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    01 September 2022, Volume 28 Issue 17
    Literature Analysis
    Effectiveness and safety of molecular targeted drugs in treatment of refractory thyroid cancer: a meta-analysis
    Zhao Liuyan, Song Shoujun, Xue Haibo
    2022, 28(17):  2369-2376.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.001
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    Objective To systematically evaluate the effectiveness and safety of molecular targeted drugs in the treatment of refractory thyroid cancer by meta-analysis, and to provide valuable evidence-based medical information for clinical application. Methods The PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang Data, and SinoMed databases were searched for targeted therapy literatures of thyroid cancer from their establishment to April 13, 2022. The studies were screened, the basic data were extracted, and the risk of bias in the included studies was evaluated. The RevMan 5.4 software was used to perform meta-analysis. Results Eight studies were included. The total sample size of the experimental group, treated with molecular targeted drugs, was 1 201, and that of the control group, treated with placebos, was 748. Meta-analysis showed that, compared with placebos, molecular targeted drugs had a better objective response rate (ORR) (RR=14.19, 95%CI 4.12-48.93, P<0.000 1) and a disease control rate (DCR) (RR=1.40, 95%CI 1.20-1.63, P<0.000 1), and significantly improved the progression-free survival (PFS) of the refractory thyroid cancer patients (HR=0.35, 95%CI 0.25-0.51, P<0.000 01). The incidence of ≥grade 3 adverse events (AEs) in the experimental group was higher than that in the control group (RR=3.85, 95%CI 2.90-7.10, P<0.000 1). The most common AEs (≥grade 3) were diarrhea, hypertension, fatigue, palmar-plantar erythrodsesthesia syndrome, decreased appetite, and decreased weight. Conclusions Molecular targeted drugs have better clinical curative effects, and most AEs can be controlled by adjusting the dose and giving supportive treatment. Therefore, molecular targeted drugs can become a new option for refractory thyroid cancer.
    Risk factors of biliary infection after PTCD for patients with malignant obstructive jaundice 
    Wang Fengyan, Hou Jian, Zhang Daoqiang, Gong Qi, Liu Chuanjie, Han Zhihao
    2022, 28(17):  2377-2382.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.002
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    Objective To systematically assess the risk factors of biliary infection after percutaneous transhepatic cholangio drainage (PTCD) for patients with malignant obstructive jaundice. Methods The PubMed, Embase, Cochrane, Web of Science, CBM, CNKI, Wan fang, and VIP databases were searched for literatures from their establishment to April 2022. According to the selection and exclusion criteria, the relevant data were screened and extracted. The literatures' quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analysis was performed using the RevMan5.3 software. Results The 6 included literatures were all case-control studies, with 237 cases in the case group and 582 in the control group. The main risk factors of biliary infection after PTCD for malignant obstructive jaundice were biliary surgery history, grade C liver function before operation, extrabiliary drainage indwelling time >1 month, and the appearance of biliary restenosis. The combined OR values and 95%CI of the above factors were 4.42 (2.31-8.46), 11.62 (5.22-25.84), 8.39 (5.17-13.641), and 8.07 (1.86-34.98), respectively; the "age ≥60 years old" factor was not statistically significant; and the "location of biliary obstruction" factor was controversial. Conclusions Biliary surgery history, grade C liver function before operation, extrabiliary drainage indwelling time > 1 month, and the appearance of biliary restenosis are the main risk factors for postoperative biliary infection. The predictive value of age and location of biliary obstruction for postoperative biliary infection needs to be further explored. Healthcare workers should focus on these factors and take targeted precautions to reduce the incidence of postoperative biliary infection.
    Special Subject:Treatment for Glioma
    Role of ferroptosis in treatment of glioma
    Wang Ningning, Zhu Shuxia, Zhang Yuehua
    2022, 28(17):  2383-2385.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.003
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    Ferroptosis is a form of regulated cell death induced by iron-dependent lipid peroxide damage, and it is different from apoptosis, autophagy, and necrosis in molecular biology, morphology, and genetics. It plays an important role in the treatment of glioma, and induction of ferroptosis in glioma cells will become a new strategy for anti-tumor therapy. This article expounds the role of ferroptosis related genes, xCT, Nox4, NCOA4, and BECN1, in the treatment of glioma and the therapeutic effect of traditional Chinese medicine on ferroptosis in glioma, so as to provide new directions and ideas for the clinical treatment of glioma.
    Application of magnetic resonance DTI and B ultrasound in glioma resection
    Xu Gaoquan, Wang Yao, Jiang Zhuang, Zhu Ziyu, Xu Jialiang, Cui Bo, Yu Jianbo, Qian Bao
    2022, 28(17):  2386-2389.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.004
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    Objective To investigate the clinical effect of magnetic resonance diffusion tensor combined with B-ultrasound in glioma resection. Methods A total of 35 patients with low-grade glioma who were treated in Jiamusi Central Hospital from January 2020 to November 2021, including 18 males and 17 females who were (36.9±2.2) years old, were selected as an observation group. Resonance diffusion tensor and B-ultrasound were used for real-time guidance in the surgery for the observation group. And 35 patients who underwent conventional glioma resection during the same period were selected as a control group, including 16 males and 19 females who were (37.2±2.3) years old. The operation times, intraoperative blood loss, hospital stays, tumor localization accuracies, total surgical resection rates, and postoperative complications were compared between the two groups. Activities of Daily Living (ADL) scale and Karnofsky Performance Status (KPS) were used to evaluate the quality of life and health status of the two groups. The comparison of enumeration data and measurement data between the two groups was performed using χ2 and t tests. Results The operation time, intraoperative blood loss, and hospital stay in the observation group were less than those in the control group [(174.6±16.4) min vs. (220.3±18.3) min, (42.3±10.7) ml vs. (65.2±9.4) ml, and (10.2±2.4) d vs. (16.4±3.2) d], and the tumor localization accuracy and complete resection rate were higher than those in the control group [91.42% (32/35) vs. 65.71% (23/35) and 88.57% (31/35) vs. 62.86% (22/35)], with statistical differences (all P<0.05). There was no statistical difference in the incidence of postoperative complications between the two groups (P>0.05). Before the surgery, there were no statistical differences in the scores of ADL and KPS between the two groups (both P>0.05). After the surgery, the scores of ADL and KPS were significantly higher than those before the surgery in both groups, and were higher in the observation group than in the control group [(74.3±3.6) vs. (62.5±4.6) and (64.6±7.8) vs. (60.7±7.4)], with statistical differences (t=8.142 and 2.146, both P<0.05). Conclusion The application of magnetic resonance diffusion tensor and B-ultrasound in patients taking glioma surgery has accurate surgical positioning, and can effectively reduce intraoperative bleeding and hospitalization time and improve surgical efficiency, accuracy, autonomous activity, and quality of life
    Basic Research
    Effect of diamine glycyrrhizinate on CRP/TGF-β-mediated chronic hepatitis fibrosis 
    Huang Xiaoqu, Su Meixia, Yang Shichun, Cai Jie, Pan Jieting
    2022, 28(17):  2390-2395.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.005
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    Objective To study the effect of diamine glycyrrhizinate on chronic hepatitis fibrosis mediated by C-reactive protein (CRP) and transforming growth factor β (TGF-β). Methods From September to December 2021, 50 rats who were 8 weeks old and whose body weight was (200±20) g/mouse were randomly divided into a control group, a model group, a high-dose group, a medium-dose group, and a low-dose group, with 10 ones in each group. The chronic hepatitis fibrosis models were established using concanol protein A; high, medium, and low doses of enedrine glycyrrheate were administered by gavage. The control group and the model group were given equal doses of normal saline. The liver pathological changes and serum levels of CRP, alanine transaminase (ALT), aspartate transaminase (AST), hyaluronic acid (HA), laminin (LN), collagen Ⅰ (PC Ⅰ), collagen Ⅲ (PC Ⅲ) , and other fibro-related indicators were compared between these groups. The mRNA expressions of CRP, TGF-β, LN, PC Ⅰ, and PC Ⅲ in liver tissue were detected by polymerase chain reaction (PCR). The protein expressions of CRP, TGF-β, LN, PC Ⅰ, and PC Ⅲ in liver tissue were detected by Western Blot. The data were compared between two groups by t test, and between the 5 groups by one-way ANOVA. Results The levels of CRP, ALT, AST, HA, LN, PC Ⅰ, and PC Ⅲ in the control group were significantly lower than those in the model group [(7.34±1.19) mg/L vs. (121.98±1.37) mg/L, (48.32±16.92) U/L vs. (169.31±20.31) U/L, (29.28±18.12) U/L vs. (163.08±25.97) U/L, (7.98±1.23) mg/L vs. (17.39±1.39) mg/L, (73.20±11.08) μg/L vs. (119.34±14.98) μg/L, (8.09±1.57) μg/L vs. (27.46±2.05) μg/L, and (9.07±1.69) μg/L vs. (29.91±2.17) μg/L; all P<0.05]. Compared with those in the model group, the levels of CRP, ALT, AST, HA, LN, PC Ⅰ, and PC Ⅲ in the low-dose group, the medium-dose group, and the high-dose group decreased as the dose increased [(87.20±1.29) mg/L vs. (53.19±1.23) mg/L vs. (18.29±1.20) mg/L, (112.87±19.28) U/L vs. (87.29±18.78) U/L vs. (57.92±17.38) U/L, (139.98±23.09) U/L vs. (102.35±21.34) U/L vs. (78.98±19.87) U/L, (14.27±1.28) mg/L vs. (10.31±1.27) mg/L vs. (8.38±1.25) mg/L, (102.47±13.37) μg/L vs. (82.37±12.84) μg/L vs. (78.39±12.06) μg/L, (22.98±1.82) μg/L vs. (16.62±1.72) μg/L vs. (10.35±1.68) μg/L, and (23.23±1.79) μg/L vs. (17.45±1.78) μg/L vs. (12.57±1.72) μg/L], with statistical differences (all P<0.05). The mRNA and protein expressions of CRP, TGF-β, LN, PC Ⅰ, and PC Ⅲ in the control group were lower than those in the model group [(0.92±0.23) vs. (2.98±0.32) and (0.87±0.08) vs. (2.94±0.21), (1.19±0.17) vs. (3.29±0.29) and (1.09±0.07) vs. (3.02±0.23), (0.93±0.18) vs. (3.91±0.38) and (1.18±0.10) vs. (3.45±0.26), (1.02±0.22) vs. (4.32±0.32) and (1.08±0.08) vs. (3.96±0.28), and (1.23±0.19) vs. (4.23±0.29) and (1.13±0.10) vs. (3.32±0.23); all P<0.05]. Compared with those in the model group, the mRNA and protein expressions of CRP, TGF-β, LN, PC Ⅰ, and PC Ⅲ in the low-dose group, the medium-dose group, and the high-dose group decreased as the dose increased [(2.21±0.28) vs. (1.97±0.30) vs. (1.39±0.26) and (1.96±0.18) vs. (1.54±0.14) vs. (1.18±0.09), (2.94±0.24) vs. (2.09±0.27) vs. (1.49±0.20) and (2.18±0.21) vs. (1.86±0.19) vs. (1.28±0.14), (3.09±0.30) vs. (2.39±0.26) vs. (1.52±0.25) and (2.46±0.24) vs. (1.87±0.20) vs. (1.37±0.16), (2.93±0.28) vs. (1.82±0.24) vs. (1.28±0.20) and (2.08±0.28) vs. (1.76±0.24) vs. (1.29±0.13), and (3.21±0.25) vs. (2.19±0.28) vs. (1.47±0.24) and (2.87±0.20) vs. (2.09±0.19) vs. (1.21±0.11)], with statistical differences (all P<0.05). Conclusion A high dose of diamine glycyrrhizinate can alleviate liver fibrosis, and inhibiting the expressions of PCR and TGF-β is a possible molecular mechanism mediating this improvement.
    Protection of Astragaloside from intestinal ischemic/reperfusion injury in rats 
    Zhang Jing
    2022, 28(17):  2396-2399.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.006
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    Objectives To explore the protection of Astragaloside Ⅳ from intestinal ischemia reperfusion injury in rats and to observe its effect on the expression of vascular endothelial cell growth factor. Methods From January to June 2017, fourty-five male Wistar rats were divided into a surgery group (group A), an ischemia-reperfusion group (group B), and an Astragaloside Ⅳ group (group C), with 15 ones in each group. Laparotomy was operated in group A; the mesenteric arteries in group B and group C were clipped for 45 min; 10 min before the arteries were clipped, group C were intraperitoneally injected Astragaloside Ⅳ 6.0 ml·kg-1; 24 h later the rats were killed, and their intestine and serum tissues were detected; the intestine tissue was observed under light microscope after HE staining; serum diamine oxidase (DAO) and D-lactate were measured by enzyme-linked immunosorbent assay (ELISA); the expression of VEGF protein was detected by Western blot. One-way ANOVA was used for the comparison between the 3 groups. If P<0.05, there is a statistical difference. Results Compared to group B, group A and group C had milder intestinal villus damage and better intestinal villus arrangement. The serum levels of D-lactate in group A, group B, and group C were (1.24±0.08) μg/L, (7.41±1.07) μg/L, and (5.78±0.48) μg/L, and the DAO levels were (2.27±0.19) IU/ml, (9.36±1.03) IU/ml, and (6.82±0.52) IU/ml, respectively, with statistical differences between group B on one hand and group A and group C on the other hand and between group A and group C (all P<0.05). The expressions of VEGF in group B and group C were higher than that in group A, and that in group C was the highest. Conclusion Astragaloside Ⅳ protects intestine from ischemia reperfusion injury upregulating the expression of vascular endothelial cell growth factor.
    Scientific Research
    Establishment of a culture method for skin flora of human antecubital fossa and its application in assistance in diagnosis of atopic dermatitis 
    Zheng Minling, Luo Haimin, Feng Junhui, Zhang Yuncai, Lin Ying, Li Wenjun, Qu Pinghua
    2022, 28(17):  2400-2405.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.007
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    Objective To establish a method for the isolation and culture of antecubital fossa skin flora, and to investigate its application value in the assistance in diagnosis of atopic dermatitis (AD). Methods In this prospective experimental study, a total of 8 AD patients who met the Williams diagnostic criteria and 8 healthy volunteers were recruited. The skin specimens of the antecubital fossa were collected for the isolation and culture of skin flora. The effects of growth temperature, gas environment, pH value, salt concentration, and culture medium on the growth of skin flora were investigated to establish a culture method for human skin flora. Based on the established skin flora culture method, 34 AD patients who were (14.43±8.03) years old, including 21 males and 13 females, and 26 healthy volunteers who were (29.38±7.47) years old, including 12 males and 14 females, admitted to Department of Dermatology, Guangdong Provincial Hospital of Traditional Chinese Medicine from September 2019 to March 2020 were selected, and the skin specimens of the antecubital fossa were subjected to culture. MALDI-TOF mass spectrometry and 16S rRNA gene sequencing were used to identify and count all the bacteria growing in the fixed unit area on the medium. The differences in skin microbiome between the AD patients and the healthy volunteers and between the AD patients with lesional and non-lesional skin were compared by Kruskal-Wallis H test. Combined with the severity of local skin damage in the AD patients, the application value of quantitative Staphylococcus aureus count in the diagnosis of atopic dermatitis was discussed. Results The optimum growth temperature for the culture of human antecubital fossa skin flora was 28-32 ℃, the optimum pH was 6-7, and the optimum salt concentration range was 0.5%-5.0%. More bacteria species and quantities were detected in Columbia blood and Haemophilus chocolate agars. Comparison of quantitative bacterial culture results showed that the species diversity of antecubital skin bacteria in the healthy control group was generally higher than that in the AD patients (the AD skin lesions and non-skin lesions groups); the total distribution density of skin bacteria in antecubital fossa of the AD skin lesions group was significantly higher than those of the AD non-skin lesions group and the healthy control group (H=24.25, P<0.05; H=13.41, P<0.05). The proportion of Staphylococcus aureus detected in the patients with skin lesions was significantly positively correlated with the severity of AD (r=0.411, P<0.05). Conclusions Based on the above quantitative microbial culture method, the skin flora diversity data, especially the proportion of Staphylococcus aureus quantitatively cultured on Columbia blood agar, can be used as a microbiological index to evaluate the severity of skin lesions in AD patients, which is of great significance for guiding the clinical treatment and prognosis evaluation of AD.
    Is adenocarcinoma of esophagogastric junction an independent distinct entity? 
    Liu Junna, Liu Lijuan, Zhao Kaile, Niu Qiong
    2022, 28(17):  2406-2410.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.008
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    Esophagogastric junction (EGJ) carcinoma refers to a malignant tumor involving EGJ and within 5 cm from the proximal or distal part of EGJ. With the attention paid to Helicobacter pylori and the change of living habits, the incidences of gastric cancer and esophageal cancer have decreased, while the incidence of EGJ cancer is increasing year by year all over the world. Because this disease locates on the esophagus and stomach, that whether it is territory of the esophagus or stomach or an independent region has become a hot topic in recent years. This paper discusses the characteristics of different parts of the disease through its definition, etiology, risk factors, endoscopic characteristics, etc., so as to help clinical and scientific researchers have a deeper understanding of the disease and improve the cured rate.
    Theoretical basis and overview of Banxia Xiexin decoction in treatment of digestive diseases 
    He Wenguang, Liu Xiaoli, Xie Yicheng
    2022, 28(17):  2410-2413.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.009
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    A large number of studies have shown that Banxia Xiexin decoction can effectively treat and improve digestive diseases. This article reviews the application of Banxia Xiexin decoction and summarizes its clinical advances and mechanism, so as to provide necessary references and guidance for clinical practice and evidences for further research.
    Current status and influencing factors of medication adherence in patients with non-dialysis chronic kidney disease
    Bai Hehe, Jiang Minghuan, Peng Lirong, Nie Xiaojing, Wang Jinping, Ma Li, Xia Li
    2022, 28(17):  2414-2419.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.010
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    Objective To investigate the status of medication adherence in patients with non-dialysis chronic kidney disease (CKD) and analyze the influencing factors. Methods From January 2020 to December 2021, convenience sampling was used to select the non-dialysis CKD patients admitted to Xi'an Central Hospital as the research objects. A cross-sectional questionnaire survey was conducted with the General Data Questionnaire, 8-Item Morisky Medication Adherence Scale, Beliefs about Medicines Questionnaire, Multidimensional Scale of Perceived Social Support, and Hospital Anxiety and Depression Scale. Univariate analysis and multivariate logistic regression were used to analyze the influencing factors of medication adherence in the non-dialysis CKD patients. Results A total of 342 non-dialysis CKD patients were enrolled, including 185 males and 157 females, and they were (63.6±24.7) years old. The medication adherence score was (6.02±1.54), including 141 patients with low adherence (41.23%) and 201 patients with moderate or high adherence (58.77%). Multivariate analysis showed that the number of drugs, CKD stage, experience of adverse drug reactions, belief about medication, social support, anxiety, and depression were the influencing factors of medication adherence in the non-dialysis CKD patients (all P<0.05). Conclusions The status of medication adherence of non-dialysis CKD patients is still not ideal. Medical staff should take targeted intervention measures according to the key factors influencing adherence to improve their medication adherence and delay the progress of CKD.
    Oral hypoglycemic agents in outpatient pharmacy at some hospital from 2018 to 2020
    Hu Jun, Gao Yue
    2022, 28(17):  2419-2423.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.011
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    Objective To investigate and analyze the trend of oral hypoglycemic drug use in the outpatient department of Shanghai Songjiang District Central Hospital, and to provide references for clinical rational drug use. Methods The consumption sum, DDDs, and defined daily cost (DDC) of the oral hypoglycemic drugs in the outpatient pharmacy of Songjiang District Central Hospital from 2018 to 2020 were analyzed retrospectively using the defined daily dose (DDD) analysis recommended by the World Health Organization. Results From 2018 to 2020, the oral hypoglycemic drugs with top two Sales amounts in Shanghai Songjiang District Central Hospital were α -glycosidase inhibitors and biguanides, and the sales amount of dipeptidyl peptidase (DPP-4) inhibitors increased year by year. The drugs with top three DDDs were glimepiride, metformin, and acarbose. Metformin and acarbose showed the most significant decrease in DDC. Conclusions α-glycosidase inhibition, biguanides, and insulin secreting agents are still the first-line treatment drugs in Songjiang District Central Hospital, which meet the recommendation of guidelines. DPP-4 inhibitors have a great market prospect, and odium-dependent glucose transporters 2 (SGLT-2) will gradually emerge.
    Umbilical single-hole laparoscopy for pubertal adnexal torsion in adolescent women: report of 5 cases and literature review
    Ding Yan, Cui Sufen, Zhou Jie, Liu Haiyan
    2022, 28(17):  2424-2427.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.012
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    Objective To investigate the clinical effect of umbilical single-hole laparoscopy in the treatment of adnexal torsion in adolescent women. Methods The clinical effects of five adolescent women with adnexal torsion (tumor diameters of 9, 9, 5,10, and 9 cm) undergoing laparoscopic surgery at Hospital Affiliated to Yangzhou University from March 2018 to June 2021 were retrospectively analyzed. Results All the 5 patients achieved satisfactory clinical results. The laparoscopic single-hole laparoscopic treatment could completely remove the tumor wall and protect the ovarian function, with an aesthetic incision. Conclusion Laparoscopic single-hole laparoscopic treatment for adnexal torsion in adolescent women has advantages in terms of complete removal of tumors, protection of ovarian function, reduction of pain, and aesthetic incision.
    Prenatal ultrasound features and clinical prognosis of fetal umbilical artery occlusion
    Liu Yanfang, Liu Xiangjiao, Li Ling, Zhao Qin, Shang Ning
    2022, 28(17):  2428-2431.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.013
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    Objective To investigate the ultrasonic characteristics and pregnancy outcomes of fetal umbilical artery occlusion. Methods A total of 13 cases of fetal umbilical artery occlusion firstly found in Guangdong Maternal and Child Health Care Hospital or referred from other hospitals from January 2016 to December 2021 were analyzed retrospectively. The pregnant women were 19-38 (28.08±6.25) years old. The prenatal ultrasound characteristics were analyzed. The fetal outcomes were followed up. Results ⑴ Eleven cases were found in late pregnancy, and 2 cases in mid-pregnancy. Two umbilical arteries were found during pregnancy and one umbilical artery was found in the later stage. ⑵ Five cases were found that the fetal meridians were less than gestational weeks, 1 case had abnormal fetal structure, 1 case had racket-shaped Placenta, 1 case had umbilical cord wrapped around neck 2 times, 1 case had saccular distension of umbilical vein in abdomen, 1 case had decreased fetal heart rate, and the other 3 cases had no abnormality. ⑶ Six pregnant women chose timely termination of pregnancy or Cesarean section within 2 days. ⑷ Eleven fetuses survived, and 2 did not. Conclusions Fetal umbilical artery occlusion has obvious ultrasonic features. Only the time of delivery of umbilical artery occlusion is determined by the complications of premature delivery and the fetus conditions.
    Effects of ganglioside sodium combined with mild hypothermia on Fas/FasL signaling pathway and apoptosis of nerve cells in patients with severe craniocerebral injury
    Chen Guiping, Li Min, Tian Zhihua, Shen Jianbo, Cui Jie, Duan Haifeng, Zhang Hao, Ru Xiaohong
    2022, 28(17):  2432-2437.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.014
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    Objective To explore and analyze the effects of ganglioside sodium combined with mild hypothermia on the Fas/FasL signaling pathway and apoptosis of nerve cells in patients with severe craniocerebral injury. Methods A total of 118 patients with severe craniocerebral injury who were admitted to Jincheng People's Hospital from February 2020 to February 2022 were selected and divided into a control group and an observation group according to different treatment plans, with 59 cases in each group. Seven cases in the control group and 5 in the observation group died or dropped out of the research, resulting in missing clinical data. In the end, there were 52 cases in the control group, including 30 males and 22 females who were (35.69±3.14) years old, and 54 cases in the observation group, including 28 males and 26 females who were (35.77±3.20) years old. The control group were given conventional treatments, such as lowering intracranial pressure, protecting brain cells, anti-infection, and antispasmodic; in addition, the observation group were treated with ganglioside sodium and mild hypothermia. The clinical efficacies, Glasgow Coma Scale (GCS) scores, middle cerebral artery (MCA) blood flow velocities, tumor necrosis factor-α (TNF-α) in cerebrospinal fluid, Fas, Fas ligand (FasL), and caspase-9 (Caspase-9) protein before and after the treatment, and hospital stay were compared between the two groups. χ2 t, and F test were applied. Results The total effective rate and the hospitalization time were 82.69% (43/52)) and (44.05±13.52) d in the control group, and were 96.30% (52/54) and (35.36±14.11) d in the observation group, with statistical differences (χ2=5.271, P=0.022; t=3.236, P=0.002). The GCS scores 1, 2, and 4 weeks after the treatment were higher than those before the treatment in both groups, and were higher in the observation group than in the control group [(7.43±0.86) vs. (6.96±0.87), (8.58±0.99) vs. (7.54±1.02), and (10.58±1.24) vs. (8.98±1.12)], with statistical differences between these two groups (t=2.796, P=0.006; t=5.324, P<0.001; t=6.977, P<0.001). The MCA blood flow velocities 1, 2, and 4 weeks after the treatment were lower than those before the treatment in both groups, were (88.47±7.58) cm/s, (81.98±12.84) cm/s, and (72.87±12.84) cm/s in the control group, and were (85.33±8.10) cm/s, (75.45±14.15) cm/s, and (66.86±13.78) cm/s in the observation group, with statistical differences between these two groups (t=2.062, P=0.042; t=2.490, P=0.014; t=2.234, P=0.022). The levels of TNF-α, Fas, FasL, and Caspase-9 2 and 4 weeks after the treatment were (1.04±0.51) mg/L and (0.79±0.32) mg/L, (34.55±7.25) μg/L and (27.10±5.58) μg/L, (89.34±5.77) μg/L and (20.87±6.55) μg/L, and (23.54±5.47) pmol/L and (14.23±4.69) pmol/L in the control group, and were (0.83±0.41) mg/L and (0.36±0.12) mg/L, (40.14±8.20) μg/L and (10.35±4.14) μg/L, (102.47±5.78) μg/L and (17.53±5.28) μg/L, and (40.69) ±6.78) pmol/L and (8.69±0.25) pmol/L in the observation group; the levels of TNF-α, Fas, FasL, and Caspase-9 were lower 4 than 2 weeks after the treatment in both groups; 2 weeks after the treatment, the TNF-α level was lower and the levels of Fas, FasL, and Caspase-9 were higher in the observation group than in the control group; 4 weeks after the treatment, the levels of TNF-α, Fas, FasL, and Caspase-9 were lower in the observation group than in the control group; there were statistical differences (all P<0.05). Conclusion Ganglioside sodium combined with mild hypothermia in the treatment of patients with severe craniocerebral injury can improve their coma degree with outstanding clinical effect. It can inhibit cell apoptosis by acting on the process of neural Fas/FasL signaling pathway, shorten hospital stay, and get a good prognosis.
    IL-4, IL-6, IL-17, and TNF-α in diagnosis of different types of rheumatoid arthritis
    Zhang Tingting, Zhang Cheng, Niu Guanghua
    2022, 28(17):  2438-2442.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.015
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    Objective To explore the relationship between the serum levels of interleukin 4 (IL-4), interleukin 6 (IL-6), interleukin 17 (IL-17), and tumor necrosis factor α (TNF-α) and different traditional Chinese medicine syndrome types of rheumatoid arthritis. Methods It's a prospective study. A total of 100 patients with rheumatoid arthritis admitted to Hospital Affiliated to Liaoning University of Traditional Chinese Medicine from June to November 2021 were selected, and 60 healthy volunteers were included as a control group. The gender, ages, courses of disease, and other general data and the levels of IL-4, IL-6, IL-17, and TNF-α were compared between the groups. Chi square test, t test, and one-way ANOVA were applied. Results Among the 100 patients, there were 12 males and 88 females, and they were 36-72 (51.48±12.93) years old. In the control group, there were 14 males and 46 females, and they were 18-60 (52.27±13.21) years old. There were no statistical differences in the general data between the two groups (all P>0.05). Compared with those in the control group, the levels of IL-4, IL-6, IL-17, and TNF-α were all increased in the patients with liver-kidney deficiency syndrome, cold-damp arthralgia syndrome, damp-heat obstruction syndrome, and phlegm-stasis-arthralgia-blocking syndrome, with statistical differences (all P<0.05). The levels of IL-4, IL-17, and TNF-α were (8.27±2.20) pg/ml, (56.58±10.80) pg/ml, and (16.61±2.90) pg/ml in the patients with cold-damp arthralgia syndrome, which were higher than those in the other patients; the level of IL-6 was (95.28±16.20) pg/ml in the patients with damp-heat obstruction syndrome, which was significantly higher than those in the patients with liver-kidney deficiency syndrome, cold-damp arthralgia syndrome, and phlegm-stasis-bi-blocking syndrome [(57.54±12.04) pg/ml, (52.18±10.30) pg/ml, and (51.75±13.03) pg/ml; all P<0.001]. Conclusions The levels of serum inflammatory factors in patients with different syndromes of rheumatoid arthritis are different. The levels of IL-4, IL-17, and TNF-α in patients with cold-dampness arthralgia syndrome are the highest, and the level of IL-6 in patients with damp-heat obstruction syndrome was the highest, which may be used as the basis for clinical syndrome differentiation.
    Effect of comprehensive intervention and health education on inhaled drugs for patients with chronic obstructive pulmonary disease
    Li Jun, Pan Yanping, Wang Chunhua, Huang Qiang, Ding Hao, Zhou Yan, Zhou Liangtao
    2022, 28(17):  2442-2446.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.016
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    Objective To explore the application effect of comprehensive intervention and health education in inhaled drugs for patients with chronic obstructive pulmonary disease (COPD), and to guide the promotion of clinical work. Methods Fifty-six patients with COPD treated in Huangshi Fifth Hospital from May 2020 to October 2020 were selected as the research objects, and were divided into a study group and a control group by the random number table method, with 28 cases in each group. There were 21 males, 7 females, and 20 smokers in the study group, and they were (68.5±2.8) years old, with a disease course of (12.6±2.2) years. There were 23 males, 5 females, and 21 smokers in the study group, and they were (69.5±3.0) years old, with a disease course of (12.2±2.6) years. The control group chose the conventional method for guidance. On the basis of the control group, the study group applied the comprehensive intervention and health education management mode. The accuracies and compliance of inhaler use in the two groups after the intervention were evaluated. t and χ2 tests were applied. Results After the comprehensive intervention and health education management mode was adopted, the accuracy and compliance of inhaler use in the study group were higher than those in the control group [96.43% (27/28) vs. 64.29% (18/28) and 78.57% (22/28) vs. 42.86% (12/28)], with statistical differences (χ2=9.164 and 7.487; P=0.003 and 0.006). Conclusion Using comprehensive intervention and health education management mode to guide the use of inhalants in patients with chronic obstructive pulmonary disease can effectively improve the accuracy and their compliance, so it is worthy of clinical application.
    One case report and literature review of severe agranulocytosis induced by methimazole tablets
    Deng Xiaohong, Hunag Chaozhong , Liu Zhenjie, Luo Qiang, Li Tao, Hou Shizhao, Xu Ning
    2022, 28(17):  2447-2450.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.017
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    Objective To analyze the general rules and clinical characteristics of severe agranulocytosis caused by methimazole tablets. Methods Based on a case of severe agranulocytosis caused by methimazole tablets, the literatures on severe agranulocytosis caused by methimazole were collected from the databases of CNKI, Wanfang, and PubMed from their establishment to February 2022, and the general rules and clinical characteristics of which were statistically analyzed. Results A total of 44 literatures were included. A total of 49 patients were enrolled in this study, including 7 males (14.3%) and 42 females (85.7%), with age of (39.3±15.5) years and an average daily dose of (29.9±11.9) mg. The severe agranulocytosis usually occurred 1-3 months after medication and most patients were accompanied by high fever and sore throat. The symptoms of most patients improved after treatment, but some patients died of severe septic shock and respiratory failure. Conclusions Methimazole can cause severe agranulocytosis. Clinicians should keep a close eye on rational use of drugs so as to reduce and avoid severe agranulocytosis.
    Correlation of serum levels of miRNA-26b, Hcy, and β-APP with severity of Alzheimer's disease and the clinical significance
    Wang Wei, Zheng Liping, Chang Liguo, Guo Fushan
    2022, 28(17):  2451-2455.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.018
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    Objective To observe the serum levels of micronucleotide-26b (miRNA-26b), homocysteine (Hcy), and β amyloid precursor protein (β-APP) in patients with Alzheimer's disease (AD), and to analyzed their correlations with the severity of the disease and clinical significance. Methods Sixty-five patients with AD treated in Liaocheng Third People's Hospital from August 2019 to March 2022 were selected as an observation group, including 28 males and 37 females, and they were (75.61 ± 5.13) years old. According to the score of Global Deteriorate Scale (GDS), the patients were divided into a mild AD group (27 cases), a moderate AD group (21 cases), and a severe AD group (17 cases). Sixty healthy examinees in the same period were selected as a control group, including 31 males and 29 females, and they were (74.82 ± 5.27) years old. The serum levels of miRNA-26b, Hcy, and β-APP were detected. The data were analyzed by SPSS 23.0. The data were compared between 3 or more than 3 groups by one-way ANOVA, and between 2 groups by LSD-t test. The levels of serum indicators in the observation group, the control group, and the AD patients with different disease degrees were compared. The correlation between them and the severity of AD was analyzed. Results The serum levels of miRNA-26b, Hcy, and β-APP were (0.51±0.16), (21.45±6.29) μmol/L, and (92.57±28.60) ng/L in the observation group, and were (1.07±0.28), (15.07±4.38) μmol/L, and (51.54±9.27) ng/L in the control group, with statistical differences (all P<0.05). The serum levels of miRNA-26b, Hcy, and β-APP were (0.36±0.15), (26.27±5.62) μmol/L, and (102.72±26.47) ng/L in the severe AD group, were (0.58±0.14), (17.83±4.39) μmol/L, and (81.21±22.68) ng/L in the mild AD group, and were (0.54±0.15), (22.20±4.54) μmol/L, and (98.96±25.89) ng/L in the moderate AD group, with statistical differences between the severe AD group on one hand and the mild AD group and the moderate AD group on the other hand (all P<0.05). The scores of GDS, Mini-Mental State Examination (MMSE), and Activity of Daily Living Scale (ADL) were (6.22±0.43), (6.76±1.31), and (13.58±1.68) in the severe AD group, were (2.51±0.39), (23.47±3.19), and (24.10±1.37) in the mild AD group, and were (4.36±0.38), (16.24±2.55), and (18.93±1.59) in the moderate AD group, with statistical differences between the severe AD group on one hand and the mild AD group and the moderate AD group on the other hand (all P<0.05). Pearson correlation analysis showed that serum miRNA-26b was negatively correlated with GDS score, and positively with MMSE and ADL scores (r1=-0.613, r2=0.702, r3=0.536, all P<0.05); serum Hcy was positively correlated with GDS score, and negatively with MMSE and ADL scores (r1=0.608, r2=-0.549, r3=-0.625, all P<0.05); serum β-APP was positively correlated with GDS score, and negatively with MMSE and ADL scores (r1=0.720, r2=-0.568, r3=-0.489, all P<0.05). Conclusions In AD patients, the serum level of miRNA-26b decreases, and the levels of Hcy and β-APP increase. The severity of AD relates to the serum levels of miRNA-26b, Hcy, and β-APP; they participate in the progress of AD.
    Psychological distress status of patients with failure of first in vitro embryo transfer and their spouses and influencing factors
    Wei Qinhua, Shi Xian, Lu Hanmei, Ren Jianzhi
    2022, 28(17):  2456-2460.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.019
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    Objective To investigate the psychological distress of patients with failure of the first in vitro embryo transfer and their spouses and to analyze the influencing factors. Methods This study was a retrospective study. From September 2020 to September 2021, 160 couples who failed to undergo the first in vitro embryo transfer in 73rd Group Army Hospital of Chinese People's Liberation Army were selected as the research objects. They were divided into two groups according to the patients and their spouses. The General Data Questionnaire, Simple Psychological Status Questionnaire, Mental Resilience Scale, Simple Coping Style Scale, and Comprehending Social Support Scale were used to investigate the objects, and the results were compared. t test was used for statistical analysis. The correlation of psychological distress with the scores of psychological resilience, simple coping style, and understanding of social support was analyzed by Pearson correlation analysis. The influencing factors of psychological distress were analyzed by multiple linear regression. Results The psychological distress score was (22.48±6.81) in the patients, and was (19.57±6.38) in their spouses (P<0.05). Multiple linear regression analysis showed that age, infertility time, infertility type, and negative coping style were all risk factors for psychological distress of the patients and their spouses, while psychological resilience and social support were protective factors (all P<0.05). Conclusions Psychological distress of patients with failure of first in vitro embryo transfer and their spouse is common, and the patients' psychological distress degree is higher than their spouses'. Age, infertility time, infertility type, and negative coping style are all risk factors for psychological distress, while psychological resilience and social support are protective factors. Nursing staff can formulate targeted nursing interventions to help them effectively alleviate psychological distress.
    Treatises
    D-dimer level combined with thromboelastography in evaluation of coagulation dysfunction in patients with gestational hypertension
    Yu Zhenying, Qiu Caixiang
    2022, 28(17):  2461-2465.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.020
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    Objective To explore the application value of D-dimer (D-D) level combined with thromboelastography in the evaluation of coagulation dysfunction in patients with gestational hypertension. Methods A total of 100 patients with gestational hypertension who were admitted to People's Hospital of Economy and Technology Development Zone, Linyi from January 2020 to January 2021 were selected as the research objects of the observation group, and were divided into group A (68 cases; a pregnancy hypertension group) and group B (32 cases; a pregnancy hypertension coagulation dysfunction group) according to whether they were complicated with coagulation dysfunction or not. And 54 healthy puerperae without gestational hypertension and coagulation function were selected as the research objects of the control group (group N). Group A was (26.49±2.18) years old, group B (26.83±2.34), and group N (26.71±2.29). Independent-sample t test was used for the comparison between groups, and paired t test within group. The D-D levels, coagulation function indicators, and TEG parameters of the groups were observed, and their relationship with coagulation dysfunction in the patients with gestational hypertension was analyzed. Results The D-D level in group B was higher than that in group A [(1.09±0.22) mg/L vs. (0.85±0.10) mg/L], and the levels in both groups were higher than that in the control group [(0.42±0.07) mg/L], with statistical differences (all P<0.05). The TEG parameters K, R, CI, MA, Angle angle, and LY30 were (1.28±0.12) min, (4.08±0.39) min, (2.51±0.26), (69.15±7.02) mm, (69.73±7.02)°, and (1.07±0.24)% in group B, were (1.56±0.17) min, (4.23±0.44) min, (2.23±0.24), (67.05±6.23) mm, (68.39±6.85)°, and (0.98±0.11)% in group A, and were (1.93±0.21) min, (4.59±0.46)min [CI (1.47±0.13), (64.97±6.52) mm, (64.93±6.52)°, and (0.90±0.20)% in the control group, with statistical differences (F=24.015,7.875、37.050,4.190,4.181 and 2.020; all P<0.05). The coagulation function indicators PT, APTT, FIB, and TT were (10.64±1.08) s, (26.85±2.74) s, (3.91±0.38)g/L, and (16.28±1.64) s in group B, were (11.35±1.16)s, (24.53±2.84) s, (4.02±0.43) g/L, and (15.43±1.56) g/L in group A, and were (11.87±1.22) s, (14.98±1.51) s, (29.06±2.94) s, and (4.32±0.44) s in the control group, with statistical differences (F=7.067,3.853,6.582 and 6.663; all P<0.05). Compared with D-D and TEG alone, the combination of the two had a higher diagnostic value for coagulation disorders in the patients with gestational hypertension, with a statistical difference (P<0.05). Conclusions D-D is highly expressed and TEG parameters are abnormal in patients with gestational hypertension and coagulation dysfunction, suggesting that the above indicators may participate in the occurrence and development of coagulation dysfunction in patients with gestational hypertension. The joint test of the two has a high diagnostic value for coagulation dysfunction in patients with gestational hypertension.
    Relationship between serum levels of cTnI, NT-proBNP, and uric acid and prognosis in patients with acute heart failure
    Lai Chengzhe
    2022, 28(17):  2465-2470.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.021
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    Objective To explore the relationship between the levels of serum cTnI, NT-proBNP, and uric acid and the prognosis of patients with acute heart failure. Methods Eighty patients with acute heart failure were selected from Department of Cardiovascular Medicine, The Fourth Affiliated Hospital of Guangzhou Medical University from September 2020 to September 2021. The patients' general clinical data were recorded, and they were followed up for half a year. According to the occurrence of cardiovascular and cerebrovascular diseases in the past six months, the patients were divided into a poor prognosis group (35 cases; with cardiovascular and cerebrovascular diseases), including 19 males and 16 females who were (72.11±4.23) years old, and a good prognosis group (45 cases; without cardiovascular and cerebrovascular diseases), including 24 males and 21 females who were (72.67±4.28) years old. The influencing factors of prognosis were analyzed, and the predictive values of single and combined levels of serum cTnI, NT-proBNP, and uric acid on prognosis were analyzed. t test was used for the measurement data of normal distribution, and rank-sum test for the measurement data not of normal distribution. Results There were no statistical differences in the general clinical data between the two groups (all P>0.05). The serum levels of CTnI, NT-proBNP, and uric acid in the poor prognosis group were significantly higher than those in the good prognosis group (all P<0.05). The independent influencing factors in the poor prognosis group included serum NT-proBNP and uric acid levels. The predictive efficacy of serum cTnI for poor prognosis was as below: area under curve (AUC) was 0.757, sensitivity 0.657, and specificity 0.822. The AUC, sensitivity, and specificity of serum NT-proBNP for poor prognosis were 0.980, 0.943, and 0.956. The AUC, sensitivity, and specificity of serum uric acid level for poor prognosis were 0.830, 0.943, and 0.578, respectively. The AUC, sensitivity, and specificity of the combination of the three indicators for poor prognosis were 0.996, 0.971, and 0.956. Conclusions The levels of serum cTnI, NT-proBNP, and uric acid in patients with poor prognosis are significantly higher than those in patients with good prognosis. The levels of serum NT-proBNP and uric acid are independent influencing factors of poor prognosis. The three indicators can accurately predict the prognosis of patients with acute heart failure, and the combination of them has the highest predictive value for their prognosis.
    Effects of paravertebral nerve block combined with general anesthesia on postoperative recovery quality and analgesia in patients with middle and lower thoracic esophageal cancer
    Zheng Xianxia, Du Dongmei, Han Fengyang
    2022, 28(17):  2470-2473.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.022
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    Objective To investigate the effect of paravertebral nerve block combined with general anesthesia on postoperative recovery quality and analgesia in patients with middle and lower thoracic esophageal cancer. Methods According to the random number table method, 86 patients with middle and lower thoracic esophageal cancer admitted to Zaozhuang Chest Hospital from February 2020 to February 2021 were divided into a control group and an experimental group, with 48 cases in each group. The control group had 31 males and 12 females who were (54.18±6.26) years old, and received general anesthesia. The experimental group had 33 males and 10 females who were (55.18±7.26) years old, and received paravertebral nerve block combined with systemic anesthesia. Both groups were observed until 48 hours after the surgery. The postoperative recovery-related indicators, the Quality of Recovery-40 (QoR-40) scores 24 h after surgery, the scores of Ricker Sedation-Agitation Scale (SAS) and Visual Analogue Scale (VAS) 4, 24, and 48 h after the surgery, and incidences of postoperative adverse reactions were compared between the two groups. The measurement data were expressed as (x±s), and were tested by t test. The count data were expressed as [cases (%)], and were tested by χ2 test. Results The times for complete recovery of spontaneous breathing, calling and opening eyes, extubation, and orientation recovery were (3.42±0.74) min, (7.92±1.33) min, (6.92±1.25) min, and (11.15±1.24) min in the experimental group, and were (5.76±0.71) min, (11.33±1.52) min, (14.94±1.83) min, and (23.63±3.27) min in the control group (t=14.962, 11.071, 25.730, and 23.401; all P<0.05). Twenty-four hours after the operation, the QoR-40 scores of the experimental group were higher than those of the control group (all P<0.05). Four, twenty-four, and forty-eight h after the operation, the scores of SAS and VAS decreased in the two groups, and were lower in the experimental group than in the control group (all P<0.05). The incidence of postoperative adverse reactions was 20.93% (9/43) in the control group, and was 9.30% (4/43) in the observation group, with no statistical difference between the groups (P>0.05). Conclusion Paravertebral nerve block combined with general anesthesia for patients taking middle and lower thoracic esophageal cancer surgery can effectively shorten the postoperative recovery time, reduce pain, and improve postoperative recovery quality.
    Clinical Research
    Effect of Uphis products on wound repair after CO2 fractional laser surgery for depressed acne scar
    Qin Xiaomin, Li Jinjin, Zhu Zibo, Chen Qi, Kang Xu
    2022, 28(17):  2474-2478.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.023
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    Objective To observe, evaluate, and analyze the clinical effect of Uphis products on wound repair after CO2 fractional laser surgery. Methods A total of 60 patients who received CO2 fractional laser treatment from July 2018 to February 2019 in Department of Dermatology, Guangdong Provincial Hospital of Traditional Chinese Medicine were selected, and were divided into an observation group and a control group according to the nursing methods after surgery, with 30 cases in each group. The observation group had 13 males and 17 females who were (23.43±2.12) years old, and used Uphis multi-effect repairing liquid to spray their faces and revitalizing and soothing repairing masks after surgery every morning and evening for 20 minutes each time. The control group had 20 males and 10 females who were (23.63±3.54) years old, and sprayed their faces with normal saline and used normal saline masks after surgery every morning and evening for 20 minutes each time. Both groups were continuously treated for 7 days, and the patients' facial restoration was tracked for nearly 7 days. The measurement data were expressed as (x±s). The results of pain and itch index, the days for scars starting to remove, the total days of scar removal, and the days of missing work in the two groups were tested by t test. The clinical efficacies and the incidences of adverse reactions in the two groups were tested by chi square test. Results After the treatment, there was no statistical difference in the pain rating score between the observation group and the control group [(2.46±1.41) vs. (2.70±2.83), (t=0.401 8, P=0.534 0)]. The observation group had itching. The itch index score of the observation group was significantly lower than that of the control group [(0.36±0.70) vs. (1.73±0.62)], with a statistical difference (t=5.179 3, P=0.001 3). The days for scars starting to remove, the total days of scar removal, and the days of missing work in the observation group were significantly lower than those in the control group, with statistical differences (t=4.281 7, 5.067 3, and 4.073 5; all P<0.05). The nursing satisfaction of the observation group was significantly higher than that of the control group [96.67% (29/30) vs. 76.67% (29/30)], with a statistical difference (χ2=5.192 3, P=0.001 8). Conclusion Uphis products can effectively shorten the duration of facial erythema after CO2 laser surgery and the times of postoperative wound scab formation and removal, relieve itching, reduce the incidence of pigmentation, promote wound repair, and improve the treatment efficacy.
    Discussion of treatment regularity of acute pancreatitis based on keeping-six-hollow-organs-unobstructed theory 
    Wang Xiaoyu, Lin Zhanhong
    2022, 28(17):  2478-2480.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.024
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    Acute pancreatitis has a high incidence rate and a mortality rate. In order to improve the cured rate and reduce the mortality rate, comprehensive treatment of traditional Chinese and Western medicine is often used in clinic. This article summarizes the experience of traditional Chinese medicine in treating acute pancreatitis, mainly from the perspective of dialectical treatment, and takes the keeping-six-hollow-organs-unobstructed theory as the guidance to explore the role of the "unobstructed" method in treating acute pancreatitis.
    Observation on antibacterial test of a traditional Chinese medicine antibacterial lotion in vitro
    Zheng Chunchan, Tang Sanmei, Jiang Xiaoli, Zou Ruitao, Cai Guiyue, He Renliang, Tan Shuai, Zou Yanjun
    2022, 28(17):  2481-2484.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.025
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    Objective To explore the antibacterial effect of a traditional Chinese medicine compound preparation, Ze'er Fu Skin Bacteriostasis Lotion, and provide experimental basis for the clinical application of the lotion. Methods The antibacterial effects of 100.0%, 50.0%, 25.0%, and 12.5% Ze'er Fu Skin Bacteriostasis Lotion for 2, 5, 10, and 20 min on Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans were experimentally observed by the plate dilution method form september to November 2021 at Dermatology Hospital, Southern Medical University, with sterile saline as the blank control group. The data were expressed as (x±s). The experimental data were analyzed by variance analysis and correlation analysis. Results The antibacterial rates of 100.0%, 50.0%, 25.0%, and 12.5% Ze'er Fu Skin Bacteriostasis Lotion for 2, 5, 10 and 20 minutes on Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus,and Candida albicans were all over 90.0%. When 100.0% Ze'er Fu Bacteriostasis Lotion was used for 2, 5, 10, and 20 minutes, the antibacterial rates were (0.97±0.02), (0.99±0.03), (1.00±0.00), (1.00±0.00), respectively; when 50.0% Ze'er Fu Antibacterial Lotion was used for 2, 5, 10, and 20 minutes, the antibacterial rates were (0.95±0.02), (0.96±0.02), (0.97±0.01), and (0.98±0.01), respectively; when 25.0% Ze'er Fu Bacteriostasis Lotion was used for 2, 5, 10, and 20 minutes, the antibacterial rates were (0.93±0.01), (0.94±0.01), (0.95±0.01), and (0.97±0.01), respectively; when 12.5% Ze'er Fu Bacteriostasis Lotion was used for 2, 5, 10, and 20 minutes, the antibacterial rates were (0.92±0.01), (0.93±0.01), (0.93±0.01), and (0.95±0.02), respectively, there were statistical differences in the antibacterial rates between Ze'er Fu Skin Bacteriostasis Lotion with different concentrations for 2, 5, 10 and 20 minutes (F=5.947, 7.030, 52.993, and 8.912; all P<0.05). The correlation analysis showed that the antibacterial rate was positively correlated with the concentration of antibacterial lotion, and the Pearson correlation coefficients of action for 2, 5, 10, and 20 min were 0.769, 0.789, 0.950, and 0.806, respectively (all P<0.01). At the same concentration, there were no statistical differences between the antibacterial rate and strain species and durations of action (all P>0.05). Conclusion Ze'er Fu Skin Bacteriostasis Lotion has strong antibacterial effect on Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans, and the antibacterial effect increases with the concentration.
    Foot bath with Wenjing Huoxue Fang for diabetic peripheral neuropathy on lower limbs
    Wang Xuefeng, Zhao Yun, Song Yunping, Zhao Wenlu
    2022, 28(17):  2485-2488.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.026
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    Objective To observe the efficacy of foot bath with Wenjing Huoxue Fang in the treatment of diabetic peripheral neuropathy on lower limbs. Methods From April 2019 to October 2021, 172 patients with diabetic peripheral neuropathy on lower limbs treated at Jiaozhou Branch, Shanghai East Hospital, Tongji University were selected as the research objects, and were randomly divided into a control group and a treatment group, with 86 cases in each group. The control group had 44 males and 42 females who were 36-76 years old, and took conventional treatment and warm water foot bath. The treatment group had 46 males and 40 females who were 38-78 years old; on the basis of conventional treatment, they took foot bath with Wenjing Huoxue Fang. The symptom scores, nerve conduction velocities, and biochemical indicators before and after treatment and the clinical efficacies were compared between the two groups. The measurement data were expressed as (x±s), and compared by t test. The enumeration data were expressed as cases (%), and compared by χ2 test. Results The levels of fasting blood glucose (FBG), postprandial glucose (PBG), glycosylated hemoglobin (HbA1c), and low density lipoprotein cholesterol (LDL-C) were (7.56+1.23) mmol/L, (9.86±0.89) mmol/L, (7.13±0.56)%, and (3.05±0.57) mmol/L in the control group, and were (6.62+0.58) mmol/L, (7.97±1.02) mmol/L, (6.27±1.11)%, and (1.78±0.63) mmol/L in the treatment group, with statistical differences (all P<0.05). The total effective rate of nerve conduction velocity was 89.5% (77/86) in the treatment group, and was 69.8% (60/86) in the control group, with a statistical difference (χ2=10.366, P<0.05). The scores of traditional Chinese medicine syndrome and Toronto Scoring System were (10.21±1.23) and (2.21±0.18) in the control group, and were (8.15±1.28) and (1.01±0.38) in the treatment group, with statistical differences (t=10.761 and 26.466, both P<0.05). Conclusion Foot bath with Wenjing Huoxue Fang for diabetic peripheral neuropathy on lower limbs has ideal clinical efficacy, can improve the patients' nerve conduction velocity and biochemical indicator levels, and is conducive to the patients' recovery.
    Case Report
    Emergency surgery for duodenal stromal tumor bleeding after endoscopic and interventional treatment failure: a case report and literature review
    Pi Mingrun, Guo Ling, Cui Xijun
    2022, 28(17):  2489-2491.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.027
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    The incidence of duodenal stromal tumor is rare. Due to its special anatomical structure and incidence rate, there are few reports of emergency surgery for its life-threatening bleeding. This paper reports a case of duodenal stromal tumor bleeding who underwent emergency surgery after failed drug, endoscopic, and interventional therapies. No tumor recurrence was found after 2 years' follow-up.
    Nursing Research
    Effect of liquid dressing combined with transparent dressing in prevention and treatment of incontinence-associated dermatitis in severe adult patients
    Sun Hongxia, Liu Xinping, Shang Qingzhu, Zhong Qin, Yu Wenxia
    2022, 28(17):  2492-2495.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.028
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    Objective To investigate the effect of liquid dressing combined with transparent dressing in the prevention and treatment of incontinence associated dermatitis in adult severe patients. Methods This study was an experimental study. One hundred and fifty adult severe patients hospitalized in Department of Critical Care Medicine, Nanjing Jiangbei Hospital from January 2020 to December 2021 were randomly divided into an experimental group and a control group, with 75 cases in each group. In the control group, there 39 males and 36 females, they were (68.32±17.23) years old, and their APACHE Ⅱ score was (24.68±7.12). In the experimental group, there were 43 males and 32 females, they were (69.04±16.39) years old, and their APACHEⅡ score was (23.73±6.34). The control group were treated with liquid dressing after skin cleaning, and the experimental group with liquid dressing and transparent dressing. The cured rates of IAD, the incidences of pressure injury, the scores of perineal skin, the healing times, and the treatment costs were compared between these two groups. t test was used for measurement data, and Chi-square test for count data. Results The cured rate of IAD, perineal skin score after nursing, dermatitis healing time, and treatment related cost were 98.67% (74/75), (4.55±1.35), (4.69±1.95) days, and (70.19±28.28) yuan in the experimental group, and were 86.67% (65/75), (5.12±1.21), (5.78±2.11) d, and (168.48±68.29) yuan in the control group, with statistical differences between the two groups (all P<0.05). The incidence of pressure injury was 1.33% (1/75) in the experimental group, and was 5.33% (4/75) in the control group, with no statistical difference between the two groups (P>0.05). Conclusion The effect of liquid dressing combined with transparent dressing in the prevention and treatment of grade 0-1 IAD in severe adult patients is reliable and worthy of clinical application.
    Influence of health education based on micro-video on postpartum rehabilitation effect of primiparae
    Yang Yunmei, Fang Liqin
    2022, 28(17):  2496-2499.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.029
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    Objective To explore the effect of micro-video health education on the postpartum rehabilitation effect of primiparae. Methods A total of 60 primiparae admitted to Ruijin People's Hospital from March 2019 to March 2021 were selected as the study objects, and were divided into a control group and an observation group by the double-blind method, with 30 cases in each group. The control group were (30.34±2.22) years old, and received routine intervention. The observation group were (30.25±2.15) years old, and received micro-video health education based on the control group. The rehabilitation indicators, postpartum depression, sexual function, and pelvic floor muscle recovery were compared between the two groups. The measurement data were compared between these two groups by independent-sample t test, and were compared within the group by paired t test. The numeration data were compared by χ2 test. Results The time of uterine involution, durations of lochia and lactation, score of Edinburgh Postpartum Depression Scale (EPDS), and lactation amount were (7.02±1.02) weeks, (5.21±0.81) d, (2.71±0.32) d, (5.05±0.72), and (145.52±10.26) ml in the observation group, and were (8.01±1.15) and (7.36±1.05) d, (3.52±0.52) d, (7.65±1.02), and (123.21±9.15) ml in the control group, with statistical differences (all P<0.05). There were no statistical differences in the scores of orgasm, dyspareunia, libido, vaginal lubrication, sexual life satisfaction, and sexual arouse and total score between these two groups before the intervention (all P>0.05), and were after the intervention (all P<0.05). The postpartum recovery rates of pelvic floor muscle strength grade 3-5 were higher and the recovery rates of muscle strength grade 1-2 were lower in the observation group than in the control group [26.67% (8/30) vs. 6.67% (2/30), 33.33% (10/30) vs. 10.00% (3/30), 30.00% (9/30) vs. 6.67% (2/30), 3.33% (1/30) vs. 40.00% (12/30), and 6.67% (2/30) vs. 36.67% (11/30)], with statistical differences (all P<0.05). Conclusion Postpartum micro-video health education for primiparae can improve their postpartum related indicators, sexual function, and pelvic floor muscle strength, and the application effect is remarkable.
    Influence of midline venous catheterization on patients with intracranial infection undergoing intravenous therapy
    Li Meng, Guo Yuanli, Yang Caixia, Ma Keke, Zhang Lin
    2022, 28(17):  2500-2504.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.030
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    Objective To investigate the effect of midline venous catheterization on patients with intracranial infection who received intravenous therapy. Methods A total of 118 patients with intracranial infection who were admitted to The First Affiliated Hospital of Zhengzhou University from August 2019 to November 2021 were selected for the prospective study. According to the different methods of intravenous catheterization, they were divided into an indwelling needle group and a midline group, with 59 cases in each group. The indwelling needle group had 31 males and 28 females who were 39-75 years old, and peripheral-intravenously indwelled needles. The midline group had 36 males and 23 females who were 36-72 years old, and took midline venous catheterization. The puncture success rates, catheter placement, indwelling times, puncture times, complications, usage costs, and patient satisfaction were compared between the two groups. The indwelling time, puncture times, and cost were expressed as (x±s), and were compared between these two groups by independent-sample t test. The complications were expressed as cases (%), and were compared by χ2 test. The satisfaction was expressed as cases (%), and compared by rank sum test. Results Compared with the indwelling needle group, the midline group had a higher one-time success rate [91.52%(54/59),χ2=5.081,P<0.05] and lower catheter/indwelling needle slippage and accidental extubation rates [5.09%(3/59)、1.70%(1/59),χ2=4.236、11.670,all P<0.05]. The indwelling time in the midline group was longer than that in the indwelling needle group , and the number of punctures was lower than that in the indwelling needle group (t=133.261、50.935,all P<0.05). The total incidence of complications in the midline group was 3.39% (2/59), which was lower than that in the indwelling needle group 20.34% (12/59), and the patient satisfaction was higher than that in the indwelling needle group [96.61% (57/59) vs. 79.66% (47/59)]. There was no statistical difference in the cost between the two groups (t=0.445,P>0.05). Conclusion Compared with peripheral venous catheterizaiotn, midline venous catheterization can increase the catheter indwelling time, reduce the number of punctures and incidence of complications, and improve patient satisfaction without increasing the cost.
    Family-centered nursing intervention for patients with breast cancer undergoing chemotherapy by implantable venous port
    Xie Yingying
    2022, 28(17):  2504-2507.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.031
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    Objective To explore the effect of family centered care (FCC) on the complications and quality of life of breast cancer patients undergoing chemotherapy by implantable venous port (VPA). Methods This was a prospective study. Eighty breast cancer patients taking chemotherapy by VPA in Luoding People's Hospital from June 2018 to December 2020 were selected, and were divided into a control group and an observation group by the random number table method, with 40 cases in each group. The control group were 28-62 (48.65±5.68) years old, and the course of disease were 3~20 (8.13±2.42) months;The observation group were 26~63(49.37±5.75)years old,and the course of disease were 4~20 (8.35±2.16) months. The control group were routinely cared for 6 months; in addition, the observation group took FCC for 6 months. The self-care abilities [Self-Care Ability Scale (ESCA)] and qualities of life [Breast Cancer Patient Quality Of Life Scale (FACT-B)] before and after the intervention and the incidences of complications after catheterization were compared between the two groups. The measurement data were expressed as (x±s), and were compared between these two group by independent-sample t test and within the groups by paired t test. The enumeration data were expressed as rates (%), and were compared by χ2 test. Results After the intervention, the scores of ESCA and FACT-B in the observation group were higher than those in the control group [(140.73±11.28) vs. (121.26 ± 12.41) and (159.36 ± 12.84) vs. (123.50 ± 14.43)], with statistical differences (t=7.343 and 11.742, both P<0.05). The incidence of complications after catheterization in the observation group was lower than that in the control group [20.00% (8/40) vs. 2.50% (1/40)], with a statistical difference (χ2=4.507, P<0.05). Conclusion FCC can improve the self-care ability and quality of life of breast cancer patients undergoing chemotherapy by VPA, and reduce complications after catheterization.
    Summary
    Development and research of advanced practice nurses of cardiac rehabilitation 
    Shen Rongrong, Bai Yan, Zhou Wenqin
    2022, 28(17):  2508-2512.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.032
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    The secondary preventive nursing of cardiac rehabilitation led by advanced practice nurses shows positive results in the prevention and treatment of cardiovascular diseases and makes positive contribution to the high-quality management of chronic diseases. This article summarizes the development, clinical value, and future development mode of advanced practice nurses of cardiac rehabilitation at home and abroad, so as to provide references for the development of advanced practice nurses of cardiac rehabilitation in our country.
    Research progress on medication of resolvin D2
    Yang Lei, Tian Demin
    2022, 28(17):  2512-2515.  DOI: 10.3760/cma.j.issn.1007-1245.2022.17.033
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    Resolvin is a newly discovered endogenous proinflammatory mediator in recent years. Regressin D2 produces anti-inflammatory and analgesic effects by binding to its receptor G Protein-Coupled Receptors18. It has attracted more and more attention in inflammatory diseases, pain diseases, nervous system diseases, and other fields. It also shows excellent application prospects in other fields, such as respiratory system, digestive system, cardiovascular system diseases, and tumor diseases. It is expected to provide a new scheme for the development of new clinical drugs.