61.19% patients were Hp positive in chronic cor pulmonale group, which was significantly higher than that of 26.19% in the control patients(P < 0.01).The arterial partial pressure of oxygen(PaO2), saturation of oxygen(SaO2) and acid-base(pH) values of patients in the chronic cor pulmonale group were significantly lower than those in the control group, and the arterial partial pressure of carbon dioxide(PaCO2) was significantly higher than that in the control group (P < 0.01).The PaO2, SaO2 and pH values of patients in the Hp infection group were significantly lower than those in the non-Hp-infected group, while PaCO2 was significantly higher than that in the non-Hp-infected group(P < 0.01).IL-6, TNF-α, hs-CRP and IL-8 levels were significantly higher in patients in the chronic cor pulmonale group than those in the control group, and the serum inflammatory factor levels were also significantly higher in the Hp-infected group than those in the non-Hp-infected group(P < 0.01).The leukocyte count and neutrophil fraction were significantly higher in the chronic cor pulmonale group than those in the control group, and both were also significantly higher in the Hp-infected group than those in the non-Hp-infected group(P < 0.01).Multivariate logistic regression analysis revealed that Hp infection in patients with chronic cor pulmonale was associated with total leukocyte and absolute neutrophil values, serum IL-6, TNF-α, hs-CRP and IL-8 levels, and functional indicators of blood gas analysis, PaO2, PaCO2 and SaO2(P < 0.05 to P < 0.01). ConclusionsHp infection is associated with the impairment of pulmonary function, systemic inflammatory response and hypoxemia in patients with chronic cor pulmonale.
2023, 48(10): 1407-1411.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.018
Abstract:
ObjectiveTo analyze the expressions of omentin-1 and vascular cell adhesion molecule-1 (VCAM-1) before and after renal transplantation, and to explore the correlation between the expressions of omentin-1 and VCAM-1 and cardiovascular events after renal transplantation. MethodsA total of 105 patients with renal transplantation were selected.Among them, 49 patients with cardiovascular events after operation were defined as the study group, and 56 patients without cardiovascular events were defined as the control group.The levels of serum omentin-1 and VCAM-1 were detected by enzyme-linked immunosorbent assay.Pearson method was used to analyze the correlation between the expressions of omentin-1 and VCAM-1.ROC curve was drawn to evaluate the predictive value of omentin-1 and VCAM-1 levels on cardiovascular events after renal transplantation.Kaplan-Meier curve was used to analyze the relationship between the expression levels of serum omentin-1 and VCAM-1 and postoperative cardiovascular events.COX regression analysis was used to analyze the risk factors of cardiovascular events after renal transplantation. ResultsThere was no significant difference in the expressions of serum omentin-1 and VCAM-1 between the two groups before operation (P>0.05).After operation, the expression level of serum omentin-1 in the study group was significantly lower than that in the control group (P < 0.01), and the expression level of VCAM-1 in the study group was significantly higher than that in the control group (P < 0.01).After renal transplantation, the expressions of serum omentin-1 and VCAM-1 were negatively correlated (r=-0.734, P < 0.05).ROC curve showed that the area under the ROC curve (AUC) of serum omentin-1 and VCAM-1 in predicting cardiovascular events was 0.899 (95%CI: 0.832-0.966) and 0.833 (95%CI: 0.747-0.920), and the cut-off value was 149.25 μg/L and 1142.443 ng/mL, the sensitivity was 91.8% and 65.3%, and the specificity was 87.5% and 98.2%.The AUC of the combined prediction was 0.915 (95%CI: 0.853-0.977), the sensitivity was 87.8%, and the specificity was 89.3%.The incidence of cardiovascular events 5 years after operation was as follows: patients in the high expression group of omentin-1 were significantly lower than those in the low expression group, and patients in the high expression group of VCAM-1 were significantly higher than those in the low expression group (P < 0.01 and P < 0.05).The high expression of serum omentin-1 was an independent protective factor of cardiovascular events in patients with asthma after renal transplantation (P < 0.01), and the high expression of serum VCAM-1 and hyperglycemia were the independent risk factors of cardiovascular events after renal transplantation (P < 0.01 and P < 0.05). ConclusionsThe expressions of serum omentin-1 and VCAM-1 are closely related to the occurrence of cardiovascular events after renal transplantation, and can be used as predictors of cardiovascular events after renal transplantation.
2023, 48(10): 1412-1416.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.019
Abstract:
ObjectiveTo detect the expression of Cbl-b gene and platelet parameters in peripheral blood mononuclear cells (PBMCs) of patients with primary immune thrombocytopenia (ITP) and investigate their clinical significance. MethodsA total of 68 patients initially diagnosed with ITP (ITP group) and 40 healthy subjects (control group) were selected for the study.The relative expression of Cbl-b mRNA and platelet parameters [platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet larger cell ratio (P-LCR)] were detected and compared between the two groups.The difference in Cbl-b mRNA expression between other subgroups of patients in the ITP group was detected and its correlation with some clinical indicators was analyzed.Logistic regression and ROC curves were used to analyze the risk factors for the development of ITP as well as its diagnostic value for ITP. ResultsThe expression of Cbl-b mRNA and PLT in the ITP group were lower than those in the control group (P < 0.01).MPV, PDW and P-LCR were higher than those in the control group (P < 0.01).The expression of Cbl-b mRNA increased with higher platelet grading, and it was higher in the bleeding score < 2 points subgroup than it in the bleeding score ≥2 points subgroup (P < 0.05 to P < 0.01).The expression of Cbl-b mRNA was positively correlated with PLT (P < 0.01) and negatively correlated with bleeding score, MPV and P-LCR (P < 0.05 to P < 0.01).The logistic regression analysis showed that the decreased expression of Cbl-b mRNA (OR=17.525, 95%CI: 2.589-118.637), elevated MPV (OR=2.515, 95%CI: 1.506-4.200) and elevated P-LCR (OR=1.211, 95%CI: 1.067-1.376) may be the independent risk factors for ITP (P < 0.01).The ROC curve analysis showed that the area under curve for Cbl-b mRNA, MPV, P-LCR and the combination of the three indicators to predict the occurrance of ITP were 0.920, 0.899, 0.883 and 0.972, and the predicted area under curve of the combined tests was higher than that of the single test. ConclusionsCbl-b gene expression in PBMCs is decreased, MPV and P-LCR are increased in ITP patients.Cbl-b gene correlates with bleeding score, PLT, MPV and P-LCR, and the abnormal expression of them may be a risk factor for ITP.Combined detection of the three indicators has a high predictive value for ITP.
2023, 48(10): 1417-1420.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.020
Abstract:
ObjectiveTo investigate the application value of two-dimensional speckle tracking imaging(2DSTI) in the evaluation of left atrial structure and function in elderly patients with nonvalvular atrial fibrillation(NVAF). MethodsSixty elderly NVAF patients and 60 healthy volunteers were divided into the observation group and control group, respectively.According to the size of left atrium, the observation group was divided into the left atrium enlargement group and nonenlargement group.The observation group and control group were examined using dimensional ultrasound and 2DSTI to obtain relevant parameters[including left atrial maximum anterior posterior diameter(LAD), left atrial maximum volume(LAVmax), left atrial volume index(LAVI), left atrial minimum volume(LAVmin), left atrial emptying fraction(LAEF), ventricular systolic left atrial strain(LASS), strain rate(LASRS), atrial systolic left atrial strain(LASA) and strain rate((LASRA)], and the results of left atrial structure and function were compared between two groups. ResultsThe LAD, LAVmin and LAVI in observation group were higher than those in control group, and the LAEF, LASS, LASRS, LASA and LASRA in observation group were lower than those in control group(P < 0.01).The levels of LAEF, LASS, LASRS, LASA and LASRA in left atrium nonenlargement group were lower than those in control group, and the levels of LAEF, LASS, LASRS, LASA in left atrium enlargement group were lower than those in left atrium nonenlargement group and control group(P < 0.05 to P < 0.01), but there was no statistical significance in the LASRA level between the left atrium nonenlargement group and enlargement group(P>0.05).The results of Pearson correlation analysis showed that the LASS and LASA decreased with the increasing of LAVI, and which was negatively correlated(r=-0.702, -0.741, P < 0.05). ConclusionsThe 2DSTI examination can quantitatively detect the impairment of left atrial function in patients with NVAF.The impairment of left atrial function may still be detected in patients without atrial enlargement, and the left atrial function decreases with the enlargement of left atrium.
2023, 48(10): 1421-1426.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.021
Abstract:
ObjectiveTo explore the application value of mammography radiomics nomogram in predicting the expression status of breast cancer Her-2 before surgery. MethodsA retrospective analysis was performed for 262 women with invasive ductal carcinoma (IDC) who underwent a mammogram before surgery or puncture.According to the 7∶3 ratio, 183 cases were randomly divided into training set, and 79 cases into test set.Region of interest (ROI) was manually delineated by mammogram image, radiomics features were extracted by least absolute shrinkage and selection operator (LASSO) regression, dimensionality reduction was retained through statistical and LASSO machine learning methods, and logistic regression was used as a classifier to estabish radiomics models; combined with image data, single-multivariate logistic regression was used to screen independent risk factors to establish image feature models.The radiomics nomogram model was established by combining the radiomics features with independent risk factors.The ROC curve was used to analyze the predictive performance of each model, calculate the area under the curve (AUC), and draw the calibration curve and decision curve to evaluate its efficiency. ResultsThe nomogram model had the best prediction performance, with the training set sensitivity of 84.62% and specificity of 84.75%, the AUC value of 0.920, the sensitivity of the test set of 84.00%, the specificity of 83.33%, and the AUC value of 0.916.In the calibration curve, the prediction curve of the nomogram model was in good agreement with the ideal curve, and the decision curve had a good net benefit. ConclusionsMammograms can be a useful tool for preoperative assessment of Her-2 status in breast cancer patients.
2023, 48(10): 1427-1431.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.022
Abstract:
ObjectiveTo understand the current situation of disease uncertainty in patients after laparoscopic pancreatic necrosectomy, and to explore its influencing factors. MethodsA total of 105 patients who underwent laparoscopic pancreatic necrotic tissue removal were selected as the research object by convenience sampling method.The general situation questionnaire, disease uncertainty scale and social support rating scale were used to understand the current situation of patients' disease uncertainty, and the influencing factors were determined in combination with multiple linear regression.In this study, 105 questionnaires were distributed and 105 valid questionnaires were recovered, with an effective recovery rate of 100%. ResultsThe disease uncertainty score of patients after laparoscopic pancreatic necrosectomy was (95.40±8.46) points, which was at a medium to high level.Pearson analysis showed that the level of social support was negatively correlated with the patient's sense of disease uncertainty (P < 0.01);the results of multiple linear regression showed that lower educational level, more than 1 debridement during hospitalization, tube insertion at discharge, and longer hospitalization time were risk factors for patients' disease uncertainty (P < 0.05 to P < 0.01). ConclusionsAt present, the disease uncertainty of patients after laparoscopic pancreatic necrosectomy is at a medium to high level, which should be paid attention to in clinical nursing.Analyzing its influencing factors and formulating targeted nursing strategies can provide reference for reducing patients' disease uncertainty and providing high-quality nursing services.
2023, 48(10): 1431-1436.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.023
Abstract:
ObjectiveTo analyze the risk factors of postpartum anxiety in preeclampsia pregnant women, and to initially construct a clinical risk prediction model for preeclampsia pregnant women complicated with postpartum anxiety. MethodsTwo prospective collections of preeclampsia pregnant women were enrolled in the cohort.Among them, 264 cases were collected from January 2017 to January 2019 as training samples to construct a prediction model, and 100 cases collected from March 2019 to January 2020 were used as validation samples for clinical validation of the prediction model.After the research subjects were included in the cohort, their basic data were collected according to standard operating procedures, and various physiological and biochemical indicators were obtained by laboratory examinations.The end point of the study was whether there was postpartum anxiety at 6 weeks postpartum.Firstly, the cohort from January 2017 to January 2019 was established with a prediction model, and a stepwise regression method was used to perform multivariate logistic regression analysis to screen independent risk factors for preeclampsia pregnant women complicated with postpartum anxiety, and to construct a prediction model.Then, Hosmer-Lemeshow was used to test the calibration of the model, and the area under the ROC curve was used to evaluate the discriminative ability of the model.Lastly, the cohort from March 2019 to January 2020 was used to prospectively validate the prediction model to evaluate the clinical applicability of the model. ResultsTwenty-three cases of 264 training samples were excluded due to loss of follow-up and poor outcome, and 241 cases completed the study, of which 63 cases developed postpartum anxiety, accounting for 26.14% (63/241).Analysis of baseline data of 241 pregnant women complicated with preeclampsia showed that the relationship between couples, whether family members had sex discrimination, hematocrit (Hct), estradiol (E2), and interleukin 6 (IL-6) might be influencing factors of preeclampsia pregnant women complicated with postpartum anxiety (P < 0.05 to P < 0.01).Logistic regression analysis showed that poor relationship between couples, gender discrimination in family members, Hct ≥53.70%, E2≤45.80 pg/mL, IL-6 ≥58.66 pg/mL were risk factors for preeclampsia pregnant women complicated with postpartum anxiety (P < 0.05 to P < 0.01).A prediction model of postpartum anxiety in preeclampsia pregnant women was constructed: Logit (P)=0.725×couple feelings+0.752×sex discrimination in family members + 1.277×Hct+1.657×E2+0.787 × (IL-6)-3.670.The area under the ROC curve of this prediction model was 0.829 (95%CI: 0.768-0.890), the threshold of the model was 0.411 through the maximum Youden index (0.521), the corresponding sensitivity was 0.821, and the specificity was 0.800.The goodness of fit test was used to evaluate the calibration of the prediction model, which showed that the prediction model had good fitting degree and high accuracy (χ2=5.26, P>0.05).It was clinically verified that the sensitivity of this model to predict postpartum anxiety in pregnant women with preeclampsia was 84.00%, the specificity was 78.79%, and the accuracy was 80.22%. ConclusionsPoor relationship between couples, gender discrimination in family members, Hct≥53.70%, E2≤45.80 pg/mL, IL-6≥58.66 pg/mL are risk factors for preeclampsia pregnant women complicated with postpartum anxiety.The prediction model based on those has good differentiation ability, high calibration, high accuracy, strong operability and high clinical value.
2023, 48(10): 1436-1440.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.024
Abstract:
ObjectiveTo analyze the status and influencing factors of stress among nursing students in late-stage of clinical practice, so as to provide reference for developing targeted interventions to relieve the stress. MethodsA total of 214 nursing students in late-stage of clinical practice were investigated with the positive psychological capital questionnaire, simple coping style scale and pressure source questionaire. ResultsThe average stress score of nursing students in late-stage of clinical practice were (3.13±0.69) points.The results of multiple stepwise regression showed that personal professional attitude, parents' attitude towards nursing students' professional choice, resilience of psychological capital and negative coping style were the influencing factors of stress (adjusted R2=0.314).The more individuals like their professional attitude, the more parents support nursing students in choosing nursing majors.The higher the score of psychological capital resilience, the lower the score of negative coping styles, and the lower the pressure on nursing students. ConclusionsThe stress of nursing students in late-stage of clinical practice is in the middle level.The personal professional attitude, parents' attitude, resilience of psychological capital and negative coping style can affect the stress level.
2023, 48(10): 1441-1444.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.025
Abstract:
ObjectiveTo explore the influencing factors of hypoglycemia newborns delivered by pregnants with gestational diabetes mellitus(GDM), and construct a risk prediction model. MethodsThe clinical data of 479 GDM pregnants with regular obstetric check-ups and their newborns were retrospectively analyzed.According to the blood glucose level of newborns delivered by GDM pregnants, the newborns were divided into the hypoglycemia group(n=71) and normal group(n=408).The clinical data between two groups were compared.Multivariate logistic regression was used to analyze the influencing factors of hypoglycemia in newborns delivered by GDM pregnants with.The nomogram model was drawn using R3.4.3 software, and the receiver operating characteristic(ROC) curve was used to evaluate the discrimination of the nomogram model.The predictive performance of the nomogram model in 1 000 samples was verified using the repeated sampling method(Bootstrap). ResultsThe differences of the gestational week, prenatal BMI, fetal body mass, prenatal training, blood glucose during delivery and delivery mode between two groups were statistically significant(P < 0.05 to P < 0.01).The results of multivariate logistic regression analysis showed that the pregnant women with high prenatal BMI(OR=1.887, 95%CI: 1.215-3.454), poor blood glucose control during delivery(OR=2.581, 95%CI: 1.762-5.283) and cesarean section(OR=1.889, 95%CI: 1.274-3.548) were the risk factors of neonatal hypoglycemia in GDM mothers(P < 0.01).The long gestational week of puerpura(OR=0.488, 95%CI: 0.274-0.892), estimating the heavy fetal body mass(OR=0.472, 95%CI: 0.171-0.895) and more maternal prenatal training(OR=0.558, 95%CI: 0.215-0.781) were the protective factorsof neonatal hypoglycemia delivered by GDM mothers(P < 0.05 to P < 0.01).Based on the above six indicators, the nomogram prediction model was constructed.The results of ROC curve analysis showed that the AUC area of the nomogram model predicting the risk of hypoglycemia in newborns delivered by GDM mothers was 0.869(95%CI: 0.815-0.906), which indicated that the discrimination ability of model was good.The results of Bootstrap test shows that the MAE of deviation calibration curve was 0.015, which indicated that the deviation calibration curve fit well with the ideal curve. ConclusionsIt is of certain value to construct a predictive model of hypoglycemia risk of neonates delivered by GDM pregnants based on gestational age, prenatal BMI, fetal weight, prenatal training, blood glucose during delivery and delivery methods.
2023, 48(10): 1445-1450.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.026
Abstract:
ObjectiveTo investigate the relationship between cancer-related fatigue and social support and hope levels in patients with multiple myeloma undergoing chemotherapy. MethodsA total of 178 patients with multiple myeloma chemotherapy were chosen as the research objects.The patients' general information was investigated, and cancer fatigue scale (CFS), Herth hope index (HHI), social support rate scale (SSRS) were used to evaluate the cancer related fatigue degree, level of hope and social support of patients.Pearson analysis and logistic regression analysis were used to analyze the relationship between cancer induced fatigue and other indicators. ResultsIn the general data of patients, gender, residence, economic income, anemia degree and treatment methods had statistically significant effects on CFS scores (P < 0.01).The scores of CFS, HHI and SSRS were (25.46±3.35) points, (35.75±4.39) points and (21.46±3.21) points, respectively.The correlation analysis results showed that cancer related fatigue was negatively correlated with the level of hope, overall support, subjective support and utilization of social support (r=-0.268, -0.795, -0.795, -0.695, P < 0.05).Logistic regression analysis showed that positive action, subjective support and objective support were negatively correlated with cancer related fatigue (P < 0.05 to P < 0.01). ConclusionsThe patients with multiple myeloma undergoing chemotherapy were mostly in the middle level of cancer related fatigue, with low level of hope and social support, the patient's hope level and social support can be improved to alleviate or avoid cancer related fatigue.
2023, 48(10): 1451-1456.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.027
Abstract:
ObjectiveTo understand the current status of medication compliance in patients with coronary heart disease after percutaneous coronary intervention(PCI), and to analyze the mediating effect of mindfulness psychological trait on health literacy and medication compliance. MethodsThe convenience sampling method was used to select 212 patients with coronary heart disease after PCI as the research objects.The general situation questionnaire, five-factor mindfulness scale, health literacy of patients with chronic diseases and Morisky medication compliance scale were used to conduct questionnaire survey.Pearson analysis was used to analyze the correlation between mindfulness psychological trait, health literacy and medication compliance, and a structural equation model was established to test the mediating effect. ResultsThe total score of mindfulness psychological trait of patients with coronary heart disease after PCI was (96.76±10.64) points, the total score of health literacy was (87.55±9.47) points, and the total score of medication compliance was (6.24±0.72) points.Pearson analysis results showed that the total scores of mindfulness psychological trait and 4 dimensions were positively correlated with the total scores of health literacy and 3 dimensions (P < 0.05 to P < 0.01);the total scores of mindfulness psychological trait and the 4 dimensions were positively correlated with the total scores of medication compliance (P < 0.01);the total score of health literacy and the 4 dimensions were positively correlated with the total score of medication compliance (P < 0.01).The results of the structural equation model showed that the mindfulness psychological trait had a partial mediating effect between health literacy and medication compliance, and the mediating effect accounted for 35.38% of the total effect. ConclusionsThe scores of mindfulness psychological trait, health literacy, and medication compliance in patients with coronary heart disease after PCI are all at a moderate level.There is a close positive correlation between medication compliance and health literacy and mindfulness psychological trait in patients.Mindfulness psycholegical trait has 35.38% mediating effect between health literacy and medication compliance.
2023, 48(10): 1457-1461.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.028
Abstract:
ObjectiveTo explore the current situation and influencing factors of prehospital self-rescue ability in patients with coronary heart disease. MethodsA total of 189 patients with coronary heart disease were selected as the research object, and the self-rescue ability of the patients was investigated through the pre-hospital self-help ability questionnaire.The patients were divided into the high ability group and the low ability group according to the self-rescue ability score.The sociodemographic characteristics, past history, and disease cognition of the two groups were compared, and multiple linear regression was used to analyze the related factors affecting self-rescue ability. ResultsAmong the 189 questionnaires, 3 invalid questionnaires were excluded, and 186 valid questionnaires were finally obtained, including the high-ability group (89 cases) and the low-ability group (97 cases).There were statistically significant differences between the two groups in age, gender, whether to live alone, education level and place of residence (P < 0.05).There was no statistically significant difference in body mass index, ethnicity, marital status, monthly income, and medical insurance (P>0.05).The difference between the two groups with or without cerebrovascular disease, hyperlipidemia, and family history of coronary heart disease was statistically significant (P < 0.05), and the difference between the two groups with or without diabetes and hypertension was not statistically significant (P>0.05).The difference in disease awareness, relevant training, self-rescue information and sources of self-rescue knowledge between the two groups was statistically significant (P < 0.05).Multiple linear regression analysis showed that age, lack of disease awareness, self-rescue knowledge from family members and self-rescue information sources from propaganda boards significantly negatively affected the pre-hospital self-rescue ability of coronary heart disease patients.In addition, the course of disease and self- rescue training experience had a significant positive impact on coronary heart disease.The prehospital self-rescue ability of patients with heart disease (P < 0.05 to P < 0.01). ConclusionsPatients with older age, lack of disease awareness, self-rescue knowledge from family members and self-rescue information from propaganda boards had low pre-hospital self-rescue ability, while those with long disease duration and self-rescue training experience had the higher pre-hospital self-rescue ability.
2023, 48(10): 1462-1464.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.029
Abstract:
ObjectiveTo explore the application effect of action-oriented method in clinical teaching of master's professional degree students majoring in surgery, and to provide reference for improving the quality of clinical teaching for master's professional degree students majoring in surgery. MethodsFifty-one master's professional degree students majoring in surgery who received clinical teaching in gastroenterology were randomly divided into an observation group (n=26) and a control group (n=25).Action-oriented and traditional teaching methods were used for clinical teaching, respectively.One month later, clinical teaching effectiveness evaluation and satisfaction survey of teaching effectiveness were conducted. ResultsThe students in the observation group achieved higher scores in theoretical written tests, medical record writing, case analysis, skill operations, and total scores than the control group (P < 0.05 to P < 0.01).The satisfaction scores and total scores of the observation group students in terms of learning interest, teaching mode, and practical ability cultivation were also higher than those of the control group (P < 0.01). ConclusionsThe action-oriented teaching model can significantly enhance students' self-learning ability, effectively cultivate the clinical thinking of master's professional degree students majoring in surgery, and improve the clinical training effect of surgical master's professional degree students majoring in surgery.
2023, 48(10): 1465-1468.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.030
Abstract:
ObjectiveTo investigate the application effects of problem-based learning(PBL) mode assisted by picture archiving and communication system(PACS) in the teaching of rare cardiovascular diseases by cardiovascular specialists. MethodsA total of 16 students who underwent standardized training for cardiovascular specialists were selected as the study objects, and divided into the observation group and control group(8 trainees in each group).The observation group was taught using PBL based on the PACS system, while the control group was taught only using PBL teaching.The rare disease theory in all trainees was tested before and after the course to assess their knowledge of rare diseases.After the course, the course performance(including regular grades and theory tests) in all students were assessed, and the course satisfaction was investigated by questionnaire. ResultsThere was no statistical significance in the results of the theoretical test on rare diseases before the lecture between two groups(P>0.05).However, the total scores in the observation group were significantly higher than those in control group after the lecture(P < 0.01).The scores of individual speaking enthusiasm and group cooperation in the observation group were significantly higher than those in control group(P < 0.01).In theory examination, the scores of objective questions, image analysis and case analysis in the observation group were significantly higher than those in control group(P < 0.01).The results of questionnaire survey showed that the satisfaction in the improvement of cardiovascular image reading ability in the observation group was better than that in control group(P < 0.05). ConclusionsThe PACS-assisted PBL teaching mode is helpful to improve the cognition of special training students to rare cardiovascular diseases, and improve the teaching quality.
2023, 48(10): 1469-1471.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.031
Abstract:
ObjectiveTo compare the teaching effect of obstetrics and gynecology course in the intelligent classroom environment. MethodsClasses A and class B of the same grade were randomly assigned.The teaching of obstetrics and gynecology course adopted different modes.Class A in the intelligent classroom environment was the experimental group, while class B in the traditional teaching environment was the control group.The final exam scores and other teaching effect indicators of the two groups were compared. ResultsThe pass rate (≥60 points) and excellent rate (≥80 points) of group A reached 100.0 % and 72.0%, respectively, both of which were higher than those of group B (P < 0.05).In terms of overall teaching effectiveness, students' mastery of obstetrics and gynecology knowledge and skills, improvement of students' ability to analyze and solve problems, improvement of communication and collaboration abilities, informatization level, and teacher-student interaction in group A were superior to group B, with statistically significant differences (P < 0.01). ConclusionsIn the smart classroom environment, the overall teaching effect of obstetrics and gynecology course is better than that of the traditional teaching mode.The pass rate and excellent rate of students in the final examination have been improved, and the students' ability in all aspects can be improved.
2023, 48(10): 1472-1474.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.032
Abstract:
ObjectiveTo analyze the application effects and students' recognition degree of integrating ideological and political elements into situational simulation teaching in Medical Genetics experiment course. MethodsOne hundred and eighty undergraduate students majoring in clinical medicine from the 2021 grade students(6 classes) were divided into the control group (90 students taught by traditional laboratory teaching methods) and the observation group (90 students taught by situational simulation teaching combined with ideological and political elements).The grades of experimental results, evaluation of the core dimension of medical ethics and recognition degree of teaching methods for ability improvement were compared between two groups. ResultsThe experimental class scores of the observation group were better than those of the control group(P < 0.05).The approaching clinical experience, improving learning initiative, improving doctor-patient communication skills and improving humanistic care awareness in the observation group were significantly higher than those in control group(P < 0.01).At the same dependent variable level, the results of multiple linear regression analysis of core dimensions of medical ethics and professionalism showed that the score of very dimension and total score in the observation group were higher than those in control group(P < 0.05 to P < 0.01). ConclusionsThe application of situational simulation teaching combined with ideological and political elements in the Medical Genetics experiment course is helpful to improve the students' experimental results and cultivate the good medical ethics, and students have a high degree of recognition for ability improvement.
2023, 48(10): 1475-1478.
doi: 10.13898/j.cnki.issn.1000-2200.2023.10.033
Abstract:
ObjectiveTo understand the sources and influencing factors of psychological stress among clinical medical graduate students, and provide support for graduate students' mental health education. MethodsA self-designed Graduate Psychological Stress Survey Questionnaire was used to investigate and analyze the current status and influencing factors of psychological stress among 462 clinical medical graduate students. ResultsAmong the 462 medical graduate students, 311 students (67.32%) had stress perception.Medical graduate students who resided in cities and towns had a higher perception of stress than those in rural areas and cities (P < 0.05), and the number of people with stress in the second year and above of doctoral program was higher than that in the first year of doctoral program (P < 0.05).The sources of stress from high to low were as follows: learning, environment, employment, economy, and emotion factors.Among the 311 medical graduate students with stress perception, 230 students (73.95%) felt stress for less than 6 months (short-term) and 81 students (26.05%) felt stress for more than 6 months (long-term).Gender and stress sources including learning, employment, emotion, and economy factors were the influencing factors of perceived stress time (P < 0.05 to P < 0.01).Female students were more prone to long-term stress than male students, and emotion and economy factors of stress sources increased the risk of long-term stress (P < 0.05 to P < 0.01). ConclusionsThe stress perception rate of medical graduates is relatively high, residence and grade are the influencing factors of stress perception, and gender, emotion and economy factors of stress sources are the influencing factors for the duration of stress.Teaching management departments should pay attention to students in senior grades and those who live in cities and towns, and also to the time periods when pressure is prone to occur such as entering higher education and employment, provide targeted psychological counseling to students, and cooperate with tutors and full-time head teachers to guide medical graduate students in handling the pressures and challenges of work and study actively.
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