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2023 Vol. 48, No. 8
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2023, 48(8): 1013-1017.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.001
Abstract:
ObjectiveTo explore the effect and potential molecular mechanism of phillygenin (PHI) on Crohn's disease (CD) -like colitis induced by 2, 4, 6-trinitrobenzene sulfonic acid (TNBS). MethodsEighteen wild-type mice (C57BL/6J) aged 6-8 weeks were randomly divided into control group (WT group), model group (TNBS group) and PHI administration group (PHI group), with 6 mice in each group.Mice in the TNBS group and PHI group were treated with TNBS-induced CD colitis model while mice in the PHI group were given PHI administration (20 mg·kg-1·d-1, gavage) after modeling, while mice in the WT group and the TNBS group were given the same amount of 0.9% sodium chloride solution.After 7 days, the disease activity index (DAI), bodyweight changes and colon length were used to evaluate the symptoms of colitis.HE staining and histological inflammation scores were used to observe the injury degree of colon tissue.The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interferon-γ (IFN-γ) in colonic mucosal tissues of mice were determined by enzyme-linked immunosorbent assay.Network pharmacology was used to predict the possible mechanism of PHI action on CD and further verified by Western blotting. ResultsThe DAI scores and colon shortening in the PHI group were significantly lower than those in the TNBS group (P < 0.01), but still higher than those in the WT group (P < 0.01).The body mass of mice in the PHI group was higher than that in the TNBS group and lower than that in the WT group(P < 0.01).The scores of colon histology and the levels of inflammatory mediators (TNF-α, IL-6 and IFN-γ) in colonic mucosa in the PHI group were significantly lower than those in the TNBS group (P < 0.01), but still higher than those in the WT group (P < 0.01).Network pharmacology analysis identified a total of 63 potential targets of PHI on CD.Bioinformatics enrichment analysis showed that PHI was mainly involved in the regulation of inflammatory response, and might be related to interleukin-17(IL-17) signaling pathway.Finally, Western blotting showed that the expression levels of IL-17, interleukin-17RA and nuclear factor κB activator 1 in colonic mucosal tissue of mice in the PHI group were significantly lower than those in the TNBS group, but still higher than those in the WT group(P < 0.05 to P < 0.01). ConclusionsPHI can improve TNBS-induced CD-like colitis in mice, which may be related to the inhibition effect of IL-17 signaling pathway.
2023, 48(8): 1018-1023.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.002
Abstract:
ObjectiveTo explore the inhibitory effect of artesunate (Art) on an in vitro cultured model of Toxoplasma Gondii infection. MethodsAn in vitro infection model was established by infecting macrophages (Mφ) in the peritoneal cavity of mice with Toxoplasma Gondii RH strain expressing stable green fluorescent protein in the cytoplasm (RH-GFP).The experiment was divided into four groups: control group (0.9% sodiuom chloride solution), Art group (concentrations of 1.562 5, 3.125, 6.25, 12.5, 25, 50, 100 and 200 μg/mL), Azithromycin (Azm) group (positive control, concentrations of 12.5, 25, 50, 100, 200, 400, 800 and 1 600 μg/mL), Art+Azm group (concentrations of Art 1.562 5+Azm 12.5, Art 3.125+Azm 25, Art 6.25+Azm 50, Art 12.5+Azm 100, Art 25+Azm 200 and Art 50+Azm 400 μg/mL.After 24 hours of incubation, the change in proportion of parasites and cells was detected by flow cytometry, and the morphology and structural changes of tachyzoites were observed by Giemsa staining. ResultsCompared with the control group, the proportion of tachyzoites in the Art group decreased significantly with the increase of concentration from 3.125 μg/mL (P < 0.01), the proportion of free parasites was less than 0.3% at 50 μg/mL, and the infection rate of Mφ was less than 1.6%.In Azm group, the proportion of tachyzoites was less than 0.6% at 400 μg/mL, and the infection rate of Mφ was less than 3.5%.In the Art+Azm group, the proportion of tachyzoites in the Art 12.5+Azm 100 μg/mL group was less than 0.04%, and the infection rate of Mφ was less than 1.8%.Giemsa staining showed that with the increase of concentration in each group, the Toxoplasma Gondii tachyzoites gradually swelled and transformed from a banana shape to one with foamy cytoplasm.The internal structure collapsed and disintegrated until the cell membrane ruptured and contents spilled out, and only the solidified and deeply stained nuclei or fragments remained in the field of view. ConclusionsArt can significantly kill the free tachyzoites of Toxoplasma Gondii in vitro experiment and reduce the infection rate of host cells, and the anti-Toxoplasma Gondii effect is positively correlated with the concentration within a certain range.
2023, 48(8): 1024-1029.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.003
Abstract:
ObjectiveTo investigate whether interleukin-34 (IL-34) can affect the proliferation and migration of stem cells from apical papilla (SCAPs) by the regulation of nuclear factor-κB (NF-кB). MethodsThe enzymatic digestion method was used to culture SCAPs from the apical papillae of mice with medium incisors.The expression of CD44, CD45, CD90 and CSF-1R on the surface of SCAPs was identified by flow cytometry.SCAPs were divided into 4 groups including blank control group, IL-34 group (100 ng/mL IL-34), CSF-1R group (100 ng/mL IL-34+25 ng/mL anti-CSF-1R) and NF-κB group (100 ng/mL IL-34 + 1 μmol/L BMS-345541).Western blotting was used to analyze the relative expression of p-IкBα, IкBα, p-P65 and P65 protein in the cytoplasm and nucleus of SCAPs at 30, 60 and 120 minutes in each group.Transwell assay was performed to analyze the migration ability of SCAPs in each group.IL-34 concentration was changed to 50 ng/mL in each group, and CCK-8 was used to analyze the change of proliferation of SCAPs in each group. ResultsFlow cytometry identified that SCAPs expressed CD44, CD90 positive and CD45 negative, and CSF-1R expressed on the surface of SCAPs.Compared with the control group, the relative expression of p-IкBα, p-P65 in the cytoplasm and p-P65 in the nucleus of SCAPs treated with IL-34 was significantly increased and the proliferation and migration ability of SCAPs were enhanced.Compared with the IL-34 group, the proliferation and migration of SCAPs were decreased in the CSF-1R and NF-кB group, and the expression of p-IкBα, p-P65 in the cytoplasm and p-P65 protein in the nucleus of SCAPs was significantly reduced. ConclusionsIL-34 can regulate NF-κB signaling pathway in SCAPs and regulate the proliferation and migration of IL-34 through NF-κB signaling pathway.
2023, 48(8): 1030-1035.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.004
Abstract:
ObjectiveTo establish a lung ischemia-reperfusion (I/R) model in C57BL/6 mice, and to study the role of cannabinoid 2 (CB2) receptor in lung I/R injury by pretreatment with CB2 receptor agonist JWH-133 and antagonist AM-630. MethodsForty-eight mice were randomly divided into the following 4 groups: Sham group, I/R group, JWH133 group and AM630+JWH133 group, with 12 mice in each group.In Sham group, the hilum was separated by thoracotomy without clamping, and then ventilated for 3 hours.In the I/R group, after thoracotomy, the left pulmonary hilum was clamped with vascular forceps for 1 hour, and reperfusion was performed for 2 hours after release.JWH133 group: JWH-133 (5 mg/kg) was intraperitoneal injected 5 minutes after clamping of the pulmonary hilum, and the left hilum was occlusioned for 1 hour of ischemia, and then reperfusion was performed for 2 hours after release; AM630+JWH133 group.AM-630 (2 mg/kg) was intraperitoneally injected 30 minutes before JWH-133 injection, and the rest was the same as JWH133 group.Each group was then randomly divided into two subgroups for blood gas analysis, lung wet-dry ratio determination, lung histopathological examination and apoptosis-related proteins (Bcl-2, Bax, caspase-9) detection. ResultsCompared with I/R group, oxygenation index was increased, lung wet-dry ratio and pathological score of lung injury were significantly decreased in JWH133 group, lung tissue structure was improved by HE staining, the expression of Bcl-2 was significantly increased, and the expression of caspase-9 and Bax was significantly decreased.These effects were reversed by intraperitoneal injection of AM-630 prior to JWH-133 administration. ConclusionsIntraperitoneal injection of CB2 receptor agonist JWH-133 can inhibit the apoptosis of lung tissue in mice, and obviously alleviate the lung ischemia-reperfusion injury.Apoptosis may be involved in activating CB2 receptor-mediated lung protection.
2023, 48(8): 1035-1039.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.005
Abstract:
ObjectiveTo investigate the clinical application value of immediate laparoscopic pedicled greater omental breast reconstruction after total mastectomy for non-puerperal mastitis. MethodsA total of 52 patients with refractory non-puerperal mastitis were divided into the observation group(35 cases) and control group(17 cases).The observation group was treated with laparoscopic pedicled greater omental breast reconstruction immediately after total mastectomy, and the control group was treated with glandular suture after breast segmentectomy.The postoperative indexes, recurrence rate, complication rate and cosmetic effects were observed and recorded in two groups. ResultsThe operation time in the observation group was significantly longer than that in control group, and the indwelling time of the postoperative drainage tube in the observation group was significantly shorter than that in control group (P < 0.01).After 6 months of postoperative follow-up, the postoperative inflammation recurred in 3 cases in the control group, and the recurrence rate of which was 17.65%.No case in the observation group recurred after operation.The differences of the ostoperative aesthetic effects and satisfaction were staistically significant between two groups(P < 0.01). ConclusionsThe immediate laparoscopic pedicled greater omental breast reconstruction after total mastectomy is safe, reliable, has low recurrence rate and good cosmetic effects in the treatment of complex and refractory non-puerperal mastitis, which is worthy of promotion.
2023, 48(8): 1040-1044.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.006
Abstract:
ObjectiveTo investigate the optimal interval of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGD) in high-risk patients with acute cholecystitis, and to explore the risk factors of delayed surgery. MethodsCase data of 89 patients with high-risk acute cholecystitis were collected and categorized according to the different intervals of LC after PTGD: group A (time ≤4 weeks), group B (4 weeks < time ≤8 weeks), and group C (8 weeks < time ≤12 weeks).Patients in group A and group B with low incidence of PTGD puncture tube detachment, bleeding, puncture related infection and other complications were combined into group AB (catheter duration ≤8 weeks), which were compared again with group C (8 weeks < catheter duration ≤12 weeks) with high incidence of complications.Based on the clinical data collected after admission, the optimal time for LC after PTGD was analyzed, and the risk factors affecting the delay of surgery after PTGD were discussed. ResultsThere was no statistically significant difference in the first time of getting out of bed between group A, group B and group C (P>0.05).The time of first feeding fluid, discharge time and exhaust time after operation were shorter in group B (P < 0.05), the time of operation in group B and group C was shorter (P < 0.05), the postoperative complications in group A and group C were higher (P < 0.05), the proportion of patients who switched to laparotomy in group C was higher (P < 0.05), and the proportion of puncture tube shedding, bleeding and puncture tube-related infection in group C was higher (P < 0.05).The single factor results showed that the proportion of gallbladder wall thickness, abdominal operation history, calculi, age, history of hypertension, history of coronary heart disease and history of diabetes in group C were higher than those in group AB (P < 0.05).The results of multi-factor analysis showed that: preoperative gallbladder wall thickness ≥ 6 mm, previous history of abdominal surgery and age were the risk factors for delaying surgery for PTGD (OR>1). ConclusionsThe optimal surgical interval for LC after PTGD is 4-8 weeks.Preoperative gallbladder wall thickness ≥ 6 mm, history of abdominal surgery, and advanced age may be risk factors for prolonged surgical interval.
2023, 48(8): 1045-1049.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.007
Abstract:
ObjectiveTo study the effect of intraoperative fluoroscopy of wrist joint combined with internal fixation of volar "T" type universal locking titanium plate on distal radius fracture. MethodsA retrospective analysis was made on 42 cases of distal radius fractures treated with open reduction and locking plate internal fixation.Henry's approach was adopted for the operation.Four position fluoroscopy of wrist joint (standard anteroposterior lateral position, lateral tangent position and carpometacarpal flexion tangent position) was performed during the operation to determine whether the screws entered the joint cavity, lower radioulnar joint and penetrated the dorsal cortex of distal radius.All patients underwent routine three-dimensional CT reconstruction of wrist joint after the operation, and imaging evaluation was performed.The quality of fracture reduction before and after the operation of distal radius fracture was compared, the Cooney wrist function score before the operation and at the last follow-up was compared, and the detection rate of the screws with problems in the anteroposterior and lateral positions of the wrist joint and the four position films during the operation was compared. ResultsAll patients had a surgical time of 45-90 minutes, a surgical bleeding volume of 20-100 mL, and all surgical incisions healed clinically in the first stage.There were no complications such as incision infection or steel plate exposure.At the last follow-up, the excellent and good rate of Cooney wrist joint function score was significantly higher than before surgery (P < 0.01).After treatment, the radius height, palm inclination angle, and ulnar deviation angle of the patient were significantly higher than before treatment (P < 0.01).There was a statistically significant difference in the detection rate of screw problems between anteroposterior and lateral fluoroscopy and four position X-ray fluoroscopy (P < 0.01).All problematic screws during the surgery were promptly adjusted. Postoperative three-dimen sional CT examination of the wrist revealed that in one of the 42 cases, a screw in the radial column penetrated the dorsal cortex by about 2 mm.No symptoms of dorsal tendon irritation were observed during follow-up. ConclusionsThe application of "T" type universal locking titanium plate at the volar side of the distal radius in the treatment of distal radius fractures can achieve satisfactory fracture reduction and better clinical effect.Patients can achieve rapid rehabilitation exercise.
2023, 48(8): 1050-1055.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.008
Abstract:
ObjectiveTo construct a novel clinical-radiomics model of kidney stone for predicting the stone-free rate (SFR) of percutaneous nephrolithotomy (PCNL) and validate it. MethodsThe clinical and imaging data from 113 patients undergoing PCNL were retrospectively collected, and divided into stone removal group and stone residue group according to the results of the CT scan or X-ray of kidney-ureter-bladder review after operation.The clinical and radiomics data of patients were collected, the volume of interest was drawn on the CT images and 120 radiomics features were extracted using image analysis software and computer programming language tool.The variables of the training group were selected to obtain the best feature selection.A novel clinical-radiomics model was established by multivariate logistic regression analysis, and the area under the curve (AUC) was used to evaluate the predictive effect of the model. ResultsThe 113 patients underwent a follow-up examination of urological imaging one month after surgery, among them, 68 cases had stones removed and 45 cases had residual stones, and the overall SFR was 60.2%.There were statistically significant differences in gender, postoperative blood white blood cell (WBC), hospital stay, stone length, stone width, and Guy's score (GSS) of patients between the two groups (P < 0.05 to P < 0.01).Univariate logistic analysis showed that there were statistically significant differences in gender, GSS, postoperative blood WBC, stone length, and stone width (P < 0.05 to P < 0.01).Multivariate logistic analysis showed that gender, GSS, and postoperative blood WBC were independent predictors of postoperative SFR of PCNL (P < 0.05 to P < 0.01).The 14 meaningful radiomics features selected by Lasso regression were analyzed using univariate and multivariate logistic analysis, the results showed that there were statistically significant differences in maximum three-dimensional diameter and sphericity (P < 0.05 and P < 0.01).The maximum three-dimensional diameter and sphericity were used to construct a clinical-radiomics prediction model, the AUC in the training set was 0.923, which in the validation set was 0.876, and both was better than GSS. ConclusionsThe constructed novel clinical-radiomics model combined with clinical features can help to predict the SFR in PCNL patients, and provide reference for urologists in preoperative communication and selection of surgical methods.
2023, 48(8): 1056-1059.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.009
Abstract:
ObjectiveTo explore the efficacy and safety of simple endoscopic papillary balloon dilation in ERCP treatment of choledocholithiasis with periampullary duodenal diverticula (PAD). MethodsThe clinical data and therapeutic process of 301 patients undergoing endoscopic retrograde cholangiolithotomy were retrospectively analyzed.The patients were divided into PAD group and non-PAD group, and the differences of baseline characteristics and therapeutic indicators between the two groups were compared.The PAD group was further divided into the simple balloon dilation group and sphincterotomy combined with balloon dilation group, and the stone removal effect and postoperative complications of the two groups were compared. ResultsThe overall incidence of PAD in 301 patients with choledocholithiasis was 51.2%.There were statistically significant differences between the PAD group and non-PAD group in gender, age, diameter of the common bile duct, maximum diameter of stones, and opening method of the ampullary sphincter (P < 0.05 to P < 0.01).The implementation rate of simple balloon dilation in the PAD group was significantly higher than that in the non-PAD group (P < 0.01).There were statistically significant differences in the methods of expanding the ampullary sphincter in patients with different diverticulum types.The rate of prophylactic hemostasis using metal clips in the EPBD group was significantly lower than that in the EST+EPBD group, and the diameter of the common bile duct was larger than that in the EST+EPBD group (P < 0.05 to P < 0.01). ConclusionsSimple endoscopic papillary balloon dilation is safe and effective in ERCP with PAD, and demonstrates the advantage of simplified operation.
2023, 48(8): 1060-1064.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.010
Abstract:
ObjectiveTo investigate the correlation between serum soluble triggering receptor expressed on myeloid cells 2 (sTREM2) and total imaging load and cognitive function in cerebral small vessel disease (CSVD). MethodsA total of 86 patients with CSVD were selected as the observation group, and 70 outpatients with cerebrovascular disease risk factors and negative head MRI results were selected as the control group.Serum levels of sTREM2 and interleukin-6 (IL-6) were measured by ELISA.The observation group was divided into mild group (0-1 point), moderate group (2 point) and severe group (3-4 point) according to the total CSVD imaging load score.The Mini-mental state examination (MMSE) was used to evaluate the cognitive function level of the observation group.The correlation between sTREM2 and IL-6 level, total imaging burden of CSVD and MMSE score was compared. ResultsSerum levels of sTREM2 and IL-6 in the observation group were higher than those in the control group, and MMSE scores were lower than those in the control group (P < 0.01).The levels of sTREM2 and IL-6 in moderate group and severe group were higher than those in the mild group, and those in the severe group were higher than those in the moderate group (P < 0.01).The MMSE scores of the moderate group and severe group were lower than those of the mild group, and those of the severe group were lower than those of the moderate group (P < 0.01).In the observation group, sTREM2 level was positively correlated with IL-6 level, and negatively correlated with MMSE score (r=0.842, r=-0.526, P < 0.01).With CSVD as the dependent variable and sTREM2, IL-6, age, hypertension, diabetes, low density lipoprotein and MMSE as the independent variables, logistic regression analysis showed that sTREM2, age and hypertension were the risk factors for CSVD. ConclusionsThe expression of sTREM2 in peripheral blood of CSVD patients is increased, and it is positively correlated with cognitive impairment.The higher the total imaging load of CSVD, the more significant the increase of sTREM2.STREM2, age and hypertension are risk factors for CSVD.
2023, 48(8): 1064-1066.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.011
Abstract:
ObjectiveTo explore the developmental level of children with autism spectrum disorder (ASD) and provide basis for early detection, early diagnosis, and targeted intervention. MethodsA total of 45 children aged 18 to 36 months who were diagnosed with ASD were selected as the observation group, and 40 children who received normal physical examination during the same period were selected as the control group.The gesell infant developmental scale was used to test the development of children in the two groups, and the developmental quotient (DQ) of the corresponding ability zones of the two groups was compared. ResultsThe DQ of gross motor, fine motor, adaptive ability, language energy and social ability in the observation group were significantly lower than those in the control group (P < 0.01).Children with ASD had the lowest DQ in the language energy zone, followed by social ability, adaptive ability, fine movement, gross movement, and there was a significant difference between the DQ in each energy region (P < 0.05).There was no difference in the DQ of the corresponding ability zones between boys and girls in the observation group (P>0.05). ConclusionsThe level of development of children with ASD in each ability zone is lower than that of normal children, and the language and social ability zones lag behind most obvious.
2023, 48(8): 1067-1070.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.012
Abstract:
ObjectiveTo investigate the application value of pressure control mask ventilation combined with external compression in preventing gastric flatulence in laparoscopic cholecystectomy during induction of general anesthesia. MethodsSixty patients scheduled by laparoscopic cholecystectomy were randomly divided into the observation group and control group(30 cases in each group).Immediately after anesthesia induction and injection of muscle relaxants, the observation group was treated with 15 cmH2O pressure control mask ventilation combined with external compression of the stomach, and the control group was treated with 15 cmH2O pressure control mask ventilation.The oxygen saturation(SpO2) in two groups were recorded before anesthesia induction(T0), at 1 min (T1) and 2 min (T2) after mask control ventilation and immediately after endotracheal tube insertion(T3).The anterior-posterior and left-right axial diameters of gastric sinus were measured using ultrasound T0 and T3, and the cross-sectional area (CSA) of the gastric sinus was calculated.The endoscopic classification of gastric morphology was recorded at the beginning of the operation.The nausea and vomiting within 24 h after the operation were followed up. ResultsThere was no statistical significance in the age, body mass index(BMI), operation time and anesthesia time between two groups(P>0.05).There was no statistical significance in the CSA of the gastric sinus at T0 between two groups(P>0.05).The differences of the CSA in two groups were statistically significant between at T3 and T0(P < 0.01), and the difference value of CSA in the control group was higher than that in observation group.The difference of the incidence rates of nausea and vomiting after 24 h of operation were statistically significant between two groups(P < 0.05). ConclusionsIn the induction period of general anesthesia, the use of pressure control mask ventilation combined with external compression of the stomach can improve the gastric flatulence of patients treated with laparoscopic cholecystectomy, and it is worthy of clinical application.
2023, 48(8): 1071-1075.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.013
Abstract:
ObjectiveTo investigate the influencing factors of restenosis after stent implantation in patients with severe stenosis of middle cerebral artery (MCA) and the analysis of the best beneficiary population. MethodsA total of 142 patients with severe MCA stenosis were studied retrospectively.The patients with severe MCA stenosis diagnosed by computed tomography angiography or digital subtraction angiography were followed up for one year.The patients were divided into no restenosis group and restenosis group.The incidence of restenosis, neurological deficit and activities of daily living before and after treatment, blood flow velocity of MCA stenosis were followed up, and the influencing factors of postoperative restenosis were analyzed. ResultsAfter one year follow-up, the restenosis rate was 16.20%.The National Institutes of Health stroke scale (NIHSS) after treatment was lower than that before treatment, and the Barthel index was higher than that before treatment (P < 0.01).The end diastolic blood flow velocity and peak systolic blood flow velocity after treatment were lower than those before treatment (P < 0.01).There were significant differences between the two groups in morphological classification, type of passage, smoking, type 2 diabetes, transient ischemic attack, postoperative residual stenosis and stenosis degree (P < 0.05 to P < 0.01).There was no significant difference in site classification, gender, age, hypertension, hyperlipidemia and coronary heart disease (P>0.05).By multivariate logistic regression analysis, smoking, type 2 diabetes, transient ischemic attack and postoperative residual stenosis were the risk factors for restenosis (P < 0.01). ConclusionsApollo stent implantation in patients with severe stenosis of MCA can significantly reduce the incidence of restenosis and neurological deficit, improve the daily life of patients, improve blood flow speed.Morphological classification, pathway classification, smoking, type 2 diabetes, transient ischemic attack, postoperative residual stenosis and the degree of stenosis are the influencing factors for the occurrence of restenosis after surgery.Among them, smoking, type 2 diabetes, transient ischemic attack, postoperative residual stenosis are predictors of postoperative restenosis, and the patients without predictive factors are the best beneficiaries.
2023, 48(8): 1076-1079.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.014
Abstract:
ObjectiveTo investigate the therapeutic effect of two surgical approaches on distal tibial comminuted fracture (Pilon fracture) and its effect on ankle joint function. MethodsFifty patients with Pilon fracture of distal tibia were selected as the study subjects and divided into observation group and control group according to the surgical approach.The control group was treated with anterolateral approach of distal tibia, and the observation group was treated with anterolateral approach combined with posterolateral approach.The perioperative relevant indexes, postoperative imaging reduction, postoperative clinical therapeutic effect, postoperative functional recovery and adverse reactions were compared between the two groups. ResultsThere was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05), but there was significant difference in fracture healing time between the two groups (P < 0.05).According to Burwell-Charnley evaluation criteria, the excellent and good rate of the control group was significantly lower than that of the observation group (P < 0.05).According to Tornetta standard analysis of treatment effect, the excellent and good rate of the observation group was significantly higher than that of the control group (P < 0.05).Kofoed and AOFAS scores in the observation group were significantly higher than those in the control group (P < 0.01).There was no significant difference in the occurrence of postoperative adverse reactions between the two groups (P>0.05). ConclusionsCompared with the anterolateral approach of the distal tibia, the anterolateral approach combined with posterolateral approach for Pilon fracture can effectively improve the ankle joint function, shorten the postoperative recovery time of patients, and have better safety.
2023, 48(8): 1080-1084.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.015
Abstract:
ObjectiveTo design and synthesize a novel Cu(Ⅱ) complex based on 3,5-dibromosalicylaldehyde-4-aminoantipyrine Schiff base ([CuL2]), and evaluate its anticancer activity. MethodsA novel Schiff base ligand, 3,5-dibromosalicylalde-4-aminoantipyrine (HL), was synthesized by condensation reaction of 3,5-dibromosalicylalde and 4-aminoantipyrine.The [CuL2] was synthesized by solvothermal method with HL and Cu(Ac)2·H2O.The [CuL2] was characterized by X-ray single crystal diffraction, polycrystaline powder X-ray diffraction (PXRD), Fourier transform infrared spectroscopy (FT-IR) and thermogravimetric analysis (TGA-DSC).The in vitro anticancer activity of HL and [CuL2] on MDA-MB-231, SMMC-7721, CNE-2Z and A-549 cells was determined by MTT assay.The effect of [CuL2] on apoptosis and cell cycle of MDA-MB-231 cells was analyzed by flow cytometry (FCM). ResultsX-ray single crystal diffraction analysis showed that [CuL2] was a mononuclear metal complex, belonging to the monoclinic crystal system, with space group of C2/c and 4-coordination micro-torsion square structure; PXRD showed that the crystallinity of [CuL2] was good, and the crystal structure accorded with the results of single crystal test; the FT-IR characteristic peaks were consistent with the molecular structures of ligand and complex; TGA-DSC analysis showed that [CuL2] had good thermal stability below 270 ℃.The MTT assay results showed that when HL forms a complex with Cu (Ⅱ), [CuL2] had better anticancer activity than HL, and its inhibitory activity on MDA-MB-231 cells and SMMC-7721 cells was stronger, which was slightly lower than that of cisplatin.The FCM analysis results showed that [CuL2] could induce apoptosis in MDA-MB-231 cells (P < 0.05), and induce cell cycle arrest in G0/G1 and S phases in MDA-MB-231 cells (P < 0.05). ConclusionsThe [CuL2] is synthesized, which can inhibit the activity of MDA-MB-231 and SMMC-7721 cells, and induce cell cycle arrest and apoptosis in MDA-MB-231 cells.
2023, 48(8): 1085-1089.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.016
Abstract:
ObjectiveTo establish a nomogram to predict the risk of malignancy of suspicious calcifications in the breast for guiding clinical decision making. MethodsA total of 178 patients with breast microcalcifications detected by mammography and localized with image guidance was retrospectively analyzed.All calcifications were classified by a breast radiologist according to the fifth edition of BI-RADS.Univariate and multivariate logistic regression were used to analyze the relationship between the imaging features of calcifications and the clinical features of patients.Based on multivariate logistic regression analysis, a nomogram was developed to predict the risk of malignancy, and the corresponding diagnostic efficiency of the model was evaluated using ROC curves. ResultsAmong the 178 patients with microcalcification, 114 were suspected of calcification.In the suspected calcification group, there were statistically significant differences in malignancy rates among the < 50 years old and ≥50 years old groups(P < 0.01), amorphous/coarse heterogeneous calcification and fine pleomorphic/fine linear or subdivided dendritic calcification, regional/clustered calcification and linear/segmental calcification in the distribution of calcification(P < 0.01).Age≥50 years old, calcification type of fine pleomorphism/fine line or fine branch, and calcification distribution of line segment were independent risk factors of malignant lesions.Based on these three factors, a predictive nomogram was established, and the corresponding area under the curve was 0.747 (95%CI: 0.658-0.836). ConclusionsIn early diagnosis of breast cancer, image-guided localized biopsy of breast microcalcifications has certain value.Morphological descriptors of suspicious microcalcifications are required for subclassification, and a nomogram combining morphology and distribution descriptors of suspicious microcalcifications can accurately predict the risk of malignancy.
2023, 48(8): 1090-1097.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.017
Abstract:
ObjectiveTo investigate the value of radiomics nomogram based on DCE-MRI in predicting PD-L1 expression in breast invasive ductal carcinoma of breast. MethodsA retrospective analysis was conducted in 91 patients with invasive ductal carcinoma who underwent preoperative breast MRI examination and confirmed by pathology at The First Affiliated Hospital of Bengbu Medical College.The patients were randomly divided into a training set (n=54) and a test set (n=37) at the ratio of 6∶4.The second stage of DCE-MRI was selected to delineate the 3D region of interest (ROI) layer by layer at all levels of lesion.The optimal radiomics features were screened through minimum absolute contraction and regression with the least absolute shrinkage and selection operator, the radiomics score (Rad-score) was obtained by support vector machine to construct the radiomics model, independent risk factors of clinical and imaging features were screened through univariate and multivariate logistic regression to construct a clinical model, and Rad-score combined with risk factors of clinical and imaging features was used to construct a radiomics nomogram model finally.The prediction efficacy of each model was analyzed by the receiver operating characteristic curve, and the corresponding area under the curve (AUC) was calculated to obtain the optimal model.The predictive efficacy and clinical utility of the model were evaluated using the calibration curve and the decision curve. ResultsThe radiomics nomogram model had the best diagnostic performance.The AUC, sensitivity, and specificity of the nomogram model were 0.938, 81.8%, 95.2% for the training set and 0.904, 65.2%, 100.0% for the test set, respectively. ConclusionsThe radiomics nomogram model based on DCE-MRI is highly valuable in predicting the PD-L1 expression in invasive ductal carcinoma of breast, and is helpful to evaluate the treatment effect and prognosis of patients.
2023, 48(8): 1097-1100.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.018
Abstract:
ObjectiveTo investigate the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) features and corresponding semiquantitative parameters in triple negative breast cancer (TNBC). MethodsA total of 30 patients with surgical-pathologically confirmed TNBC and 60 patients with surgical-pathologically confirmed non-TNBC (nTNBC) were analyzed retrospectively.The MRI features (maximum diameter of lesion, ADC value, mass shape, margins, tumor number, intratumoral signal intensity in T2WI, peritumoral edema) and the semiquantitative parameters (Tpeak, SER, Epeak) were compared between the two groups. ResultsCompared with the nTNBC group, the TNBC group showed high intratumoral T2WI signal, peritumoral edema, and enhanced early ring enhancement (P < 0.05 to P < 0.01), while there were no significant differences in the maximum diameter, ADC value, mass shape, tumor margin and tumor number between the two groups (P>0.05).Compared with the nTNBC group, the TNBC group showed lower Tpeak (P < 0.01), higher SER values and Epeak values (P < 0.05 and P < 0.01). ConclusionsDCE-MRI manifestation of TNBC has some characteristics, including early rim enhancement, peritumoral edema, high signal intensity on T2WI, fast Tpeak, high SER and Epeak, which can be served as important features in diagnosis.
2023, 48(8): 1101-1104.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.019
Abstract:
ObjectiveTo evaluate the differential diagnosis of benign and malignant breast BI-RADS category 3 and above nodules by ultrasound radiomics. MethodsA total of 164 breast nodules of BI-RADS category 3 and above diagnosed by ultrasound were retrospectively analyzed.The lesions were divided into training set (n=123) and test set (n=41).Base on feature extraction engineering of ultrasound radiomics, the high latitude feature parameters of the region of interest in the image were extracted, and the feature dimension reduction was used to screen the reliable features which established the model for classification research.The training set was used to establish the model, and the test set was used to verify the accuracy of the model. ResultsThe sensitivity, specificity, accuracy and area under ROC curve of the model established by ultrasound radiomics were 87.51%, 84.62%, 85.00% and 0.854(0.707-0.946), respectively. ConclusionsUltrasound radiomics has certain diagnostic value in differentiating benign and malignant breast BI-RADS category 3 and above nodules.
2023, 48(8): 1105-1110.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.020
Abstract:
ObjectiveTo investigate the effect of splenectomy on liver function in patients with Wilson's disease (WD). MethodsA total of 97 WD patients were divided into normal spleen group, splenomegaly group and hypersplenism group according to abdominal two-dimensional color ultrasound and platelet count, and 31 healthy physical examiners were used as control group during the same period.The differences in liver function indexes between groups were compared.Splenectomy was performed in 28 patients with hypersplenism, and the differences in liver function indicators before and after surgery were compared. ResultsExcept for aspartate aminotransferase mitochondrial isoenzyme (m-AST) and lactate dehydrogenase (LDH) had no significant difference between the groups (P>0.05), the other liver function indexes were statistically significant in each group (P < 0.05 to P < 0.01).Compared with the control group, the total bile acid (TBA) and activated partial thromboplastin time (APTT) were increased, and the prealbumin (PA) and hemoglobin (Hb) were reduced in the normal spleen group; compared with the normal spleen group, total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), total bile acid (TBA), alkaline phosphatase (ALP), adenosine deaminase (ADA), prothrombin time (PT), and APTT were increased in the splenomegaly group, and PA, serum fibronectin (FN), and PLT were reduced.Compared with the splenomegaly group, the aspartate aminotransferase (AST), DBIL, TBA, ADA, PT, APTT and the thrombin time (TT) were increased in the hypersplenism group, and PA, FN, total cholesterol (T-CHO), white blood cell count (WBC), red blood cell count (RBC), Hb, PLT were reduced, and the differences were statistically significant (P < 0.05).TBIL, DBIL, IBIL, TBA, ADA, PT, APTT and TT levels decreased compared with preoperative levels in hypersplenism patients with WD 14 days after splenectomy, total protein, albumin, FN, T-CHO, WBC, PLT, alanine aminotransferase, AST, m-AST, γ-glutamyltransferase and LDH were significantly higher than those before surgery (P < 0.01). ConclusionsAfter splenectomy, liver synthesis function and liver metabolic function are significantly improved.Excluding short-term factors of surgical trauma, hepatocyte damage and membrane permeability are also improved, and splenectomy can significantly improve liver function in patients with WD hypersplenism.
2023, 48(8): 1111-1114.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.021
Abstract:
ObjectiveTo analyze the dietary risk factors and protective factors for the occurrence of colorectal cancer, and to provide the basis for the prevention of colorectal cancer. MethodsA case-control study was conducted with 55 newly diagnosed colorectal cancer patients from Minhang Hospital Affiliated to Fudan University from January to March 2021 as the case group.Simultaneously, 96 non-colorectal cancer patients matched for age, gender, and region during the same period were selected as the control group.A food frequency questionnaire was utilized for face-to-face surveys of the subjects, with single factor analysis conducted using non-parametric tests and χ2 tests, and multi-factor analysis via conditional logistic regression. ResultsSingle factor analysis results indicated a correlation between colorectal cancer and factors such as animal offal, dark vegetables, fungi, fresh milk, yogurt, beef, poultry, nuts, pickled foods, eggs, educational level, and occupation.Logistic regression analysis results revealed that animal offal (OR=3.471, 95%CI: 1.395-8.634) increased the risk of colorectal cancer, while dark vegetables (OR=0.131, 95%CI: 0.036-0.482), fungi (OR=0.245, 95%CI: 0.083-0.726), fresh milk (OR=0.243, 95%CI: 0.085-0.696), and eggs (OR=0.221, 95%CI: 0.086-0.570) decreased the risk. ConclusionsAnimal offal is a risk factor for colorectal cancer, while dark vegetables, fungi, poultry, and eggs serve as protective factors.
2023, 48(8): 1115-1120.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.022
Abstract:
ObjectiveTo explore how local universities can seize opportunities in the process of integration of higher medical education in the Yangtze River Delta, and to understand the cognitive level and willingness tendency of different populations in local universities towards the integration of higher medical education in the Yangtze River Delta. MethodsThe questionnaire was used to investigate different populations in Bengbu Medical College.A total of 106 management staffs, 298 teachers, and 2 385 students were investigated.The cognitive level and willingness tendency of survey subjects towards the integration of higher medical education in the Yangtze River Delta, and the influencing factors of different populations' willingness tendency towards the integration of education in the Yangtze River Delta were analyzed. ResultsThe proportion of students with high willingness tendency in the Yangtze River Delta region was 51.66% (1 232/2 385), which were 56.71% (169/298) and 53.77% (57/106) in teachers and management staffs, respectively, and the highest proportion was found in teachers.In the student population, there was a statistically significant difference in the overall willingness of students with different genders and identities towards the integration of education in the Yangtze River Delta (P < 0.05 and P < 0.01), and different degrees of understanding level, cognition o development goals, cognition of existing measures, cognition of development trends in their own university, cognition of development measures, and overall cognition towards the integration of education in the Yangtze River Delta were statistically significant with students' overall willingness towards the integration of education in the Yangtze River Delta (P < 0.01);the results of binary logistic regression analysis showed that students' identity, cognition o development goals, cognition of existing measures, cognition of development trends in their own university, development measures, development measures in their own university and overall cognition were the influencing factors of students' willingness tendency towards the integration of education in the Yangtze River Delta (P < 0.01).In the teacher population, different levels of development measures, development trends in their own university, cognition of resource sharing and overall cognition towards the integration of education in the Yangtze River Delta were statistically significant with teachers' overall willingness towards the integration of education in the Yangtze River Delta (P < 0.01);the results of binary logistic regression analysis showed that cognition of development measures, cognition of development trends in their own university, cognition of resource sharing were the main influencing factors of teachers' willingness tendency towards the integration of education in the Yangtze River Delta (P < 0.05 to P < 0.01).In the management population, there was a statistically significant difference in the overall willingness of management staffs with different profession levels towards the integration of education in the Yangtze River Delta (P < 0.05), and different levels of development policies, understanding levels, development measures, development disorders in their own university, development measures in their own university and overall cognition towards the integration of education in the Yangtze River Delta were statistically significant with management staffs' overall willingness towards the integration of education in the Yangtze River Delta (P < 0.05 to P < 0.01);the results of binary logistic regression analysis showed that cognition of development measures and cognition of development measures in their own university were the main influencing factors of management staffs' willingness tendency towards the integration of education in the Yangtze River Delta (P < 0.01 and P < 0.05). ConclusionsThe willingness tendency of students towards the integration of higher medical education in the Yangtze River Delta needs to be further improved, and management staffs and teachers have a high willingness tendency towards the integration of higher medical education in the Yangtze River Delta.It should improve the top-level design, innovation awareness and interest coordination to further enhance the willingness tendency towards the integration of education in the Yangtze River Delta.
2023, 48(8): 1121-1125.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.023
Abstract:
ObjectiveTo investigate the influence of WeChat chat robot intervention on the psychological status, treatment compliance and complications of patients with hemodialysis arteriovenous fistula. MethodsA total of 120 patients with hemodialysis arteriovenous fistula were prospectively selected and divided into observation group and control group by random number table method, with 60 cases in each group.The control group received routine psychological care intervention, while the observation group was given WeChat chat robot intervention on the basis of the control group for 4 consecutive months.The psychological status, treatment compliance and complications of the two groups of patients after intervention were compared. ResultsAfter the intervention, the SAS score of (30.12±6.33) points and SDS score of (40.32±6.54) points in the observation group were lower than those of the control group (36.21±5.87) points and (45.36±6.11) points (P < 0.01);as for the treatment compliance score, the observation group was compliant with diet was (36.23±2.15) points, fluid intake compliance was (27.11±2.07) points, medication compliance was (24.01±0.85) points, and dialysis protocol compliance was (19.04±0.32) points which were higher than those in the control group (34.64±2.37) points, (26.31±2.04) points, (23.61±0.56) points, (18.91±0.40) points (P < 0.05 to P < 0.01);the complication rate of the observation group was 3.33%, which was lower than that of the control group 18.33% (P < 0.01), and the complication risk of the observation group lower than that in the control group (log-rank χ2=4.65, P < 0.05). ConclusionsCompared with conventional nursing intervention, the application of Wechat chat robot intervention in hemodialysis arteriovenous fistula patients results in better mental state, higher treatment compliance, and lower complications.
2023, 48(8): 1126-1129.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.024
Abstract:
ObjectiveTo explore the application effect of "pictorial nursing preparation list" in day surgery of spinal endoscopy. MethodsUsing a convenience sampling method, patients who underwent day spinal endoscopic lumbar discectomy from March to May 2021 were selected as the control group, and patients who underwent day spinal endoscopic lumbar discectomy from June to July 2021 were selected as the observation group.The control group used the original "written nursing preparation list" management program, and the observation group used the "pictorial nursing preparation list" management program.The preoperative preparation time from patient admission to the start of surgery (T1), intraoperative waiting time due to lack of items (T2), effective operative time (T3) and postoperative surgeon's satisfaction with care scores were recorded separately for the 2 groups of spinal endoscopic day surgery, and statistical analysis was performed. ResultsIn the control group, T1 was (14.70±5.26) min, and the longest steps accounted for were wrong placement of the operating bed, wrong placement of the C-arm machine, and inability to find the marker pen; T2 was (6.11±2.16) min, and the longest intraoperative steps accounted for were insufficient preparation of local anesthetics, wrong preparation of the surgical patch, and unskilled connection of the light source imaging machine; T3 was (56.51±8.98) min and postoperative surgeon satisfaction score with nursing was (85.12±4.78) points.After using the "pictorial nursing preparation list", T1 and T2 in the observation group [(12.53±4.68) min, (4.96±2.04) min] were significantly lower than those in the control group (P < 0.05), and the surgeon's satisfaction score was significantly increased compared with the control group [(92.41±4.29) points, P < 0.05]. ConclusionsThe "pictorial nursing preparation list" can significantly reduce the "ineffective" time of spinal endoscopic day surgery, standardize the surgical process, improve the efficiency of day surgery table, and can be extended to other endoscopic day surgery processes.
2023, 48(8): 1130-1134.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.025
Abstract:
ObjectiveTo analyze the independent risk factors of mid-term defecation dysfunction after transanal total mesorectal excision (TaTME) in patients with low rectal cancer, and establish a nomogram model. MethodsA total of 172 patients with low rectal cancer who received laparoscopic assisted TaTME from January 2016 to January 2020 were selected as the training group, and 32 patients who received the same operation from February 2020 to February 2021 were selected as the validation group; the patients in training group were divided into LARS and non-LARS group according to the occurrence of low anterior resection syndrome (LARS) at the follow-up of 6 months after surgery.The medical records of the patients in two groups were compared.The independent risk factors affecting the occurrence of LARS were analyzed by using univariate and multivariate logistic regression models.The nomogram model for predicting the LARS in low rectal cancer patients after TaTME was established by using R software and validated. ResultsThe LARS score of patients was (14.78±4.54) points, including 84 LARS patients (48.84%) and 88 non-LARS patients (51.16%).Univariate and multivariate logistic regression analysis showed that preoperative radiotherapy, anal sphincter injury, distance between anastomotic stoma and anal margin, tumor diameter, and length of ischial spine were independent risk factors for LARS (P < 0.05 to P < 0.01).The C-indexes of the nomogram model in both training group and validation group were are 0.836 and 0.827, respectively.ROC curve showed that the AUCs of the nomogram model in both training group and validation group were 0.829 and 0.808, respectively. ConclusionsPreoperative radiotherapy, anal sphincter injury, anastomotic distance from anal margin, tumor diameter, and ischial interspinous diameter are the independent risk factors for LARS.The nomogram model established with the above indicators has good predictive efficacy.
2023, 48(8): 1135-1138.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.026
Abstract:
ObjectiveTo investigate the status of acceptance of disability and analyze the relationship between acceptance of disability and medical social support in stroke patients. MethodsThe convenient sampling method was used to investigate stroke patients hospitalized.The general condition questionnaire, acceptance of disability scale-revised (ADS-R) and medical outcomes social support survey were used, and the correlation between disability acceptance and medical social support was analyzed. ResultsThe total ADS-R score of stroke inpatients was (79.60±10.66) points, which was at the medium level.After standardized scoring, the score of expanded dimension was 66.53 points, the score of transformation dimension was 61.36 points, the score of inclusive dimension was 59.50 points, and the score of subordinate dimension was 51.10 points.Gender, age, occupation status, monthly family income, whether the need for care and the sequelae had significant effects on acceptance of disability in stroke patients (P < 0.05 to P < 0.01).The correlation analysis results showed that the total score of disability acceptance and the scores of expansion, inclusion, and transformation dimensions were positively correlated with the total score of medical social support and practical support, information and emotional support, social interactive support, and emotional support (P < 0.05 to P < 0.01).The subordinate dimension of ADS-R was negatively correlated with the total score of medical social support and practical support, information and emotional support, social interactive support and emotional support (P < 0.05). ConclusionsUsing the low acceptance of disability in stroke patients as an entry point, a full range of social support and targeted interventions can enhance their level of disability acceptance.
2023, 48(8): 1139-1143.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.027
Abstract:
ObjectiveTo measure the health utility value of patients with cervical intraepithelial neoplasia and analyze its influencing factors, so as to provide evidence for improving health-related quality of life in this population. MethodsA total of 125 patients with cervical intraepithelial neoplasia were collected and measured by five-dimension health scale (EQ-5D-5L).Tobit regression model was used to determine the influencing factors. ResultsThe health utility value of 125 patients with cervical intraepithelial neoplasia was (-0.39, 1), and the mean value was (0.88±0.14).Among the five dimensions, the number of cases with problems was as follows: mobility in 14 cases (11.20%), daily activities in 21 cases (16.80%), self-care in 27 cases (21.60%), anxiety or depression in 80 cases (64.00%), and pain or discomfort in 55 cases (44.00%).There were statistically significant differences in the health effect values of patients with cervical intraepithelial neoplasia in different age groups, marital status, employment status, disease course, disease uncertainty group and general self-efficacy group (P < 0.05 to P < 0.01).Tobit regression model showed that age, disease course, disease uncertainty and general self-efficacy were the factors influencing health utility value (P < 0.05 to P < 0.01). ConclusionsMore attention should be paid to the psychological status of menopausal and newly diagnosed female patients with cervical intraepithelial neoplasia, and the health-related quality of life should be improved by reducing the uncertainty of the disease and improving the self-efficacy of patients.
2023, 48(8): 1143-1146.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.028
Abstract:
ObjectiveTo explore the application effects of ultrasonic debridement combined with new functional dressing in the treatment of trauma infecting wounds. MethodsSixty-two patients with trauma infecting wounds were randomly divided into the observation group and control group according to random number table method (30 cases in observation group and 32 cases in control group).The control group was treated with the traditional treatment methods, and the observation group was treated with ultrasonic debridement combined with new functional dressing covering and dressing the wound.The pain scores at the first 3 dressing changes, wound healing time, total cost of dressing changes and scar condition after 3 months of follow-up were compared between two groups. ResultsThe pain scores at the first 3 dressing changes in the observation group were significantly lower than that in the control group(P < 0.01).The wound healing time in the observation group was significantly shorter than that in the control group(P < 0.01), and there was no statistical significance in the total dressing change cost between two groups (P>0.05).After 3 months of follow-up, the scar score in the observation group was lower than that in the control group(P < 0.05). ConclusionsUltrasonic debridement combined with new functional dressing in the treatment of trauma infecting wounds can reduce the pain of patients during operation, promote wound healing, reduce scar formation, and does not increase the total cost of dressing change, which is superior to the traditional dressing change method.
2023, 48(8): 1147-1151.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.029
Abstract:
ObjectiveTo analyze the correlation between post-traumatic stress disorder (PTSD) and fear of disease progression, ICU environmental stressors in patients with acute respiratory failure (ARF), and to provide guidance for clinically formulating effective nursing interventions for ARF patients. MethodsA total of 142 patients with ARF were selected as the research objects, and they were investigated with the general situation questionnaire, the Chinese version of the ICU environmental stressor scale (ESQ-C), the simplified version of the fear of disease progression questionnaire (FoP-Q-SF) and the post-traumatic stress disorder scale-civilian version (PCL-C). Pearson analysis was used to analyze the correlation between PTSD and fear of disease progression, ICU environmental stressors in ARF patients. ResultsThe PTSD score of 128 patients points with ARF was (39.60±4.58) points, the score of fear of disease progression was (35.63±5.46) points, and the ICU environmental stressor score was (121.55±14.35) points. Gender, educational level, comorbidities and psychological capital were the influencing factors for PTSD in ARF patients (P < 0.05).Pearson analysis results showed that there was a positive correlation between PTSD in ARF patients and fear of disease progression, ICU environmental stressors, and there was a positive correlation between ICU environmental stressors and fear of disease progression (P < 0.05). ConclusionsThe scores of PTSD, fear of disease progression, and ICU environmental stressors in ARF patients are all at a moderate level, and there is an interplay between PTSD and fear of disease progression and ICU environmental stressors. Clinical medical staff should pay attention to ICU environmental stressors and fear of disease progression in ARF patients, and take targeted measures to reduce the level of PTSD symptoms.
2023, 48(8): 1152-1157.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.030
Abstract:
ObjectiveTo establish a motivational interview program based on THRIVE model, and investigate its intervention effects on post-traumatic growth of young and middle-aged stroke convalescent patients. MethodsSeventy-five young and middle-aged stroke patients were randomly divided into the observation group(38 cases) and control group(37 cases).The control group was treated with traditional psychological nursing intervention, and the observation group was treated with the motivational interview protocol based on THRIVE model.The changes of traumatic growth before and after intervention were compared between two groups. ResultsAfter intervention, the total score and dimension scores of Chinese post-traumatic growth inventory (C-PTGI) in the observation group were higher than those in control group(P < 0.05).At 4 weeks and 12 weeks after intervention, the scores of life perception, self-transformation and relationship in the observation group were higher than those before intervention(P < 0.01), and after 12 weeks of intervention, the scores of life perception, self-transformation and relationship in the control group were higher than those before intervention(P < 0.05).After 4 weeks and 12 weeks of intervention, the scores of new possibilities and personal strength in the observation group were higher than those before intervention(P < 0.01), and there was no statistical significance in the scores of new possibilities and personal strength in the control group between before and after intervention(P > 0.05).After intervention, the DT score in the observation group was lower than that in control group(P < 0.05), the score of differences in the observation group was lower than that in control group(P < 0.05), and the DT score in the observation group was significantly lower than that before intervention(P < 0.01).After 12 weeks of intervention, the problems of "getting along with family, sleep, fatigue/fatigue, sadness, worry, fear and depression" in the observation group decreased compared with those before intervention(P < 0.05), while there was no statistical significance in the control group between before and after intervention(P > 0.05). ConclusionsIt is necessary to pay attention to the intervention of post-traumatic growth in young and middle-aged stroke patients.The motivational interview based on THRIVE model can reduce the problems and degree of psychological distress, and improve the level of post-traumatic growth.
2023, 48(8): 1158-1162.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.031
Abstract:
ObjectiveTo investigate the effects of chronic disease trajectory framework intervention program on the health literacy, self-care ability and quality of life in patients with heart failure. MethodsSixty-seven patients with chronic heart failure were randomly divided into the observation group(34 cases) and control group(33 cases).The control group was treated with the routine nursing intervention, while the observation group were treated with the chronic disease trajectory framework intervention program.The health literacy, self-care ability and quality of life between two groups before and after the intervention were evaluated using the heart failure specific health literacy scale(HFS-HLS), self-care of heart failure index(SCHFI) and Minnesota living with heart failure questionnaire(MLHFQ). ResultsBefore intervention, there was no statistical significance in the scores and total scores of HFS-HLS, SCHFI and MLHFQ between two groups(P > 0.05).After 3 months of intervention, the scores of HFS-HLS, SCHFI and MLHFQ in the observation group were significantly improved compared with those before intervention, and the scores and total scores of HFS-HLS and SCHFI in the observation group were significantly higher than those in control group(P < 0.01), while the scores and total scores of MLHFQ in the observation group were significantly lower than those in control group(P < 0.01). ConclusionsThe effects of chronic disease trajectory framework intervention program in chronic heart failure patients is better than that of conventional nursing, which is helpful to improve patients' self-care ability and health literacy level, and improve the quality of life.
2023, 48(8): 1163-1167.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.032
Abstract:
ObjectiveTo explore the effect of Xiao's double-C nursing model based on combined evaluation strategy in percutaneous nephrolithotomy (PCNL) perioperative patients. MethodsFifty-four patients with kidney stones treated with PCNL were randomly divided into observation group and control group, with 27 patients in each group.The control group used traditional nursing methods, and the observation group used Xiao's double-C nursing model based on combined evaluation strategy.The postoperative exhaust time, postoperative hospital stay, postoperative pain degree at 24 hours, bleeding, urine leakage, patient comfort and nursing satisfaction were compared between the two groups. ResultsAfter intervention, the observation group showed significantly lower postoperative exhaust time, total hospital stay, postoperative pain level at 24 hours, intravenous fluid infusion duration, and total fluid infusion volume compared with the control group (P < 0.05 to P < 0.01), while comfort and nursing satisfaction were significantly higher than those of the control group (P < 0.01).However, there was no statistically significant difference in postoperative blood and urine leakage between the two groups (P > 0.05). ConclusionsXiao's double-C nursing based on combined evaluation strategy can promote the recovery of gastrointestinal function, shorten the length of hospital stay, and improve patient comfort and nursing satisfaction without increasing postoperative complications of hematuria and urine leakage.
2023, 48(8): 1168-1172.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.033
Abstract:
ObjectiveTo investigate the effect of load deep breathing training based on PERMA model in lung cancer patients undergoing chemotherapy. MethodsSeventy lung cancer patients undergoing chemotherapy were selected as the study subjects, and were randomly divided into observation group and control group using a random number table method, with 35 cases in each group.The control group received routine nursing methods of chemotherapy, while the observation group received load deep breathing training based on the PERMA model, with an intervention time of 8 weeks.The changes in lung function, exercise endurance, respiratory difficulty level, and quality of life were compared between the two groups before and after the training. ResultsAfter 8 weeks of intervention, the maximal voluntary ventilation (MVV), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and six minute walk distance (6MWD) in the observation group were higher than those in the control group (P < 0.05 to P < 0.01), MVV, FVC and FEV1 were higher than those before intervention and at discharge (P < 0.05 to P < 0.01), and 6MWD was higher than that before intervention (P < 0.05);there was a statistically significant difference in the grade distribution of modified Medical Research Council scale between the two groups (P < 0.01), the rate of grade 0 and grade 1 in the observation group was 62.85% (22/35), which was significantly higher than that of 25.71% (9/35) in the control group (χ2=9.78, P < 0.01);the emotional well-being (EWB), additional concerns-lung scores (LCS), and total scores of quality of life of lung cancer patients in the observation group were higher than those in the control group (P < 0.05 to P < 0.01), while physical well-being, EWB, functional well-being, and LCS scores were higher than those before intervention (P < 0.05 to P < 0.01). ConclusionsLoad deep breathing training based on PERMA model can improve lung function indicators, enhance exercise endurance, reduce dyspnea grade, and improve the quality of life of lung cancer patients undergoing chemotherapy.
2023, 48(8): 1173-1175.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.034
Abstract:
ObjectiveTo explore the teaching design and practice effect of integrating ideological and political elements into undergraduate practice teaching of clinical medical students. MethodsA total of 162 undergraduate students of grade 2017 who practiced in The First Affiliated Hospital of Bengbu Medical College from June 2021 to May 2022 were selected and randomly divided into an observation group and a control group using the number table method, with 81 participants in each group.The control group was taught the regular internship, the observation group was taught with integrating ideological and political elements into teaching on the basis of the control group.After 16 weeks of teaching, students' subjective cognitive feelings and their scores in the entrance and graduation exams were evaluated. ResultsStudents in the observation group had better subjective feelings of integrating ideological and political elements during the internship teaching than those in the control group (P < 0.01).The theory of internal medicine, skill assessment and graduation examination were higher than those of the control group (P < 0.01). ConclusionsIntegrating ideological and political education into medical students practice teaching can help to continuously improve students' ideological cognition, stimulate their interest in learning, improve their professional performance, and be beneficial to cultivate socialist medical talents.
2023, 48(8): 1176-1178.
doi: 10.13898/j.cnki.issn.1000-2200.2023.08.035
Abstract:
ObjectiveTo evaluate the application effect of clinical practice teaching mode of medical laboratory specialty under the background of medical big data. MethodsTwenty-eight interns in 2018 were set as the control group, which received traditional teaching method, and 32 interns in 2019 were set as observation group, which was guided to use medical big data to cultivate student's scientific research thinking and clinical problem solving ability in the process of clinical practice.The theoretical test score, passing rate of national laboratory physician qualification examination, and quantitative assessment indexes such as analysis ability of inspection report, communication ability with clinic, complaint handling ability, and consultation and answer ability were compared between the two groups. ResultsAfter using different teaching modes during the internship, the theoretical test score in observation group was higher than that in control group (P < 0.05).There was no significant difference in the passing rate of national laboratory physician qualification examination between the two groups (P > 0.05).The analysis ability of inspection report, communication ability with clinic, complaint handling ability, and consultation and answer ability in observation group were significantly better than those in control group (P < 0.01), and the total score of quantitative assessment was obviously higher than that in control group (P < 0.01). ConclusionsGuiding laboratory interns to analyze medical big data can improve their interest in learning clinical knowledge, promote the convergence of theoretical knowledge and clinical practice, and lay a solid foundation to better serve the clinic and patient.
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