Table of Content

15 July 2023, Volume 29 Issue 14

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Special Subject:Endometrial Diseases

Expressions of SUMO specific proteinase 1 and ER in endometrioid adenocarcinoma and their relationship

Li Yunhui, Zhu Bowen, Cui Xin

2023, 29(14):  1925-1929.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.001

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Objective　To investigate the expressions of small ubiquitin related modifier (SUMO) specific protease 1 (SENP1) and estrogen (ER) in endometrioid adenocarcinoma and their relationship. Methods　Eighty samples of endometrioid adenocarcinoma tissue and 80 samples of normal endometrial tissue that were surgically removed in Luoyang Central Hospital from October 2018 to October 2020 were collected; the expressions of SENP1 and ER were detected by immunohistochemistry. The expressions of SENP1 and ER in the normal endometrial epithelial cells and the endometrial carcinoma cells (ishikawa) were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. The ishikawa cell lines were divided into two groups: one group used ER specific inhibitor (fulvestrant) to silence the expression of ER; the other group served as the control group; the expressions of SENP1 were observed. Pearson correlation coefficient was used for the correlation analysis. Results　The expressions of SENP1 and ER in the endometrioid adenocarcinoma tissue were higher than those in the normal endometrial tissue; their expressions were positively correlated (r=0.6). The expressions of SENP1 and ER in the endometrial carcinoma cells were higher than those in the normal endometrial epithelial cells. After silencing the expression of ER in the ishikawa cell line, the expression of SENP1 decreased, and the expressions were positively correlated (r=0.5). Conclusions　SENP1 and ER are highly expressed in endometrioid adenocarcinoma; they are positively correlated with each other; together they promote the occurrence and development of endometrial carcinoma.

Effect of long non-coding RNA FAM83H-AS1 on proliferation, invasion, and metastasis of endometrial carcinoma cells

Song Xiaoxia, Tian Jin, Liu Yuling, Jiang Qiuhui, Liu Xiaoyan, Wang Qianqian, Zhang Lili, Zhou Xiaoli, Zhao Xiaoli

2023, 29(14):  1930-1935.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.002

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Objective　To explore the effect of long non-coding RNA (lncRNA) family with sequence similarity 83, member H antisense RNA1 (FAM83H-AS1) on the proliferation, invasion, and metastasis of endometrial cancer cells. Methods　The tumor tissue and adjacent tissue were collected from 39 patients with endometrial cancer who were treated at Zhengzhou People's Hospital from October 2018 to October 2020. Reverse transcriptase-quantitative polymerase chain reaction (qRT-PCR) was used to detect the epression levels in the endometrial cancer tissue and adjacent tissue. The shRNA plasmid targeting FAM83H-AS1 was transfected into the endometrial cancer cells HEC-1A and HEC-1B by the Lipofectamine 2000 transfection kit; the transfection efficiency of shRNA was detected by qRT-PCR. The cell proliferation test, TUNEL staining, EdU staining, flow cytometry, and Transwell test were used to detect the growth, proliferation, apoptosis, migration, and invasion abilities of the FAM83H-AS1 knockdown endometrial cancer cells. Paired t test and analysis of variance were applied. Results　The expression level of lncRNA FAM83H-AS1 in the cancer tissue was significantly higher than that in adjacent tissue. The expression level of lncRNA FAM83H-AS1 was not significantly correlated with the patients' age and tumor size (both P>0.05), but was correlated with their histological type, FIGO stage, lymph node metastasis, and histological grade (all P<0.05). Knocking down lncRNA FAM83H-AS1 weakened the proliferation activity of the endometrial carcinoma cells, promoted the apoptosis, and inhibited the migration and invasion. Conclusions　The expression level of lncRNA FAM83H-AS1 is significantly increased in endometrial cancer tissue. Knocking down FAM83H-AS1 weakens endometrial cancer cells' proliferative activity, promotes their apoptosis, and inhibits their migration and invasion.

New Medical Advances

Clinical value of speckle-tracking imaging in evaluating left ventricular function in patients with aortic stenosis

Chen Jiayao, Chen Shiyan, Ouyang Liangyan, Zhu Zhimin, Chen Fei, Qiu Shaodong

2023, 29(14):  1936-1939.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.003

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Speckle-tracking imaging (STI) is an inexpensive, radiation-free, repeatable technique, and can track the movement track of myocardium. It can detect the decline in myocardial strain capacity at the early stage of aortic stenosis, and guides clinical treatment decisions. This article reviews the application of STI in the evaluation of left ventricular function and surgical efficacy and in the prediction of postoperative complications and prognosis in patients with aortic stenosis.

Research progress of bone sialogin in malignant tumors

Li Zhenlian, Kang Xiaoling, Li Huibin, Liao Yanxia, Peng Dayun, Gao Hongyi

2023, 29(14):  1940-1943.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.004

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Bone sialoprotein (BSP) is a non-collagenous phosphorylated glycoprotein secreted by bone matrix and tumor cells, and exists in extracellular matrix (ECM). By binding to integrin avβ3, it can mediate the adhesion between tumor cells and ECM, promote the degradation of ECM, participate in angiogenesis and humoral immunity, etc. It plays a key role in the process of malignant tumor proliferation, invasion, and metastasis, and is considered as a new tumor marker. This paper summarizes the biological characteristics of BSP and the recent studies on the correlation between BSP and malignant tumors, and evaluates the clinical significance of BSP in the early diagnosis, efficacy evaluation, and prognosis monitoring of malignant tumors.

Research progress on risk factors of intravesical recurrence and intravesical instillation after radical nephroureterectomy for upper tract urothelial carcinoma

Xu Meng, Xing Shaoqiang, Zhu Xingwang, Zhang Xuefeng, Wang Shipeng

2023, 29(14):  1944-1949.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.005

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The intravesical recurrence (IVR) rate of upper tract urothelial carcinoma is relatively high after radical nephroureterectomy. Currently, there are many studies on the risk factors of IVR, but many of them are controversial. The risk stratification and prediction model are not yet mature, and a personalized intravesical instillation scheme guided by it has not been formed. Intravesical perfusion can reduce the recurrence in bladder, but there are controversies about the times, timing, and drugs. The prediction, bladder perfusion, surgery, and follow-up of IVR after radical nephroureterectomy are mainly draw lessons from primary bladder cancer. An independent standardized scheme has not yet been formed. The risk factors of IVR and intravesical instillation scheme have become the foci in recent years. This article reviews them.

Laboratory Medicine Column

Effect of resveratrol on biofilm formation in Staphylococcus aureus

Tang Xiaohua, Peng Qi, Yuan Wenchang

2023, 29(14):  1950-1954.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.006

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Objective　To explore the impact and molecular mechanism of resveratrol at subinhibitory concentrations on the formation of biofilms in Staphylococcus aureus. Methods　This study was from January to April 2023. We determined the minimum inhibitory concentration (MIC) of resveratrol against the SYN strain using the broth microdilution method. The formation ability of biofilms was assessed using the crystal violet method. The impact of sub-inhibitory concentrations of resveratrol on biofilm exopolysaccharide production was detected by the phenol-concentrated sulfuric acid method. The impact on the release of extracellular DNA (eDNA) in response to sub-inhibitory concentrations of resveratrol was detected through phenol-chloroform extraction. The regulatory mechanism of resveratrol on biofilm formation in the SYN strain was investigated using real-time fluorescent quantitative polymerase chain reaction (PCR). The experimental results were analyzed using the GraphPad Prism 8.0 software and presented statistically. Results　The SYN strain demonstrated a minimum inhibitory concentration (MIC) of 1 024 mg/L for resveratrol. The crystal violet staining showed that resveratrol significantly influenced the formation of Staphylococcus aureus biofilms, and the influence increased with its concentration. The subinhibitory concentrations promoted the release of Staphylococcus aureus extracellular DNA (eDNA), and enhanced the biofilm formation. The results of real-time fluorescent quantitative PCR indicated that resveratrol exhibited down-regulatory effects on the expressions of genes saeR, saeS, lrgA, and nuc, which are associated with eDNA release in Staphylococcus aureus. Conclusion　By inhibiting the SaeRS binary regulatory system of Staphylococcus aureus, the subinhibitory concentrations of resveratrol effectively decrease the expression of cardiac enzymes and the level of LrgA, leading to the release of eDNA and robustly enhancing the production of Staphylococcus aureus biofilms.

Correlation between serum levels of MBP, GLOⅠ, and hs-CRP and diabetic peripheral neuropathy

Zhu Peixuan, Lu Meijuan, Cao Bindong, Meng Hui

2023, 29(14):  1955-1958.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.007

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Objective　To investigate the correlation between serum levels of myelin basic protein (MBP), glyoxalase Ⅰ (GLOⅠ), and high-sensitivity-C-reactive protein (hs-CRP) and diabetic peripheral neuropathy (DPN). Methods　From July to December 2021, 30 patients with DPN treated at Guangzhou General Hospital, Foresea Life Insurance were selected as an observation group A [9 males and 21 females; (60.46±11.65) years old; their body mass index was (24.50±1.68) kg/m²], 30 patients with diabetes mellitus (DM) but no peripheral neuropathy as an observation group B [8 males and 22 females; (54.12±10.47) years old; their body mass index was (24.66±1.72) kg/m²], and 30 healthy persons taking physical examination as a control group [11 males and 19 females; (56.54±7.26) years old; their body mass index was (25.01±1.86) kg/m²]. The serum levels of MBP, GLOⅠ, and hs-CRP in all the subjects were detected. The serum levels of MBP, GLOⅠ, and hs-CRP in the three groups were compared by one way analysis of variance. The correlation between the serum levels of MBP, GLOⅠ, and hs-CRP and DPN was analyzed by Pearson correlation. Results　The levels of MBP and hs-CRP in the observation group A were higher than those in the observation group B and the control group, and the level of GLOⅠ was lower than those in the observation B and the control group (all P<0.05); the levels of MBP and hs-CRP in the observation group B were higher than those in the control group, and the level of GLOⅠ were lower than that in the control group (all P<0.05). Pearson correlation analysis showed that the serum MBP and hs-CRP levels were positively correlated with DPN (r=0.297 and 0.615, both P<0.05), and the serum GLOⅠ level was negatively correlated with DPN (r=-0.501, P<0.05). Conclusions　High levels of MBP and hs-CRP and low GLOⅠ level are associated with the occurrence of DPN. The detection of serum levels of MBP, GLOⅠ, and hs-CRP is helpful in diagnosing DPN.

Value of immunomagnetic bead separation technology in detection of vaginitis caused by Candida albicans

Yao Qiong, Xu Min

2023, 29(14):  1958-1961.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.008

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Objective　To analyze the clinical value of immunomagnetic bead separation technology in the detection of vaginitis caused by Candida albicans. Methods　One hundred and ninety women who were took vaginal secretion examination at Zhengzhou People's Hospital from June 2021 to January 2023 were selected as the study objects; 102 patients with candida albicans vaginitis were included into the case group, and the rest 88 healthy volunteers who underwent routine gynecological examination were included into the control group. The vaginal secretions were detected by the wet film microscopy and immunomagnetic bead separation technology; the results of vaginal secretion culture were set as the gold standard. The detection and diagnostic efficacies of the two techniques were compared. χ² test was applied. Results　The detection rate of vaginitis caused by Candida albicans, diagnostic accuracy, sensitivity, and specificity by the immunomagnetic bead separation technology were higher than those by the wet film microscopy [86.27% (88/102) vs. 68.63% (70/102), 95.26% (181/190) vs. 81.58% (155/190), 86.27% (88/102) vs. 68.63% (70/102), and 94.32% (83/88) vs. 85.23% (75/88); χ²=8.908, 9.139, 8.908, and 4.501; P=0.003, 0.003, 0.003, and 0.034]. Conclusion　Immunomagnetic bead separation technology can effectively detect the infection type of vaginitis patients, and is of great significance in improving the diagnostic accuracy of vaginitis caused by Candida albicans and guiding clinical treatment.

Retrospective analysis on false positive results in HIV screening by chemiluminescence microparticle immunoassay

Wang Songzi, Wang Yichong, Li Liubing, Liang Jiaying, Deng Jiankai, Cui yingpeng

2023, 29(14):  1962-1966.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.009

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Objective　To explore the factors causing the high false-positive rate in human immunodeficiency virus (HIV) detection by chemiluminescence microparticle immunoassay (CMIA). Methods　The medical records of 295 patients positive in HIV detection by CMIA in First Hospital Affiliated to Sun Yat-sen University from January 2018 to December 2020 were retrospectively analyzed. The patients were (47.4±16.7) years old. There were 185 males who were (47.5±17.4) years old and 110 females who were (47.2±15.5) years old. According to the results of HIV confirmatory test, the patients were divided into a true positive group (101 cases) and a false positive group (194 cases). The correlations of false positive results with detection time, gender, age, and S/CO value were analyzed. The case data of 155 patients positive in HIV detection by CMIA were collected, and were divided into a true positive group (77 cases), a false positive group (78 cases), and a negative group (78 cases). The relations of false positive with the patients' diagnosis and other laboratory indicators were analyzed. SPSS 24.0 was used for the statistical analysis. The ratios were compared by χ² test. Results　The false positive rates in 2018, 2019, and 2020 were 47.6% (39/82), 67.3% (66/98), and 77.4% (89/115), respectively, indicating that the false positive rate of HIV screening by CMIA increased year by year. The false positive rate in the patients under 20 or over 70 years old was relatively higher (P<0.05). The false positive rate in the female patients was higher than that in the male patients [87.3% (96/110) vs. 53.0% (98/185)], with a statistical difference (P<0.05). The S/CO value of the most patients with false positives was low; the false positive rates of the patients with diseases of the circulatory system, digestive system, urinary system, and reproductive system were higher. Conclusion　Age, gender, S/CO value, and complications of circulatory system and digestive system may cause a higher false positive rate.

Scientific Research

Effect of silver ion antibacterial functional dressing combined with NPWT for patients with chronic infectious wounds

Wu Shibing, Meng Qingye, Chen Ting, Guo Feng

2023, 29(14):  1967-1971.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.010

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Objective　To study and analyze the clinical effect of silver ion antibacterial functional dressing combined with negative pressure wound therapy (NPWT) for patients with chronic infectious wounds. Methods　One hundred and fourteen patients with chronic infectious wounds who were treated in Lianyungang Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from October 2017 to October 2022 were selected as the study subjects. The patients were divided into a control group and a study group by lottery, with 57 cases in each group. There were 27 women and 30 men in the control group; they were (57.12±3.76) years old; their course of disease was (30.24±4.52) d. There were 26 women and 31 men in the study group; they were (56.85±3.91) years old; their course of disease was (30.01±4.29) d. The control group were treated with NPWT, and the study group with NPWT and silver ionomer antibacterial functional dressing. The clinical efficacies, levels of inflammatory factors [hypersensitive C-reactive protein (hs-CPR), procalcitonin (PCT), and fibrinogen (FIB)], dressing change times, wound healing times, pain degrees, and wound closure indexes of the two groups were observed. The data were statistically analyzed by χ² and t tests. Results　The total clinical effective rate of the study group was higher than that of the control group [98.25% (56/57) vs. 85.96% (49/57)], with a statistical difference (χ²=4.343, P<0.05). After the treatment, the levels of hs-CRP, PCT, and FIB in the study group were lower than those in the control group [(8.41±0.85) mg/L vs. (9.25±0.89) mg/L, (0.33±0.10) μg/L vs. (0.40±0.11) μg/L, and (3.94±0.61)g/L vs. (4.42±0.66) g/L], with statistical differences (t=5.153, 3.555, and 4.032; P<0.05). The dressing change times, wound healing time, and pain degree in the study group were lower than those in the control group [(9.78±3.54) times vs. (15.34±4.34) times, (19.43±5.13)d vs. (25.67±5.51)d, and (3.89±1.34) vs. (4.76±1.51)], with statistical differences (t=7.495, 6.258, and 3.254; P<0.05). The wound closure indexes 7, 14, 21, and 28 d after the treatment in the study group were higher than those in the control group [(39.54±4.46) vs. (36.40±4.38), (56.34±3.74) vs. (54.25±3.35), (80.24±5.85) vs. (70.46±5.18), and (96.03±3.24) vs. (87.65±4.32)], with statistical differences (t=3.792, 3.143, 9.450, and 11.716; P<0.05). Conclusion　Silver ion antibacterial functional dressing combined with NPWT in the treatment of patients with chronic infectious wounds is effective, and can further reduce their inflammatory reaction, dressing changes, and pain degree, and accelerate their wound healing, so it is worthy of clinical application and promotion.

Clinical effects of digital guide plates in second stage implantation surgery versus traditional incision surgery 

Gao Yufeng, Chen Zhifei, Xu Yanhua, Zhu Fangyong, Wu Xiangbing, Hou Deqiang

2023, 29(14):  1971-1974.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.011

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Objective　To explore the clinical effects of digital implant guide plates in second stage implantation surgery versus traditional incision surgery. Methods　Twenty-four patients who were scheduled for second stage implantation surgery in Hospital Affiliated to Jiangnan University from January 2019 to December 2020 were randomly divided into a digital template group (group A) and a conventional group (group B), with 12 cases in each group. There were 5 males and 7 females in group A, with an average age of 31.5 years. There were 4 males and 8 females in group B, with an average age of 34.2 years. During the second stage implantation surgery in group A, the digital implant guide plates used in the first stage surgery were applied; the gingiva was cut by trephine; and the healing abutments were placed. In group B, traditional gingival incision was performed in the second stage implantation surgery, and the healing abutments were placed. The times of second stage operation, durations of postoperative pain, intraoperative bleeding volumes, postoperative healing times, postoperative pain scores, and service satisfaction of second stage operation were observed and compared between the two groups. t test and Fisher's exact probability were applied. Results　The second stage operation time in group B was longer than that in group A [(18.15±4.51) min vs. (5.52±2.32) min], with a statistical difference (P<0.05). The intraoperative bleeding volume, postoperative score of Visual Analogue Scale (VAS), duration of postoperative pain, and postoperative gingival tissue healing time in group A were better than those in group B [(0.50±0.10) ml vs. (1.34±0.52) ml, (1.02±0.66) vs. (8.24±3.41), (5.51±1.35) h vs. (19.66±2.55) h, (4.41±1.51) d vs. (10.11±2.45) d], with statistical differences (all P<0.05). The patient satisfaction in group A was significantly better than that in group B [91.67% (11/12) vs. 66.67% (8/12)], with no statistical difference (P>0.05). Conclusions　The application of digital implant guide plates in second stage implantation surgery can significantly reduce the operation times, intraoperative bleeding volume, postoperative gingival tissue healing time, and pain duration, and improve the patients' satisfaction with surgery.

Relationship between mean arterial pressure and renal function in EICU patients with septic shock

Wang Qifei, Sun Ming, Zhang Weiping

2023, 29(14):  1974-1979.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.012

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Objective　To explore the relationship between mean arterial pressure and renal function in emergency intensive care unit (EICU) patients with septic shock. Methods　Retrospective analysis was used. Eighty-three EICU patients with septic shock treated at Jiaozhou Hospital, Dongfang Hospital, Tongji University from January 2018 to January 2020 were included as the study objects. The patients were divided into group A (46 cases), group B (25 cases), and group C (12 cases) according to the actual maintenance level of mean arterial pressure (MAP) after early guided therapy. In group A, the actual MAP was maintained < 75% of the normal MAP in the one year before entering EICU; in group B, 75% of the daily MAP in the one year before entering EICU < the actual maintenance MAP < 90% of the daily MAP in the one year before entering the EICU; in group C, 90% of the daily MAP in the one year before entering the EICU < the actual maintenance MAP < the daily MAP in the one year before entering the EICU. The changes of renal aorta and interlobar artery hemodynamic indicator (peak diastolic value, mean flow rate, and blood perfusion index) and renal function indicators (serum creatinine, blood urea nitrogen, serum cystatin C, and blood lactic acid) were recorded before and after the treatment. The occurrence of acute renal injury 72 hours after the treatment was observed. The data were compared between the groups by t and χ² tests and analysis of variance. Results　The diastolic peak flow rates, mean flow velocities, and perfusion indexes of renal aorta and interlobar artery in the three groups were significantly higher after than before the treatment (all P<0.05). After the treatment, the diastolic peak flow rates, mean flow rates, and blood perfusion indexes of renal aorta and interlobar artery in group A were significantly lower than those in groups B and C (all P<0.05); the diastolic peak flow rates, mean flow rates, and blood perfusion indexes of renal aorta and interlobar artery in group B were significantly lower than those in group C (all P<0.05). The levels of serum creatinine, blood urea nitrogen, serum cystatin C, and blood lactic acid in the three groups were significantly lower after than before the treatment (all P<0.05). After the treatment, the levels of serum creatinine, blood urea nitrogen, serum cystatin C, and blood lactic acid in group A were significantly higher than those in groups B and C (all P < 0.05); the levels of serum creatinine, blood urea nitrogen, serum cystatin C, and blood lactic acid in group B were significantly higher than those in group C (all P<0.05). Seventy-two hours after the treatment, the incidence of acute kidney injury was 56.52% (26/46) in group A, was 24.00% (6/25) in group B, and was 41.67% (5/12) in group C; the incidence of acute kidney injury in group A was significantly lower than that in group B (P < 0.05). Conclusion　Moderate increase of mean arterial pressure in EICU patients with septic shock can improve their renal hemodynamics, regulate their renal blood supply and renal function, and reduce the incidence of acute renal injury, so it has high clinical value.

Effects of different intraspinal anesthesia methods and local anesthesia drugs on rapid recovery of women taking cesarean section

Wang Muye, Li Yujie, Wang Shouping

2023, 29(14):  1980-1985.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.013

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Objective　To compare the anesthesia effects and satisfaction of different intraspinal anesthesia methods and local anesthesia drugs for women taking selective cesarean section, and to observe their impact on the women's rapid recovery. Methods　This was a prospective, randomized, controlled, and double-blind study. A total of 150 single pregnant women who underwent selective cesarean section in The Third Affiliated Hospital of Guangzhou Medical University from April to October 2022 were selected; their America Association of Anesthesiologists (ASA) grade was Ⅰ-Ⅱ; they were 22-39 years old; they had no complications of other systemic systems; they took subuterine transectomy. They were divided into a ropivacaine group (SR group), an epidural lidocaine group (EL group), and an epidural mepivacaine group (EM group) by the random number table method, with 50 cases in each group. In the SR group, 3 ml of isobaric 0.5% ropivacaine was directly applied in the subarachnoid space into the L3-4 interspace; in the EL and EM groups, 12-15 ml of 2% lidocaine or 2% mepivacaine were applied in the epidural space through L2-3 direct approach, respectively. The indwelling catheters were placed in the epidural spaces of all the three groups. The anesthesia effects (time to most superior level of block obtained, drug dose, maximal cephalad sensory block level, and neonatal blood gas), anesthesia satisfaction (satisfaction of patients, surgeons, and anesthesiologists with anesthesia effects), complications, and related recovery indicators (motor block recoovery, Bromage score, postoperative analgesia, time for first off-bed activity, time for first exhausting, time for first peeing, and hospital stay) were observed and recorded. One way ANOVA and Kruskal-Wallis rank sum test were applied. Results　The EL and EM groups had longer duration of anesthetic drug effect and increased drug dosage. However, the incidences of intraoperative hypotension and nausea and vomiting and postoperative urine retention were 34%(17/50), 24%(12/50), and 14%(7/50) in the SR group, were 14%(7/50), 4%(2/50), and 2%(1/50) in the EL group, and were 16%(8/50), 6%(3/50), and 0 in the EM group, with statistical differences (all P<0.05). The times for first off-bed activity of the ER, EL, and EM groups were (23.52±4.22) h, (18.30±3.80) h, and (19.10±5.93) h, respectively; the the hospital stays were (72.68±12.69) h, (65.28±19.88) h, and (65.67±6.14) h respectively; it indicated that the EL and EM groups had better postoperative recovery indicators (all P<0.05). There were no statistical differences in satisfaction, neonatal blood gas, and administration of narcotics in the postoperative period between the three groups (all P>0.05). Moreover, there were no statistical differences in the anesthesia effect and postoperative recovery indicators between the EL and EM groups (all P>0.05). Conclusion　Compared to ropivacaine combined with lumbar epidural anesthesia, epidural application of lidocaine or mepivacaine can promote the patients' rapid postoperative recovery, and it is consistent with the modern ERAS concept.

P16/Ki-67 double staining in screening cervical cancer

Gao Yali, Wu Kunying

2023, 29(14):  1986-1990.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.014

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Objective　To investigate the application value of double staining of suppressor gene protein 16 (P16)/proto-oncogene cell proliferation nuclear antigen (Ki-67) in screening cervical cancer. Methods　The clinical data of 100 patients with cervical lesions who were treated at Zhengzhou Maternal and Child Health Hospital from October 2020 to May 2022 were retrospectively analyzed. The patients were (55.65±2.14) years old. All the patients received P16/Ki-67 double staining test, liquid based cytology (TCT) examination, and high-risk human papillomavirus (HR-HPV) detection. The biopsy results under colposcopy were used as the gold standard. The measurement data were analyzed by t test, and the enumeration data by χ² test. The value of HR-HPV, TCT, and P16/Ki-67 double staining in the diagnosis of cervical lesions was analyzed by the receiver operating characteristic curve (ROC). Results　Among the 100 patients with cervical lesions, 14 cases (14.00%) were found with inflammatory lesions by colposcopy, 26 cases (26.00%) cervical intraepithelial neoplasia (CIN) Ⅰ, 26 cases (26.00%) CIN Ⅱ, 28 cases (28.00%) CIN Ⅲ, and 6 cases (6.00%) cervical squamous cell carcinoma (SCC). The sensitivity, specificity, and accuracy of HR-HPV in the diagnosis of cervical lesions were 97.6%(84/86), 85.71(12/14), and 96.00%(96/100), respectively; the sensitivity, specificity, and accuracy of TCT in the diagnosis of cervical lesions were 88.37%(76/86), 78.57%(11/14), and 87.00%(87/100), respectively; the sensitivity, specificity, and accuracy of P16/Ki-67 double staining in the diagnosis of cervical lesions were 91.86%(79/86), 85.71%(12/14), and 91.00%(91/100), respectively; there were no statistical differences between HR-HPV, TCT, and P16/Ki-67 double staining (all P>0.05). The areas under the curves (AUC) of HR-HPV, TCT, and P16/Ki-67 double staining in the diagnosis of cervical lesions were 0.917, 0.835, and 0.888, respectively. There were no statistical differences in AUC between P16/Ki-67 double staining on one hand and TCT and HR-HPV examination on the other hand (both P>0.05). Conclusion　P16/Ki-67 double staining in screening cervical cancer and precancerous lesions is as effective as TCT and HR-HPV. It has the advantages of high efficiency, objectivity, simplicity, and repeatability, and can be used as a new choice for screening cervical cancer and precancerous lesions.

Prognosis assessment by CD64 index combined with tricuspid annular plane systolic excur sion in elderly patients with severe pneumonia

MiaoLei , Shen Xiaozhu, Liu Lu, Liao Jingxian

2023, 29(14):  1990-1995.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.015

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Objective　To investigate the value of neutrophil CD64 index combined with tricuspid annular plane systolic excursion (TAPSE) in prediction of prognosis of elderly patients with severe pneumonia. Methods　A total of 145 patients over 85 years old with severe pneumonia who were hospitalized in Lianyungang Second People's Hospital, Kangda College, Nanjing Medical University from November 2019 to November 2022 were selected. The TAPSE was measured by bedside echocardiography; the CD64 index was detected within 24 hours after admission. According to the 28-day short-term follow-up results, the patients were divided into a survival group and a death group. The gender and proportions of the patients with hypertension, diabetes, coronary heart disease, cerebral infarction, and chronic lung disease in both groups were recorded. The white blood cell counts, platelet counts, levels of hemoglobin (Hb), creatine kinase isoenzyme (CK-MB), albumin (ALB), glomerular filtration rate (e-GFR), neutrophil CD64 index, interleukin-6 (IL-6), procalcitonin (PCT) troponin T (cTnT), and lactic acid (Lac), TAPSE, and left ventricular ejection fractions (LVEF) were compared between these two groups. t, rank sum, and χ² tests were applied. The death risk factors of the patients were screened by binary logistic regression analysis. The receiver operating characteristics curves were drawn to analyze the abilities of CD64 index and TAPSE in prediction of death risk. The Kaplan-Meier survival analysis was used to analyze neutrophil CD64 index and TAPSE in the prediction of death risk. Results　Among the 145 patients, 41 died and 104 survived, with a mortality rate of 28.28%. The CD64 index and levels of IL-6, PCT, cTnT, and Lac in the death group were significantly higher than those in the survival group (all P<0.05), while the TAPSE and LVEF in the death group were significantly lower than those in the survival group (both P<0.05). The binary logistic regression analysis showed that chronic lung disease, neutrophil CD64 index, and TAPSE were the main risk factors for death in the elderly patients (all P<0.05). The area under the curve (AUC) of TAPSE was 0.757 (95%CI 0.662-0.851), and the cut-off point was 2.025; the sensitivity was 80.50%; the specificity was 62.50%. The AUC of neutrophil CD64 index was 0.846 (95%CI 0.772-0.919), and the cut-off point was 4.130; the sensitivity was 82.90%; the specificity was 83.70%. The AUC of TAPSE+CD64 was 0.899 (95%CI 0.840-0.958); the sensitivity was 90.20%; the specificity was 79.80%. The patients were divided into two groups according to whether the neutrophil CD64 index was higher than the cut-off point of 4.130; the Kaplan-Meier curve analysis showed that the 28-day survival rates of the two groups were statistically different [88.17% (82/93) vs. 42.31% (22/52); χ²=37.737, P<0.001]. The patients were divided into two groups according to whether TAPSE was greater than the cut-off point of 2.025; the Kaplan-Meier curve analysis showed that there was a statistical difference in the 28-day survival rate between the two groups [87.67% (64/73) vs. 55.56% (40/72); χ²=18.722, P<0.001]. Conclusions　CD64 index combined with TAPSE can be used to evaluate the prognosis of elderly patients with severe pneumonia and guide the classification of treatment.

Clinical features and prognosis of children versus adults with anti-NMDA receptor encephalitis

Li Zhigang, Tang Xiaomei, Zhong Shuisheng

2023, 29(14):  1996-2000.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.016

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Objective To analyze the clinical characteristics and prognosis of anti-NMDA receptor encephalitis in children versus adults, and to provide guidance for the diagnosis and treatment of anti-NMDA receptor encephalitis in children and adults. Methods　The clinical data of 46 patients with anti-NMDA receptor antibody-positive encephalitis diagnosed after hospitalization at Guangdong 999 Brain Hospital from January 2017to January 2019 were retrospectively analyzed. The patients were divided into a children group (<14 years old) and an adult group (≥14 years old). There were 11 children and 35 adults. The children group were (7.6±3.7) years old. The adult group were (27.4±13.0) years old. The first symptoms, main clinical symptoms, auxiliary examination results, and prognosis of the two groups were compared and analyzed. χ² test was applied. Results　The main first symptom was mental symptom in both groups; 9 (81.8%) children' first symptom was mental symptom, and 18 (51.4%) adults'. Main clinical symptoms: the incidence of central hypoventilation in the children was lower than that in the adults [9.1% (1/11) vs. 25.7% (9/35)]; more children had extrapyramidal system symptoms than the adults [36.4% (4/11) vs. 11.4% (4/35)]; there were statistical differences (χ²=3.36 and 3.62; both P<0.05). Auxiliary examination: the positive rate of abdominal ultrasound or CT in the adults was lower higher than that in the children [14.3% (5/35) vs. 0], with a statistical difference (χ²=2.16, P<0.05). Conclusions　Anti-NMDA receptor encephalitis has varied clinical symptoms, but both children and adults usually start with abnormal mental behaviors, especially children. Fewer children have central hypoventilation than adults, but they are more likely to develop extrapyramidal symptoms. This study suggests that there are differences between children and adults with anti-NMDA receptor encephalitis. Primary physicians should be sensitive and prudent in the diagnosis and treatment of pediatric encephalitis, and try to strengthen the understanding of the disease so as to achieve early diagnosis and treatment and improve prognosis.

Treatises

Intracranial hematoma puncture urokinase liquefaction versus decompressive hematoma removal through bone flap in treatment of patients with hypertensive intracerebral hemorrhage 

Shi Huaizhi, Li Jiteng, Zhang Chunsheng

2023, 29(14):  2001-2004.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.017

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Objective　To analyze the effects of intracranial hematoma puncture urokinase liquefaction versus decompressive hematoma removal through bone flap in the treatment of patients with hypertensive intracerebral hemorrhage. Methods　Eighty-four patients with hypertensive intracerebral hemorrhage admitted to Bayannur Hospital from August 2018 to August 2022 were selected as the research objects. There were 41 cases in the observation group, including 23 males and 18 females; they were 41-73 (63.2±9.5) years old. There were 43 cases in the control group, including 21 males and 22 females; they were 43-76 (59.3±11.8) years old. The observation group were treated with intracranial hematoma puncture urokinase liquefaction, and the control group with decompressive hematoma removal through bone flap. The surgical status, hospitalization costs, and scores of Glasgow Outcome Scale (GOS) in the 2 groups were compared. χ² and t tests were applied. Results　The operation time, treatment cost, hospital stay in the observation group were lower than those in the control group [(0.82±0.24) h vs. (3.61±0.56) h, (46 380.51±35 633.35) yuan vs. (72 834.60±32 785.26) yuan, (15.52±13.50) d vs. (23.32±16.83) d], with statistical differences (t=29.42, 3.48, and 2.34; all P<0.05). After the treatment, the scores of National Institute of Health Stroke Scale (NIHSS) and Barthel Index (BI) in the observation group were better than those in the control group [(12.87±3.13) vs. (18.98±4.85) and (82.23±7.94) vs. (56.88±6.79)], with statistical differences (t=6.82 and 15.75; both P<0.05). Conclusion　Intracranial hematoma puncture urokinase liquefaction has the advantages of shorter operation time, lower treatment cost, and shorter hospitalization time than decompressive hematoma removal through bone flap, and is safe and effective and can reduce neurological damage and improve the patients rehabilitation and life quality.

Clinical Research

Analysis on blood transfusion after ABO allogeneic hematopoietic stem cell transplantation

Zhu Xiaoying, Shi Jingli, Zhu Weiyan, Kong Cunquan, Yan Beizhan

2023, 29(14):  2005-2007.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.018

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Objective　To study the clinical characteristics of blood transfusion after ABO allogeneic hematopoietic stem cell transplantation. Methods　Four patients with ABO blood group incompatibility who took allogeneic hematopoietic stem cell transplantation at Henan People's Hospital from January 2021 to July 2022 were analyzed. During the transplantation, the characteristics of blood group changes in the 4 recipients at different time periods were analyzed to select the appropriate blood products for the recipients' blood transfusion. Results　After the ABO allogeneic hematopoietic stem cell transplantation, the patients' blood types gradually changed with the time of transplantation. We selected the corresponding blood components for the patients' infusion according to their blood type change, making the infusion safe and effective. Conclusion　As the blood group of patients after ABO allogeneic hematopoietic stem cell transplantation changes, we select matching blood components for their blood transfusion to ensure the safety and effectiveness of blood transfusion.

Different surgical methods under arthroscope for patients with osteoarthritis and popliteal cyst

Liu Dongguang, Li Mengchang, Tan Yuexian, Lai Huanle, Zeng Yanzuan, Li Yiting

2023, 29(14):  2008-2012.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.019

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Objective　To observe, evaluate, and analyze the clinical effects of different arthroscopic operations in the treatment of patients with osteoarthritis and popliteal cyst. Methods　A total of 40 patients with osteoarthritis and popliteal cyst admitted to Department of Orthopedics, Yangjiang People's Hospital from July 2021 to March 2022 were selected and divided into a control group and an observation group according to the operations, with 20 cases in each group. There were 9 males and 11 females in the control group; they were (49.03±8.01) years old. There were 10 males and 10 females in the observation group; they were (48.91±7.59) years old. The control group were treated through the single posterior medial arthroscopic approach by valvulotomy and internal drainage, and the observation group through double posterior medial arthroscopic approaches by joint cleaning and popliteal cyst resection. The incidences of complications such as incision infection, joint infection, and vascular and nerve injury and patient satisfaction after the operation, the scores Visual Analogue Scale (VAS) and knee joint function and Rauschning-Lindgren grades before and after the operation, and the recurrence rates were compared between the two groups. Independent sample t and χ² tests were applied. Results　The incidence of postoperative wound infection, joint infection, and vascular and nerve injury in the observation group was significantly lower than that in the control group [10.00%(2/20) vs. 40.00%(8/20)], with a statistical difference (χ²=3.333, P<0.05). The VAS scores 3, 6, and 9 months after the surgery were significantly lower than those before the treatment in both groups (all P<0.05), and the scores in the observation group were significantly lower than those in the control group (all P<0.05). The knee function scores 3, 6, and 9 months after the surgery were significantly higher than those before the treatment in both groups (all P<0.05), and the scores in the observation group were significantly higher than those in the control group (all P<0.05). There were no significant changes in the Rausning-Lindgren grading in the two groups between before surgery and 3, 6, and 9 months after the surgery (all P>0.05); there were no statistical differences in the Rausning-Lindgren grading between the two groups at the corresponding time points (all P>0.05). After 12 months' follow-up, the recurrence rate of in the observation group was significantly lower than that in the control group [5% (1/20) vs. 20% (4/20)], with a statistical difference between the two groups (P<0.05). The satisfaction of the observation group was higher than that of the control group [95.00% (19/20) vs. 80.00% (16/20)], with a statistical difference (P<0.05). Conclusion　Joint clearance and popliteal cyst resection through double posterior medial arthroscopic approaches in the treatment of patients with osteoarthritis and popliteal cyst can effectively reduce the incidence of complications, and the knee function recovery effect is more satisfactory, with the advantage of a low recurrence rate and high patient satisfaction, so it is worthy of clinical promotion and application.

Case Report

Synchronous occurrence of gastric stromal tumor, intrahepatic cholangiocarcinoma, and pancreatic intraductal papillary mucinous tumor in one case

Zhang Xiumei, Xu Weiwei

2023, 29(14):  2013-2015.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.020

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Multiple primary tumors (MPT) are cases describing no similar histopathology between two or more primary tumors. This paper introduces one case with gastric, liver, and pancreatic lesions found by physical examination; the MPT was indicated by energy spectrum CT enhancement examination; the patient was finally pathologically confirmed with gastric stromal tumor, intrahepatic cholangiocarcinoma, and pancreatic intraductal mucinous papillary tumor, which was a clinically rare process. For MPT, it is easy to be misdiagnosed as metastasis clinically. This paper provides references for its clinical diagnosis and treatment.

One patient with reversible splenial lesion syndrome after novel coronavirus infection and literature review

Yue Xianghai, Yang Jing, Ren Chengli, Jiang Dongxiao, Bi Yuhua, Zhan Xia

2023, 29(14):  2016-2017.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.021

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In the past three years, the novel coronavirus disease-2019 (COVID-19) has become a global pandemic. The case of reversible splenial lesion syndrome (RESLES) induced by COVID-19 infection is rare. This article reports a patient with RESLES secondary to COVID-19 infection, and reviews the related literatures.

Nursing Intervention for Patients with Chronic Obstructive Pulmonary Disease

Application of sitting Baduanjin in ventilator withdrawal of patients with AECOPD taking endotracheal intubation

Chen Jieya, Shi Haixia, He Wei

2023, 29(14):  2018-2021.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.022

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Objective　To explore the effect applying sitting Baduanjin in the ventilator withdrawal of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) taking endotracheal intubation. Methods　This study was a prospective controlled study. Eighty patients with AECOPD taking endotracheal intubation at The First Affiliated Hospital of Guangzhou Medical University from June 2021 to May 2022 were divided into an observation group and a control group by the random number table method. The patients dropped out of the study because of their own reasons during the intervention were excluded; at last, there were 37 cases in the observation group and 38 cases in the control group. There were 12 females and 26 males in the control group; they were (68.76±14.86) years old. There were 12 females and 25 males in the observation group; they were (64.97±13.42) years old. The control group took routine tracheal intubation nursing; in addition, the observation group were intervened by sitting Baduanjin. The ventilator withdrawal indicators and comfort degrees were compared between the two groups. χ², rank sum, and t tests were applied. Results　The mechanical ventilation time and hospitalization days in the observation group were significantly shorter than those in the control group [(7.84±2.82) d vs. (9.18±2.60) d and (16.32±4.08) d vs. (19.37±3.64) d], with statistical difference (t=-2.147 and -3.404; both P<0.05). The numbers of cases of no discomfort, mild discomfort, moderate discomfort, and severe discomfort in the observation group were better than those in the control group [3 (8.1%) vs. 1 (2.6%), 14 (37.8%) vs. 6 (15.8%), 18 (48.6%) vs. 23 (60.5%), 2 (5.4%) vs. 8 (21.1%)], with a statistical difference (Z=-2.870, P<0.05). Conclusion　Sitting Baduanjin is conducive to shorten the mechanical ventilation time and hospitalization days of patients with AECOPD taking endotracheal intubation, and can also improve the comfort of endotracheal intubation.

Risk assessment of aspiration and rehabilitation intervention for patients with acute exacerbation of chronic obstructive pulmonary disease

Li Dan, Qin Yanzhu, Zhang Lingyun, Sheng Qingqing, Liang Xinyin

2023, 29(14):  2022-2026.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.023

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Objective　To evaluate the risk of aspiration and rehabilitation intervention for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods　Seventy-eight patients with AECOPD treated at Department of Respiratory Medicine, First Hospital, Guangzhou Medical University from June 2021 to April 2022were selected by the convenience sampling method, including 66 males and 12 females. They were 46-90 (72.77±11.81) years old. Among the 78 patients, 21 cases had dysphagia disorder, and the rest 57 cases did not. The risk of aspiration was assessed according to the clinical dysphagia, including comprehensive medical history assessment, oral, facial, and laryngeal function assessment, and bedside drinking and swallowing tests. According to the evaluation results, graded rehabilitation intervention was carried out. The patients' swallowing function before and after the intervention and the recovery effects were compared. χ² and Mann-Whitney U tests were applied. Results　Among the 78 patients, 21 cases had dysphagia disorder, accounting for 26.93%. Advanced age, mMRC score, and self-care ability of daily life were the factors affecting the patients' abnormal swallowing function of (χ²=4.262, 11.001, and 10.645; all P<0.05). Swallowing rehabilitation intervention could improve their swallowing function. The passing rates of repeated saliva swallowing test, water swallowing test, and swallowing paste test were better after than before the intervention [61.53% (48/78) vs. 44.87% (35/78), 74.36% (58/78) vs. 52.56% (41/78), and71.79% (56/78) vs. 55.13% (43/78)], with statistical differences (χ²=4.351, 7.989, and 4.672; all P<0.05). Conclusions　Identifying the risk factors of aspiration in patients with AECOPD and guiding the nursing measures of swallowing rehabilitation can improve their swallowing function and reduce the complications and disease burden of aspiration.

Emotional intervention combined with acupoint application of traditional Chinese medicine for elderly patients with COPD in remission stage

Tao Yuxia, Xia Xinyuan, Xia Xiaoping, Xia Qiuyu

2023, 29(14):  2026-2031.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.024

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Objective　To analyze the clinical effect of acupoint application combined with emotional intervention for elderly patients with chronic obstructive pulmonary disease (COPD) in remission stage, and to explore its effect on the recovery of lung function. Methods　One hundred elderly patients with COPD in remission stage treated at Department of Geriatrics, Jiangyin Hospital of Traditional Chinese Medicine from January 1, 2019 to December 31, 2021 were selected for the randomized controlled trial. They were divided into a control group and an observation group by the random number table method, with 50 in each group. There were 26 males and 24 females in the control group; they were 60-80(70.22±6.19) years old. There were 30 males and 20 females in the observation group; they were 61-80 (70.51±6.35) years old. The control group took routine nursing intervention; in addition, the observation group took emotional intervention and acupoint application of traditional Chinese medicine. The clinical curative effects, pulmonary function indicators, psychological states, and self-care abilities were compared between the two groups. t and χ² tests were applied. Results　The total effective rate in the observation group was higher than that in the control group [96.00%(48/50) vs. 82.00%(41/50)], with a statistical difference (χ²=5.01, P<0.05). After the intervention, the forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), FEV₁/FVC, and peak expiratory flow (PEF) in the observation group were better than those in the control group [(2.95±0.29) L vs. (3.35±0.62) L, (2.26±0.31) L vs. (3.29±0.52)L, (80.11±7.96)% vs. (65.93±5.64)%, and (3.74±1.12) L/s vs. (6.68±1.89) L/s], with statistical differences (t=4.13,12.03,10.28 , and 9.46; all P<0.05); 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 [(38.91±3.66) vs. (43.65±3.53) and (40.33±3.17) vs. (45.81±3.29)], with statistical differences (t=6.59 and 8.48; both P<0.05). The score of Self-care Ability Scale for the Elderly (ESCA) in the observation group was higher than that in the control group [(154.64±10.37) vs. (123.35±10.85)], with a statistical difference (t=18.64, P<0.05). Conclusion　Emotional intervention combined with acupoint application of traditional Chinese medicine for elderly patients with COPD in remission stage can effectively adjust their bad psychological state, improve their pulmonary function and self-care ability, and further increase the clinical therapeutic effect, so it has important research value.

Nursing Research

Effect applying Peplau interpersonal relationship theoretical nursing measures in cataract patients after phacoemulsification

Tian Wei, Li Qun, Ji Yongjing, Yao Fei, Yang Hongying

2023, 29(14):  2032-2036.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.025

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Objective　To explore the effect applying Peplau interpersonal relationship theoretical nursing measures in cataract patients after phacoemulsification. Methods　A total of 96 cataract patients treated by phacoemulsification at Jinan Second People's Hospital from July 2021 to August 2022 were selected for the randomized controlled trial. They were divided into a reference group and an intervention group by the random number table method, with 48 cases in each group. There were 26 males and 22 females in the reference group; they were (68.46±3.39) years old. There were 28 males and 20 females in the intervention group; they were (68.45±3.26) years old. The reference group took routine rehabilitation nursing measures, and the intervention group Peplau interpersonal relationship theoretical nursing measures. One day after admission and 1 day before discharge, the psychological congruence, social support, and quality of life of the two groups were observed. t test was applied. Results　One day after admission, there were no statistical differences in the post-traumatic growth level, social support, and quality of life between the two groups (all P>0.05). One day before discharge, the scores of sense of control, sense of understandability, sense of meaning, and sense of psychological agreement in the intervention group were higher than those in the reference group [(25.24±1.41) vs. (24.48±1.43), (29.33±1.45) vs. (28.52±1.43), (24.27±1.43) vs. (23.54±1.45), and (83.28±1.45) vs. (82.52±1.43); all P<0.05]. The scores of subjective support, objective support, and support utilization and the comprehensive score in the intervention group were higher than those in the reference group [(21.26±1.45) vs. (20.49±1.39), (15.31±1.39) vs. (14.52±1.45), (14.29±1.37) vs. (13.51±1.39), and (53.33±5.42) vs. (49.53±5.42); all P<0.05]. The scores of far vision moving light sense, adjustment ability, reading and writing fine work, and life ability and the comprehensive score in the intervention group were higher than those in the reference group [(21.27±1.48) vs. (20.51±1.43, (22.26±1.42) vs. (21.49±1.43), (21.27±1.42) vs. (20.48±1.38), (22.24±1.41) vs. (21.48±1.39), and (92.23±5.42) vs. (89.49±5.43); all P<0.05]. Conclusion　Peplau interpersonal relationship theoretical nursing measures for patients after phacoemulsification for cataract is beneficial to enhance their psychological congruence and social support, and improve their postoperative quality of life.

Body rehabilitation and quality of life of patients with urologic neoplasms after robotic surgery

Chen Minjie, Zou Ling, Liu Fen, Li Yuchen, Guo Shengjie, Zheng Xia

2023, 29(14):  2037-2041.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.026

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Objective　To analyze and compare the differences in pain, activity of daily living, quality of life, and complications between two kinds of robotic surgical systems for patients with urologic neoplasms. Methods　Twenty patients with urologic neoplasms who underwent endoscopic robotic surgery in Sun Yat-sen University Cancer Center from July 2021 to December 2021 were recruited by the random and single-blind method. They were divided into an experimental group (10 cases) and a control group (10 cases). The experimental group used domestic surgical robot, and the control group used Da Vinci surgical robot. The data of age, gender, body mass index (BMI), education level, employment status, comorbidity, family history, tumor classification, postoperative complication, postoperative pain, activity of daily living (ADL), recovery of gastrointestinal function, quality of life, and others of the two groups were analyzed and compared. t test, rank sum test, and Fisher exact probability were used. Results　There were no statistical differences in gender, education level, employment status, age, BMI, comorbidity, and tumor classification between the two groups (all P>0.05). The incidence of postoperative complications, the time of bowel sound recovery, the times of first flatus and defecation, pain score, and the ADL scores on day 1, 2, and 3 after the operation were 10% (1/10), (17.83±8.97) h, (21.49±7.94) h, (63.08±37.45) h, (3.00±1.05), (37.00±11.35), (64.50±13.01), and (75.00±10.80) in the experimental group, and were 20%(2/10), (18.97±7.24) h, (22.05±8.80) h, (49.97±29.15) h, (2.60±0.52), (47.50±12.08), (61.59±10.56), and (74.50±14.42) in the control group, with no statistical differences between the two groups (all P>0.05). There no statistical differences in the scores of EORTC quality of life QLQ-C30 (V3.0) 1 week and 1 and 3 months after the operation (all P>0.05). Conclusions　There are no significant differences in postoperative function recovery, complications, and quality of life between the domestic surgical robot and the Da Vinci surgical robot. It is of positive significance for popularization and application of the domestic surgical robot system in clinic as well as nursing.

Effect of continuous comprehensive thermal insulation measures on resuscitation of patients with lung cancer after radical surgery

Huang Liyi, Li Zhiyong, Chen Feiqiang, Wu Yanqin

2023, 29(14):  2042-2046.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.027

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Objective　To explore the effect of continuous comprehensive thermal insulation measures on resuscitation of patients with lung cancer after radical surgery. Methods　Sixty patients with lung cancer who undergo selective radical surgery at Longhua District Central Hospital from October 2021 to October 2022 were selected for the randomized controlled trial. They were divided into a reference group and an analysis group by the random number table method, with 30 cases in each group. There were 24 males and 6 females in the reference group; they were (55.23±7.11) years old. There 23 males and 7 females in the analysis group; they were (53.92±6.44) years old. The reference group took routine thermal insulation measures, and the analysis group continuous comprehensive thermal insulation measures. The anal temperatures before tracheal intubation (T1), 30 (T2), 60 (T3), 90 (T4), 120 (T5), and 150 (T6) min after induction, and after the operation (T7) and the surgical indicators were compared between the two groups. t and χ² tests were applied. Results　The anal temperatures at T1, T2, T3, T4, T5, T6, and T7 were (36.89±0.34), (36.62±0.45), (36.23±0.36), (35.88±0.27), (35.72±0.28), (35.61±0.34), and (35.24±0.89) ℃ in the reference group, and were (36.90±0.30), (36.91±0.34), (36.67±0.36), (36.50±0.42), (36.44±0.47), (36.40±0.56), and (36.44±0.66) ℃ in the analysis group (t=0.287, P=0.774; t=2.816, P=0.006; t=4.736, P<0.001; t=6.801, P<0.001; t=7.208, P<0.001; t=6.604, P<0.001; t=5.931, P<0.001). The extubation time of the reference group was longer than that of the analysis group [(42.26±6.26) min vs. (28.50±5.37) min; t=9.137, P<0.001]. The retention time at recovery room in the reference group was longer than that in the analysis group [(68.19±10.35) min vs. (55.43±6.79) min; t=5.646, P<0.001]. The intraoperative blood loss in the reference group was higher than that in the analysis group [(452.74±44.41) ml vs. (336.69±37.19) ml; t=10.973, P<0.001]. The incidences of postoperative shiver and hypothermia in the reference group were significantly higher than those in the analysis group [(23.33% (7/30) vs. 3.33% (1/30) and 20.00% (6/30) vs. 3.33% (1/30); χ²=5.192 and 4.403, P=0.022 and 0.044]. Conclusions　Continuous comprehensive thermal insulation measures can reduce the anesthesia extubation, retention time at recovery room, intraoperative blood loss, and incidences of shiver and hypothermia of patients with lung cancer after radical surgery.

Application effect and nursing care of intrauterine transfusion for fetuses with maternal-fetal Rh incompatible anemia

Zhong Chunling, She Xiyun

2023, 29(14):  2046-2050.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.028

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Objective　To explore the effect of intrauterine blood transfusion and summarize nursing experience for fetuses with maternal-fetal Rh incompatible anemia, and to improve the clinic curative effect and reduce the complications of intrauterine blood transfusion. Methods　This was a non-randomized controlled study. A total of 19 pregnant women who received intra-uterine blood transfusion treatment for fetal anemia due to maternal-fetal Rh blood group incompatibility from January 2020 to June 2022 in First Hospital Affiliated to Sun Yat-sen University were selected as the study objects by the convenience sampling method. The pregnant women were(31.39±4.13) years old. The gestational weeks were (26.34±4.71) weeks. There were 2 primiparas, 17 metaparas, 9 cases with adverse pregnancy history, and 4 cases with fetal edema. Intrauterine transfusion was given; corresponding nursing care was given before, during, and after intrauterine transfusion. The concentrations of fetal umbilical cord blood hemoglobin (Hb) and hematopoietic volumes (HCT) before and after the transfusion and the occurrence of complications after transfusion were recorded. t test was used to compare the data before and after the transfusion. Results　 The fetal umbilical cord blood Hb and HCT concentrations were significantly higher after than before the blood transfusion [(121.56±27.69) g/L (69.90±22.34) g/L and (36.87±7.84)% vs. (21.17±6.52)%], with statistical differences (t=-11.937 and -12.702, both P<0.05). One case (5.26%) developed fetal bradycardia after intrauterine blood transfusion; one case (5.26%) died in the uterus. The follow-up visit showed that 17 cases (89.47%) were prematurely born, and 1 case (5.26%) was full term. Conclusions　Fetal anemia caused by maternal-fetal Rh blood group incompatibility can be effectively treated by intrauterine transfusion. In terms of nursing, it is necessary to strengthen the care of fetal intrauterine transfusion, including preoperative psychological care, medication care, and article preparation, intraoperative postural care, medication care, transfusion care, and disease observation, and postoperative complications observation and nursing and health guidance, which is of great significance to ensure the effect of blood transfusion and reduce complications of intrauterine transfusion.

Application of tracing nursing mode in whole process management of empty-nest patients with abnormal uric acid living on minimum subsistence allowances

Zhou Lixia, Chen Lijuan, Xie Jianyi, Huang Jinjin

2023, 29(14):  2051-2054.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.029

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Objective　To investigate the effect of the application of tracing nursing mode in the whole process management of empty-nest patients with abnormal uric acid living on minimum subsistence allowances. Methods　Seventy-two empty-nest patients with abnormal uric acid living on minimum subsistence allowances at Physical Examination Center, Guangzhou First People's Hospital were selected by the convenient sampling method from January 2018 to June 2019, including 45 males and 27 females; they were 48-77 (68.00±3.65) years old. They were intervened by tracing nursing mode, including health file establishment, regular diet and exercise guiding, body weight measurement, etc. Three months later, the nursing effect was comprehensively evaluated. ｔ and χ² tests were applied. Results　After the intervention, the patients' body mass index (BMI), waistline, and systolic and diastolic pressures were significantly lower after than before the intervention [(22.14±2.76) kg/m² vs. (25.92±3.23) kg/m², (87.14±10.92) cm vs. (90.91±11.19) cm, (131.34±17.88) mmHg (1 mmHg=0.133 kPa) vs. (135.23±18.48) mmHg, (77.23±8.86) mmHg vs. (82.42±9.07) mmHg], with statistical differences (t=7.55, 2.05, 4.07, and 3.47; all P<0.05). The serum uric acid (SUA) levels in the male and female patients were significantly lower after than before the intervention [(386.2±46.3) μmol/L vs. (440.8±55.9) μmol/L and (331.2±42.5) μmol/L vs. (380.6±51.7) μmol/L], with statistical differences (t=5.05 and 3.84; both P<0.05). The patients' satisfaction with the nursing work was higher after than before the intervention [100.00% vs. 83.33% (60/72)], with a statistical difference (χ²=3.78, P<0.05). Conclusion　Applying tracing nursing mode in the whole process nursing and management of empty-nest patients with abnormal uric acid living on minimum subsistence allowances can reduce SUA and change patients' lifestyle.

"Internet+" continuous nursing care based on Guangzhou long-term care insurance system for stroke patients

Mo Miaomiao, Fan Yuzhen, Zhang Xiaopei, Ye Richun, Ding Meizhu, Lin Meizhen, Nie Xiangfei

2023, 29(14):  2055-2059.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.030

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Objective　To explore the effect of "internet+" continuous nursing care based on Guangzhou long-term nursing insurance system for stroke patients. Methods　This was a retrospective study. From March 2020 to September 2021, 31 stroke patients who received "internet+" continuous nursing care based on Guangzhou long-term nursing insurance system in The Second Affiliated Hospital of Guangzhou University of Chinese Medicine were included into this study, including 18 males and 13 females who were (74.29±6.70) years old. There were 23 cases of ischemic stroke and 8 cases of hemorrhagic stroke. The scores of Basic Activities of Daily Living (BADL) and modified Rankin Score (mRS), stroke recurrence, death rates, readmission rates, and satisfaction before and after the continuous nursing care were compared. t test was applied. Results　The score of BADL 3 months after the continuous nursing care was higher than that at discharge [(49.68±11.47) vs. (46.13±9.81)], with a statistical difference (t=4.573, P<0.05). The score of mRS 3 months after the continuous nursing care was higher than that at discharge [(3.68±0.60) vs. (3.84±0.58)], with a statistical difference (t=-2.402, P<0.05). None of the 31 stroke patients had stroke recurrence, readmission, or death within the 3 months after discharge. The satisfaction score of stroke patients and their family members was (96.84+7.51); the satisfaction of the medical staff was (91.04+8.27). Among the patients, 66.67% felt that their symptoms improved or relieved, and 96.67% expressed their willingness to recommend this service to similar patients. Conclusion　"Internet+" continuous nursing care based on Guangzhou long-term nursing insurance system for stroke patients can meet their needs  in home care, improve their BADL score and quality of life, reduce the burden of care and finance, and increase the medical staff's career achievement.

Application value of comprehensive nursing intervention on pain and sleep quality in patients with advanced lung cancer

Deng Xiaofang, Wu Yingying, Chen Liufei, Pan Jianting, Guo Yanfen

2023, 29(14):  2059-2062.  DOI: 10.3760/cma.j.issn.1007-1245.2023.14.031

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Objective　To investigate the application value of comprehensive nursing intervention on pain degree, sleep quality, and quality of life (QOL) in patients with advanced lung cancer. Methods　A total of 98 patients with advanced lung cancer admitted to Seventh Hospital from January 2020 to January 2022 were selected for the randomized controlled trial, and were randomly divided into a control group and an observation group, with 49 cases in each group. There were 29 males and 20 females in the control group; they were 39-79 (57.02±7.46) years old. There were 30 males and 19 females in the observation group; they were 40-78 (56.87±7.38) years old. The control group were given routine nursing intervention, and the observation group comprehensive nursing intervention, for 4 weeks. The pain degrees, sleep quality, and quality of life (QOL) were compared between the two groups. t test was applied. Results　After 4 weeks' intervention, the scores of Visual Analogue Scale (VAS) in the observation group and the control group were significantly lower than those before the intervention [(1.27±0.45) vs. (4.61±1.52) and (2.49±0.98) vs. (4.57±1.48)], and the score in the observation group was lower than that in the control group[(1.27±0.45) vs. (2.49±0.98)], with statistical differences (t=8.373, 4.743, and 8.359, all P<0.05). After 4 weeks' intervention, the scores of Pittsburgh Sleep Quality Index (PSQI) in the observation group and the control group were significantly lower than those before the intervention [(5.19±1.37) vs. (7.39±0.61) and (6.53±1.31) vs. (7.42±0.59)], and the score in the observation group was lower than that in the control group[(5.19±1.37) vs. (6.53±1.31)], with statistical differences (t=7.935, 3.966, and 4.625; all P<0.05). After 4 weeks' intervention, the QOL scores of the observation group and the control group were significantly higher than those before intervention [(8.69±1.31) vs. (6.59±1.32) and (7.42±1.29) vs. (6.61±1.28)], and the score of the observation group was significantly higher[(8.69±1.31) vs. (7.42±1.29)], than that of the control group (t=5.6307, 3.9664, and 3.0557; all P<0.05). Conclusion　Comprehensive nursing intervention for patients with advanced lung cancer can effectively reduce their pain degre, and significantly improve their sleep quality and quality of life.

Investigation Report

A survey on influencing factors of unpaid blood donation among college and technical secondary school students

Cao Xiaojuan

2023, 29(14):  2063-2065.  DOI: 10.3760/cma.j.issn.1007-1245.2023.12.032

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Preventive Medicine

Disease burden and changing trend of pancreatitis among residents in Jiangsu in 2010 and 2018

Hu Naiyuan, Yu Hao, Zhou Jinyi, Xie Ye, Li Qiumei, Yang Wenbin, Shi Qiaomei, Zhao Pei, Jiang Meng, Xu Qin, Wang Mengmeng

2023, 29(14):  2066-2069.  DOI: 10.3760/cma.j.issn.1007-1245.2023.12.033

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Objective　To analyze the disease burden and changing trend of pancreatitis among residents in Jiangsu in 2010 and 2018. Methods　Using the results of the Global Burden of Disease 2019, 123 165 cases of pancreatitis in Jiangsu in 2010 and 2018 were analyzed by years of life lost with disability (YLD), years of premature death (YLL), and disability-adjusted life years (DALY), including 79 584 males and 43 581 females who were 23-76 (49.62±5.14) years old. The disease burden and changing trends in the patients were analyzed. Results　The number of deaths from pancreatitis in Jiangsu in 2018 was as high as 36 000, including 21 000 males and 15 000 females, and the mortality rate was as high as 50.00%. In 2010 and 2018, the changes of DALY rate (325.6%), YLL rate (26.2%), and YLD rate (106.2%) of pancreatitis in Jiangsu were all higher than the global changes (-3.2%, -5.8%, and 32.6%). After being standardized by age, compared with that in 2010, the standardized YLD rate in Jiangsu increased by 21.6%, while the global standardized YLD rate dropped by 1.1%; the standardized YLL rate of pancreatitis in Jiangsu and the world both decreased as much as each other; compared with that in 2010, the DALY rate in Jiangsu decreased by -25.4%, and the global standardized DALY rate by 28.6%. Conclusions　Compared with that in 2010, the burden of pancreatitis in Jiangsu in 2018 was getting heavier and higher than the global average level. Clinical intervention should be carried out through various ways to reduce the burden of pancreatitis on the family and society as much as possible.