Table of Content

01 August 2022, Volume 28 Issue 15

Previous Issue   

Literature Analysis

Meta-analysis of risk factors of postoperative vascular crisis in patients after severed finger replantation

Liu Fengjing　Liu Huiwen　Wang Meiling　Chen Bizhen

2022, 28(15):  2073-2078.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.001

Asbtract ( )  

References | Related Articles | Metrics

Objective　To systematically evaluate the risk factors of vascular crisis after replantation of severed fingers. Methods　The databases Wanfang, CNKI, VIP, China Biomedicine, Web of Science, PubMed, and The Cochrane Library were searched from their establishment to April 30, 2022. According to the inclusion and exclusion criteria, two researchers independently screened the literatures, extracted the data, and evaluated the literatures. The Revman 5.3 software was used for the meta-analysis of risk factors. The results were expressed by odds ratio (OR) and 95% confidence interval (CI). When P≥0.1 and I²<50%, the fixed effect model was used for the meta analysis. When P<0.1 and/or I²≥50%, the random effect model was used for the meta analysis. Results　A total of 9 literatures were included, including 1 728 patients, and 303 patients had vascular crisis, and the incidence of vascular crisis was 21.26%. Meta analysis showed that gender (women) (OR=3.73, 95%CI 2.04-6.82, P<0.000 01), age < 12 years (OR=4.71, 95%CI 3.41-6.50, P<0.000 01), smoking history (OR=4.06, 95%CI 3.08-5.35, P<0.000 01), ischemic time > 10 hours (OR=3.04, 95%CI 1.52-6.07, P=0.002), cause of injury (crush avulsion injury) (OR=4.09, 95%CI 2.89-5.78, P<0.00001), and dissociation plane (distal segment dissociation) (OR=4.10, 95%CI 3.03-5.54, P<0.000 01) were the risk factors of vascular crisis after finger replantation. Conclusions　The incidence of vascular crisis after replantation of severed fingers is high. Targeted preventive measures should be taken for replantation patients such as female, young age, smoking history, long ischemic time, crush avulsion injury, and distal segment disconnection, so as to reduce the incidence of vascular crisis and improve the severed fingers' survival rate after replantation.

Acupoint selection rules of acupuncture and moxibustion in treatment of drug addiction withdrawal depression

Zhao Xiaorui, Li Jia, Che Hongxia, Zhang Xiong, Zhang Shengjie

2022, 28(15):  2079-2083.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.002

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the acupoint selection rules of acupuncture and moxibustion in the treatment of drug addiction withdrawal depression. Methods　Relevant clinical literatures of acupuncture and moxibustion for drug addiction withdrawal depression basing on searching Chinese and English databases were collected to establish the prescription database. SPSS 22.0 was used for descriptive analysis and cluster analysis, and SPSS Moderler 18.0 was used for association rule analysis to explore the characteristics and rules of acupoint application in the treatment of drug addiction withdrawal depression by acupuncture and moxibustion. Results　Based on the 28 included literatures, the results showed that acupuncture and moxibustion treatment for drug addiction withdrawal depression had a fixed collocation of acupoint compatibility, and the highest correlation group of acupoint confidence was Neiguan-Sanyinjiao-Shenmen and Zusanli-Sanyinjiao-Shenmen. Two clustering groups could be obtained by cluster analysis. Conclusion　Through data mining technology, it is found that acupuncture and moxibustion treatment of drug addiction withdrawal depression has certain rules, and Neiguan, Zusanli, Shenmen, and Sanyinjiao are the main acupoints of acupuncture and moxibustion in the treatment of drug addiction withdrawal depression.

Scientific Research

Effect of psoralen in reversing GST-π mediated multidrug resistance

Hua Yitong, Hou Changran, Zhang Haojie, Gao Xiaoyuan

2022, 28(15):  2084-2088.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.003

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the role of psoralen in reversing glutathione s-transferase π (GST-π) mediated multidrug resistance (MDR) and the possible mechanism in MCF-7/ADR cells. Methods　The research time was from 2015 to 2020. We measured the cell viability by CCK-8 assay to evaluate the cytotoxicity and MDR reversal activity of psoralen. The alteration in targeted genes was examined. The real-time polymerase chain reaction (RT-PCR) was used to detect the expression of GST-π. Western blot was used to analyze the level of GST-π protein. The immunofluorescence method was applied to observe the activation of NF-κB. The measurement data were compared by the independent-sample t test. If P<0.05. there is a statistical difference. Results　The intracellular adriamycin drug concentration increased significantly after psoralen treatment. Compared with those of the control group, psoralen reduced the expression of GST-π on the mRNA and protein levels in the treatment group. The NF-κB inhibitor (SN50) could significantly inhibit the expression of GST-π in breast cancer MCF-7/ADR cells. Conclusions　NF-κB signaling pathway may be one of the mechanisms of GST-π mediated MDR. Our results showed that psoralen involved in reversing GST-π mediated MDR. GST-π mediated drug resistance mechanism may be related to the NF-κB signaling pathways, and it may be the key factor of downstream in the NF-κB signaling pathways.

Research progress of PI3K/AKT/mTOR signaling pathway in pathogenesis of autoimmune diseases

He Chengyan, Ma Lei, Xue Haibo

2022, 28(15):  2089-2093.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.004

Asbtract ( )  

References | Related Articles | Metrics

Autoimmune diseases (ADs) are a kind of diseases caused by the disorder of immune tolerance and the immune response to autoimmune antigens. Recent studies have found that there are close relationship between the phosphatidylinositol-3-kinase/protein kinase B/target of rapamycin (PI3K/AKT/mTOR) signaling pathway and AD, mainly involved in immune cell proliferation and differentiation, inflammatory cytokine secretion, autophagy levels, and abnormal oxidative stress. This review focuses on the research progress of PI3K/AKT/mTOR signaling pathway in the pathogenesis of AD.

Clinical effect of dexmedetomidine and propofol combined with a low dose of esketamine in hysteroscopy

Du Shuping, Wang Xiaodong, Pan Hongxia, Meng Qingwei, Wang Weiwei, Yu Songyang, Wang Zhijuan

2022, 28(15):  2093-2097.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.005

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate clinical effect of dexmedetomidine, propofol, and a low dose of esmketamine in hysteroscopy. Methods　Niety-six female patients who were 18-60 years old and underwent gynecological hysteroscopic surgery in Weihai Municipal Hospital from January to December 2021 were selected, were divided into a control group (48 cases) and a study group (48 cases) by the random number table method. The control group was anesthetized with dexmedetomidine and propofol, and the study group with dexmedetomidine, propofol, and a low dose of esmketamine. The mean arterial pressures (MAP), heart rates (HR), and pulse oxygen saturations (SpO₂) when entering the room (T0), when the Ramsay score reached 5 (T1), at cervical dilation (T2), and when they woke up (T4) were observed and recorded. The dosages of propofol during operation, the recovery times after operation, and the occurrences of perioperative adverse reactions were recorded. The independent-sample t test, repeated measure ANOVA, and χ² test were applied. Results　At T1, the MAP, HR, and SpO₂ in the study group were obviously higher than those in the control group [(68.5±8.9) mmHg (1 mmHg=0.133 kPa) vs. (59.3±7.5) mmHg, (75.3±6.4) beats/min vs. (60.5±7.7) beats/min, and (98.5±0.6)% vs. (95.5±1.1)%; all P<0.05]; at T2, the MAP and HR in the study group were lower than those in the control group [(73.8±10.1) mmHg vs. (83.5±11.8) mmHg and (76.1±9.7) beats/min vs. (89.7±8.7) beats/min; both P<0.05]. The dosage of propofol in the control group was greater than that in the study group [(269.2±29.2) mg vs. (216.7±25.2) mg; t=9.430, P<0.001]. The recovery time in the control group was significantly longer than that in the study group [(6.9±1.3) min vs. (5.5±1.2) min; t=5.482, P<0.001]. The incidences of locomotor response and respiratory depression in the control group were significantly higher than those in the study group [25.0% (12/48) vs. 4.2% (2/48) and 31.2% (15/48) vs. 6.2% (3/48); both P<0.05]. There were no statistical differences in the incidences of postoperative nausea and vomiting and vertigo between the two groups (both P>0.05). Conclusion　The use of dexmedetomidine, propofol, and a low dose of esmketamine in gynecological hysteroscopic anesthesia has smooth circulation and breathing, rapid postoperative recovery, good controllability, and a low incidence of adverse reactions, with high clinical application value.

Performance verification of Getein1600 dry immunofluorescence quantitative analyzer in determination of procalcitonin#br#

Yu Jinqi, He Wei, Lin Qianqian, Chen Yingting, Ou Caiwen, Song Liting

2022, 28(15):  2098-2100.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.006

Asbtract ( )  

References | Related Articles | Metrics




Objective　To verify the performance of Getein1600 dry immunofluorescence quantitative analyzer in the determination of procalcitonin (PCT), to ensure the accuracy and reliability of the PCT assay results, and to provide quality assurance for clinical practice. Methods The precision, accuracy, and linear range of PCT assay via Getein1600 dry immunofluorescence quantitative analyzer were verified based on the requirements of the relevant Chinese industry guidelines (WS/T 420-2013) by collecting specimens from Clinical Laboratory, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine in August 2019 and designing the test. Results　The reproducibility standard deviations (S_r) were 0.01 and 0.59; the intermediate precisions (S_l) were 0.01 and 0.57; the relative bias (¯b_rel) between the investigated method and the reference method was 19.01; the linearity was established within the range of 0.10-36.81 μg/L, with a R² of 0.997 9. All the verification results were within the range in the Instructions for Use. Conclusion　Getein1600 dry immunofluorescence quantitative analyzer shows a good performance in PCT assay, and is suitable for the measurement of clinical samples.

Influence of perfusate in shoulder arthroscopy

Ma Mingliang, Lin Chao, Li Jian, Xu Chuang, Cao Heng, Wang Linwei, Zhang Lichao, Lin Zhenzhou, Liu Mingting

2022, 28(15):  2100-2103.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.007

Asbtract ( )  

References | Related Articles | Metrics

Shoulder pain is a common clinical symptom, and its possible causes of shoulder joint include osteoarthritis, shoulder sleeve related diseases, long head biceps tendon related diseases, glenoid joint instability, and other diseases. In the diagnosis and treatment of shoulder joint pain, shoulder arthroscopy is a commonly used diagnostic and therapeutic technique, and is increasingly used in clinical work. Arthroscopic shoulder surgery requires the use of a large amount of irrigation fluid, which is usually safe, but has an impact on the patients' physiological status and may present with serious complications, such as electrolyte changes and weight changes. This article reviews the research progress in this area.

Nerve root block combined with shock wave in treatment of cervical spondylotic radiculopathy

Jian Yanpeng, Zhou Jinge, Yue Xiaoxiang, Li Genfeng, Xu Songshan, Liu Weijie, Fan Jun, Wang Yigong

2022, 28(15):  2104-2108.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.008

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical effect of nerve root block and shock wave in the treatment of cervical spondylotic radiculopathy. Methods　From June 2019 to June 2020, 60 patients with cervical spondylosis radiculopathy treated in Xuchang Central Hospital were divided into a control group and a study group by lottery, with 30 cases in each group. There were 13 males and 17 females in the control group, and they were (41.09±4.41) years old. There were 14 males and 16 females in the study group, and they were (41.85±5.27) years old. The control group were treated with nerve root block, and the study group with shock wave and nerve root block. After the treatment, the clinical efficacies, scores of Visual Analog Scale (VAS), and neck disability indexes (NDI) of the two groups were compared and analyzed. Chi square test, independent sample t test, and ANONA were applied. Results　After 4 weeks' treatment, the total clinical effective rate of the study group was higher than that of the control group [86.7% (26/30) vs. 63.3% (19/30)], with a statistical difference (P<0.05). After 2 weeks' treatment, the scores of VAS of the two groups were lower than those before the treatment, and the score in the study group was lower than that in the control group [(2.93±0.54) vs. (3.84±0.79)], with a statistical difference (P<0.05); the NDI's of the two groups were lower than those before the treatment, and the NDI in the study group was lower than that in the control group [(23.03±2.74) vs. (26.55±1.87)], with a statistical difference (P<0.05). After 4 weeks' treatment, the score of VAS and NDI of the study group were lower than those of the control group [(1.29±0.44) vs. (2.23±0.85) and (13.76±2.33) vs. (19.77±4.42)], with statistical differences (both P<0.05). Conclusion　For patients with radiculopathy of cervical spondylosis, nerve root block or nerve root block combined with shock wave can alleviate their discomfort, but the latter is better on reducing their pain, so it is worth being clinically generalized.

Relationship between midline structure deviation degree and prognosis in patients with massive cerebral infarction after surgery

You Huichao, Sun Dengjiang, Ouyang Heping, Li Wenqi

2022, 28(15):  2108-2112.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.009

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the relationship between midline deviation degree before surgery and the prognosis after decompression for massive cerebral infarction and provide clinical references. Methods　A retrospective case-control study was conducted. According to the inclusion and exclusion criteria, the data of the patients with massive cerebral infarction treated at Hubei No.3 People's Hospital from October 2014 to October 2020 were collected to analyze the risk factors of death after decompressive craniectomy for massive cerebral infarction, and to study the relationship between the preoperative midline deviation degree and short-term death and long-term functional prognosis. SPSS 26.0 was used for the statistical analysis. t and χ² tests and Fisher's exact test were applied. The influencing factors of long-term Barthel index (BI) were analyzed. Multiple linear regression analysis was applied. Results　A total of 77 patients with massive cerebral infarction who underwent standard decompressive craniectomy were collected, and 39 patients were included at last, including 27 males and 12 females who were 39-86 years old, with an average of 58.7. The patients with a preoperative linear structure deviation less than 10 mm had an increased risk of death after decompression as compared with the patients with a preoperative linear structure deviation ≥ 10 mm [odds ratio (OR)=11.48, 95% confidence interval (CI) 1.12-118.14]. The patients whose Glasgow Coma Scale (GCS) score ≤7 had an increased risk of death after decompression as compared with the patients whose GCS score >7 (OR=13.12, 95%CI 1.41-122.43). Preoperative coma, GCS score, and the deviation degree of cerebral linear structure did not affect the long-term BI of the patients who survived after surgery. Age was one of the factors affecting the long-term prognosis of the survived patients after surgery. With the increase of age, the patients' BI decreased. Conclusions　Preoperative cerebral linear structure deviation <10 mm and GCS score ≤7 points are the risk factors of death after decompression for massive cerebral infarction. The preoperative deviation degree of cerebral linear structure does not affect the long-term functional recovery of survived patients after decompression.

Correlation between alcoholic osteoporosis and alcoholic liver disease

Wei Haitao, Liu Rui, Xun Wei, Wang Min, Liu Zhongyang, Zhang Wenlong, Wang Jing

2022, 28(15):  2113-2117.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.010

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the relationship between alcoholic osteoporosis and alcoholic liver disease and the pathogenesis. Methods　One hundred and twenty-two patients who had been drinking for over 5 years and who were treated at First Hospital and Second Hospital of Baotao Medical College, Inner Mongolia University of Science and Technology were retrospectively studied, and they were (40.0±14.6) years old. There were 82 males, who drank alcohol ≥ 40 g/d, and 40 females, who drank alcohol ≥ 20 g/d. The bone mineral density (BMD), liver function, osteocalcin, 25-hydroxyvitamin D [25(OH)D3], tumor necrosis factor α (TNF-α) were detected and liver color ultrasound examination was performed in all the patients. According to the BMD, liver function, and abdominal color ultrasound results, the patients were divided into an alcoholic osteoporosis group (35 cases), an alcoholic liver disease group (45 cases), and an alcoholic osteoporosis complicated with alcoholic liver disease group (42 cases). Forty-five healthy examinees of an age during the same period were selected as a healthy control group. SPSS 24.0 was used to analyze the data. t test was used for the measurement data. Results　The levels of osteocalcin in the alcoholic osteoporosis group, the alcoholic liver disease group, and the alcoholic osteoporosis complicated with alcoholic liver disease group were (24.73±3.66) μg/L, (27.34±2.94) μg/L, and (17.44±3.09) μg/L, and the levels of 25(OH)D3 were (22.47±2.82) μg/L, (25.63±3.84) μg/L, and (16.87±4.33) μg/L, which were lower than those in the healthy control group [(32.65±3.27) μg/L and (30.21±4.22) μg/L], and the levels of osteocalcin and 25(OH)D3 in the alcoholic osteoporosis complicated with alcoholic liver disease group were lower than those in the alcoholic osteoporosis group and the alcoholic liver disease group, with statistical differences (all P<0.05). The levels of osteocalcin and 25(OH)D3 in the alcoholic osteoporosis group were lower than those in the alcoholic liver disease group, but with no statistical differences (both P>0.05). The levels of TNF-α in the alcoholic osteoporosis group, the alcoholic liver disease group, and the alcoholic osteoporosis complicated with alcoholic liver disease group were (10.33±3.41) pg/ml, (13.23±4.02) pg/ml, and (16.94±3.92) pg/ml, which were higher than that in the healthy control group [(5.54±2.39) pg/ml], and the level in the alcoholic osteoporosis complicated with alcoholic liver disease group was higher than those in the alcoholic osteoporosis group and the alcoholic liver disease group, and the level in the alcoholic osteoporosis group was higher than that in the alcoholic liver disease group, with statistical differences (all P<0.05). Conclusions　We consider that alcoholic liver disease and alcoholic osteoporosis play a complementary role in the pathogenesis. Osteocalcin, 25(OH)D3, and TNF-α may be the common pathogenesis, which is not only the initial factor of the disease, but also the results.

Disinfection effects of four disinfection products on CT examination beds

Ren Yanmin, Wu Fengjiao, Li Ailan, Zhu Xin, Zhang Yu, Sun Lina

2022, 28(15):  2117-2121.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.011

Asbtract ( )  

References | Related Articles | Metrics

Objective　By using four disinfection products, to disinfect the CT examination beds, to compare their disinfection effects, bacterial colonies on the surfaces of the objects, and the economic cost, and to provide references for the convenient, effective, and economical disinfection method of clinical use. Methods　From April 2020 to January 2021, the CT examination bed surfaces at Hospital Affiliated to Heze Medical College, Heze Municipal Hospital and Dingtao District People's Hospital were wiped by quaternary ammonium disinfection wipes (199 samples), 75% alcohol wipes (194 samples), 500 mg/L chlorine disinfectant wiping (180 samples), and bed unit disinfection machine (82 samples) for surface disinfection. The disinfection effects after disinfection and the numbers of bacteria on the surfaces of the CT beds were compared, and the economic costs of the four disinfection methods were analyzed. The comparison between multiple samples was did by Kruskal-Wallis test; the counting data was expressed as a rate, and were compared by χ² test. Results　The qualified rates of quaternary ammonium disinfection wipes, 75% alcohol wipes, 500 mg/L chlorine disinfectant wiping, and bed unit disinfection machine were 98.99% (197/199), 98.45% (191/194), 99.44% (179/180), and 100.00% (82/82), respectively, with no statistical difference (χ²=1.882, P=0.597); and there was no statistical difference in the disinfection effects between the four disinfection products. The bacterial colony numbers after disinfection of the four disinfection products were 0.1(0.3) cfu/cm², 0.6(1.0) cfu/cm², 1.0(0.7) cfu/cm², and 0.0(0.1) cfu/cm², respectively, with a statistical difference (H=17.857, P<0.05); the removal effects from high to low were as below: bed unit disinfection machine, quaternary ammonium disinfection wipes, 75% alcohol, and 500 mg/L chlorine-containing disinfectant; the economic use costs from high to low were as below: bed unit disinfection machine (22.00 yuan/time) > 75% alcohol = 500 mg/L chlorine disinfectant (1.74 yuan/time) > quaternary ammonium disinfection wipes (1.25 yuan/time). Conclusion　After comparison, quaternary ammonium disinfection wipes have the advantages of reliable disinfection effect, simple and convenient operation, time saving, and low cost of use, and can be promoted in hospitals.

Prevalence of dental caries in 6-19 years old students in Shanwei, Guangdong Province 

Shen Yue, Fan Jiayi, Huang Qiuwei, Zhong Wenjia, Zheng Ting, Zhao Luodan, Cheng Huilin, Yang Zhiqian, Zhuang Peilin

2022, 28(15):  2122-2126.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.012

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the prevalence rate of dental caries, DMFT, and proportion of decay missing filling in 6-19 years old students in Shanwei, Guangdong Province, and to provide basic data for caries prevention in Shanwei. Methods　Using Multistage cluster sampling method, 5 110 students who were 6-19 years old were included from 2 primary schools, 2 middle schools, 2 high schools, and 1 vocational high school at urban area in Shanwei and 2 primary schools, 2 middle schools, 1 high school at Haifeng District, including 2 620 boys and 2 470 girls, and were detected for caries from October 10 to 16, 2021 and were statistically analyzed. t test, χ² test, and one-way ANOVA were applied. Results　The caries rate of deciduous teeth was 88.54% and the DMFT was (4.79±3.47) in the 6-9 years old group, and there were no statistical differences between the boys and the girls (both P>0.05). The caries rates of permanent teeth in the 6-9 years old group, the 10-12 years old group, 13-15 years old group, and 16-19 years old group were 10.13%, 41.41%, 61.56%, and 65.98%, respectively, and the DFMT's were (0.16±0.55), (0.85±1.30), (1.77±2.16), and (2.29±2.24), respectively, indicating that the caries rate of permanent teeth and DFMT increased with age; the prevalence rates and DFMT's were significantly higher in the girls than in the boys in all the groups (all P<0.05). The filling rates of deciduous teeth in the 6-9 years old group and the 10-12 years old group were 1.22% and 2.76%. The filling proportions of permanent teeth in the 6-9 years old group, the 10-12 years old group, 13-15 years old group, and 16-19 years old group were 18.03%, 29.90%, 38.01%, and 47.86%, respectively, indicating that the filling proportion of permanent teeth increased with age. Conclusion　The caries rate and DMFT of deciduous teeth in 6-12 year old students and those of permanent teeth in 6-19 year old students in Shanwei are relatively high, but the filling proportion is relatively low, so it is necessary to increase the public resources of oral health in this area and take reasonable and effective prevention and control measures to reduce the prevalence of dental caries in students.

Application of remote scientific rehabilitation guidance and education in hemiplegia rehabilitation

Meng Yunqing, Liu Guijuan, Fan Zhichao, Qi Hui, Bao Sarula, Zhu Runxiu

2022, 28(15):  2127-2131.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.013

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effects of different stages of stroke hemiplegia rehabilitation training combined with remote scientific rehabilitation guidance and education on the patients' limb motor function and daily living ability. Methods　Sixty-four patients with hemiplegia during the recovery period of stroke admitted to Rehabilitation Medicine Group, Department of Neurology, People's Hospital of Inner Mongolia Autonomous Region from September 2020 to August 2021 were selected and divided into a remote group and a conventional group, with 32 cases in each group. In the conventional group, there were 19 males and 13 females, with an age of (59.78±7.62) and a disease course of (28.63±12.45) days. In the remote group, there were 20 males and 12 females, with an age of (60.47±7.82) and a disease course of (27.47±13.96) days. Both groups received hospitalization rehabilitation for 4 weeks, and were transferred to communities and continued to receive community rehabilitation for 2 months. The conventional group received conventional rehabilitation treatment in the whole process. The remote group received conventional rehabilitation treatment and remote rehabilitation education and guidance in the whole process. Both groups were evaluated before and after the treatment in People's Hospital of Inner Mongolia Autonomous Region and during the 2-month follow-up of community rehabilitation. The simplified Fugl-Meyer Motor Assessment (FMA) was used to assess limb motor function, and the Functional Independence Measure (FIM) was used to assess daily living ability. Independent-sample t test, paired t test, and χ² test were used. Results　Four weeks after the treatment, the scores of FMA and FIM were higher than those before the treatment in the remote group [(49.31±11.18) vs. (29.03±9.18) and (62.90±12.60) vs. (37.75±10.99); both P<0.001] and in the conventional group [(43.81±11.84) vs. (26.78±9.65) and (53.56±13.44) vs. (38.09±11.64); both P<0.001], and were higher in the remote group than in the conventional group (P=0.038 and 0.003). After 2 months' community rehabilitation, the scores of FMA and FIM were significantly higher than those after the treatment in the remote group [(61.63±12.95) vs. (49.31±11.18) and (76.31±15.28) vs. (62.90±12.60) ; both P<0.001] and in the conventional group [(51.63±14.58) vs. (43.81±11.84) and (62.13±16.65) vs. (53.56±13.44); both P<0.001], and were higher in the remote group than in the conventional group (P=0.002 and <0.001). Conclusion　Different stages of rehabilitation training combined with remote scientific rehabilitation education and guidance can significantly improve the limb motor function and daily living ability of stroke patients with hemiplegia.

Medicine prescriptions and clinical efficacy of elderly diabetic patients complicated with hypertension in community health service centers

Chen Jingwen, Yang Zhiwen, Fang Weijun

2022, 28(15):  2132-2135.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.014

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the medicine prescriptions and clinical efficacy in elderly diabetic patients complicated with hypertension in community health service centers, and to provide references for the rational drug use for those patients in community health service centers. Methods　The medicine prescriptions and clinical efficacy in 355 elderly diabetic patients complicated with hypertension treated at Xiaokunshan Community Health Service Center from January to March 2021 were retrospectively analyzed. Among the 355 patients, there were 132 males and 223 females, and they were (77.98±5.42) years old. Results　The top 5 hypoglycemic agents for the 355 patients were sulfonylureas [60.6% (215/355)], biguanides [48.5% (172/355)], α-glycosidaseinhibitors [37.5% (133/355)], insulin [14.4% (51/355)], and thiazolidinediones [7.6% (27/355)], and the top 5 antihypertensive drugs were calcium antagonists [67.0% (238/355)], angiotensin Ⅱ receptor antagonists (ARB) [61.1% (217/355)], β-receptor blockers [6.7% (24/355)], angiotensin converting enzyme inhibitors (ACEI) [4.2% (15/355)], and diuretics [3.9% (14/355)]. The blood glucose qualified rate was 89.3% (317/355), and the unqualified rate 10.7% (38/355). The blood pressure qualified rate was 84.2% (299/355), and the unqualified rate 15.8% (56/355). Conclusion　The drug administration of elderly diabetic patients complicated with hypertension is reasonable in the community, and their disease condition control is basically stable, but some treatment cannot be followed and evaluated, some treatment effect is not qualified, and some irrational drug use is also found.

Application of continuous nursing in treatment of bromhidrosis by subcutaneous pruning through small incision combined with negative pressure suction and curettage

Yu Ting, Liu Xiaojia, Li Gaofeng, Ding Wei

2022, 28(15):  2136-2139.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.015

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of continuous nursing in the treatment of bromhidrosis by subcutaneous pruning through small incision combined with negative pressure suction and curettage. Methods　Eighty patients with bromhidrosis treated by small incision subcutaneous pruning combined with negative pressure suction and curettage in Outpatient Department, The First Affiliated Hospital of Hunan Normal University from May 2020 to May 2022 were selected. According to different nursing measures, the patients were divided into an observation group and a control group, with 40 cases in each group. There were 32 males and 8 females in the observation group, with an age of (25.5 ± 7.1); there were 10 cases of Park grade Ⅱ, 16 cases of grade Ⅲ, and 14 cases of grade Ⅳ. There were 32 males and 8 females in the control group, with an age of (25.2 ± 5.9); there were 11 cases of Park grade Ⅱ, 17 cases of grade Ⅲ, 12 cases of grade Ⅳ. The observation group implemented continuous nursing during the whole perioperative period, while the control group adopted routine nursing. One week after the operation, the patient satisfaction and complications of the two groups were calculated and compared.  Independent-sample t and χ² tests were applied. Results　The total satisfaction of the observation group was 97.5% (39/40), which was significantly higher than that of the control group [82.5% (33/40), with a statistical difference (χ²=5.100, P=0.025). There were only 2 cases of subcutaneous hematoma in the observation group, and the incidence of complications was 5.0% (2/40); there were 5 cases of subcutaneous hematoma, 3 cases of flap necrosis, and 1 case of infection in the control group, and the incidence of complications was 22.5% (9/40); the incidence of complications in the observation group were significantly lower than that in the control group (χ²=5.165, P=0.023). Conclusion　In the treatment of bromhidrosis by small incision subcutaneous pruning combined with negative pressure suction and curettage, the implementation of continuous nursing in the perioperative period can improve the patients' satisfaction, and reduce the incidence of surgical complications, so it is worth being clinically generalized.

Ruiyun procedure for hemorrhoids combined with Milligan-Morgan in treatment of mixed hemorrhoids

Zhang Chuanze, Yang Xiaozhao, Peng Ruyi, Xie Yongcan, Xing Zhuan, Chen Puqu

2022, 28(15):  2140-2143.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.016

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical effect of Ruiyun procedure for hemorrhoids (RPH) combined with Milligan-Morgan (M-M procedure) in the treatment of mixed hemorrhoids. Methods From January 1, 2016 to March 1, 2020, 145 patients with mixed hemorrhoids of grade Ⅲ to Ⅳ who were admitted to Department of General Surgery, Luoding People's Hospital were selected and divided into a control group and an observation group by the random number table method. The control group had 70 cases, including 30 males and 40 females who were (44.97±9.86) years old, and were treated with M-M procedure. The observation group had 75 cases, including 32 males and 43 females who were (45.83±10.27) years old, and were treated with RPH and M-M procedure. The therapeutic effects, perioperative indicators, incidences of adverse reactions, and recurrence rates of hemorrhoids were compared between these two groups. The independent-sample t and χ² tests were applied. Results　The operation time and wound healing time of the observation group were shorter than those of the control group (t=7.135 and 5.986, both P<0.05); the intraoperative bleeding volume of the observation group was significantly less than that of the control group (t=6.372, P<0.05). The total effective rate was 100.00% (75/75) in the observation group, and was 100.00% (70/70) in the control group, with no statitical difference (P>0.05). The incidence of complications during 3 months' follow up after the operation and the 6-month recurrence rate were 2.67% (2/75) and 1.33% (1/75) in the observation group, and were 10.00% (7/70) and 7.14% (5/70) in the control group, with statistical differences (χ²=3.345 and 3.081, both P<0.05). Conclusion　RPH combined with M-M procedure in the treatment of mixed hemorrhoids is effective and can effectively shorten the operation time and wound healing time, and reduce intraoperative bleeding volume, complications, and recurrence.

Effects of oral and nasal enteral nutrition supports for elderly patients 

Bao Qinwen, Gong Chen, Liao Jingxian, Bai Xueling

2022, 28(15):  2144-2149.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.017

Asbtract ( )  

References | Related Articles | Metrics

Objective　To compare the effects of oral nutritional supplements (ONS) and nasal feeding nutrition (NF), including nasogastric tube nutrition (NGT) and naso-jejunal tube nutrition (NJT), on nutritional support for elderly hospitalized patients (≥ 80 years old). Methods　One hundred and eight elderly patients admitted to the Geriatric Department, Respiratory Department, Emergency Department, Gastrointestinal Surgery Departmet, Hepatobiliary Surgery Departmet, Pepartment Neurosurgery Department, and Critical Medicine Department of Lianyungang Hospital, Jiangsu University from September 2018 to December 2021 were selected. The support of enteral nutrition (EN) was analyzed. According to the EN support methods, they were divided into an ONS group (50 cases, including 31 males and 19 females) and an NF group (58 cases, including 38 males and 20 females). The NF group included 40 cases in the NGT group and 18 cases in NJT group. The patients were 80-98 years old. The average age was 85.7 in the ONS group and 84.9 in the NF group. The EN support time was more than 14 days, and the intake of the amount of calories and nitrogen was the same. The serum prealbumin (PA), total protein (TP), albumin (ALB), hemoglobin (Hb), and red blood cell (RBC) counts, as well as inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), and tumor necrosis factor α (TNF-α)] and the immune indicators [CD3+, CD4+, CD8+, immunoglobulin (Ig) G, IgA, and IgM], were compared between the ONS group, the NGT group, and the NJT group. The SPSS 18.0 software was used for the data analysis, t test and F test for the measurement data, and χ² test for the counting data. If P≤0.05, there is a statistical difference. Results　There was no statistical difference in protein nutritional status between the three groups before EN support (P>0.05). After EN support, the levels of serum PA, TP, and ALB significantly increased (all P<0.05), the levels of CRP, IL-6, PCT, and TNF-α obviously decreased (all P<0.05), but the Hb and RBC count did not increase significantly (all P>0.05) in all the 3 groups. The IgG, IgA, IgM, CD3+, and CD4+ of the ONS group were higher than those of the NGT group and the NJT group at the same time points (all P<0.05), and the CD8+ was lower than those of the NGT group and the NJT group (both P<0.05). Fourteen days after the treatment, the incidences of diarrhea (6%, 3/50), reflux (8%, 4/50), and gastrointestinal bleeding (2%, 1/50) in the ONS group were statistically different from those in the NGT group and the NJT group (all P<0.05); and the incidences of vomiting (4%, 2/50) and recurrent pulmonary infection (4%, 2/50) in the ONS group were statistically different from those in the NGT group at the same time points (both P < 0.05), but were not statistically different from those in the NJT group at the same time points (both P > 0.05). Conclusions　In the EN support of elderly patients (≥ 80 years old), ONS and NF supports can effectively improve their protein nutritional status, and ONS has more significant effect. EN for elderly patients can significantly alleviate the disease severity, improve the levels of inflammatory mediators and oxidative stress, and reduce the incidence of complications, and has definite effect.

Comprehensive nursing intervention for patients with composite soft tissue defect of fingers repaired by free wrist striated perforator composite tissue flap

He Haizhen, Yang Yingyan, Wu Wenqiang, Guo Junguang, Liu Shihao, Yu Cheng,

2022, 28(15):  2150-2153.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.018

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the clinical effect of comprehensive nursing intervention patients with composite soft tissue defect of fingers repaired by free wrist striated perforator composite tissue flap. Methods　From April 2018 to June 2021, 62 patients with composite soft tissue defect of fingers repaired by free wrist striated perforator composite tissue flap at Dongguan First Hospital Affiliated to Guangdong Medical University were selected, and were divided into two a control group and an observation group by the random number table method, with 31 cases in each group. The control group had 24 males and 7 females who were (32.98±6.02) years old, and were routinely cared. The observation group had 25 males and 6 females who were (33.97±5.83) years old, and were routinely and comprehensively cared. The flap survival, hand function recovery, and nursing satisfaction were compared between the two groups. t and χ² tests were applied. Results　The pain scores of Visual Analogue Scale (VAS) 1 and 2 weeks after the intervention in the observation group were significantly lower than those in the control group (t=5.549 2 and 8.678 1, both P<0.05). The cured rate was 80.65% (25/31) in the observation group, and was 64.52% (20/31) in the control group, with no statistical difference (χ²=2.0261, P=0.085 7). The nursing satisfaction was 96.77% (30/31) in the observation group, and was 74.19% (23/31) in the control group (χ²=6.369 0, P<0.01). Conclusion　Comprehensive nursing intervention for patients with composite soft tissue defect of fingers repaired by free wrist striated perforator composite tissue flap can significantly reduce their VAS score, effectively prevent the occurrence of vascular crisis, promote the healing of skin flap, and improve the nursing satisfaction, so it is worth being clinical generalized.

Influencing factors of secondary sex ratio at birth after in-vitro fertilization and embryo transfer

Ni Yunping, Hong Ruifang, Lu Shan, Chen Xulong, Deng Xuemei, Yuan Qilong

2022, 28(15):  2154-2159.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.019

Asbtract ( )  

References | Related Articles | Metrics

Objectives　To explore the influencing factors of secondary sex ratio (SSR) at birth after in-vitro fertilization and embryo transfer (IVF-ET). Methods　The sex data of the babies delivered by the women treated by IVF-ET at Department of Reproductive Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2013 to June 2021 were collected. The SSR were analyzed by different embryo stages (cleavage stage or blastocyst stage), different fertilization methods [in vitro fertilization (IVF) or intracytoplasmic sperm insemination (ICSI)], and different sources of sperms (epididymal, testicular, or ejaculation). The data were analyzed by multivariate logistic regression analysis. The measurement data were analyzed by one-way ANOVA, and the enumeration data by χ² test and Fisher's exact test. Results　The overall SSR was 116∶100 (1 158∶998). The SSR's of cleavage-stage embryo transfer (1 310 deliver cycles) and blastocyst stage embryo transfer (433 deliver cycles) were 108∶100 (870/809) and 147∶100 (277/189), with a statistical difference (P<0.05). The SSR's of IVF treatment (1 306 cycles) and ICSI treatment (433 cycles) were 121∶100 (879/724) and 97∶100 (264/272), with a statistical difference (P<0.05). The SSR of sperms from puncture was 90.2∶100 (37∶41). There was no statistical difference in SSR between different sperm sources treated by ICSI (P>0.05). The SSR of sperms from testicular puncture was slightly higher than that of sperms from epididymal puncture. Conclusions　Blastocyst stage transfer might be associated with a higher SSR than cleavage stage embryo transfer. The SSR of embryos transferred from IVF treatment is higher than that of embryos transferred from ICSI treatment. The stage of transferred embryos is an independent risk factor for the SSR at birth.

Treatises

Prediction of severity and prognosis of patients with acute pancreatitis by helical CT perfusion parameters combined with serum D-dimer

Wang Ting, Li Wenwu, Zhang Guifeng

2022, 28(15):  2160-2165.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.020

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of spiral CT perfusion parameters combined with serum D-dimer (D-D) in the prediction of the severity and prognosis of patients with acute pancreatitis (AP). Methods　The clinical data of 117 AP patients were retrospectively analyzed, and these patients were divided into an MAP group (mild, 42 cases), including 25 males and 17 females who were (57.9±8.3) years old, an MSAP group (moderate, 37 cases), including 22 males and 15 females who were (58.6±8.1) years old, and an SAP group (severe, 38 cases), including 24 males and 14 females who were (57.4±8.7) years old, according to the disease severity, and were divided into a survival group (95 cases) and a death group (22 cases) according to the prognosis within 28 days after admission. All the patients underwent helical CT perfusion scan, and the serum D-D expression level was detected by immunolatex turbidimetry. The differences of perfusion related parameters, such as blood flow (BF), blood volume (BV), mean passing time (MTT), and surface permeability (PS), and serum D-D expression levels in each group were compared; the correlation of spiral CT perfusion parameters and serum D-D expression level with the patients' severity and prognosis was analyzed. The value of spiral CT scanning parameters combined with serum D-D in predicting the patients' severity and prognosis was analyzed. The count data and measurement data were compared by χ² and t tests. ANOVA was used for the comparison between the 3 groups. Results　There were statistical differences in BF, BV, and serum D-D expression level between the AP patients with different severities and prognosis (all P<0.05), and no in MTT and PS (P=0.405 and 0.283). With the exacerbation of the disease, the BF and BV significantly decreased (both P<0.05) and the serum D-D expression level significantly increased (P<0.05). The BF [(59.57±8.36) ml·100 g^-1·min^-1 vs. (87.06±23.59) ml·100 g^-1·min^-1] and BV [(6.05±1.87) ml/100 g vs. (15.82±8.63) ml/100 g] in the death group were significantly lower than those in the survival group, and the serum D-D expression level [(1.47±0.28) mg/L vs. (0.84±0.39) mg/L] was significantly higher, with statistical differences (t=9.755, 15.161, and 11.205; all P<0.001). BF and BV were negatively correlated with the patients' severity and prognosis (r=-0.573 and -0.585, both P<0.05); the serum D-D level was positively correlated with the patients' severity and prognosis (r=0.617, P<0.05), while MTT and PS were not significantly correlated with the patients' severity and prognosis (r=0.175 and 0.207, both P>0.05). The AUC, sensitivity, and specificity of BF and BV combined with serum D-D in predicting SAP and death were better than that of single indicator (all P<0.05). Conclusion　Spiral CT perfusion parameters (BF and BV) combined with serum D-D has important clinical value in predicting the severity and prognosis of AP patients.

Clinical Research

Clinical features of patients with hypertrophic pachymeningitis and increased serum IgG4 

Ye Jinlong, Zhang Weijing, Liu Baozhu, Li Bo, Pan Mengqiu, Kuang Zuying, Wang Zhanhang

2022, 28(15):  2166-2169.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.021

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical features of patients with hypertrophic perimeningitis and increased serum IgG4. Methods　Twenty patients with hypertrophic pachymeningitis and increased serum IgG4 who were hospitalized in Guangdong 999 Brain Hospital from January 2018 to January 2021 were collected, and their clinical data were retrospectively analyzed. Results　Among the 20 patients, there were 9 females and 11 males. The age of onset was (50.8±16.5). Their main clinical manifestations were headache [90.0% (18/20)], decreased vision [35.0% (7/20)], diplopia [25.0% (5/20)], tinnitus [25.0% (5/20)], fever [20.0% (4/20)], epilepsy [20.0% (4/20)], drooping eyelids [15.0% (3/20)], and limb weakness 10.0% (2/20). The enhancement of cranial MR in all the patients indicated that the dura mater was strengthened and the serum level of IgG4 was elevated. Conclusions　Hypertrophic pachymeningitis with elevated serum IgG4 has various MRI manifestations, mainly involving the dura mater, and could be combined with skull destruction and cerebral cortex infiltration damage. All patients considering the diagnosis of hypertrophic pachymeningitis should detect serum IgG4, and take meningeal biopsy if it is necessary to further confirm the diagnosis.

Relationship between serum semaphorin 4D and osteoporosis in people over 40 years old

Liang Huzhen

2022, 28(15):  2170-2174.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.022

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the relationship between serum soluble semaphore 4D (Sema4D) and osteoporosis in people over 40 years old at Shunde District, and to provide references for the early detection, diagnosis, and treatment of osteoporosis. Methods　A total of 174 patients with primary osteoporosis treated at Lunjiao Hospital at Shunde District from January to June 2021 were selected. The general clinical data, serum bone metabolism indicators [1,25 dihydroxy vitamin D (1,25(OH)₂VD), total type I collagen N-terminal propeptide (PINP), β-collagen degradation products (β-CTX), and osteocalcin (N-MID)], bone mineral density (BMD), and serum Sema4D were recorded. The patients were divided into an osteoporosis group (103 cases) and a non-osteoporosis group (71 cases), and the differences in the above indicators between these two groups were analyzed. And the patients were further stratified, and the differences between the patients with postmenopausal osteoporosis (70 cases), male osteoporosis (45 cases), and senile osteoporosis (83 cases) in the osteoporosis group and the non-osteoporosis group were analyzed. t and χ² test was applied. Results　The age and levels of β-CTX and N-MID were (74.058±10.179), (0.459±0.420) μg/L and (9.756±0.904) μg/L in the osteoporosis group, and were (58.296±12.052), (0.339±0.026) μg/L, and (9.290±1.425) μg/L in the non-osteoporotic group, with statistical differences (all P<0.05). The 1,25(OH)₂VD level and BMD were (64.348±13.310) nmol/L and (71.014±23.960) nmol/L in the osteoporosis group, and were (-3.748±1.208) and (-1.596±0.725) in the non-osteoporosis group, with statistical differences (both P<0.05).The age, PINP, β-CTX, and N-MID of the postmenopausal women in the osteoporosis group were significantly higher than those in the non-osteoporosis group, while the BMD was lower (all P<0.05). The age and β-CTX of the male osteoporosis group were significantly higher than those of the non-osteoporosis group, while the BMD, 1,25(OH)₂VD, and PINP were lower (all P<0.05). The PINP, β-CTX, and N-MID of the elderly osteoporosis group were higher than those of the non-osteoporosis group. The BMD of the elderly osteoporosis group was lower than that of the non-osteoporosis group (P<0.05). There were no statistical differences in the serum Sema4D levels between all types of primary osteoporosis patients in the osteoporosis group and the non-osteoporosis group (all P>0.05). Conclusion　There is no obvious correlation between serum Sema4D and osteoporosis in people over 40 years old at Shunde District. Further stratified analysis of primary osteoporosis did not find a correlation between serum Sema4D and osteoporosis. In the future, we should consider expanding the sample size and controlling related factors when including cases, in order to more objectively reflect the relationship between Sema4D and primary osteoporosis.

Functional training in conservative treatment of patients with lumbar disc herniation

Yang Xu

2022, 28(15):  2175-2177.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.023

Asbtract ( )  

References | Related Articles | Metrics

Case Report

Four cases of systemic lupus erythematosus complicated with lymphoma and literature review

Yang Caihong, Li Wanjun, Xiao Yunjian

2022, 28(15):  2178-2181. 

Asbtract ( )  

References | Related Articles | Metrics

This paper retrospectively analyzed the clinical data of 4 patients with systemic lupus erythematosus (SLE) and lymphoma, and the related literatures were reviewed to investigate whether there was a relationship between SLE and lymphoma, to provide experiences for the clinical practice in the future, and to avoid missed diagnosis and misdiagnosis. All the 4 patients were female, and were 47-61 years old. Among the 4 patients, 3 developed lymphoma with a SLE duration of 7-10 years, while lymphoma was detected in 1 patients just 3 months after being diagnosed as SLE. In terms of the outcomes of the 4 patients, 3 responded well to chemotherapy, but 1 abandoned therapy due to being in a critical condition and died finally. The clinical characteristics are quite similar between SLE and lymphoma, and they are hard to identify. This finding may suggest that more attention should be paid to the incidence of lymphoma when SLE patients suffer from fever, lymphadenopathy, or blood cell reduction, and taking effective treatment on this kind of patients early may contribute better life quality.

A case of contrast-induced encephalopathy with memory disorders caused by ioversol and literature review

Wang Wei, Zhao Zhanwei

2022, 28(15):  2182-2184.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.025

Asbtract ( )  

References | Related Articles | Metrics

Contrast-induced encephalopathy is a rare neurological complication after vascular interventional therapy. This paper reports a case of contrast-induced encephalopathy characterized by transient memory loss caused by ioversol, in order to provide some references for the diagnosis and treatment of this kind of situation in clinical work.

High intensity focused ultrasound ablation combined with clearing guided by ultrasound for one case of pregnancy on uterine wall

Zhang Xiuzhi, He Wei

2022, 28(15):  2185-2187.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.026

Asbtract ( )  

References | Related Articles | Metrics

One case of primary myelolipoma of the spleen and literature review

Hou Guoqi, Tang Yan

2022, 28(15):  2188-2189.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.027

Asbtract ( )  

References | Related Articles | Metrics

Primary myelolipoma of the spleen is very rare, and is slightly more common in middle-aged and elderly women. At present, only 2 cases have been reported in China. Radiologists and pathologists have not so much understanding of this disease, and preoperative imaging and postoperative pathology are easy to cause misdiagnosis. This article reports a case of primary myelolipoma of the spleen, which is helpful for us to improve the understanding of this disease.

Nursing Research

Case management and WeChat group management mode for patients with polycystic ovary syndrome

Zhang Yuhong, Deng Meilian

2022, 28(15):  2190-2193.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.028

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of case management and WeChat group management mode for patients with polycystic ovary syndrome (PCOS). Methods　Four hundred and twenty-six patients diagnosed with PCOS from August 2019 to June 2020 were managed by Gynecological Endocrine Nursing Clinic, Third Affiliated Hospital of Guangzhou Medical University. They were 18-41 years old. They were randomly divided into a control group and an experimental group by the double-blind method. The control group took the case management mode, and the experimental group the case management mode and WeChat group management mode. The application effects of the two groups were analyzed retrospectively. The data in both groups were statistically analyzed by SPSS 20.0 χ² test was 1 used for the count data ,and rank sum test for ranked data. Results　The mastery rate of PCOS knowledge, compliance (diet control rate, reasonable exercise rate, medication compliance rate, health behavior intervention rate, reasonable sleep rate, and rate of relieving psychological stress), and nursing satisfaction were 94.37% (201/213), 84.04% (179/213), 85.45% (182/213), 90.14% (192/213), 81.22% (173/213), 73.24% (156/213), 86.38% (184/213), and 93.42% (199/213) in the experimental group, which were significantly higher than those in the control group [82.63% (176/213), 62.91% (134/213), 54.93% (117/213), 82.63% (176/213), 72.30% (154/213), 58.22% (124/213), 78.40% (167/213), and 78.40% (167/213)], with statistical differences (all P<0.05). Conclusion　Case management and WeChat group management can achieve obvious results in improving self-management ability and compliance of PCOS patients, and provide more comprehensive treatment and care for PCOS patients and improve their quality of life, so it is worth being clinically generalized.

Influencing factors of urinary leakage in severe stroke patients indwelled with catheters 

Feng Xiaoyu, Deng Li, Pan Sihao, Cao Yingchun, Wu Xiaobing

2022, 28(15):  2193-2196.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.029

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the influencing factors of urinary leakage in severe stroke patients indwelled with catheters, and to put forward the treatment countermeasures. Methods　By consulting the literatures, the causes of urinary leakage in the patients indwelled with catheters were screened, mainly including the type, material, infection, blockage, and so on. The clinical data of 110 severe stroke patients indwelled with catheters in the neurological intensive care unit of First Hospital, Guangzhou Medical University from January 2018 to December 2020 were collected and statistically analyzed, and the influencing factors of leakage were explored. The measurement data were compared between two groups by t test and between more than two groups by ANOVA, and the univariate analysis was did. Results　Among the 110 patients, 22 had urinary leakage. The univariate analysis showed that there were no statistical differences between the patients with urinary leakage and the patients without urinary leakage in age, education level, gender, type of urinary catheter, amount of air bag injection, and diarrhea (all P > 0.05), and were in length of hospital stay, days of indwelling catheter, constipation, urine sediment, fever, gastric retention, and abdominal distension (all P<0.05). Logistic regression analysis showed that the length of hospital stay, the length of indwelling catheter, constipation, abdominal distention, and urinary sediment were the factors of urinary leakage. Conclusions　The incidence of urinary leakage in severe stroke patients indwelled with urinary catheters is high. We should do a good job in urinary catheter management and strengthen the control and prevention of factors causing urinary leakage, so as to reduce the incidence of urinary leakage.

Current situation and influencing factors of emergency nurses' core competence in disaster care in Guangdong Province

Liu Jianying, Li Xiaorong, Lan Jian, Deng Yongxiang, Yuan Ailan, Zhai Kangfa, He Jinghua

2022, 28(15):  2197-2202.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.030

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the current situation of emergency nurses' core competence in disaster care in Guangdong Province and to analyze the influencing factors. Methods　The convenience sampling method was used to select 286 nurses in the emergency departments in major hospitals in Guangdong Province from November 10, 2021 to November 20, 2021 as the study objects, including 45 males (15.7%) and 241 females (84.3%). There were 7 nurses (2.4%) under 20 years old, 100 (35.0%) between 20 and 29, 139 (48.6%) between 30 and 39, and 36 (12.6%) between 40 and 49. The General Information Questionnaire, Disaster Nursing Core Competence Questionnaire, and Nurses' Innovation Behavior Scale were used to investigate the nurses. t test, analysis of variance, and rank sum test were used for the univariate analysis. Pearson correlation analysis was used to analyze the correlation. Multiple linear regression analysis was used for the multivariate analysis. α=0.05 on both sides. The present situation and influencing factors of disaster nursing core competence were analyzed. Results　The total score of disaster nursing core competence of the 286 emergency nurses was (3.210±0.735). The univariate analysis showed that gender (t=3.049, P=0.003), age (t=4,159, P=0.003), marital status (t=6.285, P<0.001), years of working (t=3.508, P=0.008), and department position (t=5.091, P=0.007) were the influencing factors of disaster nursing core competence score. The results of multiple linear regression analysis showed that age (t=2.766, P=0.006) and innovation ability (t=15.902, P<0.001) were the main factors that affected the core competence of emergency nurses in disaster nursing, which could explain 52% of the total variation. Conclusions　The core competence of disaster nursing of emergency nurses in Guangdong Province needs to be improved. Emergency nursing managers should establish and optimize disaster rescue teams according to the actual situation, and strengthen the cultivation of emergency nurses' core competence of disaster care and innovation ability, so as to improve the quality of disaster rescue.

Investigation Report

Myopia prevention and control knowledge and prevention behaviors of adolescent parents

Wu Min, Yu Na, Zhai Xiangjuan, Fu Te, Huang Shuo, Wang Lingyun

2022, 28(15):  2203-2208.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.031

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the myopia prevention and control knowledge and behaviors of adolescent parents, and to guide the prevention and treatment of myopia in adolescents. Methods　A cross-sectional survey method was used to select the adolescent parents who brought their children for vision diagnosis and treatment in Eye Clinic, Jinan Second People's Hospital from August 2021 to January 2022. And the parents' general information was investigated by the General Information Scale. The Adolescent Parents' Myopia Prevention Cognition Questionnaire and Parents' Myopia Prevention Behavior Questionnaire designed by the senior physicians in Eye Clinic, Jinan Second People's Hospital were used to investigate the knowledge and prevention behaviors of the adolescent parents on myopia prevention and control. The data were analyzed by SPSS 22.0, and compared between the groups by χ² test. Results　A total of 664 adolescent parents were surveyed, including 292 males (45.06%) and 356 females (54.94%), and 648 valid questionnaires were obtained; 69 (10.65%) were <30 years old, 439 (67.75%) 30-40 years old, and 140 (21.60%) >40 years old; 66 ones' education level was junior high school or below (10.19%), 351 ones' high school or technical secondary school (54.17%), and 231 ones' junior college or above (35.65%). According to the presence or absence of myopia in the children, the parents were divided into a myopic adolescent parent group and a normal vision adolescent parent group. The aware rates of "the reading light intensity at night should be ≥200 Lux", "the writing distance, the distance from the chest to the table, and the distance from the book to the eyes should be kept at 3.3 cm, 6.0-7.0 cm, and 33.0 cm, respectively", "even if desk lamp lighting is used, the incident light should be from the opposite side of the dominant hand", "vision training can delay the increase of myopia diopter", "wearing overcorrected myopia glasses can aggravate the progression of myopia", "refractive surgery is an effective way to correct the vision of people ≥18 years old with stable diopter, but reasonable expectations should be maintained", and "every day outdoor activities or physical exercise for 1 to 2 hours helps prevent myopia" in the myopic adolescent parent group were lower than those in the normal vision adolescent parent group [69.21% (281/406) vs. 76.86% (186/242), 55.17% (224/406) vs. 71.07% (172/242), 74.88% (304/406) vs. 85.95% (208/242), 77.09% (313/406) vs. 84.30% (204/242), 79.80% (324/406) vs. 89.26% (216/242), 74.14% (301/406) vs. 81.82% (198/242), and 88.18% (358/406) vs. 93.80% (227/242)], with statistical differences (χ²=4.405, 16.133, 11.212, 4.879, 9.756, 4.614, and 5.465; all P<0.05). There were statistical differences in the prevention behaviors, such as "the parents regularly urge or bring their children to the ophthalmology institutions to check their vision", "the parents often urge their children to maintain good sleep", "the parents often urge their children to go outdoors", "the parents often supervise their children to maintain good eye habits", "while they live together, the parents control the teenagers' screen time", "the parents frequently discuss or share topics related to the hazards and prevention of myopia with teenagers", "compared with good eyesight, the parents insist on excellent academic performance and put it into action", etc. between these two groups (all P<0.05). Conclusions　The parents of adolescents who received the questionnaire survey in Jinan Second People's Hospital were not optimistic about the awareness rate of knowledge related to myopia prevention. Parents of normal vision adolescents are better than parents of myopia adolescents in knowledge awareness rate and myopia prevention behaviors.

Summary

Progress in endoscopic diagnosis of early gastric cancer

Zhao Ailing, Liu Yipin

2022, 28(15):  2209-2214.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.032

Asbtract ( )  

References | Related Articles | Metrics

China is a country with a high incidence of gastric cancer with high morbidity and mortality. Early detection and diagnosis can reduce the mortality of gastric cancer and improve the patients' prognosis. The detection and diagnosis of early gastric cancer are highly dependent on gastroscopy screening, but the screening of early gastric cancer by traditional white-light endoscopy has some limitations. With the rapid development of science and technology, more and more new endoscopic imaging techniques have been applied. This paper reviews the application value of multiple endoscopy techniques in the diagnosis of early gastric cancer.

Application progress of ultrasound-guided nerve block in obstetrics and gynecology open surgeries

Wang Pengfei, Zhao Xi, Zhang Chenxi, Pan Xin, Zhang Yong

2022, 28(15):  2215-2219.  DOI: 10.3760/cma.j.issn.1007-1245.2022.15.033

Asbtract ( )  

References | Related Articles | Metrics

Women are more sensitive to pain, and the trauma of open surgery is big. Most patients will experience moderate to severe pain after some obstetrics and gynecology surgeries, so the demand for analgesia is high. Nerve block can block the injurious stimulus from the injury site, and is widely used in auxiliary anesthesia and perioperative analgesia in various operations to relieve postoperative pain and reduce the amount of opioids. In recent years, with the continuous development of ultrasound technology, the reliability and safety of nerve block have been greatly improved. Therefore, this paper reviews the common ultrasound-guided nerve block methods in obstetrics and gynecology surgeries, and briefly describes their blocking methods and application progress, so as to provide relevant references and basis.