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Semaglutide combined with clomiphene for obese patients with polycystic ovary syndrome and insulin resistance Yang Qiaofen, Li Xingmei, Zhang Xuan International Medicine and Health Guidance News    2024, 30 (11): 1802-1807.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.009 Abstract （163）            Knowledge map    Save Objective To evaluate the effect of semaglutide combined with clomiphene for obese patients with polycystic ovary syndrome (PCOS) and insulin resistance. Methods A total of 102 obese patients with PCOS and insulin resistance who were treated at Yulin Hospital, First Hospital, Xi 'an Jiaotong University from January 2022 to December 2023 were selected for the randomized controlled trial. They were divided into a control group and a study group by the random number table method, with 51 cases in each group. The control group were (28.45±3.21) years old; their disease course was (5.36±0.76) years. The study group were (28.38±3.19) years old; their disease course was (5.41±0.77) years. The control group took clomiphene, and the study group clomiphene and semaglutide, for 12 weeks. The body mass indexes (BMI), glycemic and lipid metabolism indicators [homeostatic model assessment of beta-cell function (HOMA-β), homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), and total cholesterol (TC)], endometrial and ovulation conditions (endometrial thickness, cervical mucus score, and number of mature follicles), serological indicators [protein tyrosine phosphatase 1B (PTP1B), fibroblast growth factor 21 (FGF21), and insulin-like growth factor (IGF)], changes in intestinal floras (Enterococcus, Enterobacteriaceae, Bifidobacterium, and Lactobacillus), and adverse reactions (nausea and vomiting, hypoglycemia, fatigue, and dizziness and headache) were compared between the two groups. t and χ2 tests were used for the statistical analysis. Results After the treatment, the BMI and levels of HOMA-IR, TG, TC, and HOMA-β in the study group were better than those in the control group (t=2.433, 6.282, 3.749, 9.145, and 7.105; all P<0.05); the endometrial thickness, cervical mucus score, and number of mature follicles in the study group were higher than those in the control group (t=27.240, 10.097, and 6.883; all P<0.05); the levels of PTP1B, FGF21, and IGF in the study group were lower than those in the control group (t=4.558, 14.640, all 5.001; P<0.05); the numbers of Enterococcus and Enterobacteriaceae in the study group were lower than those in the control group [(7.01±0.33) vs. (7.98±0.39) and (7.24±0.47) vs. (7.85±0.51)], while the numbers of Bifidobacterium and Lactobacillus in the study group were higher than those in the control group [(9.88±0.71) vs. (9.13±0.67) and (9.89±0.36) vs. (9.73±0.34)] (t=13.559, 6.281, 5.487, and 2.308; all P<0.05). The incidence of adverse reactions in the study group was lower than that in the control group [3.92% (2/51) vs. 11.76% (6/51)], but the difference was not statistically significant (χ2=2.170, P=0.141). Conclusion Semaglutide combined with clomiphene for obese patients with PCOS can effectively reduce their BMI, improve their glucose and lipid metabolism indicators, promote the development of their uterine endometrium and ovulation, adjust their serological indicators, and improve the composition of intestinal floras. Reference | Related Articles | Metrics

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Efficacy of daglipzin combined with insulin degludec and liraglutide injection in treatment of patients with diabetic nephropathy and poor blood glucose control Chen Ying, Duan Shuangli, Li Li International Medicine and Health Guidance News    2024, 30 (23): 4009-4014.   DOI: 10.3760/cma.j.issn.1007-1245.2024.23.026 Abstract （145）            Knowledge map    Save Objective To observe the effect of dagliprazin combined with insulin degludec and liraglutide injection in the treatment of patients with diabetic nephropathy (DN) and poor blood glucose control. Methods A total of 167 patients with DN and poor blood glucose control treated at Hanzhong Nanzheng District People's Hospital from February 2022 to February 2024 were selected for the randomized controlled trial, and were divided into a study group (83 cases) and a control group (84 cases) by the random number table method. There were 47 males and 36 females in the study group; they were (57.39±8.16) years old; their disease course was (12.51±2.23) years; there were 48 cases of DN stage Ⅱ and stage 35 cases of stageⅢ. There were 50 males and 34 females in the control group; they were (56.47±8.23) years old; their disease course was (12.36±2.19) years; there were 51 cases of DN stage Ⅱ and 33 cases of stage Ⅲ. The study group were treated with dagliprazin and insulin degludec and liraglutide injection, and the control group with dagaglizin and insulin glargine, for 3 months. The clinical efficacies, renal function, blood glucose, markers of renal injury, peripheral blood cytokines, and the incidence rates of adverse drug reactions were compared between the two groups by t and χ2 tests. Results Before the treatment, there were no statistical differences in the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) and urine albumin-to-creatinine ratio (UACR) between the two groups (all P>0.05). After the treatment, the levels of Scr and BUN and UACR in the study group were lower than those in the control group [(65.24±8.93) μmol/L vs. (76.12±10.43) μmol/L, (6.23±1.12) mmol/L vs. (8.04±1.41) mmol/L, and (92.32±14.26) mg/g vs. (106.21±18.35) mg/g], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPBG), and glycosylated hemoglobin (HbA1c) between the two groups (all P>0.05). After the treatment, the levels of FBG, 2hPBG, and HbA1c in the study group were lower than those in the control group [(6.14±0.76) mmoL/L vs. (7.01±0.89) mmoL/L, (8.16±1.49) mmol/L vs. (9.32±1.73) mmol/L, and (5.21±0.59)% vs. (5.82±0.68)%], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of N-acetyl-β-D-glucosidase (NAG), retinol-binding protein (RBP), and neutrophil gelatinase-associated lipocalin (NGAL) between the two groups (all P>0.05). After the treatment, the levels of NAG, RBP, and NGAL in the study group were lower than those in the control group [(15.12±2.54) U/L vs. (18.84±3.01) U/L, (1.08±0.21) mg/L vs. (1.37±0.26) mg/L, and (51.26±8.13) μg/L vs. (62.13±10.28) μg/L], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of free fatty acid (FFA) and peroxisome surge activator receptor γ (PPARγ) between the two groups (both P>0.05). After the treatment, the levels of FFA and PPARγ in the study group were lower than those in the control group [(9.03±1.76) μg/L vs. (11.26±2.51) μg/L and (1 306.49±201.43) ng/L vs. (1 148.52±159.47) ng/L], with statistical differences (both P<0.05). The total effective rate of the study group was higher than that of the control group [85.54% (71/83) vs. 70.24% (59/84); P<0.05]. The incidence rates of adverse drug reactions in the study group and the control group were 6.02% (5/83) and 4.76% (4/84), respectively, with no statistical difference (P>0.05). Conclusion Dagliprazin combined with insulin degludec and liraglutide injection in the treatment of patients with DN and poor blood glucose control is effective, can improve their renal function, blood glucose, markers of kidney injury, and peripheral blood cytokines, and does not increase adverse drug reactions. Reference | Related Articles | Metrics

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Research progress of perivascular adipose tissue inflammation involved in the occurrence and development of aortic dissection Wang Ao, Zou Mingrui, Han Yuexin, Wang Yujiu International Medicine and Health Guidance News    2024, 30 (10): 1590-1593.   DOI: 10.3760/cma.j.issn.1007-1245.2024.10.002 Abstract （131）            Knowledge map    Save Aortic dissection (AD), also referred to as aortic dissection aneurysm, is a perilous condition associated with high mortality rate. Recent studies investigating the alterations in inflammatory markers during the disease progression suggest that inflammation plays a crucial role in determining the clinical outcomes of AD. The initial manifestation of inflammatory response occurs within the aortic adventitia and surrounding adipose tissue. Perivascular adipose tissue (PVAT) orchestrates arterial wall inflammation through proinflammatory mechanisms, which are closely linked to the occurrence and progression of various cardiovascular diseases. Consequently, detecting and intervening in PVAT inflammation holds immense significance for comprehending early pathophysiological changes in AD and implementing timely preventive measures among individuals at high risk. Reference | Related Articles | Metrics

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Research progress of enhanced external counterpulsation in cardiac rehabilitation Shen Guzhuo, Chen Yanli, Li Xiufen International Medicine and Health Guidance News    2024, 30 (12): 1937-1941.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.001 Abstract （126）            Knowledge map    Save Cardiac rehabilitation is a comprehensive treatment that helps to reduce the risk of myocardial ischemia and improve the patients' quality of life. In addition, cardiac rehabilitation can also relieve the patients' negative emotions, help the patients improve self-cognition and emotional regulation ability, and promote the mental health. As an important means of cardiac rehabilitation, external counterpulsation has a positive impact on patients' long-term survival and quality of life by increasing coronary artery perfusion pressure, improving the function of cardiovascular system, and reducing the risk of cardiovascular disease and the rate of re-hospitalization and other prognostic indicators. This article discusses the research progress of enhanced external counterpulsation in cardiac rehabilitation from several aspects of clinical application and mechanism. Reference | Related Articles | Metrics

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Advances in METS-IR and cardiovascular diseases Wang Xinyu, Guo Yishan, Liu Qian, Wang Dong International Medicine and Health Guidance News    2024, 30 (14): 2289-2293.   DOI: 10.3760/cma.j.issn.1007-1245.2024.14.001 Abstract （123）            Knowledge map    Save With the improvement of living standards, the incidence and mortality of cardiovascular diseases are increasing year by year and have become an important public health problem. Insulin resistance status is closely related to the pathophysiologic process in the occurrence and development of cardiovascular diseases. In-depth study of the intrinsic link between insulin resistance and cardiovascular diseases is essential for early prevention, treatment, and follow-up of cardiovascular diseases. Traditional insulin resistance testing methods are cumbersome, time-consuming, and expensive, making them unsuitable for hospitals, not to mention being unable to be generalized in large-scale populations. Metabolic Score for Insulin Resistance (METS-IR) is a new type of predictors of insulin resistance, and METS-IR reflects insulin resistance with high efficiency and simplicity. Moreover, elevated METS-IR is positively correlated with cardiovascular diseases and poor cardiovascular prognosis. Based on this, this article summarizes the diagnostic and clinical value of METS-IR in common cardiovascular diseases. Reference | Related Articles | Metrics

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Risk factors and delay strategies for progression of chronic kidney disease Li Xinmeng, Liu Qianqian, Liu Yunqi International Medicine and Health Guidance News    2024, 30 (11): 1766-1770.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.002 Abstract （121）            Knowledge map    Save Chronic kidney disease (CKD) is a complex disease and is often asymptomatic in the early stages, and can lead to renal dysfunction and progression to end-stage renal disease (ESRD) with a variety of complications, such as cardiovascular disease (CVD) and other complications. Current susceptibility factors for CKD include sex hormones, thyroid hormones, and familial genetic factors, etc. Risk factors for the disease onset and progression include glomerulonephritis, hypertension, diabetes mellitus, proteinuria, hyperlipidemia, and accumulation of urinary toxins. Current CKD treatments aims at slowing the progression of CKD and preventing cardiovascular diseases, so new treatments need to be developed to stop disease progression. This article reviews the risk factors of the progression of CKD and strategies for slowing its progression. Reference | Related Articles | Metrics

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Summary of best evidence for thirst management in ICU adult patients receiving mechanical ventilation Bian Hong, Yu Ping, Zhou Zhiyin, He Ping, Sun Qin International Medicine and Health Guidance News    2024, 30 (10): 1730-1734.   DOI: 10.3760/cma.j.issn.1007-1245.2024.10.030 Abstract （119）            Knowledge map    Save Objective To summarize the evidence related to thirst management in ICU adult patients with mechanical ventilation, and to identify the best evidence. Methods A systematic search was conducted on domestic and foreign databases for relevant literatures on thirst management in ICU adult patients with mechanical ventilation, including guidelines, clinical decisions, systematic reviews, evidence summaries, original studies, recommended practices, and best clinical practice information books. The search period was from the establishment of the databases to June 30, 2023. Two researchers were responsible for evaluating the quality of the included medical literature databases, PubMed, International Guide Library, China Guide Network, and the British National Institute for Health and Care Excellence (NICE) clinical research literatures, and were responsible for extracting evidence consistent with quality standards. Results Finally, 10 pieces of evidences were included, including 4 systematic reviews, 3 randomized controlled trials (RCTs), 1 expert consensus, and 2 evidence summaries. A total of 16 best evidences were formed from six aspects: influencing factors, evaluation content, evaluation tools, intervention measures, effect evaluation, and personnel management of thirst in ICU adult patients with mechanical ventilation. Conclusions In terms of clinical application evidences, it is necessary to evaluate the clinical conditions/environment of the hospitals, the positive and negative factors of doctors and nurses in applying evidences, and patients' preferences to carry out targeted evidence selection. In addition, as the best evidence continues to be updated over time, users should also continuously update the evidences and effectively respond to the thirst management issues of adult critically ill patients through scientific nursing methods, thereby promoting the improvement of nursing quality. Reference | Related Articles | Metrics

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Research progress on ultrasound in evaluation of endometrial receptivity in female infertility patients Hu Yujuan, Hong Xiaofang, Zhang Shuyue, Zhong Jianxing, Song Chujun, Cui Xu, Liang Weixiang, Liu Tao International Medicine and Health Guidance News    2024, 30 (11): 1776-1780.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.004 Abstract （119）            Knowledge map    Save In recent years, more and more women have sought assisted reproductive technology to help them conceive due to fertility or reproduction problems. Infertility has become a major problem affecting human health. Good endometrial receptivity (ER) is a key factor for successful pregnancy, and accurate and efficient assessment of endometrial receptivity has become a research hotspot. Endometrial pathology biopsy techniques are generally considered the gold standard for the evaluation of ER. However, due to its invasiveness and lag in evaluation, it is difficult to reflect the immediate endometrial receptivity, so its clinical application is limited. As a non-invasive examination method, ultrasound can continuously monitor in real-time during the cycle, and has been widely used in the diagnosis and treatment of female infertility, and has become the preferred examination method for infertility. This review focuses on ER, and describes the research progress of ultrasound endometrial morphology, endometrial blood flow, endometrial peristalsis wave, endometriography, and endometrial elastography in detail. Reference | Related Articles | Metrics

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Analysis of the effect of quality control circle activities on reducing the incidence of local pain of peripheral intravenous potassium supplementation Zhong Lei, Ye Xiaorong, Liu Fangyun, Su Lishan International Medicine and Health Guidance News    2024, 30 (10): 1746-1751.   DOI: 10.3760/cma.j.issn.1007-1245.2024.10.033 Abstract （117）            Knowledge map    Save Objective To explore the effect of quality control circle activities on reducing the incidence of local pain of peripheral intravenous potassium supplementation. Methods A quality control circle activity group was established in December 2021 in the Second Affiliated Hospital of Guangzhou Medical University, and 124 patients undergoing peripheral intravenous potassium supplementation in our department from January to July 2022 were selected as the control group. There were 52 males and 72 females, aged (48.03±17.96) years, with a body mass of (52.81±8.72) kg. The current situation of pain incidence was investigated and the causes were analyzed by using a single dimension pain scale (oral 5-point scoring method), and the key points for improvement were determined. The target value was set and the countermeasures were formulated. Ninety-four patients undergoing peripheral intravenous potassium supplementation in our department from January to June 2023 were selected as the observation group. There were 32 males and 62 females, aged (51.39±18.98) years, with a body mass of (54.17±6.99) kg. The quality control circle activities were carried out and continuous quality improvement was made. The incidences of pain in the two groups were compared and the causes were analyzed. Statistical methods used were χ2 test and t test. Result The incidence of local pain in the observation group was lower than that in the control group [17.02% (16/94) vs. 48.39% (60/124)], with a statistically significant difference (χ2=23.16, P<0.05). Conclusion Quality control circle activities can effectively reduce the incidence of local pain in patients undergoing peripheral intravenous potassium supplementation, and improve the patients' medical experience and satisfaction. Reference | Related Articles | Metrics

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Insulin glargine combined with semaglutide for type 2 diabetes mellitus patients with poor glycemic control and hypertension Li Chuansong, Liu Jiajing, Liu Yanfeng International Medicine and Health Guidance News    2024, 30 (11): 1807-1811.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.010 Abstract （110）            Knowledge map    Save Objective To investigate the efficacy and safety of insulin glargine combined with semaglutide injection in the treatment of type 2 diabetes mellitus (T2DM) patients with poor blood glucose control and hypertension. Methods One hundred and four T2DM patients with poor blood glucose control and hypertension treated at Jinan Maternal and Child Health Hospital from July 2021 to February 2023 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 52 cases in each group. There were 30 males and 22 females in the control group; they were (48.04±4.03) years old; their body mass index was (24.08±3.15) kg/m2; their duration of T2DM was (5.96±0.74) years; their duration of hypertension was (2.96±0.41) years. There were 28 males and 24 females in the study group; they were (47.13±4.48) years old; their body mass index was (24.14±2.86) kg/m2; their duration of T2DM was (6.13±0.85) years; their duration of hypertension was (3.03±0.38) years. The control group were treated with semaglutide injection, and the study group with insulin glargine and semaglutide injection, for 3 months. The glucose metabolism, islet function, lipid metabolism, and blood pressures before and after the treatment and incidences of adverse drug reactions were compared between the two groups by t and χ2 tests. Results The levels of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), and glycosylated hemoglobin (HbA1c) and insulin resistance index (HOMA-IR) were lower after than before the treatment in both groups; the levels of FPG, 2hPPG, and HbA1c and HOMA-IR after the treatment in the study group were lower than those in the control group [(5.91±0.76) mmol/L vs. (6.49±0.88) mmol/L, (8.47±0.96) mmol/L vs. (9.58±1.06) mmol/L, (5.27±0.73)% vs. (6.19±0.97)%, and (4.53±0.69) vs. (5.39±0.86); t=3.935, 5.774, 9.724, and 5.624; all P<0.05]. The levels of triglyceride (TG) and total cholesterol (TC) were lower after than before the treatment in both groups; the levels of TG and TC after the treatment in the study group were lower than those in the control group [(2.11±0.31) mmol/L vs. (2.49±0.39) mmol/L and (4.74±0.58) mmol/L vs. (5.29±0.75) mmol/L; t=5.500 and 4.183; both P<0.05]. The levels of low density lipoprotein cholesterol (LDL-C) in both groups after the treatment were lower than those before the treatment (both P<0.05); there was no statistical difference in the level of LDL-C after the treatment between the two groups (P>0.05). There were no statistical differences in the systolic and diastolic blood pressures after the treatment between the control group and the study group [(121.03±14.28) mmHg (1 mmHg=0.133 kPa) vs. (116.81±15.41) mmHg and (84.01±9.62) mmHg vs. (81.98±8.56) mmHg; both P>0.05]. There was no statistical difference in the incidence of adverse drug reactions between the control group and the study group [11.54% (6/52) vs. 13.46% (7/52); P>0.05]. Conclusion Insulin glargine combined with semaglutide injection for T2DM patients with poor blood glucose control and hypertension can effectively control their glucose and lipid metabolism and improve their function of pancreatic islets, and is safe. Reference | Related Articles | Metrics

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Effectiveness and safety of Levosimendan treatment in patients with acute heart failure Guo Zhen, Wang Taoli, Li Naijie International Medicine and Health Guidance News    2024, 30 (12): 2039-2043.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.021 Abstract （110）            Knowledge map    Save Objective This study aimed to evaluate the clinical application effect of Levosimendan in patients with acute heart failure (AHF). Methods A total of 98 patients with AHF admitted to Tongchuan People's Hospital from January 2021 to October 2023 were included in this study and were randomly divided into two groups, with 49 patients in each group. There were 27 males and 22 females in the control group, the age was (67.14±6.65) years old, and the New York Heart Association (NYHA) grading was grade Ⅱ in 20 cases, grade Ⅲ in 15 cases, and grade Ⅳ in 14 cases. There were 28 males and 21 females in the observation group, the age was (66.57±6.64) years old, and the NYHA grading was grade Ⅱ in 19 cases, grade Ⅲ in 16 cases, and grade Ⅳ in 14 cases. The control group received standard treatment, and the observation group received standard treatment plus Levosimendan (intravenous injection), with a treatment period of 4 weeks. The duration of clinical symptoms (chest tightness and shortness of breath), myocardial enzyme levels [myeloperoxidase (MPO), N-terminal pro B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), and matrix metalloproteinase 9 (MMP-9)], and cardiac function indicators [left ventricular diameter (LVD), left atrial diameter (LAD), Left ventricular short axis shortening fraction (LVFS), tricuspid annular plane systolic excursion (TAPSE), and heart rate (HR)] before and after treatment, as well as the occurrence of adverse reactions during treatment were compared between the two groups. Independent sample t test and χ2 test were used. Results After treatment, the duration of chest tightness [(1.82±0.37) min/time] and dyspnea [(1.68±0.39) min/time] in the observation group were shorter than those in the control group [(2.49±0.42) min/time and (2.59±0.41) min/time], with statistically significant differences (both P<0.05). The levels of MPO [(2.89±0.61) pg/L], NT-proBNP [(2.05±0.67) g/L], cTnI [(2.58±0.56) μg/L], and MMP-9 [(58.58±7.41) μg/L] in the observation group were lower than those in the control group [(4.36±0.83) pg/L, (4.69±1.54) g/L, (2.97±0.63) μg/L, and (90.64±8.84) μg/L], with statistically significant differences (all P<0.05). The levels of LVD [(40.44±4.84) mm] and LVFS [(31.41±2.54)%] in the observation group were higher than those in the control group [(32.65±4.64) mm and (22.63±3.68)%], while the levels of LAD [(29.89±3.38) mm], TAPSE [(15.85±3.03) mm], and HR [(69.85±8.23) beats/min] were lower than those in the control group [(37.65±4.65) mm, (17.59±3.13) mm, and (86.52±8.51) beats/min], with statistically significant differences (all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion Levosimendan shows good efficacy and safety in patients with AHF and can be considered an effective treatment option for this condition. Reference | Related Articles | Metrics

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Research progress on the relationship between obstructive sleep apnea hypopnea syndrome and gut microflora  Lu Manlu, Zhu Jiwei, Ding Honghong, Yu Yan, Pan Lei International Medicine and Health Guidance News    2024, 30 (10): 1585-1589.   DOI: 10.3760/cma.j.issn.1007-1245.2024.10.001 Abstract （109）            Knowledge map    Save Obstructive sleep apnea hypopnea syndrome (OSAHS) is a respiratory disorder characterized by intermittent hypoxia and impaired reoxygenation that manifests during sleep. Researches have demonstrated a significant association between OSAHS and gut well-being, as it has the potential to disrupt the gut microbiome, modify the gut metabolites, compromise the integrity of the intestinal barrier, and trigger the systemic inflammation. This article provides a comprehensive review of the current research advancements pertaining to the relationship between OSAHS and gut microflora, and highlighting the potential role of disturbances in gut microflora in the progression of OSAHS, albeit with an incomplete understanding of the underlying mechanisms. Reference | Related Articles | Metrics

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Palliative care cognition and hospice care attitude among undergraduate nursing interns and correlation analysis Gai Na, Lei Qingmei, Shi Shengwen, Yan Hongbo, Ou Lishan, He Yuxi, Guan Yuxian International Medicine and Health Guidance News    2024, 30 (9): 1543-1547.   DOI: 10.3760/cma.j.issn.1007-1245.2024.09.030 Abstract （107）            Knowledge map    Save Objective To investigate the current situation of palliative nursing cognition and hospice care attitude of undergraduate nursing interns in Guangzhou, and to provide references for the teaching and training of undergraduate nursing students. Methods Two hundred and five undergraduate nursing interns from Second Hospital, Guangzhou Medical University, First Hospital, Guangzhou Medical University, and First Hospital, Guangdong Pharmaceutical University in Guangzhou were selected by the convenient sampling for the investigation, including 82 males and 123 females. There were 75 ones <22 years old, 117 ones 22-23 years old, and 13 ones >23 years old. The questionnaire included general demographic data (gender, age, student origin, feeling for patients taking hospice care, understanding of palliative care and hospice care, understanding of nursing for patients taking hospice care, and attitude to the patients' family members), The Chinese version of Palliative Care Knowledge Questionnaire (PCQN), and Chinese version of Fromelt End-of-Life Care Attitude Scale (FATCOD-B). t test, analysis of variance, and Pearson correlation analysis were used. Results Among the 205 collected questionnaires, 62.0% (127/205) interns were from urban areas, and 38.0% (78/205) from countryside; 53.2% (109/205) were not from one-child families, and 46.8% (96/205) from one-child families; 60.5% (124/205) did not choose nursing by their own will; 55.1% (113/205) did not know palliative care, and only 44.9% (92/205) knew; 63.4% (130/205) did not know the differences between palliative care and hospice care; 43.4% (89/205) knew the connotation of palliative care; 42.0% (86/205) took care of end-of-life patients or their family members in practice or life ever; 52.7% (108/205) did not take care of end-of-life patients in their internship; only 39.5% (81/205) talked about death with the patients or their family members. The scores of palliative care cognition and hospice care attitude in the 205 interns were (36.62±3.98) and (99.38±8.93), respectively. There was a positive correlation between palliative care cognition and hospice care attitude (r=0.282, P<0.01). Conclusions Undergraduate nursing interns' knowledge about palliative care and clinical care should be improved. College teachers should pay attention to the cultivation and training of nursing students' professional knowledge and skills in these two aspects, and carry out the theoretical study and curriculum practice of relevant knowledge in undergraduate study. Reference | Related Articles | Metrics

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Research on the fingerprint quality of compound Jinju oral liquid Liu Yanlin, Ruan Liying, Tan Benren, Liu Xuehua, Zhou Qiuxia, Xu Yun International Medicine and Health Guidance News    2024, 30 (11): 1854-1857.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.019 Abstract （107）            Knowledge map    Save Objective To provide some scientific references for controlling the quality and evaluation of compound Jinju oral liquid establishing the fingerprint of compound Jinju oral liquid by high performance liquid chromatography (HPLC). Methods The Discovery C18 chromatography column (250.0 mm×4.6 mm, 5 μ m) was used; the mobile phase was acetonitrile-0.1% phosphate solution gradient ution; the flow rate was 1.0 ml/min; the column temperature was 30 ℃; the detection wavelength was 245 nm. The study was from January 2022 to December 2023. Results A fingerprint of compound Jinju oral solution was established. A total of 21 common peaks were calibrated, and 6 of the common peaks were identified. Conclusion HPLC is simple and stable, and can provide some scientific references for controlling the quality and evaluation of compound Jinju oral liquid. Reference | Related Articles | Metrics

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Value of three-dimensional ultrasound imaging in diagnosis of congenital uterine malformation Xu Yinhui, Zhang Hao International Medicine and Health Guidance News    2024, 30 (11): 1812-1816.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.011 Abstract （106）            Knowledge map    Save Objective To explore the value of three-dimensional ultrasound imaging in the diagnosis of congenital uterine malformation. Methods The clinical data of 80 patients with suspected congenital uterine malformation treated at Weihai Municipal Hospital from May 2021 to April 2023 were retrospectively analyzed. They were 22 to 38 years old, with a median age of 28.34. Among them, 32 cases were infertile, 28 cases had primary abortion, and 20 cases had recurrent abortion. All of them were examined by two-dimensional ultrasound and three-dimensional ultrasound, and the combined diagnosis results of hysteroscopy and laparoscopy were regarded as the gold standard. The diagnostic efficiencies of two-dimensional ultrasound and three-dimensional ultrasound were compared, and the classification accuracy of three-dimensional ultrasound was calculated. χ2 test was used. Results A total of 80 patients with suspected congenital uterine malformation were screened out. The gold standard (hysteroscopy combined with laparoscopy) showed that there were 60 cases of congenital uterine malformation and 20 cases of non-congenital uterine malformation. Two-dimensional ultrasound showed that there were 50 cases of congenital uterine malformation and 30 cases of non-congenital uterine malformation. Three-dimensional ultrasound showed that there were 58 cases of congenital uterine malformation and 22 cases of non-congenital uterine malformation. The accuracy and sensitivity of three-dimensional ultrasound in diagnosing congenital uterine malformation were higher than those of two-dimensional ultrasound, and the missed diagnosis rate was lower than that of two-dimensional ultrasound (χ2=4.80, 4.91, and 4.91; P<0.05), but there was no statistical difference in specificity and misdiagnosis rate between the two methods (both P>0.05). The accuracies of three-dimensional ultrasound in diagnosing complete mediastinal uterus and incomplete mediastinal uterus were 94.74% (18/19) and 96.67% (29/30), respectively, and the accuracies in diagnosing other different types of congenital uterine malformations were 100.00%. The accuracies of two-dimensional ultrasound in diagnosing complete mediastinal uterus and incomplete mediastinal uterus were 78.95% (15/19) and 86.67% (26/30), respectively, and the accuracy in diagnosing arcuate uterus and residual horn/single horn uterus was only 66.67%(2/3), while the accuracies in diagnosing other different types of congenital uterine malformations were 100.00%. Conclusions Three-dimensional ultrasound imaging is of great value in the diagnosis of congenital uterine malformation, with high sensitivity and accuracy. At the same time, it can accurately classify diseases and has good clinical diagnostic value. Reference | Related Articles | Metrics

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Observation of the sedative effects of different doses of dexmedetomidine combined with midazolam on children with mental disorders undergoing cranial magnetic resonance imaging  Lei Yangang, Zhao Ningxia, Qiao Cheng, Li Yu International Medicine and Health Guidance News    2024, 30 (12): 1999-2003.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.013 Abstract （104）            Knowledge map    Save Objective To evaluate the sedative effects of different doses of dexmedetomidine combined with midazolam on children with mental disorders undergoing cranial magnetic resonance imaging (MRI). Methods This study was a randomized controlled trial. From January 2021 to October 2023, 84 children with mental disorders requiring cranial MRI at Xi'an Traditional Chinese Medicine Brain Disease Hospital were enrolled in this study, and were divided into two groups according to the random number table method. In the low-dose group, there were 23 boys and 19 girls, aged (5.95±0.93) years, 9 cases of autism, 7 cases of hyperactivity disorders, 7 cases of depression, 5 cases of anxiety disorders, and 14 other cases. In the high-dose group, there were 25 boys and 17 girls, aged (5.84±0.97) years, 8 cases of autism, 7 cases of hyperactivity disorders, 11 cases of depression, 6 cases of anxiety disorders, and 10 other cases. At 30 min before MRI examination, the low-dose group was given 2 μg/kg of dexmedetomidine via nasal drip and 0.1 mg/kg of midazolam via intravenous injection, and the high-dose group was given 3 μg/kg of dexmedetomidine via nasal drip and 0.1 mg/kg of midazolam via intravenous injection. The coordination (completion rate and incidence of agitation), vital signs at different time points (heart rate, blood pressure, and pulse oxygen saturation), sedation effects (modified Ramsay sedation scale scores 10, 20, 30, 40, and 50 min after administration), and adverse events were observed in the two groups. χ2 test and t test were used. Results There were no statistically significant differences in the examination completion rate or incidence of agitation between the low dose group and the high dose group [85.71% (36/42) vs. 90.48% (38/42), 21.43% (9/42) vs. 19.05% (8/42)] (χ2=0.045, P=0.500; χ2=0.074, P=0.786). There were no statistically significant differences in the heart rate, mean arterial pressure, or pulse oxygen saturation between the two groups before administration (all P>0.05). The heart rate and mean arterial pressure of the low-dose group were higher than those of the high-dose group 10 to 50 min after sedation (all P<0.05). The pulse oxygen saturation of the low-dose group was higher than that of the high-dose group 10 to 40 min after sedation (all P<0.05), and there was no statistically significant difference between the two groups 50 min after sedation (P>0.05). There was no statistically significant difference in the Ramsay score between the two groups 10 to 50 min after sedation (all P>0.05). The incidence of adverse events in the low dose group was lower than that in the high dose group [4.76% (2/42) vs. 19.05% (8/42)], with a statistically significant difference (χ2=4.086, P=0.043). Conclusion Low-dose dexmedetomidine combined with midazolam administered nasally is safe and effective, suitable for children with mental disorders undergoing cranial MRI. Reference | Related Articles | Metrics

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Application of modified volume viscosity swallowing test and swallowing angiography in dynamic assessment of swallowing function Zhang Xiaoman, Wu Xiuwei, Gao Xin, Wang He, Fang Na International Medicine and Health Guidance News    2024, 30 (11): 1923-1927.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.033 Abstract （104）            Knowledge map    Save Objective To investigate the effect of modified volume viscosity swallowing test (VVST) combined with swallowing angiography in the dynamic assessment of swallowing function. Methods Eighty patients with swallowing dysfunction treated at Xuzhou Municipal Hospital, Xuzhou Medical University from July 2020 to August 2021 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 40 cases in each group. There were 26 males and 14 females in the control group; they were (56.23±6.12) years old; there were 25 cases of stroke, 8 cases of esophageal cancer, 3 cases of laryngeal cancer, 2 cases of nasopharyngeal cancer, and 2 cases of other diseases. There were 25 males and 15 females in the observation group; they were (56.12±6.08) years old; there were 24 cases of stroke, 8 cases of esophageal cancer, 4 cases of laryngeal cancer, 2 cases of nasopharyngeal cancer, and 2 cases of other diseases. The control group were evaluated by VVST, and the observation group were evaluated by VVST and swallowing angiography and were guided individualizedly. The clinical efficacies, gastric tube retention rates, extubation success rates, incidences of complications, swallowing function status classification, and scores of quality of life were compared between the two groups. χ2 test was used. Results The treatment efficacy in the observation group was higher than that in the control group [95.00% (38/40) vs. 75.00% (30/40); χ2=6.275; P<0.05]. The gastric tube retention rate in the observation group was lower than that in the control group [5.00% (2/40) vs. 22.50% (9/40); χ2=5.165; P<0.05]. The extubation success rate in the observation group was 100.00% (40/40), and that in the control group 92.50% (37/40), with no statistical difference (χ2=3.117; P>0.05). The incidence of complications in the observation group was lower than that in the control group [7.50% (3/40) vs. 30.00% (12/40); χ2=6.646; P<0.05]. The proportion of grade I feeding-swallowing function in the observation group was higher than that in the control group [70.00 % (28/40) vs. 45.00% (18/40); χ2=5.115,P<0.05]; the proportion of grade Ⅲ feeding-swallowing function in the observation group was lower than that in the control group [12.50 % (5/40) vs. 32.50% (13/40); χ2=4.588; P<0.05]. Conclusion VVST + swallowing angiography in the evaluation of swallowing dysfunction is helpful to develop personalized intervention programs to improve the patients' feeding-swallowing function, reduce the risk of complications and gastric tube retention rate, and achieve good prognosis. Reference | Related Articles | Metrics

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New progress in treatment of intestinal bacterial overgrowth Gao Wenwen, Zhang Xiang, Wang Hong, Yin Yanhui International Medicine and Health Guidance News    2024, 30 (9): 1418-1421.   DOI: 10.3760/cma.j.issn.1007-1245.2024.09.003 Abstract （104）            Knowledge map    Save Small intestinal bacterial overgrowth (SIBO) is defined as an increase in the bacterial content of the small intestine above the normal value and is associated with various diseases, such as irritable bowel syndrome, inflammatory diseases, etc. The treatment for SIBO is still controversial. Therefore, this article reviews treatments for SIBO, including antibiotic, probiotics, prokinetic, herbal therapy, dietary therapies, and other treatments. Reference | Related Articles | Metrics

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Research progress on ulcerative colitis in traditional Chinese and western medicines Zeng Xianhu, Li Ming, Li Zilong, Xiang Xu, Tian Hui, Li Huizhu, Ma Longjie, Fang Xiaoli, Chen Li, Tang Ran International Medicine and Health Guidance News    2024, 30 (9): 1415-1418.   DOI: 10.3760/cma.j.issn.1007-1245.2024.09.002 Abstract （103）            Knowledge map    Save Ulcerative colitis is a non-specific intestinal inflammatory disease that mainly affects the rectum and colon, typically characterized by chronic, persistent, and recurrent symptoms. The lesion is limited to the mucosal layer or muscular layer, mainly characterized by ulcers, and may be accompanied by varying degrees of intestinal wall congestion, edema, and bleeding. The patients' clinical symptoms include intermittent diarrhea, feces with mucus and pus, abdominal pain, and urgency. This disease is difficult to cure, has a high recurrence rate, and a high cancer transformation rate, and is closely related to the incidence of colon cancer. Western medicine medication often uses mesalazine enteric coated tablets, glucocorticoids, immunosuppressants, etc. Generally, treatments, such as rest and nutritional support, are used. For patients who meet surgical indications, total colectomy and ileal pouch anal anastomosis can be used. With the continuous development of traditional Chinese medicine surgery, the internal and external treatment methods of traditional Chinese medicine have unique advantages and good therapeutic effects in the classification and treatment of ulcerative colitis. This article summarizes the clinical diagnosis, treatment, and research status of ulcerative colitis in recent years. Reference | Related Articles | Metrics

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Progress in endovenous treatment of thrombotic iliac vein compression syndrome  Ye Feiting, Yan Leilei, Zhang Chengde International Medicine and Health Guidance News    2024, 30 (12): 1950-1954.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.004 Abstract （101）            Knowledge map    Save Thrombotic iliac vein compression syndrome (TIVCS) is caused by iliac vein compression, resulting in iliac vein return obstruction and blood stasis, followed by ipsilateral lower extremity deep venous thrombosis (LEDVT). Without effective treatment, it can lead to pulmonary embolism in the acute stage, seriously endangering the life and health, and may develop into lower extremity post thrombotic syndrome (PTS) in the later stage, which seriously affect the quality of life. At present, endovenous treatment is the main therapy, including inferior vena cava filter (IVCF) implantation, catheter directed thrombolysis (CDT), percutaneous mechanical thrombectomy (PMT), balloon angioplasty, and stent implantation. However, there is still controversy about the timing of iliac vein stenosis treatment, and there is no unified standard. Therefore, this article reviews the progress of endovenous treatment for TIVCS. Reference | Related Articles | Metrics

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Research progress on correlation between airborne pollen and allergic diseases Ren Xuebao, Hou Li, Zhang Liping, Ma Yuanling, Li Yanmei International Medicine and Health Guidance News    2024, 30 (11): 1771-1776.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.003 Abstract （101）            Knowledge map    Save Allergic diseases, such as allergic rhinitis, allergic asthma, and atopic dermatitis, are systemic diseases caused by immune system disorders. Their incidence is increasing year by year due to some factors, such as environment and climate changes. Pollen is one of the common allergens in the world, and its transmission modes include wind-borne, insect-borne, bird-borne, water-borne transmission, and so on, and wind-borne transmission is the most common. Airborne pollen refers to wind-borne pollen that causes allergic inflammatory reaction when inhaled or contacted. Allergic diseases caused by pollen not only affect the patients' quality of life, but also endanger life in severe cases, so it is crucial to do a good job in monitoring airborne pollen and exploring how pollen causes the occurrence of allergic diseases. In this paper, we the describe the research progress on the correlation between airborne pollen and allergic diseases. Reference | Related Articles | Metrics

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Construction of sensitive indicators for quality of nursing care in internal medicine treatment for liver failure Zhang Sisi, Jiang Shuxian, Fan Chenmeng, Chen Miaoxia, Li Lili International Medicine and Health Guidance News    2024, 30 (9): 1559-1564.   DOI: 10.3760/cma.j.issn.1007-1245.2024.09.034 Abstract （100）            Knowledge map    Save Objective To construct a sensitive indicator system for the quality of nursing care in internal medicine treatment for liver failure. Methods The researchers reviewed the literatures in March 2022. By combining evidence-based literatures with expert interviews, and based on the structure-process-outcome model, a preliminary construction of nursing quality sensitive indicators of internal medicine treatment for liver failure was carried out. Two rounds of expert inquiries using the Delphi method were conducted; the indicators were revised and evaluated based on the experts' opinions; the best quality evaluation index system was constructed. The SPSS 26.0 software was used for the statistical analysis. The experts' general data were statistically described by frequency, proportion, and (). The experts' positive coefficient was expressed by the questionnaire recover rate. The experts' authority coefficient and degree were expressed as authority coefficient. The importance degree was weighed by importance scoring. Results The response rates for expert consultations were all 100%, with the expert authority coefficients for the first round being 0.958 and the second round 0.943, both over 0.700. The Kendall coordination coefficient ranged from 0.089 to 0.237 (P<0.05). Finally, the sensitive indicators for the quality of nursing in internal medicine treatment for liver failure were constructed, including 3 primary indicators, 13 secondary indicators, and 29 tertiary indicators. Conclusion The sensitive indicators for the quality of nursing in internal medicine treatment for liver failure constructed in this study have good reliability, scientificity, and a certain degree of specialized sensitivity, which can provide certain basis for the evaluation of the quality of medical treatment and nursing for liver failure. Reference | Related Articles | Metrics

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Finger exercises combined with gripping in reducing limb swelling in patients taking transradial coronary intervention Huang Libin International Medicine and Health Guidance News    2024, 30 (13): 2249-2252.   DOI: 10.3760/cma.j.issn.1007-1245.2024.13.026 Abstract （98）            Knowledge map    Save 桡动脉；经皮冠状动脉介入治疗；改良手指操；握力；疼痛程度；肿胀程度 Reference | Related Articles | Metrics

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Molecular mechanism of regulation of insulin secretion Liang Lichan, Wang Yangyang, Lin Dejian, Chen Liqiang International Medicine and Health Guidance News    2024, 30 (13): 2145-2147.   DOI: 10.3760/cma.j.issn.1007-1245.2024.13.007 Abstract （96）            Knowledge map    Save Insulin is secreted by pancreatic β cells, and is the key active molecule in the body to regulate metabolism. Insulin biosynthesis is regulated at the transcriptional and translational levels. The cis-acting elements and trans-acting factors included paired box 6 (PAX6), pancreatic and duodenal homeobox-1 (PDX-1), V-maf musculoaponeurotic fibrosarcoma oncogene homolog A (MafA), and B-2 / neural differentiation factor 1, and they involve in insulin biosynthesis. Insulin secretion involves the formation, transport, and fusion of insulin secretory vesicles. Insulin is not only controlled by blood sugar, but also affected by free fatty acid and amino acid. In addition, different hormones can also affect insulin secretion, such as melatonin, estrogen, leptin, growth hormone, and glucagon-like peptide-1. This review focuses on the molecular mechanism of insulin synthesis and secretion, in order to understand the pancreatic β-cell dysfunction and the occurrence of diabetes mellitus. Reference | Related Articles | Metrics

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Effective dose of remimazolam combined with etomidate for general anesthesia induction by BCD method Chen Jinming, Cheng Xiaolei, Sun Hao, Mo Guixi International Medicine and Health Guidance News    2024, 30 (11): 1791-1796.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.007 Abstract （96）            Knowledge map    Save Objective To determine the median and 95 percent effective doses (ED50 and ED95) of remimazolam combined with etomidate for general anesthesia induction by the biased coin design (BCD) method in two stages. Methods One hundred and four patients taking general anesthesia by tracheal intubation at Affiliated Hospital of Guangdong Medical University from September 1, 2022 to October 31, 2023 were selected, and were divided in two stages (group S1 and group S2) for the BCD experiment; they were 18 - 64 years old. In group S1, the fixed dose of etomidate was set as 0.15 mg/kg; the first patient was given remimazolam 0.25 mg/kg; when the patient was not conscious, the score of alertness /sedation (OAA/S) ≤1, and bispectral index (BIS) ≤60, the patient was given sufentanil 0.4 μg/kg and atracurium 0.2 mg/kg; the ED50 and ED95 of remimazolam for the next patient were determined by the BCD method based on the situation of tracheal tube insertion in the previous patient. Similarly, the ED50 of remimazolam was fixed in group S2, and the ED50 and ED95 of etomidate were measured. The cardiovascular response to tracheal intubation before induction (T0) and before (T1) and 1 (T2) and 3 min (T3) after intubation and the incidences of hypotension, bradycardia, muscle tremors, hiccup, injection pain, etc. were recorded.The repeated measurement analysis of variance, χ2 test, and Fisher exact probability were applied. According to the dosage of medication, the effective dose and 95% confidence interval (CI) were calculated by the Probit probability unit method. Results There were 52 cases in group S1, including 21 males and 31 females; they were (40.7±12.2) years old; their body mass index (BMI) was (22.8±3.1) kg/m2; there were 11 cases of grade Ⅰ and 41 cases of grade Ⅱ of American Society of Anesthesiologists (ASA). There were 52 cases in group S2, including 27 cases and 25 cases; they were (39.7±12.7) years old; their BMI was (22.4±2.8) kg/m2; there were 3 cases of grade Ⅰ and 49 cases of grade Ⅱ of ASA. When 0.15 mg/kg etomidate was used for the general anesthesia induction, the ED50 and ED95 of remimazolam required to prevent cardiovascular response to tracheal intubation were 0.253 mg/kg (95%CI 0.130-0.265 mg/kg) and 0.285 mg/kg (95%CI 0.276-0.352 mg/kg), respectively. The ED50 and ED95 of etomidate combined with remimazolam (0.25 mg/kg) required to prevent cardiovascular response to tracheal intubation were 0.191 mg/kg (95%CI 0.084-0.212 mg/kg) and 0.254 mg/kg (95%CI 0.234-0.413 mg/kg), respectively. There were no statistical differences in HR at T0, T1, T3 between the two groups (all P>0.05). The HR at T2 was higher than that at T0 (all P<0.05). The MAP's at T0 and T2 were higher than those at T1 and T3, with statistical differences (all P<0.05). The was no statistical difference in MAP between at T0 and T2 (all P>0.05). No bradycardia occurred in both groups. All the patients had successful intubation at one time. There were statistical differences in the incidences of injection pain and hiccup between group S1 and group S2 [17.3% (9/52) vs. 0 and 11.5% (6/52) vs. 0; both P<0.05]. There was no statistical difference in the incidences of muscle tremors and hypotension between the two groups (both P>0.05). Conclusion Remimazolam combined with etomidate is safely and effective for endotracheal intubation in the 18 to 64 years old. The ED50 and ED95 of remimazolam can provide references for precision medication in clinic when it is combined with etomidate. Reference | Related Articles | Metrics

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Pars plana vitrectomy with ranibizumab as adjuvant for patients with proliferative diabetic retinopathy Yi Wei, Zhao Jie, Yang Fan, Mi Qianqian, Cheng Yue, Wang Dan International Medicine and Health Guidance News    2024, 30 (11): 1904-1908.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.029 Abstract （95）            Knowledge map    Save Objective To observe the effect of pars plana vitrectomy (PPV) with intravitreal injection of ranibizumab injection as adjuvant for patients with proliferative diabetic retinopathy (PDR) and its influence on surgical complications. Methods Forty-five patients with PDR (45 eyes) treated in Jilin Provincial People's Hospital from June 2022 to October 2023 were selected as the study objects. The patients were divided into a control group (24 cases and 24 eyes) and an experimental group (21 cases and 21 eyes) according to the different treatment methods. There were 17 males and 7 females in the control group; they were (57.46±9.14) years old; their disease course was (8.08±4.75) years. There were 11 males and 10 females in the experimental group; they were (52.09±10.20) years old; their disease course was (10.00±3.61) years. The control group took PPV; in addition, the experimental group were intraocularly injected 0.05 ml ranibizumab injection one week before the surgery. The basic data, operation times, intraoperative data (incidences of iatrogenic hole, using electrocoagulation, intraocular filling with inert gas and silicone oil, and significant intraoperative bleeding), and incidences of surgical complications were compared between the two groups. The best corrected visual acuities (BCVA) before and 1 and 3 months after the surgery were evaluated. t and χ2 tests were applied. Results There were no statistical differences in the basic data between the two groups (all P>0.05). The operation time and incidences of iatrogenic hole, using electrocoagulation, intraocular filling with inert gas and silicone oil, and significant intraoperative bleeding in the experimental group were lower than those in the control group [(51.00±5.65) min vs. (71.29±6.19) min, 9.52% (2/21) vs. 45.83% (11/24), 4.76% (1/21) vs. 41.67% (10/24), 14.29% (3/21) vs. 50.00% (12/24), and 4.76% (1/21) vs. 33.33% (8/24)], with statistical differences (t=11.426; χ2=5.529, 6.382, 4.922, and 4.068; all P<0.05). There were no statistical differences in the BCVA before and 1 and 3 months after the surgery between the two groups (all P>0.05). The BCVA 1 and 3 months after the surgery were lower than those before the surgery in both groups, with statistical differences (t=7.656, 9.603, 5.090, and 10.325; all P<0.05). The patients were followed up for 3 months; there were no statistical differences in the early hemorrhage (≤1 month)  and total incidence of complications (both P>0.05), but was in late hemorrhage (> 1 month) (t=4.564; P<0.05) between the two groups. Conclusions Intravitreal injection of ranibizumab can reduce the incidence of complications during PPV for patients with PDR, shorten the operation time, and improve their BCVA after surgery. Reference | Related Articles | Metrics

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Application of double tutor teaching mode based on the group standards of the Chinese Nursing Association in new nurses Zhao Fang, Sun Yanqi, Tian Qinju International Medicine and Health Guidance News    2024, 30 (12): 2097-2101.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.034 Abstract （95）            Knowledge map    Save Objective To explore the application effect of double tutor teaching mode based on the group standards of the Chinese Nursing Association in new nurses. Methods A total of 85 newly enrolled nurses from Tengzhou Central People's Hospital Affiliated to Jining Medical College from January 2022 to September 2023 were selected by convenience sampling method, and were simply randomly divided into a routine group (43 cases) and a standard group (42 cases). In the routine group, there were 12 males and 31 females, aged (23.27±4.16) years. In the standard group, there were 15 males and 27 females, aged (22.98±3.09) years. The routine group was managed by the training strategies in the Trial Measures for Standardized Training of Clinical Nurses, while the standard group implemented the double-tutor teaching mode based on the group standards of the Chinese Nursing Association. The double tutors included a nursing department tutor and clinical tutors, respectively. The tutor of nursing department was a fixed supervisor who was responsible for the whole training process of new nurses; the clinical tutors were handed over with departments, and each department was in charge of one-to-one teaching by a clinical teacher.  Both groups were taught for 40 weeks.The theoretical and operational achievements, clinical comprehensive ability, self-efficacy, and satisfaction of the nurses in the routine group and the standard group were recorded and compared. t test and χ2 test were used. Results The theoretical and operational scores of the standard group were higher than those of the routine group [(95.33±6.25) points vs. (80.27±5.03) points, (90.17±5.43) points vs. (82.06±6.26) points] (both P<0.05). The scores of each item of clinical comprehensive ability of the standard group were higher than those of the routine group, with statistically significant differences (all P<0.05). Before training, there was no statistically significant difference in the score of General Self-Efficacy Scale (GSES) between the standard group and the routine group [(20.12±10.11) points vs. (20.67±10.36) points] (P>0.05). After training, the GSES scores of the standard group and the routine group were higher than those before training, and the GSES score of the standard group was higher than that of the routine group [(33.28±10.27) points vs. (26.71±8.31) points], with statistically significant differences (all P<0.05). The satisfaction scores of new nurses in the standard group on teaching content, teaching method, and teaching arrangement were higher than those in the routine group [(29.06±4.79) points vs. (23.08±4.17) points, (32.68±4.02) points vs. (27.02±4.79) points, (36.41±6.17) points vs. (31.68±6.22) points], with statistically significant differences (all P<0.05). Conclusion The double tutor teaching mode based on the group standards of the Chinese Nursing Association can improve the theoretical and group standard operation performance of new nurses, improve their clinical comprehensive ability, and increase their self-efficacy, with high satisfaction. Reference | Related Articles | Metrics

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Effect of heart regulating and mind calming acupuncture combined with cognitive behavioral therapy on patients with chronic insomnia Zhang Lintao, Wang Jin, Chen Jie, Yuan Jie International Medicine and Health Guidance News    2024, 30 (13): 2225-2229.   DOI: 10.3760/cma.j.issn.1007-1245.2024.13.021 Abstract （94）            Knowledge map    Save Objective To analyze the effect of heart regulating and mind calming acupuncture combined with cognitive behavioral therapy on patients with chronic insomnia (CID). Methods One hundred and two patients with CID treated at Hospital Affiliated to Shaanxi University of Chinese Medicine from September 2021 to August 2023 were selected, and divided into a control group and an observation group by lottery, with 51 cases in each group. There were 29 males and 22 females in the control group; they were (40.26±8.54) years old. There were 27 males and 24 females in the observation group; they were (42.73±8.15) years old. The control group received cognitive-behavioral therapy, while the observation group received heart regulating and mind calming acupuncture and cognitive-behavioral therapy. Both groups were intervened once a week for 4 weeks. The treatment effects and scores of Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) and serum neurotransmitter levels before the treatment and after 4 weeks' treatment were compared between the two groups. Independent-sample t test and χ2 test were applied. Results The total effective rate of the observation group was higher than that of the control group [96.08% (49/51) vs. 84.31% (43/51)], with a statistical difference (χ2=3.991,P=0.046). After 4 weeks' treatment, the scores of ISI and PSQI in the observation group were lower than those in the control group [(9.53±2.74) vs. (11.23±2.58) and (6.17±2.45) vs. (10.32±2.62)], with statistical differences (both P<0.05). After 4 weeks' treatment, the levels of γ-aminobutyric acid and glutamic acid in the observation group were higher those in the control group [(10.42±1.32) ng/L vs. (8.61±0.95) ng/L and (17.42±0.92) μmol/L vs. (15.62±5.52) μmol/L], with statistical differences (both P<0.05). After 4 weeks' treatment, the scores of SAS and SDS in the observation group were lower than those in the control group [(31.42±5.52) vs. (39.63±5.47) and (36.15±6.43) vs. (41.62±5.79)], with statistical differences (both P<0.05). Conclusion Heart regulating and mind calming acupuncture combined with cognitive behavioral therapy for patients with CID can improve the treatment effect, alleviate their insomnia, improve their sleep quality and serum neurotransmitter levels, and alleviate their adverse emotions. Reference | Related Articles | Metrics

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Effects of prone position ventilation at different angles on patients with acute respiratory distress syndrome Liang Yandong, He Weifeng, Liu Qiujiang, Li Yanhong, Yu Jiayan International Medicine and Health Guidance News    2024, 30 (12): 2063-2067.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.027 Abstract （94）            Knowledge map    Save Objective To evaluate the effects of prone position ventilation at different angles on patients with acute respiratory distress syndrome (ARDS). Methods This prospective, randomized, controlled clinical trial included 96 patients with ARDS admitted to the Intensive Care Unit (ICU) of Guangdong Second Hospital of Traditional Chinese Medicine from July 2021 to June 2023. The patients were randomly divided into group A (0° prone position ventilation), group B (30° prone position ventilation), and group C (45° prone position ventilation), with 32 cases in each group. There were 19 males and 13 females in group A, aged (50.25±11.31) years, with a body mass index (BMI) of (23.42±3.16) kg/m2. There were 17 males and 15 females in group B, aged (51.93±12.48) years, with a BMI of (22.72±4.15) kg/m2. There were 20 males and 12 females in group C, aged (52.39±12.82) years, with a BMI of (24.76±4.31) kg/m2. The observation time was 5 days. The patients in group A were continuously ventilated in the prone position at 0° for 16 h every day and lifted up every 2 h to prevent stress injury. In group B, after maintaining 0° prone position for 2 h, the patients' body was tilted to the left for 30° with the 30° turning pad for 2 h, then it was tilted to the right for 30° for 2 h, finally returned to 0° prone position. This was repeated until 16 h of prone ventilation was completed. In group C, after maintaining 0° prone position for 2 h, the patients' body was tilted to the left for 45° with the 45° turning pad for 2 h, then it was tilted to the right for 45° for 2 h, finally returned to 0° prone position. This was repeated until 16 h of prone ventilation was completed. The changes in oxygenation indicators [oxygenation index (PaO2/FiO2), arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2)], hemodynamic indexes [heart rate (HR), mean arterial pressure (MAP), and central venous pressure (CVP)], Murray Lung Injury Score (MLIS), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, and multiple organ dysfunction syndrome (MODS) score were compared among the three groups. The incidence of pressure injury was also observed. One-way analysis of variance, LSD method, paired t test, and χ2 test were used. Results After 5 days of prone position ventilation, the PaO2/FiO2, SaO2, PaO2, and PaCO2 in the three groups were improved compared with those before ventilation, and the improvement ranges of group A and group B were better than those of group C (all P<0.05). There were no statistically significant differences in the HR, MAP, or CVP among the three groups before and after 5 days of prone position ventilation (all P>0.05). After 5 days of prone position ventilation, the MLIS, APACHEⅡ, and MODS scores of the three groups were lower than those before ventilation; those of group A and group B were lower than those of group C [(1.72±0.37) points vs. (1.54±0.16) points vs. (1.89±0.26) points, (11.02±2.69) points vs. (11.01±2.01) points vs. (12.87±2.06) points, (5.64±0.37) points vs. (5.34±0.67) points vs. (6.19±0.43) points] (all P<0.05). The incidences of pressure injury in group B and group C were lower than that in group A [15.63% (5/32) vs. 18.75% (6/32) vs. 40.63% (13/32)] (P<0.05). Conclusions Prone position ventilation at different angles can improve the oxygenation and alleviate the condition in patients with ARDS. Among the studied angles, 30° prone position ventilation shows the most significant improvement and reduces the incidence of pressure injury. Reference | Related Articles | Metrics

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Application of three ultrasound-guided nerve blocks combined with general anesthesia in laparoscopic cholecystectomy Huo Jianzhen, Wang Chun'ai, Zhang Chengjiang, Cao Ting International Medicine and Health Guidance News    2024, 30 (11): 1781-1785.   DOI: 10.3760/cma.j.issn.1007-1245.2024.11.005 Abstract （93）            Knowledge map    Save Objective To investigate the application of three ultrasound-guided nerve blocks in conjunction with general anesthesia in laparoscopic cholecystectomy (LC). Methods Sixty patients taking selective LC at Yulin Hospital, First Hospital, Xi 'an Jiaotong University from October 2022 to November 2023 were selected for the randomized controlled trial, and were divided into an erector spinae plane block (ESPB) group, a paravertebral nerve block (PVB) group, and a transversal-midpleural nerve block (MTPB) group by the random number table method, with 20 cases in each group. All the patients received ultrasound-guided nerve blocks combined with general anesthesia. There were 9 males and 11 females in the ESPB group; they were (49.85±10.58) years old. There were 8 males and 12 females in the PVB group; they were (54.40±10.51) years old. There were 7 males and 13 females in the MTPB group; they were (49.95±11.61) years old. The intraoperative remifentanil and propofol dosages, intraoperative and postoperative mean arterial pressures (MAP), scores of Visual Analogue Scale (VAS), and levels of C-reactive protein (CRP), norepinephrine concentrations, and blood glucose levels at various time points after surgery, as well as postoperative adverse reactions, were recorded and compared. t, F, and χ2 tests were applied. Results There were no statistical differences in the propofol dosage, MAP's before and after the surgery, and score of VAS 24 h after the surgery between the 3 groups (all P>0.05). The remifentanil dosages, MAP's during the surgery, and scores of VAS 2 and 8 h after the surgery in the MTPB group and the PVB group [(1.09±0.50) mg, (89.96±4.56) mmHg (1 mmHg=0.133 ) kPa , (4.95±3.14) , and (3.55±2.50) ; (0.84±0.47) mg, (90.42±5.08) mmHg, (4.60±2.56) , and (4.00±2.55) ] were lower than those in the ESPB group [(1.77±0.29) mg, (93.00±3.90) mmHg, (7.75±1.89) , and (5.95±2.87) ], with statistical differences (F=25.04, 4.06, 8.94, and 4.65; all P<0.05). There were no statistical differences in the blood glucose levels 2, 8, and 24 h after the surgery between the 3 groups (P>0.05). Two, 8, and 24 h after the surgery, the levels of CRP and NE in the MTPB group and the PVB group [(2.83±0.82) ng/dl, (3.34±0.99) ng/dl, (2.75±1.10) ng/dl, (361.89±44.43) ng/L, (351.01±56.17) ng/L, and (358.16±43.28) ng/L; (1.84±0.93) ng/dl, (2.14±1.09) ng/dl, (1.70±0.90) ng/dl, (303.31±55.97) ng/L, (302.45±47.87) ng/L, and (297.46±44.68) ng/L] were lower than those in the ESPB group [(3.87±1.15) ng/dl, (3.89±0.82) ng/dl, (3.92±1.11) ng/dl, (400.77±55.38) ng/L, (407.11±58.59) ng/L, and (403.27±51.48) ng/L], with statistical differences (F=21.62, 16.96, 22.75, 17.67, 18.54, and 25.94; all P<0.05). There was no statistical difference in the incidence of adverse reactions between the 3 groups (P>0.05). Conclusion Application of MTPB or PVB combined with general anesthesia in patients taking LC provides effective postoperative analgesia, reduces intraoperative remifentanil dosage, prolongs analgesic effect, inhibits postoperative stress responses without causing serious adverse reactions, but MTPB is simple and safe. Reference | Related Articles | Metrics

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Important role and mechanism of lipid metabolism in breast cancer progression Cai Yiwei, Yan Chenming, Yue Linhao, Wang Xiaohong, Jia Zhongming International Medicine and Health Guidance News    2024, 30 (15): 2470-2473.   DOI: 10.3760/cma.j.issn.1007-1245.2024.15.002 Abstract （93）            Knowledge map    Save Breast cancer is a malignant tumor originating from breast epithelial tissue, and its incidence rate is increasing year by year. Studies have shown that the level and regulation of lipid metabolism play an important role in the tumor cell proliferation, migration, invasion, metastasis, and development of drug resistance. This paper reviews the role and mechanism of lipid metabolism in the breast cancer progression from three aspects: lipid metabolism components (fatty acids, triglycerides and cholesterol), lipid metabolism signaling pathway, and regulatory genes of lipid metabolism, offers insights into the potential clinical value of targeted lipid metabolism therapy, and provides theoretical references for formulating effective treatment strategies and developing metabolism-targeted drugs. Reference | Related Articles | Metrics

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Different doses of nafamostat mesilate for patients taking hemodialysis Quan Xing, Xiao Qian, Song Li, Quan Zilin, Yin Yan, Feng Zhonglin International Medicine and Health Guidance News    2024, 30 (15): 2579-2584.   DOI: 10.3760/cma.j.issn.1007-1245.2024.15.023 Abstract （92）            Knowledge map    Save Objective To explore the anticoagulant effect and safety of different dosages of nafamostat mesylate for patients taking hemodialysis. Methods According to the dosages of nafamostat mesylate, the patients were divided into a 10 mg/h nafamostat mesilate group (33 cases), including 23 males and 10 females who were (58.8±16.0) years old, and a 20 mg/h nafamostat mesilate group (32 cases), including 17 males and 15 females who were (62.6±15.7) years old. All the patients took hemodialysis for 4 h per time, 3 times per week. The data were compared between the two groups by independent-sample t test or non-parameter test. The rates of venous clotting, artery clotting, and cumulative catheter blockage were compared between the two groups by Kaplan-Meier survival analysis and log-rank test. Results A total of 65 patients undergoing maintenance dialysis were included; they underwent 178 case times of nafamostat mesilate anticoagulation, including 87 case times in the 10 mg/h nafamostat mesilate group and 91 case times in the 20 mg/h nafamostat mesilate group. There were no statistical differences in gender, age, body weight, height, coronary heart disease, diabetes mellitus, bleeding causes, and laboratory indicators between the two groups (P>0.05). More patients had venous clotting score of 3 in the 10 mg/h nafamostat mesilate group than in the 20 mg/h nafamostat mesilate group [6.9% (6/87) vs. 3.3% (3/91)], with a statistical difference (P<0.05). The treatment time in the 20 mg/h nafamostat mesilate group was longer than that in the 10 mg/h nafamostat mesilate group [(225.0±21.3) min vs. (217.0±18.1) min], with a statistical difference (t=-2.587; P<0.05). The pre-dialysis transmembrane pressure and arterial pressure in the 20 mg/h nafamostat mesilate group were significantly lower than those in the 10 mg/h nafamostat mesilate group [(57.0±43.4) mmHg (1 mmHg=0.133 kPa) vs. (77.3±31.2) mmHg and (-82.3±28.9) mmHg vs. (-71.1±29.4) mmHg], with statistical differences (t=3.488 and 2.448; both P<0.05). The survival analysis showed that there was no statistical difference in the catheter blockage rate between the two groups (P>0.05). After anticoagulation with nafamostat mesilate, 2 cases (3.1%) experienced aggravated bleeding in the 65 patients. Conclusion Anticoagulation with nafamostat mesilate in standard hemodialysis treatment has a low incidence of venous clotting occlusion and minor bleeding risk. The 20 mg/h dosage of nafamostat mesilate exhibits better effectiveness, can reduce the rate of venous clotting and offer a new anticoagulation method for patients taking maintenance dialysis at high risk of bleeding. Reference | Related Articles | Metrics

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Effect of multidisciplinary collaborative intervention on wound healing and quality of life in patients with chronic wounds Tan Shaomei, Yao Jingbin, Mo Huixin International Medicine and Health Guidance News    2024, 30 (12): 2078-2082.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.030 Abstract （92）            Knowledge map    Save Objective To explore multidisciplinary collaborative intervention strategies for patients with chronic wounds, in order to improve their wound healing effect and quality of life. Methods A prospective study method was used to select 72 patients with chronic wounds admitted to Wound Repair Department, The Fourth People's Hospital of Nanhai District, Foshan City from April 2022 to March 2023, and they were divided into a control group and an observation group with 36 cases in each group by the random number table method. There were 19 males and 17 females in the control group, aged (61.14±8.69) years, with the duration of ulcer of (51.69±14.89) d, and they received routine intervention for chronic wounds. There were 21 males and 15 females in the observation group, aged (60.53±7.28) years, with the duration of ulcer of (52.94±13.39) d, and they adopted multidisciplinary collaborative intervention model on the basis of the control group.  Both groups were intervened until wound healing or 4 weeks after discharge.The Bates-Jensen Wound Assessment Tool (BWAT) and Chinese version of Wound Quality of Life Scale (Wound QoL) were used to evaluate the patients' wound healing status and quality of life, and the patients' wound healing rate and healing time were recorded. Independent sample t test was used for the measurement data and χ2 test was used for the count data. Results The wound healing rate of the observation group was higher than that of the control group [94.4% (34/36) vs. 77.8% (28/36)], and the wound healing time was shorter than that of the control group [(43.39±12.86) d vs. (52.94±15.07) d], with statistically significant differences (χ2=4.181, t=2.894, both P<0.05). At the 4th week of intervention and after wound healing or 8 weeks after discharge, the BWAT scores of the observation group were lower than those of the control group [(17.53±5.68) points vs. (23.64±7.74) points, (13.33±1.41) points vs. (15.42±4.98) points], with statistically significant differences (t=3.818 and 2.414, both P<0.05). After wound healing or 8 weeks after discharge, the total score of Wound QoL of the observation group was lower than that of the control group [(29.44±4.69) points vs. (39.28±5.64) points], with a statistically significant difference (t=8.046, P<0.05). Conclusion The multidisciplinary collaborative intervention model can improve the wound healing in patients with chronic wounds, shorten the wound healing time, and improve the quality of life. Reference | Related Articles | Metrics

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Clinical observation on the treatment of tubal infertility with warming kidney and promoting blood circulation method combined with uterine laparoscopy  Liu Na, Jing Rui, Guo Jiayi International Medicine and Health Guidance News    2024, 30 (10): 1687-1692.   DOI: 10.3760/cma.j.issn.1007-1245.2024.10.021 Abstract （92）            Knowledge map    Save Objective To investigate the effect of tubal infertility (TI) treated with warming kidney and promoting blood circulation method combined with uterine laparoscopy. Methods A total of 112 TI patients admitted to Yan'an Traditional Chinese Medicine Hospital from February 2021 to August 2022 were selected for a prospective study and were divided into two groups with 56 cases in each group by the random number table method. In the control group, the age was (28.18±3.13) years old, the course of disease was (3.11±0.52) months, and there were 28 cases of unilateral obstruction, 9 cases of bilateral obstruction, and 19 cases of partial obstruction. In the study group, the age was (28.54±3.27) years old, the course of disease was (3.16±0.56) months, and there were 26 cases of unilateral obstruction, 10 cases of bilateral obstruction, and 20 cases of partial obstruction. The control group was treated with uterine laparoscopy, and the study group was treated with warming kidney and promoting blood circulation method on the basis of the control group. The total effective rate, TCM syndrome score, fallopian tube patency, inflammatory factor level [interleukin-4 (IL-4) and IL-6], ovarian function indexes [luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2)], pregnancy rate, and adverse reactions were compared between the two groups. Paired sample t test, independent sample t test, and χ2 test were used. Results The total effective rate of the study group [96.43% (54/56)] was higher than that of the control group [80.36% (45/56)] (P<0.05). After treatment, the TCM syndrome score of the study group was (10.01±1.28) points, which was lower than that of the control group [(14.15±1.96) points] (P<0.05). After treatment, the patency rate of fallopian tube in the study group was 96.43% (54/56), which was higher than that in the control group [82.14% (46/56)], with a statistically significant difference (P<0.05). After treatment, the levels of IL-4 and IL-6 in the study group were (5.09±0.72) ng/L and (4.62±0.63) ng/L, which were lower than those in the control group [(6.66±0.95) ng/L and (6.25±0.86) ng/L] (both P<0.05). After treatment, the LH and FSH levels in the study group were (7.42±1.21) IU/L and (5.33±0.82) IU/L, which were lower than those in the control group [(13.38±2.15) IU/L and (11.06±2.11) IU/L], but the E2 level [(230.38±25.19) IU/L] was higher than that in the control group [(185.57±20.23) IU/L] (all P<0.05). After treatment, the pregnancy rate of the study group was higher than that of the control group [62.50% (35/56) vs. 42.86% (24/56)], with a statistically significant difference (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups [5.36% (3/56) vs. 8.93% (5/56)] (P>0.05). Conclusion The treatment of TI patients undergoing uterine laparoscopy by warming kidney and promoting blood circulation method can effectively improve their tubal function and regulate the levels of sex hormones, with ideal effect and high clinical application value. Reference | Related Articles | Metrics

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Research progress on treatment for patients with slow transit constipation based on interstitial cells of Cajal Xiao Zhengping, Li Baosong, Zhang Zhirui, Jiang Hong International Medicine and Health Guidance News    2024, 30 (9): 1409-1414.   DOI: 10.3760/cma.j.issn.1007-1245.2024.09.001 Abstract （91）            Knowledge map    Save Slow transit constipation (STC) is a common type of functional constipation characterized by slowed colonic motility and delayed intestinal transit, and often accompanies by symptoms such as infrequent bowel movements and difficulty in defecation. Studies indicate that the development of STC is related to abnormal changes in interstitial cells of Cajal (ICCs). This article summarizes the classification, markers, and functions of ICCs, as well as their relationship with STC, highlighting that abnormalities in the quantity and function of ICCs can influence the symptoms of patients with STC. Additionally, the article reviews various treatment strategies for patients with STC, such as the use of microbiota preparations, traditional Chinese medicine, physical therapy, and molecular treatments, and their potential impacts on ICCs, providing new treatment insights for patients with STC. The authors suggest that ICCs can serve as potential therapeutic targets for STC; future research should focus on the role of ICCs in the pathogenesis of STC, develop specific therapeutic approaches, and assess the feasibility of clinical applications of emerging strategies, such as stem cell therapy and gene therapy, so as to offer new treatment options for patients with STC. Reference | Related Articles | Metrics

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Efficacy of rituximab in the treatment of refractory primary IgA nephropathy Yan Li, Wang Lizhen International Medicine and Health Guidance News    2024, 30 (12): 2030-2034.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.019 Abstract （90）            Knowledge map    Save Objective To investigate the efficacy and safety of rituximab in the treatment of refractory primary immunoglobulin A (IgA) nephropathy. Methods Seventy-three cases of refractory primary IgA nephropathy treated at Tongchuan People's Hospital and Xi'an International Medical Center Hospital from September 2021 to September 2023 were selected, and were divided into an experimental group of 38 cases and a control group of 35 cases based on the treatment methods. There were 19 males and 16 females in the control group, the age was (52.03±14.90) years old, the body mass index (BMI) was (23.17±1.25) kg/m2, and the course of disease was (3.19±0.83) years. There were 23 males and 15 females in the experimental group, the age was (50.78±13.22) years old, the BMI was (23.52±1.17) kg/m2, and the course of disease was (3.50±1.02) years. The control group was treated with oral methylprednisolone tablets combined with Tacrolimus capsules, and the experimental group received rituximab via intravenous infusion in addition to the treatment in the control group. After 3 cycles of treatment, the efficacy, adverse reactions, renal function [serum creatinine, 24 h urinary protein quantification, and estimated glomerular filtration rate (eGFR)], and immunological factors [IgA, IgG, and galactose-deficiency (Gd)-IgA1] were compared between the two groups. Independent sample t test, paired t test, and χ2 test were used. Results After 3 cycles of treatment, the levels of serum creatinine [(79.31±6.52) µmol/L] and 24 h urinary protein [(0.73±0.21) g] in the experimental group were lower than those in the control group [(83.06±7.14) µmol/L and (0.87±0.23) g], but the eGFR [(82.16±5.39) ml/(min·1.73 m2)] was higher than that in the control group [(79.04±5.51) ml/(min·1.73 m2)], with statistically significant differences (all P<0.05). After 3 cycles of treatment, the levels of IgA [(1.84±0.41) g/L] and IgG [(9.53±1.37) g/L] in the experimental group were higher than those in the control group [(1.53±0.38) g/L and (8.86±1.17) g/L], but the level of Gd-IgA1 [(6.23±0.95) mg/L] was lower than that in the control group [(7.01±1.59) mg/L], with statistically significant differences (all P<0.05). The total effective rate of the experimental group [89.47% (34/38)] was higher than that of the control group [65.71% (23/35)], with a statistically significant difference (P<0.05). There was no statistically significant difference in the total incidence of adverse drug reactions between the two groups (P>0.05). Conclusion The combination of rituximab and Tacrolimus in the treatment of refractory primary IgA nephropathy has shown good efficacy and safety. Reference | Related Articles | Metrics

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Clinical study of treatment of early prosthetic joint infection after total hip arthroplasty by debridement, antibiotics, and implant retention combined with local perfusion of vancomycin Pan Xi'an, Zhang Yuanjin, Zhang Guofu, Li Jun, Sun Farui, Zhou Dingkang, Liu Bingxia International Medicine and Health Guidance News    2024, 30 (12): 1966-1971.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.007 Abstract （90）            Knowledge map    Save Objective To investigate the clinical efficacy of treatment of early prosthetic joint infection (PJI) after total hip arthroplasty (THA) with debridement, antibiotics, and implant retention (DAIR) combined with local perfusion of vancomycin into hip joint. Methods A total of 21 patients with early PJI after the initial THA who received DAIR combined with local perfusion of vancomycin into their joint cavity in Department of Orthopaedics, Huangshi Central Hospital from July 2018 to May 2022 were enrolled. Among them, there were 11 males and 10 females, aged (67.05±11.04) years, all patients with PJI within 3 weeks after the initial THA, and the follow-up time was (18.95±4.07) months. The operation was performed by a fixed medical team, all operated by the same doctor, and DIAR surgery was used for debridement. Sensitive antibiotics were given intravenously within 2 weeks after surgery. The patients with culture negative could be given vancomycin intravenously, 0.5 g of which was given intravenously every 12 hours, and vancomycin solution was injected into the joint cavity once every 2 days (the protocol was 0.5 g of vancomycin powder dissolved in 60 ml of normal saline and pushed into the joint cavity by self-irrigating tube under sterile conditions). The joint fluid was retained and drug concentration in the joint cavity was monitored. Intravenous medication for 2 weeks was followed by oral antibiotics for 4 weeks. The Visual Analogue Scale (VAS) score and Harris Hip Score (HHS) were used to evaluate the pain and hip joint function. The white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were used as infection indicators, and differences in their levels before surgery and at the last follow-up were determined by paired t-test. Results A total of 21 patients were enrolled; their age was (67.05±11.04) years old and 11 of them were male. All the patients were followed up for over 12 months, with a follow-up period of (18.95±4.07) months. The overall infection control rate was 90.5% (19 cases were cured and 2 cases failed). At the last follow-up, the VAS score was decreased compared with that before surgery [(1.62±0.67) points vs. (5.86±1.06) points], the HHS was increased compared with that before surgery [(77.92±7.72) points vs. (41.30±7.77) points], and the WBC, ESR, and CRP levels were all decreased compared with those before surgery [(5.04±0.86) ×109/L vs. (10.62±1.02) ×109/L, (19.00±8.08) mm/h vs. (65.57±18.00) mm/h, (5.86±1.80) mg/L vs. (57.05±19.16) mg/L], with statistically significant differences (t=13.766, -16.159, 17.654, 12.610, and 12.570, all P<0.001). Conclusion DAIR combined with local perfusion of vancomycin into joint cavity can effectively control the hip joint infection and relieve the hip joint pain in patients with early PJI after THA. Reference | Related Articles | Metrics

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Analysis of rpoB gene mutation characteristics in 256 Gene Xpert MTB/RIF-positive pulmonary tuberculosis patients in Xi'an area Cui Jian, He Zhiqing International Medicine and Health Guidance News    2024, 30 (12): 1988-1992.   DOI: 10.3760/cma.j.issn.1007-1245.2024.12.011 Abstract （90）            Knowledge map    Save Objective To analyze the mutation characteristics of rpoB gene in 256 cases of rifampicin-resistant real-time fluorescence quantitative nucleic acid amplification test (Gene Xpert MTB/RIF) positive pulmonary tuberculosis in Xi'an area. Methods Two hundred and fifty-six MTB strain strains were isolated from outpatients and inpatients with Gene Xpert MTB/RIF-positive pulmonary tuberculosis who visited Shaanxi Provincial Tuberculosis Control Hospital from June 2020 to June 2022. The strains were not collected repeatedly. They were from 174 sputum samples and 82 bronchoalveolar lavage fluid samples. The patients were (45.67±8.36) years old. The PCR products of rpoB gene of 256 rifampicin-resistant strains were analyzed by DNA direct sequencing. The 256 rifampicin-resistant strains were divided into low-, medium-, and high-resistant MTB strains according to the degree of rifampicin resistance, and the mutation sites of the three kinds of strains were compared by χ2 test. Three rifampicin-resistant MTB strains were artificially induced, and the PCR products of rpoB gene were analyzed by DNA direct sequencing. Results The sequencing report showed that 253 of the 256 rifampicin-resistant strains had rpoB locus mutation, and the mutation rate was 98.83% (253/256). There were 10 mutation types including C→T, T→G, C→G, A→T, C→A, A→G, G→A, G→T, T→C, and A→C. There were 14 amino acid codons including serine, leucine, alanine, histidine, tyrosine, glutamic acid, lysine, arginine, aspartic acid, proline, methionine, valine, isoleucine, and glycine, all of which were point mutations. The mutations of rifampicin-resistant strains were mainly concentrated at locus 531 [53.75% (136/253)] and 526 [23.32% (59/253)]. Other sites included locus 513, 516, 533, 515, 513, 532, 522, 511, 519, 518, and 533. Compared with those of low- [37.88% (25/66)] and medium-resistant MTB strains [37.04% (20/54)], the incidence of amino acid mutation at locus 531 of high-resistant MTB strains [66.91% (91/136)] was increased (χ2=22.154,P<0.001). There was no statistically significant difference in the incidence of amino acid mutation at locus 531 in low- and medium-resistant MTB strains (P>0.05). There was no statistically significant difference in the incidence of amino acid mutation at locus 526 among the low-, medium-, and high-resistant MTB strains [22.73% (15/66) vs. 25.93% (14/54) vs. 22.06% (30/136)] (χ2=0.331, P=0.847). Three artificially induced rifampicin-resistant MTB strains all had rpoB gene locus mutation. The mutation of low- and medium-resistant MTB strains were located at locus 526, and the mutation of high-resistant MTB strain was located at locus 531. Conclusions The mutation rate of rpoB gene in Gene Xpert MTB/RIF-positive pulmonary tuberculosis patients in Xi'an area was high, mainly point mutations, mainly concentrated at locus 531 and 526. The 531 TCG→TTG mutation had the highest mutation frequency among the rpoB gene mutation types. The mutation of low- and medium-resistant MTB strains were located at locus 526, which was associated with high drug resistance. Reference | Related Articles | Metrics

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Study on the effect of voice training on postoperative voice recovery in patients with vocal cord polyps Zhang Yarong, Wang Jin International Medicine and Health Guidance News    2024, 30 (10): 1757-1760.   DOI: 10.3760/cma.j.issn.1007-1245.2024.10.035 Abstract （90）            Knowledge map    Save Objective To study the impacts of voice training on vocal function and hospital satisfaction degree after vocal cord polyp surgery, in order to analyze the overall treatment effect. Methods This study was a randomized controlled trial. A total of 96 patients with vocal cord polyps admitted to Dongguan Houjie Hospital from June 2020 to December 2023 were divided into an observation group (48 cases) and a control group (48 cases) according to the random number table method. The control group, 25 males and 23 females, aged 35-68 (41.23±5.24) years, received routine nursing intervention after vocal cord polyp surgery. The observation group,22 males and 26 females, aged 33-66 (42.15±5.32) years, received voice training after vocal cord polyp surgery. The normalized noise energy (NNE), fundamental frequency perturbations (Jitter), amplitude perturbations (Shimmer), and overall patient satisfaction were recorded and analyzed before intervention and 1 week after intervention. Statistical methods used were χ2 test and t test. Results After intervention, the scores of five items of voice disorder index of the observation group ("It is difficult for others to hear my voice", "hoarse vocal cords limit my social life", "I feel that I can't keep up in conversation", "my voice sounds hoarse and dry", and "I feel that I am less outgoing than before") were all lower than those of the control group, with statistically significant differences (t=3.57, 4.90, 4.35, 7.70, and 2.24, all P<0.05). The NNE, Jitter, and Shimmer of the observation group were lower than those of the control group [(-9.62±4.28) points vs. (-11.45±3.18) points, (0.23±0.06) points vs. (0.33±0.08) points, (1.25±0.44) points vs. (1.78±0.65) points], with statistically significant differences (t=2.18, 6.37, and 3.12, all P<0.05). The overall patient satisfaction in the observation group was higher than that in the control group [85.42% (41/48) vs. 58.33% (28/48)], with a statistically significant difference (χ2=3.49, P<0.05). Conclusion Voice training can effectively improve the laryngeal function in patients with vocal cord polyps, alleviate the voice disorders, and restore the voice function, with high overall patient satisfaction, which has high promotion and application value. Reference | Related Articles | Metrics

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Effect analysis of functional training based on fragmentation time on patients with ankylosing spondylitis during the rehabilitation period Gao Huan, Han Danying, Zhao Yan International Medicine and Health Guidance News    2024, 30 (10): 1735-1739.   DOI: 10.3760/cma.j.issn.1007-1245.2024.10.031 Abstract （90）            Knowledge map    Save Objective To explore the effects of functional training based on fragmentation time on spinal joint motion and inflammatory cytokines in patients with ankylosing spondylitis. Methods A randomized controlled trial was conducted on 109 patients with ankylosing spondylitis in the First Affiliated Hospital of Henan University of Science and Technology from April 2021 to September 2022. They were divided into two groups by the random number table method. In the control group, there were 37 males and 17 females, the age was (53.51±6.83) years old, the course of disease was (3.21±1.12) years, and the pain sites were peripheral joints in 18 cases, lumbar spine in 14 cases, and sacroiliac joint in 22 cases. In the observation group, there were 36 males and 19 females, the age was (54.13±6.62) years old, the course of disease was (3.33±1.21) years, and the pain sites were peripheral joint in 19 cases, lumbar spine in 15 cases, and sacroiliac joint in 21 cases. The control group was given routine functional training program, and the observation group was given functional training based on fragmentation time. The improvement of symptoms [Bath Ankylosing Spondylitis Functional index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), total joint Pain (Pain-VAS), and total joint Stiffness (Stiffness-VAS)], spinal joint mobility [scoliosis, modified Schober index (degree of lumbar flexion dysfunction), chest expansion degree, and cervical spine rotation], and inflammatory factors [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and erythrocyte sedimentation rate (ESR)] were compared between the two groups. Independent sample t test, paired sample t test, and χ2 test were used. Results After intervention, the BASFI score, BASDAI score, Pain-VAS score, and Stiffness-VAS score in the observation group were lower than those in the control group [(3.87±0.58) points vs. (5.27±0.62) points, (3.17±0.46) points vs. (4.23±0.63) points, (1.27±0.56) points vs. (2.57±0.46) points, (1.73±0.43) points vs. (3.17±0.51) points], with statistically significant differences (t=12.177, 10.017, 13.254, and 15.948, all P<0.05). The scoliosis, modified Schober index, chest expansion degree, and cervical spine rotation in the observation group were higher than those in the control group [(17.36±0.77) cm vs. (13.28±0.65) cm, (4.85±0.18) cm vs. (3.91±0.17) cm, (4.55±0.17) cm vs. (3.61±0.15) cm, (58.73±1.96)° vs. (53.37±1.84)°], with statistically significant differences (t=29.866, 28.020, 30.590, and 14.714, all P<0.05). The levels of CRP, TNF-α, and ESR in the observation group were lower than those in the control group [(11.74±2.17) mg/L vs. (14.01±2.45) mg/L, (29.72±4.16) ng/L vs. (43.15±5.52) ng/L, (19.85±3.22) mm/h vs. (25.72±3.53) mm/h], with statistically significant differences (t=5.123, 14.325, and 9.073, all P<0.05). Conclusion Functional training based on fragmentation time can effectively improve the clinical symptoms and spinal function in patients with ankylosing spondylitis, and reduce the levels of inflammatory factors. Reference | Related Articles | Metrics