Channel: Treatises http://journal23.magtechjournal.com/Jwk3_gjyyws EN-US http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/1007-1245/current.shtml http://journal23.magtechjournal.com/Jwk3_gjyyws 1007-1245 http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.020 Objective To observe the efficacy and safety of argon knife combined with iodophor pleurodesis by medical thoracoscopy in the treatment of malignant pleural effusion. Methods A total of 54 patients with malignant pleural effusion who were hospitalized in Department of Respiratory and Critical Care Medicine of our hospital from October 2017 to May 2020 were retrospectively analyzed. Among them, 18 patients underwent argon knife combined with iodophor pleurodesis by medical thoracoscopy (observation group), and 36 patients underwent cis-platinum pleurodesis after thoracic closed drainage (control group). The efficiency and safety of the two groups were compared. Results The total effective rates of the observation group and the control group were 94.44% (17/18) and 52.78% (19/36), with statistically significant difference (P<0.01). The adverse reactions rates of the observation group and the control group were 50.00% (9/18) and 41.67% (15/36), without statistically significant difference (P>0.05). Conclusion Argon knife combined with iodophor pleurodesis by medical thoracoscopy has the advantages of high curative effect, high safety, and less adverse reactions in the treatment of malignant pleural effusion, which is worthy of clinical promotion.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.021 Objective To compare the clinical curative effect of negative pressure combined ureteroscopic lithotripsy and flexible ureteroscopy combined holmium laser lithotripsy (f-URS) on unilateral upper urinary tract calculi. Methods Eighty patients with unilateral upper urinary tract calculi who were treated in our hospital between June 2018 and June 2020 were enrolled. They were randomly divided into control group and study group, 40 cases in each group. The control group was treated with f-URS, while the study group was treated with negative pressure combined ureteroscopic lithotripsy combined holmium laser lithotripsy. The hospitalization time, operation time, stone clearance rate, as well as levels of hemoglobin (Hb) and serum creatinine (Cr) before and after treatment were compared between the two groups. The incidence of complications after treatment in both groups was statistically analyzed. Results The operation time in the study group was longer than that in the control group [(54.12±6.25) min vs.(35.41±5.73) min] (P<0.05), the stone clearance rate within 24 h after surgery was higher than that in the control group [90.0% (36/40) vs.62.5% (25/40)] (P<0.05), and the total incidence of complications was lower than that in the control group [5.0% (2/40) vs.25.0% (10/40)] (P<0.05). There were no statistically significant differences in hospitalization time and stone clearance rate within 30 d after surgery between the two groups (both P>0.05). After treatment, Hb in both groups decreased (both P<0.05), and there was no statistically significant difference in Hb between the two groups (P>0.05). There was no statistically significant difference in Cr before and after treatment, as well as between the two groups (all P>0.05). Conclusions For patients with unilateral upper urinary tract calculi, both negative pressure combined ureteroscopic lithotripsy and f-URS are effective treatment methods. Compared with f-URS, negative pressure combined ureteroscopic lithotripsy can avoid more complications, with more significantly curative effect on the stones with diameter longer than 20 mm.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.022 Objective To explore the application value of B-type natriuretic peptide (BNP), D-dimer (DD), and homocysteine (Hcy) in the clinical diagnosis and risk classification of acute pulmonary embolism (APE). Methods A total of 89 APE patients admitted to the intensive care unit (ICU) of our hospital and 30 healthy physical examination people from July 2018 to June 2020 were selected as the research objects. According to the severity of APE, the patients were divided into high-risk group (36 cases), medium-risk group (31 cases), low-risk group (22 cases). The levels of BNP, DD, and Hcy in the three groups were detected and analyzed. Results Through one-way analysis of variance, the levels of BNP, DD, and Hcy in different risk grade APE patient groups and healthy control group were not exactly the same (all P<0.001), the BNP and Hcy levels of the high-risk group, medium-risk group, and low-risk group were higher than those of the healthy control group (all P<0.05), and the DD levels of the high-risk group and the medium-risk group were higher than those of the low-risk group and the healthy control group (all P<0.05). ROC curve analysis showed that the areas under the curves (AUC) of BNP, DD, and Hcy were 0.762, 0.583, and 0.644, respectively. When BNP, DD, and Hcy took 153.62 μg/L, 1.13 μg/L, and 15.24 μmol/L, they achieved the maximum diagnostic efficiency, with the sensitivity and specificity of 88.7% and 82.4% for BNP, 72.5% and 79.3% for DD, and 63.6% and 90.8% for Hcy. Spearman correlation analysis showed that the levels of BNP, DD, and Hcy were positively correlated with the risk classification of APE patients (r=0.736, 0.715, 0.628), with statistically significant differences (all P<0.05). Conclusion The levels of BNP, DD, and Hcy have important guiding significance in the clinical diagnosis and risk classification of APE. It is clinically recommended to perform these three tests at the same time for patients with suspected APE to obtain the best diagnostic accuracy.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.023 Objective To investigate the effects of Banxia Baizhu Tianma decoction combined with Tongdu Tiaoshen acupuncture method on TCM syndrome score of patients with posterior circulation ischemic vertigo (turbid phlegm disturbing orifices type). Methods From June 2017 to August 2019, 122 patients with posterior circulatory ischemic vertigo (turbid phlegm disturbing orifices type) were selected in our hospital. They were divided into observation group (n=61) and control group (n=61) according to simple randomization method. The control group was given betahistine hydrochloride sodium chloride injection, and the observation group was given Banxia Baizhu Tianma decoction combined with Tongdu Tiaoshen acupuncture on the basis of the control group. The efficacy, TCM syndrome score, peak blood flow velocity (Vs) of the vertebrobasilar artery during systole, vasoactive substance [thromboxane B2 (TXB2), 6-keto-PGF1α] before and 2 weeks after treatment were compared between the two groups. Results The total effective rate of the observation group was 91.80% (56/61), higher than that of the control group [77.05% (47/61)], with statistically significant difference (P<0.05). After 2 weeks of treatment, the TCM syndrome score of the observation group was lower than that of the control group, the Vs of the vertebrobasilar artery in the observation group was higher than that in the control group, with statistically significant differences (both P<0.05). After 2 weeks of treatment, the level of plasma 6-keto-PGF1α of the observation group was higher than that of the control group, the level of plasma TXB2 was lower than that of the control group, with statistically significant differences (both P<0.05). Conclusion Banxia Baizhu Tianma decoction combined with Tongdu Tiaoshen acupuncture has a significant effect on posterior circulation ischemic vertigo (turbid phlegm disturbing orifices type), which can effectively improve the symptoms of patients and increase the blood flow velocity of the vertebrobasilar artery.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.024 Objective To analyze the effect of amantadine combined with dalingfu on mental state and cognitive function of patients with Parkinson's disease. Methods A total of 122 patients with Parkinson's disease who were treated in our hospital from January 2017 to July 2019 were selected and were divided into the observation group (oral amantadine and dalingfu) and the control group (oral amantadine and levodopaand benserazide hydrochloride) by the random number table method. The clinical efficacy, mental status, cognitive function, symptom score, serum index, and adverse reactions of the two groups were observed. Results The effective rate of the observation group was 93.44% (57/61), which was higher than 78.69% (48/61) of the control group (P<0.05). After treatment, the MMSE score and MoCA score of the observation group were higher than those before treatment and those of the control group, and the UPDRS score was lower than that before treatment and that of the control group (all P<0.05). After treatment, serum levels of GSH-Px, SOD, DA, 5-HT, NE, and BDNF in the observation group were higher than those before treatment and those in the control group, and serum levels of MDA, IL-6, and IL-1β were lower than those before treatment and those in the control group (all P<0.05). During the treatment period, the total incidence of complications in the observation group was 11.48% (7/61), and 8.20% (5/61) in the control group, without statistically significant difference (P>0.05). Conclusion Amantadine combined with Dalingfu can effectively improve the cognitive function and mental state of patients with Parkinson's disease, and its effect may be related to the restoration of serum neurotransmitter levels.]]>