Table of Content

15 March 2023, Volume 29 Issue 6

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New Medical Advances

Research progress of Hashimoto's thyroiditis

Yao Wenjie, Song Kaiyu, Jiang Guantong, Chen Xi, Zhou Jin

2023, 29(6):  741-744.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.001

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Hashimoto's thyroiditis is characterized by thyroid-specific autoantibodies and is one of the most common autoimmune diseases. In recent years, its prevalence is increasing dramatically and has gradually become a hot topic in the society. This literature review introduces the pathogenesis of Hashimoto's thyroiditis from three aspects: immune factors, autophagy, and apoptosis affecting the disease, hoping to gain a deeper understanding of the disease and to better guide clinical work.

Fecal microbiota transplantation based on systemic biology in treatment of COVID-19

Gu Jiabo, Meng Jun, Chang You, Jin Heiying, Liu Jianlei

2023, 29(6):  745-749.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.002

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There is no specific drug or treatment for COVID-19 caused by SARSCoV-2 currently. In this paper, by studying the relationship between COVID-19, intestinal flora, and immune system, and the related mechanism of intestinal flora affecting COVID-19, fecal microbiota transplantation in the treatment of COVID-19 is explored so as to provide new methods for the treatment of COVID-19.

Research progress on correlation between nitric oxide and atherosclerosis

Cheng Jinfeng, Li Yang, Wang Qianqian, Zhen Mengmeng, Wu Yuting, Cheng Yanli

2023, 29(6):  749-752.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.003

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Atherosclerosis (AS) is a common arterial vascular disease; it is a complex pathological process and is the root cause of cardiovascular and cerebrovascular diseases, such as coronary artery disease (CAD), heart failure, and stroke. Nitric oxide (NO), an endothelium-derived relaxation factor, is the first gas molecule in the body that is considered a signaling medium. NO generated under different conditions has an inhibitory or promoting effect on AS. In this paper, we summarize the different roles of NO generated by endothelial nitric oxide synthase (eNOS) in AS process.

Meta Analysis

Rate of delayed consultation in students with pulmonary tuberculosis in China: a meta-analysis

Ye Yuqi, Zhu Aiyong, Wang Xinguo, Liao Xiaogang

2023, 29(6):  753-761.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.004

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Objective　To evaluate the delay of tuberculosis treatment in Chinese students. Methods　CNKI, Web of Science, Wanfang Data, Pubmed, SinoMed, VIP, and The Cochrane Library were searched for the cross-sectional studies on the delayed rate of tuberculosis treatment in Chinese students from January 2000 to July 2022. Stata 17.0 was used for the meta-analysis. Results　A total of 57 cross-sectional studies were included, including 67 105 subjects and 39 831 students with delayed treatment of pulmonary tuberculosis. Meta-analysis showed that the delayed rate of tuberculosis treatment in the Chinese students was 47.8% (95%CI 47.6%-48.1%) (P<0.001). The results of subgroup analysis showed that the delayed rates of the male and female students were 50.0% and 50.7%, respectively; the delayed rates of the students who were in primary school and below, middle school, high school, and college and above were 43.2%, 46.1%, 46.1%, and 46.0%, respectively; the delayed rates of the students from the eastern, southeastern, central, southwestern, southern, and northern regions were 43.7%, 44.1%, 37.8%, 50.5%, 54.7%, and 50.5%, respectively; the delayed rates of the local and non-local students were 51.9% and 50.6%, respectively; the delayed rates of the students discovered by medical treatment or recommendation, health examination, referral, follow-up, and other methods were 46.3%, 44.4%, 50.7%, 53.6%, and 35.7%, respectively; the delayed rates of the students taking initial treatment and retreatment were 52.9% and 46.3%, respectively; the delayed rates of the students with negative and positive pulmonary tuberculosis were 46.0% and 52.4%, respectively; the delayed rates in the first, second, third, and fourth quarters were 41.6%, 37.5%, 34.7%, and 37.6%, respectively; the delayed rate of treatment published between 2000 and 2010 was not included due to the low quality and small number of relevant literatures, and the delay rates from 2011 to 2015 and from 2016 to 2021 were 46.9% and 44.4%, respectively; the delayed rates of the Han and minority groups were 77.4% and 54.9%, respectively. Conclusions　The delayed rate of medical treatment of students with pulmonary tuberculosis in China has slightly decreased in recent 10 years, but the overall rate is still high. The delayed rate of tuberculosis treatment in Chinese students is affected by gender, region, household registration, education background, quarter, ethnicity, and other factors.

Scientific Research

Inhibitory effect of 5-Aza-dC on malignant melanoma in vitro and its mechanism

Yao Xiaoling, Su Ning, Shi Xiwen, Zhao Tingxiu, Jin He

2023, 29(6):  762-767.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.005

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Objective　To study the effect of 5-Aza-2'-deoxycytidine (5-Aza-dC) on the malignant biological behaviors of mouse melanoma B16 cells, such as proliferation, apoptosis, migration, and invasion in vitro, and its mechanism. Methods　This study was from January to June 2022. The effects of 5-Aza-dC on the proliferation, migration, invasion, and apoptosis of murine malignant melanoma B16 cells were examined by CCK-8 assay, cell scratch test, Transwell invasion test, and flow cytometry test. The expression levels of apoptosis-related proteins, Bcl-2 and Bax, and connexin 43 were detected by Western blotting. Mann-Whitney U and Welch tests and one-way ANOVA were applied. Results　The results of CCK-8 assay showed that the cell survival rates of the 5-Aza-dC groups were significantly lower than those of the blank control group and the DMSO group (all P<0.01). The comparison of the cell survival rates at different times of drug administration under the same drug concentration showed that the cell survival rate decreased as the time of drug administration prolonged (P<0.01). The results of cell scratch test showed that the cell scratch healing rate of the 5-Aza-dC group was significantly lower than that of the blank control group [(74.67±11.91)% vs. (100.00±0.00)%; P<0.05]. The Transwell invasion test results showed that the number of invasive cells in the blank control group was significantly higher than that in the 5-Aza-dC group [(444±65) vs. (2±1); P<0.01]. The flow cytometry test (Annexin V/PI double-staining) results showed that the apoptosis rate of the 5-Aza-dC group was significantly higher than that of the blank control group [(11.35±0.66)% vs. (2.51±0.04)%; P<0.01]. The Western blot results showed that compared with those in the blank control group, the expression of BCL-2 was down-regulated and the expressions of Bax and CX43 were up-regulated in the 5-Aza-dC group. Conclusions　5-Aza-dC can promote the apoptosis and inhibit the proliferation, migration, and invasion of murine malignant melanoma B16 cells. The anti-tumor effect of 5-Aza-dC may be related to the up-regulation of CX43 protein expression.

Effect of Yiqi Fumai injection combined with furosemide for patients with dilated cardiomyopathy and heart failure

Zhang Fengqiao, Li Shuai, Li Shengli

2023, 29(6):  768-772.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.006

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Objective  To investigate the effect of Yiqi Fumai injection combined with furosemide for patients with dilated cardiomyopathy (DCM) and heart failure. Methods  A total of 98 patients with DCM and heart failure admitted to Shangqiu People's Hospital from June 2019 to March 2022 were selected for the random control trial, and were randomly divided into a control group and an observation group by the envelope method, with 49 cases in each group. The control group were treated with furosemide, and the observation group with Yiqifumai injection and furosemide. The clinical efficacies of the two groups were compared. Before (T0) and after (T1) the treatment, all the patients underwent ultrasound electrocardiogram scanning; the indicators of cardiac function were measured; the D-dimer (D-D) level was measured by immunoturbidimetry; the level of pro-B-type natriuretic peptide (BNP) was detected by the immunofluorescence quantitative method; the level of angiotensin Ⅱ (ANG Ⅱ) was detected by enzyme-linked immunosorbent assay. The adverse drug reactions were compared between the two groups. t and χ² tests were applied. Results  The total effective rate of the observation group was higher than that of the control group [95.92% (47/49) vs. 83.67% (41/49)], with a statistical difference between these two groups (P<0.05). Compared with those at T0, the left ventricular ejection fractions (LVEF) at T1 in both groups were higher (both P<0.05); the LVEF at T1 in the observation group was higher than that in the control group (P<0.05); the left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) at T1 were lower than those at T0 in both groups (all P<0.05); the LVEDD and LVESD in the observation group were lower than those in the control group (both P<0.05). Compared with those at T0, the plasma levels of D-D, BNP, and ANG Ⅱ at T1 were lower in the two groups (all P<0.05); the levels in the observation group were all lower than those in the control group (all P<0.05). Conclusion  Yiqi Fumai injection combined with furosemide for patients with DCM and heart failure not only has a high total clinical effective rate, but also improves the patients' heart function and reduces the levels of DD, BNP and ANG Ⅱ, so it has high application value. 

Comparative study on common evaluation indicators of ovarian reserve function

Gong Jinkun, Chen Weiping, Chen Xiaoping

2023, 29(6):  772-776.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.007

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Objective　To compare the common evaluation indicators of ovarian reserve function, and to observe the predictive effect of each indicator on decreased ovarian reserve function (DOR). Methods　This was a retrospective analysis. The women of childbearing age who were examined in Guangdong Second Traditional Chinese Medicine Hospital from June 2019 to June 2022 were selected. According to the clinical diagnosis, they were divided into a hypofunctional ovarian reserve group (72 cases; a decreased group) and a normal ovarian reserve group (42 cases; a normal group). Age, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E₂), ovarian volume (OVVOL), antral follicle number (AFC), ovarian interstitial artery blood flow velocity (PSV), resistance index (RI), and pulsatile index (PI) were collected from all the women as the evaluation indicators, and the differences between the two groups were compared by independent-sample t test and Mann-Whitney test. The correlations between the above indicators and ovarian reserve dysfunction were analyzed by Pearson correlation analysis. The indicators' sensitivities and specificities were measured by receiver operating characteristic curve (ROC). Results　The age, levels of FSH and LH, RI, and PI of the decreased group were higher than those of the normal group, while the E₂ level, AFC, OVVOL, and PSV of the decreased group were significantly lower than those of the normal group, with statistical differences (all P<0.01). DOR was positively correlated with age, FSH, LH, RI, and PI (r=0.353, 0.332, 0.275, 0.448, and 0.491; all P<0.01), and negatively with E₂, AFC, OVVOL, and PSV (r=-0.034, -0.860, -0.623, and 0.330; P> 0.05 for E₂ and P<0.01 for the rest). The areas under the ROC's of AFC, FSH, and OVVOL for predicting ovarian reserve were the top three, 0.996, 0.935, and 0.893, respectively; their AUC's were above 0.850; they were very good in accordance with the AUC classification. The corresponding cutoff values, sensitivities, and specificities were 5.75, 95%, and 97%, 8.66 U/L, 88%, and 95%, and 4.49 cm³, 76%, and 89%, respectively. Conclusion　At present, the commonly used evaluation indicators of ovarian reserve function (AFC, FSH, and OVVOL) have high accuracies in determining whether ovarian reserve function is decreased, with promotion and application value in clinical diagnosis.

Effect of massage combined with exercise therapy on motor function of children with cerebral palsy

Wan Ge, Cheng Yulong, Shang Qing, Geng Xiangju

2023, 29(6):  776-780.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.008

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Gushen Yutai ecological therapy combined with psychotherapy for infertile patients with qi-depression constitution PCOS

Peng Shaofang, Shan Haiping, Lin Fengmin, Huang Qixiang, Wu Peichun, Jiang Huiqin, Lu Peijin, Chen Xiexin, Ma Xiao'en

2023, 29(6):  781-785.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.009

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Objective　To investigate the effect of Gushen Yutai ecological therapy combined with psychotherapy on the efficacy, pregnancy rate, constitution, anxiety state, and sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), and prolactin (PRL)] of infertile patients with qi-depression constitution polycystic ovarian syndrome (PCOS). Methods　From January 2021 to June 2022, 128 infertile patients with qi-depression constitution PCOS who were treated in Shantou Central Hospital and Department of Gynecology of Traditional Chinese Medicine (TCM), Rehabilitation Branch, Shantou Central Hospital and who met the inclusion criteria were selected. They were divided into group A who were 24-36 years old, group B who were 23-40 years old, group C who were 25-38 years old, and group D who were 25-42 years old according to the principle of randomized control, with 32 cases in each group. Group A took routine therapy. Group B took Gushen Yutai ecological therapy and routine therapy. Group C took Gushen Yutai ecological therapy, routine therapy, and mental therapy. Group D took Gushen Yutai ecological therapy, routine therapy, mental therapy, and four-season music assisted pregnancy therapy. One menstrual cycle was taken as a treatment course. After three treatment courses, the clinical pregnancy conditions, TCM constitution classifications, scores of determination self-test scale (CCMQ) qi-depression constitution and Self-Rating Anxiety Scale (SAS), and basic sex hormone levels before and after the treatment in the four groups were compared. χ² test and analysis of variance were applied. Results　The clinical pregnancy rates of group A, B, C, and D were 28.13% (9/32), 53.13% (17/32), 56.25% (18/32), and 58.38% (19/32), respectively, with statistical differences between group B, C, and D and group A (all P<0.05). The scores of CCMQ qi-depression constitution and SAS in group C and D were significantly better as compared with those before the treatment, with statistical differences (all P<0.05); the scores in group D were better than those in group A and B after the treatment, with statistical differences (all P<0.05). The total effective rates of group A, B, C, and D were 50.00% (16/32), 90.63% (29/32), 90.63% (29/32), and 93.75% (30/32), respectively, with statistical differences between group B, C, and D and group A (all P<0.05). After the treatment, the levels of LH and PRL in group D were much better than those in group A, with statistical differences (both P<0.05). Conclusion　Gushen Yutai ecological therapy combined with conventional therapy and psychotherapy can effectively improve the anxiety of infertile patients with qi-depression constitution PCOS and their physique, regulate the levels of sexual hormones, and increase the pregnancy rate.

Effect of lactic acid bacteria capsules combined with nifuratel for elderly patients with bacterial vaginosis

Zhao Yingying

2023, 29(6):  786-790.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.010

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Objective　To study the effect of nifuratel + lactic acid bacteria capsules in the treatment of elderly patients with bacterial vaginosis. Methods　This was a prospective study. Eighty-three elderly patients with bacterial vaginosis treated at Traditional Chinese Medicine Hospital Affiliated to Nanyang Medical College from June 2019 to January 2022 were selected and were divided into a control group (41 cases) and an observation group (42 cases) by the random number table method. The control group were (73.22±2.16) years old. The observation group were (73.15±2.28) years old. The control group were treated with nifurtel, and the observation group with lactic acid bacteria capsules and nifurtel. The symptom improvement, vaginal microecological environment indicators and scores, and adverse reactions in the two groups were observed and compared. χ² and t tests were applied. When P<0.05, there is a statistical difference. Results　After the treatment, the pain improvement time, itch relief time, mucosal congestion relief time, and remission time of abnormal leucorrhea in the observation group were shorter than those in the control group [(2.14±0.35) d vs. (3.47±0.25) d, (1.19±0.36) d vs. (2.82±0.41) d, (1.33±0.24) d vs. (2.25±0.64) d, and (2.05±0.31) d vs. (3.77±0.82) d], with statistical differences between these two groups (t=19.879, 19.259, 8.711, and 12.698; all P<0.001). After the treatment, the H₂O₂ and leukocyte esterase (LE) and Nugent scores in the observation group were lower than those in the control group [(3.76±0.32)% vs. (4.37±0.18)%, (1.17±0.26) vs. (2.32±0.41), and (3.13±0.25) vs. (4.22±0.82)], with statistical differences between these two groups (t=10.668, 15.299, and 8.233; all P<0.001). The proportions of the patients with grade Ⅰ-Ⅱ vaginal cleanliness and grade Ⅰ-Ⅱ vaginal flora diversity in the observation group were higher than those in the control group [83.33%(35/42) vs. 56.10%(23/41) and 90.48% (38/42) vs. 60.98% (25/41)], with statistical differences between these two groups (χ²=7.312 and 9.872; both P<0.001). The recurrence rate in the observation group was lower than that in the control group [2.38% (1/42) vs. 9.76% (4/41)], with a statistical difference between these two groups (χ²=4.776, P=0.029). There was no statistical difference in the incidence of adverse reactions between these two groups (P>0.05). Conclusion　Nifuratel + lactic acid bacteria capsules for elderly patients with bacterial vaginosis can speed up their recovery, improve their vaginal microecological environment, and avoid recurrence, and does not significantly increase the adverse drug reactions, with high safety.

Correlation of COVID-19 nucleic acid antibody expression pattern with basic diseases and laboratory indicators

Li Guohua, Liang Enyu, Zhang Qiaoxuan, Wang Yunxiu, Huang Hui, He Min, Li Ling, Ke Peifeng

2023, 29(6):  790-795.  DOI: DOI: 10.3760/cma.j.issn.1007-1245.2023.06.011

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Objective　To analyze the correlation of COVID-19 nucleic acid antibody expression pattern with laboratory indicators and patients' basic diseases.Methods　A total of 95 patients diagnosed with COVID-19 in Hubei Provincial Hospital of Traditional Chinese and Western Medicine from January 28 to March 3, 2020 were collected and classified into 7 groups (group 1 to group 7) according to different expression patterns of nucleic acid and antibody results; the general information, basic disease history, and laboratory test results in each group were retrospectively analyzed and compared. Kruskal-Wallis rank sum test was used to compared the measurement data between the groups, and χ² test was used for the comparison of percentages. When P<0.05, there is a statistical difference.Results　The abnormal rates of serum interleukin 6 (IL-6) in the antibody and nucleic acid negative group (group 1) [62.5% (5/8)] and antibody negative and nucleic acid positive group (group 2) [100.0% (2/2)] were the highest. When the antibody pattern was the same under different staging modes, the abnormal rates of CD4⁺ T lymphocytes, CD8⁺ T lymphocytes, IL-6, serum amyloid protein A (SAA), and C-reactive protein (CRP) and the critical rate of the patients in the nucleic acid positive group were significantly higher than those in the nucleic acid negative group. The abnormal rates of SAA and CRP in all the patterns did not change much, and the specificities were not high. The group with double positive antibodies and positive nucleic acid (group 7) had the highest abnormal rate (94.44%, 17/18) of CD4⁺ T among all the test indicators. In the double-positive antibody groups, the probability of critically ill patients in the nucleic acid negative group was 2.36 times those in the first positive nucleic acid test group (group 5) and the subsequent positive nucleic acid test group (group 7). Compared with the double antibody positive and nucleic acid positive group (group 6), the patients with underlying diseases in group 5 were more likely to progress to critical type, especially the patients with abnormal glucose metabolism and cardiovascular diseases.Conclusions　For patients with double negative antibodies and negative nucleic acid many times, early abnormal IL-6 can be used as an early warning indicator when the nucleic acid of COVID-19 antibody is negative. The specificities of CRP and SAA as the monitoring indicators of disease progression are low. When the COVID-19 antibodies both are positive and if the decrease or continuous decrease of CD4⁺ T indicates that the patient is in a state of viral replication, the subsequent nucleic acid can become positive. When the antibody pattern of COVID-19 is the same, the nucleic acid detection rate is related to the patients' immune status. The higher the nucleic acid detection rate is, the higher the patients' severity is, indicating that the patients are in a state of poor prognosis. If the patients' COVID-19 antibodies both are positive, regardless of negative or positive nucleic acid test results, the patients with abnormal glucose metabolism are more likely to develop severe COVID-19 than the patients with other underlying diseases.

Development of infants and children who were 0-3 years old in Binzhou City during COVID-19 epidemic

Liu Congcong, Gao Wenting, Wang Xin, Lyu Panpan, Geng Limeng, Liu Fang

2023, 29(6):  796-800.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.012

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Objective　To explore the development of infants and children who are 0-3 years old taking health examination at home in Binzhou during COVID-19 epidemic. Methods　This article adopted the cross-sectional research method. A total of 2 282 infants and toddlers who took health checkups at Department of before (from April 1 to May 31, 2019) and after from April 1 to May 31, 2020 the COVID-19 epidemic were collected. Their developmental quotients and scores of each energy area of Neurological and Psychological Development Scale for Children Who are 0-6 Years Old were calculated. According to their age, the children before and after the epidemic were divided into an 0-4 months old group who were <5 months old, a 5-8 months old group who were ≥5 and < 9 months old, a 9-12 months old group who were ≥9 and ≤12 months old, a 1-2 years old group who were >12 and ≤24 months old, and a 2-3 years old group who were >24 and ≤36 months old. The influence on each energy area in the groups were evaluated. χ² and t tests were applied. Results　The scores of developmental quotient, gross motor, fine motor, adaptive ability, language, and social behavior in the infants and children who are 0-3 years old after the epidemic were higher than those before the epidemic [(96.7±9.1) vs. (93.6±8.7), (95.5±14.3) vs. (93.7±14.9), (92.0±12.9) vs. (88.6±13.7), (94.6±12.8) vs. (91.2±13.1), (102.5±18.2) vs. (97.6±17.4), and (98.8±16.5) vs. (96.7±14.9)], with statistical differences (all P<0.01). In group comparisons, statistically significant differences were found in the below: developmental quotient, fine motor, language and social behavior in the 0-4 months old group; developmental quotient, gross motor, fine motor, cognition, language, and social behavior in the 5-8 months old group; developmental quotient, gross motor, cognition, and language in the 9-12 months old group; and developmental quotient, fine motor, and cognition in the 1-2 years old group. In the 2-3 years old group, there were no statistical differences (all P>0.05). Conclusion　The developmental level of infants and children who are 0-3 years old increases during home isolation and is more pronounced before the age of 2 years.

Treatises

Effect of Shexiang Baoxin Pills on angiogenesis in rabbits with acute myocardial infarction through SIRT1/mTOR signaling pathway

Wei Jingxun, Dong Binchang, Du Xin, Xu Huipu

2023, 29(6):  801-807.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.013

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Objective　To explore the mechanism of Shexiang Baoxin Pills (SBP) participating in angiogenesis after acute myocardial infarction through the SIRT1/mTOR signaling pathway. Methods　The trial was from October 2021 to March 2022. Forty New Zealand male rabbits were selected; they were 2-3 months old; their body weight was 2.0-2.5 kg. The rabbit models of acute myocardial infarction were established by ligating the left anterior descending coronary arteries with silk thread. The limb lead ECG was recorded to determine the models' success. The rabbits were divided into a control group (SBP+ normal rabbit group), a sham operation group, a saline + AMI group, and an SBP + AMI group, with 10 in each group. The animals were sacrificed 7 days after the operation, and the myocardial tissue was collected. HE staining was used to observe the histological changes of rabbit myocardium in each group; the degree of acute myocardial infarction was observed by picric acid staining; the immunohistochemical method was used to detect the expression of vascular endothelial growth factor (VEGF), SIRT1, Beclin1, and mTOR protein in the myocardial tissue of each group; immunofluorescence CD31 labeled microvascular density (MVD) was used to observe the rabbits' vascular regeneration in each group. F test was applied. Results　Compared with those in the control group and the sham operation group, the expressions of VEGF, Beclin1, and mTOR in the normal saline + AMI group and the SBP + AMI group were higher, while the expression of SIRT1 was lower (F=47.478, 34.179, 40.908, and 21.710; all P<0.05). Compared with that in the normal saline + AMI group, the myocardial infarction area in the SBP + AMI group was smaller, with a statistical difference (F=68.865, P<0.05); the CD31 immunofluorescence labeled MVD and the positive expressions of VEGF, Beclin1, mTOR, and SIRT1 in the SBP + AMI group were higher than those in the normal saline + AMI group. Conclusions　Autophagy is enhanced after acute myocardial infarction; SBP can affect angiogenesis through the SIRT1/mTOR signaling pathway after acute myocardial infarction and inhibit ventricular remodeling and decline of cardiac function.

A cross-sectional survey study on myopic adolescents wearing corneal contact lenses

Wu Min, Yu Na, Wang Lingyun, Xue Ling, Huang Shuo, Fu Te

2023, 29(6):  807-813.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.014

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Objective　To investigate the current status, normality, and health literacy of myopic adolescents wearing corneal contact lenses (CL). Methods　A cross-sectional study was conducted on the myopic adolescents wearing CL in Eye Clinic, Jinan Second People's Hospital from March 2022 to July 2022. Six hundred and four questionnaires were handed out to the adolescents, and 561 ones were included for the analysis, including 156 cases and 405 cases; they were 14-25 years old; according to their age, the were divided into a 14-17 years old group (133 cases) and an 18-25 years old group (428 cases). The scale designed by our ophthalmology team was used to investigate their current status, normality, and health literacy. χ² and t tests were applied. Results　There were statistical differences in the CL source, CL type, CL expiration date, average wearing time per week in the past six months, and wearing spectacles between these two groups (χ²=13.220, 34.769, 11.065, 49.498, and 7.710; all P<0.05). The proportions of the myopic adolescents who purchased CL from non-professional institutions, wore spectacles, and had soft contact lenses in the 18-25 years old group were higher than those in the 14-17 years old group [(67.99% (291/428) vs. 60.15% (80/133), 94.39% (404/428) vs. 87.22% (116/133), and 64.02% (274/428) vs. 40.60% (54/133)]. The accurate rates of that the adolescents checked whether there was pollutant or precipitate on the lenses before they put on the CL, washing hands before putting on or taking off the CL, and rubbing both sides of the lenses each time they cleaned them were the highest, and were 96.26% (540/561), 93.05% (522/561), and 78.97% (443/561), respectively. The proportions of the myopic adolescents who wore them at the recommended time, who checked lenses for contamination or deposits before wearing CL, who soaked the CL for more than 4 h, and who cleaned CL thoroughly once a week and air dried them in the 18-25 years old group were higher than those in the 14-17 years old group [71.26% (305/428) vs. 57.14%(76/133), 97.89% (419/428) vs. 90.98% (121/133), 64.49% (276/428) vs. 53.38%(71/133), and 70.79%(303/428) vs. 49.62% (66/133)], with statistical differences (χ²=9.282, 13.484, 5.301, and 20.202; all P<0.05). Health literacy of wearing CL: 77.90% (437/561) agreed that long-term wearing of CL could cause corneal hypoxia and induce epithelial damage; 74.69% (419/561) agreed that CL could increase the risk of keratitis and conjunctivitis; 80.04% (449/561) agreed that CL could cause visual fatigue and even dry eyes; 89.84% (504/561) agreed that prolonged wearing time was harmful; 79.32% (460/561) agreed that wearing CL beyond the shelf life was harmful. Conclusions　The types of CL worn by myopic adolescents in this group were mainly soft contact lenses, and the proportion of CL from non-professional institutions such as online shopping was high; the overall standardized wearing behaviors of the myopic adolescents had room for further improvement; myopic adolescents mostly recognized the potential hazards that CL might bring. Ophthalmologists, CL manufacturers, and CL practitioners should better educate patients to promote the standardized use of lenses, and need to pay attention to the proper management of discomfort and eye examinations during CL wearing.

Effects of homocysteine and cystatin C on efficacy of intravenous thrombolysis for patients with acute ischemic stroke

Wu Shaohui, Xiao Yingxiu, Yang Danxiao, Peng Haicong, Huang Xiaoxin

2023, 29(6):  813-817.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.015

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Objective　To investigate the effects of different levels of homocysteine (Hcy) and cystatin C (CysC) on the short-term efficacy and prognosis of patients with acute cerebral infarction treated by intravenous thrombolysis using alteplase (rt-PA). Methods　A total of 179 patients with acute ischemic stroke (AIS) who were hospitalized in Jieyang People's Hospital from January 2019 to January 2022 were retrospectively selected as the research objects, including 124 males and 55 females, with an average age of 65.6. All the patients were treated with intravenous thrombolysis of rt-PA. All the patients were evaluated using the modified Rankin Scale (mRS) 90 days after thrombolysis. They were divided into a poor prognosis group (mRS score>2; 59 cases) and a favorable prognosis group (mRS score≤2; 120 cases). Through univariate analysis, the statistically significant independent variables were selected for multivariate logistic regression analysis, and the receiver operating characteristic curves (ROC) were made to study the predictive value of each indicator on the prognosis of thrombolysis. The data were analyzed by t and χ² , nonparametric tests. Results　The proportion of the patients with hyperhomocysteinemia, CysC level, platelet count, and NIHSS score before thrombolysis in the favorable prognosis group were all lower than those in the poor prognosis group, with statistical differences (χ²=16.249, Z=-2.455, t=-2.172, and Z=-6.366; all P<0.05). Multivariate analysis showed that hyperhomocysteinaemia, CysC, NIHSS score before thrombolysis, and platelet count were independent risk factors for the patients' prognosis. The predicted cut-off values for poor thrombolysis outcomes of Hcy and CysC in the patients were 11.30 μmol/L and 1.135 mg/L; their sensitivities were 0.610 and 0.542; their specificities both were 0.767. Conclusion　Hcy and CysC are independently related to the poor prognosis of thrombolysis in AIS patients, and can be used as two indicators in the prediction of the poor prognosis of thrombolysis.

Effect of oxygen delivery directed hemodynamic management on cerebral protection in patients undergoing liver transplantation

Pan Zhihao, Hao Yuxia, Zhang Hao, Liu Zhiwu

2023, 29(6):  818-822.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.016

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Objective　To investigate the effects of different oxygen delivery (DO₂) directed hemodynamic management on perioperative cerebral function in patients undergoing liver transplantation. Methods　Forty patients scheduled for liver transplantation in 970th Hospital of People's Liberation Army from January 2019 to December 2019 were selected for the random control trial, including 28 males and 12 females; they were 34-64 yeas old. They were randomly divided to a control group and an experimental group, with 20 cases in each group. The control group received common hemodynamic management; the DO₂ during operation was maintain between 350～500 ml·min^-1·m^-2. The experimental group received DO₂ directed hemodynamic management; the DO₂ were maintained above 500 ml·min^-1·m^-2. Arterial blood samples were obtained after induction of anesthesia and before surgery (T₀), at 30 min of anhepatic phase (T₁), 30 min after neohepatic phase (T₂), at the ending of surgery (T₃), 24 h after surgery (T₄), and 48 h after surgery (T₅) for the determination of serum S100β protein (S100β) and neuron-specific enolase(NSE) concentrations in both groups. The regional cerebral oxygen saturation (rSO₂) was monitored by near-infrared spectroscopy at T₀, T₁ , T₂, and T₃. The cognitive function was assessed by Mini Mental State Scale (MMSE) 1 d before and 3, 5, and 7 d after surgery. χ² and t tests were applied. Results　The S100β and NSE concentrations at T₂ and T₃ and after the surgery were significantly higher than those at T₀ in both groups. The concentrations of S100β at T₂, T₃, T₄, and T₅ and the concentrations of NSE at T₂, T₃, and T₄ in the experimental group were significantly lower than those in the control group (t=6.268, 4.396, 4.245, 7.615, 2.172, 8.619, and 3.555; all P<0.05). Compared with those at T₀, the rSO₂ at T₁ in both groups were significantly lower; the rSO₂ at T₁ in the experimental group was significantly lower than that in the control group (t=-13.136,P<0.05). Conclusions　The DO₂ directed hemodynamic management can improve the cerebral oxygen metabolism during surgery in the patients undergoing liver transplantation, decrease the levels of S100βand NSE in serum and the incidence of postoperative cognitive dysfunction, and protect their cerebral function.

Clinical Research

Effect of remazolam combined with remifentanil on intraoperative circulatory function and PONV in elderly patients taking ophthalmic general anesthesia

Zhao Qing, Wu Xiandeng, Wu Peng

2023, 29(6):  823-828.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.017

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Objective　To explore the effect of remazolam combined with remifentanil on intraoperative circulatory function and postoperative nausea and vomiting (PONV) in elderly patients taking ophthalmic general anesthesia. Methods　Ninety-four elderly patients undergoing general anesthesia surgery in Ophthalmic Operating Room, Jinan Second People's Hospital from April 2021 to July 2022 were randomly divided into a control group and a study group, with 47 cases in each group. There were 27 males and 20 females in the control group; they were (67.89±7.58) years old. There were 25 males and 22 females in the study group; they were (68.18±7.82) years old. The control group were given propofol 0.6-1.2 mg/kg for anesthesia induction and 4-10 mg•kg^-1•h^-1 for maintenance. The study group were given remazolam 0.1-0.3 mg/kg for anesthesia induction and remazolam 0.8-1.2 mg•kg^-1•h^-1 and remifentanil 0.1-0.2 μg•kg^-1•min^-1 for maintenance. The cardiac indexes (CI) and cardiac outputs (CO), mean artery pressures (MAP), and oxygen saturations (SpO₂) were compared between the two groups before anesthesia induction (T₀), when anesthesia induction succeeded (T₁), immediately after laryngeal mask placement (T₂), and 20 minutes after surgery (T₃). The rates and severities of postoperative nausea (PON), postoperative vomiting (POV), and postoperative nausea and vomiting (PONV) were compared between the two groups. The anesthesia recovery indicators (awakening time, extubation time, and restlessness during recovery) were compared between the two groups. The χ², t, and Mann-Whitney U tests were applied. Results　The CI's at T₁, T₂, and T₃ in the study group were higher than those in the control group [(2.89±0.43) min•m^-2 vs. (2.64±0.41) min•m^-2, (2.71±0.37) min•m^-2 vs. (2.54±0.33) min•m^-2, and (2.85±0.40) min•m^-2 vs. (2.60±0.38) min•m^-2]. The CO's at T₁, T₂, and T₃ in the study group were higher than those in the control group [(5.26±0.47) L/min vs. (4.92±0.43) L/min, (4.72±0.41) L/min vs. (4.46±0.38) L/min, and (5.10±0.45) L/min vs. (4.78±0.40) L/min]. The MAP at T₂ in the study group was higher than that in the control group [(75.50±6.73) mmHg vs. (72.14±6.25) mmHg,t=2.508,P<0.05]. The SpO₂ at T₂ and T₃ in the study group were higher than those in the control group, with statistical differences (t=2.699 and 2.209; both P<0.05). The incidences of PON, POV, and PONV within 48 h after the operation in the study group were lower than those in the control group (χ²=4.065, 4.821, and 5.317; all P<0.05). The severity scores of PON and POV 6 h after the surgery in the study group were lower than those in the control group (Z=2.403 and 2.354; both P<0.05). The severity scores of PON and POV 12 h after surgery in the study group were lower than those in the control group (Z=2.136 and 2.081; both P<0.05). The awakening time and extubation time in the study group were lower than those in the control group [(20.40±3.98) min vs. (13.62±2.84) min and (23.25±4.15) min vs. (15.17±3.32) min; t=8.922 and 10.423, both P<0.001]. Conclusions　Compared with propofol anesthesia induction and maintenance, the application of remazolam and remifentanil in elderly patients taking ophthalmic general anesthesia has relatively stable intraoperative CI, CO, MAP, and SpO₂, and the incidence and severity of PONV are lower. The disadvantage is that the recovery time and extubation time are relatively long.

Effect of clinical pathway management on qualified treatment for patients with gout

Wu Weirong, Gong Wenjing, Huang Shaomei, Lou Aiju, He Shiwen

2023, 29(6):  829-832.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.018

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Objective　To study the effect of clinical pathway management on qualified treatment for patients with gout. Methods　A total of 1 147 patients with primary gout who were treated at Liwan Central Hospital from March 2020 to March 2021 were included in the study. The patients were randomly assigned to a test group (643 cases) and a control group (504 cases) according to the registration. The test group carried out standardized whom-process management (implemented in the form of clinical pathway); of which 510 patients were regularly revisited and completed the study, including 465 males and 45 females who were 17-87 (52 ± 16) years old. In the control group, 213 patients were regularly revisited and completed the study, including 194 males and 19 females who were 15-81 (51 ± 13) years old. The observation period was one year. The serum uric acid level, joint ultrasound, and other indicators were regularly re-examined; the situation of subsequent visit was recorded. The data were analyzed by t and χ² tests. Results　The subsequent visit rate, the qualified rate of serum uric acid, and clinical cured rate in the test group were 79.2% (404/510), 54.3% (277/510), and 3.5% (18/510); those in the control group were 42.3% (90/213), 18.3% (39/213), and 0.5% (1/213), respectively; there were statistical differences between these two groups (χ²=166.486, 45.498, and 5.496; all P<0.05). Conclusion　Clinical pathway management can significantly improve the subsequent visit rate of gout patients, qualified rate of serum uric acid, and clinical cured rate.

Percutaneous vertebroplasty in treatment of senile osteoporotic vertebral fractures

Chen Zheng, Jiang Lei, Sang Fei, Liu Qingbai

2023, 29(6):  833-836.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.019

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Objective　To investigate the effect of percutaneous vertebroplasty (PVP) in the treatment of senile osteoporotic vertebral fractures. Methods　A total of 112 senile patients with osteoporotic vertebral fractures admitted to Huai'an First Hospital, Nanjing Medical University from March 2017 to February 2019 were selected and divided into a study group and a conventional group according to the surgical methods, with 56 cases in each group. There were 36 males and 20 females in the study group; they were 60-81 (69.36±7.89) years old. There were 35 males and 21 females in the conventional group; they were 61-83 (69.89±7.93) years old. The study group were treated by PVP, and the conventional group by percutaneous screw internal fixation. The vertebral compression rates, vertebral height recovery (operation time and amount of bone cement injection), and incidences of adverse reactions of the two groups were compared. t and χ² tests were applied. Results　After the surgery, the vertebral compression rate and vertebral height recovery in the study group were statistically higher than those in the conventional group (t=5.20 and 5.46; both P<0.05). The operation time in the study group was shorter than that in the conventional group (t=5.19, P<0.05). The amount of bone cement injection in the study group was less than that in the conventional group (t=16.248, P<0.05). The incidence of adverse reactions in the study group was lower than that in the conventional group [3.57% (2/56) vs. 14.29% (8/56)], with a statistical difference (χ²=3.953, P<0.05). Conclusions　PVP for elderly patients with osteoporotic vertebral fractures can effectively restore the vertebral height, improve the vertebral compression rate, and has high safety.

Dipeptidyl peptidase-4 inhibitor combined with metformin for newly diagnosed type 2 diabetic patients

Song Yunhong, Liu Yanan, Zhang Zongli

2023, 29(6):  836-838.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.020

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Case Report

A case of solitary extracranial rib metastasis after operation for benign meningioma

Zhang Xiumei, Liu Pengtao

2023, 29(6):  839-841.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.021

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One case of surgical removal of an incarcerated pessary and literature review

Shi Juanjuan, Liu Yang, Yang Hui, Cui Xiujuan, Li Nan

2023, 29(6):  841-843.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.022

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Pelvic organ prolapse (POP) is a common disease affecting quality of life in women. Vaginal pessaries are an effective treatment for POP in women who wish to avoid or delay surgery or who have contraindications. This article reports the diagnosis and treatment process of one patient with an incarcerated pessary after surgical removal in Tengzhou Central People's Hospital, reviews the related literatures on pessary management, and aims to improve the attention of clinicians to pessary follow-up and management.

One case of pneumonic-type lung adenocarcinoma with cough and little sputum as clinical manifestations and literature review

Li Fei, Sui Xiaojun

2023, 29(6):  843-846.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.023

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Pneumonic-type lung adenocarcinoma is a special type of lung cancer, and its lung imaging findings are difficult to distinguish from pneumonia. Invasive lung adenocarcinoma is a common pathological subtype of pneumonic-type lung adenocarcinoma, and is often clinically manifested as a large amount of foam sputum. This article reports a patient with cough and little sputum as clinical manifestations admitted to Weihai Central Hospital Affiliated to Qingdao University on February 21, 20202; the disease progressed after anti-infection treatment; the patients was finally pathologically confirmed as invasive lung adenocarcinoma; the relevant literatures were reviewed so as to help clinical work.

One case of non-smoking desquamative interstitial pneumonia

Xu Xun, Shen Qiang, Zhang Yanqiong

2023, 29(6):  847-849.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.024

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Desquamative interstitial pneumonia is a relatively rare idiopathic interstitial lung disease, and needs to be confirmed by pathology. There are few domestic case reports, and non-smoking desquamative interstitial pneumonia is even rarer. On July 10, 2019, one case was found by percutaneous lung biopsy in Shanghai Songjiang District Central Hospital. The report is as follows.

Nursing Research

Nursing reflection of poor prognosis after clipping for multiple large aneurysms in bed-process segment

Zhang Chun, Feng Juanjuan, Li Xiang, Hu Xiaoxia

2023, 29(6):  850-854.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.025

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Based on the poor prognosis of a patient with multiple large aneurysms in the bed-process segment, the nursing work was introspect and discussed. The basic comprehensive nursing, management and observation of electrolytes, precise tumble piecewise discrepancy quantity management, effective and safe drainage control and management, reasonable postoperative sedation and analgesia, blood pressure and intracranial pressure management, early prevention of complications, establishment and perfection of the preoperative discussion of special cases of nursing problems, and weak links were improved overall. The aim is to increase the level of specialized nursing, to improve the comprehensiveness, timeliness, and objectivity of nursing staff's observation of illness through learning, and to achieve the transformation from general specialized nursing to individual intensive nursing.

Continuous nursing service mode for pregnant women with scar uterus

Yue Yaping, Xia Wenyan, Niu Wenfang

2023, 29(6):  854-858.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.026

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Objective　To observe the influence of continuous nursing service mode on the pregnant women with scar uterus. Methods　Ninety-one pregnant women with scar uterus treated in Zhengzhou Maternal and Child Health Hospital from May 2021 to May 2022 were selected for the study. The pregnant women were divided into a control group (45 cases) and an observation group (46 cases) according to the admission order. The control group were 28-43 (35.69±3.50) years old and 36-41 (38.65 ± 1.03) weeks pregnant, and took cesarean section 27-63 (45.28±8.74) months ago. The observation group were 27-44 (35.78±4.03) years old and 36-40 (38.36±0.72) weeks pregnant, and took cesarean section 26-65 (45.67±9.42) months ago. The control group took routine nursing, and the observation group took continuous nursing service mode. The delivery modes, adverse delivery outcomes, delivery coping abilities before and after the intervention, anxiety, and nursing satisfaction were compared between the two groups. t and χ² tests were applied. Results　The natural delivery rate in the observation group was higher than that in the control group [50.00% (23/46) vs. 26.67% (12/45)], and the cesarean section rate and incidence of adverse delivery outcomes were lower than those in the control group [28.26% (13/46) vs. 48.89% (22/45) and 4.35% (2/46) vs. 22.22% (10/45)], with statistical differences (χ²=5.233, 4.090, and 6.348; all P<0.05). After the intervention, the score of Delivery Coping Scale (CCB) in the observation group was higher than that in the control group [(51.23±5.84) vs. (46.72±4.29)], and the score of Generalized Anxiety Disorder (GAD-7) was lower than that in the control group [(10.05±2.83) vs. (12.57±3.46)], with statistical differences (t=4.191 and 3.807; both P<0.05). The nursing satisfaction of the observation group was higher than that of the control group [95.65% (44/46) vs. 77.78% (35/45)], with a statistical difference (χ²=6.348, P<0.05). Conclusion Continuous nursing service mode for women with scar uterus pregnancy not only increases the natural delivery rate and decreases the incidence of adverse delivery outcomes, but also improve their ability to cope with delivery and nursing satisfaction.

Effect of nutritional combined with cognitive intervention during pregnancy on risk of lower extremity deep vein thrombosis after cesarean section in patients with severe preeclampsia

Niu Wenfang, Yue Yaping, Xia Wenyan

2023, 29(6):  859-863.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.027

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Objective　To explore the effect of nutritional intervention combined with cognitive intervention during pregnancy on the risk of lower extremity deep vein thrombosis after cesarean section in patients with severe preeclampsia. Methods　This was a prospective study. A total of 112 patients with severe preeclampsia admitted to Zhengzhou Maternal and Child Health Hospital from May 2020 to January 2022 were selected and divided into an intervention group and a conventional group by the random number table method, with 56 cases in each group. The conventional group were (26.91±2.13) years old, with a gestational age of (39.31±3.12) weeks. The intervention group were (26.94±2.07) years old, with a gestational age of (38.89±2.99) weeks. The conventional group were given traditional nursing measures, while the intervention group were given pregnancy nutrition intervention and cognitive intervention. The incidences of lower extremity swelling, pain, and deep vein thrombosis, nursing satisfaction, and coagulation function indicators and lower extremity venous blood flow velocities before and after the intervention were compared between the two groups. χ² and t tests were applied. Results　The incidences of lower limb swelling, pain, and deep vein thrombosis in the intervention group were significantly lower than those in the conventional group [3.57% (2/56) vs. 16.07% (9/56), 5.36% (3/56) vs. 25.00% (14/56), and 5.36% (3/56) vs. 19.64% (11/56)], with statistical differences (χ²=4.940, 8.391, and 5.224; all P<0.05). After the intervention, prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT) in the intervention group were longer than those in the conventional group, and the fibrinogen (FIB) level was lower than that in the conventional group (all P<0.05). After the intervention, the blood flow velocities of popliteal and femoral veins in the intervention group were higher than those in the conventional group, with statistical differences (both P<0.05). The nursing satisfaction scores of professional nursing, self-care guidance, information support, and condition observation in the intervention group were significantly higher than those in the conventional group, with statistical differences (all P<0.05). Conclusion　Nutritional intervention combined with cognitive intervention during pregnancy can reduce the risk of lower extremity deep vein thrombosis in patients with severe preeclampsia after cesarean section and improve their coagulation function, lower extremity venous blood flow velocity, and satisfaction, so it is worthy of further promotion and application.

Qualitative research on puerperae's demand for postpartum rehabilitation services

Liang Qianwen, Ma Yingrui, Xu Ying, Tong Fushuang

2023, 29(6):  863-867.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.028

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Objective　To understand the current demand for postpartum rehabilitation services in parturients, and to provide evidences for the service direction of postpartum rehabilitation medical institutions. Methods　A descriptive qualitative research method was used in the study. Eight parturients in Postpartum Rehabilitation Department, Hospital Affiliated to Liaoning University of Traditional Chinese Medicine from August to October 2021 were selected by the purposive sampling and maximum variation strategy for semi-structured in-depth interviews. They were 28-35 years old and 38-39 weeks pregnant. The inductive content analysis method was used to analyze, sort out, and summarize the data, and the theme was refined. Results　The data were analyzed and summarized into 4 themes and 9 sub-themes: postpartum physiological demand recovery (demands for postpartum weight adjustment and postpartum constitution nursing), postpartum psychological rehabilitation needs (psychological support and family attention demands), professional qualification requirements of postpartum rehabilitation services (demands for professional organizations and workers), and postpartum rehabilitation health education requirements (demands for health education, guiding, and guidance). Conclusions　Postpartum rehabilitation medical institutions should strengthen the knowledge publicity of postpartum rehabilitation; it is recommended that relevant departments should improve the professional qualification of postpartum rehabilitation services, so as to meet the demand of postpartum rehabilitation services, reduce the incidence of postpartum complications, and improve puerperae's quality of life.

Influence of nursing management guided by IMPACT mode on cognitive ability and life quality in patients with Alzheimer's disease

Zhao Nan, Wu Dongya, Chang Liguo

2023, 29(6):  868-872.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.029

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Application of PBL combined with CBL mixed teaching in cancer pain teaching for nurses taking standardized training in oncology department

Xiao Shujing, Cai Jiaozhi, Yang Minfei, Li Juan, Wu Aiqing, Ruan Xiaoshan

2023, 29(6):  872-876.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.030

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Objective　To explore the effect applying problem-based learning (PBL) combined with case-based learning (CBL) mixed teaching in cancer pain teaching for nurses taking standardized training in oncology department. Methods　From January 2021 to June 2022, 60 nurses taking standardized training in Department of Oncology, Second Hospital Affiliated to Guangzhou University of Chinese Medicine were selected as the study objects. They were simply and randomly divided into a control group and an observation group, with 30 in each group. There were 2 males and 28 females in the control group; they were (23.0±1.0) years old. There were 30 females in the observation group; they were (23.3±1.6) years old. The control group implemented the conventional clinical teaching method, while the observation group implemented the PBL combined with CBL mixed teaching. The theoretical knowledge of cancer pain, cancer pain management abilities, self-efficacies, and satisfaction were compared between the two groups after four weeks' teaching. t test, χ² test and Fisher exact test. Results　The scores of theoretical knowledge of cancer pain, cancer pain management ability, and self-efficacy in the observation group were higher than those in the control group [(83.27±4.84) vs. (79.60±6.18), (85.07±4.22) vs. (82.70±3.90), and (4.63±2.11) vs. (2.40±2.18)], with statistical differences (all P<0.05). The degrees of satisfaction with teaching mode and work arrangement in the observation group were higher than those in the control group [90.0% (27/30) vs. 66.7% (20/30) and 93.3% (28/30) vs. 70.0% (21/30)], with statistical differences (both P<0.05). Conclusion　The application of PBL combined with CBL mixed teaching in cancer pain teaching for nurses taking standardized training in oncology department can effectively improve their self-efficacy, professional theoretical knowledge, clinical thinking, and cancer pain management ability.

Application of enterprise WeChat in staff training and assessment system of central sterile supply department

Fan Huizhen

2023, 29(6):  877-880.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.031

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Objective　To explore the application effect of enterprise WeChat in the staff training and assessment system of central sterile supply department (CSSD), and provide references for promotion in the future. Methods　Twenty-eight female staff who underwent on-the-job training and assessment in Central Sterile Supply Department, Guangzhou First People's Hospital from June 2018 to June 2020 were selected. According to the time sequence, the 28 staff were divided into a control group (from June 2018 to June 2019) and an observation group (from July 2019 to June 2020), with 14 in each group. The control group were 19-40 (33.31±1.21) years old, and the observation group 21-40 (32.62±1.09). The control group used traditional training methods, and the observation group were trained with the self-designed enterprise WeChat-workbench based on the training methods of the control group. t test was used to analyze the scores of post skill assessment, disinfection and isolation quality control, training assessment satisfaction, and clinical satisfaction of the two groups. Results　The scores of basic knowledge training assessment, specialized skill training assessment, the skill operation training assessment, quality control, satisfaction of training assessment, and clinical satisfaction in the observation group were higher than those in the control group [(90.85±5.32) vs. (80.37±4.90), (89.27±5.49) vs. (82.03±6.12), (91.44±6.91) vs. (83.84±5.37), (96.828±6.094) vs. (90.032±7.581), (95.402±7.228) vs. (83.267±5.904), and (96.098±5.423) vs. (84.372±6.028)], with statistical differences (t=5.490, 6.118, 4.906, 7.850, 8.214, and 9.687; all P<0.05). Conclusion　Applying enterprise WeChat in staff training and assessment system in CSSD can effectively improve their mastery of basic knowledge, technical skills, operation skill, quality control, training assessment satisfaction, and clinical satisfaction, so it is worthy of clinical promotion and reference.

Effects of internet-based peer support combined with cognitive education on psychological status and quality of life in patients with severe facial acne

Zhong Jiemin, Shao Lei, Wang Yanfang

2023, 29(6):  881-885.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.032

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Objective　To explore the influence of internet-based peer support combined with cognitive education on psychological status and quality of life in patients with severe facial acne. Methods　Ninety patients with severe acne treated in Dermatological Department, Guangzhou Institute of Dermatology from December 2021 to June 2022 were selected. According to the nursing methods, they were divided into an observation group and a control group, with 45 cases in each group. There were 26 males and 19 females in the observation group; they were (22.95±4.36) years old; their course of disease was (7.12±2.89) months. There were 25 males and 20 females in the control group; they were (22.58±4.21) years old; their course of disease was (7.20±2.75) months. The control group received routine nursing; in addition, the observation group received internet-based peer support and cognitive education. The nursing time was 3 months. The General Self-efficacy Scale (GSES), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Self-care Ability Scale (ESCA), and Dermatology Life Quality Index Scale (DLQI) were used to evaluate the patients before and after the nursing. t and χ² test were applied. Results　After the nursing, the GSES score in the observation group was significantly higher than that in the control group [(3.29±0.61) vs. (2.83±0.68)], with a statistical difference (P<0.05); the scores of SAS and SDS in the observation group were significantly lower than those in the control group [(43.15±8.31) vs. (51.97±7.98) and (38.66±4.14) vs. (45.74±3.89)], with statistical differences (both P<0.05); the scores of self-care skill, self-care responsibility, self-concept, and health knowledge level of ESCA in the observation group were higher than those in the control group [(25.37±4.96) vs. (21.68±5.02), (16.98±4.88) vs. (13.85±4.03), (29.79±8.26) vs. (24.34±7.99), and (45.23±9.97) vs. (39.61±8.98)], with statistical differences (all P<0.05); the scores of symptom perception, daily life, leisure life, interpersonal relationship, and work and study of DLQI in the observation group were lower than those in the control group [(3.28±0.69) vs. (3.92±0.75), (1.32±0.41) vs. (2.77±0.71), (2.79±0.61) vs. (3.26±0.81), (0.85±0.26) vs. (1.75±0.38), and (1.13±0.42) vs. (2.73±0.66)], with statistical differences (all P<0.05). Conclusion　The combination of internet-based peer support and cognitive education for patients with severe facial acne can improve their knowledge of psychological conditions and diseases in conventional drug therapy and nursing, sense of self-efficacy, self-management ability, and quality of life, enable them to actively participate in disease management, and relieve adverse emotions, so it has good clinical promotion significance.

Hospital Administration

Practice of hospital honest risk management and supervision in new era

Cen Weijiu, Liu Xiaoqiong, Chen Yingxiao

2023, 29(6):  886-888.  DOI: 10.3760/cma.j.issn.1007-1245.2023.06.033

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With the deepening of the new medical reform, China's public hospitals have achieved rapid development. The state has also given a lot of financial support to the health cause, so as to meet the masses' requirements for public medical services. However, under the background of the continuous promotion of the new medical reform and in the important period of the transformation from the old system to the new one, some hospital staff are affected by some bad values, leading to deviation of beliefs and behaviors, seeking personal gains by taking advantage of their positions, encroachment on national assets, and committing crimes. In addition to personal factors, the occurrence of this situation is closely related to the lack of clean government education and risk prevention system in hospitals. Therefore, in the new era, how to do a good job in hospital honest risk management and supervision has important practical significance.