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2023 Vol. 48, No. 4
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2023, 48(4): 421-425.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.001
Abstract:
ObjectiveTo investigate the mechanism of Periostin (POSTN) regulating AKT signaling pathway to activate the epithelial-mesenchymal transition (EMT) of gastric cancer cells. MethodsPericancerous, cancerous, metastases and primary tumor tissues of patients with gastric cancer at different pathological stage were selected for immunofluorescence staining with POSTN and CD44.POSTN gene was overexpressed or knocked out in human gastric cancer cells MGC 803, and AKT inhibitor LY294002 was added for culture.The expression levels of POSTN, CD44 and EMT-related genes in gastric cancer cells were detected using RT-qPCR and Western blotting.The proliferation level of gastric cancer cells was detected using CCK-8.Transwell assays were used to detect the migration and invasion of cells. ResultsThe expression of POSTN in metastasis was higher than that of primary tumor, and the expression of POSTN in primary tumor was higher than that of pericancerous tissue.Compared with normal MGC 803 cells, the expressions of POSTN, CD44, α-sma, snail, slug, Vimentin were increased and E-Cadherin was reduced in gastric cancer cells overexpressing POSTN, while POSTN knockout inhibited the expressions of CD44, α-sma, snail, slug, Vimentin and increased the expressions of E-Cadherin.The overexpression of POSTN promoted the metastasis and invasion of gastric cancer cells, while the reduction of POSTN inhibited the metastasis and invasion of gastric cancer cells.The addition of LY294002 significantly improved the expression changes of α-sma, snail, slug, Vimentin, E-Cadherin, proliferation activity, migration and invasion ability caused by overexpression of POSTN gene in gastric cancer cells(P < 0.01). ConclusionsThe expression of POSTN in the cancerous and metastatic of gastric cancer is up-regulated, and the later the clinical stage, the higher the expression of POSTN in the cancerous; POSTN activates the EMT of gastric cancer cells by regulating the AKT signaling pathway, thereby promoting the proliferation, migration and invasion of gastric cancer cells.
2023, 48(4): 426-431.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.002
Abstract:
ObjectiveTo investigate the effects and mechanism of low molecular weight heparin(LMWH) combined with cisplatin(DDP) on the autophagy of human hepatocellular carcinoma(HCC) BEL-7404 cells. MethodsThe BEL-7404 liver cancer cells were treated with different concentrations of LMWH and DDP alone or in combination for 48 h, and divided into the control group, LMWH group, DDP group and L+D group.CCK-8 method was used to measure the effects on cell proliferation ability.Dansylcadaverine fluorescence staining was used to observe the autophagy levels.The expression of autophagy-related protein mRNA was detected by RT-PCR.Western blotting was used to detect the expression of autophagy-related proteins and pathway proteins. ResultsCompared with other groups, the cell proliferation ability significantly decreased(P < 0.05), the green fluorescence autophagy body significantly increased, the mRNA and protein expression levels of autophagy-related protein LC3Ⅱ significantly increased(P < 0.01), the p62 significantly decreased(P < 0.01), and the protein expressions of P-AMPK/AMPK, P-ULK1/ULK1 and Beclin1 significantly increased in the L+D group(P < 0.05 to P < 0.01). ConclusionsThe LMWH combined with DDP can significantly increase the autophagy of BEL-7404 cells, which may be realized through activating AMPK-ULK1-Beclin1 signaling pathway.
2023, 48(4): 432-435.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.003
Abstract:
ObjectiveTo observe the dynamic expressions of interleukin-35 (IL-35) and foxhead box p3 (Foxp3) in experimental rats with periapical periodontitis, and to explore the role of IL-35 in periapical periodontitis. MethodsForty SPF-grade SD rats were selected and randomly divided into 5 groups.The model of periapical periodontitis was established by pulpotomy of the unilateral mandibular first molar.One group was sacrificed at random on the 0, 7, 14, 21 and 28 d after operation, respectively.X-ray films were taken in the mandible to observe periapical changes.The periapical tissues of the mandibular first molars were collected and stained with hematoxylin-eosin(HE) to observe their histopathological changes.The expressions of IL-35 and Foxp3 mRNA in the periapical lesions were dynamically detected using real-time quantitative PCR (RT-qPCR). ResultsX-ray and HE staining showed that with the extension of pulp exposure time, the degree of periapical periodontitis increased gradually, and the inflammation tended to be stable after the pulp cavity was opened for 21 to 28 days.The clinical manifestations and histopathology confirmed the successful establishment of the periapical periodontitis.RT-qPCR results showed that the mRNA relative expression levels of IL-35 and Foxp3 increased in a fluctuating trend at different periods of operation (P < 0.01), increased rapidly at 0-7 days after pulp opening, decreased at 7-21 days (P < 0.05), and increased at 21-28 days (P < 0.05).Pearson correlation analysis showed that there was a positive correlation between IL-35 mRNA and Foxp3 mRNA expression (r=0.609, P < 0.05). ConclusionsThe expression level of IL-35 in periapical periodontitis is inversely proportional to the degree of inflammation, which may be involved in the occurrence and development of periapical periodontitis by regulating the expression of Treg.
2023, 48(4): 436-440.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.004
Abstract:
ObjectiveTo explore the effect of circPTPRA on the proliferation and migration of rheumatoid arthritis fibroblast-like synoviocytes and its regulatory effect on miR-140-5p. MethodsThe primary human normal fibroblast-like synoviocyte and rheumatoid arthritis fibroblast-like synoviocyte were isolated and cultured.The synovial fibroblasts of rheumatoid arthritis were divided into NC group(without transfection), si-NC group(transfected si-NC), si-circPTPRA group (transfected si-circPTPRA), miR-NC group (transfected miR-NC) and miR-140-5p group (transfected miR-140-5p mimics), anti-miR-NC+si-circPTPRA group (co-transfected anti-miR-NC and si-circPTPRA), anti-miR-140-5p+si-circPTPRA group (co-transfected anti-miR-140-5p and si-circPTPRA).The expression levels of circPTPRA and miR-140-5p were detected by qRT-PCR.The cell proliferation was detected by MTT test, and the cell migration was tested by Transwell chamber.The targeting relationship between circPTPRA and miR-140-5p was detected through the dual luciferase reporter gene experiment. ResultsCompared with normal fibroblast-like synoviocytes, in rheumatoid arthritis fibroblast-like synoviocytes, the expression of circPTPRA was increased, while the expression of miR-140-5p was decreased (P < 0.01).Compared with the si-NC group, in the si-circPTPRA group, the cell viability was decreased, the number of migrating cells was decreased (P < 0.05).Compared with the miR-NC group, in the miR-140-5p group, the cell viability and the number of migrating cells were decreased (P < 0.01).CircPTPRA could target miR-140-5p.Compared with the anti-miR-NC+si-circPTPRA group, the cell viability was increased as well as the number of migrating cells in the anti-miR-140-5p+si-circPTPRA group (P < 0.01). ConclusionsInterference with the expression of circPTPRA can inhibit the proliferation and migration of rheumatoid arthritis fibroblast-like synoviocyte by targeting the expression of miR-140-5p.
2023, 48(4): 441-444.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.005
Abstract:
ObjectiveTo investigate the level of prostate specific antigen (PSA) in elderly men over 60 years old in Yangzhou, and explore the relationship between PSA screening and early diagnosis and treatment of prostate cancer. MethodsThe detailed inclusion and exclusion criteria was formulated, and 3 102 elderly men over 60 years old who underwent physical examination in Yangzhou from May to July 2020 with complete follow-up information were selected.The serum PSA level was detected by chemiluminescent enzyme immunoassay.The patients who met the prostate cancer puncture criteria were subjected to transperineal prostate biopsy guided by B-ultrasound, and Gleason score was performed. ResultsWith the increase of age, the proportion of abnormal PSA level increased significantly (P < 0.01).A total of 62 elderly patients underwent prostate biopsy, of which 38 patients had PSA between 4-10 ng/mL, and 14 patients (36.8%) were diagnosed as cancer; PSA>10 ng/mL in 24 cases, and 15 (62.5%) cases were diagnosed as cancer by puncture.With the increase of PSA level, the proportion of positive prostate puncture increased (P < 0.05).According to the tumor staging of puncture positive subjects, with the increase of PSA, the higher the Gleason score of tumor and the greater the risk coefficient (P < 0.05). ConclusionsWith the increase of age, PSA shows an upward trend, and the higher the level of PSA, the greater the possibility of prostate cancer, and the higher the degree of malignancy.Early and regular PSA examination is recommended for elderly men.
2023, 48(4): 445-448.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.006
Abstract:
ObjectiveTo investigate the value of the lymphocyte CD4+/CD8+ ratio, N-terminal brain natriuretic peptide precursor(NT-probNP) and interleukin 6(IL-6) in evaluating the prognosis of patients with septic shock. MethodsSeventy-seven patients with septic shock were selected for prospective study, and the CD4+/CD8+ ratio, NT-probNP, IL-6 and Maximun lactate (Lac) levels in all cases were detected in the first 24 h after septic shock.The gender, age, acute physiology and chronic health status scoring system Ⅱ(APACHE Ⅱ) score, combined with underlying diseases and other data were recorded.The independent risk factors of death in septic shock patients were analyzed by logistic regression analysis, and the CD4+/CD8+ ratio, NT-probNP and IL-6 were analyzed by linear correlation regression with APACHE Ⅱ score.The receiver operating characteristic(ROC) curve was drawn to analyze the value of CD4+/CD8+ ratio, NT-probNP and IL-6 in the evaluation of prognosis of patients with septic shock. ResultsThe levels of NT-probNP and IL-6 in septic shock death group were significantly higher than those in survival group(P < 0.05), and the CD4+/CD8+ ratio in septic shock death group was significantly lower than that in survival group.The results of logistic regression analysis showed that the age, APACHE Ⅱ score, underlying disease, Lac, NT-probNP and IL-6 were the independent risk factors of death in patients with septic shock, and the CD4+/CD8+ ratio was a protective factor.The IL-6 and NT-probNP had a good correlation with APACHE Ⅱ(P < 0.01), while the CD4+/CD8+ ratio had not significant correlation with APACHE Ⅱ(P>0.05).The ROC curve showed that the predictive efficacy of serum NT-probNP, IL-6 and blood CD4+/CD8+ ratio on the death of septic shock patients on day 1 were 0.793, 0.678 and 0.708, respectively(P < 0.05).The area under ROC curve was 0.840(P < 0.05). ConclusionsThe CD4+/CD8+ ratio, NT-proBNP and IL-6 are significantly correlated with the severity and prognosis of septic shock patients.The combination of these three factors has excellent predictive value for the prognosis of septic shock patients.
2023, 48(4): 448-452.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.007
Abstract:
ObjectiveTo understand the role and safety of belimumab in inducing remission of systemic lupus erythematosus (SLE). MethodsA total of 31 patients with SLE who met the inclusion conditions were selected as the observation group, belimumab was combined with routine treatment for 3-6 months in the active phase of the disease.Patients with SLE treated with routine therapy in the same period were selected as the control group.The changes of laboratory indicators, disease activity index of systemic lupus erythematosus (SLEDAI score), change in glucocorticoid dose and adverse events were compared between the two groups before and after treatment.The illness changes and safety observation indexes of the two groups were statistically analyzed. ResultsAfter 3 months of treatment, the CRP, ESR, IgG, ANA, dsDNA, anti-nucleosome antibody, SLEDAI score and prednisone dose in the two groups were lower than those before treatment, and the C3, C4 and platelet count were higher than those before treatment.The C4 level and platelet count in the observation group after treatment were higher than those in the control group, while the dsDNA and SLEDAI scoreand prednisone dose were significantly different in different time periods (P < 0.05 to P < 0.01).The two groups were well tolerated during the treatment and follow-up. ConclusionsBelimumab combined with routine treatment can improve the therapeutic effect in patients with SLE, significantly improve the condition in the early stage, have higher benefit rate with continuous using and have good safety.
2023, 48(4): 453-456.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.008
Abstract:
ObjectiveTo explore the curative effect of budesonide inhalation combined with montelukast sodium and levocetirizine on the treatment of children with cough variant asthma. MethodsA total of 80 children aged 6-12 diagnosed with cough variant asthma were selected as the research objects, and randomly divided into the observation group and the control group, with 40 cases in each group.The control group received budesonide inhalation aerosol inhalation therapy and corresponding supportive treatment, while the observation group received oral montelukast sodium and levocetirizine on the basis of the control group.The clinical efficacy was evaluated by measuring the levels of inflammatory factors and other pulmonary function indicators before and after treatment, and recording the total effective rate and the occurrence of adverse reactions. ResultsThe total effective rate of the observation group was 100.00%, which was higher than 72.50% of the control group (P < 0.01).Before treatment, there was no significant difference in the levels of inflammatory factors and lung function indexes between the two groups (P>0.05).After treatment, the levels of IgE, IL-4 and IL-13 in the observation group and the control group were significantly lower than those before treatment (P < 0.01), and the reduction range in the observation group was greater than that in the control group (P < 0.01).After treatment, the indexes of lung function in the observation group and the control group were significantly higher than those before treatment (P < 0.01), and the increase in the observation group was greater than that in the control group (P < 0.01).The rate of adverse reactions in the observation group occurred was also lower than that of the control group, and the difference was statistically significant (P < 0.05). ConclusionsBudesonide inhalation combined with montelukast sodium and levocetirizine in the treatment of children with cough variant asthma can significantly improve the effective rate and lung function, reduce the levels of inflammatory factors and the incidence of adverse reactions, which is worth promoting in clinical appilcation.
2023, 48(4): 457-461.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.009
Abstract:
ObjectiveTo investigate the effects of tirofiban combined with fasudil on the coagulation, fibrinolysis, inflammation and echocardiographic parameters in patients with acute myocardial infarction(AMI) after PCI. MethodsA total of 206 AMI patients treated with PCI were selected, and divided into the observation group(n=103) and control group (n=103) by random number table.The control group was treated with tirofiban, and the observation group was treated with fasudil on the basis of the control group.The immediate postoperative thrombolysis in myocardial infarction(TIMI) grade, TIMI myocardial perfusion grade(TMPG), adverse reactions and major adverse cardiovascular events(MACE) after 3 months of surgery were compared between two groups.The thrombin fibrinolytic indexes[including the thrombin time (PT), activated partial thrombin time(APTT), fibrinogen(FIB) and plasminogen activator inhibitor-1(PAI-1)], inflammatory indexes[including the tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and hypersensitive C-reactive protein(HS-CRP)] were compared between two groups before operation, and after 3 d and 7 d of operation.The echocardiographic parameters[including the left ventricular ejection fraction(LVEF), cardiac index(CI), left ventricular end diastolic diameter(LVEDD) and left ventricular end systolic diameter(LVESD)] were compared between two groups before surgery and after 7 d of surgery. ResultsThe immediate postoperative TIMI classification rate of grade 3 and rate of TMPG grade 3 in observation group were higher than those in control group(P < 0.05).After 3 d and 7 d of operation, the levels of PT and APTT increased, while the levels of FIB, PAI-1, TNF-α, IL-6 and hs-CRP decreased in two groups compared with before operation(P < 0.05), and which in observation group was better than that in control group(P < 0.01).After 7 d of operation, the levels of LVEF and CI in two groups increased, the levels of LVEDD and LVESD decreased compared with before operation(P < 0.05), and which in observation group were better than that in control group(P < 0.01).There was no statistical significance in the incidence of adverse reactions between two groups(P>0.05).The incidence of MACE in observation group was lower than that in control group after 3 months of operation(P < 0.05). ConclusionsTirofiban combined with fasudil can improve the overall therapeutic effects of PCI, reduce the risk of MACE in AMI patients, and the safety is guaranteed.
2023, 48(4): 462-465.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.010
Abstract:
ObjectiveTo explore the predictive value of CHA2DS2-VASc score, baseline NIHSS score and neutrophil/lymphocyte ratio (NLR) for short-term prognosis in patients with non-valvular atrial fibrillation (NVAF) complicated with acute cerebral infarction. MethodsThe patients with NVAF complicated with acute cerebral infarction hospitalized from 2018 to 2020 were continuously included, and the clinical data of all patients were completely collected.The patients were divided into poor prognosis group and good prognosis group according to the modified Rankin scale (mRS score) 90 days after the onset of the disease.The differences in relevant data between the two groups were compared.The independent influencing factors for short-term prognosis were analyzed using binary logistic regression.The predictive value of CHA2DS2-VASc score, baseline NIHSS score, NLR single index and the combination of the three for short-term prognosis of NVAF complicated with acute cerebral infarction was evaluated by ROC curve. ResultsA total of 238 patients were included in this study, including 90 patients in the poor prognosis group and 148 patients in the good prognosis group.There were statistically significant differences between the two groups in age, gender, combined pulmonary infection rate, baseline NIHSS score, CHA2DS2-VASc score, NLR, uric acid, C-reactive protein, and fibrinogen (P < 0.05 to P < 0.01).The CHA2DS2-VASc score, baseline NIHSS score, and NLR were independent influencing factors for short-term prognosis in patients with NVAF complicated with acute cerebral infarction (P < 0.05 to P < 0.01).The area under the ROC curve for short-term poor prognosis of NVAF complicated with acute cerebral infarction predicted by three indicators and their combination were 0.816, 0.885, 0.726, and 0.932, respectively (P < 0.01). ConclusionsThe CHA2DS2-VASc score, NIHSS score and NLR have a certain predictive value for the short-term poor prognosis of NVAF patients complicated with acute cerebral infarction, which can be used to assess the patient's early condition and further optimize treatment strategies.
2023, 48(4): 466-469.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.011
Abstract:
ObjectiveTo investigate the correlation of serum trimethylamine N-oxide (TMAO) level and coronary heart disease (CHD) and the degree of coronary artery stenosis. MethodsA total of 390 patients who underwent coronary angiography (CAG) were selected, including 285 cases in the CHD group, 173 cases in the acute coronary syndrome (ACS) group and 112 cases in the chronic coronary syndrome (CCS) group.Another 105 patients with CHD excluded by CAG were included in the control group.ACS patients was divided into three subgroups: ST-segment elevation myocardial infarction (STEMI) group, non-ST-segment elevation myocardial infarction (NSTEMI) group and unstable angina pectoris (UAP) group.According to Gensini scoring criteria, CHD patients were divided into mild stenosis group, moderate stenosis group and severe stenosis group.Serum TMAO level was measured by enzyme-linked immunosorbent assay (ELISA), and the general information and serum TMAO level were compared among the groups. ResultsThere were no significant differences in age, gender, height, weight, body mass index, triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine, urea nitrogen, blood glucose and history of diabetes mellitus among the three groups (P>0.05).Compared with the control group, the proportion of hypertension, the proportion of smoking, the levels of LP-PLA2, BNP and TMAO in the ACS group and CCS group were significantly increased (P < 0.01), and the levels of TC, IL-6 and hs-CRP in the ACS group were significantly higher than those in the control group (P < 0.05 to P < 0.01).Compared with the CCS group, the levels of TC, IL-6, hs-CRP, LP-PLA2 and TMAO in the ACS group were significantly higher (P < 0.01).There was no significant difference in serum TMAO level among the three groups (P>0.05).Logistic regression analysis showed that TMAO, TC, LP-PLA2, smoking and hypertension were independent risk factors for CHD (P < 0.05 to P < 0.01).ROC curve analysis showed that the optimal cut-off value of serum TMAO for diagnosing CHD was 13.80 μmol/L, AUC was 0.702, sensitivity and specificity were 73.70% and 62.90%, respectively.The AUC of TMAO+IL-6+ LP-PLA2 +hs-CRP was 0.792, and the sensitivity and specificity were 71.60% and 74.30%, respectively.The levels of TMAO in the moderate and severe stenosis groups were significantly higher than those in the mild group, and those in the severe group were significantly higher than those in the moderate group (P < 0.01). ConclusionsThe level of serum TMAO in patients with CHD is higher, and the level in patients with ACS is higher than that in patients with CCS, which is an independent risk factor for CHD and can be used as a potential index for the diagnosis and evaluation of the degree of coronary artery stenosis in CHD.
2023, 48(4): 470-473.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.012
Abstract:
ObjectiveTo investigate the correlation between different concomitant types of cerebral small vessel disease and vascular cognitive dysfunction. MethodsA total of 96 outpatients and inpatients with cerebrovascular disease were selected as the observation group, while 90 normal subjects with normal cognitive function and imaging examination were selected as the control group.After enrollment, all subjects were subjected to GE Signa 3.0T EXCITE HDMR system for head MRI scan+DWI+SWI+MRA, and the films were read by two MRI specialists at the associate chief physician level.According to the results of the head MRI, the subjects were divided into single type of cerebral small vessel disease group, two types of cerebral small vessel disease group, three types of cerebral small vessel disease group, four types of cerebral small vessel disease group and normal control group.Neurological evaluation was performed on the patients using the Montrel cognitive assessment(MoCA) and the mini mental state examination(MMSE).The levels of MoCA and MMSE in different subjects were compared, and the correlation between the complexity of cerebral small vessel disease and MoCA and MMSE was analyzed. ResultsThe levels of MoCA and MMSE in the observation group were significantly lower than those in the control group(P < 0.01).The differences of MoCA and MMSE scores in patients with different types of cerebral small vessel disease were statistically significant(P < 0.01).The scores of MoCA and MMSE were as follows: single cerebral small vessel disease group>two types of cerebral small vessel disease group >three types of cerebral small vessel disease group >four types of cerebral small vessel disease group(P < 0.05).Correlation analysis showed that the complexity of cerebral small vessel disease was negatively correlated with MoCA and MMSE(P < 0.01). ConclusionsThe vascular cognitive dysfunction in patients with cerebral small blood vessel disease is significantly higher than that in healthy people, and the vascular cognitive impairment is more serious with the complexity of cerebral small vessel disease.
2023, 48(4): 474-478.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.013
Abstract:
ObjectiveTo investigate the value of COSSH-ACLF, MELD and AARC-ACLF model in short-term prognosis of artificial liver in treatment of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF). MethodsA total of 44 patients who were diagnosed HBV-ACLF collected in July 2017 to November 2020 in the First Affiliated Hospital of Bengbu Medical College and performed artificial liver therapy were selected, including improvement group (27 cases) and progression group (17 cases).The correlation indexes and the model system score were compared between the two groups.ROC curves were drawn for indexes with P < 0.05, and the area under the curve (AUC) was compared. ResultsThe scores of international standardized ratio (INR) and MELD, COSSH-ACLF, AARC-ACLF comprehensive scoring systems in the progression group were higher than those in the improvement group, and the differences were all statistically significant (P < 0.05 to P < 0.01).ROC curve analysis showed that INR and MELD, COSSH-ACLF, AARC-ACLF model systems had good predictive value for short-term prognosis of patients with HBV-ACLF treated with artificial liver (AUC was 0.801, 0.834, 0.796, 0.709, respectively, P < 0.05 to P < 0.01), and there was no significant difference between the three model systems (P>0.05). ConclusionsAll three model systems have a good predictive effect on the prognosis of HBV-ACLF patients receiving artificial liver treatment.
2023, 48(4): 478-481.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.014
Abstract:
ObjectiveTo explore the relationship among the time in range (TIR), fluctuation of blood glucose, glycated hemoglobin (HbA1c) and microangiopathy in type 2 diabetes mellitus(T2DM). MethodsA total of 142 patients with T2DM were divided into the diabetic microangiopathy group (DMAP group) and the control group (NDMAP group) according to their diabetic retinopathy and diabetic nephropathy.The general clinical data, laboratory data and dynamic blood glucose index were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between DMAP and each index.The influencing factors of DMAP were analyzed by binary logistic regression analysis.The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of HbA1c and TIR for DMAP. ResultsThere were significant differences in the course of disease, HbA1c, cholesterol (TC), blood glucose standard deviation (SDBG), mean blood glucose (MBG), mean amplitude of glycemic excursions (MAGE) and TIR between the DMAP group and NDMAP group(P < 0.05 to P < 0.01).Spearman correlation analysis showed that DMAP was negatively correlated with TIR (r=-0.424, P < 0.01), and positively correlated with HbA1c, MBG, SDBG and MAGE (r= 0.471, 0.314, 0.371, 0.233, P < 0.01).Binary logistic regression analysis showed that HbA1c was a risk factor for DMAP and TIR was a protective factor for DMAP.ROC curve analysis results showed that the area under the ROC curve for HbA1c and TIR was 0.792 and 0.763, respectively. ConclusionsHbA1c and TIR are both related to DMAP, which can predict the risk of DMAP.
2023, 48(4): 482-485.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.015
Abstract:
ObjectiveTo explore the effect of low-dose calcitriol combined with sevelamer carbonate on chronic kidney disease-mineral and bone abnormalities (CKD-MBD) in patients undergoing maintenance hemodialysis (MHD). MethodsA total of 84 patients with MHD were selected as the research objects, and they were divided into the control group and observation group using a random number table method, with 42 cases in each group.Patients in the control group were given hemodialysis treatment and oral sevelamer carbonate, and the patients in the observation group were given oral administration of low-dose calcitriol on this basis for 2 months.The clinical efficacy, high-sensitivity C-reactive protein (hs-CRP), blood phosphorus, blood calcium and serum parathyroid hormone (iPTH) levels, abdominal aortic calcification (AAC) point before and 2 months after treatment, and the occurrence of adverse reactions were observed and compared. ResultsAfter 2 months of continuous treatment, the total effective rate of the control group was 69.05%, which was higher than that of the observation group 88.10% (P < 0.05).The serum hs-CRP, phosphorus, and iPTH levels of the control group and the observation group were significantly lower than those before treatment, and the blood calcium level was significantly increased (P < 0.05 to P < 0.01).The serum hs-CRP, phosphorus, calcium and iPTH levels of the observation group were significantly lower than those of the control group (P < 0.01).After treatment, the AAC scores of the observation group and the control group were significantly increased, which of and the observation group was significantly lower than the control group (P < 0.01).The total incidence of adverse reactions in the observation group was 7.14%, the total incidence of adverse reactions in the control group was 11.90 %, and there was no significant difference between the two groups (P>0.05). ConclusionsCombined application of low-dose calcitriol and sevelamer carbonate in MHD patients on the basis of conventional treatment can effectively reduce blood phosphorus and iPTH levels, improve the micro-inflammatory state, delay vascular calcification, and improve the therapeutic effect.It has good safety.
2023, 48(4): 486-489.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.016
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ObjectiveTo investigate the effectiveness and feasibility of ultrasound-guided percutaneous transluminal angioplasty(PTA)in the treatment of arteriovenous graft(AVG)stenosis, and analyze the influencing factors of patency rate after PTA. MethodsThe inner diameter of stenosis, hemodialysis blood flow, brachial artery blood flow changes in 36 maintenance hemodialysis patients with AVG stenosis before and after PTA were retrospectively analyzed, and the therapeutic effects were evaluated.The patency rate was detected every 3 months after surgery. ResultsAll 36 patients were successfully operated.Before the treatment of PTA, the diameter of stenosis, AVG blood flow and brachial artery blood flow were(1.58±0.35)mm, (144.13±19.12)mL/min and(352.30±42.01)mL/min, respectively.After the treatment of PTA, the diameter of stenosis, AVG blood flow and brachial artery blood flow were(3.71±0.62)mm, (275.75±14.29)mL/min and(616.83±45.92)mL/min, respectively.The differences of the diameter of stenosis, AVG blood flow and brachial artery blood flow between before and after treatment were statistically significant(P < 0.01), and which indicated that the treatment was effective.The patients were followed up for 3, 6, 9 and 12 months, and the primary patency and secondary patency rates were 80.6%, 66.7%, 47.2% and 38.9%, and 88.9%, 75.0%, 69.4% and 58.3% at each time-point, respectively.There was no statistical significance at each follow-up time between primary patency rate and secondary patency rate(P>0.05).The age of patients with postoperative 1 year patency was lower than that of patients with postoperative 1 year non-patency(P < 0.01). ConclusionsThe PTA guided by ultrasound is an effective method in the treatment of AVG stenosis, and the older the patient is, the lower the postoperative patency rate is.
2023, 48(4): 490-493.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.017
Abstract:
ObjectiveTo investigate the correlation between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammatory index (SII) and the prognosis of newly diagnosed multiple myeloma (MM) patients. MethodsAfter six months of treatment, the patients with MM for the first time were divided into the remission group (n=34) and non-remission group (n=25) according to their prognosis condition.The relationship among NLR, PLR, SII and the outcome of MM patients was explored, the independent risk factors of MM prognosis were analyzed by logistic regression analysis, and ROC curve was used to evaluate the prognostic value. ResultsThere were no significant differences in PLR, underlying diseases, age, gender, blood calcium concentration and creatinine between the remission group and the non-remission group (P>0.05).NLR and SII in remission group were lower than those in non-remission group (P < 0.01).Multivariate logistic regression analysis showed that high level of SII was an independent risk factor for MM prognosis (OR=1.005, P < 0.05).ROC curve analysis indicated that the area under the curve was 0.754 and the specificity was 85.3% when SII predicted the survival of patients.The area under the curve of NLR was 0.722 and the specificity was 79.4%. ConclusionsNLR and SII can be used to evaluate the prognosis of MM.Furthermore, the prognostic value of SII is better than NLR.
2023, 48(4): 493-497.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.018
Abstract:
ObjectiveObjective to investigate the effect of Sacubitril/trivalsartan on left ventricular remodeling and cardiac function in patients with acute anterior myocardial infarction after emergency percutaneous coronary intervention(PCI). MethodsSixty inpatients with acute anterior myocardial infarction of Hefei Second People's Hospital from January 2019 to December 2019 were selected as the research objects.The patients were randomly divided into experimental group(n=30) and control group(n=30).Both groups were treated with emergency PCI.Besides the conventional treatment, for 12 months, Sacubitril/trivalsartan and benazepril were given to the patients in experimental and control group respectively.The follow-up was done at the day before discharge and at 1, 3, 6 and 12 months after discharge.Left ventricular end diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF), interventricular septal thickness(IVST) and left ventricular mass index(LVMI) were recorded.At the same time, NT-proBNP, KCCQ, 6MWT, cardiovascular adverse events and adverse drug reactions were recorded. ResultsLVEDD in the observation group was lower than that in the control group at 1, 3, 6, 12 months after discharge(P < 0.05 to P < 0.01);LVEF in the observation group increased 1, 3, 6 and 12 months after discharge compared with the day before discharge(P < 0.05), LVEF in the control group increased 6 and 12 months after discharge compared with the day before discharge(P < 0.05), LVMI in the observation group decreased 3, 6 and 12 months after discharge compared with the control group(P < 0.05).With the prolongation of treatment time, NT proBNP of patients in the two groups decreased gradually(P < 0.05), and the observation group decreased significantly at 1 and 3 months after discharge when compared with the control group (P < 0.05 and P < 0.01);KCCQ of patients in the two groups increased at 3, 6, 12 months after discharge compared with the day before discharge(P < 0.05), and 6MWT of patients in the two groups increased significantly at 1, 3, 6, 12 months after discharge compared with the day before discharge(P < 0.05).There was no significant difference between the two groups in the total incidence of major cardiovascular and cerebrovascular adverse events and adverse drug reactions(P>0.05). ConclusionsSacubitril/trivalsartan can improve the cardiac function of patients with acute anterior myocardial infarction as effective and safe as benazepril, even better in patients with left ventricular remodeling and cardiac function improvement speed.
2023, 48(4): 498-501.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.019
Abstract:
ObjectiveTo investigate the predictive value of modified shock index (MSI) on cardiac dysfunction and prognostic risk in septic shock patients. MethodsA total of 139 patients with septic shock were selected, the general clinical data, laboratory testing indicators, APACHE-Ⅱ score and cardiac function indicators were collected at admission, shock index (SI), mean arterial pressure (MAP) and MSI were calculated.According to their 1-month prognosis, the patients were divided into survival group and death group.Pearson correlation model was used to analyze the correlation between MSI and cardiac function in septic shock patients, and logistic multivariate regression analysis was used to analyze the risk factors affecting the prognosis of septic shock. ResultsIn survival group, the systolic blood pressure and diastolic blood pressure were higher, while heart rate and APACHE-Ⅱ score were lower than those in death group (P < 0.01).MAP, cardiac index (CI) and left ventricular ejection fraction (LVEF) were higher than those in death group (P < 0.01), while N-terminal pro brain natriuretic peptide (NT-proBNP), left ventricular end diastolic volume (LVEDV), SI and MSI were lower than those in death group (P < 0.01).MSI was positively correlated with NT-proBNP and LVEDV levels in septic shock patients (r=0.601, 0.598, P < 0.01), and was negatively correlated with CI and LVEF (r=-0.683, -0.659, P < 0.01).The increased APACHE-Ⅱ, SI, MSI and LVEF were all risk factors for mortality of the septic shock patients (OR=1.668, 55.070, 9.077×105, 1.259, P < 0.05 to P < 0.01), while the increases of MAP, CI and LVEDV were the protective factors for mortality of the septic shock patients (OR=0.861, 0.191, 0.941, P < 0.05 to P < 0.01). ConclusionsFor patients with septic shock, the higher the MSI, the worse the cardiac function.At the same time, MSI is an independent risk factor for mortality of septic shock patients, and MSI can be used as a predictor of cardiac dysfunction and prognosis at admission.
2023, 48(4): 502-506.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.020
Abstract:
ObjectiveTo explore the relationship between non-suicidal self-injury (NSSI)in adolescents with depression and their childhood psychological trauma. MethodsSeventy adolescent patients diagnosed with depressive disorder according to DSM-5 diagnostic criteria were selected.According to the presence or absence of NSSI, they were divided into depression with NSSI group and non-NSSI group, with 35 patients in each group.And 35 normal adolescents matched with gender, age and education level were used as the healthy control group.The Ottawa self-injury scale, the childhood trauma questionnaire (CTQ) and the Hamilton Depression Scale (HAMD-24) were used to evaluate the clinical symptoms. ResultsThe scores of emotional abuse, emotional neglect and total score of CTQ in NSSI group were higher than those in non-NSSI group, and the above three scores and physical abuse scores in the two groups were higher than those in the healthy control group, the difference was statistically significant (P < 0.05 to P < 0.01).The scores of sexual abuse and physical neglect in NSSI group were higher than those in healthy control group (P < 0.01).The frequency of non-suicidal self-harm was positively correlated with emotional neglect scores and cognitive impairment scores of HAMD scale in NSSI group (P < 0.05). ConclusionsThere is variable correlation between NSSI self-injury behaviors in adolescents with depression and childhood psychological trauma.
2023, 48(4): 507-511.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.021
Abstract:
ObjectiveTo investigate the comprehensive situation and influencing factors of pupils' school adaptation in a district of Shanghai, and to provide a basis for follow-up intervention. MethodsA total of 2 580 pupils from grade 2 to grade 5 in five schools were selected.Teachers filled in the teacher-student assessment scale to understand the students' school adaptation level.Parents filled in the social support assessment scale and the family function scale.Pupils filled in the children's social anxiety scale, the children's social expectation scale and the children's self-consciousness scale.Statistical analysis was performed. ResultsThe total scores and subscale scores of school adaptation in different schools, grades and genders were significantly different(P < 0.01).Parents' filling in and whether they were single parents had statistical significance on students' school adaptation except for self-report ability(P < 0.05 to P < 0.01).Except that there was no correlation between objective support and task orientation(P>0.05), the level of family social support was positively correlated with students' school adaptation and subscale(P < 0.05 to P < 0.01).The problem-solving factor in the family function scale had a negative correlation with students' school adaptation and subscale(P < 0.01), no correlation with communication factor and total function(P>0.05), and a positive correlation with other subscales(P < 0.05 to P < 0.01).Children's social anxiety and subscale fear of negative evaluation, social avoidance and distress were negatively correlated with students' school adaptation scale, while children's social expectation level was significantly positively correlated with students' school adaptation scale(P < 0.01).The factors of children's self-consciousness and behavior, intelligence and school, physical appearance and attributes, anxiety and sociability were significantly positively correlated with the total scale and subscale of students' school adaptation(P < 0.01), and happiness and satisfaction were significantly positively correlated with task orientation, behavior control and peer social ability in the subscale of school adaptation(P < 0.01).Intelligence and school, gender, grade, problem solving, children's social expectations, emotional intervention, children's social anxiety, father's ancestral home, objective support, physical appearance and attributes, happiness and satisfaction were the influencing factors of students' school adaptation(P < 0.05 to P < 0.01). ConclusionsThe pupils' school adaptation is influenced by many factors such as family environment and children's own mental health, future interventions should enhance the role of important factors.
2023, 48(4): 516-520.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.023
Abstract:
ObjectiveTo explore the mediating effect of self-disclosure between stigma and loneliness in breast cancer survivors based on the theory of social penetration, and provide theoretical support for carrying out intervention plan. MethodsA total of 220 breast cancer survivors who meeting criteria in the First Affiliated Hospital of Bengbu Medical College from November 2021 to April 2022 were selected as research subjects by convenience sampling method.The general data questionnaire, social impact scale (SIS), distress disclosure (DDI) index and loneliness scale (UCLA-8) were used to conduct a questionnaire survey, the correlation between various variables was analyzed, and the mediating effect of self-disclosure was tested. ResultsThe score of SIS, DDI and UCLA-8 of breast cancer survivors were 63.24±7.28, 38.28±8.76 and 18.59±4.37 points, respectively.Stigma was positively correlated with loneliness (r=0.595, P < 0.01), and self-disclosure was negatively correlated with stigma and loneliness (r=-0.405, -0.487, P < 0.01).Self-disclosure had some mediating effect between the stigma and loneliness, and the amount of mediating effect was 21%. ConclusionsLoneliness is common among breast cancer survivors, and self-disclosure and stigma are closely related to it.Medical staff should cooperate with family and social resources to take measures to reduce stigma and promote self-disclosure, so as to reduce loneliness and improve the overall quality of life.
2023, 48(4): 521-525.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.024
Abstract:
ObjectiveTo investigate the relationship between psychological resilience, family cohesion, adaptability and loneliness in radioactive 125Ⅰ seed implanted cancer patients. MethodsA total of 106 cancer patients who received radioactive 125Ⅰ seed implantation were selected according to the convenience sampling method.The general data of the patients were collected and the psychological resilience level were evaluated by Connor Davidson resilience scale (CD-RISC).Based on he family adaptability and cohesion scale Ⅱchinese version (FACESIICV) and loneliness scale of university of california at los angeles (UCLA). ResultsThe score of loneliness scale, psychological resilience scale and family adaptability and cohesion scale of the radioactive 125Ⅰ seed implanted cancer patients were (40.01±8.63), (61.79±14.54) and (116.32±18.80) points, respectively.There were statistically significant differences in loneliness scores among different genders, occupations, education level and per capita monthly income of family (P < 0.01), statistically significant differences were observed in psychological resilience scores and family adaptability and cohesion scale scores among different genders and per capita monthly income of family (P < 0.01).There was a significant negative correlation between loneliness scale score and psychological resilience scale score (r=-0.912, P < 0.01) and a significant positive correlation between psychological resilience scale score and family adaptability and cohesion scale score (r=0.884, P < 0.01).Additionally, a significant negative correlation between the scores of loneliness scale and those of family adaptability and cohesion scale (r=-0.907, P < 0.01) were found in the study.Gender, occupation, education level, family per capita monthly income, psychological resilience score, family adaptability and cohesion scores were included in the multiple linear stepby-step regression analysis of the influencing factors of loneliness.The scores of family cohesion, adaptability and per capita monthly income of family were statistically significant (P < 0.01). ConclusionsDifferent gender, occupation, education level and per capita monthly income of family were the influencing factors of loneliness among the radioactive 125Ⅰ seed implanted cancer patients, as soon as possible to evaluate the degree of loneliness and effective intervention ahead of time, improve the patients' family adaptability and cohesion, it has a significant effect on reducing the degree of loneliness and is of great significance to promote the patients' early return to family and society.
2023, 48(4): 526-529.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.025
Abstract:
ObjectiveTo explore the effect of sequential comprehensive rehabilitation training program under risk assessment in elderly patients with chronic heart failure. MethodsA total of 56 cases of senile chronic heart failure were selected and divided into control group (n=28) and observation group (n=28) according to the order of hospitalization time.The patients in the control group received routine rehabilitation nursing, while patients in the observation group received sequential comprehensive rehabilitation training under risk assessment.The fear of exercise, exercise compliance, 6-minute walking distance (6MWD), left ventricular ejection fraction (LVEF) after one month, quality of life and readmission rate after three months were compared between the two groups. ResultsBefore intervention, there were no statistically significant differences in exercise compliance rate, exercise fear score, 6MWD, LVEF, and quality of life scores between the two groups (P>0.05).After one month of intervention, the exercise compliance rate, 6MWD, LVEF of the observation group were higher than those of the control group (P < 0.05), and the exercise fear score was significantly lower than that of the control group (P < 0.01).After 3 months of intervention, the quality of life score of the observation group was significantly lower than that of the control group (P < 0.01), and the readmission rate of patients in the observation group was 0.00% (0/28), which was lower than 17.86% (5/28) of the control group (P < 0.05). ConclusionsThe sequential comprehensive rehabilitation training program under risk assessment can effectively alleviate the fear of exercise in elderly patients with chronic heart failure, promote the compliance of rehabilitation training, and improve the rehabilitation of cardiac function, raise the quality of life, and reduce the readmission rate.
2023, 48(4): 530-533.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.026
Abstract:
ObjectiveTo investigate the effect of cardiac rehabilitation training based on rehabilitation risk assessment on cardiac function and major adverse cardiac events (MACE) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). MethodsA total of 149 cases of ACS patients undergoing PCI were selected and randomly divided into control group (74 cases) and observation group (75 cases).The control group performed routine cardiac rehabilitation training after PCI, the observation group performed cardiac rehabilitation training based on rehabilitation risk assessment.The cardiac function, incidence of MACE and nursing satisfaction were compared after 3 months. ResultsAfter 3 months of rehabilitation training, the left ventricular ejection fraction, left ventricular diastolic end diameter, N-terminal brain peptide sodium, and 6-minute walking test in the observation group were significantly better than those in the control group (P < 0.01).The incidence of MACE in the observation group was lower than that in the control group, but the difference was not statistically significant (P>0.05);The nursing satisfaction of the observation group was significantly higher than that of the control group (P < 0.01). ConclusionsCardiac rehabilitation training based on rehabilitation risk assessment is used for ACS patients undergoing PCI, helping to improve patient cardiac function, reduce the incidence of MACE, and promote patient cardiac rehabilitation and nursing satisfaction.
2023, 48(4): 534-538.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.027
Abstract:
ObjectiveTo investigate the effect of different treatment pressures of intermittent inflation compression (IPC) device on the prevention of deep venous thrombosis(DVT) of lower limb in severe long-term bedridden patients. MethodsOne hundred and twenty cases of critically ill long-term bedridden patients were selected as study subjects.They were divided into the control group, trial 1 group and trial 2 group randomly.The control group took 30 mmHg, the trial 1 group took 45 mmHg, and the trial 2 group took 60 mmHg.The incidence of DVT within 15 days, the D-dimer (D-D) levels before and after treatment, the peak blood flow in the femoral veins of both lower limbs and the incidence of deep tissue injury in the pneumatic therapy sleeve were compared among the three groups. ResultsThere was no statistically significant difference in the incidence of DVT among the three groups(P>0.05).Compared with the pre-treatment period, the D-dimer levels in the three groups decreased significantly after treatment (P < 0.05), and the comparison between the groups revealed that the reduction of D-dimer in the three groups was trial group 2 > trial group 1 > control group (P < 0.05).There was no statistically significant difference in the peak blood flow in the femoral veins of both lower limbs among the three groups before treatment (P>0.05).There was no statistically significant difference in the peak femoral venous blood flow between the three groups before treatment (P>0.05).After treatment, the peak femoral venous blood flow was significantly faster in both trial group 1 and trial group 2 compared with the control group (P < 0.05 and P < 0.01).NO case of deep tissue injury occurred in the control group (0%), 1 case in trial group 1 (2.5%), and 7 cases in trial group 2 (17.5%), and the incidence of deep tissue injury in trial group 2 was much higher than that in the control group and trial group 1 (P < 0.05 and P < 0.01). ConclusionsThe pressure parameter of 45 mmHg is more recommended for the application in patients with long-term pneumatic therapy, which can reduce the incidence of DVT, improve the coagulation function of the body and the blood circulation of patients' lower limbs and avoid the occurrence of deep tissue injury at the same time.
2023, 48(4): 538-543.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.028
Abstract:
ObjectiveTo analyze the influencing factors of frailty in maintenance hemodialysis (MHD) patients and establish a nomogram model for frailty risk. MethodsA total of 222 patients with MHD were selected by convenient sampling method.According to whether the patients had frailty, they were divided into frailty group (n=85) and non-frailty group (n=137).Univariate and multivariate logistic regression model were used to screen the risk factors of frailty in patients with MHD.Bootstrap was used for internal verification of the model.The receiver operating characteristic (ROC) curve, Homster-Lemeshow goodness-of-fit test combined with calibration curve, and clinical decision curve analysis (DCA) were used to evaluate the performance of the model. ResultsThere were 85 cases of frailty in 222 patients with MHD, and the incidence of frailty was 38.3%.Logistic regression analysis showed that age ≥60 years old (OR=3.454, 95%CI: 1.775-6.719), the number of dialysis complications (OR=1.609, 95%CI: 1.173-2.207), albumin level (OR=0.901, 95%CI: 0.835-0.971), physical exercise (OR=0.684, 95%CI: 0.564-0.829) and night sleep time (OR=0.476, 95%CI: 0.316-0.716) were independent risk factors of frailty in patients with MHD (P < 0.05 to P < 0.01).Based on five independent risk factors, the nomogram prediction model of frailty in MHD patients was established.The area under ROC curve was 0.829 (95%CI: 0.777-0.882).After internal verification by Bootstrap resampling method, the consistency index of the model was 0.812.The fitting degree of nomograph model was good (P>0.05).The calibration curve showed that the correlation between the predicted probability and the actual probability incidence was good.The DCA showed that the model had good clinical practicability when the threshold probability was 0.03-0.83. ConclusionsThe prediction model based on the risk factors affecting the frailty of MHD patients has good differentiation, consistency and clinical practicability, and can provide guidance for the prevention of the frailty of MHD patients.
2023, 48(4): 544-547.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.029
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ObjectiveTo study the effect of arteriovenous fistula exercise on the upper limb motor function and frailty level in maintenance hemodialysis patients. MethodsSeventy maintenance hemodialysis patients were selected as the study subjects, and were divided into control group (n=31) and exercise intervention group (n=39) according to the time of admission.The control group was given routine nursing guidance, and the exercise intervention group was given exercise intervention guidance for 16 weeks with arteriovenous fistula exercise.The upper limb motor function and frailty level in the two groups were compared before and after intervention. ResultsAfter intervention, the total score of upper limb motor status scale, and the score of shoulder, elbow, forearm and wrist in the exercise intervention group were significantly higher than those in the control group (P < 0.01), and significantly higher than those before intervention (P < 0.01).There was no significant difference in the total score of upper limb motor status scale, and the score of shoulder, elbow, forearm and wrist in the control group between before and after intervention (P>0.05).After intervention, the total score of tilbury frailty indicator, and the score of physical asthenia and psychological asthenia in the exercise intervention group were significantly lower than those in the control group (P < 0.01), and lower than those before intervention (P < 0.05).There was no significant difference in the scores of social asthenia between the two groups after intervention (P>0.05), and there was no significant difference between the two groups before and after intervention (P>0.05).There was no significant difference in the total score of tilbury frailty indicator, and the score of physical asthenia, psychological asthenia and social asthenia in the control group between before and after intervention (P>0.05). ConclusionsAfter 16 weeks of intervention with arteriovenous fistula exercise, the upper limb motor function of dialysis patients is significantly improved, and the frailty level is relieved.
2023, 48(4): 548-554.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.030
Abstract:
ObjectiveTo investigate the intervention effect of symptom management dynamic model on oropharyngeal symptom cluster in nasopharyngeal carcinoma (NPC) patients undergoing concurrent chemo-radiotherapy. MethodsOne hundred and four patients with NPC undergoing concurrent chemo-radiotherapy were randomly divided into intervention group (53 cases) and control group (51 cases).The control group was given routine nursing and symptom management log, while the intervention group was given symptom management dynamic model on the basis of control group.The intervention began on day 1 of radiotherapy and ended 2 weeks after discharge, a total of 8 weeks.The severity of oropharyngeal symptoms was compared between the two groups at the end of the second week, the fourth week and the sixth week after the intervention and at the end of the second week after discharge.The quality of life between the two groups was compared before and after the intervention. ResultsThe symptom scores of pain, abnormal taste, dysphagia, sticky saliva and dry mouth showed time effects and inter-group effects both in the two groups, and positive interaction effects were found for pain and abnormal taste symptoms (P < 0.05 to P < 0.01).After intervention, The physical, cognitive and emotional domains of quality of life in the intervention group was higher than those of the control group (P < 0.05 to P < 0.01).After intervention, the quality of life of patients in social, physical, role and function domain were higher than before (P < 0.05). ConclusionsThe symptom management dynamic model can significantly reduce the severity of oropharyngeal symptom cluster and improve the quality of life of patients with NPC with concurrent chemo-radiotherapy.
2023, 48(4): 554-557.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.031
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ObjectiveTo explore the application effect of online interaction teaching and standardized patients (SP) combined teaching mode in thoracic surgery innovative teaching. MethodsA total of 40 third-year medical students of the clinical major were selected and divided into two groups.The control group received the traditional teaching of online, and the observation group arranged SP for interactive teaching through smart mobile terminals such as micro-class and micro-video.The teaching effect of the two groups was evaluated by online assessment and Wechat questionnaire. ResultsThe scores of theoretical knowledge and operation level in the observation group were significantly higher than those in the control group (P < 0.01), and the doctor-patient communication, disease analysis, interest in learning and ability improvement self-evaluation were significantly better than those in the control group (P < 0.01).In the evaluation of teaching effect, the students in the observation group were significantly better than those in the control group in terms of thinking enthusiasm, classroom concentration, content mastery, clinical thinking, cooperation and communication (P < 0.01). ConclusionsThe application of online interaction teaching mode combined with standardized patients in thoracic surgery teaching is conducive to stimulating students' learning autonomy and enthusiasm, enlightening clinical diagnosis thinking, cultivating the ability of combining theory with practice, improving teaching quality, cultivating students' team cooperation ability and improving comprehensive quality.
2023, 48(4): 558-561.
doi: 10.13898/j.cnki.issn.1000-2200.2023.04.032
Abstract:
ObjectiveTo explore the application effects of 3D printing technology combined with multimedia teaching based on CT angiography(CTA) data source in the teaching of abdominal aortic dilatation diseases. MethodsFrom April to October 2020, a total of 60 doctors with master degree in vascular surgery, regulatory affairs trainee and undergraduate interns from the First Affiliated Hospital of Bengbu Medical College were selected, and divided into the observation group and control group according to the random number allocation method(30 cases in each group).Four typical abdominal aortic dilatation cases treated with vascular interventional therapy in hospital were selected, and detected using CTA before operation.The 1∶1 solid model was made by 3D printing technology according to CTA data.The control group was taught with the traditional multimedia teaching method, while the observation group was taught with multimedia instruction combined with 3D printing technology based on CTA data source. ResultsThe total score in observation group was higher than that in control group(P < 0.05).The test scores of abdominal aortic anatomy, interventional therapy for dilated aortic diseases, indications and contraindications in observation group were significantly higher than those in control group(P < 0.05).The understanding the anatomical structure of vascular system, understanding the characteristics of aortic dilated disease, understanding the instruments and procedures of endovascular surgery, learning initiative and confidence in observation group were better than those in control group(P < 0.05).The satisfaction of the observation group was 90.00%, which was higher than that of the control group(60.00%)(P < 0.05). ConclusionsThe 3D printing technology combined with multimedia teaching based on CTA data source in the teaching of abdominal aortic dilatation disease can significantly improve the students' academic performance and satisfaction.It has a good application effect, and is suitable for promotion.
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