Table of Content

15 September 2023, Volume 29 Issue 18

Previous Issue   

New Medical Advances

Research progress on new immunosuppressive agents in treatment of idiopathic membranous nephropathy

Yang Jia, Xi Zhefan, Zou Haozhen, Xu Qiang, Dong Hua

2023, 29(18):  2517-2521.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.001

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Idiopathic membranous nephropathy is the most common cause of nephrotic syndrome in adults. Although conventional immunosuppressive drugs can improve the remission rate, there are serious adverse effects and some patients can progress to end-stage renal disease within a few years. This article mainly introduces the progress on new immunosuppressive agents in the treatment of idiopathic membranous nephropathy.

Application of sacubitril/valsartan in patients with heart failure taking dialysis 

Xi Zhefan, Yang Jia, Zou Haozhen, Dong Hua

2023, 29(18):  2522-2525.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.002

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Sacubitril/valsartan is an angiotensin receptor neprilysin inhibitor. It can inhibit the breakdown of endogenous natriuretic peptides and block angiotensin receptors, thereby reducing the activation of the renin-angiotensin-aldosterone system. It can also promote myocardial remodeling, inhibit myocardial fibrosis, increase the glomerular filtration rate, and delay the deterioration of renal function. Sacubitril/valsartan is beneficial to patients with chronic kidney disease by reducing cardiovascular risk and delaying the progression of chronic kidney disease. As a result, sacubitril/valsartan is one of the important drugs for heart failure, hypertension, and uremia. However, its long-term use may also cause some adverse reactions, especially kidney damage. There are few reports on the application of sacubitril/valsartan in patients with end-stage of renal disease and heart failure. The purpose of this study is to observe the application of sacubitril/valsartan in maintenance dialysis patients with heart failure, to investigate its safety, and to provide references for researches in relevant fields.

Dizziness/Vertigo in The Elderly

Dizziness/vertigo and posterior circulation ischemia in the elderly

Zeng Zhaolong

2023, 29(18):  2526-2528.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.003

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This article comprehensively analyzes the relationship between dizziness/vertigo and posterior circulation ischemia in the elderly, points out the main symptoms of posterior circulation ischemia and the clinical manifestations and common diseases of posterior circulation ischemia, and introduces the examination items of posterior circulation ischemia and their advantages in detail and how to choose an appropriate examination method according to the conditions, so as to provide help for clinicians to fully understand dizziness/vertigo and posterior circulation ischemia in the elderly.

Diagnosis thinking of dizziness/vertigo in the elderly

Hu Yunxin

2023, 29(18):  2529-2531.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.004

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Dizziness/vertigo is a common disease among middle-aged and elderly patients in the department of neurology, outpatient department, or emergency department. According to the characteristics of the elderly, this article expounds the contents of history collection, physical examination, and auxiliary examination in the diagnosis process of dizziness/vertigo, and provides the diagnosis thinking, so as to correctly diagnose and assess the disease.

Diagnosis and treatment of benign paroxysmal positional vertigo in the elderly

Sun Yongqi

2023, 29(18):  2532-2535.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.005

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Benign paroxysmal positional vertigo is a kind of peripheral vestibular disease induced by the change of head position relative to the direction of gravity, and is characterized by recurrent transient vertigo and characteristic nystagmus. It is self-limiting and easy to recur. Elderly patients with benign paroxysmal positional vertigo have a long clinical course and a high recurrence rate. Treatment for elderly patients with benign paroxysmal positional vertigo is the same with the treatment for general population. Through accurate diagnosis and encouraging patients to receive treatment as early as possible after the onset of symptoms, their quality of life can be improved.

Nursing care for elderly patients with vertigo

Xu Yongli

2023, 29(18):  2536-2537.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.006

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Vertigo is a common disease in the elderly. According to the clinical characteristics of elderly patients with vertigo, this paper expounds its clinical nursing methods and points for attention, so as to provide references for its clinical nursing.

Reproductive Medicine

PDCA cycle management in reducing twin pregnancy rate in women taking fresh cycle embryo transfer of IVF-ET by early follicular long-term protocol 

Jiang Chunyan, Zhao Feiyan, Wang Jing, Huang Jie, Ma Xiang

2023, 29(18):  2538-2543.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.007

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Objective　To explore the effect of PDCA cycle management in reducing the twin pregnancy rate in women taking fresh cycle embryo transfer of in vitrofertilization-embryo transfer (IVF-ET) by the early follicular long-term protocol. Methods　The clinical pregnancy outcomes of the women taking fresh cycle embryo transfer of IVF/intracytoplasmic sperm injection (ICSI) by the early follicular long-term protocol for the first time at Department of Reproductive Medicine, First Hospital, Nanjing Medical University in 2018 were retrospectively analyzed. The quality improvement objectives, increasing the selective single embryo transplantation rate and decreasing the twin pregnancy rate, were put forward. The PDCA (plan, do, check, and action) management cycle was employed, and corresponding regulations and standardized procedure were formed; in 2019 in the next cycle, it was applied to reduce the twin pregnancy rate. The data in 2018 and 2019 were matched by the propensity score method to eliminate the interference factors. t test, nonparametric rank sum test, and χ² test or Fisher's precision probability were applied, If P<0.05, there is a statistical difference. Results　A total of 1 429 patients with egg retrieval cycles were included, including 603 patients (603 cycles) in 2018 and 826 patients (826 cycles) in 2019. The rate of single embryo transplantation in 2019 was higher than that in 2018 [59.20%(357/603) vs. 80.75%(667/826)]; the twin pregnancy rate in 2019 was lower than that in 2018 [21.57%(88/408) vs. 8.22%(43/523)]; there were statistical differences (both P<0.001). The implantation rate, clinical pregnancy rate, and live birth rate in 2019 were not significantly lower than those in 2018, and the miscarriage rate was not significantly higher(all P>0.05）. Conclusion　Continuous PDCA cycle management of embryo number during assistant pregnancy can reduce the embryo number and twin pregnancy rate, so it is worth being generalized.

Effect of body mass index on pregnancy outcomes of women taking intrauterine insemination

Ding Peihui, Lao Kaixue, Su Zhe, Wang Yanlin

2023, 29(18):  2543-2549.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.008

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Objective　To investigate the effect of body mass index (BMI) on pregnancy outcomes in young infertile women during intrauterine insemination (IUI) assisted conception, and to shorten treatment course, reduce treatment cost, and improve the clinical pregnancy rate analyzing the remaining effective influencing factors. Methods　The clinical data of the 1st IUI cycle of 1 082 young couples who underwent husband-sperm IUI for pregnancy at Department of Reproductive Medicine, Binzhou Medical University Hospital from September 2016 to August 2022 were retrospectively analyzed. The ages, years of infertility, and levels of follicle-stimulating hormone (FSH) of the normal body weight group (group A), the overweight group (group B), and the obesity group (group C) were compared and analyzed. The relationship between the basic information and the outcomes of IUI for pregnancy in the PCOS/control group was analyzed. The data were compared between the groups by Kruskal-Wallis H test, χ² test, and Fisher's precision probability test. The correlations of the data with the clinical pregnancy rate and live birth rate were analyzed by multivariate logistic regression analysis. Results　There were statistical differences in the age, years of infertility, basal FSH level, natural/propulsive, and PCOS/control between these 3 groups (all P<0.05). There were no statistical differences in the clinical pregnancy rate, live birth rate, and abortion rate between the 3 groups (all P>0.05). The logistic regression analysis of female related factors affecting clinical pregnancy rate and live birth rate of IUI showed that the effects of ovulation promotion treatment on the clinical pregnancy rate and live birth rate were statistically significant (OR=1.564 and 1.619, both P<0.05); the effect of years of infertility on the live birth rate was also statistically significant (OR=0.884, P<0.05). Conclusion　In young infertile women taking IUI assisted conception, BMI does not affect their pregnancy outcomes, but ovulation promotion therapy helps obtain clinical pregnancy and live births, and years of infertility affects the live birth rate.

Effect of female BMI on pregnancy outcomes with intrauterine insemination

Liu Yan, Li Tao, Ou Jianping

2023, 29(18):  2549-2554.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.009

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Objective　To investigate the effect of body mass index (BMI) on clinical outcomes in female patients with intrauterine insemination (IUI). Methods　The data of the couples with the women taking IUI at Center for Reproductive Medicine, The Third Affiliated Hospital of Sun Yat-sen University from May 2020 to February 2021 were retrospectively analyzed. According to the women's BMI's, they were divided into a low weight group (BMI <18.5 kg/m²), a normal weight group (18.5 kg/m²≤BMI < 24.9 kg/m²), and an overweight group (BMI ≥ 24.9 kg/m²). There were 256 cases in the low weight group; and they were 31 (28, 33) years old. There were 1 336 cases in the normal weight group; they were 32 (29, 34) years old. There were 253 cases in the overweight group; they were 31 (28,34) years old. The basic data and clinical outcomes of IUI assisted pregnancy in the three groups were compared. U and χ² tests were applied. The logistic regression was used to analyze the relevant influencing factors of clinical pregnancy rates and live birth rates in the BMI group of the three groups of IUI. Results　There were statistical differences between the three groups in years of infertility, basal (follicle-stimulating hormone) FSH, basal luteinizing hormone (LH), infertility type, antral follicle number, and causes of infertility (all P<0.05), and no statistical differences in the women age, the total number of viable sperms in the men, and endometrial thickness of HCG (all P>0.05). The clinical pregnancy rates in the low weight group, the normal weight group, and the overweight group were 8.59% (22/256), 13.85% (185/1 336), 17.00% (43/253), and the live birth rates were 7.81% (20/256), 11.23% (150/1 336), and 14.23% (36/253), respectively; both increased with BMI; there were statistical differences (both P<0.05). The ectopic pregnancy rates in the low weight group, the normal weight group, and the overweight group were 4.55% (1/22), 5.95% (11/185), and 6.98% (3/43), and the miscarriage rates were 44.55% (1/22), 12.97% (24/185), and 9.30% (4/43), respectively, with statistical difference (both P<0.05). There was no statistical difference in the biochemical pregnancy rate between the 3 groups (P>0.05). There were statistical differences in the proportions of spontaneous cycle, oral drug stimulation cycle, and oral plus intramuscular drug stimulation cycle between the three groups (all P<0.05). Multivariate regression analysis of the clinical pregnancy rate and live birth rate showed that different BMI's between the three groups were not associated with the clinical pregnancy rate and live birth rate (both P>0.05). Conclusion　The multivariate analysis showed that BMI did not correlated with IUI, incicating that female BMI was not associated with the clinical pregnancy and live birth rates of IUI.

Effect of peer education based on WeChat group on reproductive quality of life in patients with obstructive azoospermia

Lin Qiaoying, Chen Liping, Liu Fang, Ren Jianzhi, Na Xuhong, Zhou Jialing

2023, 29(18):  2555-2559.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.010

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Objective　To explore the effect of peer education based on WeChat group on reproductive quality of life in patients with obstructive azoospermia. Methods　A total of 110 patients with obstructive azoospermia admitted to 73rd Group Army Hospital of People's Liberation Army from July 2021 to August 2022 were selected for the prospective study and were divided into a control group and an observation group by the random number table method, with 55 cases in each group. The control group were (32.02±5.06) years old and received routine health education. The observation group were (32.16±4.60) years old and received routine health education and received peer education based on WeChat group. The two groups were intervened for three months. The disease perception [scores of Brief Illness Perception Questionnaire (BIPQ)], fertility pressures [scores of Fertility Problem Inventory (FPI)], self-esteem [scores of Rosenberg Self-Esteem Scale (SES)] and fertility quality of life [scores of Fertility Quality of Life Scale (FertiQol)] before and after the intervention were compared between the two groups. The statistical data were analyzed by t test. Results　After the intervention, the score of BIPQ in the observation group was lower than that in the control group [(50.87±4.69) vs. (53.47±5.23); P<0.05]; the total score of FPI in the observation group was lower than that in the control group [(139.00±9.66) vs. (157.10±11.02); P<0.05]; the scores of social concern, sexual concern, need for parenthood, and rejection of childfree life of FPI in the observation group were lower than those in the control group (all P<0.05); the score of SES in the observation group was higher than that in the control group [(35.54±6.48) vs. (29.12±5.63); P<0.05]; the total score of FertiQol in the observation group was higher than that in the control group [(70.56±6.64) vs. (60.17±5.48); P<0.05]; the scores of emotional response, mind-body relation, marital relationship, environment, and tolerance of FertiQol in the observation group were higher than those in the control group (all P<0.05). Conclusion　Peer education based on WeChat group can provide better support to patients with obstructive azoospermia, significantly reduce their disease perception ability and fertility pressure, and improve their self-esteem and fertility quality of life.

Thyroid Cancer

Expression and diagnostic value of miRNA150-5p in papillary thyroid carcinoma

Li Xuan, Zhao Wenyu, Guo Yiting, He Liang, Li Junhong, Zhang Yanfang

2023, 29(18):  2560-2565.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.011

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Objective　To investigate the expression of miRNA150-5p in papillary thyroid carcinoma (PTC) and its utility in differentiating PTC from benign thyroid nodules (BTN). Methods　In this study, 43 PTC patients and 19 BTN patients diagnosed in Luoyang Central Hospital affiliated to Zhengzhou University from October 2021 to January 2022 were included. The clinical data of the two groups were statistically analyzed. The real time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of miRNA150-5p in the PTC tissue, paracancerous tissue, and BTN tissue, and were verified through The Cancer Genome Atlas (TCGA) RNA-Seq database. The univariate and multivariate logistic regression models were used to analyze the influencing factors of PTC. The value of miRNA150-5p in the differential diagnosis of thyroid nodules was analyzed by the receiver operating characteristic curve (ROC). Results　The expression of miRNA150-5p in the PTC tissue was lower than those in the matched paracancerous tissue and BTN tissue (both P<0.05). The age of the PTC group was lower than that of the BTN group (both P<0.05). The thyroid stimulating hormone (TSH) level of the PTC group was significantly higher than that of the BTN group (P<0.05). Univariate and multivariate logistic regression analyses showed that the higher the expression of miRNA150-5p, the lower the risk of PTC (OR=0.980, P<0.05). The ROC analysis showed that the area under the curve (AUC) was 0.797; the sensitivity, specificity, and accuracy were 67.44%, 89.47%, and 74.19%, respectively. Conclusion　MiRNA150-5p is significantly under-expressed in PTC tissue and has good diagnostic efficacies for benign and malignant thyroid nodules, so it may serve as a potential biomarker in the diagnosis of PTC.

Relationship between expressions of CCL11 and VEGF in thyroid carcinoma and pathological features

Zhang Honghong, Li Yong

2023, 29(18):  2566-2570.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.012

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Objective　To investigate the relationship between the expressions of CC chemokine ligand 11 (CCL11) and vascular endothelial growth factor (VEGF) in thyroid carcinoma and pathological features. Methods　One hundred and twenty thyroid cancer tissue pathological specimens collected from Hospital Affiliated to Qingdao Binhai University from December 2020 to December 2022 and 60 benign thyroid disease tissue specimens collected during the same period were retrospectively analyzed. The 120 thyroid cancer tissue pathological specimens were set as an observation group, including 42 males and 78 females who were 25-87 (54.58±5.36) years old. The 60 benign thyroid disease tissue specimens were set as a control group, including 21 males and 39 females who were 26-86 years old. The immunohistochemical streptavidin-peroxidase (SP) method was used to detect the positive expression rates of CCL11 and VEGF. The relationship between CCL11 and VEGF on one hand and the pathological characteristics of thyroid cancer on the other hand was analyzed. χ² test was applied. Results　Compared with those in the control group, the positive expression rates of CCL11 [95.00% (114/120)] and VEGF [80.00% (96/120)] in the observation group were significantly higher (χ²=64.685 and 33.264; both P<0.05). The positive expression rates of CCL11 in the patients with Ⅲ + Ⅳ TNM stages [100.00% (48/48)], lymph node metastasis [100.00% (48/48)], and T3 + T4 depths of invasion [98.68% (75/76)] were significantly higher than those in the patients with I + Ⅱ TNM stages [91.67% (66/72)], no lymph node metastasis [91.67% (66/72)], and T1 + T2 depths of invasion [88.64% (39/44)] (χ²=4.211, 4.211, and 5.923; all P<0.05). The positive expression rates of VEGF in the patients with poorly differentiated thyroid tissue [96.43% (27/28)], Ⅲ + Ⅳ TNM stages [95.83% (46/48)], lymph node metastasis [91.67% (44/48)], T3 + T4 depths of invasion [94.74% (72/76)], and recurrence or metastasis [95.56% (43/45)] were significantly higher than those in the patients with high + moderate differentiation [75.00% (69/92)], I + Ⅱ TNM stages [69.44% (50/72)], no lymph node metastasis [72.22% (52/72)], T1 + T2 depths of invasion [54.55% (24/44)], and no recurrence or metastasis [70.67% (53/75)] (χ²=6.161, 12.535, 6.806, 28.134, and 10.889; all P<0.05). The positive expression of CCL11 in thyroid cancer tissue was positively correlated with TNM stage, lymph node metastasis, and depth of invasion (all P<0.05). The positive expression of VEGF in thyroid carcinoma was positively correlated with the degree of differentiation, TNM stage, lymph node metastasis, depth of invasion, and recurrence or metastasis (all P<0.05). Conclusions　The positive expressions of CCL11 and VEGF in thyroid cancer tissue are related to pathological features, such as TNM stage, lymph node metastasis, and depth of invasion. By detecting the expression of CCL11 and VEGF, the disease severity can be effectively evaluated, so as to provide scientific references for subsequent treatment.

Scientific Research

Mechanism regulating β-catenin translocation by Jiedu Xiaozheng Yin to inhibit proliferation of side population cells in human Huh7 and PLC/PRF/5 cell lines

Yang Ruiming, Xue Yi, Jiang Zhishan, Cao Zhiyun, Chen Xuzheng

2023, 29(18):  2571-2575.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.013

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Objective　To investigate the mechanism by which ethyl acetate extract from Jiedu Xiaozheng Yin (EE-JXY) inhibits the growth of hepatocellular carcinoma cells, specifically focusing on side population (SP) cells in hepatocellular carcinoma. Methods　This study was from January to May 2023. Human Huh7 and PLC/PRF/5 cell lines were cultured in vitro. The presence of SP cells in the Huh7 and PLC/PRF/5 cell lines was determined and subsequently isolated by the flow cytometry. The colony formation ability of the SP cells was detected by the plate cloning assay. The SP cells' ability to form spheres in vitro was evaluated by the clonal sphere-forming assay. The effect of EE-JXY on the β-catenin protein translocation in the SP cells of hepatocellular carcinoma was detected by immunofluorescence. Results　The SP cells' quantity in the EE-JXY group was significantly lower than that in the blank group. The EE-JXY group showed a significant inhibition in the clonal formation and pellet formation abilities of the SP cells in vitro. The results of immunofluorescence showed that the β-catenin in the cytoplasm and nucleus was translocated to the cell membrane in some SP cells by EE-JXY. Conclusions　EE-JXY can significantly inhibit the proliferation of SP cells in Huh7 and PLC/PRF/5 cell lines; the mechanism may be related to the inhibition of β-catenin translocation.

Effects of remazolam and propofol in laryngeal mask anesthesia for patients taking non-glaucomatous ophthalmology

Wang Peng, Guo Shanshan, Tan Xiangjian

2023, 29(18):  2576-2580.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.014

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Objective　To compare the effects of remazolam and propofol in the induction and maintenance of general anesthesia for patients undergoing non-glaucoma eye surgery. Methods　Seventy-five patients taking non-glaucoma ophthalmic surgery at Eye Hospital Affiliated to Shandong University of Traditional Chinese Medicine from January to December 2022 were divided into a control group (37 cases) and an observation group (38 cases) according to the odd and even hospitalization numbers. There were 20 men and 17 women in the control group; they were (50.51±3.78) years old. There were 21 men and 17 women in the observation group; they were (50.55±3.76) years old. The control group took general anesthesia by propofol laryngeal masks, and the observation group by remazolam laryngeal masks. The hemodynamics, anesthesia and emergence, Riker sedation-agitation scores, and adverse reactions were compared between the two groups. t and χ² tests were used to analyzed the data. Results　The mean arterial pressures (MAP) after laryngeal mask placement, before surgery, and at drug withdrawal in both groups (mean artery pressure,) were lower than those before anesthesia induction; the MAP's before surgery and at drug withdrawal in the observation group were higher than those in the control group [(87.57±9.65) mmHg (1 mmHg=0.133 kPa) vs. (82.54±9.84) mmHg and (87.78±9.55) mmHg vs. (81.10±9.68) mmHg; t=2.235 and 3.008; P=0.028 and 0.004]. The heart rates (HR) before surgery and at drug withdrawal in both groups were lower than those before the induction of anesthesia; the HR's before surgery and at drug withdrawal in the observation group were higher than those in the control group [(76.17±9.67) beats/min vs. (71.40±9.77) beats/min and (76.55±10.45) beats/min vs. (70.08±10.76) beats/min; t=2.125 and 2.642; P=0.037 and 0.010]. The disappearance time of eyelash reflex in the observation group was longer than that in the control group [(45.16±10.27) s vs. (33.69±7.54) s; t=5.501, P<0.001]. The intraoperative body movements in the observation group was fewer than that in the control group [(1.02±0.22) times vs. (1.48±0.25) times; t=-8.465, P<0.001]. The Riker sedative-agitation scores 1 and 10 min after tube withdrawal in the observation group were lower than those in the control group [(3.31±1.04) vs. (3.95±1.10) and (3.35±0.92) vs. (3.91±0.95); t=-2.590 and -2.593; P=0.012 and 0.011]. The overall incidences of agitation, nausea and vomiting, delusion, hypoxemia, and blood pressure decline in the observation group and the control group were 10.53% (4/38) and 16.22% (6/37), respectively, with no statistical difference (χ²=0.525, P=0.469). Conclusions　Remazolam can be effectively used for inducing and maintaining laryngeal mask anesthesia in patients taking non-glaucoma ophthalmic surgery. Compared with those in the patients taking propofol anesthesia, the hemodynamics of the patients taking remmazolam anesthesia is more stable and the sedative effect is better.

Predictive value of C-reactive protein/albumin ratio and systemic immune inflammatory index for respiratory failure in patients with Guillain-Barré syndrome

Bai Chengfang, Chang Qinda

2023, 29(18):  2580-2584.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.015

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Objective　To investigate the value of C-reactive protein (CRP)/albumin (ALB) ratio and systemic immune inflammatory index (SII) in the prediction of respiratory failure in patients with Guillain-Barré syndrome (GBS). Methods　A total of 108 patients with GBS who were admitted to Liaocheng Third People's Hospital from May 2018 to May 2022 were selected for the retrospective analysis, including 69 males and 39 females who were (52.15±12.46) years old. They were divided into a respiratory failure group (25 cases) and a pure GBS group (83 cases) according to whether they had respiratory failure during hospitalization. The general clinical data, such as Hughes Functional Classification Scale (HFGS) score at admission and so on, and CRP/ALB and SII at admission were compared between the two groups. t and χ² tests were applied, the combined detection of the two in the prediction of respiratory failure in the GBS patients was analyzed by the receiver operating characteristic curve (ROC). Results　The CRP/ALB and SII at admission in the respiratory failure group were significantly higher than those in the pure GBS group [(3.05±0.35)×10^-3 vs. (2.45±0.31)×10^-3 and (1 453.87±142.65)×10⁹/I vs. (392.75±35.53)×10⁹/I], with statistical differences (both P<0.05). The ROC analysis showed that the area under the ROC of CRP/ALB combined with SII in the prediction of respiratory failure in the GBS patients was higher than those under the ROC's of CRP/ALB and SII (P<0.05). There were statistical differences in HFGS score at admission, cranial nerve involvement, and CRP/ALB and SII at admission between the respiratory failure group and the pure GBS group (all P<0.05). Multivariate logistic analysis showed that HFGS≥3, CRP/ALB ≥ 2.85×10^-3, and SII≥870.52×10⁹/I were important influencing factors for respiratory failure in the GBS patients. Conclusion　The combined detection of CRP/ALB and SII has a high predictive value for respiratory failure in GBS patients.

Correlation between serum levels of thrombospondin 2, urea nitrogen, and creatinine and proliferative diabetic retinopathy

Qin Yanping, Huang Hongbo, He Jianming, Han Guangjie, Ke Liuhua, Qin Zhenzhong

2023, 29(18):  2585-2587.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.016

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Effect of cerebral circulation therapy on cognitive function and activities of daily living in elderly patients with cerebral infarction

Xu Jun, Du Juan, Li Min, Liu Xingxing

2023, 29(18):  2588-2592.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.017

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Objective　To explore the effect of cerebral circulation therapy on cognitive function and activities of daily living in elderly patients with cerebral infarction. Methods One hundred and thirty-one elderly (≥65 years old) patients with cerebral infarction hospitalized in Department of Neurology, Lianyungang Second People's Hospital from October 2017 to September 2019 were enrolled and divided into a control group and an observation group by the random number table method. The control group were treated with conventional drugs and rehabilitation therapy; in addition, the observation group took cerebral circulation therapy once per day and 5 times per week for 2 consecutive weeks. The patients were followed up to 90 days after onset. The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate their cognitive function. The Fugl-Meyer Motor Function Score (FMA) was used to evaluate their motor function. The Barthel Index (BI) was used to evaluate their activities of daily living. The modified Rankin Scale (mRS) was used to assess their prognosis. Independent-sample t, Mann-Whitney U, and χ² tests were used to compare the data between the groups. Results　Among the 131 patients, 2 were out of the follow up and 1 died; at last, 128 finished the 90-day follow up, including 63 cases in the observation group and 65 cases in the control group. The 90-day follow up showed that the scores of MoCA, FMA, and BI in the observation group were higher than those in the control group [(19.08±2.93) vs. (15.83±2.62), (73.59±5.90) vs. (67.42±7.66), and (69.63±7.89) vs. (66.23±6.45)], with statistical differences (all P<0.01). The proportion of the patients with good prognosis (mRS score ≤ 2) in the observation group was higher than that in the control group [82.5% (52/63) vs. 61.5% (40/65); χ²=4.313, P=0.038]. There were no serious adverse reactions in both groups. Conclusion　Cerebral circulation therapy has certain effect on cognitive function and motor function in elderly patients with cerebral infarction, and can improve their activities of daily living and prognosis.

Tropisetron and esomeprazole in prevention and treatment of chemotherapy related gastrointestinal adverse reactions in patients with colorectal cancer

Li Shanshan, Liang Bing, Liu Qiwei

2023, 29(18):  2592-2596.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.018

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Objective　To explore the preventive and therapeutic effects of tropisetron versus esomeprazole for chemotherapy related gastrointestinal adverse reactions in patients with colorectal cancer. Methods　One hundred and twenty-four patients with colorectal cancer taking chemotherapy at Nanyang First People's Hospital from January 2020 to January 2022 were selected for the randomized controlled trial. They were divided into groups A and B by lottery, with 62 cases in each group. There were 32 males and 30 females in group A; they were (55.25±5.37) years old. There were 31 males and 31 females in group B; they were (56.07±5.22) years old. Group A took tropisetron and chemotherapy, and group B esomeprazole and chemotherapy. Both groups were followed up for one year. The incidence of gastrointestinal adverse reactions during chemotherapy, the scores of Index of Nausea, Vomiting, and Retching (INVR) on day 1, 7 and 14 of chemotherapy and after one chemotherapy cycle, and the long-term quality of life were compared between the two groups. χ² and t tests were applied. Results　After the treatment with different drugs, the incidence of gastrointestinal adverse reactions during chemotherapy, the acid reflux frequency, the nausea frequency, and the vomiting frequency in group A were lower than those in group B [12.90% (8/62) vs. 30.65% (19/62), (1.16±0.23) times/d vs. (3.44±1.22) times/d, (2.14±0.45) times/d vs. (4.41±1.23) times/d, and (1.27±0.33) times/d vs. (3.11±1.25) times/d; χ²=5.729; t=14.461, 13.647, and 11.207; all P<0.05]. There was no statistical difference in the score of INVR between groups A and B on day 1 of chemotherapy [(20.33±5.41) vs. (21.24±5.18); t=1.272, P>0.05]. The scores of INVR on day 7 and 14 of chemotherapy and after one cycle of chemotherapy in group A were lower than those in group B [(15.11±3.46) vs. (18.61±3.12), (12.33±2.46) vs. (14.24±3.36), and (10.19±1.47) vs. (12.25±2.72); t=5.915, 5.156, and 5.246; all P<0.05]. During the follow-up period, the scores of physiological status, social/family status, emotional status, functional status, sleep status, and compliance status of Functional Assessment of Cancer Therapy of Colorectal (FACT-C) in group A were higher than those in group B [(22.45±5.33) vs. (19.35±5.31), (23.36±5.27) vs. (20.18±5.32), (20.31±5.24) vs. (17.25±5.33), (21.25±5.16) vs. (18.44±5.28), (23.11±5.17) vs. (20.21±5.22), and (23.35±5.25) vs. (20.22±5.32); t=3.244, 3.344, 3.244, 2.997, 3.108, and 3.297; all P<0.05]. Conclusion　Tropisetron is better than esomeprazole in the prevention and treatment of gastrointestinal adverse reactions.

Effect of recombinant human erythropoietin combined with L-carnitine for patients with chronic renal failure taking hemodialysis

Wang Ying, Fu Dongmei, Li Sa

2023, 29(18):  2596-2600.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.019

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Objective　To investigate the effect of recombinant human erythropoietin combined with L-carnitine for patients with chronic renal failure taking hemodialysis. Methods　A total of 94 patients with chronic renal failure who received hemodialysis in Anyang Third People's Hospital from December 2019 to December 2021 were selected as the research objects. They were divided into an experimental group and a control group by the random number table method, with 47 cases in each group. There were 27 males and 20 females in the experimental group; they were 37-76 (49.12±9.26) years old; they had been taking hemodialysis for 5 months to 5 years. There were 26 males and 21 females in the control group; they were 39-79 (49.12±9.26) years old; they had been taking hemodialysis for 3 months to 6 years. The experimental group took recombinant human erythropoietin and L-carnitine, and the control group recombinant human erythropoietin. Both groups were followed up for 3 months. The clinical efficacies, levels of albumin and hemoglobin, and incidences of adverse reactions were compared between the 2 groups. t and χ² tests were applied. Results　The total effective rate of the experimental group was higher than that of the control group [95.74% (45/47) vs. 80.85% (38/47)], with a statistical difference (χ²=5.045, P<0.05). After the treatment, the levels of albumin and hemoglobin in the two groups were significantly higher than those before the treatment, and the levels in the experimental group were higher than those in the control group [(114.15±16.04) g/L vs. (103.62±10.99) g/L and (39.93±5.79) g/L vs. (31.56±4.54) g/L], with statistical differences (t=3.713 and 7.799; both P<0.05). The incidence of adverse reactions in the experimental group was lower than that in the control group [6.38% (3/47) vs. 21.28% (10/47)], with a statistical difference (χ²=4.374, P<0.05). Conclusion　Recombinant human erythropoietin combined with levocanidine for patients with chronic renal failure taking hemodialysis can improve the effect and their levels of albumin and hemoglobin, and reduce the incidence of adverse reactions, so it is worth being clinically generalized in similar patients taking hemodialysis.

Correlation between thyroid dysfunction and disease progress in patients with coronary heart disease

Liu Chaoyang, Zhou Fujiao

2023, 29(18):  2601-2605.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.020

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Objective　To observe the influence of abnormal thyroid function on the severity of ICU patients with coronary heart disease and its correlation with the number of coronary artery lesions. Methods　A retrospective study was conducted on 113 patients with coronary heart disease who were admitted to ICU, First Hospital, Nanyang Medical College from January 2021 to June 2022. According to the results of thyroid function examination, 43 patients with normal thyroid function were classified as a normal group, 35 patients with hyperthyroidism as a hyperthyroidism group, and the remaining 35 patients with hypothyroidism as a hypothyroidism group. The disease incidences, Gensini scores of coronary artery disease, and the proportions of the patients with different severity of coronary heart disease were compared between the three groups. The receiver operator characteristic curve (ROC) was drawn to validate thyroid function as the disease severity predictor. According to the numbers of lesions, the patients with only 1 lesion branch were classified as group A, the patients with 2 lesion branches as group B, and the patients with 3 lesion branches as group C; the thyroid function test results were compared between the three groups. The Spearman correlation coefficient was used to verify the correlation between thyroid function and lesion numbers. χ², t, and F tests were used. Results　The score of Visual Analogue Scale (VAS), the frequency of attacks, the duration of pain, the degree of coronary stenosis, and the Gensini score of the hypothyroidism group were (5.25±1.41), (4.14±1.25) times/day, (5.41±1.38) min, (68.12±10.46)%, and (35.25±5.47), which were higher than those in the hyperthyroidism group [(4.12±1.35), (3.04±0.13) times/day, (4.29±0.73) min, (60.21±10.44)%, and (32.44±5.48)] and those in the normal group [(3.92±0.48), (2.23±0.45) times/day, (3.11±0.46) min, (53.77±10.63)%, and (28.35±5.25)], with statistical differences (F=14.98, 62.28, 61.50, 17.95, and 16.22; all P<0.05). The proportion of the patients with severe coronary heart disease in the hypothyroidism group was 68.57% (24/35), which was higher than those in the hyperthyroidism group [34.29% (12/35)] and the normal group [23.26% (10/43)], with a statistical difference (χ²=45.825,P<0.05). The ROC showed that as the TSH level increased, the T3 and T4 levels decreased, and conditions of the ICU patients with coronary heart disease gradually worsened. The TSH level in group C was (8.27 ± 2.33) mU/L, which was higher than those in group B [(6.62±2.33) mU/L] and group A [(4.41±1.28) mU/L]; the T3 and T4 levels in group C were (0.72±0.11) nmol/L and (3.71±0.37) μg/dL, which were lower than those in group B [(1.25±0.36) nmol/L and (5.15±1.88) μg/dL] and group A [(2.05±0.41) nmol/L and (7.44±2.12) μg/dL]; there were statistical differences (F=30.48, 155.25, and 46.43; all P<0.05). The Spearman correlation coefficient test showed that the number of coronary lesion branches in the ICU patients with coronary heart disease increased with the TSH level and as the T3 and T4 levels decreased. Conclusions　Hypothyroidism can exacerbate the severity in ICU patients with coronary heart disease; the TSH level is positively correlated with the number of lesions, while the T3 and T4 levels negatively with the number of lesions.

Treatises

Effects of cell block section and liquid-based smear on immunocytochemical staining of cytological samples

Jiang Lijuan, Tang Futing, Jing Hongxia

2023, 29(18):  2606-2610.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.021

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Objective　To investigate the differences of immunocytochemistry results between cell block section and liquid-based smear of cytological samples. Methods　Fifty samples of pleural fluid diagnosed as lung adenocarcinoma in Jiangsu Hospital of Chinese Medicine from January to December 2022 were retrospectively analyzed. The immunocytochemistry staining of four antibodies to cytokeratin 7, epithelial specific antigen (MOC-31), aspartic protease A (Napsin-A), and thyroid transcription factor-1 (TTF-1) was performed on the cell block sections and liquid based smears, respectively. The positive expression rates and staining intensities of the four kinds of antibodies in the tumor cells on the cell block sections and liquid-based smears were compared. χ² test or fisher exact probability method were used. Results　There were statistical differences in the strong positive expression rates of MOC-31, Napsin-A, and TTF-1 between the cell block sections and liquid smears [80.0% (40/50) vs. 100.0% (50/50), 66.7% (28/42) vs. 88.9%(40/45), and 76.7% (33/43) vs. 95.7%(44/46); χ²=11.111, 6.285, and 6.811; all P<0.05]. Conclusion　Both the cell block and liquid-based smear have good immunocytochemical effects on different antibodies in serosal cavity effusion samples, but the liquid-based smear can improve the intensity of immunocytochemical staining. When the cell block staining is not effective, the liquid-based smear is recommended for immunocytochemical staining.

Medication Research

Network pharmacology study on mechanism of Taohong Siwu decoction and Wuling powder in treatment of venous thromboembolism

Song Jiefei, Zhou Yingguang

2023, 29(18):  2611-2616.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.022

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Objective　To explore the mechanism of Taohong Siwu decoction and Wuling powder in the treatment of venous thromboembolism based on network pharmacology and molecular docking technology. Methods　The main active components and targets of Taohong Siwu decoction and Wuling powder were screened through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The disease-related targets were screened through the Genecards Database, Gene Database, and Therapeutic Target Database. The shared targets of drugs and diseases were obtained by the Venny2.1.0. The PPI network maps of common target protein interactions were obtained by the STRING11.5 database. The gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed by the Metascape online platform. The AutoDock software was used for molecular docking. Results　One hundred and three active components, 213 drug targets, 1 991 disease targets, and 68 shared targets were obtained. The main active components include quercetin, Kaempferol, luteolin, β-sitosterol, and stigmasterol. The key targets are tumor necrosis factor (TNF), protein kinase B (AKT) 1, interleukin (IL) 1B, vascular endothelial growth factor (VEGF) A, matrix metalloproteinase 9 (MMP9), and so on. The biological processes and signaling pathways involved include positive regulation of cell migration, inflammatory response, fluid shear stress, arteriosclerosis, VEGF signaling pathway, etc. Conclusion　Taohong Siwu decoction and Wuling powder can prevent venous thrombosis and inhibit the injury of vascular endothelium and the aggregation of platelet by regulating Phosphatidylinositol 3-kinase (PI3K)/ Protein Kinase B(AKT), hypoxia inducible factor (HIF)-1α, and other signaling pathways through quercetin, kaempferol, luteolin, and so on.

HPLC in determination of emodin in modified Ganlu Xiaodu Dan

Liu Yongqian, Liao Xinran, Liufu Weiqing, Wang Tao

2023, 29(18):  2617-2620.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.023

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Objective　To establish a high performance liquid chromatography (HPLC) method to determine the content of emodin in modified Ganlu Xiaodu Dan. Methods　In this experiment, emodin in modified Ganlu Xiaodu Dan was extracted based on the protocol of Chinese Pharmacopoeia (2015 Edition). The HPLC separation was performed on the Agilent ZORMAX SB-C₁₈ chromatographic column (4.6 mm×150.0 mm, 5 μm); the injection volume was 10 μl; the gradient elution was conducted with methanol as mobile phase A and 0.1% phosphoric acid aqueous solution as mobile phase B for 15 minutes; the column temperature was room temperature; under the detection wavelength of 254 nm, the emodin content was detected. Results　The emodin in modified Ganlu Xiaodu Dan showed a good linear relationship with the peak area in the range of 2.000-8.000 μg (R²=0.999 8). The recovery rate was 100.17% (n=6); the relative standard deviation(RSD) was 1.87%; the average emodin content in modified Ganlu Xiaodu Dan was 13.936 8-14.831 1 µg/·g. Conclusions　The HPLC method can be used to determine the content of emodin in modified Ganlu Xiaodu Dan. The method is simple, rapid, accurate, and reliable, with ideal separation effect and good repeatability, and can provide experimental basis for the quality control of modified Ganlu Xiaodu Dan.

Case Report

One case of community-acquired Chlamydia psittaci pneumonia and literature review

Lu Rong, Ma Lihua, Ning Chunhong, Ma Wei, Xu Shuping

2023, 29(18):  2621-2624.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.024

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A 71-year-old male patient was treated at Second Department of Respiratory and Critical Care Medicine, Wuzhong People's Hospital because of fever, cough, and malaise for 13 days weeks. The chest CT showed that the upper lobe of the left lung had a consolidation shadow near the pleura. The consolidation shadow was enlarged after anti-infection treatment. Bronchoscopic alveolar lavage was performed for metagenomic next-generation sequencing, and the results suggested Chlamydia psittaci. The patient's medical history and clinical symptoms led to the diagnosis of community-acquired Chlamydia psittaci pneumonia. The patient was treated with levofloxacin. His temperature returned to normal; his respiratory symptoms were improved; the consolidation shadow in the upper lobe of the left lung was significantly resolved on chest CT. The treatment course was 13 days. The treatment course of this case was shared to provide clinical experience for community-acquired pneumonia difficult to define etiology.

One patient with chronic obstructive pulmonary disease and persistent prolonged APTT treated with aid of APTT mixing test 

Yan Bin, Hu Tianxi, Men Xiang, Duan Jinxia, Wang Ruijuan, Du Weipeng

2023, 29(18):  2625-2628.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.025

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Activated partial thromboplastin time (APTT) is a common screening test for coagulation. Multiple causes, such as coagulation factor deficiency, presence of coagulation factor inhibitors, or lupus anticoagulants, can lead to prolonged APTT, but the treatment options and outcomes are quite different. This article reports the diagnosis and treatment of a patient with chronic obstructive pulmonary disease and persistent prolonged APTT. The patient had a previous diagnosis of chronic bronchitis and was admitted to Nanyang Central Hospital on December 6, 2021 because of fever and shortness of breath exacerbated after activity. He was initially found to have a significantly prolonged APTT (up to the critical value criteria), which was not corrected by plasma infusion and vitamin K. The APTT mixing test indicated antiphospholipid syndrome. The patient's conditions were improved significantly after hormonal treatment. This report is intended to deepen clinicians' understanding of the APTT mixing test, to improve the application of this test in primary testing laboratories, and to help clinicians quickly identify patients at risk for bleeding or thrombosis and reduce missed diagnoses and misdiagnoses.

One case of lumbar intervertebral infection and intracranial infection caused by staphylococcus aureus

Yin Xiaoling, Sun Shuangxi, Wang Yumei, Kang Junyang

2023, 29(18):  2628-2630.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.026

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Primary lumbar intervertebral infection caused by Staphylococcus aureus is rare, and the combination with intracranial infection is rarer. A 64-year-old male patient was admitted to Weihai Central Hospital with nervous system symptoms. The diagnosis was confirmed after physical examination and related auxiliary examinations. After multidisciplinary treatment, the patient achieved good prognosis.

Nursing Research

Effect of construction of sensitive early rehabilitation index through evidence-based nursing intervention on swallowing function in patients with acute stroke

Yang Fang, Xiao Hui, Wei Yaqiong

2023, 29(18):  2631-2635.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.027

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Objective　To construct the sensitive early rehabilitation index of swallowing dysfunction in patients with acute stroke through evidence-based nursing intervention, and to observe the effect on swallowing function in patients with acute stroke. Methods　Seventy patients with acute stroke treated at Department of Neurology, Lianyungang Hospital of Traditional Chinese Medicine from January 2020 to October 2021 were selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 35 cases in each group. There were 23 men and 12 women in the control group; they were 57-77 (67.10±9.11) years old. There were 21 men and 14 women in the control group; they were 56-76 (66.76±8.74) years old. The control group were routinely cared. In the observation group, the sensitive early rehabilitation index of swallowing dysfunction in patients with acute stroke was constructed through evidence-based nursing intervention. The swallowing function before and 2 weeks after the nursing, swallowing times, and incidences of adverse events were compared between the two groups.χ² and t tests were used. Results　Two weeks after the intervention, the drinking water test scores were lower than those before the intervention in both group; the score in the observation group was lower than that in the control group [(2.12±0.46) vs. (2.46±0.45)], with a statistical difference (t=3.126; P<0.05). Two weeks after the intervention, the scores of the standard swallowing function rating scale (VFSS) and functional eating scale (FOIS) were higher than those before the intervention; the scores in the observation group were higher than those in the control group [(6.43±1.07) vs. (5.48±1.16) and (4.26±0.45) vs. (3.89±0.51)], with statistical differences (t=3.561 and 3.218; both P<0.05). Two weeks after the intervention, the body mass index (BMI) and levels of serum albumin (BSA) and hemoglobin (Hb) were higher than those before the intervention in both groups; the BMI and the levels of BSA and Hb in the observation group were higher than those in the control group [(22.12±2.61) kg/m² vs. (20.43±2.22) kg/m², (37.58±5.23) g/L vs. (35.35±4.23) g/L, (91.57±12.15) g/L vs. (85.42±12.32) g/L], with statistical differences (t=3.407, 2.592, and 2.731; all P<0.05). The incidence of adverse events in the observation group was lower than that in the control group [2.86% (1/35) vs. 22.86% (8/35)], with a statistical difference (χ²=6.248; P<0.05). Conclusion　Evidence-based nursing intervention for patients with acute stroke and construction of sensitive early rehabilitation index of swallowing dysfunction patients with acute stroke through evidence-based nursing intervention can improve their swallowing function and nutrition and reduce the occurrence of adverse events.

Application of atomized inhalation combined with tracheoscopy in children with ARDS after congenital heart disease surgery

Pang Qiuhe, Hu Penghe, Zhu Chunhe, Zhang Yuanyuan

2023, 29(18):  2636-2641.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.028

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Objective　To investigate the application value of nebulizing inhalation combined with tracheoscopy in children with ARDS after congenital heart disease (CHD) surgery. Methods　Sixty children with ARDS after CHD surgery who were admitted to Fuwai Central China Cardiovascular Hospital from August 2022 to March 2023 were selected for the randomized controlled trial. The patients were divided into a control group and an observation group by lottery, with 30 cases in each group. In the control group, there were 19 males and 11 females who were (9.36±1.40) months old; their body weight was (7.66±1.14) kg. In the observation group, there were 17 males and 13 females who were (9.24±1.38) months old; their body weight was (7.58±1.13) kg. All the enrolled children underwent open-heart surgery under extracorporeal circulation and were complicated with ARDS after the surgery. Both groups received routine nursing care for ARDS patients after CHD surgery; in addition, the observation group received atomization inhalation and tracheoscopy. The levels of respiratory function indicators [platform pressure (Pplat), air way peak pressure (Ppeak), and dynamic lung compliance (Cdyn)] 2 h and 3 d after the intervention were compared between the two groups. The postoperative recovery and the incidence of adverse reactions were evaluated in both groups. χ² and t were applied. Results　Two hours and 3 days after the intervention, the PaO₂, SaO₂, PaO₂/FiO₂, and Cdyn in the observation group were higher than those in the control group [(58.42±8.76) mmHg (1 mmHg=0.133 kPa) vs. (53.69±8.05) mmHg, (79.71±11.95) mmHg vs. (69.36±10.40) mmHg, (87.61±13.14)% vs. (80.44±12.06)%, (95.39±14.45)% vs. (88.26±13.23)%, (198.92±29.83) vs. (184.17±26.65), (215.06±32.25) vs. (189.74±28.46), (4.84±0.72) vs. (4.26±0.63), and (6.47±0.97) vs. (4.85±0.72)], with statistical differences (t=2.177, 3.578, 2.201, 2.285, 2.019, 3.224, 3.320, and 7.345; P<0.05). Two hours and 3 days after the intervention, the PaCO₂, Ppeak, and Pplat in the observation group were lower than those in the control group [(37.65±5.64)mmHg vs. (41.71±6.25) mmHg, (32.33±4.84) mmHg vs. (36.45±5.46) mmHg, (23.43±3.51) cmH₂O (1 cmH₂O=0.098 kPa) vs. (25.75±3.86) cmH₂O, (21.76±3.26) cmH₂O vs. (23.85±3.57) cmH₂O, (13.98±2.09)cmH₂O vs. (15.56±2.33) cmH₂O, and (11.76±1.76) cmH₂O vs. (13.92±2.08) cmH₂O], with statistical differences (t=2.641, 3.092, 2.435, 2.367, 2.764, and 4.342; all P<0.05). The duration of mechanical ventilation and ICU stay in the observation group were shorter than those in the control group [(121.48±18.22) h vs. (144.35±21.65) h and (192.66±28.89) h vs. (264.24±39.63) h], with statistical differences (t=4.426 and 7.994; both P<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group [3.33% (1/30) vs. 20.00% (6/30)],with a statistical difference (χ²=4.043,P<0.05). Conclusion　Atomization inhalation combined with tracheoscopy has significant clinical effects for children with ARDS after CHD surgery, and is conducive to improving the levels of arterial blood gas indicators and respiratory function, promoting their postoperative recovery, and effectively reducing the risk of adverse reactions.

Effect of nutritional support through straight nasointestinal tube on nutritional status in critically ill elderly patients

Liu Xinping, Liu Pei, Sun Hongxia, Mei Chengqing, Zhong Qin, Yu Wenxia

2023, 29(18):  2641-2645.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.029

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Objective　To investigate the effect of nutritional support through straight nasointestinal tube on nutritional status in critically ill elderly patients. Methods　This was a prospective study. A total of 36 elderly patients in critical conditions hospitalized at Department of Intensive Care Medicine, Nanjing Jiangbei Hospital, Nantong University were selected from March 2021 to July 2022, including 28 males and 8 females. They were (72.28±13.97) years old; their BMI was (23.58±3.36) kg/m²; the score of nutritional risk screening (NRS 2002) was (6.00±0.77); the score of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) was (22.33±2.47). The straight nasointestinal tubes were blindly inserted by their bedsides for the patients' nutritional support. The nutritional conditions before and 7, 14, 21, and 28 days after the nutritional support were compared. LSD-t test and χ² test were applied. Results　The success rate of blind insertion of straight nasointestinal tube at one time was 94.44% (34/36). The levels of hemoglobin and albumin were higher after than before the treatment, and the overall differences were statistically significant (F=7.561 and 6.987; both P<0.05). There were statistical differences in the levels of hemoglobin, total protein, albumin, prealbumin, and blood glucose between before and after the treatment (all P<0.05). There were statistical differences in the incidences of gastric retention [26/36 (72.22%) vs. 0/36 (0%)], vomiting aspiration [12/36 (33.33%) vs. 1/36 (2.78%)], diarrhea [8/36 (22.22%) vs. 1/36 (2.78%)] and diarrhea [6/36 (16.67%) vs. 1/36(2.78%)] between before and after the treatment (χ²=11.613, 11.359, 6.222, and 3.956; all P<0.05). The intestinal mucosal barrier function (diamine oxidase, D-lactic acid, and bacterial endotoxin) was improved after the treatment, and the overall differences were statistically significant (F=3.322, 10.957, and 14.016; all P<0.05). There were statistical differences 14, 21, and 28 d after the treatment (all P<0.05). Conclusions　The success rate of blind insertion of straight nasointestinal tube at one time is high; it can improve the nutritional status, reduce the incidence of feeding intolerance, and protect the intestinal mucosal barrier function.

Qualitative study on needs eating out of home of diabetic patients

Liang Yan, Liu Nan, Zhang Han

2023, 29(18):  2646-2649.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.030

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Objective　To explore the needs of diabetic patients for dining out and provide references for them. Methods　The phenomenological research method in qualitative research was adopted. From September to November 2022, a total of 18 diabetic patients from Zhongshan Hospital, Dalian University were selected for semi-structured interviews. The Colaizzi analysis method was used to code, analyze, classify, and refine the themes of the data. Results　The diabetic patients' needs eating out were summarized into four themes: the needs of diabetic diet, dignity and privacy protection, social support, and emotional and psychological support. Conlusions The needs eating out of diabetic patients are ultimately the needs of diabetic diet and social support. Under the guidance of the government, it is necessary to give full play to the allocation of market resources, start with diabetic diet and social support, and gradually improve the conditions for diabetic patients to eat out. It can maintain the stability of blood glucose when eating out, reduce complications, promote health, and improve their quality of life.

Effect of short video remote intervention based on WeChat group combined with IMB model in home care for patients with liver cirrhosis

Kong Min, Jin Xin, Zhao Qin

2023, 29(18):  2649-2654.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.031

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Objective　To explore the effect of short video remote intervention based on WeChat group combined with IMB model in home care for patients with liver cirrhosis. Methods　Eighty patients with liver cirrhosis who were discharged from Bayannaoer Hospital from February 2018 to February 2021 were selected and divided into a control group and an observation group, with 40 cases in each group. In the control group, there were 18 males and 22 females who were (45.18±4.35) months old; the control group was intervened by IMB model. In the observation group ,there were 19 males and 21 females who were (45.78±3.67) months old; the observation group was intervened by short video based on WeChat group on the basis of the control group. The changes of general information, negative emotions, self-efficacy levels, and various quality of life levels were compared between the two groups. t and χ² tests were applied. Results　After the nursing, the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group were better than those in the control group [(41.05±5.15) vs. (46.78±6.34) and (31.27±3.15) vs. (38.79±5.97)], with statistical differences (t=4.437 and 7.046; both P<0.05). After the nursing, the scores of self-care, reasonable rest, medication according to doctor's advice, health management, emotional control, and pain and discomfort control in the observation group were better than those in the control group [(8.01±1.52) vs. (7.16±1.24), (7.88±1.67) vs. (6.48±1.03), (8.34±2.64) vs. (7.16±1.24), (8.98±2.34) vs. (7.12±1.34), (8.21±1.42) vs. (6.24±1.24), and (8.67±1.67) vs. (7.11±1.03)], with statistical differences (t=2.741, 4.513, 2.559, 4.363, 6.609, and 5.028; all P<0.05). The scores of physiological function, physiological function, physical diseases, general health status, energy, social function, emotional function, and mental health in the observation group were higher than those in the control group [(87.49±7.57) vs. (64.27±6.48), (80.34±6.34) vs. (57.48±5.98), (85.49±7.34) vs. (62.24±6.48), (81.34±7.69) vs. (58.49±6.57), (88.67±6.37) vs. (64.27±5.37), (86.18±7.34) vs. (63.49±6.27), (88.49±6.34) vs. (63.18±5.34), and (90.15±7.34) vs. (67.68±6.34)], with statistical differences (t=14.738, 14.987, 15.018, 14.288, 18.522, 14.866, 19.311, and 14.652; all P<0.05). Conclusion　The application of short video remote intervention based on WeChat group combined with IMB model in home care for patients with liver cirrhosis can achieve remarkable intervention effect, improve their self-efficacy, self-care ability, and quality of life, and ease their negative emotions.

Qualitative study on life concerns of patients new to peritoneal dialysis based on need hierarchy theory 

Ling Chen, Zhang Yunfang, Huang Liqiu

2023, 29(18):  2654-2658.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.032

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Objectives　To explore the life concerns of patients new to peritoneal dialysis based on need hierarchy theory, and to provide references for medical staff to formulate targeted intervention measures. Methods　Using the phenomenological method of qualitative research, a semi-structured interview was carried out on 10 patients new to peritoneal dialysis at Huadu District People's Hospital from October 2019 to February 2020. There were 8 females and 2 males; they were (48.9±12.83) years old. Results　The life concerns faced by the patients included five themes: lifestyle change, disease uncertainty and fear of complications, self-feeling burden, disease shame and low sense of self-worth identity, and helplessness to work and ideals. Conclusions　Medical staff should strengthen health education and provide various solutions. They should optimize the training content and methods and improve the adaptation of patients new to peritoneal dialysis caused by disease uncertainty. Multiple social relationship support should be established to reduce the patients' negative emotions.

Qualitative study on experience of workplace violence experienced by junior nurses

Chen Xiaohong, Liao Guoping, Luo Yangyang

2023, 29(18):  2659-2663.  DOI: 10.3760/cma.j.issn.1007-1245.2023.18.033

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Objective　To analyze the psychological experience of workplace violence in junior nurses, and to provide references and basis for related research. Methods　The descriptive phenomenological research method was used. Semi-structured in-depth interviews were conducted on 12 female junior nurses who suffered workplace violence at Zhongshan Dongfeng People's Hospital from August to September 2021. They were 21-28 years old and had worked 1-4 years. The data were analyzed by the Colaizzi 7-step analysis method. Results　The psychological experience of young nurses subjected to workplace violence was mainly divided into three categories: emotional experience, coping style experience, and cognitive experience. The emotional experience included negative emotion and self-reflection; the coping experience included individual coping and seeking external support; the cognitive experience included adaptation and understanding of occupation, adjustment of coping style, and recognition of personal emotional regulation ability. Conclusion　Managers should pay attention to the training of workplace violence, strengthen the negative emotional counseling of nursing staff, and carry out the training of coping knowledge and communication skills of workplace violence.