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Table of Content

    15 October 2023, Volume 29 Issue 20
    New Medical Advances

    Research progress of GSDMD-mediated pyrodeath in atrial fibrillation

    Shang Xue, Zhao Jiahao, Li Xinxi, Zhu Hui, Zhao Ke, Liu Zhenxing, Xu Huipu
    2023, 29(20):  2825-2828.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.001
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    Pyroptosis is a programmed death mode recently discovered. Its pathways include the classical pyroptosis pathway, non-classical pyroptosis pathway, other caspase-mediated pyroptosis pathway, and granulozyme mediated pathway. Gasdermin protein (GSDM) is the final efficient protein. GSDMD is one of the Gasdermin pore-forming proteins that have been studied extensively and deeply. Pyrodeath is associated with chronic inflammatory diseases, tumors, atherosclerotic diseases, metabolic diseases, and neurodegenerative diseases. In recent years, it is found that pyrodeath involves in the cardiovascular field, but the research on atrial fibrillation is still in its infancy. Further research on the mechanism of pyrodeath in atrial fibrillation may become one of the effective strategies for atrial fibrillation in the future.

    Research progress of autoimmune factors in premature ovarian failure

    Fan Yuhan, Liu Ziqin, Zhu Yue, Cui Shuna
    2023, 29(20):  2829-2833.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.002
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    Premature ovarian failure refers to the cessation of ovarian function in women before the age of 40. It is characterized by amenorrhea with a high gonadotropin level and a low estrogen level. The diagnostic criteria are as below: the duration of amenorrhea is more than 4-6 months; two consecutive tests with the interval of more than 4 weeks showed FSH > 40 U/L. Premature ovarian failure affects the quantity and quality of oocytes, leading to the decline or even loss of female fertility, and endangers women's health. However, the cause of premature ovarian failure is unknown and may be related to a variety of factors, such as genetic factors, environmental factors, age factors, immune factors, iatrogenic factors, etc. Among them, the immune factors have a complicated mechanism acting on this disease. Therefore, the immune factors involved in premature ovarian failure are summarized in this paper to provide diagnosis and treatment ideas for its clinical prevention and treatment.

    Research progress on immune-mediated inner ear disease

    Wang Yaoyao, Ma Xiufang
    2023, 29(20):  2833-2836.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.003
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    Immune-mediated inner ear disease is a kind of disease caused by immunity. One of its clinical manifestations is sensorineural hearing loss. This review is to compare the clinical features of systemic autoimmune diseases and organ-specific inner ear diseases that affect hearing, and to discuss the latest pathogenesis, diagnosis, and treatment.

    Research progress of assessment tools for adults' oral health literacy assessment

    Wang Lu, Xie Henan, Zhao Qimei, Xie Zheng
    2023, 29(20):  2836-2841.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.004
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    Oral diseases are common and frequent diseases affecting the health of Chinese residents. Oral health literacy assessment is important basis for formulating oral health literacy management plans. To achieve good oral management and reduce the social and economic burden, it is of great significance to monitor, evaluate, and take measures to improve the population' oral health literacy. This article reviews the main content, characteristics, advantages, and limitations of commonly used comprehensive measurement tools for adult oral health literacy, so as to provide references for clinical nurses to choose appropriate assessment tools.

    Gastric Cancer

    Screening key functional modules and prognostic genes of stomach cancer by weighted gene co-expression network analysis

    Wu Han, Xu Lei, Wang Miaomiao, Cui Zhongze, Wu Shuhua
    2023, 29(20):  2842-2847.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.005
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    Objective To investigate the correlation between gastric cancer gene sets and clinical characteristics and to identify the candidate biomarkers analyzing the key functional modules of stomach cancer by the weighted gene co-expression network analysis (WGCNA). Methods The study was from January to April 2023. The gene expression profile of GSE65801 was screened from the Comprehensive Gene Expression Omnibus (GEO). WGCNA was used to construct the gene co-expression network of gastric cancer and to identify the co-expression modules. Function (GO) and pathway (KEGG) enrichment analyses and protein interaction (PPI) analysis were performed. The prognostic genes were screened out by survival analysis. Results Twelve co-expression modules were obtained by the WGCNA, and the modules with the most significant differences were selected for subsequent studies. These genes were mainly predominantly enriched in mucoglycan metabolism, vascular development, epithelial cell proliferation, regulation of cell response to growth factor stimulation, regulation of cell growth, cell adhesion, and other functions, as well as key signaling pathways, such as PI3K-Akt, MAPK, and Ras. Five prognostic related genes were screened out by the prognostic analysis, including VCAN, SERPINE1, HGF, IGFBP7, and FSTL3. Conclusion Some gastric cancer related modules and prognostic genes are identified by WGCNA, which provides a crucial theoretical basis for further research on the molecular mechanism underlying the occurrence and development of gastric cancer as well as targeted therapy.

    Research progress of polyamines and Helicobacter pylori-induced gastric cancer

    Chu Linlin, Wang Na, Hao Jiahui, Sun Xiao, Liu Chengxia
    2023, 29(20):  2848-2851.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.006
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    Polyamines is a class of aliphatic compound, characterized by low molecular weight and certain biological activities, including putrescine, spermine, and spermidine, which are necessary for cell growth and survival. With the development of understanding polyamines and cellular function, researchers pay more attention to the metabolism of polyamines in anticancer. This article discusses the synthesis process of polyamines and the polyamine metabolism in the development of gastric cancer. Polyamines is related to kinds of cancers. In this review, we focus on the role of polyamine dysregulation in the context of Helicobacter pylori-induced gastritis and subsequent progression to gastric cancer. Due to the emerging implication of polyamines in cancer development, there is an increasing number of promising clinical trials using agents to target the polyamine metabolic pathway for potential chemoprevention and anticancer therapy.

    Research progress of NKG2D and its ligands in treatment of gastric cancer

    Li Zongrui, Liu Weipeng, Hu Baoguang
    2023, 29(20):  2852-2856.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.007
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    Natural killer cell 2D (NKG2D) and its ligands play an important role in the recognition, initiation, enhancement, or inhibition of lymphocyte effects in NK cells. In recent years, the NKG2D receptor on NK cells has become a hot research topic with the deepening of tumor immune evasion research. As a serious disease affecting human life span, gastric cancer's treatment has been a difficult problem. In recent years, major breakthroughs have been made in the immunotherapy of cancer. NKG2D and its ligands may be a potential direction of immunotherapy. Therefore, this paper reviews the research progress of NKG2D and its ligands in the treatment of gastric cancer.

    Scientific Research

    Cognition and willingness toward traditional Chinese medicine in Madagascar residents

    Liu Xiaohui, Ma Jianhua, Wang Shuang, Zhang Rui, Su Li, Fang Yue, Pu Yongjie, Luo Juan, Chen Qing, Yuan Ying, Bai Jun, Wen Jianqiang
    2023, 29(20):  2857-2864.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.008
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    Objective To investigate the current awareness and willingness in Madagascar residents toward traditional Chinese medicine. Methods A total of 415 patients who were 18-69 years and who attended one representative hospital in the north, east, and south of Madagascar from March to August 2021 were included, including 174 males and 241 females. The awareness of traditional Chinese medicine, utilization of traditional Chinese medicine health services, and related factors affecting the willingness of Malagasy residents to use traditional Chinese medicine were analyzed. The SPSS 25.0 software was applied to analyze the data by χ2 test, Spearman correlation analysis, and multivariate logistic regression analysis. If P<0.05, there is a statistical difference. Results The respondents had a good overall understanding of traditional Chinese medicine (365 cases, 88.0%), but lacked in-depth understanding. The results of logistic regression analysis showed that the residents of Chinese Han nationality (OR=5.016) and Antandero nationality (OR=2.492) of the 12 ethnic groups knew the most about traditional Chinese medicine, and the awareness rates of traditional Chinese medicine among the residents with college degree (OR=2.656) and university undergraduate degree (OR=4.424) were high (all P<0.05). The Beshi Mizaraka people (OR=0.207) had the lowest trust in traditional Chinese medicine, and the residents with high school (OR=3.720), college (OR=2.838), undergraduate (OR=5.812), and master's degrees or above (OR=5.165) had the highest trust in traditional Chinese medicine (all P<0.05). The people with lower income (OR=0.336 and 0.279) made more use of traditional Chinese medicine (P<0.05). Conclusions Malagascar residents have certain understanding of traditional Chinese medicine. Nationality, education level, and family income are the main factors affecting their knowledge, belief, and practice of traditional Chinese medicine. The sense of experience and satisfaction with traditional Chinese medicine health services and the lack of a suitable Chinese medicine service platform are the main factors for the underutilization of traditional Chinese medicine.

    Clinical effect of shoulder three-needling acupuncture and moxibustion combined with small needle knife in treatment of patients with shoulder periarthritis 

    Li Shengli, Liu Yang
    2023, 29(20):  2864-2868.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.009
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    Objective To investigate the clinical efficacy of shoulder three-needling acupuncture and moxibustion combined with small needle knife for patients with shoulder periarthritis. Methods A total of 112 patients with shoulder periarthritis treated at Armed Police Hospital of Guangdong Province between January 2020 and December 2022 were selected. They were divided into a control group and an observation group by the random number table method, with 56 cases in each group. There were 32 males and 24 females in the control group; they were (71.45±4.06) years old. There were 30 males and 26 females in the observation group; they were (71.22±4.13) years old. The control group received small needle knife treatment once a week, for 3 times; in addition, the observation group took shoulder three-needling acupuncture and moxibustion once a day for 5 d, and stopped 2 d, then continued the treatment for 5 d. The treatment effects, traditional Chinese medicine syndrome scores, shoulder joint function, pain degrees, and daily living abilities were compared between the two groups. t and χ2 tests were applied. Results The effective rate of the observation group was higher than that of the control group [96.43% (54/56) vs. [82.14% (46/56)], with a statistical difference (χ2=5.973, P<0.05). After the treatment, the scores of shoulder pain, activity limitation, and heavy sensation in the observation group were significantly lower than those in the control group [1.88±0.25) vs. (2.57±0.32), (1.52±0.21) vs. (2.11±0.29), and (1.07±0.22) vs. (1.88±0.26)], with statistical differences (all P<0.05). After the treatment, the scores of pain, daily living ability, range of motion (flexion, extension, abduction, and internal rotation), and muscle strength and the total score in the observation group were significantly higher than those in the control group[(12.42±2.28) vs. (9.05±1.82), (17.44±2.62) vs. (14.63±2.24), (34.25±4.18) vs. (30.06±3.99), (23.63±2.73) vs. (20.11±2.52), and (88.15±8.76) vs. (73.53±6.69)], with statistical differences (all P<0.05). After the treatment, the scores of daily living ability and pain degree in the observation group were better than those in the control group [(85.52±8.92) vs. (76.69±7.14) and (1.62±0.43) vs. (2.27±0.51)], with statistical differences (t=5.783 and 7.291; both P<0.05). Conclusion Shoulder three-needling acupuncture and moxibustion combined with small needle knife for patients with shoulder periarthritis can promote symptom relief, reduce pain, improve their range of motion and daily living ability, and enhance their activity level, so it deserves further promotion.

    Effect of ANO1 inhibitors in Ang-induced VSMC proliferation

    Yu Jie, Yao Gang, Han Xiaohua, Zhao Lan
    2023, 29(20):  2869-2873.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.010
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    Objective To investigate the role of recombinant anoctamin 1 (ANO1) inhibitors in angiotensin Ⅱ (AngⅡ) -induced proliferation of vascular smooth muscle cells (VSMC). Methods The study period was from July 2019 to June 2022. The rat thoracic aorta smooth muscle cell line A7r5 was cultured in vitro; the AngⅡ stimulated A7r5 cells were used to establish the cell proliferation models; 10, 100, and 500 nmol/L ANO1 inhibitors (A01) were used for the intervention; a control group was set up (intervention with the same amount of normal saline); Hoechst 33342 fluorescence staining was used to observe the morphological changes of VSMC induced by AngⅡ after the intervention of ANO1 inhibitors; the protein western blotting was used to detect the expression levels of apoptosis-related proteins in the VSMC cells induced by AngⅡ after the intervention of ANO1 inhibitors. One-way analysis of variance was used for multi-group comparison, and LSD-t test was used for pairwise comparison between groups check. Results The Hoechst 33342 fluorescence staining results showed that the ANO1 inhibitor concentration increased, the bright blue cells (chromatin condensation and apoptotic bodies) were getting more, indicating that the number of apoptotic cells increased. The apoptosis rates of the low-, medium-, and high-dose groups were (17.60±1.36)%, (36.30±3.50)%, and (61.25±6.33)%, respectively, which were higher than that of the control group [(4.32±0.51)%], with statistical differences between the groups (all P<0.05), indicating a dose-dependent relationship between AngⅡ-induced post-proliferative apoptosis of VSMC and ANO1 inhibitor concentration. The results of protein western blotting in the detection of AngⅡ-induced apoptosis related proteins in VSMC after ANO1 inhibitor intervention showed that there was a statistical difference in the main effect of EPK, AKT, CDK4, Cyclin D1 protein relative expression levels between the groups (P<0.05); compared with those in the control group, the relative protein expressions of EPK, AKT, CDK4, and Cyclin D1 in the low-, medium-, and high-dose groups decreased in a dose-dependent manner, with statistical differences between the groups (all P<0.05). Conclusions ANO1 inhibitors can significantly inhibit AngⅡ-induced VSMC proliferation, and the mechanism may be related to the inhibition of the EPK/AKT signaling pathway and cell cycle progression.

    Effect of percutaneous endoscopic lumbar discectomy for patients with adjacent segment degeneration after lumbar fusion surgery

    Li Xiuzhi, Li Yuwei
    2023, 29(20):  2873-2877.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.011
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    Objective To explore the clinical efficacies of percutaneous endoscopic lumbar discectomy (PTED) versus decompressive fenestration and discectomy under x-tube operation system for the treatment of adjacent segment degeneration (ASD) after lumbar fusion surgery. Methods The data of the patients with ASD who underwent operation at Luohe Central Hospital from January of 2019 to January 2021 were analyzed retrospectively. According to the inclusion criteria, we collected the data of 37 patients with unilateral protrusion. There were 18 patients in the endoscopic group treated with PTED and 19 patients in the fenestration group treated with decompressive fenestration and discectomy under x-tube operation system. There were 8 males and 10 females in the endoscopic group; they were (48.50±9.49) years old. There were 9 males and 10 females in the fenestration group; they were (48.15±9.75) years old. All the cases were diagnosed by lumbar anterior-posterior X-ray, lateral X-ray, lumbar dynamic X-ray, and MRI. The imaging showed that adjacent segments of degenerative intervertebral discs protruded or extruded towards the inner side of the spinal canal, with compression of the dural sac and ipsilateral nerve roots. The operation times, intraoperative bleeding volumes, numbers of fluoroscopy, and hospitalization times were compared between the two groups. The clinical efficacies were evaluated by Japanese Orthopaedic Association Scores (JOA) of 29 points for low back pain. The improvement of limb pain was evaluated by the Visual Analogue Scale (VAS). t and χ2 tests were used. Results The operation time, intraoperative bleeding volume, hospitalization time, and number of intraoperative fluoroscopy in the endoscopic group were (49.44±10.65) min, (7.44±1.97) ml, (4.61±1.03) d, and (13.83±2.03) times; those in the fenestration group were (50.89±9.63) min, (117.00±54.48) ml, (12.31±1.79) d, and (1.15±0.37) times; there was no statistical difference in the operation time between the two groups (P=0.666) and were in the intraoperative bleeding volume, hospitalization time, and number of intraoperative fluoroscopy (all P<0.05). The intraoperative bleeding volume and hospitalization time in the fenestration group were higher than those in the endoscopic group. The fluoroscopy times in the endoscopic group was higher than that in fenestration group. There were no statistical differences in the scores of JOA and VAS before and 3 months after the surgery and at the last follow-up (all P>0.05). There were 2 cases in the endoscopic group and no case in the fenestration group complicated with cerebrospinal fluid leakage. There was no case complicated with infection and nerve root injury in both groups. At the last follow-up, spinal instability was well in both groups through postoperative X-ray examination. Conclusion For the lumbar disc herniation caused by adjacent segment degeneration after lumbar fusion, PTED can achieve the same clinical effect as fenestration decompression surgery and avoid the scar of the original surgical approach. It has the advantages of less trauma and quick postoperative recovery and can be used as an effective surgical method to treat symptomatic ASD after lumbar fusion.

    Establishment and application of reference interval of thromboelastography for healthy people in core water source area of South-to-North Water Diversion Project 

    Xu Ci, Yang Xun, Yan Bin, Ren Dongfang, Jia Yanwei
    2023, 29(20):  2878-2882.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.012
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    Objective To establish the reference interval of thromboelastography for healthy people in the core water source area of the South-to-North Water Diversion Project, and provide an effective basis for the diagnosis and treatment of diseases in this area. Methods This is a prospective study. One hundred and sixty healthy volunteers in Nanyang City from October 2021 to June 2022 were included. Their peripheral venous blood was collected according to the standard method of Reference Intervals of Clinical Laboratory Test Items (WS/T402-2012). Thromboelastography was used to measure the conventional coagulation and fibrinolysis indicators, including D-dimer (DD), prothrombin time (PT), fibrinogen (FIB), thrombin time (TT), activated partial thromboplastin time (APTT), and TEG parameters [coagulation reaction time (R), hemagglutination time (K), hemagglutination velocity (α angle), maximum strength (MA), and comprehensive index (CI)]; the 95% confidence interval was calculated to determine the reference interval of each parameter of thromboelastography. Comparisons between the two groups were made by the t test and non-parameter test. The results of Spearman's rank correlation analysis were used for the correlation analysis. Results Of the 160 study subjects, 107 were male and 53 were female, with an age of (54.2±10.4) years. There were no statistical differences in the conventional coagulation and fibrinolysis indicators between the males and the females (all P>0.05). The normal reference ranges of thromboelastography parameters established were as below: R 5.06-10.06 min, K 1.41-4.22 min, α angle 41.81°-70.50°, MA 48.03-67.69 mm, and CI -5.50-1.40. Compared with the thromboelastography parameters of the females, the K value of the males was significantly higher [(2.54±0.70) vs. (2.96±0.70); t=3.70, P<0.01], while the α angle and CI values were significantly lower [(56.34±7.18)° vs. (52.21±6.57)° and (-2.02±1.94) vs. (-2.93±1.72); t=-3.53 and -2.88, both P<0.01]. The R value was positively correlated with APTT (r=0.26, P<0.01), K negatively with FIB (r=-0.28, P<0.01) and positively with TT (r= 0.26, P<0.01), α angle negatively with TT (r=-0.25, P<0.01), α angle, MA, and CI positively with FIB (r=0-24, P<0.01; r=0.49, P<0.01; r=0.25, P<0.01), and CI negatively with TT and APTT (r=-0.19, P=0.02; r=-0.19, P=0.02). Conclusions The reference range of thrombelastography in healthy population in Nanyang is still different from the reference range provided by the manufacturer. It is necessary to establish the reference range of thrombelastography in this area. It can provide accurate results for the diagnosis and treatment of diseases, but thromboelastography cannot replace the traditional coagulation test.

    Effect of combination of tofacitib and eramode for patients with rheumatoid arthritis and its effect on cellular immune function

    Wei Sha, Lin Wentao, Zhao Tingting, Niu Yanni, Zhang Nina
    2023, 29(20):  2883-2886.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.013
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    Objective To investigate the effect of tofacitib combined with eramode for patients with rheumatoid arthritis and the effect on their cellular immune function. Methods A total of 102 patients with rheumatoid arthritis admitted to Jincheng People's Hospital from January 2020 to December 2022 were selected and divided into a combined group and a conventional group by random number table method, with 51 case in each group. The conventional group took eramode, and the combined group took eramode and tofacitib, for 3 months. The clinical efficacies, inflammatory response [interleukin (IL) -10 and IL-12], cellular immune function [immunoglobin G (IgG) ], and adverse reactions were compared between the two groups. χ2 and t tests were applied. Results After the treatment, the total effective rate of the combined group was higher than that of the conventional group [94.12% (48/51) vs. 78.43% (40/51)], with a statistical difference between the two groups (P<0.05). After the treatment, the levels of IL-10 and IL-12 in the combined group were lower than those in the conventional group [(31.34±4.97) ng/L vs. (39.42±5.12) ng/L and (3.28±0.51) ng/L vs. (6.59±0.91) ng/L; both P<0.05]. After the treatment, the levels of CD3+ and CD19+ cells in the combined group were higher than those in the conventional group [(66.78±6.45)% vs. (55.12±5.28)% and (88.76±12.45)% vs. (65.67±10.11)%; both P<0.05]. After the treatment, the serum IgG level in the combined group was lower than that in the conventional group [(10.23±1.24) g/L vs. (14.78±2.32) g/L; P<0.05]. There was no statistical difference in the total incidence of adverse reactions between the two groups [9.80% (5/51) vs. 7.84% (4/51); P>0.05]. Conclusion Tofacitib and eramode for patients with rheumatoid arthritis is significantly effective and safe and can reduce their inflammatory response and improve cellular immune function, so it worthy of clinical promotion and application.

    Protective effects of SGLT 2 inhibitors versus GLP-1 receptor agonists on renal function in type 2 diabetic patients with infection

    Wang Lixin, Wang Minglei, Liu Changhu, Liang Jun, Li Min, Gao Linlin
    2023, 29(20):  2887-2891.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.014
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    Objective To explore the effects of sodium-glucose cotransporter 2 (SGLT 2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists on renal function in type 2 diabetic patients with infection. Methods One hundred and twenty type 2 diabetic patients with infection treated in Jinan Second People's Hospital from January 2020 to January 2023 were selected and randomly divided into a control group and an observation group by lottery, with 60 cases in each group. There were 23 males and 37 females in the control group; they were (55.23±5.46) years old. There were 26 males and 34 females in the observation group; they were (54.87±4.98) years old. Both groups maintained primary hypoglycemic therapy and received anti-infection treatment. Before and after the treatment, fasting plasma glucose (FPG), glycated hemoglobin A1c (HbA1c), 2-hour postprandial blood glucose (2hPBG), the insulin resistance index (homeostatic model assessment of insulin resistance, HOMA-IR), levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), the clearance rates of positive bacteria, and the changes in renal function-related indicators were compared between the two groups. Before the treatment, there were no statistical differences in the blood glucose levels and HOMA-IR between the two groups (all P>0.05). After the treatment, the FPG, HbA1c, 2hPBG, and HOMA-IR decreased in both groups, and those in the observation group were lower than those in the control group [(6.51±0.96) mmol/L vs. (7.73±0.52) mmol/L, (5.95±0.72)% vs. (7.80±0.67)%, (7.90±0.74) mmol/L vs. (13.57±1.86) mmol/L, (2.56±0.33) mmol/L vs. (3.15±0.29) mmol/L; t=8.656, 14.570, 22.146, and 10.403; all P<0.05]. Before the treatment, there were no statistical differences in the serum lipid levels between the two groups (all P>0.05). After the treatment, the levels of TC, TG, and LDL-C decreased and the HDL-C level increased in both groups, and the levels in the observation group were better than those in the control group [(4.98±0.95) mg/dl vs. (5.36±1.02) mg/dl, (1.66±0.31) mg/dl vs. (1.88±0.34) mg/dl, (1.89±0.45) mg/dl vs. (2.77±0.77) mg/dl, and (1.13±0.22) mg/dl vs. (1.02±0.14) ; t=2.112, 3.704, 7.643, -3.267; all P<0.05]. Before the treatment, there were no statistical differences in the levels of renal function indicators between the two groups (all P>0.05). After the treatment, the levels of β2 microglobins, cystatin C, blood creatinine, and blood urea nitrogen were higher than those before the treatment in both groups, and the levels in the observation group were lower than those in the control group [(1.55±0.13) mg/L vs. (1.62±0.21) mg/L, (1.32±0.34) mg/L vs. (1.49±0.24) mg/L, (94.42±9.62) mg/L vs. (97.54±8.96) mg/L, (5.36±2.34) mg/L vs. (5.54±2.41) mg/L. There was no statistical difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Both SGLT 2 inhibitors and GLP-1 receptor agonists for type 2 diabetic patients are effective, have glucose- and lipid-lowering effects, and can protect renal function, but SGLT 2 inhibitors is better.

    Treatises

    A novel prognostic feature of lung squamous carcinoma based on cuproptosis associated lncRNAs

    Zhang Jiaqi, Zhou Erle, Wang Shasha, Xu Yinghan, Jiang Yixin, Yu Ning
    2023, 29(20):  2892-2900.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.015
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    Objective To establish a risk prognostic model of cuproptosis associated lncRNAs in lung squamous carcinoma (LUSC) based on the Cancer Genome Atlas (TCGA) database. Methods The gene and clinical data were obtained from the TCGA database. The cuproptosis related genes were obtained from the cuproptosis related studies. The prognosis model of lncRNAs was established by co-expression analysis and Cox regression analysis. The prognostic value of the model was evaluated. The relationship between cuproptosis associated lncRNAs and LUSC was analyzed. The differences between the groups were analyzed by Student's t and Wilcoxon tests. The Kaplan-Meier survival analysis were tested by Log-Rank. Results A total of 5 lncRNAs participated in the construction of the model. The validation analysis found poor overall survival (OS) and progression-free survival (PFS) in high-risk patients. Independent prognostic analysis, receiver operating characteristic (ROC), C-index, and Nomo chart showed that the model could accurately predict the patients' prognosis. Further analysis showed that cuproptosis associated lncRNAs might participate in the progression of LUSC by affecting citrate-tricarboxylic acid cycling and immune-related functions, and high-risk patients had a greater potential for immune escape. Conclusions In this study, a risk and prognosis model of LUSC cuproptosis associated lncRNAs is constructed. It can accurately predict prognosis and is closely related to multiple LUSC functions.

    Regional homogeneity of brain function at rest in patients with occupational noise deaf

    Li Yunxin, Wang Aijie, Huang Ranran, Li Lin, Xu Leilei
    2023, 29(20):  2901-2905.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.016
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    Clinical Research

    Application of "Zang-qi timing theory" in treatment of patients with migraine

    Zhang Yewen, Liu Zhongqin, Xu Huachun, Bian Shujuan, Gao Shiting
    2023, 29(20):  2906-2910.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.017
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    Objective To observe the clinical effect of treating patients with migraine under the guidance of "Zang-qi timing theory". Methods One hundred and twenty-one patients with migraine treated in the outpatient department of Ping'an District Hospital of Traditional Chinese Medicine from January to September 2022 were selected for the prospective study. According to the random number table method, they were randomly divided into a treatment group and a control group. The control group had 18 patients, including 2 males and 16 females; they were (52.23±3.01) years old; they were treated with basic prescriptions. The treatment group were divided into a liver disease group, a heart disease group, a spleen disease group, a lung disease group, and a kidney disease group according to the time rule described in Suwen · Zang-qi Fashi Lun. There were 23 cases in the liver disease group (6 males and 17 females), with an age of (51.34±4.76); there were 19 cases in the heart disease group (3 males and 16 females), with an age of (49.53±5.01); there were 19 cases in the spleen disease group (6 males and 13 females), with an age of (53.14±3.95); there were 20 cases in the lung disease group (4 males and 16 females), with an age of (50.67±4.28); there were 22 cases in the kidney disease group (5 males and 17 females), with an age of (51.97±5.12). The five groups were given different herbs from the five flavors according to the "Wuzang Kuyu Buxie" theory. After 4 weeks' treatment, the pain degrees, durations, and attack times and efficacies were evaluated. The Wilcoxon signed rank test was used for the inter-group comparison. Results The total effective rate of the treatment group was significantly higher than that of the control group [91.67%(88/96) vs. 68.75%(11/16)], with a statistical difference (χ2=4.964, P<0.05). There was a statistical difference in the score differences of pain severity, duration, and attack times between before and after the treatment between the treatment group and the control group [5.00 (4.00, 6.00) vs. 4.00 (3.00, 5.00), 2.00 (0, 2.00) vs. 0 (0, 1.00), and 4.00 (2.00, 4.00) vs 1.00 (0, 2.00)], with statistical differences (Z=-3.154, -2.648, and -3.860; all P<0.05).  Conclusions It has a good effect to treat migraine under the guidance of "Zang-qi timing theory". The analysis of this clinical study can provide basis and ideas for the further study of "Zang-qi timing theory".

    Effect of different block methods on anesthesia in elderly patients with intertrochanteric fractures of the femurs

    Yang Tingjia, Wang Hongwei, Duan Zhiqiang
    2023, 29(20):  2911-2914.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.018
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    Resection and moist exposed burn ointment for patients with seborrheic keratosis

    Liu Liuhong, Wu Shuyi, Zheng Xiufen, Xu Jiaoxiong, Zhang Lian, Fu Zhengzheng, Zheng Wen, He Renliang
    2023, 29(20):  2914-2918.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.019
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    Objective To evaluate the clinical efficacy and adverse reactions of resection combined with moist exposed burn ointment (MEBO) in the treatment of patients with seborrheic keratosis. Methods In this retrospective analysis, 43 lesions of 30 newly diagnosed patients with seborrheic keratosis were selected from departments of dermatology of Dermatology Hospital of Southern Medical University, Zhongshan Traditional Chinese Medicine Hospital, Shunde Hospital of Southern Medical University, Huangpu People's Hospital from January 2018 to March 2022. There were 16 males and 14 females; they were (54.27±11.4) years old. All the patients took resection and moist exposed burn ointment. The wound healing rate and the incidence of adverse reactions were analyzed. Results A mong the 43 lesions confirmed as seborrheic keratosis, 40 had skin lesion, 2 were diagnosed as actinic keratosis, and 1 was diagnosed as viral warts by the pathological examination. Forty seborrheic keratosis lesions were included in this study for observation. The wound healing time was (9.10±0.80) days; erythema occurred in 1 wound after wound healing; one diabetic patient had 1 wound infection, and the wound healed with mild scar after anti-infection and dressing change; 2 wounds had pigmentation after wound healing; the incidence of adverse reactions was 10% (2/40). After 3 months' follow-up, the recovery rate of the 40 wounds was 100%, and no recurrence of skin lesions was observed. Conclusion Treating seborrheic keratosis by resection combined with MEBO has the advantages of a high implementation rate of pathological examination, good clinical efficacy, short wound healing time, and few adverse reactions.

    Three different energy platforms in treatment of patients with benign prostatic hyperplasia

    Ye Yinglin, Ruan Yongtong, Chen Jufeng, Xu Beixun, Pan Jie, Ao Dawen, Wu Yuanshun
    2023, 29(20):  2919-2923.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.020
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    Objective To investigate the safety and clinical efficacy of green laser prostatic enucleage in the treatment of patients with benign prostatic hyperplasia by comparison between the holmium laser, green laser, and bipolar plasma therapies for benign prostatic hyperplasia. Methods In this prospective study, 90 patients who were hospitalized in Yangjiang Hospital of Traditional Chinese Medicine from October 2019 to December 2021 were selected; they were 64-90 years old, with an average of 78. According to the treatment methods, they were divided into a transurethral green laser prostatic enucleage group, a transurethral holmium laser prostatic enucleage group, and a transurethral bipolar plasma prostatic enucleage group, with 30 cases in each group. The hemoglobin, maximum urine flow rate, residual urine, international prostate symptom score, and quality of life score were measured before and after the surgery. The postoperative adverse reactions, lengths of indwelling urinary catheter, hospital stays, and occurrence of recent complications were recorded. The χ2 and t tests were used. Results The operation time, hemoglobin decrease during the operation, length of indwelling urinary catheter after the operation, bladder lavage time, and hospital stay were (50.5±14.3) min, (6.0±4.9) g/L, (80.1±17.5) h, 0, and (7.6±1.3) d in the transurethral green laser prostatic enucleage group, were (72.3±16.9) min, (10.5±4.5) g/L, (87.1±18.5) h, (20.0±4.6) h, and (8.1±1.2) d in the transurethral holmium laser prostatic enucleage group, and were (66.5±14.3) min, (7.7±3.4) g/L, (84.3±17.4) h, (17.0±4.3) h, and (7.4±1.0) d in the transurethral bipolar plasma prostatic enucleage group; those in the transurethral green laser prostatic enucleage group were better than those in the other two groups, with statistical differences (all P<0.01). Threes cases had complications after the surgery in the transurethral green laser prostatic enucleage group, 8 in the transurethral holmium laser prostatic enucleage group, and 5 in the transurethral bipolar plasma prostatic enucleage group, with no statistical difference (P>0.05). Conclusion Transurethral green laser prostatic enucleage has the characteristics of precise curative effect, less bleeding, and fast recovery, and can be used as the first choice for the surgical treatment of prostatic hyperplasia.

    Case Report

    One patient with MOG antibody-associated diseases manifested as Todd's paralysis and literature review

    Zhou Li, Lyu Renhua, Ju Weiping
    2023, 29(20):  2924-2928.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.021
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    The clinical phenotypes of myelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases are complex and difficult to identify. In this paper, we report a case of MOG antibody-associated diseases with Todd's paralysis and analyze its characteristics of symptomatology, imaging, and electrophysiology, so as to increase the understanding of such diseases, achieve early identification and immunotherapy, and improve prognosis.

    One case of CD4-CD8-TCRγδ+ T cell large granular lymphocytic leukemia complicated with pure red cell aplastic anemia and literature review

    Liu Jinli, Zhang Yujie, Xu Tengfei
    2023, 29(20):  2929-2932.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.022
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    In order to improve the understanding of CD4-CD8-TCRγδ+ T cell large granular lymphocytic leukemia and to reduce the misdiagnosis and missed diagnosis in the clinic, we retrospectively analyzed the clinical data of a patient with CD4-CD8-TCRγδ+ T cell large granular lymphocytic leukemia complicated with pure red cell aplastic anemia who was admitted to Weihai Municipal Hospital in March 2021 and reviewed the related literature.

    One case of cerebral amyloid angiopathy-related inflammation and literature analysis

    Chen Caixia, Xu Zhenyuan, Cong Yanbin, Wu Xijuan
    2023, 29(20):  2933-2936.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.023
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    Cerebral amyloid angiopathy-related inflammation (CAA-RI) is an inflammatory reaction caused by the deposition of β amyloid protein (amyloid β, Aβ) in the vascular wall and peripheral vessels of the central nervous system, resulting in a series of related symptoms. We report an elderly female patient with cognitive impairment as the first symptom who was admitted to Weihai Central Hospital due to acute lobular hemorrhage. Craniocranial MRI showed multiple T2 and FLAIR hypersignals with asymmetric distribution of subcortical white matter and deep brain tissue, accompanied by low signal in the left temporal lobe (considering new blood). Susceptibility-weighted imaging (SWI) indicated multiple cortical/subcortical scattered microbleeds and cortical surface iron deposits; the gene detection indicated ApoE epsilon 3/epsilon 4; the cerebrospinal fluid trace total protein level was 1 097 mg/L; the Aβ42 level decreased; the tau protein level increased; the symptoms improved after the high-dose hormone shock therapy. At present, the understanding of CAA-RI is insufficient. There are few reports of related cases at home and abroad. Through the analysis of this case and the review of relevant literatures, this paper aims to improve clinicians' understanding on this disease, to make early diagnosis and treatment, and to improve the patients' prognosis.

    Secondary Pneumocystis jirovecii pneumonia in one non-HIV patient during recovery period of COVID-19

    Li Fei, Guo Lijuan, Wu Jingbo, Shi Xinjie
    2023, 29(20):  2937-2940.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.024
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    Pneumocystis jirovecii (PJ) is an opportunistic pathogen that can cause PJ pneumonia (PJP), which is common in human immunodeficiency virus (HIV) infected individuals. This paper reports a patient with COVID-19 and without underlying disease of HIV admitted to Department of Respiratory and Critical Care Medicine, Weihai Central Hospital, Qingdao University. The patient was improved after treatment but deteriorated during follow-up and was clearly diagnosed with PJP by the next-generation sequencing (NGS). This paper reviews the relevant literatures so as to provide some help for diagnosis and treatment of PJP.

    Nursing Research

    Effect of weight management based on protective motivation theory combined with grading activities for patients with chronic congestive heart failure

    Jin Qian, Wu Hongyan
    2023, 29(20):  2941-2946.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.025
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    Objective To analyze the effect of weight management based on protective motivation theory combined with grading activities for patients with chronic congestive heart failure. Methods From March 2019 to March 2021, 90 patients with chronic congestive heart failure hospitalized in Department of Cardiology, First People's Hospital of Lianyungang City were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 45 cases in each group. There were 27 males and 18 females in the control group; they were (62.37±3.15) years old. There were 31 males and 14 females in the study group; they were (62.54±3.40) years old. The control group took routine nursing and grading activities; in addition, the study group took the weight management based on the protective motivation theory. The levels of serum indicators, changes of echocardiogram indicators, weight management ability, and improvement of quality of life were compared between the two groups before and one month after the intervention. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to evaluate their quality of life. t and χ2 tests were applied. Results Before the intervention, there were no statistical differences in serum indicators, electrocardiogram indicators, weight management ability, and quality of life between the two groups (all P>0.05). One month after the intervention, the serum levels of N-terminal probrain natriuretic peptide (NT-proBNP) and galectin-3 in the study group were lower than those in the control group [(3.17±0.71) ng/L vs. (4.98±0.67) ng/L and (6.37±1.24) ng/L vs. (9.27±2.15) ng/L], with statistical differences (both P<0.05); the left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) in the study group were lower than those in the control group [(55.07±4.27) mm vs. (58.41±5.12) mm and (40.29±3.45) mm vs. (45.37±4.87) mm], with statistical differences (both P<0.05); the left ventricular ejection fraction (LVEF) in the study group was significantly higher than that in the control group [(52.19±7.67)% vs. (48.67.6.24)%], with a statistical difference (P<0.05); the scores of body weight measurement, knowledge, belief, and behavior of the weight management ability and the total score in the study group were better than those in the control group [(4.86±1.24) vs. (1.98±0.68), (3.98±2.18) vs. (2.25±1.17), (8.15±3.74) vs. (5.67±3.15), (9.99±4.87) vs. (6.49±3.04), and (26.98±12.03) vs. (16.39±8.04)], with statistical differences (all P<0.05); the scores of physical domain, emotional domain, and other domain of MLHFQ and the total score in the study group were lower than those in the control group [(13.08±3.74) vs. (16.48±5.37), (2.27±1.34) vs. (4.29±2.11), (9.67±2.18) vs. (11.04±3.16), and (25.02±7.26) vs. (31.81±10.64)], with statistical differences (all P<0.05). Conclusion The application of weight management combined with grading activities based on the protective motivation theory in patients with chronic congestive heart failure can improve their activity endurance, promote their recovery of cardiac function indicators, strengthen their attention to weight management, ensure the smooth treatment of diseases, and improve their prognosis.

    Effect of painless labor combined with music therapy on parturients in natural labor

    Wang Xiaoli, Duan Xiujun, Zhang Lijuan, Xu Yanli, Li Huanmin
    2023, 29(20):  2947-2950.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.026
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    Objective To observe the effect of painless labor combined with music therapy on women in natural labor. Methods A total of 88 parturients who were going to take natural delivery at Dongchangfu Maternal and Child Health Hospital from January to June 2022 were selected for the randomized controlled trial. They were divided into a reference group and a combination group by the random number table method, with 44 cases in each group. The reference group were (30.56±1.06) years old; there were 30 cases of first birth and 14 cases of second birth; the gestational weeks were (39.18±0.48) weeks. The combination group were (30.75±1.13) years old; there were 31 cases of first birth and 13 cases of second birth; the gestational weeks were (39.25±0.54) weeks. The control group traditionally delivered. The combination group received music therapy on the basis of the reference group. The scores of Visual Analogue Scale (VAS) and Hospital Anxiety and Depression Scale (HADS), the adverse events during the treatment, and the numbers transferred to cesarean section were compared between these two groups. t and χ2 tests were applied. Results The VAS scores of the 2 groups were lower 12 than 2 h after delivery (both P<0.05); the VAS score 12 h after delivery of the combination group was lower than that of the reference group (P<0.05). Before the intervention, there was no statistical difference in the HADS score between the two groups (P>0.05); the HADS scores of the two groups were lower after delivery than before the intervention (both P<0.05); the HADS score after delivery of the combination group was lower than that of the reference group (P<0.05). The incidence of adverse events in the reference group was 9.09% (4/44), and the incidence of adverse events in the combination group was 11.36% (5/44), with no statistical difference (P>0.05). Conclusion Painless labor combined with music therapy can relieve the pain and improve the negative emotions of parturients in natural labor, and is safe and reliable, so it is worthy of promotion.

    Application of meridian massage combined with auricular acupoint sticking in patients with sleep disorders

    Yu Lingling, Han Yanqiu, Xiao Yun
    2023, 29(20):  2951-2955.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.027
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    Objective To study the value applying meridian massage and auricular acupoint sticking in patients with sleep disorders. Methods A total of 82 patients receiving treatment in Outpatient Department of Traditional Chinese Medicine, Lianyungang Hospital of Traditional Chinese Medicine from December 2021 to December 2022 were selected for the randomized controlled trial. They were divided into a control group and a research group by the  random number table method, with 41 patients in each group. There were 20 males and 21 females in the control group; they were (39.87±12.32) years old. There were 18 males and 23 females in the research group; they were (40.02±12.35) years old. The control group received auricular acupoint sticking, while the research group received meridian massage and auricular acupoint sticking. The sleep indicators and sleep quality of the two groups were compared on the first day of treatment and when they were followed up for 4 weeks. χ2 and t tests were applied. Results When they were followed up for 4 weeks, the total sleep time, slow wave sleep time, sleep latency period, sleep efficiency, wake times, and wake time after sleep were improved in both groups, and those in the research group were better than those in the control group [(439.68±21.23) min vs. (426.23±20.13) min, (5.98±1.09) min vs. (5.49±1.03) min, (20.31±3.19) min vs. (21.89±3.20)min, (86.87±3.46)% vs. (84.96±3.26)%, (1.50±0.19) times vs. (1.62±0.23) times, and (5.46±1.39) min vs. (6.26±1.42) min], with statistical differences (t=2.908, 2.066, 2.212, 2.541, 2.544, and 2.546; all P<0.05); the scores of all dimensions and total score of Pittsburgh Sleep Quality Index (PSQI) were lower than those on the first day of treatment in both groups, and the scores of time getting into sleep, taking hypnotics, sleep time, sleep disorder, sleep quality, day time function, and sleep efficiency and the total score in the research group were lower than those in the control group [(1.79±0.23) vs. (1.92±0.29), (1.82±0.30) vs. (1.98±0.36), (1.82±0.16) vs. (1.91±0.19), (1.83±0.11) vs. (1.89±0.12), (1.69±0.29) vs. (1.86±0.31), (1.72±0.17) vs. (1.82±0.19), (1.79±0.14) vs. (1.86±0.16), and (11.46±3.28) vs. (13.24±3.26)], with statistical differences (t=2.221, 2.159, 2.292, 2.331, 2.533, 2.481, 2.082, and 2.434; all P<0.05). Conclusion Acupoint massage combined with auricular acupoint sticking can effectively improve the sleep quality of patients with sleep disorders, and the improvement degree is better than the simple use of auricular acupoint sticking.

    Application of predictive nursing intervention based on evidence-based medicine in patients with urinary tract infection after kidney transplantation

    Yang Zhihui, Suo Jingjun, Zhou Chuanchuan
    2023, 29(20):  2956-2960.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.028
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    Objective To explore the effect of predictive nursing intervention based on evidence-based medicine on urinary tract infection and emotional state of patients after kidney transplantation. Methods This is a prospective comparative experimental study. According to the admission order, 80 patients taking at Center for Kidney Transplantation and Diagnosis and Treatment of Kidney Diseases, Zhengzhou Seventh People's Hospital from January 2021 to December 2022 were divided a control group and an observation group, with 40 cases in each group. There were 24 males and 16 females in the control group; they were 22-64 (43.67±7.25) years old. There were 23 males and 17 females in the observation group; they were 25-67 (44.39±8.15) years old. The control group took routine nursing; in addition, the observation group took predictive nursing intervention based on evidence-based medicine. The psychological status [Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS)], quality of life [Quality of Life Scale for Patients of Renal Transplantation (QOL-RT)], satisfaction, catheter retention times, urination function, and incidences of complications were compared between the two groups. t and χ2 tests were used. Results The catheter retention time and urination function in the observation group were better than those in the control group [(6.87±1.33)d vs. (8.94±1.52)d and (2.01±0.31) vs. (1.54±0.32)], with statistical differences (t=6.482 and 6.672; both P<0.05). The total incidence of complications in the observation group was lower than that in the control group [10.00% (4/40) vs. 42.50% (17/40)], with a statistical difference (χ2=10.912, P<0.05). After the intervention, the scores of SDS, SAS, and QOL-RT in the observation group were better than those in the control group [(41.26±4.18) vs. (46.14±3.66), (37.81±5.69) vs. (44.87±4.38), and (94.67±8.45) vs. (87.64±7.34)], with statistical differences (t=5.555, 6.218, and 3.972; all P<0.05). The satisfaction of the observation group was higher than that of the control group [100.00% (40/40) vs. 80.00% (32/40)], with a statistical difference (χ2=6.806, P<0.05). Conclusion Predictive nursing intervention based on evidence-based medicine can reduce the risk of urinary tract infection in patients after kidney transplantation, improve their urination function, quality of life, and nursing satisfaction, and regulate their psychological state.

    Application of ERAS in patients taking laparoscopic colorectal cancer surgery and its effects on clincal indicators

    Li Yage, Yao Lingling
    2023, 29(20):  2961-2965.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.029
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    Objective To observe the value applying enhanced recovery after surgery (ERAS) in patients taking laparoscopic colorectal cancer surgery and its effect on the levels of interleukin (IL) -6 and tumor necrosis factor-α (TNF-α). Methods One hundred and twenty-one patients with colorectal cancer treated at Pingdingshan Second People's Hospital from June 2020 to December 2022 were selected for the randomized controlled trial. All the patients were treated with laparoscopy. The patients were divided into an ERAS group (61 cases) and a conventional group (60 cases) by the random number table method. There were 31 males and 30 females in the ERAS group; they were 55-75 (65.25±5.76) years old. There were 30 males and 30 females in the conventional group; they were 57-73 (66.18±5.24) years old). The conventional group took routine perioperative management to assist the surgery, and the ERAS group took ERAS management to assist the surgery. The changes in pain mediators and inflammatory reaction related indicators before and after the treatment, postoperative rehabilitation, and incidences of surgical related complications were compared between the two groups. χ2 and t tests were applied. Results Through different managements, the levels of 5-hydroxytryptamine (5-HT), substance P (SP), and β-endorphin (β-EP) after the surgery in the ERAS group were lower than those in the conventional group [(0.41±0.13) μmol/L vs. (0.85±0.27) μmol/L, (10.27±3.25) ng/L vs. (12.66±3.71) ng/L, and (46.25±10.16) ng/L vs. (51.12±10.46) ng/L], with statistical differences (t=11.450, 3.771, and 2.598; all P<0.05). The levels of IL-6, TNF-α, and IL-1β after the surgery in the ERAS group were lower than those in the conventional group [(14.62±5.13) ng/L vs. (17.76±5.26) ng/L, (48.45±10.25) ng/L vs. (52.65±10.36) ng/L, and (9.06±2.15) ng/L vs. (12.29±4.34) ng/L], with statistical differences (t=3.324, 2.242, and 5.200; all P<0.05). The time to recover exhaustion, time to eat, and time for first off-bed activity after the surgery and hospital stay in the ERAS group were shorter than those in the conventional group [(20.12±5.16) h vs. (23.11±5.41) h, (22.25±5.31) h vs. (25.62±5.44) h, (1.27±0.33) d vs. (2.41±0.75) d, and (8.41±2.32) d vs. (10.36±3.28) d], with statistical differences (t=3.111, 3.448, 10.852, and 3.781; all P<0.05). The incidence of postoperative complications related to surgery in the ERAS group was lower than that in the control group [4.92% (3/61) vs. 16.67% (10/60)], with a statistical difference (χ2=7.169, P<0.05). Conclusion The implementation of ERAS management strategy in the perioperative period of patients with colorectal cancer undergoing laparoscopy can effectively relieve their pain and reduce inflammatory reaction, and has positive significance in accelerating their postoperative rehabilitation process and reducing the risk of related complications.

    Floating acupuncture therapy combined with mind map for rehabilitation education in treatment of patients with knee osteoarthritis

    Feng Xiaojing, Liang Murong, Tang Yinglian, Luo Yanhui
    2023, 29(20):  2966-2971.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.030
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    Objective To design and make a mind map of rehabilitation education for patients with knee osteoarthritis (KOA), and to explore its application effect. Methods A total of 96 patients with KOA who were admitted to Lianzhou People's Hospital from January to October 2022 were selected for the randomized controlled trial. All of them received floating acupuncture therapy. They were divided into a reference group and a mind mapping group by the random number table method, with 48 cases in each group. There were 25 males and 23 females in the reference group; they were (58.82±3.71) years old. There were 27 males and 21 females in the mind mapping group; they were (58.34±3.54) years old. The control group took routine nursing. In the mind mapping group, a mind map research and design team was set up; the team preliminarily worked out the content of KOA's mind map for rehabilitation education through literature retrieval, drew the first draft of the mind map for rehabilitation education with the curtain software, determined the final draft of the mind map after the expert group meeting and verification, and implemented the intervention. The intervention time was 0-12 weeks. The differences of knee function [osteoarthritis index (WOMAC)], balance ability [Berg Balance Scale (BBS)], daily living ability [modified Barthel Index Scoring Scale], and self-efficacy between the two groups were compared. χ2 test was used. Results After 12 weeks' intervention, the scores of WOMAC of the observation group was significantly lower than that of the reference group [(17.68±3.06) vs. (21.50±5.42)], with a statistical difference (t=4.252, P<0.05); the scores of BBS, modified Barthel index, and self-efficacy of the mind mapping group were significantly higher than those in the reference group [(47.51±10.14) vs. (43.36±9.09), (90.50±14.10) vs. (83.20±14.94), and (3.99±0.63) vs. (3.72±0.68)], with statistical differences (t=-2.111, -2.462, and -2.018; all P<0.05). Conclusion The content of rehabilitation education model under mind map is objective and comprehensive, so it can be popularized in rehabilitation education for KOA patients.

    Effect of nursing measures of integrated Chinese and western medicine on self-care ability of patients after lung surgery

    Qiu Xueling, Tan Weilu, Chen Jingxin, Yang Chunxin
    2023, 29(20):  2971-2975.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.031
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    Objective To analyze the effect of nursing measures of integrated Chinese and western medicine on the self-care ability of patients after lung surgery. Methods Eighty patients who underwent lung surgery at First Hospital, Guangzhou Medical University between July and September 2022 were selected for the randomized controlled trial. The patients were divided into a control group and an experimental group by computer lottery, with 40 cases in each group. There were 19 males and 21 females in the control group; they were 27-75 (55.73±11.45) years old. There were 18 males and 22 females in the experimental group; they were 29-72 (53.75±10.85) years old. The control group received routine western nursing care, including pressure therapy, infrared lamp irradiation, and mechanical-assisted sputum drainage; in addition, the experimental group received integrative Chinese and western medicine nursing measures, including moxibustion and Chinese herbal hot compresses. The activities of daily living level (BADL Scoring Scale), pain scores (Numerical Rating Scale), and pressure injury risk (Braden Scoring Scale) of the two groups were compared on the day of surgery and the first and second day after surgery. t test was applied. Results The scores of activities of daily living level on the day of surgery and the first and second day after surgery in the experimental group were higher than those in the control group [(31.75±4.21) vs. (23.13±3.96), (78.88±3.45) vs. (68.13±3.79), and (98.50±1.26) vs. (91.50±2.38)], with statistical differences (t=9.432, 13.265, and 16.439; all P<0.05). The pain scores on the day of surgery and the first and second day after surgery in the experimental group were lower than those in the control group [(2.12±0.71) vs. (2.44±0.65), (1.98±0.42) vs. (2.28±0.53), and (1.07±0.38) vs. (1.53±0.44)], with statistical differences (t=2.102, 2.805, and 5.004; all P<0.05). The scores of pressure injury on the day of surgery and the first and second day after surgery in the experimental group were higher than those in the control group [(15.58±1.24) vs. (13.85±1.16), (18.93±1.53) vs. (17.60±1.48), and (22.30±0.62) vs. (20.45±1.35)], with statistical differences (t=6.443, 3.951, and 7.876; all P<0.05). Conclusion Nursing measures of integrated Chinese and western medicine for patients after lung surgery can significantly improve their self-care ability and reduce their pain and risk of pressure injury.

    Effect of dual-heart care model intervention on self-efficacy in patients with heart failure

    Zhong Yujuan, Wu Songjiong, Su Liuru, Xiao Dandan, Ye Lifang
    2023, 29(20):  2976-2980.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.032
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    Objective To observe the effect of dual heart care model intervention on self-efficacy in patients with heart failure. Methods A total of 96 patients with heart failure admitted to Department of Cardiovascular Medicine, Dongguan Liaobu Hospital from June 2021 to December 2022 were randomly divided into a control group and a study group, with 48 patients in each group. The control group included 28 males and 20 females, aged (68.81±4.12) years. The study group included 26 males and 22 females, aged (68.34±4.35) years. The control group received routine care for heart failure, and the study group received dual-heart care model intervention based on routine care, including emotional care and behavioral intervention. The cardiac function, psychological state, self-efficacy, daily living ability, and complications were compared between the two groups before and after nursing. Independent sample t test and χ2 test were used as statistical methods. Results After 6 months of nursing, the left ventricular ejection fraction (LVEF) and 6-minute walking distance (6MWD) of the study group were higher than those of the control group [(46.22±5.35)% vs. (43.71±5.63)%, (268.85±25.51) m vs. (253.44±23.68) m], the left ventricular end-systolic diameter (LVESD), Self-Rating Anxiety Scale score, and Self-Rating Depression Scale score were lower than those of the control group [(32.21±2.22) mm vs. (33.56±2.13) mm, (38.66±4.59) points vs. (41.28±4.75) points, (39.25±4.60) points vs. (41.93±4.87) points], and the scores of Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) were higher than those of the control group [(34.18±2.64) points vs. (32.83±2.57) points, (53.11±3.52) points vs. (51.35±3.61) points], with statistically significant differences (t=2.239, 3.067, 3.040, 2.748, 2.772, 2.539, and 2.418, all P<0.05). The proportion of self-confidence of the General Self Efficacy Scale (GSES) in the study group was higher than that in the control group [83.33% (40/48) vs. 62.50% (30/48)] (χ2=5.275, P=0.022). There was no statistically significant difference in the incidence of complications between the two groups [2.08% (1/48) vs. 8.33% (4/48)] (χ2=1.899, P=0.168). Conclusion Dual-heart care model intervention can promote the improvement of heart function in patients with heart failure to some extent, delay the disease progression, improve the psychological status, and enhance their self-efficacy and daily living ability.

    Investigation Report

    Analysis of occupational stress and occupational burnout of workers from an aluminum enterprise in Foshan

    Xu Na, Wu Yuqun, Yao Yan, He Fengping, Huang Yongshi
    2023, 29(20):  2981-2984.  DOI: 10.3760/cma.j.issn.1007-1245.2023.20.033
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    Objective To analyze the current situation and correlation of occupational stress and burnout in workers from an aluminum enterprise in Foshan, and to provide evidences for mental health intervention measures for occupational population. Methods The cluster sampling method was used to investigate the occupational stress (Effort-Reward Imbalance Model, ERI) and job burnout (Maslach Burnout Inventory-General Survey, MBI-GS) of the on-the-job workers in an aluminum enterprise in Foshan in 2020. Among them, 75.07% (274/365) were males and 24.93%(91/365) were females; 19.73% (72/365) were <30 years old, 36.99% (135/365) were 30-40 years old, and 43.29% (158/365) were ≥40 years old. The SPSS 20.0 software was used to analyze the status and influencing factors of occupational stress and burnout of the aluminum enterprise workers. χ2 test was used for the comparison between the groups. The influencing factors were analyzed by multiple logistic regression. The correlation between occupational stress and occupational burnout was analyzed. Results The detection rate of high occupational stress in the aluminum enterprise workers was 54.79% (200/365). The detection rate of high occupational stress in the workers with less than 10 working hours per day was higher than those in other groups (χ2=6.923, P<0.05). The detection rate of occupational burnout was 54.79% (200/365); the detection rate of occupational burnout was higher in the workers with college education and above (χ2=9.770, P<0.05). The occupational stress was related to occupational burnout (r=0.169, P<0.05). Conclusions The aluminum enterprise workers in Foshan has a high level of occupational stress and burnout. Workers with shorter working hours are more likely to have occupational stress; workers with higher education level are more likely to have occupational burnout; workers with occupational stress are more likely to have occupational burnout.