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Outcome analysis of carotid plaque in patients with satisfactory hypertension control in Guangzhou communities Yang Dongheng, Zhu Qike, Ye Bowen, Deng Haiya, Fu Shushu, Mo Mingshu, Xu Pingyi, Tian Zuojun International Medicine and Health Guidance News    2022, 28 (10): 1333-1337.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.001 Abstract （267）            Knowledge map    Save Objective To investigate the clinical outcome of carotid plaque in patients with satisfactory hypertension control in Guangzhou communities. Methods From January 2016 to December 2019, 326 patients in Guangzhou communities were continuously recruited in the study, they were hospitalized in Department of Neurology, The First Affiliated Hospital of Guangzhou Medical University and also underwent carotid ultrasonography twice within half a year to one year. There were 166 males and 160 females, aged (71.17±0.60) years. The patients were divided into a non-hypertension group (NH group, 56 cases), a satisfactory hypertension control group (SH group, 195 cases), and an unsatisfactory hypertension control group (USH group, 75 cases). The clinical outcomes of carotid plaque (△Crouse score) of the three groups were compared. Then, a stratified analysis of △Crouse score was performed between younger than and equal to or older than 70 years old among the above three groups. Finally, the hypertensive patients were further subdivided into three subgroups of hypertension with satisfactory control twice (160 cases), satisfactory control once (35 cases), and unsatisfactory control twice (75 cases) to analyze the △Crouse score. The measurement data were tested by one-way ANOVA or Kruskal-Wallis method, and the count data were tested by χ 2 test. Results There was no statistically significant difference in the △Crouse score between the SH group and the NH group ( P>0.05); there was a statistically significant difference in the △Crouse score between the USH group and the SH group or the NH group [0.400 (0.000, 1.900 ) points vs. 0.000 (-0.200, 0.700) points vs. 0.000 (-0.200, 0.200) points] (both P<0.05). There were no statistically significant differences in the △Crouse score between the SH group and the NH group in patients younger than and equal to or older than 70 years old (both P>0.05). Among the three hypertensive subgroups, there was statistically significant difference in the △Crouse score between the two subgroups with and without satisfactory hypertension control twice ( P<0.05), but there was no statistically significant difference between other subgroups ( P>0.05). Conclusions For hypertensive patients of all ages, after satisfactory hypertension control, the progression of carotid plaque is not significantly different from that of non-hypertensive patients. However, it is significantly accelerated in patients with unsatisfactory hypertension control. Reference | Related Articles | Metrics

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Values of changes of heart rate and oxygenation index after extracorporeal membrane oxygenation and scores of APACHEⅡ and SOFA in prognostic prediction in patients with respiratory failure Yuan Fawei, Feng Huibin, Yin Huan, Zheng Kun, Mei Xiping, Yuan Lixue, Zhu Xiaomei International Medicine and Health Guidance News    2022, 28 (10): 1338-1342.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.002 Abstract （209）            Knowledge map    Save Objective To explore the values of changes of heart rate and oxygenation index (PaO 2/FiO 2) after extracorporeal membrane oxygenation (ECMO) and scores of Acute Physiology and Chronic Health Evaluation (APACHEⅡ) and Sequential Organ Failure Assessment (SOFA) in prognostic prediction in patients with respiratory failure. Methods A retrospective analysis was performed on 84 patients with respiratory failure who received ECMO treatment in Huangshi Central Hospital from February 2016 to February 2021, including 45 males and 39 females, aged (43.28±9.59) years. Taking 180 days after receiving ECMO support as the research endpoint, they were divided into a survival group (39 cases) and a death group (45 cases). The differences in heart rate, PaO 2/FiO 2, APACHEⅡ score, SOFA score, and clinical data were compared between the two groups; multivariate logistic regression analysis was used to analyze the factors affecting the patients' prognosis; the receiver operating characteristic curve (ROC) was used to analyze the predictive values of the above indicators on the patients' prognosis. The count data were tested by χ 2 test, and the measurement data were tested by independent sample t test. Results The results of the multivariate logistic regression analysis showed that too short ECMO support duration, high APACHEⅡ score, high SOFA score, reduced PaO 2/FiO 2, and high heart rate were influencing factors of death ( OR=0.802, 1.630, 2.010, 1.127, 1.132; all P<0.05). The results of the ROC analysis showed that the areas under curve (AUC) of heart rate, PaO 2/FiO 2, SOFA score, APACHEⅡ score, and combination of the four indicators in predicting patients' prognosis were 0.855, 0.858, 0.863, 0.857, and 0.991, respectively, indicating that the combination of the four indicators had a higher prognostic value than single indicator, with a sensitivity of 95.6% and a specificity of 100.0%, respectively. Conclusions Changes in heart rate, PaO 2/FiO 2, SOFA score, and APACHEⅡ score are influencing factors of the prognosis in patients with respiratory failure after ECMO. At the same time, they have good predictive values for patients' prognosis. The combination of the four indicators can improve the accuracy and sensitivity in the prediction of prognosis for such patients, worthy of clinical promotion. Reference | Related Articles | Metrics

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Research progress on the correlation between Cry1 and atherosclerosis  Cheng Jinfeng, Wang Qianqian, Zhen Mengmeng, Cheng Yanli International Medicine and Health Guidance News    2022, 28 (10): 1343-1346.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.003 Abstract （184）            Knowledge map    Save Circadian rhythm is an internal adaptation mechanism produced by the body's long-term adaptation to changes in the external environment. The system that controls this rhythm is called circadian clock. The clock genes regulate multiple physiological responses, while the disorder of their expression causes the occurrence and development of a series of diseases, seriously affecting the body health and survival. In recent years, a large number of studies have revealed that the abnormal expression of Cry1 affects the development of atherosclerosis. Here, we summarize the role of Cry1 in atherosclerosis and its mechanisms. Reference | Related Articles | Metrics

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Clinical observation on four-level incremental exercise for 11 cases of high-risk coronary heart disease undergoing percutaneous coronary intervention under extracorporeal membrane oxygenation combined with intra aortic balloon counterpulsation Ding Yanli, Liu Yanping, Yang Honglei, Yang Ru, Liang Shan, Hu Xuhong, Yuan Qingchuan International Medicine and Health Guidance News    2022, 28 (10): 1347-1351.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.004 Abstract （190）            Knowledge map    Save Objective To investigate the effect of four-level incremental exercise on patients with high-risk coronary artery disease undergoing percutaneous coronary intervention (PCI) under extracorporeal membrane oxygenation (ECMO) combined with intra aortic balloon counterpulsation (IABP). Methods A total of 11 patients with high-risk coronary artery disease treated by PCI under the joint protection of ECMO and IABP in The First Affiliated Hospital of Henan University of CM from January 2018 to December 2020 were treated with four-level incremental exercise, including 9 males and 2 females, aged (66±18) years. They were retrospectively summarized and intervened by early step-by-step exercise, level 1 exercise from the end of surgery to the time of ECMO extraction, level 2 exercise from the time of ECMO extraction to 48 hours after ECMO extraction, level 3 exercise from 48 hours after ECMO extraction to moving out of coronary heart disease care unit (CCU), and level 4 exercise after moving out of CCU. After four-level incremental exercise, the postoperative application of instruments, catheter application, complications, deep venous thrombosis score before surgery and before discharge (after incremental exercise), lower limb muscle strength, score of Self-rating Anxiety Scale, and score of Insomnia Severity Index Scale were summarized and evaluated. Comparison of the measurement data used paired t test. Results Among the 11 patients, the longest application time of ECMO was 139 hours and the longest application time of IABP was 206 hours. Catheter application: the central venous catheter was used in 11 cases, the urinary catheter was retained in 9 cases, and the noninvasive ventilator was used in 2 cases. Exercise outcomes: 7 patients successfully completed the training, and 4 patients completed it after blood transfusion treatment. The score of deep venous thrombosis before discharge was significantly lower than that before surgery [(10.00±1.26) vs. (11.51±1.37), P=0.012], the score of Self-rating Anxiety Scale before discharge was significantly lower than that before surgery [(48.54±8.67) vs. (67.27±11.58), P<0.001], and the score of Insomnia Severity Index Scale before discharge was significantly lower than that before surgery [(13.18±3.97) vs. (17.18±4.81), P=0.045]. Conclusions Under the comprehensive evaluation and monitoring, the four-level incremental exercise training method can improve the cardiopulmonary exercise in patients with high-risk coronary artery disease undergoing PCI under the support and protection of ECMO combined with IABP, improve the exercise endurance of lower limbs, reduce the complications, and improve the quality of life. Early exercise training can be carried out under the strict evaluation and monitoring. Reference | Related Articles | Metrics

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Catheter maintenance KAP and its influencing factors among primary caregivers for 6-12 years old children with ALL undergoing PICC catheterization Zhang Xueli, Xu Yanjie, Ma Ping International Medicine and Health Guidance News    2022, 28 (10): 1352-1356.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.005 Abstract （222）            Knowledge map    Save Objective To analyze the catheter maintenance knowledge-attitude-practice (KAP) and its influencing factors in primary caregivers for 6-12 years old children who undergo perpherally inserted central catheter (PICC) chemotherapy for acute lymphoblastic leukemia (ALL). Methods A total of 80 primary family caregivers for 6-12 years old children who received PICC chemotherapy for ALL in Children's Hospital Affiliated to Zhengzhou University from June 2019 to June 2021 were prospectively selected. There were 37 males and 43 females, aged (33.17±3.89) years. The general data questionnaire and PICC KAP questionnaire were investigated, and the level of KAP and its influencing factors were analyzed. Independent sample t test was used for comparison of the measurement data between the two groups, one-way AVONA was used for comparison among multiple groups, and LSD- t test was used for pairwise comparison. Results The total score of KAP was (73.07±5.93) points, which was at the medium level as a whole. The KAP current status in the primary family caregivers was related to the caregivers' gender, educational level, residence, occupation, payment method of medical expenses, and monthly income and children's catheterization time and catheterization history (all P<0.05); multiple linear regression analysis showed that children's catheterization history and catheterization time and caregiver's gender, educational level, occupation, and monthly income were independent influencing factors of catheter maintenance KAP current status in the primary family caregivers (all P<0.05). Conclusions The KAP current status in primary family caregivers for 6-12 years old children with ALL undergoing PICC catheterization chemotherapy is at a medium level, which is related to children's catheterization history and catheterization time and caregiver's gender, educational level, occupation, and monthly income. The intervention measures can be formulated according to the influencing factors to improve the KAP status. Reference | Related Articles | Metrics

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Clinical effect of comprehensive nursing in children with congenital hypospadias after urethroplasty Xu Hui, Fu Pinjia, Zhang Fuhong International Medicine and Health Guidance News    2022, 28 (10): 1356-1359.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.006 Abstract （183）            Knowledge map    Save Objective To explore the best nursing method for children with congenital hypospadias after urethroplasty. Methods A total of 85 children with congenital hypospadias who received surgical treatment in Zhumadian Central Hospital from July 2019 to March 2021 were selected as the research objects for the prospective study, and they were divided into a control group (42 cases) and an observation group (43 cases) with the envelope method. The children in the control group were (6.34±1.34) years old, and the children in the observation group were (6.76±1.41) years old. The control group was given routine nursing intervention, and the observation group was given comprehensive nursing intervention. The time of first defecation, incidence of urinary fistula, change of pain degree, and nursing satisfaction were compared between the two groups. The measurement data were tested by independent sample t test, and the count data were tested by χ 2 test. Results The first defecation time of the observation group after surgery was (31.42±8.89) h, which was significantly shorter than that of the control group [(36.85±9.14) h] ( t=2.777, P=0.007). The incidence of postoperative urinary fistula in the observation group was 4.65% (2/43), which was significantly lower than that in the control group [21.43% (9/42)] (χ 2=5.308, P=0.021). The pain scores of the observation group 1 d, 3 d, and 7 d after surgery were (5.41±1.09), (4.13±1.05), and (3.14±0.54) points, which were lower than those in the control group [(6.13±1.23), (4.85±1.17), and (3.60±0.75) points] (all P<0.05). The nursing satisfaction degree of the observation group was higher than that of the control group [97.67% (42/43) vs. 78.57% (33/42)] (χ 2=7.470, P=0.006). Conclusion Comprehensive nursing intervention in children with congenital hypospadias after urethroplasty can speed up the recovery process and increase the safety, is recognized by children and their families, and has a high application value. Reference | Related Articles | Metrics

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Effect analysis of feeding related symptom group intervention based on Muzer model for patients with esophageal cancer undergoing chemoradiotherapy Zhu Zhenzhen, Gu Ning, Li Man, Chen Lifang, Zheng Peijie International Medicine and Health Guidance News    2022, 28 (10): 1360-1363.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.007 Abstract （168）            Knowledge map    Save Objective To explore the effect of feeding related symptom group nursing based on Muzer model for patients with esophageal cancer undergoing concurrent chemoradiotherapy. Methods A total of 103 patients with esophageal cancer who underwent concurrent chemoradiotherapy in The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from August 2018 to October 2020 were selected and grouped according to the random number table method. The control group consisted of 51 patients, 30 males and 21 females, aged (57.53±6.22) years; the observation group consisted of 52 patients, 32 males and 20 females, aged (58.00±6.57) years. The control group was given routine nursing, and the observation group was given feeding related symptom group intervention based on Muzer model. The remission rate of feeding related symptom group, body immunity, and nutritional indicators were compared between the two groups. χ 2 test was used for the count data, independent sample t test was used for inter-group comparison of the measurement data, and paired t test was used for intra-group comparison of the measurement data. Results After intervention, the body weight, hemoglobin (Hb), and albumin (Alb) levels in the observation group were higher than those in the control group [(65.87±2.39) kg vs. (54.30±1.95) kg, (123.95±11.25) g/L vs. (103.76±8.75) g/L, (269.95±18.59) g/L vs. (204.77±15.23) g/L], with statistically significant differences (all P<0.05). After intervention, the remission rates of anorexia, nausea and vomiting, dry mouth, fatigue, distress and sadness, drowsiness, and sleep disorder and the levels of CD3 +, CD4 +, and CD4 +/CD8 + in the observation group were higher than those in the control group, and the CD8 + level was lower than that in the control group (all P<0.05). Conclusion The feeding related symptom group nursing based on Muzer model can effectively improve the nutritional status and immunity in patients with esophageal cancer undergoing concurrent chemoradiotherapy, and improve the remission degree of chemoradiotherapy related symptom group. Reference | Related Articles | Metrics

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Application of standardized health education based on the concept of precise nursing in cesarean section parturients with hyperthyroidism during pregnancy Wang Li, Wang Lihua, Fu Shuiling International Medicine and Health Guidance News    2022, 28 (10): 1363-1367.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.008 Abstract （171）            Knowledge map    Save Objective To explore the application of standardized health education based on the concept of precision nursing in cesarean section parturients with hyperthyroidism during pregnancy. Methods A total of 166 cesarean section parturients with hyperthyroidism during pregnancy admitted to The Third People's Hospital of Xintai City from October 2019 to October 2021 were selected and were divided into an observation group (83 cases) and a control group (83 cases) by the random number table. The age of the observation group was (23.55±2.67) years old and the gestational age was (37.62±2.11) weeks; the age of the control group was (24.17±2.92) years old and the gestational age was (37.29±2.44) weeks. The observation group adopted the standardized health education based on the concept of precision nursing, while the control group adopted the conventional health education and nursing. The maternal knowledge mastery rate, postpartum hemorrhage rate, breastfeeding, psychological status, and complications were compared between the two groups. Independent sample t test and χ2 test were used. Results Compared with those in the control group, the maternal knowledge mastery rate in the observation group was better [(96.33±7.25) points vs. (85.62±6.49) points, t=10.027, P<0.001], and the success rate of breastfeeding was higher [93.96% (78/83) vs. 80.72% (67/83), χ2=6.556, P=0.010]. Compared with those in the control group, the rate of postpartum hemorrhage [1.20% (1/83) vs. 10.84% (9/83), χ2=6.769, P=0.009], the score of Edinburgh Postnatal Depression Scale (EPDS) [(9.26±2.11) vs. (10.87±2.19) points, t=4.823, P<0.001], and the incidence of complications [16.87% (14/83) vs. 34.94% (29/83), χ2=7.019, P=0.008] in the observation group were lower. Conclusion Standardized health education based on the concept of precision nursing can strengthen the knowledge mastery rate in cesarean section parturients with hyperthyroidism during pregnancy, improve the success rate of breastfeeding, and reduce the rate of postpartum hemorrhage, EPDS score, and incidence of complications. Reference | Related Articles | Metrics

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FGF23 and Klotho in AKI update Liao Zhennan, Li Qiang, Song Zhuoheng, Cao Rui, Li Weilong, Wang Jie, Dai Hongbo, Luan Shaodong, Hu Bo, Yin Lianghong International Medicine and Health Guidance News    2022, 28 (10): 1367-1371.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.009 Abstract （247）            Knowledge map    Save Acute kidney injury (AKI) has high morbidity and mortality worldwide, as a risk factor for chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD), which brings an increasingly health burden to patients. Fibroblast growth factor-23 (FGF23) and a-Klotho (Klotho) pathways have been emerging as the novel biomarkers to predict the occurrence and prognosis of AKI in recent years. After AKI occurrence, it is found that the level of FGF23 in serum increases and the expression of Klotho decreases. This article reviews the expression changes and related mechanisms of FGF23 and Klotho in AKI. Reference | Related Articles | Metrics

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Clinicopathological analysis and imaging diagnosis of PEComa Zhang Yongxin, Xiao Xuehong, Tang Binghang, Li Wei, Huang Hongxing, Yuan Runqiang, Lu Yangbai International Medicine and Health Guidance News    2022, 28 (10): 1372-1376.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.010 Abstract （293）            Knowledge map    Save Objective To investigate the clinical characteristics and CT and MRI manifestations of perivascular epithelioid cell tumor (PEComa), and to improve the diagnostic accuracy for PEComa. Methods The imaging and clinical data of pathologically confirmed 1 renal malignant PEComa patient admitted to Zhongshan City People's Hospital on December 30, 2021 were collected, and the location, size, morphology, boundary, density, and enhancement characteristics of tumor and its relationship with surrounding tissues were analyzed combined with relevant literatures published in CNKI and Wanfang database from 2000 to 2021, and the imaging manifestations were summarized. Results The patient's tumor was located in the left kidney and underwent laparoscopic radical resection of the lesion. The lesion was postoperatively pathologically confirmed as malignant PEComa. No metastasis or recurrence was found during the follow-up. A total of 239 patients were recruited from the literatures, including 54 males (22.6%) and 185 females (77.4%), 20 cases of whom were clearly malignancy. The main clinical features were low back pain and lumbago, followed by unintentional discovery in physical examination, and the rarest reasons were emergency diagnosis of tumor rupture and hemorrhage, hematuria, abdominal mass, and unintentional discovery of lesions in other places. Pathologically, PEComas were composed of epithelioid cells from clear to eosinophilic cytoplasm distributed radially around blood vessels, usually expressing melanocytes and myogenic markers, characterized by HMB45+. Imaging features were visceral or retroperitoneal masses with well-defined boundaries, low to isodense density on plain scan, and mild/obvious uneven enhancement on enhanced scan. Conclusion PEcoma is a rare disease, and imaging examination based on clinical, CT, MRI, and other imaging findings helps to improve the diagnostic accuracy. Reference | Related Articles | Metrics

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Clinical study on the treatment of renal and upper ureteral calculi by tubeless and traditional PCNL Pan Xiaolong, Li Xiao, Heng Baoli, Zhu Guangjian, Huang Zhen, Wu Fanyu International Medicine and Health Guidance News    2022, 28 (10): 1377-1380.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.011 Abstract （237）            Knowledge map    Save Objective To analyze the safety and efficacy of tubeless and traditional percutaneous nephrolithotomy (PCNL) in the treatment of renal and upper ureteral calculi. Methods A total of 72 patients with upper ureteral calculi and/or renal calculi with comparable calculus burden who were admitted to Yingde People's Hospital from May 2019 to November 2021 were prospectively collected and were simply randomly divided into two groups, with 36 cases in the tubeless group and 36 cases in the traditional group. The stone clearance rate, operation time, postoperative complications, hospitalization cost, and postoperative pain were compared between the two groups. t test was used for the measurement data, and Chi-square test or Fisher's exact test was used for the count data. Results There were statistically significant differences in the operation time [(81.67±3.02) min vs. (95.56±5.17) min], hospital stay [(6.33±0.20) d vs. (9.52±0.22) d], hospitalization cost [(12 580±269.7) yuan vs. (14 199±208.6) yuan], time of extubation [(2.75±0.13) d vs. (6.06±0.07) d], postoperative ambulation time [(14.33±1.98) h vs. (70.00±2.40) h], and postoperative pain score [(1.72±0.18) points vs. (4.06±0.29) points] between the tubeless group and the traditional group (all P<0.05), while there were no statistically significant differences in the decrease of hemoglobin and rates of perirenal hematoma, fever, and stone clearance (all P>0.05). Conclusion Tubeless PCNL is safe and effective in the treatment of renal and upper ureteral calculi, and has the advantages of reducing the postoperative pain, early out of bed activity, early removal of urinary catheters, promoting the postoperative rehabilitation, shortening the hospital stay, and reducing the hospitalization cost compared with traditional PCNL. Reference | Related Articles | Metrics

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Value of noninvasive high frequency oscillatory ventilation in the treatment of term infants with mild acute respiratory distress syndrome Yan Tao, Yang Minxia, Tao Zhiyun, Liao Peina, Yan Meijie International Medicine and Health Guidance News    2022, 28 (10): 1381-1384.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.012 Abstract （159）            Knowledge map    Save Objective To study the value of noninvasive high frequency oscillatory ventilation in the treatment of term infants with mild acute respiratory distress syndrome (ARDS). Methods A total of 60 term infants with mild ARDS treated in Gaoming District People's Hospital of Foshan from February to December 2021 were divided into a double level group and a high frequency group by the random number table, with 30 cases in each group. In the double level group, the ratio of male to female was 18:12, and the gestational age was (36.41±2.94) weeks; in the high frequency group, the ratio of male to female was 19:11, and the gestational age was (36.58±3.05) weeks. The infants in the double level group were treated with noninvasive double level positive pressure ventilation and the infants in the high frequency group were treated with noninvasive high frequency oscillatory ventilation. The blood gas analysis indexes, oxygenation indexes at different time points, clinical indexes, complications, and clinical treatment effects of the two groups were compared. The measurement data were tested by independent sample t test, and the count data were tested by χ 2 test. Results In terms of blood gas analysis indexes, the arterial carbon dioxide partial pressure (PaCO 2) in the high-frequency group was lower than that in the double-level group, with a statistically significant difference between the two groups ( P<0.05). After 24 h and 48 h, the oxygenation indexes of the two groups continued to decrease, and the oxygenation index in the high frequency group was significantly lower than that in the double level group (all P<0.05), with better oxygenation improvement. There were no statistically significant differences in the total oxygen inhalation time, total noninvasive respiratory support time, and total hospital stay between the two groups (all P>0.05). The rate of endotracheal intubation in the high frequency group [6.67% (2/30)] was lower than that in the double level group [26.67% (8/30)], with a statistically significant difference ( P<0.05). The incidence of complications was 3.33% (1/30) in the high frequency group and 13.33% (4/30) in the double level group, without statistically significant difference between the two groups ( P>0.05). The effective rate of the high frequency group [93.33% (28/30)] was higher than that of the double level group [73.33% (22/30)], with a statistically significant difference between the two groups ( P<0.05). Conclusion The effect of noninvasive high-frequency oscillatory ventilation in the treatment of term infants with mild ARDS is ideal, and it can improve their oxygenation and blood gas indexes, with high safety and high feasibility. Reference | Related Articles | Metrics

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Urinary neutrophil gelatinase-associated lipocalin as a diagnostic marker for urinary tract infection: a systematic review and meta-analysis Li Rugang, Huang Jieping, Zhang Kuizheng, He Min, Tang Junping, Zeng Xiaolin, Wu Huilan, Chen Zhiqiang, Liang Zezhi, Qin Xiaoyan, Huang Ling International Medicine and Health Guidance News    2022, 28 (10): 1385-1390.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.013 Abstract （199）            Knowledge map    Save Objective To study the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of urinary tract infection (UTI) through a meta analysis. Methods PubMed, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang Database were searched for related studies published up to November 2021. Two researchers independently judged the studies and extracted the data. Meta analysis was performed by STATA 12.0 software, including evaluation of specificity, sensitivity, likelihood ratio, and odds ratio and drawing summary receiver operating characteristic curve (SROC) and Fagan diagram. Results In all, 14 studies were enrolled, including 2 362 children and adolescents. The studies were highly heterogeneous, and there was no threshold effect or publication bias. Using a bivariate random effect regression model, we found that for the diagnosis of urinary tract infection, urinary NGAL's summary specificity and sensitivity were 0.82 (95% CI: 0.74-0.88) and 0.82 (95% CI: 0.73-0.89) respectively. Additionally, the negative likelihood ratio, positive likelihood ratio, and diagnostic odds ratio were 4.58 (95% CI: 2.81-7.46), 0.22 (95% CI: 0.14-0.34), and 20.66 (95% CI: 8.64-49.38) respectively. The area under the SROC was 0.89 (95% CI: 0.86-0.91). According to the Fagan diagram, application of urine NGAL to detect urinary tract infection enhanced the prior probability to 20%, increased the probability of positivity to 53%, and reduced the probability of negativity to 5%. Based on the meta-regression analysis, the heterogeneity was due to other covariates. Conclusions Urinary NGAL is highly effective in diagnosing urinary tract infection in the early stage. Although urinary NGAL may be used in the diagnosis of urinary tract infection, a comprehensive evaluation and analysis of clinical parameters should be performed on every patient. Reference | Related Articles | Metrics

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Effect of strengthened muscle strength training combined with "321" health education on TKA patients Liu Qin, Wei Guiyan, Gu Sicun, Huang Yanpeng, Guo Ziyan, Shi Jingjing, Dong Xuehong International Medicine and Health Guidance News    2022, 28 (10): 1391-1394.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.014 Abstract （217）            Knowledge map    Save Reference | Related Articles | Metrics

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Clinical research on the prognosis of restrictive versus liberal strategy for blood transfusion in elderly patients during operation Fu Xin, Xu Yao, Ma Chunling, Li Wankui, Deng Kaiqing International Medicine and Health Guidance News    2022, 28 (10): 1394-1398.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.015 Abstract （175）            Knowledge map    Save Objective To explore the effects of restrictive and liberal blood transfusion on the prognosis in elderly patients undergoing different elective surgeries. Methods A total of 80 elderly patients undergoing elective surgery in The First Dongguan Affiliated Hospital of Guangdong Medical University from January 2019 to June 2021 were randomly evenly divided into two groups using computer numbers. There were 26 males and 14 females in the control group, aged (64.82±2.71) years; there were 22 males and 18 females in the observation group, aged (65.67±3.39) years. The patients in the control group were given liberal blood transfusion when hemoglobin (Hb) <100 g/L, while the patients in the observation group were given restrictive blood transfusion when Hb <70 g/L. The safety and efficacy indexes of the two groups were recorded and compared before surgery (T0), at the end of surgery (T1), 1 day after surgery (T2), and 7 days after surgery (T3). t test was used for the measurement data and χ2 test was used for the count data. Results At T0, there were no statistically significant differences in the mean arterial pressure (MAP), heart rate (HR), Hb, international standardized ratio of prothrombin time (PT-INR), and creatinine (Crea) between the two groups (all P>0.05). At T1, T2, and T3, there were no statistically significant differences in the MAP, HR, PT-INR, and Crea between the observation group and the control group (all P>0.05); the Hb levels of the observation group were (81.50±12.17) g/L, (101.60±8.33) g/L, and (117.45±18.23) g/L, which were significantly lower than those of the control group [(109.00±11.23) g/L, (125.33±9.34) g/L, and (136.50±25.55) g/L], with statistically significant differences (all P<0.05). At T0, there were no statistically significant differences in the cerebral arterial blood oxygen content (CaO2), cerebral oxygen uptake rate (CEO2), lactic acid (Lac), and Mini-Mental State Examination (MMSE) score between the two groups (all P>0.05). At T1, T2 and T3, there were no statistically significant differences in the CaO2, CEO2, and Lac between the observation group and the control group (all P>0.05). At T2 and T3, the MMSE scores in the observation group were (24.04±1.91) points and (27.32±2.14) points, which were significantly higher than those in the control group [(21.81±2.48) points and (23.51±2.31) points], with statistically significant differences (both P<0.05). The blood transfusion volume and incidence of complications in the observation group were (2.08±0.26) U and 5.00% (2/40), respectively, which were lower than those in the control group [(3.17±0.83) U and 15.00% (6/40)], with statistically significant differences (both P<0.05). Conclusion Restrictive blood transfusion for elderly patients undergoing elective surgery can effectively balance the level of cerebral oxygen metabolism, maintain the stability of circulation, and promote the recovery of cognitive function. Reference | Related Articles | Metrics

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Study on the application of micro-class integrated case teaching model in probation of obstetrics and gynecology Zhu Yi, Guo Yanhong, Xu Meiyan, Lin Qiuchan, Song Liping International Medicine and Health Guidance News    2022, 28 (10): 1399-1401.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.016 Abstract （176）            Knowledge map    Save Obstetrics and gynecology is an important clinical discipline in medical colleges and universities. The traditional classroom teaching model restricts teachers' teaching effect and students' learning effect. Micro-class integrated case teaching model provides an opportunity for the classroom teaching reform of medical higher education in China. By analyzing its present situation and characteristics, this paper puts forward the teaching reform ideas for obstetrics and gynecology, further designs the teaching mode, and looks forward to its possible results and positive significance, providing a new perspective for the teaching reform. Reference | Related Articles | Metrics

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Application of "volume ultrasonic image" as an auxiliary tool in the undergraduate education of Chinese medicine colleges and universities in ultrasonic diagnostics Liu Jia, Jiang Yanhui, Yan Dan, Wu Xiaoxi, Pan Xiyang, Chen Ling, Wang Lu, Zhang Jianxing International Medicine and Health Guidance News    2022, 28 (10): 1402-1407.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.017 Abstract （146）            Knowledge map    Save Objective To investigate the application value of "volume ultrasound image" as an auxiliary tool in the undergraduate education of Chinese medicine colleges and universities of ultrasound diagnostics. Methods A total of 115 undergraduate students in the clinical majors in Guangzhou University of Chinese Medicine were included, and were divided into two groups (85 students in the ordinary class and 30 students in the test class). There were 26 boys and 59 girls in the ordinary class, aged (21.96±2.51) years; there were 10 boys and 20 girls in the test class, aged (21.40±2.38) years. The ordinary class received the traditional ultrasonic diagnosis teaching, while the test class received the new teaching method of "volume ultrasound image" as an auxiliary teaching tool. The evaluation of teaching quality and teaching satisfaction of the two groups were compared, as well as investigations in the future and ultrasound medical teaching. Independent sample t test was used for the measurement data, and Chi-square test or Fisher's exact probability method was used for the count data. Results The degree of knowledge mastery of the test class was significantly higher than that of the ordinary class [93.33% (28/30) vs. 40.00% (34/85)], and the teaching effect and teaching method satisfaction evaluation of the test class were significantly higher than those of the ordinary class [83.33% (25/30) vs. 21.18% (34/85), 83.33% (25/30) vs. 28.24% (24/85)], with statistically significant differences (all P<0.05). For the suggestion of ultrasound curriculum content, 52.94% (45/85) of the students in the ordinary class believed that the teaching model should combine with ultrasound images and anatomical structures, 46.66% (14/30) of the students in the test class thought the frontiers of new technologies and scientific research should be augmented. Conclusion The teaching method with "volume ultrasound image" as an auxiliary tool can significantly increase students' interest on learning, improve their hands-on ability, enhance their understanding and memory of ultrasound medicine knowledge. Reference | Related Articles | Metrics

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Exploration of online and offline blended teaching model in clinical teaching of breast surgery Xu Rui International Medicine and Health Guidance News    2022, 28 (10): 1407-1409.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.018 Abstract （151）            Knowledge map    Save  The clinical teaching for medical students in the practice stage mostly adopts the traditional "theme-oriented model", which has disadvantages such as low students' participation, students' inability to apply theoretical knowledge into practice, and students' poor practical ability. In the era of Internet+, it is found that the above problems can be better solved by integrating information technology into teaching. Reference | Related Articles | Metrics

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Clinical study on serum sST2 protein in predicting heart failure in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention Zhang Xiaojuan, Zhao Xiling, Ma Shumei, Wang Lei, Zhang Linmeng International Medicine and Health Guidance News    2022, 28 (10): 1410-1413.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.019 Abstract （169）            Knowledge map    Save Objective To explore and analyze the clinical value of serum soluble suppression of tumorigenicity 2 (sST2) protein in predicting heart failure in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention (PCI) treatment. Methods The clinical data of 110 patients with acute ST-segment elevation myocardial infarction treated in Binzhou Central Hospital from June 2019 to January 2021 were selected for the retrospective analysis, and all the patients received PCI. The serum sST2 protein levels at the time of admission and immediately after surgery were compared. At the same time all the patients were divided into a heart failure group (29 cases) and a non-heart failure group (81 cases) according to whether the patients developed heart failure within 6 months after PCI, and the serum sST2 protein levels of the two groups were compared. Single factor analysis was used firstly, and then logistic regression analysis was used to analyze the high-risk factors affecting heart failure after PCI. χ 2 test was used for the count data and t test was used for the measurement data. Results The serum sST2 protein level in the 110 patients immediately after surgery was significantly higher than that at the time of admission [(73.35±20.69) μg/L vs. (51.24±12.58) μg/L], with a statistically significant difference ( t=9.577, P<0.001). According to the multivariate logistic analysis, the high-risk factors for heart failure in patients with acute ST-segment elevation myocardial infarction after PCI included older age, multiple site infarction, number of lesions ≥2, left ventricular ejection fraction (LVEF) <50%, time from onset to PCI ≥12 h, serum sST2 protein level immediately after PCI, and slow or no reflow after PCI (all P<0.05). Conclusions The patients with acute ST-segment elevation myocardial infarction may have elevated serum sST2 protein level immediately after PCI. At the same time, the serum sST2 protein level is higher in patients with postoperative heart failure. Older age, multiple site infarction, number of lesions ≥2, LVEF <50%, time from onset to PCI ≥12 h, serum sST2 protein level immediately after PCI, and slow or no reflow after PCI can all be considered as the high-risk factors affecting heart failure in patients with acute ST segment elevation myocardial infarction after PCI. Reference | Related Articles | Metrics

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Clinical effect and safety of pulmonary surfactant combined with NCPAP in the treatment of NRDS in different periods Li Hongjun International Medicine and Health Guidance News    2022, 28 (10): 1414-1417.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.020 Abstract （204）            Knowledge map    Save Objective To explore the clinical effect and safety of pulmonary surfactant (Ps) combined with nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory distress syndrome (NRDS) in different periods. Methods A retrospective analysis was performed on the data of 93 infants with NRDS admitted to Xuchang Central Hospital between June 2020 and October 2021. According to the different treatment time, they were divided into an early group (51 cases) and a late group (42 cases). In the early group, there were 28 males and 23 females, with a gestational age of (34.12±1.75) weeks; in the late group, there were 22 males and 20 females, with a gestational age of (33.48±1.64) weeks. The early group was treated with Ps and NCPAP within 6 h after birth, while the late group was treated with Ps and NCPAP within 6-12 h after birth. The curative effect after 3 d of treatment, changes of blood gas indexes after 1 d and 7 d of treatment, assisted ventilation time, disappearance time of clinical symptoms, hospitalization time, and the occurrence of adverse reactions during hospitalization were compared between the two groups. t test was used for the measurement data and χ 2 test was used for the count data. Results After 3 d of treatment, the response rate of treatment in the early group was 96.08% (49/51), which was higher than that in the late group [83.33% (35/42)], with a statistically significant difference ( χ 2=4.280, P=0.039). After 1 d of treatment, the partial pressure of arterial oxygen, pH, and oxygenation index were improved in both groups, and those in the early group [(84.28±8.73) mmHg (1 mmHg = 0.133 kPa), (7.16±0.28), and (194.58±17.42) mmHg] were higher than those in the late group [(75.13±7.89) mmHg, (7.02±0.26), and (176.08±21.05) mmHg], with statistically significant differences (all P<0.05); the partial pressure of carbon dioxide was decreased in both groups, and that in the early group was lower than that in the late group [(40.86±3.12) mmHg vs. (46.03±2.87) mmHg], with statistically significant differences (all P<0.05). After 7 d of treatment, there were no statistically significant differences in the blood gas indexes between the two groups (all P>0.05). The symptom disappearance time of shortness of breath, dyspnea, and three-concave sign and assisted ventilation time were (2.38±0.71) d, (2.01±0.51) d, (2.10±0.73) d, and (13.85±3.94) d, respectively, which were shorter than those in the late group [(3.52±1.02) d, (3.27±1.32) d, (3.08±0.94) d, and (15.68±4.21) d], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions There is no significant difference in the safety of Ps combined with NCPAP in the treatment of NRDS in different periods. However, the short-term curative effect of early treatment is more significant, which can accelerate the relief of clinical symptoms and the recovery of blood gas indexes. Reference | Related Articles | Metrics

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Efficacy of triple chemotherapy with osimertinib, pemetrexed, and bevacizumab on EGFR mutant NSCLC Ci Mingwei, Liu Nan, Gao Lulu International Medicine and Health Guidance News    2022, 28 (10): 1418-1421.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.021 Abstract （569）            Knowledge map    Save Objective To investigate the efficacy and safety of triple chemotherapy with osimertinib, pemetrexed, and bevacizumab in epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC). Methods The clinical data of 106 patients with EGFR-mutant NSCLC who were diagnosed in Weihai Central Hospital from July 2016 to December 2018 were retrospectively analyzed. The cases in the control group [53 cases, 31 males and 22 females, aged (60.37±3.54) years] were given pemetrexed and bevacizumab, and the cases in the observation group [53 cases, 26 males and 27 females, aged (60.82±3.57) years] were given the combined treatment of osimertinib, pemetrexed, and bevacizumab. The chemotherapy efficacy, serum tumor markers, adverse reactions, and survival rate were compared between the two groups. Independent sample t test and paired t test were used for the measurement data, and χ 2 test was used for the count data. Results After treatment, the total effective rate and disease control rate in the observation group were 81.13% (43/53) and 92.45% (49/53), respectively, which were significantly higher than those in the control group [60.38% (32/53) and 77.36% (41/53)], with statistically significant differences ( χ 2=5.517, 4.711; P=0.019, 0.030). Before treatment, there were no statistically significant differences in the levels of cancer antigen 125 (CA125), keratin 19 fragments (CYFRA21-1), and carcino-embryonic antigen (CEA) between the two groups (all P>0.05); after treatment, the levels of CA125, CYFRA21-1, and CEA in the observation group were (38.69±4.69) U/ml, (2.51±0.52) μg/L, and (17.69±3.19) μg/L, respectively, which were significantly lower than those in the control group [(54.23±5.36) U/ml, (4.91±0.73) μg/L, and (26.73±5.34) μg/L], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ 2=1.485, P=0.223). The 3-year survival rate of the control group was 52.83% (28/53), which was significantly lower than that of the observation group [73.58% (39/53)], with a statistically significant difference ( χ 2=5.972, P=0.015). Conclusion The therapeutic effect of triple chemotherapy of osimertinib, pemetrexed, and bevacizumab for patients with EGFR-mutant NSCLC is good, which can improve the patients' prognosis without increasing adverse reactions. Reference | Related Articles | Metrics

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Effect analysis of Qilianhua Jiedu pill combined with traditional Chinese medicine ointment in the treatment of patients with pneumonia Che Qifu, He Lijie, Shen Zhongda International Medicine and Health Guidance News    2022, 28 (10): 1422-1426.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.022 Abstract （533）            Knowledge map    Save Objective To study the clinical application effect of Qilianhua Jiedu pill combined with traditional Chinese medicine ointment in the treatment of pneumonia. Methods A total of 126 pneumonia patients admitted to Jiamusi Hospital of Traditional Chinese Medicine from September 2019 to September 2021 were selected as the treatment objects. The patients were numbered according to the order of admission and were randomly divided into an observation group and a control group, with 63 cases in each group. In the control group, there were 31 males and 32 females, aged (48.39±10.18) years; in the observation group, there were 36 males and 27 females, aged (46.96±10.22) years. The control group was treated with traditional Chinese medicine ointment, and the observation group was treated with Qilianhua Jiedu pill and traditional Chinese medicine ointment. The clinical efficacy, symptom subsidence time, inflammatory factors levels, immune function indexes levels, and treatment safety were evaluated and compared between the two groups. t test was used for the measurement data and χ 2 test was used for the count data. Results The total effective rate of the observation group was 92.06% (58/63), which was higher than that of the control group [77.78% (49/63)], with a statistically significant difference ( χ 2=5.020, P=0.025). After treatment, the subsidence time of fever, cough, soreness, and pulmonary rales in the observation group were (2.09±0.56) d, (3.27±0.90) d, (4.18±0.90) d, and (5.38±1.16) d, respectively, which were shorter than those in the control group [(2.86±0.79) d, (4.15±0.94) d, (5.47±0.98) d, and (6.29±1.32) d], with statistically significant differences (all P<0.05). Before treatment, there were no statistically significant differences in the levels of inflammatory factors and T lymphocyte subsets between the two groups (all P>0.05). After treatment, the levels of C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α in the observation group were (12.41±3.02) mg/L, (39.32±4.94) ng/L, and (53.99±5.87) ng/L, respectively, which were lower than those in the control group [(15.42±4.10) mg/L, (43.76±5.31) ng/L, and (58.45±6.84) ng/L], with statistically significant differences (all P<0.05). After treatment, the levels of CD3 +, CD4 +, and CD4 +/CD8 + in the observation group were (53.98±5.83)%, (54.87±5.61)%, and (1.94±0.35), respectively, which were higher than those in the control group [(48.76±5.47)%, (50.19±5.35)%, and (1.67±0.32)], and the level of CD8 + was (28.15±3.04)%, which was lower than that in the control group [(30.87±3.09)%], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ 2=0.321, P=0.571). Conclusion Qilianhua Jiedu pill combined with traditional Chinese medicine ointment has a significant curative effect in the treatment of pneumonia, which can inhibit the expressions of inflammatory factors in the body and improve the patients' immunity, with mild adverse reactions. Reference | Related Articles | Metrics

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Exploring the effect of traditional Chinese medicine diet therapy in regulating phlegm-dampness constitution type hypertension based on the theory of "simultaneous conditioning of five internal organs" Li Batong, Wen Yingying, Yang Nianhua, Yu Jianlan International Medicine and Health Guidance News    2022, 28 (10): 1426-1430.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.023 Abstract （306）            Knowledge map    Save Objective To explore the effect of traditional Chinese medicine (TCM) diet therapy in regulating phlegm-dampness constitution type hypertension based on the theory of "simultaneous conditioning of five internal organs". Methods Seventy hypertensive patients with phlegm-dampness constitution who were treated in Lingling District Hospital of Traditional Chinese Medicine in Yongzhou City from January 2018 to June 2019 were collected as the research objects, and they were divided into two groups by the random number table method, with 35 patients in each group. There were 18 males and 17 females in the control group, aged (59.80±11.96) years; there were 21 males and 14 females in the treatment group, aged (58.20±11.64) years. The control group was given routine clinical treatment, and the treatment group was given TCM diet intervention based on the theory of "simultaneous conditioning of five internal organs" on the basis of conventional treatment. The phlegm-dampness constitution symptoms, blood pressure and blood lipid levels, and qualities of life of the two groups were compared and analyzed. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ 2 test was used for the count data. Results After intervention, the scores of chest tightness and abdominal distension, heavy body, mouth phlegm, and thick greasy tongue coating in the treatment group were (0.62±0.12) points, (0.52±0.10) points, (0.67±0.13) points, and (0.56±0.11) points, respectively, which were lower than those in the control group [(0.71±0.14) points, (0.58±0.12) points, (0.75±0.15) points, and (0.64±0.13) points], with statistically significant differences (all P<0.05). After intervention, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels in the treatment group were (113.67±12.63) mmHg (1 mmHg=0.133 kPa) and (79.65±8.85) mmHg, respectively, which were lower than those in the control group [(121.54±13.50) mmHg and (84.31±9.37) mmHg], with statistically significant differences (both P<0.05). After intervention, the levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) in the treatment group were (4.12±0.82) mmol/L, (1.25±0.25) mmol/L, (2.47±0.49) mmol/L, respectively, which were lower than those in the control group [(4.65±0.93) mmol/L, (1.41±0.28) mmol/L, and (2.79±0.56) mmol/L], and the level of high-density lipoprotein cholesterol (HDL-C) was (1.82±0.36) mmol/L, which was higher than that in the control group [(1.64±0.33) mmol/L], with statistically significant differences (all P<0.05). After intervention, the scores of physical function, psychological function, social function, and material life in the treatment group were (81.47±9.05) points, (83.61±9.29) points, (84.36±9.37) points, and (82.73±9.19) points, respectively, which were higher than those in the control group [(75.52±8.50) points, (76.82±8.54) points, (79.24±8.80) points, and (77.19±8.57) points], with statistically significant differences (all P<0.05). Conclusions Based on the theory of "simultaneous conditioning of five internal organs", TCM dietetic conditioning has a good effect on hypertensive patients with phlegm-dampness constitution. The physical symptoms of the patients are greatly relieved, their blood pressure and blood lipid levels are effectively improved, and their quality of life is improved. Reference | Related Articles | Metrics

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Comparative study of different surgical approaches in the treatment of zygomatic complex fractures Li Changdong, Wang Siming International Medicine and Health Guidance News    2022, 28 (10): 1431-1434.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.024 Abstract （539）            Knowledge map    Save Objective To observe the effects of open reduction and internal fixation through local small incision and semi coronal incision in the operation of zygomatic complex fractures. Methods A prospective study was conducted to select 93 patients with zygomatic complex fractures who were treated in the Department of Stomatology, The People's Hospital of Taierzhuang District, Zaozhuang from January 2017 to August 2021. The patients were divided into a transcranial semi-coronal incision group (45 cases) and a local small incision group (48 cases). The operation time and intraoperative bleeding volume were compared between the two groups. Three dimensional reconstruction of maxillofacial CT was performed again 3 months after operation to evaluate fracture reduction and healing, and the success rate of reduction was compared between the two groups. The incidence of adverse reactions such as alopecia and scalp sensory disturbance was compared. Independent sample t test was used for the measurement data and χ 2 test was used for the count data. Results In the semi-coronal incision group, there were 33 males and 12 females, aged (36.24±7.58) years; in the small incision group, there were 37 males and 11 females, aged (34.81±6.73) years. The operation time and intraoperative bleeding volume of the semi-coronal incision group were (116.84±23.36) min and (86.73±20.47) ml, respectively, which were higher than those of the local small incision group [(87.31±18.59) min and (25.06±12.53) ml], with statistically significant differences (both P<0.05). The success rate of reduction in the semi-coronal incision group was 97.78% (44/45), which was significantly higher than that in the small local incision group [83.33% (40/48)] ( χ 2=5.544, P=0.189); there was no statistically significant difference in the success rate of Zingg type B reduction between the two groups ( P>0.05); the success rate of type C reduction in the semi-coronal incision group was 95.24% (20/21), which was higher than that in the local small incision group [70.00% (14/20)], with a statistically significant difference ( χ 2=4.609, P=0.032). The incidence of adverse reactions in the semi-coronal incision group was 24.44% (11/45), which was higher than that in local small incision group [6.25% (3/48)], with a statistically significant difference ( χ 2=6.012, P=0.014). Conclusions Patients with Zingg classification type B can choose the local small incision approach to reduce the amount of bleeding and complications such as temporal depression and local alopecia. Type C patients can choose the semi coronal approach to achieve accurate reduction and reliable fixation. Reference | Related Articles | Metrics

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Anesthesia management for recurred atrial fibrillation during cesarean section in a patient after mitral valve replacement Zhang Jingwen, Xiang Yuan, Yang Xuemei, Liu Hui International Medicine and Health Guidance News    2022, 28 (10): 1435-1437.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.025 Abstract （518）            Knowledge map    Save There are numerous case reports describing successful drug or electrical cardioversion for atrial fibrillation in pregnancy, but very few of those cases occur during cesarean delivery. This article introduced a patient with paroxysmal atrial fibrillation since mitral valve replacement thirteen years ago treated in West China Second University Hospital in 2019. During her cesarean section under general anesthesia, atrial fibrillation recurred after the placenta was removed. The anesthesiologist used esmolol and cedilanid to control the ventricular rate, and after the operation, the laryngeal mask was used to replace the tracheal tube to reduce the cardiovascular response to extubation. The sinus rhythm was restored, and the patient passed the recovery period from anesthesia smoothly. We aimed to analyze the success and insufficiency of anesthesia management in this case, and provide a reference for the anesthesia management of cesarean section in pregnant women with high risk of atrial fibrillation. Anesthesia management in this case may have been better if laryngeal mask intubation is used immediately after induction of general anesthesia, cedilanid or electrical cardioversion is applied earlier after the onset of atrial fibrillation, and perioperative monitoring of invasive blood pressure and echocardiography is used. Reference | Related Articles | Metrics

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A case of acute superior mesenteric venous thrombosis diagnosed by emergency ultrasonography Chen Xiuxiao, Sui Wenqian, Wu Yuanyuan International Medicine and Health Guidance News    2022, 28 (10): 1438-1439.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.026 Abstract （177）            Knowledge map    Save Reference | Related Articles | Metrics

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Invasive fibroma in incision after right lung surgery: a case report and literature review Wang Haiwen, Song Tao International Medicine and Health Guidance News    2022, 28 (10): 1440-1442.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.027 Abstract （252）            Knowledge map    Save Reference | Related Articles | Metrics

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A case report of malignant melanoma with pleural effusion Zhao Bangfeng, Zhang Yanqiong, Xu Xun International Medicine and Health Guidance News    2022, 28 (10): 1442-1444.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.028 Abstract （270）            Knowledge map    Save The incidence of malignant melanoma is increasing year by year. However, it is relatively rare to see a doctor in department of respiratory medicine with pleural effusion as the first symptom. In October 2021, 1 case was found in Shanghai Songjiang District Central Hospital, and was reported as follows. Reference | Related Articles | Metrics

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Application experience of stirrup shape multifunctional leg support in the treatment of nephron-ureteral calculi in the oblique lateral lithotomy position combined with PCNL and URSL Zou Qian, Chang Houchan, Bie Fenggui, Lyu Wenze, Chen Qingke International Medicine and Health Guidance News    2022, 28 (10): 1445-1448.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.029 Abstract （196）            Knowledge map    Save Objective To investigate the application effect of stirrup shape multifunctional leg support in the treatment of nephron-ureteral calculi under the oblique lateral lithotomy position combined with percutaneous nephrolithotomy (PCNL) and ureteroscopy lithotripsy (URSL). Methods A total of 65 patients were selected from Guangdong Provincial People's Hospital from January 2019 to May 2021, who underwent PCNL combined with URSL in the integrated oblique lateral lithotomy position. Among them, 34 patients in the control group [20 males and 14 females, aged (54.62±10.31) years] were placed in the oblique lateral position with conventional lithotomy leg support, and 31 patients in the observation group [21 males and 10 females, aged (54.77±12.61) years] were placed in the oblique lateral position with new stirrup shape leg support. The time spent in position placement and vital signs such as arterial pressure change of the healthy upper limb, heart rate, and pulse oxygen before position placement and after the patient was restored to the supine position were recorded. Independent sample t test was used for the measurement data and Chi-square test was used for the count data. Results There were no statistically significant differences in the systolic blood pressure, diastolic blood pressure, heart rate, and pulse oxygen index between the two groups before and after surgery (all P>0.05). Secondary statistical analysis was performed on the differences of systolic blood pressure, diastolic blood pressure, heart rate, and pulse oxygen index before and after surgery, and the differences were not statistically significant (all P>0.05). The time spent in position placement in the observation group was (16.32±1.17) min, which was shorter than that in the control group [(33.47±3.54) min], with a statistically significant difference (P<0.05). Conclusions The stirrup shape multifunctional leg support has the advantages of high safety, easy operation, all-round protection, and flexible adjustment. It has obvious advantages in the oblique lateral position (one body position). Reference | Related Articles | Metrics

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Systematic review on the effect of cardiac rehabilitation on the quality of life in patients undergoing coronary artery bypass grafting Yuan Lijuan, Xiang Shengxiao, Yuan Tiantian, Hao Haiqin, Xie Ping International Medicine and Health Guidance News    2022, 28 (10): 1448-1457.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.030 Abstract （178）            Knowledge map    Save Objective To systematically evaluate the effect of cardiac rehabilitation (CR) on the quality of life in patients undergoing coronary artery bypass grafting (CABG). Methods Databases, including PubMed, Web of Science, EMBASE, Medline, The Cochrane Library, CNKI, Wanfang Data, VIP, and SinoMed, and some other resources such as Yimaitong, Metz Medicine, and China Clinical Guidelines Library website were searched to collect the randomized controlled trials (RCTs) involving CR and routine care on the quality of life in patients after CABG from the establishment of database to May 2021. The data were analyzed by the RevMan 5.4 statistical software. Results A total of 10 RCTs were included, with a total of 773 patients, including 383 cases in the CR group and 390 cases in the conventional treatment group. The meta analysis results showed that compared with the conventional treatment group, the CR group improved in terms of physiological function ( MD=11.85, 95% CI 5.25-18.45, P=0.000 4), physiological function ( MD=6.96, 95% CI 4.94-8.97, P<0.000 1), somatic pain ( MD=6.74, 95% CI 2.39-11.10, P=0.002), general health ( MD=12.22, 95% CI 7.35-17.10, P<0.000 01), vitality ( MD=14.45, 95% CI 6.92-21.79, P=0.002), social function ( MD=7.11, 95% CI 2.83-11.39, P=0.001), emotional function ( MD=9.70, 95% CI 2.64-16.76, P=0.007), and mental health ( MD=11.10，95% CI 4.61-17.58， P=0.000 8), but were not statistically significantly different in terms of physical health ( MD=9.29, 95% CI -8.74-27.32, P=0.31) and mental health ( MD=8.51, 95% CI -12.26-29.29, P=0.42). Conclusions For patients undergoing CABG, postoperative CR training can improve their quality of life to a certain extent, but there is no significant improvement in physical health or mental health. Considering the large heterogeneity of some literatures included in this study, it needs to be verified by conducting high-quality, large-sample, and multi-center RCTs. Reference | Related Articles | Metrics

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Effect of BrainHQ visual rehabilitation training on memory function in patients with cerebral infarction Wan Qin, Ma Li International Medicine and Health Guidance News    2022, 28 (10): 1458-1462.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.031 Abstract （357）            Knowledge map    Save Objective To explore the effect of BrainHQ visual training on the memory function in patients with cerebral infarction. Methods A total of 108 patients with cerebral infarction treated in Wuxi Second People's Hospital from February 2019 to January 2021 were simply randomly divided into two groups, with 54 cases in each group. The control group was given routine rehabilitation training, including 30 males and 24 females, aged (63.57±5.38) years, with a course of disease of (2.32±0.98) months. The observation group was given BrainHQ visual training on the basis of the control group, including 32 males and 22 females, aged (63.21±5.25) years, with a course of disease of (2.38±0.95) months. The memory function, executive function, negative emotions, and quality of life were compared between the two groups. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and Chi-square test was used for the count data. Results The total score of memory function in the observation group after intervention was (20.98±1.73) points, which was higher than that in the control group [(17.30±1.89) points] ( P<0.001); the total score of executive function in the observation group was (20.63±2.73) points, which was higher than that in the control group [(17.76±3.02) points] ( P<0.001); the scores of anxiety and depression in the observation group were (32.29±3.90) points and (30.12±3.17) points, respectively, which were lower than those in the control group [(40.21±5.67) points and (38.98±4.05) points], with statistically significant differences (both P<0.001); the total score of quality of life in the observation group was (103.61±4.78) points, which was higher than that in the control group [(90.05±5.94) points] ( P<0.001). Conclusion BrainHQ visual training combined with conventional rehabilitation training can effectively enhance the memory and executive functions in patients with cerebral infarction, relieve their negative emotions, and promote the improvement of patients' quality of life. Reference | Related Articles | Metrics

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Study on the relationship between work-life balance and resilience in nurses returning to work after the second childbirth in Nanyang area Liu Xue, Song Hang, Li Yanzhuo International Medicine and Health Guidance News    2022, 28 (10): 1463-1467.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.032 Abstract （156）            Knowledge map    Save Objective To investigate the status quo of work-life balance and resilience in nurses returning to work after the second childbirth in Nanyang, and to analyze their correlation, so as to provide references for promoting the mental health and professional development in nurses returning to work after the second childbirth. Methods From February 2019 to February 2021, 112 nurses returning to work after the second childbirth from 3 public tertiary general hospitals in Nanyang City were conveniently selected as the research objects. The enrolled subjects were all registered nurses under 45 years old, who had been engaged in clinical nursing for no less than 2 years, and ex-office training, sick leave, and intern nurses were excluded. The general situation scale, work-family balance scale, and medical staff resilience evaluation scale were used for investigation. Independent sample t test or ANOVA was used for the measurement data, multiple stepwise regression analysis was used for multivariate analysis, and Pearson correlation analysis was used to analyze the correlation between work-life balance and resilience. Results The total score of work-life balance in the 112 nurses returning to work after the second childbirth was (37.53±7.76), the total score of resilience was (58.79±9.88), and there was a positive correlation between the two (r=0.419, P<0.05). There were statistically significant differences in the resilience score among nurses returning to work after the second childbirth with different nursing age, monthly income, age of the first child, and whether they participated in pre-job training before returning to work (all P<0.05). The work-life balance could independently explain the variation of resilience in nurses returning to work after the second childbirth (41.60%) (F=24.365, P<0.05). Conclusions The work-life balance and resilience in nurses returning to work after the second childbirth are correlated. The higher the work-life balance, the higher the level of resilience. Nursing managers should pay attention to the work-family balance in nurses returning to work after the second childbirth. While improving the management mechanism, strengthening the humanistic care, and promoting the balance between nurses' work and personal lives, they should strive for the understanding and support of nurses' family members to enhance nurses' personal resilience, promote the health, and improve the quality of work. Reference | Related Articles | Metrics

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Research progress of sepsis-related biomarkers and mechanisms of action Guo Runjing, Hao Dong International Medicine and Health Guidance News    2022, 28 (10): 1468-1471.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.033 Abstract （248）            Knowledge map    Save Sepsis is a common clinical syndrome of multiple organ dysfunction caused by a critical infection, and is one of the major clinical causes of patients' death, with a high morbidity and mortality. Despite significant improvements in antibiotic use and life support, the mortality in patients with sepsis is still high. Early identification of biomarker changes in sepsis is of great benefit in providing ideas for the treatment of sepsis and determining the prognosis of patients. Reference | Related Articles | Metrics

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Advances in the mechanism of rituximab for the treatment of primary nephrotic syndrome in children Yao Chao, Duan Peifeng International Medicine and Health Guidance News    2022, 28 (10): 1472-1476.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.034 Abstract （285）            Knowledge map    Save Primary nephrotic syndrome is a common kidney disease in children, and long-term treatment with glucocorticoids and immunosuppressive agents brings many adverse effects. Rituximab, a chimeric human/mouse monoclonal anti-CD20 antibody, was first used as a biologic agent in the treatment of nephropathy in 2002. As a novel drug with great therapeutic potential, it is chiefly characterized by its short treatment course, high compliance, high remission rate, and slight adverse effects. However, the current research on rituximab for primary nephrotic syndrome is mostly focused on its efficacy and safety, and the specific mechanism of its treatment for nephrotic syndrome is not clear enough. This paper summarizes the mechanism of rituximab in the treatment of nephrotic syndrome in recent years, hoping it could be exploited in clinical practice. Reference | Related Articles | Metrics

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Diagnosis and treatment of Waldenstrom's macroglobulinemia  Li Jianping, Yu Wenzheng International Medicine and Health Guidance News    2022, 28 (10): 1476-1480.   DOI: 10.3760/cma.j.issn.1007-1245.2022.10.035 Abstract （236）            Knowledge map    Save Waldenstrom's macroglobulinemia (WM) is a rare type of indolent non-Hodgkin's lymphoma, which is mainly characterized by immunoglobulin M type monoclonal immunoglobulin and lymphoplasmic cell infiltration. Most patients can not achieve complete remission (CR) after treatment, so it is considered to be an incurable disease. In recent years, with the in-depth research on WM pathogenesis and the development of immunology and molecular biology, the new achievements have been made in the research and development of new targeted drugs, and all of them have provided new therapeutic targets and schemes for the treatment of WM patients, which has significantly improved the clinical prognosis. We reviewed the diagnosis and treatment of WM. Reference | Related Articles | Metrics

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Application of simulated reduction verification in intensity modulated radiotherapy for breast cancer patients Fang Yongwen, Fang Jianlan, Liu Biaoshui, Yao Wenyan, Lin Xiaosheng, Lin Chengguang, Xiao Liangjie International Medicine and Health Guidance News    2022, 28 (11): 1482-1485.   DOI: 10.3760/cma.j.issn.1007-1245.2022.11.001 Abstract （181）            Knowledge map    Save Objective To analyze the error of simulated reduction verification in breast cancer patients before radiotherapy and to explore the necessity of simulated reduction verification before radiotherapy. Methods One hundred and seventy-four breast cancer patients who received radiotherapy in Sun Yat-sen University Cancer Center from November 2020 to November 2021 were randomly selected for the retrospective study, with a total of 870 cone beam CT (CBCT) placement errors. The breast cancer patients who underwent X-ray simulation reduction verification before radiotherapy were set as group A; the breast cancer patients without simulated reduction verification were set as group B, and CBCT was used for postural verification during the treatment. The postural error data after CBCT calibration for the first treatment and the time required for the first treatment (the time in group A was the simulation reset verification time plus the first treatment time, and the time in group B was the first treatment time) were recorded and observed. The independent-sample t test analysis was conducted respectively. Results The errors in the SI direction of the head and foot between group A and group B were (0.07±0.33) cm and (0.15±0.43) cm, with a statistical difference ( t=3.575, P<0.001); there were no statistical differences in the left and right LR and anterior and posterior AP directions (both P>0.05). In the analysis of the first treatment time, the time of group A was much shorter than that of group B [(17.73±2.87) min vs. (34.51±3.28) min], with a statistical difference ( t=48.480, P<0.001). According to the formula M PTV=2.5∑+0.7σ, the external boundaries of group A and group B in all directions were calculated as below: LR 7.6 mm and 7.9 mm, SI 7.6 mm and 10.6 mm, and AP 10.2 mm and 10.7 mm. Conclusions The repeatability of the patients in group A in the SI direction of the head and foot was better than that in group B after being verified by simulated reduction before radiotherapy; in the analysis of the first treatment time, the time of the patients in group A was much shorter than that in group B, and the time of the patients maintaining the treatment position was shortened. Reposition verification before upper breast cancer radiotherapy can improve the precision of radiotherapy and reduce the patients' positional uncertainty caused by a long single treatment time. Reference | Related Articles | Metrics

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Expressions of Ki-67, EGFR, and E-cad in breast cancer and their effects on prognosis Cheng Chen, Li Xueping, Xu Yi, Zhao Hongyan, Zhao Haitao International Medicine and Health Guidance News    2022, 28 (11): 1486-1491.   DOI: 10.3760/cma.j.issn.1007-1245.2022.11.002 Abstract （372）            Knowledge map    Save Objective To investigate the expressions of Ki-67, EGFR, and E-cad in breast cancer and their effects on prognosis. Methods One hundred and sixty-seven breast cancer specimens from Lianyungang First People's Hospital and Lianyungang Hospital of Traditional Chinese Medicine between May 2015 and December 2021 were retrospectively studied. The patients were followed up, and their data were sorted out. The SPSS 24.0 software was used for statistical analysis. The chi-square test was used to compare the enumeration data between the groups. Spearman analysis was used to evaluate the correlation of biological prognostic factors with clinicopathological characteristics and the Neo-bioscore prognostic evaluation system. The overall survival and survival analysis were observed by the Kaplan-Meier method. Single factor analysis was performed, and the survival curves were drawn. Cox regression model was used to carry out multivariate analysis to further exclude the influence of confounding factors. Results The patients was averagely 46.4 years old. The pathological molecular typing of breast cancer was significantly different from the expressions of Ki-67 and EGFR ( χ 2=30.463, P<0.001; χ 2=25.652, P<0.001); there were statistical differences between the expressions of Ki-67 and EGFR and between the expressions of EGFR and E-cad ( χ 2=7.167, P=0.007; χ 2=18.576, P<0.001). There was a close positive correlation between the expression levels of EGFR and Ki-67 ( r=0.207, P=0.007), and a negative correlation between the expression levels of EGFR and E-cad ( r=-0.325, P<0.001); the Neo-bioscore score of breast cancer was positively correlated with the expression levels of Ki-67 and EGFR ( r=0.324, P<0.001; r=0.176, P=0.023), and negatively with the expression level of E-cad ( r=-0.162, P=0.037). The Kaplan-Meier univariate and COX model multivariate survival analysis showed that the Ki-67 expression level and Neo-bioscore score of breast cancer were the prognostic factors of breast cancer ( χ 2=3.950, P=0.047; χ 2=13.372, P=0.004), and were the independent risk factors affecting the survival of breast cancer patients. Conclusions The expressions of Ki-67, EGFR, and E-cad have an auxiliary judgment effect on the expressions of proliferative active molecules, making personalized and targeted therapy possible, and have a direct or indirect correlation with the prognosis of breast cancer patients. Dynamically monitoring the effect of tumor-targeted therapy has better clinical service. Reference | Related Articles | Metrics

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Clinical effect of immunohistochemical detection in pathological diagnosis of breast cancer  Yang Yang, Li Jianhua, Cheng Yao, Zhu Ruiping International Medicine and Health Guidance News    2022, 28 (11): 1492-1494.   DOI: 10.3760/cma.j.issn.1007-1245.2022.11.003 Abstract （179）            Knowledge map    Save Objective To analyze the clinical effect of immunohistochemical detection in the pathological diagnosis of breast cancer. Methods The subjects of the study were 241 female breast cancer patients who were admitted to Zhongshan Hospital, Dalian University from January 1, 2019 to August 1, 2021. All the patients underwent surgical treatment after enrollment. According to the surgical resection of breast tumor specimens, the ER+ (estrogen receptor positive) PR+ (progesterone receptor positive) patients were included in the positive group (121 cases), and the ER- (estrogen receptor negative) and PR- (progesterone receptor negative) patients were included in the negative group (120 cases). The positive group were (56.87±4.35) years old, and the negative group (57.13±4.46). Both groups underwent immunohistochemical detection, and the results were compared. The independent-sample t test was applied. Results The proportions of HER-2 (human epidermal growth factor receptor) (+) and HER-2 (-) of breast tumor specimens and the axillary lymph node metastasis rate were 23.96% (29/121), 76.03% (92/121), and 31.40% (38/121) in the positive group, and were 85.00% (102/120), 15.00% (18/120), and 65.83% (79/120) in the negative group, with statistical differences (all P<0.05). Conclusion Immunohistochemical detection can provide effective references for the pathological diagnosis of breast cancer, clarify the positive rate of HER-2 and axillary lymph node metastasis, and point out an accurate direction for further clinical intervention, and is conducive to the improvement of the prognosis. Reference | Related Articles | Metrics

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Investigation on constitution types of traditional Chinese medicine, Kupperman score, and treatment methods of perimenopausal patients with breast cancer  Kang Mengling, Li Liangfang, Liu Dongdong, Huang Lezhen International Medicine and Health Guidance News    2022, 28 (11): 1495-1499.   DOI: 10.3760/cma.j.issn.1007-1245.2022.09.004 Abstract （104）            Knowledge map    Save Objective To observe the improved Kupperman score, constitution types of traditional Chinese medicine (TCM), and treatment methods of perimenopausal patients with breast cancer and the influence of TCM constitution types on Kupperman score. Methods We conducted a cross-sectional survey on the perimenopausal patients with breast cancer treated at Breast Department, Guangdong Provincial Hospital of Chinese Medicine and The Second Clinical College, Guangzhou University of Chinese Medicine in 2015 by questionnaire. The questionnaire content included general information, the patients' diagnosis and treatment, TCM constitution types, and improved Kupperman score. We used descriptive statistical analysis, independent-sample t test, rank-sum test to observe the patients' common TCM constitution types and kupperman score, and to explore the effects of different treatment methods and TCM constitution types on kupperman score. Results A total of 228 people were included in the survey, they were (52.50±4.75) years old. We found that the patients' TCM constitution types were often mixed; and the common constitution types were as below: blood stasis type (116 cases, 50.9%), qi stagnation type (110 cases, 48.2%), yang deficiency type (109 cases, 47.8%), and qi deficiency type (101 cases, 44.3%); 96.1% (219/228) of the patients had a Kupperman score over 6, 89.0% (203/228) had fatigue, 85.1% (194/228) had insomnia, and 85.1% (194/228) had emotional agitation. The Kupperman score was higher in the chemotherapy group than in the non-chemotherapy group ( P=0.013). There were no statistical differences in the Kupperman score between the radiotherapy, endocrinological treatment, and targeted treatment. The total Kupperman score of the patients of normal constitution was lower than that of the patients without this constitution, while the total Kupperman scores of the patients with the other 7 types of constitutions except intrinsic constitution were higher than those in the patients without these constitutions, with statistical differences (all P<0.05). Conclusions Blood stasis, qi stagnation, yang deficiency, and qi deficiency are the common constitution types of respondents. Perimenopausal syndrome occurs in most respondents. Chemotherapy can exacerbate perimenopausal symptoms. Normal constitution is a protective factor for the occurrence of perimenopausal syndrome, while the other seven constitutions except intrinsic constitution are the risk factors. Reference | Related Articles | Metrics

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Tet in regulation of Th17/Treg cell differentiation and in participatesion of pathogenesis of autoimmune diseases Jiang Guantong, Zhou Jin, Xue Haibo International Medicine and Health Guidance News    2022, 28 (11): 1500-1504.   DOI: 10.3760/cma.j.issn.1007-1245.2022.11.005 Abstract （174）            Knowledge map    Save CD4 + T cells are an important part of human immunity. T helper cell 17 (Th17) and regulatory T cells (Treg), two newly discovered subsets of CD4 + T cells, play a key role in the occurrence and development of autoimmune diseases. Th17 cause autoimmunity and inflammation, while Treg inhibit the emergence of diseases and maintain immune homeostasis. Ten-eleven translocation (Tet), as a key factor in DNA demethylation, affects the Th17/Treg balance and involves in the progression of autoimmune diseases when it is absent. This review focuses on the research of the regulatory role of Tet on Th17/Treg cell immunization balance and the possible pathogenesis of autoimmune diseases. Reference | Related Articles | Metrics