Table of Content

01 March 2024, Volume 30 Issue 7

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New Medical Advances

Research progress of TRPV1 channel in infectious diseases

Zhao Bo, Li Siwei, Xing Tian, Gao Ping, Zhu Hongzhe, Li Min

2024, 30(7):  1057-1062.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.001

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Transient receptor potential vanilloid receptor 1 (TRPV1) is a non-selective cation channel in the members of the transient receptor potential family, and expresses mainly on sensory neurons. The receptor is widely distributed in vivo and has complex biological effects. In recent years, studies have found that inflammatory factors, pain signaling, body temperature, and neuronal sensitivity can be modulated by activating or inhibiting TRPV1, which may be involved in the production of infectious diseases, but it has not been used clinically. This paper reviews the physiological role of TRPV1 in infectious diseases and its regulatory mechanism, and provides new ideas for the prevention and treatment of infectious diseases.

Research progress on incidence rate and surgical treatment of long bone nonunion

Li Mengqi, Li Peng, Du Gangqiang, Sun Hongsuo, Zhang Kai

2024, 30(7):  1062-1066.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.002

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Bone nonunion is one of the complications of fractures. Its location and etiology are diverse, and the treatment methods are not exactly the same. The complex interaction between different factors makes it a difficult problem for clinical orthopedic doctors. Most nonunions occur after long bone fractures, mainly in the clavicle, humerus, forearm, femur, and tibia. In clinical treatment, there are many surgical methods to choose. The author reviewed the incidence and surgical treatment of long bone nonunion in recent years, in order to provide references for further research and application in the field of surgical treatment of bone nonunion.

Role of capsaicin receptors in pathogenesis of diarrheal irritable bowel syndrome

Cui Xiao, Liu Liang

2024, 30(7):  1066-1070.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.003

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Diarrheal irritable bowel syndrome (IBS-D) is one of the common functional gastrointestinal disorders characterized by intermittent abdominal pain and diarrhea. IBS-D is a chronic functional disease with a long course and easy recurrence of symptoms, and seriously affects the patients' quality of life. At present, it is believed that its pathogenesis is closely related to factors such as visceral hypersensitivity, brain-gut axis imbalance, intestinal flora imbalance, etc. Current studies have shown that capsaicin receptors are involved and play an important role. In this article, the specific mechanism of capsaicin receptors involved in visceral hypersensitivity, brain-gut axis imbalance, and intestinal flora imbalance is reviewed, so as to provide references for exploring the pathogenesis and therapeutic targets of IBS-D.

Research progress on ESBLs positive Klebsiella pneumoniae

Ding Jiawen, Li Na

2024, 30(7):  1071-1074.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.004

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Klebsiella pneumoniae is a Gram-negative bacteria, belongs to Enterobacteriaceae, is facultally anaerobic, and often colonizes on the human upper respiratory tract and intestinal tract. It is an important opportunistic pathogen and one of the common pathogens of nosocomial infection. In recent years, due to the irrational use of antibiotics and other reasons, the drug resistance has been increasing year by year. The extended-spectrum β-lactamases (ESBLs), discovered since the 1980s, are one of the main causes of drug resistance of Klebsiella pneumoniae. In this paper, the drug resistance genes, typing and homology analysis ESBLs-producing Klebsiella pneumoniae are reviewed, so as to provide references for the prevention of ESBL-positive Klebsiella pneumoniae pneumonia and rational use of antibiotics in clinical treatment.

Treatises

Baofukang suppository combined with 5-ALA photodynamic therapy for patients with cervical intraepithelial neoplasia and high-risk HPV infection

Ren Jie, Di Man, Zhang Li, Wang Jingjing, Wang Juan

2024, 30(7):  1075-1078.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.005

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Weighted gene coexpression network analysis on immune-related biomarkers in colon cancer

Wang Miaomiao, Zhang Ruizhe, Xu Lei, Wu Han, Wu Shuhua

2024, 30(7):  1079-1086.  DOI: a.j.issn.1007-1245.2024.07.006

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Objective　To identify the immune-related prognostic genes that may be involved in the development and progression of colon cancer, and to screen the immune biomarkers analyzing the data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus database (GEO) by weighted gene co-expression network. Methods　The study was from November to December 2022. The weighted gene coexpression network analysis was performed on immune-related genes in GSE41657 and TCGA datasets for colon cancer, and the immune-related biomarkers were screened from key modules. The gene expression data and clinical information from the TCGA database were further analyzed. Results　The most critical immune-related modules in the occurrence and development of colon cancer were obtained; their functions were enriched in chemokine signaling, migration, activation, proliferation, and migration of immune cells; their pathways were enriched in the chemokine signaling pathway, antigen processing and presentation, MAPK signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway, and NF-Kappa B signaling pathway. Ten genes were identified as the prognostic targets of colon cancer, including NMB, SCG2, IL1A, ULBP2, INHBB, COLEC12, F2RL1, ANGPTL1, NR3C2, and TNFRSF17. Two genes, COLEC12 and ANGPTL1, which were the most closely correlated with colon cancer immunity, were screened out through the TIMER database. They were enriched in many immune-related and cancer-related pathways, including the JAK Stat signaling pathway, Toll-like receptor signaling pathway, and MAPK signaling pathway. They may play important roles in tumor immune microenvironment. Conclusion　COLEC12 and ANGPTL1 may regulate colon cancer and its immune microenvironment through a variety of signaling pathways, and are expected to become potential immunotherapy targets.

Distribution and drug resistance analysis of Carbapenem resistant Gram-negative bacteria in some hospital from 2021 to 2023

Huang Shuangwang, He Yuwei, Liang Zhuwei, Wang Nan, Su Xin

2024, 30(7):  1087-1090.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.007

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Objective　To analyze the distribution and drug resistance characteristics of Carbapenem resistant Gram-negative bacilli (CR-GNB) isolated from Guangdong Provincial Second Hospital of Traditional Chinese Medicine. Methods　From January 1, 2021 to June 30, 2023, 2 754 strains of CR-GNB were identified by clinical isolation and identification in Guangdong Provincial Second Hospital of Traditional Chinese Medicine. The WHONET5.6 software was used to analyze the distribution characteristics of CR-GNB and the characteristics of drug susceptibility detection resistance. Results　A total of 2 754 strains of CR-GNB were clinically isolated and screened, including 843 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP), accounting for 30.6%, 765 strains of Carbapenem-resistant Acinetobacter baumannii (CRAB), accounting for 27.8%, 679 strains of Carbapenem-resistant Pseudomonas aeruginosa (CRPA), accounting for 24.7%, 203 strains of carbapenem-resistant Escherichia coli (CREC), accounting for 7.4%, and 264 strains of other CR-GNB, accounting for 9.5%. The main sources of CR-GNB samples were sputum (1 702 strains, 61.8%), urine (639 strains, 23.2%), alveolar lavage fluid (232 strains, 8.4%), blood (78 strains, 2.8%), and secretions (71 strains, 2.6%). The main departments were respiratory and critical care medicine (532 strains, 19.3%), intensive care medicine (365 strains, 13.3%), Acupuncture Kang District 1 (325 strains, 11.8%), and Acupuncture Kang District 7 (181 strains, 6.6%). A total of 1 330 strains (48.9%) were isolated from the Acupuncture Kang Districts. CR-GNB generally has multiple drug resistance or pan-resistance to antibiotics, and the sensitivity rate of a few drugs is high. The sensitivity rate of CRKP to tigacycline was 100.0%. The sensitivity rates of CRAB to amikacin, tobramycin, and minocycline were 73.9%, 59.0%, and 49.3%, respectively. The sensitivity rates of CRPA to amikacin, tobramycin, and polymyxin B were 78.1%, 75.5%, and 46.5%, respectively. The sensitivity rate of CREC to tigecycline was 100.0%. Conclusions　The CR-GNB isolated in Guangdong Provincial Second Hospital of Traditional Chinese Medicine are mainly CRKP, CRAB, CRPA, and CREC. CR-GNB is multi-drug resistant or pan-resistant, and the available therapeutic drugs are limited. Clinical use of antibiotics should be regulated, and effective and feasible treatment plans should be formulated according to the drug resistant characteristics of CR-GNB to prevent nosocomial infection and spread of CR-GNB.

Anesthesia

Bibliometrics analysis of current status of researches on postoperative delirium based on Web of Science database

Tan Huiling, Shen Ning, Yang Jing, Zhang Hongyan, Zhao Yuan, Ding Zhendong

2024, 30(7):  1091-1098.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.008

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Objective　To offer novel insights for both domestic and international research endeavors examining the present research status, trends, and focal points pertaining to postoperative delirium (POD) by bibliometric analysis. Methods　On July 10, 2023, the Web of Science (WoS) core database was searched to identify the literatures on POD published between 2002 and 2022. The various aspects, including annual publication volume, citation frequency, country of publication, affiliated institutions, journals, authors, keywords, and direction, were examined. The CiteSpace software was applied to provide the visual representation of the overall characteristics. Results  This study included 1 208 publications. The analysis showed that the annual publication volume of literatures related to POD increased from 2002 to 2022; the United States is the country with the most publications, followed by China; Inouye Sharon and Marcantonio Edward R emerged as the two most prolific contributors in term of publication volume; Harvard University emerged as the institution with the highest number of publications; the elderly, long-term hospitalization, cancer, pain, hip fractures, cardiac surgery, abdominal surgery, and patients in intensive care were of particular interest in POD researches. Establishment of predictive model for POD, management model of preventive system, patients' long-term outcomes, etc. had high attention. Conclusions  Researches on POD are steadily expanding, but there is disparity between China and developed nations. The focal point of future research endeavors should be the implementation of systematic and standardized approaches to assess, prevent, and treat POD.

Meta-analysis on effect of esketamine in combination with remazolam besylate for patients taking endoscopic retrograde cholangiopancreatography

Si Wenli, Zhang Quanyi

2024, 30(7):  1099-1104.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.009

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Objective　To systematically review the effect of esketamine in combination with remazolam besylate for patients taking endoscopic retrograde cholangiopancreatography(ERCP). Methods　The randomized controlled trials (RCTs) on esketamine and remimazolam besylate for patients taking ERCP published at CNKI, VIP, Wanfang, PubMed, Web of Science, Embase, and the Cochrance Library from their establishment to March 2023 were searched. The experimental group was anesthetized with the combination of ketamine and remifentanil besylate for ERCP, while the control group with other intravenous anesthetics. Two unrelated researchers carefully screened the literatures based on the inclusion and exclusion criteria, and conducted statistical analysis using the Review Manager 5.4 software. Results　Six RCTs were included, with a total of 532 patients. Compared with other anesthesia drug regimens, the esketamine combined with remazolam besylate group had lower probabilities of hypotension and respiratory depression (RR=0.29, 95%CI 0.17～0.50; RR=0.18,95%CI 0.08～0.38). Conclusion　The combined use of ketamine and remazolam besylate for patients taking ERCP can significantly reduce the probability of adverse events, and is a more stable and safer anesthesia method.

Effect of dexmedetomidine combined with spinal-epidural anesthesia on laparoscopic ovarian cyst surgery

Wang Jun, Liao Weiyu, Wang Xiaoxu, Zhao Qibing

2024, 30(7):  1104-1110.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.010

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Objective　To investigate the anesthetic effect of dexmedetomidine combined with lumbar epidural anesthesia on laparoscopic ovarian cyst surgery and its influence on cognitive function and stress response. Methods　A total of 108 patients with ovarian cysts admitted to Ankang People's Hospital from January 2020 to August 2023 were selected, and were divided into a control group and a study group by the random number table method, with 54 cases in each group. The control group were (49.85±5.68) years old, with a body mass index of (23.01±1.59) kg/m² and a disease course of (4.62±0.71) years. There were 20 cases of grade Ⅰ and 34 cases of grade Ⅱ of American Society of Anesthesiologists (ASA) in the control group. The study group were (51.05±6.23) years old, with a body mass index of (23.18±1.47) kg/m² and a disease course of (4.79±0.76) years; there were 18 cases of grade Ⅰ and 36 cases of gradeⅡ of ASA in the study group. The control group were given midazolam and combined spinal-epidural anesthesia, and the study group dexmedetomidine and combined spinal-epidural anesthesia. The perioperative hemodynamics, intraoperative shivering, pain, cognitive function, stress response, inflammatory response, and adverse reactions were compared between the two groups using t, LSD-t, and χ² tests. Results　The mean arterial pressures and heart rates before anesthesia induction (T0), at skin incision (T1), anesthesia for half an hour (T2), and at the end of operation (T3) were (93.02±5.97) mmHg (1 mmHg=0.133 kPa), (81.03±4.86) mmHg, (84.51±6.24) mmHg, and (86.12±4.05) mmHg and (83.73±5.16) times /min, (68.76±4.16) beats/min, (74.31±4.13) beats/min, and (76.02±4.84) beats/min in the study group, and were (94.16±6.08) mmHg, (84.58±5.12) mmHg, (83.67±5.73) mmHg, and (89.73±4.14) mmHg and (84.59±5.01) beats/min, (72.32±4.85) beats/min, (76.85±4.26) beats/min, and (79.88±5.01) beats/min in the control group; there were statistical differences in the mean arterial pressure and heart rate between different time points in both group (F=9.143 and 8.769; both P<0.001); there were statistical differences in the mean arterial pressure and heart rate between the two groups (F=8.371 and 8.416; both P<0.001); there were statistical differences in the mean arterial pressure and heart rate change trends between the two groups (F=9.168 and 9.316; both P<0.001). The incidence of shivering in the study group was lower than that in the control group [5.56% (3/54) vs. 18.52% (10/54); χ²=4.285, P=0.038]. The scores of Visual Analogue Scale (VAS) 4, 12, and 24 h after the surgery in the study group were (2.17±0.36), (3.07±0.38), and (2.45±0.41), and those in the control group were (2.21±0.39), (3.38±0.42), and (2.69±0.43); there was a statistical difference in the score between different time points (F=9.054; P<0.001); there was a statistical difference in the score between the two groups (F=8.031; P<0.001); there was a statistical difference in the change trend of VAS score between the two groups (F=7.968; P<0.001). Before and 12 and 24 h after the operation, there were no statistical differences in the score of The Mini-mental State Examination (MMSE) between the time points and in the score change trend between the two groups (all P>0.05). Twenty-four hours after the operation, the levels of epinephrine, cortisol, and reactive oxygen species in the study group were (112.35±15.71) ng/L, (298.47±40.12) nmol/L, and (115.71±12.89) mmol/L, and those in the control group were (126.54±18.67) ng/L, (321.54±45.13) nmol/L, and (127.54±15.32) mmol/L, which were higher than those before the operation; those in the study group were lower than those in the control group [t=4.274, P<0.001; t=2.807, P=0.006; t=4.342, P<0.001]. Twenty-four h after the operation, the levels of interleukin-6 (IL-6), interleukin-21 (IL-21), and high mobility group protein B1 (HMGB1) in the study group were (40.02±4.93) ng/L, (9.02±1.51) ng/L, and (42.76±5.01) ng/L], and those in the control group were (43.98±5.27) ng/L, (10.17±1.69) ng/L, and (46.89±5.84) ng/L, which were higher than those before the operation; the levels of IL-6, IL-21, and HMGB1 in the study group were lower than those in the control group (t=4.032, 3.729, and 3.944; all P<0.001). There was no statistical difference in the total incidence of adverse reactions between the two groups (χ²=0.375, P=0.540). Conclusion　Dexmedetomidine combined with spinal-epidural anesthesia for laparoscopic ovarian cyst resection has significant anesthetic effect, and helps maintain the stability of perioperative hemodynamics, reduce the risk of intraoperative shivering, relieve perioperative pain, stress, and inflammation, does not affect the patients' cognitive function, and is safe and reliable.

Colunm of Stomatology

Single-visit versus multiple-visit root canal treatments for patients with dental pulp disease

Lu Jian, Wang Yajun, Song Jie

2024, 30(7):  1111-1116.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.011

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Objective　To analyze the effects of single-visit and multiple-visit root canal treatments for patients with dental pulp disease. Methods　Eighty patients with dental pulp disease treated in Liaocheng Third People's Hospital from March 2020 to March 2023 were selected for the randomized controlled trial. They were divided into an observation group and a control group by the random number table method, with 40 cases in each group. There were 21 males and 19 females in the control group; they were (40.37±8.30) years old; their disease course was (8.60±3.15) months. There were 20 males and 20 females in the observation group; they were (40.22±8.45) years old; their disease course was (8.55±3.20) months. The control group received multiple-visit root canal treatment, while the observation group single-visit root canal treatment. The Visual Analogue Scale (VAS) was used to assess the patients' pain level after the treatment. The analgesics-used rates, levels of inflammatory factors [interleukin-6 (IL-6), interleukin-2 (IL-2), high-sensitivity C-reactive protein (hs-CRP), serum osteoprotegerin, and receptor activator of nuclear factor-κ B ligand (RANKL)] before and after the treatment, dental chewing function (dental occlusal force, bleeding index, and gingival index) and incidences of complications were compared between the two groups. t and χ² tests were applied. Results　After the intervention, the score of VAS and analgesics-used rate in the observation group were lower than those in the control group [(2.64±0.58) vs. (3.24±0.67) and 0 vs. 10.00%(4/40)], with statistical differences (t=4.282; χ²=4.211; both P<0.05). Before the treatment, there were no statistical differences in the levels of IL-6, IL-2, hs-CRP, osteoprotegerin, and RANKL between the two groups (all P>0.05). After the treatment, the levels of IL-6, IL-2, hs-CRP, and RANKL in the observation group were lower than those in the control group [(1.16±0.34) ng/L vs. (1.34±0.35) ng/L, (0.29±0.04) ng/L vs. (0.33±0.06) ng/L, (1.14±0.11) mg/L vs. (1.65±0.22) mg/L, and (0.35±0.06) ng/L vs. (0.39±0.08) ng/L]; the level of osteoprotegerin in the observation group were higher than that in the control group [(0.43±0.08)μg/L vs. (0.36±0.07)μg/L]; there were statistical differences (t=2.233, 3.508, 13.114, 2.530, and 4.165; all P<0.05). Before the treatment, there were no statistical differences in the dental occlusal force, bleeding index, and gingival index between the two groups (all P>0.05). After the treatment, the bleeding index and gingival index in the observation group were lower than those in the control group [(0.48±0.10) vs. (0.90±0.19) and (0.47±0.09) vs. (0.76±0.15)]; the dental occlusal force in the observation group was higher than that in the control group [(140.18±11.85) lbs vs. (116.75±9.97) lbs]; there were statistical differences (t=12.372, 10.485, 9.569; all P<0.05). After the intervention, the total incidence of complications in the observation group was lower than that in the control group [5.00% (2/40) vs. 22.50% (9/40)], with statistical difference (χ²=5.165, P=0.023). Conclusion　Single-visit root canal treatment is more effective in reducing pain and decreasing inflammation levels in patients with dental pulp disease than multiple-visit treatment.

Effect of concentrated growth factors combined with guided bone regeneration in repairing tissue defects after anterior cystic apical surgery

An Baili, He Zhuan, Li Qin, Zhang Bo

2024, 30(7):  1116-1120.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.012

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Objective　To explore the effect of concentrated growth factors (CGF) combined with guided bone regeneration (GBR) in repairing tissue defects after anterior cystic apical surgery. Methods　Eighty patients with tissue defects after anterior cystic apical surgery treated at Xi 'an No.3 Hospital from January 2020 to January 2023 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 40 cases in each group. There were 24 males and 16 females in the control group; they were (46.91±8.02) years old. There were 19 males and 21 females in the observation group; they were (46.58±7.94) years old. The control group were treated with GBR, while the observation group with CGF and GBR. The periodontal probing depths (PD), clinical attachment loss (CAL), gingival recession (GR), aesthetic restoration effects [pink esthetic score (PES) and white esthetic score (WES)], and overall satisfaction rates were compared between the two groups. t and χ² tests were applied. Results　There were no statistical differences in PD, CAL, and GR between the two groups before the operation (all P>0.05). After the operation, the PD, CAL, and GR in the observation group were better than those in the control group [(4.51±1.06) mm vs. (5.33±1.01) mm, (5.08±1.13) mm vs. (6.84±1.42) mm, and (2.97±0.80) mm vs. (2.49±0.87) mm], with statistical differences (t=3.542, 6.134, and 2.569; all P<0.05). Three months after the treatment, the scores of near middle gingival papilla, far middle gingival papilla, labial gingival margin curvature and height, and root convexity/soft tissue color and texture and total score of PES in the observation group were higher than those in the control group [(1.84±0.57) vs. (1.32±0.42), (1.96±0.64) vs. (1.41±0.51), (1.86±0.68) vs. (1.35±0.66), (1.97±0.65) vs. (1.46±0.52), (1.92±0.67) vs. (1.49±0.54), and (9.55±1.45) vs. (7.03±1.38)], with statistical differences (t=4.288, 4.251, 3.404, 3.875、3.160, and 7.962; all P<0.05). Three months after the treatment, the scores of crown shape, crown contour, crown color, and crown surface texture, and transparency/individualization and total score of WES in the observation group were higher than those in the control group [(1.94±0.61) vs. (1.68±0.52), (1.95±0.50) vs. (1.47±0.54), (1.86±0.33) vs. (1.43±0.46), (1.91±0.49) vs. (1.52±0.41), (1.93±0.56) vs. (1.56±0.54), (9.59±1.26) vs. (7.66±1.34)], with statistical differences (t=2.051, 4.125, 4.804, 3.861, 3.008, and 6.636; all P<0.05). The overall satisfaction rate in the observation group was higher than that in the control group [97.50% (39/40) vs. 72.50% (29/40)], with a statistical difference (χ²=9.804; P=0.002). Conclusion　CGF combined with GBR repairing tissue defects after anterior cystic apical surgery is clinically effective, may provide the patients with biomaterial and a new regeneration strategy and a choice in periodontal tissue reconstruction at department of oral and maxillofacial surgery.

Therapeutic effect of CAD/CAM glass-ceramic high inlay in repairing large area defects of maxillary first premolars

Yan Yan, Tian Hongxu

2024, 30(7):  1121-1125.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.013

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Objective　To observe the efficacy of CEREC 3D chair side computer-aided design and manufacturing (CAD/CAM) glass-ceramic high inlay in repairing large area defects of maxillary first premolars. Methods　A total of 72 patients with large maxillary first premolar defects admitted to Yantai Yantai Mountain Hospital from February 2017 to June 2019 were retrospectively selected, including 31 males and 41 females who were (38.57±7.21) years old. All the affected teeth were repaired by the CEREC 3D chair-side CAD/CAM technique one week after one-time root canal treatment, and were followed up for 24 months after the restoration. The repair effects 3, 6,12 and 24 months after reprir and their repair satisfaction 24 months after repair were analyzed. χ² test was applied. Results　Three months after the restoration, all the patients achieved grade A in terms of edge fit, restoration defect, porcelain fracture, restoration loss, color matching, connection relationship, and periodontal development. The proportions of the patients with grade B of different evaluation items 6, 12, and 24 months after restoration slightly increased, with no statistical difference in the repair effect between different times (χ²=0.383, P=0.702). Twenty-four months after the restoration, the satisfaction rates with the restoration color, restoration shape, surface smoothness, and inlay edge suitability were 86.11% (62/72), 98.61% (71/72), 88.89% (64/72), and 97.22% (70/72), respectively. Conclusion　CAD/CAM glass-ceramic inlay is an effective method for repairing large-area defects of maxillary first premolars after root canal treatment, and is worthy of clinical application.

Application of Bio-Gide absorbable biofilm and artificial bone meal filling in patients taking dental implantation

Yang Dan, Lei Minghui, Fu Jingmin

2024, 30(7):  1125-1130.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.014

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Objective　To investigate the effect of Bio-Gide absorbable biofilm combined with synthetic bone meal filling for patients taking dental implantation. Methods　Ninety-eight patients with single anterior tooth loss and labial bone defect treated at Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine from January 2020 to April 2022 were selected and divided into a study group and a control group by the random number table method, with 49 cases in each group. The control group included 29 males and 20 females who were (40.95±8.03) years old. The study group included 26 males and 23 females who were (41.37±7.86) years old. The control group took oral repair membrane and synthetic bone meal filling. The study group took Bio-Gide absorbable biofilm combined with synthetic bone meal filling. The implant success rates 3, 6, and 12 months after the implantation, periodontal health and labial bone wall thicknesses before and 12 months after the implantation, bone defect regeneration 3 months after the implantation, levels of gingival crevicular fluid factors before and 3 months after the implantation, and postoperative complications 12 months after the implantation were compared between the two groups. t and χ² tests were applied. Results　There were no statistical differences between the two groups in the implant success rates 3, 6 and 12 months after the implantation and periodontal pocket depth, attachment loss, and gingival bleeding index before the implantation (all P>0.05). Twelve months after the implantation, the gingival bleeding index, periodontal pocket depth, and attachment loss in the study group were lower than those in the control group [(1.01±0.16) vs. (1.13±0.19), (2.19±0.36) mm vs. (2.41±0.42) mm, and (2.01±0.32) mm vs. (2.23±0.38) mm], with statistical differences (all P<0.05). There were no statistical differences in the labial bone thicknesses at the 1, 4, 7, and 10 mm sites between the two groups right after the implantation (all P>0.05); 12 months after the implantation, the labial bone thicknesses at the 1, 4, 7, and 10 mm sites in the study group were higher than those in the control group [(2.21±0.36) mm vs. (2.03±0.34) mm, (2.32±0.41) mm vs. (2.07±0.38) mm, (2.39±0.41)mm vs. (2.13±0.38) mm, and (2.62±0.41) mm vs. (2.31±0.45) mm], with statistical differences (t=2.545, 3.130, 3.256, and 3.565; all P<0.05). Three months after the implantation, the bone graft height and osteogenic height of the study group were higher than those of the control group [(2.71±0.43) mm vs. (2.42±0.39) mm, (2.62±0.41) mm vs. (2.29±0.37) mm], with statistical differences (t=3.497 and 4.183; both P<0.05). There were no statistical differences in the levels of vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) between the two groups before the implantation (both P>0.05). Three months after the implantation, the levels of VEGF and BMP-2 in the study group were higher than those in the control group [(46.58±7.12)mg/L vs. (39.56±6.28)mg/L and (486.57±62.18)ng/L vs. (429.84±59.67)ng/L], with statistical differences (t=5.176 and 4.608; both P<0.05). There was no statistical difference in the incidence of total complications between the two groups [8.16% (4/49) vs. 10.20% (5/49); χ²=0.122; P=0.727]. Conclusion　Bio-Gide absorbable biofilm combined with synthetic bone meal for patients taking dental implantation can improve their periodontal health, reduce their bone loss after surgery, and promote the regeneration of bone defects.

Clinical Research

Clinical effect of rt-PA combined with edaravone dexborneol for patients with ischemic stroke

Zhang Xiaojing, Wang Xiaoqin, Qu Yuan

2024, 30(7):  1131-1136.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.015

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Objective　To evaluate the effect of intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) combined with edaravone dexborneol on neurologic function and oxidative stress in patients with ischemic stroke (IS). Methods　Seventy-eight patients with IS treated in Baoji Gaoxin Hospital from January 2020 to October 2023 were selected for the randomized controlled trial. They were divided into a control group and an observation group by the random number table method, with 39 cases in each group. There were 23 males and 16 females in the control group; they were (63.03±6.42) years old; their disease course was (31.12±6.43) h. There were 22 males and 17 females in the observation group; they were (62.88±6.29) years old; their disease course was (30.74±6.39) h. The control group took intravenous thrombolysis by rt-PA; in addition, the observation group were treated with edaravone dexborneol. The treatment efficacies, scores of neurological function [National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS)], and levels of oxidative stress indicators [glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), and reactive oxygen species (ROS)] and inflammatory markers [interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and high-sensitivity c-reactive protein (hs-CRP)] were compared between the two groups. χ² and t tests were applied. Results　After two weeks' treatment, the overall efficacy in the observation group was higher than in the control group [79.49% (31/39) vs. 56.41% (22/39)], with a statistical difference (χ²=4.77; P<0.05). After two weeks' treatment, the scores of NIHSS and mRS in the observation group were lower than those in the control group [(7.87±0.96) vs. (9.88±1.83) and (1.78±0.14) vs. (2.04±0.21)], with statistical differences (t=6.07 and 6.43; both P<0.05). After two weeks' treatment, the levels of GSH Px, SOD, MDA, and ROS in the observation group were better than those in the control group [(219.78±24.13) mg/L vs. (189.88±23.12) mg/L, (154.78±11.95) U/ml vs. (138.67±13.16) U/ml, (47.01±5.64) μmol/L vs. (51.94±6.34) μmol/L, and (508.57±36.34) μmol/L vs. (576.34±38.44) μmol/L], with statistical differences (t=5.59, 5.66, 3.63, and 8.00; all P<0.05). After two weeks' treatment, the serum levels of IL-6, TNF-α, and hs-CRP in the observation group were lower than those in the control group [(8.45±3.12) ng/L vs. (13.67±3.96) ng/L, (0.72±0.28) ng/L vs. (1.23±0.34) ng/L, and (9.67±4.28) ng/L vs. (14.78±4.55) ng/L], with statistical differences (t=6.47, 7.23, and 5.11; all P<0.05). Conclusion　Intravenous thrombolysis by rt-PA combined with edaravone dexborneol for patients with IS can significantly improve the treatment efficacy and their neurological function and reduce the levels of oxidative stress and inflammatory factors, and has better therapeutic effects than rt-PA alone.

Curative effect of Huayu Fuming Decoction combined with calcium oxybenzenesulfonate capsules for patients with early diabetic retinopathy

Wang Manhua, Zhang Tao, Zhang Yonggang

2024, 30(7):  1136-1141.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.016

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Objective　To explore the curative effect of Huayu Fuming Decoction combined with calcium oxybenzenesulfonate capsules for patients with diabetic retinopathy (DR). Methods　One hundred and four patients with DR treated at Ankang Hospital of Traditional Chinese Medicine from May 2020 to May 2023 were selected for the randomized control trial, and were divided into a control group (52 cases) and a treatment group (52 cases) by the random number table method. There 29 males and 23 females in the control group; they were (45.91±1.83) years old. There were 27 males and 25 females in the treatment group; they were (45.82±1.79) years old. The control group were treated with calcium oxybenzenesulfonate capsules,0.5 g each time, 3 times a day, and the treatment group with calcium oxybenzenesulfonate capsules and Huayu Fuming decoction, 200 ml was 1 dose, 1 dose per day, for 1 month. The Chinese medicine syndromes, scores of Chinese version of Quality of Life Scale for Low Vision (CLVQOL), macular thicknesses, blood spot areas, levels of blood glucose indicators, and serum levels of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and interleukin-1 (IL-1) were compared between the two groups before and after treatment. The efficacies the and adverse reactions in both groups were statistically analyzed. t and χ² tests were used for the statistical comparison. Results　The total effective rate of the treatment group was higher than that of the control group [96.15% (50/52) vs. (82.69% (43/52), with a statistical difference (χ²=4.98, P=0.026). After the treatment, the scores of traditional Chinese medicine syndrome and CLVQOL in the treatment group were better than those in the control group [(7.28±1.36) vs. (11.71±1.50) and (113.25±10.48) vs. (89.76±8.17)], with statistical differences (t=15.78 and 12.75; both P<0.05). After the treatment, the macular thickness and the area of blood stains decreased in both groups. After the treatment, the macular thickness and blood spot area in the treatment group were lower than those in the control group [(306.42±11.09) μm vs. (355.37±13.17) μm and (1.04±0.26) mm² vs. (1.85±0.37) mm²], with statistical differences (t=20.50 and 12.92; both P<0.001). After the treatment, the levels of fasting blood glucose (FBG), 2 h fasting blood glucose (2 hFBG), and glycosylated hemoglobin (HbAlc) in the treatment group were lower than those in the control group [(6.30±1.18) mmol/L vs. (7.35±1.24) mmol/L, (15.40±4.25) mmol/L vs. (17.35±4.32) mmol/L, and (3.76±0.95) μmol/L vs. (5.41±1.12) μmol/L], with statistical differences (t=4.42, 2.32, and 8.10; all P<0.05). After the treatment, the levels of VEGF, PDGF, and IL-1 in the treatment group were lower than those in the control group [(88.75±14.03) μg/L vs. (136.22±17.41) μg/L, (4.43±0.97) μg/L vs. (6.12±1.08) μg/L, (21.06±4.05) ng/L vs. (25.42±4.57) ng/L], with statistical differences (t=15.31, 8.40, and 3.97; all P<0.05). The incidence of adverse reactions in the treatment group was lower than that in the control group [3.85% (2/52) vs. 15.38% (8/52)], with a statistical difference (χ²=3.98; P<0.05). Conclusion　Huayu Fusing Decoction combined with calcium oxybenzenesulfonate capsules for patients with DR has ideal effect, and can improve their traditional Chinese medicine syndromes and quality of life, and reduce macular injury, blood glucose level, and serum levels of VEGF, PDGF, and IL-1, with a low incidence of adverse reactions and good safety, so it is worthy of promotion.

Effects of fixation with F shape hollow nails versus with traditional parallel nails for patients with femoral neck fractures

Peng Liangzhen, Zhang Fenghai

2024, 30(7):  1142-1146.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.017

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Objective　To observe the effects of different hollow nail distribution techniques in open reduction and internal fixation for patients with femoral neck fractures and the influence on hip joint function and fracture healing. Methods　One hundred and twenty patients with femoral neck fractures admitted to Xinyang 154th Hospital from May 2021 to May 2022 were selected for the randomized controlled trial. The patients were divided into group A and group B by lottery, with 60 cases in each group. There were 32 males and 28 females in group A; they were (55.26±5.17) years old; the fracture course was 2-14 (8.33±0.21) d; there were 27 cases of type Ⅰ and Ⅱ and 33 cases of type Ⅲ and Ⅳ of Garden fracture typing. There were 30 males and 30 females in group B; they were (55.31±5.22) years old; the fracture course was 3-13 (8.35±0.16) d; there were 25 cases of type Ⅰ and Ⅱ and 35 cases of type Ⅲ and Ⅳ of Garden fracture typing. Group A took the fixation by traditional parallel nails, and group B by F shape hollow nails. The surgical conditions, postoperative hip joint function recovery, fracture healing within 3 months after surgery, and postoperative complications were compared between the two groups. t and χ² tests were used. Results　There were no statistical differences in the surgical time, intraoperative bleeding volume, and intraoperative irradiation time between the two groups (all P>0.05). Before the surgery, there were no statistical differences in the scores of pain, function, malformation, and joint movement range between the two groups (all P>0.05). After the surgery, the scores of pain, function, malformation, and joint movement range in group B were higher than those in group A [(38.74±0.82) vs. (38.41±0.25), (40.56±0.83) vs. (40.27±0.22), (3.57±0.88) vs. (3.25±0.31), and (3.61±0.85) vs. (3.36±0.25)], with statistical differences (t=2.982, 2.616, 2.657, and 2.186; all P<0.05). Under different fixation techniques, the fracture healed rate within 3 months after the surgery and the fracture healing time in group B were better than those in group A [86.67% (52/60) vs. 68.33% (41/60) and (4.25±0.31) months vs. (4.58±0.86) months], with statistical differences (χ²=5.175; t=2.796; both P<0.05). The incidence of postoperative complications of group B was lower than that of group A [6.67% (4/60) vs. 8.33% (11/60)], with a statistical difference (χ²=6.215; P=0.013). Conclusion　Compared with traditional parallel nails, the application of F shape hollow nails in open reduction and internal fixation for patients with femoral neck fractures has better effect, and is of positive significance in promoting their recovery of hip joint function, accelerating the process of fracture healing, and reducing the risk of postoperative complications.

Investigation on knowledge, attitude, and practice of fracture prevention in patients with osteoporosis and analysis on risk factors of thoracolumbar fractures

Liu Jianxia, Niu Luye, Li Yanan, Zhu Xiaoguang

2024, 30(7):  1146-1151.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.018

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Objective　To investigate the knowledge, belief, and behaviors of fracture prevention in patients with osteoporosis (OP), and to analyze the risk factors of thoracolumbar fractures in patients with OP. Methods　This was a cross-sectional survey study. A total of 320 patients with OP admitted to Outpatient Department, Zhengzhou Orthopedic Hospital from February 2020 to November 2022 were selected as the research objects, including 179 males and 141 females who were 45-78 years old. The levels of knowledge, belief, and behaviors of fracture prevention in the patients were investigated by questionnaire. The patients were divided into a thoracolumbar fractures group (35 cases) and a non-thoracolumbar fractures group (285 cases) according to the occurrence of thoracolumbar fractures. The scores of knowledge, belief, and behaviors, heights, weights, and bone mineral densities (BMD) were compared between the two groups by the t test. The good rates of knowledge, belief, and behaviors, and proportions of the patients with different genders and ages, diabetes, coronary heart disease, smoking history, drinking history, previous brittle fracture history, parental fracture history, and glucocorticoid treatment history were compared between the two groups by the χ² test. The risk factors for thoracolumbar fractures in the patients were analyzed by the logistic regression analysis. Results　The total scores of knowledge, belief, and behavior dimensions of fracture prevention in the patients were (16.12±3.12), (129.02±17.50), and (22.02±6.12), respectively. The good rates of knowledge mastery, belief, and behaviors in the patients were 66.88% (214/320), 64.22% (411/640), and 53.96% (518/960), respectively. The total scores of knowledge, belief, and behavior dimensions in the thoracolumbar fracture group were higher than those in the non-thoracolumbar fracture group [(12.54±4.12) vs. (16.56±3.00), (117.51±16.35) vs. (130.43±17.64), and (18.34±3.11) vs. (22.47±6.49)], with statistical differences (t=7.15, 4.12, and 3.71; all P<0.05). The good rates of knowledge mastery, belief, and behaviors in the thoracolumbar fracture group were lower than those in the non-thoracolumbar fracture group [40.00% (14/35) vs. 70.18% (200/285), 34.29% (24/70) vs. 67.89% (387/570), and 28.57% (30/105) vs. 57.08% (488/640)], with statistical differences (χ²=12.81, 30.65, and 30.59; all P<0.05). The proportions of women, the patients ≥65 years old, and the patients with alcohol consumption history, previous brittle fracture history, and glucocorticoid treatment history in the thoracolumbar fracture group were higher than those in the non-thoracolumbar fracture group, with statistical differences (χ²=4.05, 11.73, 4.36, 5.73, and 4.65; all P<0.05). The BMD of the thoracolumbar fracture group was lower than that of the non-thoracolumbar spine fracture group, with a statistical difference (t=5.55, P<0.05). The results of logistic regression analysis showed that women [odds ratio (OR)=3.047, 95% confidence interval (95%CI) 2.456-4.412], age ≥65 years (OR=5.977, 95%CI 2.657-7.025), history of alcohol consumption (OR=1.883, 95%CI=1.236-2.012), history of brittle fractures (OR=1.919, 95%CI 1.658-2.365), and history of glucocorticoid therapy (OR=1.508, 95%CI 1.136-1.789) were all risk factors for thoracolumbar fractures in the patients (all P<0.05), while the BMD was a protective factor (OR=0.421, 95%CI 0.211-0.741, P<0.05). Conclusions　The levels of knowledge, belief, and behaviors of fracture prevention in patients with OP need to be improved. Women, age ≥65 years, alcohol consumption history, previous history of brittle fractures, and history of glucocorticoid therapy are all risk factors for thoracolumbar fractures in patients with OP, and BMD is a protective factor.

Effect of Xinhuang tablets combined with Fufang Tongye Shaoshang You for patients with acute gouty arthritis

Hu Wei, Yuan Wenxia, Xiong Wenjia, Liu Huanbing

2024, 30(7):  1152-1156.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.019

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Objective　To observe the curative effect of Xinhuang tablets combined with Fufang Tongye Shaoshang You for patients with acute gouty arthritis. Methods　A total of 96 patients with acute gouty arthritis treated at First Hospital, Medical College, Nanchang University from January 2022 to December 2022 were selected, and divided into group A, group B, and group C by the random number table method, with 32 cases in each group. There were 28 males and 4 females in group A; they were (53.37±16.53) years old; their acute disease course was (2.56±0.92) d. There were 30 males and 2 females in group B; they were (54.18±17.42) years old; their acute disease course was (2.53±0.89) d. There were 29 males and 3 females in group C; they were (53.61±17.21) years old; their acute disease course was (2.61±0.93) d. The three groups were treated with conventional drugs; in addition, group A were treated with Xinhuang tablets, group B with Fufang Tongye Shaoshang You, and group C with Xinhuang tablets and Fufang Tongye Shaoshang You. All the three groups were observed 3 weeks. The general data (age, gender, body mass index, drinking, smoking, and acute disease course), scores of Visual Analogue Scale (VAS) and osteoarthritis index (WOMAC) before and 1, 3, 5, and 7 d after the treatment, and traditional Chinese medicine syndrome efficacies were compared between the 3 groups. t and χ² tests were applied. Results　There were no statistical differences in the general data between the three groups (all P>0.05). There were no statistical differences in the scores of VAS before and 1 d after the treatment between the three groups (both P>0.05). There were statistical differences in the scores of VAS 3, 5, and 7 d after the treatment between the three groups (all P<0.05). The scores of VAS 3, 5, and 7 d after the treatment in the group C [(4.84±1.30), (2.97±1.31), and (1.81±1.15)] were lower than those in group A [(5.63±1.26), (4.34±1.33), and (2.97±1.28)] and group B [(6.38±1.21), (5.38±1.21), and (5.38±1.21)], with statistical differences (all P<0.05). There were no statistical differences in the scores of WOMAC before and 1 d after the treatment between the three groups (both P>0.05). There were statistical differences in the scores of WOMAC 3, 5, and 7 d after the treatment between the three groups (all P<0.05). The scores of WOMAC 3, 5, and 7 d after the treatment in the group C [(113.50±28.78), (82.66±31.82), and (50.19±34.90)] were lower than those in group A [(128.09±25.59), (110.31±28.29), and (87.84±33.19)] and group B [(154.19±20.59), (148.19±20.59), and (137.28±20.62)], with statistical differences (all P<0.05). The total effective rate in group C was 96.9% (27/32), that in group A 78.1% (25/32), and that in group B 53.1% (17/32), with a statistical difference (χ²=49.937, P<0.001). Conclusion　Xinhuang tablets combined with Fufang Tongye Shaoshang You for patients with acute gouty arthritis is effective, and can shorten their disease course, relieve their pain, and reduce the frequency of dressing replacement by clinical nurses.

Safety and feasibility of endoscopic treatment for patients with foreign bodies in digestive tracts

Wang Zhenwen, Zhu Liang, Zeng Hao

2024, 30(7):  1156-1160.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.020

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Objective　To explore the safety and feasibility of endoscopic treatment for patients with foreign bodies in digestive tracts. Methods　The data of 77 patients with foreign bodies in digestive tracts treated by endoscopy in Department of Gastroenterology, Gaoxin Branch of The First Affiliated Hospital, Jiangxi Medical College,Nanchang University from October 10, 2019 to August 20, 2023 were retrospectively analyzed. There were 41 males and 36 females. They were 2-91 (46.40±27.03) years old. Seventy-five patients (97.4%) had foreign bodies in the upper digestive tracts, and 2 (2.6%) the lower digestive tracts. Results　Among the 77 patients, 45 cases (58.4%) had foreign bodies in the upper esophageal segments. The main foreign bodies were fish bones [32.4% (25/77)] and other animals' bones [20.8% (16/77)]. Most foreign bodies were sharp, with a proportion up to 51.9% (40/77). The one-time successful removal rate of foreign bodies was 100.0%(77/77). The total incidence of complications in endoscopic foreign body removal was 57.1% (44/7,), including 36 cases of mild complications [81.8% (36/44)], 4 cases of gastrointestinal perforation [9.1% (4/44)], 3 cases of wound damage with infection [6.8% (3/44)], and 1 case of active bleeding [2.3% (1/44)]. Conclusions　Endoscopic treatment is the first choice for the treatment of foreign bodies in the digestive tracts. Foreign bodies should be removed as soon as possible to reduce complications related to foreign bodies. Endoscopic treatment of foreign bodies in digestive tracts is safe and effective.

Medication rules of differentiation and treatment of rheumatoid arthritis by Zhang Minghe and Fan Yongsheng

Wang Pengfei, Wang Yanni, Jiang Ping

2024, 30(7):  1161-1166.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.021

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Objective　To analyzed the medication rules of differentiation and treatment of rheumatoid arthritis (RA) by Zhang Minghe and Fan Yongsheng. Methods　The data mining method was used. One hundred and fifty-two patients with RA treated at Zhang Minghe Clinic and 125 patients at Fan Yongzhen Clinic from April 2018 to December 2019 were selected; each patient's information was collected more than 3 times; among which, the 1-3 treatment times with good efficacy were selected, and 217 effective treatment times were obtained from Zhang, and 201 from Fan. With the help of "Ancient and Modern Medical Records Cloud Platform (V2.1)", the data of the two professors' cases were sorted out, the similarities and differences of the cases were compared and analyzed, and the rules and characteristics of the differentiation and treatment of RA were summarized. Results　Among the 217 treatment times by Zhang, the top 2 Zhengsu were phlegm dampness [56.68% (123/217)] and cold[50.69% (110/217)], and the tope 2 syndrome types were cold-dampness obstruction [43.78% (95/217)] and damp-heat obstruction [21.20% (46/217)]. The categories of commonly used Chinese medicine were wind-dampness drugs, heat-clearing drugs, blood-activating drugs for removing blood stasis, etc. According to association rule analysis, there was no correlation between the efficacy of commonly used Chinese medicine and its highly correlated Zhengsu and syndrome types. The core prescriptions were obtained through complex network analysis. The common treatment methods in the 201 treatment times by Fan were Tongluo, dispelling wind, dispelling dampness, Yiyin, and so on. The categories of commonly used Chinese medicine were deficiency tonifying drugs, wind-dampness dispelling drugs, surface relieving drugs, etc. Through the analysis of association rules, it found that the treatment method was consistent with the efficacy of traditional Chinese medicine with high correlation. Through complex network analysis, it found that the Tongluo method was highly correlated with other treatment methods. Conclusion　Zhang pays attention to disease differentiation and drug use, and takes the "clearing heat and detoxifying method" as the basic treatment; Fan pays attention to syndrome differentiation and treatment, and often makes flexible differentiation and treatment according to the syndrome types. The common rules of the two for RA are dispelling wind and removing dampness, Tongluo, clearing heat and detoxifying, activating blood circulation and removing blood stasis, and Fuzheng and protecting the stomach.

Prevention and treatment methods of postoperative tension blisters in patients after suegery for ankle joint fractures and the effect 

Chen Jingsong, Liu Ran, Li Qi, Wang Xiangyu

2024, 30(7):  1167-1171.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.022

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Objective　To explore the effect of peroxide fatty acid ester wet compress combined with foam pad in the prevention and treatment of tension blisters in patients after ankle fracture surgery. Methods　One hundred and sixty-eight postoperative patients with ankle fractures admitted to Zhengzhou Orthopedic Hospital from January 2022 to April 2023 were selected for the randomized controlled trial, and were divided into 4 groups by the random number table method, with 42 cases in each group. There were 26 males and 16 females in the control group, they were (45.15±7.82) years old; there were 23 cases of type A, 14 cases of type B, and 5 cases of type C of Danis-weber. There were 24 males and 18 females in group A; they were (44.85±7.96) years old; there were 22 cases of type A, 13 cases of type B, and 7 cases of type C of Danis-weber. There were 27 males and 15 females in group B; they were (44.50±7.66) years old; there were 24 cases of type A, 14 cases of type B, and 4 cases of type C of Danis-weber. There were 25 males and 17 females in group C; they were (45.20±7.93) years old; there were 24 case of type A, 15 cases of type B, and 3 case of type C of Danis-weber. The control group were given routine methods to prevent and treat tension blisters; group A were treated with conventional methods and peroxide fatty acid ester wet compress; group B used conventional method+foam pad; group C were treated with the conventional method+fatty acid peroxide wet compress+foam pad. One-way ANOVA, non-parametric methods, and χ² test were used. Results　The incidence of tension blisters in group C was lower than that in the control group [2.38% (1/42) vs. 25.64% (10/39); χ²=9.322, P=0.002]. The affected area in group C was less than that in the control group [1 vs. 4 (2, 5); U=6.154, P=0.008]; the diameter of the largest blisters in the group C was shorter than that of the control group [2.0 cm vs. 4.2 (2.5, 5.6) cm; U=12.415, P＜0.001]. There was a statistical difference in the regression time of blisters between the 4 groups (F=3.529, P=0.021). The scores of physiological, psychological, spiritual, socio-cultural, and environmental comforts of the four groups were higher after than before the nursing; the scores of group A, group B, and group C were all higher than those of the control group; the scores of group C were higher than those of group A and group B; there were statistical differences (all P<0.05). The total satisfaction rates of group A and group C were higher than that of the control group [85.37% (35/41) and 100.00% (42/42) vs. 66.67% (26/39); χ²=3.859 and 16.676, both P<0.05]; the rate of group C was higher than those of group A and group B [100.00% (42/42) vs. 85.37% (35/41) and 83.33% (35/42); χ²=6.625 and 7.636, both P<0.05]. Conclusion　Peroxide fatty acid ester wet compress combined with foam pad in the prevention and treatment of tension blisters in patients after ankle fracture surgery is effective and ideal.

Tolvaptan for intractable edema in a patient with diabetic nephropathy syndrome

Liu Ruixi, Yang Yang, Gao Jinxiang

2024, 30(7):  1172-1176.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.023

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Diabetic nephropathy syndrome (DNS) is a secondary nephrotic syndrome mediated by nonimmune factors. Such patients become more dependent on diuretics for the treatment of their induced edema due to ineffectiveness of the hormone as the onset of their disease is nonimmune mediated. The novel diuretic tolvaptan, a selective vasopressin V2 receptor antagonist independent of albumin, is currently used primarily to reduce edema caused by cirrhosis, heart failure, and abnormal antidiuretic hormone secretion, and may also be used as an adjunctive therapy in autosomal dominant polycystic kidney disease, but is used less frequently in patients with DNS. In this article, we discuss the effectiveness, safety, and future prospects of tolvaptan in the treatment of patients with DNS by sharing the experience of a DNS patient with edema treated with tolvaptan.

Risk factors of gastrointestinal adverse reactions in patients with T2DM treated with metformin

Gao Linlin, Sui Yun, Wang Lixin

2024, 30(7):  1176-1181.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.024

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Objective　To analyze the risk factors of gastrointestinal adverse reactions in patients with type 2 diabetes mellitus (T2DM) treated with metformin. Methods　A total of 318 patients with T2DM admitted to Department of Internal Medicine, Jinan Second People's Hospital from December 2018 to August 2022 were selected for the retrospective study. After receiving metformin for the first time, according to whether the patients had gastrointestinal adverse reactions within 1 treatment course (3 months), they were divided into a gastrointestinal adverse reaction group (61 cases) and a non-gastrointestinal adverse reaction group (257 cases). The risk factors of gastrointestinal adverse reactions in the patients were analyzed by univariate analysis and multivariate logistic regression analysis. t and χ² tests were applied. Results　Sixty-one cases (19.18%) of the 318 patients complicated with gastrointestinal adverse reactions. The body mass index (BMI) of the gastrointestinal adverse reaction group was lower than that of the non-gastrointestinal adverse reaction group [(21.47±1.15) kg/m² vs. (22.89±1.01) kg/m²]; the metformin dosage and the proportions the patients who drank, took insulin treatment, and took the combination with alpha glycosidase inhibitor in the gastrointestinal adverse reaction group were higher than those in the non-gastrointestinal adverse reaction group [(1 379.12±122.03) mg/d vs. (1 184.12±112.16) mg/d, 29.51% (18/61) vs. 16.73% (43/257), 34.43% (21/61) vs. 21.01% (54/257), and 47.54%(29/61) vs. 26.46%(68/257)]; there were statistical differences (t=9.605 and 12.000; χ²=5.191, 4.922, and 10.336; all P<0.05). The results of multivariate logistic analysis showed that increased BMI was a protective factor for gastrointestinal adverse reactions in the patients (OR=0.520, P<0.05); increased dose of metformin, alcohol consumption, and combination with alpha-glucosidase inhibitors were risk factors for gastrointestinal adverse events in the patients (OR=2.008, 2.179, and 1.933; all P<0.05). Conclusions　Patients with T2DM mellitus treated with metformin are at risk of gastrointestinal adverse reactions. The risk factors include decreased BMI, increased dose of metformin, alcohol consumption, and combination with alpha-glucosidase inhibitors. For high-risk patients with gastrointestinal adverse reactions, intervention strategies should be timely adjusted according to the above factors.

Transanal endoscopic submucosal dissection in treatment of patients with early rectal cancer 

Wu Peng, Yang Hongwei, Li Chaojie

2024, 30(7):  1181-1185.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.025

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Objective　To explore the effect of transanal endoscopic submucosal dissection (ESD) in the treatment of patients with early rectal cancer. Methods　Ninety-two patients with early rectal cancer treated at Xuchang Longyao Hospital from August 2020 to August 2022 were selected and were divided into a transanal group and a laparoscopic according to the therapeutic methods, with 46 cases in each group. There were 25 males and 21 females in the transanal group; they were (57.88±5.03) years old; their body mass index was (22.51±1.55) kg/m²; their longest tumor diameter was (2.46±0.31) cm. There were 23 males and 23 females in the laparoscopic group; they were (58.22±5.34) years old; their body mass index was (22.69±1.71) kg/m²; their longest tumor diameter was (2.51±0.33) cm. The transanal group took transanal ESD, and the laparoscopic group laparoscopic surgery. The perioperative indicators, postoperative recovery, and levels of inflammatory indicators [interleukin (IL)-6, IL-8, C-reactive protein (C-reactive protein, CRP)] and tumor markers [carcinoembryonic antigen (CEA) and carbohydrate antigen 724 (CA724)] before and after the surgery and prognosis in both groups were observed. The count data were analyzed by χ² test, and the measurement data t test. Results　The operation time and intraoperative bleeding volume in the transanal group were less than those in the laparoscopic group [(59.43±5.22) min vs. (82.77±7.35) min and (30.58±4.31) ml vs. (59.79±8.44) ml], with statistical differences (t=17.560 and 20.905; both P<0.001). The postoperative exhaust time, first feeding time, and hospital stay in the transanal group were shorter than those in the laparoscopic group [(1.85±0.32) d vs. (2.21±0.41) d, (2.01±0.28) d vs. (2.35±0.37) d, and (4.75±0.69) vs. (5.48±0.72) d], with statistical differences (t=4.695, 4.970, and 4.965; all P<0.001). The serum levels of CRP, IL-6, and IL-8 24 and 72 h after the surgery in the transanal group were lower than those in the laparoscopic group [(39.58±5.42) mg/L vs. (44.76±6.13) mg/L, (58.19±5.62) ng/L vs. (63.77±7.18) ng/L, (56.79±4.53) ng/L vs. (60.48±4.42) ng/L, (24.55±4.39) mg/L vs. (28.47±5.13) mg/L, (49.35±4.01) ng/L vs. (55.73±5.24) ng/L, and (40.28±4.32) ng/L vs. (48.76±4.11) ng/L], with statistical differences (t=4.294, 4.151, 3.954, 3.938, 6.558, and 9.646; all P<0.001). One year after the surgery, the levels of CEA and CA724 in the transanal group were lower than those in the laparoscopic group [(5.35±1.08) μg/L vs. (5.83±1.11) μg/L and (3.62±0.54) IU/ml vs. (3.88±0.58) IU/ml], with statistical differences (t=2.102 and 2.225; P=0.038 and 0.029). One year after the surgery, there was no statistical difference in the recurrence rate between the two groups [0 vs. 4.35% (2/46); χ²=0.511, P=0.474]. Conclusion　Transanal ESD in the treatment of patients with early rectal cancer can optimize the operation, reduce blood loss and inflammatory reaction, improve their digestive function, and shorten their postoperative recovery process, and their prognosis is good.

Estradiol valerate tablets combined with metformin for infertility patients

Wu Xiaorong, Zhan Meng, Cao Yiran

2024, 30(7):  1186-1189.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.026

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Objective　To explore the effect of estradiol valerate tablets combined with metformin for infertility patients. Methods　Eighty-six infertility patients treated at Ankang Central Hospital from July 2021 to September 2022 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 43 cases in each group. The control group were (29.34±1.81) years old; their body mass index was (27.09±1.63) kg/m²; their disease course was (1.62±0.84) years. The study group were (28.71±1.67) years old; their body mass index was (28.11±1.72) kg/m²; their disease course was (1.58±0.92) years. The control group took valerate estradiol tablets; in addition, the study group orally took metformin. Both groups were treated for 8 weeks. The hormone levels [estradiol (E₂), luteinizing hormone (LH), and serum progesterone (SP)], levels of oxidative stress indicators [advanced oxidation protein products (AOPP) and glutathione peroxidase (GSH-Px)], endometrial thicknesses, and follicle diameters before and after the treatment, ovulation rates, and pregnancy outcomes after 1-year follow-up were compared between the two groups. t test was used for the measurement data, and χ² test for the count data. Results　The hormone levels, oxidative stress indicators, endometrial thickness, and follicle diameter were better after than before the treatment in both groups. After the treatment, the levels of E₂, SP, GSH-Px, LH, and AOPP, endometrial thickness, and follicle diameter in the study group were better than those in the control group [(92.17±8.79) ng/L vs. (79.98±7.67) ng/L, (19.37±2.76) μg/L vs. (14.95±1.94) μg/L, (182.23±18.75) mg/L vs. (169.87±14.98) mg/L, (9.89±1.41) IU/L vs. (11.86±1.38) IU/L, (36.32±3.67) mg/L vs. (51.89±3.32) mg/L, (11.87±1.86) mm vs. (9.82±1.63) mm, and (11.09±1.06) mm vs. (9.87±1.01) mm], with statistical differences (t=6.852, 8.591, 3.377, 6.548, 20.631, 5.435, and 5.464; all P<0.05). There was no statistical difference in the early pregnancy miscarriage rate between the study group and the control group [2.33% (1/43) vs. 6.98% (3/43); χ²=1.049; P=0.306)]. The ovulation rate and pregnancy rate in the study group were higher than those in the control group [86.05% (37/43) vs. 60.47% (26/43) and 67.74% (29/43) vs. 44.19% (19/43)], with statistical differences (χ²=7.182 and 4.715; both P<0.05). Conclusion　Valerate estradiol tablets combined with metformin for infertility patients can improve their endometrial thickness, follicle diameter, hormonal balance, oxidative stress, and ovulation and pregnancy rates.

Bevacizumab combined with TC regimen in treatment of patients with advanced recurrent ovarian cancer

Yue Hong, Chen Wenhua, Fan Zhigang, Zhang Shulian, Chang Jiefang

2024, 30(7):  1190-1194.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.027

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Objective　To explore the effect of bevacizumab combined with the TC (paclitaxel/carboplatin) regimen in the treatment of patients with advanced recurrent ovarian cancer. Methods　Ninety-two patients with recurrent advanced ovarian cancer treated at Hanzhong Central Hospital from November 2017 to November 2022 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 46 cases in each group. The control group were (52.34±8.45) years old; there were 24 cases of stage Ⅲ and 22 cases of stage Ⅳ of International Federation of Gynecology and Obstetrics (IFGO). The observation group were (53.21±9.67) years old; there were 23 cases of stage Ⅲ and 23 cases of stage Ⅳ of FIGO. The control group were treated by the TC regimen; in addition, the observation group took bevacizumab. The clinical efficacies, serum levels of tumor markers [carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), carbohydrate antigen 199 (CA199), and vascular endothelial growth factor (VEGF)], one-year survival rates, and quality of life [evaluated by Karnofsky Performance Status (KPS)] after the treatment, and adverse reactions were compared between the two groups. t and χ² tests were applied. Results　After six cycles of treatment, the disease remission rate in the observation group was higher than that in the control group [78.26% (36/46) vs. 54.35% (25/46); χ²=7.771, P=0.005]; the levels of CA125, HE4, CA199, and VEGF in the observation group were lower than those in the control group (all P<0.05). The one-year survival rate after the treatment in the observation group was higher than that in the control group [73.91% (34/46) vs. 46.65% (21/46); χ²=7.640, P=0.006]. The score of KPS in the observation group was higher than that in the control group [(72.52±8.13) vs. (64.60±7.58); t=4.832, P<0.001]. The main adverse reactions in both groups were bone marrow suppression, gastrointestinal reactions, and hepatic and renal damage; there were no statistical differences in the incidences of these reactions between the two groups (all P>0.05). Conclusion　Bevacizumab combined with the TC regimen in the treatment of patients with recurrent advanced ovarian cancer has good clinical efficacy, can improve their one-year survival rate and quality of life and reduce the serum levels of tumor markers, and has controllable adverse reactions.

Case Report

One case of AITL with monoclonal B lymphocyte and monoclonal plasma cell proliferation

Xu Tengfei, Liu Jinli, Zhu Yongcun

2024, 30(7):  1195-1198.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.028

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Angioimmunoblastic T⁃cell lymphoma is an aggressive lymphoma with poor prognosis. To improve the understanding of AITL and the level of diagnosis and treatment and to reduce the missed diagnosis and misdiagnosis, the diagnosis and treatment of a patient with AITL accompanied by monoclonal B lymphocyte and monoclonal plasma cell proliferation were reported.

Nursing Research

Nursing intervention for patients with ovarian hyperstimulation syndrome

Li Xiaomei, Lu Jian, Qin Li, Ling Yanlan

2024, 30(7):  1199-1202.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.029

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Application of time and meeting management combined with SWOT analysis in construction of a lower limb deep vein thrombosis prevention and treatment system

Li Jinli, Bai Tao, Niu Hao

2024, 30(7):  1202-1206.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.030

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Objective　To explore the application of time and meeting management combined with SWOT analysis in the construction of a lower limb deep vein thrombosis prevention and treatment system. Methods　One hundred and ten patients with lower limb deep vein thrombosis admitted to Fuwai Central China Cardiovascular Hospital from February 2022 to August 2022 were selected as the research objects. The patients were divided into a control group and a study group by the random number table method, with 55 cases in each group. There were 27 males and 28 females in the study group; they were (51.66±14.79) years old. There were 28 males and 27 females in the control group; they were (50.91±15.74) years old. The control group used routine management methods. The study group adopted a prevention and treatment system constructed by combining time management, meeting management, and SWOT analysis. The incidences of pain, swelling, and venous dilation, the levels of D-dimer (D-D) and hemorheological indicators [plasma viscosity (PV) and fibrinogen (FIB)] before and three months after the intervention, and patient satisfaction were compare between the two groups. t and χ² tests were applied. Results　Three months after the intervention, the incidence of pain, swelling, and venous dilation in the study group was lower than that in the control group [9.09%(5/55) vs. 27.27%(15/55)], with a statistical difference between the two groups (χ²=6.111, P=0.013). The levels of D-D, PV, and FIB in the study group were lower than those in the control group [(8.51±1.25) mg/L vs. (27.17±4.12) mg/L, (1.16±0.12) mPa/s vs. (1.68±0.39) mPa/s, and (2.29±0.34) g/L vs. (3.84±0.62) g/L], with statistical differences between the two groups (all P<0.001). After the intervention, the overall satisfaction rate in the study group was higher than that in the control group [65.45% (36/55) vs. 30.91% (17/55)], with a statistical difference between the two groups (P<0.001). Conclusion　The combination of time management, meeting management, and SWOT analysis can provide personalized treatment strategies for patients with lower limb deep vein thrombosis and precise treatment tailored to their specific conditions and risk factors, and has good effect in preventing pain, swelling, and venous dilation.

Impact of feedback nursing based on emotional adaptation theory on adverse emotions in patients with functional dyspepsia 

Qi Xiangjuan, Liu Hongxia, Li Man, Zhang Ying

2024, 30(7):  1207-1211.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.031

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Objective　To explore the effect of feedback nursing based on the emotional adaptation theory for patients with functional dyspepsia (FD). Methods　One hundred and twenty patients with FD treated at Second Hospital, Tianjin Medical University from January 2022 to January 2023 were selected as the study objects. They were divided into a control group and an observation group by the random number table method, with 60 cases in each group. There were 34 males and 26 females in the control group; they were (40.23±6.59) years old. There were 33 males and 27 females in the observation group; they were (41.15±6.70) years old. The control group took routine nursing care, and the observation group feedback nursing based on the emotional adaptation theory, for 3 months. The scores of clinical symptoms, anxiety, depression, and quality of life before and after the intervention and treatment compliance were compared between the two groups. t and χ² tests were applied. Results　After the intervention, the scores of postprandial fullness, upper abdominal pain, bloating, and loss of appetite in the observation group were lower than those in the control group [(1.35±0.22) vs. (2.01±0.30), (1.03±0.10) vs. (1.65±0.27), (1.19±0.20) vs. (1.78±0.34), and (1.10±0.15) vs. (1.68±0.26)], with statistical differences between the two groups (all P<0.001); the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in the observation group were lower than those in the control group [(15.06±2.72) vs. (18.95±3.52) and (18.63±3.54) vs. (22.09±4.17)], with statistical differences between the two groups (both P<0.05); the treatment compliance rate of the observation group was higher than that of the control group [95.00% (57/60) vs. 80.00% (48/60)], with a statistical difference between the two groups (P=0.013); the score of Gastrointestinal Quality of Life Index (GIQLI) of the observation group was lower than that of the control group [(95.66±9.42) vs. (102.34±10.41)], with a statistical difference (P<0.001). Conclusion　The application of feedback nursing based on the emotional adaptation theory in patients with FD can alleviate their clinical symptoms, and improve their anxiety and depression emotions, treatment compliance rate, and quality of life.

Clinical effect of ward-clinic-family mode combined with continuous nursing for patients with diabetic retinopathy

Yu Na, Yang Nana, Wu Min, Zhang Dimei

2024, 30(7):  1211-1217.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.032

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Objective　To analyze the clinical effect of the ward-clinic-family mode combined with continuous nursing for patients with diabetic retinopathy. Methods　One hundred and twenty patients with diabetes retinopathy admitted to Jinan Second People's Hospital from August 2021 to August 2023 were selected for the prospective study. They were divided into a control group and an observation group by the random number table method, with 60 cases in each group. There were 35 males and 25 females in the control group; they were (55.31±12.13) years old. There were 31 males and 29 females in the observation group; they were (56.18±11.05) years old. The control group took continuous nursing; in addition, the observation group were intervened by the ward-clinic-family mode. The blood glucose control effects, best corrected visual acuities (BCVA), and scores of the Scale of Quality of Life for Diseases with Visual Improvement (SQOL-DVI), Summary of Diabetes Self-care Activities (SDSCA), and Exercise of Self-care Agency Scale (ESCA) were compared between the two groups. t and χ² tests were applied. Results　After the intervention, the levels of fasting blood glucose (FBG), postprandial blood glucose (2h-PG), and glycated hemoglobin (HbA1c) in the observation group were lower than those in the control group [(8.75±0.86) mmol/L vs. (9.18±0.91) mmol/L, (9.91±1.53) mmol/L vs. (10.64±1.63) mmol/L, and (8.53±0.66)% vs. (8.79±0.71)%], with statistical differences (t=2.660, 2.529, and 2.078; all P<0.05). One week and one month after the intervention, the BCVA of the observation group were lower than those of the control group [(0.36±0.11) LogMAR vs. (0.41±0.12) LogMAR and (0.30±0.10) LogMAR vs. (0.36±0.11) LogMAR], with statistical differences (t=2.379 and 3.126; both P<0.05). After the intervention, the scores of symptom and visual function, physical function, social activity, and mental mind and psychology and total score of SQOL-DVI in the observation group were were higher than those in the control group [(16.28±2.41) vs. (14.93±2.39), (17.96±2.34) vs. (16.90±2.17), (26.76±2.76) vs. (25.21±2.63), and (26.46±3.68) vs. (25.05±3.75), and (87.46±10.68) vs. (81.99±10.46)], with statistical differences (t=3.081, 2.573, 3.149, 2.079, and 2.834; all P<0.05). After the intervention, the scores of diet, exercise, blood glucose monitoring, and foot care and total score of SDSCA in the observation group were higher than those in the control group [(4.35±0.40) vs. (4.11±0.39), (4.81±0.67) vs. (4.47±0.70), (2.59±0.40) vs. (2.40±0.35), (4.58±0.36) vs. (4.34±0.36), and (13.74±1.77) vs. (12.82±1.65)], with statistical differences (t=3.328, 2.718, 2.769, 2.609, and 2.945; all P<0.05). The scores self-care skills, responsibility of self-care, self-concept, and health knowledge and total score of ESCA in the observation group were higher than those in the control group [(22.37±3.75) vs. (20.25±3.19), (17.27±3.60) vs. (15.81±3.42), (25.49±5.92) vs. (23.18±5.26), (43.01±3.20) vs. (41.15±3.49), and (108.41±10.64) vs. (102.35±11.13)], with statistical differences (t=3.335, 2.278, 2.259, 3.043, and 3.049; all P<0.05). Conclusion　Ward-clinic-family mode combined with continuous nursing for patients with diabetic retinopathy can effectively strengthen the hypoglycemic effect, and improve their quality of life, self-management ability of patients, and self-care ability.

Intestinal nutrition support strategy for neurosurgical critically ill patients with dysphagia

Chen Ruo, Jiang Lei, Zhao Xudong, Chen Qianqian

2024, 30(7):  1217-1221.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.033

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Objective　To explore the nursing based on the enteral nutrition support strategy for neurosurgical critically ill patients with dysphagia. Methods　One hundred and eighty neurosurgical critically ill patients with dysphagia admitted to Wuxi Second People's Hospital from January 2021 to January 2023 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 90 cases in each group. There were 50 males and 40 females in the control group; they were (56.11±3.58) years old. There were 48 males and 42 females in the observation group; they were (56.26±3.85) years old. The control group took traditional nursing intervention, and the observation group took the enteral nutrition support strategy on the basis of control group. The clinical indicators, incidences of complications, and nutritional indicators, scores of Glasgow Coma Scale (GCS) and Dysphagia Severity Rating Scale (VGF), and immune indicators before and 2 weeks after the intervention and were compared between the two groups. t and χ² tests were applied. Results　The NSICU stay and ventilator support time in the observation group were shorter than those in the control group [(12.01±2.68) d vs. (13.59±3.02) d and (5.03±1.02) d vs. (6.68±1.30) d], with statistical differences (t=3.712 and 9.473; both P<0.001). Two weeks after the intervention, there were statistical differences in the levels of albumin (ALB), prealbumin (PAB), and total protein (TP) and the scores of GCS and VGF between the observation group and the control group [(40.54±2.12) g/L vs. (33.57±2.03) g/L, (39.25±3.41) g/L vs. (30.26±2.68) g/L, (70.64±5.74) g/L vs. (62.31±5.11)g/L, (13.54±1.67) vs. (9.11±1.05), and (8.56±1.21) vs. (7.21±1.03); t=22.528, 19.664, 10.283, 21.304, and 8.060; all P<0.001]. There were statistical differences in the levels of immunoglobulin (IgA), IgG, and IgM between the observation group and the control group [(2.45±0.65) g/L vs. (2.12±0.49) g/L, (13.89±2.14) g/L vs. (12.44±2.02) g/L, and (1.92±0.63) g/L vs. (1.57±0.52) g/L; t=3.846, 4.674, and 4.065; all P<0.001]. The incidence of complications in the observation group was lower than that in the control group [5.56% (5/90) vs. 14.44% (13/90)], with a statistical difference (χ²=3.951; P=0.047). Conclusion　Nursing based on the enteral nutrition support strategy for neurosurgical critically ill patients with dysphagia can effectively shorten their NSICU stay and ventilator support time, improve their nutritional indicators, swallowing function, and immune function, and reduce the incidence of complications.

Qualitative interviews on training experience and needs of healthcare assistants

Yang Sumin, Cai Yingying, Chen Mengyun, Chen Manhua, Huang Qiongshan, Chen Lianhua, Lin Maozhen, Xing Zehua, Huang Linchun, Ni Shuangli

2024, 30(7):  1222-1225.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.034

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Objective　To understand the training experience and demand of healthcare assistants, and to provide some references for improving the curriculum system. Methods　The objective sampling method was used. With information saturation as the rule, Semi-structured interviews were conducted on 18 healthcare assistants at Jieyang People's Hospital from August to Decmber 2020, including 5 males and 13 females who were (44.12±5.12) years old. Nvivo 20.0 was used to analyze the data. The interview topics were summarized. Results　Five related topics were formed, including teaching organization and training effect, assessment organization system, sense of professional value, endogenous deficiency, and other training needs. Conclusions　This course has strong practicability and good training experience for healthcare assistants. In the future, the training program will be improved according to the training needs of healthcare assistants. By reflecting the core competence of healthcare assistants through various evaluation forms, the vocational education and training management program is more scientific, advanced, and practical.

Effects of cognitive belief behavior pattern on quality of life and self-management in patients with glaucoma

Wang Jing, Nie Qiaoli, Tao Yuan

2024, 30(7):  1226-1232.  DOI: 10.3760/cma.j.issn.1007-1245.2024.07.035

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Objective　To investigate the effects of cognitive belief behavior pattern  on onemotion, quality of life, and self-management ability in patients with glaucoma. Methods　Onehundred and sixty-two patients taking glaucoma surgery in Jinan Second People's Hospital fromMarch 2022 to March 2023 were selected for the prospective control study, and were divided an observation group and a control group by the random number table method, with 81 cases in each group. There were 50 males and 31 females in the control group; they were (58.06±3.03) years old.There were 48 males and 33 females in the observation group; they were (58.85±7.01) years old. During the hospitalization, the control group took conventional nursing; inaddition, the observation group took cognitive belief behavior pattern.The effects of nursing intervention on the patients' emotions, quality of life, and self-management ability before (at admission) and after (at discharge) the intervention were observed and compared between the two groups. The measurement data were compared by t test, and the count data by χ² test. Results　After the intervention, the scores of Symptom Checklist 90 (SCL-90), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) in the observation group were lower than those in the control group [(13.74±3.06) vs.(15.46±3.30),(12.29±4.16) vs.(14.33±3.68),(15.41±6.02) vs.(17.98±7.01)], with statistical differences between the two groups (t=3.440, 3.306, and 2.503; P<0.001, P<0.001, and P=0.013). The scores of symptom and visual function, physical function, socialactivity, and psychology in the observation group were higher than those in the control group [(87.27±9.36) vs. (69.16±8.74), (79.15±5.93) vs. (73.13±7.36), (63.83±7.70)vs. (59.35±8.13)], with statistical differences between the two groups (t=12.728, 5.732, 3.601; all P<0.001). The scores of rational diet or one-time drink lots of wate, compliance to medication,eye care skills, health knowledge mastery, and awareness of timely treatmentwith eye discomfort in the observation group were higher than those in the control group [(87.27±9.23) vs. (69.16±8.74), (79.15±5.91) vs. (73.13±7.36), (63.83±7.07) vs. (59.35±7.19), (69.15±3.01) vs. (60.12±3.16), (80.21±4.76) vs. (76.55±5.32)], with statistical differences between the two groups (t=12.822, 5.740, 3.999, 18.622, and 4.614; all P<0.001). Conclusion　Cognitive belief behavior pattern for patients with glaucoma can improve the rehabilitation effect, and significantly improve their mood, quality of life, and self-management ability.