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Table of Content

    01 November 2022, Volume 28 Issue 21
    Special Subject:Cerebrovascular Diseases
    TGF-β signal transduction pathway and hereditary cerebral small vessel diseases
    Ren Qianqian, Xu Suiyi, Song Shina, Li Changxin
    2022, 28(21):  2961-2964.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.001
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    Transforming growth factor β (TGF-β) is a kind of biologically active regulatory factor, and is widely expressed in endothelial cells, nerve cells, fibroblasts, epithelial cells, etc. TGF-β can participate in hereditary cerebral small vessel diseases (CSVD), such as CADASIL, CARASIL, and HTRA1 gene mutation-related CSVD (symptomatic carriers) and Fabry disease mediating Smad-dependent and -independent signaling pathways. The TGF-β signaling pathway may lead to CSVD by affecting endothelial cell function, structural changes in the vascular wall, and increased permeability of the blood-brain barrier. However, the dysregulation of this pathway cannot be used as a monism to explain the occurrence of CSVD. Therefore, TGF-β protein family and its receptors, TGF-β signal transduction pathway and its transduction mechanism, and TGF-β signal pathway and hereditary CSVD are reviewed in this article.
    Effect of ischemic preconditioning in protection of neurological function in patients with ischemic stroke
    Feng Bo, Lou Bo, Li Xue, Zuo Xiuting, Yin Yue
    2022, 28(21):  2964-2964.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.002
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    Objective To study the effect of ischemic preconditioning in the protection of neurological function in patients with ischemic stroke. Methods A prospective randomized parallel controlled study was conducted on 110 ischemic stroke patients admitted to Liaocheng Third People's Hospital from June 2019 to June 2021, and the patients were divided into group A and group B by the random number table method, with 55 cases in each group. There were 23 males and 32 females in group A, and they were 52-74 (62.78±4.77) years old. There were 27 males and 28 females in group B, and they were 51-73 (61.48±4.59) years old. Group B were treated with conventional drugs, and group A with post-adaptation therapy for distal ischemia on the basis of group B. The clinical efficacies and the scores of National Institutes of Health Stroke Scale (NIHSS) and Barthel Index of Activities of Daily Living (BI), infarct volumes, serum levels of S100 protein (S100β), neuron-specific enolase (NSE), neopterin (Npt), and galactose lectin 3 (GAL3), and blood rheology indicators (plasma viscosity, whole blood high cut viscosity, whole blood low cut viscosity, fibrinogen) before and after 3 months' treatment were compared between the two groups. χ2 test was used for the enumeration data, and t test for the measurement data. Results After 3 months' treatment, the total clinical effective rate of group A was higher than that of group B [94.55% (52/55) vs. 81.82% (45/55)], with a statistical difference (χ2=4.274, P=0.039); the NIHSS score was lower and the BI score was higher in group A than in group B [(9.74±1.83) vs. (12.25±2.82) and (75.26±5.38) vs. (62.47±6.02)], with statistical differences (t=5.496 and 11.748; both P<0.001); the infarct volume of group A decreased more than that of group B [(3.35±1.02) cm3 vs. (3.79±1.11) cm3P<0.05]; the whole blood low cut viscosity, whole blood high cut viscosity, plasma viscosity, and fibrinogen level in group A were lower than those in group B [(5.08±0.79) mPa·s vs. (6.63±1.02)mPa·s, (4.22±0.51) mPa·s vs. (4.85±0.62) mPa·s, (1.17±0.34) mPa·s vs. (1.36±0.40) mPa·s, and (2.86±0.34) g/L vs. (3.53±0.42) g/L; all P<0.05]; the levels of S100β, NSE, Npt, and GAL3 in group A were lower than those in group B [(1.37±0.38) μg/L vs. (1.74±0.46)μg/L, (15.28±3.37) μg/L vs. (19.72±4.73) μg/L, (6.95±1.78) nmol/L vs. (9.07±2.24) nmol/L, and (9.68±2.27) g/L vs. (11.94±3.04) g/L; all P<0.0]. Conclusion Ischemic preconditioning adjuvant therapy for ischemic stroke patients can improve the curative effect and their daily living ability, neurological function, and recovery, reduce the infarct volume, and regulate their hemorheological state.
    Factors related to efficacy of endovascular therapy for patients with acute ischemic stroke
    Li Mingyue, Li Ziru, Yao Yuan, Yuan Jun
    2022, 28(21):  2969-2973.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.003
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    With the publication of five randomized controlled clinical trials in 2015, endovascular therapy has become the preferred treatment for patients with acute cerebral infarction caused by large artery occlusion. Some patients have poor prognosis despite recanalization. By consulting relevant data, the author found that there were many factors that may affect the effect and prognosis of recanalization. This article reviews the possible factors affecting the efficacy of endovascular therapy, including time window, hyperglycemia, collateral circulation, blood pressure, number of thrombectomy, and National Institutes of Health Stroke Scale (NIHSS) score.
    Diagnostic value of soluble tumor necrosis factor-like apoptosis weak inducer for early neurological deterioration of acute cerebral infarction
    Tong Lin, Li Wei, Gao Su, Li Weiwei, Yang Junli
    2022, 28(21):  2974-2979.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.004
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    Objective To observe the expression level of soluble tumor necrosis factor-like apoptosis weak inducer (sTWEAK) in the serum of patients with acute cerebral infarction and to explore its diagnostic value for early neurological deterioration (END) in patients with acute cerebral infarction. Methods One hundred patients with acute cerebral infarction admitted to Yantai Affiliated Hospital of Binzhou Medical University from January to December 2021 were selected as an observation group, and 30 healthy individuals who were examined in Yantai Affiliated Hospital of Binzhou Medical University during the same period were selected as a control group. There were 58 males and 42 females in the observation group; they were (65.52±5.96) years old; their body mass index (BMI) was (22.89±1.31) kg/m2. There were 19 males and 11 females in the control group; they were (63.53±6.54) years old; their BMI was (23.01±1.56) kg/m2. The serum sTWEAK levels of all the subjects were measured. The patients were divided into an END group (31 cases) and a non-END group (69 cases) based on the criterion of "increase in National Institute of Health Stroke ecale (NIHSS) score by 2 or more points within 72 h after admission", and the baseline data and laboratory parameters were collected. The factors influencing the occurrence of END in the patients with acute cerebral infarction were analyzed by multivariate unconditional logistic regression, and the diagnostic value of sTWEAK on the occurrence of END of the patients with acute cerebral infarction was evaluated by plotting the receiver operator characteristic curve (ROC). Results The serum sTWEAK level in the observation group was higher than that in the control group [(276.65±42.03) pg/ml vs. (75.31±26.67) pg/ml; t=24.743, P<0.001]. The NIHSS score, white blood cell count (WBC), hypersensitive C-reactive protein (hs-CRP), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), and sTWEAK at admission in the END group were higher than those in the non-END group (all P<0.05); the Alberta Stroke Program Eady CT Score (ASPECTS) in the END group was lower than that in the non-END group (P<0.05). Logistic regression analysis showed that the elevated levels of hs-CRP, HbA1c, and sTWEAK were all independent risk factors for the development of END in the patients with acute cerebral infarction (all P<0.05). The optimal cut-off point for serum sTWEAK to diagnose the occurrence of END in the patients with acute cerebral infarction was 275.63 pg/ml, with an area under curve (AUC) of 0.859, a sensitivity of 82.90%, and a specificity of 78.60%. Conclusions Patients with acute cerebral infarction show abnormal expression of serum sTWEAK, and its level is related to patients' END; it is an independent risk factor affecting the occurrence of END in patients with acute cerebral infarction, and can be used as a valid indicator for diagnosing whether END occurs in patients with acute cerebral infarction to a certain extent.
    Reproductive Medicine
    Influence of different ovarian stimulation protocols on pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with endometriosis based on propensity score matching 
    Zheng Juan, Sun Xiaohua, Ren Jianzhi, Shi Xian
    2022, 28(21):  2980-2985.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.005
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    Objective To investigate the impact of different ovarian stimulation protocols in fresh cycles on the pregnancy outcomes in frozen-thawed embryo transfer (FET) for patients with endometriosis (EMs). Methods A retrospective study was conducted analyzing the clinical data of 1 342 EMs patients in Reproductive Medicine Center, 73rd Group Army Hospital of PLA from June 2012 to December 2021 who were 20-44 years old. They were divided into a modified long protocol group (1 161 cases) and an antagonist protocol group (181 cases) according to the treatment schemes. The propensity score was used to match to the two groups' clinical characteristics, and the pregnancy outcomes were analyzed. Independent-sample t test was used for the measurement data, and χ2 test for enumeration data. Multivariate logistic regression was used to analyze the patients influencing factors. Results The clinical pregnancy rate in the modified long protocol group was significantly higher than that in the antagonist protocol group before propensity score matching [50.65% (588/1 161) vs. 41.99% (76/181); χ2=4.695, P=0.031]. After propensity score matching, there was no statistically significant difference in the clinical pregnancy rate between the two groups (P>0.05). Multivariate logistic regression analysis showed that age, number of transplantation times, blastocyst transfer, and number and quality of embryos transfer were the independent factors affecting the pregnancy outcomes of FET for patients with EMs (all P<0.05). However, the ovarian stimulation protocol in fresh cycles did not have significant influence on the outcomes (P>0.05). Conclusion Different ovarian stimulation protocols in fresh cycles does not affect the pregnancy outcomes of frozen-thawed embryo transfer for patients with EMs.
    Effect of male partners' age on pregnancy outcomes in frozen-thawed embryo transfer cycles
    Cheng Ling
    2022, 28(21):  2985-2989.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.006
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    Objective To investigate the effect of male partners' age on pregnancy outcomes and neonatal births during frozen-thawed embryo transfer cycles. Methods Four hundred and eighty-four couples who attended First Hospital Affiliated to Xiamen University from January 2017 to December 2020 and underwent their first frozen-thawed embryo transfer (FET) after in vitro fertilization-embryo transfer (IVF/ICSI) were selected for the retrospective study, and were divided into group A (389 cases) and group B (95 cases) according to the men's age. All the women were less than 35 years old. The men in group A were under 35, and those in group B ≥35. The general data and pregnancy outcomes of the two groups were compared. The independent-sample t test, χ2 test, and Fisher's exact test were applied. The influence of the men's and women's ages on pregnancy rate and live birth rate were analyzed by binary logistic regression analysis. Results The male partners' age, female partners' age, total gonadotropins (Gn), basal estradiol (E2), and endometrial thickness on the day of conversion in group B were higher than those in the group A [(37.05±3.30) vs. (30.07±2.67), (31.74±2.01) vs. (29.04±2.84), (2 126.97±780.37) U vs. (1 857.31±598.67) U, (56.04±29.47) pg/ml vs. (47.88±19.23) pg/ml, and (10.23±1.66) mm vs. (9.80±1.73) mm; all P<0.05]. The human chorionic gonadotrophin (HCG) day E2 level in group B was lower than that in group A [(3 683.14±1 791.67) pg/ml vs. (4 088.25±1 681.98) pg/ml; P<0.05]. There were no statistical differences in other indicators and pregnancy outcomes between the two groups (all P>0.05). Conclusion In the first FET cycle, the male partners' age has no effect on pregnancy outcomes and neonatal births when the female partners are <35 years old.
    Basic Research
    Effect of miR-34a based on AKT/mTOR pathway on osteoarthritis rats and its mechanism
    Zhou Lun, Ding Yuan, Lyu Zhou
    2022, 28(21):  2990-2994.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.007
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    Objective To explore the effect of microrNA-34A (miR-34a) on osteoarthritis in rats based on the AKT/mTOR pathway and its mechanism. Methods The study was form February 2020 to May 2021. In this study, 43 healthy male SD rats were selected for prospective study, and they were 6-9 weeks old. Among them, 10 rats were randomly selected as a blank group, and The remaining 33 rats were established as the osteoarthritis models. The 30 rats successfully modeled were randomly divided into a model group, an up-regulated miR-34a group, and a silenced miR-34a group, with 10 rats in each group. The expression of miR-34a was detected by real-time polymerase chain reaction (RT-PCR), and The levels of interleukin-1β (Il-1β), tumor necrosis factor-α, TNF-α, interleukin-4 (IL-4), and interleukin-10 (IL-10) was detected by enzyme-linked immunosorbent assay (ELISA). The expressions of phosphorylated protein kinase B (pAKT) and phosphorylated mammalian target of rapamycin (pmTOR) were detected by Western blot. F test was used for the comparison between ≥3 groups, and independent-sample t test was used for the comparison between two groups. Results The expressions of miR-34a in the blank group, the model group, the up-regulated miR-34a group, and the silenced miR-34a group were (0.94±0.08), (2.39±0.26), (2.12±0.23), and (1.54±0.17), rthe Makin scores (0.35±0.05), (4.13±0.19), (3.02±0.16), and (1.15±0.09), the IL-1β levels (3.68±0.37), (7.51±1.23), (5.72±0.95), and (4.63±0.72) ng/L, the TNF-α levels (37.45±4.85), (62.05±7.49), (56.26±6.25), and (43.85±5.10) ng/L, the IL-4 levels (115.75±16.81), (50.43±9.42), (75.82±11.94), and (93.85±13.86) pg/ml, the IL-10 levels (106.49±17.51), (60.85±10.23), (76.81±13.07), and (91.05±15.02) pg/ml, the pAKT (1.00±0.01), (1.95±0.29), (1.71±0.26), and (1.71±0.26), and the pmTOR (1.00±0.01), (1.89±0.24), (1.56±0.25), and (1.25±0.15). Compared with those in the blank group, the expression of miR-34a, Makin score, IL-1β, TNF-α, pAKT and pmTOR were higher in than those in the model group, the up-regulated miR-34a group, and the silenced miR-34a group, while IL-4 and IL-10 were lower those in the model group (F=25.290, P<0.001; F=91.260, P<0.001; F=14.144, P<0.001; F=13.077, P<0.001; F=15.525, P<0.001; F=17.580, P<0.001; F=16.080, P<0.001; and F=10.676, P<0.001). Compared with those in the model group, the expression of miR-34a, Makin score, IL-1β, TNF-α, pAKT, and pmTOR were lower than those in the up-regulated miR-34a group and the silenced miR-34a group, while IL-4 and IL-10 were higher, with statistical differences. Compared with those in the up-regulated miR-34a group, the expression of miR-34a, Makin score, IL-1β, TNF-α, pAKT, and pmTOR were lower than those in the miR-34a silencing group, while IL-4 and IL-10 were higher than those in the miR-34a silencing group, with statistical differences (all P<0.05). Conclusion Silencing of miR-34a has an intervention effect in osteoarthritis rats, and reduces the inflammatory response and the Makin score, and the mechanism of action is related to the AKT / mTOR signaling pathway.
    Psoriasis Research
    Research status of TLC identification and HPLC fingerprint/specific chromatograms of quality standard of traditional Chinese medicine formula granules and discussion on feasibility of application of extractive reference substances
    Rao Lifen, Li Yongxue, Guo Longgang
    2022, 28(21):  2995-3003.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.008
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    Formula granules are granules of single traditional Chinese medicine; they are extracted, concentrated, dried, and granulated by modern production technology and use decoction pieces as the raw materials. The final granule products have lost the properties and microscopic characteristics of the original decoction pieces. Therefore, it is necessary to use thin-layer chromatography, fingerprint/specific chromatogram, extract detection, content determination, and other methods to control their internal quality. In this paper, referring to official documents, national and provincial quality standards of formula granules, and documents on the quality standards for formula granules in recent years, we focus on the application information of thin-layer identification and fingerprint/specific chromatogram in the standard for formula granules, and discuss the progressiveness of the current standard and the content to be improved. The feasibility of the application of the extractive reference substances of formula granules is discussed.
    Scientific Research
    Research progress of sphingolipid metabolism and ferroptosis in liver cancer 
    Wang Junnan, Jin Junfei
    2022, 28(21):  3004-3008.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.009
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    Ferroptosis is a cell death mode different from apoptosis. Recent studies have found that ferroptosis involves in the treatment and drug resistance of liver cancer. A large number of studies have confirmed that sphingolipid metabolism is closely related to the occurrence and development of liver cancer. There is interaction between sphingolipid metabolism pathway and ferroptosis pathway, and both are closely related to liver cancer. This article reviews the recent research progress on the interaction between sphingolipid metabolism pathway and ferroptosis pathway and its influence on the occurrence, development, and treatment of liver cancer.
    Application effect of multidisciplinary collaborative rehabilitation nursing mode in stroke patients with dysphagia 
    Li Yaru, Liu Yanan, Chen Jie
    2022, 28(21):  3009-3013.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.010
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    Objective To explore the application effect of multidisciplinary collaborative rehabilitation nursing mode in stroke patients with dysphagia. Methods A prospective study was conducted. A total of 94 stroke patients with dysphagia admitted to Zhumadian Central Hospital from March 2019 to March 2022 were divided into a control group and an observation group by the random number table method, with 47 cases in each group. The control group had 24 males and 23 females who were (65.93±2.15) years old, and took routine nursing for 4 weeks. The observation group had 25 males and 22 females who were (65.89±2.13) years old, and took multidisciplinary collaborative rehabilitation nursing for 4 weeks. The swallowing function, psychological states, nutritional status, complications, and quality of life in the two groups were compared. t andχ2 tests were applied. Results The swallowing function of the observation group after nursing was better than that of the control group, with a statistical difference (Z=3.398, P=0.001). The scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) after nursing were (38.46±2.15) and (34.65±2.03) in the observation group, and were (49.87±2.19) and (40.83±2.06) in the control group, with statistical differences (t=25.488 and 14.649; both P<0.001). The levels of hemoglobin (Hb), albumin (ALB), and prealbumin (PA) after nursing were (120.76±12.94) g/L, (43.67±4.34) g/L, and (255.72±20.69) mg/L in the observation group, and were (106.49±11.63) g/L, (39.67±4.30) g/L, and (210.09±20.53) mg/L in the control group, with statistical differences (t=5.623, 4.489, and 10.733; all P<0.001). The incidence of complications in the observation group was lower than that in the control group [4.26% (2/47) vs. 17.02% (8/47)], with a statistically difference (χ2=4.029, P=0.045). The scores of energy, family activity, language, activity ability, emotion, personality, self-care ability, social role, thinking, upper limb function, vision, and work of Stroke-Specific Quality of Life Scale (SS-QOL) after nursing were (11.18±1.36), (9.96±1.35), (16.89±2.54), (22.37±2.61), (16.87±2.38), ( 9.94±1.12), (18.96±2.43), (16.89±2.28), (11.28±1.39), (15.57±2.19), (10.24±1.18), and (9.24±1.32) in the observation group, and were (8.94±1.34), (6.84±1.21), (13.59±2.51), (18.96±2.57), (13.38±2.34), (6.92±1.05), (14.48±2.40), (13.57±2.24), (8.94±1.37), (12.38±2.17), (7.78±1.16), and (6.98±1.30) in the control group, with statistical differences (t=8.043, 11.799, 6.336, 6.382, 7.169, 13.486, 8.993, 7.121, 8.220, 7.094, 10.192, and 8.363; all P<0.001). Conclusion The multidisciplinary collaborative rehabilitation nursing mode for stroke patients with dysphagia can improve their swallowing function, adverse mood, nutritional status, and quality of life, and decrease the incidence of complications such as aspiration pneumonia.
    Meta-analysis on influence of transcutaneous electrical acupoint stimulation on recovery of gastrointestinal function in parturients after cesarean section 
    Ding Shengshuang, Huang Weihua, Duan Rongrong, Lu Xiaoting, Zhang Jie, Qin Xiaoyu, Xue Jianjun
    2022, 28(21):  3014-3019.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.011
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    Objective To evaluate the intervention effect of transcutaneous electrical acupoint stimulation (TEAS) on the recovery of gastrointestinal function in parturients after cesarean section by meta-analysis. Methods The randomized controlled trials about TEAS on the recovery of gastrointestinal function in parturients after cesarean section were searched from The Cochrane Library, PubMed, Web of Science, EMbase, VIP, CNKI, WanFang Data, and China Biology Medicine disc (CBM) from their establishment to February 27, 2022. The RevMan5.3 software was used to conduct meta-analysis on the included literatures. Results Eight literatures were included, with 851 parturients who took cesarean section. Meta-analysis showed that compared with routine nursing or sham TEAS, TEAS could shorten the first exhaust time (MD=-6.97, 95%CI -9.92--4.02, P<0.000 01), the first defecation time (MD=-12.61,95%CI -20.69--4.53,P=0.002), and bowel sound recovery time,(MD=-3.32, 95%CI -4.76--1.88, P<0.000 01), and reduce the incidences of postoperative abdominal distension (RR=0.44, 95%CI 0.27-0.69, P=0.000 4) and nausea and vomiting (RR=0.39, 95%CI 0.26-0.58, P<0.000 01) and hospital stay (SMD=-0.65, 95%CI -0.83--0.46, P<0.000 01). Conclusion TEAS is helpful to the recovery of gastrointestinal function after cesarean section, but due to the small number of included literatures, follow-up related studies are still needed to further confirm it.
    Reproductive health status, cognition, and related influencing factors of female college students
    Tang Haiying, Tang Ying, Yang Jie, Ma Juan
    2022, 28(21):  3020-3028.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.012
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    Objective To understand the reproductive health status, cognition, and related influencing factors of female college students, and to provide references for reproductive health education and health care guidance in colleges and universities. Methods From May 9 to 31, 2022, the 18-24 years old female college students were randomly sampled from Guangdong AIB Polytechnic to conduct a questionnaire survey on reproductive health diseases, knowledge of reproductive health care, and medical treatment. The classification description, chi-square test, or Fisher exact test in statistical methods were adopted to analyze the survey results, and the multivariate logistic regression analysis was used to explore the risk factors of reproductive health diseases in the female college students. Results The survey showed that 48.28% (602/1 247) of the female college students had ever suffered from diseases related to reproductive health, and 37.69% (470/1 247) had ever suffered from two kinds of gynecological diseases. Drinking, having sexual life, and living in different places were the influencing factors of the number of reproductive health diseases in the students. The risks of the number of reproductive health diseases ≥3 of the female college students who drank alcohol, had sexual life, and came from counties and towns were 1.804, 1.814, 1.789, and 1.814 times higher than those of the students who did not drink alcohol, had no sexual life, and came from cities, respectively, with statistical differences (all P<0.05). Fifty-three point eighty-one percent (671/1 247) of the female college students did not know the breast health care knowledge; 36.57% (456/1 247) did not know it was necessary to prevent reproductive organ injury during sexual life; 29.51% (368/1 247) and 28.95% (361/1 247) did not know the measures to prevent sexually transmitted diseases, contraception, and unwanted pregnancy during sexual life; 44.83% (559/1 247) had not received reproductive health education. The female college students from cities received more reproductive health education than those from counties and towns, suggesting a statistical difference in reproductive health knowledge between the female students from different places (P<0.05); 45.71% (570/1 247) of the female college students chose to observe the situation in treatment of disease. There was no statistical difference in the cognition of medical treatment between the female college students in different grades (P>0.05). Conclusions There are reproductive health problems in female college students. Unhealthy habits and premature sexual behaviors both influence reproductive health. Colleges and universities should conduct comprehensive, systematic, and effective reproductive health education and health care guidance in different ways, as well as correct medical guidance.
    One case of uterine angiomyolipoma and literature review
    Rui Jiamin, Huang Caihong, Jiang Zhou, Cui Shuna, Li Shihua
    2022, 28(21):  3029-3031.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.013
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    Angiomyolipoma (AML) is a kind of perivascular epithelioid cell tumor (PEComa). It is a benign tumor composed of varied proportions of blood vessels, adipocytes, and epithelioid or spindled smooth muscle cells. The incidence of AML is low, and there is no guideline or consensus. In this study, we report the diagnosis and treatment of a woman with uterine AML. Meanwhile, the clinical manifestations, diagnosis, molecular mechanism, treatment, and prognosis of PEComa are discussed through literature review.
    Effect of Western medicine and Yiqi Fuzheng Jiedu Decoction + Zusanli acupoint injection for patients with advanced gastric cancer
    Zhang Shaopeng
    2022, 28(21):  3032-3036.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.014
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    Objective To observe the clinical effect of Western medicine chemotherapy combined with Yiqi Fuzheng Jiedu Decoction + Zusanli acupoint injection in the treatment of advanced gastric cancer. Methods Seventy patients with advanced gastric cancer admitted to Second People's Hospital of Pingdingshan City from January 2019 to January 2022 were selected as the study objects. The patients were divided into a control group and a study group by lottery, with 35 cases in each group. There were 20 males and 15 females in the control group, and they were (55.17±2.24) years old. There were 23 males and 12 females in the study group, and they were (55.44±2.37) years old. Both groups were treated with the same chemotherapy regimen; on this basis, the study group were treated with Yiqi Fuzheng Jiedu Decoction + Zusanli acupoint injection. The scores of main and secondary syndromes of traditional Chinese medicine (TCM), the levels of tumor markers, such as carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724), CA125, CA199, and alpha fetoprotein (AFP), the levels of immune indicators, such as T lymphocyte subsets (CD) CD3+, CD4+, and CD8+, objective remission rates (ORR), disease control rates (DCR), and incidences of adverse reaction were compared between the two groups. t and χ2 tests were applied. Results After the treatment, the scores of the main (stomachache and deficiency of appetite) and secondary (short of breath and lack of strength and listlessness) syndromes of TCM in the study group were lower than those in the control group [(1.21±0.36) vs. (1.96±0.44), (1.04±0.27) vs. (1.88±0.62), (1.13±0.45) vs. (2.02±0.17), and (1.25±0.33) vs. (2.29±0.41)], with statistical differences (t=7.805, 7.349, 10.946, and 11.690; all P<0.05). The levels of CEA, CA724, CA125, CA199, and AFP in the study group were lower than those in the control group [(3.12±0.45) μg/ml vs. (5.41±0.26) μg/ml, (6.63±0.24) U/ml vs. (8.92±0.71) U/ml, (30.21±1.14) U/ml vs. (32.47±1.36) U/ml, (32.14±1.15)IU/ml vs. (34.24±1.36) IU/ml, and (20.12±2.23) mg/L vs. (23.25±2.76) mg/L], with statistical differences (t=26.068, 18.077, 7.534, 6.976, and 5.219; all P<0.05). The CD3+, CD4+, CD8+, ORR, and DCR in the study group were higher than those in the control group, with statistical differences (t=3.183, 11.144, and 8.822; χ2=7.198 and 9.181; all P<0.05). The incidence of adverse reactions was 14.29% (5/35) in the study group, and was 11.43% (4/35) in the control group, with no statistical difference (χ2=0.365; P>0.05). Conclusions The combination of traditional Chinese medicine therapies such as Yiqi Fuzheng Jiedu Decoction + Zusanli acupoint injection and Western medicine chemotherapy for patients with advanced gastric cancer can improve their clinical symptoms and signs, reduce the levels of tumor markers, and delay the disease progress. This combination has not significantly enhanced adverse reactions, and its safety is acceptable.
    First aid value of emergency triage system based on intelligent platform for patients with multiple injuries
    Zhang Xinyu, Qian Xiaojing
    2022, 28(21):  3037-3040.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.015
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    Objective To explore the first aid value of emergency triage system under intelligent platform for patients with multiple injuries. Methods One hundred and forty patients with multiple injuries treated in Wuxi Second People's Hospital from January 2020 to January 2022 were selected as the research objects, and were randomly divided into a control group and an observation group, with 70 cases in each group. There were 52 males and 18 females in the control group, and they were (52.51±5.67) years old. There were 53 males and 17 females in the observation group, and they were (52.11±5.04) years old. The control group received routine triage nursing, and the observation group received emergency triage system nursing under the intelligent platform. The first aid situations, rescue efficiencies, and the incidences, of adverse events formed in the rescue process of the two groups were compared. t and χ2 tests were applied. Results The emergency treatment time, early warning time, venous channel establishment time, and triage evaluation time in the control group were significantly longer than those in the observation group, with statistical differences (t=2.417, 2.399, 3.049, and 2.585; all P<0.05). The observation group was better than the control group in rescue initiation, opening venous channels, airway cleaning, respiratory support, and specimen submission for examination, with statistical differences (t=2.066, 2.098, 3.373, 2.597, and 3.247; all P<0.05). The incidence of adverse events in the observation group was lower than that in the control group [7.14% (5/70) vs. 18.57% (13/70)], with a statistical difference (χ2=4.080, P=0.043). Conclusion The emergency triage system nursing under the intelligent platform for patients with multiple injuries can effectively improve their first aid time and the rescue efficiency, reduce the incidence of adverse events, and facilitate their rapid prognosis, so it is worthy of reference and adoption by all departments.
    Effects of mindfulness cognition combined with self-compassion intervention on depression and post-traumatic growth of pregnant women induced by fetal malformation
    He Yanjuan, Zeng Lihong, Zhao Lihui, Huang Jiali
    2022, 28(21):  3041-3046.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.016
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    Objective To explore the effects of mindfulness cognition combined with self-compassion intervention on depression and post-traumatic growth of pregnant women induced by fetal malformation. Methods Sixty-three pregnant women who needed induced labor due to fetal malformation hospitalized in Department of Obstetrics, Changsha Maternal and Child Health Care Hospital from October 2020 to October 2021 were randomly selected as the research objects. They were divided into an experimental group (33 cases) and a control group (30 cases) by the random number table method. The control group were 23-38 (29.21±7.03) years old, and were given routine postoperative nursing after induced labor. The experimental group were 22-39 (28.72±7.65) years old, and were intervened by mindfulness cognition and self-compassion on the basis of the control group. The levels of self-compassion, the severities of stress response, postpartum depression, and post-traumatic growth levels of the two groups were compared before and after the intervention. The t, chi square, and rank sum tests were applied. Results After the intervention, the scores of general humanity, self-friendliness, and mindfulness were (7.87±0.56), (4.36±0.51), and (4.18±0.62) in the experimental group, which were higher than those in the control group (all P<0.05); the scores of isolation, self-criticism, and excessive addiction were (2.62±0.32), (2.83±0.23), and (2.97±0.51) in the experimental group, which were significantly lower than those in the control group (all P<0.05); the degree of stress response in the experimental group was significantly lower than that in the control group (Z=3.310, P<0.05); the depression score in the experimental group was significantly lower than that in the control group [(8.32±2.57) vs. (11.25±2.27); t=4.776, P<0.05]; the scores of life perception, personal ability, new probability, interpersonal relation, and self-change and the total score of post-traumatic growth were (19.50±4.35), (10.01±2.25), (15.65±3.35), (9.87±3.67), (16.21±2.34), and (83.35±13.25) in the experimental group, which were higher than those in the control group (all P<0.05). Conclusion Mindfulness cognition combined with self-compassion intervention applied to pregnant women taking fetal malformation induced labor can improve their self-compassion, depressive state, and post-traumatic growth, and reduce the degree of stress response, so it is worthy of reference and promotion.
    Correlation of sevoflurane and desflurane with patients' postoperative recovery quality 
    Song Qianqian, Zhao Xiujie, Wang Yewen, Zhang Quanyi
    2022, 28(21):  3046-3050.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.017
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    Postoperative complications affect patients' postoperative recovery. Good postoperative recovery can shorten their hospitalization time, reduce hospitalization cost, and increase their satisfaction. Different anesthesia methods may have different effects on patients' recovery. Inhalation anesthesia is a commonly used anesthesia method, and sevoflurane and desflurane are two commonly used inhalation anesthetics. They have different pharmacokinetic characteristics, so they may have different effects on the patients' postoperative recovery quality. This study mainly reviews the correlations of sevoflurane and desflurane with postoperative cognitive dysfunction (POCD), respiratory complications, postoperative nausea and vomiting (PONV), sore throat, recovery, and so on.
    Genetic screening of maturity onset diabetes of the young and related clinical features
    Huang Ke, Shi Shousen, Zhang Yanfang
    2022, 28(21):  3050-3054.  DOI: 0.3760/cma.j.issn.1007-1245.2022.21.018
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    Objective To analyze the detection rate of gene mutation in patients with maturity onset diabetes of the young (MODY) in Luoyang Central Hospital, Zhengzou University, and to explore the MODY-related clinical features. Methods This was a retrospective cross-sectional study. A total of 121 diabetic patients with onset age <40 years treated at Department of Endocrinology, Luoyang Central Hospital, Zhengzhou University from August 2016 to November 2021 were included. Their general conditions and clinical indicators were collected, and genetic screening was performed. t and χ2 tests were applied. Results A total of 121 patients with early-onset diabetes mellitus were included, including 31 cases(25.6%) of type 1 diabetes mellitus (T1DM), 78 cases of (64.5%) type 2 diabetes mellitus (T2DM), and 12 cases (9.9%) of uncertain clinical type. MODY gene detection revealed that 7 patients among these 12 patients carried MODY mutation [3 cases of hepatocyte nuclear factor 1A(HNF1A), 2 cases of GCK, 1 case of hepatocyte nuclear factor 4A (HNF4A), and 1 case of hepatocyte nuclear factor 1B (HNF1B)]. Compared with the patients with T1DM, the patients with MODY mutation had obvious family history of diabetes (χ2=13.444, P<0.05) and relatively higher C-peptide levels 1 and 2 hours after meal and negative insulin autoantibody (t=29.410 and 5.039 andχ2=38.000; all P<0.05). Compared with the patients with T2DM, the patients with MODY mutation had a relatively younger age of onset, lower body mass index (BMI), shorter course of diabetes, obvious family history of diabetes, and higher 1-hour postprandial blood glucose (t=1.082, t=0.120, t=4.752, χ2=4.575, and t=0.970; all P<0.05). Conclusion In clinical practice, MODY-related gene screening should be performed in a timely manner for patients with relatively early onset, negative insulin antibodies, family history of diabetes, and relatively high blood glucose and C-peptide levels, so as to improve the diagnostic accuracy and provide precise and individualized treatment as soon as possible.
    Surgical treatment assisted by 3D printing technology for Schazker V and tibial plateau fractures
    Zhang Feng, Li Wei, Song Yuanzheng, Zhang Shuaigong, Lin Feng, Shen Bing, Wang Shufang First Traumatic Department, Tengzhou Central People's Hospital, Jining Medical University, Tengzhou , China
    2022, 28(21):  3055-3059.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.019
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    Objective To explore the efficacy of 3D printing technology-assisted surgery in the treatment of Schazker V and Ⅵ tibial plateau fractures. Methods A total of 30 patients with Schazker V and Ⅵ tibial plateau fractures who were admitted to Tengzhou Central People's Hospital from January 2020 to January 2021 were selected and randomly divided into a control group and an observation group, with 15 cases in each group. There were 7 males and 8 females in the control group, and they were (60.40±10.76) years old. There were 6 males and 9 females in the observation group, and they were (53.40±17.82) years old. The control group were treated with traditional surgery, and the observation group with 3D printing technology-assisted surgery. The perioperative parameters, including operation duration, bleeding volume, number of fluoroscopy during operation, number of screw replacements during operation, and fracture reduction time, in the two groups were evaluated. The t test, Fisher's exact test or Free-man-Halton test, and rank sum test were applied. Results The operation duration, bleeding volume, number of fluoroscopy during operation, number of screw replacements during operation, and fracture reduction time in the observation group were lower than those in the control group (t=-10.729, -20.315, -10.837, -16.472, and -6.153; all P<0.05). There were no statistical differences in the hospitalization time and cost between these two groups (t=-0.105 and 0.345; P>0.05). The Rasmussen score and score of Hospital for Special Surgery (HSS) in the observation group were higher than those in the control group (z=-2.108 and -2.320; both P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group [6.7% (1/15) vs. 46.7% (7/15)]. Conclusion The patient-specific 3D printed model provides a comprehensive understanding of the characteristics of tibial plateau fractures, allowing accurate patient-specific preoperative planning, intraoperative guidance, and prediction of intraoperative difficulties, so it optimizes clinical outcomes.
    Effect of internet technology nursing on self-management ability of vascular access in hemodialysis patients
    Zhang Lifeng, Huang Xuefeng, Pan Huijuan
    2022, 28(21):  3059-3059.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.020
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    Objective To explore the application value of internet technology nursing in vascular access management in hemodialysis patients. Methods Eighty hemodialysis patients admitted to Southern University of Science and Technology Hospital from January 2021 to March 2022 were selected. According to the chronological order, 40 patients who received routine nursing from January to July 2021 were set as a control group, including 23 males and 17 females, with an age of 28-60 (39.12±5.56) and dialysis time of 8-35 (27.29±3.18) months; among them, 8 cases' education level was primary school, 11 cases' middle school, 13 cases' high school, and 8 cases' college or above; the rest 40 cases who underwent internet technology nursing from August 2021 to March 2022 were selected as an observation group, including 21 males and 19 females, with an age of 27-61 (39.58±5.62) and dialysis time of 8-34 (27.14±3.25) months; among them, 6 cases' education level was primary school, 13 cases' middle school, 15 cases' high school, and 6 cases' college or above. Both groups were nursed for 3 months. The self-management abilities, qualities of life, and vascular access complications of the two groups were compared. t and χ2 tests were applied. Results After the nursing, the scores of problem solving, emotional processing, executive self-care, and partner relationship and the total score of Self-Management Behavior Scale (SMSH) in the observation group were higher than those in the control group [(16.13±1.62) vs. (14.76±1.57), (13.15±1.40) vs. (11.84±1.70), (23.63±2.01) vs. (21.24±1.97), (13.04±1.35) vs. (11.79±1.46), and (65.95±5.11) vs. (59.63±4.02)], with statistical differences (all P<0.05). After the nursing, the scores of psychological function, physical function, social function, and material life of Generic Quality of Life Inventory 74 (GQOLI-74) in the observation group were higher than those in the control group [(74.38±6.44) vs. (69.12±5.03), (76.19±5.84) vs. (70.58±4.76), (79.04±5.73) vs. (71.81±5.20), and (75.21±5.80) vs. (68.42±5.36)], with statistical differences (all P<0.05). The incidence of vascular access complications in the observation group was lower than that in the control group [5.00% (2/40) vs. 20.00% (8/40)], with a statistical difference (P<0.05). Conclusion Internet technology nursing for hemodialysis patients can improve their self-management ability and quality of life, maintain the safety of vascular access, and reduce complications, and has high clinical application value.
    Treatises
    Clinical significance of borderline amniotic fluid index in preterm pregnancy
    Chen Xiaoying, Wang Fang, Zhang Rui, Liang Haiying
    2022, 28(21):  3064-3066.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.021
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    Objective To investigate the recent changes in the conditions and clinical impact of case characteristics in those preterm pregnant patients in hospital care and followed up by outpatient department without enough borderline amniotic fluid index (50 mm<AFI≤80 mm). Methods This was a retrospective study. The conditions of 114 inpatients and 347 outpatients who were initially found isolated borderline amniotic fluid index (50 mm< AFI<80 mm) at 28 to 37 weeks of gestation between January 2019 and December 2021 were compared and analyzed. The patients were divided into three different outcomes according to the ultrasonic review results within 3 to 10 days. The outcome compositions in the two groups were compared and analyzed. The combined diagnosis features of the patients with different amniotic fluid changes were explored. The χ2 test and Fisher's exact test were applied. Results Twenty-three cases (20.2%) had A outcome, 32 cases (28.1%) B outcome, and 59 cases (51.8%) C outcome in the study group. Eighty-six cases (24.8%) had A outcome, 104 cases (30.0%) B outcome, and 157 cases (45.2%) C outcome in the control group. There was no statistical difference in the three outcomes between the two groups (χ2=1.652,=0.438). There were no statistical differences in the incidence of common co-diagnosis (breech, the pregnant woman of local complications, cord around neck twice, the racket shape the placenta, pregnancy with moderate/severe anemia, and placenta previa) between the three different outcomes in the patients with borderline oligohydramnios (all P>0.05). Conclusions Dynamic observation is necessary for the diagnosis of only borderline oligohydramnios, one examination alone should not be used as references for adverse fetal outcomes. It has not been determined whether traditional treatment such as inpatient fluid infusion and low molecular weight heparin is worthy of application. Follow-up by outpatient department can save medical resources and relieve patients' anxiety.
    Metatarsal cortex index in clinical diagnosis of metatarsal stress fractures 
    Li Zirui, Yu Kangjun
    2022, 28(21):  3067-3071.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.022
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    Objective To analyze the value of metatarsal cortical index (MCI) in the diagnosis of metatarsal stress fractures. Methods Forty-one patients with metatarsal stress fracture who were treated in Xianning Central Hospital from January 2019 to October 2021 were selected as an experimental group, including 26 males and 15 females, and they were (36.2±8.9) years old; 41 healthy people matched by age and gender in the experimental group were selected as a control group during the same period, including 25 males and 16 females, and they were (34.9±9.7) years old. The clinical data, propeptide of type Ⅰ procollagen (PINP), type I collagen cross-linked C-terminal telopeptide (CTX-I), 25-hydroxyvitamin D[25-(OH)D], and MCI were compared between these two groups. t test was used for the measurement data, and chi square test for the enumeration data. Results The bone mineral density (BMD) of the experimental group was smaller than that of the control group (t=-2.043, P<0.05). The levels of CTX-I in the experimental group were higher than that in the control group (t=3.670, P<0.05). The levels of PINP and 25(OH)both in the experimental group were lower than those in the control group (t=-2.164 and -2.075, all P<0.05). The MCI's of all the metatarsals in the experimental group were lower than those in the control group (t=-2.062, -2.019, -2.012, -5.889, and -2.083; all P<0.05). The results of Spearman correlation analysis showed that each MCI was positively correlated with metatarsal stress fractures. Multivariate logistic regression analysis showed that CTX-I (OR=6 065.508, P=0.021) was an independent risk factor for metatarsal stress fractures, while MCI Ⅳ(OR=0.011, P=0.001) was a protective factor for metatarsal stress fractures. The areas under the receiver operating characteristic curve (ROC) (AUC) of CTX-I and MCI Ⅳ in the diagnosis of metatarsal stress fractures were 0.825 (95%CI 0.735-0.914) and 0.869 (95%CI 0.793-0.945). The optimal cutoff values of CTX-I and MCI IV were 0.34 ng/ml and 1.7%. The diagnostic sensitivities of CTX-I and MCI IV were 66% and 81%, and the diagnostic specificities of CTX-I and MCI IV were 83% and 85%. Conclusions CTX-I and MCI IV are the influencing factors of metatarsal stress fracture, and can be used as important indicators in the diagnosis of metatarsal stress fracture.
    Clinical Research
    Spatial distribution of delayed cerebral ischemia caused by ruptured aneurysms at different locations
    Zeng Yile
    2022, 28(21):  3072-3076.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.023
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     Objective To clarify the spatial distribution of aneurysm rupture location and delayed cerebral ischemia (DCI) induced by aneurysmal subarachnoid hemorrhage (aSAH), and to clarify the predictive value of DCI at different locations for the prognosis of patients after aneurysmal rupture. Methods A total of 150 patients with aSAH treated at Second Affiliated Hospital of Fujian Medical University from January 2018 to December 2021 were selected, including 90 females and 60 males with an average age of 55. Cranial CT (CCT) scan was performed at least once 24 to 48 h after aneurysm treatment, and again at least 14 days after bleeding event. The distribution characteristics of cerebral lobe DCI corresponding to aneurysms at different locations were analyzed. χ2 and t tests were applied. Results The most common site of ruptured aneurysm was the middle cerebral artery (MCA), accounting for 26.0% (39/150), followed by the anterior cerebral artery (ACA) [22.0%(33/150)]. DCI occurred in 18.0%(27/150) of the patients. DCI was slightly more common in the women than in the men [21.1% (19/90) vs. 13.3% (8/60)]. Aneurysm location had no effect on the incidence of DCI (χ2=2.57, P=0.77). There was no significant difference in the frequency of DCI between anterior and posterior circulation aneurysms [18.7% (25/134) vs. 12.5% (2/16); χ2=0.15, P=0.61]. In the DCI patients, the most frequently involved region was the ipsilateral MCA region [32.0%(8/25)], followed by the ACA region [28.0%(7/25)]. DCI was an important marker of their poor prognosis. Conclusions In patients with ruptured aneurysm, the occurrence of DCI is related to the distribution of blood supply of parent artery. Therefore, monitoring and warning of specific brain areas in patients with ruptured aneurysms is the premise of drug intervention, which will significantly improve their overall prognosis.
    Effect of tigecycline combined with cefoperazone-sulbactam in treatment of severe intra-abdominal infection in ICU
    Du Jiangtao, Li Yang, Ouyang Shandan, Liu Bingzhen, Lin Zhen
    2022, 28(21):  3077-3081.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.024
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    Objective To investigate the effect of tigecycline combined with cefoperazone-sulbactam on plasma matrix metalloproteinase-9 (MMP-9), immune function, and inflammatory indicators in patients with severe intra-abdominal infection in ICU. Methods Eighty cases of severe abdominal infection in ICU admitted to Intensive Care Department, Hospital of 73rd Group, China's People's Liberation Army from April 2016 to April 2021 were seledted as the research data, including 46 males and 34 females who were (61.57±4.08) years old, and were randomly divided into a control group and an observation group by lottery, with 40 cases in each group. The control group were treated with cefoperazone-sulbactam, and the observation group with tigecycline and cefoperazone-sulbactam. The therapeutic effects and incidences of adverse reactions of the two groups were compared. χ2 and t tests were applied. Results The effective rate was 92.50% (37/40) in the observation group, and was 75.00% (30/40) in the control group, with a statistical difference (χ2=4.500, P<0.05). After the treatment, the levels of MMP-9, Toll-like receptors-4 (TLR-4), and collagen type Ⅳ (Ⅳ-C) were lower than those before the treatment in both groups, and were lower in the observation group than in the control group, with statistical differences (t=8.886, 9.097, and 10.124; all P<0.05). After the treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) were lower than those before the treatment in both groups, and were lower in the observation group than in the control group, with statistical differences (t=7.858, 3.807, and 5.396; all P<0.05). After the treatment, the levels of CD3+ and CD4+ and CD4+/CD8+ increased in both groups, and were higher in the observation group than in the control group, with statistical differences (t=3.326, 5.062, and 4.682; all P<0.05). During the treatment, 9 patients had adverse reactions, including 4 in the control group and 5 in the observation group, with no statistical difference (P>0.05). Conclusions Tigecycline combined with cefoperazone-sulbactam for ICU patients with severe intra-abdominal infection can effectively relieve their symptoms, improve their health and immune function, and reduce the levels of plasma MMP-9, TLR-4, Ⅳ-C, and inflammatory factors and inflammatory response, and achieve definite curative effect. Combination medication does not significantly increase adverse reactions, but it needs to strengthen monitoring. It is worth being generalized.
    Case Report
    One case of lymphocytic hypophysitis with abdominal pain as the first symptom
    Hu Xiuhui, Xu Weiwei
    2022, 28(21):  3082-3083.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.025
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    Pulmonary endometriosis with hemoptysis as the main symptom: a case report
    Zhang Suxia, Ma Hongmin
    2022, 28(21):  3084-3087.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.026
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    Six percent to 10 percent women of childbearing age suffer from endometriosis. Endometriosis mostly locates on ovary, peritoneum, and other parts, and only 2% on chest. It is very rare to involve the lung parenchyma and lead to pulmonary endometriosis (PEM), which is easy to be misdiagnosed or missed. The paper reports a case of pulmonary endometriosis confirmed by imaging and follow-up due to hemoptysis, so as to increase clinicians' understanding of PEM.
    Three cases of appendiceal mucinous neoplasms misdiagnosed as ovarian tumor
    Xing Jialing, Ai Jun, Zhou Ping
    2022, 28(21):  3087-3089.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.027
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    This article reports 3 cases of appendiceal mucinous neoplasms misdiagnosed as ovarian tumor. All the patients were asymptomatic with atypical ultrasound manifestations; two cases had slightly elevated carcinoembryonic antigen (CEA); all the 3 cases were confirmed by surgery and pathology. Appendiceal mucinous neoplasms is a rare tumor with atypical symptoms, and is easily misdiagnosed. This case report will help clinicians to improve the awareness of appendiceal mucinous neoplasms, reduce preoperative misdiagnosis, and increase the success rate of surgery.
    A case of bilateral primordial uterus complicated with ovarian mucinous cystadenoma and literature review
    Yu Wenjing, Liu Zhiqiang, Yao Tongtong, Ge Na
    2022, 28(21):  3090-3092.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.028
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    Primordial uterus, also known as trace uterus, is a special congenital uterine abnormality. Primordial uterus is extremely small, only 1-3 cm in length. It is a rare disease, and its etiology is still unclear. By reviewing the clinical data of a patient with bilateral primordial uterus complicated with ovarian mucinous cystadenomatosis in Binzhou Medical University Hospital and reviewing relevant literatures, this paper aims to understand the research progress of the disease and provides ideas for physicians to diagnose and treat such patients clinically.
    One case of infection by legionella pneumophila
    Zhang Wenying, Zhang Xiaohe
    2022, 28(21):  3093-3094.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.029
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    Nursing Research
    Integrated management and perioperative nursing care for children with congenital diaphragmatic hernia
    Liu Cuifen, Zhang Ying, Hong Chun, Tang Jing, Liu Qianli
    2022, 28(21):  3095-3097.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.030
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    Effect of progressive upper extremity functional exercise on patients with systemic lupus erythematosus
    Wang Li, Bai Jingzhi, Yang Xue
    2022, 28(21):  3098-3102.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.031
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    Objective To explore the effect of progressive upper extremity functional exercise on hand function, activity, and quality of life in patients with systemic lupus erythematosus. Methods A total of 49 patients with systemic lupus erythematosus admitted to Department of Rheumatology and Immunology, Tengzhou Central People's Hospital from January to June 2021 were selected as a control group, and 49 patients with systemic lupus erythematosus admitted from July to December 2021 were selected as an experimental group. There were 14 males and 35 females in the control group, with an age of (32.22±1.87) and a disease course of 3.0 to 8.0 years; the experimental group included 17 males and 32 females, with an age of (32.09±1.71) and a disease course of 3.5 to 9.0 years. There were no statistical differences in the general data between the two groups. The control group received routine nursing care and did voluntary exercise. On this basis, the experimental group formulated a progressive upper limb function exercise program according to individual differences. The differences in hand function, daily activities, and quality of life between the two groups were compared. The SPSS 19.0 software was used for statistical analysis, t test was used for the measurement data, and χ2 test for the count data. Results Fourteen days after the intervention, the grip strength and pinch strength of the hands were (29.48±9.56) SD and (5.67±1.68) SD in the experimental group, and were (23.83±9.54) SD and (4.01±2.06) SD in the control group, with statistical differences (t=10.616 and 4.675; P<0.001); the scores of upper limb activity function and upper limb symptom were (49.17±5.23) and (17.66±2.37) in the experimental group, and were (56.33±4.54) and (19.46±2.34) in the control group, with statistical differences (t=5.701 and 3.604; both P<0.001); the scores of physical health and fatigue were (72.90±21.45) and (69.43±22.16) in the experimental group, and were (57.33±22.13) and (57.46±22.49) in the control group, with statistical differences (t=12.795 and 11.605; both P<0.001). Conclusion Progressive upper limb function exercise for patients with systemic lupus erythematosus can improve their grip and pinch strength of the hands, functional status of the upper limbs, and physical health and fatigue, and is helpful for their recovery.
    Summary
    Research progress of histone lysine-K specific methyltransferase 2B
    Fei Wwng, Ma Changlin
    2022, 28(21):  3103-3106.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.032
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    Clinical progress of glucagon-like peptide 1 receptor agonist in treatment of diabetic nephropathy
    Guo Chaohua, He Qing, Xing Yuanyuan
    2022, 28(21):  3106-3108.  DOI: 10.3760/cma.j.issn.1007-1245.2022.21.033
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    Diabetes affects global health problems. Diabetes nephropathy is one of its common microvascular complications, and also one of the major diseases leading to nephropathy (ESRD). At present, glucagon-like peptide 1 receptor agonist (GLP-1RA), one of the hypoglycemic drugs, has become the main treatment for diabetes patients, and can effectively reduce blood glucose. More and more studies have shown that GLP-1RA can protect the kidney no matter what the hypoglycemic effect is. This article analyzes the clinical research progress of GLP-1RA in the treatment of diabetes by analyzing clinical data.