Table of Content

01 January 2022, Volume 28 Issue 1

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Special Subject:Cerebrovascular Diseases

Gastrodin exerts neuroprotective effect on stroke rats by regulating miR-155-mediated Notch pathway

Liu Zhen, Zhang Lei, Hu Canfang, Luo Guojun, Tang Dingzhong

2022, 28(1):  2-7.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.001

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Objective　To explore the protective effect of gastrodin on the nerves of stroke rats and its mechanism. Methods　From January 2020 to March 2021, 94 healthy clean SD rats whose body weight were (250±10) g were divided into a sham operation group, a model group, a low-dose gastrodin group (50 mg/kg), a medium-dose gastrodin group (100 mg/kg), and a high-dose gastrodin group (150 mg/kg). The rats' nerve function was scored by Longa; the brain water content was calculated by weighing; 2, 3, 5-triphenyltetrazolium chloride (TTC) staining was used to observe the cerebral infarction; the morphology of neurons in hippocampus was observed by hematoxylin eosin (HE) staining; the activities of Caspase-3 and caspase-9 were determined by colorimetry; real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of microRNA-155 (miR-155); and Western blot (WB) was used to detect the expression of Notch1 and its ligand Jagged1. The measurement data of normal distribution were expressed as (x±s), and were compared between 3 or more than 3 groups by one-way ANOVA and by SNK-q test between two groups. If P<0.05, there is a statistical difference. Results　Compared with those in the sham operation group, the neurological function in the model group was seriously damaged; the brain water content, cerebral infarction rate, and activities of Caspase-3 and caspase-9 were significantly increased; the expression of miR-155 in the brain was significantly increased; and there were no statistical differences in the expressions of Notch1, Jagged1, and Hes1 (all P>0.05). Compared with those in the model group, the neurological function in the low, medium, and high dose gastrodin groups was reduced; the brain water content [(81.52±2.19)%, (80.39±2.24)%, and (79.33±2.05)% vs. (87.44±2.56)%], cerebral infarction rate [(24.66±2.35)%, (20.87±2.06)%, and (15.65±1.54)% vs. (32.15±3.59)%], and activities of Caspase-3 [(2.48±0.31), (2.12±0.27), and (1.43±0.21) vs (3.27±0.42)] and Caspase-9 [(2.05±0.25), (1.76±0.20), and (1.23±0.16) vs. (2.79±0.36)] were significantly decreased, the expression of miR-155 [(2.15±0.18), (1.97±0.16), and (1.63±0.15) vs. (2.64±0.27)] in the brain was significantly decreased, and the expressions of Notch1 [(0.77±0.13), (0.84±0.16), and (0.95±0.18) vs. (0.42±0.09)], Jagged1 [(0.68±0.10), (0.73±0.15), and (0.87±0.16) vs. (0.38±0.06)], and Hes1 [(0.81±0.12), (0.93±0.15), and (1.07±0.17) vs. (0.43±0.07)] were significantly increased. Conclusion　Gastrodin can down-regulate the expression of miR-155 and activate Notch pathway, and protects the nerves of stroke rats.

Application of territorial arterial spin labeling in perfusion assessment of ischemic cerebrovascular diseases

Zhou Jianguo, Fu Dayong, Liu Xiaoli

2022, 28(1):  8-10.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.002

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Territorial arterial spin labeling (tASL) is a new magnetic resonance brain perfusion imaging technology gradually developed and popularized in recent years. The difference from the whole brain perfusion imaging method is that tASL can selectively label single or multiple blood supply arteries, display blood perfusion information within brain parenchyma area, and determine responsible blood supply arteries. This article reviews the clinical application of tASL in ischemic cerebrovascular diseases.

Correlation between gene polymorphism of CYP2C19 and clopidogrel resistance in patients with acute cerebral infarction in Hohhot area

Fu Hongxia, Fu Yongwang, Li Pan

2022, 28(1):  11-14.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.003

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Objective　To observe the correlation between the gene polymorphism of CYP2C19 and clopidogrel resistance in patients with acute cerebral infarction. Methods　From May 1, 2018 to October 30, 2019, 181 patients with acute cerebral infarction treated at Department of Neurology, Inner Mongolia People's Hospital were included, including 105 males and 76 females, and they were 43~85 years old. The CYP2C19 genotypes were divided into an extensive metabolism type (CYP2C19*1/*1), an intermediate metabolism type (CYP2C19* 1/*2 and CYP2C19*1/*3), and a slow metabolism type (CYP2C19*2/*2, CYP2C19*2/*3, and CYP2C19*3/*3). The patients' age, smoking, alcohol consumption, diabetes, hypertension, hyperlipidemia, homocysteine, National Institute of Health Stroke Scale (NIHSS) score, and genotypes were compared. χ² test and rariance analysis were used for the comparison between the groups. If P<0.05, there is a statistical difference. Results　Among the 181 patients, 92 cases (50.83%) were of the extensive metabolism type, 69 (38.12%) the intermediate metabolism type, and 20 (11.05%) the slow metabolism type. The age, gender, diabetes, hypertension, hyperlipidemia, and homocysteine had no correlation with clopidogrel resistance (all P>0.05). The NIHSS score was (3.29±2.14) in the extensive metabolism type group, (3.83±2.47) in the intermediate metabolism type group, and (5.90±3.81) in the slow metabolism type group, so the NIHSS score was correlated with clopidogrel resistance (P<0.01). The 3 groups were followed up for 1 year, and the incidence of endpoint events was 3.26% (3/92) in the extensive metabolism type group, 5.80% (4/69) in the intermediate metabolism type group, and 20.00% (4/20) in the slow metabolism type group. According to the CYP2C19 genotypes, the Log-Rank test for the survival analysis showed that there was a statistical difference between the extensive metabolism type group and the slow-metabolism group (χ²=7.856, P=0.005). Conclusions　The CYP2C19 genotype can affect the clinical efficacy and antiplatelet effect of clopidogrel for patients with acute cerebral infarction. Clopidogrel has a low response in patients with acute cerebral infarction who carry CYP2C19*3/*3. Patients with acute cerebral infarction in Hohhot area are mainly of the extensive metabolism type and intermediate metabolism type. The recurrence rate of the slow metabolism type is higher than those of the extensive metabolism type and intermediate metabolism type.

Influencing factors of post-stroke cognitive impairment

Ji Haiyan, Tang Qingrong, Qiao Jubo

2022, 28(1):  15-18.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.004

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Post-stroke cognitive impairment (PSCI) seriously affects the patients' quality of life and prognosis and brings loads of burden to their families and the society. PSCI is reversible in early stage, so interventions should be done to improve their cognitive function. This article reviews the progresses on the influencing evaluation tools, epidemiology, and factors of PSCI, including demographic factors, disease factors, lifestyles, and mental disorders, so as to provide references for developing prevention and interventions of PSCI.

Effect of early rehabilitation exercise based on intermediate frequency pulse therapeutic apparatus for stroke patients with hemiplegia 

Xian Hongxia, Liu Yonglin, Zhan Tingting

2022, 28(1):  19-22.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.005

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Objective　To explore the clinical value and rehabilitation effect of intermediate frequency pulse therapy and early rehabilitation exercise for stroke patients with hemiplegia. Methods　Eighty stroke patients with hemiplegia treated at Gaozhou People's Hospital from March 2020 to March 2021 were selected as the study objects, and were divided into an observation group and a control group by the random number table method, with 40 cases in each group. There were 24 males and 16 females in the control group, and they were (62.89±4.42) years old. There were 26 males and 14 females in the observation group, and they were (62.63±4.05) years old. The control group only took intermediate frequency pulse therapy, and the observation group were treated by intermediate frequency pulse therapeutic apparatus and acupuncture and did early rehabilitation exercise, including psychological rehabilitation, limb function rehabilitation exercise, daily living ability training, passive muscle and joint training, active training, etc. The clinical rehabilitation effects were compared between the two groups. χ² and t tests were applied. Results　The neurological deficit scores (National Institute Health Stroke Scale, NIHSS) after the treatment in the two groups were lower than those before treatment in the same group, and the NIHSS score in the observation group was significantly lower than that in the control group [(10.54±3.02) vs. (15.71±4.32)], with a statistical difference (t=6.203, P<0.001). After the treatment, the scores of activity of daily living and motor function were (68.54±6.02) and (60.81±5.02) in the observation group, and were (61.71±6.32) and (55.42±4.27) in the control group (t=4.949 and 5.172; both P<0.001). The scores of quality of life in the observation group were significantly higher than those in the control group, with statistical differences (all P<0.05). The patient satisfaction in the observation group was higher than that in the control group [95.00% (38/40) vs. 80.00% (32/40)], with a statistical difference (χ²=4.114, P=0.042). Conclusion　During the treatment of stroke patients by intermediate frequency pulse therapeutic apparatus, early rehabilitation exercise can significantly improve their neurological deficits, motor function, and ability of daily living, and achieves an ideal rehabilitation effect.

Scientific Research

Study on mechanism of miR-3529-3p inhibiting proliferation of ovarian cancer SKOV-3 cells by down-regulating expression of E2F3 gene 

Wan Shuqiong, Bao Qunli, Huang Geng, Jiang Yanping, Zhang Qingdong, Wang Chuping

2022, 28(1):  24-27.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.006

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Objective　To explore the mechanism of microRNA (miR)-3529-3p in inhibiting the proliferation of ovarian cancer SKOV-3 cells. Methods　This study was from January to May 2021. NC mimic (NC group) and miR-3529-3p mimic (miR-3529-3p group) were respectively transfected into the ovarian cancer SKOV-3 cells. Real-time reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the transfection efficiency. The CCK-8 method was used to detect the optical density value of each group. The colony formation test was used to detect the number of colonies formed in each group. The miRNAMap database was used to predict the target gene of miR-3529-3p. qRT-PCR and Western blot were used to detect the expression of target gene. Independent-sample t test was used. Results　The expressions of miR-3529-3p in the SKOV-3 cells in the miR-3529-3p group and the NC group were (1.01±0.07) and (9.55±1.50), respectively. The expression of miR-3529-3p in the NC group was significantly lower than that in the miR-3529-3p group (t=5.68, P<0.01). The CCK-8 method showed that miR-3529-3p overexpression inhibited the proliferation of the SKOV-3 cells (P<0.05). Compared with that in the NC group, the number of colonies formed in the miR-3529-3p group was significantly reduced (P<0.05). The target gene of miR-3529-3p might be E2F transcription factor 3 (E2F3). Compared with that in the NC group, the expression of E2F3 gene in the SKOV-3 cells in the miR-3529-3p group was significantly reduced (P<0.01). Conclusions　miR-3529-3p can inhibit the proliferation of ovarian cancer SKOV-3 cells, and its possible molecular mechanism is achieved by targeting and inhibiting the expression of E2F3.

Research progress of traditional Chinese medicine regulation of NLRP3 inflammasome in treatment of sepsis

Lin Hua, Luo Ning, Qin Chao, Yu Yonghao

2022, 28(1):  28-32.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.007

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Sepsis is one of the most common infectious diseases. Inflammatory response is an important mechanism of sepsis from mild to septic shock. NOD like receptor protein 3 (NLRP3) inflammasome is a protein complex in human body. It is regulated by many factors and can trigger immune response and cell death. When the regulatory mechanism of NLRP3 inflammatory body is unbalanced, excessive inflammatory response will cause cell damage, even irreversible tissue lesions, and accelerate organ damage. At present, NLRP3 inflammasome has attracted extensive attention as a potential therapeutic target for sepsis. This paper reviews the main activation pathways of NLRP3 inflammasome, the mechanism of NLRP3 inflammasome affecting the process of sepsis, and the regulatory effect of traditional Chinese medicine on NLRP3 inflammasome in sepsis.

Individualized precise eradication of Helicobacter pylori 

Jiang Xin, Gao Xuefeng, She Qiang, Ding Yanbing

2022, 28(1):  32-37.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.008

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Helicobacter pylori (Hp) infection is associated with digestive tract diseases and the incidence of multiple systems throughout the body, with a high infection rate and strong pathogenicity, and is threatening people's health. In recent years, due to the abuse of antibiotics, antibiotic resistance has been increasing year by year, which leads to the decline of Hp eradication rate, and it has become a difficult clinical problem. In recent years, in order to improve the Hp eradication rate, domestic and foreign scholars have made active exploration, proposed the concept of "individualized" precise eradication therapy, and selected individualized drug radical cure plan according to the patients' specific circumstances. This article reviews the individualized differences in patients treated with Hp eradication combination, so as to provide valuable suggestions for clinicians to select the best treatment for Hp eradication.

Trastuzumab combined with capecitabine and oxaliplatin for patients with upper gastric cancer and Her-2 overexpression

Wang Hongli, Ya Guowei, Liu Yunhe

2022, 28(1):  38-41.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.009

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miR-4795-3p inhibits proliferation and invasion of gastric cancer cells by targeting EGFR

Lan Guoyu, Tang Shouyuan, Huang Geng, Zhu Zhongzhong, Li Xinming, Luo Haiping, Jiang Jinping

2022, 28(1):  42-45.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.010

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Objective　To investigate the effect of microRNA (miR)-4795-3p on the proliferation and invasion of gastric cancer cells by regulating the expression of epidermal growth factor receptor (EGFR). Methods　The negative control mimic (a negative control group) and miR-4795-3p mimic (a miR-4795-3p group) were respectively transfected into the gastric cancer BGC823 cells from June to December 2020. Real-time polymerase chain reaction (qRT-PCR) was used to test the transfection efficiency. The MTS method and Transwell experiment were used to detect the proliferation and invasion ability of the BGC823 cells. The bioinformatics software miRcode predicted the target gene of miR-4795-3p, and the dual luciferase reporter gene experiment was used to verify the binding of miR-4795-3p to the target gene. qRT-PCR and Western blot were used to detect the target gene expression. The software SPSS 21.0 was used to analyzed the data. The independent-sample t test was used for the comparison between the groups. If P<0.05, there is a statistical difference. Results　The expressions of miR-4795-3p in the BGC823 cells of the miR-4795-3p group and the negative control group were (1.02±0.11) and (11.04 ± 1.23), respectively. The expression of miR-4795-3p in the negative control group was significantly lower than that in the miR-4795-3p group (t=8.14, P<0.01). Compared with those in the negative control group, the absorbance of the BGC823 cells in the miR-4795-3p group was significantly decreased (P<0.05), and the number of cell invasion was significantly reduced (P<0.01). miR-4795-3p and EGFR had complementary binding sites, and miR-4795-3p could complementally bind to EGFR (P<0.01). Compared with that in the negative control group, the expression of EGFR in the BGC823 cells in the miR-4795-3p group was significantly reduced (P<0.01). Conclusion　miR-4795-3p inhibits the proliferation and invasion of gastric cancer BGC823 cells by targeting and negatively regulating EGFR expression.

Related risk factors of lung complication incidence in patients after heart valve replacement

Kang Chanchan, Li Qiujun

2022, 28(1):  45-48.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.011

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Screening value of carotid ultrasound combined with cardiac color ultrasound for coronary heart disease

Mo Yan, Liu Dan, Li Dong

2022, 28(1):  49-52.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.012

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Objective　To analyze the application value of carotid ultrasound combined with cardiac color ultrasound in screening coronary heart disease (CHD). Methods　A total of 114 patients suspected with CHD at Yingkou Central Hospital were selected, including 68 males and 46 females. They were 32-78 (58.76±7.54) years old. All the patients underwent carotid ultrasound and cardiac color ultrasound examinations. The coronary angiography was the golden standard. They were divided into a CHD group and a non-CHD group. The ultrasound examination indicators [carotid intima-media thickness (IMT), plaque score, and Tei index] were compared between the CHD group and the non-CHD group and between the CHD patients with different lesions. And correlation analysis was conducted. The diagnostic efficiency of carotid ultrasound combined with cardiac color ultrasound was analyzed by the receiver operator characteristic curve (ROC). The independent-sample t test was used for the comparison between two groups. The one way ANOVA was used for the comparison between 3 or more than 3 groups. Results　The carotid IMT, plaque score, and Tei index in the CHD group were significantly higher than those in the non-CHD group [(1.29±0.20) mm vs. (0.68±0.11) mm, (2.25±0.32) vs. (0.86±0.14), and (0.58±0.09) vs. (0.42±0.06); all P<0.05]. The carotid IMT, plaque score, and Tei index in the multi-vessel lesion group were higher than those in the double-vessel lesion group and those in the single-vessel lesion group (all P<0.05), and those in the double-vessel lesion group were higher than those in the single-vessel lesion group (all P<0.05). The vessel number of lesions was positively correlated with the carotid IMT, plaque score, and Tei index (all P<0.05). The areas under the ROC's (AUC) of carotid IMT, plaque score, Tei index, and their combination were 0.781, 0.765, 0.703, and 0.897, respectively. The sensitivity and specificity of the combination were 91.4% and 72.3%, respectively. Conclusion　Carotid ultrasound combined with cardiac color ultrasound can effectively improve the diagnostic efficiency of CHD, which is of important application value in CHD screening.

17-OHP and ATCH combined with serum testosterone in early screening of neonatal congenital adrenal hyperplasia

Zhang Xiaofang, Wei Yulei

2022, 28(1):  53-56.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.013

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Objective　To investigate the value of 17-OH-progesterone (17-OHP) and adrenocorticotropic hormone (ACTH) combined with serum testosterone in the early screening of neonatal congenital adrenal hyperplasia (CAH). Methods　Forty newborns with CAH admitted to Children's Hospital of Zhengzhou University from January 2019 to January 2021 were selected as an experimental group, and 50 healthy newborns during the same period were selected as a control group. The general data of the two groups were compared. The levels of 17-OHP, ACTH, and serum testosterone were detected. The receiver operating characteristic curve (ROC) was used to analyze the efficacies of the above indicators in identifying CAH and the best cut-off values. The areas under the ROC's (AUC) of the three indicators alone and the combination were calculated. The software SPSS 20.0 was used to analyzed the data. The independent-sample t test and χ² test were used. ROC was used for the data of the continuous variants with statistical significances. If P＜0.05, there is a statistical difference. Results　Among the 40 cases in the experimental group, there were 15 girls (37.50%) and 25 boys (62.50%), with an age of 3～7 (4.75±1.14)d. Among the 50 cases in the control group, there were 19 girls (38.00%) and 31 boys (62.00%), with an age of 3～8 (4.70±1.16) d. There were no statistical differences in the boy proportion and age between these two groups (both P>0.05). The levels of 17-OHP, ACTH, and serum testosterone in the experimental group were significantly higher than those in the control group [(132.15±34.68) nmol/L vs. (85.71±5.82) nmol/L, (52.62±12.58) pg/ml vs. (40.58±6.31)pg/ml, and (9.47±2.15) nmol/L vs. (6.23±0.32) nmol/L], with statistical differences (t=9.319, 5.907, and 10.526; all P<0.001). The single and multiple test of 17-OHP, ATCH, and serum testosterone in the subjects were completed, and it found that the best cut-off values of the above indicators were 82.43 nmol/L, 48.04 pg/ml, and 13.35 nmol/L, respectively. The AUC of the combination of 17-OHP, ATCH, and serum testosterone was 0.904, and the AUC's of 17-OHP, ATCH, and serum testosterone were 0.836, 0.877, and 0.677, respectively. The former was significantly greater than the latter, with statistical differences (all P<0.05). Conclusion　Compared with the independent detection of 17-OHP, ATCH, and serum testosterone, the combined detection in the tandem mode has better diagnostic efficiency and good early screening value.

Clinical study on thyroid function of premature infants in disease state

Zhang Bing, Chen Peng, Zhang Chengyun, Chen Haiyan, Xu Mei

2022, 28(1):  57-60.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.014

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Objective　To investigate the clinical significance of thyroid function changes in premature infants in disease state. Methods　This was a retrospective stady Ninety premature infants treated at Neonatal Intensive Care Unit, Zhengzhou First People's Hospital from January 2019 to December 2020 were selected; among which, the 48 ones in disease state were set as an observation group, and the rest 42 ones who had no complications a control group. The observation group were divided into a critical group and a not-critical group according to the disease severity. There were 48 boys and 42 girls, with an gestational age of (31.17±1.44) weeks and a birth weight of (1 449±255) g. The serum levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH) were detected on day 7 and 14 after their birth. The thyroid function was compared between the groups. The statistical software SPSS 21.0 was used to analyzed the data. The measurement data of normal distribution were expressed as (x±s), and compared between the groups by independent-sample t test. Results　The levels of FT3 at the first and second inspection in the observation group were lower than those in the control group [(3.36±0.68) pmol/L vs. (3.80±0.75) pmol/L and (3.49±0.75) pmol/L vs. (3.94±0.60) pmol/L], with statistical differences (both P<0.05). There were no statistical differences in the levels of FT4 and TSH at the first and second inspection and the FT4 level at the first inspection in the critical group were lower than those in the not-critical group [(3.15±0.64) pmol/L vs. (3.60±0.65) pmol/L, (3.30±0.80) pmol/L vs. (3.73±0.63) pmol/L, and (15.08±3.19) pmol/L vs. (17.21±3.78) pmol/L], with statistical differences (all P<0.05). The levels of FT4 and TSH at the second inspection were (17.57±3.15) pmol/L and (6.24±2.02) mU/L in the critical group, and were (19.10±2.27) pmol/L and (6.58±2.10) mU/L in the not-critical group, with no statistical differences between these two groups (all P>0.05) and with statistical differences between the first and second inspection in the same group (all P<0.05). Conclusions　FT3 decreases in premature infants in disease state, and FT3 and FT4 reduce in the critical ones. Thyroid hormone decrease and disease severity of premature infants interact with each other.

Predictive values of electroencephalogram, event-related potential, and general movements quality assessment in neurodevelopmental outcomes of high-risk infants

Ding Jiejun, Ding Yanshu, Jin Wenjie, Hu Yongsu, Zhang Qinfen

2022, 28(1):  61-65.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.015

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Objective　To investigate the predictive values of electroencephalogram (EEG), event-related potential (ERP), and general movements (GMs) quality assessment in the neurodevelopmental status of high-risk infants at 1 year old. Methods　Seventy-one high-risk infants hospitalized at Affiliated Changzhou Children's Hospital of Nantong University from January 2016 to June 2018 were included in this prospective study, including 38 males and 33 females. The gestational age was < 37 weeks in 23 cases, 37 to 42 weeks in 43 cases, and > 42 weeks in 5 cases. There were 23 cases of premature delivery, 13 cases of asphyxia, 8 cases of neonatal hypoxic ischemic encephalopathy, 5 cases of hypoglycemia, 9 cases of intracranial hemorrhage, 3 cases of purulent meningitis, 1 case of bilirubin encephalopathy, 7 cases of neonatal severe pneumonia, 3 cases of necrotizing enterocolitis, and 5 cases of bronchopulmonary dysplasia; some high-risk infants had multiple diseases at the same time. EEG and ERP were performed in the high-risk infants at 4 weeks of corrected gestational age, and GMs quality was evaluated twice 4 and 12 weeks after birth. The Gesell score was used to assess their neurodevelopment outcomes at 1 year old. With the Gesell scores as the neurodevelopmental outcomes at 1 year old, the sensitivities, specificities, and positive and negative predictive values of EEG, GMs quality assessment, EEG + ERP, and EEG + ERP + GMs were calculated to predict the high-risk neonatal neurodevelopmental outcome. The enumeration data were expressed as cases (%), and were compared between the groups by χ² test. The Kappa coefficient consistency was used to test the consistencies of the Gesell scores with EEG, GMs quality assessment, EEG + ERP, and EEG + ERP + GMs. Results　Of the 71 high-risk infants at the corrected age of 1 year diagnosed by the Gesell assessment and neurological tests, 3 cases (4.23%) had cerebral palsy, 14 cases (19.72%) had psychomotor retardation, and 54 cases (76.05%) were normal. The sensitivity, specificity, positive predictive value, and negative predictive value of EEG + ERP + GMs in the prediction of the neurodevelopmental outcomes in the high-risk infants were 90.00%, 95.08%, 75.00%, and 98.31%, respectively, which were the highest. The Kappa coefficient consistency for the reliability of predicting the neurodevelopmental outcomes of the high risk newborns by the EEG + ERP + GMs method was substantial at 0.785, while the other three methods got relatively low Kappa values. Conclusions　EEG, GMs quality assessment, and EEG + ERP have high predictive values for adverse neurodevelopmental outcomes in high-risk newborns; the combination of EEG, ERP, and GMs quality assessment can greatly improve the prediction of neurodevelopmental outcomes of high-risk newborns.

Qualitative study of nurses' real inner experience in public health emergencies

Feng Yanying, Shi Guang, Huang Ximei, Huang Wanmin

2022, 28(1):  66-70.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.016

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Objective　To investigate the current situation of nursing emergency management, to explore the core abilities of emergency rescue nurses, the problems they suffered, the solutions and their self-awareness, and to provide references for public health nursing management. Methods　The objective sampling method was used to select 25 nurses from three different hospitals at Panyu District. The nurses were numbered from 001 to 025, including one male and 24 females. They were 25-50 years old, with an average of 36. Semi-structured interviews were conducted with each nurse. The content of the interviews included the interviewees' recognition, the nursing management in public emergencies, and personal feelings during emergency works. We used the NVivo software to sort and analyzed the data. Results　Through the interviews among the 25 nurses who participated in public emergencies, 4 themes and 6 sub-themes were extracted: the professionalism of the emergency rescue nurses (core competence and selection criteria), the emergency rescue nurses' problems that they had during their work (core issues and concerns; adjustment and response procedure), the emergency rescue nurses' self-awareness (role awareness, personal experience, and experience). Conclusions　The nurses involved in public health emergencies have high requirements for professionalism, but insufficient clinical training. Nurses face conflicts between family and work. They always feel anxiety, fear, and pressure. The work experience changes in stages. They experience the conflict of social roles but find a sense of professional identity finally. Therefore, it is recommended that talent cultivation and the construction of a social support system should be implemented.

Effect of intervention strategies based on goal execution concept on treatment compliance of diabetic patients

Guo Xiaoli

2022, 28(1):  71-74.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.017

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Objective　To explore the effect of intervention strategies based on goal execution concept on the treatment compliance of diabetic patients. Methods　From November 2019 to November 2020, 70 diabetic patients hospitalized in Linzhou Hospital of Traditional Chinese Medicine were divided into a study group and a control group by the random number table method, with 35 cases in each group. The control group had 19 males and 16 females and were (64.28±3.25) years old. The study group had 20 males and 15 females and were (64.28±3.25) years old. The control group was given diabetes cognition education. The study group took intervention strategies based on goal execution concept. The cognition levels, blood glucose control, and treatment compliance of the two groups before and after the intervention were observed. The measurement data of normal distribution were expressed as (x±s) and were compared between the two groups by the independent-sample t test. The enumeration data were expressed as cases (%) and compared between these two groups by χ² test. Results　After the intervention, the cognition levels of medication, exercise, diet, and smoking in the study group were significantly higher than those in the control group [(34.03±4.42) vs. (27.26±4.47), (33.38±4.61) vs. (25.45±4.55), (28.54±4.13) vs. (24.33±4.16), and (35.27±4.14) vs. (29.03±4.55); all P<0.001]; the fasting blood-glucose and 2-hour postprandial blood glucose in the study group were better than those in the control group [(6.08±1.41) mmol/L vs. (8.86±1.94) mmol/L and (9.94±2.41) mmol/L vs. (11.97±2.46) mmol/L; both P<0.001]. The compliance rate in the study group was significantly higher than that in the control group [97.14% (34/35) vs. 71.43% (25/35)], with a statistical difference (χ²=8.373, P=0.003). Conclusion　The intervention strategies based on goal execution concept can improve patients' awareness of diabetes and treatment compliance, and effectively control their blood glucose, which has positive clinical significance and is worthy of promotion and application.

Mechanism of obesity influencing thyroid function in patients with obstructive sleep apnea hypopnea syndrome

Zhang Huaqin, Zheng Yanwen, Wu Haiyan

2022, 28(1):  75-78.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.018

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Obstructive sleep apnea hypopnea syndrome (OSAHS), also known as obstructive sleep apnea hypopnea syndrome, is a common sleep disorder in clinical medicine. According to relevant research reports, obesity is the highest risk factor for OSAHS. The relationship between the disease and thyroid function is not very clear, but some patients with OSAHS have hypothyroidism at the same time. Some scholars believe that this is not different from the incidence of hypothyroidism in the general population. At the same time, some scholars believe that obese patients with OSAHS and children with OSAHS have high risk of hypothyroidism. At present, the influence mechanism of obesity on thyroid function in OSAHS patients is still unclear. OSAHS patients are prone to recurrent apnea, hypoventilation, and micro arousal during sleep, leading to hypoxia. Obesity aggravates hypoxia and causes metabolic disorder, insulin resistance, and leptin, adiponectin, and functional changes. The change of vitamin D level can cause the change of thyroid function. Abnormal nerve regulation and inflammatory reaction can cause the change of thyroid function. In addition, obesity itself can also lead to changes in thyroid function. This article explores the mechanism of obesity on thyroid function in patients with OSAHS.

Correlation of zinc-a2-glycoprotein with C-peptide and uric acid in patients type 2 diabetes mellitus

Wu Min, Huang Shuyu, Wang Xing, Zou Yi, Hu Xiaoping, Jiang Jingwen, Liao Shibo, Zhu Zhao, Huang Gao, Li Ling

2022, 28(1):  79-81.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.019

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Objective　To investigate the correlation of zinc-a2-glycoprotein with C-peptide and serum uric acid (SUA) in patients type 2 diabetes mellitus (T2DM), and to provide theoretical references in the prevention of hyperuricemia and its complications in patients with T2DM. Methods　From May 2019 to May 2021, 110 patients with T2DM treated at Department of Endocrinology, Affiliated Xiaogan Hospital of Wuhan University of Science and Technology were chosen, and were divided into an observation group (54 cases,including 28 males and 26 females), the ones complicated with hyperuricemia who were (55.2±6.68) years old, and a control group (56 cases, including 28 males and 28 female), the ones not complicated with hyperuricemia who were (55.8±5.80) years old, cases, according to whether they were complicated with hyperuricemia. The fasting serum levels of ZAG, C-peptide, and plasma glucose (FPG), glycosylated emoglobin A1c (HbA1c), blood lipid, and related clinical indicators were detected. The data were analyzed by the software SPSS 17.0. The independent-sample t , χ², and nonparamertric tests were used for the comparison between these two groups. Partial correlation analysis and multiple stepwise regression analysis were used to analyze the ZAG and other clinical indicators. Results　The fasting serum level of ZAG in the observation group was higher in than that in the control group [(60.01±24.56) mg/L vs. (44.35±17.20) mg/L, P<0.05]. The fasting serum level of ZAG in the patients with T2DM was positively correlated with SUA (r=0.543), body mass index (r=0.240), C-peptide (r=0.437), and triacylglycerol (r=0.372), and negatively with high density liptein cholesterol (r=-0.447), with statistical differences (all P<0.05). Conclusions　The serum level of ZAG in the T2DM patients with hyperuricemia is higher than that in the ones with no hyperuricemia. ZAG may induce lipid metabolism disorder in T2DM patients, participate in insulin resistance, and increase SUA, so it could be a new target in the prevention and treatment of hyperuricemia and other metabolism diseases.

Evaluation of continuous intervention effect of intelligent nursing information system applied to patients with acute attack of chronic heart failure after discharge

Yang Fengling, Liang Linli, Li Tingting, Zheng Chuzhen, Huang Xueyue

2022, 28(1):  82-85.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.020

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Objective　To evaluate the effect applying intelligent nursing information system in the continuous intervention for patients with acute chronic heart failure after discharge. Methods　This was a retrospective study. A total of 100 patients with acute chronic heart failure admitted to Intensive Care Unit (ICU), Houjie Hospital from January to December 2020 were selected. From January to June 2020, 50 patients with acute attack of chronic heart failure in ICU who received routine care under the intelligent nursing information system were selected as a control group. From July 2020 to December 2020, the rest 50 patients with acute attack of chronic heart failure in ICU were selected as an experimental group. The control group had 28 males and 22 females; they were (60.6±4.7) years old; the disease duration was (5.1±0.6) years; and the hospitalization duration was (20.2±2.7) days. The experimental group had 27 males and 23 females; they were (60.5±4.8) years old; the disease duration was (5.2±0.5) years; the hospitalization duration was (20.1±2.6) days. The scores of Exercise of Self-Care Agency (ESCA) and quality of life, readmission rates, and incidences of adverse reactions were observed and analyzed in the 2 groups. t test and χ² test were used for the comparison between the groups. Results　Before the intervention, the scores of ESCA and quality of life were (99.1±13.5) and (66.1±7.4)) in the control group, and were (98.6±13.8) and (65.8±7.1) in the experimental group, with no statistical differences (both P>0.05). After the intervention, the scores of ESCA and quality of life were (101.1±10.5) and (74.2±8.1) in the control group, and were (108.9±11.4) and (82.1±9.4) in the experimental group, with statistical differences (t=3.559 and 4.502; both P<0.001). Within one year after discharge, the readmission rate and incidence of adverse reactions were 4.0% (2/50) and 2.0% (1/50) in the experimental group, and were 18.0% (9/50) and 22.0% (11/50) in the control group, with statistical differences (χ²=5.005 and 9.470; P=0.025 and 0.002). Conclusion　The implementation of continuous intervention under intelligent nursing information system can improve the self-care ability of ICU patients with acute attack of chronic heart failure, reduce the occurrence of adverse reactions and readmission rate, and improve their quality of life.

Effect of triple therapy of traditional Chinese medicine combined with enhanced recovery after surgery on gastrointestinal function recovery of patients with after laparoscopic colorectal cancer surgery

Ren Junhua, Li Yanhua, Li Qunzhi, Liu Qin, Tang Zhijun

2022, 28(1):  86-89.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.021

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Objective　To explore the effect of triple therapy of traditional Chinese medicine combined with enhanced recovery after surgery (ERAS) on gastrointestinal function recovery after laparoscopic colorectal cancer surgery. Methods　A total of 60 patients who underwent laparoscopic colorectal cancer surgery at Changde Hospital, Hunan University of Traditional Chinese Medicine from April 2019 to February 2020 were selected and divided into a treatment group and a control group by random number table method, with 30 patients in each group. There were 17 males and 13 females in the treatment group, and they were (57.8±8.9) years old. There were 15 males and 15 females in the control group, and they were (58.4±7.7) years old. Both groups adopted the ERAS concept for perioperative preparation, and the treatment group additionally took Chinese medicine triple therapy (ear point pressing bean, moxibustion, and Chinese medicine hot ironing). The postoperative auscultation times of first bowel sound, first anal exhaust times, first defecation times, and postoperative abdominal pain scores were observed and compared between the two groups. t test and MANOVA of repeated measuring were applied. Results　The postoperative auscultation time of first bowel sound, first anal exhaust time, and first defecation time were (12.99±1.16) h, (29.91±2.28) h, and (52.39±6.17) h in the treatment group, and were (19.50±0.97) h, (32.68±1.14) h, and (60.63±4.18) h in the control group, with statistical differences (t=5.139, 3.516, and 10.037; P=0.028, 0.032, and 0.013). The pain scores 1, 3, and 5 days after the surgery were (3.57±0.63), (2.83±0.59), and (1.50±0.68) in the treatment group, and were (4.07±0.45), (3.23±0.43), and (1.73±0.58) in the control group, with statistical differences in the pain scores 1 and 3 days after the surgery (P=0.011 and 0.004) but no statistical difference in the pain score 5 days after the surgery (P=0.160). Conclusion　Triple therapy of traditional Chinese medicine combined with ERAS for patients after laparoscopic colorectal cancer surgery can effectively promote their postoperative gastrointestinal function recovery, and has clinical significance in promoting their postoperative rapid recovery.

Treatises

Correlation between non-alcoholic fatty liver disease and TyG in overweight or obese people 

Yang Dan, Zhou Xiaoyan, Jiang Yimin, Lei Rong, Liu Mi

2022, 28(1):  90-95.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.022

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Objective　To investigate the correlation between the triglyceride glucose index (TyG) and overweight or obese people with or without non-alcoholic fatty liver disease (NAFLD). Methods　A total of 5 685 over 18 years old males and females who underwent physical examination in Affiliated Hospital of North Sichuan Medical College from January to October 2020 were selected and divided into a normal body mass group (an NG group; 2 397 cases) and an overweight or obese group (an OG group; 3 288 cases) according to body mass index (BMI). At the same time, the OG group was divided into a non-NAFLD group (1 670) and an NAFLD group (1 618) according to whether they had NAFLD or not. TyG was calculated and the differences in TyG, general data and clinical biochemical indexes were compared between the groups. The measurement data of normal distribution were expressed as (x±s) and compared between the groups by independent-sample t test. The measurement data not of normal distribution were expressed as M (P₂₅, P₇₅) and compared between the groups by Mann-Whitney U test. The correlations were analyzed by Pearson correlation analysis, Spearman correlation analysis, or stepwise linear regression analysis. The influencing factors of overweight or obese people with NAFLD were analyzed by binary logistic regression analysis. Results　Compared with those in the NG group and the non-NAFLD group, the ages, waist-hip ratios (WHR), blood pressures, fasting blood glucose (FPG), glycated hemoglobin (HbA_1C), liver and kidney function, blood lipid and TyG levels in the OG group and the NAFLD group were statistically different (all P<0.05). Correlation analysis showed that TyG was positively correlated with age, systolic blood pressure (SBP), diastolic blood pressure (DBP), FPG, HbA_1C, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), total protein, albumin, creatinine (Cr), uric acid (UA), triglyceride (TG), total cholesterol (TC), and very low density lipoprotein cholesterol (VLDL-C) (r=0.044, 0.19, 0.245, 0.512, 0.449, 0.144, 0.232, 0.183, 0.392, 0.081, 0.187, 0.075, 0.256, 0.836, 0.355, and 0.718; all P<0.05), and negatively with globulin (r=-0.04, P=0.021) and high density lipoprotein cholesterol (HDL-C) (r=-0.408, P<0.001). Multiple linear stepwise regression analysis showed that age, DBP, FPG, GGT, albumin, UA, TG, TC, VLDL-C, and HDL-C were the independent influencing factors of TyG. Binary logistic regression analysis showed that TyG, HbA_1C, ALT, albumin, UA and LDL-C were the risk factors for NAFLD in the overweight or obese patients (all OR>1, all P<0.05), while FPG, Cr, and TC were the protective factors (all OR<1, all P<0.05). Conclusion　TyG is closely related to overweight or obesity combined with NAFLD.

Chlorogenic acid inhibits apoptosis of human periodontal ligament cells in high glucose environment via AKT signaling pathway

Xiong Yanlin, Xie Lina, Qi Liuying

2022, 28(1):  96-99.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.023

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Objective　To explore the effects of chlorogenic acid on the apoptosis of human periodontal ligament cells (hPDLCs) in high glucose environment and AKT signaling pathway, with in vitro hPDLCs as the experimental objects. Methods　The hPDLCs were cultured in vitro and treated with normal glucose (5.5 mmol/L), high glucose (25.0 mmol/L), and high glucose and chlorogenic acid (high glucose, 25.0 mmol/L; chlorogenic acid, 1 mg/ml). The apoptosis assays of hPDLCs in different groups were conducted, and the expressions of p-AKT and AKT protein were detected by Western blot. The measurement data of normal distribution were expressed as (x±s), and were compared between the groups by independent-sample t test. Results　The apoptosis rate was (6.66±0.18)% in the normal glucose group, and was in the high glucose group, with a statistical difference (t=32.789,P<0.001), indicating that high glucose could significantly promote the apoptosis of hPDLCs. The expression level of p-AKT protein in the high glucose group was significantly lower than that in the normal glucose group. The apoptosis rate in the high glucose and chlorogenic acid group was lower than that in the high glucose group [(11.32±0.17)%], with a statistical difference (t=17.710,P<0.001), indicating that chlorogenic acid could inhibit hPDLCs' apoptosis caused by high glucose and up-regulate the expression of p-AKT protein in high glucose environment. Conclusion　Chlorogenic acid can inhibit the apoptosis of hPDLCs, which may be achieved by activating the AKT signaling pathway.

Clinical Research

Relationship between vitamin D status and anemia in infants

Luo Hui, Li Hui, Wang Siyue, Luo Youwen, Mei Shiwei

2022, 28(1):  100-103.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.024

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Objective　To understand the relationship between vitamin D status and anemia in infants in Guangzhou, and to provide measures for the prevention of vitamin D deficiency and references for the prevention of anemia in infants. Methods　A cross-sectional analysis was used to investigated 8 530 infants who were 3-36 months old and took physical examination at Guangdong Woman and Children's Health Hospital in 2018, including 4 935 boys and 3 595 girls. Their blood samples were collected for the detection of 25-hydroxy vitamin D and hemoglobin. t test, χ² test, χ²_trend test, and Pearson correlation analysis were applied. Results　The level of 25-hydroxy vitamin D was (81.05±25.41) nmol/L in the infants. There was no statistical difference in the level of 25-hydroxy vitamin D between the boys and the girls (P>0.05). The incidences of vitamin D deficiency and insufficiency were 7.68% (655/8 530) and 37.47% (3 196/8 530). There was no statistical difference in vitamin D status between the boys and the girls (P>0.05). As the infants was elder, the serum level of 25-hydroxy vitamin D was lower (P<0.05), and the incidences of vitamin D deficiency and insufficiency were higher (χ²_trend=143.200, P<0.001). The level of hemoglobin was (118.68±10.30)g/L in the infants. There were no statistical differences in the level of hemoglobin and the detection rate of anemia between the boys and the girls (both P>0.05). As the infants were elder, the level of hemoglobin was higher and the detection rate of anemia was lower (χ²_trend=446.532, P<0.001). The levels of hemoglobin in the vitamin D deficiency group and the vitamin D insufficiency group were lower than that in the vitamin D sufficiency group (P<0.05). The incidences of anemia in the vitamin D deficiency group and the vitamin D insufficiency group were higher than that in the vitamin D sufficiency group (P<0.05). The level of 25-hydroxy vitamin D was positively correlated with the hemoglobin level in the infants (r=0.149,P<0.001). Conclusions　The incidence of vitamin D insufficiency is high in 6-36 months old children in Guangzhou. The level of 25-hydroxy vitamin D is positively associated with hemoglobin in infants. Vitamin D deficiency or insufficiency may be associated with anemia in infants. Comprehensive measures should be taken to improve the vitamin D status and anemia of infants.

Characteristics of serum IgM and IgG in children infected with novel coronavirus B.1.617.2 variants and the thought

He Yanfang, Liu Dianyue, Lin Jing

2022, 28(1):  104-106.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.025

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Objective　To analyze the characteristics of serum immunoglobulin (Ig) M and IgG in children infected with the novel coronavirus B.1.617 2 variants and provide references for epidemic prevention and control in the era of pandemic. Methods　Twenty-eight 2-17 years old children infected with the novel coronavirus B.1.617 2 variants treated at Guangzhou Eighth Hospital, Guangzhou Medical University were selected as a study group. One hundred and twenty-five 21-92 years old patients during the same period were selected as a control group. The serum levels of IgM and IgG collected from both groups. The clinical characteristics and the rules of serum IgM and IgG were analyzed. The χ² test and independent-sample t test were used. Results　In the study group, 4 cases were negative in IgM antibodies, and 3 cases in IgG antibodies. The average of the highest titers of IgG and IgM were 20.53 and 3.16 in the study group, and were 263.18 and 19.78 in the control group (both P<0.05). Conclusions　The antibody titers of IgM and IgG in children infected with novel coronavirus B.1.617.2 variants are lower than those in adults. The clinical symptoms of children are milder than those of adults.

Clinical features and prognosis of acute appendicitis complicated with septic shock

Cao Huan, Chen Huanting, Pan Li, Zhou Hui, Wang Zhan, He De

2022, 28(1):  106-109.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.026

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Objective　To investigate the clinical characteristics, susceptibility factors, and prognostic factors of severe acute appendicitis complicated with septic shock, and to provide references for the treatment of this kind of disease. Methods　The data of the patients who underwent laparoscopic acute appendicitis resection from October 2013 to October 2021 at Department of General Surgery, Shenzhen Bao 'an District People's Hospital were retrospectively collected. The patients with acute appendicitis and septic shock were set as an observation group, and the patients with acute appendicitis and matched baseline data were set as a control group. The general conditions, clinical characteristics, inflammatory indicators, and prognostic factors were compared between the two groups by χ² test and t test. Results　The observation group had 17 cases and 9 males (52.94%) and were (33.2±3.41) years old. The control group had 100 cases and 59 males (59.00%) and were (32.1±3.30) years old. In the observation group, all the 17 patients were cured and discharged without death. Three patients had postoperative incision infection (17.65%) and 5 postoperative fever(29.41%), and 4 postoperative gangrene (23.53%) in the observation group, and 2 (2.00%, 2/100) had postoperative incision infection, 3 (3.00%)postoperative fever and 1 (1.00%, 1/100) postoperative gangrene in the control group, with statistical differences (χ²=11.612, 8.895, 13.725, P=0.109, 0.003, <0.001). The observation group had longer operation time and hospital stay and higher percentages of drinking white blood cells, and neutrophils, procalcitonin, and a rate of gangrene than the control group, with statistical differences between the two groups (all P < 0.05). There were no statistical differences in age, gender, smoking, liver function between the two groups (all P > 0.05). Conclusions　Patients with acute appendicitis and septic shock have a long disease course, high levels of inflammatory indicators, and dangerous conditions. Clinicians should pay attention to it and choose surgical treatment as soon as possible.

Clinical application of super sliding guide wires in male patients with difficult catheterization

Hong Huaishan, Wu Jinfeng, Liu Zhihua, Lin Youcheng, Zhou Zhipeng, Ye Liefu

2022, 28(1):  110-112.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.027

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Objective　To explore the clinical effect applying super sliding guide wires in male patients with difficult catheterization. Methods　The clinical data of 135 male patients who were 40-87 years old and took catheterization under the guidance of super sliding guide wire after conventional catheterization failure from June 2013 to March 2020 at Fujian Provincial Hospital were retrospectively analyzed. Results　Among the 135 patients, 130 cases were catheterized successfully, with a success rate of 96.3%; and 5 cases underwent cystostomy. No serious complications, such as urethral pseudotract, mucosal tear, and massive hemorrhage, occurred in all the patients. Conclusion　Catheterization guided by a super sliding guide wire is a simple, practical, convenient, safe, and effective method, so it is worthy of clinical promotion.

Chromatographic sign in prediction of hematoma stability and prognosis of patients with intracerebral hemorrhage

Hui Peiquan, Nie Quanmin, Song Lei, Qin Shiqiang, Wang Zengwu, Cheng Bing, Pang Chunxiao

2022, 28(1):  112-116.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.028

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Objective　To explore the value of computed tomography (CT) chromatographic sign in the prediction of the hematoma stability and prognosis of patients with intracerebral hemorrhage. Methods　Two hundred and twenty-one patients with hypertensive intracerebral hemorrhage treated at Department of Neurosurgery, Weifang people's Hospital from January 2016 to July 2019 were selected, including 100 males and 121 females, with an average age of 60. The changes of the sub high density areas shown by CT were dynamically observed at and after admission. The sub high density areas gradually increased significantly, and the chromatographic sign was positive. The patients with chromatographic signs were treated by puncture and drainage. The patients without chromatographic signs were treated by open hematoma evacuation. The clinical data, hematoma stability, and prognosis were compared between the patients with and without chromatographic signs by t, Mann-Whitney U, and χ² tests. Results　Within 72 h after admission, 154 patients had chromatographic signs, and 67 did not have. At admission, there were no statistical differences in age, the proportions of drinking history and hypertension complication, diastolic pressure GCS score, and hematoma volume first showed by CT scan between the patients with and without chromatographic signs (all P>0.05). One hundred and forty-three cases had hematoma stability and 135 cases had good prognosis in the patients with chromatographic signs, and 51 and 45 in the patients without chromatographic signs, with statistical differences (χ²=12.196 and 12.983; both P<0.001). Conclusion　Chromatographic sign can independently predict the hematoma stability and prognosis of patients with intracerebral hemorrhage, so it is worth being generalized.

Case Report

Keeping uterine of one patient with massive haemorrhage after uterine curettage for caesarean scar pregnancy complicated with complete hydatidiform mole

Huang Jinxia, Zhang Renmin, Wang Jingjing

2022, 28(1):  117-119.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.029

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Myelodysplastic syndrome complicated with tracheoesophageal fistula: a case report and literature review

Xie Ping, Kang Hanwei, Kang Junyang, Yang Fang

2022, 28(1):  119-121.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.030

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This paper reports a case of myelodysplastic syndrome complicated with tracheoesophageal fistula. The patient was admitted with fever as the chief complaint. After admission, chest CT, gastroscopy, and fiberoptic bronchoscopy were performed on the patient. The patient was diagnosed with mediastinal infection and tracheoesophageal fistula. Due to the patient's basic disease of myelodysplastic syndrome, it was difficult to treat. Therefore, multi-disciplinary consultation and literature review were required for the difficulty of treatment, and finally the treatment was given up. Through the analysis and summary of this rare critical disease, the clinical experience is accumulated, hoping to be helpful in the diagnosis and treatment of similar diseases.

Nursing Research

External application of Chinese medicine and acupoint massage in relieving galactostasis in puerperae

Yu Yan, Shi Tingqi

2022, 28(1):  122-124.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.031

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Experience of gastric tube implantation for patients with laryngeal carcinoma complicated with retropharyngeal abscess and the nursing experience

Zhong Sumei

2022, 28(1):  125-127.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.032

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Laryngeal carcinoma is one of the most common malignant tumors on head and neck. Retropharyngeal abscess is one of the rare but serious complications of laryngeal carcinoma, which tends to require gastric tube implantation for adjuvant treatment. However, some factors, such as abnormal anatomical structure, dysphagia, and other conditions, tend to lead to high risk of adverse events of gastric tube implantation and a poor success rate. Based on the current evidences of evidence-based nursing, a case of laryngeal cancer with retropharyngeal abscess is reported in this paper, and the gastric tube implantation method and strategy of quality nursing care are analyzed. Lastly, we summarized the relevant experience, in order to provide new ideas for improving the success rate of gastric tube implantation and the quality of nursing for these patients.

Nursing intervention of oral mucositis caused by apatinib for digestive tract tumors: a report of 5 cases

Li Fen, Ke Chunlian, Deng Xiaohong

2022, 28(1):  128-131.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.033

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Objective　To summarize the nursing experience of patients with oral mucositis caused by apatinib for digestive tract tumors. Methods　From June 2020 to June 2021, 5 patients with digestive tract tumors, including 3 males and 2 females who were 43 to 56 years old, treated at Department of General Surgery, Lingnan Hospital, Third Hospital, Sun Yat-sen University developed oral mucositis after taking apatinib, including 2 cases of degree 4 oral mucositis, 2 cases of degree 3, and 1 case of degree 1. The patients were given nursing interventions, including comprehensive psychological care, strict medication guidance, personalized diet program, comprehensive health education, and so on. Results　The 2 cases of degree 4 had rapid relief of pain, and could eat by mouth after 2 days. All the 5 patients had no clinical symptoms after 3-5 days' care. Conclusions　Timely detection and evaluation of the clinical manifestations of patients with oral mucositis is the key. The nursing key points are formal treatment and comprehensive care, relieving their pain symptoms, developing personalized diet program, and paying attention to their psychological nursing and health education.

Clinical practice effect of case managers in whole course medical management of nasopharyngeal carcinoma patients

Chen Chunlan, Li Suxia

2022, 28(1):  131-136.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.034

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Objective　To explore the clinical practice effect of case managers in the whole course medical management of patients with nasopharyngeal carcinoma. Methods　From January 2018 to December 2019, 1 019 patients with nasopharyngeal carcinoma confirmed by the pathological diagnosis the first time who were treated at Foshan First People's Hospital were selected, including 661 males and 358 females. They were (48.22±12.1) years old. They were divided into an experimental group (510 cases) and a control group (509 cases) by the random number table method. The experimental group took the routine holistic nursing mode and case management mode; the professional case managers provided continuous care and full-time and all-round service for the patients in the diagnosis, treatment, and follow-up stages. The control group took the routine nursing mode during the period of hospitalization; the patients were evaluated at admission; the nurses in charge provided disease-related treatment and nursing according to the medical advices every day during hospitalization; the patients took health education before discharge; etc. The rate staying for treatment, reexamination rate half year after discharge, patient satisfaction with hospitalization, and rate of treatment interruption were the observation indicators. The enumeration data were compared between these two groups by χ² test. Results　The rate staying for treatment, reexamination rate half year after discharge, patient satisfaction with hospitalization, and rate of treatment interruption were 80% (408/510), 98% (400/408), 95% (388/408), 100% (200/200), and 2% (8/408) in the experimental group, and were 68% (346/509), 92% (318/346), 80% (277/346), 95% (190/200), and 8% (28/346) in the control group, with statistical differences (all P<0.05). Conclusion　The whole course continuous care provided by case managers for patients can improve their timely and correct diagnosis rate, retention rate, reexamination rate, follow-up rate, patient compliance, disease-related knowledge rate, and patient satisfaction, and reduce the rate of treatment interruption.

Summary

Corona virus disease 2019 and psychological Health: from physiological mechanism to social influence

He Xiaobo, He Jing, Lei Xianyang

2022, 28(1):  137-140.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.035

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Research progress and misdiagnosis of pyogenic granuloma

Liu Yue

2022, 28(1):  140-144.  DOI: 10.3760/cma.j.issn.1007-1245.2022.01.036

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Pyogenic granuloma is a benign, acquired vascular tumor with nodular vascular hyperplasia, mild trauma, and easy bleeding as the main clinical manifestations. It is not a true tumor,  and can be further diagnosed clinically by asking medical history, clinical manifestations, dermoscopy and histopathological examination and other auxiliary means.Due to its clinical manifestations of bright red or brown-red papular lesions, it is easy to be confused with some vascular and neoplastic skin diseases, and it is easy to be misdiagnosed when clinicians are inexperienced in the diagnosis of this disease. From 1992 to 2021, 18 misdiagnosis literatures of pyogenic granuloma were published in Chinese academic journals, with a total of 34 cases and more than 10 misdiagnosed diseases; many of them were misdiagnosed as true hemangioma, basal cell carcinoma, non-pigmented melanoma, eccrine poroma, gangrene, common wart, clear cell acanthoderma, etc. In order to reduce the misdiagnosis of pyogenic granuloma by clinicians in the future, we should further strengthen the understanding of its clinical manifestations and the use of necessary auxiliary examinations, so as to avoid the pain caused by misdiagnosis and mistreatment.