Table of Content

15 December 2023, Volume 29 Issue 24

Previous Issue   

New Medical Advances

High frequency ultrasound characteristics of postpartum diastasis recti abdominis and its correlation with delivery mode

Luo Si, He Junchu, Liang Yinru, Li Zhenzhou

2023, 29(24):  3529-3532.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.001

Asbtract ( )  

References | Related Articles | Metrics

In this paper, we reviewed the current research status of the high-frequency ultrasound features of postpartum diastasis recti abdominis and its correlation with delivery methods. It focuses on exploring the relationship between delivery methods and high-frequency ultrasound features of postpartum diastasis recti abdominis. We have discovered the widespread application of the high-frequency ultrasound technology in the evaluation of postpartum diastasis recti abdominis. Its high-frequency ultrasound features are of great significance for accurate evaluation and monitoring of postpartum diastasis recti abdominis. We have summarized that delivery methods have impact on the high-frequency ultrasound features of postpartum diastasis recti abdominis.

Research progress of NLRP3 inflammasome in pathogenesis of diabetic nephropathy

Li Mengjie, Liang Dong, Xing Wenhua, Lin Qianyu, Zhang Hui, Zhang Xiaomin

2023, 29(24):  3532-3537.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.002

Asbtract ( )  

References | Related Articles | Metrics

Diabetic nephropathy (DN) is one of the most common and serious complications of diabetes and is associated with increased mortality in patients with diabetes. Inflammation is an important part of the development of DN. Nucleotide-binding oligomerizing domain-like receptor protein 3 (NLRP3) inflammasome is the most deeply studied inflammasome in recent years, and its abnormal activation has also been shown to be positively correlated with the progression of DN. This article mainly reviews the pathogenesis and research progress of NLRP3 inflammasome in DN.

Research progress of iodine contrast agent examination in patients with type 2 diabetes mellitus taking metformin

Qi Yanzhi, Wu Yanping

2023, 29(24):  3537-3541.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.003

Asbtract ( )  

References | Related Articles | Metrics

At present, metformin and iodine contrast agent are widely used in clinic. Due to the risk of acute renal injury induced by contrast medium, patients with type 2 diabetes mellitus (T2DM) are often prohibited or postponed the examination and treatment by iodine contrast agent, resulting in misdiagnosis or delay of treatment and indirect damage to patients. Therefore, how to safely and standardizedly use iodine contrast medium in patients with T2DM has been the focus of clinical attention. By analyzing the clinical research and related guidelines of metformin and iodine contrast agent, this paper discusses the safety of metformin and iodine contrast agent, in order to provide references for clinicians.

Leukocyte-associated immunoglobulin-like receptor 1 in diabetes

Yang Lingyu, Jin Yongjun

2023, 29(24):  3542-3545.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.004

Asbtract ( )  

References | Related Articles | Metrics

Leukocyte-associated immunoglobulin-like receptor-1 (LAIR-1) is an immune inhibitory receptor that mediates immune suppression. It can affect the occurrence and development of various metabolic and immune diseases by regulating inflammatory responses. Type 2 diabetes mellitus is the most common form of disease that leads to insulin production defects. It is now recognized that the inflammatory response is a result of immune response to high blood glucose levels. This low-grade chronic inflammation damages the beta cells of the pancreas and leads to insufficient insulin secretion, resulting in high blood glucose. This review elaborates on the mechanism of inflammation in type 2 diabetes mellitus and the impact of LAIR-1 on its development.

New progress in targeted therapy for atopic dermatitis

Fang Xiangfang, Huang Yujie, Li Yanfeng, Wang Zhongyong

2023, 29(24):  3546-3550.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.005

Asbtract ( )  

References | Related Articles | Metrics

Atopic dermatitis is a common chronic, recurrent, and inflammatory skin disease, and seriously affects children's growth and development and adults' quality of life. Traditional therapeutic drugs often have many limitations and are not effective for patients with moderate to severe atopic dermatitis. In recent years, the emergence of new targeted drugs such as biologicals and small molecule inhibitors has brought good news to patients with moderate to severe atopic dermatitis.

Lung Diseases

Therapeutic effect of antolini hydrochloride combined with docetaxel for elderly patients with NSCLC who took TP/PDL1 targeted chemotherapy and failed

Bai Xiaohang, Chang Zhendong, Mu Yanyan

2023, 29(24):  3551-3556.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.006

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical efficacy and safety of antolini hydrochloride combined with docetaxel for elderly patients with non-small cell lung cancer (NSCLC) who took paclitaxel, cisplatin, and toralizumab combination regimen (TP/PD-L1) and failed. Methods　The elderly patients with NSCLC who who took TP/PD-L1 and failed at Nanyang Central Hospital from January 2019 to January 2022 were prospectively selected and divided into control a group (46 cases) and an experimental group (47 cases) by the random number table method. There were 20 males and 26 females in the control group; they were (68.50±0.81) years old. There were 22 males and 25 females in the experimental group; they were (68.97±0.77) years old. All the patients were given dexamethasone acetate tablets before formal salvage 1.0 mg/time, 2 times/day, for 3 days, and withdrawn; 500 ml 0.9% NaCl was infused as hydration treatment before the formal chemotherapy administration. The control group intravenously dripped docetaxel 80 mg/m² for more than 1 h, once a day, for 21 d; 21 d was set as a treatment cycle. In addition, the experimental group orally took antolini hydrochloride 0.15 mg·kg^-1 in the early morning, 1 time/d, and stopped 7 d after every 14 d; 21 d was set as a treatment cycle. Both groups were treated for 4 cycles and followed up 1 year. The clinical efficacies, peripheral blood CD4⁺/CD8⁺ T lymphocyte subpopulation distribution, and incidences of adverse drug reaction rates were compared between the two groups by t and χ² tests. The Kaplan-Meier survival curves were plotted at 1 year to compare the difference in progression-free survival between the two groups. Results　A total of 97 cases were screened for enrollment in this project, and 4 cases were withdrawn due to lost visit and initiative quitting, and a total of 93 cases were successfully enrolled, including 46 cases in the control group and 47 cases in the experimental group. After the treatment, the objective remission rates were 57.45% (27/47) and 34.78% (16/46) and the disease control rates were 78.72% (37/47) and 58.70% (27/46) in the experimental group and the control group, respectively, with statistical differences (both P<0.05). There were statistical differences in the CD4⁺, CD8⁺, and CD4⁺/CD8⁺ between the experimental group and the control group [(587.69±13.98)/μl vs. (369.06±10.85) /μl, (401.71±8.51)/μl vs. (477.71±9.53)/μl, and (1.49±0.04) vs. (0.79±0.03); all P<0.05]. The median progression-free survival times were 9.9 months [HR=1.493 (95%CI 0.837-2.664)] and 8.8 months [HR=1.120 (95%CI 0.622-2.017)] in the experimental group and the control group, respectively, with a statistical difference (P<0.05). The adverse reactions found in both groups included myelosuppression, fever, impaired gastrointestinal function, nausea, and skin allergy; the incidences of adverse drug reactions in the experimental group and the control group were 36.17% (17/47) and 34.78% (16/46), respectively, with no statistical difference (P>0.05). Conclusion　Antolini hydrochloride combined with docetaxel is clinically effective and safe in the treatment of elderly patients with NSCLC who take TP/PD-L1 targeted chemotherapy and fail, and can significantly improve the ratio of CD4+/CD8+ T lymphocyte subpopulations in peripheral blood and their median survival time.

Effects of acetylcysteine combined with budesonide atomization on lung function and airway inflammation in patients with AECOPD

Xin Yanan, Lyu Xin, Liang Fang, Li Wei, Yang Qiaofeng

2023, 29(24):  3556-3561.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.007

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the effects of acetylcysteine combined with budesonide atomization on lung function and airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods　A total of 89 patients with AECOPD admitted to Liaocheng Third People's Hospital from February 2020 to February 2023 were selected and divided into an observation group (45 cases) and a control group (44 cases) by the envelope method. There were 24 males and 20 females in the control group; they were (58.69±3.64) years old. There were 25 males and 20 females in the observation group; they were (58.74±3.62) years old. The control group received conventional treatment; in addition, the observation group took acetylcysteine and budesonide atomization. The therapeutic effects, lung function [the forced expiratory volume in first second (FEV1), peak rate of expiration flow (PEF), forced vital capacity (FVC), and FEV1/FVC], blood gas indicators [oxygen partial pressure (PaO₂), blood oxygen saturation (SpO₂), and CO₂ partial pressure (PaCO₂)], serum levels of fetuin-A, retinol binding protein 4 (RBP4), and adiponection (APN), and incidences of adverse reactions were compared between the two groups. t and χ² tests were applied. Results　After the treatment, the total effective rate of the observation group was higher than that of the control group [97.78% (44/45) vs. 81.82% (36/44)], with a statistical difference (P<0.05). After the treatment, the FEV1, PEF, FVC, FEV1/FVC increased in both groups; those in the observation group were higher than those in the control group [(1.42±0.15)L vs. (1.26±0.13)L, (3.06±0.75)L/s vs. (2.60±0.78)L/s, (1.43±0.21)L vs. (1.26±0.19)L, and (64.52±3.64)% vs.(62.37±3.67)%; all P<0.05]. After the treatment, the PaO₂ and SpO₂ increased and PaCO₂ decreased in both group, and those in the observation group were better than those in the control group (all P<0.05). After the treatment, the level of fetuin-A increased in both groups; the level in the observation group was higher than that in the control group [(408.54±40.83) mg/L vs. (390.44±37.39) mg/L; P<0.05]. After the treatment, the levels of RBP4 and APN of the two groups decreased; the levels in the observation group were lower than those in the control group [(54.63±14.24) mg/L vs. (61.43±14.63) mg/L and (8.44±2.07) μg/L vs. (9.45±2.16) μg/L; both P<0.05]. There was no statistical difference in the total incidence of rash, laryngeal irritation, nausea and vomiting, and headache between the two groups (P>0.05). Conclusion　The combination of acetylcysteine and budesonide atomization for patients with AECOPD is effective, and can significantly improve their pulmonary function and blood gas indicators, and better control their airway inflammation.

Effect of advanced analgesia in improvement of respiratory function and stress state in patients taking thoracoscopic radical resection of lung cancer

Wang Wenyan, Zhang Peizhong

2023, 29(24):  3561-3565.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.008

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effect of advanced analgesia in the improvement of respiratory function and stress state in patients taking thoracoscopic radical resection of lung cancer. Methods　One hundred and twenty-six patients who underwent radical lung cancer surgery at First Hospital, Nanyang Medical College from January 2021 to December 2022 were selected as the study objects. The patients were divided into a conventional group (63 cases) and an experimental group (63 cases) by the computer randomization method. There were 40 males and 23 females in the conventional group; they were (55.18±5.27) years old. There were 43 males and 20 females in the experimental group; they were (56.35±5.22) years old. The conventional group received routine anesthesia and analgesic intervention, while the experimental group received advanced analgesic technology assisted anesthesia. The analgesic effects and respiratory function and stress response before and after the surgery were compared between the two groups. χ² and t tests were applied. Results　The scores of Visual Analogue Scale (VAS) 3, 6, and 12 h after the surgery in the experimental grop were lower than those in the conventional group [(4.24±1.35) vs. (5.31±1.47), (3.71±0.26) vs. (4.42±1.25), and (2.88±0.24) vs. (3.35±0.27)], with statistical differences (all P<0.05). The number using postoperative patient-controlled analgesia pump (PCIA), time staying in the anesthesia recovery room (PACU), and PCIA discontinuation time in the experimental group were shorter than those in the conventional group [(2.28±0.36) times/h vs. (4.24±1.33) times/h, (85.45±10.24) min vs. (93.36±10.27) min, and (20.35±5.41) h vs. (23.39±5.18) h], with statistical differences (all P<0.05). Before the surgery, there were no statistical difference in respiratory function and stress response between the two groups (all P>0.05); after the surgery, the respiratory rate (RR), peak expiratory flow rate (PEF), and forced expiratory volume in the first second (FEV1) in the experimental group were higher than those in the conventional group [(16.44±5.14) beats/min vs. (13.31±5.22) beats/min, (472.55±50.69) L/min vs. (433.75±50.58) L/min, and (81.15±10.36)% vs. (75.33±10.27)%], with statistical differences (all P<0.05). After the surgery, the levels of norepinephrine (NE) and cortisol (Cor) in the experimental group were lower than those in the conventional group [(170.33±20.46) ng/L vs. (185.33±20.72) ng/L and (231.45±30.61) μg/L vs. (252.45±30.63) μg/L], and the superoxide dismutase (SOD) level was and higher than that in the conventional group [(275.25±50.66) U/ml vs. (231.45±50.33) U/ml], with statistical differences (all P<0.05). Conclusion　The implementation of advanced analgesia technology in the anesthesia for patients taking lung cancer radical surgery can effectively enhance the analgesic effect, and has positive significance in improving their respiratory function and reducing their stress response.

Effect of a low dose of dopamine on rehabilitation process of patients with severe pneumonia

Jiang Ning, Li Jing

2023, 29(24):  3566-3570.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.009

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the effect of a low dose of dopamine on rehabilitation process of patients with severe pneumonia. Methods　Ninety patients with severe pneumonia treated at Nanyang First People's Hospital from October 2020 to October 2022 were selected for the randomized controlled trial, and were divided into a conventional group (45 cases) and an experimental group (45 cases) by the computer random method. There were 30 males and 15 females in the conventional group; they were (67.52±5.23) years old. There were 31 males and 14 females in the experimental group; they were (66.21±5.31) years old. The conventional group took conventional treatment; in addition, the experimental group took low-dose dopamine adjuvant treatment (the dopamine was added to 50 ml 5% glucose solution at 1-3 μg/kg for intravenous dripping 24 h/time). The inflammatory factors, lung function improvement, rehabilitation progresses, and prognosis after the treatment were compared between the two groups. χ² and t tests were applied. Results　Before the treatment, there were no statistical differences in the levels of serum inflammatory factors between the two groups (all P>0.05); after the treatment, the white blood cell count (WBC) and relative expression levels of Toll like receptors 2 (TLR2) and 4 (TLR4) in the experimental group were lower than those in the conventional group[(5.25±1.41)×10⁹/L vs. (6.65±2.14)×10⁹/L, (30.13±5.24) vs. (33.19±5.23), and (32.45±5.41) vs. (35.15±5.26)], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the cardiopulmonary function indicators between the two groups (all P>0.05); after the treatment, the forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and peak rate of expiration flow (PEF) in the experimental group were higher than those in the conventional group [(84.45±10.21)% vs. (78.44±10.31)%, (2.88±0.46)L vs. (2.24±0.35)L, and (482.45±50.63) L/min vs. (445.23±50.16) L/min], with statistical differences (all P<0.05). The cough disappearance time, fever relief time, dyspnea improvement time, lung rale disappearance time, and hospital stay in the experimental group were shorter than those in the conventional group [(4.45±1.23) d vs. (5.66±2.08) d, (3.26±0.72)d vs. (4.24±1.06) d, (2.45±0.46) d vs. (3.06±0.72) d, (2.58±0.26) d vs. (3.11±0.63) d, and (14.42±3.39) d vs. (17.72±4.39) d], with statistical differences (all P<0.05). The incidence of complications in the experimental group was lower than that in the conventional group [8.89% (4/45) vs. 22.22% (10/45)], with a statistical difference (P<0.05). The incidence of drug-related adverse reactions in the experimental group was 13.33% (6/45), and that in the conventional group was  11.11% (5/45), with no statistical difference (P>0.05). Conclusion　Low-dose dopamine can effectively alleviate the inflammatory reaction in patients with severe pneumonia, and is of positive significance in promoting their recovery of lung function, speeding up the recovery process, and reducing the incidence of complications. Moreover, this drug is safe and does not significantly increase the risk of adverse drug reactions.

Thyroid Diseases

Value of routine ultrasound combined with serum thyroglobulin antibody level in diagnosis of Hashimoto's thyroiditis

Zhao Changqian, Xie Li, Zhang Min, Guo Jinhong

2023, 29(24):  3571-3575.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.010

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the value of routine ultrasound combined with serum thyroglobulin antibody (TGAb) level in the diagnosis of Hashimoto's thyroiditis. Methods　A total of 86 patients with suspected Hashimoto's thyroiditis admitted to Liaocheng Third People's Hospital from March 2021 to October 2022 were selected, including 40 males and 46 females who were (41.67±3.35) years old, and the pathological diagnosis results were statistically analyzed (67 cases were pathologically diagnosed as Hashimoto's thyroiditis, and 19 cases non-Hashimoto thyroiditis). According to the pathological diagnosis results, they were divided into a Hashimoto's thyroiditis group and a non-Hashimoto's thyroiditis group. The routine ultrasound diagnosis of Hashimoto's thyroiditis was performed in both groups. The serum TGAb levels of the patients were detected. The diagnostic efficacies of routine ultrasound, serum TGAb level, and the combination in the diagnosis of Hashimoto's thyroiditis were compared. Multivariate logistic regression analysis was performed to analyze the diagnostic values of TGAb level and leopard pattern for Hashimoto's thyroiditis by receiver operating characteristic curve (ROC). Results　The leopard pattern in routine ultrasound and TGAb level in the Hashimoto's thyroiditis group were higher than those in the non-Hashimoto's thyroiditis group [53.73% (36/67) vs. 26.32% (5/19) and (83.25±8.14) IU/ml vs. (46.34±6.27) IU/ml; both P<0.05]. The multivariate analysis results showed that the TGAb level was correlated with the diagnosis of Hashimoto's thyroiditis (OR=3.615, P<0.05). The areas under the curves (AUC) of the routine ultrasound, TGAb level, and combination in the diagnosis of Hashimoto's thyroiditis were 0.756, 0.706, and 0.838; the specificities were 57.9%, 63.2%, and 84.2%; the sensitivities were 86.6%, 71.6%, and 89.6%. The diagnostic efficacy of the combination was better than those of the single examinations. Conclusion　conventional ultrasound and serum TGAb level both have certain value in the diagnosis of Hashimoto's thyroiditis, but the combination has higher diagnostic value, and can provide reliable basis for the clinical diagnosis.

Correlation between expressions of microRNAs in peripheral blood and levels of thyroid hormones and its predictive effect on thyroid dysfunction

Zhu Linqing

2023, 29(24):  3575-3579.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.011

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the correlation between the expressions of micro ribonucleic acid (miRNA) in peripheral blood and the levels of thyroid hormones, and to predict thyroid dysfunction. Methods　One hundred and twenty-six patients with thyroid dysfunction who were treated in Hospital of Traditional Chinese Medicine Affiliated to Nanyang Medical College from January 2021 to December 2022 were selected as the research objects. According to the different levels of thyroid hormones, the patients were divided into a hyperthyroidism group (60 cases), including 35 males and 25 females who were (55.25±5.61) years old, and a hypothyroidism group (66 cases), including 36 males and 30 females who were (56.16±5.28) years old. The levels of thyroid hormones and the relative expressions of miRNA-192 and miRNA-21 in peripheral blood were compared between the two groups. Spearman correlation analysis was used to analyze the correlation between the relative expressions of miRNAs and the levels of thyroid hormones. The predictive efficacy of miRNA expression on thyroid dysfunction was verified by drawing receiver operating characteristic curves (ROC). χ² and t tests were applied. Results　The levels of thyroid-stimulating hormone (TSH), free thyroid hormones 3 (FT3), FT4, total thyroid triiodothyronine 3 (TT3), and total thyroxine (TT4) in the hyperthyroidism group were (1.25±0.16) mU/L, (12.44±4.28) pmol/L, (25.35±10.46) pmol/L, (6.62±2.41) nmol/L, and (182.44±50.47) nmol/L, and those in the hypothyroidism group were (4.86±1.33) mU/L, (5.16±1.44) pmol/L, (17.44±5.49) pmol/L, (2.25±0.46) nmol/L, and (121.44±50.72) nmol/L], with statistical differences (t=20.880, 13.035, 5.383, 14.450, and 6.758; all P<0.05). The relative expression of miRNA-192 in the hyperthyroidism group was lower than that in the hypothyroidism group [(0.34±0.11) vs. (0.92±0.45)], while the relative expression of miRNA-21 was higher than that in the hypothyroidism group [(0.61±0.23) vs. (0.22±0.07)], with statistical differences (t=9.720 and 13.128; both P<0.05). The Spearman correlation analysis showed that miRNA-192 was positively correlated with TSH and negatively with FT3, FT4, TT3, and TT4; miRNA-21 was negatively correlated with TSH and positively with FT3, FT4, TT3, and TT4. According to the ROC validation, the relative expression of miRNA-192 decreased, as the TSH decreased and the FT3, FT4, TT3, and TT4 increased; the relative expression of miRNA-21 increased, as the TSH decreased and the FT3, FT4, TT3, and TT4 increased. Conclusion　The relative expression of miRNA in peripheral blood is closely related to the changes of thyroid hormone levels, which has a high predictive effect for hyperthyroidism or hypothyroidism.

Liver-spleen-kidney co-regulation with self-made Xiaoying Decoction in differential treatment of patients with Hashimoto's thyroiditis

Zhou Liangjun

2023, 29(24):  3580-3584.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.012

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical effect of liver-spleen-kidney co-regulation with self-made Xiaoying Decoction in the differential treatment of patients with Hashimoto's thyroiditis (HT). Methods　This is a prospective study. Ninety patients with HT admitted to Tai'an Hospital of Traditional Chinese Medicine between September 2020 and June 2022 were selected. They were divided into a control group and an observation group the random number table method, with 45 cases in each group. In the control group, there were 4 males and 41 females; they were (46.98±2.23) years old. In the observation group, there were 5 males and 40 females; they were (47.62±2.35) years old. Both groups took routine western medicine (orally too levothyroxine sodium tablets); in addition, the observation group took self-made Xiaoying Decoction. Both groups were treated for 12 weeks continuously. The clinical curative effects after the treatment, the levels of thyroid function indicators [free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH)], thyroid antibodies [thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)], and serum inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10)] before and after the treatment, and adverse reactions during the treatment were compared between the two groups. χ² test, Fisher exact probability test, and t test were used for the statistical comparisons. Results　After the treatment, the total clinical response rate of the observation group was higher than that of the control group [88.89% (40/45) vs. 71.11% (32/45)], with a statistical difference (χ²=4.444, P=0.035). After the treatment, the levels of serum TSH, TgAb, and TPOAb in the observation group were lower than those in the control group, and, [(1.76±0.22) mIU/L vs. (2.39±0.33) mIU/L, (237.62±48.47) IU/ml vs. (326.97±46.23) IU/ml, and (218.28±36.09) IU/ml vs. (302.54±40.20) IU/ml], with statistical differences (t=10.865, 8.949, and 10.463; all P<0.05). After the treatment, the level of serum IL-10 in the observation group was higher than that in the control group [(94.36±10.36) ng/L vs. (84.86±10.37) ng/L], while the levels of serum IL-6 and TNF-α were lower than those in the control group [(8.14±1.26) ng/L vs. (10.21±1.26) ng/L and (84.20±11.95) ng/L vs. (104.37±11.13) ng/L], with statistical differences (t=4.348, 7.802, and 8.280; all P<0.05). There was no statistical difference in the total incidence of adverse reactions during the treatment between the two groups (P=0.677). Conclusion　The liver-spleen-kidney co-regulation with self-made Xiaoying Decoction for patients with HT can effectively improve their thyroid function, reduce the levels of thyroid antibodies, and inhibit their inflammation response, with good safety during treatment.

Effect of evidence-based theory of operation room responsibility nursing for patients taking thyroid surgery

Xu Yingying, Cui Yingying

2023, 29(24):  3585-3589.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.013

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the effect of evidence-based theory of operation room responsibility nursing for patients taking thyroid surgery. Methods　One hundred and seven patients undergoing thyroid surgery in Zhumadian Central Hospital from June 2021 to September 2022 were selected for the randomized controlled trial, and were divided into an observation group (54 cases) and a reference group (53 cases) by the random number table method. There were 32 males and 21 females in the reference group; they were 26-63 years old. There were 33 males and 21 females in the observation group; they were 25-62 years old. The reference group took traditional nursing intervention; in addition, the observation group took evidence-based nursing intervention under the operation room responsibility system. The satisfaction with nursing services, pain levels, vital signs, incidences of complications, and psychological statuses [Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)], quality of life (WHOQOL BREF), and comfort (GCQ) before and after the intervention were compared between the two groups. χ² and t tests were applied. Results　After the intervention, the satisfaction rate of nursing services in the observation group was higher than that in the reference group [98.15% (53/54) vs. 81.13% (43/53)], with a statistical difference (χ²=8.397, P<0.05). After the intervention, the total incidence of complications in the observation group was lower than that in the reference group [1.85% (1/54) vs. 15.09% (8/53)] with a statistical difference (χ²=4.491, P<0.05). After the intervention, the diastolic blood pressure, systolic blood pressure, and heart rate in the observation group were lower than those in the reference group [(72.71±4.54) mmHg (1 mmHg=0.133 kPa) vs. (79.58±5.31) mmHg, (121.86±5.61) mmHg vs. (132.81±7.07) mmHg, and (79.14±3.73) beats/min vs. (91.21±4.37) beats/min], with statistical differences (t=7.198, 8.883, and 15.377; all P<0.05). After the intervention, the scores of HAMA, HAMD, and VAS in the observation group were lower than those in the reference group, while the scores of WHOQOL-BREF and GCQ in the observation group were higher than those in the reference group [(32.18±1.78) vs. (39.68±2.27), (42.33±2.89) vs. (48.18±3.41), (4.58±0.28) vs. (6.13±0.17), (99.79±6.67) vs. (90.51±7.93), and (96.65±9.25) vs. (88.95±9.74)], with statistical differences (t=19.038, 9.580, 34.533, 6.556, and 4.194, all P<0.05). Conclusion　The application of evidence-based theory in operation room responsibility nursing for patients undergoing thyroid surgery during the perioperative period can reduce their pain, improve their comfort, nursing service satisfaction, psychological status, and quality of life, and stabilize their vital signs.

Meta Analysis

Sequential therapy combined with probiotics for helicobacter pylori: a meta-analysis

Xie Jiaxin, Diao Dechang, Wei Lin, Liu Yangchen, Tan Ping, You Jiuhong, Long Lifang, Xie Xiangqi, Zhu Xinxin, Lin Meizhen

2023, 29(24):  3590-3598.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.014

Asbtract ( )  

References | Related Articles | Metrics

Objective　To systematically evaluate the efficacy and safety of sequential therapy combined with probiotics in the treatment of Helicobacter pylori (Hp) infection. Methods　The randomized controlled trials of sequential therapy combined with probiotics in the treatment of Hp infection were retrieved from the establishment to June 20, 2022. The literatures were screened according to the inclusion criteria. The modified Jadad scale was used to evaluate the bias risk. The RevMan5.3 software was used for the statistics and analysis. Results　A total of 22 randomized controlled trials involving 3 158 patients were included. Meta-analysis results showed that the total negative conversion rate (OR=3.99, 95%CI 3.10-5.14, P < 0.001), effective rate (OR=4.98, 95%CI 3.57-6.94, P<0.001), recurrence rate (OR=0.20, 95%CI 0.07-0.56, P=0.002), symptom score (OR=-1.41, 95%CI -1.51--1.31, P<0.001 ), and incidence of adverse reactions (OR=0.28, 95%CI 0.21-0.36, P<0.001) of sequential therapy combined with probiotics in the treatment of Hp infection were better than those of the control group. Conclusion　The negative conversion rate and effective rate of sequential therapy combined with probiotics in the treatment of Hp infection are higher than those of the simple sequential therapy, and the symptom score, recurrence rate, and incidence of adverse reactions are lower.

Scientific Research

Tuberculosis epidemic characteristics of students at Panyu District, Guangzhou from 2013 to 2022

Wu Jiating, Yang Yanjun, Wu Shaomin, Huang Yunshi

2023, 29(24):  3599-3604.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.015

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the characteristics of tuberculosis epidemic in students at Panyu District, Guangzhou from 2013 to 2022, and to provide references for the formulation of comprehensive prevention and treatment measures. Methods　The tuberculosis epidemic data at Panyu District, Guangzhou was collected from the "Chinese Disease Prevention and Control Information System - Monitoring and Reporting Management System" and analyzed in combination with the demographic data. SPSS 25.0 was used for the statistical analysis. χ² test was used to compare the differences between the categorical variables. Results　From 2013 to 2022, a total of 953 cases of pulmonary tuberculosis were reported at Panyu District, with an average annual student reporting rate of 21.10/100 000, with the highest reported incidence in 2017 and the lowest in 2022. There were 422 positive cases of pulmonary tuberculosis, and the average annual student reporting rate was 3.34/100 000. The number of active tuberculosis cases was higher in the males than in the females, with a male to female ratio of 1.55∶1; the total numbers of cases reported in different levels of schools were 562 cases (58.97%) in the universities or colleges, 175 cases (18.36%) in the high schools, 169 cases (17.73%) in the vocational and technical schools, 34 cases (3.57%) in the junior high schools, and 13 cases (1.36%) in the primary schools. The numbers of cases in both male and female students were the largest in the universities or colleges; there was a statistical difference in the proportion of male and female students in the total number of cases between different levels of schools (χ²=20.289, P<0.001). They were (19.50±2.98) years old; the youngest was 7 years old; the maximum was 32 years old; it began to rise significantly at 15 years old, and dropped to single digits at 27 years old; it showed an M-shaped situation in the 15-26 years old; it reached the first peak at 18 years old, and reached the second peak at 21 years old; the 16-23 years old people accounted for 88.98% (848/953) of the total reports. There were more than 100 cases reported in 4 months, with the highest number of cases reported in April (124 cases), followed by December (113 cases), March (103 cases), and September (103 cases); relatively fewer cases were reported in February and July. 47.53% (453/953) of the cases came from 12 universities or colleges in Guangzhou University Town, and the average annual incidence rate of each university was statistically significant (χ²=56.720, P<0.001); the highest of which was 40.1/100 00 (131/3.263 7) at Guangdong University of Technology, and the lowest was 8.32/100 000 (4/0.481 0) at Xinghai Conservatory of Music. Conclusions　After 2017, the overall epidemic of tuberculosis among students at Panyu District, Guangzhou showed a downward trend. Iniversity students are the key group for prevention and control. It is necessary to carry out active surveillance while focusing on the tuberculosis knowledge education of male students in universities and vocational and technical schools.

Effect of Ziwu Liuzhu TEAS on pregnancy rate in obese women with polycystic ovary syndrome

Huang Cuiyu, Su Nianjun, Zhang Bing, Wang Songlu, Liao Liujun, He Biyu, Zhao Chunmei, Pan Biqi, Zhang Xiqian, Liu Fenghua

2023, 29(24):  3604-3610.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.016

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of letrozole combined with Ziwu Liuzhu transcutaneous electrical acupoint stimulation (ZLT) on the rate of ovulation induced pregnancy in obese patients with polycystic ovary syndrome (PCOS). Methods　Two hundred and ninety-five 20-40 years old patients with PCOS, a body mass index (BMI) ≥24 kg/m² and/or a waist circumference≥ 80 cm, and at least one unobstucted fallopian tube who were treated at Guangdong Women and Children Hospital were selected for the cohort study. The patients' baseline conditions before ovulation induction were collected. According to the patients' actual conditions, they were divided into 2 groups. The patients who were willing to take ZLT were set as a ZLT group; on the fifth day of menstruation, they started to orally take 2.5 mg letrozole per day for 5 days, and took ZLT 2-3 times per week, 30 min per time, for 5 cycles. The patients who did not wish to took ZLT were set as a control group; on the fifth day of menstruation, they started to orally administer 2.5 mg letrozole per day for 5 days. The pregnancy status in both groups was collected. Multivariate COX regression analysis and sensitivity analysis of propensity score matching (PSM) were performed for the two groups after multiple interpolation. Results　A total of 295 obese patients with PCOS were enrolled, including 45 cases (56 cycles) in the ZLT group and 250 cases (373 cycles) in the control group. There were no statistical differences in the baseline data between the two groups. The anovulatory cycle rate was 3.57% (2/56) in the ZLT group, and was 1.88% (7/373) in the control group, with no statistical difference between the two groups (P>0.05). The multi-follicle growth cycle rate was 0 in the ZLT group, and was 0.80% (3/373) in the control group, with no statistical difference between the two groups (P>0.05). The COX multi-factor analysis showed that after adjusting BMI and antral follicle count (AFC), the adjusted HR=2.03 (95%CI 1.08-3.81), P=0.027. After the multiple interpolation of the 3 sets of data, the COX multi-factor analysis showed that after adjusting BMI and AFC, the adjusted HR=2.04 (95%CI 1.42-2.93), P<0.001. According to the BMI, the patients were divided into an overweight group and an obese group for subgroup analysis, and found that the pregnancy rates of the control group and the ZLT group in the overweight group were 20.2% and 26.9%, and the adjusted HR=1.32 (95%CI 0.58-3.03), P=0.509; the pregnancy rates of the control group and ZLT group in the obese group were 11.1% and 31.6%, and the adjusted HR=3.93 (95%CI 1.31-11.72), P=0.014; the interaction P=0.171. The caliper values of BMI and AFC were set as 0.2 and 1.0; the propensity score matching was performed at 1∶1, and the adjusted HR=1.99 (95%CI 1.06-3.73), P=0.031. Conclusion　Ledrazole combined with ZLT can increase the ovulation induction pregnancy rate of obese patients with PCOS by 1 times, and by 3 times in the obese group.

Effect of transcutaneous acupoint electrical stimulation combined with epidural labor analgesia on postpartum depression in women taking vaginal delivery after cesarean section

He Xiuling, Feng Yanqin, Luo Manyun, Duan Dongmei, Lin Meizhi, Zou Wenxia

2023, 29(24):  3611-3616.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.017

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of transcutaneous acupoint electrical stimulation combined with epidural labor analgesia in promoting vaginal delivery after cesarean section and preventing postpartum depression. Methods　A total of 120 women who took vaginal delivery after cesarean section and underwent prenatal examination and delivery in Guangdong Women and Children's Hospital from October 2021 to October 2022 and required labor analgesia were selected and divided into a control group and an observation group by the random number table method, with 60 cases in each group. The control group were 32 (30, 34) years old, with a gestational age of (39.48±0.88) weeks; they took epidural labor analgesia. The observation group were 33 (31, 34) years old, with a gestational age of (39.48±0.68) weeks; they took percutaneous electrical acupoint stimulation and epidural labor analgesia. The scores of Visual Analogue Scale (VAS) at the time of labor, before and 1 h after the implementation of labor analgesia, at the time of uterine opening, and 1 h after the end of labor, the times of labor, and the maternal and infant outcomes were compared between the two groups. The Edinburgh Postpartum Depression Scale (EPDS) was used for screening postpartum depression 42 days and 6 months after delivery. The independent sample t test, nonparametric test, χ² test, and analysis of variance of repeated measurement were used. Results　The scores of VAS before and 1 h after the implementation of labor analgesia, at the time of uterine opening, and 1 h after the end of labor in the observation group were (6.13±0.70), 1(0,1), (1.47±0.77), and 0(0,1), which were lower than those in the control group [(8.32±0.87), 3(3,4), (4.03±0.80), and 1(0,1)], with statistical differences between the two groups (F_groups=528.457, P<0.001). The first stage of labor in the observation group was shorter than that in the control group [4.70 (3.55, 6.80) h vs. 6.10 (4.30, 7.45) h], with a statistical difference (Z=-2.150, P=0.032). The scores of EPDS 42 days and 6 months after delivery in the observation group were lower than those in the control group [6.00 (5.00, 8.00) vs. 7.00 (6.00, 12.75) and 3.00 (2.00, 4.75) vs. 5.00 (4.00, 8.00)], with statistical differences (Z=-2.488 and -5.406, P=0.013 and <0.001). Conclusion　Transcutaneous acupoint electrical stimulation combined with epidural labor analgesia can reduce the risk of postpartum depression in women taking vaginal delivery after cesarean section, alleviate their labor pain, promote their labor progresses, and facilitate natural delivery.

Effects of sandplay on negative emotions and sleep quality of parturients during postpartum rehabilitation

Yu Bin, Xu Jiejie, Li Qiuping

2023, 29(24):  3616-3620.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.018

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effects of sandplay on negative emotions and sleep quality of parturients during postpartum rehabilitation. Methods　One hundred parturients admitted to Zaozhuang Maternal and Child Health Care Hospital from January to December 2019 were selected for the randomized controlled trial, and were divided into a study group and a control group by the random number table method, with 50 cases in each group. The study group were (31.45±1.45) years old and (36.25±1.36) weeks pregnant. The control group were (31.16±1.22) years old and (36.65±1.25) weeks pregnant. The control group took routine intervention and did sandplay. The control group took routine intervention. The negative moods [Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS)], sleep qualities [Pittsburgh Sleep Quality Index (PSQI)], qualities of life (SF-36) of the two groups were compared. The enumeration data were compared by χ² test, and the measurement data by t test. Results　After the intervention, the scores of SDS and SAS decreased in both groups (all P<0.05), and the scores of the study group were lower than those of the control group [(32.41±2.30) vs. (40.22±2.64) and (30.10±2.15) vs. (36.55±2.32); t=15.772 and 14.419; both P<0.05]. After the intervention, the scores of sleep quality, time getting into sleep, sleep time, sleep efficiency, sleep disorders, hypnotic drugs, and daytime dysfunction were all decreased in both groups (all P<0.05); the scores in the study group were lower than those in the control group [(1.22±0.21) vs. (1.58±0.26), (1.16±0.18) vs. (1.42±0.22), (1.10±0.15) vs. (1.37±0.24), (1.15±0.20) vs. (1.50±0.23), (1.14±0.24) vs. (1.42±0.30), (1.13±0.16) vs. (1.50±0.20), and (1.12±0.12) vs. (1.47±0.16); t=7.617, 6.468, 6.746, 8.120, 5.153, 10.215, and 12.374; all P<0.05]. After the intervention, the scores of physiological function, physiological function, physical pain, general health status, social function, emotional function, and mental health of SF-36 were (18.53±2.24), (12.25±2.10), (9.44±1.42), (12.18±2.15), (7.25±2.14) (11.02±2.03), (15.33±2.10), and (122.14±5.22) in the study group, which were higher than those in the control group [(15.12±1.43), (10.85±2.16), (8.32±1.06), (11.24±1.25), (6.16±1.22), (10.33±1.31), (12.36±1.63), and (110.36±5.12)], with statistical differences (t=9.073, 3.286, 4.469, 2.673, 3.129, 2.019, 7.900, and 11.392; all P<0.05). Conclusion　Sandplay for parturients during postpartum rehabilitation can improve their negative emotions, sleep quality, and quality of life, so it is worthy of clinical application and promotion.

Application effect of opioid free and autonomous respiration preservation in general anesthesia for laparoscopic radical esophagectomy

Lu Siyao, Xu Guoting, Li Xilong

2023, 29(24):  3620-3624.  DOI: 10.3760/cma.j.issn.1007-1245.2023.22.019

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the application effect of opioid free and autonomous respiration preservation in general anesthesia for laparoscopic radical esophagectomy. Methods　One hundred and sixteen patients with esophageal cancer admitted to First Hospital, Nanyang Medical College from January 2021 to January 2022 were selected as the study objects. All the enrolled patients underwent laparoscopic radical surgery. According to the treatment plans and anesthesia indications, the 56 patients who did not use opioid analgesics during surgery were set as an observation group [30 males and 26 females; (60.44±5.25) years old]; the regional nerve block anesthesia and laryngeal mask airway general anesthesia without opioid preservation of spontaneous breathing were performed. The rest 60 cases were set as a control group [35 males and 25 females; (61.23±5.18) years old]; the routine tracheal intubation general anesthesia was performed. The clinical indicators, arterial blood gas indicators before and after the surgery, pain during rest and when they coughed after surgery, and adverse reactions were compared between the two groups. t and χ² tests were applied. Results　The operation time of the observation group was slightly longer than that of the control group [(232.45±50.33) min vs. (216.37±50.26) min], with no statistical difference (t=0.651, P>0.05). The recovery time, the first time to get out of bed after surgery, and hospitalization time in the observation group were shorter than those in the control group [(5.15±1.33) h vs. (6.72±1.32) h, (2.31±0.33) d vs. (3.76±1.28) d, and (10.31±5.46) d vs. (13.49±5.11) d], with statistical differences (t=6.378, 8.224, and 3.240; all P<0.05). There were no statistical differences in the arterial blood gas indicators 1 d before the surgery between the two groups (all P>0.05). One day after the surgery, the oxygen saturation of blood (SaO₂), partial pressure of end-tidal carbon dioxide (PETCO₂), and partial pressure (PaCO₂) in the observation group were better than those in the control group [(0.984 4±0.053 6) vs. (0.952 5±0.051 7), (42.35±5.14) mmHg (1 mmHg=0.133 kPa) vs. (45.77±5.12) mmHg, and (43.19±5.23) mmHg vs. (46.11±5.28) mmHg], with statistical differences (t=3.262, 3.588, and 2.990; all P<0.05). The scores of Visual Analogue Scale (VAS) when they were at rest and coughed and the incidence of adverse reactions in the observation group were lower than those in the control group [(3.25±0.14) vs. (4.49±0.32), (4.04±0.77) vs. (5.63±1.28), and 5.36% (3/56) vs. 16.67% (10/60)], with statistical differences (t=26.705 and 8.036 and χ²=6.525; all P<0.05). Conclusion　Laryngeal mask general anesthesia without opioid and keeping spontaneous breathing can accelerate the recovery and rehabilitation process of patients after laparoscopic radical resection for esophageal cancer, and has positive significance in improving their arterial blood gas indicators after surgery, alleviating postoperative pain, and reducing the incidence of adverse reactions.

Effect applying remazolam in painless gastroenteroscopy in elderly patients

Song Zhiyong, Zhang Xiaohua, Li Quan, Wang Zhao'an, Ren Gaoyan

2023, 29(24):  3625-3628.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.020

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of remazolam on cognitive function and hemodynamics in elderly patients undergoing painless gastroenteroscopy. Methods　One hundred and two elderly patients undergoing painless gastroenteroscopy at Shouguang Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were selected for the randomized controlled trial, and were divided into an observation group and a routine group by the random number table method, with 51 cases in each group. There were 31 males and 20 females in the observation group; they were (9.63±6.25) years old. There were 20 males and 31 females in the routine group; they were (79.06±6.93) years old. The observation group took tsyloremazolam and afentanil for anesthesia, and the routine group took propofol and afentanil for anesthesia. The times to come to and times to leave the room, the scores of Mini-Mental State Examination before and 2 and 5 d after the operation, and the blood pressures and oxygen saturations before (T₁) and 3 (T₂), 6 (T₃), and 9 min (T₄) after administration were compared between the two groups. t and χ² tests were applied. Results　The time to come to and the time to leave the room in the observation group were shorter than those in the routine group [(7.25±1.15) min vs. (9.69±1.68) min and (28.74±4.25) min vs. (37.85±6.23) min], with statistical differences (t=14.195 and 7.852; both P<0.05). There were statistical differences in the scores of MMSE of group, time, and interaction between the two groups (F_{between groups}=17.358; F_time=19.652; F_interaction=13.745; all P<0.05). The scores of MMSE 2 and 5 d after the operation in the observation group were higher than those in the routine group. The systolic and diastolic blood pressures and oxygen saturation at T₂ in the observation group were higher than those in the routine group (F_{between groups}=9.580, 9.541, and 19.520; all P<0.05). The systolic and diastolic blood pressures and oxygen saturation at T₃ and T₄ were higher than those at T₂ in the routine group (F_时间=8.852, 9.580, and 8.520; all P<0.05). Conclusion　Applying remazolam in painless gastroenteroscopy in elderly patients can shorten their time to come to, improve their cognitive function, and reduce the impact on their hemodynamics, which is worthy of clinical application.

Raceanisodamine for children with acute gastroenteritis and its prevention of abdominal spastic pain

Cheng Cheng, Pu Haibo

2023, 29(24):  3629-3633.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.021

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effect of raceanisodamine (654-2) combined with conventional therapy for children with acute gastroenteritis and its prevention and treatment of abdominal spastic pain. Methods　One hundred and twenty-eight children with acute gastroenteritis treated at First Hospital, Nanyang Medical College from January 2021 to December 2022 were selected for the randomized controlled trial. The enrolled children were divided into a conventional group and a combination group by the random number table method, with 64 cases in each group. There were 34 boys and 30 girls in the conventional group; they were 3-14 (8.52±1.16) years old. There were 32 boys and 32 girls in the combination group; they were 5-12 (8.61±1.25) years old. The conventional group took routine treatment, while the combination group took routine treatment and 654-2. The symptom relief after the treatment, the gastrointestinal smooth muscle function and pain improvement before and after the treatment, and the incidences of adverse reactions were compared between the two groups. χ² and t tests were applied. Results　After different treatments, the diarrhea relief time, abdominal pain relief time, antiemetic time, and fever relief time of the combination group were lower than those of the conventional group [(15.22±4.41) h vs. (18.66±4.14) h, (7.25±2.41) h vs. (8.61±2.25) h, (4.61±1.25) h vs. (5.33±2.11) h, and (6.62±2.31) h vs. (7.76±1.25) h], with statistical differences (t=4.550, 3.300, 2.349, and 3.472; all P<0.05). After the treatment, the levels of glial cell derived Neurotrophin (GDNF), brain-derived neurotrophic factor (BDNF), and CC chemokine 3 (CCR3) in the combination group were better higher than those in the conventional group [(50.65±10.23) ng/L vs. (44.61±10.12) ng/L, (6.62±2.41) g/L vs. (7.93±2.75) g/L, and (13.39±3.26) kDa vs. (15.77±3.41) kDa], with statistical differences (t=3.358, 2.866, all 4.036; all P<0.05). The scores of Visual Analogue Scale (VAS) 24, 48, and 72 h after the treatment in the combination group were lower than those in the control group [(4.45±1.23) vs. (5.66±2.17), (3.21±0.76) vs. (4.26±1.35), and (2.62±0.38) vs. (3.41±0.47)], with statistical differences (t=3.881, 5.422, and 10.457; all P<0.05). After the treatment, there was no statistical difference in the incidence of adverse reactions between the combination group and the conventional group [7.81% (5/64) vs. 6.25% (4/64); χ²=0.186; P>0.05]. Conclusion　654-2 combined with routine treatment for children with acute gastroenteritis can effectively promote their recovery of symptoms, improve their intestinal smooth muscle function, and inhibit their abdominal spastic pain, and does not significantly increase the risk of adverse drug reactions, with relatively high safety.

Effect of Xuebijing combined with hemoperfusion on mitochondrial inflammatory pathway and blood lipid levels in patients with severe acute pancreatitis

Li Zhaolong, An Xia, Zhang Hongwei

2023, 29(24):  3633-3637.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.022

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effect of Xuebijing combined with hemoperfusion (HP) on the mitochondrial inflammatory pathway and blood lipid levels in patients with severe acute pancreatitis (SAP). Methods　One hundred patients with SAP treated at Nanyang First People's Hospital from March 2020 to January 2023 were selected for the randomized controlled trial. The patients were divided into an observation group and a control group using the random number table method, with 50 cases in each group. There were 30 males and 20 females in the observation group; they were 43-77 (60.22±5.17) years old. There were 29 males and 21 females in the control group; they were 45-75 (61.32±5.33) years old. The observation group took Xuebijing and HP, and the control group took HP. The expression levels of related proteins in the mitochondrial inflammatory pathway, blood lipid levels, and levels of inflammatory indicators before and after the treatment were compared between the two groups. t and χ² tests were applied. Results　After the treatment, the positive expression scores of formyl peptide receptor 1 (FPR1) and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) in the observation group were lower than those in the control group [(15.41±5.23) vs. (18.77±5.63) and (31.44±10.24) vs. (39.62±10.13)], with statistical differences (t=3.09 and 4.02; both P<0.05). After the treatment, the expression levels of mitochondrial ubiquitin-oxidoreductase (MT-ND) 1, MT-ND3, and MT-ND6 in the observation group were lower than those in the control group [(0.42±0.11) vs. (1.17±0.25), (1.31±0.25) vs. (1.86±0.36), and (0.92±0.45) vs. (1.44±0.27)], with statistical differences (t=19.42, 8.87, and 7.01; all P<0.05). After the treatment, the levels of total cholesterol (TC), triacylglycerol (TG), and low-density lipoprotein cholesterol (LDL-C) in the observation group were lower than those in the control group [(4.11±1.25) mmol/L vs. (5.33±1.76) mmol/L, (2.47±0.27) mmol/L vs. (3.05±0.79) mmol/L, and (1.95±0.77) mmol/L vs. (2.56±0.61) mmol/L], with statistical differences (t=4.00, 4.91, and 4.39; all P<0.05). After the treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and serum amylase (AMS) in the observation group were lower than those in the control group [(75.52±10.41) ng/L vs. (81.44±10.39) ng/L, (70.33±10.49) ng/L vs. (76.62±10.37) ng/L, and (255.36±50.61) IU/L vs. (282.45±50.11) IU/L], with statistical differences (t=2.85, 3.02, and 2.69; all P<0.05). Conclusions　Xuebijing can effectively inhibit the expression levels of mitochondrial inflammatory pathway related proteins in SAP patients; Xuebijing combined with HP can significantly reduce the patients' levels of blood lipids and inflammatory reaction.

5-fluorouracil in improvement of short-term efficacy and long-term survival of patients with advanced gastric cancer

Wu Shanshan, Ma Wenjun

2023, 29(24):  3638-3641.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.023

Asbtract ( )  

References | Related Articles | Metrics

Objective　Observe To observe effect of 5-FU on improving the short-term efficacy and long-term survival of patients with advanced gastric cancer. Methods　Ninety-eight patients with advanced gastric cancer treated at Nanyang First People's Hospital from January 2020 to May 2022 were selected for the randomized controlled trial, and were divided into a conventional group (48 cases) and an experimental group (50 cases) by the random number table method. There were 25 males and 23 females in the conventional group; they were 43-77 (60.22±5.13) years old. There were 29 males and 21 females in the experimental group; they were 45-75 (60.33±5.21) years old. The conventional group took XELOX standard chemotherapy, and the experimental group first-line chemotherapy containing 5-FU. Both groups were treated for 4 weeks. The short-term efficacies, long-term survival cycles and quality of life after one-year follow up, and incidences of chemotherapy related adverse reactions were compared between the two groups.  t and χ² tests were applied. Results　The objective relieved rate and disease controlled rate in the experimental group were higher than those in the control group [76.00% (38/50) vs. 62.45% (30/48) and 82.00% (41/50) vs. 66.67% (32/48)], with statistical differences (χ²=4.309 and 6.159; both P<0.05). The median PFS and OS in the experimental group were higher than those in the control group [(9.25±2.11) months vs. (7.24±2.25)months and (10.24±2.21) months vs. (8.01±2.18) months], with statistical differences (t=3.060 and 2.306; both P<0.05). The scores of physical status, social and family status, emotion status, and functional status of Functional Assessment of Cancer Therapy-General (FACT-G) in the experimental group were higher than those in the control group [(22.41±5.13) vs. (19.33±5.16), (22.25±5.23) vs. (19.45±5.23), (19.47±5.18) vs. (16.23±5.35), and (22.36±5.24) vs. (19.31±5.17)], with statistical differences (t=2.963, 2.649, 3.046, and 2.899; all P<0.05). During the follow up, the incidence of chemotherapy related adverse reactions in the experimental group was lower than that in the conventional group [24.00% (12/50) vs. 37.50% (18/48)], with a statistical difference (χ²=4.279, P<0.05). Conclusion　Compared with the standard chemotherapy, 5-FU assisted first-line chemotherapy can improve the short-term efficacy of patients with advanced gastric cancer, and has positive significance in prolonging the patients' life cycle and improving their quality of life, and is safe.

Treatises

Changes in bone density and arthritis score after intervention with metformin in ankylosing spondylitis model mice

Zheng Jinchang, Xiang Min, Sun Jiecong, Lin Han, Wei Bo, Wu Shaoke, Hu Zibing

2023, 29(24):  3642-3644.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.024

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effects of metformin on bone mineral density and peripheral arthritis score in ankylosing spondylitis (AS) model mice. Methods　The study was from September 2021 to June 2022. The BLAB/c mice were induced by proteoglycan to establish AS mouse models. The mice were divided into an experimental model group, a model control group, and a blank control group, with 10 in each group. The mice in the experimental model group were given metformin, the other mice were given normal saline by gavage once a day for three weeks. The climbing and suspension activities of the mice were observed; the scores of diseased joints were recorded; the bone density was measured in each group. t test was used for the statistical analysis. Results　After 8 weeks of induced immunity, the mice showed symptoms of peripheral arthritis, and the AS model mice reached their peak in the arthritis score at 12 weeks. The arthritis score of the mice treated with metformin was significantly lower than that of the model control group. The climbing and suspension activity of the model mice decreased. The bone mineral density of the model group was significantly lower than that of the blank control group. The bone density of the model group was significantly lower than that of the blank group. The bone mineral densities of the model mice treated with metformin were significantly higher than those in the model control group [femur: (0.101±0.003) g/cm² vs. (0.029±0.009) g/cm²; tibia: (0.070±0.005) g/cm² vs. (0.025±0.007) g/cm²; lumbar vertebra: (0.060±0.007) g/cm² vs. (0.043±0.004) g/cm²], with statistical differences (all P<0.05). Conclusion　Metformin can significantly improve the symptoms of peripheral arthritis and increase bone mineral density in AS model mice.

Nicorandil combined with hydration in prevention of contrast-induced nephropathy after percutaneous coronary intervention

He Haiyan, Lu Fei

2023, 29(24):  3645-3648.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.025

Asbtract ( )  

References | Related Articles | Metrics

Objective　To evaluate the safety and efficacy of nicorandil combined with hydration therapy in the prevention of contrast-induced nephropathy (CIN) in coronary heart disease patients after percutaneous coronary intervention (PCI). Methods　Two hundred patients with coronary heart disease treated in Department of Cardiology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2022 to April 2023 were randomly divided into a control group and a nicorandil group, with 100 cases in each group. There were 59 males and 41 females in the control group; they were (64.33±10.24) years old. There were 55 males and 45 females in the nicorandil group; they were (65.11±10.21) years old. The control group were treated only with hydration, while the nicorandil group with nicorandil and hydration. Serum creatinine (Scr) and cystatin C (CysC) were tested in all the enrolled patients before and after the operation. The estimated glomerular filter rate (eGFR) was calculated. The changes in the serum levels of Scr and CysC and eGFR, as well as the incidences of CIN and serious adverse cardiovascular events, were observed in both groups. t test, χ² test, and Fisher exact probability test were used for the statistical comparisons. Results　There were 17 cases (8.5%) of CIN among the 200 patients, including 13 cases (13.0%) in the control group and 4 cases (4.0%) in the nicorandil group. There was a statistical difference in the incidence of CIN between the two groups (P<0.05). Compared with the control group, the nicorandil group had low lower serum levels of Scr and CysC and higher eGFR after the operation, with statistical differences (all P<0.05). No serious adverse cardiovascular events occurred in the patients. Conclusion　Nicorandil combined with hydration can reduce the incidence of CIN after PCI, with no serious cardiovascular adverse events.

Electromyographic biofeedback in treatment of patients suffering from hemiplegia during acute stage of cerebral infarction

Lin Wenjun, Lin Xiaoting, Huang Gengbing, Lin Yuwei, Yu Zixi

2023, 29(24):  3649-3652.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.026

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of electromyographic biofeedback in the treatment of patients suffering from hemiplegia during acute stage of cerebral infarction. Methods　One hundred patients suffering from hemiplegia during acute stage of cerebral infarction treated at Jieyang People's Hospital from July 2021 to June 2023 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 50 cases in each group. At last, there were 47 cases in the observation group, including 26 males and 21 females who were (65.40±10.45) years old; there were 50 cases in the control group, including 29 males and 21 females who were (68.40±13.78) years old. Both groups routinely took neurological drugs and early rehabilitation; in addition, the observation group took electromyographic biofeedback treatment. The scores of Munual Muscle Testing (MMT), Brunnstrom's neurophysiological assessment, and Barthel index were compared between the two groups before and after the treatment. Wilcoxon non-parameter test was applied. Results　The scores of MMT and Brunnstrom's neurophysiological assessment of the upper and lower limbs and Barthel index were higher after than before the treatment in both groups (all P<0.05); after the treatment, the scores of MMT of the lower limbs [3.00 (2.00, 4.00) vs. 2.00 (2.00, 3.00)], Brunnstrom's neurophysiological assessment [upper limbs: 2.00 (2.00, 3.00) vs. 2.00 (1.00, 2.00); lower limbs: 3.00 (2.00, 4.00) vs. 2.00 (2.00, 3.00)], and Barthel index [55.00 (50.00, 65.00) vs. 35.00 (15.00, 55.00)] in the observation group were better than those in the control group (all P<0.05). Conclusion　Electromyographic biofeedback for patients suffering from hemiplegia during acute stage of cerebral infarction can promote their recovery of the hemiplegic limbs' function, so it is worth being clinically generalized.

Effect of transversus abdominis plane block combined with intravenous esketamine on analgesia after cesarean section in elderly parturients

Yang Wenchao, Li Yongcheng, Chen Qingze, Tu Yuanyan

2023, 29(24):  3653-3656.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.027

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of transversus abdominis plane block combined with intravenous esketamine on analgesia after cesarean section in elderly parturients. Methods　A total of 72 parturients who received lower uterine segment cesarean section in Dongguan Maternal and Child Health Hospital from August 2022 to August 2023 were selected for the randomized controlled trial. The included parturients were divided into a control group and an observation group by the random number table method, with 36 cases in each group. The control group were (40.42±9.43) years old; their body mass index was (23.59±7.49) kg/cm². The observation group were (41.91±9.32) years old; their body mass index was (23.62±7.51) kg/cm². Both groups received combined spinal-epidural anesthesia, and ultrasound-guided transversus abdominis plane block was performed in both groups after the operation. The observation group received intravenous injection of esketamine 0.5 mg/kg after the fetuses were delivered. The control group was intravenously injected the same amount of normal saline during the same period. The resting pain scores of Visual Analogue Scale (VAS) of the two groups 2, 4, 6, 12, 24, and 48 h after surgery were recorded. The first patient-controlled analgesia (PCA) times, the total numbers of PCA within 48 h, and the numbers of flurbiprofen axetil rescue analgesia cases were recorded in the two groups. The times of off-bed activities in 48 h and first anal exhaustion times in the two groups were recorded. The occurrences of analgesia-related adverse reactions, such as dizziness and nightmares, in the two groups were recorded. The measurement data of normal distribution were compared between the two group by the independent-sample t test, and the enumeration data by χ² test. Results　The resting pain VAS scores 6 and 12 h after surgery of the observation group were significantly lower than those of the control group [(1.12±0.37) vs. (1.74±0.45) and (1.14±0.38) vs. (1.78±0.47); both P<0.05]. The first PCA time of the observation group was longer than that of the control group [(9.82±1.94) h vs. (5.13±1.47) h; P<0.05]. The total number of PCA in 48 h and the number of flurbiprofen axetil rescue analgesia cases in the observation group were lower than those in the control group [(7.14±1.44) times vs. (10.62±2.92) times and 2.78% (1/36) vs. 25.00% (9/36); both P<0.05]. The times of off-bed activities in 48 h in the observation group was higher than that in the control group [(10.27±2.13) times vs. (8.14±1.68) times; P<0.05]. The first anal exhaustion time in the observation group was shorter than that in the control group [(8.52±1.63) h vs. (12.35±2.41) h; P<0.05]. The incidence of vertigo in the observation group was lower than that in the control group [5.56% (2/36) vs. 27.78% (10/36); P<0.05]. Conclusions　Transversus abdominis plane block combined with intravenous injection of esketamine has significant analgesic effect on elderly parturients after cesarean section; it can reduce postoperative pain VAS score, prolong the first PCA time, reduce the total number of PCA, and promote postoperative recovery.

Clinical Research

Clinical characteristics of cerebrospinal fluid in 13 cases of intracranial malignant melanoma

Lin Yu, Xu Shaoqiang, Cheng Yanjun, Shi Hongzhi

2023, 29(24):  3657-3660.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.028

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical, imaging, magnetic resonance imaging (MRI), cerebrospinal fluid biochemistry, routine, and cytological features of patients with intracranial malignant melanoma (IMM), and to improve the diagnostic ability of IMM. Methods　The clinical manifestations and imaging MRI, cerebrospinal fluid biochemical, routine, and cytological characteristics of 13 patients with IMM admitted to Guangdong 999 Brain Hospital from December 2021 to August 2023 were retrospectively analyzed. Results　Among the 13 patients, the cerebrospinal fluid was colorless and transparent in 8 cases (62%), was muddy in 2 cases (15%), and was protein-positive in 7 cases (54%); the number of nucleated cells was normal in 5 cases (38%), and was slightly increased in 8 cases (62%); the cerebrospinal fluid cytology was lympho-monocyte response type in 4 cases (31%), and was mixed cell response type in 3 cases (23%); melanoma cells were found in all the 13 cases (100%). The cerebrospinal fluid biochemistry showed that the protein increased in 7 cases (53%), lactate dehydrogenase increased in 10 cases (77%), and lactic acid increased in 10 cases (77%). The common symptoms were headache (77%, 10 cases), dizziness (38%, 5 cases), and fatigue (38%, 5 cases). MRI showed abnormal enhancement of meninges (92%, 12 cases). Conclusion　IMM has some characteristics of cerebrospinal fluid routine and cytology, cerebrospinal fluid biochemistry, clinical manifestations, and MRI manifestations, which can provide clinicians with great help. Especially, finding melanoma cells in cerebrospinal fluid is of great significance for diagnosis, and pathological diagnosis can confirm the final diagnosis.

Early efficacy of arthroscopic debridement combined with traditional Chinese medicine packages in treatment of patients with knee gouty arthritis

Luo Yuming, Shen Qingliang, Ou Xiumin, Ge Yingjie, Yang Lin, He Ting, Xie Jie

2023, 29(24):  3661-3666.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.029

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the early efficacy of arthroscopic debridement combined with traditional Chinese medicine packages in the treatment of patients with knee gouty arthritis. Methods　Ninety patients with knee gouty arthritis who were treated in Liwan District Orthopedic and Traumatology Hospital from May 2020 to June 2022 were selected for the randomized controlled trial, with a total of 90 knees. The patients were divided into a conservative treatment group, a minimally invasive treatment group, and a combined treatment group by the random number table method, with 30 cases in each group. The conservative treatment group were (42.93±3.28) years old, with a disease course of (9.72±3.74) months. The minimally invasive treatment group were (43.03±3.64) years old, with a disease course of (10.01±3.83) months. The combined treatment group were (43.58±5.60) years old, with a disease course of (9.86±3.95) months. The conservative treatment group externally applied self-made Chinese medicine packages, once a day. The minimally invasive treatment group took minimally invasive debridement under arthroscope. The combined treatment group were treated with arthroscopic debridement and postoperative Chinese medicine packages. All the three groups were treated with the same anti-inflammatory and analgesic drugs. The scores of Visual Analogue Scale (VAS) and Lysholm joint function of knee joint (Lysholm) and laboratory indicators (white blood cell, blood uric acid, erythrocyte sedimentation rate, and C-reactive protein) before and 1, 2, and 4 weeks after the treatment, and recurrence rates within six months were observed. The repeated measurement analysis of variance and non-parameter test were applied. Results　There were statistical differences in the scores of VAS and Lysholm and laboratory indicators in the three groups between before and 1 week after the treatment (all P<0.05); there were no statistical differences in the scores of VAS and Lysholm and laboratory indicators 1 week after the treatment between the 3 groups (all P>0.05). Two weeks after the treatment, the scores of VAS and Lysholm in the combined treatment group were 2.00 (1.00) and (81.67±6.35); the scores in the minimally invasive treatment group were 2.00 (1.00) and (80.37±5.58); the scores in the conservative treatment group were 3.00 (1.25) and (77.23±6.10); there were statistical differences between the combined treatment group and the minimally invasive treatment group on one hand and the conservative treatment group on the other hand (all P<0.05), and no between the combined treatment group and the minimally invasive treatment group (both P>0.05). Four weeks after the treatment, the scores of VAS and Lysholm in the combined treatment group were 1.00 (1.25) and (87.03±5.26); the scores in the conservative treatment group were 2.00 (1.00) and (80.70±5.80); the scores in the minimally invasive treatment group were 1.50 (1.00) and (82.33±5.36); there were statistical differences between the combined treatment group on one hand and the minimally invasive treatment group and the conservative treatment group on the other hand (all P<0.05), and no between the conservative treatment group and the minimally invasive treatment group (both P>0.05). All the patients in the 3 groups were followed up half year; no case recurred in the combined treatment group; 1 case recurred in the minimally invasive treatment group; 3 cases recurred in the conservative treatment group. Conclusions　Arthroscopic debridement and traditional Chinese medicine packages for patients with knee gouty arthritis both are effective. The combination of the two has better early effect, and can reduce the recurrence of gout, delay the disease progression, so it is worthy of clinical application.

Efficacy and safety of treatment for Helicobacter pylori infection in penicillin-sensitive population with quadruple regimens containing furazolidone or metronidazole

Wang Xianling, Bi Caiying, Zhou Guoqiang, Yan Youhong, Liu Sichun, Su Jiandong

2023, 29(24):  3666-3670.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.030

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the efficacy and safety of the treatment for Helicobacter pylori (H.pylori) infection in penicillin-sensitive people with quadruple regimens containing furazolidone or metronidazole. Methods　The clinical data of 120 patients with H.pylori infection who were treated with quadruple regimens containing furazolidone or metronidazole from June 2021 to April 2023 in Dongguan Songshan Lake Tungwah Hospital due to allergy to penicillin were collected. The patients were divided into a furazolidone group (62 cases) and a metronidazole group (58 cases) according to the drugs they took. All the patients received ¹³C urea breath test again at least 4 weeks after the treatment. The general information and incidences of adverse reactions of the two groups were compared. Intention to treat (ITT) and per protocol (PP) were used to analyze the eradication rates of H.pylori in the two groups. t and χ² tests were applied. Results　Among the 120 patients, 97 completed the treatment and follow-up; there were 50 cases in the furazolidone group, including 25 males and 25 females, with an age of (38.7±11.2) years; there were 47 cases in the metronidazole group, including 21 males and 26 females, with an age of (41.9±11.6) years. The overall incidence of adverse reactions in the furazolidone group was 28.0% (14/50), and that in the metronidazole group was 17.0% (8/47), with no statistical difference (χ²=1.655, P>0.05). The ITT and PP analyses showed that the eradication rates of H.pylori in the furazolidone group were 72.6% (45/62) and 90.0% (45/50), and those in the metronidazole group were 74.1% (43/58) and 91.5% (43/47), with no statistical differences (χ²=0.037 and 0.064; both P>0.05). Conclusions　The quadruple regimens containing furazolidone or metronidazole are effective in the eradication of H.pylori infection, but there are certain adverse reactions. They can be used as plans and choices for the initial treatment of H. pylori infection in people with penicillin allergy.

Clinical effect of minimally invasive acupotomy combined with tight control strategies for patients with gouty arthritis

Xie Qixin, Wang Yuechun, Lou Aiju, Jiang Chunmei, Zhong Shan, He Shiwen, Wu Weirong

2023, 29(24):  3671-3675.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.031

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the clinical effect of minimally invasive acupotomy combined with tight control strategies for patients with gouty arthritis. Methods　Fifty-five male patients with gouty arthritis who took tight control strategies for decreasing uric acid after minimally invasive acupotomy for at least one month at Guangzhou Liwan Central Hospital from March 1, 2020 to March 1, 2022 were selected. According to the surgical sites, the patients were divided into a knee joint group (41 cases), (55.58±14.4) years old, and an ankle joint group (14 cases), (45.71±10.9) years old. The scores of Lyshom Knee Rsting System (Lyshom), American Orthopedic Foot and Ankle Society (AOFAS), and Visual Analogue Scale (VAS), levels of uric acid (UA) and C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) in all the patients were compared between before and after the treatment. The clinical effects and postoperative complications of the two groups were evaluated. Z, t, and χ² tests were applied. Results　In the knee joint group, the score of Lysholm was higher and the score of VAS was lower after than before the treatment [(88.30±7.69) vs. (55.85±14.07) and (1.95±1.18) vs. (7.92±1.37)], with statistical differences (Z=-7.60 and t=21.17; both P<0.05). In the ankle joint group, the score of AOFAS was higher and the score of VAS was lower after than before the treatment [(88.43±8.36) vs. (60.92±10.88) and (1.71±1.14) vs. (7.14±1.83)], with statistical differences (t=-7.50 and Z=-4.54; both P<0.05). The UA levels, ESR's, and CRP levels in the knee joint group and the ankle joint group were lower after than before the treatment, with statistical differences (Z=-5.58, -5.37, -4.08, -3.30, -3.30, and -2.67; all P<0.05). One month after the surgery, no acute gouty attack occurred in both groups. Conclusions　Minimally invasive acupotomy combined with tight control strategies for patients with gouty arthritis can reduce their inflammation, improve their joint function, and relieve their pain. However, it is necessary to enhance infection prevention and patient education after minimally invasive acupotomy.

Wang Jiuyuan's experience in treating hemospermia with Xiaochaihu Tang 

Jin Suping, Pan Lei, Wang Jiuyuan

2023, 29(24):  3675-3677.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.032

Asbtract ( )  

References | Related Articles | Metrics

Xiaochaihu Tang is a classic prescription for the treatment of Shaoyang syndrome and heat entering the blood chamber. Professor Wang Jiuyuan has extensive experience in the application of Xiaochaihu Tang in the treatment of hemospermia. Its important pathological mechanism is causing frenetic movement of the blood; elucidating the mechanism will help broaden the thinking of the diagnosis and treatment of spermatozoa disorders.

Efficacy of three-dimensional vaginal ultrasound in diagnosis of scar pregnancy classification

Zhao Hui, Li Miaozhu

2023, 29(24):  3678-3681.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.033

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the efficacy of three-dimensional vaginal ultrasound in the diagnosis of scar pregnancy (SP) classification. Methods　Sixty patients with SP treated at Haizhu District Women and Children Health Care Hospital from July 2020 to July 2023 were selected as the study objects. They were (31.52±4.27) years old. All the patients were examined by three-dimensional vaginal ultrasound. The results of surgical pathologic diagnosis were set as the gold standard. The diagnostic efficacy of three-dimensional vaginal ultrasound in the diagnosis of SP classification was explored. χ²  test was used. Results　SP was detected in 59 cases by three-dimensional vaginal ultrasound, and one case was missed, with a diagnostic accuracy of 98.33% (59/60) and a missed diagnosis rate of 1.67% (1/60). There was no statistical difference in the SP detection rate between three-dimensional vaginal ultrasound and surgical pathology (χ²=0.099, P>0.05). The coincidence rates of three-dimensional vaginal ultrasound in the diagnosis of the simple pregnancy sac type and uterine type were 100.00% (43/43) and 100.00% (11/11), and that of mixed mass type was 83.33% (5/6). There was no statistical difference in the detection rate of SP in different types between three-dimensional vaginal ultrasound and surgical pathology (χ²=0.067, P>0.05). The coincidence rates of type I and type Ⅱ were 100.00% (41/41) and 100.00% (10/10), and that of type Ⅲ was 88.89% (8/9). Conclusion　Three-dimensional vaginal ultrasound has a high diagnostic accuracy in SP classification, a high diagnostic coincidence rate for different SP classification and diagnostic image features, and a high diagnostic efficacy, so it is recommended to promote in clinical use.

Shugan Hezhong Jiangni prescription in treatment of patients with reflux esophagitis and Zhongxu Qini syndrome

Cao Zhijuan, Zhang Yanhong, Song Zhenzhen

2023, 29(24):  3681-3685.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.034

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical effect of Shugan Hezhong Jiangni prescription in the treatment of patients with reflux esophagitis and Zhongxu Qini syndrome. Methods　A total of 62 patients with reflux esophagitis treated in Ningxia Chinese Medicine Research Center from July 2020 to January 2022 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 31 cases in each group. There were 20 males and 11 females in the control group; they were 34-78 (54.67±10.01) years old; their disease course was 2-11 (5.99±2.01) months. There were 21 males and 10 females in the observation group; they were 35-79 (55.85±10.34) years old; their disease course was 2-12 (6.23±2.11) months. The control group were treated with rabeprazole sodium enteric-coated capsules and mosapride, and the observation group with Shugan Hezhong Jiangni prescription. Both groups were treated for 60 d. The clinical efficacies, gastroscopy grades, and incidences of adverse reactions were compared between the two groups. t and χ² tests were applied. Results　After the treatment, the scores of main symptoms and secondary symptoms and the total score decreased in both groups (P<0.05), and the scores of the observation group were lower than those of the control group [(7.23±1.46) vs. (10.29±1.85), (2.97±1.03) vs. (4.85±1.74), and (10.20±1.65) vs. (15.14±2.37)], with statistical differences (t=8.212, 5.880, and 10.819; all P<0.05). The total effective rate of the observation group was higher than that in the control group [90.32% (28/31) vs. 64.52% (20/31), with a statistical difference (χ²=5.905, P<0.05). After the treatment, fewer patients had grade C and D of Los Angeles Grading (LA) in the observation group than in the control group [22.58% (7/31) vs. 48.39% (15/31)], with a statistical difference (χ²=4.509, P<0.05). During the treatment, the incidence of adverse reactions was 9.68% (3/31) in the observation group, and was 6.45% (2/31) in the control group, with no statistical difference between the two groups (correction χ²=0.218, P>0.05). Conclusion　Shugan Hezhong Jiangni prescription in the treatment of patients with reflux esophagitis and Zhongxu Qini syndrome can relieve their symptoms and is effective, safe, and reliable.

Nursing Research

Clinical effect of thumbtack needle therapy for opioid-induced constipation in patients with cancer pain

Lin Jian, Lyu Liqiong, Wu Yuling, Tang Xiang, Ma Yanqiong, Cai Ruyi

2023, 29(24):  3686-3690.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.035

Asbtract ( )  

References | Related Articles | Metrics

Objective　To evaluate the effect of thumbtack needle therapy for opioid related constipation in patients with cancer pain. Methods　Eighty cancer pain patients with opioid related constipation who were admitted to Department of Oncology, Guangdong Second Hospital of Traditional Chinese Medicine from January 2020 to January 2023 were selected as the research objects. They were divided into an observation group and a control group according to whether they took thumbtack needle therapy for constipation, with 40 patients in each group. There were 26 males and 18 females in the control group; they were (61.05±8.82) years old. There were 26 males and 16 females in the observation group; they were (61.83±9.09) years old. The control group received routine care for opioid related constipation; in addition, the observation group took thumbtack needle therapy. The scores of the Opioid Related Constipation Assessment Scale and the severities of constipation were compared between the two groups. t test, analysis of variance, and χ² test were applied. Results　Before the intervention, there were no statistical differences between the two groups in terms of gender, age, education level, body mass index, nutrition screening score, and score of Visual Analogue Scale (VAS) (all P>0.05). The scores of Opioid Related Constipation Assessment Scale before the intervention and on day 7 and 14 of the thumbtack needle therapy in the observation group were lower than those in the control group [(35.55±9.26) vs. (32.80±6.37), (29.35±5.81) vs. (36.08±8.86), and (23.23±6.45) vs. (37.95±7.65)]. The scores of bowel movement patterns, outcomes, and drug impact dimensions in the observation group were lower than those in the control group, with statistical differences (all P<0.05). The severities of opioid related constipation and on day 7 and 14 of the thumbtack needle therapy in the observation group were lower than those in the control group, with statistical differences between the two groups (all P<0.05). Conclusion　Thumbtack needle therapy has a significant effect on opioid related constipation, improving the symptoms of opioid related constipation in patients with cancer pain and reducing the severity of opioid related constipation.

Effect of dance movement therapy on improving non-suicidal self-injury behaviors in adolescents

Guan Yanxia, Cheng Simin, Cai Minyi, Shao Hua, Sun Chunyan, Li Huiping

2023, 29(24):  3691-3695.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.036

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of dance movement therapy (DMT) on improving non-suicidal self-injury (NSSI) behaviors in adolescents. Methods　Forty-seven patients diagnosed with NSSI and admitted to Department of Psychiatrics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University from June to December 2022 were selected for the randomized controlled trial. The patients were divided into a control group (24 cases) and a dance movement group (23 cases) through the computer-generated randomization process. The control group were (14.79±1.32) years old; there were 9 males in the control group. The dance movement group were (15.35±1.82) years old; there were 4 males in the dance movement group. The control group were routinely cared; in addition, the dance movement group took dance movement therapy. The scores of NSSI behaviors, depressive emotions, and feelings of loneliness before and after the intervention were compared between the two groups. The independent sample t test, paired t test, χ² test, Fisher's exact test, or rank sum test were used. Results　Before the intervention, there were no statistical differences in the scores of the self-harm behavior questionnaire, health questionnaire, and loneliness scale between the two groups (all P>0.05). After the intervention, the scores of self-harm behavior questionnaire, depression scale, and loneliness scale in the dance movement group were lower than those in the control group [2.00 (0.00, 5.00) vs. 3.00 (2.00, 14.50), 7.00 (3.00, 8.00) vs. 8.00 (4.00, 13.00), and (38.70±8.20) vs. (44.63±9.31)], with statistical differences (all P<0.05). Conclusion　Dance movement therapy may effectively relieve the patients' non-suicidal self-injury behaviors, and reduce their depression and loneliness.

Dynamic interaction model nursing care for patients with craniocerebral injury

Su Xiaofei, Bao Zhongyuan, Tan Bijun

2023, 29(24):  3695-3699.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.037

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the effect of dynamic interaction model nursing care for patients with craniocerebral injury. Methods　Eighty patients with craniocerebral injury treated at Central Hospital Affiliated to Jiangnan University from January 2020 to January 2023 were selected and were divided into a control group and an observation group according to the admission order, with 40 cases in each group. There were 25 males and 15 females in the control group; they were (39.20±2.01) years old. There were 28 males and 12 females in the observation group; they were (39.19±1.98) years old. The observation group took routine nursing care, and the observation group took dynamic interaction model nursing care. The Exercise of Self-care Agency Scale (ESCA), Fugl-Meyer Assessment (FMA), and MOS 36-Item Short-Form Health Survey (SF-36) were used to evaluate the self-care ability, motor function, and quality of life in both groups. The χ² and t tests were applied. Results　On the day of admission, the total scores of ESCA, FMA, and SF-36 in the control group were (86.63±2.05), (13.24±2.65), and (53.23±3.21), and those in the observation group were (86.07±2.11), (13.19±2.76), and (53.19±3.17), with no statistical differences (t=1.204, 0.083, and 0.056; P=0.232, 0.934, and 0.955). After 30 days' intervention, the total scores of ESCA, FMA, and SF-36 in the control group were lower than those in the observation group [(130.49±4.56) vs. (133.42±3.96), (23.16±2.38) vs. (24.81±2.16), and (66.96±3.05) vs. (68.33±2.97)], with statistical differences (t=3.068, 3.247, and 2.035; and P=0.003, 0.002, and 0.045). Conclusions　Dynamic interactive model nursing care for patients with craniocerebral injury can significantly improve their self-care ability, motor function, and quality of life.

Air-entrained warm humidity oxygen therapy for infants with pertussis syndrome

Yuan Linghao, Wang Xiaoyun, Li Shuhuan, Rao Baoyu

2023, 29(24):  3700-3704.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.038

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effect of air-entrained warm humidity oxygen therapy for infants with pertussis syndrome. Methods　This study is a single center and controlled experiment. Fifty infants with pertussis syndrome admitted to Department of Pediatrics, Shunde Hospital of Southern Medical University were selected as the study objects and were divided into a control group and an observation group, with 25 cases in each group. The cases in the control group were selected from January 2020 to March 2021, including 17 males and 8 females who were (3.84±2.96) months old, and took existing and traditional treatment and nursing measures. The cases in the observation group were selected from April 2021 to June 2022, including 14 males and 11 females who were (3.69±2.98) months old; on the basis of the treatment and nursing in the control group, the observation group took air-entrained warm humidity oxygen therapy. The oxygen saturations (SPO₂), respiratory rates, sputum viscosities 48 and 72 h after the intervention, scab formation, and spasmodic cough relief times were compared between the two groups. The incidence of adverse reactions in the observation group was calculated. χ² test, t test, analysis of variance of multivariate repeated measurement, and non-parameter rank sum test were used for the statistical comparisons. Results　The SPO₂ increased with the intervention time, and the respiratory rate decreased as the intervention time prolonged in both groups (all P<0.05). As the intervention time prolonged, the SPO₂ in the observation group was higher than that in the control group (P<0.05), and there was no statistical difference in the respiratory rate between the two groups (P>0.05). Forty-eight and 72 h after the intervention, the numbers of cases of sputum viscosity (Ⅰ degree) in the observation group was higher than those in the control group (7 cases vs. 1 case and 17 cases vs. 3 cases), and the numbers of cases of sputum viscosity (Ⅲdegree) in the observation group were lower than those in the control group (4 case vs. 18 cases and 1 case vs. 15 cases), indicating that the sputum dilution effect in the observation group was better. The relief time of spasmodic cough in the observation group was significantly better than that in the control group [(4.32±1.18) d vs. (7.24±2.02) d; P<0.05]. No adverse reactions, such as respiratory arrest, phlegm blockage, and pressure-associated skin injury, occurred in the observation group. Conclusion　Air-entrained warm humidity oxygen therapy can effectively improve the airway environment of infants with pertussis syndrome and promote their recovery, and is safe.

Effect of red furnace tendon therapy combined with early pulmonary rehabilitation on lung function and quality of life in stroke patients

Cai Xiuwei, Wang Hui, An Qiao

2023, 29(24):  3704-3708.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.039

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of red furnace tendon therapy combined with early pulmonary rehabilitation on lung function and quality of life in stroke patients. Methods　Sixty-four stroke patients admitted to Guangdong Provincial Second Traditional Chinese Medicine Hospital from April 2021 to December 2022 were selected as the study objects, and were divided into a control group and an observation group by the random number table method, with 32 cases in each group. There were 16 males and 16 females in the control group; they were 45-77 (61.34±1.35) years old. There were 16 males and 16 females in the control group; they were 45-76 (61.54±1.32) years old. The control group took early pulmonary rehabilitation training, and the observation group took red furnace tendon therapy and early pulmonary rehabilitation. The lung function, quality of life, rehabilitation effects, and emotional status were compared between the two groups. t test was applied. Results　The forced vital capacity (FVC) and first second forced expiratory volume (FEV₁ )were higher after than before the nursing in both groups; the FVC and FEV₁ after the nursing in the observation group were higher than those in the control group [(2.71±0.90) L vs. (2.13±0.80) L and (1.71±0.71) L vs. (1.33±0.44) L], with statistical differences (t=2.725 and 2.574; both P<0.05). The scores of the 8 dimensions of 36-item Short-Form (SF-36) after the nursing in the observation group were higher than those in the control group (all P<0.05). The scores of Fugl-Meyer Motor Function Assessment Scale (FMA) of upper and lower limbs were higher after than before the nursing in both groups; the scores after the nursing in the observation group were higher than those in the control group [(55.87±2.12) vs. (50.21±2.28) and (25.17±2.68) vs. (20.25±2.74)], with statistical differences (t=10.284 and 7.262; both P<0.05). The scores of US National Institutes Stroke Scale (NIHSS) in both groups were lower after than before the nursing; the score in the observation group was lower than that in the control group [(7.09±0.94) vs. (10.23±1.42)], with a statistical difference (t=10.431; P<0.05). The scores of Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) in both groups were lower 30 d after than before the nursing; the scores 30 d after the nursing in the observation group were lower than those in the control group [(27.34±1.87) vs. (33.53±1.99) and (34.75±2.82) vs. (37.54±3.01)], with statistical differences (t=12.823 and 3.826; both P<0.05). Conclusion　Red furnace tendon therapy combined with early pulmonary rehabilitation for stroke patients can accelerate their recovery of pulmonary function and improve their quality of life.

Study on career status and influencing factors of new pediatric nurses

Tang Guoyi, Shi Xuan, Wang Jingyan, Yang Li, Li Congqun

2023, 29(24):  3709-3714.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.040

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the career status and influencing factors of new pediatric nurses. Methods　A total of 169 new pediatric nurses from Guangzhou Women and Children Medical Center were investigated using the self-designed general situation questionnaire, Career Status Evaluation Scale, Nurse Organizational Climate Perception Scale, and Nurse Work Stress Source Scale from September to December 2021. t test, one-way ANOVA, Pearson correlation analysis, and multiple stepwise regression analysis were used to explore the influencing factors of the new nurses' career status. Results　The new pediatric nurses was (24.56±1.83) years old; 97.04% (164/169) of the nurses were female. The total score of career status of the new pediatric nurses was (80.47±10.93), and the scoring rate was 69.97%. The scoring rates of the four dimensions from high to low were as below: retention intention, organizational commitment, professional identity, and career satisfaction. There were no statistical differences in the career status between the new nurses with different marital status, education levels, working years, job titles, and departments (all P>0.05). The total score and scores of professional identity, job satisfaction, and organizational commitment in the nurses on the front line positions were higher than those in the nurses not on the front line positions, with statistical differences (all P<0.05). There was a positive correlation between career status and perceived organizational climate (r=0.541, P<0.05), and a negative correlation between career status and perceived organizational climate (r=-0.359, P<0.05). The results of multiple step regression analysis showed that the factors influencing the career status of the new pediatric nurses were front-line anti-epidemic posts, management support, resource security, and management and interpersonal relationship stressors, which explained 53.7% of the variation (F=49.713, P<0.01). Conclusion　The new pediatric nurse career status is on the medium level; the nurses on the front-line anti-epidemic posts score higher than the nurses not on the front-line anti-epidemic posts; organizational climate conditions and work pressure have important influence on career situation; in order to do a better job of new nurses' career management, nursing managers should take measures to strengthen the construction of organizational atmosphere, improve the working environment, reduce work pressure, and so on.

Correlation between social support and work pressure of nurses in intensive care unit

Zeng Lili, Cai Mianmian

2023, 29(24):  3714-3718.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.041

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the social support status and working pressure of intensive care unit (ICU) nurses, to explore the correlation between them, and to provide references for reducing the work stress of ICU nurses. Methods　In December 2021, 94 ICU nurses from Second Hospital, Fujian Medical University, including the nurses from ICU, pediatric ICU, and RICU, were randomly selected for the investigation by the work stress source scale and social support rating scale. A total of 94 questionnaires were distributed to the nurses, and 85 valid questionnaires were collected. There were 3 males and 82 females who were 22-42 years old. The results of the scales were analyzed in conjunction with the nurses' general information. t test was applied. Results　The total score of social support for the 85 nurses was (38.85±7.08), and was at a moderate level. The nurses in pediatric ICU (43.52±6.47), with more nursing years (43.85±5.55), with higher positions (42.56±6.17), and who were married (43.52±6.52) had higher levels of social support, with statistical differences between the groups (F=6.36, 6.23, 4.07, and -5.49; all P<0.05). The average score of ICU nurses' stressors was 2.434, and was at a moderate level. The highest score for nursing professional and work related issues was (2.56±0.57). The nurses with higher positions and on the regular payroll had higher pressure from time allocation and workload issues [(2.89±0.86) and (2.82±0.62)], while those with more nursing years, higher positions, and who were married and on the regular payroll had higher pressure from work environment and equipment issues [(2.93±0.86), (3.00±0.85), (2.48±0.80), and (2.61±0.79)]. Social support was negatively correlated with ICU nursing majors and work related issues (r=-0.192, P<0.05), and positively with work environment and equipment issues (r=0.353, P<0.05). Conclusions　Social support can alleviate the work pressure of ICU nurses, but currently there is less social support for ICU nurses with fewer nursing years, low positions, and unmarried status. In the context of increasing social support, it is necessary to improve the working environment of ICU nurses, reasonably allocate the equipment and nursing management of various ICU nurses, and reduce work pressure.

Reflection and recommendations on promoting development of China's nursing system in post-pandemic era

Chen Jingwen, Zhou Ying, Liang Qianru, Liu Chunqin, Ma Yu, Feng Xue

2023, 29(24):  3719-3724.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.042

Asbtract ( )  

References | Related Articles | Metrics

The COVID-19 pandemic has had a broad and profound impact on the global public health system. In the post-pandemic era, the transformation of health concerns, the sharp increase in health needs, and the increasing demand for high-quality care require us to pay more attention to the development and changes of nursing education, nursing research, nursing practice, nursing communication, and the cross-fusion of nursing and other disciplines, so as to help build a healthy China. Therefore, this article analyzes the contributions and shortcomings of China's nursing system in current stage under the background of the COVID-19 pandemic, and put forward suggestions for nursing education, research, practice, and communication, in order to provide references for the sustainable development of China's nursing system in the post-pandemic era.

Influence of intensive team education on specialized medical compliance of patients with new hypertension in physical examination

Fan Wenwen, Zhang Ying, Peng Rong, Huang Guitian, Chen Wenzhong, Li Jin, Yao Yuan, Chen Jieyi

2023, 29(24):  3724-3727.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.043

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of intensive team education on specialized medical compliance of patients with new hypertension in physical examination. Methods　Sixty-four patients diagnosed with hypertension by physical examination the first time in Guangzhou First People's Hospital from January 2021 to December 2022 were selected as the study objects. The 31 patients who took traditional education from January to December 2021 were set as a control group; the rest 33 patients who took intensive team education from January to December 2022 were set as an experimental group. There were 21 males and 10 females in the control group; they were 28-58 (41.65±8.47) years old. There were 21 males and 12 females in the experimental group; they were 25-59 (41.42±8.02) years old. The knowledge mastery and specialty compliance of the two groups were investigated by the self-administered questionnaire. The hypertension knowledge awareness rates and the compliance to cardiovascular specialty were compared between the two groups. t and χ² tests were applied. Results　The hypertension knowledge awareness rate in the experimental group was better than that in the control group [(96.97±7.28) vs. (82.58±12.37)], with a statistical difference (t=-5.711, P<0.05). The compliance to cardiovascular specialty in the experimental group was better than that in the control group [84.84% (28/33) vs. 48.38% (15/31)], with a statistical difference (χ²=9.639, P<0.05). Conclusion　Intensive team education for patients with new onset of hypertension in physical examination can improve their disease knowledge awareness rate and specialist compliance, and improve the treatment rate of patients with newly onset hypertension.

Effect applying remote wireless self-controlled intrathecal analgesia system in hospice care for patients with cancer pain

Feng Suqing, Ju Jinjin, Li Jinhua, Liu Yazhen, Chen Yunlei, You Cheng, Wu Lijing

2023, 29(24):  3728-3731.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.044

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effect applying remote wireless self-controlled intrathecal analgesia system in hospice care for patients with advanced cancer pain. Methods　A total of 32 patients with advanced cancer pain who underwent implantation of intrathecal drug delivery devices in Department of Pain Medicine, Second Hospital, Guangzhou Medical University from March 2021 to November 2022 were selected, including 14 males and 18 females who were (62.59±12.93) years old. The Numerical Rating Scale (NRS), Pittsburgh Sleep Quality Index (PSQI), and Barthel Index (BI) were used to assess the patients' pain degree, sleep quality, and life self-care ability before and after the operation. The repetitive measure analysis of variance was used. Results　The scores of NRS and PSQI the first day after surgery (T1), when they discharged (T2), and 1 week after discharge (T3) were lower than those before the operation (all P<0.001). There was no statistical difference between the scores of BI at T0 and T3 [(65.94±26.98) vs. (60.16±24.21); P=0.106]. Conclusion　Application of remote wireless self-controlled intrathecal analgesia system in hospice care for patients with advanced cancer pain can reduce their pain and improve their life quality and sleep quality, and is safe.

Pharmacy Management

Varicella vaccination hesitation status of children's parents and its influencing factors at Panyu District, Guangzhou

Huang Yunshi, Yang Yanjun, Wu Shaomin, Wu Jiating

2023, 29(24):  3732-3735.  DOI: 10.3760/cma.j.issn.1007-1245.2023.24.045

Asbtract ( )  

References | Related Articles | Metrics

Objective　To understood the varicella vaccination hesitation status of children's parents and its influencing factors at Panyu District, Guangzhou, and to provide references for the prevention and control of varicella. Methods　From July to December 2022, the hierarchical multi-stage cluster sampling method was used to select the vaccination records of 1 385 children from the kindergartens and primary schools at Panyu District, Guangzhou; a questionnaire survey was conducted on their parents, including 460 males and 925 females who were (33.02±7.01) years old. The differences in the general demographic data of Chinese version of Vaccination Hesitation Scale were compared by t test and analysis of variance. The multivariate logistic analysis was used to explore the main influencing factors of vaccination. Results　The one-dose and two-dose vaccination rates of varicella in the surveyed children were higher than the overall vaccination rates of varicella vaccination shown in the survey of 120 surveillance sites in China in 2020 [61.66% (854/1 385) vs. 52.72% (11 662/22 121) and 48.38% (670/1 385) vs. 11.43% (2 528/22 121)], with statistical differences (χ²=41.859 and 1 513.754; both P<0.05). The comparison results of the total scores of the Vaccination Hesitation Scale of different characteristics respondents showed that the scores of female, the ones who stayed at home for housework or were unemployed, the ones whose family income ≥ 10 000 yuan, the family members except parents, the ones whose children were in primary school stage, and the ones who had more than two children were relatively higher, with statistical differences (t=-9.411, 5.731, -6.334, -5.815, -17.264, and -4.271; all P<0.05). The results of the linear regression analysis showed that the main factors influencing the children's parents in delaying or refusing the vaccination were academic stage, family structure, occupation, and family income (t=20.604, 8.827, 4.598, and 2.825; all P<0.05). Conclusions　There is still much room for the improvement in the vaccination rate of varicella at Panyu District, Guangzhou. The parents' vaccination hesitation is affected by many factors. The advantages of vaccination should be used as propaganda in the parents whose children are primary school students, who have more than two children, who stay at home for housework or are unemployed, and who have better family income.