International Medicine and Health Guidance News

Meta-analysis of stellate ganglion block in treatment of migraine

Yan Wanhong, Xue Jianjun, Jia Yu, Wang Shitai

2023, 29(12): 1629-1635. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.001

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Objective　To systematically evaluate the clinical efficacy and safety of stellate ganglion block for migraine. Methods　The PubMed, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, China Science and Technology Journal Database, and WanFang Data were searched for randomized controlled trials on stellate ganglion block in the treatment of migraine from their establishment to September 2022. A risk of bias assessment tool recommended by the Cochrane Handbook was used to evaluate the inherent bias of the included studies. The data were statistically analyzed by the RevMan 5.4 software. Results　In the final meta-analysis, 26 studies with a total of 2 074 patients were included. The results showed that the effective rate in treating migraine in the stellate ganglion block group was higher than that in the control group (RR=1.21, 95%CI 1.15-1.29, P<0.001). The duration of headache attacks (MD=-2.80, 95%CI -4.32-1.28, P<0.001) and the headache score of Visual Analogue Scale (MD=-1.02, 95%CI -1.35-0.68, P<0.001) after the treatment in the stellate ganglion block group were lower than those in the control group. There was no statistical difference in the incidence of adverse reactions between the two groups (RR=0.98, 95%CI 0.46-2.09, P=0.95). Conclusion　The stellate ganglion block, an effective treatment for migraine, has obvious advantages in terms of reducing headache severity and improving headache duration, and does not increase its related adverse reactions.

Regulation of integron-cassette system expression in bacteria

Wang Xiaotong, Dai Wanqin

2023, 29(12): 1636-1639. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.002

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The problem of bacterial drug resistance has become a global problem. Acquisition of exogenous antimicrobial resistant genes through horizontal gene transfer is the main reason for the emergence and dissemination of antimicrobial resistant bacteria. Integrons are mobile gene element that can capture and express drug resistance genes through site-specific recombination which were first proposed in 1989 and play an important role in bacterial drug resistance. Integrons allow bacteria to quickly respond to changes in selective pressure by recombining resistance gene cassettes of varying sizes. In order to increase the selective advantage of bacteria, the expression of integrons and gene cassettes are strictly regulated to reduce the adaptive cost to host bacteria. This paper reviews the concept, structure, and function of integrons and the mechanism of the expression regulation of integron-cassette system.

Research progress of platelets in liver cirrhosis

Zhou Zhaonian, Zheng Weiqiang

2023, 29(12): 1640-1643. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.003

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Platelets, the main effector cells in hemostasis, undergo dynamic changes in their structure and function and are involved in complex pathophysiological processes through granule release, associated signaling receptors, and platelet aggregation and activation. Significant thrombocytopenia is present in patients with cirrhosis, and increasing evidences suggest that platelets play important roles in processes such as immune inflammation, host defense, angiogenesis, tissue repair, regeneration, etc. The potential role of platelets in cirrhosis is reviewed in the hope of improving the survival quality of patients with cirrhosis.

Value of symbolic play test in screening children with autism

Zhou Chang, Lyu Panpan, Feng Yan, Liu Fang

2023, 29(12): 1644-1648. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.004

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Objective　To evaluate the value of symbolic play test (SPT) in screening children with autism. Methods　A total of 261 children with language problems were collected from Department of Pediatrics, Guangrao County People's Hospital from November 2021 to September 2022. Among them, 194 were diagnosed with autism and were included into the observation group, including 56 girls and 138 boys who were (41.70±13.70) months old; 67 children were diagnosed with language development delay and were included into the control group, including 20 girls and 47 boys who were (29.85±7.56) months old. The Gesell Developmental Scale, SPT, and Autism Behavior Checklist (ABC) were used to evaluate the 261 children. The Gesell child developmental levels (adaptability, gross motor, fine motor, language, and personal social interaction), symbolic play abilities, and scores of ABC were compared between the two groups. The value of SPT in screening children with autism was explored. χ² and t tests and Pearson correlation analysis were applied. Results　The scores of adaptability, gross motor, fine motor, language, and personal social interaction and SPT age, adaptive months, and personal social age in the observation group were lower than those in the control group [(50.41±15.46) vs. (78.87±13.40), (59.06±16.69) vs. (83.49±13.40), (56.38±17.79) vs. (82.67±15.70), (35.94±11.71) vs. (57.34±12.23), (42.01±13.61) vs. (67.69±14.98), (12.77±8.44) months vs. (19.06±7.04) months, (20.08±7.59) months vs. (23.08±6.13) months, and (16.89±6.77) months vs. (20.37±6.84) months], and the score ABC of was (90.94±13.83) in the observation group, and (26.48±10.67) in the control group, with statistical differences between the two groups (all P<0.001). The correlation analysis showed that the original SPT score was positively correlated with Gesell test scores of adaptability, gross motor, fine motor, language, and personal social interaction (r=0.405, 0.225, 0.308, 0.507, and 0.532; all P<0.001), and negatively with ABC (r=-0.386). In the observation group, the original SPT score was negatively correlated with ABC (r=-0.211, P<0.001); in the control group, the original SPT score was negatively correlated with ABC (r=-0.346, P<0.001). Conclusions　Compared with the children with simple language development delay, autism children have development delay of symbolic play ability. SPT plays a role in early identification of autism.

Comparison of two methods for detecting respiratory pathogens and correlation study of inflammatory indicators in children

Xie Cong, Ling Xiaomei, Yuan Baoli, Wang Zhijian, Ren Guangli

2023, 29(12): 1649-1652. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.005

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Objective　To explore the advantages and disadvantages of two methods for detecting respiratory pathogens in children with lower respiratory tract infection, and the correlation between C-reactive protein (CRP), procalcitonin (PCT), and interleukin (IL)-6. Methods　Using cohort study, a total of 239 children with lower respiratory tract infection treated at The Second Affiliated Hospital of Guangzhou Medical University from September 2020 to November 2020 were divided into a respiratory tract antigen group (121 cases) and a serum antibody group (118 cases). The respiratory tract antigen group used immunofluorescence assay to detect respiratory antigen from throat swabs. In the serum antibody group, the indirect immunofluorescence method was used to detect the related pathogen IgM in the serum of the children. The blood routine, CRP, PCT, and IL-6 were detected in both groups. χ², t, and rank sum tests and Pearson correlation analysis were applied. Results　There were no statistical differences in general information (age, gender, course of disease, and clinical symptoms) and inflammatory indicators (white blood cell count, neutrophil percentage, CRP, and PCT) between the respiratory tract antigen group and the serum antibody group (all P>0.05). The level of IL-6 was 6.44 (2.29, 13.24) ng/L in the respiratory tract antigen group, and was 6.78 (3.05, 14.72) ng/L in the serum antibody group, with a statistical difference (P<0.05). The positive rate of pathogen detection was 30.58% (37/121) in the respiratory tract antigen group, and was 11.02% (13/118) in the serum antibody group, with a statistical difference (P<0.05). IL-6 was correlated with CRP (R²=0.254), and the equation was Y=-0.001X²+0.929X+5.677 (0<X<200). Conclusion　In children with lower respiratory tract infection, the respiratory antigen detection is superior to antibody detection and IL-6 can cause 25.4% CRP change in children.

Neuroelectrophysiology of Miller-Fisher syndrome versus Guillain-Barré syndrome in children

Xue Yingjie, Zhao Bojie

2023, 29(12): 1653-1657. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.006

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Objective　To analyze nerve electrophysiology indicators of Miller-Fisher syndrome (MFS) versus Guillain-Barré syndrome (GBS) in children, and to explore the nerve electrophysiology characteristics of both. Methods　Referring to the GBS-MFS diagnostic criteria formulated by the multinational expert classification team in 2014, 33 cases diagnosed with MFS and 105 cases diagnosed with GBS were retrospectively collected from Henan Children's Hospital from January 2013 to June 2020. In the 33 cases of MFS, there were 23 boys and 10 girls who were (78.15±43.22) months old. In the 105 cases of GBS, there were 69 boys and 36 girls who were (64.73±33.90) months old. The neuroelectrophysiological data of the children were collected and sorted out. The data were statistically analyzed by t, rank sum, and χ² tests. Results　Among the 33 children with MFS, 19 cases (57.6%) had abnormal H-reflex, 14 cases (42.4%) abnormal sensory nerve conduction, and 9 cases (27.3%) normal nerve electrophysiology; among the 105 children with GBS, 98 cases (93.3%) had abnormal motor nerve conduction, 92 cases (87.6%) abnormal H-reflex, 62 cases (59.0%) abnormal sensory nerve conduction, and 44 cases (41.9%) abnormal needle electrode electromyography. Among the indicators of sensory nerve abnormalities, the incidence of decreased amplitude of sensory nerve action potential (SNAP) in the MFS children was the highest (33.3%, 11/33), and the incidence of SNAP not extracted in the GBS children was the highest (36.2%, 38/105). The GBS children had lower SNAP amplitude and slower sensory conduction velocity (SCV) than the MFS children (both P<0.05). Conclusions　The nerve electrophysiology abnormalities in MFS children are mainly H-reflex abnormality and sensory nerve abnormality; the most common indicator of paresthesia is SNAP amplitude reduction. The nerve electrophysiology manifestations in GBS children are motor and sensory nerve abnormalities, and the motor nerve abnormalities are the most significant. There are obvious differences in nerve electrophysiology between children with MFS and GBS. Understanding these differences can provide more references for the early diagnosis and differential diagnosis of MFS and GBS.

Low ionic coacervate and card microcolumn gel technology for transfusion testing of neonates with ABO hemolytic disease

Chen Liangli, Chen Fang

2023, 29(12): 1657-1660. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.007

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Objective　To explore the values of the low ionic coacervate technique and card microcolumn gel technique for clinical blood transfusion testing of newborns with ABO hemolytic disease. Methods　Seventy-six newborns who developed ABO hemolytic disease and were admitted to Xianning Central Hospital between May 2019 and March 2022 were prospectively and randomly selected for this study, including 43 males and 38 females who were (2.85±0.95) d old. All the newborns were clinically tested for blood transfusion using the low ionic coacervate technique and card microcolumn gel technique. The final neonatal treatment outcomes were set as the gold standard. The success rates, test efficacies, and testing times of the transfusion testing techniques in the two groups were compared by χ² and t tests. Results　Among the 76 neonates, 69 cases were successfully treated, and the treatment success rate was 90.79%; 7 cases failed, and the treatment failure rate was 9.21%. The blood coordination success rate by the low ionic coacervate technique was not statistically different from that by the card microcolumn gel technique [85.53% (65/76) vs. 94.70% (71/76); P>0.05]. The sensitivity, specificity, and accuracy of the low ionic coacervate technique were not statistically different from those of the card microcolumn gel technique [85.51% (62/69) vs. 98.55% (68/69), 57.14% (4/7) vs. 57.14% (4/7), and 85.52% (66/76) vs. 92.11% (72/76); all P>0.05]. The examination time of the low ionic coacervate technique was shorter than that of the card microcolumn gel technique [(16.11±1.79) min vs. (17.43±1.94) min], with a statistical difference (P<0.05). Conclusion　There are no significant differences in the success rate of blood matching and test efficacy between the low ionic coacer vate technique and the cartridge microcolumn gel technique in the transfusion test of clinical neonatal ABO hemolytic disease, but the test time of the low ion polyamine technique is relatively shorter.

Epidemiological analysis of pulmonary tuberculosis at Yuexiu District, Guangzhou from 2018 to 2022

Liang Zhiqiang, Liu Guobiao, Chen Qichen, Du Yuhua, Wu Guifeng, Lei Yu, Bao Wanling, Li Hua, Liu Zhihui

2023, 29(12): 1661-1666. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.008

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Objective　To understand the epidemiological characteristics of tuberculosis at Yuexiu District, Guangzhou and to provide scientific basis for the development of regional tuberculosis control strategies and measures. Methods　The online reported data of tuberculosis patients at Yuexiu District, Guangzhou from 2018 to 2022 were derived from "Tuberculosis Management Information System" of "China Information System for Disease Control and Prevention". Based on the demographic data of the seventh national population census in 2020, the reported incidence rates of tuberculosis by gender, age, and sub-district in the five years and the annual percentage of the reported cases in different months in each year were descriptively analyzed. Their five-year change trends were also analyzed. Results　A total of 2 504 cases of pulmonary tuberculosis, including 1 426 pathogenic positive cases and 1 078 pathogenic negative cases and 2 337 cases of initial treatment and 167 cases of re-treatment, were reported in the whole district during the five years. The reported incidence of pulmonary tuberculosis was 48.22/100 000. From 2018 to 2022, the reported incidence rates of pulmonary tuberculosis were 51.89/100 000, 49.39/100 000, 47.27/100 000, 49.58/100 000, and 42.94/100 000, respectively; those of the males were 2.07, 1.84, 2.03, 1.74, and 1.91 times those of the females. The 5-year average reported incidence rates of the 0-, ≥15-, ≥25-, ≥35-, ≥45-, ≥55-, ≥65-, and ≥75- years old groups were 1.55/100 000, 44.31/100 000, 47.16/100 000, 30.98/100 000, 46.57/100 000, 75.05/100 000, 79.22/100 000, 98.28/100 000, and 48.22/100 000, respectively; the change trends of these rates in the 8 age groups in the five years were roughly the same as that of the 5-year average reported incidence rate. In terms of case reporting time, the percentages of the number of cases reported in each month to that of a year ranged from 5.12% to 11.50% in the five years. It was the most common feature of each year that the numbers of the reported cases in February and October were relatively small, and the number of the reported cases in September was the biggest. The general incidence rates of pulmonary tuberculosis of different sub-districts ranged from 30.14/100 000 to 64.05/100 000 in the five years. The top five sub-districts were Zhuguang Street (64.05/100 000), Renmin Street (62.48/100 000), Kuangquan Street (60.13/100 000), Guangta Street (59.70/100 000), and Beijing Street (58.67/100 000); while the top five sub-districts whose incidence rates were from high to low were Liuhua Street, Guangta Street, Beijing Street, Renmin Street, and Dadong Street. Conclusions　The incidence of tuberculosis at Yuexiu District, Guangzhou in the five years was lower than that in Guangzhou, but the decrease was small. Therefore, tuberculosis control should be vigorously strengthened.

Anesthetic effect of alfentanil in intermuscular sulcus brachial plexus block guided by ultrasound

Chen Xiaolin

2023, 29(12): 1666-1670. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.009

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Objective　To investigate the anesthetic effect of alfentanil in intermuscular sulcus brachial plexus block guided by ultrasound and its influence on the patients' hemodynamics and stress response. Methods　Eighty patients with upper limb fracture who were treated at First Hospital, Nanyang Medical College from March 2020 to May 2021 were selected for the randomized controlled trial. The patients were divided into a study group (41 cases) and a control group (39 cases) by lottery. There were 22 males and 19 females in the study group; they were (48.42±3.38) years old. There were 21 males and 18 females in the control group; they were (48.89±3.53) years old. Both groups received ultrasound guided intermuscular sulcus brachial plexus block anesthesia; the control group used ropivacaine; the study group used alfentanil. The arterial oxygen saturations (SaO₂), nitric oxide (NO), mean arterial pressures (MAP), adrenocortical hormone (ACTH), heart rates (HR), superoxide dismutase (SOD), and pain scores [Visual Analogue Scale (VAS)] were compared at different times of anesthesia. t test was applied. Results　There were no statistical differences in HR, SaO₂, and MAP between the two groups before the block (t=0.191, 0.182, and 0.020; all P>0.05); 30 minutes after the block, the SaO₂ [(0.993 5±0.106 2) vs. (0.874 5±0.048 0)] and MAP [(90.50±10.21) mmHg (1 mmHg=0.133 kPa) vs. (83.45±9.68) mmHg] in the study group were higher than those in the control group, and the HR [(69.05±8.43) beats/min vs. (74.59±8.31) beats/min] was lower than that in the control group (t=5.527, 2.875, and 4.803; all P<0.05). There were no statistical differences in SOD, ACTH, and NO between the two groups one day before the operation (t=0.937, 0.984, and 0.071; all P>0.05); three days after the operation, the SOD, ACTH, and NO in the study group were lower than those in the control group (t=7.589, 3.989, and 5.319; all P<0.05). The VAS score of the study group was higher than that of the control group 1.0 hour after the operation (t=2.980; P<0.05); there were no statistical differences in the VAS scores 0.5, 3.0, 24.0, and 72. hours after the operation between the two groups (t=0.617, 1.077, 0.349, and 0.705; P>0.05). Conclusion　Ultrasound guided intermuscular sulcus brachial plexus block with alfentanil can effectively reduce the patients' stress response and postoperative pain and keep their hemodynamics stable during operation, so it has high application value.

Application of hydromorphone combined with ketorolac tromethamine in analgesia for patients undergoing laparoscopic cholecystectomy

Weng Hongliang, Li Yujian, Li Zhibing, Li Xingda, Chen Benfa, Ma Yufeng

2023, 29(12): 1670-1673. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.010

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Objective　To explore the value applying hydromorphone combined with ketorolac tromethamine in analgesia for patients undergoing laparoscopic cholecystectomy. Methods　One hundred and twelve patients who took laparoscopic cholecystectomy in Linyi Central Hospital from July 2020 to June 2022 were selected for the randomized controlled trial. They were divided into a study group and a conventional group by the random number table method, with 56 cases in each group. There were 34 males and 22 females in the study group; they were (59.36±12.36) years old. There were 33 males and 23 females in the conventional group; they were (59.96±13.52) years old. The study group were anesthetized with hydromorphone and ketorolac tromethamine, and the conventional group with ketorolac tromethamine. The hospital stays, operation times, postoperative pain degrees [score of Visual Analog Scale (VAS)], and adverse reactions of the two groups were observed. t and χ² tests were applied. Results　The hospital stay in the study group was shorter than that in the conventional group [(5.58±3.01) d vs. (8.52±3.14) d; t=5.058, P<0.001]. The VAS scores in both group were lower 9 than 6 h after the operation; the VAS scores 6 and 9 h after the operation in the study group were lower than those in the conventional group (t=37.133 and 26.641, both P<0.001). The incidence of adverse reactions in the study group was lower than that in the conventional group [5.36% (3/56) vs. 17.86% (10/56); χ²=4.264, P=0.039]. Conclusion　For patients undergoing laparoscopic cholecystectomy, 0.04 mg/kg hydromorphone combined with 0.5 mg/kg ketorolac tromethamine can promote their recovery and reduce the incidence of adverse reactions, and has significant sedative effect, so it is worthy of promotion.

Effect of ginkgo biloba dropping pills combined with valsartan capsules in treatment of elderly patients with hypertension

Liu Ning, Zheng Xueyan, Dong Min, Sun Baolian

2023, 29(12): 1674-1677. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.011

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Objective　To observe the effect of ginkgo biloba dropping pills combined with valsartan capsules in the treatment of elderly patients with hypertension. Methods　A total of 116 elderly patients with hypertension admitted to Jinan Second People's Hospital from January 2020 to December 2021 were selected for the randomized controlled trial. The patients were divided into a combined treatment group and a basic treatment group by the random number table method, with 58 cases in each group. There were 38 males and 20 females in the basic treatment group; they were (70.23±3.51) years old. There were 39 males and 19 females in the combined treatment group; they were (70.92±3.67) years old. The basic treatment group were treated with ginkgo biloba dropping pills, and the combined treatment group with ginkgo biloba dropping pills and valsartan capsules. The blood pressures before and after the treatment, clinical efficacies, and incidences of adverse reactions during the treatment were compared between the two groups. t, Z, and χ² tests were applied. Results　The diastolic blood pressures and systolic blood pressures in the 2 groups were lower after than before the treatment (all P<0.05); after the treatment, the diastolic blood pressure and systolic blood pressure in the combined treatment group were lower than those in the basic treatment group (both P<0.05). The total effective rate of the combined treatment group was significantly higher than that of the basic treatment group [96.55% (56/58) vs. 72.41% (42/58); P<0.05]. There was no statistical difference in the incidence of adverse reactions during the treatment between the combined treatment group and the basic treatment group (P>0.05). Conclusion　Ginkgo biloba dripping pills combined with valsartan capsules in the treatment of elderly patients with hypertension can effectively improve the clinical efficacy and reduce their diastolic and systolic blood pressures, and is safe, so it is worthy of promotion.

Relationship between miR-374a-5p and intrastent thrombosis within 6 months after PCI for patients with ST-segment elevation myocardial infarction

Li Jing, Zhou Jing, Pan Sancong

2023, 29(12): 1678-1682. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.012

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Objective　To explore and analyze the relationship between miR-374a-5p and intrastent thrombosis within 6 months after percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction. Methods　The clinical data of 138 patients with ST-segment elevation myocardial infarction treated by PCI at Jincheng People's Hospital from April 2020 to March 2022 were retrospectively analyzed. According to whether intrastent thrombosis occurred 6 months after the surgery, the patients were divided into a formation group (27 cases) and a non-formed group (111 cases). All the clinical baseline data and laboratory examination indicators were reviewed. The univariate and multivariate logistic regressions were used to analyze the factors of intrastent thrombosis within 6 months after PCI for the patients with ST-segment elevation myocardial infarction. The receiver operating characteristic curve (ROC) was used to analyze the value of miR-374a-5p in determining the intrastent thrombosis within 6 months after PCI for the patients with ST-segment elevation myocardial infarction. Results　There were no statistical differences in the gender, age, body mass index (BMI), history of hypertension, history of hyperlipidemia, site of infarction, emergency PCI time, total cholesterol (TC), triacylglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), platelet count (PLT), heart rate (HR), and left ventricular ejection fraction (LVEF) between the formation group and the non-formed group (all P>0.05). The proportions of the patients with diabetes history and multiple stentings and the serum miR-374a-5p level in the formation group were higher than those in the non-formed group, with statistical differences (all P<0.05). The area under the ROC was 0.699; the standard error was 0.049; the significance was <0.001; the progressive 95% confidence interval was 0.604-0.795; the miR-374a-5p cut-off point of intrastent thrombosis within 6 months after PCI surgery in the patients was 1.115, indicating that miR-374a-5p had good diagnostic value. Logistic regression analysis showed that history of diabetes, multiple stentings, and miR-374a-5p could be used as risk factors for intrastent thrombosis within 6 months after PCI in the patients with ST-segment elevation myocardial infarction (all P<0.05). Conclusions History of diabetes, multiple stentings, and miR-374a-5p can be used as risk factors for inrastent thrombosis within 6 months after PCI for patients with ST-segment elevation myocardial infarction. The detection of miR-374a-5p level can evaluate the prognosis of patients with ST-segment elevation myocardial infarction.

Correlation between non-HDL cholesterol level and cerebral infarction lesions

Wang Mingnan, Ou Yongguang, Xia Runian, Lou Qing, Wu Shaolin

2023, 29(12): 1683-1687. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.013

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Objective　To analyze the correlation between non-high density lipoprotein cholesterol (non-HDL-C) level and cerebral infarction lesions. Methods　Sixty patients with cerebral infarction treated in Zhaoqing Hospital of Traditional Chinese Medicine from June 2020 to December 2022 were selected as a cerebral infarction group, and 60 volunteers without cerebral infarction who took medical examination during the same period as a control group. The total blood cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) in both groups were detected. The non-HDL-C and non-HDL-C to HDL-C ratio (non-HDL-C/HDL-C) were calculated. The general data, including gender, age and other factors, of the two groups were collected. The multivariate logistic regression analysis was performed and the receiver operating characteristic curves (ROC) were drawn to analyze the correlation between non-HDL-C, non-HDL-C/HDL-C, and cerebral infarction lesions. Results　The proportions of the elderly, smoking, drinking, hypertension, and diabetes and the levels of LDL-C, non-HDL-C, and non-HDL-C/HDL-C in the cerebral infarction group were higher than those in the control group, while the level of HDL-C in the cerebral infarction group was lower than that in the control group, with statistical differences (all P<0.05). Multivariate logistic regression analysis showed that age, hypertension history, high LDL-C level, low HDL-C level, high non-HDL-C level, and high non-HDL-C/HDL-C level were independent risk factors for cerebral infarction (all P<0.05). The areas under (AUC) the ROC's of non-HDL-C, non-HDL-C/HDL-C, and the combination in the diagnosis of cerebral infarction lesions were 0.797, 0.817, and 0.856 (all P<0.05); the sensitivities were 0.550, 0.617, and 0.800; the specificities were 0.933, 0.867, and 0.750, respectively. Conclusions　The level of non-HDL-C is closely related to the occurrence of cerebral infarction lesions. Non-HDL-C and non-HDL-C/HDL-C are factors influencing cerebral infarction lesions. Single tests and the combination have good diagnostic value for this disease.

Value of vascular wall high-resolution MRI in differential diagnosis of atherosclerosis and acute arteritis

Tang Xueke, Qu Qizhi, Xu Dan

2023, 29(12): 1688-1692. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.014

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Objective　To investigate the value of vascular wall high-resolution magnetic resonance imaging (MRI) in the differential diagnosis of atherosclerosis and acute arteritis. Methods　A total of 60 patients who were suspected of atherosclerosis or acute arteritis and admitted to Liaocheng Third People's Hospital from October 2020 to October 2022 were enrolled, including 42 patients with atherosclerosis (an atherosclerosis group) and 18 patients with acute arteritis (an arteritis group). There were 32 males and 28 females; they were 32-75 years old. The general data and vascular wall high-resolution MRI characteristics of the two groups were compared. t and χ² tests were applied. Results　There were statistical differences in age, hypertension, hyperhomocysteinemia, morphology of diseased vessels, signals on T1 weighted imaging (T1WI)/T2 weighted imaging (T2WI), range of diseased vessels, vessel wall thickening mode, enhanced vascular wall, and deep tiny flow voids (DTFV) between the two groups (t=10.60; χ²=14.95, 4.37, 8.74, 6.75, 7.70, 20.68, 13.02, and 25.71; all P<0.05). The logistic regression receiver operating characteristic curve (ROC) found that the area under curve (AUC) of the combination of multifocal lesions and eccentric thickening in the differential diagnosis of atherosclerosis and acute arteritis was 0.871 (95%CI 0.759-0.944); when the cut-off value was 0.551, the sensitivity and specificity were 83.33% and 77.78%, respectively. Conclusion　Vascular wall high-resolution MRI is of high value in the differential diagnosis of atherosclerosis and acute arteritis.

Clinical efficacy of vincamine sustained-release capsules combined with brimonidine tartrate eye drops in treatment of anterior ischemic optic neuropathy

Gu Chen, Ding Youshu, Bi Chao

2023, 29(12): 1693-1697. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.015

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Objective　To observe the clinical efficacy of vinblastine sustained-release capsules combined with brimonidine tartrate eye drops in the treatment of anterior ischemic optic neuropathy. Methods　A prospective study was conducted on 118 patients with anterior ischemic optic neuropathy admitted to Jining Puming Eye Hospital and Jinan Second People's Hospital from March 2020 to March 2022. They were randomly divided into a conventional group (59 cases with 64 eyes) and a combined group (59 cases with 64 eyes) by the red blue bicolor method. The routine group [31 men (35 eyes) and 28 women (29 eyes); 51-60 (55.78±4.20) years old; disease course 5-10 (7.28±2.11) days] were treated with brimonidine tartrate eye drops, and the combined group [30 men (34 eyes) and 29 women (30 eyes); 51-61 (55.82±4.31) years old; disease course 5-10 (7.30±2.15) days] with vinblastine sustained-release capsules and brimonidine tartrate eye drops. The clinical efficacies and incidences of adverse reactions of the two groups were compared. t and χ² tests were applied. Results　The total effective rate of the combined group was higher than that in the conventional group [96.88% (62/64) vs. 79.69% (51/64)], with a statistical difference (χ²=9.14, P<0.05). After the treatment, the thicknesses of peripheral nerve fiber layer and retinal ganglion cell complex in the combined group were lower than those in the conventional group [(66.15±11.19) μm vs. (83.06±14.23)μm and (61.37±6.27) μm vs. (74.11±7.82) μm], with statistical differences (t=7.473 and 10.17, both P<0.05). After the treatment, the 60'P100 and 15'P100 latencies in the combined group were lower than those in the conventional group [(108.21±2.34) ms vs. (110.78±2.74) ms and (110.25±3.12) ms vs. (113.58±3.68) ms], with statistical differences (t=5.71 and 5.52, both P<0.05). After the treatment, the amplitudes of 60'P100 and 15'P100 waves in the combined group were higher than those in the conventional group [(5.21±1.07)μV vs. (4.23±1.02) μV and (6.79±1.26) μV vs. (5.38±1.14) μV], with statistical differences (t=4.82 and 6.64, both P<0.05). After the treatment, the standard deviation of corrected visual field shape and the mean deviation of visual field in the combined group were significantly lower than those in the conventional group [(3.34±0.38) vs. (3.72±0.42) and (-5.01±1.42) vs. (-6.54±1.59)], with statistical differences (t=5.37 and 5.74, P<0.05). After the treatment, the light sensitivity and visual acuity of the combined group were significantly higher than those of the conventional group [(17.51±2.30) dB vs. (14.52±2.27) dB and (0.73±0.25) vs. (0.48±0.16)], with statistical differences (t=7.40 and 6.74, P<0.05). Conclusion　Vinblastine sustained-release capsules combined with brimonidine tartrate eye drops has obvious effect in the treatment of patients with anterior ischemic optic neuropathy, and can significantly improve their visual field, visual acuity, light sensitivity, and amplitude and latency of P100 wave of visual evoked potential and reduce the thickness of peripheral nerve fiber layer and retinal ganglion cell complex, with high safety.

Effect of placement of laryngeal masks at different target controlled concentrations of propofol on pharyngeal pain in patients undergoing hysteroscopy

Wang Yanbin, Huang Rui

2023, 29(12): 1698-1703. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.016

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Objective　To investigate the effect of placement of laryngeal masks at different concentrations of propofol by target controlled injection (TCI) on postoperative sore throat (POST) in patients undergoing daytime hysteroscopic surgery under general anesthesia with non-muscle relaxant laryngeal masks, and to search for a better combination of propofol and remifentanil TCI concentration in the effect room during the placement of laryngeal mask. Methods　One hundred and twenty-two patients who underwent daytime hysteroscopic surgery in First Hospital, Xiamen University from August 2019 to July 2020 were selected; they were 30-55 years old; their body weight was 48-65 kg. They were divided into P_3.0, P_3.5, and P_4.0 groups by the random number table method, with 42 cases in each group. The TCI concentrations in the propofol effect chamber during laryngeal mask implantation in the three groups were 3.0, 3.5, and 4.0 mg/L, respectively. The hemodynamic parameters and entropy indexes before and after laryngeal mask implantation, as well as the failure rates of laryngeal mask implantation, the presence of blood filaments on the mask surface after mask removal, scores of Visual Analogue Scale (VAS) 20 minutes (T0), 3 hours (T1), 6 hours (T2), and 24 hours (T3) after mask removal, and incidences of adverse reactions and VAS score>3 on the first, second, and third day after the surgery were compared between these three groups. Results　In the P_3.0 group, there were statistical differences in blood pressure, heart rate, reaction entropy, and status entropy between before and after laryngeal mask implantation [(72.48±9.46) mmHg (1 mmHg=0.133 kPa) vs. (79.14±11.68) mmHg, (65.40±9.02) beats/min vs. (71.50±9.69) beats/min, (56.62±9.12) vs. (62.24±11.48), and (53.02±8.73) vs. (58.62±11.33); t=2.88, 2.98, 2.48, and 2.54; all P<0.05]. The incidence of bloodstaining on the mask surface in the P_3.0 group [21.4% (9/42)] was higher than those in the P_3.5 [7.1% (3/42)] and P_4.0 [4.8% (2/42)] groups, with a statistical difference (χ²=6.91, P<0.05); The failure rate of first laryngeal mask implantation in the P_3.0 group [16.7% (7/42)] was higher than those in the P_3.5 [4.8% (2/42)] and P_4.0 [2.4% (1/42)] groups, with a statistical difference (χ²=6.73, P<0.05). The VAS scores at T1, T2, and T3 in the P_{3. 0} group were higher than those in the P_3.5 and P_4.0 groups (F=7.99, 10.49, 10.60; all P<0.05); the overall incidence of VAS score > 3 on the first day after surgery in the P_3.0group [23.8% (10/42)] was higher than those in the P_3.5 [9.5% (4/42)] and P_3.0 [4.8% (2/42)] groups, with a statistical difference (χ²=7.45, P<0.05). Conclusion　When the concentration of TCI in the effective chamber of propofol reaches 3.5 mg/L and the TCI concentration in the effect chamber of remifentanil is 4.0 μg/L during daytime hysteroscopic surgery under general anesthesia without muscle relaxants, the placement of laryngeal mask has a low failure rate, low stress response, and a low incidence of POST, which is conducive to improving the anesthesia satisfaction of patients undergoing daytime hysteroscopy and rapid postoperative recovery.

Fundus laser combined with intravitreal injection of ranibizumab for patients with retinal vein occlusion secondary to macular edema

Chen Lili, Zhu Chengbao

2023, 29(12): 1703-1707. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.017

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Objective　To investigate and analyze the clinical efficacy of fundus laser combined with intravitreal injection of ranibizumab (IVR) in the treatment of retinal vein occlusion secondary to macular edema (RVO-ME). Methods　Sixty patients with RVO-ME who were treated in Jinan Second People's Hospital from March 2019 to May 2022 were selected as the research objects. They were divided into an observation group and a control group by the random number table method. The observation group had 16 males and 14 females, with an age of (54.66±2.31) years. The control group had 15 males and 15 females, with an age of (54.70±2.29) years. Both groups were treated with fundus laser; in addition, the observation group were treated with IVR. The central macular thicknesses (CMT), levels of vitreous cavity related factors, best corrected visual acuities (BCVA), central choroidal thicknesses (CCT), and disease related complications were compared between the two groups. t and χ² tests were applied. Results　The CMT's in the observation group and the control group were lower after than before the treatment (F=501.71 and 303.62; both P<0.05); there were statistical differences in the CMT's at different time points after the treatment between the two groups (t=11.37, 6.71, and 5.29; all P<0.05). After the treatment, the levels of vascular endothelial growth factor (VEGF), interleukin (IL)-6, and IL-8 were lower than those before the treatment in both groups, and the levels in the observation group were lower than those in the control group [(256.49±62.13) ng/L vs. (294.18±60.39) ng/L, (42.58±6.15) ng/L vs. (51.30±6.44) ng/L, and (41.08±6.13) ng/L vs. (49.87±6.34) ng/L], with statistical differences (t=2.38, 5.36, and 5.46; all P <0.05). The BCVA's in the observation group and the control group were higher after than before the treatment (F=27.64 and 21.29; both P<0.05). Conclusion　Fundus laser combined with IVR for patients with RVO-ME can effectively reduce the CMT and levels of vitreous cavity related factors, and improve their BCVA.

MSCT and MRI in curative effect evaluation of TACE for patients with hepatic carcinoma

Chi Qiang, Qi Wei

2023, 29(12): 1708-1712. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.018

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Objective　To explore the value of multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) in evaluating the curative effect of transcatheter arterial chemoembolization (TACE) for patients with hepatic carcinoma. Methods　Seventy patients with primary hepatic carcinoma (PHC) who underwent TACE in 970th Hospital of People, Liberation Army between January 2019 and June 2021 were selected, including 35 males and 35 females who were (50.14±8.34) years old. There clinical data were collected. The digital subtraction angiography (DSA) and 6-month follow-up results after TACE were taken as the golden standard. The receiver operating characteristic curve (ROC) was used to compared the accuracies of MSCT and MRI in evaluating the curative effect of TACE. χ² and Z tests were applied.Results　The DSA and follow-up results showed that there were 61 residual or recurrent lesions and 37 non-residual or -recurrent lesions in the 70 patients. MSCT showed 43 residual or recurrent lesions and 55 non-residual or -recurrent lesions, with a sensitivity of 67.21% and a specificity of 94.59%. MRI showed 55 residual or recurrent lesions and 43 non-residual or -recurrent lesions, with a sensitivity of 90.16% and a specificity of 100.00%. The sensitivity of MRI was higher than that of MSCT (P<0.05). Four lesions with obvious tumor capsules were detected by MSCT, and 11 by MRI. The detection rate of tumor capsules by MRI was higher than that by MSCT (P<0.05). The ROC analysis showed that the area under the curve (AUC) of MRI in evaluating the curative effect of TACE was greater than that of MSCT (0.951 vs. 0.809; P<0.05). Conclusion　Both MSCT and MRI can be used to evaluate the curative effect of TACE for patients with hepatic carcinoma. However, MRI is more sensitive to recurrent/residual lesions and tumor capsules, so it has higher evaluation value.

Hyperthermia occurred after intravenous infusion of pantoprazole sodium for injection in a patient

Zhao Zhanwei, Cong Ying, Cui Hongxia

2023, 29(12): 1713-1716. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.019

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This article reports an elderly diabetic patients at Weihai Central Hospital, Qingdao University. The patient had a fever after taking pantoprazole sodium for injection after stent placement in the left subclavian artery. After having a fever, the patient took anti-infection and anti-fever treatment, but had no ideal effect. The lung CT showed no pulmonary infection and the 2 cultures were negative, so the pharmacist doubted that it was drug fever, and recommended the patient stopped the suspicious drugs, and the patient's body temperature returned to normal. The case analysis showed that the patient could have a fever after intravenous infusion of pantoprazole sodium for injection. Therefore, the clinical occurrence of unexplained fever should be considered the possibility of drug fever.

One case of primary mucoepidermoid carcinoma on anterior chest wall skin

Hou Guoqi, Tang Yan, Li Yingming

2023, 29(12): 1716-1718. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.020

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Control effect of neurocritical program cluster management for patients with nosocomial infection and their prognosis

Liang Ning, Li Peng, Zhang Youjian, Wang Huijie, Li Yan, Zhang Jie, Sun Mingjie

2023, 29(12): 1719-1723. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.021

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Objective　To investigate the effect of neurocritical program cluster management for patients with nosocomial infection and their prognosis. Methods　From January 2019 to January 2021, 116 neurocritical patients were prospectively analyzed in the Henan Provincial People's Hospital. According to the management schemes, the patients were divided into a traditional management group and a program cluster management group, with 58 cases in each group. There were 38 males and 20 females in the program cluster management group, with an age of (54.3±14.3) years. There were 33 males and 25 females in the traditional management group, with an age of (57.3±12.6) years. During the period, the infection control ability, scores of Glasgow Coma Score (GCS), Modified Rankin Scale (MRS), and National Institute of Health Stroke Scale (NIHSS), and nursing satisfaction were evaluated to compare and analyze the infection control abilities and prognosis of different management groups. t and χ² tests were applied. Results　After the two groups were treated with the traditional management and program cluster management schemes, the scores of infection control ability of the medical workers in the two groups were improved; the score in the program cluster management group was higher than that in the traditional management group [(263.3±12.4) vs. (235.5±10.3)], with a statistical difference (t=8.85, P<0.05). After the management, the scores of GSC, NIHSS, and MRS in the program cluster management group were better than those in the traditional management group [(10.12±1.66) vs. (8.13±1.52), (7.46±0.76) vs. (10.52±2.92), and (1.87±0.86) vs. (2.46±0.74)], with statistical differences (t=2.30, 7.72, and 3.96; all P<0.05). The nursing satisfaction in the program cluster management group was higher than that in the traditional management group [94.83% (55/58) vs. 82.75%(48/58)], with a statistical difference (χ²=4.25, P<0.05). Conclusion　The GSC score and nursing satisfaction of patients increase after neurocritical program cluster management, while the scores of MRS and NIHSS decrease. The results show that neurocritical program cluster management can significantly improve the infection control score of nursing care and improve their prognosis.

Application of intermittent nasal feeding through gastric tube for patients with dysphagia after stroke

Zhao Zi, Li Yin

2023, 29(12): 1724-1728. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.022

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Objective　To explore the effect of intermittent nasal feeding combined with rehabilitation nursing for elderly patients with dysphagia after stroke. Methods　Eighty-six elderly patients with dysphagia after stroke who were admitted to First Hospital, Nanyang Medical College from July 2019 to June 2022 were selected for the prospective study. The patients were divided into a control group and an observation group by the random number table method, with 43 cases in each group. Both groups received rehabilitation training for swallowing function. The control group [23 males and 20 females; (67.49±3.12) years old; disease course (26.10±6.54) d] carried out continuous nasal feeding through nasogastric tube. The observation group [21 males and 22 females; (67.88±3.64) years old; disease course (25.76±6.82) d] carried out intermittent nasal feeding through oral gastric tube. Both groups received continuous intervention for 4 weeks. The swallowing function, nutritional status [levels of prealbumin (PA), transferrin (TRF), hemoglobin (Hb), and serum albumin (ALB)], neurological function, daily living ability, and incidences of complications were compared between the two groups. χ² test and rank sum test, and t test were applied. Results　The classification of water swallow test after the intervention in the observation group was better than that in the control group, with a statistical difference (Z=3.19, P<0.05). The score of contrast examination of swallowing (VFSS) after the intervention of the observation group was higher than that of the control group [(8.78±0.96) vs. (7.02±1.13)], with a statistical difference (t=7.87, P<0.05). The levels of PA, Hb, ALB, and TRF after the intervention in the observation group were higher than those in the control group [(0.38±0.09) g/L vs. (0.32±0.08) g/L, (145.36±11.65) g/L vs. (136.42±13.51) g/L, (37.62±4.46)g/L vs. (33.07±5.41) g/L, and (2.48±0.39) g/L vs. (2.32±0.33) g/L], with statistical differences (t=3.27, 3.29, 4.26, and 2.05; all P<0.05). The score of the National Institutes of Health Stroke Scale (NIHSS) after the intervention of the observation group was lower than that of the control group [(18.84±1.45) vs. (24.26±1.78)], while the score of the Ability of Daily Living Index (ADL) of the observation group was higher than that of the control group [(75.66±5.43) vs. (61.54±5.05)], with statistical differences (t=15.48 and 12.49; both P<0.05). The incidence of complications in the observation group was lower than that in the control group [9.30% (4/43) vs. 35.56% (14/43)], with a statistical difference (χ²=7.03, P<0.05). Conclusion Intermittent nasal feeding combined with rehabilitation nursing can alleviate the degree of dysphagia in elderly patients with dysphagia after stroke, improve their nutritional status, neurological function, and daily living ability, and decrease the incidence of complications, so it is worthy of promotion.

Application of multidimensional individual care mode in elderly patients with coronary heart disease

Li Jing, Sun Aichen, Wang Guiling, Ren Qianqian, Wang Dan

2023, 29(12): 1729-1733. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.023

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Objective　To analyze the effect of multidimensional individual care mode for elderly patients with coronary heart disease. Methods　One hundred elderly patients with coronary heart disease admitted to Tai'erzhuang District People's Hospital from March 2018 to March 2022 were selected as the research objects. They were divided into an observation group and a control group by the random number table method, with 50 cases in each group. There were 30 males and 20 females in the control group. There were 29 males and 21 females in the observation group. The control group took routine care, and the observation group adopted multidimensional individual care. On the day of admission and 15 d after the intervention, the cardiac function levels of the two groups were compared. The Seattle Angina Questionnaire (SAQ) was used to evaluate their quality of life. The incidences of adverse events within 15 d were compared between the two groups. t and χ² tests were applied. Results　Fifteen days after the nursing, the heart rate, left ventricular end-diastolic inner diameter, and left ventricular end-systolic internal diameter in the observation group were lower than those in the control group [(69.03±2.76) beats/min vs. (70.45±2.81) beats/min, (52.01±2.76) mm vs. (53.46±2.81) mm, and (39.45±2.05) mm vs. (40.34±2.01) mm], with statistical differences (t=2.55, 2.60, and 2.19; all P<0.05); the scores of limited physical activity, stable angina pectoris, angina pectoris attack, satisfaction, and subjective feeling of the disease of SAQ in the observation group were higher than those in the control group [(61.49±6.43) vs. (58.34±5.46), (68.35±7.26) vs. (65.45±6.34), (69.84±3.06) vs. (68.23±4.37), (85.26±2.75) vs. (83.96±2.02), (63.42±3.19) vs. (62.01±2.76)], with statistical differences (t=2.64, 2.13, 2.13, 2.69, and 2.36; all P<0.05). The incidence of adverse events in the observation group was lower than that in the control group [6.00% (6/50) vs. 20.00% (10/50)], with a statistical difference (χ²=4.33, P<0.05). Conclusion　The application of multi-dimensional individual care mode in elderly patients with coronary heart disease can significantly improve their cardiac function and quality of life, and effectively reduce the incidence of adverse events, with remarkable effect.

Clinical value of clinical nursing pathway on recovery of nerve function and improvement of limb function in patients with intracranial hemorrhage

Gao Libing, Zhou Na, Song Yanjun, Fu Jie

2023, 29(12): 1734-1738. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.024

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Objective　To explore the clinical application value of clinical nursing pathway in restoring neurological function and improving limb function of patients with intracerebral hemorrhage. Methods　A total of 98 patients with acute intracerebral hemorrhage in Zhengzhou Ninth people's Hospital from January 2015 to February 2021 were prospectively analyzed. The patients took emergent CT to decide the treatment scheme after admission. The patients were randomly divided into an observation group and a control group, with 49 in each group. There were 34 males and 15 females in the observation group; they were (56.4±16.3) years old. There were 31 males and 18 females in the observation group; they were (59.4±15.4) years old. The control group received the traditional nursing mode after admission, and the observation group the clinical nursing pathway mode. The National Institute of Health Stroke Scale (NIHSS), Barthel index, nursing satisfaction, Hamilton Anxiety Scale (HAMA), and Fugl-Meyer Assessment Scale (FMA) were used to evaluate the patients in both groups after admission and before discharge to evaluate their improvement of neurological function, daily activity ability, and adverse mood. χ² and t tests were applied. Results　The scores of NIHSS and HAMA in the observation group were lower than those in the control group [(8.0±5.6) vs. (10.6±3.3) and (4.28±1.08) vs. (5.76±0.92)], with statistical differences (t=2.82 and 7.30; both P<0.05). The scores of Barthel index, FMA, and nursing satisfaction in the observation group were higher than those in the control group [(65.3±9.7) vs. (57.0±6.4), (84.28±10.21) vs. (75.18±11.12), and (39.7±6.4) vs. (30.5±5.2)], with statistical differences (t=5.02, 4.12, and 5.24; all P<0.05). Conclusion　The establishment of clinical nursing pathway can significantly improve the postoperative neurological function recovery of patients with acute intracerebral hemorrhage, alleviate their adverse psychological mood, and enhance their ability of postoperative daily activities.

Effect of nutrition knowledge training and teaching in obstetrics on nurses' nutrition support nursing, knowledge, belief, and behavior

Zhao Cong, Jiang Qiuhuan, Zhang Qian

2023, 29(12): 1738-1742. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.025

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Objective　To explore the influence of nutrition knowledge training and teaching in obstetrics on nurses' nutrition support nursing, knowledge, belief, and behavior. Methods　A total of 42 obstetric nurses who were trained in nutrition knowledge in Henan Provincial People's Hospital from July 2020 to June 2021 were selected as a study group, including 7 males and 35 females who (34.81±2.53) years old. A total of 39 obstetric nurses before the training in Henan Provincial People's Hospital from July 2019 to June 2020 were selected as a control group, including 4 males and 35 females who were (35.17±2.41) years old. The awareness rates of nutrition support, scores of knowledge, belief, and behavior, maternal and infant nutrition support, and satisfaction were compared between these two groups. χ² test or Fisher exact test was used for the enumeration data, and independent sample t test for the measurement data between these two groups. Results　The awareness rates of basic nutrition, obstetric nutrition, identification of nutrition-related problems, and malnutrition nursing in the study group were higher than those in the control group [97.62% (41/42) vs. 82.05% (32/39), 92.86% (39/42) vs. 76.92% (30/39), 95.24% (40/42) vs. 79.49% (31/39), and 92.86% (39/42) vs. 71.79% (28/39); all P<0.05]. The scores of nutritional support knowledge, belief, and behavior in the study group were higher than those in the control group [(4.95±0.83) vs. (4.37±0.68), (24.81±3.75) vs. (22.96±2.27), and (25.38±3.84) vs. (23.06±2.36); all P<0.05]. The incidence of macrosomia in the study group was lower than that in the control group [5.00% (5/100) vs. 16.00% (16/100); P<0.05]. The neonatal body weight of the study group was lower than that of the control group [(3 161.18±319.47) g vs. (3 508.41±348.62) g; P<0.05]. The scores of nutrition support nursing, nursing attitude, and overall satisfaction in the study group were higher than those in the control group [(9.25±1.52) vs. (8.74±1.69), (9.06±1.68) vs. (8.45±1.41), and (27.45±2.14) vs. (26.24±2.66); all P<0.05]. Conclusion　The training and teaching of nutrition knowledge in obstetrics department is helpful to improve nurses' ability of nutrition support nursing, knowledge, belief, and behavior and pregnant women's nutritional status in obstetrics department.

Effect of graffiti filling painting on stigma and self-efficacy of male patients with chronic schizophrenia

Liu Xiaoqun, Guan Fangping, Zheng Hongxiu, Zhang Yuchuan

2023, 29(12): 1743-1747. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.026

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Objective　To explore the effect of graffiti filling painting on self-efficacy and stigma of male patients with chronic schizophrenia. Methods　From April 2020 to March 2021, 65 male patients with chronic schizophrenics admitted to Fuzhou Neuropsychiatric Hospital were selected. The were randomly divided into a painting group and a control group. One case in the painting group and 2 in the control group dropped out of the study because of discharge, and 62 cases completed the whole intervention. The 30 cases in the control group were (46.03±4.98) years old, and received routine psychiatric nursing care. The 32 cases in the painting group were (45.18±5.03) years old, and received graffiti filling painting intervention and routine psychiatric nursing care. The General Self-Efficacy Scale (GSES) and Stigma Scale for Mental Illness (SSMI-C) were used to measure the patients' self-efficacies and stigma in both groups, and the results were compared. χ² and t tests were applied. Results　Before the intervention, the score of GSES was (15.46±2.74) in the painting group, and (15.52±2.79) in the control group, with no statistical difference (P>0.05); the score of GSES after the intervention in the painting group was higher than that in the control group [(17.92±2.42) vs. (16.04±2.25)] and that before the intervention, with statistical differences (both P<0.001). Before the intervention, the score of SSMI-C was (52.23±7.64) in the painting group, and (51.85±6.48) in the control group; the score of SSMI-C after the intervention in the painting group was lower than that in the control group [(41.78±4.86) vs. (50.01±4.13)] and that before the intervention, with statistical differences (both P<0.001). Conclusion Graffiti filling painting intervention for patients with schizophrenia can improve their self-efficacy and self-confidence, stabilize their emotions, reduce their stigma, promote their rehabilitation, and make them return to society as soon as possible.

Influence of early warning intervention mode under 4R crisis management theory on perioperative nursing satisfaction and complications of patients with thoracic trauma

Zhu Shanshan, Zhao Xia, Pei Xiaodan

2023, 29(12): 1747-1751. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.027

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Objective　To study the application value of early warning intervention mode under 4R crisis management theory in the perioperative period of patients with thoracic trauma. Methods　One hundred and eight patients with thoracic trauma admitted to Nanyang First People's Hospital from June 2020 to May 2022 were selected as the study objects, and were divided into a control group and a study group by lottery, with 54 in each group. There were 29 males and 25 females in the control group who were (42.79±3.84) years old. There were 31 males and 23 females in the control group who were (43.12±4.06) years old. The control group took routine nursing; in addition, the study group implemented early warning intervention mode under 4R crisis management theory. The emergency indicators, treatment effects, life abilities [Barthel index (BI)], and nursing satisfaction were compared between the two groups. χ² and t tests were applied. Results　The prehospital emergency response time, diagnosis time, and rescue time in the study group were shorter than those in the control group [(10.59±1.32) min vs. (12.48±1.87) min, (30.48±4.85) min vs. (36.72±5.03) min, and (36.75±5.29) min vs. (42.48±5.34) min], with statistical differences between the two groups (all P<0.05). The rescue success rate and the incidences of crisis events and complications in the study group were better than those in the control group [94.44% (51/54) vs. 74.07% (40/54), 3.70% (2/54) vs. 14.81% (8/54), and 1.85% (1/54) vs. 14.81% (8/54)], with statistical differences between the two groups (all P<0.05). After the intervention, the BI score and nursing satisfaction in the study group were higher than those in the control group [(67.35±4.52) vs. (53.88±4.19) and 96.30% (52/54) vs. 83.33% (45/54)], with statistical differences between the two groups (both P<0.05). Conclusion　Early warning intervention mode under 4R crisis management theory for patients with thoracic trauma can improve the emergency efficiency and rescue success rate, reduce the incidences of crisis events and complications, and improve their living ability and nursing satisfaction.

A qualitative study on needs and challenges of social support of breastfeeding of mothers during transitional period of preterm infants

Hang Lin, Zhang Jieping, Xiang Danyu, Chen Yuying, Sun Xinxin, Yin Yue, Liao Yuexia

2023, 29(12): 1752-1755. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.028

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Objective　To describe the mothers' experience of breastfeeding difficulties during transitional period of premature infants, to analyze their needs and challenges for social support, and to provide references for developing breastfeeding intervention programs suitable for the transitional period of premature infants. Methods　The purpose sampling method was used select 18 mothers who had premature infants and were followed up by Outpatient Department, Hospital Affiliated to Yangzhou University from June to November 2020 for semi-structured in-depth interview. The mothers were 27-41 years old. The Colaizzi 7-step analysis method was used to analyze the data. Results　After the in-depth interview, two themes and three sub-themes were extracted, including the challenges of social support (differences in parenting philosophies between generations) and social support needs (expecting targeted guidance from professionals and expecting active participation and support from the spouse). Conclusion　In order to improve the difficulties of breastfeeding, it is very important to pay attention to the psychology of the mothers of preterm infants and to strengthen the education of breastfeeding knowledge and the support.

Application of comprehensive nursing intervention in treatment of androgenetic alopecia with nano-microneedles

Wan Changlan, Yu Yong, Yang Kunxia, Shen Xiuling, Wu Hui, Li Runxiang, Li Zhenjie

2023, 29(12): 1756-1759. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.029

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Objective　To observe and analyze the therapeutic effect and the changes of anxiety and depression in patients with androgenetic alopecia treated with 5% topical minoxidil introduced by nano-microneedles after strengthening comprehensive nursing intervention. Methods　Eighty male patients with androgenetic alopecia admitted to Outpatient Department of Zhongshan Fourth Road, Guangzhou Institute of Dermatology from September 2021 to October 2022 were selected and divided into a control group and an observation group by the random number table method, with 40 cases in each group. The control group were (36.96±8.80) years old, and the observation group (37.05±9.69). Both groups were treated with 5% topical minoxidil by nano-microneedles. The control group were given routine nursing intervention, and the observation group comprehensive nursing intervention. The clinical efficacies, densities and thicknesses of new hair, and anxiety and depression scores were compared between the two groups after the treatment. t and χ² tests were applied. Results　The total effective rate of the observation group was significantly higher than that of the control group [87.5% (35/40) vs. 67.5% (27/40)], with a statistical difference (χ²=4.59, P<0.05). After comprehensive nursing intervention, the number of hair in the control group was significantly higher than that in the observation group (221.35±25.16) pieces/cm² vs. (204.37±28.12) pieces/cm², with a statistical difference (t=2.84, P<0.05). After the intervention, the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group were lower than those in the control group [(45.55±3.43) vs. (48.20±4.71) and (46.43±1.57) vs. (49.33±4.23)], with statistical differences (t=2.88 and 4.07; both P<0.05). Conclusions　Comprehensive nursing intervention can effectively alleviate the anxiety and depression of patients with androgenetic alopecia treated with nano-microneedles, and improve the therapeutic effect.

Value of chain care for preventing extravasation of contrast in enhanced CT

Chen Xiangrong, Huang Ranran, An Bo, Yu Guozheng

2023, 29(12): 1760-1763. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.030

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Objective　To explore the value of chain care for preventing extravasation of contrast in enhanced CT. Methods　One hundred patients treated at Yantai Yantaishan Hospital from March 2019 to March 2022 were selected as the research objects, and were divided into a control group and an observation group by the random number table method, with 50 cases in each group. There were 26 males and 24 females in the control group; they were (58.21±5.18) years old. There were 27 males and 23 females in the observation group; they were (58.01±5.04) years old. The control group adopted routine nursing process management, and the observation group applied chain nursing countermeasures. The contrast extravasation rates and extravasation grades during the CT-enhanced scan and the satisfaction scores were compared between these two groups. t and χ² tests were applied. Results　After the intervention, the contrast extravasation rate in the control group was higher than that in the observation group [60.00% (30/50) vs. 34.00% (17/50)], with a statistical difference (P<0.05). The extravasation grade in the observation group was lower than that in the control group, with a statistical difference (P<0.05). The satisfaction scores of service attitude, appearance, responsibility, and health education in the control group were lower than those in the observation group [(77.36±1.01) vs. (78.03±1.36), (76.64±1.30) vs. (77.45±1.53), (77.41±1.31) vs. (78.00±1.52), and (79.01±2.06) vs. (80.26±2.61)], with statistical differences (all P<0.05). Conclusion　Chain care for patients taking clinical CT enhanced scanning diagnosis can effectively prevent contrast extravasation and improve their extravasation grade and satisfaction with nursing service, so it is worthy of reference and adoption by all departments.

Application value of group psychotherapy combined with continuous nursing care in rehabilitation of patients with mental disorders caused by alcohol dependence

Zhang Fang, Zhang Li, Zhuang Qingjie, Zhou Lianjie, Yang Guofang, Pang Qingli

2023, 29(12): 1764-1768. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.031

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Objective　To explore the application value of group psychotherapy combined with continuous nursing care in the rehabilitation of patients with mental disorders caused by alcohol dependence. Methods　A total of 102 male patients with mental disorders caused by alcohol dependence treated in Liaocheng Fourth People's Hospital from February 2020 to February 2021 were selected, and divided into a conventional group and a combined group by the random number table method, with 51 cases in each group. The conventional group were 27-69 (54.74±8.74) years old. The combined group were 28-72 (55.47±8.81) years old. The conventional group took group psychotherapy, and the combined group continuous nursing care and group psychotherapy, for 3 months. The scores of Human Quality of Life Scale (GQOLI-74) and Self-rating Depression Scale (SDS) before and after the treatment and the early recovery after 3 months' treatment were compared between the two groups. t and χ² tests were applied. Results　After 3 months' treatment, the score of GQOLI-74 in the combined group was higher than that in the conventional group [(75.74±10.28) vs. (68.57±9.14)], with a statistical difference (t=3.72, P<0.05). The scores of SDS in both groups were lower after than before the treatment; the score of SDS after 3 months' treatment in the combined group was lower than that in the conventional group [(24.74±3.94) vs. (32.74±4.85)], with a statistical difference (t=9.14, P<0.05). After 3 months' treatment, the score of early recovery in the combined group was higher than that in the conventional group [(12.14±1.34) vs. (8.24±0.82)], with a statistical difference (t=20.82, P<0.05). Conclusion　Group psychotherapy combined with continuous nursing care in the rehabilitation of patients with mental disorders caused by alcohol dependence can improve their quality of life, depression, and rehabilitation effect, so it is worthy of promotion and application.

Application effect of "humanoid figure" nursing mode in perinatal period of parturients taking cesarean section

Zhong Chunyan, Xu Wanzhen

2023, 29(12): 1768-1772. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.032

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Objective　To explore the effect of "humanoid figure" nursing mode in the perinatal period of parturients taking cesarean section. Methods　This study adopted the prospective randomized controlled study method. A total of 85 parturients who delivered by cesarean section in Women and Children's Hospital Affiliated to Xiamen University from March 2022 to August 2022 were selected as the study objects. After numbering, they were divided into a control group (42 cases) and an observation group (43 cases) according to the digital parity method. In the control group, there were 19 primiparae and 23 multiparae; they were (29.38±3.11) years old. In the observation group, there were 23 primiparae and 20 multiparae; they were (28.97±3.08) years old. The control group were intervened by the routine obstetric nursing mode, and the observation group by the "humanoid figure" nursing mode. The postpartum rehabilitation indicators, uterine involution, pain degrees, and postpartum complications of the two groups were compared. t, χ², and rank sum tests were applied. Results　The amount of postpartum hemorrhage in the observation group was lower than that in the control group [(567.38±64.18) ml vs. (694.72±80.66) ml], with a statistical difference (t=8.064, P<0.05). The time of postpartum hemorrhage, the time of first milk secretion, the time of incision healing, and the total hospital stay in the observation group were all shorter than those in the control group [(3.97±0.56) d vs. (4.45±0.69) d, (27.34±5.25) h vs. (31.19±6.74) h, (5.18±0.76) d vs. (5.97±0.85) d, (7.22±1.09) d vs. (8.65±1.21) d], with statistical difference (t=3.525, 2.955, 4.520, and 5.728; all P<0.05). There were no statistical differences in the heights of uterine descent 24 h after delivery and at discharge between the two groups (both P>0.05); the height of uterine descent 72 h after delivery in the observation group was higher than that in the control group [(1.56±0.34) cm vs. (1.22±0.37) cm; t=4.413, P<0.05]. After the intervention, the pain degree of the observation group was significantly lower than that of the control group (Z=-2.065, P<0.05). The incidence of postpartum complications in the observation group was lower than that in the control group [4.7% (2/43) vs. 21.4% (9/42)], with a statistical difference (χ²=3.924, P<0.05). Conclusion　The application of "humanoid figure" nursing mode in the perinatal period of parturients taking cesarean section has significant effect, is helpful to promote postpartum recovery, and can relieve pain and reduce the risk of complications.

Application of conceive-design-implement-operate teaching mode in improving coaches' ability of intravenous infusion therapy

Lu Suxiang, Pan Suming, Cai Aifang, Zeng Yayan, Wang Yueying

2023, 29(12): 1773-1776. DOI: 10.3760/cma.j.issn.1007-1245.2023.12.033

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Objective To explore the effect of the conceive-design-implement-operate (CDIO) teaching mode in the improvement of coaches' ability of intravenous infusion therapy. Methods　Thirty-four female coaches of intravenous infusion therapy in Jieyang People's Hospital who were 25-45 years old were selected as the study objects. In the first ten days of May and October 2019, before and after the training of intravenous infusion, the cross-sectional survey on intravenous infusion in the hospital was carried out. The China Registered Nurses Core Competence Scale was used to assess the objects. From June to October 2019, CDIO training was conducted. The changes of the coaches' clinical core competence before and after the training were compared; the training satisfaction of CDIO teaching mode was evaluated; the indirect effect was evaluated by the quality of intravenous infusion in the whole hospital before and after 3 months' training.t and χ² tests were applied. Results　After the implementation of CDIO teaching mode training, the coaches' ability of critical thinking increased from (25.47±5.05) to (35.53±8.22), the ability of clinical nursing from (28.59±5.92) to (34.35±7.93), the ability of professional development from (19.62±4.41) to (23.47±5.18), and the ability of education/consultation from (21.06±5.58) to (26.97±6.15); the satisfaction with teaching was 97.06% (33/34) or above; the qualified rate of choosing infusion tools in the whole hospital increased from 82.11% (1 065/1 297) to 85.74% (1 377/1 606); the correct rate of dressing fixation increased from 81.57% (1 058/1 297) to 86.24% (1 385/1 606); the correct rate of flushing and sealing tubes increased from 80.96% (1 050/1 297) to 84.12% (1 351/1 606); the incidence of transfusion-related complications decreased from 5.47% (71/1 297) to 2.80% (45/1 606); there statistical differences (all P<0.05). Conclusions　Using CDIO teaching mode for training can effectively improve the training effect, coaches' comprehensive ability of intravenous infusion therapy, and the quality of nursing care of intravenous infusion therapy in hospitals.

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