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2023 Vol. 48, No. 12
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2023, 48(12): 1621-1626.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.001
Abstract:
ObjectiveTo evaluate the efficacy and safety of gelatin hydrogel microspheres prepared by microfluidic technique for loading ropivacaine in the treatment of incision pain. MethodsThe hydrogel microspheres were prepared by microfluidic technique, the methacryloyl gelatin (GelMA) droplets were obtained by coaxial shearing, and then the hydrogel microspheres were obtained by UV curing after cyclic freezing.Ropivacaine was loaded into hydrogel microspheres through coincubation, the surface characteristics of the microspheres were observed with optical microscope and scanning electron microscope, and the release rate in vitro was measured by dialysis.L-929 and SH-SY5Y cells were divided into 0.9% sodium chloride solution control group (Ctr group), hydrogel microsphere group (GelMA group), ropivacaine group (R group), hydrogel microsphere ropivacaine group (Gel-R group), respectively.Cell proliferation and survival were detected by CCK8 method and Calcein/PI live/dead staining method.SD rats were randomly divided into blank control group 2 (Ctr group 2), microsphere group 2 (GelMA group 2), ropivacaine group 2 (R group 2), hydrogel microsphere ropivacaine group 2 (Gel-R group 2).The mechanical pain threshold in behavior was determined with vonfrey method in the incision pain rat models.The incisional tissues of the rat's foot, and hearts, livers, kidneys were harvested to determine histocompatibility by HE staining. ResultsThe hydrogel microspheres prepared by microfluidic technique had the characteristics of rounded shape, concentrated particle size distribution, and loose and porous structure, which possessed the function of loading and slowly releasing ropivacaine.In the cell experiment, the results of CCK8 method showed that the toxicity of the Gel-R group was lower than that of the group R (P < 0.05).The live/dead staining results showed that during the 5-day culture period, compared with other groups, more dead cells appeared in the R group.Behavior results suggested that the Gel-R group 2 exhibited analgesic effects throughout the entire incision healing process.The HE staining indicated that there was no significant tissue damage or inflammatory response in the tissues at each incision, and no obvious pathological manifestations were observed in the organs. ConclusionsThe gelatin hydrogel microspheres prepared by microfluidic technique have the properties of regular morphology and complete structure, and they can prolong the action time of ropivacaine and have good biocompatibility in animal models and cell experiments.
2023, 48(12): 1627-1633.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.002
Abstract:
ObjectiveTo investigate the effects of miR-302c on regulating the expression of CXC chemokine ligand 8 (CXCL8) on the proliferation and invasion of esophageal squamous cell carcinoma (ESCC) cells. MethodsThe ESCC tissues and their corresponding adjacent tissues were collected from ESCC patients who underwent surgical treatment, as well as human ESCC cell lines Eca109, Ec9706, TE-11, TE-10 and normal esophageal epithelial cell line Het-1A were set as the study subjects, the expression of miR-302c was detected by qRT-PCR.Eca109 cells were transfected with LipofectamineTM2000 transfection kit and divided into blank group (cells not transfected), miR-NC group, miR-302c mimics group, si-CXCL8 group, si-NC group, miR-302c mimics +OE-NC group and miR-302c mimics+OE-CXCL8 group, the expression of miR-302c in each group was detected by qRT-PCR; the cell proliferation in each group was detected by MTT method; the cell invasion in each group was detected by Transwell assay; the dual luciferase reporter gene detection experiment was used to verify the targeting relationship between miR-302c and CXCL8;and the protein expressions of CXCL8, Cyclin D1, matrix metalloproteinase (MMP)-2 and MMP-9 were measured by Western blotting. ResultsThe expression level of miR-302c in ESCC tissues was significantly lower than that in adjacent tissues (P < 0.05), when compared with the normal human esophageal epithelial cell line Het-1A, the expression level of miR-302c in human ESCC cell lines Eca109, Ec9706, TE-11, TE-10 was significantly reduced (P < 0.05), and the expression level of miR-302c was the lowest in Eca109 cells, therefore, Eca109 cells were selected for follow-up research.miR-302c targeted and negatively regulated the expression of CXCL8;up-regulating miR-302c and silencing CXCL8 could both inhibit the proliferation and invasion of Eca109 cells, and significantly reduce the protein expressions of Cyclin D1, MMP-2 and MMP-9 (P < 0.05);overexpression of CXCL8 could reverse the effect of up-regulation of miR-302c on the proliferation and invasion of Eca109 cells. ConclusionsUp-regulating the expression of miR-302c can inhibit the proliferation and invasion of ESCC cells by targeting and inhibiting the expression of CXCL8.
2023, 48(12): 1634-1639.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.003
Abstract:
ObjectiveTo investigate the expression of LINC01605 in oral squamous cell carcinoma and its influences on cell invasion and migration. MethodsForty oral squamous cell carcinoma tissues and corresponding paracancerous tissue specimens from patients with oral squamous cell carcinoma were collected, and the relationship between the expression of LINC01605 in oral squamous cell carcinoma tissues and clinicopathological characteristics was analyzed.Oral squamous cell carcinoma CAL-27 cells in logarithmic phase was randomly separated into: CK group (normal culture), si-NC group (transfected with si-NC), si-LINC01605 group (transfected with si-LINC01605), pcDNA group (transfected with pcDNA), and pcDNA-LINC01605 group (transfected with pcDNA-LINC01605).QRT-PCR was applied to detect LINC01605 expression in tissues and cells; CCK-8 assay was applied to detect cell proliferation; plate cloning assay was used to detect the ability of cells to form clones; Transwell assay was applied to detect cell invasion; scratch assay was applied to detect cell migration; Western blotting was applied to detect the expression of proliferating cell nuclear antigen (PCNA), matrix metalloproteinase (MMP)-2, MMP-9, neural cadherin (N-cadherin), and epithelial cadherin (E-cadherin) in cells; and in vivo xenograft assay was used to detect tumor growth. ResultsThe expression of LINC01605 in oral squamous cell carcinoma tissue was greatly higher than that in adjacent tissue (P < 0.01).The expression of LINC01605 was related to TNM stage, degree of differentiation and lymph node metastasis (P < 0.05 to P < 0.01).Compared with CK group and si-NC group, the obsorbance value, clone formation rate, number of invasive cells, scratch healing rate, PCNA, MMP-2, MMP-9, N-cadherin protein expression, and the mass of transplanted tumor in CAL-27 cells in the si-LINC01605 group decreased (P < 0.01), while the expression of E-cadherin protein increased (P < 0.01).Compared with CK group and pcDNA group, the change trend of corresponding indexes in CAL-27 cells in pcDNA-LINC01605 group was opposite to the above (P < 0.01). ConclusionsLINC01605 is highly expressed in oral squamous cell carcinoma tissues, and silencing LINC01605 can inhibit the invasion and migration of CAL-27 cells.
2023, 48(12): 1640-1644.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.004
Abstract:
ObjectiveTo investigate the relationship between serum soluble ST2 (sST2) and coronary atherosclerotic heart disease (CAD) in patients with type 2 diabetes mellitus (T2DM). MethodsA total of 334 patients who underwent coronary angiography were selected and divided into three groups: 77 cases in T2DM group, 143 cases in CAD group, and 114 cases in T2DM combined with CAD group.Seventy-two healthy people were selected as the control group during the same period.The clinical biochemical indicators of each group were collected for analysis and comparison.According to the Gensini score, the T2DM combined with CAD group was divided into mild group with 31 cases and severe group with 83 cases.Serum sST2 levels were detected by ELISA, the differences of sST2 levels among the groups were compared and the correlation analysis was performed with Gensini score. ResultsThere were statistically significant differences in sST2 among the control group, T2DM group, CAD group, and T2DM combined with CAD group (P < 0.01).The sST2 level in the severe group was higher than that in the mild group of T2DM combined with CAD (P < 0.05).Multivariate linear stepwise regression analysis showed that Gensini score, HbA1c, LDL were positively correlated with serum sST2 level (P < 0.05 to P < 0.01), while HDL was negatively correlated with serum sST2 level (P < 0.05).Binary logistic regression analysis showed that HbA1c, sST2, and Gensini score were risk factors for T2DM combined with CAD (P < 0.05 to P < 0.01), and HDL was a protective factor for T2DM complicated with CAD (P < 0.01).The area under the curve for the accuracy of T2DM combined with CAD was 0.851, the sensitivity was 61.4%, and the specificity was 92.1%. ConclusionsSerum sST2 is a risk factor for T2DM combined with CAD, which can be used as a serum marker to evaluate the occurrence and severity.
2023, 48(12): 1645-1648.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.005
Abstract:
ObjectiveTo monitor the depth of anesthesia during general anesthesia using bispectral index (BIS), and investigate the influence of BIS monitoring on postoperative delirium (POD) and survival of flap in aged patients undergoing radical resection of oral cancer. MethodsA total of 68 patients undergoing radical resection of oral cancer aged from 65 to 80 years, with ASA physical status Ⅰ-Ⅲ were randomly divided into two groups.The BIS group (n=34) underwent adjustment of anesthesia to maintain a BIS value between 45-60.The non-BIS group (n=34) underwent standard intraoperative hemodynamic monitoring.The POD was assessed 1 day and 5 days after operation using confusion assessment method for intensive care unit (CAM-ICU).The occurrence of adverse reactions during operation was recorded.The use of drugs during the operation, the time of indwelling tracheal catheter after the operation, and the survival of flap were recoded. ResultsThe incidence of POD was lower in the BIS group [11.8% (4/34)] compared with non-BIS group [38.2% (13/34)] on the first day after operation (P < 0.05).The incidence of POD was lower in the BIS group [8.8% (3/34)] compared with non-BIS group [29.4% (10/34)] on the fifth day after surgery (P < 0.05).Meanwhile, BIS monitoring could reduce the use of propofol during operation, reduce the occurrence of hypotension during operation, and reduce the use rate of ephedrine during operation.There was no significant difference in the delayed recovery, intraoperative awareness rate and remifentanil dosage between the two groups (P>0.05), and there was no significant difference in the survival rate of flap between the two groups (P>0.05). ConclusionsBIS monitoring can reduce the incidence of POD in the elderly patients undergoing radical resection of oral cancer, but has no significant impact on the survival rate of flaps after surgery.
2023, 48(12): 1649-1651.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.006
Abstract:
ObjectiveTo explore the effect of sodium hyaluronate acupoint injection combined with arthroscopic debridement on joint function and serum indexes in treatment for knee osteoarthritis (KOA). MethodsA total of 120 KOA patients were divided into observation group and control group according to the random number table method, with 60 cases in each group.The control group was treated with arthroscopic debridement, and the observation group was combined with acupoint injection of sodium hyaluronate on the basis of the control group.The dysfunction, joint pain and stiffness scores, excellent and good rate of joint function, serum basic fibroblast growth factor (bFGF), angiopoietin 1(Ang-1), Ang-2 before and after treatment, and adverse reactions were compared between the two groups. ResultsAfter treatment, the scores of dysfunction, joint pain and stiffness, serum bFGF, Ang-1 and Ang-2 in the two groups were lower than before treatment (P < 0.05), while which in the observation group were lower than those in the control group (P < 0.01).The excellent and good rate of joint function in the observation group was 91.67%, which was higher than 78.33% in the control group (P < 0.05).In the two group, no adverse reactions such as infection, allergies, and severe local pain during injection were found within 3 months after the operation. ConclusionsSodium hyaluronate acupoint injection combined with arthroscopic debridement in treatment for KOA can effectively improve the joint function and clinical symptoms of patients, and down-regulate serum bFGF, Ang-1 and Ang-2, which is a safe and effective treatment plan.
2023, 48(12): 1652-1656.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.007
Abstract:
ObjectiveTo investigate the selection of surgical approaches and throat defect repair methods for hypopharyngeal carcinoma with different T stages. MethodsThe clinical data of 65 patients with hypopharyngeal cancer who underwent operational repairment were retrospectively analyzed.Of all patients who aged 42-77 years, 64 were males and 1 was female, 1 case had stage Ⅰ, 8 cases had stage Ⅱ, 31 cases had Ⅲ, 25 cases had stage Ⅳ of hypopharyngeal carcinoma and no distant metastasis was detected.On surgical methods, 1 case received total laryngectomy with partial esophagectomy, 24 cases received total laryngectomy with partial hypopharynx, 36 and 4 cases were subjected to partial hypopharynx and partial hypopharynx, respectively.All patients underwent neck dissection.On surgical approaches: esophageal approach in 1 case, pharyngeal approach in 2 cases, epiglottic anterior space approach in 6 cases, retrocricoid approach in 9 cases, supraglottic space approach in 11 cases, pharyngeal combined thyroglossal membrane approach in 13 cases, thyrochondral dehiscence combined with epiglottic anterior space approach in 17 cases and combined approach in 6 cases.The residual laryngotracheal tissue flap, submental island flap and pectoralis major muscle flap were used to reconstruct the function of pharynx and part of esophagus, and epiglottis, band myofascial flap and thyroid perichondrium flap were used to repair the laryngeal cavity.No radiotherapy was given in stage Ⅰ and Ⅱ, and postoperative adjuvant radiotherapy was given in stage Ⅲ and Ⅳ (dose 50-60 Gy).Some cases were treated with platinum neoadjuvant chemotherapy before operation and concurrent radiotherapy and chemotherapy after operation. ResultsThe 3-year overall survival rate was 63.9%, the disease-free survival rate was 51.8%, the 5-year overall survival rate was 42.6%, and the disease-free survival rate was 41.7%.Laryngeal function retention rate was 61.5%, and tracheal casing expulsion rate was 38.5%.Postoperative pathology confirmed that the positive rate of cervical lymph nodes was 66.2%, and the incidence of pharyngeal fistula was 9.2%.The average time of gastric tube removal was 21.8 days, and 2 patients had anastomotic stenosis. ConclusionsAppropriate surgical approach and throat repair methods according to different stages of hypopharyngeal carcinoma can be beneficial in operational exposure, mucosa preservation, defects narrowing, surgical trauma reduction, and can improve the laryngeal function retention rate of hypopharyngeal carcinoma while ensuring the survival rate of patients.
2023, 48(12): 1657-1660.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.008
Abstract:
ObjectiveTo explore the relationship between the prognostic nutritional index (PNI) and coronary collateral circulation (CCC) in patients with coronary chronic total occlusion (CTO). MethodsA total of 140 patients who underwent coronary angiography to confirm the diagnosis of CTO were selected and devided into low PNI and high PNI according to the median PNI 48, and divided into poor CCC formation group (Rentrop 0-1, n=44) and good CCC formation group (Rentrop 2-3, n=96) based on the Rentrop grading.The general clinical data and laboratory test results were compared between the two groups.Logistic regression was used to analyze the risk factors of poor CCC formation. ResultsCompared with the high PNI group, the low PNI group had older age, more numbers of vascular lesions, higher incidences of heart failure and major cardiovascular adverse events, higher proportion of poor CCC formation, and higher scores for neutrophils, urea nitrogen, and CHA2DS2-VASc scores.The proportion of complete revascularization and previous myocardial infarction was relatively low, and the levels of white blood cells, lymphocytes, albumin, and triglycerides were lower in low PNI group, with statistical significance (P < 0.05 to P < 0.01).Compared with the good CCC formation group, the poor CCC formation group had lower albumin levels, a higher proportion of low PNI, and a higher CHA2DS2VASc scores, with statistically significant differences (P < 0.05 to P < 0.01).In multivariate regression analysis, low PNI in CTO patients was associated with poor CCC formation. ConclusionsLow PNI was an independent risk factor of poor CCC in CTO patients.
2023, 48(12): 1661-1665.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.009
Abstract:
ObjectiveTo investigate the effect of ultrasound-guided stellate ganglion block (SGB) on improvement of cerebral oxygen supply-demand balance in patients with permissible hypercapnia through real-time monitoring of intraoperative changes in cerebral oxygen saturation (rSO2) during beach chair shoulder arthroscopic surgery. MethodsA total of 86 patients undergoing elective shoulder arthroscopic surgery were randomly divided into an SGB group and a control group (CN group) using a random number table method, with 43 patients in each group.Both groups underwent ultrasound-guided SGB surgery at the level of the C6 transverse tubercle on the surgical side.The SGB group was injected with a mixture of 0.25%ropivacaine hydrochloride and 1%lidocaine hydrochloride in 6 mL, while the CN group was injected with an equal volume of 0.9%sodium chloride solution.Both groups underwent rapid induction tracheal intubation and mechanical assisted breathing after tracheal intubation.Later, the operation was performed in the beach chair position, and the ventilation strategy was adjusted during the operation to gradually increase PETCO2.The rSO2 levels of patients in each group at 10 minutes after entering the room (T0), 10 minutes after SGB (T1), lie flat for 10 minutes after induction (T2), 10 minutes of beach chair position after induction (T3), 30 minutes after stabilization of PETCO2 35-40 mmHg levels at the beginning of surgery (T4), and 30 minutes after stabilization of PETCO2 45-50 mmHg levels at the beginning of surgery (T5) were recorded.The occurrence of cerebral desaturation events (CDE) during surgery, the occurrence of nausea and vomiting, and the use of vasoactive drugs were recorded. ResultsAt T3-T5, the rSO2 on the surgical side of the SGB group was higher than that of the CN group (P < 0.05 to P < 0.01).There was no statistically significant difference in non-surgical rSO2 between the two groups (P > 0.05).Compared at different time points within the SGB and CN groups, there was a statistically significant difference in the changes in rSO2 between the surgical and non-surgical sides over time (P < 0.01).There was no statistically significant difference in the scores of the simplified mental state examination, incidence of postoperative nausea and vomiting, and incidence of CDE between the two groups of patients on the first day before surgery and the first day after surgery (P > 0.05). ConclusionsThe decrease in rSO2 levels caused by beach chair position during shoulder arthroscopic surgery can be effectively improved by adjusting the permissible hypercapnia after ventilation, and this improvement can be more effectively reflected in the effect of SGB on the surgical side.
2023, 48(12): 1666-1669.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.010
Abstract:
ObjectiveTo explore the effect of sevoflurane and desflurane with the same minimum alveolar concentration (MAC) on the surgical pleth index(SPI) during laparoscopic cholecystectomy. MethodsA total of 90 patients scheduled for laparoscopic cholecystectomy were admitted, and randomly divided into sevoflurane (group S) and desflurane group (group D), with 45 patients in each group.Group S was induced by intravenous infusion of propofol effect chamber concentration of 3 μg/mL + remifentanil effect chamber concentration of 3 ng/mL, inhalation of sevoflurane and intravenous injection of 0.6 mg/kg rocuronium.Group D was induced by intravenous infusion of propofol effect chamber concentration of 3 μg/mL + remifentanil effect chamber concentration of 3 ng/mL, inhalation of desflurane and intravenous injection of 0.6 mg/kg rocuronium.Anesthesia maintenance was performed by continuous inhalation of 1.0 MAC sevoflurane or desflurane, combined with intravenous infusion of remifentanil at an effect chamber concentration of 3 ng/mL.The depth of anesthesia sedation and analgesia was monitored.Heart rate (HR), mean arterial pressure (MAP), bispectral index (BIS) and SPI before anesthesia induction and during pneumoperitoneum were compared between the two groups. ResultsBefore anesthesia induction, there was no statistically significant difference in BIS, SPI, HR, and MAP between the two groups (P > 0.05).During pneumoperitoneum, the SPI, BIS, and MAP in the group D were significantly lower than those in the group S (P < 0.05). ConclusionsIn laparoscopic cholecystectomy, desflurane with the same MAC can produce lower SPI values compared to sevoflurane, suggesting that desflurane can produce deeper levels of analgesia.
2023, 48(12): 1670-1675.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.011
Abstract:
ObjectiveTo study serum exosomal microRNA (miRNA) as potential biomarkers for predicting osteoporosis in postmenopausal women. MethodsMiRNA in the serum of female patients with osteoporosis over 65 years old and healthy controls was detected.RNA sequencing was used to identify differentially expressed miRNA.TargetScan, PicTar, and miRanda databases were used to predict target genes.A protein protein interaction (PPI) network using the STRING database was constructed and visualized using Cytoscape software.Finally, the biological functions of the target gene were analyzed using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). ResultsEight significantly upregulated miRNAs were found in postmenopausal female patients with osteoporosis.Using the cytohubba plugin in Cytoscope, the top ten core genes were calculated based on their network functionality, including SOS1, ITGB3, SMAD4, PAK1, NRAS, PLCG1, MET, HGF, CCND1, and CDKN1B.GO enrichment analysis showed that the target genes were mainly concentrated in protein binding, metal ion binding, DNA binding, and ATP binding.The PI3K-Akt signaling pathway and mitogen activated protein kinase (MAPK) signaling pathway were the most significantly enriched target gene signaling pathways. ConclusionsAbnormal serum exosomal microRNAs are associated with postmenopausal osteoporosis and can serve as potential biomarkers for predicting osteoporosis in postmenopausal women.
2023, 48(12): 1676-1680.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.012
Abstract:
ObjectiveTo observe the clinical efficacy of braided bag dilated vertebroplasty in the treatment of osteoporotic vertebral compression fracture (OVCF) with peripheral wall breakage. MethodsThirty patients with OVCF with periphery wall breakage were treated surgically by braided bag dilation vertebroplasty, and the preoperative and postoperative pain VAS scores, Cobb angle and anterior and mid-vertebral body height recovery, kyphosis correction rate, and bone cement leakage were observed and compared. ResultsThe pain of postoperative patients was significantly alleviated, the Cobb angle and the height of the diseased vertebrae were recovered and the kyphosis correction was obvious, the preoperative and postoperative differences were statistically significant (P < 0.05), and only 2 vertebral bodies of the bone cement leaked slightly on the upper endplate, which did not cause any response. ConclusionsThe braided bag dilated vertebroplasty in the treatment of OVCF with peripheral wall breakage can significantly relieve pain, reduce the incidence of bone cement leakage, correct Cobb angle, restore a certain vertebral height.
2023, 48(12): 1680-1684.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.013
Abstract:
ObjectiveTo investigate the relationship between changes of serum growth differentiation factor-15 (GDF-15), N-terminal-B-type natriuretic peptide (NT-proBNP), leukocyte differentiation antigen 40 ligand (CD40L) levels and prognosis in patients with ventricular arrhythmia. MethodsA total of 180 patients with ventricular arrhythmia were selected as the observation group, and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group.The serum GDF-15, NT-proBNP, CD40L levels were compared between the two groups.The correlation between serum GDF-15, NT-proBNP, CD40L levels and Lown grading were analyzed.The serum GDF-15, NT-proBNP, CD40L levels in patients with different prognosis were compared.The relationship between serum GDF-15, NT-proBNP, CD40L levels and the prognosis of patients with ventricular arrhythmia were analyzed.Receiver operating characteristic (ROC) curve was drawn, and the predictive value of serum GDF-15, NT-proBNP, and CD40L levels in the prognosis of patients with ventricular arrhythmia were evaluated. ResultsThe serum GDF-15, NT-proBNP and CD40L levels of the observation group were significantly higher than those of the control group (P<0.01).Spearman correlation indicated that there was a positive correlation between serum levels of GDF-15, NT-proBNP, and CD40L in patients with ventricular arrhythmia and Lown grading (P<0.05).The serum GDF-15, NT-proBNP, and CD40L levels in patients with poor prognosis were significantly higher than those of patients with good prognosis (P<0.01).Logistic regression analysis showed that serum levels of GDF-15, NT-proBNP, and CD40L were all influencing factors for the prognosis of patients with ventricular arrhythmia (P<0.05), and the AUC of the predictive value of serum GDF-15, NT-proBNP, and CD40L levels for the prognosis of patients with ventricular arrhythmia were 0.666, 0.767, and 0.777, respectively, and the AUC of all indicators in combination was 0.855. ConclusionsThe serum levels of GDF-15, NT-proBNP and CD40L in patients with ventricular arrhythmia are significantly increased.Clinical monitoring of their levels can help predict the prognosis and guide the formulation of clinical treatment plans.
2023, 48(12): 1685-1688.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.014
Abstract:
ObjectiveTo explore the effects of different timing of intensive breastfeeding on physical development, blood biochemical indicators, complications and neurological development of premature infants during hospitalization. MethodsAccording to different timing of intensive breastfeeding, 122 preterm infants were divided into early group (60 cases were added with fortification when feeding up to 50 mL·kg-1·d-1) and late group (62 cases were added with fortification when feeding up to 100 mL·kg-1·d-1).The growth and development, biochemical indicators, incidence of complications, and neonatal behavioral neurological assessment (NBNA), magnetic resonance imaging (MRI) and amplitude integrated electroencephalography (aEEG) were compared between the two groups. ResultsThe weight gain rate during hospitalization in the early group (17.28±3.5) g·kg-1·d-1 was higher than that in the late group (15.71±3.4) g·kg-1·d-1, with statistical differences (P < 0.05).However, there was no significant difference in head circumference, growth rate of body length, average length of stay and time to return to birth weight between the two groups (P>0.05).There was no significant difference in albumin, preprotein, urea nitrogen, alkaline phosphatase and blood phosphorus between the two groups at discharge (P>0.05), and the blood calcium level in the early group was higher than that in the late group, with statistical significance (P < 0.05).The incidence of feeding intolerance (FI) in premature infants in the early group [16.6% (10/60)] was higher than that in the late group [4.8% (3/62)] (P < 0.05).However, there was no significant difference in the incidence of necrotizing enterocolitis, nosocomial infection, retinopathy of prematurity, anemia and bronchopulmonary dysplasia between the two groups (P>0.05).The abnormal rate of head MRI in the early group was lower than that in the late group (P < 0.05), and there was no statistically significant difference in the abnormal rates of NBNA and aEEG between the two groups (P>0.05). ConclusionsEarly supplementation of breast milk fortifiers can promote weight gain and increase blood calcium levels in premature infants, and the abnormal rate of cranial MRI is lower than that of the late group.
2023, 48(12): 1689-1692.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.015
Abstract:
ObjectiveTo explore the effects of aspirin combined with clopidogrel, aspirin combined with agatroban on ischemic modified albumin (IMA) and neural function in patients with transient ischemic attack. MethodsA total of 124 patients with transient ischemic attack were divided into two groups according to the random number table method.The control group (62 cases) was treated with aspirin and clopidogrel, and the observation group (62 cases) was treated with aspirin and agatroban.After 14 days of treatment, the scores of IMA, National Institute of Health stroke scale (NIHSS) score, fibrinogen (FIB), activated partial thrombin time (APTT), prothrombin time (PT), matrix metalloproteinase 9 (MMP-9) and disease remission rate were compared between the two groups. ResultsThere was no statistical difference in MMP-9, FIB, PT, APTT and NIHSS scores in each time period between the two groups (P>0.05).The IMA in the observation group was higher than that in the control group 14 days after treatment (P < 0.05).At the same time, the disease remission rates in the observation group were higher than those in the control group 7 days, 10 days and 14 days after treatment (P < 0.05). ConclusionsAspirin combined with clopidogrel and aspirin combined with agatroban can reduce neural impairment, improve IMA and blood coagulation function, but for patients with transient ischemic attack, aspirin combined with agatroban is more effective.
2023, 48(12): 1693-1696.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.016
Abstract:
ObjectiveTo investigate the clinical effect of two methods in the treatment of ureteral calculi. MethodsA total of 184 patients with ureteral calculi were randomly divided into two groups.Both groups were treated with B-ultrasound-guided shock wave lithotripsy.The control group (91 cases) was given Jinqiancao granules orally for 2 weeks after operation.The observation group (93 cases) was treated with tanluoxin hydrochloride sustained-release tablets and furosemide tablets before lithotripsy.After operation, Shuangjin Paishi granules and tanluoxin hydrochloride sustained-release tablets were taken every day for 2 weeks.The positioning time and rate of complete stone crushing, intraoperative, postoperative and total stone free rate, ureteral segmental stone free rate, and complication rate were observed. ResultsThe stone localization time in the observation group was significantly shorter than that in the control group (P < 0.01).The dispersion distance of crushed stone particles and the maximum transverse diameter of crushed stone particles were significantly different (P < 0.05).The rate of complete stone crushing, intraoperative, postoperative and total stone free rate in the observation group were significantly higher than those in the control group (P < 0.01).There was a statistically significant difference in the clearance rate of lower ureteral calculi between the two groups (P < 0.05).The incidences of postoperative WBC positive urine, microscopic hematuria, gross hematuria, pain and stone street in the observation group were lower than those in the control group (P < 0.05 to P < 0.01). ConclusionsThe extracorporeal shock wave lithotripsy, which applies diuretics and α 1A receptor blocker before operation, and Shuangjin Paishi granule combined with tanluoxin hydrochloride after operation, has the advantages of short stone localization time, good lithotripsy effect, high stone free rate and low complication rate.
2023, 48(12): 1697-1700.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.017
Abstract:
ObjectiveTo investigate the risk factors of bronchopulmonary dysplasia (BPD) in premature infants with different gestational ages. MethodsNinety-five premature infants with different gestational ages diagnosed as BPD were retrospectively analyzed.According to gestational age, there were 16 cases of super premature infants (< 28 weeks), 62 cases of extremely premature infants (28-31+6 weeks), and 17 cases of middle and late premature infants (32-36+6 weeks).The history of disease during pregnancy, prenatal hormone use, and gender, birth weight, asphyxia, patent ductus arteriosus, medication, transfuse blood, mechanical ventilation time, oxygen inhalation time, hospitalization time of premature infants with different gestational ages were analyzed.Some children were followed up after discharge. ResultsAmong BPD preterm infants with different gestational ages, the effect of maternal pregnancy with preeclampsia on middle and late preterm infants was significantly higher than that of extremely premature infants and super premature group, and the differences were statistically significant (P < 0.05).The mechanical ventilation time of the super premature infants was significantly longer than that of the extremely premature infants and the middle and late premature infants, and the difference was statistically significant (P < 0.01).The oxygen inhalation time of super preterm infants was significantly higher than that of extremely preterm infants and middle and late preterm infants, and the difference was statistically significant (P < 0.01).The hospitalization time of super preterm infants were significantly higher than those of extremely preterm infants and middle and late preterm infants, and the difference was statistically significant (P < 0.01).The incidence of patent ductus arteriosus in super preterm infants was significantly higher than that in extremely preterm infants and middle and late preterm infants, and the difference was statistically significant (P < 0.01).The incidence of pneumonia in middle and late premature infants and super premature infants was significantly higher than that in extremely premature infants, and the difference was statistically significant (P < 0.05).During the follow-up 45 children (between 6 months and 5 years old), it was found that some children had different degrees of growth retardation, respiratory diseases, hearing impairment, vision disorder and abnormal brain development, and 5 children died. ConclusionsThere is diversity in the factors that contribute to the occurrence of BPD in premature infants.The younger the gestational age, the longer the duration of mechanical ventilation and oxygen use, resulting in an increased risk of developing BPD and a poorer prognosis.Therefore, pregnant womem should do well in pregnancy and it is necessary to standardize rational drug use and oxygen use, adopt lung protective ventilation strategy, and actively and comprehensively support treatment for premature infants.
2023, 48(12): 1701-1704.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.018
Abstract:
ObjectiveTo explore the influencing factors of meconium aspiration syndrome (MAS) in full-term neonates and construct a prediction model. MethodsThe data of 507 full-term neonates and mothers with meconium-contaminated amniotic fluid detected by prenatal examination from March 2018 to May 2021 were retrospectively analyzed.According to whether MAS occurred within 3 days after birth, they were divided into MAS group and non-MAS group.The related indexes of the two groups were compared.Multivariate logistic regression analysis was performed.A prediction model was established.ROC curve was used to analyze the model discrimination.The goodness of fit was used to test the model calibration.A total of 184 full-term neonates with meconium-contaminated amniotic fluid from July 2021 to March 2022 were selected as the clinical verification of the model. ResultsThere were 62 cases (12.23%) of MAS in 507 full-term neonates with meconium-contaminated amniotic fluid.The fetal distress, gestational age of delivery, mode of delivery, amniotic fluid pollution, neonatal umbilical cord blood pH value and neonatal Apgar 1 min score were independent influencing factors of MAS in full-term neonates (P < 0.05 to P < 0.01).The prediction model equation was constructed as follows: Logit (P)=0.704×fetal distress (0=no; 1=yes)+0.625×gestational age at delivery (measured value)+0.443×mode of delivery (0=natural birth; 1=cesarean section) +1.267×amniotic fluid pollution index (0=degree Ⅰ; 1=Ⅱ degree; 2=degree Ⅲ)+0.694×neonatal umbilical cord blood pH value (measured value) +0.783×neonatal Apgar 1 min score (measured value)-27.894.The area under the ROC curve was 0.877 (95%CI: 0.828-0.927).The sensitivity and specificity of the maximum Youden index (0.736) were 88.70% and 84.60%, respectively.Goodness of fit test showed χ2=1.13, P>0.05, indicating that there was no over-fitting phenomenon in the model.After clinical verification, the sensitivity of the model was 87.50%, specificity was 85.63%, and accuracy rate was 85.87%. ConclusionsThe influencing factors of neonatal MAS in full-term pregnant women are fetal distress, gestational age, cesarean section, amniotic fluid pollution, neonatal umbilical cord blood pH value, and neonatal Apgar 1 min score.A prediction model is constructed based on above, which is well distinguished and has high prediction efficacy.
2023, 48(12): 1705-1708.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.019
Abstract:
ObjectiveTo investigate the clinical effect of hysteroscopy combined with laparoscopic folding suture in the treatment of cesarean scar diverticulum. MethodsThe clinical of 68 patients with uterine diverticulum were analyzed. Among them, 36 cases underwent hysteroscopy combined with laparoscopic folding suture were set as observation group, and 32 cases undergoing hysteroscopy combined with laparoscopic incision suture were set as control group. The intraoperative blood loss, operation time, postoperative complications, and postoperative efficacy of patients in the two groups were compared. ResultsThe intraoperative blood loss in the observation group was significantly lower than that in the control group, and the operation time was significantly shorter than that in the control group, and the differences were statistically significant (P < 0.05). The postoperative menstrual days in the two groups were shorter than those before surgery, and the differences were statistically significant (P < 0.05). The incidence of postoperative complications in the observation group was 8.33%, which was lower than that of 31.25% in the control group, and the difference was statistically significant (P < 0.05). The postoperative effective rates of the two groups were 91.7% and 87.5%, respectively, but the difference was not statistically significant (P>0.05). ConclusionsThe two surgery methods are effective for the treatment of cesarean scar diverticulum, and hysteroscopy combined with laparoscopic folding suture has better clinical efficacy with less intraoperative bleeding, shorter operation time, fewer postoperative complications, and preserving the integrity of the uterine muscle layer, which is especially suitable for older patients with urgent fertility requirements.
2023, 48(12): 1709-1713.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.020
Abstract:
ObjectiveTo explore the expression levels of N-Myc downstream regulated gene 2 (NDRG2) protein and mammalian target of rapamycin (mTOR) in peripheral blood of patients with ischemic stroke, and analyze its correlation with patient prognosis. MethodsA total of 300 patients with ischemic stroke were selected as the observation group, and divided into mild group (n=99), moderate group (n=113) and severe group (n=88) according to the National Institute of Health stroke scale. According to the modified Rankin scale (mRS) 90 days after discharge, they were divided into poor prognosis group (mRS>3, n=108) and good prognosis group (mRS ≤ 3, n=192). At the same time, 278 healthy subjects were randomly selected as the control group. The clinical data of patients were collected, enzyme-linked immunosorbent assay was used to detect the expression levels of NDRG2 protein and mTOR in peripheral blood. Pearson method was used to analyze the correlation between NDRG2 protein, mTOR, and routine biochemical indicators in patients with ischemic stroke. The patients were followed up for 3 months after discharge, and the ROC curve was used to analyze the value of NDRG2 protein and mTOR in predicting poor prognosis of ischemic stroke. ResultsThe levels of NDRG2 protein and mTOR in the peripheral blood of patients in the observation group was significantly higher than those in the control group (P < 0.01). The levels of NDRG2 protein and mTOR in the peripheral blood of patients with severe neurological deficits were higher than those in the moderate and mild groups, and which in the moderate group was also higher than those in the mild group (P < 0.05). The peripheral blood NDRG2 protein and mTOR levels in ischemic stroke patients were positively correlated with low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TG), total cholesterol (TC), homocysteine (Hcy), D-dimer (D-D), lipoprotein a, hypersensitivity C-reactive protein (Hs-CRP) (P < 0.05 to P < 0.01), and negatively correlated with high-density lipoprotein cholesterol (HDL-C) (P < 0.01). The levels of NDRG2 protein and mTOR in peripheral blood of patients with good prognosis were lower than those of patients with poor prognosis (P < 0.01). The peripheral blood NDRG2 protein and mTOR levels were evaluated for poor prognosis in ischemic stroke, with AUC of 0.733 and 0.952, sensitivity of 62.04% and 89.81%, and specificity of 76.56% and 89.58%, respectively. The AUC of the combined assessment of ischemic stroke was 0.958, with a sensitivity of 86.11% and a specificity of 93.23%. ConclusionsThe levels of NDRG2 protein and mTOR in peripheral blood of patients with ischemic stroke are both high. The combined detection of NDRG2 protein and mTOR has high predictive value for poor prognosis of ischemic stroke.
2023, 48(12): 1714-1721.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.021
Abstract:
ObjectiveTo investigate the value of constructing a combined CT imaging and clinical features prediction model for evaluating epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer (NSCLC). MethodsA total of 258 patients with pathologically confirmed NSCLC (182 in the training group and 76 in the validation group) were enrolled. Single factor and multiple factor logistic regression analysis were used to analyze and screen out independent factors affecting EGFR mutation to build CT imaging-clinical prediction model. A nomogram was drawn to visualize the model. Finally, receiver operating characteristic curve, calibration curve and decision curve were used to evaluate the practicability of the model. ResultsFinally, gender, smoking status, burr sign, and pleural indentation sign were screened as independent predictive factors for NSCLC EGFR mutations, and a CT imaging-clinical prediction model was established. In the training and validation groups, the predicted area under the curve of the model was 0.799 and 0.797, respectively (P < 0.01), indicating good predictive performance. The calibration curve showed that the prediction models of the training and validation groups had good consistency with the observed results. Decision curve showed that the model had achieved good clinical benefits in predicting EGFR mutations. ConclusionsThe CT imaging-clinical feature prediction model has well predictive value for EGFR mutations in NSCLC patients and can be served as noninvasive tool for preoperative clinical prediction.
2023, 48(12): 1721-1725.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.022
Abstract:
ObjectiveTo construct and validate the value of constructing nomogram model based on clinical-radiological parameters in preoperative prediction of lymph node metastasis in advanced gastric cancer (AGC). MethodsA retrospective analysis was conducted on 216 gastric cancer patients confirmed by pathology, who were randomly divided into a training group (n=158) and a validation group (n=58). The clinical data and computed tomography (CT) imaging features of patients were collected for univariate and multivariate logistic regression analysis, the validation group was used to validate, the nomogram model was constructed with R 3.5.3 software package, the prediction efficacy of the nomogram model was evaluated using receiver operating characteristic (ROC) curve, and the clinical practicality of the model was validated by calibration curve and decision curve. ResultsAmong the 216 patients, 130 cases were positive for lymph node metastasis and 86 cases were negative for lymph node metastasis. In the training group and validation group, there were statistically significant differences in alcohol consumption history, peritumoral fat infiltration, degree of enhancement, CT-lymph node status, and platelet to lymphocyte ratio (PLR) in preoperative prediction of lymph node metastasis in gastric cancer patients (P<0.05 to P<0.01). Multivariate logistic regression analysis showed that alcohol consumption history, peritumoral fat infiltration, CT enhancement degree, CT-lymph node status, and PLR>161 were independent influencing factors for preoperative prediction of lymph node metastasis in gastric cancer patients (P<0.05). A namogram model was constructed to predict lymph node metastasis in gastric cancer patients based on alcohol consumption history, peritumoral fat infiltration, CT enhancement degree, CT-lymph node status, and PLR. The area under the ROC curve of the model was 0.789 (95%CI: 0.719-0.860) in the training group and 0.791 (95%CI: 0.678-0.905) in the validation group, respectively. The sensitivity and specificity of the model were 67.4% and 78.3% in the training group, and 62.5% and 84.6% in the validation group, respectively. The calibration curve and decision curve confirmed the clinical practicality of the model. ConclusionsAlcohol consumption history, peritumoral fat infiltration, CT enhancement degree, CT-lymph node status, and PLR are independent influencing factors for the occurrence of lymph node metastasis in gastric cancer patients. The namogram model constructed based on them has good prediction efficacy and can assist clinical decision-making to some extent.
2023, 48(12): 1726-1729, 1733.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.023
Abstract:
ObjectiveTo explore the value of ultrasound (US), real-time tissue elastography (RTE) and fine needle aspiration cytology (FNAC) in the diagnosis of axillary lymph node (ALN) status in patients with invasive breast cancer of non-special type (IBC-NST). MethodsA total of 107 ALNs from 96 female IBC-NST patients were included in the study, each lymph node underwent US, RTE and FNAC examination.The target lymph nodes were scored according to the characteristics of the 2-dimensional acoustic image of the target lymph nodes.According to the elastography color distribution of the lymph node, the different RTE elastic maps were scored.The above two scores were added up.Finally, the FNAC or histopathological results were used as the diagnostic gold standard, the receiver operator characteristic (ROC) curve of the three methods was constructed, and the boundary value of score, the area under the curve (AUC) and the diagnostic efficacy of the three methods were calculated, respectively. ResultsThe sensitivity and specificity of US, RTE, US combined RTE and FNAC for diagnosing ALN status in IBC-NST patients were 74.6%, 77.3%;76.2%, 86.4%;88.9%, 79.5%, and 88.9%, 100%, respectively.The AUC of US, RTE and the combined method were 0.814, 0.844 and 0.915, respectively. ConclusionsUS and RTE techniques show better diagnostic value for ALN status in IBC-NST patients, and the combination of the two was more advantageous.FNAC has the highest diagnostic efficacy, but there is still a partial false-negative rate.
2023, 48(12): 1730-1733.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.024
Abstract:
ObjectiveTo investigate the clinical data and ultrasonic hemodynamic differences in different types of subclavian artery steal syndrome (SSS). MethodsA total of 121 patients with SSS detected by ultrasonography in The First Affiliated Hospital of University of Science and Technology of China were selected, including 53 patients with type Ⅰ, 40 patients with type Ⅱ and 28 patients with type Ⅲ.The clinical data and hemodynamic parameters of the patients were analyzed. ResultsThere was no significant difference in age, sex, etiology and lesion site of typeⅠ, type Ⅱ, and type Ⅲ SSS (P>0.05).The vertebral artery diameter, peak systolic velocity (PSV) and end diastolic velocity (EDV) on the affected side of SSS were smaller than those on the healthy side (P < 0.01).There was no statistically significant difference in the diameter of the affected vertebral artery, the EDV of the vertebral artery and the EDV of the healthy vertebral artery among the three types of SSS (P>0.05).The PSV of the affected and healthy vertebral arteries of type Ⅲ SSS was the fastest, and there was no significant difference between type Ⅰ and type Ⅱ SSS (P < 0.05).The vertebral artery RI in the affected and healthy side of type Ⅲ SSS was higher than that in type Ⅰ (P < 0.01 and P < 0.05).The degree of SSS blood steal was positively correlated with the degree of subclavian artery stenosis (rs=0.527, P < 0.05). ConclusionsThere are differences in hemodynamics between the affected and healthy vertebral arteries of different types of SSS.Combining with the spectral morphology of vertebral arteries, the degree of blood steal and the degree of subclavian artery stenosis can be better judged.
2023, 48(12): 1734-1739.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.025
Abstract:
ObjectiveTo construct a scientific and systematic evaluation index system of network contract nursing service quality, and provide reference for patients and their caregivers to objectively evaluate network contract nursing service quality. MethodsBased on the SERVQUAL model from December 2020 to June 2021, the contents of the evaluation index system of network contract nursing service quality were determined through policy research, literature review, semi-structured interview and expert consultation, and the weight of the index was determined by combining the analytic hierarchy process. ResultsThe effective recovery rates of the two rounds of expert consultation questionnaires were 100% and 96%, the expert authority coefficient was 0.79 and 0.81, and the Kendall coefficient of concordance was 0.180 and 0.171, respectively, the difference was statistically significant (P < 0.01).The final evaluation index system consisted of 5 first-level indicators, 12 second-level indicators and 34 third-level indicators. ConclusionsThe evaluation index system of network contract nursing service quality based on SERVQUAL model is scientific and reliable, which can provide a basis for the evaluation and continuous improvement of network contract nursing service quality.
2023, 48(12): 1739-1743.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.026
Abstract:
ObjectiveTo explore the frailty status of patients with systemic lupus erythematosus (SLE) and analyze its influencing factors. MethodsA convenience sampling method was performed to select 203 patients with SLE as the research subjects.The general data questionnaire, Chinese version of Tilburg frailty scale, Charlson comorbidity index (CCI) and Barthel index were used to investigate the research subjects. ResultsThe frailty score of patients with SLE was 7 (7, 10) points, the morbidity of frailty was 73.9%.The Charlson comorbidity index score was above 2 points in 56.2%.The Barthel index score was (90.05±15.64) points.Spearman correlation analysis showed that the frailty was positively correlated with polypharmacy (rs=0.215), CCI (rs=0.485) (P < 0.05), and negatively correlated with self-care ability (rs=-0.538, P < 0.01).The results of the multiple linear regression analysis showed that increased age, high CCI scores, low BI scores and polypharmacy might be independent risk factors for high frailty scores in patients with SLE (P < 0.05 to P < 0.01). ConclusionsThe incidence of frailty in SLE patients is high.Medical staff should identify frailty early, formulate and implement individualized intervention measures to reduce its incidence.
2023, 48(12): 1744-1749.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.027
Abstract:
ObjectiveTo explore the chain mediating effect of psychological resilience and perceived social support on the psychological state and nursing compliance of PICC patients. MethodsA total of 123 PICC patients were included, and the patients' psychological resilience, perceived social support, psychological status and nursing compliance were evaluated.The mediating effect of psychological resilience and perceived social support on the relationship between psychological status and nursing compliance in PICC patients were analyzed. ResultsA total of 106 valid questionnaires were obtained in the end.The S-AI and FoP-Q-SF scores of patients with gynecological tumors and catheter-related complications were higher than those of patients with other types of tumors and those without catheter-related complications (P < 0.05 to P < 0.01);patients with a monthly household income of ≥ 5 000 yuan had lower scores for nursing compliance, S-AI, and FoP-Q-SF than those with a monthly household income of < 5 000 yuan, while PSSS and CD-RISC were higher than those with a monthly household income of < 5 000 yuan (P < 0.05 to P < 0.01).Pearson correlation analysis showed that psychological resilience score, perceived social support scale score were negatively correlated with psychological state score in PICC patients (P < 0.05), and positively correlated with nursing compliance score (P < 0.05).The mediating effect of psychological resilience on the psychological state and nursing compliance of PICC patients was 21.98%;the mediating effect of perceived social support on the psychological state and nursing compliance of PICC patients was 20.55%. ConclusionsPsychological resilience and perceived social support are significantly correlated with the psychological state and nursing compliance of PICC patients.Mental state can affect patients' nursing compliance by affecting their psychological resilience and perceived social support ability.
2023, 48(12): 1749-1754.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.028
Abstract:
ObjectiveTo explore the mediating effect of uncertainty tolerance between locus of control and work engagement in nurses, and to provide reference for clinical nursing management and training. MethodsA total of 282 nurses from two hospitals in Chengdu and Deyang of Sichuan province were selected as subjects by convenience sampling method.A general demographic information questionnaire was used to investigate demographic characteristics, the intolerance of uncertainty scale was used to investigate uncertainty tolerance, the Internal Control and Powerful over Others and Opportunities Scale was used to investigate the level of sources of psychological control, the Work engagement Scale was used to investigate work engagement, and the structural equation model was constructed to validate the mediating role of uncertainty tolerance in the relationship between nurses' sources of psychological control and work engagement. ResultsThe internality, powerful others, chance, intolerance of uncertainty and work engagement were (18.27± 4.52) points, (23.65±5.80) points, (22.86±5.48) points, (31.27±8.72) points, (54.01±8.58) points, respectively.All of them were pairwise correlated (P < 0.01).Multiple regression analysis showed that the locus of control and uncertainty tolerance could explain 41.6% of the work engagement.The results of structural equation model showed that the uncertainty tolerance had a partial mediating effect between the locus of control and work engagement, and the mediating effect accounted for 44.3% of the total effect. ConclusionsThe locus of control can directly and positively affect the nurses' work engagement or indirectly through the mediating effect of uncertainty tolerance.In nursing management and training, we should pay attention to the relationship between the three, improve the internality level of nurses and the cognition and coping ability of uncertain events, and ensure the level of work engagement.
2023, 48(12): 1755-1758.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.029
Abstract:
ObjectiveTo explore the effects of psychological elasticity and social support on the fear of progression in patients during induction period of maintenance hemodialysis (MHD). MethodsA total of 152 patients in the induction period of MHD were investigated by general data scale, psychological elasticity scale, social support scale and fear of progression scale. ResultsA total of 143 patients were included in the survey.The total score of elasticity questionnaire, social support and fear of progression were (58.73±10.37) points, (38.15±5.59) points, (46.53±7.02) points, respectively.There were significant differences in the scores of elasticity of MHD induction period patients with different age, marriage, educational background, family monthly income, complications and hemodialysis knowledge (P < 0.01).There were significant differences in social support among patients with different age, marriage, educational background and family monthly income (P < 0.01).The patients with different age, marriage, family monthly income, complications and hemodialysis knowledge were significantly different in fear of progression (P < 0.01).There was a negative correlation between psychological elasticity and the fear of progression (P < 0.05).In the dimensions of social support, except the utilization of support, the other dimensions were negatively correlated with fear of progression (P < 0.05).Multiple linear regression analysis showed that age, marriage, family monthly income, complications, hemodialysis knowledge, psychological elasticity and social support were the influencing factors of fear of progression. ConclusionsFear of progression in patients during MHD induction period is a complex psychological feeling affected by many factors.Clinically, medical staff should take targeted intervention measures to help patients establish correct coping styles, so as to alleviate the fear of progression.
2023, 48(12): 1759-1765.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.030
Abstract:
ObjectiveTo summarize the best evidence for non-pharmacological intervention of delirium in adult patients in ICU, and evaluate the effect of its application. MethodsAccording to the "6S" evidence pyramid model system, the literature was searched to obtain and summarize the best evidence of non-pharmacological interventions for delirium in adult ICU patients.There were 40 ICU nurses and 150 patients were recruited in a tertiary hospital in Wuhu, Anhui province by using the convenience sampling method.Based on the Joanna Briggs Institute(JBI)evidence-based health care model as the theoretical framework, through baseline audit, analysis of obstacles to the application of evidence, introduction of evidence, as well as re-audit of evidence after application, compare the incidence of delirium, the clinical outcome of patients and the level of knowledge of nurses on the prevention and management of delirium before and after the application of the best evidence. ResultsFinally, 17 best evidences were included, including seven parts: risk factor identification and risk prediction, assessment and diagnosis, physical restraint, cognitive training, family participation, sleep management and early rehabilitation exercise.After the application of the best evidence, the incidence of delirium and unplanned extubation in ICU patients were significantly reduced, the length of hospitalization was significantly shortened (P < 0.05), and the duration of delirium was shortened (P < 0.01).The level of relevant knowledge of nursing staff was improved (P < 0.05).When the evidence was reviewed again after application, the implementation rate of each review standard was higher than the current review. ConclusionsThe application of the best evidence for non-pharmacological intervention of delirium in adult patients in ICU has improved the delirium management process, which can prevent and reduce the incidence of delirium in patients, and improved clinical outcomes of patients.
2023, 48(12): 1766-1770.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.031
Abstract:
ObjectiveTo investigate the effects of dietary fiber(DF) diet on gastrointestinal dysfunction in patients with early enteral nutrition after craniocerebral injury. MethodsA total of 90 patients with traumatic brain injury were divided into the control group(group A) and observation group(group B and group C) according to the order of admission time (30 cases in each group).Group A was treated with the enteral nutrition suspension.The group B was treated with the enteral nutrition suspension combined with low DF, and the group C was treated with the enteral nutrition suspension combined with high DF for 7 days.The incidence rates of diarrhea, constipation, vomiting/reflux and gastrointestinal bleeding were observed in the three groups.The C-reactive protein(CRP), white blood cell count(WBC) and procalcitonin (PCT) were recorded on the first, fourth and seventh day of admission.The GCS scores of three groups were recorded before and after intervention. ResultsThe differences of the incidence rates of gastrointestinal dysfunction among the three groups were statistically significant(P < 0.01).The incidence rate of intestinal dysfunction in group C was lower than that in group A(P < 0.05), but there was no statistical significance between group B and group C(P>0.05).The incidence rate of diarrhea in group C was lower than that in group A(P < 0.05).There was no statistical significance in inflammatory indexes among the three groups on the first day(P>0.05).On the fourth day, the level of CRP in group A was higher than that in group B and group C, and the levels of WBC and PCT in group A and group B were higher than those in group C(P < 0.01).On the seventh day, the levels of CRP in group A and group B were higher than that in group C, the WBC level in group A was higher than that in group B and group C, and the PCT level in group A was higher than that in group C(P < 0.01).After intervention, the proportion of GCS score with 7-9 points in group A was lower than that in group C(P < 0.05). ConclusionsDF diet can reduce the incidence rate of gastrointestinal dysfunction in patients with early enteral nutrition and inflammatory reaction of patients with craniocerebral injury, and has no effect on the change of consciousness in the short term.The effect of high DF diet is better than that of low DF diet.
2023, 48(12): 1774-1776.
doi: 10.13898/j.cnki.issn.1000-2200.2023.12.033
Abstract:
ObjectiveTo investigate the awareness and influencing factors of the health management of osteoporosis, and put forward corresponding scientific suggestions for improving the quality of life of the elderly osteoporosis patients. MethodsUsing simple random sampling method, 194 elderly patients with osteoporosis aged over 60 years old in Nantong were selected as the survey objects, and the self-compiled general status questionnaire and osteoporosis knowledge questionnaire were used. ResultsThe total score of osteoporosis knowledge in the elderly was (12.71±3.79) points, and the overall level was low.The results of univariate analysis showed that the differences in the osteoporosis knowledge of different gender, marital status, annual family income, occupation, and whether to drink milk every day were statistically significant(P < 0.05 to P < 0.01), The results of multiple linear regression analysis showed that the gender, marital status, annual family income, and whether to drink milk every day were the independent influencing factors of osteoporosis knowledge scores, and the score of osteoporosis knowledge was higher in the elderly with osteoporosis who were female, had a spouse, had a high household income, and drank milk every day(P < 0.01).The proportion of elderly osteoporosis patients who want to learn about osteoporosis through TV was the highest, followed by expert lectures and community publicity boards. ConclusionsThe cognitive level of osteoporosis is the result of multiple factors.Society and family should work together to pay more attention to osteoporosis and develop health education programs suitable for the characteristics of the population.
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